Search for tag: "couples"

You have two at home working... or not. How do you divide up the home work? The parents are home, the kids are home, and there's home work to be done. So how does it get divided up? For the purposes of this little podcast, let's assume two parents of gender norms of male and female and school kids.

A recent New York Times article sums up the potential divide with the heading, "Nearly half of men say they do most of the homeschooling, 3% of women agree." And there you have it. It's all about potentially hurt feelings, different expectations, definitions, and language. It's all about cultural norms, family norms, and the relationship. In fact, the patterns of sharing the home work that were established before the COVID-19 epidemic are probably carried on during lockdown, but with even greater chances for misunderstanding and hurt feelings.

When the surveys show that couples don't see their participation reliably, men overestimate their contribution to home care or child care and homeschooling, there's the possibility of resentment. Women may resent the fact that they are doing most of the home work. Men may resent the fact they're not getting enough credit. Women may feel stressed and resentful for all the planning that they have to do that makes sure that things get done. Men may not even be able to see this work.

So we're talking about relationships, and we're not even speaking the same language. The languages that we are speaking are filled with unspoken assumptions and subtexts.

So some ideas. Write down the jobs, including the middle jobs of making the schedules and the lists and who are the players. Agree on the list. This is important to start from the same place.

Each person makes a list of their best world with who would do the jobs. This is the fantasy list. I like to shop and I like to cook, but I don't like to do anything else inside or outside the home. I like to read kids stories at bedtime, if that's on the list. Everything else should be done by you. Now remember, this is just a fantasy list.

Now each person then makes the same list with what is their best assessment of the shared work that they could put up with. This is the tolerable list. Let's not use the word "fair" or this is what I think is fair, because fairness is too emotionally loaded. You cannot negotiate fairness because it looks too different for men and women. Be specific. How often would the house be vacuumed? How long after dinner would the dishes get done? That sort of stuff.

Now get together with a smile over your fantasy lists. Let the other person go over their fantasy list without interruption. Just let them get it out and smile. Then go over your I could cope with this list. Compare each job one by one, your dividing up and his dividing up. Remember this is the couple in this paradigm, but it could work for same-sex couples or with sentient children. The lists won't match, but you can negotiate with numbers -- how often, what time, etc. Remember you cannot negotiate feelings. All feelings are real and must be heard and appreciated. You can negotiate numbers. Negotiation should be done in good faith. The other person may not do the job exactly to your specifications, but just let it go.

The final list of who does what and when should be posted. Give it a week, then reassess. In my case, waiting to get the kitchen clean may be too stressful for me. I'd just rather do it myself. So maybe there's a swap in the making.

This problem of who does what in the relationship will last long after the COVID-19 lockdown. Find a way to work it out and work it with the hope and a smile. And thanks for joining us on The Scope.

Dr. Chan: How does a pre-pharmacy major end up in medical school? What sparks an interest in something called PM&R? What happens when you and your spouse end up in the same rotation? How do you organize interviews for couples matching? Today on "Talking Admissions and Med Student Life" I interview James and Laura, fourth-year medical students here at the University of Utah School of Medicine.

Announcer: Helping you prepare for one of the most rewarding careers in the world, this is "Talking Admissions and Med Student Life" with your host, the Dean of Admissions at the University Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Well, welcome to another edition of "Talking Admissions and Med Student Life." I've got a couple in my office today. I'm so excited. Laura, James. Say hi.

Laura: Hi. Thanks for having us.

James: How's it going?

Dr. Chan: Great. Okay, so let's start the beginning. Both of you are from Utah.

Laura: Yes. I'm from Logan.

James: Yeah. And I'm from Taylorsville.

Dr. Chan: And where did you guys meet?

Laura: We met at Utah State.

James: Yeah, so we met in college. My next door neighbor was one of Laura's best friends. And so that's how we got introduced.

Dr. Chan: Okay, and what year is this about?

James: It was my sophomore year.

Laura: I think 2011.

James: Yeah, 2011.

Dr. Chan: Okay, love right away, love at first sight? Or was there some mental gymnastics that had to take place? Or how did it go?

James: Well, we dated for like eight months, and then we took a break and then we dated again for like another eight months. And then we got engaged. Does that sound about right?

Laura: Yeah. I met so . . .

Dr. Chan: Is that your version of reality, Laura? Or how do you feel about that?

Laura: Yeah, that's my version, I guess. James, so we met because . . . okay, my best friend actually was in love with James.

James: This is eight years ago, so . . .

Laura: This is the real story. So she was in love with James, and so she always wanted to hang out with him. And I was like trying to be a good wing woman and set them up. But James, I guess wasn't into her.

James: Well, I only have eyes for my neighbor's best friend. So after a few times hanging out, I got her number. I got Laura's number, I should say. And my neighbor, her friend was like distraught about it. And but actually Laura's parents, Laura asked her parents, "So should I go out with him or not? Because I don't think that my friend wants me to go out with him." And her dad was like, "Oh, you should definitely go out with him." And her mom was like, "No, you should be a good friend. You shouldn't go out with him. Because your friend . . ." Well, anyway, she followed her dad's advice.

Laura: I was a good friend, for the record.

James: You were a good friend.

Laura: And I said, "Hey, your crush asked me out. What do you think about this?" And she was like, "You should go out with him. It's fine. Nothing can get between us."

Dr. Chan: And then the friendship ended right there, Right?

Laura: And then the friendship ended right there.

Dr. Chan: She never talks to you again. She dropped the mic and walked away. All right. What year did you get married?

James: In 2013, yeah, 2013.

Dr. Chan: 2013. All right. And then at what point in your relationship did you both start thinking about med school? I mean, or did it predate getting together? I'm just curious how that kind of unfolded.

Laura: So James was always pre-med ever since I met him in 2011. And I was actually pre-pharmacy. And then after we broke up, actually, I was going through the committee process at Utah State, and everyone was like, "You are really competitive for med school, like have you considered going to med school?" And so then I kind of changed my mind at that point. And we were broken up.

James: Just to clarify. So the committee, the folks on the committee process at Utah State told her she had a stronger application than really any of the pre-meds. And she wasn't pre-med. So they were like, "Why aren't you going to medical school?" I mean, you hadn't really considered it seriously before then, right?

Laura: Yeah. So I started shadowing a pediatrician in Logan. And that's kind of when I realized it, it was what really was for me because it combined the patient care that I really liked with the medical decision making that I liked in the best way.

James: And bragging moment, she studied for the MCAT for just like 35 days and just like destroyed the MCAT. So anyway, I'm just throwing that out there.

Dr. Chan: Laura, for those of you who can't see at home, Laura is making faces.

Laura: Thank you.

Dr. Chan: All the secrets are coming out. Okay. All right. So I think this is fascinating, because then, like the first iteration of you applying together, what year was that?

Laura: Oh, gosh.

James: Oh, well, so we didn't apply together. It was 2000 . . . Let's see, we got married in '13. It was 2013. It was the '13-'14 academic year that you were applying to medical school. So you were applying to medical school right when we got engaged. And so she was in the midst of the application process at that time. I was not ready to apply. I hadn't taken physics yet. I hadn't done like my MCAT prep. And we didn't think I would have enough time to like give it a good go, yeah, catch up, really.

Laura: So what happened was I applied and got into the University of Utah, which is where I really wanted to go. And then James had to apply the next year when I was a first-year medical student.

Dr. Chan: And was that your strategy at the outset? Or did you kind of like broad net . . .? Because I don't know how many schools you applied to, but I get the sense the theme was you wanted to stay in Utah. Or were you willing to kind of be apart for a while? Or how did that look? Yeah.

Laura: Yeah, we knew that there was a chance that we would be apart for medical school. So that wasn't like a deal breaker for both of us going to medical school, but we thought Utah was kind of like our best chance.

James: Yeah. We definitely thought our odds were best in Utah. We were both Utah applicants. We kind of knew, you know, Utah it's pretty transparent about the things that you need to do, and we felt like we were meeting high marks on those things. And so when Laura got in, we were encouraged. And then we moved to Salt Lake City. I worked here for a year. I literally was just answering phones at one of the hospitals for a year while I was applying to med school, but I applied to a lot of schools knowing that Laura was already in medical school at the U. And I actually I got into like three other schools before I got into the University of Utah. So it was tenuous because I thought maybe I'd be moving to St. Louis or Pennsylvania, but then the call came in March.

Dr. Chan: Okay. I called you in March. I vaguely remember that.

James: It was a good day. It was a really good day.

Dr. Chan: All right. So you were separated by a year.

James: Mm-hmm.

Dr. Chan: Initially.

Laura: Yes.

James: Initially.

Dr. Chan: Okay. So how was that? I mean, like, you know, because like Laura's going through med school. She's kind of, you know, like the hard part about medical school in my view is that like people talk about it. There's definitely this image of what med school is like out in the media or like what people think culturally or stereotypically, but then you go to med school, and it's like hard to describe. That's one of the reasons why I do this podcast is just to kind of learn about it. So like, James, has Laura . . . or Laura, like, was it easy? Was it hard? I mean, how would you describe the jump from going, you know, from undergrad to medical school?

Laura: Yeah. So, first of all, I was so nervous to start medical school. I was like the most anxious I've ever been probably. But then when I got here, I just fell in love with it. So I had a really great first year I thought. I had a lot of fun learning all the anatomy, histology. I had a good time. I thought it was fun.

James: And I would say, I mean, I from the outside, I got to see Laura starting medical school. She was really nervous about starting, but as soon as she actually started, I could tell she was having a really good time. I mean, she was always excited to tell me about the things she was learning. And it didn't seem like, I mean, of course, she was studying like several hours every single day. But it didn't seem like something that she begrudged by any means. I mean, she was having a lot of fun. Like I remember she always after anatomy lab day, she'd always come home and be like, "Oh, yeah, we dissected this today. We got to see the heart, and finally we exposed the muscles." I mean, there's a lot of like excitement. So it was exciting for me I think as I got to kind of have a . . .

Dr. Chan: Kind of got to live through it, to begin with.

James: Yeah. And I kind of I think it was good for me too, because I kind of knew what the schedule would be like coming into med school. And I had been to the med school, I mean, plenty of times, just dropping her off and picking her up.

Dr. Chan: Cool. So how did it feel being on two separate years initially?

Laura: Yeah. So . . .

Dr. Chan: Because like, just for people that don't know, the first year schedule, for the most part, is mornings off, class in the afternoon. And classes, widely defined small group activities, etc., etc. Second year, class schedule's flipped, more classes, more activities in the morning and afternoons off. So like how did that work in your guys' relationship?

Laura: It's funny, because whenever we told people, we were both in medical school, they were always like, "Wow, you must never see each other. That's so sad." And we saw each other basically all day because all the med students' first and second years are in the HSEV. That's the building where we get educated and where we study. So really, I feel like we just were with each other almost all day, except for when we were in class.

James: And I would say it's, I mean, it's funny, because I mean, the way that the day looked, we would both get here, we would usually come together in the morning. So we'd get here before 8 a.m. And then whoever wasn't in class in the morning or afternoon would just study. So I would study in the morning, she would study in the afternoon.

Dr. Chan: You guys are in the library. Library was kind of your home . . .

James: Yeah, definitely.

Dr. Chan: . . . away from home because I remember seeing you a lot in the library.

James: Yeah. And we'd also I mean, at night we would be here, you know, we might go home, make dinner and then come back to the HSCB from like, 7: 00 till 10: 00 or 11: 00 some days. It just depended.

Dr. Chan: Do you guys live close by?

James: Yeah.

Laura: Yeah. The first year we lived in like the . . .

Dr. Chan: The towers?

Laura: No.

James: Not that close.

Dr. Chan: Not that close.

Laura: Yeah. And then we moved to close to downtown, close to like . . .

James: Salt Lake Regional.

Laura: Yes, Salt Lake Regional.

Dr. Chan: All right. Not too far. Okay, so when did the discussion start? Or maybe it started immediately about Laura doing something else for a year? So you guys started being the same year? Or was that a late, I mean, how did that kind of unfold?

Laura: No. So we knew about the couple's match, before we even applied to medical school. So we had always planned that I would take a year doing something else so that we would be on the same track. So I was trying to figure out what I wanted to do. Kind of the end of my first year, start of my second year, I was thinking about what I wanted to do. And I finally decided to do the unique program at University of Utah. That's the master's in bioengineering.

Dr. Chan: Okay.

Laura: So it's the Bio Innovate program.

Dr. Chan: And what were you considering? And why'd you end up on that one?

Laura: Yeah, there's a few things, a few options. So you can always take the year and just do research. You can do an MPH, you can do an MBA. So I really liked the master's in bioengineering, because I felt like it kind of fit my mindset. Like I was always interested in improving healthcare and things like that. So it really drew me in.

Dr. Chan: Was that like Bench-to-Bedside type activities? Or were these engineering classes? Or what were you doing?

Laura: Yes. So basically, it trains you on problem-based clinical innovation. So how to appropriately identify a clinical problem, how to, you know, vet the problem, make sure that it's worth going after, how to go through the FDA process for medical devices. And so, basically, I was on a team and we found a problem. We took the problem through prototyping, through the FDA, all the way to like forming a company during that year. It was really fun.

Dr. Chan: Oh, can you talk about it? Is it . . .?

Laura: Yeah.

Dr. Chan: Or what was the product? What was the device?

Laura: Yeah, yeah. So it was really fun because I was on a team with three other women. And so we went after a women's health problem. We ended up developing a new videoscopic vaginal speculum, and we just thought the pelvic exam need a ton of work.

Dr. Chan: Could use some updating.

Laura: Yes, exactly. And it was just a really fun year working on that. We took it to Bench-to-Bedside, which is the medical device competition in Utah, and we ended up winning first runner up. So we got $10,000 in seed funding for our product, and then we formed a company. We have filed an international patent on it since then. And it's going through kind of like licensing negotiations right now.

So how does that work with you continuing on with your training? I mean, do you get I mean, are you on like the board? Or how are you still connected to the company? I mean, how does that work?

Laura: So I'm not really anymore. The University of Utah has rights to that patent. And they're in charge of negotiating the licensing agreement, and then I'm moving for residency.

Dr. Chan: Foreshadowing, yes. Spoiler alert. Yes.

