Oct 1, 2015

Polite Request


Attention scum sucking spammers.

This blog is not abandoned; however, your goals of making untold fortunes through convincing people to refinance their loans through you probably should be in favor of doing virtually anything else with your lives.  Seriously, go empty that garbage can.  Now empty another one.  Congratulations, you just found something more fulfilling than spamming blogs.

In short, you're dumb and your mother dresses you funny.

We now return to waiting for me to have something relevant to blog about.

Aug 13, 2015

Board certified and it feels so good!

So apologies for the delay, but yes, on the last week of July, a mere 12 weeks after taking that nightmare of a test, I received confirmation in the form of a nondescript email (or more accurately by my refreshing the website every ten minutes for 12 weeks and driving everyone crazy) that I was "successful" in both the Anatomic and Clinical Pathology portions of the exam.

So I'm a double boarded pathologist, baby!  At the end of this year, if all goes well in Cytopathology, I'll be TRIPLE boarded, which I believe doubles my mana on all offensive plays.

As far as the fellowship, well, there's no place like home, but I'm getting really spectacular training and experience.  But I do miss my own office and my surrogate Charleston family.

Now, the greatest challenge: Finding that first real pathology job.  Clock is ticking!

But yes, the short version:  I PASSED!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Jun 8, 2015

Now is as good a time as any...

I took the AP/CP pathology boards in the middle of May, far earlier, as I mentioned, than I had previously anticipated, and wanted to update everyone, save for a few things.

1.  The ABP is absolutely *insane* about giving any slip of detail about the exam, to the point that they asked us *directly before taking it* if we used rememberances, and better yet, if we knew anyone who used rememberances.  This strikes me as overkill, piles on the stress at a bad time, and has a "are you or have you ever been associated with communists" feel.  It was a continuance of a lecture I received at an event a couple of years ago delivered to us in a tone of voice more fitting for disobedient children than doctors with a minimum age of 24.  The simple fact of the matter is if the variety of honors codes and oaths haven't gotten to us by now, nagging us in the minutes before a 2300 dollar, 16 hour exam probably isn't going to ferret out the evildoers and it's disrespectful to those going through it since the vast majority of us are not poring over half-remembered previous questions for guidance.

2.  It's hard for me to critique the whole process since 1) I like my job and they're the gatekeepers 2) I know some members on the ABP and they're cool people that I can't imagine are responsible for the babytime fun talk 3) I don't know my results yet, so whether that monster of a test bore fruit or not is beyond me.

3.  The end of boards corresponded with having a bunch of administrative nightmarishness drop onto me from the future employment end, which then corresponded with getting a terrific headcold, so I've spent more of the last week curled on my couch crying rather than blogging.  I got better.

Things I can say:

The shorthand.  Pathology residency usually consists of a dual program comprised of Anatomical and Clinical Pathology.  This lasts four years (doing either separately is 3 years), and to be employable in a difficult job market, most people complete a fellowship.  Some fellowships are boarded (like cytopathology); some are not (like gynecologic pathology).  Nearly all pathology fellowships are a year long, contrasted to some of our clinical colleagues that have three year fellowships.  Fellowships are typically compensated like an extra year of residency.  Being board certified in AP/CP pathology is pretty much a requirement to "sign out" anything in pathology, which is, have your name on a report and the report goes into a system.  Since my residency is two parts, I'm technically taking two board exams, which were administered on consecutive days.

Pathology exams, unlike almost every other field, and allegedly due to the microscope requirement, are held in Tampa, Florida.  There are several weeks between May and early July in which whole residency programs are assigned dates to show up and attend.  It's expensive, time consuming, and notoriously difficult.  You are usually at least there with your equally miserable colleagues, as I was.  So knowing that, let's go.

-I was told by everyone that it was an awful experience and virtually everyone feels like they failed.  This in no way prepared me for how bad it would actually be.  I didn't think I'd feel better off than anyone; I just underestimated exactly how heartbreakingly awful the process is.  I mean, few people feel great after the RISE, but this was like being kicked in the gut repeatedly by someone wearing steel toed shoes while another person stood above you describing the details of your dog dying.  Just awful.  I came out too beaten down to cry, but several others did.  The worst part is coming out after your first day feeling like an utter failure and knowing you're going to have to start the whole process over again the next day.

-One of my colleagues and I managed to separately utterly ruin the confidence of other people coming in to take it the day after our last exam by her "that was f-ing awful" (and she never swears) to a man she thought was in business (taking it the next day) and my response to a wide eyed girl in the elevator who said "Did you finish your exams?  Congratulations!" to which I responded "it is definitely wayyyyy too early for congratulations".  I need to stop talking to people in elevators.

