MATCHED!

 I can't believe that I can finally write these words - I MATCHED! To family residency in Newfoundland. IN CANADA! This was something that I was told was next to impossible, that the odds were against me, that it most likely wouldn't happen.

And yet it did. I did it. 12 years after I started this journey, I finally made it. 

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. 

287

 Year 5 - my penultimate year of medical school - has started!

It's crazy to think that I'm already in 5th year. I can't believe how quickly the time has passed! 5th year always seemed to me so far away, and so close to the end. 

But this year is going to be intense. This is the year that I'll have to study for the Canadian medical licensing exam (MCCQE1) as well as the NAC, an OSCE style exam that I need to take as an IMG. Not to mention I'll need to be stalking the AFMC student portal to try and snag an elective rotation or two in Canada prior to applying to residencies. Which will be happening in just ONE year from now.

Its making me nervous, I'm not going to lie. As of my last check of the CaRMS website, it looks like I will be eligible for one of 287 IMG family medicine spots. In ALL of Canada. It seems like so little! Part of me almost doesn't even want to bother, but I also know that I can do it if I do everything right. I also think that one of the reasons that so many people are unsuccessful is also because there are so many requirements and things that need to be done way in advance, I can see people dropping the ball. Also, I'm going to apply as broadly as possible. Sure I'd prefer to be in Ontario most, with BC second, but I'm not going to true my nose up at Saskatchewan or Manitoba. I just want to get my foot in the Canadian door.

My plan is to start studying for the MCCQE1 now with a goal to write the exam in May. Part of me would prefer to wait till the summer break but I also a) need to do the NAC and b) need the summer to be as free as possible because of the possibility to do electives in Canada. And because my sister is going to try her third attempt at having her wedding go ahead (being cancelled twice now thanks to Covid) and I'd love to attend without the exam hanging over my head. That and being able to have a chance to do a retake if I fail.

I've been recommended by almost everyone to use the USMLE Step 2 question bank from UWorld as my main study focus with the Canada Qbank as my supplement for the Ethics part and CBD portion. I want to try and get through the UWorld Qbank twice and then move on to Canada Qbank and then do the MCCQE1 practice exam like a week or two before the actual one. Its an ambitious plan, especially considering that we are almost fully back in-class/in-hospital at school (for which I am actually super grateful). 

If anyone has any additional tips or advice, I welcome them in the comments!

Need to level up

Its really been hitting me recently that I'm now half way through 4th year. We are now clearly on the downhill portion of my medical school journey. But it also means less time to get those required experiences checked off my list.

My post-grad group has been very popular especially lately. I've managed to secure some great speakers to run info-sessions on getting into various English speaking residencies and inspired one member to start a spin-off group for those who want to pursue residency in German.

But I've also been attending some of these sessions too, because I also have a lot to learn and recently a friend of mine did one on the USA. He really reinforced how much the average med student as accomplished before even getting accepted into medical school and how these are the people we are competing with for residency. I mean, it's not that different in Canada.

And as much as I'd love to be able to say "HEY! I graduated med school with three kids!"  its really not going to be enough. I need to push myself to do more, to improve my CV and overall experiences.

I've started to work on a research paper on the attitudes of medical students in Poland towards abortion. I found a great mentor to help me, but I'm still waiting for approval from our school's ethics committee. I heard they can take ages though so I thought I'd just start doing the analysis and write up of the report. My mentor suggested that I present it as an abstract at a medical student conference coming up in May so I want to try and finish my preliminary work for it in the next few weeks to meet the deadline.

Next my husband suggested that since I've received both doses of the covid vaccine already, that I volunteer at some local clinics. I've called two of them already and have received a very positive response and will hear back soon as to when etc they need me. I told them I'm willing to help out in any fashion.  To be honest, I have been feeling a bit guilty, for lack of a better word, that I was able to get the vaccine so early. I think its a bit crazy for us med students to get it, when most of our courses are online. And also a bit pointless - I contacted the IM department at my university to see if I can finally complete my mandatory IM summer practice that I was supposed to do last summer, and was still told I can't because of COVID, because they still don't know if we can transmit the virus to others Sigh. So I'm just sitting at home, with all my classes on MS Teams for the next few weeks. When I mentioned this to my husband he told me to try locally instead. And that way I can both be useful, close to home and potentially include it in my CV, even if it won't count towards my practical experience requirement. 

