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Mitch: This is The Scope Radio at the AAMC 2022 Learn Serve Lead conference, where we are having discussions with some of the top minds in academic medicine about how they are trying to build from the ground up and give rise to the new way of doing things.

We are joined today by three individuals who are here to talk to us a little bit about a new program. We're joined by Dr. Michael Good. He is the Executive Dean of the Spencer Fox Eccles School of Medicine at Utah Health.

As well as Dr. Karyn Springer. She is the Assistant Dean of the Population Health Clinical Learning program at University of Utah Health, as well as the Senior Medical Director of the Graduate Medical Education Strategy at Intermountain Healthcare.

And finally, we're joined by Taylor Dean. He's the Program Manager at University of Utah Health for the Population Health Scholars Program. Now, the Population Health Scholars Program is a new medical education program developed with a very special collaboration between both the Spencer Fox Eccles School of Medicine at University of Utah and Intermountain Healthcare.

So, keeping with the idea and theme of this conference and of these kinds of discussions we're having, I'll kick it off to you guys. What is it that makes this Population Health Scholars program so different? How is this helping us rise up and build from the ground up?

Dr. Good: Yeah, I think this is really exciting for me. Dr. Springer and I, and Taylor and I, have talked before that, first of all, this is a partnership. What we're creating here, no one of our organizations could do it by themselves. It's the coming together in a collaborative, synergistic way that allows this Population Health Scholars program to be created and to move forward.

So, what is population health? I think certainly in my own medical school, it was exclusively focused on the care of the individual patient that's right in front of you. And that always will be first and foremost in a physician's work and in our medical education program, whether it's the patient in the clinic or in the hospital, in the operating room, the delivery suite. First and foremost, we take care of the patient who's come to us to help solve their health challenges.

But increasingly, and we think in a really innovative way here at University of Utah, we're also thinking about patients as a population, a group. How do we improve the health of a population, for example, a community, a municipality, a group of individuals with a certain disease? Different populations will have different healthcare needs, but we look at health and wellness not only from the individual patient, but from the collection of patients, the group, the population.

And Dr. Springer can share the way that Intermountain Healthcare is using this approach in the delivery of care. We are trying, and I believe one of the first medical schools in the country, to introduce in a meaningful way the concepts of population health into our medical education program. Did I get it close?

Dr. Springer: Yes, very. I think you're right, Dr. Good. The uniqueness of this program really is being able to get upstream in helping our new physicians, future physicians really understand that practicing medicine, while we continue to focus on the patient, like you mentioned, in the exam room, in the delivery suite, in the OR, which is still important, there are so many additional things that affect health besides just that particular thing.

And being able to train students in that environment and help them see not only from an academic side of what that means, from the theories, etc., but also see what it looks like in practice and actually delivering that care is very important. And that really addresses the whole person.

And I think that's really the focus of population health, is that it looks at, "Well, how is this person's health affected by their spiritual background, by their emotional background, by their social determinants of health, their housing, their food insecurities, other things like that, their access to care?" and not just focusing on that particular problem.

And seeing how the connection of understanding the importance and teaching it in a medical-center-type classroom, seminar, etc., and then connecting that with, "Hey, this is actually what it looks like to practice," is a huge way of actually getting upstream to teaching our future physicians how they will need to practice going forward.

Taylor: I think that that is the really great opportunity that we have with this program. And part of the reason it was developed is because they get an educational experience through their participation in the Population Health graduate certificate, so they get recognized through that.

They learn those foundational concepts and then, through this collaboration, are actually in the communities that they'll be serving in the future working with the leading institution about implementing that population health.

So, they really get both the background and then the application which is a really exciting and a unique component of the program.

Dr. Good: So, the program is. . . We're into the second year. As Taylor was mentioning, the first couple of years are a lot of what we call foundational knowledge, learning the underlying science, if you will, the research studies that say, "These particular approaches work in a population health context."

But Dr. Springer, one of the things you've done that's been just great is each of our scholars in the program . . . And we should mention in the first 2 years we've had, I think it was, 11 scholars the first year, 10 the second year, and then we're planning for 15 in the third class. One aspect is what's learned in the classroom, if you will, but also there's a phenomenal mentoring component of the Population Health Scholars Program that's already been implemented. Why don't you tell us a little bit about that?

Dr. Springer: Yeah, thank you. So, one of the things that I think . . . And I can think back to my medical school time, as well as you, where you get involved as a first-year, and just class and how excited. You remember how excited you are. "Please get me into the clinical aspect. Let me see what I'm really going to be like."

And so this program provides an opportunity to connect one-on-one with a practicing physician within Intermountain Healthcare. And that allows the student to really be able to see and ask those questions of not only just, "What is it like to be in your specialty? What is it like to be a physician? How do you balance and integrate work and life, and what is your practice like?" but it actually allows that student to go shadow with their mentor as a first-year, be involved in projects.

If that mentor is involved in some sort of research project, getting them involved in that aspect, being able to really see what it's like to be a member of the Intermountain Healthcare Medical Group, because that's really where they're going to end up in the future.

And this is very unique, because unlike just a short type of mentorship or coaching relationship, it's meant to be longitudinal. We instruct our mentors. We train them to help how they should mentor, and tell them, "This is definitely through all four years of medical school," and we hope even into residency. And then ideally, the circle comes forward when they actually join our practice. And then hopefully they become mentors themselves for the future scholars.

Dr. Good: Just to make sure I understand it right, each scholar in the program is paired one-on-one with a practicing physician. And that is a longitudinal relationship over at least the four years of medical school . . .

Dr. Springer: At least the four years.

Dr. Good: . . . If not as we get into this and learn more. Oh, that's phenomenal. And then you also mentioned . . . I guess we should add in the forgivable loan scholarship component of this. So, again, highly competitive. We have about 125 medical students in each class currently at the Spencer Fox Eccles School of Medicine at the University of Utah. And so of those 125 for the past couple of years, it's been 10 to 11 in the Scholars program. Headed to 15, but again, highly competitive. And with it comes a 50% tuition forgivable loan scholarship.

So, Taylor, why don't you tell us a little bit about the forgivable loan scholarship and particularly how the forgivable part is implemented?

Taylor: Yeah, that's an important part, especially from the student's perspective.

Dr. Good: There you go.

Taylor: So, it's a really unique component of the program that we hope will really benefit these students in the long run. This program, we aim to emphasize primary care and population-health-related specialties in the future, so this financial assistance component can go a long way in that regard.

But as students are accepted into the program, they receive 50% of their tuition and fees covered through their participation provided by the endowment from Intermountain Healthcare.

Dr. Good: That's probably an important point to mention here at this point. Very appreciative of an endowment gift from Intermountain Healthcare. And that endowment generates the funds that are able to cover the 50% tuition benefit.

Taylor: And so with that benefit, the students, as I mentioned, receive . . . or as you all mentioned, they receive 50% of their tuition covered in the hopes that they'll then return and work for Intermountain Healthcare in the future. And that work and employment in the future will then count towards forgiveness of the loans that they receive during their time in medical school.

This will come in a one-to-one ratio. So, for example, a student in the first year of the program has received their first year of tuition covered. Their first year of work and employment within Intermountain Healthcare in the future will then forgive that component of the loan, and that will transpire for those four years until, hopefully, the entire loan is forgiven. And they then just continue on with Intermountain after that.

Dr. Springer: And I would even go stronger than that, Taylor. It's not just that we hope. They are guaranteed an offer with Intermountain Healthcare for an employment offer in one of those specialties.

One of the big challenges in a medical student's life is, "Okay, am I going to get into residency?" And then after that is, "Well, where am I going to find a job?" The competitiveness of that, and, "Is it going to be something where I'm going to have to potentially go somewhere because I have to get my loans paid back and not be able to choose exactly where I want to be?"

And so this endowment from Intermountain Healthcare, the tuition support, and then the guaranteed offer post-residency I think really looks at the comprehensive nature of how we can help the students, not only just in learning, but also, hopefully, relieve some of the stress that comes along with that process of being a medical student and the transition to being a physician practicing generally.

Dr. Good: Dr. Springer, I think that's so important. We're here at the AAMC meeting, and just this morning, the session I was at was with medical student leaders from across the country and the deans of the medical schools. And they talked about that stress at the transition points from undergraduate medical education to residency, and then from residency into practice.

The other thing I like about the structure of this program is it's good for Utah and it's good for the Rocky Mountain West. Obviously, we're quite proud of our graduates of our medical school. They are highly competitive for the best residencies across the nation. Many of them will do their residency in our Utah-based training programs.

But in a way, we want our graduates to go out and benefit from some of the other great residency programs across the country, on the coasts, everywhere. I won't do any names. We all have our favorites.

But there's about a 65% to 70% probability that someone coming out of a residency program will practice where they graduate from residency. And so to me, this creates a great incentive to what I call "get them home."

Bring them back. As you point out, guaranteed employment in the largest health system in Utah, now in the Rocky Mountain West with some of the recent additions.

And so I just think it's one of those rare win-win-win. This is good for the student, it's good for our health systems, and ultimately it's good for the people of Utah and the Rocky Mountain West because we get the great highly trained physicians back into our workforce and caring for our citizens.

Dr. Springer: Yeah, I think it speaks to the power of collaboration, and I think that is very unique. You don't see that. I think we've had conversations about this before, that there really aren't programs that are like this throughout the country where you have an academic public institution like the University of Utah and then a private not-for-profit institution like Intermountain Healthcare really collaborating and seeing the big picture for the community, for the students, for the general health of our population, and really trying to find a creative collaborative solution to bringing physicians back to where we need them.

I mean, as you know, Utah ranks 49th or 48th out of 50 states in terms of primary care per capita.

Dr. Good: Some work to do.

Dr. Springer: So, we have some work to do. This, I think, represents an opportunity to help hopefully ameliorate some of that as well as put a little buffer in for the future of how to continue to improve and not just be a one-time solution, but an ongoing, scalable, sustainable solution to that problem.

Dr. Good: Let's talk about a couple of other aspects of the program. Taylor, you mentioned it quickly, but it's probably worth pointing out the Scholars now have added credential when they graduate. Tell us a little bit about that aspect, the certificate.

Taylor: Yeah. This is a great development that occurred over the last year with a lot of collaboration from the Department of Population Health at the University of Utah. I want to mention Dr. Fagerlin and Dr. Ozanne, who are the directors and co-directors of that certificate.

But you can almost envision this as a . . . Most of us have a major that we went through in college and then some of us chose to do a minor as well. And so along with their primary education and getting an MD, these students also receive a Population Health graduate certificate.

And so through this experience, they're provided a lot of additional foundational knowledge of what population health looks like. So, they're in the classroom learning about different population-health-related concepts, how it's applied in different settings. We have a plethora of different speakers from across both the University of Utah Health system and Intermountain, as well as started to provide some support and knowledge in this realm as well.

So, students participate in that, and then they also have the opportunity to participate in a population-health-related capstone project. So, they're exploring topics that are . . . that they're specifically passionate about, that they see their role or career moving towards in the future.

And so they are emphasizing certain population-health-related topics that they want to get involved in, and then making change in the sense that they're doing extra work on this capstone project that they can then implement in the future.

And so, like we mentioned, a really unique component of the program and hopefully we'll emphasize or highlight them as they move into their residency process of, "Hey, this student who's done this extra work and has an additional layer of knowledge that the others might not." And so, really an exciting component as well.

Dr. Good: Yeah. Well stated. And residency positions for a variety of reasons across the country become more and more competitive. That added credential makes our graduates, the graduates of the Population Health Scholar program, even more competitive for those highly sought-after residency positions in the country.

So, again, I'm glad you . . . Thanks for the shout-out for Dr. Fagerlin and Dr. Ozanne, because they've really, in partnership with you, put together that certificate. And I'm really, really pleased with that.

Taylor: Through the development of this program, we've also really been exploring these enrichment-type opportunities with Intermountain Healthcare. So, on top of the mentorship component of the program, we've also had collaboration with a few different entities of Intermountain: Castell, their population health arm; SelectHealth, the payer behind Intermountain; as well as just a few additional community health initiatives that they have in place there.

And so students have the opportunity to get involved in these areas as well with mentors outside of their paired mentor, but folks in the community who are working on these things or in these organizations who have a really specialized skill set. Students are exposed to this early on and they can gravitate and, once again, find those opportunities that speak to them.

And we've had a great experience with this so far, and it continues to build as we've developed relationships and learned a little bit more about the different things that Intermountain are doing and how we can position students to learn firsthand how that care is being provided and how population health is being implemented.

I don't know if you have anything to add to that.

