He was slightly amusing, I’d give him that. Behind me, low-voltage chatter buzzed like a distant swarm of insects. I didn’t let myself turn around, refused to seek out anyone in particular.
“Questions?” Garcia asked, not bothering to hide his glee. “No? Then let’s roll.”
The first three names were announced one by one. Nervous clapping followed each. #5—Tessa Edwards, pink hair—got the loudest cheer, likely because she’d made fast friends with half the intern class. She patted the lanky guy from yesterday on the shoulder, high-fived Finn, and joined #3 and #22 at the front while Finn sat back, a steep crinkle between his eyebrows.
I kept my arms crossed, shoulders loose, and looked away just as I sensed he might be about to glance at me.Deep breaths, fair scores.
#19—Cam Nguyen.
“Last but also first after Round One…” Garcia drew it out like a TV host fishing for dramatic effect and a memorable catchphrase. “We’ve got number 12. Finn Hayes—come on up.”
A beat passed before Finn stood, his smile as brilliant as it had been that night in the bar. Which I really wasn’t meant to remember, especially right now. I sipped coffee and fixed my face into something flat and unreadable while Finn walked up, some residents clapping for him, others groaning their disappointment. His gaze flicked toward the judges’ row just long enough to catch mine for a fraction, then skitter off again.
Neutral.
The finalists were herded outside while the remaining residents received the same case the finalists would be handed one by one. I didn’t watch them go. Why would I?
“If you’re sitting there pouting,” Garcia told the room, “here’s a tip: The only thing worse than losing is being remembered for being salty about it. So shake it off, because the same case they’re sweating over? Is now your learning moment. No talking, no phones, you got the same sixty minutes. We’ll collect your notes before the first presentation.”
Ah, yes. Welcome to medicine—where every loss means homework.
While interns scrambled for pen and paper, I reviewed the rubric Garcia had suggested in more detail: clarity of thought, diagnostic reasoning, treatment plan, poise under pressure. Equal weighting.
Jesus Christ, I needed another coffee.
An hour later, #22 started us off, nerves obvious. The case? A premature infant, born at thirty-four weeks, with signs of feeding intolerance, abdominal tenderness, and sepsis labs. NEC—necrotizing enterocolitis. God, I’d scrubbed in on one earlier this week, the bowel so inflamed it shredded under the clamps.
Diagnosis was the easy part. The decisions that came after? Less so. You had to resect enough to save the kid while leaving enough to avoid short gut. A brutal balancing act, with terrified parents pacing outside.
Every intern in the room had the same case still printed out in front of them, their notes already collected. The finalists, well—they had the added bonus of performing under a spotlight, the rest of their class as a live audience. No pressure.
#22 was solid, thoughtful, but stumbled slightly during his explanation of when to take the patient to the OR—he hesitated,then backtracked, which made it clear he wasn’t sure where the non-operative window ended and the surgical urgency began. Points docked.
#3 impressed: polished thoughts, calm cadence, and good eye contact. She also handled our questions confidently. Full score. A quick sideways glance showed she got the same from all the others. She’d been just four points behind Finn in yesterday’s ranking—fuck, he’d need to do well. If…
Jesus. I wanted him to win, didn’t I? Despite it all.
Neutral.
Next up—Edwards. She strode in with pink streaks flying and opened with a confident “Good morning. Our patient is a ten-day-old preemie, who presents with abdominal distension, bilious vomiting, and feeding intolerance.” Excellent, to-the-point overview. “Febrile,” she continued, “tachycardic, slightly hypotensive.”
Damn, she was good. Smooth delivery, no hesitation, yet not so fast that she tripped over her own words. Presentation done, we moved into the same questions we’d asked the other two, starting with Garcia. “You diagnosed this as a case of necrotizing enterocolitis,” he said. “Correct. Can you list the primary risk factors?”
And Edwards just…froze. Her mouth moved, but nothing came out. Someone in the audience coughed, and she recovered like it was a signal, but the damage was done. Her answers came hesitantly after that, confidence cracked.
Three out of five points, similar scores from the others. She’d already lost. She knew it, too, based on the dejected curve of her mouth as she made her exit. Too bad, really—I liked her.
Just two more.
#19. Cam Nguyen. His ideas were solid but the voice a shade too soft, like he didn’t trust his own assessment. Four threes including mine, one four. So…#3 was the person to beat, andFinn needed twenty-two points to do it—at least two fives if the rest were all fours.
The timer reset. I reached for my coffee, realized it was empty, and rubbed a thumb along the rim of the cup.
Okay.Finn.
He walked up to the podium, temples slightly damp as if he’d splashed water on his face. After three days of carefully averted eyes, it was strange to look my fill—striking angles, lashes too long, tension pulling at his mouth. He looked like someone who gave a damn. Pen in one hand, he tapped it once against the notes in front of him before laying it flat on the podium. A breath. A quick glance up at us judges.
“So—uh. Good morning.” His voice came out a little too fast, and he paused for another breath, then smiled. “Our patient is a thirty-four-week premature male, day-of-life ten, previously healthy. He presents with one day of fever, poor feeding, increased sleepiness. On exam: a distended, tender abdomen with decreased bowel sounds.”
