Wednesday, August 30, 2017

2 months in

Hi guys!!!

Just a quick update: I'm still alive! Lol

This is the last day of my 2nd month of Intern Year! Time is going by so quickly; it's hard to wrap my head around it. The days are filled with excitement, anxiety, stress, uncertainty, laughter, teamwork, and patients (of course!). My Co-Residents & I are getting our bearings, gaining some confidence, and realizing we can actually do this! Then a nurse pages you and instantly you second guess everything, rationalize everything, go thru every worse case scenario in your mind but still manage to come up with an appropriate response/plan and all is right in the world again. That's the best way I can explain how many of these days go. 

I've already rotated on the In-Patient Medicine Service and Pediatrics and have spent some time in Clinic. Peds really consists of following the babies in the Newborn Nursery...I get to cuddle all the little ones every day!!!! I only see the newborns because most hospitals in our area refer all sick kiddos to the Children's Hospital of Wisconsin (CHW) for care in the case of emergencies and hospitalizations. I actually start my next rotation at CHW on Friday, pray for me!

Can you believe patients actually make appointments to see me? Yeah, I can't really believe it either but it's happening and it's actually pretty cool! I officially have patients ha!

I'll be sure to check in after the Children's Hospital Rotation and let you guys know how exciting (crazy & scary) it is. I'm sure it will be tons of fun and a huge learning opportunity. I'm looking forward to working with a whole new group at an entirely different facility--fun, fun, joy, joy😱. 

That's all I have for now. Best of luck to all the 4th year Med Students applying for the Match this coming season! Enjoy the journey. Hopefully I'll see some of you passing thru my program this fall during Interview Season. If you see me, don't be shy :)

Until next time......

Saturday, July 1, 2017

New Beginnings--I'm an Intern!

Ahhhhhhhh, Today-July 1, 2017 begins my Intern Year!!!!
Totally can't believe its here.
But before New Resident details let me recap what's been going on since Match Week; because I think thats the last time I posted.  I don't know how that happened! I'm gonna try to do better. Really....

So, first--GRADUATION!!!!! Woooot wooooot!





Graduation season was a ton of fun!
My family, friends & I went back to St. Maarten...where it all started.  It was great being on the island without worrying about school, studying, applications, or interviews.  It was just fun in the sun, reconnecting with classmates, and enjoying everything the island had to offer.

I stayed for 3 weeks and went to the beach as much as possible!!!! I'm looking forward to going back.  I LOVE that island!

Aside from graduation, for the last few months, I've been vacationing & getting organized for my start of Residency.  


Now, about Intern Year--it's here! 
I made it to Milwaukee and got settled in, met my new Co-Residents & had Orientation this past week. My Resident class is super cool! We all get along so well and are all really happy to have matched into our program.  
Our Seniors & Faculty are ridiculously nice and have done everything they can to help us feel comfortable and get acclimated to the program. 
I almost feel ready to start, hahahaha.  
No, seriously, I'm as ready as I can be for this next step.  
We've studied & prepared, gotten office space, business cards, LONG white coats & even the dreaded pagers--and now it's time to get down to business...
Tomorrow, lololol.  That's when my first shift is.  So I have a few more hours to wrap my head around the fact that I'm starting my first job as an MD.

Let's go!


Until next time...


Monday, April 17, 2017

Road To Residency--10 Helpful Tips for IMG's

Just like the journey to and through Medical School is long, settle in a while because this post is long also.  
For the non Med Student/Potential Med Student readers: I apologize in advance...this post will totally bore you! You should come back when there's more fun things to read & more pics to look at. 

For the Med Students: It's definitely a lot to absorb all at once but hopefully you pick up a couple points that you find useful in your quest for Residency. 

By no means am I an expert when it comes to being successful in the Residency Match process however here are a few tips/suggestions to help with the process as an IMG (International Medical Graduate).

1. What Kind of Doctor do you want to be? Have you always wanted to go into a particular field? Which rotations did you like best/least as 3rd Year Student? Determine which specialty you want to pursue additional training in and learn more about it. Ideally you have been thinking about this and have some clue by now. Schedule Sub-I's early in 4th year because those are often rotations students get LOR's from.  More on those later. 

