Ian is a 4th year medical student taking some time off to figure out what he wants to do with his life so he created a podcast to help him explore his specialty as well as help others with the same struggles.
He is doing great things over at The Undifferentiated Medical Student podcast, which is similar to the Specialty Stories podcast but it has a different format and with longer interviews. The reason he started it is because he was undecided about what he wanted to do on his path and where he wanted to match for a specialty. Today, we're diving into all of that.
[01:40] Not Knowing What Specialty to Choose
Ian basically didn't know which specialty to choose when he was halfway through his third year that's why he decided to take some time off to figure out what he wants to do with his life. As a result, he created a podcast about exploring medical specialty and choosing a career in medicine.
Prior to starting the podcast, specifically halfway through his third, which for most medical students, is a year where you're given the opportunity to explore all the specialties and make your choice. That's when Ian discovered that you don't really get an entire third year and it's not enough time to explore all the medical specialties out there. In fact, there are 120 specialties and subspecialties listed on the Careers in Medicine website (and this is not even an exhaustive list). Ian admits he definitely didn't see 120 specialties or subspecialties during his third year. Additionally, they don't even get to finish their third year before they have to make big decisions about their career, planning acting internships (AI), doing research, establishing relationships with big names in the field to help them with their application.
So he realized he wasn't even close to making a decision and the idea of planning an AI is a big investment. You have to be a good medical student to get those letters, to do what you needed to do, and to look good in the eyes of residencies. Ian was just not ready to commit to that. AI stands for an Acting Internship wherein fourth year students pretend to be PGY-1 interns. Other schools call them sub-I's (sub-internships)
[04:08] Playing Semi-Pro Hockey
Ian starts his story as a student athlete in college where he played hockey for four years. He was heavier on being an athlete than he was being a student. He was part of two national championships, winning one of them, and he was able to see phenomenal growth from such experience. While he was a neuroscience major and was premed, he definitely was not committed to going to medical school at that point. By the end of the four years he spent in college, he was not ready to stop playing hockey thinking he was just getting good at it so he wanted to keep playing. And so he did. He played two years of semi-pro hockey in Sweden for another couple of reasons. First is growth, having been able to dedicate himself completely to his sport. Second, playing hockey in Sweden means you have access to the rest of Europe. He had a team that spent for his housing, food, equipment so the salary he was getting he used for traveling to a handful of countries across Europe.
Towards the end of his second year playing in Sweden, he felt he was maxing out as a hockey player and he got as good as he was ever going to get. And just suddenly, he felt he was ready to let go of the game. It was awesome considering it was on his own terms. It was also in this moment that he wanted more from life and wanted to think about his future. For Ian, hockey was not a direction he would have found satisfying. So he frankly talked to himself about what he really wanted to do until he realized he wanted lifelong learning, lifelong growth, more responsibility, and making contribution.
[08:45] Ian's Thought Process in Wanting to Become a Physician
Born to a father who's a physician and a mother who's a nurse, never was there a point that they ever suggested that he should choose medicine but he saw how satisfying his father's career was. Ian explains that picking neuroscience as a major in college was somewhat accidental. He hasn't picked a major as a Junior and looking at your credits, he realized he was just two credits away from being a neuroscience major. Not being able to finish all of the premed requirements, he was keeping the option open rather than actively pursuing a career in medicine.
Although financial security was part of his thought process in getting into medicine, he found medical science as fascinating in terms of learning. He also considers contribution in medicine is on a personal level where you get to directly see the contribution you're making in many cases; alongside, is the opportunity to have very meaningful person-to-person interactions. One of the highly motivating reasons that he had for medicine were these relationships and not many other careers offers a mix of medical sciences plus personal interaction. As opposed to being a dietitian for instance where you still get lifelong learning, Ian thinks physicians have an opportunity to really influence their environment. They get to make decisions and that excites him.
[13:28] Contribution to Patient Care and Forming Relationships
The funny thing is that Ian was having a very hard time putting his feelings into words. Although he can do it better now, he still isn't satisfied. That you like science and that you want to help people are valid reasons but it's a little bit trite as to be meaningless. When you're trying to make it sound novel and truly articulate your motivations as to why you're doing this or why you have the energy to suffer through studying for the MCAT, to go through your application process, to immediately start studying your pre-clinical studies, to start full-time studying for Step 1 and then do a third year, where is the motivation coming from?
Ian thinks this is a tough question to answer but I disagree with him. You have to realize what the answer is first and the answer should always be that contribution factor. The contribution to patient care is what drives you day in and day out every time you're interacting with another patient and making that impact is what keeps you going to suffer through your internship year or clinical rotations in medical school.
As far as relationship goes, Ian believes it's not merely a one-way street in connecting on a non superficial level with patients. They come to you and open up to you. That is a two-way street and that becomes a relationship. And relationships are so awesome when they're open and real. Part of contributing to patients is that you get something back in the form of relationship.
Moreover, considering the healthcare reform and policy changes we're going through now, this should not affect you decision to apply to medical school. If you're doing this for that patient care aspect and for those relationships, these will never change in healthcare. That relationship dynamics will never change.
[17:35] Postbac and MCAT Prep
Towards the end of Ian's second year in Sweden playing ice hockey was when he started to realize medicine was something he really wanted to do so he began shadowing with their team's physician who is an orthopedic surgeon. Towards the end of the season, he started studying for the MCAT (March 2011) and then took the MCAT a couple of months later for which he didn't do very well. While he started filling out his AMCAS application, he found himself in a crossroad between just taking the MCAT score as it is at 29 coupled with a semi-decent undergrad GPA of 3.07 and having to double down with a postbac program and try for something better. He took the latter path and enrolled in an independent postbac program through the Harvard University Extension School in Boston. Having access to his college's advising office, he didn't need the advising that comes along with a postbac program. Anyway, Ian started knocking off classes he needed where he took Intro Bio. He already took Organic Chemistry in the summer between his two seasons. So he started to slowly boost his GPA and really double down on the MCAT.
