It could always be worse.

In May of 2013, my second-born was three weeks old and our house was annihilated by a hailstorm. We huddled in the basement as huge hail and glass-shattering winds swept through our home, tore shingles from our roof and shredded our exterior paint. We were ten months into residency, and still struggling to transition from the abundant loans of medical school to a tight PGY-1 paycheck. We went to bed after the storm had passed feeling like the unluckiest family in the world.

I still panic during storms. The months of dealing with contractors as a new home owner, the stress of paying out the deductible on our homeowner's insurance when we were also paying hospital bills for our new baby, the nap times disturbed as our whole neighborhood reroofed, the whole process. It was awful. And here's what's worse: the day after our hailstorm, an F5 tornado hit Moore, Oklahoma, and twenty-four people died. The panic I feel now is less about the stress that we went through, and more about the fear of what could have happened.
Our anniversary was this week. Eight years, almost every bit of them wonderful and all but our first dominated by medical school or residency. The sitter was booked and our reservations were scheduled, and thank goodness we hadn't bought the movie tickets in advance because (of course), the day ran long with a trauma case added on, and my apologetic husband called to tell me we'd need to reschedule. 

Our poor kids, they couldn't figure out why I was crying. And you know, I got mad. I got so mad at that inconsiderate patient who just HAD to have something awful happen on our special day and just HAD to go into surgery to make my husband late. 

I'm embarrassed to say how long it took me to regroup sympathetic feelings. This poor patient, having surgery on a Friday night. And my frustration transitioned into something else. I'm still disappointed we missed our date. But it could have been so much worse. It could have been my husband needing surgery, or me, or our precious kids. I sat up waiting for my husband to come home. In the hospital, there was a wife wondering whether her husband would come home. 

It could be worse. 

A hailstorm is nothing next to a tornado, and missing an anniversary date can't possibly be compared to missing a spouse because you're in the waiting room and he's on the table.

But. They're both bad, right? It's important that we allow ourselves those moments of frustration and grieving when our plans get canceled and our schedules are flipped on their heads and our kids are begging to see their daddy, since it's been three days. I am still so grateful that our hailstorm didn't spin into a tornado and that we were all safe, but while gratitude made the next six months of repairs easier to bear, it didn't make them fun. Residency is so hard on families, and just because there are paths that are harder (military spouses, I salute you!), it doesn't take away from the difficulties that we face.

So dig into that container of phish food if your date gets canceled, sister, you've earned it. Allow yourselves a Netflix marathon instead of scrubbing your floors. And hey, if you're feeling really gutsy, don't cancel the sitter. Take yourself out to a movie instead. And allow yourself to feel disappointed. It could be worse. It's still not fun.

You are more than your match.

My mother-in-law has this story she tells about when she was a young wife to a young army private, recently stationed abroad. All the homesick base wives banded together and had regular play dates and dinners and outings. One of these shindigs was hosted by the wife of an uppity-up on base. After everyone arrived, she gathered the girls together and said, "Now, everyone, let's get to know each other! Go ahead and line up by rank."

At one side of the room, women loudly compared how many years their husbands had dedicated to the military, the number of bars on their uniforms, the purple hearts and awards they had received and the famous hands they'd shaken. At the other side, my mother-in-law whispered with several other wives, "my husband's only been in four months." "He hasn't been promoted yet." "I don't even know what all these ranks mean."

Eventually, they all ended up in a meandering line around the room and the hostess stepped out from her place at the head of the line. "Ladies," she said, "You don't have a rank. Your husbands, they have a job title. But that doesn't make anyone better than anybody else."

It's a big week, girls. Some of you will find out that your husband matched at his dream program, his first choice. His last choice. The place you totally forgot he interviewed at. Some of you will find out that your husband, your best friend, the smartest and hardest working guy you know, didn't match. Anywhere.

And the moral of the story here is that it doesn't really matter where you match or whether you match, whether you train at Harvard or in Hicktown, at least in terms of your intrinsic worth. You and your husband  are good people, and the world is so lucky to have you.

Best of luck, everyone.

Residency Roundup: The Good

Its easy to dwell on the negatives of residency. Many, many posts focus on the (understandably)hard and long parts of training. I thought it would be refreshing to share some positives I have found through the last 3.5 years.

My Five Favorite things about Residency.
1. No administrative stuff!- We are not responsible for any staffing, billing, RVUs, contract responsibilities, office maintenance, advertisement of practice...

2. Time off does not mean less pay- We just returned from a 5 day family trip and didn't have to think about making up the time or finding coverage over the practice.

3. Attitude toward our finances- I appreciate that during residency other people I meet don't have falsely high expectations of my lifestyle.  A huge home, a German made car, perfect skin care, kids in coordinated outfits, magazine worthy home decor and many other ideas I have overheard that a 'doctors family' is assumed to have.  While each of those items are a great/fun thing to have, I relish the time in residency where none of those expectations exist.  

4. Benefits- Our program has amazing Medical, Dental, and Vision coverage.  We paid nothing for our third child's birth!

5. Co-residents = instant friends- We feel extremely lucky to have matched with another family very similar to ours.  They know exactly what we are going through because they are the only ones in the same program!  Rarely in life are you 'matched' with someone so closely. 

We all have difficult times!  We survive.  We move on.  But, as we move on, we all need to remember that life currently has great stuff happening:) 

:)Cami

p.s. What are your favorite things about residency??

Clean house, clean life.

Our first apartment together was a shoebox, a little afterthought built on top of a two-car garage with a hidden staircase around the back of the main house that snaked up to our studio. As newlyweds, we could fit our non-furniture belongings in our '93 Geo, which was good, given that our futon took up most of our floor space.

From the shoebox we moved cross-country to medical school, where we started out in an orange-tiled one bedroom: our square footage doubled! And our belongings grew with our space, as medical texts, professional clothes for me, and short white coats for him filled up our shelves and closets.

