Search for tag: "transition"

Dr. Chan: What's it like moving from Boise, Idaho to Middlebury, Vermont? How can an outdoorsy lifestyle influence you to pursue a career in medicine? On this episode of "Talking U and Med Student Life," second-year med student, Joe, talks about rural medicine, why he ended up in Utah, and how to get started snowboarding in the great Utah mountains.

Welcome to another edition of "Talking U and Med Student Life." Fantastic guest today. Joe, how are you doing?

Joe: I am excellent. How are you?

Dr. Chan: I'm hanging in there, and we'll talk about that later. Living life in a pandemic. It's been interesting, difficult, and challenging, and beautiful all wrapped into one. All right, so Joe, what year are you now?

Joe: I am currently a second-year, MS2.

Dr. Chan: All right, second-year med student. And we're going to talk about what medical education looks like in a pandemic. But I want to go into a quick time machine. All right? So let's go in a time machine together and go back, back, back, back. So, Joe, what prompted you to become a doctor? What event in your life or were there a series of events, and how old were you? When did this start entering your brain?

Joe: Ah, sure. So I've always really been interested in science, and I sort of knew I wanted to do something in science probably starting in about third or fourth grade. But one of the real inciting events for me, and, you know, you read personal statements all day. And the thing that I talked about in my personal statement was, when I was 15, I was whitewater kayaking and a man dislocated his shoulder right in front of me. And one of the other members of our team was a wilderness first responder, and they kayaked over and reduced this man's dislocated shoulder while they were floating down the river next to each other. And so I immediately thought, "You know, that's a skill I want to have." And so I started with wilderness first responder as a wilderness EMT. I worked as an EMT. I did a bunch of wilderness sort of medicine-related things in college. And sort of every step of the way I wanted more and more knowledge, more and more skills. And fully pursuing medicine seemed like the perfect place for me.

Dr. Chan: Awesome. I mean, so a lot to unpack there. So this is back during high school, correct? You said you were 15?

Joe: Correct.

Dr. Chan: So college, where'd you end up, and how'd you pick that school?

Joe: Yeah. So I grew up in Boise, Idaho and I absolutely love Idaho, still go back every chance I can. But I wanted to try something a little different for college, and so I traveled out to New England, to Vermont, and I went to Middlebury College. And then while I was there, that afforded me a lot of opportunities to do some outdoor things, do a lot of wilderness, medicine-related stuff with teaching, with instructing rock climbing and kayaking, and things like that. And . . .

Dr. Chan: How was it going from Boise to Middlebury? That sounds like a big jump. Or wasn't that a big jump?

Joe: It was very different.

Dr. Chan: Yeah.

Joe: It was . . . Yeah. Yeah, I mean, it was interesting. I always say think of Boise as a pretty small town. I mean, I think currently it's about 200,000 people. The whole valley's got 500,000 or so. But Middlebury, Vermont, the college itself makes up about 3,000 humans and the town itself makes up about 6,000 humans. So it's the kind of place where the general store will say, "We close at around 5 p.m." or things like that. So you've got to come in a little early in case the owner is feeling like going home or you might not get your groceries.

Dr. Chan: Wow. And then, so when you went to Middlebury, was there like a premedical program, or did you start to waver, or like how did that go? How did your metamorphosis go during your undergraduate days?

Joe: Yeah, I started out as a physics major, but I knew that medicine was sort of my goal overall. We didn't have a premedicine, really, track. It was sort of you do whatever you're interested in, and as long as you check off enough of the boxes of which classes you need to take, then you were sort of granted the blessing of the premedical committee. And if you wanted to, you could do a committee letter or things like that. The University of Utah was at the top of my list when I was applying. And I knew that the University of Utah was not interested in committee letters. So it was nice that I had the option, but yeah, they had a group of people that could guide you if you needed assistance or needed direction. But I ended up graduating biochemistry major because it meshed a lot better with not only the premed requirements but of what I became interested in as I went through college.

Dr. Chan: How did you get all those necessary activities, like the research, like the community service? How did you do that at Middlebury?

Joe: Yeah. We had the distinct privilege of not having any graduate program, which sounds a little funny because I also did research at the U after my sophomore year working for a Ph.D. student in a chemistry lab. But being the only students on campus as undergraduates, it meant that when I pursued a research opportunity, I got to sort of be in charge of my own project working on Lyme disease. So they were all small labs, maybe three to five students. And it was 100% undergrad-driven. So it was a wonderful experience. I really loved it.

Dr. Chan: That's great. And then, you know, when you talk about Vermont, I also think about Ben & Jerry's ice cream. Do you have any stories to share? What is your favorite flavor?

Joe: Ooh, my favorite flavor of Ben & Jerry's is Half Baked. They were about, you know, 55 minutes north of us in Vermont, which means you had to pass by five or six creameries on your way there. But if anyone's from the East and they know of Maple Creemees, they'll know that that's really the best ice cream in Vermont. And we had it on tap at our college from 8 a.m. to 8 p.m. every day.

Dr. Chan: So I guess it was so common it wasn't that unique to you. To me, it's like very unique out here, but I guess back there it was just like water. Like it was everywhere, right?

Joe: Yeah, exactly. Yeah, you could hardly walk, you know, 100 yards without bumping into an ice cream dispensary.

Dr. Chan: Wow. And then, you know, you're hitting your senior year, you're looking at med schools. What was your strategy going in? What schools were you looking at, and how were you going to do that?

Joe: Sure, yeah. So being in Vermont and being sort of that . . . I guess about half of Middlebury students are from like the just outside of Boston, New York, Pennsylvania, that kind of area. And so all of my friends were really looking at schools in that area. And the few of us Westerners were sort of split up and didn't particularly know where to look. So I sort of looked all over the West, and being from Idaho without a program of our own when I was applying, I mean, Utah was by far the most attractive option. And mostly, I mean, from a financial perspective, from an outdoor-access perspective, Utah really checked all the boxes for me. But, you know, I applied everywhere and couldn't believe it when it worked out.

Dr. Chan: So Idaho technically does not have their own medical school. But University of Utah, University of Washington, through the WWAMI Program, do take Idaho residents. And we take 10 and they take 40. Did you apply to WWAMI? What were your thoughts about WWAMI? I mean, I'm just curious, Joe, like I've never had this conversation with you. How did you end up in Utah?

Joe: Yeah, absolutely. Yeah, so I definitely applied to WWAMI. And I have . . . I'm trying to think, I have at least four or five close friends who are at the WWAMI Program up in Moscow, Idaho. And yeah, I liked a lot of things about their program, but I think for me, the U is a more attractive option because it gave me a lot broader of options. I wasn't particularly sure of what kind of medicine I wanted to go into, whether it would be primary care or emergency. All I've done is emergency work in my life. And so I'm still leaning that direction.

But at the WWAMI Program, it felt a lot like they were University of Washington students who were sort of off on their own. It felt like they had a good strong sense of community with those, you know, 40 students living in and amongst each other in that same location. But it felt more like a satellite campus than a full-blown medical school the way that the University of Utah does, where it feels like we have all of these enormously beneficial resources right at our fingertips.

Dr. Chan: Yeah. I like how you said that, Joe. I think there's 125 medical students per class and there's 10 Idaho students. And I would argue the 10 of you are fully integrated into everything that the other students do to the point where I don't think people, unless you self-identify as from Idaho, people don't realize you're probably from Idaho unless you tell people, correct?

Joe: Exactly.

Dr. Chan: Yeah. And I think, yeah, we're a quaternary, tertiary care center and we just have a lot of opportunities. And our students get to have first access, first pass at all those activities. And yeah, I agree with you. Like I think WWAMI is a fantastic program. But they are based, the Idaho piece is based in Moscow. So yeah, I just think the two wonderful programs serving the state of Idaho. It's all good. So, all right.

So Joe, you get here, and then what was your impression? Because like let me frame this question. Like everyone has this conception of what med school is like, right? And I think that's born from the media or tales that are told around the dinner table. Everyone has an idea of what med school is like. But then you come here and then you start medical school. So what was that first semester like? Was it doable? Was it overwhelming? How would you describe your experience jumping from premed to med?

Joe: Sure. Yeah, so the sort of . . . the way that I like to think about it is there's all of the work that I did in undergrad where I was a biochemistry major, and so I was taking all of these biochemistry classes. And then I graduated, and I studied for the MCAT by doing a 10-week intensive course. And it felt like I was learning an entirely different side of medicine when I was studying for the MCAT. It felt like nothing I had actually learned in undergrad.

And then when I got to medical school, it felt like a whole other switch, where it felt like every time I had, you know, heard about some process when I was in undergrad or some process when I was studying for the MCAT, when I got to medical school and we approached those same topics, we would spend part of our time sort of getting everyone caught up on, oh, I don't know, like what the Krebs cycle is or something like that. But then we would always take it a step further, and you'd have to really, really be familiar with every single aspect of what was going into every single process we were learning about, even when we were doing that Foundations of Medicine, first six months to catch everyone up.

And I was mostly surprised at just how cursory of an understanding I actually had about so many topics before going to medical school and how much sort of work I had to put in to really understanding the nuances. But I felt personally like the first six months were difficult but doable. I had a strong group of people around me that I could study with and we could bounce ideas off of each other. But we could also, you know, really get outside, or exercise, or in some form almost every single day during my first year of medical school. So I was surprised at how much outdoor activity I was able to get in while simultaneously studying.

Dr. Chan: Was it hard, Joe, going from . . . And I'm just going to put my own projection out there. You're kind of big fish in little pond Middlebury because just being kind of at the top and just doing so well, and then you come to medical school and then everyone just knows . . . so smart, knows what they're doing. Was that a transition for you, or you felt you did that pretty well?

Joe: I think that when I was at Middlebury I was very much a small fish in a big pond as well.

Dr. Chan: Okay, okay. I'm just trying to use outdoor analogies.

Joe: Yeah, oh, absolutely. So I felt like when I got to the University of Utah that that sort of imposter syndrome really carried nicely through and I got to maintain my sensation of imposter syndrome through undergrad all the way into medical school. I'm constantly astounded at the students I get to spend time with.

Dr. Chan: How would you describe your imposter syndrome? Because it has different definitions depending on who you are. So how would you describe it?

Joe: Sure. So I feel like when you first get into any program, and I'd be fascinated to ask this question to a current MS1 because they're all seeing each other simply over Zoom, and it's a less personable space. But for me, when I arrived here, a lot of it was, holy cow, what did this person sitting next to me do in undergrad? Or realizing that they're, you know, 4 or 5 years older than me and have 17 more publications than I do and things like that.

So for me, it's the, when you get into Foundations of Medicine, you get into that first six-month course. Everyone's starting from a very different place, and we all had to, you know, be our own interesting person. But when you first arrive, it's really astounding to see how impressive sort of the accolades of your peers are. And then sort of as I've moved through, now as a second year, and especially with COVID when a lot of our opportunities that were, you know, in-person were shut down, or moved off, or things like that, and we're already starting to feel the pressure of taking Step 1, and thinking about our CVs, and our applications to residencies. It's seeing just how much your fellow students can be learning and also, you know, participating in their extracurricular activities while they're here, while they're in their second year.

Dr. Chan: Joe, you mentioned maintaining outdoor activities, or learning, or growing. And it sounds like you've struck a pretty good balance with, you know, life, and wellness, and academics, and personal time. What was your secret? How did you do that? Did you like map it out ahead of time? I mean, did you put it down on your schedule, or was it more spontaneous, you know, a couple of hours here and there? Like how did you do that?

Joe: Yeah, so one of my favorite expressions I ever heard in undergrad . . . And I've been so extremely privileged in where I've gone to school because I've always had outdoor access so immediately close by. But the sentiment that stuck with me most from a professor was, "If you do not have 30 minutes per day or in your day to do something for yourself, either physically outside or for your mental-emotional health, if you don't have 30 minutes in a day where you can sit down and do that, you need to take 60 minutes that day to do it."

And so there's sort of a point of diminishing marginal returns on studying for a lot of us. And I found pretty early on that if I got, you know, seven or eight hours of sleep every night, and I spent at least, you know, 30 minutes to an hour either walking or hiking in the foothills that come straight out of the medical school, or going to the climbing gym nearby, or things like that, if I took that time, I performed better and better than if I spent that hour, you know, re-reviewing notes from a lecture or something like that. I didn't actually perform better and I didn't retain anything better.

So I've tried to keep a really strong crew of people where we can sort of spontaneously say, "Hey, does anyone want to go, you know, climb in Big Cottonwood Canyon at 5 p.m. today?" And you'll always find one or two people who are willing to do that. I wish I was a more organized person who kept a tight-knit schedule to include that, but I absolutely know students who write in one-hour run at 4 p.m. and when their calendar goes off, they put on their shoes and go out.

Dr. Chan: Wow. Joe, that's fantastic. And I also know that, you know, like you mentioned, hiking, and walking, and I think you said rock climbing, I think you also have the skill of ski and snowboarding. So I'm curious, how long have you been a skier or a snowboarder?

Joe: Sure.

Dr. Chan: And yeah, just like what's your favorite resort here? And I think another great selling point of Utah, just access to a lot of different areas where you can do that.

Joe: Yeah. I don't know that I can say that the University of Utah has the best skiing of any medical school in the world because I don't know enough about the world, but in the United States, I think you'd be hard-pressed to make an argument that there's better skiing anywhere else. Yeah, so I started skiing when I was two years old. And in my family, it wasn't really an option. You were a skier, and you were a skier at age 2. And so I grew up racing a little bit, and when I was 15, or I guess, yeah, right when I was about 15, I was diagnosed with osteochondritis dissecans, which is a bone disorder. And we'll get to learn all about it in a couple of months here in skin, muscle, bone, and joint. But basically, I had to take about five years off of skiing, almost six years off of skiing because I was getting several knee surgeries to sort of reconstruct the bone at the end of my femur. And then luckily, about halfway through college I got to get back into it.

And yeah, so my favorite resorts here in Utah, this year we keep an Excel doc, a Google Excel doc called the All-Class Shredders List. And it's everyone who's interested in skiing writes in their phone number, they write in their email, and they write in what pass they're getting. So I know that last year it was about 70% Ikon Pass and, boy, about 30% split amongst the Epic Pass, and things like that. I was in Ikon Pass last year, and I think as of either later today or tomorrow I'm going to be buying my Ikon Pass as well. But for the University of Utah students, the price is marked down from $1,200 to $400. So it's hard to not take advantage of that. But in terms of favorites, I don't think I can confidently choose a favorite. I got unlimited days of solitude last year through the Ikon, so I certainly went there the most but . . .

Dr. Chan: So Joe, I don't even know what they call them, are you like a quadruple, Olympic, black diamond skier? Is that your level? Is that your . . .

Joe: I will say that I am very comfortable on black diamonds and comfortable on double black diamonds. But that being said, I am maybe the 15th best skier in the MS2 class. So there's a . . .

Dr. Chan: I love how you phrase it, yes. You cannot humblebrag, I will humblebrag for you. All right? That's awesome, Joe. So what if . . .

Joe: There are . . .

Dr. Chan: What if you're a brand-new . . . you know, what if there's a med student listening and they want to get interested in skiing. Like what would be some good, you know, equipment and maybe a good place to start out?

Joe: Yeah.

Dr. Chan: Obviously, our time machine isn't real. We can't go back to when they are two years old to get that experience you got. Like so how would like a 20-something-year-old start?

Joe: Sure, absolutely. So yeah, we have . . . I can't remember what the actual number is, but I think we have 60 students or something in our class, the MS2 class on the All-Class Shredders List who do ski already or snowboard already. But we had about five or six students who started skiing last year. And all of them, they skied together in a group, and they would ski with their more experienced friends and get their lessons that way. But we had a lot of students who went from either never having skied before or not having skied in 10 years to being really confident skiers on, you know, the intermediate and advanced ski terrain.

One of the things I love about the University of Utah is the rec center has gear rentals. And so you can rent skis from either the University of Utah rec center for a day or a weekend. And I think it's $25 for a day and $40 for a weekend for the ski boot, pole setup. So if you're interested in learning and you have some fellow MS1 students who come in with you and, you know, they're your good friends that you've already made and you want to run flashcards on the chairlift, which is absolutely a thing I recommend doing with your friends, then yeah, it's about $25.

And lessons, you can get access to professional lessons through Solitude. I was looking into this recently for a different friend, and it was $75 a day for college students on top of the pass for the day, which I think is in the $75 to $100-range. So skiing has always been a very expensive and exclusive sport. And I think that having the $25 rentals through the University of Utah makes it a little more accessible to people than having to do, you know, the $125 rentals from the resort.

But yeah, there's a few different options for renting equipment at the U for pretty reasonable prices. You can do seasonal rentals as well. There's a couple of companies in town that do seasonal rentals on skis. So yeah. My biggest recommendation is if you've got that study group and you've got some experienced skiers in your group, and they're willing to teach you, then I can't recommend enough that you reach out to them and reach out to your whole class and see who else is new to skiing and try and get a little . . . a crew together. It's a great community, and it'll be interesting to see what COVID does this year. We're all on the edge of our seats on that.

Dr. Chan: I love how you mentioned doing Anki cards on the ski lift. I did not know that was a thing, but my hats off to all of you who are doing that. That's like combining a lot of . . . Your generation, the ability that you guys have to multitask, it's amazing. So that's so cool.

And then, Joe, do you have like a favorite memory or a memorable time when you were skiing or boarding? Like something that just stood out to you, like this crystallized beautiful moment where it was like epiphanous and you hit nirvana or a scary situation where it got resolved. I'm just curious, because you've been in the backcountry doing all sorts of difficult hills, and yeah, so I'm just curious like if you have any memories you can share.

Joe: Oh, man. There's two moments that come to mind. One is more on the idea of Anki and studying, but it was, I was up with two fellow students [Stany and Alli 00:25:07] and we were sitting on the chairlift in between runs. And it was, you know, a Sunday before a Monday exam. And we couldn't resist, because I think we'd gotten 60 inches of snow that week or something like that. And so we had to go out even though we had a test on Monday. And we talked through questions on the chairlift of what we thought we were going to get quizzed on and what we thought we needed to understand, and filled in the memory gaps. And the next day during the test, there was somewhere between 6 and 10 questions that were exactly covering the topics we talked about on the chair. But I think the more salient moment, like one of the happiest skiing moments I've ever had was last year at the end of the year, at the end of the first semester, this is obviously pre-COVID, we had 31 of us MS1s go down to Jackson Hole, Wyoming. And Jackson Hole is on the Ikon Pass. So we just rounded up 31 students who had the Ikon Pass. We rented three houses in Jackson Hole. And I think everyone, overall, for lodging and food, we cooked all of our meals together for five days. I think the average . . . I think the price that every student paid was $105 for 5 days' worth of skiing, food, lodging in Jackson Hole. But there was one day where we had all 30 of us out on the slopes together riding as one giant group, and it was one of the coolest things I've ever seen, to see, you know, these 30 students that were sort of struggling together through academics but then also getting to get out and ski together.

Dr. Chan: Joe, that's beautiful. I love that image. Maybe when we post this pod, we can like throw up an image. I want to throw up an image of that, and then maybe you and your awesome beer that you're rocking.

Dr. Chan: All right, last question, Joe, we've talked a little bit about it, but pandemic, like because it was at the very end of first year, right? And then things started to kind of go . . . you know, the announcement came out. Like how was it from your perspective as a med student? And as a follow-up, like what's it like to be a med student during a pandemic, and what does your day look like? So I'm just going to throw that out there. I want to hear your perspective.

Joe: Yeah. It's been very interesting. And it's been varied as well, which has been sort of one of the things that we, as students, do talk about is how different units feel different. I think that when you're in Foundations of Medicine, it's all about getting as much time talking between students to make sure that everybody's on the same page of how well you need to understand something, how in-depth, and what nuances you think the professors care about or things like that, things you think you should care about.

And then once you move into the second semester of your first year, which is when COVID hit for us, you're in the host and defense. We were in what's called host and defense, which is the bugs and drugs course. And that one is just so much more memorizing that it felt more like an individual course. So it felt more like, you know, you're watching your videos, you're watching these things. You're running your hundreds of cards a day to try to get all of these little facts, you know, nailed into your brain. So there's a little bit less of a student community during that.

But when COVID hit, it was, you know, March 13th. That Friday, the 13th, I actually had a hernia repair that day, and I was completely laid up for about six weeks after it. So that was the first day we also shut down classes, which was, you know, perfect because I didn't have to come into school but also very socially isolating. But when we switched, the Monday after they shut down classes unexpectedly, we had . . . I think we missed out on one hour's worth of lecture. And the professors seamlessly transitioned to Zoom. I was really, really impressed. We basically lost zero time, we lost zero material with host and defense. When we finished this summer and we came back, it felt a little bit like there was still so much hope that we would be able to be in person that the course wasn't as well established for the second-years to be ready for online. So it was a little grating for the first couple of weeks to try and suss out exactly how we were going to be maneuvering through COVID and our second year of med school.

And I think a lot of us felt really isolated from a summer apart and not feeling comfortable getting together with our big study groups that we did previously. And then sort of as this second year has gone on, we've sort of come to accept more and more and more that it's most important to stay distant, to stay online. But yeah, it was interesting that the spring when that massive change happened it wasn't that bad, but then I think a lot of us, really mentally and emotionally, struggled. I know personally, I mentally and emotionally struggled with the fall semester more than the spring. Yeah.

Dr. Chan: And then, is it every single day Zoom? Or like what does a typical week look like now in the middle of a pandemic for a second-year med student?

Joe: Yeah. So right now we have asynchronous and we have synchronous. So it's usually, for this current unit, we're currently in CR and R, which is like the circulation and renal and respiratory. And that has mostly, most of the days has been asynchronous. So, you know, you just click on and watch the prerecorded lecture whenever you're interested. But then maybe two or three days a week we're in-person. We're digitally, you know, synchronous, where we'll all Zoom in at the same time and we'll have a team-based learning or a case-based learning. And they'll break us up into small groups and things like that. So that's usually like Wednesday mornings, Fridays. And then actual in-person activities when we're learning our clinical skills on Wednesday afternoons. We've been in-person probably just over 50% of the time. So that's from maybe 1 p.m. to 5 p.m. on Wednesdays every other week for the last, you know, four months we've been in-person. But everything else is Zoom. And for . . . Yeah.

Dr. Chan: Oh, go on. Sorry.

Joe: Oh, I was going to say for a person like me who, you know, I've got, I certainly have some attention deficit problems. And sitting in front of a computer for hours a day is sort of the antithesis to the way that I like to learn. But I found ways to, you know, set my computer up on a dresser or a desk or something like that and, you know, jump around my apartment, my living room, and try and run cards, and things like that, keeping my body moving. But yeah, I am ready to be back in person when that day arises.

Dr. Chan: Do you like the synchronous or asynchronous model better, Joe?

Joe: I think the asynchronous model works better for me because if I'm sitting in front of a computer for eight hours a day watching a lecture, probably about every 15 minutes my brain will wander off. And if it's a synchronous session and I just missed, you know, 20 seconds of material, then I desperately am lost or I don't know exactly what I needed to know from that. But if it's asynchronous, I can pause. I can back it up 30 seconds, and I can restart, or I can pause, stand up, get a drink of water, back it up 30 seconds, and restart. So, for me, the asynchronous works much better because I can pause, I can make sure I'm really understanding what they're saying. Sometimes I have to repeat a section four or five times just to figure out what the professor is trying to emphasize there.

Dr. Chan: Joe, I love it. It sounds like you're adaptable, resilient. And I think you, the faculty, the students, I think everyone's trying to do the very best job they can in really extraordinary, challenging, unprecedented circumstances. And it sounds like it's coming together.

Joe: Yeah.

Dr. Chan: Fits and starts though, fits and starts.

Joe: Yeah, absolutely.

Dr. Chan: Joe, we're almost out of time. I guess my last question is what advice do you have for anyone listening out there who is thinking of applying to medical school? What would you say to them? What counsel would you give them?

Joe: Yeah. I think the most important thing for me is to take your time. I took two years off after graduating and I absolutely loved it. I spent time working. And actually, I was talking to a professor yesterday during a small synchronous session. He shot me a message in the Zoom Chat privately asking what my prior experience with that topic was because we were talking about pulmonary embolisms. And I was an emergency department scribe for almost two years. And things like that, things that are extremely clinically relevant to scribing, you just excel at when you're an actual medical student. And so I can't recommend to people enough that they, you know, take a breather after undergrad, work a job, you know, build up some money, and be able to have a ski pass, be able to do things like that. Be able to have some sort of different nonacademic life experiences before you get here. And if you have the opportunity to scribe, that was the most helpful preparation for medical school I've ever had.

Dr. Chan: Great. Joe, well, I appreciate coming on the pod. We'll have to have you come back and share more of your adventures as you continue to go through our medical school. It sounds like you're doing really, really well.

Joe: Oh, absolutely. It was wonderful to talk to you.

Dr. Chan: All right. Thanks, Joe.

Joe: Hey, have a good day.

The following is a summary of this episode. For the full experience, we encourage you to subscribe and listen.

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

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

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

Dr. Chan: What's it like being a first-generation college student and choosing to chase your career in medicine while combating self-doubt? How do you flawlessly perform a scene from "The Sound of Music" in front of your new classmates during your medical school orientation? How does one go about deciding what to pursue their residency program in, particularly anesthesia?

Today, on "Talking Admissions and Med Student Life," I interview Max, a fourth-year medical student here at The University of Utah School of Medicine.

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

Dr. Chan: Well, welcome to another edition of "Talking Admissions and Med Student Life." Max, finally, we meet.

Max: Finally.

Dr. Chan: Since you've been gone for so long. Fourth-year student.

Max: Yes.

Dr. Chan: And we're going to wait until the end to talk about what you chose.

Max: Okay.

Dr. Chan: So let's go back to the beginning, man. When did you decide to become a doctor?

Max: So, for me, it was one of these things where I always revered doctors. I thought they were cool. I have an uncle who did family medicine and he did a ton of humanitarian work. He would go to Africa and come back and show these slideshows and I'd be like, "Yeah. That's something I want to do."

Service has been a big part of what brings me joy and I thought if I could pick a career where service is a huge component of it. You have a very steady life as well. You're not going to lose your job as a doctor. And it helps that I really like science. But all those things combined together led me here. I had a lot of doubt as to whether I could do it, but pushed through that and we're here.

Dr. Chan: Where did the doubt come from?

Max: In my immediate family, both of my parents did a little bit of college. Neither of them graduated. I have a twin brother who went to some college but didn't graduate. Older brother, same story. And so, for me, I was like, "Can I do this?"

I remember getting to . . . I started undergrad at The U. I remember getting up here having to fill out all the financial aid stuff and I was like, "You know what? Maybe I should just stay home." It was overwhelming.

Dr. Chan: It's daunting. Yeah.

Max: Yeah. I come from a pretty small hometown, Spanish Fork. It's getting way bigger, but it's pretty sleepy. A lot of people stay around there. And so I think when I got here, I had . . . My first semester, I remember thinking it was going to be like high school and it wasn't. You actually have to write papers and do stuff. So that was a little bit of an adjustment.

But once I hit my stride in college, I started realizing, "Oh, I can do this." General chemistry isn't the most impossible thing. Organic chemistry still is, but I made it through.

Dr. Chan: Okay. Well, let's back up a bit. How did you wind up at The U to start? Walk me through the decision-making process. So you grew up and went to Spanish Fork High?

Max: Went to Spanish Fork High.

Dr. Chan: Okay.

Max: Most people in Spanish Fork, if they go to college . . . I feel like a decent amount do. They'll just go to UVU. It's 20 minutes away. Pretty much if you have a heartbeat, they'll accept you. And a lot of people do trades as well. And for me, I was like, "I want to be a little different." And so I was like, "All right. I'll go 20 minutes further to Salt Lake City."

Dr. Chan: Did you live at home and commute or did you live in the dorms?

Max: So, starting out, I lived in the dorms and I have many dorm stories to pull from there. So, yeah, I lived in the dorms. That was part of the reason why I think I had some freshman struggles with classes. I had a lot of fun.

And I started out wanting to do exercise physiology, and partway through that, they actually just got rid of the degree. And so, eventually, I did about two years here, went on an LDS mission.

Dr. Chan: Where'd you go?

Max: I went to Japan, south of Japan, and . . .

Dr. Chan: Could you speak Japanese before?

Max: I took a class in high school.

Dr. Chan: But that was enough for them to say, "Oh, Max, you need to go here."

Max: Yeah. They're like, "He's interested? All right. Here you go." But that class was mostly like the teacher would bring in Japanese treats and show us cool shows from Japan and I . . .

Dr. Chan: Anime and manga?

Max: Yeah. Exactly. So, yeah, the learning . . . I thought I'd be set to go. And day one of trying to learn the language, I was already way over my head.

Dr. Chan: Wow. So you're at The U. Were you doing pre-med stuff before you left for your mission?

Max: I was, but I didn't have much direction. I just took classes because you needed to have so many credits. But yeah, it was always on my mind. Medicine was the ultimate goal. So did that, did the mission, came back. Since the degree was gone . . . I had a really cool physiology professor who taught some neuroscience within that class. I was like, "This is pretty cool."

Dr. Chan: I want to hear about a story about you in Japan because I just have this image of you running around the country doing your thing.

Max: Yeah.

Dr. Chan: And Japanese is a fairly hard language to master.

Max: Yeah. I feel like I really just dove in. Once I was there, I tried not to speak English as much as possible. I was about six inches taller than the average Japanese person, blonde hair, blue eyes, and so I stood out. A lot of people, I'd be riding my bike by and they'd say, "Oh, doitsunin," like, "That's a German. That's a German man." I have no German ancestry, but to them, they thought I was German.

So everywhere I went, I was either scaring people when they'd open their door because I'm like this big looming figure. But the younger generation of Japanese girls tended to gravitate toward Americans. And so it would be fun because we'd be riding our bikes, we rode bikes everywhere, and there'd be a little gaggle of high school girls who had been paying attention and they'd be talking to each other. And then I'd go say something to them in Japanese and they're like, "Oh, no. He understands.' But yeah, I scared a lot of people when they opened their door, hit my head on a lot of doorways.

