In case you are not a Facebooker, I matched into a Family Medicine residency! I am thrilled to be headed back to the great Pacific Northwest!
Match day itself was an experience in and of itself; one I will probably never forget. The anxiety and buildup to this day (arguably this starts even before medical school) left many of us trembling with fear and excitement as we waited for our names to be called by the dean to come get our envelope. I was so shocked when I opened my envelope I didn't even recognize the program at first. But we survived! And not too much worse for wear!
I'll leave you with a quick story my attending told me on my last day of clinical work before match day....
He's an older attending with 40-some odd years of experience. He said he still remembers his match day all those years ago. They handed out buttons they could pin to their white coats for the rest of the school year that read "FYBIGMI" (pronounced "fuh-big-me") and stood for "eff you buddy I got my internship." A thinly-veiled message to any attending supervisor that the student had matched and is now coasting through to graduation day. I can't believe they had that much snark in medicine back then!
And that's where I'm at now...a glorious month of reading books and going on hiking and backpacking trips...Ah, to finally be a 4th year with nothing to do but prepare for the big move!
Friday, March 22, 2013
Thursday, March 14, 2013
A few months later and we are finally at the big moment! Tomorrow is basically the biggest day of medical school. Yes, graduation is important too and technically gives us our title (Yours Truly, MD). But tomorrow we find out where exactly we will be doing our residency training for the next several years. On Monday I found out that, yes, I did in fact match to a program (one of the 11 I interviewed at). In the meantime, those who were not fortunate enough to match had the opportunity to scramble into any open positions. So once the stress of discovering whether I matched was lifted, it's been a relatively stress-free week. Today I just felt excited to find out where I'm headed!
Today was a big day too! It was my last day working as a medical student. There are still a few months left in the school year, but all that's left is an independent study month (reading books and backpacking) and an update course (a refresher on key medical school teachings and tips on internship survival). Next time I see a patient, I will actually be their doctor, as scary as that sounds!
Monday, January 21, 2013
That was a long hiatus! In my absence, I have been celebrating holidays with family, doing 11 residency interviews, and visiting friends all over the west. It felt good to be out there...though each visit was brief, I felt like I really saw a lot of people and didn't have to rush like I have the past few years that I've lived in Virginia.
The interviews went well. I met so many residents and faculty that are all really excited about the future of Family Medicine and I would be happy to train at any of the programs I saw. And I think I did a good job of picking awesome locations as well. Most places I looked have housing options that sit right next to great outdoors activities, so I could be out hiking or biking or paddling or skiing any day that I'm not working until dark 'o clock.
And tomorrow, I go back to work. After about 2.5 months of not even thinking about medicine. I start geriatrics at the VA hospital. I am definitely excited to go back and to have more purpose in my day-to-day life, but also intimidated by my own rustiness. My schedule is set up so that I can see a wide variety, starting with outpatient clinics, then nursing home, palliative care and finally house calls, plus wound care rounds when I'm with the inpatient teams.
And this may be totally detrimental to my psyche, but...
30 days until Rank Lists are due
53 days until THE MATCH!
Sunday, November 18, 2012
Emergency Medicine
Another rotation down, folks! I finished my EM rotation a week ago and then it was a frenzy of getting ready for my first residency interview: dusting off my suit and shoes, doing a mock interview, learning everything I could about the program, etc. More on that later. I'm off to California tomorrow for a week of relaxing and eating at my home away from home with my parents before I get back on the interview trail.
EM was a really great rotation. For probably many reasons, students have a lot more independence in the ED. In the past, I worked closely with a resident and though I did my own evaluation and assessment of our patients, it was still a team effort to make and execute the plan for their care. On my EM rotation, I was essentially an intern. As long as patients were stable, I could assess them independently, write up the note and put in all the orders I thought were appropriate before presenting to my attending and then they would sign off on my orders as long as they were within reason. It was a tough transition at first because the ED is a high-speed environment, and as a student you are not really responsible for efficiency of patient management. So it was a bit of a learning curve to figure out how to thoroughly evaluate a patient, write a complete note, make sure your orders were placed and signed off in a timely fashion, and finally present the patient to the attending (who may or may not be seeing one of their 10 other patients). Once I got the hang of it, though, it was a pretty fun rotation. I saw a really good code (aka resuscitation of a cardiac arrest patient) finally, and managed patients with a huge variety of problems.
Although, what post would be complete without getting on my primary care soapbox? I definitely reaffirmed (for the 10,000th time) my desire to enter the field of family medicine. You see a similar variety of patients in a primary care office (though, less critical in nature at times), but you actually have the time to do a complete workup and have the benefit of follow-up visits with patients. Sure, it's kind of a thrill to go into that code with guns blazing: popping in arterial and central venous lines, the AutoPulse squeezing away, intubations, vasoactive drugs, etc. But, I guess in the end I will feel better about my day's work if I can prevent someone from meeting that violent end.
