Leaving Medical Residency

Chelsea Turgeon quit residency to become a career transformation coach

Dr. Frances Hardin: Welcome to this week’s episode of Promising Young Surgeon. This week, Chelsea Turgeon joins us to discuss her epic life, including her decision to leave, her residency training, how she arrived at that decision, and what she’s done to create her dream life since then. Chelsea Turgeon is a career transformation coach, six figure CEO, best selling author, and full time digital Nomad of four years, she is a residency training dropout with a lengthy track record of academic excellence and achievement through medical school. She graduated at the top of her class and matched into her top choice, OB GYN residency. She was in the middle of her second year of OB GYN residency when she made the decision to quit residency and strike out on her own. Now she travels the world as a digital nomad, entrepreneur and podcaster. Thank you so much for joining us today, Chelsea.

Chelsea Turgeon: Thank you for having me.

I think residency is pretty challenging and just difficult for everyone

Dr. Frances Hardin: Well, I’d really love to start with talking a little bit about what residency was like for you, what your training experience was like, and what led to ultimately the decision to leave.

Chelsea Turgeon: Yeah, yeah, absolutely. So for me, and I don’t think I’m alone in this residency was hard. I think residency is pretty challenging and just difficult for everyone. but it’s one of those things that. It’s a level of hard that you really need your why? You need a reason why you’re doing it to keep going. I’ve had this recently with, like, hiking. I was hiking this mountain. It was like 13,000ft up. And we left at midnight. We were doing a hike starting at midnight. We were trying to get there for sunrise. And partway through the hike, I was like, I don’t want to keep doing this. I wanted to quit tired. The altitude was starting to get to me. And the only reason I kept going was because we had this intention setting ceremony before we left where we all came up with our why. And my friends were reminding me of that. And so it’s one of those things where unless you have this really solid grounding in why you’re doing this, it’s hard to keep going. And so for me, in the middle of residency, and I’ll just go back to, like, the things that were hard for me. One sleep deprivation, I think that’s hard for everybody. And I don’t know if that’s something that. Yeah, I think that’s just a hard for me that I’ve realized now I’m not willing to really compromise on, other parts that were hard. Just, like, not enough time to see your patients, to get all the notes done. Just feeling like, I was constantly in a rush, just sort of that time frenetic ness was really hard. just the sheer amount of information you had to learn, the life or death decisions, all of those pieces that are pretty hard for everybody. But then for me, as I’m, going through this, and as I keep coming back to, like, why am I doing this? Like, why am I waking up every day and putting myself through this? I’m just, like, coming up short over and over again, and I can’t connect to why I’m doing this. And so that’s when I, like, I ended up taking five weeks off. I was really doing my soul searching, really connecting to, like, what? Like, what is the purpose of me doing this here? And the why that? Yeah, go ahead.

Dr. Frances Hardin: Well, no, I really love that, and I definitely want to get more into the five weeks, so, yeah, I totally get what you’re saying. And I think that I definitely identify with. I think most people recognize the difference between spending a lot of time, blood, guts, and tears on something that they love or feel passionate about or feel truly called to do, as opposed to something that they are doing because it is their job. And I definitely notice anecdotally that some of my co residents who dreamt of being a head and neck surgeon since the age of four, which, I mean, that’s pretty niche, I don’t know who they were talking to that, like, they got it planted in their head.

Chelsea Turgeon: They’re like, okay, I gotta be.

Dr. Frances Hardin: A head and neck surgeon. Very specific dream, but having, you know, trained under the same conditions that I did and kind of receiving the same, if not worse, abuse, they just took it really very well in stride and as part of the bigger picture, because they were like, again, this has been the dream since four, so you can do whatever you want to me. And I guess that the reason that this all links up to the bigger picture, though, is that the reality is if we only have surgeons who feel that way, there’s just not going to be enough surgeons. And so, like, I obviously feel very strongly that this should be a job and a workplace that will also accommodate, like, a young, bright person who’s hardworking, who cares a lot, but it may not be, you know, their. Their deepest calling, because otherwise we’re losing so many, like, potential phenomenal physicians and surgeons.

Chelsea Turgeon: That’s such a good point that, like, you can see how for some people, they can withstand all of the, I’m gonna say, the nonsense that comes along with training because. Because it is so deeply their calling. But then that doesn’t. It doesn’t need to be such an intense screening process that those are the only people who survive it.

Dr. Frances Hardin: Right. We just already are in a doctor shortage, so, you know, that’s. I think that that’s too limiting.

You took five weeks off to explore what you might do after residency

But, in terms of those five weeks that you took off, what was that conversation like where you ended up at that decision with your PD jointly and then. Yes. How did you spend that time? In a smart way that was very constructive for you?