Our next move was to a townhouse with the same orange tile, and man, does a seven-pound baby come with baggage. After two years in our townhouse we moved again for residency, to a house! 1800 square feet to fill, and attic space to boot. Our old Geo (may she rest in peace) would be rolling in her junkyard if she saw all the stuff that eight years of marriage and two small children accumulates.

We have a few years yet before our next move, but we know it'll be back to an apartment, and probably a small one. And so I've begun the purge. 

I started with the medical books. My favorite place to sell books is Amazon buyback--Amazon will directly buy books for a set fee, and they cover shipping. Your only responsibility is to print a label, stick it on a box, and drop it off at your local post office. Hasta la vida, libros. If Amazon isn't currently buying your books, try a local used bookstore, especially if you have a medical school in town. The closest ones to campus are generally more willing to accept textbooks. If nobody bites, donate them to Goodwill, or to a local medical student. He or she will be more than happy to take them off your hands.

I'm a total e-reader convert, so I also sold some of my hardcovers that were taking up space. Buy the digital copies with the money you make if you miss them!

Clothes were next. I am a packrat, and I've hardly gotten rid of any clothes over the past . . . since high school. I had a very full closet plus several large totes in the garage, and let's be honest, my body's changed since having babies and the only time this full-time momma wears professional gear is when I'm curious if it still fits. (You guys! it does! mostly.) I was ruthless going through my closet. Haven't worn it in a year? Gone. Fits but will look better if I lose a few pounds? Gone. 

I separated the clothes into a few piles. I ordered bags from ThredUp.com and LikeTwice.com; both are companies that buy old clothes. Pay attention to the brands they accept--ThredUp takes more brands, but pays less upfront. They also take more expensive items on consignment, which pays out well. LikeTwice is more particular about its brands, but their customer service is a lot nicer and they pay more per item. They also have an easier return policy if you want to get your items back for any reason. Between the two companies, I got rid of all my garage clothes and made a nice chunk of change in return. (And hey, if you want a hookup, I can email you codes to get $10 off an order at either place!)  Anything else, I donated to Goodwill.  

My last attack was on my kids' toys. After sorting out anything that was incomplete, broken, or unloved, about half their toys were left. I'm in the middle of organizing their remaining toys into bins and boxes for easier cleanup. 

It's a good feeling, having less stuff. Getting dressed each morning is easier, since all my clothes live in my closet and I love all of them. My kids have an easier time finding toys they actually want to play with, since all the distracting and broken toys (and...pretty much any toy that makes noise. Sorry, boys) are gone. And my husband is refilling his empty shelves with books that actually apply to his specialty. 

We still can't fit our belongings in a car, and our lives will never again fit in that adorable studio where we began our marriage. But we have less stuff than house, and I feel like my life is in order. 

Until the next box of toys from Grandma comes, I guess. 

Celebrating Christmas

A confession: I've been a wee bit Scrooge-like this holiday season. While we are ever so grateful that Michael is in a residency that we both like quite a lot, considering that it is still a surgical residency, I feel compelled to bah humbug a bit about spending our first Christmas in a new city not only without our extended family, but also without our own little family of four all together. Michael, it turns out, will be spending the twenty-fifth day in December at the hospital.

After Grinching about for the better part of a week, I had this thought: What are we celebrating, anyway? We know from our friends in Whoville that it's not about ribbons or boxes or bags, or trees, lights, or reindeer-shaped cookies. It's not even about the music, although you guys, Pandora's been locked on the Mannheim Steamroller station since before the last trick-or-treater left our neighborhood.

Christmas, then, is about family, a special family, that winked into existence as all families do with the birth of an extraordinary baby. Christmas celebrates that child who grew up to be Christ. Who never turned away the sick or lonely, and especially not the children, not when He was tired or it was inconvenient, and probably He went out helping people on Yom Kippur and Hannukah, even when His ever-graceful mom just wanted to have a sit-down meal with the whole family together.

And if that's how He whose birth we celebrate spent His time, how can I begrudge Michael's residency giving him the opportunity to pay tribute to Christ by tending to the sick and showing compassion to those who would surely also rather be home with their families?

So here's our Christmas: we will celebrate on the twenty-fourth or twenty-sixth with the music and the food and the presents and the children festooned with ribbons and bows. And on Christmas, we will celebrate Christ.

Let the match be the bad guy, and other advice to get you through your holiday dinners

I kind of hate that the match spans the holidays, because instead of focusing on turkey and presents and thanks and families, there's always this sneaky voice in the back of your mind saying "the maaaatch is coming cloooooser." And then there are the louder voices of well-meaning relatives who are so innocently curious about the match process.  

It's been a few years since we matched, but I still remember agonizing over some of the questions and commentary we got from our families. For those of you in the midst of matching this year, here are some tips of how I wish I'd handled things when we were matching.  

First: Avoid specifics, and don't make promises. When Grandma tells you that there's a program near her, and you know the program's not a great fit, you can reply: "Oh Grandma, it would be so fun to live closer to you! I'll let you know if they invite us to interview there. And could you pass the gravy?" Oftentimes, explaining that not every program is right for you is a much longer and more emotionally perilous conversation than you want to have over dinner. Mention its positives and that if they invite you, you'll go, and conveniently forget to mention that you didn't even apply there.

Second: Blame everything on the magic of the match. If Uncle Steve asks where you want to match, and your dream program is an eye-watering two-thousand miles away from family, you can say, "Just to cover our bases, we're applying all over. We're definitely looking at [program near family], and also at [a few other places you're applying]. We're so excited to see where the match will send us! How's cousin Mike doing in school?" Later, you can follow this up with, "We're as shocked as anyone that we matched [far, far away]. We're going to make the best of it, though, and we're so, so excited we matched! Come visit!" Let the match be the bad guy. You don't want to move far away, but the match is making you. 