2. Be Realistic. Realistically assess your scores and see how that aligns with the averages in the specialty you wish to pursue. I'm all for people chasing their dreams. If you have always wanted to specialize in a field where your scores aren't as high as the specialty average, apply VERY broadly and consider applying to a backup specialty as well. 

3. Look at your school's Match history. Most schools publish lists of the Specialties and Programs their graduates have matched in. Use this list as a guide for where to apply. If graduates from your school have matched there, you have a good shot at matching there as well. While you're at it, check the websites of other International Medical Schools as well to see the programs where their graduates have matched, those programs are likely IMG friendly as well!

4. Check the list for unmatched programs. The NRMP publishes a list of every single program and specialty in order by State. It shows how many slots were available and how many were filled for the last 5 years.  Programs that went unfilled are great programs to consider applying to because they may be more willing to give you a chance as an IMG. Here's a link to the 2012-2016 list: NRMP Program Results 2012-2016 Main Residency Match

5. Get your coins ready NOW!!! If you're still on campus, start saving. If you're doing clinical rotations, save whatever you can for the time you have left.  I suggest you save your money for Residency searching in a separate account. I was able to save a little every semester and used that to finance the application season. I spent about $7,000 on Residency search associated fees: ERAS and NRMP fees; travel-plane tickets, hotels, rental cars, tolls, gas, Lyft, Uber; food; clothes & dry cleaning and whatever other misc interview associated expenses came up. Without that savings I would have been in trouble! After The Match is over, if there's any money remaining in that account, put it to good use...like moving expenses to wherever your residency placement is! Or use SOME for a post Med School Vacation like I did!!!!!  The rest will help with those aforementioned moving expenses.

6. Apply as broadly as possible. I can't stress this enough!!!! Apply to as many programs you are eligible for and your budget can handle--within reason! US students apply to about 30 programs or less. Even if you have the exact scores/grades as a US student, IMG's don't have that luxury. We're forced to apply to many more programs in order to have a shot at Residency. Most IMGs work just as hard, if not harder, to have a seat at the table. It's not right, nor fair but it's the reality we're faced with until things change. I think as more IMGs continue to match at these great programs, the attitudes of many Program Directors will shift. But until then, this is what we have to deal with. You don't wanna be cheap at this point bc the prospect of having to pay ERAS & NRMP registration costs & fees and interview related expenses again is not an easy pill to swallow. The IMG's I know have applied for anywhere between 50-200 programs.  If your scores are lower or you had to re-take any of your STEP Exams, you may end up closer to the higher end of that range.  

Oh! And be sure and apply to your dream program even if they don't usually accept IMG's!!! You will kick yourself if you don't give it a shot. You never know what can happen. 

7. Write a great personal statement. One that's original and talks about you, your motivation for why you want to pursue a career in medicine, why your chosen field, and where do you see yourself practicing in the future. Write this yourself! I don't know why anyone would pay someone else to write their statement but there are services available. Don't do it! Who can convey your passions better than you? This is where you can show the selection committees who you are. If you have blemishes on your academic record, explain them & mention what you learned and/or how you overcame difficult situations. Be honest & concise and then move on. Experts have suggested staying away from controversial topics (think religion and politics), super abstract pieces, and long drawn out stories. 

Make your statement succinct, about 1 page in length, and be sure it contains no errors. Have multiple people review it and ask for critical feedback. You may have to write your statement multiple times, I sure did. I had 3 different statements with totally different approaches before settling on what I wanted to write. Once I was sure, I re-wrote, and fine tuned it about 10 times! Seriously, maybe more than that. But I was satisfied when I was finished. Once you have a statement you're satisfied with, accept that you may still need to tweak it for different programs.  Be sure to check each programs website because some require specific things to be included in your statement.  Don't count yourself out for something silly like not following directions.  You can upload as many Personal Statements as you want into the ERAS Portal and then assign them to the various programs as you see fit.  I ended up with about 6 different versions of my personal statement.

