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??

I couldn’t have survived medical school and now residency without practicing these simple steps

Having three kids under age four and a husband in PGY2 is no small feat. Some days, life is awesome. My DrH actually gets to come home when he says he will, helps with the kids, cleans up after dinner and gives me a foot rub while we watch TV. We call these “Golden Days” and we savor them. But more often than not, life is a struggle.

I could write a book on why savoring the Golden Days will save your sanity and marriage, but I think that point is fairly universally understood. What isn’t universal is how to cope with the crappy days; because no two people’s crappy days are the same. Here is the advice I’ve learned so far (and wish I would have gotten earlier in this journey!).

Your DrH would rather be at home. Yes, he’s gone all the time. But he’d rather be at home with you than at work. That’s just the way of things. His constant absence from your life isn’t because he doesn’t like you; it’s because he likes you enough to provide for you. (I know that we all know this. But as women, we’re emotional beings and have to remind ourselves to be rational about things!)
Learn To Be Independent. I finally found happiness and sanity in this crazy life of residency when I realized that I needed to implement and adhere to a schedule, regardless of my DrH’s schedule. At first, I’d let the kids stay up until 10pm to see Daddy. But the next day we’d all be cranky and irritable. Yes, putting the kids to bed at 8pm means they may go several days without seeing their dad. But it also means that they’re respectful, kind, easy to get along with and much less prone to temper tantrums during the 12+ hours I’m with them. If my husband happened to come home early, we consider it a happy surprise and we’re all overjoyed. If not, at least I know that tomorrow won’t be Grouch City.

Recharge Your Batteries. Walk the aisles of target. Lock yourself in your bedroom and paint your toenails while chatting with a friend. Go out to dinner with your mom. Whatever gets you out of the house and away from the kids; away from the dishes in the sink and the Mount Everest sized pile of laundry for a few hours. When you return to face reality, you’ll feel recharged, refreshed and reenergized to tackle the tasks at hand.

Take breaks. Let the dishes sit for a few hours. Skip that project you’d planned on getting done today. The way to enjoy your kids is by getting on the floor and playing with them. Even the best laid plans of educational play, sensory exploration or science lessons devolve into tickle fights and indoor soccer. But it’s the tickle fights that they’ll remember anyway, so let it slide. That being said:
Pick Your Battles. With your husband and kids, especially. If the problem will go away by a change of your attitude, then let it go. There are so many real problems, so many bigger fish to fry, that the little stuff has to be ignored. Recognize also that one person’s mountain is another’s molehill. What is unacceptable behavior to you may be par for the course for someone else. Only you can decide which hills you’re willing to die on.

Have Sex. Often. And with gusto. It’s a great stress reliever and brings you closer as a couple. It’s easy to forget to be intimate when you’re both so exhausted, but it’s important to schedule one on one “Mommy and Daddy Time”.

Act As A Team. I tell my three year old “We’re all on the same team. We’re Team Westbrook and we cheer for each other.”. On occasion, I’ve had to remind my DrH that I’m on his team. We’re stronger together than we are apart, and neither of us could function as we do now without the other. He’s gone all day working so that I can raise the kids and run the house. I run the house and raise the kids so he can be at work all day to both advance his career and provide for the family. We’re equal partners on the same team, working toward the same goal.

Be Kind. Really, is there anything more simple and yet more important? Stress is so quickly accompanied by short tempers, which can lead to compounding the problem. As I tell my children: it’s important to be kind, even when you don’t feel like it. Being snotty (while satisfying at times) serves no purpose. You’d be amazed what a difference being polite will make. I’m still working on this one!

