PAULINE HUYNH

From the middle school diaries that started it all

ALL THINGS EDUCATION

Oh, 2021.

Goodness, it’s been three years since I last posted an annual recap.

One of the things I struggled with over the past few years was maintaining this blog in a way that felt authentic to me yet remained sensitive to my professional trajectory. Not only were some of my most important lessons from interactions with patients, but I also didn’t want to publicize my struggles during my application cycle. Because of this, I marked several entries private and instead dabbled into bullet journaling for that tangible and intimate way of documenting my life.

While those hesitations still persist today—with more patient stories and moments of imposter syndrome than ever before—2021 was a transformative year, and one that deserved as full a recap as I can comfortably share.

So let’s begin.

(Disclaimer: I dropped a few affiliate links in this post, which means I would receive a commission if you purchase through my links, at no extra cost to you. Please read full disclosure for more information.)

January 2021

January started off strange because I wasn’t home for the holidays due to the pandemic. The month itself was a blur–I remember tying up my interview cycle, including my one at Kaiser where I actually panicked afterward, and just waiting for the Match to be over. I had also double-booked two interviews in one day because of time zone differences and that was exhausting. Would not recommend unless you’re absolutely terrified about your matching prospects (like I was).

February 2021

Overall hazy aside from the panic of crafting my rank list. As someone who has strong goals of pursuing a career in academia, I really struggled to create a rank list that reflected my priorities and the…fuzzies (culture, vibes, pick your term) during interview day itself. I remember having several conversations with my mentors, and watching that list change on an hourly basis. Looking back, I don’t know what I could’ve done to save myself from that unnecessary stress–but it was indeed unnecessary.

Sometime in early February, I had also made the decision to move home after the Match so I started consolidating and selling all of my things. Shout out to 2016!Pauline who had the foresight to start a spreadsheet detailing all of her purchases–it made reselling items 100x easier than it would’ve been otherwise.

March 2021

Easily the most transformative month this year in terms of my self worth and the trajectory of my professional career. I submitted my rank list and just breathed a sigh of relief.

One day, I will write a separate blog post about this, but holy hell, I was so proud of my decision to dual-apply into preliminary surgical positions and being transparent about that with my mentors. It wasn’t a typical decision, and I had plenty of folks try to talk me out of it (in addition to talking me out of frankly dual-applying into general surgery, which was good advice). However, the minor stress of applying into prelim positions and adding a few extra interviews was 1000% worth the peace of mind it gave me in early March, when I otherwise would’ve screamed from anxiety and stress.

Match Week itself was a roller coaster. Monday was a rush of emotions because I initially didn’t feel anything getting the notification email, since I thought it would be the same whether I matched categorical or preliminary.

Then I learned that the messages would have been different, and screamed when I realized that I had matched into otolaryngology. My dreams came true!! That said, the rest of the week was such an odd mixture of feelings. I was anxious to know where I would be spending the next 5-7 years, ecstatic beyond belief, but also ?guilty after learning how some phenomenal folks did not match. It truly reminded me of how random the Match progress can feel.

Match Day itself was incredible–also a mix of feelings, from finding out where my new home would be, receiving congratulatory calls, celebrating with friends and family, telling my parents that I would be coming home…it was an emotional experience all around.

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I flew home at the end of March after bidding farewell to some incredible mentors, and got to spend the next 2 months with family. Somehow managed to resell over $1200 worth of apartment goods, and traveled home with only 2 checked-in suitcases and a carry-on.

April – May 2021

An absolute blur but eyyyyyy, I graduated! Spent most of my days virtually apartment hunting and being baffled at housing prices in the bay, even after taking pandemic-related concessions into consideration. In the end, I found a place that I really liked, and drove up with family for move-in at the end of May.

For whatever reason, I also started delving deep into real estate during this time (lol with what money). Tried to see if I could somehow make house-hacking work, then ultimately shoved that idea into the backburner.

Within the online space, I spent some time this month updating the website and cleaning up (or outright archiving) a number of blog entries. It was also during this time that I realized how I had transitioned from my longform content to microposts akin to a something I’d write on Twitter or Tumblr. I was also debating whether I wanted to become more anonymous—surely, a physician (in training) with a blog can only garner negative attention, if it picks up traction at all?—or to continue owning my experiences, my voice, and my decision on what to share.