Most medical students are smart. Grades and test scores may be similar. Your personal statement is one of the only things you have complete control over and the best tool to set you apart from everyone else. The statement is important, period. 

8. The early bird gets the worm. Prepare your application so that it will be submitted on the first day that application season open: Sept 15th (this date may change when it falls on a weekend, so check the dates on the ERAS website).
What does prepare mean?? It means have a COMPLETED application ready--STEP 1, STEP 2 CK, STEP 2CS, Personal Statement, LOR's, & EGFMG Certification. The MSPE (aka Dean's Letter) won't be released by the schools until Oct 1st so don't worry about this. Just be sure everything else is uploaded and submitted well in advance so a complete package can be transmitted on Sept 15th. 
Here's the thing--can you submit without all of the exam scores? Sure. 
Should you? No! 
As an IMG/FMG, you will give yourself the best shot at getting the maximum number of interviews if you have a complete package when the programs start their reviews. If you can't submit your app on the first day, get it in as soon as possible after Sept 15th.

About those LOR's: You usually only need 3 and 1 of those must be in the Specialty you are applying for.  Some specialties (like EM) have more specific requirements, so verify what you need early! You may need to restructure your rotation schedule to make sure you can get the letters you need. 
Start asking for them earlier than you think you should because some letter writers take a while to get them back to you. Ask while you are almost finished the rotation/still at the hospital if possible.  If it's in your 3rd year, ask the Student Coordinator if they can hold the letter on file for you until it's time to be submitted to ERAS. 
When you request a letter, do it in person if you can and then follow up with an email.  In your email consider including the following info:
-remind them who you are, thank them for agreeing to write you a strong letter of support, let them know which specialty you're applying to, your AAMC ID
-if you received positive feedback from the Residents or other Attendings during the rotation mention it
-provide a brief CV for them and be sure it includes the dates of your rotation
-a copy of a rough draft of your personal statement if you have it available (see, starting early helps)
-a picture of you in your email signature/attached, especially if it's been a while since your rotation or if they have many students
-in the email body tell them what attachments you are including
-the date you would like them to have the letter ready. I would suggest July 15th! Maybe it will actually be ready by Aug 15th. Seriously.  
-ERAS Letter upload info (pdf). You will be able to generate this once you open an ERAS account (registration opens in early June)
-Include your contact info and ask if they need anything else 
-include the contact info of the Student Coordinator if they will be uploading the letter for you
Follow up 1-2 weeks before the due date you mentioned and ask if they have questions.  Let them know that you will forward the ERAS Recommendation Letter upload information to them once your account is set up and they can upload the letter directly.  

9. Prepare for your interviews. Interview invites are sent out as early as Sept 16th!! When you're invited for an interview, respond immediately! Set email alerts on your cell phone so you get the invites and can reply right away.  Put all of your interviews on your calendar and be sure to note if there's a candidate dinner the night before and if the program will cover any lodging expenses. I was fortunate and quite a few programs helped with this cost!  Keep this info handy when making travel plans. 

Try to schedule interviews as early as possible in the season--your clothes will fit, you will be fresh, and you won't seem disinterested. As additional invitations come in you can add them later. Schedule interviews at less preferred programs early so you can get some practice and get over any nervousness.  Contact programs that are in the same area and see if you can interview around the same time to save on travel expenses. By strategic scheduling, I was able to interview with 3 Michigan programs in the same week saving on hotel and plane ticket costs. 

Get a few interview outfits ready & don't be afraid to show a little bit of your own personal style.  
Review common interview questions in advance. 
Review the program websites a few times before going on your interview and make a list of questions to ask the Program Directors, Residents & other interviewers. Jot down notes immediately after each interview so you can look back on them later. Send thank you notes/emails to programs post interview.  If you have additional questions for the programs, reach out to them with the contact info provided on interview day. 