Chelsea Turgeon: Yeah. So I’ll just go a little bit back before I even get to the five weeks because there was just a lot of things leading up to it as well. So I had my first inkling that I really did not want to continue this in residency was during November of my intern year. And I remember meeting with my chief resident at that point, telling her, like, I really don’t want to continue this. I don’t think this is right for me. And as you probably know, in medicine, it’s a lot harder to quit than it is to get started in the first place, that people really don’t want you to leave, which is fine. Like, you don’t want to leave on a. You don’t want to just leave at the first moment you feel like you want to, because you do want to be sure about it. I get that. And so during this conversation with my chief resident, we really came to the conclusion that I’m going to give it my best shot, stay in it for a bit longer, and then reevaluate. And so I was doing that through, all of intern year, and I got to the end of intern year, and I was doing a lot better, just skills wise, confidence wise, getting better feedback from my attendings, and just at a place where I felt like I was like, okay, I got the hang of this, and I still didn’t want to do it. I had. My first rotation of second year was with, it’s like, in the community, it was like, it’s outpatient. So we got to do these electives second year, and mine happened to be the very first rotation. And during that time, it’s like, you get to start exploring what you think you might want to do after residency. And for me, I was very disillusioned with the idea of fellowship or continuing in the academic world, and so I was like, the only thing I could see myself doing is sort of like, community based outpatient. I’m, not all outpatient because people are laboring, just sort of a community based type practice. And so I go out into the community, and I’m practicing with people, and for some reason, it was even worse. Like, it was even worse to me than academia. I think, a lot of the people that I was working with, it just felt like nobody had fulfillment or satisfaction. It’s like, you could tell people chose that route because they were disillusioned with academia. But it was sort of. I don’t know, it was just like, this consolation prize that people were not jazzed up about anything. It was just a very dead, inside kind of a place. And I went to multiple places and locations, and so I just got to this point where I was like, okay, I would not be doing this, and I would not be. I’ve already eliminated everything else. And so I hit this point at the very beginning of second year where I was like, I do not see myself being fulfilled in any of these scenarios after residency. And so then comes the question, like, then why would I keep going in residency, right? So I met again with my program director, this time chief resident and program director, to say, like, I really don’t think I want to continue. But I had these two really difficult rotations coming up. It was, ob nights and guy nk, and for some reason, I was talked into, like, just get through those and then see how you feel. Which, looking back, it’s like, that doesn’t really make sense. Why would doing harder things make me want to do it more? But, anyway, so I was going through those rotations, and by the end of gain onk, it was like, I think it was like, eight or nine weeks of those two back to back. By the end of gain onk, I was just like a complete zombie, dead inside. My program director messaged me, like, the very last day of gain onk, and was like, we need to meet. And during that meeting, I think people had probably noticed I wasn’t feeling well or doing well. And she was telling me, like, people are starting to notice. So what do you want to do? Like, I don’t want you to shoot yourself in the foot. If you do decide you want to continue, I want you to continue with full enthusiasm. And so what do you feel like you need? Do you want to take this next rotation off? And to me, that felt like the biggest gift. So when she initially said that to me, I felt this huge relief, this huge sense of, like, oh, my God, I can just take five weeks off. And I agreed very excitedly. But then, literally, the moment after I agreed, then I just felt this deep, like, shame and failure and this sense of, like, I shouldn’t need this. I shouldn’t need to take five weeks off. I should be able to just keep going. So it was this really interesting experience of, like, this is what I wanted, but I shouldn’t. Yeah.

Dr. Frances Hardin: And I think that that is so tough for all of us because it’s almost like an identity death. Like, you were a machine. You were a high achieving, very academic minded, academically excelling person. And so I totally agree with you. And I think that it makes a lot of people afraid to even consider something else because this is so tied up in their identity. Like, most people, that would be a whole other trigger for an existential crisis to have an identity death like that.

Chelsea Turgeon: Yeah. Yeah. And so I still, like, it wasn’t enough shame or whatever for me to, like, not want to take the leave. Like, I knew I needed it, and so I still, like, agree, but it was just this interesting feeling of, like, oh, I feel like a failure. And I remember I had not, like, I had a box of my stuff. I don’t know what I was bringing, but I just remember, like, going home that day knowing, like, I’m not coming back for five more weeks, and I was, like, carrying some of my stuff with me that I wanted to not leave at the hospital. And I’m, like, going it down in the elevator and being like, I’m a failure. Like, I failed. And it was just, like, a really hard first couple days because that was my initial, like, pain point that I had to work through before I was able to just start coming back to, like, myself and what I really wanted.

Dr. Frances Hardin: And I think that it’s scary because you are a person who is, like, pretty in tune with themselves. You know, you’d been in tune with yourself prior to training, things like that, having done, like, a lot of the self work. And so you even felt some of that shame, even with your logical mind, you know, saying, oh, there’s nothing to be ashamed of. If this were my friend, I’d be, like, reassuring them, you know, you’re all good from outside looking in, but I guess what would you say to the regular trainee who does have an experience that brings them to that point, that first pain point of, like, the shame, or I gave up or not. just, I gave up. But, like, most trainees will feel this even if they, like, ask for one mental health day or something like that, if they’re like, I’m at a breaking point. Like, I’ve been in the hospital for 40 hours. So, like, can I please step out or go home or whatever the request may be. I think that puts them there as well.

Chelsea Turgeon: Yeah, our brain is not that reliable in general, especially in situations like this and especially in relation to ourselves. Like, our brain is not. Unless you’ve done a lot of self work and self compassion work and all of that. It’s like our brain is, we tend to be much harsher to ourselves than to anyone else and then harsher towards ourselves than other people are to us. And so I would say, like, just don’t trust your brain initially and see if you can find somebody who is really compassionate and who will give you that sense of unconditional love and compassion. Ideally someone not in the medical field, unless you know for sure that the person in the medical field is full of self compassion or, like, full of compassion. But I think just finding somebody who you can share those feelings with, maybe a therapist if you have one, or maybe just like a friend or family member that you love, like, outside of medicine, and just letting them know how you’re feeling and what you’re going through and just asking them, like, can you just say something really nice to me or compassionate? Because it’s, like, hard to practice it on ourselves initially, and I think it helps to come from someone else. Yes.

Dr. Frances Hardin: that’s so funny because it reminds me of this old quote, I think, from, like, whitney Cummings. And the quote is, like, your reptilian brain is trying to kill you. You know, like, none of us were evolved for this. We definitely were not evolved for residency training. Like, sorry, no offense, we were not made to be residents. And so, of course, a lot of those, negative loops and chemical experiences that we have when we’re, like, constantly sleep deprived, maybe emotionally activated because of the events at work, things like that. Sure. It just.

You decided on medical school after five weeks of journaling

It gets you so dysregulated. So after the first pain point, after those first couple days, into the five weeks, then what did the remainder of the time look like?

