An International Medical Graduate with USMLE SCORES: Step 1-78, Step 2 CK-79 Pre-Matched in 2008 to an Internal Medicine residency Program (categorical). There were 1700 applicants and only 9 positions, and I got one of them. This is a blog of My Residency Journey: a True Miracle of God

Wednesday, December 10, 2008

Day 166 THIS IS SPARTAAAAA !!!


Wow, what a day, or shall I say morning. Today I was post call after being in the unit and we ended up getting into an emotional noon conference. Geesh, it got a bit “ugly” kind of. Basically yesterday while we were in the unit one of the rounding attending suggested to us that we should have a physician advocate. It all started when I saw him log on to his computer from the icu floor. He has a program which was gotomypc. He was able to log on to his computer in the office. We were all standing their and we were pretty surprised. (we are not giving email access in the hospital for security reasons since someone downloaded a virus to the hospital main frame, but we have hospital email) he asked us “why you guys can’t check your emails?” We were like, not really. He then kind of laughed at us and said “man, you guys are getting cheated!” He said it in a joking way. It didn’t seem to come of mean spirited to me. He was like “you guys should have a physician advocate. We told him we have the chief resident, and he said that we needed someone who is independent. An outsider to fight for you- someone who is not linked to the admisinstration.” Well the seniors felt it sounded like a good idea. Anyways, we didn’t think anything of it. The seniors said they were going to discuss it amongst themselves. And yesterday at the noon conference one of the seniors brought it up to the chief resident. Right away the tone of the chief change.- I’ve known for some time now, and it looked like he was pissed. He answered to the senior “why what happen? What do you need now?” the senior right away just stayed quiet. We then told him that the idea was to have an independent outsider that would go to the administration with complaints without fearing retribution. It didn’t seem like it was a problem to me. But, man the chief took it personal. I think he took it to mean that he wasn’t doing his job. The guys was kind of pissed. It was debated for a few minutes, and he went on to defend some of the fundings that the program had given us. Anyways, it didn’t seem like it went to well with the chief resident, and I thought that it was over, but then today, the program director was at noon conference! Damn, felt like I was in a soap opera. So much emotion. Needless to say she was pissed. She was like “ok, so why is it that you guys want a physician advocate?” Man her tone sounded pretty pissed off. It was like she was sayng “Ok… now what are you guys complaining about?” A bit of background on this. She has been working really hard and has been under a lot of stress this year. This is her first time in as program director, and has had to deal with a lot of issues and drama. ( I think I wrote about this previously. A lot of the first years wanted to leave the program) Anways, seems like she was pissed off at the unit residents. The seniors and me!! or she was pissed off mostly with the attending who was “feeding” us these suggestion. I was in shock. I was thinking to myself “what da hell?” How did I get involved in all is?” even one of the assistant directors was like “this is really bad. Its pretty disrespectful. There were even people that went to the program director nd had suggested to her to make changes to the program etc..” and she went on to say that its unacceptable. This is not the way you do it. One of the seniors was their, and she was trying to explain the conversation, but it really was not well received. The program director was obviously emotionally hurt. I think she definitely took it the wrong way. I don’t think anyone meant any disrespect to her or the chief resident. I even try to explain they those in the unit love the program and always defend the program. We feel they were doing a good job. Anyways, I can’t believe I somehow got in the middle of all this. I’m really dumbfounded for words. She said at the end she just wanted to clarify everything. One of the other seniors try to cool the situation and told her that it wasn’t meant in any harm.. It was only a suggestion to help everyone out, and burden the load. Anyways, man I’m still in shock. I tried to talk afterwards with the chief, but it seemed like he was still pissed off. Too!!
Man, and I thought I knew people pretty well, but I guess we are all human after all. We all have flaws and feelings get hurt. I think from this second on, I’m just going to mind my business, stay low- key. And do my “time”. It’s tough trying to please everyone in the program. Must be a very stressful job. I will try to find the time to talk to her and thank her for all that she does in the program. I think I’ll write her a personal letter through email. But today was the last day I get involved in hospital politics. I’ll let someone else deal with it. Don’t want to be in fights or hurt relationships with people.
God bless. Got to get some rest.
For those still going through interviews- good luck !!
Dr. Mike

Day 152 : Frustrated Interns, E.R and Residency Life

Well it’s been a while since my last update. I’m real sorry for that. The last few post have been about some tips helping those trying to get residency. I have also updated the site so it could be a bit easier to navigate through it. I also updated my story (link) If there are some wondering how I was able to get residency please click on my links. I also have a picture of my pre-match contract that I included in one of the links. I will post copies of my usmle score for those that might not believe my experience.

