Dear Family and Friends....

My dear family and friends,

Please understand that residency is hard. I love being a doctor and it's what I've wanted to be since I was six years old. But that doesn't mean that every day is fun and easy. I work 12 hour days, sometimes longer. And in those long hours I do more than just see kids in the office with strep throat or adjust patient's blood pressure medications. I not only have to take care of patients in clinic, but I see patients in the hospital. I take care of people who are really sick and dying, and then I have to tell their families that their loved one is dying. I have to make important decisions about which antibiotics to give someone who's septic. I have to closely monitor their kidney function. I have to manage their laundry list of medications. I have to inform patients that they have cancer. I make life and death decisions on their behalf, including deciding when to stop treatment and let them die.

On top of all that, I'm responsible to for answering phone calls from patients. I have to refill their medications. I send out referrals. I call other specialists to talk about their care. I type up letters to inform them of their test resulst. So when I'm working in the hospital delivering babies or in the ICU, I still have to be responsible for my dozens of clinic patients. And in between all of that I'm actually expected to read and learn more stuff (as if medical school wasn't enough). This involves me going as far as looking up medication dosages on my iphone while on the toilet when I have two minutes to actually go to the bathroom, and attending lectures during lunchtime. So even when I get to eat, I have to listen to a lecture about hemorrhoids and anal fissures.

I guess what I'm trying to say is that as much as you think you know what I do for a living, I feel like you never really know. This is why I'm telling you all this. Because my job not only is physically demanding and exhausting, but it takes an emotional tole on me. And then I come home and have to be a wife, mother, daughter, and friend.... which certainly isn't any easier. So please forgive me for those days that I come home later than usual, or if I don't answer your phone calls for weeks on end, or if I can't go to that family function that everyone else is at. It's not that I don't want to see you or talk to you. It's that I'm a resident. My time is not my own. I have hundreds of patients that I will see and be responsible for throughout residency, and it's a big responsibility.

Just know that I appreciate all your support, but please try to understand that these next three years are probably going to be the toughest of my life and I'm probably going to need you more than ever (even if it's just to listen).

Love,
Maria

One Month of Being a Doctor

As you can probably tell from my month-long absence from blogging, my first weeks of residency have kept me quite busy. After orientation I started off with Maternal-Child Health (which is just a fancy way of saying "OB & pediatrics") as my first rotation. Quite honestly, it's been such a surreal experience that thinking about it just now has perpetuated a revelation that I am actually a real-life doctor. It wasn't being in the hospital or seeing patients or anything else really that made me feel like a doctor because it's something I was so used to doing as a med student. What I think really makes it real is that I was the one making decisions for my patients. Which medications to give, which labs to order, when to discharge the patient.... all these questions were usually defaulted to the physicians I was working under, but now it's on me.

What's even more crazy is that I actually got to deliver babies! Seriously, I brought life into the world. Really, it was all the work of the amazing moms who actually had to do it. I was more or less just a glorified baby catcher. (They should design some sort of sterile catcher's mitt for doctors because those suckers are slippery when they come out.) Delivering babies is by far the most gratifying part of my job. It's one of the happiest moments in a couple's life and you're there to share the experience, and most of the time they're so grateful to you. I still tear up and get all sappy afterwards when I get to put the baby in the mom's arms for the first time.  Definitely made all the long hours worth it.

In addition to delivering healthy babies, I also got to take care of them afterwards. But with the good comes the bad, and unfortunately there were also some not so healthy babies. It's always hard taking care of sick people, but when they're tiny sick people it's even harder. Everything you do has to be that much more meticulous and you're constantly on edge, but the reward is SO much better when they finally do get better (and the majority really do get better). And then it's bittersweet when they get to finally go home.

I was really nervous starting out residency on such an intense rotation, but I'm really glad I did. There's no easy way to start residency. You just have to dive right in, not just getting your feet wet but getting soaked from head to toe. And now that I'm on a rotation where I actually have a bit of time to breathe (clinic and community medicine), I can really appreciate where I'm at right now. I'm a doctor. I'm really here, doing what I love at an amazing residency with some pretty awesome fellow residents. And even though I know the next three years are going to be pretty tough, if my first few weeks are any indication of what it's going to be like, then I have a feeling I'm going to love it.

Well... Here Goes Residency!

I officially started residency yesterday, although I have a week and a half of orientation, EMR training, ACLS, and lots of meetings before I actually start "working". It's hard to describe what exactly I was feeling when I walked into the conference room Monday morning to meet with my fellow residents and the residency director. I wasn't too nervous since I was quite familiar with the hospital already after spending two and a half months doing rotations there fourth year. I also met some of the other residents last week at a shin ding at my house. Plus, I already knew the residency director because I worked with him before.

When I pulled up to the hospital I got the honor of parking in the physician lot. You know you made it when you get to park in physician parking. Quite honestly, though, I really thought that I was going to walk into the hospital and someone was going to tell me it was all a hoax and I wasn't really a doctor. Thankfully, that did happen. After meeting the remaining of the residents I hadn't already met, the residency director started his welcome spiel. I knew it was going to be a great three years since he started off by playing the beginning of the very first episode of scrubs. (He said he was going to walk in and act out a scene from the first episode of Grey's Anatomy, but his family highly discouraged it).

I'm not gonna lie, the rest of the day was pretty boring. A VERY long morning of hospital orientation mumbo jumbo, followed by ACLS training. I had just done a course in January, but still had to do it. I didn't mind though, because honestly it was a good way to get to know my fellow residents a little more. We had to do another whole day of ACLS training today, which I'm proud to say we all passed! So feel assured that the family medicine residents are fully qualified to resuscitate you should you go into cardiac arrest.