Chelsea Turgeon: Yeah. So I’m still really proud of myself for the way I approached that time. When I look back, at it, it’s like, how did I know how to do all of that? I’m not sure, but I feel like I approached it in the exact correct way for what I needed. And so what I did was I just wrote out in my journal exactly what my intentions were for those five weeks. So initially, I was feeling overwhelmed because I was like, I have to figure out my whole life. And that’s really scary. Right? So what an overwhelming idea to figure out your whole life in five weeks. I decided through my journaling to narrow it down to a binary question, like, do I want to be a doctor, yes or no? It wasn’t even, do I want to keep going with ob Gyn? Do I want to keep going? Going in this particular program, because I think where we start to get, we get muddled and confused and overwhelmed. I’ve worked through this with clients, too, is when they’re trying to answer 100 different questions at once. And, because you don’t have clarity on one, you can’t answer the other. And this is contingent on that. And so I was just like, no contingencies. No. If this, then that just, do I want to be a doctor, yes or no?

Dr. Frances Hardin: And what I really liked about your story, you know, just, of course, sharing a little bit of background context. But when we really go granularly and talk about even your medical experience, medical school experience, and then the decision to go to medical school, like you have talked about, you know, as part of your story, just how even the decision to go to medical school was in part because you were academically excellent. And, of course, like, people are always impressed when they meet a promising young woman, and she’s like, I’m going to go to medical school. I’m going to become a doctor. People are hype. They love that. And so it does make it harder for one to even know what they truly want. As opposed to what maybe family, friends say, like, peer pressure, societal pressure to succeed.

Chelsea Turgeon: Yeah, yeah, exactly. And so I had been listening to external voices for so long around the topic of career without totally realizing that’s what I was doing. but what I wanted to do is just dial it down to, like, how do I want to contribute to the world? And is being a doctor the best way for me to do that? And, it is a binary question, but it’s still a huge question. Right? So I don’t want to downplay the fact that that’s still difficult and that’s hard to answer. And the thing is, I don’t think I really answered it through my brain. I did not answer it through a pro con list. I answered it by going on walks in nature and by journaling and by connecting to myself through meditation and yoga and by not having conversations with anyone else in my life about the big elephant in the room. M like, what am I going to do? So it’s not that I isolated myself entirely, but I just put up a boundary at that point that I was not going to ask for anyone else’s advice or opinion or feedback on what I was going to do. And it was really going to come from within. And that was. It took a while, right? It took like, the first two weeks, I was just sleeping a lot, and I didn’t feel like I had a lot of clarity. The week three, I went on a hiking trip to Utah, and that’s when I started to feel a little bit more clear. And then week four was when it really hit me that I didn’t want to go back. part of that was I really, I was able to drill down to, like, how do I want to contribute to the world? And what I was writing at that point was like, I want to help people live healthier and happier lives. And then I was kind of having a conversation with myself in the journal. And so I was like, well, is medicine the only way to do that? I was like, it can’t be. And then I was like, well, do I feel like I’m living a healthier, happier life in medicine? And I was like, no, I don’t. And so it’s like this series of kind of self questioning really brought me to this place of, like, this actually doesn’t feel like an aligned career path for me.

Dr. Frances Hardin: If you could go back, would you go to medical school again?

Chelsea Turgeon: I think the easy answer is no, because I see that being a doctor was never going to be right for me. But I do actually love my journey. I love that I did it only to. The, other reason I think it’s good that I did is because I’m very stubborn and I wouldn’t be told otherwise.

Dr. Frances Hardin: I know. Oh, my gosh. Well, obviously, you know, I think. I think we’re cut from the same clause because I totally, I mean, in my twenties, you could not tell me anything. Honestly, before my twenties, you could not tell me anything. I’m in m, I’m m in my early thirties now, and I might listen, you know, like, I might. I’m definitely, like, It’s either, okay, I’m gonna listen a little bit or I’m gonna die. So now you can tell me some stuff. But it’s so funny because that’s even the same thing that I was told in my early twenties. If you can be anything else, if you can picture yourself doing anything else or having a great skill set suited for anything else, don’t become a surgeon. And of, course I was like, it wasn’t that I couldn’t see myself doing anything else. It was just literally that I saw that as, like a direct challenge.

Chelsea Turgeon: Yeah. I feel the other, the other part of that is like, yes, it was a direct challenge and I watch me like, I’m that kind of person, so I get that. But the other thing that I think was really good about why I went, the fact that I went to HM med school, is I almost needed to get to this point where I achieved everything I thought I could have wanted, checked all the boxes of what could impress people, the prestige I needed to do it all, to see that, like, that wasn’t the answer. And if I hadn’t done it all and done it quickly and sort of peaked at like 27, you know, like, in the eyes of society, then I think I would still be chasing the wrong type of validation. so like, I am glad that I did it and I checked those boxes and had that experience of like, okay, so this is not the answer because I feel really empty and now I need to figure out what will fulfill me on the inside.

Dr. Frances Hardin: And not only that, but I think that what’s been so cool, like, with your business and with the work that you do, I mean, of course, I understand that you work with a ton of healthcare professionals and so, yes, your experience as a physician, going through the medical training system and becoming a physician like that is integral. Cause how could you best serve like that type of population without your own experience? So I definitely love that. And I love how it feels like by the end of one’s twenties it is possible to kind of look back. That’s the first time that I ever, ever looked back and loved the journey or like had anything nice to say about the journey, but it, it took that much time. And like the wisdom that comes with age to get to the back end of your twenties, which I understand that you’re at as well.

Your program director knew by week four that you weren’t coming back

And I want to talk about travel a little bit and, you know, the big 30. So you knew by week four, four to five then. And so how did that go when you went back to meet with your program director?

