Went from having a secure future to being virtually unemployed in a week. Not seeing any other way out of this

[UnemployedMD]

Would you be able to go for more schooling in subspeciality and look for employment after that? I am sure your parents would not mind supporting you for more education. The world simply has become hypercompetitive. Another possibility is to intern/practice in another country.

If you intern in another country you can never return to America to work as a doctor without applying to the process I just finished dealing with and completing residency (including internship all over again). Even if you've been in practice for 40 years in another country this still applies to you. Yeah my school would allow me to get a free master's degree, but is that really going to make a difference for next year? Your grades and test scores are what set you apart from the rest and though I passed all my boards and have full certification to practice to TRAIN as a doctor, I can't treat anyone without this next step. I don't even know if I can even call myself a doctor since it would technically be illegal for me to treat someone in any capacity with my credentials at the moment. It is a surmountable roadblock I agree. But is no guarantee it gets me anywhere, will require at minimum one year of constant agonizing stress (watching my classmates all get what they want last week was like taking a thousand knives to my chest all at once) and can potentially shake me to levels of agony and stress I cannot even imagine. And this all after I literally spent the last 9 months preparing to apply (getting letters of recommendation, logging hospital times in the midst of a pandemic while most students stayed at home afraid to catch it, taking perhaps the single longest, painful and most high stakes exam of my life, kissing the ass of every single person on the dozen interviews I went on, and even drove over 1000 (1600km) miles across the country to optionally visit one) all for them to let me just slip through the cracks and allow to occur what I worked so hard to prevent from happening. It just leaves me so scared, disgusted in this system and literally afraid of waking up for the next year. This past week for me was basically an exact scene by scene reenactment of the last half of the movie Titanic. And the best option for me (or the only one I can realistically live with after sacrificing so much) is to buy another ticket on the Titanic. That is the most sensible option for me right now and it is why I am thinking seriously about ending it.

I am an avid chess player. I know when I am in trouble and there is no way out. This is not checkmate but such a situation where you need a major mess up by the other player (miracle) in order to come out ahead. It is actually considered rude to continue playing a hopeless game wasting time when it is obvious you have lost. Why people don't see life in a similar way I can't say I know.

 

[mpnf]

You are a very intelligent guy. PLEASE don't ruin your future career that I'm sure you will have after all effort you've put into it. You are healthy physically and mentally, your parents are in a good position financially speaking and have seen and probably appreciated all the dedication you put into by studying their respected profession. Trust me, I'm 27 and there are far more unfortunate reasons to wanting to end your life. A year pass by quickly. DON'T GIVE UP ONLY FOR THIS REASON....Look at what you got and how many people would like to be in your shoes and keep going. No doubt you have a very bright future ahead of you. A bad event don't define you or how things will turn out in the future. I know you are a strong guy and will make it through this.

God bless you.

 

[LeGuitarist]

Hi everyone. New to this forum but have lurked for a long time during challenging periods in my life. But what has happened to me most recently has finally pushed me to officially joining.

Some background on myself. I spent the last decade of my life training to become a physician and graduated from medical school last month. I live in the United States where education towards becoming a doctor is perhaps one of the longest and most arduous processes one can possibly pursue. Last Monday was the day all soon to be doctors find out if/where they are going to be starting their career. It is a broken system that relies on a computer algorithm to place you into a one of however many places interviewed you. Even though I statistically had a 98% of getting a spot based off how many places interviewed me...I didn't. My life has literally been in shambles all week as a result of shear bad luck out of my control and I can't live with the shame I've caused my family. My parents are both doctors, have supported me through everything and paid for all my education, expenses, etc (probably approaching 1/2 a million dollars) and they don't deserve to now have to support an unemployed disappointment of a son for the the next year (at least) as he prepares to potentially go down with the titanic trying this year long application process again. Needless to say, this is the tip of the iceberg in my life and just getting to this point has been a nightmare I could honestly write a book on. There are basically no career opportunities for unmatched MDs in this country without getting a residency. At least aside from basically starting all over from scratch in another career which I honestly don't have in me.

I don't have any close friends, my relationships have all been toxic/short lived (one nearly drove me to the brink of insanity), and despite being in my mid twenties, I haven't experienced even a fraction of the things most people my age have as a majority of my life up until now has had me completely focused on this.

I have not left my home in a week. Can barely eat, sleep and just feel completely exhausted. I am at the end of my ropes and don't see a way out of this.

As I do live in the US and own firearms, I do have very lethal means accessible to me to potentially ctb. I would plan to do so in a way that causes the least amount of psychological trauma possible to those I love. Perhaps even one where there are no remains. Was thinking about swimming out far (I am a very strong swimmer and can swim for miles without stopping) into the ocean and shooting myself in the water (this way if I miraculously survive the gunshot I would just immediately drown and then sink to the bottom). I just wanted some other's perspectives on it before I actually pull the trigger (pun intended).

I'm so, so, so sorry that that happened to you; I know being unemployed can be tough; I've experienced it myself, and I can confirm that it is horrible. But like you said, you're being judged based on a horrible computer algorithms, and needless to say, computers aren't always the most accurate, so just because you're unemployed now doesn't mean you're talentless; the opposite, in fact. Like you mentioned, becoming a doctor isn't exactly an easy path, and only the best of the best pursue this career. Once you find a job, you'll have a high and steady income, as well as the satisfaction of knowing that you're helping people. And besides, not having a job now doesn't mean you won't ever find a job. You should never give up hope, however hard that may seem. Just look at any famous person, and you'll find that all of them went through rejection over and over again. The only reason why they succeeded is because they never gave up. If they could do it, why can't you?

As to your relationships, I'm so, so, so sorry about all of that. Humans are social creatures, and not having any close friends can really put a big toll on you. The thing is, sometimes you just have to put yourself out there. I know it's easier said than done, but putting yourself out there is the best way to earn better relationships--and, as a bonus, conquer your fear (assuming that you have a bit of social anxiety). Try going out to a bar, and just starting up a conversation with someone you find attractive there. Trust me, it'll help.

