Very Thankful Thursday

This Thursday we have a lot to be thankful for! I cannot tell you how incredibly thankful we are for matching, and for matching exactly where we did. We truly feel like we beat the odds matching in neurosurgery coming from a school that didn't even have a residency program. We just feel so fortunate.

We do know some people that didn't match, and it broke our hearts, as they are great people. We can only hope that their new paths will end up better than expected, but there is no doubt that they are having a challenging time accepting the unexpected. Unfortunately with "match," crap happens. Every year there is always at least one, if not several unexpected results. (And I swear I am not trying to scare any of you), but there is always a qualified applicant who for some reason doesn't match, or there is some rock star candidate who matches at their #9 even though everyone thought she was going to her #1. It just happens. I am not trying to scare anyone, just reminding you that no matter how certain something may seem, there is no certainty, in medicine, or in the match. So if you can, let go and accept it for what it is. Out of your control.

For Drew and I it meant a lot of praying, both in deciding his specialty and in applying and ranking our programs. Most importantly though, is how we prayed. We didn't pray for program X, or to be in state K. We prayed that God's will would be done, and that we could accept whatever that would be. And therefore we truly are at peace (and excited) about where we are headed. We feel that we are going exactly where we are meant to go. (Hopefully I will still feel that way in seven years!). And my motto: expect the worst, hope for the best.

And finally, for those of you who are third years, or married to third years. The anticipation of match is much worse than the actual thing. Last year, the night before match, Drew and I couldn't sleep, we were horrified that next year it would be our year. But oddly enough we actually were able to get some sleep the night before match day this year. So as scared as you are now, really it only gets better, because with time you learn to accept the uncertainty and all the possibilities. And also, it flies by! Before you know it you will be looking back and wondering where your fourth year of medical school went!

And being thankful for matching, here are a few more photos from last week.

After we found out the news we made calls to our family and friends to share the good news.

Drew with my fabulous sister and my awesome nephews

Wearing our awesome t-shirts! Thanks again Lindsay!

The soon-to-be doctor and me

Taking shots with my girls Lindsay and Shannon

At the beginning of the bar crawl

We are so thankful, I cannot tell you how blessed we feel.

Answers - Part One

Okay so as promised here are a few of the questions that were asked:

Q: My question to you, without getting too specific, is are you guys likely going to have to relocate very far for residency? I'm curious because we lucked out in the sense that there are more residencies in the NYC metro area than in some entire states, so our move will only be a matter of a few miles, and I know that is not the case for many residents and their families across the country. How will this affect your career?
A: One thing I had no clue going into this process was just how little control I would have over my future. I am a total control freak that absolutely hates change! I seriously went off to college because I knew all of my friends were leaving and I didn't want to be left behind, but I was scared to death to go. And then when college was over I think what made my decision to go to law school so easy was that I was scared to enter the real world - I figured law school would be an extension of college (boy was I wrong!).
Anyways, when I married Drew I knew I would have to follow him to medical school but I figured that once he was done we would get to "pick" where we wanted to live. Unfortunately with applying to residency, certain specialties aren't located everywhere, and then there is the whole matching process that really takes things out of your control. Although I was weary (probably an understatement) to move to Springfield, Illinois, I have really grown to love it here. Unfortunately due to Drew's chosen specialty, the only way we will stay here is if he doesn't match in neurosurgery. There is no neurosurgery residency program here, and in fact there are only about 100 programs in the entire country. Then when you factor in the fact that it is a highly competitive specialty, you really have to prepare to go anywhere you can match. I try not to think to much about leaving my job because I absolutely love it and the people in my office. I also am still worried about matching, so until we get word on March 15th saying that Drew matched in neurosurgery, I won't make any career plans. If, heaven forbid, he doesn't match, we would stay here and figure things out for a year. If there was a neurosurgery program here, we would absolutely considering staying.
Also as an attorney I am only licensed in the state of Illinois, which means if we match anywhere outside of Illinois, I will have to take another bar exam. Another thing I am choosing not to think or stress about, I will deal with that after March 15th.
No I do not want to leave my current job, and I do not want to take another bar exam, but ultimately we put a lot of thought and prayer into Drew's decision to pursue neurosurgery and I feel like it is his calling. Therefore I feel like God already has the next steps in our journey planned for us, I can only hope that that plan includes a new job for me that I enjoy half as much as my current one.

