Rank Order List Advice

On her blog, Marissa Nicole has discussed oh she and her husband have used their parents as a resource when creating their list. I think this is wonderful, but Mr. and I didn't opt to involve our parents much in the decision making. Part of this is because I already basically know the advice.

My parents are academic types. They actually met at a university that has a top tier law school, a top 10 business school, and one of the best music programs in the country. My dad was in law school, and my mom was in the music school. Through my college search when I was in high school, I learned that, in my father's opinion, it's not just about the name, but matching the offerings of the program with your own needs. I was in a rather unique program at NYU studying the entertainment industry - an industry that in the US only really exists in NYC and LA. When I considered switching my major to accounting, my dad said I should transfer back to an in-state school because his alma mater was just as good for less than half the price.
In short, my parents advice would be to go where he can get the best training. They'd love for us to be at the program closest to them, but not at the expense of his training.

Neither of my in-laws finished college, but my mother-in-law's father had a PhD from Princeton and moved the family frequently for work. She gets that the best opportunities aren't always in the same place, but she'd love for us to move closer to them and start giving her grandchildren.

So, who have we actually gone to for advice? Mr. has gone to various orthopedic surgeons in the area. For his independent study project requirement, an article on a specific orthopedic procedure, he's being overseen by a Spine attending with whom he has worked before. They have been in contact at least weekly since the fall. He received the specific advice that operating experience is paramount in determining rank order.

As for me, I've been talking to my boss a lot. I know it's often best to play your cards close to your chest, but I respect my boss too much to not keep her in the loop with everything. I plan to go to law school starting Fall 2011, and expect to be a slightly above average but not stellar applicant. My boss has advised to go to law school in cities where BigLaw exists if I want to do BigLaw. On our list, that would be New York, Chicago, or DC. (Ideally for her, we'd stay in New York, and I'd go to Fordham at night, continuing to work for her during the day.) While there are better schools in other cities on our list, they tend to train attorneys to work in those states, and the big firms don't necessarily look at mid-top-tier programs in smaller cities rural areas. I'm taking that to mean I will need to be aggressive in my job search, which I'm planning on being anyway.

In general, a lot of people have a lot of advice, but we've focused in to figure out what's legit and what we really want. I'm pretty happy with our list. I think it does well to look out for our oft conflicting interests. Should be interesting to see how it all plays out!


01 day until ROL is due
06 days until my LSAT score is back
20 days until Black Monday
23 days until Match Day!

Writing the Essay

No, my fellow fighting violets, I'm not talking about the required writing seminar at NYU that all freshman must take in some form or another. I'm referring to a little step in the residency application process known as the Personal Statement.

Though he's been talking about writing his first draft for the past few weeks, Mr. finally sat down last night and hammered out what turned out to be a nearly 800 word piece on how he came to choose orthopedic surgery. While I'm not sure if there is a specific word count, my cousin's statement (which received high praise) was just about 600 words long. Better too long for a first draft, so I feel this is a good start. Of course, after the edits I made to it this morning, it is now 2 words longer. Oops!

If I were the applicant, I think the personal statement would be one of my favorite elements. For one, I'd get to talk about myself, but more importantly I'd really use the opportunity to make those who read them see me as an individual and not merely a list of accomplishments. Mr., on the other hand, finds this element particularly stressful. It's rare for the personal statement to help you, but it can very easily hurt you. As an otherwise highly competitive candidate, Mr. primarily aims to "do no harm" with his statement but is nervous because he's not necessarily a strong writer...or so he thinks.

Upon listening to what Mr. tells me what he wants to say and then reading what he actually puts down on paper, it seems that he was taught ridiculous writing rules that are decent guidelines when first learning how to organize one's thoughts but very restricting parameters when attempting to be eloquent and eye-catching. As a result, my favorite phrases from his statement arose when he told me something and I responded, "write that down, just like you said it" and continued to insist despite his concerns that it wasn't the proper essay structure.

