Search for tag: "mds"

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: So will testosterone solve all my problems as a man? That's today on "Who Cares About Men's Health," providing information, inspiration, and a different interpretation about men in men's health. He brings the MD to the show. Ladies and gentlemen, Dr. Troy Madsen.

Troy: Yeah. Ready to talk about testosterone. I am curious, very curious. Where do we go with this? What do we do?

Scot: Offsetting the MD, I bring the BS. My name is Scot Singpiel. And Mitch, he's responsible for bringing the microphones. Welcome, Mitch.

Mitch: Hello. Hi.

Scot: I think Mitch needs some testosterone. You know how low key he is.

Mitch: It's low T day. I mean, based on everything I see on the internet, that's got to be what's going on.

Scot: Well, yeah. I mean, you go to the internet . . . I'm going to do my impersonation of the internet. You ready for this?

Mitch: I love it.

Scot: All right. You're, like, "You have low energy? You've got to get some T. You putting on a few pounds of fat? You've got to get some T. You having trouble sleeping? You've got to get some T." That's my impersonation of the internet. It's the answer to everything.

Troy: It is. It cures everything.

Scot: Yeah. So we're going to find out if that is actually true or not with Dr. John Smith.

So, Dr. Smith, what is the common complaint you get when somebody comes to you and they're interested in testosterone treatments? What problem are they trying to solve? What are they trying to cure? All the things I talked about? Something else?

Dr. Smith: Absolutely. I mean, I think the thing about testosterone is the symptoms are so wide-reaching -- fatigue, cognition, erectile issues. They've heard on the internet, or they've talked to a friend who's on testosterone, and they're like, "Man, it just changed my life. It fixed everything." Which in some people's cases that may be true, but for most people, it definitely can play a role in helping them out, but I don't think it's the cure-all that you're talking about, that the internet shows. It's not making Frank Thomas who he is today.

Scot: And that's dangerous, right? Because you can get testosterone without even having a face-to-face conversation with a doctor, right? You can essentially just order it online. Is that true or is that overstated?

Dr. Smith: I think some of the newer companies you've got out there that are making things available . . . hopefully you're getting at least a video conferencing going over your medical history with someone who's a medical provider, whether it be a nurse practitioner, a PA. Hopefully you're talking with a physician. If they're not doing it that way, they're doing it wrong.

But testosterone is one of those things where it can be very helpful. I have quite a few patients that are on it, and I think it is one of those things that can definitely benefit people. But the extent that it benefits them kind of varies between patients.

Scot: Testosterone, I get the impression that it's probably not a do-it-yourself sort of a thing. It's not something you want to, as a layperson, just dive into on your own. Why is that?

Dr. Smith: Well, there are certain . . . everything has a risk and a benefit, and testosterone is no different. For people who have low testosterone, replacing it can really make a difference. It can give you that increased boost of energy, help you with weight loss, help you with metabolism, help with sleep. It can help with erections. I mean, it can help with cognition in people who have low testosterone. However, it's not necessarily the thing that's going to fix all those problems.

And oftentimes I'll go through people's history and say, "Hey, man, your testosterone is normal. Adding more to the mix isn't likely to fix things. We should look at other issues." And so I think really just taking that deep dive and seeing if it's something that is right for you is important.

Troy: I guess, John, I've seen all this stuff Scot mentioned, you see all these things on the internet, you see TV ads, etc. Yeah, I think I wonder myself, "Man, is my testosterone low? Should I be worried about this?" At what point do you tell people, "You should get your testosterone level checked"?

Dr. Smith: I think if you've looked at some of the other . . . if you've talked to your primary doctor and kind of gone over things, the usual suspects of a thyroid issue or vitamin deficiencies, things like that that they check a lot, if those are all normal, I think it's completely reasonable to look at it.

Some people say, "Oh, well, my dad had low testosterone and I got it checked in my 30s." But if you look at the facts of the matter, about 40% of people over the age of 45 have a testosterone level of 300 or less. And so that's a decent amount of the population that's out there. And so I think if you have an interest in it, it's okay to ask to have it checked because it's better to know and to at least know what your options are where it may be a benefit to you.

Scot: And how do you do that, then?

Dr. Smith: So your regular doctor can check it. You can make an appointment with a men's health specialist like we have at the University of Utah. We have a men's health group with multiple different providers. We have nurse practitioners, PAs, and multiple MDs and DOs that can take care of your needs as far as checking the hormones. But that's the first thing that we do.

And hormones, ideally, should be checked before 10:30 in the morning because our bodies spike testosterone between the early hours of the morning. Usually people will say between 4:00 a.m. and 10:00 a.m. in the morning. And so we want to check it to see what your body is actually doing.

If you're low in the morning, the odds are that you're high in the afternoon are going to be really slim to zero because your body spikes it in the morning to give you that boost of the hormones that you need to get you through the day.