Dr. Chan: Yeah. The apartments there . . . I just imagine you're on the 95th floor and they're like a cubicle and that's how you sleep.

Max: And pretty much everywhere, you sleep on the floor, and you have just this big blanket. They called it a futon. And that was a little bit of an adjustment. The food was . . . I learned to love it. There are some pretty gross things out there as well that as a point of pride . . .

Dr. Chan: So it was not just sushi for two years?

Max: No. I wish. But the gross stuff, even Japanese people don't like it. There's this one food called natto. It's fermented soybeans and you put a little soy sauce in, but when you mix it up, it almost becomes mucus-y and it's repulsing to most people. But there are the little old grandpas, they're like, "No. It's great for your heart. It's great for all these things." So I was like, "Okay. By the end of this, I'm going to love it." And so what I'll do is I'll buy it sometimes and make my American friends try it out.

Dr. Chan: Were you doing any community service in Japan? Were you teaching English or working in hospitals or doing anything like that?

Max: So I was there when the tsunami happened.

Dr. Chan: Oh, okay.

Max: I think it was 2009, and so we had a ton of service opportunities.

Dr. Chan: Did you hear about that? How did you learn about that happening? Were just people talking about it? You're not allowed to watch the news, right?

Max: Yeah, not much. And you sneak it on the . . . you're getting a haircut, you sneak some news. So I was actually on a train in the very south of Japan and we were headed to an area, and mid-train ride, they just stopped the train and they said, "Tsunami alert." And where I was, was almost as far away from the tsunami as you could get, but still, that far south, since we were close to the water, they stopped the train.

Dr. Chan: This never happens, right? People were freaking out on the train?

Max: Yeah. People were freaking out and they stopped the train and they're like, "There's a tsunami up near Sendai.' Everybody gets off. So we stayed in this random town. I have no idea where it was. Middle of the night. But we had a lot of other missionaries come from those areas and it was a ton of service.

We were able to go up there, help clean up. The hospital situation . . . I mean, everywhere was just over-flooded. And so me having no real medical training, we were just there to try to help direct people, help clean up, whatever we could do, but it showed me if this earthquake that's supposed to be coming to Utah eventually happens, there's a lot of work that we could do to prepare.

Dr. Chan: Yes. Walk a lot. Okay. So you're on your mission, and then I think you make a big decision during your mission. Walk me through that. Because you end up transferring, right?

Max: I did. So mission was nice because, for two years, you didn't really have to think that much about . . .

Dr. Chan: Life.

Max: Yeah. Exactly. It's like you just have a purpose and you go do it. So I had a lot of people who were like, "BYU is pretty good. It's cheap. They have good professors there. A lot of research opportunities." And for me, they have a neuroscience degree that I was really excited about. And so, during that time, I think I had companions and probably half of them were BYU students, so they were in my ear telling me it was a good choice.

Utah for undergrad, I'm sure I'd have been plenty happy staying up here as well, but yeah, for those reasons, I was going to save a lot of money down at The Y as well. I decided to transfer down there.

Dr. Chan: And so, after your mission, you went straight to BYU?

Max: Yes.

Dr. Chan: Okay. How was the jump from The U to BYU? Night and day? A lot more praying, a lot more scriptures?

Max: Oh, yeah. I remember getting in . . . it was like a class of 300, 350 people. Huge science, entry-level class for all the pre-med people. And they started out with a spiritual thought and a scripture and then a prayer. And I was like,"Can they do that?"

Dr. Chan: It's very embedded down there. It's kind of the way of life.

Max: Yeah. Exactly. So that was different. I remember my first three classes as well were in the oldest building on BYU campus. It felt like it was crumbling. And I remember walking in that morning and thinking, "What have I done?"

Dr. Chan: "What is this place? Why does it look like this?"

Max: Exactly. But no, eventually, I loved it. I had great research opportunity. I was able to teach, at the missionary training center, Japanese for three, almost four years. So it was an awesome experience.

Dr. Chan: And is that where you first saw me? Because I think I talked to . . . is that that class?

Max: Yeah.

Dr. Chan: Okay. Tell me about it.

Max: I remember . . . so, Dr. Chan, to those who haven't met him, he's very friendly and a very inviting person. But just knowing . . .

Dr. Chan: Thank you.

Max: Yeah. Just knowing that he's the Dean of Admissions was terrifying.

Dr. Chan: In a class of 350, I was terrifying?

Max: I was on the second row.

Dr. Chan: Did I call on you?

Max: You might have. I would have had no idea what I would have said.

Dr. Chan: Oh, my goodness. This just makes me laugh.

Max: So you walk in and I remember just thinking, "This is the man standing in the way."

Dr. Chan: Yes, it's me. It's the committee. It's not me. All right. So you're at BYU. How is it being a pre-med at BYU? Because there are a lot of pre-meds that come out of BYU.

Max: Tons.

Dr. Chan: Is it overtly competitive? Is it subtle?

Max: I feel like if you find a good group of people you can study with and get in with, it's not too bad of an experience. But yeah, there, it's very much . . . there are some people in the classes that are like . . . you know, they'll call out the professor because they want to make sure that their grade is high enough.

I think that's everywhere, but at BYU I think we had 300 in my class who were going into pre-med. And once I found out I got into The U, there were people who came up to me and they're like, "Oh, you got into The U?" I was like, "What?"

Dr. Chan: "You're the one."

Max: Yeah.

Dr. Chan: All right. So walk me through the application process. How many schools did you apply to? What was your strategy?

Max: So, for me, I think I applied to between 30 and 40. I just shotgunned to places that sounded fun living. I went through it with my wife and we thought, "Where would be fun? Where would be reasonable? And what are some schools that would actually be interested in taking me?" And so I applied to probably 25 MD, 30 MD, and then a handful of DO schools, because I did not want to reapply.

And most of the interviews that I got were in the West. So University of Colorado, University of Arizona, a couple of DO schools in the area as well, University of Utah. Went to all those interviews and I think it was pretty clear that we wanted to stay in the West after doing those. Well, I also got an interview at the Uniformed Health Sciences.

Dr. Chan: Oh, okay. Back in D.C.?

Max: Yeah. And that's like the military route, and I really thought about that one, but through some conversation, we decided I'd rather not have a military career. It has its pros, it has its cons, but for our family, we decided to do something else.

So, for me, it was ultimately between Utah, Colorado, Arizona. Once we got that beautiful call from you . . .

Dr. Chan: Yeah. I remember calling you. You were very excited. You were a little stunned at the beginning, but you were very excited.

Max: I was taking an exercise class. I'm not a runner, so I think I had just finished running two miles, which is pretty good for me. I was walking up a big staircase and I got the call from you, so I'm sure I was out of breath. I was stunned.

Dr. Chan: Was it an immediate yes or did you have to talk to your wife, or what was kind of the internal discussion?

Max: From the very beginning, my wife, she was so confident that I would get into The U. And I think we had just found out that she was pregnant with my son. He's 3 now.

Dr. Chan: I remember that. Yes.

Max: Yeah. So we just found out . . .

Dr. Chan: I met her at White Coat.

Max: Yeah, so we had just found out she was pregnant. Both of our families were here, a time of transition. So Utah just made sense. So once we found out, I was able to cancel a handful of other interviews. We knew we wanted to be here.

Dr. Chan: Okay. So there's a perception of med school. You can't really fully understand med school. I'm trying to do that with the podcast, but in a way, you have to actually be in med school to understand it. What was the biggest surprise to you? Because people have this notion med school is going to be X, but then you came, you started, and it turned out to be X, but maybe some Y. What were your thoughts? Was it a surprise? Was that a hard jump to go from undergrad to grad school like this?

Max: I think so. During undergrad, you're doing a lot of things to make yourself competitive. So I was working a job. I was doing all this volunteer stuff. I volunteered with hospice, so I was spending a significant amount of time doing that and other activities.

I was surprised that once I got to med school . . . I mean, it took time to figure out how to study and whatnot. I actually had more free time.

Dr. Chan: Really? Okay.

Max: Yeah. I had some more free time. You hear from everybody, "Oh, med school is going to kill you. It's going to be the hardest thing ever." And so I went in expecting that and it was a lot better.

Dr. Chan: So what were you doing with your free time?

Max: Golfing.

Dr. Chan: Preparing for the life.

Max: Yeah, exactly.

Dr. Chan: So it wasn't hard?

Max: There were things that were challenging about it. I think figuring out the best way to study . . . it's just so much more information. I remember we had our first lecture. It was Dr. Formosa, who's a big name in biochemistry, cell biology, microbiology stuff. And he did his lecture and it was so esoteric and the stuff he'd been researching for 20 years. I remember thinking, "Yeah, I'm never going to learn this."

Dr. Chan: Too much detail.

Max: Yeah. So I had a panic moment maybe the first week. I was like, "I don't know." But then I looked around and everyone else was panicked and it was like, "Well, there are 100 of us and we've got to get through it somehow." And I think safety in numbers, kind of this "we're all going through it together" helped through that initial shock phase. But once I figured out a way to study, figured out a way to prioritize my time, it was pretty smooth.

Dr. Chan: And then you were in my CMC, my Clinical Method Curriculum group.

Max: Yes.

Dr. Chan: So how was that? I'm just curious. I love asking this. What was your perception? When you found out I was going to be your CMC preceptor, did that freak you out or did that make you happy?

Max: Once I was in and had a couple of conversations with you, I was like, "Oh, Dr. Chan is awesome." You went from the gatekeeper to just an awesome mentor. And so I loved that. And I actually took Step 2 CS last week.

Dr. Chan: Oh, you did?

Max: Yes.

Dr. Chan: Okay.

Max: And then one of my patient encounters . . . I did JVD, jugular venous distention, and I recalled clear back to when you were teaching us JVD.

Dr. Chan: Oh, wow.

Max: Yeah. So it was a positive experience.

Dr. Chan: I would like to think that you used that often during your last two years, but I doubt . . . were you doing JVD in a lot of your patients?

Max: No. But you do it for show on CS.

Dr. Chan: Yeah. You do for OSCEs. You do it for clinical skills and CS.

Max: Exactly.

Dr. Chan: Okay. Yeah, and I remember that. You were like this big, burly, happy guy. I remember we could talk about the interesting fact about you. I remember at orientation, Dr. Stevenson called you out in front of the entire class for "The Sound of Music." Explain that to people.

Max: So I had never seen the movie, "The Sound of Music." My wife's family was super into it and the "Hills Are Alive, all of that. So once we got married . . . well, I guess as long as I can remember, people were like, "Oh, you're Friedrich from The Sound of Music. You look so much like him. And I was like, "Okay. Cool." And I eventually watched the movie. I was like, "Oh, I look a lot like that guy." It's weird. I had this weird out-of-body thing where I was like . . . Even his mannerisms are super similar.

Dr. Chan: Did you ever dress up for Halloween?

Max: No. I didn't want to do that to myself.

Dr. Chan: Okay. Maybe down the road.

Max: So, yeah, we have this lookbook for the entering class, and in it, it says, "Say something interesting about yourself." And I think I mentioned that I have a twin brother and that people mistake me for Friedrich from "The Sound of Music."

And at the orientation, Dr. Stevenson, who ran the whole thing, was talking about people's different interesting things they brought up. He called my name out and I thought it'd be a couple of questions about my "Sound of Music" experience, and it definitely wasn't. He was like, "Let's have you come forward." And he played one of the songs from "The Sound of Music."

Dr. Chan: Yeah. He went all-in on the audiovisual.

Max: Yeah. And so I did a very poor job of singing and dancing along.

Dr. Chan: Yeah. You danced. I remember that. In front of the entire . . . you just met these people. Oh, my goodness.

Max: Yeah. And one of my classmates', Jabber, he's awesome. I played basketball with him. He's hilarious. He, for the first six months of med school, thought that I was in the movie. He looked at me and he's like, "Bro, I can't believe you were in movies and stuff." And I was like, "That movie was made 60 years ago."

Dr. Chan: Okay. So, during the first two years, Max, what were you thinking of becoming? I think surgery was up there, wasn't it?

Max: Surgery was up there.

Dr. Chan: Emergency medicine maybe.

Max: Emergency, ophthalmology.

Dr. Chan: Okay.

Max: I had shadowed people in nearly every specialty, and I'm one of those people that you could pick for me and I would probably have a happy career. And that's a good thing, I think, because it helped me know that medicine was the right choice. But when it came time to actually choosing, I think . . .

Dr. Chan: So don't say it. So the future is wide open, a lot of different ideas. How did third-year start? How did you start ruling in, ruling out different fields? What was third-year like for you?

Max: So I think the big one that most people experience is medicine versus surgery. That's the big breakpoint. And I started with medicine and I liked it. I really liked my attendings. It was nice. But once I moved to surgery next, I thought, "Oh, rounding is not really my thing." There were some days where you would round for four hours before lunch, go get lunch, and then round for four more hours.

Dr. Chan: A lot of talking. A lot of thinking.

Max: Yeah, exactly. And my attention span, I'm good for a couple of hours and then my mind just starts to wander to the pain in my feet as I'm standing there.

Dr. Chan: Trying to look interested.

Max: Yeah, exactly. And so, once I moved to surgery, the hours are longer, you can have some attendings that are a little more intense, but I loved being in the OR. There's a problem right in front of you and you're there to fix it. I like the kind of immediate gratification that comes from that. So surgery was definitely high on the list.

I have people I know that have done emergency medicine, which is pretty high on the list as well. But then ophthalmology was up there as well. I had a cool mentor in undergrad, so I liked aspects of pretty much everything.

Dr. Chan: So how did you make your decision then if you'd liked everything? Walk me through that.

Max: So, for me, it was as I experienced it, I would talk a lot with my wife, talk with friends. I'd ask her, "What was I like coming home from surgery?" or, "What was I like coming home from this emergency medicine?"

Dr. Chan: So you would ask Kelsey, "Did you like ophthalmology Max or internal medicine Max or family medicine Max?"

Max: Exactly. And that was helpful. And I think one thing I really noticed was how I felt going in for shifts as well. Going in for surgery, I was always tired, but I was excited.

Dr. Chan: Yeah. The hours can be daunting. Waking up at, what, 3:00 or 4:00, going into the hospital.

Max: Yeah. So that was . . . you kind of get in the groove, but there are times where I was like, "I don't know if I could do this for 30, 40 years." But once I was there, it was really exciting.

So you have to choose to do an emergency medicine elective. And another one I was interested in was anesthesia because you're in the OR, but I had never rotated on it. And so, at the end of third year, it's coming that time where you have to pick and I was still thinking, "Okay. Emergency medicine."

So those that don't know, Dr. Chan does psychiatry.

Dr. Chan: Yep.

Max: Child and adolescent psychiatry. I had rotated through UNI up here and thought, "Oh, I could definitely do some child and adolescent as well." There's a program where you do . . . it's called triple board where you're peds, adult psychiatry, child psychiatry. So there was a month period where I thought, "Oh, that's something I want to do as well." So I was all over the board. I loved it all. I thought I could do it all.

Dr. Chan: What did you do for your elective time during third year?

Max: Yeah. So I did emergency.

Dr. Chan: Oh, okay.

Max: I did emergency. Well, I did research. It was my proper elective time, and that was in ophthalmology. And I figured out that the lifestyle is great, a lot of people really like it, but it wasn't a perfect fit for me. And then the rest of that time, I did emergency medicine, and then I stacked anesthesia right after that. That was the deciding point for me.

Dr. Chan: So why anesthesia?

Max: That's what I chose.

Dr. Chan: Yeah. Why?

Max: So anesthesia, for me, they felt like my people. Was just the very most basic. I would go into the OR. Generally, really chill people tend to calm the seas. They're somebody who you really advocate for one person at a time, which I loved.

The chair here at The U, Dr. Egan, he says that in anesthesia you have the mind of an internist, the technical orientation of a surgeon, and the heart of a psychiatrist. I mean, you don't dive in as deep into any of those, but you get to have pieces of different specialties, which I loved.

I could still work with my hands. You still use all that physiology and pharmacology that you pound into your head during med school. And a lot of times, you're meeting someone on the scariest day of their life. They're about to . . .

Dr. Chan: A lot of anxiety.

Max: Yeah. A lot of anxiety. A lot of times, they're leaving that surgery with a very different life than they went in. And as the anesthesiologist, you get to meet them, you get to greet them, you get to calm their nerves, and you're this advocate for them throughout this procedure. The surgeon does their thing. They fix it. You're the one who keeps them going throughout that whole thing. And I love the opportunity to be . . . one person at one time, you are 100% their advocate.

Dr. Chan: I love your eyes just light up when you're talking about it. So did Kelsey see that too?

Max: Absolutely. Yeah. So I did emergency medicine for a month, and then right after I did anesthesia. I wanted to see how the two compared, and I would come home from emergency medicine shifts and even though the hours aren't as long, I was tired.

And they generally funnel the cool stuff to med students, you know, suturing, iliac repairs, different things like that. And I started noticing before I'd go in, I have a pit in my stomach, and coming home, I was pretty tired. And so I thought, "Well, if it's not emergency, I really hope it's anesthesia because I've got to pick soon." And day one or two of anesthesia, I was in the operating room. They let me do some intubation and talk with patients before. I knew it was the one for me.

Dr. Chan: So what does anesthesiology residency look like? How long is it and what kind of rotations are there on it?

Max: Yeah. So it's four years.

Dr. Chan: Okay.

Max: Your first year is an intern year. You can choose between . . . there are basically three options. You can do a prelim year in medicine. So you're rounding, doing all of . . . you're basically an internal medicine resident intern for a year. You can do surgery where it's the same deal but for surgery, and then you can do something called a transitional year. And those are a blend of the two. There are some transitional years that have a reputation for being super chill. There's one in Santa Barbara where I think you work 30 hours a week. So everybody applies to that.

So you have your first year. It can vary widely. And then three years of anesthesia training. You spend . . . do you want me to keep going on?

Dr. Chan: Sure. Keep going on. Yeah.

Max: Yeah. So first year is just getting used to the OR. They'll rotate. The big disciplines within anesthesia are obviously OR, just general anesthesia. You can do regional where you're doing blocks, nerve blocks before surgery. A lot of times on the burn unit, they have a lot of pain, so you'll go in and do a nerve block to take away the pain.

Dr. Chan: Like for laceration repairs.

Max: Yeah, exactly.

Dr. Chan: Okay.

Max: OB is a big part of it where you go and you're doing epidurals. You're helping with pain management there. And then there's chronic pain, which is people with back pain, nerve pain. You're managing them long term.

Dr. Chan: Yeah. That's fascinating because when I think of anesthesia, you do have this image of they provide general anesthesia, they knock the patients out, bring them back to life. But yeah, you've talked about there's also this clinic component where you're treating people who have chronic pain. Yeah, I can see psychiatry being a huge part of that, like motivational interviewing and helping people. That's a fascinating dynamic when you think about it. I don't think too many people think of anesthesiologists like that.

Max: Absolutely. And I didn't know much about what else you did. There's a perception of people that go into anesthesia. When my non-medicine friends hear that I'm doing anesthesia, they're like, "Oh, you're going for the big bucks," or, "You want an easy job."

But when you're in the OR, it's not easy and it can be really scary at times. You are breathing for that person. You are making sure their heart is beating normally. You're the one making sure their brain is getting blood flow and you have to act quick. And I like that component. There's kind of the emergency medicine acuity there, but in a very set environment.

Dr. Chan: So what is or what was your strategy for applying to anesthesiology programs? How many are there? How many did you decide to apply to? How did you determine if you're a competitive person for these programs?

Max: Yeah. So I followed a rule where you apply to 60% of schools that you think you're a really good fit for, 20% that are fallback schools where you're like, "Eh, I'll go there," and then 20% that are reach.

Board scores is a big part of deciding where you fit well. I was pretty happy with how I did on my boards. I felt like I did well with clinical grades, and so there were definitely plenty of reach scores. Most of the schools in the middle, I felt if they're interested in me, I'd be a really good applicant. So we went about it like that.

There's a big list. Doximity does a list of ranking according to reputation, research output. You could spend months looking up all these schools. So I spent a good amount of time looking at how these schools rank up. And then location is another big one. I'm married. I have a 3-year-old son. We're from Utah. Utah is comfortable. The West is comfortable.

Dr. Chan: It's home.

Max: Exactly. And so somewhere in the West we thought would be ideal, but I still applied to programs on the East Coast and have loved those interviews as well.

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

Max: So I applied to, all together, about I think 50.

Dr. Chan: Fifty? Okay. Wow.

Max: And that includes intern year applications as well.

Dr. Chan: Okay.

Max: So you have to apply to those separately.

Dr. Chan: Fun.

Max: Yeah. More money.

Dr. Chan: There are no programs that are combined?

Max: There are plenty of programs that are combined, but there are also a bunch where it's not combined. And if you end up getting in there, you have to find your own intern year.

Dr. Chan: So you have to go out and interview for these intern years?

Max: Yeah.

Dr. Chan: And kind of do the whole process?

Max: Yeah, exactly.

Dr. Chan: Wow.

Max: And it's a different feel. They're really nice. I did mostly medicine the intern years. They're super nice, but they also know you're only going to be there for a year.

Dr. Chan: Yeah. You're a hired gun for them.

Max: Yeah, exactly.

Dr. Chan: when you go on these anesthesiology interviews, do they ever test you for your skills? Do they say, "Oh, start an IV or intubate," or they don't do that? It's all just talking.

Max: So that's one thing. Another confirmation to why anesthesia has been great for me is it's just talking.

Dr. Chan: Okay. All right. No . . .

Max: No surgery.

Dr. Chan: They're not like, "Okay, IV. Do it. Go"?

Max: Yeah. And most of it has been super chill, super laid back. Depending on the program you're at, you can have anywhere from a 10-minute interview to a half an hour, which can be daunting because you're like, "What am I going to talk about for a half hour?" But people in anesthesia are generally laid back and those 30 minutes fly by.

Dr. Chan: Okay. This is fascinating, Max. That's why I love talking to you. What's the perception of nurse anesthesia? Does that get talked about in interview days or is that . . . I'm just curious what you guys learn about that.

Max: Sure. That was something I considered before choosing the field. Everyone thinks, "Oh, nurse anesthesia, they're taking over all the anesthesiologist jobs. It's cheaper." Every nurse anesthetist I've worked with has been excellent. They're wonderful.

And generally, in residency, the things I've looked for are, "Are you working to relieve nurse anesthetists? So are you going in to make sure the nurse anesthetists get home, or is it vice versa?" And if you're a resident who's relieving nurse anesthesia, you're probably going to work a lot more. You're maybe more of a workhorse in that environment, whereas vice versa, the program is prioritizing your time, your own study.

Dr. Chan: Your education.

Max: Yeah. But a lot of people in anesthesia in general, there's a concern that "Are there going to be less jobs because nurse anesthesia, they can do very similar things, more routine cases?" They can step in and . . .

Dr. Chan: And that leaves the complex cases for the anesthesiologists, which have inherently more risk. And then you talk about insurance coverage. It's hugely controversial. It's one of these things that I don't think there's an answer. It's just how the system has evolved.

Max: Right.

Dr. Chan: But I do know to get a bunch of anesthesiologists go and just talk, like, "Oh, what do you think about nurse anesthesia?" and then they go, "Oh . . ." and everyone has opinions on this.

Max: And most people I've talked to in anesthesia who've done it forever, they're not super concerned about it taking jobs away or killing their pay, anything like that. It more has turned into rather than doing one patient at a time . . . if it's at a surgery center where the acuity is lower, they'll just observe two or three rooms. And nurse anesthetists will be in those rooms. And if anything happens, you step in and can help.

So I would love to do one patient at a time all the time, but it's nice to have those skills to manage multiple rooms as well.

Dr. Chan: Yeah. It sounds like the field is evolving, like all fields do.

Max: Yeah.

Dr. Chan: All right. And so, going into your decision, because you have to make a rank list, wasn't it due in a couple of months?

Max: Yeah. I think it's due February or so.

Dr. Chan: So do you have some sort of really complicated Excel spreadsheet at home, or is this just by your gut, or is Kelsey in charge of your rank list and you just give her the password and she's just going to do what she does?

Max: I think it'll be an amalgamation of all of those. I'll say, "Honey, how do you feel? Where do you want to live?" But I'm very much a go-by-gut feel. I've done about eight or nine interviews at this point. The magic number to match almost 100% possibility of matching if you do about 12 interviews.

Dr. Chan: Okay.

Max: I'll probably do 10 or 11, but going into it, it's very much been a gut feel. The programs I leave where I was like, "Yeah, I really got along with the residents. I really like the area," those are the places that I tend to think about more.

Dr. Chan: All right. This has been great, Max. So, looking back, what advice would you give anyone who's listening out there who might be struggling with the idea of going to med school or unsure if they can do it or maybe has that doubt or doesn't come from a background in medicine? What would you say to them?

Max: I'd say medicine isn't for everybody and there are definitely those who get into medicine . . . their whole life, they were like, "Medicine or bust," and they get into it and they're disappointed. But if you know that it's something you're really interested in, give it a shot.

I had a lot of self-doubt, like I said before, but once I got in, once I put the time in . . . I think some people, they really want to do something, but sitting down and actually putting the time in, showing that dedication is another thing entirely.

So, for me, once I sat down, I was like, "Okay. I'm really going to study for this organic chemistry test. I'm really going to get through and do the hard stuff." That's where I gained some confidence.

And so you'll have hard classes. You'll have moments where you think, "Maybe it's not worth it." Just buckle down, get through that obstacle, and you'll have confidence coming out the other end.

Dr. Chan: Awesome. Well, we should have you come back, Max, after the match because I'm very curious to see where you end up.

Max: I'm curious to see where I end up as well.

Dr. Chan: It's been fantastic having you in the CMC group, but also just being part of our school and just part of our community. And everyone loves you and Charlie and Kelsey. Just keep on . . . I'm just so proud of you.

Max: Thank you.

Dr. Chan: All right. Thanks, Max.

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

Dr. Chan: How do you use your post-cycle feedback to strengthen your application for next round? Do you have to redefine your study habits for medical school? How do you set boundaries with your families surrounding your limited time? And how do you strategize the match with a spouse in a Ph.D. program?

Today on "Talking Admissions and Med Student Life" I interview Guinn, 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: Welcome to another edition of "Talking Admissions and Med Student Life." I have a great guest today fourth-year med student Guinn. How are you doing?

Guinn: I'm doing well.

Dr. Chan: Post-match.

Guinn: Post-match.

Dr. Chan: We're not going to talk about where you matched until the end, kind of like some suspense. All right. So Guinn, let's start in the beginning. When did you decide to become a doctor?

Guinn: You know, I think I had thought about it for a while. When I was a kid, I always thought I'd be architect. But I think like pretty classic pre-med, started taking science, really liked that. I did have a family member who was a physician. And so I think probably like a lot of people who have parents that are physicians, that's just kind of in your mind, something you might want to do because you're seeing their career and what they like. And so I thought about it, got into college, really started enjoying the sciences, but really felt like medicine was how I wanted to practice those sciences. And so kind of solidified it by my first or second year of undergrad.

Dr. Chan: Okay. So I want to break that down because you grew up in Utah, right?

Guinn: Yeah.

Dr. Chan: Where did you go to undergrad?

Guinn: University of Puget Sound up in Tacoma, Washington.

Dr. Chan: So why there? How'd you end up there?

Guinn: I always . . .

Dr. Chan: I don't know if they have a large presence in Utah or they have a lot of alumni running around. Like how'd you end up up north?

Guinn: I was like a very naive 17-year-old and was like, "Oh, I want to go to a liberal arts school," if I even knew what that was. And the Pacific Northwest sounded cool. And so that was kind of like where I ended up looking and then got there and ended up really liking it. But it was, you know, I kind of thought back on that like it was, I don't know, maybe silly. I think I could have gone anywhere or . . .

Dr. Chan: Did you go on a campus tour?

Guinn: Yeah, I went and looked.

Dr. Chan: I assume they have nice looking buildings and there's like . . .

Guinn: It's beautiful. I think they catch everyone on the campus. It's gorgeous.

Dr. Chan: There's a Pacific breeze from the ocean and coffee and seafood. Yeah.

Guinn: And the Northwest is really cool and very different than Utah. I wanted to spend some time outdoors and just those lush forest areas are pretty entrancing.

Dr. Chan: Okay. Well, were you the only one from Utah up there or . . .

Guinn: No, there's actually quite a few people that end up in that area, or Lewis & Clark or Portland State. So quite a few Utahns kind of end up there.

Dr. Chan: Okay. So you're up there and loving the sciences, solidified your decision to go to medical school, and then what happened next?

Guinn: Definitely kind of like got on that train, started checking all the boxes, everything I thought I should be doing. I ended up taking the MCAT pretty early. I applied trying to go straight through, so I guess that would have been at the end of my junior year kind of coming into my senior year. Applied not to a ton of schools, but definitely was wanting to come back to Utah and to Salt Lake City. Interviewed here pretty early, and then kind of went through the process. I had . . . didn't end up actually . . . I don't think I got any other interviews. Like I only interviewed at Utah.

Dr. Chan: So how many applications did you fill out the first time?

Guinn: Ten, something like that.

Dr. Chan: Okay, 10-ish.

Guinn: Ten-ish.

Dr. Chan: And got one interview offer.

Guinn: Yeah.

Dr. Chan: All right. So part of you is like, "Okay, that's okay." But you would have been better to have more interview offers?

Guinn: Yes.

Dr. Chan: Okay.

Guinn: I definitely felt kind of surprised and disappointed, but I like really wanted to go to Utah. So I was excited about [inaudible 00:03:29] there and going there. And waited to hear and then in March, I think it was March, April, I'm forgetting now.

Dr. Chan: What year is this?

Guinn: This was 2014 after I graduated and got waitlisted. And so then was waiting. And then I think in June is when I heard that I like didn't make it off the waitlist and was kind of needing to figure out what I was going to do next year and definitely felt like I would reapply.