And honestly, no method is able to cause no psychological trauma. Just from what you wrote, I can tell that your parents care about you a lot. If you had a child, wouldn't you be devastated if they suicided? The only thing worse than death is watching your loved ones die. And tbh, if you swim out to sea and pull the trigger, you might be reported missing, and that would cause even greater trauma to your parents. Even if you end up writing a letter or something, the police will still obviously have to open a case and search for your body, as it could be a murder.

Again, I'm so, so, so, sorry about what has happened to you; you really don't deserve this. Feel free to reach out to me anytime about anything, whether that's just a shoulder to cry on or any feedback and help you need. Good luck, and you can do it!

 

[UnemployedMD]

If there is truly no deficiency in your record that has gotten you rejected then I think there is still a good chance you can still become a doctor.

Is it possible that you applied to somewhere too competitive? Or maybe it was just a fluke. There is nothing wrong with applying again.

If you are telling the full story in this post then I truly believe you can still become a doctor.

It seems like you have worked very hard and the news has crushed you. It would be best to wait for the dust to settle before making a decision.

There are deficiencies in my application. Nothing that is inexcusable like cheating or some sort of safety, ethical, or judgment lapse. But I did repeat one semester (honestly was the last time I needed to actively seek counsel on a site like this as that is the only time in my life I can ever remember feeling this depressed). My board scores, though I passed on my first attempts were lower than average but I was applying to the two least competitive specialties in medicine and even getting what is considered a solid number of interviews means my application caught their attention (only 10% of applicants at most programs are invited to interview) and I got ranked. All you need is to be on one rank list to get a job but being on more lists obviously increases your chances. It is up to chance which programs (it varies almost randomly from year to year) fill before reaching the end of their lists and by chance I happened to (presumably as I only confirmation from one place so far) to be placed in the middle of most of their lists AND none of the programs I applied to went down their entire lists to fill (about 1/4 of all the programs in the speciality I applied to are in this category as most medical students don't want it: in which case if even just one of these programs is one that interviewed you, it would be a mathematical impossibility for you not to get placed). So basically I just got really really unlucky with what was my best chance to match (being a fresh graduate). Most of my friends got spots (ironically in their dream specialities location, etc) with not even half as many ranks I had.

But going back to your question. Yes, there are some blemishes but ones I've paid my dues for (an additional semester of work with my back even more against the wall) and they are ones that I cannot change now.

 

[mini_weeny]

I got tinnitus and hyperacusis from a gun that went off while I was mishandling it. It's the reason I'm here. Also if u survive a gunshot to the head well... ur a physician. Have you thought of a different angle to this situation maybe work for an ONG like Doctors Without Borders, physicians are always needed somewhere and I think you can still find happiness. You are young and healthy, I think there's so much you can do still that can bring you self realization. You can come to Mexico and set up your own drs office for foreigners in Cancun or Cabo. If u have a license you can probably work as a hotel physician. I think there are many things that you can do with your career just think outside the box. It would be a shame to lose you as a person and as a professional. :) The American dream is not always a happy dream.

 

[UnemployedMD]

I got tinnitus and hyperacusis from a gun that went off while I was mishandling it. It's the reason I'm here. Also if u survive a gunshot to the head well... ur a physician. Have you thought of a different angle to this situation maybe work for an ONG like Doctors Without Borders, physicians are always needed somewhere and I think you can still find happiness. You are young and healthy, I think there's so much you can do still that can bring you self realization. You can come to Mexico and set up your own drs office for foreigners in Cancun or Cabo. If u have a license you can probably work as a hotel physician. I think there are many things that you can do with your career just think outside the box. It would be a shame to lose you as a person and as a professional. :) The American dream is not always a happy dream.

At this point then, I think I have been brainwashed into not having the capabilities to think outside of the box to this degree. Or maybe I have some level of undiagnosed ASD (I do tend to be resistant to change so there is that). Can't work for Doctors Without Borders without a medical license but I could be wrong. I do believe it is still American funded in which case this rule would apply but honestly not 100%.

Yes the consequences of a botched suicide attempt with a firearm is not pretty. I've seen survivors of gunshot wounds to the head and believe me its even worse than you probably already think it is. That is why I suggested doing it after swimming a sufficient distance out to sea. You a have a roughly 95-99% of being killed from a gunshot wound to the head, specifically that hits the brain. But hey knowing my luck I'd probably be one of the vegetative survivors. That way even in the unlikely scenario I survive, I will certainly be incapacitated and drown immediately after. All there is to do is walk/take public transit to a beach town during an off hour of the day, walk out into the ocean, swim for an hour or so, and do the deed. It actually seems a lot easier than I would have imagined to literally disappear off the face of the Earth and to have your remains naturally disposed of with no one ever being able to recover them (jumping off a cruise ship is also a something I would consider but of course there is COVID and all so there aren't any to take). If I am really going to do this I really want to make sure it is done correctly and that there is no possibility of me screwing this up too. Even it that maybe requires a bit of creativity.

 

[mini_weeny]

At this point then, I think I have been brainwashed into not having the capabilities to think outside of the box to this degree. Or maybe I have some level of undiagnosed ASD (I do tend to be resistant to change so there is that). Can't work for Doctors Without Borders without a medical license but I could be wrong. I do believe it is still American funded in which case this rule would apply but honestly not 100%.

Yes the consequences of a botched suicide attempt with a firearm is not pretty. I've seen survivors of gunshot wounds to the head and believe me its even worse than you probably already think it is. That is why I suggested doing it after swimming a sufficient distance out to sea. You a have a roughly 95-99% of being killed from a gunshot wound to the head, specifically that hits the brain. But hey knowing my luck I'd probably be one of the vegetative survivors. That way even in the unlikely scenario I survive, I will certainly be incapacitated and drown immediately after. All there is to do is walk/take public transit to a beach town during an off hour of the day, walk out into the ocean, swim for an hour or so, and do the deed. It actually seems a lot easier than I would have imagined to literally disappear off the face of the Earth and to have your remains naturally disposed of with no one ever being able to recover them (jumping off a cruise ship is also a something I would consider but of course there is COVID and all so there aren't any to take). If I am really going to do this I really want to make sure it is done correctly and that there is no possibility of me screwing this up too. Even it that maybe requires a bit of creativity.

