medical monday : importance of the rank list

There may not be an official link-up anymore for the Medical Community to meet up, but that doesn't mean there isn't information and stories to be shared!  I'm not necessarily going to make this a typical thing but I did have stuff I wanted to share during this busy time for medical students finishing their interviews and making their NRMP Match lists.

Over the past 2 years I have posted a lot of things pertaining to our personal journey getting to where we are currently (into our 2nd year of Kyle's Gen Surg residency program in a completely new state with our first house and first kid).  You can read more in the links at the end of this post.

This post is about the importance of your rank list.  Real life style.  We were lucky when making our list that our #1 choice was also the city that we liked the best with the program with the best perks, but after filling that #1 spot in our list making, it got a lot more murky.  Thankfully, we got our #1 spot on Match Day.  And we don't regret it one bit.

Not only is Kyle extremely happy here, but I am as well.  Sure we could have made members of our families much happier by staying put in Louisville, and I would have probably been fine with staying where we already had a Community of support with nearby babysitters, but Kyle most likely would not have been nearly as happy in his program as he is here, and that would have seeped into our daily lives.  Kyle is legitimately friends with his coworkers, I am legitimately friends with their wives.  We have never been made to feel "bad" for having a baby during first year; in its own way, this program has been very "family friendly" for a Surgery program.  We never felt weird bringing Myles along to the interview dinners, and several of the other residents would immediately take him from us so we could be sure to eat.  

But it isn't just that, in the past week alone, I met a few of the girls for our monthly get-together, this month, our hostess of the month, Julia, picked a painting class for us and brought a ton of snacks while Beth brought the wine.  I was pretty exhausted from my day with Myles but it was exactly what I needed.  Such a great time with those girls every time we are able to hang out and just have others who understand this life.

Later in the week, I got to be a part of a meal train that was organized for one of our new moms in the program. Her husband was on nights so she needed someone to just hang out in the evenings so she could talk to someone that could actually talk back to her for a little bit.  Getting to meet baby Jack was a big bonus to my week! Thankfully Kyle was able to be with Myles during both of these events so I could participate and see my friends.  

Then, this Saturday was the big yearly exam for our residents, the ABSITE (American Board of Surgery In-Training Exam).  Its kinda a big deal.  So every year (weather permitting), their Program Director (who takes the test with them), invites everyone who isn't working afterward, out to his farm to eat some chili and do some skeet shooting with shotguns!  It was a great way for everyone to just chill out after months of studying, even if the main topic of conversation was the test.

I cannot tell you how important it is to consider your happiness when making your list.  Don't just pick a program because it is "the best in the country".  Pick it because the residents you meet seem to really like each other and you can see yourself fitting in with them.  Pick it because it is what is best for you and your spouse.  Pick it because the location has things you will love to get out and do.  Of course there isn't much time outside of some residencies, but there is time, and if you have people around you and stuff to do that you love, it makes the bad days a mere blip on your way to your much coveted days off. 

Past posts of information 

before residency : interviews

rank order list submitted

the Match : what is it?

the Match : tears of joy

the pregnancy announcement

trauma alert

from the other side : interviewee dinner

one year down

from the other side : the dinner

For those of you finding your way from the Medical Monday Blog Hop, welcome!  This is such a fantastic way to find people in the same boat as you.  Because really, not many people really get this strange life of ours unless they have lived it.  Hope to see you around!

Last Thursday, while Kyle's family was in (babysitters!), we were able to go enjoy one of the resident interview dinners.  You know, that casual night where interviewees show up the night before their real interviews, get free food, and get to ask the residents of the program for the scoop.

Kyle and I were the first to arrive at Mellow Mushroom, and so parked ourselves at the bar.  Eventually a few other residents showed up and we were waiting for our table to become unoccupied by its previous tenants.  I was glad to see that Beth, another resident wife, was also going to be there.

When Kyle was interviewing last year, I only made it to one of the dinners... Wilmington, NC to be exact.  I accompanied him to 4 interviews, but I wasn't feeling well for Savannah, wasn't invited to Charleston, and didn't realize I was invited to the one here in Greenville.  More on that here.

Oh how wrong I was... I have come to find out that not only do the residents here show up with their wives, but sometimes they bring their kids!  Hallelujah!

But I digress.

The interviewees began to arrive, there were 5 this time.  I was immediately struck with what I remember the most from the one dinner I attended.  The look on their faces.  They all had it.  It screams a range of emotions and thoughts all at once.  "Please like me!  What am I getting myself into? Are you guys cool?  Don't screw this up!  I hope the food is good.  I'm so tired of traveling.  Am I going to Match here?  Will I want to Match here?  What questions should I ask?  Should I be funny or serious?  Everyone says just be yourself, but what 'self' should I show right now?  Am I allowed to have a beer, because everyone else is, but is this a test?!"

