Whether you’re a resident preparing for fellowship, or a fellow preparing to finally, actually, enter the real world, or in any other field and changing jobs, I have one piece of advice:

Take Time Off. DO NOT Go Straight From One Part Of Life To Another.

I know this is not always possible. In medicine, fellowships start on July 1st and you have no choice but to comply. So for those of you who do have a choice, those that are going straight into the workforce, and those of you who are fellows now and will finish next summer, this is for you. (To other professionals looking to make a change, I think this post may apply to you as well)

Allow me to address all the comments I’ve heard in this regard:

“Wellllllll, I’m Not Sure If I Should…..”
As physicians in the making, you have given up your summers starting the second year of medical school. You have studied, volunteered, and rotated through the hospital, always on the go. For the past 8 odd years, you have not had any real time off. Think about it, aside from the 1-2 week vacations you take a resident….?! If there’s anyone in the universe who deserves some time off, it’s you.

For anyone outside of medicine, you’re making a career change or switching companies/jobs for a reason. Whatever that reason is, I applaud you for taking a step towards change and hopefully betterment. However, before you dive into a new role, shouldn’t you decompress from the job you’re leaving? Clear your mind, or as they do with fancy meals, cleanse your palate? Yes, you should. Leave behind any negativity and allow yourself time off to truly start fresh.

“I Feel Bad For Not Starting Right Away, My Job Needs Me!”

Some residents and fellows I’ve spoken to talk about how they’ve been told that their new job is desperate and short-staffed. Let me tell you something: they will ALWAYS be desperate. They will ALWAYS be short-staffed. They will ALWAYS need another person to help out.


You alone are not going to magically solve all of their problems once you join the team. While I’m sure you’re talented and a hard worker, no one person has the power or the ability to fix all the issues plaguing a department. Trust me. No one is that special.

“What If They Take My Job Offer Away?”

The fact of the matter is, if you have a job offer, you have the upper hand. The decision of when to start work should be purely YOUR OWN. Work is work and will always be there. There’s no end to the madness that is medicine. However, your youth, your time with family, your time to travel will NOT always be there.

I tell everyone not to sign anything until the contract specifies the start date you are looking for. You will not lose your offer by requesting this. At the end of the day, they need you more than you need them. Barring you making crazy requests, you will get what you ask for. Time off is not unreasonable and they know that. Don’t let them take advantage of you.

(For my job, I wanted to start in September. They gave me a September 1st start date-a Thursday–I said NOPE, start me after labor day. I signed the contract only after they changed it)

“I Can’t Afford Time Off — I Have Loans!”

This is a sticky issue. Everyone’s financial situation is different and everyone feels the pressure of dealing with it differently.

Your loans are looming over you, but honestly going straight into work is not going to make a big difference in the long run. My story: to pay off my student loans, I did income-based repayment all throughout training and my monthly rate did not increase to reflect my attending pay raise until halfway through my first year as an attending. For those that are in deferment, you will likely get a grace period before your first bill comes due. (Check with your lender also)

I know it’s not paid time off, but a few weeks to have fun, relax and recharge is not going to set you back that much. Also, if you plan for this time off in advance, then you can save for it.

“I Can’t Afford Time Off For Vacation”

You may not have disposable funds now, but if you plan ahead, this is completely doable. Plus, you don’t necessarily need to take a crazy vacation during your time off. There are plenty of budget-friendly travel options available to help you spend less, should you choose to travel. Remember, how you choose to define time off is up to you.

If you do want the time off for vacation time and travel, then remember: traveling does not necessarily mean you have to go on a fancy first-class trip to the other side of the world. Maybe you do a cross-country road trip; maybe you take a short vacation versus a long one. There are options and ways to make this happen.

Also, as a last note to point out, your ability to take so much time off will be limited, if not impossible, once you start working. Usually, depending on your leave policy at your job, in order to receive paid leave, you will either have to bank time-based on hours worked, based on years of experience or you’ll have a contractual period of annual leave time set aside for paid vacation (this is especially true for salaried positions).

Outside of those parameters, you will not be able to take additional leave. The exceptions, of course, are FMLA (family and medical leave act, sick time, unpaid leave, short term disability, etc; however, dipping into that kind of personal time requires that specific criteria are met and only eligible employees may qualify. If you don’t, you may end up with an unpaid leave of absence.

In addition, any unused vacation time is forfeited, meaning it does not carry over into the next year. It’s a lot to consider, but definitely take all of this into account when making your decision.

“What About Health Insurance?? I Can’t Live Without Coverage.”

Cobra. Apply for this once you’re done training. Alternatively, you can purchase monthly insurance coverage depending on the amount of time off you take. I did this via Blue Cross Blue Shield. Not super cheap, but not crazy expensive either, in other words, completely doable. Alternatively, if you have a spouse who gets coverage through work, you can look into joining his/her plan temporarily.

In addition, I recommend you become up to date with any checkups, testing, physicals, and dental work BEFORE you finish your training. That way you go into your time off fresh and clean and won’t need to worry about scheduling an appointment as soon as you start your job either. Gives you some leeway.

“If I Take Time Off, I’m Going To Forget Everything I’ve Learned”

You won’t, even if you wanted to, even if you tried. Trust me. You could do this stuff in your sleep.

Advantages Of Time Off

Lets summarize what I’ve been trying to say. Time off will give you these perks to look forward to :

  • Time to travel (the beach is calling your name)
  • Can you imagine studying for boards and NOT going to work??? (let this sink in for a moment)
  • You have time to move and get settled in a new place (if you need to)
    Time to catch up on years of lost sleep (seriously, my dark eye circles went away, it was amazing)
  • Time with family (or to produce one ;-))
  • Time to regroup and re-focus on your career goals and regain perspective of what you’d like to accomplish going forward

Take Back Control

You see the pattern here? Over the last several years you have GIVEN your time to study, to work, to train, to learn. Now I encourage you to TAKE time, for yourself, for your family, for your sanity.

I talked in my MD/MBA post about how I think physicians need to take back control of our careers. Here I want us to take back control of our lives. Our jobs should not dictate how we spend our time. Rather, we need to make sure that, in addition to our career, we have time to be human and do the things we enjoy.

So use your time off to reconnect with yourself and to remind yourself of the things you love and are passionate about outside of work. Use those hours and days to do something that helps you truly relax and reminds you of all of your strengths, so that when you come back to work, you’re not only well-rested but also empowered to tackle the work ahead of you.

I not only encourage time off between jobs and but to also to carry this idea with you throughout your career.

Because without balance there’s burnout. Without time off you lose sight of your purpose.

So Instead: Be Balanced. Be Well Rested. Be In Control.


By: Author Sanjana Vig, MD, MBA

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