Scot: And when you take a look at that test, it's a range, right? So a man gets the test done and you've got some numbers and there's a range. And what does that tell you? Let's pretend I'm at the low end of the range, but I'm still considered normal. Is that somebody that you would suggest testosterone therapy for?

Dr. Smith: I think a lot of it is the discussion that you have with the patient. So the range is huge too. If you look at the range, most labs are between 300 and 1,000. Some are a little less, some are a little more, but just for intents and purposes of this discussion, about 300 to 1,000.

So let's say, Scot, you're at 350. Well, what does that mean? Insurance requirements say that we've got to get two tests that show a low value before 10:30 in the morning. So let's say we've done that. You come in, your first one was 350, your second one was 340 or 338. What do we do from there? Well, then we have a discussion.

And I think in a lot of those folks, it is reasonable to discuss therapy. People outside the normal range, it's obviously okay to discuss that as well, but people tend to feel better in a range around 400 to 700. Sometimes, some people will say 600 or higher. There's a lot of different variability out there between who you talk to about it.

But again, if you're feeling the symptoms of fatigue, decreased libido, decreased erectile quality, some of those things are really hitting you hard, and you're like, "I'd love to try testosterone to see if it would help some of those symptoms," I think it's completely reasonable to do that.

Mitch: But insurance won't cover it unless you are beneath that range?

Dr. Smith: Not necessarily. Insurance wants to see that you're in the low. Really, I think it's reasonable for anybody that's 350, 400, and below. You can talk to them about testosterone replacement therapy. And if there's benefit there, insurance usually won't balk at it. And if they do, and it is helping you, cash pay for this stuff is not obscene.

Mitch: I'll just disclose. Now, I had my testosterone levels checked after we did a previous episode, and my number is right around 400. And my primary care provider is like, "Oh, no, you don't need to. We don't need to. There's no need to talk about testosterone therapy." And so I've kind of put it in the back of my mind.

But then at the same time, you have the weird people on the internet that they say you need to be 600 or 1,000 or above to be healthy. And it's just like if I'm right there, I'm at the 400, maybe it would be helpful. What would you say to someone in my situation?

Dr. Smith: I think you've got to look at the whole picture, but I think it's definitely something that you could consider. Again, most primary care doctors don't do a lot of hormone replacement, so they're going to say, "Hey, you're well within normal range. We're not going to touch it. We're not going to do anything," because that's their comfort zone.

This is the thing that I do every single day where I get people sent from their primary care doctor to talk about this stuff. And I think it's an in-depth conversation of, "Hey, let's look at the whole picture. Is there anything else going on that's a problem, or could be seen as a problem? Do you have a thyroid issue? What is your BMI? How does your weight look? What's your exercise routine?" and things like that, because those things can be done before supplementing testosterone.

And there are some interesting numbers out there with diet and exercise. If people will lose weight of 10 pounds or so, you can increase your testosterone by 100 points by losing 25 pounds and getting diet and exercise.

But a lot of times, it's hard to get the motivation to go do diet and exercise when you're overweight and you're really lethargic. And so it's like, "Would testosterone help me get there?" and a lot of those things as well.

And so again, exercise 15 minutes a day for 6 months of moderate intensity exercise will increase your testosterone by 22 points. And then if you're exercising for 30 to 40 minutes a day, you'll increase it by 50 to 60 points. And so again, there are things you can do other than testosterone if you're kind of in that range, and any of those things fit.

Now, Mitch, I know you're super fit, so that doesn't really . . .

Mitch: Yeah, I'm the fittest guy.

Dr. Smith: . . . matter for you. But if those are things that you can do, those are modifiable things you can do in your life to increase your testosterone naturally.

Mitch: Got you.

Troy: You mentioned diet also, John. I mean, it sounded like we're talking more about weight loss here, but are there any kind of dietary changes in terms of foods you're eating or foods you can eat or even supplements that would increase your testosterone levels without actually having to go for any sort of hormone replacement therapy?

Scot: Raw eggs and meat, right?

Dr. Smith: Right. Exactly.

Troy: Well, sure. Yeah.

Dr. Smith: You've seen Gascon in "Beauty and the Beast." That's how he got so huge.

Troy: Exactly.

Dr. Smith: There are no real big things that are out there that are known to necessarily just be super beneficial, other than eating as clean as you can.

Testosterone is a hormone and hormones are built on a backbone of cholesterol, so they're kind of fat. They're built on fat. And so when you have excess fat tissue, sometimes the hormones like to hang out there because they don't love water. And so you'll find that people may have a higher testosterone level when they lose that body weight, because now they don't have as much body fat and that testosterone is able to kind of circulate. Plus, you're in better health and your body is able to just do what it does better.