Personally, I was a little worried about being there... how much am I, as the wife, allowed to share?  I mean, I know a lot of nitty-gritty stuff.  What was my role supposed to be?  I looked around... none of them had spouses with them.  Hmm.

I ended up interacting with 3 of the five... solely because they were the ones sitting close to me.  I found out that 2 of them were married... their wives just didn't join them on this interview.  I was able to share with them that the wives here make an effort to hang out officially once a month, but most of us are truly friends and get together more often than that.  I was also able to share with them how much we love it in this city... and how glad I am that MY husband is in this program.

Of the three I talked to, one seemed to be trying a little too hard.  Another made it his goal to ask lots of probing questions, and the other seemed to have mastered the balance of enjoying himself/remembering that this was part of the interview process as well.  Near the end, I came to find out that he knows one of the friends that I have made here, and his wife is hoping they end up at this program.

I hope they end up here too.

Overall, it was a really fun night.  Who knows if any of them will be here next year; that is just part of it with the Match.  I wish them the best; but for me, it was a nice time with my husband and his coworkers.  I was able to watch the pride they have for their program really shine, but not without being mostly honest with the interviewees about the realities of it as well.  It was nice to let loose without having to worry about Myles for a couple of hours, but I am also excited knowing that it is ok for us to bring him along if I want to go to any more of the dinners.

And the pizza was pretty great too.

Since it is Match Season and I am on the other side now, I don't want to leave without giving a little advice for those going through it:  

SERIOUSLY.  SEND THANK YOU CARDS.

medical monday : i was in your shoes

I am so glad to have found this little blog hop last year!  Like many of you, I started looking for advice during the residency interview season.  My husband was a 4th year in Kentucky and I was terrified of what was to come!  Thankfully, I ran across this great resource of others going through the same thing (or who went through it at one point).  They have been a continuous source of support both directly and indirectly since I started participating, and I hope those of you new to this find the same thing.  

Since it is officially interview season once again, I thought I would share links to my old posts from our journey through it last year in case you are here looking for that sort of information.  If not, I invite you to check out some of the other topics to the right and say hello.  There are also ways to follow my little blog shown on the right :-).  

Welcome to Medical Monday!

Links:

the beginning of a new normal

my first ever post explaining why I am blogging in the first place...

before residency: interviews

the basic layout of an interview's schedule and advice on how to get the most out of the experience

rank order list : our dice throw

how I felt the day we submitted the list

the Match : what is it?

exactly what this sounds like... an explanation of what the Match is and advice on making your rank order list.

the Match : tears of joy

opening the Match letter.  These pictures still make me tear up.

well whadya know?!

Our big announcement we were holding in during the Match, and what will hopefully be coming to fruition in the next week!

4th years and SOs... enjoy this time.  Have fun with the process.  I know how stressful this time is, there is more to our story than what you are able to read on here since I started this blog right after we finished with the interviews.  Many of you are unknowingly meeting the people that you are going to be great friends with in a year from now.  Some of you may not have such a happy ending.  But it is all worth it.  Every step of this process is worth it.  Don't worry about the small moments that you are worried you messed up or missed... it is all just part of it.  As a spouse that attended some of the trips with my husband, I know this really well.

It was the interview for what is now our home.  We had never heard of this small city in South Carolina before.  The program had us staying in a nice hotel in the heart of their downtown.  We weren't sure what I was supposed to do about the resident dinner that night... it just wasn't clear to us in the invitation.  So I found a sushi restaurant a few blocks away and grabbed my book.  I walked to the restaurant alone (in the middle of the night...and felt completely safe in this new place).  Shortly after ordering my husband was texting to say I had been invited and there were other wives there.  I felt awful.  I really wished I could be there with him to meet these people; hoping I wasn't messing anything up by NOT being there.  But I put it out of my mind and enjoyed my dinner alone, followed by a walk through the downtown.  It was a clear night in January, there were lights in all of the trees, everything but the restaurants was closed.  But it was just so charming.  I went back to the hotel and knew this is where I wanted us to be.  There was no time the next day for us to explore before we had to rush to the next interview location, so my accidental night out was all we had to go on with our feelings on location.  But it was enough.  With just a little bit of convincing, my husband ranked Greenville as our #1.  This place had everything we were looking for, and I hadn't even met the people.  

Several months later we moved here, and during orientation week, I was 'remembered' by another spouse as "the one that went to dinner alone".  While slightly embarrassed for just a second to be remembered that way... I don't mind.  It is one of the reasons we are here.

