21 July 2014

Med School Update: Clueless Fourth Years Seeking Advice

This was a common occurrence last year during rotations:

Physician, after asking a difficult anatomy question: What year are you?
Scott: Oh, I'm a third year.

There was great comfort in saying those words - he had just finished two years of book work, and even if he was at the end of his third year and had completed many rotations and "pimping sessions" (where the doctor grills the med student with complex questions on disease function or drugs), he still had an excuse for not knowing the answer... or by knowing the answer, he was some how more impressive.

That excuse is gone.

And fourth year can be intimidating. Some audition rotations give their fourth year students great responsibility because the next year they will be doctors charged with the care of patients. On the other hand, some audition rotation sites will have plenty of interns (first year residents), residents, fellows, and faculty who have received their doctor status. Fourth year students are then merely given the opportunity to shadow. No matter what the experience is, in audition rotations the student has a glimpse of what their working life would be like if they were a resident there.

Even though we've begun fourth year, the schedule and process of fourth year medical students is still so mysterious to me. There is little to no direction from the school (Scott may receive emails from the school's rotation office, but that rarely gets relayed to me). The decision of where to do audition rotations and where to fulfill school rotation requirements is all up to the student. Scheduling of those rotations is all up to the residency hospital systems, so your fourth year schedule is at the mercy of every residency coordinator.

When do you start applying to residencies? When are interviews supposed to occur? How does the match really work (in layman terms, please)?

This is about the time when I really wish there was a class ahead of us, and I could have spent the last few years watching them mess up and learning from their mistakes. Alas, we are the first graduating class on this campus.

Using my finely honed research skills, I have found some helpful articles linked below. But truly, if someone out there has gone through this mysterious process and can offer advice, I would be overjoyed to read said advice.

Applying for Residencies
AAMC: The Cost of Applying for Medical Residency
NRMP Match: Tips and Reminders
AAMC: Roadmap to Residency

Residency Interviews
DIT: When Should I Schedule Interviews?
DIT: 6 Tips for Residency Interviews
Chief Resident Interview Tips
Interview Stream (Resource offered to students at COMP-NW)

UPDATE POSTS: Residency applications

18 July 2014

Yr 3 Perspective of a Med School Wife: Jenny

I really appreciate that Jenny was willing to share some of her story. Even though Jenny and Terryol are no longer together, she is likely his best cheerleader.

Every time I see Jenny in town she exudes courage, patience, and kindness. I am so impressed with all that she's accomplished, and we are extremely lucky to include her in our medical school journey!

Q: What are your responsibilities this last year while your med student was on rotation?

A: I continue to live my dream job of being a homeschooling mom.

Q: How are you preparing for residencies?

A: I have been decluttering (inside and out), finishing projects/books or passing them along. That way I will not be as intimidated if we end up needing to move.

I have had more exercise opportunities this past year. I always bike but that was about all Lebanon had (for my interests) until the pool opened several classes and opportunities enabling kids to swim while moms workout. We even got coached in masters swimming sessions for about 6 months! Being healthy and happy is the only preparation I think we really have any significant control over.

I have been surprised how tentative 4th year really is and admire all those that have already moved knowing their original homes are the best base camp for them. We are exited graduation will be here momentarily - this whole process really does go by quickly. 

Q: Any advice SOs beginning third year?

A: Make sure you have some worthwhile hobbies/projects going on so that your oil lamp/joy stays full.

14 July 2014

Yr 3 Perspective of a Med School Wife: Alyssa

Alyssa is a first time contributor to our little perspectives game, but the more the merrier I say. Everyone's family has unique circumstances, especially during third and fourth year of medical school. Each perspective helps me to see what I can do to better support my student and what I might expect in the future. Thank you for sharing, Alyssa!

Q: What are your responsibilities this last year while your med student was on rotation?

A: We have 4 kids ranging in ages from nine year- old to a one year-old, so my day was pretty much just keeping up with them and all their activities -from soccer practices to guitar lessons, church activities, and homework. Their schedules kept me pretty busy. Then there is all the housework, laundry, planning and cooking meals etc. Because Zach was gone a lot, I am also in charge of financial aid for him, taxes, benefits, and insurance for our family.

Q: What did you do differently in year three to support your med student?

A: The same as the last two years, just let him tell me his schedule and what he has to do. To make it easier on myself I would tell myself he is not going to be able to make it to most things and if he is able to show up it's a bonus. That way he is able to study for shelf exams and keep up with the quizzes and coursework that goes with each rotation.

