Match Day

I did a much better job staying busy during my critical care rotation compared to my previous rotation.  Overall, the rotation was a positive, educational, and low-stress experience that reaffirmed my desire to be a critical care specialist.  I imagine that it also was good preparation for my final emergency medicine rotation.  This was the first rounding rotation where I really felt like the residents and attendings wanted my input, and it made the experience that much more fulfilling.

My interview at Hartford on Valentine’s Day went very well.  There was a snow storm the day before the interview, so I was the only one of three candidates who was able to make it to the interview.  Laura Hobbs is obviously a fantastic residency program director – well-organized, motivational, conscientious, and caring.  And the department is obviously well-regarded by doctors, nurses, and other professions at that hospital.  They have a gorgeous new pharmacy on the top floor or the hospital and claim to be working “at the top of [their] license.”  I ranked Hartford as my first choice for PGY1 residency.

My grandfather was hospitalized a couple weeks ago after he fell, hit his head, and developed an intracranial hemorrhage.  It’s not clear whether the fall was due to the olanzapine and zolpidem that my grandmother was giving him (he was so sedated by these medications that he had become incontinent and unable to walk without a cane) or due to an electrical conduction issue in his heart (he had a pacemaker placed during his hospitalization).    Thankfully, he is doing well, but they need to figure out what is the best/safest living arrangement for him.  A 92-year-old with dementia probably shouldn’t be living alone with his limited-mobility wife.  I think that he might be happier in a group living arrangement where he has more people to talk to, but it’s impossible for me to really assess the situation from the opposite coast of the country.

Graduation poster day was last week.  I feel like it was a little anti-climactic.  We worked and revised and obsessed over every little detail of our posters for hours as the culmination of this two-semester course approached.  We got 15 minutes to talk about our poster, and then it was all over.  I think my evaluators liked the topic of my poster, but I’m still waiting for my feedback.  I feel like I should have done better with the oral presentation; I was rather nervous/excited.

My final case presentation for my critical care rotation was on Tuesday.  At my preceptor’s suggestion, I focused on heparin thromboprophylaxis for ICU patients with thrombocytopenia.  I had a patient with ARDS whose platelets dropped below 50k, so VTE prophylaxis was stopped.  Four days later, we found that she had developed a femoral DVT and started her on a therapeutic heparin drip.  She had three chest tubes placed because she developed pneumothorax, but she never had a bleeding complication even though her platelet count dropped as low as 20k.  For her, it seems that the risk of thrombosis outweighed the risk of bleeding despite severe thrombocytopenia.  I received several compliments on my case presentation, and my preceptor asked me to create a summary sheet based on my case presentation to educate pharmacists in the department.  Best compliment I could get.

I gave a presentation yesterday for Packages for Preemies.  Happily, Packages for Preemies seems to be going well this year under Amina and Katreena’s leadership, and we had a good turnout for the presentation.  It seemed like the P2s enjoyed the presentation, but it might have been a little over the heads of the P1s.  I turned Peter’s NICU records into a case presentation, giving an overview of his problem list and treatment plan on day of life 0, 4, and 50.  Perhaps I went too far in presenting objectifying Peter’s story as a medical case; I didn’t talk about how his birth affected me emotionally.  I did however, start the presentation with Part 1 of the “Never Let Go” mini-documentary, and I closed with a summary of the economic and human cost of preterm birth.  It’s still hard to talk about how Peter’s birth affected me emotionally, but it’s fairly easy to talk about his NICU stay from a medical perspective… even in front of a crowd of 50.

The Rho Chi and Phi Lambda Sigma (aka Pharmacy Leadership Society or PLS) faculty advisors, the PLS president, and I have been planning the first JOINT induction dinner.  The two societies had previously held their inductions on separate evenings, but there was an overwhelming vote in favor of combining the two dinners this year.  To my surprise and delight, I received an invitation to join PLS last Friday.  I had assumed that like last year, I had been overlooked in the call for PLS nominations.  Apparently, I had not been overlooked, but I was not required to submit an application like the P2 students.

Unfortunately, today – Match Day – was not a happy day for me.  I regret to inform you that I did not match.  I’m kind of in shock.  The most shocking part of this is that I didn’t match with Baystate.  And they still have two open positions.  So apparently, they didn’t rank me.  Why, oh why didn’t they rank me?  What have I done wrong?

Not sure what I will do.  I can try for one of the two residency positions at Baystate, and I can try for one of the two positions at Mt. Auburn Hospital.  After that, I guess I’ll need to change my career goals.

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