Yes I understand I'm that kind of person who hates change even if it's minuscule. However after my injury that has left me absolutely homebound and in complete terror of sound all the time I'm awake, I think I was a fool and I would do anything to just have a normal functioning body, I would prefer to be a double amputee than having this ear disorder. You are still lucky in so many ways, I hope you can see this before you make that decision. Don't compare yourself to others or live for other ppls expectations of you, the only one that should matter to you is you.

 

[-Tandem-]

I'm amazed that you think it would be easier on your loved ones to not have a corpse. So yeah, I think your method sucks. Besides, how would you keep the gun dry as you swim out to the middle of the ocean with it?

You could easily purchase a waterproof case and strap it to your back

 

[UnemployedMD]

Yes I understand I'm that kind of person who hates change even if it's minuscule. However after my injury that has left me absolutely homebound and in complete terror of sound all the time I'm awake, I think I was a fool and I would do anything to just have a normal functioning body, I would prefer to be a double amputee than having this ear disorder. You are still lucky in so many ways, I hope you can see this before you make that decision. Don't compare yourself to others or live for other ppls expectations of you, the only one that should matter to you is you.

Regarding the last statement. This is a large part of why I cannot cope. This is how people in this profession think and how my family functions. It is all about making comparisons to others and caring what other people think about you. This situation honestly reminds me much of the way the Japanese army generals acted at the conclusion of WWII. They killed themselves as soon as the surrender agreement was signed because they felt it was better to be dead with their dignity and free-will intact than to live a life of shame and defeat. This is a methodology of thinking that goes back to the Middle Ages in Japan (samurai/bushido) and it is honestly why I am struggling so much right now. There is no way I can hide this from anyone. At least not for long. People will all find out. Oh btw, my siblings are all super competitive with me and treat me horribly (even my twin brother). I can't deal with how he we will act towards me when he eventually finds out what happened.

 

[saltshaker]

> There are basically no career opportunities for unmatched MDs in this country without getting a residency.

Then get a residency. Harden the fuck up OP you got more opportunities then the vast majority in this forum! Stop ruminating and make some calls or something! Are you really going to come this far and give up? Pull all the strings you have, use up every connection.

If you try hard and still fail, then you have my blessing and can kill yourself.

 

[UnemployedMD]

> There are basically no career opportunities for unmatched MDs in this country without getting a residency.

Then get a residency. Harden the fuck up OP you got more opportunities then the vast majority in this forum! Stop ruminating and make some calls or something! Are you really going to come this far and give up? Pull all the strings you have, use up every connection.

If you try hard and still fail, then you have my blessing and can kill yourself.

Just getting to this point and has required to me to look deep inside myself and pull motivation and drive out of times I have really felt similarly hopeless. I have already had numerous obstacles to overcome (for the sake of not making this into even more of a sob story than it has already been I will spare you of them), and despite having access to every resource and advantage out there compared to my peers, I have still managed to come away with nothing. Only this time, I was all but assured of success and have actually been happy and optimistic for probably the first time in years leading up to precisely this moment last week.

 

[saltshaker]

OP i'm sorry if that was harsh, what is one thing you can do to get back on track?

 

[UnemployedMD]

OP i'm sorry if that was harsh, what is one thing you can do to get back on track?

That is the thing. I feel like my options are very limited and I am trying to get lucky and find a residency position outside of this standard process. But luck hasn't been on my side at all to this point and it is more than likely just going to be a bunch of dead ends (honestly still holding out on a glimmer of hope I can save the year with something like this) but the number of unmatched candidates who find a way into residency this way are rare and I am a pragmatic person.

I do have a good number of hobbies/interests that I can pursue easily to take my mind of this, but they aren't working this time as 99% of my current time (even my dreams) are spent ruminating on how to get myself out of this nightmare and what is going to happen to me if I can't (and decide to keep living)

Options I have are to almost miraculously find an outside residency spot (dream scenario for me at this point even if its not in my desired speciality and I have to move someplace I've never even been to for several years). Aside from this, the other options get grim and depressing fast.

 

[saltshaker]

Hold onto that hope imo, there's nothing else for you out there, ask your parents for help and explain to them how distressed you are. Have a few drinks first if it helps.

If you don't get in this year, can you try again next year?

Consider unorthodox methods, like what if one of these expected residencies had a bad accident? This is the saltshaker way of solving problems.

 

[UnemployedMD]

Hold onto that hope imo, there's nothing else for you out there, ask your parents for help and explain to them how distressed you are. Have a few drinks first if it helps.

Consider unorthodox methods, like what if one of these expected residencies had a bad accident? This is the saltshaker way of solving problems.

My parents are trying their hardest and pulling every string they can to save my career. On top of what I've been doing trying to find answers and find a solution to what seems like an almost unbeatable blow. I feel so horrible putting this additional stress on them and I can see their own sadness from what my situation has caused and that is actively killing me too.

I can try again next year. But my application was not the strongest to begin with and I worry I will now be seen as damaged goods to programs if I try again. They want people who are trainable and the longer out of medical school you are (even if only one year) the less likely they are to see you as someone like this.

There is only so much stress one person can handle before they just enter into a rapid downward spiral and I feel myself unraveling more and more as each day passes.

 

[roguetrader]

I can understand where you're coming from. Growing up in a life of privilege with very high expectations can land you in periods like this. Most people will not see what you're going through because on paper, it doesn't seem super bleak.

 

[Symbiote]

Start networking with hospitals and other places where they are accepting residency at. You want people already in the profession to vouch for you when the time comes rather than let some computer algorithm do the work for you. It's the same as getting any other job out there, you have to know someone to get in somewhere, which sucks especially if you have social anxiety issues or you're a closet NEET.