The BIG extra thing for me was I made cupcakes for each rotation site he was at to say THANK YOU to everyone who helped him. I made enough for his preceptors and office staff at each rotation. It was a way for the preceptors to remember him, and it helped grease the wheels when he asked them to write letters of recommendation. I usually made them in week 3 of the rotation.

Q: What surprised you about clinical rotations?

A: How much he was still gone. You think it's going to be better because EVERYONE says third year is better (which it is to a point) but they still have quizzes and assignments with every rotation.  Depending on the preceptor you get, there is a LOT of on-call weekends and nights. For us it was PEDS, OB and IM that were the rotations that he was gone the most. He also had to leave for two months to do two rotations on the coast (surgery and family medicine).

Then there is didactic week every 12 weeks where there are practical and written exams, so the students are of course cramming for those.

 The biggest change I saw for positive was actually in Zach. He was happier and not so beat down and mentally tired. They are finally actually practicing medicine in a clinical setting. They aren't sitting in a classroom for 8+ hours and then studying to all hours of the night on top of that. 

Q: How are you preparing for residencies?

A: I think our situation is a little bit different because we have 4 kids...and they are older. We have to think about their needs as well as what is best for Zach. Obviously we wanted Zach to have the best residency possible, but with also the best possible situation for our kids as well.

So we looked up all the DO OB/GYN rotations...Zach looked at the programs and what they offered as far as education and training. My job was to look at everything else. I looked at pay, vacation time, benefits, perks (malpractice insurance, paid CE, paid license fees etc), and cost of housing. Housing and pay were a big one. Some of the residencies sounded great...but it was in downtown Detroit and the pay wasn't that great. $42K a year with 4 kids would have us living in the ghetto...that's all we would be able to afford. So we tried to find the balance...where could we afford to live that was safe for our kids, but get Zach a great residency education.

Then Zach ranked them and stating in December started trying to set up auditions. Most don't open up until January, and with most if not all of his residency auditions you HAVE to be persistent and DOUBLE CHECK and DOUBLE confirm EVERYTHING! Often he talked to many different people, and one person would say he was ʺpenciled inʺ for a certain time period...Zach wouldn't get an email, so he would call next week and the department head would not know a thing about it.

Q: Any advice SOs beginning third year?

A: Don't expect a ton of one on one time with your student. They still have lots of work and their schedule depends entirely on their preceptor. Make some sort of treat for the preceptors and staff. It's very much appreciated, and it really helps them remember you. Zach is known as the cupcake guy. Everyone was very excited when they found out he was rotating through their office. :)

11 July 2014

Yr 3 Perspective of a Med School Wife: Maren

Thank you, Maren! I'm so glad you were convinced to write again this year. Maren is also one of my brave friends having posted from our 1st year and 2nd year.

Maren and her family had some unexpected changes this last year, but from what I've heard they found a great settling place.

Q: What are your responsibilities this last year while your med student was on rotation?

A: Almost everything having to do with our household, except for car maintenance and getting the trash to the curb and being an involved dad. It was only recently that I thought to ask Jared to pitch in more around the house, even though he's had more time for the last year.

Q: What did you do differently in year three to support your med student?

A: I have helped/(nagged?) him to set up rotations and offered him a quiet hour every night to study while I deal with the kids. He really hasn't needed much from me and has mostly tried to offer me more support this year since he has more time to do so.

Q: What surprised you about clinical rotations?

A: How much of a positive change there was in Jared's attitude once he was off campus and back in the real world working, and how much more time he had compared to 2nd year. Also, it was fun and surprising to see Jared's strengths discovered through his different experiences, and it surprised me how quickly he knew, when he started each rotation, whether he loved, hated, or felt indifferent about that area of medicine.

Q: How are you preparing for residencies?

A: We are mentally preparing to have a pretty horrible next few years. Jared is rotating with three different residency hospitals with the Air Force, because he's hoping to get an Air Force residency. We tried to choose the hospitals with the most likelihood of him getting the residency according to the number of new residents they accept each year. We don't really care where we go, although we'd prefer to be in the West, because we figure there will be pros and cons to each place. We just want Jared to get a residency that he will feel good about.

Q: Any advice SOs beginning third year?