My official doctor ID badge!

Though it's only been two days, I can tell already that I'm going to get along with my fellow residents. The program did a great job of picking a group of people that will mesh well together. And a huge reason why I even wanted this program in the first place was because I like the residents a lot and thought I would fit in well. If you're gonna spend three years and countless hours working with a group of people, it's definitely a bonus if you all get along and like each other. In the end I could really work with anyone, but I'd rather work with people who are my friends. So here's hoping to making many new friends over the next few years!

The Day I Became a Doctor

So it's been about a month since I've posted anything. As a matter of fact, my last post was the day before graduation. And since then it's been such a hectic past couple of weeks, I took a bit of a sabbatical from blogging. It wasn't just that we had to move, my husband had to work two weeks straight, and I had to get a bunch of stuff done to prepare for residency..... I really just wanted to spend all the time I had to be with my boys. Now I'm starting my first day of residency tomorrow, so what better time than to start blogging again!

To fill you in I have to start where we left off, which is med school graduation. I keep telling people that it felt like when I got married. There were years of preparation put into this big event, so much build up and excitement, and then it felt like it went by so fast. I tried so hard to just live in each and every moment of the day, but just coordinating it all was so distracting. You see, I had two graduations. The first of which was with the entire university (undergrads, nursing students, etc.), then we had what's called the "hooding ceremony". The hooding ceremony is the real deal. It's just for the medical students, and it's where we get "hooded" with this fancy piece of green velvet fabric symbolizing that we are officially doctors. 

Dr. Doane, my hooder. Such an amazing physician! 

After spending over three hours and listening to over 1,000 names get called at the first graduation, I was anxious to get on to the hooding ceremony. What was so memorable about it was that it's full of all this old school tradition. From the entrance music, to the actual hooding, to the oath we all recited at the end. We're talking YEARS of tradition. Each and every doctor who graduated before me essentially went through the same thing. What was especially great, was that we could pick a physician to hood us who we knew personally. So I asked one particular doctor who I did my third year family medicine rotation with, who was really the one to inspire me to go into family practice and has been a wonderful role model for me.

UNECOM class of 2012

Got my diploma!

When we first walked into the auditorium, I remember just looking all around and being completely overwhelmed with emotion. All these people surrounding us were the people who supported us throughout the last couple years. Our parents, family, friends. Then looking at my fellow classmates and feeling this sense of camaraderie, and being grateful that I hadn't gone through it all alone. As I walked up onto the stage to get hooded, it felt very surreal. Was this really happening? I was in school for so long (especially after taking an extra year) that it felt like a black hole that I would never get out of. And here I was, five years later. I was finally a doctor. To prove that the whole thing wasn't some hoax, they actually gave us our real diplomas afterwards. Seriously! There was no taking it back. I officially graduated. 

I can't even express how memorable that day was and how blessed I felt to have my family and friends there to cheer me on... my parents, husband, Killian, my cousin Chrissy (who's my best friend), and Dr. Doane (who hooded me). All of them have played such an important role in helping me get to this point. When I was just a little girl, I told my parents I wanted to be a doctor and from the first time I said it, they have always supported me and told me I could do it. Then there's my patient husband, who has stuck by me and supported me throughout it all... long nights of studying, moving a billion times, dealing with my anxiety and freak outs, and being such an amazing dad that we could actually have a child in the middle of it all. Speaking of my little boy. Despite the struggles of raising a child, he's been my source of balance and grounding throughout it all. If I had a rough day, just coming home to him melted it all away. 

My wonderful, supportive, loving family!

Even though it's been a crazy last five years between being a medical student, getting married, and having a baby, I wouldn't change a thing about it. I say all the time that everything happens for a reason and I KNOW that I wouldn't even be in the same place I am today if I hadn't done it this way. Quite honestly, I don't even know if I would have made it through school without having my son. You see, after I had him and took time off, it gave me time to really put thought into what specialty I wanted to do. Plus I think the time away from it all helped me to reboot and refocus when I started back up again. Not that having a newborn was at all relaxing or anything, but I love being a mom. And I loved that I made a conscious decision not to delay having a family just because I was becoming a doctor. 

So fittingly, I have officially changed the name of this blog. Because I have actually survived medical school. Now I'm back on the bottom of the totem pole as a first year resident, and my next challenge is to survive three years of residency. I'm sure it'll be hard, but I'm really looking forward to it. And who knows what'll happen along the way. If medical school was any indication, I'm bound to be in for a crazy ride. But I'm right where I'm supposed to be and doing what I love to do. Life truly doesn't get any better. 

The Day Before I Become a Doctor

You may think that even though I've finished all my required credits, fulfilled all my hours of rotations, passed my boards, and signed a sweet residency contract that I'm pretty much already considered a "doctor". Well, not quite. Tomorrow's my graduation day and as far as I'm concerned, I won't officially be Dr. Boylan until I walk across that stage. 

It has been a whirlwind of a week, coming back up to campus for all the graduation week events. Dinners with the class, meetings with the Dean, a big fat envelope from financial aid telling me I basically owe a gazillion dollars..... And finally my family will all be arriving this evening. I am overwhelmed with emotion and excitement. Even just sitting in Panera right now writing this post, I'm looking around thinking, "Here I am just an ordinary woman, but in 24 hours I'll be a doctor."

Anyways, I have lots to go do (like enjoy this gorgeous weather we're having up in Maine). I just want to thank all my friends and family in advance who are taking time out of their busy schedules to come celebrate this exciting event with me. I love you guys!

