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!

Pathology rotation

Medical School Advice looking back on things

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.

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.

Ranking Programs

I've only done 2 interviews so far, and I am already continuously thinking about pros/cons of each particular program.  It is difficult because outside of the actual environment and teaching of the hospital there are other things to consider such as family, significant other, and lifestyle.

Residency Interview

First off all, it's just exciting to be in the position to have one interview, especially with the uncertainty of whether there were even any interview spots available by the time I applied.   I was fortunate enough to get 5 interviews, all in California, after I ended up applying to 36 family medicine programs.

This past week, I had two interviews, two days apart.  Both places seemed like programs that prepared their residents well. They both seemed great and similar on paper, but they both had a different "feel." Throughout my short interview trail, I've been hearing "gut feeling" as a term used to describe where a resident choose to work at. I've been starting to understand what they mean by gut feeling, as one program just seemed like a better fit for me despite both programs appealing in similar ways.

During my first interview, I made the mistake of leaving to the destination to arrive 10 minutes early.  The night before, I was sure to iron and lay out my clothes, but I still left a little later than planned.  I ended up making a wrong turn, despite directions from my GPS, and had issues finding the main lobby.  This accumulated in me arriving just in time for interview.  I was further delayed by these sweet elderly women volunteers who took a while to print my nametag.  My poker face was not up to par, as one of them stated, I know you guys think we're inefficient old women.  (She must have saw a look of concern on my face, because of my late arrival.)  I assured her that was not the case and was preoccupied about being late to the interview.  In retrospect I should have left at least 30 minutes before.

The actual interview went well. I had a great time discussing the program with the residents and program directors. The interviews were much more laid back than I was expecting.  Not many difficult questions, just a question about a time I had overcome a failure.  Mainly, it was just us two having a discussion and getting to know each other better.  After interviews, we had lunch with the resident, this is usually a way to get more informatoin about lifestyle, the city, and how well you would fit in with the group. We were then taken on a tour of the city and to the local clinic.  The interview was really fun, but also tiring, probably from the anxiety and anticipation of what the interview is going to be like and how well they will like you.