Guess who's back, back again

Wow, this may have been the longest I've left the blog, eh?  Apologies, it is not so long and thanks for all the fish, at least not at this point.

It's hard to find a relevant point, to not make a blog intended to be a first hand look at life going through SGU and entering residency as an IMG, and not my personal livejournal and travel blog.

But Grenada is so far away.  I know there are changes on the island, new restaurants, new hotels, new apartments, probably new professors, a new deal in the making, the details of which I have no knowledge of, nor how it affects the school, nor how the teaching is currently going.  I don't know what their current going tuition is or how it compares to other schools in the states, nor what the current fixed interest is on graduate student loans and Grad Plus loans, all centers of my universe and increasing amount of time ago.

New York keeps me closer, and I still get up there, but again, that's all social.. the amazing people I met in Grenada or in Brooklyn and kept as friends.   Those in three year rotations are settling in for their real jobs, one in Maine, one in New Hampshire, others moving around, and I follow them as friends, remembering our times in New York as apartment parties and park walking and bar hopping, rather than as a harried short coated medical student only now realizing that not a single resident I worked with remembers my name, save for the one that miscellaneously showed up in South Carolina to do a fellowship and I ran into him at the gym.

I could talk about the effect of being an IMG on my current residency, but the simple fact is, there isn't one.  Pathology is poorly prepared for in *any* medical school (that's a rant for a different day), and once you're in, you're in.  I have two other IMGs in my class and a DO, and none of the former since (I hope we didn't break them), and unless we remind everyone else, which we will occasionally do with gusto since no one appreciates both the grass clearance and taste of goats, it doesn't flicker on their radar.  I got the fellowship I wanted without a lot of difficulty in the application process, which is considerably cheaper than the medical school and residency processes.  Things still cost a bit more, but that cost is offset by our generous education fund.  So what's life in a pathology residency in South Carolina like as an IMG?  Pretty  much like it is for any other pathology resident in South Carolina.  We eat, we drink, we ill advisedly run over the Cooper River Bridge, and we read books and squint at slides.  And no, don't call us squints.  We've seen Bones too.

And it's been difficult to write as of late because things have been so busy, but largely busy in a completely unbloggable way, though I can do my best.

Someday, I'll get to the end of Nicaragua and Christmas...

I mentioned I'd been accepted onto a committee, which holds meetings four times a year, which is both time consuming and incredibly awesome.  I've now been to three of them (San Diego, Chicago, and Portland) and have enjoyed luxury hotels, fine wine, and eight hours a day in a room with a ring of microscopes hanging with awesome people.  It's one of those things you never really picture in medical school because it seems so ridiculous.  Pathologists travel with microscopes?  These ones do.  So you just sit in a conference room, talk about cytopathology projects, and look at pap smears?  Yup, sure do.

I could attempt to start from the beginning but that would be difficult.  July was a rough month but also marked the meeting in Oregon's wine country, which also featured the nicest hotel I've probably ever stayed in, and it gave me a chance to make some headway on a project I've been working on for them, but it's difficult to do projects at home and projects on the road.

July was also noob month.  It marked the time that someone trusted me to be competent enough to train others in their most difficult rotation.

It was frightening, since I don't feel particularly qualified to teach anyone anything, but it also made me appreciate how far I've come in the meantime.  I'm much faster now.  Still slower than most of my colleagues, but so much faster than first year.  I know what to skip.  I know when to stain.  I joke with the attendings who still intimidate people.  I get praise from attendings who used to intimidate me.  The first years would ask me things that seemed silly.  Not stupid, but just... wow, that used to be me.

So hopefully they came out of it confident, but I know that it did wonders for my confidence.  Now I'm in an elective month, which gives me some breathing time, work on presentations, work on papers, and start the intimidating march to the board exams, which actually seems really scary.  Everyone is so relieved to finish the USMLE series, particularly when it's dragging into the Step 3, but then reality hits you.  Every test is the big one, and failing the dual pathology boards invalidates the others.

You're really all in too.  Fortunately I like my job because the reality of the loans sits in a panic on my chest from time to time where I realize... I can't go blind.  I need my eyes.  I can't get brain damaged.  I need my brain.  I need my ability to work.  I can't have a high risk pregnancy (didn't want a kid, so this is fine), I can't get sick for months on end, I can't rely on the boyfriend to support me (wouldn't want to anyway) and all has to stay on track because there aren't other options.  That's kind of the scary part.  With compound interest knocking my loan figures over 400 grand at this point, it's even more succeed or die than it was previously, but when I finished first term in Grenada, my world, and the maybe 20 grand I'd taken out for that term seemed like the world, and it seemed like my world was crumbling, and that was a moment where it could all go sour and ruin my life.

But twenty grand is nothing, ultimately.  It's in the low range of a new car (which is why I don't drive a new one).  Every value seems a little bit more insignificant once you pass it.  I remember before I started medical school when having bad credit and less than a thousand dollars outstanding seemed insurmountable.  It's weird how it happens when you least expect it.

But things are good with the boyfriend; things are good at home; with a few exceptions, things are relatively good at work.  I try to encourage the new people to talk to me or to talk to each other since I remember being so certain I was going to quit first year, so certain I would get washed out in Grenada, always so certain that each step would mean failure.

But despite the sweat generated by carrying a 400 thousand dollar loan on your back, I can't say I have regrets.  That's a question I get asked a lot as an IMG by prospective students.  Would I recommend others do what I did?  No.  Go to a US allopathic if it's at all possible.  Take out loans to apply to more schools and fly to them.  Don't wait after college.  Don't become a doctor at all.  It's a fiscally irresponsible decision.

But it was also the best decision I've made.  Medical school and residency have given me some of the best friends ever, and it kicked me out of my home state in the most immediate way possible, took away all promises of security and stability, and made me become something else.

Now I'm going to get back to work before I start quoting Arrow (because it's an awful show) but I'm back, kids, hopefully with something of value to say.