Dr. Chan: Okay. And I think at that time, and we still have this process in place, I think you got feedback.

Guinn: Yes, I did.

Dr. Chan: Okay. So a good pre-med team advisor up at UPS.

Guinn: Yes.

Dr. Chan: All right. Okay. So what was some of the feedback? I don't know if you could remember?

Guinn: Yes. No, I definitely remember.

Dr. Chan: Okay.

Guinn: I had good MCAT scores, but not great, and I had really good grades. And so I think I was feeling very surprised, like, I hadn't done better in the application process. I think that might be common for a lot of people, kind of like, "Oh, well, like, I do well academically, so like I should get into medical school."

Dr. Chan: And everyone on some level does well academically, yeah.

Guinn: Exactly. And so you look at your feedback, and I really felt like a lot of it was like really valid. And so it was definitely . . . it was like a hard process, but it's like a really good learning process. So some of the things I got, one was that a lot of the volunteer work I had done, I think looked superficial, and when I like really reflected on it, I think it was. Like I was definitely I was super . . . I just wanted to do really well academically. And so I think the volunteer things I did were definitely to kind of to check off boxes and they weren't really like . . . I just wasn't that invested in it. And I really took that to heart.

So I had moved back to Utah after I graduated, and so I ended up finding a few different things that I wanted to do in Salt Lake that would actually engage me with my community. And so I had kind of . . . I'd ended up taking this Gender Studies class my late junior or senior . . . I guess, it was early in my senior year, which was totally new for me. I had just taken it because I liked the professor, but thought that would be weird, and then ended up loving kind of women's issues and women's health issues. And so I ended up getting a volunteer with Planned Parenthood, and I volunteered at the County Jail where I taught sex ed. And then I also volunteered with the Rape Recovery Center and worked on the crisis line with them. And so those are kind of the two main community things I did. And it like changed a lot of how I ended up thinking about my career and what I wanted to do.

Dr. Chan: That's excellent.

Guinn: So that ended up being really cool.

Dr. Chan: Yeah. And then for people, I mean, did you just cold call them, or did they have like a website where you can kind of click on boxes and volunteer?

Guinn: Rape Recovery Center had boxes and you could like fill out an application. It takes a while though to get everything in place.

Dr. Chan: Background checks and all that stuff, yeah.

Guinn: All that stuff. And then similar with Planned Parenthood, I think it's different now. At that time I filled out an application and then could immediately start volunteering at the jail. It takes a lot of hoops to actually get into the jail, but I could start that process immediately. I think now they have you volunteer as like an ambassador or something first before you can get involved with like more of the program side of things.

Dr. Chan: And did you change your strategy? Did you like apply to more schools or different schools?

Guinn: Yeah, I applied to . . .

Dr. Chan: And did you get more interview offers the second time around?

Guinn: I did, yeah. So I applied to a lot more schools. I think more like almost 30. I applied . . . like I hadn't done any of the Texas schools. I applied to like all of the Texas schools. And then I think I ended up getting five or six interviews, but I interviewed at The U early and then got into The U. And I had gotten one other interview to date by that time, and then when I got into The U, I ended up canceling my other ones because I wasn't as excited about them as I was Utah.

Dr. Chan: Okay, all right.

Guinn: I just accepted Utah.

Dr. Chan: So looking back, I know, you know, bittersweet, didn't get in the first time, but do you feel that was a good year?

Guinn: For me . . .

Dr. Chan: For kind of not jumping right from undergrad into . . . essentially it created a gap year I get the sense.

Guinn: It did create a gap year.

Dr. Chan: Okay.

Guinn: It did end up being beneficial. You know, I guess, in a lot of ways, the way I've ended up . . . So I actually ended up meeting the person I'm now married to in my class. And so I can't actually think about that year without getting . . . I'm not even particularly spiritual but without feeling like things happened for a reason because I don't know that we would have met if I hadn't got in the first time. So one it was a good growing experience. But two, I like can't think about the entire thing without thinking about that, because it just feels very, I don't know, how things were supposed to happen.

Dr. Chan: Yeah, it kind of just worked out for the best.

Guinn: Yeah.

Dr. Chan: Timing.

Guinn: Timing, yes.

Dr. Chan: A lot of what happens in life is serendipity, timing, a little bit of luck sprinkled in, so . . .

Guinn: Yeah.

Dr. Chan: All right. Yeah. From my vantage point, yeah, when you hit my radar, I remember I worked on that feedback. I put a lot of good notes in there. And then I'm shocked by how many people don't listen to my feedback and just keep on doing what they do. And I remember at the committee when your application came up, they were very like, "Wow, this is a really strong application. Like, wow, she really did a lot of great stuff after graduating." So I think that was very pivotal and like just the growth that you demonstrated and showed the committee was really impressed by.

Guinn: Well, that makes me happy. It would shock me that someone who didn't let you into medical school was telling you what to do to get in, that you wouldn't but . . .

Dr. Chan: You know life is funny. All right. So you start medical school. So this is the fall of . . .

Guinn: Fall of 2015.

Dr. Chan: 2015. You know, and one of my favorite questions I ask Guinn, is, you know, people have this view of medical school. It's kind of interesting, like, you know, when you're outside and you have this view of medical school, like you kind of like think "Oh, it's like this, this and this," and then you start medical school. I mean, what . . . did it meet your expectations? Was it harder? Was it easier? How would you describe, you know, those first few months?

Guinn: The first few months are really overwhelming, and they were very different. You know, I went to a small liberal arts school, so like the big classes and the amount of information was just very different than my undergraduate. But in some ways, it was a lot the same. And I think one of the things I definitely learned was you might think it's more different than it actually is. So you start medical school, and frequently, you know, they'll do little things with the upperclassmen and they'll tell you how to study and all this stuff.

And kind of you're just like overwhelmed with all these like advice and tips and resources, which are very great and awesome. But it also you kind of just look at these people and go, "Oh, well, you've been in medical school for a year and you're telling me that I need to do X, Y, Z thing." And to study totally differently and medical school is so different and I'm going to have to do everything differently.

So I looked threw everything I had done at undergrad like out the window and was like, "Oh, I need to do Anki flashcards and I need to do everything online and I need to do all these things." And that didn't actually go very well for me and like my first test didn't go that well. And I kind of had to go back and like, "Wait, I do know how to study. I have done this before, and I have been doing this for a long time." And I went back to a lot more of kind of what academic strategies I had done in undergrad and that works better for me, you know, obviously incorporating new things, but remembering that you know how to be a student and you're still just a student.

Dr. Chan: Did you feel that coming from a small liberal arts college you were prepared?

Guinn: Yeah.

Dr. Chan: Okay.

Guinn: Academically, yeah.

Dr. Chan: Because I, you know, I've talked to a lot of people and sometimes I go like, "My undergraduate career is more like, you know, these seminars or essay tests." And all sudden you pivot to this culture where there's multiple choice everywhere, and, just like you said, like the volume of information it's pretty fast-paced and . . .

Guinn: It was different. I think I probably took one multiple choice test in college. So definitely, that was different, but I, you know, I was a science major. I think that was helpful. I'd seen a lot of biochemistry . . . I was a biochemistry major. I had seen a lot of biochemistry before, and I had memorized things for biology, so it wasn't too different.

Dr. Chan: Yeah. And sometimes I wonder about the culture, because, you know, I go out and do these presentations where I talk to a lot of different pre-med groups across Utah. And I kind of tell like, "Look, you know, like this is the best and brightest from BYU, from Utah State, Weber State here." But also and you're a part of this cohort, there's all these people that grew up in Utah, went out of state for college, and they're coming back and they're super smart, too. So you put everyone in like this environment where, you know, there's just like type A personalities for the most part and people want to excel and do well. So I think it just makes for a fascinating culture. I mean, what were your impressions?

Guinn: No, I think it was. So at Puget Sound, I was like, you know, a "type A person," sat in the front and I think everyone kind of viewed me in that way. And I sat in the back row of medical school for the first two years. So you're like . . . I think your peers' perception of you and I just felt a little different. I think I went from being the like, in some ways, I think I felt even maybe like a little looked down upon or something, like I was super career driven or something like that. And then here, that was kind of the norm, and I actually felt like on the more relaxed side of people.

Dr. Chan: How'd you find balance?

Guinn: In life?

Dr. Chan: During medical school?

Guinn: During medical school?

Dr. Chan: Yeah. Because the academic part can be all-consuming if you let it.

Guinn: Absolutely, yeah. I think like a lot of people, especially in Salt Lake, I tried to get outside. And so especially in the first two years would always try to go skiing or hiking, you know, once a week or something like that. And then other exercise things throughout the week. One of the things I found challenging was actually being back home, in that I'm really close to my family. And my partner's really close with his family. And we love that and love spending time with them. But that was like a time commitment that I hadn't had in undergrad because my family didn't live there. And so family expectations and, you know, you want to spend time with them, but finding that balance that was pretty hard, but I did try to spend time with them but still, like, set some boundaries about what I had time for and what I didn't.

Dr. Chan: Okay. Well, you mentioned your partner. Can we say his name?

Guinn: Yes.

Dr. Chan: Jake. All right. So let's hear that story. So what did you guys, like when did you appear on each other's radar? You know.

Guinn: We met at the social at Poplar like the Saturday before medical school started.

Dr. Chan: Okay. So orientation week, okay.

Guinn: And we actually have a ton of mutual friends going back forever, like our parents know each other. His like next door neighbor was actually my brother's college roommate in Montana, randomly like all of these connections, but we'd never met. So I like knew who he was, but I had never met him.

Dr. Chan: So you had heard of each other . . .

Guinn: Yeah.

Dr. Chan: . . . but didn't know each other. Okay. So was it love at first sight, or were you guys friends first or . . .

Guinn: Jake should tell the story. We were friends first.

Dr. Chan: Okay.

Guinn: I was not immediately interested, but Jake was apparently. And then we started dating in maybe October.

Dr. Chan: Okay. So right there during first year?

Guinn: Yeah.

Dr. Chan: And did you guys keep it kind of like secret for a while? Because I know like there's like this weird kind of dynamic.

Guinn: It was super weird.

Dr. Chan: Yeah, this dynamic, because like, for those who don't know, like, so med school, like, one of the cool things about it, and also the challenging aspects is, as a class, you kind of march through the curriculum together. So you see each other every day. You start doing rotations together. So dating each other can get tricky at times, because sometimes couples get together and stay together, but sometimes they don't. So there's this dynamic. So what was it like in your class like?

Guinn: I was very concerned about this concept of, "Oh, we're going to be in the same class for two, you know, and like very much together for the first two years. What if we . . . things don't work out and it's going to be super awkward?" And it just really wasn't like a thing at all that was . . . like, now looking back, it seems really silly to have worried about. You know, the class definitely had little . . . would tease us about it and things. We were the only couple that got together in our class, which I think is kind of unusual. So it didn't end up . . . it wasn't too weird. A little weird at first.

Dr. Chan: Okay. Did you guys like sit together and study together? I mean.

Guinn: Yeah, we spent like every hour together. We would study in the same space. We didn't do a lot of actually studying together, but we'd study in the same areas. And then we'd sit together and kind of do things the first two years, but spent a huge amount of our time together before he left to get his Ph.D.

Dr. Chan: And that was my next question. So he's on a different track.

Guinn: He is.

Dr. Chan: He's on the MD-Ph.D. track. So how would you describe that to people who don't know?

Guinn: Yeah, so you do two years of medical school. And then you step out to get a Ph.D., which takes three to five years. And that can be in anything. Jake's is in biochemistry. And then you reenter medical school for the third and fourth year. And it's for people that, I think, for the most part, want to do a large, a lot of basic science kind of in their careers, but also some clinical practice.

Dr. Chan: So you started this journey together and the first two years you were together, but then he kind of goes off in this direction and you go off in the other direction.

Guinn: Yeah, it was different.

Dr. Chan: How was that? I mean, how did you navigate that?

Guinn: It was hard. It was super hard, and third year you're so busy. So you just went . . . I went from seeing him like every second of the day to definitely not during third year. He would try to work kind of when I was working so, you know, I think a lot of lab people or some amount of lab people end up kind of working later in the day and then they like work later at night. But like for instance, when I was on OB, Jake would drop me off at labor and delivery at 5:00 in the morning and go into lab, and then he was like ready to leave with me at the end of the day. So that worked well.

Dr. Chan: Okay. So there's a perception that when you get your Ph.D., there's like a little bit more flexibility in the schedule.

Guinn: That is true.

Dr. Chan: Okay.

Guinn: I always thought it like our classmates always say these things like, "Oh, is Jake, like, so relaxed? Like, how is that?" And it just like drives me nuts because he works so hard. So it's definitely it's a lot of time and it's a lot of stress, and it's a very different stress but it is more flexible.

Dr. Chan: Okay. Because like, yeah, like there's like experiments running and research protocols and like sometimes they run at night. So, yeah, it's good old badge card access to get into the lab.

Guinn: Absolutely.

Dr. Chan: All right. So if I had talked to you at the beginning of med school, because what I remember about your application, I would have said, "Oh, I think Guinn's going to go into OB-GYN or something similar." Talk about how did your career choice evolve? And like, how did . . . and how much did third-year kind of factor into that? Like, how did that evolve?

Guinn: Third year was the most of it. So yeah, I had kind of developed this interest in reproductive health, reproductive justice, women's issues. And I think I thought that that meant I should be an OB-GYN, like, "Oh, these are my interests. Therefore, I should be an obstetrician-gynecologist." And those definitely are my maybe social interests, but kind of third . . . end of second year and then third-year starting I realized that academically and kind of professionally I really loved internal medicine. So it was one of my first rotations. I think it was my second rotation third year, and I just loved it. I loved how we thought about things. I loved working through problems. I really like the breadth, just every different patient, every different type of organ system. Big long medication lists, I think, freak a lot of people out. I like loved it, think about all these different things, how they interplayed.

Dr. Chan: Big long rounds.

Guinn: Big long rounds. I was like totally fine with that rounding forever.

Dr. Chan: Yeah, rounding internal medicine is notorious, yeah.

Guinn: And so I just loved it, and I liked my OB rotation a lot as well. I had that later in my third year, and definitely, you know, I think you hear a lot of people like, "Oh, I thought I would love this and I hate it." I did not hate it at all. It was awesome. It's amazing. But internal medicine just seemed like a much better fit for me. I was a lot more excited about it.

Dr. Chan: So OB-GYN and internal medicine was kind of neck and neck for a while, or is it just like internal medicine was just so . . .

Guinn: It just kind of took over.

Dr. Chan: Took over, okay.

Guinn: And I think because I had thought I was going to be an OB for so long, I like held on to that. But I felt really good and secure about my decision.

Dr. Chan: So you decided to go into internal medicine. What was your strategy at the start of fourth year when it comes to match?

Guinn: It was a little different than I think a lot of people's, because I . . . yeah, it was just different. I think a lot of people have the option to maybe go anywhere. Because Jake's in the MD-Ph.D. program, I obviously have the option to go everywhere. But that was a huge consideration is where he would be and how we were going to work through that. And so I knew that I thought I really wanted to go to Utah. But I also really wanted to seriously consider my options and not get in this place where either I put all my eggs in the Utah basket, and that doesn't work out. Or, you know, 10 years from now I'm like, "Well, I stayed in Utah for you, and I could have gone somewhere else."

Dr. Chan: I would be worried if you talked like that in 10 years too. Sounds like some progeria going on, Guinn. You should go see an internist about that. Yeah.

Guinn: Perfect. So I wanted to feel really good about it and that was also the advice. You know, it's kind of, I guess, a little funny. So in internal medicine, they're really awesome about working with our medical students here and like do a lot of advising. And so I was sitting down with the program director and assistant program directors, and they talked about where you want to go, and you can be really open and honest. But it was kind of funny, because I was like, "Oh, well, I want to go here."

Dr. Chan: I mean, yeah. I mean, from a strategy, did you just show all your cards? Were you just so honest with them going, "You know what? My partner's here."

Guinn: I did tell them that in the beginning.

Dr. Chan: You are my number one.

Guinn: And that was advice, you know, I got from our Dean Adam Stevenson kind of about where I should go or like how I should go about it or how people had kind of done that in the past. Being like upfront about it, but not super in their face, or acting like you for sure thought you would get in here, you know, anything like not being I don't know the word, not humble, I don't know, something like that. So talked to them, told them what I wanted, but then I kind of like laid low and did my thing for a while. And then at the end, when I had like finished all my interviews, I kind of came back and said, I did end up telling them that I was ranking them number one.

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

Guinn: I applied to 16 programs.

Dr. Chan: Sixteen?

Guinn: Mm-hmm.

Dr. Chan: Okay, and how many interview offers did you get?

Guinn: I got interviews at 13.

Dr. Chan: Okay, and did you go on all?

Guinn: And then I went . . . No. I went to eight.

Dr. Chan: Oh, you went to eight.

Guinn: Yeah. So I kind of did a lot of like eight programs, maybe like five programs I was like very interested in and then some reaches, and I didn't really get interviews at kind of like my more reach schools. And then some schools I like wasn't as excited about. And then at Utah, they interview all the students going to the University of Utah first. And so that was my first interview, which was kind of nerve-wracking because that's where I wanted to go.

But I did that first, and then I had my other interviews in November, December. And then kind of towards the end of December, you get all this stress because everyone's talking about like, how many interviews you need to go on and what you need to do, and there's this huge fear of not matching. But I felt confident in the programs I had interviewed at that like I was going to match somewhere. And I did, I felt good about Utah. I didn't want to put all my eggs in that basket, but I felt pretty good about it. And so I ended up canceling a few of my last ones just kind of on a money, time, soul sort of thing.

Dr. Chan: When you interview at other programs, did you also share, you know, like the existence of Jake and how he's back in Utah? Or is that something again, you didn't really share because you didn't want them to, like, rank you lower because of that? Do you understand what I'm saying?

Guinn: Yeah, No, I do. I was super like wigged out about it. I just thought I was going to get all this like questions, yeah, they weren't going to rank me or something. I like even thought about like not wearing my wedding ring or something. But no one actually cared or asked me. So that like wasn't an issue at all. In San Diego, I interviewed at a few programs there. And that was kind of a city we identified, like would maybe work for a transfer or whatever. And so, when I was in that city, I did kind of tell them, and it was like this is one of the cities that will work for us. And at some institutions, I just didn't mention it, because I kind of felt like it was none of their business.

Dr. Chan: It wasn't germane.

Guinn: Yeah. And they might rank me low or something.

Dr. Chan: Okay. And then you mentioned San Diego, so I get the sense you were kind of focused in the West.

Guinn: It was geographical, yes.

Dr. Chan: It was geographical, but then also you mentioned transfer. So did Jake do a little bit of like research into like what programs . . .

Guinn: Yeah, we did.

Dr. Chan: . . . would even accept transfers because I know . . .

Guinn: So I guess even The U on our website we say we don't accept any transfers, but sometimes they will for like special circumstances.

Dr. Chan: Yes, special circumstances, but priority is given to those whose partner matches into a postgraduate program.

Guinn: So if like I had matched. If I wasn't from here and had matched here, then you would give maybe preference.

Dr. Chan: Preference to someone, but they still have to meet all our criteria, etc., etc. There's still a process. Yeah.

Guinn: So we kind of looked. But we were kind of like, well, we'll probably be able to figure this out like at any of the places if that works. There was one school, so UT Southwestern, I interviewed there and really loved it. That was actually kind of hard. I like really liked it there and thought I might want to go there. And that was a place we thought Jake could transfer the last two years, but maybe even in the middle of his Ph.D. There was a lab that was very similar to his lab. So we were kind of trying to figure that out, but it's hard to like get, you know, full steamrolling on something that you don't know is going to happen yet or not or you're not even sure if you want to happen yet.

Dr. Chan: Okay. So these programs, they e-mail you the love letters? I mean, what was your strategy? What was your . . .

Guinn: Oh, the love letter thing totally stressed me out. So you have this big lecture, and basically, at every single interview I went for internal medicine, they would say "Do not send us a thank note," like not only like do not need to, like, but please don't.

Dr. Chan: It will be a mark against you . . .

Guinn: Yeah, and like don't communicate with us.

Dr. Chan: . . . if you don't listen to this specific instruction in this moment. Do not send a thank you note.

Guinn: Yes, and so I'm sitting there, I'm like, "Okay, great. I'm not sending a thank you note. They told me not to." And then you're like talking to people afterwards and they're like, "Oh, God, they say that, but, of course, you send thank you notes." And I had not sent a single thank you note, so I was like, "Well, [crap 00:24:19]. Either this is the worst." And then you're sitting there with Dr. Stevenson and he's kind of going over everything and is saying all this stuff about love letters. And I'm just sitting there freaking out because I was told not to. And I don't know what to do.

And so all the internal medicine people were kind of wigging out as a group. And so we kind of talked to our program director about it, and they felt like that was not something we needed to do. And besides your number one that those were kind of useless. So that was the advice a lot of us got. I don't know what everyone else did. I knew I wanted to go to Utah. Several people had told me I should tell our program director that they were my number one. So I did, and then I didn't talk to anyone else and I didn't send a single thank you note.

Dr. Chan: Okay, perfect.

Guinn: But I was like stressed about it. You just get all this, I don't know, conflicting evidence.

Dr. Chan: So you talked to our own people here in Utah, like you clearly communicated you want to stay number one, number one. Did you feel compelled to like do like extra rotations here to kind of show off your skill?

Guinn: I did and yeah, I guess that was the skill.

Dr. Chan: Or you know, doing more sub-I? I mean, how did you kind of formulate that because you wanted to stay?

Guinn: Early in the fourth year, when I thought that most likely I would want to stay here, I scheduled like all of . . . I scheduled a lot of things at The U for my whole fall. So instead of doing something at IMC, for instance, like my sub-I, I did . . . I tried to do everything here where there was just more people that I thought would know me and the program director and that sort of thing.

Dr. Chan: All right. So going up to February, your rank list.

Guinn: Yeah.

Dr. Chan: So there's a term that it's not the most politically correct term, suicide matching, meaning you only list one program. Did that ever come into your . . .

Guinn: Heck no.

Dr. Chan: Okay. All right. So what was your thought process going in to creating your rank list?

Guinn: I just . . .

Dr. Chan: With these eight programs you met or you interviewed at, yeah.

Guinn: Yeah. I think it would have been hard to be long distance with Jake. But I think it would have been a lot harder to not match. So I definitely I put Utah as number one, but I definitely ranked every program I interviewed at because I wanted to go somewhere. The other places I put I end up putting other schools that I loved, but maybe would have been even more difficult second and third. And then kind of places that were . . . it was actually, no. The whole thing was based on where I wanted to go actually. And some would have been more challenging for us to do long distance. But at that point, I felt pretty good about Utah happening, so it kind of all felt like a formality.

Dr. Chan: Any . . . I mean, like I think it's fascinating because like, you know, I've talked to a lot of couples who did the couple's match. What you went through was very different.

Guinn: Yeah.

Dr. Chan: Any, like, any thoughts or feelings like towards Jake, like, oh, you know, you talked about Southwestern, you could have matched there, you could have gone there, but then like, you know, but he needs to stay here. So like did, like feeling of compromise?

Guinn: Absolutely.

Dr. Chan: And, you know, like and how did you navigate that in a relationship where, again, all things being equal, you guys are equal partners, but like someone is making a "sacrifice"? Like, yeah, how'd you do that?

Guinn: We talked about that a lot. It's the first life decision I've made with another person. You know, we just we got, we met in medical school. We got married after our second year. So everything I've done in my life to this point is it just has been what I want to do and what worked for my career. And so that was a big learning curve and decision was kind of going through that together.

And I was feeling really unsettled for kind of the whole fall. And there was kind of this moment in December where Jake had kind of done a lot more research and kind of figured out that, like, maybe he could move to UT Southwestern, which at that point, I had like really, really liked that school.

And there was just something about him having like made that effort and having it actually like kind of feel more like a choice for the first time, that it just like felt like this like huge, like, weight off my shoulders. And I just felt so much better about the whole thing. And it like felt so much clearer. And so I did . . . we put a lot of thought into that, like do we want to try to rank? You know, I don't know that I would have even matched there. But would we want to rank UT Southwestern work and try to have Jake transfer mid-Ph.D. and do all that? And we decided not to and that Utah felt like a lot better and a lot better for us. But having had him make that effort and have it really feel like a choice, felt really, really good.

Dr. Chan: Okay. That felt very validating.

Guinn: Yeah.

Dr. Chan: Yeah. Because I can see that. I mean, I think it's not uncommon when two people are very successful and have careers and that wanting to stay together. But if one gets a great job offer in another location, it's hard for the other partner to have the exact same opportunity. So the concept of sacrifice.

Guinn: Yes.

Dr. Chan: And I think it's common in all relationships, all marriages, all couples, as they navigate this thing we called life. So I was just kind of curious to see how you and Jake kind of figured that out together.

Guinn: It ended up working really well. And I think it's something that, like you said, will kind of be coming up again and again.

Dr. Chan: Taking turns.

Guinn: Yeah, and we're going to have to work through this several more times so.

Dr. Chan: So February, you submit your list. From February to March, feeling good? Second thoughts?

Guinn: Super anxious. And, you know, they had essentially told me, you know, they can't like exactly tell you, but they'd like essentially told me I was coming . . . like, of course, I would match here. But it's just this weird moment in your life, where your entire future is and it's not really this way, but it feels like it's in a single person's hands. Like when you're applying to medical school, you know, there's like the admissions people, but there's like a whole committee and there's all these like kind of like precedents and things. And there's the same thing for residency. And maybe I'm wrong, but my perception was that the residency program director here could like . . . she I think really likes me, but at some moment could be like, "Oh, I don't actually like Guinn," and like could just change my entire future.

Dr. Chan: Squash you like a bug.

Guinn: Yeah, in like a second. And that just felt so vulnerable. And I did not like it, you know, as opposed to like for the rest of your career if one person doesn't like you, but you're otherwise doing well, that's not going to totally tank you. So that was uncomfortable, but it all worked out.

Dr. Chan: So you adopted a strategy of avoiding like all the power players within internal medicine?

Guinn: Kind of not. I was like involved in this like Women's Leadership Group, and I was like, had invited the program director like to this thing. And then we ended up having like a miscommunication like about the event, and I like wigged out. I was like, "She's going to hate me and she's like going to drop me off her list." But that didn't happen. So that was good.

Dr. Chan: Okay. All right. So match week, Monday, were you stressed at all about not matching? Were you . . . was your anxiety level on Monday higher than on Friday? So Monday, you find out if you matched and Friday you found out where you matched.

Guinn: I felt like I would match.

Dr. Chan: Okay. So you were not worried going into Monday?

Guinn: I wasn't worried, but you still have this like, you know, the numbers for internal medicine and you can look. They have all these things online where you can like plug in like, I don't know, a bunch of your data and see how many people have like matched. So I felt like statistically very comfortable that I would match. But you do get all this like I think just anxiety about like what if? You never know like, that weird things happen? So I wasn't too stressed. I just spent a night, so I sent alarm, woke up in the morning, had matched, went back to sleep.

Dr. Chan: Yeah. Friday, who's there?

Guinn: I didn't want to invite my parents.

Dr. Chan: Why?

Guinn: I felt like I was like most likely going to match at Utah, and then if I didn't, I was going to be like utterly devastated. And if there's anyone in the world who could like make me cry, it would be like looking over at my mom and seeing that she's like, "Oh, like my poor baby," and like feeling badly for me and I would start crying. So I kind of . . .

Dr. Chan: So it was more of a defensive measure?

Guinn: Yeah, I kind of didn't want to invite them, but then I decided they might not love that. So I did end up inviting them and then Jake came.

Dr. Chan: Okay. So you got . . . he came down from the lab.

Guinn: Came down from lab, we opened the letter. I matched at Utah.

Dr. Chan: Okay. I mean, how did it feel?

Guinn: It felt really good. I just felt like so relieved. The whole day, I thought the whole day was a little weird. Like it's a little theatrical or something.

Dr. Chan: Yeah, it's kind of developed into a thing.

Guinn: Yeah. And where I like kind of felt like I was most likely going to match here. It wasn't really a surprise. So the whole thing was a little . . . it felt a little funny to me.

Dr. Chan: Anticlimactic.

Guinn: A little yeah.

Dr. Chan: Okay.

Guinn: But it was still fun to see like where all my classmates were going. You know, that was a surprise for a lot of them. And it was fun to see who else was coming, going to be in Utah next year.

Dr. Chan: Yeah. How big is the program here?

Guinn: Thirty categorical, which means people that will continue in internal medicine for all three years. But medicine is also a specialty where you have preliminary interns who do a year in medicine before they go into something like neurology or anesthesia. And so there's 30 categorical and then 30 prelim students.

Dr. Chan: Oh, okay, pretty large.

Guinn: So my intern class will be 60.

Dr. Chan: Okay. How many fellow classmates from Utah?

Guinn: There is one other woman, Taryn, who is internal medicine categorical. And then there's three or four people who are doing their prelim here next year, which will be fun.

Dr. Chan: And then, you know, match was a couple of weeks ago, a few weeks ago. Feeling good since then? Does it feel weird because you kind of transition from med school to intern year? I mean, how do you . . . I mean, where are you at right now?

Guinn: I'm very excited.

Dr. Chan: Okay.

Guinn: I'm a little nervous. There's this security of being a medical student and not a doctor that's about to go away.

Dr. Chan: Yeah. I remember like the first time I got my contract like, "Wow, I've never made that much money in my life."

Guinn: Yes, a paycheck.

Dr. Chan: And then I think it was like a 30-page document, which is like, it's like a big deal. It's like I'm going to have to just read through this thing and sign it. A lot of it is just very lawyer talky, so yeah.

Guinn: So I'm nervous but really excited. I was on an internal medicine rotation in March. So I was, you know, around a lot of people who are going to be my co-residents or my uppers or whatever, next year. So that was fun. People I'll be working within the future. But I'm really excited.