Troy: Speaking of our concerns . . . obviously, Mitch has thought about it. I've thought about it. I know, Scot, you've told us before you've had your testosterone level checked. I think a lot of men wonder about this, and I think we get concerned and we say, "Hey, maybe I don't have a lot of energy," whatever it might be. Of those who come in to get tested, what percent really have low testosterone?

Dr. Smith: I mean, my practice is kind of skewed, because by the time a lot of these guys get to me, they've already had it checked with their primary doctor who's not going to treat them unless they're outside of the normal range. And then when they are, they get referred to our office. A lot of primary care doctors don't love treating testosterone patients and they know that that's kind of what we do.

And so I get a skewed percentage. Most of the people who come in and are looking for testosterone have already kind of been pre-screened, so they are low. I would say a vast majority, at least three-quarters of the people that I see, already have testosterone levels that come back and are low and they're there to talk about therapy as a referral from their primary doctor.

Troy: Interesting. Yeah, I just wondered if it's one of these things that it's just something else for us to worry about. And if a lot of us are getting tested and it's a small percentage, or maybe it is, like you said, over 45% . . . I think you mentioned 45% of men have levels under 300. So maybe more of us should be getting tested at some point and we're just not getting tested.

Dr. Smith: Yeah. It's around 40% over the age of 45, you'll see low testosterone levels. And again, it's one of those things where you tend to hit that middle age, people tend to not necessarily be as active, and things like that as well. So there are a lot of things that go into it.

But if we're looking at the actual testosterone itself . . . Let's say you come in, you're low or you're low normal, and you want to try testosterone. There are a lot of things you need to have a discussion with the patients about. Are you interested in having children in the future or any more children if you already have children? What are your goals as far as that goes?

There are multiple different ways to treat testosterone these days or to treat low testosterone, I should say. And kind of having that full disclosure discussion with the patient goes a long way, because there are multiple different modalities of treating it from oral medications to topical medications, to injections, to long-term injectables, to subcutaneous pellets. I mean, there's a myriad of different treatment options that we can discuss.

Scot: And of your patients that you start on therapy, you mentioned that the symptoms can be very broad and caused by a lot of different things. Maybe you're not getting enough sleep. Maybe you've got too much stress in your life. That's why you're low energy. Maybe you're not eating the right foods or exercising. That's why you don't feel good. How many after they get testosterone that come in that have low testosterone actually go, "Yeah, that made a difference," versus, "I'm about the same"?

Dr. Smith: Majority of them. But that also varies via the root that they get testosterone. So I'll talk kind of a little bit about each modality. Oral options is . . . there's a medication called Clomid. A lot of people know it as a fertility medication. Women use it for fertility purposes. But what the medication does is it stimulates your body to produce more testosterone and more sperm. This is a very gradual improvement in testosterone. And a lot of times people don't feel that robust boom, that jolt of energy and things, because it's kind of a low-key slow rise of the testosterone back into the normal range. They don't have that big boost.

And most of the time, when people have that boost, it's from the injection because they're injecting a bolus of testosterone that then is being absorbed into the body and they have their levels shoot outside the normal range. So they feel like Superman. It gives them that rush of testosterone, which you don't get with topicals, the lotions, and you don't get with the oral because it's doing what your body normally did before you didn't create enough testosterone. And so you don't get those super highs that you would have before.

So a lot of patients know, "Oh, man, I do have more energy. I do feel good." The ones who do injections tend to come back and have more of a, "Man, that's great. This stuff is great," because they get that boom, that rush, that spike of testosterone very quickly.

Troy: And then how long until that wears off?

Dr. Smith: So usually people inject on a weekly basis, sometimes every other week, depending on their injection tolerance. And I do have a few patients who inject multiple times per week of low doses because they don't like that roller coaster effect. You do really get a high of testosterone and then it kind of fades out over the course until you do your next injection.

And so that's what they notice. They're like, "Man, I just get this high, and I feel it for about two to three days, and then it kind of wears down and I feel pretty good. And then when I do my next injection, I get that high again." I see that a lot more frequently with people who inject testosterone rather than take oral medications or do topical gels.

Scot: And what about side effects or downsides to testosterone therapy?

Dr. Smith: Man, it's almost like you wrote a script for that or something.

Troy: Talked about the good stuff. Let's talk about the bad stuff.

Dr. Smith: I'm going to make you feel like Superman. And now I'm going to tell you the downside.

Scot: Kryptonite is no good for you.

Dr. Smith: Exactly. You really have to monitor things with testosterone. So testosterone can cause an increase in red blood cell mass, and that in and of itself isn't necessarily a bad thing as long as it doesn't get outside of the normal range too far. That puts you at an increased risk of a cardiovascular event, like a heart attack or stroke.