If the MD thing doesn't work out, at least you have the knowledge to become a tenured professor at a major university. The pros of that is you'll have a six-figured income (300k/yr) with full benefits, and days off since you're on a university calendar. Doctors don't have days off or even full benefits. Something to think about.

 

[Jean Améry]

If you're a licensed MD couldn't you find work abroad? Perhaps with doctors without borders as a) you'd be able to practice medicine which would look good on your resumé, b) you'd do people who have it worse than you materially a huge favour and c) you'd finally get to see a bit of the world after all the hard work you've put into your studies.

As to shame: I don't see why you should be ashamed about something that isn't your fault.

As a doctor you're a smart and well-educated individual: do you think you're currently in a position to give your life and prospects a fair evaluation? If the answer is no perhaps you ought to wait before doing something that is quite final. There is something to be said for CTB as the last option. Especially since you seem to have parents who care a great deal about you which would translate into much grief after you're dead.

Even the philosopher Seneca who wrote extensively on suicide and saw it as a dignified way out of bad situation (via libertatis) cautioned against decisions based purely or predominantly on emotion. As an intellectual perhaps it would serve you to dedicate some time to studying the stoic position on suicide as it is quite rational and might offer guidance on the dilemma you're facing.

 

[profoundexperience]

I'm wondering 3 things:

1. If you had a patient of yours come to you... and tell you a similar story (maybe make them from another profession)... how would you, as a doctor, and as you... with your own personal "style" go about helping them?
2. Aren't there some type of "lower rungs on the ladder" you can somehow leverage? This may sound very stupid... but how hard would it be for you to become a licensed nurse-practitioner? Get your foot in the door at a hospital you would like to do a residency at... make real connections with decision-makers: Years ago, I was an engineer and the company I was working for had a "secret project" that only certain people could work on... Just by dumb luck (I was just interested... not trying to "game the system")... I started hanging around the lab where the "secret" work was being done... asking questions and being there to lend a hand... SUDDENLY I became "the guy" who was responsible for delivering the secret product to customers. I, honestly not intending to, bypassed like 5 of my more senior colleagues. JUST BY BEING IN THE RIGHT PLACE AT THE RIGHT TIME AND SHOWING GENUINE INTEREST.
3. Do you "give good interview"? It sounds to me like you may not. You need to fix that shit! How? Ask respected professionals if you can treat them to lunch and do a practice interview with them. Be blunt and honest!! Tell them that you think you're interviewing skills are weak, that you really respect their achievements and opinions... and you'd like their opinion on how you can be better. All people love to think they're important.

P.S. I'd try to do #3 with some decision makers at hospitals you didn't contact/apply to. Maybe even chiefs at very small hospitals. Find out something impressive about them... and ask them for their help. The worst they can say
is "no".

Read "How to Win Friends and Influence People": The #1 rule is to always be more interested/impressed in them than they are in you... BUT DO IT GENUINELY... really research their bios.

 

[UnemployedMD]

I'm wondering 3 things:

1. If you had a patient of yours come to you... and tell you a similar story (maybe make them from another profession)... how would you, as a doctor, and as you... with your own personal "style" go about helping them?
2. Aren't there some type of "lower rungs on the ladder" you can somehow leverage? This may sound very stupid... but how hard would it be for you to become a licensed nurse-practitioner? Get your foot in the door at a hospital you would like to do a residency at... make real connections with decision-makers: Years ago, I was an engineer and the company I was working for had a "secret project" that only certain people could work on... Just by dumb luck (I was just interested... not trying to "game the system")... I started hanging around the lab where the "secret" work was being done... asking questions and being there to lend a hand... SUDDENLY I became "the guy" who was responsible for delivering the secret product to customers. I, honestly not intending to, bypassed like 5 of my more senior colleagues. JUST BY BEING IN THE RIGHT PLACE AT THE RIGHT TIME AND SHOWING GENUINE INTEREST.
3. Do you "give good interview"? It sounds to me like you may not. You need to fix that shit! How? Ask respected professionals if you can treat them to lunch and do a practice interview with them. Be blunt and honest!! Tell them that you think you're interviewing skills are weak, that you really respect their achievements and opinions... and you'd like their opinion on how you can be better. All people love to think they're important.

1. I can't say I am entirely sure what you are trying to illicit here. But I would of course try to be empathetic and offer them whatever support I could. Whether that be emotionally, medically, etc. Medicine gives you a front row seat to all kinds of human tragedy so I don't pretend to not be aware enough to realize other people have major issues too. Though if I survive this somehow I would probably be even more understanding of patients with a story like this and perhaps even offer my own life experiences as some sort of motivation.

2. Not really. You can't just become a NP or a PA without additional years of expensive schooling which would be almost insulting to do at this point already knowing 10 times whatever I would be "taught" actually doing something like this. The system in my country is flawed in this way. And besides, I already did this to an extent (got an audition rotation at a program through shear connections a few months ago in a time where most of my peers were studying at home). I was well liked there, knew all the faculty, got my letters of reference from anyone I could there, and even they interviewed me, acting like they would have liked to train me, yet still stepped me over. I applaud you for having gotten your foot in the door through hard work and connections you have made, but this approach has already failed me in life more times than I can count. The definition of insanity is doing the same thing over and over again expecting a different result which is exactly how doing charity work in a hospital at this point after investing 500k in education costs would feel to me at this point.

3. I think that I do interview well or at least adequately at the very least. Everyone who spoke to me seemed happy to interview me and all my interviews went smoothly. They all flowed well, I acted as cordially and respectfully as humanly possible, yet I still lost.

The biggest problem I am facing right now is I honestly don't know if I have the emotional energy left at this point to do whatever it takes to get my foot in the door. Like I said before, aside from a miracle happening, I am going to be feeling the way I do right now for at least another year (and it's only been a week so far). I don't think I can tolerate that level of uncertainty after already having gone through a decade of it when I KNOW it is only going to get worse as each day passes. A car can only be in the red for so long before its engine completely meltdowns, and I am not sure I can put myself through that or live with myself if I can't pull through here and do exactly that. This more than anything else is the reason I am here today.

