End of the Trails

The match lists are due on Wednesday, and since I'm in Montana with questionable internet connections, I'm glad I submitted mine before I left Seattle. The final verdict?
1. UW Traditional Track
2. UW Seattle Primary Care Track
3. UCSD
4. OHSU
5. UW Boise Primary Care Track
6. Dartmouth
7. University of Utah
8. University of Michigan
9. UC Davis
10. University of Wisconsin

I will be very happy with any of the top 5. In fact, which one I would like to rank first varies from day to day, so I don't think I'll be disappointed with any of those if I match there. #6, 7, and 8 I'd be less excited about, but still are programs that I really liked. #9 and 10 are at the bottom of the list for a reason. Generally there was just something about the program that didn't feel right, but not something I could really put my finger on, and I liked them well enough that I'd be willing to go there rather than risk "scrambling."

So that's the end of my Interview Trails. I'm done with this blog. Match Day is on March 16th. You will all find out shortly after 9am PST (or is it PDT?) where I'm going. And if you will miss my periodic blogging, never fear. I have a new one that I should be keeping fairly up to date: Free Time.

The Rank List

The sun finally came out today, and I went for a run around Green Lake. As I was running I saw a bald eagle sitting in a tree, right by the trail. I love where I live, and I really don't want to go anywhere else. So I have come up with a (tentatively) final rank list, which I will submit next week (just in case I change my mind). Before I share that list with you all, a bit of clarification. Some programs, such as University of Washington, have multiple tracks which you can rank separately. They are designed to provide you with the appropriate training for your interests. For instance, at UW they have the traditional track, geared towards subspecialty medicine. They also have two primary care tracks, which give you a little more training in the clinic setting. So if you really want to go to a particular program, it would benefit you to apply to all of their different tracks. Which helps explain my list:

1. University of Washington, traditional track. This would provide me excellent training since I am leaning toward specialization at this point (endocrinology? hematology? oncology?), in an excellent city, and I wouldn't have to move. Yay!

2. University of Washington, primary care track. Again, I wouldn't have to move, and the primary care track is very similar to the traditional track. And the specialties that I am interested in are largely outpatient specialties, so extra clinic time would probably be helpful.

3. University of California San Diego. Ok, so I'd have to move. But I'd move to San Diego! The beach! The sun! It's warm! The program is similar to UW's, but smaller and more supportive, I think. If I weren't so opposed to moving, I would probably choose this one first, as I think I personally would do better in a program like this, but I will do fine in Seattle. And I really, really don't want to move.

4. University of Washington, Boise track. For this fun track, you do your first and third years in Seattle, and your second year you are at the VA Hospital in Boise. I was initially very opposed to this idea. I didn't want to have to move twice in three years. But I think it is actually a nice compromise between the UW Seattle tracks and UCSD. It's a good program, you get a lot of autonomy 2nd year, you learn a lot, and the Boise group tends to be a very close-knit, supportive group. Kind of like a smaller residency program within the ginormous UW residency.

5. Oregon Health Sciences. Portland is nice. This program is nice. They have a very interesting chronic care curriculum, teaching residents how to involve patients in their own care with chronic conditions such as diabetes and hypertension. It would definitely be a less intense program than UW, but close enough to Seattle, that I wouldn't really feel like I was losing a whole lot by moving.

6. University of Michigan. Ok, so there are only so many programs on the west coast. If I don't get to stay at one of the top 5, it's time to head east. Michigan is an excellent program. Very academic, very research oriented. Downside? It is in Michigan. But close to Detroit, so you can get on a plane and get out without too much trouble. And Ann Arbor is actually quite nice. Their residents have a "union" so you get better pay and more vacation time than they do at other programs. Probably because they have to bribe you to move to Michigan.

7. Dartmouth. Hanover! Can you get any more remote than that? Not really, but it is a very supportive program. The residents are very happy, and have lives outside of medicine, which is encouraged by the program directors (what a novel idea! Keep your residents happy!). And life in a small town, while a definite change from life in Seattle, wouldn't be all bad.

8. University of Utah. They have mountains. They have Mormons. What more can you ask for? Yes, you have to buy beer at a liquor store. Yes, everything closes on Sunday. Yes, the local news is hilarious due to its amateur nature. But you can be on a ski lift in 30 minutes!

9. University of California Davis. It's tough to decide how to rank #8 and 9. Sacramento is close to Tahoe. Except on weekends, when everyone in the Bay Area decides to drive to Tahoe and traffic is miserable. Sacramento seems to be an up-and-coming city, and it's on the west coast. I don't know... I might change my mind and rank this one higher than Utah (this is why this is a tentative final list).

10. University of Wisconsin. It was a weird interview. I just didn't really click with the program. I probably shouldn't even rank it, but I'd rather end up there than nowhere, and I really don't think I'm going to have to worry about #10. At least I hope not... I'm hoping for something in the top 5. But any of these are good programs and will give me the training I need.

That is where things stand for now. I welcome any comments and input. I'll post my final final list after I submit it.

