Looking up...

 Its amazing how much can change in a short amount of time.

My previous post was definitely negative. I was LOW at the time.

But some good news!

1. I decided to follow up with the Foundation Programme in the UK and they actually ended up saying I CAN retake the SJT. So literally 4 hours after I landed back in Poland I hopped a plane to London so I could take the exam.

2. I ended up passing the first round of the Irish internship exam. I honestly don't know how, because it was such a weird exam. And I discovered almost everyone else that I know that took it, failed. Today I took the second part and waiting to take the final part on Friday.

3. I got two interviews for Canada! One with Memorial University of Newfoundland & Labrador and one with Saskatchewan! I'm still in shock. And pretty proud of myself that I got that far. Getting those interviews was a massive confidence boost.

But I was bitterly disappointed to be rejected by Ontario and Dalhousie (I was also rejected by Manitoba, but for some reason that one didn't bother me as much). Still. I'm incredibly grateful that I will at the very least have the UK as a back up - that feeling of having a safety net again is back.

And good news I discovered that this year for the second iteration of the CaRMS match, Ontario will be making all unmatched spots "competitive" - in the past IMGs would only be able to apply to any unmatched IMG spots, which is incredibly rare. But I guess because so many spots were going unmatched last year they needed to make a change. 

It's funny because even though I felt a huge wave of relief by being selected by Saskatchewan (and MUN) for interviews, a part of me almost hopes that I don't match and will be able to try for Ontario in the second round.

Of course, thats purely an emotional response - because Ontario is my home province and I want to go home. And I would be fine being anywhere, even up north in Thunder Bay or Timmins. Logically though I know that is stupid and I'm going to do my very best in the interviews. 

At the end of the day, Canada is my goal. If I have to spend some time in Saskatchewan or Newfoundland, so be it. I'm definitely leaning to Saskatchewan though - its a shorter return of service (two years vs five years with MUN) plus the steams I can apply to are a bit better for my family. 

Anyway, now I need to get back to studying for finals. I have psych tomorrow and I'm not as prepared as I'd like to be. 

Waiting

 I honestly don't even know where to start.

What a rollercoaster I've been on.

I started this final year of med school just gunning for Canadian medical residency, but with the sure knowledge that I'll have the UK as a back up. Last minute I decided to apply for Irish internship, because why not? Always good to have options.

I ended up doing really well on the NAC, and my score was in the "pass with superior performance" category. However my MCCQE1 score was slightly below average which was a bit disappointing. I needed more time to study for it, but I just didn't have the time. As it was, I took it on the last possible day to take it to make me eligible for the 2023 CaRMS cycle and had already missed the BC special pre-application deadline, and made me out of the running for over 50 Family Medicine spots. In the end, when I compared my scores to those of people who got interviews in the previous match cycle, it seemed my scores were on the low end of competitive, but still competitive enough to get an interview. So I was going into it all full of hope and knowing I have some solid back ups.

But.

Unfortunately, my SJT for the Foundation Programme for the UK experience has been an absolute nightmare. I decided to take the exam on the first available date. Since we were going to New Zealand for Christmas (and because I got a Family Medicine clinical elective in Jordan's home town), I wanted to have it done and ticked off my list. Unfortunately, I had so many technical issues, the proctor asked me if I'd like to just void my exam and retake it later. I agreed. However I had to get approval and by the time I got it, I was already in NZ. I took the retake, again remotely because the closest center was in Sydney and this time all was good. Except for some reason the proctor ended my exam when I was starting the final section. I contacted the exam provider and they admitted the error was theirs and that I can retake the exam. However, the FP said I can't. Even though it wasn't my fault at all. So now I'll probably just end up with a horrible score and as a result, a super low rank.

