September 10, 2020

New Beginnings in a Time of COVID-19

Starting your intern or CA-1 year can be a challenging transition even under the best circumstances. Residents are learning new roles, meeting new people and, oftentimes, exploring a new home. So what happens when you add an ongoing pandemic to the transition?

We caught up with three U-M Anesthesiology interns and two CA-1s to chat about keeping well during COVID-19, lessons learned so far and advice for medical school students looking ahead to this virtual recruitment year. 

 

Drs. Kat Krukowski, Thomas Epperson, Chika Nwosu, Dominick Alton, Sunny Singh
Drs. Kat Kurkowski, Thomas Epperson, Chika Nwosu, Dominick Alton and Sunny Singh share their experiences.

Let’s start with Match Day, which looked a little different this year. What was your experience like?

Dr. Chika Nwosu's drive-thru match day ceremony
Nwosu waits to receive her envelop during a drive-thru Match Day ceremony.

Chika Nwosu, MD (Intern): Never in a million years did I imagine that Match Day 2020 would be cancelled and we would not be able to celebrate with our colleagues and mentors. But my school (Florida International University College of Medicine) did a great job of trying to make it memorable for us. We had a "Drive-Thru Match Day," where our deans handed us our letters with a pole, and we were able to grab them from our driver seats. Our teachers were on the sidelines with balloons and signs, and everyone was honking. It was a good reminder that even though celebrations looked different this year, it did not take away from the fact that our hard work paid off and we were officially doctors!

And I was ecstatic when I found out I matched at Michigan Anesthesiology! I honestly thought that I was being pranked — I couldn't wrap my head around the idea that I had been chosen to be a part of such an incredible residency. After we found out that we matched, our intern class hopped on to Zoom to “meet” one another and to just celebrate virtually. That was an amazing moment. I just felt so fortunate and lucky.

Thomas Epperson IV, MD (Intern): Match day was definitely different this year. I will say, though, that being able to open my match letter at home with my wife, all while being surrounded by family (in a socially distanced way, of course), was an experience we will never forget. We were actually quite nervous given the fact that we were couples matching (anesthesiology and otolaryngology). When we found out that we both matched at Michigan Medicine (our #1 choice), we were beyond ecstatic. We had spent four years apart during medical school (we were at different schools), so not only finding out that we would be training at the same hospital, but also training at one of the top institutions in the country...well, we were speechless. 

What most surprised you during your first few weeks as an intern?

Epperson: I don't think this came as a surprise, but more so an affirmation of my decision to choose Michigan Medicine as my top program: I could not get over how nice everyone was! I know that sounds odd, but it has been so true. Every single colleague that I have had the pleasure of working with this year has strengthened me as a person and a physician. The attendings, fellows, residents, nurses- — everyone is just such a pleasure to work with. It’s seriously a beautiful thing and makes the stress of intern year so much more bearable.

Nwosu: One thing that surprised me was adjusting to the realization that we are actually doctors. Whenever anyone would call me doctor, I was positive they were talking to someone else. I did have that feeling of impostor syndrome.. and to be honest, I still have that feeling. It is difficult to get out of the medical student mindset and reframe the way we view ourselves. 

CA-1s: How was the bootcamp experience?

Dominick Alton, DO (CA-1): Bootcamp was what I expected it to be: exhausting. There was a huge learning curve, but I had great support from the seniors and faculty that trained me. I also had to cut my bootcamp short to start on OB, but that experience was rewarding, as learning neuraxial anesthetics was really satisfying and seeing a lot of happy parents after seeing their newborn made work really worthwhile.

Sunny Singh, MD (CA-1): It's pretty close to what I imagined it to be, to be honest. I knew going in that it was going to be very draining/tiring and that there would be still so much more to learn. However, looking back, when comparing myself on my last day to my first day of bootcamp, it was incredible how far I came and how much I learned.

What’s one takeaway you’ve had already?

