Nights Are Awesome!

I’m surprised to find myself saying this but I’m actually in love with the night-shift inpatient rotation so far! Granted, it’s been very very slow on the ward (things you’re not allowed to say out loud but I don’t believe in that vudo shenanigans) and after that first night, which was much more busy and crazy, things have been pretty much going at just the right pace for me to keep up and have a little extra time to do some reading on the side. Tonight’s topic was gastric outlet obstruction since I got to experience that diagnosis for the first time tonight! Which was pretty neat, …though of course not for the patient… praying for them!
Getting to and from work on nights takes about half as much time, that alone is a huge relief. I hate traffic with a vengeance! 


And I get to stop and notice the beauty around me a little more as I’m not so consumed with the sweltering heat and insanely crushingly long lines of cars and stop and go traffic! Also the weather has been fantastic in the morning drive homes – been rolling down the windows, taking in the fresh air. 
Course I do miss my Andy man… he gave me the oh so sweet present of his attention and joy when I awoke and emerged from my hybernation yesterday afternoon, greeting me with a huge smile and jumping down from his chair to hug me and the preceded  to sit on my lap and smile up at me. The little sucker! 


I miss him and the hubby loads and the in-laws- whom I am barely getting to see while they visit… yes these are the down sides. 

But I am mostly struck by how pleasant it’s been… I suppose I waisted so much dread over it, only to find it’s not so bad when the nights not busy! You get to run around the hospital, not confined to one little space or area, pretty much do completely random and new and interesting things all night! I so feared not knowing things and being ridiculed for it, I was totally wrong to fear that because the peeps I’m working with are so awesome about giving you pointers and help figuring out how to manage the ward! So I feel very blessed… and hope that this post may put to rest fears in new intern to be’s in the future or interns about to start on nights!

Starting Residency – on Nights

I’m only two shifts in, so I can not speak in great depth about the adventures of being a new intern on nights.  But wanted to post a short update anywhoooo…

 

Getting on the correct sleep schedule wasn’t too too bad, I slept in later than usual on my first day (went from getting up around 5:30/6 to getting up at about 8am) and then I took a quick nap in the afternoon while Andy was out for his nap.  But I must say, I was quite fuzzy and drunk feeling by the end of that first shift.  By the time I hit the hay – it was 8am and I had stayed up about 24 hours total, because I got off work a little later than I was supposed to – worked for 14 hours and it was only supposed to be a 13 hour shift (many programs, even to this day, have something more like 18 or 24 hour-long shifts for the resident, and yeah I’ve been told countless times that it was even worse, “back in the day” before duty hour restrictions! Oy, I can only imagine!).  I mean I do remember everything that happened, I wasn’t that out of it, and I remember feeling pretty coherent, however, it was a very slow and cumbersome version of myself I was having to work with.  In addition, I was trying a lot of new stuff and running into countless strange road blocks/new challenges along the way and my brain was ever so reluctant to confront them!

 

I extremely was blessed to work with a very kind, thorough, methodical, and organized senior resident, who not only offered support in every challenge I faced but showed me both by example and by walking me through the various new tasks residents must accomplish – such as how to properly admit patients, how to address nursing concerns on patients experiencing short runs of V-tach, or fevers, or fussy sick babies, as well as other night-shift-type duties.  This helped immensely!

 

Among my new tasks, one of the first was answering calls from the nursing staff.  Unsure of myself initially, I answered with a, “Hello, this is Captain Bier?”  And gradually throughout the night I started to remember to answer with a slightly more confident version of that phrase, making sure to call myself Doctor instead of Captain, as no one really goes by rank when doing any kind of patient care!  I got calls about critical lab values, about patients needing sleep aids, or antipyretics… I learned to make a couple decisions on my own, and a bunch with the second opinion of my senior resident, and even one where I did a quick exam of the patient and called the attending to get his input on a decision.  It felt really good knowing I wasn’t on my own to deal with things with which I wasn’t comfortable flying solo.  I was just a little concerned, because I didn’t feel like I knew when it was ok for me to decide something on my own – as a result, I would always go back to my senior and tell him what had happened whenever I had made a decision, kind of my way of asking/testing him out to see if what I did was appropriate.  He never gave me the impression I was doing too much on my own, so I supposed that’s a good thing.  Hopefully I will get better at this…

 

As I said, I only worked two shifts – and then I got two days off!  Was a glorious little “weekend,” especially as it was the 4th of July in D.C.!  Got to spend some marvelous quality time with the fam, which was great… sad that tomorrow it all must come to an end and despite the fact I now have my in-laws in town visiting, I’m sure I’ll hardly see them, as I have to work!

I can say that going from medical student to intern has been pretty exciting!  Walking in on day one was yes of course very intimidating, but it was crazy the difference between how I felt walking in that first day and walking in the second!  So much more confidence and excitement for the shift to come!  Don’t get me wrong, I was still in a state of being constantly slightly terrified haha, but it’s just so cool to finally be able to say that I’m a doctor and I can finally sign stuff and get things moving.  Yes, there are people above me, who are still signing on that bottom line of a lot of what I do, but it’s definitely different, and more engaging than it used to be as a student.  Also, I feel like I can be myself more because I’m not in a perpetual state of interviewing for a job anymore, feeling like I need to always be searching for what they want me to say or do.  Instead I’m thinking more independently and making more sincere friendships with those around me.  So that’s exciting!

