I am 90% sure I am going to quit being a doctor, the 10% is just trying to figure out how

I am hoping other Canadian ex-doctors may read this and have some advice for me on other career plans, because I'm feeling a little lost on where to go next. For some context: I am a Family Doctor in Canada, and for sake of privacy of myself or my patients, I won't be informing anyone of where I work. I did undergrad, med school and residency here in Canada, and I am 4 years out from residency now.

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Burn out is well known as a consistent problem in medicine. We have higher depression rates, divorce rates and suicide rates than the average population. I knew this throughout medical school and said "It won't happen to me". And well, here I am, contemplating how to leave the profession after putting 14 years into this so far and hilariously posting it on reddit of all places. I hope if you're a medical student, you listen and heed my warning - this is not a profession for the sensitive and soft-hearted. This is a profession for those who can withstand high stress, bureaucracy, bullying and entitlement of others. I unfortunately do not have the strength to maintain my own mental health under this and I would strongly recommend that if you do not identify strongly with the statement "I have thick skin and I can handle anything", then get out now before you run down this rabbit hole too far. I'm going to explain the above description of medicine for anyone who may be curious.

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High Stress. This is may seem sort of intuitive, and in fact, on it's own, it is manageable. Combine it with everything else, and this is what will kill a doctor in the end. We work long hours every week. We take our jobs home with us, with endless charting and paperwork. We are on call overnight, weekends and holidays - whether that's in a hospital or even in a clinic, we are always "on call" regularly. You learn how to function on less than an hour of sleep in 24hrs. You learn how to eat in less than 5 min just so that you can make it to the next patient. You are told that your career comes first, the rest of your life comes second in sacrifice for patient care. We are told during medical school "You will make a mistake, you are human, just always own up to it and learn from your mistakes" but then when you get in to the real world, you realize "If I make a mistake, the patient will destroy me on Google Review/RateMD, possibly submit a complaint to the college, I might have to face a review board with the college, my colleagues might throw me under the bus to save their own asses and I may lose a ton of money. So don't make any mistakes". You are acutely aware you have people's lives in your hands and you literally could kill someone everyday, even if they just happened to have an allergy they were unaware of to a simple antibiotic. The worst of it is that medicine is rapidly changing every day so trying to keep up with the newest diseases and treatments is like running on a hamster wheel that never stops, and your stress over "not knowing enough" or "I don't know about X, Y or Z, therefore I am less than my colleague Dr.______" never ends. It is so stressful, everyday, day in and day out, and you are taught absolutely no self management skills in med school (maybe they do now, but 6 years ago they did not for me). If you are a medical student - be ready to have an army of coping skills in your back pocket for stress, because this will be the most stressful job you will ever have, and it won't stop until you quit, retire or die, whatever comes first. It.Does.Not.Get.Better.After.Residency - don't buy in to that bullshit statement they feed you.

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Bureaucracy. American doctors, you are not alone!! I always read about my American counterparts complaining of haggling with insurance companies - guys, try fighting your own government! I am going to give a scenario of bureaucracy in Canada: I was working in a government-facility/center that does urgent care in the evenings and family medicine clinic during the day. It has access to IVs, a crash cart and nursing staff during all opening hours, but no "urgent care" is supposed to be provided during the day/family medicine hours. One day, a woman brought in her friend in the middle of the day, saying she had a fever and wasn't well. In fact, when I saw the patient, she was barely conscious, and her vital signs were extremely concerning. I called for a "code" given her condition and we brought in the crash cart, started IV fluids & medications and called for paramedics. She eventually went to ICU for septic shock but survived. The next day, I was dragged into a meeting with management of the clinic where I was actually shredded by the director for using crash cart supplies and nursing staff outside of urgent care hours. When I asked what else I was supposed to do when I saw a very sick patient and we had access to something that could prolong her life, the director said "You should have just called 911 and waited. We have a mandate that no urgent care nursing staff or supplies are to be used during family clinic hours, and you knew this but you disregarded the rules anyway." I was essentially put on 'probation' after this, and I left the job less than a couple months later. Sounds crazy right? Isn't our job to help the sick to the best of our abilities? I wish this was an isolated incident but it's not. The Canadian provincial health authorities are incredibly good at making this job so overwhelming with bureaucracy. I have had them withhold thousands of dollars from me for over 6 months simply because they fired so many people in the billing department that they couldn't find my contract anymore. I was told I wasn't allowed to continue working in an ER department that I had been working in for 2.5 years because I had moved out of town, despite the fact that I offered to stay in-house at the hospital for my entire shift and they were short physician coverage for the ER. I have attended meetings where I have begged for changing things for patient safety, such as using automated medication lists instead of handwritten ones, and I was told they didn't want to spend money on the toner/ink or giving nursing the extra task to print out something for the chart. I could go on and on and on. If you're a Canadian, don't kid yourself, there are people actively working within your local health authority to try to reduce costs at the expense of your health, and doctors can't do much to stop them.

