Overcoming Alcohol Addiction in Residency

Dr. D’s story is one of resiliency, hardships, and success. Despite the struggles that she endured throughout her training, when we first met her she had a huge smile on her face and exuded warmth and a sense of calm. Having faced down the potential loss of everything she worked for, Dr. D was most concerned with sharing her story so that others in similar positions can learn from her and feel supported. She has chosen to remain anonymous for now, but she anticipates this to change soon.

It takes an extreme amount of courage to share this information. There is still very much a stigma associated with physicians seeking help for struggles with alcohol, substance use disorder and mental health issues. But perhaps more importantly, there is a profound lack of information around the resources available and stories of success by doctors who have dealt with these issues and maintained their livelihood. We hope that Dr. D’s story can inspire others to seek help or treatment and encourage those who see physicians struggling to speak up and lend a hand.  

I: Take us back to the beginning. How was your residency experience?

Dr. D: Everything started for me in medical school actually. I went to medical school in the Caribbean. I felt very alone and isolated, and started to drink to cope with the stress and to help me sleep. It wasn’t problematic for my career at the time.

I matched into the Internal Medicine residency program at an academic hospital in the midwest. With the increased stress and demands of intern year, my drinking escalated. I was still alone, isolated and depressed.. without healthy coping skills whatsoever.

I was drinking almost every night. Drinking after work to decompress and to relieve my anxiety became my routine. I never drank at or before work, but I consistently felt terrible in the mornings, making work very difficult. Throughout my first and second year, I was still functional. Despite the constant hangovers, I felt that I was hiding it well enough and was able to complete my duties at the hospital.

By the end of 2nd year, I was no longer functional. I started calling in sick, missing days of work (and as you know, doing this in residency is EXTREMELY frowned upon – especially because some other tired resident has to cover for you). There were days when I simply felt too sick, or was still drunk in the morning, and could not make it to the hospital. At this point, the program started to notice and realized that I was no longer performing as expected. My program director asked to meet with me.

I: Did your program director ask what was happening to you?

Dr. D: She never specifically asked what was wrong. She basically said, ‘We notice something is wrong. You’ve been acting differently and missing a lot of work. Take some time off and fix it.’ (not in those exact words)

So I was told to take a leave and come back when I was better. Of course during my time off, I never sought help. Not only was I not ready to admit that I was a problem drinker, I had convinced myself that I could fix this on my own.

More importantly, and the biggest barrier to my recovery, was that I was terrified of the stigma associated with it and the potential repercussions if anyone found out. I knew I should probably go to AA, but I didn’t even want to risk running into someone I knew or have someone at the hospital hear about it.

I was terrified of losing my career. I was ashamed. I was lost. 

After all, I’m a physician, we are supposed to be perfect.

I: Was there anyone you could talk to about your struggles during this period?

Dr. D: I was seeing a therapist at the time. This was an independent therapist that I had sought out, not associated or provided by my hospital. I opened up to him about what was going on. He encouraged me to seek additional help, go to rehab or at least AA meetings. I wasn’t ready to listen. I can’t stress enough how scared I was to accept I had a problem!

There was no one else for me to talk to. My mom lived a few hours away, she knew that I was struggling, but there was no one in town or within my program that I felt I could confide in. 

Frankly, I was too embarrassed to admit my problem to any of my colleagues. There was one attending at the hospital who had always supported me, and continues to, but I couldn’t bring myself to open up to her. 

I: What happened after you returned from your leave of absence?

Dr. D: I came back to the hospital and was sent to the EAP (Employee Assistance Program). They assigned someone to talk to me, but I did not feel that it was impactful and was still afraid to admit what was really happening to me. My performance didn’t really improve and I was put on probation by the program.

I still find it odd that no one asked me WHAT my problem was. Or if I was drinking too much at home or if I was depressed. I assume people never suspected it was alcohol related because I never drank at work. 

I: Were there any concrete steps to help you during this probationary period? An action plan put into place by your program?

Dr. D: I don’t recall any discrete improvement plan created. 