He basically started from square one. He got an Examkrackers study book and really loved it. He also got a study buddy in the form of Khan Academy where he started with all the first lessons for Bio, Physics, Chemistry, Organic Chemistry. By double down, Ian means going back to the very beginning, starting with the first principles and work forward with Examkrackers. Then he took the MCAT again and got a 36 (which means he was on the 95th percentile).
He also did well in his classes that helped with his GPA so by the time he applied, his GPA was 3.4 accumulative. Although he didn't go to Harvard University for college but only its extension school, he still thought Harvard's reputation helped in his application. He took organic chemistry was from a community college but it was fine (contrary to what other people are saying). Ian took the extra time and he couldn't be any happier for doing this.
Ian first took the MCAT in around June 2011 and matriculated to Case Western Reserve University School of Medicine in the Fall (July 2013) so that means dedicating another year and a half to get to where he wanted to go. But for Ian, it was worth every second of it especially considering that he almost hit submit when he filled out his AMCAS application for the first time with his 29 and 3.07. Luckily, he didn't.
[22:54] Interview and Personal Statement
Although Ian got to where he exactly he wanted to go and with a great MCAT score and a boosted GPA, he still only got four interviews out of the 25 schools that he applied to and he only got accepted at one place and off the waitlist.
As to why this was the turnout, Ian suspects he just didn't have a track record that demonstrated interest of working towards medical school or maybe in the way he presented himself on the interview.
Fundamentally, the fact that you like science and you want to help people are both good, but not for a medical school interview answer. Those ideas are wonderful ideals to have in mind, but your motivations to go to medical school and how you communicate them are very, very important and Ian thought he was perhaps lacking in articulation.
Helping him out with his personal statement were his dad and his roommate who were both willing to dedicate time and giving him honest feedback. Ian thought his personal statement was okay but he just didn't get the response he had hoped for.
Ian did not have a lot of clinical experience and being around patients and being in the hospitals because he was out playing hockey which was what he loves doing. And because of his less exposure and experience, he really didn't start formulating these thoughts in his mind about what specialties he may or may not like.
[26:23] His Thought Process to Choosing a Specialty
He was interested in a lot of different things and one of the common ways to decide what specialty you want to go into that people would suggest is to start eliminating but he was having trouble doing that. Admittedly, less clinical exposure before medical school has definitely contributed to that. But when he played hockey, he got a dislocated shoulder and then an orthopedic surgeon came along and fixed everything up that he was able to play again. Although it was not a light bulb moment for him, he considered doing Orthopedic Surgery knowing the direct impact such specialty can have on a patient's life. They hang out with athletes and which he is one so he had that thought process going in.
However, getting to third year, he again liked a lot of things so he was having trouble eliminating the majority of them. Then he was suddenly asked to schedule an AI but he just wasn't ready to do it.
In hindsight, the question he would have been asking himself back in first year was why he hadn't started to explore now. The problem was classes and tests were simply dominating first year life. He also didn't know where he could have gone when he was busy studying all the time. An alternative to that is getting halfway through your third day and you realize there are so much things you haven't explored yet. Ultimately, the answer is to reach out to somebody once a month and start the exploration process even if it hurts. He used to argue to himself that it was a good thing he was studying since Step 1 was 20 months away so it's okay to be studying now. However, this is not true since many people give the time they have in studying during the first two years then they get to their third year realizing what they do and they do just fine. Whereas only a minority find themselves lost. So how do you balance it? Ian thinks you have more time than you realize in the first two years to explore.
[29:46] Mentorship and Shadowing
Another problem Ian saw was the lack of mentorship, not because of the scarcity of people who can do it, but Ian finds mentor-mentee relationships as often hard to form considering they are an investment so they often don't happen. When a mentor talks to you and pushes you, it plants a seed. When you see it, feel it, and hear it, it makes it visceral and you get a better understanding of the talking points of what specialties are and what they'll mean in your future career and what your life will look like. It just makes things real versus reading it off a book.
As soon as you know that you might be interested in being a physician, start getting a diverse experience even as a college student or an undergrad. Ian recommends you stick with one physician and get a diverse experience. If you stick with that one physician, chances are, you'll be able to form that mentor-mentee relationship which can be so powerful. You just need to get out there and see a variety of things to be able to start formulating your own talking points about what's important to you.
I certainly agree with Ian since I had that experience. I didn't get in the first time I applied to medical school and realized I was missing some shadowing experience so I found an Orthopedic Surgeon as my mentor whom I shadowed two to three times a week for more than six months and we were able to build a great relationship. I also credit getting into medical school from his letter of recommendation. Although letters are not that powerful, still they have made a big dent in my application.
Hanging out with a physician also gives you that excitement being able to see their contribution and you get to see where you're going. Understanding where you're headed from the beginning just opens up whole reservoirs of motivation to keep going. Shadowing a physician 2-3 times a week for 6 months really allows you to get to know that physician very well. Getting out there, getting to know somebody, finding a mentor, and getting as much clinical exposure as you can would really help and you need to start early.
[33:30] The Undifferentiated Medical Student Podcast
When he got to medical school and it started swallowing his life, he was doing nothing else but medicine so he started to feel very uni-dimensional. So he turned to podcast as a way to get an infusion of something that wasn't medicine. The reason he was able to do it with audio versus video or reading was that you can be listening while doing something else. Listening then becomes a secondary activity while you're doing all the things you need to be doing during the day. You can also train your ear to listen to it twice the speed so you can get a lot of audio quickly. He simply found himself ripping through audiobooks and different podcasts. He just loved the utility of audio plus the fact that they are targeted information on what you want to learn demand, it's on-demand, you can listen to it anytime, and for the most part, it's free.