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Bullying. I wanted to separate this from the bureaucracy, even though that is also a form of bullying. When I say 'bullying', I mean from other doctors. This happens in particular to junior doctors like myself. Senior, jaded doctors who are simply looking for a way to make enough money to retire faster especially like to single out the ambitious, naive and well-meaning junior doctors. I was one of those, I'm now just jaded and depressed lol. But I spent 3 years having the life sucked out of me by a former mentors and other doctors immediately after residency. Statements that I heard for example:

"You shouldn't quit doing 24 hr solo ER shifts. You need to work longer hours, otherwise you will lose your skills."Translation: if you work longer ER shifts, I won't have to do those shifts, so do it anyway even if it risks patient safety.

"You should take on more patients. I know you work part time, but it looks bad if you don't take on more people."Translation: I want you to take on more people so that we can make more money off you for overhead, even though you have the shortest wait times in the clinic and you frequently see my patients when I am too busy for weeks.

"Wow, what an interesting diagnosis! And you figured that out as her family doctor?"Translation: I am a specialist and I am better than you, I'm not even hiding it.

"It must be so difficult to be a female doctor and a mom. You can only really be good at one of those things. And I don't think you're being a very good doctor"No translation needed. And when I brought this to my medical director as a formal complaint against the doctor, they told me that I wouldn't win because I was a young female doctor going up against a senior male doctor with no recorded proof of the conversation. They closed my case immediately without even talking to him. (Edit: also ironically, I don't have kids, he just assumed I did because I was a woman working part time - when actually I was commuting an 1.5hr twice daily to provide care for a underserved rural community so I couldn't do full time)

I have seen many specialists blame family doctors for anything and everything, and even dictate it in to their reports. I have seen senior family doctors throw their most difficult patients on the junior doctors, and then laugh when the junior doctor complains that they are lost and frustrated with the patient. I have seen doctors team up and actively try to sabotage the work of other doctors, simply because they don't like the person. We gossip ALL THE TIME, it's like a chicken coop of hens pecking at each other endlessly. Camaraderie is something we advertise but don't actually practice.

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Entitlement. If you have gotten this far, and you are not a doctor, well done. This is for you, as a patient. Doctors are not Starbucks baristas. Patients come in so often demanding pills, then refuse to take medication when we want to give them something. They fight us on diagnoses we make because it doesn't match their Google search, and yet when we don't know what's wrong with them, they call us incompetent. We recommend alternate therapies other than medication, like physiotherapy, counselling or dietician support, and then they fail to show up to those appointments we arrange with other healthcare professionals and ask for more pills. Then at the end of it all, we get told we are lining the pockets of Big Pharma and we are poisoning everyone with vaccines. It is madness. And I hate it. Where did this come from? Our age of entitlement. About 15 years ago, well-meaning physicians said "This system is too patriarchal. We need to bring patients in to the fold and make them part of their own healthcare team. We will call this patient-centered care". So in medical school, you are constantly fed the line "The patient is the center of the team. You must ensure that you come to a mutually agreed upon diagnosis and plan with the patient. You must ask them their feelings and thoughts about every step of diagnosis to treatment. You must ask them what they think is the cause of their concern. You must always make sure the patient is the leader of the team." This has swung medicine from a physician-dominated patriarchal field to the far extreme of the customer service field that is no different from your local Aritzia clothing store. We are only here to serve the patient's wishes now, and if we don't, they are given multiple avenues through complaint departments or social media to destroy us professionally. Did you know that the majority of regulatory colleges in Canada do not have a single department or place for doctors to report concerning patient behaviour? We do not have an ombudsperson or a neutral individual to air our grievances over anything - from patients to fellow doctors, we have no where to report anonymously. If I have a patient who is aggressive, or even violent, I can't report it to the college or even "flag" the patient for future doctors. We are simply told to grin and bear it, because that was the fine text in the Hippocratic oath that we missed.

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If you read all that, thank you. You may be the only person who has heard all that other than my spouse (that poor guy right?). If this was your job everyday, would you stay? All the money in the world can't make a person happy, and the compensation for being a Family Doctor is sort of sad compared to what we pay in income tax, overhead and personal sacrifice. I am depressed. I have Generalized Anxiety Disorder. I have a borderline eating disorder and body dysmorphia. I have considered suicide, although never had a plan or would act on it because I do love my spouse and friends too much to do that to them. I can't take anti-depressants or counselling ironically because my spouse lost his job and his benefits that I was under, so I don't have a drug plan to cover my medications or counselling. (Fun fact: Doctors have no guaranteed benefits in any province of Canada - no drug coverage plan, no dental/vision/physio/counselling coverage, no life or disability insurance, no pension, no EI, no maternity leave. We must pay other organizations/companies to get any of those things). I have gone to the free counselling offered by my college and they all just tell me to build "thicker skin", and then beg me not to quit. The best irony of all? I'm the doctor who refuses to buy into Big Pharma, so I don't have any samples of anti-depressants that I could steal from my own clinic while I wait for my spouse to get a new job with benefits. So. Damned. Ironic.

So I am likely going to leave the profession. My plan is to build up the biggest nest egg I can collect in the next year or so while contemplating my next career move. People tell me "Do what you're passionate about" - guys, I have no passions anymore, I'm sort of dead inside with depression, so please don't tell me that. If you are a doctor in Canada, please let me know what you did if you left or know someone who left.

If you think you can identify me from any of the above, please do not post anything publicly, you can direct message me. I will delete this post entirely if people ask me where I am from or where I work.

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Thanks for reading.