Two auditions down - no more to go

So I just finished up the second of two audition rotations yesterday and they both went really well.

I learned things from both places that I really liked and things that gave me pause as well.
When I was talking with a friend, they said to me something very true - if I had sone an audition rotation at one of my current top choices would I like it as much or would I find something that I am less than thrilled with?
On interview day you only see a few people - only tour a few places and do not really get a sense of the whole program and the pitfalls and advantages.  You see what they want to present - and never get to hear the dirty little secrets.
But when you rotate with a program you get a true sense of behind the scenes - you know everything.  The good, the bad and the ugly.  You have seen the underbelly of the beast and know what you are in store for vs being surprised.
Maybe that is the advantage of being here and having life experience - I am not naive enough to think that every place is as perfect as they portray themselves on interview day.  There are bad parts to every place - every thing has a downside.
I think this is going to be the most difficult part of the rank list - knowing that there are parts I will not be happy with.  Balancing that with the known pieces that give me pause and my overall reservation may change.
I think of the two places I interviewed I would be okay ending up at either - maybe one over the other but either would suffice.  But neither creates that sense of excitement and "this is it" I keep hearing about from people who have walked this path ahead of me.  Maybe I have not found it yet - maybe I never will.
But I am done with audition rotations and they both went better than I could have dreamed - landing me interviews at one place that I may not have otherwise gotten one.
Now off to Emergency Medicine for four weeks :)

The craziness of interview season

So I know by now you are all wondering what did she decide to do?
Well that can be answered by one simple question - I am matching family medicine with an intention to complete a sports medicine fellowship once I have finished with the three years of family.  In the end I know I am making the right choice for both me and my family and I have picked the right career for me personally as well.  I am so excited to start next June - but before I can get there I have to survive match.  
You know what - no one tells you how crazy this process is.  All I heard last year from my fourth year friends (who are now interns) was how fast this year went.  Of course they would say that about every year ahead of me - but in this case I do have to say they were 100% correct.
I submitted ERAS on 8/3 - late by many standards since the osteopathic match opened up 7/1- and that is when the craziness began.
I will fully admit I came into this match process and into interview season expecting a few interviews here and there - but I was expecting a whole lot of silence and rejections.  In retrospect I think it was the sheer process of getting here that I still carry with me.  That student was still there - the one who was repeatedly told she would not get here, the one who was told she had no chance, the one who was rejected so many times or heard nothing so many times that it came to be what she expected.  Instead two days after I submitted my application I received my very first interview invite! I was so excited - someone actually wanted ME - which absolutely shocked me.  After all, I am nothing special or spectacular - I am simply me.  I did average in my classes - mostly B's with a few scattered A's and a couple of C's but no failures.  I scored slightly above national average on COMLEX Step 1, ditto to Step 2 CS and passed Step 2 PE.  When I looked at my classmates who are applying with me I felt, and I still feel, remarkably deficient.  I did not do as much volunteer work - the things I did I did while I was at school because I wanted to leave after school time for home and family time.  I was not as involved in organizations as some of my counterparts - I just feel rather under qualified.  My running joke while I was doing the dance with the personal statement and what it was going to say was that it would consist of two simple sentences which spoke the truth:
"I survived medical school with three children.
That is all."
Obviously, my final personal statement consisted of much more than those two sentences but I digress.  I applied to programs in the immediate area, those within our predesignated radius of 3-4 hours and some farther programs reachable by commuter flights.  Then the interview invites came in - and kept coming in - and kept coming in.  Each one brought, and still brings, the same sense of complete and utter surprise and astonishment.  Each one still makes me stop in awe and think that someone actually wants me - not someone else but me.
And here we are the second week in October and I have been on 6 interviews already with many more scheduled.  So far this season I have received 31 interview invites - I have scheduled most of them but not all of them. Not too bad for the person who a little over 5 years ago thought that this would be impossible and she would never be here and would never realize this dream
I am so incredibly blessed - and am still incredibly blessed.  I get to spend the rest of my life doing what I was meant to do which also happens to be what I love.
But I can not believe that it is already October - this year is flying by.  And interviews and travel make it go so  much faster.  So to those behind me I say buckle up and enjoy the ride.

