So far I have been with a very supportive inpatient team, but there have been many challenges along the way. Residency is definitely not easy but it's nice to finally have a paycheck.
Wednesday, September 12, 2018
Being a resident is pretty cool. It feels surreal being on the other side at the same hospital that I did my rotations at. It's been a difficult transition actually feeling and behaving like a doctor i.e. placing order and making decisions. There is the constant underlying fear of doing something to harm the patient, which is counterbalanced by the excitement of being able to make decisions with the comfort of knowing that there are more experienced providers who I can go to for advice. Planning out the day and figuring out which tasks take longer than others has been difficult, especially because some things that are not ordered in the morning will not get done later if ordered in the afternoon or on weekends, such as ultrasounds or echocardiograms.
Monday, August 20, 2018
Residency
Residency is just as hard as they said it would but, however it is also so rewarding. Being able to make decisions that affect people's lives is heavy and rewarding at the same time. I believe that I still have a huge learning curve but I am learning over time. Trying to get better daily and making mistakes along the way.
Thursday, March 22, 2018
MATCH 2018: I MATCHED!
I matched to my #1 Choice, Clinica Sierra Vista (CSV)/Rio Bravo Family Medicine , in my hometown of Bakersfield, California. Yeeee!
It is a great feeling and relief to know I have a residency spot. Throughout medical school as a Caribbean medical student, and despite maintaining a positive attitude, there was a feeling of uncertainty that I never fully managed to conceal. The real possibility of being an M.D. without the opportunity to get a decent job after school if I didn't get into a residency position. I just maintained the faith through the doubt and it paid off.
This is a journey imagined since seeing that Ross was signing a contract with Kern Medical and that I may have an opportunity to rotate at home and establish some relationships. I always envisioned returning for residency. I was dismayed when I found out the Family Medicine residency at Kern was ending during my 3rd year of medical school, and elated when finding out that Clinica Sierra Vista was stepping up and creating their own Family Medicine rotation to fill the void. I was able to begin my first rotation of Family Medicine with CSV and from that point on I knew that this is where I wanted to be. However, I wasn't bold enough to tell the program director that yet, but I have a co-intern who indeed did tell her. I loved the family atmosphere, care shown when dealing with the patients, and the relationships the residents built with their patients during the clinics. When I finished the rest of my core rotations, I knew that family medicine was my residency of choice and CSV would be my #1 choice.
I didn't think I would be applying for the 2018 match. I took a two month withdrawal to study for Step 2 CK and didn't take it until August 23, which meant I probably wouldn't have the scores by the time applications opened. I spoke with my advisor, who said that I should delay the match until 2019 to be ensured that I have a complete application including USMLE STEP 1, STEP 2 CK, and STEP 2 CS results. I had yet to take or schedule Step 2 CS. Therefore, I decided to push back the match until 2019, and I spread out my rotations to give breaks in between. As I entered my Family medicine Sub-I rotation in October the program director said she was surprised to not see my application, and she thought I had applied to internal medicine. I assured her that I had not, but explained my situation. She, along with the program coordinator, then encouraged me to apply, so I rushed to get a token for residency application, write my personal statement, get a final letter of recommendation, schedule STEP 2 CS, study for and take STEP 2 CS, and complete my ERAS application all while doing a sub-internship. Throughout this process, my advisor was upset, and continued to strongly advise me not to apply. I just continued to pray that everything would work out. I managed to condense my schedule again in order to push up my graduation date.
It wasn't until early November that I finally completed my application, which is extremely late considering many people already had interviews and the application opened in mid Septmber. This definitely caused some anxiety for me. Ultimately, I applied to 39 programs, significantly less than the 250-350 that I was initially advised to apply for. I still believe Ross is correct in recommending such a high number of applicants; it is better to be safe than sorry when considering the repercussions of not matching. Because I was applying so late, I thought that I was mostly gambling on the CSV program so I would focus my efforts there and the programs surrounding my hometown. Outside of that, I just applied to the family medicine programs that take the most Ross students over the last 3 years. All five of my interviews ended up coming in cities in Central California. It was nice to be able to drive to my interviews and not worry about back-to-back flights. Actually, applying late saved me alot of money with interviews and also with flights. I probably saved at least $6,000 compared to what other students spent on application fees, traveling, and hotel stays.