Having this problem of not knowing what he wanted to go into, which he knew was also a problem for many, he saw the podcast as a way to solve his own problem as well as help others in the process by recording the conversations.
The Undifferentiated Medical Student podcast is similar to the Specialty Stories yet different. He brings on guests through referrals from past guests as he found it difficult to cold call physicians and convince them to do a two-hour interview although it's easier for him to secure guests now that the podcast is already gaining popularity.
At that time, he sent a survey to his third and fourth year classmates asking them what questions they would raise if they were to sit down with a physician. Getting hundreds of responses, Ian categorized them into three categorie. First, was objective information about the specialty. Second, was the subjective process of what they personally find important or meaningful. Lastly, is their long term career advice irrespective of medical specialty. Ultimately, the questions he would ask would something he would be interested in asking. And so those three parts became the framework for his podcast.
A big chunk of his interviews basically come from doing a deep dive into the wisdom of their guests. So they stick to the script until they say something that needs further explanation and then he asks a follow up question. This results to a divergent discussion of the things they didn't even know they were going to talk about.
[38:40] Final Words of Wisdom
Ian wishes to tell students who might still be probing and exploring their options is to keep probing and exploring their options. If you're a premed, check out Khan Academy. For medical students and premeds, consider mentorship. Medical students forget they have a very privileged status as a medical student. If you asked nicely and not act like an idiot, you can literally go anywhere and see anything in the hospital. You have earned the right to do that so just overcome your fear of being a medical student and reach out to people. Do that early. And when you reach out to somebody, don't be a dead fish. People like interesting people so be enthusiastic as enthusiasm unlocks doors. If you come to somebody with very specific questions about what you want to learn, you have the keys to the kingdom. Your hospital ID badge is active too so you can literally go everywhere.
[40:19] Applications are Now Open!
The AMCAS and AACOMAS applications are now open. As you're opening up those applications and getting ready to fill in all your information, remember to give your personal statement one last look over and make sure there are no typos anywhere. Make sure your extracurriculars are polished up to the best they can be before submitting anything. The worst feeling in the world is when you click submit and then seeing that typo that was staring you in the face the whole time.
If you need any help with your personal statement or extracurriculars, I'm offering some personal statement editing and extracurricular editing. Just shoot me an email at email@example.com and I will point you in the right direction on how to sign up for that.
Dr. Ryan Gray: The Premed Years, session number 232.
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.
Welcome to The Premed Years, it's great to have you here. Today I have another podcaster on with me, a medical student turned podcaster, who is doing great things over at the Undifferentiated Medical Student, and his podcast- Ian's podcast is very, very similar to my Specialty Stories Podcast. Different format, longer interviews, but doing something very similar. And the reason he started it is because he was undecided about what he wanted to do on his path, and where he wanted to match for a specialty. So that's what we're going to dive into today.
Ian, welcome to The Premed Years, thanks for joining me.
Ian Drummond: What's up, Dr. Gray?
Dr. Ryan Gray: It's nice to have another podcaster on the line with me.
Ian Drummond: Yeah it's nice when everyone knows the audio situation. I've experienced the same thing.
Dr. Ryan Gray: So I want to dive into your podcast eventually, but I'm interested- the normal question that I use to open up is when did you realize you wanted to be a doctor? But I want to open up with your current struggle. When did you realize that you didn't know what kind of doctor you wanted to be?
Ian Drummond: Yeah, so I guess I would have to say sometime in the middle of third year. By the way, for anyone listening, I am a third year- actually I'm a rising fourth year medical student who's taking some time off to figure out what he wants to do with his life, and my chosen mechanism for doing so is making a podcast about exploring a medical specialty and choosing a career in medicine. But before I started making the podcast, I think it was halfway through my third year, which is nominally I think for most medical students the year where you're given an opportunity to explore all the specialties and make your choice. But that's kind of when I discovered what I call, and have been calling the fallacy of third year in that you don't really even get an entire third year- or rather one year is not that much time to explore all the medical specialties out there. If you've ever seen the Careers in Medicine website, it lists 120 specialties and sub-specialties, and that's not even an exhaustive list. And so I definitely didn't see 120 specialties or sub-specialties during my third year. And then the other component was that we don't even get to finish our third year before we have to make big decisions about our career. Planning acting internships, doing research, establishing relationships with big names in your field, help with your application, anything like that. And so I got to the middle of my third year, and I said, “Wow I'm not even close to making this decision,” and the idea of planning an AI which is a big investment, four weeks, you have to be on your game, you've got to be a good little medical student to get those letters to do what you need to do to look good in the eyes of residencies, and I just was not ready to commit to that.
Dr. Ryan Gray: Define AI.
Ian Drummond: So AI is an acting internship. It's when fourth years pretend to be an intern, they act as though they were an intern, an intern being a PGY1.
Dr. Ryan Gray: Yeah so in my school we called them sub-I's. Sub-internship.
Ian Drummond: Yeah so I always re-learn the lesson that I should always say the full word. Acting internship, or a sub-internship, I believe those are exactly the same thing.
Dr. Ryan Gray: Yeah they should be. Okay so- alright so let's rewind to little Ian that is pre-med school and says, “I want to be a doctor when I grow up.” What led you to that decision?
Ian Drummond: Yeah so it wasn't a singular ‘aha' moment, I did not know from day one that I wanted to do it. I guess I'll start the story in college, I was a student athlete, I played hockey for four years, but I was heavier on the athlete than I was on the student, and my mind wasn't really always on my studies. And I would argue for healthy reasons. I was lucky enough to be a part of two national championships, or play in two national championships, and I actually won one of them. This is DIII hockey, and that was a phenomenal experience. The personal growth that comes along with that, being a part of the team, the special mix of skills, and team culture, and a coach that's unafraid, and unhesitating to rip into you. Phenomenal growth.
