“Greatness begins beyond your comfort zone.”

Robin Sharma

These last several weeks have been an exercise in sitting with and leaning into discomfort. Each day is full of firsts as I continue to hone new skills. I’m polishing my communication abilities as I provide updates and have serious discussions with patient families, handle urgent situations and build relationships with patients over time. I’ve come a long way in just these few short months since starting residency. I need to keep remembering just how far I’ve come when imposter syndrome has me doubting myself. I’m absolutely my worst enemy there. I found myself under an incredible amount of pressure recently, the vast majority of which was self-induced. It set me up for anxiety and insecurity as I worried about whether I knew enough, was doing enough, if my performance was up to par. That negative headspace was not at all productive and blocked me from being my best. I’m grateful to one of my senior residents, who cared enough to make that connection and point it out to me. She also shared her own experiences with similar struggles, letting me knowing that I wasn’t alone. I can’t tell you how reassuring that was to hear and the perspective shift our conversation helped me make was a game changer. I’ve since been changing the story I tell myself. I’m here to learn, first and foremost. I’m not expected to know everything. I’m doing my best and that’s enough. I actively kick my imposter syndrome to the curb and it’s made an incredible difference.

A huge factor leading me to that point was also quite simply exhaustion. Working nearly 80 hours a week in the ICU was beyond draining physically, mentally, and emotionally. Thank goodness this current rotation provides a break from patient care responsibilities as we learn various procedures and other skills there just isn’t time to teach on the floors. The best part of this block though, is that my entire cohort is all on the same rotation together. It’s been a blast to catch up and spend time together. We planned a weekend getaway to the Adirondacks, which was incredible. We hiked, played games, laughed a ton and got to know one another even better. I think we all needed to unplug for a minute. I certainly miss being able to exercise as much as I want to and have not been cooking nearly as much as I’d like for myself. I’ve been prioritizing sleep and keeping up with family and friends, and that’s okay. As time goes on, I look forward to rekindling more of my passions. I want to join a choir and get involved in the community. There is so much more to me than being a doctor, but the job doesn’t always make it easy to nurture those sides of me. I’m grateful I had the chance to go home and see family for Thanksgiving. While the trip home, as always, was too short, it was so nice to see everyone and reconnect with who I am outside of medicine.

We all have our own experiences and strengths that color how we see the world and contribute to our identities. As a leader in the future, I hope to harness the strengths of my colleagues to form an effective team where all know they’re valued. I can’t wait to be the upper level resident I always wanted. Something I hope to change is how we approach feedback. So frequently, we hear mostly negative feedback about how we forgot this or did that wrong. Rare are the times where we get positive feedback about areas where we’ve excelled. It’s an opportunity missed to point out one’s strengths, so that they can be built upon and utilized to the fullest. I already am trying to do this with med students on my team. I hype them up every chance I get, making sure all know the incredible work they do. I aim to be as specific as I can in my feedback, giving examples of patients they took care of to highlight where their strengths shined though and ways I might have thought about something differently to help them take it to the next level. Moving forward, I look forward to growing into the thoughtful leadership I’ve seen modeled by my mentors and discerning the path my career will take in the future.

“You don’t always need to be getting stuff done. Sometimes it’s perfectly okay, and absolutely necessary, to shut down, kick back, and do nothing.”

Lori Deschene

I have certainly neglected this blog lately! I’m on a much-needed vacation home and now getting a chance to write. That residency has been busy is an understatement! So far, I’ve spent two weeks on one of our general pediatric inpatient units, two weeks in our pediatric illness clinic, one month in the neonatal intensive care unit, two weeks covering the pediatric hospital floors overnight, and two weeks in our pediatric emergency room. I’ve learned a great deal and am gradually becoming more independent as I navigate my role as a doctor. Now that I’m three months in, I’m recognizing that I still love everything about clinic and endocrinology, and that my superpower is being human. My favorite moments have been when I get to spend time and truly be present with patients. Singing happy birthday to a patient to make their crummy day just a little brighter, teaching a little future doctor about ultrasound, or simply giving stressed caregivers a hug are just a few moments that were bright spots in often long days. Don’t even get me started about the incredible medical students that I’ve had the privilege of working with. They are kind, thoughtful and incredibly bright. I love getting to show them the ropes and answer their questions. It’s become my mission to build them up and be their hype person because, honestly, they’ve got this and don’t need much else from me. Hopefully, all our shameless plugging will lead some to pursue Med-Peds training. I savor these experiences and will cherish them forever because they remind me that I have a greater impact than I realize. I can’t think of a better antidote to imposter syndrome.