And I thought I would never need physics again - HA!

I am spending a week in the special care nursery on the baby side for my pediatrics rotation and today was day 1 :)

So what does the neonatologist I am working with decide to talk about today but everyone's favorite subject - thermoregulation. *insert me doing a huge gulp because physics and I generally do not play well together*

So we begin basically with the basic information about why we worry about preemies.  Larger surface area per body weight, not as much brown fat stored, no shiver mechanism etc.

Then he says we understand teh physiology we need to discuss the physics of why they do what they do.
*insert silent gulp from me*

So what are the four ways a preemie, or any baby for that matter will lose heat?

1. Radiant - we naturally lose and gain heat from  the environment, thus the warmers

2. Evaporation - babies are wet and our breath is moist so that is  why they dry them off quickly

3. Conductive - wet towels or blankets are cold and a baby would lose heat, that is why they change blankets

4.  Transduction - babies lose heat simply through the movements we do and air flow we create, we need to be extra careful with preemies to not move them too much and make them lose heat that way

Much to my surprise I actually remembered all of these - and just when I thought that I would never need physics again!!!

Almost famous?

I was fortunate enough to be contacted by Rose Raymond, a staff writer for the DO online magazine to discuss my blog and how it came to be.  And so I gave my first ever interview halfway through third year of medical school - something I would have never in a million and one years imagined I would do.

To begin with she asked me the all important question - why did I start this blog to begin with in the first place?

And I had to stop for a second to think, to really think and figure it out.  Part of me knew it was something I had to do if I got to this point, it was something I needed to do.  And another part of me looked at the blogs out there and found that they were written by men - not to many written by the female voice, and I wanted to correct that.
But the bigger part, the part that I am hesitant to admit even to myself at times, was purely selfish.  I waned to document this journey, yes, but I also wanted to prove to every single person along the way who told me I should not be doing this or I had no business doing this or I would never do this that not only could I do this but here is how I did it.

And then I felt more than a tad ashamed - I have not written as much as I should during this incredible journey.  I am afraid my documentation skills are lacking at best, and permanently missing at worst.  But as anyone with children and a life outside medicine knows - sometimes, no oftentimes, life has a funny way of sneaking up on us and getting in the way.  Not that it si an excuse but I am afraid I have been a victim of too much life.  Too much going on in first year to give it the attention that it needed, followed by the heticness of board prep second year followed by a major family issue that has needed far more attention than I could have ver imagined since January - and life has been messy.  But as any nontraditional would tell you - life is indeed messy, sometimes messier than others and I unfortunately seem to be doing more cleaning up rather than managing lately.
I can make no promises but I am going to make more of a concerted effort to document the last leg of this journey - match *eek*.

And she asked me what I got from doing this.  That answer came quickly - I get you all.  When I least expect it, I get a comment left on my blog that reminds me there are others considering this path who have been told they can not or they should not or how could they - and I know that I must continue to shine a light down a path that was previously dark for them.  I know I must show them that it can be done - with a lot of careful juggling and balancing and doing your best tightrope walker impression but that yes it can be done.
I think of the gentleman who approached me at the first health areer professions day I did as a medical student at MWU who was a non-traditional student and who told me he was there because my blog had made MWU seem like a very non-trad friendly place and accepting of its students.  Both of the previous statements are very true in my experience, by the way.  And I remember him telling me he was there because of me - because I showed that it could be done.  I also remember the complete awe I felt at that moment - I had inspired someone I had never met and who did not know me from another person on the street to go down this path.  Unfortunately, he did not keep in contact with me and I do not know what happened to him - but  I often wonder if he followed his dream and where it may have landed him.

But mostly, while doing this interview I kept thinking of the quote which was on my graduation announcements from University of Wisconsin-Parkside:
"The only way of imagining the limits of the possible is to reach a little way past them into the impossible" Arthur Clarke

Thank your or riding with me on this impossible journey my friends - you provide strength in times when needed.

