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Dr. Chan: What's it like being a star on reality TV? How do you apply all of your non-traditional pre-med life experiences towards a medical school application? On this episode of "Talking U and Med Student Life," hear from first-year med student Alan's story and inspiration towards becoming a doctor and how he balances his studies, work-life, and family all while here at the University of Utah School of Medicine.

Welcome to another edition of "Talking U and Med Student Life." I've got a fantastic guest today. Alan, how are you doing?

Alan: Really good. How are you doing?

Dr. Chan: I'm doing okay. Hanging in there. Lots going on. And we'll talk about it a little bit. And Alan you're a first-year student, correct?

Alan: Correct.

Dr. Chan: Correct. All right. So and we were kind of talking about it earlier, but you know, first-year med student during a pandemic. I'm sure we'll get into the details, Alan, but I want to hear your story. Let's go back to the beginning. When did you start thinking med school? Let's talk about kind of your journey that got you to this point.

Alan: So I think it's important for everybody to know that I'm an older student, I'm 41, so my pathway to medicine took a little bit. I think it kind of started . . . I've always kind of wanted to do something important for society. I've always wanted to be like this really key cog, making a difference in the world.

And so my dad was a construction worker. My mom, she grew up in the Philippines. She has like a fifth or sixth-grade education. It wasn't really in the books. My dad was a construction worker, became a prison guard, and I didn't find out till my 20s that my dad had a degree. And I asked him why and he didn't really like it. He didn't care about it. He didn't find importance in going to school and education. He felt like his degree didn't help him at all. It's just a waste of his time.

So just medical school was like never . . . it wasn't that it was that I couldn't be a doctor, but that just wasn't the path that was for me. That was for people that were naturally gifted or wealthy or any of those things that just kind of wasn't in the works for me. That's just kind of the vibe that I grew up with.

So I went to school, did terrible, and then I left and this was like back in '97. I left and decided I'm just going to go into construction. And I worked my way up, and I said I'm going make a difference in construction. I'm going to be part of this important cog of a society. And I started building elevators because I felt elevators were so important. It's going to be such a good career. And, you know, with time it kind of grew stale with me.

Dr. Chan: Is this in Utah, Alan? Did you grow up in Utah? Where's this going on?

Alan: I grew up in San Diego. This is San Diego.

Dr. Chan: San Diego. Okay.

Alan: Yeah. So can I tell a funny story?

Dr. Chan: Sure, go ahead. We are all about funny stories.

Alan: So I went to this urgent care and I just needed this little procedure done and the doctor there was this kind of older white guy from South Africa. And when we're going through the procedure, it was so unprofessional. He's coughing on me. He definitely had a cold. There's no question he had a cold. He wasn't wearing a mask. He's coughing and he's cussing and he's talking to me about American politics and capitalism and all this other stuff. And we get about three-quarters way through the procedure and he says, "Okay, I got to step out for a second. I've got to go Google to make sure I'm getting all the right nerves." And he walks out.

And I'm going, "Oh my gosh, did my doctor just say, 'I got to go Google . . . I got to go Google how to figure out how to do this'"? He walks back in, he finishes the procedure, and I sound like I'm really talking bad about the guy. It was a really unprofessional experience, but it was fun. He was really relatable. And the procedure went fine. It was fine. Like there was no complications. There was minimal scarring. It was fine. And I left there going, you know, if that guy can do it, I can do it.

And this is kind of like in my mid to late 30s. This is the first time in my life I had ever learned that doctors were real people, that, you know, they don't know everything, that sometimes they have to check on things, and that as funny as it is and as weird as it was, that was a really good experience for me to learn that I could be a doctor. And I still kind of felt like I was a little old, so it still took a little more convincing. And then, yeah the, "Wipeout" experience and kind of all history from there. Should I talk about that?

Dr. Chan: Yeah. So when did this doctor experience happen? Like in the 2000s or when did this go down?

Alan: So I was probably about 35-ish. So we're talking maybe six years ago around there. Six, seven years ago.

Dr. Chan: So you had to go back to school. And so what was that process like? What did that look like for you?

Alan: So I still hadn't quite made that decision yet. So can I jump into "Wipeout"? Is that okay?

Dr. Chan: Sure. Let's talk about "Wipeout." I love it. Let's get all the stories out. I love it.

Alan: Well, this is all part of the journey. And so I got injured in high school. My shoulder was just in shot. I couldn't sleep on it. I couldn't throw a ball. I saw a doctor. He said it would heal. It never healed. And so I just, okay, 20 years, I'm just going to live with the shoulder and I did. That was going to be my new life, just the shoulder that didn't work.

Then I was on this TV show called "Wipeout" where I just got wrecked. I got hurt so bad, and my shoulder was wasted. The very first round, we ended up going through and we won. It was a really cool experience. But by the end of the show, my shoulder was done. I couldn't use it. I couldn't lift anything. So this is 20 years after the original injury, 20 years of like just can't sleep, thinking that my life is going to be messed up forever.

And I go get surgery, and after surgery, I would say probably within three months, my shoulder was mostly there within six months, 100% like before high school. All the strength was back. This whole part of my life that I thought was gone was restored. I thought it was gone forever. I thought I would never teach my kid how to throw a ball. I mean, that really hurts a dad's feelings. And it was amazing. I didn't think that part of my life would ever come back.

And so now I have this experience where I know that I can be a doctor and now I have the strong desire to be a doctor. It was just like kind of a push over the edge later on. I just became very unsatisfied with how stale construction was getting for me and that was it, man. I took three years of undergrad schooling to get back, but I jumped ship and here I am.

Dr. Chan: I want to go back to "Wipeout." How did you get on that show? What's the audition process like? Did you have to like send in a video of you like jumping on things or jumping off the things and diving into large vats of liquid? I mean, how did that look like?

Alan: I actually applied, I think, three or four times. It looks so fun. It's not. It's a really good experience, but I wouldn't call it fun. But yeah, so they don't want athletes. They want people that can wipe out. They want people that can be on a TV show and not be afraid to look like a moron in front of millions of people. And I'm your guy. I am not afraid to look like a moron in front of millions of people.

So you just, you apply. You kind of show that you have a personality, that you're kind of larger than life. And I think that they liked that. I had applied many times, so I kind of learned what they're looking for. And then I found somebody who was a lot like me, just a knucklehead, and it was a team episode and we both got on.

They started asking us questions. They started asking us questions during the interview. We didn't really work together. The episode was like boss and employee, but he and I didn't really work together. We were both elevator guys, but he worked for a completely different company, but he had the personality that I wanted. So I called them beforehand when they invited me to do the audition. You have to do a written audition. Then they invite you to come to an in-person audition. And they said, "We want you to audition for this boss-employee episode." And I said, "Well, the guy that I'm going to audition with doesn't really work with me." And they said, "We don't care. Just make up some stories and we'll go with it."

Dr. Chan: Are you telling me reality TV isn't completely real? Is that what you're saying, Alan?

Alan: Yeah. You wouldn't think, right?

Dr. Chan: So were you the boss and he and employee or vice versa?

Alan: Yeah, we just did paper rock scissors on the way up. And so we were in San Diego. We had to drive to Burbank. It's like a two and a half-hour drive. And so we're just like, I don't know, who wants to be boss? I don't know. I'll be boss. So ended up I was boss, he was employee.

We go to the interview, and, you know, we're acting like knuckleheads and jumping around and make up these funny stories. And so the guy goes okay, "Okay, okay. Tell us a story that's really funny about you two guys working together." Remember we don't really work together, so I'm going, "Oh, shoot," but we had told a lot of stories. That's important, right? So then we finished the audition, and we go to the real show and the producer comes up and he says, "Okay, everybody I'm going to prod you guys to tell a certain story on camera." Anyways, anybody watching . . .

Dr. Chan: If we tell too many stories and it's hard to keep track of what's right . . . what was . . . to keep it consistent. Or do they not even care about consistency?

Alan: They don't care. They just want to laugh.

Dr. Chan: And so, okay. Because I've seen the show, what's the show like when the camera's off? Is it everyone relaxes, or it's just full-on everyone's in character? I mean, do they encourage wipeouts, I assume? I mean, do they encourage you to kind of put your life and body on the line.

Alan: Yeah. So that's a really good question. That kind of is one of the reasons that it's a really good experience. I wouldn't call it fun. So the first round is the one that we love to watch, where everybody is like getting hurt and that one's controlled by people. They're like pushing buttons. So you're going to wipe out. You know you're going to get a hit, so you take a hit.

But then when you're not on camera, you're kind of in the trailer in the back lot and you just sit there and nobody's like really excited. Some people are already hurt in between rounds. Everybody's for the most part friendly. There's a few people. I go back and watch that episode. I'm like, oh, that guy was a jerk. I'm so glad he lost. Oh, man. But yeah, there's a lot of downtime.

During one of our episodes, they were filming an episode for "The Bachelors," I guess like the bachelors and bachelorettes, that TV show. They did an episode of "Wipeout," and so they were filming the same day we were filming, and so on that day we weren't allowed to come out of our trailer. They didn't want us to look at them or see them or whatever.

Dr. Chan: Or spoil it for the masses about who made it, the rose ceremony. Yeah.

Alan: Speaking of reality TV, I don't watch "The Bachelor" or "Bachelorette," but I made an excuse that I had to go to the bathroom. And you have to leave the trailer to go the bathroom, and the bachelors were coming out and there was one girl, I guess, that she was really like high drama on the show. And so now there's no cameras rolling, this is just people walking to the trailer. Everybody's exhausted. Everybody's hurt. There's no cameras. And I hear this girl going, "I don't even know, like, this is so stupid. I don't even know why I'm here. I don't need this. I've got more publicity than this. I don't need this show and I don't need these people." And she's the blah, blah, blah, and I have no idea who she is.

So when the season like actually ran, when it aired, I went back and watched and I guess she was like a high drama person on camera and I can tell you off-camera she was also a high drama person. She ran half the course and quit and then, yeah, walked off the show.

Dr. Chan: Wow. So Alan, how far did you make it on "Wipeout," and what's the secret if myself or any of our listeners want to do well in "Wipeout"? How far did you go and get, and what's your secret to success to win this?

Alan: Oh, my gosh. I hope you go, Dr. Chan. I hope you go.

Dr. Chan: It's on the bucket list. Might not get to it to be quite honest.

Alan: The secret is to not be afraid. You're going to get hurt. Know they're going to hurt you and you got to take the hit. You got to take the hit and keep going. When you're watching the show, it's each event is like three, four, five minutes long. When you're doing the show, the events are like 30 minutes long. They're really aggressive. People are yelling at each other, cussing at each other. You got to remember, this is like Hollywood. This isn't Provo, right? So they're really letting each other have it.

The staff is yelling at the contestants. It's pretty aggressive. So you got to have thick skin and you just got to keep going. You're exhausted. You're swimming fully clothed with your shoes, life jacket for 30 minutes. It's really hard. So you just got to be the type of person who's going to take the hit, who's going push through it, who's not going to get upset.

There was one person. She did take an injury, but I think the stress was getting to her and she was like, "I need to stop. I need to stop. I'm hurt. I need to stop. We just need to stop." And they're like, "We are not stopping. If you want to stop, you're getting in an ambulance." "I need to stop. I need to stop." Boom. Pulled her, yanked her, put her in the ambulance, and took her out.

So yeah, it's a high-stress environment, but push through, be willing to take a hit, and might win some money.

Dr. Chan: Yeah. So how far did you get, Alan?

Alan: We won. So we won our episode. It was me and my partner. We won 25 grand each. And then they had another episode where the champions of each episode come back and compete again. I can tell you right now, I knew all the champions. I saw the champions. I met all the champions in the trailer on a different day, and nobody wanted to come back to that episode. Everybody was hurt. People are hobbling around. People's arms are in like wraps. Everybody's hurt, nobody wants to come back, but all of us were afraid that if we didn't come back, we wouldn't get paid for winning our previous episode. So most of us came back, like 9 out of 10 of us came back, something like that. But it was a good experience. Happy I did it. Wouldn't do it again.

Dr. Chan: Sounds really traumatic behind the scenes. I don't know, like I've talked to other folks who've tried out for "Jeopardy" and "The Price is Right." Like this "Wipeout" sounds like it's yeah, it sounds really dangerous. It's not like those others. All right. So you mentioned kids. And so at the very beginning, you know, you said you're, you know, mid-thirties, early forties. So in the world of admissions, that makes you a non-traditional student. And like what was that like going back to school and doing your pre-med reqs with a family and how did you make that work? Again, what are your tips? What's the secret to your success?

Alan: That's a really good question, thanks. So I think first you have to accept the fact that life is going to change. A lot of people kind of want to go back to school and think I don't really want to disrupt my life, but that's not really an option especially if you want to get into medical school. There's a lot of requirements get into medical school, so you have to accept that your life is going to change. You're going to miss some things.

So, you know, you're going to miss some dance recitals. You're going to miss some cheer tryouts, whatever it's going to be. And so then you kind of have to be creative. And so one of the things that we did . . . oh, first of all, let me say this is the number one most important thing going back to school, especially going to medical school, is make sure your spouse is just as invested as you are or even more so, because every minute that I'm not home is a minute that she's alone with the kids. And so as much as on the surface, it looks like getting into med school is hard for me, it's probably harder for your spouse. So make sure they're totally invested in this whole goal.

So, but then going to school, like one of the creative things that I try to do to try to combine schooling with kids is I was going to BYU, and so what I would do is I would have my wife . . . I still wanted the one-on-one time with my kids, so I'd have my wife drop off a kid with me at school for about an hour, maybe two hours, and they would have alone time with dad and I would get them treats from the vending machines and we would just kind of talk.

And we would walk from building to building into these large . . . BYU has a lot of these large classrooms, and we would just kind of walk around these large classrooms and pick up all the pencils, all the mechanical pencils and highlighters and erasers and whatever that the students left behind that day. And then the kids were, you know, they'd walk off like 15, whatever.

Dr. Chan: Like a scavenger hunt. I love it.

Alan: Like a scavenger hunt. Yeah. The kids loved it. They were super excited. They got to have alone time with dad and I got to have time with them. And anyways, that was something we did. And you kind of have to make a lot of deals. I'm going to miss your cheer competition. To make it up for you, I'll give you some alone time on Saturday, and I'll take you to nickel arcade or we'll go on a date or whatever. So you got to be creative, but it's work and life is going to change for sure.

Dr. Chan: How many kids do you have, Alan, and what are their ages?

Alan: I barely have six kids, and my youngest is four years old. My oldest is 14, and they're every two years in between.

Dr. Chan: Okay. And I think that puts you, I think you have the most kids in medical school. I don't know of any other students that have six. Is that correct as far as you know?

Alan: As far as I know. I don't know if that's like something I want the trophy for.

Dr. Chan: All right. So you're going back to school, you're trying to find balance, you know, as a father, as a husband. As a pre-medical student, how did you do all . . . You mentioned BYU and classes, and there is an academic component to getting prepared for med school. But how did you do all the other activities, like the research and community service? How did you fit that into your busy schedule?

Alan: So one of the things that I think kind of is in the heads of these medical school students is we want to like see what other medical students have done. Like, oh man, you got into medical school, what did you do? And you start to try to build your résumé following the résumé of some successful students before you.

And I tried to do the same thing. That was kind of my mindset for my first year. And then during my second year, I had this opportunity to join the wrestling team. And I thought, well, you know, this is O Chem 1. Everybody says this is such a really hard time right now, and plus I have other hard classes as O Chem 1, Anatomy, and, oh gosh, I had a few other hard ones. And I said I can go and I could focus on studies and get an A or A-minus, whatever it's going to be, or I can follow my passion and wrestle and show the admissions committee who I really am and show them something they've never seen before.

I became like the second oldest person in history to ever qualify for the national championships, but I thought that that was more descriptive of who I am. And so that did cost my grades a little bit, but I decided at that point that my application would be a reflection of me, what I'm passionate about, and where I feel like I can make the biggest difference.

So when I was going out and volunteering and doing these extracurriculars, it didn't feel like I was taking time away from my family or taking time away from studies. It felt like I was developing me and showing the admissions committee who I really was.

I know that sounds really cheesy, but that's the absolute truth. And so I think my application looked very different than a lot of other students because I took that route.

Dr. Chan: And you mentioned the wrestling. So have you always been a wrestler, or where does that come from or is that something kind of came later in life?

Alan: So I was a wrestler in high school. I was a really good wrestler high school. BYU had a wrestling team back then, and they invited me to be on the NCAA team that they used to have back in '97, but they wouldn't give me a scholarship. And at the time their coach was this Olympic champion, Mark Schultz. And he called me on the phone and he says, he gives me a spot on the team. I had no idea that that was a big deal. I thought I was a stud. I thought I was going to, you know, go places with scholarships and whatever, and that's not the path for wrestlers.

So I ended up going to BYU, and I didn't take the spot that he offered me, so I had to fight for it. And there's a kid who came from Ricks College. This is like back before BYUI. This kid came from Ricks College. He had already wrestled two years of junior college, and he and I had to wrestle for the spot. Since I turned it down, we had to wrestle for it, and he kicked the snot out of me. He gave me the worst beating I ever had in my entire life.

He ended up winning the starting spot and going to the nationals, NCAA national. So he was a stud. But when I left BYU, I wrestled a couple of years of junior college, and then, yeah, so it was a 20-year gap. A 20-year gap between like, when I'd last wrestled in junior college and when I wrestled again at BYU.

Dr. Chan: So you're kind of the prodigal wrestler. You wrestled 20 years ago and then you came back and joined the same team. Am I understanding that correctly?

Alan: Oh, so yeah. So BYU, actually, I think I'm probably one of the only people that I was on the . . . well, I guess I wasn't on the team, so I turned my spot down, but I did wrestle with them back in '97 when they had a NCAA team and they closed the team and then I came back and wrestled for the club team and then they closed the club team. Either I have bad luck, or I don't know.

Dr. Chan: Wow. All right. So Alan, so you're finishing up your pre-med reqs, you're doing all the things you need to do. You have your large family, life is happening, and I think you're still working during this time too, right?

Alan: Yeah. So what I did is I couldn't afford to work like during the school year. So from September to whatever May, I just couldn't find the time to work, but I also couldn't take on the debt. I've got a mortgage. I've got to raise kids.

So what we did is the day that school . . . I would take my finals on like a Friday, and we bought a trailer and on Saturday morning I would have the trailer heading to San Francisco and I would spend the next four months in the San Jose, San Francisco area because they pay, I make about in one summer, I'll work 80 hours a week and I'll make triple there what I'll make here and they pay for all my expenses and everything like that.

So I'd go to San Francisco. I'd build elevators. And that would just be like hard, just 80 hours a week, Monday through Sunday. And then I would finish my workday on Saturday out there, pack up my trailer, boom, I'm back here for ready for school on Monday. So I didn't have a summer vacation, no breaks, no time to breathe, just boom, boom, boom. But, you know, that's what we had to do. It worked for us, but it was not free. It was a lot of work. Having eight people live in a trailer, that was a fun experience.

Dr. Chan: That's amazing. And so what was your strategy when you started looking at medical schools, like where did you want to apply? How did you approach this as, again, a non-traditional student with a lot of stuff on your plate? What was your strategy going in?

Alan: Okay. Number one, I don't have to kiss up to you. I'm already in. I don't have to kiss up to you. Number one was always Utah. That was always from the get-go, always number one. So all my GPA and everything that was always working to get the goal to go into Utah. If for some reason Utah didn't work out, I had to go somewhere where I could raise a family. Had to be affordable, had to be safe, had to have good schools.

As a matter of fact, there was one school . . . I kind of like, I applied wide. I applied DO-MD. I applied to like 40 schools. And then in one of the secondaries, I don't want to say the name, but one of the secondaries, it said, "Tell us why you want to come to our school." And so I Googled the area where the school's at and even like the surrounding area, I don't know why I applied. I thought it was going to be better than it was, and it just wasn't going to be a good place to raise my family. And I'm really glad they asked me to start with a secondary, because after looking at the map, after looking at the schools, after looking at the living conditions, I go like, "You know what, I actually don't want to go there." So I didn't fill out the application. Go ahead.

Dr. Chan: So you applied broadly, so 40 schools. And again, I can ask you this now, Alan, because like you're already in here, but like how many interview offers did you get?

Alan: So I got two MDs, and I got a lot of DOs. I felt like my story was very DO friendly. It's really important to point out that my GPA as a young undergrad was really, really bad, and I took a lot of classes and got bad grades in a lot of classes.

So when I came back to school, no matter how good I was doing and I did pretty well when I came back, but I couldn't get that GPA to come up. Like it just really wouldn't budge. So when I applied, my overall GPA was pretty low. Can I say that? I'm not ashamed of it. Can I say that?

Dr. Chan: Yeah, you can talk about it.

Alan: My overall GPA applying was 3.05, and the minimum for most schools was 3.0. So I took all hard sciences. All of my G's were done. I had nothing but hard sciences left. And so I ended up with like a 3.7, because you know, O Chem and cell bios is really a rough route. But so when I applied, I had to kind of like keep that in mind that my GPA was going to be a weed out.

So anyways, going back to your question, sorry to go on a tangent, but I ended up with two MDs and then I think like maybe six or seven DOs. But I also, thanks to you, I heard back from Utah early, and as soon as I heard back from Utah, I withdrew. And so maybe there's . . .

Dr. Chan: When you say "heard back," when I called and accepted you?

Alan: Yes. Sorry.

Dr. Chan: All right.

Alan: Yeah, go ahead.

Dr. Chan: Alan, with all your experiences, I'm just curious because . . . it's hard for me because I meet so many people. I do remember you on your interview day. I just remember you just had like a very positive energy, positive karma about you. I do remember you mentioning the "Wipeout" thing when we were doing like a little ice breaker.

