Imposter Syndrome, Match Week, & Beyond

I was on an outpatient pediatric cardiology elective during Match Week 2017. I hadn’t slept well on Sunday night, the night just prior to getting the email that would either say “Congratulations!” or “We are sorry….”. Internally, I was a mess. I was acutely aware of my heartbeat and the seconds ticking by as I awaited that email. My preceptor was also acutely aware, repeatedly asking, “Anything yet?” between patients and echos that morning. I felt like I was going to die. Sitting in his office, my phone dinged with the receipt of an email.

“Congratulations!”

Instantly, my tachycardia subsided. I sighed audibly and my preceptor’s face brightened. So, so very relieved that I did not have to SOAP into an unfilled position. And yet simultaneously a new panic took over. Which program?!? I had applied to too many, received 22 interview invitations, attended 19, and ranked 14. Who was I to have deserved a spot? All of those who didn’t Match were just as deserving…. there just are not enough spots to accommodate everyone.

My Imposter Syndrome had begun long ago. I had applied to medical school four times,by the time I had matriculated, I had not carried a full course load of hard science in over 4 years. I was old. Could I even do this? 

To make matters worse, I was accepted to my school off of the waitlist at the very last moment – I had already put a deposit on a seat at a different school and had signed a lease on housing when I received a phone call and immediately switched directions. Subsequently, given that the switch had been so late in the game, I never received an acceptance letter to the school I was attending. I showed up to the White Coat Ceremony 5 days after accepting the waitlist offer and wondered if there would even be a white coat waiting for me, if my name would even be on the program. It had all happened so quickly, and at the last minute. Somehow, everything had worked out, my name was in the program, I received my white coat at the ceremony, and it was off to the races. It still felt like I had dreamed it. Am I really supposed to be here? Am I the consolation prize?

During that year, I was also pregnant with my first child, and just knew that I would be perceived as not being dedicated to my craft. Could I be good at more than just being a student? Could I also be a good mom and wife? Do I really belong here?

Later, on my first day as a second year medical student, my badge failed to give me access to the instructional building. I called the IT department to see if there was anything they could do. “Why would you want access to the medical building?” the man on the phone asked. “We have you down as being a Dental student.” I explained that, no, I was a second year medical student and my badge had worked on that entrance for a year. He said he’d call me back. After much waiting, I received a call from IT. “I had to call the Admissions Office to see if you were were actually a student here. I didn’t believe that you were.” I didn’t know whether to laugh or be angry. Did others think I wasn’t meant to be here?

Fast forward to Match Week. I was the beholder of an email with happy news, but I had to wait four more days to find out which program I would start in a few short months. I had applied coast to coast, so my family could literally move just about anywhere based on the outcome of an algorithm. I agonized for those four days, even though I knew that no amount of worry or panic would change the program that would be unveiled on Friday. The morning of Match Day, it was raining – was that a poor omen? As the hours and minutes and seconds ticked closer to noon, my anxiety ramped into high gear. What if I just didn’t open the envelope? There is no way I Matched into my #1. There is just no way. They can’t want me, I’m not good enough for them, I’m not deserving of Matching there. And yet they did want me, because my top choice was listed on my Match letter, and it was binding.

During Orientation, my program director stood in front of my cohort and said, “You are in the right place at the right time and we are here to support you.” I wrote down his words and have read them over to myself many times. I don’t know why the first thing I always think about myself has to be so negative. Maybe someday I will finally grow out of my Imposter Syndrome.

To everyone who finds out where they Matched tomorrow, or for those who accepted a position in SOAP, know this: You are deserving of that spot. You are in the right place, at the right time. And the only person who determines your goals is YOU.

Tips for Pediatric Residency Interview Season 2019

It is now past the mid-September application submission date, which means it has been two years since I submitted my ERAS application for residency. I feel like I blinked and the entire intern year went by; I’m already at the end of my fourth month as a second year, senior resident. I’m currently on my program’s Recruitment Committee and I cannot wait to start meeting candidates for next year’s intern class! Congrats to everyone who submitted their apps and are waiting for interview invitations to roll in, or who are starting the interview process!

Interviews can be so daunting; for many years now, residency slots have been harder and harder to get. There are far more applicants than there are slots, which is making even “non-competitive” specialties, like my beloved Pediatrics, more competitive. You have to be able to make a great impression on your interview day, and many 4th year medical students are facing their first real job interviews (because this is NOT like medical school interviews at all).

