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July 2004 Internship Journal

I am going into physical medicine and rehabilitation. This is a four-year residency, with a one-year internship, and three years of physical medicine and rehabilitation (PM&R). The first year of any residency is called an internship. There are several kinds, surgery, OB/GYN, internal medicine, and transitional, and because they can be done anywhere in the country, we apply to them separately. I am doing an internal medicine internship at East Carolina University in Greenville, North Carolina (about three hours east of Wake Forest). This will consist of rotating through different months like General medicine, Cardiology, Neurology, Oncology, etc. After this year, Michelle and I will move to Charlotte where I will do the three years of my rehab residency.

How did I end up at East Carolina you might ask? This is a very long story, which I will try to make brief. I wanted to do my internship at the hospital in Charlotte where I will do my PM&R residency. I thought that if I did not match there, I could stay a Wake Forest. My interviews at both places went great. About two weeks after my interview at Wake Forest, I received a letter from the program director saying that he hoped that I would stay there.

Going into Match week, I was very anxious. I knew that the program in Charlotte is extremely competitive, so I felt like I had a 50-50 chance. Wake Forest should have been a sure thing, but for some reason I had a bad feeling. We were told that if we did not match, we would get a page at noon on Monday (match day is on Thursday). That Monday, I had computer training. I could not stop looking at the clock. The training session ended at noon, so I headed home. By 1230, I started to get really excited. Then my pager went off. I did not even have to look at the number to know who it was. I got home, and returned the page. I was told that I matched in Charlotte for PM&R, but I did not match for an internship. I later found out that there had been closed-door meetings and it was decided that they would be lowering their precedent by making accommodations for me, and "they did not want to open that door."

This left me in what is called "The scramble." Long story short, Michelle and I were calling programs from Cooperstown, New York to Lubbock, Texas trying to explain to them how an internship as a C5 quadriplegic would be possible with an assistant. Well, it took two days of phone calls, a trip to Greenville, NC, and a month of waiting anxiously to get my contract, but I got one. The hospital would provide a nurse practitioner to help me examine my patients, and I would provide an assistant to be with me throughout the day to help return phone calls, look up labs on the computer, etc. No one really knows how this is going to work because no one has ever done this, but I am ready to give it a try.

Orientation officially started on June 29. Michelle came with me for my computer training. During the session, one of my fellow interns told us that our call schedules were online. I knew that I was starting with radiology and therefore would not be on call for the month of July, but I wanted to see what August had in-store for me. We couldn't wait for the session to be over to see my call schedule for my first real month as an intern, so we pulled it up. Well, we couldn't find my name. Later that day, I asked the old chief resident why I was not on there. She said they were still working on my schedule.

The next morning, we had our departmental orientation. I asked the new chief resident about my call schedule, and he shocked me by telling me that the hospital had decided that I would not take call. Once again, people were having meetings without me to decide very important things in my life.

I met with my chief residents the next day and they assured me that things would work out. We set up a meeting with our program director for Tuesday, July 5. Later that day, I met with the nurse practitioner that was hired to be with me. I told her what was relayed to me in orientation, that we had to be there at 6 a.m. and we would get one day off a week. She was very surprised to hear this. She is a single mom, and therefore cannot be at the hospital any earlier than 8 a.m. She was told that I would not have to work on the weekends, and that because I was going into rehab, I did not need to take call. Needless to say, I was quite upset, and because it was a holiday weekend, I would have to wait three days before our meeting.

I spent the weekend thinking of what to say to convince them that I should be able to take call. I was so anxious by Monday that I started counting the hours until the meeting. I felt like I had been tricked into coming here, but because it was already July, I knew I had no other options.

Tuesday morning finally came. After one minute of the meeting, it was obvious that we were all on the same page. Now, we just had to work out the logistics. I went down to the radiology reading room feeling very satisfied.

I have been spending most of my time with a neuroradiologist looking over head and spine films. My goal is to be able to know what I'm looking at when one of my rehab patients comes with their films. So far, it has been a very good month.

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