So I'm curious, like, because you know, obviously, you've been on some TV shows, you've been a wrestler. So like, you know, you have some athletic experience. Did you have butterflies in your stomach? Like what was more anxiety-provoking, like being on reality TV, getting ready for that big match or interviewing for med school? Like how did you call that feeling? You know what I'm saying? Was it stressful or were you able to navigate? I'm just curious how you approached it.

Alan: There's no question med school was more nerve-wracking

Dr. Chan: Than being on reality TV show. Interesting.

Alan: Well, you know, okay. So before, Utah was my third interview. I don't want to say I did one . . . like I'll say because it's funny. Okay. So I did get invited to the DO down in St. George Rocky Vista, and I got an invite the day after I applied and I got invited to the very first day of interviews.

So I was so arrogant that, like, they really wanted me to go there. And then they sent me this email that said, just so you know, we accept 80% or 75% of all the students that get interviewed. So, you know, just because you're getting invited, know that you got a really good shot. And I was so arrogant. I didn't prepare. I was just so dumb. I walked in, I did the interview and I knew I blew it. I couldn't get through my thoughts straight. I didn't practice like expressing myself and getting to the point. And I just, I walked out, I knew I blew it and I got wait-listed. I got wait-listed. It was heartbreaking. But I'm so glad that happened because it prepared me to prepare.

So I started doing practices. I started doing MMIs and constant scenarios. I was interviewing myself constantly, constantly, constantly, constantly. So by the time I came to the University of Utah, the interview like I felt prepared, but I was still nervous because remember that GPA always weighted on my mind. I couldn't get that off my shoulders. That always weighed on my mind. I always felt like less of a student than everybody around me because I was carrying that stain on my record.

So as much as I felt prepared, I felt I was always nervous that that was going to hold me back from ever getting into med school. And I think if I knew then what I know now, I wouldn't be quite as nervous about it, but yeah, it was horrible. I couldn't sleep. It was rough, really rough.

Dr. Chan: Alan, I'm glad you're here.

Alan: Thank you.

Dr. Chan: And I just have a few more questions because we're almost out of time. So starting med school in a pandemic, what's your experience been? How do you do with all the Zoom? I mean, what's your perspective starting med school during the middle of a full-blown pandemic?

Alan: I guess the good news is that we're all in the pandemic, right? It's not just me. And so I don't feel like I'm kind of at any type of any losing position because everybody across the nation I think is doing the same thing. So I don't think it's really negatively impacting like how competitive we are or anything like that. So that part doesn't really weigh on me.

One of the key things I wanted out of medical school is to make some really good connections. That's been kind of hard. I do feel like the class right now is starting to break off into cliques. Not like in a bad way, but people are just kind of getting used to who they see all the time. And so even when I go to med school, you know, cordial hi's here and there but we don't really know that many people outside of like maybe 10, right?

Dr. Chan: Yeah. The small groups, the dedicated groups.

Alan: Yeah. Yeah. So that part's been hard. I'd I hope to kind of like network a little more, but the learning has, you know, most learning is going to be on your own anyways, so I don't think that has hurt me too bad. And in some ways, since I still live in like an hour away from campus, in some ways it's kind of helped me because I don't have to make that drive every day. Then I'm going to make do, and it's not that bad. Yeah.

Dr. Chan: And going back to being non-traditional, like how has that balance been now that you're in med school with your family? Has that been manageable? Has it been actually more manageable as a med student compared to pre-med life? Like how would you describe it?

Alan: No, this is harder. There's no question about it. This is harder. I'm trying to figure out. I really like, I really, really liked the way that the University of Utah sets up their first year, where we have all of these tests that don't count towards your grade. And I feel like I just really feel like the University of Utah has nailed the first semester. We call it foundations of medicine. I feel like they nailed it.

So it really kind of gives you a chance to figure out who you are, how you're going to dedicate time, how you're going to figure out your life, how you're going to reorganize things.

The first half of this semester so far, I'd say I did a really poor job of managing my time and finding balance. It's been really hard. Dude, I gained like 10 pounds, and it was hard. I was studying like 12 to 14 hours a day, but then you start to figure out, more efficient, be more aggressive. And I started waking up early to exercise, started an exercise group. And so kind of with time it's gotten better. And so I found time now, I could spend time in the evenings with my kids and go on weekends, but there's no question about it. There is less time now than it was before, but you make it work and that's all you can do.

Dr. Chan: Yeah. Can I pivot, Alan, and ask some more questions? Because you just have this wide variety of experiences. Just want to pick your brain a bit. Is that okay?

Alan: Yeah. Yeah. Whatever you want.

Dr. Chan: So how long have you been an elevator repair person?

Alan: About 14 years.

Dr. Chan: Okay. So help me because sometimes when I step on an elevator and it's really high and it starts to like shake a little I'm okay. It's statistically really small that that's going to plummet, right? We've all been there. Everyone listening to this has been there when you've been in an elevator and it kind of shakes a little bit extra and you just kind of have that thought that's in your mind, right?

Alan: Yeah. So it's not like the movies. So every elevator is held up by like six cables and one cable can hold up the whole weight of the elevator. It can be full with all the weights and all the people and one cable can hold up the weight of the elevator. So don't think that like if one cable breaks you're going to lose it. There's elevators running with one broken cable right now and the repairman hasn't gotten to it. That's really unsafe, but for different reasons.

The scarier part is there are emergency breaks on elevators, so it won't fall. If it falls, it'll fall a very short distance. The actual danger is number one, when we work on the elevators, we have to shut the doors off sometimes because the doors are what keep the elevator . . . Anyways, sometimes we have to bypass the doors and the door is like a safety circuit. The elevator won't run when the doors are open. Sometimes we have to bypass that feature and sometimes people forget to unbypass it. So what happens is people will get on the elevator, the elevator will think the doors are closed, and it will just take off. And when you're on the elevator, it doesn't feel like it's that fast, but an elevator takes off really fast. And so if you're halfway through the door when the elevator decides to take off, yeah, that's more common. Super, super rare. I don't want to scare people. That's super rare, but that happens way more often.

I think elevators have only fallen twice in the history of modern elevators, but people getting hurt by doors that were bypassed, yeah, I know people that have done that, that have hurt people because of that.

Dr. Chan: That sounds terrifying as well. Another elevator question. So, Alan, I'm just going to pick your brain. So there have been rare times when like elevators have been stuck and it's full of people. And I remember, you know, you kind of look at the plaque and say like not to exceed this weight limit. And then I started looking around at everyone in the elevator. So I'm just asking you, like that's just a suggestion the weight limit. I'm fairly sure that like there can be more like, there's probably like some leeway there. You can probably go a couple of hundred pounds above that weight limit, correct?

Alan: Yeah. A couple of hundred, couple of hundred is okay, but usually like with modern elevators, they have weight sensors and so it won't budge if it gets overloaded. It won't budge. But actually if you overload an elevator, that's really unsafe, but you can't do it with people so don't get too nervous about that.

Dr. Chan: Okay. I think we've all been there. We've all kind of looked at each other, going collectively, are we below the whatever the thousand-pound weight limit is? And then you start thinking like, okay, is this now in a danger zone?

All right, Alan, last question. You mentioned movies, which movie in your opinion has the best elevator scene? Again, it doesn't have to be . . . so I actually looked this up. So the two in my mind are "Die Hard" and "Speed," but maybe you have another one. I'm just curious, like, are those legendary among elevator repair people or because it was so farcical, but they are so action-packed?

Alan: "Die Hard," every movie has it wrong. Let me say that. Every movie has it very wrong. Like if we can't open the hatch, we can't get out. If I'm stuck in an elevator, I'm stuck in an elevator just like everybody else. There's no secret.

The movie I think that has it best is probably "Ocean's Eleven." At the very end, you know, they sneak into the vault and then they open the doors and they throw that little bomb out there. That's a real elevator pit. I can tell from the picture that they shot that in a real elevator pit. There's some things that are wrong with that scene too, but if we're talking like most accurate, that one.

Dr. Chan: Okay. I love it. "Ocean's Eleven." I'm going to have to pay attention. I know exactly. Is that where they kind of, yeah. The little smoke bomb and, yeah. Okay. That's fascinating. See, I thought it was going to be like "Die Hard" because I think there's a lot of elevator scenes in "Die Hard." It's kind of part of the plot.

So, all right. Alan, this has been fantastic. We're going to have to have you come back because I just know there's going to be more stories and more questions. So I just really enjoy talking to you and just hearing, you know, how you've gotten to this point and just how well it's going.

Alan: Hey, thanks a lot for having me. I really like the U. I'm glad I chose it. This has been an awesome, awesome place to be in medical school.

Dr. Chan: All right. Great. Well, thanks, Alan and take care. I'll talk to you soon.

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"That is the first time I really went, 'Wow! This silly little hobby of mine can actually be used to make a difference in somebody’s life.'"

On this episode of Talking U & Med Student Life, learn about what cosplay is and how one of our medical students has fostered her passionate hobby into great opportunities throughout her journey in med school thus far. What cosplaying opportunities does SLC have to offer prospective medical students? How do you balance attending virtual med school, working full time, and studying for tests?

Hear what MS2 Erin has to say about how she got started in cosplay and what wonderful cosplaying opportunities she has had while attending the University of Utah School of Medicine.

Dr. Chan: Interested in hearing about taking a gap year, managing your wellness, and learning how to attend med school virtually? On this episode of "Talking U and Med Student Life," hear what first-year med student, Lily, has to say about what brought her to The U and how she is navigating med school practically virtually.

Welcome to another edition of "Talking U and Med Student Life." I have a fantastic guest today, first-year medical student, Lily. Hello, Lily. How are you doing?

Lily: Good. How are you?

Dr. Chan: I am hanging in there. We're in the middle of a pandemic. What an amazing, unfortunate, unprecedented challenging time we're living in. How is your family? How are your loved ones doing?

Lily: Yeah, definitely. Well, first, thank you so much for having me on your podcast. I am so honored. But yeah, it's definitely not the way I expected to see medical school start, especially online. I was super excited for all the hands-on experiences we would have, so this has been quite an adjustment.

But everything has been good so far. My family is actually in New York right now. So I'm just transitioning on my own here. But they're all doing good. They're just quarantining and trying to be safe.

Dr. Chan: So I want to start, before we talk about . . . because I'm just fascinated what does medical education look like in the era of COVID. I want to start back at the beginning, Lily. So, when did you first know you were going to be a doctor? When did that first idea come to you?

Lily: Oh, gosh. Well, at first, I actually wanted to go into pharmacy because when I was little, my grandpa was a pharmacist. And he was the wise owl of our family. He didn't speak very often. But when he did, everyone listened. And I come from a really, really large family. I have over 70 cousins and over a dozen aunts and uncles. So that's kind of a big room to be able to quiet when you talk.

And my mom actually . . . so my family is from Afghanistan, and my mom was a pharmacist in Afghanistan as well. So that was just always a career I really wanted to go into. And as I started progressing through high school, I was doing more shadowings in hospitals, and I started to notice how passionate I was about working with actual patients and being able to have conversations with them and check in on them and have more longitudinal relationships where you get to build rapport and trust with them.

And in my experiences, I wasn't really getting enough exposure to patients. I was definitely learning a lot about the medicine side of things, but I realized that I wanted to focus a lot more on patients. And that's when I started to look more into MD perspectives, which was very daunting because I am a first-generation college student, and I am the first female in my family to be attending medical school. So to fathom even graduating from a university and to now be in higher education . . .

When filling out forms for school . . . my parents in America are kind of registered as having a GED or high school diploma. It's just been really mind-blowing to see that transition through just our generations.

But yeah, so as I started college, that's when I started kind of focusing a bit more on medicine and being involved in health science programs that really navigated the ethics side of things so that I could kind of understand the humanistic portions of medicine a lot more. And that just kind of fueled me more and more, and I continue to pursue medicine and here we are.

Dr. Chan: Was it hard coming from a family of pharmacists to pivot to medicine, or are they pretty supportive?

Lily: They're super supportive. So it's kind of interesting because my mom always wanted me to kind of study something and not have a super stressful job. She just wanted me to be able to settle down and have a family and be comfortable. And so just knowing that I want to pursue medicine and be in school for so long, and be stressed out all the time, and studying all the time, she was really nervous for me and kind of wanted me to maybe focus on something else. But my dad was really persistent about me wanting to pursue whatever I wanted to.

That's kind of the American dream, is being able to start from anywhere and get to where you are. And my parents have struggled a lot being refugees here in America, and so I think, for them, it's really like a prideful thing to see that their children have been able to accomplish so much.

So I definitely think he was kind of hesitant at first because we also just don't understand, like, the process of Western institutions and going into medicine. But as I've kind of pursued it, they've become more and more encouraging and supportive.

Dr. Chan: How was that with your parents being refugees growing up? I mean, did they talk about it? How is that part of you? How has that helped you in your journey to become a doctor?

Lily: Oh, yeah, definitely. My parents are very proud of their identity. We're all from Afghanistan, and my parents moved here a little over 30 years ago. And it's really interesting to kind of hear about their experiences and realize how privileged I am from all the hardships that my parents have endured for me to be able to be where I am today.

My dad always tells a story that kind of sticks in my head when he first moved to America. He learned English in three months out of the stress of needing to be able to maintain a job. He can't lose his job, so he needs to understand the language. So he learned a whole new language in such a short period of time in order to maintain a job. And he tells stories about how when he first moved to Utah, he was in a tiny one-bedroom apartment. And he used a hot plate as a heater for his apartment, but also to cook on, and that's just mind-blowing to me. That's not even one of the large hardships that he's faced.

But yeah, so I was definitely raised to be very prideful of who I am and where I come from. And so I've definitely watched my parents work insane hours and incredibly hard to make sure that we feel like we have everything that we need in order to go through college.

But of course, that was a bit far-fetched when it came to medicine just because my parents never actually went through Western education. And so, when it came to FAFSA, or applications to college, or the MCAT, or the ACT, all of those things were definitely very foreign to my family, and I just had to learn to navigate that kind of on my own with them being like, "Good luck."

Dr. Chan: How did your family end up in Utah? The Afghanistan-Utah connection, what brought them here? I'm just curious to learn more about that.

Lily: So my grandma was actually sponsored by her oldest son to be in Utah, and my dad was actually living in Oakland, California, working for the airlines. And so, when my grandma was initially here, a lot of my dad's family was here.

When my parents got married, they were alone in Oakland, California. And my mom did not speak the language. She didn't have a driver's license, no family, nothing. I'm sure it was terrifying. And then my dad was working for the airlines, so she would be home alone, basically, for the majority of the weeks and stuff. And so my grandma was really trying to push for them to move here to be closer to family so that my mom would have more of a support system. And so they decided to pack up from California and move here, and we've just stayed here ever since.

Dr. Chan: That's wonderful, Lily. And then you mentioned being a first-generation college student and navigating the Western education system. How did you do that? I mean, did you have mentors, or what kind of resources did you have? What did that look like when you started looking at colleges?

Lily: So it was actually interesting. I went to school here, and then I also ended up pursuing my undergraduate at the University of Utah. So I've been a through and through Utahn. But it was hard. In high school, I didn't understand anything about scholarships or FAFSA or how to apply for things. And I really wanted to pursue being able to attend college, but I was very nervous about the financial burden and the ability to pay for all of those things and pursue a degree. And so it was a lot of learning from my peers I think in undergrad.

As I was kind of looking at out-of-state colleges, I didn't have the best experiences at my high school with having support to pursue those opportunities. I definitely had advisors telling me, "It's really expensive to go out of state," or, "Some of the schools you're looking at are really expensive," and, "Even if you were to get in, you might not be able to afford to stay." And so it was kind of discouraging going through that route.

And so I ended up asking some of my friends who were also applying to college and whose parents knew a bit better how to navigate the system what they were doing. And that's how I started learning about different application systems.

And my cousin, who was in college, was able to help edit some of my personal statements and stuff. But it was very trial by error and just kind of doing it but not knowing what I was doing. But I was fortunate enough to get into the University of Utah, and from there, I was able to find a lot of mentors, especially BIPOC mentors, who understood my struggles and understood how difficult it was to navigate the system kind of blindly, because you really don't know and there's no one that was kind of ahead of you to explain it to you. My brother went to the University of Utah, but he himself also struggled. And so it was really nice to be able to find mentors.

I was involved with student government and also doing research and a part of the health sciences program at The U, and all of those leaders were able to kind of steer me and explain to me things to focus on or to put my time and energy into. And they were great resources for me.

Dr. Chan: Lily, what did you do for student government?

Lily: So I actually did a couple of things. I was involved in student government for four years, and I sat on assembly, representing my college for one year during bills. And then I also was the director of diversity for two years, doing programs and conferences, educational seminars and trainings. And then I also was the chief of staff my senior year, so just kind of doing more of the administrative duties.

Dr. Chan: That's so cool. It sounds like it grew year after year too. The entire time, were you still medicine all the way, or did you think about political science and law school, or anything like that?

Lily: Yeah, what was really interesting was, in my undergrad, I probably didn't even seem like a pre-med student because I surrounded myself with people outside of medicine. And so I was involved in student government where those were kind of the predominant majors like you were explaining. And then I also was an anthropology major. And so a lot of people in that field were also not pre-med, and they were interested in research, or they were interested in going into Ph.D. programs.

And I honestly really enjoyed that because I didn't feel like I was always talking about medicine in my classes, or there wasn't this constant kind of competitive atmosphere with being pre-med and wanting to achieve great things.

But it never really steered me in a different direction. If anything, I think I had a different perspective in those spaces, where I was able to kind of relate what I was learning in student affairs to how that applies to healthcare and patient care, and then also bringing in my very different experiences because I wasn't a political science major in that environment.

Dr. Chan: And it sounds like heavy academic load, you're involved in student government, and yet you still have time to volunteer. What kind of community service activities were you doing during this time?

Lily: Honestly, looking back, I'm amazed that I was able to do so many things. But I think that that's the time in your life where it's really important to push yourself to do all these things.

For me, honestly, as I was pursuing extracurriculars to do, I obviously was referencing what schools wanted you to kind of hit in regards to subjects and categories. But I didn't want to pursue any type of extracurricular activity that was just checking a box because I didn't think I would enjoy it. I was putting in so much time every week to be involved. And so I wanted to make sure that whatever I was doing was going to be something that I was genuinely passionate about and something that I would be doing outside of a pre-med check.

That being said, I kind of tie back into my identity and what I was passionate about. And so I tutored refugee women at the Women of the World Center. And that was an amazing experience. I did that for about two years. I was able to help them just navigate basic English skills to be able to describe symptoms when they go talk to a doctor, or how to find groceries in the grocery store, or navigating public transportation, and really just the essentials in order to survive in Salt Lake or wherever they're living so that they're able to do their daily activities.

And that was really nice because you build friendships with them, and they end up feeling like they're a parental figure to you. A lot of them would call me their daughter and stuff, and so when I left, it was really sad. But I think that doing those kinds of volunteer trips were really enjoyable.

But outside of that, I also was in a student organization called United in Service for Humanity where we fundraised for the children of conflict in Syria. And we would do ice skating events downtown to raise money for these foundations. And we would also participate in a Day of Dignity downtown, where we would have health screenings, and we'd collaborate with the School of Dentistry for dental screenings, and then have hygiene kits just for people experiencing homelessness, since that is a pretty large population in the downtown area.

Dr. Chan: So, Lily, everything I'm hearing . . . and again, you're on the podcast so people know you got into med school, obviously. But it sounds like you have all these activities, all these experiences, you have these wonderful defining moments that are making you you. Leading up to the decision to apply to med school, though, I do know that you took a gap year. So can you just talk about that? What kind of went into your decision for that? Because it sounds like you could have applied right after you graduated or during your last year, but you decided to wait. So can you just talk about that a little bit?

Lily: Yeah. It's kind of interesting. I think people have either really strong feelings about a gap year or really strong feelings against a gap year. I actually decided to take a gap year because I was shadowing a lot of physicians during my last two years out of college. And I'd always ask them these questions and a lot of them were telling me, "Take a gap year. Take a gap year because you're going to be studying, you're going to be in school, you're going to be doing this full-time for the next eight years of your life. And during your gap year is when you're able to really focus on things that you're passionate about and also kind of grasp that this is really what you want to go into."

And so I didn't want to just take a gap year and just kind of sit on the couch and do nothing and relax, even though that's well deserved for any students who are graduating, especially during COVID times. So that's totally a valid reason also, if you wanted to spend time with your family. But for me, I just wanted to make sure that medicine was something that I genuinely wanted to go into and that I was passionate about. And I also wanted to make sure that I was giving my body and mind a break to be able to be recharged for medical school.

So during my gap year, I ended up working in mental health at the University Neuropsychiatric Institute. That was an amazing experience that I honestly think contributed a lot to my ability to answer questions during interviews and experiences that I was able to pull from. I honestly think that that was one of the largest things that I was able to utilize during interviews. I just learned a lot during that experience.

But I also was able to just learn like adulting skills of being able to cook and pay bills and take care of life outside of college, which was really nice because now that I'm in medical school, you don't really have time to figure that out. You kind of have to just do it all at once.

Dr. Chan: Lily, I love how you worked at UNI for a year during your gap year. What kinds of responsibilities/jobs did you have at UNI?

Lily: So I worked in UNI as a psychiatric technician, and so my basic role was to make sure that patients are safe. I actually worked the night shift, so I was just making sure that they were safe throughout the night and making sure that they have whatever they need.

The specific unit that I work on actually works a lot with individuals experiencing homelessness, undocumented domestic violence, a lot of very vulnerable populations in Utah that I really hadn't had as much experience with as I would have wanted going into medical school. So I'm really grateful for that experience.

But since it is a unit where it's a free service, we really get anyone from any walk of life, whether it's college students or older parents or whoever it may be. And so my main priority was just to make sure that they were healthy and safe, that they felt comfortable, that they had whatever they needed.

My unit also had a social worker and a medical provider as well. And so I was able to really learn those interprofessional relationship skills as well during my time.

