Evolution.

That extra hour that Daylight Savings gave me today was a glorious gift.

I got to “sleep in” and I still got up at a very reasonable time to take full advantage of my day off!

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It feels great to wake up refreshed and know that you have the full day to do whatever you want with it. My last day off from work was last Sunday, unless you want to count my interview day at CHOP that took place on Tuesday since I didn’t have to work that day either, though I was at the hospital most of the day learning about CHOP and interacting with residents and faculty members. Speaking of, I think interview day went well overall! I got great vibes from the faculty members I interviewed with and it was wonderful to meet both the Residency Program Director as well as the Chair of Pediatrics and Physician-In-Chief of the hospital system. I now have three interviews down, and quite a few more to go! My next one is taking place next Monday in Pittsburgh and just so you know, Pittsburgh and Philly are on OPPOSITE SIDES OF THE STATE. Don’t be a dummy like me and assume that they are close to one another just because they are both cities in Pennsylvania. I had to get a flight because with my tight schedule, I just couldn’t afford to drive 5+ hours to get there and another 5+ hours to get back. SMH. I’ve never been to Pittsburgh before though, so it should be a cool experience!

Back to my second week of my sub-internship at CHOP. I’ve definitely adjusted to the flow of things a lot more since my first couple of days here, and I’ve become more comfortable with my team as time has passed on. With that being said, I’ve come to realize how much this place can humble you. I’ve been consistently challenged to think independently, to provide quality care as the primary “physician” for my patients, and to adjust my performance based on the constant feedback that I’ve been receiving. In these past two weeks, I’ve learned so much not only about medicine and the reality of patient care in an inpatient setting, but also about myself and my strengths and weaknesses. I’ve come to realize that while I may know more than I previously thought I did about certain things, there are also quite a few things that I didn’t know that I didn’t know, if that makes sense.

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I’m starting to consistently think about and do important things that I had only intermittently thought about or done in the past, such as providing discharge criteria for admitted patients, referencing evidence-based research in my patient presentations, committing to specific plans for specific problems that my patients have, prioritizing important tasks to be completed earlier in the day (discharges, consults, etc.), becoming familiar with the dosing and time intervals of medication administration, coordinating care with other members of the healthcare team, giving concise & high-quality handoffs to interns starting their shift, completing concise discharge summaries, putting in orders; the list goes on and on. I’m literally doing intern-level work with the only difference being that I have a lighter patient load than the interns do, I have less experience than they do (it literally takes me twice as long to do just about anything that they do), and I have some additional support from the senior residents on my team.

While my days have been long and exhausting, my learning experience has been spectacular. There’s nothing like throwing yourself into a sub-internship position in a brand-new city at one of the top children’s hospitals in the world. Some may call it insane, but I call it yanking yourself out of your comfort zone and embarking upon a challenging experience that forces you to evolve and become comfortable being uncomfortable. Okay yeah, I admit it’s pretty insane. It’s actually not what I initially asked for when applying to this visiting clerkship program. However, when this was the only option given to me, I ultimately accepted it because I wanted to experience what working at a hospital like CHOP would be like, I wanted to expand my network by meeting brand-new people and mentors, and I wanted to make the most out of my fourth-year of medical school by diversifying my experiences as much as possible. Plus, it is all being paid for, so why not? 🤷🏿‍♂️

get your billion back make it rain GIF by Billion Back Records

It has been a tough two weeks for sure, but I can literally feel myself becoming a better clinician as a result of this experience. This has definitely been a very necessary experience for my growth, and it’s great to get this insight as to what intern year will most likely look like. Of course now that I’ve started to get into my groove, my schedule is being flipped-turned-upside down and I’m going to be working a week of nights this week, starting tomorrow night.

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I’m not sure how this is going to go, but what I do know is that I’m going to continue to do my best and maximize my learning opportunities during my night shifts! I’ll surely be admitting a ton of patients, which will give me great practice in completing the admission process and writing great H&P (History & Physical) notes. Because the night team is much smaller than the day team, I’ll get the opportunity to get more one-on-one time with my senior resident, which will give me more opportunities to elicit feedback in order to continue improving my skills. Only thing that’s really gonna suck is the fact that my sleep schedule is going to be all screwed up, especially the first couple of days. I’m sitting here trying to plot on how to alter my sleep schedule today knowing damn well that I’m going to be tired on my first night shift, no matter what I try to do to prevent it. My circadian rhythm is just that strong. *Siiiiiiiigh*

On that note, I’m going to go ahead and enjoy my day off! I’m sad that I missed both Howard’s homecoming last weekend and UMiami’s homecoming this weekend due to my rotation schedule…they both looked like a lot of fun. Too bad the ‘Canes aren’t doing so hot this year on the football field. Welp, there’s always next year….😪😪😪

Have an amazing week!