There you go, ladies. I hope this advice hits home with some of you! These are the things that I’ve had to learn in my 5 years of marriage. I couldn’t have survived medical school and now residency without practicing these simple steps! Good luck! -Jackie Westbrook

Journaling the Journey

Journaling the Journey

By Tiffany Sweeney

My husband and I are nearing the end of our medical training.  It has been almost nine years.  During these training years, we have moved four times, lived in three different states, and have grown our family.  As spouses or partners, we find ourselves cheering on our doctors (or doctors-in-training) through all the tests and exams, encouraging them through the long hours of rotations, and tolerating their forgetfulness and exhaustion through the many hours/days spent at the hospital.  We pick up the slack at home, learn to fill bigger shoes, and generally, support them through the highs and lows.  The question becomes … who is there to support and encourage us? 

Throughout this medical journey, we meet unforgettable and invaluable friends.  Then, we move away from them or grow apart or sometimes, just get lost in our daily lives.  Our doctors support us the best they can, but they can often fall short after the other responsibilities that fill their plates.  And, things happen outside of our little families that are completely out of our control that only add to the stress of our situation (i.e., economic strain, family crises, or sickness and death of family and friends).  We don’t deny that this path is a difficult one that contains struggles.  I found myself often seeing the negative, wishing the training was over, and getting lost in the difficulties that we have faced.

Throughout my life, I have always turned to writing in the difficult times.  In the elementary and teen years, I wrote angsty poetry.  As I grew older, I turned instead to blogging, then journals, particularly after the death of my father in 2012.  I began reading published journals, reading about how to journal, and even attended a journal club at my local library, where I sat the youngest among the group.  I discovered that through my writing, I have been able to find my support, work through my struggles, and find the positive that is needed in my life.  

Throughout my reading and experiences, I have discovered that journaling serves a multitude of purposes.  It documents life and family stories.  It shows me where I have been and how much I have grown.  It helps me to work through some of my anxieties and frustrations.  It assists me in finding the positive during difficult times.  It even highlights the things that I’m avoiding … it shows me what I am NOT writing and dealing with!  And, it has helped me to find the important things in life and heal through those times.

As 2014 approaches, I encourage you to begin journaling your journey.  Pick up a journal.  Get crafty with a memo notebook.  Grab the closest three ring binder.  Write.  Write.  Write.

Here are a few tips to get you started . . .

·         Write down the date at the top of your page.  Some people even choose to write down the time and where they are writing from (i.e., I sit on my oversized chair today, curled up with a blanket as I sip a bit of hot chocolate).

·         Free write.  If you don’t know what to do, set a timer for 15 minutes and just write.  Maybe start with a single word, the first one that comes to mind.  Or, maybe start with a favorite quote or passage from your current read.  Remember, this is only for you, unless you choose to share.  Sometimes you will be surprised what free writing will bring out!

·         Write down things you want to remember.  Did your daughter say something that made you laugh?  Did your son accomplish something that swelled your heart with pride?  Did your husband get off early and the two of you went off on a surprise date?  Document these.

·         Add to your writing.  Doodle.  Cut out newspaper clippings.  Glue in movie stubs.  Choose a color of pen that suits your mood.  Tape in postcards that your husband sent you from the interview trail.  Get creative in whatever way best suits you.

·         Write when you want.  You don’t have to journal every day.  Write when you feel like it, when the mood strikes you, when your husband is working night shifts, or when you need to get some particularly bad feelings off your chest.

·         Find the positive.  On a bad day, vent away, but don’t forget to document the good things in life.  Create a gratitude journal by simply writing down what you are thankful for at the end of every day.  Or, share what did go right or the way you had wanted it to.  Sometimes, you may need to focus on the small things.

·         Use inspiration.  Write down quotes that inspire you or touch you deeply.  Share your own thoughts about what that quote brews inside you. 

·         Share life stories.  Share your stories.  Share your children’s stories.  Document the stories of your parents, grandparents, etc.  What are some of your most memorable moments?  Do you remember the day that your spouse was accepted to med school?  What was it like to live through match day?  What were your feelings watching your doctor walk across that stage at graduation?

·         Re-read.  Every once in a while, go back and read what you have written.  Seeing where you have come from can sometimes help in choosing where to go from here.  Remind yourself what you have accomplished.  Reminisce.  Laugh.  Cry.  Discover what you are NOT writing about, but what may be on your mind often.  And, if you so desire, share with those you love and trust.