-Mild gripe.  This hotel has hosted this exam for a lot of years.  Everyone in the hotel knows you are there to take the pathology exam, and if they didn't, the fact that you're checked in under the exam rate should tip them off.  As such, call me Ms. Sancho if you like, but please don't say "Good luck on your exam, Ms. Sancho".  If you know I'm taking that exam, you know we're all doctors.  Or better yet, don't wish me luck.  Just kick me in the shin as I'm checking in, so I know what to expect.

-That hotel is nice but absurdly dark.  When you already feel bleak, having Fight Club lighting doesn't improve your mood.  And I had a gorgeous "lobby view" which looked out into the across offices.  The only thing worse than working in a cubicle is watching other people work in cubicles.

-Computers broke.  For an exam that costs the same amount as a lower model used car, getting the software on par with the SAT would be cool.

-There are totally other culinary choices than Panera.  Are you people blind?  Or did you think a giant shopping mall doesn't have a food court?  Also, while the hotel is a'ight, their room service ain't not bad and you can get them to deliver a burger to your room during the exam break.

-Everyone I know says Tampa is a really nice place.  I honestly feel so dejected from the exam that I have absolutely no desire to go there again in the near future (though if I failed, I have to go back, and if I passed, I have to go back for the cytopathology exam).  People asked if I was going to stay over the weekend (since I was off Tuesday-Friday) and check out the beaches.  I scarpered back to Charleston as fast as I felt safe to drive (the next morning).  The only reason I didn't leave earlier is I didn't feel equipped to handle a long drive when I was that wiped out.

-Exam study destroys your health.  I may have already mentioned that.  The months leading up to the exam did more damage to my back than if I'd been moonlighting as a crash test dummy, and I had to up my blood pressure meds back up to a full pill.  Feh.  I'll find out I passed both exams the day before I have a hypertensive stroke.

So there's that.  The rest of my non-reporting has been a frustrating flurry of paperwork.

Took ACLS, and not only passed it, but had the instructor out at my honey's wrestling match, in which a man was concussed.  I did about 5 seconds of voodoo "doctor" neurological hand waving in front of the concuss-ee's face before going outside and getting the instructor/former medic to come help, so worth the price of admission I guess?  Still no excuse for training pathologists to run codes.

Paperwork is a nightmare.  It never stops being a nightmare.  Even when you think you are on top of *everything*, something will come back to bite you unexpectedly so prepare for it.

An example:  In between college and medical school (A LONG time ago), I worked a number of odd jobs for money, as one does.  Since there is a noticeable gap between school attendances, I didn't want to just write: "2004-2006: Played Halo.  Ate at Taco Bell".  So I had the main time fillers listed without much detail (since it's completely irrelevant to my present job), and they've been sitting on my CV for nine years, unmolested by SGU, the ECFMG, the Step exams, ERAS, residency, the state licensing board, or the FCVS, thus I had no reason to expect that one 3 month entity, in the interim, was progressively burying any evidence I ever worked there, up to and including absorbing the entire company into another, shutting down the office I worked out of, and possibly salting the earth behind it to ensure nothing would ever grow.

This is where you go from being mildly annoyed that the government is always spying on you to relying on it.  As I scrambled to not fail my employment history, I found that the usual suspect for being up in your business, the IRS, was tied up in hacker attacks.  I briefly considered whether offering some cash up to a Ukranian mobster would get them to relinquish my ancient W-2s from the IRS website, but I put that up as Plan B.  Nothing yet at the social security office, and apparently there isn't a master number where you can just desperately punch in your social security number, caution to the wind, and get a full print out of your work history, shoe size, and social media posts.  Big Brother sucks at being Big Brother.

Fortunately, where the government fails at creating a dystopian nanny state, the internet always has your back, so I was able to sufficiently cyberstalk an old work contact based on a long forgotten forwarded email to get employment verification.

So that was stressful.  Pretty much, spend a few days crawling through all your paperwork, including your CV.  Now pretend you're on an episode of CSI.  If you can't link the soil on your shoe to that barista job in 99, strike it from your CV so it doesn't pop up again to testify against you in court.  I spent a terrifying couple of days convinced I was about to be broke and homeless because the software staffing markets in the early 2000s were someone volatile.

The final date until the move is approaching fast.  I'm really going to miss Charleston, and I've come to think of it like home, but Texas will be a whole new set of opportunities.  Let's hope that somewhere in late July or early August, you'll get the second to last of the "I PASSED" blogs and not a "NO I CAN'T DO IT AGAIN!!!!" blog.

Apr 17, 2015

The more things change, the more they stay the same...

So here I am, a full five months after my last blog post.

My moving date to head to Texas is June 19th.  The dreaded boards, moved up for what seems to be the sole purpose of panicking my class, are May 13-14.

