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nbp's diary

8 years 11 months ago #78570 by nbp
I got honors in peds! So happy. And because I got honors, I have been invited to meet with the chairman of pediatrics to discuss my career options. I'm still very up in the air about whether to do peds or child psych. One of my problems is that I know I need to focus on what my career will look like, not on what my training will look like, but my training is what I am immediately faced with and what I get the most exposure to as a medical student. Child psych will be 5-6 years but (I think) will be relatively relaxed compared to peds training. Plus, I think I am unlikely to be a generalist so I would likely do a fellowship in peds, so the length of training would end up equivalent. But what matters is what I will be doing 10 and 20 years from now, not during residency. I had a peds EM fellow put it to me this way: what kind of phone call do you want to be getting in 15 years? It's an interesting question but I don't know the answer.

It's also tough because I've had a lot of positive responses from people about child psych, particularly from one of the program directors at a program I love (also one of the most competitive in the country), and that motivates me to want to pursue that direction. Conversely, my husband just doesn't hold much respect for the field of psychiatry. Of course, I know that I need to choose for myself and not for anyone else. Still, I find myself running circles in my mind while trying to fall asleep at night. Which is silly, given that I haven't even had my psych rotation yet!

I am doing psych in May/June, and I decided that I will do an adult rotation, since I am doing a child psych AI in July. If I haven't decided by then I will do a peds elective in August, or my Peds AI if I can manage to move it to August (lots of people in my class want to do peds so the AI is really high demand). Hopefully by then I will feel confident in where I want to apply - it's just so nerve wracking now not to know.

As for now... surgery. Yuck x 100. I'm on the trauma service which is actually really not bad at all. It's really easy to get lost so that no one notices your absence, and I've left during the late afternoon on multiple occasions. Never been there past 5:30, and I usually show up at 6:30. Which all makes me very nervous because I end the rotation on hepatobiliary, which I hear will be much worse. Not to mention that I syncopized in the OR on Monday, and whacked my head on the OR floor. It sucked. I have since been very nervous about a repeat incident. Twice the other day I had to sit down in the middle of an operation - I don't know if I really was going to pass out but I am being pretty paranoid about it. I don't know how I'm supposed to manage the rest of this rotation if I'm constantly feeling presyncopal in the OR! It will be especially bad on hepatobiliary when I'm stuck in 12-hour Whipples. If anyone has any words of wisdom on this feel free to PM me or comment on my thread in the Medical Student forum.

In other news, my husband is job hunting and finally got a (phone) interview. He loves the job and is hoping to get called in for an in-person interview. I will be happy for him if he gets the job but I am also really concerned: the job requires a significant amount of travel (at least 50%)! I have no idea how we'll handle that. I know I should just wait before worrying because he might not even get another interview with them, but as you have probably picked up by now, I can't help but worry ;)

Anyway, DH and DD just walked in the door. More later :)

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8 years 11 months ago #78574 by nbp
So about that job possibility... I just don't know how we'd handle it. I wouldn't want to be selfish and ask him not to take the job, but part of the reason I'm handling this year so well is that I don't have to stress out about getting home in time to pick DD up from daycare, etc. If he does get the job (big if at this point, I know), he would have two months of on-site training prior to any travel. IF I manage to get my peds AI in August, I think I might be able to manage him traveling after that, though of course that's way more than two months from now. I can see what our babysitter is up to over the summer - perhaps she could help out more then. But still, this would be a really big deal. I will try not to worry any more until there is something to worry about - a skill I am working hard at :)

DD is amazing, as always. She is in such a wonderful stage right now. I have really been treasuring every moment I have with her: reading together, coloring together, and my favorite: holding her in my arms and singing to her every night before bed. These are truly some of the most precious moments I could imagine. I am so blessed to have her.

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8 years 9 months ago #79510 by nbp
Well, the job didn't pan out, so no worries there I guess. DH is being very lazy about his job hunt, and while we could use the extra income, it's hard to complain because it is SO nice to have him at home.

Surgery is OVER, and somehow I survived. I will NEVER set foot in the OR again, unless I am a patient, god forbid. Such a miserable experience. I am finishing up a week of vacation now and then 4th year officially starts Monday! I am starting with my neuro/psych rotation, which will be 3 weeks of inpatient neuro followed by 5 weeks of inpatient psych. I'm a little nervous about the neuro part because I will be missing three days the first week to go to a conference, which is a lot of time given that it only goes for 3 weeks. I hope it doesn't give my residents/attendings a bad impression, and I hope I manage to find time to study for the shelf and do well on it. Psych I am really looking forward to... hopefully I will begin to get a better sense of whether to pursue psych or peds. I am most excited about my child psych acting internship in July. And great news - I just found out I got a peds AI in August! The benefit is that I wanted a peds elective in August in case I hadn't made up my mind yet, and for another letter opportunity. It certainly didn't have to be the AI, but now I will have that requirement out of the way so much earlier (we all have to do one AI in either peds, IM, surg, or family). I originally had it in November - now I've got a light elective then, which means I will have much more flexibility for interviews.

