BigRedMed's journey through 4th year...

Pre-Med & Medical School Careers in Medicine
41

<p>Update...</p>

<p>I realized I left off one of my programs when I submitted my application the first time, so I submitted to them last week.</p>

<p>So with 22 programs, I have 9 invitations to interview so far, with 6 interviews set up, some even with travel and hotel booked (actually, most of the peds programs pay for your hotel, but the more competitive specialties this is not always the case). I've yet to hear from the top three places I want to hear from, but have a couple programs I'm excited about that I've set up interviews with.</p>

<p>Anyways, it's still pretty early (as my friend doing derm was very adamant about today), and I'm already approaching a point of critical mass where statistically I <i>should</i> match without issue. I feel that if I interview at 10 places, it shouldn't be any problem (besides I interview extremely well).</p>

42

<p>Up to 14 invitations after this week. Still nothing from my top three. </p>

<p>7 interviews are confirmed, plus I'll set up two more on Monday for the programs in my hometown (more to appease my parents than anything else - I'm on a vacation month in January so it doesn't really matter much).</p>

<p>Hopefully next week pulls in some of the ones I really want to hear from.</p>

<p>In scheduling news, I thinking that I might alter my M4 TA month - April - and change it to an general peds private practice. My peds clerkship (which my school has since revised) included a week of private practice, and I had a great time with the docs out there. One of them had been a pediatrician in town since the early 1960's! He's now even taking care of grandchildren of some his first patients! That one week taught me an enormous amount (and I know now that I wasn't even that good at the time - it was my 9th week of third year). I'm still weighing the options and probably will decide in January. It wouldn't be a very taxing month, and I'm sure those docs out there would be understanding of it being the last month of med school and all, but it would provide some extra exposure in preparation for being an intern.</p>

<p>PrincessDad - do you have any thoughts? I know you said earlier about trying things that I wouldn't otherwise be exposed to, which this is pretty much doing the opposite, but I'd like to know what you think.</p>

43

<p>As a faculty member at a top 20 medical school ( I also coordinate our 4th yr student elective in our specialty), I would highly discourage anyone doing an "audition" elective in any specialty. If your performance is substandard(I have seen MANY students who were) and you believe that you can overcome academic weakness by "dazzling" everyone by showing up, or if you appear to be overly impressed with yourself(even if you are academically strong) that will also be apparent to everyone and can only hurt your chances of matching at your dream program.
The 4th yr of medical school should never be squandered to get "vaycay" time. It should be used to strengthen and build upon skills learned in the 3rd year. Too often, I see students who are permitted to do as many as 3 electives in the same specialty,usually as away (audition) rotations, when they should be taking those rotations in other specialties that will enhance their skills when they embark on their intern year.
Regardless of the specialty selected, all 4th yr students should do a month of emergency medicine and a month of ICU work,even if the school does not require it.</p>

44

<p>Got my first rejection today - Oregon Health Sciences U. They were one of my top choices and I was really hoping that I'd get a chance to see their program. I knew that OHSU is a very popular place because of Portland, and so it's not entirely surprising. </p>

<p>I do have 16 invites, but I did withdraw from one program already - it was a program that I had thrown on at the last minute, and after further examination, I realized they had 8 months of Q4 call...all the other programs I'm looking at are 6 months or fewer of Q4. One program I'm interviewing at is q6-7 (it's a busy night though, but still, only once a week? that's totally doable). I'm definitely not opposed to working, but it seemed excessive when no place else is that intense. Plus it was one of the few places that didn't fit my warmer climate standard that most of my other locations possess. </p>

<p>Only 5 more programs to hear from - 1 that I really want to interview at (and will be very disappointed if I'm rejected), 1 that I'd be thrilled to hear from, 1 I'm fairly indifferent to, 1 that I've heard is otherwise malignant (but is a great location), and 1 that I'd be shocked if I got an interview from, but not really worried about getting rejected (kind of wondered why it hasn't happened yet actually).</p>