The osteopathic trek to Philadelphia

This week marked another checkmark in my slowly dwindling things to do before I graduate - I made the trek to Philadelphia to take part in the COMLEX-PE which is offered outside Philadelphia in Conshocken.
Since I have never been out to Philadelphia, I decided rather than spend the night, or nights i n my case, near the testing center that I would spend my time in the city of brotherly love itself.
I ended up staying about 5 blocks away from Independence Hall and very close to Chinatown so I was in the heart of everything.
Even though my test was Tuesday afternoon, I opted to fly in Monday night because I did not want to have to worry about flying in Tuesday morning and getting delayed at either airport or running into extra daytime traffic.
I flew out on Southwest which was a first for me.  Now I had avoided this airline because I was scared of the whole no assigned seats thing given I had never travelled that way before.  But in talking to people who had flown and were more seasoned travelers than I, I found out the insider secret to traveling if one is going to fly Southwest.  The secret, or so I was told, was to do one of two things - 1. opt for the early bird online check in which would automatically check me in or 2. check in myself online 24 hours before my flight.  Since Sunday was Easter and I wanted toe pend as much of it as possible with my family, I opted to do the early bird online check in.  I have to say that despite all my reservations, I was actually quite pleased with who smooth flying Southwest was.  I was fortunate enough to be one the first boarding group both directions so had my virtual pick of seats - I of course decided to sit by the window both ways, even after deciding on the way out that it was not a brilliant idea given the over water takeoff and landing.  I actually find that I prefer the organized boarding of Southwest - everyone has their spot in line and people are very polite about making sure they are in the proper place - versus the usual gang rush to get to the gate to get to the assigned seat on time.
Although I do have to admit one very large flaw in my plan - arriving at night.  I drove by my hotel numerous times before stopping to ask a police officer for help.  Of course I will also say that it did not help that the only sign on said hotel was on top of the 7 story tall billing admits bunch of other equally tall or taller buildings.
For those following behind me - it goes really quick.  The 14 minutes you have fly by and then the 9 minutes to write a note seem like a blink comparatively speaking.  It seems like you have just started and then all of a sudden you are done.
So with an afternoon session, I did not get to se much of Philly Tuesday night so I opted to do my touristy stuff Wednesday morning before my flight left in the afternoon.  I went down to Independence lane and saw the Liberty Bell, toured Independence Hall and visited the tomb of the unknown soldier.  It was a beautiful area and the historic district was absolutely stunning with its cobblestone streets.
So now I wait six to eight weeks to find out if I managed to pass - let the wait begin.

The inevitable series of "what if?"s

The other night on our way to Medieval Times for a belated anniversary dinner, we passed Harper College.  The oldest, now already thinking of college even though she has yet to step foot in a high school, immediately asked us what kind of college it was.  We told her it was a junior college then proceeded to explain how people used them and how it was similar to McHenry County Community College which is much closer to us.  And for some reason I began explaining the concept of reciprocity agreements to her - that one could take a class at Harper even if you lived in Mchenry's district if that class was not offered at Mchenry - I am still unsure why I decided I had to explain this to her right at that very moment.  After a brief pause, she told us that she would never go to a community college.

And it was this conversation that got me thinking of every step and decision that I have taken on this road that has brought me to this place, this time - the series that have lead me here, and how different they could be if one path was taken instead of another.  When I look back as a whole, I am still amazed by the path that brought me here and I thought I would take this time to review the what ifs that I have had along the way.

The conversation of course got me thinking. I went to community college after high school, because I was not entirely sure how I would like college, but I had an offer to attend Winona University immediately after college.  And I wonder what would have happened had I accepted that offer.  Would I have gone forward and simply become the genetic counselor I had in my mind?  I certainly would have never ended up at Southern Illinois, which means I would have never failed, which means I would have never considered any alternative.  I am grateful for my time at CLC though - as it taught me that I could believe in myself again.  Havings toggled in highs chool to be average, it was nice to be above average and have the grades to back it up.  It was nice to be surrounded by peopelw ho were with me in my struggle.

