Match Day!!

It's crazy how four years of hard work and craziness all culminates into one moment: Match Day. My heart was pounding when I received the envelope that contained the place where I would be molded into a real doctor, and where Stephen and I will raise our little family for the next few years. Some med schools have a ceremony where students are called one-by-one to a podium to receive their fate, but since I am in a rural medicine program with only a small number of students we got to do our own thing. Most of my classmates wanted to open their envelopes one-by-one with each other, but I chose to just open mine with Stephen and then join the group afterward. I knew that one little envelope contained so many emotions for me (regardless of what program I would get), and I wanted to process it with Stephen first. My top two programs were two of the most family-friendly institutions that we had encountered on the interview trail, and my number three was Hopkins (my dream hospital when I started med school, but very far from my family and a longer/more intense program than my top two). I ended up ranking a world-renowned institution as my number one and then a Michigan hospital close to Stephen's family as my number two. I wanted my number one so badly, but at the same time I knew that getting it would be bittersweet since neither family would be closer than a 7 hour car trip away.

After I got my envelope, I rushed to the car where Stephen was waiting and couldn't wait any longer to rip open the envelope. And then I saw it, my number one program...I felt a flood of excitement and then relief at knowing where we are going. Stephen kissed me and told me how proud he was of me...and the rest is kind of a blur :)

When I look back at the journey that has brought me to this point, I really see God's hand in it all. After sharing our news with family and then on Facebook, I started realizing that I know several nurses and doctors from my Haiti volunteer work that live around the area where I'm going (some even offered to help us with moving!) Over the weekend, I found a rental house on Craig's List across the street from the hospital where I'll be spending all my time except for a few off-service rotations. A close family friend who lives in the area was able to go look at the house and see that it is beautiful (much nicer than we require!) and only a 5 minute walk from the emergency department where I'll be working (such a relief that I'll be so close to Stephen and the baby). And when I talked to my residency program about our baby due just a few weeks before orientation starts, they were incredibly supportive (I have multiple options including taking maternity leave or some vacation time in July). 

We are thankful for so many reasons right now, and excited for the journey to come!

I finally know what I want to do with my life...

via

And it was the hardest decision that I've ever made.

I started medical school with the clear idea that I wanted to be an ER doctor. Having worked almost two years as an ER nurse and spent extensive time volunteering in Haiti with ER docs, I felt confident in my decision. But the farther along that I got in medical school, the less certain I was...I liked continuity with my patients, with is not really present in emergency medicine, and I found myself with a different personality than many of my classmates planning to pursue emergency medicine. Then enter OB/GYN...

Delivering a baby is unlike anything else in medicine or life. There's something about the raw joy of that moment and the privilege of being a part of it...nothing really compares. I also liked the prenatal care, the postpartum care, and supporting women with fertility issues. There were a couple of problems though. I knew that I would be a natural family planning OB, which mean that I wouldn't do tubal ligations or prescribe contraceptives, placing me in a very small minority of OBs. This would have implications on where our family would live, based on me finding a hospital and group that would support me practicing this way. I also knew of the implications on family life in traditionally one of the worst residencies in terms of hour requirements, and even after residency as an attending since babies are never born at predictable hours.

In August I spent a month in St. Louis, at an OB/GYN residency that was strong, high-volume, and NFP-friendly (about one-third of the residents are NFP-only). It was one of the best months of my medical school career. I participated in many, many deliveries and did some of my own. I got to know the residents, a smart, kind, and supportive group. I reaffirmed my love for OB and discovered that it was possible and needed to be an NFP-only OB/GYN (possible, but not always easy). I prayed that God would show me what I was supposed to do.

I guess I should add that when I prayed, I told God (always risky in a way) that it would help me make my decision if Stephen and I became pregnant. We had tried for a couple months, knowing that there was only a brief window between residency interviews and the start of intern year, and hadn't been successful yet. I knew that it would impact my decision if I were expecting, because of doing one of the hardest residencies with a newborn. We found out that we were pregnant the month after St. Louis (yes, God listens).

I still interviewed for OB, but I also interviewed in emergency medicine. EM was my 'first love' in a way, and residency and life after were light years different (probably one of the best residencies with a family, and certainly a great lifestyle afterward for having children). However, there was a nagging feeling inside that I didn't want to give up OB. It took me months to make my decision (which I solidified pretty much right before our rank lists were do). I reflected on life, my priorities, why I went into medicine in the first place. As I got closer to decision day, I realized a few things. One was that I didn't like the operating room: as much as I wanted to like surgery and did like the idea of it, it wasn't for me and probably never would be. Surgery is a huge part of OB, and this helped make the decision easier. I also realized that I would miss a lot of the medicine that I'd learned by pursuing OB. It's a very specialized field, and the broad spectrum of knowledge that I'd always hoped to have as an emergency physician wouldn't be a part of it. Knowing both of this things helped me to be at peace in the end, because I didn't want to make the decision based only on family life or the fact that being an NFP-only OB would be difficult.

And so I made my decision of emergency medicine. There's a part of me that still has a hard time letting go of the idea of delivering babies (not that I won't ever in the ER, ha) but I know in my heart that it was the right decision for both our family and for me. It was reaffirmed last month when I was working in the ICU: ER doctors can pursue a fellowship in critical care and become an intensivist, and I realized that the ICU encompasses so many of the reasons that I went into medicine: caring for patients at their most vulnerable, and practicing in a field that requires me to use all of the pathophysiology that I've learned on a daily basis.

That brings me to today, Match Day. If deciding between emergency medicine and OB was the hardest decision that I've ever made, then ranking programs was a close second. I was so torn between the programs closer to family and a few programs at some of the top hospitals in the nation. Ultimately, I ended up ranking the two programs that I felt were the combination of most family friendly with the best education at the top...one is close to family, where we'll have a lot of support, the other is at a world-renowned facility. The Match leaves a certain element to fate (and God) since we rank our top programs and the programs do the same, but then it all goes into one big computer system to give us our assignment. It's 5:30 a.m. now, and in only a few hours we'll know...the countdown continues...