Stages: Dominique

UPDATE: Dr. Cross is no longer a student, but a graduate and doctor starting residency at her top choice this July. Many congratulations to her!


We start out Season 2 in discussion with Dominque during MATCH week 2021. We talk about her journey to becoming a doctor, the challenge of perfectionism, and the match system. 

Our stages series will include discussions with medical professionals at various stages of their careers. 

Follow Dominique @DivaDrCross

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Transcript

Victoria (00:00:06):

Welcome to night shift delirium, a podcast about junior doctors and the world that surrounds them. I'm your host Victoria, a junior doctor based in England. And today is the first official episode of season two. We're starting off season two with our stages series. We're starting season two with Dominique, who is an M4 or a fourth year medical student. And we're speaking to her during her match week. This is a great episode, and I hope you enjoy it. Welcome to our shift. Y'all

Victoria (00:00:49):

Welcome to night shift delirium. Today. We are chatting with Dominique, as a part of our season two stages series. The stage of series is looking at doctors and premeds and people at different stages in their career. Dominique is in a very, very exciting stage right now, literally this week is probably the most exciting. So before we get there, tell us a little bit about yourself. Sure. 

Dominique: So first of all, Vicky, thank you so, so much for having me on. Um, but again, my name is Dominique cross. Uh, I am a fourth year medical student at the Philadelphia college of osteopathic medicine in Philadelphia, Pennsylvania, and yes, super excited because I just matched this week. So we will find out where on this probably Friday. So yeah, very, very, very excited about it. Let's see. I am not your average medical students and I'm sure we'll get into that.

Dominique (00:01:54):

As part of this conversation prior to medical school, I actually had a career in research, everything from bench to bedside. So I did wet lab research. At one point I eventually moved into clinical research. Then I got my master's in public health and wound up going back into research prior to going to medical school. So I'm very familiar with things on the research side and now moving into the clinical side, which I think well-informed my careers. So let's see, uh, I'm a Raven claw and in my spare time, I like to sing. I like to journal and as much as I hate going to the gym, I do it because I have to. So that's that on that, um, that is amazing. I mean, I obviously know that you have had a nontraditional journey as have I. 

Victoria:

I think one thing that I really like about this podcast is that we really highlight a lot of voices and a lot of stories that are not the like typical went to pre-med, you know, an X boom, boom, boom became a doctor eight years or whatever for four later after undergrad.

Victoria (00:03:01):

So I really love that in yes, yes, yes. There's a lot to get into, I guess. Well, first before we get into that, we'll just say, give a brief explanation of match week for people in the UK and other countries that listen, that don't know what match me is. 

Dominique:

Sure. So, um, in the medical school system, within the United States, we know that we do four years of undergraduate education, um, in which you receive a bachelor's degree. And then you go on some medical school where you can, uh, where you get your degree, either the MD degree or the DO degree, which I am getting. And as a fourth year student, we do match week, which is I'm sorry, let me back up where, uh, after medical school, we then complete a residency, which is our training period. It's almost like on the job training, if you will.

Dominque (00:03:53):

So as a fourth year medical student, you apply to residency and it's almost like applying to school again, except you're applying for jobs. It's sort of a cross between, um, you apply to a number of different programs in your chosen specialty or teas of choice, and then said, programs. These hospital systems will choose to interview you. And at the same time you are interviewing those programs to see if they are the right fit for you. At the end of the interview season, which runs from, for us this year was October through February. You will then as a student rank all of the programs with which you interviewed or with whom you interviewed in the order in which you would want to work there, the programs then in turn rank the medical students that they interview in the order in which they would like them to come to that program, these lists go into a computer magic happens.

Dominique (00:04:55):

And then this thing called the match is, is, um, is established. And essentially it works out the decisions between the students and the programs to see which ones are the best fit for the program. And for the student, it does represent a binding contract. So if you do match, if I, as a student match, um, on March 15th, which was a Monday, I found out that I matched somewhere and then this coming Friday, I will actually find out where I benched. So it's a binding contract. So wherever on Friday I find out I will be, I am contractually obligated to go there. And it's a really big thing in medical school as a fourth year, it's almost bigger than graduation even. And yeah, so it's, it's a really fun time for many fourth years across the country right now. 

Victoria: 

Yes, yes, yes. I think it's, it's really interesting obviously being sort of understanding the American system and going through the UK system.

Victoria (00:05:57):

So right now I've finished my first year and I'm in my second year now of what we call foundation training. And from here, the next step is to apply into your specialty training. So whatever it is that you're applying into it is different. There is an application process to do the foundation bit. Um, but this one is where like you have an exam, but you have to take the interview for where I'm applying into is literally 15 minutes. Half of it is clinical. The other half of it is, um, so like giving you different scenarios when you have to, they judge you on your answers. Then the other half is like selling your entire life story in six minutes, which is hard when you've done a lot of different things by both you and I. Absolutely. Absolutely. And then from there you rank, so you're supposed to get some sort of numerical score, which gives you a rank of all of the applicants in the whole country.

Victoria (00:06:57):

And then you rank your, your jobs are like the hospitals that you work at and you'll be there for, for my program at seven years. So there, yeah. Training here is exponentially longer, but yeah, so you're, you're not interviewing actually with the hospital or anything. You're just interviewing with leaders, I guess we can say, or attendings in this specific field. And then, um, they're the ones who assess you. They're not really asking you about like, if you like, you know, Philly, like you like Wiz or what, you know, whatever, it's not like really specific to the area. And then at the end of the process, when they tally everything up, whoever is number one gets whatever their number one choice was. Whoever's number two gets whatever their number two choice was. And like, let's say your number, if I'm number 200 looking at my list, if the first, you know, 10, um, jobs that I want are taken because maybe, uh, I don't know, Cambridge has four positions available if four people have already selected that, but I'm automatically off.

Victoria (00:08:07):

Even if say they're doing a study that I was involved in or whatever. So it's very different. I don't know. I think there's pros and cons to both, but yeah, so it's, it's nice, you know, seeing everyone going through the match stuff now, because that's, what's familiar to me, that's what I have known since ages ago and this UK self I'm literally figuring out as I go along, which most people are doing when they're calling it's medicine. Anyway. So yeah, what's interesting though, is that it is there. 