And what if I had gotten stubborn at College of Lake County?  What if I had not gotten scared of the idea of having two majors or frustrated at not finding anyone who knew where I wanted to go?  Where would my path have led then?  I probably would not have gone to Southern, I would have ended up somewhere else.  I would not have met  my husband, I would not have had to endure the trial of Southern.  But if I had not endured that trial, I would not have gained from that experience.  For as hard as it was to be scrutinized, to received death threats and to struggle in something I thought would be not such a struggle - I would not have learned to fight for what I want, what I truly want.  I also learned not to settle as settling leads in my case to struggle - I learned to accept my destiny, not knowing at the time where it would lead me.

What if the lady at University of Illinois Urbana-Champaign had been nice to me that day I walked into the admission office with a sealed transcript when we visited?  What if she had not looked at me like I did not belong there and what if she had not been condescending when she told me they would need my ACT and it had to be above a 22 (it was)?  What if my parents had not decided to keep going down to Southern and I had instead attended Columbia in Chicago? The same series of events could apply as above and I have no doubt I would not be where I am today.

This has been such an incredible journey, each fork navigated, each improbability overcome.  So for those who say you can never go to medical school with failing grades, I say yes it is possible with a lot of determination and will.  For those who say you can not go to medical school with community college classes as part of your prerequisites I say you can.  To those who say you are too old - I say you are never too old to pursue your dream and your passion.

And for this journey, this remarkable journey that has taken me here, I am incredibly grateful.  Even things that seemed like a misstep or a detour at the time proved to be a learning experience.  In fact I was telling someone that the other day - even if you do not know why you are where you are at the time it will eventually become clear what you were supposed to learn and gather, even if it is not obvious at the time.

May those of you still on this journey know that if you falter, it is not the end and may you be grateful for the lessons learned.

almost done with third year - how time has flown

I thought that time only flew when one was talking about children. I am experiencing a bit of that now as I battle with the ever growing closer 8th grade graduation and the label of being a parent to a high-school freshmen *double eek* - especially since I swear she was a little baby being photographed in her first Halloween outfit (she was a duck). But I have to say that this last year has absolutely flown by.

The days of board prep do not seem so terribly long ago - of being immersed in questions and hoping and praying to just pass so it does not have to be done again.  Yet here I sit, a mere 14 weeks from being finished with 3rd year and it seems like just yesterday I walked into an operating room for the first time.

And I have learned so much this year.  I have learned about the type of doctor I want to be, and about the type of doctor I do not.  I have eliminated specialities as careers, been pleasantly surprised by some and still not sure about others.  I have seen the good and the bad of medicine.  I have seen a doctor whose hands are tied because there is no good option for treatments, being limited by insurance and deductibles and the realities of a patients financial situation.

There have been days when I have faced the improbable in the eye and managed to keep my composure - and then come home and hug my kids a little tighter, cry and be so incredibly grateful for what I have.

I have found my strength from my family - who have given me cards and tokens of support when I least expect it.

But I have also found it in the clinic - in the patient who is grateful that I am there. In the patient who is grateful for that hand to hold, or someone to explain at least a plausible explanation or why they are feeling this way.  I found it in the patient who told me I was a gift and she would follow me wherever I practiced because she appreciated me and my approach so much - I can not tell you how incredibly humbling an experience that is, and how good that felt.

I find myself being thankful.  It is no secret that I was originally wait listed at the Biomedical Sciences program here, that there were some doubts about my ability to do this or that I came into this experience with a huge chip on my shoulder and something to prove.  I had to prove to others that this can be done with a family - it can be done after you have been out of school for a while that it can be done if others tell you to quit.

And I am grateful for that call.  The call that came that day in August after I was on the wait list for the Biomedical sciences program, the call that came after I had been accepted into a graduate entry nurse practitioner program at DePaul - the call that would change my life.

After this year, I have come to realize that life is a series of events - al of them in which a higher being has their hand.  They guide us to be in the right place at he right time.  Sometimes that lands us somewhere good - oftentimes that lands us somewhere bad.  I have learned to cherish those right place right times moments - because it is those moments that I draw on and remember when I hit the wall and begin to think I can not do this anymore.  It is those moments that make every sacrifice, every first missed, every game late to, every conference skipped, every family gathering skipped, every bit of what it takes to do this so worthwhile.  It is those moments when I am reminded of why I am doing this in the sea of why am I doing this?