At this point, I imagine some of you are probably thinking, "Come on now, M. Your writing isn't exactly brilliant; where do you get off giving writing advice?" And that is certainly a fair point. My writing is not brilliant, but my reading is. At some point in almost all my jobs and internships, I have been assigned the task to read or proof things, not just for grammatical errors but for content and style as well. I once went through a pile of film scripts and was asked to discard any that weren't interesting after the first 10 pages or so. Another time I reworded descriptions of corporate event planning offerings in client presentations. As a legal secretary, I was often given the task of drafting correspondence to our clients or fixing the correspondence written by associates. Though I had many weaknesses as a producer, I'd like to think one of my strengths (as evidenced by the reviews and my other small successes) is piece selection. I know good work when I see it whether its intent is to entertain, to sell, or to simply just communicate. And though I often lack the talent to create good work from scratch, I truly enjoy tweaking rough drafts to help turn them into final, polished products.

So, this morning I took a look at Mr.'s first draft. I printed a copy and went to town with my pen. Then, I opened the Word doc, set the page to "track changes" and created a redline. After saving and printing the redline, I accepted all changes to give Mr. a clean draft with my edits. I'm sure there will be many more incarnations of Mr.'s personal statement. I don't even know if he'll accept any of my advice, but at the very least it's certainly fun to witness this creative work.

Photo by CPSutcliffe

Away Rotation Update

As mentioned earlier, Mr. applied for two visiting student clerkships ("away rotations") in orthopedic surgery in the midwest. They're both strong programs. One is at a very good hospital affiliated with a top-notch university in an extremely popular city. Let's call that Program A. The other is a strong program with seemingly very happy residents in a city that is far less exciting to most but is halfway between our families and thus very desirable for us. We'll call it Program B.

The application for Program A required listing up to 2 alternative courses and 3 alternative dates. They also needed his Step 1 scores, a letter of recommendation, and his transcript in addition to all of the other usual administrative things. So, he applied for Ortho, Peds Ortho, and Trauma for July, September, and October.
The application for Program B required listing up to 4 alternative combinations of elective + date. So that he wouldn't be scheduling any conflicts, he listed a number of different ortho electives all in the month of August.

As STM's hubby heard back from the many programs he applied to, Mr. and I became antsy. We thought he'd be fine, but we wanted to know something. I would bug him every night when I got home, asking if he'd heard any news, and he would remind me that he would let me know as soon as he heard.

Then, today as I walked back to my office after lunch, typing a text to my friend in the Navy to see if he's in town for Fleet Week, my iphone vibrated. At first I thought I had a new email - a google news alert about the Schumer governance bill or something. However, for once today I had no new emails. Then I saw the little number by my SMS icon. New text message. From Mr.:
"I have been accepted to rotate at [Program A] in July for orthopedics."
I called him as fast as I could hit the speed dial on the touch screen. I can't remember our brief conversation, but I couldn't contain my excitement. Not only is this a great opportunity for him, but it also means that so far, things are going as planned. I'm very much looking forward to getting home tonight and reading his acceptance e-mail. Then we'll tell his Program A city friends that he'll be staying with them and figure out how much we'll pay them. I'll also start looking for flights to visit him.

Are wives normally this excited upon learning their husband will be gone for a month? :)

Susan Boyle & The Match

Like many Americans & Brits, I have watched - and been moved by - Susan Boyle's performance on Britain's Got Talent. The song she sang, "I Dreamed a Dream" from Les Misérables, has been in my repertoire since I was 15 and saw that episode of Dawson's Creek where Katie Holmes' character sings it in a beauty pageant.
While not the most challenging song ever written, it does provide a number of challenges. The range required spans the break many female singers have between their chest and head voice, so you have to use your mix voice for the higher notes so as to not sound like two different people. While trained singers tend to bridge their break rather seamlessly, I've found it an issue for amateurs and pop stars alike (Shakira is the worst about it!).
Also, a lower-tempo song, the phrases are sometimes on the longer side, requiring good breath support. Personally, I always tend to have breath support issues which are only made worse when I'm nervous. Now, I've been singing in public my whole life. I don't really get nervous performing. I don't really care if audience members don't love me; I just enjoy being up there. However, I'm a ball of nerves whenever I audition because if the casting directors don't like what I do enough, I don't get the opportunity to do something I want. Ironically, this tends to hurt my audition. The nerves make breathing even more difficult, making my voice crack and my phrases trail off far too early. I hate auditions, but they're necessary in order for me to do what I love.