Dr. Springer: I'm so glad you mentioned that. Those enrichment opportunities really represent a way for students to help expand their passion. And the thing with medical school . . . Obviously, you have to have the base science knowledge, and I think if people can feel . . . I mean, this is not unique to, of course, medical students or people who are working, right? If people find their passion, that helps, I think, really create additional resilience and wellness and things like that.

And as a first-year medical student, a second-year medical student, you are very busy learning all sorts of things. And I think that while you might theoretically know that some of these things are out there, it would be potentially difficult to find.

And so the unique thing about the Scholars Program and what Taylor was talking about, these enrichment opportunities that are connected as well with the pathway certification and classes, is that these are things that are really presented to the students almost like a menu of options for them to choose from, and just really expanding.

It's one of those things where as a medical student, you may not even know what you don't know. Well, I will say you definitely don't know what you don't know and what's out there. And I think having these opportunities where it's like, "Hey, look, have you considered working with pediatric health initiatives? We'd heard from them. Or working with SelectHealth and understanding how data applies? Or we've looked at Precision Genomics and how that applies to population health."

All these different opportunities are things that allow the students to really, which is why we call them enrichment opportunities, enrich their education and really hopefully create that passion and that flame of, "Hey, yeah, this is exciting. I want to be able to do this now and in the future."

So, beyond the competitiveness of their applications to residency or whatever else for jobs in the future, etc., that is something I think really goes a long way.

Dr. Good: Well stated. When people find their passion, in some ways it's almost magical.

For me, another really exciting part of the Population Health Scholars program that in some ways is being worked on in the drawing board right now is next year we'll enter the third year of the program, which includes really the heavy clinical years. And one of the things I'm excited about is the scholars, the students, will spend actually probably large parts of their clinical learning in the value-based clinics of Intermountain Healthcare.

Tell us a little bit about that, because I was certainly impressed as I learned about them in and of their own, but then what a wonderful learning environment they're going to be for the Population Health Scholars, particularly as they enter their third and fourth year.

Dr. Springer: Yeah. I'll talk about just one aspect and then maybe I'll have Taylor talk about the second aspect. The first aspect is really just the traditional type of rotations, the block rotations where we have a pairing with a preceptor and, of course, the student.

And the preceptor, I think, is one of those in primary care, in pediatrics, in family medicine, so internal medicine, where we have these value-based care clinics within Intermountain where they are focused on looking at not just generating visits and RVUs and producing things like that, but really taking a little bit more time with the patients.

Most of them have 30-minute visits. They have care managers or care advocates or care guides who are involved with the patient so they can get data ahead of time about, "Hey, this person has this care gap need," or, "This person needs to have this done," or, "This has an issue with social determinants of health of some sort." And those things are all incorporated within the visit, so that's really the focus of our value-based care clinics.

And so being able to expose, again, like we said, "Here's all the actual education piece," and then being able to translate to, "Hey, this is what the value-based care clinic is and actually how you might practice," is the connection with that.

The second part of that is we're really looking at creating a longitudinal integrated clerkship experience for our population health or LICs. And I might have Taylor just talk a little bit more about the work we've done on that.

Taylor: Yeah, this has been a really exciting component of the program and I know something that the students are really looking forward to. But as we shift as a medical school towards this longitudinal integrated curriculum . . . which is really focused on three things for those who may not be aware. It's that longitude relationship between the student and the patient, the student and the preceptor, and the student and the place. It really emphasizes those three components.

And so as we've shifted to the third and fourth year of these students' education and how we can supplement that with population-health-related learning, one really exciting component is the shift to this model where students are paired with an Intermountain physician or doing their rotations at Intermountain clinics where they're paired with Intermountain physician preceptors in all of the different specialties.

They're really located and practice their clinical learning at one or two unique sites over the course of the entire third year. It's a little bit of a shift away from the traditional models where, and you both probably know much more than me, they spend eight weeks or so . . .

Dr. Good: I graduated from medical school, believe it or not, almost 40 years ago. It was four weeks of cardiology at Place A, four weeks of pediatrics at Place B, four weeks of OB. And so that word longitudinal is really important because, as you say, these will be months long, and probably in some cases year-long, assignments at an institution, a place, a facility.

And that's actually really important in Utah, because so much of our state is rural. And so we envision our students, many of them, being part of our rural communities and rural healthcare on that longitudinal basis.

The next word is equally important, integrated. So, it won't be cardiology for this period and pediatrics for this or obstetrics. We've got some early experiences where one of our students told us they were delivering babies on Monday, and they were suturing small wounds on injured patients in the ER. They were following the physicians around in their day-to-day environment. So, much more realistic, longitudinal, integrated clerkships.

And coming back to the value-based clinics, you were mentioning many of the characteristics, time, team approach. But for the audience, we gather the whole population health community, the preceptors, the students, the faculty. And I know at one of our dinners, which we do twice a year, one of your colleagues was talking about . . .

So, again, many physicians come to the office and they see the patients that have called in and requested appointments. But if I understand it right, in a value-based approach, value-based clinic, the team might meet a week or two, they look at the schedule, and say, "You know what? We really don't need to see Mike or Taylor, but boy, we really should find Joe and Mary because we know they have health problems that if we don't see them, their conditions could get worse and they could end up in the hospital." Have I got that, right? It's a very different management of a clinic.

Dr. Springer: It's really looking at right person, right care, right place, I would say, is how I would put it. And when you see your schedule, obviously, we're not going to ignore people who want to come in.

Dr. Good: Fair enough.

Dr. Springer: But the difference is our team is really looking at, "Hey, Mrs. Smith hasn't been in. She's a diabetic, and she is not controlled, and she has hypertension, and she was actually just in the ER. Let's reach out to her and find out what needs she has. Is there something we can provide to help her get the care she needs?"

Maybe it's in a clinic visit, but it may not be. It may just be, "Hey, we think that one of our home visits, we need to do that. We need to send our home visit team." Or maybe it's just my care manager who needs to talk to her weekly to help her stay out of the ER, set some goals around her health, get her care. And so it's a very unique process because we don't necessarily wait for the disasters or for people to reach out to us.

Dr. Good: It's a very proactive, prevention-oriented approach, which I think is great. And I think our students are really going to learn about population health firsthand by being part of these value-based clinics and the physicians and their teams that practice in those clinics. I mean, the list of unique things about this program keeps getting longer and longer.

Dr. Springer: I just want to point out something you mentioned about the teams. Just a quick comment about that, and we've had this conversation before. Whether or not a physician has a formal leadership position, physicians are seen as leaders.

And medicine no longer is just the physician doing everything. It really absolutely is a team approach. And that includes your medical assistants, care managers, care guides, maybe an advanced practice provider like a nurse practitioner or a physician's assistant. And the physician really is the leader of that team. The physician is seen as a leader in the community.

And I think that's a really unique part of this particular program as well, is exposing the students firsthand as a first-year to leaders like you in University of Utah Health, other leaders who are really taking charge of where academics and medicine is going, and leaders in Intermountain Healthcare. So, an integrated delivery system.

We've had meetings where you've talked with the students, our chief executive officer, our CEO, has talked with them, our region officers. And I think that is a very unique part of this program, is to start early on of telling them that they are our future leaders and that we need them to be leaders.

Dr. Good: You get me talking about teams and we'll be here all day because everything you said, Dr. Springer, is so true. Great health care is delivered by great teams. The health professions and medicine in general, it's really only been in the past couple of decades where this transformation from individuals to teams has happened.

We're blessed in Utah because, actually, the football team had a great experience last night and the Jazz are back in season. That's sports, but I think high-performance sports teams, there are lessons that we learn there about roles and responsibilities in a team. How do you divide the work? How do you communicate what each are doing? The environments that the Population Health Scholars will learn in are very team-oriented, and that'll be another unique component of their education.

I'm seeing our producer here warm up the hook, so we better . . .

Mitch: A little bit.

Dr. Good: As you can tell . . .

Dr. Springer: We can talk all day.

Mitch: Yeah, and it's so fascinating. I just don't want to keep you guys from the great other lectures and lessons that we're learning here at the AAMC.

Thank you so much for talking to us about population health. This seems like just quite a fascinating topic and a really interesting, innovative approach to how we keep people healthy and how we educate. And it's just so exciting to hear the three of you talk about all this. So, thank you so much, Dr. Good, Dr. Springer, Taylor. Thank you so much for joining us.

And if you're listening right now, you can hear other discussions from the AAMC floor at uofuhealth.org/aamc22.

And if you're interested in any other health-related podcasts, talk shows, basic information, you can also hear more of me at thescoperadio.com.

Listen to our other AAMC conversations:
• The Power of Diversity in Medicine
• Reducing the Distance Between Patient and Provider
• Doing the Work: EDI as a Shared Responsibility
• Personal Identity and the Philosophy of Caring
• Grappling with Post-Pandemic Burnout and Trauma

Dr. Chan: What was it like to start dating at the beginning of second year med school after being just friends for the first year? Was it nice to date someone going through the same thing as you? How do you create a strategy for couples matching? And finally, what are the benefits of both parties attending the same interview day for residency programs? Today on "Talking Admissions and Med Student Life," I interview Parvathi and Anish, 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: Okay. Welcome to another edition of "Talking Admissions and Med Student Life." I have two super guests today, Par and Anish, fourth-year medical students who have matched. We're going to save that to the very end, but I'm very excited you're here. I've known you for many years. I've seen you around for many years. Let's complete the circle of life and let's talk about it. Okay. So let's start at the beginning. How did you two meet? Was it Second Look Day? Was it orientation week?

Parvathi: Yeah. I think it was Second Look Day.

Anish: No, it was orientation week, because I didn't come to Second Look Day. So it was during orientation week.

Dr. Chan: Was that a different Anish you met?

Anish: That's messed up.

Dr. Chan: Okay.

Anish: It was during orientation week, and I was actually talking to one of my other friends, and I was looking for an excuse to talk to Parvathi, and I made some sort of dumb excuse to introduce this other friend, and that's how we first met.

Parvathi: No. You know what he did, he like threw this other friend under the bus. He like told some story that was very embarrassing to her, and that's how you introduced yourself. Yeah.

Dr. Chan: Is this a story that is appropriate to recount?

Parvathi: I think he said something like she coughed and threw out her back or something. I was like, "Why would just say that?"

Anish: [inaudible 00:01:52] threw out her back.

Dr. Chan: So that was your opening impression?

Anish: It was. It was.

Dr. Chan: That Anish has overwhelming empathy for people who have [inaudible 00:02:02] . . .

Anish: It was.

Dr. Chan: . . . and . . .

Anish: But at that time we were both dating other people. We were both in relationships at that time.

Parvathi: Yeah. That's true.

Dr. Chan: Okay. So this is orientation week.

Anish: Yes.

Parvathi: Yeah.

Dr. Chan: So you still remember each other . . .

Parvathi: Yes.

Dr. Chan: . . . and just friends at first?

Anish: Yup.

Parvathi: Yup.

Dr: Chan: Okay. And how did that friendship evolve? I mean, what happened?

Parvathi: I think, so we would hang out, you know, like other friends, and I don't know. Okay.

Anish: You're so bad.

Parvathi: Okay. What?

Anish: First year was very difficult for me, and so I was struggling a lot. I was living really far away, and I didn't have a lot of friends.

Dr. Chan: So med school is difficult or your relationship with Parvathi was difficult?

Anish: No. Med school was difficult.

Parvathi: We weren't in a relationship at that time.

Anish: We weren't in a relationship. And so it was really tough. And so I struggled a lot. And . . .

Dr. Chan: Where were you living?

Anish: I was living in Sandy, so that's, you know.

Dr. Chan: Okay, that is a far drive.

Anish: Yeah, and everybody else was, you know, in downtown. So I felt really socially and sort of physically isolated, and Parvathi was kind of the friend that I really opened up to about it and that's where our friendship really started to blossom.

Dr. Chan: That's very beautiful.

Parvathi: It is.

Dr. Chan: That's the best of your recollection. Okay. All right. So would you guys study together?

Parvathi: Actually, no.

Anish: Never.

Parvathi: We have never studied together.

Dr. Chan: You have different styles of learning or . . .

Anish: Yeah.

Parvathi: Yeah.

Anish: I like to study alone.

Parvathi: Yeah. He studies alone. I would study with a group of people here at HSEB, but honestly, it was a lot more like hanging out than studying. So Anish is probably more sensible to study on his own.

Dr. Chan: All right. Sounds good. Sounds good. So med school is hard. When did you move? Or you're still living out in Sandy?

Anish: So I still lived in Sandy. I've lived in Sandy all four years. First year, progressed and it got better, and I felt like I made really good friends. One of them obviously was Parvathi. And then just over that year, both of our other relationships, you know, sort of dissolved, and that summer she actually went to Boston and I was here. We were doing research and we were just talking.