 

[Greenberg]

To be or not to be: Here is a thought of persistence and failure. The following is an excerpt on Abraham Lincoln:

Abraham Lincoln Didn't Quit

Probably the greatest example of persistence is Abraham Lincoln. If you want to learn about somebody who didn't quit, look no further.

Born into poverty, Lincoln was faced with defeat throughout his life. He lost eight elections, twice failed in business, and suffered a nervous breakdown.

He could have quit many times – but he didn't and because he didn't quit, he became one of the greatest presidents in the history of our country.

Lincoln was a champion and he never gave up. Here is a sketch of Lincoln's road to the White House:

• 1816: His family was forced out of their home. He had to work to support them.
• 1818: His mother died.
• 1831: Failed in business.
• 1832: Ran for state legislature – lost.
• 1832: Also lost his job – wanted to go to law school but couldn't get in.
• 1833: Borrowed some money from a friend to begin a business and by the end of the year he was bankrupt. He spent the next 17 years of his life paying off this debt.
• 1834: Ran for state legislature again – won.
• 1835: Was engaged to be married, sweetheart died and his heart was broken.
• 1836: Had a total nervous breakdown and was in bed for six months.
• 1838: Sought to become speaker of the state legislature – defeated.
• 1840: Sought to become elector – defeated.
• 1843: Ran for Congress – lost.
• 1846: Ran for Congress again – this time he won – went to Washington and did a good job.
• 1848: Ran for re-election to Congress – lost.
• 1849 Sought the job of land officer in his home state – rejected.
• 1854: Ran for Senate of the United States – lost.
• 1856: Sought the Vice-Presidential nomination at his party's national convention – got less than 100 votes.
• 1858: Ran for U.S. Senate again – again he lost.
• 1860: Elected president of the United States.

 

[UnemployedMD]

To be or not to be: Here is a thought of persistence and failure. The following is an excerpt on Abraham Lincoln:

Abraham Lincoln Didn't Quit

Probably the greatest example of persistence is Abraham Lincoln. If you want to learn about somebody who didn't quit, look no further.

Born into poverty, Lincoln was faced with defeat throughout his life. He lost eight elections, twice failed in business, and suffered a nervous breakdown.

He could have quit many times – but he didn't and because he didn't quit, he became one of the greatest presidents in the history of our country.

Lincoln was a champion and he never gave up. Here is a sketch of Lincoln's road to the White House:

• 1816: His family was forced out of their home. He had to work to support them.
• 1818: His mother died.
• 1831: Failed in business.
• 1832: Ran for state legislature – lost.
• 1832: Also lost his job – wanted to go to law school but couldn't get in.
• 1833: Borrowed some money from a friend to begin a business and by the end of the year he was bankrupt. He spent the next 17 years of his life paying off this debt.
• 1834: Ran for state legislature again – won.
• 1835: Was engaged to be married, sweetheart died and his heart was broken.
• 1836: Had a total nervous breakdown and was in bed for six months.
• 1838: Sought to become speaker of the state legislature – defeated.
• 1840: Sought to become elector – defeated.
• 1843: Ran for Congress – lost.
• 1846: Ran for Congress again – this time he won – went to Washington and did a good job.
• 1848: Ran for re-election to Congress – lost.
• 1849 Sought the job of land officer in his home state – rejected.
• 1854: Ran for Senate of the United States – lost.
• 1856: Sought the Vice-Presidential nomination at his party's national convention – got less than 100 votes.
• 1858: Ran for U.S. Senate again – again he lost.
• 1860: Elected president of the United States.

This is inspirational no doubt. Though Lincoln was depressed and had a number of mental health issues as a result of the damage all this inflicted on his psyche. But that is besides the point.

How many people actually get to become success stories like this? How many others with this sort of adversity (yes admittedly the likes of which I've never experienced) just go down with the ship and are forgotten about by the system. I went into medicine knowing (or rather being promised by others) that it is a secure path to a comfortable, protected career so long as you make sacrifices early and work hard. Just when I finally reach the end of the process and am expecting to finally reap the rewards of this whole pursuit, the whole thing literally just collapses around me. Despite being an avid casino goer and enjoying taking risks in a controlled way, I really feel like no matter what I do from this point forward is a gamble with basically everything I have done to get to this point riding on it. I'm not sure if that is a weight I can carry. Maybe some people are just built differently, but I really don't feel like that was something I was lucky enough to be born with. I have been fighting my whole life and now am just tired and numb. I really just want the pain to end but after insinuating that I could get out of this mess to my parents by ctbing and willing my own savings to partly make up for the investments they have put into me, they say that doing so would destroy both of them and ruin the remainders of their lives. So it looks I am truly stuck here now. God help me.

 

[Greenberg]

This is inspirational no doubt. Though Lincoln was depressed and had a number of mental health issues as a result of the damage all this inflicted on his psyche. But that is besides the point.

How many people actually get to become success stories like this? How many others with this sort of adversity (yes admittedly the likes of which I've never experienced) just go down with the ship and are forgotten about by the system. I went into medicine knowing (or rather being promised by others) that it is a secure path to a comfortable, protected career so long as you make sacrifices early and work hard. Just when I finally reach the end of the process and am expecting to finally reap the rewards of this whole pursuit, the whole thing literally just collapses around me. Despite being an avid casino goer and enjoying taking risks in a controlled way, I really feel like no matter what I do from this point forward is a gamble with basically everything I have done to get to this point riding on it. I'm not sure if that is a weight I can carry. Maybe some people are just built differently, but I really don't feel like that was something I was lucky enough to be born with. I have been fighting my whole life and now am just tired and numb. I really just want the pain to end but after insinuating that I could get out of this mess to my parents by ctbing and willing my own savings to partly make up for the investments they have put into me, they say that doing so would destroy both of them and ruin the remainders of their lives. So it looks I am truly stuck here now. God help me.

This may sound like hard love but my intention is sincere and to be helpful.

