Ross University School of Medicine 2010 Graduation

As of June 4th, 2010 it is official, I am now a physician! Graduation week ended awesome, just packing things up and ready to make the 10 hour drive to NYC. Nice scenic route with good convos the whole way. Along for the trip was my husband, dad and I in one car and my mom, step-dad, sister and grandma in another. My own little entourage, haha! We get there, pretty tired and ready to just have dinner, drinks and some sleep to get rested up for the big day we all have been waiting for!

My I woke up at about 5am just to slowly get ready with a shower, straightening my hair, makeup and truly not sure what to expect. I was able to meet up with my friend Robyn in the lobby of the hotel which she was staying at too! It was so wonderful to see her and walk over together to the Theater at Madison Square Gardens across the street! We went with gown, tams and hoods in hand ready to see what was in store. We arrived about 7am to what we thought would be an organized get together to see old friends from Dominica and mingle - weeeelllll, there was mingling but organized? We were packed in there like a can of sardines, haha! No places to sit until we walked in at 9:30am outside the doors of the theater, which was great for us ladies in high heels - ouch. We had a continental breakfast, though I wasn't too hungry... I was just anxious to get in there! Then the fun part of the day came... getting in alphabetical order - alllll 650 of us! I was kinda bummed because I wanted to be by a couple friends but turned out just fine. Then 9:30am came and Pomp and Circumstance began to play. We were broken up into two lines A-L, M-Z and I saw the first group walk in first. Finally when it was my turn to enter into the theater, I had my first thought. I rarely remember "what was the first thing on your mind", but it was God. I, as well as all who read this blog, know how difficult times would be for me throughout all of this. The times I thought I would fail; the times I didn't fail but wanted to quit; the times I didn't quit but found myself sometimes crawling my way towards the next goal or milestone only to come out, on this day, a graduate - a doctor. I remember giving my thanks to God, just knowing He made this possible by giving me the strength to push myself, dare I say straight to the edge haha... But then I walked in, of course looking for family in a huge crowd.

When we were seated, I was in the front row on the right side of the theater. Everyone was waving looking for family way up in the seats. I did the only thing I could! My mom and I have always outlined a heart to just say I love you. This started back in high school when I was at track meets waiting to start my races. I sometimes would be scanning the stands over and over because I never felt right starting a race without her. To get my attention we would do the heart and worked like a gem during this fine day! After the last of us walked in, a standing ovation for all the graduates. Cue in the tears! There was nothing I could do about it - and I didn't want to, so I let my tears roll. I think those next to me thought I was nuts. Oh well! Next were the welcomes and commencement speeches which were fantastic! Here is a link to the address: http://www.rossu.edu/news/Dr-Dexanne-Clohan-Delivers-Commencement-Address-at-Ross-University-School-of-Medicine-Graduation-Ceremony.cfm They all had great messages that seemed so relevent to me, especually this commencement address - truly touched me. After this, they stated our requirements were fulfilled and declared us fully qualified to graduate as physicians. One row at a time we lined up to go backstage, where we were again lined up like a snake wrapping around the poles to stop at each checkpoint: name card in hand, hood folded neatly on our left arm, smile and GO! We went out in sets of three, luckily I was the last in a set so I could stay on the stage the longest. As one of my old professors took my hood, I remember him saying "How are you today?" All I could tell him was how nervous I was! I didn't even have to do anything haha but it was just so exciting! I passed by the other professors who hooded others, saying hello and handing my card over to my old faculty advisor for the student council, which I was the president of on the island. It was great to see her. I still don't know if she truly recognized me, now that I was graduating under a different name but she gave me a hug and a familiar smile so I am hoping that she really did. Then she passed my name card down to the speaker and stood in front of the podium where he annouced my name, "Dr. Jessica Lynn S." followed by the screams of my family and friends! It was such a quick moment but I will never forget it.

Once the empty diploma holder was in hand (haha, fyi just got it in the mail today!) I walked back stage where each person from MSG I saw congratulated me. I kept thinking, "They are congratulating all 650 of us?!" I was impressed because it seemed so genuine. Moving towards the back I had one more picture taken and then I moved back down to my seat to watch the few others get their diploma as well, I swear I screamed for at least half of us - I forgot how many people I reall knew! I saw each of them get hooded, coming from a new, scared person just landing on "the island" not knowing what to expect from such an institution coming into their own now looking so professional, proud and most importantly prepared and eager student turned physician, ready to go out and make a difference in the world. I literally was in awe, as though I was watching the best fireworks show on the fourth of July. Again, I'm sure people looked at me like I was nuts - but that was just fine by me. I was soaking it in baby! After we were all seated, we recited the Hippocratic Oath and were proclaimed graduates, alumus and now forever fellow physicians heading out into the world of medicine.

The day was followed by good times in NYC, some drinks great food and another night of sleep in the city that doesn't sleep. We woke up early and were on the road by 6:30am Saturday, ready to get home for a relaxing day and night with friends. Overall, a wonderful, fabulous, time of my life, one of the best days of my life! I am so grateful to my family and friends who have supported me and finally have found myself to be proud of my accomplishments, in and of itself was no easy task! I had always struggled with looking back and being proud of what I did, and I can say now that I truly do.

I am now a proud graduate of Ross University School of Medicine and a prepared and eager new physician truly ready to make a difference in our world. Congratulations to my friends and now collegues - WE DID IT!!!

Hippocratic Oath (modernized)

I solemnly swear by all that I hold dear that I will carry out to the best of my ability and judgement the duties and responsibilitiesimcumbent upon one who practices the profession of medicine.

I will abstain from any act, either by omission or commission, that could harm those I serve; and never will I betray the confidences of those who place their trust in me.

In order to best serve my patients, I commit myself to a lifetime of study so that I may stay fully current in the practice of my profession.

With full understanding of the special place of trust physicians hold in the hearts and minds of their patients, I dedicate myself to the service of all who seek my care.

Graduation Week!!!

Here we are - graduation week!!! Things are going well with my time off. I really utilized my time and made some great improvements to the house. My research for my third project is near completion (finally) and now time to get ready to forevermore hit the books for my upcoming residency, which I feel ready to begin.

Of course though, we can't have a smooth road to graduation, haha... Oh Ross. I really have not had to rely on the school for much in terms of obtaining rotations, I have done all on my own. The problem comes after the rotation is done and the more tortuous road to getting evaluations completed, submitted and graded. Goodness! I understand how many students there are but come on, no need for excuses. I have now been done with rotations for six weeks and still my last evaluation isn't graded. Of course it makes me nervous for graduation. Am I cleared? Can I go? If I show up with my tam and hood - would I even be on their list to call to the stage?! After a million (almost literally) phone calls, I am assured that I am set to walk. Basically at that point I just have to take their word! So frustrating when I am very punctual and proactive to get things done as soon as possible to have such a slow response.

Finally, the grading... Sigh, I don't know who came up with the grading system but I know for a fact that my attendings are not familiar with our system. Basically it is 4 categories of ranking students 1-5. The first two (knowledge based) are weighted twice as much as the last two categories (personality, responsibility). Anyway the point is I had a grade that was absolutely ridiculous. My worst I think since biochemistry, haha. When I called to check on it, there was a bit of shock how their rankings translated into that grade but it was a two week rotation which meant it wouldn't count for much anyway. It was so close to graduation that changing it would probably tack on an extra month or two of constant phone calls. It was looking like I would be graduating with honors but alas looks like I will just miss it although changing this grade would still not change that fact. So, I left it alone. Just think it is interesting how the grading system works. I think there should be some sort of reform to this like even having a part where the attending gives their suggestion on the letter grade to give because I am sure that some wouldn't agree to their translation of their 1-5 rankings... Anyway, just those last minute frustrations! Nice to vent it out and move on because let's face it - bigger things are on their way!!! :)

I am so excited for this week and really didn't think I would be. Now being June, this is my final month (not even) before this craziness begins... Again, going at it with a positive attitude. Can't afford to dread starting and thinking negatively - that will make it just a terrible and depressing experience. So I am really looking forward to it! Still working on planning a balance for the house, timing out more appropriate days for housework, grocery shopping, time with family, etc. It will all work itself about and hopefully soon will begin to get my first schedule!

I did find out that I will be having a Wednesday clinic to see my own patients! I think that is a good day, it will break up the week! It will not be on the main campus but that is alright. I will be with two guys I have been talking with on Facebook and am SO happy about that! All in all, looking up! :) I can't believe that my whole four year process is here, on this webpage - all my thoughts, feelings, frustrations, elations, etc. I definitely plan on reflecting on some of these posts throughout this week and REALLY try to take in the importance of this week. I will official be a physician forever after and feel truly humbled with a intense feeling to be sure I live up to not just my own aspirations but expectations of those who will train me and dedication to those patients I will serve from this time forward!

...For now, just gonna enjoy this week and celebrate in it! I will start it with a big WOOOOOOHOOOOOO!!!!! :P

Just a hello during my time off!

