There's No Homework Like No Homework

Rotations are finished. Residency is on the horizon. I am basking in the space between...vacation-land. Although there is plenty to do in preparation for the next steps, this time is just as precious as it sounds. Letting go of the time schedule, burdens of major responsibility and trivial concerns is more relieving than I imagined it would be.

Recapturing Lost Time

While I could have been intently studying for my next board exam, reviewing the pharmacokinetics of anti-microbials or rehashing the Kreb's cycle, I chose to rest the organ I've exercised intensely for the last four years. Traveling here and there, sometimes without a phone or computer to really dive into the organic "R and R" so badly needed. Mother's Day was no exception. With no prior commitments and time to spare, I made the trek to surprise my mother even though it was the week before graduation where I would see her again. Why would I do it? Because I could. Time allowed and it makes for a better story than going to the arcade for a day.

With only one week remaining before graduation the obvious excitement has somewhat worn off since starting vacation. As it stands now, only time is between me and a degree. No more exams, interviews or documents need my attention. My vacation time seems more valuable at this point than a 4 hour meeting of name-calling and black robes. Yet we are required to attend the event, perhaps for the school to maintain its public appeal of graduating x number of doctors this year. Attending graduation will be the public culmination of all this hard work put to rest. An opportunity for close friends and relatives to say, "I know that guy, how on earth did he become a doctor?" I suppose deep down inside I want to be there too, because it is a proof-giving ceremony validating the last 25 years of my life. Something few events can do.

Here is to a lifetime of dreams, four years of hard work, relationships made and kept, mothers and fathers who support, being a medical student who experiences bipolar highs and lows, and most importantly to the years ahead. The next time I post here will be as a doctor, not that far removed from the student, but across the line a marathon winner.

Question of the Week

Was it hard?

Answer & Explanation

In Stitches

Eat, sleep, and breath medicine. That's how medical school is for so many who live through it. We get so caught up in the world of bacteria and mutant cells that we forget to live a little. The years in medical school are filled with crazy first experiences and stories that we would be wise to remember forever. Some moving, others hope inspiring and then there are those that just leave you in stitches.

Medical Memoirs

It wasn't long ago that I was traveling the country with countless hours on flights and layovers. I felt fortunate and honored that Dr. Anthony Youn had contacted me about his latest publication In Stitches, his medical school memoir. It gave me something to do during those long trips and kept me amused as I could so easily relate to his medical training experiences.

Now, I'm not normally much of a reader, but I was surprisingly drawn to the reminiscing of a fellow medical professional. A clever chronology of events, short stories and laughable themes kept me reading until I finished only days after beginning. Dr. Youn's adventure, and misadventure, portrayed the development of his character through inner trials and external challenges. As a young man slaving away to make his father happy, he realized along with his father that happiness can only come from following our own dreams. Achieving big goals requires a sense of confidence, boldness and stamina; all of which develop over time through humorous and touching events.

It was the perfect time for me to read his tales as I had been through the classwork, clinicals and would soon be starting residency. As a practicing plastic surgeon, he lives in the light at the end of the tunnel that is finally coming into view for me. No matter how difficult school becomes, at least there will be some great stories in the end. I think he sums it up well in this small paragraph:

Thanks to my small circle of close friends, my focus, work ethic, and drive to succeed, I slowly grew up. I entered medical school a shy, skinny, awkward nerd with no confidence, no game, and no clue. I came out, four years later, a man.

For someone entertaining the thought of attending medical school, current students, or one just wanting a glimpse into the life of a medical student, I would recommend this memoir.

Question of the Week

When inflating the balloon on a Foley catheter what is the proper solution to use and why?

Answer & Explanation

Residency Interviews - In Summary

Looking back over the last five months of 2011, I realize how busy life really was during that time. It seems that I was always on the road working towards the next step and getting ready to meet the next goal along the path. The bittersweet sunset to all the travels, new locations and challenging interviews has come and is now a memory.