Laura: For me, like that project is more how I learned to do this medical device innovation. And so, for me, I'm going into dermatology. I think dermatology is just primed for medical innovation and, you know, dermatologists already personalize so much of their medicine, it just makes perfect sense.

Dr. Chan: All right, yeah. Okay, so bioengineering?

Laura: Yes.

Dr. Chan: So then you guys, you do that for a year. James is finishing out second year, and then you're finally linked. Start third year together? Is that accurate?

James: Yeah. it was really nice Because I mean, I'd always been, I wouldn't say I felt like I was behind. But I mean, like Laura, always she always like . . .

Dr. Chan: She lorded it over you, that you were an underclassman at all times.

James: No, it was just, it was really nice, because, for the first time, we were kind of going through the same things together. So rather than, like, one of us like having a fresh take on something and the other person having already been through it, we got to do a lot of things at the same time. So it was a lot of fun to kind of work through the clinical years, like third and fourth year together.

And our first rotation during June of our third year was family medicine. And we both got to go together and do rural family medicine down in southern Utah. I was in, we were both in St. George at different clinics. And I was in hurricane for part of my time too. But it was really fun because we both got to see clinical problems at the same time, like the same thing, study together for our shelf exams. It was a really fun time, I thought.

Dr. Chan: Did you actively try to have similar rotations? Or is that just happenstance you're on family medicine together?

James: It just happened. We ended up having family medicine, pediatrics, and OB-GYN at the same time, but we never were on the same teams.

Dr. Chan: And you played it cool?

Laura: Yes.

James: Yeah. I mean, I think all the [inaudible 00:14:58] Directors, I think knew that we were a couple.

Dr. Chan: Because they can kind of tell there's some sort of energy about . . .

James: We'd show up together. We'd eat each other's food.

Laura: Dr. Good specifically.

James: Yeah.

Laura: Well, and we talked . . .

Dr. Chan: We just met Dr. Good, I don't know, we just seemed to hit it off. Don't all the third years kiss each other?

Laura: We had talked about it with Dr. Stephenson, and I guess some couples try to be together and some don't want that, like people to know that they're a couple and so we were kind of like let's not try to be together.

Dr. Chan: Let's play it cool.

Laura: Yeah. Let's play it cool.

Dr. Chan: All right. Okay, so James, if I had talked to you in the first two years of med school, what were you thinking of going into? And then what changed your mind? How did you evolve to your eventual choice?

James: Okay, this is a good conversation to have. So I came into med school planning to become a physiatrist. So that's a doctorate in physical medicine and rehab. I was exposed a lot during my undergrad. I did a lot of research in motor control and motor rehabilitation. My undergrad was in exercise science. So it really fit kind of the things that I was interested in. And then I shadowed quite a bit in the different areas of PM&R, which because it's quite broad.

Dr. Chan: And let me just explain what that is to people because people they don't know too much about PM&R. So what kind of doctor is that? And what do they do?

James: So physical medicine and rehab doctor or a physiatrist, it's sometimes called, they're doctors who take care of patients who have been through like life-altering changes in function, so a spinal cord injury, a stroke, a traumatic brain injury, or other types of brain injuries, as well as acute and chronic, like musculoskeletal injuries, so polytrauma patients, once these people are stabilized and out of ICU setting, out of the hospital floor, a lot of them benefit from daily like rehab, from physical therapy, occupational therapy, speech therapy, so they come to what's called the rehab floor.

Dr. Chan: Or another facility.

James: Yeah, or another facility, yeah, it could be a standalone hospital or rehab hospital. But medically they're run by PM&R doctors. So we manage heart failure, infections, lines, you know, wounds, different surgical problems that need to be addressed by other doctors. We basically quarterback all the medical problems so that the therapist can do their thing with the patients three hours a day. And so they have to meet strict criteria to come and see us in the rehab wing. But I just like that because we get to do both the acute setting, but then we get to follow them in the outpatient setting as well.

So there's a lot of good continuity. I love the neuromuscular system. So just a lot of the medicine that I like to do. And during med school, I would say up until third year, that's what I was planning on doing. I really liked my surgery rotation and not because of the surgery, but I liked the anesthesia aspect of it. When I was on my community rotation for two weeks at Altaview I got to do like most of the intubations, because the anesthesia team there was very into medical students because they hardly get medical students there. And so I got to do a lot of intubations there. And I thought that it was really fun, immediate medicine. You get to give medicine, see the effects immediately, which is pretty rare for a lot of doctors. And so like I considered anesthesia pretty seriously during third year.

But then I finally came back and did a two-week elective in PM&R at the end of my third year. And it just kind of sealed the deal. I got to go back to the rehab unit. And it's just that's the environment that I really enjoy. It's very multidisciplinary. We get to work with like seven or eight different allied health professionals. Everyone's kind of giving their take on what the patient needs, and the patients are very involved in that process. So it just seems like good medicine, and it was what I was most interested in.

Dr. Chan: So you were the prodigal PM&R doc. You maybe left a little bit, but then you came back home.

James: Yeah, yeah. Again, I would say I'm lucky because a lot of students never see anything in PM&R during med school. It's very sub-acute. It's kind of like after the fact, you know, everything's about trauma and surgery and acute medical problems in the hospital. But we are more focused. We're kind of like the post-acute care specialists.

Dr. Chan: Okay. I like that. I learned something. That was beautiful. All right. What about you, Laura?

Laura: Yes. So I . . .

Dr. Chan: You mentioned dermatology?

Laura: Yes. So I went to med school thinking I would do pediatrics. And I just really like taking care of kids. And that has not changed since I started medical school. But then I shadowed a dermatologist kind of by happenstance. And I just thought he was a really good doctor. So I kept shadowing him and fell in love with dermatology along the way.

Dr. Chan: So is this in the first two years?

Laura: It was the kind of the end of my first year.

Dr. Chan: Okay, yeah.

Laura: So I love dermatology. I think it's perfect for me. It's a very broad field. And people think that it's not, but it is. I say that dermatologists are experts in a lot of things. And it's fun, because you can make a really broad differential with lots of organ systems. It's really nerdy, which fits me. I like knowing, you know, details of things. I like the idea of being the consult expert on something. So . . .

Dr. Chan: All these rashes have these really intricate names.

Laura: I love that. James always makes fun of me for that.

James: I do. It's a constant.

Laura: What do you say? You're like, "How many adjectives can you put in a rash?"

James: And none of the adjectives actually end up meaning anything about the diagnosis. They're all misnomers too.

Laura: They're all misnomers.

Dr. Chan: Interesting. So third year, were you tempted at all by anything else?

Laura: I was actually, yes. So I, for a minute there, thought that I was going to be a general surgeon. I loved my surgery rotation. It was kind of in the dead of winter. But I ended up loving it. And I was on I remember, bariatric, Fogart bariatric service, which was so fun. And I was like, you know, I could see myself really doing this. And so I would spend time like outside of my rotation, going to other surgeries, exploring other surgical specialties to see what I liked.

But anyway, in the end, I kind of was like, you know, they always say, if you love the OR more than anything else, then be a surgeon. And I was like, "I'm not sure that that's totally me." So I went back to dermatology.

Dr. Chan: Okay. Okay, so you have your fields picked. What is your strategy going into fourth year and interviews and residency application? Did you have a coherent strategy at the beginning? Or was it kind of ad hoc?

James: I mean, I think we kind of thought we had a good strategy. And I think it's important . . .

Dr. Chan: What was your initial strategy?

James: So we made a list of all of the PM&R programs and all of the dermatology programs, and we knew from the gate that we were . . . dermatology is more competitive than PM&R. But physical medicine and rehab is still really competitive. It's a small field. There's not a lot of . . .

Dr. Chan: All fields are competitive nowadays.

James: Yeah.

Laura: So true.

Dr. Chan: It's just a different degree of competitiveness. Yeah.

James: So the first thing we did was see all of the cities where the programs lined up, because they're both small fields. So it's not like internal medicine or surgery where you can apply to Chicago, and there's 35 different programs in one city, you know. I mean, even in the largest cities, they're still like five programs in, you know, in Chicago, New York.

Dr. Chan: So you're targeting larger Northern cities?

James: Well, we were targeting the whole nation actually. So we literally . . . I applied to 65 of the 75 PM&R programs, and you applied to . . .

Laura: I applied to 110 dermatology programs.

James: Of the 117 . . .

Dr. Chan: Dermatology clinics.

Laura: Yeah, I think there's like a 100 . . .

Dr. Chan: So if you feel comfortable in sharing, how much did that initially cost? Because we're talking about clicking those boxes, right? Like the little Amazon bin, the cart just growing.

Laura: Yeah. Well, I actually got a fraud alert from my credit card when I tried to pay that. So I was like . . .

Dr. Chan: So ballpark is $10,000?

James: Not that much.

Laura: No. So initially, it was probably $2,500 for each of us just for the ERS application.

James: And that included . . .

Dr. Chan: That's before interviews, before anything. That's the first step.

James: And I will say we did not know . . . I mean, we knew we were going to spend a lot on interviews, but we didn't know coming out of the gate that it was going to cost us several thousand dollars each just to apply. And we had to apply to prelim years too.

Dr. Chan: Well, all those programs, it takes, like, you know, to print the paper, to open up a file.

Laura: Yeah, that's what it is.

James: We can talk about the racket of all of this another day.

Laura: That's another topic.

James: It does kind of count. I'll put that on the record. It's a racket for sure.

Dr. Chan: All right. So the initial strategy, apply broadly, a lot of programs. Okay.

James: And just see what happened, because we didn't know how competitive we would be. We didn't know. I mean, it's . . .

Dr. Chan: It's the kind of same thing in med school. Like I know, there are certain key differences in the match. But one of I think the core similarities are, if you apply broadly, and then you start seeing how many interview offers you get, you get a kind of a sense of how competitive you are nationally and like what your odds are, right? So if you apply to 50 med schools and you get like 2 interview offers, like you're kind of in rough shape. But if you apply to 50 med schools and you got like 30 interview offers, you go, like, you're in really good shape, right? I would venture the same thing is true for both your fields.

Laura: Yeah, totally.

James: Definitely. That's the, yeah, that's the case.

Dr. Chan: So who started hearing first? Or you know, how did the interview offers trickle in? And then, okay, so yeah. You guys are making faces at each other trying to figure how this all unfolded.

James: I'll start off by saying, so dermatology interviews very late. And we knew that going into it.

Dr. Chan: They want to maximize anxiety.

James: Yeah. So it's hard because PM&R interviews, I mean, starting from mid-October until mid-January, but I'd say 90% of the programs interview before New Year's. So I started getting interviews almost . . . we submitted like late, late September, like the 28th or something, I think. I can't remember the exact date. And then we started getting, I started getting offers within the week for programs.

And so the interview offers, a lot of programs offer more spots than there are, or they offer more interviews than there are spots for those interviews. So you have to literally the minute you get the text, like the second you get it, you have to schedule it.

We both had instances where we missed it by a couple minutes, and we were not able to get an interview. We both had that happen. So you have to get it immediately. We both set up a separate email account and had the emails forwarded to our text messages, our phones on full ring to get the email and the text message to make sure we didn't miss it.

Dr. Chan: Wow.

James: We were both on away rotation at Northwestern when this was happening. So we were both in Chicago, and we had to like step out of rounds. And the good thing is at least my attending teams were really, they were really good about it. But you have to schedule them immediately on a phone and it's . . .

Dr. Chan: Did you have time to coordinate between the two of you? Like were you texting? Or you just okay . . .?

James: There's zero coordination.

Dr. Chan: Or you just have to like just grab that interview offer and just deal with the consequences and the flights and all the other stuff afterwards?

Laura: Yes. So the problem with having different interview seasons is I don't know where I am getting interviews yet. And James's interviews are piling in. So he actually just went on every single interview he got basically.

James: Well, that's not true. But . . .

Laura: But basically.

Dr. Chan: It feels true.

James: I went on.

Laura: You tried to.

James: I went on nine interviews before Laura had even received a second offer. She only had received one offer because most interviews for dermatology don't even come out until after Thanksgiving. And I had been on nine interviews by then.

Dr. Chan: So again, this is great. I love talking about this, because there's so much like so much going on. So James, did you feel that you were kind of like the tip of the spear, meaning that you had to be on your A game because, you know, Laura might have to . . . you know what I'm saying? You were kind of the first wave of the couple. And if you were very, very impressive, that there might be some communication where they would kind of say, "Hey, we really like this James guy. You know, let's make sure that Laura gets an interview," or did you not think like that?

James: So that was definitely my mindset. And I can say as soon as Laura even hinted that dermatology might be her target, like when she was in second year, I knew I had to be the best student I could be, the best applicant to whatever I went into because of that, just because I knew I couldn't be the one that brought down the dermatology application because it's so competitive. And I think that that definitely helped through during interview season. And we tried, we can talk about communication of when I got an offer emailing to ask that they look at my significant other's applications . . .

Dr. Chan: So you're very upfront with that?

James: Yeah. We were very forward on that.

Dr. Chan: Transparent.

James: We emailed and called every, basically every program I was offered an interview to make sure they knew, (a), that I'm couples matching and, (b), that my wife was applying to dermatology. And if they could just reach out and let them know, "Hey, this applicant's significant other hasn't been invited to our program to interview. Just so you know."

Dr. Chan: Did they respond to that? Or was there a wide spectrum of like some people will go, will be silent? Or people would acknowledge they got the email or . . .

Laura: Yeah, for the most part, I think PM&R was very friendly about it. Dermatology I . . .

Dr. Chan: "Don't tell us what to do."

Laura: I couldn't really tell, so we just did it anyway.

Dr. Chan: Okay. All right. So your interview seasons are different. You're interviewing and your interviews start coming in. And going back to the overall strategy, what started to shift? I mean, did you feel like you started saying no to certain programs? Or you're just saying yes to everything? Or and is it budget? I mean what was the budget at and did you just blow right through it?

Laura: Yes, we did. So we couldn't feasibly have a budget, honestly, because we didn't know how it was all going to play out. And we knew that we needed to go on as many interviews as possible to maximize our chances. Yes. And so we had a shared calendar, and we'd put in all of our interviews on there, so we could see each other's interviews, and more towards, you know, when things were ramping up for me, we could start canceling interviews James had where I got rejected. So that was nice.

And then it was also places I hadn't heard from where James had already interviewed, I was kind of like harassing them, like please . . .

James: In a pleasant way.

