PMY 196 : 2 Applications, an MBA and More. This Doc is Outside the Box

Session 196

In this episode, Ryan talks with Dr. Nii Darko, an amazing surgeon and podcaster. His podcast Docs Outside the Box, featuring “ordinary doctors extraordinary things.” Nii uses his show as a way to rekindle his love of medicine.

Today, Ryan and Nii talk about his medical school journey, his greatest influencer to become a physician, his MCAT experience, the importance of reaching out to people, and what needs to be done to increase the number of minorities in medical school.

Here are the highlights of the conversation with Nii:

Nii's journey of becoming a physician:

  • Growing up in Queens, New York and being always interested in medicine
  • No prior exposure to the medical world except for The Cosby Show as his only window (Bill Cosby actually played the part of an obstetrician)
  • Nii's aha! moment: Shadowing a trauma surgeon and witnessing an organized chaos as they treated a patient with multiple gunshot wounds

Bill's memories of The Cosby Show and wanting to be a physician:

  • Growing up in the projects and a two-parent household
  • Growing up poor but having a stable household environment
  • Latching on the the TV show personality of what a physician is
  • Never had any feeling of inferiority but knowing that he just had to work harder

Nii's medical school journey:

  • Thinking that doing well in school will get you to medical school
  • Running track in college and everything was in periphery including academics
  • Being an OK student and not reaching out to his premed advisors
  • Not applying to a broad range of schools and just doing it on his own
  • Applying the first time and getting wait-listed, and getting rejected

His next steps to figure out why he got rejected:

  • Going through the mourning process for being rejected
  • Having no “plan B”
  • Stepping back and deciding to be more strategic on things
  • Working at the Sports Authority selling sneakers
  • Getting invited to become a graduate assistant to help coach the track team and in return get a portion of his school tuition paid for
  • Knowing his MCAT score and his application had to get better

Not doing well in the MCAT the first time:

  • Nii got a 21
  • Not studying for the MCAT because he was scared and was naive to what the MCAT actually was
  • Not understanding the concept of doing practice tests

Seeing the importance of reaching out to people:

  • You cannot be an island.
  • Find people who are doing the same thing as you.
  • Try to find support groups and forums.
  • Dealing with his ego the he didn't need any help (to the point of even throwing a postbac program letter away)

How to get more minorities to be interested in being premed students:

  • Pipeline programs from multiple sources
  • The need for more grassroot approaches
  • Physicians, lawmakers, teachers going back to reach and getting involved
  • Not just a “physician” issue but a public health issue
  • An issue on cultural competence that needs to be addressed
  • Increasing the amount of medical schools to increase the amount of seats available to minority students

Factors affecting the low number of minorities in medical school:

  • Price tag of education
  • Lack of role models and opportunity pipeline programs
  • Delayed gratification is discouraging

The impetus behind Docs Outside the Box:

  • Nii's entire life as a delayed gratification
  • Interest in computers, running, and connecting with people fell by the wayside in order to become a physician
  • At his happiest times when he's involved in doing different things
  • There is so much more to him than being a physician
  • Learning about stories of so many ordinary doctors doing extraordinary things

Some pieces of advice for premed students:

Take a deep breath. Relax. Dream what it's like to be on the other end but really understand why. It's tough to get in but you can always re-apply.

Think strategically. No man is an island. Reach out to other people. It's a team approach and cooperative. Read books on the best way to become the best applicant.

Links and Other Resources:

Nii's podcast, Docs Outside the Box

Nii's blog, Keeping Up with the Darkos

Join the AMSA Premed Fest on October 1-2, 2016 in Tampa, Florida and get the chance to hang out with other premed students, medical student, and doctors and learn about the reality of what becoming a physician looks like. Learn about emerging issues like physician-assisted suicide, how to ace your interview, and participate in suturing clinics. Every activity is focused on helping you get into medical school. Use this Coupon Code: MSHQ17  and get a discounted registration cost of $49 for AMSA members and $69 for non-AMSA members.

Take this opportunity to meet and greet Dr. Ryan Gray at the event. He will be one of the speakers specifically talking about how to ace your medical school interview.

www.mededmedia.com

www.medschoolinterviewbook.com

Transcript

Introduction

Dr. Ryan Gray: The Premed Years, session number 196.

Hello and welcome to the two-time Academy Award nominated podcast, The Premed Years, where we believe that collaboration, not competition, is key to your premed success. I am your host Dr. Ryan Gray, and in this podcast we share with you stories, encouragement, and information that you need to know to help guide you on your path to becoming a physician.