<p>My first interview is on November 11th at my home program.</p>

45

<p>Took Step 2 Clinical Knowledge today...much easier than Step 1 in my opinion and was a much shorter day (at least for me) even though there are more questions on Step 2 (8 blocks of 46 questions compared to 7 blocks of 50 on Step 1). </p>

<p>I studied a decent amount for it leading up to it, but mostly focused on my weak areas (derm, rheumatology, hematology, and nephrology) in the last week. Of course, as is always the case, I ended up with very few questions in any of those areas (which really surprised me about rheum). </p>

<p>I think I did fairly well, students from my school have historically done significantly better on Step 2 than on Step 1. Some of my friends have gained as many as 38 points on Step 2. I'm expecting an increase and would be disappointed if my score didn't go up at least 10 points. 15 would be solid and 23 would be awesome. But in the grand scheme of things, it's not going to make that big of deal. </p>

<p>Dean's Letters were released on Saturday, so the final say from programs will be coming shortly. Have had a couple rejections in the past couple days. None were surprising or unexpected. Still waiting two more programs...including the place I am most hoping to hear from...but at this point I realize the timing of things and so it won't be a surprise if they reject me. I am very excited about a number of places I have interviews, so I'm not worried. </p>

<p>First interview is on Tuesday. Peds is a nice specialty to interview for - every place has a resident dinner the night before, and all my programs are paying for my hotel rooms. This is not the case for some of my friends, so I'm thankful. It makes things much easier and much cheaper.</p>

46

<p>Okay, it's been a crazy, crazy week.</p>

<p>Last saturday, flew to LA. I took Step 2 Clinical Skills on Monday, but one of my good friends lives out in LA so I made a weekend of it. CS was a joke, and a waste of time and money. Unless I completely blew it, there's no way I failed. It was one of those things that was so simple and straight forward that I gradually became more worried that there was some big component of the test that I was missing (med school makes you paranoid that you're an idiot if something is too easy).</p>

<p>CS was monday from 3pm to 11pm, and yes went almost the whole time. Tuesday, I flew out of LA at 703am LA time, and didn't get back home until almost 4pm Central time, which was just enough time to change clothes and go to the student run clinic. After several hours there, I drove the 3 hours to my parent's house. Wednesday was a travel day and I got ready for Interview #2. I had interview #1 at my home program the week before, but I won't be posting any info on that one.</p>

<p>BDM - these will follow the order of my note on Facebook if you're interested in seeing who lines up with who.</p>

<p>Program A: home program, no data in order to protect my identity.</p>

<p>Program B:
I really liked this program, but I'm not really high on the city it is located in. And there were just enough things that the residents said to make me a touch uneasy (dropping it from a 9.0 to a 8.5 because of the uncertainty of what was meant by some of the comments), but overall, I left very impressed. The residents all seemed very happy, they seriously could not stop talking about their program and they were always asking if I had any more questions. That's the first lesson about residency interviews - at least in Peds - they spend almost as much time selling you on their program as you do selling yourself to them. Unlike med school where having three really good questions is enough, I seriously need like 30. It makes it hard though because the other applicants have similar questions so only one of you can ask about things like call schedules and who caters noon conferences. Anyways, this program had a huge number of positive things - benign call schedule, lots of elective time (though mostly in the third year), gorgeous hospital (the PICU was amazing), lots of research, friendly residents - but I might need a second visit to check out the town and see if it's a place I could be happy.</p>

<p>Dinner the night before was at a great restaurant (i had pork osso bucco), lots of residents showed up, there were 6 applicants plus two of the fiancee's of two of the applicants. I really liked the other people who interviewed with me too, which doesn't count for much, but if they're having similar applicants all interview season, I'd be pleased with my resident class if I ended up there. I think there were like 7-8 residents there. It's a free meal for sure, and early in the interview season, but still, impressive to have that many there. </p>

<p>Interview day was an early morning (for me at least as I haven't been on a real service in 3 months). Met with the department chair, heard about the overall direction of the Children's hospital, I interviewed with a Peds ER attending, then the Program director, got a tour, another lunch out - this time with about 5 residents (different then the night before), then an interview with the Chief resident. I felt pretty comfortable with everyone, and loved having so many residents to talk to (even though I heard about most things 6 or 7 times). It really stood out that they were HAPPY. </p>

