uh

not “uh” but university hospitals.  here is another residency interview update:

uh

i went in thinking it would be terrible – afterall, they interview 25 people per day and have three interview days.  to me, that just screams “we don’t care about you as a person”.  i didn’t leave the interview dinner feeling like it would be any different.  the student to resident ratio was grossly out of proportion, and i was just exceedingly relieved to find one of my classmates there.   we were then able to commandeer a couch, and we had the luxury of talking until people came up to us.  the program director was exceptionally nice, giving us hugs as we left the party early – the food was meh, and the company was average (particularly some of the other candidates).

at the actually interview day, we sat through 1.4 million lectures, but then quickly proceeded to our interviews. 

1: great lady, we had a nice discussion on ethics and morality.  she gave me an honest comparison to metro. i liked her spunk and honesty.

2: residents – pretty cool, although one was a bit timid to me, she was adorable nevertheless.  this was a time my board scores were mentioned by my irritation was mollified by their questions regarding the ccc.  all is forgiven. bonded with the third year resident – he would make an awesome chief.

3. pretty cool generalist who knew the former chair of the ob dept i did my clerkship in.  pretty easy to bond with her over that.  now in retrospect can hardly think of what we talked about.  not that interesting – although this was probably more to do with her velvet tie-dye shirt more than anything.  yikes, it was mesmerizing.  (side note: mesmerizing i think came from some magical dude named mesmer – yes?)

4. the program director’s husband who i had talked to the night before – genuinely a nice guy.  we had a nice discussion about reading, which i am quite fanatical about this year.  i am itching to read something now even though i should already be sleeping.

5. prog director herself – picture this:  middle age lady, maybe early 50s, pretty, likes wearing animal prints, bright colors (esp red!).  she definitely preoccupied with people’s appearances as she commented on it throughout the day – not applicants, but on her co-workers… appropriate time to mutter “awkwaaard” under my breath.

so there you go.   i did like the day overall though.  i’ll definitely be keeping them high on my list – got a good vibe.

time flies

it’s almost frightening how quickly time has passed me by.  only 3 months ago i was panicking over submitting my common application form on eras – what if there is a typo, did i remember all of my extra curriculars, did i properly cite all of my research, etc.  not 1 week later, i was compulsively checking my e-mail and the eras website waiting to hear back from programs.  time went too quickly – i had the opportunity to start interviewing in october, but couldn’t bear the thought of starting that phase of my life.  my first interview did end up beginning in mid-november, but i was grossly unprepared compared to now… i hadn’t really wanted to start.  even now i approach most of my interviews with dread.  i hate even the thought of smiling when i don’t feel like it, or laughing at a joke i don’t think is that funny.  i hate asking questions i don’t care about regarding topics that won’t actually influence my decision to go to a residency.  so, inevitable, my disdain for these actions has led to me 1. not doing them 2. cringing when i see others doing them.

i have also become extremely cynical about the whole process.  there are three areas that are continually commented on in my application: 1. my boards scores (i guess i should have figured – they are very nice) 2. letters of recommendation 3. research.  and while these are nice, why comment on them?  i hate when i feel like they don’t even care about what i have to say, but are salivating for me to come to their program because my score on step 2 is bitchin’.  yes, bitchin’.  but ultimately, i would rather talk about my life, my hobbies, everything except medicine.  it has consumed my life for so long.

and on that same note, i still dread the progression of time.  i think about how i have spent my entire life in school and studying. what will i do when i am responsible for patients.  a real job.  people dependent on me.   no more winter and summer and spring vacations.  today is only one more reminder of those things as my month in the ed comes to a close.  

it has been a pretty entertaining month – although sometimes i am extremely bored and all i can think about is how much i want to leave.  today was not one of those days fortunately.  it was a wonderful way to end the month, especially since i was able to spend tonight’s shift working with my favorite e.d. resident.

step 2 cs

silliness.  i am sure i did just fine. 

what it entails:  12 standardized patient interviews – 15 minutes to see the patient, 10 minutes to write a note, including your assessment and plan. something like 98% of US medical grads pass it without a problem (it is pass/fail).

my only observation was the pattern of all the other students not requiring the full 15 minutes to do a complete history and focused physical exam on the patients.  the very idea of this blows my mind – as a medical student, you should have plenty of questions in your repertoire to take up 15 minutes… but these interviews didn’t just involve doing the aforementioned tasks – you also had to summarize and explain your plan… basically – it should take you 15 minutes unless it’s an unbelieveably easy case.

although i suppose it doesn’t matter.  we’ll all pass, and we’ll all be good doctors regardless of that test.   plus i am pretty sure they are not going to continue administering it next year.  stupid.  not surprised.

