Getting Back Into Clinical Medicine After Time Away Can Be Tough

I wanted to share my experience with taking some time off of doing clinical medicine. It has been a really nice time away but getting back into it was a bit tougher than I thought.

It’s Nice Being Away

I left because I was under a lot of stress, I was getting some bad anxiety being in the exam room with patients. Looking back it was the long hours in the Urgent Care along with doing a decent amount of administration work.

I felt great not having to go into the clinic, being able to spend my time as I pleased and work on some side-projects. I didn’t miss the work but realized at some point I would have to get back into it if I wanted to keep up my skills as well as my medical license.

My First Day Back In The Urgent Care

On October 21, 2016 I did my first 8-hour shift in the Urgent Care after being away nearly 3 months. Surprisingly, I wasn’t stressed or anxious. It crossed my mind that I would be anxious a few days earlier but I slept great the night before and the time flew by when I was seeing patients.

I did fine with most patients and it hadn’t been long enough away that any major system changes had taken place. I actually was in a much better mood, my patients picked up on that.

By end of the day I felt energized, I celebrated with some wine and called it a night.

What Didn’t Go Well – Feeling Rusty

I had a tougher time making quick clinical calls, should this patient get managed outpatient or do they need to be admitted? Should I get the x-ray or should I trust my gut instinct?

What stood out to me the most was that I wasn’t able to have as broad of a differential as I usually do and I felt as though I needed to focus a lot more in order to not miss something.

I recall an OB/Gyn patient that just took me much longer to work-up, I ended up needing to call the OB on call, which was helpful and I’m glad I had the luxury to do so. It’s just that by calling the specialists and dragging my feet the flow slowed down which meant that I was feeling more behind.

If I was feeling that rusty with only 3 months away, I worry that with more infrequent work or even longer times away I would be a mess, no longer feeling comfortable in my position.

I should add, these past 3 months I was doing some telemedicine work and reviewing a ton of cases on Figure1, so I wasn’t completely out of the loop.

What Am I Gonna Do Moving Forward

I am not terribly excited about working a ton but I need the stimulation and I don’t want to forget my clinical medicine quite yet.

I could start doing volunteer work, it’s something I’m slowly working on. Soon I’ll be starting a gig with a group in Portland that does tattoo removal, that should be a great experience.

I also need the income since I’m increasing my household size. Maybe I don’t need to do 10-hour shifts, 4-6 hours at a time should be plenty. Doing them more frequently, reading up on more illnesses and continuing reading the Figure1 cases should be a good way for me to maintain my skills.