Becoming a Doctor: Part 2

We made it through Medical School... now what?!? We are in the beginning process, obviously since T just graduated Med School early May, so I don't have a whole lot of detail for the next stages in our journey but here is what I know so far and what I've been told we can expect.
Internship
-Internship is basically just the first year of residency, so T is considered an intern presently. They generally start July 1st. Sometime during the intern year guess what? Yup! Another exam. Time for Step 3! Yay! From what I understand after Step 3 is completed and passed and after your internship is completed you are now considered a licensed doctor. This means you can practice basic medicine as a doctor.
-While every doctor's intern year is unique to what 'type' of doctor s/he will become a few things are true all across the board. The hours are horrible (typically 12-18 hour days) sometimes everyday of the week, all times of day are work times (nights, holidays, weekends, there are no exceptions), although the doctor may not be physically seeing patients there is ALWAYS charting that has to be done (sometimes 4+ hrs a day), and they are the bottom of the totem pole. All the grunt work heads their way. Ugh. It is what it is, like joining a frat. The did pass a law within the last 10 years or so. The ACGME has set up new guidelines for Medical Residents. Such as 80 hr work week cap, 24 hr limit on continuous duty shift, 10 hr rest period between shifts, 1 out of 7 days off averaged over a month, in house call no more than 1 every 3 nights, etc. For more info you can browse Medical Resident Work Hours on Wiki.
-Once the intern year is over they have a ceremony, almost like a graduation. Their last day of work is June 30. They have to complete one whole year for it to 'count'. In the military they are allowed 14 days off which can only be taken during certain periods which make it extra complicated.
Residency
Now it is time to finish your residency.
-Depending on the specialty that you chose it can be anywhere from 3-6 years (including the intern year). Typically if the specialty has primarily based clinic hours the programs run 3-4 years but if they are more procedural or surgical they run 5-6 years.  Some programs in the military require that you do a year of research during your residency as well.
-Once residency is close to being complete guess what? Time for another exam? Woohoo time to take your set of boards for your specialty. After your board exam is complete (& you pass) then you are a Board Certified Doctor.
-As I mentioned prior we are taking the military route. Our path will be a little different once we are getting close to the end of residency. Most people will be able to practice medicine at a clinic, hospital, or even private practice. At this point T will be a 'real' doctor and now it is time to pay back the military his years. Depending on how long his residency is will determine how many years he has to pay back. If his residency is a 3 yr program then he will have to pay back 4 years but if his residency program is 5-6 then he will have to pay back 5-6. Basically you have to pay back your residency length or med school length whichever is longer.
Fellowship (optional)
-Now one may think that you are finally done right!? Wrong. Depending on your specialty you have the option to go on and do a fellowship. What does that even mean? Now remember there are always exceptions but generally this is how it works. Let's say your child needs to see a Pediatric Rheumatologist (like our J). That physician has to have completed two programs and passed both sets of boards; one in Pediatrics and one in Rheumatology. They could do Peds as their residency then Rhum as a fellowship or vice versa. Same is true for Pediatric Infectious Disease and several others not just Ped areas those are just examples. Now there is also another exception. Let's say you need to see a Cardiologist. They typically do a 3 year residency in Internal Medicine and then a 2 year fellowship in Cardiology. Internal Medicine is one of the best residencies because there are so many avenues that can be taken after that residency. The possibilities are almost endless.
Maintenence
Once all these things are complete you may think you are done now but alas your are never really done. Just like other professions (esp science based ones) you have to take classes to keep up to date with new and improved bigger and better things, attend seminars, and keep your license up to date (that process varies state to state). 

And now I *think* you may be done. Unless you practice for several years, get bored and decide to change your specialty, then it is back to do another fellowship and boards for that area.

Hmmm.... makes me wonder if T picked the right profession. Ahhh of course he did! It fits him to a T! Ba-zing!!

