I Matched!!

Wow.  What a day.  The Ides of March.  Match Day.

It's been a crazy ride.  I'm SO glad that my med school doesn't make students read where they matched out loud to the entire class.  So many people would've completely broke down crying (in joy or sadness).  Instead, my med school puts all the match envelops in a bin and chooses out names at random.

As each of my friends go up to get their results, I see their faces downcast as they matched their 6th or 8th place.  Finally one of my friends matched her #1 and I was called shortly after.  I was SO nervous - like nauseated and heart palpitations.  Imagine my (shock and) surprise when I matched at my NUMBER TWO rank!!  :-D

It's not my #1, but it's (obviously) the next best.  I had psyched myself up for my #1 so much in my head that really almost all of my other ranks paled in comparison, which is unfair.  It's unreal.  Even now I can't quite believe it.

Actually I'm starting to have irrational doubts now.  Will I be okay with the culture shock of moving so far away?  Did I make the right choice in the order of ranking my programs?  Did I lower myself as a candidate for not ranking more "prestigious" programs higher?  Will I have the time and energy to have a social life outside the hospital?

Like I said, irrational.  In retrospect, this may be the perfect match for me, even though it's #2.  It's a smaller (but not "small") program without fellows, and so more attention can be paid towards teaching me and mentoring me.  It still has all the sub-specialties represented and is a free-standing children's hospital - so my training is automatically solid.  And it's still in the state I want to be in (albeit not quite in the area of the state I'd prefer to be in, but that's okay).

It was a tough match this year.  Lots of disappointed people who applied to a surgical programs, or even medicine programs.  The number of American med school graduates keep growing, but the residency slots are static (some programs may even have shrunk a little as a consequence of the crap going on at the federal government level).  It's only going to get tougher but at the end of the day, most people match, which means most of us will become the clinical doctors that we went to med school to be.

In about 2 months, I will have an MD and have a spot as a pediatric resident.  :-)

Lonely Thoughts

First of all, thanks to those who read my last post.  Alas, said guy in that post has been accepted to a 4-year university in another state (one I didn't apply to for residency) and has a crush on another guy for a while now.  The chances of something physical between us are vanishingly small.  But I'm okay with that, I seriously wish him all the best - I'd rather have him as "just" a friend than not at all.

I'm glad that I'm done with surgery - forever.  It's almost surreal.  It's been such a privilege to be a part of surgery.  I think that's the main reason why I don't hate the OR (operating room).  At no other time can you say you've been hands deep in another person's abdomen, or held a person's bowels out of the way, or cut off a person's leg.  It is a privilege - as is all of medicine - to help someone in such an intimate way.  But whereas I willingly relinquish my privilege to ever do surgery, I acquire the privilege of being the first doctor a child sees in life and helping kids and families through good times and bad.  And that's exactly what I signed up for.
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So the real purpose of this post is to vent my annoyance.  Over the past year, most of my friends have paired up and a number have/will be getting engaged.  And much of our conversations involve them talking (either positively or venting) about their significant others.  And it irritates me.

I know they don't mean to, but I can't bring it up.  I can't ask them to not be with their other half especially when I'm friends with all of them too.  I've apparently been described by some friends as a "bitch" lately for being annoyed and snapping heads off at particular things.  Maybe I have but I'm not going to apologize for it.  I know I'm treated (unconsciously) as a secondary friend by now.  People will bend over for their significant others but make excuses to not hang out when I ask.  I expect no less.

I'm at such a stagnant time-point in my life.  It's frustrating.  I hesitate to act until I know where I'll end up for residency (Match is next Friday! oh my!!).  But here everyone is on the way to getting married and I'm not much further than I was since I started this blog . . .

Maybe I should just focus on me, my career, and accept that I'll be alone forever.

To Hold and Be Held

Held so tightly by ~TopScoff on deviantART

I had been debating whether to post this or not, but I've decided that I want to remember the event as vividly as I can.  The following will get graphic, so if your sensibilities are easily offended, please skip this post.  I assure you, I will blog again soon.

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I met him online months ago, in a forum not unlike this one.  We messaged for a while before we added each other's IM.  I had half-jokingly agreed that if I got an interview in his area, he must visit me and I'd take him on a date.  Sometimes the stars do align, if only briefly.