Dr. Chan: I remember that, diabetes research. Right?

Parvathi: Mm-hmm.

Dr. Chan: Yeah, wow.

Anish: And when she came back, I asked her out, and that's kind of where it started.

Dr: Chan: So this is the summer of 2015?

Anish: Yes.

Parvathi: Yes.

Anish: And then the August 1st when school started, I asked her out and that's when our new relationship started.

Dr. Chan: Okay. Awesome. And then did you keep it secret for a while, or how people find out about it?

Parvathi: Oh, so that whole summer when we'd been talking, we kept it secret from everyone except for Douglas Chan who is a really good secret keeper. So I want the records to show. He didn't even tell his girlfriend, and he was the only one that knew, and then we came back and on the first day of school, we told everyone. Everyone was like so shocked. Some people were very angry that I didn't share this with them. Then they got over it, and it was great.

Dr. Chan: Awesome. Awesome. So you're together starting second year?

Anish: Mm-hmm.

Parvathi: Yeah.

Dr. Chan: All right. So going into third year, what was your strategy? Did you try to have rotations together or . . . Because like third year's tough because like students are kind of doing . . . the hours are weird, long hours at the hospital. Some students who are in a relationship try to coordinate schedules so they'll be on a "easy rotation" and have more free time together, versus people who are very scared to kind of be in the same hospital with someone. How did you guys approach that?

Anish: We didn't coordinate at all.

Parvathi: We didn't coordinate at all. We didn't think it was that imperative to our relationship to be like in close physical proximity at all times. I mean, I don't know. Texting and things like that make it so easy to be in touch all the time, that it didn't really make a difference. And it was kind of nice because then we'd be on different rotations where one of us might be on an easier rotation and the other one might be on a harder rotation, and that way, the person on the easier rotation could come to the other person's house or whatever. And that sometimes works better than if you're both in it together.

Anish: Yeah. And we always set at least one day a week to spend together, whether it was our off day, whether we had a short day, you know, we would just . . . even some days it was just that we grabbed dinner together before, you know, we had to go to bed. And so that's sort of how we managed third year was trying to just make the time when we have it.

Dr. Chan: What does it mean to you to have the shared experience going through medical school together? I mean, in what ways has that impacted your relationship?

Anish: Yeah. I would say that it's strengthened it. You know, I would tell any medical student or any medical student hopeful that nobody will understand what it's like to go through medical school other than the people going through it with you, and to have somebody in a relationship with you who's going through the same thing, it's unbelievable. It really makes everything a lot better.

Parvathi: Yeah. I'd say the same thing. Some people . . . well, a lot of doctors, you know, get married to each other. And now I see why, because in medicine I feel like you're in this different culture almost, or you have like a different language. You say all these words sometimes in like normal conversation that then you realize other people don't really understand. And when you're with your significant other who is in the same field, you can talk in that same language and like, you have like nerdy jokes that nobody else would get, and . . .

Dr. Chan: They understand perfectly what a bad call night looks like.

Parvathi: Exactly. And when you say like, "Oh, I have to stay late today," they know exactly what that means. They know you're not making an excuse not to, you know, come meet with them or whatever.

Dr. Chan: And then talk about maybe patients that have impacted you or, you know, passed away or difficult attendings things like that.

Parvathi: Yeah, yeah. When you talk about difficult experiences like that, they have like been there through the same thing. So that's so helpful to talk to someone like that.

Dr. Chan: Awesome.

Parvathi: For sure.

Dr. Chan: All right. Let's, again, I'll go back to the beginning. So before medical school, what kind of medicine did you think you would go into? And how did that change during your four years here?

Parvathi: Do you want to start?

Anish: Sure. So . . .

Dr. Chan: Or if it changed.

Anish: So it actually, I don't think it changed for me. So I actually didn't ever think I was going to go into medicine until maybe my junior year of college. And then when I did and I applied and was getting ready to come here, you know, I always knew that I wanted to do something sort of intensive, something where I'd get to do procedures and really see like hospital medicine and, you know, going through medical school that stayed totally true. You know, I've loved my internal medicine rotation. I've loved my ICU rotation. And so, for me, either it was sort of just identifying the things I liked beforehand and then just looking at the fields that emphasized that. And so it stayed true for me throughout medical school.

Dr. Chan: So where did you end up selecting?

Anish: So I'm going into internal medicine.

Dr. Chan: Okay. And what is internal medicine for people who don't know what that is? And what about it attracted you to it?

Anish: Sure, so internal medicine, I like to tell people those are the doctors that you're going to see if you get admitted to the hospital from the emergency room. So, you know, if you get a pneumonia, if you get some sort of infection, if you, you know, have heart failure, or something like that, like those are the types of physicians that you're going to see in the hospital. And the reason I chose it is because I really liked that kind of core physiology. I really like thinking about how the body's organs work together and how they influence each other, and I really felt like internal medicine sort of allowed me to see that, sort of explore that physiology in each patient that I saw.

Dr. Chan: So six weeks of internal medicine during the first half of third year and then six weeks of internal medicine the second half.

Anish: So eight weeks of internal medicine, third year.

Dr. Chan: Oh, eight weeks. So, okay. So when you did your rotation, did it just feel natural? Like, "This is my home. These are my people."

Anish: Yeah. So, actually, my first two weeks, I did not like it at all. I was on a specialty orientation.

Dr. Chan: Why? Oh, okay.

Anish: It was my first experience on internal medicine, and I had no idea what was going on and it was a specialty. And so I really had no idea what was going on.

Dr. Chan: Can you name the body part?

Anish: It was hematology oncology.

Dr. Chan: Oh, okay. Blood cells.

Anish: Yeah. So, you know, like I understood blood cells, but I didn't understand cancers that well. And so I felt really lost, and I remember like I would call Parvathi at the end of the day and be like, "I don't know if I can do this." Like, "It is so difficult." And then I made it through those two weeks, and I hit inpatient wards, which is just kind of like general medicine.

Dr. Chan: Yeah. Not so much specialized towards cancer.

Anish: Exactly, yeah.

Dr. Chan: Okay. Yeah.

Anish: Yeah. And I loved it. I loved every minute of it. I loved the types of patients I saw. I loved the things I got to do. And so, you know, so that part really reinforced my desire to go into internal medicine.

Dr. Chan: Okay, cool. How about you Par?

Parvathi: So I started out thinking that I would go into pediatrics actually, mostly because those are the only like shadowing experiences, volunteer patient experiences that I'd had previous to medical school. And as I went through medical school, actually I started third year on internal medicine because I thought, you know, that would prepare me well for pediatrics.

Dr. Chan: You don't like treating old people, right? So, yeah.

Parvathi: Old people so . . .

Dr. Chan: Compared to pediatrics.

Parvathi: Oh, I didn't know about old people. They're so adorable. And so that totally changed everything. And so I remember like starting my first day of third year on internal medicine general wards, and I met this resident who was just so enthusiastic about medicine and about teaching, and I like really looked up to him, and then I met this other attending who would, you know, take us on like little teaching sessions throughout the hospital and find patients with really interesting physical exam findings.

And I thought this was the most interesting thing that I could be doing. And I felt like I really connected with the residents and the attendings that I worked with. And pediatrics was fun too, but it just didn't feel the same. And on medicine I felt like you could really talk with patients through really difficult situations, like, you know, palliative care conversations and really involve the patient in their care. Whereas in pediatrics, I felt like you don't really involve the kid, you know. So yeah, that's kind of why I ended up choosing medicine. I felt like I connected with the people and . . .

Dr. Chan: Did you go through like a crisis? Did you like doubt that decision?

Parvathi: Yeah.

Dr. Chan: Was it hard to let pediatrics go or . . .

Parvathi: Yeah, it was, because I have been so committed to pediatrics before and I had done EPAC, which is this program we have here, where you have pediatric like experiences through the first two years of medical school, and some people choose to apply straight into pediatrics at the end of second year. I didn't choose to do that, but I thought, you know, I was definitely going to do peds. And so I was like, "Oh no. How can I switch now?" And then I remember like asking my friends and family what they thought I should go into. And they were like, "Oh, you should definitely go into internal medicine."

Dr. Chan: Really? Why did they say that?

Parvathi: I don't know. They said that was more of my personality, and I don't know what that means, but I took it as a compliment. I don't know. I don't know.

Dr. Chan: We're going to find out in the next few years. So you switched to internal medicine?

Parvathi: Yes.

Dr. Chan: Okay. All right. So I think it's rare, because I've interviewed couples who have gone through the couples match before, but for you two to both choose the same field, I don't think I've seen that. So did you run into that?

Parvathi: I've met a couple of residents who couples matched into medicine together. They might go into like different fields, but . . .

Dr. Chan: Okay. Yes, because internal medicine, the residency lends itself to do a fellowship.

Anish: Yes.

Parvathi: Exactly.

Dr. Chan: So three years internal medicine, and then most of the fellowships are three years, correct?

Anish: Most of them.

Dr. Chan: Okay. All right.

Parvathi: Yeah.

Dr. Chan: So I'm not going to hold you to it. But as of today, if you had to go into a fellowship, would you? And which one would you?

Parvathi: You know, I actually would not do a fellowship. I want to be a hospital medicine hospitalist, so you don't need a fellowship for that because most internal medicine residencies prepare you really well to take care of patients in the hospital. Yeah, I want to do that because I think you get to see the widest like diversity of patients that way. You see a lot of interesting things, and you're constantly learning from your colleagues who are specialists. So you can kind of have a knowledge of like everything, which I really like.

Anish: And I'm actually thinking pulmonary critical care.

Dr. Chan: Oh, wow.

Anish: So I really liked kind of that intensive medicine and being in the ICU and sort of having those really sick patients. And then I think the field also lends itself to kind of having a good outpatient lifestyle, and sort of as you get older and sort of the intensive schedule gets harder, you can, you know, retire into a nice pulmonary or sleep clinic or something like that.

Dr. Chan: You're not intimidated by the ventilator?

Anish: No.

Dr. Chan: All the knobs.

Anish: No.

Dr. Chan: All the readings.

Anish: I say add more knobs, really.

Dr. Chan: Okay. You need more knobs on that thing. Yeah. And there's like 10 different readings on that. It just looks terrifying. It looks like . . . to me, it's like a nuclear bomb. If you touch the wrong button and you twist this like, bad things could happen. So, cool. All right. So third year is about to come to an end. You're thinking both, you're committed to internal medicine. When does the conversation between you about the couples match, when does that start happening?

Parvathi: When did we have that?

Anish: I mean, we started to have it I think during our second to last third-year rotation. So that's like, it's probably right about now, this time last year, April-ish.

Dr. Chan: So spring 2017.

Anish: Yeah. And we started to talk about it. You know, is the couples match the right move for us? Is it, you know, what does that mean for our relationship? It was a lot of really intensive conversations that actually kind of continued into the summer and almost until we submitted ERAS. Yeah.

Dr. Chan: Well, I mean, what was your initial strategy as you started looking at programs? I mean, how did you decide . . . because like this going through residency applications is stressful enough. There's a lot of complexity to it. There's a lot of different layers to it. It's fairly expensive. We can get into that. But throwing on a couples match, tying, yoking, having your application, you know, linked to another person sounds much harder or more beautiful when you look [inaudible 00:16:17] because, again, going through it together.

Parvathi: It's both, yeah.

Dr. Chan: So what was your strategy at the beginning?

Parvathi: At the beginning, the very beginning, I think our strategy was just to apply broadly. I know they always tell you to kind of choose a region of the country, or, you know, if you like a certain city, look in, you know, those areas. But to be honest, like both of us didn't really know like a specific area that we were interested in more than any other area. We did know that a lot of programs on the East Coast are really, really good programs, and also really close to each other, even in different states or whatever. You could drive like an hour and be, you know, close to each other. So that was, we kind of focused on that area because we knew there was like a high density there. But other than that, we just kind of applied to other states and places that sounded nice.

Dr. Chan: So targeting larger cities.

Parvathi: Yes, larger cities.

Dr. Chan: So in case you didn't get into the same program, you made meet in the same city because it's [inaudible 00:17:12] . . . so internal medicine program, there's a lot of them in larger cities and multiple programs.

Parvathi: Mm-hmm.

Dr. Chan: All right.

Parvathi: Yeah. So that was kind of our initial strategy. And we, you know, asked around to like residents and interns that we were working with and asked where they applied and what their top five programs were and why. I think that was really helpful too, actually.

Dr. Chan: So how many programs did you apply to?

Parvathi: Forty-two. Yeah. Both of us did, right?

Anish: I applied to 37.

Parvathi: Oh.