Dr. Chan: I'm sorry, Lily. Did I ever interact with you? Did you ever see me on call? Was I ever floating around? I feel bad because I wasn't like, "Oh, yeah, Lily." I can't remember seeing you there, so . . .

Lily: No. I don't think that we actually ever overlapped. My unit is kind of isolated from inpatient. We're more of a transitions unit.

Dr. Chan: Oh, I see. All right. Because when you said UNI, I'm like, "Oh, I'm there sometimes, a lot of time." Cool. All right. So you're wrapping up your gap year. You have your eyes towards medical school. What was your strategy applying to medical school? Did you cast a broad net? Did you put all your chips on Utah? How did you kind of approach this decision?

Lily: So I actually spent my gap year also studying for my MCAT. I wanted to really focus on that because standardized testing is very stressful. And so I kind of started that after I graduated. I was doing that and taking my exam.

And then from there, I made a list of the schools that I wanted to prioritize. Definitely the University of Utah was at the top of that list because I have family and friends. And growing up at this institution, I just was able to kind of understand the values of the school.

And so I really didn't cast a very large net I would say. I think it's important to be very intentional about the schools that I was applying to since it is a very expensive process and I didn't know how I was going to pay for all of those applications.

I actually didn't apply as vast as people may recommend sometimes. But I applied to 15 schools, and the ones that I focused on were ones that had a focus on inclusion, diversity, and social justice efforts at their universities. And also, I looked at institutions that would be closer to any extended family that I may have on the East Coast. I think it's really important to have a social support system while you're in medical school, so that was something that I prioritized.

And then I also kind of focused on what types of specialties that they had and what were the things that I was passionate about going into.

But then from there, even if I received interviews, I really prioritized, "Do I see myself being happy and being well there in that environment?" And there were some schools that I decided to not pursue interviews with because I didn't feel like they would be as prosperous to me as other schools that I was willing to interview at. So I think it's important to be kind of selective, but also not so selective that you minimize your ability to get in.

Dr. Chan: I totally get it. It's fascinating, again, because I've done this for a few years now, and just to hear your experience wending your way through the process, being very thoughtful and mindful of your values, and the direction you went ahead in your career, and just the research you have to do into this stuff.

I always tell people all med schools look the same, and we have accreditation standards we all have to meet, but, yeah, there are different priorities, different cultures, different programs that are kind of nestled and embedded within all the different med schools you look at, and to find one that resonates with you and mirrors your core values, I think, is extremely important.

Lily: Definitely. I was surprised also with how much research you ended up having to do. I had an entire spreadsheet color-coded of all of the pluses and minuses for institutions. And then from there, you kind of have to even go outside of the school and wonder, "What is the community like? What is the city like? Will I feel safe there?" and other things that you have to process as well.

Dr. Chan: And then, Lily, when did you get in? When did I call you?

Lily: It was, like, the second to last week of November.

Dr. Chan: So pretty early in the process. Did you ever waver? Did you ever think about going somewhere else, or did you feel pretty committed?

Lily: I felt very committed to the University of Utah. I did have some pending interviews before and afterwards, but once I got the call, it just kind of clicked and it felt right.

And I was really excited to go to The U. I feel like I was almost thinking of these other institutions as more of like, "If I don't get in, then this is where I could be happy at." But I was also wondering if I didn't get in, which I thought definitely was something that could have happened of maybe being waitlisted and applying again next year. Then that was kind of where my mindset was at. Would I want to pursue a different school, or would I want to wait on a waitlist and reapply next year?

So I think just as I was processing all that, I realized what school I definitely wanted to go to.

Dr. Chan: And I think when I talked to you on the phone, if I recall correctly, you were pretty shocked and just overwhelmed with joy. I remember it was really a good conversation.

Lily: Yes.

Dr. Chan: So I guess to kind of pivot to what's going on now, I'm curious, from your standpoint, you're coming to The U, you're an incoming medical student, and then COVID starts happening, and it gets worse and worse and worse. Before med school started, what did that feel like knowing that you're going to be a doctor, but you're not yet at med school, but we're just being consumed by this public health crisis? What was that like as an incoming student from the outside looking in?

Lily: I felt like it was a lot of . . . "hurry up and wait" is a phrase that I've heard a lot. And I definitely think that's how I felt. You're stuck inside, you're quarantining. It's the time where I would want to be able to be more involved and more engaged and see what things the School of Medicine is doing for outreach and participating in those things, especially before our course load gets busy and stuff.

But I just felt very out of the loop. It was difficult because a lot of my classmates and I wanted to get to know each other, but because of COVID, no one really wanted to meet in person and no one knew anyone yet. And so it was a lot of navigating kind of the unknown and a lot of just impatiently wanting to be involved, especially since I was still working at the time up at UNI.

We had medical providers who were talking about potentially going to New York and helping at their hospitals there. And for me, that's something that I resonate with so much, especially having family that's in New York and stuff, being able to kind of be at a crisis and help out as needed.

But kind of being stuck and knowing that I didn't really have the skills to help in that sort of way yet was kind of frustrating. But also, I was really, really excited to see how this would shift our curriculum and what we would be prioritizing in the upcoming years. And I've been really impressed with how much that's been integrated into our learning so far.

Dr. Chan: Lily, what does medical school look like for you? With the pandemic and everything going on, what does your typical day or week look like? I mean, how is that going?

Lily: Honestly, just learning off of off Zoom University, as we call it, I am even more impressed for everyone who was going to medical school in person. I really don't know how they had time to do everything they did because I already feel so incredibly busy, and yet I am not even leaving my home to commute anywhere. So just impressed by all the students that came before me.

But basically, I wake up pretty early in the morning, probably around 6:00 a.m. and I just take the dogs on a walk and start getting ready for the day. And then I'll just be reviewing material and studying until classes start. You attend classes in your sweats or whatever you're comfortable with. But we'll sit in class for a few hours. And then once classes are over, it's typically a reviewing of that day or reviewing for the next day.

And I feel pretty consistently it can get a little rundown if you just stay at your desk all day, and you stare out the window and see other people outside, but you're kind of inside just staring at a screen. So I've been trying to learn how to navigate Zoom fatigue and potentially sitting outside, or taking breaks and going into other rooms and just getting more sunlight in the day.

But it hasn't honestly been as hard as I was imagining it going into it because I've never really been an online learner before. A lot of my classes were always in person. But at the same time, I'm really grateful that we're able to have one day of classes in person so that I'm able to see my peers and my colleagues and also be engaged with anatomy in person. I think that's something that I was really excited about.

Dr. Chan: So it sounds like, as I know the schedule, Monday, Tuesday, Thursday, Friday are all Zoom. Correct?

Lily: Yes.

Dr. Chan: And then Wednesday is in person. So what's different about Wednesday? Is that your highlight of the week, and what kind of learning activities are you doing on Wednesday where you come to campus?

Lily: Definitely. Wednesday is definitely the highlight of the week. You're going through quizzes on Monday, or you're going through really dense material on Tuesday, and you feel like this is a really long, tough week, and then you get to Wednesday and you get to go on campus and feel like a medical student wearing your scrubs and with your badge and going through the hospital and going through the labs. It kind of rejuvenates you for the rest of the week, at least for me.

But yeah, I get to school, and we have anatomy labs in the morning, and we have our cohort there. We're masked up and wearing our goggles, but we're able to look at cadavers and talk about things and relate them all in person from what we've been talking about online. So that's really, really nice. I've always really enjoyed anatomy lab, so I'm grateful that we were able to do that.

And then from there, we go through Histology. It's kind of a hybrid version where we're not necessarily at the microscopes looking at slides, but we're able to sit with our same cohort and go through slides and talk about the activity in that manner.

And then from there, we go to Clinical Methods. So really, Wednesdays are like a full day of classes from 8:00 to 5:00. But they breeze by. They go so fast. And with Clinical Methods curriculum, we get to learn the process of actually being a doctor in regards to taking patient histories or vital signs or doing different types of examinations, and then correlating that to different diseases that you may see.

So it's really the process of learning all of the things that you actually see in clinic versus what you read about in your books. And it's been really enjoyable. I'm really grateful for all of the instructors that bring their experiences into the classroom to help us navigate that.

Dr. Chan: You kind of talked about earlier with COVID, with Zoom, it was initially difficult to kind of get to know your classmates, and build a culture, and get to know them. Is it still kind of a struggle, or is it good to have that one day a week in person? How is that going, just that connection with your classmates?

Lily: I think it's hard because a lot of us have immunocompromised people at home or maybe ourselves. And so it's definitely been difficult to pursue a lot of friendships outside of classes and whatnot. Also, just with COVID and quarantine in general, you want to make sure that you're following all of the state guidelines.

But it really has been nice to be able to see people in person, connecting faces to masked faces, I guess. It's nice to get to know the people, at least in my immediate groups, and build friendships from there.

One of the girls in my group, her name is Arielle, and we actually take our dogs to the dog parks on Fridays now since we met through these in-person labs. And it's just been nice to kind of get outside in a safe way.

But outside of that, I think that I definitely would love to get to know my classmates more. Hopefully, as the curriculum goes forward and as things change with COVID, that may happen at some point. But I think that our cohort does a good job of communicating online and then also studying together. So I feel like I'm getting to know some people. It would be nice to get to know more people as time goes on, though.

Dr. Chan: And going back, as we talked about earlier, Lily, your core values, what you're interested in with healthcare disparities in Utah, with cultural humility, have you been able to do activities during the first few months of med school? I guess just how does that look like now for you? Have you been able to do those types of activities to kind of go back to your core passions and values?

Lily: We do have a Friday class called Layers of Medicine that I really enjoy going to. My group there is the same group that I see on Wednesdays, and we're able to have conversations relating specifically to kind of the major issues that we see in society and those disparities that are observed in healthcare.

It's been really nice to have those conversations as well as having different ethics professors come speak to us throughout the weeks and really pinpoint some of these issues and have us dialogue on them.

So I do feel like I am, curriculum wise, getting exposure to those things. And I'm excited to see how that progresses as we move forward.

Outside of that, because of COVID, it's been kind of difficult to get involved with student groups and interest groups that are focused on those things, since they're not really meeting in person because of the large group sizes. But I have been able to meet some people who have been involved in those groups and find out more about what they're doing.

I also currently sit on an anti-racism working group with the School of Medicine administrative staff, and that's been really nice to meet with them every week and get to know my peers in other years and really discuss what the future of our culture here at The U looks like and how we want to be a more inclusive and equitable place.

Dr. Chan: Lily, I appreciate your insight as you've gone on this journey towards becoming a doctor during these incredibly challenging and unprecedented times. And you alluded to it with going to the park, but what do you do for wellness? What do you do for resiliency? What do you do to take a step back and make sure that your batteries are charged? What would you share with others out there listening?

Lily: It's really interesting because no one is going to tell you, "It's time for a break," or, "It's time to go take a bath," or, "It's time to go eat something." There's no one kind of hovering that's going to know your schedule the way you do and have those mindfulness checks on you.

And I really have struggled with that because that's something that I've had to learn to navigate as opposed to, "Class is done, and I've finished studying, and now my night has begun." It's really been a lot of learning, "Okay, now I need to cut it off," because you could always study and you could go on for hours and hours. And so that's something that I'm still learning how to navigate.

But I definitely think having a schedule has been very helpful. I will schedule in my breaks for the week and when I want to be done. After class on Friday, Friday night, that is the night that I'm free, that I'm able to spend time with the dogs and spend time seeing my friends, or even just talking to my parents on FaceTime, or just making time for things that kind of help you take a break from the workload.

I also think it's nice to just have small rewards to look forward to. Like, maybe you want to go on a hike, or maybe you want to go on a drive, or get ice cream on Saturday. Just small things to kind of look forward to throughout the week really help to energize you to get through your materials and you can enjoy those breaks.

But on the daily schedule, I think it's just good to schedule in those lunch breaks and breakfast breaks, and, "I'm going to go on a walk outside," or, "I could keep going, but it's 9:00 p.m. and that's my cutoff." Just having those kind of reminders are really helpful.

I definitely felt, "I don't have enough time for baths," but you definitely can schedule time for baths if you really want to. And so I think it's just kind of really managing that and having people around you that support you but also know when to say, "It's time for a break."

Dr. Chan: Lily, it sounds like you're doing really well given the circumstances of everything going on, being a first-year med student in the era of COVID.

I guess the last question before we wrap up, any advice for anyone that's listening out there who is thinking about going to medical school, or is considering it, or maybe just questioning their decision and trying to figure out what their path is? What would you say to them? What would be your advice?

Lily: Definitely. I would say don't be afraid to pursue great heights. I think that medical school sounds incredibly daunting and difficult, but it's not impossible. I'm here and there are so many other students that are here, and you can definitely get there as well.

Reach out to mentors, your peers, people who are in medical school. Gather bites from them. One of the biggest things that I've learned is people are always willing to help you in medical school. No one wants you to fail. No one wants you to do poorly. And I think that that's something that's really, really important.

And just be involved as much as you can, even with COVID. If you're able to do something online to be a part of the healthcare system, or to be doing something that kind of gives you more exposure to that, I think it's important to have that exposure to see if that's something that you're passionate about. But also recognize that there are so many different fields that you can go into and you don't need to have it all figured out by the time you step in the door. And it's okay to feel that way.

Dr. Chan: Lily, I'm just happy you're here. I'm happy that you're going to be taking care of my family and loved ones one day. And I'm excited to see . . . I'll have to have you come back on the pod, but I'm really curious to see if you become a psychiatrist. We'll have to talk a little bit more about that when you get a little bit closer to making a decision. But I appreciate your time and I just appreciate you. So thank you for being on the pod.

Lily: Thank you so much. And thank you so much for thinking of me. This was a wonderful experience.

Dr. Chan: How do you strategize to apply and get into medical school? What activities help prepare you for medical school? How should you consider the financial implications when applying to medical school and residency programs? And why are couples slow to announce that they're dating while in medical school? Today on "Talking Admissions and Med Student Life," I interview a couple, Nisha and Milo, both former fourth-year medical students who recently graduated from 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 got two great guests on today, Milo and Nisha. How are you guys doing?

Milo: Doing well.

Nisha: Yeah. Doing well.

Dr. Chan: Fourth-year students about to graduate in a few days, I think, right?

Milo: Yeah, Wednesday.

Dr. Chan: Wednesday . . .

Milo: Friday. Friday.

Nisha: Friday.

Dr. Chan: Friday. Friday, but it feels like tomorrow. Yes.

Milo: Yes, yes.

Dr. Chan: All right.

Milo: Yeah. There was the quarantine.

Nisha: Yeah.

Dr. Chan: Yeah. Yeah. And we'll talk about that. Yeah. So I want to start . . . I love the story. I love hearing people's stories. So let's go back to the beginning, and Nisha, let's start with you. So when did you first want to go to med school? When did that enter your consciousness, and was it like one moment that stood out, or is it a series of moments that led you to become a doctor? Curious to hear when that started for you.

Nisha: You know, when I was very young, I wanted to be a doctor, but that changed as I got older until I went to college and I realized, you know, I really loved biology, especially human biology and at the same time, I was also an English major and I did a lot of work in research with human rights types of issues. And I realized that medicine was a really good combination of the two where, you know, there's a lot of science and stuff like that, but you also can make a really big impact on people's lives and the health of communities. And so that was when I realized that that's what I wanted to do for sure.

Dr. Chan: And then Milo, how about you? When did you come to the decision?

Milo: Yeah. I've always had an interest and aptitude for science. Initially, I thought I was going to get into research. Cancer has kind of run in my family, and growing up, I would always tell people, "Hey, I'm going to go cure cancer." And I didn't really realize how difficult that would be and what would actually be involved even in cancer research until I got into college and started doing some research and realized that full-time research was probably not for me, although I did enjoy the research. I still had a love for science and got introduced into medicine with the research I did but really wanted to work more hands-on with people and have research be part of what I did, but not entirely what I did. So I was talking to my uncle who was actually in maternal and fetal medicine and he said, "Well, come shadow me. It sounds like what you're looking for may actually be a career in medicine." I went and shadowed him, and he was right. I think it just combined the problem solving, the science, working with people. It just combined everything into a package that fit really well for me.

Dr. Chan: And where did both of you grow up? And, like, where did you end up going to undergrad?

Nisha: So I grew up in Emmett, Idaho, which is a pretty little rural town close to Boise. And I did my undergrad at the College of Idaho, which is in Caldwell, about 45 minutes from Emmett where I grew up. And I double majored in English and biology there.

Milo: I grew up all over the West. I was born in Phoenix, Arizona, and then for my dad's work in construction, we moved really pretty much every year or two. We bounced between Utah, Idaho, and Arizona mostly, ended up back in Arizona when I finished high school, and went to University of Arizona for the in-state tuition.

Dr. Chan: Finances do come into play with these things. So I totally get it. I totally get it. And then while you were in undergrad, for both of you, like, what kind of activities did you do that prepared you for med school? What kind of groups or organizations were you part of?

Nisha: I worked at the women's and men's center at the College of Idaho, where we worked with students that had experienced relationship violence in particular, but were also struggling with other mental health issues. And that, you know, had a big impact or prepared me to, you know, talk to people about issues that were difficult and find ways to help them and connect them with resources. And then I also did some shadowing and with the Idaho program involved in shadowing, and then I did research with the Idaho INBRE Program, which is for undergraduate researchers and we did a biochemical and microbiology research, which also really helped prepare me for medical school and helped prepare me for the kind of critical thinking in particular that you need in medicine.

Milo: And I did quite a bit of volunteering in hospice through a hospice facility in Tucson. I founded a chapter of the Medical Reserve Corps at University of Arizona, which focused on getting communities involved in emergency preparedness and how to respond as a community member if they were to be the first person on the scene of an emergency. And then I got involved in research in speech and language and ended up long-term with an MRI lab looking at language learning and language pathology.

Dr. Chan: And what were . . . how did you, like, what was your process like when you started looking at medical schools? I mean, did both of you look at, like, spreadsheets, or did you go by word of mouth? Like, how did you start coming up with a strategy when you looked at medical schools to apply to?

Nisha: So there's a lot of, you know, pieces that you need to apply to medical school. And I actually found that the University of Utah's website and their requirements were pretty in depth and in detail. So those were the guidelines that I used to make sure I had all the boxes checked off for medical school. And then for me, what was important or one of the things that was important was finances. So, you know, I looked into the schools that had, you know, either scholarship opportunities or that would allow me to have in-state tuition, and Idaho works with the University of Washington and the University of Utah. So that had a, you know, pretty big influence on my decision about, you know, where to apply and for medical school.

Milo: For me, I mostly wanted to stay West. It was where I was familiar with, and my family was planning on staying in either Arizona or Utah. So I applied mostly to Western medical schools, which narrowed the list down pretty significantly. And then finances were also something I had to consider. So I picked public universities that typically had better tuition.

Dr. Chan: And then I don't know if we're going to talk about it, but did both of you get in the first time, or what was that process like or, like, talk about that. Like, if there's any bumps in the journey, like, how did that go?

Nisha: So I applied technically twice. The first time I applied, I had some family issues. Right before the secondary applications were due, my grandfather got diagnosed with cancer and ended up dying pretty shortly afterwards. And so I decided that I wasn't ready to start medical school at that time. And so I didn't finish completing the application cycle. I did apply the following year, and that year, I got in off of the waitlist for the University of Utah.

Dr. Chan: And Nisha, was it like an immediate yes in your mind, or were you kind of fielding other offers? I mean, like help me understand what you're going through right then.

Nisha: When I got accepted to the University of Utah?

Dr. Chan: Yeah.

Nisha: So I had actually taken what, you know, probably a pretty big risk, but I had only applied to the University of Utah and the University of Washington that year. And I really loved the University of Utah on my interview day. And when I got accepted off of the waitlist, it was an immediate yes and that's where I wanted to be.

Dr. Chan: I find, I mean, that's great, Nisha. I love that. And it's interesting, because like I've worked in Idaho for many years and I feel that, like, University of Washington, they definitely have like a bigger brand name in Idaho and I just see purple everywhere that I go. And so, yeah, I'm just curious, like with you being in right, I would argue kind of right in the middle of Idaho, kind of in between Utah and Washington. Yeah. Like, yeah. So I'm happy that it sounds like our website and our interview day really helped sell you on the program.

Nisha: Yeah. You know, I really, you know, I liked the people that I met, and I liked the idea of being in one place for all four years of medical school. And, you know, I really liked the campus, and it seemed like, you know, the opportunity to work out in multiple different hospitals in the area was also really appealing to me.

Dr. Chan: How about you, Milo? How was your journey?

Milo: It was on the longer side. It took me three application cycles to get in.

Dr. Chan: So you hated me, but then liked me at the end, right?

Milo: Well, I didn't apply. So the first application cycle, I put in primaries, but I was actually doing some shadowing with the neurosurgeons at U of A, at that point. And there were some things that came up in the shadowing that made me kind of pump the brakes on going all in on medical school right away. I knew that with the debt you accrue in medical school, once I got in, I was kind of locked in. You really want to come out the other side a doctor, or you get into some financial issues. So, you know, I saw some issues with the insurance companies and just some of the policy that I saw in shadowing. There were neurosurgeons there who were working, kind of fibbing their hours so they could work over the 80-hour limit. And they spent a lot of time just arguing with insurance companies over what they thought was necessary and what would get paid for. And I really had to think if that was worth, you know, because if it was just patient care, I knew that that's what I wanted to do, but there were just some things that I thought detracted from that and I had to consider if that was worth it. So I actually didn't finish the secondaries the first year I applied.

And the second year, I think I applied to I think 8 or 10 schools. I got an interview only with University of Arizona and got waitlisted and didn't end up making it in that year. Then actually, I moved out to Utah because my family was out there and wanted to establish residency in case I got into medical school there. I got a job at a lab that I really loved doing neuroimaging and only applied to Utah that third year because I was with my family doing some research that I really loved. And I figured if I get into Utah, that's really where I'm targeting and that would be great, and if not, then I'm in a good situation anyway, but I did get in that year.

