January 2021 in Review

Much love to all my readers!

Happy New Year! Yes, I realize this post is a bit late, but it's been hard to find the time to sit down and type. Right now, I'm currently in the middle of working a 12 hour shift, so I figure if I take a minute or two in between patients today, I can finally give everyone a full update on how the beginning of 2021 has been for me. (Yeah, that didn't happen. Started this post yesterday and finishing today)

Blessed to celebrate 34 years of life!

If you've been following my blog over the years, then you already know January is my favorite month. Why? Because it's my birthday month! I was immunized against COVID-19 (more on that below), and took a solo trip to Saint Lucia during my birthday weekend. It was my first time being on a plane since flying for residency interviews last year, and while I was a little hesitant to travel at first, everything worked out safely and perfectly! I received mandatory PCR testing before my trip, was tested again while on the island, and strict protocols were in place that included staying masked, frequent temperature checks, and excursions limited to 4 people or less. My resort was incredibly beautiful and I literally could have stayed in my room the entire time and not gotten bored. I also went whale watching for the first time (an incredible experience), enjoyed a nice sunset cruise, and had an amazing personalized birthday dinner at my resort. I took some amazing pictures (tripods are great!) and videos which are posted to my Instagram highlights if you'd like to share in all the birthday fun. I couldn't have asked for a better getaway and amazing kickoff to the year. The shot above is one I took in my room (it only had three walls). Views!

Fully vaccinated with new hair to match

As for the getting the vaccine, I received my first dose on December 23rd and my second and final dose on January 9th. I had no side effects from the first dose other than mild arm soreness. About 12 hours after the second dose, I did have the side effects of fever, alternating between hot and cold sensations, headaches, and a weird boost of energy, but all the side effects subsided within 24 hours after taking ibuprofen. I am extremely happy to have 95% immunity at this point. My profession puts me at higher risk, so it helps having some peace of mind that I will not suffer from some of the devastating effects I have seen from the virus. With that being said, I will continue to do my part to help end this pandemic by wearing my mask, practicing social distancing, and educating those around me.

Happy Work Vibes

As for work, everything is pretty much the same...just busy! Winter months in the urgent care setting are already an extremely hectic time and when you add on a pandemic, things can get a bit crazy. It is a blessing to have a job during a time when so many are without, so I can't complain though. Plus, I've adapted to the times, and I've definitely enjoyed the challenge and variety of going between physical patients to virtual patients to managing COVID testing. There's never a boring day and this girl likes to stay on the go!

Taking another leap of faith!

In terms of the residency application process, I'm happy to say that I will be participating in the match this year, and unless an opportunity outside of the match pops up, interview season has officially concluded for me. I even submitted my rank list while I was on vacation to hopefully bring in a little good luck. There are really no words to describe how stressful and painful this process has been over the years, but I truly miss surgery and being in the operating room. I am extremely anxious over what the news next month will be, but at the same time, I have faith knowing everything will work out no matter the outcome. At the start of this year's process, I wrote a few posts that I still plan to share once match season officially is over, but my plan to write up weekly updates kind of fell through with my busy schedule. With that being said, there won't be a lot of posts released, but I will still give everyone a good glimpse into the process.  

That's pretty much it for updates. As always, I wish everyone a great month ahead, and thank you for reading!

Life as an Urgent Care Physician

Managing more than just colds and coughs!

Since I've started practicing, a lot of you have reached out to me wondering what it's like working as an urgent care physician, and what a typical day entails. This post will hopefully give you a glimpse into my current role and answer a lot of your commonly asked questions.

How would you describe urgent care?

The best way to describe urgent care would be something along the lines of "Emergency Medicine meets Family Medicine (with a sprinkle of Surgery)." I manage patients from 3 months old to 100+ years old, and I get to do a little bit of everything. Whether I'm treating an asthma exacerbation, performing vaginal exams, managing fractures, suturing lacerations, doing incision and drainage procedures, or treating something as simple as a UTI (just to name a few), urgent care pretty much does it all. We don't treat super complex things like heart attacks or other life-threatening issues, but oftentimes these patients will come to the urgent care instead of going to the emergency room, and it is my job to stabilize them until EMS transport arrives to take them to the emergency room. We perform x-rays, EKGs, place splints and boots, and can even provide IV hydration if needed. We then refer to specialists for ongoing management if a patient requires continued care. Urgent care offers a great deal of variety and I think it's a really great way to keep clinical skills current while avoiding burn out.