Similarly, Mr. is having a rough time with anxiety over this upcoming year. Is he choosing the right day for Step 2 CK? Will he stand out at his away rotations? Will he get enough interviews? And finally, will he match? After reassuring him that he will match but if by some fluke he doesn't it still won't be the end of the world, I gently reminded him that a career in orthopedic surgery doesn't stop being stressful.
He replied, "I know, but then I'll be doing what I want to be doing. I'll be learning about and then practicing surgery."
And that's when I realized that, like me, Mr. gets nervous for auditions despite his confidence when he performs.

Part of what I found so inspiring about Susan Boyle was her ability to perform despite her obvious nerves. I listened carefully at the bridge, waiting for her to crack or take an obvious breath in the middle of a phrase, and yet she powered through. Though Mr. is nervous about all that is ahead of him, I'm confident it won't show during his extended audition for residency. Still, the countdown for the match has begun. 10 months, 3 weeks, 5 days.

My Latest Project

Hopefully STM will jump on here to explain her latest project, but for now I'll tell you what I'm working on.

Since Mr. is now thinking he wants to specialize in Ophthalmology, I have been charged with finding out what in the world this early match stuff means and what he needs completed by when.

First, I went to SF Match, where I learned:

• You register online no earlier than June and pay $100
• You're applying to start PGY-2
• You also need to go through the regular match for a transitional year
• Each individual program has its own due dates for the application sometime between June and December
• Your match list is due in the beginning of January (for the class of 2009 it's January 8, 2009)
• You learn your match results in January, before you submit your match list for your transitional year.

Awesome. So next I wanted to find out where the top ophthalmology residencies are. Unlike college or even medical school, figuring out residency rankings seems to be a little tricky. So far I've looked at NIH to see which residency programs received the most awards, and then I looked at the top hospitals for ophtho in US News & World Report. The first is flawed because it's three years old and purely based on monetary awards. The second is flawed because its referring to hospitals, not residency programs and thus doesn't focus on teaching, research, etc. (not to mention most residents rotate through a handful of hospitals within a single program). If anyone has other listings, let me know!

Anyway, using those two lists, I created a spreadsheet with 35 ophthalmology residency programs and am going through right now listing the city, state, region, NIH ranking, US News ranking, US News reputation score, CAS deadline, interview time frame, number of positions available each year, contact information, and the website.

I'll ask Mr. if he wants me to add anything. Suggestions welcome!

Might we have a winner?

Opthomology! erm, Opthamology! grrr.... Ophthalmology!!

Mr. attended a 'speed dating' event this morning to help determine what he wanted to specialize in and to network with doctors in that specialty. There actually wasn't an Orthopedics table nor an Otolaryngology table, but the ophthalmologist he met did assure him that there is more than meets the eye when it comes to doctoring the... eye. And in doing so, he helped sway Mr. toward that profession.

Not only is there more going on with the eye than say, the hand (Mr. had recently mentioned specializing in hand surgery...), but there are also symptoms for larger problems that show up in the eye. So, as an ophthalmologist, Mr. would be able to still diagnose larger problems including diabetes and a bunch of other diseases and conditions I had never heard of before/can't remember now.

Of course, ophthalmology has an early match program, so now we're running around trying to find out how it works. It looks like there will still be time to do an away or at least an elective in optho before making any definite decisions. He'll also (hopefully) shadow during his next break and take a week to specialize in optho during his surgery clerkship.

I hope this sticks. When he was telling me about it, he really did finally seem to care about the work/life balance aspect of it. "I've been working hard a long time" (he started working at 16 and didn't stop until coming to medical school, where he's also done research outside of class and worked as a PA in anatomy). "I think I'd like a career where I can spend time with my family."

