Friday, September 28, 2007

And More Residency Talk - Yawn

I just reviewed my Anes programs from the ACGME website which allowed me to see how long the programs have been given accreditation before they’re revisited. The max is a 5 year time difference between visits with anything 3 years or less worrisome.

Essentially what I've been led to believe is that your programs should have 4 or 5 year cycles. If you're concerned about getting into a residency, then consider something that might have a 3 year cycle as well - just to keep your number up. A program with 2 years or less is on "probation" and if they have only one year between - avoid at all costs.

Now, it might go without saying that you'd think the higher echelons of residency would carry longer cycles - right? Well, not always. One northeastern, ivy league school had a 3 year cycle for their Anesthesia department. Surprising and illuminating.

So, naturally after I checked my programs out (and found some rather interesting finds – like a program I'd been quite keen on having a 3 year cycle) I decided to review my school’s residencies. Basically, sweet and short: they all suck.

The longest I found had a 3 year cycle, with the majority having only 1 and 2 years. Since they were reviewed last winter that makes me feel even worse about the ratings – I was in the hospital, getting pimped, sleep deprived, and irritable while these programs sucked. Hell, the one that I didn’t get high honors in is on probation with one year allowance! WTF is up with that?

Anyway, it’s a good idea for anyone applying this year or next to review the accreditation status of your programs selected as well as their board pass rates that can also be found on the site.

Tuesday, September 25, 2007

Heavenly Home

How rude of me! I forgot to mention how nice it’s been to be home these past few days. I seemed to pick right up where I’d left off with everyone. The first night was wonderful.

I came home to presents, a homemade banner that said “Welcome Home Daddy!” with my kid's pictures drawn all over it, and the comfort of knowing that Wife was busying herself with various home projects while I was away (a friend told me that, in the army, the husband always was comforted if he came home after some time away to a rearranged home – it meant that his wife wasn’t out with someone else).

Daughter didn’t know what to make of my glasses and was a bit taken aback by the new look, but soon realized what was different, asked me about them, and then proceeded to run circles around Wife and I while we hugged and kissed for several minutes. Wife called me a 40-year old man with them.

Daughter has been able to get right back into the swing of “our” routine when getting ready in the mornings. Wife and I thought she might be resistant, but it’s like I never left – except that she’s nervous when I leave her alone. She thinks I might be leaving again…so reassurance is necessary.

The weather, though, is awful. Coming from mild fall-like weather with little humidity to sweltering summer-like conditions and damp air is just nauseating. Sunday the family went for a walk in the woods which turned into a 2-mile jog. Partly because of being out of shape, but mostly from the humidity, I could not stop sweating. Wife got concerned, but I just told her that I wasn’t “conditioned” to the atmosphere here and it would take some time. But God it sucks being this hot.

Monday, September 24, 2007


In an attempt to make me feel fantastic despite having to dress up for the first time in several months I ditched the tie. Open shirt collar, white undershirt, dress slacks, nice shoes and matching belt, white coat – no tie.

For whatever reason this made me feel fantastic this morning. As did the Tassimo coffee that I’d been missing since I was away for a month.

Now, time to fake interest, yet again, in a rotation with little to offer.

Friday, September 21, 2007

Homeward Bound

Tomorrow I head home. Home to Wife, Daughter, and Son. I'm very happy that it's so close.

The rotation went well and I start my Fam Med 4th year rotation Monday which is already making me cringe. Me no likey dressing up and wearing my white coat. Gahhh.

Tonight I shall imbibe with some friends one last time, record some of the memories with my camera, and get packed.

When I get home I'll try to post some pics from the area including the hospital's beautiful view of downtown and the outdoor scenery. I wish I'd been able to do more extracurriculars, but obviously this was a rotation not to fuck around with.

Funniest Moments

I’ve seen some rather interesting events while in medical school. From the apparent "horrific" use of the word "Oriental" rather than "Asian" by a classmate our first year, to the obviously homosexual classmate who had, up to this point, attempted to claim being straight only to admit his alternative lifestyle while in a surgical case and then suddenly remember that I was on the other side of the curtain and try to blow it off, I’ve seen quite a smattering of funny moments.

However, taking the cake is the neurosurg resident that sings, dances, and performs ballet in the OR, while in sterile garb. But wait, it gets better. One day she began to curse and berate herself regarding her troubles closing an incision while her attending was in another case and proceeded to amuse the OR staff with her difficulty.

F-bombs were launched without abandon while the scrub tech constantly asked her to watch her language. 45 minutes of waiting, hearing her alternate from singing curses to loudly yelling profanities, and catching the bug-eyed look on my attending’s face as he walked into the room - expecting the patient to be close to awakening – only to find the situation had not progressed much from the last half hour, was priceless.

Although I guess you had to be there to enjoy the humor.

Thursday, September 20, 2007

Just As I Thought

I’ve received e-mails from programs asking me to get my ERAS file complete so they can invite me for interviews. Unfortunately the missing portion of my application is controlled not by me, but by the school. Specifically it’s my transcript that I verified was completed and accurate with the dean that’s not been uploaded.


Remember when I talked about how the school told us they had their shit together this year? Yeah, right.

Sunday, September 16, 2007


I've noticed that there are a lot of people in health care that take shots at medical students and younger residents while they can. As a resident gains more seniority these people begin to behave differently and almost cower from their gaze. Being one of these students who has received harrassment from various nurses, techs, and assistants I can understand how one might get riled up when you're the object of another's fun.

