Quitting Residency

My interview at UW went well. Quite well actually. They have funding for a 4th fellow starting this summer, and have offered the position to me. This would mean I would have to leave my residency program a year early. This isn't as unusual as it sounds... there are 2 or 3 people from our program who do this each year, called "short-tracking." It's a way for people who are interested in academic medicine to spend more time doing research. I'm not sure of all the requirements... I'm meeting with our program director next week to find out if I can even do it. You need to have completed certain rotations during your first two years in order to be eligible for board certification in internal medicine, and then I would need to complete a 4 year endocrine fellowship in order to be board certified in endocrinology.

Besides the practical issues of finishing residency early, and the fact that I'm on call in the ICU the day that I would have to be in Seattle starting fellowship and the fact that I would have to take two weeks off in August for my honeymoon, I'm not sure if I want to start fellowship this summer. There are many good things about it: I get out of the match and am guaranteed a spot for my fellowship in Seattle, I get to go back to Seattle, I don't have to do my 3rd year of residency, I never have to work in the ER again. But I had a 3 year plan. If I go to Seattle this summer, my 3 year plan suddenly becomes a 2 year plan and I have some adjustments to make. Part of me wants to stay here and finish residency like I had originally planned. But the other part of me thinks I should just go to Seattle and get on with my life.

The big deciding factor will be whether or not I am limiting my options by leaving residency early. I need to be board eligible in internal medicine and endocrinology. I don't want to close any doors. With medicine, there is always more to learn, and I will be giving up some experiences. But most of 3rd year for internal medicine is spent doing electives. I've had the same responsibilities this year as a ward resident that I would have next--2nd and 3rd year residents function at the same level, unlike other specialties where each year you gain more responsibility.

So we'll see... if I don't take the oppoturnity, I can still go the regular route, take my chances with the match and start fellowship in 2009 as I had been planning. And in many ways, that would be easiest, but is easiest always the best way to go? Who knows.

Odds and Ends

I've been working all weekend, which hasn't been too difficult, it's just a bit annoying to work an entire week, then all weekend, and then another entire week all without a day off. I miss having normal days off. Adam will be quick to point out that I often only work half the day. Which is true (although I would say "often" is a bit of an exaggeration) but even on those days that I come home at 3pm, keep in mind I am often at work between 7 amd 8 am so that is still a full 8 hour day. I think I am justified in feeling tired.

But I have found time to cook dinner every day this week, which always makes me happy. I love cooking. I made fish stew one night, Greek marinated kebabs with salad and asaparagus another night. We had chicken piccata. Then a left-over night to catch up on everything. Tonight I made chicken soup. I've taken to buying whole chickens and cutting them up for parts whenever I make anything chicken. Then I use the leftover parts to make chicken stock. It's very easy, although takes about 8 hours. But it's nice to have chicken stock on hand. It makes me feel so domestic.

I also finished two knitting projects. The baby blanket for my friend's new little girl:

It is nice and soft and machine washable, but I chose a flannel backing that completely clashes with the knitted part. The colors are way off. But It took so long to sew that damn backing on (I haven't yet learned to operate the sewing machine I got for Christmas... I will get around to the one of these days!) so I just left it. Baby won't be able to tell the difference anyway, right?

I also made a shopping tote from Michelle's recycled sweater:

That sweater has plenty of yarn left to give, so perhaps I'll make more of these. It's pretty brainless work, and probably the most practical thing I've ever made.

Tomorrow I'm off to Seattle for my UW interview. I'm very nervous about this one, because it is where I want to go, and I'm interviewing with some of the top experts in my research areas of interest. Which is actually a very good thing--this program is a perfect fit for my interests in obesity and body weight regulation. Hopefully they will think the same. I hope it isn't raining in Seattle. It's been raining here for days it seems, and I could use a bit of sun. :)

A Walk in the Woods

Taking advantage of the beautiful weather this weekend, after a surprisingly stormy week, we headed up to Mount Laguna for a hike today. Mt. Laguna is at about 6000 ft, and as such gets the majority of San Diego County's snow fall. Given the absurd amount of rain we got this week, we expected there to be some snow, but the warm weekend had caused most of it to melt. However, San Diego children will take whatever snow they can get, and there were many many people up there, trying to get some last minute sledding in on whatever patches of snow they could.