<p>Some concerns did exist as far as is this a place where they simply expect you to learn by carrying high patient loads (several of the residents described it as a "work" based program, but the administration didn't, even when I pressed them) vs a place where there's a significant blending of didactic lectures, case reports, teaching at the bedside, informal attending lectures, and residents teaching each other. Also a little concerned about recent boards pass rates, but that seems fairly variable from year to year in most programs. </p>

<p>That said, it was a cool place with some unique options. We'll have to see how further interviews pan out, but this program would probably be the top choice at the moment between Program A, Program C and Program E (where I did my away rotation in August), as the current 4 programs I've seen up close...but we still got a long ways to go before that becomes at all meaningful.</p>

<p>Tomorrow I'll get to Program C.</p>

47

<p>Program C: </p>

<p>I've managed to cluster most of my interviews geographically to help cut travel time and costs, so this is in a similar geographic area. </p>

<p>I did manage to make the pre-interview dinner the night before despite my travel schedule...and they took us to the Cheesecake Factory...this seriously bothered me. I can go to the Cheesecake Factory whenever, so this is not impressive, and if you want to show off your city to me, take me some place unique. Major negative points right off the bat. I also didn't click very well with the residents. They weren't nearly as outgoing, and they didn't really expound on their answers to my questions like the residents at my home program and program B did. It made conversation difficult. I seriously left the dinner having enjoyed meeting one applicant's fiancee and one resident's husband more than the residents I met. I was talking with those guys about college football and one of the residents even asked us to stop talking about football...again, major negative points. At the dinner there was only me and 2 other applicants, and I didn't really connect with them either, despite the fact that one was from my hometown.</p>

<p>Anyways, the dinner put me in a bad mood and it was hard to keep an open mind about the program the next day. The program had a number of things that could have been stellar, but failed to impress me in the details. For example, they have an extremely new Children's Hospital that everyone was raving about...which to me looked entirely too much like an adult hospital that just happened to be painted like a children's hospital. I was very disappointed. It just seems that other places had much better layouts for kids and their families. Their PICU was nice though. Another example is that they have a night float system (which I like and is becoming somewhat of a major criterion for me) but it's part of all your regular ward months, so you're doing 3 weeks of days and then a week of nights, rather than just making it one month of being the mole. If we're going to talk sleep schedules, then please give me everything all at once. They have a lot of nationally well known faculty, but very few elective months that might give you the opportunity to work more closely with them.</p>

<p>Didn't like the Chairman much, and the PD was rather bland compared to those at Programs A and B, but I LOVED the assistant PD. She's very high on education and teaching interns about learning style and upper levels about teaching styles. She and I hit it off entirely and at one point she even said "I'm sold, how can I get you to come here?" she laughed it off quickly because the elephant in the room at all these things is that rank lists and statements which imply offers of a position are very big no-no's in the match agreement. She, and one of the Chief Residents were the high points of my visit, but the chief will of course be gone next year if I were to go there, so he's a null value. Absolutely awesome guy, but null value for the program.</p>

<p>The city itself I liked better than program B's, and compared to my home program I might rank this program higher simply because it's some place new. I don't have any fears about my training that I'd get there, but I really was not feeling my interactions with the residents, just poor vibes all around, and it seemed as though they were really limiting our opportunities to interact with them. I also didn't have an interview with any faculty members, just the PD and the assistant PD.</p>

<p>The oddest part of the day was the fact that there was one of the applicants who was from this school and was obviously looking to stay (and the department wanted her to), who wasn't at the dinner the night before, who about midway through the day started trying to sell me on the program. I actually did like her, but it was odd having a fellow applicant push you towards the program. She told me there was nothing she didn't like about the program (something I find impossible to believe). She definitely spent more time trying to sell me than she did the other 2 applicants (I figure she recognized how awesome I am and figured I'd be a great addition to their program ;)). </p>