A: Don't go too crazy with the extra time-- try to help your spouse continue to have a study schedule (albeit a lighter one) for step 2 boards. And stay organized with what needs to get done when, and how you need to prepare for 4th year/residency application. Also, relish the year! 4th year is not quite so fun with away audition rotations, and then comes the dreaded residency.

09 July 2014

Yr 3 Perspective of a Med School Wife: Tabetha

Tabetha is one of only a few brave souls who have offered their perspectives each year on my blog. I'm so glad she did, because her perspective shows that we all have different paths on this medical school journey, and we each need to find the best method for supporting and maneuvering this system that works best for our family.

During the first two years of medical school, Tabetha was a flight attendant and was constantly on the go. Then as you might remember from last year's post, Tabetha's husband and medical student, Brian, was accepted to be an OMM fellow in his third year. That is quite the honor and CV builder! His schedule was thus quite different from other third year students. Click on the following links to read Tabetha's posts from our 1st year and 2nd year.

Q: What are your responsibilities this last year while your med student was on rotation?

A: This year was very different for us from past years. To start, a wonderful opportunity presented itself, and I was fortunate to change jobs. My last trip flying was in September, and on October 1st I started a new job where I was able to stay home! This was a huge change for us in my schedule. While I am now home more, I am actually significantly busier than I was and it has been much more difficult for me to manage taking care of everything (laundry, groceries, cooking, cleaning, etc.) on my own. Brian and I split just about everything when it comes to chores. In May, my sister moved in with us (she is applying to medical school this year), and since moving in she has been a huge help with cooking and cleaning!

Q: What did you do differently in year three to support your med student?

A: Year three has been both easier and harder for my med student husband. It all boils down to the rotation he's on. Some rotations he LOVES, which makes life very easy! Certain rotations have been very hard on him. Whether it was simply a specialty he didn't enjoy or a preceptor who has long since forgotten what it's like to be a 3rd year med student... these rotations took forever to end. During these rotations I had to be extra understanding and supportive when Brian would come home grumpy, or sad, or mad, or any number of emotions. During years 1 and 2 I could usually anticipate when he would need extra support (the week before a test), but since rotations were constantly changing I was never sure what I would get!

Q: What surprised you about clinical rotations?

A: Since we have many friends who are ahead of us in the med school game i don't feel anything really caught me off guard when it came to rotations. I suppose the only thing that really surprised me was how much Brian disliked certain rotations. I anticipated he'd come home from every rotation thinking ʺthis is it!ʺ but in fact he came more often than not saying ʺthis is NOT it!ʺ

Q: How are you preparing for residencies?

A: Since Brian was accepted into the Fellowship program we are actually behind a year. While we have and continue to discuss residency possibilities, we still have a little more time to begin applying for audition rotations as he won't be doing those until Fall 2015.

For us, location is definitely important. We have previously spent time living in an area we didn't like and know how detrimental it can be to hate where you live. Ideally we would LOVE to stay on the West Coast (no farther east then Denver), but unfortunately there just aren't enough residency programs on the west coast for us to put all our eggs in one basket. A lot of our time has been spent discussing the ʺwhat ifsʺ and where in the Midwest and on the East Coast we think we would be happy should we end up there.

Of course, program is important too, and there are some programs Brian will apply to even if it's somewhere we don't necessarily want to live. We just have to tell ourselves over and over--it's only temporary!

Q: Any advice SOs beginning third year?

A: Keep an open mind! Anything can happen! It is very possible your student doctor will fall in love with a rotation they had never considered or end up hating a rotation they were convinced was ʺThe Oneʺ.

As I've said in years past, continue to communicate! It is so important for couples to discuss everything! Talk about the future, keep an open mind, and enjoy every second! It goes by so much faster than you realize!

07 July 2014

Yr 3 Perspective of a Med School Wife: Morgan

I miss Morgan!

I didn't realize when we started this medical school journey, that after the first two years of book work our good friends would move away. I always imagined our medical school family sticking together for four years supporting each other with vent sessions and date nights. We were lucky to have Morgan, Chase and Colt nearby for most of the year. They moved farther away at the end of this year so that Morgan could be near family while her husband is traveling in Year 4.

Morgan always gives great advice in her perspective posts. You can read Morgan's perspective from Year 2 by clicking on this link.

Q: What are your responsibilities this last year while your med student was on rotation?

A: Taking care of my crazy one year old. Keeping up with the house, groceries, cooking, etc. I took over paying all of the bills this year, just to make things easier and make sure nothing gets missed. I did most the packing and unpacking for our moves. And most important being supportive!