Third: Don't (necessarily) share your rank list. When your mom tries to pin down your rank list, you can say, "Man, I wish my husband would make up his mind about it! I think he'll be up until midnight on the night it's due getting it sorted out. Why didn't Aunt Emily eat anything but jello salad at dinner? Is she on another crazy diet?"

That third point might need more explanation: when my husband was a second year, we heard of a couple that refused to share their final rank list with a single soul outside of AMCAS. I thought they were crazy, and two years later we happily spilled our list to everyone. I have since seen the wisdom of the other approach.  Here's what happens: as soon as you mention "We're hoping to match at X," your family and friends hear "They're going to match at X!" This invites all kinds of comments, ranging from "When you're at X, we'll come visit you! They have an amazing museum there that I've always wanted to visit!" to "Why X? What's wrong with the programs closer to home?" Maybe this doesn't make you feel crazy, but for me, I felt like if we didn't match at our number one, we were letting everyone down.

We didn't match at our number one. Or two, three, or four. We matched about halfway down our list, at a far-away program we now love but weren't very familiar with during the interview process. We spent the week following the match in mourning for those programs we didn't match at and, unfortunately, some family members did too. My poor, sweet husband kept getting asked "So...what do you think you did wrong at the other interviews?" (Answer: not a single thing. Ortho is competitive!)  Keeping your match list to yourself, or at least to a small, select support group, can help avoid those awkward moments.

Fourth: Support your significant other, completely. When your cousin says, "You need to get your husband to apply in X field or Y location,"or "I can't believe he's taking you away from us!" remember this phrase: "Becoming a doctor is my husband's dream. I am so happy to support him and his dream, wherever it takes us, just as he's supported me with mine." 

And as long as you mean those words when you say them, you'll get through whatever the match throws your way, together. 

A Doctor's Strange Life: Or, How I Learned to Stop Hurrying and Love the Call.

You guys have no idea how long I've been waiting to use this title. 

My husband and I can talk. Our first date, we planned on doing dinner and a movie and we chatted so long during dinner--I remember he brought up Hegelian dialectics to impress me and I still have no idea what that means, but obviously it worked--that we didn't make it to dinner and, when he took me back to my apartment six or eight hours after the date had started, we still hadn't run out of things to say. We still haven't eight years later. 

So when we found out that he matched at the program that takes the most call out of any of our ranks, we were concerned about how it would affect our relationship. He's Q4 for the almost the whole first four years--that is a YEAR on call. Miserable. 

Which I was, for a while, and I rushed through each call day just trying to get it over with faster. And then I realized: spending an entire year of residency hurried and miserable sucks. 

Thus began operation Learn to Love the Call: 

• When DrH has to take weekend call, our sons and I sometimes go on a date to a restaurant and talk about whatever they have on their toddler-sized minds.
• If the hospital's slow, we meet DrH at the cafeteria for dinner...until we're interrupted by his pager.
• We give ourselves license to eat hot dogs, pancakes, cold cereal, or once, memorably, nothing but cheese and raisins for dinner. Nothing fancy unless we feel fancy!
• We snuggle up on the couch and watch Thomas the Tank Engine,
• Or have a crazy dance party in the basement.
• And get into pajamas whenever we feel like it. Sometimes it may still technically be morning.
• When the kids go to bed, I catch up on my trashy reality TV shows,
• Or the latest book I'm into,
• Or I call a friend and talk until I'm all talked out.
• I've learned to refinish furniture,
• Clean the bathtub 'til it shines,
• Sew a quilt from start to finish,
• And bake too many brownies, cakes, and pies.
• (Consequently, I also try to catch up on my wall sits and crunches.)

We're almost halfway through residency and maybe two-thirds of the way through call. And I'm thrilled that calls are no longer miserable, but this I will admit: the moment when I turn off the light and call it a night, alone? I don't think I'll ever learn to love that.  

Although I've found that sleeping diagonally across the bed really does take the edge off.  

More husband than doctor

I didn't want a doctor when my world fell apart. I'd already consulted Dr. Google and knew the differences between melanoma in situ (please, please let it be in situ) and stages one, two, three and four, which I read through tears so thick my four year old started spinning around me and singing, "let's be HAPPY!  No more being sad!"

Which is a lot easier when my mom, my too-young-for-this, healthy-as-can-be mom, hasn't just been diagnosed with cancer, staging undetermined.

I didn't want a doctor. I wanted my husband to come home and forget everything he knows about cancer and mortality rates and treatments, about pathology and incisions and turnaround times and make me feel better.

He did.

He held me and I cried. He took the boys outside to play so I could cry some more. He made dinner. He bathed our kids and got them ready for bed, and then he went back to work.

Between patients, he called me. "I have a fracture coming in soon, but I wanted to know how you're doing," he'd say. "I love you. Your mom will be fine. Try to sleep, and you'll feel better in the morning."

And in the morning, when things were a little better, a text: "I'm headed to clinic, but I love you. Your mom will be fine. Try to keep your mind off it. We'll know more soon."

And in the afternoon, when I was doing a lot better: "I'm studying now. Call me if you need me and I'll come home."

And a few hours later when, suddenly, I wasn't: "Leaving now. I'll be home soon."

Residency doesn't allow time off to comfort your wife while she's waiting for pathology to call, and while he was able to sneak away the first day, he was Q2 for the next week. But when he couldn't hold my hand, he held my heart together with prayers and sweet words, and day by day we got through it. And when we found out that she was just a a single surgery and an awful, beautiful scar away from being cancer free, he comforted me again while I shook with relief and disbelief, because how can I be so lucky that my mom, who for a week I was sure would miss my sons' first days of school, their baptisms, their high school graduations, their weddings, was just at stage one and was going to be okay. And my husband. My husband.