ELECTION DAY IS FINALLY UPON US!!! GO VOTE!!!

“One finds limits by pushing them.” – Herbert Simon

– Black Man, M.D.

New City, New Flow

Alright, let me start off by saying that I’m definitely going to be enjoying EVERY SECOND of my fourth-year up until the minute that I enter the hospital for my first shift as an intern next year, because if intern year is going to be even busier than I’ve already been during my first week of my Sub-Internship, I’m not 100% ready for it yet. 😅

While I’ve gotten so much great learning in the hospital this past week, I’ve had such little free time outside of it. Like, my days would usually consist of me getting up at 4:15 AM to make sure that I got to the hospital by 5:30 AM in order to adequately pre-round on my patients and write progress notes, some of whom would be people that were newly admitted overnight. Then I would go to morning report around 7:30 AM (or Grand Rounds around 8:00 AM), round on patients with various attending physicians until about 11 AM or so, work on any orders, discharges, consults, etc. until noon conference, come back from conference in order to spend my afternoon executing the care plans that we’ve decided on for our patients while at the same time coordinating patient care between various entities both inside and outside of the hospital, checking in on my patients, admitting new patients, writing H&Ps, attending impromptu learning discussions hosted by attendings, going to simulation labs and learning conferences specifically designed for the Sub-Interns at CHOP this month, writing discharge summaries, and a few other things that I can’t think of at the moment, before finally handing off my patients to the long-call intern and going home around 5 PM (plus or minus an hour).

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After getting home, I would have a couple hours to myself to take care of emails and other tasks that I couldn’t attend to during the day, before going to bed around 8:30 PM-ish, only to get up and do it all over again. And when I was on long call last Wednesday, I didn’t even leave the hospital until 9:30 PM due to a complicated admission. So yeah, long days with some awesome learning opportunities, but little free time lol. However, I did finally get the chance to explore a little bit of Philly with some of my good college friends last night after my 11-hour shift ended, although I first had to fight the urge to crawl into my bed and crash. I’m glad I was able to spend some time with them, because I hadn’t seen them in such a long time. We also grabbed some Philly cheesesteaks during our night out, which were freakin’ delicious after I put some hot sauce, ketchup and salt on them. On a sidenote, I didn’t realize how many friends I had up in Philly until I posted on IG that I was up here…even though my schedule is hectic, I’m gonna really try to make time for everyone I told that I would link up with, but it won’t be easy 😅.

Because I am here as a Sub-Intern, the responsibilites that have been entrusted to me are relatively enormous to what I’ve been used to. I mean, I knew I would be working hard and would have a good level of autonomy over my patients…but daaammmnnn! *in my best Chris Tucker voice* They really meant it when they told me that I would have full autonomy over my patients. I literally have been feeling like I’m my patient’s doctor, much more than I did when I was a third-year medical student. I mean yeah, I had a sub-internship (or Acting Internship as we call it at Wake) a couple months ago at Wake in Heme/Onc and I was doing a lot back then too. Even though I was pretty autonomous at that time, there was only so much I could do because of the fact that we had a lot of Oncology patients. So with that said, there was a good amount of oversight taking place by not only my senior resident, but also by the attendings. Because this current rotation is primarily a Gen Peds service mixed in with a few other specialties and we’re not dealing with chemotherapy on a daily basis, I am able to do more.

And BOOOYYY have I been doing more.

I honestly wasn’t prepared for it all the first day I picked up my patients. Even though I looked like I was doing fine from the outside (I got positive reinforcement from my senior resident on my first day, to my amazement), internally I was very frazzled and I felt like I just couldn’t get myself together. I was having trouble prioritizing patient tasks and trying to keep up with everything while at the same time trying to get used to this new service at a new hospital in a new city. Of course my senior resident and the other interns were there to answer questions and to support me, but because I hold myself to (sometimes ridiculously) high standards, I found myself becoming frustrated throughout the day as well as in my second day on the service because I didn’t feel like I was adapting to the flow of things quick enough. I quickly learned that while I’ll be getting high-quality education about medicine during the course of this month, what I’ll also be receiving that is just as important is high-quality education in the practical delivery of patient care in our complex healthcare system. Yeah I have the book knowledge, but I am definitely lacking on the more practical side of patient care, which I know will come with time spent during residency. That being said, I’ve been learning some very useful things this past week and am sure that I’ll continue to learn even more during these next three weeks.