Dr. Chan: And then I know this is in the future, but have you already thought about fellowship? Is that in your cards? Like what?

Guinn: What medical student isn't always like looking 10 years ahead?

Dr. Chan: Yeah. Thinking about the next plan, yeah.

Guinn: I don't know if I will do a fellowship or not. Right now I think I'm going to do hospital medicine, which does not require a fellowship. And I'm probably . . . I don't think there are any like accredited fellowships, but there are some like kind of optional fellowships for hospital medicine that I would think about. We would like to move somewhere for Jake's residency, and I would kind of like to diversify my training in some sort of way. So I think I will do my residency here and then work as a hospitalist for at least a few years. And then if I want to do a fellowship in a subspecialty or in something, like more work in quality improvement or hospital medicine, I would wait and apply to that until we know where Jake and I are moving for his residency.

Dr. Chan: Okay. Does he know what he wants to go into?

Guinn: He's not sure. And you know, he hasn't done any of the clinical things. If I were to guess, I would say medicine subspecialty, and they have some like accelerated physician-scientist training programs, which I like the sound of. So I would guess something with cardiology or oncology, but you never know.

Dr. Chan: I'm going to pivot right now, Guinn. Let's talk about student government.

Guinn: Yeah.

Dr. Chan: So you're pretty involved. Like what are the kind of different activities you're doing?

Guinn: Right now?

Dr. Chan: Yeah.

Guinn: So I'm one of the student body co-presidents. There's three of us. I'm also part of this group, we've gone through a few name changes, but right now we're going with it's called WEWIL, Women Empowering Women In Leadership. And it's a women's leadership group that started my second year that has been really rewarding and really awesome.

And then as part of student government, but it kind of morphed into its own thing, we also started this peer mentoring program that we call You Crew, which we kind of came up with as an idea to address this . . . a couple of different issues. One, we had a lot of peer mentoring programs that would pop up for like two months and then totally die and fizzle out. So we wanted something we thought might be a little more lasting.

And two, there's this huge divide between preclinical students and clinical students. And like I didn't know a single third or fourth year in my first or second year. And then now it's like, you just don't see them because you're in the hospital and they are in the classes. And we felt like it would really benefit students to actually have some of those relationships and help them network and build more of a sense of community here.

So it was our first year. We've had some successes, definitely some not so successes, but the whole idea was that these little "Crews." It was 100% opt-in, but for second, third, and fourth-year students. And kind of trying to encourage more just organic community within those little groups, but creating a space where they could get together and text each other before their Step One day, and kind of that sort of thing, and then doing a couple of big events each year. And that's been really cool. And we're actually like meeting next week to kind of pass it on to the next group and talk about how they want to take that next year.

Dr. Chan: For a program, yeah, to have sustained success you need to like groom like . . .

Guinn: Yes, exactly.

Dr. Chan: . . . fellow leaders after you carry the touch a bit, yeah.

Guinn: Yeah, I actually I ended up having the class presidents like nominate people in their classes that they thought would do a good job with it and kind of approach those people to take over.

Dr. Chan: So student body president, what does that mean? What does that entail?

Guinn: It's a lot of administrative things. It's a lot of like answering e-mails and making sure everything's happening.

Dr. Chan: Going to meetings.

Guinn: Going to meetings. The main thing is kind of supporting the class leadership and helping them with everything they're doing and checking in and helping them navigate that process. We have three main events we're in charge of, which are our formal and we call it prom.

Dr. Chan: Sweet.

Guinn: A roast at the end of the year, which is always fun.

Dr. Chan: Super sweet.

Guinn: And then elections for the incoming students. And then besides that, it's a lot of what you want it to be. So for us this year, this new peer mentoring program was something that we wanted to do and that we were in charge of and put up. But it could be anything. We're actually doing elections for the new people this week.

Dr. Chan: So from my vantage points, again, like I . . . that's why I love having you on the pod. Like I see, like the official dean's office, when there's an issue or something happens, my vantage point is they try as much as they can to involve student leadership and figure out like what's the student response or what do we need or what are the students asking for? I mean, do you feel that way? I mean, because do you feel like there is a good kind of cooperation between like the official administration and also the student leadership kind of tackle a lot of things?

Guinn: Yeah, I feel like they really try hard to involve us in a lot of things. I think the biggest challenge has been capturing the voice of the medical school and getting that back to administration, especially because we frequently have pretty different voices going on. And so as leadership, you're kind of trying to make sure you're speaking for your entire class or the whole school and figure out what students' responses are. But those can often be very different.

Dr. Chan: Yeah. I mean, if you have 125 students per class, 125 different personalities, different backgrounds, different cultures, different undergrad degrees, different undergrad institutions. I think, Guinn, I think it's really hard for you to, you know, for you as a group to kind of speak for the entire . . . I mean, what do you do? Do you like send out polls? Or do you have like town halls?

Guinn: It's a lot of surveys, and I think we like, oh, we over-survey.

Dr. Chan: Or you just know oh, so and so is really frustrated with this and you kind of approach them.

Guinn: Yeah, we will do some of that. I think an area that we could improve on . . . One hard thing is that the people in student leadership often tend to be the people who are more involved in the school, and then they're also kind of like hanging out with more people that are more involved. And a large group that I think gets underrepresented are people who are maybe somewhat less involved with all of the school things, but still have, you know, opinions about the school. So a thing that I guess comes up a lot is, you know, we got rid of mandatory attendance. So now there's encouraged attendance for some events and not for others. And there tends to be this kind of like dichotomy.

Dr. Chan: Yeah, still people are not happy.

Guinn: Yeah. No one is ever happy. Medical students are not . . . I'm kidding. They're happy, but . . .

Dr. Chan: They're content.

Guinn: They're content. So I think that's something we could do better at is kind of capture, but it's hard to capture the voice of all these different people. And I think more town halls would probably be better. We do a lot of surveys. We do a lot of just like word of mouth. And then try as much as possible to be open and approachable for people to bring us issues. But they don't definitely as often. It's definitely more kind of the student leadership soliciting from other people.

Dr. Chan: Yeah, I think it's age-old problem with leadership, like how proactive do you be versus reactive, right? And, you know, it's hard to be proactive, because sometimes you don't know what the problems are until like there's like a raging fire, but then you don't want to be over-reactive. So yeah, a lot of it's just kind of navigating all of these different personalities and different interests. And there's like multiple organizations involved. And I sometimes feel like the students think like, "Oh, the dean's office can just like wave a magic wand and change something like."

Guinn: It does not work that way.

Dr. Chan: Yeah, it's a lot more complicated than that. And then, especially I think with your experience, Guinn, have you seen like, you know, the different departments are fairly autonomous, right? So they're all kind of part of the med school, but they're also, you know . . .

Guinn: Doing their own.

Dr. Chan: . . . doing their own thing, and like they have different people and different interests. And so it's kind of like how do you build a coalition to enact change? And how do you get the right people in the room and the right discussions going and build positive momentum to do something that's impactful and meaningful? So but it sounds like you've done a great job with like this You Crew and then talk about WEWIL. Yeah, what's WEWIL about? Yeah.

Guinn: So that started. It was my second year, yeah. So Vivian Lee was still here. She was the senior vice president. And it actually kind of started . . . I think it was like an interest of hers and we had kind of talked about it, but getting more female leaders in medicine. More than 50% of medical -- what's the word -- matriculants now are women, but the leadership positions . . . I actually don't remember these numbers, but they're very small. It's like 20% or something.

Dr. Chan: It's not 50%.

Guinn: It's horrible. It's kind of this idea of like, how do we get more women involved in leadership in medicine specifically? And we did kind of a couple of things the first couple years and then this year, I have a really wonderful group. We have representation from like all four classes. And we did a couple of smaller events in the fall, kind of geared more towards mentorship and professional development and kind of cultivating from that way. And then our big event is actually coming up. It's a week from . . . two weeks from yesterday. And that's kind of this half-day conference we're doing and talking about a lot of different aspects. So we kind of put it into a few different buckets, but basically getting a lot of our invested and involved female faculty members here who like people that students kind of identified as mentors and role models and getting them to come in.

We're doing a panel session, and then we're doing all these small groups, talking about everything from kind of career navigation basics, because, you know, we have students from all four classes and we actually also invited some pre-med students this year. So people are in some different phases of the career. You know, a pre-med student could be just about to take their MCAT as opposed to like people who've already matched.

So talking about things like finding your passion and what you actually want to do, or being a mother in medicine, or different leadership styles and what that means. Taking risks, which is something that I think a lot of women maybe have felt like less comfortable with or isn't talked about as much with women as opposed to men. But really trying to take a very positive approach to everything and not just like sitting and talking about all the negative aspects, more just like looking forward.

Dr. Chan: And do you feel it's been positive, like it's been received very positively? Like a lot of like interest?

Guinn: Yeah.

Dr. Chan: Because I think I've heard some students talking about this.

Guinn: We've actually had really a lot of interest and a lot of positive responses. I think it's been really beneficial helping MS1s and MS2s network and kind of gain some mentorship and development in those early stages. And then it's just like this refreshing break. You get kind of down in the weeds sometimes of all of your, like, the daily life of the medical school, and you know, either studying for your finals or boards or, you know, your clerkship things. And it's kind of nice, I think, to take a moment in whatever setting, either this workshop or different things we've done and kind of step back and think, "Wow, like look at these like inspiring, cool, female-identifying leaders. And this is awesome that they're doing these things, and I want to do things like that. And I want my career to look like this, or I want to impact people's lives in this way." And it's really refreshing and kind of gets you re-energized.

Dr. Chan: Something that's always, you know, that I've struggled with is, you know, like the female, the woman medical students, like they, you know, sometimes they're confused for nurses when they start doing rotations. You know, and then, you know, and like, by and large, I think the faculty don't say things that are inappropriate, but every once in a while, yeah. But like patients sometimes, you know, I've been in the room when they refer to a female med student as like Mrs. or honey, you know.

Guinn: I would say often, yeah.

Dr. Chan: Or honey or sweetheart.

Guinn: Yep.

Dr. Chan: Or make some sort of weird, appropriate . . . inappropriate joke, you know, and it's really hard, you know, and like sometimes like, "Oh, what is the administration doing about this?" Like, well, we can create modules till the end of time, but like I don't know how to change a 90-year-old's behavior.

Guinn: No, like society.

Dr. Chan: Yeah. And so there's definitely this undercurrent. I think what you're doing, Guinn, is fantastic. But I just think there's an undercurrent, like society that just is doubtful and is always saying things that are inappropriate. I don't know it's . . . I struggle. Like I go, "What's the best response to that? Like, how do you support someone in the moment? You know, do you correct the person right then and there? Do you pull that person aside?" Like, I don't know. What would you say to that?

Guinn: That's actually one of our workshop topics.

Dr. Chan: Yeah, and did this happen to you?

Guinn: Oh, yeah. Well, one thing, in general, I always try to be really clear about is because being mistaken for a nurse is really common. And it bothers me in that I'm in my medical training and I am going to be a physician. But I like to be really careful about not, in any way, like down talking nurses or anything, like it's so bad to be a nurse or anything like that. So I always like, you know, you don't want to say anything and like, "Oh, of course, I'm not a nurse." Like nurses are wonderful and amazing and work really hard and are very educated. So I always like to be very careful about that.

Typically, I try to correct people. As a student, it's hard because you introduce yourself by your first name, because you're not a doctor yet. So you can say I know some women who introduced themselves as Student Dr. so and so, and that's one tactic some people do. I personally feel more comfortable with their name. I've heard a lot of residents who personally introduce themselves as "Hey, I'm Dr. so and so, but you can call me Guinn."

So those are kind of some little tactics that can set the stage. I remember actually talking to Dr. Lamb about this and we were all kind of complaining about it. And she made some comment like, "Why do you think I wear my white coat?" And that was . . . yeah, it in some ways sucks that you have to or think about it, but in some ways it's also nice to get some little tips about like.

Dr. Chan: Put the uniform on.

Guinn: Yeah. Okay, that's something I could do where people would think of me in that way and maybe my male counterparts don't have to, but whatever, I don't know. That's something you can do. And then the bystander one is one I think about a lot. A common thing on rounds is with a female attending male medical students, and the patient will spend the entire time like talking to the male medical student as opposed to like the female attending. And so thinking about that and what are things you could do, either as the attending or if you're the male medical student, or if you're a male attending, and you had someone kind of down talking to your female medical students, what are things you can say? And I don't have all the answers to that yet, but I think a little bit of it, like a toolbox of little phrases or something you have, would be really useful. So people can come to our workshop.

Dr. Chan: I'm going to have to go to this workshop and learn more. This is fascinating.

Guinn: Things you can say.

Dr. Chan: Just talking about this just kind of triggers a lot of memories and just trying to figure this out. It's really hard, you know, and I want our students to feel supported at all times. And I feel like, you know, what is . . . what do we do? What do the academic centers do? I think we strive for the ideal. We try to teach the students like this is what you should be doing. This what you should be learning. But then like, you know, out there is the world, and it can be a very difficult place. And you know, so when we launch our students into all these different rotations or where they . . . if they're doing, you know, if they're working in these different clinics and volunteering, there's stuff that happens, and I hope we have our students to be very prepared for those moments, but I think it's hard. It's really hard, yeah.

Guinn: I think a lot you just have to learn on the fly or experience yourself and kind of figure out how you want to go about it and then also how you want to think about it. You know, I don't know if some 90-year-old at the VA calls me honey or a nurse, I frequently just don't . . . like I don't care. I don't care. I'm like whatever. I'm doing my job. Give me the information I need. I'm going to check you for pitting edema. I'm going to go on my way.

Dr. Chan: Yeah. I don't think the VA needs to have more training modules. Okay, well, Guinn, this has been fantastic. I've really enjoyed . . . yeah, it's been it's, in fact, just watching you grow over the years, and yeah, I'm just excited for the next phase of your journey. Like you're going to be a doctor in a few short weeks. And yeah, then you're going to start residency and then fellowship and wow, it's just amazing to watch you grow.

Guinn: It goes very fast.

Dr. Chan: Yeah. Cool. Well, thanks for coming on, Guinn.

Guinn: Thank you so much for having me.

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 makes medical school so uniquely difficult? How do you carve out that precious quality time for loved ones? What's it like to finally embrace your past as part of your future? And what's it like to anticipate Match Day? Today, on "Talking Admissions and Med Student Life," I interview Kyle, 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: Welcome back, Kyle.

Kyle: Thank you.

Dr. Chan: I'm so glad you're back. All right, Kyle. I know we chatted a long time ago.

Kyle: We did.

Dr. Chan: But we're here now. You're a fourth-year student.

Kyle: I made it.

Dr. Chan: You made it. You made it. Hallelujah. Amen. All right. Okay. So let's jump back to, if you can, first year, your second year at the beginning. As a non-traditional student, how'd it go?

Kyle: It was a lot harder than I thought it would be. I remember having a conversation with a third-year medical student before applying and he told me, "It's hard." And I could see the defeat on his face. And I remember thinking, "I have done a ton of stuff. I've taken, you know, 17 credits while working full time managing a family. You don't know what hard is, man." But then you get here and you realize that it's not the amount of effort, it's that it's relentless, that it doesn't stop coming and it is challenging. But I made it. Most of us make it. So it's not designed to make you fail, but it is very challenging. It's hard.

Dr. Chan: If you're comfortable sharing, how old were you when you started medical school?

Kyle: I think I was 34.

Dr. Chan: Thirty-four. Okay. So you're out of school for a fair amount of time?

Kyle: Yeah. Yeah, a little out of practice.

Dr. Chan: So how was that jumping back in? I mean, was it just like deep end of the pool, fire hose kind of feeling or . . .

Kyle: Yeah, absolutely. Again, because I'm comfortable in the classroom setting, I love learning and I wanted it. I craved it. I came back for it. But then it just . . . it hits you and it's the transition where you're spending most of your day now in trying to acquire knowledge and you get tired. Your brain can only do so much. And yeah, it was a challenge, but it did get easier as time went on to kind of stay focused and to stay in the books.

Dr. Chan: How'd you strike that balance? How did you find that balance between family life, family responsibility, because you have kids, and giving it all in med school, studying? Small groups, all the interest groups they have running around, all the different activities. Like how'd you find that? How'd you do that?

Kyle: I think it kind of finds itself. I mean, we all kind of accommodate to the best of our abilities, and then the rest kind of just goes by the wayside. I think the challenge is in kind of allowing yourself to kind of make mistakes, and, you know, sometimes you're overcommitted at home, sometimes you're overcommitted in the classroom, sometimes you're overcommitted in extracurriculars and it's this constant fluctuation. And they're not all equal. But, you know, for me, I had a very supportive family. And so it wasn't just me trying to become a doctor. My whole family, my wife, and my kids, they just loved the idea, and they were so supportive and kind.

And, you know, quality time isn't quantity time. And I think when you have less time, it helps you prioritize what's important. And so, for me, I would take 5 to 15 minutes a day and spend it with one kid at a time and do whatever they wanted to do. And they loved it. And they missed me and I missed them a lot, but we felt like we were getting enough attention. I might need to run this past them. I felt like I was getting enough attention from them. I think they were happy with it. They seemed happy, but . . .

Dr. Chan: So it sounds like they also, you know, in a way, they've earned their M.D. too. It sounds like a team effort.

Kyle: Yeah. And I'm guessing that doesn't stop. I think, you know, even from here on out, it's I may be spending less time studying at home, maybe not actually, but I think that is part of being a physician is, you know, that responsibility, that privilege comes with the price, not just on us, but on our families and it takes special people, special families to do this.

Dr. Chan: Did you ever hit the wall? Did you ever think about . . .

Kyle: Oh, man.

Dr. Chan: . . . you know, "I made a mistake. I shouldn't be here," kind of imposter syndrome, thought about quitting?

Kyle: I always said that the only thing worse than being in med school was not being in medical school. And so absolutely, absolutely, hit walls but . . . Absolutely wanted to quit. But the option was not being a physician, not being successful, not showing my family that, you know, they can accomplish the goals that they set out to do. And that kind of feeling of responsibility was helpful to me. I felt like, you know, this wasn't just for me. This was all of our journey and that was really helpful.

But, yeah, you have those moments where it just feels like you can't take any more. But the breaks come and people are supportive. I think the challenging part is letting people know that, "Hey, I'm struggling." But if you can learn to do it, your peer support is huge.

Dr. Chan: Are you saying letting people know that you're struggling, like among peers, or like the administration, or both, or . . .

Kyle: Absolutely both.

Dr. Chan: Okay.

Kyle: Absolutely both. But I think your peer support is probably the most essential because you're kind of all going through it together, you understand and, yeah. That's helpful.

Dr. Chan: So, at the end of your second year, you probably had an idea, right? You were probably leaning towards a field before third year started. Do you remember what you were thinking about back then? Or were you kind of like, "Everything's on the table. Well, I'm going to experience third year," or what were your thoughts back then?

Kyle: Radiology. So I wanted to be on a team at primaries that kind of assesses for child abuse. And I loved radiology, I loved imaging, but it was kind of interesting because when I came to medical school, I wanted to do primary care, and for some reason, they kind of talk you out of it in the first two years, so you don't have a lot of exposure.

Dr. Chan: I don't think, officially, that's supposed to happen.

Kyle: Okay. So unintentionally.

Dr. Chan: We're supposed to like advertise everything, I think.

Kyle: Yeah. I don't know if that happened. Like I feel like you get a lot of exposure to some really amazing specialties. And, yeah, radiologist just kind of piqued my interest. So I did some research in radiology, found a mentor in radiology, and just really liked part of it. But when you're a med student, things are exciting, and it's not like what it will be like as a physician. And so, as I kind of got closer to time to choose, the thought of being a radiologist became less attractive.

Dr. Chan: Okay. So back up here. So the first two years of med school you were doing research and shadowing radiologists?

Kyle: Yeah.

Dr. Chan: Okay. And, you know, you're in a dark room, you're watching, you know, it's all about pattern recognition. And did then you sort of liked it, it sounds like.

Kyle: Oh, it's exciting. But then, you know, I leave my two hours with the radiologist and I go back my huge social groups, sitting in class learning, but they stay there in that dark room and they have to keep looking for patterns.

Dr. Chan: And the list grows. There's a lot of imaging going . . . Trust me, there's a lot of imaging. You probably saw there like the list.

Kyle: Oh, man.

Dr. Chan: The list, like the six computer screens.

Kyle: Which is what I thought looked amazing. But, again, I like talking to people and that just wasn't going to do it for me.

Dr. Chan: Did you actually do a radiology rotation during third year?

Kyle: I was . . .

Dr. Chan: Because there's some elective time built in, so.

Kyle: It was scheduled to. I canceled it.

Dr. Chan: Oh, okay. So you're thinking radiology. Third year starts, and what were the highlights of third year? What rotations just kind of resonated with you? Like, "Oh wow, this is great rotation."

Kyle: There were . . . There was only a few I didn't really like.

Dr. Chan: Okay. So, okay. I guess it means . . .

Kyle: I liked a lot of . . .

Dr. Chan: . . . We can focus on the negative. So which did not resonate with you?

Kyle: Surgery was really hard.

Dr. Chan: What about surgery?

Kyle: The public transportation doesn't get to this school until, you know, 5: 45, I think. And we had to be here at 4: 30, which means my wife had to drive me. And we live about 30 minutes away.

Dr. Chan: That's love right there.

Kyle: Oh, my gosh. I know.

Dr. Chan: Where do you guys live?

Kyle: Midvale.

Dr. Chan: Midvale. Okay.

Kyle: So it was a taxing experience on the family. And then . . .

Dr. Chan: What do you talk about on the drive in at 4: 30 in the morning, repeatedly?

Kyle: "I'm so sorry, sweetie. I love you."

Dr. Chan: Let's just try the radio at this moment.

Kyle: Yeah.

Dr. Chan: Okay. All right.

Kyle: We talk about the day and the kids, because she's not going to see me again till later. But, yeah, surgery is very time-consuming.

Dr. Chan: You coming in at 4: 30, pre-rounding, rounding. OR opens up 6: 37.

Kyle: And the OR's fun. It's fun to be in there. It's fun to be in that environment. It's fun to see a body that is alive, because we do our anatomy and cadavers are amazing. But that's not what living tissue looks like.

Dr. Chan: Yeah. Living tissue is very different.

Kyle: And it is amazing. It's amazing to see it in action. It's amazing to see how surgeons see humans and some of the amazing things they can do. So being in the OR was always fun, but that's only a small part of it. And, you know, a lot of surgeons say they like doing stuff with their hands, but I saw mostly laparoscopic and so they're just like turning their wrist slightly. And I was like, "Man, that's not using your hand. That's like wrist-turning."

Dr. Chan: Did you ever get to turn your wrists?

Kyle: I did. And it didn't go well.

Dr. Chan: Did they make the comment like, "Whoa, seasick. Rocking the boat"?

Kyle: Yes, all the time.

Dr. Chan: Because I remember when I got to drive, it's like, you know . . . Because they make it look so easy.

Kyle: They do.

Dr. Chan: It's like steady. It's like steady. But when you're doing it, it's like, you know, like it's rocking. It's rocking.

Kyle: It is actually . . . I was so surprised because they do make it look so easy, and you think, "Eh, it's just these little turns." No, there is a skill involved, and yeah, I'm not willing to put in the time to acquire that.

Dr. Chan: What time are you getting home at night?

Kyle: So I did vascular surgery the last two weeks, and I think the shortest day I did was 17 hours.

Dr. Chan: Wow.

Kyle: And it was brutal. We got one day off a week, but I left every day before my classmate who wanted to go into surgery, and my shortest day was 17 hours. So that was a challenge.

Dr. Chan: Does the public transportation run that late at night?

Kyle: It did.

Dr. Chan: Okay. So your wife didn't have to come back and pick you up from work?

Kyle: She did not come back and get me. And I needed that train ride home, honestly, to just kind of get back into family mode, because the environment is so serious that if I came home too early, my emotion was serious, and I had a harsh reaction to my family often. But, again, they're so flexible and understanding.

Dr. Chan: So it's good to kind of have like that break, that process of driving or taking the train home?

Kyle: Yes. Let it go, to just kind of let it go.

Dr. Chan: Wow. So surgery was not the highlight. Well, did not resonate with you, I guess.

Kyle: Absolutely not, just the lifestyle. Like in being in the OR is amazing, but the lifestyle was challenging and I didn't think that I was up to that task.

Dr. Chan: I remember when I was a third-year, doing my surgery rotation, because I agree with you. I love the OR. The thing that was hard was like it was like the time and not just like the hours, but it's like, you know, surgeries are blocked X amount of time, but something happens in the middle of the surgery and all of a sudden, the schedule just kind of, you know, everything . . . A one-hour run-of-the-mill procedure can turn into a three to four to five-hour . . .

Kyle: Yeah. Without being able to plan for it. You don't know which one of those is going to require more time going in, and it's never the one you think it is.

Dr. Chan: Yeah. Yeah. And I remember being jealous sometimes because I remember like, you know, the schedule pushes late and then the . . . You know, God bless the anesthesiologist, but they're on kind of the shift schedule.

Kyle: Yeah.

Dr. Chan: So like, you know, 7: 00 rolls around.

Kyle: Someone comes and . . .

Dr. Chan: So the anesthesiologist says, "I'm out of here," you know, like in right in the middle of the procedure, and, you know, another anesthesiologist shows up to get kind of report, to get signed out and then, you know, and then the surgical team stays there because they finish the surgery, but the anesthesiologists rotate out.

Kyle: Yeah. They're like, "It's time for me to go."

Dr. Chan: Yeah. It's like, oh, you know . . . Yeah. I just remembered that like, oh I wish, I wish. Yeah. So.

Kyle: But what they do is incredible, and it was hard not to . . . So at no point did I ever want to be a surgeon, even though I did really love the OR. But I'm kind of glad, because I got to stay there in that environment and it felt all informative. It didn't feel like I was wasting my time. It felt like this was an opportunity. And I will be forever thankful for that, because what they do is truly incredible. And unless you were there, it's not like what you see on the movies. I mean, it is mundane. They stay focused, they stayed dedicated, and they treat every patient like they matter while they're on that table. And it's kind of incredible to see. The sacrifice they make is amazing.

Dr. Chan: So going back to the radiology, I mean, because like all throughout third year, I would argue, you're exposed to radiology because of the different services or ordering images, and you kind of hustle on down to radiology and get them read. So did those kinds of radiology kind of experiences resonate with you, or did you start to feel yourself pull away a bit?

Kyle: I started to pull away. Again, as you go into third year, your focus stops being academic, which was comfortable. I knew how to be a good student, even though I found that the material's super difficult, but I knew that life and I was comfortable with it. As you go into third year, you're seeing that clinical life is not academic life. It's very different. And I think what I found rewarding was not the time I spent in front of a computer screen. It was the time I spent in front of patients, the time I spent talking with, you know, my classmates with attendings, with residents.

And although radiologists do get some of the communication with their peers, they don't get as much time with patients, where I feel like that's kind of where I wanted to have an impact, and I did, I started pulling away. I started just kind of realizing, I guess, what my preference was. So, yeah, when you're sitting in front of a computer screen for two years studying, because most of my resources were online, sitting in front of a screen as a physician doesn't sound that bad. But when you actually get to talk to people and get to interact in their life and just be part of these defining moments, it feels kind of just incredible to be in that moment with them, to share it with them. Although it's sometimes sad, sometimes it's very happy, and I wanted to be in that moment.

Dr. Chan: So what started creeping up on your list? What started to . . .

Kyle: Family medicine. Internal medicine. I really liked the inpatient setting and then . . . So I was thinking internal medicine pretty heavy, honestly. And then my second to last clerkship was in psychiatry. And once I was in that environment, I couldn't believe that I had ever considered anything else. And it was almost immediate where I was like, "This is what I want to do."

Dr. Chan: What about . . . made that difference, what about psychiatry?

Kyle: You know, they talk about finding your people, and that was part of it. I was with like-minded kind of people who were not afraid to analyze themselves and kind of just moved past it. Their interactions with patients was beautiful. It was . . . You know, they possessed skills that I didn't have, and that I desperately wanted, where they could get to information from people who are not capable of communicating it, people who, especially . . . So I started on 5 West, so people with severe mental illness and medical complications.

Dr. Chan: Yeah, comorbidity. Yeah.

Kyle: And so you get some of the medicine, but at the same time, these people are often unable to communicate. They're trying, but because of the mental processes that are going on, they lack the ability to structure any kind of I'd say understandable communication. But over the time, the psychiatrists were able to get to what they needed enough to treat it, and you got to see improvement that was just astounding. But, again, just kind of being in that environment with people who I felt were very similar to me was just instantly rewarding. And I know that makes me sound so selfish. But I mean, really, I'm thinking about what I'm going to do for the rest of my life. And I found them very comfortable, and I wanted to be there. And I just found it really easy to get up and get motivated and . . .

Dr. Chan: So, Kyle, if you asked me four years ago what you would end up in, I would have put psychiatry pretty high, because I know, you know, you had a background, if I recall correctly.

Kyle: Social work.

Dr. Chan: Yeah. You have a social work background. I remember, didn't you like live or you're a parent at a residential facility for a while?

Kyle: Yeah. Yes. You got a good memory. Yes, sir.

Dr. Chan: So, yeah, I think that's part of a little bit of who you are. So do you . . . And so, I mean, do you feel like you kind of resisted that the first couple of years in med school or . . .

Kyle: Hard and intentionally, and it was a mistake. But, you know, I came to medical school to be different, and I felt like part of that was in kind of denying who I was prior to coming in. I didn't know what it took to be a doctor, but I knew that I was striving for a goal that I felt was out of reach. And so part of that focus was in me kind of denying who I was and saying, "I want to be different. I want to be more." And that was not necessary. You know, that was kind of a mistake in how I just viewed this process.