Dr. Chan: Oh, we're learning stuff together. It's beautiful. All right. So applied to all these programs, and then did the interview offers come at the same time? Are they staggered? If one got invited to one program, would the other one shoot off an email and let that program know that, "Hey, I'm very interested. I'm going through a couples match"? How do that process work? How'd you handle that?

Anish: Yeah. So actually, our first interview invites, I remember I had gone to sleep, and then it's like 10:30, 11:00 at night, and I get this call, and I get a call on my cell phone, but I'm trying to sleep, so I ignore it. And then all of a sudden my home phone goes off, and [inaudible 00:18:19] and I'm trying to sleep. I answer the phone like, "Oh, what's going on?" Like, you know, "What's the emergency? Because why, you know, why I called twice this late at night." She's like, "Oh my gosh, we got our first interview invite. We have to book a place now. We have to get everything ready. We have to schedule it."

Dr. Chan: "Wake up, Anish. Wake up. This is not a dream. This is not a drill." Yeah.

Anish: I'm trying to wake up. I'm opening my laptop. I'm like panicking a little bit. We end up booking an interview spot, and then two weeks later we end up canceling this, and we ended up not interviewing at that school at all. So that was all for naught.

Dr. Chan: Why did you cancel?

Anish: It ended up being too expensive for us to fly out.

Dr. Chan: Oh, okay.

Parvathi: That soon.

Anish: Yeah. And we just felt like and over time we got more and more invites that were at schools that we liked a little bit more. And so that school kept falling further and further down the list for where we really want to go. But, honestly, a lot of our interviews just kind of trickled in. Usually, we would get interview invites together at the same time. There was maybe one or two that one of us got earlier than the other, but then the other one would get the invite the next day or something like that, or the next week or whatever it was.

Dr. Chan: So how many programs did you interview on the same day with the same time?

Anish: So that's hard because sometimes we interviewed at the same program but on different days that week. So like, in Maryland, we interviewed at three programs, but we interviewed at those programs on different days just because they didn't have room for both of us on one day.

Dr. Chan: Was it beneficial or is it more stressful to have the other person there on the interview day?

Anish: I don't know.

Parvathi: Honestly, we would end up getting like split up at some point during the interview day because internal medicine programs are pretty large. And so how interview days work is they usually have like, I don't know, 20 plus people, and they get split up into different groups for like tours and activities and things like that. So we'd get split up for that reason anyway. So I wouldn't really see him for the rest of the day. So it doesn't really make a difference, but it was a little bit like a little nicer when we'd, you know, get there at the same time and be a little nervous together, and be like, "Oh, this is going to be okay."

Dr. Chan: Yeah. And then you can immediately compare notes afterwards. Like what [inaudible 00:20:39]

Parvathi: Exactly. Yeah.

Dr. Chan: . . . what was your impression?

Parvathi: Exactly.

Dr. Chan: Oh, so and so was super nice, or so and so was super creepy, yeah.

Parvathi: Yeah. Yeah, yeah, yeah. We always did that anyway, but yeah.

Dr. Chan: And would you like have a system which like, is there some Google spreadsheet that you immediately log in . . .

Parvathi: Oh, yes.

Dr. Chan: . . . and put like . . . Okay. Who was in charge of that?

Parvathi: Okay. So this is me.

Dr. Chan: Okay.

Parvathi: So I discovered that there is something called like the NRMP, like Prism or something. There's this app.

Dr. Chan: Prism not prison.

Parvathi: Yeah, not jail.

Dr. Chan: Not jail, okay. National Resident Matching Program. Yeah.

Parvathi: I know that's kind of what it feels like at times. No.

Dr. Chan: Okay.

Parvathi: It's this app, and it has all of these like different categories for each program. And the idea is that right after you interview at a program, you can kind of go through and rate each one of those categories.

Dr. Chan: Oh, it's like a cheat sheet, a rubric.

Parvathi: A rubric, yeah. It's like a grading rubric for each program that you go to. And it's like, you know, quality of the faculty, quality of the program director, like research opportunities there, things like that. And so I figured we could make an Excel sheet on like Google Docs or whatever and put both of our . . . like have two columns for me and Anish, and we could compare our thoughts on each program that way. And we were pretty good at it for like a couple of programs, and then it got really exhausting. But, I mean, if you want to be systematic about it, that's a way to do it.

Dr. Chan: All right. So describe the process leading up to submitting your rank list. What did you value together? What ended up kind of tipping one program over another? How did that look like?

Parvathi: Honestly, like, when you ask for advice from people on how to rank programs, a lot of people say gut feeling should be really important. I was like, "No. That's ridiculous. We are evidence-based and, you know, things like that."

Dr. Chan: We're scientific.

Parvathi: Yeah, scientific, that's actually true. Like, when you go somewhere and, you know, the first person there greets you, and the program director comes around and shakes your hand, you know, things like that really make a difference. And the faculty that you interview with, do you feel yourself connecting to them? Do you find someone at that program that you can picture yourself becoming? Things like that become really important as you go through the interview process. And I feel like that was very important to me.

Anish: So we had to make a linked rank list because we were couples matching, which means that whereas most people have maybe like 11 or 12 programs that they rank and submit, we had to do every combination of both of our rank list. So I ended up interviewing at 19 schools, and you had what? Six?

Parvathi: Fourteen, yeah.

Anish: Fourteen schools. And so, you know, 19 times 14 it was something like 266 combinations. And then on top of that, we did, just to be safe at the end of the list, you do a combination where one of you doesn't match and the other one matches. And so we had to do all of the combinations of that.

Dr. Chan: So like the danger zone, if you get that far down, you kind of go your separate ways as far as the match goes.

Anish: Yeah.

Dr. Chan: Yeah. Just to make sure the other person does . . .

Anish: Matches.

Dr. Chan: If someone matches, at least one person better than zero people matching.

Anish: Right. So only one of us would have to go through this [inaudible 00:23:52] if we had to.

Dr. Chan: Interesting.

Anish: And so, in the end, I think we had like, ended up having 300 combinations on our rank list, and we made it all by hand, and we went through it multiple times, and it was really exhausting. And, honestly, after our first five or six combinations at the top of our list, you know, we didn't really care what the other, whatever 280 of them were because at that point we were just going to schools and ranking them because we could. You know, we really only cared about the ones that we ranked at the top. And so, you know, those ones were more of a discussion than our last 200.

Dr. Chan: Okay. Awesome. So you submit the rank list. Obviously it takes a month for the computer algorithm to run. What was it like during that month?

Anish: It was awful. There was multiple checking of our rank list to make sure we had submitted it correctly. There was a lot of panic waiting. I remember like I had switched to an elective, and it just felt like the slowest elective I'd ever been on in my life.

Dr. Chan: So it gives you downtime, you're just thinking about, "Did I do the right thing?"

Anish: Yeah. And you just sit there and you keep thinking about it, and you keep thinking about it, and you're like, "There's literally nothing I can do about it right now." But you can't stop thinking about it.

Dr. Chan: Is it like radio silence from these programs? Are they still . . . Because I know there's like, there's a lot of emails that go back and forth, and, you know, we call them love letters from either side. You know, so was it complete radio silence? Or how is that during this time?

Parvathi: So most of the programs that we interviewed at made it very clear that they have a policy that they do not communicate with you after interviews, and that's really nice, actually. I don't know if that's the case with other specialties. It seems like maybe that's not the case, but for us, it was pretty nice. If anything, they would send like little reminders that you can do a Second Look Day or something like that. But none of them would ever be like, "Hey, you know, we really liked you. You should rank us number one." Like we didn't get any of that, so that was really nice.

Dr. Chan: All right. So take me to the Monday before match.

Parvathi: Oh, okay. So I highly . . .

Dr. Chan: More stressful than match day itself?

Parvathi: Yes.

Dr. Chan: Because that's when you found out if you match.

Parvathi: If you match, right. So they have this process where, just so, you know, you know whether you match or not. You get an email on the Monday before where you know so that on Friday you don't show up if you didn't match. So I was on advanced internal medicine, which is like this pretty busy rotation, which I highly recommend during the month of March because it kept your mind off of this whole process. So I was like pre-rounding on patients, and at 9:00 that's when the email goes out. I was sitting there, and I just checked my email and I was like, "Oh, I matched. Thank goodness. You can move on."

Dr. Chan: What were you doing, Anish?

Anish: So . . .

Parvathi: Oh.

Dr. Chan: That's okay.

Anish: I was actually at outpatient sleep clinic, and we didn't have any patients until like 10:00 and I was there at 7:00 in the morning. And so overall . . .

Dr. Chan: Were you sleeping?

Anish: I was not. I wish I was. I just remember the night before, even though I like knew, in my heart, me and Parvathi had definitely matched somewhere, I just like, still like couldn't sleep that night before and I still woke up very early. And I actually was talking to my attending when he got there, and all of a sudden it was like 9:15 and Parvathi sends me a text like, "Yay, I matched." I was like, "Oh, I should probably check on that." So then I looked, and then, of course, we both matched. And so, you know, it ended up working really well.

Dr. Chan: Okay. All right. Friday morning, both of your families there?

Anish: Just my family was there.

Dr. Chan: All right. Just your family. So, you know, there's only like a little program, and then here in Utah, because it has to be like noon East Coast time. So we opened up our envelopes at 10:00. They cut the red ribbon. Walk me through what happened.

Anish: There was a mad dash to get to our letters, and me and Parvathi had decided that we wanted to open it in front of our parents.

Dr. Chan: Simultaneously?

Anish: Yeah, simultaneously together. So we were on probably the south side of the room, and our letters were all the way on the opposite side on the north side. And so we ran all the way to get our letters, and then we had to run all the way back to our table, and all the while we're like going through this crowds of people and they're opening their letters, and they're throwing their hands up, and I'm just getting more and more anxious because I haven't opened it yet. And then finally, we get to the table.

Parvathi: Yeah, that journey between that table where our letters were and our table where our parents were was like the longest . . . It must've been like one minute, but it felt like two hours of, "Move out of my way."

Dr. Chan: Yeah. You're holding this hot envelope, hot news.

Parvathi: Yeah. Oh my gosh. Yeah, we opened it together. And I struggled so much with opening this letter. It's like, "Oh, I forgot how to open envelopes."

Dr. Chan: Were you trembling?

Parvathi: Yeah. I was like shaking, but we opened them and it was good news, and we were so excited. Oh, also before . . . so the university has a lot of like social media people at the event who are, you know, recording . . .

Dr. Chan: Yep. I think you made it to the official video part.

Parvathi: Oh, yeah. So this lady asked us beforehand, "Do you mind if we film you opening your envelopes?" And we're like, "Yes, as long as we don't cry." Cut that out. No, but, yeah. So we were being videotaped at all angles, and yeah, it was a good day.

Dr. Chan: All right. So we'll start with Par. Where are you headed? Where'd you match to?

Parvathi: I matched at Brown University in Rhode Island.

Dr. Chan: Rhode Island, okay. So sell us on Brown. Why Brown?

Parvathi: So I felt like this was another one of those gut feeling things. When I got there, I like met all of these really nice people. They had morning report that day, so we watched all the residents come in, and it was like this really interesting case. And you could just tell that they were like really good friends with each other, and they were just talking about this case and coming up with different ideas. And I felt like I want to be one of them. And then the person that interviewed me is a hospitalist, and talking to her I felt like . . . We talked about my hobbies, and we had some of the same hobbies, and I really connected with her. And so I don't know. The whole day I just felt like very at home and very comfortable, and I felt like, you know, they had all of the nice things, like the research opportunities, the academic, like, rigor of a good internal medicine program.

Dr. Chan: The Ivy League. Ivy League.

Parvathi: And Providence, it's just a cool town. There's a lot of good restaurants there, which is very important to me.

Dr. Chan: How many residents are there per year? How big [inaudible 00:30:39]?

Parvathi: So they have 30 categorical interns.

Dr. Chan: Okay. Interesting. Wow. And then, how many hospitals are kind of within the system?

Parvathi: So there's three hospitals, which is cool. There is a Miriam Hospital, there's the Rhode Island Hospital, and there's the VA. So that's really nice. So we get a VA experience as well.

Dr. Chan: Okay. All right, cool. All right. Anish, where did you match?

Anish: So I'm going to Beth Israel in Boston, yeah.

Dr. Chan: Okay. Harvard?

Anish: It is a Harvard-affiliated hospital.

Dr. Chan: Harvard-affiliated hospital. Yes.

Anish: It is.

Dr. Chan: So sells us on Beth Israel.