He's a great resident. On his way to becoming an exceptional surgeon.

He is an even better husband.

The Sweet Life

Have you guys heard of the marshmallow experiment? It's the one thing from my freshman-year-of-college child development class that stuck with me, instead of, for example, something useful like how to navigate the way-harder-than-two-which-wasn't-actually-terrible-at-all threenager year, or what the appropriate response is when your child asks how his baby brother got in your tummy in the first place and this immature mother's first reaction was to blush and change the subject to anything else, literally anything.

I digress. The marshmallow experiment was created at Stanford about forty years ago. Children from ages three to six were offered a marshmallow, and then were left alone in a room with a promise that if they didn't eat the marshmallow until the test administrator returned, they would receive a second marshmallow. The test examined delayed gratification, and follow-up studies indicated that the kids who were able to hold out for that second marshmallow did better in life later on. Look it up. It's cool stuff.

I tried to go off sugar for a week a while back, and I lasted about six hours. I confessed my failure to my husband, Michael, who suggested we try it together. And do you know what? We did it. When I thought I HAD to have chocolate chips, he talked me into eating a banana. When he was craving soda, I encouraged him to drink milk. And we both, somehow, gave up late-night bowls of ice cream.

I'm not sure if Michael and I would have passed or failed the marshmallow test as children. Despite my near-crippling weakness for sugar, our life outcomes are good, so we might have done ok. But as his class is getting ready for their halfway party this winter (two-point-five years done! And...two-point-five years to go.  Not including fellowship), I've been thinking a lot about that lesson in child development 101: delayed gratification pays off, eventually. Someday, these years and years of studying and supporting and debt and stress and anxiety will result in a better prize than a marshmallow, that's for sure.  

And based on our own little sugary experiment, Michael and I are stronger together. When he's craving a shorter residency and better hours, I'll encourage him to remember what he loves about his field. When I see my friends flying out to vacation in Cabo, he'll remind me that we'll get there, and in the meantime, we can drive out to Kansas City for golden weekend if we want. And together, we'll get through it.  

(I'll confess, though, that we're back on sugar now, and I'm suddenly craving s'mores. With extra marshmallows.)

Residency Roundup: Skipping the 10-Year Reunion

It may shock you to learn that this theater geek, this Buffy Summers fangirl, was not counted among the cool kids in high school.  

Ten years ago, I didn't so much walk at graduation as I did run, ready to lock the door on the previous four years and throw away the key. When I got the invitation to my ten-year reunion, though, I surprised myself - I kind of wanted to go.  

I thought it would be fun to show up with anecdotes about my clever and delightful children, and let everyone see that I still fit in my circa-2004 American Eagle flares. And I would cap it off by saying that I'm so sorry I couldn't bring my husband to meet everyone, but he's off saving people's lives because, you know, he's a doctor.  

It's a nice story, right?  A Pinterest-perfect snapshot of my life. I'd definitely omit that my youngest may be sleeping like an angel right now, but even though he's fifteen months old he's only slept through the night twice. And that my three-year-old son is, as I write, protesting my cruelty at requiring him to go to bed by calling me a "mean girl who isn't very nice."

The high school jeans?  Yeah, they only fit because I had food poisoning.  (Don't tell.)

And the doctor, who's off, you know, saving people's lives, couldn't be there because residents aren't allowed to take time off during the summer trauma season, and anyway, he hasn't had a real vacation since February.  

Ultimately, resident salaries are tight and cross-country flights for three aren't in the budget, so there wasn't a real chance for me to go. So what's the point of dreaming up these perfect tidbits to share with the rest of my class?  Kind of embarrassing to admit, ladies, but I guess that a small part of me wanted to show that not only do I fit in somewhere now, but I fit in even better than they do. 

Obviously, I am nothing if not petty.

I didn't always fit in at my high school. But in the intervening decade, I've learned an important lesson: life's not about fitting.  It's about committing - committing yourself to the life you chose.  I chose to marry a premed.  We chose to start our family in medical school, and to expand it during intern year. When he chose a long, hard residency, I chose to encourage him instead of begging him to pick anything--anything--else. When we matched far from family and friends, we chose to look on the bright side and make it an adventure. Every day my sweet and hardworking husband wakes up at some awful pre-dawn hour and chooses to go in and round and operate all day sometimes night and then day again and not complain (usually) about how tired he is. 

I fit in here. This crazy, doctor's-wife life works for me because I choose it every day, and if I could go back to 2006 when this whole path started, I would choose it again.

I imagine, had I learned these lessons in high school, I might not have felt the urge to lock that door so tightly.  And maybe I'd have bit the financial bullet and attended my ten-year reunion and laughed about how we were all so dorky and what was with frosted lip gloss and who was your prom date again, and aren't we so glad we're not 18 anymore. Go Apollos.  

I guess there's always our twentieth to choose maturity.  But, and let's just keep this between us here, on the off-chance that I get food poisoning again and still fit into my high school jeans, you can bet your class ring that I'm going to wear them.  

The Wretched Cytokines

by: Tasha Priddy




I was in a band once. We called ourselves the Wretched Cytokines, and we named our first album Fluid in the Interstitial Spaces. The Wretched Cytokines had four members: my parents, my brother, and me, and we formed when my mom was in her first year of medical school. I was ten, my brother was eight, and my parents were great sports about taking breaks from work and studying to belt out Queen and Meat Loaf ballads in shaky four-part harmonies and imagine we were the greatest up-and-coming rock band the earth had ever seen.

