A day in the life of a VCU Health resident

What is it like to go to a health system every day to train as a future surgeon? Ashley Matthew, a first-year urology intern, explains.

Dr. Ashley Matthew.
Dr. Ashley Matthew, a resident in her first year with the Department of Urology at VCU Health, moved to Richmond in the summer of 2020 before starting her intern year. Matthew mentions the support of her department and peers in the training environment, the resources and commitment to safety at the health system and the ability to explore Richmond, a city that has "Southern charm with that Northern flair," as reasons she is glad she made VCU her top choice for residency match. (Tom Kojcsich/University Relations)

For Ashley Matthew, M.D., Ph.D., things look different than they did last year in a lot of ways. Some of it is the little things — a different electronic medical record system than she used in medical school, a different cafeteria where she gets her red pepper gouda soup on Mondays. Some of it is the bigger things — a different and rapidly changing city, new colleagues, the new title “urology intern” that follows her name.

And of course, there are the masks.

“The biggest thing I’ve had to grow accustomed to, as with most of us, is when I walk out the door, putting on my mask,” Matthew said. “Even still there’ll be some times where I’ll forget and then I’m about to walk out the door, and I’m like, ‘Wait, something’s missing.’”

But Matthew is adapting with grace. And she’s found the support of her peers to make it through a time of great change.

While finishing her M.D.-Ph.D. studies at University of Massachusetts Medical School, Matthew had an opportunity to visit VCU Health for her urology residency interview before selecting it as her top-choice program. In the months since Matthew matched at VCU, the world changed dramatically as the pandemic took hold.

Physically visiting for a residency — or even interviewing in person for a graduate or health sciences program — this year is an opportunity most health professional students haven’t had. So what has it been like for someone new to Richmond who spends their days at VCU Medical Center?

Before arriving in June, even finding a place to live near the MCV Campus downtown presented a challenge, Matthew said.

“I think moving in the middle of a pandemic where a lot of us were not able to come to the city and take a look at the apartments that we're moving into — there were a lot of unknowns,” she said. “We didn't get the typical orientation experience where you get to meet your co-interns (in person), but I think nevertheless we're stronger because we’ve had to come to work in these circumstances.”

Matthew and her fellow interns completed their Graduate Medical Education orientation via Zoom, like many other meetings she and others at VCU Health have had since. As she interacts with other residents on the consult service, she said they’ve had opportunities to get to know each other better while working with patients.

“Everything is so intertwined at VCU that we get to run into other interns from different fields, so I feel like we’re bonding even though we didn’t have the typical way of bonding.”

Matthew said she has had the support of her co-interns, residents and attending physicians to make this year easier.

“I think the most supportive cohort of people that I usually spend a lot of time with in the city are my co-residents within the Urology Department,” she said. “They are everything. I love all of them. We all have our quirks, and we all get along really well together. We’re all a big family.”

Adjusting to some of the safety changes has been a noticeable difference. When she goes to work in the morning, she wears her mask and face shield. Every day going into the hospital before rounds at 6 a.m., Matthew walks up to the temperature-scanning stations on her way in and gives a thumbs up to a greeter near the hospital’s entrance to show she’s feeling well and her temperature is normal.

Matthew has taken notice of the extra precautions everyone takes. Some days, when she sees patients on a consult in the Emergency Department, Matthew dons additional protective gear, which she knows can make patients nervous. She often shares that the reason behind the precautions, much like the reasons for staying 6 feet apart, maintaining handwashing protocols or wearing a mask, is for both of their safety.

During the day, lunch and breaks are different from what she was used to in her years of medical school on clinical rotations, eating in groups with friends. She often picks up food from one of the mobile carts and food trucks that line the sidewalks outside VCU Medical Center at lunchtime or from grab-and-go lunch spots or the Gateway Building cafeteria.

“We have this really good red pepper gouda soup in the cafeteria every Monday; the residents love it,” she said with a smile.

On my interview day, I thought that the urology residents were so genuine. They were a group of people that I could see myself bonding with like an instant family, and the same with the attendings.

In addition to spacing out the tables and chairs in the spacious cafeteria, the health system has opened up several additional areas for lunchtime seating, including a patio, and has installed Plexiglas to increase safety in break rooms, including resident rooms on her different services where Matthew says she’ll sometimes eat or take a moment to rest.

After returning to her service and finishing the day’s procedures, Matthew often heads home around 5 p.m. and will occasionally do some exploring. She’ll often pick up dinner from one of the neighborhood spots but looks forward to the day when she can dine indoors at restaurants in Shockoe Bottom, Scott’s Addition, the Fan and other neighborhoods in a locale consistently ranked by magazines and other outlets as one of the best food cities around.

“That’s the great thing about residency; I have a great emergency medicine resident friend, Melissa, who sent me a whole list of places to try,” she said.

In addition to finding the program she wanted at VCU Health, Matthew said the cost of living and variety of things to do made Richmond a particularly appealing option for residency. And, she said, she was keen to move somewhere warmer after growing up in Boston.

“I love Richmond,” she said. “I think that it's a great city. I like to say that it's where the North meets the South. It has that Southern charm with a Northern flair.”

But she also recognizes that the city is one of many in the U.S. that has seen major social change. Last summer, Richmond’s Monument Avenue, a main thoroughfare that for decades had displayed statues of Confederate veterans, became the epicenter of protests against police brutality and racial injustice, and underwent a significant transformation. She has seen the city change, a change that has carried over to the university and health system as it relates to diversity and equity.

“People are having discussions about race and equality in medicine and throughout many different facets of life. What I like about Richmond, or at least I could say the VCU experience in Richmond, is I feel like they are trying to take a stance on diversity and not just diversity of race but in gender and gender identity, and that’s really important to me. I think a lot of the residency programs here are trying to improve diversity and take a stance on that,” Matthew said.

It’s part of the culture of the residency program that she’s been impressed with since she first stepped foot on VCU’s campus to interview. “On my interview day, I thought that the urology residents were so genuine,” she said. “They were a group of people that I could see myself bonding with like an instant family, and the same with the attendings.

“I didn't feel this hierarchy between attendings and residents where you feel uncomfortable learning from them or feel bad if you get something wrong in front of an attending,” Matthew said. “I felt like they would be teaching me how to be a great surgeon and, not only that, it would be done in an environment that’s enjoyable and, so far as an intern, it’s been just that.”

Matthew has advice for students who are preparing to match into residency programs in March.

“This is a great training environment. There’s so much collegiality, support, so many resources and just great care — great surgeries, especially if you’re considering a surgical specialty. There's just so much to do and so much to learn, and you’re constantly learning every day. I think that going into residency, if you have a vigor for learning, you can make the most out of every situation.

“A big part of being a surgeon is learning to operate, and I feel highly confident that when I graduate from the VCU Urology Department, that I’m going to be able to operate on the level that is going to make me very comfortable as an attending.”

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