Sunday, January 11, 2009

ER: Third Day

This afternoon I went to work and reintroduced myself to Dr. Trot. "Oh, did you get the short end of the straw?" he joked. Not really; I chose to work with him because he came highly recommended. He was also known to work at "lightning speed" and I soon saw how true that was. He moved really quickly from room to room so that whenever I finished seeing a patient, I had really search for him or his scribes. I never even knew the histories for half the patients he saw, focusing only on the 6-7 that I picked up. Now that I had an Epic password, I realized just how much Dr. Trot expected me to do. Aside from documenting everything, he also wanted me to order labs and tests by myself and have him approve those later on. There were other times where he'd tell me to order things in rapid succession and I'd have to ask him to repeat himself. "Don't try to memorize these, write them down," he said. Very different from Dr. McC, who said I didn't need to write things down, just do a 45-second presentation of what was important. I prefer writing them down though.

My first patient was a 58-year-old Type I diabetic who initially came for nausea and vomiting but later developed DKA during his stay in the ER. "What tests do you order?" asked Dr. Trot, and I said ketones and ABG. Another patient was a woman in her sixties who hadn't had anything to eat or drink for 8 days b/c she "felt sick," and she looked very jaundiced. Her liver enzymes came back normal, however, and I overheard Dr. Trot ask his scribes what the most deadly cancer was. "Pancreatic?" said one. Yup...painless jaundice usually points in the direction of pancreatic cancer. I also had two abdominal pains. One said his entire family got food poisoning about a week ago but only his symptoms persisted. CT showed a perfed appendix. Another guy had flank pain and hematuria so I immediately thought it was a pyelo. "What about leukocytes?" asked Dr. Trot. Oops, those were negative. "He has chronic hematuria from a kidney tumor," he said. "Talk to him about it." *sigh* Clearly I was not asking any right questions. One woman came in with suprapubic pain and increased urinary frequency, and I was all for calling it a UTI. A beta-HCG revealed she was pregnant (she already had a 12-year-old son and was shocked to get the news), and a sonogram revealed she was 7 weeks along. She also had PID and had to be treated for that. Then an 18-year-old girl came in with flank pain that turned out to be from an ovarian cyst. I had to do pelvics on both. Meanwhile, Adam got to do two LPs, a shoulder reduction, and a paracentesis (which I observed along with Ryan D's wife, who was shadowing Adam's preceptor). When I joked that Adam should give me an LP if he's too busy, he said that it was Dr. Trot that gave him these procedures. -_- Not fair, but I guess Dr. Trot preferred for me to see patients. Besides, I'm sure if Dr. Trot sees me around in the future with nothing to do, he'll give me something to do. My last patient had a bad case of hyperemesis gravidarum (this was her third pregnancy and her previous two were equally bad), and she wondered aloud if she was being punished somehow. I spent about 5-10 minutes listening to how every pregnancy has been so difficult for her and that she would like nothing better than to be happily pregnant like most expectant mothers, but fortunately her faith was sustaining her through her ordeal. *sigh* Rough times.

I left the hospital shortly before 11 pm, without ever hearing back from my jaundice patient (her CTs were done very late), but maybe it's best that I don't know what's wrong with her.

Saturday, January 10, 2009

ER: Second Day

Today I was scheduled to work the 5:30 pm shift with Dr. McC, who showed us around the ER at orientation, because he said if we needed suture practice he'd be happy to show us early in the rotation. Because I just came back from 3 days in Philadelphia for interviews, I had yet to complete the online courses required to get an Epic password, so I needed the (lone) scribe to log me into computers to document my HPIs, ROS, and physical exams. For the most part it was fine. One notable case was an 85-year-old woman with "poop coming out of her vagina." There was a lot of fecal matter in her diaper and we had to make sure that there really was a rectovaginal fistula so this poor woman got a pelvic exam. And when Dr. McC removed the speculum, the head was entirely covered with fecal matter. So yeah...looked like there was a fistula except it wasn't visible on CT, so surgery had to be consulted. For the most part it was a fairly busy night, but Dr. McC never fell behind. I had to learn some terminology/Dr. McC-isms like IGYWUs (I got your work ups, pronounced "Iggy-woos"), IGY-Qus (I got your quickies), Triple Whammy (Vicodin, Motrin, and Robaxin) and BAH (big-ass heart).

