Warning: Longer than usual entry. Read at your own time-mgmt risk.

Well, I have a lot to catch up on with you. As usual, I’ll just do my random item bullet list with a little anecdote at each stop.

• Ken update – As many of you will know from Facebook, very happily the brain tumour my friend Ken had was successfully removed in an 11 hr surgery and proven to be benign. I saw him in hospital on day 4 post-op and he was up and about and doing very well – scheduled to be released the next day. His work has been generous and caring with him (the CEO visited him twice, including the morning he went in for surgery!) and have given him the month of December off with pay. He’ll start back at work in January. I’m delighted for him! I’ll be curious to keep in touch and also to see what ripple effects such a life-threatening experience has on the way he lives his life.

• Rural family practice – The last month I’ve spent driving daily on a dark, rainy winding road to a small community about a 45 minute drive outside Victoria. As you can probably guess I won’t miss the drive, although I did enjoy the extra time in the morning listening to CBC Radio 2. I’m sad that my favourite morning show host, Tom Allen, who had the best combination of humour, quirky stories and cool music has left and is now just in the afternoon but I’ll deal with it. Anyway, my family practice preceptor was awesome!!! He’s wonderful and caring with patients and the wit & wisdom that he brings to his practice make his patients love him. He really showed me the depth of relationships a family doctor can develop with his/her patients and the rewards they bring. A couple of times patients obviously had stress manifesting their physical symptoms and came to him to discuss a recent job loss or some other stressful situation. He was an excellent teacher and while I unfortunately slowed him down, he never seemed frustrated by that or whiz through things that were important for me to learn. I loved that before I’d see a patient or maybe after, he’d give me the context in which he knows them – the inside scoop. “This person had a bunch of money, spent it all, got divorced and now he’s struggling with alcohol addiction and both of his parents are also alcoholics. I’m not sure why he’s here today – go find out.” That kind of thing. A quick soundbite that summarized the few facts he knew about someone which is really helpful in knowing in advance so that you can direct the conversation more knowledgeably. But boy, does he work hard. We worked 10-12 hour days and then he’s also in 4 call groups, one for maternity care, one for his community, one for hospice, etc… I didn’t have to do call with him happily because I was quite eager for each weekend to arrive so I could have a break! He’s committed to excellent patient care and maintains hospital privileges (that is, acts as the main coordinating physician to his patients when they’re in hospital), delivers babies, visits people at home and in nursing homes if required and offers palliative care at home. On my first day he asked me about my interests and it resulted in me getting very involved with one family delivering palliative care at their home. It was a wonderful opportunity for me to explore that interest and sooo rewarding. On my last day at the clinic, I received a card and some flowers from the woman whose husband’s care I was overseeing with my preceptor. It had become a habit for me to call almost daily to check in and go to their house 2-3 times per week to deliver more medicine, see how they were both doing, etc. One of the palliative care docs I worked with at the Hospice had said to me once that that work is just as much about the living as those that are dying – staying in touch with how caregivers are doing and trying to support them practically and emotionally through an incredibly difficult time. Anyway, no surprises there for me as to how much I loved that work. But I also really enjoyed the variety of people and problems that you see in a family practice! A great month overall.

• BCMA – On the last day of my rotation, my preceptor had a meeting at the BC Medical Association in Vancouver. He’s very involved in medical politics – the BCMA, CMA, etc and was more than willing to include me in his day of meetings there. Knowing of my interest to put my MBA to use again eventually in something medicine related, he set up meetings for me with various people there so that I could see how the BCMA works and whether it might shed some light on any opportunities that I want to pursue there in future. It was great & very productive. I met some wonderful dynamos, learned about a med school issue that I was able to bring back to my class president to solve and found out that I may indeed want to get involved in the work of the BCMA at a future date. They do far more than negotiate with the government re fees, but they also promote healthy lifestyles with both the public and government, working with government on issues related to health for the public (eg. The recent cellphone ban while driving). Anyway, it was a great day and an excellent end to my rotation.

• Residency – Yesterday was the deadline for residency applications, which will start next July, assuming I’m successful in my two BIG comprehensive oral & written exams. I’ve applied to do a family practice residency at various schools including: UBC, U Calgary, U Manitoba, Queen’s, and Dalhousie. And while a few months ago I would have told you I wanted to stay here in the Island Medical Program for residency (and there are benefits to that since I intend to return to practice here), I’m starting to get interested in going somewhere else to experience a different program/hospitals/group of physicians. We’ll see. I'm just going to stay open-minded at this point. After an extensive application process which is like med school apps all over again (reference letters from physicians you’ve been working with, essays to each program, transcripts, etc), now we just sit back and wait to learn whether we’ve been awarded an interview at the schools we’ve applied to. Then in January, in a flurry of 2 weeks of travelling that seems rock-star or royalty in proportion (except with far less class and more nervousness), we’ll fly around the country (on our own dime of course) and interview with these schools. Late February we submit our ranking of preference for the schools to which we’ve interviewed and the schools rank us. This info all goes into a centralized database which spits out the “best match” for the most number of people and determines your fate (i.e. which school/city I’ll be going to) for the next couple of years. Crazy to feel so not in control re where I’ll be living next July for 2 years but ultimately I only need to rank the programs that I would be quite happy going to. The results of the match are legally binding so you don’t want to rank something second if you’d be devastated going there. Ugh.

• Up next – We’re back in the classroom for the month of December which will be a nice reunion with my classmates whom I’ve seen rarely for the last year. This week I’ve had off to work on residency applications and apparently to stare at the piles of paper in my apartment and wish them away without actually doing anything about them. Until now. Better go.