When the trying times are over, when the training is complete, you will have a reminder of what life was like, how strong you are, how much you have grown, and so much more. 

For interesting reading on journals, I recommend these titles:

·         Leaving a Trace:  On Keeping A Journal by Alexandra Johnson

·         Use Your Words:  A Writing Guide for Mothers by Kate Hopper

·         Creative Journal Writing:  The Art and Heart of Reflection by Stephanie Dowrick

I also recommend these links for further reading and proof of the benefits on keeping a journal:

·         What Kids Learn From Hearing Family Stories

·         Create Six Word Memoirs  With Kids

·         10 Famous Authors on the Importance of Keeping a Journal

·         100 Benefits of Journaling

Do you journal?  What is your favorite thing to write about?  What are other ways that you find yourself working through the good times and the bad of medical training and beyond?

Tif blogs regularly at Tif Talks Books, a site for all things books and literacy for the whole family. (Website link is http://www.tiftalksbooks.com)

Survivor Story:  Med School, Residency, Job, and Beyond!

V and I got married in July of 2001, and he began medical school that August.  Going back further, I was in the room when he opened the acceptance letter, I was waiting for him after he finished the MCAT, I prayed with him about whether or not he would pursue medicine at all, I studied with him for college finals, I was friend to this goofy guy who played fun music in his Isuzu Rodeo and frequented coffee shops.  When we met in 1997, I had no idea we would ever be more than friends, and I certainly had no clue what our lives would look like as we stepped into his medical training as newlyweds.  

I don't believe anyone can adequately prepare another person for any experience by trying to explain her own experience.  It is helpful, to be sure, but it is when we face things on our own that we truly learn.  With that disclaimer, I've tried to pull up some memories of distinct periods of time to share.

A special note to wives of medical students:  let your husband study as much as he needs to.  Know that "your turn" for his undivided attention will come.  He loves you, he wants to do well so he can provide for you.  He feels a tremendous pressure to succeed, and to make each test, each course, count.  Support him in prayer, in word, and in deed.  It is hard to put oneself last.  It goes against our nature.  

We lived in a poorly insulated, old house in New Orleans during V's med school years.  We had one cat, and we all spent a lot of time in the room we designated "the office".  I sat with the cat on my lap, and read, wrote, sketched, and tried to stay awake in support of my husband.  He didn't have to study hard in college to do well, but the increase in information going into med school was exponential.  He would even study in bed, when I couldn't stay awake, using a headlamp to light his books.  Post-exam days I would find him catching up on sleep.  I was so anxious to be with him again, to have his attention, but there was more opportunity to practice patience.  I did a lot of praying for patience and contentedness during those four years.  

A special note to wives of residents:  this is a particularly rough part of the journey.  This is where my husband became something of a lost sheep for a time.  God nudged me constantly to pray for him, and now that we're on the other side, V has said how truly priceless my prayers were.  Residency for him meant nearly no time to nourish his body, spirit, or mind.  Running on empty for that long is almost impossible.  

V's residency was a very busy ENT program in a fairly large city.  We saw a lot of big, life-changing personal struggles around us, and went through some ourselves during those five years.  V became a skilled surgeon and a very thorough and caring physician, but at great cost to himself, and our family.  We had become parents at the end of his 4th year of med school, and I found myself doing so many things on my own.  It was harder emotionally and mentally than physically, to me.  I knew that this stage of training was pivotal to V's career, but my heart seemed to always long for more.  I did even more praying for patience, endurance, contentedness, peace, and the ability to give when I just wanted to have more of my husband.  

A special note to wives of physicians who have recently finished residency:  rejoice, be thankful together.  Keep your eyes on things that are true, lasting, and good.  The world has much to offer, but its riches fade and do not fulfill.  Remember the days of little when there is abundance.  If you are a people of faith as my husband and I are, keep asking God how He wants your husband to use his gifts and calling to medicine.  And keep praying.  Bloom where you have been planted, even if you are not where you'd hoped or expected to be!

