Busy, busy.

Hey gang,

I’m still in residency, despite the lingering imposter syndrome.  This past year I’ve been sure to keep up with emails from people that find this site, but I’ve neglected the posts.  Figured I drop in a quick update and remind everyone that you can email me at any time.

Residency is full of surprises, some rotations are better than hours (whether it’s the service, the hours, or the people). There were times when I wasn’t sure how I was going to make it through the week. Sometimes I needed to call for a ride home, sometimes I had to cancel plans, and sometimes I needed a few coffees to keep me going. The other day I was hitting the unlock button on my car keys trying to get my apartment door to open (that was a new one!). Despite all of that, I enjoyed it. I felt more of a sense of satisfaction that I mattered and was making a difference for patients. I could see myself improving drastically in a short amount of time and can’t believe how much I learned. I forged close bonds with my colleagues through the long days and nights and found mentors that inspired me to take on extra projects or read more about things that I didn’t necessarily find interesting before. Plus, Step 3 was my only test for the year 🙂

So for all of you at different stages in the process, keep up the good work! I believe in you. So many before you have gotten through it all despite life’s curveballs and obstacles.

Take some time to give yourself some self love and compassion. There are only so many hours in the day, and we spend most of them taking care of others. Never forget to take care of yourself first.

Send me emails with questions or asking for encouragement.

Intern year

I am two months into my intern year, and to say it’s flown by is an understatement.  From getting my first long coat to signing my first paper prescription, it’s been a whirlwind.  There have been nights I’ve come home after being in the hospital for 18 hours.  There have been days where I can’t remember if I’ve eaten a meal.  It has been intense, but I love it and I am so happy to have the opportunity that I have to be a real team player in making a difference in people’s lives.

So I’m just checking in to let you know, once again, that if I can do it, you can do it!

A few things that have been key to my survival as an intern:

  1. Sleep when you can. Literally whenever and wherever you can.
  2. Fight to keep a work-life balance. Make time for a hobby that you enjoy, for a 5 minute a phone call a day with a friend, 10 minute bursts of exercise throughout the day, mindfulness, whatever it is to help prevent burnout
  3. Write everything down. If you don’t write down that critical lab value or that reminder to call your mom on her birthday – you won’t remember it.
  4. Be active in your learning. Admitting a patient with 20 meds at home? Don’t just say continue all of them – figure out why they’re on each and be thoughtful about inpatient meds.  If you have time, go back later and recheck the mechanism and side effects of those drugs. Residency is exhausting and it’s a lot of grunt work, but this is the only time where you will get the chance to have this much repetition to build a solid foundation.  I struggle with this, because it’s so much easier to let it go and just get the work done and get home.
  5. Take ownership of your patients. Sure you have senior residents, attendings, and maybe even a med student to help cover all the bases, but things fall through the cracks. Ultimately you as the intern are the face of that patient’s care and your name is all over the medications and orders.
  6. Budget and put as much as you can on autopay. You’re making money – YAY! Don’t blow it all in one place. Look up White Coat Investor or something and outline a general budget.  Live within your means and save up for a rainy day (or unexpected car troubles).  Also, remember you’re going to be tired and might have trouble enough knowing your schedule for the week, so you better have your rent, electricity/utilities, car insurance, and whatever else you can on autopay because you might forget.  Don’t waste your hard-earned money on late fees.
  7. Enjoy your career. This isn’t just some job or some stepping stone. This is your career, the life you’ve been working towards for so many years.  Learn to love it. Build a solid foundation now and do your future self a favor.

I don’t know when I’ll get a chance to write another post, but send me your ideas!

On to the next chapter

I matched! To a top program to boot. Which proves anything is possible if you work hard.

There were days when I doubted myself and my competitiveness during the interview process.  Times I thought I wasn’t good enough and shouldn’t apply to ‘reach programs’ to save some money.  Thankfully, I thought ‘screw that noise’ and went for it, and I got into a program that was one of those ‘reach programs’.

So keep working hard and believe in yourself – it’s all possible! Please reach out to me if you want any advice or just someone to listen.