Several weeks ago I went to an interview near him.  When I arrived at the train station, he was sitting there waiting for me in a black hoodie and jeans.  He was thinner and slightly shorter than me with dark brown hair, mesmerizing grey eyes, and a short goatee.  We first stopped by my hotel to drop my things off then went to a nearby Thai restaurant for lunch - his first time having Thai food.  Afterwards we went to a local natural history museum; I totally geeked out and I think he was amused by it all, haha.  It was a tiny museum and so we decided to stop for coffee on our way back to my hotel.  We chatted for a while over our coffee - him a mocha, me a chai latte.

There were still several hours before my pre-interview evening event, so we headed back to my hotel to see if there was any good movies on.  As he flipped through the channels, I positioned myself behind him to give him a back massage.  He had been so stressed lately and there were so many knots in his back - there were knots in places I didn't know a muscle could knot!  I began on his shoulders and kneading his upper back, working the knots out.  As I moved down, I found knots between his ribs and in his lower back.  At this point he laid on his stomach so I could get better access to his lower back.  I got a bit daring and went further, massaging his butt and upper thighs - wouldn't you have known, he had knots there too (somehow)!

I gave him a thorough massage for a good 30 minutes or more before he sat up.  He leaned back into me until we were both lying on our backs on the bed.  He turned towards me and wrapped his arms and legs around me like a koala to a tree, and laid his head in the crook of my neck.  I rested my head on his, smelling his hair.  To hold and be held like this, to cuddle, was such indescribable pleasure and relaxation.  As he cuddled I stroked his back and arms with my arm that was wrapped around him.  This guy really loved cuddling.  It's on par with a little kid/toddler in the amount and quality of physical affection, and it was awesome to hold and be held like that.

With my other arm, I stroked his chest, his stomach - first over his shirt then under.  Then I moved my hands down to his hip and around under his boxer-briefs to grab his fuzzy butt a few times.  He didn't object.  To test the limits of this, I moved my hands around to the front until I felt the head of his cock, already hard and completely wet with precum.  I massaged it a bit with my fingertips until he rotated himself till he was on top of me.  He undid his belt and unzipped his jeans, the tip of his cock peeking above his underwear.

He leaned in for a kiss.  It was awkward at first on my end, as it has been a really long time since I had kissed anyone.  As we kissed I had my hands on his cock, giving it a few strokes.  He then took off his shirt, pants, and underwear, revealing his entire cock for the first time.  It was one of the most beautiful uncut cocks I had ever seen - he was so hard that his foreskin had pulled back entirely.  He claimed it was about 6.5" but it looked closer to 7" and was quite thick.  He leaned in to kiss again before reaching into my pants to find my cock hard and wet with precum (I don't usually precum much, unless I'm very aroused - which I was).  He undid my belt, pulled off my pants, gave my cock a few strokes, pulled back my foreskin and put my cock in his mouth.

He knew what he was doing, sucking and licking my foreskin in such an oh-so-exciting way.  He stroked me a bit before I had him lie back to return the favor.  I gave his cock a good squeeze and saw a large drop of precum bead at the tip.  I pulled his foreskin over and licked the tip in circles before pulling it back and tried to suck as much of his cock as I could.  I put my tongue between his foreskin and the head and licked in circles, causing him to moan a little.

At some point he was above me and we tried to 69 . . . it was hilariously awkward because we couldn't quite coordinate ourselves.  We mostly ended up sucking and playing with each other's balls and asses for a bit.  He had me stop a couple times because he was close to cumming, so I paused while he kept going on me.  I would've given myself completely over to him had he a condom on him.

Maybe an hour later I was close to cumming.  It's weird being on the edge of cumming but not quite being able to because someone else is in control and they switch it up between oral and different strokes just as you're about to go over the edge.  It had been a week since I had gotten off (not much time what with the constant traveling, dining, and interviewing) and I was soooo sensitive.  When I started to cum, it came out like a flood - it gushed with each spasm but in between it felt like cum was still pouring out.  One of the best orgasms I've had.

He had laid himself across me in such a way that my cum splattered his chest.  It was my turn to return the favor.  Soon he was moaning and riding the same edge that I had just been - almost there but not quite.  Finally I got him over and his cum sprayed all over.  I teased his cock head a bit - knowing it'd get super sensitive post-orgasm - until he told me to stop.  We cuddled for a little bit in the afterglow before quickly deciding that we should shower and clean up, haha.