The band never really amounted to much, which is why I've had to resort to being a medical groupie for almost half my life. My mom started medical school when I was in fifth grade and she graduated from her Family Practice residency just before my senior year of high school. I had a brief reprieve from all things medical during college, until I met a handsome, curly-haired history major who was preparing to take the MCAT. We got married a year later, and he is now starting his PGY-3 year in ortho, and our two sons and I are his biggest fans.

One thing I learned from my first medical school and residency experience is that your whole family goes through residency together, and that you might as well make it fun. When, in seventh grade, I made a comic book representation of a bean's journey through the digestive tract, my mom took it to show her classmates. As a teenager, I would study with my mom and we'd quiz each other on family medicine boards questions (her) and The Scarlet Letter (me). When Mom had to work holidays, my dad would pack up a yummy dinner or order a pizza and we'd crowd in the call room and eat together, with her pager providing an occasional distraction. For our after-school snack, Mom taught us how to peel our oranges and then how to suture them back together. And, memorably, when she learned about how the inner ear affects balance, my brother and I were her guinea pigs and she dripped cold water into our ears and had us attempt to walk in a straight line, and we all giggled when we couldn't do it.

As I go through round two of residency, I'm realizing how hard she worked, not just as a resident but as a mom, to make sure that we knew we were an important part of her life. And I'm grateful that my husband is willing to make the same sacrifices. Our kids are a little bit young for suturing and at-home dissections, but he never shies away from telling his kids what he really does at work, and teaches them while he does: our three-year-old recently took a tumble, and when I asked him if I could take a look at his knees, he said "you mean my patellas?" He puts his books away until the boys are in bed, and spends time snuggling, roughhousing, and reading with them, and makes sure they don't feel neglected.

I'll admit, when I met my handsome history major and he announced his intentions to become a doctor, I wasn't thrilled. I knew more about the process then than he did, and I knew exactly how long and painful it can be. I'm kind of embarrassed about feeling that way, though, because my mom's training was such a wonderfully defining part of my own life, and I loved (and still love!) having a Dr. Mom. Our children are already benefiting from my husband's training, and even though they're young, I hope they remember the thrill of eating birthday cake smuggled into the hospital, the joy of playing impromptu games of mini golf using bone models as clubs, and the fun of making new friends each July whose moms and dads are just like theirs.

So for those of you in residency, and particularly those of you who have children, make it fun. Eat in the call rooms. Teach your kids what their resident does at work, and let their Dr. Moms and Dads take their work home every now and then - just be aware, and I say this from personal experience, that if you bring a fetal pig home to dissect as a family project, your kitchen will stink for days. And I give you all official permission to form a Wretched Cytokines tribute band - may you have more success (and every bit as much fun) as we did.

Residency Roundup: The Next Step!

What next step is awaiting your medical family this June or July??

In June, my DrH transitions from being a junior resident to a senior resident! We finally get to say good riddance to primary call! 

No more attempting to sleep at the hospital waiting for crazy things to happen!  As a PGY4 and chief (PGY5) resident, we can plan DrH sleeping in our home every night!  Of course with this change the nightly back-up call pages will begin and our sleep could be interrupted... but at least we can rely on seeing DrH more!  

The preparation of the next two months has my head spinning: finishing up PGY3 (including the remaining 14 on-call night shifts), Child #1 finishing Kindergarten, Child #3 entering the world in 3 weeks, deciding if a fellowship is in our future, and watching our Med school friends and family prepare to move to ridiculously far away residencies.  

Each of you has your own preparations to make as this transition approaches. Good luck and enjoy what you can!  Brighter horizons are ahead.

Happy Spring!
Cami

Residency Roundup: Run A Match

Last Tuesday was DrH's residency program's final interview day for the entering 2014 class!  I was able to attend their applicant dinner that evening and met six of the interviewees.  I was impressed by their kindness and hope them each a successful match.

The feelings that surface during this time of anticipation, pressure, chaos, excitement... are exhausting, and I empathize with each applicant.  This year, more than the previous two, has me on edge for the match.  This is mainly due to the fact my Brother-in-law is eligible for the 2014 match, which could send/assign my sister and her family anywhere!

I'm sure many of you MS4 families are having to explain over and over again what exactly is 'the Match'. While reading the nrmp.org site I found the following information helpful.

• The Matching Process- a general synopsis. 
• Run a Match- a document describing the process of algorithm that matches each MS4 and residency spot.  My family would have found this interesting during our match...and would have saved them from hearing my simplified analogies;)

Here are some important dates to have marked on your calendar (if not already!):
February 26, 2014- Rank Order List Deadline.  Must complete and certify your list by 9:00pm ET.  Three years ago we decided to put a preliminary list in the system to avoid any last minute computer glitches and then updated the list with minor changes the day or two before the cutoff.

• Interesting facts on Rank Order List Length. 
• My previous post that outlined our match list. 

March 17, 2014- Matched?!? Applicants receive notification of a successful match!  Or the beginning of the SOAP process for unmatched MS4 students.

March 21, 2014- MATCH DAY!!  www.nrmp.org even asks for pictures of the 'Match Face'!   Make contact with your program director or residency coordinators to show your excitement!  Congratulations!

If your DrH has previously match and you have any pearls of wisdom please share!
Best of Luck!!
Cami

Residency Roundup: New Year's Resolutions

Happy Holidays!
I send warm wishes of holiday bliss and wonderful memories!
For many people the beginning of a new year allows for a refreshing overview of their lives and make simple conclusions and goals to help improve areas. Traditionally I have been opposed to making New Years goals, finding them petty and unobtainable.  While working on this post however, I came across the following list that has me thinking.

The Top 10 New Year's Resolutions in 2012 were the following:
1. Lose Weight
2. Getting Organized
3. Spend Less, Save More
4. Enjoy Life to the Fullest
5. Staying Fit and Healthy
6. Learn Something Exciting
7. Quit Smoking
8. Help Others in their Dreams
9. Fall in Love
10. Spend More Time with Family

These are all great goals that would improve each of our lives.  Each family in residency deals with unique challenges, lifestyles, triumphs, and disappointments.  So contrary to previous years, I am going to compile a list of general resolutions that could help all Resident Families.

