By Dr. Munaha Mostofa
CaRMS season has officially come to an end and I’ve been spending many evenings as of late having lengthy discussions with friends who were going through the match process, helping them decide what they want the next phase of their lives to look like. After all, during my own CaRMS circuit, I had made the decision to move across the country to pursue residency in a program and city I had no familiarity with. I now consider myself somewhat of an expert on making dramatic life decisions.
I had been in the Maritimes for nearly half my life, having completed all my postsecondary education in an idyllic (and gorgeous) seaside university campus in New Brunswick. The farthest I ever moved from home was to live just a few hours away to attend medical school at Dalhousie University and when I say I was homesick during the first few weeks of that move, I’m really making a gross understatement. But like all things in life, we adapt and learn to make lemonade with lemons and while I can admit that the rest of my medical school experience was filled with endless sleepless nights, crippling imposter syndrome and scheduled breakdown sessions, it also consisted of an immense sense of accomplishment, more knowledge than I could have ever hoped to gain and making some of the closest friends to help get through that grueling experience. Unfortunately, and fortunately, these don’t change much as we continue to progress further into our medical training!
As anyone who has gone through medical school (or is currently going through it) can attest, it passes by at breakneck speed and before we know it—or are ready for it—we are interviewing from program to program, perfecting the art of the humble-brag, meeting a concentrated group of people who have the same medical interests as us, exploring new cities together (something that, unfortunately, is on hold given the current pandemic climate) and, honestly, having one of the best experiences that medical training has to offer! But following the high of CaRMS comes the immense responsibility of deciding where to spend the next two to five (or more) years of our lives. It comes with trying to determine the priority of factors like how far we want to be from family, which programs our friends will be ranking and potentially matching to, the size/cohesiveness/reputation of a specific program, the supports in place for resident physicians, what the city has to offer and many other considerations.
I knew pretty early in my medical career that I wanted to do psychiatry and was fortunate enough to have the opportunity to have exposure to this specialty in many different programs across the country. The goal of my pre-CaRMS electives and CaRMS interviews was not just to “sell myself” to each program, but to really determine which program tried their best to sell themselves to me. While it was tremendously difficult to narrow down my top choices for residency—because at the end of the day, most programs are amazing and have their own set of unique incentives and enticing factors—there were two programs that I fell in love with completely. One of them made sense: it was close to home, located in a beautiful city and I had friends in the program. The other one, University of Alberta, made zero sense: it was an eight hour flight from home, the winters here can be miserable (especially for someone who is originally from the equator) and I had no friends or connections in the city.
But my elective at the U of A left a lasting impression on me; it had one of the most cohesive and collegial resident physician groups I had seen, staff that were always eager to teach, tons of supports in place from the program and a complex patient population that would provide endless learning opportunities. Ultimately, it came down to one thing: I saw myself working with the people here for the next five years—staff, resident physicians and patients. This was the program I had the most fun in, where I truly believed I would become the best physician at. As crazy as it may seem, the deciding factor for me was when I had a dream that I was giving a speech at a stadium, extolling the virtues of this program. I guess my subconscious had figured out what would be best for me! Fortunately, I did match to U of A psychiatry and it was been one of my greatest decisions. I think I might want to live here forever…
While residency comes with its own set of challenges and insecurities, it’s important to recognize that we’ve made it this far, which ultimately means that we’re suitable to be physicians and we belong wherever we end up. We’ve earned it. But to have a truly enjoyable and memorable experience, there are two things that are key: surrounding yourself with people who love and support you and making sure you love and support yourself. The former was initially a challenge given that I knew no one in the city when I started residency here, but I followed the golden rule: “Be the kind of resident physician I wanted to work with as a medical student.” With that in mind and getting involved in as many extracurricular activities and events as I could manage, I’ve been able to find my people. The self-care bit is always challenging for people who aren’t used to putting their needs above others’; but neglecting yourself is a surefire way to achieve burnout. Therefore, taking the time needed to look after myself without feeling any guilt and asking for help when I need it has been a skill I’ve been actively working on and it’s some of the best learning I’ve done. And this is what residency is for: learning to juggle a hundred things at once and prioritizing, and sometimes that means prioritizing yourself. At the end of the day, it’s simultaneously challenging and rewarding, but you learn to trust and love the process, I promise!
Dr. Munaha Mostofa is a psychiatry resident physician at the University of Alberta.