Thursday, 29 September 2016

Welcome to Cold and Flu Season

I am currently in bed, feeling sorry for myself because I've got a bad cold, for which I have my lovely and generous little children to thank. Do you have any idea how miserable it is to cough and sneeze constantly whilst 8 months pregnant? It's awful. I've been sicker than usual with this pregnancy and I'm very glad that it will be over with in 18 days. As a severe asthmatic, I'm already prone to getting sick more than most people so being worse than that has really sucked.

Everyone else in the house is sick too this time. At least the kids are old enough to be relatively self-sufficient. My husband and I were both feverish, achy, and slow to get started this morning so my son came into our room, told us that he got himself and his sister breakfast, and they went and watched Netflix for a while. This is why I prefer parenting school-aged children to babies. Babies have their charms and all, but they won't take care of themselves when you're sick.

The fact that I am curled up in bed feeling terrible today doesn't mean I've been unproductive, though. My brain may feel like it's immersed in molasses, but I've been able to get quite a few things done. Finalizing a few things around my November/December electives, sending out a number of emails, had a phone call about services for my son, and have been doing some reading in preparation for the neuro teaching session and test tomorrow. I actually feel pretty accomplished for the day.

And since it seems my fever has finally broken, I should be able to get some effective studying done this afternoon and evening, which will be good.

Like life, medical school marches on even when you're sick. Leaving the work to later just ends up making it all that much harder to get through so I'm glad I didn't take the day completely off, anyway.

I am taking the day off from cooking, though. I'd planned to make a roast in the slow cooker today. It'll keep for tomorrow. Tonight is whatever we feel like ordering in, and I'm not going to feel a moment's guilt about the almost undoubtedly unhealthy supper we're likely going to have.

Also, just because it's that time of year:

Get Your Flu Shot (as soon as this year's is available in your area.)

Wednesday, 28 September 2016

Getting Involved

I haven't really done much in the way of extracurricular stuff in medical school yet, but I'm starting to feel the pressure. I look at my CV and it's kind of thin. 

I have...
- No research (have a meeting about this today. Hope to change it! Especially because this looks like awesome research)
- One exec position 
- Planned/executed a successful networking event with my group (super fun)
- Volunteered with national organization's AGM 
- A Quality Improvement project
- Two POCUS certifications
- (Just agreed to this so haven't done it just yet) Organizing a skills night for students interested in a particular specialty

That's pretty much it. It's not really a whole lot. I've got some classmates who have CVs as long as my arm detailing all the advocacy and research they do, all the conferences they've attended/presented at, multiple committees they've run, events they've planned, changes they have helped implement in the community and our program. My classmates are super active, involved people who care about the world and our futures and I think it's awesome, but I'm feeling a bit lackluster by comparison. 

It's not that I want to do things to pad my CV, but I am starting to worry that I'm not really being as involved in my school and my community as a medical student should be. We are encouraged to use this time in our lives to become leaders and I'm not really doing that. I'm worried this will impact me come CaRMS time, but beyond that, I worry I'm not really fulfilling my role as much as I should. 

Although frankly right now I'm way too tired to do much more than worry about it. Fortunately I will no longer be pregnant soon enough, so I'll actually have some energy back and be able to get involved as much as I'd like to. (I realize people assume I won't be sleeping with a newborn in the house, but that period is relatively brief and I will not be the one primarily responsible for nighttime care.) 

There are things I want to do, events I want to get involved in. I passed on a lot of really cool stuff over the last year because I was really focused on trying to ease the transition into medical school for myself and my family, and then I was too tired with the pregnancy. But preclerkship is when the typical student would have the most time to get involved, to take charge with events and groups, to get involved in advocacy and research. I'm looking ahead at clerkship, with its standard 10+ hour days plus call, and realize that fitting more into my schedule is going to be a challenge. But I'm going to make it happen. 

I want to be more active in the community and in my program. I want to do research. I want to help host events, and get more comfortable with public speaking, with organizing people, with taking a leadership role. I want to use this time to work on these skills because it's part of the experience of medical school and so far I haven't really done that. 

Sunday, 25 September 2016

Falling Into Place

Things seem to be getting sorted out around my electives. I knew they would, but that didn't stop me from a considerable amount of panic over the last while, as has been abundantly apparent by my recent posts.

I have things booked for my four weeks in Nov/Dec. Well, one is agreed to but not fully booked in the system yet; just waiting on confirmation of one piece of information before I do that. 

