Ventura Interview...

To my faithful friends and family... I've recently finished my interviews for the family medicine residency, with my last one at the program in the Ventura County Medical Center. This is a wonderful program! I am very delighted to have spent some time there and also to be interviewed there. This program is the OLDEST program in CA and possibly the oldest program of family medicine specialty in the country. The program of 'General Practice' started in 1928, and when Family Medicine became a specialty, it was the first to start in CA in 1969. This program is also the largest family medicine program with 14 candidates in each class. Why did I chose this program to interview among other programs? Well, I wanted a 'broad spectrum' training. From caring for pregnant women to deliverying their babies to taking care of both mom and baby and the family. I think this is how medicine should be, and it was the way medicine was done for thousands of years.

With our current healthcare situation of specialty heavy care, I think the ability to provide continuity of care has diminished. Why would anyone want to go to gazillion different specialists for care, with everyone of them just focusing on a part of the whole body and no one tracking how the entire person is doing? I think this is where Family Doctors are important. However, with our current system, family doctors do not get reimbursed very well compared to specialist... hence, the reason why majority of medical school graduates are going into specialties. Unless there are ways to standardize the payments, it is almost not financially feasible for family physicians to pay off our immense student-loans compared to specialists.

However, with much evaluation and temptation, I've realized that being a doctor is about taking care of people, and being a patient advocate. It is about being a resource for patients. It is about seeing what the patients and their communities need before they see it. It is about helping people to being able to adapt to their ever changing environment. We, as physicians, hold tremendous responsibility, and were given the unique opportunity to make our future together better than the past.

I can write like this for another hour, but I'll spare you. Let me just end with my experience at Ventura. In my opinion, I interviewed them as well as they interviewed me. I felt that I did my best in trying to find out where is going to be my home for at least the next 3 years. I've spent over 1 month of time working with their doctors and getting to know their residents. I am very impressed with people's credentials here. I am also impressed with how knowlegeable their family physicians are here. Being a county program and their association with UCLA, as the primary physicians in the hospital, their Family Doctors still run the ICU, still deliver babies, and do C-sections. Being a Trauma Center and a base for paramedics, their family medicine residents still run the trauma codes and follow patients into trauma surgeries with the trauma surgeons. They also have a wonderful clinic where they provide continuity of care for their patients, who they may have delivered their babies or taken care of them in the hospital. There, they also have an Osteopathic medicine clinic, where the D.O. residents can apply their art of OMT to their patients. Being a strong allopathic program linked with UCLA, this is a plus in my book.

So, overall, a program 1 mile from the surfs, sunny California with good weather year round, and a strong broad-spectrum program... I would recommend this program to anyone.

Recent Residency Interviews

So, I am nearing the last bit of my interview trail for a Family Medicine Residency Program. These last 2 days, I interviewed at 2 programs, Merced and Modesto. They are both broad spectrum family medicine training programs. Broad spectrum meaning that they train resident doctors to do everything from caring for kiddos to elderly, to doing obstetrics and gynecology, and to doing lots of office procedures.

Both of these programs are part of the UC Davis system of family practice residencies. They are both situated in the Central Valley of CA. So, the picture to your left is my summary of the 2 days while I was there. FOGGY! The fog was so thick that I couldn't see more than 50 yrd beyond me.

I've met an attending physicians at each place that really enlightened me with regards to the type of medicine I would like to practice. I'll tell you a little bit about why they are so encouraging. The first one is Dr. K. Dr. K is very passionate about his patients. He made it his career goal to change unhealthy behaviors of the patient. In fact, he says to me that if he does not educate and work with his patients to be healthier, then he has done nothing good for them. He is not satisfied just seeing patients on their visits. He would even go as far as telling them that they would have to find another doctor if they continue to be unwilling to work together toward a better health. He does it so lovingly, that I know he doesn't usually resort to threats. I am sure a large portion of his patients comply. Now, what are the unhealthy behavoirs that he works so hard to change? All these issues are called "Silent diseases," which if can be tightly managed will significantly reduce morbidity as we age and in effect directly increases our Quality of Life!

1. Smoking cessation
2. Diabetic disease management: tight control on the blood sugar
3. Hypertension disease management: tight control on the blood pressure
4. Asthma disease management: proper treatment combinations for the symptoms
5. Obesity management: help patients to reduce BMI as way to reduce long term morbidity

These are just a few things. I believe that if we as physicians could impact patient health in these areas, our world would literally be in a much healthier place. Dr. K relentlessly follow up with patients periodically and re-evaluates treatments and lab results to help his patients to keep tighter control. You see, these are diseases that 'slowly disables us WITHOUT US KNOWING!' That's why Dr. K thinks it is imperitive that we as physicians need to be come patient advocates in educating and helping patients.

