Fellowship Update
The fellowship program is six months in, and it seems to have simultaneously flown and crawled by. Three emergency departments and one trauma service. We function solo now in most capacities, seeing between 20-35 patients per shift. We see all the bread and butter cases, along with the simple procedures like laceration repair. Depending on the location and the shift, you need to be a little scrappy to get in on things like central lines and chest tubes. I’ve found that if you are enthusiastic and engaging, usually that helps your chances of procedural exposure. In some places, there is the opportunity to work up the more complicated patients, which is always educational. Initially, being associated with four different hospitals was a bit much, but overall it’s a useful eye opener. Each hospital and department has its own quirks and unique characteristics, giving a wide range of perspectives and experiences to draw from going forward.
Things with the Fellowship aren’t perfect, there are rough patches, stemming primarily from sources outside our control. For multiple reasons I’ll leave those details vague. Now that we are further along, some have been more forthcoming about the beginning attitudes at different sites concerning the program. This explains the initial feeling of unease that engulfed my first few weeks at one of the hospitals. We all knew that we were signing up for a brand new gig, but we naively did not anticipate a lot of what has happened. A few things are still in the works, an OB rotation, ultrasound training, ideally another external rotation. They are planning on changing our main sites from the two non-teaching hospitals, to the teaching hospital that houses the trauma service we rotate on. This comes with it’s own pros and cons, but the way I see it, everything is what you make of it. We rotate with anesthesia right now for intubation. I was able to find the coordinator for EMS ride-alongs, who has agreed to let me set up times to go with the EMS crews, which is amazing.
Last week, after working a shift with the medical director for my region, he took the time to write me a detailed letter acknowledging my diagnostic skills progression. It was incredibly touching and meaningful, I didn’t take it lightly.
Outside of the ED, figuring out the world of medical careers is its own beast to tackle. I’ve been approaching everyone that I can possibly think of who might be able to lend a perspective from their own experiences, and received some very helpful ideas. Notably, it’s the EM docs at my Reserve unit that have again reinforced my appreciation for a military family.
I’ve been drawn to the West side of the US forever, but felt torn for two very specific reasons. The Floridian panhandle houses the South Walton lifeguards, and the military community of the Emerald Coast. Both are crews of amazing individuals who will always be near and dear to my heart, and both who I want to continue working with. I was fortunate enough to speak with a PA who had spent his entire career in the Special Operations world, and who felt that it was not unreasonable for me to both find a niche in that world for myself, and split my time between Florida and the West. I don’t know what will happen at the end of the day, but that’s the adventure of life.
On that note, life lately in general has become overwhelmingly incredible. I’m so used to spending all my free time working, or looking for work. Add military duty to that, even on active duty I held a part time job, as well as during undergrad, post-bacc, and graduate school. Everyone else would go on break, I would go to work and that’s a simple reality that a million people live every day. But now, even on a limited fellowship income, I am the proverbial kid in a candy store and it is intense.
My list of goals is currently inexhaustible, everything outdoors. I dream about all the multi-day backpacking trips, all the outdoor sports, all the new cultures and countries. It’s why I chased emergency medicine, and why I plan to eventually achieve more than the in-hospital knowledge I’m gaining now. Pre-hospital, wilderness, and deployment medicine have always been on the list of goals. These things that have been on my mind since I was 12, now a distinct possibility of realization on the horizon. That plane ticket outside the country that seemed so out of reach before, is now becoming a viable option. Each new experience I have is a Pandora’s box of things I want to do that I never even knew about previous to that and I can’t hold it all in, I might burst.
