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Troy: You've got to say something like, "Troy puts the stud in studies," or something like that. Something good. I'm just kidding.

Scot: I will never say that.

Troy: I was just trying to think of something better than "Troy's articles" or whatever you called it.

Scot: That's us. It's a "Sideshow" episode. That's what we like to call a soft start. You caught us in the middle of a little prepping trying to decide what we're calling this segment, where Troy scans the medical journals so you don't have to and then shares an article that hopefully is of some interest.

Troy: Hopefully.

Scot: Yeah, this is "Who Cares About Men's Health," a "Sideshow" episode. My name is Scot. With me, as always, the MD to my BS, Dr. Troy Madsen.

Troy: Hey, Scot.

Scot: And Producer Mitch.

Mitch: Hey there.

Scot: All right, Troy. Let's take a look at your articles, hear what you've got. Go ahead and put those articles on display.

Troy: Look at the articles.

Scot: Yeah. Go ahead and put those articles out on display for us. We're going to pick one.

Troy: Oh, we're picking?

Scot: Oh, yeah. I mean, unless you just decided you had one that you . . .

Troy: I decided.

Scot: Oh, okay.

Troy: This title is so good that I knew even if I gave you my list of five, including the one on green urine that I keep trying to get you to pick, I know you'd pick this one.

Scot: All right.

Troy: And I'm just going to read it to you and if you don't like it, if you're just like, "No, we would not have picked that one," let me know and I'll pull up some other ones.

Scot: Okay.

Troy: The title of this article from the "Journal of Emergency Medicine," the title is "Battlefield Acupuncture Versus Standard Pharmacologic Treatment of Low Back Pain in the Emergency Department: A Randomized Controlled Trial."

Mitch: Oh, Troy, I did a bunch of interviews about this. Keep going.

Troy: Yeah. Tell me I have not piqued your interest.

Scot: So when you say battlefield, you mean like a war battlefield?

Troy: That's a good question.

Scot: Oh, okay. Well, I guess, Troy . . .

Troy: I'm hoping I piqued your interest enough that I can . . . I'll explain what battlefield acupuncture is. I didn't know before this article.

Scot: Move forward with this one. Go for it.

Troy: Okay, we got it. So battlefield acupuncture, to your question, is a technique using acupuncture. So you're familiar with acupuncture? You use these little needles in different spots. Ideally, the way this is designed, it's supposed to then relieve pain or lead to different effects.

Acupuncture, of course, is considered an alternative therapy, and it's one of those things where it has gained more mainstream acceptance as these types of studies have come out. But it's been considered a traditional therapy, an alternative therapy. It is not something I have ever done or have ever practiced. I did spend a day shadowing, spending time with an acupuncturist during med school, which was really cool, to kind of see what she did and hear her philosophy and see her approach and see the patient's response.

But battlefield acupuncture is a technique where there are certain little needles that look more like little tiny darts that are placed in specific places in either one or both ears.

The idea behind this is that these spots are said to influence the central nervous system pain response. And by putting these little needles in these different spots in the ear, they then decrease pain that is coming from other sites in the body. I mean, that's the theory. Again, I'm not a traditional practitioner, but I'm just kind of reading what I found on it.

Scot: Time out. In the ear, or in the part around the ear, or the earlobe?

Troy: In various parts. So yeah, let me clarify that. Not in the tympanic membrane. You're not going in the ear hole. These are different spots . . .

Scot: Okay.

Troy: Yeah, these are different spots on the auricle of the ear. You do not want to puncture the eardrum. These are spots . . .

If you just do a Google search for this, you can see photos of where these spots are. They're basically at the very top of the auricle of the ear, so the very top of the ear, and then kind of maybe half an inch down from there. And there's another spot half an inch down from there. There's a spot on the earlobe. There's a spot just on the very front part of the earlobe.

So they're like little tiny darts, and they actually have a tool that you use to place these. They just stay in place until they fall out. So it's usually three or four days. You put these in there, you leave them in, and you just send people home with these in place.

Scot: Wow.

Troy: Yeah, it's fascinating. Again, I have never done this. I've never been trained on this. This is the first article I've seen looking at treatment of low back pain.

And then you might ask, "Why would I even care about this? Because surely I have some great treatment for low back pain." I can tell you that when you see a patient come to the ER, the first thing you'll see is their name and a chief complaint and that's what shows up. And when the chief complaint is low back pain, that to me is one of the most frustrating things to go and see because there is so little that I can offer.

It used to be these patients would come in and everyone would just get opioids, like, "Okay, here's your script for Norco or Lortab." That's a horrible way to approach it and that's what's led to the current opioid epidemic.

So now when people come in, I say, "Well, you can try ibuprofen or Tylenol." "Well, I've already been trying that."

"Well, you could try some lidocaine, some numbing cream on there." "Well, I've tried that."

"Well, you could try physical therapy." And we actually had a physical therapy in our emergency department and did a study on it, and that was great. But that person was only there 30 hours a week and the emergency department is open 24/7, so that's not something I can offer that often.

So if there was something I could actually do and say, "There's evidence behind this and this is going to help you," and people actually did it and said, "Wow, it helped me," that would be really cool.

So this study, essentially what they did is they took patients who came into the emergency department . . . It's a fairly small study, more of a pilot study we would call it, where it's kind of like, "Hey, let's try to see if it works. If it works, let's do a bigger study."

So they only had 52 patients. Twenty-six of these were randomized either to getting this battlefield acupuncture done or to just standard treatment, which would be the stuff I talked about where it's just like, "Hey, do whatever you normally do."

The patients with the battlefield acupuncture had a significant decrease in their pain score when compared to the patients who just had standard treatment.

And they then contacted these patients two to three days after they were there and found that the patients who had the battlefield acupuncture continued to have a significant improvement in their pain scores compared to those who were sent home either with a prescription or with just standard stuff we would do for low back pain.

Of course, there were no difference in any adverse effects. It's not like these patients were getting a lot of infections, they were complaining of a lot of pain or bleeding, or anything like that.

So their conclusion was that this potentially shows some promise. I can tell you please don't come to the ER right now and ask for battlefield acupuncture, because we don't have the tools there. It is not something we're doing. But maybe a study like this and some subsequent studies, if they continue to show this works, maybe it's something we're going to learn to do. I would love to be able to offer something better than what I can realistically offer in the ER.

So kind of a cool study. A pretty simple thing, it looks like, to do. It's just something we're not doing now, but maybe we'll see more of this in the future.

Mitch: I have to chime in because I've done it.

Troy: So when you say you've done it, have you performed this on people?

Mitch: Yes, I have.

Troy: Wow. This is cool.

Mitch: Okay, so 2011, it was my old life as a documentary filmmaker. We were working on a project called "The Painful Truth," and we were traveling all over the country investigating chronic pain patients and how they are treating their different conditions and how it impacts their family. And I got to actually go to this big medical conference. And one of the rooms where they were doing a breakout session was all about battlefield acupuncture.

You go in there and up on front, there's like this cute small woman who's been studying it and she published the paper. And then there are these military guys in full uniform with all their awards and medals and everything, talking about how they were using acupuncture in the ears and the tragus and all these different parts to stop people from going into shock on the battlefield.

Troy: Wow. So that's where it got the name then. I had no idea before this.

Mitch: So I was actually able to get one of them to be interviewed with us. And when we were talking about the interview, he pulls out first an orange and he's like, "Here's the tool. I want to show you how easy it is here. Here, why don't you go ahead and put some of these little brads in." And it's like a little gun and it's just, "Pew, pew, pew." So I bedazzled an orange.

And then he's like, "Do you want to see what it feels like?" And I'm like, "Absolutely, yes, a thousand times." And so he clips my ear. I'm trying to find some photos of it right now. But he clips my ears, and I didn't feel anything because I wasn't going into shock. But I'm like, "Wow."

And then he asked if I would feel comfortable doing it with my cameraman, and I said, "For real?" And the guy was not sure, but I'm like, "Oh, come on. It'll be fun." So yeah, I got to basically bedazzle my cameraman's ear with this tool. And it was just . . .

Troy: Did they draw the spots on there for you to shoot this little gun into, or did you just see it and you're just like, "Okay, there, there, there"?

Mitch: So they had a little printout and they were like, "Here's where you're going to do it." And then when I was doing it, he took his little Sharpie and did little dots on the guy's ear to be like, "Here's where you're going to shoot it."

Troy: Make sure you hit the right spots, yeah.

Mitch: And so the big part of it is that this for them at that time was . . . This was not necessarily something that a battlefield medic would need to have special training for. They can train anyone to do it, right?

Troy: Yeah. It's sounds so simple.

Mitch: So it was really kind of cool to . . . And especially for him, the guy who was giving me the interview and everything, he was like, "These for so long have been treated as 'alternative medicine.'" Big quotation fingers there. But they're starting to find real applications. And so it's kind of exciting to hear that you also found a study about it.

Troy: Yeah, that is fascinating. Again, it's not something I've ever been trained on. And there probably are other emergency-department-based studies that have done this kind of thing, but there are not a lot. And maybe there are some others with low back pain, but this is the first time I've seen this.

I would love to be able to do this. Again, I would love to also maybe see some larger studies just saying, "Yeah, this panned out and we are seeing an improvement and this works."

Again, Mitch, like you said, it sounds super simple to do. As I've looked at pictures of it, it's like, "Okay, just hit these five spots." It's not rocket science, and you just need that tool, the same tool you had, which we don't have. But that's so cool you were doing that.

So if we can do this, I'm going to bring you in to teach us all how to do it, Mitch. Apparently, you're the expert now. You have more experience with this probably than any physician in our emergency department. So you're coming in.

Mitch: Okay. All right.

Troy: I love it.

Scot: Can we get you one of these guns on eBay?

Mitch: I don't know.

Troy: They have them on eBay?

Scot: What do they cost? What does one of these things cost?

Troy: I don't know. I've never looked into it.

Mitch: It was like a handheld staple gun. It was between a hole-punch, like one of those single handheld hold-punches. It was kind of like that plus a staple gun. It didn't feel too technical.

Troy: Yeah. We should probably clarify. Don't do this at home with a staple gun. It would be unwise and unsterile. But yeah, it seems like if you have the proper tools and a sterile device that's designed for this, it doesn't sound difficult.

Scot: Troy is a physician, right? Mitch mentioned something that resonated with me. Alternative medicines, right? There's a lot of stuff out there that people swear by. But as a physician, or at least many physicians I've talked to, until they can see some hard evidence that it actually makes a difference, they don't really accept it as a treatment. But it sounds like you would be in all the way on this because of this study?

Troy: I would like to see at least a couple more studies that replicate the results. At the same time, I don't want to just do something just to do it. It would be nice to see something that helps. I would be open to doing this if a patient . . . if I talk to them about options and I said, "Hey, there's been a small study. It seems to make a difference."

The big thing for me is, "Is there a big downside to this? Am I going to be causing harm?" And if I'm not going to be causing harm, and they did not report significant adverse effects with this, if I'm not going to be causing infections in their ear, or a lot of bleeding or things like that, and there's reasonable evidence to support it, I would offer it to a patient specifically that way. I would say, "This is something . . . there's been a small study." I'd say, "We can try it if you're interested."

Scot: And if this really did work, that sounds like it would change your life. It would make you go from seeing name and back pain to name and I can help this person. Name and back pain, going, "Oh, geez," to name and back pain and, "I have something I could probably do."

Troy: I would love to have that. If anyone asks me, "What is the most frustrating thing you deal with in the emergency department?" it is back pain, because people come there wanting answers and wanting a quick fix and it's a 15-minute discussion often of saying, "Hey, this is what you need to do. It's going to be a long process. You're going to have to do physical therapy. I'm not going to prescribe opioids for this. I do not want to do that. I do not want to create potential for addiction." And then I'll offer them the Lidocaine, things like that, and say, "Well, maybe this will help."

But yeah, to be able to just be like, "Yeah, I can try this. We can do this and there's evidence to support it," would be wonderful.

So we'll see what happens. Again, it's one of those articles where you see it like, "Oh, that's really cool." I can't say it changes my practice right now where I'm going to start doing this. Obviously, I don't have the tools to do it right now or the training. But it's one of those that maybe we're going to see more on this. It takes a while for these things to come into practice, but maybe in five years, this will be a standard approach in the emergency department. Who knows?

Scot: All right. You made it to the end. Good for you. Be sure to check out some of our other "Who Cares About Men's Health" episodes.

What you just heard is what we call a "Sideshow." It's where sometimes we talk about health topics that aren't necessarily directly related to what we normally would talk about, which is the core four plus one more. That is to be healthy now and in the future, you should concentrate on your nutrition, your activity, your sleep, your emotional health, and you've got to know your genetics.

Plus, we also have episodes that are dedicated just to men's health issues. So check out some of those episodes as well.

And if you know somebody that would find any of them useful, please go ahead and let them know about the podcast. It's the best way that you can help us grow the podcast.

If you want to reach out, lots of ways to do that. You can call us at 601-55SCOPE and leave a voicemail, you can email us at hello@thescoperadio.com, or you can check out our Facebook page. That's facebook.com/whocaresmenshealth.

Thanks for listening, and thanks for caring about men's health.

Dr. Chan: How do you find balance between medical school and your wellness and life outside of school? What's it like having your third-year clerkship rotation cut short because of COVID-19? How does a career in business and football prepare one for a career in medicine? Today on "Talking Admissions and Med Student Life," I interview Bridger, a third-year medical student about to start his fourth year 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." This is our first Zoom interview because we're going through some COVID pandemic. On the line I've got Bridger. How are you doing, Bridger?