Interview Season

Sometimes the numbers say it well:

• 1 Board exam
• 2 Case reports written
• 3 Coasts
• 4 Clinical rotation sites
• 5 Months
• 13 States
• 14 Residency Interviews
• 25,468 miles traveled

View Larger Map

It was a lot of road and air time, which I always thought would be fun. At first it was, but as time went on it became very exhausting living out of a suitcase and never in one place for too long. I met great people along the way and was able to visit some fantastic places which can be seen in the links below:

• August
• September
• October
• November - Part 1, Part 2
• December - coming soon

One might think from my photos that I wasn't doing much in the way of rotations at hospitals, but I would prefer to maintain some patient privacy while working. With all that excitement and stress behind me, it is time to prepare for the less adventurous yet fear provoking Match. In a week's time I will be submitting my rank list for residency programs and within a month hopefully hearing good news. It is just a matter of time at this point, but at least things are moving along well.

Question of the Week

What programs are the forerunners in your rank list?

Answer

Residency Interview – The Thirteenth

The anticipation for this day was growing throughout the interview season as many students spoke highly of the hospital and potential opportunities well before I had a chance to see it for myself. Lehigh Valley Health Network incorporates a number of hospitals in the Lehigh Valley region of Pennsylvania. If the size of the lettering has anything to do with the caliber of the program, they are off to a good start.

Lehigh Valley Hospital

Our day started with a short presentation of the program and the large group of interviewees was divided to spread the masses. The interviewing half had four stations with two interviewers each. As there were so many stations and interviewing students, these sessions were not excessively long which left plenty of opportunity to ask questions and provide answers. With couches in every room, the tension was definitely less than most and certainly more comfortable than other programs offered. Between program director, assistants, clinical faculty and ancillary staff many of the common interview questions were exhausted rather quickly. I definitely appreciated meeting the majority of the teaching staff and being able to ask specific questions of those holding particular responsibilities.

At lunch we all sat in our formal-wear lining the tables of the cafeteria learning everything we could from current residents. It was a moment to relax and really determine if we felt as though the program would be a good fit for us personally. Satiated, we made our way to the shuttles for a tour of the medical facilities. State-of-the-art simulation labs that modeled patient rooms, healing decorations and quarantine-prepared spaces were among some of the unique features we observed. Much of the remodeling benefits both the patients and staff. Fellowship, research and altruistic opportunities were in abundance. The emergency medicine program monopolizes one facility and shares responsibility for another. Being accredited trauma centers, they see a number of pediatric and adult cases that smaller facilities may not.

Being this late in the interview season, it was somewhat difficult to maintain a sense of enthusiasm that was obvious at the onset. Nonetheless, this program definitely elicited a sense of excitement as it has so much education to offer including well-trained emergency physicians. I can only imagine that the upcoming residency match will bring them some of the strongest applicants from around the world.

Question of the Week

What do you like to do when you are not working?

Suggested Considerations

Residency Interview - The Twelfth

After a rejuvenating weekend in Philadelphia, my morning commute took me across the beautifully blue Benjamin Franklin Memorial Bridge into New Jersey where I found the UMDNJ School of Osteopathic Medicine. Interviews would be ongoing throughout the day and I was fortunate to have mine early, leaving the remainder of the day to explore the surroundings.

University of Medicine and Dentistry of New Jersey

I joined the in-progress round table discussion between students and residents while waiting to be called for my formal interview. It was an opportunity I had become familiar with through the course of previous interviews; probing the minds of current interns and residents as to their thoughts on the program.  When used accordingly, these can usually be a solidifying factor in choosing for or against a program. Knowing how current residents feel towards faculty, facility and curriculum is a vantage point that cannot be overlooked. On this particular day, they were very positive about the program and spoke highly in this regard. 

It did not take long before I found myself across the table from my interviewers: the  program director, an assistant director and the manager of the emergency department. These men, sage in their years and thoughtful in their remarks were attentively looking for the next residents to fill their intern class. In their professional and experienced manner, they described characteristics of loyalty, integrity and honest above all else that they sought. For them, a cohesive residency would be an effective one. I was impressed by their warmness and desire to truly provide their residents with the best program possible. My questions were respectfully answered and I was told what to expect in the coming weeks approaching the Match. 

