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.

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!

Welcoming 2017

Looking back over the past year, I thought I’d start out with my resolutions for 2016. How well, or how poorly, did I do? Where do we go from here?

Here’s an excerpt from last year’s New Year’s post:

Last week, I found this idea: a “7 x 2016”, a prompt for making wishes become goals instead of ‘traditional’ resolutions. I really liked that idea, so here goes mine, with a couple additions:

Learn how to.….. speak in medical Spanish. Back in high school and even college, I was pretty good in speaking Spanish with native speakers. However, it’s true that what you don’t use, you lose. I’ve bought a guide and have already conquered the first chapter. Here’s hoping for better communication with some of my future patients. This one has been a success, in some ways. One of the perks of being a medical student is that sometimes we are offered discounts on this… like Rosetta Stone. Our class got a deal on the Spanish set, and I jumped at the chance to use a program to increase my skills. I’m still not done with the program or with the Medical Spanish text I bought, but every little step is a victory so I’m calling it a win.

Start……. My Year of Kindness. One thing I’ve been noticing lately is a genuine lack of kindness in our community. I’ve got a few ideas on what to target for each month, and I’m really hoping this new venture is a success. More on that soon. This was also a success, and one that I am very proud of. In January of last year I pioneered a project christened My New Kentucky Home that served the refugee and new immigrant populations of my city, and it was a smashing success. What a way to kick off a year of Kindness!

Stop…… Doubting myself. I do it all the time. It’s a hard habit to break, but I realize what a detriment it is to my psyche and my performance as a student, wife, and mom. There is no room for it anymore in this new year. I have gotten better at this. It is a very slow process, but I’m gaining more optimism by the day. It’s so easy to give up on some things because they seem so daunting. Slowing changing that inner voice has helped my life in a big way.

Travel to.….. This one is my favorite, I think. While I feel like I am overdue for a visit to somewhere outside the USA. It’s been almost 5 years since we went to the Caribbean. However, I think that adventure might still be awhile off. This year, we’re planning on a post-third year pre-Step 2 studying family vacation to Washington, DC and Virginia Beach–three new states for me and the Ladybug’s first trip to a beach. Much slower-paced than we’re used to, but that’s ok! Making memories with my family is a priority this year. We made a ton of memories on that trip to DC and Virginia Beach! The little one had a blast too, so I think another beach vacation is in the cards for 2017.

Find…. Two half-marathons to run this year. With rotations, it’s not like I can just pick which ones to do this far ahead of time, so I’m wondering if I should skip the local half-marathon in April (during my OB/GYN rotation… just watch my week of nights in L&D be the same time as the race) and plan for one in summer and another in the fall. Any suggestions for fun ones to run? As it turned out, the local half marathon WAS during my two weeks of Labor and Delivery, when I was working intense hours at an intense pace. So, this goal was a flop. I failed. But that doesn’t mean that I didn’t gain something along the way. I was much likely to be found at the gym this year, even if I didn’t get to run in those races that I hoped for. I no longer hate the gym. I no longer feel that it is a chore to go, but instead I actually look forward to going. Baby steps! My most consistent part of the year was probably during Step 2 studying, since I would get in a run before sitting down to study as part of my daily routine.

Try…… New restaurants in our area. Since there is a great probability that we just may not be living here after The Match, I’ve insisted that instead of always going to the same places (which I love, honestly), that we try some new places that are unique to the Louisville area. We’ve asked friends of ours to go with us to a new restaurant once a month. I’m really excited for this new Double-Date Night! This was also a major fail. Between my schedule, the Handsome’s long hours at work, and conflicting schedules with friends, this one did not get off the ground. However, we still have high hopes for 2017 and adding more friends to the mix.

Be more……. Girly. Since being in med school, I quit dressing nice for class/school in general unless it was absolutely necessary. Then once I became a mom, I put myself last on the list of people to care for. I love dresses but don’t think they look right on me. Since losing so much weight, the brand-new clothes I bought for rotations in July already don’t fit me, which is a blessing and a curse. I hope to actually acquire some style this year, and maybe even keep my nails painted and try new lipstick or something. So this one is a win for me too. This has been the first year in a long time where I actually took care of myself. Taking pride in my appearance wasn’t on the radar before because I was simply trying to survive, and spending time on myself didn’t feel like it had good return on investment. However, now I am feeling better about myself (it’s all part of changing that inner dialog!).