Hallelujah!

Now, if he changes his mind, yet again, and decides that ortho really is what he wants to do, I will still support him. But I'm still excited about ophthalmology for now. :)

By George, she's got it!*

So Mr. wasn't as thrilled with otolaryngology as I was. Basically, I think my 'Eureka!' moment should have come a year earlier when he had time to get excited about it, shadow doctors, scrub in on surgeries, etc. BUT, he is considering it. In fact, I think it's basically down to 2. Two high-paying, uber competitive surgical specialties that begin with the letter 'O' (in order of likelihood):

1. Orthopedics
2. Otolaryngology (yes, I really like that word)

When we both took a look at the little data that we could find, I've learned that when comparing the two, the pay for otolaryngology isn't quite as high and the hours (after residency) aren't that much better. That said, I'm still pulling for ENT over Ortho. I can't really explain why. Maybe it's because the only medical problems I've ever had have been in in my head and neck? Or because I'm a singer and thus have a fascination with the vocal cords? Or perhaps because I've read about ortho being bad enough times that I have this notion that it's very very very bad and anyone who chooses it hates sunshine and happiness. Or maybe it's a combination of those things. Who knows. I just have to keep repeating the mantra I wrote yesterday: it's important to find the right speciality for him, because if he's miserable in his job, he'll be miserable at home, and I won't want to see him those extra hours throughout the week anyway!

Regardless of which he chooses, though, my pseudo-obsession with the idea of otolaryngology finally made the whole location part of residency search 'click' with me. After my blog post, I went to go find the various match statistics and research the different residencies. This past year, there were 273 otolaryngology spots to be filled. By comparison, Ortho, also very competitive, has 636 spots. A lot of programs only have 2 ENT spots to fill. Yikes! Mr.'s a competitive candidate, but that doesn't leave a lot of wiggle room. I started thinking, 'okay, we have to apply to every single program in the midwest and NYC as well as Baltimore, Tennessee, and certain programs in the South. Maybe we should throw Connecticut and Boston into the mix, too. And well, since Pennsylvania is between NYC and the midwest, we might as well look there as well. Oh, what the hell - lets just apply to all of them and see where he gets interviews.' Oh. yeah. That's how it works. Maybe people going into peds or medicine have some options with regards to region, but with the competitive specialties, you just have to go where you can.
I don't know why it took me so long to get that. I think I had just been reading too many message board posts saying 'I have a family so I'm only looking in x area' that made me angry Mr. didn't have the same mentality. But at the end of the day, you just have to go where you match. And in our case (competitive as we are), not matching is not an option.

That said, I still hope he ranks certain midwestern locations rather high... :)


*Bonus points for correctly naming that musical
**Double bonus points for naming the song in said musical
Googling is cheating. ;)

When I grow up...

After a long wonderful day of various events, I got home to Mr. who, at 10:00pm, hadn't eaten dinner yet. I made him some spaghetti, and an hour or so later, technically my 'bed time', he decided that he was going to choose his specialty before going to sleep.

He started out with a list of 6:

1. Orthopedics
2. Gynecologic Oncology
3. Ophthalmology
4. Interventional Radiology
5. Otolaryngology
6. Anesthesiology

Naturally I was excited to hear 3 of the 4 ROAD specialities (if IR still counts for Radiology, that is), but I think my enthusiasm for those three delayed our bedtime unnecessarily.

This was our pro/con list (disclaimer: our pros and cons may not be the same as yours):

Orthopedics:
Pros: High pay, Lots of procedures, deals with various anatomy, challenging, has helped with research in the field, changes lives (going from not walking to walking makes patients happy)
Cons: Notoriously poor work/life balance

Gynecologic Oncology:
Pros: Interesting Procedures, knows that he finds it interesting based on his rotations
Cons: Moderate pay, would have to do OB/Gyn residency first (no guarantee he'd match in gyn onc and he doesn't want to be an OB)

Ophthalmology:
Pros: High pay, great work/life balance, cool procedures
Cons: Focused on only one tiny part of the body, early match (so he'd apply before doing a rotation in it)