Bridger: I'm good, man. Thanks for having me on here. It's going to be fun.

Dr. Chan: Yeah. And what year are you in med school right now?

Bridger: I'm a third-year. Well, I guess I'm a third-year until tomorrow when I pass my OB/GYN Shelf, and then I guess I'll technically be in between third and fourth year.

Dr. Chan: And just to get into it a little bit, what rotation were you on and how were you notified that you were pulled off for safety reasons? Like, how did that go from your perspective, from a med student perspective?

Bridger: So I was on OB/GYN, and as you know, that's a really hands-on specialty. And so I did my first week on obstetrics. It was a lot of fun. We got to see a lot of deliveries and stuff. And then I was on nights when things started changing, but because I was on nights, it was a little bit different. I was the only med student, and it was a little bit more . . . flexible may be a good word, because they actually had me still on the procedures and stuff. And so I was still able to participate during my week on nights.

And then I had my weekend call shift that Saturday, and so, again, I was the only med student, so I was still able to participate in the surgeries and the deliveries and stuff. And then Sunday is when we got the email that said that we got pulled from clinical duties. And so I only got two of the six weeks on obstetrics this year. We did two weeks online after that, and then next year we'll have two more weeks that we kind of plug into our schedule whenever we can figure it out.

Dr. Chan: Were you surprised or could you kind of see it coming based on the chatter with the docs in the hospital, or were you completely blindsided by it?

Bridger: Well, I wouldn't say I was completely blindsided by it. I think it was kind of tough, like I said, being on OB with it being such a hands-on specialty. The original talks were, "Well, you guys can go. You can be in the hospital. You just can't see patients, and you can't have PPE. So you can't be in contact with the patients, but you can still do everything else." And I'm like, "Well, what is everything else?"

This is OB/GYN, right? If I'm going to show up at 4:00 in the morning to write a couple of notes and then sit around until 5:00 p.m. not being able to talk to patients because I can't wear masks or deliver babies because I can't wear a gown and gloves, this is going to be a little bit different OB/GYN experience than I was planning on.

So that was kind of my initial thoughts. I was like, "If I'm not going to be able to do OB/GYN and it's kind of just like trying to figure out how to keep the clock rolling on us, I'd rather just do the time later where I can actually see patients and learn the things that you learn on OB by kind of doing it."

Dr. Chan: And I know, from an administrative perspective, there was a lot of late night phone calls and emails and a lot of reaching out to . . . it's not just the University of Utah Hospital, but the partner hospitals, like IHC, VA, and everyone kind of has a different structure in place. It was stressful. It's still very stressful, but I just remember that week very clearly. There were a lot of things that started moving very, very quickly.

Bridger: Yeah, totally, I can imagine. I mean, I think it's hard for the students to realize this is not something that you guys have ever been through before on the admin side of things. I think we all are so excited to be in the hospital and finally learning with patients and learning the hands-on side of things after being stuck in the classroom for the last couple of years pretty heavy. And so I think it was kind of hard for a lot of us to swallow going back to laptop med school, you know?

Dr. Chan: Online learning, yeah.

Bridger: Yeah. I mean, it's just, like you said, kind of unprecedented times trying to figure it out as we go.

Dr. Chan: Yeah. And then I think we're still trying to figure it out both on, I think, an international/national level as well as a local level about "How do we move forward?" And I think there are some good ideas being put out, but the details are still kind of fuzzy because the virus is still among us, so it's really hard. It's really difficult.

Bridger: Yeah.

Dr. Chan: So we'll come back and talk about that a little bit near the end, but I want to focus on really positive things.

Bridger: Let's do it.

Dr. Chan: So, Bridger, let's go back to the beginning, man. When did you first have the idea that you wanted to go to med school? Walk us through that process. Was it a moment, kind of like epiphany, or was it a series of moments? What was your journey like at the very beginning? Where did that come from?

Bridger: For me, the earliest memory that I can think of, period, not just medicine related, like my earliest memory, is I was probably 3, maybe 4, and we were at my house and my little brother and I were playing around. He's two years younger than me. And he was walking around, running around, and he went up to my mom as my mom was cleaning a glass frame, and the glass slipped out of the frame and hit his back and give him like a little . . . I don't know. I'd probably say it was a couple of inches, little gash on his back. And so he started bleeding, and I lost it. I was like, "What is going on?"

So we get in the car, we drive down the street to the Alta View emergency room, and I remember the nurses and people coming up to check him out. And I was so protective and I was so worried about what was going on with my little brother. Would he be okay? And the doc walked in, he looked at me, and he gave me a pair of gloves, and he gave me a mask, and he was like, "I'll let you sit here, I'll let you watch, and I'll let you help, but you've got to calm down." So he caught me off guard.

So he gave me a mask. I'm sitting there wearing gloves, and I'm just sitting there watching as he stitches up my little brother's back. And I just remember, at that moment, looking at that guy like he was a superhero. I looked at that guy like he just saved my little brother. He just took control of the situation. He calmed me down, which nobody could do. I think that's when I was first really impressed by the medical field, and I think that's where my original desire to want to go to med school came from.

And so that was kind of my plan growing up. It was always go play football, go to med school, and become a doctor. And then when I was playing football . . . I was that guy that didn't really have to study in high school, like, ever.

Dr. Chan: Where'd you go to high school, Bridger? Because I assume you were a football star at your high school.

Bridger: I was all right. I went to Jordan.

Dr. Chan: Jordan? Okay. And what position did you play?

Bridger: So at Jordan, I kind of played everything. I played receiver on offense, and then . . .

Dr. Chan: Punter? Were you a punter too?

Bridger: I did punt, actually. Yeah.

Dr. Chan: Okay. I love it.

Bridger: You were trying to make a joke, but yeah, I actually was. So I punted, I returned, and then on defense, they kind of played me wherever depending on the team we were playing, so I'd either line up the safety or linebacker.

I had to play D-end a couple of games when we played . . . who was that? I don't know. We played somebody that had a really good tight end, so I had to play D-end, which sucked at 180 pounds.

So in high school I kind of just played wherever, and then when I got to play in college, I played safety.

Dr. Chan: Again, we don't have too many people who matriculate to med school who played college football, so I have to ask were you recruited? Did you walk on? What was that experience like, and were you pretty open that you said, "Hey, I want to go to med school after this," or did you kind of keep that hidden? How was that process?

Bridger: Yeah, so my recruiting process was kind of a mess. I had some offers to some smaller schools. Brown was one of the bigger schools, obviously, being Ivy League. But the way that their scholarship process worked, I think my GPA was like a 3.89 and my . . . I couldn't even tell you my ACT number, but all I can tell you is the combined total of my ACT and my GPA didn't get me a full-ride scholarship. I didn't qualify for a full-ride scholarship to an Ivy League school.

And so I was thinking about just going out to Brown and just paying for that first year until I could just kind of roll my academic qualifications from my first year of playing to, I guess, qualify me for the scholarship or whatever.

And then I went and talked to The U, and it just felt like a really good fit. I did tell them that I wanted to go to med school and they were like, "Yeah, that's great." I mean, it's kind of a different story than they're used to hearing from a lot of their recruits. But that was the original plan.

But going back to where I was saying I didn't really study in high school, I just didn't have the study habits when I got up to college. So I was taking pre-med classes, and I was spending way more time focusing on football than I was academics, and I figured that's kind of how I'd always been, and I'd figure it out, and it wouldn't be that big of a deal. And I got a C in my first . . .

Dr. Chan: Oh, no.

Bridger: . . . pre-med biology class.

Dr. Chan: I call that jokingly a gentleman's C, right?

Bridger: Yeah. There you go. Exactly. So I got smoked in my first undergrad biology class and quickly realized that I didn't have the study skills at that time to manage football and pre-med.

So I kept playing football. I switched my degree to business, played for a few more years, and then I actually got a concussion and decided that I wanted to use my head for something other than smashing into people. So I stopped playing football and kind of did the business thing for a while.

Dr. Chan: Was it hard to walk away?

Bridger: Oh, yeah. Definitely. It was weird going to school not playing football. I hadn't done that since I was in, like, second grade, third grade. It was always kind of just that's what you did. You woke up early, you worked out before school, you went to school, you went to practice, and that's just kind of the routine. And so, when I took that football piece away, I didn't really like school anymore.

I've always kind of looked at school like if it's getting you to a profession that requires school and requires a degree, then it's awesome, but if you're going to school for something that you could learn elsewhere and you could do kind of a more hands-on approach, that's always kind of been the way that I did it.

And so I went and I started a couple of businesses and did that side of things. And it was two weeks before I got married actually. We had a house, brand-new truck, and we were just kind of living it up for being some young kids. I was doing pretty good at . . .

Dr. Chan: Well, what were your businesses, Bridger?

Bridger: So I had a window-cleaning business that I started with a couple buddies and sold. After about a year and a half, we sold that. And then I had a sales company. It was basically . . . what I did was I had managed and trained sales teams, and that kind of helped on the corporate side of things, like managing the . . . Basically, it was kind of like a liaison between the operations and the sales side of things.

So I did that for a little while, and then I had a contract that I was ready to sign a couple of weeks before I got married with a really nice salary, awesome benefits, and everything just kind of made sense on paper, but I just didn't feel good about it. It was kind of weird. I knew that once I kind of made that call, that's what I was going to be doing, you know?

Dr. Chan: Mm-hmm.

Bridger: And so I drove over to the house. My wife was living in the house at the time, or my fiancÈe, I guess, at that time, and I was like, "Hey, I don't know about this." She's like, "Well, what do you think kind of what's going on with the numbers?" I'm like, "The numbers are great. Everything looks like it makes sense." She was like, "Well, figure it out and let me know."

So I kind of took a few hours, I hiked up into the mountains, and I kind of just got quiet. I was just kind of thinking about, "What do I really want to do? What are my motivations?" And it was at that time that I was like, "Man, I think I need to go back to school and be a doctor." I was like, "Gosh, that's going to be brutal. I'm just about to get married. I don't want to go to school for the next 10 years or whatever it's going to be."

And so I came home and I told her. I said, "Hey, I think I need to go to med school," and she was like, "Cool. Whatever I've got to do to support you, let me know. If that's what you feel like you need to do, let's do it."

So we got rid of the house. We sold the truck. We moved into a basement apartment. We downsized big time. And right after we got married, I went out and worked for the summer to try and make as much money as I could to kind of fund this journey, and here we are seven years later.

Dr. Chan: Bridger, did you already have your degree by then or you already graduated, so you had to go back to school and do some post-bacc pre-med reqs?

Bridger: Exactly, yeah.

Dr. Chan: What did that kind of look like for you?

Bridger: Exactly. So, basically, I went back and I had straight pre-med classes to go. So I was taking pretty much biology, chemistry, physics every semester. I had to start from the very beginning, and so it was basically just . . . Because of the two-year, four semesters, I guess it's five semesters, chemistry track, that's what it was. So it was two and a half years of pre-med, knocking out all of those prerequisites, and then just working when I could and studying for the MCAT.

Dr. Chan: Did you feel when you went back to school . . . you mentioned earlier the studying skills. Was it better or different as . . . I'm going to use the term as kind of a more "nontraditional student." Because it sounds like things were different in your life. You didn't have football. You were married. You kind of had more focus, I would guess. I mean, did you notice that when you started taking these classes, you were a little bit older than the other students? Do you understand what I'm saying, Bridger?

Bridger: Yeah, I understand the question. For me, I've always been able to learn really well. I've always really enjoyed learning and studying on my own. I just never had to do it for academics before. I love reading. I love learning. I love that mental game, almost, of just "How much information can I gather?" But I'd never had to do it before in a structured setting of, "This is the chapter you've got to read. These are the questions you've got to do."

So, as far as, my approach coming back, I just kind of told myself that this was what I wanted to do now, and I wasn't studying because I had to. I was studying because I wanted to. And I think that was the shift for me, was being able to take my natural inclination to want to learn and want to work intellectually, and just knowing that this wasn't something that I just had to pass the class or whatever, like academics kind of was before for me. You do good just to do good. But for me, it was like, "This is going to get me where I want to go."

And so I think just the perspective shift on doing it because I wanted to and I was interested in it, and because it was going to help me get into med school, rather than doing it to just pass a class was really the biggest difference that made kind of the change for me.

Dr. Chan: Bridger, you wrap up your studies. You take and pass the MCAT. What was your reasoning? Like, how many schools did you apply to? What was kind of your thought process? What was your kind of strategy, I guess, when you started applying to med schools? What did you look for and how you kind of worked through that?

Bridger: So I've kind of done this a little bit nontraditionally, I'd probably say. What I did was I kind of went for the numbers. That's just where my mind goes. I had a couple of med schools that people had mentioned. People that I knew went to this med school or that med school, so I knew a couple of those. And then I just read a lot of the online forums.

And then what I did was I went on every med school's website that I was looking at, and I figured out how many students that they took from in state. If it was an out-of-state school, I figured out how many they took from in state. And then I took the number of males and females as far as their percentages went per class, and I kind of averaged that out. And then I looked through their class directories almost, and I was like, "Okay, how many students have they taken from Utah before, or what percentage of students are coming from their surrounding states?" And so I went super heavy on the numbers and I only applied to, I think, 13 or 14 schools.

