Reflections on Residency

Job 3:26: I have no peace, no quietness; I have no rest, but only turmoil.

I do not know how the heck I am going to get through the next month. I am now done with my (10) interviews and it is time for "contemplation" over where to rank. It is now the 15th of January. Here's the "shortlist" of the timeline for the next months:

• January 15, 2007 (TODAY!!): Rank order list entry begins. Applicants and programs may start entering their rank order lists at 12:00 noon eastern time.
• January 31, 2007: Quota change deadline. Programs must submit final information on quotas and withdrawals by 11:59 PM eastern time.
• February 21, 2007 (a.k.a. FREAK OUT DAY FOR TARA): Rank order list certification deadline. Applicants and programs must certify their rank order lists by 9:00 PM eastern time. Staff will be available to answer your questions during the final deadline hours. CERTIFIED applicant and program rank order lists and any other information pertinent to the Match must be entered in the R3 System by this date and time.
• March 12, 2007: Applicant matched and unmatched information posted to the Web site at 12:00 noon eastern time.
• March 13, 2007: Filled and unfilled results for individual programs posted to the Web site at 11:30 am eastern time. Locations of all unfilled positions are released at 12:00 noon eastern time. Unmatched applicants (I HOPE THIS IS NOT ME) may begin contacting unfilled programs at 12:00 noon eastern time.
• March 15, 2007: MATCH DAY!! Match results for applicants are posted to Web site at 1:00 pm eastern time. At Mayo, we have some sort of Match Day dinner where our classmates (and, of course we, too!) all find out where we're going!
• March 16, 2007: Hospitals send letters of appointment to matched applicants after this date.
• Around the end of June or so: Intern year/orientation starts!!!!

I really have no, no, idea how I'm going to do all this ranking stuff. I feel pretty lost. I really liked almost all of the 10 programs I interviewed at and will probably rank 8-9 (we are to rank all places which going to would be preferable to not matching!). But in what order, I have no idea. I'm not sure about university or community/unopposed, big or small, 3- or 4-year (UC Davis FP/OB), hard-core or warm and fuzzy... I really feel that, by matching at one, I'd be missing out on all the others! Boo. But I'm not sure I could juggle 8 internships at once:) I'm looking for some guidance here!

I have TOO MANY OPTIONS. I actually had two more interviews scheduled-- one in Vancouver, WA (a northern suburb of Portland) and the other in Tacoma, WA, which is halfway between Olympia and Seattle. But I ended up cancelling them for a few reasons-- I was struggling a bit on the road and kind of wanted to go "home" to be around good friends, I needed no more confusion to add to my current perplexed state and feel I have enough really good options, and I heard Tacoma smells.

I mean, the odor wasn't the only reason I cancelled the interview. I heard that Tacoma was not that nice of a city to live in-- it's quite industrial, and I also heard that there are some dangerous parts with gang activity and whatnot. But someone did say that it smells (from paper mills or something). As I was driving south on I-5 from Seattle down to Olympia (and back the other day), I did roll down the window and take a whiff to check it out myself. And (,Lesley!) it did have some sort of odor, although difficult to describe.... As far as the SW Washington program goes, I figured that, if I was going to be around Portland, I might as well as try to go to OHSU, which I already knew I liked. So that was that. And I got to return home (to see it start to snow!) a week before I had previously planned to.

HOW AM I GOING TO DO THIS???? I have had episodes of feeling near-panic. I have about a month. I KNOW that I'm in a good position in that I know I will end up where I'm "supposed to," at a program I really like. That's comforting. I really feel that after this rank day (2/21), I will feel so much more happy and at peace because things are no longer, in any way, in my hands. I know I don't have ultimate control and that God will put me where I really belong to be. Lesley sent me verses to remind me of this fact:
Proverbs 16:9 In his heart a man plans his course, but the Lord determines his steps.
Proverbs 16:33: The lot is cast into the lap, but its every decision is from the Lord.

However, I feel like I have some control now in the rank list and I DON'T WANT IT. Do you think that the Holy Spirit will enter the NRMP website for me and click on the programs for choices 1-9 (paying particular attention to choices 1-3)? :)

I'm trying to view this as a win-win situation (and, as a resident told me, "You really should be thrilled. You have great options. It's not like you're in a lose-lose situation trying to decide between amputation and chemotherapy or something." Eesh. Good point.), but I'm just confused. I also feel very alone in this whole thing. Like I'm going to make this huge life-changing decision but I'm going to do it all on my own. I could end up anywhere. Would it be better to start completely over fresh in a place like Sacramento, where I know no one and would really have to rely on myself for happiness and support (initially)? Or should I try to go somewhere where I have some friends.... like Denver or Portland, realizing that intern year is going to be tough and could be even more so without a built-in support system? I really just want to belong somewhere! It's scary feeling like I don't quite fit in anywhere to settle down... yet.

I wish I had a significant other to be able to "veto" certain locations or cities despite them having good programs (there are other good reasons for being with someone, but this is the role I need right now!). And what makes this hard is that I only applied to programs in towns and cities that I thought it would be great to live in. So this is not helping me now. But among those: is sun (but with the potential for very large blizzards!) really that important? Could I live somewhere with 5 months of rain? A resident I met recently jokingly offerred to make my rank list for me. Anyone else want to step up to this plate to do me this service? :).

What is very unsettling is that I'm not sure what all is going to change in this month's time. Are things going to suddenly become clear one day? I may need to go back to the notes I wrote about these programs (this blog has been good for that!). I may need to focus on enumerating the negatives I found (there are fewer of those than positives). I may need to get back in contact with the residents I met. Some places have second look weekends, which I'm not sure I can attend (I don't want to take any more flights in a long time!). I may need to just poll friends and family :). Other suggestions?

One person asked me if I had heard of "The Grid System" for figuring it out. I was told to make a list of all of the programs and then decide what 5 things or so are really important to me. Then I was told to rate each program with a 1-5 based on those factors, add the numbers up in a blind style, and then arrive at an objective number. Some people included a subjective "how did you feel while there?" factor as one of those 5 criteria, which really does make sense although it seems somewhat contradictory to the "objectivity" aim of the exercise. Someone else said to write the programs' names on slips of paper and draw them, one by one, out of a hat, gauging my reaction to having (hypothetically) "matched" there. Hmm.

I know that this will be on my mind daily for the next month, but perhaps I should limit myself to weekly "contemplation times" (i.e. on Mondays or something) and not let worry cloud the rest of my weeks. I DON'T KNOW!!!!! AARGH!!!!!!!!!

Matt. 6:27, 34: Who of you by worrying can add a single hour to his life?... Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.

Ps 29:11: The LORD gives strength to his people; the LORD blesses his people with peace.

I sure hope so. :) I will be praying hard for clarity and peace in the next few weeks, as well as for clarity for many of my friends and classmates who have some big decisions on the horizon. It will all work out, right?