The other day I looked in awe at the profile of my youngest - all of a sudden she looked so o-l-d, and I found myself wondering when she grew up.  It is the same way I sometimes catch the reflection of myself in a mirror and I wonder "who is this person and where did I go?".  This experience has forever changed me but it has not changed me.

So for those entering this path anew or considering entering this path I say - buckle up and enjoy the ride.  Because before you know it, you will be facing match and boards and patients in clinics show ill at times take your breath away.

To the almost end of third year - and the almost start of fourth :)

On the decision NOT to take the USMLE

Being an osteopathic student in this world is difficult - so many more questions that face us, with the big one being so you take the USMLE? During my second year, I thought that if I was going to take the USME in addition to the COMLEX that I would delay and take it later in the year. This decision was made for a multitude of reasons. First and foremost - I know me and I know how I prep for big life changing determining tests and I knew that there was no way I could efficiently prep for two tests at once. I knew I needed to focus on one than the other. My logic was I need the COMLEX in order to graduate, I needed to take it by a certain time for rotations - I did not need the USMLE for my continuation forward in the program. Also, there is no rule that I had to take the USMLE in June/July - I only had to take it sometime before the residency application process which was not going to be for another year, so why not take the time and make sure I could devote the proper time and attention to it. Secondly, I was not sure if it was really needed for what I wanted to do or where I wanted to go. So I wanted to take time to make sure I was making the right decision. After all was said and done, as the title implies, i ultimately decided NOT to take the USMLE. And of course that brings up the question of....why not? It starts and end with me in the answer of what kind of residency program I want to be and who I want to be in that program with. I have to admit the decision on what kind of doc is still out for a verdict - but I am getting a clearer vision of what kind of program I want to be in as I rotate through various programs and with various persons. I have rotated with 3 MD preceptors so far, and as can be expected on either side of the DO/MD fence, the preceptors were varied in their personalities and interactions with others. Now I am not here to MD bash or say that all MDs are like this or that - I will freely admit that there are equally bad preceptors on the DO side as well. The first MD preceptor I had was wonderful. He was very down to earth and open and funny and very open to OMM and its application in the proper patients. The second group of MD preceptors I had seemed to look down on me as a DO student and one even told me that she thought there was no use for OMM ever. Now I know that there are doubts, even among my fellow students about the use of OMM, and among practicing DOs about the applications and use of OMM - but I do believe that there is a valid use for OMM in certain patients. I do not think it is the cure for everything - it is not going to help diabetes of hypertension - but there are very specific cases and patients that it can prove to be very useful for. This was the experience that made me really sit back and consider the type of people I want to be in a residency program with and what kind of program where I would find that. The third MD preceptor I had was also very down to earth and open to OMM and its use for the correct kind of patient. After taking all this into consideration - I thought I wanted to be among people that were at least open to OMM, not that everyone should be a guru or ready to champion OMM to everyone, but they should be able to recognize that proper use can help people with chronic back pain or were on crutches recently and recognize that their pelvis is now likely to be misaligned. When it comes to the end of the road - I want to be around people who are at least open to the whole structure-function connection and the application of OMM. So then the question arose about which type of program I was likely to find this in - straight DO, straight MD or dually accredited. Being that I wanted to keep OMM as part of my skill set, that eliminated MD only residency programs for me. This realization lead me to one big question - why I am thinking about taking the USMLE? I had figured I would need it to keep my options open so I could stay closer - but Chicago is DO friendly and has many dually accredited programs. Then my husband and I had a discussion - could we really handle me being somewhere else for a few years? Yes it is challenging, yes it would be hard, yes it would not be easy as a wife or mother - but if push comes to shove and that is where I was matched to, we could handle it. This talk alone opened up a whole slew of doors that were closed - which again brought up the question of why the USMLE? All of these questions surrounding why to take he USMLE and there was only one answer staring at me - I came to a very logical conclusion. I did not need to take the USMLE - it was superfluous and unneeded and would make no difference to the kind of progress I wanted to apply to. So that is why I decided not to take the USMLE - I know other who have made this decision may have other reasons I thought I would share mine in the hopes that it may help someone else who faces this decision.