Iowa is unique in that we have this academic center and it's not in this large, massive city. Pediatrics programs tend to be localized in bigger cities to get bigger hospitals and to have these large academic centers to have the research you need. But we're unique in that we're in a smaller college town and we still have all of those opportunities. And it's a little bit hard to find, to have that like smaller community kind of feel and that close-knit community feel that comes from being in a smaller town with all the advantages. That’s one thing I've really liked about here, and I felt it's unique from a lot of the places I went to. 

In terms of pediatric residencies, it's a little bit on the smaller side, as in there's like 16 to 18 residents. I know it's big for some programs, but in Peds there are plenty of programs with like 20 to 30 residents. We still get a lot of like the academic side and a lot of research here, so that's what’s nice. Additionally, if you're interested in a fellowship, there's plenty of opportunities to explore. 

It was pretty smooth living in Iowa City for four years. Making the transition, I already had a community here. I knew the area fairly well. I knew the kind of things I like to do to unwind and for fun. So in that way, it was a pretty easy transition for me. I mean, it was hard coming up (from Atlanta) for medical school. 

I remember this time around, I thought it was a plus staying in the same town. From a work standpoint, there are a lot of things changing and it is very stressful. And it's nice that all of the other things that could have changed were not as stressful and were much smoother. I could imagine it would have been a lot more stressful if everything was changing, like the town, as well as, going from med school to residency.

One gets a better sense of what it looks like on the inside. So getting to actually see what the interaction is with the directors, associate directors, and staff. Getting to see, especially when it gets stressful or if you start to have really busy workloads, what the support is like from a program. Those are the things you don't get a great sense of. And it's really good here. 

We have really supportive directors and associate directors who are very quick to respond to any sort of concerns or questions. They're very approachable. They meet frequently to talk about the program and things they could help change or adapt, which is very useful at this time where things are quickly changing and needing a lot of quick adaptations. So I feel like I've been really grateful to be here for those reasons. 

I didn’t get a sense of those things when I was interviewing or rotating in the hospital.

That's something that I think looking back now, I wish I had done differently, which probably everybody, once they get in, they realize, “Oh, I wish I had focused on these things more than others.” Not that I did anything wrong, but particularly when you're applying and you're very nervous and want to make the right decision, you end up focusing on lots of different aspects and little details. 

I wish I had just picked out what are the most important things for me, which is family-wise, being close to my wife's family was really important. And having a community, which ended up being really helpful, especially going into COVID, having people to spend time with, and then having a great director and staff that I felt were approachable. Which I have here.

And lastly, opportunities for research or fellowship I wanted, are probably the major things.

And then all the other things like call schedules and whether they have global health or not. There's a number of things that you ask about. Parking sometimes comes up; all the little things that come up that I realized don't matter as much.

Otherwise, making sure people are close and that they seem happy. It's really important. I think if you're nervous about whether a program really works people really hard or isn't as worried about wellness or something you just like, just make sure that people are happy and I feel that will cover a multitude of things. And then you can focus less on the little details about their schedules.

Right now I am in my second year. For most pediatrics residents, there's quite a bit of thought about what you're going to do next because you have to make those decisions by the end of your second year when you apply for fellowship. So there have been thoughts, things that I didn't think about much going into residency, like, “Do I want to work in a city or in a rural setting?” which does affect what you end up doing because fellowships and subspecialties are in academic settings and cities typically. And so in a general pediatric type practice, you can do more in a rural setting. 

Additionally, things like finances, which I never thought about, are interesting. And then going into fellowship, there's actually a financial setback of it versus just going into practice. Studies have shown that in your career, there's an average net loss of like $750,000 going into fellowship versus going to general pediatrics because you push it off for three years, like getting a salary and then you sometimes make less money. So that all just comes into the fellowship decision. You have to really love what you want to do. It's not about the money. So trying to figure out, “Do I really love this enough to do a fellowship?” I had never thought about it in that way, going into residency. I thought it was basically going to be the same financially either way. 

Going into interviews, there are so many people interviewing on a daily basis that I thought, “Oh, most of us would probably just be kind of lost in the numbers or people won't remember me. It's just more for me to learn.”

But I have noticed being on the other side gives you a new perspective on interviews. One being, people remember you if you take a lot of interest or if you have some connection. Those sorts of things that I feel like I wish I'd had that perspective on the other side because it is helpful. Residents are asked what they thought about each of the applicants. And if there is somebody who had a very unique conversation with me, I will remember them and it's to their advantage. So I think like trying to learn about the program and take an interest in specific things and then being engaged, it's helpful and useful.

Residency is very difficult, and it's different with COVID as medical school probably has been for students. Constantly changing. Like last year, we didn't see much bronchiolitis or ear infections, which usually you see all the time in Peds, so we didn't get that training. And now, we're at max capacity because we have a respiratory season during the summer, which is very odd. So there's just a lot of things changing very quickly and it's been stressful and hard. And I think just making sure you have that support, like social support outside of work, and making sure that wherever you go, you can feel like you're supported by the residents and staff. It's huge. And I think I would put it as high in my priority, especially during the time that we are in.