Home stretch! Rank list

I found out today that there are 45 days left until Match Day.  Seems so close, and each day I keep going back and forth between programs on my rank list.  If you would have told me 3 years ago during my repeat year that things would turn out this well and I would be weighing my options, I wouldn’t have believed it.  Granted – I haven’t matched yet – but I am actually hopeful!

If I can do it, you can do it.  There will be tough days and it will take hard work, but it is all possible.

If it helps, I will share my stats:

Step 1: 213, Step 2: 229. 1 HP in first two years, 2 HP in 3rd year.  Externship, 2 year research project, and good amounts of volunteering/leadership roles. Number-wise I am below average, but my extracurriculars and projects set me apart.

I applied to 40 psychiatry programs, received 15 invites, a few wait lists, and went on 13 interviews.  I went to a few places ranked in Doximity’s top 30.  After talking with some advisors, I do think I was a bit limited regionally since I went to college and medical school in the same area.  This means I could have probably saved some money by not applying to so many, but I wasn’t sure where I wanted to go, so I applied all over the country.

There are so many factors to consider when choosing a program.  The thing that makes it tough is that there is not one set of criteria that will work for everyone, and so you need to figure out what matters to you.  My main advice is try not to have preconceived notions of places and don’t underestimate the ‘gut feeling’ factor when ranking.

Let me know what questions you have.

How time flies!

Quick update – just finished an away rotation and had a wonderful experience.  I am scheduling interviews and on my way to a week-long conference in the morning.  Life is exciting!  I realize as this month has flown by, there have been so many other months where I get to the end and I think ‘what the heck happened?’ and cannot recall much.  So below is some advice for those of you who are in the earlier steps of the journey.

It is so easy to get caught up in the cycle of study-eat-sleep-repeat.  Recently, I started making time for 5 minutes of mindfulness each night. I think it has made a big difference with calming me down and getting a better night’s sleep.  Too bad I didn’t start sooner than fourth year, it probably would have been even more helpful during test week!

Here are a few things I wish I would have done while I was in school:

1. Paused after various experiences to jot down my thoughts and reflect on how the experience impacted my career path.  This would have made expanded on my CV, preparation for interviews, etc easier.  Also it would have probably made me be more grateful for all the opportunities I have.

2. Volunteer more. I found it difficult to commit to long term projects, especially third year when you have little control of your shcedule.  However, I think if I had really wanted to make it work I could have.  During college I did a program similar to Big Brothers Big Sisters and I wish I would have continued that.

3. Read the news.  At times I felt like I was out of touch with reality.  I actually like physical newspapers, but the Skimm is a nice, quick substitute.

4. Wrote down lessons learned from people I worked with.  Some providers made me think “Wow I want to be just like you when I grow up.” and others I thought, “Ugh, I really don’t like how you phrased that.”  There were people who seemed to be very happy with their work balance of clinic, research, and also home life.

5. Unplugged and slept more.  We’ve all done it, thought ‘Oh I’ll just see what my friends are up to on social media since I haven’t seen them in awhile’ and then BAM an hour or more is gone.  Time and sleep are priceless, and I wish I would have been more efficient with my time.

Back to the Future (Planning)

I am patiently awaiting (read: trying to ignore) Step 2 CK scores and working on ERAS.  This time around, I felt more relaxed during the test.  I did some breathing exercises, made myself move on when I got stuck, tried to not to change my answers, and did my best to be positive the week up and during the test.  Hopefully that all worked to my advantage!

Post-test events were lovely.  Basically I went out to eat every day for a week and read a book.  My rotation this month was spectacular with a wonderful attending, so basically I was spoiled.

Then I got down to business revisiting my personal statement, CV, etc.  While working on my PS, I decided to pull out the one that helped get me into medical school.  Had I not known that I wrote both, there is no way I would have guessed they were written by the same person.  My writing skills have declined…and I just don’t feel as inspired this time around.

What are your thoughts for writer’s blocks and ideas for inspiration?

Remember to take some deep breaths today and think about what you are grateful for!

Fourth year… at last we meet!