Dominique:

I do hear a little bit of similarity to the match in, in certain ways. Um, I think that in the UK system, knowing that each applicant is ranked and where you fall on that ranking determines where you go, I don't like that. And I'm glad, I'm glad I say so because I'd be in bad shape. Okay. Let's keep it real.

Dominique  (00:09:00):

But in a way, which is similar, is that in the U S match process, um, it's, it works as such where there are a certain number of spots in each program, right? And every applicant, um, can rank as many programs that they interviewed. So, um, but the difference is, for example, if I write program a as number one and program a has four spots, right? As long as program a ranks me at one, two, three or four, I'm going to program a, now let's say I rent program. I ranked programs a and B program B ranked me number one, but program a ranked me number four, if I ranked program a first, then the algorithm takes my preference into account. And so because program a ranked four has four spots and I was number four. I will still go to program a because that's my preference.

Dominique (00:10:04):

So in that way, I know a lot of people don't believe it, but the match is actually in favor of the applicant. And, uh, it is really hard to believe when you're in the midst of it. And you're like, oh my God, the next three to seven years of my life is based on this. But it really does work in the applicant's favor at the end. 

Victoria:

Yeah, absolutely. I think that is really important. I think, I mean, seeing how I don't have to rank every country, I mean every job in the country, but I, hypothetically I could be ending up in Scotland for the next seven years. Never been there, don't know anything about any of the hospitals there, you know? Um, it's really luck of the draw obviously. Well, now the other thing that can happen is there's rounds of this. So first round and second round, I think if you get, let's say I get a spot in, um, I don't know, York, whatever, some random city here, I get a slot in New York, but I don't want to go there.

Victoria (00:11:06):

However, I'm not, I'm not willing to give up my posting this year. I can hold it for the second round because a lot of people are going to get allocated somewhere that they don't want to. People have families, you know, plus if you're like a London girl, you know, you definitely don't want to end up in the boonies somewhere. So they might say, you know what, I'm not going to take that spot, but maybe I wanted that position. And so I'm able to hold my spot in the event that someone gives up something else higher up on my list. And the second round, if not, I can either go to the one that I wanted that was on my list or keep my same spot. Now that is to taking a year out of training, which is very common here. Very normal because training is so long. So they'll do a year of locuming R or moonlighting and making a lot of money.

Victoria  (00:12:03):

It is very, very common, very, very in all stages. Well, cause it's a long thing. I mean, it would be difficult to find people to commit to essentially like for my specialties that I'm applying into nine years of on calls of, you know, that's quite a lot. So yeah. People take out time all the time either to get money, to get married, to have kids to vacation for a year. So that is a really nice, I think option because Lord knows lifestyle is not easy. 

Dominique:

Okay. Yeah. So that's, that's really cool though. That's really cool. So it's, trade-offs, you know, like you have a longer training period, but it seems like yours is more flexible than ours is here in the US our training is shorter, but it's not quite as flexible.

Victoria:

So let's get into the story. Let's get into how we got to this day, um, with, you know, when did you know you wanted to be a doctor?

Dominique (00:13:07):

Um, so first of all, let me just back this up by saying, listening to your story. Um, I did not realize how much we had in common. It was common. So I was like, I'm embarrassed to think that I didn't even know that, but anyway, so I've known since I was a very little girl that I wanted to be a doctor. My mother still remembers, you know, I'd be four or five years old when I had the doctor's kit, you know, all the things, right. But I remember becoming seriously, seriously interested in medicine when I was in, I believe it was the seventh or eighth grade. There was a little girl who I went to church with, who was diagnosed and subsequently passed away of cancer. And I used to go and sit with her while she was in the hospital, bring her toys and, you know, just sit and talk to her and everything like that.

Dominique (00:14:05):

And I would always watch the doctors come in and talk to her. And sometimes she would be in a mood where she didn't want to talk and I would have to talk for her and, you know, just early advocacy, right. 13 years old or early advocacy. And I remember when she died, I remember saying I'm going to be a doctor like that today. I'm going to be a doctor. So, um, w all the way through high school, knowing I was going to be a doctor wound up at the illustrious Xavier university of Louisiana team HBCU, of course. Um, and even going through Xavier, um, still wanted to be a doctor, but I started to become a little bit disillusioned. And I think if I'm very honest with you with myself, I became a bit disillusioned because I had to work. And in my previous academic career, all through high school and whatnot, it was, it was almost natural to me.

Dominique (00:15:05):

It was not that I wouldn't put in the work, like I would do my assignments and things like that. But in order for me to keep up at the same level, I had to work a lot harder. And I wasn't used to that. Right. I was so used to, I'm going to do the work, I'm going to get my A's and that's that, that ain't the way college worked. And it wasn't because I didn't, uh, I didn't have the capacity to do it. I just, I rest on my laurels and I did it for a little too much. Now I didn't do poorly in college. Let's be clear, but I certainly could have done better if we just talk in real, you know, so became a little disillusioned. And then hurricane Katrina actually hit my senior year of college. It was the first semester of my senior year.

Dominique (00:15:52):

And when that happened, my cause I think I missed the fact, my family is from the new Orleans area. So we had relocated to Houston for several months. And by comparison, we really came out of that situation pretty well. We were able to get back into our home that December. And by then I was exhausted. I was in a place, you know, when I was living in Houston, we were living in a home. We had 16 people living in our house. I, when I realized we weren't coming back to new Orleans, I immediately went and enrolled in school at the university of Houston downtown. I immediately went and found myself a job in a research lab that one of the labs that I worked in the summer previous, and it was a two hour commute each way to work into school because I didn't have a vehicle and I'm living in a house with all these people.