Epperson: Write everything down during rounds. Everything. It makes life so much easier. Also, don't short yourself on your physical exam. I know that sometimes they seem rather useless in the most obvious clinical scenario, but you'd be surprised just how much you can learn about a patient from a thorough physical exam.

Kat Krukowski, DO (Intern): Every first couple days on a new rotation of intern year is challenging. In a short amount of time you have to learn the patients and unit's workflow/processes. The best part about U-M is the culture. So many people are willing to help you and give you the support you need. I can't imagine being anywhere else for this reason!

Alton: My biggest takeaway from bootcamp is that bootcamp continues after the traditional bootcamp month ends. There is still so much to learn, and I have yet to scratch the surface with regards to basic anesthesia knowledge (hence why the basic exam is a year later).

Singh: That there's still so much to learn! But also that I must strike a balance between being confident and trusting my knowledge/skill set (i.e. not selling yourself short) with knowing when to reach out and ask for help. Like Dr. [Kevin] Tremper says, ‘Asking for help is not a sign of weakness but a sign of genius.’

What are you doing to stay well during this time?

Epperson: Starting residency during a global pandemic has definitely been a challenge. Free time is now more cherished than ever before. By now, we've all gotten to experience the new stress of safeguarding our patients' lives in the best way that we can — a tall challenge that demands the best of someone. I think my number one takeaway from starting residency, in general, is to make time for the things and the people you care about. Unfortunately, COVID has made that even more relevant. We as physicians function better and are better advocates for our patients when we have taken care of ourselves. I'm a tennis player. Tennis is my release. It helps that I can social distance while playing tennis! I also couldn't be where I am and be at my best without the love and support of my wife and my family. 

Dr. Sunny Singh
Singh and his wife, Andrea, explored Yosemite last summer. Dr. Andrea Bouwhuis also is a U-M anesthesiology resident.

Singh: Spending quality time with my wife, family and friends has been very helpful toward adjusting to this new normal. Getting outside, playing golf and staying active in other ways has also been a great way to blow off steam. For me, personally, being active allows me to stay well not just physically, but mentally and emotionally as well. 

Alton: Currently, I have been going on a lot of walks with my family and fiancé in Novi. We try to go to different parks in the Metro Detroit area to get a new view. Besides the walks, my fiancé and I are ready to start our marriage with all the cooking we have been doing since the pandemic started. Learning new recipes has been great for keeping things fun when we were stuck at home and all the great foods we’ve eaten have been pleasing to the mind/soul.

Now that you’re a few weeks into this new experience, any advice you would have given yourself on Day 1?

Alton: Don’t miss your morning coffee.

Singh: Don't be hard on yourself and take a learning approach as opposed to a performance approach. Your primary objective should not be to impress your attendings or others around you. Rather, it should be to learn and become a competent anesthesiologist, while being thoughtful and considerate to those around you in the process.

Epperson: Take the time to FaceTime your family and the people you love! It is so refreshing. Also, make time to eat! You get so busy you forget you need food to survive. 

Nwosu: Everything is going to be OK. It's OK to feel like you don't know anything, it's OK to feel like you're way in over your head. Don’t forget: There are 500 new interns who are also going through this. Every other doctor before you has gone through this. And it will pass. But be kind to yourself. You’ve made it this far and you are here for a reason!

Who has had a positive impact on your experience so far?

Singh: There's been many faculty, staff, and residents that have had a positive impact on my experience so far. So many so that I can't single anyone out. That just goes to show how strong our department is with regards to the quality of our people. It's reassuring to know that every day I go to work, I know that all my anesthesia peeps have my back.

Drs. Thomas and Madison Epperson
Epperson and his wife, Madison, who is a U-M otolaryngology intern.

Epperson: My wife, Madison, a U-M otolaryngology intern, has been my rock throughout my life and my intern year.