10. Get ready for the Match! Don't forget to register for NRMP, which is separate from ERAS, before the early deadline, the fee was $75 this year. You don't want to waste money on late registration fees. Determine how you want to rank the programs you've interviewed at and rank them accordingly. Rank your favorites at the top. You have nothing to lose by ranking a top tier program high on your list. Be sure to submit your Rank List and certify it by the due date! Don't be like that well known Cardiothoracic Program in NY that didn't submit their Rank List by the deadline this year. 
Once you certify your list, pat yourself on the back for getting through a crazy few months and enjoy the last rotations you may have as a Medical Student. 

Also, try your best not to stress too much while waiting for Match Day. Hahahahaha, that's a joke right!?! I know...It's much easier said than done but for your sanity you have to at least try.  

One last thing...if you don't Match and need to SOAP, be prepared. The NRMP will send you an email letting you know your eligibility to participate in SOAP a few days before Match Day. SOAP is the supplemental offer and acceptance program for unmatched applicants. This is where unmatched applicants apply to programs that didn't fill all of their spots. This is another way for students to secure a spot. Sometimes it's in a field other than their original choice but it's still a Residency spot! 

Whew, I know that was A LOT of info!  This process is no joke but being organized & prepared will serve you well! GOOD LUCK!!!

Students: What other questions do you have?  
Newly Minted Residents: What other tips do you have for students??
Leave them in the comments. 

 Until next time... 

Saturday, March 18, 2017

MATCH DAY SUCCESS!!!

                                                #AUCMatchMadness

What a surreal week it's been! 

I found out on Monday-March 13, 2017 that I Matched!!! Woooohoooooo!!!!

Then on Friday I learned where I was headed...I'm going to Milwaukee, Wisconsin! I Matched in Family Medicine at my #1 Choice!  I couldn't be happier!  I applied to a bunch of places and interviewed at quite a few.  I met some really nice people along the way.  The programs were all very good and I would have been satisfied with Matching at any of the places I interviewed.  Honestly!!  I can fit in just about anywhere as long as the situation isn't totally toxic.  I get along well with others. And I'm no stranger to working hard.  

There was just something extra special about this program that resonated so strongly with me.  Actually a few things: a huge focus on community outreach and engagement, Residents can tailor their learning to what they want to do in the future, and they support Global Health electives.  Win-win-win for me.  I'm thrilled I matched with them and I'm looking forward to starting the next phase my career there!

But before all that, I have one week left of school :|

I have a post planned on a few strategies I found helpful when preparing my ERAS application, applying, and interviewing, so check back soon if you're preparing for the 2018 Match Season which opens up in just a few more months!

Thanks for all the support and well wishes. Until next time....


Wednesday, March 8, 2017

5th Semester questions about Clinical Rotations in the UK???

Hi!  

A friend of mine, Dr. C (DOCTOR!!!! ahhhhh, I'm so excited) is working as a Clinical Fellow at AUC this semester.  He asked if I could answer a few questions from some of his 5th semester students about my UK clinical experience.  This was a super informal discussion but they said it would be ok for me to share the info in case their questions or our answers can help another student decide if the UK may be right for them!  

The conversation took place over a group chat...

Dr. C: Hey ParadiseMed, I have a few students that are interested in going to England for Core rotations. I talked to them about my experience at Ealing and I would really appreciate it if you share and/or answer any questions they might have about Romford.

ParadiseMed: I thought doing cores in the U.K. was a great experience. I don't think it took away from learning or opportunities compared to US students. We got lots of hands on experience and going over there has in fact been a welcomed talking point during residency interviews.

Students: The Romford Site is back and will be seeing their first round of AUC students soon. We are current 5ths and are looking to start clinicals in September. There is a little difference with Romford now tho...they have "buddy paired" with a psych hospital in Baltimore (Spring Grove) since they do not have their own psych rotations.

I would like to know what you thought of the Romford rotation (hospital, staff, your schedule/experience) as well as the overall area of Romford for housing and such. I'm married and my spouse will be joining me for a long as possible (most likely 6 months with the current visas)


ParadiseMed: I thought the site was good. Huge hospital. Lots of opportunities to participate in things. U would likely be at Queens (aka "Romford) and King George's hospital (we did Medicine there). They have every department and tons of patients. The Consultants (Attendings) are great. The working environment is great. The junior docs are very nice. And ppl are willing to teach you.

