Foliage from last year when I was in a wedding and decided to go on a solo hike. I do not recommend doing this after it has rained, the trail is slippery, you have zero phone service, and no one else was in the parking lot.
If you’ve stumbled across this entry, it is likely that either you or someone that you care deeply about has failed some sort of examination. It may be a low-stakes or a high-stakes one. It may be in the setting of a course, or it may be in the setting of a medical board examination. Either way, there is something so disarming about failing an exam. It really cuts deep. I am going to make the generalization that most people who are seeking advice after failing an exam are those who typically haven’t encountered this challenge before.
Either way, you are here and seeking advice on how to move forward.
I’ve been asked whether my schedule is more “humane” or “manageable” now that I’m an attending. The answer is a resounding “yes!”… but, I still have blocks of long weeks. The work never stops being challenging for one reason or another. There are certainly still weeks when I am scheduled to work 70 hours. Yet even with this assignment, the work still feels so much better than when I was in training. Long weeks as a trainee felt exhausting because there was always something new to learn. Long weeks as a first-year attending also felt exhausting for the same reason. Now that I’m a few years out, I feel more at ease, confident in my clinical skills, and able to appreciate how incredible the work I get to do is.
A blast from the past. This was taken in the MGH Ether Dome in the summer of 2016 when I started as an anesthesiology resident. I was so bright-eyed and bushy-tailed back then!
A glimpse into competitiveness through Match data
It has been almost a decade since I applied to anesthesia residency. It’s crazy how time flies. When I applied to the specialty back in 2014, anesthesiology was a somewhat competitive specialty – for the 2015 match, there was a total of 1,859 applicants for the 1,094 PGY-1 positions offered in through 120 anesthesiology programs [of note, back in my time, there were many more advanced spots available, so of note, there were also 1,581 applicants for the 506 PGY-2 anesthesiology positions; for the sake of consistency to compare between 2014 and currently, I’m going to only focus on the PGY-1 positions]. In the 2023 match, there were a total of 2,959 applicants for the 1,609 PGY-1 positions offered through 172 anesthesiology programs [and there were 2,006 applicants for 301 PGY-2 positions].
If we only look at PGY-1 positions and assume that everyone who applied could occupy a spot, back in 2015, the match rate would be 1,094/1,859 = 58.8% while in 2023 the match rate would be 1,609/2959 = 54%.
I have been part of planning the American Medical Women’s Association [AMWA] meeting for almost a decade now. Although I’m striking a glamorous pose, take note of how not glamorous this room looks [it’s just a handful of us that unpack pallets of boxes, set up technology, and make the program run…]. This organization is one that I’ve said “yes” to for many years… but only more recently learned how “no” could make a huge difference in my enthusiasm for the work.
At heart, I am a selfless, people-pleaser that would rather suffer in silence than let others down. When I feel like I’ve let someone down, it crushes my soul. This leads me to tumble down the rabbit hole of saying “yes” to things. At work, this often translates into non-promotable assignments [aside: did you know that women are 48% more likely to to volunteer for non-promotable work and even when we learn to say no, we are disproportionately assigned to these types of tasks?]. In medicine, it’s often exceptionally difficult to tease out which tasks are “non-promotable work” and which ones will have indirect benefits through gaining knowledge, learning a new skill, or valuable connections that could lead to career advancement in the future.
Throughout medical training, we are conditioned to be generous with volunteering our time for research projects, organizations, and anything that might help get us to that next step. Understandably, when training is finally done, some of us are left wondering… now what? Especially in an academic environment, it seems like everyone has a million projects they’re working on and those who have “made it” to professorship/leadership were the ones that hustled the most [i.e. said “yes” to everything].
But is that approach sustainable? And most importantly, is that the approach you should take?
From my Memorial Day weekend in Austin, TX. Peace out seemed like an appropriate photo for the entry title, no?
Oh, hi!
It has been a while since I updated here [woah, almost a year?!]. I kept telling myself it was time to write something or record something but the passion just hasn’t been there. A couple weeks back, I actually recorded a video, but I wasn’t excited to edit it. Either way, I’ve wanted to explore writing regularly again as a way to stay true to myself and practice articulating things that are important to me. Someday, I’d love to write a book [yup, I’m writing it here so that all two of you reading this entry can hold me accountable].
Anyway, for my first entry of 2023, I thought I’d start with a big one.
For those of you who follow along on YouTube or my social media channels, I’ve been very open about the fact that I enjoy my job. Sure, I can come up with reasons to hate it, but there is no such thing as the perfect job/career/anything. In general, I think I’m the type of person who would try to see the best in any job I’m in, or figure out how to make the most of it. But there was actually a time after I finished fellowship when I wondered if my current job was the right fit.
I actually went as far as reaching out to someone I knew in a private practice group to ask if they would hire me[!].
I took my anesthesia critical care medicine board examination on October 9, 2021 – a significant delay from my graduation from my fellowship in June 2020 because of pandemic restrictions. It was a different experience studying for this exam because I was working as an attending at that point and this board exam doesn’t have as “straightforward” of resources to use [e.g. BASIC/ADVANCED/ITE = TrueLearn + review book]. Also, it feels weird to have to study for yet another exam when you’re finally DONE with training.
During a talk I gave recently to an anesthesia department about social media for use by medical professionals, I used the example of typing into Google: “Are anesthesiologists…” and allowing the predictive text to fill in the rest. The FIRST response on Google is: “Are anesthesiologists doctors?” which I used as a demonstration that we [as anesthesiologists] need to do a better job with letting the public know our role in the surgical team.
For the 2022 Match, the ERAS application included a “supplemental” portion that introduced something called preference signaling. 3 specialties participated in this pilot [though ENT started this starting with the 2021 Match cycle] and this year, this program is expanding to additional specialties [16 total]… including anesthesia.
Although the gender gap in medical schools has recently closed, women physicians still face challenges. I’m frequently asked what the relevance of my work in @amwadoctors is… and well, here are a couple reasons we still have work to do on gender equity:
I have dreamed of becoming a doctor since I was a young girl. But nothing prepared me for the realities of the profession [of note, I’m a first-generation college graduate and no one in my family practices medicine]. If you are pre-medical and plan on embarking on the journey to becoming a physician, I ask that you consider these 5 reasons NOT to become one:
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