During the interviews, I did develop a "gut feeling" about which program I thought would be a good fit or not. You can tell from the interactions with the faculty, residents, and overall feel of the hospital. After the CSV interview, I felt like that was home, and I knew that that was my #1 choice. Additionally, it would allow me to be at home with my fianc, who signed a 3 year contract as a nurse with a hospital in Bakersfield. But of course I would have been happy to match anywhere and she would've been supportive.
Keeping with the theme, I am now scrambling to get the paperwork in order for the California PTAL, which is the main thing I need to complete before residency.
Ross threw an excellent match party in Los Angeles at Madera Kitchen in Hollywood. We had an open bar and appetizers. I got to connect with my old interviewer from Ross, along with other staff. I was also excited to see how well my classmates had done, and saw some really impressive match sites. I'm really proud of our group and how well we react to adversity.
This process has further taught me to lean of God and let Him direct my steps. On to the next part of the journey!
It is a great feeling and relief to know I have a residency spot. Throughout medical school as a Caribbean medical student, and despite maintaining a positive attitude, there was a feeling of uncertainty that I never fully managed to conceal. The real possibility of being an M.D. without the opportunity to get a decent job after school if I didn't get into a residency position. I just maintained the faith through the doubt and it paid off.
This is a journey imagined since seeing that Ross was signing a contract with Kern Medical and that I may have an opportunity to rotate at home and establish some relationships. I always envisioned returning for residency. I was dismayed when I found out the Family Medicine residency at Kern was ending during my 3rd year of medical school, and elated when finding out that Clinica Sierra Vista was stepping up and creating their own Family Medicine rotation to fill the void. I was able to begin my first rotation of Family Medicine with CSV and from that point on I knew that this is where I wanted to be. However, I wasn't bold enough to tell the program director that yet, but I have a co-intern who indeed did tell her. I loved the family atmosphere, care shown when dealing with the patients, and the relationships the residents built with their patients during the clinics. When I finished the rest of my core rotations, I knew that family medicine was my residency of choice and CSV would be my #1 choice.
I didn't think I would be applying for the 2018 match. I took a two month withdrawal to study for Step 2 CK and didn't take it until August 23, which meant I probably wouldn't have the scores by the time applications opened. I spoke with my advisor, who said that I should delay the match until 2019 to be ensured that I have a complete application including USMLE STEP 1, STEP 2 CK, and STEP 2 CS results. I had yet to take or schedule Step 2 CS. Therefore, I decided to push back the match until 2019, and I spread out my rotations to give breaks in between. As I entered my Family medicine Sub-I rotation in October the program director said she was surprised to not see my application, and she thought I had applied to internal medicine. I assured her that I had not, but explained my situation. She, along with the program coordinator, then encouraged me to apply, so I rushed to get a token for residency application, write my personal statement, get a final letter of recommendation, schedule STEP 2 CS, study for and take STEP 2 CS, and complete my ERAS application all while doing a sub-internship. Throughout this process, my advisor was upset, and continued to strongly advise me not to apply. I just continued to pray that everything would work out. I managed to condense my schedule again in order to push up my graduation date.
It wasn't until early November that I finally completed my application, which is extremely late considering many people already had interviews and the application opened in mid Septmber. This definitely caused some anxiety for me. Ultimately, I applied to 39 programs, significantly less than the 250-350 that I was initially advised to apply for. I still believe Ross is correct in recommending such a high number of applicants; it is better to be safe than sorry when considering the repercussions of not matching. Because I was applying so late, I thought that I was mostly gambling on the CSV program so I would focus my efforts there and the programs surrounding my hometown. Outside of that, I just applied to the family medicine programs that take the most Ross students over the last 3 years. All five of my interviews ended up coming in cities in Central California. It was nice to be able to drive to my interviews and not worry about back-to-back flights. Actually, applying late saved me alot of money with interviews and also with flights. I probably saved at least $6,000 compared to what other students spent on application fees, traveling, and hotel stays.
During the interviews, I did develop a "gut feeling" about which program I thought would be a good fit or not. You can tell from the interactions with the faculty, residents, and overall feel of the hospital. After the CSV interview, I felt like that was home, and I knew that that was my #1 choice. Additionally, it would allow me to be at home with my fianc, who signed a 3 year contract as a nurse with a hospital in Bakersfield. But of course I would have been happy to match anywhere and she would've been supportive.