Dominique (00:16:51):

I'm just really trying to fend for myself because my parents are worried about my siblings, trying to get them together. And we were okay, let me be clear. But I was just very tired. I did it, but I was very tired. And I remember going to my mom and saying, I need to put off medical school, or I'm going to put off medical school because I'm exhausted. And as much as I thought that she was going to say she was going to like, lighten me up for it. She didn't, she said, I'm not surprised at all. And I'm honestly glad you did. Okay. Well, that didn't go the way I expected, but okay. So wound up going back to Xavier graduating. And I took a job back in Houston at the same lab I was working in during that Katrina semester. I got like, um, during some, doing some wet lab research, absolutely hated it.

Dominique (00:17:46):

Not only that, but I was terrible at it. So I wound up moving into clinical research and I really found my niche. I took a job as a research compliance and operations coordinator, and I really began to learn the process of clinical trials, drug development, device development, that whole bit. And I got to work on some really, really great projects. Um, if anyone has ever heard of the HeartMate two, it's a ventricular assist device, I, um, actually helped audit that project and, and things like that. So worked on some really, really great projects while I was there. And I really liked the work. And next thing I know, one year had turned into five years. So I decided to apply to medical school. This was my second time actually applying and I did not get in. Um, however, I was offered the opportunity to receive my MPH on my master's in public health, from Drexel university in Philadelphia.

Dominique (00:18:48):

At the same time, my cousin was moving to Philadelphia for law school. So it worked out just perfectly. And I wound up going to Philly getting my MPH, and then I wound up getting back into clinical research at another hospital, really, really great hospital in Philly. Again, worked on some really great projects. Um, one of which my, probably my proudest professional moment is that I actually worked on the clinical trial for the first FDA approved gene therapy. So that was, yeah, that's probably my proudest professional moment ever. It was such an amazing project with amazing people. And I'm just so thrilled and so blessed and privileged to have been able to have been a part of that. Um, and then next thing you know, here's another three years have gone by, I applied, I applied to med school again, didn't get in mind. You I've taken the MCAT, maybe four times, don't even remember.

Dominique (00:19:52):

No, it was three times at that point. So, um, and score just wasn't moving applications, just weren't moving. It just, wasn't going by way. So I want to move into a different research project, same hospital, another amazing project. And I had taken the MCAT again, or I had applied for the MCAT again to sit for it, and my grandmother passed away. Um, and one thing about me and my grandmother, that was, that was the homie. That was my home girl. That was that. And it was two things my grandmother wanted for me. She wanted to see me in a white coat and she wanted to see me in a white dress. So when I started, I'm sorry. So my mcat actually was postponed because I was supposed to take it the day of her funeral. So I wound up moving to test back. And when I retook the test for the fifth time at this point, my score finally improved and it was the highest score I had ever gotten.

Dominique (00:20:50):

Okay. You can’t tell me my grandmother wasn't in on that. So, you know, again, I'm working on this great project, I'm still moving around, still doing all the things, all the good phase and having a really good time and really building my career. But I remember being at an event for work and in the middle of the event, I just sort of stopped them, blanked out. And I said to myself, I can't do this for the rest of my life. I have to try again. I'm not going to be happy doing this for the rest of my life. I have to try it again. And I remember leaving the event, going, sitting in my car balling because I'm just like, I can't give this up. This is not my dream as I'm doing well in it, I'm doing phenomenally in it. I'm working with and for great people, I'm helping people, all the stuff that, you know, we talk about as physicians and love to do, but I wasn't satisfied.

Dominique (00:21:56):

And I knew something spiritual happened in that moment. And I said, I got to do it again. So I, I applied again and this time I was totally quiet. I said nothing to no one, even my parents until I got an interview. And even then I only told a select few people and I got one interview and I got one acceptance. And here I am.

Victoria:

Love that. Love, that love, that love that so much. There's so much in there. You know, there is so much in there, but I think probably what stands out the most is the spiritual side of it. You know, I really do believe in divine intervention and divine guidance and how things just don't feel, right. Unless you're working in your purpose and in your calling. And that's exactly what you're doing. And like, once you start listening to your calling and your, you know, what you're supposed to be doing, things work out, you know, like so much stress so much.

Victoria (00:23:10):

I mean, I fully understand this, you know, while I really liked this research thing, I'm enjoying myself, I'm learning a lot. I'm contributing to the world of science and people's lives, but there's something very different when you're looking at the research side of it and the clinical side, you know, like I always say very, I always say very selfishly that I went back to medicine because I wanted more instant and immediate gratification that I could see. And it's selfish. It's not for like, you know, some altruistic thing I want, feel good about what I'm doing. Not that you don't feel that in research, but you know, it's just..

Dominque:

 There's something to be said when you see it working. Yeah. There's something to be said for that. 

Victoria:

Absolutely. Yeah, for sure. That is so, so good. Um, I want to ask, if you, like, now you are in this position where …you know, you've made it!  You have, you have…

Victoria (00:24:13):

I mean, listen, let me tell you when I was in, I think I was, you know, in med school and you listen to my story. So you know that like my partner passed away and all this stuff, and I was just so lost in grief. And I spent some time with my grandmother and she was like, oh, you're a doctor. And I was like, oh Lord, I'm drowning. Like I am not a doctor yet. And she's like, it's just a piece of paper. Like you are walking in your calling and your purpose. It's just a piece of paper. And I was like, call me Dr. K. But honestly, listen, it's true. You have made it like, you've gone through so many hurdles that at this point it's getting through, you know, the next few years, which will be rough, but you will get through it. You've done hard, you know, more difficult things. So you’re there, you’ve made it.

Victoria (00:25:01):

What what advice would you give yourself? To, I don't know, Dominique at 21, knowing what you know now, what advice would you give yourself? 

Dominique:

Ooh, Lord have mercy, man. One is something I wish I would've learned earlier, but, um, there's something that I teach kids quite often. And I say to them, strive for excellence, not for perfection growing up. I was, and, and I'm still working on it, but I am a recovering perfection, very, very hard on myself. Um, and it's so interesting because I just saw a meme recently that said something to the effect of if you diminish yourself so that people can't, I know I'm not quoting it. Right. But so that people can't criticize you because you've done it yourself. That's a trauma response. Right. And I felt so seen in that because there are so many things that I chose not to do, or I delayed because I was afraid of failure or because it did not look perfect.

