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 😳 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?

Matched!

The first time I ever went to a Match Day, I thought it was a special kind of wonderful. A huge room absolutely packed with family and friends, medical students jumping for joy with their envelopes telling them where they were going for their training… it was so much fun.

And it wasn’t even MY DAY. It was just so fun seeing everyone else so happy.

And yet, I was unbelievably sad. Three failed applications to medical school and I had just about given up. I’m sure any sane person would have.

But, I am stubborn, and I am just different. I remember telling David once that I didn’t know if I would ever truly be happy, working as a scientist but regretting never going to medical school. I’m pretty sure even he, my biggest supporter, thought I had lost my damn mind when I said that. Maybe I was just being dramatic, but at the time I was working a job that I absolutely hated, due to circumstances beyond my control. Attending that Match Day filled me with a newfound optimism. I’ve got to try just one more time. Whatever the outcome, then I will be done and I will move on. Just one more time.

Now, almost 5 years later, and my Match Day is this Friday. Today I got this email:

I started a new rotation today, and we were busy seeing patients when I heard a very faint ding! in my pocket. And I just knew, That’s it. That’s gotta be the email. As soon as I had a split second to check, all I saw was, “Congr–“ on the subject line.

And now my Facebook and Instagram feeds are all filled with the same picture from friends in med schools across the country, and I am so happy for everyone. We are almost at the finish line for this leg of the race.

So, so happy. I get a Match Day, I get to have a residency position to start the process of being a pediatrician. I am so overwhelmingly relieved. The constant stress of medical school has all been in the hopes of landing a residency.

First and second year: Make good grades and pass Step 1 so I can land a residency.

Third year: Make good grades and get good letters so I can land a residency

Fourth year, early on: Pass Step 2 and put together a great app so I can land a residency.

Fourth year, after interviewing: Please let me Match into a residency! Did I put programs in the right order to Match? Did I rank enough programs? Will I actually get to be a resident?

It almost makes me wonder if Match Day will be anti-climatic. Thank goodness that’s all over???

All of that aside, I am so relieved. In four days we will have an answer and can start looking for a house. I’m ready. I’m so ready. I’m not ready. But I’m ready. There will always be so much I don’t know, but I am finally almost there. PagingDrAllie, pediatric resident physician.

A dream, ever so close to becoming true.

 

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!

Interview Season in Pictures

The best year of medical school is the year you are accepted. The second best year is 4th year. Or so I was told four years ago. =)

Somehow it is already Christmas Break of my 4th year of medical school and in less than 5 months people will start calling me “Doctor” and I’m actually going to know how to do stuff and know things. It’s pretty unbelievable that after so many years of wanting to go to medical school and going through the process of applying to medical school four times and thinking it would never happen for me…. I am actually almost done. It doesn’t quite feel real.

I am very happy to report that the nightmares I was having back over the summer, before the ERAS residency application opened, were completely unfounded. I have more interviews than I know what to do with and the odds are in my favor that I will actually Match in March and will have my first job as a physician come next June/July. It’s been an incredible experience, if not time-consuming, alienating, and exhausting, but a necessary evil in the long run. I have met so many incredible people in the field of Pediatrics, and I feel so lucky to be going into the best specialty! (I may be a bit biased 😉 and I’m sure all of my colleagues in other fields feel the same way about their specialty.) I can’t wait to get started on my career but at the same time, I wish this year would slow down.

Over the past several months, my Instagram feed (@PagingDrAllie) has been flooded with snapshots of the interview trail. Because what else am I supposed to do when I’m going to new states, new cities, new places all by myself for nearly three months?

I purposefully do not share where I am interviewing. Not only for anonymity (which really, in having this blog, I’m probably not doing a very good job about that anyway), but I feel that sharing and bragging about those sorts of things is just in bad taste. A program that I am not thrilled with may be a friend’s top choice and they may not have received an interview invitation…. and I’m not the type of person who relishes in others’ despair. Below I’ve gathered some of my Instagram shots from my travels, with captions. I hope you enjoy a small taste of my life living out of a rental car!

One of the unexpected bonuses of traveling so much in November/December: all of the hotels and hospitals are wonderfully decorated for Christmas (and Hanakkuh, and others), which delights my soul in a particularly special way. There’s just something about twinkle lights that makes me deliciously happy.

 

This has been my view for so long that anything else almost seems foreign. After awhile, all of the hotels just blur together. There have been a couple that have really wow’d me in terms of the bedding. As a mom of a two-year-old, having a full night’s sleep, alone, without interruptions (or being kicked in the face) is a luxury beyond belief. Even so….. I do miss my own bed at home. Once I’m actually working, maybe we can investigate investing in a bigger bed that is as comfortable as this one was!

 

The bad thing about racing home, while driving alone, is that when you’re driving into a beautiful sunset, there is no one to share the experience with. Which means you pull over onto a safe pullout/shoulder and snap a few quick shots before getting back behind the wheel and trying to make up for those minutes.

I spent a week and a half in a new state to interview at several programs, thinking that would be best for my rental car and time. What I didn’t anticipate when I scheduled those interviews was how much I’d already be missing home and my kiddo, even that early in the interview season. So the Handsome came up with a brilliant scheme: instead of coming all the way home, I’d meet him and the Ladybug at the halfway point between home and the next interview to spend a weekend doing things she’d love like swimming in a heated pool and an excursion to the Children’s Museum there. So after my last interview of the week on a Friday, I raced to our rendezvous as quickly as I could to surprise the little one and when I came into the room….. she was already asleep. Figures.