What are the hours like?

Urgent care offers a very flexible lifestyle and the hours are pretty nice. The practice where I currently work has two locations, one that is open 9am - 1030pm seven days a week and the other that is typically open 9am - 8pm (with slightly earlier closing times on Fridays and on the weekend). At the location with longer hours, shifts are 9am - 4pm and 4pm - close. The other location usually just has one shift that lasts the entire day until closing time. I usually work until about an hour or so after closing time since we have a rule that as long as a patient walks in the door before the official closing time, they will be seen. Usually someone will walk in around 10:28pm with something more complex to deal with, which means I'm working until at least midnight or whenever that patient is fully managed. Despite this, the hours are still insanely better than any day in residency since I never worked less than a 12 hour shift on any given day during my training. 

What is the patient load?

I typically see an average of 20 patients per shift, but this number can vary by more or less depending on the day. It is a job that requires quick thinking and efficient management, but I have never felt super overwhelmed. Sometimes a ton of patients will all come into the waiting room at once, and other times it is a more steady flow of about 3 patients per hour.

Is there help?

When I work, I am the only physician on staff, so I am responsible for seeing and managing all the patients. There is a front desk person that checks everyone in, a medical assistant who does triage and any procedures I may need done (such as x-rays, injections, strep tests, giving IVs, etc.), and at the busier location, I also have a scribe who follows me into the room and types up the majority of my notes so that I can focus on patient care. During my training, I often split my work with at least one other individual and I usually had more senior residents and attending physicians to step in if I needed help. Urgent care differs in that I do not have anyone to split the load with, but I never truly feel alone as I can always call up one of the other physicians in the group for advice, to provide a second set of eyes on an x-ray image, or to even come in if I feel swamped and need help (thankfully I have not had to do this yet *knocks on wood*). Our medical malpractice insurance company also provides helpful resources such as UptoDate for free, so I always have access to the most current medical information and treatment guidelines for my patients.

How is your work-life balance?

My work-life balance now is spectacular compared to how it was during my training. Before I worked no less than twelve hour shifts per day at least six days a week with every third day consisting of a full 24 (which almost always turned into a twenty-eight) hour shift. Right now, I work an average of three days a week with shifts that range from seven hours to eleven hours. The most hours I have worked in one day since starting urgent care was 14.5 and that is only because I picked up another physician's shift and worked a double. I work less than half of what I did during my training, am more than fairly and doubly compensated, and I have time to explore my passions and do some of the things I love outside of medicine. Even better, we are asked for our desired work schedules in advance of each month's schedule being made, so I am able to plan trips and spend more time with my daughter. The work-life balance is without a doubt one of the best things I've got going for me right now, and it will surely be missed if I end up going back to residency.

What new insights have you gained from working at an urgent care?

Believe it or not, I have learned a lot working in urgent care and not all of it is medical. The main thing I have learned is the power of collaborative relationships. I don't think I truly appreciated the power of collaboration during my training (probably due to fatigue and the type of environment I was in), but now it is more evident than ever and a daily necessity. Whether I'm speaking to a radiologist about a patient I sent for an outpatient CT scan, getting advice from a specialist, or working with my staff to make sure a patient is fully taken care of, I am so appreciative of the collaboration that urgent care involves. It has also enhanced my teaching skills as I am frequently educating patients on things like why I will not prescribe antibiotics for their colds or the importance of seeing their primary care physicians for follow up care. Medicine truly is a team sport, and it sometimes takes many individuals working together to ensure a patient gets the most appropriate care. Additionally, working at an urgent care has strengthened my critical thinking and self-directed learning skills, and the beauty of having work-life balance has taught me a lot about self-worth and recognizing the signs of burn out. Lastly, I've gained more insight into my self as an individual. Whether it's been learning to trust my own inner knowledge base or recognizing my limits as a physician, I continue to work on myself daily and being in the urgent care setting has truly allowed me to continue to learn and grow as a physician.

I hope this sums it up and answers most of your questions, but if not, feel free to ask away in the comments below!

The Training Wheels are Off and the Doctor is In: An Update

My glow is back!

So many changes have occurred since my last full post! Over the past three months alone, my life has made a complete 180 degree turn, and I couldn't be happier at the moment. It was only six months ago when I found out yet again that I didn't match into a categorical general surgery spot, and it was so stressful worrying about how I would be able to pay bills, take care of my child, and still continue to live my dream of being a physician. I never could have imagined how smoothly everything would come together for me, and I can't help but feel anything other than blessed and thankful. I've finally settled down enough to write about my recent experiences, so this post will serve as a quick recap for your viewing pleasure :)

Goodbye Philly!