Laura: Yes, in a very pleasant way, you know, or like, and that actually worked a couple of times. So James had an interview at a couple of schools. And one of them is the place that we matched, actually, where I hadn't heard from them. And so I kept emailing them. And I said, "Hey, my significant other has an interview there. Please, can you tell me if I'm on a waitlist, even so we know if James should cancel or not?" Because it's just so expensive. And a couple of programs said, "Yes, like you are on a waitlist." And then I got off the waitlist, you know, which was awesome. So that worked a couple of times.

James: We should save the end of that story for later. But I think it is important to recognize so upfront, like the way that the calendar looked, I mean, I had two and three interviews scheduled on like many Monday . . . mostly Mondays and Fridays are the hottest interview days.

Laura: James overbooked.

James: And most of my Fridays from Thanksgiving until the middle of January had at least two interviews scheduled, most of the Mondays. So I just want to talk about the courtesy, like it's hard because you want to give like at least a week's notice.

Dr. Chan: So they can find someone else to fill the spot.

James: It's a really valuable spot. A lot of time, it's a lot of, the whole department has to interview all these people. And it's a lot of doctors' time, and obviously, you want them, you want all the applicants to get the interviews that they need. And so you don't want to hold on to it too long. But it was hard because when we were not . . . like say I had three offers, and it was a week away, and I knew which one I wanted to go to. But it was still early enough that Laura hadn't heard from any of the programs. So you have to start making these decisions like, well, which one is the most feasible for us versus which one is the one I want the most because it's the most competitive program? So it's a lot of tough decision making.

Laura: Yeah, we had to like kind of shot in the dark on a few instances.

James: And I would say our thoughts like where we thought we were going to get interviews, we were almost always wrong. Like of the three if I thought, "Oh, well, this one is probably the one that we are going to . . ."

Dr. Chan: Laura just showed me the Google Calendar. It's quite impressive. A lot of different colors.

James: It's just too much. Yeah. I mean, it's just funny because the places we thought we'd get interviews, we didn't get interviews, and the places we would never have dreamed or imagined we would get interviews, places we'd never been before with no ties at all, we got like, we got interviews. And so it's just the whole process was really random.

Laura: I remember, specifically, James had an interview in Birmingham, Alabama. And I was like there's no way Alabama would interview me. That's so random. And then he was about to cancel it and I got an interview. So like you really have no idea.

Dr. Chan: So how many total interviews did you each go on?

Laura: I got 13 offers and went on 11.

James: For dermatology.

Laura: For dermatology.

James: And for prelim year.

Laura: Yeah, so for dermatology, you have to do your intern year is not included in that. And so I had to interview for intern year separately. So I think I went on 25 interviews total for prelim.

James: Twenty-five.

Laura: Yeah. No, 17.

James: You were offered.

Laura: That's right. So I went on 17 for prelim, went on 11 for dermatology.

James: And I, let's see, I was offered 46 PM&R interviews. I went on 23, and then I was, I don't know how many prelims I was offered, but I went on 9 prelim interviews. So and I will say I mean, as an aside, most specialties don't have to do prelim views, but both of our specialties do. And they are very competitive. You don't realize it when you're applying, you're like, "Oh, I'll get an intern year. It's just an intern year. There's always open spots." But they are very competitive. You're competing with dermatology, radiation, oncology, radiology, anesthesia.

Dr. Chan: You like the programs with elective time, you know. Yeah, I know exactly what you're saying.

Laura: It's surprisingly competitive.

James: Yeah. Yeah. We were actually surprised. And we were very fortunate to have a lot of prelim interviews. But if we hadn't applied so broadly, because we were couples matching, I don't think we would have been as successful.

Dr. Chan: Do you mind sharing how much budgeted that you had to pay? Like we're talking flights?

Laura: Yes.

Dr. Chan: Rental car rentals.

James: We were talking about this.

Dr. Chan: Hotel nights, because most of these programs aren't putting you up in a hotel. Right?

Laura: No.

Dr. Chan: You're on your own.

James: I think we both had one program put us up.

Laura: Yeah. So sit down for this.

Dr. Chan: I am.

Laura: You are sitting, good. Probably $40,000 between the two of us.

Dr. Chan: American dollars?

Laura: America dollars.

Dr. Chan: Wow. Wow. Wow. Wow.

James: Yeah. And I would say that probably accounts for we both did two away rotations also, and those were not cheap. I mean, Laura went to Seattle and to Chicago, and we were together in Chicago. So I was in Chicago, and then I went to Rochester, Minnesota. So but both rotations were not cheap either. But I would say definitely the bulk of our money was spent on interviews.

Laura: Yeah. So probably $30,000 for the interviews and then $10,000 for the application process and . . .

Dr. Chan: And then did anything . . . Did you have some catastrophe, some travel plane issue or weather issue? Or did everything kind of run smoothly? Because I know that can create also havoc in the schedule and the cost?

James: We were actually, I think, pretty fortunate as far as like making our flights. Laura had one big delay when she was trying to get across the country. I think you were trying to get back to Alabama from Spokane.

Laura: Oh, yeah.

James: No, you were trying to get to . . .

Laura: Somewhere crazy.

James: It was somewhere in the South. And she was flying to Spokane connecting in Salt Lake. And the flight ended up because of weather and de-icing, it was delayed.

Laura: I basically I ran through airports constantly. But I never had a big catastrophe. So I feel very lucky.

Dr. Chan: It's just sounds so stressful.

James: Yeah, I will say we both definitely ran through a lot of airports. I mean, I know O'Hare Airport, like better than a Chicagoan. I definitely, feel that way.

Dr. Chan: All right. So you interviewed all these programs. I assume you're kind of taking notes and you're kind of forming in your mind, you know, why a certain program is better for you, a better fit than others. How did you approach your rank list? Was it kind of an ongoing discussion? Or did you like dedicate like, okay, date night, this weekend, we're going to just hash this sucker out? Like, what was your kind of approach? What kind of values did you try to like adhere to? I don't know if there was an initial strategy, so, like, what was your thought process? How'd you do that as a couple?

Laura: So I think our rank list was kind of ongoing. We had some shared notes on our phones that we could look at where we each kind of like wrote down what our individual rank lists were, and then we would go to the gym and work out and like talk about our rank list at the gym, like a lot.

James: Yeah. All the time.

Laura: So I had heard that making the request for couples can be very, what's the word? Tenuous?

James: Yeah. A lot of back and forth because . . .

Dr. Chan: Well, it can create stress on a relationship.

James: And I think we were actually pretty fortunate because I think, first and foremost, we both had a lot of really good options. And I think that's the big thing is I don't think there was a program that ended up being on a rank list that we wouldn't, that we didn't think was a good program.

Laura: Yeah.

James: So things like geography were, there were certain places we were more interested in living than others, but we were definitely okay with moving like anywhere. And obviously, strength of the program, but we were looking for also the kindest program. And I think that was something that varied more than we thought it would between programs, just in when you visit, you can just really tell the culture of a program by even how they treat their residents and things like that. Those were things that we're really interested in. And that affected like where we ranked certain programs.

Laura: Yeah, I think I valued collegiality of a program very highly. And then also, you know, the academic strength of the program overall. I think those were kind of my top two things. And I don't know, I felt like a lot of our ranks between me and James, we both liked a lot of the same programs, so it ended up being pretty easy for us to make a rank list.

Dr. Chan: Okay. So no disagreements or no program that was kind of an outlier for one of you?

James: I mean, we went back and forth, I would say. Our lists, the very top of and the very bottom, I would say they weren't big changes there. But the kind of the middle, I think we changed quite a bit over the two months that we were seriously like conversing about a lot of different programs. But I think we were pretty much in agreement by the end about where we ranked things.

Laura: There's a derm program that I really liked. It's kind of it was like a top derm program that I really liked that wasn't as strong in PM&R. And I think that was the only one that I wish had been a little bit higher, but we matched above that, so it's okay.

Dr. Chan: And this entire time going back to the, like the thank you notes or love notes, like, are you guys just like carpet bombing all these places? Like what's your strategy here? And I assume I get the sense PM&R kind of responds, but like dermatology is just kind of like radio silence.

Laura: Yeah. So I . . .

Dr. Chan: I guess what the question is, what was your communication like with the programs? As the rank list evolves and gets solidified, what were you doing to kind of share those feelings? Yeah.

Laura: I think the interview and post-interview communication culture is different between specialties. And in dermatology, I had kind of understood, you tell your number one program they're your number one, and then you don't tell any of the other programs anything really. So that was what I did. What did you do, James?

James: Yeah. And I think, yeah, the statement that the cultures are different is true. I would always . . . the coordinators are like your best friends and these interviews and before and after, because they obviously have the time to respond to things. And they're mostly very, very nice people. They are really organized. And on interview day, I would always get a sense of how much they valued thank you notes. And I had two kind of coordinators specifically that told me, "Oh, I know that the program director looks specifically to see whether you've sent thank you notes or not," which is important.

So I sent thank you notes to every single interviewer that I had whose email address I could get, and some programs don't write . . . and if they tell you specifically not to, then I didn't. And I had a few that were like that. But besides that I sent a strongly worded like letter to every single program that we were ranking, saying that I liked their program. And then for my number one, I just told them that they were my number one and the reasons why they were.

Laura: Yeah. So James had a lot more emails to send then, because dermatology, almost every program said specifically do not send thank you notes.

Dr. Chan: All right. So you submit your rank list in February. How was it from February to March? Felt good? Doubting yourself?

Laura: Yeah. I felt good. So part of it was I was off rotation in February. And after, like submitting my rank list, I was like, I felt like free. I was like, you know, this is awesome. The load's off my back. I can just hang out.

Dr. Chan: Need to work.

Laura: Yeah.

Dr. Chan: And make some money, pay back that $40,000 little gift that keeps on giving?

Laura: Definitely.

James: Yeah. Yeah, I agree. I think I was, I wouldn't say at peace, but I was content that it's out of my hands. You know, I think everyone says that. Everyone seems to echo that sentiment that even if they, thinking back, like, oh, I wish I would have changed four and five or something, at least, you know, you can't change it anymore. And it's kind of like you're letting this computer just make a decision for the rest of your life. And you can kind of just abide by that. And no, you couldn't have done anything different because, at this point, you can't. So I think the pressure was kind of off in some ways. And we knew we had a lot of good options. But we always kept telling ourselves like we could drop to the very bottom of our list.

Even if though we wanted to get, you know, one of our top five, I think we said any of our top five would have been great options, we would have been thrilled about that. We always told ourselves, we ended up having like 11 different programs that we ranked together. And even if we dropped down to the bottom one, we said, you know what? Like going into this, our most important thing was that we'd be together for training. It's still a good program. And we would be thrilled just to be able to have that.

And I think it's worth . . . we should probably talk a little bit about how we made our rank list, because the couple's ranked list, it can kind of be a mess. You connect your applications through the NRMP's portal for the match. So rather than having a list of, you know, 12 programs, you have a list of combinations of those 12. Luckily, ours were so spread out that it was kind of, we didn't have to do the A with A, A with B, B with A. They were all in the same city. We didn't have that scenario. We had one city for each set of programs. So our list was fairly short for our primary list. But we did do some like secondary and tertiary lists below the primary list. I don't know if you want to talk about that a little bit.

Laura: Yeah, just to make sure like some couples are okay with living apart a certain distance, and we kind of decided we weren't okay with that. And also, the secondary list is kind of like to make sure you at least get a prelim spot. So that was our strategy.

Dr. Chan: So the Monday of match week, was that more anxiety provoking than the Friday, or what was your feeling?

Laura: I think it was.

James: Yeah, I agree.

Dr. Chan: Because this is when you, this is where you, no, this is the time when you find out if you matched, and then Friday, you find out where you matched.

Laura: Yes.

Dr. Chan: So Monday, could be very difficult full attention.

Laura: Yeah, yeah. I was very anxious for that Monday. Just because like, you know, there's always a chance that you don't match. And especially with a couples match, we felt additional pressure. And so I was on the ICU rotation, and I was just so anxious. We were on rounds, and you get the email at 9 a.m.

Dr. Chan: Which I heard was a few minutes late this year.

James: It was a few minutes late.

Laura: It was. And so I just I was like I need to like get up and just walk out and . . .

Dr. Chan: You start coffee.

Laura: I just told my team, I was like, "I'm going to find out if I matched. If I don't come back, you know why." So I just walked out and waited for the email. And when I got it, I was just, I was so happy. I was like crying. I'm so happy that I had matched.

Dr. Chan: Where were you, James?

James: So I was off rotation in March. I'm just doing research this month. And so I actually went to Dr. Stephenson's office, because they have rooms set aside for people where you can go and you can just find out from Dr. Stephenson as soon as he finds out if you matched or not. And the reason I did that is because the way that our couples match rank list was set up, we prioritized Laura's match over mine in the secondary lists. So we had our list of us together. But then after that, we had Laura matching dermatology and me matching just intern year, just because the dermatology match is so much more competitive.

And so I wanted to get that email because the email tells you if you partially matched, that is you only got either a prelim year or maybe just an advanced position, but not a whole match or if you matched entirely. So I wanted to find out if I matched like entirely, because I, if I knew that then it also meant that Laura match because we landed one of our first 11 programs together. So I went, I just wanted to hear it from the horse's mouth like, "Okay, you're good. I'll see you on Friday." And that's what happened, right? When the emails came out, he just popped his head in and said, "You're good to go. I'll see you Friday." So it was a really good day. I ran out of the School of Medicine. I was jumping up and down all the way to my car. So it was a really good moment.

Dr. Chan: And then Friday, who was there? Both your families or . . .?

Laura: Yeah, so my parents were there, my, one of my siblings and his wife.

James: And my parents were there. And my twin brother was there as well with his girlfriend.

Dr. Chan: And had you prepared them? Because we really haven't talked about Utah. Had you prepared them for the possibility that you could be moving away?

Laura: Yes. Well, I told them, I said . . .

Dr. Chan: "I love you, but I need a break."

Laura: No, like . . .

Dr. Chan: "A physical distance break."

Laura: They were actually aware of my rank list.

Dr. Chan: Okay.

Laura: So they knew, but I told them, I was like, "No matter where we match, you have to be happy for me. That's how it works."

Dr. Chan: You were lecturing them about unconditional love?

Laura: Yes.