Dominique (00:26:26):

And what I, what I tell kids now is you need to strive for excellence, not for perfection, because number one, take the pressure off yourself, right? We always strive to do our best, but we are not perfect and never will be. We are not God. We will never be there. I said, but more importantly than even vet is when you consider yourself or view yourself as perfect, then you have nothing more to learn. And when you have nothing to learn, why are, why are you even here? Your mind can't even be open to anything else if you're not willing to learn something new. So when you say you're perfect, or when you act as if things are perfect, then it's like, well, nothing needs to change. Well, what are you open to learning? What are you open to doing? So I would teach myself that earlier on, that's probably the biggest piece of advice that I would give myself.

Victoria (00:27:35):

It’s like you are literally speaking to my soul, to my spirit. Definitely, definitely, definitely on this spirit of perfectionism, but even on a deeper level where you said, um, if you have nothing else to learn, then what are you like, what are you even doing? And this is, this is a little dark, but I'm still going to share it. Um, you know, when, when Christopher passed away, I was really, you know, like lost, you know, and I just couldn't understand. There were, there were moments where I just couldn't understand what I was doing. Like, why am I even here? Why was I the one that, you know, remained? You know? And I really had to like have a real, come to Jesus moment and recognize that, you know, in life and in death, when your purpose, when you finished your purpose, then you go, you go home, home to the Father, you know, like, and until that happens, you are here.

Victoria (00:28:39):

So there's a lot to learn. There's a lot to do. Like I'm still walking in my purpose. And until that happens, you know, I'm here. So I'm not going to be perfect in everything. I'm not going to have everything together all the time, but that's all part of the journey in the end, you know? So that really, really resonates with me. And I think it's so, so important, especially for the non-traditional person, because I think a lot of times we do delay because we're like, oh, well, I don't know. And I could just do this because usually you're like, when you have that kind of stuff, you're okay. And other things, you know, like it's, you excel in a lot of things. And so it's easy to sort of just be in your comfort zone, but you really have to challenge yourself. And I think that's really important for any young budding scientist or budding Doctor.

Victoria (00:29:32):

Like you have to challenge yourself. You cannot only see, I mean, even in whatever you specialize in, you will become an expert in whatever field is, but things are changing. There are pulmonologists who were floored with COVID, you know, understand because it's a new thing. So like, it's just so important on this. They always tell us that it's lifelong learning and we roll our eyes. We realize we have to continue taking exams until we die. It's true. I mean, it's just so, so, so, so, so, so, so important. 

Dominique:

Um, one other thing that I have really come to learn is, you know, we always say that nothing, nothing worth having comes easy. You know what I mean? Um, and for, you know, chronic for chronic overachievers, like you and I, for example, we are so used to things just coming easy to us. So we want to do what we're good at because it's easy and we're good at it.

Dominique (00:30:38):

Right. Um, and then, you know, social media culture. Yes. Yeah. I'm going to say this, but social media culture likes to ascribe to anything that's for me, it's just going to come to me and it's all very easy. And if it doesn't and I say like, honestly, because one thing about me is bad as smart and actually put this on one of my Instagram posts, med school, humbled, the hell out of me, literally and figuratively, you know, and, and this is not just school itself because there were issues with school itself that I had. And then there were some issues outside of school that I could not control, you know? And it started literally Vicky from the day I got my acceptance letter started going down. Right. But I was reminded of one of my favorite Bible verses, which is 1 Corinthians 16:9

Dominique (00:31:48):

And it says for a great and effective door is open unto you. And there are many adversaries. The key, the key word in that verse for me is AND. Yes. You have a great door. Yes. You have a great opportunity. The opportunity is there, there are also adversaries. Nobody said, you know, what is the old song said? Nobody told me the world, the role was going to be easy. It's not right. There are going to be adversaries. And so I, I just do not ascribe to that. Anything that's for me will come easily to me. I absolutely reject the absolutely ascribe it. And I do encourage other people to reject it because some things are going to come easy, but then there are some things that are not, and we have to work.

Victoria:

 absolutely, absolutely. We are, listen, we are for the vibe and the work.

Victoria (00:32:44):

Okay. That part because when you had your moments where you were crying in your car, the vibe we'll call it was divine intervention. The emotional reaction was recognizing what your purpose was and what you to do as well as realizing this was going to be a task. This was not going to be something easily accomplished, you know, and you did it. And yeah, I mean, I think that's so, so important because people tend to think, you know, when you go through medical school and people are like, oh, you weren't tired, blah, blah, blah. But in their minds, a lot of times it's like, oh, well it wasn't really that hard. She's smart. And it's like, Hey, um, smart intelligence really doesn't have to do with a lot of the passing exams and working extra hours. Like the physical toll that medicine takes on you is so underestimated. Like people don't realize physically you're doing a lot, um, emotionally you're doing a lot. And that often comes out physically as well. Like it's just a really exhausting, um, profession that people sort of dismiss it as like, oh, they're smart. So they did this, but like, there's so much more that goes into it.

Victoria (00:34:08):

Okay. So you're going on a trip and there are three objects that you can take when your trip with you, an ECG or an E K G your white coat, and a bag of normal say line, you're going on a trip that forces you to get rid of one thing. So what's the first item that you're going to get rid of. And what's the second item that you're going to get rid of the third item that you have, that you chose to keep represents the most important thing to you in your career. The ECG represents an analytical mind. You value knowledge, and you value items that can inform your opinion. Your white coat is your prestige, your pride, your white coat show status, a bag of normal say, line is practical. Hey, you never know when you might need to fluid challenge yourself. Plus you're going on a journey who knows how long that's going to be. You value the practicalities of life, things that are sometimes simple, but overlooked and very important. So what does your objects tell you about yourself? Is it true? Yeah, I made this game up. So none of this might actually be true.

Victoria (00:35:34):

So did you have one specialty you applied into this year or were there multiple? 