And part of third year was coming to the conclusion that those skills that I had acquired for a decade before coming to medical school were useful. They were a part of who I was. They were what made me a good candidate. They're what made me a good student and what could make me a good physician. And I didn't want to kind of deny those skills. But I did, those first two years and the start of third year, it was full denial of everything that made me capable of being here. I was like, "I got to be different. I got to be a doctor." And so it was kind of healing, a healing process to kind of come to terms with who I wanted to be and that I already had some ability that was going to be useful. It's amazing.

Dr. Chan: When you told your family about the psychiatry idea, did they also kind of push up back against it? Because like . . .

Kyle: Not at all.

Dr. Chan: Okay. So they saw it?

Kyle: Yeah. They're like, "Oh, good, finally." I mean, kind of, you know, you said that you would have guessed. They were all like, "Yeah, it's about time." And so . . .

Dr. Chan: Or did you say, "Oh, actually, I want to be a vascular surgeon."

Kyle: They would have been supportive no matter what.

Dr. Chan: Okay. Okay. All right. But that would have been tough . . .

Kyle: They have this tendency . . .

Dr. Chan: . . . tough bridge to across.

Kyle: Oh, man. That's the problem is that they are . . . They're too supportive at times, and so they won't tell me what their preference is often until after I make a decision. And so they did it in med school. When I told them I was coming to the U, they said they didn't have a preference of where I went. And then I was like, "I'm going to the U," and all of a sudden it's a party. And they're like, "Thank goodness." So they have this tendency of being like, "Oh, yeah, we're fine with it." Really, they have a preference. So they loved the idea of me being a psychiatrist, no pushback at all.

Dr. Chan: Okay. So fourth year starts and, you know, to become a psychiatrist, there are different roads. And I know you were hoping and considering a somewhat different road. So could you talk about that?

Kyle: Yeah. So in my third-year clerkship, I got to work with triple boarders. I had never heard that term before, but there are people who are pediatricians and psychiatrists and the resident . . .

Dr. Chan: Pediatrician, adult psychiatry, child psychiatry. So that's the Triple Board? Yeah.

Kyle: Yes.

Dr. Chan: Sorry, go on.

Kyle: So I only interacted with them in the inpatient, adolescent, and child psychiatry at uni. And their skills were amazing. But in talking about their program, it was five years and whereas everyone who works with children, I believe, has to have at least a fellowship in child and adolescent. Is that true?

Dr. Chan: Yeah.

Kyle: Okay. That took five years as well. The difference is that they also acquired a pediatric board at the same time. And a lot of my work prior to coming here was in kind of underserved areas and people who've had a lot of mistrust in physicians. And I liked the idea of having a board in pediatrics, because, you know, in my mind, in kind of thinking how I would utilize this, it's always my desire to be inpatient somehow. And so in wanting to do inpatient child medicine, I thought, "You know what? I could also spend some time in a community setting, maybe offering free services and going to these communities that didn't have access." And how nice would it be to not just treat people for their psychiatric needs, which are vast, but to be able to say, "You know what? You know, there might be these medical concerns, and you might want to go see someone else." And so that became very attractive to me. In reality, I knew and I was being told that triple boarders don't use peds.

Dr. Chan: Not as much as they should.

Kyle: No, they just don't use it. And so, in most cases, it kind of falls off and they stop getting licensed.

Dr. Chan: Yeah. You have to be certified in pediatrics every seven years. And I've known a fair amount of triple boarders who've just let that lapse.

Kyle: Yeah. It seems like that's just kind of how it is. But, again, it was just so attractive.

Dr. Chan: Yeah. You're like the marines. You're like, you know, Triple Board, you can jump out of a plane . . .

Kyle: Do whatever.

Dr. Chan: . . . You can fly a plane, jump out of a plane into water and swim, jump back on the plane.

Kyle: Yeah. It was hard to find a downside. And . . .

Dr. Chan: So, as you're creating your application, you were dual applying? I get the sense.

Kyle: I was dual applying.

Dr. Chan: Okay. So you're applying to Triple Board programs as well as adult psychiatry programs?

Kyle: Yeah, which is what you do because there's only nine Triple Board programs now. And it's just getting more and more competitive in psychiatry. And so you dual apply, and the only question is do you dual apply as a triple boarder in pediatrics or in psychiatry?

Dr. Chan: I see.

Kyle: And so I dual-applied in psychiatry. And it's about 50/50, but some will dual apply in peds. And so, that way, you have a backup. But most will also apply to all nine Triple Board programs.

Dr. Chan: Did you?

Kyle: No. Not at all. And so my number one choice was the Triple Board program here at the U. And my number two choice was psychiatry. So . . .

Dr. Chan: So your strategy, from the outset, it sounds like was to stay in Utah?

Kyle: Yeah, for the family.

Dr. Chan: For the family. So did you like . . . So you submitted your application?

Kyle: Yeah.

Dr. Chan: Did you apply to other programs?

Kyle: I did. But only in adult psychiatry.

Dr. Chan: Okay. So how many interview offers? Or first of all, like how many . . . So when you're doing this dual applying, I'm sure you're talking to Dr. Stevenson and Student Affairs. You're coming up with a good plan. So how many programs did you apply to and how many interview offers did you get?

Kyle: So, based on my step scores and my standing, they have these algorithms that kind of tell you how many you should apply to, to get the number of interviews you want. And I ended up applying to about 30, but I didn't get as many interviews as I wanted to get. And so my goal was to get 12 interviews. I ended up getting 10.

Dr. Chan: All right. But that's still really good.

Kyle: Yeah, it is.

Dr. Chan: I guess that missing two caused anxiety.

Kyle: The whole process causes anxiety, and so you don't know where to put it. And so, yeah, you end up putting it on an arbitrary number of interviews based on a very minuscule part of your application. But that's the only objective information we have and so we're going to use it. And so, yeah, it did. It caused some anxiety.

Dr. Chan: Did you kind of focus in the West since, kind of close to Utah, as a kind of a backup? If you didn't match here, at least you'd be nearby? Or what was your strategy?

Kyle: So, you know, I told you just a second ago that wanting to stay in Utah was for my family and that was just not true. They want me to stay in Utah, and I did too, but I actually loved the programs here, so I got to throw that out. For me and my family. But in choosing where we wanted to apply, I think our biggest concern was cost of living. And so everywhere we applied to, we thought, "This is somewhere we could afford to live."

Dr. Chan: So New York City?

Kyle: Out.

Dr. Chan: San Francisco.

Kyle: Yeah.

Dr. Chan: Seattle, San Diego, no. Do not sniff it. Doing like a . . .

Kyle: Not even for a second. And we made a few mistakes along the way. We applied to Baylor, because when we looked at Baylor, it was in Waco. But their medical center is in Houston. It was not cheap. And so . . .

Dr. Chan: The internet lied.

Kyle: It wasn't a perfect process.

Dr. Chan: So were you a little surprised?

Kyle: Oh, my gosh. So surprised. So surprised. I shouldn't be, but, yeah, very surprised.

Dr. Chan: Some Western, Midwestern programs.

Kyle: There's . . .

Dr. Chan: Cost of living tends to be cheaper in those areas.

Kyle: Absolutely.

Dr. Chan: So we're looking at Oklahoma City, Iowa.

Kyle: Yeah, Nebraska.

Dr. Chan: New Mexico.

Kyle: Yeah. All over. And then some East Coast programs too. I grew up in North Carolina, so I applied to UNC and Duke. California just . . . Most of the places that had really good kind of hospital settings were just too expensive, so I didn't really apply there. But Texas had a lot of . . .

Dr. Chan: Yeah. Did your little surprise there in Baylor came in, you said Waco, Waco's cheap. Did you take your family with you, or did you go by yourself to the interview offer, interviews?

Kyle: The only one I took my family to was in UNC. And that's just because that's where I'm from. I wanted them to have some Bojangles' chicken, and it was as good as I remembered.

Dr. Chan: As good as Popeye's?

Kyle: U is so much better. To me.

Dr. Chan: Yeah. I remember Bojangles'. I remember Bojangles'. Yeah.

Kyle: To me. Well, so they weren't as impressed, but it's good.

Dr. Chan: All right. So you're interviewing. It's going well. I assume you liked most of the programs. Anything turn you off out there? You don't have to name names or programs, but did anything?

Kyle: Yeah. So, as you're applying, you realize pretty quickly that the resources you used to kind of choose are not accurate. Things change in residencies. Program directors change. Call schedules change. It depends on how many residents are there. There just are a lot of differences between . . .

Dr. Chan: A lot of variables.

Kyle: Yeah. And the only way you're going to know is by going and visiting the school. But also, I realized that, you know, there's a few different kinds of programs. There's programs where their name will set you up, and their name is what makes it attractive. And then there's programs where the resident life makes it attractive. And then there's a few where there's both, where you come out of a program that is well-respected and also you have a fairly good life. And for me, I'm older, I have older kids, and I like spending time with my family. I know I want to be there as much as possible. And it was a real . . . it was a challenge when it came to choosing a program with a name that I felt was well-respected or where the life was well-respected.

And I thought . . . I was surprised by how pulled I was to bigger names, but the allure wore off like pretty quickly when you get to meet residents and they just look kind of beat up and . . . Or one program that I won't talk about, but, you know, they hid residents. I got to see a lot of third and fourth-year psychiatry residents who are in their outpatient years and have time. But when you don't see one intern or one PGY2 resident, like it's a red flag.

Dr. Chan: Yeah. It sounds like a real warning sign. Yeah.

Kyle: Like can I get eyes on these humans? Are they alive? Yeah. So, yeah, there were some surprises. But it's fun. It's fun to go on interviews. You're in such a kind of non-stop environment, and then you hit interview season and you're not in any clinics and it's . . . You're going to places that are fun to go to. People are treating you well. You're getting free meals, and it's like . . .

Dr. Chan: I know.

Kyle: "This is awesome."

Dr. Chan: They roll out the red carpet for you. They try to put their best foot forward.

Kyle: Yes. It's not like . . .

Dr. Chan: They have like all these like really professional brochures and pamphlets.

Kyle: Oh, man. Yeah, they gave you swag, and, oh, my gosh. They treat you like $1 million. There's not a lot of scrutiny. You feel just like they want you, and it's amazing. You're not . . .

Dr. Chan: It's a good feeling, Kyle.

Kyle: It's so good.

Dr. Chan: I promise you. It will get better too when you apply for fellowships and attendings.

Kyle: Really?

Dr. Chan: Yeah. Their carpet gets a little bit more plush, a little bit more red.

Kyle: Stop it. Stop it. I feel spoiled already.

Dr. Chan: All right. So decision time. So when you created your rank list or your match list, what kind of like values . . . well, how did you set up your algorithm? How do you determine that?

Kyle: So the Utah programs were easy, because I loved the Triple Board program out here. It was the only one I wanted to interview at. It was the only one I wanted to be at. And then for this psychiatry portion, it depended on, again, cost of living was what excluded a lot of applications to residency. So that was clearly the most important. But, again, salary, environment, you know, being able to find affordable, safe housing, call schedule, how often are people on call? Didactics.

The University of Utah, I'd say, what made them most attractive was that they have a full didactic day, where you are in class and where you are learning. And I did not see that at any other program. There were a lot that had half days where you went in, you did paperwork, you saw the patients, and then you got to spend the last half of the day in class. But nowhere else had a full day of learning. I just thought that was incredible.

Dr. Chan: Yeah. Because I think the hard part is, is like what is a medical resident? And, you know, and like, to me, it's like residency is this weird transition from medical school, where you're a full-time learner, to an attending, where you're a full-time clinician. So what is residency? It's kind of this weird world where you are a learner but also a worker, you know, so like, so to have a full-time day dedicated to lectures is a big deal, because that's clearly kind of a statement that you're going to be a learner in our program and not have other clinical duties that would kind of infringe upon that.

Kyle: And I felt like it demonstrated a residency that was resident-oriented, that cared about their residents. Like that's, I mean, just kind of unheard of, again, unheard of. So I found that kind of amazing. But didactics, how often are they allowing you time to learn from people who are in the field and have the experience I'm hoping to acquire? But, yeah, cost of living and money.

Dr. Chan: So you send in your match. It sounds like Triple Board was number one.

Kyle: Yup.

Dr. Chan: And then the psychiatry program was number two here at Utah. Walk me through match week. So were you worried you weren't . . . I mean, that Monday. I know it's . . . And as I've learned over the years, because I don't . . . I'm getting so old, Kyle, I can't remember very well. But as I've learned, as I've talked to students, the Monday is actually more stressful on some level than the Friday. So were you worried about not matching? I mean, when you got that email on Monday that you did match?

Kyle: Oh, man.

Dr. Chan: So were you nervous? Tell me about that.

Kyle: Yeah. And so, again, I felt like I was a pretty good applicant, but it's hard to judge. And it doesn't matter, you know, because they're seeing so many residents that have all the qualifications they're looking for. We're not really that different. And so, all of a sudden, as I got closer to the Monday, to seeing if I was actually matched, the anxiety kind of starts to build and the stress of thinking, you know, "I'm either going to have a week that is normal, or I'm going to be very busy for a week trying to find a residency that will accept me."

Dr. Chan: Because on Monday you find out if you matched, and then the Friday you find where you matched.

Kyle: Exactly. And so the anxiety started to build, you know, "Did I make the right choices? Am I as good as I thought I was? And how's this going to go for me?" And so we, because we live in Midvale, we decided to drive up towards the University of Utah in case I didn't match, that I would be very close, that I could come in and have Dr. Stevenson and all the resources to kind of help me find a . . .

Dr. Chan: A residency program. Yeah.

Kyle: . . . residency. So we kind of creeped up here.

Dr. Chan: I didn't know that. Wow.

Kyle: We just kind of hung out around.

Dr. Chan: Would you say like, did you like stop at like little locations?

Kyle: We stopped at Starbucks.

Dr. Chan: Like do some errands on the way up towards the U? Okay.

Kyle: We stopped at Starbucks and just kind of sat there, and I had a Frappuccino and just enjoyed life and was like, "This could get bad." But, again, the goal was to be close to the U, but also to kind of contain some of the anxiety. And so my wife was with me, and we just thought happy thoughts and waited. But it's a different kind of stress, and it is absolutely more anxiety-provoking than Friday when you find out where you match. "Will I match?" And . . .

Dr. Chan: So when did the email drop?

Kyle: It dropped.

Dr. Chan: Or did you . . . Do you log in? How is it set up now?

Kyle: Yeah. No, they email you, and it came three minutes late and I was like, "This is ridiculous." That was the longest three minutes of my life.

Dr. Chan: IT, Waco, Texas.

Kyle: Yeah. They said it was going to happen at this time. Where's my email?

Dr. Chan: Baylor.

Kyle: So we're just sitting there waiting, and then the alert happens that, "Hey, you got an email." We logged in. It said we matched and it was a huge relief.

Dr. Chan: Instant relief. Retreat. Do not need to go to the U. Go back home.

Kyle: Yeah. I went home.

Dr. Chan: Go back towards the Midvale area.

Kyle: Yeah. I know. And it's wild, because it's kind of unpredictable in finding out who does and doesn't match. It's kind of random. And there are people that I talked to that expected not to match and matched, and there's many that expected to match and didn't. And so . . .

Dr. Chan: Yeah. Because all of you know each other, you're all friends, or at least colleagues, acquaintances.

Kyle: And qualified. And qualified to match. And so, yeah, it's just . . . I mean, almost everybody matched. And so, when you look at it as the likelihood of if you're going to match or not, it's kind of silly to feel so much anxiety. But until you know, it feels like it's a lightning strike, and it could happen to any of us.

Dr. Chan: So the anxiety ramps up on Monday.

Kyle: Oh, man.

Dr. Chan: Plummets after you find out you matched.

Kyle: Plummets, yeah.

Dr. Chan: And then the rest of the week . . .

Kyle: The rest of the week . . .

Dr. Chan: Does it start kind of creeping back up towards Friday again?

Kyle: Yeah, I think, but not to that level. I think it's not anxiety at that point. And, you know, there is very little difference between anxiety and excitement. But, you know, now the expected outcome is positive, and so it's more excitement and it's just like, "Let's just get to Friday. Why am I having to wait? Like they know where I'm at, just tell me. Just tell me where I'm going." And so it becomes more excitement. But that same kind of energy, that energy that is just like, "I got to find out. I can't contain this." And so, yeah, it does ramp up a little bit more.

Dr. Chan: And then what happened on Friday? I mean, whole family?

Kyle: So, for me, you know, it's my wife and my kids, but my kids were sick. And so they stayed home. The plan, initially, was we were going to find out all together, but, again, with them having the sniffles, we didn't want them around everybody. And so we had them stay home. But we came, saw everybody. The energy of Match Day is very exciting, because they pull us up to a building or the Rice-Eccles Stadium.

Dr. Chan: Yeah. The tower, yeah.

Kyle: Yup. The tower. I'd never been up there.

Dr. Chan: You'd never been up there.

Kyle: No. That was the first. . .

Dr. Chan: Well, okay. Gorgeous view. Would not want to be in that building during an earthquake because I feel . . . I'm sure it's very seismically safe. I'm not trying to diss anyone, disrespect anyone, but I just like . . . But that view, and then you just kind of look straight down and like, yeah, like the parking lot is right there. Yeah.

Kyle: Yes. Absolutely. But beautiful. They had it all decorated, and everyone's happy and smiling, and we're all just waiting for a time when they're going to let us go get an envelope and find out where we want to go. So super fun.

Dr. Chan: So you grabbed your envelope?

Kyle: Yup.

Dr. Chan: Opened it right there, or you took it back to your wife and do it together?

Kyle: I took it back to my wife. Yeah. This impacts all of us, and so I didn't feel like I had earned that privilege to just open it up myself and experience this on my own. So I took it back to her. We opened it together and . . .

Dr. Chan: What'd it say and how do you feel about it?

Kyle: It said that I had matched to the University of Utah in psychiatry, and it had a number of, you know . . . When you apply to match, you're applying with a number that identifies the program and it had that identifier. And I was like, "Man, is this just adult, or is this Triple Board?" I couldn't remember. And it wasn't specific enough to really tell me what it was. And so I had to Google it real quick, get on my device and find out which one it was. And it was adult psych, and it was very exciting for my wife, and I felt a little bit of sadness. And I was surprised.

Dr. Chan: Why?

Kyle: Because during the process of figuring out where to rank programs, they fluctuate constantly. And for a large portion of that process of trying to figure it out, the adult psych program at the University of Utah was my number one choice. And it fluctuates constantly. And, you know, that goes for the rest of the lists too, not just the top choice. So, you know, clearly, there was a lot that attracted me to just the adult program. But you get your order in. You let the programs know, "You're my number one or you're at the top of my list, please pick me." And then you open it and it not being my first choice kind of felt like a little . . . I felt sad. Like, you know, maybe like, "Well, why didn't they . . . They said they like . . ."

Dr. Chan: Yeah. Why didn't I get my number one? Yeah. Yeah.

Kyle: Why didn't I get my number one? And I think. . .

Dr. Chan: Am I might not good enough to be a Triple Boarder?

Kyle: Yeah, absolutely. And I think that it was a very similar experience for me and the few that have kind of . . . we've talked about not getting our first choice where, you know, going in, we all felt like our top three would be absolutely amazing and acceptable, but there is a process of grief in kind of everything you're missing out of. And, you know, even a few people who got their first choice, you have to experience a little bit of grief for what you didn't get.

Dr. Chan: Yeah. Saying goodbye to those other . . . The Match forces other doors to be closed.

Kyle: Absolutely.

Dr. Chan: Yeah. And there's one that's open, and that's great, but sometimes, I don't know, it's . . . To me, it just sounds like human nature. You kind of like, oh, it's kind of oh . . .

Kyle: "What am I missing?"

Dr. Chan: Yeah. Like these other programs. What does it mean? Yeah.

Kyle: But the sorrow is short-lived, and then, you know, eventually you just start thinking about all the positives. The programs, they contact you and welcome you. I got welcomed in emails from some of the attendings I had worked with on my site clerkship. And, again, it's short-lived sorrow. And you say goodbye to what you're going to miss, and then you start to welcome what is to come and it's become, you know, very exciting and just . . . again, just kind of ready to get going. And so I'm still in fourth-year clerkships. I'm still kind of living . . . It's actually a lot easier, but the end of fourth year, much easier. But at the same time, all this celebration, all this excitement knowing where I'm going to go and it's like, "Okay, now I just have to wait months."

Dr. Chan: I remember a week or two after the match when I matched, I got my . . . It was the first contract I've ever signed. Did you get the contract?

Kyle: Yeah. And I haven't signed it yet.

Dr. Chan: Yeah. It's because. . . To me, I was like anxious, like, "This is a huge document." It's like it mentions all this stuff I would never thought of before. So I remember, yeah, I sat on it for a few days, kind of read everything.

Kyle: Which is funny because I'm going to sign it.

Dr. Chan: Yeah.

Kyle: I don't know if it matters, but, yeah, I want some time.

Dr. Chan: Yeah. But it feels . . . I mean, like, you know, yeah. I mean, like I wasn't a non-traditional student per se. And I know you've worked prior to med school, but for me, that was like . . . Like my resident salary was a lot of money. I had never made that much money before in my life. And I just remember like, "Wow, this is a lot of money." You know, and I was just excited to be earning, you know, and then you know, all the benefits, like the insurance plan, everything is kind of put into it. I just remember like, "Wow, this is a big step." I felt like a grownup. You know, like this is the type of stuff grownups do, like who are working full time.

Kyle: You know, I feel old, but, I mean, similarly, I mean, even having worked as a social worker, I have never made as much as I will make as a resident, and it's . . . I'm sure that will wear off because I know that residents work very hard. But, yeah, it's exciting. It's exciting to think, "I will be supporting my family better than I ever have." And it's also weird to think that, you know, "Already, this process was paying off. Already, I'm seeing the benefits of the choices I made."

And, you know, that is one thing that's different, because when you're buried in second year and third year of medical school, there are moments where the problem isn't how hard you're working, the problem is that you don't see that it will ever benefit you and you feel kind of like you're spinning your wheels. And now, again, the windows are opening up and you're starting to see the light. And I'm starting to see the benefits not just in the salary, which, yeah, more than I've ever made. It's going to be amazing. But also, in my kids, because they're older, I'm starting to see, in their choices, their willingness to kind of work hard and pursue academics. And that was the motivator.

When I started this process, I wanted to demonstrate that, you know, you don't have to say goodbye to your dreams as an adult. You don't have to accept what the world gives you. You can work hard and achieve your dreams. And that kind of got suppressed as I was in an environment that was just so difficult and so continuous. But now coming out of it, again, getting to see the benefits, it is kind of amazing.

My daughter's pursuing an engineering degree at the University of Utah, and even though that is her accomplishment and she works so hard for it, I can't help but feel like, you know, part of this process in coming back to school had an impact in that although she will not pursue medicine, most likely, because she saw how hard it is, she also chose a very difficult profession and is fine with it and is like, "I can do this."

And, again, coming from a family that didn't value education and almost valued the opposite of education, it's just kind of amazing to see that change in my own children, in their goals, and in what they think is possible. I don't know how much of an impact I had, but, at least, it's what I wanted and now I am starting to see it.

Dr. Chan: Wow. Kyle, that's beautiful. And, unfortunately, we're almost out of time, But I'm excited that you were able to come back and that you're also going to stay local. So I can have you come back here, I mean, kind of check-in just to kind hear how intern year, and as residency kind of unfolds, and how you, you know, how you're still growing and you're going to start like another phase of your journey to become a doctor. And it sounds like this positive, beautiful aspect impact will have on your family too. Well, thank you, Kyle. I appreciate 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 was it like to start dating at the beginning of second year med school after being just friends for the first year? Was it nice to date someone going through the same thing as you? How do you create a strategy for couples matching? And finally, what are the benefits of both parties attending the same interview day for residency programs? Today on "Talking Admissions and Med Student Life," I interview Parvathi and Anish, successful couples match and recent graduates here at the University of Utah School of Medicine.

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

Dr. Chan: Okay. Welcome to another edition of "Talking Admissions and Med Student Life." I have two super guests today, Par and Anish, fourth-year medical students who have matched. We're going to save that to the very end, but I'm very excited you're here. I've known you for many years. I've seen you around for many years. Let's complete the circle of life and let's talk about it. Okay. So let's start at the beginning. How did you two meet? Was it Second Look Day? Was it orientation week?

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

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

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

Anish: That's messed up.

Dr. Chan: Okay.

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

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

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

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

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

Dr. Chan: So that was your opening impression?

Anish: It was. It was.

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

Anish: It was.

Dr. Chan: . . . and . . .

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

Parvathi: Yeah. That's true.

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

Anish: Yes.

Parvathi: Yeah.

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

Parvathi: Yes.

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

Anish: Yup.

Parvathi: Yup.

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

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

Anish: You're so bad.

Parvathi: Okay. What?

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

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

Anish: No. Med school was difficult.

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

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

Dr. Chan: Where were you living?

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

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

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

Dr. Chan: That's very beautiful.

Parvathi: It is.

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

Parvathi: Actually, no.

Anish: Never.

Parvathi: We have never studied together.

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

Anish: Yeah.

Parvathi: Yeah.

Anish: I like to study alone.

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

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

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

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

Parvathi: Mm-hmm.

Dr. Chan: Yeah, wow.

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

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

Anish: Yes.

Parvathi: Yes.

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

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

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

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

Anish: Mm-hmm.

Parvathi: Yeah.

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

Anish: We didn't coordinate at all.

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

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

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

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

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

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

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

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

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

Dr. Chan: Awesome.

Parvathi: For sure.

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

Parvathi: Do you want to start?

Anish: Sure. So . . .

Dr. Chan: Or if it changed.

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

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

Anish: So I'm going into internal medicine.

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

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

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

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

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

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

Dr. Chan: Why? Oh, okay.

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

Dr. Chan: Can you name the body part?

Anish: It was hematology oncology.

Dr. Chan: Oh, okay. Blood cells.

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

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

Anish: Exactly, yeah.

Dr. Chan: Okay. Yeah.

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

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

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

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

Parvathi: Old people so . . .

Dr. Chan: Compared to pediatrics.

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

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

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

Parvathi: Yeah.

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

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

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

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

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

Parvathi: Yes.

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

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

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

Anish: Yes.

Parvathi: Exactly.

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

Anish: Most of them.

Dr. Chan: Okay. All right.

Parvathi: Yeah.

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

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

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

Dr. Chan: Oh, wow.

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

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

Anish: No.

Dr. Chan: All the knobs.

Anish: No.

Dr. Chan: All the readings.

Anish: I say add more knobs, really.

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

Parvathi: When did we have that?

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

Dr. Chan: So spring 2017.

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

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

Parvathi: It's both, yeah.

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

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

Dr. Chan: So targeting larger cities.

Parvathi: Yes, larger cities.

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

Parvathi: Mm-hmm.

Dr. Chan: All right.

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

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

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

Anish: I applied to 37.

Parvathi: Oh.

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

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

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

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

Dr. Chan: Why did you cancel?

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

Dr. Chan: Oh, okay.

Parvathi: That soon.

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

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

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

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

Anish: I don't know.

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

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

Parvathi: Exactly. Yeah.

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

Parvathi: Exactly.

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

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

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

Parvathi: Oh, yes.

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

Parvathi: Okay. So this is me.

Dr. Chan: Okay.

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

Dr. Chan: Prism not prison.

Parvathi: Yeah, not jail.

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

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

Dr. Chan: Okay.

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

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

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

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

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

Dr. Chan: We're scientific.

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

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

Parvathi: Fourteen, yeah.

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

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

Anish: Yeah.

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

Anish: Matches.

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

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

Dr. Chan: Interesting.

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

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

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

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

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

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

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

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

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

Dr. Chan: More stressful than match day itself?

Parvathi: Yes.

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

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

Dr. Chan: What were you doing, Anish?

Anish: So . . .

Parvathi: Oh.

Dr. Chan: That's okay.

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

Dr. Chan: Were you sleeping?

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

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

Anish: Just my family was there.

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

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

Dr. Chan: Simultaneously?

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

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

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

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

Dr. Chan: Were you trembling?

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

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

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

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

Parvathi: I matched at Brown University in Rhode Island.

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

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

Dr. Chan: The Ivy League. Ivy League.

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

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

Parvathi: So they have 30 categorical interns.

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

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

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

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

Dr. Chan: Okay. Harvard?

Anish: It is a Harvard-affiliated hospital.

Dr. Chan: Harvard-affiliated hospital. Yes.

Anish: It is.

Dr. Chan: So sells us on Beth Israel.

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

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

Anish: So . . .

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

Anish: Yeah, so . . .

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

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

Dr. Chan: Mass General. Yeah.

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

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

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

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

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

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

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

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

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

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

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

Anish: No.

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

Anish: No.

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

Anish: Yes.

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

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

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

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

Anish: Yeah.

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

Anish: I was. I was on cruise ship.

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

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

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

Anish: Yeah.

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

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

Dr. Chan: Okay. In what way?

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

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

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

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

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

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

Parvathi: Yeah.

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

Parvathi: Yeah.

Dr. Chan: What are your thoughts?

Anish: And Ivy League.

Dr. Chan: And Ivy League. Yeah.

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

Dr. Chan: Are your families concerned?

Parvathi: About?

Dr. Chan: Living so far away from home.

Parvathi: Oh. So my parents moved to Dubai.

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

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

Dr. Chan: Okay.

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

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

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

Dr. Chan: Pre-conditioned.

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

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

Parvathi: We call it an engagement.

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

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

Anish: Not technically.

Dr. Chan: Okay, not technically.

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

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

Anish: There will be a ring exchange.

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

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

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

Anish: So Hinduism.

Dr. Chan: Okay. All right.

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

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

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

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

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

Anish: [inaudible 00:41:51]

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

Parvathi: That's too bad.

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

Anish: I mean, it probably happened.

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

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

Anish: Yeah, not that I know.

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

Anish: Yes.

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

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

Parvathi: I don't think so.

Anish: So it's tough.

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

Dr. Chan: Event.

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

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

Parvathi: Negotiate?

