This is the #1 question I usually get asked as a resident.
“What are you hours like?”
What are my hours like? Great question.
So, the long and short of it is that if you were to add up how much I work, on average, it would be 60-80 hours per week (80 being the legal maximum as averaged over a 4 week period).
On a day to day basis, the answer is trickier.
On an inpatient surgical rotation (vast majority of my GYN rotations), we usually round between 6-7 and OR cases start at 7:30. We then “sign out” to the night team at 6 pm, which usually puts you leaving around 6:30.
There are three caveats to this:
- As an intern, you have to “pre round” on the patients, meaning you see everyone, write the notes, and are ready to “present” by the time the rest of the team gets there. So, that can mean some pretty early mornings – I saw a couple of 4:30s when I was an intern and also didn’t see daylight. Thankfully, that’s only one year of your life, so there’s literally light at the end of the tunnel.
- As a senior, you’re doing bigger OR cases….which can go later. So, that “sign out at 6” thing might not always happen.
- 5:00-5:45 pm is the ER witching hour. For some reason, a majority of consults come . at this time. And, this can often thwart said “sign out at 6” thing.
On an OB rotation, its a bit more “shift-work” so it’s usually 7 am to 6 pm….with sign out usually ending around 6:30-7 pm. The short caveats to this are that you round on post partum as an intern and antepartum as a 2nd and 3rd year…so depending on how many patients you have, you get there earlier than 7 am.
Then, we get to nights and weekends.
We have a night float system meaning that there is a dedicated night team Sunday night through Thursday night. You work from 6 pm until sign out the next morning at 7 or 7:30 am.
My longest stretch of nights was 5 weeks in a row. I began to question my sanity towards the end. For any of you who work the night shift as nurses, I throw you a hands up emoji. Living opposite of the world is hard.
Now, on to weekends…the fun part.
Weekends we have a “call” team. This confused a lot of people my first year – I would say I was on call and some people thought this meant I was at home with a pager. FALSE. Call = at the hospital working.
When it’s your lucky weekend on call, you work either Friday night (so you end up working 24 hrs on Friday) then Sunday day (from 7:30 am to 7:30 pm). OR you work Saturday for 24 hours (Sat 7:30 am to Sun 7:30 pm). The jury is still out on which of these is “better.”
Let me tell you — working for 24 hours straight is not something I’d wish upon anyone! It takes a lot of coffee and adrenaline to make it through. New moms – I also send you a hands up emoji.
My parents are continually confused – are you awake? are you asleep? They’ve operated the last four years under the pretense that “I’m always working….or working out.” My parents know me so well.
So, that’s the answer to one of the most common questions I’m asked.
Here to answer your burning questions – that’s what I’m here for.
Until next time…
Daily coffee tally: 1 …but its only 9:45 am so….TBD
NYC Half – the great winter running motivator.
I’ve been lucky enough to run this half several times – I think this is the race I’ve repeated the most.
I went back and looked at my results on NYRR, mostly so I could accurately count how many times I had run this race.
Here’s a breakdown based on year, what I was doing in my life, how I felt.
Where was I in life? 3rd year of medical school, on clinical rotations, I think on my peds rotation, but don’t quote me on that
Any particular recollection? I was training for a marathon at the time and I know this was slower than my PR at the time (which I think was like 1:48…maybe). I remember being a bit disappointed because I thought I would run faster. I also remember it being fairly warm during the race and I was overdressed. However, I also remember it being extremely windy at the finish.
Where was I in life? 4th year of medical school (if you’re confused, I took a research year between my 3rd and 4th years). I was literally LIVING THE DREAM at this point. About to graduate medical school, one rotation left, lots of free time, and people basically congratulated me on living giving said impending graduation.
***Even more special, “Match Day” for residency was two days before this race. I got the program I wanted to go to so I think that high is was drove me to a PR. A mile 8, I remember thinking “OMG isn’t this the best! We’re at mile 8!” Normally, I’m like “omg, only 8 — we still have 5 more?!”
It was also 20 degrees at the start and I couldn’t feel my arms. Another reason I probably ran faster than I thought — to feel my extremities.
Time? 1:42:25 (still my PR)
Any particular recollection? An AMAZING day. PR. Just matched. No worries. 4th year dream world. Had Hu Kitchen pancakes after. Basically, I was a unicorn for a day.
