<p>Okay, so kind of a long time between updates.</p>
<p>When I last posted, I was pretty close to my interview at program F, and was having a very tough time deciding how I would shake out B, D, and F (with program E essentially being a safety). I mean it was literally, minute to minute what program I was feeling was best for me. I’d get to thinking about one thing I either really liked about a program or something I had misgivings about and the order would flip. In talking with some of my friends, I found out that I wasn’t alone in having trouble figuring things out, which was extremely comforting. Going on winter break, I ended up bringing all my “propaganda” the programs had given me home for the holidays so that I could sort through it all. What I ended up doing was taking a mental break from the whole process and just not thinking about medicine or my future for about 3 days. It was a tremendous calming effect. It also allowed me to come back to everything a little fresh and review my notes and then the information I had to see what I could make of it. </p>
<p>One of the big things I started looking at, on the advice of my attending from December, was the amount of elective time and how much was truly up to me to decide what I did. Without getting too much into specifics, every program is supposed to provide a spectrum of subspecialty experiences, but some programs give you a ton of wards experience and make you take the subspecialties as electives (usually in the form of '4 electives must be from the following list of 7 subspecialties) while others - like programs D and F dedicate months in their curriculum to subspecialties. So in some programs 10 residents might make up 10 entirely different combinations of subspecialty months, while at programs D and F, every resident gets exposure to the same set of subspecialties because that’s what’s required by that particular program. Maybe (as a hypothetical) instead of doing 5 general wards months as an intern, you do 2 and the remaining three months are split between doing a month of GI, a month of Infectious disease and 2 weeks of rheumatology with 2 weeks of Allergy/Immunology. </p>
<p>With this focus on electives available, programs D and F really separated themselves out. One of the reasons they are able to do this is because their centers are so large that they have subspecialty services that are consistently active enough month to month to provide consistent training experiences. But I do think it represents an important point. I’ve had a couple people tell me when they find out I want to do critical care that they think intensivists are like super-charged general pediatricians, and so with that in mind, I have to see as much as I can if that’s what I want to do. So I think going to a place where I know I’ll spend time, guaranteed, without having to pick one over another, is a plus. Additionally having the freedom to really make the elective months what I want them to be, will allow me to develop new skills and knowledge that will help me in my future.</p>
<p>So with all that said, as it stands right now, my top two are programs F and D. Currently, I’d say that while I go back and forth on which is my number one, F has been the more frequent #1 choice.</p>
<p>Program B has fallen into a solid #3 position, though, I had an interview today (Program I - yes I’ve been busy this week with three interviews…I’ll post about G, H and I over the weekend), which is making that #3 spot difficult as well. With 9 interviews down, I am getting tired. I still find it fun and exciting to go to these new places, and meet these people I might be working with for the next three years, but it’s impossible to have same level of enthusiasm as I did back in November when I interviewed at program B. As I’m going through my thoughts for the battle for spot 3, I’m definitely becoming aware of that difference. It’s leading me to wonder what counts for more - the enthusiastic assessment which has been a constant in my thoughts for the last 8 weeks or the more savvy, but perhaps slightly cynical views I’m carrying with me to interviews now?</p>
<p>The one thing that sticks out is how much this reminds me of the fraternity rush process. I think it’s particularly accurate for specialties like peds and medicine where the selling of positive points is a two way street. While I’m sure that even in radiology and derm, the programs try to explain why they’re great, I bet there’s a lot more expenditure by the applicants to prove they belong in one of these competitive fields. Anyways, the key thing is that I really have go by how much I trust the residents and faculty when they tell me about their program, much in the same way I had to determine which chapters I trusted during the rush process while a freshman in college. </p>
<p>Anyways, I continue to find comfort in the match stats and in knowing that I now have 5 programs I’d be really happy to end up at. I still have three more interviews to go next week, then I’m DONE, which is exciting but also a point I don’t think I really thought about getting to.</p>
<p>The NRMP opens on 1/15 to begin rank list entry!</p>