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

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

Anish: [inaudible 00:43:20]

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

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

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

Anish: Not really.

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

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

Anish: Oh, yes.

Parvathi: Yes.

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

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

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

Anish: Okay.

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

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

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

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

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

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

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

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

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

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

Parvathi: Thank goodness.

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

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

Parvathi: Mine will probably be somewhere else.

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

Parvathi: Thanks, Dr. Chan.

Anish: Thanks, Dr. Chan.

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

Dr. Chan: What is more difficult, applying to medical school or applying for a residency? Why is it important to be flexible? How do setting low expectations create less disappointment as a spouse of a medical student, and what is the Medical Student Alliance? Today on Talking Admissions and Med Student Life I interview Annie, spouse of a recent graduate here at the University of Utah School of Medicine.

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

Dr. Chan: All right. I have another great guest today on our podcast Talking Admissions and Med Student Life. Hello, Annie. How are you?

Annie: Good. Thank you.

Dr. Chan: And now Annie is not a medical student, but she's married to one and we're going to talk about that. All right. So does he prefer Peter or Pete? Did you clarify this before you came over here?

Annie: He . . . with everyone he goes by Pete and I have always called him Peter.

Dr. Chan: Okay.

Annie: But now we have a son named Peter, so Pete's great.

Dr. Chan: Fantastic, okay. So let's start in the beginning. Like how did you meet Peter?

Annie: We actually met in junior high school.

Dr. Chan: Oh, okay.

Annie: We sat in English class near each other, and he always likes to say that I remember the guy who sat on the other side of him, but I don't remember him. So we met, yeah, in eighth grade and kind of went through junior high and high school together always knowing each other. And then struck up a relationship senior year of high school and kind of started hanging out. And then dated, yeah, for a while and . . .

Dr. Chan: So this is very prophetic. So if you were together since senior high school, you must've made decisions together where you're going to undergrad.

Annie: Yeah. So he . . . I actually wanted to go up to Utah State, had a scholarship up there but felt like I needed to be down at BYU, and he had signed with UVU. He was playing baseball there. So I knew if I went to BYU, I would be closer, and so I went there. He went to UVU. We dated for a year, and then he was off to serve an LDS mission for two years where we wrote letters back and forth and . . .

Dr. Chan: Where did he go?

Annie: He went to New Jersey.

Dr. Chan: Okay.

Annie: Yeah, somewhere in New Jersey.

Dr. Chan: All right. So you didn't have to worry about the letters getting lost in the mail per se?

Annie: Not really, no. And now . . .

Dr. Chan: Sending care packages were reasonable rates, yes?

Annie: Yes. Yes, they were. And yeah, now you can email. Back then the rules were a little different with missionaries. So we wrote physical letters, and I was looking through the book the other day and it was so fun to see like, "Oh, my gosh. We have a lot of history."

Dr. Chan: That's awesome.

Annie: So yeah, it's fun.

Dr. Chan: And then so when did you get married?

Annie: So we got married in December of 2010.

Dr. Chan: Okay.

Annie: I was able to graduate that same month and work through his undergrad, and then, yeah, we always kind of knew that medical school would be the plan.

Dr. Chan: Well, yeah. So that was my next question. Like so when did that . . . I mean, was that clear back in junior high school? Did Pete start talking about med school?

Annie: No. His dad's a doctor, and so I knew he always was interested in the field. But when he got back from his mission, he, you know, kind of dabbled in other things to make sure it's really what he wanted. And so I think it was maybe six months to a year after we were married that he for sure decided that medical school was the plan.

Dr. Chan: Okay. And do you come from a background of medicine or healthcare?

Annie: No. My brother actually just finished his residency or . . . yeah, finished his residency this last year. So he's just a couple of years ahead of us, but that's the only one from my family. I mean, you know, I have like great uncles or something but . . .

Dr. Chan: Well, the reason I was asking is, you know, it sounds like Peter comes from a background of medicine. When this discussion . . . when the decisions were being made, did you have any hesitation? Like, "Oh, you know, like there's . . ." Because there's an image of like physicians. And maybe like you gleaned some knowledge from Peter's family, but, I mean, were you hesitant at all?

Annie: No. His parents were very open about what it was like for them and that it wasn't an easy path. And so . . . but I knew I always said, "Whatever makes you happy. I want you to be happy. I want to be able to stay home and take care of kids." That's kind of what I always wanted to do. And so I wanted him to be in a profession where he was going to be happy and make enough money that he could support us that I could be home. So if doctoring was it, then that was great with me.

Dr. Chan: Right. So like you're all in? Like, "Oh, this . . . we're getting on the medicine train. It's leaving the station." All right. So he starts applying to schools. If I recall correctly, you know, he got into other schools, but he eventually ended up here.

Annie: Yes.

Dr. Chan: Like help us . . . like walk us through that. Was that really stressful?

Annie: It was.

Dr. Chan: Or was it more stressful applying to medical school or is it residency or is it just all different sorts of stress?

Annie: Totally medical school. We were talking the other day about the MCAT, and he said, "That was the hardest." I mean, and you think back to step one and step two and all those tests that you continue to take, but I think the MCAT was the first and it was really scary and, you know, we wanted the best score so that he could get into the best school and, you know, that was best for us. So we were actually waitlisted here at the U. And we were headed to Kentucky of all places and it was out of state tuition and it was really expensive, but I have family there so I was really excited.

Dr. Chan: Oh, okay.

Annie: I was excited to be near my brother and my nieces and nephews and so . . . anyway, we were putting it all in there and kind of waiting to hear back, and then we came to second look day, we heard I think right before, the day before second look day.

Dr. Chan: Yes, I remember that, yeah.

Annie: And I was able to come that year and come see it, and that really solidified for me that this would be a great place.

Dr. Chan: So our gain was Kentucky's loss.

Annie: Maybe. I don't know.

Dr. Chan: And we'll talk more about that when I . . . when you start interviewing for residency programs if he ventured forth out there. Okay. So you get into the U. And then you . . . did you guys move closer to campus? Because I remember you were originally . . . you know, you were down in Utah County.

Annie: Yes. We were down there for his undergrad, and our families are down there. He had some grandparents who were leaving on an LDS mission and were leaving a house up here in Salt Lake and asked us to take care of it. So that was another draw for the U was that we would have free housing for 18 months while they were gone. Well, free but, you know, we had to take care of the place and stuff.

Dr. Chan: That's awesome.

Annie: It was really nice.

Dr. Chan: So jumping from undergrad where, you know, both you and Peter are studying, it's fairly busy. Was it a big jump up into the medical school? I mean, like did . . . like what were his hours like? You know, were you seeing him far less? Did it just seem much more intense? Like how would you describe that?

Annie: Yeah. So when he was in his undergrad, he held a part-time job. I was working full time, but he actually . . . we had one child at that point, our daughter, and he would actually take her so that I could go into the office and work some time because I worked from home, but I would go into the office and he . . . I would say it was more like half and half of what we spent with our daughter. He spent half the time, I spent half the time. We had time together in the evenings. And so that was a huge change when we came to medical school, because that is not how it was. I transitioned out of working when we moved up here, and so I was home full time with our daughter. And he was at school full time. So I don't know if you want to hear like scheduling.

Dr. Chan: Yeah. I mean, like was it possible with the young child at home for him to study at home?

Annie: Yeah.

Dr. Chan: Or was he more of a library studier and then . . . like how many hours was he putting in a week?

Annie: So I'd have to calculate those hours, but his daily schedule was he . . . we had a little study at home, so he would leave before our daughter was up, which was smart because, you know, once the baby's up it's harder to leave. So he would leave before we woke up. So, you know, between 6:00 and 7:00 a.m. he would head out of the house, come to campus, study all day and then he . . . we knew that we could expect him home by 6:30, and that's when we had dinner together as a family and he would help me get our children down.

We had one child for a while, and then we had another. So he would help me get them down during first and second year, and then he would go back to studying. So we would have him between 6:30 and 8:00 was family time, and then once our daughter was down, he'd go back to it and put in a couple more hours that night before bed. So yeah, he was putting in a lot of hours, but I think the key . . .

Dr. Chan: Yeah, it sounds like a lot more than undergrad days.

Annie: Oh, for sure. Yes, a ton more. I think the key for us was just that we knew we could count on him for those. He said, "I will be home at 6:30." And I said, "I will have dinner ready and then we'll spend some time with our daughter and you help me get her to sleep," or our son when he arrived as well. "Help me get them down for bed and then you can go back." And so that was pretty typical. Just a couple of hours with him every day.

Dr. Chan: What did you do on the weekends?

Annie: On the weekends, as long as it wasn't a test weekend, he would usually say, "I will take off one night of studying." So a Friday night or Saturday night so that we could have a little date night whether it was out or in or whatever. So, yeah, he did that. He studied all day. Saturday was just like every other day to us. But then we decided that . . .

Dr. Chan: So he was out of the house though? He would come up here? Yeah.

Annie: Yes, he would, yeah. It was hard if he was home. We had a little study that had glass windows for a while so our daughter, you know, could see him.

Dr. Chan: And the children somehow do not realize that you need to study. They're like, "Let's play. It's time to play."

Annie: Yes. "Why are you here and not playing with me?" But then we moved and didn't even have a study in our next apartment, and so, yeah, he would just come to campus. It was just easier for him to focus while he was on campus. But then we decided together that Sunday would be a family day and a day for religious worship for our family. So yeah. He never studied on Sundays, and that was really nice. It was the one day that we knew we had all to ourselves as a family and . . .

Dr. Chan: Because a lot of the tests are on Monday. Not all of them, but I think most of them are probably on Monday so yeah.

Annie: And that made for a very stressful Sunday night, because he would start thinking, "Oh, my gosh. I spent the whole day with my family. I haven't even looked at what, you know, I'm supposed to do." But that was just a commitment that he felt like he wanted to make and . . .

Dr. Chan: Yeah. Would he start studying after the kids went to bed on Sunday or no?

Annie: No.

Dr. Chan: Okay, all right, all right.

Annie: No. He would get super stressed.

Dr. Chan: Because again, I've talked to various people with different interpretations. Sometimes it's like, "Oh, after the kids go to bed or when the sun goes down . . ." Kind of like, you know.

Annie: Yeah. Well, it's just whatever works for you, and that was kind of what . . . you know, I don't . . . he may have randomly at . . . sometimes, you know, if he really felt ill prepared but he would get stressed whether he was prepared or not. And so I just kind of took it upon myself to say, "Okay. Try to distract him, you know. Let's do something fun. The kids go down. You know, let's hang out. Let's watch a show. Let's do something so that you're not focusing on this test that you have tomorrow."

Dr. Chan: I love that, Annie, because I think inherently, you know, in relationships the other partner picks up signs and cues regarding stress and going through medical school is fairly stressful.

Annie: Yes, it is.

Dr. Chan: So like what were some of the things? You know, you kind of mentioned some, but like what were some of the things you did to help alleviate that stress?

Annie: You know, we . . . well, we laugh about it, but on Sunday nights I would always say, "I will give you a stress relieving massage." So we'd put the kids down. I'd rub his shoulders, scratch his head, whatever he needed, you know, and we'd laugh about it because . . .

Dr. Chan: Put on a little Enya.

Annie: Yes, exactly. Some mood, you know, music. But I don't know that that really relieved stress, but he knew that I was trying. And so I tried to distract him talking about other things and just remind him that, "Remember this is a commitment that we've made and you may feel stressed about tomorrow morning, but I am very grateful that you spent the whole day with us, with me, with the kids, with our families," that we would go and see on Sunday sometimes. So I'd just try to remind him and say, "You know, you actually are prepared. Remember you studied all Saturday and you studied all week." So just try to relieve that stress for him in any way because . . .

Dr. Chan: So I like how you said kind of distract him, so doing different type activities that were not necessarily medically related. So yeah.

Annie: Yes, for sure.

Dr. Chan: Did you help him study at all? I mean, did you like help like with flashcard creation or kind of quiz him, or would you kind of take the book and kind of . . . you know what I'm saying?

Annie: Yeah, no, totally. He would make his own flashcards. He felt that that was part of the studying and getting the knowledge ingrained, but he would help . . . he would hand me flashcards or like sheets of paper that he wrote tiny little things. And I can't pronounce anything, you know. I'm like, "This just makes me feel like an idiot when we're studying. I'm helping you study, but I'm like . . ." I start saying the word, you know, and he finishes it for me so maybe that helped, but yeah, I did quiz him when he felt like he needed it. And that was another fun way to spend time together, but he could still be studying and help me feel part of the loop, you know, of the things he was doing.

Dr. Chan: That's great. That's great. Now when second year started, you know, my perception . . . I mean, the jokes I make, I make a lot of jokes in my brain. So, you know, first year of med school, you're going like 35, 40 miles per hour, and then second year is like 50, 60 miles per hour in terms of like amount of material and things you need to cover, and then there's like . . . there's a pretty big test at the end of second year. Did you notice a jump in the studying or the stress, or was it pretty the same as the first year?

Annie: You know, his schedule was the same whether . . . I know classes change from like morning to afternoon or the other way around. His schedule was the same. He was gone from home. So that didn't really change. I think our life circumstances changed. We had a baby like during finals week of first year. So I was dealing with a new colicky, you know, little baby, and so I think that circumstance changed for me. I was busier than just having one child. But yeah. I do . . . and I especially remember the stress of step one approaching and that was really stressful and, you know, you could tell he was more stressed and maybe studying a little more. But I would say his schedule still stayed the same. He was very good about making sure that I had those two hours in the evening and the kids had those two hours with him. So his stress level's probably higher, but the schedule for us seemed the same so . . .

Dr. Chan: So talking about schedule, third year. So third year has a whole bunch of different rotations -- surgery, psychiatry, family medicine, pediatrics -- and they all have different cultures, different start times, different end times. How would you . . . did you like the consistency over the first two years or, I mean, how did you feel about it?

Annie: So that was hard because just as you're figuring out something it changes on you, you know. And I think that was . . .

Dr. Chan: So you get a rhythm going, yeah. And then it switches.

Annie: And someone asked me the other day like, "Which year was the hardest?" And I really couldn't say. I just said, "Every time there was a change." You know, when something . . . you know, when step one was approaching and maybe his studying had to go to a little more, that was hard. And then from second . . . when third year started and the schedule's all different, that was hard. There was just these transition times of trying to figure out what worked. And third year that happens every six weeks almost.

Dr. Chan: Yeah, four to six weeks it switches, yeah.

Annie: It just totally switches. So that year we kind of shifted gears, and I had to really be better about being flexible. And we didn't have a newborn anymore at that point, which was nice so that I could, you know, just do things with my kids, and if he could come, great, and if he couldn't, then we just did without him and . . . it's definitely a test of your, you know, ability to be flexible and okay with . . .

Dr. Chan: Yeah, it can be very disruptive because you don't know . . . well, you kind of know when he needs to leave the hospital. I mean, when he needs to get to the hospital in the morning, but at night my experience has been it's very variable. You know, especially during the rotations where there are procedures or surgeries going on because some . . . you know, you don't leave at 5:00. You kind of stay in the OR until the case is complete and things can happen in the OR and things can drag on much later. And then you're kind of at the whims of the residents or attendings kind of, you know, you're helping out the team, so yeah. I can . . . and then the weekends are completely variable so . . .

Annie: Yes. Yeah, it can be like a regular weekday every day of the weekend, which can be hard. I think one thing that helped as we adjusted into that is that I realized that he would do his best to be home when he could, and as long as I trusted him on that, that it wasn't like he was staying longer than he needed to . . . I know there were times when he'd come home and say, "Some of my . . . you know, the attending or whoever said you can go, you're free to go." And some of his peers would say, "I'm going to stick around." Just because they wanted to go the extra mile and show that they were really committed. And I think that was great, and yet I appreciated that he said, "You know what? The attending said I could go. I do my very best. I put it all in while I'm here, but if he said I can go, then I have a family that I can go home to." And I appreciated that just because I knew that if he could be with us, he would be, and if he didn't feel like he could leave, then I trusted that and that that was his . . . that was what was best for his education. And so I think that helped me to just feel like if he's not here, he wants to be, but he can't be. And so we would just move on and be okay with that.

Dr. Chan: Did you start forming opinions based on, you know, his availability and if he was stressed or, you know, how tired he was? Did you just start forming opinions about these different fields of medicine?

Annie: Yeah, yeah, for sure. I think I was a little scared with how much he enjoyed surgery. Like, "Oh, no. Don't enjoy this."

Dr. Chan: All right. So I mean, let's talk about that, yeah. So what did he like about it and, yeah, how did that go like when he talked to you about that, yeah?

Annie: Yeah. One of the things that we really looked for when he was through the rotations we started realizing who he was surrounded with and how he got along with them. And there is kind of a culture in each little, you know . . . he would go to, you know . . . some things he thought he'd really like and he would go to and say, "Yeah, I really didn't get along with the people there. They weren't my people, you know."

Dr. Chan: They weren't his tribe, yeah, yeah.

Annie: Yes, exactly. They were great people, they were fun to work with, but he didn't feel buddy-buddy. They weren't his tribe. So I think in surgery, you know, a lot of times they're kind of that athlete type, where he, you know, he was into baseball and he got along with those types of people and loved that, and he loved the OR, working with his hands and he just thought it was so cool to see everything that's going on. But in the end he just thought, "You know, I could do this. I would love it, but I don't know that I have to do it." And if that wasn't the only thing that he felt pulled towards that I said, "Let's continue exploring then. Because that's a very hard road. And if that's not . . . if that was the only thing that you felt fulfilled by and you really wanted to do it, I would be supportive. But if it's not, then let's explore some of the other options."

So yeah. When he went to family medicine, we did a rural rotation in Kenab, Utah, and he loved it. He was . . . and we always knew that that was a big possibility because his father and his grandfather and possibly his great-grandfather I think . . .

Dr. Chan: And possibly his great-great-grandfather.

Annie: Right. I think it only went to his great-grandfather, but they . . .

Dr. Chan: Who was William Ostler.

Annie: They were all family medicine doctors. And so he was really pulled towards that and always grew up thinking that's what a physician was. And so I was excited that he felt very fulfilled by that.

Dr. Chan: Did he . . . it sounds like he might've felt torn during third year because he liked other fields that were not family medicine.

Annie: Yes.

Dr. Chan: So I assume there was a lot of discussion with you about this because it's about . . . this is about career choice. It's about path.

Annie: It is, yeah.

Dr. Chan: It's about the future.

Annie: And figuring out . . . yeah. So we really tried to stay in tune with each other, to have him come home and tell me about his day and, you know, what he liked about the day. And I kind of saw a pattern that every time he had a great conversation with a patient is when he came home and felt like, "Oh, my gosh. This was the best day, is that I talked to a patient. I helped them through their problem." And so he would say, you know, family . . . people would say, "Well, family medicine is only this or only this." And he could say . . . and I could remind him that actually it's, you know, talking to people and helping them through their problems, whatever those problems may be. And psychiatry was a big pull for a while.

Dr. Chan: Oh, yeah. I remember talking to him about that, yeah.

Annie: Yeah, and he . . .

Dr. Chan: Well, there's a lot of psychiatry in family medicine. Yeah, yeah.

Annie: There is, yeah. Well, and I would remind him that.

Dr. Chan: Yeah.

Annie: You know, you can do a wider range of things. I think if he had went straight to family or straight to psychology he would've had a hard time because he wanted to do some other things too. And so I would remind him of that, that in family medicine there's a lot. You can even do OB. We explored that for a while because he was very interested in that, yes. There's procedures and there's counseling and, you know, a psychiatry aspect and all those different things so . . .

Dr. Chan: So a lot of discussions. How did the family weigh in at all, or did they keep good boundaries because . . .

Annie: His dad . . . yeah.

Dr. Chan: Okay. Because like, you know, like if you come from a legacy of a certain field . . .

Annie: Yes.

Dr. Chan: It's just different for people, and it's hard to kind of talk about it and navigate it and . . .

Annie: Yes.

Dr. Chan: And I'm not sure if they have like clinics that they envision Peter taking over one day or being in or being in . . . you know what I'm saying? So I'm just curious how that kind of played out?

Annie: We're in a good position because his dad's dad wanted him to come and join his practice. And his dad felt like he had better options other places, and so he didn't join his dad. And so he's very sympathetic to Pete in that way, in that he realizes that he didn't join his dad and so it may not be what's best for our family and for my husband Pete at the same time. They're all named Peter so it gets confusing.

He's very sympathetic to that, and he never wanted to put any pressure on . . . in fact, for a long time we were just like, "I don't know if he . . ." You know, Pete never knew. Like, "If I chose family medicine, would my dad want me to come practice with him because he never said anything?" And I think he was just waiting for Pete to make his own decision so that he didn't feel pressure at all. And once Pete was really all in on family medicine, then he said, you know, "If you want to come, you could join. You know, I'd be happy to have you." And he's been really nice about that.

So I think it's really open. There may be a place here. We'll see, you know, when we're done with residency if there's a place here. Or if there is somewhere else, then I think his family would be supportive of that. They're great.

Dr. Chan: Sounds like more decisions need to be made down the road. We'll see you . . . life is a winding road. We'll see what happens. All right. So third year is wrapping up. Peter's feeling really good about family medicine. You're feeling good about family medicine. What was your application strategy for residency? How did you guys approach that? How did you value certain things over others? What did you guys do?

Annie: So I was pregnant and due with a baby during interview season of fourth year, during residency interviews. So I went with him in July when I was largely pregnant. We went to the . . . there's a convention in Kansas City that all the family medicine programs . . .

Dr. Chan: The Super Bowl I call it, yes. Everyone is there from family medicine, yeah.

Annie: Yeah. And I knew that I wouldn't be able to go and scope out really things with him during the interview process, so I went with him to that and we had a list of things we wanted. He wanted a small community, because after going to Kenab in third year, we thought practicing in a rural community is definitely something that we could see our family doing. So we looked for those community based programs that were going to train him all the way around.

A lot of the other . . . some like academic programs focus more on research and maybe less procedures or, I mean, it just depends on the program, but we really wanted something that would give him a well-rounded training so that we could go anywhere and he would feel comfortable delivering babies or, you know, doing procedures or doing whatever if we were going to go rural.

Dr. Chan: So as a couple did you kind of go through all the booths together, or did you kind of like divide and conquer? You go your way and then you kind of, "Oh, yeah. I talked to them too. Let's compare notes." And oh, you know, and I know everyone's like pushing swag in your hands, I guess.

Annie: Yes. We got so much swag. We came home and gave it to our kids. But yeah, no, we stuck together. We had an idea of places that we wanted to see and locations that we were okay with and there . . . it's kind of nice because a lot of them . . . you know, all the Texas programs were down one aisle and all the Washington programs were down one aisle.

Dr. Chan: Oh, they recreated like the United States map that . . .

Annie: Well, it wasn't . . . yeah. I mean, sort of.

Dr. Chan: You could make that claim, Annie. You just say, "Yes. You know, they laid it out. It was the shape of the different states, the booths, you know.

Annie: No, that would've been cool though.

Dr. Chan: That would've been cool.

Annie: But no, they had all the whammy programs. So, you know, Washington, Idaho, western United States were kind of in one place, and then, you know, we went down the Texas aisle and we were interested in North Carolina for whatever reason. We've always thought that would be really cool to live there. So we went down and saw some of their programs. So we had an idea.

And we actually found some that weren't really on our list that we went and looked at. And so yeah, it was great to get a feel for going and talking and, you know, me being there, you really get a feel for how family friendly, and family medicine is great. I think almost every program's family friendly, but a lot of the people said, "Hey, if you're around and want to come to the interview, you are welcome. We will set you up with spouses for lunches so you can talk to them." And they were all very nice. And that helped us feel like, "Okay. These programs really are okay with us coming."

And one of our big questions was, "Do any of your residents have families?" Because we were pregnant with our third and we knew that we would be taking a family with us, and that was important to us that there were other residents, you know, who might be in our same position instead of just, "Oh, no, everyone here is single. You would be the only married guy with a family, you know." So that was nice to kind of get a feel for.

Dr. Chan: Awesome. So the big Super Bowl, the big events in July in Kansas City, and that really kind of . . . sounds like it helps kind of drive your decisions of, you know, what residencies to actually apply for. So how many did you apply for?

Annie: I think that we did 13.

Dr. Chan: Thirteen?

Annie: Yes.

Dr. Chan: Okay. So the interview offers start to trickle in. What was your strategy? Did you say yes to everything right away or . . .

Annie: So we put . . .

Dr. Chan: Or did you end up canceling some interviews or . . .

Annie: Yeah. I think we did. I think he did all the interviews. So I think five. I'd have to count them. Four or 5 of those 13 were in Utah so that . . .

Dr. Chan: Local programs, yeah.

Annie: Yes, local programs. And so I remember him putting his email on my phone so that his emails were coming through, and the second that he got an invite I would go on . . . because he was in a rotation where it was harder to get to his phone. So I would go on and schedule his interviews and so . . .

Dr. Chan: The power.

Annie: Yes, exactly. I was his secretary there for a week or two. So I went in and would schedule them and tried to figure . . . you know, we have like two or three programs in Texas, so I tried to get those in line with each other so that he could just have one flight down there, rent a car and drive around. So yeah. He got a bunch of interviews. I think we didn't end up cancelling any interviews. There were some that he thought, "You know, maybe I'm not as interested, but when it's already scheduled and . . ." You know, it'd be like one program down in Texas, and he was going for three. And so it's like, "Why cancel one when our flight's already . . ." You know? So and we didn't feel like we overdid it. I know we have friends who said that they applied to a lot more.

Dr. Chan: Well, I think there's just the anxiety that drives decisions because people . . . you know, and rightfully . . . it's a balancing act. So like people don't want to feel like, "Oh, I didn't apply enough." Because you need to apply . . . the more programs you apply to, the more likely you are to get interview offers, and the more interview offers you get, the more likely you are to match into the program you want to. So like there's like this algorithm that people tend to overshoot because I think that people are just very, very nervous about not matching, you know.

Annie: Yes. Well, and Pete got, you know, I think 12 interviews out of those. There was one place that didn't offer an interview.

Dr. Chan: Oh. That place, not so good. Yeah.

Annie: No, no.

Dr. Chan: This is Peter we're talking about. Yeah, yeah.

Annie: For whatever reason they didn't think he was an interesting applicant. I think he got waitlisted interview or something, so we only interviewed at 12. But yeah. That was . . . we interviewed at all of them and put . . .

Dr. Chan: And did you get to go with him to like at least the Utah ones?

Annie: I did go . . .

Dr. Chan: Because like there's usually a dinner the night before. It's an opportunity to meet like the spouses or families.

Annie: Yes. I think I only went to one dinner of one of the Utah programs.

Dr. Chan: Well, I hope Peter brought dinner back home to you. Yeah.

Annie: You know, so we had . . .

Dr. Chan: Or to-go order. Yeah.

Annie: Yeah, yeah. We had a daughter. I was just like up all night. You know, we had this brand new newborn, so it was a little harder for me to do anything. But I did go to an interview with him that was right before Christmas, and it was in Coeur d'Alene, Idaho, and so we dropped our kids off with my grandmother who's in Boise, and then we flew from Boise to Coeur d'Alene and so . . .

Dr. Chan: Yeah. Even though on the map it looks close, but that's actually very far. It's a really killer drive too. I've made that drive a couple of times, and it's not a straight shot. It's very windy, up and down and like 20 miles because you go through all these little towns. You have to drop down to 20 miles per hour and then, you know, so . . .

Annie: We're used to doing the trip to Boise though so . . . I have family there so . . .

Dr. Chan: That's a better straight shot, yes, yep.

Annie: So we went there, dropped our kids off, flew, went in for a day or two with our little two-month old attached to me and, anyway, we went. So I did get to go on that one interview. And then I went on a second look with him as well to one of our top programs that we were looking at in Indiana. And it was just far for us to be moving, and so we wanted to . . . I wanted to go and make sure that it was something . . .

Dr. Chan: Well, you were at our second look day for medical school. What does a second look day look like for a residency program?

Annie: It's different for every program. This program had specific days that they did, and they did like an Olympics. So they split you into teams, and you had a specific color you were supposed to wear and they had a big thing. They had a bowling night the night before and then Olympics the next day and . . .

Dr. Chan: Like Olympics as far as who can like remove this mole and stitch it up or like literally jumping into a swimming pool and swimming as fast as you can?

Annie: No, not even that. They called it the Olympics, but it was more like how many saltine crackers can you eat and, you know, like funny things. They put on like just like things that you make a fool of yourself, you know. Kind of minute to win it sort of things.

Dr. Chan: Oh, my goodness.

Annie: There was a taboo where you would . . .

Dr. Chan: Did they prep you ahead of time?

Annie: No.

Dr. Chan: Because if I showed up to . . . like I would think like, you know, people were wearing, you know, nice clothes and like it's a semi-formal event and . . .

Annie: No, no.

Dr. Chan: And then all of the sudden, like eat this, you know, we've all been there, Annie. Like I can devour a sleeve of Girl Scout cookies with the best of them, right. But like in front of other people . . . yeah, so . . .

Annie: We're like potentially . . . yeah. It was a little . . . I was . . . I actually had my daughter and I went and walked around the children's museum, so I missed some of it. But they told us that this is like a fun relay race kind of day, so wear tennis shoes and, you know, exercise clothes and they prepped us.

Dr. Chan: Did it help this program or not help this program?

Annie: They were a really fun program.

Dr. Chan: Oh, okay. Because I was about to say like, again, that's kind of different. It's a little on the weird side so, yeah.

Annie: And you get to know the people in a different way than you would in a more formal setting, but I think that was just their style. They like to be fun. Everyone there was fun loving, and so I think . . . some of the residents were like, they do it every year, you know. They were like, "Oh, this again?" And, you know, there was one girl on our team that was like, "I'm a poor sport. I'll admit it. I don't like coming, you know." And there were others that were like, they just live for this. It was so fun. Their team won every year, you know.