This was also probably the best running shape I have ever been in my life. See also – BQ a month or two later. I will probably never have as much time to train as I did that spring. Thus, I’ve realized this was probably my peak as a runner.
Where was I in life? 2nd year of residency and trying to survive in the foxhole that is residency. This was also during my SoulCycle kick. See also, bank statements from this period and multiple purchases to SoulCycle, LLC.
Any particular recollection? I was really scared before this race because I really didn’t run that much before it. My longest run was definitely 8 miles max. I did a lot of SoulCycle so I knew I was in good cardiovascular shape, but was unsure how my legs would take the pounding. I survived and got a whole milk latte afterwards.
I also ran with Jaime during this race, which was super fun! And, we both did it for Every Mother Counts, which was also fun and meaningful.
I remember talking to Jaime a lot about how I was terrified I wouldn’t match into REI and how I might not survive residency. I think that run was mostly a therapy session for me. Thanks, Jaime :).
Where was I in life? 3rd year of residency and still in the foxhole. Preoccupation – resident research project to present, fellowship application. However, starting to see a way out of the residency foxhole.
Any particular recollection? Yes, I trained more for this race (running wise) than any other in residency. Meaning I ran long runs and workouts (mostly Mile High Run Club) and such. I remember being super exhausted on a lot of long runs but also having some really fast workouts. I was hopeful that maybe I could run under 1:45 if the stars aligned, but also knew that residency is a leech that can sometimes suck the life force out of you, no matter how much coffee.
I ran over 1:45, but under 1:50 and was pretty happy with that. Still wanted that 1:45, but at the end was like “I gotta go home – I start nights tonight!”
I also got hot chocolate and a blanket at the finish so that was all a win-win.
I did feel fairly fatigued that night and nauseous that morning. So, I checked some labs at work. My Hct was 36. And my cholesterol was 119. Booyah. [ie nothing is wrong with me other than being a resident.]
So, where does that bring us?
Well, now I’m a 4th year resident, getting ready to graduate! I will leave the foxhole! Although, to be honest, a little sad to do so. The foxhole has been very mentally, emotionally, and physically exhausting, but also a whole lot of fun.
My ultimate half marathon goal is to one day run under 1:40. I give myself about a 5% chance of that happening in residency or probably ever.
Not that I don’t think I couldn’t run a sub-1:40 with proper training — more that life is full, excitingly busy (as Ali likes to say), and that there are other goals I have right now that mean more to me than a 1:40. Might not stay that way forever, but for now, that’s the truth.
I’d love to run under a 1:45. I give myself a 10% chance of this happening.
I give myself about a 60% chance I’ll run under 1:50…if I modestly train.
That leaves about 25% I’ll run over 1:50.
Closer to the time, I can adjust these percentages based on what I actually did. It will depend how much residency and winter (really, winter) suck out of me.
So, if I’m giving myself these wacky percentages that are generally point to something that isn’t a PR. I bet a lot of runners out there would be like “then why train?”
I’ve thought that myself.
What I think brings me back to these races — despite the high mental/physical/emotional demand and profound exhaustion of an OB/GYN residency — is the feeling of racing.
I just want to feel like I’m racing – like I’m out of breath, that I’m trying my best, that I’m not sure I’ll make it to the next mile, and…well, you get it.
So, that’s the goal – to feel like I’m racing – and if thats 8:45/mile or 7:45/mile, that’ll be fine.
Given that my workout routine in residency is fairly capricious and mostly based on what’s going to make me happy at the moment, here’s what is making me happy.
I train at a Crossfit gym (but don’t do Crossfit, actually) and it is so much fun. I train with Alex Silver-Fagan. She is extremely knowledgeable and knows her stuff. Two thunbs up or insert the hands up emoji. Or both.
We’ll see how this translates into racing.
I also still love boxing (Shadowbox) and Pilates (Flex). And, running, obviously — its my real one, true love.
Ideally my plan would be 3-4 days running and 2 days of strength training. It also includes 3 cups of coffee a day and the occasional “I’m too tired” day.
TBD. Who doesn’t love a good experiment?
Ideas, suggestions, comments welcome!
That’s all for now:
Daily Coffee Tally: 3
First of all, its 6:30 pm and I’m in my pajamas. Christmas pajamas. Watching World News Tonight. I have no idea why I’m single.
So, the 5 of you who read this know that I am an OB/GYN resident. If you didn’t, now you do.