<p>So anyways, I'm realizing how important it is to see the programs because there was a lot of unexpected things. Given that both programs had some positive things and negative things, I'm hopeful that there's a program I find which is able to combine everything. Program B is certainly an option and if I somehow ended up at program C, I can always tell myself it's only 3 years, but I'm excited to see what else is out there.</p>

48

<p>er round of interviews this week.</p>

<p>Program D:</p>

<p>Loved this program. Education wise, it fulfilled a lot of what I'm looking for - lots of dedicated didactic time, but a busy hospital that has a very large geographic coverage area that presents a wide variety of pathology. </p>

<p>The interview day was very similar to the other programs: show up, meet with the Chairman or program director, faculty interview, interview with PD and chief resident, then lunch and tour. </p>

<p>This program only has dinner with the residents two times a week, and dinner was scheduled for the evening after my interview (and I was flying to another program) so I wasn't able to go. I really wish it would have worked out differently, but there are a couple residents from my school and a neighboring medical school who know what my current city is like. My tour guide was one of these residents and I felt like I connected with her pretty well.</p>

<p>The city had a lot to offer, though is not without it's flaws. The residents were very reassuring about a lot of my concerns so I think it could be okay. </p>

<p>No night float for interns, but they do night float for the upper level residents. This is a pretty new change for them, but they do have some sound reasoning for the setup. </p>

<p>One thing I really liked is that they start all their interns with 2 half days of continuity clinic, and then after the first year, you can apply to use one of those clinic sessions for research or advocacy projects. </p>

<p>Overall, this program is neck and neck with program B at this point. Both programs have some unique aspects that I really like, but neither is perfect. But I would be extremely happy at either one.</p>

49

<p>What is night float and continuity clinic?</p>

50

<p>The ACGME (the group that accredits residency programs) requires that pediatric residents (and those in certain other fields - IM, FM, OB/GYN for sure) take part in activities that include acting as the primary clinic physician for a distinct panel of patients. So essentially, every resident has their own "clinic practice" that's entirely made of patients that they are the primary doctor. You tell the family to ask for you when they schedule appointments including well child checks. Residents are able to recruit into their continuity clinics. In peds, this most often takes place when on newborn nursery when the parents don't have a designated pediatrician for their newborn. You'll then do all the well-baby checks and gives you the opportunity to develop a relationship with the patient and their family. Most places I've been by the end of three years, residents usually have patient panels of about 250-300, but sometimes it's more.</p>

<p>Night float is a system in which ward coverage follows more of a shift schedule setup. There are designated people who only work nights for 2 or 4 weeks. What results is a more benign call schedule because there's an assigned person coming in for that time period. It also means there's better continuity of care because the person coming in at nights is the same (what's common, particularly for supervising residents - 2nd and 3rd year residents - is "cross cover" so the person doing the call is coming in from another service and doesn't know the patients). After seeing it in place, it's become something that I desire from my programs. But since it is a disruption of sleep schedules, I'd rather go for 2 or 4 weeks so that at least I can get in a pattern. The one week on system that Program C does, is not a good thing in my mind. </p>

<p>Program E:</p>

<p>This is the place where I did my away rotation in the PICU back in August, so it was much more of a known entity for me, but I'm definitely glad that I came back out to get the full court press of being recruited.</p>

<p>Missed the resident dinner because of travel, but did get in earlier than originally planned. I'm getting good at flying standby :) One of my best friends is a resident out here, and he and I and some of his friends in other departments went out and got a little tipsy. It made Friday morning a little rough, but not that bad. </p>

<p>Because of my time out here, and the fact that I learned about my love of Peds Critical Care from my month here, even if I don't come to this program, I'll be forever indebted to this place.</p>

<p>This department really puts a huge emphasis on teaching, which is important to me. They have won multiple "best clerkship" awards from third year students in the past, which is very encouraging. I know that I got a lot of good bedside teaching and some great impromptu lectures while in the PICU. </p>

<p>The biggest thing about this program is that it will be opening a brand new children's hospital in early 2010...or right in the middle of my intern year. Construction of the structure is pretty much done, but the insides aren't anywhere near complete, but it makes it extremely difficult to assess the program. What I do know is that this program is about ready to launch. There are plans to roughly double the faculty size, there is a significant amount of research funding that's been secured, and they are expanding the size of the residency program by two residents. </p>

