From Graduation to Fellowship

Wow so much has happened since I last blogged. I had all intentions of writing an individual post about each experience of life got in the way, so I will summarize to catch everyone up. I graduated residency from The Johns Hopkins University Department of Orthopaedic Surgery!!!

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5 years ago when I started on this journey I was humbled to even have the opportunity to train at such an amazing place. As you have seen from my posts throughout the last 5 years, the training was not easy. Surgical training is tough and when I started out my skin was paper thin; I had never been cursed at, never been told I sucked by a medical student or resident above me, never had to question whether I was resilient or smart enough for the task at hand, etc etc. But again, surgical training is like none other; every surgical resident has his or her share of stories of feeling like a total failure after a case or patient experience in the ER, every resident also has days where everything went perfectly and they actually received positive feedback. Every resident has that experience where they were left to do a case in the OR by themselves with the associated glee and terror that is often associated with that. Also every resident has the experience where they were left to alone to do a case, and unfortunately they had to call the attending in because they reached the limit of their abilities. It was not an easy task but by God’s grace, many sleepless nights, incredible stress, intermittent depression, family stresses, etc I made it through. Would I do it again? Yes I would; Hopkins is tough, but as I look back on the training I received, the mentors I gained, the patients both rich and poor I was able to treat, it was an unparalleled experience which has set me on a career trajectory the heights of which I have yet to see.

 

About two weeks after I graduated from residency I boarded a plane for the state of Maine to take part in the Maine Board Review course. It was hosted at Colby College which for me is truly in the middle of nowhere. The benefit however is that for 2 weeks I was away from my wife and kids, had 3 meals/day already prepared for me by the college and my sole job was to study for the boards. I continued my trend started in medical school and skipped all of the lectures. Instead I got access to the 8,000+ questions The Maine Board Review course offered and jumped feet first into studying. The questions they provided were SAE test questions, where were twice as long and hard as the OITE questions I was used to taking. This resulted in many days feeling completely deflated at the scores I was getting especially so close to the test time. I had a goal of doing 400 questions a day which was admirable, but by the end of the first week my brain was so tired I was barely doing 200 questions a day. I worked on week areas which were Hand, Shoulder and Elbow, Adult Spine, and Sports. When these subjects demoralized me and stripped me of my self-confidence, I would jump back into Pediatrics and Trauma and Tumor to start getting better scores. By the end of the 2 weeks I think I completed about 3,200 questions and I had extensive notes and stuff I did not know…WHICH WAS A LOT. After I flew home to Maryland, the days leading up to the test for anxiety filled. I wasn’t doing any more questions; instead I was just reviewing the notes I took while doing the questions in Maine. I had taken so many notes that it often took me 5 hours to review notes for each subject. The night before the test I prayed with everything I had in me. I tried to remember all of the other tests I thought I was going to fail in the past..the MCAT, STEP I, my epidemiology final in med school, my pathophysiology final in medschool, Step II, Step III. I even went back in a private written journal I had and read the testimony of how I pasted some of those tests almost 7 years ago. God gives us testimonies to solidify our faith when the future trials come, as they always will. Reading these testimonies got me through the night and then I woke up and took the behemouth of ABOS Part 1 Board Examination.

 

IT WAS THE HARDEST TEST I HAVE EVER TAKEN IN MY LIFE.

 

I can describe it in no other way. There were 8 blocks, with about 52 questions for the first 7 blocks. Where there was about 10 minutes left in the first block I looked at my screen and I had 17 questions left!!! After expelling my bowel and bladder contents into my pants, I raced through the remaining questions going with my gut feeling and choosing the first answer that seemed right. For the remaining 7 blocks each question stem was so long and took so much thought I barely had time to answer each question and I definitely had no time to go back and check the questions I flagged, which is what I have done for all previous standardized tests. When I walked out of that room I felt terrible, more terrible that I had felt after any test in my life. I knew I prayed, I knew I did my best, but I know also that prayer does = the answer I want always. I didn’t know what to think.

 

I spent about 2 weeks with my family, playing daddy and husband, devoid of any clinical responsibilities and then I boarded the plane to San Diego to start my pediatric orthopaedic fellowship. So far San Diego has far surpassed all of my expectations. This program is fellow focused and the attendings are so dedicated to teaching you nonstop that you barely have time to read all of the material that is suggested. But that is a good problem to have. In addition I have my own clinic, seeing patients with trauma that I operated on. The first day I had clinic, saw my patient, and realized there was no attending to present to I became giddy with delight. Of course I could always walk to a pod close by to ask a random attending a question if I was concerned but the autonomy and push to “grow up” as a surgeon and doctor is exactly what I needed. Only 2 months in I have learned so much and have also started the process of looking for jobs and even interviewing at a couple of institutions. I ask that you stay tuned to hear where I eventually decide to work!

 

Two weeks ago I received this letter in my email:

 

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There are many graduated orthopaedic resident that did not pass this test, and while I worked hard, I’m certain I didn’t work harder than some that failed. I don’t know why God continues to bless me like this, but I am eternally gratefully and I hope I can use all that He has given me not for myself but for whatever task He gives me in the future.

 

With all that said, I write this blog post on the plane, flying back from the Scoliosis Research Society meeting in Prague, Czech Republic. If you are interested in deformity surgery of the spine, there is no other meeting to attending. Hearing the latest and greatest research regarding peds spine, and meeting so many leaders in the field was priceless. I still struggle with understanding how God intends for me to navigate the academic world such as this and the missionary field. I don’t know if its possible without giving up something else important like family, but I’m open to Him showing me which steps to take as he orders my path.

 

 

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