I’ve definitely become acclimated to the service as the days have progressed, and I think that I’ve finally gotten somewhat more comfortable in the flow of things here. I went from asking myself on my first day why I decided to do this to myself when I could’ve been crusin’ through a much easier elective back in Winston, to being grateful yesterday that I was given this opportunity to leap out of my comfort zone and challenge myself in ways that will only benefit me in the long-run. I’m excited to be able to continue to expand my network, (try to) explore Philly some more while linking up with friends here, learn from the diverse patient population here, learn how to be even more efficient in patient care in the hospital and how CHOP’s hospital system works, and take advantage of the other various learning opportunites that will present themselves while I’m here. I’ve already grown quite a bit since I’ve been here and will only continue to grow some more as I take on this tough rotation day-by-day. It also helps to know that this is my last tough rotation of my fourth-year, so I’ll definitely be smooth-sailing after these next three weeks 😎. Well, relatively speaking at least. I still have other rotations to complete, but they shouldn’t be that difficult. But before those other rotations, I have both Thanksgiving and Winter Break to enjoy, as well as my four-week flex block that I will be using for the majority of my interviews!

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Speaking of, I got word a few days ago that I was blessed with an interview at CHOP that is very conveniently taking place this Tuesday! 🙏🏿 That definitely makes life a lot easier since I’m already up here and all. Between this interview and my next one taking place in a couple of weeks in Pittsburgh, I’ll have been able to knock out both my Pennsylvania interviews during my month up here. By the way, if you weren’t already aware like I wasn’t, Pittsburgh is about a five-hour drive from Philly. Yeah, it blew my mind too.

I guess this was one of those days where I just couldn’t seem to stop typing. I’ll end my post here so that we can both get on with our days haha. I hope you have a spectacular week!

AND PLEASE, PLEASE, PLEEEASSEEE EXERCISE YOUR RIGHT TO VOTE!!! IT’S CRUNCH TIME!!!

I’ve been going through a lot this past week in trying to get my absentee ballot (that I requested over a month ago) and have been sending in multiple emails and calls to my county’s board of elections because believe it or not, EVERY VOTE COUNTS. According to their office, they’ve FINALLY sent out my ballot yesterday, which is ridiculous but whatever. I REFUSE to let my voice be silenced, and it is imperative that you believe that your voice deserves to be heard, because it absolutely does. Voter suppression is real y’all, and I’m sure that there are some shady things going on with the overall voting system. However, attempting to make your voice heard with your vote is much better than not voting at all!!

“Falling down is not a failure. Failure comes when you stay where you have fallen.” – Socrates

– Black Man, M.D.

The Power of Adaptability

This week is my last week in D.C. and I’m not ready to leave just yet 😭😭😭.

I’ve really settled into the flow of things in my rotation and have quickly gotten used to the diverse nature of this city. I’ll probably never get used to the traffic in this city, but I’ve managed to get around without losing my mind, which is an accomplishment if you ask me. 😊 I kept telling myself that I would eventually start using the metro to avoid the congestion, but I would always end up leaving for clinic each morning in my car. It’s just easier and more convenient to me, even though I spend a good amount of time on the road as well as a good amount on gas money.

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After this upcoming week, I’ll be heading up to Philly to start another Pediatric inpatient rotation at the Children’s Hospital of Philadelphia. I’ll be on a general pediatric team that also treats kids with allergic, immunologic, rheumatologic and hematologic conditions. Yeah I know, that’s a lot of different types of conditions. I just recently got my schedule for the rotation and boooyyy am I going to be busy 😅. I’m really going to be living like an intern…six day work-weeks with only one day off each week, one week of nights, case conferences, teaching sessions, performing patient responsibilites on an intern level — yeahhh I’m gonna be working for real. I probably won’t see much outside of the hospital to be honest…but that’s okay, there’ll be plenty to see in the hospital. Plus, being in the north and all, I’m sure that it’s going to get cold real soon so staying indoors wouldn’t be such a bad idea. Shoutout to the power of positive thinking 🙌🏿😂.

With all the time I’m going to be spending in the hospital, I’m definitely going to be able to see a wide variety of illnesses and there’s a good chance that I’ll be participating in very unique and interesting cases. Also, as you may already know if you’ve been following my posts these past couple of months, I just so happen to have some experience in hematology, allergy and immunology….so I’m fortunate in that I’ll be able to continue building upon the knowledge that I’ve accumulated in those sub-specialties so far. 😄 In addition, I’ll get to network with a variety of people and will be paired with mentors who will undoubtedly be instrumental in helping me lay the foundation for my future career. Until I get to my experience at CHOP however, I need to get through a mountain of modules that need to be completed prior to rotating there.