A few days after I officially finished my intern year, I packed up my belongings, sold what wouldn't fit in my car, and I made the long drive back from Pennsylvania to Georgia. During that time, I had no real plan on what I would do for work as I didn't have any jobs lined up, and I was still waiting to hear back from a couple of residency programs I interviewed at for open PGY-2 positions. I only knew I wanted to be back in the south and that I would figure out everything later. During the last week in June, I took the time to relax, hang out with a few friends I made while living there, and enjoy some sight seeing in Philadelphia one last time before I was gone for good!

Badge Official!

During my final week in Philadelphia, I submitted the application to obtain an unrestricted medical license in the state of Georgia (I had to wait until my final day of training to officially have a complete application), and I received the approval email around three weeks later. This approval meant I could finally start working as a general practitioner, and I immediately applied for various jobs in my area. I also spoke with an old classmate who connected me with an awesome urgent care physician who told me his clinic was looking for a new physician. Just a few days after this conversation, I had a chance to check out the clinic and interview with the owner. I started training the following week working alongside other physicians as I couldn't fully work on my own until my DEA license was approved. Luckily the approval took less than two weeks, and my training was paid, so it was a super smooth transition. By the first week of September, I was working full shifts as the only physician on staff, and as we near the end of the month, I am starting to feel a lot more comfortable with my new role. I guess you can say the training wheels are officially off since, for the time being, I am no longer a resident physician, but a fresh urgent care physician.

Mommy-Daughter Time!

This new position is such a welcome change from the stress of residency life. I am no longer working insane hours, I have great work-life balance with much more free time, and I actually get to spend time with my daughter. I agreed to let her continue to stay with my parents another year to enjoy band, her friends, and her dwindling time in middle school, but being only six hours away from her by car (and one hour by plane) is way better than the two flights or twenty hour drive it took from the northeast. We pretty much get to see each other in person now whenever we want, and it's kinda fun making random trips in the middle of the week to help with homework or just relax with my little one.

Third time's a charm?

This new chapter in life doesn't mean my long-term goals have changed just yet. I am still one stubborn individual, and I submitted my ERAS application for yet another go-round of the residency match cycle. Having to re-apply sucks, but the bright side is I didn't have to struggle to pay for my applications this cycle, and no matter the outcome, I know I will have a job this time next year. In the past, I've been pretty quiet about the process, but this time around I will share more about it on the blog to help out my medical student readers. I'll also write a post detailing urgent care life since people close to me have asked a lot of questions about it. As for now, I'm going to use the next few days I have off to relax, and I hope everyone reading this has an amazing weekend!

Work-Life Balance as a Resident Physician

Post-Call Glow

I promised my next topic would be on work-life balance in residency, so this post will be about how I am currently trying to maintain this balance during intern year with a few tips for those of you who will be in my shoes in upcoming years. Even though I'm only a month into residency, I currently live for my post-call days and the rare times I actually get a day or weekend off. It's during these times that I can actually feel (and look) like a normal human being again while getting caught up. Also, since my daughter usually spends her summers away and hasn't started to miss me yet, I've been able to have some extra fun without worrying about making the flight to see her on my days off.

I had the blessing of not only having a day off during my second week for the 4th of July, but a post-call day that Friday and a full "golden weekend" off. I was definitely excited for the chance to explore the city during the holiday, and what made it even better was having a friend from my GA-PCOM family in town to experience all the fun with. We went to a block party on the parkway, listened to some great music, and ate lots of yummy food from some of the food trucks that lined the street.

As for my Golden Weekend, I was super excited that Atlanta United was coming to town to play, and with tickets only being $29, I was definitely in attendance. Plus, my friend had never been to an ATLUTD game, so it was a good first experience. We had great seats, the stadium was outdoors with a gorgeous view of the Delaware river, we won the game, and although the Philly fans were a bit intense, they were actually pretty nice for the most part. There were even fireworks after the game (pictured above) which we were happy to see since we both had early work schedules and were too tired to stay up for the fireworks that occurred on the 4th of July. Afterwards, we got a chance to walk around the city to check out the nightlife, talk, and have a few drinks. It was much needed, and I felt so alive! The next day, I slept in (so wonderful!) and took a walk to the Spruce Street Harbor Park where I people-watched, ate more food, and enjoyed a day out in the sun.

