From the trenches of internship

11/13/2005

I am doing a Med-Peds residency at the Marshfield Clinic & St. Joseph's Hospital in WI. This was my first weekend off in 6 weeks. I actually got both Sat and Sun off -- didn't have to go to the hospital, didn't have to answer pages. Unbelievable!

I just wanted to say that residency is great but can tax you physically. I had to make a poster presentation at the American Society of Human Genetics last month. I was up all night preparing the poster. The next night, I was up all night on call. The following day, I was post-call and snoring loudly in the plane from Marshfield to Salt Lake City. I presented my paper the following day. The next morning, I was on the plane back and on call the following night.

Having said all this, I would not trade it for the world. I am living a dream. I am learning and doing a great deal and loving every minute of it. There are poignant experiences that burn into one's memory: like doing chest compressions on an 8 month old female infant who did not survive the code. I had been up all night and the child was flown in by copter in the morning, pulseless and not breathing. I don't think I shall forget that experience.

To all you medical students out there, doing USMLEs, attending classes and looking forward with trepidation to residency: hang in there; learn the best you can; make the knowledge yours -- not just short term memory for a test. You will need it! But it's worth it in the end. During residency, no one cares where you went to medical school, what grades you got in path or physio or whatever, or what scores you got in the USMLE. Everyone comes to know what you do and don't know by the way you function on the wards and in the clinic. It's the knowledge that's really yours that shows then.

Passing the last USMLE exam -- Step 3

I received good news over this 4th of July weekend and wanted to share it with you. In order to qualify for an H1-B visa, my residency program required me to take the USMLE Step3 before they could offer me a contract. It was scary thinking of doing step 3 before beginning residency. Did you know that while the pass rate for steps 1 & 2 for foreign medical graduates is in the 80s, the pass rate for FMGs for step 3 is only 56%? I wonder why. I have read horror stories on the web of folks who got 98 and 99 in steps 1 and 2 and then failed step 3. So I was nervous.

Anyway, I found out on Saturday that I have passed Step 3 with a significant margin. I want to encourage all of you out there from MUA and Saba that our schools do deliver the goods. I am proof of that. Keep working hard and you will match in the specialty you want and hopefully, where you want too.

Vijay

Good NEJM articles on becoming a doctor

In the last two issues of the New England Journal of Medicine, there have been some excellent articles regarding becoming a doctor...1. Abraham Verghese's The Calling talks about how he came to choose medicine as a career and the importance of literature in developing as a physician (if you were my student, you can guess why I liked this one).2. Dr. Treadway's The First Day describes the experience of learning to take a good history and conduct a good physical examination and how learning these skills go hand in hand with developing compassion for patients.3. Sobel (a fourth year medical student) writes about the language of medicine one learns while a clinical clerk -- its great reading for learning to give the short presentation of your patient on rounds, to an attending or a consulting physician.4. Dr. Goldfinger (no, I do not think he is a proctologist) writes a humerous but pointed piece about the use of medical jargon and acronyms in medicine -- especially in students' presentations.

Match Results 3/18/2005

This is a quickie...

I remember the moment I found out where I was to spend the next four years of my life doing residency. I was working in a lab at the NIH. It was 3/15/2005 -- Match Day. I had been logging on to the Match website every few moments waiting for my news. It finally came! I had matched in Med/Peds in the Marshfield Clinic in WI. I remember going down and stepping outside the building. It was a cold morning. I called my mother in Panama and gave her the news. I posted a message on our school's clinical experiences web site that read:

Congrats to all of you out there that matched this year! I've heard from a few folk with their good news. As for me, I matched in the Internal Medicine/Pediatrics program at the Marshfield Clinic in Marshfield, WI. I am thrilled that I got the specialty of my choice. I am also thrilled that I got into the Marshfield Clinic -- a national center for genomic medicine as well as a major place with lots of fellowships and residencies.

I am sure we all share the same feelings of gratefulness to our schools' faculty and administration for all their support and help through the years that led to this day.