There were other ER docs working around us, most notable was Dr. "Trot," who was getting a lot of attention b/c he recently appeared on a TV commercial. He and Dr. McC discussed colleges for their kids at one point, so I offered some input about UT. Then towards the end of the evening, Dr. Trot came by and asked if I'd done any LPs before. I said no (which wasn't entirely true; Dr. F let me attempt one on my last shift but I'd failed), so he sent me to another room to do an LP on a young guy with a fever. Fortunately with Dr. Trot's guidance (he let me set up, which I did correctly except for marking the spot where the needle was to go in), I was able to get CSF on the second try, and I talked to the patient to keep his mind off the procedure (we knew we were in the spinal canal when he said, "OW!") CSF looked clear, which was good. Fortunately we all finished by midnight (by which time Dr. McC was ready and eager to go home so we didn't go over sutures), so I spent the next 30 minutes taking all my courses so that I could activate my Epic password. I'll be working with Dr. Trot tomorrow, and I do not want to appear like I don't know anything in front of him.

Tuesday, January 6, 2009

ER: First Day

Today was my first official day of ER at Harris. Orientation was yesterday and I found that I was working with Adam, Kate, and a PA named Jeremy. The four of us were able to plan our schedules together after getting our IDs made. I'll be working a couple of 4 a.m. shifts because Dina and Ben both said the attending there was really nice.

Since I didn't have a log-on, I followed Dr. F (the attending I signed up with) and his two scribes most of the time. Toward the end of the shift I was allowed to see a few patients on my own and then report my findings to him. Everything in ER is so fast-paced and not very detailed. ER physicians just want the important facts. That's something I'll have to get used to b/c I tend to focus on details.

Thursday, December 18, 2008

Interview: University of Southern California

First Impressions: Even before coming to LA I had heard stories about USC, namely how the hospital was too large and cramped (5 patients per room!) and that residents were on q4 call for most of the year. 5-6 weeks before the interview, I got an email from USC saying that they recently moved all their patients and staff from the old hospital to a brand new hospital, and that we would be taking a tour of the new hospital since we'd be doing our training there.
Pre-Interview dinner: None, but I did drive around LA and met up with a friend in Burbank for cheap sushi ($3.95 for a six-piece spicy salmon roll!) and lots of anime-related fun.
Interview Day: I had to take a shuttle from the parking lot to the Outpatient building near the hospital, but instead I got off at the county hospital and asked where to go from there. I ended up having to walk up several flights of stairs across the campus and ended up asking a medicine resident I met in the courtyard where the department of medicine was. We had a big group of about 20-25 applicants, not unlike UIC. Looking among the applicants, I saw that we came from a wide range of places. There were three DO students, students from more prestigious programs like Stanford, Yale, and Cornell, and then everything else in-between. It really was a mix of students from all backgrounds. Most of the applicants, however, had strong ties to LA and or else wished to return to California after going to med school in a different state. I was probably the only person there with no ties to California.

The chief resident, Antonio, came to speak to us; he had a loud voice and an overly-enthusiastic personality to match. He told us why he loves USC and is staying to do his fellowship there before turning our attention to the program director. The PD welcomed us and spoke to us for about 30-40 minutes about the program before taking everyone on a tour around the brand new county hospital, which just opened six weeks ago. Indeed, the hospital looked very nice, with mostly private rooms and wide spaces, large windows with more natural light, and a great view of downtown LA that also includes the Hollywood sign from one angle. But it was clear that the hospital hasn't been "settled in" yet; the walls were too plain (no paintings or decorations), the halls seemed relatively quiet, and the call rooms had a bed, a table with a phone, and not much else. Eventually they'll put more computers in the call rooms and everywhere else, but right now they're still settling in. Throughout this tour, the PD walked extremely fast, often leaving us in the dust; one applicant commented that he walked faster than most surgeons he knew. Another thing no one appreciated: today was an unusually cold day in LA (about 40s-50s), and the PD made us stand outside shivering while he spoke to us about the transition from the old to new hospital. Couldn't he have done that indoors?