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Now about my most recent week in the Capital.

I had a pretty full schedule of events last week, those of which included a couple of food allergy clinic days, an inner-city asthma clinic day, a mock interview session, my first residency interview at Wake Forest, a couple of one-on-one meetings with faculty here at Children’s National, an allergy & immunology department-wide morning conference, a meeting with one of Senator Cory Booker’s legislative assistants on Capitol Hill, and a great weekend with my girlfriend and other friends who are here in D.C. Yeah I know, I told you it was going to be a lot lol. I did my best to take things one day at a time though and that helped me get through everything that I experienced throughout the week.

The food allergy clinic days were the usual, where I helped consent patients and their families to oral food challenges, took histories, performed physical exams, and presented the diverse array of patients that I interacted with to my attendings. The inner-city asthma clinic was unique in that it was designed specifically to comprehensively address issues regarding asthma in children, which meant that there was an extensive amount of time dedicated to this mission. The patient and their family would meet with an asthma educator and the physician, with some visits taking as long as 90 minutes if necessary! 😯 I’m glad that I got the chance to participate in that experience, because I also ended up learning some very useful information about asthma and all the various substances in the environment that can trigger it.

As a participant of the Minority Senior Scholarship Program (MSSP), I got the opportunity to engage in a mock interview session as well as to go to Capitol Hill to talk with a legislative assistant about her role in health policy while also asking her questions regarding health policy and how we as future physicians can help influence it for the sake of our patients. The mock interview session was very helpful because not only was I able to practice my interview skills a couple days before my first residency interview, but I was also able to gain some valuable advice that will really help me out on the interview trail. The session at Capitol Hill was primarily a conversation between the students in the MSSP and a legislative assistant, who explained how she helps advise Senator Cory Booker and answered the barrage of questions that we had for her. She encouraged us to keep our passion for advocacy as we grow into physicians and shared with us how much she admired the work that Pediatricians do when it comes to advocating for their patients. It was a really cool experience overall, even though we didn’t end up going inside the Capitol building like I initially thought we would lol. I’m not gonna lie, I was getting hype as we drove up to the Capitol building in our Uber, but we then took a sharp turn left and ended up at another building a couple of blocks away. But then again, it’s not every day that you get to walk into the office of a Senator!

As for my interview at Wake, it ended up going pretty well overall! I definitely felt welcomed, many aspects of both the pediatric residency program and life in Winston-Salem were reinforced to me, and I had some great conversations with my two interviewers. That particular interview day was a day specifically for interviewees who had some sort of tie to Wake Forest, so I was able to connect with the majority of my classmates who are also going into Pediatrics, which was nice. Honestly, the only stressful part about the whole day was the fact that I had to fly from D.C. to Raleigh Tuesday night, pick up a rental car from the airport, drive to Chapel Hill to stay the night at my girlfriend’s place, and drive in a rental car from Chapel Hill to Winston early Wednesday morning through the rain in order to make it to the interview group with only a couple of minutes to spare. And then after the day was over, I had to drive back to Chapel Hill to pick my stuff up, drive to Raleigh, return the rental car and fly back to D.C. that night in order to go to clinic the next morning.

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It was definitely A LOT, but it was also worth it. With my first interview complete, I feel that much more comfortable attending interviews at other institutions. Plus, I felt like I got a solid feel of what residency at Wake would be like. With that said, I feel adequately prepared for my interview here at Children’s National this Friday! 😁

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My busy week was topped off with a fun weekend with my girlfriend and other good friends of mine. Between eating at a “bottomless” brunch, eating some of D.C.’s deep-dish pizza, visiting various monuments, viewing portraits at the Smithsonian National Portrait Gallery, watching a movie (The Oath) before it’s nationwide release date, and (painfully) watching the UM vs. UVA game at a bar/restaurant/arcade, I had an awesome time! The Canes may have lost (in a ridiculous fashion, to say the least), but it’s the time spent with the people I care about that matters!

I’ve been typing for a good amount of time now, so I think that it’s about time that I end this post and start putting in some more work on these modules that I really need to finish up. 😅

I hope that your week turns out to be an excellent one!

“The winners in life think constantly in terms of I can, I will, and I am. Losers, on the other hand, concentrate their waking thoughts on what they should have or would have done, or what they can’t do.” – Denis Waitley

– Black Man, M.D.