:goodvibes: Sure, he was selling his program and I'm not foolish enough to think that I'm that special. But, he was talking about expanding the faculty in my interest area in the coming years...

You can imagine how flattered I am. You can imagine how I'm thinking that this sounds awfully appealing, an academic career in a field that is looking for people with my interests. And my doubts about being in critical care, about the hours and the call nights for the rest of my career and the intensity of it all wearing me down, well I wouldn't have that problem in GI. I would have the problem of seeing vague abdominal complaints in clinic, some of my least favorite patients to see, right after the adolescent males who complain in the EC that it "burns when I pee..." :crossfingers:

A quick update to let y'all know that I survived the emergency centers! :rotfl: If there was a dancing smilie, I'd use it! 2 months of EC is more than I ever wish to do and I'm thrilled to be away from it until January. It was very busy this weekend with all the kids back in school sharing their various viruses and showing up in the EC with "fever" of 99.5 and cough (NOT an emergency!).

I wasn't 100% sure I'd make it through all three of my 12hr shifts. I'm recovering from the bronchitis and was still having some pretty impressive coughing fits up until yesterday. I only had to walk out of patient rooms twice today with a coughing fit. No one wants to watch the doc hack up a lung in the exam room.

I started my GI rotation today and am thrilled to be back in clinics. I don't enjoy general clinic, but I do really like GI.

Vacation starts Thursday and I'm looking forward to getting lots of rest and relaxation. I truly value sleep and rest as a resident in a way I never did before!

Back from my wonderful, wonderful vacation. I am well rested and have been full of smiles all week. Hubby and I ran a half marathon in Kauai and it was the most beautiful race course you can imagine. The people were so friendly and the race well organized. It was my husband's first HM and he couldn't stop talking about how great it was.

I spent some serious time pondering my future while sitting relaxed on the porch of our hotel room. A few things became pretty clear to me in that time. I'm sorry to say that now that I'm back home, I feel pretty cloudy and distressed about the decision again. I guess it's to be expected from someone like me who tends to overthink things and who is finally contemplating the final path my training will take. My day to day future career depends very much on my decision. No pressure there! :rolleyes:

Fortunately, I also spent quite a lot of time taking pictures of gorgeous scenery, relaxing by the ocean and the pool and reconnecting with my husband. :goodvibes: Can you believe our first date was 21 years ago, Labor day? Time flies! Heaven knows I don't feel old enough to claim that length of time! But then I look at my daughter, who needs a homecoming dress and wants to go out to dinner with her boyfriend, and my sons needing rides to band sectionals and fretting over haircuts and I see that I will not be able to continue to pretend I'm in my late 20's much longer... :rotfl:

As my decision gets made and I start my application process for fellowship I will let y'all know how it all came about. Sorry for the mystery right now!

So I just sat and read the last 2 pages of my blog. I think it's interesting how well it really does reflect the life of a resident. There were lots of happy posts and tired posts and posts about wanting to quit and posts about future career... There were posts about running (my hobby), lots of posts about my kids, posts about weight, posts about missing friends and family. All the usual stuff, I suppose!

This is an interesting post for me because I've come to a decision and it isn't the one everyone has been expecting from me. I've decided to apply for fellowship in Pedi GI!

It seems sudden, and indeed the decision has happened over the course of about 3 weeks. My insightful conversation with the GI director as well as the wonderful days I've spent in clinic thus far played a huge role. The fact that I was being strongly encouraged by some folks I like and respect didn't hurt, either. Ultimately, though, I've been struggling with this decision since GI first hit my radar in med school. I did Neo and GI electives in med school. My research bridges both fields and I've long known that my interest in Neo has been very GI-focused.

(For those who don't know, GI is Gastroenterology. The field is actually Gastroenterology, Hepatology and Nutrition. So that's, esophagus to colon, liver and nutrition. They treat everything from chronic constipation to reflux to colitis to hepatitis to malabsorption disorders to liver transplants and so on.)

Back to what I was saying. The 2 fields have been vying for my attention a long time. I've been very comfortable saying "Neonatology" when asked about my career plans for over a year now, though. It was definitely my comfort zone. And believe me, it was very hard to give up the idea that I would be a neonatologist.

However, GI has many things that I want from my career. It just took me a while to see that these things were vital to me. One of those vital aspects is patient continuity. I want to be able to follow my patients over time, see the results of my treatments, watch them grow up. I had thought clinic time wasn't that important to me. Turns out I just wasn't in the right clinic! I also really enjoy working with the kids who are old enough to talk back to me. I do love working with babies, but some of my favorite patients recently have been the 3yr olds and the 12 yr olds that I connect with. I enjoy the interaction.

And here's another thing, once I started making the decision to go with GI, my feelings about residency started to change as well. I lost a lot of that "what am I even doing here?" feeling. The resentment over all the hours and weeks started to fade, too. I think somewhere in my head I knew I didn't want to do the Neo fellowship and it turned into not wanting to do residency at all. Now that I'm excited about my path again, I feel better about the whole thing.