Dominique:

So I actually applied to two specialties. Um, but they're very similar, so similar in some ways. So I applied for a combined internal medicine and pediatrics specialty, and then I also applied for regular straight what we call categorical internal medicine. I really, I really want, if I'm being honest, I really want med paeds. I really want the combination. Um, I discovered med paeds right before I entered medical school. Um, because you know, when you get into medical school, you start looking up any and all things, medical school, right. So I came across it in sort of my I'm so excited about medical school journey, um, that, oh, let me look into this. Oh, this seems interesting. It's both adults, it's kids. Um, it opens me up to do fellowships in either specialty.

Dominique (00:36:34):

Um, it's a little bit different for family medicine in that, uh, number one, when I complete that program, I would be both a full internist and pediatrician, as opposed to family medicine, where you may be more kid heavy, more adult heavy, that sort of thing. Also, I find that I like inpatient medicine more, at least at this point in my life I do. And, um, family medicine tends to lend itself more to outpatient medicine. So I preferred med peds in that regard. Additionally, family medicine training requires some surgery and some OB GYN, which I wanted no parts of. And therefore I felt like med paeds was, was just kind of a good fit for me. I also apply however, categorical internal medicine, um, because my, because there are only 77 medpeds programs it is a little bit more competitive than some of the other specialties.

Dominique (00:37:35):

Um, and you know, I have to be realistic about things. So I did apply for internal medicine as well. And I also loved the ICU. I feel like I am most at home in the ICU. If I were to do a fellowship, it will probably be [pulmonary critical care], and I wanted to leave that option on the table. So that's the reason why I chose to categorical internal medicine, as opposed to categorical pediatrics for the second specialty. Um, and that's where we are. However, I do feel like I would miss the kids a lot if I didn't get med Peds or if I don't get med paeds, I won't know. And so Friday I'm going to medicine, I'm going to go through a slight mourning period because I'm going to miss my kids. Um, so we'll see. 

Victoria:

Very interesting. Um, well, I'll just clarify for the non US people.

Victoris (00:38:24):

So intensive care is a separate specialty here. It's not necessarily like a fellowship, but you do, and it's not often pulmonary related really at all. So yeah, so it's a different, it's a slightly different thing. You just, basically, you do your foundation training, you do this core training that they it's like three extra years of rotating and then you would apply into intensive care. Um, and that, I think it's like, I don't know, maybe four or five more years, maybe six. I don't know. It's long.

Dominique:

I’m clutching my imaginary pearls. 

Victoria:

Yeah, they take like a full decade. Okay. But, um, yeah, that is, that is really interesting. And I actually didn't really think about the difference between, uh, internal and peds as well versus family medicine, because I'm someone who's more inclined towards OB GYN and family medicine. So when you were saying, I was like, oh right, okay. That's good actually, hospital. That sounds good to me. And then I was like, oh wait. Nope, but the whole surgery and OB GYN bit. Nope, Nope.

Dominique  (00:39:39):

You know, I would say, listen, there are two specialties that I said, walking into medical school, I wanted no parts of... One was psych and one was OB and you know what? No.

Victoria:

 I said like, because well, what was our reproductive health unit started the first day showing like a prolapsed vagina, just a picture, which I found to be quite traumatic. Can we start with, I don't know, a photo of a basic anatomy? OGBYN, well outside of America, is a very male dominated specialty. So the approach is different and we'll just leave it there. But that being said, going through, I was like going through my rotations third year, I was like, right, this is lit. I want to deliver some babies in some capacity, 

Dominique: 

I'm going to let you have that.

Dominique (00:40:42):

Pass them to me when, when they get out, let me tell you something. COVID took my OB rotation and I was absolutely okay with it. I was absolutely fine. I did a couple of afternoons in the OB GYN clinic because one thing I did want to be is a responsible student. I wanted to be comfortable doing a bimanual exam. I wanted to be comfortable doing that. I was not going into residency, not knowing how to properly examine the female body. So I did spend a couple of afternoons in the clinics to make sure that I can, um, you know, properly examine comfortably examine, um, you know, those of us with female bodies and, um, that were going into residency. I wouldn't be, you know, just so clammed up and then the patient clammed up and it's all bad. So, but yeah, as far as all of the other stuff, you can, keep it. I believe it's up to the likes of you.

Dominique (00:41:41):

Listen, I’ll see the kids when they get out. I got you. 

Victoria:

So, I mean, you mentioned COVID, how has it affected your med school training? And the application process is also so different. 

Dominique:

It is all very different. So I actually lost my last two rotations of third year due to COVID. Um, one of them was okay because it was radiology and OMT, which is two weeks each both of those can easily, well, not so much OMT. So I have to have training in that, but radiology, can you just tell people what that is because people, yes, no, absolutely. So, um, and if you don't mind, I'm going to back up just a little bit, just explain the difference between MD and DO. Cause I know there are some folks who don't really know. So in the U S medical training system, there are actually two medical degrees that are recognized nationwide.

Dominique (00:42:43):

One is the MD degree, which is the more traditional degree, the doctor of medicine. That's the one that most people know right. Then there is the doctor of osteopathic medicine degree, which is the same degree plus some change. And what I mean by that D.O.s, um, as a doctor of osteopathic medicine or a D.O., if you will, we do all of the same coursework, all of the same training that MDs would do that your regular doctor would do. However, in addition to that, we have to have some training in what is called osteopathic manipulative medicine or OMM. And essentially it is some training that focuses much more on the musculoskeletal system than anything. Um, and as sort of just like what I like to call an extra tool in our arsenal, if I can describe OMM, I would call it a cross between physical therapy, massage therapy, and even in some ways, a little bit of actually, no, I'm not even gonna say that.

Dominique (00:43:51):

I'm going to just say it's a cross between like physical therapy and massage therapy. So we do a lot of like muscle strengthening, um, some muscle loosening exercises we can do. Um, there are some techniques that are all manual using nothing, but our hands where we can, um, execute some techniques that theoretically would help some move, you know, help circulation and blood flow and lymphatic flow, things like that. Um, so it's just some extra training that we have in that now in practice, many dos don't really do OMM as much, many reasons, and that's a whole other episode, but, um, regardless both an MD and a DO you still have to take the same boards, exams, um, or equivalent boards exams, um, still three steps. You still have to do a residency. You still do the same four years of medical school. So if your doctor is an MD or a DO, just know that they are equivalent and they've had the same training.