1. Perspective- Remembering that DrH works part of a team and appreciate when others are working or covering call.
2. Patience- Just get the bad days over with - better days lie ahead.  (Christmas Day is our official residency 'hump day'!!! The longest 2.5 years ever.)
3. Love- Finding new small ways to show love and appreciation within our homes and while DrH is at the hospital. 
4. Involvement- Stay busy.  Use service, hobbies, and/or work to keep your mind and time active. 
5. Happiness- Focusing on what is going amazing in your life.  We would all prefer to spend more time with DrH, but while waiting we need to find happiness in the small things around us.
6. Confidence- Especially our MS4 families!  Have confidence and success in your new residency city, as you prepare, move, and meet new acquaintances.


I suggest we look to 2014 with renewed ideas, hope, and happiness!

Happy New Year!
Cami

Residency Roundup: After the Interview

Many MS4 families have completed one or more interviews! Congratulations on starting yet another step in the 'process'.:)
The first wave of interviews brings a new onslaught of information and pressure.  How are you ever going to rank all these programs??  Below are a few points to ponder as you and your DrH prepare for your rank list.

• Rank each program after each interview.  Another family ranked different aspects of the programs (COL, research, salary...) and compiled an average score for each program.  We just generally put each program at the top, middle, or bottom of the list with an explanation. 
• First impressions- DrH should write them down while on his return flight home.  This was the most important for us.  We went with our guts on the majority of the rank list.  
• Personal Priorities- Academic prestige, research opportunity, average case numbers and variety, home/in house call, proximity to relatives, parking pass...etcetera.  What are DrH's career goals? What procedures do you want to learn? Will your family be comfortable? 
• Co-residents, Attendings, and Staff- Are they people you can be around? What is the atmosphere? Our bottom rank was due to a program director getting sloppy drunk and telling inappropriate stories.  
• Facilities and Human Resources- Insurance coverage, meal plans, vacation requests. 
• Housing locations- Would it work for your family? Jobs? School? Transportation?

Three years ago as we 'made' our rank list interview by interview, we continued to remind ourselves that  matching is left up to a computer program.

We ranked 15 programs

#1 DrH's Dream residency spot.
#2 Solid program, low COL, Family Friendly
#3 Close to Family
#4 Great personality match, 2 hrs from family
#5 Good program, low COL
#6 Medical School program, wouldn't have to move
#7-#14 No particular order
#15 Rather go here than nowhere

We are grateful to have matched at #4.  When we opened the match letter, we both didn't even remember this program on our list... but ten minutes after the match the program director called to welcome DrH into the program and we have felt blessed to be here since.

Happy and Safe Travels to all interviews!
Cami

Residency Roundup: Interview Prep

Welcome to the Residency Interview Season!! 

 Hopefully, you are successfully juggling the quick responses to offers, the calendar filling up, purchasing travel plans, all while continuing MS4 rotations. 

I've compiled a list on how to prepare for residency interviews. 
DrH should bring this information to each interview!

• Program background- Basic information on FRIEDA https://freida.ama-assn.org/Freida/user/viewProgramSearch.do.  Go the the programs website for more details, how long the program has been active, number of faculty, current research emphasis. 
• Bios for the faculty and specifically for whom your DrH will be interviewed by.  My DrH read each bio while flying to the new location.  
• Bring copies of CV, cover letter, and research.  Many programs didn't want separate copies...but some appreciated them.
• QUESTIONS!! - There is a bunch of time set aside for questions.  Make your list based on what is most important to you and your family.  I recommend between 4-10 good questions ranked in order of importance.
• Home or in-house call
• Clinic hours 
• Average Cases for the current residents
• Mentoring program
• Research requirements
• Vacation requests
• Locations- housing, schools, recreational activities
• HR- Medical, Vision, Dental insurance? Parking? Food?
• More ideas-  https://www.aamc.org/download/77936/data/residencyquestions.pdf

This is another great list!! 

http://www.ama-assn.org//ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section/transitioning-residency/the-residency-interview-making-most-it.page

The AMA page lists possible interview questions.  Such as 'Why did you choose this specialty?" or 'What are your strengths?'  We typed each question with DrH's answer and we rehearsed his response.  Obviously, you cannot predict what question they will use, but this practice will help.  Here are some other possible question your DrH will be asked. http://som.georgetown.edu/docs/2012%20Handout%20Residency%20Mock%20Interviews.pdf

Warm wishes to all MS4 families.

Cami

If you have some additional interview prep advice please leave a comment below:) 

Residency Roundup: Duty Hours

I have noticed several reoccurring questions on our LDW facebook group about residency!  LDWblog is a perfect platform to provide answers that will be helpful to current and future resident wives. 

This week there was some questions/concerns about residency work hours and restrictions.  While I'm sure there are differences between how each specialty applies the rules, I wanted to post and dissect the real ACGME 2011 regulations for your guidance and information.
http://www.acgme.org/acgmeweb/Portals/0/PDFs/dh-ComparisonTable2003v2011.pdf

Here are my 'favorites':

-Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities and all moonlighting.   http://www.acgme.org/acgmeweb/Portals/0/PDFs/dh-faqs2011.pdf  for more information in their FAQs.  You get desensitized to the 80 hour weeks!  Its the weeks that push that four week average up that are brutal.  I overheard someone who works for the state department, joyously talking about how much overtime pay they received for working only 52 hours...wouldn't that be something!  The second link to the FAQs has some great followup examples and explanations.  I personally did not expect all the Journal Club, Dissection Lab, Tumor Board type meetings that keep DrH away from home that is not added into the '80-hour work week'. 