EM was a really great rotation. For probably many reasons, students have a lot more independence in the ED. In the past, I worked closely with a resident and though I did my own evaluation and assessment of our patients, it was still a team effort to make and execute the plan for their care. On my EM rotation, I was essentially an intern. As long as patients were stable, I could assess them independently, write up the note and put in all the orders I thought were appropriate before presenting to my attending and then they would sign off on my orders as long as they were within reason. It was a tough transition at first because the ED is a high-speed environment, and as a student you are not really responsible for efficiency of patient management. So it was a bit of a learning curve to figure out how to thoroughly evaluate a patient, write a complete note, make sure your orders were placed and signed off in a timely fashion, and finally present the patient to the attending (who may or may not be seeing one of their 10 other patients). Once I got the hang of it, though, it was a pretty fun rotation. I saw a really good code (aka resuscitation of a cardiac arrest patient) finally, and managed patients with a huge variety of problems.
Although, what post would be complete without getting on my primary care soapbox? I definitely reaffirmed (for the 10,000th time) my desire to enter the field of family medicine. You see a similar variety of patients in a primary care office (though, less critical in nature at times), but you actually have the time to do a complete workup and have the benefit of follow-up visits with patients. Sure, it's kind of a thrill to go into that code with guns blazing: popping in arterial and central venous lines, the AutoPulse squeezing away, intubations, vasoactive drugs, etc. But, I guess in the end I will feel better about my day's work if I can prevent someone from meeting that violent end.
Wednesday, October 17, 2012
MRICU, etc.
It's hard to believe that my ICU month is over! I spent the last 4 weeks in my hospital's Medical Respiratory Intensive Care Unit, which handles patients with primarily medical or respiratory problems (as opposed to cardiac or neurosurgical problems, we have special ICU's for those people!). I felt feeble in the beginning with so many new things to learn: ventilators, pressors, sedation. And how easy it was during third year to think of vital signs as such a minor thing (a fever might point you in the direction of an infection, or a fast heart right might make you think dehydration). But in an ICU they can not only change rapidly and dramatically, but you also have to look at them in the context of how much fluid and pressors are required to keep the vital signs at an acceptable level. But those things quickly became routine, since so many people in the ICU require these types of life support.
I saw some really crazy things happen too. I saw a guy with a massive upper gastrointestinal bleed go through a massive [blood] transfusion protocol (he got upwards of 30 units of blood in the blink of an eye) and go on to have a Blakemore tube placed. I watched a young guy get placed on ECMO. I helped with countless central lines and even got to try my hand at placing one by the end of the month.
But the things I may never forget are much sadder, maybe too sad for these pages. So many people die in ICU's and to be honest, it's a terrible place to die. I wish more people had this kind of opportunity so that they could better understand what they might want at the end of life. The ICU should be there to resuscitate patients who have a good chance at life after the ICU, not to prolong the lives of those who have no prognosis, who are essentially dead or dying when they get wheeled to our floor. Then it becomes a gut wrenching process of keeping the patient alive long enough to guide the family from shock and denial to acceptance or to convince the family that palliative or hospice care would be in the patient's best interest. I don't think anyone goes into medicine wanting to do this kind of work, but it's the sad reality of our current system.
Anyway, on to brighter and cheerier things. The residency interview invites have flooded my inbox and I can't wait to go on all these adventures! I also started my Emergency Medicine rotation and we're three days in and I have yet to do any work...can't complain about that. My first shift in the ED is tomorrow. Hold onto your hats!
I saw some really crazy things happen too. I saw a guy with a massive upper gastrointestinal bleed go through a massive [blood] transfusion protocol (he got upwards of 30 units of blood in the blink of an eye) and go on to have a Blakemore tube placed. I watched a young guy get placed on ECMO. I helped with countless central lines and even got to try my hand at placing one by the end of the month.
But the things I may never forget are much sadder, maybe too sad for these pages. So many people die in ICU's and to be honest, it's a terrible place to die. I wish more people had this kind of opportunity so that they could better understand what they might want at the end of life. The ICU should be there to resuscitate patients who have a good chance at life after the ICU, not to prolong the lives of those who have no prognosis, who are essentially dead or dying when they get wheeled to our floor. Then it becomes a gut wrenching process of keeping the patient alive long enough to guide the family from shock and denial to acceptance or to convince the family that palliative or hospice care would be in the patient's best interest. I don't think anyone goes into medicine wanting to do this kind of work, but it's the sad reality of our current system.