I have less than a month to determine whether I learned enough in the last four years to be a board certified pathologist.  I have a month after that to make all my peace with Charleston, do all that stuff I meant to do, and see all those people I've had to put off under the guise of "sorry, I'm studying".

I now have a great deal of real world friends in addition to my fabulous colleagues, so while the colleagues understand "Hey, I'm not going to your Game of Thrones party next weekend because I need to compulsively hit flash cards", the real world friends with jobs and homes and dogs are like "We never SEE you anymore".  And they don't.  And it's sad.

But tests tests tests.  I definitely feel anxious.  I was always on the smarter end of the spectrum where I've been, so while biochem sent me into a self-induced fear spiral and I never quite grasped pharmacology, despite my tooth gnashing and panic, I was in the upper bracket.  My social life was just not really in order.

Now, the situation is set perfectly.  The hospital, upon seeing all the fourth years freak out at the time announcement, pretty much freed us from clinical duties for the duration and sent us to our offices with 10,000 dollars worth of books.  But I'm not the big fish in a little pond anymore.  I'm easily not in the top half of my brilliant colleagues, which is fine, so long as I'm in enough of the top part of the country to pass the exam.

Still, I don't feel the acute panic I have in the past, I think just because I've grown up and I've gotten too tired of always stressing about it, since it rarely helps.

So I have my system, and you know what Vegas says about people with a system.

Every day is a different topic.  I use the new knowledge to make flash cards.  I set alarms for an hour and every hour it goes off, I drop and do 10 push ups, 15 situps and then make a hashmark for both on my calendar.  When I have enough hashmarks and enough flash cards, I can go home.  At home, or at the Barrel, which is even better, I can iPad my way through the flash cards.  Then repeat over and over.

It's dull naturally.  I like the material, but I can't paint a picture of that as being a laugh riot, but it's the whole first year of medical school thing all over again.  Take a big test.  Be afraid because you're going to a new place.  Hope you do well in the new place.  Be prepared to take another big test.

I have my permanent South Carolina license now, so I'm now technically a doctor.  I'm working on my Texas training licence.  More of those infernal steps I told you about.

So then, do my cytopathology fellowship, and then, take another test, apply for a job, and maybe that cycle will finally end, and I can look back at the last 10 years of my life or so and say "Yes, I am now a doctor.  Officially."

Speaking of doctor things, I have to take ACLS now despite managing to never take it at any time in the past.  Having pathologists run codes is a terrible idea, I think anyone can agree on that, so that'll be another 200 dollars and two days, and worst of all, a day of testing the immediate week after the Tampa tests, but what's a girl to do when she needs that J-O-B?

Other things.... I ran the princess marathon, managed to run it the whole way through, and was both really glad that I did, and really glad that I got to go to Universal Studios and Islands of Adventure since I haven't been there in over a decade and everything's all built up and cool.  The princess made me feel like I can accomplish something, so there was that:

You know, even if I wasn't really a princess, but an English school girl, but my point remains valid.

I also managed to squeeze in the Bridge run since I kind of bombed it last year.  My goal was to get a sub hour time, which I missed by 3 minutes, but it still made me feel pretty good about myself, and I didn't throw up.

Committee life has been good also.  We did an extended trip to Key Largo in January, and I got to go scuba diving for the first time in forever.  We've also never been to the keys, so went down to Key West to check out the Hemingway house and all the six toed cats, the conch sandwiches, and 90miles to Cuba, and of course, the sunset.  It was an incredible time, and I got to see a friend from medical school due to the most random of coincidences.  I still miss the connections I had there.

Last month I hit Boston at USCAP and realized the boards were getting to me, because I'd left the boyfriend at home, and it was probably the most depressed I've ever been out of state.  I finally got enough enthusiasm to take a run around the frozen harbor, but it was not a labor of love.  The speakers were great; I made a lot of connections, and I got to crash other programs' parties, but I really just wanted to be home.  I've come to love Charleston so much and it's really sinking in how quickly I'm leaving it.

Lot of paperwork heading for the new place.  We've already been down to pick out our apartment (with the help of my lovely aunt) and it seems like it's going to be a great place to live.  I've already distanced out the Trader Joe's, Whole Foods, and closest Ethiopian restaurant cause I'm 'that guy'.  Then all the paperwork.  Gotta get that ECFMG certificate out again.  Gotta find all those step scores.  Gotta write to the school again and beg for my transcript.  It never ends.

So now it's just study study study drive to Tampa and breathe.  See all my friends, kayak, go out to dinner, go out to parties, and the like, but now, back to the books.  Hopefully by the next time I post, you'll have a "I'M FINALLY A REAL DOCTOR; NO THIS TIME, I ACTUALLY MEAN IT, I'M BOARD CERTIFIED!!!" post. I truly hope, at least.  And we'll see whether a Caribbean MD was really enough for me.