After the tour around the county hospital, Antonio met us in the courtyard and escorted us back to the conference room, where there were bagels and fruit waiting for us. Thank goodness, too; I hadn't had breakfast that morning and I was originally afraid that this would be a repeat of Sinai Hospital (no breakfast, starving until lunchtime). One by one, Antonio called us out of the conference room to escort us to our interviews while the others waited in the conference room and chatted with residents who came in to talk to us. My first interviewer was an internist who didn't shake my hand b/c she was recovering from a cold. She asked me some of the usual questions, like what brought me to LA, and I told her I was looking all over the place but liked USC b/c of the diverse pathology and learning opportunities. At any rate I don't know if I made a favorable impression on her or not; there were times, looking back, where I seemed a bit hesitant. My second interview was with one of the other chiefs, who was apparently chosen to speak to me because he was a DO. He was really nice and assured me the program was DO friendly, and said he didn't get his internship approved by the AOA b/c he didn't feel he needed it. I don't know how much weight my interview with him had, but he seemed confident that the match always favors the applicant so that I should just relax and ahve fun at my interviews. He specifically said that he chose USC because of the q4 overnight schedule b/c he learned best by following up with patients throughout the night, and that on a regular day, he could leave as soon as his work was done, sometimes as early as 2:00 pm, so he got plenty of time off. "Night float doesn't mean you work less hours," he said. It gave me a lot to think about.

With both interviews done, I was free to sit among other interviewees and chat with the residents. They had good things to say about the program, of course, and about LA in general. LA really is a charming city, despite its horrendous traffic, especially today with its sunnier skies and the palm trees lining the streets. After lunch, the chairman spoke a few words and then we were unofficially dismissed for the day. Several people left to catch flights out of LA, and Antonio took the rest of us on a tour to "Mother County," the old county hospital which, until six weeks ago, had housed all the patients that were now in the brand new hospital.

I'd heard stories about how ghetto the old hospital looked, but I had no idea how ghetto until I walked through the doors. It was really like something out of a history book. The halls were dark, there was writing on the walls that clearly dated back to the 1930s or 40s, and lots of old pictures dating from the early 1900s or late 1800s. We walked into one of the patient rooms which had one tiny window, one closet-sized bathroom, and five beds separated from each other by curtains. "These curtains are going up for auction next week!" said Antonio. "Anyone watch Fear Factor? Would you be willing to lick one of these curtains for $30,000?" All of us were amazed that as little as two months ago, there were actual patients in this poorly-lit museum of a hospital room, and I could see now why some people got scared away from USC because of "Mother County." The old hospital is a historic landmark and can't be torn down, but plans are in the making to consolidate all business in the hospital to the first 4 floors (it's a 19-story building). Thank goo
dness they're in a newer hospital now.

Overall Impression:
Pros: LA, lots of diverse pathology, good training for either primary care or fellowship, brand new hospital with great view, allowed to leave hospital whenever you're finished. Plan to rank high.
Cons: Large program (54 categoricals per year), q4 overnight for 7-8 months

Wednesday, December 17, 2008

My Own Personal Star Encounter

I wasn't planning to write about this because it sounds very unbelievable, even to me, but it really happened.

Everyone knows I'm crazy about anime; it's something I've never tried to hide. Last October, after my psych rotation ended, I drove to Houston to attend my first anime convention, and it was there that I met and befriended Kyle, a voice actor famous for his roles in popular anime such as Naruto, Dragonball Z, Bleach, and Gurren Lagann. He's one of the few voice actors I've heard of who really invites anime fans to become his friend (others just sign autographs and end it right there), and we found common ground in both being from the DFW area. We occasionally chat on AIM and I ran into him again at two more conventions (anime cons are like a drug; once you attend one, it's hard to stop). When I told him I was coming to LA for an interview, he suggested meeting up for lunch at Burbank, then said if I wanted to, I could go to work with him and sit in on an anime recording session. No way was I going to turn that down.