Anish: So the thing that I . . . first of all, Boston is just a really cool city. I've visited there with Parvathi twice now, and, you know, I just really love the city. And then the other thing that really sold me was that I'm really into medical education. I really wanted to teach in my future, and that's kind of their whole model there. You know, they're all about education and making you the best intern that you can be and, you know, really trying new educational experiences. And so that was something that really resonated with me. And then during my interviews, both of my interviewers I felt were, you know, attendings and faculty that I'd want to interact with, and I want to work with some day. And so, you know, all that stuff just really added up into me ranking it as high as I did. Yeah.

Dr. Chan: Awesome. Awesome. And how many residents are a year in internal medicine?

Anish: So . . .

Dr. Chan: And you get to rotate at different . . . I mean, how many hospitals are within the system?

Anish: Yeah, so . . .

Dr. Chan: Because I know there's tons of teaching courses in Boston.

Anish: Yeah, there's tons. So in terms of how categorical interns, I think there's around 43, something like that. And then, we also rotate at a VA clinic, and then we also rotate at Dana-Farber as well as our main, Beth Israel Medical Center. And the other thing that I really liked about that is you actually get to work with interns and residents from some of the surrounding programs, so like Boston University and Brigham and Women's.

Dr. Chan: Mass General. Yeah.

Anish: Yeah. So, you know, you get to be on teams with them because you all kind of share the same hospital space.

Dr. Chan: Awesome. How far apart is Rhode Island and Boston?

Anish: Yeah. So it is an hour drive almost exactly from our two hospitals. But there is a train that's only about 30 minutes.

Dr. Chan: So walk people through this, because you matched in similar areas, not the same cities. So is the plan for Par to stay in Rhode Island and then Anish up in Boston and you'll just see each other on the weekends? Or how is that going to look like?

Parvathi: So for our first year, we're going to have separate places in Boston and Providence and just kind of meet up wherever. But after we get married . . .

Dr. Chan: Oh, we're going to talking about that. That's so exciting.

Parvathi: We're probably going to find some place in the middle and just commute from there.

Dr. Chan: Okay. All right. Sounds good. And Rhode Island, Boston, more expensive than Salt Lake, I assume?

Parvathi: More expensive. Rhode Island is not as bad. Boston is pretty bad.

Dr. Chan: Little bit worse. All right. Fair enough. Okay. A couple more questions in my mind. This has been great. I love having you guys. All right. Anish, you talked about living in Sandy during med school. But as far as I recall, you grew up in Utah. Anish: Yes.

Dr. Chan: Okay. So it's not like you were not from Utah and you ended up in Sandy . . .

Anish: No.

Dr. Chan: . . . through a series of unfortunate events.

Anish: No.

Dr. Chan: Nothing bad about Sandy. All right. So let's talk about . . . So looking back, your four years, what surprised you at med school? What kind of resonated with you? Because you went from Johnny Hopkins to here.

Anish: Yes.

Dr. Chan: So, you know, I guess multi-layered question. I guess I'm asking you multiple questions within one question. Not a good technique. Was it hard coming back? Especially since living in Baltimore is pretty different, I would say.

Anish: Yeah. So it was hard to go to Baltimore. That was a very interesting transition, and it was hard to come back. You know, I spent four years in Baltimore. I really got, you know, involved in the culture. I changed as a person, and then, you know, I came back to Utah. I went back to Sandy where I grew up, and it felt kind of weird, you know, to go back home for a little bit. And that was part of what made first year a little bit difficult was that I was adjusting to everything again. And, you know, people describe medical school as a fire hydrant, and, you know, the first couple of years you're just getting blasted with water, and, you know, the last few years you've learned to swim a little bit better, but it never lets up.

And so, you know, that's what it felt like. So it wasn't as hard to adjust. It wouldn't have been as hard to adjust coming back if I had just been moving here for a job or something. But, you know, having to adjust to med school and coming back to Sandy and, you know, living with my parents, all that stuff kind of added up. But in the end, you know, I've actually loved it. I loved coming back to Utah. One of the reasons actually, when I got my interview invite here, don't take this personally, Dr. Chan.

Dr. Chan: Oh, I have stories on my end.

Anish: Yeah.

Dr. Chan: Because I remember calling you and you were on some cruise ship.

Anish: I was. I was on cruise ship.

Dr. Chan: I just hear all the screaming in the background, like, "Anish, Anish. Hey." Yeah.

Anish: I wasn't actually sure if I want to take the interview invite here. Obviously my parents, you know, obviously I did. And, you know, I came back, I stayed with my parents, and I came for the interview, and I just fell in love. You know, I forgot how much the University of Utah has meant to me growing up here, and, you know, seeing how all the med students were so friendly was something that I missed about the Utah culture. And, you know, once I kind of got over the med school, being overwhelmed by med school, all that stuff kind of came back to me and I just, you know, I love this place.

Dr. Chan: Awesome. I need to ask this. Hopkins, do you feel it was . . . because like, Hopkins has a very, you know, it's a very academically, very rigorous, very research-oriented institution. Do you feel the medical school curriculum was harder? Was it the same?

Anish: Yeah.

Dr. Chan: Because I know a lot of pre-med students come out of Hopkins?

Anish: Yeah, that's very true. So I think Hopkins was very difficult, but med school was harder.

Dr. Chan: Okay. In what way?

Anish: Just the amount of material that you're expected to know and stay on top of. You know, it doesn't compare to what I was expected of being undergrad.

Dr. Chan: Okay. All right. Par, what are your thoughts about med school looking back?

Parvathi: It was a great time. I honestly really enjoyed medical school. I feel like in undergrad, so I actually lived at home with my parents in undergrad. I just felt kind of like I just commuted to school, and . . .

Dr. Chan: You went to main campus? At the U? Yeah.

Parvathi: Yes. I did undergrad here, and I just felt kind of disconnected a little bit. And I had these like very large classes, and, you know, trying to get into med school, I was balancing so many different activities. But once I got to med school, I feel like everything kind of came together. I found a group of people that I connected with on so many levels and who are now like, basically my family members. And so, yeah, I don't know. It's been like the greatest four years of my life.

Dr. Chan: That's awesome. So, unlike Anish though, who has lived outside of Utah, this is going to be what I perceive like in your adult formative years, the first time leaving.

Parvathi: Yeah.

Dr. Chan: How are you feeling? Are you nervous because you're going to this big East Coast city?

Parvathi: Yeah.

Dr. Chan: What are your thoughts?

Anish: And Ivy League.

Dr. Chan: And Ivy League. Yeah.

Parvathi: Okay. so, I mean, I lived outside of Utah before in my childhood, and it's like several different places, but now I'm going to be like an actual adult moving out on my own. So that's a little bit scary, but I also know that like, the program that I'll be, I'll be around people who I will also connect with, and I feel like I'm going to a good place, so I'm not that worried, and I know that I can make friends wherever, and Anish will be close by.

Dr. Chan: Are your families concerned?

Parvathi: About?

Dr. Chan: Living so far away from home.

Parvathi: Oh. So my parents moved to Dubai.

Dr. Chan: Okay. I forgot that. Your parents like to wander the planet. Yeah.

Parvathi: They're like half a world . . . yeah. My parents, they just move all the time.

Dr. Chan: Okay.

Parvathi: So I don't know. They're like in different time zone [inaudible 00:39:09]. They think I can do it. They think I'll be okay.

Dr. Chan: All right. Anish your parents? Your family is excited?

Parvathi: I think they're kind of sad, but excited. You know, they're happy that me and Parvathi are going on to, you know, pursue our dreams at these great programs. But, you know, they're sad that they're losing us to halfway across the country. And my brother also did med school here and he also went to a program in New York. And so, you know, they're kind of used to the . . .

Dr. Chan: Pre-conditioned.

Parvathi: Yeah. They're used to their sons moving away.

Dr. Chan: All right. Okay. Last two minutes, last question. So help me understand, because I've been invited to it. I don't fully comprehend it. So what does this ceremony coming up, what does it mean? What does . . . . yeah.

Parvathi: We call it an engagement.

Anish: Dr. Chan's referring to me and Parvathi's engagement ceremony. It's coming up April 7th. It's kind of, you know, our parents have already talked to me, and Parvathi had talked before that about getting engaged. And, you know, now that we know that we're going to be so close to each other, we've gone through this great journey together, we felt like now was the best time to do this.

Dr. Chan: So right now you're not engaged at this moment?

Anish: Not technically.

Dr. Chan: Okay, not technically.

Anish: There's no ring on these fingers, Doctor.

Dr. Chan: But, so that's the ceremony, is there a ring exchange?

Anish: There will be a ring exchange.

Dr. Chan: Okay. All right. I'm just learning so much. This is fantastic. And then is there some sort of like a promise you make to each other? Or do your families get to talk? Do you get to talk? Or how does this work? For people who don't know.

Anish: [inaudible 00:40:53]. There's kind of a religious component to it, a religious ceremony, which is essentially like we're being promised to each other, betrothed to each other.

Dr. Chan: Could you talk about what religion is this?

Anish: So Hinduism.

Dr. Chan: Okay. All right.

Anish: And we make an announcement kind of at the end that, you know, both of us are going to get married. So it's kind of . . . So in India, you know, people do this in a variety of ways. Sometimes people do it, you know, a couple months before, sometimes they do it the day before. It's just sort of, you know, tradition.

Dr. Chan: Okay. So is there a possibility . . . I'm not saying it's going to happen to you two, but like, can someone say no at this thing? Or you just simply don't show up if you're going to say no. Like you don't want to get engaged.

Anish: I really don't know the answer to that. I don't.

Dr: Chan: Okay. I'm just trying understand [inaudible 00:41:44] to get set in motion.

Parvathi: No, there's no like opportunity to object or anything.

Anish: [inaudible 00:41:51]

Dr. Chan: So is someone gets cold feet and they just . . you know what I'm saying?

Parvathi: That's too bad.

Dr. Chan: I'm sure it probably happened in history . . . Okay.

Anish: I mean, it probably happened.

Parvathi: It's probably happened before, but it better not happen.

Dr. Chan: Okay. Not in the recent memories in the Indian-American community within Utah.

Anish: Yeah, not that I know.

Dr. Chan: All right. All right. Fair enough. So you go through the ceremony, and then it sounds like it's kind of a prelude to the wedding itself, which will be in the future.

Anish: Yes.

Dr. Chan: So what does an Indian wedding look like? Does it have a special name or . . .

Anish: I don't think it has a special name.

Parvathi: I don't think so.

Anish: So it's tough.

Parvathi: Well, so we're from different regions of India. So I'm from a state in the south called [Kerala 00:42:33], and Anish's family is from North India. And weddings in those areas look very different. So where I'm from, it's a very simple ceremony.

Dr. Chan: Event.

Parvathi: Yeah, you go to the temple, you get married, and there's like a feast afterwards.

Dr. Chan: So I'm going to do a Dr. Chan hot take right now. So just like how both of you are negotiating, and you learned to talk about your different programs and rank lists, so you will also negotiate and talk about the wedding or no? Is that completely . . .

Parvathi: Negotiate?

Dr. Chan: As far as like if there's two kinds of different visions of the ceremony?

Parvathi: Oh, I don't think our visions have clashed yet. If they do, then I assume that I will just win.

Anish: [inaudible 00:43:20]

Dr. Chan: That's similar all across the world and all cultures.

Parvathi: Actually, so as far as our opinions go, I don't think ours officially matter anymore, because in the very beginning of this engagement planning process, both of us, they would ask us, you know, "What do you think of this person for photography or this for music?" And now we just don't hear about things.

Dr. Chan: So I'm fascinated. A few more questions. [inaudible 00:43:49] a few more questions. So, you know, like, when I asked my wife to marry me, I felt this overwhelming kind of weird societal pressure to ask the dad's permission, and there's all sorts of history tied into that, and you can argue if that's right and if that's proper. Does that exist? Anish, did you have to talk to Par's father?

Anish: Not really.

Parvathi: No. Basically our parents just talk together. Anish didn't really say very much at all. Neither of us did. I mean, our parents basically just talked it out amongst themselves, and that was it.

Dr. Chan: Okay. All right. Fair enough. Were you in the room for this discussion or no?

Anish: Oh, yes.

Parvathi: Yes.

Dr. Chan: Oh, okay. Was it super awkward?

Anish: Oh, very much so. Before that discussion, Parvathi and I had discussed engagement and getting married. So between us we had already kind of established that this is where we want the relationship to go. And then, individually we told both of our parents and our parents said, "Okay, well, you know, traditionally the parents talk to each other." And so we did and, you know, everything worked out.

Dr. Chan: Okay. My last question, I promise you.

Anish: Okay.

Dr. Chan: So, again, when I went through the marriage process, which is glorious, but super stressful, there was this weird thing where the bride's family pays for this, this and this. And the groom's family pays for this, this and this. Is that kind of the same case for you guys?