James: Well, I mean, I think it's important just let your loved ones know, especially for the couples match, that just landing together is a monumental feat. I mean, especially in small specialties with I mean, there's like less than 500 spots in each of our specialties. So nationally, the fact that you can both end up at the same program for training, it's really, really difficult. I mean, the numbers are not with you. And as you can see from our, from all of this, it's a lot of work. And so my parents, they didn't really know my rank list. And I didn't really go through all of the intricacies of the match with them. But they did know that there was a possibility that we wouldn't be together. And I kind of, I think the overarching theme that if we end up together, it's a win, they understood that.

So that was kind of how they went into it. But I think that they knew that we, there's a big possibility we could be leaving Utah. I should say there's only one PM&R and one derm program in Utah. It's at the University of Utah. Most states only have one or zero.

Dr. Chan: Okay. So a bunch of speeches, they cut the ribbon, and what do you guys do? Do you go get your envelopes and open it just the two of you? Do you bring it back to your families? How do you do that? Simultaneous? One goes before the other?

Laura: Yes.

Dr. Chan: Open each other's? Oh, I have so many variations of it.

Laura: Yes. So much you could do. I don't know if I fully considered all of those options. But we basically made a beeline for the table immediately, and then brought it back to our family and opened at the same time.

James: Well, and I mean, they called us all up before they cut the ribbon and there's just this mass, there's a horde of us students. We're all up there. We're like, salivating trying to . . .

Dr. Chan: You can just feel the energy.

James: Everyone's kind of like, "Oh, hey, oh, hey," you know, it's like we're exchanging pleasantries, but really, it's like, "Get out of my face. I want to get my envelope."

Laura: Yeah, I was like, I'm pretty sure one of the news outlets here took a photo of me like reaching across everyone to like grab my . . .

Dr. Chan: Throw out some elbows.

James: Yeah, I'm getting out of the way. I'm like standing straight up. My arms are up just to let her through and grab her envelope because she was not, I mean, nothing was going to stand in our way.

Dr. Chan: So where'd you match?

Laura: We matched at . . .

James: Vanderbilt.

Dr. Chan: Nashville, Tennessee.

James: Yeah.

Laura: Music City. Yes. We're so excited.

Dr. Chan: Home of white-hot barbecue. I don't know. There's all these ghost pepper barbecue.

Laura: I didn't know this actually.

James: They're like Commodores. I know that. That's about all I know. Lots of good music.

Dr. Chan: So how do you feel about it?

Laura: We're thrilled to be matched at Vanderbilt. And it's a great program for both of us. It was very high on our list. And Nashville is a really fun city.

James: So yeah, we were both super stoked. And I would reiterate, like we said, one of the things we were really interested in was matching at programs that had really collegial I think, just to borrow Laura's word, collegial programs with really friendly cultures. And I think we both noticed that at Vanderbilt immediately when we got there was. Everyone was very collegial. And for programs as highly ranked as Vanderbilt was for both of our specialties, we were really surprised by that. And so I think that's one of the reasons why it was ranked so highly was because it was really good training combined with a really, really friendly culture in both of our departments. So we were really happy about it.

Laura: Yeah.

Dr. Chan: How did your families react?

Laura: They were happy I think. I could tell that my parents were sad that I was moving away, but . . .

Dr. Chan: They're secretly hoping for like the Western U.S. kind of thing.

Laura: Yeah, exactly. But which I knew was going to be their reaction if I was moving. But they were very, very, very happy for me.

James: Yeah, my folks were really happy as well. I think that they were, they're also kind of bummed I think that we're moving, but at the same time, I think they knew going into it, they knew that, you know, medical training can take people all over. So I think . . .

Dr. Chan: You guys can always come back.

Laura: Yeah.

Dr. Chan: As attendings or for fellowships or whatever.

James: But I will say, I mean, Match Day was kind of bittersweet, because we found out we're actually not going to be in the same city for intern year.

Dr. Chan: Oh, was that also in the envelope?

James: It was in the envelope, yeah. So and that's something that's the couple's match, you can couples match into your primary training, but each, like we said, a PM&R and derm both require a prelim separate rank list for each program. So our rank one, we rank a program, and then you have to make a sub-list under that program of different intern years that you rank for that program, because they only cover years 2 through 4 of training. And so you can't couples match into those sublists. And so we knew going into it, there was a big possibility that some of the intern years might not be together.

Laura: Yeah, I feel like that's a whole other podcast, Dr. Chan, that right there.

Dr. Chan: You'll have to come back. So where did you match for your prelim year?

Laura: So I'm going to be at Providence Sacred Heart Hospital. It's in Spokane, Washington.

James: And I'm going to be actually in Nashville. So my program was categorical through PM&R, so it's a prelim year at Vanderbilt.

Dr. Chan: So I like what you said, bittersweet. So just this rush of emotions, like the main, you know, Vanderbilt, but like the first year. Yeah, thousands of miles.

James: Yeah, it was . . . And I think it was hard. Our families were, I think they knew going into also . . .

Dr. Chan: Confused.

James: Yeah.

Dr. Chan: What is it? What's going on?

James: My parents I think we're pretty confused. They're like, "Oh, well, I thought the match made it so you could be together." I'm like, "Well, yeah, that's true, but the prelim year it doesn't account for." And I think that's just one of the intricacies of the couple's match that's hard, but it's just the way that the system is set up.

Laura: Yeah. I was like it was definitely bittersweet, because I was like crying of happiness. But also I was like, oh, like, you know, it's sad that we didn't get that first year together. But I think overall, very happy.

James: Once we had some time to process, I think that it was . . . it's hard because everyone's like up jumping up and screaming like, "Oh, I'm going here. I'm going here." And we were so happy about Vanderbilt. But I think in the moment, we were kind of, like, shocked. We're like, "Oh, like, we're not going to be together. What does that mean?" You know, especially, I mean, we've just finished talking about how . . .

Dr. Chan: You've been together for the past eight years.

James: Yeah, we did the impossible by getting into the same med school in different years, you know, and there's no couples match for med school admissions. You know, it's very, you just, you both need to get into the same school. And so I think it was just we were surprised, I think. We thought that our, we knew it was an option, but it just was, it was just it caught us off guard. And I think it took us some time to process that. But we definitely, overall, are really stoked about Nashville. It's going to be really good training for us.

Dr. Chan: Are there direct flights from Nashville to Spokane?

Laura: No.

James: No. definitely not.

Dr. Chan: Laura looked into this.

Laura: It's like, I don't even know [inaudible 00:53:20].

Dr. Chan: That's only about a 30-hour drive.

Laura: Yeah, yeah.

James: Yeah.

Laura: And I don't think Spokane has direct flights to a lot of places except like Seattle.

Dr. Chan: Well, it'll go by quickly. I'm sure once you're . . . Have you gotten your call schedules, rotation schedules already?

James: They're in the works.

Dr. Chan: So then you can start looking at the weekends and the vacations, and it'll just like, like, Laura, you just showed me on your little Google Calendar, it'll be kind of like that. Okay.

Laura: It will be really interesting. I think it'll be fun. We have family too in Seattle. So it'll be fun to hang out with them a lot, and nieces and nephews in Seattle.

Dr. Chan: You guys doing all the different programs started reaching out to you.

Laura: And yeah, it's kind of . . .

Dr. Chan: Congratulating you.

Laura: Oh, my gosh, Match Day is such a crazy day because like oh, my gosh, it's so crazy. You're finding out where you going. You know, you're thrilled at where you match. You're finding out your intern year is not together. And then you're getting like bombarded with phone calls from your programs because they want to call you and congratulate you. And they're also sending me 1,000 emails of like documents to fill out.

Dr. Chan: And then like, I remember when I matched and then I got my official contract in the mail a few days later, and I've never signed, I've never made that much money before.

Laura: Yeah.

Dr. Chan: And I just remember and this contract was like a huge deal. I never signed a contract like that. Because it was like a multi, it's probably even bigger now. It was like in this like folder. I remember I had to like read through it and like, "What am I agreeing too?" It's like I have a lot of bargaining power with this. So you end up signing it. But I just remember, like, this is a big deal to sign the sucker.

Laura: I just was saying that in there. I was like, "We actually have to read contracts now because like we're employed."

Dr. Chan: So you've gotten your contracts?

Laura: Yes.

James: Yeah.

Laura: So it's really exciting to actually have a job.

James: Yeah. And I always reiterate the craziness of Match Day, like literally my phone was exploding the whole day. Both of our batteries by lunchtime for our phones were down to like 10%, because I'm getting Twitter notifications and everyone's posting their photos. And one of my good friends I met on the trail actually, he's going to be my co-resident at Vanderbilt. And we met at like three different interviews, and we really, we got along really well and he was texting me like, "Hey, we're going to be co-residents. It's going to be so great." And I'm like, I'm trying to like still process you know, like, "Oh, I'm moving to Nashville. Okay, I'm going to be in Nashville for sure. Laura's going to be in Spokane." Our families were like, "Oh, like, so what does this mean? How long is your training?" You know, it's just there's 1,000 people around you. Everyone's screaming. It's just a lot of stuff going on. It's a really, really stressful day.

Laura: It's such a crazy day. I just don't know how to explain it. Because I, yeah, I was getting texts from all my friends, Like, "Where are you going?" I'm getting tweet notifications, Instagram notifications. People are calling me for my . . .

Dr. Chan: You're trying to explain this Spokane-Vanderbilt thing.

Laura: Yes. My family's trying to talk to me. Oh, gosh, it was so crazy.

James: Well, and we had, we had some people on the phone also that were kind of calling in, like Laura's brother is a missionary in another country. And he was calling in for Match Day. And so we were trying to explain to him over the phone about it and video chat wasn't working. And it was just, I mean, it's just, I have like nine siblings, so everyone's texting me. There were just . . . you can't replicate that type of like notification overload. And maybe once I'm an attending, it'll be like every day. I don't know. But for March, when I was on rotation, it was a lot all at once. So but it was fun. It's a fun day.

Dr. Chan: Well, it sounds like you guys are, sounds like . . . well, first of all, congratulations.

James: Thanks.

Dr. Chan: I'm like really happy for you. And it just sounds like the journey is like continuing and I think you're going to have more stories, and I'm just it's just so cool that like I think Vanderbilt is a great program, Spokane is a great program.

And hopefully, you guys end up back in Utah one day, because we can really use you as physicians, but then I know statistically where you do residency you're more likely to stay in practice. I don't know. We'll have to see. Do you guys have any family in the South in Tennessee or . . .?

James: No, the closest we have is my brother lives in D.C., like the D.C. area of Virginia. So that's, we'll be a lot closer to him.

Dr. Chan: It's only an eight-hour car ride.

James: Most of our family is here I would say.

Laura: And my one of my brothers is applying to law school. So we'll see where he gets in. He did apply to Vanderbilt, which I think would be so fun if he got in there.

Dr. Chan: Cool.

Laura: Yeah.

Dr. Chan: Well, we'll have to have you guys come back and just have an update. But I'm just so excited for you guys. This is so amazing. So good.

Laura: So exciting. I'm just thrilled like, finally, being a real doctor and doing what you want to do is just kind of like indescribable.

James: Yeah, it's just really exciting. I think you work, you spend years and years and years of your life kind of thinking about what this is going to be like, and then it actually happens. And you're like, "Oh, I have a contract. I have a job. My first doctor job." And of course, it's more training, but it's so exciting just to think that you're going to be in charge of patients and you're going to get to take care of them and kind of . . .

Dr. Chan: You're going to have an MD after your name now.

James: Yeah, yeah. It's . . .

Dr. Chan: When you write orders, like people do it, you know like, it means something.

James: It's really exciting. So I mean, we're really thrilled to be moving, to be doing our, the next step of our training, next step of our career and the next step of our life really, you know. We're looking at where we're going to live and you know, doing . . .

Dr. Chan: Have you already gone out to the different cities to scout out apartments?

James: We're going to do that.

Dr. Chan: Can you afford a house with two residents salaries in Nashville?

James: Oh, yeah, we're looking at houses this weekend actually. We're flying out.

Dr. Chan: Exciting.

Laura: So exciting.

James: Yeah, super stoked.

Dr. Chan: All right. Well, thanks, James, thanks, Laura.

James: Thank you.

Laura: Thanks so much.

Announcer: Thanks for listening to "Talking Admissions and Med Student Life" with Dr. Benjamin Chan, the ultimate resource to help you on your journey to and through medical school, a production of the Scope Health Sciences Radio online at thescoperadio.com

Interviewer: Six reasons women love men that get a vasectomy. Dr. Alex Pastuszak is a urologist and reproductive expert at University of Utah Health, and he's counseled thousands of patients through this decision. And today we're going to find out the top six reasons that women love men that get a vasectomy. Let's just start with number one.

Dr. Pastuszak: Reason number one, they don't have to think about birth control anymore. I mean, it's one thing less on your to-do list. Instead of having to go get your birth control every month, either from the pharmacy or from your doctor, you've got your guy who's already taken care of it. Once a vasectomy is done and the lab results come back and there's no more sperm, you're good to go.

Interviewer: All right. Yeah, that's awesome, because so often the woman is responsible for birth control, and, you know, even with other long-term options, in three years you've got to go back or whatever. So it's one and done as they say.

Dr. Pastuszak: One and done.

Interviewer: Okay. Six reasons women love men that get a vasectomy, number two.

Dr. Pastuszak: All right. So a vasectomy is really reliable. I mean, just think about the financial and emotional burden that an unplanned pregnancy can have on someone's life. A vasectomy is more than 99 percent effective. It's really only secondary to abstinence, which most couples, once they're in a partner relationship, don't really want to have. You can test to see that it's been effective, and it's going to prevent you from having a pregnancy down the road.

Interviewer: So that reliability, yeah, I mean a financial hardship or a really tough decision could come if you've decided, you know, we're done having children, and then you have to deal with that. So a vasectomy, very reliable. I like that. What about number three on the top six reasons women love men that get vasectomies?

Dr. Pastuszak: Another great reason is that there are no side effects for the woman, and quite honestly there are almost no side effects for the men either. Remember, the risks of side effects are really about in the 1–2 percent range. So other forms of birth control can have significant side effects for women.

Just think about all the hormonal manipulation that all of these birth control options, except tubal ligation, have. And this can leave women feeling awful, gaining weight, and just in general not wanting to continue with that birth control. Why not just one and done it and get that vasectomy?

