When applying to PGY1 residency programs as a fourth-year pharmacy student, I wasn’t sure if I would regret my decision. I will describe my life in words so you can visualize why I had built-up anxiety up until that moment. When I was accepted into pharmacy school in the fall of 2016, I was being questioned by Muslims in the Arab American community about whether I wanted to continue my education. At that time, I was almost 22, and most of my Arab female classmates were engaged or married, or they already had children; I was still single. I chose to pursue an education in the health care field and was determined to receive a doctorate degree. Luckily, I got engaged in August 2017, a couple of weeks before starting pharmacy school, and the community’s concern for why I was still single ended for a short time.
I was at the University of Illinois at Chicago’s College of Pharmacy, and my fiancé was a pharmacy student at the Midwestern University Chicago College of Pharmacy. Fast forward to the summer after the P2 year: we traveled to Palestine and got married in June 2019. Everything was exactly right. I was proud, happy, and full of joy that my life was coming together. I had my hands on both the career and the man of my dreams. However, several months after getting married, I started getting the popular questions, “Are you pregnant?” “Are you expecting?” “When are you planning to have kids?” These questions reopened the circle I thought I had closed, and now I had an empty space that I felt pressure to fill. Come residency application season of the P4 year, I had been married for 2 years and was still not ready to have children. I didn’t want to sell my career path short to please those around me, despite always wanting to be a “young” mom.
If I got accepted into residency, this would mean I would postpone trying to have a baby by at least 1 more year. This was a risk I was willing to take, despite all the discouragement I received from those around me. I matched to my No. 1 choice on Match Day, and I knew this was the best decision I could have made for myself. I started residency and was content with my choice. Unfortunately, in August of my PGY1 residency, I ended up getting a cystectomy and oophorectomy. At this moment, I was starting to think I had made the wrong decision, and I began to worry that I wouldn’t be able to conceive after having one of my ovaries removed. My program director and co-residents all knew of this struggle and helped me get through the year by providing me with both encouragement and support. With that, I decided to early commit to the PGY2 ambulatory care program and started to believe that everything happens for a reason and everything in my life would fall into place at the right time.
In September of my PGY2 year, I took a pregnancy test, and it was positive! This was assurance that, despite everything that had seemed to work against me, waiting to conceive had been worth it. But I had to break the news to my program director because my due date is May 2023, before the end of my residency, and I was scared and didn’t know how she would react. When I told her, her response was as simple as “Congratulations! I am happy for you, and we will figure it out together.”
The beginning was difficult because I had to push through morning sickness and being tired all the time. The expectations remained the same – which I appreciated because I didn’t want my preceptors to think I couldn’t complete my responsibilities as a resident. The hard part was trying to figure out the best times to go to my appointments. This was more time-consuming because I had to take some time out of the clinic, stay late, or schedule my appointments during my project time. This meant having fewer nights and weekends to myself because I had projects and presentations that had to be done for my rotations and residency requirements that I could not fit into my allotted project time.
After getting used to making my appointments as part of my residency routine, I found out I had gestational diabetes. This meant more appointments, more medications, and more responsibilities. I started using basal insulin and had to test my blood glucose four times a day, which is difficult during a rotation day. I had to keep reminding myself that everything I was doing was to ensure I had a safe and healthy delivery and baby. But checking my blood glucose four times a day was getting difficult. I was having hypoglycemic episodes in the middle of the night, and I asked to be prescribed a continuous glucose monitor. After receiving it, I was able to monitor my blood glucose more closely, which helped me realize when I required bolus insulin in addition to my basal because my postprandial blood glucose values were elevated. Again, I reached out for a prescription – this time, for bolus insulin. Every time I thought that I had enough on my plate, something else was added to it.
I now realize that I am the patient I see in my ambulatory care clinics. My obstacles have allowed me to further appreciate my role as a pharmacist and continue to advocate for my patients. As the baby and the bump continue to grow, the number of ultrasounds, labs, and doctor appointments also continue to grow. Similarly, as my residency comes to an end, the number of projects, presentations, and responsibilities has been growing. However, I have learned that nothing is impossible, everything happens for a reason, and this timing is just right.
About the Author:
Reham Awad is a current PGY2 ambulatory care resident at the University of Illinois Chicago College of Pharmacy in Chicago, Illinois, where she also graduated from pharmacy school and completed her PGY1 residency. Her clinical interests include primary care, cardiology, and anticoagulation. In her free time, Reham enjoys going on nature walks, coloring, and watching Netflix.
Disclaimer: The thoughts, views, and opinions expressed in these articles are solely those of the author(s), and do not necessarily reflect the views or opinions of the American College of Clinical Pharmacy (ACCP). These articles are provided for informational purposes only, and should not be construed as medical, legal, or financial advice. This information is intended for a clinical pharmacy audience, but is not a substitute for professional judgment. ACCP disclaims all liability regarding any actions taken or not taken based on this information, including impact on patient care and the decisions made by the individual providing care. Reliance on any information provided on this site or any linked website is solely at your own risk.