Uniquely Milwaukee, Christmas Edition

Funny story - A few weeks ago I went to Target to pick up some groceries and stopped by their seasonal Christmas display to check out what Target was putting out for holiday décor this year. While I was walking around I saw a bunch of signs posted around the store that said:

Remember, St. Nick is coming tonight!

Target was REALLY busy. A lot busier than I'd seen it before, and initially when I walked in the store I thought that was because the holiday shopping bug had suddenly hit the suburbs of Milwaukee. But when I saw those signs, the thought occurred to me that maybe Target had set-up a picture area for kids to sit with Kris Kringle.

When I was checking out with my groceries, I made a similar comment to the Target checkout girl. "It sure is busier than usual! Everyone must be here because Santa is coming to the store." "WHAT?!" She got all excited, almost jumping up and down, looking toward the front of the store.

I looked too. No Santa chair set up at the front of the store, that I could see.

She turned to the cashier next to her. "Did we get Santa to come to the store tonight?"

"Oh! You mean the signs?" asked the other cashier Target girl. "No, St. Nicholas is coming tonight."

"OH!" Everything suddenly made sense to Target checkout girl. "St. Nicholas is coming tonight," they explained to me.

Uh, yeah... still confused. Repeating the sign wording to me doesn't clarify things.

Until I got home and googled it. Though the tradition has died a bit over the years, apparently there are still remote parts of Europe and of course Milwaukee, Wisconsin where Saint Nicholas (not to be confused with Santa Claus) still visits the homes of good little boys and girls in early December and leaves a treat for them in their shoes.

We must not have been good this year, at least on a saintly level, because St. Nick did not visit our Milwaukee suburb apartment. We'll try harder for next year.

Piles of Laundry

When you get married and move in together, you discover that your spouse has strange habits. That makes it sound like its just the husband. Wives are quirky too. For example, I like the dishwasher loaded a certain way. It makes sense to me, but no one else I know loads it the way I do. If someone puts a dish in on their own and it's "out of place", I'll get my hands dirty to move it where I want. Strange habits.

Dr. Hubby has the habit of leaving his used clothing on the floor when he changes. This is the very reason why whenever we move and set up our new bedroom, his side of the bed is furthest away from the door. If it is impossible to train him from leaving piles of clothes on the floor, at least I can hide them behind the bed.

There are a couple reasons why I don't feel any responsibility to pick up those clothes:

First, while I adore having a clean home, I respect that Scott has his own way of doing things. Most of the time when clothes are left on the floor, its because he's changing out of lounging clothes that haven't been dirtied.  Admittedly, I don't wash my lounging clothes after ever use either... except I fold mine back up and put them in a proper place. If Scott went around moving my lounging clothes like he knew best, I'd be perturbed. So as long as this habit is contained to a hidden corner of the bedroom, and occasionally those clothes are moved to the laundry hamper, I won't complain or touch his pile.

The second reason I do not move all those clothes directly from the floor into the laundry is because I can never tell what needs to be washed. I'm not going to go smelling all of his clothes to figure it out. He can take care of it. He also knows that clothes in the laundry hamper get washed.

Which is why this scene that took place earlier this week was confusing to me.

I woke up and was getting ready for work, when I noticed that there was a pile of scrubs NEXT to the laundry hamper, AWAY from the designated corner.



I texted Scott.

"What does it mean when you put your used scrubs on the floor NEXT to the laundry basket?"

He sends back laughing/crying emojis.

"No, really.  What's the difference between the floor next to the laundry basket and the corner?"

Apparently, we have need of three different laundry baskets in our house. One for dirty clothes. Another for lounging clothes that will be reused. And a final basket for scrubs that are dirty and need to be washed, but if they aren't washed by the next time Dr. Hubby needs to wear scrubs, they will get worn again. (Yikes!)

That night I discovered that the two floors piles were picked up and a load of laundry was done, without me saying another word. We get each other.

Uniquely Milwaukee

Besides the O's that have their roots in northeastern Europe (A's are a bit odd too, where bag sounds more like beg), we have come across a few tidbits that we feel are unique to this area, dOncha know!

1. Fish Fry Friday/Friday Fish Fry: We've found that the people of Milwaukee love to eat out. Restaurants around here have a pretty great turn out most nights. But THE MOST packed night of the entire week is Friday. Almost every restaurant in town hosts a fish fry on Friday, where their entire menu revolves around fried fish. I'm not exaggerating when I say every restaurant. They advertise it on their billboards, but it seems like the locals have their favorites.

It's not local fish. Icelandic cod is what we had, I'm pretty sure. So it's not like this tradition stemmed out of an overabundance of fish.When I took my parents to Fish Fry Friday in Franklin, WI I told them that the tradition came from Lent, where Catholics abstain from eating any meat except fish. They corrected me and said that once upon a time, that was the case every Friday, not just during the period of Lent.

I am a fish snob. I grew up in Alaska, so fish rarely impresses me. I thoroughly enjoyed my fish meal at St. Martin's Inn. I asked the waitress if they shared their recipe for clam chowder. BEST I've ever HAD! It will be a difficult experience to top, but there are a million restaurants in Milwaukee that are willing to try.

2. Trick-or-Treating, NOT on Halloween Day: Sometime in October I was warned that I should check my city's website to see what day trick-or-treating would be. Uh... is this a trick question?

Nope. Apparently cities in the Milwaukee area (can't vouch for the state) decide what day kids will go around to collect candy, doors can only be knocked during a certain time frame, and kids can only knock on doors of homes with Halloween decorations and lights on.

Which means that people really go out when decorating their homes for Halloween. It's kind of a big deal.

Found this historic gem from Bayview, south of Milwaukee, 2013

3. Cheese: We've eaten a good amount of cheese here. I like cheese with flavor and Wisconsin has some good options. If I said, you could get good cheese anywhere though, I may get in trouble by Wisconsinites and Oregonians alike. So I won't say that.

The other day I was driving around town and I heard a holiday radio ad for Crystal Farms Cheese, that unfortunately is not available for me to play for you. So you'll have to bear with this script that I remember, because this ad needs to be documented.

*upbeat Christmas music in the background
Wanda: O, Tracy. I'm sO glad ya came to Cindy's Christmas party this year. But can you believe she didn't put out one cheese ball!
Tracy: O, I knOw! That's why I carry Crystal Farms Cheese around in my purse during the holidays. That way I can nibble on my favorite cheddar any time I get a hankerin'.
Wanda: You smart cookie! Break me of a little bit of that Crystal Farms cheddar.
*sounds of chewing and cheesy satisfaction
Cindy: Ladies! It looks like you found the appetizers just fine.
Tracy: Right... the appetizers. *teehee
Crystal Farms Cheese - Don't Leave Home Without It.

It was epic. And if I wasn't driving I would have a recording for you now. Sorry, folks!

4. Passing on the Right: Speaking of driving, I hope that the native drivers of Milwaukee never rent a car in any other state in the US, because they have some crazy unwritten driving rules. If a car in front of you wants to turn left, instead of politely waiting behind them until the time when they do turn, Milwaukee drivers keep driving at the same speed and pass the turning car on the right. There are very few middle-of-the-road turning lanes as you get closer to downtown Milwaukee. Even where we are in the suburbs, where there are often turning lanes, city engineers have designed right hand passing lanes on small neighborhood streets where traffic commonly stops to turn left. It also means that sometimes one lane turns into two lanes or two lanes turns into three lanes because someone thinks you might be turning and they aren't patient enough to wait and find out.

It's bizarre, and takes some getting used to. I solemnly promise to only pass on the right in this fashion while driving in Milwaukee.