Now, those incidents are rare, but it's something that we definitely keep an eye on. And that's a reason why we follow these folks with labs regardless of the type of replacement that we do.

Other things that we follow is your estrogen levels can rise because testosterone is a precursor to estrogen. There is a molecule called aromatase that actually converts testosterone to estrogen. Their chemical formula is very, very similar.

Your body likes to keep a ratio of about 10-to-1 testosterone to estrogen, and so the higher your testosterone goes, the higher your estrogen level goes.

And some people will develop breast sensitivity, nipple tenderness, or breast growth from elevated estrogen if their bodies are over-converting to estrogen. And so we watch that closely because that can be bothersome to folks.

And then a couple of the other things, we always monitor PSA in folks that are over the age of 40, or at least I do in my practice because . . . There's not an increased risk of prostate cancer, but if you were to develop prostate cancer, testosterone would feed the prostate cancer.

It's kind of like if you have a match and it's lit, nothing happens. But if you have a match and you pour a gasoline on it, you have a problem on your hands. And so the prostate cancer would represent the match and the testosterone would represent the gasoline. It would help it to kind of progress faster in a way.

And those are the things that we really kind of keep an eye on, especially people with family history or people who have had prostate cancer that we're treating with testosterone, which yes, we do that quite frequently.

Troy: So now that we've talked about the risks of taking the testosterone supplement, let's just say someone is like, "Okay, I've had my testosterone level checked. It's low. I don't want to assume those risks." What's the downside of that?

Dr. Smith: So the downside is you can develop osteoporosis with time. There are some studies that . . . initially some studies came out with testosterone that said testosterone supplementation caused cardiovascular issues, and now it's become the opposite. That's been debunked, and there is some literature out there, I don't know that it's super robust, that said low testosterone can increase your risk of cardiovascular events. So those are the big things of not having enough.

Long term, it's really difficult to assess a lot of those risks, but those are the risks. if you were to just have low testosterone.

Scot: Do you have anybody ever come in that you just are like, "No, it's not a good idea for you"?

Dr. Smith: Yeah. I mean, people who come in with a testosterone level of 600 from their primary care doctor. It's a bad idea.

Scot: Yeah. But I mean low testosterone. Is there ever a time where it's just like, "No, probably not. The risks are too big"?

Dr. Smith: So I think the one thing that I didn't get to with the risks is testosterone replacement will cause sterilization. It will stop you from being able to have children. When you supplement testosterone . . . not all methods of supplementation will hurt fertility, but injections will. Anything that's injectable topical or the long-term injectables or pellets all will cause sterility to a point. And so those things are things that you've got to have those conversations.

So if someone comes into my office and they have low testosterone and they don't want to take the pill like Clomid and they're like, "I just want to do injections, but I still want to have kids in six months," I would say, "Let's hold off until you're done having kids or until your wife gets pregnant, or go donate some sperm so that you can have children if that's your goal, before we start therapy."

Scot: Mitch, given the information that you just got today, are you going to go in? You're going to get some T?

Mitch: I don't know. I'm in a place where I think that after this conversation, I would like to go talk to a men's health specialist, especially if there is a hesitation from primary care physicians to just be like, "Oh, you're in the normal range. You're good." There is a curiosity there. There is an interest there, knowing where I'm sitting at on the levels, if they think it would be something that could help with some of the situations that I'm dealing with right now.

Scot: I guess I'm afraid that it just sounds like another pill. I don't mean that as I don't want to take drugs. I just mean we're all looking for the quick fix, right? So yeah, maybe I'm a little tired. Would I like to lose some fat? Sure. Would I like to have a little bit more muscle mass? Yeah. If I'm in that normal range and on the low end, I don't know. It just feels like I'm expecting too much. I'm going in for the wrong reasons. Does that make sense to anybody?

Dr. Smith: And I don't think you can necessarily . . . I mean, again, I'm not trying to sell testosterone here. I just think that . . .

Scot: No, that's not the point of this. We're just trying to get some information, for sure.

Dr. Smith: Right. But I think that if you want to feel your best and be able to do your thing to the healthiest you can be, I don't think it's a bad thing to come in with the desire to be healthier, to feel better, to have more energy. Again, when you start testosterone therapy, you do have a change in lean muscle mass by about five kilograms switch over from body fat to lean muscle.

Scot: Hold on a second. Hey, Siri, convert five kilograms to pounds.

Dr. Smith: Right. Exactly.

Troy: That's a lot of pounds.

Dr. Smith: It's 2.2 pounds per kilogram.

Scot: It's 11 pounds there. All right.

Dr. Smith: Actually, I said that incorrectly. It's five pounds of fat or two and a half kilograms. My apologies.

Troy: That's still a lot.

Dr. Smith: But still, a five-pound change in your body mass, it can be substantial. It can really help. And again, those are just the numbers that we have from the literature that's out there. And so it can be beneficial.

