I applied to a specialty at the last possible second and got in. Here's how.

This story also begins during the COVID-19 pandemic, but right after my Step 2 story. For about a year I had been committed to applying to a particularly competitive specialty, and this specialty was the focus of all my energy. Applying to that specialty helped keep me afloat and focused when most of the world was going literally insane.

When I came back to school from Step 2 studying, according to my school’s rules, I needed two rotations before my sub-internship in my chosen specialty. I finalized plans for the first rotation as I was on the plane flying back to the place where my medical school is — it was otolaryngology (ENT).

I thoroughly enjoyed my two-week ENT rotation. After weeks and weeks of being stuck at home with nowhere to go, the physicality of surgery and the brutal hours were exactly what I needed. Just being able to go to the hospital every day made me so happy and grateful.

One day, I was in the outpatient surgery building helping with a tympanoplasty (eardrum replacement), a typically very short and safe surgery. The patient was in his 40s and had pituitary stenosis— his pituitary gland, a major gland in the brain that releases several important hormones, didn’t work. This meant that he had to take several synthetic hormones per day just to keep going. One of those hormones was cortisol, which, among other things, helps keep the blood pressure from getting too low. Accordingly, he was given a fairly large dose of hydrocortisone (synthetic cortisol) before the surgery to make sure this didn’t happen. 

As usual, the patient was sedated, intubated, marked and draped. The timeout was given and the operation started. As I watched on a screen, the attending otolaryngologist walked the resident through the surgery. Everything was peaceful…until it was not.

All of a sudden the anesthesiologist popped up from behind the curtain. “His blood pressure is dropping,” she said with alarm. “I’ve given him about four pressers, and it’s still not going back up. You’re going to have to finish the surgery quickly!”

All of a sudden the OR turned into a flurry of hurry. As the attending otolaryngologist finished the surgery in 30 minutes, the anesthesiologist gave more pressures and eventually gave him more hydrocortisone, which finally made his blood pressure go back up. In time, the surgery finished, the patient woke up, and he went home the same day as if nothing had happened.

I was in awe. I knew that without the anesthesiologist, the patient would have died — not because of pain, but because of a medical problem that only she out of everyone could see coming.

That experience stayed with me as I went for my next rotation. On my mother’s advice, I signed up for both physical medicine and rehabilitation (PM&R) and anesthesia for that month, hoping one of them would take me. Anesthesiology took me first.

I was somewhat familiar with the field at this point in time. Before medical school, as a fresh college graduate, I had done some shadowing in anesthesiology, and I had worked on a quality improvement project in a chronic pain clinic. Despite this, I had never considered anesthesiology as a possible specialty — probably because my shadowing had been done before I learned any of the material in medical school.

I came to my rotation not knowing what to expect. To my surprise, I ended up really, really liking the rotation! I really came to admire the way anesthesiologists think. Surgeons are apparently the bosses of the OR, but anesthesiologists take care of the patient’s breathing, circulation, positioning, pain level and so much more, often at the exact same time, all in the high-energy environment of the OR. It was incredible to be at the intersection of thinking and doing things — pushing medications, putting in IVs and central lines, taking arterial blood gases, intubating and extubating. I had enjoyed surgery a lot but I found it very physically tiring; conversely, I found that internal medicine didn’t have enough physicality to satisfy me. Anesthesiology was the perfect mix of them both. I really looked forward to coming to work every day and I was actually sad when the rotation was over.

My faculty advisors for my other specialty had told me to double apply over a year before, but that entire time I hadn’t found another specialty that I liked. One day, two months after my anesthesia rotation, the thought of double applying came to my head again, giving me agony. I prayed about it and talked to my brother and went to sleep. The next day, the thought came to me — “why not anesthesia?”

Immediately I talked to my parents about it. My dad, who is an anesthesiologist himself, was absolutely overjoyed!

To this day, I cannot thank the anesthesiology department at my school enough. With seven weeks to go, I was able to get two recommendation letters from faculty. For my third letter I used a research letter from a preventive medicine doctor who I worked with on several projects spanning multiple specialties. I already had my Step 1 and 2 scores and my research from medical school. I had my anesthesiology research from before medical school and I made sure to put that down in my application. And since I actually really like anesthesiology, my personal statement was easy to write!

Because I had a lot of research for my other specialty, I got asked often why I didn’t do that specialty during interviews. When I got that question, I usually answered with why I chose anesthesia; this answer was acceptable to everyone, while also not being a lie.

I chose anesthesia because, as I mentioned, I love the way anesthesiologists think, and I enjoy that they get to both think and do things. I also really like that the heart of the specialty is relieving pain and making things possible. Without anesthesia, surgery would be impossible not only due to pain but due to the complex medical issues involved with patients. And without proper pain medication, a lot of people, sadly, wouldn’t be able to live their lives.

I got better interviews than I was expecting for both specialties that I applied to. Admittedly, till the very end I thought I was going to match in to the other specialty. Lo and behold, Match Day hit…and anesthesia called me home.

I was expecting to write a different blogpost for Match Day, but God writes the best stories. You can catch me behind the curtain in Wisconsin starting this summer! 

(Or actually next summer, since anesthesiology does a medicine intern year. Sigh…)