Dr. Chan: Okay, so a decent number. It's a good number. Not cheap.

Bridger: Yeah. Gosh, man, that was another shock. I'm like, "Holy moly, this is expensive."

Dr. Chan: Yeah, it's like Amazon. The more boxes you click, the more your checkout cart grows.

Bridger: Yeah, exactly. Holy moly. So I kind of just went pretty heavy on the numbers, and I looked at schools that were going to be historically favorable to a white guy from Utah.

And I kind of just sent them out. I got quite a few interview invites, but lucky for me, I interviewed at . . . George Washington was my first school, and then the week later, I interviewed at The U. That was right before Christmas break, and so everything kind of quiets down over the holidays. And then I came back. I think it was early June. No, early January, sorry, where I got the phone call from you. I was actually pulling into work when you called me.

Dr. Chan: I remember that, yeah. You were driving. I remember that.

Bridger: Yeah. I think I'm the only med . . .

Dr. Chan: I don't recommend anyone driving and answering their phone, but I notice a lot of people tend to do it when I call. Public service announcement.

Bridger: Yeah, I think I'm probably the only med student that, as soon as I said it, I was like, "I can't believe you just said that." But it was funny. You were like, "Hey, Bridger, this is Dr. Chan. Do you have a minute?" And I vividly remember my response was, "Hell, yeah, Dr. Chan. What's up?"

Dr. Chan: That's great.

Bridger: And I was like, "You just said that? All right. Good. Well, let's see if they still want you in after that one."

Dr. Chan: Going back to your interview day, Bridger, I'm curious. You've played in a lot of big games. Is it kind of the same anxiety right before the big game? I mean, did you feel kind of like that competitive sense and were you able to kind of quiet your nerves, or was it a completely different sensation before a big interview day?

I'm talking performance, kind of like, "Okay, you're on the big stage." I'm just curious what your thought is, because you've played in a lot of really important games, and I would argue interview day is also very important game day.

Bridger: Oh, yeah.

Dr. Chan: So I'm curious what your strategy was and your thoughts about that.

Bridger: For me, my interview day, I honestly thought you guys were pranking me. So I'm in the room and I thought you guys were just like . . . because of the athletic background or whatever, I thought you guys were like, "Oh, let's kind of just see where his head is at."

So out of my interview group, everybody else gets called out of the room and I'm sitting in the old . . . I guess it's now Academic Success, but before it was Academic Success, I was sitting in that office, and everybody else had gotten called out to their interview. And so I'm sitting there and I still haven't been called out, and they're like, "Oh, your person is just running a little bit late." And I was like, "Okay."

So I'm sitting there by myself, and then I get pulled back into . . . they were doing construction back there, and I get pulled into this room and there's a guy with an impact rattle gun on other side of a piece of sheet rock. And so it literally is me and this lady who showed up 15 minutes late for a 20-minute interview sitting in this teeny tiny room that's kind of like a makeshift office while they're doing construction. And it sounds like I'm in a mechanic shop, so we're basically yelling at each other.

And I'm like, "This is kind of funny." I literally thought you guys were just messing with me. I thought you guys were watching how I'd handle the stress. And I'm just like, "This is kind of crazy."

And so we have our super quick interview, and she's like, "Okay, well, sorry I showed up late, but it looks like you'll do a good job." So I had no idea where I stood there.

And then I went into my next interview, and I remember . . .

Dr. Chan: Because this is before MMI. Yeah, I think you were getting traditional interview style back then.

Bridger: Well, I had two traditional interviews, and then I had the MMIs after. So I was in that hybrid year.

Dr. Chan: Okay. That's right.

Bridger: And so my second interview, I go in there, and I remember who it is, but I won't call him out. He was like, "I do this a little bit different. I've been doing this for a while. So I've already looked over your application. I just have two questions." So he asked me the two questions. And like 5 minutes in to the 20-minute interview, he's like, "Okay, we're done here." And I was like, "Oh my gosh, I blew it. Five minutes and, 'We're done here'? I get, 'We're done here'?"

Dr. Chan: As the admissions dean, this stuff makes me cringe. I'm sorry, Bridger.

Bridger: No, it's okay. So I get back into . . . I'm back in the little waiting room with the lady that's running the day, and she's like, "You just want to hang out with me today." I was like, "I guess that's the plan," because I sat in there for 15 minutes with her the first time and 15 minutes on the second one.

And so, for me, honestly, I think the whole situation was just kind of so bizarre to me. I don't know if I was nervous or if I was more just kind of like intrigued by the whole day. But maybe that didn't answer your question. I guess, for me, the big day is never the time to prepare. You know what I mean?

Dr. Chan: Yeah.

Bridger: Game day, when the lights are on, that's . . . if you're trying to prepare it that time, you shouldn't be there, you know?

And so I kind of looked at the interview days and the second look day and that kind of stuff, I look at that as kind of fun. The games are when it's fun. All the practice, and all the early mornings, and the late nights, and all the work that you put in beforehand is kind of where I feel like it makes sense to stress. I feel like when it's game time, that's when it's time to have fun. That's when it's time to just kind of let go and prove that you deserve to be there rather than worrying about all the other stuff.

Dr. Chan: That's great. So, Bridger, you decide to stay here, come to our school. How was that jump from more or less pre-med reqs, undergrad classes, to med school itself? Was that a smooth transition? Did you have to learn new study skills? What was the first couple of years like?

Bridger: Oh, yeah. I remember that first Foundations quiz that we had, and I remember I got a decent score on it and I was like, "Oh cool. I deserve to be here." You know what I mean? And then I saw the average and I was like, "Oh my gosh. These kids are geniuses." I was like, "What in the heck? Maybe I don't deserve to be here."

I thought I did pretty well, and then I saw that I'm on the backside of that curve and I was like, "Holy moly. I worked like crazy for this, and I didn't even hit the little top of the curve. Wow, this is next level. This is as big of a jump as it was going from high school football to college football. Everything is just a completely different level and a completely different speed."

Dr. Chan: And did you have to redo how you studied? I mean, how many hours a week were you putting in, and changes you had to do to your routine, or how did you kind of tackle that?

Bridger: So I totally changed my routine. I would not recommend this route for anybody, and I've said that in some of the talks and stuff that I've given to the other classes. But my personality is really pretty all-or-nothing. I kind of struggle with balance big time.

And so, after that first quiz . . . I worked pretty hard. I studied quite a bit, and like I said, I thought I did well, but to see where I was at compared to everybody else, I was just like, "Hey, this is going to require another level."

And so what I did, and like I said, I wouldn't recommend this, but I kind of just buried myself in school. I was at the library as they'd open it every day. I was the first one there, and then I would study all day. I wouldn't really eat. I had those Uncrustables, horrible little peanut butter and jelly sandwiches that I'd buy by the box at Costco, and I'd throw a couple of those in my backpack and I would just sit and study all day.

I wasn't exercising anymore. I wasn't sleeping near enough. I kind of just lost myself in the studying side of things, and I just worked like crazy. Yeah, my scores went up a little, but honestly, the bang for the buck that I was getting from everything that I was putting in wasn't worth everything that I was giving up on the personal and the health side of things.

Dr. Chan: Yeah. And then did you feel like . . . you said balance. Did you feel that as far as exercise, and wellness, and your relationship with your wife and your family, did that go through a rough patch during that time? I mean, what are your thoughts on that?

Bridger: Yeah, totally. So I came in . . . and it's funny. I guess I'm probably the only med student you've had on here talk about their weight coming into med school and then changing, but I . . .

Dr. Chan: Yeah, that's one of those questions I don't routinely ask, but if you want to spontaneously talk about it, go for it, man.

Bridger: Yeah, exactly. So I came in at like 185, 190. Yeah, I was pretty healthy, in pretty good shape. I had maintained taking care of myself pretty good during my pre-med years. I had a couple of shoulder surgeries that kicked me back, but overall, I was still taking pretty good care of myself. And by the end of the first year of med school, I was like 165 pounds.

Dr. Chan: Wow.

Bridger: I just withered away. I just wasn't taking care of myself. As far as my life with family and stuff, my family has always kind of seen me dive into whatever it was, and so, for them, this wasn't anything new. There was no concern of, "Oh, well, he's not really taking care of himself." It's more just, "Well, he's got something in his sights that he wants to do and this is kind of how he feels like he's going to accomplish it. So it is what it is."

I think, for me, what I would do differently, definitely just on the family side of things, is I missed a ton of family stuff, whether it was little weekend vacations or just going out to eat or hanging out on the weekend, kind of just fun little stuff. I passed on a lot of that so that I could study, and I would definitely go back and prioritize time with family a little bit better if I could go back and do it again.

Dr. Chan: Okay. Third year rolls around, and you kind of mentioned at the beginning that it's kind of a pivot. You go from more classroom-based to much more experiential learning, being in the clinics, the wards, the different hospitals. Was that an exciting transition for you to get away from the classroom and do more hands-on experiences?

Bridger: Oh, 100%, yeah. This is why I went to med school. Seeing patients, doing the work, kind of like the teamwork side of things, figuring out how to work with all of the different staff in the hospital, and the patient and their family. I was so excited to get out of that damn library and get into the hospital and start really doing what I came to med school to do.

Dr. Chan: What was your least and most favorite rotation during your abbreviated third year as it were?

Bridger: So I came to med school to be a surgeon. It was never a matter for me whether I was doing medicine or doing surgery. It was always just like, "What kind of surgery am I going to do?" So I spent a ton of time before med school, during my first and second years in the OR, just getting to know surgeons and getting to a place where they knew that I was going to be somebody that would one day be their colleague so that they would kind of give me more learning opportunities than I would have otherwise had as a third-year med student.

And so I loved my surgery rotation. I did trauma surgery at The U and I had an absolute blast. I was pulling, like, 100-hour weeks and I just loved it. I loved being at the hospital first thing in the morning and I loved leaving when it was dark. I loved the grind and I had a blast.

But then I got on psychiatry and something was just different, and I fought the . . .

Dr. Chan: Really? Interesting.

Bridger: Yeah. So I'm actually going into psychiatry.

Dr. Chan: Oh, you spilled it, Bridger.

Bridger: I know. Sorry. Yeah, so I'm actually going into psychiatry.

Dr. Chan: That's fascinating, Bridger. I want to learn more, because, again, if you loved surgery so much, what is it about psychiatry that changed your mind, I guess?

Bridger: Yeah. So it's a really hard question to answer because I don't really know if I can name one thing. I've got classmates that wanted to go into surgery, and then they got on their surgery rotation and they did the trauma surgery and they just hated it, right? They hated the hours. They hated the work. They hated the people. It was just . . .

Dr. Chan: They hated the grind? Yeah.

Bridger: Yeah, exactly. And they're like, "Hey, I've got to find something else." Where for me, my first two weeks on . . . sorry, I guess it's three weeks. So it was three weeks and three weeks before and after the holiday break for me. So my first couple of weeks on psychiatry, I was just like, "Man, like I really like this."

I've always been fascinated by psychology and the mind and kind of how the mind affects everything else. And so I've always studied psychology and that kind of stuff on my own and it's always been fascinating, and I've always thought that it was the most interesting field of medicine. I never considered it as a career because, like I said, I came to med school to be a surgeon. I didn't even have a crack in that door as far as something else sneaking in and changing my plans.

But as I was on psychiatry, I talked to a couple of the attendings about it, and I loved the specialty. I loved that my ability to communicate and connect with patients really made a difference, right? I'd had some experiences on medicine, or surgery, or some of the other rotations where the patient was being extra difficult and I was able to kind of go in there as the med student with a little bit more time than everybody else and really communicate with the patient, kind of connect with the patient, and get a little piece of information that they weren't really going to give up because they didn't like us, or didn't trust us, or didn't want to be there.

Dr. Chan: Yeah, or the team was in a hurry but you had a little bit more time. This is beautiful, Bridger. I love it.

Bridger: Exactly. So I'd had those experiences where I was able to connect with somebody who nobody else could or did, and it made a difference in the care. I saw that everybody else was like, "Yeah, great. Good job. You talked to the patient. We don't really care. Just, 'Give us the information,' or, 'This is going to kind of steer the course of what we're trying to do.'"

But when I got on psychiatry, I was on child and adolescent, and we had a . . . he was 16, 17, 18, something like that. He was just really difficult, right? We'd come in and he'd be swearing at us and yelling at us and kind of just angry and ornery all the time. And the attending is like, "Well, why don't you give it a shot? The kid obviously hates me, so see what you can do." You know what I mean?

And I was able to connect with him, and I was able to kind of help him take his guard down and just be like, "Look, man, we're here to help. And all the things you're saying, you might think they're true, and that's fine. You're not hurting our feelings here. But you're here, so why don't you get something out of it?"

I was pretty direct and just kind of approached it the way that I just naturally would. I wasn't thinking from a textbook on how to say this so that they do this or anything like that. I kind of just like approached it in a natural way for me.

And we walked out and the attending was like, "Kid, you've got a gift. You're pretty good at this, and your ability to do that will help you in whatever field you go into, but you've mentioned that psychiatry is interesting to you. If you pursue that path, you could be a pretty exceptional psychiatrist if you learned all the things that you'd learn through that training on top of kind of just your natural ability to read people and communicate."