June 2021

More AMA-related stress, with several breakdowns leading up to the meeting. Starting trying to thrift & DIY everything in my apartment as a coping mechanism. The AMA Meeting itself was a success, and I’ll be forever privileged to have served the Medical Student Section as its Delegate.

Met some of my co-residents, and attended orientation!

Tried to play 3-dimensional chest with my intern year schedule to optimize everything from finances, to Step 3 studying, to getting my licenses, fees, checkups for long-term purchases (like disability insurance).

July 2021

Another transformative month. Just as in March, I experienced major shifts in my self esteem and perceived competence. I vaguely mentioned this in a previous post before but nothing prepares you for the steep learning curve that is intern year. I’ll forever remember my first night cross-covering 6 surgical services with over  70 patients. First prescription. First page. The feeling of being overwhelmed all night. First trauma activation, quickly followed by second, third, forth. Seeing the Epic system for the first time, then being told to round on and write notes for 26 patients. Being asked to discharge patients when I didn’t know how to discharge a patient. Crying in the elevator ride down to the parking lot. Feeling extremely, extremely inadequate. Feeling angry, then a bit proud of myself when the next cross-coverage shift the following weekend didn’t feel quite as big of a disaster.

Studied for Step 3. Tried to take it at the end of anesthesia, but due to scheduling issues, I ended up pushing it towards the end of my general surgery rotation. Also deliberated on whether to adopt a cat, and tested my ability to afford one by squirreling away “pet fees” every month in my budgeting app, YNAB.

August – October 2021

Started my HNS rotations! Gosh I learned so much. Leaned heavily on my co-residents and attendings for support. Chose to sleep in the call room during my first two call shifts because I was terrified of sleeping through a phone call or of late nights (because we are technically on home call at Kaiser, there isn’t really a post-call day). Also battled with imposter syndrome a lot more during my HNS rotations because unlike with my off-service rotations, I interviewed with Kaiser. These are the folks who spoke with me, ranked me, and chose me. Whatever their initial expectations were, I was terrified of not meeting them, especially since unlike many of my predecessors, I didn’t do multiple ENT subinternships and the last time I actually learned neck anatomy was like…2-3 years prior. Additionally, receiving consults as the junior-most person in the department was (and continues to be)…an experience.

It was also during this time that I started to feel the financial strain of frontloading my long-term purchases and sinking funds. I made the decision to automatically invest 10% of each paycheck into my Roth 403b, knowing that it could leave my budget feeling tight especially once my moving concessions ended and I would start paying rent. Then, in a span of like 2-2.5 months, I dropped nearly $10,000 on:

  • Roth IRA contributions
  • Disability Insurance (third party)
  • Surgical loupes (that would later be reimbursed)
  • USMLE (reimbursed)
  • DEA & California Medical License (reimbursed)

I don’t regret frontloading my expenses, and the hefty reimbursement check was pretty to see, but whew.

Also attended a family wedding! It was nice to just fly home and escape for a bit.

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November 2021

Rotating off-service is such an interesting experience. I definitely learned a lot, but there’s definitely something to be said about combing for the information I need to treat this set of patients on this service, and knowing that I’ll likely not need to know it again for my actual specialty. This, along with the laundry list of tasks and shift work schedule (e.g. being able to sign out my worries), made emotionally disengaging…distressingly easy. I questioned myself and the quality of care I provided often because of it, even as I knew tasks were being completed.

In the midst of all this, I also realized that I wanted to chase too many things in my personal life (to be discussed at another time). I spent an excessive amount of time playing 3-dimensional chess with hypotheticals, starting and pausing projects, shifting money around in my budgeting app. Looking back, I could’ve saved myself so much time had I just put my head down and focused on one particular goal.

December 2021

Surprisingly blurry given how recent it is. I remember watching my dining out budget dwindle fast (was not prepared for food delivery every shift during that week of nights…) and my holiday sinking fund going down with it.

Returning to the HNS service has also been a treat, but as I expected, the first week back was an adjustment. It’s such a great feeling to return though, even as I’m learning new things every day.

Last month was also was when I started making products for my Etsy store. To be honest, I’m still trying to gauge whether this is something worth investing my time toward, but I also enjoy creating and sharing products. I think, over the next year, I’d like to establish some sort of system that would allow me to still help and share these products with those (like students) who may not have the funds to afford it.