Again, racing home (or to the next interview city) and I was alone with a great sunset.

This one, though, was on my way home for a weekend. This shot doesn’t do it justice, because it was seriously one of the most gorgeous displays I’ve ever seen.

This year, I’m taking a course that explores the marriage of Art with Medicine and Wellness. One of the stipulations of the course is that we make time to visit museums, aquariums, etc to help boost our wellness. The Georgia Aquarium is one of the very, very few aquariums to house Whale Sharks, and I couldn’t pass up the opportunity to visit when I was in Atlanta. I really wish I would have had more time there!

One morning right before I left home for the majority of three weeks straight. Foggy yet golden, I couldn’t help but snap a shot to remind me of home.

Thank you notes are the bane of my existence. I was raised to express gratitude where it is due, so I’ve always been a fan of handwritten notes. I had no idea that I would be writing 4, 5, or 6 or more per program, though. Mentors have pressed upon me that for Pediatrics, thank you notes are pretty important, so I should make sure each one is personalized because all of them may wind up in my file, and if they are verbatim alike, it could be a mark against me so….. I spend a lot of time writing these things.

In one city, I came into town a bit early to catch up with an old friend from college at a local coffee shop before dinner with the residents. I wanted the chance to walk the city to get a good feel for it, and as I made my way to the coffee shot, I happened to notice the sky. This shot doesn’t really capture the cotton-candy sky, but I still liked the way it turned out anyway.

I left one program just in time to sit at a coffee shop in a different city for an hour or two before meeting the residents of another program for dinner, so I took that time to compose more thank you notes.

Niagara Falls at dusk! 🙂

Probably one of my favorite shots. It doesn’t quite look real, and this is #nofilter.

There was one interview that was really, really far away. Luckily, the Handsome could go with me and we made the executive decision to take the Ladybug with us and stop over at the halfway point, Niagara Falls. She LOVED it, and I am so glad that we weren’t deterred from bringing her with us. The first thing she said was “Whoa!” which was quickly followed by, “Mommy! BIG WATER!” All three of us marked off a couple new states and this little one got to add a new country to her passport as well!

I never knew the northeast was so pretty, even in late autumn! One thing I didn’t get to take a photo of: while driving through the mountains I saw where a semi took out the biggest black bear I’ve ever seen. So sad!

On the very first morning where I was supposed to be traveling to an interview, I went out to our deck for some meditation before beginning the long drive. It was so peaceful until the small flock of geese came by to interrupt me. Not a bad way to start out an interview season, I think.

I am almost done with my interview season. Some of the advice I got from last year’s graduating class were to wrap up the interview season before Christmas break, but that didn’t work out for me. I’ve been on a ton already, but I still have 5 more in January, and I am really excited for those programs. I’ve been keeping a running “rank list” and my top 5 are very clear in my mind already, programs that I loved to pieces. I’m hoping a few of my last interviews also make it into that category.

Rotation: Psychiatry


Psych wasn’t a bad rotation… I got out early a few times, including the day of the daycare Family Fun Night where we were the first to play in the bubbles! 

Name/Location of Clinical Rotation

Child Psych inpatient with Child Psych clinic, Addiction Clinic and Bipolar Clinic, with two Emergency Psych Services shifts

What did I like most about this specialty?

I learned a lot on this specialty about all of the services that we could offer that didn’t necessarily restrict the patient to the inpatient setting. We had a large variety of clinic settings, inpatient, outpatient, and emergency psych services. For child psych, we had an inpatient unit that included school sessions for elementary students and junior high/high school students. There were also group activities and art and music therapies. It was pretty interesting to see those sorts of things in the hospital setting. We even had federal services available for girls who we thought might be trafficked.

What did I like least about this specialty?

I came across a lot of patients that were violent. I knew it was a possibility with this service, but I didn’t expect it to be so frequent. This was the first time I’ve ever been threatened, so that was fun. 

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

I believe so. We got a very broad view of the different types of psychological illnesses and a variety of practice subspecialties and clinic settings.

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 really like finding community services that benefit patients, and I honestly think this specialty had the most available services out in the community. That being said, I really don’t think this type of practice suits me very much. Psychological issues are usually fraught with social issues as well, and it is so hard to treat not only the illness per se, but also the home environment and lots of other issues. If the home environment is the root cause, and then you send them back to the same environment, what are the odds of them getting better? 

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

Inpatient, outpatient, and a mix of both. It was pretty interesting to see so many different practice types, including the Emergency Psych service at our adult university hospital.

What info do I still need?

None–this was a very enlightening rotation.

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

I learned so much about this specialty that I didn’t know beforehand. I didn’t really think that psych would be a good fit for me, and even with being selected for the pediatric version of psych, it wasn’t a good fit. I really admire the people that go into psych and especially child psych. In the child psych unit, I heard some of the most disturbing, horrifying, unbelievable stories I’ve ever heard in my life. 

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

It cemented for me that this is not my future specialty although I do find the resources to be very valuable for pediatric patients that I will definitely use in the future.

Right now, how interested am I in this specialty?

Pretty far down the list.

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

There are a bunch of patients that I met on this rotation that have shaped how I practice with other patients. That has been very valuable and formative for me.