And so, over the holiday break, that kind of stuck in my mind of, "This might actually be something that I could do." I kind of opened that door a little bit, and I was talking to one of the attendings that I worked with and he said, "Just try it on. Try it on. Go around for a couple of days like that's what you're going to do. When people ask you, tell them that you're going into psychiatry. See how it feels. See what they say. See how their reaction is and whether that bothers you or not."

He said, "Because that's one thing that's different than going into plastic surgery. People ask, 'What are you going into?' And you say, 'Oh, plastic surgery.' And they're like, 'Oh, wow.' When you say psychiatry, they go, 'I thought you were in med school. I thought you were going to be a real doctor,' and all that stuff."

Dr. Chan: Welcome to the club, Bridger. I'm excited.

Bridger: Yeah, there you go.

Dr. Chan: You've got great insight, little nuggets. I love it.

Bridger: Yeah. And so it was actually really interesting the first time somebody asked me and I said, "I think I'm going to do psychiatry." It just felt good to say. That sounds weird, but I smiled as I said it, where before it was like, "I don't know if I'm going to do plastics, or ortho, or trauma, or peds." I was always fighting, fighting, fighting for the decision on, "What's the right call? Why do I want to do this? Why do I want to do that? The patient population and the hours and the training."

It was always such a chaotic decision for me because I could see myself kind of doing well on all of them, but that was the first time that I said, "This is what I'm going to do," and I just felt really good about it. And after that, I was like, "Man, that advice to try it on was gold."

And so I came back from the break and I was like, "I think I'm doing psych." I was at the VA for my last three weeks and I loved it. I totally threw myself in. I mean, I tried to do that all year, kind of throw myself in of, "If I were actually in the specialty, if this is what I was going to be doing, how would I act on this?" Because I guess I didn't really know, but I figured, "I'm here, I'm paying a ton of money to be here, I might as well dive into the experience head first and kind of get everything I can out of it."

But that was the first time that I was just like, "This is definitely what I'm going to do." And as much fun as I had on surgery and other rotations, every experience that I've had since making that decision has just confirmed that that's what I want to do.

Dr. Chan: Bridger, I love it. It's just a beautiful story, and it so resonates with me. I can just tell by the way you describe it how . . . yeah, it sounds like a journey. And I always talk to the students about a journey going from pre-med to med to eventually a practicing physician, and it's just kind of a beautiful transformation that's taking a hold of your life. And as you kind of figure this stuff out in the midst of a COVID/coronavirus pandemic, it sounds like you're in a good place with your decision.

Bridger: Yeah, definitely.

Dr. Chan: We're running out of time, Bridger, so just a couple of more questions.

Bridger: Sure.

Dr. Chan: The first one is you kind of talked about your weight, and apparently you're well known for some type of exercise regimen. So can you talk a little bit about that, and just where that came from, and what that entails?

Bridger: Yeah, sure. So I guess I'm like the med school nut job. People look at me like I'm crazy. But after I kind of let myself go that first year, I decided that I just wasn't going to let that happen again. I was going to be waking up at 4:00 a.m., hitting the gym before I had to be up to the school. I was still going to be at the school by 6:00. And so it was one of those things where, with me living off campus, I had to factor in the commute time. So I was waking up at 4:00 a.m. working out every day.

And then I came across this . . . it's not really a workout program. It's almost like a mental toughness program that this guy came out with. And what it is, is two workouts a day. Each has to be 45 minutes. One of them has to be done completely outside. You drink a gallon of water a day. You take a five-minute cold shower. You have to stick to a diet, and you've got no cheat meals, no dessert, no sweets, no alcohol. You read 10 pages of personal development, business development type reading, like nonfiction. Let's see what else. Ten minutes of goal-setting meditation visualization kind of stuff in the morning. And it's 75 days straight of that.

Dr. Chan: No days off, no weekends, just full straight up?

Bridger: No, nothing. Exactly.

And so, when I came across this program, I was like, "When would be the absolute worst time in my med school schedule and the seasons?" Being in Utah, the winters are pretty rough outside. And so what I did was I decided to do it during surgery, peds, and then it tailed off in psychiatry, but that also happened to be over Halloween, Thanksgiving, Christmas, New Year's. So that's what I did.

The first time I tried it, I got, like, 18 days in, and then it was my 24-hour call on trauma surgery and we were literally in the operating room all night. And usually, I had been able to . . . I had my first call while I was doing it and I did fine because I just ran around the hospital outside for 45 minutes, but that second time, I literally couldn't get out of the OR. I just didn't have any time. And so I failed my first attempt on Day 18, and then I made it through the 75 days.

There are different phases to the program, so I finished Phase 1 during my family medicine clerkship while I was down in Manti, which was also freezing cold. It gets super cold down there. So I did that while I was on my rural family med rotation.

And then I actually just barely, over this last weekend, failed Phase 2. Well, I guess it's the third phase, but it's called Phase 2. When I was out roofing this chicken coop that I just built in my backyard, my water bottle rolled off and spilled, and I did not remember to factor in the water, so I actually failed on Day 21 of Phase 2. I guess that would have been my Day 130-something that I'd been doing this dang near straight, and I failed by 10 ounces of water, so I just had to start over three days ago.

Dr. Chan: But even with the starting over, have you seen a change either mentally or physically? Can you talk a little bit about that?

Bridger: Yeah, totally. So the physical change has been an awesome byproduct, honestly, but I think the program is 100% a mental program. There are so many takeaways for me just as far as not negotiating what you want. So many times before, I would want something, but I'd let things get in the way, like that first year being a perfect example, right? Everybody says you go to med school and, "Oh, wow. Well, you're really going to have to work like crazy for the next four years and kind of sacrifice everything else," and that's just seems to be the story that everybody tells themselves. But I just decided that I was going to challenge that story and I was going to do it during the worst possible time for my schedule just to prove that it could be done.

And it's actually been kind of cool because a lot of people in the med school, like you said, it's kind of getting around. It's funny that I'm talking about this on a med school podcast. But it is kind of funny that it's gotten around and people have been like, "Wow, you're able to do this during med school, and not only during med school but during the worst possible time in med school?"

And I did it at that time, one, because I think, for me, the bigger the challenge, the more excited I am to kind of do it. But two, I really wanted to do it during that time so that when . . . I've had several classmates and underclassmen and people kind of hitting me up about the program, and making their attempts at it. And one of them has finished it and the other one is on Day 20-something right now. And a bunch of them have kind of gotten a few weeks in and failed and started over and whatever.

But it's been really, really cool to me to kind of just know that that's the impact, I guess, that I'm having on some of the students. They look at me and they go, "If he can do it, I can do it," and I love that. And so it's been, actually, really fun to kind of not only push just for myself, but on the days that I really don't want to do it and it's freezing cold outside and I don't want to go do a 45-minute outside workout when it's freezing and snowing on Christmas Day, it was like, "Well, if I don't, then that just kind of gives everybody a reason, 'Well, on these kinds of days I don't have to do it.'"

And so I just kind of took all those options off the table and just . . . it's actually been really fun to kind of get all the messages and stuff from different med students that are like, "I'm on Day 7 and it's awesome, and I'm starting to see some change." It's just been kind of fun.

Dr. Chan: That's beautiful. I love it, Bridger. This is all . . . I don't know. It's just so great how far you've come in such a short amount of time.

I guess the last question before we have to sign off, Bridger, can you tell us the Utah football tuxedo story? Because that's kind of legendary in my mind.

Bridger: Oh my gosh, yeah. So I think that story has evolved. It wasn't quite a tuxedo, but it's funny. Man, I was not planning on telling this story. I think Sam probably put you up to this. He's always trying to get me to tell this story.

Dr. Chan: It's a good story.

Bridger: Yeah. Gosh. Okay. So my very first day of football at the University of Utah was worse than anybody . . . like, you could make a movie out of it and people would be like, "Yeah, that would never happen."

So I meet with Coach Whitt and I'm wearing dress slacks, a shirt, and tie. We're in his office and we're kind of finishing the "welcome to the team" kind of deal. And because of the way that my timeline worked out with different schools that I was talking to, I was like a week behind as far as the recruiting curve, I guess.

And so I'm in his office. I'm wearing the dress clothes, whatever. I'm wearing a pair of brown wingtip dress shoes. He goes, "Okay. We'll just go down to the weight room, tell the coach that you need your workout gear, and hop in on the workout, and we'll just get you rolling right now." So I said, "All right." So I walk downstairs to the weight room.

Dr. Chan: So it's Sunday dress. You were dressed in your nice clothes, right?

Bridger: Yeah, I looked like I'm ready to go to church.

I walk through the doors of the weight room and I'm like five minutes late, and so everybody is in their workout gear. And at The U, you don't just show up in gym clothes. You have to wear the outfit for the workout, you know? So I walk in and there's a little strength and conditioning coach. He's probably like 5'8". He's balding and he's kind of chubby.

And I walk over to him and I go, "Hey, I'm Bridger. I was just up with Coach Whitt. He just told me to get the workout gear and jumping on the workout." And this guy just tears into me. "If you're here for all the free crap . . ." Man just starts going off. I obviously can't repeat what he said on the podcast, but he just starts tearing into me and I'm like, "Who in the heck is this guy? What did I do to piss him off?"

So he goes, "If you're going to get in on the workout, that's what you're wearing. I'm not walking away from the workout to get you workout gear." And I'm like, "Okay."

So I just jump in line while they're doing all their warm-ups and stuff, and lucky me, it happened to be leg day that day. And so I'm wearing wingtip dress shoes, freaking slacks, a shirt, and I took the tie off and put it in the corner or whatever. But we're doing box jumps, and squats, and deadlifts, and lunges. And so, of course, we're doing a box squat and I drop down and blow the back end of my left pant leg out. So I've got this huge hole in my pants. You can see my underwear and I'm like, "What in the heck?" And everybody's looking at me like, "Who is this kid?" I haven't met a teammate yet. Nobody knows who I am.

Dr. Chan: This is your first impression.

Bridger: This is my first impression. So I walk in, I'm doing this workout, my pants are blown out, I'm doing box jumps in dress shoes so I'm sliding all over the place, and everybody's looking at me like, "Who in the hell is this kid and why is he here?" So I'm the most uncomfortable I have ever been in my entire life. Of course, nobody is talking to me. Nobody wants anything to do with this weirdo that's working out in dress clothes.

And so we go to the locker room and it's like we're going out to practice. It was a Monday, and Mondays we do shells, which is basically just a foam vest instead of actual shoulder pads. And so you just throw the foam vest on under your jersey and then you're just wearing shorts and your cleats. Well, nobody told me that and they apparently didn't have shells for me, and so they just put my pads in my locker, and so I'm like, "Okay." So I just put on all my gear.

And the way that it worked is I was supposed to go to meetings, but I didn't know where my meeting was, and so I kind of just sat in the locker room and I put my stuff on.

So I went out there and I got out there early, and I'm the one kid out of 135 guys wearing shoulder pads. And so everybody else is just wearing shorts and their little foam vest under their jersey, and I'm suited and booted and I'm the only one. And everybody is like, "Who is this guy?" People were literally thinking that it was some kind of . . . you know, somebody won a contest where they got to hang out with the team for a day. And so they're like, "What?"

Dr. Chan: Do you think it was almost like hazing? Did that go through your mind, like, "They do this to everyone"?

Bridger: Yeah, it totally went through my mind. I'm like, "What in the heck is going on?" So I'm just trying to blend in. I'm just trying to hide behind everybody. When they're calling people out for drills, I'm just like, "I am not getting anywhere near this field today." And of course, "New guy," somebody yells. So I have to go out there and I'm on punt. And I'm lined up against Brice McCain, who played in the league for quite a few years after he finished up.

But they line me up on punt team and I'm like the kill man, so that means I'm lined up out wide. And basically, my job is get off the line, get past the defender, and basically just fly down to the guy that catches the ball. I had done that all through high school, whatever.

I go, I line up, and I'm lined up just like I always have, and they snap the ball and I go to do my little, I don't know, jab, step, swim move to get off the line that worked every single time in high school, and I'm literally upside down before I even realize what's going on.

He had gotten under my pads and just had thrown me, and then I'm trying to get up off the ground and he just keeps shoving me on the ground. I literally couldn't even get off the line and four yards down the field before I had gotten pushed down three or four times. Of course, he starts talking crap. "Welcome to college football," this and that, and I'm just like, "Oh my gosh."

Dr. Chan: Wow.

Bridger: And so, after that, we get back in and nobody is talking to me. Everybody is like, "Who is this guy?" And so I didn't know that they did your laundry up there. You just leave your stuff in your locker and they wash it and put it back in there. So I'm packing all my stuff into my gym bag so that I can drive home and wash my clothes for the next day of practice. And everybody else thought that I was just quitting. They thought I was literally packing my crap.

Dr. Chan: Oh, wow.

Bridger: And so they're like, "You're done?" And I'm like, "What do you mean?" They're like, "Dude, they do the laundry here. Just leave it." I'm like, "Oh my gosh." So, after that day, I was just like . . . I literally had never had so much uncomfortability tossed at me at once. It was, by far, the worst first day of anything I think anybody has ever had. And so, after that, I was just like, "Well, can't get any worse than this."

Dr. Chan: That's a wonderful story, Bridger.

Bridger: Yeah.

Dr. Chan: And then looking back, did everyone just kind of laugh about it and you were kind of known for that?

Bridger: Oh, totally, yeah. I wouldn't say I was known for it. It was something that people would laugh about and talk about, because after putting in the work and always . . . like, after that day, I committed to just be first one there, last one to leave kind of thing.