Once I got to LA, I briefly visited Hollywood and then drove on to Burbank to meet Kyle for sushi. Then at 2:00 pm we went to the recording studio where Kyle showed me around the soundproof recording booth (it was small!) and let me see what a typical script looked like. The director and sound engineer welcomed me to the studio and let me have a seat where I could see all the action. Clips of the anime (whose name I won't reveal) were played in their original Japanese, and then Kyle would record his own lines in English. Precision was everything; he had to match the mouth flaps of the animated character, and if his emotion was not what it should be, the director would tell him how to improve and then have him redub his lines again. This was the first time I got to see dubbing in action and I was totally engrossed with what was happening. It's not every day a normal person can set foot in an anime dubbing studio.

After one hour and 22 lines later, it was time for a break, so I met Kyle in the hallway and he asked me what I thought about dubbing so far. Just as we were chatting, someone else walked into the hall and greeted Kyle by name. "Hey Johnny, how's it going?" said Kyle. When I saw who it was, I think I froze. OMG. No way. This man was at the top of the list of voice actors I've always wanted to meet, not only because of the voices he provided in Bleach and Code Geass (which I watch faithfully), but because I'm a huge fan of his music. Johnny is the lead singer of his own band, Eyeshine, and I've listened to both of his CDs so many times that I can sing along to most of the songs by heart, with "Waterfall" being my favorite. More people know him for being a former Power Ranger, but I liked him more for his anime work and music. And there he was, just a few feet away chatting with Kyle.

Johnny had a recording session at 3:00 pm, apparently, so while he went to another soundproof room to get ready, Kyle gave me a knowing look as though asking if I knew who that was. I nodded my head, but had no idea what to do. What do I say to the man who has one of the most famous voices of the anime world? And even if I had it in me, I refused be one of those crazy fangirls I'd seen at conventions who scream and swoon at the sight of a VA. That only freaks VAs out, and that was the last thing I wanted to do. Finally Kyle said, "Have you met Johnny yet?" and I said, "No." So as Johnny came out of the room, Kyle said, "Johnny, this is my friend [crescendo]."

"Hi, nice to meet you," I said, and we shook hands as Johnny said hi as well. "I have both your CDs, actually," I said. "Really?" he asked, interested, and I added that I was a regular at the Eyeshine forum, particularly the Bleach section, and he said, "Awesome. We're working on our 3rd CD, actually." I asked when he thought it would be released (because I plan to buy it for sure). "We're hoping to have the final version by the end of the month, but it probably won't be available on the website until late January," he said. "We're still working on the melody of one of the songs, it's not quite right yet." At that point the secretary came in and told Johnny that the president of the company wanted to see him, and as he left Kyle joked that Johnny was about to get a yellow slip (meaning he's getting fired). "They can't fire him, his voice is too valuable," I said, and Kyle agreed.

The break ended, and Kyle finished the rest of his lines in about 30 minutes. I didn't see Johnny again before we left, but afterwards as Kyle was giving me a ride back to my car, I said, "I didn't come off in a bad way, did I?" Kyle said, "No, you did good. He really seemed interested when you said he liked his music." I hope so. Voice actors hear all the time that fans love their voice, but voice acting is just a small part of what Johnny does. Not many anime fans know that he has a band, or that he wrote the lyrics to most of his songs, and I think that by listening to his songs, fans get a real appreciation for what kind of man he is. One of my favorite songs, "Not Really Good," was described by him as a "cry for help through struggles of being a believer." Not many people can put such personal struggles down in words, much less a song, and that impressed me. There was so much I would have liked to tell Johnny about how much I loved his music and voice over work, but sadly there wasn't enough time.