Q: What did you do differently in year three to support your med student?

A: I don't feel like I did much different. We did talk more about the future and discuss the pros and cons of different specialties and different residencies. Chase said that having me be as excited as he is about residency and the future has been a great motivation and support for him.

Q: What surprised you about clinical rotations?

A: First of all, I didn't know that we would have to be moving, but we ended up loving our home base city.

It was interesting to see how different each rotation was. Some rotations I got to see my husband a lot more and other rotations he was gone pretty much everyday for very long days.

My favorite part of rotations was seeing the excitement my husband had. He was so happy to be out of the classroom using the knowledge he had gained and then trying to learn everything he could from the rotations. It was great to know that all this work, sacrifice, and time was all going to be worth it because I was able to see that he is going to love his job when it is all said and done!

Q: How are you preparing for residencies?

A: Right now we have really scaled down our spending and are budgeting so when graduation comes we will be able to make our loan payments and pay that off as quickly as possible.

As far as considerations for audition rotations... Chase wants to do Otolaryngology (Ear, Nose, & Throat). That really narrowed down residency locations. There aren't very many DO ENT residencies. From there we researched online the different residency programs. There was a helpful forum on Student-Doctor Network where students had shared their audition rotation experience. Once we had narrowed it down, Chase got in contact with a current resident from the programs he was really interested in and asked them questions. Another big consideration was how many residents they take each year. A lot of the ENT Residencies only take one each year so Chase made sure to set up audition rotations with the ones that take 2 or more each year.

Q: Any advice SOs beginning third year?

A: Try to not compare your journey with others'. Dream about the future - it's motivating! Support the other SOs - we need all the support we can get! Do something fun when your husband has time off!

03 July 2014

Yr 3 Perspective of a Med School Wife: Megan

Megan's picture, June 2014: Waking Up from Naps is Hard to Do
Thank you to Megan who was brave enough to provide her perspective again this year! You can read her Year 2 perspective blog post by clicking here.

Megan and Devin moved to Medford in June of last year, and happened to live just down the street from my parents. Medford was their home base for year three, with the majority of Devin's rotations scheduled in Southern Oregon. Scott and I were able to see their family every time we went down to visit my parents. It also came in handy to have my parents down the street when Megan went into labor while Devin was in Lebanon for the second didactic week. Yeah, really!

Now Megan has moved to Utah to be with family while Devin is traveling for audition rotations. We will miss having them somewhat close for visits!

Q: What are your responsibilities this last year while your med student was on rotation?

A: Cleaning, cooking, making lunches, being pregnant, taking care of a rambunctious 3 year old, taking the dog for walks, giving birth (all alone, I might add), caring for a newborn and not sleeping at all- ever. It's been a great year! It really has :)

Q: What did you do differently in year three to support your med student?

A: Raised two kids instead of one...

Actually, I didn't change too much when it came to supporting Devin on a day-to-day basis. I still would make his lunch, when needed, and make sure he had uninterrupted study time at night.

Q: What surprised you about clinical rotations?

A: The amount of time that Devin had to ʺworkʺ each month varied greatly with which rotation he was on. When considering which specialty we wanted to pursue we were told to choose the lifestyle we wanted and then look at what specialties fit that. The clinical rotations were really able to give us a good feel of what type of lifestyle fit our family.

Q: How are you preparing for residencies?

A: We were a little late in the game when it came to finding away rotations. We were waffling between specialties and really didn't feel 100% good about any of our choices. So we finally had to sit down and write out a game plan and stick to it. Because we were late in the game with audition rotations, we really just had to take what we could. And, even though we don't absolutely love the locations of his away rotations, we figure it will be a good experience, anyways. And who knows, maybe he will fall in love with one of the places! But if not, there's always interviews at other locations.

Q: Any advice SOs beginning third year?

A: Try to decide on a specialty early in the year. Use your elective rotations wisely! If you are going for a competitive specialty look into research. If you think you may have an interest in one specialty but your clinical rotation is way late in the year (April/May) you may consider using one of your elective rotations and doing that specialty then. Just, utilize your elective rotations. :)

01 July 2014

Yr 3 Perspective of a Med School Wife: Shelli

I am so glad that Shelli was willing to share her perspective again this year. (You can read her first year perspective by clicking on this link.) Shelli is a wonderful mama, an amazing cook, and she has a wonderful voice as a writer. She is also the perfect support for her husband, Eldon, while he studies through medical school.