Shortly after interviewing, we joined the interns for a tour of the hospital. All facilities are community based without trauma designation. The hospital we toured was relatively clean, organized and efficiently run from what I observed. Although the interns were helpful, it would have been nice to have an upper level resident join us to answer questions interns were unequipped to field. Overall, our interview day was relatively short, yet I felt that it was a strong contender on my list of residency programs.

Question of the Week

What are you looking for in a residency program?

Suggested Considerations

Residency Interview - The Eleventh

With my trusty rental car ready to go and a seven hour drive ahead, I braved the New York traffic. At first the stop and go nonsense was getting to me, but it made the Pennsylvania countryside drive well worth the effort. The open road, starry night and blaring music were a perfect recipe for calming the interview tension.

Conemaugh Memorial Medical Center

I arrived after midnight and found my hotel to be quite comfortable for the few hours before waking to interview. The sun was up, fog filled the rolling Allegheny mountains and a crisp winter air was obvious as my breath condensed the air before me. It was a beautiful drive into the small valley town of Johnstown, Pennsylvania where I found my way to Conemaugh Memorial Medical Center. It is an impressive Trauma I medical center that stretched over multiple blocks on the side of a mountain and was busy even for the early morning hours.

We were greeted by the emergency medicine staff and invited to join the conference sessions already in progress. I enjoyed the interested participation of residents and faculty who seemed very much like a family in discussion. This program is pioneering an approach to the curriculum by reading the current journals in place of textbooks which tend to be years behind. It is a novel approach and seems to be effective from their initial assessments.

Individual interviews started shortly thereafter with one member of the faculty in three separate interviews. The first I was surprised to be invited to ask questions, which was an obvious deviation from the normal interview process. In fact there were no questions asked by the interviewer! As I went on to meet with the program director, he again provided me answers to my questions, yet asked none. I was astonished that I had made my way through two "interviews" and no questions were asked of me. Was I missing something? Are they getting the information they need about me? My third interview started along the same lines, but I was not going to let my line of thought lead the entire discussion. After one question, I stopped to offer time to my interviewer. His questions were unique, not related to medicine and more along the lines of how I approach an answer. When those were exhausted, he promptly provided me with a case similar to an oral board. I am happy to report that I passed with an appropriate diagnosis.

The interviews were followed by lunch and a tour of the facilities. I was surprised at the business of the hospital in such a small community setting. We even made our way to the helipad which had a beautiful view of the surrounding valley. This program is located in a neat location with all the benefits of a trauma center. It is willing to find new ways to approach learning and ensure competency in its residents all while maintaining the important family ties. It is one program I will not regret visiting.

Question of the Week

If you were to go on vacation between medical school and residency for two weeks, where would you go, what would you bring, what would you do and who would you bring with you?

Residency Interview - The Tenth

After a transcontinental flight from the West, I found myself in the Long Island rain of New York heading to a pre-interview dinner on the town with the emergency medicine residents of Good Samaritan Hospital.

Good Samaritan Hospital

The table full of appetizers surrounded by residents and students full of questions. It was beneficial learning how residents cope with work, manage their time and invest in their future careers. It was definitely preparatory for the interviews.

We started the day later than most interview days which helped those of us who traveled through multiple time zones. Morning conference was a faculty or resident presentation with ensuing discussion. We had a detailed tour of the emergency department. I was most surprised by the rooms divided into two by a curtain, effectively doubling the bed space. Aside from the tight quarters, it appeared that work was unimpeded and frantically busy. Between trauma, pediatric and adult services, Good Samaritan is one of the busiest EDs on Long Island. The EM program is notably heavy with research and presentations commonly winning the majority of competitions attended.

