And just like that, I'm almost halfway done with my first year of fellowship.

While January will be the official halfway point of my academic year, I figured that it was worth noting just how close I am to that halfway point and just how fast time is moving. It's baffling to me that it is already December and that it has already been five months since I moved to Atlanta! Time is really flying, but that's mostly because I've been working like crazy throughout my time here.

When we last checked in, I told y'all that fellowship was hard and that I was grindin' it out on inpatient weeks, outpatient clinics, and night/weekend call shifts. Well, that has most certainly not changed. I'm still working really hard and have powered through five more inpatient weeks, with most of them being time on the consult service but also some time on our general nephrology service. In conjunction with those weeks, I've also had numerous night and weekend call shifts, including the Thanksgiving holiday weekend. Yep that's right, I worked all through Thanksgiving and because it was reduced holiday staffing, it was literally me and the attending covering both our consult and general nephrology services, with a resident helping cover the general nephrology service with us. Bruh, that extended holiday weekend was so busy. I really didn't get much good sleep at all. At one point, there were 33 patients between our two services. Like, whyyyyyy 😭😭😭

We got through it though, and cared for each of those patients the best we could. I just kept telling myself I was thankful to have a job (🙃) as I hastily trudged through that tough stretch of work while just wishing I could have some good food with some loved ones, catch up with them, and watch some exciting football games. Thankfully I'll be off for Christmas and New Year's, so I'll make up for lost time then! It will be really nice to get in the holiday spirit and to spend some quality time with family while not having to worry about any work as I catch up with them.

Leading up to the holidays, I have one more week of inpatient time where I'll be the lone fellow on both the general nephrology and the consult services before I get to enjoy a nice stretch of outpatient time where the majority of my clinical obligations will be in the various clinics we rotate through. I won't be totally off the hook though, there will be some night call shifts sprinkled throughout my outpatient time. But better that than having them crammed in my inpatient weeks like they usually are. Unlike my inpatient weeks, I'll at least be able to get some sort of rest after call shifts during my outpatient weeks.

My upcoming stretch of outpatient weeks will somewhat mirror the previous stretch of outpatient weeks I had over a month ago that separated my slogs of inpatient time. During those weeks of normalcy, I was able to work on setting myself up for future success by crystallizing a solid idea of what research and QI projects I want to focus on during my time in fellowship, being intentional about learning more about nephrology by reading textbooks and articles, and getting a handle of the different flows of the various outpatient clinics I work at (dialysis, transplant, general nephrology). I even went ahead and added an additional clinic experience on my schedule to get a sense of how we care for our lupus patients in our combined rheumatology/nephrology lupus clinic! I'm glad that I made the effort to do that because it not only gave me an idea of what outpatient care for this patient population looks like, it also afforded me the opportunity to see some patients that I had previously taken care of in the hospital and helped me cement in my working knowledge what their care plans look like as they transition from the hospital to the clinic. It was also just wonderful to see kids that looked sicker in the hospital look more like their normal healthier selves in clinic.

While most of my time during this period of relative calm was spent in outpatient clinics, there was one week where I was expected to attend daily seminars focused on research. During this special week, all the first-year fellows in pediatrics were excused from most of our clinical duties and we got together in an auditorium to get a crash course in topics designed to set us up for success as we delve in to our research projects for fellowship. The seminars were about 4-5 hours long each day, but the organizers packed A LOT of content into them, including but not limited to the following:

• Turning QI into outcomes research
• Grantsmanship 101 (things to know and do before looking into grants)
• Working & collaborating in the pediatric research environment at Emory & Children's
• Nuts and bolts of epidemiology research (study types, bias & confounding, prevalence & incidence, diagnostic tests, etc.)
• Leveraging the electronic medical record for research
• Information security in research
• Unmasking the IRB
• How to consult and leverage the biostatisticians ready to help us with our projects
• Using social media & other online resources effectively to bolster research
• Pearls for writing a scientific abstract and a scientific manuscript
• Lunch with different types of researchers (I did education/teaching research, community engagement research, and clinical research)

It was a ton of information to absorb and file away in our mental cabinets. I really hope that they give us access to the slides like they said they were going to because as important as the information was, there was no way I was going to remember the vast majority of what was said to us without having anything to refer to. It was overall a really chill week where we did a lot of sitting and listening while also mingling and catching up with each other after 3+ tough months of actively learning how to be fellows in our respective subspecialties!

