Sometimes events beyond our control interfere with radiology residency. It may be a personal situation, a new business opportunity, mental illness, or severe burnout. Some of these issues are outlined in my previous article called The Struggling Resident. And perhaps, one or many of these reasons have you thinking about taking a leave of absence.

But, what does this option entail? Many residents don’t really know the details about taking a leave of absence. So, we will talk about the potential consequences of what can happen after a leave of absence and why you really need to take the option only as a last resort. Then, we will discuss what situations merit taking a leave of absence; a circumstance where you might want to think about taking a leave (but very carefully!); and finally, situations where it is almost never appropriate to take a leave.

Truth or Consequences

Why is it so serious to take take a leave of absence from residency for a period of time? Maybe it’s six months, a year, or more. Well, there are so many reasons why it can become a serious issue.

1. It will potentially take you off schedule for getting into a fellowship. Many fellowships will not consider residents who begin in the middle of the year.

2. You will likely have to start paying your own health insurance and benefits. Believe it or not, it can cost tens of thousands of dollars for health insurance for a family. You may pay a few hundred dollars out of pocket per month when you are employed, but when you are not it can run over a thousand dollars per month. Can you cover those expenses?

3. You create a reason for future employers not to hire you. Many employers become very concerned when they see a gap in your employment history without a really good reason.

4. It can cause irreparable harm to your residency program and classmates. You can no longer take call and the rest of the class needs to shoulder the responsibilities. It does not set you in the light of a team player.

5. And finally (and perhaps most importantly!), you may be legally required to start paying off your humongous debt load. That can be a real bear!

I Can’t Do My Job

So, when should you unconditionally take that leave of absence? Basically, I think it comes down to one situation: you cannot perform your job duties safely. If you are able to perform your duties as a resident, radiology residency is a temporary affair (albeit 4 years). And, believe it or not, many physicians would love to be in your shoes. So, if you are able and healthy, you should really put all efforts into completing your residency.

That being said, if you have a mental illness, severe disability, or significant trauma, by all means, take that leave of absence. You took the Hippocratic oath and may not be able to abide by it in these circumstances. So, these conditions necessitate a leave. My advice: If it is some reason that does not involve breaking the oath, do what you can to pursue other endeavors until after your residency. You will have a great field to fall back on.

A Once In A Lifetime Opportunity

Every once in a while, a confluence of events occurs that leads a resident to consider a job opportunity in another field that you may have always wanted to pursue. Perhaps, you just got that call to anchor a TV show. Maybe you created an invention and a large company wants to buy out your patent for 5 million dollars that will take a long time/lots of work to seal the deal. Or, you’ve been dancing for years and a director in Broadway wants you on his show.

As I began brainstorming about what issues may eventually allow a resident to take a leave without regrets, some of these reasons could potentially cause a resident legitimately to rethink a radiology residency. I get it. Just remember for those of you with significant debt… if you don’t pay your debts, the IRS can garnish your wages for the rest of your life. And, these unique situations are not always a means of securing a lifestyle for years to come. (although occasionally it can be) So, those residents in this unusual situation, really need to think long and hard about taking a leave of absence.

Situations That Do Not Merit A Leave

If you are thinking of starting a business, quitting medicine, or think you need some time off to relax and travel the world, this is not the time. You’ve already been through 4 years of college, 4 years of medical school, and a year of internship. What is four more years or less in the scheme of things to complete a radiology residency?

So what are some other situations that really should not be used to take a leave of absence during residency? Most anything else. These would include taking a leave to pursue another sub specialty (why can’t you just wait it out to apply so you don’t have a gap in employment?), mild burnout, starting a new business (can you wait until after residency?), attempting to train for the next Ironman triathlon, and so on.

Taking a leave of absence is a very big deal. Many residents may dream of taking a leave at one time or another to go for something that they never had a chance to do before. However, think twice my friends. Oftentimes, it sounds good in principle but the practicalities behind it don’t really make much sense!