Even as I write, I still can't believe all of this happened. I have no proof that I even set foot in a dubbing studio, just a few snapshots of TV studios around Burbank as Kyle drove me around to see the sights. But I have my memories and a warm fuzzy feeling that hopefully won't fade anytime soon. Especially if Eyeshine comes to a convention in Texas before I graduate; then I can finally get my CDs autographed =)

Monday, December 15, 2008

The Test for Perfect Pitch

This afternoon I watched an anime movie titled Full Score of Fear, in which the main character investigates the murders of students at a music academy (anyone catch the musical term in the title?) Interestingly enough, the culprit also planted a bomb inside a pipe organ, and the main character was able to find the bomb only because he noticed that one of the notes played by the organ was consistently "flat," or slightly off-pitch. He was able to do this because he had absolute pitch, aka "perfect pitch," the ability to identify or recreate a musical note without an external reference (i.e. a piano). Most of the viewers probably thought, "Huh? That note was flat?" because the alteration in pitch was very slight, but fortunately, I was able to pick it up.

I don't know when I realized that I had perfect pitch, but I think it was sometime in high school. I could always tell when someone was playing out of tune, and what I lacked in dynamics, I made up for with near-flawless intonation. I can identify single notes pretty well, but chords are more of a problem b/c I haven't had the proper training for it (1-2 years of piano). Even still, I had to wonder just how "perfect" my sense of pitch was. So when I surfed the web and found an auditory test to determine whether or not I had perfect pitch, I knew I had to take it.

After filling out a brief questionaire, the computer began producing different tunes in succession. I had 3 seconds to identify each note after I heard it and click the appropriate "key" on the virtual keyboard. There were 80 tunes altogether, 40 piano tones and 40 "pure" tones, and sometimes the notes were so high or so low on the spectrum that I honestly couldn't tell what they were, or else I ran out of time before I could identify a note. When my scores came out, however, I scored a 30.25/40 on pure tones and 31/40 on piano tones. That's well above the Absolute Pitch cutoff point at 24.5, confirming what I already know regarding my sense of pitch.

Now whenever interviewers ask me to tell them something interesting about myself, I can with all honesty say that I have perfect pitch, and with the data to prove it =)

Friday, December 12, 2008

Interview: Exempla St. Joseph's Hospital

First Impressions: I had driven by St. Joe's (as the hospital is known) back in August when I visited my sister, so I knew it was a fairly good size (550 beds), and I'd also heard good things about the program from one of my ICU residents, who'd gone to med school at CU. My sister lived about 30-40 minutes from the hospital but I was fine with commuting. Had to wake up before 6:00 a.m. to make a 7:00 a.m. interview but it was fine.
Pre-Interview dinner: A meet-and-greet was held downtown at a bar called Lodo's, former Mattie's House of Mirrors back in the day when the 2nd floor was a brothel), and I was among the first to arrive. Imagine my surprise when I saw a familiar face: Jeremy! He'd interviewed at St. Joe's earlier that day and would be interviewing at CU the same day I had my St. Joe's interview. He seemed really enthusiastic about the program and said that Denver was the farthest east he's applying (geographically). Our only regret was that we couldn't attend Kasha's memorial service. A lot of residents attended the social, and all of them were nice and helpful. Jeremy and another applicant kept talking about how great morning report was, so I knew I'd have to see it for myself.
Interview Day: This was the smallest interview group I'd ever been in; there were only six of us altogether. The reason for this was that the PD interviews with every applicant, but it turned out to be a good thing b/c we all got to know each other sort of well. We first had breakfast with one of the interns, Carolyn, and she let us to the cafeteria and told us to get whatever we wanted. We had to write down the amount we spent at the cashier table. Fortunately my food did not cost the most. We chatted for a while with Carolyn about the program before the PD, Dr. Gibbons, came in to speak to us. He went into more detail about what the program had to offer and then turned us loose for interviews. My first interview was with him. He was very nice and didn't ask any hard questions, just what drew me to "St. Joe's" and other common questions. He did read aloud some comments from my Dean's letter and my rec letters, and like an idiot I said, "Wow" when I heard some of the things Dr. RR wrote about me. Even still, Dr. G assured me that based on my application I am definitely competitive for a spot at St. Joseph's, and that was good. In between interviews, my fellow applicants and I sat together and chatted about random things. Then I went to my next interview, which was low-stress as well. My interviewer asked how I heard of St. Joe's and seemed pleased when I told him that an ICU resident I worked with (Tony G) had graduated from CU and had many positive things to say about the hospital. "It's nice that people have heard of us outside of Colorado," he said.