<p>The PD is AWESOME, and he really goes to bat for his residents to get them things they ask for. You can tell that he's well aware of the coming future and the opportunity it represents to transform the program. He's definitely the type of guy who thinks about hwo the tiny things play into the larger picture. </p>

<p>Socially, I already know a lot of the residents, and I know a lot of residents in other fields (obviously including one of my best friends). </p>

<p>What it comes down to is that I could do very well here as well. This is not quite the "wow" that I got from Programs B and D, but I'm not sure what that really means in this context: I've been here already so it's more familiar, and perhaps more importantly, the things that wowwed me at the other places are coming to this program.</p>

<p>I think the one thing that is a drawback is the location. It's not a place that I would have chosen (either for my away rotation or to apply to) were it not for my friend who lives here. I don't want to say that I felt pressured to come/apply/interview but it was one of those things that wasn't my decision...which may also play into the lowered excitement level. </p>

<p>As I go forward, I keep reminding myself that about 85% of US M4's that match get one of their top 3 choices. Right now, Program E is solidly in position 3 and I know that I would be happy here. So it's comforting to know that I've got 3 programs (B,D,E) that I can rank and be well assured of my future. And with 8 more interviews to go, it's likely that I'll find a couple of other places that I also really like. On the other hand...this is going to be an extremely difficult decision to really go through and rank all these programs and make a final decision.</p>

51

<p>Last interview for 2008, and at interview #6 of 13, very accurately the middle point of my interview trail.</p>

<p>Program F:</p>

<p>This was a program that I didn't originally intend to apply to at the beginning of this whole process. My new department chair at my school came from a faculty position at this school and was adamant about me applying to this school. And I'm definitely glad he did.</p>

<p>This program was excellent. You can take a lot of the statements I made about program D, and apply them to this program. Lots of didactics, big hospital, lots of pathology. Really in terms of educational programming this residency has everything I'm looking for. I was really, really, really impressed. </p>

<p>The residents were excellent - extremely outgoing, EXCITED about their program. The dinner the night before was at one of the resident's houses, and the other applicants and I could barely get a word in edgewise. The residents on the interview day were similar. The fact that it's getting further and further into the interview season, I have no doubt that they could be tiring of selling the program, but it didn't seem that way...</p>

<p>Despite it's size, the program does a lot to protect it's interns and residents. On the general peds floor the average load for a intern is only 6-8 patients. So while there's a ton of patients, and the hospital is extremely busy, they're not using the interns merely as slave labor. This leaves time for other educational activities. </p>

<p>Despite all the awesome things about this program, it doesn't have anything as unique as some of the other programs I'm looking at. That's not necessarily a bad thing, but as I'm going through the issues in my mind, those unique things tend to stand out.</p>

<p>As far as the location, this program is in a big city, and I know there's going to be plenty to do and stay busy with. That said, it's not a place that I'm excited about living in. So we'll see how that plays in to it.</p>

<p>I do really like this program but am somewhat of the opinion that I'm not that competitive for this program. With the other programs, I really feel like if I rank them #1 on my rank-order-list (ROL) that I will have a great chance ending up there. For some reason with this program, I'm less confident. Not really sure why, but that's the gut feeling I get.</p>

<p>Overall, this is another program that'll be at the top of my ROL, but we'll see how it all shakes out.</p>

52

<p>Would be incredibly helpful if any of you could delineate timelines and important milestones to accomplish for each year of med school.</p>

53

<p>The trouble is, because specialties want different things (and even then, nothing is ever a "requirement"), there are no definitive guidelines. Even the different medical schools and their thrust as "research" schools will cause differences between what's normal and abnormal. Further, personal preference is vitally important as well.</p>

<p>For me, going into pediatrics, and seeing any possible research career as extremely secondary to my clinical interests, what's necessary is wholly different than someone interested in radiation oncology where a significant number of applicants (21% of those who matched) have PhD's. </p>