Q: I was wondering if you knew of any great blogs or resources for med students husbands? I can't imagine the preppy boyfriend dropping by one of ya'lls blogs, but I do think that it would do him good to hear some of what other people go through... like for instance, he doesn't believe me when I say that during the clinical and residency years, it is entirely possible that I will spend 24-36 hours continuous at the hospital.
A: I did spend some time searching last night and unfortunately I couldn't find the blog of a male medical spouse. I do think you will spend 24-36 consecutive hours at the hospital, but most of the time that will be because you are on-call for the night and therefore you will have some advance notice of when it is going to happen. The good news is that a lot of programs have what is called "post call" so that when you worked all day, and were on call all that night, you get to leave the hospital by a certain time the next morning (usually by noon). Your hours will greatly vary by your specialty and by your med school and residency program. A good resource to check out is FREIDA program search. Programs fill out surveys yearly and one of the questions pertains to the maximum amount of consecutive hours on duty. Another resource for him to check out is the International Spouse Network, although most of the members are female, there are some male spouses as well. It is a good resource to ask questions, and also a place where medical spouses can chat with other spouses who actually understand the stress and time constraints a medical career can have on a family. (I say that because the average person thinks a doctor's life is cushy because they are "rich," they don't always realize the time commitment involved).

Q: My question is if your costs counter for applying for residency are accurate? Currently it is at $900 and I have been told by some fourth years at our school to save up $10,000 to be on the safe side. I am sure that it may be more expensive for us since there are no programs my husband (or most students) are even interested in in our state but I was just curious since there is such a discrepancy and I have seen you mention how expensive it has been.
A: No that amount was not correct. We got so busy with interviews that I didn't keep up with my tally of expenses, but now my costs should be up to date. Applying to residency can be between $1,000 and $15,0000 depending on how many programs you apply to, how many you interview with and where the interviews are at. We were lucky in that although he took 16 interviews (he applied to 42 programs and was offered 23 interviews) he was able to drive to 10 of the interviews (he probably should have flown to one of those though). We also saved a lot of money with having him stay with friends and family whenever possible. Some locations (such as Dallas) were also a lot more affordable to fly in and out of. My expenses do not include the cost of any meals or snacks and I may have missed a few baggage fees in my calculation.
Here is a brief breakdown of our costs:

ERAS Fees: $655.00 (to apply to 42 programs).
Interviews: $4,307.98 (Hotels, plane, car rental, gas, airport parking for 16 interviews)
NRMP Fee: $50
Total = $5,012.98

Although that is a lot of money I still think it is on the low end. The two most expensive interviews were $811.62 and $717.16. One of our interviews was "free" in the sense that Drew didn't have to spend any gas money because he was already in town from an interview in the same city the day before, and he stayed with family so there was no hotel bill. Two programs also covered the hotel cost and he stayed with family/friends for five of the interviews. I have spoken with two other wives who applied in ortho (another competitive surgery) and their spouses did 18-22 interviews and their costs were closer to $10,000 and $15,000 (I know one of them said the cost to change two flights was very expensive!).

I apologize as my answers were longer than expected but hopefully they were helpful to someone! I still have more to answer but I figure that was more than enough for one blog post!

I'm so over it!

This applying to residency and match process. Yep, I am over it! It has been exhausting and seriously has been non-stop since July. And I am not even the med student! July was studying for the boards. August/September/October - we were apart for away rotations. September he officially applied to residency programs. September/October/November - were filled with scheduling and organizing interviews. And as soon as Drew got home from his away rotations at the end of October, he started interviews right away. And the interviews have pretty much been every week since (with the exception of a two week break for Christmas).
Tonight I am waiting for Drew to get home from another interview. Thank goodness it is his second to last!

:Sigh of Relief:

This process. Has been. Exhausting.

The funny thing is that is that fourth year is supposed to be the easiest! And I guess academically (with the exception of his Away rotations) it has been the easiest year for Drew. But this whole match process has been much more time consuming than the actual academic portion of medical school. I've been so incredibly jealous of Drew friends that are applying to different specialties in which they didn't have to do away rotations; didn't have to take as many interviews; and are virtually positive where they are going to Match.

I am ready to be done organizing travel itineraries, and picking out suits and ties, and paying astronomical credit card bills for travel expenses. I am ready to have a routine, and have my husband in the same state with me for seven consecutive days. I am ready to stop wondering what our future will hold. I am ready for March 18th. Well maybe not... but as for this whole process, I'm over it! And you're probably over me talking about it! Thank God we only have one more left!