I kind of grew on the team and I was actually somebody that contributed and it was funny to laugh about it looking back of where I started to where I ended up.

Dr. Chan: And did Coach Whitt . . . he heard about this, right?

Bridger: I mean, he was the one that called me out for getting out there on punt team and . . . obviously, you can't blend in when you're the only one wearing full pads and whatever, so I'm pretty sure . . .

Dr. Chan: Did it make him a smile at least, or who knows?

Bridger: Yeah, honestly, I think it was one of those things where it's just like all you can do is laugh. It's one of those situations where there's not really another option that makes any sense at that point.

Dr. Chan: Well, Bridger, this has been fantastic. It's good talking to you. I'm just so happy with how far you've come. Just hang in there. Stay safe and healthy during this time and we'll get the rotations going soon. And I'm excited you're going to become a psychiatrist, man. That's great. I'm really pumped for that.

Bridger: I'm really excited. Yeah, it'll be a lot of fun. Thank you for . . .

Dr. Chan: We'll have you come back in a few months and give a little update about . . . I think it's also fascinating, too, going through the residency application process, especially with COVID and everything going on. I would love to have your insight and take on things because it's going to probably look a little different. Yeah. Cool.

Bridger: Anytime, man. Let me know.

Dr. Chan: All right. Thanks, Bridger.

Bridger: Okay. I'll talk to you later. See 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.

Dr. Chan: What triggers someone to decide they want to go to medical school after completing their first year of college? How does one's vision of their future physician practice evolve throughout medical school? Why is it important to always go to the dinner hosted by a potential residency program? Today on "Talking Admissions and Med Student Life," I interview Anna, 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: Got another great guest today, Anna, fourth-year med student. How are you doing?

Anna: I'm doing good. How are you?

Dr. Chan: Good. Doing good. Again, this is beautiful because you were in my CMC group. So you're at the end of your medical school journey, but let's go in a time machine. Let's go back. So Anna, like when, how old were you? What was going on? When did you decide to become a doctor? What prompted you?

Anna: So I never thought about medical school until I was in college, kind of towards the middle/end of my first year. That's when I like started to seriously think about it, and then during the beginning of my second year, I was like completely set on it. So kind of a little bit later.

Dr. Chan: And where'd you grow up?

Anna: So I was born in Ukraine. My parents and I came to Los Angeles when I was really little. So I grew up in the LA area. Kind of moved around a little bit, but grew up there, went to college there and then moved to Utah.

Dr. Chan: So, and we are talking UCLA, right?

Anna: Yeah, for college.

Dr. Chan: Okay. So UCLA. A lot of pre-meders at UCLA.

Anna: A lot. It's super competitive.

Dr. Chan: Yeah. So did that kind of dissuade you at all or do you feel like you got caught up in the premed culture?

Anna: I was definitely one of those people that didn't want to say that I was premed because people were pretty competitive and you know, I wasn't really. I'm not a super competitive person. I'm a lot more relaxed and yeah, it was kind of a little scary sometimes to be around that kind of culture. But there's a lot of great people who are premed. Not everyone is really competitive like that, but definitely intimidating. Our classes were enormous and you know, a lot of those classes had to, you know, weed people out. And so that was a little bit hard.

Dr. Chan: Were you living in the dorms or at home?

Anna: I lived on campus my first year and then the next three years I lived at home and just commuted.

Dr. Chan: Pretty bad commutes.

Anna: Oh yeah, really bad. Really bad.

Dr. Chan: California is known for that.

Anna: Yeah. To do the 101 to the 405.

Dr. Chan: I'm just going to nod my head like, oh yeah. Parking lot. The whole thing. So what kind of activities were you doing at UCLA to prepare you for med school?

Anna: So I did a lot of different things. So one of the things that I did that I really loved was drug outreach and education. There's this group called DOEP. Like D-O-E-P, Drug Outreach, and Education Program. So basically, our goal was to talk about drug use in a very open and neutral way. Just be like people do drugs and you know, this is why and here's information you should know so you can make responsible choices.

So we talked to like elementary through high school kids. We talked to college students and just like went around the community and talked about that. That was the thing I did. And then, you know, I did volunteer work at the hospital. I did clinical research. I did molecular research and bioinformatics research and volunteered a lot. I did some integrative medicine. It was like a group that I was part of. Yeah, so a lot of different things.

Dr. Chan: Were you on the swim team?

Anna: I was on the club swim team, but I only did that in my first year like really consistently because I was on campus. And then during my second year I was also a part of it, but it was harder because I was commuting so far. And then my last two years I didn't. I wasn't part of the team but that was really, that was fun. I liked that.

Dr. Chan: And then you said like the idea of going to medical school really came to you in college. Was there a specific event that happened during like a volunteer experience or it was kind of more of a series of things? Like I'm just curious how you arrived to that.

Anna: Yeah, I think it was more of a series of things. So I became a lifeguard after high school, like during my last year in high school. I was like doing training and doing all of that stuff and we have to do, you know, first aid and learn a lot about kind of really basic medical conditions and how to manage things and stabilize before, you know, going to the next like higher level.

And I remember during that summer before college when I was working and I was, you know, studying for that, I really loved that. I'd never thought about medicine before, but kind of learning about like how can you tell when someone has a stroke or a heart attack or you know, a broken arm and all this stuff. I thought that was really cool and empowering to learn about. And so that kind of planted the seed to actually consider medicine.

And then during my first year, my roommate at the time wanted to be a pediatrician. And in the beginning, we didn't really know a lot of people. So she said, "Hey, I'm going to this AMSA meeting, American Medical Student Association." She's like, "Do you want to come just so you know, we can both find it together?" And I went along with her just, you know, to keep company and then it was like, "Whoa, this is really awesome." We had like a neurosurgeon from UCLA talk about medicine, and I was really glad I went to that meeting because that's when I kind of began to more seriously consider it.

Dr. Chan: And then did you work with like a premed advisor or was there a premed club at UCLA? Because we kind of talked about the premed culture, but don't they have some groups kind of dedicated to like helping the students?

Anna: So we had advisors for every major and my major was a pretty, you know, science-heavy major. And so I just went to my advisor for that and she kind of gave me advice of what classes to take. But I don't think I ever really met with a dedicated pre-med advisor. I know that we had that, but I felt like I got good enough information from her.

Dr. Chan: And then what year did you take the MCAT?

Anna: I took it after my second year that summer. Well, I took the old one and then I took the new one during my third year during the winter. Actually during the spring. Yeah.

Dr. Chan: Any tips about how to study for the MCAT?

Anna: Well, I think so I took it twice and although they were both different tests. I think the second time I looked at it more as a marathon and something that I have to do a little bit every day. And rather than trying to just cram information that would be important, I just tried to live my life and incorporate studying into it and that worked a lot better. I was less stressed. I did a lot better. It was not painful.

Dr. Chan: Didn't pay for any of like the tutoring services or the special classes?

Anna: I took on this online Kaplan course and that was helpful. Kind of gives some more structure. I think without that structure it would have been really hard. Some people do. I don't know how. Props to them.

Dr. Chan: All right, so you take the MCAT twice. I assume you were okay with your score the first time, but you wanted to improve it or you just wanted to see what the new MCAT was like or what was the reasoning?

Anna: Yeah. So the first time I got like a decent score, I think I got above average, but I knew that some of the schools I was thinking about applying to said that they might actually prefer the new one. And then there was one part of my MCAT that I wasn't happy with. I think it was my verbal, my first time around. So it was like, well, I'll take it again and try to increase that score. And yeah, that's what I did.

Dr. Chan: All right. So I love having you on Anna because I've always wanted to ask this question. So you're a California resident, and what was your strategy going into applying to medical schools? And let me just give you this caveat that I've worked here for a long time, we get thousands and thousands of applications from California. And now that I have you in the hot seat, I can now ask you, like from the other side, when you're an undergrad, I mean, what are people telling you?

Because like I get the sense that all the California med schools are full. That's really hard to get into them because like, there's literally millions of people applying. Thoughts, what was your strategy? How did you navigate? I mean, do people know that they probably have to apply out of state or some people still like, no, I'm going apply to a California school. Like what was your strategy? What was your thinking going into that process?

Anna: Yeah, so, well, I think looking back, I kind of wish I had talked to more people or maybe had a dedicated premed advisor that I could talk to because I just went off of what I heard my friends were doing and saying. And so definitely people from California are like thinking about applying to other schools because it's so saturated. So that's definitely in the back of everyone's mind. And I think beyond that it was just like, what are some like great programs or places to live or where would you want to be, you know, close. And so I applied, you know, the West Coast and then some places on the East Coast. But yeah, that's sort of what I did.

Dr. Chan: Do people, if you're an undergrad at UCLA, do you guys even apply to the med school or is it kind of like they never take their own graduates, you know what I'm saying about, or do all of you apply to UCLA? Just kind of okay, we'll see if they take me.

Anna: Yeah, I think the people that I knew and myself, we all applied to UCLA and occasionally people will get an interview. Like I got an interview. I didn't get in though, but I was actually really surprised that I even got one because most people, I mean I didn't get a whole lot of California interviews in general.

Dr. Chan: Yeah. Did you apply to all the California schools?

Anna: I probably did. I don't really remember, but I probably did.

Dr. Chan: So I'm hearing that kind of a West Coast strategy, a little East Coast thrown in. So do you remember the number? How many schools did you apply to?

Anna: I don't remember, but probably 40 or 30.

Dr. Chan: Forty, okay. Thirty or 40.

Anna: Something like that.

Dr. Chan: Allopathic and osteopathic.

Anna: Just allopathic.

Dr. Chan: Just allopathic. Okay. And so this is your last year at UCLA? So were you thinking like if you're not successful this year, would you take a gap year? I mean, like what was kind of your like thinking going into the process?

Anna: Yeah, I thought if I didn't get in this time, I would, you know, get some kind of research job and then try again. So yeah, that's what I thought about.

Dr. Chan: So you sent out 30 to 40 offers. How many interviews did you get?

Anna: I think I got seven.

Dr. Chan: Seven interviews. Okay. Seven or eight.

Anna: It feels like such a long time ago.

Dr. Chan: Okay. Obviously, we're one of the schools. Were we at the beginning, middle, end?

Anna: I'd say the middle towards the end.

Dr. Chan: Okay. And then had you ever been to Utah before?

Anna: No.

Dr. Chan: Okay. So what do you remember from your interview date here? I'm curious.

Anna: So I actually came here with my best friend. She had always wanted to go to Utah, and I've heard a lot of great things and I had known people were visiting so we decided to make a trip out of it and we stayed for like three days or four days. And it was the end of November, so it was snowing. It was really beautiful.

Dr. Chan: So you drove up.

Anna: We flew.

Dr. Chan: You flew. Okay.

Anna: Yeah. And I remember, honestly, this was the of my favorite interviews because everyone was so kind and loving and warm and I just thought it would be such an amazing place. I loved everybody that I met. It was really unique because I feel like some places try to intimidate you a little bit, but here everyone was really welcoming and the mountains really just like hit you. When we first got in, I was really shocked at how enormous they are.

Dr. Chan: How big they are. How close they are to the city.

Anna: And how close they are, so it was beautiful.

Dr. Chan: So you interviewed at Utah, really great experience. And then interviewing at these other schools, anything, any advice about interviewing you would give to people? I mean, did you do a lot of practice? Did UCLA offer practice interviews or you just kind of go in cold turkey or you were on Student Doctor Net just kind of reading about the latest gossip or what were you doing here?

Anna: I think that they did offer mock interviews at UCLA, but I didn't really use those resources. I wasn't like the best premed but a lot of the stuff I did, I would just look online and see questions that have been asked before and I would write out my thoughts and that's pretty much how I prepared.

Dr. Chan: Okay. All right. And then, you know, with different schools you were probably were exposed to like different cultures during the interview day. Anything stand out to you from other schools? You don't have to name them or you could.

Anna: Well, I think like a good number of schools really want to like sell themselves and show that they're a good program, and then some schools are kind of trying to show off how competitive they are and how great they are and like, oh, you should be lucky that you're even here. So that's kind of what I saw in the schools that I had seen. And sometimes it's kind of a mixture of both, but yeah.

Dr. Chan: So I remember Anna when I called you, I think it was in February or March.

Anna: Something like that, yeah.

Dr. Chan: You were really calm to the point where I interpreted as like, you're not coming.

Anna: Oh, no.

Dr. Chan: Yeah, you seemed so . . . it was just like, "Oh, hey. This Dr. Chan." And you were like, "Oh, hey. How are you? Okay. That's nice." And I don't know if you were like in shock or you were just surprised.

Anna: Oh, yes. Absolutely.

Dr. Chan: And I think you may or maybe you were in between classes or something. I don't know. I just remember you were very calm about the whole thing, so I just thought that, oh, she's probably not coming here. So again, well, what was going on in your side? I'm curious.

Anna: So I was in class.

Dr. Chan: Okay. That is correct.

Anna: I was in virology lab and then I saw that I got a phone call from 801.

Dr. Chan: Utah.

Anna: I think that's Utah. And so the whole time I was waiting until I could leave to like take a bathroom break. And so I left really fast to make the call. And I think I was just was like, oh, I only have a few minutes and I wonder how this phone call is going to go. So I was just really shocked and then I had to go back to class.

Dr. Chan: Okay. So great feeling.