My last time on campus as a medical student.

Wordless Wednesday: Five Years of Becoming a Doctor

So I'm packing to head up to school for graduation week. With all this nostalgia floating around my head, I thought what better than to just post some of my favorite pics from throughout my five years of medical school. Enjoy!

Happy as a clam at my white coat ceremony first year!

My proud family. Little did they know how rough the next five years would be!

Making Strides Against Breast Cancer walk 2007

AMA conference in Hawaii 2007

Medical Spelling Bee! 

Me and the bestie at the Spelling Bee!

Winners of Osteostache 2009

Me and Ken after I did his hair for Osteostache!

Judging the Osteostache competition and showing off the prizes!

Portland Seadogs game spring 2009! 

Bacteriology review. I was Mycoplasma. 

Mycoplasma Pneumonia

Got our numbers for "the lottery"... to find out where we go third year.

Two of my favorite med school pals at my wedding summer after second year.

The wonderful third year crew at Lakes Region Hospital.

Last but not least, my last day as a medical student!

Graduation pics to come :)

Mom's the Word!

I woke up this morning to the voice of my little boy saying "Ma! Ma!" as him and my husband were plotting to come wake me up with a cup of coffee, flowers made of tissue paper, and red velvet cupcakes spelling out "Happy Mother's Day". It was just what I needed! It'll be my second year as a mom, and even though in some ways it's gotten a lot tougher (battling a soon-to-be two year old), it certainly keeps getting better. Especially when you get to have coffee and a cupcake for breakfast just because you're a mom!

Me with Killian at 1 month old.

I was looking back through my photos of when Killian was first born. And even though it really wasn't that long ago, I feel like so much has happened in the past 22 months that it's hard to remember what it was like when he was first born. Of course I could never forget waking up at five in the morning and with steady contractions, the fourteen hours of labor, or the two and a half hours of pushing. Then staying up till two in the morning just staring at this brand new beautiful little baby boy. I remember the instant feeling of complete unconditional love and joy that I had him. And I knew my world was forever changed.

My handsome little man today.

Now almost two years later.... we have a walking, talking, very persistent, super silly, and amazing loving little boy. I just can't believe how much has happened between now and then. Being a mom has been the best and hardest thing of my life. Each day you are responsible for teaching your child how to behave, how to act, how to talk, how to not do things that will injure himself. It's exhausting! But dispersed through all that responsibility of trying not to mess up your kid, are moments of sweet perfection. Like when he climbs up on your lap and settles into your chest and you become intoxicated by the smell of his hair. Or when he comes up to you and puckers his lips, wanting a kiss just because.

My mom with Killian when he was born.

And what Mother's Day wouldn't be complete without paying homage to my own mom. She has always done so much for me and never expected anything in return. Not only has she been a great mom to me, but a fantastic grandmother to my child. She has been one of my greatest cheerleaders in life, even when she had to drive me to cheerleading practices and competitions when I was younger, or make a cake at the last minute for me to bring to school (because I forget to tell her I volunteered to do so), or bring me to a hypnotist so I could get over my fear of doing a back handspring in gymnastics (which never did work).

Looking back on all my mom's done for me, I can tell that I will certainly have my plate full in the coming years with Killian. Everyone says that being a mom is a selfless job, but the reward of getting to see your child grow and turn into the person they're born to be is priceless. I can't wait to bring Killian to hockey practices or stay up late helping him with his science fair project (which will win first place) or help him pick out an outfit for his first school dance. So much to look forward to. I love being a mom and all that it brings.

So on this Mother's Day I am very thankful for having grown up with such a caring and loving mom who would literally do anything for me. And I'm also grateful not just because I got to eat a cupcake for breakfast, but because 22 months ago I got the greatest gift of all when I became a mom. So happy Mother's Day to me and Happy Mother's day to all my friends and family who are moms. You have all been an inspiration to me in one way or the other.

Happy 1 Year Bloggerversary to Me!

It's hard to believe that it's already been a year since I first started my blog. I honestly thought in the beginning that it'd be something that fizzled out quite quickly over time, especially being so busy with medical school, being a wife, taking care of my little boy.... but surprisingly I've kept up with it. Sure, I could have written a bit more here and there, but over 70 posts in a year is impressive for a first time blogger!

I always told myself that if I ever thought this was a chore or a task to get done then I wouldn't do it anymore. I wanted my blog to always be something that was therapeutic and fun for me, so if I ever felt like it was something I "had" to do then it just wouldn't work. Thankfully writing this blog is still quite enjoyable for me and hopefully just as enjoyable for those reading it.

It's typically on your birthday that you reflect back on the year that passed, but today I've actually put more thought into it than on my birthday. I think it's because looking back through my posts over the past year, I can see how far I've come. I can honestly say that I'm a different person... I've grown to be more confident in myself and not worry so much about what others think of me. And by writing my thoughts and feelings and putting them out to the online world, I've become more vulnerable but strangely comfortable with it.

I was away over the weekend for a women's physician mentoring weekend in Maine and one of the things we did during dinner was go around the room saying one thing we're grateful for, something we're good at, and something we're struggling with. I thought it was a great way of gauging where I'm at today and reflecting on my future. So with that said, I'm grateful that in just a few short weeks, after five longs years of hard work, I'll finally be graduating medical school. I'll be starting my dream job as a family practice doctor, which something I absolutely love to do (and not a lot of people can say that they love their job).

What I think I've been good at is being able to balance my life as a medical student, a wife, and a mom. The key for me has been to always recognize that being a doctor is my career, but my family and my friends are my life. And it's the people who surround me who give me strength and support, and truly help define the person I am today. Without them I couldn't be the doctor I will soon be and for them I am forever grateful.