After a brief overview of the program and surrounding area, we had lunch with the residents and faculty. We were then off to interview. Three separate interviews, each in panel format composed of three faculty and residents. The atmosphere calm, to the point and mutually educational. The area is culturally diverse, hospital continuously active and personnel readily available making this residency a strong place to establish a professional foundation. It was not until I was back in the car headed towards metropolitan New York that I got a taste of vehicular congestion, an avoidable yet frustrating association with this part of the country.

Question of the Week

What is your favorite movie?

Suggested Considerations

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

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

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

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

Residency Interview – The Sixth

Only a couple states away my alarm sounded early enough to get me moving in the right direction. Sheer terror came over me, however, when I realized I would be driving across time zones putting me at risk for being an hour late to my destination. Needless to say, but I may or may not have driven a little faster than intended

Genesys Hospital & Health

Between the early morning hours and minimal traffic, lost time was quickly made up and I arrived in time for the afternoon interviews. The brisk breeze and color changing trees was a relaxing welcome to Genesys Hospital near Flint, Michigan. Walking in the hospital felt more like finding myself at a hotel lobby. The smells of a busy food court, music from a self-playing grand piano and visually pleasing flowers filled the foyer just beyond the doors. I quickly questioned if I had gone to the right place. Noticing the other suited students, it was apparent I was not lost.

After a brief meet-and-greet over lunch, the program director provided an overview of the day and residency program. We then divided accordingly to our respective interviews. One by one we met with the program director, assistant director, department manager, director of clinical education and chief residents. Each focused on various aspects of the interview including teamwork, leadership, extracurricular activities, and business aspects of medicine. This style was new to me and I tried to take advantage of the opportunity by not repeating answers. I will admit, however, that it felt as though the process was longer since these interactions were so numerous, yet the total time commitment was less than most programs. Well done Genesys.

There was plenty of time to interact with residents and have questions answered in a no-pressure setting. They took us on tours of the emergency department, hospital and associated athletic club. All were very busy, which I did not initially expect by the surrounding rural-esque environment. Genesys lived up to the great things I heard all the way across the country in Las Vegas and I’m glad I had the opportunity to visit their program in person. 

Question of the Week

What non-medical book have you read lately?

Suggested Considerations

Residency Interview - The Fifth

The sun was still sleeping when I arrived at the hospital for my early morning interview. Having only worked a handful of shifts, getting to the emergency department was not a problem. Finding the interview room in time might be.

St. James Hospital & Health

Fortunately, I found the program director as he entered the building suited and ready to interview. A couple days prior I responded to a call on the medical floor to see if I could be of help before my shift ended. The resident in charge was unable to pass an endotracheal tube through the vocal cords and as luck would have it, I found myself at the head of the bed finishing the job. It didn't take long for the program director to catch wind of the event and in the moments before the interview it became a topic of discussion. Good thing for me...the patient was still living.

Only another student and I would be interviewing that day for one of the largest emergency medicine residencies in the country. After a short presentation about the St. James program, its many hospitals spread across the Chicago community and various local highlights, we sat for our individual interviews. They were short and to the point allowing the chief residents, director and me an opportunity to learn about each other and the program. Despite having nine hospitals in the system, we only toured the Olympia Fields facility where the interview took place.

The remainder of the morning was consumed by a didactic session with the current residents, faculty and guest lecturers. Being near a city with so many hospitals and residency programs, they are privileged to have recognized physicians lecturing on a regular basis. As quickly as it had begun, the day seemed over and it was already time to start my afternoon shift. I think it would be helpful to see some of the other facilities, but the residents trickle through my rotating ED enough to get an idea of their character. I continue to be impressed by their caliber, friendliness and hard work ethic. Since my childhood stomping grounds are miles away, this program definitely has an added bonus when it comes time to make a residency decision.

Question of the Week

If you could meet and have a discussion with any person alive or dead, who would it be and what would you discuss?

Suggested Considerations

Residency Interview - The Fourth

Despite being invited to meet with the residents for dinner before interview day, I was not be able to join them due to a drive through Ohio's more rural parts. It was probably for the better since I was still wrapping my head around an interview early in that afternoon. 

