Celebrations!

Following the graduation ceremony, Tony and I had a family party back at our house.  It was a great way to close out the day, surrounded by great company and good food.

My mom offered the suggestion of having beef on weck (excellent alternative to Tony and my idea--- pizza).  It was a huge hit, and went well with the variety of salads and sides that other people brought.  It was a huge group effort!

The celebratory toast was well-fueled by champagne and my father-in-law’s favorite… Red Cat.  Not a single drop was left in the several bottles finished by the end of the night.  Luckily, people had many hours over which to finish it.

I really enjoyed seeing my mom and mother-in-law together.  They had no problem entertaining one another!  Kit joined in too :)

The guys of course didn't have any trouble keeping each other entertained.  

Tony and I really enjoyed seeing Matt, Sarah, Lindsey, and James.  Tony and Matt at one point brought in some live music, as they went upstairs to play a little bit of bass.  Sarah, Lindsey, and I agreed that we need a girl’s day soon!  I am looking forward to visiting at Sarah and Matt’s house with Tony (and Butters) next week!

Kit and I used the opportunity to get some pictures together.  She educated me on the importance of “skinny arm,” to prevent this: Laura Gross Arm

The retake with “skinny arm” came out much better.  We will have to add Liz in also the next time we all are together.

Since my Grandmom passed away, I know it has been very hard for Granddad.  They were married for more than 60 years, and really were the loves of each others’ lives.  This weekend was the first time I really saw my Granddad enjoy himself since she passed in January.  He enjoyed talking with Pete and Paul, and I am sure entertained them with a few of his great stories. 

Lori and Mitch brought the cake, which was a huge hit!  The design was awesome, and not a single piece left by the end of the night.  

Butters desperately hoped for just a single piece (or maybe two).  He eyed the cake in between distributing puppy kisses to the guests.  He also accidentally got a few sips of champagne that someone had left too close to his level.  Luckily he didn't appear tipsy at the end of the night.

Paul, Jess, and Margie also stayed for the weekend.  Jess and Butters finally got a picture of their matching Tootsie-Roll shirts.   We had a very low-key time together after the eventful Friday.  We played Cranium (first time for Jess) and enjoyed one of Tony and my favorite local restaurants, Militello’s.  

What a great end a weekend of celebrations!

Graduation!

This past Friday, Tony and I graduated for the third and final time.   Even though we have been through high school and college graduation ceremonies, this experience really was the one we had been waiting for.  I remember sitting in Uris Library at Cornell studying organic chemistry thinking that medical school was an eternity away.  At the start of med school, 2012 was a fantasy time that seemed would never come.  And, sitting here typing a few days later, it still feels pretty surreal to finally be a doctor.

For the ceremony, Docapella (our medical school Acapella group that Tony and I participated in) had its final performance. 

It was pretty cool to go out in style singing the national anthem.  And, we had a lot of fun getting the ole' group together again in the days leading up to graduation.  It felt great to end on a good note (lol... bad pun).  

During the ceremony, we each received our rolled up diplomas (the REAL thing) one at a time.  When making our way to the stage, we handed a card to Dr. Severin (our dean for 1st and 2nd years of med school) with the phonetic spelling of our names for him to announce.  I think in some cases the phonetic versions were harder to make out than the real name.  Regardless, Dr. Severin made it look easy!

I snuck in a quick hug for my husband before we each were “hooded” on stage (having our graduation hoods placed on each of us by a few of the doctors whom taught us).  We all signed the “doctor’s book,” which contains the first doctors' signatures for graduating physicians from UB. 

My favorite part of the day was spending it with family and friends.  Even though we looked like we had just stepped out of the Renaissance in our silly hats, we made sure to get a bunch of pictures (thanks, Dad, for weathering the crowd to get the photos!!).  We missed my sister, Liz, but know she has been hard at work getting things underway with the new job!  Tony and I were grateful to have so many family members there to celebrate.

Fourth Year: The Final Stretch

Fourth year is pretty much amazing.  After the stress and intense learning curve of third year, fourth year is a brief moment in time where you can take a step back and take a breather.  There certainly are stressors between applying for residency and finishing up rotations.  However, it is the last time before residency that you can really have some solid break time.  And, by the end, you will be a doctor!

Rotations

I had a chance to take some pretty neat rotations this year.  There are a few required rotations (Advanced Medicine, Neurology, and Surgical Subspecialties), but the rest you get to choose. I completed 3 psychiatry rotations (general psych, psych ER, and hospital psych consults).   I participated in a Forensic Pathology rotation, assisting in autopsies at the county morgue.  Through a Faith in Medicine course, I worked with patients at Hospice and free clinics. 

Board Exams: 

We had to take 2 additional board exams: Step 2 CK (Clinical Knowledge) and Step 2 CS (Clinical Skills). 