And we are so, so, happy.

medical monday : a debate

Sorry for my long absence on here... I have been gently "fussed" at for the past few days from people back here in KY who have been looking for a new post everyday. Haven't you all noticed yet that I don't write much when I am away?  I'm sort of busy with baby showers, family time, and soaking up this little slice of heaven:

But I did want to be sure to participate in today's Medical Monday link-up!  So I sit here on my parent's deck and recount a subject I thought about in the middle of the night last week, to see what you all think about it.

I also want to put out the disclaimer that Kyle and I have not discussed this at all, he will be reading my thoughts about it for the first time just like any of you. He has not mentioned anything near this scenario...it is purely my own thoughts from a sleepless night.

Backstory: Kyle just finished up his Peds rotation, and the whole month he has been hoping that a sweet 3 year old girl would too. Not just because she was sweet, but because he wanted so badly to send her home before her birthday.  He got attached.  He got a bit down early last week because it looked like it wouldn't happen, but now thinks she may get to go home on her birthday exactly.

Which got me thinking at about 2 am one night, what is the appropriateness of a doctor giving a patient (I was really only thinking about Peds and will continue this post only thinking about Peds) a present? I do feel like it is a completely bad idea for a new resident to do something like that... But what about his superiors, or he himself in a few years? Would it be wrong to give a 3 year old little girl who is nervous of doctors and has been stuck in the hospital for the past month, a little birthday present? Nothing extravagant... Even if the doctor kept several little things to slip his special cases on occasion... A hot wheels car or a simple little beaded bracelet?

There is a lot of educational material/guidelines on the web about doctors accepting gifts from patients.. But I couldn't find anything about the reverse situation.  Which is why I am asking you... Wives of residents, doctors yourselves, fellow medical life people of some sort... What do you think?

Is it inappropriate for a doctor to try to cheer up a long term patient with a little token of acknowledgment?  Slip a kid a little something special just to say "I hate that you have to be here too but maybe this will make you smile today." Because we know our doctor husbands/wives/friends/etc. are not drones.  Sometimes they may seem that way because they are tired and just want to take care of the patient that they will never see again as quickly as possible.  But a lot of times there are repeat customers that they become attached to.  That they "bring home" frequently. And sometimes it isn't enough to just want to make them better... Sometimes you just want to make a little girl smile.

Medical Monday : and so it begins

I completely meant to write a real post specifically for this Medical Monday...  However we were a bit busy the past several days.  Mostly just enjoying each other's company, soaking in the last moments of life before residency.

There were some moments of normalcy... Kyle mowed the lawn for me this weekend, we bought tile for the coffee bar at Home Depot...  but the rest of time was spent either relaxing or getting to know the other residents.

I must say, with each event that passed over the past few days, our desire to be here, for him to be in this program has just been more and more confirmed as the right thing.  So how about a list?

• the first day of orientation, the entire group had a program-led moment of prayer.  Not just the typical generic religious moment... they said "Jesus" and everything.  
• Kyle noticed another staff member walking around with a badge that said "I will pray with you if you ask" (or something to that effect).
• the upper level residents are all GOOD friends.
• the attendings hang out in their spare time, and were all very welcoming at the get together last week.
• doctors take each other home when someone is too tired to make it alone.
• every time Kyle took a tour of a different area of the hospital, everyone... and I mean everyone... has sincerely expressed their desire to help the new interns in any way possible.
• (as mentioned before) the hospital orientation leader was fine with Kyle leaving in the middle of the day to be with me for the ultrasound last week.
• the other interns are awesome.  They are all REALLY excited for the "first baby of the group".  And want to get me a puppy since Kyle won't let me (lol :-P)

So the first day of residency... the day I have been so nervous about... how'd it go?  

For him, it began at 3am (in the hospital about 3:45).  Was somewhat uneventful but good.  He checked out around 5pm and was home before 6pm in time for dinner.  So his 14 hour day wasn't bad, and we had enough time to eat and catch up on a few shows before his 8:30pm bedtime.

For me, though I had difficulty falling back to sleep after he got up, sleeping through the first 4 hours of his first day (I got up around 8) really made the day feel like a normal business day.  I got some chores done, ran some errands and relaxed a bit.  I survived.

I hope everyone else had a pretty good first day whether you are a new PGY1, or beginning your final year of residency.

No matter what, we can all celebrate another successful Medical Monday!

weekend replay : going aways

It was a very busy weekend for us!