Before I jump into our awesome guest this week, I want to let you know about a great opportunity for you to be a part of, and that is AMSA's Premed Fest which is happening October 1st and 2nd in Tampa, Florida. Now Premed Fest, you come and hang out with other premed students, medical students, and doctors, and learn about the reality of what becoming a physician actually looks like. You can learn about emerging issues like physician assistant suicide, get insight on how to ace your interview, and participate in suturing clinics. Every activity is focused on helping you get into medical school. Now they mentioned how you can learn about acing your interview; guess who's going to be there talking about acing your interview? That's right, I will be speaking at AMSA's Premed Fest October 1st and 2nd 2016. I think I'm only speaking one of the days, I know I'm only speaking one of the days, but the conference is the 1st and the 2nd. And you can save some money by using the coupon code MSHQ17 and you get a discounted registration cost of $49 for AMSA members, and $69 for non-AMSA members. So I really hope to see you in Tampa, Florida October 1st and 2nd. If you go there and you listen to this podcast, come say hi to me and introduce yourself because I would love to meet you. Again October 1st through 2nd in Tampa, Florida, AMSA's Premed Fest. Go to www.AMSAPremedFest.org. That's all one word, www.AMSAPremedFest.org to register. Again the coupon code MSHQ17.

So this week I'm talking to an amazing surgeon physician who is doing some great things, kind of like what I started doing several years ago with a website and a podcast, talking about some interesting things around medicine. Now this physician is using what he's doing to rekindle his love of medicine, and he's going to talk about that, about how what he's doing has given him some more motivation, some more inspiration to hopefully avoid burnout, and he's talking to awesome physicians and what they're doing outside of work, related to work sometimes as well. Let's go ahead and say hi to Dr. Nii Darko.

Nii, welcome to The Premed Years, how are you doing?

Dr. Nii Darko: I'm doing great, thanks for having me on the show man, I'm excited to be here.

Dr. Ryan Gray: I'm excited for you to be here. I'm excited to listen to your story again. We talked offline about it a while ago and now we get to record it, and so I'm just excited. I want to start with your background, and when you initially decided you wanted to be a physician.

Meeting Dr. Nii Darko

Dr. Nii Darko: Well you know, probably ten years ago, or maybe even five years ago the story would be really funny, but now it has a little bit of an eerie kind of taste or thought process to it. So I grew up in New York City, I grew up in Queens, New York and then afterwards moved to Newark, New Jersey. But for me, nobody in my family was in the medical field. My mother actually was a nursing assistant but nobody else in my family was in the medical field. And growing up I remember just kind of seeing what I saw on TV, and kind of trying to aspire to be whatever was something that kind of resonated with me. So if it was- you know I was growing up in New York City and during the eighties I liked Darryl Strawberry, and I liked anybody from the Mets. So if it was someone on music videos, I liked someone from music videos. But most importantly my most favorite TV show during that time actually was The Cosby Show. So you can see where this is going.

Dr. Ryan Gray: Yeah. The Cosby Show is the butt of the joke nowadays.

Dr. Nii Darko: Exactly, exactly. So the thing that fascinated me was I was always interested in medicine, I was always interested in the lifestyle of a doctor at that time, but I didn't know what really a doctor did, what he- what the daily lifestyle was for a doctor. So my only window into that was The Cosby Show. And for me, beautiful wife, kids, lived in Brooklyn, nice lifestyle, funny, affable type of personality. I mean what else is there really to want other than that and what he has in his life.

Dr. Ryan Gray: So remind me, because I used to watch Cosby, was he a doctor in the show?

Dr. Nii Darko: Yeah he was an OB-GYN doc.

Dr. Ryan Gray: I did not remember that.

Dr. Nii Darko: Yeah he delivered babies.

Dr. Ryan Gray: Okay.

Dr. Nii Darko: Yeah so that was my first experience with physicians, and then obviously from then, obviously I had pediatricians and so forth. But that was the lifestyle that I kind of put on a pedestal in my life, and that was the first experience, and then from there kind of I just had multiple experiences where I said, ‘You know what? This is what I really want to do.' And another big experience for me was when I was seventeen years old, by then we had moved from Queens, New York to a town outside of Newark, New Jersey, and I had an experience where I got to shadow a trauma surgeon. And literally my parents dropped me off in front of the hospital, they talked to the trauma surgeon who was going to watch me for- or let me shadow him for a couple hours, and literally as soon as they left a guy got shot multiple times, and I literally got whisked into the ER, they put me in the corner, and it was just like this chaos. But obviously to them it's organized chaos; people are going crazy, and this guy is screaming because he's in pain, and people are being directed to go here, there, all these different areas. But the person who was the coolest, the person who was in charge was the physician I was watching. And you know he's just telling people to do this, telling people to do that, and it's literally like almost like he's like a maestro, like it's a concert. You know and people are- to me it's like chaos. And then just like that, boom, he makes a decision to go to the operating room. Obviously at that time and at that age I wasn't allowed to go. I waited a couple hours and I come back and he's hugging the family, letting them know that their son is okay, and I didn't really understand all the specifics of what was going on, but I just kind of fell in love with medicine then. I fell in love with being a trauma surgeon at that very moment. I knew that that's what I wanted to do, and I guess the rest is history.