After a couple of false starts, we eventually found the trailhead we were looking for and hiked a 7 mile loop through the woods and meadows. It was great being outdoors, despite the horrible sun burn I ended up with (who expects to get sunburned in February???) and Toutou seemed to enjoy the snow as well, even playing with Adam for a few minutes before remembering that she hates him.

We also had a very successful day of geocaching. Yes, we are dorks like that, but it makes the hike that much more enjoyable if you are working towards a goal. Like a hidden box of crappy toys! Enjoy the picutres.

Interview #3

Today was my interview at UCSD. It was a bit odd being at the hospital wearing a suit, but a good interview. I didn't expect much from the program, but it was actually went better than I expected. It's definitely not as academically oriented at UCSF--over 90% of fellows go into private practice/HMO. The clinical load is not as heavy, with only 4-5 months of inpatient consults (versus a full year at UCSF and 6 months at OHSU), plus your clinical duties can extend into 2nd year. We met with one of the fellows, and she kept commenting on how hard they work at other programs. I think I want to work hard... it's the best way to learn. How hard can endocrinologists work anyway? Almost no one does a 3rd year and it's not clear that many fellows get additional funding. Plus, the lab I'm most interested in working in doesn't generally take MD fellows (but would probably be able to set me up with someone who does). There's been some drama with a fellow recently leaving the program, and all of the clinical trials at the VA are on hold for protocol review (one of the PI's does a lot of drug studies), but overall you get a good education. And San Diego isn't a bad place. The best part was meeting with one of my interviewers (who did her fellowship at UW) who spent our entire 40 minute interview telling me what I needed to do in order to get accepted to the fellowship program... at University of Washington. :)

The current standings:
1. UCSF
2. UCSD for their program, OHSU for the city and faculty
3. OHSU for their program, UCSD for the city and faculty

I could go either way with UCSD and OHSU. Next up... UW on 2/26. I fly in at 10 pm Monday night, and fly out 10 pm Tuesday night. Quick trip but it's hard to get time off these days.

Happy Cupid's Day

Being staunchly opposed to the idea of supporting the commercial aspect of Valentine's Day, Adam and I are keeping it low key tonight. I got out of work early today, so decided to cook dinner, complete with Valentine's Day cupcakes. It was the inaugeral use of our first wedding gift: the Kitchen Aid mixer. I have an unhealthy love of this appliance. And it did not disappoint. First task--red velvet cupcakes with cream cheese frosting. Look at the beautiful mixer! Look at the scary red cupcake batter!

Look at them baking!

While they were baking, I made the rest of our dinner--chicken with mushroom cream sauce, peas with pearl onions and brown Basmati rice. Definitely not a low fat meal (there's 1/2 c. of sour cream and 1/2 c. heavy cream in that mushroom sauce!) but tasty.

And now we are going to settle in to watch one of those classic romantic movies--the Thomas Jefferson documentary by Ken Burns. We're a load of fun, aren't we?

Super-Freaky

This is Toutou, aka "superfreak":

She belongs to one of my fellow residents who is doing a rotation in Cambodia for a month, so we are dog-sitting. Toutou is a very good dog. She is housetrained, and doesn't chew on things, and it content hanging out at the house all day while we work. But Toutou is also bi-polar. She loves me. Won't leave me alone. Is thrilled to see me come home from work each day. Wants to do nothing but play. But Toutou hates Adam. Growls and barks at him every chance she gets. Won't let him near enough to her to put on her leash, so he can never take her out. Won't even take food from his hand. This could become problematic, if she still hates him in two weeks. I have to go to Seattle for an interview, so it will be just the two of them. She may not pee until I get back.