Dr. Chan: So both of you, I mean, this kind of flies in conventional advice I give to people, but both of you essentially kind of suicided applied to like one, maybe two programs. Usually, I tell people like, "Oh, 10 to 15," but it sounds like you both felt fairly confident in what you were doing. Is that accurate, would you say?

Nisha: Yeah. And, you know, I think for me, just looking at the numbers as someone from Idaho, I think statistically I was most likely to get into the two schools that I applied for. It was also cheaper for me to just apply to two schools, and the in-state tuition was also very appealing. So those were kind of what led my decision to just apply to those two schools. My plan was that if it didn't work that year and I hadn't got in, then I would extend my application further and, you know, improve my application as necessary, but I was, you know, willing to apply to more programs the following year if I didn't get in.

Milo: Yeah. You said I had a lot of confidence and I don't know if I had a lot of confidence, but I was in a situation that I was happy with, and if I didn't get in that year, I figured I'd get there eventually. And I was enjoying what I was doing at the time. So it wouldn't have been a disaster if I didn't get in that year.

Dr. Chan: And I can tell you from my end, now I can say that since we're having this conversation four years later, I remember talking to you Milo on the phone and you were so excited. I remember like I thought, "Oh, you're definitely coming." And then Nisha, when I talked to you, you were pretty cool, and I think you're holding your cards close to your chest. I don't know. Maybe you were stunned, but I came away from that phone conversation with you going, "I don't know if she'll come here," because you were pretty cool on the phone. So I don't know if you remember that phone call that many years ago, but that's kind of how I remember it.

Nisha: Yeah. I think I was pretty stunned actually. Because I had been waitlisted, I didn't have a lot of hope of getting into the University of Utah. And so I had really mentally prepared myself to do another application cycle. And so, when I got the call, I think I was pretty shocked at first, but also, you know, so that was kind of my initial reaction. But, you know, obviously, I did decide to go here, and I have loved all of it.

Dr. Chan: Do you remember being excited, Milo?

Milo: Yeah. Yeah. I actually woke up to your phone call, and it was earlier than I expected to hear back. But when I saw the number, like it kind of clicked and I picked up the phone kind of thinking that I was going to be on the phone with you. And I was super excited. Like I said, I only applied to Utah because I figured, you know, that's really where I wanted to be and just getting to stay here, stay with my family, go to a really great school, it checked all the boxes for me. So I was very excited.

Dr. Chan: Great. And then I want to jump . . . okay. I love asking this question, especially couples. So what is your first memory of each other? Was it during second look day? Was it during orientation week? Was it . . . were you anatomy lab partners? Like, how did you guys meet initially?

Nisha: So we met and we were in the same clinical skills group actually, which was the first time that I remember meeting Milo. And then we did a lot of studying together that first year. Me and Milo and another one of our friends were kind of in a study group, and we spent, you know, lots and lots of time going through all of the material and writing stuff on the whiteboards. So that's kind of some of my first memories.

Milo: Yeah. Definitely, where we met was the learning communities, like within the first week of medical school. And then I think walking back from classes to our cars, I ran into Nisha and we had like this really nice, in-depth discussion about, like, the world and politics. And it was just such a change from all of the preliminary conversations you have with everyone else kind of like, "Hey, where are you from? Do you know what specialty do you want to do?" Just really kind of superficial small talk and I'm really bad at that. And it was just such a striking change that that really stuck out in my head.

Dr. Chan: Nisha, do you remember this or do you not remember this?

Nisha: Yeah, I definitely remember that and for the same reason because it had been, you know, a lot of just the small talk conversations, which, you know, are obviously important, but were pretty tiring for me. So it was nice to have a conversation about things that I was, you know, that I was interested in and passionate about, and it was just really nice to connect with someone that wasn't the small talk superficial level.

Dr. Chan: And who is your . . . what was the name of your CMC group, and who was your instructor?

Milo: We were Powder Mountain. We started out with Dr. Barrett, who was fantastic, but he had a great job opportunity that he left for. And then we got hooked up with Dr. Glasgow and Dr. English.

Dr. Chan: Okay. I love it. And so it sounds like CMC really brought you together. And then, you know, again, like I've done other podcasts with other couples who ended up doing the couples match. Were you . . . how do you feel about becoming a couple? I mean, I know there's some, sort of . . . sometimes I talk to the med students and there's like this weird code, where they're like, "Okay, we're not going to date each other, but maybe we will." You know, and then, so I've noticed couples are very slow to kind of like announce that they're a couple. I mean, did you guys grapple with that at all, or were you pretty much like, you know, once you guys were together, you're together and you didn't care about like any sort of silly codes like that? Do you understand what I'm saying?

Milo: Yeah. I think it took us a while to get to the point where we were together because yeah, there's complications with dating a classmate who you're going to be in a program with for four years. But I think once we got to that point, I wouldn't say we overtly announced it, but we probably didn't try to hide it either.

Nisha: Yeah. We were really good friends for about two years before we started dating. So it was right before we went into the third year that we were really officially dating. And so we also didn't see a lot of our classmates around that time, which I think kind of made it a little bit easier, at least from the kind of announcing standpoint. And because we had been good friends for so long, at least for me, that made me a less worried about moving forward and becoming a couple and, you know, also with the knowledge that the match was going to come up in two years and so if we were going to stay together, that would probably mean doing couples match together. And so I think, yeah, just . . .

Dr. Chan: I love it. It sounds like it came together quite nicely on a kind of good schedule.

Nisha: Yeah.

Milo: Yeah, it definitely did.

Dr. Chan: And speaking of the first two years, how was that jump from undergrad to med school? Was it relatively easy? Was it kind of like the fire hose analogy? Did you have to redo your entire study kind of skills? Like, how was that jump from undergrad to med school for you?

Milo: Yeah. So I actually took five years between undergrad and med school. So I actually think it was . . . I felt recharged and like ready to go back into the classroom. It was kind of like a fire hose. I forget who told it to me, but when I was a first-year medical student, someone told me the first two years of medical school, like going from undergrad to first year is like going from zero miles per hour to 40 miles per hour. And you just have a lot of adaptation that you need to do. It feels like it's moving really fast, even though the material isn't quite as hard. And it just feels like a really big jump.

And I think I agree with that. I definitely. Maybe it was relearning study strategies after having been out of it for five years, but I felt like it was a pretty big jump and took a lot of adaptation. And then from first to second year is like going from 40 miles per hour to 60 miles per hour where it, you know, it's harder stuff, but you've got a lot of your habits formed at that point, and you just kind of have to lean on them a little bit harder and work a little bit harder for the material.

Nisha: Yeah. I agree with that. I think I had to learn how to process material in a different way. When I was in my undergrad, I took extensive handwritten notes on everything, which was really one of the ways that I learned well, and that was not really possible in medical school or it was at least quite a bit more difficult. So I had to, you know, learn some other strategies besides that. And I had also never really done any group study in undergrad, but I found that in medical school, group study was actually one of the things that worked best for me.

One of the other challenges that I had was going into medical school, I knew that taking multiple-choice tests was not my forte and it was something, you know, that I had not done as well with. In the undergrad, I did not do very many of them. So one of the things I really had to focus on was how to take multiple-choice tests, how to think about those types of questions. And I was actually really lucky because Milo is very good at them, and he was willing to spend a lot of time talking through strategies with me and helping me, you know, focus on the material, learning the material in a way that would kind of let me showcase that knowledge in a different way.

Dr. Chan: Great. It sounds like you guys were like, to you use a business term, a lot of synergy, you know, coming together. It sounds like you were able to kind of really develop some great skills, study skills, academic skills that really paid off.

Milo: Yes, absolutely.

Dr. Chan: And Milo, you alluded to it like a little bit. So if I had a time machine and I went back four years ago and I asked you what specialty you would go into, what would have you said, and then, how did third year either help or not help that decision? So I'm just curious. Yeah. I mean like, what would you have gone into, and then how did third-year kind of play into it?

Milo: Yeah. Mine's pretty easy. I thought I was going to do neurology, and I'm doing neurology. So, yeah. A lot of that was that's the research that really ended up pulling me in towards the end of college, and the five years I took between undergrad and medical school were a lot of neurology research. So I came in with a strong basis in it, knew that I really enjoyed it. Tried to keep an open mind through the first three years of medical school. I gave pathology a good look actually and internal medicine a pretty good look as well. And in the end, it actually came down to internal medicine and neurology, and they're really similar. I think people go into them for a lot of the same reasons, but I've always really liked learning about the brain and the nerves and, you know, they both had similar aspects and I picked the organ system that I liked the most, and that was neurology.

Nisha: For me, I went into medical school thinking I was going to do surgery, either general surgery or urology. And part of that was because I had shadowed a urologist and I got to watch some surgery and I just thought it was like the coolest thing ever. So, you know, I thought that that was going to end up being what I wanted to do. And in third year, my very first rotation was internal medicine, and I really enjoyed it. I think it was, you know, some of the longest hours in third year, but I was always excited to be there the next day and checking on my patients.

And after that rotation, which I enjoyed so much, the rest of the rotations were not as enjoyable as that was for me. Although, for some reason, I was so convinced that I was going to be a surgeon and I was kind of still thinking in my mind that that was the direction I was going to go. And it was Milo who actually said to me, he was like, "It's your life and you can do whatever you want, but you've been kind of miserable since your internal medicine rotation. So I don't really know why you're still going the surgical route." And that made me stop and think and realize, you know, what I really realized that that was what I had enjoyed doing the most. And when I made that decision, it was something that I was really happy with and really excited to do.

Dr. Chan: So a lot of people have told me like it was like finding your people. And it sounds like neurology, internal medicine, you found your people. Would you agree with that?

Milo: Yeah, absolutely. One word that got thrown around about neurologists on the interview trail at least was quirky. And definitely, I'm a little bit quirky. And I just felt like I fit in really well with the neurology crowd.

Nisha: Yeah. You know, I really like, you know, puzzles and problem solving, and that's a lot of what internal medicine is, is you get, you know, someone that comes in with non-specific symptoms and you have to figure out what's going on. And that's something that I really enjoy. And it also made sense because before medical school, I did quite a bit of research in a lab. And one of the things I loved about that was, you know, experiment didn't go the quite the way that we were expecting is, you know, a lot of troubleshooting and trying to figure out what was going on. And, you know, that was an aspect that really carries over into internal medicine, which I enjoy. It's a lot of kind of sitting and thinking. And, you know, one of the things I really love about hospital medicine, in particular, is that you get the answers, you know, you can see improvements and you get, you know, order labs and you can get them back pretty quickly. So there's kind of this real-time feedback on what's going on, which I also really enjoyed.

Dr. Chan: And then going into fourth year, did you, like so, when did, like, the discussion start kind of coalescing around the couples match, and when . . . like, because I know sometimes, students do away rotations. Like how did that kind of factor into, like, as you transitioned to fourth-years?

Milo: Yeah. Neither of us did an away rotation, but I think we had been together and felt like we fit together for a good year and a half previously. And so we just kind of . . . I don't know. We didn't have too big a discussion about it. It was just kind of, "Hey, you want to do this?" "Yeah." "Okay." And we did.

Nisha: Yeah. I agree with that. And neither of us did an away rotation, and for a large part, at least for me, that was just due to some of the advice that I got, which was in internal medicine, it wasn't really necessary unless there was somewhere in particular that you really, really wanted to go. And we didn't feel that strongly about any particular place.

Dr. Chan: So, yeah, I guess that segues to my next question, Nisha and Milo, like, what was your strategy for the couples match? Like, how many programs did you apply to? Did you try to identify like a certain geographical area of the country? Or did you just check all the boxes and just took the money and threw it through the window? Like what did you do? What was your strategy?

Milo: Well, at risk of sounding a little bit snooty, I guess, we just took the NIH, like, top 100, I guess top 50, like, funded schools and just went through those, cut a few of them and applied to most of the top 50. Well, no, about half of the top 50. I think most of the top 30. We ended up applying to like 20 . . .

Nisha: Twenty-two programs I think.

Milo: Twenty-two. And that was kind of our initial cut was the NIH list.

Nisha: Yeah. And I think we were really lucky too that our scores throughout medical school were very, very similar, and neurology and internal medicine are pretty comparable in terms of, you know, a program that was good at neurology was also usually pretty good at internal medicine and vice versa. And, you know, and we were very similar in competitiveness, both in terms of the specialties and in numbers, as I said before. So I think that made it a lot easier for us. I think it would have been more challenging if one of us was going into, you know, a very, very competitive specialty, and we might have had to make more sacrifices if that had been the case. But I think that was something that made it quite a bit easier to couples match, and, you know, we got interviews to pretty much all of the same places, and, you know, they were pretty close together in time as well. So that was nice.

Dr. Chan: I love it. I'd never heard of this NIH method. Are both of you thinking of, like, doing research during your residency careers, or what was kind of the logic behind using the NIH?

Nisha: So I actually had met with one of the internal medicine advisors, Dr. Lappe. And I was trying to sort out, you know, because you're supposed to apply to, like, some reach schools and some safety schools and then, you know, kind of schools that are in your range. And I was trying to figure out like, how do I know the competitiveness of schools? And she just, like, Googled the NIH internal medicine funding list, and that's what came up. And she looked at the list and she was like, "This is . . . the order that these are in is pretty consistent with the competitiveness of the schools." And so, you know, and she said like, "These are the schools that I think are, you know, within your grasp. These are the ones that I think are reach programs." And so that was why we used that list.

Milo: Yeah. I think moral of the story is have a good mentor and speak with them regularly, because Dr. Lappe was just invaluable, honestly, to both of us. And she spoke mostly to Nisha, but she gave advice to both of us and we both told her like, "These are our scores, these are our thoughts." And she was fantastic.

Dr. Chan: And I think, so it sounded like 22. So you each applied to approximately 20 some odd programs?

Nisha: Yeah.

Milo: Mm-hmm.

Dr. Chan: And then the interview offers sounded like coming in. Did you have to make hard decisions about turning down some interview offers, or did you just go out and do them all? Like, how did you approach that?

Milo: Yeah. We had to cut some of them. I think we got the majority of the ones we applied to, and we cut down to, I think, 12 or 13.

Nisha: Yeah.

Milo: So we ended up cutting about 10 each. And again, having a good mentor for that Dr. Lappe and on the neurology side, Dr. Wold and Dr. de Havenon spent a lot of time talking with us about which to keep and which could probably go.

Nisha: Yeah. And, you know, at that point, we started looking a little bit more into, you know, how much does it cost to live in that area, you know, some of, like, the benefits offered by the different schools and kind of some of the lifestyle around the schools, which we had looked into initially, but not quite as hard as when we actually got the interview offers and realized we needed to cut down to fewer programs than we had interviews for. So we used that to make some of our decisions as well.

Dr. Chan: And did you, I mean, like, and again, kind of like back to when you were applying to med school, would you, like, call each other or text each other at night and kind of give like each other's opinions, or was there some sort of Google master document spreadsheet where you would kind of, you know, pros and cons? Like, how did you kind of synthesize all this information you were getting as you both hit the interview trail?

Nisha: So we called each other usually after the resident dinner, the night before the interview, and then usually, like, on the way to the airport or at the airport the day after the interview was over and just kind of talked over our initial thoughts. And, you know, we typed some of the stuff that we really liked or, you know, or were more concerned about in a Google Doc. But in the end, it kind of came down to, I think, the feeling that we got at the different interviews and the places that we just enjoyed being the most or felt like we fit in the best.

Milo: Yeah. While I was at the airport, I would write down like in-depth the handwritten notes in a notebook about each program. And actually, when it came time to make the decision, I don't think I even went and looked at those outside of the top maybe two or three programs that we were thinking of. In the end, I agree it just came down to feel, how well you thought the program would take care of you and how well you thought you would meld into the program.

Dr. Chan: And did you send, like, you know, because like in the world of medical education, we call them love letters, like when you start corresponding with these different programs or love emails as it were, did you feel you had to do that, and what was your, like, who would do the writing? Or was there a place that like interviewed one of you and the other place was like not as quickly sending out interview offers, and did you have to kind of use some love letter-ish maneuvers with them? Like, how did you do that? Nisha: So, in terms of the actual interviews, there was one place where he got an interview that I was waitlisted. And then after his interview, I got an interview there. And then there was a couple of interviews that I went on, but they made sure to ask me if my partner had gotten an interview yet and said that they would, you know, press the other program. But for the most part, we got interviews to the same places. And then at the very end, we sent a love letter to our number one program, individually to our respective programs and said, you know, both that this is our number one program and our partner is also going to be ranking this program number one. But, you know, even in terms of that letter, we weren't really sure as to whether or not we needed to send it or not, but decided that it probably wouldn't hurt us to do that, especially because we said very specifically this is our number one program, and we only sent it to one place.

Milo: Yeah. I think on my end, I thought it was important to send that kind of final you're my top school love letter. Towards the beginning of the interview trail, I did send schools kind of thank you letters detailing some of the things that stuck out to me about their school and some of the things that I liked about their program. That kind of fell off around the middle of the interview trail. And actually, a number of schools just outright said like, "Don't do it. It fills our inboxes. We probably won't read them. Save everyone some time."

Dr. Chan: Unless you have a really catchy header line, we're not going to open this.

Milo: Yeah. That said, there were some that . . . I think there was one that actually it sounded like they really wanted us to send a thank you letter on the neurology side. So I definitely sent emails for those.

Nisha: Yeah. And I think almost all of the internal medicine programs on the day said, "You don't need to send thank you cards to your interviews or to the main program. We're happy that you're here. We know that you're happy that you're here. Please don't send us anything," which I think is different as compared to some other specialties. So that was probably pretty specialty-specific.

Dr. Chan: And when you started looking at your list and you started finalizing it's, like, was the number one choice for both of you pretty crystal clear, or is there some horse-trading negotiation? How did you work that out as a couple, because, like, I get the sense from both of you, your applications were very similar and very competitive, but again, my experience with couples match, you know, it's like all things as you navigate in life, there's trade-offs and there's accommodations and there's and yeah. So a lot of people kind of try to figure out . . . like compromise. The word I'm trying to use is compromise. So, yeah, how did you guys do that? Or was that even an issue for both of you?

Milo: It was an issue. There were some trade-offs for sure. So, actually, I had wanted to just stay at Utah. My family is actually right in Holladay. And I really hadn't seen them. They moved after I graduated from high school, and I hadn't really had a chance outside of med school to, like, be near them and close to them. And so I figured like Utah's a great school, I know the neurology faculty, and I love working with them and my family's here. So I had actually wanted to just stay in Utah. And Nisha said, you know, like, "Let's be a little adventurous. This is our one chance to, like, go out, gain other skills and then maybe come back here after that." And so our compromise ended up being we would each choose our top non-Utah school, put those at one and two, and then put Utah third. And that's what we ended up doing. There was a little bit . . . and then we both got kind of our choice in the top three.

Nisha: Yeah. And I was, you know, really appreciative of Milo's willingness to compromise on this one. And, you know, I think we were also lucky though that our top programs, the ones that we had liked the most were similar. So, but I will say even within that, I mean, there were several programs that we both really, really liked, and there wasn't like a clear number one for us. And I think when we were getting ready for interview season, a lot of people made it sound like, oh, they went to this one program, and they just loved it and they knew it was the program for them and it stood out above all the rest. And we had a lot of programs that we really liked. And so we also did do some, a lot of talking and kind of compromising on how we were going to order those as well. And geography did play some of a role in that, but then so did cost of living and other things that were kind of our future goals.

Milo: Yeah. I think Nisha brought up a really good point. Other students, I heard say like, "I went to this place and it was the one for me." And actually, at the resident dinners, that was an answer a lot of the residents gave us too when you ask them like, "Hey, what made you choose here?" They said like, "I just knew it was the one." And I don't think either of us had that feeling about any one school.

Nisha: Yeah. There's a lot of good programs.

Dr. Chan: There's a lot of excellent programs. And now, I'm going to kind of turn to something before you tell us where you matched because it's kind of pertinent to what's going on. Like, what rotations were you on when, like, when COVID started happening, and how was that communicated to you and kind of like the emotions of, you know, I graduate soon, match is supposed to happen. Like, what were you doing at that time and how was that?

Milo: Yeah. I had just finished my core sub-I on cardiology, and I had a planned two-week break to go be at my brother's wedding and he just snuck it in actually. We got back from the wedding, and like three days later everything shut down, and we were told the classes wouldn't happen and no more, no more clinical clerkships or anything. So I just remember . . . I actually did not think it was going to be that big of a deal to be honest. And my brother-in-law, he's a surgeon, and I saw him at the wedding and we were talking about it and we're both kind of like, "Yeah, you know, it's concerning and definitely something to keep an eye on, but in terms of, like, large-scale impact, maybe not." And then like half a week later, I talked to him again, and we were both like, "Wow, we got that wrong." And it was just weird. It's surreal. And honestly, it's still a little bit surreal. Having gone from a really busy sub-I being in the hospital to just being at home and trying to stay away from everyone and figure out what to do with my time, it's a big change. And the whole experience has just been surreal.

Nisha: Yeah. I was on radiology, and it was kind of confusing for a couple of days in terms of what was actually going to happen because we were about halfway done with the rotation. So, you know, we weren't sure if we were going to have to come into the hospital because we weren't seeing patients, or whether it was going to transition to online. But I thought the school handled it very well, and we were, you know, given updates really regularly. So, you know, that helped eliminate some of those questions.

One of the things that I think was harder was that Milo and I had both planned for our advanced internal medicine rotation to be our very last rotation, because we wanted that to help us get prepared for intern year, and that was done mostly online, which was still a good experience and we still learned a lot, but that also kind of shifted some of the plans that we had or in terms of getting ready for internship.