Hi all! It's me in the middle of my time off! :) Things are going well which to me means, I am keeping busy. It is very hard for me to be able to kick back and relax, so I have been doing my usual housework and research but alot of fixing up around the house and outdoors. I wasted no time getting started as my first week off I began building a retaining wall/flower bed around our patio we got last summer. The week after that I had to rip up alot of rock and fabric liner around our house to prepare for a privacy fence and white picket fence on our corner lot, which will really expand our backyard space. Over the next week or so I have finished picking and planting my flowers and herbs in the flower bed (had to wait until it warmed up a little bit more). It is such a transformation! I am working on anything and everything to make the house as improved as possible before beginning residency - that seems to be my focus...

That being said, I have also become quite the coupon lady lol. My wonderful mother-in-law has been getting me into it for about a year now but now it has expanded to not just groceries but to things at Walgreens, CVS, etc. It's now an addiction! I only buy things on sale and what I have coupons for to make it a double sale (=clearance, lol?). This plan also is to prepare for residency. I enjoy doing alot of the housework around the house even though my husband is fantastic in doing this as well. I love trying to do it all, which I am sure will come back to bite me soon enough. Though, by keeping up with my sales and stocking up on things in our giant pantry, I am hoping that it will save me from having to do big shopping runs and saving time to be home when I am off!

I have been looking up different ways to prepare for residency, though not in my reading and studies -that is a given. But ways to prepare my home and protect my time off from certain chores that can either be done on a scheduled day or to find ways to make things easier/fast to do. Also, looking to make my own "happy bag" (name of the bag is a work in progress, haha!) for my time in the hospital. This will include things like food, my iPod for morning pre-rounds, organized rounding sheets that I have made, pictures, bathroom things for refreshing/on-call like face wash, toothbrush, deodorant, etc. I think it will help me get through the days easier. This will also be helped with finalizing my own plan of how to complete my work. Since I have done my rotations at HFH, I know what a day in the life is like as far as rounding, lectures and call nights. This will make my days run smoother and full of me frantically running around or confused at what needs to be done next.

Time is moving along quickly though. My graduation is later than most, coming up June 4th at Madison Square Gardens! Should be a nice trip spent with my family and fellow graduates. More of that to come! We are trying to plan little weekend trips but I am at least hoping to be able to SIT and relax. Slowly, I'm getting there but in the meantime I think I will keep getting things done! :) Gotta go for now, but plan on writing again this week of wrapping up rotations and getting set for my graduation audit!

Life's to do list: Medical school - CHECK! :)

I really wanted to post before my final day, today April 16th, as a medical student. Particularly how I felt the day before. First of all, oh my goshhhhh the senioritis was in FULL swing. I was starting to find myself staring off a bit more, antsy to get the work done. I feel bad because this month was great and I didn't want to be disrespectful but I couldn't help thinking about the end. So yesterday I had clinic with my attending. It is pretty laid back, the only issue I have with this is for some reason new patients come in and I get a 5 second history then BOOM - go. In hindsight, it wasn't really any different than Step 2 CS, lol. But this was a patient referred to the clinic and not knowing the full story was a bit irritating. Just gotta forge through and get the job done. Really wasn't that bad and in the end thought it was good to just get thrown in there and be exposed to more situations that might not leave you feeling as comfortable as you would like.

Oh,the symmetry of medical school! Little did I know, yesterday April 15th, was my final day in medical school. This last day situation reminds me of the FIRST day of clinicals (see my July 15th, 2008 post!) where I had the same feeling of just wanting to be thrown into the uncomfortable situation and face it head on. "I have just finished my second day in my FM rotation! I was so worried that it wouldn't be what I was hoping for but I know I am already getting some great experience. I am in an outpatient practice for the next six weeks with my preceptor and on my first day she asked if I would want to follow her around to learn the ropes or just jump on in and work up my own patients. I really wanted to be thrown into the mix and that's just what happened. We had about 15-17 patients my first day, 9 of which I worked up. My preceptor of course asked if it was alright for me to come in to do my exam and then the floor was mine!" I think this is a great attitude to have in clinicals. It makes you so unafraid to go in and do it again afterwards and makes you so much stronger!

Anyway, yes the LAST day of medical school. Turns out, the resident and two pharmacy students could not make it in for Friday's rounds and in the end my attending told me to turn in my paperwork, ID and pager and that this would now be my final day in medical school. I just paused looking at her, wanting to say "No, it's ok! I'll come in!" but I didn't say a word I was just stunned. She told me "Seriously!" (with a big smile on her face). I couldn't help smiling and truly tearing up to the though that this was the very end of my education as a student and made the fellow team laugh so much they had to give me a tissue! I felt bad and told her with my eyes welled up that it wasn't because she was letting me finish today but just the fact that this was the end of the long road of being a student, truly to what will be I'm sure the most challenging thing I will ever do in my entire lifetime. Of course though, I had my patient to present and I did with tissue in hand, haha. The rest of the clinic day was great (of course because in my mind I was done after just a few more patients!). She kept introducing me as the student becoming a doctor after the day was done. Not gonna lie, it felt good but tried not to get too excited and let that news overshadow the patient's reason why they came to see us.

In the end, I was told that I was an exceptional student and as a critique (I guess?) was that I worked too hard. Haha, I always had something brought in that I read from the patients before had plus all my research that I am working on - which she loved. We hugged and I went on my way to the hospital to drop off my pager and such. It still didn't feel over until I got all of that out of my way and I was on my way home!!! Just like I thought, I did cry when I was done. Tears of shear disbelief that it is all over. The four years of ups and downs, elation, depression, feelings of accomplishment and failures was done - in the end elation and accomplishment winning out!

~Just a recap!~
Dominica 16 months [X]
Saginaw 5th semester 12wks [X]
USMLE Step 1 [X]
Family Medicine rotation 6wks [X]
Psychiatry rotation 6wks [X]
OB/GYN rotation 6wks [X]
ENT elective rotation 2 wks [X]
Surgery rotation 12 wks [X]
USMLE Step 2CS [X]
Radiology elective rotation 2wks [X]
Pediatric rotation 6wks [X]
Internal Medicine 12wks [X]
USMLE Step 2CK [X]
Oncology Research 12wks [X]
Pulmonary elective rotation 4wks [X]
Gastrointestinal elective weeks 4wks [X]
Anesthesiology elective 2wks [X]
Infectious Disease elective 4wks [X]

So here I am, on what was supposed to be my last day - in my jammies, having a cup of coffee and watching the Today Show! I still haven't celebrated yet but throughout these four years I feel like I have been celebrating all along the way, I don't want to torture them with something else haha. But I will celebrate this weekend, I'm sure. After that I have definitely found some hobbies to do, inside the house and out. I plan on doing some things for fun and also brushing up on my Spanish, maybe ASL and working on my research. All in all, I am trying to be determined to relax, not get bored and prepare for the residency ahead as best I can.

It is over. And to all of you out there reading this - it does end, I assure you. Just hang in there and don't give up! I thought I had all the passion, drive and determination in the world. While I still feel like I do, even having that wasn't enough to keep me from feeling the shaky ground every now and again. Thank you all for your support, to my family and friends for their constant love and understanding through the good and bad. I love you all!

Don't Quit
When things go wrong as they sometimes will,
When the road you're trudging seems all up hill.
When the funds are low and the debts are high,
And you want to smile, but you want to cry.
When care is pressing you down a bit,
Rest if you must but don't you quit.
Life is strange with its twists and turns,
As everyone of us sometimes learns.
And many a failure turns about,
When you might have won had you stuck it out.
Don't give up though the pace seems slow,
You may succees with another blow.
Success is failure turned inside out,
The silver tint of the clouds of doubt.
And you can never tell how close you are,
It may be near when it seems so far.
So stick to the fight when you're hardest hit -
It's when things seem worst that you must not quit.

Well - seem as though we made it through Chapter 1: The Island and Chapter 2: Saginaw and Clinicals! Time to turn the page in medical school's book to a new chapter! Chapter 3: Residency!!! All I can say is, buckle your seat belts and get ready for a great ride for not only my journey as a resident physician but with my life at home as a wife and many of these wonderful joys to arrive as well! You comin' along? :)

Only one Monday to go as a medical student...

So, infectious disease. Not too shabby! This is a consult month, so really it isn't hard. The hard part for me is just these antibiotics (which is why I chose ID for an elective - to get help in this area). My attendings are very nice and am really not having any dread going in but I think I can confidently say - I am starting to get checked OUT. I am so happy I lasted this long without feeling this way but having my last day of medical next Friday, I am full of excitement and anticipation! I keep thinking about how I will feel!

April 16th is my last day and then freedom for a while! I am feeling that I don't want to waste away my vacation. Granted I do not want to study the whole time either but I just feel so determined to getting myself organized for residency - to make the most out of my time at Henry Ford Hospital (HFH) and at the same time getting what I want out of my own personal life as well. Balance. I'm working on my checklist for that now and am excited to feel like I think I can achieve it.

