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

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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 ­čś│ 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?

129 Days


Today I was reminded that even though I’ve learned so much in med school, there is still SO MUCH I don’t know and need to learn, practice and repeat. The answers don’t always come from textbooks. I am so thankful that as an intern, there will still be several layers of supervision as I learn to navigate the responsibility of making medical decisions. 129 days! Tonight’s agenda, though, is learning about QI & peds EKGs as well as reviewing some articles & brushing up on sedation meds. (And NO, I’m not hardcore studying for Step 3 yet, but I ALWAYS keep reading material & a To Do list on me!)

On a separate note, my ROL (rank order list, the list of my preferred residency programs in the order of my preference) is certified and will be locked in tomorrow night at 9pm. Match Day is LESS THAN A MONTH AWAY and I am so excited. I just want to KNOW already. I’m itching to start the house hunting, moving, moving on with my life, etc!

Life These Days

Here is just a glimpse of what 4th year has looked like for me since late August/early September:

Please pardon the language on this picture, but I laughed at it because I recently completed a two-week EKG interpretation course and my ACLS training! Lets just hope that I don’t forget everything I learned in that elective because it was fun and useful but now I won’t see it again for a while.

There has been much more free time in fourth year, and you can bet that I am taking full advantage of it. The Ladybug and I hit the local parks for fun as often as I can muster with rotations, studying, ERAS-app production, etc.

I had my ACLS training early in the year, around the time that our ERAS applications were due. I wanted to get it out of the way before interview season started. This was a fun 2 day course with hands-on training (And I passed! Always a relief!); even though the EM residents running it told me they were sorry that I’d have to take it again–Pediatrics has a separate ACLS-style training course that I’ll take in the spring summer, either on my own or in coordination with my residency program.

Downsizing. Since we’re moving next year (either away to a new city/state or even just into a house if I match into our home program), I do NOT want to move all of this stuff, yet again. So we are downsizing and minimizing, which included our movie collection. I took a ton of books and movies to Half Price Books, and the movies that we did keep we transferred to a DVD case and threw away all of these cases. SO MUCH MORE SPACE!! I am so, so pleased with getting rid of all of that.

On the first day of Step 2 studying way back in July, I found the back of my earring caught in my hair but the actual earring itself was nowhere to be found. I panicked. These earring were a wedding anniversary gift from my grandma’s late husband, given to me on my wedding day. I not only wore them the day I got married, but also for every medical school interview, the day I got my first med school acceptance, every day of gross anatomy, the day I learned I was expecting, the day we learned she was the Ladybug, the day we met her and brought her home, the day I took Step 1… So they were beyond special to me. I love you Jed everywhere and retraced every step I had taken that morning. I had been to daycare, the gym, and all over campus. It was nowhere to be found. I have ugly-cried so many times since then, and I couldn’t bear to tell my grandma. I even had the thought of someday taking the remaining earring to a jeweler and having a replica pair made. It has been over 11 weeks since this happened, and I had given up all hope of finding it, took Step 2 without them, and put the remaining one safely in a jewelry box. One night this past week, the Ladybug was fighting sleep and crystal nf for a certain bedtime toy. I looked under her bed and GUESS WHAT I FOUND! How many times have I walked right by it without noticing it?! How many times have I swept that carpet and yet, there it was! I am so relieved! (And I never had to tell grandma that I lost it!)

I also passed Step 2 CK (total relief, I can never tell how I performed on those things) and updated my ERAS application before the September 15th deadline/release date. Now I only have Step 2 CS (the in-person part where we take care of a dozen standardized patients in the course of a day) and then I am totally done with exams (minus the AI, acting internship, elective shelf exam that I take in late October) until after I graduate and get my MD!

The Nightmares

Since we returned home from our vacation, I’ve been having nightmares. Not every night, but most nights. They reflect my current fears– failing Step 2, not getting any interviews, not Matching…

I’m not sure what to do about them. I thought that once I started filling out my ERAS application for residency that I’d gain some confidence looking back over all I have accomplished in the past 3 years. Instead, I wonder if there is anything about me that will stand out enough to land my first job as a physician (-in-training).

This week is the big week: my ERAS application will be officially submitted and many programs will start downloading applications. I may even get some interviews to schedule this week. My Step 2 scores should also come back this week. I’m excited and terrified at the same time. I seriously think I have looked over every single pediatrics program in the country. My list has been whittled down to the places where I think that I (and my family) will be happy, with lots of things for all three of us to do and enjoy. I had a meeting with my home program’s residency director, and she helped me to go through the list to make sure it was realistic. She said I had a good group of programs and she thinks I will do well–which helped my confidence a bit and since then, no new nightmares! She also told me that she loved my personal statement, which was unexpected but also boosted my confidence a bit.

Here’s to having a good week, a great start to the application and Match process, and finding the right place for my family and I as I transition to being an actual doctor next year.

Rotation: Inpatient Neurology

Name/Location of Clinical Rotation

Inpatient stroke at our local stroke center/Inpatient General Neurology

What did I like most about this specialty?

It was pretty relaxed. I got to spend a lot of time with my patients, and there was a lot of time to think and research things for my patients.

What did I like least about this specialty?

There were some really sad stories, and what I didn’t like about Neuro was that a lot of the time, the patients never got better; at best, we might halt or slow a disease process, but we didn’t really fix anything.

Did this clinical rotation give me a good sense of what practice in this specialty would be like?

I was on inpatient stroke/neuro consult and had my ED experience, which gave me a lot of unique experiences. I enjoyed that part, and I feel like I got a view of a large scope of that sort of practice.

Did my interests, values, kills and personality fit with this specialty? If yes, how did they fit? If not, why might they not be compatible?

I liked that I got so much time with my patients, but it isn’t the right specialty for me. It did not click at all.

What are the possible practice settings exist for this specialty? Do any of them interest me and do I know enough about them?

There’s inpatient, outpatient, and subspecialties in stroke and lots of things that I didn’t know about prior to this rotation! I feel like I got a good view of them, but I don’t see myself pursuing neurology. Right now my list is: IM>Neuro>Surgery, but I’m only on my third rotation!

What info do I still need?

None–I feel like I saw enough and got a good enough feel of it to know that I am interested in looking elsewhere for my specialty selection.

Has my perception of this specialty changed? If yes, how?

I learned a lot on this service. I really sucked at localizing lesions in the beginning, and with the neuro exam encompassing so many steps, I was always nervous performing a total neuro exam in front of my attending and residents. I felt like I had a good relationship with many of my patients. I still wonder about some of them, how they are doing. I do have a much higher respect for the specialty now.

Did my clinical rotation experience influence the likelihood of choosing this specialty?

Now that I’ve gotten a chance to really see what working in neurology is like, I do not think I will be selecting it, but it has been a positive experience.

Right now, how interested am I in this specialty?

IM>Neuro>Surgery at this point.

What information do I still need to evaluate this specialty? Any other comments or reflections?

Some of these patients were so sad. I tried to give my patients plenty of time to complete the MMSE exam, but it was frustrating to them as well as me when they tried so hard on this silly set of tests and sometimes could just not do them no matter how hard they tried.