Interviews: Done

Well, all is complete.  Finished all my interviews, am one week into vacation, and it has been a busy vacation indeed!  After getting my thank you notes all figured out, had a weekend in Monterey to take care of wedding vendor business (Florist, Cake, and Hair/Makeup).  We also have a guest for the month, and another guest coming next week.  It's nice to be busy with only fun things.  Ordered the Save-the-Dates, got the guest list finalized... just riding out the end of the month.  Things are pretty much going awesome, and I feel very confident that I will match at my top choice, and if not then my second choice, both in Sacramento.  I doubt Davis will rank me particularly high, and after that one then Redding and Modesto are perfectly feasible options.  

Not too sure what else to update - I feel very fortunate compared to some of my classmates.  I know what I want, I'm competitive in the field that I want, I'm compatible with the field I want...  Compared to others who don't know what they want or aren't competitive for what they think they want.  I'll probably hold off on any more updates to this blog until I start my Neurology rotation in January, and then the Emergency Department rotation mid-January.

Change in Reception...

Well, this was certainly a little different than the previous places I went to. Today's interview day went okay. It was mostly negative, though. First off, none of the residents who were showing us around seemed to know what they were doing. The day started off with a tour, instead of an orientation like all my previous days had started, so we didn't even have an agenda. The person giving the tour was an intern resident, who has only been with the program since July and hasn't even worked in all the hospital departments yet. Usually it's a 2nd or 3rd year resident who does the tours. They also were frank about telling us some of the negatives about the program. When we got back, first I was with a faculty member and she seemed to start off a little colder but she warmed up gradually. Went over my application, I got a bit of a skeptical vibe from her, but I kinda shrugged it off, it didn't seem to be a big deal. After that interview, I was with a current resident who was pretty nice and seemed to like me fine. He even told me a little about the criteria for ranking people, which he probably shouldn't have, and said that being a Spanish speaker, interested in OB/GYN, underserved and rural medicine, etc. are all part of their checklist for whether to rank someone or not. 

After that came the program director (PD). I was willing to give him the benefit of the doubt at first, but he didn't seem particularly warm or excited about me. Certainly not like the Sutter had. Sutter probably knew I had genuine interest in them based on me doing the sub-internship, and I had spent a month with them being nothing but nice and pleasant and enthusiastic. I basically felt like the PD here started the interview with the assumption that I was a lying game-player trying to dupe them into thinking I wanted to be in their program so they would rank me highly. For one, he didn't seem enthusiastic or happy at all when I said (TRUE) stuff that matched their mission goals. I DO want to work with Spanish speaking patients, I DO want to have full-spectrum experience and know what resources are available to uninsured patients in California. I don't want to do nothing but OB/GYN but I'd like to be able to handle my primary patients when they get pregnant instead of sending them off to a "specialist".  He basically told me not to rank them unless I really wanted the program, and whenever I said what I liked about the program he seemed entirely nonplussed and just reiterated his previous statements. He even went so far as to say that it's "better to scramble for a residency than match at a place that is just a backup." 

Also, mid-interview, he asked about my Spanish experience and then proceeded to say (in MEXICAN Spanish) "How about we chat in Spanish for a bit?" At first I was thrown off because he used the Mexican-Spanish word for chat instead of the more common verbs like hablar or charlar. I never use the word he used, but based on the context of the rest of the sentence I figured it out after a second of confusion. I asked what he would like to discuss and he said tell me about a patient I saw in the past year. So I start telling him about a patient, and I wanted go on, since I was starting to get going better, and he basically cut me off and played it off like he just likes hearing peoples' accents. First off, part of me feels like he intentionally used the Mexican parlance to make it more challenging. Second, he didn't even let me talk long enough to hear much of an accent, OR let me get in the rhythm of it. He knows it's not my native language, and interviews are somewhat stressful even when you're a competitive semi-confident applicant. Obviously he was checking to make sure I didn't just lie all over my application.  I was expecting to run into someone who would want to speak Spanish with me as a subtle 'test', after all, they always say never to overestimate your language skills unless you can conduct the interview in Spanish.  It wasn't the fact that he tested me, but his skeptical expression and tone. I kind of wonder if it was because my personal statement seemed overly-tailored for their program - I only tailored the very last short paragraph, but the rest of the personal statement (the generic family medicine part) just so happens to perfectly suit their mission statement over the other programs a bit. My scores are also pretty competitive.  Maybe on paper it looks a little too good to be true for their program.