-A Review committee may grant exceptions for up to 10% or a maximum of 88 hours to individual programs based on a sound educational rationale. So what programs cannot justify the 88 hours? Although they are suppose to get permission first;)  I know of a program (not ours, I promise) that keeps to the 80 hr average but has 'volunteer shifts' that put the intern hours way above regulations.  

-Residents must be scheduled for a minimum of one day free of duty every week (when averaged over four weeks).  At-home call cannot be assigned on these free days.  Four a month.  Are weekends really two days long??

- Duty periods of PGY1 residents must not exceed 16 hours in duration.  Seemed like a good idea.  But it makes the other PGY years make up for the hours.  PGY2 was not awesome.

-Duty periods of PGY2 residents and above may be scheduled to a maximum of 24 hours of continuous duty in the hospital.  Programs must encourage residents to use alertness management strategies in the context of patient care responsibilities.  Strategic napping, especially after 16 hours of continuous duty and between the hours of 10:00pm and 8:00 am in strongly suggested.  I find this standard a tad humorous... strategic napping...where and when does that fit in? At the computer? On an extra gurney? Haha...who likes to nap when your ridiculously loud pager can and will go off at any minute? 

- It is essential for patient safety and resident education that effective transitions in care occur.  Residents may be allowed to remain on-site in order to accomplish these tasks; however, this period of time must be no longer than an additional four hours.  This is a huge one!  Although, it covers practically any variable that could keep DrH at the hospital, it defines what their real job is: patient care and learning.  They cannot leave after stitching up half an ear, or ditch the last clinic appointment because time is up!


Hopefully, as this year moves along we can focus on the time together and less on time apart!  

Cheers!

Cami

Residency Roundup: Tips for medical wives entering intern year

Happy Graduation and Moving month to all our starting residents!  
I think back 2 years ago to our frenzied month of boxes, paperwork, goodbyes, and then hellos and remember it felt like a bittersweet whirlwind.  During each transition during this long process I have felt awkward, like beginning a new phase with the understanding that I truly knew very little nothing about what was to happen. 

To help each new intern family succeed  this coming year I scoured the internet for some solve-all tips.  I found this awesome article on kevinmd.com written by Elizabeth Breuer, MD "Tips for medical students entering intern year".  http://www.kevinmd.com/blog/2011/06/tips-medical-students-entering-intern-year.html  (click to read full article)

Here are Elizabeth Breuer's nine tips for interns:
1. You might have been a good medical student but you now know essentially nothing.
2. Accept the fact that you will (do) dumb things and you might hear about it.
3. Having a pager sucks.
4. It's ok to be absolutely terrified.
5. If you are completely over your head, ask for help.
6. Things that seem scary will become second nature.
7. It's ok to complain.
8. Step back and realize how totally amazing your job is.
9. Most importantly, work hard, keep your head down, take care of your patients and take responsibility for your actions.

What our husbands and/or partners do is important and a big deal.  But as their support, confidant, teammate, and cheerleader through this journey, we need our own recommendations for success which is why I sorted out our own 'doctors wives' intern tips.  

My nine tips for new intern wives:
1. Remember YOU are the constant.  
2. Learn to be flexible. Ideally, flexible and patient:)
3. Long call days or horrible month rotations will end.  
4. Find or continue ways to keep your sanity.  Hobbies, Family, Friends, Work, etc. 
5. During those really bad days where regret, hurt, and loneliness catch up with you, remember you are not alone! Other wives have survived those feelings.  Breath, you can and will do this.
6. Invent new ways to connect with your Doc.  Meet up at the hospital for a meal or Face-time your goodnight calls. 
7. You and you DrH are accomplishing something amazing.  
8. Document, remember this time of hard work and sacrifice.  
9. Most importantly, remember LOVE.  


Happy Wishes to all our new Doctor's Wives!!

Cami

Residency Roundup: Making Friends in Residency

As we have slowly moved through this medical training, I have found that making friends has become increasingly complicated.  While preparing this post I have been reflecting on my friendship efforts over the last two PGY years.  Below I have listed how residency has complicated finding friends and what approaches have had success.  

Why friends are hard to find during residency.

- Time with DrH-  DrH/Daddy is coming home! Finally! Quality family time is important, which I then hesitate to interrupt in order to nurture a new friendship.
- Mothering-  I stay home with our two cute kids.  Their needs are the priority for my schedule.  My adults interactions are often limited to parents of my children's friends.
- Conflicting call schedules with co-resident families-  Should be easy to be awesome friends with a co-resident family.  But in actuality their DrH is home opposite of your husband.

- Friends with other couples-  Invited as a couple or family for a visit but they insist on rescheduling until DrH can attend. 

- Unpredictable schedule- I claim the 'univerise' is working against my social plans.  Every time ....well at least most of the time... when I plan to have people over or meet up with new friends, that is when DrH's has a long case and can't make it home.  If only doctors could predict all delays and emergent cases!
- Finding people to understand our sacrifice for the DrH's training-  This topic could be a blog post by itself.  I have had abrasive conversations with people that misunderstand or have no empathy towards how difficult and lonely this crazy path is. 

How I have found friends during residency. 

- Keep trying-   Set small goals to keep your confidence.  Find new and simple ways to include others (costco trips, lunch  date, or phone converstions)

- Be seen at events -  I attend all or most of my local resident support group, DrH's program parties/events, children's play group, and church meetings.  Consistency shows you are interested and reliable.  This is not an easy thing, I just had to commit to the idea. 

- Coordinate schedules  -  Calling the other co-residents wife and combing through the schedules to plan evenings together.  Midnight grocery shopping, phone calls after kids are asleep, dinners togethers while both DrH's are working all have built a friendship.