I don't think there's a wrong reason to come in to look for it. Most patients aren't coming in to be like, "Hey, man, I saw this magazine with this guy Schwarzenegger on it and he was pretty big. I kind of want to get there. Can you help me?" Those aren't the patients that I see.

People come in, they're like, "I'm really fatigued. I feel tired at night. My libido is down. I want to feel better. And I want to see if testosterone may be helpful in that regard." And they're not looking necessarily as a magic bullet or trying to use it as a substance of abuse where they can go and just change their whole body composition. But I think it is very beneficial for a lot of people.

Scot: Troy, where do you stand on it?

Troy: As we talk about this, I just feel like there are so many other things I need to address. That's way down the list. We talk about energy and everything there. I feel like, wow, I'm still trying to figure out how to sleep and those kinds of things. So I'm kind of hung up on that still. We've talked about this and if we talk about it today, I am still kind of curious about it, but I don't think I will be getting tested any time soon. I'll say that.

Scot: I noticed a parallel from another show that we did. You're talking about using testosterone treatments to kind of get over that hump, right? Let's say that you would like to exercise more, but you don't have the energy and you do find you do have a low testosterone. That was almost kind of like using medication for mental health. If you're having challenges with your mental health, it can be really hard to become motivated to exercise or eat well, or maybe you don't even sleep well. So you can take medications for a short period of time until you kind of get those things working. We talk about that Core Four, how they all interact with each other. And then possibly come off of it. Am I understanding that correctly?

Dr. Smith: Yeah. And I think if that's your plan, you've got to look at a way to keep the testicles producing while you do that. If you went to an injectable or a topical testosterone that's going to shut down the body's production . . .

So let me nerd out a little bit with the physiology of this. Your body has these precursor hormones called FSH and LH. And those are the two hormones. They are in both men and women. In women, they regulate the menstrual cycle, and in men, they stimulate the testicles to make testosterone and sperm.

And when you give testosterone, it's a negative feedback loop. And so your body sees there's enough testosterone in the bloodstream and stops sending FSH and LH to stimulate the testicles. And so you've got to do something to keep those testicles producing if you're going to be on testosterone in the short term. That's where other drugs come in.

There's an injectable called HCG that we use to help stimulate. It's an LH analog, meaning it's not LH, but it will stimulate the LH receptor on the testicle. And it will continue to have the testicle continue to produce at a lower level, even though you're giving yourself exogenous testosterone.

And then if you decide to come off after six months or a year or whatever, after you've gotten in shape and you've gotten that motivation, then you don't have this complete drop-off of testosterone where your body has to start making it again where it hasn't for the last year.

Scot: But it would. If you're using a topical solution that's telling your body then not to produce more testosterone, does that mean you're dedicated to that for the rest of your life?

Dr. Smith: You can. Now, you can come off of it. And the thing I tell people is if your body was already not producing enough and you haven't done a darn thing to change that, your body is not likely going to go back to producing more than it was before you started the drug. But then there's always that kind of window where your body has to catch up and it's not producing hardly anything at all and you just feel like garbage.

Troy: But it would come back over time?

Dr. Smith: Yes. And that's the part where the HCG comes in to help it, where you don't have as big of a drop-off. Scot: All right. So now I need to ask the question that I think everybody is wondering. I've heard that if you're on testosterone treatments, your testicles get smaller. Is that true?

Dr. Smith: Absolutely.

Scot: Okay. How small are we talking? Yeah.

Troy: What are we talking here? Yeah. Like raisin-size?

Scot: I mean, for running marathons, Troy, that might not be a terrible deal. Right?

Troy: Thanks, Scot. Much less chafing. Yeah.

Dr. Smith: He's looking out for you, Troy. He's looking out for you.

Troy: Exactly. It'd just be nice smooth surface down there.

Dr. Smith: You'll shave minutes off your time.

Troy: Exactly. All that extra weight.

Dr. Smith: Yeah, you won't have the metronome like you've got now, but it'll work out.

Troy: That's right.

Dr. Smith: But they do shrink, and over time you'll notice that testicular size loss happens the longer you're on testosterone. So people who've been on, say, long-term injectable testosterone, they'll shrink down and be very, very small when you get down to it, almost to raisin-like size that you'll see, which is something that I always talk to people about. And again, that's where HCG can come in if you want to preserve testicular size.

And to some people, that's important. And to other people, I say, "If you're not looking to have kids and it doesn't really matter to you . . ." I've never, ever in my experience of having this had someone come in with their spouse and had them saying, "Man, you know what? I just wish Troy's balls were bigger."

So I don't know how much it really matters, but I think a lot of times it is kind of the vanity side of it, of, "This is what I know, this is what I've had my whole life, and I don't want it to change."