And finally, something I struggle with is trying to not always beat myself up, especially over the small things. I always feel like I'm never doing enough as a medical student or a mom or a wife. After all, we are all our own harshest critics. But in all seriousness, I need to let go sometimes and just be happy with myself. Whether it's regarding my parenting skills, my physical appearance, or my ability as a future physician. There's always room for improvement, but no need to bash yourself along the way.

So to wrap things up, I'd like to thank all those who have been following along in my journey. I truly appreciate every single person who has taken the time to read my words and those who've left some great comments. Even if just one person was getting something positive from my blog, then it's all worth it. Please stick around to read about my journey through residency and balancing being a doctor and a mom.

So Long Crib, Hello Toddler Bed

After my little guy (and my husband) recovered from the plague that was Hand, Foot, & Mouth disease, we thought we were getting back on track. Killian was happy and playing like his usual self. He went back to sleeping in his crib after spending a few nights on the air mattress watching Mickey Mouse Clubhouse nonstop. Everything seemed to be back to normal.... then something switched.

It was as if a demon had possessed my child. He went from the boy who I used to brag about how good his sleeping habits were to a full blown insomniac. Every time we put him in his crib this week for a nap or for bed he'd scream bloody murder. And I'm not one to just give in easily, so I let him cry. Sure enough, though, he had a bit more stamina that I did because 20 minutes later he was still at it. Then I'd go in and give him a binky and lay him back down, only for him to get right back up and at it again. It was like this for up to two hours one night.

So I did what any other mom would do when they were at their wits end. I googled. I thought maybe he developed some sudden phobia of his crib, whether it was from when he was sick and in pain, or some weird thing he heard or saw one night. Who knows, but when I googled it I found out that it really isn't that rare. Especially at this age. From about a year and a half to two years old kids start developing fears and phobias. What makes it worse is that they can't reason their way out of the fear, especially since you can't explain to them that the shadow they saw on the wall isn't a monster or that they won't really get sucked down the tub drain.

He also very well could be going through a phase, but this is one phase I wasn't going to be able to put up with long seeing as we already went through a week of not sleeping when he was sick. So I found some really great advice on my google search, and it seemed the best thing to do was eliminate what was making him freak out: his crib. So last night we converted his crib to a toddler bed, and tried to make it as comfy and inviting as possible. Then we made a huge deal about how awesome his big boy bed is and had a little party in his room to celebrate.

We went through his normal bedtime routine: Tubby, pjs, milk, story time.... lots of story time. Then we tucked him in and left him like we would in his crib, but he was having none of that. So I brought him back to his bed and sat on the floor next to him and exactly four minutes later he was out like a light. My husband and I went to bed with much anxiety just waiting to see when he'd wake up and freak out running into our room. He did get up once at one in the morning, but we just walked him back to his bed and he went right back to sleep. The best part was when he woke up in the morning, he just waltzed right in our room and hopped on our bed.

I was more nervous about nap time today, but we did the same routine of milk, story time, and sitting with him for a few minutes before he fell asleep (as evidenced by the picture below). It's been almost two and a half glorious hours of nap time so far, which is much improved from no nap time yesterday. And I finally got a little time to myself to just breathe.

Another milestone accomplished, another crisis averted (for now). Man, being a mom is rough. Just when you think you've got things down, a curveball gets thrown at ya. Just one of the joys of being a parent.

For those who are contemplating it, here's a great article on how and when to transition your child from a crib to a toddler bed: Tackling the Toddler Crib-to-Bed Transition. Good luck and God's speed.

It's not the man that makes the mustache, but the mustache that makes the man.

My husband turned 30 last week and I wanted to do something fun and unique to celebrate. So what better than having a mustache bash? I've always poked fun at him for not being able to grow too much facial hair, despite all of our friends being able to create facial hair masterpieces. It was the job of all the (male) guests to show up wearing their best mustaches, and I provided ones for those (women) who couldn't muster one up for themselves.

I've never heard of a mustache bash before until I saw it on Pinterest. Apparently it's a popular theme for a little boy's party or a baby shower for a woman having a boy. My first order of business was making mustaches and bow ties on a stick. Then I went hunting for anything mustache-related. I was quite surprised at just how much mustache paraphernalia there is! I got these cute little mustache picks to top off the Irish car bomb cupcakes I made. Then there were the mustache straws to drink some Boylan root beer with. My all time favorite were the mustache finger tattoos.

Everyone got to vote for their favorite mustaches, and the winner went home with a new razor and shaving kit (if they so choose to actually shave off the "award winning" mustache). Really what more do you need than some good friends and sweet 'staches? We had such a fun time, and it was by far my favorite themed party. My hubby is not only 30, but officially a man now. A man with a mustache... sort of.

Hand, Foot, & Mouth... YUCK!

I mentioned yesterday that the little dude wasn't feeling too great. Well, as his rash started spreading and he started to scream every time he ate anything my diagnosing skills started to hone in. Fifth disease, chickenpox, measles?! I finally came to the conclusion (with validation from the pediatrician) that he had Hand, Foot, & Mouth disease. It's a stinky little virus (the Coxsackievirus, to be exact) that causes fever, followed by a rash that usually presents as blisters on the palms of hands, soles of feet, and sores in the mouth.

Well, the reason why it took me so long to even know it was that was because he never got the blisters on the hands and feet, but he did get a nasty blistery rash on his bottom. He also has the rash all around his mouth and spread all over his body. Apparently, it commonly presents this way. So my poor love bug literally can't eat anything without screaming in pain because of all the sores in his mouth, and can only tolerate sips of water. My hubby and I were up pretty much all night with him. 

