Monumentous Event!

Let it be known that on this day, Friday January 23rd, I have taken my very last in house call as a resident!!!!! Never again will I have to sleep at the hospital or be at the hospital and not sleep because I’m busy reducing fractures in the ER at 3 am. Never again will I have 5 pagers for every different orthopaedic service on my hip while also being harrassed by the ER about seeing a consult. Never again will I have to be the first person a nurse pages at 3am for a new tylenol order or because a drug seeking patient wants more dilaudid. Never again will I have to stand up front of my attendings in the morning boards and present all of my consults with the hope of not getting reamed for my chosen plan of care.

Now I’m not totally out of the woods. I won’t be taking in house call anymore, but I will be taking chief call, which means that i will the person junior residents call if they need help figuring out what to do with a patient when they are doing their in house call and I will be the person they call if a case has to go to the OR in the middle of the night. The the plus is that I will be home when they call me, and there is nothing likely sleeping in your own bed. But that is fun stuff, (or at least I say that now); most of the strain from now on will be the mental strain of thinking about the various treatment plans needed. It’s an exciting time for sure.

Fellowship interviews are going great. A recent article was published in JBJS talking about the orthopaedic fellowship match (http://jbjs.org/content/97/1/e3.long). Its a good read, but what it shows is that almost all ortho residents are pursuring fellowships, of which Hand and Joint Arthroplasty seem to be the most competitive. Peds is one of the least competitive fellowships (you either love kids or you don’t) but its likely one of the strongest subspecialties at my residency, so that combination is making for a really nice interview experience. I have 4 interviews left at the Children’s Hospital of LA, Rady’s Childrens Hospital in San Diego, Hospital for Sick Kids in Toronto, and Children’s National Hospital in DC. After that the choice of how I should rank these various programs is going to be really really tough. Thankfully I know that God hasn’t led me wrong yet from high school up to now, so I’m confident He will make it clear where I should go.

8 Responses to Monumentous Event!

  1. Whitney says:

    Congratulations!!!! I commend you on your many years of hard work and dedication! Not many people can fathom the journey we take to get where we ultimately end up. I’m in my first year of medical school and can only fathom what’s ahead. God is faithful and forever loving; celebrate and embrace this highlight in your life!

    • DoctaJay says:

      Thank you and good luck in your studies. The journey is almost in hindsight as good as reaching the goal at the end of it, so enjoy it.

  2. Jeff W says:

    DoctaJay!

    It’s been a while. On call doing MICU admissions tonight. I had some extra time and caught up on some reading. Found my way back to your blog. Looks like exciting things are happening over there. Good luck with the fellowship applications!

    • DoctaJay says:

      Hey JeffreyMD! I think you are more faithful in blogging than I have been. Are you planning on pursuing a fellowship?

  3. Yande says:

    Congratulations!

    I have a bit of an off-topic question; do you feel like new surgery residents are being trained well? I’ve read some articles on how older surgeons feel like the 80 hour work week among other things are reducing the amount of operating time for residents, and they are becoming less well trained. A doctor posted an article about how fellowship directors feel that less than half of recent graduates can treat people post-op and do basic surgeries independently. Others have criticized the findings for being biased and not well done (this was mainly about general surgeons however).

    I know things are different based on which residency on goes through, but what do you think of the 80 hour work rule and surgeons? Do you feel like surgeons are generally being exposed and taught enough cases?

    Thanks for your time!:

    • DoctaJay says:

      Hey Yande. I think its a little bit of the chicken and the egg. What I have found is that yes, surgical residents in all specialities are likely operating less, and less independently because of the work hour restrictions. But what I have also found is that there has been a general change in the culture of most hospitals, where residents are almost never left alone to operate on patients. If you ask most of the attending aged 50 yo and older, they were often operating on patients alone, without supervision. Experiences that like make you grow up quickly as a surgeon, sometimes at the expense of hurting patients. So the benefit is that probably less patients are being hurt by residents doing procedures without guidance, but the downsides is that with residents not getting to operate unsupervised much, they don’t get this experience until their fellowship or until they are an attending, and then the growing pains start. I think attendings see vast improvements in the surgical skills of residents if the culture still allowed us to operate on patients by ourselves…I don’t think the culture of surgery/medicine will return to this though.

  4. Kenel says:

    DoctaJay,

    I love watching basketball and recently, I was watching a documentary on two basketball players whose injuries were shocking. About one and two years later respectively, Paul George & Kevin Ware, thanks to the awesome work of the orthopedic surgeons and the medical team, they are shooting the basketball again!!

    I still refuse to watch a second or even a third time those gruesome injuries. As I consider a career in anesthesia, I’ve had a thought or two about these frightening sports injuries. And I’ve been told that on orthopedics wards, patients tend to suffer the most given residual pain after successful surgeries.

    Do surgeons have the occasional initial shock, given such injuries, as the rest of us (the general population)?

    A heartfelt congrats to the family!!

    • DoctaJay says:

      I can’t speak for all surgeons, but there aren’t many extremity injuries that produce a shock for me. Mangled fingers for some reason make me a bit queasy, but I can still operate on them after I focus on the task at hand. Unfortunately you have to have some level of detached or else you won’t be able to get through a normal day in orthopaedics.

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