Dr. Ryan Gray: Kind of like an attending.
Ian Drummond: Maybe, yeah. Probably not as bad. So that's where my mind was, and while I was actually a neuroscience major, and I was premed, we didn't actually have a premed track, I definitely wasn't committed to going to medical school at that point. And actually by the end of my four years at- it was Middlebury College, I was not ready to stop playing hockey. I felt like I was just getting good at the sport and I wanted to keep playing. So what I actually did was play two years of semi-pro hockey in Sweden, which is awesome and I recommend that to anyone for a couple of reasons for me personally. One was- again another period of sort of growth, this time in the realm of hockey. I mean I was a student athlete, and I just told you that in college I was more on the athlete side of things. But I still had my studies and the studies and the athletics kind of detracted from the other, and I wasn't able to fully dedicate myself to one thing. And so being able to go play hockey as a semi-pro in Sweden and dedicate myself completely to my sport was an amazing experience. I mean I experienced so much growth in the game that would have happened so much more slowly in college just because you're juggling so many other things. It was eat, sleep, play hockey literally, and I loved it. Other thing about playing hockey in Sweden is that you have access to the rest of Europe, and I had a team that was paying for my housing, my food, my equipment, and the salary I was getting which wasn't a lot, was great travel money. So I got to bounce around to a bunch of countries in Europe, phenomenal, and then a lot of the other money was also spent on beer. And you definitely need a beer budget because beer is expensive in Europe. So I did that, but towards the end of my second year playing in Sweden, I definitely felt like I was maxing out as a hockey player. I got as good as I was ever going to get, and I remember sort of- it wasn't instantaneous but sort of a miraculous letting go of hockey. I was like, ‘Wow I'm ready to let go of the game.' But that was awesome because it was on my own terms, but it was at this moment sort of halfway through my second year of playing hockey in Sweden that I started to say, “I want more from life. I want to think about my future.” The thing about playing semi-pro hockey is that there are a lot of guys that are like thirty, sometimes even forty and they're washed up, sometimes even fat. You don't need to be fit anymore. Really good hockey players but not really going anywhere with their lives, at least not the direction that I would have found satisfying. And it was really at that moment that I started talking to myself frankly about what I wanted out of life, and sort of the things that came to mind were I want lifelong learning, I want lifelong growth, I want more responsibility, I want to make contribution and when you're playing video games eight hours a day with your hockey buddies waiting for practice to start, those things don't happen.
Dr. Ryan Gray: Yeah alright so what's interesting there, lifelong learning, contribution, that doesn't describe being a physician. Being a physician describes those, but there are many things that you can do for that. But you said you were a neuroscience premed in college, so what led to that first decision of being premed in college? Or was it just some kind of in the clouds thinking of, “Oh being a doctor sounds like it'd be cool.”
Ian Drummond: Yeah it wasn't even- I honestly- so another part of the story is that my father is a physician.
Dr. Ryan Gray: Aha!
Ian Drummond: There it is. I had that example. But really at no point did he ever pressure me- my mother was a nurse, and at no point did they ever suggest that I should choose medicine. But it was on the table, and part of the story was how satisfying I saw my father saw his career. I mean he was sometimes a short-tempered physician, he was an anesthesiologist, but he never complained about his job, and I saw how satisfied he was with it. I intuited that even if I couldn't explain it as a little eight year old Ian. But in college when I was doing neuroscience, honestly it was again late in my college career, I accidentally became a neuroscience major. I realized I was a junior, and I hadn't picked a major, and I looked at what credits I had, and I was like, ‘Oh my gosh I'm two credits away from being a neuroscience major.' And finishing some of the premed requirements, and I didn't finish all of them, orgo being one of them and I also bombed bio. But doing these things was more like I was keeping the option open rather than actively pursuing a career in medicine.
Dr. Ryan Gray: Okay. Alright.
Ian Drummond: Did I answer your question?
Dr. Ryan Gray: I think so, and I'll dig in more. So you have this change of heart, or whatever you want to call it as you're playing hockey, and trying to figure out what you want for the rest of your life; lifelong learning and contribution. Again I kind of already said that that can describe many different careers, and I always push back on students that I'm working with to be like, “That's not a good reason to be a physician.” So from that point- yeah so from that point, where did you go? Obviously with your father being a physician, your mom being a nurse, you knew healthcare. So how did you determine for yourself if being a physician was right for you?
Determining Medicine was the Right Path for Ian
Ian Drummond: Yeah so you definitely can get lifelong learning in a lot of places, you can get growth in a lot of places and a lot of careers, responsibility, contribution. One other thing I didn't mention is that in stark contrast to being a semi-pro athlete, financial security is something that's offered by being a physician, so I'd be lying if I told you that wasn't also part of my thought process. But in terms of learning, it's like, ‘Well what are you interested in learning?' And I found the medical sciences fascinating. In terms of contribution though, yeah you can make contributions in a lot of ways to society and to people, but I think that the contribution in medicine, it's a very personal type. You get to directly see the contribution that you're making in many cases, in that when you help somebody with their health you can see the result of that. And alongside of this, and a very important conversation is about the very meaningful person-to-person interactions and one of the highly motivating reasons that I had for medicine were these relationships that I don't think many other careers offer that mix of medical sciences plus this personal interaction to do with your health. I mean in medicine, we're not just talking about like a, ‘Hey how are you doing, get to know you.' It's a ‘Take your clothes off, and tell me your secrets, and tell me them fast because it might save your life.'
Dr. Ryan Gray: ‘Tell me them fast because I only have thirteen minutes before my next patient.'
Ian Drummond: Right and the EMR is eating up twelve of those, so let's go. So yeah I think it's the contribution was on a personal level, it's a human interaction thing. And I don't know why relationships are so satisfying, but they are.
