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The Long and Winding Road

Each time I participate in the UMMS interview day, my own interview day seems farther and farther away (and I’m usually quite thankful not to be wearing a suit). Well, the time for dusting off the suit is coming soon. In medical schools across the country, preparation for the upcoming residency application season is beginning. Students are attempting to craft personal statements (which, like when applying for medical school, is a task that sounds much easier in theory than it is in practice), updating their CVs, and asking for letters of recommendation.

In terms of letters, the residency application has an additional kind: the Medical Student Performance Evaluation (MSPE) or, more colloquially, the Dean’s Letter. Written by one of the medical school deans, the MSPE gives a summative evaluation of your performance in medical school, including comments from third-year clerkship evaluations, as well as notable characteristics that are evidenced by extracurricular and co-curricular involvement.

In order to create these letters for each graduating student, the deans meet with students individually to discuss their content and for us to give input. For example, at my MSPE meeting last week, we decided to include my love of learning languages as a notable characteristic (I’m fluent in French, but am working to improve both my general/medical Spanish and Mandarin Chinese).

The other aspect of the application process that bears mention at this point would be narrowing down the residency programs to which I will be applying. I will be pursuing a residency in family medicine, which means there are over 500 programs to which I could apply. That number is slightly overwhelming to say the least.

I spent several weeks (at least) freaking out over how I could possibly narrow down to 20-ish programs and soliciting advice from everyone I knew who has already been through the process. The principal answer: start by defining your geographic preferences then decide what program characteristics are important to you (for family medicine, common factors are the strength of OB training and desired population characteristics, such as focus on the underserved). Several people steered me to the AAFP (American Academy of Family Physicians) website, which has a search engine of available residency programs that easily delineates these characteristics.

Prepping my application has a long way to go, but baby steps. In the meantime, I’ve enjoyed being an M4, including my vacation time last month. I was able to go to London with my family and we had an amazing time.

This sign made me laugh. I was on the upper deck of a tour bus and was going to try to get a clear shot but the bus went up on a curb and I had to abort that mission or I would have dropped my phone on the pavement (not sidewalk, our tour guide said that was too descriptive for the Brits). “Changing priorities, 50 yds ahead” indeed.

Sara is a fourth-year medical student at UMMS. When not in the hospital, she can usually be found on the golf course or at a Michigan sporting event cheering on the Wolverines.

200 Years. Forever Valiant.

This month, I’m working as a Family Medicine sub-I (or sub-intern) on the department’s inpatient service. Essentially a sub-I is supposed to act like an intern, except for the fact that someone else (usually the senior resident) has to sign off all of the orders that I place. I’ve now finished my first week on service and am finally (sort of) getting the hang of it. At the very least, I’m starting to remember where things are in MiChart (UM’s electronic medical record). With spending good chunks of my Internal Medicine and Psych rotations at other hospitals, it’s been a little while since I routinely pre-rounded and put in orders.

I’m enjoying my time here and really enjoy working with the team. It’s a smaller group than some: the attending, the senior resident, the family medicine inter, the psych intern, and me. It’s really great to feel like these are my patients instead of the intern’s patients that I’m helping with. And, it further confirms my desire to pursue family medicine because of the broad spectrum of clinical conundrums it entails and the amazing people you meet.

Our day starts at 7 a.m. in the hospital cafeteria where we meet with the night resident for signout to learn what events transpired overnight for our patients and to hear about any new people admitted. Rounds usually begin around 9 a.m. In between we go see our patients and formulate preliminary treatment plans for the day. During rounds, we present our patients to the team and attending, and make modifications to the plan. After rounds, we return to our team room and put in the orders allowing those plans to come to fruition. Our team admits new patients every day, so the day team admits until 5:30 p.m. and signs out to the night resident at 7 p.m.

This month also marks the kickoff of certain events for the U-M bicentennial. Yes, the University of Michigan turns 200 this year. On my own birthday a couple of Saturdays ago, I was lucky to be released from clinical duties early enough to attend the True Blue concert, celebrating notable achievements over the past two years. (While 7 p.m. is the theoretical time we are off duty, you stay until your work is done, which can sometimes be a bit later.) So, I was thrilled to be released in time to attend the concert with my family. My brother, as part of the Michigan Men’s Glee Club, was honored to perform. Other notable appearances were Darren Criss, Andrea Joyce, Jim Harbaugh, and the entire Michigan Marching Band on stage at once for “Varsity and the Victors.” Go Blue!

Sara is a fourth-year medical student at UMMS. When not in the hospital, she can usually be found on the golf course or at a Michigan sporting event cheering on the Wolverines.

CONGRATULATIONS!!

Yesterday was a momentous day in the lives of my original* classmates, one that they anxiously awaited with anticipation. What event was this? Match Day, where soon-to-be doctors learn where a computer program has matched them to train for the next several years of their life (thankfully, most students at Michigan get one of their top choices, but nevertheless we bow down to our robot overlords). Coincidentally this year, the third Friday in March fell on St. Patrick’s Day, further confirming what we already knew – the M4s would soon be consuming a fair amount of “happiness.”

Michigan holds its annual Match Day celebration at the North Campus Research Complex, replete with maize and blue balloons (including a grid replicating our famous block M). Students and families must wait until noon, when the envelopes with their futures inside can finally be opened. The celebration begins at 11:30 with opening remarks by Dean Raj, announcement of student awards and class-elected speaker, and the class video. This year’s video was amazing and hilarious, including attempts at singing by some of the students, among other photos and videos starring our class.