Chelsea Turgeon: Yeah, so the funny thing is she was, we were texting like throughout the thing. She would basically text me once a week and be like, so how’s it going? And then finally on like week four, we were doing a phone call. And the funny thing is I never even said it specifically, but she really inferred and it was really nice. So I told her, like, I’m not excited about the idea of coming back. And she was, she just sort of took that right away and was like, okay, she’s not coming back. She’s turning in her resignation. So then she kind of got the ball rolling for me to start doing that, which was nice, because it’s a hard thing to say out loud.

Dr. Frances Hardin: Yeah, that is really classy that she didn’t make you say it.

Chelsea Turgeon: Yeah. But then, I mean, I did have to say it to, like, all my friends and family members and all of that, but, But with my program director, I just, you know, we were already in conversation, so end of week four, she kind of knew that I wasn’t going to be coming back. I went in and, like, had to sign some papers and turn stuff in. And then they created this plan for me that I was sort of, like, negotiating. I was like, okay, well, I don’t need to leave right now, but I want to be leaving in the next three months. And I still didn’t have things totally planned out, what I was going to do, but I was like, if I have about three months, I’m gonna figure it out. And I was like, but it’d be nice to have a paycheck for those three months. So I sort of negotiated, like, these are the things I’d be willing to do. These are the things I’d rather not do. And so they basically got me covering clinic for all the other residents, while the other residents were kind of covering me in the hospital setting. And so I was kind of doing that. And then I did have to do a full antepartum rotation for about six weeks as well, the very end of my time. And I did normal, like, covered normal call during the holidays because it was like December time when I was doing all of this. So we kind of created that. I had three months to really get all my other stuff together, and I still had to show up every day at the hospital with my co residents who are not thrilled with me. And that was a difficult time because I felt really alone. But I also started, to feel excited. Cause I was making all my other plans on the side of what was next.

Dr. Frances Hardin: Yeah, like, the light at the end of the tunnel was there. But I’m sorry. Cause I can only imagine, you know, of course, being a resident is really tough. So I can imagine what co residents would respond like to just know that their schedule is maybe about to become more tenuous. And not only that, but, like, maybe see somebody live out their dreams and escape the hospital. That’s like the ultimate fantasy. Like, that would be. That would be hard to watch somebody escape when you are in the dredges of it. But I still hope that people, you know, were generally kind and understanding about it. But I’m not obviously gonna hold my breath for stuff like that. Cause you have the right mindset. By just being, like, I had my plan in motion. I stayed professional. I fulfilled my professional duties. Yeah, no worries either way.

Chelsea Turgeon: Yeah. Like, I definitely, like, I do not talk to any of my co residents anymore. Like, at all. Like, it was, like, there are. I don’t want to pretend like, everything’s sunshine and rainbows when you quit. Like, there’s decisions and sacrifices and things that you have to decide to be okay with. And probably half of them were, like, actually angry with me, and then the other half was, like, neutral and they kind of understood, but they still didn’t really want to hang out with me outside of, you know, going to work. And, as you probably know, like, in residency, your co residents are, like, your best friends. And so I really did, like, lose my social circle for about three months. And it’s just a part of it, I think even in the. In the moment when it sucked and felt awful, I knew, like, it’s okay. Like, I’m gonna find other friends at some point in life. Like, I’m not gonna be a friendless loser forever. And so it’s just one of those things that you have to be okay with some people not being thrilled with you when you’re following your own path.

Dr. Frances Hardin: Yeah. And, you know, to represent both sides of the spectrum, though, that’s still pretty good that you were friends with them beforehand, because I will say, yes, I definitely do still keep in touch with a couple residents. definitely, there’s a handful of just solely female surgeons, I guess, but I keep in touch with them, and a couple are very close friends. So I agree to that extent. But I will say that, in my personal training experience, m it’s much more the type of thing where I just think, oh, like, mostly they terrorized me. Like, we had a run of senior residents who were really huge bullies. Like, just absolutely drunk with power, lording it over the junior residence. Just really very, very horrible to work with. And so, of course, you could have an experience like mine or you could have an experience like yours where at least, I mean, there was some basis of friendship. But I understand what you mean because you always have. You pay for it one way or the other. I’m very. You picked freedom, and you know how much I respect you and the decisions that you made.

One thing that I think of when you were talking about med school is conditional happiness

One thing that I think of when you were talking about your journey, especially med school, reaching the top of the mountain, getting your top choice residency program, it’s that whole, like, conditional happiness, the destination fallacy, you know, when I x, y, z, I’ll be happy. And it’s so easy because you get on the conveyor belt. Most people do in their teens, if not at age four, like, you know, some of my colleagues. But in your teens, you get on, and then you’re like, okay, if I get into a great, medical school, I’ll be happy. But that lasts for 1 minute. Then you get into medical school, and you need to start worrying about matching into residency. And then you’re like, if I just graduate residency, attending life will be great. But, of course, this is called a fallacy for a reason, you know? And it really is very oppositional to contentment and, like, peace in one’s daily life. And so it is troubling to think of how many doctors do give up, like, a decade of peace and contentment. Sure, there might be the rare, very Zen person who’s able to, like, marry the two, and they can be in this grinder, the meat grinder, and also have contentment and, like, really love the journey the whole time, but I have, I have not met that person yet. And so we just put off and put off.

Chelsea Turgeon: Yeah, it’s so hard, that idea. And I think it’s not just doctors who do it. It’s, like, literally all of society. And so it doesn’t feel like it’s incorrect. It feels like we are, like we’re pursuing life correctly, that we just need all these circumstances to happen, and then we’ll feel better. And people do it with their own appearance. Like, if I lose weight, then I’ll be happy. If I have a partner, then I’ll be happy. And we just do it so pervasively that it’s really hard to recognize or notice, especially. Probably most of our parents have grown up like that. And just everywhere you look, there’s examples of, like, in a capitalistic society in general, it’s like, if you have this next thing or achieve this next thing, you’ll be happy. But then I think what makes it really dangerous in medicine is the things are so far away and so long that, like, then, it’s harder to find out soon enough that it’s not really gonna work out the way you think. Like, you know, because our training is such. It takes such a large portion of our lives that it’s easy to keep that mindset for, like, 10, 12, 15 years, basically. Whereas other people, maybe they get their reality checks sooner.