Well I’ve accomplished my goal to stay up until 1am, now it’s time to climb in bed, and tomorrow twill be: nights – day number three!

Quick Summary of How the Match Went!

For those of you who don’t know, I am now heading into the final week of this month long orientation to the Family Medicine Residency of …my top choice program! Fort Belvoir!  I was talking to a med student the other day (oh haha, I remember what it was like to be a med student…), just one year behind me in the process, and realized that I was already forgetting many of the interview trail details and tips I would have offered up just 6 months ago!

So before it’s all gone, here’s a “brief” synopsis…

RANK LIST: I wanted to be in Family Medicine, no 2nd choice specialties.  I wanted a military residency but also wanted to be in the D.C. area (as my hubby was there) so my rank list on the military application, which I had drafted up sometime in August, but was officially due by Oct 1st, looked like this…

#1. Fort Belvoir

#2. Civilian Deferred

#3-11? or so… Other military bases

My civilian/

SCHEDULING “auditions”/”Acting Internships”/”Sub-I’s”: I wanted to do my audition rotations as soon as I could, but also planned to do them after taking step 2 of the board exams, which I took end of May with just one week of scheduled exclusive study time, and I got a 608 (COMLEX, Level 2), think it went pretty well.  I chose to do them back-to-back so it would interfere with my school’s curriculum as little as possible and less flying around in theory AND some less jumping around for daycare for Andy.  I rotated at Eglin Air Force base in July and Fort Belvoir in August.  After scheduling these (which I did so in December the year prior), I also stuck an extremely stressful but extremely useful audition with the Georgetown Family Medicine Residency program in my schedule immediately before the one in Eglin – so I did that one in June.  I had to schedule that one through VSAS (visiting student application system) I believe.  If it wasn’t VSAS, then I must have done it by simply communicating with the Program Coordinator.  You can search for that information sometimes by just googling it, of course, but also on https://services.aamc.org/eras/erasstats/par/, ERAS (https://apps.aamc.org/myeras-web/#/landing … but your school must give you your application token to utilize this site), NMS (https://www.natmatch.com/aoairp/instdirp/aboutproglist.html) and http://opportunities.osteopathic.org/search/search.cfm.

CIVILIAN ONLINE APPLICATION: I applied to 34 allopathic residencies via ERAS, and eventually I also submitted an application for the osteopathic residencies via NMS, even though I applied for only 2 programs.  Applying to so many programs cost me a lot of money, probably about $500 total.  But I had no idea how many interviews I would get, and I wanted to have at least 10, with 3 of them being my top choice programs.  I started with fewer and gradually added some programs to my list as I did further research, and many of the programs in which I submitted very late applications, like all of the University of Pennsylvania ones that I randomly decided I wanted to apply to, never got interviews at, and they had like 3 different sites to which I applied.  I perhaps wouldn’t have applied for so many if I had done further research, and you can use sites like Doximity or the program’s website if often a good resource, but then again some programs have very limited info online, and sometimes you really have to go there and meet the people to understand what it’s like.  I submitted my finalized applications for both systems rather late – but I think did receive offers for a lot of interviews – 16 total, including all but 1 of my top tier programs!  So there is a tip for you – make sure you are aware of the soonest date you can submit your application so you can be first in line to get interview spots.  Although I will note that it kind of worked out for me, because by submitting my application later, I got the later interview spots which I was able to later cancel because after December 7th, I had my military match results, and knew I got Fort Belvoir.  Within about 2 weeks after submitting, I wrote emails to the programs that were among the top half in my list in which I didn’t get interviews, and this worked about 50%.  Just a note saying hey, I’m applying and really interested in your program, a couple tidbits about why that program specifically.  I know that one of the programs (University of Maryland) has a very allopathic-only type attitude, at least their faculty/residency selection would attest to this, also they don’t allow osteopathic students to audition, so this was a big clue to me to not bother applying, but I had to give it a try.

Some random tips –

  1. Always write your thank you notes! I also wrote some personalized follow up notes after the military match day, just saying that I’m so sorry to be withdrawing my ERAS application, and how much I enjoyed the program-just of course to my favorite programs/programs I really got close with like Georgetown and Grant Medical Center.
  2. Always go to the dinner/meal with the residents that are often included with the interview.  Unless you really cannot make it, in which case write them a nice email explaining why you are declining.
  3. Communicate with your school/home program because they may be assuming you’re planning to interview/apply there – I had an awkward encounter because I communicated in a rather delayed manor, but in my defense it wasn’t intentional and I was taking my time in getting my application/list of programs finalized… anyway it was frowned upon.

Some things I didn’t know until going into the interview season –

  1. You can’t rank a program that you didn’t interview with
  2. You can add programs to your ERAS application after you’ve submitted your first finalized version

So anyway, hopefully this helps a few medical students out there! Please post questions, I’d be glad to help you out!

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Before my Wright State interview at Good Samaritan Hospital