How leaving medicine mirrors escaping a cult

Chelsea Turgeon MD recently appeared on The Podcast by KevinMD to discuss her thought-provoking perspective on the medical profession, as outlined in her KevinMD article, “Why Does Leaving Medicine Feel Like Escaping a Cult?” As a physician coach who left clinical practice six years ago, Chelsea brings a unique, outsider’s lens to the challenges physicians face when contemplating an exit from medicine. Her journey—from burnout in residency to building a fulfilling career outside the profession—sheds light on why leaving medicine can feel so fraught with shame, guilt, and even cult-like entrapment.

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Exploring the cult-like dynamics of medicine

Chelsea admits the title of her article uses intense language intentionally: “Why does leaving medicine feel like escaping a cult?” Her goal was to provoke thought and encourage critical reflection on the medical profession’s culture. When deeply immersed in it, she explains, the normalization of certain practices makes it hard to see what’s happening. But having stepped away for six years, Chelsea now views medicine from a broader perspective. She recalls writing her book, Residency Dropout, and hearing from countless physicians who confessed, “I left medicine years ago, but I never felt like I could talk about it.” These individuals often hid their decisions in shame. She shares the story of a client who, after leaving medicine, hid from a neighbor knocking at her door in the middle of the day—terrified of anyone discovering she was no longer practicing. Why, Chelsea asks, does such deep shame and guilt accompany the choice to leave?

She points to comments she receives on LinkedIn when sharing her own story of prioritizing herself and exiting medicine—remarks like “Shame on you for leaving.” Even more troubling, she notes, is the alarming rate of physician suicide, which exceeds that of other professions and the general population. “Why is that our only means of escape?” she wonders. Her article emerged from these observations, crystallized after watching a documentary about the NXIVM cult. The parallels, she says, felt eerily familiar.

Chelsea’s journey out of medicine

Chelsea’s path out of medicine began with what she now sees as misguided motivations. She entered the field driven by a mix of superficial reasons—“I like helping people, I’m good at science, I’m smart enough”—and deeper issues like perfectionism, a need for achievement, and feelings of unworthiness. She excelled academically, earning top grades, stellar board scores, and a spot in her top-choice OB-GYN residency. Yet, at the height of her success, she felt empty. This realization sparked a crisis during her fourth year of medical school, prompting a personal values realignment and a spiritual awakening through mindfulness meditation. She concluded medicine no longer fit her.

Still, she lacked the courage to leave then. It wasn’t until her second year of residency, amidst profound burnout, that she hit rock bottom. “There’s nowhere else to go but up,” she thought, resigning with over $100,000 in student loan debt still looming. She sold her belongings, booked a one-way ticket to South Korea, and began teaching. Over the next six years, Chelsea traveled to over 55 countries, built a six-figure online business, and now coaches hundreds of physicians to escape burnout and rediscover purpose.

Cult-like traits in medicine

Reflecting on her experience and researching cults, Chelsea identifies several parallels with medicine. One is the “expensive involvement”—the massive financial investment required upfront. Medical students take out substantial loans, and the prolonged training period delays financial payback compared to fields like law. This debt, she notes, traps many of her clients, tying their livelihoods to a specialized skill set and creating a form of financial control.

Another trait is “mind-altering practices,” exemplified by debilitating work routines. These grueling schedules leave little time for reflection, keeping physicians in survival mode—rushing to the next break or vacation without pausing to assess their situation. Sleep deprivation and relentless hours weaken resilience, leaving even the most capable physicians feeling scared to leave. Similarly, medicine demands “inordinate amounts of time devoted to group activities.” The culture glorifies working holidays and all-consuming schedules, a complaint Chelsea hears often: “It’s not that I hate the work; it’s that I want to do other things, but I’m at home charting.” Studies suggest a primary care physician’s expected workload exceeds 24 hours a day—an impossible standard.

This leads to “isolation from others.” The intense focus on medicine shrinks social circles, as physicians struggle to relate to outsiders. Chelsea recalls feeling her college friends couldn’t understand her struggles, fostering self-isolation compounded by circumstantial busyness. She marvels at how non-medical friends react with shock to 24-hour shifts—a norm in medicine but unthinkable elsewhere—highlighting the lack of outside perspective.

The illusion of hope and external pressures

During her own residency, Chelsea faced the common refrain: “Tough it out; it gets better after residency.” This “illusion of hope,” she says, is another cult-like feature, promising delayed gratification that often fails to materialize. She tried quitting during intern year but was persuaded to stay, a decision she’s now grateful for—it gave her clarity that her departure wasn’t about incompetence but misalignment. Yet, the culture of silence persists. On LinkedIn, critics have told her, “You took someone’s spot,” blamingasco her for limited residency positions, or accused her of “glorifying leaving,” fearing an exodus. Chelsea rejects these as systemic issues, not personal failings.

Coaching physicians at a crossroads

As a physician coach, Chelsea works with clients facing burnout and disillusionment. Many arrive in a “tweak to tolerate” phase—making small changes like reducing hours or shifting roles to endure their jobs. One celebrated not crying on the way to work, a bar Chelsea finds heartbreakingly low. Instead, she helps clients connect to their “truth,” asking not just how to survive but what they truly want. Responses vary: some crave systemic change, advocating for the underrepresented; others seek holistic healing beyond “bandaging sickness.” For those who rediscover passion, she notes direct primary care—longer patient visits—often reignites fulfillment.

Escaping the financial trap

For physicians trapped by debt and an unfulfilling job, Chelsea advises against lofty questions like “What’s my passion?” when burnout runs deep. Instead, she suggests asking, “What feels like relief?” Cutting hours or taking a sabbatical might lift them to baseline, where deeper reflection becomes possible. Systemically, she’s skeptical of reform, believing medicine’s inertia resists meaningful change. “The whole thing needs a makeover,” she asserts, advocating a grassroots approach where physicians prioritize self-care and exit if needed.

Key takeaways for physicians

Chelsea leaves readers with a powerful message: Your lived experience matters. How you feel is real and valid, and honoring it is OK when making career decisions. Her insights challenge the status quo, urging physicians to reclaim agency over their paths.