Dr. Frances Hardin: Yeah, totally. Doctors are just the masters of delayed gratification, for sure. I mean, and especially the people who stay in academics and things like that. But, you know, it rings true how even in your residency experience, really, like, a year before you left, you were like, hey, guys, what’s up? I’m having some thoughts. I’m having some dark thoughts. Like, you know, what? What’s up? And they. They were like, give it a year. And, I mean, I myself have been told things like that. Okay, well, it’ll be different at the next stage of training, and it has not been different yet, you know?

Chelsea Turgeon: yeah. Yeah. So I want to just. Can I say something about that quickly, too, of, like, I. Like, I understand where people are coming from when they’re trying to give you that advice. But what I think for me now, like, if I were to work with younger students or mentor them, like, I think the biggest thing that’s missing is reflecting, like, deferring everyone back to their own experience to make their decisions. And I think that’s the biggest problem, is nobody is not nobody, but for the most part, people are not, like, really checking in with, like, what is it that you’re feeling? Like, you be the judge of your own experience. What is it for you that’s making it difficult? They’re kind of brushing it off with these blanket statements around, like, it’ll be better at this point. It’ll be better at that point without really allowing each person to be their own individual, like, decider of their experience. And I feel like that’s where it gets to be the most dangerous, because maybe it is true. Like, for me, it really was true. I needed to wait a, year to really feel confident and comfortable in my decision. That was true. But for some people, it’s not. Some people really know right away. And so I think that’s just what’s missing is the honoring of your own experience in making these decisions.

Of course, a lot of residents feel trapped. But there are two common reasons they cannot leave

Dr. Frances Hardin: Of course, a lot of residents feel trapped. Even if there are, like, little alarm bells going off. We become excellent at ignoring those sensations, thoughts, what have you. But, you know, one of the most commonly cited reasons, I guess there’s really two commonly cited reasons that I can think of why a resident would be, like, I cannot leave. Number one reason would just be, like, straight up embarrassment. You know, the shame component. Like, they just will not admit, even though, like, nobody’s thinking about you. You know, this is your own life, and life is too short. But, you know, of course, all these different, thought distortions we have. And so the shame component. But then number two, of course, the financial component, because I even trained with residents who would be like, wow, this is, like, some bullshit, but, I am $200,000 in debt, and so I cannot leave. And they just kind of mutter about that and go about their day miserably. But what advice would you have for people who maybe are hearing those little warning bells and ways to think about those two common roadblocks differently?

Chelsea Turgeon: Yeah. Yeah. I love that.

A lot of us have very narrow social circles and very narrow worlds

Okay, so let’s do the shame component first, because it’s so real and so true. Like, that was, for me, a big thing for a while is, like, what would people think about me? Because for so long, I’ve been pursuing this path kind of for other people’s feedback and for other people to be impressed. I wouldn’t have really admitted that to myself at the time, but that was a huge driver is. I really lived for that. Like, the atta girl or the, like, oh, people are impressed with me when I say that I’m a doctor. And, it really did bolster my ego in a very temporary way, but that was real. So what happens if that’s what you’re struggling with? Our world in. In the medical field is really narrow and small. So, a lot of times, the only people you’re following on Instagram are in medicine. The only people you hang out with outside of work are in medicine. It’s not true for everyone, but I think a lot of us have very narrow social circles and very narrow worlds. And so if you’re in a social circle where, like, the only thing you know is this one level of success, this one type of success, of course it’s going to feel like if you’re not following that path, that you won’t be successful. So I would say, like, broaden your horizons. Like, open up your world. See if you can even just start following people on Instagram who have nothing to do with medicine, I think that really helps. I had one of my clients, so I was like, you literally have to unfollow everyone in the medical field on your Instagram for, like, at least during match week, but, like, really all the time. so just starting. Because for every. For everything that induces, like, shame in one social circle or one culture, there’s other cultures where, like, people are proud of that one thing, right? So it’s all just this relative association. And, like, I can see that now as I travel, as I interact with people in different countries and in different professions. Like, everyone values different things, but you’re just in a society right now that really values. Not sleeping, prestige, powering through. And so, like. But what could happen if you were in a society that valued something different? And the cool thing is that, is that we live in a world where we have access to the Internet, where you can tap into all these different micro communities and places that value other things. So can you start. Can you start trying to find those types of communities? Maybe it’s like a sports thing that you’re pursuing on the side, or, like a church group or religious something. Can you just start to find other communities that have different value systems, so that you don’t feel like your whole world is this one area that only values this one thing? Yes.

Dr. Frances Hardin: And that. I love that so much, because that even happened to me when I went and did my ent residency training at a program that was not prestigious. you know, I had insecurities. I remember asking my then boyfriend, you know, now husband, about it, and I was like, you know, people are gonna judge me. They’re gonna look at me, you know, differently and. And this and that. And he was like, and here’s the great thing about the fact that he is not in medicine. He does bring that perspective, like, very much into my life, into our home, of a person who has a lot more appreciation for things that are not just in the narrow, very narrow, academically defined regions of success. He was like, what are you talking about? He’s like, you’re a doctor, and you’re an ent. And I was like, oh, but, you know, like, is your, Is your family gonna think worse of me? And, like, you know, maybe your friends will judge me. He was like, come on. Like, grow up, my friend. My friends are amazed that you’re a doctor. They have no idea what ent is. You know, already, like, being a surgeon, being a doctor of any kind is, like, a great feat. And the point is that the. In the real world, people don’t even differentiate. He was like, okay, how many people do you think could look down on you? I was like, anybody? I was like, maybe neurosurgeons, maybe the whole rest of the ents. I was like, I mean, cardiothoracics, they could absolutely. Like, they could roast me. They’d be like, well, she’s. She’s here in the food chain of the hospital. And again, he’s like, what is that? Like, a couple hundred people? Like, truly, we need to open our eye.

