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!) 🙂

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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.

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!