grace

it was not too long ago in my religious discussions with z that the topic of grace came up, and i recall inquiring into what grace really meant.  his answer was it’s when you come by something you didn’t necessarily earn, which for some time was sort of inconceiveable to me.  i was always of the mantra that everything you have you should earn…but there are somethings that we all have that we did nothing to attain. 

nothing taught me more about grace than my recent interview at allegheny.  the program director was commending me on all of my positive characteristics and traits, but specifically my intelligence.  it was a nice interview because it was a lot of compliments for me, but when he raved about my “brilliance”, it really struck me on how fortunate i have been. 

i know i have  a very blessed life, but for some reason my epiphany came right then.  how lucky to have two very intelligent parents, with the only factor limiting their going to college was 1. their lack of ambition (my father) 2. three children by age 23 (my mother).  my mother eventually went back, but i just wonder what she would have achieved if she hadn’t married so young.  how lucky for me that she did marry early, because i wouldn’t be here.  how lucky for me that i have such a supportive family that has encouraged me throughout these four years.

and that is a minor sampling of God’s grace in my life.  i pray i never forget to thank Him for all he has given me and all that continues to come my way.

interviews

i have been rather lazy when it comes to update about interviews, so here i am to update about the past four.  i need to keep on this for the rest of time so that when i need to rank, i have yet another source, especially for my earlier interviews.  i need to have something to remember them by.  so my four interviews in order of occurrence:

metrohealth/ccf

when i first went to this interview, i looked back on it more positively than i should have, but that is the problem with a first interview.  you have nothing to compare it to.  if all that mattered to me was my interaction with the residents and the program coordinator, then i would certainly consider going there.  however, the feeling i got from the attendings was completely different.  the program director asked me about the state of summa and the things that dr. f would be getting into, which i thought was inappropriate and irrelevant to my interview.  another attending told me that they came back to metrohealth for the benefits, when i asked why she came back after leaving for two years.  now i am sure that was certainly a reason, but that should not be number one.  then most of the attendings asked, “well why should we take you?”  i just felt like the attitude of the attendings toward the residents was not an environment i would want to be in.  i should note it wasn’t all bad.  there was one attending that was into medical education that i completely bonded with, and i know i would enjoy working with him.  and again, i was interviewed by a resident who i definitely enjoyed talking to.

so overall, it was meh. (which p.s. is now a word in the dictionary!)

aultman

my reception at aultman was certainly a welcoming one.  despite their statement at the dinner and throughout the day that they all get along i was a little skeptical because only 3 showed up to the dinner, 2 of which were interns.  it was a frustrating interview because you would ask the residents one simple question and all three would feel the need to provide an anecdote to answer with none of them telling you something different.  however, it was pretty clear that liked being there and were happy.  as to the attendings, they were all welcoming and kind, and i felt like i would be wanted there. the main downfall?  it’s canton.

musc

loved it, loved it, loved it.  i loved the residents, the musc students, the attendings.  it was like i was at summa – but without having to have been there for 10 weeks.  i was there for a few hours and felt comfortable.  they had some students from the north, so i know they would be willing to take students from there and it was one more way for me to bond.  i liked all of the attendings, and it was a rare occasion that they tried to pimp me on my application.  instead they tried to find out about my life outside of medicine and how i worked to maintain it.  i had very personal conversations with the attendings.  basically, there was nothing after that interview that i could say i didn’t like.  the program director was completely and utterly wonderful.  if i decide i’d like to go out of state (which is definitely a strong possibility), i will be striving to go there.  i may try and go back for a second look if i can get z to go as well.

summa

summa was…summa.  they know how i feel about them, and vice versa.  if i decide to stay in the area, i will certainly be there and loving it.  dr. f is wonderful, the residents are great overall, and i know who the chiefs will be and they are awesome.  the attendings are all incredible, and i know them well.

so right now, the two top contenders are summa and musc.  we’ll see where things go.  i will start trying to make individual posts about interviews.

crazy awesome

yesterday i had the joy of not only viewing but also actively participating in a “laparoscopic salpingoophorectomy” which is a fancy-schmancy way of saying we’re taking out a tube and ovary.

as the surgery began, i took to my usual post between the patient’s legs to push on a tool that would suspend the uterus in air within the patient’s abdomen.  it’s an easy task, and i have never minded doing it because unlike retracting, it requires no physicial exertion and still affords the opportunity for the medical student to watch the surgery.

yesterday was different though.  as i stood there, the doctor asked if i would like to stand up at the side of the table.  flabbergasted at why this would be an option, i asked him what he would do. 

“i’ll stand there and hold the uterus up while you come down here.”

“why would you do that” – as i start to edge back from my trusty position.