Dr. Ryan Gray: Yeah. So it's funny, I'm going to push back on you like I do with students that I work with. Be like, ‘Okay well you could have that personal contribution and science related stuff doing- being a registered dietician. You get lifelong learning in food science.'
Ian Drummond: Yeah I think this is where the responsibility and the influence comes in. You definitely get those things as a dietician but I think physicians have an opportunity to really influence their environment as a physician. They get to make decisions. That excites me.
Dr. Ryan Gray: Okay, interesting. Alright so for you listening right now, this is the kind of thinking that you have to go through, this thought process as you figure out how to tell your story of why you want to be a physician, this is the kind of thought process that I have with students. So that's good.
Ian Drummond: Yeah and Dr. Gray, the funny thing is, is that I had a very hard time putting these feelings into words. And I can do it better now, and I'm still not satisfied with it, and it's a wonder that I got into medical school in the first place, that I convinced anybody to take me seriously because I had the problem that you like to harp on. My answer was, ‘I like science and I want to help people.' These are very valid reasons. I mean I don't think that that's what you're harping on, it's just a little bit trite as to be meaningless.
Dr. Ryan Gray: Yeah.
Ian Drummond: And you're trying to make it sound novel and truly articulate your motivations. ‘Why are you doing this? Why do you have the energy to suffer through studying for the MCAT? To go through your application process to immediately start studying your pre-clinical studies year one of medical school, to basically start full-time studying for Step 1, and then do a third year which is you don't get to make your own schedule, you're working twelve, sixteen hours a day. Where is the motivation coming from?
Dr. Ryan Gray: Yeah.
Ian Drummond: And that is a very tough question to answer, even now that I'm on the other side.
Dr. Ryan Gray: So I would disagree that it's not a tough answer, but you have to realize what the answer is first, and the answer should always be- and I would hope it always is, and you said it kind of in a roundabout way, but I don't think you're picking up on it yourself. That contribution factor. The contribution is to the patient, right? To patient care. That's what drives you day in and day out every time you're interacting with another patient and making that impact. That's what keeps you going to suffer through your internship year, through your clinical rotations in medical school. So you talked about it, but you weren't picking up on the fact that that's really what it is that's motivating you.
Motivation behind Becoming a Physician
Ian Drummond: Yeah it's possible. I mean that's why you're the expert, Dr. Gray. I think that the relationship bit though, I mean and it's not just a one way street, in connecting on a non-superficial level with your patients, helping patients and them opening up to you. I mean that's a two-way street, that becomes a relationship. And again, I don't know why relationships are so awesome when they're open and real like that, but part of contributing to the patients is that you get something back in the form of a relationship.
Dr. Ryan Gray: Yeah, I've always talked about- students will ask me about healthcare, and the healthcare reform that we're going through now, and insurance, and this and that. I said, “It's good to know what's going on in the world, but that shouldn't affect your decision to apply to medical school.” Because again, if you're doing this for that patients care aspect, those relationships, that will never change in healthcare. Once you close the door and it's patient and physician, or patient and medical student, that relationship, that dynamic will never change. There may be a robot next to you that helps you form your differential diagnosis, but there's still going to be a human that's going to help you, that's going to need to be there to form that relationship with the patient.
Ian Drummond: Definitely.
Dr. Ryan Gray: Alright so I feel like this is like a Dr. Phil kind of scenario where I'm trying to diagnose you and figure out where to go now.
Ian Drummond: Let me know what your answer is.
Dr. Ryan Gray: So you are exploring this, and I don't think I asked earlier, what did you do next? You have this thought of, ‘Okay I want to- this is the type of life I want to lead, these are the things that I'm interested in.' How did you make that leap from figuring out those traits and that lifestyle to, ‘Okay I'm ready to be a physician, I know that being a physician is right for me.'
Ian Drummond: What did I do next?
Dr. Ryan Gray: Yeah.
Ian Drummond: So towards the end of my second year in Sweden playing ice hockey, and when I was starting to realize that medicine might be it, I actually did some shadowing with my team physician, an orthopedic surgeon which was pretty cool. He was taping up my hand or whatever and I was like, “Hey do you mind if I follow you back to the hospital?” So I got to hang out with him, and then actually towards the end of the season as well I started studying for the MCAT, and so this was March of 2011, and I think I took the MCAT a couple months later, and I actually didn't do very well. I actually had already filled out my AMCAS application, and I was at a crossroads. I was thinking to myself, ‘Well do I just take my MCAT score as it is,' it was a 29 which was the old MCAT obviously, and I had to look all these numbers up, but it was somewhere around the 75th percentile, which shows that you know something about the exam. You don't just take the MCAT-
Dr. Ryan Gray: Which is a decent score.
Ian Drummond: And I think that correlates to 508 now on the new exam, something like that.
Dr. Ryan Gray: A little lower, probably 506-ish maybe.
Ian Drummond: There you go. You know it shows that you know something, but you definitely don't walk away from the exam feeling like you conquered the world. Coupled with a semi-decent undergraduate GPA of 3.07, I was like, ‘Okay do I go through with this application or do I double-down with a postbac program and try for something better?' And that was uncomfortable, and it was a little painful because sort of my expectation and my father kind of encourages, “Oh yeah just take the MCAT and apply to medical school and see what happens.”
Dr. Ryan Gray: A little different from his days.
