This is going to be a long post, but I wanted to write this down before I forget the details. This fellowship process was one of the most difficult we've endured. Richard, of course, took the brunt of it, and watching him wade through the trenches just about ripped my heart out. But, we are in a better place now, things are settled for now, and I feel the need to write it down.
Ever since I've known Richard, even before he was 100% sold on medical school, he knew that if he did go to medical school he wanted to do MSK radiology. We knew this path required four years of medical school, a five year residency, and a one year fellowship. We were completely on board.
Radiology fellowships are determined way in advance. Even though Richard's residency won't be done until June 2016, fellowships for that year started opening applications in the spring of 2014.
Last winter Richard met with his program director here to start thinking about where to apply. We decided on about ten programs. These were all excellent programs that historically have done well with MCW. We felt very confident and we were excited for what lay ahead. Richard sent applications to places in Washington, California, Colorado, Arizona, Michigan, Virginia, and here. I would have loved to stay here, because really, I never want to move from Wisconsin. Richard though had more interest in moving, and I understood why. He has had all of his training here, and was looking for a different perspective, rightly so. However, he also loves the program here and has such respect for the MSK radiologists here. We were hoping that best case scenario, he would have at least two or three fellowship offers, including here, and we would be able to decide where to go.
Richard sent his first application in on April 1st to Washington. We were optimistic and excited. Several weeks later we heard from them that their funding had been cut, they could only take one fellow, and they filled with an internal candidate. This did not dash our hopes, it was only one program, little did we know this would be the story of the next months!
Back to MCW, rumor had it that funding was also being cut at MCW, and that they might only take one fellow, instead of the historical two they usually take. The end of June, just before we left on vacation to Utah, Dr. Carrera told Richard that indeed their funding had been cut and that the following week the radiologists were meeting to determine which resident to take for the MSK fellowship. Richard and one other resident both wanted this fellowship. By this point in time, Richard had sent in multiple fellowship application, and the other resident had sent in zero. He is from here, wants to stay here, and wanted to wait and see what happened at MCW before he applied elsewhere.
We left on vacation and tried to put this out of our minds. Richard came back to Wisconsin after a week in Utah while I stayed back with the kids. On July 3rd he called to tell me that he had not been chosen for the fellowship. We had tried to prepare ourselves for this, but it was a blow. Maybe it was good we were a part for this, but maybe it made it harder. Not sure. I, of course, was sad for Richard. He had a hard time going to work for the next couple of weeks, but he still did, and did his best as he always does. I was also devastated that our time in Wisconsin now had an end date. Even though we still had two years ahead, I knew that come July of 2016 we would be somewhere else.
This is where things really started to get stressful. Richard was yearning for that first interview invitation. We had heard from a couple of other programs by this time that they had decreased their fellowship spots, and had once again, filled internally. Richard sent in a couple more applications to other programs, including one to the University of Utah. I was dead set against applying to Utah. I had been talking Richard out of this for months. He listened to me, until he didn't get the fellowship here, he applied to the U, and then told me about it later. :)
In the middle of August he had received an interview invitation from Utah. He was in D.C. and called me. He was so excited. I was happy for him, but sad for me. Up until this time I had had a hard time praying about this whole thing. I don't know why, and I still don't know why I felt uncomfortable (not sure that's the right word) praying that he would get a fellowship. Instead I had just asked for faith and patience. In the end, that's what we needed, so I guess I was inspired. But, from the day that he got that Utah interview, I began praying for other interviews so we would have more options. One more option came in Kansas City.
Both interviews were scheduled for Fridays in September. The University of Utah was first, and Kansas City was one week later. By this point in time, we had no other options, pretty much every other program he applied to had been filled, internally, and funding had been cut. Story of the year!
Two days before Richard's Utah interview, I was in the shower thinking about this. I felt bad that I had not been super supportive of this Utah option. That night I apologized to Richard for my lack of support and promised him that if this worked out, I would back him up 100%. The next evening, the night before his interview (he was already in Utah), I was washing the dinner dishes and the kids were playing. Again, I was thinking about fellowships, and I had the most peaceful feeling come over me about Utah. I felt so calm and good about it. The thought crossed my mind that maybe we needed to be there. Clearly, nothing else had worked out, maybe that is where we needed to be. I woke up that next morning still filled with that peace, and excited for Richard. I sent him a text wishing him the best of luck and I said about twenty prayers for him that morning. He called me that afternoon after the interview. He felt good about it and was very impressed with their program. He felt like their strengths were MCW's weaknesses, and he was very excited about the possibility of being there. The U gave no timeline as to when they would make their decision, but we figured it would be a week. Richard was on their last day of interviews, so we figured a week would be ample time for them to meet, make a decision, and extend an offer.