A lot has been going on since my last update. I’m rotating right now in the Emergency room. ( It’s one of the easier and lighter rotations. ) There are a few ER attending, but I choose which one to work with so it really makes life for the intern better. I basically work with the helpful and nice doctors, lol. I shy away from the more “aggressive” ones. It also helps that I’m doing the rotation with another of the senior residents which is very helpful, and she covers me.

A lot has been going on that I haven’t told you guys, and I will try to be as specific as I can without naming names. Over the last few months I had discovered that some of the first years had wanted to leave. I wrote a blog about it, but I have not been able to locate on my computer to post it. I was pretty devastated when I found out. I even met up with my counselor, and I even cried about it to him. Me and another 1st year resident have been trying to find out who wants to leave and if there is anything that we could do about it. It seems like a lot of them have been upset with a few things in the program. One of them being that they don’t have a lot of time to study, that the attending don’t round consistently, that they are looking for fellowship, and this hospital doesn’t have it. Basically what a few of them were complaining about it the fact that it is not a university program. I can understand some of their frustrations, but I still don’t understand what they expected when they came to see the program. This is not Harvard. We are not the university of Penn. Anyone can see that it is a community hospital. But this doesn’t mean that it’s an inferior program. We have a steady inflow of patients and a lot of opportunity to learn a lot. We take care of a large patient community, and this gives you a lot of opportunity to learn. There are 2 ways to learn medicine. You can passively learn it by reading a book , or you can actively learn it treating and caring for patients. I understand you need to read, but the majority of medicine that you will learn will come from actively being involved in the care of people. Well anyways, I went through a pretty bad stretch of 2 weeks when I found out they wanted to leave. I told the program director and the assistant program director that I would advice them to hand out contracts earlier, so that they at least know who is leaving and then we can look for someone to replace them. Well, this happened about 2 months ago. In the last few weeks I don’t think a lot of them are leaving. One of the reasons is that if you go to a university program they will have to repeat the 1st year and that is pretty devastating. I will keep you posted on what happens.

During the last weeks the program has begun to interview candidates. They are giving about 100 interviews for about 9-10 spots. What is different this year is that they are not giving any pre-match offers yet. They are going to wait until they interview everyone before deciding. I see about 3 of the interview candidates pass by the wards when we are working. I just look at them in amazement and think about my situation and think about the interviews that I had to go to. It’s pretty amazing that I’m here. It truly is a miracle. I spoke with the program director and she said that she can’t believe how any great candidates she has. I remember telling her to be careful who you choose and those that want fellowship. (Because a lot of people complain in the program about their not being any fellowship and they have been talking about leaving). It’s a sad reality. I know it might not sound fair to a lot of people. But programs are interested in people that don’t want to leave the program. They want to invest their time in someone who will be with them for a long time. One of the seniors told me that the previous program director was hiring an older “crowd” of residents because they were less likely to leave. Our batch of interns is the first group that are “young”. Don’t get me wrong they graduated a long time ago, but they are younger than the current residents ! Its been pretty stressful for the program directors. They plan on maybe giving early contracts, so that they will at least know, if any of the residents want to leave, and so they can start interviewing for new residents. I’l l keep you guys posted on what happens.

All in all, I know that a lot of you are going through a pretty tough time now. Its pretty stressful. You are going on interviews and desperately trying to get a spot. But hang in their!! You can do it!! Keep doing what you have to. I have tried to help a few of you. If you guys need my help. You can email me at themadmike31@gmail.com . I have responded to some of you. I will respond to most of you, just be patient. I know that some times people ask where I did my externship, but I don’t like to promote any program in general. I don’t post it publically because I will be accused of being a fake. This blog is a testimony of my life. A testimony of the goodness of God and his grace. I don’t deserve any of the blessings that I have received. I’m grateful for all the goodness that God has given me. And if I can help even one person to better their lives, and to have a bit of peace, then all my struggle would have been worth it.

I never mean to brag about my situation, because I know a lot of people are trying to get residency. I only talk about my situation because I believe that it can happen to you, if its God’s will. I have posted a few tips, and you can look back at the archive.

Overall , residency life has been pretty good. Most of the interns have become pretty comfortable managing all the problems were faced with. Medicine is repetition. And the more patients you treat, the more your able to manage. After 100 chest pains, you kind of get comfortable with it. That’s just one example. The patients will change, but the basics will remain. You will see this when you start residency. At first you will be nervous as heck, but as time goes by you will adjust.

Have to run guys.

God bless

Dr.Mike