<p>Basic outline: Pass your classes. Stay active with an EC or two. If your school is research heavy find a project early, if not do research between M1 and M2 if it interests you. Pass your classes, pass Step 1. Work your butt off but be nice during M3, try to decide what interests you, pick an advisor that will help you with the path into that field, hopefully find someone to write you an LOR on as many rotations as you can (you don't have to send it to programs if you don't want to...and remember an LOR from someone who really knows you is always better than from someone who couldn't pick you out of a crowd). Schedule Step 2, write a personal statement, get a Chairman's letter from your home department in your specialty, send off ERAS application, await interview invites.</p>

54

<p>Okay, so kind of a long time between updates.</p>

<p>When I last posted, I was pretty close to my interview at program F, and was having a very tough time deciding how I would shake out B, D, and F (with program E essentially being a safety). I mean it was literally, minute to minute what program I was feeling was best for me. I'd get to thinking about one thing I either really liked about a program or something I had misgivings about and the order would flip. In talking with some of my friends, I found out that I wasn't alone in having trouble figuring things out, which was extremely comforting. Going on winter break, I ended up bringing all my "propaganda" the programs had given me home for the holidays so that I could sort through it all. What I ended up doing was taking a mental break from the whole process and just not thinking about medicine or my future for about 3 days. It was a tremendous calming effect. It also allowed me to come back to everything a little fresh and review my notes and then the information I had to see what I could make of it. </p>

<p>One of the big things I started looking at, on the advice of my attending from December, was the amount of elective time and how much was truly up to me to decide what I did. Without getting too much into specifics, every program is supposed to provide a spectrum of subspecialty experiences, but some programs give you a ton of wards experience and make you take the subspecialties as electives (usually in the form of '4 electives must be from the following list of 7 subspecialties) while others - like programs D and F dedicate months in their curriculum to subspecialties. So in some programs 10 residents might make up 10 entirely different combinations of subspecialty months, while at programs D and F, every resident gets exposure to the same set of subspecialties because that's what's required by that particular program. Maybe (as a hypothetical) instead of doing 5 general wards months as an intern, you do 2 and the remaining three months are split between doing a month of GI, a month of Infectious disease and 2 weeks of rheumatology with 2 weeks of Allergy/Immunology. </p>

<p>With this focus on electives available, programs D and F really separated themselves out. One of the reasons they are able to do this is because their centers are so large that they have subspecialty services that are consistently active enough month to month to provide consistent training experiences. But I do think it represents an important point. I've had a couple people tell me when they find out I want to do critical care that they think intensivists are like super-charged general pediatricians, and so with that in mind, I have to see as much as I can if that's what I want to do. So I think going to a place where I know I'll spend time, guaranteed, without having to pick one over another, is a plus. Additionally having the freedom to really make the elective months what I want them to be, will allow me to develop new skills and knowledge that will help me in my future.</p>

<p>So with all that said, as it stands right now, my top two are programs F and D. Currently, I'd say that while I go back and forth on which is my number one, F has been the more frequent #1 choice.</p>

<p>Program B has fallen into a solid #3 position, though, I had an interview today (Program I - yes I've been busy this week with three interviews...I'll post about G, H and I over the weekend), which is making that #3 spot difficult as well. With 9 interviews down, I am getting tired. I still find it fun and exciting to go to these new places, and meet these people I might be working with for the next three years, but it's impossible to have same level of enthusiasm as I did back in November when I interviewed at program B. As I'm going through my thoughts for the battle for spot 3, I'm definitely becoming aware of that difference. It's leading me to wonder what counts for more - the enthusiastic assessment which has been a constant in my thoughts for the last 8 weeks or the more savvy, but perhaps slightly cynical views I'm carrying with me to interviews now?</p>

<p>The one thing that sticks out is how much this reminds me of the fraternity rush process. I think it's particularly accurate for specialties like peds and medicine where the selling of positive points is a two way street. While I'm sure that even in radiology and derm, the programs try to explain why they're great, I bet there's a lot more expenditure by the applicants to prove they belong in one of these competitive fields. Anyways, the key thing is that I really have go by how much I trust the residents and faculty when they tell me about their program, much in the same way I had to determine which chapters I trusted during the rush process while a freshman in college. </p>