Anna: I was really excited. I think it took a while to process.

Dr. Chan: Yeah. So again, like other offers or, I mean, why did you pick the U? I mean, like what was the decision making going up to that?

Anna: Yeah, I had two other offers and you know, they were good schools, but I just really loved my Utah interview and I thought it was a great program and it was very clear that that's where I was going to go. I didn't hesitate at all and really happy that I came here.

Dr. Chan: What was it like when you moved here? So especially like, it doesn't sound like you knew anyone here. Like getting roommates and finding a place to live. What was that like?

Anna: So I feel like we have a class page on Facebook and that was a really great resource. That's how I found my roommate who's also a classmate here. And I feel like everyone was really supportive. And I remember during our orientation week we had this one session, it was like a culture of Utah for people not from here, thought that was kind of a fun thing to have. But yeah, it was kind of a slow and steady process of getting used to the culture and the people and making friendships, but it was really smooth overall.

Dr. Chan: Was your family sad to see you leave?

Anna: Yeah, definitely but they're fine. Yeah, they're fine.

Dr. Chan: I remember there was a bunny. How's the bunny doing?

Anna: He's good.

Dr. Chan: Okay. You want to talk about the bunny story?

Anna: Sure. Yeah, I guess. I mean, it's not a crazy exciting story.

Dr. Chan: But I thought the bunny couldn't travel. You placed travel restrictions on the bunny.

Anna: So he's really anxious. He was born in a shelter, so I think he was probably traumatized at some point but he gets really nervous during car rides and will just like freeze up and like I worry if we need to take him to the vet and yeah. So he's just extremely anxious. I was like, if I bring him out here driving like 10 hours or on a flight, I honestly think he might get a heart attack or something. So yeah. But he's doing great.

Dr. Chan: Is he still back in California or is in Utah now?

Anna: He's in California.

Dr. Chan: Okay. Yeah. Can't use this bunny for out here.

Anna: Yeah. No.

Dr. Chan: Yep. All right, so you start med school, what was the biggest surprise? Because I guess like people are in med school and you definitely know what med school is like but from the outside looking in like it's still kind of like this mysterious black box. What was the biggest surprise after you started?

Anna: I think coming into med school I thought it was going to be really all-consuming and that I wouldn't have time to do anything else. And although it really is all-consuming, I was surprised that I did have time to pursue other things and to like have free time and develop friendships and do fun things. So I think that was my biggest surprise. It was a pretty good surprise actually.

Dr. Chan: And the academics, was it like a lot more material or was it comparable to like a UCLA undergrad degree?

Anna: I think there were definitely some classes at UCLA that I think were harder like some physics classes and like really hard science classes but med school overall is definitely harder. I think just the sheer amount of information that you have to learn and you have to at some point just figure out what you need to focus on and things that you have to kind of let go or you know, not focus so much on, that was the hardest part. That took some adjusting.

Dr. Chan: What was your thought once you realized you were in my [Brighton 00:19:24] CMC group?

Anna: I was so excited. You are so friendly, and I was really stoked that I was in your group. I got the best group.

Dr. Chan: For those of you that this seem like . . . Anna and I know each other pretty well because we see each other once a week and I tried my best to teach you physical exam skills, interviewing skills, progress note writing skills. So I would just see you all the time. So that's how we developed. Yeah. That's how we know each other as well. So, all right. So during the first two years, what kind of doctor did you think you're going to be and why were you leaning towards that?

Anna: So during my first two years I thought most likely I would do psychiatry, but I was keeping an open mind. I thought maybe psych or internal medicine or family medicine.

Dr. Chan: I swear you said neurology at one point.

Anna: Or neurology. I thought about neurology too. So I was thinking about all those. I think I was thinking more psych, but those were still on my mind.

Dr. Chan: Were you doing any kind of interest groups or shadowing during the first two years to kind of help rule in or rule out different fields?

Anna: Yeah. So most of the stuff I did was like psychiatry centered and I did do some shadowing at the UNI HOME clinic and I don't think I did any other shadowing aside from that, aside kind of what we do in CMC and like the free clinics. I guess that's kind of shadowing in some way. But yeah, I led the psychiatry interest group and helped start the addiction medicine group. So a lot of it was kind of psych oriented. Yeah.

Dr. Chan: And like going back to the psychiatry, were you thinking that back in your UCLA days? Like where do you think that comes from, your desire to become a psychiatrist?

Anna: Yeah, I think it's a lot of small things that sort of coalesce together. When I was in college applying to medical school, the drug outreach and addiction volunteer work that I was doing had a really big impact on me. And at the time I thought maybe I would do like addiction medicine. So that was a pretty big consideration, but I think like with psychiatry in general, it just sort of makes sense and I think that's really happy that I'm going into it. And like looking back there was like a lot of small things that kind of led me there.

Dr. Chan: So third year. So you're thinking about psychiatry, you still have some others on the list, was third-year really great? Did you like being out in the wards in the hospitals? Did you miss the classroom? What was there you're like,

Anna: Yeah, so third year was great overall. There were definitely hard times. And I started with surgery, so I think I started off strong.

Dr. Chan: Was that a hard time?

Anna: Yeah, it was pretty hard. I mean I've never been in the OR until then and I wasn't really looking forward to it. I mean, I was looking forward to learning and seeing what it's like, but I was kind of scared actually. So that was kind of hard, but I'm really glad that that's the one I did first because after that all the other rotations were not that scary.

Dr. Chan: A bit easier.

Anna: Yeah. They were harder in other ways but . . .

Dr. Chan: Yeah, I remember on my surgery rotation, like we had to get up like 3 or 4 in the morning to get to the hospital to pre-round because everything's like predicated on being like first in the door when the OR opens at like 7 so you had to get all like the floor work done before 7 and then you're in the OR for hours and hours, hours and like, but then like the pagers are going off but like the charge nurse is like handling the pagers. I don't know, there's just a lot going on and then hours are kind of awful. I remember going home like 8:00/9:00 pretty consistently. Sometimes 10.

Anna: Yeah. I mean, I was at the VA for my kind of main surgery rotation and it was not as intense as what you're saying. It's still intense, but yeah, I don't think I went home past like 7:30 or 8.

Dr. Chan: Still waking up pretty early too?

Anna: For the VA?

Dr. Chan: Yeah.

Anna: Yeah, pretty early, but not like 3 or 4 in the morning. Maybe we had to be there before 6, something like that. So it was actually not that bad. Yeah, I had some other rotations at other places that were a little different.

Dr. Chan: Since you were thinking about psychiatry, did you strategically position psych kind of the middle of your third year or how'd you do that?

Anna: Yeah, yeah. I think that's the advice that I got from some classmates and so that's what I did. I had it like during December or January?

Dr. Chan: And you started your psych rotation. I was it like love at first sight or did you have like a negative experience and you started to have to rethink everything? Was it confirmational or not, I guess?

Anna: Oh, absolutely confirmational. Okay. I was, I loved it. I loved every part of it. It was really amazing.

Dr. Chan: What'd you love about it?

Anna: So I feel like, I mean, in all of medicine we have to know about, you know, someone's medical history and their social history and what's going on in their life but I think in psychiatry you really take the time and interest to like explore these other parts of someone's life and to like make a really meaningful connection with them so that they can trust you and you can, you know, interact with them in their care. And I loved how on the psychiatry rotation it was so much of a team. We had social workers and nursing. We all would meet together and talk about, you know, what's going on, what's the best plan? And I loved how we all valued each other's opinions and each person was really important in that team. I thought that was pretty unique.

Dr. Chan: Were you at UNI, the VA, 5 West?

Anna: I was at 5 West and then at UNI.

Dr. Chan: Okay. Kind of two different worlds. Which one did you like more?

Anna: Well, UNI is a very beautiful place, right?

Dr. Chan: Kind of like a ski lodge.

Anna: Yeah. Yes, definitely. It's like if I had to be inpatient, I would absolutely go to uni. In 5 West, it's a little different, has more kind of a dungeon vibe.

Dr. Chan: Because it's a little bit older. It's attached to the main hospital so more medically related psychiatric issues.

Anna: Yeah. Yeah, definitely.

Dr. Chan: Because you need to be closer in case something happens. UNI is kind of middle of Research Park.

Anna: Yes. The acuity was different. I think they're both really great places and I loved both of those experiences.

Dr. Chan: So that was midway through your third year and you just knew.

Anna: Yeah, I was.

Dr. Chan: No hope for family medicine, neurology.

Anna: I really loved family medicine and I had neurology before, but no, I was like, yeah, I know that this is what's going to happen. Yeah.

Dr. Chan: And you've told your family you want to be a psychiatrist when you grow up?

Anna: Yeah, I've slowly been telling them throughout the years.

Dr. Chan: And they've been accepting, or are they still hoping that you are a surgeon?

Anna: They are accepting now and very supportive. At first they were like, oh, are you sure you want to do psychiatry? You know, how about internal medicine or this or that, but now they're super supportive.

Dr. Chan: Okay. So third year winds down, you're in the middle of your fourth year now, what's been your strategy now that you're from California, you're here in Utah, now you're looking at residency programs, the next step in your journey to become a psychiatrist. What's been your strategy for residency applications?

Anna: Yeah, so for residency applications I've been trying to see like what part of the country would I be happy living in and what's important to me in that sense. So I've been applying kind of the West sort of Colorado West and then some places on the East Coast that I have a particular interest in. So that's been my strategy and that's what I heard from a lot of residents that like tried to think about where you could see yourself living and then explore the programs within that area. So, yeah.

Dr. Chan: I remember when I was doing my interviews, like some of these programs, like they have like a dinner the night before and I remember getting the advice, like always go to the dinner. Because that's when you interact with the residents, maybe some of the attendings but it's usually residents there and people are pretty unguarded in those events and they share a lot of information and as an outsider you can kind of pick up the culture a little bit before the interview day even starts. Is that still going on or are you doing the dinners or what have you been told?

Anna: Yeah, I think most of the places that I've been interviewing, I have had a dinner and I've gone to all of them. I think that's super-valuable to talk to the residents, see how tired or not tired they are and how excited they are to be there. Yeah, that's been really important.

Dr. Chan: And usually the interviews days too, it's like they take you on a tour, everyone has to do a tour. And after a while to me, like all the hospitals just start to look the same. It's like, oh here's the unit, here's the nurses' station, here's where the doctors write the notes. You know, it's like, here's the med room. And I think because of like accreditation standards, all these places like more or less are the same. So, feel the same way?

Anna: Yeah. So some places are a little different and more memorable, but overall it's basically pretty similar.

Dr. Chan: Is it the same interviewing for residency as it is med school or is it different?

Anna: It's very different.

Dr. Chan: How?

Anna: A lot better. I think for residency interviews it's a lot more conversational. They want to see who you are, see what you're like. Like would you be a fun person to work with? Like on a long call shift, would you be, you know, really high strung or would you be really open and willing to help and help out your co-residents? And I think also in psychiatry they really want to see if you're committed to psychiatry, like why do you want to do psychiatry specifically? So a lot of the conversations have been really fun and they go on all sorts of tangents and yeah, way better than med school interviews.

Dr. Chan: So they probably asked you a lot about the whole California, Utah because they can see that in your application, your CV.

Anna: Yeah. Yeah, definitely. A lot of people have interesting views on Utah so I have to dispel some of . . .

Dr. Chan: So you're a defender of the state.

Anna: Definitely defender of the state.

Dr. Chan: All right. So, and how many programs did you apply to?

Anna: I applied to 50, which is a lot.

Dr. Chan: Okay. Was that more anxiety-driven or are you given like advice to apply to that many?

Anna: Yeah, I was given advice that that's kind of where the average would be this year, and so I just applied to what the average number would be.

Dr. Chan: Okay. And how many interviews?

Anna: I've gotten 14 offers so far.

Dr. Chan: That's great. Isn't like the magic number 9 or 10? Isn't that?

Anna: I think it's like 11/12 thereabouts.

Dr. Chan: Okay. It's creeping up.

Anna: Everything is increasing.

Dr. Chan: Everything's getting harder. All right. And is psychiatry one of those because I have heard rumors that like because spots are so competitive that like these programs email you like the interview kind of invites and you need to like respond immediately or it's gone. So psychiatry is like that?

Anna: I think for the most part I've been able to get like interview spots but there have been some where it's like, oh this is the last interview spot that they have open. So it was like, oh man, should've gone on like three minutes earlier.

Dr. Chan: And are you crisscrossing the country? Are you like Seattle on Monday, New York City on Tuesday? Stuck in the airport in Chicago.

Anna: I've been lucky that like it's been arranged pretty well. I've been mostly on the West Coast and had a couple there and then I just had one interview on the East Coast recently. So I've just made one trip out there.

Dr. Chan: Did you interview at your "Home program UCLA"?

Anna: I interviewed at one of their community programs. It's like all of you UCLA, well . . .

Dr. Chan: Did you do an away rotation?

Anna: Not there.

Dr. Chan: Not there. Okay.

Anna: I did do an away rotation.

Dr. Chan: Interesting. What'd you do it in and where?

Anna: I did it at UC Irvine. So part of it was, so a lot more people are applying to psych this year and it was hard to get a sub-I right before applications. So my sub-I was kind of after applications were sent out, so I decided to do a sub-I before that so I can kind of show them that, you know, I know what I'm doing at least kind of yeah.