Victoria (00:44:54):

Excellent. Excellent. Excellent. So you're, you're telling us that radiology, um, was canceled, correct? 

Dominique:

Yes. So radiology was online, um, which easy cause that was online, um, OMM was online, but it, that was actually a little bit of a different experience because if manual therapy you're literally using your hands, you’ve got to touch people, you know? Um, so while there are some things that we did online, you know, some course work that we completed, it is a little bit different because you don't quite have that hands on that you used to. And then as I just mentioned, um, I did not, I was not able to do an in-person OB GYN rotation because of COVID as well. So that was completed online. That was actually a really rigorous online rotation. Um, we, we had to work, we had to work hard.

Dominique (00:45:51):

Um, so, but to be honest for the OB GYN shelf exam at the end of the rotation, because we still had to take them, even though I didn't do that rotation in person, that was the exam that I scored the highest on all year. So it was so I'm like, okay, clearly I learned something on this rotation, right? It was a, but it was a really good rotation, even though it wasn't in person and it wasn't online. The moderators did a great job with that. And, um, I was able to do a few more, a couple more online rotations before I got back into the hospital. Um, back in, I think that was July. They allowed us to come back to the hospitals to do some rotations. However, what we called the audition season in the U S was very much affected. So when we are looking to apply for residency at the beginning of fourth year, many medical students will do what are called audition rotations, where the student will go to that hospital, where they are applying for residency and do a rotation there.

Dominique  (00:46:57):

So that those who are making decisions about interviews and stuff can see that student in action. And it's almost like a, a month long interview, if you will, because they can see, you know, how you work with the other residents, how you work with the attendings, how you work with patients, what your medical knowledge is like, and you know, how hard of a worker you are that whole bit. And it really allows the student to shine if they do well. But because of COVID, there were a lot of restrictions, um, because there just could not be a lot of movement, you know? So I actually was only able to do one audition rotation and it was in Pennsylvania. And the only reason was because I was in school in Pennsylvania. And so they were only taking Pennsylvania students. So I was very grateful to have it, but it was, it's just the nature of the COVID beast, if you will, it's nobody's fault, you know, people were just trying to stay safe.

Dominique (00:47:50):

And then of course there was limited PPE. So students were pulled off of rotations to save PPE in addition to not wanting to expose anybody for COVID that didn't need to be exposed to COVID. So, you know, all these things, all of these were things, right. Um, the interview season was also, it was different than usual, but it, excuse me, it did not feel different to us necessarily because we don't know what to do. We don't know the difference. Generally speaking, when fourth year students are applying for residency, if a program chooses to interview them, that student would travel to that program. Um, so I'm a student in Pennsylvania. If I'm applying to a program that happens to be a Delaware, I would go to Delaware for that interview. Um, and that way it allows the student to see the city, to see the hospitals, see how it is navigating, meet people, present themselves a different way.

Dominique (00:48:52):

A lot of times the programs like wine and dine the interviewee. So there's like a night, you know, a happy hour or dinner the night before, and it's super fun. Um, but that didn't happen this year. So all of our interviews were on zoom or video, some other video platform, um, as a result. And there were still some really cool things that were done. And, um, and you know, in the midst of it, for example, rather than like a dinner, the night before one program had like a paint and sip. And so they sent the supply for the applicant in advance of the event and it was really cute. Um, and they, and they also set some little trinkets, um, that are representative of the city. And I just, it really made a really great impression on me. I was like, whoever's idea. This was one the year, because that was lit, um, super fun.

Dominque (00:49:54):

And so the, and again, the interviews we're on, we're on a video platform usually though. But, um, the interesting thing is that I'll, you know, allow people to take more interviews than they normally would. A lot of people, you know, they may only go on eight to 10 interviews because they're limited by the travel expense. You know, if you've got to travel far, you've got to, you know, you got to pay for, you know, air care or gas or whatever you have to do. But by, by being able to take the interview in the privacy of your own home, you could take more interviews. And I think that happened in my opinion, I don't know, but I do think that happened. Um, and it just kinda is what it is.

Victoria:

 Yeah. I think it's really interesting as well, because I have some friends who went to my med school who are, you know, in another country.

Victoria (00:50:44):

And that definitely, definitely, I think, opened up a world of opportunities for different reasons. Like them getting rid of CS really helped a lot of international graduates and then having to deal with a flight last year. Well, yeah, not this past cycle, the cycle before people would have had to have flown from wherever they are in the world to go and see someone, which is very difficult for international students. And there's so much, you know, when we talk about this whole process, there's a lot of privilege that is afforded that we have to acknowledge, you know, like you have the money to handle it. I may take out loans and things. And I remember in med school, someone was like, well, now it's not a time to be cheap. And it's just like, it's not about being cheap. It's about standard of living. It's about cost of living, how much debt you're taking on.

Victoria (00:51:38):

If you, if you're not, if you don't have your family, you know, bankrolling you not bankroll, that's not the right word, but if you don't have your family supporting you financially, that is a massive thing to fly. You know, to California, for example, a flight to Cali from the east coast is like a smooth $500. And then having to deal if they don't offer a place for you to say, you know, there's a lot that goes into it. So I think that most likely, probably a lot of people did take more interviews, but also certain barriers have been lowered. And, you know, in, in a very, very important way, as you know, this has been a very wild year dealing with everything racial, but it's, you know, and in medicine we've seen it, you know? So I think these are important things that we should maybe consider keeping.

Victoria (00:52:32):

Although I understand the dynamic of, um, interacting with people, in person, seeing the hospital, seeing the area that you're going to work. And I can appreciate that. However, there's so many barriers that people don't even necessarily think about that. Now, hopefully they're a little bit more open to.

Dominique:

 I whole heartedly agree with you. Um, I think you hit the nail on the head when you mentioned the privilege right there, you know, it's a, it's an uncomfortable conversation because nobody wants to talk about privilege, right. You know, granted, let's be clear, you have a certain amount of privilege, but because of the fact that you're sitting in medical school let's start. Right. Absolutely. But that being said, it takes so much to get through and all of these extra things, all of these extra costs that come about as a result of medical school interviews are just at fourth year.