In February and March, I have a six week elective block. I'll only have done my OB/Gyn core by that point, so it seemed as good a time as any to do some OB/Gyn electives. It'll be fresh in mind so I'll be able to put in a good effort and come in strong. Better than doing an elective before a core and not knowing much. 

Unfortunately, this being my largest elective block before CaRMS, it's also an important time for me to do visiting electives. While it's not optimal for me to be away for weeks at a time when M is so little, my husband and I agreed that it was probably a good idea to go ahead and just book electives in other cities for that time and cope with the inconvenience. It's not as bad as spending a core at a distant site, anyway, and it's necessary to keep my options open.

We decided that I'd stay within somewhat reasonable driving distance so if I get a stretch of days off I can come home, or they can come see me. So I applied at a couple schools in Ontario.

Just the other day I was offered a visiting OB/Gyn (L&D) elective for February and I'm pretty excited. I've booked a room in a house that's maintained specifically as a rental for visiting medical students. It's a 5 minute walk from the hospital so I won't have to worry about hospital parking, rather conveniently.

For now I've actually got most of my electives for this winter and for next year sorted out, which feels pretty good after all the stressing about it.

I have a total of 12 weeks elective time before CaRMS, 14 weeks if I include next summer's vacation time which I am planning to work through. I'm not going to do electives longer than two weeks, with one exception, so this is time for 7 electives. This is what I have so far:

1. Reading elective, OB/Gyn topic - 1 week
2. Psych - 3 weeks
3. Visiting L&D
4. Gen paediatrics
5. Diagnostic Imaging or MFM (I think it's likely I'll have MFM during this time, but I won't know for sure until next month.)
6. Family medicine
7. Visiting Emerg (back home - it's been penciled in, not confirmed, can't apply via portal for a while)

I am trying to find something else to replace the gen paeds elective. I don't think it's a very good idea to be caring for hospitalized sick kids during flu season when I have a baby at home who has only had one or two rounds of vaccines and is too young to get a flu shot. I am not sure I'll be able to get a flu shot before she's born either to give her some protection. I would like to do a paeds elective, but I'm not sure that's the best time to do it.

I also definitely want to do an elective back home during my two weeks vacation next summer, so I'm really hoping that they open up those sites again soon (the medical education coordinator is away and as far as I know no one has been hired to replace her temporarily.)

In Jan-Feb of 2018, I have another 6 week elective block before my last core (psych) but I'll be able to take two weeks of that off for CaRMS interviews. which is why I'm working through my vacation. I'll get stuff for that time booked later. At least I know I need to apply before June of next year to ensure that I'm not competing against visiting students for spots.

I think this is a good selection of electives which will expose me to some great skills that I'll be able to take with me into any specialty. My interests are well-represented, but I'm also exploring a broad range of options. I would like to do one more OB/Gyn elective at some point if I don't get that MFM one. This isn't what my final list will be since I do expect some changes, but even if it doesn't change much I think I'd be pretty happy with my choices.

For the first time in quite a while, I'm feeling like things are coming together nicely.

Now I just need to go finish reorganizing closets and scrubbing bird cages because it feels extremely important to get these things done before the baby. Nesting is such a weird phenomenon.

Friday, 23 September 2016

Crazy Week Takes a Tea Break

As might have become clear with my complaining over the past few weeks, things are rather at an intense pace at the moment.

I've had at least 3-4 things scheduled every day this week, from doctor's appointments to mandatory sessions. I've ended up with unscheduled things that have taken up way more time than they should in between the scheduled things. It's just been really hectic, and I'm having to let some things slide (like multiple messages and emails from other students I want to get to! Sorry if it seems like I'm ignoring your message, I'm just honestly really busy!)

Just by an odd collection of circumstances, I ended up with 4 medical appointments, a sick kid, a PA day for the kids, and a large event all in one week, on top of a CAE and a transition to a new unit and a four hour clinical skills session on Wednesday that left me totally fried.

It's times like this where I really feel the stress of being a student with a family. A paediatrician appointment for my son ended up taking most of the afternoon Tuesday. Dealing with the pain in the arse that is getting his medications covered ended up taking a lot of this morning on the phone with the government (everyone's favourite activity!) My husband ended up going to work late today so he could take our daughter to her appointment. He's taking the kids with him to work tomorrow and I am unendingly grateful to his bosses for allowing that in a pinch.