Keeping with the theme, I am now scrambling to get the paperwork in order for the California PTAL, which is the main thing I need to complete before residency.
Ross threw an excellent match party in Los Angeles at Madera Kitchen in Hollywood. We had an open bar and appetizers. I got to connect with my old interviewer from Ross, along with other staff. I was also excited to see how well my classmates had done, and saw some really impressive match sites. I'm really proud of our group and how well we react to adversity.
This process has further taught me to lean of God and let Him direct my steps. On to the next part of the journey!
Tuesday, February 27, 2018
Monday, February 12, 2018
Wedding
I got engaged over Christmas, so now I'm in the middle of planning the wedding. Wheww. I will say it's easier to plan a wedding during 4th year than any other time in residency, so I have that going for me. Not that I'm doing that much of the planning. Thanks to the God (as a patient says) for wedding planners. It's up in the air where I'll be for residency, so there's that too. The wifey is a nurse, but is signed to a 3 year contract, so she'll have to stay in Bakersfield no matter where I end up. Good thing is all of my interviews in California. So if I'm fortunate to get a residency spot I won't be too far away no matter where I end up. It also helps that I have a supportive fiance who understands the residency process, and she wants me to choose whichever program I feel is the best fit for me.
Also, I'll be done with rotations in April and the wedding is in June, so that will give me time to finalize thing and I'll be able to go away for a honeymoon before residency starts.
Also, I'll be done with rotations in April and the wedding is in June, so that will give me time to finalize thing and I'll be able to go away for a honeymoon before residency starts.
Tuesday, January 30, 2018
Oncology rotation
Cancer, cancer, cancer. During this short 2 weeks, I've had to hold back tears in front of patients as they are forced to confront the gravity of their disease. I've also been there as patients received the "bad news" we all dread. I've been forced to reflect on the brevity of life, and how little time I may have to make an impact on those around me. It was inspiring how some of the cancer stage IV patients managed to stay positive while still accepting the severity of their disease. This rotation increased my respect for Oncologists even more. As they are constantly trying to teeter the line between palliative treatment to keep the patient comfortable vs. more aggressive treatment to leave a battle ground of cells in hopes of obliterating the cancer, while trying to manage side effects of the treatment. It sucks that poisoning the body is the best resort we have come up with so far, but there are many out there doing great work to make the treatment more tolerable.
I believe there's more progress to be done in regards to combining different modalities of treatment. Nutrition is an aspect that is not addressed nearly as much as it should be. We've excepted that preserved meats with nitrites and red meats can increase the risk of certain cancers, but it still isn't standard of practice to encourage a diet heavy in leafy green vegetables. Through a limited search, I've come across an article promoting decreased rate of breast cancer growth in mice given a diet consisting of 10% flax seed. Another article indicated greater erythropoesis when using a homogenized mixture of herbs along with doxorubcin led to higher neutrophil, erythrocyte, and leukocyte counts. These studies were done outside of the United States, as unfortunately I couldn't find any significant studies of alternative medicine in the U.S. Just an article comparing those who chose to do only alternative therapy vs. only chemotherapy, with chemotherapy leading to better outcomes. Hopefully more funding goes toward using alternative medicines in adjunct with chemotherapy.
I believe there's more progress to be done in regards to combining different modalities of treatment. Nutrition is an aspect that is not addressed nearly as much as it should be. We've excepted that preserved meats with nitrites and red meats can increase the risk of certain cancers, but it still isn't standard of practice to encourage a diet heavy in leafy green vegetables. Through a limited search, I've come across an article promoting decreased rate of breast cancer growth in mice given a diet consisting of 10% flax seed. Another article indicated greater erythropoesis when using a homogenized mixture of herbs along with doxorubcin led to higher neutrophil, erythrocyte, and leukocyte counts. These studies were done outside of the United States, as unfortunately I couldn't find any significant studies of alternative medicine in the U.S. Just an article comparing those who chose to do only alternative therapy vs. only chemotherapy, with chemotherapy leading to better outcomes. Hopefully more funding goes toward using alternative medicines in adjunct with chemotherapy.
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