Ian Drummond: Yes, exactly. And I trust my father on a lot of things, and for good reasons, he's proven himself to be a phenomenal father and mentor, and so I was like, “Alright I'll do that.” But again as you identified, I think that the climate of applying to medical school today is much different. And so after sort of that painful realization that I might have to double-down, which I'm totally glad that I did, I enrolled in a sort of independent postbac program through the Harvard Extension School in Boston, which I know you know well. Which is great, open enrollment, just pay your tuition for your classes, you get into the classes automatically, it's not sort of a dedicated program. I also still had access to Middlebury College's advising office so I didn't need the advising that comes along with a postbac program, and I just started knocking off classes that I needed. I re-took intro bio, I had actually already taken organic chemistry in the summer between my two seasons, and then slowly started boosting the GPA, and then really double-downed on the MCAT, and I started basically square one. Point being I got a good study book, it was Examkrackers, I don't know if they make a book for the new MCAT, but I loved- I bleeping loved Examkrackers. They were so good, and for anyone out there who wants a study buddy, Khan Academy. If you have not checked out Khan Academy, for the love of God, go check out Khan Academy. Sal Khan is an amazing human being. He's such an intuitive teacher, and so I started with basically physics lesson one, bio lesson one, chemistry lesson on, organic chemistry lesson one. So when I say double-down, I think I really went back to the beginning, started with first principles, worked forward with Examkrackers, and I took the MCAT again, and I got a 36 which is around the 95th percentile.
Dr. Ryan Gray: Yeah.
Ian Drummond: Which helped a lot. I also did well in my classes, that helped with the GPA. I think by the time I applied, my GPA was a 3.4 accumulative. I didn't go to Harvard College, I went to the University Extension School, but I think Harvard is still a reputable institution so my classes looked good. Organic chemistry was still from a community college. I know that people say, “Don't take any classes at a community college.” I took it at a community college, worked out just fine for me, I thought it was a great class, and I am so happy that I took that extra time. So when I first took the MCAT, it was sometime maybe June of 2011, I matriculated to Case Western Reserve University School of Medicine in the fall- in July of 2013. So I guess I had to dedicate another year and a half to get where I wanted to go, but worth every second of it, especially considering that when I applied- officially applied- so again I filled out my application, my AMCAS application completely the first time, and almost hit submit with my 29 and my 3.07. I mean if I had sneezed and accidentally clicked submit, the world would have been so different, but I didn't. So the result was I got in exactly where I wanted to go, Case Western, but the other side of the story is I only got four interviews, and I only got accepted one place, Case, and I got accepted off the wait list. So I applied to 25 plus different schools, and I didn't really hear back from them, and I came to the table with a booted GPA, and I think a great MCAT score, and I still really only got four interviews.
Dr. Ryan Gray: Why do you think that is?
Only Four Interview Invitations and One Acceptance
Ian Drummond: That's a good question. I'd like to think that I'm a decent human being, and that I was attractive on some level, but maybe it was that I just didn't have a track record of demonstrated interest of working towards medical school like a lot of other students do. Maybe there was something about how I presented myself on the interview trail. I mean Dr. Gray, you doing these mock interviews with students, and discovering and really harping on, “Well why do you want to go to medical school,” and actually communicating that, “I like science and I want to help people.” Not a bad answer but not different-
Dr. Ryan Gray: That is a bad answer. For these purposes it's a bad answer.
Ian Drummond: Well fundamentally those things are good.
Dr. Ryan Gray: Fundamentally those are good, but not for a medical school interview answer.
Ian Drummond: Then we are completely in agreement. Those ideas are wonderful ideals to have in mind, but your motivations to go to medical school, and how you communicate them are very, very important. And maybe I just didn't articulate that very well. But I mean yeah, I don't know.
Dr. Ryan Gray: Who helped you write your personal statement to- obviously the personal statement is your initial presentation to the schools to say, “Hey interview me. Interview me.” And 21 of those schools said, “No thanks.”
Ian Drummond: See-ya. So it was my dad and my roommate at the time, John if you're listening, thank you. He's a systems engineer, great dude. My dad, awesome guy.
Dr. Ryan Gray: Yeah.
Ian Drummond: Both people very willing to dedicate time and giving me honest feedback. And I thought my personal statement was okay, but I didn't get the response that I thought I might.
Dr. Ryan Gray: Okay well maybe I'll have you send it to me and we'll put it in my new personal statement book once it's done.
Ian Drummond: Oh interesting, okay. What not to do.
Dr. Ryan Gray: And I'll critique it. The open critique. Alright so obviously you got into school. What's interesting on this path, and I think it probably leads to your current trouble of not truly understanding where you want to go next, is I think your own critique of what happened is you didn't have a lot of that clinical experience of being around patients, and being in the hospitals, you were out playing hockey which is what you loved doing. And so I think because you had less exposure, less experience, you didn't start formulating these thoughts in your mind about what specialties you may or may not like. And so then you start medical school, you obviously go through your non-clinical years, your coursework stuff, and then you hit your clinical years. What happened during your clinical years that led you to still not understand what you wanted to do? Did you really love everything that you were doing? Or did you hate everything that you were doing?
Ian Drummond: More of the former. I was interested in a lot of different things, and one of the common ways to help you decide what specialty you want to go into that people will suggest is, “Start eliminating, start eliminating,” and I had trouble eliminating. And yes, not having a lot of clinical exposure before medical school definitely could have contributed. Just like you had an experience with an orthopedic surgeon saving your life, help giving you back your function, I had a similar experience with hockey in that I dislocated my shoulder a bunch, and even though it looked like there was nothing wrong with it, we would just keep on dislocating and I couldn't play hockey with a dislocated shoulder. Orthopedic surgeon comes along, this was when I was fifteen or so, tightens everything up, all of a sudden I can play again. So actually going into this process, an early life experience although I didn't see it as sort of like a lightbulb moment to go into medicine, was ‘orthopedic surgery. That seems cool.' I know the direct impact that an orthopedic surgeon can have on a patient's life. I think orthopedic surgeons hang out with athletes, I'm an athlete, that seems cool. So I did have that going in, but getting to third year I think- again I had the former problem. I liked a lot of things, and I had trouble eliminating the majority of them, and then all of a sudden I was being asked to schedule an AI, and I just wasn't ready to do that.