First: You’ve got to get the interview invitation and lock in your interview date. Interview dates fill up quickly, so as soon as I got the invitation (through ERAS, Interview Broker, email, or phone call), I booked a date. This was especially tricky with email invitations, because they often give you a small set of available dates, and you have to email back your top choice for dates ASAP, so I always advise applicants to have blank email templates ready to go with the Subject line of “Interview Invitation”, and an intro with name on it so that you can enter a date, the corresponding email address, and hit “send” as quickly as possible.

Practice, Practice, Practice! If your school offers mock interviews, DO IT. Even though I’ve been through interview bootcamp, it was good to have low-stakes mock interview to point out some of the subconscious things I do when I’m nervous, plus it helped me practice some of my storylines I wanted to use during interviews. You don’t want these things to feel weird rolling off your tongue during a high-stakes real interview, so practicing them in a similar setting is invaluable.

With every single program where I interviewed, I had a list of things I wanted to leave them with to give them a solid idea of who I was and why they wanted me in their program. You have to sell yourself and your story; for introverts like me who don’t like talking about themselves, this can really be hard, but now is NOT the time to be timid or modest.

The Basics that you have hopefully heard from everyone by now:

Dress well. Know how to press a suit. Bring a second set of clothing to wear under your suit in case of emergency (like when the hotel iron on “low” melts your favorite shirt… not that that has every happened to me the night before an interview….). Never, never, never be late. (I was late to my very first interview due to a wreck that cost me an extra 20 minutes on what should have been a 5 minute drive. I was so mad. But it all worked out!) No chewing gum. Smile, smile, smile. Resist the urge to check your phone, and it had better be on silent (I once scheduled an interview while in the restroom during an interview day….). Be polite to everyone. When I was a 4th year, the advice I got was that pediatrics programs care how you treat people, and this includes everyone from the program coordinators through emails, the hotel staff, other applicants, and everyone you meet at interview dinners and through the interview day. Every. Single. Person. It is tough to be “on” all day, but it goes by quickly.

Small talk: Read a non-medical book. Binge watch some Netflix or Hulu. These are all great topics so that dinners with residents aren’t awkward and can come up in interviews as well. I am a natural introvert, so having talking points helped me a lot, as small talk is the bane of my existence.

Research the program and its people. Most programs will give you a list of people with whom you are interviewing in advance of your interview day. (There were maybe a couple of programs that didn’t, and that still wound up being ok.) Where I interviewed, the fewest number of interviewers I had was two, and the most was five. Look these people up prior to your day; it will give you fodder for interview questions and you can tailor your questions to that person’s interests (always, always, always link it to something on your application that makes you look good that also meshes with their program). Know your reasons for applying to that program. Sometimes, the honest answer to “Why are you interested in our program?” may be “You have a program and I need a job next year…”, but this shouldn’t be the case for the majority of your programs, and there needs to be something that this program has that you would be a good fit for. Every answer needs to show you in a good light and how you would fit into the program or how it would build upon your strengths/meets your career goals.

Other Tips:

If you aren’t using the NRMP’s PRISM app, you should be! You can keep track of your interview dates, programs, and it even has a handy rating tool that I used immediately after each interview that made a preliminary Rank Order List for me. I will definitely be using it for the Fellowship Match next year.

Making that Rank Order List

I’m currently on my second (and last) vacation of intern year, and it is also the week that 4th year medical students across the country must submit and certify their Rank Order Lists (ROLs), ranking all of the programs where they interviewed… basically, choosing which programs will be a the top of their lists and which they will *hopefully* Match into next month. In just a few weeks, we find out who will get to replace us as interns next year! (But really, how on earth am I almost a senior resident?!)

Making our ROL last year was much more nerve-wracking than I ever anticipated. It’s a big decision to put all of those programs into a list and then submit that list into an algorithm that has the power to put you (and in my case, a family in tow) anywhere in the country for (potentially) years of your life.