Either way, I had been starting to consider that the place might be nice to be at, if it came to it - it would definitely give me my Spanish experience, the residents all seemed pretty chill and nice, and the earlier faculty member I was interviewed by seemed nice and interesting.  Plus its location is pretty nice is near some nice places.  Ultimately, this program director's attitude was a complete turnoff, and the PD plays a pretty significant role in your residency training over the next three years.  I don't want to have to be around someone like him who treats me in such a judgmental manner and isn't even open to hear what I have to say. One of the other faculty members also attacked a 3rd year student from UCSF who was giving a talk about a global non-profit organization she started before medical school that was reducing maternal morbidity and mortality worldwide.  After we finished clapping and it was opened up for comments and questions, the first guy who raised his hand was this faculty member who essentially told her that some of their efforts were a waste of resources and time, and that they were going about it wrong.  Not a single word of encouragement.  A couple other people commended her after that initial commenter, and of course she took the initial criticisms in stride, but...I was upset because her accomplishments were honestly quite impressive.  

Two Interviews Left...

Well, two more days of GI left, and two interviews left.  I decided to cancel my Reno interview.  I've gotten good enough vibes from three of my top four programs, and two of my backup programs, that I don't really want to risk driving my two-wheel drive car into Reno in January when it would be at the bottom of my rank list anyway.  I am almost tempted to cancel the next two interviews, because I'm getting tired of interviews, the novelty has worn off, and these last two places are also at the bottom of my list.  However, one of the interviews is Thursday, and the next one is a week from Thursday.  They are coming up so soon that I might as well just do them.  

Currently on my GI rotation - mostly just trying to get through it.  I'm already tired of seeing colonoscopies.  They're interesting enough, but ... pretty brutal to watch and most of them are very routine.  Nice preceptor, very glad I'm only spending two weeks doing this.  Really more like one week considering the Thanksgiving vacation and my two interview days.  After this, it's a month off!

On another note, got my wedding dress ordered, got my car repaired (one more expensive repair coming up but I'll do that after I get my next loan disbursement), and have all of December off during which I get to visit my maid of honor in Seattle, have two friends stay over, and celebrate two Christmases.  Oh yeah, and my Birthday.  The guy at the Pinkberry Frozen Yogurt place today guessed that I was turning twenty - off by about 6 years.  Glad I still pass for a college kid in a college town.  I would think it would be even more obvious when you're surrounded by people who actually are younger than you.  Also going down to Monterey soon for a few days to check out wedding venues, and next year Mom's taking us to Hawaii for a few days.  All-in-all, 4th year is winding down to be pretty good, and I feel like when you really set your mind to something, anything can happen...

Probably because today's interview felt like it went really well.  Maybe I was just overconfident or over-comfortable  but I feel like I got really good vibes from them.  Like Kit always says, "Be nice to the administrative people, because they make a big difference and are usually unappreciated."  Very true.  When I did my sub-internship at this place (my number one choice for residency), I tended to go through the back entrance since the front included the waiting room.  The back entrance I had to ring the bell every day and they were always smiling and very happy to get up and open the door for me - I even apologized most of the time, saying I wish there were some easier ways to get through, and started using the other door after a while.  I always chatted with them, smiled a lot, showed my appreciation.  Today I feel like they not only remembered and liked me from before, but I felt like they tried to put the spotlight more on me a few times, and I feel like they even might have talked a little to the program director.  They definitely made an effort to remind her that I had done a sub-internship at the site, and when she came back while I was the only one sitting in the room (others had gone to their scheduled interviews, I was on a scheduled "break") she said she had looked over my application just then and talked to me in a kind of informal interview.  Just the level of comfort from knowing the facility and all the residents was really encouraging and confidence boosting.  