Dominique (00:53:37):

Let's not talk about all of the board prep, materials, all of the supplemental materials that require being paid for, you know, having to find somewhere to live, you know, your four years. And if you are like me and you attend a school that does not have its own hospital in which to rotate, then you may have to move around a lot. So either you've got to relocate or you've got a Jew, you've got to drive a lot. And even the little things just like gas, adding up and the wear and tear on your vehicle. And if you have one at all, cause I have friends who did not have one, you know, and they were literally running around Philly on buses and trains and that's a lie, you know? So I do appreciate the point that you're making, um, as it relates to having the video interviews and decreasing barriers, I think that is one way where we can sort of, even out that, that privilege, if you will.

Dominique (00:54:37):

Yes. There's something to be said for going in person. I know for me, I was slightly disappointed about not being able to visit in person simply because I just, I present better in person, you know? Um, you know, I'm on a, if I'm on an in-person interview, I'm dressed to the nines like hair perfect, you know, perfect. All of the things and I'm just on, and I know how to be on. Whereas on a video conference, I had to be a lot more conscious about being on like, no, this is still an interview. Don't get relaxed if you will. So, um, but your point is very well taken. Um, and I honestly agree with you. I think of all of the things where we could sort of cut some costs. This is certainly one of them. Yeah. Yeah. And even, I mean, I, I definitely see what you mean.

Victoria (00:55:32):

I fully agree. I mean, I'm definitely someone who is like on in person. I do my best in sort of virtual settings, but I know that I could do better person, but not that on the other side of it, I want to see where maybe I'm going to be living like absolutely look different online than they do in person and people equally, as you can be on, people can also be on, it can also sort of present something and then you see the way, you know, some people are making faces or nurses looking at somebody kind of funny. And you're like, you know, let me, let me take a pause, take a minute. You know? So I think, I think there is definitely a side of that that is really important. I don't know a way to make it equitable where you get to really see someone in person.

Victoria (00:56:20):

And then also, like, I think it would be difficult to say let's have a mixed model because probably people who kind of embrace person, aren't going to stand out more, you know? But anyway, it's just, it's interesting stuff. I mean, we're, we're being really faced with a lot of different challenges in terms of healthcare delivery. And also decision-making about who's going to be the providers due to COVID and I mean, it's worth conversations for sure. For sure. So what are you going to do when you find out where you're going on Friday? What's the first thing you're going to do? Are you, are you recording yourself? Are you having a party, a virtual, like what's the team? What's the setup. Oh, all. Okay. Let me, let me be quick. So first of all, I really was not going to do anything at first. I was just going to open it and, you know, have a good time and have a glass of champagne because there will be shared champagne.

Dominique (00:57:14):

Um, but I decided to do a semi small something. Um, mainly because my grandfather is 88, he's almost 89. And you know, I told him, I already told you guys about my grandmother. Um, but my grandfather is now in a space where he definitely will not make it to graduation because we can't fake it for feeling like, you know, his health condition is just too fragile to take him to Philly for graduation. So I wanted him to be a part of something. So I'm in new Orleans with my family right now. So I decided to do something because I wanted him to see that I, if he can't see me graduate, he would see that. So, you know, we got a few little decorations, we're getting some pedal fours, I've got the match balloons, you know, everything is black bowl because saying, come on Orleans.

Dominique (00:58:16):

Um, so it's really cute. And granted, this was supposed to be something super duper small. And then my mother and her friends got involved and now it's become a whole situation. I say, y'all, we are still in the middle of a global pandemic, like put that on the invitation.

Victoria:

 Okay. Will we be seeing, you know, the second lines? 

Dominique:

Okay. For the people that, when it comes to new Orleans and their second line, one thing that they all caught up, you know, um, because thrill, but no, no second. Now we gonna save that for graduation.

Dominique (00:59:03):

They lucky my family and I rented a car. They lucky called it as a thing. Cause my family was talking about rent, the party bus to come the field, doing that no more for the people that don't know. That's probably like a 15 hour drive, not a party bus playing bounce all the way up a, they have been discussing it since my first year. They're like, listen, I love it. At this point for everything that I have been through to get to this point. And my family has watched me go through all of this. I said, I'm not arguing with anybody. I'm going to let people do what they want to do. And honestly, Vicky. And I just said this to someone else. I have no idea why people are so kind to me when people are so kind to me, I have the most amazing village.

Victoria (01:00:01):

You are an amazing person. Like, let me tell the story ,for the people that don't know our story? But we are, we were initiated in the same chapter of Delta Sigma Theta. And let me tell ya, Dom, when, when we knew that Dominique was going to be around or someone heard she was around, you know, for black Greek life, there's a lot of deference. Lord knows a whole lot of deference. So Dominique was around or we knew she was going to be around. Or we heard about her being around. Everyone was like, all right. Y'all like, you gotta be on point. You gotta like, you know, and it was just like a known fact that you know what you have to just not be perfect, but you know, you need to have cross your T's dot your eyes. Make sure you look right. Make sure you know, your information, just be on point be what Dominique expects you to be.

Victoria (01:00:59):

And everyone was like a little scared, you know? But one thing about Dominique, you were so kind to all of us once you're like, okay, greet me. And they we’re like, we've passed that. But from that moment, the kindest person, so supporting so loving, like you would take us out for food pay for everyone's meals at Chili's or wherever, whatever chili deal. So welcoming. So warm. So like when you talk about people being kind to you and you don't know why you put a lot of love into the universe and it will absolutely come back to you tenfold. 

Dominique:

Thank you. Thank you. And it is certainly has, cause I'm like, don't nobody do nothing else for me, like seriously, but I'm just like, and this is something that I am learning is just to let people be a blessing because sometimes in they're being the blessing to you, they can receive a blessing. Right um, and the other thing that I've, that I'm learning recently is that sometimes people are blessed just by being in proximity.