After all interviews, we went to attend morning report, which was unlike any other morning report I'd ever been to. One resident, Travis, immediately said that he had an "awesome" case to present despite good-natured teasing from his peers, and the case was interesting (skin lesions secondary to drug toxicity). This was followed by two other interns reporting on interesting patients they had seen recently, and each time, someone was asked to interpret the patient's EKG and CXR, or whatever tests are necessary. One case showed a brain contusion that looked like an epidural hematoma (except you can see brain tissue), along with a skull fracture and contrecoup lesion secondary to trauma. Yikes. But through it all, the residents were laughing and joking amongst each other and with the attendings when appropriate, and this, to me, was what "camaraderie" was. One of the guys even compared it to "being in college again." Someone once said that the residents at St Joseph's are among the happiest in the area, and I was seeing that now with my own eyes that it was no exaggeration. Also during morning report, specialists will come in when needed to do some teaching, which I thought was cool. Usually only general medicine internists attend morning report.


After morning report the three prelim applicants went with a prelim intern on a tour while the categoricals followed Matt, the chief resident whom I met last night. He showed us the call rooms (nice view), the clinic, the ER, the ICU, and even the work-out room (which he said was lousy but I thought it was much better than the one at my school so no complains from me). Lunch was, once again, at the cafeteria where we got anything we wanted, and Matt introduced us to a 3rd year (he called it "turd year") who's actually found a job at AMH effective next fall. He went to UTA for undergrad so he was familiar with Arlington. Noon conference featured a lecture on "altered mental status" which I thought was useful. The lesson of the day: know how to recognize locked-in syndrome.
Overall Impression:
Pros: Denver, good training for either primary care or fellowship, genuine camaraderie, nice call rooms, closely affiliated with University of Colorado
Cons: Small program (9 categoricals per year), not university-based

Monday, December 8, 2008

Loss of a Classmate

Last night while surfing around on Facebook, I got a PM from Ilona asking if I'd gotten an email about Kasha and if she had really died. Me: WHAAAAAAAAT?! I had not gotten any emails about anyone dying (apparently Eryn only sent emails to a select few), and I did some sleuthing of my own and read the latest Facebook statuses to see who else might know something about this. Seeing Amber R online, I asked her what happened, and she sent me a link to an online article. It said that Kasha and her husband were both dead, victims of an apparent murder-suicide, and that Kasha had been shot multiple times.

I couldn't believe it. This was too surreal. Last January during my surgery rotation, a woman was brought to the JPS ER with GSW to the eye after her husband shot her before turning the gun on himself. She didn't survive, and I later read online that she and her husband left behind a 4-year-old daughter. Even back then, I wondered how men like that could be so selfish and cruel. And now, especially after visiting the Holocaust museum which vividly detailed the many crimes men commited against other men, I find myself wondering why this happened, and to Kasha, of all people, who had so much going for her. Ranked high in our class, applying for a dermatology residency, mother to 8-year-old twins...it really is such a waste.

Dr. Moorman held a meeting at Luibel at 4 pm today so that we could discuss what had happened to Kasha, so I went and found many familiar faces there: Jenny, Mike W, Jeff, Hunaid, Lauren, Kim, Carisa, Asuka, both Ambers, and Rick, to name just a few. I could see Rachel, Blakely, and Lori being interviewed by CBS in the atrium, so I stayed away from there. Amber L, Molly, and Venessa were crying hard. Desiree and Kate, Kasha's closest friends, were nowhere to be found. At times I felt like I shouldn't even be there because Kasha and I were mere acquaintances at best. But then I remembered Kasha introducing herself to me on the first day of orientation, volunteering with her at the Juvenile Diabetes walk and seeing her take balloons home for her twins, saying hello to her in the halls, and decided that I had to stay. Even though I didn't know her as well as others did, the fact remained that I knew her, and that was enough.