The rotation is going well though. I find myself finishing my pre-rounds and new consults in record time, just ready to get the day going and done with. Not that I hate being there, the teaching is great... but you know - kinda close to the eeeennndddd... gonna be a docctorrrr soooonnnn. Anyway, turns out that waiting for rounds takes about 3-4 times as long as it does to do my work - oh well, they are so nice to work with anyway! Luckily my attending has meetings like crazy tomorrow and told me to just take the day off. YAY! That never (literally) happens. There is plently that I can get done, especially that pesky task of ordering my cap and gown!!! Hopefully, I can do some research too :)

Well I hope everyone has a good day tomorrow too! I will talk to you soon <3!

P.S. It is barely April and I have already tied my total amount of posts for 2009, haha!

PGY-I Resident Physician in Internal Medicine at....

...Henry Ford Hospital in Detroit, Michigan!!! I am very excited that not only will I be at the closest hospital to my hosue that I applied to, but that I am so familiar with the fantastic people and processes that would most likely be quite overwhelming for myself if I were to start off at a brand new place. It is so nice also to just have that weight lifted off my shoulder and constant questioning of "Where will I be?", "Will I have to reapply?", yada yada.

I know I didn't post the day of the Match but even a few days out it feels just as good. I had a small happy dance then afterwards crashed out of emotional exhaustion over these past 4 years. I am sure with my vacation to come after this month, I will be wanting to add up all the hours of sleep I can get! I have been able to get ahold of my fellow residents through Facebook and we have started a little group to get to know each other better! So far there are 12 out of the 37 who have joined in the past few days :o)! They are all so nice and I am really looking forward to working with them. Out of the 37 there are FOUR Ross University students! I am so proud!!! I know we will do an excellent job!

As for now, I am currently (3/23/10) in my first week of infectious disease. I'll tell ya getting the motivation to not just do this last month but get to know a whole new hospital system, people, processes and hospital layout for ONE month is quite challenging. Though I think I realize what indeed is at the end of this month - the END of medical school and the END of my time as a student! Granted I must wait until graduation to officially say so, but April 16th, 2010 - I am calling myself a physician! Then I will have until about the beginning of July to soak it all up!

There is quite the amount of paperwork to be done: first is of course - the contract - and a 44 page packet to seal the deal with busy days of filling out forms. I hurried and got it all day and sent everything out yesterday, as it is due this Friday. I can't see how the resident from outside the country can get it done and mail it in time?! Anyway, the forms are all for limited licensing, controlled substance licensing, health care forms, fingerprinting forms, computer access forms, ACLS/BLS forms... the list goes on. I was able to leave my first day of ID early (hated doing that) and get my fingerprinting out of the way which was the only thing from keeping me to send in my packet. What's next? Yes folks, I am still working on changing my name, lol. It isn't hard but just alot of things you need to change. Basically, I finished the important documents but needed to finish my passport and SSN.

So everything seems all set to start! I will keep you all posted on things as they go! Only about 24 days to go until medical ends!!!

I MATCHED!

Oh yes, I recieved an email from the National Residency Match Program stating: "Congratuations! You have matched!" WOOHOO!!! I am an Internal Medicine physician at "fill-in-the-blank" hospital! haha, I think the anticipation for Thursday surpasses mine for today.

I was pretty confident that I would match but am just ever so curious to know which of the six hospitals grabbed me first! :) I am very happy though I have to admit, not as jumping off the rooftops as I thought I would be?! WHYYYYYY! Come on Jess, it's okay to celebrate! So funny, like I have said before - my family has always been telling me to look back and be proud of all I have done to get to 'x' point. Hopefully this time I can actually be able to do it!

Wow, granted I have my last month of an infectious disease elective - but darnit - I'm a doctor! :) I suppose I should continue in joining in the Facebook fun of congratulating everyone and probably cracking open a beer or two! This week is a celebration and I am so glad that I have it completely off so I can hopefully soak up this week and remember it forever as a time when I look back on these four years; the major- lol major - sacrifices my family and I have made, the energy, tears and doubt all for the feeling of success, accomplishment and privilege of knowing that I am a physician and will forever be for the rest of my life have a greatly blessed chance to serve and improve the lives of others!

Congratulations to all who have found their own success in the match! As promised here is something I had found that I wrote before I began this blog. It was a post on one of the forums I followed, after a 10 month long wait on the LECOM-Erie waitlist for enterance into their medical school. I was a nervous wreck, posted nearly everyday, wondering if I would ever get chosen. It was this day I was passed up and I then decided to attend Ross University and never looked back - enjoy!

~July 28th, 2006 @ 01:24 PM~
"Been a long wait but it's alright...

Thanks everyone! And also to everyone over the past almost 10 months that has let me vent about this school. It has really meant so much to me and been a blessing to be able to come on here and get so much advice and support.

I am still hoping for even these last few hours but I am going to begin to finish up my prep to get ready for Ross! Leaving in a few weeks with my mom so she can help settle me in on the Rock! She's the best!

At least I still get to become a doctor... I really do love ya'll, thanks for everything!"

...Well, looks like I still got that chance to become a doctor and here I am! Congratulations to all and celebrate this moment well!!! :)

"If I Matched" Day...

EEEEeeeeekkkkkk! Twelve noon tomorrow! I will find out if I have indeed matched into an Internal Medicine residency program :)! Yes folks, I will be hopefully contracted in to be an employee, better said - a physician - at hospital on my ranked list. Me. A physician. Okay, not gonna lie, that is majorly cool to say! Me, a doctor. Lately sounding more like something that is more overdue than before when it was something funny and unbelievable to say, lol.

I posted on Facebook on how embarassing it would be to NOT match and to have told everyone, haha. Ah well, you know me - just telling it like it is and whatever happens, happens. To be honest, I am really not that worried about tomorrow. It is the anticipation for Thursday that is just starting to get to me. Funny looking at some forums and how freaked out people are getting - just about tomorrow!

Anyway, I think that it will come down to my top two choices. What are they? Tsk, tsk, tsk... Patience people! ;) I really don't see myself going past #2 but at most I see myself going to my #3 choice as I have gotten a great vibe from the program. That's it! If tomorrow equals a match, Thursday equals me completing my residency in most likely my top three spots. Not too shabby.

So, I leave my final question before my time as a student is setting and residency rises: Do I start to party and celebrate tomorrow? Wait until Thursday? Both? Believe it or not, this is my question haha. I definitely know that Wednesday will already be crazy with St. Paddy's Day... Hmm, maybe I should just commit to a week of celebration, haha! Welp, I am not sure what else to leave you all with but that this is a great feeling. I am more feeling a sigh of exhaustion and "it's about time" than "WOOHOO", but maybe that will change. Maybe it is just me but that's how I feel.

I am gonna dig up on old post from a forum for tomorrow if all goes well - from before I started on the island, lol. Quite nostalgic post, lol! So, yep - there it is... After starting this blog in August of 2006, here I am hopefully to post tomorrow about my new employment as an Internal Medicine physician! :) Thank you all for your love and support (even during my hiatuses, lol). Catch you on the flipside ;)!

It's the Final Countownnnnn! (by Europe, lol)

It is official, there is one month left of medical school! I have just finished my anesthesia rotation of two weeks and am now on a little mini vacation for the next 10 days to celebrate St. Paddy's Day and of course, Match Day 2010! First off, anesthesia was really awesome. As compared to my pulmonary and GI months, which were all consult months, anesthesia was much different than anything I've done lately. Even back when I was in my surgery rotation over a year ago (wow...) I had always wondered what was going on behind those sheets with all those monitors and such.

For one thing, I actually was able to SIT through a Whipple procedure this time, haha. But really, it was great to learn the ins and outs of how they work and felt I got way more than 2 weeks worth of knowledge. While the organization for the rotation was a bit lacking, I was able to work with one particular resident at least 4-5 times who was extremely talented at teaching students and especially relating it to the field in which they were interested. For me, he tried to relate anesthesia to medicine, in particular to the ICU and vent management. Of course, there was teaching on general anesthesia too as is done in surgery. The days were not too long, except for those days when they had 6:30am lecture, lol. My days ended almost always between 3 and 3:30pm, though most students got out much earlier.

I was able to do multiple intubations though and definitely became more comfortable with them. and LMAs as well. Mostly though it was just taking in all the knowledge that the residents could offer. On my last day, I was able to leave around 1pm and was so happy. I was able to take my mom out to lunch one last time and thank the medical education department for allowing me to come and rotate there as Ross is not an affiliated hospital. After, I walked out the doors of Henry Ford Hospital after a near 10 month experience. On the shuttle back to my car, I looked back thinking whether or not I would return this coming July for my residency...