This is not to say anything bad about Neonatology. I still love the field. I still hope to work closely with Neonatologists and want to focus my academic work on GI problems that start in neonates. Neo will always be close to my heart and I hope to spend a little time in the NICU on a regular basis. And I will always be grateful for the fantastic mentorship I received. :goodvibes:

So now I just have to get my brain to realize the decision is made and I can stop obsessing about it. :laughing: I actually had to tell myself in the middle of the night that I could stop weighing the positives and negatives in my sleep!

It's the weekend and I have the day off. I'm on 1st back-up call tomorrow, so if anyone calls in sick, I have to go in. I dodged a bullet at the beginning of the month when I was on back-up and didn't get called. Doubt I'll be so lucky on the weekend. But we'll see. I could be the "intern" on call tomorrow night. ugh! :laughing:

Good news, I didn't have to be the back-up "intern" on Sunday. Instead, I took the risk and went to get a pedicure while carrying my beeper. I figured the worst that could happen was that I'd have to ask them to take off the polish if I got paged in the middle of it. Worst that could happen is I would sit around all day, doing nothing but watching my pager and waste a perfectly good Sunday. Lucky for me, my gamble paid off!

I've been on the Liver service for a grand total of 3 days now. I love it. The learning curve is crazy steep and I feel about as smart as a rock, but it's really interesting and engaging. The happiness I feel on this service spills over into my continuity clinic as well.

If only I could open the top of my head and pour in a couple of textbook of information! :goodvibes:

Whoa! I'm gone a few days and we get a facelift! I knew it was coming, but had forgotten. Thought I would post today just to get used to the new stuff. I'm going to miss the old smilies, though.

For the first time I also noticed the number of views my blog gets. Not that many! Maybe my blogging isn't as interesting as I thought it was? Well, I mainly do it for myself and in the hopes that some other non-traditional moms will see it and think "If she can do it, so can I!"

I started in our giant Level III NICU today. It's rather intimidating. There's room for about 75 beds and most are full. Luckily, we residents only cover about 32-36 of those. We can each carry up to about 8 or 9 patients at a time. Doesn't sound so bad until you see just how sick some of these tiny babies are. For privacy reasons, I can't talk about our patients, but suffice it to say that being in a tertiary referral hospital in a large medical center at a children's hospital means we see some of the sickest newborns anywhere. My first call night there is tomorrow night. The good news is, there's also a fellow and an attending in-house at all times. *phew*

Oops, just realized it's time to go pick up my son from band practice. One of those rare days when I'm able to do that. Gotta pull my weight around here! (kidding! )

Working in the NICU this month at the children's hospital. It's exhausting! I fell asleep on my bed, face down, in my scrubs after work today. It's q5 call (every fifth day), but the calls are very little to no sleep. Checking blood gases every few hours on sick patients, plus admissions and minor crises along the way. I've had the chance to intubate a 900gram baby twice now. I got the first one on my very first try :D, but the second time around I was too nervous with mom standing at bedside and didn't get it. Later on, however, I got an LP that someone else wasn't able to get. Procedures are that way sometimes. *shrug*

Boy was I right about not being critical care material. I can do it, but it doesn't suit me well. In the middle of rounds, when patients are trying to decompensate and the Cardiology folks want to round with us on their patients right now, and I'm trying to present and some administrative person is haggling me about paperwork XYZ, I just want to walk out of the unit. It's too much stimulation for me! When things quiet down in the afternoon and I have time to think and go at my own pace, I like it much much better. I certainly like the patients and think it's interesting, I just don't care for the craziness at times. Good that I figured that out. If I had started this month still thinking Neo was it, I would be incredibly stressed right now.

Kids are doing well. Autumn is around the corner for us. It might actually cool off enough this weekend to feel like October. Funny that autumn is my favorite season and we get so little of it in Texas. I do have to apply to some east coast programs and Denver and others for GI. Maybe I should consider a relocation! lol. The boys would love it if we moved to Colorado. My daughter would be furious, since it would be her senior year. Family obligations abound, as ever. Speaking of family, one of my brothers and his family, my parents and an aunt and uncle will be in town for Thanksgiving. Can't wait!

This is one of those days when I am "so over" residency. Seriously. It's sunny and 78 degrees outside and low humidity, which is remarkable for this part of Texas. I'm tired. I'm working nearly 80 hour weeks in the NICU and it's exhausting. It's also stressful. And somehow I never noticed this before, but all the fellows and attendings are very somber and sometimes grim folks. They rarely smile! It's bad enough being around stressed parents and sick babies, but to not even be able to smile at your co-workers is miserable. I know they're not all that way, but I never realized how somber this group is. Also, got fussed at for not having some details in my interim summary for a patient we transferred yesterday morning. Hmmm... I was oncall that night before and some one else is supposed to write discharge summaries. But that person was at a concert instead and just assumed my summary could be sent without anyone looking over it. (I need a :rolleyes: smiley here.) Needless to say, I'm not feeling too bad that I was working my butt off on call while that other person was at a concert not writing their own summaries. (besides, the missing detail was in my transfer order...) Nope, not bitter. Just over it.

Nothing, by the way, prepares you for hearing that both your just-turned 13 yr old sons have dates to the first school dance in a few weeks.

