A New Level

When I was a resident, I always wondered what attendings and fellows did after morning rounds. I knew that I was grinding out my work all day long and while I had some attendings who would be right there with us in the trenches getting the day's work done, I had others who would disappear for long periods of time in the afternoon, though they were always a phone call or a text message away. When I became a chief resident and served as an attending on service, I finally experienced what life was like as an attending on the hospitalist service. It was certainly more chill and I had time to do administrative work, but the increased amount of responsibility for the patients I was charged with caring for outweighed any tranquility that my leadership role had brought me. Plus, I couldn't help being in the trenches working with the residents in the afternoon or teaching both them and the medical students something new whenever I had the chance.

By the end of my chief resident year, I had a clear idea of what life was like as a resident and as an attending. However, I still had no idea what life was truly like as a fellow. I figured that they stuck around for morning rounds and then took a few calls in the afternoon while learning from some 1:1 attending-led teaching sessions and getting some research work done. They always swore they were busy, but from my perspective as a resident, it seemed like they lived a pretty chill life to me.

Boy was I wrong.

If I learned anything from these past ~3 months as a fellow, it's that fellowship is HARD. Granted, I'm training in a notoriously tough subspecialty, I'm at a program with a high volume of patients, and the first year of fellowship is known to be clinically heavy…but man! Now I know why I rarely ever saw fellows after rounds while I was a resident. They were busy busting their tails just like we were, except they had more responsibility over a larger amount of patients, were fielding a stream of calls day & night from both inside and outside the hospital about patients that they had no time to review, were writing a bunch of detailed consult notes, and were learning how to be a doctor in their chosen subspecialty. Essentially, they were just trying to survive. I'm well aware of this now because I'm quite literally living this life. 🙃

In the time between my last post in early August and now, it feels like I've lived a LOT of life as a nephrology fellow. I've worked four weeks of inpatient medicine (my first week couple weeks of inpatient time on the general nephrology and consult services were actually nuts 🫠), have had eight overnight house call shifts not including my first weekend call shift that I completed this past weekend (the lack of sleep I get during these call shifts make the next day of work A STRUUUGGGGGLE 😩), and worked more clinic half-days than I can count right now. I could go into a lot more detail about my time during these shifts, but I won't because I would never stop typing. However, what I will say is that because I've worked so many hours so far at this high-volume program, I've gotten the opportunity to see a large variety of nephrology-related patient presentations and have subsequently gained so much knowledge about kidney-related concepts in a remarkably short period of time. I can really feel myself actively absorbing and retaining high volumes of information as I grind day in and day out caring for kids with all types of rare conditions, kids on various types of dialysis, kids fresh out of kidney transplant surgery, and much more. As much as I hate writing notes (something that I was hoping would go away as a fellow 😐), I must admit that they do force me to gain a better understanding of what's going on with the patients I'm caring for.

Alongside my clinical exposure, my program provides us with an abundance of learning opportunities to take advantage of, most of which come in the form of lectures, workshops, and patient care conferences. It can be dizzying to try and keep up with everything going on around me, but I do my best to take advantage of as many opportunities as I can. Having outpatient-centered weeks to break up the grind of inpatient medicine has been super helpful because it gives me some down time to reorganize my life and to really take some deep dives into learning more about certain topics that interest me. Plus, I can catch up on some much-needed sleep during these weeks. 🙏🏿

As busy as I can be, especially during my inpatient weeks, I do feel really lucky to be at a program that is as supportive and as collegial as the one I'm currently training at. Even when I'm feeling a worn-out zombie with a low threshold to snap on someone during my post-call days, my attendings, co-fellows, and the ancillary staff I work with somehow find a way to keep me in a good enough mood to make it through the day. Now that I've had some legit experience working as a fellow and have a much better idea of what to expect in my fellowship training, I'm finding that I'm getting more used to the grind of being on service and being on call. Not to say that it's going to get much easier, but at least I'll have a better idea of what I'm doing and that will help me be more efficient with my time, which will ultimately make my overall experience a better and more manageable one.