Chelsea Turgeon: But.

Dr. Frances Hardin: And that’s the thing, is, I even was there many years ago, you know, that’s, like, eight, seven years ago now. But I love all of your concrete advice, and I definitely would just echo to people. Yes. Like, that made my life immediately better to get some much needed non medical, outside human perspective. And then not only that, but it just allowed me to almost break the fourth wall and see beyond academics and academic achievement. Right. Like, I am m absolutely not, trying to really impress, like, yeah, those couple hundred ents who could look down on me. I’m like, what’s up, guys? I’m chilling, you know? And I really have enjoyed feeling free of that pressure.

Chelsea Turgeon: Yeah. And it’s like if you’re, if you’re trying to operate your life based on a ranking system and based on just excelling in any ranking system, there’s always going to be a way that your on the bottom, then there’s always going to be a, like, there’s always going to be a way for you to not be enough or not feel enough. And so it’s like, that was a huge thing that I started doing is I was listening to these podcasts. they’re like spiritual type personal growth podcasts. And it was about like, the ranking and how we live our lives in such a ranking system. And like, how can we stop doing that? Like, how can we just stop seeing everything as better than or less than even in dating? We’ll talk about, like, to make our friend feel better with a guy. Oh, you were way too good for him, you know? So we’re ranking instead of just saying, like, you guys were not a fit, you were not a match. Right. And so we just do this in so many areas of our life where there’s better than and less than and, you know, cooler than and lame and like, can we just, like, not do that? Can we notice when we’re doing that and just be like, I wonder, like, what it would feel like to just be who we are and to not feel like we have to always measure up to each other.

Dr. Frances Hardin: That reminds me of the courage to be disliked because I loved their approach to all relationships. Just the thought that relationships and how you approach them as a person, either you believe that relationships are vertical, hierarchical, like what you’re talking about, or they are horizontal where, you know, we all, yes, we exist, you know, on this horizontal plane. And yes, we can maybe be fits or not that that’s a whole other thing.

Book argues that work should be horizontal across the board rather than hierarchical

But what I really loved about it, because I started to think, I bet I know a lot of people who would argue that work should be vertical, work should be hierarchical hierarchies. King, like, love that at work. But then they would say something like, maybe outside of work. Sure. Horizontal relationships. But the book argues that there is no such thing as a mix of the two. You are either a person who truly believes that they’re vertical across the board, or you believe that they’re horizontal across the board. And I definitely. I loved that. And I believe horizontal across the board, which is why I don’t love the extreme hierarchy and vertical approach that people take to medicine.

Chelsea Turgeon: I love that. I think that’s so true because it’s hard to turn on or off. It’s like, oh, I feel horizontal in this setting, but vertical, and it’s like, that’s. Yeah, I think that’s such a. Yeah, I’m interested to read that because I think that’s the vertical is the ranking system, and nobody really wins in that because you’re always just trying to win, trying to get to the highest. but, yeah, horizontal. That feels like the way to go.

Dr. Frances Hardin: Yeah. And I will make a plug for, on rethinking residency. Doctor Lathan does this hidden curriculum whole segment, and I loved her recent piece. is about specialty disrespect, and I love it. Like, she’s med peed, she’s faculty, she works with residents. Like, a really brilliant person who writes on all these topics. But, like, I love that. And I agree. Right. Like, why are people nagging on em? Things like that, you know? Of course, the more specialty disrespect is allowed and, like, encouraged with the next trainees, the sicker that the culture of medicine becomes. And so I really loved her piece, and, you know, it’s about maybe a more vertical approach to those.

Chelsea Turgeon: Yeah.

Dr. Frances Hardin: And so for part two of it, we talked about shame, but part two is, like, the financial golden handcuffs. What would you say to those people?

Chelsea Turgeon: Yeah, I love that. So I just did a podcast yesterday. I’m doing a series of, like, hot take Tuesdays where I’m just, like, saying what I think unfiltered, on my podcast, just like, a short little episode. And so I did my one yesterday about, like, how I left with $120,000 worth of student loans, because that might seem a little crazy to some people. so when I was first unhappy, you know, back in that first part of intern year, when I felt unhappy and, like, this isn’t what I want to do, leaving did not feel like an actual option because of the money, because of my loans, it almost was like, oh, that’s a cute idea. That would be nice. And just, you know, leave and, like, pursue your dreams and do what you want, but, like, let’s be realistic. Because you have $120,000 worth of student loans, which is not even. That’s probably, like, middle of the road for a lot of people. Yeah. And then some people have undergrad loans, too, that kind of add on top of that. So I understand. And I’ve been in that place where it’s like, it doesn’t feel like a real option because you have, you have this set of student loans. But then when things started to shift for me was during that five week leave of absence. I was on a call, like a free call with a physician burnout coach. And she did the whole coaching thing where she’s like, if I could wave a magic wand and you could have anything you wanted, what would you want your life to look like? You know? And it’s kind of a silly question, but I just, I was very clear. It was so interesting. I was like, well, I would, you know, have a morning where I wake up and I have time to journal and, like, do self care. And then I’d go to a cafe and be, like, working on my laptop. And I wasn’t sure what I was working on yet, but it was like, yeah, I’m, like, working on something I care about. I’m on my laptop. and so I described this whole day to her, and as I’m describing it, I’m like, oh, this is awesome. This feels so good. And she’s like, well, what’s keeping you from getting that? And I was like, the money?