But, the week did end up productive. We got a new family doctor, who I really like. I'm participating in some non-school, but career-related networking activities. I did end up confirming an elective (woo! Finally!) Also have a new therapeutic approach to my son's challenges, so I'm hoping that maybe we'll start to see some progress there.

I haven't really had much time to spend with my family, or even to catch up on my own needs, though. I ended up taking a nap in the medical student lounge yesterday because I managed to arrive just over an hour early for clinical skills, after dropping off my daughter to my husband at his work, and it was the first chance I'd gotten to sleep.

Fortunately, the next three weeks look a bit quieter, so I'll have lots of time to study, get caught up, and work ahead a little. I've felt like I've had very little time for it this week, which is a bit distressing considering the rate at which the material is flying at us.

Yesterday did have one of those lovely little moments, though, where I got to leave everything at the door for a little bit and just enjoy myself for a short while.

We ended up keeping our daughter home from school yesterday because her cough - she's got a bit of a cold, nothing particularly bad - sounded horrible and she just did not feel well first thing. She actually ended up getting quiet a bit better rather quickly so after an appointment, I decided we'd stop at a lovely little tea shop for lunch. She was, as she often is, dressed up in one of her fancy dresses, and I was a bit more put together than usual myself. We had scones with devon cream and jam, finger sandwiches, small sweets, and lovely sweet rooibos tea from pretty china cups. She was so, so thrilled and chattered until I dropped her off about her 'fancy tea party.' I don't get time for many of these moments, but I absolutely love it when I do get to just connect with one of my kids for a while. 

Sunday, 18 September 2016


I've hit a bit of a wall. Well, more than a bit.

The last few weeks have been very, very stressful. I normally do fairly well with keeping all the balls in the air but right now I just am not. I am exhausted. Utterly physically, emotionally, mentally spent. And there's no recovery time on the horizon.

There's no point in the near future that I can look at and say "I'll definitely be able to take some time to put myself first for a bit." The baby will be tiny during my two weeks break this December, and we have someone coming to stay with us, so I'm not going to be able to have downtime then (although my friend will most likely watch the kids so I can go out which will be nice.) I have to work through my vacation next summer so that I'll have time off for CaRMS.

I suppose I can schedule some 'me' time in December 2017, when we have three weeks off.

I knew, going into this, that it would be hard. Medical school is hard. Having a baby is hard. Doing both at the same time is obviously going to be very hard. I'm still very committed to doing this and pushing through what I knew would be a rough few months, though. This is not an unexpected period of difficulty and I was bracing myself for it.

But right now I'm having a hard time, and I think it's perfectly reasonable to express that. I expect that a lot of med students hit a wall around this period; this last little bit before clerkship. We have a LOT of material to learn in a very short period of time, and we have the uncharted country of clerkship looming in the near future.

I know I need to make some time, somewhere, to take care of myself, but it's hard to find it. I've basically been spending no time with my kids lately just to have time to go over the material over and over because my ability to retain information is shot so my usual "look at it once, know it" method isn't working. I require more sleep than usual, but it's so broken up that it's not really particularly restorative sleep. My appetite is gone. I've averaged only about 1400 calories a day (I have tracked what I've eaten for years) in the last week and only really that much because I've been forcing myself to eat because I'm pregnant. Still losing weight, but at least it's slowed. Some people stress eat, I do the opposite. Food is just extremely unappealing when I'm stressed.

So I'm tired and overwhelmed. But like with every other time I have faced periods like this - there's plenty of times I've written similar posts over the years I've kept this blog - I will get through it, and things will get better because they always do, so I'm looking forward to that.

Just need to keep on.

Friday, 16 September 2016

Just The Facts: Specialty Selection

For those unfamiliar with how it works, here's a quick breakdown of how medical students become residents (as I understand it from the perspective of someone who hasn't done it yet.)
- In November of your last year, you submit your applications via CaRMS to residency programs.
- Late January to early February, you are interviewed by programs that are interested in you.
- Programs create a ranked list of residents that they are interested in.
- Applicants create a ranked list of programs they are interested in.
- The match algorithm is run which supposedly should optimize the number of applicants and programs receiving their highest possible choices.
- In March, you're told where you're going, and the programs are told who they are getting.

