is this as good as it gets?

sometimes i wonder if these months between the match and residency will be the best ones of my life. i'm fairly certain when people talk about how awesome fourth year is they are not referring to the ulcer-inducing process of applying, interviewing, and biting their nails waiting for the residency match. they are speaking of these months between the match and internship that are filled with few clinical responsibilities. my classmates are "learning spanish" in central america or backpacking across europe or asia.

since the match, i have spent my time experimenting with julia child recipes, playing beethoven on the piano, and reading about the history of ireland. i can now remember how wonderful eight hours of continuous sleep are, and i can make time to have meals with old friends. every minute i spend with my husband no longer has to be "quality time" but can just be us goofing off and watching family feud. these interests and habits have been buried for four years while i have been training to be a doctor. now that they have resurfaced, will i have to bury them again come june? i hope not.


currently reading: i finished best food writing 2005 and am now on how the irish saved civilization by thomas cahill. it has a great title but has been a bit of a bore so far. (i have been keeping up with the journal a day but not so much with the cardiology textbook.)

trying not to become stupid

it might be too late! maybe all that i've learned in medical school has already leaked out of my brain! is taking care of patients like riding a bike? even if you don't do it for a while, does it comes back?

well, i hope that's true. i'm not very good at riding a bike. i never learned as a child, but i bought a huffy at toys 'r' us after college. my husband has been giving me lessons every summer for the last four years, but i still have trouble turning right. each year, i start unsure of myself and sometimes have an incident before i become comfortable on two wheels again. early in the biking season one year, i rode into someone sitting on a bench! (that's a long story.) anyway, the point is that even my rather poor biking skills come back pretty quickly ... but not instantaneously.

i hope i don't get out of practice with seeing patients. i wouldn't want to be the patient equivalent to that guy on the bench. for my daily bus rides, i carry three reading materials in my bag--Dr. Lilly's Pathophysiology of Heart Disease, the New England Journal of Medicine from April 2006 with an article about trans fats, and a pleasure reading book. i'm sad to say that i've read three books for pleasure in the last month, and the poor journal and textbook have not yet been opened. i even read the free daily newspapers left on the bus rather that crack open the textbook weighing down my bag.

there are two reasons i can come up with why i shouldn't be sad about reading books for pleasure.

1. it's good for me. a physician i used to work for encouraged me to read non-medical books. he told me i would be a better doctor if i was more well-rounded, so he gave me a harry potter book as a going away present. i'm also not much of a sports fan, but i try to keep up with the sports headlines because it's something my patients are very interested in.


2. somehow everything comes back to medicine. i'm currently reading Malcolm Gladwell's The Tipping Point: How Little Things Can Make a Big Difference. i thought it would be more about sales psychology. it is, but the first chapter discusses reasons behind a syphillis outbreak in baltimore in the mid-1990's. the debate about healthcare--who gets it, how they get it, and who pays for it--is ongoing; it's inescapable in today's world. sounds like a topic for a future post!

i'm a goal-oriented person. it's hard for me to accomplish anything without a to-do list. so, here it is:

1. flip through one journal a day. i have a year's worth of NEJM's and JAMA's on my floor, and they are not moving to the next apartment with me.


2. read two chapters a week in my heart book. i should know all of it, so hopefully it'll go quickly.


3. continue reading one pleasure book a week. next week's picks: best food writing 2005 or mark kurlansky's salt: a world history. i recently read kurlansky's cod: the fish that changed the world, and it was a fun yet sobering read.

that sounds like a lot of reading, but i have a lot of time. that's also nothing compared to what i was reading my first two years of medical school. i have you all to keep me accountable!

"dear dr. jess"

i'm back! i had writer's block for the last few days partially induced by this blog's sudden popularity and my husband's warnings not to say anything that will have professional consequences for me in the future. as you can see, i've taken great pains to be anonymous (see this blog's name ... not my real name! really!) i've read quite a few doctors' blogs, so i'm hoping i will also figure out how to write about my life without violating any privacy laws.

anyway, i received my first piece of mail addressed to "Doctor" yesterday! i got a bit of a thrill; unfortunately, it was from a bank that wants me to buy real estate. i thought most of the nonmedical world was oblivious to the match, but apparently mortgage lenders know that i just received a conditional offer from my residency program already. their business strategy is a pretty good one as the idea of going from negative income to positive income makes me feel rich! however, my data-oriented husband sent me a few articles on the pitfalls of home ownership plus a very persuasive spreadsheet about how we're better off renting. who can fight all that data? *sigh* i guess there's no condo for me in the near future. that's okay. i already spent some of my yet-to-be-earned salary outlet shopping this weekend!

and the paperwork begins!

this morning, i was thinking that maybe i should have delayed the start of this blog until internship since i only have two more weeks of patient interaction scheduled before graduation. the rest of the time is vacation and research. what could i blog about between now and mid-june?