Becoming a Doctor: Part 1

The process of becoming a doctor is quite complicated. Unless you yourself or someone very close to you has been through it chances are you don't know too much about it. I can honestly say that even our family (although they care deeply and try to understand) don't really understand the process. There were/ are several things that we didn't understand. The purpose of this post is to layout the process, in a nutshell. Keep in mind that not all Medical Schools are set up the same and that we took the military approach so our journey may be slightly different that some one else's although they are probably pretty similar.(Disclaimer: I am not in any way trying to say that any other profession doesn't have a complicated process of completion, I am just stating our process for this journey.)
Pre-Med School
To start with there are several types of undergraduate courses that need to be taken so that a future doctor can be appropriately prepared to take the MCAT. These may include but are not limited to; chemistry, physics, organic chemistry, physiology, & anatomy.  The MCAT is a standarized test like an ACT or SAT that ranks you so you can apply to Medical Schools. Now the fun part comes. Applying to Med Schools. There is an application that must be filled out along with a fee paid. This fee can range typically from $100-250 just for the school to look at your application. If they like what they see than they will set up an interview with you. At that point you must fly to that location for the interview. After all the interviews have been completed you have to wait for a couple months to see if you got accepted anywhere. Once you get accepted then plans can be made to relocate for Med School!
Med School
*Med School consists of a four year program. Typically the two years are classroom/ lecture style years with exams. In our case the years were broke up into 'blocks'. The students would attend classes and work together in their PCL groups for eight weeks, then during week 9 they would test M-W. They would get their test results back on F. If they passed all their exams they would get week 10 off, if not they would have to retake them. The first year had four blocks so roughly 40 weeks. The second year is basically the same.
*Also because T is in the military he had to go to a 45 day program (BOLC) between year 1 & 2 in SA, TX.
*Between your 2nd  & 3rd year of Med School another test is required. Step 1. This is another national test that can be taken at a local testing center.
*The next two years consist of 'rotations'. These years (3 & 4) are spent in clinics and hospitals working with patients under an attending physicians. These rotations require you to work a little bit in every field to get a 'taste' of the different types of medicine. They typically are 8 weeks long in length. During these 8 weeks the student is required to work all the hours that their attending physician is working. Including but not limited to: mornings, days, nights, holidays, weekends, overnights, call, etc. Some of the rotations that are completed include: family practice, obgyn, pediatrics, surgery, neurology, psychiatry, & internal med. During the Family Med rotation T was required to do 4 weeks of rural medicine in which he had to stay in a small town for those 4 weeks. Now he got lucky in that his doctor let him go home Friday evenings and start at 9 Monday mornings so he could spend time with us on the weekends during those 4 weeks. His location was 2.5 hours from our home so it was quite the drive for him. Year 3 had 6 rotations back to back starting July 1st. Year 4 was set up a little different. You are required to do 4 weeks in surgery and 4 weeks in internal medicine. Beyond that you are allowed to choose up to 6 other fields for 4 weeks each. You are allowed 12 weeks off during this year but during that time you must travel for residency interviews. During this time also T had to do two 4 week away rotations for the military. He was in WA state for 4 weeks then was in HI for 4 weeks. This made a long 8 weeks for me at home!! 
*Now sometime during the end of 3rd year/ early 4th year it is time to take the Step 2 exam. This exam ironically has two parts. The CS is a physical exam that is taken at a particular test location. There are only 5 locations in the US so T ended up going to Chicago for his since it was the closest. Then the CK part is written and that was taken locally.
*Another part of Med School requires that you do a research project that has to be completed sometime during the first half of 4th year.
*Now it is time to wrap up Med School with a week of lectures back on the main campus and GRADUATION!!!

WooHoo!! We made it! Now if that wasn't crazy enough, we had the great idea to add 3 boys to our family during that time. Never a dull moment.

Wrapping up week 3

T is wrapping up week 3, only 49 more to go. (I will write a separate blog about that though.) So while T has been off working 16+ hr days including weekends, what have the kids and I been up to?
We have been attempting to finish things around the house. Moving in takes far more time than one can imagine especially when you have kids. We finally got all the boxes unpacked and now we are working on the final details of organization around here.
I went on my first venture up to A (about 80 miles one way) for J's Ped Rhum appt by myself. It was a success if I do say so myself. I was there on time and everyone behaved themselves, for the most part. J is doing awesome btw.
I tried to go the art museum with the kids but that did not turn out as successful. I thought it was an event catered to kids but turns out I was wrong and we ended up leaving. It could have been better but could have been a whole lot worse too. I do think a lesson was learned by all which is an important thing too. The whole way home (20+ mins) the kids didn't say ONE word. When we came in our development I drove right by our house. The kids then asked where we were going. I told them I would take them to the park because that fits our family better, then we discussed the appropriate behavior that is expected of them. Life goes on, live and learn.
Since the art museum didn't quite pan out we set up a park play time with some other military families that the moms are home with the kids while the dads are off being doctors. It was nice to meet and visit with some new women that are in my similar position and the kids got to play with some other kids on a new fun playground. E was super excited because he did the monkey bars all by himself for the first time and N was tickled pink since she mastered the fire pole on her own! Win, win, win.
Other than that we have been staying busy with our day to day routines; nothing too eventful.

a little different down here

We moved to TX the end of May so we have been here about 6 weeks or so. There have been a few things that are a little different that I have noticed verses the upper Midwest.