Also, when they're saying to the interview group "We allowed to tell you that you're a shoo-in for the program," I couldn't help but feel like they were half-directing it at me.  I don't know.  They aren't allowed to tell us this stuff because if they do, then students get the wrong idea, and cancel their other interviews and put all their eggs in one basket when there are no guarantees that the program plans to follow through.  It's all part of the game I suppose.  

On another note, we toured the Davis maternity facilities and when I graduate, it would be pretty sweet to deliver my first baby there.  They have one of the lowest C-section rates in the country, have facilities to allow you to be in a pool for labor or for water birth deliveries... it looks pretty dang awesome.  You can also connect your music player up to the sound system in the rooms.  I have 4 years or so to figure it out, so we shall see.  But I've got my eyes set on that location - not to mention it's only 10 minutes from where I live now.  That would be pretty awesome.

Sub Internship - Week 3

Well, I know I haven't been updating much - it's been busy.  A lot of fun stuff going on - seeing all kinds of patients, getting to know the residents and faculty... it's really enjoyable.  I had almost forgotten how much I enjoyed family medicine - there are so many things you get to do in family medicine that you can't do in other fields of medicine.  A day could involve diagnosing a patient with anorexia, managing a patient with depression, removing a sebaceous cyst, performing maneuvers to treat a patient's vertigo, putting a cast on a 10 year old boy, identifying a rash and prescribing antibiotics to prevent future heart complications, managing a patient with hypertension + diabetes + chronic kidney disease + depression + foot ulcers + macular degeneration, managing a patient with sinusitis, counseling a patient on weight loss, removing an ingrown toenail, identifying a urinary tract infection... and so on.

Essentially any medical problem a patient has, they go to you first.  So much fun.  I'm at the point where I know enough that sometimes it feels like I really have the answers.  There have been many encounters that would be blog-worthy in these past weeks, I just don't know where to start.  A woman at 37 weeks gestation who has gestational diabetes, who also just developed symptomatic gallstones, who has an OB/GYN physician who seems indifferent to the fact her pregnancy is one problem away from becoming an emergency surgery?  Breaking the news to a young skinny girl that she has dieted to the point that she isn't having periods and needs to gain more weight when that's the last thing she wants?  A man with crippling chronic pain from an accident years ago who is allergic to morphine?  

The residents have been great, the attendings have all been great, I feel like I fit in really well.  I love the area, the city, our new place.  I really hope I get into this program.  

Currently my tally is 8 interviews scheduled out of 11 programs I applied to.  I think I'll get an interview with Davis, and I am still hoping for at least one more interview offer.  I'm not holding my breath for one of the programs.  I'm kind of looking forward to interviews as well - two places are covering my lodging.  One of them is letting me stay with a resident, and another is paying for my hotel room.  Tomorrow hopefully I can relax a bit.  I need to get back on my exercise regimen but I strained my calf muscle two weeks ago and it still hurts really bad and I don't want to be impatient and hurt it even more.  After next week I start Pediatric Psychiatry - should be nice.

Sub-Internship Day 1

Things are going well so far - they have EPIC electronic medical records and I have full access, so I have started making my own note forms and am getting on great with everyone I've met.  To make things better, before the end of the day I had an interview request from Merced, called Salinas and confirmed my interview for end of November, and the coordinator I met this morning (at place I am currently doing my sub-internship) sent me an e-mail requesting/confirming an interview date!  So now I have two interviews scheduled, and two I'm waiting for official date scheduling, but 4/11 within 1 week of applying ain't bad!  

I also like my preceptor and hope to get along with everyone super well.  I'm just trying to remember to smile as much as humanly possible, without it looking inhuman.  They seem to think my patient presentations are pretty decent too, even though right now I feel like I'm so scatterbrained.  It's been a LONG time since I did any rotations in a clinic, so my outpatient presentation skills are really rusty.  Shouldn't be long before I'm back in the swing of things, but until then, it's a slightly rocky start.  I'm definitely glad I'd touched base with a couple current residents - it's nice to see familiar faces, who all seem encouraging. 

At any rate, I think I'm going to go and read up on some stuff I saw today and then do some pleasure-reading.  