UC Davis

The interviews are over! The last one was today: UC Davis in Sacramento. It's a nice program, fairly small, and everyone seems very happy here. The hospital is beautiful. Apparently UC Davis is the only of the UC hospitals that is making money. And since they are a non-profit, they keep investing that $25 million annual profit in their hospital and educational resources.

Sacramento is a growing city, but it seems very suburban. Lots of sprawl (which I guess is easy since it is surrounded by nothing), new housing developments, new restaurants. When I ask the residents what they think about living in Sacramento, they inevitably answer "it grows on you." I've also heard it described as "a nice place to raise a family" which usually means "boring." It is a good location though, less than two hours from Tahoe, less than two hours from San Francisco. So there would definitely be ample opportunities for weekend adventures--a very important consideration when planning where to spend my years as a resident. They encourage research by their residents, although most do clinical research. While this is something that I think I would like to explore more, I'm not sure I want to completely give up on the idea of bench research. I don't know if this is the right place for me. I did enjoy my interview, and definitely enjoyed staying with Scott and Kathy Nichols (Dad's fraternity brother from his college days), but I just can't seem myself living in Sacramento at this stage in my life. I'm still young (yes, 30 is considered young) and I'm not ready to live in a city that is good for raising a family.

Now I have to come up with a rank list. The first two are easy--I want to stay in Seattle, and if I can't stay in Seattle I want to go to San Diego. But then I'm torn between OHSU and Dartmouth. Right now I'm leaning towards OHSU, because it is close to home, and it's a city. I'm not sure I'm ready to settle down in Hanover. I've done my time there. I love the snow, but I like living where it doesn't snow and being able to drive to the snow. But the Dartmouth program is fabulous. All of the residents are happy, they get along well, and they are smart. The faculty is there because they choose to be. They are good at what they do, and they enjoy teaching. And I love Hanover. The location is great--right in the mountains (small mountains, yes, but montains nonetheless), close to skiing, hiking, Boston. But it too is a good place to raise a family (boring), and I'm not sure I'm ready for small town life yet.

Dartmouth-Hitchcock

I'm finally approaching the end of the road, as far as interviews go. Dartmouth is 2nd-to-last, one more this Friday and then I'm done! It was great returning to Hanover even though it was for such a short time. It's such a beautiful part of the country. Cold, but beautiful. I really enjoyed my visit. The program would be a great fit for me, I think. I love the idea of training at an academic medical center in a small town. The residents all get along well, and seem very very happy. The hard part would be going so far away from my life here on the west coast. But I anticipate it will only be for 3 years, and I can't imagine ending up anywhere other than the northwest in the end. So maybe it would be a good adventure?

The hospital is beautiful, it's only about 10 years old. They built it from the ground up (the old hospital was in Hanover, they demolished it during my undergraduate years). The newest wing was just opened last year, so the entire hospital is state of the art. And very nice. Inside it looks more like a shopping mall than a hospital.

It does get cold in Hanover. It was ten below with the wind chill. But it was sunny, which was very nice, given the seemingly non-stop rain we've had in Seattle since before Christmas. I liked the Dartmouth program more than I thought I would. Seattle and UCSD are still in the lead, but it's going to be a tough choice between OHSU (in Portland) and Dartmouth. Friday I interview at UC Davis in Sacramento, and then I'm done. Rank lists are due mid-February, and the moment of truth, Match Day is March 16th (I think).

Boston

Originally I had several interviews lined up for my trip east, but as I got more and more tired of making small talk and asking interesting questions, when really all I want to know is how many weekends will I have off, how many weeks of vacation do I get, and do I really have to work 80 hours a week, I cancelled everything except my Dartmouth interview. Which made for a lovely 2 day vacation in Boston.

Kendell and I took the red-eye on Jet Blue. A lovely airline, that will give you all the snacks you want. But the damn seats only reclined about an inch, which did not make for the most comfortable sleeping experience. We took the train to our hotel in Brookline (I love cities with functional public transportation!) and wandered the streets in search of coffee and a bagel. We later headed down to Newbury Street for a little window shopping. We strolled through the Public Gardens and stopped to admire the ducklings, from one of my favorite childhood books.

We also spent some time strolling on the Freedom Trail, attempting to find an educational aspect to our trip. We spent the next morning at the Isabella Stuart Gardner Museum near Northeastern University. It's one of my favorite museums. I love that the building is as much a part of the display as the art itself. Adam was able to get a cheap flight to Boston for this weekend as well, and we met up Friday night for dinner in the North End. Fabulous Italian food, and I got to meet one of Adam's friends from his Boston days. Now I know where Adam gets some of his more interesting ideas. It was a lot of fun.

After spending the next few days driving around New England, taking Kendell to visit Brown and Wesleyan, we've ended up in Hanover. It was a bit of a harrying drive north. It was 50 degrees while we were in Boston. Sunny. Warm. Yesterday it was pouring rain. But still warm. Today? Well, currently it is 5 degrees, with a substantial wind chill. It snowed last night, which made the drive interesting. Especially since they don't seem to care much for plowing the roads in Vermont.