the answer came in my mailbox today in the form of 2 lbs of paperwork (not an exaggeration) from my future residency program. they certainly didn't waste any time. the cover letter went something like the following:

Congratulations! We're so excited that you'll be joining our program. Make sure you get your butt back in the country in time to attend Advanced Cardiac Life Support training!!!

i only had enough energy to fill out the first third, which included a conditional offer of appointment form, application for a limited medical license, affirmative action statement, permission for a credit and criminal background check, and medical information release forms.

things i don't know what to do with yet:

• lab coat and nametag request form. what is my numerical lab coat size? how do i want my name written on the side--middle initial or no middle initial? i almost never use my middle initial, but as my husband says, the initial adds certain authoritativeness. do i want to seem authoritative? as long as it says "MD" after my name, it's fine with me.


• continuity clinic request form. where do i want to have my outpatient clinic for the next three years? there is a page description on each site included, but somehow they mostly end up sounding similar. they also give us phone numbers to contact preceptors and residents, so i guess i have some research ahead of me. however, i'm not sure what i would ask except "is this the clinic site i should avoid like the plague?"


• vacation request form. i haven't bought plane tickets for places i hope to go to this spring yet, so it's hard to think about which weeks i want to take off between july 2007 and june 2008. christmas? pretty unlikely i'll get that request, but what are my nine other top choices for time off?

i know residency involves a lot of paperwork. i just didn't expect it to start so soon.

hello world (and Paul Levy!)

i've been thinking about starting a blog about my upcoming residency training for a while, and it occurred to me this week that match day was a good time to start. i figured i would fumble around with the format and find my voice after a while. however, i didn't expect paul levy, the ceo of beth israel deaconess medical center and one of my favorite bloggers, to be reading my posts during my first week!

then again, this is why i started this blog. i've had blogs in the past to keep in touch with my friends and share my kitchen experiments and love of celebrity gossip. when it came to medical issues, i was standing on the sidelines reading other people's blogs. however, the more time i spend training to be a doctor, the more i feel that i have something to say and something to contribute to the ongoing dialogue about healthcare in this country. i'm not sure what it is yet, but i'll figure it out along the way.

so, welcome everyone!

my number one!

i matched at my first choice! after a month of people saying "oh, you know you'll match there" but not really knowing, i'm ecstatic. i'm glad my husband was there to lend his support right before because i probably looked green. afterwards, i cried tears of joy and relief. i've been doubting myself about whether i picked the right program, but this feels right. if i had ranked the other program first and matched there, maybe i would have felt the same way. however, all is right in the world ... for me.

overall, my class did very well. we matched people into a lot of top programs, and i'm so proud. however, there were some disappointed people. they got into great programs but not their top choices. it was written all over their faces, and it was hard to know what to do but say, "that's a great program! congrats!"

people in general were just happy and relieved to know where they were going to be for the next few years. this match process feels crazy long, and the residency match is unlike anything else in the professional world. in most professions, you apply for a job, they give you an offer. you have a chance to mull it and your other offers over before accepting. not for the future doctors of america! there's a lot of nice words said on both sides, a wink or two, and then you rank each other. it sounds a lot like this weird british dating experiment i saw on pbs. or maybe a professional sports team draft? i'm not sure either of those analogies are good ones.

anyway, since i matched at my home program, the head of the primary care track came by the match celebration to find me. i was so touched that she took time to welcome me into the program, and it reassured me that this program is exactly where i want to be.

T minus 12 hours!

okay, if one more person asks me if i'm excited about the match, i'm going to punch him/her in the face. no, i'm not excited about where i'm going to be living and breathing for the next three years!

even though i only applied to programs in the city i currently live in and my number one is my home program, there's still a crazy sense of anticipation regarding opening that envelope tomorrow. i'm known to get very emotional (i still can't watch the scene when nemo's mom gets eaten), so i've been practicing my reactions to all the possibilities that could be in the envelope. i think i would be very happy at my top 3, and i could make the best of the rest on my list. my husband will be there to capture it all on film or erase the film and just hold me while i weep. of course, i won't be alone! there will be 150 or so other people dashing for the mailboxes at the same time.

will i get any sleep tonight? i hope so!

and so it begins!

i've matched! i just don't know where yet.

from: NRMP Staff
reply-to: nrmp@aamc.org
to: me
date: Mar 12, 2007 11:50 am
subject: Did I Match?

Congratulations! You have matched.

could this email have a worse subject line? thursday is the day, but knowing that i matched makes me feel that this is actually happening. i will really be starting my training somewhere this summer. i will really be making money in a few short months! there are plenty of doubts in my head about whether i'm ready for this next step, but right now, they are overshadowed by giddy excitement and nervousness over finding out where i'll be living and breathing for the next three years.