At age 33, I got my first job as an outpatient pediatric attending. With great pay, nice coworkers, and exceedingly better hours than in training, to everyone around me, I had finally “landed.” Soon after I began working, however, I woke up with trepidation every morning, forcing myself to get out of bed.

Why wasn’t I relishing the fruits of my labors? After all this time, I no longer trailed the line of ducklings through the hospital wards – now, I was the mama duck. What a luxury. But to me, it was hell. I kept waiting for the shoe to drop, fearing backlash from making the slightest mistake. I felt a knot in my stomach each time I had to enter a patient room. I nervously signed each note at the end of the day, already embarrassed that my coworkers would judge what I wrote. I felt constant anxiety.

Gradually, however, I started listening to my body and mind a little more closely. Did I truly want to devote time and energy constantly following up on my patients, sacrificing sleep while on call, and worrying about messing things up all the time?

The answer, I realized, was hell no. I decided to give notice that I was leaving just over four months after starting work. I instantly felt a weight lifted from my shoulders; I could finally be free to devote mental energy to something else that I actually enjoyed. I started waking up with less agony, knowing that my days at my job were numbered. Then, in the midst of my excitement for the future, I was hit with a new source of dread: telling my family.

For the past 15 years of my life, my identity to them was “future Dr. Kristin.” They’d always been there for me through the grind of climbing the medical ranks. I felt a huge knot in my stomach in the moments leading up to telling them I couldn’t do it anymore.

As I grappled with how I would break the news, I considered five reasons that kept me on the medical track for so long and made it difficult for me to leave:

1. The decision was made for us, not by us. The path to practicing medicine is arduous. Most doctors are 30+ years old when they start their first “real job.” Many will say they decided to pursue medicine at age 18. But is college really a time when we can make professional decisions? While depending on our families to provide food, shelter, and education for us, we tend to deeply trust their notions of what a “safe” career path is. But on a pre-med track, we prioritize competitive science courses over those we are passionate about, leaving little time to formulate a career path that aligns with our true interests.

2. We seek out family approval. Wanting to make Mom and Dad proud is an innate desire shared by the vast majority of humans. We are willing to go to great lengths to hear those words: Good job. Way to go. You’re doing great. By choosing medicine, we check off all our families’ boxes: a steady stream of income, high salary, respect, and job security. Suppose we choose a less prestigious career path. In that case, we risk experiencing that look of disappointment or dissatisfaction that remains implanted in our brains until we better align our career goals with our family’s ideals.

3. We’re constant competitors. As doctors, in academia we have been trained to compete against those around us, from the pre-calculus exam in high school to answering questions on rounds. Surpassing the performance of the person beside us gives us a fleeting sense of self-approval that we can take with us through to the next academic obstacle. But this fuel depletes rapidly, and we quickly require another victory to maintain our sense of merit in the medical field.

4. We are haunted by debt. We are convinced that the only way to pay back the hundreds of thousands of borrowed dollars is to continue as practicing physicians. How would we make payments while maintaining a comfortable lifestyle if we quit? Most of us also have applied to PSLF (public service loan forgiveness), a government repayment program whereby ten years of income-based repayment while working at a nonprofit or university-based institution qualifies you to have the remainder of your loans forgiven. We tell ourselves if we can make it through to that ten-year mark, we can then drop the career we were never truly happy with because we’ve rid ourselves of a massive debt burden.

5. We are afraid of failure. We fear that leaving medicine is a waste of the past ten to fifteen years of our lives. Quitting reveals an inability to handle the pressure, commitment, and dedication required to maintain our status as decent doctors. But if we’re truly unhappy in our day-to-day life as a physician, wouldn’t the real failure would be to stay in a career that cultivates dread when you wake up in the morning?

The decision to leave medicine was not easy, but my family eventually understood. I had to force myself to fight against these barriers, and I had several moments where I feared I was making the biggest mistake of my life. But soon after I took the plunge and turned in my resignation notice, I felt lighter than air. I felt once again that the world was my oyster. I had the freedom to work toward a career that allowed space for creativity, flexibility, and joy. I finally had the opportunity to work toward a fulfilling career on my own terms for me and nobody else.

The author is an anonymous physician.

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