Sunday, November 27, 2011

Keep On Keeping On

Just when I finish my last audition rotation and get ready for a supposed month of vacation, I realize that interviews are still in full swing. With only a couple days of down time at home, I will soon be preparing for my next adventure on the east coast. All this travel, preparation and match anxiety has me worn out.

Performance Exhaustion

Working in the spotlight for months on end with few days in between shifts and plenty of loose ends on those days off, the moments of relaxation are nice to come by. I feel like everything is just move, move, move until there is no more energy to move. The alarm goes off, back to work, hit the road and repeat. I remember well the warnings last year's seniors gave about becoming exhausted throughout the interview season. Experiencing the long hours of peak performance and never knowing who is watching, I feel the fatigue setting in just as foretold. I can only hope that my efforts thus far and in the coming weeks will pay off come match day in mid February.

The excitement of traveling and visiting new cities is great, though it's equally rivaled by feelings of inadequacy and trepidation. I have met wonderful people in all these places, learned a great deal about the world of emergency medicine and thoroughly enjoyed my time exploring potential residencies. It's been a mixed bag of vacationing and working where the lines cross from time to time blurring the extremes of either. I really enjoy not knowing what is next or how things will turn out. It keeps an element of surprise around long enough to make things exciting. But all things being told, I am starting to realize a sleep deprivation that resembles those long days in class followed by nights of endless study, something I thought would only be a memory of the first years in medical school. In reality it is a lifestyle associated with this profession as I am quickly learning.

Question of the Week
Now that there is a light at the end of the tunnel, when do you actually become a doctor?

Answer & Wishful Thinking

Sunday, November 20, 2011

Residency Interview - The Ninth

It wasn't long ago that I visited this program for the first time doing an elective month in emergency medicine. Now six months later, I find myself on the hospital campus interviewing for a potential residency position. The interview is not only one day of suit-wearing anxiety, but a month long process of showcasing myself on every shift.

Arrowhead Regional Medical Center

After an evening out with the residents, it was not hard to see that their laid-back demeanor fit their in-hospital character well. It was as though friends were gathering rather than a professional undercover interview session over dinner. At one of the earliest interviews yet, the ties, suit coats, and slacks all found their way to the department office and patiently waited for formal interviews to begin. For most, there was no travel involved as we were already working at Arrowhead for the month. Taking turns, we were shuffled through four interviews separated by a lecture session and lunch.

My pre-lunch interviews were more energetic than the food-coma-induced afternoon interviews. The first encounter was brief with a couple of the attending faculty members. They tried to glean a perspective of performance under pressure during work situations and how we destress when not on the clock. I enjoyed the brevity and direct line of questioning they presented as it kept the mood fresh. Next up was a session with the junior residents, most of whom I have worked with in the department. Again the mood was inquisitively jovial with an opportunity to express myself outside the realm of work-place medicine. The encounters felt natural and low pressure despite the expectant nervousness associated with any interview of significance.

We then joined the rest of the residents in lecture to discuss case reports and teaching points recently experienced in the department. The cohesive nature of this group was evident as senior and junior residents worked together to respectfully formulate answers and discussion topics. Lunch was served and we made our way back to the interview chairs to finish out the day.

I was called to meet with the senior residents, two of which I had worked with previously. We recalled various experiences together treating interesting patients and elaborated on my desire to pursue a career in emergency medicine. Their conversation was welcoming and decisive as they look for students to carry on the legacy of their residency program. Shortly thereafter, I sat with the program director and another resident detailing my thoughts on the program thus far and why I wanted to be a part of it in the near future. None of the relationships were blurred between professional and informal, yet there was an overwhelming sense of family familiarity. All in all, ARMC is comfortable and inviting, as I would hope every potential employer would be.

Question of the Week
What happens when you get mad?

Suggested Considerations

Sunday, November 13, 2011

Residency Interview - The Eighth

Missing the snowstorm by a week, remnant evidence of its passing was still visible when I visited the country's northeastern city of Philadelphia. A short distance on the outskirts of the metropolitan limits was one of the community based hospitals in the Aria Health network.

Aria Health

I could not be more grateful for the generosity this program demonstrated. Their original invitation to interview a day earlier had to be turned down as I was visiting another program then. They accommodated my schedule and let me interview among students vying for another specialty the following day. At first, I felt mildly out of place as the line of thought, desired characteristics and program highlights were foreign to me during discussion and presentations. In the end, we were all students looking at a program from different angles which provided interesting insight.

As the lone emergency medicine interviewee, I was whisked away early to interview with the program director who I found as calm and kind as the treatment I had already received. We discussed the usual interview topics, how they intend to expand their program and what they have to offer. Shortly thereafter, a couple of the residents had their go at my application and put me in the proverbial hot seat. It, too, was as relaxed as my initial interactions leaving me feeling welcome and at ease with the experience.

A teaching session with the residents was led by local physicians in various specialties. Apparently, the medical institutions in the Philadelphia area are very open to sharing faculty in support of advancing medical education. This attitude creates an environment of community among health care facilities, providers and students all for the better. We toured the hospital with the residents who further answered questions about the program and health network. Despite being a smaller community hospital, the personality and character carried by the employees, residents and faculty was appreciable in my decision making. I really enjoyed my time in Philadelphia and exploring what this program had to offer.

Question of the Week
What can you bring to this program?

Suggested Consideration

Sunday, November 6, 2011

Residency Interview - The Seventh

Only one day into my new rotation I found myself standing in the long line at the airport awaiting security checkpoints before the sun reached the horizon. I would be spending the rest of the day in transit from one coast to the other losing hours fast as we crossed numerous time zones.

St. Joseph's Regional Medical Center

Waking up at 5am on the east coast was a rough task when my internal clock was screaming it was still 2 in the morning. My anxiety driven agenda helped get me out of bed, dressed and to the hospital in time to follow the medical staff into the underbelly of the large hospital. Recent construction has foot traffic rerouted on the outside, but the inside looked like a contemporary museum or lounge. Welcome to St. Joseph's in the heart of Paterson, New Jersey. Our morning started among the residents in a newly constructed auditorium reviewing cases and discussing medicine. Refreshments from the in-house Au Bon Pain worked our palates into submission before a tour of the facilities.

Among other things, the renovations have brought a whole new tower to the campus with state-of-the-art ICU, floors and revamped emergency department. Everything was so clean, colorful and busy. With various fellowships available, the latest technologies and seemingly satisfied residents, this program puts up quite a fight for a leading residency. Despite being an accredited Trauma II center, they have their fair share of trauma with what sounds like a procedure intense training. There is no lack of pediatrics and they are even gearing up for a geriatric oriented emergency unit, one of the first in the country.

Interviews were conducted after a lunch with residents in a panel format that consisted of program director, assistant program director, department manager, and resident. I felt at ease throughout the process and was intrigued by the clinical case exercise. It was done in the style of an oral board exam, something I have never practiced. Despite my travel fatigue, my answers portrayed my personality and came across the way I would have answered in a no-stress situation. I left feeling this program was a shining star among programs and was honored to interview as a guest on their campus.

Question of the Week
If one were to ask a friend of yours what one weakness you have, what would it be?

Suggested Considerations

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