5. Jewelry Refunds for the Holidays: I was just reminding Scott the other day of deals I've heard on the west coast where you buy jewelry during the holidays - if, for example, it snows on New Years Eve then you can bring your receipt in and get a full refund on all your purchases. They can offer those kind of deals in California and Oregon because they've calculated the odds and looked at the history of it snowing on that day, and feel pretty confident that they won't go bankrupt.

The other day I said to Scott, "No jewelry store would ever offer that deal in Wisconsin."

Then just last week I heard about this deal: FREE Jewelry if Green Bay Packers pass for 400 yards this Thanksgiving. 

That definitely has Wisconsin written all over it.

Residency Update: Intern Year Rotations

Scott has a new rotation scheduled every month of his intern year. So far he has done internal medicine, Ob/gyn, and community medicine. This month he will be in surgery. Each new rotation comes with a different type of schedule and new attending physicians.

Internal medicine, working in the hospital to admit patients primarily from the emergency room to stay in the hospital for monitoring, meant shift work for Scott. He worked three or four 10-12 hour day shifts in a row, then three or four 10-12 hour nights. When Scott worked night shifts he would come home between 9:00-11:00 am and sleep until 5:00 pm when he would need to get up for his next shift. Not many sleeping hours! Then he would get a day off in between night shifts and day shifts to adjust. He didn't seem to mind doing this for his first rotation, though he felt like he needed caffeine to stay up during the night. 

In internal medicine, interns are given the task of admitting most of the patients, which takes a bit of time to document symptoms, discuss the patient's medical history, create a treatment plan, and begin administering medications. The hospital here is LARGE, so Scott was admitting 4-5 patients a night, which meant there was no down time to sleep. It was pretty much go-go-go until his shift was over, but then he would need to sit down and write in all the patient charts and give his morning report to the day team before coming home. One day a week, Scott would work in the family medicine clinic too. It was a busy month where I rarely saw him awake. Like I said, though, he didn't mind this as a first rotation. His only complaint was that he rarely attended church over these first two rotations.

His next rotation had him delivering babies. Shift work again, but this time it really did him in. I've never seen him so tired. It was a similar schedule of hours, days, nights, day off, clinic. I'm not sure what made this second rotation so much worse, whether it was the back-to-back months, fewer days off to prepare for family coming in town, or maybe it was labor and delivery. In any case, by the end of the month when family came to visit, he looked pretty haggard. To graduate from this family medicine residency, Scott needs to have delivered 30 babies. He delivered 15 in his first rotation.

Last month was a month where Scott was not on-call, so he could take vacation days. This could not have come at a better time! The schedule for community medicine was 9:00 am to 5:00 pm, or sometimes just a few hours in the morning. He was working in free clinics around town, following physicians to home visits, and completing residency projects. For vacation time, Scott had scheduled to take long weekends all month long, which may have been more restful for him than taking a full week off. He was back to normal again after his first long weekend, which was a relief to me. He also had time to do sports medicine coverage at night for local games.

Last month was a bit more like we would expect his future career would be like - clinic hours, some weekend night game coverage. I could definitely get comfortable with that! 

Dreams Do Come True

Remember when I said I was dreaming of the day when I could wake up at my convenience, walk a few feet, and work from home? By a series of miraculous events, that day has come.

Let's rewind a bit.

Scott started working at the hospital in June, when he had a series of orientation meetings including an HR presentation on benefits. It was then that we made plans for me to transition off COBRA and begin using his insurance. In mid-July we found out that because of a technical error, I was kicked off the insurance plan, and we would have to appeal for me to use Scott's benefits before the next open enrollment period. Inconvenient for sure, but I wasn't worried because Scott made it sound like the appeal was no big deal.

In the meantime, I started casually looking at potential jobs. After working at the foundation in Oregon, I knew I wanted to continue working for non-profits. (Scott's cousin asked me the other day if I had something against profit. Ha! I prefer to say that I put greater value on selfless missions and forced efficiencies. Not to mention there's a huge need for business skills in non-profit organizations.) All of the fun non-profit jobs are in downtown Milwaukee, which is more of a drive than I wanted to make... especially when you consider that my dream was to work in my living room.

Then I found it! A perfect match of a job, working form home full-time for a charity federation. I applied, and when I interviewed they told me that just that morning the job had been offered to someone in-house, but they would still like to interview me for a part-time role with the potential to move into full-time this winter.

A couple weeks later I was offered the part-time job. It was just after I found out that our insurance claim had been denied. Say what?!

I scrambled trying to figure out how to get an insurance plan. I tried everything and learned that even though there is this fancy new national health insurance market, pre-existing conditions still matter and you can't just buy insurance whenever you need it.

I know, insurance talk is boring. Fast forward to the good part.

The day arrived when it was the last possible moment I could get an insurance plan without an open enrollment period. I made one last ditch effort to get a plan and called a local broker. He told me, in blunt terms, that I had run out of options. I cried. But I also knew I could make due. I would shut myself up in my bedroom and try my best not to get sick or break a bone.

Not one hour later my job called me. My full-time job opened up months before they expected, and they were offering me a full-time gig - working from home - with full benefits!

Can you say tender mercy? I can.

Now I wake up in the morning, walk over to my second bedroom a.k.a. the office, put on my snuggie and get to work. It feels good, just in case you were wondering.

Awkward Moments in a Kush Life

I have been having the best time! When we moved out to Wisconsin there wasn't any rush for me to start working. So I've been very casually looking for jobs, and in the meantime I've been preoccupying myself with city explorations, reading, and being a homemaker. There aren't many people who say they do that any more - homemaking. It's quite lovely.

Lately in the mornings, I will get up at my convenience (which happens to be very early, unfortunately), take some time to read the Book of Mormon or a General Conference talk to get me in a groove before I start my day, eat breakfast, clean up the house a bit, sit outside and read until its too hot, run errands around town when needed, and work on random projects until Scott gets home. Some days I open the window in the morning, if its cool enough outside (Milwaukee is rather muggy and thus uncomfortably warm in the summer), and hear a bird chirping or listen to the breeze... and then I sigh and think, "How can I work from home ALL the time?" I'm working on figuring that out.

Since I've gone through many books in the last month, I made a point to stop by the public library. And WHAT a library it is! A two-story building (no pun intended) with an expansive collection of fiction, non-fiction, children's library, movies, and books on tape. The library has lots of quiet space, including study rooms and meeting spaces. Possibly the best thing about this library is that it is part of a network of libraries that pools resources. So I can put a hold on a book for free, to be sent from one of the partner libraries if I can't find it in house. This network also means that my library's e-collection on Overdrive is GINORMOUS. They even have several copies of new books that have just been released. It's a beautiful thing!

*Off topic: I used to think I would never prefer reading on my iPad over reading a physical book. I love flipping pages and seeing my progress. However, after reading several books on Overdrive, I've changed my tune. The convenience of checking out a book is divine, and if the book is especially long (and mine often are), you don't have to worry about holding the book all lop-sided until you get to the middle. I'm sure Overdrive is saveing fingers from arthritis.

In addition to having a jaw dropping collection, our new library has pretty great programming. The library hosts several book clubs throughout the year, and a summer concert series outdoors. Every Wednesday afternoon in the summer they play a kids movie, and every Friday afternoon they host a non-kids movie. The first time I went to the Friday afternoon special I watched The Second Best Marigold Hotel. I walked in a little bit late, and found that I was the youngest person in the room by about 40 years. I felt like I was literally sitting with half the senior center. The entire room looked over at me when I started laughing at Maggie Smith's jokes about dying. Meanwhile, I had no idea why they were laughing at Richard Gere's jokes about aging. That's what you get for watching a movie about a retirement hotel with the senior center, I guess.

Then, this last Friday I went to see The Longest Ride. I was encouraged because it looked like there were way more cars in the parking lot this particular afternoon, and so I guessed that the younger crowd had come out to watch this Nicholas Sparks movie with me. Not so. It was just me and my older peeps again.