But that's just how it goes during this process. We have almost no power over anyone, can't really get on someone for being a jerk, and have to simply suck it up. Or get flustered, let the person know they got the best of you, and realize that you've now become the "joke bitch" for that floor.

A friend of mine has been given a rather hard time during her Sub-I from just about everyone. The latest was from a tech who prodded her into anger by insinuating that she wasn't cut out for medicine after a comment she made. My advice, had I given it, would be to just suck it up, ignore the insults, and try to keep the chip on her shoulder from getting bigger.

Because if we were to allow every instance of humiliation at the hands of "lesser people" get to us then we'd be demon asses and bitches by the time we're finished with residency.

Part of training to become a boarded physician is to learn limits. When those above us do it, they do it in hopes of keeping us grounded, well aware of our limitations, and more vigilant the next time. When it's done by those below us (like techs, MA's, and the like) they're doing it while they can, because they know in a few short years they won't be able to say one negative word without being severely castigated.

So let the fuckers make fun and just continue to improve. Reacting simply makes them feel more justified and makes you appear insecure about your level of knowledge.

Thursday, September 13, 2007

A Decision

I’ve decided to drop my last Anesthesia elective. My reasons are multiple and varied, but mostly hinge on the concept that I honestly think I’m fucking myself here.

I don’t feel I’ve done badly, in fact I feel I've been quite on point, but I honestly don’t have a clue. There’s nothing to compare my performance with other than the various medical students wandering around who, at one time or another, appear vastly superior to me and vice versa.

Some days are great – IV’s are easy, intubations a breeze, and the patient does well while I bond with the resident. Other days I get nothing right, get yanked out of a CRNA’s room to avoid her bitchiness about me "jumping on" her case, and seem to be put in the most absurd rooms where I can do absolutely nothing but sit there and stare at the EKG rhythms while important matters are attended to.

It’s been fun, but I’m scared about doing two electives in programs that I feel I’ll rank high. It’s just not been what I thought it would and it worries me. I have a good application and feel I will get interviews from most of the programs I've applied to regardless of "showing them my stuff". I feel that I could be hurting my chances here if one person thinks I'm not good for the program. It's a huge gamble.

Aside from all of that, I've also been told that most of the people I've worked with don't have anything to do with residency decisions, and even if they did they don't remember med students very well - because there's so many between now and February. So what's the point in making it harder for myself?

So, I now have to rearrange my schedule when I get back in a little over a week to fill in that month. Hopefully that won’t be hard to do.

Sunday, September 9, 2007

2 down, 2 to go

It’s been a hard 2 weeks for me. I’m quite lonesome being away from the love of my life and our kids. The thought about doing a year apart, if the situation suggested it, has been removed from my mind forever. There’s not a chance in hell that I’d want to do that first year without Wife’s presence, touch, and emotional support. You just can’t get that from a phone call.

Depsite feeling lonely I’ve done rather well, thus far, at keeping on task. I figured there’d be some times where I’d loose focus, have a hard time studying after a long day, and just want to get the hell outta the OR. Fortunately that’s not been the case, but I have been feeling rather low recently.

Yesterday I saw a movie by myself just to get a sense of normalcy again. Unfortunately Rob Zombie’s "Halloween" remake didn’t really help – quite twisted.

I believe that my appreciation of how much my wife brings to me, outside of the initial physical enjoyment, has grown exponentially. She is an amazing woman who has made me the man I am today. I don't think I truly understood how much she has done for me and how little I can do to repay her. Corny, but true.

I long for that day, 13 days from now, where I’ll be able to hold her, smell her, and reconnect with her emotionally, spiritually, and physically. I just wish it were today.

Monday, September 3, 2007

Hi There

Hello from the busy world of Sub-I! Yes, I decided to let you know about the week I’ve had (short form of course) and that I’m still alive.

I’ll tell you right now that if you’re unaware of how taxing it is to be "on" all the time you have got to put yourself somewhere for a day and try it. It drains you. It sucks the energy out of you as you try to read, look busy, appear genuine while all-the-while kissing ass, and simply going above and beyond everything you’ve ever done in order to meet expectations.

It’s hard.

Saturday was a day off and I found myself completely asleep till 8:30am. That’s early you say? Considering I’ve become accustomed to the 4 or 5 am awakenings with work, Wife, and Daughter, anytime after 7am is really late. Really late.

It’s been very interesting and fun, however, and I’ve honestly enjoyed the faculty and residents tremendously. I find myself hoping for acceptance by their institution. It’s a great place and most of the residents are very keen on the teaching environment and have been quite friendly. My IV skills are being tested constantly and my intubation success has decreased a little based on the degree of complexity I’m seeing in these patients. Thursday I go to see my first neurosurgery case ever – it was hard to consider what needed to be done, but the resident was more than ready. Needless to say, it impressed me to see how well trained this CA-2 was.

Also I've lost my contacts (one was lost after falling out of my eye - in a case nonetheless!) and I purchased some glasses. I plan on getting some contacts again, but right now the glasses are fine and are more applicable to the OR environment anyway.


Today I submitted my application to ERAS (electronic residency application service) for the hefty sum of $270! Apparently I was charged separately because I was applying to 3 different types of programs (Anes, prelim IM, and Transitional Year) despite my dean assuring me that this wouldn’t happen. Hmm, my school’s not got the most accurate information? Who knew?
Anyway, I’m glad to be where I am right now, getting the ERAS crap over with, and can now look forward to accepting interviews – hopefully.