“because i want you to come here for residency you twit.”

well, that was more than enough reason for me as i scurried around the table to my new post.  and there i stood.  my first task was putting in a new trocar, and i managed with no difficulty, both in making the incision and in placing the trocar.  next was helping out by grasping the appropriate structures.  it was a little strange getting used to it at first because you’re obviously watching a tv screen where everything you do is reversed, much like watching it in a mirror.  the rush was unbelieveable, and despite all the pressure and sweaty armpits, i managed to do a good job.  we finished up the case and i helped close the ports as though i were an integral part of the case. 

this is all of what i look forward to.   i will miss it, as tomorrow is my last day.

as an update – today the same doctor asked, “if i let you do an entire vaginal hysterectomy, will you promise to come here for residency”.   fortunately, he doesn’t have any lined up tomorrow so i didn’t have to answer that question.  it’s nice to feel wanted.

step 2

well the score is in, and i managed a 262/99 which is flipping awesome.  another weight off my back.  and i am in the top 25% of my med school which is definitely also a bonus.  both of which will make matching a cinch.  wish me luck, i only have a bazillion interviews to do.

full of air

nothing makes a gynecologist’s heart drop faster than when they hear one of two things:

1. “why is the foley bag full of air?”

2. “the urine is red.”

those both mean one of two things – damage to the ureters or damage to the bladder.  despite their reputation of perf’ing plenty of these structures, it has been a rarity in my experience, albiet a limited one.  and by rarity, i mean it never happened in a case i have been in prior to today.  i was unfortunate enough to be in the case where the trocar (google it) went through both walls of the bladder. 

it was still something i needed to see – mostly because it’s a very possible complication when operating in that area, and because i was able to see a physician deliver bad news, something that can be particularly easy.  it was a fun morning though since i was the only one working the doctor – i got a lot of one-on-one attention.  the positive of this was negated by the fact that i only got 3 hours of sleep and said such idiotic things like:

“tomorrow’s game was bad news then…” – that was when refering to yesterday’s steeler’s game.   really?  tomorrow’s game was bad news? slick.

and all is right in the world

michael phelps tore up the olympics, dede continues to eat trash, and i am going to pittsburgh for a month, starting this monday.

not only that, but something earth shattering has happened.  drum roll please:

i have honored a shelf.  my last and least favorite one.  this is awesome on two levels: 1. i honored a shelf 2. it shows continued improvement throughout the school year and not that i burned out and stopped trying.  i never stopped trying despite how disappointed i was every time.

so yea..going to pittsburgh.  there are no words to describe my joy in finding out upmc would be having me come for an elective.  not only will i be going to a mecca of an academic institution, but i am going to have the month of my life hanging out with bri and kyle.  we all already have so many plans.  it’s incredible.  and i’m not going to lie, it will be fun to see the pburgh boy out there.  my male counterpart.

so, you’re married, right?

this past monday, i had the pleasure of interviewing eight, count ‘em, eight fake patients.  while most of them went relatively well, a few stand out in my mind as being the exact opposite.  here are a few of my favorites:

the firefighter:

i walk into the room and ask the patient what brings him in. “i’m having horrible thoughts”.  i ask him what kind of horrible thoughts.  and he says, “well, you see, i’m a firefighter.  and recently i was fighting a fire with my brother, when he fell off the ladder above me.  i tried to keep him from falling, but i wasn’t strong enough and he fell and died.  then it was even worse because i had to identify his remains.”

clearly this is someone with post traumatic stress disorder, but no matter who you are, there is no way to be prepared for that.  i felt like i was hit by a bus.  i didn’t know what to say because i couldn’t even fathom that, and i definitely was not expecting that to be his complaint when i walked into the room.  after the interview, the patient and physician (who was watching me from behind a one way mirror) rate me on my performance.  ha, the patient didn’t think i was very empathetic, at least in the beginning, but the physician thought i did awesome.  then they ask how i felt about it, and i definitely articulated my aforementioned thought of feeling like i was hit by said bus.

the abdominal pain:

woman comes in with abdominal pain – after a history and physical, it seems pretty obvious it’s either appendidicits, pid, or a ruptured ectopic pregnancy (with the latter being the most feasible).  each of those is pretty much an emergency and don’t really allow one to fart around asking stupid irrelevant questions like, what is your parent’s health like?  the physician comes in and basically critiques me because i didn’t ask her if she was married or if she was trying to get pregnant.  hey guess what buddy, both those questions are irrelevant, and more importantly, asking if a woman is married when she could potentially be pregnant is just a bit insulting.  these days you don’t need to be married to be prego.  well, you didn’t before either, but you get the idea.

 

blah.  i hate these fake patients sometimes because it is soooo impractical.  that kind of stuff is not what happens on the floors.