Monday, March 23, 2009

What Capstone Taught Me

-First, I am even more scared to get sued than I was before. I don't think that is what they were going for with their "Don't worry, you can avoid getting sued" talk.

-By the way, malpractice insurance is frickin' expensive.

-Also, it now seems inevitable that I, or someone I know, will develop a drug or alcohol problem. If it is someone I know, I will be forced to report that person to the Medical Licensing Board and potentially ruin their lives.

-Say what you will about the MD/PhD pathway (Lord knows I have), but at least I am not well into six figures in debt like my classmates, who will have to work just as hard as me (who am I kidding, I'm going in to Derm... they will have to work harder) and be much poorer for a looooooooong time.

-Docs sure do seem to get the s*** end of the stick.

-I figured it would be awful to have to tell the family of a patient that their loved one might die because I screwed up; standardized patient family members have helped me realize that "awful" is the understatement of the year.

-Sometimes, there are patients who have had bad health care experiences who have a lot of valuable things to say. And sometimes, there are patients you want to smack because they clearly think they understand what happened to them, but in reality they got most of their information from qacks and you have to listen to their ridiculous nonsensical ramblings about how awful doctors are.

-Apparently--and this TOTALLY blew my mind--it's a bad idea to have sex with one of your patients, especially if that patient has borderline personality disorder. Holy Cow! I am so glad I sat through an hour long lecture to learn this gem, because otherwise I might have gotten into real trouble!

-Residency is hard. No, seriously.

-You won't have time to take care of yourself, but you owe it to yourself and your patients to take care of yourself. Whatever that means.

-Finally and most importantly: I am completely done with medical school. Holy 8 year training program completion, Batman!

Friday, March 20, 2009

Dr. VonB is a lucky, lucky girl

Well, I am still in shock, but I have managed to get everything I hoped for. Yesterday I found out that I matched into my top choices for preliminary year (pediatrics) and my advanced year (dermatology)!
Match day was kind of bitter sweet. Lots of friends leaving, lots staying; lots got what they wanted, some were disappointed. I was a lucky one, getting what I wanted, sticking around. I'm sure I will be even more excited as days go on, but for now I'm kind of still in stunned disbelief.
Here's the thing: I can't tell you how excited I am about dermatology!! I love, love, LOVE it. It is just about perfect for me. I've said it before, but I get to do everything I love. Great diagnostic work, surgery, and kickass immunology. Plus, my daughter will probably even know what I look like!
As for intern year, I am also very excited, but nervous. It's such a huge leap, going from not doing anything without four levels of permission to basically being able to make decisions on my own. Also: the hours. Scary. And even scarier... Capstone has given me a very clear understanding of just how much stuff I've already managed to forget in just a few months. But I'm not thinking about that now. Right now all I'm thinking about is packing for a short, weekend getaway with my hubby which we have been looking forward to for months. :)
For those of you out there who matched, I hope you are as happy as I am. For those with the match still ahead... sitting on this side of things, I can tell you that keeping up with that hard work and studying does pay off! Hang in there! And enjoy the first day of spring.

Thursday, March 5, 2009

Changing gears, Step 2 CS, and OHMYGOD MATCH DAY

Well, clearly I have not been 100% on top of updating this thing, which is probably appropriate since things will be moving on soon. I have been trying to decide if I will blog about this next great phase in my training--moving from being a student to being a resident--and I'm undecided. With a baby on the way and a husband who will also be an intern, there may not be time. On the other hand, Lord knows I always have lots to say.

These days things have become considerably more peaceful. It's nice, but almost frightening--I feel as though I keep waiting for the other shoe to drop. My husband has completed chemotherapy. He gets his port out soon and in another couple of months will have his follow-up PET scan. Waiting for that is certainly a source of anxiety; I try not to think about it, and to just rejoice in seeing him slowly return to his old self. Another huge source of anxiety, which was finding appropriate child care for next year, is now gone. We found a wonderful situation which we both feel great about, with the tiny exception that it will take MY ENTIRE RESIDENT SALARY to pay for it. That's right, folks. My. Entire. Salary. Repeat after me: MD/PhD training is worth it... MD/PhD training is worth it... MD/PhD training is worth it...

The following year we will probably be able to use considerably cheaper child care, but for now this is really the only way that we can both do our jobs. I keep reminding myself that this is still an investment, and that one way or another we will be able to survive on one resident's salary. Hey, it isn't really that different than what we did before, so I guess we'll be okay.

The big YIKES on the horizon right now is: MATCH DAY. Yipe. I think that a week from Monday is when we learn if we matched or not; official Match Day, where we learn where we will be, is March 19th. Now, I know that a lot of MS4s out there are feeling anxiety about this, but allow me to put it in perspective for you: I applied to dermatology. And ranked two programs. TWO. It is the height of madness, but luckily, I have to say that the PET is scarier, so there you go. In any case, hopefully I will at least have a prelim spot for next year, and if I am a REALLY lucky girl, I will have a place to call derm home after that. One way or another it will be nice to know for sure.

I also took Step 2 CS. I don't want them coming after me so I won't say anything about it except that I expected it to be really stupid, and it exceeded those expectations like a champ. I have never been forced to do anything that was such a racket, so pointless and aggravating, in medical school or graduate school, and those of you have done either or both know that is saying something. I urge anyone with the power to do so eliminate this charade, this rip-off disguised as an exam. Everyone knows you make us do it for the money. Why give us that final slap in the face after we've crawled through the sewer tunnel to graduation? I'll say no more.

These days I am all done with rotations, and am back in my dissertation lab for a while to help out with progressing my old project. Going back to research, changing gears again, is a strange experience. It's both harder and easier than I thought it would be to come back to it. My main issue right now is fatigue. It's hard to focus, hard to care as much as I did when I was here almost two years ago. I'm trying, but it ain't easy. It's also interesting to see how my perspective has changed with just a few years of clinical work under my belt. It's a good thing, and it makes me more certain that in the end I've done the right thing with the MD/PhD. A nice place to be.

No other big insights here for now. I have a Capstone course coming up, and my forecast for that is Stupid with occasional chance of Helpfulness. It sounds like most medical schools have these, so I might post a little something there. Also expect a triumphant or tragic post regarding match results. And wherever you are, whatever stage you are in, I wish you godspeed in your endeavors. We all have it pretty tough no matter where you are in this drawn out hot mess of physician-scientist-dom. Hang in there. I can honestly say that things keep getting cooler with each passing year.