Q: What are your responsibilities this last year while your med student was on rotation?

A: What WEREN'T my responsibilities? :) No, Eldon did a lot, I'm just teasing. He went to work, studied like crazy wherever he was - hospital, clinic, home, whatever - and still managed to be a great daddy and even help me with the dishes whenever he was home to eat with us.

But I did a lot.

I cooked three meals most days, trying to avoid processed, refined foods. I washed laundry, and usually folded it. I cleaned the bathroom (note that we only had ONE bathroom), kitchen, floors, cars, every living space, and every single one of my kids' messes. I changed about a gazillion diapers, some from our infant and some from our toddler. I changed the sheets when what should have happened in a diaper happened in a bed. I handled paperwork. Insurance, healthcare, and everything else that could go wrong.

I took care of three darling little girls. Eldon would come home and be a daddy, playing and laughing with them, which I was delighted to see. I couldn't be their daddy. But I did pretty much everything else for them most of the time. Like 95% of the time. Eh, 98%.

I packed Eldon lunches, ironed his clothes, and just tried to be helpful. If there was anything I could take off his plate I tried to do it. I was happy to do it. Every minute he wasn't doing some kind of errand meant he could spend it with us.

But through all of these things and everything else I can't think of at the moment, I don't believe I did more for our family than he did. We're in this together and I think the workload is as even as it could possibly be.
Q: What did you do differently in year three to support your med student?

A: I think mostly I did the same things I usually did, but I got to see him way, way less often than before. That's what made it harder. I can do anything if he's there to hold me at the end of the day.

Q: What surprised you about clinical rotations?

A: I was surprised by how much Eldon actually got to DO. I thought he'd be in more of an observe and assist kind of role, but he did practically everything his preceptors did.

I was also surprised how much rotations changed what he thought he'd like to do. He was considering cardiology or radiology going into third year, but by the end he had fallen in love with surgery!

Q: How are you preparing for residencies?

A: We're preparing for residency in ways I hadn't anticipated. We decided to live with Eldon's parents in Mesa, because he would be gone so much (like working out of state, gone, not just working long hours, gone). Eldon wanted me to have a support team to help with our kids, and I wanted to save money and avoid paying double and triple rent when he was away.

We've been kind of picky about actual residency locations, because Eldon wanted to do as many surgical rotations as he could. So while he could find lots of other specialty rotations closer to home, he's going all over the country for surgery. As long as we settle for residency in a big city (two years in tiny, far-from-everything Lebanon almost killed me) I will be content.

*A note to those in the military: Eldon scheduled two military rotations - the maximum allowed - because we hope to do a military residency because the pay and the range of experiences are usually better. If we aren't matched to a military residency we are considering doing an intern year. That way, even though we lose a year that doesn't count toward fulfilling our commitment to the military, he will most likely get his pick for residency the following year. Those applicants with an intern year are generally considered first before those who came straight from graduation. We'll see how it goes.

Q: Any advice SOs beginning third year?

A:Find a project you can pour your heart into. It might be your job or your kids or whatever, but make sure you have something you enjoy putting lots of hours into. If your med student is gone all the time, and you're just sitting at home waiting for them you'll be miserable, or resentful, or both.

Also, Eldon kept a little journal of each of his rotations so he would remember details, especially about the way he was feeling during each one. When you look back at the end of the year and try to decide which specialty to pick you might be surprised how easily they blend together or how many critical details you forget. Eldon dismissed surgery initially, but when we looked at our notes and talked together we realized it was the happiest he ever was. No other rotation made him as excited to get out the door in the morning as surgery, and that wasn't something we would have realized just looking at the facts and statistics of each one.

Make a commitment to value your relationship more than any of the irritations or problems that come up. My goodness, there were times I wanted to run away and not stop until I reached Canada. There are so many things that might potentially drive you insane about this third year. In an effort to make me feel like Eldon and I actually lived in the same world, I would find things to celebrate. The ends of each rotation, getting high honors after a hard rotation, or even just silly things like National Pie Day. It seemed too easy to just put our heads down and just endure this year, finding little things to celebrate together helped us lift our eyes and see each other every now and then.

That all being said, we enjoyed third year more than any other year so far. Well, socially we preferred being close to our med school friends, but Eldon enjoyed rotations much much MUCH more than classes. That was exciting for both of us because we thought, "Oh good, this might actually be worth it in the end!" :)