Dr. Chan: How did it feel, Nisha and Milo, to have, you know, the realization that Match Day because like Match Day is traditionally like, I call it the Super Bowl. Like, you've worked so hard for so long to get to this point, and it's you bring together your loved ones, your family members, and it's a huge celebration and, you know, I know the Dean's office, we mourned that we couldn't offer that to you. What was your feeling? Like, did you go through, like, the five stages of like anger, grief? Like, how did . . . when you realized that you would not have a "normal Match Day" or it was it not that big deal to you? I mean, I'm just curious.

Nisha: I wasn't that . . . I mean, I was excited for Match Day, but I had never been to a previous Match Day before. So I also think because some of my friends who had been to the previous Match Days were a lot more upset about it than I was. I was actually really, really sad about graduation. That was the thing I was looking forward to the most. And I think, in my mind, I was kind of hoping like, "Hey, if we do really good quarantine and, you know, maybe we miss Match Day, but maybe this will be over by graduation," which, obviously, was very wishful thinking on my part. But yeah, for me, Match Day was not as bad as missing graduation was.

Milo: Nisha and I were flip-flopped there. I was really looking forward to Match Day and, you know, graduation as well I think maybe to a lesser extent. I really wanted to be with friends and family and open the letter and see where I was going, and just have it be a big thing with everyone around, and I thought that would be a lot of fun. And obviously, you know, it's sad that it's not happening, but luckily, we've still been able to have contact with family, and all the Zoom meetings and virtual meetings have made it still possible to see friends and peers. And so there's alternatives even if they're not quite as good.

Nisha: And I think some of the, you know, Zoom alternatives that we've figured out how to do with family and friends has actually been a really good experience, because when we leave for our residency, we kind of already have some things in place about how to keep in touch with our family that I think had this not happened, would have been, you know, more difficult to implement.

Milo: That's definitely true.

Dr. Chan: And so how did you celebrate Match Day virtually with the med school or with your families? Or how did you do that, and where did you end up matching to?

Milo: Yeah. So Match Day, we spent with our aforementioned best friend that we studied with. We went over and had brunch with her and her partner, and we all opened our match emails together and then kind of video conferenced with our families all at the same time.

Nisha: Yeah. Our program, and I'll just say we both matched to the Yale. Our program had, I think, sent out, like, an automated email saying, you know, "Oh, this is like your new Yale email," about an hour before the official match results came out.

Dr. Chan: Uh-oh, it sounds like a violation. No, I'm kidding.

Nisha: So we knew kind of where we were going. At that point, we weren't sure if it was real or not real, or if it was like a spam or something. But yeah, that ended up being where we matched at. So that was kind of a spoiler for us, but it was also kind of fun because we asked, you know, our family where they thought that we would match on our list. So that was kind of cool.

Dr. Chan: So where did you match to?

Nisha: Yale.

Dr. Chan: Where? One more time.

Nisha: Yale.

Milo: Yale.

Dr. Chan: You got to say, you got to love it. Ivy League. Whoo. So sell me about Yale. What was great about Yale's program?

Milo: Yeah. So I really loved the people there. I met with the . . . so the program director there was just fantastic. By the time I got around to Yale, it was kind of further in the interview season, and the one-hour program director meetings at the beginning, I just felt like they never really said much, but his was fantastic. He just had such a good grasp on what was important to residents and what people had on their mind in terms of choosing where to go. And he had this really cerebral way of talking about that and then provided very concrete ways of like, "Here's what we're doing or have already done in order to address these issues." So it was very clear that he had his finger very well on the pulse of the residents there and their concerns. And he was just a very thoughtful person.

And then there was a doctor that I interviewed with who was doing almost exactly the same stuff that I foresee myself doing, a lot of medical education, ended up getting his masters after residency during his fellowship. And he kind of said, "Hey, I actually requested to interview you because it seems like we had a lot of the same interests and I would love to mentor you." And he just really pulled me in. And actually, come to find out he is the nephew of Nisha's parents' next-door neighbor and they live in, like, a small Idaho town. So just crazy coincidence.

Dr. Chan: Wow.

Milo: But both him and the program director were just so accessible and eager to jump in and help, and they had some really good medical education opportunities as well.

Nisha: Yeah. You know, I felt like the people there were, you know, very nice and very friendly and very passionate about the things that they were doing, which came out a lot in the interviews. And I, you know, really wanted to go somewhere where people were really excited about the work that they were doing and were willing to involve residents in that work. And, you know, one of the things that really stood out to me was that the program director talked to all of the applicants individually, and he, you know, he knew, like, all of our names and he knew facts about us from our applications, which for as many applicants as he sees I'm sure in a week was really, it stood out to me in terms of, like, how much they care about the people that are coming to their program and are interested in knowing them as individuals.

And, you know, they also had a lot of focus on resident wellness, which I appreciated, and their noon conference education just really kind of blew me away in terms of the way that they talked about the cases that they were looking at and, you know, how they approach testing and diagnosis and how they use the cases, like this is how we've changed our policies because of this. Then, you know, really tried to focus on how to, you know, do medicine in a more efficient, evidence-based way. And I really appreciated that as well. So it was somewhere I knew the people were awesome, and I would also get, you know, a really good education and things that were important to me.

Dr. Chan: Nisha, wow, this has been great. And I guess this last question, and it's more kind of a personal question in just what you're going through, but, you know, from our standpoint, from the Dean's office, this class is very unique for many ways because, you know, you're kind of more or less the COVID generation, and you're about to start your medical careers and to be quite honestly, in an area of the country where there's a lot of COVID cases. And I'm just curious like, how are you feeling internally, like how's Yale kind of like, you know, the onboarding? I'm sure that you've gotten a bajillion emails about this, and in the midst of this, all you're supposed to be doing all the normal residency stuff and finding a place to live and all that. Like, what does this mean to you? Like, how does it feel to just know that you're uniquely positioned to start your residency program in the Northeast, right in the middle of a COVID pandemic?

Milo: Well, there's a lot of emotions. I will say that I am actually kind of itching to get back into the hospital. I think having been taken away from it since mid-March, I'm pretty eager to go back and get back to what I signed up for and what I really want to do. But there are a lot of concerns surrounding COVID. And like you said, Yale borders New York pretty closely. It's just a few hours away. So they're kind of right in the epicenter. All of the messages we've got from them are encouraging in terms of they have protective equipment. They've been incredibly supportive and very accessible in terms of asking or answering questions we have. But yeah, there's a lot going on. It's a big transition to go across the country. It's a big transition just to start up internship in general and trying to find housing and get all the paperwork done for a new program. It's a lot going on, but I think we're trying to take, take it as it comes. And I think once I get out there, I'm excited to dig in and get started.

Nisha: Yeah. I'm also excited to get back into the hospital and back into seeing patients. And the program has been really good about, you know, keeping us aware of what's going on and what things are going to be like when we get there. And a lot of, you know, they send a lot of emails that are like have positive quotes or say, you know, like good things that are happening in the hospital. And it's clear that they're really trying to, you know, keep residents as well as possible, and, you know, focus on taking care of each other as well as taking care of patients. And I think that has alleviated some of my concerns as well about that we're going into an environment that is very, very stressful, but to a program in a place that is trying to make it, you know, as safe and as well as possible for the residents.

Dr. Chan: Well, I'm just really proud of both you, and you're just a great example and I'm excited for you and kind of anxious for you too, but I think that's normal.

Milo: Yeah.

Dr. Chan: As you kind of launch into this new part of your career and journey to becoming full-fledged attendings, you're going to be MDs very soon, which is kind of crazy when you think about, you know, you're going to have doctor, MD as the new name, but, you know, I just want to thank you for coming on the podcast and just kind of talking about what you've gone through. I think it's important to kind of explore it, and like I know there are people out there that are listening that will really benefit from it.

Milo: It was a pleasure, Dr. Chan. Thank you so much for having us.

Nisha: Yeah. Thank you. We're really excited as well.

Dr. Chan: All right. Well, you guys take care and maybe we'll catch up in a couple of years and maybe have you come back on the pod and hear how it's going out in Yale. Being a Yalie, is that the right term? Do you automatically now just hate Harvard, and, you know, you officially kind of adopted the blue, but become a bulldog as it were? I don't know. Yeah. So we'll have to have you come back on the pod in a couple of years. All right?

Milo: That sounds fantastic.

Nisha: All right. That's awesome. Thank you.

Milo: Thank you.

Dr. Chan: All right. Take care, Nisha. Take care, Milo. Bye-bye.

Nisha: And you too.

Milo: You too. Bye.

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: How does an architecture internship in China make one decide to change gears and pursue medicine? What are some ways to survive and thrive during your post-bacc studies? Why is workplace culture such an important question to ask during residency program interviews? Today on "Talking Admissions and Med Student Life" I interview Lily, a fourth-year medical student 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: Well, welcome to another edition of "Talking Admissions and Med Student Life." Lily, we have been circling each other for years, and finally we are going to do this podcast. Maybe we'll do a couple more before you leave.

Lily: This is true.

Dr. Chan: All right, fourth-year med student.

Lily: Yes. Thank goodness.

Dr. Chan: And we're not going to talk about what you're going into. You were going to do a reveal.

Lily: Okay.

Dr. Chan: Let's go back to the beginning.

Lily: Okay. Yeah.

Dr. Chan: All right.

Lily: I know exactly where the beginning was and I think about it often.

Dr. Chan: You popped up on my radar. I remember you interviewed with us and you were so just full of life and energy. I remember studying your application. I remember I told myself, "There's no way that we're going to get someone like Lily to come to our med school."

Lily: Aw, keep talking.

Dr. Chan: But I remember that you were just so positive, and then I think you sent me a nice note afterwards. Then I remember you got in and I called you on the phone.

Lily: Which I remember distinctly. Yep.

Dr. Chan: It was windy, and I think you were on a golf course.

Lily: No, no, no, no, no. You're exactly right, it was windy though. I remember, to this day, I remember the exact moment. It was at Norman North High School in Norman, Oklahoma where I was doing some teaching. I distinctly remember walking through, I think it was January or so. I was walking through the halls and I picked up my phone, and I noticed a missed call from Salt Lake City. I ran outside, hence, where it's windy, on the plains of Oklahoma.

Dr. Chan: Okay, yes. Hurricanes sometimes. Tornadoes.

Lily: Yes, it will blow you away. And it was Dr. Chan. One of the best days of my life.

Dr. Chan: And you were so effusive with praise on the phone. I remember, sometimes when I call people they're like, "Eh." You know, especially people who are not from Utah.

Lily: No, no. Not me.

Dr. Chan: I know that our tuition, I get all of that. I just remember you were so positive. I went, "I think she might actually come here."

Lily: That's because I was truly, and to this day, I was so excited to come here. I'd been waiting and hoping. And it happened. You made it happen.

Dr. Chan: So let's back up.

Lily: Thanks, Dr. Chan.

Dr. Chan: So you grew up in Oklahoma.

Lily: I grew up in Oklahoma. I was born in D.C.

Dr. Chan: Born in D.C.

Lily: Grew up in Oklahoma though. Formative years we'll call it.

Dr. Chan: And then when did you decide to become a doctor? Help people understand that. You have sort of a non-traditional path.

Lily: Yeah, no. Absolutely. Also, I should mention that I just returned from several weeks of residency interviews. It feels better telling you this. The story of like, "Where did you go? Where did you come from?" I like this. I got similar questions, but I like telling you about it. Great question because I do have this kind of meandering path. I decided to go to medical school essentially at the end of my undergraduate time. It seems like, it looks like it was kind of random. However, it wasn't. I had just, to be honest, multiple things that I was interested in from an early age. Science was one of them. I went to Yale for undergrad.

Dr. Chan: Where'd you go?

Lily: I went to Yale.

Dr. Chan: Yale. Okay, okay. I've heard of this.

Lily: Go Bulldogs.

Dr. Chan: Small liberal arts college . . .

Lily: Small liberal arts school in New Haven, Connecticut.

Dr. Chan: Yes, okay.

Lily: It was a wonderful place though. It was a huge privilege to be able to go there. That was also quite random. I had my parents, you know, they went to school in Oklahoma. My dad went to the Air Force Academy. I had no family connections there. Fortunately I just had parents who, the prevailing theme throughout our life was, you know, pursuing educational opportunities. So I ended up out at Yale. And, quite frankly, what Yale does very well is the humanities, liberal arts, the arts themselves, and the most extraordinary libraries in the world. I'm biased but, you know, Sterling Library and Beinecke Rare Manuscripts Library, Manuscripts and Archives. I spent quite literally hundreds of hours in those places as an undergrad and absolutely loved it.

Dr. Chan: What was your degree in?

Lily: It was in American Studies.

Dr. Chan: Oh, okay.

Lily: Not many places have a degree in American Studies, so people are unfamiliar. But it is . . .

Dr. Chan: So it's kind of Political Science, American History . . .

Lily: Yeah, it's American History, kind of, with a social and cultural context. I did, though . . . Yale didn't have minors, but I did have areas of focus in architecture and sculpture. So I actually thought I was going to go to architecture school as an undergraduate. To get back to your original question of, you know, "Why medicine?" Or, "When did you decide to go to medical school?" I basically, the summer before my senior year of college, I distinctly remember the exact moment. I was sitting in an architecture studio in Beijing, China. Wonderful experience. I have nothing bad to say about architecture. I love design, and it's a wonderful way to spend a life, a career. But I love working with people. I love the substrate of the work of people and medicine. I did have a previous, you know, love and appreciation for the sciences as well. Medicine seemed like that that was going to better fulfill that interest. So honestly in that moment, I even remember sending my mother an email of all things, and I said, "I'm going to go to medical school." At that time, you know, I had spent my undergraduate years essentially just having interesting, fun discussions with people and arguments and debates, and writing hundreds of pages of essays. So I certainly was not in a position to apply then.

Dr. Chan: It was out of the blue.

Lily: Yeah.

Dr. Chan: You don't come from a gap background.

Lily: Completely out of the blue.

Dr. Chan: No background in medicine, no doctors in the family.

Lily: No one in my family is in medicine. Nope, not at all. So in some ways it was just very spontaneous in that sense. So began the interval quest to get into med school, which were some very difficult years.

Dr. Chan: So you just, I think you did a post-bacc program.

Lily: Yeah, I did.

Dr. Chan: All right, so how did you identify the post-bacc program?

Lily: I applied to all the ones available. I was on the East Coast. I was in Baltimore for a post-bacc program. It was probably, that was, I think, the most difficult year of my life. And I mean that honestly. As all pre-meds know, the prerequisites are quite difficult. Do them all at once, it makes it much more difficult.

Dr. Chan: So this was solely, kind of an academic post-bacc? No research, no community service?

Lily: Solely an academic post-bacc. There was research involved, but, you know, it's kind of at your discretion what you can do. And I did get involved in research and a couple projects. This was at Johns Hopkins, you know, an extraordinary place to just kind of cold call or cold email people and say, "Hey, I want to get involved." And I did that and took a bunch of classes all at once, which I don't recommend. But it was kind of a kickstart you could say to getting down the med school application path.

Dr. Chan: I get the sense, because I know we've talked about this in the past, Lily. But I get the sense that this experience wasn't the most overly reassuring path to go to medical school.

Lily: Oh, no. Yeah. Exactly, yeah.

Dr. Chan: It sounds like it was, like, stressful, super competitive on some level.

Lily: Yeah. Well, I tell people, like you said, we've talked about this before. I think things have changed even in the last, and I'm no expert of course, just my personal perspective. I think even in the last five to eight years things have changed about how, not only how you can pursue a post-bacc and how you can take classes to get into med school, and get into med school, and how you can spend your undergraduate years. But I think there are other ways that people, better, more efficient ways of getting into med school. Like, you don't have to do a post-bacc. And when I say, "Don't have to do a post-bacc," I mean, like, a formal program.

Dr. Chan: Yeah, but you still can take the classes on your own . . . yeah.

Lily: Yeah, you can still take the classes, and I highly recommend that. I actually did end up taking a few extra classes after my time in Baltimore, back in Oklahoma. And it was great because I had time to do research and I was doing some teaching. But yeah, I mean, it was a wonderful time in my life, but it was a very difficult time, because, as you said, you know, complete uncertainty if things were going to work out, which is very . . . a little bit scary.

Dr. Chan: So I get the sense the plan was you do your post-bacc, do all the pre-med reqs, and then did you take, did you study the MCAT at that time?

Lily: I didn't take it the same year.

Dr. Chan: Okay.

Lily: Which some people do do, which I respect that, but it's a lot.

Dr. Chan: It's a lot.

Lily: Yeah. It's a lot.

Dr. Chan: So then the plan was you move back to Oklahoma. You just went ahead and taught high school.

Lily: Yeah.

Dr. Chan: And then you took the MCAT.

Lily: Yeah, exactly. Exactly.

Dr. Chan: Okay.

Lily: So I tried to be a little more sane throughout the process.

Dr. Chan: Okay, all right.

Lily: Well, and I should say too, like I said, I come from this Humanities background. I will advocate for myself and say I'm a smart student. However, I was never someone who was good at multiple choice exams. To be honest, that was the biggest deterrent to potentially going to medical school. And actually just the prerequisites themselves is, I mean, every class whether it's an intro course or advanced level, all it is is multiple choice exams and testing. I did decide, though, I just made this decision that I wasn't going to let it be the deterrent ultimately. But because of that, you know, I just completely had to change how I, you know, studied and it wasn't always rosy. There were some pretty awful times.

Dr. Chan: I bet you were an amazing high school teacher.

Lily: Thank you.

Dr. Chan: Did you ever have, like, "Oh, you know, maybe I should stick around and do this"?

Lily: Oh, yeah. And they actually offered me the full-time math teacher job.

Dr. Chan: Oh, fun.

Lily: Because I was, I did love it. You know, it's funny. Every job I've ever had actually . . . actually, my first job, I don't know if I've told you this before, the first job I ever had was for a minor league baseball team . . .

Dr. Chan: Oh, I didn't know this.

Lily: Yeah, in Tulsa, Oklahoma. I was the person who did the on-field promotional things.

Dr. Chan: So you didn't have to wear a costume.

Lily: I had the option but never got the opportunity, which is upsetting.

Dr. Chan: Is it the Tulsa Tornadoes?

Lily: No, the Drillers.

Dr. Chan: Oh, okay.

Lily: Like oil drillers. I had the opportunity to wear the hot dog costume once, you know, in the race.

Dr. Chan: Oh, do the race?

Lily: Yeah, but unfortunately one of my colleagues got there first. No, but . . . okay, so that was my first job. But what I was going to say is that every job I've ever had in my life has been related to academia essentially. And I mean that in the full spectrum of things from a camp counselor, math and science, teaching, like, space camp stuff, to being a TA in the biology department at the University of Oklahoma, to assistant teaching kind of in this tutoring program for Native American students in Oklahoma, science and math. I mean truly every job I've ever had has been in education. And that's not to, and I'm leaving out, you know, not to mention the other research work I've done. So I guess the point is though is that's why medicine was so attractive to me and why even now it's been validated that I love this environment. It's a continuous learning and teaching environment. So it fits though that I have this teaching career and here we are.

Dr. Chan: I think at the core, like, you know, what is medicine? You have the awesome responsibility that you've learned a lot about the human body.

Lily: Yeah.

Dr. Chan: Medicine, procedures, and you get to educate.

Lily: Exactly, yeah.

Dr. Chan: Teach your patients why you're doing x, y, or z.

Lily: Yeah, well . . .

Dr. Chan: To me that's kind of the ethos of medical care.

Lily: Yeah, it is. You know, I don't think, I didn't even fully appreciate that though before medical school and before, even now, several years deep into it. You know, you teach your patients obviously, as you mentioned. You also teach each other. I mean, I remember, you know, the first couple of days even of my third year clerkships and, you know, you're expected all of a sudden, you just immediately have to start presenting. And I didn't even quite understand what they meant, but, you know. "Okay, Lily, you're going to do a presentation on Friday for, you know, before rounds." That's how we learn in medicine. I mean, that's, you learn these snippets and these chunks because that's what you have time for. But it's just constant, you know, education for each other. So it's a lot of fun in that regard.

Dr. Chan: So going back to Oklahoma.

Lily: Uh-huh. Have you ever been there?

Dr. Chan: Yes, lovely airport.

Lily: [inaudible 00:12:44] say now. It's actually quite nice.

Dr. Chan: Actually I didn't venture outside. It was a connecting flight.

Lily: Okay, all right.

Dr. Chan: So you said Oklahoma.

Lily: Was it Oklahoma City or Tulsa?

Dr. Chan: I'm pretty sure it was OKC.

Lily: Oh man. Okay. I can't even remember. Jeez. I'll forgive you.

Dr. Chan: All right, so what was your strategy applying to med schools?

Lily: Yeah.

Dr. Chan: You've been to Yale. You've been to Johnny Hopkins.

Lily: Yes.

Dr. Chan: You've lived on the East Coast. You've lived in the Midwest South. What's Oklahoma consider itself?

Lily: I call it the Southern Plains.

Dr. Chan: The Southern Plains.

Lily: It's not the South. It's not the Midwest. It's certainly not the Rockies or the West.

Dr. Chan: So you've grown up there. You've lived there. You're living there back then.

Lily: Yeah.

Dr. Chan: What was your strategy applying to schools?

Lily: Yeah, so quite honestly I applied all over. However, in the back of my mind though I did have ideas of where I wanted to be and specific reasons why. So, as we've talked about, I went to, I had this private, liberal arts, smaller school education. I really did go into the application process with the idea that I should have a broad background of educational experiences. So I specifically was looking for a large state medical school and state university. This is, you know, this could probably also apply to, you know, some other private medical school. But I just do believe that state flagship universities are, I think they're awesome places to be that are exciting. The collaboration of, you know, different schools within the institution as well as undergrad institution. They're just fun places to be. And like I said, I love the university environment.