The week came and Richard was in Kansas City for his interview there. He also liked this program and they were so, so friendly. He was very impressed, but still liked the U better. Well, the day came and went and we received no word from Utah. We were a little worried, but also felt fairly confident about Kansas City panning out.
Fast forward one more week. We were now two weeks away from the Utah interview and one week away from the Kansas City interview. Richard was post-call that day, so after he woke up that afternoon, he called the U. He talked to the program coordinator, who didn't give the clearest answer. But, we gathered that two offers had been extended and verbally accepted, but she was going to talk to the program director and get back to us. That didn't sound promising, and we were disappointed, but also hanging onto a thread of hope, because her answer wasn't certain. One hour later Richard got a phone call from Kansas City; he didn't get the one spot. I was at the grocery store when Richard sent me this text. I almost threw up. I felt sick to my stomach. We had two options, and they both just fell through our fingers. It was sickening.
We spent the remainder of the day hardly talking to each other or our kids. We were just going through the motions: dinner, clean up, kids to bed, sit on couch in stunned silence. It was heart wrenching to see Richard so discouraged. It was frustrating to think that after four years of medical school, three years of residency, and a mountain of debt, this fellowship might not happen. We were angry. We were sad. We were frustrated. We were disheartened.
A new day dawned on Saturday, and things were better. Still rotten, but we had sleep under our belts, some new thoughts, and desire to press on. Richard spent the day looking up every single MSK fellowship in the country and even some in Canada. He sent an email to each program that didn't clearly state they were full. He was hopeful that come Monday he would hear back from at least one that they were still accepting applications. He also emailed the MSK program director at the University of Utah. We talked through a lot of things that day. It was good. One question we both kept asking ourselves was, "Why did Utah feel so good and then not work out?"
Richard was on-call on Monday, so he didn't have to go into the hospital until noon. That morning he heard back from a few programs that they were still accepting applications. He sent applications to places in Florida, Pennsylvania, and Canada. We were hopeful. Just as he was leaving for work he mentioned to me that the U had a spot for a body fellowship that they had not been able to fill. When he said this, my heart leaped. I was surprised at my reaction, especially because I was so against Utah to begin with! I decided to keep my thoughts to myself for a few days, and see if they changed at all.
Well, they didn't change. Come Wednesday night, Richard was very discouraged. He had kept it together for the last few days, but by this night, he had had it. I listened to his thoughts, frustrations, and concerns, and after he had let it all out, I gave him my advice. I told him he needed to seriously consider doing two fellowships. I told him he had my complete support and I had zero problem doing two fellowships. Then I told him he needed to apply to the body fellowship at the U. He looked at me like I was crazy. I had just spent months of talking him out of applying to the U and here I am telling him to do it.
He got in contact with them the next day and his application was in by Friday. He was very clear and upfront with their program director about his desire to get an MSK fellowship, and that body was not his first choice. We heard back from her Friday night that she was going to be on vacation the following week, but would get back with us. We were happy at this because we figured we had at least a week and that would give us more time to hear back from the remaining MSK programs.
Also, at some point this week, Richard got an email back from the MSK program director at the U. He said that this year was extremely competitive for MSK. They usually receive about 25-35 applications for their two spots, but this year they received over 60. Richard made their interview cut, and in the end, was third on their list for the fellowship...too bad they don't have three spots! His email, while disappointing, was also encouraging. Dr. Hanrahan reiterated that Richard was a very competitive applicant, and that if anything fell through, he would be contacted.
So, here we are, the first week in October. We had a few lingering MSK options left that we were waiting to hear from about interviews, as well as an MRI fellowship in Florida Richard had applied to. Come Tuesday, Richard was post-call again and asleep at home while the kids and I were gone. Richard was woken up to a phone call from a body radiologist at the U. The doctor told Richard they really liked him as a candidate, offered him the body fellowship job and asked him if he could accept it within 24 hours. Richard, clearly shocked and also foggy from lack of sleep, said that he would need more time. The doctor agreed and said he would call him on Friday morning at 11:00 for his answer.
We talked this new proposition through for a LONG time. Part of me really wanted Richard to call him back and just accept the job so we could put this behind us. But, Richard felt very strongly about seeing all MSK options through, which I understood. However, we knew that if we asked the U for more time again, they could pull the offer, and that could also mean bad things for a potential MSK fellowship at the U the following year.
