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.

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!) 🙂

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.

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.

Psych so far

My last rotation of 3rd year is Child Psych, and let me tell you, it is so much different than everything else I’ve done this year, in good ways and  not so good ways.

The unit is a locked unit, with multiple doors and multiple keys. All trash bags in the unit are paper bags, not plastic. Most rooms with showers don’t have shower curtains. Since most of the kids are school-aged, there are school sessions throughout the day so that they aren’t counted as truant. There is art and music therapy. There is a schedule that is followed every day so the kids have to get up at a certain time, have showered by a certain time, etc.

We start out the day with table rounds at 8am (no pre-rounding). We then go see the kids before art/music/school/drama/the daily activity and go to any family sessions that are scheduled. I think write my notes and we’re usually done by noon or so. Lectures/Grand Rounds/Journal Club is in early afternoon, sometimes from 11-3, depending on the day. In the afternoons, three times a week, we have a clinic. We are either in the child clinic, the suboxone clinic, or the bipolar clinic. Those days can stretch out for a really long time.

During this rotation, we also have three “on call” days in EPS, Emergency Psych Services, and I’ve done all three of my calls. It is so much different than what I’m used to seeing in the day.

There are now only two weeks of third year left. Just two. I don’t feel like I know enough to be a 4th year medical student, but it is coming soon regardless.