Carving your own way is not always fun

So here I am, at 5:30 on a Sunday morning, awake.  I have learned that one of the harder things about working in the ER is the shifting from days to nights and back again, generally with only 24 or 48 hours to do so.  I find myself frequently staying up for 24- 36 hours because I have things to do, or simply because my body has no idea what it needs.  I stare at the ceiling and rehearse interview questions a lot.

As a fourth year student, I'm in the phase of trying to get into residency, my required postgraduate training.  Generally, that takes this form:

- take Step/ Level 2 board exam during the summer
- apply to residency programs during the fall through a standardised system, the Electronic Residency Application Service, aka ERAS
- during autumn, spend time at various residency program locations for 2-4weeks at a time, trying to impress and hopefully scoring...
- interviews, which are how a program shows interest in an applicant after their ERAS application has been submitted
- during December/ January, students and residency programs create ranked lists of the programs/ students they would like, respectively.  So I might make a list that said my #1 choice was Program A, #2 is Program B, and so on.  At the same time, those programs are making lists that might say their #1 student pick is Jane, #2 is Zoe, #3 is Steven, etc.  All of these lists are fed into a computer that works through a matching algorithm, pairing students with residency programs according to their preferences.
- Match Day, the day when all successful matches are revealed, occurs in February for D.O.s and March for M.D.s.  Everyone hopes they received a match to a program, but as some fields are more competitive than others, there are invariably not enough spots in each area for all the people who want to do that work.  Hence the Scramble.
- the Scramble is something no one wants to do.  The day after Match Day, a list of unfilled residency spots is published, and it's a barely restrained free-for-all.  Think of tossing a pile of gold pieces into a crowd and saying, "Go!"  Yeah.

I just finished my third audition rotation: one family medicine, two emergency medicine.  I have one more ER audition and then I'm finished with this part and can get back to working/ learning without also feeling like I should be jockeying for a job.

The thing about this season is that it is insecurity-inducing and it impels you to contort yourself to please people.  You see how high-stakes this is, right?  Because you want to get a job, but you know you aren't that great as you are, so you start to compromise yourself in order to look more attractive to whichever program you are with at the time.  Which of course, is a futile goal, and one not pleasing to Christ.  My job isn't to please other humans.  My job is to do my best to please Him, every day.  Walking through this time has taught me a few very important things:


- not everyone at every site will like me, and there may be nothing I can do about it
- I most certainly will not like everyone I will have to work with
- pursuing Christ will make me enemies - the more openly I do it, the more enemies I make
- being a patient advocate will make me enemies - the more openly I do it, the more enemies I make
- a few doctors still think of women as not good physician material
- some programs will expect you to abandon your dignity and become a supplicant rather than an applicant who seeks to become an equal.  These programs will provide ample opportunities for you to play their stupid game
- we who seek to glorify the Lord are truly a remnant, a small band of rebels trying not to get shot down as we slip through and around the rigid expectations of others
- calling missions "international aid" or "providing care to those who are less fortunate" is a good way to keep from getting doors slammed in my face for now
- many people will want to compare notes with you endlessly - where you've been, how many programs you applied to, what your boards scores are, how many interviews you have.  It's easy to get obsessed with statistics and probabilities
- these people will not be inspired by you telling them you trust God to place you where you're meant to be.  They will look at you with pity.  They think stress is how you know you're doing it right


I can't even tell you what a weird process this has been.  The whole point of it is to prove how awesome you are and to get what you think you want for yourself, even if getting what you want means doing a bunch of stuff you hate and lying to people.  The pressure to conform is high and constant, and I've dealt with a lot of anxiety as I grapple with this system that I must survive in but still want to reject.  It is very hard to see an opportunity to impress or agree with someone who you know has power over you, and to count the cost and deem it too high, and to consciously allow the opportunity to pass.  There's no earthly reward for that kind of behaviour. 

I work to avoid straying from pleasing God to pleasing men because God has impressed something deeply on my soul.  It is not about getting into residency.  It is not about emergency medicine or family medicine.  It isn't even about being a doctor.  My purpose is to serve the King - to trust that He will let me know what my tasks are for that day, and to work at them diligently.  The tasks themselves are pretty much incidental.

Now how is that supposed to translate in an interview, hm?