In the end there's no real great treatment for this stupid virus, except tylenol and ibuprofen for the fever and pain. Not to mention lots of snuggling and kisses :* Oh, and in case you're wondering... yes, it's contagious, but most adults have been exposed to it at some point in there life and are already immune. That, or our immune system is strong enough to just fight it off. Hopefully in a few days he'll be on the up and up, and he'll be back to his rambunctious self. 

P.S.

 Hand, Foot, and Mouth disease is not to be confused with "Hoof and Mouth disease" which is seen in cattle and swine.

Happy Easter, Happy Spring

After spending the last couple weeks on a mini-vacation from my blog, I've finally returned. It's funny how now that I have more time on my hands, I don't blog nearly as much as when I've been super busy with medical school. Probably because I've been enjoying all time I get to spend with my two favorite boys. There's lots to fill you in on!

Well it all started a few weeks ago when we had a week of absolutely gorgeous weather here in New England. Coincidentally, it was the week of my birthday. My hubby took the little man and I to the zoo as a birthday surprise. Killian had such a blast running around and seeing all the animals (especially the monkeys). Then on my actual birthday we went to the beach (Yes, it was THAT nice out!). We spent the morning basking in the sun and playing in the sand and not going in the freezing cold water. 

A week later Killian went to his special girlfriend's birthday party where there was a giant scary Elmo, who Killian wasn't at all scared of. He ate cake for only the second time in his life and left with a new pet fish which he named "Bobo." 

Then came Easter.... Killian scored big this year with the Easter bunny who left a basket full of pretty awesome toys (and no candy). We hunted for eggs, and had a pretty great day with the family. Oh, and I made some pretty delicious Italian Easter bread.

Which leads us up to today. The little man's not feeling too great. The last few weeks must have been more excitement than he could handle because he threw up last night and has had a fever all day today. Most likely it's just a virus, which just means that he gets lots and lots of cuddles and fluids. Hopefully he'll be back to himself in a day or two. 

In the meantime, I will try to be a better blogger. I'm trying to come up with some good informative topics for you all so that I'm not just rambling on about myself. I also need to think of a new catchy title for my blog since I'll no longer be a medical student and will be an actual doctor! If you have any suggestions, feel free to let me know!

A Perfect Match

As you all know from the buildup the last few months, this past friday was The Match. The day in which the future of every fourth year medical student is decided. Of course they have to torture you by having you wait until exactly 1pm to get that oh-so-important email. Each school has it's own way of doing The Match. Some have ceremonies where students get envelopes and they all open them at the same time. Others have each student read out individually in front of the class where they matched. My school's kinda lame and we don't have anything like that. We just get an email.

So my day started like any other. I woke up, went to the gym to distract myself..... hours later, minutes before 1 o'clock, my husband and I are sitting next to each other couch waiting. At exactly 1pm I open up my email to find that I have matched at NH-Dartmouth Family Medicine Residency. My first choice. The joy and happiness of it all just overcame me. Along with a sense of complete and utter relief. The last fiver years of our lives culminated in this moment. This is what you work so hard for in medical school, to get the residency of your dreams. And I did.

My Last Day as a Medical Student

Pic of me on my last day as a med student!

Four and a half years ago I stepped onto campus as a first year medical student. I vividly remember everything about that day... Getting a tour of the campus, getting my picture taken for my ID, getting sized for my (short) white coat. One of the most exciting (and scary) days of my life. Little did I know that it was only the beginning of the hardest, yet happiest, five years of my life. Hundreds (maybe thousands) of hours of studying, long days in hospitals and clinics, all mixed with getting married and having a baby.

So for the first time in five years, when my alarm went off this morning I woke up with a smile on my face. Today was my last day as a medical student. As of today I have sat through every hour of class, completed every exam, finished all my required clinical rotation credits. Today was the final time that I would introduce myself as a "medical student", and the last time I would have to wear the short white coat.

Smoothie time!

I started my day off like any other: getting some morning snuggles from my little man, followed by showering and getting dressed, having a smoothie for breakfast, and then off to the hospital. I met up with the attending in the ambulatory care center where we did a diagnostic colonoscopy on a patient with metastatic colon cancer, an upper endoscopy, two liver biopsies, and another colonoscopy. Then my day was done. I walked out of the hospital for the last time as a medical student, and if I end up returning to the same place for residency, then I'll return as a physician. Quite fitting if I say so myself.

Snuggling with my little man.

So now I'm home hanging out with my boy and basking in the fact that I get to spend the next few months just being a mom. I don't think it's actually hit me yet that I'm really really done, but maybe after The Match tomorrow, reality will hit me a little harder. Or maybe it won't even be until graduation (see countdown ticker on right side of page). Either way, the next time I step foot in a hospital, I'll be a resident physician. I'll get a tour, get my ID picture taken, and get sized for my (long) white coat. Sound familiar?

Black Monday? Not so much :)

Today is what is known in the med-school community as "Black Monday". Today is the day that fourth year med students find out if they matched at a residency program or not. Here's how the day goes.... at exactly 12pm you get an email from the NRMP saying either, "Congratulations! You have matched!" or "Sorry, you have not matched :( " Well, I don't exactly know what they say if you don't match, and nor do I think they put a frowny face, because I was lucky enough to get the happier of the two emails. Yes, my friends. I will be spending the next three years happily employed as a family medicine resident. However, here's the messed up part: If you do match somewhere, then you won't find out until Friday (4 days from now!) where in fact you did match. If you think that's nuts, then try being an actual med student and having to go through it yourself.