Dr. Moorman thanked us for coming and offered us a chance to ask any questions or just share memories of Kasha. There was awkward silence for what seemed like a long time, and then Amber said there were many unanswered questions at the moment. Rick took the microphone and told of how he ran into Kasha five weeks ago and how despite her high GPA and research experience, she was still worried that she wouldn't match into derm, and he'd assured her that she would. He said that when he thought of how Kasha's kids were now orphans, it made him angry because they would have to live with the knowledge of how their parents died, and that the direction their lives will take now is not what Kasha envisioned for them. Molly then said that she thought it was unfair for this to happen to Kasha (something we all agree with) and that Kasha deserved her DO degree posthumously because she earned it. Blakely told of how she ran into Kasha on the interview trail and how they'd spent time chatting about why they wanted to do derm, and in Kasha's case it was so that she could have time to spend with her family. There's to be a candlelight vigil held at the Atrium this Thursday, but I'll be in Denver at the time so I won't be able to make it. In the meantime, there's going to be a toy drive for Kasha's two kids, and the family will let us know if there'll be a memorial service in Texas (according to Molly, Kasha is going to be buried in Louisiana) And of course, our yearbook will be dedicated to Kasha, and the class officers will find a way to honor her at graduation.

Dr. M was there, as well as the EAP counselors, and he said that grieving is a part of healing. One of the EAP psychologists said that it's not important that we get over Kasha's death, which we never will, but that we get past it. Easier said than done, when I could hear people sniffling and blowing into tissues behind me. No one will be getting past this anytime soon.

*sigh* Why did this have to happen?

Friday, December 5, 2008

Interview: University of Illinois at Chicago

First Impressions: This was not my first time to Chicago, and since I had more time to explore, I browsed through Chinatown, went to the top of the Sears tower and walked along Michigan Avenue.
Pre-Interview dinner: This was more of a Happy Hour Q&A at the Illinois Bar and Grill located near the underground campus of UIC. Since I forgot the map and only knew vaguely where it was, I took the shuttle to what I thought would be the closest stop to the bar and started walking. Imagine my dismay when I realized that it was at least a mile's walk from the station, and I was practically an icicle by the time I arrived at the bar (temps were in the low 20s). There were a lot of people in there already, and someone offered me a beer, which I took. It only took a few sips to warm me up. =P

This was definitely the worst pre-interview event I'd ever been to b/c all they offered for food was beer, sodas, onion rings, okra, and chicken strips. I did get to meet a lot of nice people, and we got to chat with one of the chief residents and future chiefs about what UIC was like. It was hard to tell who was an applicant and who was a resident until one girl pointed out that the residents were wearing pagers. After the crowd thinned out, another applicant was kind enough to drop me off at my hotel (he knew that I'd walked from the train station)

Interview Day: This morning I took a cab to the UIC Medical Center, and there I found myself among about 30 other applicants in the same room. This was the largest group of applicants I had ever been with at one time, but it turns out there were a lot of people interviewing that day. Not just categoricals, but also prelims and IM/EM applicants. Of these applicants, there were nine of us from Texas (but I only knew of 2) Morning report covered a patient with what appeared to be a cold but turned out to be something more serious. The PD talked about the program and then the categoricals and prelims were split into groups of two to be taken to interviews and tours, respectively. "Bring your coats," said the chief resident leading the tour, because we were expected to walk outside at some point. The hospital itself was pretty old (it opened in the 1970s) but was very brightly lit, though we didn't get to see the call rooms or cafeteria (at least, not that I remember). We then had to walk outside to the brand new VA hospital (nicknamed the "Taj Mahal"), and the wind was so cold I asked some Chicago natives if that was normal. "Not for December," said one woman from Rush University. "It's usually not this cold until January." At least I was wearing pants; some girls were wearing skirts with only hose to protect their legs from the cold. The VA was beautiful. It was not like any other VA I'd ever seen, and one applicant commented that it didn't even smell like a VA. It looked like a normal hospital, with all rooms private (like the new JPS building). Definitely a selling point for the program.