That isn’t to say that everything has been easy. No way. I miss my family and friends and hate that I can’t just drive to see my nephew when he asks where I am. I’ve been working often over 60 hours, 6 days a week except for one week where I got a whole two days off. There’s been a steep learning curve as I navigate the added responsibilities of placing orders, talking to consulting teams and coordinating care. I’m now the one that nurses, patients and other team members are coming to with questions and I need to find an answer. It’s a lot, and everything’s 10x harder at 3 AM. Over time though, I’m becoming more comfortable fielding those questions and juggling the many tasks on my to- do list. In the discomfort of that learning curve, though, imposter syndrome thrives. There are certainly moments I second guess myself, wonder whether I’m good enough, doing enough or measuring up. In those moments, I remind myself that I’m not meant to know everything right away. If I already knew everything, there would be no point of training. What matters is that I’m working hard and willing to learn. In the end, my best will always be good enough for God, which is all that really matters.

Our society is so hyper-focused on perfectionism, being always accessible, always working toward the next goal that it’s no wonder burnout is such a big deal. Keeping up with watching church online, exercising, spending time with friends, and calling family have kept me grounded. There have been times though that I’ve been exhausted and wondered what would happen if I just drove off and went home to sleep. The team you are working with has such an impact on your well-being. Over the years, I’ve had teams where I came to work energized and ready to go because our team dynamic was incredibly positive, and I felt trusted and supported. I’ve also had teams where I felt like I was ignored or walking on eggshells, not wanting to say or do the wrong thing for fear of setting someone off. I never want anyone I work with to feel that way and that certainly was a factor I considered when choosing which residency programs to apply to and rank. I’m so grateful to have a supportive program full of individuals who care about me as a person. My co-residents have become a family who I know beyond a shadow of a doubt will always have my back. There certainly is no easy fix to such a widespread problem, but we must change our priorities if we are going to move anywhere in achieving a culture where balance in all areas of life is not the exception but the norm. We can start with treating one another with basic human decency and continue fighting to promote positive environments in which we all can work and learn. Our patients and future selves will thank us for it.

“Trust the wait. Embrace the uncertainty. Enjoy the beauty of becoming. When nothing is certain, anything is possible.”

Mandy Hale

Hey everyone! I apologize, I know it’s been a while since I’ve written here. In the last couple of months, I finished med school and moved out of Norfolk. I got to spend some much-needed time with family and am so grateful I got to celebrate my graduation with them.  I also got to catch up with friends from home and finally meet my friend Jill’s baby Owen, who is absolutely precious. With my family’s help, I am now moved into my new place in New York and at last have been able to come up for breath. We marveled at the beauty of Niagara Falls and ate way too much delicious food as we checked out local favorite restaurants. I’m grateful to have these last few days before orientation to continue exploring my city, start to meet my future coworkers and rest. Though, admittedly, I’ve had a little more time on my hands than I’d like recently. Yes, I’m completely aware I will be cured of that notion quickly once orientation begins.

As I’ve been relaxing, I’ve watched some of the sermons I missed recently. I love the series my church just did on the story of Jonah. Aren’t we all a little like Jonah from time to time, running as far as we can in the opposite direction of where we’re called to go? I know I certainly am guilty of trying to do things my way and maintain control. I’m always making plans, with grand ideas of what my path should look like.  Every time, God looks at those plans like, “Oh that’s cute, now we’re going to do my plan which is way better. Watch this.” So many pivotal points in my life have been moments like those that I really should know better by now than to stand in the way of His plan. That doesn’t mean it’s always comfortable. I’ve now lived in four different states and will probably always find moving to an entirely new place where I know few if any people beyond daunting. Being away from family, I’ve missed birthdays and holidays and feel a wave of guilt every time I can’t be physically there for my family when life throws us a curve ball. At the same time, I’ve become much more independent because I had to learn to figure things out on my own. I met friends who have become family, mentors I’ll forever be grateful for and grown so much along the way.

