And there you have it...

Four years, many class exams, 3 major national boards (and 2 more to come), lots of study, time, travel and nearly done with elective rotations....and we arrive at those tender, sanctified 3 annular weeks. It is time for "match"

Today, all applicants around the country (and perhaps the world) will submit to the match folks their "list" of preferences for programs. At the same time, the programs will submit their "ordered" list of students. Between now and the 12th of March, a batch of computers running a program that is more highly guarded than the formula for Coke, will make life decisions for everyone and "match" applicants with PGY1 residency slots and programs.

I can't tell you how much energy is expended on this process from the applicants end. I'm only 1/50,000 of the applicant bodies involved, each of us making a list and agonizing over each addition... the who, what, where, when and whys run like fluid through the brain. It's what these last 4 years have been about. And it's comforting to know that many of my brothers and sister MS-4's and graduates will get in with little more than high test scores, a cute smile and no healthcare experience.

Yet in the end, it'll be what it is and the more I release control, the more satisfied I am with my application at What-A-Burger.

Moments in Time - Coming and Going

There is so much activity inside the modern academic institution. Students, residents, fellows, attendings, nurses, clerks, technicians ...running around doing "their thing" in the hopes of curing and preventing illness. It's truly a marvel to hear, see and feel the "heartbeat" of the academic hospital "beast".

Yet in the moments of organized chaos and discombobulated focus there are moments of pause. That happens fairly regularly (for me at least) at my institution when the overhead speakers "click" on and we hear a short, just a few bars, music... Brahms "Lullaby" . It means that somewhere in the hospital a baby has been born. There is no announcement, no words, just the telephone-ringer-short-version of the lullaby.  I can't help it. I just stop or slow down my manic walk to the next assignment, listen and realize what's happening. I'm paying attention. A new life is coming aboard planet earth even as those leave us.

 

And so, it happened yesterday. There was a loudspeaker announcement of a "code blue, code blue, code blue,...room blah, blah, blah" as a patient arrested on the floor. Some doctor-looking folks jumped up from the conference room I was sitting in to run to the patients room.

And then, about 30 seconds later, the lullaby.  In under a minute, one patient "left" and one patient "entered". To me, a bit surreal. But I'll bet that most don't even notice such things.

Sometimes the hassle and bustle robs us of our humanity and really being present. I try not to let that happen. Or maybe I'm just sensitive to the fact that match is coming very soon and the rest of my life will reveal itself. So much easier to be "present" when I'm not studying for some major board exam.

And, there you have it!

"In every community, there is work to be done. In every nation, there are wounds to heal. In every heart, there is the power to do it." - Marianne Williamson

The season changes today from active pursuit to passive anxiety. The last of my interviews is over and rank order for "match" is due soon. I think I'll get mine out and certified today and be done with it until the match announcement on March 12 when "matched" and "unmatched" information is posted.  It's the end of this season and the wait begins.

Interviews have been absolutely fascinating. In a very short period of time, usually minutes, you have to summarize your life, education, and experience, respond to questions and concerns, and do it with a cool, calm and collected demeanor. Piece of cake!

So now, rotations continue toward graduation in the very near future. Rank order will be submitted to the God of the Match. And life will continue as if nothing is happening behind the current that Carol Merril is standing in front of. Off to the gym, where the weights don't care what I did on boards.

Entitlement

I'm daily made aware of a subsystem of medical education in the U.S. that is predicated on access, sense of entitlement and money. There are many such examples in the South where students from private, for profit institutions like Krass University and others pay exorbitant fees that amount to bribes, to practices and centers to exclusively allow only their students to attend clinical rotations and receive education thus excluding other students, programs and schools.

This sense of entitlement, bought and paid for with huge tuition, has the students feeling they have the right to be given something which others believe should be obtained through effort. This extends into match and residency as well for many of these students who become unrealistic with expectations of favorable treatment or automatic compliance with theirexpectations. But they are a cheerful bunch, willing to bad mouth and step on any other student in their way.

Lovely huh? Perpetuation of the competitive, almost manic, approach to medical education unlikely to promote anything but more entitled doctors with no sense of team work. It is nearly impossible to create an empathic, caring physician under these conditions.

The U.S. medical education system is drastically in need of review, overall and possibly trashing. But I sense nobody is willing or able to live beyond the system that seems to have a life of it's own...open to payoffs, lured by money, entranced by funding. And further privatization of the medical system is not the answer. It is in fact, part of the problem.