Family Medicine to Emergency Medicine

So I’m due to start a family medicine residency in August – but I’m currently working in the emergency department and I LOVE this job. The hours are awful, other specialties can give me shit when referring patients, and patients often want more than what I can offer them, but I love the pace of the job and the work I do.

I’ve abandoned the thought of training in a surgical specialty because it requires a minimum of 5 more years of training (and most train for 7 years before becoming attendings). And speaking to my senior colleagues makes me realize that training is not as simple as keeping a surgical logbook and attaining specific surgical skills at different levels of training. In this country, it’s all about your tick-boxes: audits, audits, and more audits; research and publications, but not just in any journal – it must be a peer-reviewed journal; teaching, with “evidence” that you’ve taught; conference presentations and poster presentations. And you’re strewn all over the country at times. And they have almost the same requirements to get into the surgical training post as well – those who meet the tick-box requirements get in. There are no reference letters highlighting whether you’ve got the surgical skills to make it in the job. You don’t get “points” for being able to be a proficient first-assist in a laparotomy. The structure of the system is flawed.

I am now at the point where I’ll be entering general practice, and this also comes with its own set of requirements during training, one of which I’m particularly not looking forward to – reflections. Every week, a requirement is to two at least two reflections either about a patients encounter or on something you’ve learned from. Personally, I’m not one to reflect – in a blog, yes. But in a portfolio – no. Especially since I know it will be read and assessed by my supervisor. In that sense, I feel my reflections will be very superficial and I won’t be as honest as I truly feel. But, whatevs.

My other thought is what if I abandon general practice and try to jump into emergency medicine training. I’d be more satisfied with my job. But training would again be another  years. The option I’m set on now is to endure the three years of general practice and then get a fellowship in emergency medicine and remain there. The options are endless. My career path is not a fluid one. The only path that’s certain for me with work is my return to Canada. My aim: return in a maximum of 3 years, if not earlier.

Company’s Coming! 

Last week, I finally wrote the MCCEE. Results coming out in about 8 weeks.

Coming up next week is the tortuous deadline for having all my work -related tick boxes filled in and completed by the appropriate people. This is one of the worst and most useless things of the Foundation Program – the dreaded ePortfolio. In theory, it’s a great concept; but in reality, there’s so much useless shit associated with it that it really does end up being just a tick box exercise at the end of the year. But enough about that.

My good news this week came from one of my closest friends who lives in Scotland – she got accepted into the same GP program as me and we’ll be spending the next three years working together!!! She started looking for a place to live and she’ll be coming down to visit in a few weeks to check out the area. Can’t wait 😉

I Matched!

Yes I have! I matched into my number one choice for the UK, and I’m going to be in South Thames for the next two years! I’m elated!!!

Although, there are still further things to rank – first, which region I’ll want to be in, and then I’ll have to rank all the programs within that region. And paperwork. I feel like now I need to get cracking, sit down, and sort out everything I still need to get completed before I graduate.

But the end is finally near. The end of being a student. The start of being a doctor is right around the corner.

UK as a First Choice

Over the past couple months, I’ve realized that I’m not entirely sure what I want to do for the rest of my life (residency-wise). Dates have slowly been approaching – for exams, deadlines for applications, etc. Instead of stressing myself out, I’ve decided that I’m going to be completely relaxed throughout the entire process. As such, I’m going to forgo trying to apply to North America for a residency. So while most of my colleagues will be stressing out over paperwork, letters of reference, payments, and other various application steps, I will be relaxing. And because I’ve chosen not to apply this coming cycle, I can postpone my North American exam dates to a later date. This means that I don’t have to stress over trying to find time to study while completing my electives. Dude – can I tell you how great this feels?!

Instead, my only worries right now are completing my own electives, making sure that I get all my paperwork ready for an online submission to the UK Foundation Program, and making sure I study effectively so that I can write my Step exams and MCC’s when the time is right for me.

I’m doing this because I’m not sure where I really want to specialize. I have it narrowed down to surgery as a definitive choice – but I can’t risk my entire future on applying for just a general surgery residency. I’ve rotated through pediatric surgery recently and I’ve realized that I absolutely LOVE it! And I always thought I hated kids and never wanted to work with them. Yet, for some reason, one of my favorite electives both in third year and in fourth, has involved dealing with children. I’ve also always considered plastics as an interesting field – but I know that as a graduating IMG, my chances of landing a plastics residency in NA are slim to none. On the other hand, neurosurgery is a complete bore. And I want to rotate through cardiothoracic surgery once again because the 3 days of it that I had in third year… well, I didn’t actually get to see any surgery…

I still need to complete a Family Medicine elective as per my school’s requirements, but I’m going to try to squeeze in as many different surgical specialties as I can before February.

On a completely separate note, my gym enthusiasm has been dwindling. I’m an avid every-day-gym-goer, but as of late, my motivation is severely lacking. I still love and enjoy Zumba twice a week, but since late July, I went on some strange binge eating frenzy, gained a few pounds, and have been very unmotivated to get back to my regular routine to work it off. I decided to take the day off tonight and will do so until I feel that I can go get a great workout in. I’ve been avoiding weights lately and I’ll usually just go for a 5K run followed by a shitty ab workout to try to make myself feel good. But it hasn’t been working… So I’m taking the night off. Maybe a day away from the gym is what I need.

I did start one of those 30-day squat challenges however. And I am following that avidly =) I’m currently up to 130 squats. Working my way up to 250. But I’m still waiting to feel the day-after burn on that…