Trauma surgery and second looks

One more week of trauma surgery to go at Maricopa. Since I missed one week for second looks back east, I've really only been on the service for two weeks. However, it has been more than enough time to confirm some things for me.

First, I'm sooo glad I didn't go for surgery. I still love the OR and surgical procedures, but the amount of BS during residency, even with the 80-hour work week limits, is ridiculous. It's like two years of hazing, then three years servitude, constant testing (and pimping) and constant time draining hassles. Residency paperwork, students, inadequate staff, off-service residents, hospital bureaucracy and the usual political battles between doctor groups, administrators and out placement agencies is never-ending. Even the chief (a PGY-4) spends a lot of time watching Attendings doing the cool stuff in the OR.

Second, Maricopa is a decent program but not one I'm crazy out. If I end up here, I'll rise above the adversity and get the education I need. But JHACO problems, EM residents that don't wait around for placentas to be delivered and general lack of professionalism (not just in EM) have me concerned. The facility is also in pretty poor shape and their U/S training is behind the curve.

On the other hand, my second looks were very confirming. I spent a day at Christiana and loved it. I almost didn't want to like Hopkins so I could rank Christiana #1 (which I still might). The people are awesome, he training second to none and the program very resident friendly. Finally, only three years, great benefits and moonlighting would lead to a reasonable lifestyle. Since I didn't rotate at Hopkins I was a little fuzzy on many aspects of the program and much less prepared for how the second look would go. But that's why the second look at Hopkins was so important.

After getting lost in Baltimore, I worked Wednesday night with the U/S director and one of the Chiefs I got to know during the initial interview. For 3-4 hours at Bayview Hospital I asked tons of questions while we handled a few patients. The facility was decent, the staff seemed fine and everyone got along well. The answers regarding the program and the area were predictable and gave me a pretty positive feeling.

Thursday I worked at the main Johns Hopkins Hospital for a few hours. The Attending was a recent Hopkins graduate and the intern was another John. Even though it was very busy, I had time to ask lots of questions and observe a lot of the ED operation. Again, while the facility was nothing spectacular and no one aspect of the program screamed at me, I had a good gut feeling for the place. I really wanted to make sure I wasn't being swayed by the Hopkins name and family/friends' awe about the institution. The two days in the main EDs were very confidence building in this respect.

Friday morning I attended Hopkin's weekly on conference day. The lectures were great, like Christiana's, and I really enjoyed hanging out with the residents. It probably didn't hurt that I was there on the day the residents consolidated their impressions of the applicants for the department. I think I made a good impression on everyone there.

The program director was out of town, so I had to catch up with him by phone a week later. I don't trust platitudes and goodwill for a decision this important to my career, but I got a really good feeling from him. Everything feels right and I've heard time and again from residents that you have to trust those feelings. Every RRC approved program can train you, but you've got to be comfortable to do your best while you're there.

After the conference I drove around Baltimore a little and stopped by a Remax office to talk with an agent in one of the neighborhoods recommended to me several times for good schools, family activities, access to Baltimore and DC and affordability. Becky was even encouraged by initial looks at job prospects based on openings listed online.

I've got 10 more days until the ROL has to be finalized and submitted for the Match. So there's plenty of time for nagging doubts about four years of residency at Hopkins without moonlighting (as of now) to change my mind. In the meantime, the house goes on the market in a week. Crazy times for the whole family.

Speaking of family, Becky's mom and grandmother left a week ago, just as they got hit with the influenza bug that Connor and I had a few weeks ago. The vaccine doesn't seem to be active against this year's strains, so there's epidemics all over the country. Like me, they acquired a pneumonia super-infection like I did. However, her grandmother is 91 years old and is now in the ICU with possible hypoxic heart damage. At that age you just don't have the immune system to fight these infections, and you go downhill in hours.

Time to get a little sleep before the five o'clock alarm. Six o'clock rounds every day for five years would be torture for me. That's not including Wednesdays where rounds start at five, lecture is from six to nine and turnover to the night crew isn't until six in the evening, thirteen hours later!