Interviewer: All right. Six reasons women love men that get a vasectomy, number four.

Dr. Pastuszak: All right. So this kind of following on what I just said about tubal ligation, you don't need a tubal ligation as the female partner if your male partner has gotten a vasectomy. Why is that important? Because vasectomy is just as effective, safer, and cheaper. So why would a woman need to put herself through a more invasive, riskier, and more expensive procedure when a guy can just go ahead and get his done?

Interviewer: All right. And number five on the top six reasons women love men that get a vasectomy?

Dr. Pastuszak: It's a one-time cost. That's it. And it's usually extraordinarily well covered by insurance. Insurance companies don't want people to have babies. They want them to not have babies. So they'll cover this the vast majority of the time. So pay for it once, and that's it, no more ongoing expenses.

Interviewer: All right. And number six and the final reason that women love men that get vasectomies?

Dr. Pastuszak: It makes a man sexier, Scott.

Interviewer: How's that?

Dr. Pastuszak: What is sexier than a man taking responsibility for the family's birth control? I mean, think about it. Women do so much. A woman, in today's day and age, is still very often both a career person as well somebody who takes care of the kids, raises the kids, and runs the household. A guy can step up and do his part. In no way, any evidence that a vasectomy is going to affect a man's masculinity.

You know, there's

• no impact on testosterone,
• no impact on sexual function,
• no impact on an ejaculatory function,
• no impact on cancer risk,
• etc., etc.

There is absolutely zero reason why a man shouldn't get a vasectomy and be rewarded by being that guy who steps up.

Interviewer: How should a woman bring this topic up in a way that a man might be more open to it if he initially is not? Like if there's a woman listening, that's like, "I don't know if my husband is going to buy into this," and she's already laid out it's going to make you sexier, is there anything else that you would recommend?

Dr. Pastuszak: So I would find that a very compelling reason, but . . .

Interviewer: Yeah, I would think so. I think we should be done really, but, you know, maybe there's that one stubborn guy out there, because, you know, we do exist.

Dr. Pastuszak: You know, it may be a process. You know, but ultimately knowledge is power. I think the facts speak for themselves, and, you know, quite honestly, like getting a man in front of somebody who can actually tell him what the experience is going to be like, either somebody who's had a vasectomy or a urologist who does these day in and day out, is a start.

Interviewer: Got you. What's the next step after you get that buy-in from your man?

Dr. Pastuszak: Go see your urologist. Go see somebody who can give you the facts.

Dr. Chan: What group hacks are made amongst classmates while on any lab? Why is it important to continue the study habits you developed for yourself when dating a classmate? How do you navigate the possibility of not couples matching? And finally, what are some of the things to compromise on as a couple when submitting your rank list? Today on "Talking Admissions and Med Student Life," I interview Taylor and Doug, successful couples match and recent graduates here at the University of Utah School of Medicine.

Announcer: Helping you prepare for one of the most rewarding careers in the world, this is "Talking Admissions and Med Student Life" with your host, the dean of admissions at the University of Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: All right. We now have another awesome podcast with a couple that went through the match together. Taylor and Doug, how do you feel?

Doug: Good.

Taylor: We feel good.

Dr. Chan: All right. So let's start at the very beginning. How did you two meet? What was your first memory of each other?

Taylor: Well . . . So we didn't know each other before medical school. We met each other just in class. I don't know if I have a specific memory of you.

Doug: I mean, I knew of her because I actually knew her roommate in undergrad and . . .

Taylor: That's right.

Dr. Chan: Ooh.

Doug: But we, like, didn't actually know each other in undergrad.

Taylor: Yeah. Douglas was part of, like, the housing. Like, he was an RA just across the street, and I was roommates with my RA. So he was kind of in that crowd. But . . .

Dr. Chan: But you guys never met?

Doug: Ah-a.

Taylor: Well, I was kind of a nerd. I spent a lot of time studying and . . .

Doug: She spent a lot of time in her room and never came out. I was in her apartment, but I'd never had met her before.

Dr. Chan: This is a great story. Did you see pictures of her . . .?

Doug: No.

Dr. Chan: . . . in the apartment?

Doug: Ah-a.

Taylor: Probably. It's, like, I don't know.

Doug: Oh, maybe. I don't know.

Dr. Chan: And the name Taylor, you could have been a boy. It's kind of a . . . No offense. It's kind of an androgynous name.

Taylor: There's no offense there. Like . . .

Dr. Chan: But Taylor Swift has done great things for you guys. She has really reclaimed it for the . . .

Taylor: She has.

Dr. Chan: . . .women in the world so . . .

Taylor: So, yeah, I guess we knew of each other, but I didn't know you until medical school.

Dr. Chan: All right. So when did you two start, when did you get together, first year or second year?

Taylor: So we were, like, we were just close friends all through first year until, we made it to the second half of the year. We started dating around April.

Dr. Chan: And this would have been April of 2014.

Taylor: 2015.

Dr. Chan: 2015. Okay.

Taylor: So three years.

Dr. Chan: All right. Sorry. Yeah. Wow.

Taylor: And then here we are moving to Albuquerque together in . . .

Doug: Oh, you're not supposed to reveal.

Taylor: Oh, sorry.

Doug: Oh, we were supposed to lead up to that moment.

Taylor: Sorry, everybody. Sorry, everybody.

Dr. Chan: It's okay.

Taylor: Retract. Retract.

Dr. Chan: When she said Albuquerque, she meant anywhere from Boston to Los Angeles and in between. Okay. So you met first year, got to know each other, got together April of your first year?

Taylor: Yeah.

Dr. Chan: All right. How did it feel to have, like, a classmate in medicine with you and be dating them? I mean, what was that like?

Doug: Well, we were very hesitant in the beginning because I, personally, had made a rule.

Taylor: It's actually exploitative. Yeah.

Dr. Chan: Yeah. So let's talk about this. Taylor looks very excited right now. Her eyes are lighting up.

Doug: I made a rule first year, no dating in the class.

Taylor: Like he had people making pacts with him.

Dr. Chan: Oh, I've heard rumors about this pact. All right. So . . .

Doug: I did.

Dr. Chan: . . . you had this personal revelation, personal code of conduct. Where did this come from, Doug?

Doug: Just, I don't know, talking with other people that have been through and, like, I just thought it would, potentially, there's a lot of potential for messiness, you know. You're in class together for four hours a day, every day, first and second year, and there's, like . . . I don't know. Just, yeah, I made that rule for myself and . . .

Taylor: And multiple other people in the class.

Doug: Yes.

Dr. Chan: So, like you said, it was a pact, so did you make people sign, like, a document or is this on social media . . .?

Doug: No.

Dr. Chan: . . .or we're talking, like, real finger blood test or . . .?

Taylor: It was just . . .

Dr. Chan: . . . or pinky swear? What are we talking about?

Doug: No. I think it was actually in anatomy lab that I was, like, kind of close with a few people in anatomy lab and we kind of made just a verbal pact not to, like, date in the class. And the funny thing is I'm pretty sure everyone that did the pact ended up dating someone in the class, actually.

Dr. Chan: You can't stop love. You just have to protect it.

Taylor: Yeah. And you're right. There you go.

Dr. Chan: All right. So, Taylor, when you heard about this pact . . . I mean, when did you hear about this or is this after you started dating or. . .?

Taylor: No. I heard about it. He probably tried to make it with me in the car.

Doug: And we followed it.

Dr. Chan: So when you had this pact, you go, no, this is stupid.

Taylor: Well, I mean, I was also not planning on . . .

Doug: She agreed.

Taylor: . . . dating. I probably agreed. Yeah. I probably did.

Doug: You did agree.

Taylor: Yeah. I mean, that wasn't necessarily what I was here for or, like, doing here. And then . . . I don't know. Obviously, we broke the pact.

Doug: It took some convincing.

Dr. Chan: So was your relationship, like, secretive for a while? I mean, did you not tell people?

Doug: I wouldn't say secretive. We just didn't announce it to the world. Like, some . . .

Dr. Chan: Did you just . . . Okay. Go on.

Doug: . . . some people were, like, surprised when they found out. But, like, it's not, like, we were trying to hide it. But we don't . . . I don't know. I guess you could say we're a little more private. We don't, like, post on social media or, like, I don't know, make it super known or, like. . .

Dr. Chan: Would you sit by each other in class?

Doug: No.

Taylor. We didn't.

Doug: We . . . I mean, in the first year, you kind of, like, establish where you sit, and that's kind of where you sit for the rest. . .

Dr. Chan: In the zone.

Doug: Yeah.

Taylor: Yes.

Dr. Chan: Just like how you have a friend zone.

Doug: Exactly.

Dr. Chan: Both of you moved out of each other's friend zone, is it?

Doug: Mm-hmm.

Taylor. Yeah. And then you move out of the friend zone. Yeah.

Dr. Chan: All right. So . . .

Taylor: So . . .

Dr. Chan: Okay. Go on.

Taylor: Oh, sorry. To kind of your question of, like, dating someone within, like, medicine and it was kind of easy for us because we didn't really know any other way, so we kind of both knew that we had to study as much as we did or, you know, clinic as long as we did. But we never knew each other before that so it would never really, it didn't really change. It wasn't a big change, so it was pretty easy.

Dr. Chan: Okay. Cool.

Doug: It did take some convincing.

Taylor: Oh, in the very beginning. I thought . . . Like, we've covered that part of it.

Doug: She was very hesitant in the beginning.

Dr. Chan: Okay. But using the Doug charm . . .

Doug: I did.

Dr. Chan: And you went over. All right. So, you know, you started dating in April of your first year, what did you guys do during that summer? Did you stick around and then Salt Lake or. . .?

Taylor: Yeah. We both did the research . . .

Dr. Chan: MSRP?

Taylor: MSRP. Yeah.

Dough: Yeah. Yeah. Yeah.

Taylor: Yeah. We both were doing that. If I remember correctly, I worked a lot more than you did that summer but . . .

Doug: You did. You did.

Dr. Chan: Okay. All right. All right. And what did you do your projects on?

Taylor: So I was . . . I did mine on, it was a project over at the pediatrics department and pharmacology. We were looking at, like, IV and antibiotics in diabetic, Type 1 diabetic children and, like, if they had higher rates of AKIs, so it was more of a chart review. But . . . Yeah. And he worked on one. He. . .

Doug: I did brown fat and metabolic syndrome.

Taylor: Yeah. And it was one that he had been working on . . .

Doug: Prior to med school.

Taylor: . . . in, prior to med school.

Dr. Chan: And then you got . . . It sounds like you had a stipend with that program.

Taylor: We did. Yeah.

Dr. Chan: Did you get the same stipend?

Doug: I think everyone does. Yeah.

Dr. Chan: Oh, okay. So even though the perception was Doug didn't work as hard. That's just [inaudible 00:07:17].

Taylor: I guess if it . . . Yeah.

Doug: I worked hard.

Taylor: You worked hard. You just didn't have to go in as much as I did.

Dr. Chan: All right. So second year rolls around, how was it being a couple and, you know, doing step one prep and not? How did that go? Did you study with each other? Did you quiz each other? Did you share materials? Like, how did that . . .?

Taylor: So I guess we didn't . . . We don't really study very well together as far as, like . . .

Doug: Uh-uh.

Dr. Chan: Oh, what happens when you study together?

Doug: Well . . .

Taylor: We learn very differently.

Doug: Through first and also second year, we kind of . . . Like, she had friends that she studied with and I had friends that I studied with. But me personally, I kind of studied maybe with someone in the same room but not necessarily with that person. That's kind of how I study, but you study, like, collaboratively, I would . . .

Taylor: Yeah. But I mix with . . .

Doug: I don't know.

Taylor: Yeah. But, I mean, the closer you get to step one, I think the more you have to do just individual studying. I think the group study kind of loses its value after some time. So we would sit next to each other and study, but we'd never really . . .

Doug: Like, quiz each other.

Taylor: . . . quiz each other or talk about it.

Dr. Chan: Was that time pretty stressful, step one, kind of leading to . . .?

Taylor: Yeah.

Doug: Oh, yeah.

Taylor: Yeah. It's pretty bad.

Dr. Chan: Was it the most stressful during med school or it was up there?

Taylor: It was up there.

Doug: I would say, yes.

Dr. Chan: Okay. All right.

Taylor: It was up there.

Doug: Yeah. Definitely for me.

Taylor: But it was . . . I mean, we got through it. Some people were getting full year so . . .

Dr. Chan: All right. So before med school started, if I had asked you what kind of doctor do you want to be, what would you have said and what did you end up choosing and why?

Taylor: I would have said pediatrics, and I'm choosing pediatrics.

Dr. Chan: Why?

Taylor: I like children. Both of my parents are public educators. I think it's kind of in me to be a teacher at a, you know, educator and I think that I deal well with children. I don't mind dealing with parents so, like, I just . . . I don't know. I like kids.

Dr. Chan: When you did your pediatrics rotation, did that just, like, everything . . .?

Taylor: I tried to keep an open mind during third year but, I mean, it was just really . . .

Dr. Chan: Was it just loving pediatrics so much or was is it disliking other things, or how . . .?

Taylor: Both. Yeah. Disliking everything else so you might pick peds.

Dr. Chan: And what kind of rotations did you do on your pediatrics rotation?

Taylor: So we all do a, it's called Glasgow. It's, like, a inpatient rotation where you kind of deal with just regular pediatric issues. So I did that. And then I also was on the GI service.

Dr. Chan: Oh, okay. A lot of poop.

Taylor: A lot of poop. And then the GI service here also runs the liver team, and we also have patients with, like, anorexia and eating disorders and the disorders that come on so you get to see not just poop but there's poop. Yeah. So those were kind of my . . . And then outpatient and then you go to the, well, baby nurseries, so you kind of get a . . .

Dr. Chan: And of those different experiences, Taylor, which one did you enjoy the most? I mean, if you . . .

Taylor: The inpatient.

Dr. Chan: . . . if you can kind of, like, project forward in your career, do you see yourself working in a hospital or a clinic or . . .?

Taylor: I think I'll be a hospitalist.

Dr. Chan: . . . Or, like, just specialize, I guess or . . .

Taylor: Right now, I would probably just be a hospitalist. They are . . .

Dr. Chan: Yeah. What attracts you to hospitalists.