Hanging out with my mentor

Since that weekend, my only time off has been during my post call days, so I've made sure to take full advantage of making the most of my free time. My favorite post-call day so far was when I got the chance to spend time with my mentor Dr. Velma Scantlebury while helping out with a dinner she was hosting for the Mandela Washington Fellows. This was a group of young African leaders who are only in the US for six weeks, so it was nice getting to meet them and hear their stories. Plus, I'm always up for free food and it was nice having some time out by the pool.

#ATLUTD #UniteandConquer

Right now, I am currently on day 14/19 without any time off unless I am post-call, so it has been extremely important that I maximize my free time to the fullest extent. As a resident, a lot of time is spent in the hospital taking care of everyone except yourself. It's easy to fall into the typical work-eat-sleep cycle, and not making any time for yourself can eventually lead to burn out. Keeping this in mind, I've made a list of things that have helped me stay sane so far. I'm sure this list will change as I get into heavier months, but so far, here are my general tips for post-call and free days:

#1: Try not to waste the day sleeping
This is probably the hardest thing to do on my list. After working 24-28 hours with very little or no sleep at all, the first thing anyone wants to do when they get home is hit the bed! It can be easy to sleep the day away, and before you know it, it's time to go back to work. I refuse to spend my entire time as a resident just working and sleeping, so I make an effort to sleep when I can while on call (even if just a 15-30 minute nap) and set my alarm to wake up when I'm post call. No matter what time I get off work on my post-call morning, my alarm is set to 230pm. So far I've been managing 4-5 hours of post call sleep, but I do have upcoming days where this will be less (such as when I attend morning general surgery grand rounds).

#2: Work tomorrow? Go to bed early
I love sleep, but if I slept all day on my days off, I wouldn't be able to sleep at night. Not a good thing when I'm typically waking up at 330/4am. So, as mentioned above, I make sure to wake up by 230pm on my days off, and I aim to go back to bed by 9pm. On days where I am truly sleep-deprived, I'll go to bed even earlier to ensure I get at least a full 7 hours of sleep (my optimal amount). This allows me to wake up feeling refreshed and ready for a new day.

#3: Have a To-Do list
It helps to have a plan for your days off. I try to keep a list of things I need to take care of, and I knock them out during my free time so I don't start to feel overwhelmed. Even if the list is something as simple as "watch Hulu, read a chapter, call daughter", it helps to have a plan.

#3: Indulge in some self-care
I am all for self-care and sometimes it's the little things that can make a big difference. On my very first post-call day, I went to the movies. Mostly to keep myself awake, but also because watching movies is something I enjoy doing. I even include blogging as part of my self-care, because I find it therapeutic. There's nothing wrong with treating yourself to a massage, pedicure, or even fancy take-out during your time off. I've done all of these when post-call, and it's a great morale boost.

#4: Get the "Adulting" out of the way
Bills and other responsibilities don't stop just because you're busy or tired. The best way to conquer them is to knock everything out when you have time off. I've utilized post-call days for grocery shopping, paying bills, and doing laundry. Things are usually less busy during the week and grocery store lines are a lot shorter. I even meal prepped the other day for my current string of back-to-back call days since I somehow managed to spend my cafeteria meal credit for the month. In the coming months, I'll utilize the time for doctor appointments and such, so that I can use my personal days for other things like making trips to see my little one and (hopefully) interviews.

#5: It's okay to not be productive
There will be some post-call/off days where you just don't feel like doing anything at all, and that is okay. Yesterday was one of those days for me. I was post-call with probably only a total of one hour of sleep in 27 hours, and I just wanted to be in bed all day. I still set my alarm for 230pm, but instead of being out and about, I stayed in bed, ate snacks, and watched Hulu all day. I think the only productive thing I did was wash clothes, and I was asleep by 8pm. Doing nothing was much needed, and I woke up feeling refreshed, and ready for another day on call.

That's all I have for a list right now. I will be post-call again tomorrow morning and Wednesday, and I already have some "adulting" items to take care of. The good news is I'll be off both days this weekend, and I will definitely be taking advantage of it. My motto is "work hard, play harder", so I am very much looking forward to another golden weekend that will only involve fun, self-care, and being around people that make me happy. If you're a resident or attending, I'd love to hear some additional tips, and to everyone else, I hope you have a wonderful week!