Hello all!

So I am kind of bad at this whole updating thing.  I am really sorry about that.  Once I take Step 2 next month, I will really try and think up some more topics to post about.  Probably about the residency application – which up until this week I was blissfully ignoring.

But the reason this last year of posts was so sparse is because third year rotations are tough.  I had no control over my schedule.  Even when I wanted to go to a legitimate lunch lecture or conference, I would get denied or take too long to write notes or be too tired to keep my eyes open.

I thought surgery would be my least favorite, but I got lucky and had some really awesome residents and attendings. There were days where I had forgotten to eat, stood on my feet for so long I thought my spine was going to snap, and where I couldn’t get my brain to send the right signals to my hands for stitching.  Despite all that, the people I worked with made me feel like a human being and surprised me with how much respect they treated me with (even though I was pretty much an idiot when it came to pimping).

Turned out OB/GYN was just as bad as some of my nastiest nightmares.  Was that in part because it made me wish I wasn’t a female?  Maybe.  It also had a lot to do with the hours, the smells and sometimes awkward moments, and the times where it made me question how in the world could I feel this terrible about life.  There were some moments.  The miracle of life and literally feeling the gigantic amounts of love and joy in a room was mesmerizing.  One particular memory that will be a ‘forever story’ for me is the night I delivered a baby alongside the doctor who delivered me.  Talk about full circle.

Anyways, here’s what y’all really care about – I officially passed all of my clerkships, evaluations, shelfs, OSCEs, and am a fourth year medical student!  It was another huge weight off my shoulders, if only briefly before Step 2 took its place.

I am making progress.  I started my ERAS application.  I am going to be a MD.

If I can do it, you can do it.  I believe in you.  You should believe in you.

Getting over fear

“I wanted your advice on how to not let the fear of failure hover over my head all day. I feel like this next year all I am going to be stressed about is failing again and it gets in the way of me studying, not to mention all the social stigmas that put me down for repeating.”

I had jotted some things down to say awhile ago and honestly found this a tough subject for me to be uplifting about. The truth is I still have issues with fear of failure. The first repeat year was the worst, but I worked my butt off and that first test I ended up being in the top scores and it was as if I could stand up tall for the first time. My school had a policy stating if a student marginalized or failed any class they would be terminated as a student. I worried too much about debt, what people thought of me, and letting down myself by not achieving my goals. That sucked.  I am more confident now with that repeat year behind me, but that little voice saying “you’re going to mess up this next test and have wasted the last 3 years,” still gets the best of me at times.

Here is some general advice of mine:

Step one: remind yourself why you started on this path in the first place.

This gets much easier third year when you’re with patients playing doctor for real.  I want to work with kids and help them have better lives.  I write down some snippets of great encounters I had with people or at clinic that help rekindle that warm feeling inside that helps me know I’m doing the right thing with my life

Step two: remember that you belong here in medical school.

The school chose you for a reason, and they have a long standing history of choosing people who end up being successful.  There are many people who never made it to the point you’re at, and they’d probably be willing to do a lot to switch places with you.

Step three: stop giving a crap about what other people say or think!

I know this can be tough, but at the end of the day does it really matter what dumb/condescending/rude remarks they’re spewing? Truth is, most of them are just as insecure and afraid about failure as you are – but it makes them feel better to knock you down and be thankful it’s you and not them struggling. I ended up finding out who my closest and most supportive friends were through this whole process and I am so grateful for that. I know that they will be lifelong friends and supporters of whatever I choose to do in life, and I will do the same for them.  That’s pretty cool.

Just remember that you’re not alone and there are people who are the future versions of you that are successful physicians and are better people and providers due to overcoming their struggles.

Does anyone else have any other suggestions or personal experience finally getting over the fear of failure?

Scrub butt and the new year

Hello all and happy new year!

Hopefully you are sticking to those resolutions still.  For me, I decided to try and kick a bad habit instead of trying something new.  I am trying to be less cynical and negative about myself, and humanity.  I’ve seen some of those ideas on FB about keeping a jar where you put positive experiences.  Instead I am going to try to write something positive down in my planner once a week.  That way, when I go back a month or two to update my CV, I can remember that I can do this whole doctor thing and that not all people are terrible.