Dr. Frances Hardin: M right.

Chelsea Turgeon: And she was like, okay, anything else? And I’m, like, looking, like, really looking in my brain, like, really? M trying to be like, okay, is there anything else keeping me from getting this? And I was like, no, it’s just money. And it was something so weird about, like, saying it and acknowledging, like, the literal only barrier between me and living this life. That felt so juicy, that felt so aligned.

When I left residency, I was still on income based repayments

was money. I was like, well, that can’t be right. Like, I’m not okay with that. Like, obviously it’s a real thing. It’s a real, like, we live in a capitalistic world where, like, we all need money to survive. I’m not going to pretend like it’s not a real problem, but I was like, if that’s the only problem, I can figure that out. And so I started just looking into, like, student loan repayment stuff because I think for some reason in my head, I was like, oh, I can only, like, I was doing income based repayments in residency. And so I was like, okay, I think the only. I had some idea that there was a cap on how long you could do those, or you could only do those if you were in training to be a doctor. I don’t know. Like, I had some weird ideas about what was going on with all of that. Like, the moment I left residency, they would take away the income based repayment and, like, my payments would skyrocket and then my salary was nothing. And so I just, like, looked into it and I was like, oh, it turns out I can just keep doing this. I can just keep doing income based repayments for a while. Yeah, yeah, you can.

Dr. Frances Hardin: That’s good to know, but. Exactly. But part of it, too, is, like, it is scary to look into it. You know, we put up all these mental blocks for ourselves. Like, if more people maybe did poke around and, like, look at some of these cold, hard facts, then more people would seriously consider.

Chelsea Turgeon: Yeah, well, and there’s a lot of vague language in there, too, that you can’t always find out. And, like, even if you get on the phone with some of loan financers, they, they kind of give you the runaround. And so there’s things where, like, I think they kind of intentionally make it a black box so that we don’t really understand what’s going on. so I just. Yeah, so what I know for sure from my own experience is that you can continue doing income based repayments indefinitely. I am still on income based repayments. but so once I figured that out, that gave me a little more breathing room, right? Because I was like, all right, I I can have some time to figure. To figure out what I want to do. I also had in my head, like, initially that being a doctor is, like, the only thing I knew of to make a six figure salary in a short period of time. So, like, when I left residency, I was about two and a half years away from being and attending, having a six figure salary. So then in my head, initially, I was like, well, whatever I change to, if I change to something, it needs to get me to a six figure salary in that time period. Like, I got two and a half years to get there because otherwise my interest is going to keep building and then everything’s going to snowball out of control. And I felt this, like, huge time pressure that, like, even when I was, like, thinking maybe I could change, I was like, whatever I do, I got to be successful immediately. And then that starts to limit your options because that, like, what makes that? How do you know? How can you guarantee that that’s going to happen? And so, so there was just a lot of other things that were starting to cause anxiety around that point. And then I just made this decision that I am going to pay my loans off a dollar at a time and I’m not going to rush it. And even if the interest gets so big that it, like, causes an avalanche on top of me, like, that’s just what it’s going to be. And I just stopped caring. It was just this weird switch of, like, this number in someone’s bank balance somewhere that I owe this money is real, right? That’s a real thing. But what felt more real was my time and my energy and the things I was doing every day. And I was like, I’m not going to send my time and my energy in a way that I don’t want to in order to make things work for this number in someone else’s bank thing somewhere. So I was like, you know what? I’m just going to do the things I want to do. I’m going to not be illegal. I’m going to pay my loans off in this income based way and, like, file my income every year, but I’m just not going to worry about it. And then what I realized, and I think I’ll qualify for this, I’m not sure. So TBD. But if you just do that, if you do income driven repayments for 20 years, it just cleared. Whoa.

Dr. Frances Hardin: I have read that before. Is that for everybody?

Chelsea Turgeon: I really can’t say because I don’t like fine print and I’m not good at, like, reading the details. So, like, don’t take this as, like, I’ll tell you in, let’s say, financial advice, right? Yeah, don’t take it.

Dr. Frances Hardin: This is not a finance podcast.

Chelsea Turgeon: Yeah, but, but when I read it, when I look through it, it looks like it is true. so it’s, it’s for, if you have a certain types of loans, it has to be federal government. If they’re not refinanced, like, there’s certain things that has to meet, which I do meet. And, if you’re making, you can’t miss a payment. So if you’re making these payments every year for 20 years, that is a sign. Like, then you should. They should be cleared. but again, I will let people know when that happens, if that happens. But even if that wasn’t the case, I just, like, let go of the need to, like, out because I think, something that keeps us freaking out about it is, like, we have to rush to pay it off before the interest starts getting out of control. And I get that, but I don’t know. Like, it’s just not a way to live. Like, if. If you would have to do things that are significantly. That are making you significantly unhappy in order to meet that, those payment requirements, I just. I don’t think it’s worth it. I think that’s a cost benefit analysis you would have to do for yourself. And I do recommend everyone doing that for themselves. Like, what is it actually costing me in, soul, in spirit, in, like, happiness and joy, in physical health?

Dr. Frances Hardin: And physical health, I will say, you know, of course, like, that’s a very real. There’s even, like, literal physical tolls. Yeah, I would say, I, you know, of course, I do think that you are in a favorable position since you support yourself, and myself as well. Like, I identify with that in that I don’t have dependence other than my cute dog and cat. And they kind of keep their costs, like, very stable. You know, they don’t do too much.

Chelsea Turgeon: You don’t stay for their college fund or anything, so.

Dr. Frances Hardin: Right, exactly, exactly. And so, you know, but I think that the, the more that we kick around ideas or, you know, open the door to have these conversations and at least be armed with this information, like, that’s. That’s a good thing.