...Yes, it all comes down to this week! Match Week! What is in store for this week? Well, Monday 3/15/10: we all find out IF we matched. This is what we might see though email or our NRMP website:

1. Congratulations, you have matched! *YAY*
2. We are sorry, you did not match to any position. (...Boo...)
3. You are NOT matched because you did not submit a certified rank order list. (Submitted one so doesn't apply to me, but man if you missed the deadline - that would suuuuuuck!)
4. You are NOT matched because you are withdrawn. (Not withdrawn, doesn't apply)

Also, there are a couple more for preliminary applicants, those who did not apply categorical position...

Supposedly, this day opens up the Scramble as well, which is literally - a scramble - for open spots in different programs nationwide. Giving homage to 3/17 - St. Paddy's Day! Yes folks, due to be a sloppy mess but great times with friends! Finally, Thursday 3/18 is Match Day, where we all find out WHERE we matched. Our school kinda goes with the flow of other schools, depending on where you are rotating. If the affiliated school as a luncheon or something, our students tend to tag along and follow their tradition. Me? I was able to get this week off to celebrate on my own without the hooplah of being around other students. I just wanted to take this time for myself and be with family and friends for this week of my life. I am sure however it works out, I will be happy with it but just in case, I want them around me :P...

So, the week is near upon us and I am not nervous at all - just merely starting to get anxious. I go on studentdoctor.net alot for some advice or to vent and also valuemd.com (better for IMGs) and I cannot believe how scared and nervous they are. Maybe it is just me but I am happy with all the places I ranked and granted, while I might be a tad disappointed where I end up - I will know it was meant for a reason. I don't see how worrying and stressing these last days does anything. In my opinion, what's done is done - there is no changing it once our rank list was submitted. It is in God's hands and best just to cut loose and enjoy life as best you can!

In light of this, that is what I am about to do - off to Malarkey's with my friends to have some good times! More to come soon enough... :)

We're gettin' there folks!

I am stumped at what to write about. I am chosing to hold off on my post about Match Day and my rankings until the day comes. I guess though I can start talking about it a little - gotta get ya a little thirsty for more later! Then I guess I will just figure something out as I go along.

So... it has come down to this nearly four years in the making of this blog - Match Day 2010. The day when I will find out where I will be obtaining my residency training in internal medicine for the next three years. Like I said before, I applied to 15 places and got 8 interviews:

St. Mary Mercy, Livonia MI
University of Toledo, Toldeo OH
Henry Ford Hospital, Detroit MI
St. John Hospital, Detroit MI
St. Joseph Mercy, Ann Arbor MI
Detroit Medical Center, Detroit MI
St. Vincent Mercy, Toledo OH
Synergy Medical Education Alliance, Saginaw MI

Of these I chose 6, leaving out Synergy and University of Toledo. As you all know I did most of my third year at Synergy and loved it. In the end though, this just proved to be to far away that I was willing to commute. I was getting enough invites from local places, I chose to decline. As for the latter, again I had the other 7 offers and felt that I would be in good contention for a residency spot with those I had interviewed at, particularly in Michigan - so I chose to decline. No real downsides to the programs, just a personal choice. This left 6 hospitals to rank in my ranking list.

First off, you must register with the NRMP (National Residency Match Program) which of course comes with a fee (come on, by now you know better than to think that we were gonna get out of ANYTHING without a fee). When the time comes and your ERAS application is submitted, it will be time for the rank list to open, approximately in late January of your match year. You get around a month to mull it over and in late February, your decision is final. It is this day that you are committed to joining the residency program you match. Not only does your list have to be final but the hospitals must submit their final list the same day as well. DUN DUN DUN - that's it. Then the near one month wait for the magical computers to do their work, lol. So I will tell you all how I ranked two weeks from today, March 18th 2010. And yes, it IS the day after St. Paddy's Day. Though what student would really take any time off, away from their patients to celebrate during this week. Really now, quite selfish! Psh, I wouldddd! I have one week left of anesthesia then an entire week off. Surely enough, as usual I will be going stir crazy with nothing to do but perhaps i can catch up on some research lol. I am real excited for a week off before my last month of school. Wow, last month. So insane to REALLY look back. Makes the last four weeks seem like a joke compared to all the rest.

Sigh, so what now? What else can I talk about today. I'm about to consolidate my loans lol. Did I tell you that? I got my grand bill in the mail and I am going to write it all out with the zeros for effect, haha: $220,000.00... Maybe I should have enlarged the font! I am taking donations! :P Ah well, knew this was coming so not much of a topic starter.

I guess I could talk about my anesthesia rotation, even though this is my first of two weeks. Umm, really like it alot! Besides the fact that I am in the OR (vomit) I am loving learning about the medications, being taught by tying in ICU vent monitoring and getting my hand at intubations. Ever since my surgery rotation, I have always been curious as to what exactly was being done behind those sheets. I am getting a boat load of knowledge in this and am getting pretty comfortable in monitoring the patient's sedation, paralytics, respirations and much more! Kinda nice to sit and chat with the resident and while being taught still, being able to take a break when we both notice something that needs to be adjusted in the medications. It is great experience though think two weeks will suffice for the time being...

Well, sorry that I don't have more to talk about. I will try and brainstorm for more ideas. Any burning questions out there, lol? Anyhoo, I'll be around! You stay classy ;)...

ERAS and Application Process...

Haha, bet you thought I was gone eh? Just kidding... Had a couple exhausting days and really wasn't up for talking about this long, long process called The Match, lol. But man, what a ride it has been.

So jeeze when did all of this begin? Right around June/July of 2009. This is when the ERAS application service opens up and basically you can start saying you are in "application season" when in fact you have until the begining of September until you are allowed to submit it - but yay anyway! So the application process is pretty straight forward. If you have gotten this far in your medical education this is just another hoop to jump through to be honest. By this time you should have your letters of recommendation written or soon to be written as the authors will have to send in their thoughts on you to ERAS directly (cover sheets are included in this section of the application that they have to submit as well). How many do you need? Most programs I think are 3-4. I had 6 but picked the top 4 that I thought would be the strongest. There were a couple people I asked early on in my 3rd year that honestly, and I say this in the most lovingly way possible - finished too quickly. I knew they didn't REALLY know me THAT well and that it was a possibility of being a "cookie cutter" LOR. In the end I ended up picking my family medicine preceptor (someone I've known for a great deal of my life and who was there to even write me a LOR for entering medical school!), my OB/GYN preceptor and assistant program director (absolutely wonderful woman who was so near convincing me that OB/GYN was for me, lol). My third came from my senior resident from heme/onc who prior to my interviews graduated to attending and staff in internal medicine. Finally my last was from my preceptor in my outpatient internal medicine clinic and division head of the program. I have to say, before I get to talking about my interview - this was one of the highlights of my interviews. In all of them, I was told how glowing and wonderful they were and in one instance how they had never seen a two page LOR before, lol! Someday I would really love to read them if I ever could do that...

Up next was my personal statement. I really worked for maybe a week on it. Not that I was lazy but usually when I get into it - I really do and I don't stop until it is perfect. I will post it at the end here to use as inspiration because after all, this is all about YOU! Stealing ideas is only refective of your own personality but getting inspiration to shine your own thoughts and journey to this point are what is important! Really there isn't much to say about this other than to show it to you but, again - and I swear that I am not trying to toot my own horn (come on you have seen all of my board scores lol) but it was loved by my interviewers as well!

There are many other aspects to the application but most are personal data, boring and obvious stuff... Though finally, it comes down to where you want to spend the next 3-5 years of your life. In the end, you submit the application in September or so then await emails to your ERAS message box - waiting for interviews! It's really that simple... Speaking of which, I had received a comment talking about how risky it seems to go the way I did. Well, could not agree with you more! It is a risky thing but the fact of the matter is - I have no interest in moving anymore, even if that means I do not match this year. Call me crazy but it has been a long road for me and Tony and right now we need to be near each other. I applied to most Michigan places and a couple Toledo places as well which were driving distance. I ended up with 8 interviews out of the 15 places I applied. I let go of two other places because I applied to them thinking - worst case I would do the distance for residency. Since I was blessed enough to receive six interviews very close to home, I dropped the other two.

I honestly think that this might be a two-parter, lol. I have so much to talk about regarding interviews that I think it is a topic in itself. So, I will let my next post deal with the fun yet at times nerveracking time visiting and interviewing at other hospitals! Until then, please partake in reading further if you so wish to :)!


So, as promised - my "Internal Medicine Personal Statement"!

In life, many hope to find their passion of what they were meant to become. It is this passion that sustains my own drive, determination and promise of a lifetime service to the health and well-being of others. Through years of preparation for this application, I have found my purpose in the practice of Internal Medicine. Since the beginning of medical school, I have always thought that this was my field of choice. Although not until my clerkship experiences fully exposed me to this field, was I completely captivated by numerous factors. Among these lay the fascination of an internist's practice. To have been educated in the foundation that all of medicine has subsequently developed, truly shows the depth of understanding and complexity of thought that must be utilized throughout any given day. In addition, the role of prevention proves to be an incalculable asset to this practice of medicine. Looking towards preventative medicine instead of chasing a cure not only provokes interest but should make even ourselves strive for such measures. Finally, throughout my clinical experience, I have discovered the perpetual importance of patient continuity. It is for these reasons to be expanded upon that I find Internal Medicine to be the specialty that I was meant to focus my innermost passion towards.

