Everyone should travel

I sit by a wood burning fire place with a cup of hot tea and spanish guitar music playing in the background, I am atop a mountain overlooking the city of Otavalo in Ecuador. This is the last stop of my 2 month traveling extravaganza and I have decided that everyone should travel.

why, you ask?

why not!?!

In the last 2 months I have developed memories, have had experiences, listened to stories of locals and fellow traveler, learned about and stepped foot on historical places, have had spiritual moments and times of inward reflection in churches and temples alike, rode elephants, slept in a hill tribe village,.... the list seems to be never-ending. But what I loved the most was meeting strangers. As silly as that sounds it was one of the best parts of my travels. Connecting with people from around the world and listening to their own experiences and what path they had taken to get to that specific moment was just fascinating. I realized how much I do not know and how much I have yet to experience and learn about the world, about how people live and think. Once I started talking to others it become evermore clear that we all tend to get stuck into a daily routine and forget to stop, observe, contemplate and breathe. We, myself included, start making excuses for not being able to travel. I met so many people of all ages (18 - 75) that had quit their job or took a 'gap year' or simply moved to a different country and just travelled while working random jobs along the way. I felt myself become jealous of those 'free spirits' - no plans, just living in the present and being open to new cultures and ways of life. Now, yes, it does take a certain type of person to be able to do that and I think I can be one of those people as a short term (1-3 years) plan because I believe I will miss world of academia and the challenges and type of learning that comes with it.

My trip was nothing short of spectacular and here are a couple of pictures to take you through my journeys, memories, and learnings.

Lahu Hill Tribe hike overnight
accommodations in a hand built bamboo hut.

the day I got blessed by a monk.
Such a special temple in northern Thailand

Lahu Hill Tribe 2 Day Hike, thailand

Monkey sanctuary in Bali

 

Ko Phi Phi Island, Thailand.

Sunrise hike up Mt Batur, one of Indonesia's active volcanoes.

Mt. Batur, Bali, Indonesia. 

the moment I officially became a doctor!

Unbelievably grateful for my parents' never ending support and encouragement through this journey.

Dream came true.

This post has been a work in progress since match results came out last friday. Be warned it is lengthy!

To spare the suspense... I MATCHED and best of all, I matched at my first choice program!
Beginning July I will be an ObGyn resident :) The week of match results was exhilarating and terrifying all at the same time. I had to read that email over and over again because I could not believe my eyes. I had known how competitive my first choice program had been based on the interview day (20 candidates per spot). I don't think the news has quite sunk in yet although I am knee-deep in paperwork, contract signing, visa arrangements and apartment hunting!!

BUT let's back up to the Match process since I promised to give out my advice as best as I could for those of you getting ready for the 2016 Match.

"The Match"

I won't go through a timeline since that can be found quite easily on the NRMP website. However, there is a timeline that is important to factor in as a 4th year medical student. For ease of reading and not to make this post super long here's my advice and things I have learned from going through the process

4th year - electives:

• great way to showcase your potential and what you have to offer to a program - as well as see how good a fit the program is for you. I always thought of electives as a two-way interview because it is important for you to love the program as well. 
• Try and set up electives in the specialty you will be applying to before the September application day. This is for two reasons: 1) programs want to see a letter of recommendation from a preceptor in their given specialty 2) being in fourth year gives you much more responsibility and offers your letter writer a chance to assess you on a different level than when you were just starting clinical rotations.
• Electives/ sub-interships in your given speciality of interest are important however try and do various other electives in things you may be interested in or have some sort of connection to that specialty. Shows you are well rounded, gives you a chance to learn more and also gives you the option to applying to two specialties if one is more competitive. i.e.. ER, heme/onc and female adolescent psych are ones I did for Ob/Gyn.

application, interviews and rank list:

• Do your research on the programs you would like to apply to. There are several sources you can use. FRIEDA is great; also the dedicated specialty committees (i.e. APGO, AAFP) usually have a list of the accredited programs. 
• Decide what is important to you... location? community vs university? fellowship oriented? class size?. This will help narrow down the programs. However the most important advice I received was "be realistic" apply to all programs that have taken candidates from your school and other caribbean schools. (there's no list of these, you have to search each individual program's website). Don't narrow down your choices even before applying - you can attend the interviews and if the program is truly not for you then do not rank it. I was pleasantly surprised by a lot of the programs that didn't look great online. Also, apply to those "reach" programs - those programs where you would love to go but don't think you have a chance... you never know.
• Start your personal statement NOW! I know it's early but it's a hard one to write and it will keep changing as you go through 4th year. My advice for this one is "make it you", don't worry if it's not what you think they expect; this is what programs have to get to know you aside from your credentials and your volunteer work. Talk about what is important to you, what are your passions? what are your quirky hobbies? Why should they choose you?
• Be ready to submit the application on the day it opens. Have your USMLE Step 2CS and CK scores in before this date. Be sure everything is already uploaded on ERAS prior to that day. Select all the programs you intend to apply to before that day so all you have to do is click submit.
• Letters of Recommendation: 3 per specialty as a minimum. Some programs will not look at your application until those 3 letters are submitted. You may add a 4th along the way (say you did an important elective in August and the letter is not ready in time, once its uploaded you can send it to the desired programs as an extra)
• Be prepared to spend money. Thousands - for the application and the interview travels. You've already invested money in this journey, this is not the time to cut down. Go all in so you only need to go through the match once. (this is for the IMGs mostly - US students tend to apply to 30 or so programs. IMGs apply to 80+ programs per specialty usually). 
• The saying is that IMGs get 1 interview for every 10 or so programs they apply to. 
• A good interview number to have for IMGs is 7-10 from what I've heard. Although there is also a caveat because it really only takes one interview to make a lasting impression - with that said the more interviews I had the more confident I felt about matching.
• I had a total of 12
• Be present on interview day. What I mean with this is be observant, be yourself and ask questions! Questions show interest and also, again, this is a two-way interview. You are trying to also decide if that is the right place for you. Be aware of how the residents interact with each other, with the attending, with the ancillary support staff. Do the staff/nurses/PAs/ medical students look happy? Also pay attention to the other candidates they are interviewing...do you get along with them? would you want to work alongside them? I think the types of candidates they interview also speaks to what a program is looking for.
• This goes without saying but, just in case, prepare for the interview! There are basic questions that can be asked and you should have an idea of how your answer will be... i.e.. Why this program/city/specialty? Tell me a little about yourself? (don't be afraid to repeat things from your application. Sometimes the people interviewing you are not the same ones who looked through applications). How do you respond to stress/conflicts/disagreements?
• Remember that at the interview stage you are now on the same level as any of the other candidates. Your personality, character and the way you interact throughout the day is what is really important. They know you have the credentials, now the program wants to know if they can work with you (are you teachable?).
• Rank the programs according to YOUR preference. Disregard what you think they are ranking you. The algorithm is in favour of the candidate (here is a better explanation). Also rank only the programs that you are willing to train at because it is a binding contract. The caveat to that is to think long and hard before not ranking a program... would you rather not match at all then go train there?

I hope all that helps and answers most of your questions about the process! It is stressful and not going to lie, insane! But completely worth it to see that email in your inbox. 

Dream came true.

On another note since I don't begin residency until July and I am finished with medical school I will be traveling South East Asia for 5 weeks and then a 2 week stint in Ecuador! Cannot wait to roam the world for the next two months.... not that I haven't been doing that for the last 4 years, but this time it will be vacation!

A quick update!

First off, thank you so much for keeping connected!! I'm sorry I haven't posted in a while (everything is going great!) but I have tried to keep up with answering your comments and questions.

I stopped posting due to the interview/ match season that started in September. Interviews have recently wrapped for me and am currently teasing out the last of my rank order list. Then the waiting begins... which will be the hardest part I think.

For those of you unfamiliar with the process of a medical student obtaining a residency, here is the simplified version:

- finish four years of medical school
- apply to your desired specialty
- Sept-Feb: interview across the country (expenses are mostly out of pocket)
- Feb: create a list of the programs you interviewed at by preference of where you would like to train
- Match Week: basically a match up between the hospitals and the candidates (both form lists of who they would like) and the computerized algorithm "matches" you up. We find out if & where we are placed the week of March 16!

I promise to reflect on the entire process and give as much advice as possible once that Match Week is over.
Until then please feel free to post questions and other comments as I have been checking back regularly

sincerely,
IDL

PS. I have officially finished medical school rotations! Feels great to have hit such a milestone, but I think it will all sink in once I get that email in March. For now, I have decided to stick around Louisiana (where I finished my last two electives) to enjoy the culture and festivals of Mardi Gras before making the long road trip home for the last time!