- Finding mothers with similar aged children -  Huge common interests, one friendship began from going to the same city park and striking a conversation with a local mother. 

- Participate in the community- Helps you feel involved in the community.  Find a service project or volunteer opportunity to help you learn to appreciate your new residency location. 

- Find a friend that can understand the unpredictable DrH schedule -  Yes, both lists have this one.  Cannot stress enough what a make or breaker this can be for a friendship.  This type of friend understands and is also flexible with the ever-changing schedule.

Melanie Gorman, wrote this helpful list for the Huffington Post, entitled "Five tips for creating new adult friends."  

Here are five tips for creating new adult friendships:

1. Like attracts like. If you want to find other people who are looking for friends, you have to be open to meeting them. Practice striking up conversations with people you know but are not close with.  Talk about things you have in common, like your kids, and then move the conversation to a more personal place and talk about yourself. Ask questions to discover what you have in common and see if there's a mutual need/interest in forming a friendship. You don't want to be a reporter and only ask questions. Take the risk to reveal things about yourself; after all, real intimacy is a give and take.
2. You're most likely to find friends in social settings that are interesting to you. While you may enjoy working the booth at your kid's soccer game, it's not the same as going to an event where people are discussing issues you love. Try www.meetup.com to find local ideas, and if you don't find one you like, consider creating your own. You might be surprised to find out how many people are interested in the same book you're reading or your favorite hobby.
3. You get out of life what you put into it, and friendships are no different. Once you find people you are interested in, try reaching out a few times. People can be shy, distracted and may mistake your overture as simple kindness. Also, you never know when someone's having a bad day. By reaching out a second or third time, you may find they're more interested in connecting and that they appreciate your efforts to get to know them.
4. Consider alternative resources like Facebook and Twitter. I know this may sound a little counterintuitive because we're talking about face-to-face friendships, but social sites are excellent places to practice. I've met several people on Twitter with whom I'd be tied at the hip if we lived in the same city. As it is, we'll settle for being virtual soul sisters. 
5. Revive friendships that may have been placed on the back burner. Scroll through your e-mail, Facebook or even your high school yearbook to find people you've lost touch with. With the invention of social media, most of us have found our long-lost sixth-grade buddies by now. Once you connect, take the extra step to invite them out for coffee/lunch. You can also host a play date and invite their kids to come along. Often kids can act as the easy topic of conversation to help you connect and explore rekindling your friendship

See her full post " Adult Friendship 101: Tips for Making New Friends After 35" at   http://www.huffingtonpost.com/melanie-gorman/adult-friendship-101_b_789388.html

Number three has inspired me to keep trying!  To often I have explained to DrH that inviting a person twice without any acceptance or return invite means they are not interested.  Melanie Gorman's article simply reminds me of human nature and the need to try again.  I suggest we forget the times a friendship hasn't worked or has had a slow start and that we find ways to build a support group with new friends. 

Cheers to new friends that help us survive residency:)

Cami

Residency Roundup: Getting Started

Welcome to Residency Roundup!  

My name is Cami!  I am married to an overworked PGY2 surgery resident and have two amazing little children that enrich our lives.   I am excited to share pieces of wisdom, hope, help, and support to families currently in residency and those preparing for it.

So, I am a list person.  Anything that I can write in list form I do.  After match day two years ago new lists began:  what sequence to pack up our tiny, gross apartment;  housing options in our new residency town;  meals that would clear out my pantry, freezer , and fridge;  graduation invites; etc... 

After we successfully and efficiently moved to residency, we realized we had no list ready for the next steps.  The following was developed from trial and error, luck, and a little research. Here is the list we needed two years ago!  

Find and Know this Information ASAP-

• First paycheck - When will it come?  
• DrH's program pays once a month, so the first paycheck came in August!! In addition to all the moving/relocating expenses, we used a short term loan from our parents to bide the time. 
• Vacation Requests - Find out when they are due, turn them in, don't miss the deadline.
• Human Resources - Read through the HR packets to understand your benefits and if you need to enroll in programs. 
• Our residency has a one-time smartphone or PDA reimbursement I found by reading everything.
• Opening socials - When are they? Make the effort to attend.
• We had one for DrH's program and one for the resident support group for spouses and families. 
• Residency Graduation - When is it? Are you invited?
• The incoming interns, in our program, are requested to attend the outgoing chiefs graduation dinner.  We are glad we made the effort to go, a short one week after med school graduation. 

To Do list for the first month- 

        (hopefully before DrH begins rotations)

• Find House to rent or own - We rented sight-unseen, so we planned a meet and greet with the landlord.
• Appliances - Our rental didn't come with a refrigerator.  One had to be secured within the first 48 hours.  Luckily we still had some time left on our moving truck to help us haul it from the store to our home.
• Set up utilities - You will need joint access to all accounts.
• Set up internet - We pay more for the extra fast internet for logging onto DrH's EMR, writing notes, and checking images.
• Local phone number - Look into Google Voice for your cell phone, if you don't want to change your number.
• Purchase a pager plan - Does your program supply one?
• Car insurance - A move to another state means different rates. (We seem to always move to a more expensive area). Call and find a new agent early on.
• Renters or home owners insurance
• Buy a second car - Which includes a smog check, insurance, and registration. 
• Parking pass for DrH's hospital- Is it provided by program?
• DMV trip - Our new state allots 10 days from your move-in date to get your license and car registration changed over.  We had to take the drivers test, thankfully easier than Step1;) 
• Medical/Dental benefits - Assign a PCP
• Thank you notes for graduation gifts
• Fill your new refrigerator 
• Meet neighbors 
• Find a Church and a Gym
• Find new friends for children
• Explore new city

Good luck forming your lists!

Cami


Leave comments below with what went wrong with your residency relocation, what could have been avoided, and what worked great!!