"There are, in truth, no specialties in medicine, since to know fully many of the most important diseases a man must be familiar with their manifestations in many organ" - Sir William Osler

Internal Medicine is the cornerstone of the medical world. Throughout my clinical experience, I have enjoyed my exposure to many different specialties. In their own time, however, each has fallen towards the way-side, unable to fulfill what I aspired to become as a physician. Upon beginning Internal Medicine, I felt that I had found a role that best complemented my personality. Over time, I found myself becoming more astute in my pursuit of diagnoses. I have developed a wider array of thoughts in my differential, pathophysiology and have begun to gain a strong foundation for my lifelong practice as a physician. Additionally, through my work in research, I have found a deeper appreciation for the efforts that make advances in medicine a possibility. This teamwork, which possibly could answer questions that have never been investigated, is an exciting experience. Being part of this team gave me a great feeling of self-worth; to impact how clinical medicine can be improved to become safer and more efficient in addition to positively influencing the future of our health care system.

"One of the first duties of the physician is to educate the masses not to take medicine." - Sir William Osler

Upon beginning my Internal Medicine rotation, it felt that I had found a role that complemented my personality. One core focus, preventative medicine, impacted me the most. In preventative care, seemingly under-appreciated in society today, lay the true foundation of the health care system. During my time in Dominica for the first two years of my medical education, I had spent a great deal of time working with the people of the island in preventative care. Most notably, the Ross Foundation for Dominican Health was a cause which I was delighted to take part. This became my most pivotal experience while in Dominica. After RFDH's first semester, there was no one willing to take control over its leadership, which left this organization a fallen victim to neglect. I found myself wanting to do more with the time that was given to me at this university and chose to lead it from that moment forward. Through RFDH, we were able to raise funds to provide their small hospital with some of their greatest needs, particularly in their neonatal unit. It was with this work that we were able to provide oximeters, an incubator and ventilator, as this facility had only one of each for a population of seventy-three thousand. For the first time in my life, I felt that my efforts made a difference and that without my efforts in this organization, these donations would not have been possible. It was an incredible feeling that will remain with me forever. In such practices of preventative care, we can find ourselves maintaining health instead of chasing after it, allowing us to remain one step ahead of the disease process.

"The good physician treats the disease; the great physician treats the patient who has the disease." - Sir William Osler

An aspect of this specialty which has great importance to me is patient continuity. I feel that it is my duty and privilege to broaden the minds of my patients in order to encourage them to become an advocate for their own health. At the same time, the patients have so much to teach the medical community as well. In my clinic and ward experience, it was wonderful to see how relationships developed that further served to be a stepping stone to improved individual health care. Never will I forget my most memorable patient during my entire clinical experience thus far. This patient was a middle-aged gentleman, kind-hearted with a fantastic sense of humor. Admitted for an exacerbation of his chronic obstructive pulmonary disease, it was soon found over his two week stay that he had inoperable cancer. Throughout the two weeks that I spent with him, I found myself wanting to be there not only for him but also for his family, whether it was for medical care, a shoulder to cry on or lended ear. In his last days before passing, I recall being there with him, now unable to recognize who I was, as he began to succumb to his overwhelming illness. Minutes after he had passed, much of his family came to visit, none of whom knew of his demise. Standing alone with this family about to enter the room, I was the only one to deliver the devastating news. It was from our continuity that they found at least some small amount of peace in my being there. It is with this patient continuity that I find purpose and potentially many future gratifying outcomes for those I will serve. This man will always be a reminder of why I belong in this specialty. To me, he represented not only the importance of continuity, but how the prevention of disease holds higher precedence than a cure. Past feelings I once had for RFDH arose in me once more, as I built a rapport with this man and many others, who have confided and trusted in me. In the future, I believe that I will incorporate into my practice this basic human connection. It is this connection that fuels my desire to continually create an atmosphere of patient education and trust, thus allowing me to guide each patient through their continuity of care.

For the next step in my medical career, I hope to join a residency program instilled with these characteristics. I further hope to be part of one rich in the tradition of teaching, as I aspire to one day pass on my knowledge to subsequent generations of physicians. Academic medicine is an extraordinary opportunity to not only continue in my education as medicine advances, but to interact with multiple levels of expertise in the fundamentals of medicine and engage in healthy, intellectual discussions.

All of my experiences that I have been through leading up to this moment have prepared me for the rigor of a competitive residency program. My affinity for teamwork will bring comradery among my colleagues and a deeper appreciation for what can be learned from each other. My goal-oriented, hard-working personality constantly challenges me to push forward towards my aspirations. It is my perseverance, determination and above all my profound passion for this profession which carries me through each passing day, dedicated to the study and the practice of medicine. I know these assets, that define my personality and character, will drive me to bring only my very best everyday to this residency program and throughout my entire career.

Step 2 CS/CK today anyone?

I wanted to spend some time talking about my research but now that I am thinking about it, since all three are currently in the process of possibly being published, I don't know if I am supposed to be talking about it? Maybe I can but I would hate to not be sure and spill the beans on something I shouldn't. I will someday soon though. So instead, I thought I would write a little bit about my Step 2 experiences :)

Well as you would probably expect since I am about to graduate, I did in fact pass both exams - and what would you know - first time around, lol just kidding, some COMP humor :P I decided to take my CS in Chicago of April 2009 pretty much right after I stopped posting when I finished my ER month in Saginaw. I have to say again that ER was the absolute best rotation to do before this exam. This exam consisted of 12 patients (6 in the first session, 6 in the last) to do H&Ps on, write up notes and forumulate a plan. Each encounter got 25 minutes, 15 for the interview and physical exam and 10 minutes after to write up your note. You can choose to write or type your note and I thought that I would type because I type faster than I can write. After some thought, I decided to write it out as I realized that I could not type out any symbols or shorthand. I chose the right way for me though and glad I did because once you choose a way to do your note you cannot change it.

I am not gonna lie, all of my encounters took abotu 10 minutes. They give you a 5 minute warning but I took that as pretty much "time's up" so I could have extra time to work on my note. The cases are really not that difficult. You know what it is pretty much immediately on most cases, it is just that you ask the correct questions, do the correct examinations and provide a workup plan for the patient. If you forget to drape or shake hands a few times - you will NOT fail, lol. Alot of people freaked out about making small mistakes, it happens to everyone including me. I forgot to drape the patient and wash my hands on my first case. I probably did some exam maneuvers wrong but really at the end of the day, I knew I passed. The First Aid for Step 2 CS was a great book for this, especially the cases in the back.

You get 8 hours to complete this exam lunch provided and all. Really by the time you get to this point to take the test, you have interviewed a great number of patients and it truly feels like another day in the office! They are great actors too. Everyone gets nervous too but believe me, it fades down after just a couple enounters - if that. Overall it was a good experience (except for the $1200 cost) and felt great about it afterwards.

After this I went onto radiology for two weeks which I had written about then onto pediatrics and IM. Again, I am very glad my IM rotation was before my Step 2 CK exam on September 29th, 2009. I will be honest, I was exhausted by this time. 3rd year finished, some of 4th year done, just got done planning a wedding and getting married - I did study but honestly just wanted to pass and be done with it. Pretty much how that turned out. I was pretty big on my First Aid book but moreso USMLEWorld questions. The day was just like Step 1, I went to the same place to take this exam but really just was ready to get in and take it. I believe I did my first 2 blocks then a break, blocks 3 and 4 then a break and a break between the rest of the 4 (yes, there is an extra block in this one). I thought it went fine though wasn't thrilled at how I did and was so exhausted of worrying, I really didn't leave crying this time or think about me failing. I actually think Tony, my folks and I went straight to the bar! Anyway, time went on and I found that I passed with a 191/78. More of a sigh of relief than celebration, lol but even looking back on it - well, whatever it is over and I am just fine with that! Granted, I didn't blow away my interviewers with my scores but honestly, they didn't have any questions about it and were quite happy with the rest of my entire application - so I really was not kicking myself about it at all. I did what I could do but know for sure this had no bearing on the physician I would become. If you would ask the staff, residents and attendings I know that most have been extremely impressed by my workups, eagerness to learn and study on my own as well as the patients' own perception of me as a future health care provider. While this will most likely be my next post, my interviews went over so well that I never looked back wishing I had done something different with my time. During all of this craziness, I had found my balance and while I probably sacrificed some of my score to do everything else that was going on in my life - it was worth it. While I can in no way gloat about my scores I can't complain about how great my life was in spite of it :)! Life as I knew it did not end and I was still moving on - and with research on my way after my IM rotation - some much needed stress-free time and especially time to recharge my batteries and enthusiasm to continue on to finish my last year.