Taylor: I like the schedule, kind of being able to see patients not really on my own time but kind of, like . . . Like, something I don't like about clinic is that feeling of, like, someone's waiting on me all of the time and I'm, like, behind and . . . I just. . . I can't deal with it.

Dr. Chan: You start avoiding exam room seven . . .

Taylor: I can't.

Dr. Chan: . . . because they've been in there too long and [inaudible 00:10:49].

Taylor: Yes. Like, I can't go in there because they've been in there for 20 minutes. So I like that part about inpatient medicine, where it's, like, acute problems. You know, a little bit sicker kids but you can kind of see them, spend more time with them, you know, if you need to or spend less time and check on them multiple times throughout the day. So I probably will do that. They're changing the pediatrics hospitalists right now to where that it's probably going to be fellowshipped after 2019, which right now it's an RA. Now you can go into it right after a residency.

Dr. Chan: How long a fellowship?

Taylor: I think it's two years.

Dr. Chan: So they're going from zero to two years?

Taylor: I think it's two but . . .

Dr. Chan: That's gutsy.

Taylor: Don't quote me. Well, actually, you are going to quote me on this thing but . . .

Dr. Chan: No worries. Yes. It's a different Taylor.

Taylor: Yeah. I need to look into it more because I'm just not sure how that's actually going to affect employment going forward. Like, how are hospitals going to . . . Like, in this time period where I'll be graduating, you know, from residency in 2021, like, what is that going to look like for the field of hospitalists?

Dr. Chan: You want to hear my prediction?

Taylor: Yeah.

Dr. Chan: That the old grandfather or grandmother, all the older physicians into it and the rising generation will just be screwed. Yup.

Taylor: Yeah. And so . . .

Dr. Chan: So they're require it for your gen . . . Yeah.

Taylor: For me, because I'm not graduating before 2019. And I think that's probably true so I'm probably looking at a fellowship somewhere.

Dr. Chan: When I say screwed, I mean that the rising generation will have additional educational opportunities. They'll become more proficient in the arts of being a hospitalist as well as caring, treating multiple diagnoses, you know, blah blah blah. Okay.

Taylor: But it's just interesting that they're doing it because they're not . . .

Dr. Chan: I would think they would create a one-year fellowship.

Taylor: Yeah. Maybe it wasn't . . .

Dr. Chan: [inaudible 00:12:26] It's, like, almost doubling the residency.

Taylor: Maybe it's one year.

Doug: But how long are the fellowships for peds.

Taylor: Three years. Mostly.

Dr. Chan: But usually, that's, like, a year or two of research build into it?

Taylor: Yeah.

Doug: Oh, is it? Okay.

Taylor: And it's just interesting that they're doing it because pediatric residencies are very similar to medicine residencies, in that, it's very impatient heavy. We do basically three years of impatient with, you know, a half day clinic a week. Like, it's not . . . Like, I'm not going to be able to be prepared for that. But I'm just . . .

Dr. Chan: So let's say it is . . .

Taylor: . . . I'm interested to see how it's really going to change the trend.

Dr. Chan: Let's say it does turn out to be a two-year fellowship, at that time, do you just, like, well, maybe you should just do a specialty, you know, because those individuals have a lot of, they do a lot of hospice work themselves?

Taylor: They do. Yeah. They do.

Dr. Chan: Yeah. Like a GI service.

Taylor: The GIs, yeah, I mean, they can do . . . The GI actually is nice because they can do inpatient, clinic, and then procedures as well. They kind of get a mixture of all three so . . .

Dr. Chan: Oh, it's looks a future discussion for you and Doug. All right.

Doug: All right.

Taylor: Yeah. Yeah.

Dr. Chan: So, Doug, what kind of doctor were you going to be?

Doug: So I also wanted to be a pediatrician coming into medical school. I had worked with kids before, like, mostly, like, adolescence and high school, kind of, like, I guess you could say, at-risk youth or whatever. But that made me think I wanted peds but I ended up picking child, well, psychiatry, probably child psychiatry.

Dr. Chan: A man after my own heart.

Doug: Because I love it. Exactly.

Dr. Chan: What did you like about child psychiatry compared to your pediatrics experience?

Doug: I think . . . I don't know. Just, like, the fact that, like, a lot of times in child's psyche, they don't, they're not where they are of their own accord, and that's common in peds, in general. But I think, like, psych, it takes that extra step of, like, getting to know them. Like, why are they there? Like, what happened to them? Like, not just physically but, like, emotionally and, like . . . I don't know. It just kind of, like, struck a chord with me that, you know, certain patients that you see remind you of maybe, like, my little brother or, you know, remind me that I could have been in that position just as easily as they are. And it also helped that I had great attendings. So, yeah, I really loved it, and I tried not to pass judgment until after I tried my pediatric rotation because I just had psychiatry first, of course. And I liked peds. I didn't have the best resident, necessarily, but it was still a good experience. But I think just overall, I kept going back to psychiatry, specifically child psychiatry.

Dr. Chan: Okay. All right. Let's talk about end of third year beginning of fourth year. What was your . . .? I mean, well, first of all, let me ask, when did the couples match idea start? I mean, did you start talking about that in third year or how far in advance was that on the radar?

Doug: Probably in third year.

Taylor: Third year.

Doug: I think you have to in third year, pretty much.

Taylor: Well . . .

Doug: Because you have to apply by the end of third year.

Taylor: Well, no.

Dr. Chan: You have to get your application. Yeah.

Taylor: Yeah. And . . .

Dr. Chan: So what was your strategy as a couple going into this match process?

Taylor: So we . . . First of all, you look at the list of programs that you can apply to you, and it's kind of intimidating. It's long. You don't really know how to narrow it, so the first strategy that we used to narrow was geographic. We wanted to be in the western half of the United States.

Dr. Chan: Why?

Taylor: I just think we're more . . .

Doug: We're just more West Coast people.

Taylor: West Coast people.

Doug: East Coast is . . .

Taylor: I don't know.

Dr. Chan: So both of your families are in Utah?

Taylor: Families are in Utah.

Doug: Yes.

Taylor: Like, I don't know. We just . . . That's what we decided.

Doug: I don't know. Yeah.

Dr. Chan: So you make a list.

Taylor: We make a list.

Dr. Chan: Did Excel spreadsheet turn?

Doug: Mm-hmm.

Taylor: Oh, yeah.

Dr. Chan: Who owns this Excel?

Doug: She does.

Dr. Chan: Okay. So Taylor is in charge of Excel.

Taylor: My mom actually helped a lot too. She would kind of, started pulling in information because the other thing that, the problem with applying for residency is that schools are not transparent about, like, their requirements, so, like, what will actually get an interview somewhere. Like, I'm specifically talking about, like, scores, experiences, research, you know, how much research do you have. You don't really have that information of, like, the school will or will not interview you. So my mom tried to, like, build an Excel document that, like, said, this is what they say you should have for volunteer, and this is what you should say.

Dr. Chan: Wow.

Taylor: It was very . . .

Dr. Chan: So your mom was trying to create, like, an algorithm?

Taylor: She was. Yeah.

Dr. Chan: You should maybe sell this.

Taylor: I know. I was thinking that.

Dr. Chan: I see a valuable piece of information.

Taylor: I know it was really nice of her. She spent a lot of time on it. And so then, I kind of took that. Because she went through a lot of hermeneuts so . . .

Dr. Chan: So she did that for you or both of you or how . . .?

Taylor: She did it for both of us.

Dr. Chan: Or did she do kind of, like, three separate, oh, this is Doug . . .

Taylor: It was like . . .

Dr. Chan: . . . and this is Taylor, and this is you guys combined or . . .?

Taylor: So she would, like, find a program and then, but she was, like, focused on pediatrics but then underneath in the next line on Excel, she'd write, like, for psychiatry, this is what they say. So she was doing a lot of work.

Dr. Chan: Was she doing, like . . . Was it just off the internet or she'd go on different websites and . . .?

Taylor: Yeah. Just off the . . .

Dr. Chan: . . . I mean, kind of aggregating it on herself?

Taylor: Yeah.

Doug: Yeah.

Dr. Chan: Okay. All right. I guess I should say that my mom loves to, like, surf the web. Like, that's what she does at night. Like my dad watches TV, and she has her computer out, and she's, like, surfing. Like, she loves to look things up and . . . So for her, it was kind of, she just worked on it.

Dr. Chan: So she's going to listen to this podcast?

Taylor: She probably is.

Dr. Chan: That's cool.

Taylor: Yeah. So she helped a lot. She put together this really nice document. And then I kind of, from there, we looked at the, you know, the schools that she, or the programs that she had put together and we kind of pulled . . . I can't even remember how many we applied for, but . . .

Dr. Chan: So you targeted western schools, schools in the west of the United States.

Taylor: Yeah. The farthest east that we interviewed was in Grand Rapids, Michigan. Everything else was west of that.

Doug: But we did apply, like, East Coast, still, some. Didn't we?

Taylor: A little bit.

Doug: I mean, we applied broadly just because we are a couples matching and we had to, kind of.

Taylor: Yeah. But it was definitely focused on . . .

Dr. Chan: How much did you set aside? How much money did this cost? Because the more programs you apply to and the more you interview, you know, all of that stuff.

Taylor: I think that our initial U.S. application was, it was under 1,000. I think it was 8 . . .

Dr. Chan: Each or together?

Taylor: Oh, each.

Doug: Each. Yeah.

Taylor. I think I almost spent, like, 800 maybe on U.S. or . . . I wish I could remember the exact numbers. And then, I also did not keep a very good track of how much it cost just for, like, interviewing. I just kind of . . . At that point, you just . . .

Dr. Chan: Yeah. You just go.

Taylor: . . . have to go.

Doug: You don't want to make yourself more depressed.

Taylor: Yeah. So, you don't . . . I didn't keep . . .

Doug: People always ask me how much to set aside, like, third years, and I have a hard time because I don't know anyone that, like, actually kept track. But . . .

Taylor: I'm sure there are people in our class that did keep . . .

Doug: There probably are . . .

Taylor: . . . track.

Doug: But I don't know. I think 10 grand is a safe number.

Taylor: Yeah. I don't think I spent more than that. That's for sure.

Dr. Chan: Is that American dollars? That's a lot then.

Doug: Yeah.

Taylor: Fair enough.

Doug: It is a lot money.

Taylor: It's a lot. It's a lot. Yeah.

Doug: And that's couples matching so we potentially interviewed at more places than if we were just singles match so . . .

Dr. Chan: So would you go out together and do interviews or just kind of separate or . . .? And . . .

Taylor: So that would have been ideal but the way it kind of works is you get an e-mail from the program, and you set it up so that it, like, sends a text to your phone because you don't want to miss it if you're not a good Wi-fi or . . . And you e-mail back immediately. So the hard part was if we got, you know, if I got an email from a program before he did, I would just set up my interview because I didn't want to lose my date. There were two or three we were able to coordinate together but for the most part, you just kind of do it. We were . . .

Doug: But they were pretty good about trying to work with us and, you know . . .

Taylor: But some of them weren't either . . .

Dough: Yeah. That's true.

Taylor: . . . and so we were just kind of . . .

Dr. Chan: So you go out and started interviewing these different programs and, you know, and I hesitate to call it this, but it's like a game, right?

Doug: It is.

Taylor: Yeah.

Dr. Chan: You interview with these programs and then, you know, then, like, afterwards there's this bizarre ritual I've detected, where, you know, thank you e-mails or thank you notes or I really like your program. Like, walk me through that, especially as a couple. Did you kind of coordinate where you kind of started responding towards people or how did that go?

Doug: No. I mean, so one of our . . . Can I say his name on here? I don't know. One of our, one of the people advising us.

Dr. Chan: Sure.

Doug: . . . basically coached our entire class into what to do, basically, just because . . .

Dr. Chan: Was it Dr. Stevenson?

Doug: Yeah.

Taylor: Mm-hmm.

Dr. Chan: Oh, that's fine.

Doug: Oh, okay. I don't know. I don't know.

Dr. Chan: I thought you were going to go someplace other . . .

Doug: No.

Dr. Chan: Okay. Dr. Benjamin. Yeah.

Taylor: Even I wasn't sure where you were going to head with this.

Dr. Chan: Yeah. Dr. Stevenson. Yeah.

Doug: Dr. Stevenson is amazing. I love you.

Dr. Chan: Yeah. I hope he's listening, too.

Taylor: Wait. I may have to [inaudible 00:21:14].

Doug: Shout out to him. So he basically coached the entire class into how to, basically, tread these waters, basically. And it is a game, you know. The programs play the game, and we play the game, and you just have to be aware. So basically, he said, you know, send a thank you to everyone. Regardless of whether you like them, just do it. You know, you don't have to and . . .

Dr. Chan: A thank you email or a thank you notes or, like . . .

Doug: Either or.

Taylor: I would just stick to email.

Doug: Emails are just usually easier.

Dr. Chan: What did you guys use?

Taylor: We did email.

Doug: I mean, I did thank you cards to [inaudible 00:21:45] because I was there.

Taylor: Oh, [inaudible 00:21:47] rotation?

Doug: Yeah.

Dr. Chan: The only danger of email, in my experience is sometimes if you start cutting and pasting, you send the wrong email to the wrong program. And now that's we're done.

Doug: Yes. So you have to be very good about that.

Dr. Chan: Very circumspect when you're filling that email.

Taylor: And I don't even know how much it really means. It's, like you said, it's a game we kind of all do it, but I don't know . . .

Dr. Chan: Well, I've talked to other people who've gone through the couples match, and I'm very curious, did you start, like, invoking the other person? Like, saying, hey, my significant other or my girlfriend or my boyfriend, my . . . Are they . . .? They're interested in the peds or psychiatry program? Did you start invoking that or did you keep it cloistered chest? Or how did you do that?

Taylor: The only instance that we did do that was to get more interviews. So there were several programs that, like, I got an interview, or you got an interview that then we would e-mail and say, like, hey, my significant other has an interview there. But as far as our thank you letters . . .

Doug: We did.

Taylor: At the very end but not right after the interview.

Doug: Oh, yeah. Yeah. Yeah.

Dr. Chan: How did the people respond to that? Did you felt that you were granted additional interviews because of the other person?

Doug: There are some specific cases that, yeah. That was definitely it.