Doctors Hospital

The west side of Columbus, Ohio felt very similar to my childhood stomping grounds; the suburban unencumbered traffic patterns with residences and businesses lining the streets. Prepared to leave my hotel early, I met another interviewing student at breakfast. We are not hard to spot as anxiety is obvious, professional attire the norm and portfolios a calming distraction. Doctors Hospital seemed to be at the center of community health with a steady flow of people coming and going. Dressed in standard suit and tie form I made my way into the educational building for the weekly didactic session among residents, faculty and fellow interviewing students. It was comforting to see other students I had met on the interview trail, once again proving how small the community within a specialty truly can be. I found the discussions by teaching staff and guests to be rather enlightening. To top off the morning session, we finished with a splinting lab before heading to the conference room for interviews.

After brief introductions were made by all in attendance, half of the group toured the facility while the others interviewed. The facilities were impressive. With so many residents in house, they have their own lounge with a mini fitness center and sleep rooms. The simulation lab was extensive and appeared to be well used by those in training. The ED was super clean, but did not seem to be as busy as one would expect for the middle of the day. One nice feature is that all the gurneys are the OB/GYN type, so that finding one when you really need it would not be a problem. The rest of the hospital was either on its way to being remodeled or in the process of getting the upgrade.

One of the strengths of this particular emergency medicine program is their involvement with the local community emergency crews. It seems that they are very involved in both ground and flight transport with regular training sessions to help educate regularly. On the flip side, with so many residency programs in one facility there are the expected clashes when one service wants to get their fair share, but has to step aside to let another service take over. In this sense, the program does not have unopposed care of all their patients. Nonetheless, trauma and pediatrics were external rotations done at inner city hospitals that get high patient volumes and acuity. With the tour complete, we started the individual interviews.

The interview was conducted by the program director, his assistant and three residents. It was a very laid back session with free-flowing conversation and questions. To my surprise, amid the questions an EKG was given to me to diagnose and manage the patient. Fortunately, I had some understanding of the tracing and could formulate an educated response and treatment, thus effectively "saving" the patient's life. This interview was somewhat unique in that the questions asked were not all typical of an interview I have experienced. They definitely required some thinking on my toes and hopefully provided insight into who I am as a person even if they weren't always well formulated answers. Overall, I left the program feeling good about the experience and enthusiastic about its potential.

Question of the Week

If you were given a large sum of money and could no longer work in medicine, what type of work would you do?

Residency Interview - The Third

The long autumnal drive from Chicago to Michigan was calmingly pleasant with beautiful weather and fall leaves changing colors all around. It was just what I needed to relieve the anxiety of another interview day on the horizon.


Sparrow Hospital

Driving through the streets, the college town feel greeted me as students busily went about their evening activities and the MSU campus seemed to remain lively even after the sun had set. I would soon be meeting some of the emergency medicine residents at Sparrow Hospital for dinner the night before my interview. The food was good and the residents friendly. Being the knowledgeable experts about their program, they answered our questions and introduced the program with great excitement. It was a perfect opportunity to get the inside scoop on a city and facility I knew little about. To make our stay that night more comfortable, reservations were made for us to stay on campus at the Kellogg Center, a business style hotel which was definitely a welcome opportunity.

After a brief meeting in the morning to highlight the program we had two personal interviews conducted by the program director and the assistant director. It was a comfortable exchange discussing program attributes and myself as a candidate. Afterwards we toured the main and secondary hospitals. I was amazed at the state-of-the-art feel as much of Sparrow was recently built. The emergency department was larger than any I had seen in my travels and seemed to have an endless supply of rooms. This undoubtedly met the demands of the community and appeared to do so in a great setting. There was ample time with current residents to have our questions answered and to really understand the underpinnings of the program. With a strong curriculum, experienced core faculty, wonderful facilities, and a supportive community this program definitely put on a great showing. The icing on the cake was a quick trip to the rooftop helipad that overlooked the city, simply beautiful.