Dr. Ryan Gray: Yeah, okay. What do you think- what questions could you have been asking yourself back when you were doing your clinical rotations that maybe would have helped you cross things off easier?
Ian Drummond: I wouldn't start during the clinical years. The question I would have been asking myself would have been first year, ‘Why aren't you starting to explore now?'
Dr. Ryan Gray: Yeah. So first year, obviously classes are dominating life, and tests are dominating life.
Ian Drummond: That's part of the problem.
Balancing Studying, Coursework, and Shadowing
Dr. Ryan Gray: Yeah that's part of the problem. How do you balance that? Where can you go to ask those questions if you're busy studying all the time?
Ian Drummond: That's a great question. I don't know the answer to that, but I'll tell you what the alternative is, you get halfway through your third year and you realize that there are a bunch of things that you haven't explored yet. So I would say that the answer is once a week, once a month reach out to somebody and start this exploration process, even if it hurts- and believe me, I know. I argued to myself all the time, ‘Well it's a good thing you're studying, Ian. Step 1 is twenty months away, and it's okay to be studying now.' And in fact that's not true. Many people, given the time that they have, only studying during the first two years get to their third year, realize what they want to do, and they do just fine. I would say that there is a large minority, maybe 25%, maybe even just under 50%, where they're kind of like, ‘Oh my God I'm lost.' So how do you balance it? I don't know, but I think you have more time than you realize in the first two years to explore. One other problem I'll throw out is a lack of mentorship, and it's not because there aren't enough people to do it, it's just that these mentor/mentee relationships are often hard to form, they're an investment, and so they often don't happen. And so having someone like you, Dr. Gray, being like poking you in the side, ‘Hey why don't you just go out half a day or even half a morning, not even half a day, like go check out the O.R. Go check out the clinic with this physician. Go out into the community, see that setting.' If you want to do international work, a little harder to do, probably expensive, but yeah go explore that too. Private practice? Find one. Academics? Find it. Public institution? Find it. And this plants seeds when you see it, when you feel it, when you hear it, hopefully but not taste it, it makes it visceral. You have a better understanding of the talking points of what specialties are, and what they'll mean about your future career, and what your life will look like. It just makes things real versus reading it off a book.
Shadowing One Physician or Get Diverse Experience?
Dr. Ryan Gray: I was recently asked a question last night actually as we're recording this now, I was speaking to a premed club, and one of the questions was, “Is it better to shadow one physician for a long time, or try to get a diverse experience of shadowing?” And what you're saying is get a diverse experience. And we've kind of been talking about medical students, but this can start as soon as you know that you might be interested in being a physician. So in high school, in college as an undergrad, you should be doing these.
Ian Drummond: I don't disagree, and I'm actually saying both things. I'm saying stick with one physician, and get a diverse experience because if you stick with one physician, chances are you'll form that mentor/mentee relationship which can be so powerful. It can be such a good force for the better. When somebody knows you, and knows how to lean on you to help you make decisions, oh my gosh, I mean that's night and day in terms of helping you spend your time wisely. The other part of it is that you just need to gather data, which means you need to get out there and see a variety of different things to start formulating your own talking points about what's important to you, and one physician can't necessarily give that to you.
Dr. Ryan Gray: Yeah, awesome. And I had that experience. The first time I applied to medical school, didn't get in, realized that I was missing some shadowing experience, and I found a mentor, an orthopedic surgeon who I shadowed two to three times a week for six plus months, and built a great relationship, and I credit myself getting into school from his letter of recommendation. Obviously letters of recommendation aren't that powerful, but I really think he made a big dent in my application, which is great.
Ian Drummond: And talk about getting excited about medicine. I mean when you hang out with a physician, you get to see that contribution we were talking about. You get to see where you're going. Gosh I worked pretty hard, I'll give myself a pat on the back, but understanding where you're headed from the beginning just opens up whole reservoirs of motivation to keep going. So when you did that experience, when you shadowed two and three times a week for six months, you really got to know that physician really well, and I'm sure you got to see the effect that you'd be having if you only stick with your training. I mean this is a slight tangent from what we were talking about, but I mean the benefits of getting out there, getting to know somebody, finding a mentor, and then just clinical exposure to as much as you can only helps, and you need to start early.
Dr. Ryan Gray: Definitely. So at some point on your journey of trying to figure out what you want, you started your podcast. Talk about your podcast and the thought process behind starting it.
Starting a Podcast for Specialties
Ian Drummond: So first of all, I love podcasts. Obviously I'm making one, but it's really that I love audio, and so audio books are included in that. And I think I've been listening to podcasts before 2013, but 2013- fall of 2013, summer, whenever I got to Case Western and medical school started swallowing my life, and I was doing nothing but medicine and starting to feel very unidimensional, I turned to podcasts as a way to get an infusion of something that wasn't medicine, and I loved that. And the reason I was able to do it consistently with audio versus video or say reading, is that you can be listening while doing something else. So listening is a secondary activity. Washing the dishes, or eating breakfast in the morning, walking to class, driving to the clinic, and then doing the dishes when you get home; I could be listening to audio, and if you train your ear to listen on a playback speed of 2x or somewhere around there, you can get through a lot of audio quickly. And so I just found myself ripping through audio books and different podcasts, so the utility of audio is something that I loved. And then podcasts are awesome because they are targeted information on what you want to learn about, it's on demand, you can listen whenever you want, and for the most part they're free. So I was having this problem of not knowing what specialty I wanted to go into, I knew it was not a problem that only I was having, and then I saw podcast as a way to be able to solve my own problem, and also help others in the process by recording the conversations. So that's where it started.
Dr. Ryan Gray: Okay talk about the thought process behind the guests that you bring on and the questions that you ask. Because your podcast is very similar to my Specialty Stories, but still very different.
