Hurricane Jill

Curiouser and curiouser

Interesting…I got a personalized letter from the program director at Duke. It said nothing about where they plan to rank me, but it was still very nice. And it was definitely not a form letter.

And UCLA un-rejected me yesterday as well. Now I have an interview there next Wednesday. That brings the total to 11, a much less anxiety-provoking number than just ten. It’s only one more interview, but somehow it makes a huge difference.

Still, if all goes well, the lowest I should fall is Cincinnati, and I plan to rank it in my top four at this point.

I have LSU, Tulane, Mayo, UCLA and USC remaining.

Baylor

Because I can’t leave out Baylor!

Pro:
1. Solid all-around program
2. Lots of operative autonomy at Ben Taub
3. Lots of new faculty
4. Good mix of hospitals
5. Outstanding tumor research, now with research year
6. Best choice if I want to stay in region
7. Already know most residents/faculty
8. In my hometown
9. Good clinical/operative reputation

Con:
1. Parking
2. Parking
3. Parking
4. Houston
5. Would be difficult to branch out from tumor research, if my interests change
6. ? academic placement history

Cedars-Sinai

This was by far my most interesting interview. Turns out Cedars is not actually in Beverly Hills. The residents were very emphatic about the fact that it was located in West Hollywood. Later I spoke to one of the LA natives on the interview, who thought it was funny that they had been so emphatic, since you’d think they’d prefer to be associated with a rich part of town over a gay part of town. But I suppose from a patient population point of view the gay neighborhood adds diversity.

The people there were interesting. I ran into a girl I met earlier on the trail, who intimated that the other students from my rotation at Barrow have been badmouthing me to anyone who will listen. So unprofessional.

This was one of those interviews where they test both your dexterity and moral compass. We had to tie a square knot with a shoelace around a candle shaped like a billiard ball (and with a similar tendency to roll away from you), while answering questions. It was harder than it sounds, although I did manage to do it in the end. Then another interviewer asked me how I would solve a particular ethical dilemma. Ethical questions are usually pretty easy to answer, since there are usually a number of ways to solve a problem that don’t involve unethical behavior. I don’t understand why people find them difficult.

The weird activity at this interview was writing a paragraph in our own handwriting on a blank piece of paper, and then signing our names, and printing our names underneath it. The paragraph could be about anything we wanted, so I used the opportunity to write them my thank you note. At one point, I asked Dr. Danielpour what he was going to do with our paragraphs, and I didn’t get a straight answer. I’m sure it’s for handwriting analysis, though. And sure enough, I just did a search on handwriting analysis and found a do-it-yourself site where you can enter in information about the writing vs. the signature vs. the printing and get a superficial analysis of the person’s character. So I entered in the information from my writing (which was a little less slanty and a lot less loopy than normal), and well, at least it presents a picture consistent with my interview. Still, it’s a bit irritating that they’d rely on a computer-generated superficial analysis. At least do us the courtesy of getting a professional opinion.

As for the program itself, here’s the pro and con list.

Pro:
1. Lots of faculty
2. Nice facilities
3. Good research support (mostly tumors/spine)
4. Lots of flexibility
5. Excellent spine and tumor experience
6. In a big city
7. Good operative volume
8. Huge book fund (>$1000)

Con:
1. 1 resident/year
2. Service can run without residents
3. Weak trauma
4. ? Vascular
5. Los Angeles
6. Program rep could go either way at this point
7. Weak ICU experience
8. Cost of living in LA
9. Loupes paid for, but out of PD’s pocket
10. High-maintenance patients

Cincinnati, BNI

Cincinnati
Pro:
1. well-rounded program
2. residents get along well
3. good children’s hospital
4. moonlighting
5. 3 residents/yr
6. low cost of living
7. Cincinnati has a lot of stuff to do
8. Can do 2 research years in 7 yr program

Con:
1. Hard to meet people in Cincinnati
2. Too many people at University/not enough cases?
3. Buy your own loupe
4. Med school significantly lower caliber than residency

Barrow Neurological Institute
Pro:
1. No double-scrubbing–every case you do is primarily yours
2. Great reputation for technical competence of graduates
3. Solid support for clinical research
4. New med school starting next year
5. Navy scrubs
6. Low cost of living in Phoenix/high resident salaries
7. Loupes and lead paid for
8. HUGE volume of cases and patient load
9. Graduated call responsibility, Q4-5 at worst
10. Fabulous ancillary staffing

Con:
1. Call is ALWAYS hectic
2. Limited bench research options
3. Phoenix
4. Very un-intellectual atmosphere
5. I’m not a jock
6. Limited peds exposure

What happened

I’m bored out of my mind right now. I have a long To Do list, which is getting done very very slowly. I get writer’s block every time I sit down to write Thank You notes, and the letter from my first away rotation still hasn’t arrived. And there have been NO new interview invitations in over two weeks. No rejections, either, but that doesn’t mean a whole lot. So I’m fighting disappointment, and right now the disappointment is winning.