I didn't live in the hospital affiliated housing bc the lady never returned any of my inquiries. I found a house share abt 1 mile or so away from the hospital not too far from Romford town center. I'm using that "town center" term very loosely. I found housing on spareroom.co.uk

The Romford site is abt 30min outside of Central London. Transportation is easy. Life was pretty good over there. One caveat is you really have to be a self starter. No one will really hand you anything or have some of the types of expectations as in the US. But they will work with you when they see you're interested and engaged. You can see/do whatever you're interested in. You wouldn't really be limited by more than ur enthusiasm. 
I had a great experience and I recommend it for the right types of ppl.
It can get lonely being away from home and family. But you will also meet lots of ppl and make new friends from everywhere. You also get the experience of living in yet another country. Not sure how the visa thing will work for your spouse...I know some things were changing recently with that so look into it before you commit.


Students: It sounds like being forward and showing initiative is needed for most the rotations in the U.K.. I've had that explained to me from people at other sites too.

What's the cost of living? Rent, bills, food, etc? 

It seems like even in the UK, students are rotating within different hospitals, is that right?

Any other "cons" jump out at you, besides the "self starter" aspect?

ParadiseMed: Yes...there are like 6 different sites (maybe more)

Cost of living there is pretty pricey! Almost like SXM prices when it comes to rent for sure. No one usually lives on their own bc it's so expensive. House shares are the norm not the exception. The hospital housing may be a little less expensive. But imagine dorm living...again...dorm furniture, decor, everything. I walked in (while visiting a friend) and thought I was back in my college dorm building.

Food can be found affordably depending on if ur cooking or eating out. It's not as bad. U also have to factor in the exchange rate to see how far your $$$ will get you with ££

If you budget you can survive with no prob. If you don't, u will run out of money lol. If you travel, u will run out of money even faster! But it was all worth it😃😃

Students: The spare room site you gave us...did you run into any issues with that? Do people on sites like that make you sign a certain lease? I'm just thinking ahead since we are only there for like 9 months-ish

ParadiseMeD: Some want a 6mo/1yr lease. Others will do month-month. If u explain ur situation they are willing to work with you. I "toured" my place via skype and then paid a deposit.  

I'd have to think of other "cons" but none jump out at me right now.

Students: Any other sites popular for housing?

ParadiseMed: That's all I used. They have more than 1 million rooms available. Granted, they are in all different parts of the country so depending on the site u choose, you should be able to find a room if u don't use the hospital/Ealing sponsored housing.


Dr. C: I have told them as well, it was a great experience. You have to show initiative and you will enjoy your rotation. You are part of the team and they will welcome you with open arms. At Ealing, one of the cons was that we have paper charts but you will get enough education. Most of the service was closing at Ealing so I finished the rest of my rotation at Northwick park, which was about 20 min away...and like ParadiseMed said, it is a great topic of discussion when you are on the interview trail. I can say for sure that I have talked about England during all my interviews, like all of them.

ParadiseMed: We had paper charts as well at King George's and Queens.

Students: I'm sold on the U.K., now it's just figuring out our preferred locations. Not sure how it was for you, but for Romford's schedule there are no breaks. You just plow right through all your rotations. I'm completely fine with that since we are September class and our rotation times are "crunched" to say the least lol

Dr C: Even at Ealing, the longest break I had was 2 weeks

ParadiseMed: Yeah, no real breaks.
If u want to try to match in 2019??? U will have to be on top of everything. You won't have time to take off to study for comp or Step 2 CK or CS. If ur a person who requires that extra time, think about that before deciding. Entering that years match will also depend on how long you take off to study for Step 1. Just think about all of those things. If u find u can't make the match the year u want, u can extend ur rotations and apply the following year. It's much more important to do well on your exams than to rush to enter the Match.
Seems crazy to have to think abt Step 2 before even taking Step 1 but u have to keep everything on ur radar.

Students: Our COMP is in 29 days.