I interviewed at far too many places: I was offered 24 interviews, planned on attending 20 (one was cancelled due to weather and then the program rescheduled me on a date I had an interview somewhere else, so I declined the rescheduled date), actually attended 19, and ranked 14. (My school’s leadership has us all believe we needed a ton of options if we wanted to successfully Match, even in “non-competitive” pediatrics.) Going into interview season, I thought that there would be a few standout programs and the rest would just be “meh”, so it would be easy. Not so. I could have seen myself being happy at just about any of the ones where I interviewed. My approach to every program was: I need my first job as a resident so I can become a badass general pediatrician. That is my top priority. And I think that I could achieve that goal pretty much anywhere. But the next priority was: Where will I be HAPPY? Because that is a completely separate entity. There were a few programs that I honestly thought, “I would be miserable there…..” but with all of the advice I received to “rank every program!”, I was hesitant to discard any of the programs. That being said, it was still much harder to make this ROL than I originally anticipated, so I needed some help with sifting through all of these programs. I did use the NRMP’s PRISM app to submit an initial ranking immediately after each interview, which set me up with a good idea of where they all fit into a list based on many factors, but it still felt a bit off.

I needed something more tactile, more visual. I wrote down every program I interviewed with onto a Post-It. All 19 of them. I then met with my med school advisor/best friend at a bookstore coffeehouse along with The Handsome and The Ladybug. At a tiny table, I took all of those Post-Its and went through them one by one, moving some higher or lower on the list. My advisor/best friend would give her input on the individual programs where she knew people, knew my interests, and knew my family and how they would all fit together. Her input helped immensely! It was nice to step back from the stress of the process to see the big picture. When we left the coffeeshop (An hour later? Two hours later?) I had a rough list and felt a little more reassured. There were still some programs that I wasn’t sure were in the right place on my list, or if I wanted them on the list at all (at that point, I had not yet discarded any of them).

So then, using those same Post-Its, I played a little game. I folded them all up, and over the course of several days, I would randomly draw one and open it…. pretending that was my envelope on Match Day. If I was excited, it stayed at (or moved to) the top of the list. If it made my heart pound and I wanted to cry….. I threw it away. Once I had played this game and drew all of the program names….. I knew my ROL, and I knew it was right for me (and my family). I submitted, certified, and never looked back. Based on the AAMC’s data for pediatrics, I knew there was a >95% chance that I would Match at one of my top 5 programs on my ROL…. and when I opened those 5 Post-It’s, I was very excited. I knew we’d be ok no matter what my envelope  said on Match Day.

I’m glad I don’t have to go through that again… at least until the fellowship Match in two years. 😉

To all of the MS4’s out there stressing over the ROL deadline TOMORROW…. it will all be ok. I can’t wait to see where everyone is headed! (But if you’re going into Peds…. my program is the best and I hope to see you this June!) 🙂

Interview with Accepted.com: We Need More Voices

While back, Accepted.com asked if I’d be interested in an interview for their podcast.

When I was a first year med student and found out I was pregnant, I immediately felt alone. There were scant other parents in my class, and were mostly men/fathers. My cousin was also pregnant, but she already had a career. I found two–just two–blogs on the Internet by mothers in medicine. There just wasn’t much out there to encourage me. Already an introvert, I retreated further into my bubble.

It eventually got better. But it doesn’t have to be that way. My med school baby was the best decision I’ve ever made. Every story will be different, but I share mine in hopes that it encourages others, and shows that you CAN do it all, even if it looks different than you imagined it.

You can find my interview here.

KevinMD blog

An article I wrote on being pregnant in medical school has been picked up and syndicated on KevinMD blog! You can find it here.

Intern Year so Far

My first rotation of intern year was inpatient pulmonology. My very first day was on “short call”, meaning that I was on call til 9pm accepting admissions (and could stay til 11pm finishing up notes). Plus it was a weekend, which meant I was cross-covering two other services until handing off to the night team. I was terrified. I started out the morning by introducing myself to the nurses: “Hi, I’m Dr. Allie, and I’m a brand-new intern. I have no idea what I’m doing. Where are the stairs? Where can I find this room number? Where do I put my used isolation gowns?”

Pulmonology was really interesting. It took awhile, but I became more comfortable with taking care of common illnesses like asthma, bronchiolitis, and Cystic Fibrosis as a doctor, instead of a med student, or someone on the sidelines.

I wanted so badly to make a good first impression that I think what I actually did was more self-sabotage than anything else. Double-checking everything because I didn’t want to make a mistake made me slow. But, by asking questions I started to learn how to do things, got acquainted with our EMR system, and quickly fell into a routine.

Without a doubt, though, the best part so far has been getting to know my co-interns, senior residents, and the attendings here. I’ve made so many more friends and it feels like I have known them all much longer than the few months I’ve been here.