Imagine watching a movie about an older man remembering his WWII days with half of the senior center. The room was in tears, laughing when Alan Alda's character, when being told that he was in the hospital to make sure he got all better said, "I've had a heart attack, a hip replacement and two knee surgeries; how much better can I get?" The laughter was empathetic, on their part, which made it rather contagious.

It should be said, that I do NOT recommend The Longest Ride. While Scott Eastwood is mighty fine to look at (strikingly similar to Hot Guy #5, for those friends who knew me in college), the acting and dialog felt forced. Also, there was unexpected nudity, more than is really appropriate for a PG 13 movie in my opinion... try watching THAT with your grandma. I spent a good portion of the movie casually looking at the floor. The rest of the crowd did not seem to be looking at the floor, but then again I could only see the two or three viewers nearest me.

Isn't my library great?! These movies aren't even out yet on video, and my library shows them for free. The August movie schedule just came out. Anyone want to see I am Big Bird with me? We can be spring chickens together.

Residency Update: Intern Year Orientation

Relaxing after working the holiday (July 4, if you can't tell by his outfit)

Dr. Chandler is now part of a family medicine residency with Aurora Healthcare (you can view pictures of each residency class with resident bios that link). For those of you who are only familiar with residents from watching Gray's Anatomy, first year residents are referred to as interns. Internship year is similar to med school, in that the residents have rotations throughout all areas of the hospital and medicine to have a broad foundational training before moving on to focus on the specialty of choice. What makes intern year different from medical school is that residents are no longer students. They now have the responsibilities and challenges of being a full-fledged doctor.

Scott's intern year started mid-June with human resource orientation for the hospital, as well as some testing and certification. July is set apart for orientation of each of the areas where Scott will be doing rotations this year. Each week in July, Dr. Chandler will be spending time in each of the rotations where he will be this coming year. This first month orientation set-up is unique, from what we've heard, to other residencies. Many residencies have the interns jump right in to full-time (80 hr/wk max) clinic responsibilities. This residency has given the interns one week to become familiar with the staff, duties, and timing of each hospital area before the interns take on the year of rotations.

An aside for those with only the TV medical jargon at their disposal or for anyone who's read the Med School Wives perspectives, some doctors do their internship year as a transitional year, transitioning from medical school to residency training. Transitional years are typically at a different hospital/residency for one year before moving on to the full residency training location. A transitional internship is common for surgery specialties, dermatology, some internal medicine specialties, pre-military training, or for yet undecided specialties.

So far in this orientation month Dr. Chandler has worked with internal medicine, newborn, and obstetrics. In addition to those rotations, he spends some afternoons working in the family medicine clinic seeing patients. He has been getting up at 4:45 Am each morning to study before leaving for 6:00 Am work (15 minute drive to main hospital). In June he was often home very early in the afternoon (3:00 Pm), but now that things are going more full swing, Scott is usually home around 5:00 Pm or 6:00 Pm, unless he has an "on call" day where he is at the hospital until 9:00 Pm. He works some weekends, Saturdays and Sundays, though weekend hours are not as predictable.

These longer hours of work are certainly a bit foreign to Scott, who had a more lax schedule in school. He has felt tired when he arrives at home and is eager to take some time to relax before resuming his studies and heading off to sleep. Any down time is cherished. He likes to use this time to go for a run, play Mo-ball at church, sit down to a meal with me, or do a crossword puzzle together. I'm just glad we're in the same city and he gets to come home after each shift.  It will be an adjustment, but we love where we are right now.

I'm still caught up in thinking that Scott is a student. The other day he was going to the hospital and said he was hoping he might deliver his first baby since becoming a doctor. "Surely, you won't be the one actually delivering the baby," I said. "Who else?" was Dr. Chandler's reply. Yep, in this particular hospital, had there been a baby to deliver that day among his patients, Dr. Chandler would have been the one to do it! Note to self: make an effort to avoid any major operations in July (when interns start).

Toto, I've a Feeling We're Not in Oregon Anymore

Dr. Chandler and I are becoming official Wisconsinites. Boxes are unpacked, and our apartment in a southern suburb of Milwaukee is feeling more and more like home. I even went out and secured a local library card and Wisconsin driver's license! Dr. Chandler is in the throws of intern-year orientation and loving it. We checked our first Summerfest concert off our bucket list, and I volunteered at Bastille Days downtown. The real kicker was getting asked to speak last Sunday in church. That's when you know you're a true newbie.

Everywhere we go (quite literally), when we mention that we've recently moved out to the mid-west from Oregon, we are inevitably asked "What have you noticed is different about Wisconsin?" Being asked this on an almost daily basis, we've come up with a decent list:

1. Midwestern charm is real, my friends. When we initially came out to Wisconsin to scope out the area for housing, we were surprised to have strangers start up conversations with us, like we were old friends, in the hotel elevator or store lines. Wisconsinites don't believe in looking at the floor when waiting if there's anyone else in the vicinity. They are the kings and queens of small talk!

I've discovered that when you walk into a business, you shouldn't blurt out you're name and why you're there after saying your initial "hello." Oh no! If she's a true Wisconsinite, before the receptionist even knows your name she'll will want to know how you're day's been, and don't be skimpy on the details. There are many reasons why I am not yet an official Wisconsinite, but my West Coast reflexes are likely the biggest culprit. I wonder if the community college offers midwestern charm classes?

2. It may be social unacceptable in Milwaukee to be a teetotaler. How it didn't occur to us before that Milwaukee would be a beer capital is beyond us. I mean it's known as the "Brew City" and is home to the Brewers baseball team, who play in Miller Park! I've been told that the reason Milwaukee has so many festivals in the summer is to have a weekly excuse to party and drink.

We've been to several residency welcome get-togethers where alcohol is offered, and everyone is always perplexed as to why we don't drink. There's a chance we might not get invited to any more BBQs. Just sayin'.

3. Cheese outranks organic produce. When we lived in Oregon, I had no problems locating great quality organic produce. In fact, in Oregon organic produce that's in season often costs only a few cents more than conventionally grown produce.

I've been to several chain grocery stores in Wisconsin and I've been lucky if I've found two feet of organic produce space. There's generally a good produce section, which often butts up against the specialty cheese section. A store here might have four organic limes and a handful of organic green apples, but I guarantee you they will have three cheese coolers. One cheese cooler for local cheeses, one cooler for cheese spreads, and another cooler for specialty cheeses.

Behold the Wisconsin local cheese cooler at Pick 'n Save

The love of cheese is strong here.

I'm sure this list will continue to grow. I've heard over and over again that we should take advantage of the hot, humid weather while we have it. Though we haven't experienced it yet, I'm told that come winter it will be -30 F. Yeah, I had to ask for clarification. They said NEGATIVE 30 degrees, below zero. It surprises me then, that so many people who were born in Wisconsin stay in Wisconsin after experiencing its winters. I guess there must be a lot to love.

Paging Dr. Chandler to Graduation

He did it, folks! Four years and $230k in loans later (yep, really!), and we are now able to call him Dr. Chandler.

Scott graduated from Western University College of Osteopathic Medicine of the Pacific Northwest on June 5, 2015. As the graduate, he had to be at the event center in Lebanon by 7:30 Am. I, the "hooder", in other words, the one who put his fancy graduation cape on after he crossed the stage, had to be at the events center at 9:30 Am. The actually graduation ceremony started at 11:00 Am and was done around 1:15 Pm.

As I mentioned, one of the special things that Western University does during graduation is allows one or two family members to "hood" the graduate after the receive their diploma on stage. So during the ceremony I was escorted back stage with the other family members and was privileged to present Scott with his first official superhero cape. I thought for sure I would tear up during the hooding ceremony. I was crying just watching the graduates walk in to Pomp and Circumstance! But when they announced Dr. Scott Ernest Chandler and he shock the Dean's hand before walking across the stage to me, all I could do was smile from ear to ear.