Dr. Ryan Gray: So rewind a little bit, and tell us how you go from watching a TV show- and it's funny that you mention the TV show as the spark of this because we always joke that you shouldn't want to be a physician because you like watching Grey's Anatomy, for you it was watching Cosby.

Dr. Nii Darko: Absolutely not, yeah.

Minorities in Medicine

Dr. Ryan Gray: How do you go from watching The Cosby Show- and actually rewind a little bit before that. Being a minority yourself, what was it about watching another minority man be a physician? Were there dynamics in your life, or things in your life where you maybe were told that you couldn't be a physician, but you were watching one on TV? Talk about that a little bit, because I know there are a lot of minorities that listen to this show that would love to hear some of those dynamics.

Dr. Nii Darko: For me it was a little bit different. I grew up in Queens, New York. Where I grew up was literally the projects, LeFrak City, but I grew up in a two parent household. My parents are from Ghana, West Africa, and I grew up in a household where my mother was there and where my father was there. And we grew up in a situation where we- looking back obviously we were poor, we were low income, but it didn't feel that way. Education was stressed very much in the household. I wasn't going to- there just really wasn't that option to fail, there really wasn't that option to not succeed. And although there was chaos outside of the apartment complex where we lived, it was a very stable environment in the house. I was kind of protected from that. And then when I went out I had three older sisters, and we were very close, and they watched over me. So I never really had that sense that I really couldn't accomplish something. I think sometimes in a situation like The Cosby Show, or in a situation of a physician when there's nobody really to kind of be as a role model, you kind of just latch onto whatever you see, and for me I latched onto the TV show of- the TV show personality, the TV show persona of what a physician is, and that was The Cosby Show. And obviously that's a big [Inaudible 00:09:29] compared to what my life is like right now, or what an obstetrician's life is right now. But for me that was what I grabbed onto. But to be honest with you, I never really had that feeling that I couldn't do this, or I couldn't do that, because in my household it was really reinforced that look, there are going to be people who judge you based off of your looks, and judge you based off of your color, but at the same time the greatest equalizer is education. You're going to have to work ten times harder- I got all of those different things. You're going to have to work ten times harder, you're going to have to do this, but that was set so early in my life, that was the norm. So I never had that feeling of inferiority, I just had that feeling that I just had to work harder.

Dr. Ryan Gray: That's awesome. So take those next steps. You go from watching a TV show, to shadowing in this emergency department, watching this gunshot wound patient come in, and be whisked away by the trauma surgeon. How did you know what those steps should be for you to start getting that exposure, and taking those steps to ultimately apply to medical school?

Starting Journey into Medicine

Dr. Nii Darko: That's a good one. I didn't know the steps. So I am the story of what you should not want to do to get into medical school. That's the reason why for me, I always give back to medical students, I always- or excuse me, premed students. I try to talk to as many college students as possible and let them know that I'm the cautionary tale of what you really should not do when you get in. So for me, I just thought that you did well in school, and if you did well in school then you would get into medical school. That's it.

Dr. Ryan Gray: Right? That's easy.

Dr. Nii Darko: That's easy. So what I mean by that is you just do well in school and then you figure it out as you go, if you know what I mean. So in college I ran track in college, I ran- I was a mid-distance runner, so for me obviously that was my world, right? And then everything else kind of was in the periphery, including academics. I was an okay student, but I just knew that everything kind of revolved around practice time, everything revolved around my track meets, and as a result I think I could have done better if I had focused more on my academics. But you know, I was an average student. I didn't reach out to my premed advisors as much as I should have, I think looking back. You know obviously there was a bunch of information that was given out, and when I went and spoke to my premed advisor, obviously the things that I was told was there are two types of med students. There's the med student who's going to get in, and there's the med student who's not going to get in. So I never thought that there was like a middle ground. The med student that got in is the one that's going to apply to Georgetown, Harvard, Yale; all the top notch schools. And then the one that applies- and then the other ones are the ones that don't get in, if you know what I mean. So there was no middle ground. So for me when I was applying, or when I was getting my experiences, my experiences were always, ‘Well I'll end up going to one of those schools,' which was a big mistake for me. So when I applied, I applied to all of those schools. I never applied to any middle of the range or- when you're applying to medical school there really isn't any safety schools.