Graduation for c/o 2011 is imminent, which is sad for me as that was my original class and most of my friends will be leaving. Even those that will be sticking around for residency will become part of a different world, it seems. Luckily I do have some other classmates that took a year out for research, so I won't be totally alone.

So much going on with DD - we are in the early stages of potty training, her language has blossomed beyond belief, with three-word combinations on occasion! She is so sweet - she says "thank you Mama" and "thank you Daddy" without being prompted. I'm sure she'll grow out of that eventually but it sure is darling while it lasts. She has been extra whiny this week, which may be because we are at my dad's house on vacation and it's just a change of pace. Maybe it's a phase. We are doing our best not to give in too much but also to choose our battles - it's a fine line for sure! She also has this funny new habit of using hugs as a stalling tactic. She knows we will never refuse a hug, so if we are telling her it's time to do something she doesn't want to do, she'll say "Hug!" and wrap her arms around us and lean her little head on our shoulder. Maybe I shouldn't let it work for her, but I just can't resist those little cuddles :)

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8 years 7 months ago #80465 by nbp
I have to say, I hated surgery so much, my goal all along was to survive (and pass). Needless to say I was SHOCKED when I got my grade, which was an honors. Wha? I seriously considered emailing the course director to tell him there must have been some mistake. The funniest thing is that my first reaction was to be concerned: when I met with the psychiatry PD here I was on surgery, and he asked about my grades and I said "well, I'm not going to honor surgery". He said "Good, it's probably better that you don't." So for a split second I thought "oh no, this is going to count against me!" LOL. In any case, I am far more relieved to have finished surgery than I am happy about my good grade. That really says something.

Neuro and psych are now over. Missing several days on neuro for the conference turned out to be pretty stressful, but it all worked out in the end. I didn't do as well on the Shelf as I would have liked, but I don't think it will be too much of a problem. The grades for neuro and psych get lumped together into one "clinical neurosciences" grade, and for the neuro component there is not cut-off Shelf score required to earn a particular grade.

Psych was fantastic. I was on an inpatient adult mood disorders unit, though in fact we saw few mood disorders and almost entirely psychosis. I learned a lot and realized that I really like adult psychiatry. That was a bit of a surprise - I chose an adult unit specifically so that I could make sure I wouldn't hate it before choosing to pursue child and adolescent psych. I am now about 95% sure I will apply for psych residencies.

Speaking of, ERAS opened on Friday. Eek! I couldn't help myself - it is a three-day weekend in between clerkships and yet I already started filling it out. I want to submit as early as possible in September, and in August I will be way too busy on my peds AI to do much, so I figure I better do my best to complete my application this month. I already have a great start on my personal statement. I am a little concerned about LORs. I have one from pediatrics, one from my research mentor, and plan to get one from my child psych AI next month. I initially planned on having one from the adult psych rotation too, but the primary attending left for paternity leave after the first two weeks so I ended up with three different attendings. The first told me he'd write me a letter, but we didn't work together very long so I'm not sure how amazing it could be. The psych PD had also suggested that getting a medicine letter would be good because programs like to see a good foundation in medicine. While I had good interactions with attendings on medicine, that was all the way back in November and December and I really didn't get to know anyone well at all. The one I knew best was someone who said to me "I really struggled whether to give you high pass or honors." I'm not sure that bodes well for a letter writer! So in any case, the end result is that I will have three strong letters but nothing from medicine or any adult discipline. I'm definitely concerned that this could be a strike against me. I plan on talking to the psych PD about it sometime this month.

As always, a little update on my little princess :). Her language is just exploding - she even says full sentences sometimes, like "I have a picnic with Daddy!". She has transitioned to the toddler room which she seems to be loving - I'm sure that is contributing to the language development too. She is getting good at expressing her emotions, too: "R sad, mama work." Heartbreaking, but so sweet. For the last five weeks on psych (and I anticipate continuing next month on child psych) I have been able to participate in drop-offs and pick-ups much more regularly. Getting so much time together as a family - we have started eating dinner all together most nights, which in addition to being pleasurable makes things so much easier, because she sits in her high-chair at the table for that, as opposed to sitting at her own pint-sized table when she eats alone (and then continuously getting up and running around while we try to keep her at the table).

Another benefit of having more time on psych (I didn't have to get in until 9 every day!) is that I transitioned from afternoon/evening jogging to morning jogging, and have now been going every other day for over two weeks! I am very proud of myself. Definitely hope to keep it up.

With the exception of some financial concerns (maybe I'll write about that later), things are going so well these days. I'm enjoying my clinical rotations, feeling good about the upcoming application season, enjoying time with my family, and making personal wellness a priority. Keep your fingers crossed that I can keep this good vibe going!! :)

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