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Taking time off in medical school

Like many of my classmates, I took the last year off from medical school. Some of us enrolled in different graduate programs to pursue a dual degree while others did a research year. The trend is becoming more common - the proportion of students who take more than four years to graduate and the number in dual degree programs are at all-time highs.

Over the past few months, several students have asked me about my experience and whether I would recommend they do the same. While the short answer is, "It depends," I think there are three questions worth thinking about while deciding whether to walk away from medical school for a year.

What do you want to get out of taking time off?

This first question sounds obvious but goes unanswered surprisingly often. Anecdotally, many people take time off because "everyone else is doing it." A majority of Stanford med students take 5+ years to graduate, creating a social norm around taking an additional year.

It's important to pause and consider what exactly you want to achieve during this time. In my case, I wanted to develop new skills and obtain a degree that would serve my professional interests. Other commonly cited reasons include increasing competitiveness for residency or personal factors.

Of course, it's possible to develop skills, build a competitive residency application, and more in the traditional four years of medical school. Most schools (including Stanford) also provide a substantial amount of elective time during the fourth year. We can use this time for the same type of personal development that many students prioritize during a year off. It's therefore helpful to articulate how you will be different at the end of your time off compared to when you started.

What is the best way to achieve your goals?

If you've decided that you have compelling reasons to take time off, the next question is how to achieve your goals. I think there are two critical decisions. The first is whether to do a degree program (e.g. MBA, MPH, etc.) or to work full-time (with work meaning research, an internship, or starting an organization, among other possibilities). A degree carries the advantage of formal teaching and would offer an additional credential. But at the same time, it requires you to spend a certain amount of time going to classes and doing homework -- and that time might be better spent elsewhere.

The second decision is whether you want to take just one year off or are willing to step away from med school for multiple years. This choice affects what options are available. For example, some degrees can be completed with one additional year of school while others require multiple (e.g. PhD, some Master's degrees). Similarly, some projects can be completed quickly while others have multi-year time horizons. All those considerations must be taken into account.

How will you stay connected to the medical school during your time away?

Finally, it's important to reflect on the relationship you will have with medicine during your time off. In some cases, it is easy to stay engaged with the medical school -- many students doing clinical research work with the same physician mentors and continue to interact with patients on a regular basis. But students who leave the medical school environment (e.g. to do an MD/MBA, work in an external job, etc.) must think about how to stay connected, whether it is through ongoing research projects, a continuity clinic, or something else.

The ability to take time off and pursue other interests during medical school is a privilege. But before acting on it, students should give careful thought to how to make the most of the opportunity.

Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the Stanford Medicine Unplugged category

Akhilesh Pathipati is a fourth-year MD/MBA student at Stanford. He is interested in issues in health care delivery.

Photo by StanfordMedicineStaff

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