These past two months were pretty rough thanks to the surgery rotation.   For those of you wanting to go into that field, I am glad that there are people that can handle that lifestyle because I am certainly not cut out for it.  Don’t get me wrong, it was fascinating and every time someone was cut open I was in awe and couldn’t believe I was pulling organs out of people.  It is one of the few times in my medical school career where I can vividly remember moments, such as getting to hold a heart during an transplant procurement.  I was also forced to face issues of mortality and spirituality multiple times throughout the clerkship, and the intensity of that took me by surprise.  My expectations were that I was going to be drained in surgery, but I had expected it to be more physical than emotional.

Tips for surgery:

-There might be a lot of standing around, have some study material to read because by the time you get home you’ll be too tired to study

-Pestana’s Review notes are a good, quick read

-The Shelf won’t ask you about what technique is best for a surgical procedure, learn some internal medicine.  Pimping might be a lot of anatomy, though.

-Always have snacks in your white coat, locker, etc.  Always.

-Don’t be surprised if it turns out you are capable of falling asleep standing up.  Try not to though and be useful in some way

-You may or may not get yelled at.  Don’t take it personally. One time you cut too short, the next time too long, and then you zone out and aren’t allowed to cut again 🙂

-If for some reason you’re not a nice person, at least pretend to be in the OR so that the scrub nurse doesn’t make your life tougher

-Don’t be scared to ask permission to do something.  Sometimes there might be a line of fellows, residents, etc. who might not think to offer you an opportunity to close

-Most recently I’ve learned to ask for feedback more often, which is good for life and good for evaluations if they’re weighted

 

That’s all for now folks.  I’m on psychiatry now so send some questions I’ll have time to write!

 

P.S. someone told me they didn’t know what scrub butt was – it’s when you’re wearing scrubs all the time so you don’t notice how much weight you gain from spending your life in the hospital/OR

Family medicine – terrifying and exhilarating

Hello all!

One clerkship down (pediatrics) and one shelf passed!  It is crazy how fast time flies when you are so busy on rotations.  It seems so long ago since I was learning to just put my stethoscope on correctly.  Now I’m stitching up people’s faces, helping delivering babies, and dealing with real patients who value me.  I don’t necessarily see myself ever practicing FM, but I am strangely enjoying my time here nonetheless.  I am always terrified because I feel like I know nothing and FM treats everyone and is the first line of defense, but man is it cool to see so many different people and things all in one day.

It has been a tough adjustment.  I miss being able to take bathroom breaks whenever I want and having a structured schedule.  However, I love actually doing things and learning via hands on experience.  It was very stressful finding time to study for boards, but seeing as how I managed to pass, I believe that I learned a lot more while in the hospital than I had thought.  I am more of a multimedia input learner anyways.  Books used to be my best friend growing up, not so much in medical school – they aren’t exactly page turners that put you in a good mood.  Plus, books never tell you good work or thanks!

Here are some suggestions I have from ym very limited M3 experience:

-Find someone who has a different clerkship schedule with you and share books (there are so many it would cost too much to have your own set)

-Read CaseFiles the first couple of weeks of a rotation.  This or some other smaller book is also great to carry around for the inevitable down time you’ll have on some rotations waiting for patients or over lunch.

-Do practice questions! Depending on your school, the question style on the Shelf is most likely quite different from what you are used to

-Find a bigger book you like and stick with it: BRS, Blueprints, First Aid, High Yield, PreTest

-Show up early, as in Vince Lombardi Time

-Participate! Even if you don’t want to have anything to do with that specialty ever – this will be your only chance to do something this cool

-Take care of yourself.  It’s tough.  Balance is like that mystical unicorn with a rainbow horn – you won’t ever find it.  You should still try, though.  At least get enough sleep and eat somewhat decent meals to keep your brain going.  If you can find a few minutes to read, relax, workout, Netflix, whatever – great.

Any other questions?