My two interviews came after the tours. From the start, the program coordinators told us that we were paired with interviewers with whom we'd have something in common. My first interviewer was a pulmonologist/critical care attending whose son is a student at LECOM; he asked me to explain osteopathic medicine to him and when I answered the best I could, he nodded his head as though he's heard the same explanation from his son (I hope that's a good thing). He did say that OMT has its benefits, pointing to his neck as he said so; I imagine he'd been on the receiving end of some HVLA, hehe. He did say that the PD likes to add some variety (i.e. DOs) to the class, so I'm going to take that as a good sign. My second interview was a DO, and he'd been to Texas some months before to interview at our school for a position of some sorts. He asked some application-specific questions and seemed interested when I told him of my background in music. I've found that it's been really useful to bring up my experiences as a violinist; it makes for some good conversation. He ended the interview with, "Do you have any questions for me?" and even though I wanted to ask him my usual questions, I didn't because we were running out of time (I was the last applicant to come out) Hopefully he won't think badly of me for it.

Lunch was delicious, and afterwards we were free to go.
I had plenty of time to fetch my luggage and get to the airport, only to find that my flight got delayed by 45 minutes. =(
Overall Impression:
Pros: University, fewer months in general wards, emphasis on specialty medicine, teaching month as a PGY3, sim labs, option of getting an MPH for free, living in Chicago
Cons: None that I can think of at the moment =)

Wednesday, December 3, 2008

Interview: Case Western MetroHealth Medical Center

First Impressions: MetroHealth provided a five-page list of hotels with discounted prices, and I ended up choosing a hotel in downtown Cleveland that provided shuttle service to the hospital and cost only $80 per night, which allowed me to spend two nights there since I planned to fly to Chicago the morning after my interview. It only cost $2 to ride from the airport to Tower City (a downtown shopping center), where I then rode a free trolley to the hotel.
Pre-Interview dinner: Dinner was held at the Metropolitan Cafe downtown, which was easily accessible by taxi. There were four residents and about 5-6 applicants there. We were given a menu from which we could choose one of about 5-6 entrees, and I chose the highly recommended Atlantic salmon. The residents were very nice and had great things to say about MetroHealth, and one of the 2nd years gave me and another resident a ride to the hotel afterwards.
Interview Day: Since I was staying an extra night in Cleveland, I didn't have to wake up earlier than usual to pack and went downstairs to take a shuttle to MetroHealth. There were about 10 of us total, and the PD came and talked to us about the program and what it has to offer. "I could spend the entire morning telling you stories of patients I've seen here," he said, and I found he was very friendly in that respect (which was good, since my first interview was with him). Overall I think my interview with him went very well. He gave me time to ask him questions before he asked me anything, and the questions he asked were pretty specific to my application. He asked me if I'd met the PD at UTMB-Austin, whom he's met on several occasions, and he asked me what novels I've read. I told him I liked mysteries but admitted to never reading any Sherlock Holmes novels, so he recommended them and said that Sir Arthur Conan Doyle (the author) was a physician as well. Interestingly enough, I remembered from one of my favorite manga/anime series that Sherlock Holmes could tell a patient's profession just from looking at his hands, so we talked about that. The PD said that he has looked at patients' hands to see where calluses are to tell their profession, and I commented that years ago, my hands could have revealed that I was a violinist (fingers slightly longer and thinner on the left hand, calluses at the tips). At any rate it was a great interview.

My second interview was with one of the chief residents, who had gone to med school at OUCOM. Since she was a DO, I asked her some DO-specific questions like whether or not I should get my osteopathic internship approved. She was very nice and seemed very interested in hearing about my Borders without Boundaries trip when I told her that some towns have no doctors and had to rely on a helicopter 90 miles away to transport them to the nearest hospital should a situation arise. We had a tour of the general hospital area with some residents and then ate lunch before the chiefs took us on a tour to the medicine floors. The medicine floors are located in totally circular buildings (seen above) which provided an interesting layout of the rooms, but it was a nice touch. Overall I had a very favorable impression of MetroHealth.

Overall Impression:
Pros: University program that's mostly resident-run (PGY3s make all the decisions and have 1-1 time with the attending), similar to county hospital, "supervised autonomy," night float, faculty mentors assigned to each resident, good fellowship placement.
Cons: Not sure yet if I want to live in Cleveland.