Dr. Ryan Gray: Yeah but according to premed students and certain three letter forum websites out there, there are the top tier, and the mid-tier, and the lower tier.

Dr. Nii Darko: Absolutely. So I did not apply to any of those schools just because that's not what my classmates or my counterparts did. And so I basically did not reach out for help much, I did not commiserate with other people, I just kind of did it on my own and just kind of did it the way how I thought it was supposed to go. And unfortunately I applied the first time and I got waitlisted at a couple of schools, and I got rejected ultimately, and that was a huge letdown for me. Big letdown for me.

Dr. Ryan Gray: At what- how many schools did you end up applying to that first time if you remember?

Dr. Nii Darko: I applied to about fourteen or fifteen medical schools, very expensive, I did everything out of pocket. I didn't know anything about fee waivers. I asked my parents if I could borrow some money to go on some of the flights for some interviews that were away from where I was, if it was a long trip from where I was in college. Everything was just out of pocket, and I just put so much effort into it, when I didn't get in it was completely devastating.

Dr. Ryan Gray: Yeah, I bet. And same for me obviously, applying the first time not getting in. What were those next steps that you took to figure out why you didn't ultimately get accepted?

Dr. Nii Darko: So I went through a couple of processes. The first one was I started to mourn. Like I really, really started to- well I mean ultimately I put my self-worth- I equated my self-worth with getting into medical school, so you can kind of guess how that went. If I didn't get into medical school then what was the point of me going through all these four years of- or three and a half years at that time of college.

Dr. Ryan Gray: There was no plan B for you?

Dr. Nii Darko: There was no plan B for me.

Dr. Ryan Gray: Good.

Dr. Nii Darko: You know I was studying biology, and I didn't know that you can do other majors because everybody did biology, or chemistry, or some type of science and then that's what they'd use to get into medical school. I understood that you needed prerequisites, but I thought well okay, if I don't get in then obviously I'm going to have to re-apply, and if I don't re-apply then maybe I'll become like a biology teacher or some type of biology researcher, something that I obviously didn't have much of a passion for. So that actually- that thought process made things very scary for me because I had no idea- I didn't do any research into understanding what it's like to do research, or to do some type of PhD bench work or anything like that. So after I mourned about things, and after I started to really reassess what I was doing, and who I was, and what this meant, somehow, some way I just kind of took a step back and said, ‘Look I need to be more strategic about things.' And the first thing I did is I graduated from college, that summer I actually worked at a company called the Sports Authority; I don't know if you ever heard of that.

Second Application Process

Dr. Ryan Gray: Oh yeah.

Dr. Nii Darko: Yeah I worked at the Sports Authority for a summer, and my coach had reached out to me and he asked me, he's like, “What are you doing right now?” “I don't know. I'm working at Sports Authority, I'll figure it out.” It's like working at the Gap I guess.

Dr. Ryan Gray: Yeah.

Dr. Nii Darko: You know I got this biology degree and I'm working at the Sports Authority selling sneakers and getting discounts on Jordans. And I said, “Well you know, I'm not really doing much.” He said, “Look why don't you consider coming back? We need someone to be a graduate assistant.” I said, “What's a graduate assistant?” He was like, “Well you can come and help us coach the track team, and the cross country team, and then in return you can get a portion of your tuition paid for if you want to continue some of your studies towards getting into medical school.” “What? Really? Get out of here.” So I thought about it for about fifteen minutes, called him back and said, “Yes I'm in.” I said, “Yes I'm in.” Because look, what else was I going to do? It's either continue working at the Sports Authority and work my way up to become manager, and then I become part of the process. Right? Next you know five years down the road I'm still working here, or I try to go back and try to get my grades better, or take the MCAT and do better on that. Because I knew at that point the biggest thing for me was my MCAT score. My grades were actually pretty solid, it was just that I knew that the MCAT score needed to get better, and then my strategy to applying to medical school needed to get better also. So that's where I was, and I decided to go back and become a graduate assistant.

Dr. Ryan Gray: Do you remember what you got on the MCAT?

Dr. Nii Darko: On the MCAT I got a 21.

Dr. Ryan Gray: Okay, yeah so not doing you much service there.

Dr. Nii Darko: Oh yeah, didn't study for it either.

Dr. Ryan Gray: Talk about that. Why did you not study for it?

Dr. Nii Darko: I was scared.

Dr. Ryan Gray: Was it scared, or was it just being naive to what it actually was?

Dr. Nii Darko: Both.

Dr. Ryan Gray: Yeah.