As a final wrap-up to the day, we were invited to dine with residents and a member of the faculty. By this time, all of our questions had been answered and it was just a matter of getting "that feeling" of knowing it was the program; a decision that is too early to make. I am pleased to have experienced this program first-hand as it was rather enlightening.

Question of the Week

Where would you like to be in 10 years?

Suggested Consideration

Residency Interview - The Second

At the beginning of the month-long rotation I was told to be ready for a spontaneous interview sometime throughout the month. Without much warning we would be pulled aside to discuss with program leaders the program and ourselves. However, I didn't think it was going to be three separate interviews on three different days.

Kent Hospital

As a courtesy gesture towards the students who rotated at the site, we were asked to not dress in formal attire. Needless to say, interviewing in jeans and a hoodie was comfortably welcome albeit a little awkward. The first sit-down session was with the chief resident, laid back and somewhat formal in questioning. It was a good way to get an idea about the program from a resident's perspective. Then the department manager pulled us aside later in the week to get to know us and our thoughts about the program. The following week the residency director met one-on-one to finish the interview process. I would imagine when formal interviews are held, it is a little more compact and rigorous, but since we had an entire month to demonstrate ourselves, there was little need doing so.

I was happily surprised with my experience at Kent Hospital. Having never really visited the Northeast and Rhode Island in particular, it was quite the adventure to be newly exposed to both in such a high-stakes way. The faculty, staff and even patients were among some of the nicest people I have met in my travels. The department itself was one of the cleanest, roomiest and most organized that I have visited. With those qualities, it made sense that a community hospital would always have a full ambulance bay unloading new patients. Although the visiting students did not get to see the ancillary rotation sites for this program, we were informed that the following hospitals are among the list: Tuft Medical Center, Massachusetts General Hospital, St. Barnabas Hospital Bronx, St. Anne's Hospital, Children's Hospital Boston, Women's and Infants, and Butler Hospital.

I left the program feeling invigorated about emergency medicine and the upcoming match experience. On the interview trail, it seems that faculty know other faculty at various programs and the rotating students will show up time and time again. As we rotate around the country and interview for residency positions, students run into each other at various sites proving how small the world within a specialty can be. All in all, despite having three individual interviews for one program, I enjoyed the opportunity of experiencing first hand what this program had to offer.

Question of the Week

Why do you want to do _____ (insert your specialty of choice)? Why do you want to come to _____ (insert the interviewing program)?

The above are guaranteed questions in just about every residency interview.

Residency Interview - The First

Just coming off of night shifts, I had a difficult time falling asleep and the anxiety of an interview the next day didn't make things any better. In total I think I may have slept four hours before my alarm sounded at 3am.

St. Barnabas Hospital

I shuffled about my morning activities while the world around me still slept and the crickets chirped. It had been a while since I knotted a tie, but this morning it went on with no problem. I was out the door by 4am and on the road for an early morning cruise to New York. My destination, St. Barnabas Hospital in the Bronx, roughly three hours away. Traffic was nonexistent and the morning fog was the worst obstacle. The hurried feel of New York was obvious as I approached the hospital with people mulling about and a full ambulance bay. I had arrived for my first residency interview.

I was fascinated by the inherent antiquity of the buildings, it gave a sense of being well established in the community. The only person in a suit, I stood out like a sore thumb among those in scrubs and street clothes as I walked the campus. It was apparent that I was there on official business. Shortly after finding the morning meeting place, the faculty lectures and student case reports consumed the early hours of this program introduction. These were followed by a tour of the emergency department and hospital before grabbing lunch that was provided for Employee Appreciation Day.

While it was difficult to digest lunch due to the building anxiety, we conversed with residents and other interviewees about the program. One by one we made our way into the "hot seat" for our personal interviews in front of a panel made up of two residents and two faculty members. The questions were focused around the program and my submitted application, both of which I felt comfortable discussing. I was then given time to ask about the program and before I knew it, we were shaking hands and parting ways. It was a breath of fresh air to have my first interview behind me. I definitely enjoyed the experience and look forward to more like it as I explore the world of emergency medicine residencies.

