Decisions

Realistically, I don't have to make any career decisions for a bit. Practically though, I should probably start thinking about it. I guess that's part of the reason I signed up for med school...maximal procrastination with regard to career decisions.

Working in the ER the past week, I'm finding myself more and more drawn to the field. Between that, eliminating fields I can't stand, and figuring out which ones I'm okay with - I'll eventually come up with a specialty choice. It's kind of scary, not really knowing what field I'm supposed to go into, especially since I'll be interviewing for residencies in less than two years.

What's more scary to me is the matching process. Matching is the way that residencies fill their programs. Programs make a ranked list of interviewees and med students rank programs they interviewed at. Through wizardry, the two lists are compared and applicants are best matched to a program based on the lists. Sounds simple and not so scary. What I'm not a fan of is the obligation to go wherever you're matched. There's no direct choice in where you go.

On that note, I've been wondering what cities I'd be okay living in. I wouldn't be averse to chilling in NYC, Boston, Philly, or DC for a few years. Truthfully though, I'd love to stay in Chicago. EM isn't as competitive as plastics, ENT, or derm but it's still pretty competitive to get into. Board scores are above average, but still not absolute rock star-ish. Since it's more competitive, wisdom would dictate applying to a large number of programs. As mentioned previously though, I'm not really wanting to leave Chicago. Especially when it's not of my own direct volition.

So basically, the question is: is staying in Chicago worth the risk of possibly not matching into EM? Answer TBD. A decent amount depends on board scores. Hopefully not so much on extracurriculars, because those are pretty much nonexistant. And I guess I may like some other specialty that's not as competitive. Until then though, I'm pretty tight with one of the attendings at the UIH ED, so I'll probably be picking her brain at some point in time. Either way, I think I found my motivation to rock boards.

Wisconsin Skiing, v3.0

As is the case for any outdoorsy activity, a group of us headed up to Wisconsin. Again, it was for skiing and we ended up about an hour north of Madison. Compared to the other places I'd been to, it was a nice step up. A lot more runs and the runs themselves were longer. Plus, the price was reasonable enough at $128 for two days. For being my third time, I thought I did pretty well. The first day was kinda disappointing - I was struggling more than I should've compared to last time. I didn't really wanna leave because of that. The second day was pretty fun, I got back to where I wanted to be and spent most of the day on a black diamond. For *that* reason, I again didn't wanna leave. I'd definitely like to go one more time before spring, but time and money might be more of an issue.

Madison itself is only about 2.5 hours from Chicago, which makes for a nice skiing daytrip. With the place being 3+ hours from Chicago, we decided to make the trip a two day affair, staying in Madison overnight. Unfortunately, we didn't get to see as much of the town as I would've liked. We didn't even wander onto campus. That was mostly a result of getting into town late and being exhausted. The night out wasn't all bad though - ate at a local microbrewery/restaurant and hit up some bar with a fake tree growing all up in it. Seems like a decent enough town, but I would've liked to see the State Street strip between the Capitol and UW's campus. It seemed pretty pedestrian friendly and sounded like a happening scene on the weekend.

There was a place about five hours into Wisconsin with a lot more runs and a higher vertical drop that we considered. But, it was obviously further and didn't have Madison nearby. Maybe next time though. I'd love to go again this winter, but realistically it probably won't happen :(

Home Sweet Home!

Gotta love upper midwest winters. We've already passed the annual winter snowfall average. We had ~40 hours of temps not getting above 0°. On top of that, it was actually colder here than at the North Pole at one point. Wind chills hit -40° Thursday. In a messed up kind of way it was kinda cool to see how cold it got. No pun intended. I realize this cold snap hit pretty much everyone, but hey misery loves company. It's not actually this stuff that makes me dislike the winters here. I'm fine with it and it just comes with living here. It *is* the middle of winter in the upper midwest - can't really say that it's unexpected. What gets kinda old is when it's mid-April and snow and sub-freezing temps are still making appearances. Whatevs, it's worth it to me - I'm a pretty big fan of the town.

On a related note, snow has a nasty habit of snarling traffic. Especially when it hits during rush hour. This was our Wednesday morning commute on the expressways.This is a weekend pic of the same, sans rush hour and snow.

Practicum, v2.0

I'm one week into my second practicum. I've gotta say, it's pretty sweet. Not only am I getting to practice physical exam skills, but my histories are getting to be reasonably complete. On top of that, I'm working on the peds floor. I haven't had much practice working with peds patients or their medical problems, so this a good chance for some exposure. Also, it forces me to figure out ways to work with difficult children who will have none of my poking and prodding for physical exams.

One thing that sucks is taking so long to do anything. A full history and physical (H&P) should probably take about half an hour. As of right now I'm hovering at an hour...and it's not even a complete physical at this point (incompetence related). Writing up an H&P takes even longer at this point. My H&Ps are done in a bit of a scattered fashion, so it can be hard to organize everything into a logical presentation. And between not being completely done with all our classes and not having much clinical problem solving experience - it takes a long time to come up with differential diagnoses and defend them.

It's pretty cool to work with kids, even if some aren't so cooperative with physical exams. Friday, I worked with a 2 week old newborn. Not gonna lie, he was ridiculously cute and I kinda wanted to steal him for a bit. That aside, he was insanely cooperative with the physical - probably moreso than even any adult. Beyond newborns, it's fun playing with the younger kids and getting them to agree to be examined. I let a four year old play with my reflex hammer to see that it wouldn't hurt. She proceeded to go to town on my hand - with the pointed end. But at least I got to check all her reflexes after that. And at least her family was amused.

On an unrelated note, some of the commutes have been shitty. It's about a nineteen mile commute which should take about thirty minutes. Twice last week that's blown up to a ninety minute parking lot commute. Once because of a pileup and another time because of unplowed roads. On a winter road related note, there are shitton of potholes around Chicagoland now. One of them ended up giving me a flat. It wasn't even a real pothole...just a widened expansion crack between lanes. Uncool. Especially when having to change a tire in 20° snowy weather in shirt and tie. Doubly uncool when one of my friends ripped his pants helping me change the tire.

Traffic aside, I'm not looking forward to practicum ending. I'm actually getting some useful (IMO) clinical experience and practice. On top of that, the residents are pretty helpful and good teachers. The entire experience is surprisingly useful, well-run, and low stress. Me likey.

Not Quite There

Indifferent would describe my attitude towards all things med school right now. Especially anything book related. Luckily we're in the hospital for two weeks before classes roll back around. Yay! Not so luckily, I have a`roided up version of the MCAT waiting at the end of the semester. It's kind of a big deal - Step I of USMLE.

It's one of three board exams in getting my MD license. And moving on to third year. This portion covers the first two years of med school. Also unfortunately, I'm not balls to the wall ambitious about Step I like I was for the MCAT. I'd like to think I'll pass. But more importantly, I need an above average score to have a decent chance at emergency medicine residencies. Student affairs says 85% of my class has already registered. And more than that have figured out study plans and/or materials. Not so much on this end.

Usually, I like to stay pretty low stress. But, a little nudge in the ambitious direction wouldn't hurt at this point. I'm just ridiculously sick of the notion of books and more studying. After Step I though, no more classes - all hospital/clinic stuff. Yay! I'm hoping the shine on that apple sticks around for awhile. Like a long while.