I'm so proud of all that my man has accomplished, and all of the random but necessary medical facts he has stored in his brain. He will be a great doctor!

We were joined at graduation by Scott's parents, his older sister and brother, some of Scott's nephews and a niece, his grandparents, and my parents. (More family wanted to attend, but we were told we were limited to 10 guests.) It was quite the party!

Sterling, Scott's special buddy and nephew, was probably the most excited to see Scott graduate and the least happy about us moving to Wisconsin. That evening with diploma in hand, Scott and his dad drove off into the sunset, hauling all of our material possessions to the great state of Wisconsin.

Tender Mercies in Medical School

We are active members of the Mormon faith. Our beliefs are so much a part of who we are and what we do, including our time in medical school. So I would be remiss if I did not acknowledge the many tender mercies that we had these last four years. Prepare yourself for a doozy of a post!

1. Being Accepted to Medical School: The process was a minor trial for Scott and I, though we felt the Lord's hand in the entire process. The second time around we spent a lot of time talking about where he may want to go to school and what he could do in the year he had been given to improve his chances. Heavenly Father buoyed us up when we were feeling pretty low. What a blessing it was that Scott was able to improve his grades, MCAT score, and gain more volunteer hours. These improvements spurred two school interviews and acceptances.

2. Oregon: In the application process, we had poured over the application time and again looking for schools to add or making edits in essays. I distinctly remember Scott calling me from a boy scout overnight he was chaperoning to ask if I would finally submit the application. On the phone, I reviewed with him the schools where we had selected to apply. Then, though I had never seen the option before, Western University's brand new Oregon campus appeared on the application list of schools. I asked Scott on the phone if he wanted to add it, and we did, knowing that he had family nearby. Little did we know that shortly after moving to Oregon, my parents would move to the state, as well!

I've talked quite a bit with my fellow med student wives about our choices to come to COMP-NW. To be honest, there were times in the last four years that we were jealous of the customer service, curriculum, resources, or prestige of other schools. However, we all had stories of prayerful consideration and an impression that Oregon was where we needed to be. Education aside, we have most definitely benefited from the supportive community of Lebanon, bountiful resources of Oregon (oh, the berries!), proximity to family, and the amazing circle of friends we made!

3. ISAC and Teaching Assistant: One of the main reasons Scott selected to attend Western University was because of their Intensive Summer Anatomy Course that allowed students to take their first anatomy course in the summer as a stand alone class and prepared them to be Teaching Assistants in the lab. Scott was lucky enough to be accepted into this elite group of students. It allowed him to complete one of the hardest first year courses before he had even begun school. As a TA, he became fast friends with his classmates and had the opportunity to solidify what he'd learned in the months before. This emphasis on anatomy helped Scott to do well in all of his courses during the first two years, not to mention all of the times he was questioned by physicians in the operating room.

4. My Job: Getting a job in Lebanon is no simple task, though with a brand new school opening up in Lebanon, you would think otherwise. The community has grown quite a bit since the medical school campus was built, but there are still very few professional jobs open, much less jobs that might actually progress my career. We decided to move to Lebanon three months before school started, since I otherwise would have had to move to Oregon without Scott since he was attending the summer anatomy course in California. Another reason for the early move was to give me a head start on the job hunt. I spent a couple months hanging out in Lebanon, applying for jobs of interest, and exploring the area.

One month after I was settled, two part-time jobs opened, one each at two different non-profit organizations in the area. I applied and was asked to interview for both. Then my then future employer contacted me and asked me if I would be interested in interviewing for a full-time job instead. After several interviews, I was offered the full-time position.

Since graduating from BYU-Idaho, I have enjoyed the jobs I've worked at and have had wonderful working relationships with colleagues. I have also felt, throughout my career, that something was missing - I needed to find some greater purpose at work. This position that I have held during the last four years of medical school has been the best job I have ever held. I have loved my experience at the foundation and have been supported in my professional development by wonderful supervisors and colleagues. It was an incredible blessing for me to be offered a position with the foundation, and then after demonstrating that I could do great work, I was continually blessed with more learning opportunities. On top of that, the job offered wonderful benefits, and I was able to help other med student wives to find positions at the organization. It was truly a privilege to work with my colleagues at the foundation.

5. My MBA: One of the amazing benefits offered at my job was tuition assistance. Before we began this medical school journey, I had started taking class towards my MBA through UMass Amherst's online program. My job allowed me to take classes, for a very small fee per unit, through Oregon State University. It was initially a tough decision to transfer credits, not knowing if I would be able to stay in Corvallis long enough to complete the OSU MBA program. After transferring credits to OSU, I took night classes while working full-time and finished the OSU program in three years. Going to school kept me very busy while Scott was preoccupied with school and away on rotations.

6. Boards: The pressure was mounting for Scott as he prepared for his boards following Year 2. A competitive score on the COMLEX Level 1 and/or USMLE Step 1 are a key component to securing an interview with competitive residencies. We were blessed to have resources for Scott to orchestrate his intensive studying regiment. I was grateful that Scott could do all of his studying at home so I could see him (though, not talk to him) during that time.  We both fasted and prayed that he would pass his board exams and if it synced with God's plan for us, that Scott could also perform well.

One of the two board scores came back, and while he had passed, it was not the number he was hoping to see. For a few days Scott moped around, saying that he would have to be a penguin doctor in Antarctica. I reassured him that his scores could never be that bad, and we spent some time researching what the average board scores were for various specialties. I found that while his one board score was lower than expected, Scott would still have a chance to interview for dream specialties, knowing that no matter where he interviewed his character and work ethic would help him stand out. Then we received Scott's second score, which was above average, helping to boost his ego back to normal. I most definitely contribute these gains to our fast and tithes, and we've since decided that Heavenly Father wanted to send a little reminder to Scott that he needed to be open to all medical specialties.

7. Third Year Rotation Electives: When we selected our home base and Scott's rotation schedule for Year 3, I asked him to select a rotation schedule that allowed for him to vacation around my birthday, since I planned a fantastic cruise to celebrate. We ignored the timing of electives during his third year, or naively thought that having electives early in the academic year would help Scott to make better, earlier career decisions. We had no idea that because the campus was new and rotations now had to accommodate a larger number of students that Scott's requests for electives would be pushed off. Scott was left to arrange electives outside of the approved system, which required 90 days of paperwork. Scott was extremely fortunate to arrange with a family medicine physician in Medford to rotate as an elective and a family medicine/sports medicine physician in Portland. An extra cool blessing came when Scott was able to negotiate with the school to count one of these rotations as his family medicine rotation in order to have an additional elective later in Year 3, giving him more career options to consider.

8. Audition Rotations: At Western University, the students are required to set up all their rotations for Year 4 and not much instruction or assistance is given to help them accomplish this major feat. Scott and I had started talking about audition rotations and the required school core rotations during March prior to fourth year. Scott made some calls with potential residency programs, but many didn't have their visiting student applications available until later in the spring. Scott was so busy with rotations and board prep, that he dedicated very little time to the scheduling of his fourth year rotations... especially since scheduling had to happen during normal business hours when Scott was likely at the hospital with patients.

So when the summer came, Scott had communicated with many audition sites, but hadn't finalized all the audition rotations that he needed. He was frustrated that residency sites were difficult to schedule and didn't follow the schedule he had in his mind. More than that he was incredibly frustrated that the school was little help during that time.