Ian Drummond: Right. Who I bring on is an easy one, referrals from past guests. It's very difficult to cold call physicians and convince them to do a two hour interview, so I need an in. Although that's changing a little bit now that the podcast is a little more popular and I can kind of point to it, and people are like, “Oh okay, maybe I'll do an interview.” The questions that I ask. I think I sent out a survey to my third and fourth year classmates at the time and I asked them, ‘If you could sit with a physician and ask them anything, what would you ask?' And I got back hundreds of responses, and I sort of categorized them into matching areas as I could determine, and I found that they fell into three categories generally. One was basically tell me objective information about your specialty. Second category of question was now tell me how you determined that specialty was right for you, and that's a subjective process of what you personally find important or meaningful. And then the last thing is okay great, your respective medical specialty, give me long-term career advice. What should I be thinking about ten, fifteen years down the road that I'm not because I'm worried about Step 1? So that's where the questions came from, but ultimately selfishly these questions were going to have to be something that I was interested in asking. And many of the questions I got from these survey forms were very helpful and questions that I wanted to know, so that became the framework, these three parts. And then a big part of my interview process is kind of what you're doing to me, Dr. Gray. Like, “Okay you like science and you want to help people. I'm going to give you a little bit of pushback because I don't know what you're talking about, and that's superficial, so let's dive into that.” And so that's actually where a big chunk of the time in my interviews comes from. I stick very regimentally to the structure of my interview because it helps us deep dive into the wisdom that my guests have to offer. We stick to the script until they say something that needs further explanation, and then I ask a follow-up question, and that's where it becomes a wonderful divergent discussion about things that we didn't even know we were going to talk about. But we still get to all the basic talking points in my sort of interview template, my flow.
Dr. Ryan Gray: Awesome. Where can people find your podcast?
Ian Drummond: www.UndifferentiatedMedicalStudent.com. It's on iTunes, it's also on Stitcher, and Google Play although I think if you pick one place, please pick iTunes.
Dr. Ryan Gray: What about all the Android people?
Ian Drummond: You can listen in too if you want.
Words of Wisdom
Dr. Ryan Gray: Ian as we wrap up here, for a premed or even a medical student who's listening to this that is struggling, figuring out what they want to do with their specialty, and what they want to be when they grow up, what would you say to them to encourage them to keep probing and exploring their options?
Ian Drummond: To keep probing and exploring their options, I just want to pump the tires of Khan Academy. If you're premed, check out Khan Academy. And then the second piece of advice would be for medical students and premeds; mentorship. Especially as a medical student, I think medical students forget that they have a very privileged status as a medical student. I mean if you ask nicely and don't act like an idiot, you can literally go anywhere and see anything in the hospital. I mean you have earned the right to do that. So just overcome your stupid fear of being a medical student, and reach out to people, and do that early. Premeds, you can do that too. Medical students, I feel like because we think we're at the bottom of the totem pole, and that we're in the way, and that we're just a nuisance, we kind of restrict ourselves and we don't help ourselves. And I guess one other key would be just when you reach out to somebody, don't be a dead fish. People like interesting people, and something that's come up a lot on my podcast, and something that I'm personally starting to internalize is that enthusiasm unlocks doors. If you are enthusiastic and you come to somebody with very specific questions about what you want to learn, I mean you have the keys to the kingdom. And then don't forget that your hospital ID badge is active too, so you can literally go everywhere.
Dr. Ryan Gray: Alright there you have it, Ian over at the Undifferentiated Medical Student Podcast. Go check out everything that he's doing at www.UndifferentiatedMedicalStudent.com.
As we're releasing this on May 3, 2017, the AMCAS application is now open, and the AACOMAS application will open tomorrow, again as we release this on May 4, 2017. So as you are opening up those applications, and getting ready to fill in all your information, remember to give your personal statement one last look over, make sure there are no typos anywhere, make sure your extracurriculars are polished up to the best that they can be before you submit everything. That's a good thing to do. The worst feeling in the world is when you click submit, and then you see that typo that was staring you in the face the whole time.
If you would like any help with your personal statement or your extracurriculars, I do offer some personal statement editing and extracurricular editing. Just shoot me an email, Ryan@medicalschoolhq.net and I will point you in the right direction on how to sign up for that.
I hope this podcast helped you understand a little bit more on the path to choosing a specialty, and maybe what you can do to avoid the trap that Ian fell into of not understanding and not knowing what he wanted to do in the end. But he is working through that, and as we are recording this he's pretty certain where he wants to go forward from here. But I wish him the best of luck. Thank you, Ian, for taking the time to talk with me today.
I do want to take a second and thank a couple people who have left ratings and reviews.
We have BTOMCUTLER who says, ‘Phenomenal. I found this while on a downslide away from the premed path. It helped me pull myself up and see that there is a team of people around me trying to get to the same place.' That is awesome. So collaboration, not competition. As I'm talking right now, I'm wearing my ‘Collaboration not Competition' shirt, and the fact that this person found out there is a team around him is awesome. So thank you for that review.
We have another one here from TinyTomN who says, ‘Convenient quality info. Love listening to this every day. It introduces me to many topics I want to learn about and to many others that I didn't know I wanted to learn about.' It's a great point. I love the fact- you just keep an open mind. I think too many students pick and choose which ones they want to listen to, but when you listen to all of them you go, “Wow I didn't know I should have asked that question,” or “Oh I didn't even know about that thing.” So you should listen to every podcast. Just saying.
We have one more here from AO35 says, ‘Superb preparation for every single stage in the premed journey. I recently found out about these podcasts about a week ago, and have been listening to it a ton since.' Thank you for that rating and review.
If you would like to leave one, you can do so at www.MedicalSchoolHQ.net/iTunes.
I hope you have a great week, I hope you catch us next week here at The Premed Years and Med Ed Media.
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