To be honest, Utah specifically, and I'm not making this up just to humor you. I distinctly remember being in Baltimore. This was like six, seven years ago. So even a couple years before I was eligible to apply to med school. And I distinctly remember going on the Utah website. I can't remember what it was specifically, but I thought to myself, "This is a place where exciting things are happening." I just truly remember that moment, and it's the absolute truth. It's been validated over the last, you know, four years. We've got buildings popping up everywhere, so many different initiatives. And it just also seemed like a unique place in the sense that . . . I'm trying to sell it for you here.

Dr. Chan: Thank you, appreciate it.

Lily: But I truly, thoroughly believe this. It's been reinforced to me even now, having traveled around the country the last couple weeks for residency interviews, we have a very unique situation out here. You know, we're the only university medical center for hundreds and hundreds of miles.

Dr. Chan: Intermountain West. It's kind of core . . .

Lily: Yeah, five states. Five states, yeah.

Dr. Chan: This side of the Rockies, yeah.

Lily: So, like, we are the place. We're responsible. I think there's, for even that reason alone makes it incredibly unique and exciting. You know, you want an expert in something, they have to come here. You know, I've worked on the ICU a couple months ago and it's on a higher floor of the hospital right next to the helicopter landing pad. And the helicopters are just constantly, constantly coming in and out.

Dr. Chan: Come in and out all the time.

Lily: Yeah, it's really amazing.

Dr. Chan: So you meet patients from, like, Colorado, Montana, Wyoming?

Lily: Yeah, absolutely. You learn how far it takes, you know, for them to drive home and, you know, you're trying to negotiate that. This is definitely no Manhattan where there's five . . .

Dr. Chan: It's not an Uber ride away.

Lily: It's not an Uber right away. Yeah.

Dr. Chan: You interviewed at all these programs. I know you got into a number of them.

Lily: Yep.

Dr. Chan: So walk me through that history in the making. Was it hard? Was it easy? Were you undecided? Like, how did you end up making that decision?

Lily: You know, it was quite easy because I loved Utah. And I told you this before. I even knew it, I was waiting on it. I told you I was waiting on it, that phone call. So, like, when you called me, I knew I was coming here.

Dr. Chan: Correct.

Lily: I just immediately got rid of my other invitations and I said I was coming out here.

Dr. Chan: Even at your home school?

Lily: Even at my home school, yeah. I did. That was an option. I have all due respect for, you know, my home state institution. You know, and I have to say it is a privilege to have traveled around the country and go to these different places. You know, certainly one's home med school is a wonderful option. Wherever, any med school is a wonderful option, especially these days it's so competitive. You know, there's so many more incredible applicants, you know, for every spot.

Dr. Chan: Yeah, more and more people applying. Yeah.

Lily: So really anywhere you can get into. But fortunately I did have some choices. But I wanted to come here. It felt right, yeah.

Dr. Chan: All right, so you get here, you come here.

Lily: Yeah.

Dr. Chan: And then you find out you're in my CMC group.

Lily: Exactly.

Dr. Chan: What was your first reaction?

Lily: We should have, we should . . . you know what's funny? I even remember where I was when I got that email.

Dr. Chan: It was randomly assigned. I had no part in it. I remember clearly the day they sent me the list of students assigned to my group. I saw your name and went, "Oh, yes." I just got Lily.

Lily: Oh, yes. Well, I'm glad it was that reaction and not one of grief or mourning. It's funny, I remember the moment too because I was actually visiting the state capitol here. I was kind of doing my, you know, welcome to Salt Lake little tour.

Dr. Chan: By visiting the capitol.

Lily: Exactly, yeah. Hey, hey, it's a beautiful view.

Dr. Chan: It's very . . . people from outside the state. But then did you also go by the Great Salt Lake?

Lily: Oh, I've been there.

Dr. Chan: It's also, like, kind of a touristy thing that . . .

Lily: I was there just two weeks ago.

Dr. Chan: . . . that people from Utah usually don't do.

Lily: Hey, now.

Dr. Chan: But for other people it's kind of, "Oh." Because it's really stinky out there.

Lily: There's some bugs. But, no, it's beautiful. There's buffalo.

Dr. Chan: It is beautiful.

Lily: Maybe I was just looking for the buffalo to feel at home like Oklahoma.

Dr. Chan: Is that Antelope Island?

Lily: Yes, exactly.

Dr. Chan: Oh, okay. I mean most people go out to, like, Saltair and kind of approach the Salt Lake from that . . .

Lily: Oh, oh, I see. Not that way.

Dr. Chan: All right, so you were at the state capitol?

Lily: Okay, yeah, so anyhow, I just remember reading that email that I was in Dr. Chan's group. So CMC is the Clinical Methods Curriculum. So I should have, we probably could've told the listeners at the beginning of this that I have had the fortune of spending four hours a week, like scheduled time.

Dr. Chan: Many hours together.

Lily: A week for the first thing of two years of med school in addition to, you know, other interactions.

Dr. Chan: Do you know they're making CMC more longitudinal now?

Lily: I did actually. I did.

Dr. Chan: And it makes them really angry but I have my Brighton 3.0 group. So you're my second group.

Lily: MS3?

Dr. Chan: Yeah, and we'll be, they'll be getting together throughout the third and fourth year.

Lily: Oh, gosh. How do you feel about that?

Dr. Chan: Well, I love it. I feel bad because I've spent so much time with you guys the first two years. And then, like, then it's nothing.

Lily: Yeah, that is true.

Dr. Chan: And just the occasional random pop-in.

Lily: Yeah.

Dr. Chan: So it sounds like, you know, just kind of check-ins.

Lily: Yeah, I think that's great. Yeah, so we meet so in a structured fashion for the first two years, and then, I guess, because we're not part of that new initiative that I just didn't get to see you anymore.

Dr. Chan: No, no, no. I saw you around. People talk about the [locals 00:19:35].

Lily: Yeah, I see Dr. Chan all the time because I . . . but, okay, anyhow.

Dr. Chan: Okay.

Lily: So CMC. I was in CMC with you. I think there were two wonderful years. So we learned how to basically, like, actually how to doctor.

Dr. Chan: Yeah, physical exam, progress note, interviewing, yeah.

Lily: All the things you want to know on the first day of, you know, MS3 . . .

Dr. Chan: Oral presentations.

Lily: Oh, yes.

Dr. Chan: This is all the stuff that really helps in third year.

Lily: Yeah.

Dr. Chan: Yeah, medical education is weird because, like, CMC is, like, super important.

Lily: Yeah.

Dr. Chan: But it's not . . .

Lily: I would argue it's the most important in many ways.

Dr. Chan: It's not as self-evident because people during their first two years are really focused on class work and step one.

Lily: Yeah, exactly.

Dr. Chan: But then everything pivots for third year. Then I think people start to realize that, "Oh, this is why CMC's so important." That's kind of, like, the knowledge you'll need for third year.

Lily: Exactly. Well, and I have, you know, I think one . . . so my background obviously a little bit broad in the academic sense, you know, lots of thinking and discussing and presenting. And I don't think it's so underappreciated now, but I do believe those skills, like, obviously one has to have a kind of a baseline ability in the sciences. But, you know, at the end of the day it really is how you're able to interact with people.

And CMC, this course, like we just said, reinforcing that presenting, learning how to present patients, but learning how to just speak in front of other people and make a concise argument and present your facts. Like, that is medicine, at least very much in the early years. That is so much of medicine. I mean, you do have to have knowledge of course of, you know, what your differential is. You know, the supporting signs and symptoms for it, which comes from, you know, the science years. But the clinical method, it's like, this is medicine. This is medicine in a nutshell. So I actually thanked you. So you're a psychiatrist. So we had a unique situation, I think.

Dr. Chan: Yes, yes.

Lily: Which I loved.

Dr. Chan: Yeah, you guys were very open about that. I remember that.

Lily: Yeah, because you've got, you know, like a pulmonologist and a neurologist.

Dr. Chan: Yeah, family practice docs.

Lily: Family practice docs.

Dr. Chan: Internists.

Lily: Yeah, so they're just, you know, loving the knee exam, but I really think, you know, we did fulfill that just fine. But I do think that you were a unique resource in that. You know, we're asking, learning how to ask difficult questions and have difficult conversations. And, like, that right there is medicine in a nutshell. It truly is. So I think it was a great experience. I was lucky to have you.

Dr. Chan: Oh, Lily, I love it. All right, I'm turning red. Okay.

Lily: There you go.

Dr. Chan: Next career choice. Okay, for the first two years every time I would officially or unofficially ask you, neurosurgery. Brain surgery, brain surgery, brain surgery.

Lily: I was very subtle though. I was never in your face. I'm very introverted . . .

Dr. Chan: No, no, no. I'd never say you were in my face, but you were, I felt pretty committed, you know, very beginning.

Lily: Yeah.

Dr. Chan: And I know you did research . . .

Lily: I did, yeah.

Dr. Chan: . . . in neurosurgery. I know you were shadowing a neurosurgeon.

Lily: I did a ton of research.

Dr. Chan: Help us understand, like, how much did third year kind of play into that? Like, the evolution of your career choice.

Lily: Yeah, great question. So I think like all, you know, med students are kind of decision path. You know, pre-meds, people have an idea of what they want to do. And even in med school, even, you know, late into third year of med school people, you know, they adjust their choices. It is true. So I, in that intervening period between undergrad and med school, I did do a significant amount of neurosurgery research. A lot of that essentially had to do with the fact that I, you know, just reached out for an opportunity, and, you know, one of the first people who responded was this neurosurgeon. And I'm deeply grateful for that experience and was fortunate to do quite a bit of research in that area.

I did continue it in the early part of med school here with a wonderful neurosurgeon up here. And, you know, I think the overwhelming theme of, kind of, my interests is that I always loved surgery. The neurosurgery part came into the fact that I was always searching for something that, quite frankly, was just kind of interesting technologically or, you know, the patients. And I still, like, regard it in that way. However, I think what I, over the course of third year, I recognized that the way I want to, the rhythm of the way I wanted to practice medicine, the people I wanted to take care of, how I wanted to spend my days, it just, like, that wasn't the best option and it wasn't congruent with that. So the big reveal, so I'm doing OB/GYN. That's the plan at least. I just absolutely fell in love with the specialty when I was on this rotation.

Dr. Chan: So where was OB in your . . . was it, like, in the middle, the end, the beginning?

Lily: No, it was actually near the beginning, which is, like, which is kind of funny. It was in the summer of my third year. So it was the very beginning. And then so I kept it in the back of my mind throughout all of third year. And also, too, the thing is, I loved everything I was doing. I mean, some people have the idea that they're going to be an orthopedic surgeon, you know, from high school or whatever. You know, I just, I knew I loved surgery, but to be honest I enjoyed every rotation. I love, you know, this is going to sound corny and clichÈ, but it's the truth, like, every time I get in a new clinical context I say, "This is fantastic."

I did love, in particular though, there is, here's another thing, a misconception. I think a lot of people think, you know, individuals go into OB/GYN because it's this, like, happy, easy context in which to work, which is the farthest thing from the truth. You know, these are people that I deeply admire, the people who are working in this field. They're dealing with very difficult situations. It's critical care essentially, but not just for one person but two people. It's, you know, you have these longitudinal relationships with patients and there's many, kind of, branches that you can, areas in which you can practice from, kind of, the general area. So I've done a significant amount of work in multiple rotations in GYN oncology for example. Another, like, fantastic area where there are these totally badass surgeons, but they're also, you know, doing chemotherapy. So I just, I loved the opportunities that, you know, that it offered.

Dr. Chan: Was it more the OB or the GYN part?

Lily: Oh, it's both.

Dr. Chan: Because you do three weeks and three weeks, right?

Lily: So I think OB is what snags people. Because, I'm not kidding you, you can ask any of my classmates or frankly any med student around the country, and labor and delivery will have been one of their favorite, if not their favorite rotation. But then they just don't end up going into it. But it'll be, like, what they had the best time in. You know, and as people should. It's a lot of fun. Like, who doesn't love to, you know, literally catch a baby. I think too, I think the people in OB/GYN, I think they're, you can't often make generalizations in medicine and you shouldn't, but I think that they're decent people. You know, the residents here are fantastic and fun to work with. They're very smart. You know, I had the fortune of working with a chief resident here for two months on my sub-Is. Literally, I did two sub-Is here and she happened to be the chief on both of them. It was the best teaching I've had in all of my clinical years of med school.

Dr. Chan: That's great, yeah.

Lily: Yeah. And so I just, you know, all things considered, I thought this is the way, you know, I want to spend my life. And, you know, and not to be, you know, too clichÈ, but I do think that there is some really redeeming aspects to it as well. You know, you help . . . I think to also doing medicine, sorry I'm backtracking a little bit. I think if you're going to do medicine, these days in particular, I mean, it should always be this way, but I think these days now, I think there is an obligation to primary care. It's not to denigrate any other, you know, super specialty. And I think we should also have, you know, an obligation to society.

I say that in the sense that I wanted some area of medicine where, you know, I'm taking care of women, you know, who, you know, socioeconomically disadvantaged in whatever way, an OB, an OB/GYN is such a perfect way of an opportunity for that, of making the community a better place. And I really believe that, you know.

Surgery's wonderful, you know, neurosurgery's wonderful and they do amazing work. Obviously, all these specialties are essential. However, hopefully you can kind of see, like, my personality. You know, I love being around people and, you know, being involved in our community and, you know, our broader Salt Lake and Utah community. So it just seemed more appropriate. It's very, you know, socially-based, values-based advocacy. You're required to advocate for other people and I think that was why it just kind of fit together.

Dr. Chan: So you do begin at the beginning of summer. Did you still do a neurosurgery rotation year after a year?

Lily: No, I didn't. Yeah, I know, right?

Dr. Chan: All right. So, like, was it, like, an instantaneous conversion?

Lily: Yes.

Dr. Chan: Or did you kind of struggle? Did you make that decision end of third year? I mean, walk me through that.

Lily: It was, I just, it was in the back of my mind through all of third year. And I did my surgery rotation in the winter, actually it was this time last year. It was December/January and I loved it. I loved my surgery rotation. So I really at that time was evaluating the context in which I wanted to practice surgery, which I think is a very important distinction.

And of course, I don't know as much as, you know, there's other people who could speak to this much better, but this is just my personal, you know, decision making on this. Surgery is very different in different contexts. You know, the people are different, the patients are different, the way you treat your patients, how often you see them, you know, the rhythm of your OR days, how much you're in the OR is very different from subspecialty to subspecialty in surgery. And even in general surgery. Don't get me wrong, like the Whipple, like the pancreas, like it's extraordinary what they do, but I just cared a lot less for it than I did some other surgery procedures. And the same can be said, you know, for the pelvic organs. I'm sure other people would . . . Dr. Chan: You're very correct.

Lily: Talking to the psychiatrist here.

Dr. Chan: All right, so . . .

Lily: So anyhow, you know, it was towards, it was towards the end of third year but they do, you guys start making us make choices pretty quickly.

Dr. Chan: You say "they," it's the system. It's not "you" . . .

Lily: The system. I'm going to loop you into the system. I'm going to include you.

Dr. Chan: The medical education system. I did not move up the day for when residency applications were due.

Lily: Well, they make you start submitting your thoughts in we'll say January.

Dr. Chan: Everything's compressed. It's this endless cycle of applying.

Lily: Yeah, it is. But that means we're well-prepared.

Dr. Chan: Before we talk about that . . .

Lily: Yeah.

Dr. Chan: . . . during this time, you also decided to embark upon your political career.

Lily: I had to think for a second of what you were talking about.

Dr. Chan: So tell me, like, do the people recruit you? How did you become involved in student government? How did this played out?

Lily: Great question. So I am a Student Body Officer, which . . .

Dr. Chan: You're Student Body President.

Lily: I'm Student Body President, I know.

Dr. Chan: El Presidente.

Lily: I am, I am. I'm a Co-President with two other fantastic guys in my class, Brian and Scott. We have had a great time. So I hadn't been formally involved in, like, class presidency or in student class council up until this point, but I'd always been involved in, like, med school things.

Dr. Chan: Yeah, yeah, you were very involved.

Lily: Yeah. Like, I love being involved in the community.

Dr. Chan: Lily's on this committee. She's tackling this cause.

Lily: Exactly, yeah. Well, it's fun, you know? You know, like we've talked about, like, that is, you know what institutions, that's what we should be doing at an institution, especially in medicine. There's lots of quality improvement advocacy. So medicine is, like, perfect for that context of my personality. So, yes, so I did end up running for Student Body President. And, yes, it was kind of spontaneous. I by no means plotted a, you know, a well thought out campaign or anything like that. But this, the three of us just decided that this would be . . . you know, I met Scott in anatomy lab freshman year and Brian was also a good friend. You know, we had amongst the three of us, kind of had different backgrounds and personalities. We quite frankly thought to ourselves, "Let's just do this. It'll be fun."

Dr. Chan: So how, I mean . . .

Lily: We thought we represented the school well.

Dr. Chan: So to an outsider, like, what does it mean to be Student Body President of medical school?

Lily: Yeah.

Dr. Chan: Like, what kind of issues do you tackle? Like, what kind of initiatives do you drive? I mean, what's the job?

Lily: Yeah, great question. It is, you know, so there were some formal, like formal obligations. So we meet essentially once a month with the administration, the Dean's office for example. And during this meeting we have our Class Presidents. So there's two Class Presidents per class. And then in addition each class has, I believe it's five class committee members. Then amongst the committee members there's, kind of, different responsibilities with the Alumni Association, with, I'm trying to think of others . . . diversity in professionalism but, kind of, other subcategories. So we are, kind of, the . . . I don't want to use the word "hierarchy," but in terms of, like, oversight . . .

Dr. Chan: You're the leadership.

Lily: Yeah. We're in leadership and so we're kind of looking out for our Class Presidents who are looking out for their, you know, their Class Councils. So that's kind of the formal organization of it. We have some, you know, formal obligations, some of which are, you know, more frivolous than others. For example, like, we order the jackets for the School of Medicine, we plan school events. At the other end of the spectrum though we get involved, we're kind of like the first call you could say for, you know, communication with the Dean's office.

Dr. Chan: Yeah, student response. Student feedback. Student reactions to X.

Lily: Yeah, student response. Exactly, yeah. And there's a lot of that. So, you know, we're heavily involved in, you know, professionalism issues, providing input, getting students involved and forming committees, and, you know, acquiring feedback to present to the administration. You know, in matters related to curriculum or professionalism issues. So it's very broad. I'm trying to think of just the most recent issues that came up.

I mean, one of the more fun things we did recently was, you know, some anonymous person donated some money to support a family for Christmas here. So we kind of helped organize that. You know, this wasn't so much . . . this is the other issue too, explaining too, is that I have so many responsibilities on different committees that they intersect, yeah.

Dr. Chan: I know, it just, yeah. You look very serious right now because I can see you're running through all of them.

Lily: I'm trying to remember which ones are discretely SBO and . . .

Dr. Chan: So here's a process question. Like, you, Scott, and Brian represent the entire student body.

Lily: Mm-hmm, yeah. That's accurate.

Dr. Chan: For better or for worse.

Lily: Yeah. Hey, for better.

Dr. Chan: How . . . well, my next question, my follow-up question. So like, the administration, they have initiative or question or they want your take . . .

Lily: Yeah.

Dr. Chan: How do the three of you represent the entire student body? Do you, like, use Survey Monkey?

Lily: No, that's so 1999.

Dr. Chan: Do you use focus groups?

Lily: No.

Dr. Chan: Do you see what I'm saying? I think it's hard because, like, the student body, there's 500 people from all walks of life, different cultures, different backgrounds, different educations, some are more advanced in their training. I would argue that people who are a little further along in med school probably kind of see the bigger picture. So how do you do that?

Lily: Yeah, great question. And we're always, we're still figuring that out. Only six months in here. So I think, you know, going back to why we ran and how we selected ourselves. So the overwhelming, kind of, reason why we're, how we're able to do that is because, like I said, we come from different backgrounds. So I'm out of state, didn't even go, I'm not even from here. I have no family here, no connections. So, you know, I have, although we have many mutual friends and cross paths with different groups of people, classmates, I know different people, let's say, than Brian who went to BYU, he's from Utah.

Dr. Chan: From here.

Lily: Yeah. And so, like, he knows, you know, many, many people in the MS1 class that I just did not know because he went to undergraduate with them. You know, Scott, he went to the University of Utah. We all studied different things.

Dr. Chan: You did form a power ticket. I love it, yes.

Lily: There we go, yeah, exactly. You got to have that varied ticket though.

Dr. Chan: Yeah.

Lily: So I think that's the first thing, is that we recognize that, you know, we all know different people. Now, to answer your question of how do you go about these things, there are many ways and you have to adapt. So we don't use Survey Monkey but good . . .

Dr. Chan: What's the 2019, 2020 version?

Lily: Well, Facebook is still up there.

Dr. Chan: Really?

Lily: Yeah, I know, right?

Dr. Chan: Because my staff was telling me Instagram is where it's at.

Lily: Yeah, you did just get a new Instagram. I followed you but I haven't gotten a follow back.

Dr. Chan: Well, I don't know how to do that because I literally, I have to sit with my staff and they have to like, it's like teaching me the alphabet. Like, I watch them and they're so fast with their little fingers and styluses. I'm going, "Wow."

Lily: There you go, I know. Well, you're going to have to move faster.

Dr. Chan: Facebook was so much easier. It's kind of an older person thing.

Lily: So we use Facebook. I mean, even just today for example, I posted congratulating our MS2 class who just finished essentially their first semester of second year med school. You know, so Facebook, we do email, we have our class panelists. You know, we show up in person too, you know, which I think is the most valuable way of communicating with people. You know, a couple months ago . . . unfortunately the MS4s have been out of town the last couple weeks interviewing across the country, but we try to be present in person. We visited the MS1 class for example conveying certain ideas and information on issues. And also just saying, "Hey." So in-person communication I think is always the best way to go. You know, you asked about how we go about kind of, like, solving issues or resolving issues.

Dr. Chan: Some of which are unresolvable.

Lily: Some of which are unresolvable. You can do your best to approach it. You can never go wrong . . .