Now, finally, I get to take care of people in need as a real-life physician. I seems surreal that I actually get to live the calling I’ve been chasing since I was that little girl who wanted to be just like her doctors when she grew up. While I’m feeling the normal uncertainty surrounding starting this new chapter in my life, I know that it’s temporary. Soon, hearing myself being called Dr. Tich won’t sound as foreign. I’ll have built a new support system, learned my way around my new town and settled into intern life. In the meantime, I’m going to lean into the discomfort and see what amazing things come from it.

“And suddenly, you know: It’s time to start something new and trust the magic of beginning.”

Meister Echkart

Hey everyone! It’s been some time since I’ve uploaded a blog post. A lot has happened since my last entry. Match Day finally came! I will be starting my journey as a Med-Peds resident at the University of Rochester this summer and I am beyond thrilled. My co-interns are an amazing group of people and everyone in Rochester has been nothing but welcoming. I couldn’t ask for anything more. Of course, moving to a different state and starting a career during a pandemic is bound to be a wild ride, but I can’t wait for this new adventure.

Now that my class is finishing up our transition to residency course and about to graduate, my friends in the class of 2022 have been choosing specialties and looking toward their upcoming application season. There are so many factors to consider: away rotations, letters of recommendation, personal statements, which programs to apply to and how to put together an application that spotlights all of your incredible accomplishments. Seriously, you all are amazing human beings and residencies will be beyond lucky to have you on their team! Here are a few things I learned as someone who recently went through the application process. I’ll talk about away rotations, letters of recommendation and personal statement now, but the process of choosing which residency programs to apply to deserves a post of its own. That’ll have to wait for my next post.

1. Away Rotations

There are a lot of mixed feelings about these. On one hand, it’s often almost expected that applicants to historically “competitive” specialties do away rotations. Away rotations can also be helpful ways to get exposure to programs in specialties your medical school has no residency. Please listen to trusted advisors in your specialty about whether you would benefit from an away. It may not be necessary. If you choose to pursue an away rotation, it does not have to be an “acting internship”. An elective rotation that allows you to get to know faculty and residents without the pressure of a high-stakes inpatient rotation can be just as effective. Solid advice I was given was to consider away rotations at programs you’re strongly interested in. An example would be doing an away rotation at a program in your home state because you’re trying to move back there. However, there are potential drawbacks to away rotations. One, they’re costly. Two, as a visiting student you’re under more intense scrutiny and need to be on your game 24/7 because the entire rotation is essentially an interview. Poor impressions can be detrimental. Another surefire way to damage your reputation is to do more away rotations than allowed by the current COVID recommendations. Programs will see that you didn’t follow the rules and taking spots from other students who need them doesn’t make you look like a team player. If the guidelines say do one away rotation only, only do one away rotation.

2. Letters of Recommendation

Ask your advisors and those of us in the class ahead of you who is known for writing strong letters! They make a huge difference. I received compliments about my letters at nearly every residency interview, so know that they get noticed. In the end, it’s important to choose faculty who know you well and can wax poetically about how incredible you are as a person and future physician. Don’t be afraid to ask whether they would be willing to write you a strong letter. If they say no or are hesitant, don’t take it personally. A lukewarm or critical letter can be detrimental, so they’re doing you a favor by letting you know they might not be the best person for the job. When you ask someone to write you a letter, it’s helpful to give them as much information about you as you can. Don’t assume your mentors know everything about you; this is your chance to ensure what you want programs to know about you is emphasized. I asked my mentors whether they could write me a strong letter, then sent them emails with the ERAS letter request form, my personal statement, CV and noteworthy characteristics once they confirmed they were willing. All three pieces drove home the themes of what’s important to me, why I chose Med-Peds and what makes me unique as an applicant. I also offered to meet with them to answer any questions. Don’t forget to thank your letter writers afterward and keep them updated. They don’t get paid extra for the work they put in and are investing in you as a future colleague.