When I wasn't busy working or listening to lectures, you already know I was making the most out of the free time I had available to me. I continued going to the Falcons games that I was able to go to, watched a lot of Miami Hurricanes football (ended up being another painful season for us 😔), enjoyed some winning streaks in my fantasy football leagues, went to a fun mimosa festival, got the chance to attend the National Kidney Foundation's Kidney Walk 2023, spent an afternoon at a patient seminar hosted by NephCure for families affected with glomerular conditions, found myself at the annual Grady Health Foundation's White Coat Grady Gala, attended Emory's annual Carter Town Hall where Yara Shahidi was the featured speaker, tried to stay consistent with my workout regimen at Orange Theory, participated in municipal elections by voting on Election Day, engaged with an ophthalmologist and a moderator in a discussion about diabetes on a livestream hosted by BlackDoctor.org that I was invited to speak on, and sat with my wife and some friends around a firepit in our driveway on Halloween night while giving out candy to children who came our way.

Oh, and I also got myself a new car! My 2005 Honda Accord was really starting to break down and it didn't make much sense to spend thousands to repair it, so I made the executive decision to upgrade to a 2019 Honda Accord, that of which I'm really loving! Shoutout to Carvana for the seamless buying experience! Not loving the fact that I have to pay a monthly car note now though…😒. That being said, I am definitely making the most of all the cool features it has, many of which are standard features in present-day cars that I'm sure many of you all have been taking for granted for a long time 😂. It makes it a bit more fun to drive to and from work each day! Lol, at least that's what I tell myself.

I know I talk about how tough my fellowship training can be at times, but I would be remiss if I didn't mention how incredible the kids and families I care for are. The circumstances I've seen them deal with both acutely and chronically are exceptionally challenging, but the vast majority of them seem to be able to handle their respective situations with grace and determination. Because of the high volume of patients we see and the fact that I've worked many hours of clinical service thus far, I've seen so many different kinds of kidney diseases, have managed many patients on various types of dialysis, have provided direct care for numerous patients in all phases of the kidney transplant process, have fielded calls from parents and providers calling from all across the state of Georgia, and have gotten to know many of the patients that our nephrology division cares for on a regular basis. I've been able to manage doing all of this while admiring the strength, tenacity, and gratitude that these patients and their families possess. As tiring as it can be to endure the work schedule that I've had to power through these past several months, knowing that I'm providing much needed care to these grateful people who are doing all they can to make it each day gives me purpose and really helps to keep me going. Even though I sometimes just want to sleep the day away and forget about work, I know that I'm getting excellent exposure and a top-notch educational experience at my training program. At the pace that I'm going, I'm know that I'll be more than ready to take on anything that comes my way by the time I've finished my fellowship training in 2026. I just have to ride the wave and take things a day at a time until then.

One day at a time.

I'm gonna go ahead and end this post on that positive note! I hope you all have such a wonderful and spectacular holiday season! Stay healthy, safe, and warm! And if you haven't donated to The 2024 Desire To Inspire Scholarship fund yet, you can do so by clicking here! Thank you!! 😄

“I am not afraid of storms, for I am learning how to sail my ship.” — Louisa May Alcott 

– Black Man, M.D.

P.S. – Match Day for pediatric fellowships just occurred not too long ago and we successfully matched two new fellows to our program! So excited to have them join us and to help orient them to our program! I'm also just glad that I'll finally have enough experience to be useful to someone else in our program 😂