Dr. Chan: Oh Lily, you're destined for higher ed administration.

Lily: I've learned very quickly.

Dr. Chan: Yeah.

Lily: But you can never go wrong by, you know, facilitating at least, you know, a good number of people who have a diverse set of opinions to contribute to the conversation, perspectives, especially in a place as diverse as a medical school as an institution like this. You have to have contributions and input from multiple people. So it is our responsibility I think to facilitate that.

Just depending on what the issue is, you know, we have our Class Presidents and our Class Councils who are readily available to contribute to these various committees. Or even, sometimes an issue will come up and we'll form a group in concert with the Dean's office, and we'll form a group that we think that, you know, we'll ask people to volunteer, we'll ask people specifically just because, who knows? They might have been affected by a particular issue. That's how we get a lot of, you know, student involvement. Some students love being involved more than others. I think we do try to make an effort though to make sure others have their voices heard as well. And sometimes I admit we do use surveys, but it's like a Google survey, Dr. Chan. I mean, come on.

Dr. Chan: Not Survey Monkey. Okay, Google survey. I'll have to have my staff show me that. Okay, so, OB/GYN residency applications.

Lily: Yeah. Hard to believe I'm in this position.

Dr. Chan: I know. Like, how many do you apply to? If you're interested in OB/GYN, do you do away rotation? What's kind of been your strategy?

Lily: Yeah, oh man. You know, we have received lots of advisement from Dr. Stevenson, our Dean.

Dr. Chan: I'm sure the internet also has more . . . the interwebs.

Lily: The internet has lots of things. I stay off of it though. I don't like to . . . that's a mess if you get into it. My strategy was basically to apply broadly, which sounds vague but that is the absolute truth. You know, OB/GYN now, you're having to apply to 50, 60, 70 programs. Of course, that all depends on what your credentials are and your background. I was a little uncertain of how I would fall into things, you know, in particular because I didn't have any explicit let's say OB/GYN research or experience, I think that's totally fine. But one of my classmates, for example, you know, he had a very specific OB/GYN volunteering and research, which is wonderful. He's a fantastic candidate. But I was just, like, very different in that regard. So I was a little uncertain how it would be received, and it's been received just fine. So I admittedly applied to many programs. I won't tell you the exact number.

Dr. Chan: It's up there though. In the 50 to 70 ballpark.

Lily: It's up there, yeah. Frankly, mostly out of necessity. I mean, it's just what you have to do. And I admit that unfortunately, you know, people have very strong opinions about this. Unfortunately I think, mentally, myself, I could not not apply to places knowing how far it's taken to get to this point and then risk not applying to enough places.

Dr. Chan: So a part of that's kind of, like, anxiety driven. It's going to cover all your bases.

Lily: Yeah, well, exactly, Yeah. And people will tell you too, and I understand there's statistics, there's numbers to back up the fact that, you know, after a certain number of applications, the return doesn't increase. However, still, it's difficult to kind of get past this fact that you have to get an interview in order to be eligible.

Dr. Chan: Do you feel comfortable sharing how many interview offers you got?

Lily: I will tell you that I went on a dozen interviews.

Dr. Chan: A dozen, good. All right.

Lily: Yeah.

Dr. Chan: So that's good, right? Isn't that kind of the sweet spot?

Lily: Yeah, so that is the sweet spot. For OB/GYN, it's apparently, like, 12 to 14 is what they say.

Dr. Chan: Okay.

Lily: And they vary from . . . I admittedly applied to mostly university programs. You know, I am no expert of course, and everyone has different opinions on community-based programs or university, and kind of what surgical numbers you get. You can ask Dr. Silver, the chair, for probably a better perspective. But just, like, personally, I think it's been deeply informed of my experience at Utah here. I just love these big academic medical centers. They're exciting places to be. They're a lot of fun. So I was looking for something kind of in that, you know, similar spirit I guess you could say.

Dr. Chan: So it's four years long.

Lily: Four years long.

Dr. Chan: Four years long. And then what kind of fellowships are attached to it? Are you thinking about a fellowship at this point?

Lily: Yeah, yeah. You're reminding me of your other question that you asked a few minutes ago.

Dr. Chan: Away rotations.

Lily: Away rotations, which is true. So I thought, everyone talks about away rotations in med school. I didn't realize that you don't have to do them.

Dr. Chan: You don't, yeah.

Lily: I know that seems kind of funny because the majority don't, but I didn't quite realize that different specialties actually, like, some of them apparently even dissuade you from doing it because you can . . . by showing up in person and showing your face you could ruin your chances.

Dr. Chan: Well, I don't think that's what they put on the websites.

Lily: That's not what they put on their website. I fully endorse, you know, visiting other institutions. And I say that too because . . .

Dr. Chan: Well, it's an audition, right?

Lily: Yeah, Well, it's an audition.

Dr. Chan: So I think if you go do an away rotation at an outside facility, it's your time to shine or not shine. Right? Yeah.

Lily: Yeah. Well, and also, shouldn't that be your attitude regardless? And that was my . . .

Dr. Chan: Well, yeah, but it's kind of high-pressure though.

Lily: It is.

Dr. Chan: Like you're always being evaluated.

Lily: No, it's true. But, quite frankly, so I applied to multiple away rotations, and I ended up selecting two of them and doing two of them in Maryland and in Pittsburg. I had a fantastic time at both. And I didn't even . . .

Dr. Chan: Yeah, different cultures, different hospital systems, yeah.

Lily: Yeah, exactly. And I think . . .

Dr. Chan: Hanging out with other students.

Lily: Yeah, no, it's true though. I think, though, it's almost a responsibility to kind of go out and have these, like . . . it's like, never again in your, well, in medicine it's a little different. Like, you can do rotations at various hospitals, but this is the first time in your life, like, you have this privilege of literally dropping yourself in the middle of, like, a hospital in, that you had no connection to previously. You literally pick up your ID and then you walk over and walk into a surgery. I mean, it's because, of course, we've negotiated these relationships with other institutions and reciprocal . . .

Dr. Chan: Yeah, reciprocity.

Lily: There's a lot of, there's a lot more to it than of course just showing up. You know, safety stuff and insurance. But that's all in place, and so I figured, you know, why not? I think it's important too you see how other hospitals operate, everyone does things differently. Even, like, how a clinic works is very different. How an OR works. You know, at one of the institutions I was at, there were many fellows. So I did it in GYN oncology, so ovarian cancer, cervical cancer, which is a pretty intense rotation. It's not a vacation by any means.

But I specifically chose GYN oncology within OB/GYN because I think it's the best way, at least for me, I thought it was the perfect venue to prepare for intern year. It's ICU based. The intern has really all the floor responsibilities, you're learning how to manage very sick women, and obviously there's some pretty extraordinary surgeries that take place. So, you know, I just think it was the best learning experience. Obviously, like, labor and delivery and obstetrics is, you know, can also be wonderful preparation. But this was just the way I chose to do it.

Dr. Chan: Was it intimidating to be in, like, a different hospital system? And everyone has, like, white coats that look really different.

Lily: Yeah, exactly.

Dr. Chan: And then people are kind of friends and they know where the lounge is, you know? And you don't know where anything is and they kind of hang out after hours and maybe they invite you, maybe they don't. You know what I'm saying?

Lily: No, no. Absolutely.

Dr. Chan: Because I remember I did one away rotation. I just remember it was, like, it was a lot of fun.

Lily: Really? In psychiatry?

Dr. Chan: It was fun. We were trying to get out there. But there's also a kind of, like, lonely. I kind of felt like, oh, this is not really an accurate feeling what it would be like exactly because I would have friends at this place if I matched here.

Lily: Yeah. No, I mean, that's a great point. And I admit, you know, the two months . . . so I was just gone completely for two months. Empty apartment here in Salt Lake City. Staying in completely new cities. Admittedly it is difficult because you are walking into a place where you don't even know where the bathroom is. And then right after you check in and get your ID, you're going to work. And you have no idea where anything is.

However, I think though, that is honestly what medicine is. In third year of medical school you will quickly learn, or I quickly learned, that you are given, you know, you get an email with instructions on where your family medicine clerkship is starting or, you know, where you're starting on surgical oncology on Monday morning at 4:00 a.m., and where you're supposed to be and what resident you're supposed to contact. And you show up and you get to work. And so, you know, your entire, at least, hopefully it gets better, but initially in medicine and the teaching or learning years in particular I should say, it is about getting comfortable with being uncomfortable. I mean, I think about this often.

Medicine is obviously embedded in science and research and evidence-based medicine, but at the end of the day medicine is really being able to get along with people. If you cannot get along with people and be able to work on a team, and you work with new people, I mean, truly, even day to day new people. You know, your resident teams will change, your attending will change. I mean, I was on the ICU a couple months ago and the first week, and this isn't normal because you usually have, you know, consistent attending for, you know, a week. But I had four different attendings on four consecutive days. So you very quickly learn to kind of get comfortable with these situations.

You know, luckily though, walking into these other programs on away rotations. I do think Utah prepares us well. You know, I was, quite frankly, confident walking in, you know. It's not that I knew . . . you don't know what you're doing at all times, but, you know, you, I know how to present a patient. I know how to round on a patient, and if I don't know something, I know where to look it up. So I think if you've done third year of medical school right, and if you work hard, honestly that's just the most important thing. If you just work hard and show up on time, hopefully earlier, but if you show up on time and, you know, be meticulous and try your best. I mean, that's medicine to me. You know, this is coming, of course, I'm a little biased so this is coming from a person who wasn't as into, like, intro to biology as the next person. But I think that's why medicine is redeeming for me. It's because you can work your butt off and, you know, if you care about people, you care about communicating with people, then that right there will set you up for success.

Dr. Chan: So in your mind right now, because you're done with almost all your interviews. Do you know what your rank list looks like or is it still kind of in flux? And where does your top fit into that?

Lily: You can't ask me this question.

Dr. Chan: Well, I'm not asking for details.

Lily: It's okay, you can. Well, how do I vaguely convey? Let me just say this. Because I know that you have such a broad audience and I never know who's listening. I would go anywhere. And I say that in the sense, I mean, who wouldn't to match?

Dr. Chan: You really are a politician. I love it.

Lily: I am a politician. Yes, exactly.

Dr. Chan: You are Student Body Officer, President.

Lily: I will say though, I do have, you know, some people have strong preferences just based off of where they have family, where they grew up or where they're trying to get back to or away to, I guess you could say. I actually don't have really any geographic preference in the sense that I, you know, have been fortunate to live in different parts of the country. And so that's honestly a strength. You know, it can be, I think it's a strength at least. I've been able to plop myself down and start over multiple times in my life in new places where I had nobody, no family, nothing. And Utah was one of those and it's worked out well. I love it here and I truly mean that. It would be an ultimate privilege to stay here for residency. And I mean it too. You know, we have a fantastic program here. The institution is fantastic. There are, you know, details that, or factors I should say, that do influence one's preferences. Everyone . . . having just got back from the interview trail, you know, they're fresh in my mind. People will tell you about case numbers and the call schedule and, you know, whether meals are paid for and whether parking's paid for.

Dr. Chan: My own bias is like, at the end of the day, all operating rooms look the same to me.

Lily: Exactly, yeah.

Dr. Chan: Because of like accreditation.

Lily: Well, it's true, yeah. Exactly, yeah. You have to fulfill certain . . .

Dr. Chan: They always with these tours like, "Oh, look at ours." And it looks like all the other operating rooms, yeah.

Lily: Well, that's exactly it though. That's what I'm getting to is that at the end of the day, like, all these residencies, most of them, but all these residencies are going to fulfill the requirements of becoming, you know, a doctor. A licensed doctor I should say. And board certified. You know, and so, for me, the question I actually have asked in these interviews, and they, who knows? This is maybe a dumb question. This is the first person I'm telling that I asked this question. But for me, a question I asked these programs, sometimes even the chair themselves, I would ask them about the culture. You know, because you can ask, like, how many, you know, total abdominal hysterectomies they do, but at the end of the day, you're going to get those numbers in. But I want to know, you know, do the residents enjoy being with each other? Do the attendings respect the residents and trust them, and vice versa? Is the chair excited to be there? And you very quickly do learn, you get a sense of the culture of places.

Dr. Chan: Yeah. Well, because I think it's important you ask the chairman, chairperson that.

Lily: Yeah, yeah.

Dr. Chan: But I don't think there's a single department chair who's going to say, "Well, actually our culture is kind of bad."

Lily: It's true though.

Dr. Chan: But you're probably looking for other clues throughout the day.

Lily: Yeah, there are other clues, yeah.

Dr. Chan: The dinner the night before, how the residents interact with each other.

Lily: You know, the caveat of course, people show you more than they tell you, of course. I don't think it hurts to ask them to tell you. You know, if they don't, that's a problem. You know, that being said, I was fortunate to interview at some wonderful places where, you know, wonderful departments, and it seems like they have great communities as you hopefully . . . well, you know me. I understand not every day is going to be an easy day at work or a happy day. Who knows? There may be more days not than, you know, than that. But, you know, I'm invigorated by coming to work every day. I love being in medicine for that reason. So I am looking for a place that does kind of fulfill that for me, culturally I guess you could say.

Dr. Chan: This has been great, Lily. Last question and I'm going to put you on the spot.

Lily: Go ahead.

Dr. Chan: What's, like, what's your anxiety about not matching?

Lily: You know . . .

Dr. Chan: Because, like, is that still, I mean, you know, because like, you, I think you're in this place where you're good.

Lily: Yeah, I don't have any. Maybe this is . . . honestly, this is not so much about not matching but, honestly, I just think of places where it's their loss if they don't get me.

Dr. Chan: Well, good.

Lily: Maybe that sounds a little arrogant but, you know, I don't really have . . . I think I have, you know, enough interviews that I'll be just fine, enough places to rank. You know, that does happen and it's happened to friends. It happens to people every single year. And I have seen people, you know, prevail through it. I think the biggest thing is that, you know, hopefully with fingers crossed, it doesn't happen.

You know, we have although getting to this point have had, you know, bumps in the road. It's not the first time, I don't think, that, you know, for myself and also my peers, other things that happened that have made us take a U-turn or, you know, adapt to the situation. There have been too many hoops to jump through and hurdles to go over to get to this point. So, you know, obviously it would be upsetting but there are ways to get through it. As you know, there's the SOAP process and some people get into residency that way. You know, it happens, but I am confident and hopeful it does not.

Dr. Chan: All right, my last question, I lied.

Lily: Yes.

Dr. Chan: Will you come back before, after you match?

Lily: What do you mean "come back?"

Dr. Chan: Come back on the podcast.

Lily: Oh, of course.

Dr. Chan: I want to talk to you some more.

Lily: Absolutely. I thought you meant just to say hi to you when I . . .

Dr. Chan: Because I still have all these questions in my mind and you're so busy.

Lily: Oh, my god. I love it.

Dr. Chan: For the listeners, I didn't touch upon Oklahoma's Sooner football.

Lily: Oh, gosh.

Dr. Chan: We have been playing phone tag to get this.

Lily: Yes.

Dr. Chan: Or email tag.

Lily: We have so many issues we need to talk about.

Dr. Chan: And you, like, no-showed me because, like you went off the grid for a couple months there.

Lily: Oh my gosh. Well, I should've shared . . .

Dr. Chan: You're a difficult person to track down.

Lily: I know. I should've shared too. And I, Dr. Chan, you emailed me to ask me the ultimate privilege, to get on this podcast. I mean, truly. Because when I was applying to med school this was a thing. I obviously couldn't have imagined the day when I would get to be on it. But, like you were saying, I admit last year, and it was during my surgery rotation though. It was this time last year you emailed me. And I forgot to email you back.

Dr. Chan: It's okay, I understand. But it's like, "Oh, Lily must be either really busy or she just really is like . . . she just passed on Chan."

Lily: It was certainly the former because I would never pass on an opportunity to talk with you, Dr. Chan.

Dr. Chan: Well, we want you to come back.

Lily: I will, absolutely. Looking forward to it.

Dr. Chan: Thanks, Lily.

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 motivates a track and field star to pursue a career in medicine? How does a series of health setbacks, while living in the Philippines, strengthen your sense of identity and goals? What's it like to trail blaze your own path to medical school while blocking out discouraging voices? Why should you always shoot your shot even when the odds aren't looking your favorite during the application cycle?

Today, on "Talking Admissions and Med Student Life" I interview Siale, a first-year medical student 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: Well, welcome to another edition of "Talking Admissions and Med Student Life." I've got a great guest today, Siale. Am I saying your name right?

Siale: Yeah, Siale.

Dr. Chan: Okay. All right. So, Siale, current first-year med student, about four or five months in. How's it going so far?

Siale: It's good. It's a roller coaster, I guess. It comes in waves where everything feels really good and then there are those moments you're like, "Why did I do this to myself?" or trying to remember like, "Why am I here? Why am I putting myself through all this stress?" But it's really just been like a dream and an opportunity to be here and do something that you feel like, "Oh, I'm supposed to be here."

Dr. Chan: Yeah, I think it's hard for people because, you know, people have an image of what med school looks like, but not until you actually are in med school . . . it's like, "Oh, okay. Now you're living the dream," as it were.

What's been the biggest surprise so far?

Siale: This is kind of random, but just how cool my classmates . . . like just how nice they are, because the pre-med world is a really kind of ugly, competitive world. So then you get to med school and you're like, "Wow, everyone is actually really nice and really helpful." And I think I was really intimidated coming into med school, but I actually feel a little like my classmates are awesome and they want to help me.

Dr. Chan: Perfect. All right. Let's jump into the Dr. Chan time machine. Let's go back in time. So, Siale, how old were you when you started thinking about medical school? How did that dream, that idea first enter?

Siale: Yeah. So my background, my mother is a home health hospice nurse. And so, when I was elementary school age after dance practice or Saturdays, my mom would take me to go with her to visit her patients, especially those who didn't have a lot of family nearby. She would take me over and visit.

And so seeing my mother as a nurse and seeing the connection she had with people, helping people heal, from a young age I was like, "I want to go into medicine." I didn't know exactly what that looked like, but looking back down my road, like my path, I felt like it's always kind of pointed to medical. And being a doctor is the way that I felt like I could fulfill a deeper purpose of what I wanted to do with my life and stuff.

Dr. Chan: So it sounds like it wasn't one aha moment. It was like a series of moments over time.

Siale: Yeah, lots of series of moments. Yeah, I grew up . . . my mom is a nurse. My dad is a contractor. He works construction work. And he's from the island, so I've seen kind of what it's like to live in the medical world, what it's like to not live in the medical world. And saw lots of things with my dad's family that I was like, "Okay, there's a big need for help here."

And while serving an LDS mission, I had some experiences with getting sick. And my experience with the medical world there, it's a lot different than in the U.S. And so just lots of small experiences where I was like, "Okay, being a doctor is the way to go."

Dr. Chan: Now, a lot to unpack there. You said your dad is from the island.

Siale: Yeah.

Dr. Chan: Which island is this?

Siale: My dad is from Tonga. He was born and raised there. He came to the U.S. when he was 18. Had some family in Utah, so he came to Utah around then. And then met my mom a few years later and they got married and . . .

Dr. Chan: And they picked Utah?

Siale: And they picked Utah, yeah.

Dr. Chan: To raise you? Okay.

Siale: Yeah, to raise me. My mother is from New Mexico. She is Hispanic and Native American. Grew up between the Indian Pueblos. Actually came to BYU for undergrad and that's where she met my dad, and they decided Utah was maybe not halfway in between Tonga and New Mexico but a good spot.

Dr. Chan: So did you get to visit Tonga and New Mexico growing up, or did you kind of stay in Utah?

Siale: No. I spent my summers in New Mexico. I went to Tonga a few times growing up, but yeah, I spent a lot of time with my family outside of Utah and it was really good for me.

Dr. Chan: How did it feel to kind of exist in these different worlds, be someone who has a background in these different worlds?

Siale: Yeah, I mean, when you're a kid, you have no idea your life is not like a . . . like growing up in Utah County, being surrounded by predominantly white, I never realized . . . My friends always made jokes like, "You're the brown friend," or whatever. But it didn't really occur to me, and I think I always tried to conform or act like I was like them.

And these experiences of having a mom with a really mixed background, and New Mexico with a world that is totally different than Utah, and a dad who is Pacific . . . I didn't know everything was so different until I probably got to high school and I was seeing, "Oh, your family doesn't do that? That's not a thing?" or just having conversations with some of my friends growing up, "Wow, we have really different experiences."

And it became a lot more evident during my undergrad that I had grown up with a really different background than a lot of people around here.

Dr. Chan: So let's go back to high school. So you had a dream about becoming a doctor, but also you were doing a lot of sports too. So what was your sport in high school? What was the thing that you just excelled at?

Siale: So originally, I did competitive dance. I started that when I was in elementary school.

Dr. Chan: Interesting.

Siale: Did competitive dance until I was a sophomore in high school. At the time, I was on a really competitive dance team, over like 30 hours a week. I was spending all my time, and this dance studio was really expensive.

But I had also always done really well in sports. I had done track and field, like the school track meets, the Hershey's track meet, growing up. I always performed really well in those and did well in my gym class. And so, when I was in eighth grade, the high school track and field coach approached me, and he told me he'd like me to come to the high school rather than do the junior high team. Because I had been doing the junior high team.

Dr. Chan: You were just dominating those junior high kids.

Siale: Yeah, that's really what it was. I was doing really well. And he said, "I think you really have a gift and I think you should come up for it." And so I was pretty open to it, but I told him, "Dance is my first love and I'm going to be a dancer," and all these things.

But then he invited me up and then . . . I mean, I didn't dominate as a freshman. I probably got dominated over, but it was a really good experience, and I was still competitive at a young age.

And he sat me down . . . during my sophomore year, I was trying to juggle this really competitive dance team. I had done volleyball in my freshman year, but my sophomore year I decided to quit and focus on dance and track. And during my sophomore track season, I had a really successful track season despite being so busy with dance and trying to balance it out. And my high school coach sat me down and he said, "Look, this can pay for your school in the future. You can go somewhere with track. You have something."