Randomness

I missed knitting group again tonight. I'm on call for renal, which is home-call, so I don't actually need to be in the hospital, but I'm terribly nervous about actually getting paged since I know, oh about NOTHING when it comes to nephrology. I find the kidneys fascinating, but I'm not smart enough to know what to do with them in an emergent situation. Basically my role is to screen calls, and if anything actually seems important (a donor kidney becomes available for a transplant patient, someone needs to be started on dialysis emergently) I call in the boss to deal with it. So with all that, and starting to stress a bit more about this whole lack of a wedding venue thing, I stayed home a cooked. Cooking is my therapy. Tonight I made tostadas, with homemade refried beans. So easy! And delicious! And therapeutic! I learned a nifty onion chopping techinque from Martha Stewart on the Today show last week. It was beautiful.

I have no interesting knitting projects going on anyway. I have one in the boring almost finished stage, and several in the not quite started phase. But nothing in the fun, I can't wait to get back to my knitting phase.

As for the wedding drama (for those keeping track) over the weekend I emailed about 20 different venues. As expected, 15 got back to me with "so sorry but every weekend in August is booked. I have a Wednesday in April available if you are interested!" Still waiting to hear back from a few, but we did get one positive response--the Wallace Falls Lodge. It's in Goldbar, WA, which is about an hour north of Seattle on the way to Stevens Pass. I have my agents headed up there sometime this week to check it out. I've gotten some feedback from others who have had/been to weddings there, and it sounds nice but it's going to be a bit more work to get set up than Fox Farm. More decorating will be needed and I'm going to have to find someone with a creative mind who can make it look pretty, since I'm going to be stuck in San Diego and unable to do any of that. But hopefully it will be nice enough that we'll want to put down a deposit, guaranteeing us at least one, if not two venues come August 9th! Adam's trying to work out a deal with the original venue to give us a discount so if we do end up going with them, we don't completely lose the $800 we're going to have to put down as a non-refundable deposit on the new place. Who knew it would be so hard to find a nice little farm/garden to hold a party?

Unexpected Nudity

Adam's brother is visiting this weekend, and it was a gorgeous day out today, so we drove out to Torry Pines State Park for a walk on the beach. It was beautiful--the tide was out, the water was flat, the sun was slowly going down. We were walking on the beach, amongst all the other people who had decided to come out to enjoy the day when I see a man walking toward us. Stark naked. Just walking along. And he didn't actually have any clothing with him. Did he drive there naked? As we walked further along, there were more of them. Naked men. Some completely naked. Some just without pants. A few wearing only shoes. We seemed to have wandered down to Blacks Beach, San Diego's unoffical nude beach. I'd heard of it, and always wondered where it was. And now... I know.

Wedding Drama

I knew things were going too well. I wasn't worried about a thing. Everything was falling into place nicely. And then... our venue is having trouble getting their event permit for this coming summer. We knew we were taking a chance with a new venue, they've only done weddings for one year, but we figured any problems would be small, logistical ones, like the fact that after we signed the contract, she changed the hours of the rental so all music must be completed by 8 pm. But no. Apparently the Vahon Island residents are very pariticular about their space and are annoyed about the weddings that have been taking place at the Fox Farm. The city has received numerous complaints on parking, music and alcohol related issues. In order to have any chance at getting her permit, she's had to make a number of concessions including no street parking (which should be ok, since they have a lot of space and people can park on the property), no amplified music (which will also probably be ok, we hired a jazz band who can probably get away without amplification. maybe) and no alcohol (not my ideal wedding, but what can you do?). Even with all that, there is still a chance the permit won't happen and then we are kind of screwed. We have to have the wedding on August 9th, because that is when my vacation will be, and people have already made plans, and we have already booked our photographer, caterer and band--with several thousand dollars of non-refundable deposits.