Dominique (01:02:17):

And I want to be that person. I want to be that person where people receive because of their proximity to me, you know, and I hope that doesn't come across as selfish or self-centered, but I just want to give off enough love and give the love of Christ, such that, you know, if some, if you need something and I call a friend of mine and tell my friend that you need something, they're going to give it because on the Stripe of your friend, Dominique is in me. And that's the kind of, I hate talking about energy. That's what I want to give off. Like, that's the type of energy that I want to put in the world. That's just my thing. I love that I love. 

Victoria:

So what are, what are you looking forward to most in the coming year, your intern year?

Victoria (01:03:11):

What are you most excited about?

Dominique:

 I'm excited and scared. The same thing. I'm going to be somebody's doctor. Yes. Like a life praise God. Like this is a miserable, lifelong dream. You know, the whole, what happens to a dream deferred. If it comes to pass, that's the answer it comes to pass. And it's now coming to pass now in the same token, you know, when I was a third year, fourth year, somebody is checking behind and now it's like, okay, whatever decision I make, somebody's life is on the line and that's humbling. You know, I'm going to be the person, you know, patients crashing the, everybody looking for the doctor in the room, I'm going to be looking around with everybody else. And it's like, oh, wait a second. You are the doctor, like when you're an adult. And it's like, you know, all the kids are looking at you because you're the adult in the room, but you don't think you're the adult in the room. Yeah. That's, that's sort of the, that's sort of where I am with that right now. So I honestly, I'm most excited about that. I really am. And you know, excited about Friday because I could finally start planning my life again, because I know where I be living the next three to four.

Victoria (01:04:29):

It’s like literally all of America. Because people think America is, I mean, they know it's big, but they don't really get it. Like it's like, where are you going to go in Europe? Where are you going to go in Asia? Like, it's just so bad. And yeah, girl, I'm stressed for you, but everything is going to work out according to God’s plan. And you are going to have an amazing Friday. I can't wait to tune in from Instagram and see what's up, you know? Okay. So I have one last question for you, but before I get there, is there anything that you want to say to maybe someone who is trying to figure out what they're doing? They don't know if they should apply, you know, that sort of thing. What do you have any advice for anyone? The advice that would give to anyone is your journey does not have to look like the next person's journey.

Dominique (01:05:25):

You don't have to do things the way people expect you to do them. You don't have to have expectations on the way you feel like you have to do things. Your journey is your journey. And even if your journey doesn't look like someone else's, it's still okay. If that's what you want to do by all means, go for it by all means, do it. And I'm gonna go ahead and put myself out there. If you need encouragement, if you need help going through it, get in contact with me because I've done it and I'm willing to help you do it too. Even if it's, if you just need to call and cry, I'm okay with that because it's not easy, but just know that your journey is just as valid as the next person's and don't expect it to look like, yes, yes, yes. That is so kind to offer yourself as a resource to people.

Victoria (01:06:26):

And we'll definitely, we're definitely going to tag you and all of that on the Instagram account. Um, and yes, I mean, I completely agree with you. The premise of most of the podcast is that your journey is your journey and it's not, no one's journey looks like even if it seems like it. And so that's important. Okay. So my very last question, before we conclude theme songs, we all know what a theme song is in a movie, every time a character enters, they have a theme song, but I want to know what your things are walking into your first day of work is going to be like, let's, you've got a security clearance and this world orientation is done, but it's, you're, you're walking on the ward. You are, you know, or the floor I think is how you got y'all stay in America, but you walked into the floor.

Victoria (01:07:15):

You've got your badge. And what is your theme song as you arrive?

Dominique: 

 Oh my gosh. Um, that is such a hard question. And I have like a solid trip, but not like one song, so, okay. So one of my favorite podcasts is ratchet and respectable, but with the DeMetria Lucas. So I'm going to give you a ratchet and a respectable, right. But the ratchet song will be Savage by Meg Thee Stallion with, uh, with the Beyonce. Yes. That will be the ratchet version. Ooh. And tell me why, tell me why for each of the songs actually. No, actually, no, I think I'm going to change that one. I think, I think the ratchet will be Like a girl. Okay. Okay. Yeah. I think the ratchet will be Like a girl. That one, because it's just like, yeah, I'm a girl and I'm gonna do whatever the heck I want, period.

Dominique (01:08:11):

You know, and I'm gonna, and I'm gonna run the world and you're just going to, to deal with it. Right. But yeah, but Savage will be a close second because it just gets me in that good ratchet mood. Like I can take over the world and my respectable song would be, um, I've got that by Anthony Brown and Group therapy. And it's a gospel song. I played that before every single exam that I took throughout medical school, every single exam every morning, that's the song I played because it reminded me that I already have the victory in hand and it doesn't matter what the trouble was or what I have gone through to get there. But victory is still my, if y'all only do the things that I want, somebody like, it was just my constant reminder that you have the victory. So I love that.

Victoria (01:09:02):

I love that. I love that. I think my I'll try and answer for my first day on when I was first, like my first day of foundation or whatever, I think in my mind, I would want it to be like, Who's that girl, you know, like [inaudible], that's what I would want. However, the real truth is that it was Ready or not. It's like, listen, we're here. I'm doing, don't ask me anything, but I'm here right here, period. And that's fine. And it's going to be a banger. Okay. Oh my goodness. This has been so, so good. So much fun. Thank you so much for joining us on our shift. And, I hope later on we can do another episode at some point.

Dominique:

 Anytime time. I would love to thank you so so much, I  had so much fun.

Victoria  (01:10:03):

I hope you all enjoyed this week's episode of delirium and learned a lot from Dominique. I know I did. I definitely heard the word of the spirit of perfectionism, which is so, so prevalent in medicine. We have a lot of really interesting episodes coming up in season two and we have some other exciting goodies like merchandise coming soon. So make sure you're following us on Instagram and on Twitter. And that you're subscribed to the podcast on Spotify, apple, wherever it is that you listen to podcasts and make sure you share it with your friends and let them know about night shifts, delirium. If you have any questions for us that you want us to answer or things that you want to hear in season two, feel free to reach out and we'll see you on our next.

Victoria (01:10:57):

So, I mean, listen, I knew we were going to be talking for a while because you have something to say and people need to hear it.

 

Guest: Dr. Dominique Cross
Host: Dr. Victoria Kyerematen