As part of our residency, we are required in our 4th year to give a “Grand Rounds.” This is a 45-1hr lecture on any topic of your choosing.
Personally, I found this quite intimidating. Why? Well, the people you are lecturing to are mostly senior to you and know much more about OB/GYN than you do. So, to bring something new to the table is somewhat difficult.
I racked my brain about what I may know that the department wouldn’t.
The best exercise classes? SoulCycle versus FlyWheel – the eternal debate? Is ClassPass worth it? 5k or Half Marathon?
Oh wait….THE INTERNET! TWITTER! FACEBOOK! I GOT THIS! I GREW UP ON THESE THINGS!
[My entire adult life has been with a Facebook account (I got it in the spring of 2004, when I graduated high school. #OG?)]
I ended up doing my grand rounds on social media and medicine…”Tweetiatricians.”
I wasn’t so sure how it would be received, but people really seemed to like it.
Given the interest, I thought I’d post a few things here that struck a chord with people.
Why should doctors care? Because, WE ALL USE GOOGLE. I even use Dr. Google, even though I tell patients “don’t google that!” And, of course, I diagnosed myself with about 6 different fatal maladies. See? Google can be dangerous.
But, Google…and the internet all together…can give you a leg up! If you find the right resources, you can go into your appointments more informed or with your expectations managed.
Look, I love twitter (fine, I like instagram more). However, Dr. Google will never replace a solid doctor-patient relationship and IRL conversation. But, can we work together – internet, doctor, and patient? I think we can. We’re all in this together. Cue “High School Musical.”
I introduced a lot of people to the wide world of Twitter.
I like to thing of Twitter as my electronic word of mouth.
What I might think is interesting…and what I want to tell my friends and family about I can now tell to anyone who happens to follow me on the internet. So, for instance, when ACOG posted a tweet regarding IUDs, I “retweeted” it to my followers. Retweeting is a way to amplify information that merits repeating, such that the most useful content can be shared with a progressively wider audience.
If we can make good medical information go viral, we could really do a lot of good.
Unfortunately, doctors have been a little slow on the uptake on social media and even slower on how to improve your visibility, SEO, etc.
***Thanks to Theodora for giving me run down on SEO***
I introduce the topic (and concept of) hashtags and you know what’s cool? There’s a company out there called Symplur that started the “Healthcare Hashtag Project.
The project tries to make Twitter more accessible to providers and the healthcare community as a whole. They attempt to help lower the learning curve of Twitter by providing a database of relevant hashtags to follow so new and existing users can find conversations that are of interest and important to them.
Symplur also lists hashtags for health care conferences and twitter chats, which I’ll talk about in a minute. They also identify the most frequent users and most frequent mentions related to a certain hashtag so you can follow thought leaders or influencers on your topic of choice.
Finally, Symplur encourages visitors to vote on hashtags that are most useful to them in hopes of brining multiple conversations together – meaning that you can vote on whether #infertility #fertility or #ttc provides the most relevant information for the topic for which you’re trying to pursue.
I think Twitter + medicine could have a beautiful future together, especially with research. We now have access to spontaneous, public comments and thoughts on healthcare. And, I personally think you could get a lot of good information out of that to help improve patient care, assess unmet needs, increase patient satisfaction, understand what concerns people have, and so on and so forth.
And, people have done that! See below:
People have also looked how accurate some tweets are.
NEWSFLASH: Some things you find on the internet are, indeed, false. So, remember to not believe everything you read.
Finaly, my piece de resistance (I can’t figure out how to get accents on my words!), my informed consent for social media.
And, one final plug — Mayo Clinic puts digital scholarship as part of its criteria for academic advancement. #tenure #professor
There was much more than this, but I thought I’d give you all some of the highlights!
Want to know my personal opinion? Ok, I’ll tell you.
I think that for physicians of my generation, who may have grown up on social media, having an online presence seems fairly normal. We’ve gotten used to broadcasting our lives, maybe developed thicker online skins over the years, and know the ins and outs of how to use all these apps and sites to our advantage. Being online and enmeshed in social media is somewhat of a skill set, I’ve come to learn (I just thought I was wasting time and brain cells in line at Whole Foods scanning Twitter all these years).
For physicians who are already in practice and not on social media, taking on a new skill set and “putting yourself out there” can be both frightening and challenging. At the end of a long clinic or OR day, a physician new to Twitter/Gram/FB may not want to sit down and figure out the best hashtag to describe his or her day.