Just because you did everything right, does not mean that you will win, especially in the game of life. You are fortunate to have been born into a family of doctors (x2) with your education fully paid for by them, i.e., no debt. Many people would envy that opportunity even if it means never practicing medicine. You have set up expectations from an early age without any forethought of contingencies.

I mean you can choose to "cry me a river," frankly you are spoiled and lack a backbone. If our first ancestors had your attitude toward life, we would have become extinct: as difficult as it may be for you, pull yourself up by your bootstraps and start accepting life with its "slings and arrows of outrageous fortune."

You can choose to ignore me but the truth is very apparent; only you cannot see it!

 

[UnemployedMD]

This may sound like hard love but my intention is sincere and to be helpful.

Just because you did everything right, does not mean that you will win, especially in the game of life. You are fortunate to have been born into a family of doctors (x2) with your education fully paid for by them, i.e., no debt. Many people would envy that opportunity even if it means never practicing medicine. You have set up expectations from an early age without any forethought of contingencies.

I mean you can choose to "cry me a river," frankly you are spoiled and lack a backbone. If our first ancestors had your attitude toward life, we would have become extinct: as difficult as it may be for you, pull yourself up by your bootstraps and start accepting life with its "slings and arrows of outrageous fortune."

You can choose to ignore me but the truth is very apparent; only you cannot see it!

What you are saying is true and I am not even disagreeing with you. I know I have been spoiled and live a life with resources probably only 1/1000 humans on Earth are afforded. But I am a somewhat egotistical person and the way I am perceived by others especially those I am close to is very important to me. Something that is more valuable to me than any amount of money or resources on Earth. I will be seen as a failure to those around me If I can't practice medicine and the pain that is going to cause me might be more that I can bear. People have always said I have been so privileged having my parents pay my way through school as if I didn't even really earn my degree on my own in the process. These people don't understand the kind of pressure having your two closest allies invest in you so deeply like that and the disappointment that comes with people you love having to be involved with your own misfortunes. Honestly at this point wish that I took out loans and didn't come from any money. That way if I were to ctb no one would be out all that money and defaulting on those loans through death could be a way for me to get back at this system that I feel has wronged me so badly.

 

[BrokenArrow]

To be or not to be: Here is a thought of persistence and failure. The following is an excerpt on Abraham Lincoln:

Abraham Lincoln Didn't Quit

Probably the greatest example of persistence is Abraham Lincoln. If you want to learn about somebody who didn't quit, look no further.

Born into poverty, Lincoln was faced with defeat throughout his life. He lost eight elections, twice failed in business, and suffered a nervous breakdown.

He could have quit many times – but he didn't and because he didn't quit, he became one of the greatest presidents in the history of our country.

Lincoln was a champion and he never gave up. Here is a sketch of Lincoln's road to the White House:

• 1816: His family was forced out of their home. He had to work to support them.
• 1818: His mother died.
• 1831: Failed in business.
• 1832: Ran for state legislature – lost.
• 1832: Also lost his job – wanted to go to law school but couldn't get in.
• 1833: Borrowed some money from a friend to begin a business and by the end of the year he was bankrupt. He spent the next 17 years of his life paying off this debt.
• 1834: Ran for state legislature again – won.
• 1835: Was engaged to be married, sweetheart died and his heart was broken.
• 1836: Had a total nervous breakdown and was in bed for six months.
• 1838: Sought to become speaker of the state legislature – defeated.
• 1840: Sought to become elector – defeated.
• 1843: Ran for Congress – lost.
• 1846: Ran for Congress again – this time he won – went to Washington and did a good job.
• 1848: Ran for re-election to Congress – lost.
• 1849 Sought the job of land officer in his home state – rejected.
• 1854: Ran for Senate of the United States – lost.
• 1856: Sought the Vice-Presidential nomination at his party's national convention – got less than 100 votes.
• 1858: Ran for U.S. Senate again – again he lost.
• 1860: Elected president of the United States.

Haha, this is like some laughable bullshit you'd hear in some sort of motivational seminar for wannabe entrepreneurs.

The idea that you can just cultivate this kind of hard-headed resilience and steely-outlook is complete nonsense perpetuated by the self-help industry.

If Abraham Lincoln did it, you can too! What's that? You're chronically depressed? Shut up, pussy! If another human being with different genes, a different upbringing and who was born in an entirely different historical period can do it, then why can't you?!

Sorry for sarcasm, but it's just such a simple, unnuanced, one dimensional take on OP's problems.

It seems OP has more going on than JUST the employment issue - just because he's from a privileged background doesn't make his suffering invalid.

 

[speck]

I understand how you're feeling right now. You mentioned that you've done a lot of thinking to get to this point, and the way you're feeling is totally valid. However, you're still so young and you've put so much work in- and exceeded your own expectations several times (ranking multiple times, having great rapport with the staff on rotation you completed, getting letters of rec). This is a rare, but not uncommon blow for young medical professionals. Someone above mentioned getting in contact with the Supplemental Offer and Acceptance Program, and I agree. Additionally, if you're unable to find a spot via your connections, maybe consider finding temporary clinical work and continuing to network. I believe that you should give yourself another chance. This is not the end for you.
You mentioned that how you are perceived is important to you. I think it's important to note that you are perceived as valuable and important by your parents. I get the impression that you have a positive relationship with them, so if I am misjudging this, please disregard but... If they did not believe in you or value you, they would not be rallying for you as they are now. This is an error and it is testing you, but the fact that your parents are working to find a solution for you should indicate that they have your back. I think they will have your back if you express to them that you are feeling lost and numb and stressed. They might even work with you to find a different path if you have decided that the medicine route is no longer fitting.
I really do hope you find a solution and are able to keep moving, but we are here to hear you no matter what.