Dr. Chan: Did they come out and say it or did they . . . or was it just kind of, hmm, it's probably lower. It's hard to tell.

Taylor: So I think, like, one example was Grand Rapids, Michigan. It's a Michigan State program. He got an interview, and I didn't, and I think they probably didn't give me one because they thought that some Utah girl is not going to make the trip to . . . Dr. Chan: Grand Rapids.

Taylor: Grand Rapids because I think that part of this whole process is very geographical. I think people . . . This was the same way, I even said it in the beginning, that's how I started, people, like, people from the Midwest are going to stay in the Midwest.

Dr. Chan: I mean, like, we have finite amount of intermix states.

Taylor: Yeah. And they're, like, we have the . . .

Dr. Chan: You know, and this person that's coming out here, they just want to check out the rapids and find out if they're grand or . . .

Doug: Yeah. Exactly.

Taylor: Yeah. Exactly. Yeah. So as soon as I emailed and said, hey, you know, my significant other was granted an interview with your psychiatry program, immediately they were like, oh, you're willing to come? Sure. So we actually did get some, you know, additional interviews. Other ones just kind of ignored. It's fair. It's fine. And then, Doug was saying, at the end of the interview season, you kind of try to send a wrap-up email. So kind of in the same, like, thank you e-mail realm of, like, a wrap-up, like, hey, now that it's over, remember me right before rank lists are due. And in that case, we did talk about our significant other in the respective programs and so . . .

Doug: And said, like, we both really liked so and so place, you know.

Taylor: We loved this city and, you know, we would love to be here in June or something. So we did mention each other at the end but . . .

Doug: And it's hard to know whether or not that helped but . . .

Taylor: We don't know.

Doug: I mean, we couples match so there's that. But, like, it's hard to know whether or not saying, oh, my significant other also is interviewing. We both really want to come out here. In my mind, if I was a program director, program, yeah, I would think that that would be a good thing. But that's just my personal opinion, so it's hard to say or hard to know.

Dr. Chan: As you went through the process, I mean, there's obviously, in any relationship, there's always kind of, like, give and take, compromise, negotiation on some level. When you started coming up with your joint rank list, what we're kind of the discussion on it? What were you two focusing on and what did you feel like, you know, like, compromise on them on some level?

Doug: Well, there's definitely geographic, and then there's definitely, like, obviously quality of programs. Of course, there's some that are better than others. And then just kind of, like, if, like, she got more interviews than I did and so that played into it as well.

Taylor: Yeah. And we had to kind of figure out how we were going to navigate that. So, like, the programs that we interviewed at together obviously go to the top of the list but then how do you rank the rest and how do you make those permutations work?

Dr. Chan: Well, how did you do that? I mean, what was kind of . . .? Like, did you have, like, a little algorithm in your mind or . . .? Yeah.

Taylor: Yeah. Most of it was, like, geographical, or as in, like, how close the program that I interviewed at would be to the one that we would rank next for him. So one of it was just, like, vicinity to each other. I don't know. Our rank list was long and convoluted . . .

Dr. Chan: How many did you . . .? Numbers.

Dough: Oh, man.

Taylor: I . . .

Dr. Chan: People have been quoting in the hundreds.

Doug: Yeah. Hundreds.

Dr. Chan: Wow.

Doug: Easy. I mean, so . . .

Taylor: It seems like it would be in hundreds. This is what I mean.

Doug: . . . so we basically made our individual lists, and then we came together and said, okay, where, like, where can we be flexible? Like, where are we willing to go? And we want to rank such and such at this place and. . . Basically, like, with the help of Dr. Stevenson, who helped a lot, basically, we were able to couples and singles match, essentially, as a way to, basically, do your ranking so that you do both.

Dr. Chan: How did that make you feel that there is a possibility that you could have not couples matched or the one of you that possibly didn't match?

Taylor: Yeah. I mean, to be honest . . .

Dr. Chan: How do you navigate that? I don't know . . .

Taylor: To be honest, going into match day, that is, we were kind of both prepared for that. And very thankful that we don't have to deal with what that would have looked like.

Dr. Chan: To be geographically separated or . . .

Taylor: Right. Right. But we were . . . It was scary. We were both nervous, and we thought. . . The way our rank list played out, like, we ranked places where we would not be together, so that was always a chance. Like, if it's on your rank list, there's a chance that that's where you'll go. And so we . . .

Dr. Chan: Is that something that, again, like, is that something you would talk about all of the time or it was a too kind of a sensitive area you just can't dwell on it too long.

Doug: No. We definitely . . . You have to, like . . . I don't know. I feel, like, if you can't talk about it, you probably shouldn't be couples matching. But we basically talked about it a lot, and kind of said, okay, obviously we want to be here in, like, together at the same place but if that's not possible then, for example . . . I don't know. And I always like to forget this.

Taylor: Like, I just, for instance, like, I got an interview at Omaha, and he didn't. But there were multiple programs like in the Midwest or even, you know, Utah kind of, like, a circle around Omaha that would have worked if I had . . .

Dr. Chan: Yeah. I drive to Omaha all the time from Salt Lake City.

Doug: Yeah. Exactly.

Taylor: Yeah. See. See.

Dr. Chan: I'm being very sarcastic.

Taylor: It's so close, but it's so close. But, I mean, like, that was, like, an example of, like . . .

Dr. Chan: Oh, I see. Yeah.

Taylor: . . . we had, like, that program where we had to figure out, you know, we had to, like, you know, face the reality that that could happen if we ranked it. So . . .

Doug: Basically, we just made it high on the list if they were, like, geographically closer together. So maybe, like, Utah and California versus Utah and Omaha, you know. That the closer it would be, you know, higher up and then the ones not so much, that would be lower down. But that's basically how we . . .

Taylor: Yeah. And to be . . .

Doug: . . . basically, made our list.

Taylor: . . . to be quite honest, I cannot recreate the list for you right now. It was very long, and I don't know what . . . We made a decision at the time, and I can't remember whether . . .

Dr. Chan: That was my next question. I want to hear what was numbers, like, 10 through 50.

Taylor: Yeah. Exactly, right?

Dr. Chan: It's just a blur of clicking boxes and . . .

Taylor: No idea. No idea. They were decisions that we were very open with each other at the time, but at this point, it don't matter so . . .

Dr. Chan: Yeah. So you're going in, and it sounds like almost ready to do the long distance thing?

Taylor: Yeah. We were.

Dr. Chan: Have you ever been in a long distance relationship before?

Taylor: I have not.

Doug: I have.

Dr. Chan: Okay. And obviously, it didn't work out because you're now . . .

Doug: Obviously.

Dr. Chan: . . . with Taylor. And so, yeah, it sounds like that was pretty stressed provoking, a stressful little thing.

Taylor: It was. We were . . .

Dough. It was.

Taylor: And I think that was probably true for all five of the couples that were in the room last month. And it was . . . Yeah. We were very nervous that that's what we were going to open.

Dr. Chan: Would your families kind of talk to you about this a lot or would it . . .? Okay. Did they understand? I mean, I think it's hard for people . . . I mean, that's one of the goals of doing this podcast is for different people to listen to it and understand it. But I get the sense from people who are not in medicine or medical education, it's hard to conceptualize what the match is and then throw on top of it, what this thing called the couples match is. Is there . . .?

Taylor: Right. And I mean, both of our families were involved, I think. I had . . . we both had trips where our parents went with us instead of each other because, you know, they had a little more flexibility. And so, I don't mean to say that they didn't understand it completely but a lot . . .

Doug: But they didn't and . . .

Taylor: . . . a lot of the decisions were between me and him, and they were just as happy for us, I think, as we were on match day so . . .

Doug: I mean, I think they knew that we were trying to go to the same place but as far as details, it's kind of hard to explain when we hardly . . . I mean, we understood it but, like, still . . .

Taylor: It's very complex.

Doug: It's very complex. Yeah. So it's kind of hard to explain to people outside of the process but essentially, it's, like, oh, we make a list, and there's also a possibility that we go in separate places, but that's just kind of the nature of the game so . . . But, yeah, I think they understood as much as they could.

Dr. Chan: So going into the Monday was that . . .? Tell me what happened on Monday when you found out that you matched.

Taylor: Oh, we were so relieved.

Dr. Chan: So what were you doing? Were you checking it together?

Taylor: Yeah. We checked it together and then we . . .

Doug: We were.

Taylor: . . . got our friends together and we went to . . .

Doug: Celebrated.

Taylor: We went to lunch.

Dr. Chan: So you found out that you matched . . .?

Doug: Aha.

Taylor: Yeah.

Dr. Chan: . . . but not where you matched . . .?

Taylor: Yeah. So you just get an email that said that you, congratulations, you matched. So we . . . Opposite of that would be you get an email that says, you did not match, and then you would enter the SOAP, which I'm sure you've probably talked about on this podcast . . .

Dr. Chan: No. No. We can talk a little bit.

Taylor: . . . before but . . .

Dr. Chan: Yeah. Let's talk about the SOAP. So it's sounds like . . . I get the sense, like, that you were prepared to SOAP it?

Doug: Mm-hmm.

Taylor: Yeah. We were.

Dr. Chan: Oh, okay. And so what was this SOAP? Yeah.

Doug: So the SOAP is basically if you don't match, there's programs that . . .

Dr. Chan: Supplemental . . .

Taylor: Offer Acceptance Programs.

Dr. Chan: Yup. Supplemental Offer Acceptance Programs.

Taylor: S-O-A-P.

Dr. Chan: Yeah. Subjective Objective Assessment Plan. That's what the SOAP meant.

Doug: Oh, yeah.

Taylor: The SOAP not . . .

Dr. Chan: Oh, it's SOAP and medicine.

Doug: Exactly. It is.

Taylor: There is so many acronyms.

Doug: So basically, like, yeah, if . . . And I actually found this out, probably not that long ago, that programs actually have to opt into the SOAP. I had just assumed that programs that didn't fill automatically went into the SOAP because that kind of made sense to me. But apparently, yeah, like. . .

Dr. Chan: It's a free country. God bless U.S.A.

Doug: Yeah. Exactly.

Dr. Chan: People can think whatever they want.

Dr. Chan: Anyways. So basically, if you don't match in to, you know, what you wanted to, the SOAP opens for you and you can, essentially, reapply for any program that did not fill their spots. And you're not limited to, like, the specialty you originally chose or anything. You just kind of hope you get into a residency program that didn't fill, basically.

Dr. Chan: So you go from that possibility to matching. It must have been, like . . .

Taylor: Yeah. Well, but I would . . .

Dr. Chan: Was it one of the most exhilarating moments of your life or . . .?

Doug: Yeah.

Taylor: It was very nice to get through this.

Dr. Chan: Did you not believe it at first? Did you . . .?

Taylor: We did not believe it at first but we . . . then we . . . but then we believed it. Yeah.

Dr. Chan: You hit the refresh several times, and it's, like, yeah.

Doug: Because you know what time it's supposed to come in, so you keep hitting refresh up until MNA and then . . .

Taylor: Right. And I think just because of, you know, we were couples matching and we knew that there were risks that we were taking, we were prepared for that. And then we didn't have to do it. So we had a nice Monday. And then a nice week.

Dr. Chan: Okay. Great Monday. The rest . . . All right. So walk me through it. So Friday, match day, both of your families are there. Ten o'clock you open the envelopes. You cut the ribbon. There are some speeches. What do you two do with the envelopes? Do you open it at the same time, or how did that unfold?

Doug: So we ended up . . . Yeah. I dragged my family over to her family's tables.

Dr. Chan: Your families weren't sitting together?

Doug: No. Well, they almost . . .

Taylor: They got there at different times.

Dr. Chan: They know you guys are . . .

Doug: They got there at different times.

Dr. Chan: . . together, right?

Doug: Yes. Of course.

Taylor: They do but . . . It wasn't . . .

Dr. Chan: And this is not the first time they've met?

Taylor: Stop. No. This is not reason.

Doug: No. No. No.

Taylor: No. No. This is not the reason.

Doug: I mean, there were couple that that happened. No. Well, it was very busy and, like, even, like, by the end, there was even, like . . .

Taylor: It was kind of a small room.

Doug: . . . a bunch of family standing in the pathway. Yeah. It's not . . .

Taylor: Well, my parents apparently got, they got there before I did and they got one of the last tables, so they just . . . It was just a . . .

Doug: First come, first served kind of thing. Anyways, so we went over, and we said, like, basically, yeah, let's open it together and then there was a nice video and . . .

Dr. Chan: Yeah. You guys made the video?

Doug: We did.

Taylor: We did.

Dr. Chan: And apparently, both of you were interviewed by the reporters.

Doug: We were.

Taylor: We were.

Doug: There was a news story.

Dr. Chan: Did you know that was going to happen ahead of time?

Taylor: We didn't know.

Doug: Not ahead of time.

Dr. Chan: Or did they kind of just, like, tracked you down and put, like, a microphone in your face?

Taylor: Yeah. I think my Mom was really friendly to the reporter and so then he, like . . .

Dr. Chan: Your mom . . . I love it. She . . .

Taylor: She, like, chatted . . .

Dr. Chan: She creates . . .

Taylor: She was chatting with one of them.

Doug: I didn't know that.

Dr. Chan: . . . Excel spreadsheets, Excels, and . . . so, you know, yeah, we should get your mom into, like . . .

Taylor: My mom should be on the podcast.

Dr. Chan: . . . Fortune 500 wife. Yeah. Get your mum in here. Yeah.

Taylor: She's superwoman.

Dr. Chan: What's your mom's name?

Taylor: Jolene.

Dr. Chan: Jolene?

Taylor: Yeah.

Dr. Chan: Hey, Jolene. Does she go by Joe or is it JJ . . .

Taylor: Either.

Dr. Chan: . . . or Sleney.

Taylor: Sleney.

Dr. Chan: Jolene, if you're listening, come on.

Taylor: Come on to the podcast.

Dr. Chan: We want to hear your secrets.

Taylor: So I think she was friendly with the reporter.

Dough: Somebody, and then somebody asked, I think, oh, it was a photographer who asked if we would talk to the reporter.

Taylor: So my mum was real chatty with the photographer and then she somehow she got them on us.

Dr. Chan: So you open your envelopes together?

Taylor: We did.

Dr. Chan: Okay. And then where are you going?

Taylor: We're going to Albuquerque.

Doug: Albuquerque in New Mexico.