And then two I added to make my own “9 x 2016”:

Less….. Screen time/wasted time on my phone. I wonder how much efficient I would be if I transferred all of my phone time to work time. Not that it’s bad to focus on something outside of medicine for awhile, but I find that I scroll through all the social media apps when I’m bored and spend much more time on them then I intend. There was good and bad to this one. I was much better about staying off of Social Media during my dedicated study time for Step 2 CK, but outside of that, I STILL pay far too much attention to my phone.

More…… Memories/Playtime with my kiddo and hubby. The Ladybug loves for momma to come home and do nothing but play until it’s her bedtime… which sometimes eats up a large amount of my study time, and sometimes makes me worry that I’m not a good medical student. However, I don’t think this is time wasted (such as when I’m on my phone). I always, always, always make sure that I tell her that I am happy to see her and that I love her as soon as I pick her up each day. I want to soak up all of this sweet toddler time as I can. This one was definitely a win. 4th year has aided in my ability to make more special moments with my family, since I’ve had much more ‘free time’ this year than in the previous three years. Every opportunity I get to pick up the little one early from daycare to take a surprise visit to the park, I take. It has been amazing and so sweet.

So what does that leave for 2017? 2016 was my best year yet for sticking to my goals throughout the year. Previously, my ‘resolutions’ were usually broken by the first few weeks of the new year. This year’s successes are making me much more optimistic for 2017 and beyond. 2017 has the potential to be the best year yet with so many new adventures on the horizon: my brother is getting married in the spring, I graduate in May, we will be purchasing our first home before the start of residency, and I will finally get my MD and start training to become a pediatrician. Many new things were introduced into my life this year, which were unexpected and totally outside of my 9×2016 list. I have started meditating using the Calm app (which I love!), increasing my yoga practice, and becoming minimalist. These were things I never saw coming but I am so glad I found them/they found me and my family, and I fully intend to keep them throughout 2017.

My 9×2017:

Learn:… Spanish. This is just a continuance, and still something that is very important to me. It has already helped me form greater bonds with my patients and their families just by saying the phrases that I do know, and acknowledging that I still have more to learn but I am TRYING.

Start: Racing. I made good strides of going to the gym more frequently and PR’ing my times, but I want to bite the bullet and actually race this year. I’ve already signed up for a local series of races where I can build up my distance.

Stop: Feeling guilty for not knowing everything. So much of medical school is realizing just how much I STILL DO NOT KNOW even when I am killing myself with studying. It is OK that I do not know everything. There is an opportunity to learn each day, and I plan on fully taking advantage of that and asking more questions… all of which will make me a better physician.

Travel to: We have several plans for travel this year, with the first adventure being next week. I could go on and on about this one, but for now I will just say there will be hiking and sunshine and a few new states/possibly countries.

Find: The right program, the right home, the right mentors. Some of these are time-dependent, but there will be a lot of work to do come Match Day (3/17).

Try: New restaurants (a continuance of our goal for last year) along with new foods! As part of interview season this year, we get a lot of dinners out with residents in all of these new cities and I’ve made it a secondary goal to try meals I would ordinarily never try. From butternut squash ravioli to my first taste of Indian food (which I LOVED!), it’s been a good idea to branch out and try new cuisines/flavors.

Be more: Of an advocate. One of the things I love most is projects, especially those that help people. I do not have much experience on the political side of things, but as I start residency it is increasingly important to me that I learn how to fight for my patients, their families, and their needs. Learning this skill is one of the things I am most looking forward to in residency, in my new role. How exactly do I plan to do that? First of all, I’ve been interviewing at programs that excel in advocacy. There are other opportunities for training through local and away electives. I’ve also been looking for great mentors. No matter where I end up Matching, I will have a solid foundation to help me with that endeavor.

Less: Screen time. This one is a hard one to break (I mean, I’m blogging right now, so….), but I realize that especially with screen time, less is more.

More: Meditation, exercise, relaxation, reflection, minimalism. All of these things, to me, go together hand-in-hand. What I haven’t been doing much of lately is reflecting and writing about how these things have helped change our lives for the better.

I am looking forward to a 2017 full of adventures and memories. What are your goals for the new year? What big adventures are on your heart and mind? Share with me! Let’s encourage each other to make 2017 the best year yet!