MD, MPH

I was called to the stage as Dr. Physician Activist in Training.  A trusted mentor placed the green velvet hood over my head.  I took an oath [that was thankfully not the traditional Hippocratic Oath].   There were hugs, pictures, and toasts.  And scene.

Next up, the real fun begins.  Residency.  Bring it on.

3 more hours

My medical school already knows.  My residency program already knows.  In 3 hours, I too will know where I will be beginning my ob/gyn training in a few short months! 

After 5 years of medical school, a year of working while applying, 2 years of a post-bac program, 4 years of undergraduate (though most of that time I thought I was going to be a Rabbi and not a doctor), ... anyhow, there has been a lot of time spent to get to this point.  While time seems to be moving a little slowly right now, it is only a drop in the bucket compared to all the time and energy spent imagining being at this point.

Blessed be our Sovereign of time and space, Who has sustained us, protected us and brought us safely to this moment.

96 hours

96 hours between when I got the email today titled "Did I match?" (Yes!) and when I will get the envelope on Friday with the location. 

For now, I'm just extremely happy with all the confirmation today brings: to know that I have a job come July; that I WILL graduate medical school in 8 weeks as otherwise I'll be in breach of NRMP's contract which the med school would never allow; and that I'm going to be an ob/gyn! 

Also, for now, I will be drinking.  That is the advice I have been given (repeatedly) regarding how to get through this week.  I'm taking it to heart.

Eager, not anxious

Anyone have suggestions or advice for surviving the next 11 days?  I'm so ready to get this show on the road and know what the next 4 years of my life will look like!  Or, at the very least, know where in the country I will be living come June/July. 

March 21st can't come soon enough!

Where did February go?

NRMP rank list submitted.
Returned from my month long international rotation.

Now what?

Oh, ya, March.
The month of my last spring break as a student, my favorite medical student convention, The Match, a visit from my mom, the triathlon I'm signed up for (though currently not feeling up to do to recovering from post-URI bronchitis), and so much more.  I think (hope?) March is going to be a good month!
Then April with my 30th birthday, and May with medical school graduation.  Time is marching on & thankfully bringing good things along the way.

So lazy

Like most of winter break, I can't seem to motivate to move off of the couch.  Break ended but my motivation hasn't come back.  I just can't do it.  It being anything.  I can't do anything at all.  

It is an absolutely beautiful day outside.  I wanted to go exercise.  I was supposed to go to clinic, so I got up and got dressed.  Clinic was canceled.  I put my pjs back on, and back to the couch I went.  Where has all my motivation gone?  Will this laziness phase ever pass?

MS4 pickup lines

Said to me tonight (in a supportive, platonic, way): "You would be at the top of my interview list if i were a PD!"  Which got me thinking about what other fun pickup lines might exist around residency applications and being a MS4. 

Maybe my mind is just in a really convoluted place. Why not have fun with it though?  What ideas do you have for MS4 inspired pickup line, dear reader?

November is starting off on a bad foot

I just got a rejection for one of my top programs.  Far from my first rejection, but this is the first rejection that I'm really really upset about.  Seriously worried that I don't have enough interviews to match, especially enough interviews outside of the South. Hopefully the month can only improve from here?

Also, being on a rotation where I'm supposed to be self motivated and self-paced is turning out pretty poorly.  Week 1 has mostly been made up of sitting on the couch, watching TV, and taking naps.  It's funny how much I get accomplished when I am busy and how little I do when I'm not.

Not enough lexapro in the world

I'm pretty sure there is nothing that can cut through the dense anxiety that has built up around waiting for residency interviews.  I am trying my best to limit the amount of times I check my email (goal: no more than every 5 minutes), replace stress eating with healthier activities (goal: stop buying chocolate and go to the gym), and have conversations that are not related to interview invites (goal: talk about something else, ANYTHING else).  I'm doing decently well on going to the gym but failing by compulsively checking my email and preservative in conversations with friends.  Things like student doctor network's discussion board where people post what invites they are getting absolutely does not help in any way.  I know it is limited to a few obnoxious people positing anyway and is not reflective to what is actually going on, and yet, like an addictive drug I keep going back for hits.  It is the only connection I can find with what is going on behind the magic curtain. 

I got to spend this weekend back in my old, premedical school, stomping ground.  I've gotten to cuddle infants and chase toddlers that have been born while I have been nose deep in books.  I am finally seeing houses that have been purchased and roots that have been planted while I've been on the wards.  I feel blessed to be embraced so warmly back by this community, but also, even more aimless and unsettled.  Where will I be come June?  Will I still be on track to a career as an ob/gyn?  Will I be living in a city of my dreams*?  Will I be making friends with my co-residents or feeling like I don't belong?  So much unknown.  Ah! 

I keep thinking it'll be better if I get 1 more interview invite.  And then I do, or I don't, and it doesn't feel better.  I just want more.  More.  MORE.  Plus, then I get a rejection or two, or three as was the case last week, and I want to curl into a ball and cry.  Clearly rejections are going to come, but why can't all the invites come first? 