My shelf

Do you have a shelf, box, case, or bookshelf where you put things that are important to you? I do. I have a shelf that I put my most precious items on. In fact they go in a box, and I tie that box with a bow, and then I put them on the shelf. This shelf is very important in my life and it is necessary for my sanity. I know that my most precious items are safe when they are on that shelf. But I have some what of a problem. I take my stuff off the shelf and take them out of the box and I lose them (and my head).
This has been a big issue lately. Our future is one of those precious things that belongs in the box. With all of this applying to residency programs my mind has been consumed with the match process. Its something that I have no control over. But I cannot control myself, my mind is constantly drifting to the what-ifs of our future. And all this worrying has led to no good. I have had stomach problems in the past but they seem to have resurfaced. But part of me believes they are somewhat self-inflicted (or worsened) by the fact that I have become consumed by this whole process. But as I've already said, it is all out of my control. And it is no use worrying over things that may never happen. So tonight I am again putting all my worries, and thoughts about our future back in that precious box. I am tying it with a bow. And then I am placing it up on that high shelf. On that shelf it is in God's hands. I will let go, and trust in Him. All things are safe in His hands.
It is only a matter of time before I take it off the shelf again, but I suppose that is only part of being human. Thank goodness I have family and friends to constantly remind me to refocus, reevaluate, re-anchor and put the box where it belongs. On my shelf. Because I don't have control. And worrying won't help me gain any control.

My "S" List

Is short. And right now, Drew's school is on it.

Last week Drew submitted his portion of his residency application through ERAS. There are various parts of this application. These parts include:

• Photo of applicant
• Profile
• CAF (which I think stands for "Candidate Application Form")
• Personal statement
• Four letters of recommendation
• USMLE transcript (test scores)
• MSPE ("Medical Student's Performance Evaluation" aka Dean's letter)
• School transcript

As the student Drew is responsible for the profile, the CAF, and personal statement. The USMLE transcript is uploaded by the USMLE and the remaining parts of the application must be uploaded by the applicant's school. So far Drew's school has only uploaded one of his four letters of recommendation... nothing else. Granted they cannot upload the letters they don't have (and they may not have all four yet) and none of the schools can upload the MSPE until October, but they still should be able to upload his transcript, his photo and his school transcript! Neurosurgery used to be part of early match (meaning match occurred in January rather March and therefore everything happened much earlier), and many of the schools are still on an early schedule. Four programs have already started offering interviews (we applied to three of those, but have only heard from one). And, I know I am being a little neurotic, considering it is only September 8th, but I know part of me is a little justified considering that I have spoken to people at other programs where their schools have submitted all the the parts to their application. Drew emailed the school last week to see if there is anything we could do to get them to upload the necessary parts and we still haven't heard back.

Okay, and that is only the half of it.

Today, I got home from work and went to check the mail. What do I find? A letter from a collection agency. Saying that we owe over $300 dollars for Drew's medical bills. I find this pretty interesting considering that we haven't even gotten a single bill, prior to this collection agency notice. Back in June when Drew was on his away rotation we did get a notice saying that he needed to fill out a claim form for insurance coverage and while he did not do it on time initially (because he was gone) he did call the school, filled out the form and got it cleared up. Or so we thought. When he had spoken to the person from student insurance they said that we would receive a bill for whatever wasn't covered by insurance. But, no bill ever came. Just a notice from collections today. And from what I understand, I don't think medical companies are allowed to even submit a bill to collections if insurance is still pending. So needless to say the collection agency is going to get a nice response "disputing the debt in writing" as the letter requests. And Drew's school and/or the hospital where the medical bill came from may also be getting an earful tomorrow!

Update as of September 9, 2009 - a friend of Drew's told us that student transcripts are not scheduled to be uploaded until mid-October so that the school can add elective grades but that if he wanted we could request to have it uploaded sooner. Drew emailed the appropriate person and his school transcript was uploaded by this afternoon!

In reference to the medical bill I drafted a letter to the collection agency (and cc'd the medical center and student insurance) letting them know that we never received a bill or a notice of coverage or denial of coverage.

First Interview Invitation!

I could hardly believe it when my phone started buzzing and ringing today. I looked to Drew's email and it said that he had an email from ERAS. My hands were shaking as I went to check the email and try to reply and accept the invitation!
Although we were hoping for an interview from this program (because Drew is doing a sub-I there next month) we were not expecting an invitation already. I replied to the program coordinator and asked if it would be possible to interview during his sub-Internship - and if not his first choice would be to interview in November. I got a prompt response letting me know that he could interview in October while he was there. Although Drew has housing while he is there they still offered to book him a hotel - this program is one of the few that actually arranges and pays for your hotel accommodations!
I should also explain that I have Drew's school email forwarded to my phone so that I can respond to any interview invitations. This is because with his sub-Is this month and next month he will most likely be in surgery when the invitations come in via email. Some programs send out (for example) 15 invites when they really only have 10 time slots. This means that only the first ten to respond will actually get the interview.
Luckily neurosurgery is one of the more organized programs and 95% of the programs have actually posted their interview dates (this is not the case with all specialties). With this information I used Google Calendar to enter all of the potential interview dates... then we will use the calendar to try and schedule the interviews as they come in. Right now many of the interviews conflict with each other but I imagine things will manage to work out as we would be lucky to be invited to half the programs we applied to; therefore I imagine by process of elimination it will be pretty easy to schedule interviews.
I hope this is just the first of many more interview invitations... but we'll just have to wait and see!

