Changes

Hayley, Fourth Year Medical StudentIn two and a half weeks the familiar faces of the class of 2014 will be lining up with hats, robes, and tassels to celebrate the completion of medical school. Many people say “medical school has flown by!” But as I think back I can remember the different years, the different flavors, the different themes. There have been so many changes – new friends, new relationships, new habits, new life directions – in both my life and in the lives of those nearest and dearest to me. I want to tell you what I remember of the four years in medical school and if you are in one of those years and feel like your life will never change, you can feel comforted knowing change is always around the corner in medical school.

First year:

New. Everything was so new. I couldn’t believe I lived somewhere where palm trees grew! Centennial complex was shiny, new, and so big! The cadaver lab was formidable. The lectures were intense – and there was tons of information to learn. Many of the subjects I had already had in college – biochemistry, anatomy, physiology – so sometimes studying felt boring. Also I wasn’t always sure why what I was learning was important. The application often evaded me. But I was a Medical Student. I had that brazen confidence of first year students. I was used to being the top in college and confident my mind could grasp anything professors cared to throw in my direction. When people asked me what I was going to be, I confidently told them I was going to be a Doctor.

Second year:

Overwhelming. First year is hard. Second year makes first year look easy. So Much Information. I felt like I was constantly drowning in a sea of pathologies I should know. Cloistering myself in the study rooms in alumni hall kept me focused… I would last there 8 or 9 hours until I got too hungry or tired or my eyes couldn’t focus anymore and then I would trudge home with my bag of books, ear buds droning Goljan, till I got home and could get out a “fun” book – something like clinical microbiology made ridiculously simple – to read while I ate something. Then out for a walk with the flashcards I had been pumping out all afternoon, then back to my bedroom to flip through some powerpoints and pathology slides. Repeat times infinity – or at least that’s what it felt like.

So many flash cards

So many flash cards

I remember one time during second year I went to the bank and needed to talk to a teller about something. While I was waiting in line I almost started crying just from the stress of being out in public and having to talk to strangers. I felt like I couldn’t even cope in society because I was so sequestered all the time. And then of course, as second year students are wont to do, I began to worry I was developing agoraphobia (which I had just recently learned about). When people asked me what I was going to be, I told them I was hoping to be a doctor someday.

Third year:

Busy. Being on a clinical rotation is much like being in a small boat tossed by the whims of the ocean. Sometimes the sailing is smooth and you can go where and when you want, but often your direction is completely out of your control – your schedule fluctuates dramatically from one week to the next as your team shifts or your rotation switches. There is really no pattern that can be established. In my scant time off I was constantly reading review books to try to prepare for the inevitable board exam at the end of each rotation. But third year is no second year. Seeing the faces of patients, understanding that the hours I had poured into learning meant something, made a huge difference to my morale during third year. I was excited to read about sarcomas because I wanted to learn more treatment options to talk about with Ms. X. I wanted to know why enterocutaneous fistulas stayed open so our team could move Mr. Y toward resolution of his large EC fistula. Everything had a lot more meaning for me. When people asked me what I was going to be, I told them I was learning to be a doctor and hoping to go into obstetrics and gynecology.

Asleep in the physician’s lounge between surgeries – instead of waking me up when the next surgery started, my attending texted me this picture.

Asleep in the physician’s lounge between surgeries – instead of waking me up when the next surgery started, my attending texted me this picture.

Fourth year:

Unique. I feel like no other year in my life will ever be quite the same as the fourth year of medical school. The first third of the year is intense – sub-I’s (sub-internships – where you attempt to play the role of an intern on your team) back-to-back, collecting letters of recommendation, the step 2 board exam, filling out the online application forms and the stress of wondering if you will receive interviews (you will – unless you completely disregard Dr. Shankel’s advice).

Then the middle third of the year is consumed with flying all over the country, evening dinners with crowds of people you don’t know, endless small talk, and always – “why do want to go into obstetrics and gynecology? Why do you want to come here?” Cities I interviewed at included the greater LA area, Palo Alto, Seattle, Portland, Minneapolis, Rochester MN, Denver, Chicago, and Boston – as you can imagine it is quite a feat to coordinate interviews especially when interviewing in specialties like OB-gyn when the program often only has 2-4 days on which they interview between October and January. Some programs just told me a day that I was going to interview.

One of my interview trail essentials – dry shampoo.

One of my interview trail essentials – dry shampoo.

When the flurries of interviews are over and the ranklist is formulated there is an interminable period of waiting. Waiting. You are aching to go to your number one, but you try to stay on okay terms with the top six on your list so you won’t burst into tears on match day.

Then match day comes. The tension is unimaginable. It is the culmination of everything you have been striving for tirelessly for the past four years. I remember the long hours in the cadaver lab first year, the even longer hours bent over pathophysiology notes during second year and the sleepless nights on surgery in third year. Did it pay off? You open the envelope and suddenly there are no more possibilities. There is just the one reality and that is your future.

And now, when people ask me what I’m going to be, I tell them I am going to be an obstetrics and gynecology resident at University of Washington next year.

Extremely happy on match day!

Extremely happy on match day!