CK:

CK is similar to step 1 in that it is multiple-choice format.  However, it is a bit longer and centered more on clinical medicine.  Luckily, most students find it to be a bit easier.  It took only 3 weeks to study for this one (vs. TEN weeks for step 1). 

CS:

CS tests your ability to interact with patients.  This should be a pretty easy test by the end of medical school, as it incorporates skills you have been developing over the last 4 years.  Largely, I think it is an expensive way to be sure that (1) you can speak English and (2) you feel comfortable interacting with patients. 

CS tests your ability to interview a patient, write up the encounter, and come up with a differential diagnosis (list of conditions the patient could possibly have based on symptoms).  The exam takes place in an office-based setting.  Unfortunately, there are only a few places to take the exam in the U.S.  Tony and I chose the closest site we could find, which ended up being Philadelphia, PA.

For Tony and I, the logistics of the CS exam were more challenging than the exam itself.  Stupidly, we waited for the weekend before the exam to arrange our hotel accommodations.  Needless to say, we didn’t have the best selection.   We ended up at probably the sketchiest hotel in Philly.  You know you are really in trouble when you see this on your room door:

However, I can’t complain too much as we did make it out alive and passed our exams!

Interviewing and the “Match” Process:

During fourth year, most medical students travel across the country interviewing with potential residency programs.  It is a time-consuming, exhausting, and expensive process.  However, most students find it to be a really valuable experience.  It allows them to get a feel for many programs and end up somewhere they really like.

All medical students must go through a “match” program.  For most students, they go through the NRMP match, which is a nation-wide matching system.  Med students can “couples match” (enter the process with another student) or match singly.  Students select their top choices for programs, and each program also ranks the students that have interviewed there.  If the program ranking is similar for both the student and the residency, the student will end up a resident at that location.  Students find out in March (Match Day) where they will be going! 

For Tony and I, our process was a little bit different.  As military medical students in HPSP (a program for students who will commit time to the military in exchange for a medical school scholarship), our match pool is smaller.  It is a more intimate process.  Students rank their programs, which can include military and civilian programs. In November, all of the specialty program directors for each military residency program actually meet together and decide on their residents.  It is not an automated system like the national match.  They take into consideration the students’ choices.  We couples matched through the military, and found out in December where we would be going.

Our interviewing process was MUCH easier than the average medical student.  We had the opportunity to interview with our program directors during our away rotation (medical rotation done at a military site).  We liked our programs so much that we didn’t interview anywhere else and only ranked one program each (this is NOT generally recommended, but worked our really well for us).

Away Rotation:

We LOVED our away rotations in San Antonio.  My away rotation experience really couldn’t have been any better.  I loved the patient population I worked with, which consisted largely of current military members and veterans.  In the psychiatry program, the staff and students worked so well as a team.  I could really see myself fitting into that clinical environment.  It was my first real look into residency life.  Also, Tony and I had a chance to catch up with our friends, the Sky family, as well as our military training friend, Mamie. 

The location was a pretty nice icing on the cake.  San Antonio is a beautiful city, with so many interesting places to explore including the River Walk, King Williams District, the Alamo, and a ton of great restaurants.  But, I would have to say that the weather really sold me.  I loved that it was pretty much always warm and sunny… a welcomed change after the seemingly endless cold winters in Buffalo (although this past mild winter was a welcomed surprise)

Letters of Acceptance and MATCH DAY!!

As part of the military match process, we received the great news in December that we had both matched San Antonio for our programs!  It was a HUGE weight off of our shoulders to know so early where we will be going.  It certainly made the rest of the year really enjoyable.

When March came, the rest of our classmates found out where they would be headed.  On Match Day (when everyone learns where they will be going), each student receives a sealed envelope that contains the program he or she matched into.  Even though Tony and I knew what was in our envelopes, it was great to watch the feelings of trepidation turned into excitement as our classmates received their matches.  We were so happy for all of our friends, and most students were really happy with the results. 

                   

Time off:

At my school, students are given three months of time off from rotations.  It is intended that these months be used for interviewing, studying for/taking board exams, and preparing for residency.  Due to the very small time commitment incurred by our interviewing schedule, Tony and I ended up with a lot of extra time off!

If you have been reading this blog or following my Facebook, you will know that Tony and I added a furry friend to our family.  Of course, raising a puppy (even though we cheated and got him at 6 months) was a time commitment.  We are enjoying watching him grow and fit in with our family.  It is now hard to imagine our life without him!

We also spent a lot of time with friends and family!  This is likely the last year in many where we can spend multiple holidays with family.  We enjoyed Easter, St. Patrick’s, Christmas, and Thanksgiving celebrations.  What a blessing! 

The last four years have been a whirlwind.  It was incredibly challenging working our way through med school, and it is a great feeling being at the end looking back. We look forward to the next step as we begin residency.  However, we are thankful for the experiences that led us to this point.