I wish I had the weekend off. I wish I could just kick back and be mentally off for 48 hours now. But I have to work tomorrow. Oh, and starting Monday, I have 3 calls and 12 days straight in a row without a day off. That'll be about 150-160 working hours. Did I really sign up for this???

Some days make me think being in primary care, being my own boss and being DONE 20 months from now sounds pretty great. I think it's time for a margarita...

My apologies to the person whose post got deleted. Please send me a PM and I'll be happy to reply. We're not supposed to respond directly on the blogs.

I'm not sure what I'm going to say just yet. I'm tired and stressed and I know I'll be venting. Also, I'm uncomfortable with the fact that I am not so anonymous.

I just ran smack into the wall of fellowship application season. I had somehow misunderstood that applications opened in Nov/Dec. Instead, they are uploaded and become available to programs to view in Dec. *sigh* I didn't realize I was supposed to be gathering documents and writing "why I want to be a specialist" essays. *groan* Good heavens I feel too old and tired for this! Doesn't help that I'm on day 9 of 12 straight in the NICU, including 3 calls. *more groaning* I'm tired and drained and ready for a break. My schedule even managed to violate the "average of 1 day off each week over a 4 week period." I've only had 3 days off in the last 4 weeks! This is made up for by my having both days off this coming weekend. Yipee? I mean, I'm happy to have 2 days off, but I'd kill for a morning to sleep in right now.

And, as has happened to me before, my sleep schedule is getting very disrupted. The more sleep deprived I get, the harder time I have getting restful sleep. Makes sense, right? No, it doesn't make sense! *ugh*

But now I need to write a clever essay that makes me "stand out from the rest."

Maybe I'll just copy an entry from my blog...

I miss the actual rolling "rotfl" smilie...

Who wants to write a brilliant essay for me? I can pay in Starbucks gift cards!

Just kidding, folks. Really.

But seriously, I feel to "old" to be doing this. I'm nearly 40. Shouldn't I be reading other people's applications by now? Shouldn't I be my own boss by now? Shouldn't I be the one deciding my fate by now? Dagnabbit.

You see my frustration and why I feel like I shouldn't express it. Someone might read it and think I'm less than 100% perfect for this fellowship. But I'm human and I've always wanted my blog to reflect that. Otherwise, how will other women be able to gain anything from my experience? Sugar coating things would only lead to other people thinking I'm false or that their own struggles mean something bad about them. And only talking about the negatives would make everyone wonder why I ever bothered in the first place.

So I said it. I don't want to write an essay today. But I need to do it, this weekend will be soon enough I suppose. My application won't be the first one completed (as were my med school and residency apps submitted on day 1). But you and I both know I'll get it done. Because that is what I do. Persevere.

Yay me.

I'm not applying for fellowship.

I'm going to do general pediatrics.

Surprised?

I'm not.

Seriously, this year has been a roller coaster thus far. Actually, that's not entirely true. It's been a drag with one hyperactive month in which I thought I had found the solution to my problems.

I'll try to lay out the decision process for you. It all started with the need to apply for fellowship right now to start in July 2011. That August my daughter will be starting her Senior year of high school and my boys will be Freshman. I had to have a couple of talks with my husband about the Match process and how I would need to rank programs not in our hometown or risk not getting a fellowship position. This was quickly followed by the realization that there is NO way that I was going to a) make my daughter move her Senior year, b) leave my daughter with her grandparents while the rest of us moved that year, or c) split up the family in any other fashion. Talk about a recipe for depression!

So then I began contemplating waiting a year to apply for fellowship or risking the single program application. Although my home program has showed a great deal of interest in me, nothing is guaranteed. The more I mentally wrestled with the idea, the more I found myself saying "I don't want to apply for fellowship!" Then I thought about doing general peds for a year and waiting and I thought about how much more sane my hours would be than they have been for the last 4 years.

That's when it finally sunk in. I don't want to be in training anymore. My family has made enough sacrifices already. I've made enough sacrifices already. I'm a doctor. I take care of children. I don't have to be the most highly trained, highly specialized physician I can be. While that highly trained career had a great deal of appeal for me professionally, it is not in line with what I want for the other parts of my life. I want to be home for dinner most nights. I want to be free most weekends to be with my family. I don't mind a Saturday morning clinic once or twice a month, but I'm done with being on call and night shifts and all that. I've seen how much the attendings work, especially the young ones who need to establish their research and pull the weight of the service.

I love working with kids and there are many, many ways to do that in Pediatrics. I had a long talk with my continuity clinic preceptor and I came to the realization that general pediatrics can be a very satisfying and sane life. Not that GI can't be, it'd just take me any extra 3-5+ years to get to that point and by then my children will be leaving home.

So there you have it. I feel tremendously relieved. I don't have to keep pushing through and persevering. I can be a pediatrician and enjoy my free time, too.

Like I keep saying, every woman has to decide what works for her. And for me, I need the flexibility in my life again. Since I made this decision, my husband's boss has brought up the possibility of him spending some time at the home office in London. If I'm not in fellowship, I can actually contemplate doing that...