Troy: Well, I will tell you, John, hearing that, I'm reassured that your patients are not talking about the size of my testicles.

Dr. Smith: Nor their wives, for that matter.

Troy: That's good.

Scot: John, let's wrap this up. I think we all know your bottom line. I think I've got your bottom line on testosterone treatments. If you're experiencing these symptoms and you get a test and you're in that low range or below, it could be a very good option to help you get some energy back, to help you with your sexual function, with few downsides, really.

Dr. Smith: Yeah. The downsides are minimal. If you're one of those people who overproduces red blood cells or something like that, we keep an eye on it, but yeah, that is the bottom line. If you feel like it's going to make a difference for you, there's a lot of good that can come from it. And it doesn't necessarily have to be a long-term thing. However, most of my patients that are on it are long term.

And I think if you do have questions, go talk to someone that knows what they're talking about. I'm happy to sit down with people. Most of my new hypogonadism patients/low testosterone folks, I like to spend time going over the benefits, the risks, and everything that is involved is involved so that they have a clear picture of what options they have.

And I do have plenty of people who come in and say, "You know what, doc? I think I am going to try to lose 25 pounds and recheck my testosterone." And then I have others who say, "You know what, doc? I just know myself and I'm not going to do that. And so I'm going to take the testosterone and try to do it that way." I think there's merit both ways. Absolutely.

Scot: John, thank you very much for having this conversation with us about testosterone. Hopefully, this will be helpful to a lot of guys. And bottom line, it sounds like perhaps guys who have talked to primary care physicians, haven't gotten a lot of conversation, it sounds like if you do go to a men's health expert, you've got a little bit more time to discuss through some of these issues and really come up with the right choice for each individual guy.

Dr. Smith: Absolutely. I'd be happy to see anybody in our men's health department at The U. I think we do a great job at taking care of folks and making sure that we go over the options and making sure that we help you make the right decision for you.

Scot: Dr. Smith, thank you for being on the podcast and thank you for caring about men's health.

Dr. Smith: Gents, thanks for having me. It's always a pleasure.

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

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

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

Doug: Good.

Taylor: We feel good.

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

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

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

Taylor: That's right.

Dr. Chan: Ooh.

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

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

Dr. Chan: But you guys never met?

Doug: Ah-a.

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

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

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

Doug: No.

Dr. Chan: . . . in the apartment?

Doug: Ah-a.

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

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

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

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

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

Taylor: She has.

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

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

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

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

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

Taylor: 2015.

Dr. Chan: 2015. Okay.

Taylor: So three years.

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

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

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

Taylor: Oh, sorry.

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

Taylor: Sorry, everybody. Sorry, everybody.

Dr. Chan: It's okay.

Taylor: Retract. Retract.

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

Taylor: Yeah.

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

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

Taylor: It's actually exploitative. Yeah.

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

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

Taylor: Like he had people making pacts with him.

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

Doug: I did.

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

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

Taylor: And multiple other people in the class.

Doug: Yes.

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

Doug: No.

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

Taylor: It was just . . .

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

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

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

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

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

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

Doug: And we followed it.

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

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

Doug: She agreed.

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

Doug: You did agree.

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

Doug: It took some convincing.

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

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

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

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

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

Doug: No.

Taylor. We didn't.

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

Dr. Chan: In the zone.

Doug: Yeah.

Taylor: Yes.

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

Doug: Exactly.

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

Doug: Mm-hmm.

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

Dr. Chan: All right. So . . .

Taylor: So . . .

Dr. Chan: Okay. Go on.

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

Dr. Chan: Okay. Cool.

Doug: It did take some convincing.

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

Doug: She was very hesitant in the beginning.

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

Doug: I did.

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

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

Dr. Chan: MSRP?

Taylor: MSRP. Yeah.

Dough: Yeah. Yeah. Yeah.

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

Doug: You did. You did.

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

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

Doug: I did brown fat and metabolic syndrome.

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

Doug: Prior to med school.

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

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

Taylor: We did. Yeah.

Dr. Chan: Did you get the same stipend?

Doug: I think everyone does. Yeah.

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

Taylor: I guess if it . . . Yeah.

Doug: I worked hard.

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

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

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

Doug: Uh-uh.

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

Doug: Well . . .

Taylor: We learn very differently.

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

Taylor: Yeah. But I mix with . . .

Doug: I don't know.

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

Doug: Like, quiz each other.

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

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

Taylor: Yeah.

Doug: Oh, yeah.

Taylor: Yeah. It's pretty bad.

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

Taylor: It was up there.

Doug: I would say, yes.

Dr. Chan: Okay. All right.

Taylor: It was up there.

Doug: Yeah. Definitely for me.

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

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

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

Dr. Chan: Why?

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

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

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

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

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

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

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

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

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

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

Taylor: The inpatient.