Parvathi: No, our parents basically just agreed to just split the costs.

Dr. Chan: Okay. Oh, I love it. I should have become Hindu. I love this. It's awesome.

Parvathi: We're just here to convert people. No, just kidding.

Dr. Chan: All right. Cool. Last question. So any advice to people thinking about going to med school or applying to med school, or they're thinking about taking that next step and doing the couple's match together? What would you say to them?

Parvathi: If you're thinking about going to med school, just ask yourself, you know, "Am I willing and prepared to put my entire life and effort and spend literally all of my time into making myself the greatest doctor that I can be?" And if the answer is no, and you can think of any other profession that you can go into, then don't go to medical school. But if you can, then do it. By all means, give it a shot. You know, it's okay if you don't get in your first time. Lots of people don't. But don't let that stop you. And yes, couples match. If you find the right guy, lock it down.

Anish: Just sort of talking about taking the next leap and couples matching, you know, one of the things that really caused us to hesitate was, you know, there's no going back on this decision. Like once we submit that rank list, like that's it. We've locked things together, and it really, this whole experience in medical school has taught me that it's okay to take the next leap because sometimes it may not work out, but sometimes it will be the best thing that's ever happened to you.

Dr. Chan: Oh, they're holding hands. It's very sweet. I love it. The displays of affections. It's great. Oh, and then, I just got a text message from one of our listeners, Anish. Are there any Taco Bells close to Beth Israel?

Anish: There aren't. Okay. I've mapped this out, and there are no Taco Bells close.

Dr. Chan: Oh, what are you going to do?

Parvathi: Thank goodness.

Anish: That's true. I'm probably going to lower LDL and then be very sad.

Dr. Chan: Okay. All right. I am so happy for both of you. This is so exciting. I truly hope you come back one day. I'm sure your families want that too. Well, at least Anish's.

Parvathi: Mine will probably be somewhere else.

Dr. Chan: Yours, somewhere in the world, exploring the world. But this is exciting. I'm excited for both you and this a beautiful journey. So thank you.

Parvathi: Thanks, Dr. Chan.

Anish: 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.

Dr. Chan: What did it mean to be a couple in medical school? Why does one change their path to line up with someone else's path? How do you manage a year apart during medical school, and what does organized chaos look like during fourth year? Today on Talking Admissions and Med Student Life, I interview Antigone and Ira, a 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: Okay. Well, welcome to another edition of Talking Admissions and Med Student Life. I have two super great guests today, Antigone and Ira. Hello.

Antigone: Hello.

Ira: Hello.

Dr. Chan: Thank you for coming. Fourth year medical students, soon to graduate . . .

Ira: Woohoo.

Antigone: Woo.

Dr. Chan: All right. We're going to start back in the beginning. Let's get it out of the way first. How did you two meet?

Antigone: Well, that depends on who you ask.

Dr. Chan: I'm asking you right now, Antigone.

Antigone: Well, I know, but we have different versions of the story.

Dr. Chan: And somewhere is the truth.

Antigone: And somewhere is the truth, yes. We first met during my interview at the U.

Dr. Chan: Really?

Antigone: Yes. Ira was the second year tour guide during that day. So he took us on a tour. We met that day. But then we didn't meet again until I came for second look day. I brought my very Greek mother with me, or rather my very Greek mother wanted to come with me. She met Ira. He was our tour guide again that day. My mom thought he was like the cutest thing and asked him all the questions about medical school.

Dr. Chan: Had you told your mom about him ahead of time, or was this a completely independent assessment, unbiased?

Antigone: No. It was totally independent, because I hadn't seen him since February when I interviewed and now it was May or April. But she asked him a million questions and sat next to him on the bus, and I sat about eight rows behind them on the bus and then promised to never interact with him again. And then I think we met one more time during orientation week.

Dr. Chan: You're hitting all the data points here, that's great. It's building towards something.

Antigone: Yes. We just talked about med school, and he told me if I ever needed help with anything, I could reach out. Then after the first week or so of school I had just done horribly on my first foundations test, and I saw Ira in the English Hub, the England Hub, whatever.

Dr. Chan: The little cafeteria.

Antigone: The cafeteria downstairs is and he told me I looked like I needed a drink. Then we went out for drinks like a month later, but that's how we met. Then after we met for drinks, it's sort of just . . . here we are. We're getting married.

Dr. Chan: It just happened.

Antigone: It just happened.

Dr. Chan: Okay. So that's version A. Ira, what's version B?

Ira: Version B is the same time frame as version A, so of course during the tour.

Dr. Chan: So you remember her on her interview day?

Antigone: No.

Ira: As you can glean from this, I, in my first year of medical school, volunteered for a lot of the tours and . . .

Dr. Chan: You were very active.

Ira: Very active in the admissions and administration and whatnot. I was doing them like once a week. So I saw probably 100 different applicants in that first year, and then of course during second look day, the next 7,500 people that come to second look day and toured all of them through.

Dr. Chan: So you don't remember her from second look day either?

Ira: Or orientation.

Dr. Chan: So you don't even remember the mom?

Ira: I remember her mom.

Dr. Chan: You remember her mom more than herself?

Ira: I remember talking to her mom.

Dr. Chan: Oh, I love doing this.

Antigone: I was very good about staying in the periphery that day.

Dr. Chan: You were hiding behind your mom.

Ira: I do remember her mom and talking to her mom and answering about a trillion questions about medical school and wondering who she's attached to here.

Dr. Chan: This is a very non-traditional student in front of me.

Ira: What I like to tell myself and what I think really happened is after that first tour, Antigone was totally hooked and she was just thinking about me the entire time leading up. She just kept thinking about it and figuring out ways that she could make sure she ended up on my tour and not the other tours.

Dr. Chan: That's a good approach. Antigone is very crafty and intelligent like that.

Ira: She is. And then we finally got to, after her first week, I remember her sitting on like one of the couches outside of English Hub, and she was sitting there staring at the wall with this blank look on her face.

Dr. Chan: This is post-test.

Ira: Post-test.

Dr. Chan: And that's your first memory of Antigone?

Ira: That's my first memory of her, just like totally no color in her skin and just . . .

Antigone: Which is not far off from normal.

Ira: And I sat down next to her and I was just like, "Wow, it's going to be okay. I know that it's a . . . as we were always told, it's like taking a sip of water from a fire hose, that becomes real very, very quickly."

Dr. Chan: The tests are very hard and medical school is hard. It's so much information in a short amount of time. So you get together. What did it mean to be a couple in medical school? How did it help? How did it define your relationship?

Ira: It was interesting because Antigone's father is also one of our clinical instructors.

Dr. Chan: Oh, boy. We're going deep now.

Ira: So I spent the first six months to a year of our relationship . . .

Dr. Chan: Was he your clinical instructor?

Ira: Yes.

Dr. Chan: He was? I did not know that.

Ira: He wasn't my CMC instructor, but he taught classes in front of the whole class.

Dr. Chan: He would randomly grade you.

Ira: Yeah. He didn't know who I was. So I spent the first six months to a year without him actually knowing who I was but within the class. And then one day when Antigone was actually talking to him in the hallway, I turned and walked down the hallway and I saw them both and I tried to dodge behind one of the pillars and she grabbed me and pulled me out and was like, "By the way, this is my boyfriend, Ira."

Dr. Chan: So I guess you had not gone home and met the parents to this point?

Ira: No. I think one of the things that was really nice overall about being a couple in medical school actually was the fact that we were one year apart because we didn't have the same stress cycles. So when one person was really stressed, the other could be the supportive one, and when the other person was really stressed, we could flip flop it. So that really, I think, actually helped our relationship a lot.

Antigone: I never really planned on dating anyone in medical school, but it's always been really nice that I never had to explain anything to Ira, like we've had so many dates that have been pushed back by hours or have had to cancel and we've had parties or events that one of us have been unable to come to because of our time commitment to school. We've never had to explain that to each other and we've never had to worry about our partner being upset with us, and that's really nice to have somebody who gets what you are going through and is supportive of what you are doing.

Ira: And there are dates in the hospital cafeteria.

Dr. Chan: Dates in the hospital cafeteria.

Antigone: We've learned to be very flexible. We have had dates at Primary Children's before I started a night shift. We've met at Starbucks at the University of Utah. We've really just had to learn how to be adaptable sometimes. It's been great.

Dr. Chan: That's great. So you're different years. I know there was a decision made to have Ira step off and do something else. So walk us through that. Were you thinking that before you ever met Antigone, or did this kind of speed up that decision?

Ira: So I've told Antigone this a couple times, but I actually view that decision as probably the biggest moment in our relationship. That was because it was something I was not thinking about at all before. It was the beginning of my third year. The application for this program called the Medical Research Scholars Program at the National Institutes of Health was something I had just heard about, and the decision came in early September. It was, "Am I really going to derail the path that I'm taking right now to line up with somebody else?"

I think that's something that in every relationship you ask yourself at some point, and you know it's the right person when the answer to that is very clearly yes. While I view it as a really big decision, it was a very easy decision. Its was one of those that I was like, "Yeah, this is the right thing to do." So I actually applied to that and I applied to another one at Rockefeller University and another one at the University of Buffalo called the Sarnoff. So, through that, I ended up getting multiple options and chose to go to the NIH.

Dr. Chan: So we're talking leaving for medical school for a year to pursue research?

Ira: Yeah. It was really incredible. I think that as far as us as a couple, it was obviously a very challenging year to do a year of long distance, but we did have an end in sight and we knew that when we got back, it would be better because we would be lined up where we would be graduating together. We're both going to be able to participate in the match together.

Dr. Chan: So a bunch of questions are on my mind. Did you ever explore sticking around here and doing a year of research here? Was that even on the table?

Ira: That was absolutely . . . I hate to say it this way, but that was 100% the contingency plan. Some of these research fellowships are extremely competitive because they're fully funded. So I had actually already reached out to a previous mentor I had here who said that he would welcome me back in his lab if I needed the time.

Dr. Chan: Great. And then when you apply, do you apply to the program, or do you apply to a specific lab? Did you know what you would be doing before you went to these places?

Ira: It depends. Some of them you would reach out and contact a principal investigator at that institution, and then I'd have a Skype interview with that principal investigator. Then if they said that they would sponsor me, they would put in application with me for the scholarship or the fellowship. That's like how the Howard Hughes Medical Institute ones go. That's how the Rockefeller University ones went. For those, I literally completely like cold called the people.

Dr. Chan: "You have a cool website. It sounded really nice online."

Ira: Yep. Completely cold called them.

Dr. Chan: How does that work when you're in medical school? Does that work a little more successful as opposed to the pre-med life? When you say cold call, you mean cold email.

Ira: Yeah. I would say that it's a plus and minus. Ultimately, what you have to show, whether you're a pre-med or in med school is a genuine interest. I think nobody wants to work with somebody that's doing the work for ulterior motives. So, lucky for me, I'm really interested in research and I really enjoy it, so that's an easy thing for me. I get invested in projects and I really enjoy them. I think what they're really looking for is somebody that's actually going to contribute to their group in the same way that they're going to give you by teaching you and taking you under their wing. It worked completely fine, I guess. Everybody replied and everybody . . .

Dr. Chan: Everyone said, "You're hired. We want you."

Antigone: Yes.

Dr. Chan: What did you do for a year?

Ira: The NIH program is completely different. You apply to the program. I think actually this is the coolest thing.

Dr. Chan: They just assign you?

Ira: No. You get to choose. You spend the first two weeks there interviewing with one of the 2,000 investigators at the NIH choosing which lab.

Dr. Chan: Sounds like a buffet.

Ira: And you're funded, so you're very wanted not for your skills in research, but because you come with money.

Dr. Chan: Oh, so it's like the roles are flipped.

Ira: Yeah. So it's an incredible experience.

Dr. Chan: So people are just salivating to have you in the lab. They get your awesome personality, and you come with some money too.

Ira: Yes.

Dr. Chan: Okay. What was this program called again?

Antigone: MRSP.

Ira: MRSP, Medical Research Scholars Program.

Dr. Chan: Okay. Is it open only to medical students?

Ira: Medical, dental, and veterinary students. They want students that are coming between their third and fourth year. So they want students that have had the clinical experience so they can choose what research projects to do based on their clinical experience and what they've observed clinically. But I ended up doing a project in the pediatric oncology branch, working with an investigator on a clinical trial for a drug called vandetanib that's used for patients with a disease called multiple endocrine neoplasia 2.

Dr. Chan: I'm nodding my head like I understand what that means. So, obviously, pediatric cancer and I guess you're just looking at the efficacy of this drug, side effects, things like that.

