(Today’s guest post comes to us from England. I met Dr. Nikki Ramskill in Orlando at a conference we both attended, FINCON18. She went through a tough time as an OB/GYN specialist and burnout caused her to take some time off in 2015. She decided to go back into training and switch to a less demanding specialty. I am delighted to have her share her burnout and recovery story with you. I took the liberty to change a few words, translating it from British to American English.)
I have been a doctor since 2009, and although I now love what I do, I haven’t always.
In 2015 I turned 30. I’d left school, at age 18 and went straight to medical school. In the UK, medical training is slightly different than in the US, as we don’t have to complete an undergraduate degree first. Whether that’s a good thing or not I don’t know. All I know is that by the time I turned 30, I was done. I hadn’t had a break from training or work for over 10 years, not to mention the intensity of studying I had to do to get into medical school.
At this point, I had been qualified for 6 years. I was 4 years into my OB/GYN training and was now at registrar level (resident in the US). In the UK we have restrictions on the number of hours we can work as doctors, and this is capped at 40 hours per week. In order to accommodate this, we have to work in shifts that are usually 12 hours long and cycling between day time and night time. The team structure has become fragmented, so you don’t have a specific consultant (attending in the US) that you work with the whole time, which makes it difficult to learn on a consistent basis.
For anyone in OB/GYN, you’ll know how stressful this patient population is to work with. In the UK we are lucky enough to have midwives who take care of our lower-risk women, and then if things go wrong, the obstetricians step in to take over. We will automatically look after the women with all sorts of serious health conditions, including heart disease, obesity, liver disease, diabetes and serious fetal complications.
It’s an emotion sensitive specialty, and the pressure is on to deliver mom and baby safe and well or face the consequences of litigation and GMC sanctions. On a background of working 40 hour weeks with fragmented training, this makes for one stressful career choice!
Add to this the undermining and bullying that goes on behind the scenes, and it’s understandable why so many people are now choosing to leave OB/GYN in the UK.
The effects of burnout
The effects of burnout for me had started a few years back. I just hadn’t been aware of it. Initially my main symptom was getting snappy and angry with work colleagues, especially those who I saw as lazy or incompetent. This behavior was absolutely uncharacteristic of me as I’m usually a happy and supportive person. I simply had no patience. I was ambitious and hardworking, and really wanted to be allowed to do more, but I felt like I was being held back. I was told I would feel better once I got more senior as I would be allowed to do more, but unfortunately this wasn’t the case.
Over the next few years, I started experiencing other symptoms of burnout like forgetfulness, frequently bursting into tears at random times, pressure headaches, IBS-type symptoms and then finally panic attacks on the labor ward. I’d have to excuse myself to calm down. Nobody noticed because I tried not to show it.
I then lost my empathy for patients. The “worried well” especially frustrated me, and I saw them as time-wasters for using up precious NHS resources for seemingly trivial matters. I can see now that this was burnout in its worst form, as no doctor should lose empathy for the people they serve. It goes fundamentally against what it means to be a doctor.
The final straw came when I made a decision that meant a mother lost her baby. She was at term, and there was no reason why she should have had a stillborn baby other than because of the choice I made. I still get emotional about it to this day.
Once this happened, I sought help. I was told that I have to deal with losing babies and things going wrong as part of the career choice I had made. I was horrified. I just couldn’t imagine working any longer in a specialty surrounded by colleagues who had such cavalier attitudes. I couldn’t forgive myself over losing that baby. I was done.
Thankfully I had a supportive tutor who allowed me some time off. I was granted a year of sabbatical leave with the option to return if I wanted to. Needless to say, I never went back.
What happened next?
During my time out, I decided to fulfill a life-long dream, and went travelling for 5 months across Australia, New Zealand, South East Asia and Japan. It was a phenomenal time, and despite not having the full funds to pay for it, I don’t regret it at all.
It was on this trip where I had my epiphany and decided to sort out my finances. Without it, there may not have been a Female Money Doctor at all.
It’s been three years since I left OB/GYN, and I have never been happier. I’m currently training to be a general practitioner in my local community, and in just under 18 months, I will be fully qualified and out in the real world on my own! I no longer have to work nights or weekends, and since starting up my blog, I have a new dimension to my practice. It’s literally re-invigorated me and I feel the joy I used to feel of practicing medicine in my early years. My plan is to work in both areas, medicine and blogging, moving forward so that I can fulfill my dream to have a varied portfolio-type career path.
The great thing is that I can still use my previous experience. It has made me a much more confident doctor, and I will always be grateful for the lessons I learned back then.
Well the next steps now are to complete my training and work on building my blog and business. It has been a phenomenal journey so far, and I can’t wait to see what happens next!
If you’re struggling with burnout, make sure you speak to someone you can trust. Take time out to reflect. What’s the point of being miserable at work, when you spend most of your time there? Especially in America with 80 hour+ weeks! The great thing is that there are always options open to you. We’re often so blinkered to what else is out there that we miss out on life.
Just make sure you look up from time to time.
If you are having thoughts of leaving medicine, please pick up a copy of The Doctors Guide to Smart Career Alternatives and Retirement and see what your options may be. You don’t have to give it all up. There are options.
Dr Nikki can be found at The Female Money Doctor, where she is helping women in the UK with their finances.