Dr. Chan: So you were really great, even that young, it sounds like?

Siale: Yeah.

Dr. Chan: You were just smoking people. You were fast.

Siale: And I did the heptathlon and I think a lot of my dance background had helped. Like, I knew how to control my body. I could jump. I had good running mechanics for hurdles and stuff, so a lot of really random things. And my dad had done track back in Tonga, and my mom had done hurdles in high school. And so I actually felt like, genetically, it was kind of like in my . . . it was just in me.

Dr. Chan: And your parents would construct obstacle courses in your home when you were little and go, "Siale, run fast." They were training you.

Siale: Yeah, I mean I grew up . . . so on my dad's side of the family, there's I think six of us the same age, and I'm the only girl and the rest are all boys. And so I grew up running outside with the boys, and they never took it easy on me. And so I just felt like I always grew up playing outside, running around, really active and stuff. And I felt like that played a big role, and pursuing track and field is just my background.

Dr. Chan: Now, talking about the college piece, does it work in the world of track and field where the coaches can recruit you and kind of watch you, or do you send them tape or . . . I mean, how does that work?

Siale: So I always wanted to go to BYU. And so, since I was so close . . . I grew up 20 minutes away from BYU. And my coach had sent other people to BYU. He had a really good relationship with the BYU coach. I was talking with him. He sent out to . . . I had other coaches approach me when I was a junior, like local schools, UVU, SUU, Utah State, but my two main choices were The U and BYU no matter what.

And my coach knew that from the beginning, so I had BYU coaches watching me probably my whole career going up to that, like leading up to college. And the Utah coaches, they were around too. I came up here and did a recruiting trip with them and stuff.

Yeah, I'd always wanted to stay in Utah, but my mom is BYU alumni, so I knew really that's where my heart . . . where I wanted to go.

Dr. Chan: Okay. So it sounds like you committed and you did track and field?

Siale: Yeah.

Dr. Chan: And what was your event?

Siale: So originally, I did the heptathlon, which is 7 events, hurdles, high jump, shot put, javelin, 200, 800. It's a little bit of everything. So in high school, that's what I did. That's what I did my freshman year.

And then I tore my ACL my freshman year, like midway through my indoor season. And so it kind of threw me for a loop on what I was going to do. And the surgery went well, physical therapy, everything went pretty well with recovering. But during my freshman year and even my sophomore year, the throws coach at BYU had approached me and he told me, "You know, you just have the build for a hammer thrower." And I didn't even know what the hammer thrower was.

Dr. Chan: Like Thor?

Siale: Yeah, like Thor. And I was . . .

Dr. Chan: I've seen this in the movies.

Siale: Yeah, I didn't even know what it was and I was kind of being close-minded, like, "Well, I really like the heptathlon." And he told me, "I think you should try it." I was being pretty stubborn about it, like, "I already have seven other events. I'm not going to try to throw one more event into the mix."

But then I noticed when I was coming back to my sophomore year, hurdling just was not the same and running mechanics. I could still while I was healed . . . I was doing physical therapy. I just didn't feel the same.

And so I sat down with the multis coach, the heptathlete coach. And we talked about this other hammer throw and she said, "You know, why don't you . . . as you're continuing to heal, why don't you learn this event? Let's see how it goes and we'll revisit . . . I want you to give it a try." Because I think she was feeling the same thing. Like, "Maybe she could be really good." You can give it a try and we'll revisit everything at the end of the season." And I'm just like, "Okay."

Started doing that and it was okay. It wasn't super stellar, I don't feel like. But then by that time, I had decided I wanted to serve an LDS mission. And so I actually left pretty quickly. I hadn't even really talked to my coaches about it because I didn't want what they had to say to play into my decision of whether or not I was going to go.

Dr. Chan: So before we talk about your mission, what is a typical day for you? I mean, what time are you getting up in the morning? When was practice? How do you balance class? I've had a lot of friends and other med students tell me, who've done college athletics, it's like a job. It's like a full-time job and it's extremely difficult.

Siale: Yeah, it's a job.

Dr. Chan: So what does a typical day look like?

Siale: So you wake up. It depends, but typically practice 7:30 or 8:00. Go to practice for a couple of hours and then go to class. So let's say I have practice from 8:00 to 10:00 and then I would go to class from like 10:00 to 1:00, and then I'd have lifting 1:30 to 3:30 or 4:30, and then after that either have more classes or you go back to study.

And then especially when I started getting into research, then it's like every hour I have . . . during my time in undergrad, I was either running to practice, I was running up to the research lab, or I was going to class, or trying to study in the library.

Yeah, it's really like a job. I mean, they are investing time and money in a spot for you. A lot of people want to be in your position. And so they control what you eat. We would do these things called bod pods where they would check your BMI and your muscle . . . like your percentage of body fat. And they were talking about what you're eating. They have a big saying like, "What you're eating and how you perform determines whether you travel or not."

It's hard because you want to do well and you want to perform well and that's how you get to travel and get to compete. But then when you're a student, they say "student athletes," so student always comes before athlete, but sometimes you don't feel that way.

Dr. Chan: You're an athlete student.

Siale: You're an athlete student. And so that can be . . . in some people, that's their dream and that's what's important to them. But I knew from the beginning I've got to do well in school if I want to . . . there's a life beyond college athletics.

Dr. Chan: Yeah. I don't know too much about this world you're talking about, but I mean, what's the next logical step if you go with this? Is it the Olympics? I mean, did some of your peers . . . is that kind of what they're aspiring to, the next level?

Siale: Yeah. People on our team have become professionals, you know, in their event. Like, my coach is . . . while he coaches, he's also a professional thrower for Sweden. And some of my classmates . . . or they just become professional runners. So they want to make a career out of it.

But I never felt like I wanted to make a career. It would be nice if the road led to the Olympics, but that wasn't ever my goal. But you kind of need to have that mindset, like, "If I wanted to go there, I could," or you want to be the best athlete you can be. And so, yeah, it's your job plus more.

Dr. Chan: Yeah. All right. Let's talk about the mission. Hard decision? Easy decision?

Siale: Oh, really hard.

Dr. Chan: Really hard?

Siale: Yeah, really hard. Being a female, it's like if I go later, you know, where is that going to put me with dating or with school? I was really concerned, you know, if I leave for a year and a half, this road is already long that I'm looking at, so this is just going to push it back out, stretch it so much further.

And with track too, that was a big thing. With track, you're not going to do anything for a year and a half. You're going to lose everything that you've worked for in a way, and you're going to come back and start from the beginning. But I just really felt like that was what I needed to do with where I was at with finding myself, finding my identity. That was something that was really important to me.

I didn't have any pressure from my parents or anything. My mom is a convert, and my dad is not a member of the LDS church. And so they were kind of like, "You know, whatever you want to do." They wanted me to go and they were supportive, but it was never like, "You need to go," or anything. But I felt like to become the person that I wanted to be, I think that was a way that I felt like it would get me there.

Dr. Chan: So you opened your call and where did you go?

Siale: I served in the Philippines.

Dr. Chan: Okay.

Siale: Yeah, my dad was excited. My dad growing up in Tonga, in the islands, he really wanted me to go somewhere that was third world where poverty was a real thing.

Dr. Chan: So were you in Manila, or were you out kind of in the islands?

Siale: I was out in the islands.

Dr. Chan: Okay.

Siale: Yeah, I served in the outer islands, in the mountain. The Filipino word is bundok, which means mountain. But yeah, I served in the outer islands very far from the city.

Dr. Chan: What was the language you learned? Because I know there's a bunch of languages.

Siale: Yeah, I learned Hiligaynon and Cebuano.

Dr. Chan: Okay. Picked up two languages.

Siale: Picked up two languages, and I can understand a lot of Tagalog, which is their main language, but picked up those. I'm still pretty fluent in both. Well, I'm fluent in those two languages and I can get by on Tagalog.

Dr. Chan: So this entire time, you know, at BYU . . . how long were you at BYU before you left for your mission?

Siale: Two years.

Dr. Chan: So two years at BYU doing a lot of athletics, serving in mission. Where is this dream of becoming a doctor? Is it kind of fading? Is it stronger? Did you see something on your mission that made it a lot stronger?

Siale: Yeah, so at BYU, my dream started to kind of fade. I got kind of discouraged. Like I said, the pre-med world is kind of an ugly, scary world. And those general chemistry classes just kind of scare you. And so I was like, "Maybe I'm not supposed to be a doctor." It kind of discouraged me. And I've always been good at math, and my grandpa is an accountant, so I was like, "Maybe I should consider accounting. I don't know."

So when I left on my mission, I said, "You know, I'm going to have an open mind and I'm going to think . . . I have a year and a half to think about it. And so I'm just going to open my mind, think about different things while I'm out here, and hopefully while I'm finding myself, I figure it out too."

While I was on my mission, I saw a lot of really sick people who just didn't have any access to it, whether it was money, they lived in the middle of nowhere, or maybe a combination of both. I saw some things that really bothered me. And then I also got sick on my mission. I had Dengue fever. I had different things happen, like my stomach . . .

Dr. Chan: Dang, you got the Dengue?

Siale: Yeah, I got the Dengue. Yeah, my stomach was always hurting. I probably had the flu and I had strep. I had pink eye. I kind of went through it all.

Dr. Chan: You lost a lot of weight.

Siale: Yeah, I lost weight.

Dr. Chan: Muscle mass.

Siale: Muscle mass. It was funny. Everyone thought I would get tan because I was always walking outside, but I was really pale and ghostly looking in all my pictures. And so I'm sure I was deficient of all sorts of nutrients.

And so, during that time, I said, "Okay, whatever career I want to do, I've got to be with people. I've got to help people." I kept seeing these people, people with TB, seeing babies with measles, all sorts of little things they couldn't even get treated for. And that really just bothered me. But as a missionary, that's not your job to take care or address medical needs. You're doing other things.

And so, while this was happening, it kept coming to my mind and I would bring it up to . . . you have companions. And so I'd talk to them about it, talk to my mom. And then I realized during that time, I was like, "I want to do something within the medical field, but I don't know if I'm going to be competitive enough when I get back to BYU to be a doctor." So I was thinking, "Okay, there's PA school. There are other ways to do medical." But I knew on my mission, "Okay, I want to do medicine," seeing all these people who didn't have . . .

Dr. Chan: So you came back and you had that fire?

Siale: Yeah. I had a lot of fire. Came home. I actually didn't register for that first semester of classes while I was on my mission. I was late. Came home and I was like, "You know what? I'm going to do the pre-med. I'm going take anatomy. I'm going to do a physics lab." And it was already like two or three days into the semester and I walked into the advisor's office. And I was like, "Okay. I signed up for these classes." And she was like, "Whoa, whoa, whoa, you just got back. This is a really hard schedule. I don't know if you're going to be able to handle this."

But then, like you said, I just had this fire. I was like, "I'm going to do it." So I ended up doing a bunch of really tough classes that first semester I got back. But then I did anatomy and I just fell in love with it. And I did really well, and I loved it.

And then it was kind of another like, "Okay, you're supposed to do something with this" And so that was another piece. And I took the . . . there was a pre-med advisement class, and then I was thinking about it and I was like, "Okay, I can do this."

Dr. Chan: Did you have a mentor or a role model during this time, or were you just kind of on your own? Because your mom has a healthcare background, but . . .

Siale: It's different.

Dr. Chan: . . . it's different. Do you understand what I'm saying? Did you have someone to help you out during this time?

Siale: Originally, no. Even some of my . . . we have an academic advisor for track and there's a pre-med advisor and then one within your own college. And all of them were kind of not super encouraging and stuff. And so I felt like I was kind of on my own. A lot of them tried to talk me into switching my major to exercise science, because apparently if you're an athlete, you have to do exercise science. And that's the route they all take, so everyone needs to do it and stuff.

The major I ended up choosing is a longer major and they were like, "Well, you could graduate and stuff earlier if you did these other majors." But I was like, "No. Physiology, that's what I want to do. That's what I like."

And so, while I was doing this, I felt like I was on my own, but then randomly I was asked to speak on this Polynesian student athlete panel at BYU. And I said, "You know, I'm pre-med. I want to go to med school and it's really important for me to give back to the Polynesian community."

And while I was speaking, there happened to be a Hawaiian doctor . . . she actually came here for med school. But she was in the crowd listening to me. And so, after that, I had this random student a few months later come up to me and say, "Dr. [Au 00:24:23] has been looking for you." And I was like, "Who's Dr. Au?

Dr. Chan: Who's this person?

Siale: Yeah, who's this person? And she gave me this physician's email address and contact info and said, "She's been looking for you. She wants you to email her." And so I was like, "Oh, this is kind of random or weird, but I'm here for it. This is good."

And so, I emailed her. And she was like, "Oh, I wanted you to know there are Polynesian female doctors. We're here. You know, I'm just one of a few, but I want to help you." And so she invited me to come shadow her, and she connected me to all the other people I ended up shadowing.

Dr. Chan: That's beautiful.

Siale: Yeah, and she helped me through the whole application process. When I applied, I was considering not applying and she called me and she said, "Let's go to dinner." And she took me out to dinner and she gave me all the reasons why I should apply and stuff. And so I'm so grateful I listened to her because it worked out. But she's been my mentor throughout this whole process.

Dr. Chan: It sounds like she made a huge difference.

Siale: Oh, yeah. I feel like I wouldn't be here without her.

Dr. Chan: Wow. Siale, going back to the application process, what was your strategy? Were you going MD and DO? How many schools did you look at? Were you looking out of state? In state? I mean, what was kind of your strategy?

Siale: Okay, so originally, after taking that pre-med class, I heard that people apply to 15 to 30 schools when they apply. Both MD and DO are both great options. And so I had really open mind, but the way everything played out with track and other things going on with family and stuff, it wasn't going to work out really for me to take the MCAT until closer to when I was graduating. So I knew I was going to have to take some sort of gap year.

And then I was originally planning to take the MCAT in June. I was going to graduate in August and I was like, "Okay, I'll take the MCAT in June." And then I ended up getting into an MCAT program here at The U. They pay for a prep course and stuff. And so I was like,"Well, if they're going to do a course, then I'll just postpone when I take the MCAT." And so I ended up waiting to take the MCAT until late August.

So then at that point, I knew, "Okay, this is not good because applications have been open since the end of May or June or whatever and you haven't even taken the MCAT yet and stuff." And so then I'd be real with myself. "Okay, I'm not going to get my MCAT scores until the end of September."

And so then originally I was like, "I don't even know if I'm going to apply." And I ended up . . . I got my scores back and then I was like, "I don't think I'm going to apply. It's just so late." And I really wasn't that happy with my MCAT score, and I was like, "Okay, I'm probably not going to apply."

And when I told my parents that, they were like . . . my dad called me and he sat me down. He's like, "You have nothing to lose. There's money and stuff, but you should at least apply to a couple of schools."

Dr. Chan: Get some reps in.

Siale: Get some reps in.

Dr. Chan: Yeah, maybe you'd learn for the next cycle.

Siale: My mom said, "Go ahead and go for it and then you'll get some feedback on what to improve and stuff." But I was still . . . I don't know. I was feeling really not confident in myself.

And so I told Dr. Au the same thing. Like I said, she called me and she took me to dinner and she sat me down and said all the reasons why I should just apply and go for it. And she told me, "Pick a handful of schools that you really want to go to. Don't waste your money trying to apply to 15 schools because you know at this point you're not going to get in."

Dr. Chan: It's too late in the cycle.

Siale: It's too late in the cycle. And so I picked a handful of schools. Here because I'm from . . . yeah, I wanted to stay in Utah. UNM because that's where my mom is from. And then University of Hawaii. That's where my husband is from. And then University of Arizona.

But I knew going into it, the odds are probably not in your favor. And so I was really open-minded, because originally I was like, "I'll apply to all MD and DO schools and you go where you get in."

And so I was taking this cycle. I was like, "This is a cycle to learn and if you get in, you get in, and if you don't, it's okay and we try again next year." And so applied to those handful of schools and ended up getting on the waitlist here and then it worked out down here.

Dr. Chan: Before we talk about that, interview offers from other schools?

Siale: Waitlist for the University of Arizona, but that was it. The rest, I was just too late, as I said.

Dr. Chan: Okay. So you got an interview here, obviously.

Siale: Yeah.

Dr. Chan: I love asking this question. So before your interview day here . . . because obviously you've run a lot of important meets. Meets, right? Matches?

Siale: Yeah. Meets.

Dr. Chan: What do you call them? Meets?

Siale: That's exactly right, yeah.

Dr. Chan: You eat meat. You run meets. That anxiety, performance anxiety. What was more stress provoking, interviewing for med school or that really, really important meet? And then what's your trick for calming your nerves? Do you understand what I'm saying?

Siale: Yeah. It was a really similar feeling. So even after all those years, I still got . . . after all those years of dance and track, I still would get nervous before meets. But I had gotten pretty good at staying calm, and then it's usually the morning of that I feel really stressed and stuff. So yeah, going into this, I was just like, "Wow, I'm so grateful. I'm getting an interview at The U. I'm just so happy."

Dr. Chan: Yeah, "I'm playing with house money."

Siale: Yeah. So I was really happy, and so I felt pretty good about it. The day before, it was funny. I was looking over possible questions and I was practicing with my husband and I was like, "I don't know what they're going to ask me. I've never done any med school interviews. I don't know." I felt really at a disadvantage, but I was like, "Here we go. I've done a lot of things like this."

Then that morning . . . we actually stayed up here in Salt Lake. I woke up at like 4:00 because I was just so nervous, I guess, and anxious and going through things in my head. Got here at the school like an hour early just because I didn't want to be late. And so I was just really anxious and nervous.

But overall, yeah, it felt a lot like a meet, like performance time. When I was there, I could feel my heart coming out of my chest and I was nervous. But then once I started talking, then I was like, "You can do this. You're okay. Just be yourself."

Dr. Chan: And then you did well. You did great because . . . on the waitlist. I remember calling you and I remember you were very serene about it. You didn't seem so excited. So sometimes I can kind of gauge . . . because I can't tell if you have other offers. I was like, "I think Siale might be going somewhere else because she didn't seem so excited." So I don't know. That was my perspective on that. I don't know what you remember about that day.

Siale: Yeah, more like shock.

Dr. Chan: Okay, so it's shock. That's the word we're looking for.

Siale: Yeah, maybe shock, really. So it was really random. I was at a . . . I did this program. It's called HEFY. It's a nonprofit that takes groups of high school kids to different countries around the world to do service or humanitarian work. And so they do a training for that. So I was at this training and then I saw someone from Salt Lake was calling, but there are so many scam phone calls. I was sitting in the training, so I just didn't answer it.

And then I clicked the voicemail thing when it transcribes the words for it because I was like, "Oh, they left a voicemail." And then all of a sudden I saw "Dr. Chan from the University of Utah" and I stopped and I was like, "Oh my gosh. The U is calling."

And so then my heart started beating. So then I was in the middle of a bunch of people. I was like, "I don't know if I should walk out. This is the middle of someone talking. I don't want to be rude." And so I was like, "Okay, I'll wait for this speaker to finish and then I'll leave."

And the boy that was sitting next to me, he's pre-med too and he was like, "Are you kidding me? Go out and call back." And he was like, You should go." So then I went out and you were in a meeting or something, and so she told me you would call me back when you had the chance.

So I remember just being nervous. And I was like, "I don't want to get my hopes up, but I don't know why . . ."

Dr. Chan: "I think it's a good phone call. It's probably not a bad phone call to get."

Siale: Yeah. And so I think I was just in shock because, like I said, I really went into this cycle open-minded, like, "It's likely it won't work out, but if . . ." And so just to think, "Oh, wow, it did," I was shocked, really.

Dr. Chan: So, Siale, the last few minutes, and this has been great. What would you say to someone out there who is listening who is thinking about medical school or is unsure? What message do you want to convey? What advice would you give?

Siale: Honestly, you can do it, really. You can do it. Even though my mom is a nurse, growing up and not seeing physicians who look like me or just feeling like, "Oh, I can't do it," because it can be discouraging and stuff, you can do it.

I mean, it's not going to be easy, and some people will take several cycles, like hearing my classmates' stories, but it's really inspired me. If someone really wants to do it, if you put the work into it, you can do it and things are going to work out the way they're supposed to.

Dr. Chan: Are you in a place in your life . . . can you be the Dr. Au for someone out there who's listening? I mean, what would you say to someone from a Pacific island community who may not have a champion? Do you understand what I'm saying?

Siale: Yeah, that's what's really important to me because I feel like I'm the product of a lot of people who've sacrificed and given so I could be in this spot. And so that's something . . . it's really important for me to give back because I feel like I wouldn't be here without all those people, without Dr. Au, without my parents, without the generations of people who came before me. And so that's a big thing.

I want to be an advocate especially for Pacific islanders, like when they see . . . when people in my church group or my nieces and nephews, when I become a physician, I want them to think, "Oh, I can do that too. Someone who looks like me, who understands me, who comes from a background, if they can do it, so can I."

And so I know being a physician, it's a hard and scary road, but if that's where your heart is, I really think it's going to work out one way or another.

Dr. Chan: Well, Siale, I'm so glad you're here. And I'm so excited to see you grow into a doctor over the next few years. Yeah, I just think there's going to be so much opportunity for you to give back and for others to reach out to you and for you to fulfill your dream, because I know you've worked so hard on it. I'm glad you got in the first time.

Siale: Yeah. What a blessing.

Dr. Chan: That's great. Cool. Well, we'll have to have you come back on, Siale, and maybe kind of give updates as you progress through medical school, because I would love to hear from your perspective how it's going, both the good and the bad. So I know it's a lot of hard work, but it sounds like you've already done so much to get to this point. So I'm just really excited for the next few years for you.

Siale: Thank you.

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.