By the end of residency, we had endured a miscarriage but also welcomed the blessing of our second child, a daughter.  Our family of four moved two hours south for V to join a seven-physician private practice.  At first it seemed ideal, but after three years we had to re-evaluate.  After weighing everything, we decided to pursue a different opportunity in a different city, an hour back north.  We learned so much about what makes a good physician, about marketing and business, and about what we wanted in V's career.  It's about so much more than tangible earnings.  

This June will mark four years after the completion of V's residency.  We feel settled; we are having a home built, our son has enjoyed his 4th grade year in this new school, our daughter is happy at home with me and will start pre-K in the fall.  We are close to both sides of our family, which is something we had always wanted.  We hope that this place will be "it".  We are still learning, too!

This is far longer than I'd planned.  I suppose I could write a book on our experiences as a couple as we've journeyed through applying to med schools all the way to being in private practice.  At least, I could write enough quantity to fill a book; as for the quality, I'll keep looking to God to give me the words.  Blessings to all.

Who has it worse?

A few weeks ago I was chatting with a friend who is also a wife of a resident.  We were at an event where children were not allowed.  We began discussing who had our kids.  I told her my two girls were with a very kind friend.  She started telling me how her husband had theirs, but he had gotten home late today, late meaning 6:00 instead of 5:00.  She started saying to me, “I don’t know how you do it….”  Instantly my mind started silently running,  “5 o’clock? Late is 5 o’clock?  I am lucky if my husband gets home by 7 or 8.  We never get to eat dinner as a family on weekdays”….and so on.

As I have been reflecting about this, I hate that my initial reaction was to compare and judge.  It is too easy to feel bad for ourselves along this medical journey.  It is too easy to think we have it worse.  Ours is the hardest life.  Anything you have to do, I have to do too but with no shoes and in zero degree weather!

My husband and I have been married for 7 years.  In 2007 we moved to St Louis to start medical school.  We were young and naive; however, medical school wasn’t too hard for us.  We had no kids.  I started nursing school and worked part time so we were both too busy to miss each other.  When we had free time we could go to the gym for hours or watch complete TV series together.   All of our medical school friends had a different story.  They all had at least one child.  Their budgets were tighter.  Their time was spread more thin.  They had more responsibilities.  They must have it worse.  Then match day came. My husband decided to go into Urology so we were part of the early match.  I had just come home from a night shift and was 6 months pregnant.  We couldn’t wait to see where we were going to spend the next 5 years.  I turned the video camera on to capture this awesome moment and my husband clicked open the email.  Then our hearts dropped.  Tears came all too easily.  He hadn’t matched.  My extremely intelligent, talented husband with great board scores and plenty of interviews hadn’t matched.  At the time, it seemed we had it worse.

During our many years of school and residency, like most, we have been living on a tight budget.  We have not been given one penny of financial help.  On the other hand, we have friends who are given monthly allowances or other financial help from their parents.  Many are or have been on state assisted programs that pay/paid for health insurance and food.   However, one of these friends lost her mother to a very abrupt cancer during medical school.  Another of these friends struggled with depression and anxiety.  Who had it worse?

As for residency, we struggle with time quantity, not quality.  He works 12 14-16 hour days and then gets 2 days off.  I get lonely.  My girls go days without seeing their daddy.  BUT he loves us and he shows it.  He doesn’t waste a minute to start a tickle war with our two year old or cuddle with our baby.  Some have the opposite problem.  Their doctor is home much more often, but he doesn’t give them the quality that they deserve.  They might choose excessive exercise, sports, TV, or video games over them.  Who has it worse?

We live 14 hours away from all of our family.  We miss them like crazy because they are awesome,  incredible and supportive.  My girls get to see their grandparents about two times a year.  Others live right down the street from their family members, but have strained relationships with them.  Who has it worse?

My point? Even if you put your situation side by side with someone in the exact same point along this medical journey, it is impossible to compare.  There are just too many factors, too many differences. 