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

Taylor: I think I'll be a hospitalist.

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

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

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

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

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

Taylor: I can't.

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

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

Dr. Chan: How long a fellowship?

Taylor: I think it's two years.

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

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

Dr. Chan: That's gutsy.

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

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

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

Dr. Chan: You want to hear my prediction?

Taylor: Yeah.

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

Taylor: Yeah. And so . . .

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

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

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

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

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

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

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

Taylor: Maybe it's one year.

Doug: But how long are the fellowships for peds.

Taylor: Three years. Mostly.

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

Taylor: Yeah.

Doug: Oh, is it? Okay.

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

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

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

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

Taylor: They do. Yeah. They do.

Dr. Chan: Yeah. Like a GI service.

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

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

Doug: All right.

Taylor: Yeah. Yeah.

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

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

Dr. Chan: A man after my own heart.

Doug: Because I love it. Exactly.

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

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

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

Doug: Probably in third year.

Taylor: Third year.

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

Taylor: Well . . .

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

Taylor: Well, no.

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

Taylor: Yeah. And . . .

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

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

Dr. Chan: Why?

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

Doug: We're just more West Coast people.

Taylor: West Coast people.

Doug: East Coast is . . .

Taylor: I don't know.

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

Taylor: Families are in Utah.

Doug: Yes.

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

Doug: I don't know. Yeah.

Dr. Chan: So you make a list.

Taylor: We make a list.

Dr. Chan: Did Excel spreadsheet turn?

Doug: Mm-hmm.

Taylor: Oh, yeah.

Dr. Chan: Who owns this Excel?

Doug: She does.

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

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

Dr. Chan: Wow.

Taylor: It was very . . .

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

Taylor: She was. Yeah.

Dr. Chan: You should maybe sell this.

Taylor: I know. I was thinking that.

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

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

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

Taylor: She did it for both of us.

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

Taylor: It was like . . .

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

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

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

Taylor: Yeah. Just off the . . .

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

Taylor: Yeah.

Doug: Yeah.

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

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

Taylor: She probably is.

Dr. Chan: That's cool.

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

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

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

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

Taylor: A little bit.

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

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

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

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

Dr. Chan: Each or together?

Taylor: Oh, each.

Doug: Each. Yeah.

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

Dr. Chan: Yeah. You just go.

Taylor: . . . have to go.

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

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

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

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

Doug: There probably are . . .

Taylor: . . . track.

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

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

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

Doug: Yeah.

Taylor: Fair enough.

Doug: It is a lot money.

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

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

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

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

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

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

Dough: Yeah. That's true.

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

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

Doug: It is.

Taylor: Yeah.

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

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

Dr. Chan: Sure.

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

Dr. Chan: Was it Dr. Stevenson?

Doug: Yeah.

Taylor: Mm-hmm.

Dr. Chan: Oh, that's fine.

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

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

Doug: No.

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

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

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

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

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

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

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

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

Doug: Either or.

Taylor: I would just stick to email.

Doug: Emails are just usually easier.

Dr. Chan: What did you guys use?

Taylor: We did email.

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

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

Doug: Yeah.

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

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

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

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

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

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

Doug: We did.

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

Doug: Oh, yeah. Yeah. Yeah.

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

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

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

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

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

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

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

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

Doug: Yeah. Exactly.

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

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

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

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

Taylor: We don't know.

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

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

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

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

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

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

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

Dough: Oh, man.

Taylor: I . . .

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

Doug: Yeah. Hundreds.

Dr. Chan: Wow.

Doug: Easy. I mean, so . . .

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

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

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

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

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

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

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

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

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

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

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

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

Doug: Yeah. Exactly.

Taylor: Yeah. See. See.

Dr. Chan: I'm being very sarcastic.

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

Dr. Chan: Oh, I see. Yeah.

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

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

Taylor: Yeah. And to be . . .

Doug: . . . basically, made our list.

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

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

Taylor: Yeah. Exactly, right?

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

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

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

Taylor: Yeah. We were.

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

Taylor: I have not.

Doug: I have.

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

Doug: Obviously.

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

Taylor: It was. We were . . .

Dough. It was.

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

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

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

Doug: But they didn't and . . .

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

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

Taylor: It's very complex.

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

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

Taylor: Oh, we were so relieved.

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

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

Doug: We were.

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

Doug: Celebrated.

Taylor: We went to lunch.

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

Doug: Aha.

Taylor: Yeah.

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

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

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

Taylor: . . . before but . . .

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

Doug: Mm-hmm.

Taylor: Yeah. We were.

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

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

Dr. Chan: Supplemental . . .

Taylor: Offer Acceptance Programs.

Dr. Chan: Yup. Supplemental Offer Acceptance Programs.

Taylor: S-O-A-P.

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

Doug: Oh, yeah.