Applying for Residency

Well, some of you may see this around the time it is posted, others may not see it until far later - why?  Residency applications.  It is a well-known fact in this world of technology and the internet that potential employers and programs "google" their applicants to see if they have any unsavory activities.  Not that this blog or any of my other interests are unsavory, because honestly they are not, but I don't know that I want any program directors perusing my blog entries and overanalyzing any hints of cynicism or detachment I may portray in them.  As always, this blog is an outlet for my medical experiences, and lets me take a step back from the nitty gritty of everything.  

I shall now continue.

A few days ago, I finished tailoring all my personal statements for the family medicine programs I have decided to apply for.  In total, I have selected 11.  I was originally only choosing 10, but my adviser encouraged me to go higher, so I added on a program in Reno, NV.  We are encouraged to send tailored applications, according to a book I have about "Acing the Match."  Supposedly, programs do not expect it, but when they see a tailored personal statement, they pay much closer attention to you.  Combine that with the fact that my personal statement pretty much screams "Amazing Family Medicine resident," and I have a decent application.  Board scores are about average for those applying, but for super clinical medicine, numbers aren't really the most important thing, and the interview is their number one criteria for ranking applicants.

That said, I sent out all my applications, each with their tailored application, on Monday.  Our Dean's letter is another major criteria they use to determine who they invite for interviews, as most programs only interview 100-250 students for about 8-16 spots, so I wasn't expecting to get much as far as responses for another couple weeks.  Much to my surprise, today I got not one, but TWO interview invites.  Super exciting!  Kind of a "This is happening too fast!" feeling.  Two other programs notified me that the received my application and will be reviewing it over the next couple weeks - one had me list my interview date preferences in case they choose to invite me for an interview after reviewing my completed application, including the Dean's letter.  Dean's letter should go out around the beginning of October, so I should start hearing from a lot more programs then.  Having two interviews already in the works is really exciting, especially when one is a program I thought would be more difficult to get an interview at, and one of the programs is in my top 4 choices.  Things are looking good.

On the other hand, next week I start my sub-internship at Sutter Sacramento, which is my tentative first choice residency program.  I am not sure whether it will still be my first choice after interviewing at a bunch of places, but we shall see.  It is the most compatible and geographically convenient of the programs I have looked at.  If I get interviews at the 10 California programs, I may just withdraw my application to the Nevada program, since they mostly accept MD students from the Caribbean, Nevada students, and DO students, suggesting their program is not of very high caliber.  I also didn't get a very strong impression from their website, short of them offering wilderness medicine.  

The next couple weeks will be exciting to see who is interested in me, and how many choices I will have.  The thing I don't know is whether they have actually read my personal statement or if these interview invitations are based on my COMLEX/USMLE scores.  I have a feeling they must have read my personal statements, because my scores, as I said, were around the average for successful family medicine applicants. I really hope I get an interview at every place I listed, because that would make me feel a lot more comfortable about the match, come March.  Time to drink in celebration!

The End of Interviews

At long last, the application process is essentially over. My last interview was today at Western U. The day started off badly with nightmares of being late to the interview and getting a parking ticket...but after that the day went pretty smoothly. One of my interviewers had a real poker face too, and made it a bit tough to know whether I did well in the interview or not. I now know he is a department chairman for pathology, so I have a feeling he is one of the committee members... I didn't have any real stumping questions and they didn't grill me, so I think the pressure was just in not being able to read their reactions to me. At any rate, I really like Western U most of all the schools and hopefully I will matriculate there.

Some other tidbits - they have a strong emphasis on medical Spanish, because of the veterinary school and Banfield on campus we get a lot of vet discounts (good for me since I have a kitty), the boards scores are impressive, there is a ton of clinical experience, and the campus is pretty nice. One of the other students there to interview surprised me a bit - he could not have looked more pissed off to be there. I do not know why he was acting the way he did, but his body language was almost flamboyant in its distaste for the school. He didn't speak to any of the other interviewees, he kept leaving the room during the current student Q&A, and I swear he was rolling his eyes during the OMM demonstration. Since he clearly couldn't hide how much he didn't want to go to Western U, I'm not worried about him getting my spot, haha. Also, the dean of admissions informed me, after the interview, that we are the last group to be receiving acceptance notices - after this point, they are interviewing people for the alternate list...but most of the people on the alternate list get into the school this year or next year at least.