Interventional Radiology:
Pros: High pay, cool procedures, possibly good work/life balance?
Cons: Would have to do a regular radiology residency first (no guarantee he'd match in the fellowship, and he doesn't want to read x-rays the rest of his life), no experience in it

Otolaryngology (ENT):
Pros: High pay, cool procedures, deals with various organ systems
Cons: No experience in it yet

Anesthesiology:
Pros: High pay, good work/life balance, requires a lot of knowledge
Cons: No procedures - would have to sit by and watch surgeons do 'the fun stuff'

Not all pros and cons are created equal, so now the list, in no particular order, is:

1. Orthopedics
2. Gynecologic Oncology
3. Ophthalmology
4. Otolaryngology

I know you're thinking 'Oh no! She lost 2 of the 3 ROAD specialties, and the 3rd is hanging on by a thread!' However, it's important to find the right speciality for him, because if he's miserable in his job, he'll be miserable at home, and I won't want to see him those extra hours throughout the week anyway!

I also am thinking that otolaryngology might be a good fit for him (and us) after doing a little more research today... the pay is really good (don't judge - we have crazy mad loans to pay off!), and it has a decent work/life balance. Plus, there are a lot of different surgeries and procedures he could do. Sure, there would be a lot of tonsillectomies, but every specialty is going to have its 1 or 2 extremely common and relatively unexciting procedures. With Otolaryngology, though, there is a wide range of less common and rather exciting procedures, too!

Now I just need to find where the good ENT residency programs are...

Puppy Please

Last night in the Village the hubby and I stumbled onto a pet shop with the cutest puppies ever. Seriously. The. Cutest. Puppies. Ever. And while I'm not so pro-pet shop (I'm all about the rescue shelters instead), I am pro dog.
But anyways, this post isn't about dogs, it's about the next set of criteria when it comes to choosing a residency. The pet shop started off this whole conversation about when we'll be able to get a dog (we can't now because there's a strict no dogs police in our med school housing). Eventually, the hubby decided he's not applying anywhere that doesn't allow dogs in the (mandatory) resident housing. I emphasize that he decided this, not me. But wanting a french bulldog more than just about anything, I heartily agreed with the new criteria.
So now it's my job to figure out what that rules out. So far St. Luke's-Roosevelt looks like it's the only program impacted, but that's just because I haven't really looked into all the others, yet. At least now I know what I'll be busy doing all weekend!

Residency Search Battle: Round 1

Okay, so we'd had this talk before, but with so much uncertainty, there was only so much that could be said.

Here's a brief history of this discussion:

First Meeting (Pre-first year)-

Mr.MW: I imagine I'll be in New York a long time.

MW: I like it for now but would like to settle back in the midwest.

Engagement (First year)-

MW: I really don't want to stay in New York after med school, far away from our families when we start having kids.

Mr.MW: I will try to get back to the midwest for residency.

A couple months in (Second year)-

Mr.MW: You know, there's a good chance I could end up in a borough for residency. This is where I have all my connections, etc.

MW: Ugh. (or something like that...)

There's still quite a bit of uncertainty, like which specialty he'll go into (though orthopedic surgery is looking likely) or where he'll feel most comfortable. However, we know one big factor that will help determine where we go next: the boards (ie, USMLE Step 1) scores are in, and he did well. Very well.

Upon the hearing the news, a friend of mine responded 'M must be happy,' assuming that with the high score, we now have the freedom to go where I want to go. But, while I'm incredibly proud of and happy for him, I know that this means he will be even more determined to go to the highest ranking program, with little regard to location.

We went round and around last night, getting everything out. It was difficult because he said some things I didn't want to hear (like, 'I'm not going to be home for dinner every night or be able to make it to every game'), but after sleeping on it, I'm ready to accept that his career is his priority. After all, I can find an adventure anywhere, and letting go just makes life more exciting.

...Plus I guess the small victory of discovering there are no borough hospitals on US News & World Report's Top 50 Hospitals for Orthopedics didn't hurt either.