<p>Anyways, I continue to find comfort in the match stats and in knowing that I now have 5 programs I'd be really happy to end up at. I still have three more interviews to go next week, then I'm DONE, which is exciting but also a point I don't think I really thought about getting to.</p>

<p>The NRMP opens on 1/15 to begin rank list entry!</p>

55

<p>FYI I'm in Australia until the 26th of February. I <em>just</em> got into Sydney and too tired to much more than chill the rest of today. After this, don't expect many posts until I get back.</p>

<p>Briefly, a rundown of my last five interviews:</p>

<p>Program G: One of the two programs in my hometown, both options my parents were adamant I look into. G is definitely my preferred choice - it's a free-standing children's hospital, they pay really well (and cost of living is low), and they have pretty extensive offerings for fellowships (just starting a critical care fellowship this July). But the residents were kind of hit and miss (some I found intolerable during my interview day). And I really want to go some place new to live for a while. I'll probably look at this program again for fellowship and the possibility will always exist that I'd come back to my hometown to practice.</p>

<p>Program H: Also in my home town but small and not tied to the children's hospital...which literally sits 2.5 miles away. Size is wrong, I wonder what sort of pathology they actually see and I didn't like the residents. Throw in the fact that they pay ~$7k less than the program across the way, and I can't fathom a reason why I'd ever choose to go there. If I wanted to go home I'd go to the children's hospital. That said...I LOVED, LOVED, LOVED their program director and I thought the faculty members I met were also extremely nice. But that's not enough to make it happen...</p>

<p>Program I: Probably my favorite location that I visited, something about the town just struck me right. That said, I wasn't excited by the program. They had a lot of the things I'm looking for, but I just can't put my finger on it. I'd be happy to end up here, because the town is cool and I'd be well trained, but just not enough to push it into the upper reaches of my rank list and I really can't tell you why other than the fact that it's one of my mid-sized programs and the top programs on my list are big...that's really all I can point to with any certainty.</p>

<p>Program J: This one has a lot of characteristics of my favorites and I really like this program. In particular they do some unique things in terms of outreach/advocacy - like having their residents go to elementary schools and teach 2nd and 3rd graders about health topics. I liked the faculty and program director. The residents I met though were unbelievably laid back...to the point of being practically indifferent. Might have been that it was late in the season but that sort of turned me off. That and this program is one of my few cold weather locations (and it snowed while I was there and there's no skiing)...but they did put me up in the nicest hotel I've ever stayed at. If anyone ever offers to put you up in a Westin - take it! Awesome, awesome beds!</p>

<p>Program K: My smallest program (they take equal numbers of peds and med/peds residents...super tiny). Simply put, it can't compete with my bigger programs and I worry alot about who's going to get the shaft when people get pregnant or sick (since I'm currently the uber-single male). That said, there are some big changes in store for this place and in 5-10 years, this might be the sort of place that I'd want to end up living as an attending. Just not right for my training and station in life at the moment.</p>

<p>Program L: I got sick and so skipped this interview...after I took their free hotel room and their free dinner. Another great hotel room, but I just had an awful cold/sinus infection and this was my third interview in three days and I just couldn't handle being "on" for one last day at a program that I wasn't particularly excited about. </p>

<p>Now because of my international travel I did submit my rank list before I left. I can still change my mind, but this is how it stands right now:</p>

<p>1) Program F: Biggest draw is the residents, easily my favorite group. Program is stellar, great training, great hospital. Lacks some of the unique things found at other places but is so strong overall that that's not an issue. City is "safe" in terms of social options because it's so big...if I can't find something to do, it's my own fault.</p>

<p>2) Program D: Another big, outstanding program. Here the curriculum is a real draw, especially the opportunity to make myself better in some of my weak areas like research. The flexibility of this program is excellent. City would be a great place to live, though is not without some issues...</p>