Learning to Study for the MCAT

Dr. Nii Darko: You know, so here's the thing. I took Kaplan, right? And at that point I didn't know what studying really meant. Like to me in college, studying was you go to school, you do the homework assignments, and then when the midterm comes you study the night before that. But that's how I studied. And I was doing okay that way, but I didn't understand the concept of a Q bank, and understanding that you need to do questions over, and over, and over, and over again. I didn't understand the concept of training your brain to take this test. It's just like how I'm training for a big event at the end of the year, I'm going to have to go through this process of going through track meet one in the beginning of the year, then going through practice at the end of that, then going through track meet number two, and then working my way to the point where I'm at this big championship event and I'm ready to go, and I'm going to be performing at peak performance, but before I got to that point I'm going to have to do all this work. I did not correlate that to taking the MCAT.

Dr. Ryan Gray: Yeah, it's interesting, I'm training for a half marathon right now, and I see the exact same correlation. Is somebody that goes out and runs a half marathon, or even a marathon, doesn't go out once a week or once a day, go run a mile each time, and then come half marathon run 13.1 miles just all of a sudden. It sounds like that's exactly what you did. You were like, ‘I'll just read a little bit here, read a little bit here, read a little bit here, and then take a big four hour test.'

Dr. Nii Darko: Absolutely, absolutely. And when I was taking it, it was still on paper.

Dr. Ryan Gray: Me too.

Dr. Nii Darko: One thing that I want to mention to you- I don't want to get off track, but one thing I do want to mention to you that I think is really fascinating, and one of the things that I want the premeds to know out there is the importance of reaching out to people and not being an island. Like that's what I was; I was an island, I didn't reach out, I had a big ego, I didn't talk with other people. It's important to find people who are doing the same thing as you, trying to find like support groups and forums. Because I'll tell you one thing that up until probably about five- maybe about ten years ago I felt pretty comfortable talking to people about, but I kept as a secret. So-

Dr. Ryan Gray: Let me ask you why. So you talked about your ego, but everybody knows that the premed world is super competitive. Was there a hint of that in there too, that you wanted to stay by yourself because you didn't want to help anybody else, or you didn't want to feel like they were going to cut you down?

Dr. Nii Darko: I never had that feeling. I've always wanted to help people, I just felt like nobody wanted to help me, and if I asked certain questions I just- I always had that feeling of, ‘Why are you asking a question? Obviously you're a dummy.' Like why would you ask that question? That type of feeling I had, so that's why I just kept things to myself.

Dr. Ryan Gray: Yeah.

Postbac Programs

Dr. Nii Darko: And in my mind that's kind of been my personality; to make it out of Queens, New York, to make it out of Newark, New Jersey you just had to be tough, you had to really focus on your grades, and I had to do the things that I had to do to succeed, and I was very successful at that. So the same thought process I carried with me in college, and it was very successful. I commiserated with people, I worked with people, but also at the same time there was- working with premed students, it's just a different animal I think. And what I was trying to get to is there was a couple of schools that I was put on the wait list, but there was one school that sent me some paperwork, and there was something that said post-baccalaureate, right? So a postbac program. You know what I did with that letter? I read that letter and I was like, ‘What is this postbac stuff?' And on that letter it said basically- and I didn't read too much in depth, but basically what it said was, ‘We apologize that you can't get into school, and we're sorry about that,' blah, blah, blah, blah, ‘but there's this great program that you can do. You can do X, Y, Z, and if you do it for a year-‘

Dr. Ryan Gray: Guaranteed admission.

Dr. Nii Darko: What did I do with that paper?

Dr. Ryan Gray: You threw it out.

Dr. Nii Darko: Threw it out. And I kept that as a secret because I didn't realize the importance of that until like a year later, and then once I got into medical school two years later I started meeting this person, that person, this person, that person. Same age as me, took two years off, some people took five years off, some people took ten years off. “Yeah I got in through this postbac program.” “Wait, what?” “Yeah I did this postbac program, they guaranteed me admission.” “Oh, that was for real?” So it became a moment of just kind of like disgust to embarrassment, and I just kept it as a secret for a long period of time, but if I had talked to other people about it that, if I had gone to someone and said, “Hey listen, I got this paper. Like what does this mean? Explain this postbac program to me. What can I do with this?” I would have started my journey a lot earlier, or a lot sooner. But you know ultimately the way how I look at things is things happen for a reason, and the reason that I'm here is just the way how the sequence of events kind of happened. You know, and who's to say if I had started medical school earlier that I would not have been as hungry, I would not have met the people that I've met in my life that kind of put me on the trajectory that I'm at right now. So I look back and I kind of- I'm like I can't believe I threw that paper away, but also at the same time it's just serendipity almost, it's just the way how it is, you know? But that's something I wanted to kind of relay to your audience members, that we all go through things, and we have things that we are kind of embarrassed about, or things that we look back on like, ‘What was I thinking?' And we're not all perfect, we all mistakes, but you can still come through things.