Factors that I know determine how programs rank you:

- If you've 'shown interest' in the specialty. This means having done at least one elective, or research, in that field. Being part of an interest group, being a student member of the professional college/assocation/society, being involved in advocacy related to the specialty. These are all ways of showing that you're interested.
- Good evaluations on cores. Often, it means *all* of your cores, not just the one most closely associated with that specialty since they're going to want to know that you don't become completely useless when you're doing something you don't enjoy as much.
- LORs (yup, premeds, you have to get these in med school too. More of them.) Programs have different requirements. Most require they be from currently registered physicians; some programs allow LORs from non-physicians. Sometimes they specify that they have to be from a certain specialty, or they may specifically request clinical or academic physicians.
- Whether or not you have done research (they all say they don't require it, but every single person involved in ranking applicants that I've talked to has said that they do consider it very strongly.)
- How well you fit into the team/culture/program. This is a hard one. It can be from having done an on-site elective - few programs seem to require on-site electives - or just from the interview and associated meet and greet activities.

Factors that will determine how I rank programs:

- Specialty. Obviously. But I'm not going to rank all programs in one specialty higher than all programs in another specialty, because there are other factors at play.
- The patient population I want to work with. This was something to consider recommended by a current resident when I requested input on how they had selected their specialty and what factors they did consider, and which ones they think they should have put more weight on.
- Lifestyle of said specialty (including during residency.) No, 2-5 years is not forever, but it's still years out of my life and the life of my family.
- The program itself; there seems to be a lot of variation in how programs actually teach and how they support their residents.
- Location.

This last one is the most critical for me, whereas it may not be as much of an issue for others. Just like with med school applications, the advice that comes from the top down is loud and clear: apply very broadly. But, just like with med school applications, I am ignoring that advice.

Especially because I am very seriously considering a specialty that requires a five year residency, the location matters a lot, particularly because my kids are older. My oldest will be either entering or in high school before I finish residency. My family would be absolutely miserable living in Toronto for five years, as an example, so I'm not even going to apply to programs there, just as I didn't for med school. Nothing against the school, it's just not a place I'm willing to live for five years. I'm also not going to apply to residencies based in Vancouver because we just won't be able to live well as a family of five on a resident's salary there (which, funny enough, is the second lowest resident salary in the country) considering the cost of living.

But, since I'm so much more strongly considering OB, and I'm excluding one of the 5 programs in Ontario right off, I'm expanding my geographic area to consider more westward. As much as I want to go home, applying to only 6 programs - 4 in Ontario plus the two Atlantic programs - in a rather competitive specialty is not really setting myself up for success matching to that specialty (I'll obviously also be applying to family med as well) so my husband and I are weighing options for western schools.

There's a lot that goes into this besides just deciding what sort of doctor I want to be. In that way, applying to medical school was far easier.

Wednesday, 14 September 2016

Now, I just have to laugh

The OB/Gyn electives coordinator - who is really super nice - suggested that I submit a request through our system or the dates in question so that she can decline it but then offer something to me if something opens up.

So I picked a random subspecialty and submitted the request.

Today it was approved. Imagine my surprise after weeks of seeing emails saying "Elective Request Declined" to finally receive one saying "Placement Contact Accepted Request."

The supervisor?

My OB.


The subspecialty I picked at random actually happens to be the clinic that he runs and there's apparently no other supervisors, as far as I can tell. I should have double checked that beforehand. He's really a fantastic OB and I've heard he's a really amazing teacher. But I can't be supervised by him as a student immediately (and I mean *immediately* - like a week later) after I've been discharged from his care. That'd put him in an awkward position and it'd be unfair for me to do that to him, and I think the school would probably feel pretty uncomfortable with it too.

If there's the perception of potential conflict, it's best to just avoid the situation entirely. Particularly when this is a specialty I'd like to pursue and I'll be applying to the residency program here.

So I've declined the offer.

It's for the best but argh!

I do have some other leads. A former tutor has gotten back to me and is glad to supervise a reading elective, so I've got that going for me for the first week, and I'm meeting next week with a researcher about doing a project during that time, so I've got some forward movement in other areas at least.

Tuesday, 13 September 2016

Joints Abound

Tomorrow is our MSK clinical skills evaluation.

I've been complaining a lot about the electives stuff, but haven't touched on a lot of what this part of school has been like yet.

This final block of preclerkship is definitely living up to its reputation as being very intense. Week one was basically "learn all limb MSK anatomy by next week."