Overall, I will say these tests are just a way of sizing you up with other candidates but it in no way exempts you from other things you may lack. Of course, if you score in the top 5% of students and have no personality, yes you might get away with it but someday, when I am a patient with some illness in my ripe old age - I'd rather have someone dedicated to their practice with a personality to connect to than someone who does nothing but pride themselves for the rest of their career about a piddly test they took "x" years ago with nothing in their personality but the God complex. Granted this is an extreme example but believe me even a little arrogance goes a long way in this type of physician. Kinda went off a little but it is my blog so that makes it ok, haha!

Well, GI has some long days and being Monday I feel the need to put my feet up and relax with the hubs until bed. I think I will talk about this year's lovely interview season next! What a wonderful one it was :)! I'll catch you on the flip side ;)...

Going back in time (again) - 2nd/3rd month IM rotation

Wow, three days in a row - I'm on a roll! Actually, I kinda want to get these posts up so I can begin writing more about current things, such as the match, interviews and preparation for residency! I spent a little of my day reading back on some older posts and cannot believe some of the things I got through and how much it really took to get where I am today... I am still trying to get these things in perspective because finally I am starting to feel that as I am making my way down to the last eight weeks of rotations that I am - gasp - maybe a little bit proud of myself.

My second month consisted of a general medicine floor. Basically, it worked the same as the heme/onc floor with calls and such but the turnover was much faster, with patients staying only 2-3 days compared to a week to two from the month before. This meant more H&Ps, workups, presentations and more. It was nice to experience a fast-paced floor as it would be once residency begins. Again this wasn't a sub-I for me but I still wanted to do as much as I could. We had a guy doing his sub-I in our group but really didn't see it much different from what I was doing. The main difference is that you are in charge of your patients and your note actually "counts" legally. I am telling you though that you can act as a sub-I, even if you aren't. Just like I said from the month before, just get involved. If you are there to work just keep asking to do things. If a new consult comes in, just take it work them up. If orders need to be written, do so. If consult calls have to be made, offer to do it. Literally these things take minutes, lol. But it really shows initiative. Anyway, that is my little rant on that!

During each month, our attendings would change at least once to round with which made it a little challenging as they all had their own styles as to how they liked things presented. But as rotations go on, you get used to listening as a resident presents another patient to the attending and seeing if the attending has criticism or praises afterwards. The order always the same but just the amount of information they really want varies. I had a very nice team again though. Of course, my intern rocked and we had a great time - even during calls! One call though was the night before my bachelorette party and yes, it was an overnight call. This team was more into me being involved all throughout the night but that night they were kind and let me sleep a bit :). It was a bit funny as my senior and three residents and sub-I on the floor were all guys. It was me and 5 guys sleeping/hanging in one room together, lol. Anyway, it was a good month. Full of the usual chief complaints but definitely learned alot.

My final month consisted of outpatient clinic work. I was set up for 8 sessions a week (a session being a 4 hour period, so Monday-Thursday all day). It was nice because my main preceptor allowed me to set up my own hours since I had just gotten married and I was preparing for my Step 2 CK exam. It was great exposure to working with appointments and such but as you can expect it was alot of clinic a week, lol. It was nice being around the same 4-5 attendings and getting exposure to their styles.

Luckily, throughout my time in heme/onc, I met some great fellows who connected me into their research department. I was able to secure a couple of elective months to doing solely research Sepember-November! It was very nice as I was able to connect to their CarePlus system from home and be there to take on more of a wifely role for a while. I really enjoyed that time. While I will end up writing about this most likely a little in my next entry, it led into the holidays which I took off December for our fabulous Hawaiian honeymood and to enjoy with family and friends. See? We are slowly catching up on things! :) We will be to the present in no time and I have spared you from many "oh woe is me" posts, lol! All there is after that is my pulmonology month and this gastrointestinal month. Just to tell you that as my first two weeks were more general GI consults the next two weeks will be hepatology, of which I am super excited to learn about!

I hope you all have a Happy Valentine's Day! We don't celebrate it much but I was actually sent flowers, chocolates and a new teddy ('Lil Tone, after my first teddy Tony Bear, haha!) to the hospital but after a crazy mix up, I never got them, someone else did and took them home only to call ProFlowers.com to tell them of the mistake. I think that they just didn't know who I was since I was only on the floor once in a while over these past two weeks. They told the lady to keep the stuff and they would resend it out the stuff Monday. So I ended up calling them to get it delivered here today and they surely did - yay! Anyway, while Tony was upset it was no longer a surprise, I am now sitting in my robe eating chocolates and watching tv :). This is the life!

Going back in time - 1st month IM rotation

First of all, I just wanted to thank those that had made comments on my last blog. I really didn't expect anyone to have kept checking up whether or not I was still writing, which makes me feel bad but really does make me want to continue on! Maybe it was the wedding planning with rotations. Or actually I bet it was because I had moved back home I could bounce things off my husband moreso than when I was away all the time. It is probably possible that I felt that I might not have needed the blog anymore... I have found though recently though how much I had missed it and actually that I might be able to get advice or give it to other students (and start sparing my hubs from my venting, haha!) In any event, thank you again and will try my best to keep up with it!

So I thought for this entry I would take a little trip back to June of 2009, my first month of my IM rotation. Pretty much was heading into a new hospital system and a quite well known one as well which made it more nerve-racking. I had been asked about how I was able to get a spot there since it was not an affiliate. Well, actually none of my 4th year elective is at affiliate facilities either, which is something else I should speak about. I obviously was sick of moving and I wanted to be home with my little family more than anything and I was willing to do anything I had to in order to do that. I does depend on your state as to how many elective you can do as a non-elective but for me it was alright. Generally it requires you to contact the medical education coordinator and jsut ask how to apply. They will tell you what you need to fax them and this is where the Ross Non-Affiliate Rotation form comes in. Once you submit that to Ross and you submit your application to the hospital, Ross will then process your application and send your transcripts, scores, vaccination records, etc. to the hospital. This takes about 4 weeks, sometimes less if you are lucky. Once it is processed the hospital will contact you that your rotation is set up. Generally this is probably just as easy as an affiliate hospital but just a couple more hoops to jump through. I have done this throughout my whole 4th year and some of my 3rd too. It doesn't take too much and definite worth any extra effort!

Anyway, so I was fortunate enough to meet much of the IM staff over the years with a relative working there. Getting to meet them and stay connected throughout my first couple of years in school, I was able to maintain some contact to hopefully one day be allowed to come for my core. I was very lucky and as far as I know, it was very hard to even get that for me. It took me six months (actually at least) for this to be ironed out with administration, faculty, etc. I was getting nervous as months were going by without it coming up on my schedule. Eventually though it worked and I was signed up for 3 months of IM! From that time, I was able to meet more people in medical education and was able to secure a couple more months of 4th year. Basically, this was all possible through the inital connection. It would be really nice if we could get that affiliate back as I know they were once ours before. From what I see, I know that we would totally rock as students for this facility. Most seem very impressed with my efforts and I feel very comfortable and welcomed to this hospital!

Getting back to my first month, I was placed in hematology/oncology. It was in June so I was placed with an intern and senior resident both about to advance in their training the next month. I have to say, I have actually ALWAYS had awesome teams to work with and this team was just the start of me realizing it! This floor, while the turnover was less - meaning longer stays for patients - it was a busy, busy floor. Basically anyone with potential cancer or someone admitted for a health reason who had a history of cancer was admitted to our floor. We had call q4, though only had to spend the night on Friday/Saturday calls, otherwise they were till 10pm. I had my own patients, though yes unless it is a sub-I, the intern is still in charge of those patients. I just pretty much followed hers. I would do as much of the admission that I could as she taught me how to write the orders, H&P, etc. I would be able to do my pre-rounds, present them daily, keep up on their daily orders/tests and have some responsibility of doing their discharge summary updates in preparation for their discharge. It was great being given so much responsibility! I really felt liek a part of the team. I was even lucky enough to start getting my own med students! I had probably 2-3 recently finished 1st years come in to shadow, here's the funny part - me! It was really great though because it was at this point where I found out how much I have really learned. Their experience in clinical science was little to none so pretty much anything I was doing or seeing could have a teaching aspect to it which made my day that much better!

I tried my best to help in calls, though my team really wouldn't push much to wake me up sometimes but really I wanted to help. I didn't just let myself sleep through my rotation, lol. Anyway, patients on this floor really touched me and for some reason I really wasn't disheartened by these people who in great proportion were in hospice. In this month, I was given great exposure to end-of-life talks with family which was hard at first. I even had a patient that was such a pivotal point in my education, he became a huge part of my personal statement. It was with this patient I had spent two weeks with, through him learning of his terminal illness, to help managing his treatment and be there for his final days. It was even with this patient I gave my first family talk, completely alone mind you, as his passing took place between visits. Maybe this is something I could post for an example for future applicants if anyone would like to read it...