This was also my first month teaching med students as a resident. When you spend your days feeling like an idiot every single minute, it starts to feel like you have nothing to offer. As I started out in residency that first month, I felt like I was barely keeping afloat. After a couple of weeks, I was much more comfortable in my role, and began dedicating more time to guiding the med students. These were med students on their first-ever clinical rotation, and it didn’t take long to feel like, “actually, there IS something I can teach you!”

School may be out, but that doesn’t mean the learning (or re-learning) ends. I’m the type that learns through reading, and my med student habits have stuck with me, so I try to always carry something to read. Many of my days look like this:

There’s still time for fun. One thing I love about my program is their dedication to wellness. Once each block or so, my program sponsors Riley Rounds, fun outings for residents (and their families!). The first one was to an Indians baseball game, and the second was at a restaurant that also hosted games. One day in the lawn between hospitals they set up an inflatable obstacle course just for residents (plus Sno Cones)! We work hard but we definitely play harder!

So far, I am really enjoying residency, even when I feel like I’ve been an inadequate idiot all day. I’m slowly learning that it is ok to stick to my gut, speak with more confidence, and say NO. One of my interviewers last year said that “putting on the doctor pants” is a difficult thing to do, but if I chose a program that supported me in ways that I needed, it wouldn’t be as difficult as it could be. I’m only a few months in so far, but I am so glad I chose this program (and that they chose me)!

To see more frequent posts and snippets about my days as a pediatric intern, follow me on Instagram @pagingdrallie

Long Time No See

The last time I posted, I had just found out that I matched into one of the programs on my Rank Order List for a residency in pediatrics, accomplishing a goal I’ve had since I was 14.

It has been such a long time since then, and I haven’t written about it. After Match Day, there was so much to do, and it felt like we had no time. It all went by so quickly.

We immediately went on the hunt for a house. On one Saturday, we toured 19 properties, put in an offer, and bought our first home.

My brother got married with my Ladybug as the flower girl:

I finished my final med school rotation in the NICU, which I absolutely loved.

We had to find a new daycare and it completely broke my heart to leave the one we’d used since the Ladybug was 8 weeks old.

I GRADUATED!

We took a family vacation to Key West, FL, Dry Tortugas National Park, and Savannah, GA.

We spent two weekends painting the house and moving in, with the help of the best family and friends.

Then the fun started. Mountains of paperwork and training and licensing and certifications before even starting orientation.

And now they call me Doctor. Paging Dr. Allie. It is real, and no longer a fantasy or far off in the future. It doesn’t feel like it at all. I’m currently on my second rotation, which means I have “survived” July of intern year, but not without rubbing one of the children’s hospital’s ladybugs for luck on my first day.

Useful Apps for Fourth Year

I cannot believe that it is already September and recruitment season is almost here. These were the apps that helped me keep my sanity through a wonderful fourth year that was full of adventure and excitement as I closed the book on that chapter of my life. 4th year was a lot of fun but still a lot of work and a TON of stress. These apps helped to relieve that stress.

***I am not sponsored by any of these apps/companies… I found them throughout the year and thought they were useful… I’m still using them!***

1. NRMP PRISM app

This app, designed by the NRMP, was great for tracking the programs I applied to, interview dates, and they even had a ranking system. I have been telling every 4th year student about this app! (And, it’s free!) You choose which Match you want to enter (Main Residency vs. specialty like Urology, vs. fellowships), add your programs, and update once interviews get going. It was so helpful, and I already had a framework for my Rank Order List (again, easing the stress… a little).

Waze

Honestly, I’ve been using this app for a long time well before interview season. It’s a crowdsourced GPS that shows you the fastest route to your destination and it updates in real time so you can avoid wrecks and traffic jams. I spent so much time on the road driving to the majority of my interviews 😳 and this app saved me a lot of time. All I had to do was type in the address and drive. (It also shows you places to stop along the way…. where to get gas, restaurants, etc.)

Audible

In speaking of all that time on the road… after awhile, I grew bored of my iTunes and even the radio and I needed something else to stimulate my brain while the miles ticked by. Audible is a branch of Amazon and there so many choices. Some books are free, you can be ‘gifted’ your first book by a friend, or you can sign up for a membership (this is what I did) and get discounts on books. In the membership, you get one credit per month to use on any book (any $ amount), plus discount if you buy additional books (plus they have new free books pop up all of the time). I spent so much time on the road (I literally stopped clocking the hours because it was insane), but I would use my monthly credit toward the longest audiobooks I could find. I started the _Outlander_ series and some of them are 30-45 hours of audiobook… and some of them I listened to more than once. Now that my round of interview season is over, I still use this every day on my commute to and from work.