Summary

In short, 2021 was a transformative year personally and professionally. I matched into the specialty of my dreams, found a home in a residency program so well suited to my goals, and am inspired to push  myself every day. At the same time, it was during this year that I found myself navigating both a “public” professional identity and a personal one. I found myself ruminating over financial aspirations and goals—nothing like “How much house do I want?” but rather “Can I house hack?” or “Is it responsible for me to get a pet at this time?”—ultimately spinning around in circles chasing my tail.

While I’ll go into my 2022 goals another time, I think my overarching goal for the year is to seek clarity: clarity on my goals, clarity on my expectations and performance as a trainee, and clarity as to how I can act on that information.

Intern year is a ride.

They say the learning curve is incredibly steep, and I’ve always believed that, but living it is something else entirely.

It’s crazy to see how much I’ve grown over the past 4 months. I’ve pushed my limits time and time again, learned more on the fly than I thought was possible (but always feeling supported), and could not be more grateful to have found a home within my residency program. I feel myself identifying more with the role of a physician and surgeon, and find myself being more at ease even seeing patients in clinic or consults for the first time. (The thrill of doing my first facial laceration repair on my own, while on call, was such a confidence boost!)

I won’t lie–I’ve also never felt quite so exhausted, especially during my time on-service. Time management is something I struggled with daily, and it was a chore to even scrap up a meal when I got home from the hospital. It’s also disheartening at times when I find myself without the energy to catch up on issues I used to advocate passionately for. I have to trust that this, too, shall pass.

That all said, I love what I do, and what I get to learn to do. I can’t believe that I get to do this for the rest of my life, and train at the most supportive residency program. I love the nurturing culture of my program, which is complemented by the autonomy that can only be developed at a county hospital and Level 1 trauma center during my off-service rotations. I love my co-residents, and am constantly inspired by their dedication to their patients, their training, and mentorship. They push me to do better daily, but have never left me feeling stranded.

✅ Week 1 of Residency

What a ride.

I’m still trying to process, but the past week has involved so many first’s.

First time hearing myself addressed as, and introducing myself, as “doctor.”

First time prescribing a medication.

First time administering medication.

First time intubating.

First time crying at work.

First time answering, and sending, a page.

First time cross-covering 6 surgical services overnight.

First time answering placing an order–and getting the order wrong.

First time getting paid as a physician!

I’ve learned so much, and am trying to lean into that growth mindset. I can’t wait to see what’s in store.

Dreams do come true.

I’m heading off to Kaiser Permanente Otolaryngology/Head & Neck Surgery in Oakland!

I’m stunned and beyond thrilled. I absolutely loved my interview day at Kaiser and all that the program emphasizes:

  • a firm commitment to equity, diversity, and inclusion–one of the few that proactively discussed ongoing efforts and initiatives
  • robust research efforts and databases pertaining to  health policy, systems, and care delivery
  • an almost apprenticeship style model of teaching with the close-knit faculty
  • a global education, where international rotations are counted toward educational hours 
  • a patient population that looks like me and my loved ones, and thus an opportunity to give back to a community that taught me so much

All in the heart of the Bay area, right in California. The best part is that I didn’t even expect to love it as much as I did on interview day:

What. A. Plot. Twist. I am so, so lucky to have found my Match.

Holy cow, I did a thing.

I’ve matched! What. A. Journey.

I didn’t even realize I was supposed to find out today. Although I’ve known that Match Week starts with an NRMP status update on Monday, I didn’t realize that the status was different between a full match or a prelim-only match.

Not many people know this, but I actually applied into preliminary surgery programs in addition to otolaryngology, and had seriously considered dual-applying to general surgery. I’ll write about my thought process on this matter another time, but the crux of this was that I was terrified and knew I did not have the…mental fortitude to navigate the SOAP if I didn’t match. Because of this, while I was very hopeful to receive an “I’ve matched!” email from the NRMP today, I didn’t think the wording of the message would be specific enough. I fully expected to find out on Friday (Match Day) if I had actually matched.