 

[UnemployedMD]

I understand how you're feeling right now. You mentioned that you've done a lot of thinking to get to this point, and the way you're feeling is totally valid. However, you're still so young and you've put so much work in- and exceeded your own expectations several times (ranking multiple times, having great rapport with the staff on rotation you completed, getting letters of rec). This is a rare, but not uncommon blow for young medical professionals. Someone above mentioned getting in contact with the Supplemental Offer and Acceptance Program, and I agree. Additionally, if you're unable to find a spot via your connections, maybe consider finding temporary clinical work and continuing to network. I believe that you should give yourself another chance. This is not the end for you.
You mentioned that how you are perceived is important to you. I think it's important to note that you are perceived as valuable and important by your parents. I get the impression that you have a positive relationship with them, so if I am misjudging this, please disregard but... If they did not believe in you or value you, they would not be rallying for you as they are now. This is an error and it is testing you, but the fact that your parents are working to find a solution for you should indicate that they have your back. I think they will have your back if you express to them that you are feeling lost and numb and stressed. They might even work with you to find a different path if you have decided that the medicine route is no longer fitting.
I really do hope you find a solution and are able to keep moving, but we are here to hear you no matter what.

The SOAP already happened. That was last week and my experience with it went something like this. Since I mentioned the movie Titanic before as close representation of what the week felt like I'll summarize it here. If anyone hasn't seen the movie this probably won't make any sense so sorry about that.

Mon: 10:55am- Titanic hits iceberg ((un)match email)

Mon: 11:00am- Mr Andrews comes to the realization that the ship will sink (once the momentary shock wore off and I realized how dire this situation is)

Mon: 11:00am-3:00- alternate between denial, concern, and panic wondering if there was some sort of error (did NRMP even run my rank list), and how a lifeboat (SOAP spots) even works since I never could have imagined the Titanic sinking (going unmatched). Meanwhile lifeboats start being prepared (the system we need to submit crashes and makes it so there is even less time than usual to get everything in place)

Tuesday 8am-10pm: 1st and second class start boarding first. Steerage are kept caged at the bottom of the ship hoping someone at least lets them out so they can stand a chance (most unmatched students without a strong medical school backing them up through the process)

Wednesday morning: Some first and second class passengers (but not all as some already have SOAP spots lined up) and steerage passengers are able to look for a lifeboat to board (getting calls/IVs) but at this point most of the lifeboats have already left (SOAP interviews have gone out/first rounds)

*****At around this point in the movie Cal slips some money into the first officers' pocket bribing him for a position on a lifeboat (wouldn't be surprised if someone actually did something like this to get a spot in SOAP)

Wednesday night: Widespread panic as ship is now actively going down fast and no lifeboats are left. Things are getting grimmer by the minute (this speaks for itself and doesn't need further clarification)

Yesterday 8am-12pm: ship about to sink, everyone says one last prayer that this whole thing is a bad dream and a miracle occurs (last two round of SOAP)

Yesterday afternoon-present time: Titanic is gone. 1000s of people in the water (me and many unfortunate others who pulled an ace of spades out of the deck last week) screaming and pleading for help as they all drown (scramble process)while none of the people in the boats/positions of power will listen to any of their cries for help (pretty much every email/call we've sent today)

*****Cal's reaction to Rose kissing Jack (how it felt watching everyone else celebrate matching on social media Friday)

*****Poor woman with infant asking Captain where she should go as the ship is about to sink. Captain just says nothing and walks away (me reaching out to my school dean for guidance on what to do now)



Even with this horrific SOAP process I still managed to pull an additional two more interviews at desirable locations to in my desired field. Of course it was just the universe's attempt to give me one last blow as I narrowly missed getting one of the spots by one rank or two ranks with other candidates taking the slots. At that point everyone was scrambling and it was almost a like a lottery system if you are able to fill one of the remaining spots that are outnumbered by a ratio of about 10:1. Just got unlucky yet again after almost getting out of this nightmare in the middle of complete pandemonium last week too.

My parents are working so hard for me and care so much but I just feel like a horrible human being who doesn't deserve any of it.

 

[Escape Artist]

You know your chess board better than any of us. It sounds like you're in hell. You shouldn't have to suffer unbearably.

BUT - I'm sure you've considered that you could have PTSD from all of this horrible stress and that the sooner you get treatment the better. I am not formally educated AT ALL (only went to kindergarten) but I've had mental and physical illness my whole life and from what I've read the prognosis isn't always as bad for PTSD that occurs in adulthood and is treated quickly with adequate methods. Even if you went through the stress for a decade, the adult brain isn't usually as easily damaged. I mean, they're getting that picture at least, right? And as I'm sure you also know - PTSD can severely distort your situation. Still, after witnessing such a messed up system it's completely understandable why you'd feel hopeless. But remember- you did all that stuff and risked exposure during this pandemic on top of your already extreme stress and pressure. I know someone with ASD who's been an EMT during this and he's not in good shape. At all. But he's going to pull through I think.

My cousin was finishing up grad school a few years ago and was a WRECK. Then he got diagnosed with adult ADHD, got meds and says everything turned around from him. He went through school struggling with that and not knowing it. He seems to be doing great now. Psych meds can be awful and damaging but sometimes I think people get an accurate diagnosis and life can get better.

I've been staring at my chessboard too and it's extremely grim. I'm resigning but it can take time to get past the SI. I was born with painful brain and spine malformations, experienced abuse and neglect as a child, have been homeless, have been in horrific psych hospitals etc etc. My mind and body are giving out fast. This is not at all to say that you're not suffering as much as I am, but I'm sure you'd agree that clinically your prognosis is probably better even if it doesn't feel like it is. Anosognosia?

I wish you would write a book about your experience with the system. I know that might not be possible given your emotional suffering, but I do know that many writers have survived through the cathartic experience. And if the right person(s) read your book things could absolutely change.

I'm rooting for you to live even though it's your right to CTB. You shouldn't have to feel guilty if your suffering is unbearable. I just really wish you could become a writer and/or badass like Dr. Kevorkian (he's my favorite doctor ever - check out the movie You Don't Know Jack - it's a great one to watch while contemplating CTB). Your writing here is powerful and clear. You seem extremely caring and compassionate. I hope this doesn't come off as "boy, if I were physically healthier and had that kind of education I'd do great things so you should do it instead!". I don't mean it that way. I believe severe mental illness is the most painful kind of illness because you often feel completely alone. Everyone deserves to live and everyone deserves to die painlessly when they choose.