Friday I left work later than expected... found out we would be having the apartment shown to potential renters the next morning... So rushed home and cleaned for an hour before we went to our next going away party at Four Pegs with some friends from church at 7pm.  It was also our 5 year anniversary and was a pretty fun night of celebrating.

Got home around 11pm.

Fell asleep shortly before midnight.

Woke up around 6:30, got up a bit later, and started the finishing touches on cleaning the apartment.

Hit up the Farmers Market with the bestie, followed by some omelet making back at her house.

Grocery and home around 1pm to start cooking for our next event.

A second going away party/pot luck at my boss's house.  Our lab is losing me and a Postdoc to residency within the next few weeks!

Left there completely miserable.  Because I've started to get a baby bump!!! And I had squeezed myself into my nice jeans for the past few hours.... we left their house right before 8pm and headed straight to the mall for some maternity clothes.  The idea of which already had me in a tizzy... I just really don't want to deal with this yet.  And it just didn't get any better because:

Louisville's JCPenney's DOESN'T HAVE A MATERNITY SECTION.

Louisville's Dillards DOESN'T HAVE A MATERNITY SECTION.

KOHLS has a PITIFUL MATERNITY SECTION.

After an hour of running around, finally ended up at Target and bought the BeBand so I can just keep wearing my normal pants for a while longer... because the bump is obviously not going to fill out maternity pants yet.  I was maybe a little bit traumatized by the experience.

Sunday was a perfect day.  Perfect weather.  Church was good.  Met up with my brother for some lunch at our favorite Asian place (YangKee Noodle), talked Kyle into buying some new shorts at Old Navy, where he made me pick out a maternity shirt to finish off his gift card, and then headed to my aunt's backyard for some alone time in the sun with a book.  I made it home before Kyle (he went to play volleyball with my bro), and got some more alone time with my current game of choice (Skyrim).  Dinner of homemade chilidogs while watching Trouble With The Curve (highly recommend!).  Ended the night with a shocking episode of Game of Thrones and it was a fantastic Sunday. (Though that episode about made me mad enough to stop watching...not really...but come on!!!)

And today is Medical Monday!  What a great way to start off my last week at work!  (My last day is Wed!)  Looking forward to reading what is going on with the rest of the medical life community today! I hope all of you moving are having an easier time of it than us!

weekend replay : easter

It was a good weekend.  And a hard one.  We had some fun with Kyle's family and relaxed some.

Friday was dinner with his sister and her husband, at his favorite Chinese restaurant.

Saturday was hard.  We went to Tennessee to see Kyle's grandfather.  He had a stroke a few months ago.  Kyle went and visited him right after it happened when we got back from an interview trip, but this was my first time seeing him.  I love that man, and was very nervous to see him.  While he is doing much better than the last time Kyle saw him (he can move his left hip a little and is speaking much clearer), he has changed a lot from the last time I saw him at Christmas.  Before the stroke.  The stroke that has shown that his cancer has returned.  The cancer we thought was confined to the kidney they removed.  This is one of the main reasons moving so far away is hard for us.  I'm glad we were able to visit this weekend, it was the first time his grandfather had been in his home since January, and was only for a few hours, but I think he really enjoyed getting to sit in his very old recliner and watch sports with his family.  It also makes me cherish that I was able to capture his 80th birthday celebration with his family and friends back at the end of summer.

Sunday was very long.  The morning started before 6am (I barely slept after 3:30) for the sunrise service out in a small country church.  A few of the Methodist churches in Kyle's home area switch up who hosts each year.  Starts at 6:30, lasts 30min-1hr, lots of old hymns and a short message, followed by a huge breakfast.  Go home, get fixed up, and return for Easter service.  Sunday school starts at 9:30, service from 10:30 to 11:30am.
Rushed home, packed, and headed to my grandmother's an hour away for an awesome lunch with my part of the family.  Drive 3 hours back to Louisville and start the laundry.  Arrive in time for the beginning of the 2nd half of the UofL v Duke game.  When we turned on the tv, they were tied, it was a great game...and I'm glad I missed the terrible leg break of one of the UofL players in the first half.  While Kyle isn't bothered by that stuff (thank goodness since he will see a lot of it), I am forever scarred from witnessing a classmate break his arm in gym during middle school.  Can. not. look.

It was a good weekend.  Delicious food.  Good time with family.  And UofL is headed to the Final Four.  I don't typically care about sports... but this is exciting.

And to top it all off, Game of Thrones returned.  If you have HBO... you should give it a shot.

Its Medical Monday ya'll.  Go link up!

the Match : what is it?

Since I am frequently (usually more than once by the same person) asked, and with one week to go before we have the "did we or didn't we" question answered, I figured it was a good time to write an explanation for what exactly this thing, the "Match", I keep referring to, is.