>The grocery store closest to us is an H.E.B. Plus. This may mean nothing unless you are a true Texan. This place has a huge variety of everything including but not limited to… electronics, toys, housewares, grilling and outdoor, party supplies, clothing, fresh sushi, butcher, organic/natural items, jewelry, floral shop, bakery, and much more. The first time we went in here we just walked around and looked at everything in the grocery store for well over an hour! And to keep our kids entertained long enough to be able to do that says something. = )

>I know that coming from ER, GF, and B doesn’t count as coming from a ‘city’ so moving to SA was truly a wake-up call in regards to traffic and city life. There are so many interstates, highways, and access roads it is enough to drive you mad (no pun intended, hahaha). I have truly become dependent upon my google map app on my phone to get me from point A to point B. The city is essentially set up like a wheel with a loop running around the central area of the city then another around the outer city. Then there are several that run right through the city. So traffic is alright if you know how to navigate 1604, 410, 35, 37, 10, 90, 87, & 281 just to name a few.  In addition to the roads there are also 3 military branches that have recently merged to add to the confusion.

>I had the privilege of experiencing a few substantial rainstorms but a few days ago we had a thunderstorm. And HOLY SMOKES. I heard the loudest thunder I have ever heard in my LIFE. The kids were running around the yard with their swimsuits on enjoying the rain while H and I were on the porch. The thunder was so loud and so long poor little H probably should have had ear protection on.  I can’t even describe how loud it was. It was unreal.

>The customer service down here is also unreal. When we go shopping (anywhere… Target, WalMart, H.E.B., CVS, Walgreens, etc, etc) associates are always asking if they can help or how our day is going or they stop and chat with the kids. In ND or MN I never had such amazing customer service. The people working down here actually like their jobs! Weird right?! 

>Last but certainly not least, people seem to enjoy seeing our family out and about. Now I know everyone is entitled to their own opinion but our family is what it is and we would not have it any other way. But let’s be honest. We have a big family and it is not very often that a couple in their early 30s have six kids. It is almost unheard of. Naturally there are always the nay-sayers and debbie-downers but we have not come across any down here (yet). Up north I would frequently get rude comments from complete strangers about my family size but down here we have got nothing but compliments.

Relandscaping

We had a new backyard put in with fresh sod. It looks beautiful. Someone (no kid will admit to who it was) decided they wanted to modify the landscaping. Rest assured we did correct their modification but I had to snap a quick pic first. = )

The Move

We moved from B to SA, only about 1500 miles away! We are now a military family. Our first military move was a mess, to say the least. First it was a mess just getting the paper work set up for movers to come and pack our things. We (and by that I mean T) had to call several different offices (in multiple states) to get put on a list serve for a company to 'pick-up' our move. Then when we finally did get 'picked-up' we were told they would pack our stuff in one day, load the next, and our things would be on their way to SA. Well after SIX days of them packing half of our things, it was on its way. We filled the portion of the semi reserved for us with our household items so all our garage items and some overflow from the house had to go into storage in B for an undetermined amount of time. Then our stuff that was on its way had one of the axels on the truck catch fire. Luckily there were not too many of our items damaged but this caused a time delay of 10-12 days! As a mommy I can assure you it is not easy to take care of your family of 8 without most of your 'gadgets' including pots and pans. We were without most things for over 3 weeks total! Anyways, we finally got our house things on a Sunday, part of our garage things Tuesday, and the last of our garage things on Friday. I don't want to sound materialistic but boy was I happy to have my things back. It is so much easier to feed the kids with a dining table and chairs. And bedtime is so much easier when the kids have their beds. = ) I would love to say that we are fully organized down here but we are not. When we lived in B we had a nice apartment that was close to 1500 sq ft. and now we are in a house that is close to 2700 sq ft. It is so nice to be able to spread out but this makes unpacking slow and difficult as toys and furniture are redistributed to different rooms in our house. I will have to write a separate post about our new home.

We are Back!!!

Well... it has been 3 years!!! I can hardly believe it has been so long since my last post. I guess life just got a hold of me and took me away. We have had so many life changes in the last 3 years. I will try to highlight the big ones...
*We moved from GF to B so T could complete his last 2 years of Medical school in May of '12.
*We were blessed with K in June of  '12.
*J was diagnosed with Systemic JIA in Aug of '13.
*We got to add H to our family in Feb of '14.
*T graduated Medical School in May of "14.
*We moved to Texas the end of May too!

My goal is to try and write one post a week. It may not be the most eventful but since we are so far removed from family and friends this will help us feel closer. I must warn you there will be lots of kid stories and events as my life revolves around them and everything I do my kids do too. (And I won't have it any other way!!)