Anyway, staff were on this floor as well, some of whom still recognize me today 8 months later and still are great to chat with! My senior as well the heme/onc fellow were wonderful about letting me get exposed to procedures too. This month I was able to a thoracocentesis and a bone marrow biopsy on my own. The biopsy was a tad difficult pushing hard enough, so yes I had to get help from that but it was great. Maybe it was how hard I worked that they allowed me a chance to try my hand at a procedure.

All in all, this month was fabulous and I am seriously considering a fellowship in hematology/oncology. I really enjoyed my time and I know that must sound so morbid but I felt like it was a place where I belonged. It also seems to be a less stressful fellowship (althought mentally I am sure it could be seen as challenging) to choose from. I have been told that to apply for fellowship requires preparation as soon as my internship year. While applications and interviews begin in PGY-II year, connections, recommendations and research should be pursued from the beginning. I am not sure how true this acutally is but at least if I chose to do this, I think I might have a nice start. I have been doing research for some time now in the heme/onc department and am currently on research project #3 (I will talk about in another blog!). So at least I am some comfort in knowing that I am on track in case I would like to pursue this!

Well, this has been quite a long post but next up I will be talking about my general medicine month, which was my second of my IM rotation! :) As always, let me know of any questions! Talk to you all again soon!

Once upon a time...

Well, I thought I would begin where I left off - pediatrics. Definitely surprised by finding out that this speciality was not for me. I, along with many of my classmates were having a hard time getting a great teaching experience in this rotation as there were not any residents to work with. We had some time on the floor, outpatient clinic, PICU and dabbled in a few curbside days in endocrine and allery clinic. Really, I have to say that this was probably one of my rotations I have to say the least about. I thought a long time ago I would be working with children, particularly in hematology/oncology but that is no longer the case. While I enjoy seeing kids, I came to a single realization. If I were to do peds, I would have to specialize - meaning it would be at least 5-6 years of post graduate training. There is no way I could do general medicine for children. All the well-child visits were just a little too monotonus to bear with the crying, screaming, etc. Just not in the cards for me but this was good! Narrowing down my options for residency.

Then came the big day... MOVING DAY OUT OF SAGINAW!!!

The day I handed in my apartment keys and permanently moved home was more than I could ever explain. Now, being done with my 16 months on the island, 5th semester gone and my nearly entire 3rd year away from home, it was time - my time to come home and yes, as I can say now since I am now months out of this time, permanently.

As soon as I came back home it was a great weekend back then onto my greatest challenge yet - Beginning at Henry Ford Hospital for my internal medicine rotation! Really I felt that IM was the route that I was going to take as it was June and application season began early in July to start working on applications. I could write for hours, no, days on this topic. I absolutely had the best months of my medical education here. This rotation consisted of three months. The first was a specialized floor, just randomly picked for me but in guess what? Heme/Onc! It was a fabulous month and definitely one I will be elaborating on in the future. My second month was in a general medicine floor that was absolutely bustling with business, a very fast-paced and high turnover floor. My last month was in outpatient clinic which was a nice break form the q4 calls.

Of course, nothing during this time could compare to August 1st, 2009. That's right everyone, I am now a happily married woman! Tony and I are married and it was the most wonderful day in my life! Now, I know alot of people say that because maybe they have to but I'm telling you it was SO FUN! Our reception rocked so much that no one even left, we had to be kicked out to close the place down! The wedding actually took place between my 2nd and 3rd months of my IM rotation. I was SO lucky because I realized that I scheduled 13 weeks instead of 12 for my rotation. So I had to drop a week. I strategically placed it a week after my 2nd month ended, so I acutally ended up with a whole week off before the big day! It worked out awesome and have God to thank for that little blessing! Also, my attending for outpatient clinic allowed me to come in the following Wednesday to begin my outpatient month so I could enjoy a long weekend with my new husband! So kind of him! Of course, with school and his work we just couldn't take time for a honeymoon (which was later taken in December, three days in Waikiki and a seven day hawaiian cruise!!!) but we were able to drive up north the day after the wedding and relax together in peace and quiet! :)

Then it was back to work. Outpatient clinic began but it was much lighter than my inpatient months so it still felt like a vacation. I will be commenting on my IM rotation I am sure multiple times, perhaps one month per blog entry to catch up but they were wonderful. Internal medicine is truly the most facinating residency in my eyes. You get the best of all worlds and see everything! So by this time, my application was submitted the first week of September - and yes I have applied for a categorical position in internal medicine!

While we are on this topic, I might as well comment that I limited myself by applying to only local hospitals. I was told this was a dangerous strategy as I might not match but I knew that I would never want to move again and if that meant that I would have to match next year, so be it. Luckily, the interviews came rolling in! I received 8 interviews and took 6. They all went quite well actually great - I still say interviews are my thang ;). My personality has the chance to come out and I feel that I can read people and situations well to the point that I come across very personable. Throughout my interviews, I got comments back on how great my personal statement was and how impressed they were by my letters of recommendation and extracurriculars. Very positive interview season which began (surprisingly early) in late November with my last being mid-January. It was a great time but I still can't imagine being one of those people who applied to 100+ programs with over 10-20 interviews. Six was plenty for me.

As for now, I am still in my fourth year. I have some research under my belt now, a pulmonary elective and half of a GI elective down with only this month, two weeks of anesthesiology and one month of infectious disease to go! 2010 has been great to me so far!

I think though that I have quite a few topics to talk about in future blogs, that is if anyone ever looks back on this since I have been quite inconsistent over months and months... To be honest, I want to keep up with this blog. I think I have missed out on giving advice, venting and reaching others interested in this field by stopping my entries. It be nice to hear if anyone would even still be interested in me continuing but maybe I just will anyway for me :)! I will plan on talking about my floor months of IM, application process, interviews and catching up with my electives/research that I have been doing over the past few months. Let's see how well I do!

Living the much updated and better life!

Well, being now the beginning of October - WHERE HAVE I BEEN? So many stories to tell! I have heard though from family that I really need to update my blog. Just letting all know that I am back and will be slowly updating what I have been up to lately.

Now being in the research department, I will have ample time to start where I left off and bring everyone to the present! :) Stay tuned, coming up next: Step 2CS, pediatrics and the end of Saginaw!

Draggin' & Doubt...

Well radiology is over and it was a nice relaxing two weeks compared to the worst I have seen. While I saw the appeal as in every specialty, I know it isn't for me. Lately in fact, I wonder if anything is for me... While these past months have been stressful, I can't help but reflect back over the last time I was truly happy with medicine. Honestly, the last time I could think of was January, my trauma surgery month. Even though it was so very busy, it has been rough since it seems. Surely you all know of my infamous countdown to come home in about 5 weeks for good and I am truly hoping this is the reason for my lack of interest in what I am doing.

I find myself not as eager to study, to see patients or even to drive to the hospital! The best way I can explain it is - remember if you didn't want to go somewhere but your mom made you go, kickin' and screaming? Yeah that is me, except it is kinda in my head. I wake up thinking, "I don't want to go in at all" while I am getting ready. I get in my car and say to myself while I am driving into the hospital "Just turn the car around or better yet hit the highway home!" I am kicking and screaming in my head yet I am constantly forcing myself into each day. It sounds terrible I know... I have definitely hit some low points and constant thoughts of doubt. If this is how it is going to be, should I do this? Is it only because I am so SO fed up with being away from home? Could it just be the constant stress of presenting patients and getting critiqued by every preceptor - not because you aren't doing it the right way but you aren't doing it THEIR way? There are so many things bothing me as of late that overall, well, I truly feel like I have lost my passion... and I can't find it.

What happened to me? I used to be so invigorated by it all... Sigh, I'm not saying I am quitting or anything. I really don't think there is a way out even if I wanted. I mean it is so much easier said than done. What am I just going to NOT show up for clinicals tomorrow and drive home only to realize I am nearing $200K in debt? Oh no problem, I can work that off in - psh - well whatever other career I would choose would go off to paying off my $200K mistake. Ok, so obviously I have thought of it... I just keep wondering it is because I am away that I am feeling this way. I felt so good rotating at home and being able to live my life. Maybe that is what is missing? Maybe then I'll get that passion back? Okay, let's think positive and say that will happen. I run into another issue... Say I make it through this crazy last year and actually obtain my M.D. degree, lol. I still am not sure what specialty I would want.

Truth or dare: Truth. What specialties have lingered in my mind for more than 10 seconds? IM, OB/GYN, FM and to a lesser extent ER. Why? Don't get me wrong, I loved my month in it but something gets to me everytime I hear an ambulance or when we'd have to take care of a drunk moron for driving his snowmobile into a tree at 3am. I know it must sound so cruel but I don't want to spend my days taking care of people that don't minimally take care of themselves. Yes, you could make that argument with IM or FM for people not managing their hypertension or diabetes but to me that is different at least. So ok, what to do now with my final 3? Well, I truly love them all but I decided to look into where residents do their curriculum rotations. To be truthful (and I think that I will mean this more when I find that passion again lol) IM is the best. They get the IM floor, cardiology, respiratory, heme/onc, pulmonary, GI and so much more that all strike my interest. FM has many of the same rotations but it seems in shorter amounts of time. Sigh, so much to choose from but I think I know the direction I am bound to take. Just ready to know for sure!