And you know, California is a state that I would be very happy to go back to or just kind of the West Coast in general so I thought that would be a good place. And my parents aren't too far away so I can kind of hang out with them and yeah.

Dr. Chan: Yeah. But it sounds like Utah is on the list too.

Anna: Oh yeah, yeah, definitely. I really loved Utah Psychiatry Program. It is amazing so I'm very highly considering it. Yeah.

Dr. Chan: Okay. All right. So last question, Anna. This has been great. So what advice would you give to applicants out there who may be wondering if they should do it, so apply to med school, who might be on the fence, who are wondering if it's worth it or not? Like looking back now at what you've learned over the past four or five years, what would you say to them?

Anna: I think I would say I think medicine is a very special field and your heart really has to be in it for the right reasons, and I think if it is, then you should do all that you can to pursue that. I think you have to give a lot of yourself to people and if that's what makes you happy and makes you feel like you know your life has meaning, then that's a really beautiful thing and you should do it.

Dr. Chan: Okay. Well, Anna, we'll have to have you come back and hear where you matched. Very curious to see where you end up.

Anna: Me too.

Dr. Chan: When I heard you were going into psychiatry, I was like, "Oh yes. Anna is going to psych." I always kind of thought, because I remember I talked to you and times a handful of times about it and I always got the neurology vibe from you. So when I heard you . . .

Anna: I remember during one of our CMC groups, you were going around saying what you thought everyone would match into and I remember you told me neurology, I was like maybe, but really?

Dr. Chan: So you've kept your cards very close to your chest. Yeah, it's been wonderful to see. I remember the first time we had CMC, you had your hair pulled back I think, and with your lookbook card, like you talked about being from Ukraine and you had kind of like this cool sweater. So I thought, "Oh, that's really cool." And yeah, it's just been amazing to watch you grow over the years to the point where you're ready to graduate and you're going to have an MD by your name very shortly.

Anna: Yeah, it's pretty surreal.

Dr. Chan: Cool. All right, well, thanks, Anna. Thanks for coming on.

Anna: Thanks.

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's it like to move from Damascus to California when you've never been to the U.S.? How does Syrian culture differ from culture in the United States? How do you turn a feeling of helplessness into a passion for helping vulnerable patient populations? How does it feel to be starting medical school with your best friend from undergrad? And finally, how does one turn a fear of public speaking into a talent for teaching in large lectures?

Today, on "Talking Admissions and Med Student Life," I interview Fadi, 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 Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Well, welcome to another edition of "Talking Admissions and Med Student Life." We've got Fadi, an incoming student. Hello, Fadi.

Fadi: Hello, Dr. Chan.

Dr. Chan: We're so excited to have you. And you have a fascinating story. We were chatting a little bit because we had some technical problems. But, Fadi, let's start at the beginning. Where were you born?

Fadi: I was born in Saudi Arabia.

Dr. Chan: Saudi Arabia. And how long did you live there?

Fadi: I lived there my first four years of life, and then I went back to Syria where I come from.

Dr. Chan: Syria. And is there a city in Syria or . . .

Fadi: Yeah, Damascus, the capital.

Dr. Chan: Damascus, okay. Awesome. And then you grew up in Syria for many years. And then as I understand it, you left.

Fadi: Yes. I left in 2015.

Dr. Chan: What's that process like? I mean, was it stressful? Was it a lottery? I mean, how did that happen? Did you have family in the U.S.?

Fadi: Yeah. So I applied for a student visa after high school, and I was able to get the student visa. So I first came to the U.S. on an F1 visa, which is a student visa. And then in 2016, my family and I applied . . . sorry, interviewed to get the green card, which we applied for in 2003, so yeah, 13 years later . . .

Dr. Chan: It took 13 years, huh?

Fadi: Yeah, we were able to get the green card.

Dr. Chan: Why the United States? Was there a particular reason? Because I know there are a lot of different countries.

Fadi: Yeah, I have a huge family in California, my aunts and uncles, and their children and grandchildren. So it would be nice to, you know, be able to visit whenever.

Dr. Chan: So you've been to the U.S. before you . . .

Fadi: I have not, no.

Dr. Chan: Before this whole process, never set foot in the U.S.?

Fadi: No.

Dr. Chan: Fascinating. Did it give you anxiety or . . .

Fadi: Yeah, I mean, traveling to a different country, I was certainly nervous. It's the fear of the unknown. But I was also excited about being able to have better opportunities for education.

Dr. Chan: So where did you end up after Syria? Where did they send you to?

Fadi: So I was looking for affordable universities that are also good and I ended up in University of South Dakota.

Dr. Chan: South Dakota. So from Damascus to South Dakota.

Fadi: Yeah.

Dr. Chan: What's the capital of South . . . Bismarck? No, that's North Dakota.

Fadi: No, I think the capital of South Dakota is . . .

Dr. Chan: St. Pierre?

Fadi: No. I want to say Rapid City or . . .

Dr. Chan: Yeah. All my listeners in South Dakota are shaking their heads.

Fadi: I'm sorry. I don't know what the capital of South Dakota is. But I was in Vermillion, where the University of South Dakota is, in the southeast.

Dr. Chan: What was that like to kind of jump from two different cultures, two different systems?

Fadi: Yeah, it's . . .

Dr. Chan: And you were like 16, 17 when this happened?

Fadi: Nineteen.

Dr. Chan: Nineteen, okay.

Fadi: So it's interesting. A lot of people would assume that I'm going to have a culture shock because they're very different cultures, and they are, but I feel like . . . since Hollywood movies are very, you know, common and ubiquitous, every person around the world has an expectation of what the culture looks like. So I wasn't really, you know, shocked by anything, as in culture shock.

But I was fascinated by some things. I was fascinated by the buttons that open doors at the entrance of every building, which is . . . you know, out of all things, why would someone be fascinated by that? But it's not so much the technology as much as the concept of it. You know, if you're in a wheelchair in Syria, your life has basically ended. You know, you need someone to take care of you. You can't enter buildings because not all buildings have ramps. We don't have any equivalent of ADA regulations in Syria. So just the idea that you can be in a wheelchair here and still pursue an education or have a job is fascinating for me.

Dr. Chan: And I perceive . . . and again, I've never been to the Middle East, nor have I been to Syria, but I've been to South Dakota. Very wide open. Not a lot of people. Was that a big jump too? Because I imagine Middle East, there's a lot more people in a very kind of smaller, tight space. I mean, did it feel weird to not . . . I mean the lack of crowds. I just imagine, you know, Syria a lot more crowded, or am I misperceiving it?

Fadi: No, there are areas in Syria that are less crowded. I mean, there are rural areas. There are urban areas. But it's true. Damascus is the capital, so millions of people live there, and it's a really big city. I moved to Vermillion. So just to put it in perspective, the population of Vermillion is less than the enrollment at The University of Utah. So, yeah, it was an interesting move.

And, you know, I come from a small village in Syria originally, which I used to go to every summer. So I also know what to expect in such a setting, but it's also interesting. I feel like every place has its ups and downs, you know? A city has more opportunities, but a rural area is more calm and peaceful and has clean air, which is, you know, still a very true comparison between Salt Lake City and Vermillion. Opportunities versus calm, peaceful, and clean air.

Dr. Chan: Did you know anyone in South Dakota? I mean, did your family go with you?

Fadi: No.

Dr. Chan: So you were by yourself? Wow.

Fadi: Yeah. I arrived there alone.

Dr. Chan: It's colder though in the winter.

Fadi: Yeah. I mean, it depends on how you define colder. If negative 30 degrees is cold, then yeah.

Dr. Chan: I define that as cold. That sounds frigid, subzero, Arctic.

Fadi: I was just kidding. It is very cold.

Dr. Chan: And it sounds like you just picked South Dakota because, would I dare say, the cheapest or the most affordable? You kind of alluded to that.

Fadi: Yeah, it was the most affordable university if I did not want to go to a community college. It was probably the most affordable university for its ranking. It's also a very good school.

Dr. Chan: Fascinating. And then when did . . . going back, what was it like growing up in Syria?

Fadi: I mean, before the war, it was normal. I had friends. I used to go to school. People used to go to their jobs. Everything was good. I mean, I never had the idea of going outside. But, you know, when the war started, everyone starts looking for opportunities outside because you can't guarantee that tomorrow is going to be just like today. You never know what the future is holding. So if you're able to find an opportunity elsewhere, that was an opportunity someone wanted to take.

Dr. Chan: It sounds like a lot of people . . . just from what I know, and we're not going to go into the details, but I think globally you look at conflict and it starts creating this uncertainty, and strife, and unrest. Again, you know, I've felt very lucky in my life. I've never lived through circumstances like that. But when I read people . . . you know, it becomes like, "How do I get from point A to point B safely?" And then food supplies start getting . . . you know, then prices start going kind of wonky.

So not only from a personal safety standpoint, but then you start thinking, "What am I going to do for my career? Is the infrastructure starting to fray and come apart?" So it sounds like a little bit . . . it sounds like it definitely started happening in Syria.

Fadi: No, that's true. I mean, we were just talking about this before we started the podcast, that it got a little safer towards the middle of 2018. But right now, people . . . I mean, at least in my area where I grew up in Damascus, people are not afraid for their lives anymore because the war kind of ended there. But it's all the financial aftermath. Everything is more expensive. You know, $1 was 50 Syrian pounds before the crisis. Now, it's 600, while the salaries did not change. They're still in Syrian pounds. So people there are earning 12 times less than they used to before the war. So it's just the financial aftermath, you know? Like, lack of fuel, lack of electricity, lack of sometimes medicine.

So yeah, it creates uncertainty, as you said. Are you sure that you have a good future in such circumstances, and when does it end? So yeah, that's one of the forces that pushed people outside.

Dr. Chan: Did you start thinking about becoming a doctor back then? I mean, when did that start in your life?

Fadi: It's really hard to pinpoint the moment when I decided that I wanted to be a doctor, but I can trace the roots to a very young age. I mean, I come from a culture where they teach you from a very young age that you can either be a doctor, an engineer, or a failure, you know?

Dr. Chan: Those are the three options?

Fadi: Yeah, you have three options, plenty of options. Pick one. But, you know, I don't think that cultural influence was one of the big reasons I decided to become a doctor. Because as I started growing up and started learning a little bit more about life, I understood that a job is something that you're going to be doing for somewhere around half of your life expectancy. So, if you're surviving that rather than enjoying that, then you pretty much wasted your life.

So I wanted to do something that I'm really interested in, something that I wanted to do. And when the war started, just all the death that was going on . . . you know, I'm one of the lucky ones that did not lose a family member or a close friend, but I have close friends who lost family members or close friends. So, it was in the vicinity, all of this . . . you know, I was just lucky not to have died. It was very random.

So I kind of mentioned this in my personal statement. I felt helpless because, you know, there was nothing I could do as a high school student in such circumstances. So it just created this feeling that I don't want to feel helpless again. I want to feel useful. So, that's kind of my selfish reason of why I want to be a doctor.

But other reasons came as I had my experiences as an undergrad. When I came here, it was kind of clear for me that I wanted to go either for an MD or a Ph.D., because both ways would equally . . . maybe not equally, but, you know, both ways would lead me to a position where I can improve the human quality of life.

So my experiences just . . . you know, I did research as an undergrad. I worked with people. I worked with patients. And I just realized that I'm more committed to working with patients, although I really enjoyed research and I know I want to keep doing research.

Dr. Chan: So it sounds like you've had this dream for a while. There's no specific aha moment.

Fadi: Mm-hmm.

Dr. Chan: But do you think you would have stayed in Syria and become a Syrian physician if the war never happened? Is that a tough question?

Fadi: It is a tough question because, you know, even before the war, some people would go to medical school in Syria and then do their residency outside. So that was an option. It was just not in my mind as a high school student. But who knows? Maybe by the time I got to med school and finished med school I would have specialized somewhere else. But yeah, I think I would have finished medical school in Syria.

Dr. Chan: Okay. Interesting. All right. So you get to South Dakota. You're doing good. How did you end up in Utah? Because, again, it's a fascinating journey, Fadi.

Fadi: So my sister finished medical school in Syria and came to the U.S. to do her residency. So she was doing medical rotations and research in a couple of places. And the plan was wherever she gets in for residency I'll transfer. And she got into The U for the radiology program and I transferred here to live with her.

Dr. Chan: Cool.

Fadi: Yeah. So I transferred here after my sophomore year. So I came here for my junior year at The U. And then . . .

Dr. Chan: And your sister is the only person you knew in Utah?

Fadi: Yeah. I basically moved here to live with her.

Dr. Chan: So your education just kept on going further west?

Fadi: Yeah.

Dr. Chan: Whence the mountains. Sorry I interrupted. Go on.

Fadi: No, that's okay. So I moved here, I lived with her for a year, and then she got married and moved to live with her husband in Michigan. So she transferred to Wayne State, but I stayed here.

Dr. Chan: That's good. And then what did you get your degree in?

Fadi: Biology.

Dr. Chan: Biology. So what kind of activities did you do to prepare yourself for the med school application outside of biology? Because I know you've been very involved in research, but I know you've done some other cool things, too.

Fadi: So most of my experiences have just felt like one led to the other, and I feel like for me that's the right way to do it. When you start medical school, you're told that it's really competitive so there are some boxes you need to check. And I'm guilty of starting my journey with box-checking, because I did not know better. But even the experiences that I had trying to check boxes were very eye-opening, and they were all important for me as an immigrant trying to learn more about the culture in the U.S. and trying to learn English.