Is this process crazy making for all 4th years or am I am exception?  I no longer seem to have a grasp on reality.  


*there are currently 4 or 5 cities of my dreams.  So far I have a single interview in 1 of these cities.  I am desperately hoping for more.  At least 1 interview in each city, and maybe even 2 or 3 in some of these cities.  Please? Pretty please?

6 months

6 months ago I was just starting to accept the newness of a breakup from the woman I hoped to marry
Today I am still struggling to heal, but the edges aren't as ragged as they were

6 months from now (2 days ago to be exact) I will match into a residency program
Today I am patiently anxiously waiting for interview invites, and continuing to grow increasingly anxious every day

An emotional 6 months behind me and an emotional 6 months to come.  Praying that I have the strength to turn the anxiety into productive energy.  That I exercise instead of eat, that I force myself to go out instead of cowering in the corner, that I embrace the blessings to be found in uncertainty.   May the next 6 months be filled with continued healing, travel, and adventure!

Another 4th year milestone

I certified and submitted my ERAS application today to an obscene number of programs.  Somehow, miraculously, my personal statement was completed and all my letters of recommendation were uploaded in time.  After all the dramatic buildup, it felt hugely anticlimactic.  

Now I get to sit by the [smart] phone and anxiously await [interview] dates. Here is to hoping that the next few months are filled with many plane flights, cross country journeys, meeting many new people, and seeing old friends along the way! 

In the meantime, tomorrow I'm reestablishing care with a therapist.  I know that I'm going to need good support in place to get through the guaranteed uncertainty of the coming months. It was strange to realize in shul yesterday that I have no earthly idea whatsoever where I will be next year for the chagim. I'm trying to embrace all the possibilities and am optimistic that the therapist will bring some useful tools too.  And the adventure continues...

A week in the life of a MS4, edition 2 (August 19 - 25)

Yesterday: Rough.  Very rough.  Lots of tears from patients and nearly some from me too.  Got feedback on how I've been doing on the rotation.  Mostly good, some not so good.  Ate a bowl of cereal for dinner as there was no energy for anything else.

Today: So much better.  Got to scrub into a pretty wonky [and awesome] c-section.  Tripped on my own shoes when walking around the table to put in closing stitches.  Broke scrub when the nurse [who I adore] reached up to catch me.  Thankfully the atending had already left the room and the residents still let me close once I was re-gowned and gloved.  Got lots of complements in clinic.  Intuited a much needed hug from a staff member who seemed very appreciative when I asked if she wanted one.  Small achievements make me feel like a rock star!  Pretty sure this sub-i is inducing some type of manic/depression emotional roller coaster.... oh well.

Tomorrow: Responsible for 2 presentations.  1 is a formal hour long thing for the whole maternal fetal medicine department, the other is a quick 5 minute topic on patient care that I will likely filibuster.  I'm sitting here writing this blog post instead of prepping for either.  Or sleeping.  Oh, sleep!

Day after tomorrow: When is that? Yep.  I can't think that far ahead.  Let's just get through tomorrow first, and hope it is more reflective of today than yesterday. 

After what may seem like kavetching, I need to reaffirm though that I am LOVING every minute of this.  High intensity, high volume, patient centric chaos is my drug of choice  I feel so lucky to get to do this each and every day! 

I should carry Kleenex in my white coat

3 patients cried on my shoulder today.  All for very good reason.  All I could do was listen, hold their hand, look at them in the eye, confirm that it all just sucks and unfortunately no there is no answer for why, and offer Kleenex.  There were a few points where I almost started crying right along with them.  A shitty, rough, complicated day indeed.  A day that requires a long bike ride or a glass of wine - neither of which I had energy for after 14 hours of running around the hospital and knowing that I have to do in again in less than 8 hours.  You know what though?  I love my job.

It weighs heavy on me, maybe too heavy, but I am so glad that at least I can be there to offer a Kleenex. 

Sub-i self evaluation

1. I want to be the best sub-I they have ever had, to be perfect
2. I get loquacious when I'm nervous
3. I seem to always be nervous during my days on the wards
4. When I get loquacious, I tend to talk about myself or tell personal stories that relate to whatever is going on
5. I'm pretty sure no one wants to hear these stories & I should just shut my mouth
6. But then I get more nervous, and more loquacious
7. Even when I make a conscious effort to not be loquacious, I still manage to over talk & over share
8.  I blame it on being an extrovert & wanting to connect --> I want to connect to people
8.  I LOVE obstetrics and get excited that I get to be doing this
9.  My excitement makes me seem young (according to the PGY2 who couldn't believe I'm older than him because I'm so "eager")
10. Partially because I love what I'm doing, and partially because I don't really know anyone in this city, 14 hour days at work are amazing but weekends off are proving rough
11. After this experience, I would highly recommend doing aways in cities where you have connections.  Without such connections, this feels way too isolating and more nerve-racking. 
12. I try way to hard to seem smart, knowledgeable, & capable which makes me less of all 3 of these
13. If nothing else, my goal is to at least be helpful in order to make my residents' lives easier
14. It is pretty difficult to be useful at a new institution where you can't even find your way through the hallways of the hospital or figure out how to use their computer system
15. I am far from perfect
16. I strongly believe that only perfect sub-Is honor, and therefor there is no chance I will honor
17. I fear that high-passing my sub-I(s) instead of honoring will mean that I don't match in OB/GYN
18. Again, back to #1, I wish I was perfect