He decided to spend the night with me after my dinner with the residents rather than drive back home.  We cuddled in bed for a while as we chatted and got sleepy.  We crawled under the sheets and he wrapped himself around me.  It felt nice, but . . . I failed to realize how warm another human body could be.  So I kind of overheated haha, and the AC/heater unit thing was making such a racket all night that I barely got any good sleep.  That said, I tried to cuddle every chance I could get without overheating (it's surprisingly awkward to sleep next to someone if you don't position yourself just so).

Happy Chinese New Year!

Take Care little Sister 2012 leaves 2013 by =ShadowSaber on deviantART

新年快乐!  恭喜发财!  身体健康!!

Happy Chinese New Years everyone.  The Year of the Dragon now gives way to the Year of the Snake.

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Apologies for the lack of posts of late.  Transitioning from interviewing and vacation back to rotations is tough, and to a surgical sub-internship no less!  My hatred for surgery is nowhere near as intense as it was last year, though my . . . displeasure for surgery is 90% in the hours (specifically how early I have to wake up).

That said, this surgery site is pretty chill all things considered.  I love taking the surgeries that don't have a resident in them because I get to be first assist and do more (and see more).  The attending surgeons here let me do a fair bit more than I was allowed to as an M3 last year.  I can see how one would love doing surgery; however, I still hate waking up before 5am and standing for hours on end putting strain on my lower back.  I should start doing some yoga . . .

More posts coming up soon (hopefully).  I have an unfinished one drafted.

To Be Wanted . . .

It's such a weird feeling (for me) to be wanted.

What I'm most caught off-guard by during these residency interviews is just how much the program wants me (I suppose that makes sense, otherwise they wouldn't invite me for an interview).  Still, I'm left awkwardly speechless when an interviewer enumerates the various things I've done in med school and react amazed when I describe them.  It's almost embarrassing.

Up until now I've received little recognition outside my circle of friends and faculty advisors for the things I've done.  Everything I've done felt like it was being quietly conducted in the shadows outside the glowing praise of my institution at large.  I never received an award or anything of that sort, and I doubt I ever will - I simply don't have the overwhelming popularity to bring visibility to the things I champion.

But at almost every interview I've been asked to describe (in some detail) the community advocacy work I've done for the Asian and LGBT communities.  Some interviewers are more keen on hearing about the health literacy project I did in the Asian-American community, others are eager to hear about the cultural competency training I forwarded in LGBT health education, and still some want to hear about my involvement on a state policy level.

At one of my recent interviews, my interviewer asked me, "How are you able to do all this?"  And I began to reply that I was lucky and these opportunities fell into my lap in such a way that I couldn't turn them down.  He cut me off and corrected me that I instead "seized the opportunities."  I never thought of it that way, but I suppose he's right.

As these interviews wind to a close, I'm more and more certain of what I bring to a residency program.  This wasn't crystal clear at the beginning, but now I know.  Programs didn't choose me because of my grades or Step 1 score (verily, I'm positive that many programs rejected me based on those criteria), but rather the extensive community outreach and advocacy work I've done.  I'm glad that the 11 places that chose to interview me saw beyond the numbers to something more important that I can bring.

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P.S. For anyone applying to residency programs, everything you write in your ERAS application is fair game for interviewers to ask you about - and they will ask you about them, so know your application stone cold.

Interview Trail - Part 1: First Impressions

H DeVos Children's Hospital 2 by ~dharvell on deviantART

I hope everyone's had a happy holiday so far and looking forward to the New Year!  Almost as soon as 2013 starts, I hit the interview trail again.  But before that, some first impressions on Part 1.  There are things I've come to realize that are personally important to me when choosing a residency program, as I'll be stuck where I match for at least the next 3 years.  So in no particular order:

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1. Location

Location, location, location.  This is huge.  More so than I initially thought.  You want to be in a city and an area of the country you can see yourself living in for the next 3+ years.  Weather and geography are major filters for many people.  Some people really want to live on the west coast, or the east coast, or NYC in particular (not entirely sure why . . . no one can survive there on a resident's salary).  Others, like me, cast a wide net over huge swathes of the country to see what might fit best.

2. Hospital

The hospital you'll be working in is very important.  Is it old?  Recently renovated?  New?  Does it have readily accessible computers?  Does it use an EMR (electronic medical record)?  Are there good ancillary staff (nurses, pharmacists, etc)?  What is the patient demographic?  One of my filters is that I only chose free-standing children's hospitals because I felt that I'd get the best pediatric training at those tertiary referral centers.  Also, children's hospitals are all so colorful and friendly!  Adult hospitals are dull and depressing in comparison (particularly the VA).

