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residency

little girl in medical lab coat

Kid in a White Coat

I am no stranger to medical institutions. I’ve spent time in hospitals and clinics all throughout my life — shadowing physicians, working in the operating room as an administrative intern and now as a first-year medical student. However, while walking through the busy corridors of The Johns Hopkins Hospital, I feel distinctly different. Of course, this could be attributed to a variety of things, such as growing older and finally beginning a formal medical education, but the biggest difference for me comes from a short white coat with my name emblazoned on the left.

In our field, the white coat inevitably carries a strange and amazing sense of power and responsibility. Although we knew very little about medicine, since the day my peers and I received our white coats, we’ve been viewed differently in the hospital setting. While wearing the white coat, complete strangers confide in you, often sharing extremely personal stories, hopes and fears perhaps hidden even from immediate family. Suddenly, you are seen as a figure of authority and are, accordingly, faced with a sense of responsibility to provide the highest level of care for the people around you. The implications of this transformative power are incredible but also daunting.

Just over half a year ago, I was a senior in college and often joked with my friends about how we were “pretending” to be adults that were ready for the real world once graduation arrived. Now, I walk through The Johns Hopkins Hospital wearing an article of clothing that boldly proclaims something quite different — that I am an adult, ready to take care of the real world. The cognitive dissonance is glaring. I don’t feel any different on the inside than I did as the young college student only a few months earlier. How is it possible that I am suddenly responsible for taking care of others’ physical and emotional well-being when I am only just now learning how to take care of myself? I understand that as a new medical student, especially one coming directly from college without having taken any gap years, these sentiments are completely normal, but the nagging feeling that I am an imposter is still very real.

Regardless of these feelings, my medical training so far has been a privilege and incredibly rewarding. And now, several months in, I’m starting to learn that the solution to alleviating the dissonance lies in perspectives. It’s important to remember that medical training is a journey — one that will continue throughout my entire career — and that’s it’s OK to not always know exactly what I’m doing right now. Rather than letting imposter syndrome undermine my confidence, I can choose to see it as an opportunity to continuously challenge myself to learn and grow. Embracing my strengths and finding the courage to accept my weaknesses with confidence will, hopefully, help me work toward a satisfying and fulfilling career as a physician — even if some days, I still feel like just a kid in a white coat.

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residency interviews

Applying for Residency: Interview Season

The last time I wrote about applying to residency, fourth-year medical students were just about to hit the submit button on the Electronic Residency Application System. Several long weeks later, the interview season has begun.

The irony of the phrase “hurry up and wait” becomes acutely painful for students during the weeks between submitting residency applications and receiving interview invitations. Applying for residency is much like applying for a job — you put together a CV, send it out to several prospective employers and hope that they are interested enough to invite you for an interview. For the past several weeks, fourth-year medical students have been eagerly waiting for those interview invitations and, after receiving them, have been busy scheduling flights, booking hotels and preparing to explain why they are an excellent fit for each program.

However, before the craziness of scheduling interviews — which requires students to strategically accept the maximum number of interviews, while allowing for adequate time to travel between cities — there is the wait. Thanks to peers applying to the same specialty and websites such as Student Doctor Network, students know almost immediately when their dream schools start sending out invitations — and are in for an unpleasant moment if they do not receive one. Thus commences the anxious wondering: Will there be a second round of interview invitations? Why did I not get invited in the first round? Is there anything I can do or say to the program to garner one of those coveted invitations? By the time I get an invitation, are there going to be any interview spots left? Unfortunately, there are no satisfactory, cut-and-dried answers to any of these questions.

By and large, though, most students will receive or have already received invitations to interview at their dream schools, and indeed, many are now weeks into the interview process. Aside from the nervousness that accompanies each interview, there is also an underlying hum of enthusiasm and excitement. The attendings and residents at each program are potential mentors; the other interviewees, future colleagues, or perhaps even future co-residents. At each interview, there is a tantalizing glimpse into the world that everyone has worked so hard during medical school to have the privilege to enter. Additionally, each interview allows the applicant a peek at how that specific program’s rounds work, what the hospital culture is like and what the program values. Similarly, programs use the interview process to find applicants with aligned goals who they think will not only learn from their institution, but also thrive in their particular environment and form part of a cohesive team.

The past few weeks have been both exciting and trying, filled with emotional highs and lows. Charles Dickens once penned, “It was the best of times, it was the worst of times …” While he was referring to London and Paris during the tumultuous French Revolution, somehow, it resonates well with this part of the application process to residency.

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doctor listens to fetal heartbeat on pregnant belly

More Training Means More Residents Meet Their Match

Matching into residency was one of the greatest days of my life. Years of hard work and dedication had finally culminated into the opportunity to become a doctor and practice medicine where I wanted, and in the specialty where I fit best. A few years into being a resident, the process started over, with the fellowship application process. In almost every field of medicine, there are opportunities to subspecialize, and fellowships are one such opportunity.

Fellowships are a way for residents to specialize in a specific area of medicine or surgery.  For example, if an internal medicine resident wants to become a cardiologist, he or she typically has to complete three years of residency, followed by three years of fellowship in cardiology. The same applies for other subspecialties — a pediatric resident who wants to specialize in taking care of sick neonates in the ICU would complete a neonatal ICU fellowship.

Over the summer, I had the opportunity to travel around the country with some of my greatest friends and colleagues within the Johns Hopkins Department of Gynecology and Obstetrics as we interviewed for fellowship positions in four different specialties: gynecologic oncology, maternal-fetal medicine, reproductive endocrinology and infertility, and urogynecology. Cumulatively, we received over 100 interviews. This fall, we met out matches and will be traveling far and wide to fulfill our dreams.

Typically, gynecology and obstetric residents either decide to subspecialize in a fellowship or continue their career as a general Gyn/Ob. In a study looking at residents who chose to subspecialize, data from 2012 showed that around 20 percent of residents apply for fellowship. Considering seven of Johns Hopkins’ nine residents applied for fellowship and 100 percent matched for competitive fellowship with acceptance rates averaging about 69 percent, we matched very well this year!

Diana Cholakian with her resident friends in the Johns Hopkins Department of Gynecology and Obstetrics
Diana Cholakian with her resident friends in the Johns Hopkins Department of Gynecology and Obstetrics

Although my colleagues and I applied for a variety of subspecialties at many different institutions, in reflecting on why we each chose a specific career path, three things were consistent.  We picked these specialties because of the “patients, procedures and problems,” and the way our careers will allow us to interact with and influence all three.

Ultimately, I chose to become a gynecologic oncologist because I love the patients, the procedures are inspiring, and the problems presented in treating their illness are challenging and complex. The fact that all of the residents and one fellow who applied into these subspecialties were placed in competitive fellowships is a testament to the success of the Johns Hopkins residency program in training future gynecologists and obstetricians.

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