To complicate things further, the next day Richard got interview invitations to two programs in Florida. One for an MRI fellowship and the other was the very last MSK fellowship spot in the country. Richard had convinced the MSK program to grant him an early interview (they weren't planning on interviewing until January) because he was already going to be in Florida. Also during this week Richard spoke with more body radiologists at the U to learn more about their program. Since they hadn't interviewed him, he had lots of questions about the ins and outs of their program. They were very kind, and reiterated that the MSK radiologists loved him, which is why they felt they could extend an offer without their own interview.
Well, Friday morning came around, the day the U wanted an answer. We had decided to ask for more time, knowing full well they might take back the offer if we did so. Richard was at work that day, I was at playgroup, and pretty close to a nervous wreck. Richard and the doctor ended up playing phone tag for a few hours that morning, but finally connected that afternoon. Before Richard even asked for more time, the doctor said again how much they liked him, but they also understood his first priority was MSK. He said they would keep the offer on the table, and that it was his, unless someone else came along who was interested, and they promised to keep us apprised of anything happening. Richard, of course, was so thankful and relieved, as was I! We had more time and an offer still waiting.
Fast forward one more week, the U called again, they had a potential candidate for the body fellowship and needed an answer in one week. By this time Richard had his interviews in Florida scheduled and thankfully they were happening that week. Before Richard left I told him I felt so strongly about Utah (for some bizarre reason!) that I was going to need a lightening bolt answer about moving to Florida. He agreed. :)
He interviewed first for the MRI fellowship. It ended up being very different from what he was anticipating. and he was not at all interested. (Two days later they did offer him the job, but he declined.) The next day he interviewed for the last MSK spot in the country. Richard went in there knowing he had to be bold and try to get an answer out of them about an offer because this was Wednesday and the U wanted an answer by Friday. The interview went well, Richard liked the program, but the program director refused to budge. He said there was no way they were extending any offers until sometime in January.
I think coming home from that trip was hard on Richard. He had exhausted all MSK options, and nothing panned out. We had both held onto every shred of hope that this would work out, but MSK wasn't going to work out this year. It was a bit defeating.
On Friday, October 24th, Richard emailed the MSK program director in Florida and asked for his application to be withdrawn because he could not wait until January for an answer. He also called the body program director at the U and accepted the job. He left her a voicemail and sent an email. (As a side note, she didn't end up getting back to us until Saturday night at 11:00 pm, and we were kind of on pins and needles until we heard from her, but it all worked out!) In the end, Richard ended up with zero MSK offers, but three body offers...how ironic?! Also, Richard just got an email from the MSK program director in Florida this week, asking him if he was still interested in the position. What?!?! We only talked this over briefly, because Richard signed the contract at the U, and as tempting as it is, we know that we need to be at the University of Utah.
I was so excited for Richard to accept this body offer from the U. I felt good about this decision and I felt very strongly about it. However, I think we were both surprised at our true feelings after it was all said and done. We were certainly relieved that the process was done, for now. But, we were sad to have the door permanently closed on an MSK fellowship for 2016. Knowing that we have to go through all of this again this summer makes me slightly sick, not going to lie. It has taken Richard some time to work through the thought of doing two fellowships. And I am also broken-hearted about leaving Wisconsin. I have gotten teary-eyed about this on multiple occasions now, but that is for a different post!
This was a challenging trial for sure. It was especially hard for me to see Richard struggling, but not being able to do much for him other than pray for him, listen, and give bits of advice. He surely had to carry the brunt of this. One light that I did see while we were wading through this, is that we were so united in purpose. We have always, always supported each other, but this went even deeper. This consumed our conversations, I proof-read and edited every single email, we talked about all our thoughts and feelings over and over again. We were completely on the same page.
My many months of prayers for faith and patience were surely heard and answered. I don't have a single doubt in my mind about moving to Utah. Are there things I'm worried about, yes, are there things I am going to long for back in Wisconsin, yes, but this Utah shift was such a huge one for me I do not doubt that it was inspired. Our families, especially our parents, were also invaluable during this whole thing. There were a lot of phone calls, a lot of advice, a lot of listening, and a lot of prayers that came from those four wonderful people. We are lucky to have them.
We will begin this process all over again this spring/summer. I am already praying that it will go well! But, until then, I am soaking up Wisconsin and all it has to offer.