Ira: Yeah. So we looked at . . . I got to learn how to do all these analysis techniques and look at landmark analysis and all these complicated stats. They taught me how to do it, which was really, really cool. I looked at the 10-year outcomes of this clinical trial. Then the other part that I absolutely loved was I got the chance to try my hand at some genome sequencing.

So I got to learn about how next generation sequencing works and really importantly with the National Institutes of Health, it's how it works and how it applies to the clinic. They have a protocol there where they're enrolling every child that comes through to get their whole genome sequenced. So to learn how that information interacts with patient care and actually helps guide patients, especially patients with cancer through their treatment options and going forward was one of the most amazing experiences of my life.

Dr. Chan: Sounds really cool. You're back there in D.C., great place to live. You're there for the entire year in between third and fourth year. That means, Antigone, you're on your third year. Walk us through that year. Did you just go ahead and buy like 20 plane flights? Did Ira end up coming more back to Salt Lake? Did you go more back to D.C.? How'd you guys work that?

Antigone: So I think we saw each other about once every three months when you average it out. When Ira first got the MRSP, we thought we were going to be able to see each other a lot more often than we ended up being able to do just because of my third year. In third year, you're definitely not in charge of your schedule. Ira also had work hour requirements he was supposed to do for the program. He left in August. The next time I saw him was in October when I flew out to go visit. Then he came home for Christmas.

Ira: Like a 30-hour . . .

Antigone: I went there for 30 hours, like I got there on Friday night and I left on Sunday morning, but otherwise, we weren't going to see each other until Christmas.

Dr. Chan: Did you throw in some D.C. sightseeing on top of it or no?

Ira: That was actually really funny. I made Antigone bike for about 30 miles when she got there, and we went and saw all the national monuments.

Dr. Chan: That's the way to do it is by bike. If you go by car, parking and traffic is really bad.

Ira: Then of course I was living 10 miles away from where the national monuments were. Rather than letting us take the subway down, we biked.

Dr. Chan: I've done that myself. It's gorgeous, people playing softball right there and ultimate Frisbee.

Ira: It was fantastic. We have a great picture on Instagram of Antigone face down on the couch after getting back from her 30-mile bike ride.

Dr. Chan: Did he surprise you with this, or did you know you were going to go on a 30-mile bike ride?

Antigone: You said I was crafty, but Ira is also very crafty. He asked me if I thought it would be fun to bike around the monuments, and I said, "Sure, that sounds great." He's like, "Okay, well, we'll bike there. It's just down the hill." But he didn't mention that it was 10 miles down the hill. So, no, I did not know what I was in for, but I've gotten used to that dating Ira Kraft. I now know to expect the unexpected.

Dr. Chan: Which could include a 30-mile bike ride.

Antigone: Yes, it could include anything.

Dr. Chan: All right, so let's step back a bit. So, before medical school, if I'd asked both of you what you wanted to go into, what would you have told me and then what did you end up choosing and why?

Antigone: I probably would have said I would be a pediatrician because I've always loved working with kids. But I was the medical student that loved everything in third year, and I would call Ira after every rotation except one and say, "I'm going to do this. I love this." It was hard for me to decide. Even when I committed to pediatrics, I still went back and forth between a couple of things. I could have easily seen myself going into OB or internal medicine.

Dr. Chan: So why pediatrics? What attracted you to that field?

Antigone: I think I just like who I am on pediatrics the most. I think there are parts of my personality that really fit with a lot of different specialties. I love working with my hands, which is why I loved OB. I loved working with child psych at uni because I used to work there.

Dr. Chan: I remember those days.

Antigone: Yes. I love those kids. I could still work in behavioral health going to pediatrics. But I just think the person that I am when I work with kids is the person that I want to be the most. For me, working with kids, I have to think about what I want to do not just now but in 30 years when I really, really don't want to get up in the morning or when I have other things going on in my life. For me, I will always, always get up out of bed, leave whatever I'm doing if a child needs help.

Dr. Chan: That's beautiful.

Antigone: Thank you. I was an English major.

Dr. Chan: Ira, before med school, what were you thinking of becoming?

Ira: I was thinking of becoming a doctor.

Dr. Chan: Okay. That's good. I'm glad you found the medical school.

Ira: To be completely honest, I don't think I knew what a doctor did until third year of medical school. That being said, I think one of the really cool things that happens at the beginning of your first year at University of Utah is there's lunch talks of every day of the first couple of weeks from different specialties. During those lunch talks, essentially the residency directors from the University of Utah come in and tell you about their specialty. One of the individuals who came in had me hooked right away, and that was Dr. Lam who gave a talk about a specialty that I didn't even know existed that was a combined internal medicine and pediatrics.

Dr. Chan: It's like the whole existence from birth until death.

Ira: Yeah. The whole thing. What I liked about it and what she sold me on is that you see both sides from a slightly different perspective. So you approach adult medicine, for example, when you're rounding and you say, "Maybe this situation might work better with family centered rounds," which is something that's very common in pediatrics. On the pediatrics side, another example would be you see a teenager that has high blood pressure and you say maybe the adult treatment regimen might actually fit this patient better than the pediatric workup.

So being able to learn that flexibility was what really got me. Of course, I stayed open to everything, similar to Antigone, a little bit less so in the fact that I don't think I loved everything to the same extent that she did, but I kept coming back to med peds, and that was always the thing that I'd find and be like, "Well, med peds is a little bit better for me than that."

Dr. Chan: So, when you did your rotations in internal medicine and pediatrics, did you like them both equally?

Ira: I would say no. First of all, the pediatrics rotation at University of Utah is absolutely outstanding and is done in a way where -- I'm sure you've heard about this on other podcasts --there's a team called the Glasgow Team that's med student run and you feel like you are the primary provider of a patient as early as the beginning of your third year of medical school because you are dictating the treatment for those patients.

Dr. Chan: With supervision.

Antigone: Yes.

Ira: With supervision. Absolutely.

Dr. Chan: The med students are not doing everything on their own.

Ira: No. It's such a time for growth . . .

Dr. Chan: Ownership.

Ira: Ownership. And at least for me, it really embodies the reason why I went to medical school. It's an incredible experience. That plus of course I had some experience in a research lab in internal medicine, so I knew that I liked the medicine and I knew that I liked the research. Actually, again, going back to that NIH program, that was another thing that completely drove home med peds for me. That was the idea of being able to write clinical trials for both adults and kids.

When I was at the NIH, there was one investigator in the pediatric oncology branch who was med peds trained. So she had to be an investigator on every trial that included patients that were both adults and kids so that they could get IRB approved to run that trial so they could have an internal medicine doctor, essentially, on the trial or they would collaborate across. So the idea to be able to do that without limitations and knowing that I want a career in research was like completely ended it for me and I knew that med peds was it.

Dr. Chan: Awesome. Combine medicine and pediatrics, four years?

Ira: Four years.

Dr. Chan: And then pediatrics three years. You guys had made up your mind. Walk me through fourth year. What was your strategy? What did you start doing? How did that work? Did someone in the relationship have the Excel spreadsheet? Was someone master of the money? How did that work?

Antigone: Well . . .

Ira: It didn't.

Dr. Chan: Is it just organized chaos?

Antigone: Yes. I wish we could tell you that we had this amazingly streamlined system and walked through all of this application process smoothly, but we did not. We applied to every med peds program.

Dr. Chan: How many are there?

Ira: Seventy-seven.

Antigone: So, with the geographical pediatrics matches, I applied to 94.

Dr. Chan: Those strike me as very, very high numbers. I'm going to go out on a limb here. I bet you got way too many interview offers.

Antigone: We did. We also went to way too many interviews and now we are broke.

Dr. Chan: Okay. Let's talk through this. This is for the benefit of the rising generations.

Antigone: Okay.

Dr. Chan: What would you have done different, or would you have done anything different?

Antigone: I think we sort of . . . I don't know if panicked is the right word, but we're sort of wired at the beginning, and every offer that came in we took and we planned to go to and a lot of the schools that we really wanted to go to, we didn't end up getting interview offers until a little bit later in the season. So I think just being a little bit more patient would have worked.

Ira: I also think that we scheduled interviews very poorly. Our thought process was that we would schedule our -- I'm doing air quotes here -- our backup programs we scheduled at the beginning of interview season thinking that that would give us some practice and then the programs that we were really excited about and really wanted to go to we scheduled in January.

Dr. Chan: You'd be smooth and suave.

Ira: So we'd be ready to go. What really what happened is we were just exhausted because we'd already gone on 20 interviews. I think that if we could do it again, I know what I would do is almost flip that, put those programs at the end so you can actually cancel them afterwards or once other ones come in of places that you want to go to.

Antigone: We also had a hard time saying no, like cancelling interviews was really hard for us. I also think what I would tell the incoming generations of medical students is not to put yourselves in a box of places you want to go because we worked ourselves up to have one dream school or school that we really thought we were going to end up going to and I went and did an away rotation there and we invested a lot of time and energy into that school and we didn't like it. The school that we are going to was not even on our radar at the beginning of all this.

Dr. Chan: Why didn't you like that unnamed location?

Antigone: The people.

Ira: I think everybody tells you that residency is about fit and finding a program. It truly is a match and it's about fit. I don't think any medical student truly believes that until after they go through the process and then every medical student believes that.

Dr. Chan: You've seen one residency program, you've seen one residency program. Right?

Ira: Yeah, exactly. It was really hard. I would still personally go on as many interviews as we did and be as broke as we are right now, Antigone maybe not quite so many. I got the feeling that I didn't know what a place was like from their website and from researching everything I could online and I still didn't know what a place was like. For me, it was equally as helpful to show up at an interview dinner and within 15 minutes say, "I don't really want to go here," than it was to be like, "Wow, this place would be interesting."

Dr. Chan: So it's about culture and teamwork and the educational environment.

Ira: Yeah. There were those places that 15 minutes in I was like, "This place doesn't fit me."

Dr. Chan: "I would like to order another steak."

Antigone: Less than 15 minutes sometimes.

Dr. Chan: I'm just curious of the numbers. How many interviews did you each end up going on?

Antigone: I went on 24.

Ira: I went on 26.

Dr. Chan: Okay. That's a lot.

Antigone: It was a lot.

Dr. Chan: This is spaced out over . . .

Antigone: Three months.

Dr. Chan: Was there any coordination between the two programs? Were you ever interviewing the same time in the same city, or were you guys crisscrossing the nation like two planes in the night.

Antigone: I think three times we interviewed together.

Dr. Chan: Was that better or more stressful?

Antigone: It was nice.

Ira: It was really nice because we hadn't seen each other for a month and we'd meet in some city we'd never been at before and spend three days there and explore the city a little bit.

Dr. Chan: Did you ever decide to play mind games with people in the interview, like pretend to not know each other?

Antigone: We talked about that.

Dr. Chan: Just start to hit it off and then you're holding hands midway through the day.

Antigone: We talked about doing that. Whenever we would plan to do that, we thought we would be together on the interview a lot of the day because med peds and peds overlap, but we were never together enough to be able to work that out, but we wanted to. It was really nice. It was nice to go to dinners together because we could get two different perspectives on what was going on.

Ira: That's that same thought. Even interviewing at separate times was really nice because we got to see each program twice.

Dr. Chan: Go home and compare notes, impressions.

Ira: We both had different things that we were looking for and looking at specifically. We'd come back from one program and I'd be super excited because I'd be like, "There's like free food at everything and it's outstanding." And then Antigone would come back and be like, "Academically it doesn't really fit our goals and whatnot." It was great because we both saw it through a different lens, and then when we brought it together, we could actually come up with something that really did fit us very well.

Dr. Chan: In every relationship, there's always negotiation, there's always compromise. It's just how it's set up. I'm curious to hear as you start preparing your rank lists, what were the give and takes? What were the things that were absolutely essential, and what were the things you could say, "That's not as important to me," as you've talked and compromised with each other?

Ira: I think that, first of all, we had, by vast majority, we essentially did like a tier system. So we had like places we loved after the interview, places we thought were really good after the interview, and places we thought that were good after the interview. Our tiers lined up almost perfectly. So we didn't really have that many challenging moments where we were like . . .

Dr. Chan: Where someone clearly had a program higher than the other person.

Ira: And then we did have a lot of choosing between one and two or two and three or three and four. But there was, I think that for me, a lot of it was the feel. Like I had, of course, an idea. I wanted free food. I wanted to be able to bike into the program. I wanted a window in the resident room. They all went out the window real quick.

Antigone: There were no windows.

Ira: There are no windows in resident rooms in any hospital all over the country.

Dr. Chan: I had no idea that was so important to you. Now that I think about it, I don't think I've ever sat in a resident room with windows.

Antigone: No, neither have we.