3. Personal statement:

Personal statements are notoriously the bane of med students’ existence. It’s hard to write about yourself and many of us haven’t done much writing (okay aside from patient notes which are decidedly different) since college. As one of my mentors has put it, letters most frequently neither help nor hurt you. Most use a standard structure of telling an attention-grabbing story, talking about your journey to medicine/your specialty, talking about why you want to do your specialty and finally why you will be great at it. If you use good grammar, have few typos and portray a message that paints you in a positive light, you’re off to a good start. I would argue that my personal statement was one of my favorite parts of my application. This is your chance to let your personality shine and show programs why you will be an incredible physician in your specialty of choice. Use it accordingly! This is a good point to also mention that anything you talk about in your personal statement or elsewhere in your application is fair game to be brought up during interviews. For example, I talked about my experiences as a patient in my essay and also during my interviews. I was comfortable discussing that part of myself and it was too important to why I’m so passionate about the career I’m trying to build to leave out. If there are facets of you that you’re uncomfortable sharing, while possibly being great motivators, best to leave them out. No one is entitled to your story. You have the power to choose how much or how little you share.

            I know this has been a longer post than typical, but hopefully the advice has been helpful. I’m so excited for the Class of 2022 and can’t wait to see where you all end up. Meanwhile, I will be savoring every last minute in Norfolk with my friends before I spend some well-earned time with family prior to starting residency.

“We think we listen, but very rarely do we listen with real understanding, true empathy. Yet listening, of this very special kind, is one of the most potent forces for change that I know.”

Carl Rogers

How is it already February? I am now finished with my interviews and the submission portal for our program lists opened to us today. Over the past month, I’ve been working in our pediatric nephrology clinic, which has been a blast. Getting to work with attending physicians who are invested in teaching and encourage you to ask questions always makes for such a great experience. I learned plenty about medicine, but also about life. The heart to hearts I had this month with my mentors about making my residency rank list and succeeding as a future resident were just what I needed moving toward Match Day. I’m so relieved to have completed my interviews, though I’m glad to have rotations to keep me occupied between now and when I find out where I will be spending the next 4 years.

As I get ready to start residency, it’s been fun honing my skills counseling patients. At our children’s hospital, nephrology typically manages patients’ blood pressures, so talking about forming healthy diet and exercise habits was common. Helping patients set goals and find ways to incorporate healthy foods and activities they enjoy was really rewarding. I also made it a point to check in with patients about how life was going beyond their health concerns. So many families’ routines have been thrown entirely out of whack by the pandemic that lots of kids have been struggling, especially with virtual school. Acknowledging what everyone’s sacrificed and taking time to truly hear people out goes a long way. Many times, people just need an outlet to vent, especially children. They’re trying to process all the changes going on around them and are acutely aware of all the pain and uncertainty in the world. So many kids are missing their friends. Those who already felt isolated are now missing the sports team or music group that was one of the few places they felt they belonged. Kids who rely on schools for food are worrying about where their next meal will come from. Not to mention, home isn’t the safest place for everyone. Some children suffer from abuse or live in unsafe neighborhoods. It’s important to take the time and acknowledge these factors so you can meet your patients where they are.  

Patients with chronic medical needs also have been dealing with reduced access to therapies and resources, as well as appointments that had to be cancelled or moved around due to COVID restrictions. Last month I was reminded how, particularly for children with complex medical needs, parents are often the experts about their child. Kids don’t always read the textbook and their parents know them best, so they frequently pick up on subtle changes we may not. As patients grow older, they will become their own biggest advocates, so it’s important to ensure they have the tools to do so and that we take the time to listen to them. Whether it’s a young patient saying “I don’t want blood work”, or your thoughtful college-aged patient providing insight about things to expect as younger patients get older, the power of getting the patient’s perspective can’t be overstated. I had the greatest time talking to one patient who was receiving dialysis, and won’t soon forget her thoughts about what she wished we would know as future doctors.