 

[Makko]

A career is like a rocket. By far the most energy is consumed to lift the first millimeter off the ground, but once you're in space you don't need any effort to keep going. I'm in law and the absolute hardest thing I did in my life is getting the first job, especially as an expatriate who started out with no connections, the amount of ass you have to kiss just to get your foot in the door is indescribable. Then, once you do get in, the first few years are torture (but not as torturous as getting the job was). Then, every step after that also becomes progressively easier until you're a senior who does everything easily, employers are fighting over you and you're swimming in money. Putting the most difficult part first is how careers work, discounting people who get artificially lifted up into positions where they don't belong. You're on the way of squeezing through, and giving it one more year is not that long. It's normal. In 10 years it's not going to matter if you got your first placement 2021 or 2022.

When it comes to career, sunk costs are not a fallacy. Giving up will mean you have suffered for nothing. This starting squeeze is by far the most difficult segment of your working life, of course it makes you want to kill yourself. That's how the game is set up, you're not some cast-off failure, you're a normal player on the field. You're still in the zone of adequacy, and you have plan B vitamins to fill your time with. Use this year to get extra courses, if I were you I'd look into leadership/medical management as these will be a merit later on in your career. Those who actually get stuck in this pre-first-job limbo for many years, that's a different story, but you're nowhere near there yet.

 

[UnemployedMD]

You know your chess board better than any of us. It sounds like you're in hell. You shouldn't have to suffer unbearably.

BUT - I'm sure you've considered that you could have PTSD from all of this horrible stress and that the sooner you get treatment the better. I am not formally educated AT ALL (only went to kindergarten) but I've had mental and physical illness my whole life and from what I've read the prognosis isn't always as bad for PTSD that occurs in adulthood and is treated quickly with adequate methods. Even if you went through the stress for a decade, the adult brain isn't usually as easily damaged. I mean, they're getting that picture at least, right? And as I'm sure you also know - PTSD can severely distort your situation. Still, after witnessing such a messed up system it's completely understandable why you'd feel hopeless. But remember- you did all that stuff and risked exposure during this pandemic on top of your already extreme stress and pressure. I know someone with ASD who's been an EMT during this and he's not in good shape. At all. But he's going to pull through I think.

My cousin was finishing up grad school a few years ago and was a WRECK. Then he got diagnosed with adult ADHD, got meds and says everything turned around from him. He went through school struggling with that and not knowing it. He seems to be doing great now. Psych meds can be awful and damaging but sometimes I think people get an accurate diagnosis and life can get better.

I've been staring at my chessboard too and it's extremely grim. I'm resigning but it can take time to get past the SI. I was born with painful brain and spine malformations, experienced abuse and neglect as a child, have been homeless, have been in horrific psych hospitals etc etc. My mind and body are giving out fast. This is not at all to say that you're not suffering as much as I am, but I'm sure you'd agree that clinically your prognosis is probably better even if it doesn't feel like it is. Anosognosia?

I wish you would write a book about your experience with the system. I know that might not be possible given your emotional suffering, but I do know that many writers have survived through the cathartic experience. And if the right person(s) read your book things could absolutely change.

I'm rooting for you to live even though it's your right to CTB. You shouldn't have to feel guilty if your suffering is unbearable. I just really wish you could become a writer and/or badass like Dr. Kevorkian (he's my favorite doctor ever - check out the movie You Don't Know Jack - it's a great one to watch while contemplating CTB). Your writing here is powerful and clear. You seem extremely caring and compassionate. I hope this doesn't come off as "boy, if I were physically healthier and had that kind of education I'd do great things so you should do it instead!". I don't mean it that way. I believe severe mental illness is the most painful kind of illness because you often feel completely alone. Everyone deserves to live and everyone deserves to die painlessly when they choose.

I feel like such a complete asshole bitching about this now when there are people like you and those you've mentioned that have been enduring hardships that frankly I have never even imagined being in.

I know you mean well and to be honest you probably deserve the life I've had and the experiences I've been afforded from being wealthy (traveling all over the world, not having debts, having a healthy body and access to good healthcare) more than anything. I would give it to you if I could and I really mean that. It is shame that after one person ctbs there is no way to give your health/opportunities/and resources you leave behind to someone like you who has more reserve and more willpower than I will likely ever have.

A career is like a rocket. By far the most energy is consumed to lift the first millimeter off the ground, but once you're in space you don't need any effort to keep going. I'm in law and the absolute hardest thing I did in my life is getting the first job, especially as an expatriate who started out with no connections, the amount of ass you have to kiss just to get your foot in the door is indescribable. Then, once you do get in, the first few years are torture (but not as torturous as getting the job was). Then, every step after that also becomes progressively easier until you're a senior who does everything easily, employers are fighting over you and you're swimming in money. Putting the most difficult part first is how careers work, discounting people who get artificially lifted up into positions where they don't belong. You're on the way of squeezing through, and giving it one more year is not that long. It's normal. In 10 years it's not going to matter if you got your first placement 2021 or 2022.

When it comes to career, sunk costs are not a fallacy. Giving up will mean you have suffered for nothing. This starting squeeze is by far the most difficult segment of your working life, of course it makes you want to kill yourself. That's how the game is set up, you're not some cast-off failure, you're a normal player on the field. You're still in the zone of adequacy, and you have plan B vitamins to fill your time with. Use this year to get extra courses, if I were you I'd look into leadership/medical management as these will be a merit later on in your career. Those who actually get stuck in this pre-first-job limbo for many years, that's a different story, but you're nowhere near there yet.

Your first paragraph could not be any more true. I see this everyday (my parents, work superiors, etc)

With respects to the bolded, I could be on the path to this scenario. It is partly up to chance if something turns around this year or the next or the next and that fear is what is driving me nuts and seeing death as potential but very permanent solution.