Dr. Ryan Gray: That's awesome. Now Nii I want to take a little twist into a more serious topic and talk about diversity in medicine, diversity with physicians. Our physician population doesn't look anything like what our population in the US looks like, and obviously being a man of color like you are, you're one of the minority physicians out there. How do we get more minority premed students, or more minorities to be interested in being a premed student I guess to begin with, and get them into medical school?

Diversity among Physicians

Dr. Nii Darko: Yeah it's a problem, particularly even worse for African American males actually. So yes, I do feel- I definitely have the perception or the feeling of being a minority at every hospital that I go at, that I work at. I think the biggest thing that we can do obviously is the pipeline programs, and it has to be from multiple sources. I think we go back and we look at, what was it from the AAMC, Project 3,000 by 2000 I believe, which was they were trying to get 3,000 minority members or minority students into medical school by the year 2000 which was a big failure. That was a top-down approach, I think we need more grassroots approaches and these pipeline programs that are feeding people from high school to college, and obviously through into medical school and so forth. I think that's the best way to approach this, but it's got to be multi-faceted. It's got to be physicians who are coming back to reach, it's got to be lawmakers, it's got to be teachers who are getting involved because it's not just a physician issue, it's really a public health issue. Because as you know, and as I know, patients really identify with their physician if their physician really identifies with them. And that's not just a color thing, but just if they can really identify with them, it's just basically cultural competence. So if I never grew up in a rural type of experience, then I really won't understand some of the things, or some of the obstacles that my patients who grew up in a rural area will have to go through. Another example would be if I'm a physician and I grew up in a rural area, if I go and I work in inner city New York City, or inner city Los Angeles, there's just certain things that I won't be able to understand and my patients won't be able to have that type of interaction. And I'm not saying that this is 100% the case, but the majority of the time that's the issue, is just cultural competence. So it's a very difficult issue, it's a very tough issue. I think another big answer would be obviously to increase the amount of medical schools. Obviously if you're increasing the amount of medical schools, you're increasing the amount of seats that are available to minority students. But it's a very nuanced answer I think, that we're going to have to find to increase the amount of minorities in medical school. And the big thing that I fear is more importantly the amount of minority males, particularly black males, and the lack of them in medical school. And I think actually based off of the numbers, I think the numbers show that each year the numbers get worse for African American males, which is pretty scary actually.

Dr. Ryan Gray: Yeah. Talk about it from a financial point of view. Obviously in your situation I think is the perfect example, growing up in the projects, being a lower socio-economic family, and then looking at that price tag of what medical school costs. I think- and this is just my own kind of anecdotal evidence, is that I think the price tag alone scares a lot of minorities away because they think, ‘There's no way I could possibly pay all that back. My family lives off of $30,000 a year, how am I going to pay back $300,000?' Talk about that.

Dr. Nii Darko: Well I think that's part of the- I think that's a part of the picture. I think one of the bigger things obviously too, is not having as many let's just say role models who are doing that in these areas, in these neighborhoods. Whether it's a suburban area, or whether it's an inner city area, if you don't see anybody who looks like you doing that job, it's very hard to envision yourself doing that job. I think one of the bigger things also is the amount of delayed gratification that's needed to get to that point too can turn a lot of people off also. We're talking about thirteen, fifteen, sometimes even seventeen years of training from high school onwards to get to that point. And I think also, I think a smaller perspective would be the amount of education- or the price tag of education to reach the end goal. So for me for example, I write about this not on my website, but me and my wife have a blog that we write called ‘Keeping Up with the Darkos' where we talk about our issues with student loans. And we don't have a negative look on loans, we just have this is what we have to do to get our loans paid off. Like we have loans that are from college, and then obviously we have loans that the majority of it is from medical school as well as from our MBAs. And it's just one of those things that you just need, that we needed to get to a point of where we're at. And yet they were useful, we needed them, if we didn't have the loans we wouldn't have been able to get to this point. So we take a different perspective on that, and that's how I feel about it. And I think for the most part, I think most people- it's expensive but I think it's kind of one of those things that's on the periphery. I think the biggest thing is just the lack of role models, the lack of opportunity, pipeline programs; those are bigger things I think in terms of minority enrollment into medical schools.

Dr. Ryan Gray: Okay. Reset your mic for me, it just started at the last minute getting a little fuzzy.

Dr. Nii Darko: How are we doing now?