His first rotation hadn't been scheduled when Scott spoke with one of his classmates about two residency sites in Utah that sounded perfect for Scott. I had researched and provided information on many residencies for Scott to consider, but I had failed to include those two residencies. Scott quickly called both residencies and by miracle and divine intervention, he was able to schedule one for his first audition in a matter of two weeks! Not only was his first audition rotation a miracle, scheduling wise, it became one of his favorite auditions of the year and prepared him to consider what he would like best in a residency.

9. The Match: I've said it before, and I'll say it again - we were incredibly blessed to land the residency we did. When applying for residencies, we prayed that we would be aware of the residencies to which Scott should apply. During audition rotations and interviews, Scott received great feedback on his potential to match. On Match Day I was telling people that I was 98% sure that Scott would match with one of his top choices; but he didn't, and we went through the emotional process of scrambling for his residency. Since residencies haven't started yet, I can't say that we scrambled into the perfect match for Scott, but it sure feels like it - family medicine, sports medicine in the curriculum, dually accredited, OMT training! We feel optimistic about the opportunities awaiting us in Wisconsin; and though we would have preferred to be spared the trial of scrambling, we feel the results were brought to us by divine design.


We are humbled and grateful to have had these experiences. They have reminded Scott and I that we should always prioritize the Lord and put our trust in His plan for us.

Yr 4 Perspective of a Med School Wife: Sierra

Sierra was kind enough to share her perspective from fourth year. The last time we heard from Sierra, we had just finished first year and she had yet to marry her medical student.

How fun is it to have book-end perspective posts!


Residency: Emergency Medicine in Jackson, Michigan

Q: How did you support your med student in year four?

A: Honestly, I don't think I did a great job at this. I took on more responsibilities at work, hoping to distract myself from missing my husband while he was on away rotations, as well as to boost my resume since we knew moving for residency was going to be very likely. Looking back, I think I would have still taken on the extra responsibilities, but I wish I would have learned to balance things better so that I could have been more available to support my husband.

But one thing I made sure to do regardless of my own stress was to listen. Just allowing my husband to process his thoughts out loud about choosing a specialty and applying for residency was probably what he needed most. I also encouraged him to go for his dream specialty, even though it was risky.

Q: Did your family move for fourth year?

A: No, we rented a room from my brother during 3rd and 4th years. We saved money this way, but it probably isn't for every couple. Even though I think the challenges of this living situation actually ended up making us stronger, we are so ready to have our own place again!!!

Q: What did your student consider when selecting residencies for applications and the match?

A: We didn't allow finances to limit his applications. I wanted him to go for his dream, so he applied to all programs in his specialty of interest, knowing that realistically, most programs weren't going to offer him an interview since he didn't audition with them. But you never know unless you try! We had most of our discussions about desired locations as he was applying for audition rotations.

Q: What was the most frustrating part about Yr 4?

A: I am sure that my husband could list several and I could probably come up with a few if I thought about it for a long time, but I am just so thrilled at the way things have turned out that I only have happy thoughts :)

Q: Any advice for medical student significant others who are approaching this stage?

A: YES! And sorry if my honesty offends anyone, but here is goes...Please make sure that you and your spouse are prepared for the possibility of not matching because anything can happen and you must be prepared. Talk prior to Match Day about which specialties your spouse would be happy with if they don't match. Prioritize them and have unique personal statements written and ready to submit on Match Day for each possible speciality, if needed. And do your research. Find out all the programs that offer the specialities your spouse is interested in and if your spouse is considering a traditional year, cross-reference to find out which programs offer multiple specialties that your spouse is interested in so you know which TRIs will be most worthy of your attention if they have openings during the scramble. Do these things with your spouse because it also helps to mentally prepare both of you and creates a clear understanding of what would happen if your spouse does not match.

Also, know that Match Day is about your spouse's future. If you find yourself taking part in the scramble, please don't cry (or at least don't let them see you cry until they have a spot). This really isn't helpful in any way. And this might be different for those with kids, but from my perspective, be willing to go anywhere. Don't sacrifice what could be your spouse's entire career for a few years in a particular location. Residency isn't permanent.

Yr 4 Perspective of a Med School Wife: Kristy

When Kristy sent me her fourth year perspective, I'd be lying if I said I wasn't the teensiest bit jealous. Her student, Josh, was able to set up great rotations around his family so they were able to spend most of the year together... and they got their first choice residency. What?! AmazAZing! Kirsty's perspective just goes to show that fourth year isn't inherently deadly.

Thanks, Kristy, for sharing again this year (1st year and 2nd year posts)!

Residency: Internal Medicine in Pueblo, CO

Q: How did you support your med student in year four?

A: One thing that I really had to focus on this year was not making him worry that the kids and I were struggling with him gone so much on rotations. I stayed as positive as I could about it all, and kept things running at home the best I could. I helped him with arranging housing options while he was away, and asked him about aspects of the audition sites that he doesn't always think about, but that I knew would affect his experience during residency. As an outside observer, there are things that I could see that he wasn't really seeing which made a difference in the end about where we chose to go for residency.

Q: Did your family move for fourth year?

A: For fourth year, we moved to Idaho to live with Josh's parents. It was a challenge to be sure, but financially it worked out really well. We felt like if we saved money on rent it would make traveling expenses for auditions less of a stress, and that it would ease my burden since I would have some help while he was away. It was a really good thing for us. Josh set up hospital affiliations in Idaho, so for the majority of the year he was able to do his rotations and be with the family. I love that we got a lot of time with him this year since that won't be the case once residency comes.

Q: What did your student consider when selecting residencies for applications and the match?

A: It was a hard decision for Josh on what kind of residency that he wanted because he was torn between a couple of specialties.  I really left that up to him because I wanted him to go into something he would really love in the long run. As far as where we would go, we focused on staying in the western states to not go to far from extended family. We looked at the list of sites available and eliminated places/cities where we didn't want our family to be, hospitals that were not compatible with Josh's long term career goals, or places that we just didn't feel right about. Josh applied for auditions that were the closest fit to his goals, and for interviews at other places that seemed okay as well. In the end, it was a matter of a lot of prayer and deep conversations about the future. The residency Josh matched into was our first choice, so we are really excited.

Q: What was the most frustrating part about Yr 4?

A: Finding a surgical sub-internship was pretty frustrating since we would think it was working out and then it wouldn't. Also, if I'm being totally honest, it was difficult to work with the school with a lot of things. It felt like they were hindering our efforts rather than ever being helpful.

Q: Any advice for medical student significant others who are approaching this stage?

A: Get an early start on planning rotations and always have a plan B, or C, or D... And really, take advantage of all the time you have together whenever it happens. It can be a fun time and is really exciting even though it's pretty nerve racking at the same time. So much of the future is figured out during this year, and that is the fun part!

Yr 4 Perspective of a Med School Wife: Megan

Even though it has been two years since Megan and Devin have lived in Lebanon, we still were able to see them last year when they were in Medford (links to Megan's 2nd year and 3rd year perspective posts). I have missed Megan and her cutie-pie kids. I would say that Scott missed Devin, but they talk frequently on the phone. So though I've heard about their plans, I hadn't heard Megan's perspective from this year. And I have to say, I'm so glad she was willing to share again this year. Megan's story is honest and detailed. Each of us has had unique paths in medical school, and Megan's story highlights that. I'm just crossing my fingers that we'll get to see them while we're both in the mid-west!

Intern Year/Residency: Internship in Jefferson City, MO

Q: How did you support your med student in year four?

A: Basically I was Devin's sounding board. He changed his mind on what he wanted to do about a million times. (I may be exaggerating, but that's what it felt like!) I was always there to listen to him weigh the pros and cons of different specialties, and (hopefully!) I was able to provide some feedback that was useful to him.

Devin was gone for three months, which may have well been three million months because that's how it felt. I held down the fort with our kids without too much, if any, input from Devin. I knew that he needed to be so mentally focused on what he was doing that I tried my best to not distract him from that.