NRMP:  National Residency Matching Program
aka: The Match.
aka: what my husband has been working hard towards for the past 4 years.

The Match program was developed in 1952 to help students find placement in their future residency programs.  Before this point, there had been dissatisfaction with the old method of competition where the hospitals benefited by filling positions early and students from holding out to the last minute.  That sounds like a lot on a student's plate... not only are they traveling and having to continue rotations (like is still done today), but they are also playing hardball with programs, waiting for the best offer but hoping not to wait too long before all positions are filled at "safer" locations, all while not being sure whether what you are waiting for or passing up is really your best possible fit for your personality or family.  And in a lot of cases, it wasn't (wiki).

The decisions that the Match makes is run by a computer using a special algorithm.  This algorithm is based upon a mathematical idea called the Stable Marriage Problem (wiki).  The Stable Marriage Problem is often defined by:

"Given n men and n women, where each person has ranked all members of the opposite sex with a unique number between 1 and n in order of preference, marry the men and women together such that there are no two people of opposite sex who would both rather have each other than their current partners. If there are no such people, all the marriages are "stable"."

If you insert the word "programs" for "men", "applicants" for "women", "match" for "marry", "group" for "sex", you have a pretty good outline for what is happening for all of the 4th year medical students right now:

Given n programs and n applicants, where each person has ranked all members of the opposite group with a unique number between 1 and n in order of preference, match the programs and applicants together such that there are no two pairs of opposite groups who would both rather have each other than their current partners. If there are no such people, all the matches are "stable".

More of a visual learner?  Me too:

image source

So how should a student make their rank list?

As honestly as possible.

Dreaming of going to that prestigious hospital that you interviewed at, but don't think you have the scores to really make it?  Put it at #1!!!!!!  Don't chicken out.  Putting a long shot that you are in love with in your #1 doesn't hurt you!  The only thing at the top of your list that hurts you, is not ranking in order of what you REALLY WANT.  Maybe its a long shot, or maybe they liked your personality more than your scores... not putting them first would be the only thing that ruins your chances with them if they really like you too. 

The bottom of the list was the trickiest for us.  The programs we aren't too excited about but would be "okay" with...the "better than nothing" portion.  We really had to get "nitty gritty" with our details to decide where to rank things on the bottom half of our list... when you aren't all that excited but still want to rank them, that extra cafeteria spending money may be the only thing that helps you decide spot9 from spot10... so don't forget your notebook of details!

What should you do with that program you interviewed at that you just had bad vibes from?  That place you REALLY don't want to go to?  DON'T PUT IT ON THE LIST.  Nothing says you have to put it on there...  Just because you spend a lot of money making it to the interview, or they sent you letters saying how much they LOVED you?  NO.  It is not worth your misery if you were to match with them.

Really the only 2 things that will hurt you if you are a good candidate are:  to not be honest with your ranking, and to put something on the list where you don't want to go.

Because, well, this is a binding contract.

On Match Day, if you open that envelope, it is mathematically your best pairing between places that wanted you and places YOU ranked.  If you don't like your location... well tough luck.  By placing them on your list, you are saying that whether you match to your #1, or your #25, you will go.  You move yourself/your family to that new place, and you will show up to work in the summer.

So be honest with yourself.  Rank the long shot.  Don't rank where you will hate to be.

The inbetween reasons for where you put what program are completely up to you.  And there are many reasons to place things in certain orders:
Fun locations, closer to family, further from family, love the program, love the city, liked the residents, better perks, better pay, housing markets... the list goes on and on and on... but make sure it is what you (and your spouse) want.  Not what your extended family preferes, not what your current friends prefer.  What YOU want.  Because you are the one that has to live the crazy life of residency firsthand.

So how am I feeling right now about next week? 

Truth:  I'm FREAKING OUT.  About 40% nervousness/anxiety, 60% anticipatory excitement.  I just want to know that everything is okay!  I want to stop worrying that the outcome is going to be bad.  I want to get the ball rolling so I can do some REAL house hunting!  And begin the arduous task of sorting and packing.

Thanks to my friend Laura for this reminder:
verse of the day:
"For I know the plans I have for you,” says the Lord. “They are plans for good and not for disaster, to give you a future and a hope."  Jeremiah 29:11 (NLT)

Good luck to all the 4th years in next week's Match.  You aren't alone in your excitement or anxiety!

Today I am participating in the Medical Mondays Blog Hop!  Anyone have anything to add to this?

For more on parts of our med school story and advice, you can read:
rank order list: our dice throw 
before residency: interviews
the beginning of a new normal

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