Dr. Chan: Well, you know, just jumping ahead a little bit. I hope Pete takes this knowledge, and he can maybe bring this to his residency program and just kind of . . .

Annie: Yeah, good ideas.

Dr. Chan: All right. So this is fascinating. Okay. So Peter's done with all of his interviews and like who's the keeper of the knowledge? Were you making an Excel spreadsheet? Was he taking notes? Like, you know, how did you come up with the list, the rank list? Like was it kind of multiple little just discussions over time, or did you have this one big meeting where it was like a date night and you just like talked about it, each program in depth? How did you guys do that?

Annie: Yeah, a little of each of that. After every program he would call me and we'd discuss it when he got home, and we kind of just naturally gravitated towards about five programs that we really knew were our top choices. And even beyond that, there was really, in the end there was really three that we were like, you know, back and forth, three, which order do we rank them? But really five programs and one night we just kind of gravitated that way. He did keep an Excel sheet, and, you know, I would put some input in it, and he did like a numerical ranking system. And so we looked at that, but we knew in the end we wouldn't go by the numbers, we'd kind of go more by our feeling.

So we took those five programs. We set out like the binder, folder things that they had given for us, and we had them all laid down on the floor and we kept switching the orders like, "Okay. So how do we feel about this one? And Pete, why is that one so high? Like when you talked to me after that interview, you didn't love it. So why in your mind are you coming back to it and ranking it so high?" And so we went back and forth a little bit and even I kind of was like set on one program and I was like, "He's going to come around. This is number one. I know he's going to . . ." And he didn't. He ended up saying no. That one ranked number two, which is funny because I was just certain that that's where we were going to rank . . . we were going to rank that program number one, and we would end up there but . . .

Anyway, he went to a second look at another program and loved that one.

Dr. Chan: No Olympics though.

Annie: No Olympics, no. And they didn't even have a formal second look. So he just said, "I'd like to come back for a second look." And they said, "Great.

Dr. Chan: As Dean of Admissions I know that well. Yes, yes.

Annie: Yes, yeah. And so he just said, "Great. We'll accommodate you." And he actually . . . his dad went with him on that trip.

Dr. Chan: Oh, fun.

Annie: Yeah. Because it was the place that I had already been and so . . .

Dr. Chan: Okay.

Annie: I had already seen it. So he went back with him, and they enjoyed themselves.

Dr. Chan: It sounds like a great movie in a way. Here's my dad. Yeah, that's okay. All right. So I'm okay. So you only ended up ranking five?

Annie: No, we didn't rank five. We just had a clear chalk line.

Dr. Chan: Okay. Because I was about to say like, "That's gutsy, you know." Yeah, okay.

Annie: No, no. We ranked every program that he interviewed at. So we ranked 12 programs. But there was just . . . for whatever reason we just had a clear five in our mind that we knew and even a clearer three. We knew four and five would be down there and that three would, yeah . . . we just had to order.

Dr. Chan: Did you have access to the list, the official list? I mean, would you log in?

Annie: I didn't. He had it on his phone, and he joked about just giving it to me and letting me do it and then being surprised.

Dr. Chan: There are some people that do that.

Annie: Yeah. I think if he had been really undecided [inaudible 00:31:55].

Dr. Chan: Every relationship is different. Every couple is different, yes.

Annie: No, he came home from one of his second looks and said, "This is it." And I said, "Okay. That's great. I'm happy with that." And so we ranked that one number one and then the other one number two and number three.

Dr. Chan: So it gets submitted.

Annie: Yeah.

Dr. Chan: You know, and obviously it takes a month to run the computer algorithms, which I totally think is hogwash, but, you know, I don't know why they make everyone wait a month. During that time, second thoughts, really anxious, or is it, you know, you guys are cool as ice?

Annie: Well, I think he felt, you know, anxious. There's always that like, "Oh, my gosh. I ranked them one and they said they would rank me one but did they, you know." And there's always kind of that, but we were comfortable with all our top three. A lot of the programs and most of the programs we interviewed at we thought we could be happy here. These are great programs. And the fact that we had a hard time numbering those three meant that we were going to be happy at any of our top three. And for family medicine that's very likely that you'll . . . I know for the U students, they will match in their top three.

Dr. Chan: Especially someone who's awesome as Peter. Peter is awesome. He's super awesome, yeah.

Annie: Well, we felt pretty good that one of those top three would be ours and even that our number one would work out so . . .

Dr. Chan: All right. So the Monday before match day he gets the email that he did match?

Annie: Yes.

Dr. Chan: Were you worried at all leading up that, or you felt pretty [inaudible 00:33:12]?

Annie: Not really.

Dr. Chan: Okay, all right, all right. So it's kind of a formality, yeah, okay. All right. So match day's on Friday. You guys sleep the night before, anxious or . . .

Annie: You know, I didn't expect to, but we were . . . he was tossing and turning and I was too. I just didn't sleep that well. It's kind of like the future just hangs in the air, and you can feel it and you just couldn't sleep that well. So we kind of tossed and turned all night.

Dr. Chan: All right. Match day. Who's there? Is the legacy of all these physicians there from his side of the family?

Annie: You know, Pete's grandfather passed away a couple of years ago, so he wasn't able to be there, but . . .

Dr. Chan: He was there in spirit, yeah.

Annie: He was there in spirit, yes. And his parents came, my parents came. Our kids were there. We wanted them there.

Dr. Chan: Eating sugar and going crazy with all the snacks? They had a lot of treats there. Yeah.

Annie: They had some, yeah. Yes. Yeah. So we were all there just ready and excited, and everyone I think knew what we had ranked number one, so they . . .

Dr. Chan: Oh, okay. So that wasn't a secret from the family?

Annie: Not really.

Dr. Chan: Okay.

Annie: I mean, initially I think Pete was like, "I didn't want to." But he felt pretty confident that it was going to . . . and even if it wasn't, we were okay with our families knowing that it was our second choice. I don't think we were worried about being too embarrassed or anything that we didn't get our top choice. They were all good programs.

Dr. Chan: Bunch of speeches and they cut the red ribbon.

Annie: Yes. Torture.

Dr. Chan: So what was Pete's MO? Did he just go up there, grab the envelope, come back? Did he open it on his own? Did he have you open it? How did that unfold?

Annie: No, he just went and grabbed it. He was holding our son. He went and grabbed it, came back.

Dr. Chan: Had your son open it? No.

Annie: No. No, no. He was just holding him, opened it and kind of said, you know, "There it is."

Dr. Chan: Okay. Very much matter of a fact, yeah.

Annie: Yeah, yeah.

Dr. Chan: Oh. I love that, Peter. All right, so, all right. So where are you guys going?

Annie: We're going to Coeur d'Alene, Idaho.

Dr. Chan: Coeur d'Alene.

Annie: Yes.

Dr. Chan: Awesome.

Annie: It's called Kootenai Health.

Dr. Chan: Kootenai Health? All right. So tell us why. Sell the program. Why was this your top choice? What did you like about it? What did he like about it? What did you like about it, you know?

Annie: Well, I think what made it so perfect for us is just because of our story. We both grew up here in Utah. We thought for a while that we were going to leave for medical school, but then ended up staying. It's so wonderful to be near family. We've both grown up here though and wanted a little last adventure. You know, we felt like we could settle here, but we could like it elsewhere and we don't really know until we try it elsewhere. So we were really hoping, I think, to leave for a residency, just because it's three years for family medicine. We knew it could be three years gone and then if we want to come back, we can.

So we looked at programs all over the country, including the Utah programs, which was hard to not rank. They're great programs, all of them here in Utah, but we just felt like for a family we wanted to leave. But then we started looking at these programs in Indiana and Pennsylvania and they are far. And it's like, "Oh, my gosh." When we flew there, we know there's a layover. It takes a whole day to get there, and I thought about doing that with three kids on my own if he couldn't come. So Coeur d'Alene started looking better and better because it's close to home, close-ish, right.

Dr. Chan: Yeah. It's the west.

Annie: But yes. It's still in the west. But it's still a way from Utah, which is . . . not like there's anything wrong with Utah, but just for our circumstances we wanted to have a little adventure for our family so . . .

Dr. Chan: Lots of fine outdoor stuff to do up there. It's gorgeous. Yeah, yeah.

Annie: It's so gorgeous. We visited the week before Christmas, so it was cold. The snow had actually just melted, but they had had snow and, you know, not . . . it was still beautiful. The lake was still beautiful, the mountains there and so anyway, we loved it. And when he went back for his second look in February, again it was freezing, but he hiked around in the freezing cold weather and just loved it. It's beautiful up there.

Dr. Chan: I'm so excited. All right, Annie. Last few questions. This has been great. First question. As you look back, as people are listening to this podcast and their loved ones are going to go to med school, what advice would you give them? How do they support them as they kind of go through this journey, this process? That's admittedly very roller-coaster-ish, right? There are good days and bad days and peaks and valleys, and what's some advice you would give those people?

Annie: Well, looking back and especially through like this residency process and all through medical school I think my mindset was never that it was his experience. It's our experience. And I think that has helped me to not feel like, "Oh, he's off studying and enjoying and learning all these new things, and I am doing whatever it is that I'm doing." For me it's being home with the kids. For someone else it may be working their own job or being in medical school themselves. I know we have a lot of couples that are both in medical school. But whatever it is that you have that . . . his thing is not more important than my thing. This is our journey together. Medical school has been our experience. And I think that's helped me support him in that it's . . . I want him to do well. It's not that he's choosing medical school over being with me or anything. It's that this is our experience, and I want him to do well so that our family can continue to do well.

I think that's helped. It's hard. For us I think expectations have been a big deal. We didn't come in blindly. We had family come through medical school and residency and said it's hard. It's not easy. And I think talking to some friends we said, "Expectations are everything. If you set your expectations low that it's going to be super hard, then you can be pleasantly surprised when they show up a little bit earlier than expected or when they don't have to study quite as hard for a test." But we just kind of . . . I mean, low expectations but just that expectation that it's going to be hard. I think that's helped.

Dr. Chan: Did the discussion ever . . . I mean, and I know, I think this happens a fair amount. Did the discussion ever, kind of is like, "Oh, you know, maybe this isn't the right path. Maybe I made a mistake or . . ."

Annie: Honestly, all the time.

Dr. Chan: Okay.

Annie: And that's part of his personality.

Dr. Chan: Yeah, and what do you do? What do you do? Again, like all relationships, all marriages, you know, everyone's a little different. And I think there's always this tactic. You know, at least, you know, in my personal life. You either plan A, just listen, or plan B, you offer solutions, or maybe C, a little bit of both.

Annie: Yeah.

Dr. Chan: You know, and I think every couple kind of navigates this because sometimes you don't want to . . . like someone to like . . . they just want you to listen. You don't want them to like offer solutions, you know. So what would you do?

Annie: Well, I really can't offer solutions, you know. I'm not like, "Oh, well, you should go back in there and, you know . . ." I think I just have never gone through this.

Dr. Chan: I have this personal belief that Peter still can make it as a baseball pitcher, you know. So I don't know if that ever . . .

Annie: He might be a bit rusty after all these years, but . . .

Dr. Chan: It's like, "Oh, Pete, let's go down to tryouts, you know, with the Bees, yes."

Annie: No, I always . . . he . . .that's . . . Pete's personality is just he does have moments of self-doubt, and I think just listening to him, and then he needs a good reminder to say, "You know what? You're awesome and you're going to be okay."

Dr. Chan: Okay.

Annie: And there were lots of moments and, I mean, I hope people don't think that because you're going through this and you're questioning because it's a big deal. You're in a lot of debt. You know, we've moved our family up here. There's a lot of sacrifices that we've made and to say . . . for moments of him saying, "Oh, my gosh. This is not what I want, you know," that's scary.

Dr. Chan: Yeah, this was really hard, or this was . . .

Annie: This is hard work, yeah.

Dr. Chan: Yeah, yeah, it's . . . yeah. And to me it's like when you're like . . . it's not just like the academic. It's also just like watching people die.

Annie: Yes, yeah.

Dr. Chan: And dealing with jerks in the healthcare system or dealing with a very bureaucratic system and interacting with insurance companies. I mean, there's all these things that comprise the field. That's very frustrating.

Annie: Yes, and I think there were lots of moments when he just said, "Oh, dear, is this what I really want? And I'm kind of too far in now." But I knew. I had deep convictions that this is the only field that he would be happy in and that he would feel fulfilled in, and that helped me when he started questioning, to not feel like unsettled like, "Oh, my gosh. We moved our family and we have all this debt and he's questioning this." I knew that this is what he would be best at.

Dr. Chan: So you were kind of just . . . you were just very reassuring, right?

Annie: Yeah, I just tried to listen and . . .

Dr. Chan: Talk him down just a bit, okay. Let's not make any big decisions tonight, yeah.

Annie: Yes, exactly. Let's sleep on it and wait till the morning.

Dr. Chan: Yeah, let's not email the dean's office saying you want to withdraw from medical school.

Annie: I don't know that he ever got to that point, but there were just hard times in him feeling that way, and I just reassured him, reminded him that this is the best thing and it's okay to have these days and feel like I'm not sure if I like it today. And that's okay. You're not going to like your profession every single day. You know you're going to have days of not being so happy with it. Hard days.

Dr. Chan: Well, I'm glad he has you as partner. All right. Last, let's talk about the Medical Student Alliance. Am I saying that right?

Annie: Yes.

Dr. Chan: The MSA.

Annie: MSA, yep.

Dr. Chan: MSA, all right. So let's . . . like what is this organization? What's your relationship to it and let's talk about it?

Annie: Okay. So the MSA, the Medical Student Alliance is organized under the UMAA, which is the Utah Medical Association Alliance. So it's like the spouses group of the UMA. And they do a lot of legislation and, you know, lobbying and that kind of thing, so they're involved in the policy and, you know, just trying to get the best things worked out for the UMA. And then . . .

Dr. Chan: When you say lobbying, so they're lobbying the state legislature or the med school itself or . . .

Annie: No, the state legislature which . . . I mean, and really I haven't been involved in that at all. I should be, but with three kids I keep busy enough. But there's lots of good just things, you know, when things are important to Utah that they go up there and lobby and make sure that what's best for the medical profession is what's happening up at the capitol. But beside that the student association . . . I mean, at a student level we just provide a support group. We're spouses and significant others. We get together, we have social nights, play groups for people with kids. We have a date night in February where we have a panel of doctors come and talk, and they just talk about strengthening marriage and relationships during the medical training because it's a hard time. And so yeah, I've made some of my best friends through the Medical Student Alliance and . . .

Dr. Chan: And this is open to men and women? Yeah.

Annie: It is. Yeah. We really haven't had that . . .

Dr. Chan: And do you have to be married or just okay a partner, significant other? Okay, all right.

Annie: It's predominantly wives that take to it. But that's just because that's who's usually interested in it the most.

Dr. Chan: Men tend to be lone wolves. Yeah, much to our detriment I guess you could say, yeah.

Annie: Well, and they . . . and we would . . . I do always get a few . . . I've done recruiting trips the last couple of years, and I do always get some medical students who are women who come and say, "I have a husband and I think this would be great for him." But I don't know if that's them saying this would be great for him, or if they would really be interested. You know, it's because it's never really turned into much, but all it takes is one husband to come and say, "Hey, I want to put together a pickup group, you know, where we go play pickup basketball or . . ."

Dr. Chan: Or play video games.

Annie: Yes, or play video games or have . . .

Dr. Chan: Sorry. I'm being very stereotypical here. I just had these images of like male activities.

Annie: Yes. Well, whatever it is.

Dr. Chan: We'll go watch that action adventure movies, yes, yeah.

Annie: Yeah. Our wives are studying. Let's go out and do something fun. So it just takes one and that's kind of the nature of MSA is that we pass on the presidency every year, and the board rolls over and everyone's in new positions. And so it kind of just depends on who's there and what they want out of it. I know in the past there's been cooking groups and book clubs and different things, and it's just whoever takes the lead and does it.

I came in as a second year. I coordinated the play groups because I had kids, and so every month we'd go out and do something fun, get out together and whoever wanted to come with their kids could come. The next year I was the co-president elect. So I was gearing up. I planned some of the big events and gearing up to be the president this year, and that's what I've been doing this year is being a co-president with one other wife, and we've just been . . . try to plan things and be a support group and do fun things and just be there for each other. It's a hard time and we all . . . it feels better when you have friends, you know.

Dr. Chan: Yeah. And I get like just like how med students reach out to upper classmen and women to kind of give them counsel, advice on the road ahead. I get the sense that with this, you know, if there's, you know, partners, spouses, husbands that if there's advice to glean like, "Oh, you know, you're about to enter third year, you know. This might happen or this might happen or you should kind of approach it like this."

Annie: Yes, exactly.

Dr. Chan: Yeah. So I see that incredibly valuable, you know.

Annie: Yeah. Well, and especially . . . I mean, when I . . . when we were looking at financial things . . . even I just would find someone who's been there and done it before like, "Okay. You have kids. We have kids." Oh, sorry. I just moved that microphone.

Dr. Chan: It's okay.

Annie: We have kids. We are trying to figure out, you know, how to navigate this and they . . . it's such a great resource. So friendships, just that, yeah, advice can be passed along. So it's, yeah, it's great. It's informal, it's fun and we just, yeah . . . it's a good resource that not very many people know about, so we'd like to get the word spread.

Dr. Chan: Yeah. I'm glad you can plug it, you know. And I think, you know, we're not in this alone, and I feel bad because like, you know, I've gotten feedback like, "Oh, you should start interviewing like significant others, spouses." And I just go, "Oh, that's a great idea, you know." So, you know, it takes a village to take . . . you know, when you treat patients and when you treat patients, it takes a healthcare team, it takes family as physicians become doctor . . . I mean, as medical students become doctors it takes so many people along the way, and no one does this alone. So the thing I'm sad about is Utah's loss is Idaho's gain, and I'm just so excited for you guys to have this like next chapter in your life, and I really hope you guys end up back in Utah too. Yeah.

Annie: We'll see.

Dr. Chan: And I do Idaho stuff a lot, so I haven't told Peter this yet though, but like I want to open up Coeur d'Alene for more of our med students to do rotations up there. So this is going to be my little tip of the spear, you know. Yeah.

Annie: That's great. It's a new program. It's fairly new, and I think that there's, yeah, a lot of room for that type of thing. I said that to Peter the other day, "I think you could come in and you have a lot to add to this new program. You have some great ideas and things." So I'm sure he'd be happy to get involved.

Dr. Chan: So I think that the danger's going to be when he graduates. They're going to, "Oh, would you like to stay?"

Annie: Well, I could see us up there. It's so beautiful. So we'll see.

Dr. Chan: Yeah, you'll have to cross that bridge when you guys get to it, but these are great options. This is great. The future is so bright. All right. Well, Annie, thank you so much for coming in.

Annie: Thank you. It's fun to be here.

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 Scientist Radio online at thescoperadio.com.

Dr. Chan: What is it like to have a spouse that was working a full-time job transition into being a medical student? How do you keep the lines of communication open when there is frustration, and why is it important to put your spouse first? What type of opinions do you offer your spouse when deciding what type of residency to pursue? Today on Talking Admissions and Med Student Life, I interview Zach, spouse of a recent graduate here at the University of Utah School of Medicine.

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

Dr. Chan: All right. Well, we've got another edition of Talking Admissions and Med Student Life. I have a fantastic guest today. Zach, how are you doing?

Zach: Great.

Dr. Chan: Now, Zach is married to a current fourth-year student. We're going to hear your perspective.

Zach: Awesome.

Dr. Chan: All right. So let's start back in the beginning. Tenley, when she started thinking about medical school, were you guys together at that point or . . .

Zach: We were not.

Dr. Chan: Okay.

Zach: So she decided she wanted to go to medical school when she was an undergrad and she applied, unfortunately did not get in the first time, did another application for the second year and also did not get in. I believe at that point in her life, she evaluated maybe her strengths and her weaknesses in her application and decided to take a year off and strengthen her application. That's where I came into the picture as I met her and we met during that time.

Dr. Chan: How'd you two meet?

Zach: We met online.

Dr. Chan: Okay. Do you feel comfortable sharing the website?

Zach: Yeah, we're good.

Dr. Chan: Because I know Tinder is very popular with the students here.

Zach: Yeah, this was before Tinder.

Dr. Chan: This was pre-Tinder.

Zach: This was pre-Tinder. This was not the old-fashioned way, but through websites, but before apps.

Dr. Chan: Before apps. All right. Is this in California or Utah? Where is this at?

Zach: We met in Utah.

Dr. Chen: Okay.

Zach: Tenley went to undergrad in California, and then we were both from Utah, so we met here in Utah. We were both just working full-time at the time.

Dr. Chan: How soon in the relationship did she kind of mention like she was applying to med school? Was that like right off the bat?

Zach: I don't . . . I remember it being one of the initial conversations about my feelings towards medical school or towards her pursuing a graduate degree of some sort. I said, "You know what? I am here for you, let's do the application." She asked, "Are you serious about going with me somewhere?" I said, "Yes, if you got in and we're planning on getting married or engaged or wherever we are in our relationship, as long as we're not deciding not to be together, I would be there to support you." So that, I felt like she told me that, and I gave her the go-ahead. That kind of won her over I guess that I supported her.

Dr. Chan: It sealed the deal. She was on the fence with you.

Zach: Just the support that someone would support her through the attempt to do her dreams.

Dr. Chan: I've met a lot of medical student applicants. This is why I enjoy doing the podcast just to explore this. I think, like you said, explore dreams. Sometimes I think there are certain applicants and sometimes women, usually women, who feel like you just said, like they want someone to support them, because historically medicine has been very male-dominated and male-oriented. So I don't know if those discussions ever came up like that or how she felt towards the process in general.

Zach: The discussion came more along the lines of previous people that she had interacted with.

Dr. Chan: Or dated.

Zach: Or dated, maybe not being as supportive of, was more stereotypical gender roles in the sense of a female should be in the home and maybe not pursue a degree. Then I kind of said, "No, let's try it and then we'll see where life takes us." At that point, we were still just getting our applications together. So I didn't know where it was going to go at that point.

Dr. Chan: Do either you or her come from a history of medicine, a family in medicine?

Zach: No. Her family is a history of lawyers, and my family is a history of just retail. My dad owned a business.

Dr. Chan: All right. So she's applying to med school. You're supporting her dream. Where were you when she told you she got in? Do you remember that day? I assume that was a great day?

Zach: She was in a parking lot with her mom in a car, and I was driving home from work. And she was crying on the phone, and she said, "Zach, I got in." It was a happy day, an emotional day. Up to that point, we had sat down at computers and looked at schools. For me, it wasn't as much doing that, it was just there to support. But the fact that she was accepted for her dream and that she was able to pursue it. I don't know, just that happiness that comes with getting something that you've always wanted and really wanted.

Dr. Chan: That's a beautiful moment. It's a touching moment. I love how you said she really strengthened the application, because if I recall correctly, she got into other schools, multiple schools.

Zach: Yeah, she had multiple.

Dr. Chan: So she went from zero to . . . yeah. So again, going back, how did you guys come to the decision to come here? What was kind of the discussion like?

Zach: So we basically made a pro-con list of each school. We made a pro-con list. Utah is the only one in state. So we had an in-state option, and we had an out-of-state option and what moving would look like, what cost of tuition would look like, what the school's program looked like. Ultimately, I told her, I said, "You need to be happy. You're going to school, so you need to be happy with the decision, and I can be happy wherever we go."

So we looked at the curriculum at the other schools and how it was taught and the ranks of the other schools. And ultimately, we came up with the decision to stay at Utah, and we lived here, so that made that part a little easier. We didn't have to move. She really enjoyed her time here. Now she's a couple weeks away from finishing up.

Dr. Chan: We'll get to that. That's kind of the big moment. I feel like the process of going through the pros and cons would also repeat itself in a few years.

Zach: Yeah, right.

Dr. Chan: It's funny how life works in a cycle like that.

Zach: Right.

Dr. Chan: So did your employment, I mean did your career factor into the discussions? Because I think in every relationship there's always kind of this negotiation, push-pull kind of compromise. How did that factor in when you were talking about med school choice?

Zach: So we talked about like what I wanted to do with my life and where I was going and if I was comfortable being a potentially stay-at-home father if we decided to have children at that point, if I was okay with that or what we would do, where our life would take us, kind of some of those long-term ideas that you hypothetically talk about.

At that point, when we applied, I had a different job. Then Tenley didn't like my job. I worked in retail. So she found me a new job. I worked in school. I work in academics at the University of Utah. So it was just, I don't know, something that we did for the time. I told myself I'd figure something out when we get to the next chapter of our lives.

Dr. Chan: Okay. So it sounds like you got to know Tenley outside of school, right? She was going through the application process.

Zach: Yes.

Dr. Chan: You were married by the time school started?

Zach: Yes.

Dr. Chan: All right. How was the transition when she went from kind of someone who was working and doing all these activities to being a full-time student? How did that look like on your end? Was it a big kind of change when all of a sudden she started to have to study all the time?

Zach: So, before school started, Tenley had a full-time job. So going into school she told me that she was going to treat school like a full-time job. So even though here at the University of Utah classes are set up where they're kind of blocked in a portion of the day, depending on the time of day and the year and such, but we would treat it like an 8:00 to 5:00 job. Since I worked here at the University of Utah, we'd drive together, which was awesome because you get to spend some time together. We'd drop her off at 8:00, and when I got off at 5:00, I would pick her up. That's kind of how it would.

So day to day, that didn't change as much. Then when tests started coming, that's when things started changing. I think some big things going into that is communication. So don't hold something back. Just be open to talk about anything with your spouse, anything you're going through, your frustrations, how things can change. Don't just come in saying you're frustrated. Come in with some suggestions, possibly like, "Hey, how could we change this?"

There's going to be some days where, you know, I recall Saturdays coming and she's getting up and going to study and she either left and went somewhere to study or she studied at home and I made her breakfast and took her a plate to where she was sitting and then she would eat and study. And then I would grab the plate and take it back to the kitchen and wash it and do my own thing, and I would make her lunch and kind of do that same thing all day. She just sat there and studied. You just have to be flexible and not be so rigid in understanding that your schedule might change and you can't be as rigid in your schedule. Be flexible, but also be willing to enjoy the times together.

So if you have just that moment to go to the grocery store together to buy some groceries or if you have to go by yourself, that's kind of what you have to do to support your spouse. But just enjoying the small times together, and I think you'll understand, and if you don't understand what that is, you'll understand and appreciate the small times. And it's great, the hour you get to spend together or the time you get to sit down and watch TV together. You go through that the first years and throughout medical school. You've got to just learn to enjoy the time you get to spend together.

Dr. Chan: There's an image of medical school before it starts. Obviously, the two of you talked about she would start studying more and probably not have as much time, kind of you referenced to do things with you. Did it meet your expectations, or was it like, "Oh, wow, this is a lot more studying than I thought?" Do you understand what I'm saying?

Zach: Yeah. I guess I projected it in my head to be a lot of studying. So then when it wasn't studying, I wasn't disappointed. That's just how I set it up in my head.

We got some advice from one of our neighbors who he is a surgeon. His wife said, "Try to take some time together. Even if you're busy every night of the week, try to take one night to spend a couple of hours together. If that's going out to dinner, if that's making a dinner together, do some activity together, because that will just help break up the studying a little bit but also just so you guys can have quality time together."

I think that's something we really tried to do throughout the first couple years was just to try to plan that time together, even if it was going to someone else's. We both have family here in Utah. So if it was even going to a family member's house together or something, just making sure we tried once a week to spend some time together. It is a daunting task to study, and it can be stressful. I think, as a spouse, you have to realize that maybe not to just throw your thoughts away or anything, but try to put them first and reduce the stressors in their life.

So figure out what your spouse's stressors are. If they appreciate a clean house or a vacuumed front room or any little thing, just try to do those for them so then it takes that little stress out of their life so they can focus on their schoolwork.

Dr. Chan: I love what you said, Zach, because I think medical school is inherently stressful. There's many, many experiences we go through in life that are very, very stressful. It sounds like you and Tenley, you did a great job in managing that stress. As a spouse, you kind of see the other side of it and kind of the roller coasters of tests and test scores coming back and those kinds of experiences.

Zach: I'm not saying like what we did was perfect. It doesn't alleviate the bad days. It doesn't take away the stressful times. It just helps to minimize them, to be there, and then the communication I think makes it open to be there for each other, so when you're having a bad day, you can just let someone vent about a test being hard or not understanding how to study for it or just talking through scenarios with them.

Dr. Chan: Would you help her study? Would you get involved in flashcards and quiz her? I talk to some couples, and they kind of build more time together. They kind of use the other person kind of as a sounding board or things like that.

Zach: I was used more as a fake patient later on.

Dr. Chan: Pretend you have chest pain right now, Zach.

Zach: For studying purposes, Tenley liked to just do her own thing. She liked to kind of be shut off, I guess, just kind of be in her own little space. That's her way of studying. But I was there. If I needed to be there, she knew I would help her with something, but we didn't really do it that way together.

Dr. Chan: Did you develop relationships with other spouses or male significant others or female significant others in the class? I know like there's something called the Medical Student Alliance where there's kind of like a support network that's kind of built in. But just my perception that tends to be a lot of women in that and not as many men, and I'm just curious what your experience was.

Zach: Yeah. Getting into med school, they came across saying, "Hey, we have these different groups that you can join." They were very female dominated as spouses, so I didn't join them. Tenley had a group of female students . . .

Dr. Chan: Classmates.

Zach: . . . classmates, peers, that we started doing stuff together. We'd all get together with our spouses. So her medical student friends, her classmates became my friends, and then we started doing stuff with their spouses, never to the point that we would just do like a guy's trip or anything like that. A group of us ran a Ragnar together. So that was a few spouses and a few medical students. That was fun and something to do in the summer, something to do in the first two years when you're less busy. But that was something fun that we did do as a group.

Dr. Chan: Okay. Awesome. As Tenley transitioned into her third year, where she has like clinical rotations and going to the hospital and her hours start being more variable depending what clinical rotation she was on, how did that change? Is that something you welcomed? Or was it better to have all the studying?