Brief Update

Okay this will have to be brief because I am tired and would like to get some rest but its been a while so I thought I would try and update.

Last week Drew finished up the last week of his first sub-Inter ship. It was pretty similar to his third week other than the fact that he was done on Friday at 4:00p.m.

Since he was in between sub-Is, I went to visit him this weekend and we finalized his personal statement and worked on the application. (I will update about the weekend later). Overall I feel really good about his personal statement. I owe that mostly to the help of another surgeon's wife who has been an absolute angel - she has given us so much advice! I cannot even imagine how much more difficult this process would have been without her words of experience and help.

The way residency applications work is that you submit all your information (personal info, experience, letters of recommendation, transcripts, test scores, personal statement etc.) through ERAS and they submit your application to the programs you wish to apply to. Yesterday was September 1st; the first day to submit your application (you have ERAS send it to the programs). Although most program applications are not due until October 1 or November 1, but with more competitive programs (ENT, radiology, derm, plastics, neurosurgery) it is very important to submit your application as soon as possible. So yesterday we did It. We submitted over 40 applications to programs in the following states: Illinois, Wisconsin, Indiana, Minnesota, Missouri, Iowa, Florida, Texas, Ohio, South Carolina, Tennessee, Georgia, North Carolina, Pennsylvania, California, District of Columbia, and Kentucky. The number of programs is so high because 1) most programs only accept 1-2 residents a year and 2) neurosurgery has a 60% match rate. For now I am just going to sit back and wait to see if interview invitations start rolling in, in the next few weeks/months.

I'll try to update on Drew's second sub-Internship later this week!

Crazy Mess

Tomorrow is the first day you can submit residency applications... and for competitive purposes it is kind of important that we get our application in. Unfortunately it is 10:00 p.m. and now I am beginning to question every word and phrase on his application. Gosh this is nervewracking! I am a giant ball of nerves... lets hope I can get some sleep tonight!

Step II - Clinical Skills

Check. Drew completed the first part of Step Two (the clinical skills portion) Tuesday, in Chicago. For those of you taking it next year, there are only five clinical skills test locations, nationwide. The other (written) portion (clinical knowledge) of the exam can be taken at the same locations that Step One is offered. Drew will be taking that portion of the exam next Wednesday (again prayers are very much appreciated it). The clinical skills portion is pass/fail, and he feels pretty good about it, so we're hoping he passed. From my understanding he "saw" 12 different patients (15 minutes each) and then had time (10 minutes) to do write-ups on the patients.
Here was the schedule: he saw 5 patients in the morning. Then they fed them lunch over a half hour break. Then he saw 4 more patients and got a fifteen minute break and finished up with the final three patients. I think he was finished around three-ish in the afternoon.
Another thing to keep in mind is that Step II is expensive. I don't know off hand exactly how much it is (I need to have my husband look up the credit card bill, but he is too busy studying for the clinical knowledge portion of the test), but I'll be sure to post the cost in the future. We took out a special loan to pay for it, and luckily with the clinical skills portion being in Chicago we were able to save some money because he didn't have to fly and he was able to stay with his sister.

In other news my darling Drew has also started his personal statement for his residency application. This seems to be a daunting task. I had to do something similar in applying for law school and it was absolutely dreadful. Having the option to write anything is often more difficult than being assigned a topic. From what I have heard...

1. They don't read too much into the personal statement.
2. It is more read to make sure that you can write competently.
3. Generally it doesn't help you but it can hurt you (meaning if it is terrible or you say the wrong thing).

Any residents, doctors or spouses want to confirm/deny any of these rumors I've heard?

Making a list

So we started the first step of applying to residency - and for us that was making a list. A list of all the programs we want to apply to. Since we expect the process to be quite competitive, Drew set a target of applying to around 30 programs (in order to increase his odds of matching). First we considered all the programs where we currently have friends and family. Next we looked at the remaining programs all over the country and thought "do we really want to live here?" This allowed us to eliminate the programs that were in locations that we could never imagine ourselves living - for example, Wyoming (no offense). We also looked at certain programs in which we decided - "No, I wouldn't ordinarily want to live in Timbucktoo, but I would live there if you got into program X." And through that very scientific process we were able to come up with our list of roughly 30 programs.