My interview at Dartmouth is tomorrow. I really enjoyed my dinner with the residents tonight. And I love Hanover. It would be interesting to come back. One more interview after Dartmouth. Then we'll come up with a rank list, and hopefully get that submitted before I head off to Montana.

University of Washington

After a two week hiatus for Christmas and New Year's, the suit is back from the dry cleaners and I'm once again perfecting my small talk skills. To re-cap my weeks off:

We had a lovely (rainy) Christmas in Seattle. Adam decided to stay on the west coast and was subjected to a crazy Christmas, Tylee-style. He took some nice pictures of us all and the puppies. New Year's was another rainy adventure. Adam and I were at REI (not an uncommon place to find us) when he got a call from his roommate that his garage was flooded. We raced to his house to find a steady drip coming from the garage ceiling. Have you ever tried to get a plumber to come out at 9 pm on New Year's Eve? Given the steady rain we had had in Seattle since Christmas, there were a lot of flooded basements and backed up sewers. So Adam's broken pipe was low on the priority list. We turned off the water, I went out and rented movies, Adam cleaned up the flood, and I made dinner. It actually was a lovely evening.

Today I had my interview at UW. I was unsure what to expect. After UCSD, I was so sure I wanted to go to San Diego that I actually didn't want to like UW. I didn't want to have to choose between Seattle and San Diego. I was hoping I would hate the UW, and it would make my decision easy. No such luck. I loved UW, which I guess I knew I would. I have enjoyed every rotation I have done here, and have loved everyone I have worked with. It's an excellent program and I would do very well to get my training here.

UW is a more competitive program that any of the others I have interviewed at, so ranking it first is not a guarantee that I will end up here. But I feel like it is the right choice for me. I will rank UCSD 2nd, and would be thrilled to end up there as well. It then becomes a tough choice between OHSU (Portland--west coast! great city! close to Seattle and mountains!) and Michigan (Ann Arbor--great program! nice, smaller city! close to Detroit!).

I still have a few more interviews. I ended up canceling University of Arizona, because it just isn't going to be competitive with the programs I've already interviewed at. I also canceled Beth Israel, in Boston. I think I'm really interested in going to a smaller, less prestigious program where I won't have to work so hard to make it clear how brilliant I truly am. I also like programs that have a less well defined hierarchy, where residents and interns are not treated as though they are the low man on the totem pole (even though they are). UW is considered a fairly well known and well respected program, but it's the west coast. It's a different world out here. I also added UC Davis, just for kicks.

My updated interview schedule for the remaining month:

Jan. 12th-13th--to Boston, hang out, go to museums, eat in the North End

Jan. 14th-15th--tour small liberal arts colleges with Kendell

Jan. 16th--interview at Dartmouth and return to Seattle

Jan. 19th-20th--fly to Sacramento, interview at UC Davis

Jan. 26th-29th--skiing in Tahoe

Jan. 29th--return to Seattle in time for Adam's 29th birthday!!

Feb. 3rd-6th--fly to San Jose, CA and drive to Carmel, CA for a conference; skipping out on the conference after I give my talk on Friday and drive to Big Sur and various other central coast attrctions

Feb. 11th--road trip to Montana!!

Feb.12th-Mar.10th--lovely Great Falls, MT hanging out with Kat and Tom, introducing them to the wonderful Sip-n-Dip Lounge at the O'Haire Motor Inn!

UCSD

I finally returned to Seattle, only to head off to the mountains for some snowshoeing. Although the lack of good snow really meant we did some ice hiking. For details and pictures from the adventure, check out Adam's blog. We returned to Seattle Sunday afternoon, where I hopped on a plane to head down to UCSD for yet another interview. Despite a 2 1/2 hour delay getting out, it was a pleasant trip (in large part because I got upgraded to first class, so I didn't mind in the least sitting on the runway for 2 hours).

It's going to be hard to find a program that will top UCSD. The program director and the chair of the department are both from University of Washington, and are trying to emulate the UW's residency program on a smaller scale (and in a better climate!). It really is an excellent program, very similar to Washington's but a smaller more tightly knit resident class. That really appeals to me, as internship year is going to suck where ever I end up, and I think having a smaller class will make it easier to bond with your fellow residents. The program is similar to Michigan in intensity, but about half the size. They have a 3 hospital system, so you get exposure to the university/county hospital, the VA and a private hospital. They give you 5 weeks of vacation your intern year (which is unheard of!). And did I mention the weather? FABULOUS. I could actually run outside, on the beach, everyday. I love it. It's going to be a tough choice, as there are many reasons to stay in Seattle. But I really like the idea of getting away for awhile, and experiencing life somewhere else. My UW interview is in a few weeks, so we'll see how that goes, and after that I think I will be able to start making some decisions, as my last three interviews are not ones that I'm really excited about. But who knows. Maybe the EBA's chicken sandwiches will be enough to draw me back to Hanover...