Life in a box...

Well, radiology is not as awful as I had thought. I am with a very nice doc that while he doesn't teach a whole lot, is not making these two weeks difficult either. Don't get me wrong, I love a challenge, but these two weeks were supposed to be vacation anyway ;). I cannot tell you how many films we have reviewed in only 3 days but I am enjoying it. I am not sure if it is going back to my anatomy roots, sitting in a dark room and getting all cozy or taking a break from endless H&Ps but it is a more relaxing way of spending these two weeks. I can see the appeal of this specialty though. It has to rank high on the lifestyle list with the hours they work, 8-4:30pm. Again too, I can see the appeal of being in a room alone just to get your work done and go home, but it totally is the opposite of what I saw my career to be like. I always wanted that patient contact. Although these past couple days, I don't have much sense of dread going to the hospital. Maybe because I know I just have to look at a screen and not worry about my interview or exam skills... Like I said though, for these two weeks it works just fine with me, a much needed relaxing rotation and hey - this is 2 weeks more of fourth year (now being a month total) that I have completed and will have that much extra time off early next year! Breaking it down, if I took no breaks for the Step and interviews, my medical school rotations end in the middle of February! How awesome would that be? Heck, graduation isn't until May and internship isn't until July!

I am not anticipating alot of time to study for the Step (planning on taking during my outpatient month of IM) and interviews - well, a topic for another post but I have I think about 12-15 programs I am looking to apply. After speaking with my medical education coordinator here in Saginaw, I supposedly should be applying to 60-150 programs... I can tell you now that will not happen. There are ~15 programs in Michigan and 2 in Ohio that I am looking to apply as I am not interested in doing a residency away from home. Yes, I know what that means. What if I don't match? What if I only get one interview? Well, I may be crapping my pants until the match - but if I don't match, then I don't. I had heard that people apply for 150 programs and only interview at a grand total of 7! I don't know if that was for a surgical residency or what but it really didn't push me anymore to go looking into out-of-state programs. I think that I will have a good shot especially if I can prove myself in my core this summer in Detroit. More of this to come in later posts but I just know how I feel about this situation and feel that I do understand the risks of such a choice.

Anyway, I better get going... I have more sitting around to do tonight (ok maybe some reading too). I just can't wait until the weekend arrives - home!

Finding a balance?

I'm troubled tonight thinking of what is to become of my life. To me, I know it will be everything I ever wanted and perfect. I will be a wife, mother and physician just to name a few...

I guess what has got me thinking more is just planning my final year and learning from the experiences of others. Tomorrow begins my attempt at securing more rotation spots to finish up medical school and it is completely exhausting to worry about finding places near home. Nothing else I can really comment on that now but I will keep you posted on how things go in that regard. Though tonight I watched a show on NOVA, "Doctor's Diaries". All were great physicians, all dedicated and all seemingly consumed by work. The men physician would get divorced or have wives that would stay home with the children and the women physicians would have no social life at all.

So two ends of the spectrum. My life as like the rest of the world will be indeed wonderful but not perfect. On the other side, I am not looking to be consumed by this career. I love it so much but there is point that I an not looking to cross. I know eventually, sometime in my career -years after residency ends - I will not be looking for a full-time job (in med terms, what like 60ish hours?). Whatever it is, I know I want to be there for my children. While I know I won't be able to be a full time stay-at-home mom, but I have no interest in sacrificing that aspect of my life for medicine. Reading that back to myself it sounded kind of harsh but what does that mean? Why do I feel like this awful person for not feeling different? Truthfully, when I am set in my career I feel fine about that statement. It is just this stupid 4th year I have to plan that is making this so difficult. I have the option of staying in Saginaw for the rest of my education - to have it all planned out and set for graduation. Yet, I am opting for making it more difficult on myself and planning it on my own to be near home. On the one hand I think I am an idiot. On the other, I think it is long overdue and I should do what is in my heart. Head vs. heart is what we have going on here people... The eternal battle. Wait no, that is good and evil... anyway...

Just what am I to do. At this point, it is April and I still have some time to figure this out. Hopefully some luck will strike me and I can work closer to home. The thing of it is, I just don't miss being around home - I am physically starting to feel it. Mentally, oh please that has been around for what probably is years, for which I have slapped myself out of many, MANY times. I am honestly physically feeling sick when I leave home. As I have told my own mother, my heart literally aches everytime as I begin my drive away from my home. It's just like, exactly like, I am just leaving a part of me there and without that piece I cannot fully engage myself in the tasks that are at hand. Again, on the one hand I feel so good having this thought, because I know my upcoming wedding is just so right, it is that piece of comfort and peace that I will have in my life forever. On the other hand, I want to yell at myself for not being tougher and sticking through this like other students - as I am not the only one to have sacrificed for this path chosen. All the years I have worked, I feel like wanting that comfort and peace is giving up or wrong. Again, in my eyes this is just another case of head vs. heart.

I am not expecting to come to a conclusion tonight. Haha, even if I wanted to - it wouldn't happen anyway. All I know is maybe I just need to ingore them both and go with another alternative - my gut. Tonight? My gut is telling me to start listening to my heart and pray. The rest will fall into place... at least I hope for that and maybe in my own heart my life will become maybe not a perfect life to all - but the perfect life for me.

*~Spring has sprung!~*

Guess who? Yes, I know I haven't been around in a long while. Lately this has been a hard thing to remedy. Like I always say, after my day is done it is hard to go back and relive the whole day so I had started to forget to write. Maybe that has been my problem too because my bitterness as of late has increased. So much has happened though since I have last written and all I intend to write about. First of all surgery is over!!! I had gotten through my last week with my second surgeon and could not wait for it to end. He gave me some constructive criticism for my last day, shook my hand and went on his way. I ran in the completely opposite direction, haha! See ya! I must say that my month with him was the hardest month in medical school for me. I have always been dreading my surgery rotation and for the exact reason for the month of February! I learned though - mostly to speak with confidence more and get thicker skin. Since that month has ended our program has our last month in the ER.

Let me tell you that I went in that month scared to ask a single question or to do anything wrong. I was like a neglected puppy that was placed in a new warm and educationally encouraging environment, and I felt... relief! I felt like I could be myself and actually enjoy being a student again. This was the whole month of March and I had 10 shifts of 10 hours. Shifts were either 6am-4pm, 1pm-11pm or 10pm-8am. The ER was full of encouragement and praise on my end. I felt like I went from being the stupidest student on earth to... well, someone that could actually pass as a physician next spring! For those looking for a great rotation before USMLE Step 2 CS - do ER! (Yes, in my absence from this blog I have taken my CS - don't worry I will talk about it too!!!) The ER gave me so much autonomy - freedom to take the reins of my own clinical experience. I was able to do my own H&Ps, differentials, workups (granted it was the resident ordering the tests but I was always asked what my differential was and what tests I would like to order). You guys - that's CS right there. A perfect month of preparation! :) That being said, if I fail my exam, my story will change. Since I just took this exam recently, I will save that for another entry but all in all it felt good and dare I say - kinda fun!

So, what is on my plate now? I just went home for two weeks after my surgery rotation completed and spent it planning the wedding, enjoying my time with family and friends and of course getting yet another glimpse of what life will be like in a matter of weeks (not months anymore!) when I move home for ever after with my Tony and puppy Maggie. Soon my time of travel will be over. No more island, no more living out of a suitcase in a hotel or a one-person apartment. Yes folks, after nearing 3 years I officially feel like my dues are paid and it is time to pick up where I left off. The summer will be spent in Detroit, which is very close to my home and I can only wish that I make a great enough impression to hopefully get the opportunity to interview there and obtain a residency! I can't wait. My homecoming has been long awaited and the emotions that I am sure will come over me will be something I have never seen. I appreciate all the opportunities that I have been given and the blessings I have had for being this close, but the time has come and I am at my limit for what my career is worth - and it calls for home... Having this without my family and friends is just less worth it as of late and it cannot come at a more perfect time. When I am home and working - it is the best of both worlds. To come home to my fiance and puppy (just turned a year old, so I guess not a puppy anymore right? :)), is just the best feeling ever. Knowing I can be with them all night long and go to work the next day only to return right back will be the best blessing ever after being through all I have these past years.

As for now, I have returned this morning to Saginaw to begin my radiology rotation which will be two weeks long. I really believe that this rotation is so valuable to any student. While they aren't the most stimulating days, maybe that is what I need now since I am kinda "checked out". After this on April 24th, I start my pediatric rotation which ends June 5th - the last day in Saginaw! I am sure I will be writing more as my countdown quickens and I just can't contain myself anymore! Well, I am sure I have some holes in my stories and have more to talk about but I will get to it soon. Today my day was 8am-3:30pm and with all that time I should have ample time to blog, hmm? :) I'm gonna read and relax but I will catch you all soon.