Take a year off

[q-school]

Question for those who have successfully taken year of. Not in training and not to do research. Just plain old taking a year off.

Until about fifteen years ago, our hospital system allowed those with twenty years in to have a non paid sabbatical of six months. It disappeared because of "credentialing" issues. Occasionally I see in threads people suggest taking a year off. I'm curious whether that is practically possible or a feature available for some specialties only.

For those in procedural or surgical specialties, how hard is it to come back? Let's assume you have been practicing more than ten years so foundation is there.

One question revolves around loss of technical skills.
Second question is from credentialing and licensing standpoint--both hospital and state.

Thanks to those who have experience and are willing to share.

[PhysicianOnFIRE]

Paging @CM

[adventure]

We've taken 6 weeks. We fully plan to take a year at some point. I don't pretend to speak to something I haven't done, but will share these from our experience ( in response to your 2nd question, mostly):

Lessons:

1. Leaving in between jobs is a natural break point. You still have to credential at the new organization when you start up. Either in 1 day, or in 366 days.

2. Fear over answering the medical licensing board question of "Explain any gaps in employment" is real. A simple explanation is probably sufficient here.

[Hatton]

I have a friend who is a female anesthesiologist who took 5-10 years off to raise her kids.  She ended up getting divorced and returned to work.  She had to do some type of residency retraining however.

I looked into an OB/GYN hospitalist job about a year after I quit OB.  My insurance carrier was fine with it since I was still doing Gyn surgery and had continued OB CME.  I decided not to do it for several reasons but credentialing would of been no problem.

[G]

From a C&P perspective, my hospital allows a one year sabbatical, no questions asked.  A second year is allowed, as well, but on occasion, questions are asked.  In practice, sitting on the committee for 8 years, I never saw an issue (for docs already active members of the medical staff), but I suspect each hospital's culture is different.  The key is not to let your privileges lapse because then it becomes a royal pain in the arse for re-upping or applying at a new place.  A review of your med staff bylaws and a quick chat with the Chief of Staff and CMO should confirm.

My group (EM) allows a year-long sabbatical.  A handful of docs have taken the opportunity, but none returned to the practice.

Q-school, thanks for starting this thread, I'm looking forward to the responses.  My plan (PoF: yes, it is written down!) is to take 1-2 years abroad when my kid would otherwise be in middle school.

[G]

By the way, I take a month off every year, and for what it's worth, I do have a little anxiety coming back regarding technical skills.  That pretty much disappears after the first couple shifts.  To your point, I have over 10 years of foundation.

To adventure's second lesson: if you don't let your privileges lapse, there is no gap to explain.  Although re-reading your post, it sounds like you don't have the opportunity to keep employment, q-school.

[CM]

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[wideopenspaces]

I'm seriously considering taking a year off to work in new zealand. So not exactly a year off but a year away from my current job. At my hospital you can take a leave of absence so they don't have to re-credential you. As part of the contract to work in NZ you have to keep up your US medical license, so I will do cme.

[YSH]

I took a year off after the birth of first child (this extended leave of absence was unanticipated but I have zero regrets about it) while we were also relocating to another state for spouse's career endeavors during that same time.  Surgical specialty.  During the time off, I volunteered at low income clinics to make connections, maintained my CMEs, went to annual meetings and made sure to keep my paper credentials up to date.

I went back into the OR approximately 18 months after last OR case prior to my sabbatical.  I landed the job with the help of a connection I made during my time volunteering.  I did have another attending scrub with me to make sure all was kosher a handful of times at the beginning (depending on what the case was, hospital credentialing requirements, volume and how technically difficult I envision it may be) but was pretty much flying solo by the 3rd or 4th month.

I think its hard to know how your surgical skills will be affected since everyone's learning curve or manual dexterity is different.  Some have a knack for working with their hands while others don't have that ability.  I also found that most colleagues were very understanding when I asked for help and did not give me a hard time.  Those who did initially eventually did come around when they realized that I was not a fluke and saw my commitment to the job.

I never had any issues with burnout as an attending but will acknowledge that I may be in a better place financially had I not taken the year or so off.  But I did learn a lot about the business side of medicine during my time off, which helped me to create my current work set up.  So, on multiple personal and professional fronts, I still consider the time I took off to be a good choice.