Anyway, on to brighter and cheerier things. The residency interview invites have flooded my inbox and I can't wait to go on all these adventures! I also started my Emergency Medicine rotation and we're three days in and I have yet to do any work...can't complain about that. My first shift in the ED is tomorrow. Hold onto your hats!
Monday, September 17, 2012
Family Medicine Elective
My first months of 4th year have already come and gone. I took the boards a month and a half ago and promptly went on vacation. I had a blast spending time with my family and catching up with a few friends.
On returning, I started my Family Medicine elective. I designed the month with the help of the lovely Family Med department at my school. The first two weeks were spent in a private practice in the 'burbs. I wanted to work with an energetic, young female so that I could try and imagine myself in their shoes. It worked! I had a blast and could almost imagine myself 5 years down the road in my shiny new practice. I spent the second two weeks at the local Family Medicine residency program. I worked with each of the attendings and several of the residents, attended lunch lectures, and even visited a couple of their other sites like the nursing home and OB clinic. I got a better feel for what residency will be like and really liked all the people I worked with. It was a great month in that it affirmed my decision to enter the field of Family Medicine.
Luckily this was a pretty laid back month, which allowed me to work on my residency applications! It wasn't all that hard really, but there are a lot of pieces to put together like getting a headshot, writing a personal statement, choosing which programs to apply to, making sure you have all your letters of recommendation from faculty members. And finally this past weekend I got to submit the thing. It felt like a lot of weight lifted off my shoulders.
Now I am back in the hospital working in the ICU. Today was my first day and I have to admit it was overwhelming seeing such incredibly sick people and not really understanding a lot of the interventions being used to treat them (ie, ventilators). Lots of learning to be had this month!
On returning, I started my Family Medicine elective. I designed the month with the help of the lovely Family Med department at my school. The first two weeks were spent in a private practice in the 'burbs. I wanted to work with an energetic, young female so that I could try and imagine myself in their shoes. It worked! I had a blast and could almost imagine myself 5 years down the road in my shiny new practice. I spent the second two weeks at the local Family Medicine residency program. I worked with each of the attendings and several of the residents, attended lunch lectures, and even visited a couple of their other sites like the nursing home and OB clinic. I got a better feel for what residency will be like and really liked all the people I worked with. It was a great month in that it affirmed my decision to enter the field of Family Medicine.
Luckily this was a pretty laid back month, which allowed me to work on my residency applications! It wasn't all that hard really, but there are a lot of pieces to put together like getting a headshot, writing a personal statement, choosing which programs to apply to, making sure you have all your letters of recommendation from faculty members. And finally this past weekend I got to submit the thing. It felt like a lot of weight lifted off my shoulders.
Now I am back in the hospital working in the ICU. Today was my first day and I have to admit it was overwhelming seeing such incredibly sick people and not really understanding a lot of the interventions being used to treat them (ie, ventilators). Lots of learning to be had this month!
Saturday, September 1, 2012
I'm a 4th year!
It's amazing to write that third year finally came to an end! It was a very long 12 months learning the ropes of the clinical world. Those first few rotations were rocky at best, my classmates and I learned the simplest things like writing daily progress notes and what "following" our patients means. Now with those concepts down pat, we have grown into baby doctors and can spend the majority of our time focusing on diagnosis and management of our patients' conditions. It's a great feeling!
4th year will be more of the same, but we'll see some new settings and have just a tiny bit more responsibility for our patients (of course, our senior team members will still have to oversee our actions) and become a more integral part of the decision making process. Here's a sneak peak of what's to come:
Block 1: Study for Step 2 Board exams
Block 2: Family Medicine advanced elective
Block 3: Medical-Respiratory ICU
Block 4: Emergency Medicine
Block 5: Interview month/Rosetta Stone-Spanish
Block 6: Geriatrics
Block 7: Endocrinology
Block 8: Reading month (aka, vacation!)
Block 9: Update course
Graduation!.....Residency!
I have a feeling it's going to go crazy fast. Hold on to your hats!
4th year will be more of the same, but we'll see some new settings and have just a tiny bit more responsibility for our patients (of course, our senior team members will still have to oversee our actions) and become a more integral part of the decision making process. Here's a sneak peak of what's to come:
Block 1: Study for Step 2 Board exams
Block 2: Family Medicine advanced elective
Block 3: Medical-Respiratory ICU
Block 4: Emergency Medicine
Block 5: Interview month/Rosetta Stone-Spanish
Block 6: Geriatrics
Block 7: Endocrinology
Block 8: Reading month (aka, vacation!)
Block 9: Update course
Graduation!.....Residency!
I have a feeling it's going to go crazy fast. Hold on to your hats!
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