So you may be asking, what happens if you don't match? If you don't match, then you have an hour before the electronic residency application service opens up for you to submit your application to programs that have unfilled positions. And unfortunately, there may or may not have positions available in the field in which you were originally applying to. Meaning, that competitive specialties like Dermatology or Anesthesiology most likely have all their spots filled, and you'd be stuck applying for a Family Medicine residency (which in my mind would be a good thing, but I'm biased). Even worse is that you probably will end up in a location not exactly where you were hoping to be in the first place. So not an ideal situation if you don't match.

Thankfully, I did not have to endure the kind of torture involved in scrambling for a spot. Like I said, I got the good email. The minutes before my iphone ticked down to 12:00, I literally thought I was going to vomit in the doctors lounge at the hospital. Every horrible thought and scenario ran through my head, and I completely forgot all the good feedback I got from programs I interviewed at. Then when I finally got one of the greatest emails of my life, I literally screamed with joy (no one else was in the doctor's lounge with me, but even if someone was I probably still would've screamed). The relief that overcame me was incredible. All the hard work put in over the past five years paid off. 

So I did what any good medical student would do. I took the afternoon off. I went home and high-fived my husband. Went for an amazing run with him and our dog on this beautiful day. Then I played with my wonderful little boy outside all afternoon. It was literally one of the most perfect days. Now I just have to endure four more days before finding out where exactly I matched at and where I'll be spending the next three years as a resident. Strangely, I'm not as anxious as I thought I'd be because I'll honestly be happy at any of the programs. Of course, I'm really hoping to get my #1 choice, but I didn't rank any program I knew I'd be unhappy at. 

So come Friday I'll share with all of you where I matched for residency. And I'm sure that day will be just as perfect as today's. 

No "Butts" About It!

My final two weeks as a medical student I'm working with a team of gastroenterologists. And I have to say, I have never seen more butts in my life! Of course, the bread and butter of a GI doc is doing colonoscopies. So naturally they see a lot of "behinds" before taking an interesting journey up the rectum and through the colon with a snazzy camera. I akin it to watching an episode of the Magic School Bus and playing a video game at the same time. If you've never seen a colonoscopy before, check this video out on youtube:

Of course, I've been doing a lot more than just traveling up people's colons. I've seen my share of GI bleeds and pancreatitis (which is a true reflection of the plight of today's society, aka: everyone's an alcoholic these days). Then you have the run of the mill gallstones and cholecystitis, meaning people eat too much fat. And of course there's lots of other cool disease. What I like so much about the gastrointestinal system is that everything is so mechanical. Something breaks and you can just go in and patch it up. Polyp in the colon? Remove it. Stricture in the esophagus? Stretch it. Simple. Easy. Saving lives.

So this week will now be my last as a medical student. I'm trying to take in as much as possible and really learn instead of slack off (kind of like cramming in as much as you can right before a big test). But I might be working a little harder to try to distract myself from the upcoming residency Match. Five days my friends. Five days. And hopefully at that point I'll have some good news for you all. In the meantime, enjoy my little video and if you're 50 years or older or have a family history of colon cancer, please schedule a screening colonoscopy.  1 in 20 people are diagnosed with colon cancer, and a colonoscopy could save your life!

March Madness

Cheers to what I hope the be one of the greatest months ever! And it's not because of college basketball. This month I will complete my last few weeks of clinical rotations, which means that in 12 days I will have successfully finished my very long and tortuous training as a medical student. I spent last month fulfilling my surgery elective requirement working with an ENT doctor. I have to admit that I was seriously dreading doing a surgery rotation, mainly because that was the one block during third year that I absolutely hated. It may have had something to do with the fact that I was in my first trimester of pregnancy and got banned from scrubbing into long procedures because I frequently had to leave the OR to puke or pee.

A happy pair of tonsils!

Anyways, as I was saying... I was not looking forward to four weeks of surgery, but I made a resolution to try to make the best of it and really learn from it. So I picked a specialty that I thought would be particularly useful to me as a family physician. What better than ENT? Seriously. So I geared up for what I thought would be a month of long hours, lots of work, and getting constantly pimped (not in a hooker way, in a getting asked medical questions to try to stump you kind of way). Turns out that I was lucky enough to find a surgeon who doesn't at all have that surgeon personality- and by that I mean doesn't make a comment that women shouldn't be doctors because they get pregnant (true story), and thankfully took pity on me as a fourth year medical student at the end of her final year. I learned how to really diagnose an ear infection, and got to watch many many tonsillectomies.

The next two weeks I'll be doing gastroenterology as an elective. And of course with any new rotation, I'm nervous just to start working with new docs, but quite frankly I'm just so excited to almost be done that I'm not as anxious as I usually am. Two more weeks left to learn all that there is to learn during my medical school career. Then to top it off, the last day of my rotations will culminate in The Match where my future as a physician will be determined, and I'll find out which residency program I'll be gracing with my presence for the next three years. A fitting end to a half a decade of hard work, blood, sweat, and tears. And hopefully if I'll be celebrating having a real job after it's all over.

Turns out the day after The Match is actually St. Patty's day, which if you're Irish like me, is kind of a big deal. So my celebration will extend well into the next day. Can't get better than that. Oh wait, yes it can! Because just five days later will be my 28th birthday. Even more reason to celebrate! Actually, the surgeon I just worked with thought it was rather funny that I always tried to find an excuse to celebrate. Why not? With a life like mine, I think every day's a reason to celebrate. Oh, and let's not forget that spring is just around the corner....