You may wonder what precipitated the gunfire on my last away rotation, when I constantly lament that I’m not on top of my game. Well, two things happened in the space of two days which made it look as though I had locked up a spot there, when in fact that was not at all the case.

First, on rounds Wednesday there was a patient in the section where I was rounding in whom an MRI was contraindicated due to some sort of metal implant, but whom everyone thought had a brain tumor of some sort. However, the CT scan that had been done instead showed a 1.5 x 2.5cm nonenhancing and ill-defined hypointense lesion in the basal ganglia/internal capsule region. So everybody in our little group took bets on what it was. The 5th year (i.e. the resident with the most say in ranking applicants) said he thought it was a lymphoma, and then turned to me and said, “if you get it right you’re in.” At breakfast, I told him my guess, which was that it was an ischemic stroke. The next day in team rounds, he said that the neuroradiologist had indeed read it as an ischemic stroke. I said, “YES!” and did a small happy dance, and the 5th year said, in front of everyone, “you’re in!” After rounds I heard the chief chiding him for saying that, and he replied with something to the effect that he thought they needed an older resident, and then I couldn’t hear any more. So later at breakfast that day, I sat down with him and the chief and made a point of saying I wouldn’d hold him to what he’d said, since he hadn’t seen all the applicants, and I hadn’t seen all the programs.

So I told the other students I’d said that, to try and head off any jealous sniping, and one of them replied, “well, of course he was joking. Nobody ever says something like that and means it.” Which I thought was kind of bitchy, but I let it go.

Then the next thing that happened was on Friday after the last two of us gave our presentations. I’d started off my presentation saying that it had been several years since I’d given a talk to an audience that size, and apologized for being a little rusty. I had let the other student go first, since that presentation was on a non-research topic and I thought that student would look better presenting before the research talk than they would after. And their talk did go well, and I was impressed. And I didn’t think my talk had gone well at all.

However, later that morning I was scrubbed into one of the program chairman’s cases, and that other student was case-hopping, and happened to be in my room when the chairman came in for the critical part of the case and made a point of complimenting me on my presentation. He said that it was a good presentation, and that I had no need to apologize for my presenting skills. He said nothing to the other student, probably because he didn’t know the other student was in the room. Unfortunately, that student happened to be the most insecure of the group, and felt at a disadvantage coming from a lesser-known school and without research experience. To make matters worse, that student was also my assigned roommate for the rotation.

So it was downhill from that point on. I don’t know how to deal with other women’s envy, and I never have been able to do it well. The problem is that I actually do care whether they like me or not, but I always feel as though the more I excel, no matter how considerate I am of them in the process, the less other women like me. I know that screwing up is not the answer, but I’m at a loss for how to keep women friends otherwise. Men don’t seem to react the same way in this respect. You excel, they respect you more. Maybe they don’t ask you out, but they don’t punish you for being better than them at something. So it feels like I really do have to choose between excelling in some particular arena and having women friends there as well.

And the sad thing is that I’m not really better than them. There was just the perception that I am. And really not even the perception, but only the other students’ impression that there was. What I mean by that is that I’m quite certain the chairman would have complimented the other student as well, had he known the other student was present. And my CT scan read was born of a year’s worth of participating in neuroradiology rounds with the neurology residents when I was on service. And the neurology residents were held to a much stricter standard when requesting MRIs than were the neurosurgery residents, and consequently there were numerous instances where there was only a CT scan available. I mean, even if I weren’t trying hard to teach myself how to read the scans, I’d have at least learned a few things by osmosis. So not only was that not an even playing field, but the other students weren’t even asked their opinion.

Still, it’s worth noting that if the situation were reversed, I’d have congratulated the student who read that scan correctly, and echoed the chairman’s sentiments had they been directed toward the other student. At most, I’d have joked within everyone’s hearing about how there were only 3 spots left now. But none of those things happened.