I’m looking forward to spending the next month in our genetics clinic as I count down the days until Match Day! I’m excited for the next adventure, but definitely not looking forward to the “see ya laters” that will soon follow. If there’s one bright side, it’s that we are way better at technology now so it will hopefully be easier to keep in touch with everyone.

“Pay attention to the things that you are naturally drawn to. They are often connected to your path, passion and purpose in life. Have the courage to follow them.”

Ruben Chavez

It is now finally 2021, the year I graduate from medical school. I have two more interviews remaining before I submit my program list and eagerly await Match Day! It’s surreal that the moment we’ve been working toward for the last four years is almost here. I cannot wait to see where all of my classmates end up for residency. My friends in the third-year class are now beginning to decide on specialties and considering where they might do rotations outside of our institution. I remember facing that decision last year and wishing desperately there was a sorting hat to tell me which specialty was for me! Looking back, these were a few of the factors I considered when choosing a specialty.

1. How do I want to practice medicine in the future?

It’s important to be honest with yourself when you’re going through rotations. Can you see yourself doing this work long-term? Do you enjoy long hours spent on call, or is a shift work or clinic schedule more your speed? Do you want to see patients, or would you rather be behind the scenes conducting and interpreting laboratory or imaging studies? If you are seeing patients, would you rather have one-time interactions where you address an immediate need or have a relationship with patients you get to know over time?

Personally, I did not enjoy 24-hour call shifts and a clinic schedule is much more my speed. Ideally, I would love to have a mix of clinic and inpatient time. I’m all about interacting with patients. It doesn’t matter whether they’re young or old, I love them all. I enjoy building relationships with people and admire the docs I’ve met who do so seamlessly. Med-Peds will allow me to do all of these things. I can practice outpatient or inpatient medicine, caring for both adult and pediatric patients and maintaining the continuity of care I value. Of course, I’d be naïve to think I won’t be working long hours, particularly as a resident. However, many Med-Peds programs have night float systems etc. that minimize or even eliminate many 24-hour call shifts, which is music to my ears.

2. Who do you want to work with?

Every specialty attracts a certain type of individual. Some are known for being blunt and decisive, others are known for multitasking and having high energy, and still others are known for being “nerdy”. The point is, you will get a sense for the personality of a specialty as you go through rotations. While not everyone fits perfectly into the stereotype of a specialty, it is important to consider whether you get along with the people you’re working with. For me, this basically was a gut check. I’d ask: Do I feel comfortable with these people, or do I always feel like I’m walking on eggshells? It might take some leg work on your part to see whether these are your people. This is particularly true if you’re at an institution where the specialty you’re interested in isn’t a core clerkship or there isn’t a residency program in that area. Shadowing, getting involved with national organizations, or networking via social media are great ways to start learning more about a specialty you haven’t been exposed to. Ultimately, if possible, an early 4^th year elective locally or an away rotation can be helpful if you’re still on the fence about a particular field.

I enjoyed my pediatrics rotation and loved my family medicine rotation, but my internal medicine rotation was moved virtually due to COVID. I had heard about Med-Peds from one of my mentors and realized it was the perfect fit for my interests and values. Whether it was a fit for my personality, however, was a bit more challenging to discern because we don’t have a Med-Peds residency. This summer, I attended webinars put on by the National Med-Peds Resident Association to learn more about programs and get a better sense for the specialty. Being surrounded by so many likeminded people was incredible. I immediately sensed that these were my people. Their energy was infectious, described aptly by others as combining the niceness of Pediatrics with the sarcasm of Internal Medicine. Meeting co-applicants on social media has been so much fun as well. Many have become fast friends and we have fun regularly sending each other pet photos in our group chat. Since we don’t get to spend time together this virtual interview cycle, connecting in these other ways has been so crucial.