A week in the life of a MS4, edition 1 (July - August)

Tomorrow: - Last day of this first away sub-i
                   - First residency interview (at the program I've been doing the sub-i at)

Weekend:   Pack up from where I've been living all year into my car

Early Next week: Drive 3000 miles in 3-4 days

6 days from now: Start next sub-I at a totally different program type of program, in a totally different State, in a city I've never really spent time in, with totally different expectations of me that I do not yet know.

Oh, and all the while, I need to be working on my ERAS application.  

And this my friends is med school.  As soon as you get comfortable in your current situation, you're shoved into something new & different that you're totally not prepared for.  The strange part?  I am so grateful for this life and love it all.  Bring it on!

Halfway through

I'm 2 weeks into my first, of two, audition rotation.  It's both wonderful to be back doing full time patient care and also making me realize how much I forgot over the past year.  I couldn't even remember how to write a procedure note today!  Opps!

Mostly, it just feels like I am on a proprietorial first date.  Complete will all the nervousness, uncertainty, over-analyzing, and retelling of the "he said/ she said" to close confidants.  I just want the program to like me and ask me out on another date (or to match for residency)!

July 1, 2013

First day of my first away rotation.  So far, so good. 

ERAS opened today, so it is also my first day of officially starting the residency application process.  

A year from today (hopefully) will be my first day as a resident. 

This one time, during brain surgery...

Today I had the opportunity to watch a neurosurgeon remove (debulk would be a more appropriate term) a really nasty & invasive brain tumor.  The following conversation occurred during the surgery:

Neurosurgeon (NS): What year are you?
Me: I'm a 4th year, sir.
NS: First, don't call me sir.  Second, what are you going into?
Me: Obstetrics
NS: Really, ob/gyn?  That's too bad.  When I first met you I had thought you very intelligent. 
silence

Then, post surgery:
Me: Thank you for letting me scrub in.
NS: Of course.  It was great having you in the case, and nice meeting you.  I still think you're making a stupid specialty choice though!

And so begins the ob/gyn bashing that I have heard so much about.

On another note - two interesting new stories today about reproductive health.  First a story on the Turn Away Study and the second was ACOG bringing attention to HR 1797, the District of Columbia Pain-Capable Unborn Child Protection Act, which is progressing in the house.  This bill would ban abortions after 20 weeks, leading to more "turn aways" and issues with access.  While it is specific to DC, it could set an ugly precedent. So glad that this is how congress is spending their time, and our tax payer money, instead of doing things like dealing with the ongoing sequestration.  Ugh!

Pride

I was sitting in the car this afternoon with my mom on the way home from the airport (I'm home for a quick weekend between finishing my research year and resuming MS4), when she retold a story about an encounter that happened this week where someone wanted her to sign a "gay rights" petition.   She retold how she told the organizer "yes, I support gay rights, my daughter's gay."  

I've been out to here for 13 years and never once have I heard her say those words.  What a long way we've come...

Happy pride ya'll!  Instead of going to dyke march & pride, I'm spending this shabbos resting and enjoying some quiet time (& kick the cold that has been trying to attack all week).  The next 11 weeks are going to bring a whole heck of a lot of transition back to med school and being my best on away rotations.  Time to rest up before the fun begins!

Where will I be in August?

Fifty percent of my away rotations (July) have been settled.  August seems to still be up in the air though.  I got a loose offer from one Midwest program and then a formal offer from another.  The latter is where my now ex-girlfriend is on faculty.  I had applied in hopes of being with her, and then in stubbornness of wanting to prove to her that she made a mistake in dumping me, but now am starting to think wiser.  I imagine it will be tricky to do well on an audition rotation while also navigating being in the same space as someone whom I am deeply in love with and want to make a life with, but who doesn't love me back.  Plus, I'm pretty sure she's the only queer Jew in the city that I'd want to date - meaning that even if I LOVE their program - the city doesn't hold much promise for other parts of my life such as, um, dating.  

The first program isn't as strong as the program with my ex, and I'm not as interested in it.  It does come in a city with more queer Jews though.  Also, while the first program sent me an email offering me a space, there has been no formal follow up and they aren't responding to my attempts to gain more information.  I need to give program #2 an answer by Friday. 

I was just informed that a program I was holding out hope for is filled for my first choice for August, and was instead offered Oct, Nov, or Dec - none of which work for me.  I called the coordinator back who has put me on a wait list for another August rotation in ob/gyn at their program, but I wont know about that until at least Monday.  Two other programs I have applications in for wont even begin reviewing them until next week. 

What do I do?!  Anyone have a crystal ball I can borrow?