And then, it was time to open the envelopes. There was a lot of screaming actually, although the vast majority of it sounded happy. M4s at the celebration already know they have matched – they received a yes/no email on Monday so they could scramble (a.k.a. use the SOAP process) to find a residency position if needed. Nearly 99% of Michigan M4s matched in the initial match this year. After the initial celebration with their families, M4s started racing around the room, finding their friends and asking “Where are you going? I’m going to ____.”

At 12:30 p.m., Dean Raj called everyone back to their seats so that a certain few brave (very, very brave) individuals could finally open their envelopes. Why hadn’t they been opened yet? These students had elected to open their envelopes on stage and announce where they are headed in front of the room. May the odds be ever in your favor. After everyone had opened their envelopes, students also had the option to come up to the stage and announce where they were going. Dean Raj and other faculty announced the students in turn, interspersing names with the score of the Michigan-Oklahoma State basketball game. Jokingly, Dean Raj promised that if Michigan basketball was playing in the NCAA tournament during Match Day again, it will be shown on the big screen.

I’m thrilled that I was allowed to witness this momentous achievement in my friends’ lives. It was certainly bittersweet, realizing that so many are moving away from here and wishing I could join in their merriment. Next year, it will be my turn. For now, I’ll just continue giving a flurry of hugs to all of my graduating friends. CONGRATULATIONS!

*I matriculated with these students in August 2013 and completed my first 2.25 years of medical school with them. I left the class to complete a master’s in bioinformatics and rejoined the class below me.

Sara is a fourth-year medical student at UMMS. When not in the hospital, she can usually be found on the golf course or at a Michigan sporting event cheering on the Wolverines.

Almost M4s

It’s hard to believe that we now have less than two weeks before we finish our last M3 required rotation. On one hand, it seemed like that the clerkships have been flying by, but it’s also hard to imagine a time without the clinical knowledge I have amassed. Nevertheless, I’m very happy to be coming to the end of my M3 year. I have learned and grown so much, but I am looking forward to greater flexibility in my schedule and electives during M4 year.

March and April are still technically part of M3 year, where we partake in career electives before officially being considered M4s. We assembled our schedule for that back in November/December; now we’re working on scheduling the rest of our M4 year. Our current system allows us to select one class at a time for your top two choices in a similar system to the NFL draft. Then, after everyone has selected each of those individually, there will be an open enrollment period for choosing the remainder of our schedule. Picking our new classes definitely makes us excited (and a little apprehensive) about the year ahead. That means it’s time to start getting ready to apply for residency (*shudders*).

Right now, we’re still in the transition between curricula, so our system for core clerkships/M4 electives will not apply to future classes. The core clerkships will transition to M2 year, freeing up more time for career electives and M4 experiences as part of the Branches. I’m excited for the chance to have more elective time, especially since I plan to apply in Family Medicine. With my upcoming schedule, I will hopefully have time to explore complimentary fields that will prove valuable in my future practice. Like Dermatology, where I can learn to recognize the scary rashes vs the not-so-scary rashes and how to best manage them.

After our last shelf of M3 year at the end of next week, we’ll have two weeks of Intersession, including taking the M4 CCA (Comprehensive Clinical Assessment), UMMS’s version of USMLE Step 2 CS.

Around this time, the current M2s will also be entering the wards for the first time, beginning their “M3” core rotations. It’s definitely quite a ride, but an incredibly enjoyable one. Good luck to them!

Earlier this season, the Michigan Marching Band performed on the court during halftime at a Michigan Men’s Basketball game. Including the drum major performing a back bend!

Sara is a fourth-year medical student at UMMS. When not in the hospital, she can usually be found on the golf course or at a Michigan sporting event cheering on the Wolverines.

Hurray for 2017!

Well, 2016 is finally over! It was definitely a tumultuous year, with the highest of highs and the lowest of lows (and I’m not just talking about Michigan Football). I think everyone had a collective sigh of relief when the clock finally ticked over to 2017 with hopes for a much better year.

For me, 2016 was similarly a time of upheaval. I earned a master’s in bioinformatics and returned to third-year core rotations. Working with patients and helping them heal have been thoroughly enjoyable experiences, but I’m very grateful for the three-week break during the holidays. It was wonderful to sleep more (especially coming off labor & delivery nights…), spend time with family, complete the miscellaneous tasks that build up when busy, catch up on favorite TV shows, and, in general, do nothing. It was amazing.

The best part – I finally managed to finish embroidering and constructing my grandma’s Christmas present, a snowglobe pillow. I had been planning its creation since September but didn’t get around to actually embroidering it until mid-December. Thankfully, I managed to finish it with time to spare.

My time on OB/GYN is dwindling with only a week of clinical duties left before the shelf when we return. I have enjoyed my time here, especially the opportunity to see mainly young, healthy women without the laundry list of comorbidities that was standard on Internal Medicine. Next up, I’ll be on Psychiatry before we begin M4 electives in March and April. M3 year seems like it is flying by now!

Happy 2017, everyone! May your New Year’s resolutions last more than two days, and may you be happy and healthy in the coming year!

Sara is a fourth-year medical student at UMMS. When not in the hospital, she can usually be found on the golf course or at a Michigan sporting event cheering on the Wolverines.