Columbia University College of Physicians and Surgeons
"Look here! Say cheese!"
After receiving their diplomas, the Duncan family went into full photo-taking mode.
It was the same for everyone else.
Four years of relentless effort had all led up to this very moment.
Many students, especially the girls, were in tears—these past four years had been incredibly tough.
Some parents also couldn't hold back their emotions, crying tears of joy.
Raising a doctor in the family was an immense honor, and the financial investment required was no joke. It was nearly impossible not to get emotional.
What?
Every med student pays for tuition independently with student loans and never relies on their parents?
Yeah, right.
That's a misconception.
Sure, plenty of students take on the burden of loans themselves, but many are supported by their families. Even those who do shoulder their own debt aren't necessarily doing so out of sheer independence—many simply don't have another option.
But now, it had all paid off.
Most of the graduation photos featured students in their academic gowns (regardless of the degree level, they were all referred to as academic gowns—high school graduates even wore similar ones), proudly holding their medical diplomas front and center.
The families attending weren't just parents and siblings; many brought along their boyfriends, girlfriends, fiancés, spouses, and even their children.
These loved ones were arguably even more excited.
Dating or starting a family with a med student was no easy feat.
But now, they could finally see the light at the end of the tunnel.
Though the upcoming residency training wouldn't come with a doctor's full salary, at least they would no longer be pouring money into education. That financial shift alone was a massive relief.
"Adam, it's time to pick up our match letters!"
Elliot called out.
"Got it."
Adam let his family know and followed Elliot and the others into the academic building, where groups of graduates were already heading inside.
At a counter set up to resemble a hospital's nursing station, students stepped forward as their names were called, receiving the envelopes that revealed which hospitals they had matched with for their residencies.
Medical residency applications worked both ways—students applied, and hospitals selected candidates. However, top-tier medical schools had established partnerships with major teaching hospitals, which meant placements were often assigned rather than purely chosen.
Medical schools allocated students based on their academic performance, placing them at hospitals of varying levels, usually within the same city.
For example, most Harvard Medical School graduates stayed in Boston.
Columbia med students, naturally, were assigned within New York.
Of course, students could opt out of their assigned match and apply elsewhere on their own, but without the school's backing, securing a residency required strong personal connections. Otherwise, the application process became significantly more challenging, and the hospitals available weren't as prestigious as those offered through the school's matching system.
This was precisely why some students practically worshipped their senior professors—not only could they impart invaluable medical knowledge, but they could also influence their students' futures. How could you not admire them?
"Where are you placed?"
"Mount Sinai. You?"
"Same here."
As graduates tore open their envelopes, discussions erupted around the room.
Adam and his group remained relatively calm. Their placements had already been determined in advance, and as expected, they were headed to the Medical Center's surgical department.
Adam glanced at a few of the other prominent students, noting their equally composed expressions. Clearly, their placements had been pre-arranged as well.
With a slight smile, Adam waved his letter at Elliot and Bianca.
"Let's go."
He stepped outside—his whole family was still waiting for him.
That day, Adam led the "Duncan Army" on a tour of Columbia University, followed by a grand tour of New York City.
The Next Day
Medical Center
Adam took his family for a full health check-up, focusing especially on his mother.
She had always been in great shape, giving birth to an entire basketball team's worth of kids—all through natural delivery.
But six years ago, when she had Toby, the fifth child, Adam had noticed a clear decline in her physical condition.
Pregnancy at an advanced maternal age carried serious risks.
With her third and fourth children, Gabby and Charlie, she had bounced back quickly, returning to work without any issues.
But by the time she had Toby in her forties, her recovery took much longer.
Now, she was pregnant with her sixth child—at nearly fifty years old. The thought alone was alarming.
Modern medicine had come a long way, but childbirth was still a life-threatening event.
"Leonard, what's the verdict?"
To get the most accurate assessment, Adam had sought out Rachel's father, Leonard, for a professional and unbiased diagnosis.
There was no other choice.
OB-GYN specialists might be more knowledgeable, but their opinions often leaned toward either excessive caution or unnecessary alarmism—neither of which Adam wanted.
As a doctor, he understood their approach, but as a son, he needed the real picture of his mother's condition.
"Your mom is in excellent health—there's nothing to worry about."
Leonard smiled. "I even double-checked with the OB-GYN department head. She's really fine. As long as she takes care of herself, everything should go smoothly. But at her age, this should definitely be the last one. Another pregnancy would be far too taxing on her body. Though if she did manage to conceive again, she'd be a medical miracle…"
"Got it. Thanks."
Adam sighed in relief and expressed his gratitude.
"In a week, you'll be starting your residency here. Ready for it?"
Leonard clapped Adam on the shoulder with a grin.
"Always."
Adam smiled confidently.
"Good."
Leonard nodded approvingly. "I've arranged for you to work under Dr. Sheni Hiron. She's one of my senior residents—very capable and has a great personality. You'll like her."
"No doubt about it."
Adam smirked.
This was the advantage of having connections—everything was smooth sailing.
Dr. Sheni Hiron was Leonard's resident, which meant she would undoubtedly take special care of Adam.
With both the "county official" (Leonard, the attending physician) and the "direct supervisor" (Sheni, the senior resident) looking out for him, Adam's opportunity to start performing surgeries would come much sooner than most.
The benefits of networking had once again proven their worth.
After a bit more small talk, Adam took the health report and rejoined his parents, first relaying the doctor's cautionary advice before delivering the good news.
"Dad, Mom, why don't you move here?"
After some thought, Adam suggested, "New York has better medical resources…"
"Haha, no need."
His mom laughed and interrupted, "Your dad and I have our whole social circle in Galveston. Moving here would be tough—we wouldn't know anyone! We're happy where we are, and besides, you just said I'm in perfect health."
"Not perfect. Pregnancy at your age is still risky."
Adam reminded her.
"Yeah, yeah, I know my body. You might be a doctor, but you're still just a resident. I, on the other hand, am a seasoned nurse. Greenhorns like you rely on people like us in the hospital!"
His mom said smugly.
Adam: "…"
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