Zach: I think, for Tenley, it was something she wanted. By the time you're done with two years of class work, you're ready for a little bit of a change, to take what you've learned in the classroom and apply it to everyday life. So I think for her, it was a good change. So, for me, it made . . . you have to build on what you done in the first two years as a couple, because your time separated gets, sorry, your time together is less. She's busier. Your rotations change. So, for us, it came back to that communication and a shared . . . We did a shared calendar on our phones so that we could put in each other's schedules and so we knew where we were.

And at this point, when Tenley started third year, we also had a child by this time. So that added another wrinkle into our lives. So just communicating and being where you needed to know. It sometimes became a daily discussion of what are we doing tomorrow and what's your schedule, what's my schedule, who's doing what. Also, I think it goes back to those basic things that we talked about doing in the first year, being there and supportive. Making lunches, I guess, is another thing that's huge. You do it through all medical school.

Prepare lunches the night before would be my best thing. It just takes away the stress in the morning to having to make the lunch while you're getting ready to go, run to class if you're late, or just making a meal for them and having some leftovers. We became a big freezer meal family. We would make like a lasagna or something, and the leftovers we would cut up and put into freezer meals. So that makes it an easily grab and go for a lunch.

Dr. Chan: That's awesome. There's a lot to unpack there.

Zach: Yeah, sorry.

Dr. Chan: No, no, this is great, Zach. I love this. It sounds like as time moved on, things got more complex in certain ways.

Zach: Right.

Dr. Chan: We were talking before I turned on the pod, but it sounds like Tenley decided to pursue a master's and you also pursued a master's. Zach: Yes.

Dr. Chan: Walk us through that. What were those discussions like? Who got their master's first? Is this some bizarre one-upmanship within your marriage?

Zach: No. Tenley during her first year of medical school, I'm going to get it wrong, so you can correct me, but they have to do an experience. Tenley chose to do an experience in Ghana. She went to Africa and did some research. That really solidified, I think, her understanding or wanting to do something in public health. So after her second year, she took a year off and did a master's in public health.

At this point, I was thinking about doing a master's too, because working in the line of work that I do in higher education administration, I was at a point where I needed an advanced degree to move on in my life. I knew residency was coming down the pipeline in a couple years. At this point, I was thinking I'll have five years' experience in this field. If I were to get a master's, that would just build my r�sum�, that if we had to move for residency, that I would have a solid r�sum� to be able to get a job somewhere else. So I applied to grad school that year and did not get in. Like you said, she did the master's.

Dr. Chan: So the original goal was to be on your master's together at the same time.

Zach: About the same time. My goal was to just graduate with my master's by the time she was done with medical school was my ultimate, just my goal. So I knew that if I applied the year that I did, so she is now in what would have been her third year of medical school, but she took the year off to do a master's. She has three years left, and I have three years to try to get a two-year degree in. So I'll apply once, see if I get in. If I don't, I'll have one more chance to get in. So that kind of was the decision of going and doing the graduate school.

Dr. Chan: And then deciding to have a kid.

Zach: And then we decided to have a child, and we did.

Dr. Chan: This was during her third year?

Zach: This is here third year. Yeah.

Dr. Chan: Okay, so during rotations.

Zach: No sorry. During her third year of her master's. We had the child while she was doing her master's degree.

Dr. Chan: So that must have been nice insofar that the schedule probably was not as demanding on her.

Zach: Right.

Dr. Chan: I'm not trying speak down to a master's of public health program, but in my experience, usually the coursework is not as demanding as medical school.

Zach: That's correct. At the same time, though, our son was born in the spring semester. She had a week off, and then she went back to classes the next week. So demanding in the way that she needed to get her coursework done. So I imagine it being similar to medical school in the sense that you still need to get your coursework done. So it's not like we were able to take a long-term leave, but definitely the demand wasn't as high on your time during that time.

Dr. Chan: Yeah. So your son is born, and everyone is pursuing different degrees and she's progressing, Third year, you mentioned at the very beginning, Zach, being a stay-at-home dad. Did that discussion ever continue to grow, or was that just kind of an idea at the beginning?

Zach: That's still a discussion to this day. You have to weigh all the options of your life, and so for us, it's continuing that conversation of dreams, where we want to be, what's best for our family, what's best for us not just for the family but financially for the family. So, for me, I guess it's still an open discussion about being a stay-at-home dad. Right now, I still am working. I still have a job. Luckily, we have a great support system here in Utah with having both of our families. My dad is retired, so he runs what he calls his Grandpa Daycare. He just watches his nieces and nephews when people need it.

Dr. Chan: And teaches them lessons of life.

Zach: He does.

Dr. Chan: And a little grandpa wisdom, little pearls and nuggets he probably drops on them.

Zach: So we were fortunate enough to have that support system. Tenley's mom is a teacher. So she's off in the summer. So we're very fortunate to have a lot of support around us to help us in that endeavor, because I don't know if we went away to school, the path that we're currently on would be that same path.

Dr. Chan: So if I were to ask you and Tenley -- Tenley's not right here. I didn't say that in the beginning. Tenley's not in the room. She's here in spirit though -- what kind of doctor she was going to be before med school, what would she have said? Then walk us through either how that was confirmed or how that changed towards the end of med school?

Zach: I'm recalling her answer that she'd tell others when she first started. It was, "I'm going to experience medical school and have an open opinion and not have a definite thought." I think that stayed true. I remember her coming through first and second year and getting a lecture and saying, "Man, that's awesome, Zach. I want that." If you're starting medical school, I think something fun to do, that I wish I would've done, is every time your spouse tells you that they like something or that they changed their mind, write that down in a notebook.

Dr. Chan: Yes. Use it against them down the road as a weapon. I married too, Zach. I know how it works.

Zach: Just to see how often it changes and how the process is.

Dr. Chan: Yeah.

Zach: So, before she went to medical school, she did benchtop research. I think she knew she was kind of done with that and she wanted to do clinical research. So, after that first year, when she did the research in Ghana, I think that solidified that she wanted to do a research aspect. So it was kind of finding everything that she loved about different things and settling on the direction she wanted to go. At one point, she loved surgery, and I think, as we've talked about, third year you go through your rotations. There were some rotations that she loved and some rotations that she said, "You know what? This is okay. I could do this, but I don't love it. I don't see myself doing this for the rest of my life."

So I think it slowly narrowed it down to a couple. Then we would talk it out and talk about (a) the lifestyle of that kind of doctor, also what that job looks like for her. Does she want to be doing the same thing every day all day? So she made her decision, and then going into her fourth year, the end of third year, beginning of fourth year, she just really was debating between two.

Dr. Chan: Before we talk about those two though, Zach, did you start forming a strong opinion? You as a spouse, even though, for example, Tenley loves surgery, the hours tend to be much worse than other rotations, and people tend to be very tired. You know what I'm saying? I don't know if you started picking up things on your end saying, "Even though you say you like X, Y, or Z, I'm a little nervous from my vantage point, because I'm seeing you at home and you seem stressed or you're very, very tired and I don't see you in the mornings." Did you start forming opinions about the different fields?

Zach: I didn't have necessarily an opinion about an exact field. My opinion was more of I want you to be happy. So you choose what you're going to be happy with. I think that frustrated her a little bit, because I didn't give her my full opinion. But then when she would talk about certain things, I would just try to remember in the back of my head, point out the good and bad, the pros and cons that she had said about the rotation and say, "Hey, remember, this is what you said before. I just don't know if you remember it," just to take it all into consideration. I would say she had an inkling, to be honest, to look back once she went to Ghana and did her research paper, of a potential direction she wanted to go.

Dr. Chan: Okay.

Zach: But hadn't made that a solid. So it was more about confirming if that was the direction she wanted to go. There were some changes through third year, and we can talk about that, because that came down to the final two of kind of what did she want to do.

Dr. Chan: So what were the final two?

Zach: So she really liked surgery. She loved surgery.

Dr. Chan: General surgery.

Zach: General surgery. She liked her surgery rotations, I guess I should say, because I don't know where all the rotations were. She just really enjoyed those. But she also enjoyed her OB/GYN rotations and the various gyn-onc, sorry, the gynecology oncology rotation, the fetal maternal medicine. So it came down to those two. That's where we kind of I think really talked more about pros and cons and the lifestyle of a surgeon. You're a surgeon and . . .

Dr. Chan: A lot of call. A lot of early mornings.

Zach: A lot of call. You're in surgery.

Dr. Chan: Hours and hours on your feet.

Zach: The other parts of being a doctor that she really enjoyed, you didn't get those as a surgeon. She wanted to be able to do some research. She wanted to be able to have some bedside care. She wanted to be able to do surgery, and there's a fourth one and I can't think of it right now. All of those encompassed in the OB/GYN. So she's able to do research if she wanted. She does some surgery in delivery. Then she has that patient care in a clinic. So it was kind of the all encompassing for her.

Now, are the hours going to be great? Are they going to be that doctor, like what I perceive as a dermatologist or a family practice physician that has more of a set hour, set schedule? No, it's not going to be that way. That's kind of what we signed up for, and that's what I signed up for going into this was I know the lifestyle of a doctor. Fortunately, I have friends that are doctors. So I understand how hectic the life can be and just to be their support, so for me that was actually another good thing going into it. One of my friends is a physician, and his wife is a physician as well. Just being there and the stages of medical school he would say, "Hey, at this point this might be a stressor, so just a heads up, you could just be there for her." So that was helpful too.

Dr. Chan: Awesome. All right. So she's picked OB/GYN. She's feeling good about it. What was your strategy when you started sending our residency applications? Did you guys kind of focus more geographically, or was there something that Tenley was looking for in a program specifically? How did that process start?

Zach: So the whole process I would start before she had narrowed down. We would just have in our discussions of where do we not want to live in the United States.

Dr. Chan: Ruling out certain parts of the country.

Zach: Yeah, just ruling out geographical areas, not necessarily programs at this point.

Dr. Chan: Is this based on weather or proximity to Utah, or good, available food?

Zach: All of the above.

Dr. Chan: Cuisine?

Zach: All of the above. Weather. I have a fear of snakes, maybe that factored into a place.

Dr. Chan: You're Googling where snake populations are the largest.

Zach: Yeah, right. That's, I guess, where we narrowed down our first list. Then once she had figured out what residency she wanted to pursue, she looked up a whole list. We went through and looked at test scores. So we sat side by side both on a computer, and we looked up test scores and what kind of application materials each of these schools needed, and we set out a spreadsheet just to detail it all out. We didn't necessarily exclude schools that were in those geographical areas, because if there was a school in an area that we didn't love, we may have applied for it. We would talk about it. So we set down the list and I said, "You need to feel good about your list." So she narrowed it down, and then . . .

Dr. Chan: Did she do any away rotations to kind of check these places out?

Zach: She did not. That's partly because we have our son, and that was going to be a burden that way to take care of that. So she did not do an away rotation. I think looking back, I think that's a great opportunity to do if it's available to you. But we did not do that.

Dr. Chan: And I get the sense, was she looking at more academic programs? It sounds like if her . . . she has an interest in research and maybe global health.

Zach: Academics, how much, so at this point, it's more like what they do for the family, how like family oriented are they. We looked at what the step two score was, what scores they accept, what their range is so that we get into that applying to, as I was told, they're called reach schools and then your safe schools, just kind of making a good grouping, I guess you could say, of those and then places you want to live and then the amount of schools you want to go to. I know she reached out not just for me, but to other professionals within the school and got their opinion on . . . laid out everything.

Dr. Chan: Kind of like the network behind the scenes. Like what do you guys think about this program? What's the reputation?

Zach: And then also where should I apply? Do you think this is a good school? Do think it's a bad school? Just any questions she had, she made sure she reached out.

Dr. Chan: So she's trying to aggregate all this data, all this information into this Excel spreadsheet.

Zach: To try to determine how many and where we apply.

Dr. Chan: So how many did you apply to? What was the final number, ballpark?

Zach: I don't remember, 30 to 40 I think is where we ended up.

Dr. Chan: And then the interview offers started rolling in.

Zach: Yeah. Those are like mini acceptance to med school days. You get a letter and you get accepted.

Dr. Chan: Now, with OB/GYN, because I know in some specialties, is what I'm asking, the interview spots are so rare or so hard to come by that you need to jump on it immediately. Sometimes they conscript the spouse to have access to kind of the email accounts. You need to respond immediately to get your top pick.

Zach: I did not . . . I was not involved in any of that. So one thing we did on the Excel spreadsheet is most places will tell you what their interview dates are.

Dr. Chan: Okay.

Zach: So they'll say, usually for OB/GYN, it was like once or month over the next four months, and they'd have interview dates. So we knew that this school might have this date, and that's something you have to think is if you get two schools on the same day that's offering you a date, which one do you want to go to? Also, there is ways of saying, "Unfortunately, I can't make it that day," because you have another offer. Most schools will come to you with two days or ask you what your best availability is. So just managing all those calendar days within that and then jumping on them. So when she was not on a rotation, we had emails pushing to her phone immediately so that she could respond to them and get back to those things. There were some that it was a matter of minutes.

Dr. Chan: Like minutes. The top ones are like that.

Zach: You have to call on and get there.

Dr. Chan: So it sounds like she did that. She was able to navigate that even on rotations.

Zach: Yeah. So, for her, that was something she was able to do. That's something I never even thought of having the spouse work on, but if that's something that you want to do in your relationship, I just say open the lines of communication to what it is and realize that you have to travel. There was a lot of . . . I knew the airport here in Utah like the back of my hand after a couple of weeks of picking her up. I could probably drive there in my sleep because you just go so often. I know some people, if they're fortunate enough, they try to do back to back interviews. So they try to fly out to, let's say, Texas and then they fly to another interview in another state and then back to Utah.

Dr. Chan: Yeah, try to stay in kind of the same state, as opposed to crisscrossing the country.

Zach: Yeah. Unfortunately for us, it was more flying in and out of Utah and then back and forth. There was one day where she flew in and then that night, she flew out to another interview as well. That was because the scheduling of the interviews came at different times.

Dr. Chan: Did you guys start turning down interviews?

Zach: We did not. We accepted all the interviews that we were given or that she was given.

Dr. Chan: Ballpark a dozen?

Zach: Yeah. We talked about this "we" thing. It's really her, and I'm just here to support. It's her interview.

Dr. Chan: That's my next question, Zach. Did you go to any of these?

Zach: I went to one. I was fortunate enough to go to one. That was partly because in the middle of all this medical school time frame, I switched jobs. So I didn't have the vacation built up at my new employment to go and it costs. Flights cost money. We did take one trip out back East.

Dr. Chan: Where'd you go?

Zach: Virginia. We made it a little vacation. So we took our son. It was all about her until the interview was over, and then we drove up to Washington, D.C. for a few days and then we came home. Those are great times, because sometimes you're not afforded those vacations during medical school. So it was time to kind of create a vacation.

Dr. Chan: Awesome. She's going out interviewing at all these places. I assume the Excel spreadsheet is just exploding with information left and right. I assume a lot of discussion between you and her as like this kid of proto-embryonic rank list starts taking shape?

Zach: Yes. As she went out, she took a notebook with her and then would write pros and cons. She didn't just think about the school. She thought about the area. She thought about me too and some of her pros and cons, like things that I would like about the cities and what maybe I wouldn't like about the cities.

Dr. Chan: I assume she was accurate, or did she sometimes read in too much? How worried was she about the snakes? I can see Tenley bringing up that question with these different programs, "Do you know what the snake population is?"

Zach: No, the snakes didn't come up. I'm a big sports fan. So if there was any sort of professional sports there, she would note that.

Dr. Chan: Okay. We're talking like basketball, football.

Zach: Basketball, football, NFL. So she just noted that. She noted the weather, what relocation would look like. Maybe the cost. She would ask residents things along the lines of, "Were you able to buy a house here? Do you rent? What type of things do you do?"

Dr. Chan: Schools for kids? Districts?

Zach: School districts.

Dr. Chan: A lot of residents have children. It's more and more common. I think like the residents, especially, I like what you said, if the residency was "family friendly." If they had a lot of married residents who have children, I think that would be kind of a great resource, for especially someone going into that residency.

Zach: Yeah. I look forward to that going forward into this residency is to look at what other people have done and they're doing as we move into phase here in a little bit. Right now, we've got a list. We've got interviews, and now we're creating that rank list. I know she really thought about it. Then finally, we went to lunch one day, and she had cut up every school into a little strip. She pulled it out in a little baggie.

Dr. Chan: Oh, I love it. I want the scene. Where is this?

Zach: We're sitting down at Zupas.

Dr. Chan: Zupas, oh great place. It's a hot tip for everyone out there. Zupas. Good karma at Zupas.

Zach: It's just a cafe with soup and sandwiches if you're not from Utah.

Dr. Chan: So the different schools . . .

Zach: Every school was listed on a piece of paper.

Dr. Chan: So they were all roughly equal then?

Zach: No. It was just like a little paper that said like University of Utah, whatever the other schools were. It was okay, let's put them out. Let's put them in a list.

Dr. Chan: Oh, I see. So you're physically moving them.

Zach: So we're physically moving them around and saying, "Do we like this?" Based off where she had been, there were some schools that she really, really liked, and there was obviously some schools that you're going to find that might not just be a good fit for you. We originally put those to the top and bottom. Then we sat and talked and ate, and then we talked about the pros and cons of why is this school in second place and this one is in the third place. Why is this one down in five? Should it be up at three? I thought you really liked this. She pulled her book out. We talked about all the pros and cons. So it wasn't like a short lunch.

Then we made the list. To save it, we took a picture of it just to keep the order. We did that a couple weeks before the rank lists were due.

Dr. Chan: The rank list were due.

Zach: So then we could think about it. So we'd talk about it, you know, every couple of nights, like, "Hey, are you feeling okay about it? What are you feeling?"; Then we'd talk, "Hey, you know what? You mentioned this school was really good. Why did you put it here instead of here on the list?" So we just still massaged it. Then once the ranks had to be submitted, I think a day or two before, we sat down and just kind of solidified the list. To be honest, I don't know if it changed much since our lunch meeting, but that was something that we sat down and worked on together.

Dr. Chan: It sounds like you had this big summit. You have all the information. I thought you were going to say that you put it in like a hat and just drew out randoms. Wow, that's gutsy. I love it. That's letting fate decide.

Zach: I think it does come to a point where there are a lot of schools that are like on equal ground. "Why do I put this school as six instead of five, when you feel like you're pretty equal?" I don't know, to me you have to go with your gut.

Dr. Chan: Your gut instinct. The problem is, and I don't see how you work around this in the way our system or society is set up. A lot of people are weighing different offers to medical school. A lot of people weigh different offers for residency programs. A lot of people weigh different offers for jobs or master's programs. You try to make the best decision you can with, I would argue, finite amount of information, because not until you actually set foot at that school, in that job, in that program, do you really know what it's like.

You can try to talk to as many people as you want. The internet is great for this. You get all this information. But it's really hard to make decisions. In hindsight, I went through med school, I know exactly what to look for now. But once you have that information, it's already in the rearview mirror.

Zach: Right.

Dr. Chan: You can try to share that with other people, but everyone's different needs. Everyone has different needs, desires, wants. It sounds like you two were very, very thorough and introspective and reflective through this.

Zach: I think what you have to do is when you're doing your list, you have to go with, like you said, your gut, but you have to understand that you're going off, like you said, the information you have now. If after match you find out more information, you're like, "I wish I could change it." You made the best decision with the information that you had at that point. That's what you have to know and go with and then just kind of trust the process, because after that, you've done everything you can and it's just waiting.

Dr. Chan: Philosophically, I sometimes have arguments, and you probably do this too, Zach. I think about, "What was my 30-year old self thinking? Why did I make that decision? When I was 30, I had this information. I was at this point in my life, and I made that decision. I can't doubt my 30-year old self." I think all of us should not try to live our life with regrets. Everyone has a little bit of regret in their life. You just have finite amount information.

Zach: Yeah.

Dr. Chan: You submit the list. How was it from that up until match week? Was it good? Were you feeling good? Was Tenley freaking out?

Zach: Feeling good but stressed. Really you're not waiting, and I didn't know this until this past year, you're not waiting for match day. You're waiting for the Monday before.

Dr. Chan: Yes. Was she ever worried that she wasn't going to match? You find out that Monday if you matched, not where you matched.

Zach: I think there's just a little bit of doubt that creeps in no matter what. So I think you're always going to have a little bit of doubt and that you're not going to match, that you're worried that something is going to happen. So that email comes and it's just kind of relief. So, at that point, it's now where. So you come to Friday.

Dr. Chan: So walk me through Friday. So the night before, are you guys sleeping?

Zach: You're dreaming about everything and the worst case scenarios and I'm dreaming. You don't sleep. I don't think Tenley really slept that week, to be honest, just stressed about where.

Dr. Chan: The big reveal.

Zach: Back to that whole pro-cons list. We came to Utah, obviously. We had Utah on our list. So you have your pro-cons, like do you stay, do you go. If we stay in Utah . . .

Dr. Chan: I assume you guys interviewed here.

Zach: Yeah.

Dr. Chan: Even if you're not interested, it's always good kind of politically just to interview at your home program. It's also a good backup option, because everything starts falling through. I'm sure Tenley and you had many discussions about this.

Zach: How life is going to happen. This is a buildup. You've been waiting for four years to match day, to residency, the next chapter. You don't know where you're going to go. You don't know where life is going to happen. You're opening that book and you're starting the next page. So you get there, and it's just this . . . you try to be helpful and nice to everyone and just, "Hey, we're excited." There's an excitement. It's a great day. It's an awesome day.

Dr. Chan: Who's there?

Zach: For most people, they bring close family. It's one of those days that it's a celebration. For Tenley, it was her immediate family and some of my immediate family were there.

Dr. Chan: And your son running around?

Zach: And our son running around.

Dr. Chan: Eating all the treats.

Zach: Yes.

Dr. Chan: A lot of sugar.

Zach: Everyone's there. Everyone has their own family, and they're excited and people are in different circumstances. They're going for different programs. One person I talked to, they had a blind match. They had interviewed for two different directions. So they didn't know where they were going until they . . . So there's this overall excitement, and you get the letter . . . they go get the letter.

Dr. Chan: So they have a bunch of speeches. They cut the ribbon. What does Tenley do? Does she go up, open it on her own, or she drag the envelope back to you guys? So how did she do it?

Zach: So we were standing in the back of the room. So she went up. They call everyone up to go get your letters. She goes and gets hers. She comes back to us. We end up going down the hall and kind of having like our own little area.

Dr. Chan: I like that. That's a good idea.

Zach: Instead of everyone around.

Dr. Chan: Instead of being in the masses. It's more intimate, more private.

Zach: You're kind of all in your own little cliques anyway with your families.

Dr. Chan: You're in your little bubble.

Zach: Anyway, so she opened it. We were all watching her, and she read it.

Dr. Chan: Were you reading over her shoulder? Or were you just watching her face?

Zach: No, I wasn't. I was taking some pictures.

Dr. Chan: The camera guy, all right.

Zach: There were multiple people with cameras. She opened it and read and then announced that we were going out of state. The flood of emotions that you've been waiting for, for years, in our case five years of where you're going to go, flood of emotions that your life is changing and what the implications of that are. So it's a happy and a sad day for us. For me it was, because it was a happy day that we know where we're going. We had this next adventure, and I signed up for this, but also that you're going to leave family. Just like any change in your life, there's going to be changes. You leave family. You're going to leave close friends. You're going to leave your job. That's just kind of the circle of life. There are these emotions of happiness and change.

Dr. Chan: So it sounds like it was a rush of both positive and negative emotions.

Zach: Yeah.

Dr. Chan: Was that by everyone, or just by you?

Zach: I would say to an extent I think there's emotions from everyone, happiness depending on just how you look at it, I guess. Happiness where you're going. Talking to other people, they got into their number one program or where they wanted to go or what they felt best for their family, if that means they're moving or if they're staying. It's an emotional day. It's happiness. It goes back to that day of opening your letter that you got in medical school. You're accepted somewhere in the next chapter of your life, and you know where you're going. So it's an emotional day. So we congratulated each other, and then we went out to lunch with everyone, the family.

Dr. Chan: Zach, when I hear you, I listen to you, I get the sense there was a lot of surprise.

Zach: Yeah.

Dr. Chan: It was kind of a shock.

Zach: I think we in our mind had built up where we were going to go. I think maybe not together, but maybe in my mind, I had made plans of what my future was going to look like, and those plans didn't happen in the way in which I thought they were going to, which is in its own way a coincidence, you could say, but there's a book called "Consider the Butterflies" and it talks about coincidences that happen in your life. I truly believe that everything for whatever reason happens for a reason. For whatever reason, we are doing what I didn't project in my mind, but it's going to be awesome.

Dr. Chan: Yeah. That's kind of life.

Zach: Things don't happen exactly every day how you want them.

Dr. Chan: So when I did the match process, I was still single. I had ranked a program in Arizona as my top choice. We exchanged the little love letters, the emails, like "Oh yeah." They kept on assuring me like that vague, pseudo-romantic language that, "Oh, we're going to rank you very high." So again, I went into match day going, "Oh, I'm in Arizona. It's close to Utah. It'll be close to family. It'll be down there. There's like tons of single people running around Arizona." Then I open up my match envelope, and it said Washington freaking D.C. My parents were there, and they said I looked like my brain had just been blown apart. I didn't talk for like two minutes, because I was just processing this because it was such a dramatic shift.

I didn't know anyone in D.C. It's on the East Coast. It's like hours and hours away. It took me a long time. I remember very clearly I went to the Barnes & Noble in Sugarhouse, and I went and bought a map of D.C. This is kind of before Google Maps and that whole thing. I said, "Okay, where the hell am I going to live?" I had not thought about this very carefully. In the end, Zach, it was the time of my life. I met my wife out there. I have some close friends I still stay in touch today. But like in the moment, it just felt overwhelming. It's like, what's happening? What is this?

Zach: Yeah. I think you have to go into match day with an open mind of anywhere on your match list is where you could go. I think for us we had determined, in our minds, where we had matched. Where we ended up was not where we had determined in our minds we had matched. So I think that's what caused the shock or the surprise the most.

Dr. Chan: Does it feel better now today than it did a few weeks ago?

Zach: Yeah, for sure. That day might be shocking, but as things happen, I think you just realize that that's what you're supposed to do. We went out. So we matched . . .

Dr. Chan: Yeah, where'd you match? We didn't even say it yet.

Zach: We matched at the University of Minnesota.

Dr. Chan: Minneapolis, Twin Cities.

Zach: Minneapolis. So we went out there this last weekend.

Dr. Chan: Not a lot of snakes, it's too cold.

Zach: No, not a lot of snakes. We found a place. So I think once those cards start to fall I guess or the dominoes start to fall of what you need to do to then get to that match day. After the match, there's the waiting game until you get your information from the school. That's life. I think you just jump on it and you just go with it. That's just where it's going to be. You can't change it. So you just go with it and enjoy it, and it's going to be a new experience. In the big picture, it's just the length of your residency. It can just be the length of your residency. You could move back. I just feel like you can go and create memories and have a good time. I've talked to other people and they say, "You know, when I was in residency," just like you mentioned, "it was a great time." They made the most of it. So I think that's a great opportunity to go make the most of it and see a new city and meet new people.

Dr. Chan: Zach, kind of like the Tao of me, the Tao of Dr. Chan, our lives are like 5,000-chapter books. We're only on like Chapter 257. There's so many more chapters to write. I totally understand. I totally feel what you're saying, but I can promise you, in a few years, it's going to be so awesome, because Tenley is going to be done with all this medical education stuff, and then you can start entertaining offers to be the attending physician wherever you want to be in this country.

One of the blessings and curses of our medical education system is that yeah, like you go to med school where you get in. You have to go through this match process. But there is so much freedom and autonomy at the backend, it's going to be beautiful. She can work as much as she wants. She can determine her own hours. She can work anywhere she wants to in this country.

Zach: Yeah and it's going to be great.

Dr. Chan: And you can always come back to Utah. Well, I ended up back in Utah.

Zach: I think that's just the next chapter. Right now, my chapter is just getting us moved to Minneapolis and that process. I think once you get to that process, it's about being supportive of your spouse, because depending on how they set up their fourth year depends on how much freedom and time they have to work towards the logistics of moving and the paperwork that needs to be done. You've just got to be there to be supportive in that situation. Tenley is starting up another rotation here soon, and so we'll go back to that life of I'll see her a couple days a week.

You have to understand too, during medical school, there's going to be some weeks that you might see each other two hours a week, especially if you're working. So for me, I left to work and by the time I got home, she had left to her overnight rotation, and the next morning, I might have seen her for 10 minutes by the time she got home before I had to leave. So just knowing that you love each other and that you're there to support each other in any way and if it's a small note, a token of appreciation, making their favorite meal, just anything to let each other know -- this is for the medical student and for their spouse -- to know each other and that you appreciate each other and that you're there for each other and that you're in it together is kind of my overall thought of how to be supportive throughout the whole process.

Dr. Chan: Zach, first of all, I want to thank you for coming on the podcast. I love talking to you. I love getting to know you. I'm also just very appreciative of you and Tenley. It's sounds like it's been a beautiful journey. It's been hard at times, but I'm just so excited for you guys, because it's a beautiful next chapter of your lives. I've been to Minnesota many times. There's tons of great stuff to do. It's a great place to raise kids. I can totally see you and Tenley ending up back in Utah down the road. Then you can become a Viking fan. In Salt Lake City, you can wear the purple.

Zach: It's going to be great. Yeah, it's just the next chapter. It's going to be fun to write, and we'll see where it goes and just be open and just try to be positive all the time. Like you said, it's not always going to be great days. There are bad days and there are hard days and there's hard weeks and hard months and hard rotations. Just being there to be a shoulder to cry on or a shoulder to be supportive in any way you can. Support means different things for different people, but however you support each other, just be there to support.

Dr. Chan: All right. Well, thank you so much, Zach.

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.