3. What are other interests you want to incorporate in your career?

Do you like teaching and want medical education to be part of your career? Is advocacy important to you? Do you want to make an impact on the global community through global health work? It’s important to think about what you want your professional identity to be and look for ways your future residency can support that. Do people in the specialty you’re interested in work in these spaces? If they don’t, and there’s another specialty you like equally but will allow you the freedom to follow those interests as well, that might be something to consider. Also, look for programs that have tracks in areas you’re interested in. Having passions like these outside of patient care will help keep you going when residency gets tough and help you maintain perspective.

I’m interested in working in academic medicine, so have been looking for programs that have medical education tracks or otherwise strong training in education. To me, giving back to those coming up behind us and passing on what I’ve learned is part of the job, so learning how to teach effectively will be important.

In summary, to all of my friends choosing a specialty, make sure you think about whether you fit with the people, but don’t forget about your other interests. Take the time to reflect about how you want to practice medicine in the future and what you want your professional as well as personal identity to look like. You won’t regret it.

“The meaning of life is to find your gift. The purpose of life is to give it away.”

Pablo Picasso

We finally made it to December! I am so ready for Christmas. I am looking forward to time with family and some much-needed rest. With the New Year nearly here, we are about three months away from Match Day and five months from graduation. Halfway through my residency interview journey, I find myself getting a better idea of what I’m looking for in a program. I love programs that show how much they care for one another, rather than telling us so. They truly are gems. As someone interested in medical education, hearing how programs will prepare you to not only be a great clinician, but also a great educator, is music to my ears. Residents who clearly get along well with one another, have fun and enjoy life outside of the hospital are my kind of people.

One of my favorite moments so far has been when interviewers reference bits of my letters of recommendation. We don’t get the chance to see them, so what your mentors have said about you is often a big question mark. Hearing how much they care is so nice, even though they’ve never been shy with their support and encouragement. Several interviewers have commented that they are impressed by my application, though imposter syndrome quickly steps in and leaves me wondering whether they’re just being nice. Why am I so quick to internally minimize these compliments? In the back of my mind I respond, not unlike my mother when recognized for the work she’s done in early childhood education, that I’m just doing my job. I truly am blessed to be here, working toward my vocation, and am grateful for the privilege.

Last week at church, our pastor was talking about discerning our purpose in life and posed three questions to get us thinking: What makes you cry? What makes you excited? What are you good at?

What makes me cry? If you know me at all, you know I feel things deeply. I cry about sad things of course, but what hurts me to my core is seeing people that have been abused, bullied, dismissed and are hurting. There are so many people who feel unheard, who just want someone to listen. They’re scared and asking for our help. They’re why I chose medicine. Having a doctor who’s been in their patients’ shoes makes such a difference. Hearing patients talk about how much they love their doc because they “get it” resonates with me so much. From my own experience, I couldn’t agree more. Having that connection as a patient is special. Seeing doctors who are patients too and embrace their personal experiences as a driving factor for why they chose their fields is everything. My experiences as a patient and my future as a doctor are so intimately connected that I couldn’t separate them if I tried. I can’t wait to be able to be the doctor that “gets it” for my patients.  

What makes me excited? In any career, it’s important to find what gives you energy. There are going to be moments where your work becomes routine, aspects of your day that you don’t enjoy. Finding the things that will get you out of bed in the morning are important to preventing burnout. I live for spontaneous patient hugs, hearing patient’s stories, and the look on a child’s face when I help them hear their own heartbeat. I love teaching patients and students and seeing the lightbulb go off when they get a challenging concept. Helping people realize they can do hard things and know more than they think is so rewarding. I love that I can get to both care for patients and teach the whole team.

What am I good at? I’m good at listening. I get along well with most and help bring people together to accomplish a common goal. Communication is a strength of mine and I follow through when I say I’ll do something. I stick with hard problems with a stubborn determination until a solution is found and always strive to do my very best. I love being part of the medical team, working with patients with complex social and medical needs to help them reach their goals. I love research as an opportunity to dive into a topic, identify a problem and find solutions to fix it. I’m grateful to have found Med-Peds and medical education, which are wonderful fits for my strengths and will allow me to fulfill my purpose.

“You will never find your place in the world by being like everyone else.”