Perhaps instead of always thinking we have it worse, we should just try to be there for one another. 

After all, we have lots to be proud of.

We can be proud of our significant others for choosing such a noble profession.

Proud of ourselves for supporting them.

Proud of each other for helping to support one another when we need it the most.

Yes, instead of feeling lonely, and pessimistic, and down on ourselves, let’s be proud.

If I knew a year ago what I know now, our residency application process would have been much different.

If I knew a year ago what I know now, our residency application process would have been much different.  Of course, I’m now glad we didn’t know…but you should.

You see, a year ago my husband and I were waiting on Step Two scores to come in and working on his application for emergency medicine residencies.  Based on past years, the only concern we had for this specialty was a Step One score on the low end of acceptable.  But, he had experiences that far made up for it.  We were absolutely positive that if he did well on Step Two, we would have our pick of programs.  And, he did more than fine!  We celebrated Step Two for several days because his score was that good.  With a sigh of relief, we sent out applications and began to dream of the future.  We thought matching in emergency was a done deal based on what we knew from past years. 

Lesson One: Be wary of trusting statistics from past years—with changing specialties, these can be unreliable!

Unfortunately, a funny thing happened with EM last year.  It was suddenly very competitive.  We just weren’t getting the interview offers we expected.  But, we got the two that we wanted most—our home school and the program my husband auditioned with.  We actually turned down one more interview because it required a plane ticket, rental car, and missing a day of the audition rotation.  (It actually turned out he had the day off…whoops!) 

Lesson Two: Don’t turn down an interview for any reason unless there is absolutely no way to avoid it!

Another friend of ours applied to dozens upon dozens of programs.  He of course, received many, many offers.  He really wanted to be somewhere different and exciting.  He could only accept less than half the offers because of time constraints.  So, he accepted the offers in the biggest cities and declined most of the less competitive programs.  In the end, he matched at our home school—the only smaller city school he interviewed with and the very bottom of his very long rank list

. 

Lesson Three: Make sure you are interviewing where you are most likely to be accepted.

When it came down to the final weeks of interviews, the advisors at my husband’s school began sending emails asking students to come in immediately if they’d only had a small number of interviews.  We discussed this but still felt confident with our plan.  In fact, we agonized over which of our two programs to rank first.  Both had given strong indications that we shouldn’t be worried about Match.

 Lesson Four: Listen to your advisor, meet with your advisor, and trust your advisor.  And, get a new one if yours isn’t very helpful!

As you can probably guess by now, we SOAPed.  While it was the worst thing that could have happened at the time, I am actually grateful that it did.  You see, we had almost applied for Family Medicine slots as well.  My husband was very torn between the two specialties.  But, after seeing the Step Two score, we didn’t do it.  In the end, we ended up SOAPing into a Family slot.  The program is fantastic, we love the town, and my husband realizes how grateful he is to be in family instead of emergency.  We like where we are and what we are doing more than anything we’d actually applied for.   

Lesson Five: Don’t be afraid to apply for two specialties.  It’s not extremely difficult and is much better than the SOAP process!

Thankfully, we had a couple things that helped us tremendously with the SOAP process—my husband’s personal statement and a letter of recommendation from a family physician.  He knew from the time he wrote his statement it that it could be used for either Emergency or Family Medicine.  The letter just happened to come during his sub-internship.  During the SOAP process, you can only use the materials you already have saved in ERAS.  So, he would have had no chance to write and load a family medicine personal statement to help him out.  And, there was really only one EM slot he could have tried to get into.  As it gets closer to Match Week, I’ll be back to discuss more specifics of what you need to know about the SOAP process.  But for now, know I want to share one last bit of advice.  

Lesson Six: If you think there is even the slightest, smallest possibility you might SOAP, consider having a personal statement that could help you into an open slot…and maybe even a letter from a faculty member outside the specialty for which you are applying.

I really don’t want this post to scare anyone, but I want to share the wisdom that we gained through the process.  Also, I’ll be glad to answer and specific questions, too!