Then a few days before we were supposed to go back to Poland my eldest son suffered from a spontaneous pneumothorax (which I actually diagnosed myself prior to taking him to the ER). Two weeks later, after being airlifted to the children's hospital in Wellington, and having surgery on both lungs, thankfully he is back home, at my in-laws house, and recovering nicely. But he can't travel for at least 6 weeks. Luckily my husband has a lot of flexibility with his job and can work remotely so he will stay with him, while I go back to Poland with our younger two to resume my final few months of med school.

But through all of this, I had to finalize and submit my CaRMS applications. I also had to take the first part of the Irish internship exam, which I had NO time to study for and no idea if I was able to scrape a 60% to pass it to be eligible for the next round.

I just feel so defeated. Today I discovered a lot of people who applied for the Ontario family medicine programs got interview invites and I haven't received one yet. I'm getting legitimately scared I'll graduate without a single job offer, in spite of the fact that I had two (what I thought) solid back ups. 

Anyway, maybe it will all workout and all this worry and stress will have been for nothing. But at the moment, I'm feeling pretty low.

And just like that

I'm just a bit over a month away from starting my final year of med school. Its crazy how quickly the time has gone. 

But honestly, the last year of med school doesn't even seem that important right now. Because so much has been going on and is going. 

Refugee crisis is on going and even though most of the people we had been housing have moved on, either back to Ukraine or moved to Canada, the US or UK, we still have one person with us. However, she is also Canada bound, having received notification of her visa approval this morning.

I'll be honest - I'm relieved that we will have the house back to ourselves because this past year has been exhausting. I don't regret a thing and would do it again without a thought, but its was a huge effort. One day, maybe I'll write it all out. But for now, I just need some peace.

And unfortunately, some of the collateral damage has been my ability to study for the Canadian licensing exam and the required exam, the NAC, that I need to take as an IMG applying to Canada. The chaos, the demands on my time and general stress of the responsibility for so many people really took a toll on me. I gained like 15 lbs, I got Covid for the second time (it was inevitable as only one of the Ukrainians was vaccinated). I got so behind on my study plan and missed out on the ability to do a clinical GP elective in the UK (I tested positive for Covid the day before I was due to start the elective). 

I was scheduled to take both the exams in September, however now I'm just going to do the NAC, as not taking it would result in a failed mark and I would have to forfeit the $3,020 that the exam cost. Not only that, my next opportunity would be in September 2023 and it would have counted as one of my 3 lifetime attempts. So I decided to focus on the NAC even though everyone recommended that I do the MCCQE1 first. But there is no way I'll be ready for that one too and at least with the MCCQE1 I only had to pay $95 to change my date to November 9th. And that is the last day I can take the MCCQE1 if I want to have a shot at a Canadian residency. God, it's so expensive to become a doctor in Canada. It's truly a profession only the rich and privileged can afford. I'm so lucky that I happen to be one of those people. 

Honestly though, I'm so confused about this whole process. Part of me thinks that applying without any real clinical experience is a waste of time, but then recently during a prep course I took for the NAC, the instructor really stressed the importance of these two exams as they are the only objective measures that program directors have to filter candidates and that realistically, the only ones that stand a chance are those that are in the top 200-300. It's a scary prospect.

But what can I do? I knew this wouldn't be easy and luckily I've gotten past the first hurdle of the UK side at least. Meaning that I scored high enough on the language proficiency part (which, let me tell you isn't that easy and many people end up not doing well enough for). So, at least I'm eligible to apply there. And the next step will be writing the SJT exam. Fingers crossed I get the chance to do it in December. We are gong to New Zealand for Christmas this year and I really want to be able to just relax.

Anyway, this summer was pretty much a bust. I've been studying full time with only short breaks for my sister's wedding a bit of time with Jordan's parents. I can't wait for it to be over and get the exams over with too. 

I probably won't do another update until after the exams are done and (hopefully) passed. Keep your fingers crossed for me!

Adjusting expectations

 Its been a while since I last updated on here and honestly its because the past 6 months (!) have been insane.