Dr. Chan: The University of New Mexico?

Dough: The University of New Mexico. Yes.

Taylor: Yeah. The University of New Mexico.

Dr. Chan: So how did it feel?

Taylor: Well, just the fact that we're going together was a big relief for us as we were just explaining. That was something we were very stressed about. And both of us actually did an away rotation in fourth year down in Albuquerque, so we kind of got to know some of the people and the residents and . . . So we were both really excited.

Doug: Very happy.

Taylor: We were very happy.

Doug: Very relieved.

Dr. Chan: Awesome.

Doug: Some tears were shed.

Dr. Chan: And then, like, crying and then a lot of, like, congratulations and hugs and you guys having this new experience of pictures being taken by the media and doing interviews, to reporters.

Doug: There were some pictures in the newspaper.

Dr. Chan: "Tribune" did a review that you guys were in.

Taylor: It was funny because the whole room, there was just so much emotion and excitement and, you know, most people are crying in some way, shape, or form. And, like, my grandmother was there and we. . .I went around the table, like, hugging my family members and when I get to my grandma, and this was, you know, several minutes after I'd opened the envelope and she finally asked, "Are these tears of happiness or tears of sadness?" She just didn't know if I was happy or sad because we were just . . . And, like, that's kind of how everyone was. Like, everyone was just . . .

Dr. Chan: Yeah. It's kind of a rush. I mean, it's very . . . It's become very ritualistic, and unfortunately, I think it's taken a life of its own. But it's gotten to this point, it's become like a bigger and bigger deal because, like . . . You know, and again, in my day, in my day, you know, our match day, I mean, it was at, like, a nice place but, like, I just remember that it wasn't as much, like, pomp and circumstance and there's, like, there seems to be a lot of more . . . And just, like, the energy, it's just, like, it just kind of crescendos to this moment.

Taylor: Well, the event is, like, very intimate. Like, you're with your family. You're standing right there and, you know, there's . . .

Doug: It's pretty small.

Taylor: It's, yeah, it is very . . . I mean, obviously, this is the first one I've ever been to so I don't know how it's changed over the years. But, I mean . . .

Dr. Chan: If you want to, you can attend them at New Mexico. You'll probably be busy but . . .

Taylor: Yeah. I'll probably be working that day.

Dr. Chan: Yeah, you know, but you're a house staff, so you're always invited to these type of events.

Doug: Yeah. That's true.

Dr. Chan: And be friends with the medical students and get to know them, and you'll be interested, and in case they go into pediatrics or psychiatry.

Taylor: Right. [inaudible 00:37:48] go.

Doug: Sure.

Dr. Chan: All right. So last few minutes sell me a New Mexico. What's great about this school? What would attracted you to the program? Why should people who are listening apply to the University of New Mexico?

Doug: First of all, there is the infamous hot air balloon festival . . .

Taylor: Yeah. That's . . .

Doug: . . . that they that there are fans for.

Dr. Chan: Is this in Albuquerque?

Taylor: Yeah.

Doug: It is. It's, like, I try to go always down there but it's, like, world known and, like . . .

Dr. Chan: Is this the part of the interview day, they kind of put you in a hot air balloon?

Doug: No. No. No.

Taylor: No. No.

Dr. Chan: They interview you in a hot air balloon . . .?

Doug: That would be sweet.

Dr. Chan: . . . and see how can you unfold it off?

Doug: But, yeah, they're known for their hot air balloons, which is really cool, and it's, like, a big festival type thing and food and . . .

Dr. Chan: I'm very curious. How much do hot air balloon rides cost?

Taylor: I do not know.

Dr. Chan: And how long do they last?

Taylor: I'm almost sure he doesn't know.

Doug: It's probably a lot. But the festival, you just go and, like, watch all the balloons go up. There's, like, hundreds of balloons that just go up.

Taylor: They have . . . There's something in the way the wind pattern is there that makes it really good for it. They call it, like, the square or the . . . I'll find out. But it, like, takes them up and over and then back down and . . . There's, like, something that, like, moves that, air balloons in the right direction. So even on days that it's not the festival, there are hot air balloons in the air. Yeah. It's wonderful weather.

Doug: It is.

Taylor: It's not . . .

Doug: It's not like Arizona.

Taylor: It's not hot like Arizona.

Doug: Everyone thinks it is.

Taylor: It's like a high desert there. It's . . .

Doug: It's, like, 70 and sunny. What do they say? 300 days out of the year or something like that.

Taylor: Yeah. Like blue skies.

Doug: Yeah. It's very cheap to live.

Taylor: It is low cost of living.

Dr. Chan: Cheaper than Utah, I hear.

Doug: Definitely.

Taylor: Yeah. Very cheap.

Dr. Chan: Great food. Great Mexican food.

Taylor: Great food. They love their green chilies down there.

Doug: They do.

Taylor: And they put the green chilies in everything.

Doug: "Breaking Bad."

Taylor: "Breaking Bad."

Dr. Chan: You always talk about "Breaking Bad."

Taylor: "Breaking Bad."

Dr. Chan: Is that part of the, a tour on the interview day?

Doug: No. But there's a "Breaking Bad" tour you can do. You can, like, see where they film and . . .

Taylor: You can.

Doug: . . . and we did a self-guided tour, actually.

Taylor: We did. We, like, looked some stuff up but . . .

Doug: So that was fun.

Taylor: So they . . .

Dr. Chan: God bless the internet.

Taylor: I know.

Doug: Yes. Exactly.

Dr. Chan: It just helps tracking the stuff here.

Doug: Exactly.

Taylor: It does. So that was a "Breaking Bad." I also really loved, "Roswell" is not too far, so there's lots of aliens stuff.

Dr. Chan: I like this image. Aliens and crabs and air balloons, and Mexican food.

Taylor: South of Albuquerque is White Sands National Park, which we haven't checked out yet but we're excited to.

Doug: It's really, apparently, where they film a lot of movies.

Taylor: In New Mexico, in general, there's a lot of movies and filming. A lot of stuff is filmed there.

Doug: It's supposed to be beautiful. There's Santa Fe, which people love.

Taylor: Santa Fe.

Dr. Chan: There's lost cruises, but that's far down south.

Doug: Yeah. In the middle there but . . .

Taylor: And, like, [inaudible 00:40:14] skiing. They keep telling me I, because, you know, on, like, on the interview day, they tried to, like, the residents and the . . .

Dr. Chan: Oh, Taylor is from Utah. Mm, let's talk about skiing.

Taylor: Oh, yeah. A little bit. It's not like city-owned. We can ski so . . . But we can go to Taos, apparently, north of . . .

Dr. Chan: Did you say it, like, that's actually a stereotype, and I'm very offended. Did you say it [inaudible 00:40:31]?

Taylor: I should have, and then they do actually have hike, because again, you know, they have to, like, show off that they do have, [inaudible 00:40:39].

Dr. Chan: We're outdoorsy like you.

Taylor: They are. They are.

Dr. Chan: We're just playing tough.

Doug: Yes. Exactly.

Taylor: But there are actually mountains. It's not completely flat.

Doug: There's lots of hiking and, yeah.

Taylor: We're excited.

Doug: But . . .

Taylor: We're excited. A new city.

Dr. Chan: And it has a Charles psychiatry fellowship.

Doug: It does.

Dr. Chan: And they'll probably have this new . . .

Taylor: I hope so.

Dr. Chan: . . . hospitalist program, which I'm sure you're . . .

Taylor: We'll see.

Dr. Chan: . . . very excited to do because it's just more years . . .

Taylor: It's just more years of . . .

Dr. Chan: . . . of making resident pay.

Taylor: . . . making resident pay. Yeah. We'll see where that goes. But we're really excited about the new patient populations, new people, new . . .

Doug: It's one of the poorest states in the U.S., actually.

Taylor: Yeah. Apparently, they go back and forth with Mississippi.

Doug: And that actually, that might repel some people, but that actually attracted us just because of the demographic we could potentially work with.

Taylor: Yeah. Like, low resource need, you know.

Doug: And I actually loved their program because they have a 24-hour psych Ed, which is separate from a normal Ed and not every program has that, and so, I thought that was a unique opportunity that residents have to train in. So, yeah, I really liked UNM when I was down there so . . .

Taylor: And we really liked . . .

Doug: . . . And we're both really happy.

Taylor: We really liked the residence.

Dr. Chan: Yeah. We have a bunch of my graduates down there.

Taylor: Oh, we do.

Doug: We do.

Dr. Chan: So it's just kind of a little community that's growing.

Taylor: Yeah. We do. Yeah, and even within our class, there are two others besides us that are going down there so we'll have . . . Yeah.

Dr. Chan: Wow. Very cool.

Taylor: Yeah. One of our OBGYN cohorts is going down there so she'll pass me babies in the labor and [inaudible 00:42:10].

Doug: And ortho.

Taylor: And then in orthopedic.

Dr. Chan: This is awesome. All right. So last question for both of you. For anyone out there listening who's thinking of applying to medical school or struggling to decide to go to medical school or, you know, what tips would you give? What counsel would you give before they embark on this journey? Because I would argue you guys are kind of at the halfway point and you still have . . .

Taylor: Thank you.

Dr. Chan: . . . and you still have residency.

Taylor: Oh, no.

Dr. Chan: You have residency to go.

Doug: Don't say that.

Taylor: Oh, no, Dr. Chan.

Dr. Chan: I know. It's sad but true. Yeah. Even though you'll be MDs very soon full, it will not be full indeed for . . .

Taylor: It's still halfway.

Dr. Chan: . . . just until you can graduate your residency program.

Taylor: Oh, go ahead.

Doug: I would say make sure it's what you really want. Don't do it because of anything else, specifically parents or money or prestige or anything like that. Like, I don't want to say it's not worth that but you have to be committed for the right reasons. Otherwise, you might not make it. And it was the most. . .

Taylor: Then it would be miserable along way.

Doug: Yeah. Exactly. It would be not enjoyable and, I mean, it was the single most difficult thing I've ever done in my life, and I never would have got through it if it wasn't what I truly wanted. So I would say make sure, like, through various. . . And I think that's the point of applying to medical school is that we see that you have experienced many different things and not just cookie cutter things. We want, you know, make sure that you have different experiences that solidify your decision to enter and go through that which is medical school.

Dr. Chan: All right. Taylor, last word of advice.

Taylor: Oh, I mean, a lot of what Doug said is true. You just make sure you want to do it and then just know that you can do it. Yeah. You can do it. We were just talking the other day that we can't believe it's over but apparently, it's only half over.

Dr. Chan: Well, at least you get paid a nice amount. I mean, you know, and. . . Does New Mexico, at the medical center, does it have, like, good cafeteria privileges for residents? I'm trying to look at the sunny side of things here. What's just a great thing to do In New Mexico? Is it, you know . . .

Taylor: It is [inaudible 00:44:39].

Doug: It's true.

Dr. Chan: It is an enchanted land, right?

Taylor: It's the land of the enchantment.

Doug: It is. It is.

Dr. Chan: Okay. There you go. There you go.

Taylor: Yeah. The food will be fine there. I'm not sure it was . . .

Doug: It actually was fine. I think you get more than I do but . . .

Dr. Chan: I hope you share. Please share.

Taylor: We'll share.

Dr. Chan: [inaudible 00:44:54].

Doug: Well, she'll be in the hospital more than me.

Taylor: Yeah. I will. Definitely. But, yeah. You can do it. Everyone can do it.

Doug: Everyone can do it.

Dr. Chan: Cool. Well, I'm excited for you guys because I have a feeling you'll wind up back in Utah one day. I'll have to have you guys come back . . .

Doug: We might . . .

Dr. Chan: . . . and get an update on the story.

Doug: We may.

Taylor: We will.

Dr. Chan: And there might be a little mini me's or something like that . . .

Doug: Maybe.

Taylor: Oh. Oh, okay.

Dr. Chan: Awesome. All right. Thank you, Doug and Taylor.

Taylor: Thanks, Dr. Chan.

Doug: Thanks, Dr. Chan.

Announcer: Thanks for listening to "Talking Admissions and Med Student Life" with Dr. Benjamin Chan, the ultimate resource to help you on your journey to and through medical school. A production of "The Scope Health Sciences Radio," online at thescoperadio.com.

Interviewer: You had a miscarriage and you're trying again, but for whatever reason, you can't get pregnant again. Is this normal? We'll find out next, on The Scope.

We're talking to Dr. Kirtly Parker Jones, the expert on all things woman. Dr. Jones, the scenario is, you and your partner got pregnant. For whatever reason, unfortunately got a miscarriage and you're trying again, but it's been a while and you can't get pregnant again. Is this normal?

Dr. Jones: Okay, good question, and the answer is, it depends.

Interviewer: It always depends.

Dr. Jones: It all depends. So the rate of miscarriage in healthy couples under 35 is about 15 percent. It's very common. And if people got pregnant relatively easily, it means they weren't taking years to get that pregnancy that miscarried, they got pregnant easily, then it is not normal for them not to be able to get pregnant again. And the vast majority of people get pregnant again.

Now, sometimes, the miscarriage is a sign of an underlying problem. So let's take the 40-year-old who took three years to get pregnant. She miscarried, she can't get pregnant. Now it's been a year or two. That miscarriage was probably a sign, along with that three years of trying, that she was running out of eggs. And now, she's kind of more run out of eggs.

So sometimes a miscarriage is a sign of an underlying problem that's getting worse, and in fact, it's true for sperm problems. So men with abnormal sperm can have more miscarriages, and in the process, their sperm is getting more abnormal. So it was sort of abnormal and they had a miscarriage, and now it's really abnormal, they're not getting pregnant.

Interviewer: So it can depend on both the woman and the man.

Dr. Jones: Right.

Interviewer: Okay.

Dr. Jones: And lastly, sometimes the treatment for a miscarriage. For example, let's say you miscarried, you passed some tissue you didn't pass at all, so they had to go in, you had a little infection in your uterus, so they did a D&C, and in the process of doing that D&C in a scarred, in an infected uterus, the uterus got scarred. And so that can be the cause of the secondary inability to get pregnant.

But for the majority of people who are not old, and they got pregnant easily, and they miscarried, the majority of them, 85 percent to 90 percent, will be pregnant again within a year. So not getting pregnant is not normal.

updated: May 9, 2019
originally published: June 29, 2017