Apparently, the NRMP states that 4 potential messages exist:

  1. Congratulations, you have matched! if you match categorical or prelim + advanced slot
  2. Congratulations, you have matched to an advanced position but not a preliminary-year position.
  3. Congratulations, you have matched to a one year position. — if you match to a PGY-1 preliminary position only
  4. We are sorry, you did not match to any position.

I hadn’t realized that Message #3 could exist, which means that upon looking back, I matched…fully.

Holy shit. I’m going to be an otolaryngologist.

The world isn’t ready.

I’m not ready.

ROL submitted

‘Tis the end.

With Rank Order Lists (ROL) due tonight, I’m still trying to process that it’s happening. Quite honestly, I don’t know how to feel.

Terrified? Yes, but also resigned and with reluctant acceptance. Whatever happens will be out of my hands.

At the same time, I feel incredibly grateful that I had the foresight (and enough self reflection) to apply into preliminary surgical programs as a back-up. It feels good to know that I likely won’t have to deal with the chaos that is the Supplemental Offer & Acceptance Program (SOAP)–because frankly, no matter how many times I read the horror stories on forums like Reddit, I know my heart can’t take the stress.

Moreover, I feel so incredibly blessed and fortunate beyond measure. The 2020-2021 residency application cycle is the most competitive in recent years from a numbers standpoint: 625 applicants for only ~350 otolaryngology slots. I knew heading into this cycle that I was not an ideal otolaryngology applicant. My board scores (233 for Step 1, 244 for Step 2) were below averages for the specialty, and I scored a pass in my Medicine rotation. I am applying with a class cohort of 9, which is frankly enormous, and everyone is so incredible in their own right. And yet, despite this, I received 12 interview invitations and was able to rank 16 otolaryngology slots given the combination of standard and research tracks.

I owe a lot of this to my mentors, who not encouraged and fostered my interests in research and advocacy, but have advocated for me every step of the way. Mentors who helped me create a back-up plan that was fair for all parties involved (e.g. don’t dual-apply if my heart is truly in otolaryngology), who reviewed my personal statement, who went over my ROL with me–sparking necessary if difficult discussions–and who supported my accomplishments.

But beyond that, I am so thankful for my friends.

Applying to residency in this virtual environment can, and did, feel incredibly lonely at times. It’s even tougher when you don’t know the rest of your cohort that well, and when checking in can be misconstrued as sizing up the competition. I’ve been incredibly lucky to have a handful of folks who applied within the same and in different specialties who are willing to share their struggles, feelings of imposter syndrome, and excitement. I can’t wait to see where we all end up.

And lastly, I feel…relieved? It feels like I can breathe a little easier, and go back to doing things I enjoy, without the fear of being under a magnifying glass. It feels good to write without fear that someone will comb through my words and use it to evaluate my professional candidacy. It feels nice to be able to reflect openly and honestly, to once again share my thoughts and experiences without needing to appear polished, and to express myself as more than Pauline the Medical Student.

So yes, I’m terrified that ROL are due tonight. I’ll probably won’t be sleeping well for the next 12 nights, and it feels odd that I’ve angsted about this process for well over 2 years (i.e. right after I got my Step 1 results in Nov 2018) only for it to suddenly end. But I’m also relieved, and excited to return to “normal,” so to speak.

And of course, I can’t wait to see where I call “home” next, and blog all about my next adventure.

Oh, 2021.

In this post, I recap how 2021 went. In short, it was a transformative year personally and professionally. I matched into the specialty of my dreams, found a home in a residency program so well suited to my goals, and am inspired to push myself every day. At the same time, it was during this year that I found myself navigating both a “public” professional identity and a personal one. I’ve struggled on how to maintain this blog in a way that felt authentic to me and remained sensitive to my professional trajectory. While those hesitations still persist today—with more patient stories and moments of imposter syndrome than ever before—2021 was a transformative year, and one that deserved as full a recap as I can comfortably share.

Read More »

Intern year is a ride.

They say the learning curve is incredibly steep, and I’ve always believed that, but living it is something else entirely. It’s crazy to see how

Read More »

✅ Week 1 of Residency

What a ride. I’m still trying to process, but the past week has involved so many first’s. First time hearing myself addressed as, and introducing myself,

Read More »
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Pauline

I am a resident physician who enjoys writing about her life in between deadlines, kitten cuddles, and caffeine-fueled adventures. I write primarily for myself, but would love to share the journey with you.

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