First, our nanny broke her leg just a couple of weeks into the beginning of my school year. In the end, she was out of commission for over 3 months and came back to work just after the end of the first semester. I had been worried about exams, especially because we had our big neurology final in January but luckily my mom came to help us during that time and it was a godsend. 

Then soon after she left, the Russian invasion of Ukraine began and with it, the refugee crisis. Jordan and I couldn't stand by and do nothing so we opened our house to them. In total we had 12 people stay at our place, ranging from one night to over two months, ages between 4 months old and 31 years old. This is the first week since the war began that we don't have someone from Ukraine under our roof! But it was a huge task with so many people suddenly needing our help - everything from helping with getting a visa to Canada for one teenage boy to taking kids to the doctor to a mini Covid epidemic in our home. Not only was my time again greatly limited but it was also very noisy and disruptive, so it was hard to get much extra studying done. I don't regret a moment of it though - it was the right thing to do and I'd do it again.

And the whole time with Covid hanging around (including both me and my middle son getting it and being quarantined) and dealing with typical parenting stresses. 

(For anyone interested in reading more about our experiences with housing refugees, please check out my instagram profile).

But now I'm less than 2 months from the end of the school year and my progress and list of things I wanted to accomplish is nowhere near where I had hoped it would be. I've only done 18% of the UWorld question bank. I haven't done ANY extra clinical work. I had to pause my work on my medical journal. I finally found a study partner for the NAC but she's suddenly become MIA. 

It's been so frustrating. Even this past week, we had the week off for Easter and I had arranged to a short GP rotation/observership with my friend who is a GP in Bristol, UK. I was excited to finally be able to see what it's like to work in the UK and also because she would be able to write me a letter of recommendation afterwards. Except the day before I was about to start, I tested positive for Covid (my second time). So of course I had to tell her and wasn't able to do it. 

I don't know, I just feel that it's like two steps forward, two steps back with this whole process. From studying the CaRMS requirements for the various residency programs, there are two things that stick out as crucial - the first is doing well on the MCCQE1 and NAC. At the moment, to get an interview for an Ontario residency (which which would be my top choice), they only offer spots to the people with the top 300 scores. Next, they will look at clinical experience.

To be honest I'm not sure how much clinical experience we are expected to get/have at this point because all elective rotations in Canada have been suspended until 2024. Which means I'll be totally ineligible to get even one before the application deadline for the 2023 intake. But I also know, learning from my NAC study partner, that there are students who are PAYING private doctors in Canada to get clinical rotations and letters of recommendation from those doctors, which is really unfair and its explicitly stated that contacting doctors outside the official channel is not allowed. 

Anyway, its looking more and more likely that I'll end up in the UK for residency. It's not the worst thing though. One thing that I like is that they have the Foundation Programme, a 2 year internship where you rotate through different areas of medicine before applying to specialty training. Part of me feels relieved at the extra training because I feel that I've been so deprived of most of my opportunities to learn. Sure it would mean postponing becoming a fully qualified doctor, but at this point in my life I honestly don't even care. I want to be a good and safe doctor for my future patients, above all else. Also, being an English speaking country, my husband will finally be able to look for a better job. The kids will be able to attend school no problem. And even though it's across the Atlantic, it's still closer to Canada than Poland. 

However its still crucial that I do well on the exams and I don't know if I will be able to, at least not by the time I'll need to write/do them in September. To be honest, I'm more worried about the NAC since I'm still a bit unclear on how exactly the exam looks and what its like. I will definitely look into a course or something that maybe I'll be able to take in August or September. In the mean time though, I'll do my best to chip away at the question bank. My plan is that if come September after I take a practice test and don't do well, I'll post pone the exam till April or May 2023 and just go to the UK and apply for residency from there. 

Well, that is that for now. Ugh. I hate how negative I sound but have to admit I'm feeling a bit down about it all. I think part of it too is I'm just feeling really exhausted after this most recent bout of Covid. Hopefully I'll get out of this funk soon. In the meantime, I'm off to do some more extensive research on the best places to live in the UK.