The First Cut is the Deepest

My little boy has officially turned into a big boy. He got his first haircut this week. I knew it was inevitable seeing as his beautiful curly quaff was starting to turn into a frizzy mullet. And since he's the ring-bearer in a wedding in a few weeks, I figured it was time to clean him up a bit. I know a lot of moms who absolutely refuse to cut their child's hair and by two years of age they could easily pass for a member of an 80s hair band. But I've never been that kind of mom who freaks out when my kid gets shots or got emotional over weaning from breastfeeding. And getting his first haircut was no different.

So my husband and I brought him to our local barbershop where my husband usually goes. When we first got there she was also cutting another little boys hair, and I thought it would be good for Killian to see but he was more interested in the candy machine instead. Thankfully this barber is smart enough to have a little TV in front of her chair to try to distract the little guys. It was then Killian's turn and my husband sat him on his lap. We prepared ourselves for a wrestling match, but surprisingly he was really good. The barber took her first snip and gave me his beautiful golden curl so I could scrapbook it (I have a whole drawer of stuff I still need to scrapbook if I ever get time). Aside from the occasional moment where he tried to dodge her, he did amazingly well.

Checking out his new do!

In a few short moments my little guy was done and even looked a few months older! I was more nervous of the barber just totally screwing up and having the shave his whole head- of course I jump to the most drastic outcome- but that didn't happen and he looked so handsome in the end. Now he has a slick new haircut to go with his fancy tux for the wedding. And maybe this "big boy" haircut will bring some big boy changes. I can already see him acting a little older!

My Personal Statement

As a medical student applying to residency you are required to write a "personal statement". Considering we've spent the last four years writing nothing more than notes, which consist mostly in medical abbreviations, it's quite the task to become grammar-literate (not a real term btw) again. The personal statement is the one and only party of your residency application where you have a chance to express your personality. It should explain why the specialty you chose is a good fit for you, what your goals for the future are, highlight your accomplishments, and maybe even tell a story of an experience that helped define the person you are today- all within the limits of one page. A personal statement can actually be quite personal to each student. I know mine is. But even so, I've decided to share it with you all. Deciding to go into family medicine was a huge decision for me, and I hope that other med students reading this can see why I choose this field and maybe consider it for themselves one day.
Enjoy.....

A 44 year old mother of three, I was seeing her for the third time in just a week. It was supposed to be an easy visit, going over the results of her MRI, which came back with “nonspecific” findings. Only now her headache was getting worse despite the medications she was taking, and she started experiencing weight gain, extreme fatigue, dizziness, unbalanced gait, and nausea. I knew at this point that it was more than just a headache. I rechecked her blood pressure, which was still elevated. After the doctor I was working with came in and evaluated her as well, we decided it was best to admit her to the hospital for further workup.

After some additional testing, she was diagnosed with metastatic small cell carcinoma and died just two weeks later. It was only my second rotation as a third year medical student, and I certainly did not expect to experience my first patient death so soon, and on a family practice rotation no less. But then again, I didn’t expect to diagnose someone with temporal arteritis or make home visits to a woman with progressive ALS. Here I was thinking that family practice was just managing hypertension, diabetes, or hyperlipidemia and I came to realize it is so much more than that.

When I first started medical school I never would have imagined that I would be drawn towards a career in family medicine. There are so many specialties out there to choose from. I couldn’t imagine just being a family practitioner. That’s the dilemma, though, there are so many specialties. How can you chose just one? At the end of third year I found myself so intrigued by absolutely everything, with a few exceptions, that I couldn’t make up my mind. I wanted to do it all, and looking back on all the rotations I had done, it was only during family practice that I got to see the entire spectrum of medicine. It was the most satisfying experience of my third year. The connections I made and relationships that were built with my patients during that six week block were unmatched during any of my other clinical rotations.

Family Practice is one of the only fields of medicine where you get the chance to treat the “whole” patient. Every other specialty focuses on just one system or part of a patient, while in family practice you actually get to see the patient as a person, get to know their story and their background. That’s what I love so much about it: you have the incredible privilege of being allowed into another person’s life. So much of getting to do this relies on one’s ability to communicate well and build trusting relationships with your patients, an attribute I consider one of my greatest strengths.

Being a family practitioner allows you to be not just a doctor but also part of a community. Meaning, your social responsibility is not just to patient care, but also to the town or city you work in. When my family opened a restaurant seven years ago, we wanted it to be more than just a place to get breakfast. We wanted to be a part of the community. Each year I’ve organized auctions raising money for David’s House, ran “Toys for Tips” events, and collected donations for the local soup kitchen. I never did these things because I had to, but because it just felt right. I wanted to use our business to bring the people of our neighborhood together and work towards a common cause and help those who are less fortunate.

As a future physician I plan to continue to be an active participant in the community that I work in. I look forward to starting new projects, helping out at local events, and being involved in health education. Whether it’s giving guest lectures at local schools about nutrition or staying late hours to work at the flu vaccine clinic. I want to be the doctor who takes the extra minute or two at the end of a visit to counsel my patients to quit smoking so that they don’t get lung cancer in the future. I will be the physician who leads by example and practice what I preach by showing my patients how to lead a healthy lifestyle. Above all, I will be the kind of doctor I’d want taking care of my family.

It Takes Two

Any married couple will tell you that it takes a lot of work to keep a marriage going strong. Sure, it's a little easier when you know you married the love of your life and your soulmate, but a lot more than just love goes into making the relationship stand the test of time. My husband and I haven't been married that long, but with both of us going through grad school, moving constantly, getting new jobs, having a child... we're certainly not free of stressors on our relationship.