Second Year: Transitions

Second year was one of those strange in-between years.  You have survived first year, but don’t know enough to be fully let loose into the clinic.  The good thing is, you know what to expect.  You come back from a summer off (likely the last on one until retirement), and know you are going to jump headfirst into coursework again.  You know that classes and studying will dominate your days, and you will again get to know the lecture hall as well as the back of your hand. 

Classes:

At my school, second year continues with organ-based modules.  A few weeks are spent learning about the main organ systems including the circulatory system, respiratory system, digestive tract, etc. Clinical opportunities continue to be available, as every other week you still spend a day with a new preceptor. 

The Boards:

The biggest difference between 1^st and 2^nd year is the dominating thought on students’ minds: Step 1.  To become a licensed MD, you have to pass four large, challenging exams: Step 1, Step 2 CS, Step 2 CK, and Step 3.  Step 1 is notoriously known as the hardest of the step exams.  The test has seven blocks of 60 minutes, each block containing 48 multiple-choice questions.  And, the questions are hard.  It is quite possibly the most important score for residency applications.  Being the first exam, you aren’t quite sure which study methods will or will not work for you.  The test covers everything from first and second year of medical school, including a lot of foundation concepts that are not covered in the other exams.  And, of all of the boards, it is the least clinical.

My experiences with Step 1:

- Planning a wedding while studying for boards was a better decision than I thought it would be

- You really can study for 10+ hours per day… everyday… for weeks… and survive

- You need some entertainment during the day to break up the monotony of studying.

- Fewer are better.  Every time another student would talk about a new great book found to study from, I would get the urge to go out and buy it.  After a few weeks of jumping between different books (and wasting quite a bit of money), I discovered it is better to choose one or two thorough sources and do practice questions

- Get some exercise.  Running everyday kept me sane

- Don’t forget to go shopping.  You will need snacks

- Leave some time for vacation at the end

Living with Medical School:

Of all of the years of medical school, I feel second year was the most eventful in my personal life.  It was an exciting year, full of changes and milestones!

- Tony and I bought our first home!  After the disaster of living in our apartment, it was a welcomed change to have a place of our own.  We loved making our little 2-bedroom house a home.  Tony and I enjoyed our adventures to estate sales as well as repainting and redecorating.  We also learned that surprises come with new homes as well.  We didn’t realize it when we bought the house, but the previous owners had a little dog that peed on the carpet in the living room… a lot.  The carpet was only 3 years old (the date was on it), and it had at least 100 stains covering just about every inch.  It was not fun ripping that up, but were overjoyed to see the wood floors underneath. After refinishing the floors, it changed the entire feel of the downstairs

- Tony and I joined the acapella group at our school, “Docapella,” even though neither of us is especially great or even good at singing.  I discovered I am definitely more of a backup singer than a soloist.  However, we made a lot of new friends.  Erik became such a good friend to Tony and I that he became the best man at our wedding later that year!

- We made new friends!  This year, we started spending more time with Matt, another medical student, and his super cool girlfriend (now fiance!!), Ashley.  The dinners, football/super bowl parties, school formals, and movie nights that followed created some of my favorite memories during medical school.

- Tony and I got married!  Growing up, I never was the girl who walked around in my mom’s wedding dress imagining the day I would walk down the aisle.  For me, it has always been more about finding that special person than preparing for a single day.  Deciding on our wedding date was more last minute than we had anticipated.  We only had 4 months to plan the entire event!  We decided on a small wedding with a large reception a week later.

We were shocked by how much enjoyment came from planning this event.  Tony surprised me and really got involved in every detail.  We reconnected with old friends, and were blown away by the generosity from friends and family.  The wedding shower, bachelorette/bachelor parties, and wedding day itself were incredible.  

(Photos by Nathan Lyman, www.tru-e-motion.com)

I will never forget looking down the aisle at my husband and seeing how emotional he became when he saw me.  Certainly an amazing time in our lives!

My Medical School Journey

I make a habit of not blogging about medical school.  So much of my time is already dedicated to becoming a doctor. Between long hospital/clinic hours and returning home to study, every waking hour can easily be eaten up by medicine.  It is nice to have a few moments spared from research articles and treatment modalities.  This blog, photography, raising a dog, spending time with Tony, laughing with family, visiting childhood friends: these are the ways I have retained my humanity while becoming a doctor.  They are the small corners of my life I resist letting medicine take over.  I have learned you can obtain outstanding board scores, ace every class, read endless numbers of books… and still be a horrible physician.  It is incredibly important to find balance in any field of medicine.

As an exception to my own rule, I will be blogging about med school over the next couple of weeks.  Graduation is right around the corner.  In 2 weeks, I will forever put away my short white coat.  In 3 months, I will put on a gleaming resident’s coat with the freshly printed letters: MD.  Again, I will be at the bottom of another food chain but with many more responsibilities (and longer days to match).  This week I will be giving up some of my blog to this journey.  There will be 4 posts: one for each rewarding and challenging year dedicated to becoming a doctor.  Look for them in the coming days!