So I can give you an example of how one experience . . .

Dr. Chan: Sure, yeah.

Fadi: . . . led to another. So, in my freshman year, I had a speech class. And when I was giving my first speech, I realized that I have a problem with public speaking. I would just, you know, get nervous. I would turn red and my heart would start beating. And I felt like, "I need to solve this. I can't carry on like this."

So I applied to become a supplemental instruction leader. So I held help sessions for general chemistry during my sophomore year. I just felt like that's a job that would force me to hold three sessions every week lecturing or facilitating group learning for a group of students. So that's public speaking. I just decided to force myself into that fear.

And it worked greatly, you know? I started having about 10 to 15 students and I would get nervous, but it was like systematic desensitization. I was forced to be in that position, speaking publicly to students. And by the end of my second semester, I was having sessions with 80 students with no problem.

Dr. Chan: Wow. So you turned a weakness into a strength almost.

Fadi: Yeah, almost. And not only that, my initial goal was to solve my public speaking problem, but I realized that I have a passion for teaching. It's just that when I see a student getting it, this light bulb moment, I just feel so happy.

So when I transferred to The U, I applied to become a tutor. Because I was planning to start studying for the MCAT during my junior year, so I wanted something with less time commitment. So I did not do supplemental instruction. I did tutoring, which turned out to be very different.

As a supplemental instructor, I needed to explain things in a way that made sense to most of the students in my session, while as a tutor, I have one student, so if I don't explain things in a way that makes sense to this one person, then I've failed my mission. So there was much more diagnosis, if you will, as a tutor than as a supplemental instruction leader.

Dr. Chan: Well, I remember, Fadi, you had a very impressive application. I mean, I remember you wrote very passionately about helping vulnerable patient populations, had some great research, and then you had a cool story. Plus, you're a really good test taker too. You'd say that too.

Fadi: Kind of, yeah.

Dr. Chan: What compelled you to stay? Because it sounds like you didn't really have any connection to Utah anymore. I mean, I assume you cast a big net. How many schools did you apply to? Were you looking at Michigan to rejoin your sister?

Fadi: I applied to The U. I applied actually to 16 schools. I chose The U for so many reasons.

Dr. Chan: How many interviews did you get?

Fadi: Can we not talk about that?

Dr. Chan: Oh, okay. Well, at least one.

Fadi: Yeah, at least one. I mean, all you need is one acceptance.

Dr. Chan: All right.

Fadi: So I had so many reasons to go to The U, actually. First of all, the quality of education. So as an undergraduate biology major here, I was required to take upper-division biology courses. So I took Basic Immunology, which is a 5000-level class. And it was a taste of . . . or at least for me, it was a taste of what grad school at The U is like.

That class was simply fascinating. It was the best class I've taken in college, the most interesting class I've taken in college. We had about 12 professors. Each of them taught the topic that they do research on. So we learned about B cells from an expert on B cells, someone whose research is on B cells. We learned about T cells from an expert on T cells and so on.

So these professors, I mean, they were so confident and so passionate about what they're talking about, to a point where I felt like, "If this is what grad school education looks like at The U, then I would like to get some." I don't know if we can mention names, but . . .

Dr. Chan: Sure.

Fadi: . . . professors like Dr. Tom Lane, Dr. Dean Tantin . . . I really enjoyed attending these lectures. It just gave me the idea that the quality of education here, especially in grad school, is wonderful.

You know, I have other reasons to believe that the quality of education in grad school here is great. My PI, who is probably the best PI that has ever existed . . . shout out to Dr. Alana Welm. You know, I know she teaches in the medical school here as well. She teaches some lectures. So that's another reason to believe that the quality of education is great. Because I love Dr. Alana Welm. She's a great PI and, I believe, a great lecturer.

So that's the quality of education part. I also believe that if you want to go to such a difficult program, like a medical program, you need some sort of support system. So I only applied to places where I have family or friends. And it turns out that I'm starting in August with my best friend who is starting medical school here at The U together.

Dr. Chan: Who's your best friend?

Fadi: James [inaudible 00:20:00].

Dr. Chan: Okay. Did you meet him in undergrad or . . .

Fadi: Yeah, we met in physics lab probably my second day at The U.

Dr. Chan: That's good. So it sounds like you didn't know anyone here but your sister, but it sounds like you found a community.

Fadi: Mm-hmm.

Dr. Chan: Yeah, it sounds like you're pretty happy.

Fadi: I'm very happy here. And Salt Lake City is a beautiful place. The U is a great university and lots of opportunities.

Dr. Chan: And I would argue, you know, despite what's going on nationally in our country and across the world, I think Utah has always welcomed immigrants and people from different cultures and faiths in a way that makes people feel welcome. Do you agree or . . .

Fadi: No, I totally agree.

Dr. Chan: I don't know if you have any really cool or embarrassing Utah stories.

Fadi: No, I totally agree. It's a very welcoming community, you know? I do feel welcome here and I do feel like I belong.

Dr. Chan: Great. All right. So I'm not going to hold you to it, but if I had to make you pick right now, what kind of doctor do you want to be and why? Again, I'm not going to hold you to it. But I always like taking the temperature. It's like,"Oh, Fadi is thinking this. Fadi is thinking that." So what are you thinking?

Fadi: I actually think . . . you know, since my research is on breast cancer, I think I'm leaning towards oncology, but who knows. I believe that you cannot really make an informed decision on what you want to do for the rest of your life until you actually get a first-hand experience of that.

Dr. Chan: That's very wise. Not too many people feel that way, though. Well, a lot of people do, I guess.

Fadi: A lot of people say, "It's really cool to operate on a human being that's open in front of me and try to fix them." I mean, yeah, that sounds like surgery, but have you actually operated on an open human being in front of you? Have you seen how it feels? Until I do that, I cannot really say that I would like to do surgery. Yeah, the concept is so cool, but . . .

Dr. Chan: Plus, how does it feel when it's like 3:00 in the morning and you're lacking sleep and you miss some family event? Yeah.

Fadi: Aside from the lifestyle, it's just the material of the specialty itself. Am I really interested in it? Do I know I'm really interested in it before I've actually experienced it? I don't know. I would like to start medical school with an open mind before I . . .

Dr. Chan: That's what I preach to everyone. Have an open mind. You're going to be exposed a lot of different fields, and doctors, and different labs. It's beautiful and hard because you don't really have to "pick" until your last year in med school.

Fadi: My sister actually initially wanted psychiatry and she ended up in radiology. So that's where I learned my lesson that you never know.

Dr. Chan: You never know. Well, is she still happy with radiology?

Fadi: She's very happy.

Dr. Chan: Because psychiatry is great. We welcome all people into psychiatry. It's a different . . . yeah, I think the med school experience is informative and I think it helps most of the time, but interns start the residency and, you know, there's a group that doesn't like it and they switch. So there's some switching that goes around, even [GME 00:23:10]. It's harder to do, but it still happens.

Fadi: Makes sense.

Dr. Chan: Cool. All right. So, Fadi, any advice to someone listening out there and they're thinking about going to med school and they're not sure, or they're not sure what to do? What advice would you give them?

Fadi: I kind of mentioned this before, that, you know, there's nothing wrong in starting your journey with box-checking, but don't finish the journey like that. These experiences are just supposed to guide you into a direction you're interested in. You know, my supplemental instruction experience guided me to other teaching experiences.

So, you know, just do what makes sense for you. Don't do what looks cool for medical schools, because I'm sure medical schools can look deeper into your application and see, you know, who you are as a person, not just as an applicant.

And it does look like medical schools . . . I mean, you probably have much more insight on this. It looks like medical schools are moving away from just focusing on numbers, and they're moving more towards choosing applicants that are humans, people who are well rounded, able to speak to a person, and relate to them.

And that makes sense, because if you're just going to accept students who did well on exams, what if these people are not that relatable or not able to speak to a patient and make them feel at ease? You know, if it's just about knowing information and doing well on exams, you would have a computer treat these patients. But that's not the case.

So, yeah, just do experiences that make sense for you. And, you know, be a human, not just a test taker.

Dr. Chan: Yeah. Awesome. Well, Fadi, congratulations. We'll have to have you come back on as you progress in your journey to become a doc. I would just be curious to see how it's going the next few years. Thanks, Fadi.

Fadi: 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.

Dr. Chan: What did it mean to be a couple in medical school? Why does one change their path to line up with someone else's path? How do you manage a year apart during medical school, and what does organized chaos look like during fourth year? Today on Talking Admissions and Med Student Life, I interview Antigone and Ira, a successful couples match and recent graduates here at the University of Utah School of Medicine.

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

Dr. Chan: Okay. Well, welcome to another edition of Talking Admissions and Med Student Life. I have two super great guests today, Antigone and Ira. Hello.

Antigone: Hello.

Ira: Hello.

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

Ira: Woohoo.

Antigone: Woo.

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

Antigone: Well, that depends on who you ask.

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

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

Dr. Chan: And somewhere is the truth.

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

Dr. Chan: Really?

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

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

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

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

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

Dr. Chan: The little cafeteria.

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

Dr. Chan: It just happened.

Antigone: It just happened.

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

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

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

Antigone: No.

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

Dr. Chan: You were very active.

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

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

Ira: Or orientation.

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

Ira: I remember her mom.

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

Ira: I remember talking to her mom.

Dr. Chan: Oh, I love doing this.

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

Dr. Chan: You were hiding behind your mom.

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

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

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

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

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

Dr. Chan: This is post-test.

Ira: Post-test.

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

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

Antigone: Which is not far off from normal.

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

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

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

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

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

Dr. Chan: Was he your clinical instructor?

Ira: Yes.

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

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

Dr. Chan: He would randomly grade you.

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

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

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

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

Ira: And there are dates in the hospital cafeteria.

Dr. Chan: Dates in the hospital cafeteria.

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

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

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

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

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

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

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

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

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

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

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

Ira: Yep. Completely cold called them.

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

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

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

Antigone: Yes.

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

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

Dr. Chan: They just assign you?

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

Dr. Chan: Sounds like a buffet.

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

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

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

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

Ira: Yes.

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

Antigone: MRSP.

Ira: MRSP, Medical Research Scholars Program.

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

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

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

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

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

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

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

Ira: Like a 30-hour . . .

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

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

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

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

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

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

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

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

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

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

Antigone: Yes, it could include anything.

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

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

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

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

Dr. Chan: I remember those days.

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

Dr. Chan: That's beautiful.

Antigone: Thank you. I was an English major.

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

Ira: I was thinking of becoming a doctor.

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

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

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

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

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

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

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

Dr. Chan: With supervision.

Antigone: Yes.

Ira: With supervision. Absolutely.

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

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

Dr. Chan: Ownership.

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

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

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

Ira: Four years.

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

Antigone: Well . . .

Ira: It didn't.

Dr. Chan: Is it just organized chaos?

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

Dr. Chan: How many are there?

Ira: Seventy-seven.

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

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

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

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

Antigone: Okay.

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

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

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

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

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

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

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

Antigone: The people.

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

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

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

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

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

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

Antigone: Less than 15 minutes sometimes.

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

Antigone: I went on 24.

Ira: I went on 26.

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

Antigone: It was a lot.

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

Antigone: Three months.

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

Antigone: I think three times we interviewed together.

Dr. Chan: Was that better or more stressful?

Antigone: It was nice.

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

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

Antigone: We talked about that.

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

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

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

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

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

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

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

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

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

Antigone: There were no windows.

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

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

Antigone: No, neither have we.

Ira: They're all built the same.

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

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

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

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

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

Antigone: You never know.

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

Dr. Chan: Wow.

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

Dr. Chan: Oh my goodness.

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

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

Antigone: I was a wreck.

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

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

Dr. Chan: Okay.

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

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

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

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

Ira: We had 512 options.

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

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

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

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

Antigone: I don't think I slept.

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

Dr. Chan: A lot of emotions.

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

Dr. Chan: Student government.

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

Dr. Chan: It's too stressful.

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

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

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

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

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

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

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

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

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

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

Dr. Chan: Where are you headed?

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

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

Antigone: I was shocked.

Ira: Total disbelief.

Dr. Chan: Why were you in disbelief?

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

Dr. Chan: For an interview.

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

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

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

Dr. Chan: High mucky-mucks.

Ira: Yeah.

Dr. Chan: As my parents would say.

Antigone: These two kids from Utah.

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

Dr. Chan: A big name school.

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

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

Antigone: I'm sure.

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

Ira: Together. Same school.

Dr. Chan: Somewhat same programs, some overlap.

Ira: Yeah.

Dr. Chan: Have you already gotten your schedules?

Antigone: No.

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

Dr. Chan: Found a place to live.

Ira: Found a place to live.

Dr. Chan: Biking distance?

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

Dr. Chan: Wow.

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

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

Antigone: Yeah, May 12th.

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

Antigone: It's been a crazy year.

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

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

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

Antigone: It's our honeymoon.

Dr. Chan: Wow. That's cool.

Antigone: We will be researching Cuban food.

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

Ira: And rum.

Antigone: And rum, yes.

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

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

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

Antigone: I agree.

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

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

Dr. Chan: That's beautiful, Ira.

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

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

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

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

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

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

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

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

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

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

Antigone: Thanks for having us.

Ira: Thank you.

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

Ira: Thank you very much.

Antigone: Thank you.

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

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

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

Antigone: You're great.

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