So thats my plan for now. That and reaching out to all my contacts to see what I can do to maximize my chances of landing a Canadian residency. I have a call with the son of a good friend of my dad's who is a family doctor in BC. He already mentioned he talked to his program director about me and will tell me everything he knows. 

I'm really hoping that I'm able to do an elective rotation somewhere in Canada this September. From my talks with other IMGs this seems to be one of the main keys to having a shot. And the more I can do, the better. Especially if I can score a strong letter of recommendation out of it. And fingers crossed my vaccinated status will allow me to skip the quarantine so I can maximize my time doing rotations and hopefully, see my parents and sisters finally! Its now been 1.5 YEARS since I saw them last. 

Another thing I want to do is subscribe to a question bank for the first part of the Canadian medical licensing exam. One tip I learned, that makes sense, is to start doing the questions NOW, even though I won't be writing the exam for like a year and a half. The guy recommending this said that it will just make me that much more familiar with the style of questions and the patterns - so even if I don't KNOW that topic yet, it will prepare me much better than simply studying the content. 

So that's me for now. Lots to do. 

When panic rears its ugly head

Today I had a panic attack. Ok, not a real panic attack but a freak out. A freak out about what the hell I'm going to do after I graduate. Will I even be able to practice as a doctor?!

Yesterday's workshop on the NHS and how to get a post-grad job in the NHS after graduation was amazing. It made me excited to have a viable option for where I could go after I graduate - and would have a wonderful experience -  but there are still some less than ideal aspects to it. Like the fact that the foundation years programme might be split up among various hospitals that may be a 100 miles apart, which would require moving every year. That would suck for my family. The fact that the training process is so much longer. Another big issue is Brexit. No one knows whats going to happen. And its so frustrating because at the moment, as an EU citizen, my path to fully licensed doctor would be pretty much guaranteed. Once the UK leave, my status drops and not only that, the UK has significantly increased the number of medical school spots so there will be even more competition.

But overall, as much as the UK system seems awesome, I still think I would prefer to go back to Canada, even if I couldn't get into the program that I want most.

So today, while procrastinating from biochem studying, I decided to read up a bit more on getting a Canadian medical residency as an IMG. I went on to a forum and stumbled upon a post by an IMG that was successful in matching back to Canada. I messaged him and he immediately messaged me back! He had some great tips and advice but his underlying message was: this is hard and getting harder. Make sure I have a good back up. That only about 50% of the Canadian IMGs in the Irish medicals school that applied got matched. That some of them were shocking because they were incredibly strong candidates. That students from med schools in commonwealth countries are preferred over students from non-commonwealth - which will make me have to fight that much harder.

The whole thing really bummed me out. Normally I am able to just not dwell on it. I'm pretty good at compartmentalizing and just shelving the issue because there isn't much good that will come from freaking out. But I took that box off the shelf today and I guess I just got scared that maybe I'm in complete denial about what my future looks like.

I just so badly want to go back to Canada. I don't even really care where, I just want to go back. I want to finish residency and start earning decent money so that my husband can take a break. I want to create some stability and a permanent "home" for my kids. I want to be closer to my sisters and their families. I want to be closer to my friends and live in a place that I feel like I belong to, a place where the values I hold most dear are respected and expressed by our country's leadership.

Luckily my husband was pretty good at calming me down. He said that there is no way I won't get a job anywhere since doctor shortages are going up everywhere and all the places that this is happening are going to have to address it sooner or later. That I still have 4 years to do what I need to do and that he is aware of the risks, aware that we won't be able to make any real plans for ages and that he is ok with that. It did make me feel better. I guess for me, the stakes are high. It's not just me who is on this journey, its my family too.

Anyway, going to get back to what I should actually be freaking out about - and thats the biochem exam.