The first part of fourth year was so much harder than the second half of the year, though. They almost feel like two separate years all together.

Q: Did your family move for fourth year?

A: We moved home and lived in our parents basement for fourth year. All of us, in one room... Yeah... It was a long year, but thankfully we are finally seeing the light at the end of the tunnel! We moved home mainly to save money. Away rotations and interviewing is expensive! And we didn't want to take out any more money than we had to.

Also, with Devin being gone as much as he was, it was incredibly nice to have help with our two small children from time to time. Living with parents gave me a little more adult interaction each day than I would have gotten had we stayed in Oregon. (I have a big family :) Someone is always around!) I was also able to start working at our family business, The Blindman, being their general office manager. It gave me something to do during the day so I didn't go crazy! And it helped financially!

Q: What did your student consider when selecting residencies for applications and the match?

A: First, it took us forever to decide on a specific specialty. We had it narrowed down to: OB, Peds, Derm and Family Practice. He loved the clinic setting, but he also loved delivering little babies. So, his first two away rotations were for OB and he HATED it. With a passion. So, yeah, waste of two months! But, at least one of his rotations counted for one of his required 4th year rotation, so not a completely lost month. He then interviewed for Peds residencies because he realized what he loved the most about OB was at the end when he was with the little baby. He interviewed at a couple of different places and was actually offered two residency spots outside of the match! At this point he did a rotation with a Dermatologist that he used to work with. The whole reason that he had gone to medical school in the first place was because of his interest in Derm, but the field is so dang competitive we hadn't really given it too much thought! But, after doing his rotation with the Dermatologist and having many in depth conversations with him and the other Derms there that he was working with, he decided that we should just go for Derm. In the grand scheme of things, if it doesn't work out we will at least know that we tried. So, Dev turned down the other residency offers and started applying to intern years. (Derm is different than any other specialty, you do an intern year and then match into Derm the next year.)

The specialty was hard for us to decide on, but other than that location was huge for me when it came to residency spots. Safety of the area and cost of living. Being a SAHM with two kids really changes your perspective, especially when you know your husband isn't going to be around a lot.

Long story short, we are headed to Jefferson City, MO so Dev can complete an intern year. Then next year we will be doing this whole audition/application process again as we apply for Derm residencies.

Interestingly enough, though, Dev's last rotation of med school was ER and he LOVED it! So, if Derm doesn't work out, ER is the back up... which wasn't even on our radar until he did the rotation. So, maybe him not accepting any of the previous offers was a blessing in disguise, even if Derm doesn't work out. Who knows :)

Q: What was the most frustrating part about Yr 4?

A: Definitely the away rotations. Though I don't think our marriage or anything suffered because of it, it also didn't do us any favors. We were still able to talk every day but he was so exhausted from his days, and the kids missed him like crazy. I was so relieved when those were over!

Also, just the not knowing where we were going to be the next year, that was crazy hard. Even though we found out in February, I am such a planner, and not being able to play - even though it was months in advance - was incredibly hard. But hey, it's kind of an adventure!

Q: Any advice for medical student significant others who are approaching this stage?

A: Figure out what you want to do early. Sign up for audition rotations EARLY! But, as your significant other is finishing up required rotations for fourth year, don't count anything out because you think it's too late. It's always better to maybe take an extra year, but have them do something that they absolutely love! I would hate to get all the way through all of these years of training and then have Dev not love what he is doing.

Be your medical students #1 fan! Schedule in as much family/couple time as possible, because I hear there's not much during residency ;)

Also, lean on family and friends during the rough months - the away rotations. Find a support group, whether in real life or online, but someone who understands and can commiserate with you when things get hard. Because they will get hard. And then they will get better. And then they will get hard, again. But, that's the life we chose, and I wouldn't trade it for anything! (Though, having a house would be nice :) )

Yr 4 Perspective of a Med School Wife: Shaila

Shaila and I were some of the lone Lebanon survivors this fourth year, and what a year it was for her family (1st year and 2nd year posts). We go to church together, so Shaila and I saw each other each least once a week. In fact, on Sunday we are going to do one of my favorite musical numbers together in sacrament meeting. Shaila has a beautiful voice, and I'm convinced I'll be crying my way through the song from my place on the piano.

Residency: Family Medicine in Auburn, WA

Q: How did you support your med student in year four?

A: I tried to support Matt by TRYING to remain positive, or to lift him up by trying to see things from a different protective. I tried to give slight nudges with my own opinion, but without trying to "parent" him. Sometimes I was super stressed and anxious about how Matt was going about things, but I would sit back and let it get done on his timeline. He didn't need more added stress with me nagging. 4th year was by far the hardest and most stressful for us. Things didn't always go as planned, but they've all worked out and only a couple days left of Matt's last rotation. Yay!

Q: Did your family move for fourth year?

A: We have stayed in Lebanon all four years of medical school for several reasons. We didn't want to keep moving our four boys around and change school and friends too much. Malcolm is now 11 and in 5th grade, Quinn is 9 and in 3rd grade, and Winston is 7 and in 1st grade. (Sterling boy is still little enough to keep me on my toes at home.) We were especially worried for Malcolm getting into those harder years of school switching.

Another reason we didn't move was the overwhelming feeling of "moving home" to try and save money and bombard our parents with our large family.  But we were blessed to receive section 8 assistance halfway through 3rd year, so living expenses out of pocket were really minimal.

We also thought Matt would have plenty of opportunity to find rotations close to Lebanon, which didn't end up being case, but we didn't have it as bad as some. The longest period of time he was away from home was 12 weeks.

Q: What did your student consider when selecting residencies for applications and the match?

A: Matt and I didn't hash out a lot of things we wanted to consider for residency. Part of the reason is that Matt and I are usually on the same page about what we want for our family. But, I'm also not like some of my fellow medical wives who are super amazing and love to research it out, so I didn't really know how it all worked. Matt's always most concerned for his children's wellbeing, then his career, so I knew he had the right perspective. I supported Matt and told him I just wanted him to be happy. If he enjoys what he's doing, he comes home happy, which keeps me happy, and our children. Matt didn't have a set decision on what he wanted to go into, so he applied for two different things and left it up to our Heavenly Father to take us where he needed our family to be, and where our family could succeed the most and where Matt could continue to become the best doctor he could be. I believe things worked out better than we could've asked for.

Matt will be doing his residency in Auburn, Wa for family medicine. We are super excited to be moving back to our "home" state, 3 hrs from our parents and to have some extended family close by. This residency also serves a Marshallese community and Matt will be able to serve some people he learned to love on his 2 year mission for our church, and possibly use his rather useless language of Marshallese.

Q: What was the most frustrating part about Yr 4?

A: Finding/setting up rotations was definitely the most frustrating part of 4th year. Not only was it difficult to find rotations close by, but also when you think you have a rotation secured, and just a few days prior, they are cancelled. Matt ended up having to take his "vacation" rotation at a totally different time then we anticipated, and in the middle of January no less!

Q: Any advice for medical student significant others who are approaching this stage?

A: Let go of all expectations you thought 4th year to be. I didn't realize I'd be as much of a single mom as I was. I also didn't realize Matt would be setting up all his own core rotations. (Not that Matt communicates these things to me well. I'm learning as we've gone along the way.)

Just love and support your SO along their stressful 4th year. Try and be a positive force and uplift them during the lows. (I know a lot of students confidence wavered 4th year.)

Take advantage of all the moments together, if they're home, spend quality time together, if they're on an away rotation, remember they are on someone else's time schedule, or a different time zone, and you don't always get to talk.

Also find support from somewhere. There were too many times I felt alone and many days when I had no contact without the outside world, or even talked to an adult. Having family so far away and friends move away, and husbands basically out of the picture, our social life basically became non-existent.