It's not just knowing the names and locations of muscles, tendons, ligaments, and bones. It's knowing where the muscles originate and where they insert, what movements they are responsible for, what their opposing muscle is, innervation, and blood supply. It's a LOT of information. It is not possible to learn it in two weeks for the entire body. We are on week 4 of the block now and I'm still just lagging, and I don't think I'm alone (although there are some superstars, like my group member who did a masters in anatomy. He's an awesome resource and super nice.) If this was all I did for two or three weeks, maybe I could do it, but right at this moment, even having done a course in anatomy prior to med school, my brain is on overload.

And really, the only way to learn all of this is to go over and over it. It's sheer brute force content acquisition. There's little in the way of concepts to connect things when it comes to MSK anatomy.

Honestly, I think we probably should have had at least 2 months to absorb this. The brain can only absorb so much information at a time; giving us little time to learn it does not mean we actually can or will be able to learn it in that time. This massive, rapid, bulk information delivery is so at odds with how the rest of our program is run that it stands out as being strange in the context of the rest of our education.

That's the thing, though. The content has to be covered. Obviously, this is stuff we need to know as doctors, and there's only so much time in the program, so some things end up compressed. Really, I think my school should start in July, like Calgary, because that extra month would be really helpful to have over the course of the program.

The clinical skills delivery for this subunit has been equally compressed. Joint examinations simply have more to them than most of the other sorts of exams we've learned. They're longer, there's a bunch of special tests to learn (basically one for every major movement) and they require that you know the anatomy really well, so it's a challenge to absorb the joint exams while you're still learning the anatomy.

The clinical skills exam tomorrow is going to be one joint exam. That's it. Fifteen minutes, OSCE-style, I have to examine one major joint/joint system. But I don't know which one, so I need to know ALL of them really well. Ankle + foot, knee, hip, spine, hand + wrist, elbow, shoulder.

We had one 2 hour session where we did lower limb, one 2 hour session where we did spine and upper limb, and then one 2 hour review session, and now we're being evaluated.

It's been *quite* a whirlwind few weeks.

But that's how med school goes, and things aren't really going to slow down between now.

Monday, 12 September 2016

Wit's End

I'm editing my post here to add a bit of context.

Keep in mind that I am one of those... slightly volatile pregnant women. I cry about everything. I get disproportionately rage-monster-y about stuff and have emotional responses that are way out of proportion to the situation. 

Please realize that my somewhat overdramatic frustration in this post is basically because I'm a hormone soup at the moment and something as simple as my socks being in the wrong drawer is enough to set off an avalanche of tears and possibly profanity. 

I cry about everything. I cried this evening because my curry wasn't perfect. I cried because I shouldn't eat ice cream. I started yelling at my car because I was low on gas. I was so frustrated that I couldn't walk normally earlier that I tried to run to see if that was any better. That went *very* poorly [and was probably hilarious to anyone who witnessed it.] This morning, I was crying *and* swearing because I couldn't find parking near the student centre and I had an appointment. 

Not every pregnant woman is like this but dear gods do I live up to the stereotype. While it's never okay to dismiss what a woman says or feels 'because hormones,' I am voluntarily disclosing the fact that I am aware I get irrationally emotional about everything at this point in pregnancy. So just keep that in mind when reading my posts over the next little bit. 

I have asked around a lot. I've gotten a lot of suggestions and recommendations. I've submitted quite a lot of requests.

And yet the rejections keep coming.

I still have no electives for November and December.

I am actually in tears because I just received another one and I'm so frustrated right now I could scream. How can EVERYTHING that I can do be full?!

It feels like the only services that aren't full are going to be things that I can't really do while recovering from childbirth.

I'm waiting on a few more emails back, but I doubt anything is going to work out - they're all long shots - and then I'm out of ideas.

I honestly have no idea what I'm going to do. I may just have to apply for absolutely any specialty without regard to my physical limitations, ask supervisors to take it a bit easy on me when I show up, and just hope I don't end up hurting myself.

With only ten weeks to go until my first day of clerkship, and absolutely nothing confirmed, I think that's exactly what I'm going to have to do.

Friday, 9 September 2016

Solidifying Some Plans - Worrying About Others

I have been continuing to try to book electives. So far, I've booked several for next year, so that's good. Family with a supervisor who I've been told is fantastic, gen paeds, and diagnostic imaging that will have a focus on paediatric and OB/Gyn imaging.