ParadiseMed: STUDYYYYYYY!! So u can enjoy the last month on the island!!!

Good luck on the Comp everyone!!!



That's it for now....What other questions do you guys have about Clinical Rotations in the UK???





Tuesday, January 31, 2017

Residency Interview Season & The MATCH




Long time, no see!
I know, my poor blog has been neglected.  I'm trying to figure out who's been reading recently even though I haven't posted anything lately, hmmmm.

I think I have a decent enough reason to have neglected my blog for a little while...I've been away interviewing for a Residency job!

Over the weekend, a family friend asked how come I haven't updated my blog recently, so since someone is reading, figured that was as good of a reason as any to give an update on what's been happening in my crazy world. 

I have been totally out of touch and actively avoiding almost everything that didn't have to do with job searching and school.  Feels like my entire life has been put on hold.  Wait, honestly, I should be used to that feeling because it's been almost a constant companion since I started Med School!  I think I've been actively avoiding anything that I didn't absolutely HAVE to do. Kind of wishing I could avoid the mandatory things as well haha. 

Back to this job search thing...It's a long, arduous & expensive process! 
The application period opened in July, I submitted apps in September, and interview season is usually October thru February. 

Submitting the applications cost me thousands of dollars...YES, THOUSANDS! As a IMG (International Medical Graduate--a US resident who attends medical school in another country), we often apply to more Residency Programs than US Grads.   Some people/programs still have a negative view of foreign trained doctors. In years past, there were a lot of foreign medical schools that weren't up to par.  However, in the last 30 or so years, many International schools have stepped up their game. They have obtained equivalency to US Med school standards and they are producing high quality physicians.  This doesn't quite matter in many circles because once something is in someone's head, it's very hard to change their minds.  But slowly ideas have been changing as programs interact with these students/doctors and they realize most of us are hard workers that can hold our own next to a US student.  It's a systemic issue, but I digress...

Because of this warped way of thinking, IMG's are often forced to apply to many more programs than US students in order to get enough residency interviews to be able to MATCH. That's another one of these nebulous ideas that many normal humans can't contemplate. MATCH for us means applying to a ton of residency programs, interviewing, then ranking each program you interview at, electronically submitting this list to a central organization who then has some sophisticated computer algorithm that collates every students lists-- compares them with how the various programs rank students, and then the computer spits out a "match".  Sounds ridiculously confusing right?!?! It's crazy! Most people think if you apply and interview for a job, if the company likes you and you like them, they can offer you a job and you can choose to accept or not. This process is nothing like that. What's in our control? Submitting a strong application, presenting our best selves to the interviewers, and seeing how well we mesh with the current people in each program.  Despite this, it feels like your fate for the next 3-7 years is up to a COMPUTER. In many ways that's the case. In many ways it's not. But in the end, the computer decides where you will train with input from us and the programs.
  

Between Nov and Jan I interviewed with Family Medicine programs across the USA. All of my interviews are finished--thank goodness! I've submitted my Rank List & now I just wait....

I have 7 weeks and 3 days left of school!!! I'm close to being finished but I also realize how much I still just don't know!!!! Residency will be the time when things will really start to come together. We will really learn to be doctors in our chosen fields. Right now I'm still in a bubble of no real responsibility but that will all change in a few months so I'll enjoy this time while I can.

Oh! Did I mention that MATCH DAY isn't until March? You see how I just left you hanging about Match Day for a minute? That's how we feel for weeks. 
This year, it's Monday, March 13th. That's the day you find out IF you Matched. Then Friday, March 17th you find out WHERE you Matched. They love keeping us on edge! My nerves can't take too much more of this. 

So that's my story of why I've been MIA. But now I'm around, sort of...
I'm super anxious about MATCH DAY.  We've worked so hard over the last 8+ Years (11 for me bc I have a Masters degree thrown in the mix as well). Now I'm just waiting for March 13, 2017.  Those of us that applied are hopeful the fruits of our labor have paid off with a coveted Residency placement. Please continue sending positive vibes that everything will work out just fine!


Until next time...