<p>3) Program B: Was my first real interview and still held up pretty well. I wonder if at least some of that is because it was so early on, as some of the things that got me excited about it subsequently turned out to be fairly common. That said, I'd be very happy to end up here.</p>

<p>4) Program J: Fits the profile of my other top programs, and they have some really unique things they do that are big draws. Weather is a big knock on this one.</p>

<p>5) Program E: the program I'm most familiar with because of my away. I look at this as my big "safety" as I think they are going to rank me fairly high because I've been there. Great teaching, new hospital in the middle of next year, a couple of friends already out there, great weather...I'd be excited to come here too.</p>

<p>6) Program I: loved the town, not sure what my problem is. Still would be happy to come here.</p>

<p>7) My home program: just to make sure that I match. It'd be disappointing to end up here though...</p>

<p>Now that it's all done...I just want Match Week to get here so that I know where I'm I going to be for the next three years.</p>

56

<p>Back from Down Under and trying to cope with the shock of going from mid 90's temperatures to 4 inches of snow on the ground (it's not going well).</p>

<p>The final day to submit rank order lists was this past wednesday the 25th of Feb, so it's all out of my hands at this point...and even though .I'm happy with my list, I hate the feeling of not being able to do anything about it now. I used to be the same way at the end of finals - it wasn't that I was necessarily worried about my grades (though I was on occasion) but more that I was absolutely prevented from doing anything more about them. I like having the possibility of control and now it's gone.</p>

<p>I did end up keeping my list fairly close to what's listed above, though I realized while in Australia enjoying the summer weatehr that I didn't miss any of the cold weather that was going on back home, so I decided to flip Programs E and J...so that I'm staying warm or going skiing with any of my top 4. I think it's odd that my top 4 went back to where it was before christmas. Almost like I shouldn't have spent all the time and money on interviews and should have gone to Australia earlier...</p>

<p>Anyways Match Day cannot get here soon enough, I simply want to know and be able to celebrate. Only about 60 days until graduation, which kind of blows my mind.</p>

57

<p>IT’S GRADUATION WEEK!</p>

<p>Started off with a bang last night. We had a bonfire/barbecue out at our class president’s parent’s house in the country. The bonfire was HUGE! probably at least 15 feet in diameter!</p>

<p>The best part? We threw our short white coats into the fire! I feel like a neophyte doctor or something…not quite an MD yet, but without the identifying markers of a student anymore. (If you’ve ever pledged a fraternity, you probably understand what I mean about this gray area between being a pledge and an initiate). </p>

<p>Anyways, I’m actually completely done, I turned in my eval from my last rotation on friday and so I’m just coasting through this week and partying with my friends. Class Banquet is Wednesday, Hooding Ceremony is Thursday and commencement is Friday! My birthday is also Thursday!</p>

<p>It’s really impossible to believe that 4 years of med school (hell, 21 years of schooling in all) has come down to this one last week. I know my real education is going to start in July, but that has a paycheck and is a job and is just different than school. I think the lack of finals and the stress of the end of the semester only adds to the oddness of having this one last week be the end of it all. Add in the complete uncertainty that is Match Day 6 weeks ago and this week is almost anticlimactic.</p>

58

<p>Congrats BRM, glad to hear it! I know this thread doesn’t have a ton of replies but I, for one, do like to read all of it. I don’t know how busy you’ll be from here on out but keep us posted if possible. Good luck on your intern year. What’ll you be doing until July?</p>

59

<p>Pretty much hanging out, having an open house back in my home town, going to weddings and moving. I start orientation on the 17th of June - have to do things like Peds Advanced Life Support (PALS) and Neonatal ALS (NALS) as part of it, then do the other things the residents in other programs have to do.</p>

60

<p>I’VE GRADUATED!!!</p>

<p>Yep, it’s Dr. Bigredmed now. Pretty amazing to say the least. </p>

<p>[Scene</a> from immediately after BRM’s graduation](<a href=“http://www.youtube.com/watch?v=9Lge2_H_8IQ]Scene”>http://www.youtube.com/watch?v=9Lge2_H_8IQ)</p>