But everything I've tried to book for November and December of this year has fallen through. I went and met with the (lovely and kind) electives coordinator and she did tell me that I should have gone and booked things before I had confirmed anything about my recovery period, and should've just cancelled anything that wouldn't have worked.

That would've been good information to have four months ago. I really should have approached her a while ago and asked how I should manage this, because it seems like I have really screwed myself over by waiting to discuss delivery with my OB. I thought I was making the right decision by making sure I had all the information before making plans. I was wrong.

I've asked for suggestions from other students and people have been really lovely about trying to be helpful, but many of the suggestions are not going to work, unfortunately. There are three big factors at play: during the first couple of months postpartum, I tend to be prone to fainting if I overexert myself, have a weak stomach for a while, and am rather apt to cry easily. Pathology may seem a good option because it has lots of sitting, but I am not going to be able to manage strong smells. Psychiatry or palliative are also probably not great ideas, because crying with the patients is generally frowned on.

It's kind of funny, actually. I've been noticing that people seem to either be horrified that I'm going to be in clinical activities so soon after having a baby and act like I'll be completely bedbound or seem to think I'll be nothing more than a little bit tired at that point. It takes time to get back to normal after having a baby, but the worst parts are the earliest few weeks. So it's not that I *can't* do clinical stuff at all, I just need to be careful about the types of things I do. Peoples' concern is very touching, though.

Beyond all that, I only have room for 6-7 electives before CaRMS at the most. I want them to be in areas that may related in some way to my career plans. I don't want to sacrifice two of those potential electives by just taking whatever I can get.

Over the past little while I have been sending out a lot more requests. Many have been rejected or have simply not received responses. I'm going to email a particular researcher again enquiring about whether he'd be willing to take me on. His research areas are of significant interest to me, and I've been told he's actually a really good teacher and I'd really like to work with him. He never responded to my email, but I'm going to try again. Being able to do research during that period would be a really fantastic option, if I could just find some. I really do want to get involved in research at some point during med school and this would be a perfect time. Unfortunately, the elective period starts in 10 weeks and research electives have to be approved at least 8 weeks beforehand so I don't have much time to find something.

I'm trying anyway, but I'll admit that I'm really starting to stress out a whole lot about not having anything for this period.

Sunday, 4 September 2016

The Inbetweens

There's a curious feeling associated being a second year student in a three year program.

The new students are excitedly going through the same discovery process that we did a year ago. They are learning about the program and we are serving as their guides. Well, my classmates mostly. I answer a few questions on Facebook and by email, but largely I've not been involved in the orientation activities since I'm way too tired and move too slowly to be of much use to anyone. But still, it's our year that is mentoring the next, just as the 2017s mentored us when they were at this exact same point in their program.

 This last year has gone very quickly. The fact that now we're not the most junior students anymore is a bit of a weird feeling to get used to. When this year's class is in our position, we're only going to have 8 months left.

That last sentence, there, that's the rub.

My husband and I were talking about residency program selection last night, because I'm really at the point where my elective selections are kind of a critical thing to get figured out. I talked to him about how the match works and explained the factors that usually play a part in selection of residents. I wanted to show my husband some stats so I hopped onto the CaRMS website to show him some reports.

And right there on the front page: The 2017 R-1 Main Residency Match is open.

Applicants can now make their online accounts. Program descriptions are up. Quota has been decided.

In 6 weeks, applicants can make their program selections. In 11 weeks, they need to be submitted.

My immediate upperclassmates are now starting their CaRMS applications. Right now.

My classmates who, 12 short months ago, were exactly where I am right now. Match day is in less than six months.

It hit me like a ton of bricks. Twelve short months from now - and twelve months goes very fast when you have a new baby - I'm going to see the words "The 2018 R-1 Main Residency Match is open" and I'm going to click the login button.

A year is no time at all.

I feel like I've barely begun medical school, I am still very much someone considered to be early in their medical education. But here I am, with the end of this phase of training looming large over the decisions I'm making right now.

Twelve months to CaRMS opening. Eighteen months to my match day.

Eighteen months until I find out what I'm doing with the rest of my life.

If you'll excuse me, I'll be over in the corner, hyperventilating.

The fact that I'm going to have a baby in six weeks is far, far less stressful right now than the fact that I have only a year to decide what direction to take my career.