It is a four-year emergency medicine program and we do rotations mainly at two different hospitals, HUP hospital at the University of Pennsylvania, and then a few blocks away, one that's called Presbyterian or Presby for short. Both hospitals give you a variety of different patient experiences. One is your big quaternary care facility similar to the University of Iowa with all the different types of cancers. And then Presby is more of the West Philly citizens including some without insurance which is a major trauma center. 

So for me, I thought we were trained extremely well at Iowa for all the blunt trauma. But I really wanted to see what it was like to do and be at a place that has a lot of penetrating trauma.

Philly has been great because it's a little bit bigger than Iowa city. A larger music scene, a few more museums and restaurants, but all the little things you love that are in Iowa city are here as well, including tons of different hospitals to choose from. So lots of different medical workers to always be surrounded by. The weather's nice, it is just so enjoyable to walk down and go to different bars and restaurants and see live music kind of outdoors at all times. I would say having lived in a few different big cities on the east coast, Philly is nice in that it's really affordable. It's the cheaper of the big cities of the East coast.

I think in residency you should say yes to almost everything because then you are learning different things and trying to see what you love to do. But I say that with the caveat as you get going and you get to your later years, remember to be able to say no and keep time for yourself. 

I think one of the bigger things I didn't run into this, but I think just looking back on my own med school class is make sure that you choose a specialty you want to do not because you think you need to do it to fulfill some extrinsic motivation. Some of my co-residents are people that have left a CT surgery residency after five or four years of it already, and then came into our class. And it's just great to see people be happy in what they're doing.

Besides my Netflix shows that I'm watching, I would say going into a wellness fellowship, I think it's interesting to start thinking about what we were taught in medical school about dealing with a hard patient interaction. I think sometimes we take for granted how hard it can be to just have a normal conversation, if a patient, and then be dissatisfied about not having an answer at times, obviously as an emergency physician. And I don't know if we get training on how to get out of situations or that it's okay to realize you're not being treated fairly and to walk away from some of those situations at times and protect yourself and your nurses and the other people in your department.

I think about how to teach that culture of protecting yourself as well. I think we've all been taught that we've gone through so much to become a doctor that you can deal with anything. Being in emergency medicine especially you go into this with the mindset of you really can deal with anything that comes at you. And recently I've liked to try to teach my interns that it's okay to come back out and tell us that they have been treated unfairly by a patient, have been yelled at by consultants if that ever happens and try to change the culture altogether. 

Yes, just realize there are going to be really hard moments, and don't be afraid to tell your co-residents you're having a hard time, or if you don't even want to say that to just tell them you need a drink post-shift.  It's important. I think what we all miss right now, obviously during COVID is going to our shift bar that we could always have some food and meet from the three different hospitals, Chop, Presby, and HUP to say, wow, this is what happened a day and realize it's good to normalize everything you're going through. And you've all been there. And you all feel that at some time, so rely on your people and don't be afraid to do that because that's how you're going to survive this. And that's what matters.