S.C. Lourie

One of the fun things about fourth year is getting to work with your classmates in the year behind you. I recently spent a few hours working with the “little sibling” I was paired with, what now seems a lifetime ago, in our pediatric emergency room. What a full-circle moment. Seeing her finally on rotations and watching her potentially finding her specialty was priceless. As we were catching up, I had the realization that I only have three more rotations left as a medical student! How wild is that? Also, we are four months away from Match Day? How is that possible? Two weeks ago, I started my residency interview journey. What a wild ride it has been. Learning about different programs and cities, meeting my future colleagues, and trying to envision myself as a part of each residency is so exciting. It definitely takes a lot of energy, though. I absolutely need to recharge my introvert battery after a long interview day. Walks with friends to decompress or curling up on the couch to watch a movie after debriefing with my family have been crucial.

This virtual interview season has come with many unexpected blessings, however. Firstly, I didn’t have to take out a whole separate loan to be able to pay for my interview travel. It seems obvious at first, but interviewing can become quickly expensive and figuring out how I would be able to pay for all of these hotel stays and flights was a source of stress for me before the shift to virtual interviews. Second, being able to interview from my own apartment has given me, in a way, a home field advantage. I’m someone who really battled nerves during medical school interviews. There’s something terrifying about sitting across from a stranger in a position of power who has the potential to, quite frankly, change the course of your life. In my opinion, the virtual format goes a long way toward leveling the playing field. I feel so much more comfortable and am able to be myself much more easily. I absolutely have grown in confidence over the last four years, which also helps, but talking to a screen during an interview has been infinitely less intimidating. Plus, I am someone who strongly feels the energy of others, so not having 10 anxious medical students in the same room helps me focus on just me.

Can I just say how cool it has been to find programs who are invested in the areas you’re interested in? The opportunity to attend lectures has given me a sense for what my education could be like as a resident. Seeing the clinics and hospitals where I may be caring for patients of all ages in just a few short months makes it so much more real that I’m about to be a DOCTOR!!! Meeting residents going into areas I’m interested in and leaders who are so invested in helping you build your career has been incredible. I love feeling the passion programs have for teaching and their commitment to helping you become a strong clinician-educator. Seeing strong female leaders in a variety of positions throughout each interview day never fails to make me smile. The number of doors opened to you in Med-Peds is endless and knowing there are people already doing what I want in a career is surreal. Most of all, I am so excited every time I see a familiar face from our group chat, Twitter or prior interviews. We are such a fun, supportive and accomplished group and I am so excited to see where we all end up. I have absolutely found my people and can’t wait to join this warm, supportive family.

“In today’s rush we all think too much- seek too much- want too much- and forget the joy of just being.”

Eckhart Tolle

Happy Sunday everyone! Also, how is it already November? I know it’s been a while since I’ve written here. Honestly, I felt like I didn’t have much to say since I had the month off of rotations and was in a bit of a funk waiting for residency applications to be transmitted to programs. It’s such a big, daunting step. The unknowns of both how the process works and what’s in store for my future stirred up some major impostor syndrome. In case this wasn’t crystal clear in past posts, patience is hard for me with big things like this and I strongly dislike that feeling of being in limbo, not knowing what’s going to happen next. Of course, like so many other times in my life where I’ve dealt with uncertainty, God’s shown up and exceeded my wildest expectations. I’m fortunate to have been granted interviews at several incredible programs that I’m super excited about. Also, can I just say that my co-applicants are amazing. They’re such a fun group of people and have become fast friends. I would be thrilled to get to work with them in residency. I look forward to starting my interview season next week.

Last week, I began my rotation in our pediatric emergency department, which has been amazing. Everyone I’ve worked with has been kind and eager for me to learn new things. I’ve certainly kept busy going from room to room. All I learned on my cardiology rotation seems to have stuck, apparently. I’ve heard a couple of innocent murmurs and recognized a patient presentation I’d only seen in exam questions previously. Providing a listening ear for anxious parents and helping the team during procedures makes me feel like I’m contributing to the team. Likewise, simple things like my resident buying my lunch or my attending acknowledging a good idea make me feel my contributions are valued.