However, I think it is important for all physicians to know what’s out there, because invariably out patients will be using the sites and apps. Meeting your patients halfway and understanding what they may have read may help you address their concerns a bit better.
In putting this presentation out there, what was most striking to me was how many people trust the internet more than their doctors.
Distrust in the medical system seems to be rampant these days. And, I can sometimes understand where people are coming from. Finding a good doctor can sometimes be difficult – one whom is both a good physician and with whom you get along with.
If we can’t stop out patients (and ourselves) from the using the internet, then why don’t we starting interacting and putting good information out there?
Let’s make the medical internet great again!
I think the ultimate point of my talk was that — while it may seem trivial and a waste of time, having a presence on the internet as a physician could be powerful. You can be a source of good information! Help people! And, that’s why we all became doctors, right?
Alright, that is all for now.
It’s 7:42 and I’m like “is it bedtime, yet?”
On another note, I got into the NYC Half. Anyone have a 3 day a week half marathon training plan that also gets you fast results? Much appreciated.
If you want some good medical advice from the internet, don’t forget to check out my friends’ website, Truly-MD. They were also on Lindsay Hein’s podcast today (“I’ll Have Another”). I thought it was awesome.
Finally, here’s one of my favorite sites for all things social media and medicine (as well as lots of other great content) –> 33charts.com He (Dr. Vartabedian) gave me the line “visibility creates opportunity” through Twitter! [And, yes, I put him in my references, but I do that all on one slide at the end!]
That’s all for now.
Daily Coffee Tally: 3
**I wrote this last night. Then fell asleep before I pushed post. #residency**
Well, hello, there.
Does anyone read this anymore?
Regardless, last we left off, I was in the middle of fellowship interviewing and racking up frequent flyer points and Delta peanuts like it was my job (only it wasn’t – I still have that 60-80 hr per week gig as an OB/GYN resident).
Long story short, I’m packing up my bags and headed to LA in June! I matched at the University of Southern California for reproductive endocrinology and infertility.
To quote the young musician-philsopher, Miley Cyrus, I’ll be hopping “off a plane at LAX with my dream and my cardigan” in late June 2017.
After 12 years in NYC (what?!) and that same number of years without a car, this is sure to be a big change! Fortunately, they have SoulCycle in LA and, even better, Philz Coffee, tons of poke, Shadowbox (coming to LA in 2017!) and the best weather imaginable. I plan to be outside everyday BECAUSE YOU CAN. Suffice it to say, I think I’m going to like it in LA.
Side note – do you have friends in LA? Do they need friends? Do they like sunshine, running outdoors, and coffee? If so, do they want to be my friend?
Since this may potentially be my last year in NYC, I have decided to do things that I…should’ve done in the 12 years I lived here. My ‘rents and I took a tour at the Metropolitan Museum of Art two weeks ago. The Met is so large and overwhelming – tours definitely help you digest the place better. Highly recommend.
Because I used to blog about running….
In running news, I ran a half yesterday, although run might be an overstatement! My co-resident Annie and I took a nice leisurely 13.1 mile stroll through Philadelphia on an oddly warm November day. We walked on the hills (they changed the course — and its now fairly hilly in some parts) because we are overtired residents. No shame, whatsoever.
Maybe it was all the fall leaves, but I think I’d like living in Philadelphia. Sign me up for one of those stone house on the Main Line. #addtocart #Imsuretheyrecheap
And, finally, a public service announcement from your favorite OB/GYN resident on the internet (RIGHT, EVERYONE?!).
I get lots of texts from my friends (I’m honored you value my opinion btw!). Besides the usual questions of “is Juju really on that beat?,” I get questions on everything from pap smears to pregnancy. And, I love it! I learn so much from the questions from my friends.
However, should you be looking for something on the internet that is credible and well written, a shameless plug here for my friends’ new website, Truly, MD.
Truly, MD is written by my friends (and mentors) Dr. Jaime Knopman and Dr. Sheeva Talebian. The aim is to be a honest, no-nonsense, but easy to read platform for everything women’s health! Trust me, if there’s a question you have…it will be answered on there!
Here’s a few of my favorites:
When Doctor Becomes Patient <- a definite must read!
That’s all I have for now.
Daily coffee tally: 2
PS – I have some incredibly annoying head cold that is causing some gnarly sinus pressure. I have to say – this is the WORST.