Dr. Ryan Gray: Perfect. Alright so I think what you're trying to say is somebody needs to reboot The Cosby Show to get another black doctor role model on TV.

Dr. Nii Darko: That would help.

Dr. Ryan Gray: It worked for you so it's got to work for somebody else.

Dr. Nii Darko: Right, absolutely. You know it's just- you know I think it's an interesting time now. I think the more diverse TV is, I think the more diverse we are in society, I think the more inclusive we are. I think that's just- I think those two things are inherent, right? The more you grow up with people that look like you. I mean we have in the Olympics you have the first fencer who is wearing a hijab. You know? When I was growing up in the high school that I went to, the high school I went to was a very diverse high school in Newark, New Jersey, and some of the best sports that we were good at were sports that I guess traditionally minority students didn't do well in. Like my school that I go to has the best soccer program- high school soccer program in the country. We also at one point had the best fencing program in the country. So seeing fencers who are African American or Hispanic, for me it's just common knowledge. Or seeing soccer players who are amazing and they just happen to be African American or Hispanic or what have you, it's just common to me. I think it's the more we have diverse experiences, I think the more inclusive we are, I think it just becomes part of the lexicon. It becomes so normal that everybody's included.

Docs Outside the Box

Dr. Ryan Gray: That's awesome. Nii, talk about your podcast, your website Doctors Outside the Box. What was the impetus for starting that?

Dr. Nii Darko: So the impetus for Docs Outside the Box is- so I went through college, that was four years, then I did two years off, and I did graduate assistantship, that was another two years. Then I went and I did medical school for four years. Then I did residency- general surgery residency for five years. Then I did a trauma fellowship in Miami for one year. So basically my entire life has been delayed gratification, delaying and sacrificing everything that I want to do, everything that I really want for this one single purpose. And during that time I had an interest- I'm a nerd, I'm not going to lie. I had an interest in computers, I had an interest in running, I've had an interest in just connecting with people, I just love talking to people; and all of those things fell by the wayside just in order for me to become this- the person that you know as Dr. Nii Darko. And at the end of training I found a job, and then for me it's just like okay, so what's next? What happens now? What do I do now? Every four years, or every five years I'm always packing my bags and going to the next thing, or my mind is thinking forward towards the next hurdle. Well I didn't have that anymore. And I started to realize that I was at my happiest times when I was involved in multiple things. So for example in medical school, I was involved in the Student National Medical Association which is the minority equivalent of the American Medical Student Association, AMSA. And when I was doing things from a national board of director’s standpoint, I had a lot of fun doing those things. I felt engaged in things. And now I'm just a doctor, and that's all I was doing, and I'm treating patients on a daily basis, it's great, but there's just so much more to me. And when I finished my fellowship I did Locum Tenens which is basically temp work. You go to different hospitals, you work as a temp person, and you go and you try out the hospital, and they try you out, and then you decide if you want to work there. But there's a circuit of places that you go to, and there's a circuit of doctors that you'll just run through, and I happen to meet multiple physicians, surgeons who were just doing extraordinary things that you would never, ever think that they were doing crazy things. Like I met people who were in Doctors Without Borders, and they would just come back from Liberia and they said that, “Hey look, I just do this to kind of just pay for when I go back to Liberia, and what I make here will help me kind of stay in Liberia, or stay in West Africa, or stay in this [Inaudible 00:34:45] environment for the next six months.” This other person is a consultant for some TV show on CBS. This person is a blogger. There's another person who's starting- and I'm like, wait, wait. I never heard any of these stories when I was in medical school. I never heard any of these stories when I was in college. And maybe I would have changed direction, maybe I would have done things a little bit differently if I had heard these stories a lot sooner, and that's when the idea for Docs Outside the Box came out. And I said look, if I take my experience of basically all the things that I wanted to do that fell by the wayside, combine that with all of these stories that are out there of these people doing extraordinary things, and they're just ordinary doctors. They're doing extraordinary things though, that's the tagline, I decided to just start interviewing people. And I started off with the people that I knew, the closest people to me, and it kind of just exploded from there. And people were just like, ‘Hey man, I want more of these stories.' And I'm like, ‘Okay sure, great, yeah. I know this person, I know that person, let me interview them.' And the reception that I've gotten so far has been amazing. It's been rejuvenating to me, not just from a personal side, but also from a practice standpoint also. It's kind of helped rejuvenate my career a little bit. Right now I'm about three years out, four years out, and it's helped to kind of just change my perspective on how I practice, and helped me to kind of understand that I need to have a more balanced approach to how I do my job. And you know, my family is very important, my family is my number one priority, my work is my number one priority, but having all of that stuff in balance is just very important. So Docs Outside the Box basically is a podcast where I interview ordinary doctors who are doing extraordinary things. And right now I'm waiting to find out when I can get you on the show because you're doing extraordinary things. I think what you're doing is amazing, I think the premeds that are your- that's your audience, they're much better for what you're doing out there, so I'd love to have you on the show. But it's really a passion project for me right now, so I hope sometime your listeners get a chance to take a listen.