Yr 4 Perspective of a Med School Wife: Maren

Props to Maren, who not only willingly contributed to this crazy blogging experiment of mine EVERY YEAR (1st year, 2nd year, and 3rd year posts), but also had a baby during the craziness that is fourth year. You are one of the strongest mamas I know, Maren!

Intern Year/Residency: Transitional (internship) year in Chino, CA

Q: How did you support your med student in year four?

A: I supported my student by not complaining about his away rotations and by trying to leave his decision-making (for residencies and last-minute rotations and stuff) up to him after giving my input. I also tried not to freak out and guilt-trip him when things didn't work out ideally.

Q: Did your family move for fourth year?

A: No. After 2nd year, we moved to Portland as a home base for both 3rd and 4th years.

Q: What did your student consider when selecting residencies for applications and the match?

A: We had to first consider military residencies, then civilian transitional years. When considering military residencies, we were going off my student's sense of what he thought he would like the most/have the best chance at/be the best at. When we considered transitional years, we decided based on location.

Q: What was the most frustrating part about Yr 4?

A: Confusing our strategy (due to lack of information) for a military residency and then missing some deadlines for civilian transitional years. I actually think things worked out for the best, but it's always hard to sit by and watch preventable problems arise.

Q: Any advice for medical student significant others who are approaching this stage?

A: Gather all the info you can about the process, strategy, and your options; and then decide with your SO what your priorities are in deciding what you want. There are a lot of different priorities to balance: your SO's sense of fulfillment in the specialty, location, the program director's attitude, salary, hours/type of call, etc.

Yr 4 Perspective of a Med School Wife: Me

Scott had his last day of medical school in April! I had my last day of work last week! Can you believe I am already writing my fourth year perspective?!

Yeah, neither can I.

I was not quiet about my feelings for this last year. Even with the emotional struggles of first year, this year in medical school would be ranked as my least favorite. Many of my friends had moved away from Oregon to be closer to families. Rotation scheduling, residency applications, and the match were stressful for me and Scott. On top of that, Scott only spent about ten weeks at home during this last year with a few weekends sprinkled throughout the year. But we made it! We're going to enjoy a month off together before graduation, and then on to residency and living in the same city together again!

Residency
Family Medicine in Milwaukee, WI

My Responsibilities
While Scott was traveling the country for rotations and board exams, I continued to work full-time in Corvallis. It is pretty incredible that I have been able to work at the same organization for the entire time Scott was in school. Working kept me busy and preoccupied while Scott was studying or out of town.

Since I finished my graduate degree last June, I found myself with more empty, dark apartment time than I would like in the evenings. I used that time to read, watch Downton Abbey, practice playing the organ at church, and continue my investigation on how nutrition plays a part in my autoimmune disease.

Supporting My Husband During Year 4
Internet research is a talent of mine, a talent that was fully utilized for Scott's benefit this year. Since COMP-NW requires that the scheduling of fourth year is done all by the student, I helped Scott walk through the process of applying for audition rotations. The school gave Scott some instructions, but together we created a spreadsheet of possible residencies and gathered the materials needed for the application.

Researching a list of possible residencies was easier after Scott had finished his first audition rotation. It happened to be a great audition site, so the experience gave him a better idea of what kind of residency he would enjoy. Scott knew from the beginning that he would like to go into sports medicine. We had originally assumed that the best residencies for entering sports medicine would be ones with connected sports medicine fellowships. However, we discovered after his first audition rotation that some of the most preparatory experiences were available at unopposed residencies that may not be connected to a fellowship. Searching residency websites for options that met these qualifications and had significant sports med experience as part of the curriculum was my task.

When Scott was on his audition rotations, I would ask him questions every day about how he felt about the site as a potential residency. How did he like the faculty? Did the residents seem happy? Did he think he would like the curriculum? These conversations helped prepare Scott for residency applications and interviews.

My research and organization skills came in handy again when we participated in the SOAP following the allopathic residency match.

In April Scott came home from his last away rotation. The last time he had lived at home (besides a few weekend visits) was September. Looking back, it's pretty incredible that we never felt like our relationship suffered during these away rotations. We talked almost every night on the phone. I asked a lot of questions to get Scott talking about what he had done during the day, even though hospital talk makes me squeamish. I had no problem talking about myself or what I'd been thinking about that day. When Scott's rotations were a little closer to home, we would make an effort to spend weekends together when possible.

Residency Applications
Applications for DO residencies begins in August of your fourth year, and the application for MD residencies typically begins in September. Last fall I wrote in this post about our experience applying to family medicine residencies with sports medicine experience in the curriculum. After a tedious search of residency websites we came up with a list of ten residencies that we felt would provide Scott with enough experience to be a candidate for sports medicine fellowships. Of the ten, we were hopeful that Scott would get an opportunity to interview with his top four favorites.

Residency Interviews
Interviews take place from October to February of fourth year. This time of year was particularly stressful for us, because on top of interview prep, Scott had to worry about scheduling required rotations with his obstinate school.

Scheduling interviews and travel was complicated as Scott had rotations planned through mid-December and only had four weeks of vacation time to play with all year. Scott interviewed with six of the ten programs, with his last interview taking place before Christmas.

COMP-NW provided an online resource for students to prepare mentally to answer residency interview questions.

The Match
Even though securing our residency was not the easiest of tasks, we are incredibly happy with the results. I described our match process in detail in this post.

Advice for Significant Others Beginning Year 3
If you are finishing your third year and your student hasn't already scheduled rotations for Year 4, check out my post about scheduling. I updated that post last fall with tips on what I think we would have done differently if we had had a second chance to schedule fourth year. Scheduling rotations can be incredibly stressful for your student. Scott had an idea for what he wanted his calendar to be, and then it was completely thrown off when each audition program came back with different dates. Encourage your student to be flexible and try to {be better than I was and} refrain from showering your student with questions about what is being calendared. Students have little to no control over the process.

Also, it doesn't hurt to remind your student to get all health records and immunizations up to date during the spring before their fourth year. These are required for audition rotation and residency applications, but it is difficult for your student to schedule a physical and shots when they are on away rotations. Best to do it now.

As for applying for residencies and what to consider for the match, there a couple things that you can learn from our experience. First, don't limit your residency application by location. We had hoped to stay west because both of our families live on the west coast. But when it comes to applications, you want to keep your options as open as possible; because it is more important that your student matches into a residency that will provide the training needed than where you live for three or four years. Travel may be expensive, if you are applying across country, but it's just something to take into account. Second, if your student is focusing his/her application on family medicine residencies, make sure it is clear in the application how committed your student is to the specialty, a priority rather than a back-up plan. Letters of recommendation should be from family physicians and essays should clearly communicate your students commitment. Competitive family medicine residencies want students who are committed to family medicine. We were probably not as clear as we should have been. Lastly, even though you hear that you shouldn't talk about ranking with residency programs, you can and should frequently mention it with favorite residencies. We didn't know that other students talked openly to their residencies about how the student ranked them ("Your program is ranked in my top five," etc.).

Fourth year is the worst, at least it was for us. Plan a vacation after your student's last rotation, before graduation, to celebrate your accomplishments!

Med School Update: The Match and SOAP

We're going to Milwaukee, Wisconsin for residency!

No need to leave you in suspense. I know you thought you'd have to scroll to the middle of my post to find out. What you didn't know was that the real juice of the story is yet to come.

For those of you who have been following along with our story from the beginning, you may be thinking to yourself right now, "I don't recall seeing any stars in Wisconsin on Katie's application map." You would be right. Scott didn't apply to any programs in Wisconsin... which means we had to scramble.

scram·ble:
1. To move or climb hurriedly, especially on the hands and knees.
2. To struggle or contend frantically in order to get something.
3. Applying and interviewing for unmatched medical residency positions in 48 hour time frame

***
Q: Why did the medical student order eggs for breakfast on Monday, March 16?
A: Because he was told to scramble.

*Ba-dum tssh*


Too soon?