What to do? I don't really know at this point. We can wait it out, and hope it all works out, and accept that this won't be exactly the wedding we had hoped it would be, but at least we will have a place to have a wedding. Assuming nothing else happens in the meantime. Or I can start trying to find another venue, but realisitically? Finding a venue for an August weekend wedding in Seattle only 6 months before the wedding is not going to happen. Sigh.

So if anyone has any bright ideas, or knows of any venues that aren't a hotel ballroom and are located anywhere within two hours of Seattle that allows outside caterers... please let me know!

I Voted

Sometime a few weeks ago. Even though the California primaries were on Super Tuesday. I love permanent absentee ballot status. I voted for Obama. Quite honestly, I don't really know the difference between Hillary and Obama (why is it that I feel the need to refer to Clinton by her first name and Barak by his last?). Hillary annoys me. Is that a valid reason for not voting for someone? I fear if she wins the democratic nomination, the fact that she annoys people will be enough to keep her from winning. I'm pretty strongly in the democratic camp though, so no matter who wins the nomination, I will be voting for them. I actually attempted to learn a bit about the issues this year, I was curious if I really was a democrat, or if I just voted that way because I grew up believing that the democrats were good and the republicans were evil. And I did agree with the democratic candidates on most issues, but not social security. I'm all for privatization of social security. I do not trust our government to invest my money in such a way that there will be anything left in 40 years. I want the option to take my retirement money and invest it as I see fit. I want to be in control of my future. Currently, I don't contribute anything to social security. I don't fully understand the details of my benefits, all I know is that the University of Califonia takes a certain portion of my paycheck each month and puts it in a 403(b) and gives nothing to social security. I like it. I get to pick which funds it goes into. I can have it if I want, at anytime (with certain penelties). And best of all, I know it will still be there for me when I retire (hopefully, I suppose there are always risks with investments).

I'm sure this is all much more complicated than I understand it to be. And if Hillary/Obama wins, it will probably never happen. But I'm still a democrat. I disagree with the republicans on A LOT of other issues.

My Love Affair

You know how when you go on a first date (a good first date mind you, bad first dates are a whole other story), and you think they are cute? And funny? And you can't stop thinking about them? And you come up with all sorts of fantasies about how your next date will go? That is how I feel about San Francisco. I'm smitten. Despite the rocky start with the pouring rain upon my arrival, Friday was a beautiful clear day. UCSF Medical Center is up on a hill by Golden Gate Park. The waiting room of the clinic overlooks the Bay. The VA hospital is on the other side of town, where the cafeteria has a lovely view of the Marin Headlands. It was gorgeous.

The program is amazing. They see an incredible variety of endocrine disorders,which is very important. Since most of endocrine is diabetes and thyroid disorders, in order to gain knowledge of the more unusual disorders, you need to get your training at an institute that gets a large number of referrals from other hospitals. You have a full year of in-patient consults, with concurrent clinics, which makes for a very busy first year, but an excellent clinical education. The research is also phenomenal. Lots of work in many different fields, and people seem to genuinely enjoy working there.

It's definitely a different program from OHSU. And better in many ways. The cities are very different too. San Francisco is the glamourous, popular girl, who everyone lusts after, but ends up alone at the prom because everyone is too intimidated to ask her out. Portland is the more down-to-earth, one of the guys type, who always gets overlooked in high school, but in the end is the one that the boys end up marrying. Every interview I go on, I'm going to have to rethink my list. My priorities change with each program I visit. But today, I think UCSF has the upper hand.

The remaining interviews have been scheduled:
Feb 15th -- UCSD
Feb 26th -- UW
March 14th -- University of Colorado
April 18th -- Stanford

And then I'm done. I've decided not to interview in Boston. I had offers from Beth Israel and Mass General, two very good programs, but in reality... I love the west coast. It fits my personality. I love the casual way people are out here. I love the mild weather. I love the mountains. And I think Adam likes it too. This feels like home. It's getting to the point in my life when I'm ready to put down roots. I think the next place we end up will be it for awhile.