Taylor: The SOAP not . . .

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

Doug: Exactly. It is.

Taylor: There is so many acronyms.

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

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

Doug: Yeah. Exactly.

Dr. Chan: People can think whatever they want.

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

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

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

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

Doug: Yeah.

Taylor: It was very nice to get through this.

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

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

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

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

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

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

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

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

Doug: No. Well, they almost . . .

Taylor: They got there at different times.

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

Doug: They got there at different times.

Dr. Chan: . . together, right?

Doug: Yes. Of course.

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

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

Taylor: Stop. No. This is not reason.

Doug: No. No. No.

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

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

Taylor: It was kind of a small room.

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

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

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

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

Doug: We did.

Taylor: We did.

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

Doug: We were.

Taylor: We were.

Doug: There was a news story.

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

Taylor: We didn't know.

Doug: Not ahead of time.

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

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

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

Taylor: She, like, chatted . . .

Dr. Chan: She creates . . .

Taylor: She was chatting with one of them.

Doug: I didn't know that.

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

Taylor: My mom should be on the podcast.

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

Taylor: She's superwoman.

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

Taylor: Jolene.

Dr. Chan: Jolene?

Taylor: Yeah.

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

Taylor: Either.

Dr. Chan: . . . or Sleney.

Taylor: Sleney.

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

Taylor: Come on to the podcast.

Dr. Chan: We want to hear your secrets.

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

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

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

Dr. Chan: So you open your envelopes together?

Taylor: We did.

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

Taylor: We're going to Albuquerque.

Doug: Albuquerque in New Mexico.

Dr. Chan: The University of New Mexico?

Dough: The University of New Mexico. Yes.

Taylor: Yeah. The University of New Mexico.

Dr. Chan: So how did it feel?

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

Doug: Very happy.

Taylor: We were very happy.

Doug: Very relieved.

Dr. Chan: Awesome.

Doug: Some tears were shed.

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

Doug: There were some pictures in the newspaper.

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

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

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

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

Doug: It's pretty small.

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

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

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

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

Doug: Yeah. That's true.

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

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

Doug: Sure.

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

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

Taylor: Yeah. That's . . .

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

Dr. Chan: Is this in Albuquerque?

Taylor: Yeah.

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

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

Doug: No. No. No.

Taylor: No. No.

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

Doug: That would be sweet.

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

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

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

Taylor: I do not know.

Dr. Chan: And how long do they last?

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

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

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

Doug: It is.

Taylor: It's not . . .

Doug: It's not like Arizona.

Taylor: It's not hot like Arizona.

Doug: Everyone thinks it is.

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

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

Taylor: Yeah. Like blue skies.

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

Taylor: It is low cost of living.

Dr. Chan: Cheaper than Utah, I hear.

Doug: Definitely.

Taylor: Yeah. Very cheap.

Dr. Chan: Great food. Great Mexican food.

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

Doug: They do.

Taylor: And they put the green chilies in everything.

Doug: "Breaking Bad."

Taylor: "Breaking Bad."

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

Taylor: "Breaking Bad."

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

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

Taylor: You can.

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

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

Doug: So that was fun.

Taylor: So they . . .

Dr. Chan: God bless the internet.

Taylor: I know.

Doug: Yes. Exactly.

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

Doug: Exactly.

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

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

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

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

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

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

Taylor: Santa Fe.

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

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

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

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

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

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

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

Dr. Chan: We're outdoorsy like you.

Taylor: They are. They are.

Dr. Chan: We're just playing tough.

Doug: Yes. Exactly.

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

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

Taylor: We're excited.

Doug: But . . .

Taylor: We're excited. A new city.

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

Doug: It does.

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

Taylor: I hope so.

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

Taylor: We'll see.

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

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

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

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

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

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

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

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

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

Taylor: And we really liked . . .

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

Taylor: We really liked the residence.

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

Taylor: Oh, we do.

Doug: We do.

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

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

Dr. Chan: Wow. Very cool.

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

Doug: And ortho.

Taylor: And then in orthopedic.

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

Taylor: Thank you.

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

Taylor: Oh, no.

Dr. Chan: You have residency to go.

Doug: Don't say that.

Taylor: Oh, no, Dr. Chan.

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

Taylor: It's still halfway.

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

Taylor: Oh, go ahead.

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

Taylor: Then it would be miserable along way.

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

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

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

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

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

Doug: It's true.

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

Taylor: It's the land of the enchantment.

Doug: It is. It is.

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

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

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

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

Taylor: We'll share.

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

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

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

Doug: Everyone can do it.

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

Doug: We might . . .

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

Doug: We may.

Taylor: We will.

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

Doug: Maybe.

Taylor: Oh. Oh, okay.

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

Taylor: Thanks, Dr. Chan.

Doug: Thanks, Dr. Chan.

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