The hubby and I at the top of Blarney castle in Ireland.

The most important factor in maintaining a healthy marriage and being able to communicate when things aren't going well. My husband and I got to a point at the end of my last rotation where we both admitted to each other that we weren't happy with how little time we had for each other. I find it takes a lot of courage to really admit when there's a problem and I'm proud that we were both able to verbalize this and discuss what we needed to do to fix it. But then again, I'm not really surprised because we've always been open and honest about things from day one.

So after identifying that our lack of actual alone time together was our primary issue, we needed to figure out a way to remedy the situation. I keep having to remind each other that with a child and demanding careers, we're certainly not going to find any extra hours in a day and it's a matter of taking advantage of what little time we do get. So we threw the parental guilt aside and arranged for the little bug to go have a playdate with his slightly older girlfriend (by older, I mean three months), while we spent our day off together.

Now it always amazed me to have a "day off". I mean, what do people do when they're not working? Or better yet, what do people who don't work do? Well, for a couple like us, who didn't want to spend much money or go very far, we opted to simply go out to lunch. Then we were going to see a movie, but nothing really good was playing. So we had an even better idea of buying a movie, blowing up our air mattress in our living room, and getting comfy while enjoying our new flick. It sounds so simple, like something we could have easily done any day, but really it was some much needed relaxation (without a toddler screaming in our ears or jumping all over us).

Not to say that quality couple time always requires us to drop the little guy off with a sitter. Today for instance, I'm lucky enough to have the afternoon off. So we're going as a family to our local museum. The point is, just to make sure you take advantage of the times you are together and not just sit in front of the TV or on your computers. I know it's going to be a struggle entering residency and working a lot more hours, but keeping a happy marriage is an important part of being healthy and also being a good example to my child.

The 2012 Residency Draft.... aka: "The Match"

In the real world, when you graduate from school, you have the freedom to go apply and interview for a job in your field. Now you may or may not get that job, but that's ok because you can just apply for another one if you don't. In the med school world this practice is thrown out the window. Most people are under the assumption that once you graduate med school, you simply apply for a job at a hospital or a practice and POOF! You're a doctor! Well, allow me to elaborate on what med students have to really go through.

After four years of undergraduate education and four years of medical school... you then have to go into residency. You'd think that after eight years of torturous biochemistry, pathophysiology, and gross anatomy, along with two years of clinical learning, that you've earned enough street cred to just go practice medicine. Well, technically as a resident you are a doctor, but I liken it to a "doctor with training wheels". And exactly how long you have to wear those training wheels depends on which specialty you go into. I'm going into Family Medicine, which requires a 3 year residency.

Now applying for residency is the tricky part. There's this big online application program called ERAS (electronic residency application service), and you HAVE to apply to residencies through this and only this (which costs $ of course). So you upload your transcripts and your CV and you write a personal statement about how awesome you are. All of this is compiled into your application. You then pick a list of residency programs to apply to. I applied to 12. Then ERAS sends all your info to these programs, at which point they decide whether they like you enough on paper to invite you for an interview. Please refer to my previous post: Hi, My Name is Maria. I want to be a Resident at your Program! on what that's like!

After interviews are all said and done is where the tricky part comes along. Programs can't just call you and say, "Congratulations! You got the job." Instead, you have to enroll in THE MATCH ("The Match" will remain capitalized from here on because when I say those words, I would like to have that "dun dun dun...." connotation with it. That's how serious it is.). It's another service, which of course costs more money, in which you have to submit a Rank Order List. A Rank Order List (ROL) is a list of the residency programs you'd like to attend in descending order of likeness. At the same time each residency program submits a list of their own, which includes the medical students they've interviewed in the order in which they like them.

Then comes match day, which this year is March 16th. Some big magical mystical computer system goes through your ROL and the residency programs lists and matches students up based on how each have ranked each other. So if I'm lucky enough that the number one program on my list, ranked me high enough, then I will likely get matched to that program. If not, then it goes to my number two, then number three. So on and so forth. If for some reason, which there are many, that you do not match with a program then you have to "scramble". To scramble means that you have to call programs that may still have an opening and hope that they like your credentials enough to give you a spot. This is every fourth year medical students worst nightmare.

The morning of THE MATCH you will receive an email or a letter from your school, which states where you have matched. Whether you matched at your number one choice or your number 10 choice, you are contractually obligated to fulfill your residency at that program. So it's really important to only rank programs you know you will be happy at. The residency director usually calls you and congratulates you, and then you can breath a giant sigh of relief knowing that you will have a job after almost a decade of schooling. Most coincidentally, THE MATCH falls right before St. Patty's day this year, which means that my celebration will continue throughout the weekend (or I'll be drowning my sorrows in pints of green beer if the unthinkable happened and I did not match).

When I tried to explain this whole process to my family, they looked at me quite puzzled. "So.... It's like the NFL draft?" they said. Well, kind of... minus the whole giant televised event where someone's up at a podium and goes, "The New England Patriots in the first round of the 2012 draft choose Maria Boylan!" And I walk up and put on a white coat and the residency director shakes my hand and we freeze and pose for a picture. And then I cry like Tom Brady did when he was drafted. Ok, not exactly like that. There's no big event, and you don't get a jersey and a million dollar contract. But I imagine the feeling is just the same.

So at this point in time, I'm getting ready to submit my ROL and then just crossing my fingers and hoping for the best. The fate of my future lies with THE MATCH gods. Luckily, I think I've got a really good group of programs on my list and would truly be lucky to do my residency with any of them. But I think they'll be pretty lucky to have me too :)