Question of the Week

You have diagnosed a patient with a terminal illness or must give grave news. How would you share this new information with your patient?

Suggested Consideration

Anti-Medical Meanderings

All this humid weather has kept me under a fan, in the air conditioning and rarely outside. The times when I am exposed to the elements are usually reserved for travel to my clinical site, exercise and exploration. Here in Miami Beach there is plenty to explore especially since I am coming from a desert.

Beautiful Exploration

Taking time out of an already busy schedule to investigate a new location is not always easy, especially when time is limited. When traveling to rotation sites out of my home city, I like to get an idea of what the community has to offer and what attractions may be in the area. On a day off, I drove to the Florida keys. I've always been curious about the tropical environment there with its long stretches of road linking numerous islands. Beautiful skies were complemented by the temperate waters and lush greenery. It was a short lived getaway that I needed. Upon my return to the mainland I pit-stopped on one part of the seemingly never ending beach. The entire coast is Atlantic Ocean beach front covered with tourists, towering resorts and one of the nicest boardwalks I've experienced. City life is bustling and the art deco facades a glimpse of times past. This is definitely a colorful place to experience medicine as the hospital caters to those who live and play here.

Traveling to places unknown is a challenge when adjusting to the newness of lifestyle and environment. If the residency match places me here, it's nice to know what I am getting myself into. To me that makes the exploratory day trip worth the effort. Getting a sense for the people and their mentality in and outside of the medical setting is key to making what will be a life influencing decision. On the flip side, this is Miami and summer, I don't know how I could have come here and not experienced what this place has to offer! Living among the locals definitely helps get an idea for what there is to do and see. In exchange for all of this I have to learn to live with the humidity which has been tougher than I imagined.

Question of the Week

An 8 year old boy with rapidly deteriorating cognitive function is not oriented to time, person, or place. On exam he has nuchal rigidity and a high fever. His mother tells you that he has been swimming in a lake at a campground in Florida. You diagnose the boy with meningoencephalitis. Which of the following represents the most likely infectious agent?

A. Neisseria meningitidis
B. Haemophilus influenzae
C. Streptococcus pneumoniae
D. Naegleria fowleri
E. Mycobacterium tuberculosis


Answer & Explanation

The Start of Audition Rotations

Let the audition rotations begin. Catching the red eye flight from Las Vegas to Miami was not exactly my idea of fun. Nonetheless, I arrived safely and got a sneak peak at where I will be spending the next month. Literally feet from the water, Mt. Sinai Medical Center serves Miami Beach meeting numerous medical needs.

Beach-side Medicine

I was amazed at the number of memorial wings, buildings and structures. This hospital has a long history of providing health care in the community which was demonstrated by the banner at the front entrance sharing the recent news that it provides the best care in geriatrics. This comes as no surprise since the population of retirees is so saturated here. In my brief exploration of the surroundings, however, I did not see too many seniors bathing in the sun and shopping around town. Perhaps I was not on the right side of town. So now I am curious as to who the hospital patient population will be; international tourists, retired seniors or partying youth.

Every hospital tends to have a unique population set. Some see greater numbers of indigent, immigrants, aged or affluent people. Testing the waters now as a medical student will help me when the time comes to make a residency rank list. Knowing what a program has to offer both in academics and patient presentation can have a significant impact on the education to be received. Fortunately, the programs that are weak in one part of the population often send residents to other facilities to get the exposure needed. Until I actually start my shifts, I suppose I will have to remain in suspense and get used to the humidity we rarely get in the desert. 

Question of the Week

A mother brings in her 10 month old child after what she thinks was a seizure. She reports that he was premature and has a history of broken ribs at 6 months of age. On exam you notice his hair to be steel colored and brittle. He appears very malnourished and small for his age. You correctly diagnose him with Menkes disease which has a deficiency of which of the following?

A. Copper
B. Biotin
C. Zinc
D. Niacin
E. Pyridoxine

Answer & Explanation