Dr. B... He is an inspiring physicians who worked many years to make healthcare available to the underserved. His foresight is inspiring. His passion is to train physician leaders to impact health policy of the community in which they serve and eventually policies of this nation. Simple concepts of policies in community developement: where to put schools, health centers, grocery stores, hospitals, community centers, fast food chains, and other businesses has huge impact in the health of the community. Often, railroads split the wealth of the town. Down wind areas are usually poor. Poor areas have fewer grocery stores, lower literacy rates, higher teen pregnancy rates, fewer access to healthcare, higher crime rates... the disparity is tremendous. Mothers who need to buy groceries, bring children to doctors, work, and all that without a car cannot simply do everything if it takes hours to walk to one thing then hours to take a bus ride to another. So, as a way to serve the poor communities, Dr. B and his team worked together with the community organizers to build a community center that consisted of childcare, medical care, and is right in the shopping center of a major grocery store. A one stop shop! Dr. B and his residents also are required to do home visits, many times at a shack of the underserved family or in the park of the homeless person... these 'home' visits developes deeper appreciation for the underserved and also shows the community that 'we' care as physicians. We care and love those who are down and out to visit them where they are. Home visits also give physicians opportunity to talk to their patients are other pertinent social issues, environmental safety issues, disease exposure and risks, and other topics not typically addressed at the 'sterile' doctor's office.

I'm inspired to incorporate these passions into how I approach medicine!


Lake Yosemite in front of UC Merced; Motto of Modesto: water, wealth, contentment, health

So, the last bit of the blog, I want to tell you about the crazy drive I did last night after the interview... I hope I will not have to do this again. So, the interview finished at around 2pm in Modesto, I decided that I should just drive straight back to Sedona, AZ... That's a 11 hour drive! So, I started thinking, ok, I'm gonna take it one step at a time, may be rest in between. So, crazy me... I drove straight through with just one stop to fill up gas. Yup it took me 11 hours :) The last part of the drive was through the mountains in Jerome, AZ (used to be copper mining town). Have you ever seen Tokyo Drift? That was just like the movie. Imagine, at about 1am in the morning, skinny, slithering 2 lane mountain road, laced with 15MPH and 20MPH 'U' turns... The road was clean, washed by rain... kinda like a car commercial. Darkness all around, shear clift on both sides, guard rail on the right, you can see nothing other than the reflective lines on the road. You are it. No one to compete with you, no one to take a piece of the road. You are the road. The road and you are one. Man, it was so good, I was whipping around the turns at twice the prescribed speed, nearly drifting, sliding, skipping... pulling 'G's' All mine... all mine... I felt like driving a go-kart in the mountain... fresh air... a full hour of exhilaration!

Then, as soon as I got back home... I couldn't resist the sweetness of the pillow...

I love Alaska, the final frontier!

YOU CAN'T BEAT THESE PICTURES!!!

Can you believe it? I was in the ‘great last frontier,’ ALASKA! I went there from 10/15 - 10/19/08 for an interview at the Providence Hospital of Anchorage for the Alaska Family Medicine Residency Program (AKFMR).

My first impression: Alaska’s natural beauty is amazing, lots of raw beauty, people are calm and nice, dawn and dusk takes about 2 hours, cold (20F in morning for a guy from CA), simply beautiful!

About AKFMR: the only residency training program in AK serving all of the 660,000 people. Their mission is to train family physicians to serve in rural Alaska. So, that makes a pretty hard core training program.

The first night I got there, I stayed with a first year resident and his roommate, The Accountant. As an introduction to the homegrown subsistence, they cooked me some genuine caribou brats! It was delicious, slightly 'gamey' (as in it tasted like wild animal), but very good! We sat around the table and talked about Alaska, and about how they are both avid fisherman and hunters. They hunt everything that God placed on this green Earth. But, they have respect for environment and the natural cycle, so, they don't just hunt for fun... Alaskans hunt to stock up their freezers so they would have food for the rest of the frozen year to survive the harsh winter. They also fish salmons and freeze them so they have fish for the rest of the year. They plant vegetables and harvest them. They make all their own meals. And… they exercise no matter its windy, snowy, icy, or when it is below zero!

Halibut Sandwish at Seward; Cajun blackened salmon

The second day I drove down to Seward in the Kenai peninsula. I drove along the ocean and took pictures of mountains reflections, bald eagles, beaver dams, glaciers, icebergs, swamps... I also went through the cool 2.5 mile tunnel in Portage to go to the sleepy sea town of Whittier. Then, I visited the wild life preserve at Girdwood. (I was surprised at how small the musk-oxs are!) Then, I went and toured around the town of Seward... I also ate a very delicious halibut sandwich at a little deli in town. That night, The Accountant taught me how to make 'Cajun blacken' silver-salmon that he caught earlier in the year. It was delicious... um, um, um... you have to be there.

The tunnel from Portage Glacier to Whittier

Going to the Kenai; Bald eagle sitting on the branches!

The next day, Friday, it was my scheduled interview at the hospital. I got there at 7:30 am and the day was started by meeting new people, staff, residents, and the program director. We were presented with all sorts of information about the program and all the in's and out's. We were also taken on a detailed tour of the hospital facility. Then comes lunch... then interviews. The hospital is brand new and beautiful with all new equipments. The interview was very good, had good conversations with all my three interviewers. That night, the residents threw us a welcome party at the house.

The day after, I drove up to Talkeetna, where it is called "Doorway to Denali" and "Home of the bush pilots." It also is a town pretty much like the town in the TV show, Northern Exposure. Here you can actually see Mt. McKinnley, which is the tallest mountain in North America, towering over 20,000 feet!

I am very pleasantly surprised by the natural beauty of the State of Alaska, its people (or the lack of people), and with the residency program. I will return!