Well, Hello, There!
From, 30, 000 feet or so.
For those of you who read this blog (ever) back in 2013, you might remember a fun little process I went through at the time called “the match.” The best way to describe is that it is somewhat like sorority rush for residency placement. You apply to programs. You may or may not get an interview. You then rank the programs in the order that you like. The programs rank the applicants in the order they like. And, then, a computer matches you up.
The horrifying thing about this that you life basically changes in one email on one day, based on a computer algorithm. You may have your heart set on a program in Colorado, but, surprise!…you’re actually moving to Florida.
And…there’s nothing you can do about it (ie the match is binding)!
No stress, right? If you don’t remember, the last time I did this I went to restorative yoga classes for about a week straight before match day in hopes of revving up my parasympathetic nervous system to help me calm down. I basically paid money for people to tell me to sit on pillow bolsters and not to think about the enormity of the whole situation.
To further increase anxiety, there is a significant chance you will NOT match this time around…seeing as there are about 80 applicants or so for 40 spots. So, the odds are somewhat better than the Hunger Games, but not entirely fantastic, either.
And, finally, when you’ve gone through the pyramid of medical training….and many people have been “weeded” out…those that are applying for such positions are generally extremely well qualified. So, the competition is intense.
As you can imagine, I’m in a glass case of emotion now. I even considered sitting down at a Tarot reader and/or psych in Soho the other day. Just to see what they said. See if they can predict what is going to happen on October 5th….and then I realized I had no idea what Tarot cards are (were? Aren’t they ancient), I was likely placing faith in a game based on probability, and psychics…well, I don’t necessarily believe anyone can predict the future. I mean, aside from Donald Trump, of course. I’m sure he can.
Of course, I do realize I am in the great fortune of having many wonderful places to interview at and the reality is that I have “good problems” to have. I am having a classic case of 30-something first-born first-world problems.
[***I totally believe in the birth order “thing.” I fulfill most first born characteristics. Ask my siblings.***]
However, being that I generally consider myself an optimist (albeit tempered by realism), I’ll point out the good parts of the interview trail:
- Meeting people! You see a lot of the same people at each interview, which is fun. The field in which I am applying is small, so its nice to meet people you will hopefully work with in the future.
- Seeing different programs, their strengths/weaknesses, and what might be possible for your career
- Running in lots of different places!
- Two west coast trips = two (or more) trips to Philz coffee
- Frequent flyer miles?
Alright, that’s all for now.
I’m returning to “Truly Madly Guilty,” which is Liane Moriarty’s newest book. Like her other novels, it is addicting. I’m also finishing up “Do You Believe In Magic: The Sense and Nonsense of Alternative Medicine” by Paul Offit, MD. It’s a great, evidence based read. Highly recommend.
Thankfully, no one on the interview trail has asked “what was the last book you read?” Oh you know, just the latest in the Emily Giffin and Liane Moriarty chick-lit genre. 😉
Until next time…
Interview coffee tally: frighteningly close to coffee infusion level
PS – I’m watching “Hitler’s Rise and Fall” on this flight. I’m sure my row mate is like “what???” Give me a good History Channel special and I’m golden…
Tomorrow is July 1.
And, while most people are figuring out their holiday weekend plans, a subset of the population is figuring out how not to poop their pants tomorrow.
Or, at least that was me on July 1, 2013.
I picked up pagers at 7:30 am and remember thinking they might have to call a medical response team on me if they went off before my seniors got there because I had not the slightest clue as to what to tell anyone if anyone asked me a question. I felt like a huge fake; I didn’t even know how much motrin we usually gave patients! And, that’s an over the counter medicine. How were people calling me doctor when I didn’t even know how much of a non-prescribed medication you give?! I felt a lot lot Bambi wandering around in the forest…
Spoiler alert – the pagers do go off, you do figure out how to answer them, and you learn how much motrin to give someone.
So, dear interns, I survived….and you will, too!
Just don’t drink too much coffee on day one – your heart rate will already be high enough and you’ll be shaking even without it.
A couple of things to read about internship, July 1, and “the July effect:”
http://danielleofri.com/july-first-part-one/ [definitely listen to this one!]
My top tips for surviving July 1 as an intern:
- Be organized
- Ask questions. No one will fault you for not knowing. In fact, they expect you to know nothing.
- Be nice to nurses, scrub techs, PCTs, etc.