Though I’ve enjoyed being back in the hospital, I was so grateful for time to relax this weekend, away from the emergency room and chaos surrounding residency applications. Because the computer system that houses our applications was down for maintenance this weekend, I was able to detach myself from my laptop. I can’t tell you how incredibly freeing that was. My friends and I went to a local national park, had a campfire and just spent time with one another roasting hot dogs and making s’mores. I didn’t realize how much I needed that reprieve. Life doesn’t stop for medical school and I’m so glad for all the adventures my friends and I have had. These are the memories that will stick with me, not the answer to that one question on the exam or my class rank. In less than a year, we’ll be going our separate ways. Until then, I plan to savor every moment. I’m excited to see where life takes us and am so grateful to have such wonderful future colleagues.

“Learn from the past, prepare for the future, live in the present.”

Thomas Monson

My pediatric cardiology block sadly came to a close this week. I learned so much and it felt great being back in the children’s hospital. Hugs from patients and working with supportive preceptors who took time to teach me and encourage my interests left my cup overflowing. There’s something about being around my peds or medicine people that leaves me feeling like I’ve come home. I hadn’t previously considered cardiology something I was particularly “good” at, but I left the rotation more confident in my ability to recognize murmurs, read EKGs and think about patient management. I also got to exercise my teaching muscles with my clinical skills groups, helping them navigate the patient interview and practice clinical reasoning. Yet again, I find myself amazed by how much I’ve learned and how far I’ve come and excited about my future as a physician and educator.

This week, I attended the first workshop of our academic clinician educator course. We had a wonderful discussion surrounding using social-emotional intelligence concepts to foster a supportive learning environment. Now that I’m in my last year of medical school, I’ve seen leadership done so many ways. Some have been effective. Others, less so. On rotations, setting expectations from day one sets the team up for success. My inpatient psychiatry rotation was one place that was done beautifully. Our residents sat us down as a group and walked through their expectations for us as well as the workflow in the psychiatry unit. They then modeled what their expectations looked like as we watched them conduct patient interviews. After that, they gave us space and trusted us to take ownership of our own patients. On other rotations, we were left to discover these expectations as the rotation progressed. Joining teams of residents who were at times overwhelmed, we often were expected to jump right in and get to work. Though this did help me work through my nerves starting a new rotation, I’d be lying if I said it wasn’t disorienting.

Another topic we discussed was different teaching styles. As a learner, I appreciate any opportunity where residents or attendings take time to go over important concepts . Sometimes this takes the form of lectures, others involve walking through cases or questions utilizing the Socratic method. Though different from one another, each serve a different purpose and are only effective if learners feel safe participating. The Socratic method commonly gets a bad reputation because it puts learners on the spot and increases the stress of an already uncomfortable situation. I absolutely have felt this, particularly when not given adequate time to think and respond. On the other hand, some of my favorite preceptors use this method, with one important caveat. They set the expectation that their questions were not to trip me up, but to see how I think through concepts and what I already know. Then they could adjust their teaching accordingly. I never once felt I was being punished by these individuals. I enjoyed the challenge of learning to think through hard problems, often found I knew more than I thought I did, and clarification where I went astray helped me understand topics better.

Finally, we discussed feedback. Firstly, the setting is key. Conversations I’ve had were we sat down in a quiet area that was private and in a “neutral” area were more comfortable than those where I felt cornered or took place in front of classmates. I’ve often been given feedback that is essentially “You’re doing great”. While nice to hear, it’s less than helpful. Specific feedback like “Please include more detail when discussing pertinent physical exam findings” or “Start considering discharge criteria and what needs to happen before patients can return home safely” is much more helpful when paired with examples of how to do so. When I have a team in the future, I plan to make a point of setting aside time before the beginning of each rotation to sit down and discuss expectations. I will make time for teaching, ensuring I take into account each individual’s interests and learning styles. Though I still have time before teaching will be expected of me, I look forward to submitting my residency application and discovering programs who will help me grow into the type of physician I dream for myself.