You talk candidly about forgetting your password on your podcast

So I really appreciate you, you know, sharing candidly about it.

Chelsea Turgeon: Yeah, I’m always going to be candid about that. I was, like, literally yesterday, as I was recording the podcast, I was like, I really want to log into my Nelnet loan servicer and just read out what I see at this exact moment. But then I had to keep figuring out my password and my email, so I was like, I’m not going to do it. I feel like also being an adult is just always forgetting your password and having to constantly re verify your identity, and it’s so annoying.

Dr. Frances Hardin: But anyways, yes, no, that alone will derail. I’ll be like, oh, yeah, I really needed something, and then I’m like, I can’t get in there.

Chelsea Turgeon: All right, table.

Dr. Frances Hardin: It’s table. Life’s too short. But, well, I really love chatting with you.

Your 33rd birthday is coming up later this year

The last thing that I wanted to tackle is actually your 33rd birthday is coming up. Am I correct on that?

Chelsea Turgeon: Yeah.

Dr. Frances Hardin: Like three years off your life earlier. So I apologize. I was like, but the big three three is coming up later this year, and you’re doing a 15 day trip to the himalayas.

Chelsea Turgeon: Yes, I am.

Dr. Frances Hardin: Oh, my gosh. Which is, like, such a dream. And I know that, like, you’ve just mentioned broadly, in the past. That, of course, like, travel is one of your passions, seeing the world. And, of course, residents and honestly, even physicians, like, even beyond residency, we have a lot of handcuffs around our time. How do you feel getting to do, like, a dream bucket list trip for your big birthday coming up?

Chelsea Turgeon: Yeah. So, what I love about it is, to me, there’s just a lot of symbolism around it. I think I told this story, as I was sharing about it, that there was this time in residency where I wanted to do a yoga teacher training and was trying to get my schedule. You know, you, like, submit it, like, for the whole year, basically, like, where you want your vacation blocks and all of that. And so I knew there was this yoga teacher training, and, like, April of that year, even though I’m submitting my stuff in, like, July the year before, and I was like, okay, I want to have a vacation block during this block so that I can request to go to that training. And it’s like, I didn’t get the vacation block. and so I couldn’t go. So I already knew that early that, like, there was something I wanted to do, like, seven months from now that I couldn’t do. And it’s so much more than just, like, Like, in the grand scheme of things, not doing a week long yoga teacher training. It’s not a huge deal. But what I think it represented to me was, like, I’m just not in control of my time. And even if they gave me a yes and I got that vacation block, that’s kind of a bare minimum for me of, like, oh, you can get something that you want if, you know, seven months in advance because I’m a very last minute person, so I really don’t tend to plan that far in advance anyways. And so, yeah, just this idea that, like, my life is so locked in and my schedule is so inflexible that that just started to feel really constraining and limiting and heavy and not that that was, like, the last straw, but it’s just one of those things that it adds up. It adds up. And so now being able to book this trip. So I had a friend, from home. She came to visit me here in Argentina, and we did hiking, and we were having such a good time, and we were just, like, kind of casually kicking around the idea of Everest base camp. And we’ve been talking about that for a bit, trekking in Nepal. And then she, like, she got back from her, like, from the trip to Argentina, and she’s like, let’s just book it. Can we. Should we book it? And I didn’t have to check with anyone. I didn’t have to do anything. I was like, yeah, let’s do it. I could just book this trip where it’s, like, two weeks off the grid, and, yeah, I’ll have to set up my business in a way that there’s no calls during that time. There’s things I have to do. It’s not like I have no responsibilities, but I can do things like that. And that feels really cool. It feels really freeing. It just feels really expansive. being able to say, yes, the things that I want to do and be the one in charge of, like, following through with that.

Dr. Frances Hardin: I love that. No, I love that for you. And I hope you have the best trip. I’ll definitely be following along. You know anyone else who. Whose dream trip, whose interest is piqued by this? Definitely check out all of Chelsea’s stuff, because her pictures on Instagram are, like, incredible.

Chelsea Turgeon: Yeah. thanks.

Do you believe in karma and why or why not

Dr. Frances Hardin: I want to finish, as I always do, with asking the question, do you believe in karma and why or why not?

Chelsea Turgeon: I love that question. yeah, I do. I believe in karma. I believe that. I think my version of it is just, like, when you put out good into the world, good returns to you. Have a harder time with the opposite. Like, when you put out bad in the world, bad returns to you, because that feels punishing. But I do think. I do think that probably is true as well. and I think. I like to think that when I’m mad at somebody else, like, I don’t need to seek revenge on them because I’m like, karma will get them. I don’t have to do it.

Dr. Frances Hardin: Yes, it’s definitely. It can be, like, a form of alternate rebellion. Definitely from that standpoint, just like a responsibility transfer. Like, okay, the universe will get you. I can’t, waste any of my time and resources, like, worrying about this and things like that. If you behave badly, you got to think or. I like. I agree. I like to just think. Okay, responsibility transfer. The universe and karma will get you. I’m m going to focus on my own stuff.

Chelsea Turgeon: Yeah, I’ll go back to me now. And, Here we go. Yeah.

Dr. Frances Hardin: Yeah. But, well, wonderful. It is so great to chat with you. Thank you for coming on again today and chatting. I mean, I feel like we could kind of talk all day about this stuff.

Chelsea Turgeon: Yes, 100%.

Dr. Frances Hardin: Next week, I will be doing another episode of the new grand rounds with Frances may Hardin. Follow me on Instagram at Francesmay dot MD and rethinkingresidency visit my website, rethinkingresidency.com, to learn more about resident physician stories and ways that residents can most effectively navigate the game of residency. I cannot wait to connect with you on the next episode of Promising Young.