Travis (TJ) Stropp has probably had the biggest impact on my decision to come to U-M. I first worked with TJ on my away rotation in September of 2019. I remember first meeting him and naturally being the typical nervous medical student who couldn't even introduce himself properly. We were doing some quick turnaround urology cases that morning. Right off the bat, TJ put me to work. He taught me things that I had overlooked (something that is easy to do as a medical student shadowing anesthesiology), and reinforced them with concrete points that helped me retain those important teachings. He was laid back and totally chill, something that goes a long way for a nervous medical student. He gave me a sense of autonomy and "you belong here..." I know that sounds silly, but it's true. I learned more that month than I had in years observing anesthesia as a medical student. Not only did that shed light on how well residents were trained at U-M, but also how committed they are to teaching medical students. That is the hallmark of a top program. TJ rocks. U-M rocks. 

Nwosu: Everyone has been incredible — this has not an easy adjustment, so I really appreciate the way that everyone has adapted. However, I have to first shout out Heather [Wourman] and Pam [Mulholland] — I wouldn't be a licensed physician without them! Even with all of the changes with COVID, they did a wonderful job in getting us situated and set up. They were with us every step of the way during our virtual orientation. They are also willing to help us with unexpected personal events. That support is tremendous.

Secondly, I can't forget Vu [Willey] and Lara [Zisblatt] and their focus on wellness! I really appreciate our wellness simulation sessions. It is a chance for us to step back and recognize how we are coping emotionally. We have to take care of ourselves to be able to take care of others. It is also a way for us to support one another. I did not realize that much of what I was going through, my co-interns were experiencing the same emotions. That camaraderie is one of the things that drew me to Michigan, and it is giving me the motivation and encouragement I need during this time. 

Alton: If there is someone I can cite from the recent months, it’s one of the current CA-2s, Tim Lozon. Although he didn’t bootcamp me, I spent many days with him on OB and in the SICU. Tim has been really great at challenging me procedurally. On OB nights, he acted as my COBAN so that I could get every epidural. In the SICU, he forced me to find patients to obtain better vascular access, and specifically, larger access (nothing smaller than a 16-gauge peripheral IV). Now that I am back at the main hospital, I am definitely more confident with both of those procedural skills.

Any advice for med students heading into this virtual match season?

Nwosu: First, congratulations on making it this far! This is the culmination of years of hard work and commitment. This year may seem different and frightening, but that doesn't take away from all that you have accomplished to get to this point. 

This is new territory for everyone, including the programs you're interviewing at! Reach out to contacts at different programs. Attend the virtual events that are being put on — program coordinators and directors are working very hard to give you a chance to get to know them and their residency. Make sure to take time to take care of yourself – physically, emotionally and mentally. And most importantly, try to have fun and enjoy yourselves. Enjoy 4th year!

Singh: That's a hard one. Take solace in the fact that you're saving money by not flying/traveling to interviews. Maybe buy yourself something nice instead. In terms of the match process itself, try to leverage people you know or friends of friends to get the scoop on certain programs. Don't be afraid to ask hard-hitting questions of the ones that truly matter to you.

Krukowski: As in person interaction/interviews will no longer be held, I think it is more important to show your top programs your interest by continuously reaching out to the program, faculty, and residents. Attend their virtual didactics or meetings as you can!

Epperson: Breathe. I can't imagine going through this interview process via a computer. I really can't, and I'm sorry that this year of celebration doesn't really seem as such. I will say, though, programs and program directors know this. They are working around the clock to make the best of this situation because they care that much about applicants. 

Do your best. Breathe. It is totally OK to stress, but try to keep everything in perspective. You have put in the work to get this far, and I promise that will not fail you now. Trust your preparation. Trust the program's commitment to making this virtual match year work. It will all work out in the end. And, also, you will save a TON of money not having to travel, which is a huge bonus.

Alton: Continue to be yourself and be proud of who you are and what you have accomplished. Everyone applying to residency has their own unique story. You don’t need to mimic someone else’s.