Maybe. But we might as well lighten up the mood. Scrambling after the Match has a terrible connotation. I think medical students unnecessarily attach some of their self-worth to Match results. They apply to residencies, interview and are told from most every program "We hope to see you next year!", try to follow-up frequently with favorite programs, and have no choice but to put their trust in a computer algorithm to determine their future. Then when results roll around, and they are informed that they didn't match, it feels like they were dumped. How could it be that no one liked us as much as we liked them?

Both Scott and I were shocked to see that he had not matched with a residency program. He had excellent board scores, good grades, stellar reviews from rotations, and great letters of recommendation. He had even done audition rotations at sites we applied to and received encouraging feedback. We were sure that he would get into one of his top five choices for residency, especially since we had been told that students choosing to go into family medicine had their pick of residency.

My egg joke, however harmless, would not have been welcomed on Monday or Tuesday of Match week.

As many of you are likely curious how the scrambling process works, I will tell you. But allow me first to preface this process description with a fact - Good students can scramble into great programs. We feel that the residency program we scrambled into is possibly an even better fit for Scott than any of his top five match programs. We are ecstatic! Call it what you want, but we chalk up this happy detour to divine intervention.

There are two different matches, the allopathic match (MD/ACGME/NRMP), featuring residency programs accredited by the ACGME and the osteopathic match (DO/AOA/NMS), featuring residency programs accredited by the AOA. Osteopathic medical students may participate in either Match; and as mentioned before, Scott decided to apply for only programs in the MD match. This year was the largest allopathic match group in history, with a total of 41,334 applicants competing for 30,212 residency positions. More than 8,000 medical students were unmatched and participated in the Supplemental Offer and Acceptance Program (SOAP, a.k.a. "scramble"). Those numbers are for the MD Match only. The  MD scramble currently functions a bit differently than the DO scramble. In the scramble following the DO Match this year, students applied to and were interviewed for unmatched positions on a first come first serve basis. It is the definition of scramble, trying to be the first one to contact open residency positions and receive an offer.  Conversely, the main goal behind MD SOAP is to restrict applicant contact with residency programs through an application process, eliminating the first come first served “scramble”. I can't say how the DO scramble and MD SOAP will function in years to come, but I can describe our experience.

Ground Zero: On the Monday of Match week (MD), the medical students received an email letting them know IF they matched with a residency that they ranked. I was at work on Monday morning and Scott was in Hawaii in the hospital prepping for his sub-internship surgery rotation. He had just finished his early morning rounds when he received an email that he did not match and would need to participate in the SOAP. He forwarded me the email. Of course my heart leapt up into my chest as I imagined what he must be feeling. I immediately requested time off work to be available for him from home. Scott hadn't expected that he would need to take time off at all for the SOAP process, but I encouraged him to request leave from his rotation. Minutes later his school contacted him, knowing that he had not matched, and suggested the same, saying that time is of the essence as scramble decisions would be made in the next 72 hours. When Scott asked the surgery chief resident for an excused absence, the resident was very understanding, actually empathetic - the chief resident in Hawaii had even scrambled into his residency! He told Scott to take care of his future and not worry about returning to work until he was ready and able.

Scott's school had informed him that he could apply to 32 programs. He could apply to programs in the specialty we had chosen before or new specialties that had open positions. Their main advice was to not be selective, just try to match with any program. Once Scott and I reached computers, we logged into the NRMP match website in order to view available positions. Scott decided he would only apply to family medicine programs, as that was our focus for the past six months. There were 72 family medicine programs available with over 100 positions open between them. We briefly scanned the list and, considering the school's advice, applied to 26 family medicine programs without knowing anything about the programs except the program name and location.

Then we resurrected the spreadsheet. We had applied to what seemed like 80% of the available programs without knowing whether or not their program would prepare Scott for his desired career in sports medicine. Program curriculum became priority over location. Scott and I took the list of 26 programs from top-down and bottom-up, and we researched each program using residency websites and the AMA FREIDA database. We marked on the spreadsheet whether the program had sports medicine curriculum, OMM training, and noted if the program had a focus that did not fit with Scott's ambitions.

I'm not going to lie - day one of the SOAP was painful and an emotional roller coaster. However, working for 10 hours straight on researching gave us focus and determination that made us forget the email we had received that morning. Suddenly we were excited about finding the diamond in the rough. It takes some wading through the desert of programs with open positions to find a program or five that have matching desirable qualities. There were no interviews on day one of the SOAP, so there was less pressure to get the diamond before someone else stole it.

Interview Day: Again, Scott informed his rotation that he wouldn't be coming in to work on day two of the SOAP. I, on the other hand, had to work on Tuesday to distract myself from not being able to help. I made myself available to Scott by keeping my internet chat app up all day so he could type out updates between interview phone calls (I didn't want to tie up his phone line).

Scott was on interview calls all day long! He started receiving calls early in the morning - Eastern time and Hawaii time are not exactly compatible, but it was encouraging to be called. A couple programs had scheduled interviews with Scott on day one, but most of the interview calls came unscheduled. Initially Scott would receive calls from residency coordinators, like a pre-screen interview to see if he would be a good fit for their program. If good vibes were exchanged on the initial call, the program director would call him. Every program director wanted to know how Scott felt about their program, what he already knew about the program (booyah for the spreadsheet!), and whether he interested. Programs that recruited him hard made multiple (Scott says "like 50") phone calls on day two, including connecting him with current residents. It was clear that they were interested.

Not every program was so persistent. Of the 26 programs that he had applied to in the SOAP, Scott received interview calls from ten programs (this is where that "don't be picky" advice starts to sink in).

In EACH of the interviews, Scott was asked why he thought he didn't match. Specifically they asked why he thought he didn't match into PM&R (Physical Medicine and Rehabilitation specialty). Scott asked each of the residencies, what in his application had given them the impression that he was hoping to match into anything but family medicine. He had only applied to one PM&R program in the Match and had long ago decided he wanted to focus on family medicine.  He was told by each program, that there was a letter of recommendation in Scott's application had indicated he would be a great match for PM&R.

Now, we could play the "what if" game until the cows come home (what if we hadn't applied to PM&R, what if we had applied to more programs from the start, what if we hadn't narrowed our scope to the western US, what if he had followed up more frequently or bluntly with his favorites... you get the idea). Whatever it comes down to, there was something in the system that caused Scott to be ranked lower on competitive residency lists, and we didn't match.

Rounds of Offers: Wednesday morning following the initial Match notification brought the first round of offers from SOAP programs. The night before offers were extended online, Scott and I discussed scenarios. There are multiple rounds of offers, so there's always the concern that you might accept an offer in round one when a better program offers in round-two or three. However, the residencies that make you an offer in round one are basically saying "We want you, and we don't think you'll be available in round two." It would be taking a big risk to hope that someone else would decline a first round offer in order for you to receive a second round offer from a better program. Scott could take two hours to consider each round of offers. There were a few programs that Scott felt would make an offer in the first round, and when offers came through online he had two offers, both  good programs with sports medicine in the curriculum. The program in Milwaukee offered Scott a position in the first round. It was a front runner in our SOAP research, possibly a better fit for training than Scott's first pick in the Match. We accepted, of course.

Signing the residency contract in Hawaii

We feel blessed and could not be happier. I hesitated in asking Scott if I could post this story on the internet, because I knew how painful the initial Match results were for him. When I did finally ask, Scott said I could because he is going to a wonderful program and it doesn't matter how he got there. Agreed. There should be no shame in going unmatched and finding your own residency.

Now if you'll excuse me, I'm going to start planning my future. *insert mischievous grin*