3. Residents

You'll be working up to 80 hours/week with your co-residents.  You'll interact with them more than you do your friends or family.  They will become your family.  What kind of residents are at the program?  Do you mesh and fit in with them?  What kind of person are you?  While everyone in pediatrics is universally nice, I can definitely see myself fitting in with the residents at some programs more than others.

4. Curriculum

The ACGME dictates the fundamental curriculum for all residents.  The money is in the details.  Some programs are well designed, with a ward structure that residents are happy with, and a ton of flexibility to explore interests.  Other programs are rigid or else in so much flux it makes one anxious.  I've definitely come across some interesting and innovative ward structures.  Also the size of the program can be important.  There are small (1-9 residents) programs, medium (10-19 residents) programs, large (20-29 residents) program, and ginormous (30+ residents) programs.  In what environment might you thrive?  Does it matter to you at all?

5. Benefits

A residency is a job, and it behooves the applicant to have some inkling of the benefits.  How much do they pay their residents?  Does the hospital cover medical/dental insurance, or do the residents pay a portion out of pocket?  Amount of vacation/sick leave?  Is there free parking?  IS THERE FREE FOOD?!  I didn't realize how important the latter was to me until I encountered a program that did not feed its residents.  All the applicants looked at each other and were like, "What is this? An adult program?"

6. Gestalt

At the end of the day, trust your gut instinct about a program after you've visited it.  Some of my friends have created Excel spreadsheets to "objectively" score programs to determine their rank order list.  But the gestalt of a place trumps all that.  I've walked away from programs feeling very good about them - they treated the applicants well, I enjoyed my interactions with residents and faculty, they gave a nice tour of the hospital, they answered all our questions and more - whatever it might be, it's definitely a good sign when you walk away from a program feeling really good.  I've also walked away from programs where I'm like "Hmm . . . not sure what to think about this place" or "I really can't seem myself working here."

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I'm only in the middle of mine.  I've heard from many other applicants that after about the 4th one they're just like, "Okay, I'm tired of this now.  Everything's blurring together."  But here I am after my 6th one and I'm still excited to go on my remaining 5 interviews and each hospital stands out fresh in my mind (we'll see if that changes later, lol).

I think the reason why is because I listened to my advisor's advice (that's what they're for, right?).  And he said that I'll get competent training anywhere because the ACGME demands it, so it's more about how I feel about the place.  Thus I try to explore the city a bit the day before the interview and really feel out the residents and see what makes them tick and whether I "belong."

Residency interviews are so much better (and more fun) than med school interviews (at least for pediatrics/internal medicine - not as much for surgery I've heard).  You are selected for an interview because they want you there.  The interviews are mostly a get-to-know-you and to convince you to go there.  To be honest, it's weird to be complimented and feel wanted, that what you've done outside the classroom and outside rotations mattered.  I can't even count how many times I've been told that the whole process favors the applicant (as long as the applicant isn't a dick).

P.S. The hospital in the picture above is very nice on the inside.  And the people are amazing.

Let The Journey Begin

And so it soon begins, the traveling across the country to visit and interview at residency programs.  And then to create a rank list from my most preferred to least preferred programs.  And finally, letting the Match dictate where I'll end up for the next 3 years of my life.

One interview down, nine more to go.  First to southern California, then to Michigan, then to Philadelphia, then Delaware, and then Chicago.  I didn't get interview invites at several programs I really wanted to have the opportunity to interview at (i.e. Kaiser North in Oakland, CA, UCSF, U of MI, UW-Madison, DC programs), but no matter; 10 interviews is plenty to match.  According to NRMP statistics, I only "need" to rank about 8 programs to virtually guarantee myself matching somewhere.

You may wonder what "matching" means.  Basically, I get interview invitations from residency programs that I send my application to.  Of the programs I interview, I create a rank list of which programs I most to least want to end up at.  Meanwhile, the programs create a similar rank list of which med students they want as residents from most to least desirable.  Then each party submits their list to NRMP and through some computer alchemy, it matches applicant and program.  This is a binding contract, so wherever the match dictates, the applicant must go for residency.  I've heard that the process favors the applicants, insofar as most applicants get one of their top 3 choices or so.

Still, it's a daunting thing.  I've come to accept that I'm almost a second-tier applicant and hence am out of the running for many of the more competitive residency programs.  And that's unfortunate but whatever.  I'm hoping to fall in love with a few programs, as people keep saying will happen.  We shall see.

Let the journey begin!  But first to finish packing . . .