Calm

At the beginning of 4th year, I downloaded the Calm app to give meditating a try to see what it was about. I liked this (FREE!) app because it had lots of material on it that I found soothing. There was plain background noise (I use mountain lake, pictured above), guided and unguided meditations, and series of meditations (such as, A Week of Calm, A Week of Stress Relief, etc), and all of that was free. Each meditation is 10 minutes long or so. Since then, they have majorly upped their game. Now even the free version has daily meditations on topics to ponder, more series meditations, a section just for music, and–my favorite–SLEEP STORIES. I have such a hard time falling asleep when I am 1) alone 2) in unfamiliar places and 3) stressed about the next day’s interviews, all of which I was doing on a regular basis during interview season. My sleep was suffering during that time, but in using this app, I gained back a lot of peace. I still use this app every day, and I upgraded to the paid version so I have access to all of the content. They are constantly adding to the content, with new daily meditations, sleep stories, music, series, etc.

Those are my top choices for useful apps for 4th year. What apps did you find helpful?

Match Day

So I haven’t posted in awhile. No worries! Match Week was absolutely crazy, and since Match Day, I’ve celebrated with endless family and friends; looked for, found, and bought a house; started my last rotation of medical school; and have just in general been enjoying life.

I don’t keep it a secret that I had to apply to medical school four times. It’s just a part of my story. However, I truly believe that by going through that process, my self-confidence has been irreparably damaged. I constantly doubt myself. I doubted that I would ever get in; I doubted that I would pass all of my classes; I doubted that I would pass my Step exams; I worried and fretted frequently about my ability to obtain a residency position, or if I did, that it would be in a place that I did not necessarily want, but that I should just feel lucky to have obtained a spot.

I never imagined that I would go from a third-time re-applicant to being actively recruited for my first job as a doctor. Not a single one of those bad, scary things that I lost sleep over ever happened.

I also never imagined that putting together my rank list would have been so hard. I absolutely loved my top 4 programs and was hopeful that I would Match at one of those four; but what if I Matched at the place at the very end of my list? Getting the “Congratulations” email from the NRMP on Monday lifted the fear of not Matching, but waiting four more days to hear where was nerve-wracking. Zillow was confused about why I was looking at houses in four different states.

On Match Day, we arrived at the Mellwood Arts Center early to take part in the festivities. Local organizations were sponsoring giveaways, provided food and drink, etc. The nervous energy that filled the room was intoxicating. My husband and I grabbed a table with several of my friends and their spouses as we anxiously awaited getting our letters at noon.

The last hour felt like it stretched on for ever and ever.

When it was finally time to go up and get our letters, I was a shaking mess. I held the thin white envelope in my hands and I was terrified. Would I Match at my #1? #2? #14?

When we got the go-head at noon, I ripped open the letter, took a deep breath, and looked for my program name.

“IND—

I dropped the letter, clasped my hands to my face and cried. David picked up the letter, read it, and cried too. Screams of triumph filled the room. Smiles were plentiful. Everyone at my table Matched at their #1 program!

 

We are moving back to Indianapolis! We could not be happier.

Motherhood and Trauma on Surgery

When I was on my surgery rotation, there was one day that was particularly rough. It was a Saturday and I was on call by myself, without any classmates. I saw more gruesome and horrifying things in that one day than I could ever imagine. It was a day that permanently broke something inside of me. There is no going back after a day like that. One of my attending surgeons even came up to me later to say how well I handled those situations (totally a lie, but pretty awesome coming from a surgeon 😂). This is why all doctors are wounded healers. 

After being awake for 30+ hours on that call day, I went home hoping to crash in my comfortable bed and try my hardest to forget everything I’d seen and done. As soon as I stepped in the door of home, I hear, “Mommy?” Coming from my daughter’s room. I was spent. I had nothing left to give mentally, emotionally,… just nothing. I felt sub-human. Still in my scrubs, shoes discarded at the door, I walk into my daughter’s room to her smiling face, chanting “Mommy!” While jumping in her crib. My sunshine, happy to see me. 

A year and a half later and I’m finally sharing a piece I wrote that day. Writing it helped me deal with some of the residual effects that I still feel. 

Med Student Mom