Dr. Ryan Gray: Yeah, Docs Outside the Box. Whatever app you're using to listen to this right now, go subscribe to Docs Outside the Box. That's an easy one.

Dr. Nii Darko: Yeah we're on Google Play- and that's another thing. Like I keep saying ‘we,' like it's literally just me. It's just me.

Dr. Ryan Gray: Well you and your guests.

Dr. Nii Darko: Yeah me and my guests, we're on Google Play, we're on Stitcher Radio, we're also on iTunes. Take a listen.

Dr. Ryan Gray: All those good places. That's awesome. Nii, as we wrap up here, I'm sure there are more than a handful of young, African American or black males that are listening to this wondering if it's possible for them to fulfill their dreams of becoming a physician. What do you tell them and every premed student out there that's on the beginning of their journey?

Advice to Premed Students

Dr. Nii Darko: So I tell them all, my advice to all of them is to take a deep breath, relax. Dream what it's like to be on the other end, which is obviously becoming a physician, but really understand why. Get the ‘why.' Why do you want to be a physician? What's so important that you want to sacrifice X, Y and Z to get to this end product of having an MD degree, or having your DO degree? Really understand the ‘why.' And then also understand that if I can do it, anybody can do it, trust me. And then number one thing that you have to do, the number one way to make yourself a better premed, is to think strategically about it. Remember like Rome wasn't built in one day. It's going to take time for you to get to the point where you are applying to medical school, and making yourself the best person that you can be. So it's very important that you are strategic, you commiserate with people, you talk with other people, you read as much as possible, you read books on what's the best way to make yourself the strongest applicant that you can. And then also at the same time, not everybody gets in. Getting into medical school is one of the hardest things that you can do. Only less than 50% of applicants get into medical school?

Dr. Ryan Gray: Less than 40% these days.

Dr. Nii Darko: And that's okay. That's okay, it's tough to get in, but you can always reapply. So my overall advice to medical students- or excuse me, to premed students, is take a deep breath, you're going to get in but be strategic about things. Try to really embrace the ‘why' of why you want to get into medical school, and remember that no man is an island. If you try to do this by yourself, you are really setting yourself up for failure because ultimately you're not going to practice that way anyway. In medicine it's a team approach, it's cooperative, you work not only- it's not you telling your patients what to do, it's you in a coordinated fashion helping your patients to a point where they're in a better state of health. So doing it by yourself is just setting yourself up to a point where you're going to be shocked when you get into medicine and you realize that there's really no place for just barking down orders, or doing things your way. It really is a coordinated effort. So that's my advice, is remain positive.

Final Thoughts

Dr. Ryan Gray: Alright that was Dr. Nii Darko sharing his path and what he's doing with Docs Outside the Box. You can go check out his podcast, his website at www.DocsOTB.com. Again links to all of this will be in the show notes which you can get at www.MedicalSchoolHQ.net/196. Again, www.MedicalSchoolHQ.net/196. Go check out everything that Nii is doing, again Docs Outside the Box.

I want to take a second to thank malala13233 that left a review saying, ‘Never stop making these.' I don't know if I can promise never, but I don't have any plans in the near future to stop. So hopefully we live up to that hope. She said, or he said, ‘This helps me with not only school, but also life problems. I really love how you guys talk about everything else in life, and not stuff related just to medicine. It's really, really, really helpful!!!!' So three really's and four exclamation points, I think we're helping that person. So awesome, thank you for that review.

If you would like to leave a review and haven't yet, www.MedicalSchoolHQ.net/iTunes will take you right into iTunes where you can subscribe. And don't forget if you like this show but don't listen to the other ones that we do, you can go check out everything that we're doing over at www.MedEdMedia.com. That also includes the medical school interview book that is now out and available on Amazon. Go check it out, www.MedSchoolInterviewBook.com. It was a best seller for the first week it was out, it has sadly dropped into the number two spot in its categories, and so it's no longer labeled a best seller right at this minute. Hopefully we can get it back up to that number one spot soon.

I appreciate you joining me here again on The Premed Years Podcast. If there's anything I can do to help make your journey any easier, any better, please don't hesitate to reach out and ask. Ryan@medicalschoolhq.net. And in the meantime, I hope you continue listening here at the Medical School Headquarters and The Premed Years Podcast.

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