Ira: They're all built the same.

Dr. Chan: I've been in where there's multiple computers and actually some bunk beds and some closets you hope are cleaned out every once in a while.

Antigone: I think we both when we were submitting, getting ready to submit our rank lists, we both independently of each other felt that our number one program should be our number one program. It was a perfect fit for both of us and us together. I think when it came to making our rank list, how we felt we would do it in the beginning didn't really end up being as big of a role, like we applied to a ton of places for geographical match options and then we didn't end up liking a lot of places in the same area.

But also, there were places that Ira loved that I didn't love as much or I thought the peds program was a little bit weaker than other places, and there were places that I loved that Ira really didn't want to live. When we sat down and looked at the paper and actually looked at the possibility of matching somewhere separately, we just decided that matching together was better than that and that we could figure out anything and that four years of our life wasn't a life sentence and that it was the most important that we match together.

Ira: It's of course different for every couple, but it was a balance for us. I think that on our rank list at our 15th-ish mark, we did have us matching at separate programs because they were outstanding, big name programs. I think in the end, that had caused a bit of anxiety because again . . .

Dr. Chan: You guys are not going to drop down to your 15th.

Antigone: You never know.

Ira: When you really think about it, we wanted to match together and we applied to all these geographical options and then we made a rank list that was 512 programs long.

Dr. Chan: Wow.

Antigone: That's a plug for how scary Dr. Stephenson makes this process.

Dr. Chan: Oh my goodness.

Ira: In the end, we just realized we wanted to do it together and, again, it goes back to the decision to take the year off. I think that part of it has also made me become a very large [inaudible 00:36:07] and I've talked to a couple of other couples that are in staggered years about the importance of matching together as opposed to one person following the other person. I think that we really did find a place that was perfect for both of us.

Dr. Chan: All right. So you submit your rank list. Then obviously, it takes a month to run the computer algorithm, obviously, because that's how it works nowadays.

Antigone: I was a wreck.

Dr. Chan: So any second thoughts, any like, "Oh my gosh, we didn't certify the list"?

Antigone: Oh yeah. I was freaked out that we didn't click a button right. I stalked Dr. Stephenson. I sent him screenshots. Ira would have to like hide my computer from me because I was obsessively checking. Did we regret what we put? I don't know if it was so much that we regretted. I don't think we regretted our list. I think we had second thoughts about like Ira said, the program, the match that that had us at separate places.

Dr. Chan: Okay.

Antigone: I think we more so did not expect to match at our number one, so we were sort of planning to not.

Dr. Chan: Well, walk me through the week. Were your more anxious the Monday when you got the email saying you did match, or you weren't worried about that? I know a lot of people say they're so happy to get that email.

Ira: We were very worried. We were worried about it, but I don't think I was as worried.

Dr. Chan: Okay. So you get the email on Monday saying you did match but not where.

Ira: We had 512 options.

Dr. Chan: All right. So, unless there was a computer meltdown . . .

Ira: We thought we had to have done something very wrong if we went 512 options down our list.

Antigone: I think matching on Monday was a little bit of a relief, but in my illogical brain, there were still more options on our rank list that had us separate than had us together and not knowing where we were on that list, I didn't sleep that entire week.

Dr. Chan: My next question, the Friday, the Thursday night before, sleep like babies? Were you freaking out?

Antigone: I don't think I slept.

Ira: It's a rough week. Match week is a rough week.

Dr. Chan: A lot of emotions.

Ira: Our match day celebration was at Rice-Eccles Stadium, and it like hit me in the elevator as we were going up. So Antigone is also very involved in . . .

Dr. Chan: Student government.

Ira: Student government and whatnot. She was getting there early, and I got there early with her to help set up. We're walking in, and we couldn't even like look at each other.

Dr. Chan: It's too stressful.

Ira: Very stressed. It really hit me in the elevator, and I like disappeared for an hour and just stood staring out the window blankly at the football field and was just like, "Okay."

Dr. Chan: Were you worried that he was going to disappear?

Antigone: No, but then he did. He had been . . . I am definitely the worrier, over-reactor stress ball of the relationship, and Ira is always like, "It's fine. I'm going to go skiing." So the whole match week, he had been great, and I would cry and I would walk around my kitchen island in circles. He was fine. Then we went to match day and I was nauseous, but I was trying to focus on like putting up the balloons and doing all that. Ira is just gone. He's not answering his phone. I was just like, "Did he run away? What is happening?"

Ira: I save all the stress for one hour and then just get it all out.

Dr. Chan: So was your mind going there, dark thoughts, calamity?

Ira: Yeah, spend it all in that one hour, because I was totally fine all the way before that, but then that one hour was awful.

Dr. Chan: I'm glad you got it out of your system. All you need to do is stare at a football field. Apparently that's your Walden Pond.

Ira: Stare at a football field, stare at the other side, look at the windows or the mountains on the other side of the valley, gorgeous.

Dr. Chan: So they have the little talks. They cut the ribbon. What did you guys do? Did you get your envelopes simultaneously and go back to your families? How did that unfold?

Antigone: We went and got our bags and went back to our tables with our family. Both our families were there. I, of course, like ripped mine open and I'm ready and Ira takes 45 minutes, it felt like, to get his envelope opened and he can't get the thing out and I'm standing there holding mine waiting and he can't get it out. Then we opened them together. There's a video and we both read ours, and then we both look at each other's to make sure they say the same thing.

Dr. Chan: Where are you headed?

Antigone: We're going to the University of Chicago.

Dr. Chan: Awesome. Congratulations. How'd it feel?

Antigone: I was shocked.

Ira: Total disbelief.

Dr. Chan: Why were you in disbelief?

Antigone: We really didn't think we would go there. I didn't hear from them at all when we applied first and Ira got an interview and we called and emailed and then I got put on the waitlist.

Dr. Chan: For an interview.

Antigone: And then I got an interview at the last minute. We didn't think we were high on their list. But it was absolutely where we wanted to go, like more than any other place. Ira really didn't want to live in a big city, and we're going to a big city. So we were shocked that we got in.

Dr. Chan: So I get the sense it was pretty near the top of your list.

Ira: It was our first choice. I think the other part about it was it was our first choice, like it was something that fit both of us very, very well. As medical students, we're really good at catastrophizing. So we think about all the things that could happen, all the contingency plans, all the . . . like for med peds at University of Chicago, there's four spots total. They interview about 70 people or so for those four spots. I think on my interview day, of course I'm sitting next to someone from Yale and someone from Harvard and all these big name schools.

Dr. Chan: High mucky-mucks.

Ira: Yeah.

Dr. Chan: As my parents would say.

Antigone: These two kids from Utah.

Ira: I'm like wow, this is really . . . how could I be considered when I'm going up against somebody from . . .

Dr. Chan: A big name school.

Ira: These big name schools. I did end up taking sort of a comedic approach to it when I was on the interview trail and every time I'd meet somebody from Yale, I'd come up and say, "Where are you from?" They'd be like, "Yale." And I'd be like, "Oh, Yale, I've heard of that school."

Dr. Chan: I'm sure they loved that.

Antigone: I'm sure.

Dr. Chan: Okay. You're going to Chicago together.

Ira: Together. Same school.

Dr. Chan: Somewhat same programs, some overlap.

Ira: Yeah.

Dr. Chan: Have you already gotten your schedules?

Antigone: No.

Ira: We know parts of it. We actually just came back. We flew out there for three days.

Dr. Chan: Found a place to live.

Ira: Found a place to live.

Dr. Chan: Biking distance?

Ira: Yeah. It's 7 miles straight down the lake front path there.

Dr. Chan: Wow.

Ira: But it's flat there. I used to bike in to school here, and it was like an 800-foot climb elevation gain just to get into school. So I was only 2 miles away, but 800 feet up for those two miles, whereas there, it's 7 miles away, but it's dead flat.

Dr. Chan: And wedding coming up next few weeks?

Antigone: Yeah, May 12th.

Dr. Chan: So 2018 is turning out to be a banner year for you guys.

Antigone: It's been a crazy year.

Ira: It's absurd. What are we doing in like a one-week span?

Antigone: So we get married on the 12th. We're both presenting at pediatric grand rounds on the 17th, and we graduate on the 18th in the morning, and on the 18th in the evening, we leave for Cuba for two weeks. We get back from Cuba and four days later move to Chicago.

Dr. Chan: And Cuba is the honeymoon, or you're going to do research there?

Antigone: It's our honeymoon.

Dr. Chan: Wow. That's cool.

Antigone: We will be researching Cuban food.

Dr. Chan: I hear it's quite yummy and tasty.

Ira: And rum.

Antigone: And rum, yes.

Dr. Chan: All right. You guys have been great. Last question for both of you. Let's bring it back to admissions. So, looking back, I know a lot of applicants do a lot of different activities. They're checking the box, or they're going through the motions. What we always advocate is those experiences really help you in medical school and help you prepare for this journey. So, looking back, can you think of an activity you did before you applied to med school that really made it worth it, that really helped you as you've gone through these four or five years?

Antigone: You want to go? I have to think.

Ira: I think the big thing is, first of all, both Antigone and I did not get into medical school our first time around. While that is so devastating when it initially happens, I think for me, that was one of the best things that could have happened to me.

Antigone: I agree.

Ira: Because of that, I took four years after my initial application to reapply. It really was a soul-searching experience where I traveled and I got a real job. But it was one of those times where I learned that life isn't an arrow. It's a windy path. It really truly is about the journey, not the destination. So if you can find a way to enjoy every step of that journey and take something out of it, that's the beauty.

That's really what helped me in medical school was when I'd walk in to see a patient and be like, "Oh yeah, this is very similar to a patient that I saw when I was a volunteering in a clinic in Tanzania," not because I went to Tanzania to check the box, but because I actually went on this soul searching journey to do that.

Dr. Chan: That's beautiful, Ira.

Antigone: I truly believe that I wasn't meant to get in my first try. I don't think that I would have enjoyed medical school as much. I don't even know if we would be together if it had worked out how it was "supposed" to work out.

Dr. Chan: Yeah, because Ira would not have been on those tours or the second look day.

Antigone: You wouldn't have seen me staring at the wall.

Ira: You wouldn't have had the chance to stalk me for six months.

Antigone: Sure. I think I needed that year to figure out who I was and to stop trying to check boxes. I think the things that stand out and the things that have helped me in medical school are, like Ira said, things that I didn't do just to check boxes. For me, the most worthwhile thing was working at uni. I think when we think about applying to medical school, we see this vision of a doctor in a really clean white coat and a stethoscope and everything is sort of like perfect.

But working with patients and seeing the team effort that goes into helping a patient and working with nurses and seeing what happens when patients don't want to take their medications and seeing what happens to families who have patients in the hospital and all of the complications that go with that. For me, working with little kids, I will never forget that, and I will never forget why I'm doing what I'm doing. I think that's really important to remember when you're studying a million hours a week and when you're taking these board exams that take up all of your life and you're not hanging out with your friends and you feel defeated, you have to remember why you're here, and checking boxes is not why you're here or at least I would hope not why you're here.

So, for me, it's those times at uni or at the AIDS Foundation, taking someone's blood who is really nervous about a test result or telling people about insurance at Planned Parenthood, that's part of being a doctor and that's why we're here, and I wouldn't take any of that back to get in a year earlier.

Ira: And I wanted to add one more thing is that I think that also applies to undergrad classes. I think it's really easy to say, "I'm studying organic chemistry to get an A in organic chemistry," but it's relevant. It's very relevant. If you understand organic chemistry, you're going to understand the pharmacology of the drugs that you learn in medical school. If you understand . . . one of the best classes that I took in undergrad was a technical writing class. It helped me learn how to not only write things like a CV and an instruction manual, but it also taught me how to read things in that manner and how to critique things.

So I think that a lot of the pre-med requirements, they're there for a reason. In the same light of enjoying the journey and taking something from those, they will apply to your future career in medicine and they are there for a reason.

Dr. Chan: That's very beautiful. That's very eloquent from both of you. I look forward to one of you replacing one day because I think you guys are ready. Well, Antigone, Ira, thank you so much.

Antigone: Thanks for having us.

Ira: Thank you.

Dr. Chan: I'm very happy. I'm happy you're going to spend your lives together, you're going to be helping kids and sometimes adults. Chicago is very fortunate to have you. I hope you move back one day.

Ira: Thank you very much.

Antigone: Thank you.

Ira: We're feeling very fortunate that you don't live in the South Side of Chicago maybe during this July when all the interns start. I think that we're ready.

Antigone: And we have loved our time here at Utah and appreciate all that everyone has done for us.

Dr. Chan: You guys are great. We'll have to have you come back one day.

Antigone: You're great.

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.