The drinking took over at this point. I felt that everything I had worked for was being dragged away from me. I had no one to turn to. Most of all, I wish someone would have just asked me, ‘What is wrong?’ But the question never came.

I ultimately failed my probation, and resigned. I was in my 3rd year at this point. I didn’t fight it, I didn’t get a lawyer, I just accepted it. I think I still had some hope then that I could get back into the program or transfer somewhere else. 

I: If you could go back, would you say something? Would you do anything differently?

Dr. D: Honestly, I don’t think I would. Without knowing that it would ultimately be OK, I had no assurances that speaking up wouldn’t be the end of my career. I really needed someone to say to me, ‘Hey, if you’re struggling with alcohol, substances, etc, these are the steps you need to take. It’s ok to admit it. Yes, you’ll have to declare it for licensing, but plenty of other doctors have done it and come out on the other side.’ 

I understand nothing can be assured, but if I knew about the MPHP, that other doctors have been through this and continue to practice after they recover – if I would have had some guidance, I would have probably asked for help.

I also think that if the question wasn’t going to be on licensing applications, I would have felt much more comfortable saying that I was struggling. That fear was the biggest barrier to my recovery, and it almost destroyed me.

I: What happened after you resigned from your residency program?

Dr. D: I finally decided to go to AA meetings. I had lost what I worked so hard, and so long for, and knew that I needed to get help. I was lucky enough to meet a doctor in one of my AA meetings who helped guide me through the process. He told me about PHP’s. This was the first time I had ever heard of something like that. He told me, ‘If you get sober, you might still have a chance.’ I was finally given hope that there was a way forward. 

After that, I voluntarily entered into a PHP. Honestly, the Missouri PHP saved my life. They gave me that glimmer of hope that I could still be a physician despite my problem, if I recovered.

Thinking back to those days, I was so sick. I went to treatment. I relapsed at one point, and entered treatment again. Eventually, one day at a time I have been able to remain sober for almost 5 years.

My life in sobriety has been amazing. It’s more than words can describe. 

However, I could not be complete without medicine. I love my career, it’s a part of me. I wanted to get back into residency and finish my training. I knew now I could do it!

Even after completing almost 3 years of residency, I knew that I would most likely have to re-enter the match. It’s so difficult to find open 2nd and 3rd year positions. I had already applied for the match, when I was fortunate enough to come across an open position at another residency program in town. They gave me a chance as a 2nd year resident. The PD heard my story and was willing to help me get back and finish my training. Without knowing me, he believed in me and gave me the chance I was praying for. 

I finished residency training and was granted a medical license in the state of Missouri. This was 2 years ago, and I have been working as an attending in outpatient medicine ever since. 

I: It’s amazing that you were able to overcome so much and stay so positive. Is there anything you would like to say to medical students/residents dealing with a similar situation?

Dr. D: You can always rise from the ashes. Struggling with alcohol, substances, or mental health is not a career-ender and it is not something to be embarrassed about. If anything, overcoming this makes you a better, more compassionate doctor. I believe I’m incredibly strong for this. 

It’s important to ask for help early though. You don’t have to suffer in silence. There are plenty of people out there, including myself, that want to see you succeed and can help. There are so many physicians out there that are struggling and also many physicians out there that have recovered.

Our career is extremely stressful, the pressure is immense. It’s no wonder the rate of physician mental health issues and suicide is so high. The stigma needs to END because it stops us from asking for help. It keeps us sick. 

We are people too, and addiction does not discriminate. 

If you are reading this and you are struggling and you are afraid, let me tell you this:

You are not alone! Recovery is possible! Your life matters! And the most important message: asking for help and acknowledging you have a problem does not mean your career is over. Seriously, if I did it, you can do it too!

If you are struggling, or know someone who is, and would like to be put in touch with Dr. D, please submit the form below and we will connect you.


One response to “Overcoming Alcohol Addiction in Residency”

  1. Your posts always make me feel like I’m not alone in my struggles and insecurities Thank you for sharing your own experiences and making me feel understood

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