Also, I know I've just spent a bit of time telling you how busy I've been as a fellow, but I would be lying if I told you that my overall schedule as a fellow was worse than my schedule was as a resident. I feel like it's actually a much better schedule due to all the free weekends I have, all the outpatient and research weeks interspersed throughout the year that break up the inpatient grind, and the lack of 24-hour call shifts (though home call can sometimes feel like a faux-24 hour call shift if you're constantly paged throughout the night). That's something for all of you residents out there currently applying for fellowship to look forward to! Disclaimer: I can only speak for pediatric nephrology training at my institution, I have no idea what schedules in other subspecialties and fellowship programs are like. 😅

Speaking of fellowship applicants, our interview season is currently in full swing! We've had a record number of applicants apply to our program, which means that we've been quite busy interviewing some outstanding candidates. I find it pretty wild that I'm over here talking about my life as a fellow at Emory when just a year ago, I was not only going through this same process as an applicant, but also playing a large role in recruiting residents to my residency program as chief resident. With my limited experience as a fellow thus far, I don't feel like I have a lot to contribute to the questions that the prospective fellows have. Hopefully though, my answers to their questions are adequate enough to give them an idea of what their lives will be like once they start their fellowship training!

As much as I've worked these past couple months, I've also been sure to make the absolute most of my free time outside of the clinical setting. To start off, I FINALLY got the chance to see Queen Bey in concert for the first time!! I can say with absolute certainty that it was the best concert that I've ever been to! 🤩

About a week after that concert (and after my busiest week on inpatient service thus far 🙃), I drove straight from the hospital to the airport to fly out to Spain for my 30th birthday celebration!

It was by far the best birthday celebration that I've ever had! I had such a relaxing and incredible time with such a phenomenal group of people, and we did so much that I can't even begin to encapsulate it all into words. We certainly made a ton of wonderful and unforgettable memories together! 🥹

We started off our week-long trip with a three-day stay in Barcelona, where we spent the majority of our time on personalized tours of the city of Barcelona (we explored some historical and famous landmarks like the Park Güell in the Gràcia district and the Basilica de La Sagrada Familia in the Eixample district), the historic Monistrol de Montserrat (we drove ~2000 feet up a mountain to get to this place 😳), and a region in the countryside of Catalonia where we tasted various kinds of Cava (sparkling wine). We also got the chance to attend a flamenco show, enjoy Spanish cuisine while dining at several restaurants in Barcelona, check out the world's best bar (they really did have some super cool drinks here and showed them off with dazzling displays 😮), cheer on the FC Barcelona fútbol (soccer) club at one of their home games, and danced our nights away in Barcelona's nightclubs! We really packed A LOT of adventure into our three days in the city!

We followed up our whirlwind experience in Barcelona with an exciting four-day stay on the island of Ibiza! While our time in Barcelona was spent adventurously exploring the city, we spent just about all of our time on Ibiza relaxing, partying, and appreciating the carefree vibes around us. Apart from all of the lounging that we did at the resort's pool and beachfront, we had a blast at a epic pool party near our resort, we ate dinner at a fancy restaurant dressed in all white, and we spend a day on a catamaran trip from Ibiza to a nearby island called Formentera. It was all just so awesome! 🥲

With all of the activities we took part in during the trip, I did not get as much sleep as I would have liked while on vacation. At the same time, I 100% do not regret sacrificing sleep to maximize the phenomenal experience I had on our trip! 😄

Coming back to the States after the trip was over was such a bummer. None of us wanted the trip to end but because we're all working adults who couldn't afford to spend extra time and money in Europe, we promptly got on our respective planes when we were scheduled to do so and headed back to reality. We all had such a great time together that we hope to go on more trips together in the future!

My birthday was capped off with a beautiful compilation video, curated by my wife, of friends and family wishing me a happy birthday and expressing their appreciation of having me in their lives. I was both surprised and touched as I received the video and watched everyone on it share their well wishes and good vibes with me. I'll forever treasure this gift! 🥹

Concerts and birthday trips aside, I've spent the rest of my free time linking up with friends in the area, finding fun things to do in Atlanta with my wife, watching both college football (I hope Miami continues to extend their winning streak!) and professional football games (I'm watching some NFL games in-person for the first time ever, what an experience 😊), experiencing all the emotions that come with fantasy football, and exploring what I want my scholarly project for fellowship to be. Additionally, the winners of the The 2023 Desire To Inspire Scholarship were recently awarded! For those of you keeping count, we've now given out almost $12,000 in scholarships out to twelve high school students over a five-year period!! I'm looking forward to another year of awarding young deserving scholars some scholarship money for college! 😄

That's a wrap for this post! My time in Atlanta has been off to a fantastic start and I hope that the good times continue to roll on in the months and years to come! 🙏🏿

“Change is not a threat, it’s an opportunity. Survival is not the goal, transformative success is”. – Seth Godin

– Black Man, M.D.

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