This Nontrad Overcame More Obstacles Than Anyone I Know

Introduction

Dr. Ryan Gray: This is The Premed Years, session number 218.

Hello and welcome to 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 Podcast, a podcast that has been nominated two times for the Academy of Podcasters Awards Best in Science and Medicine category. So thank you for joining. If you don’t subscribe to us in iTunes or on your Android device, please do. If you’re listening to this through a website, know that there are easier ways to do it. Go check out www.MedicalSchoolHQ.net/subscribe to find out how.

This week’s guest is an awesome, awesome person. And she’s going to talk about her story from growing up in another country, and coming to the states, and going back to her home country, and thinking that she would never make it back to the states, and then coming back to the states, and having to deal with obstacle, after obstacle, after obstacle.

This is a very different interview for me because Anna had a lot to say, and she was a great storyteller. So when I went back to listen to this to edit it, every time I was like, ‘Oh this doesn’t need to be there,’ she would finish off what she was saying with an amazing anecdote, or she would just tie it together with why you need to understand that part of her life, and how it’s motivated her, or helped her, or whatever it may be. So I left the majority of it unedited. I hope you enjoy listening to Anna as much as I enjoyed talking to her.

Anna, welcome to The Premed Years, thanks for joining me.

Meeting Anna and Her Interest in Medicine

Anna: Thank you so much for having me on your show.

Dr. Ryan Gray: I want to start with when you figured out in your life that you wanted to be a physician.

Anna: I don’t remember exactly what the age was, but I was living in El Salvador, Central America, and I noticed how a lot of kids around me who I used to play with would disappear. So I would ask, ‘Where are they?’ And my parents- and they would say something like, ‘Well they died of diarrhea, or fever,’ and I didn’t understand what was that? And so I began to be curious about that, and I started imagining how can we help? As a kid I was wondering why does that happen? Why should that happen? So I began to be interested, I think I was probably maybe five or six. It was I think based on my environment.

Dr. Ryan Gray: Okay. So you’re in El Salvador, you’re a young kid, learning about death of relatively- what we would consider benign things here in the states. What did you do from that point forward? So I always like to talk about like that was the planting of the seed, right? So what did you do to continue watering that seed? How did you gain experiences and continue to pursue this curiosity at that point?

Anna: Right. My sister was a year older than I am, she had diarrhea and she was sick, and she also had some blisters. And I didn’t understand again, what was happening. I started experimenting with bricks. And I have to give you the scenario, is like you’re living in this third world country, we don’t have water, we’re surrounded by basically nothing, we’re walking without shoes, and so I get these bricks and I mix water, and I say, ‘Maybe this will help her.’ So I gave that to her thinking that that was medicine. Well long story short, I got a beat down for that. But I remember that I started thinking about, ‘Okay how can- what can I do?’ So I started experimenting with things like that. After that unfortunately my dad- there was a civil war in [Inaudible 00:05:07] where I was. My dad had to go to California and work as a gardener there, and earned enough money to send us to the United States- California at that time. And when I was there I realized that first, there’s water. I was like, ‘Oh my gosh, you open a faucet and there’s water.’ Second thing is the elevators, electricity. I mean we didn’t have electricity every day, we had it three times a week. So a lot of these things, and I felt rich. I felt like I can do anything, everything was given to me. And so I said you know- and going to school, that’s free. It’s the United States, I’m there, I thought that you had to pay for school everywhere, but not the United States. And I’m talking about first grade. So going into first grade, not knowing English, and my teachers- first grade teachers, elementary teachers telling me that there’s programs for me to learn English and, ‘We’re going to help you.’ And so getting that gift of I guess just the basic necessities; the water, education, electricity, and the support from your country made me realize that man, I should look into this. What else can I do? Maybe I can find a cure for something. I didn’t know exactly what a doctor was. So my teachers in elementary school asked me, ‘What do you want to do when you grow up?’ Well I never thought about that when I was in El Salvador because I thought I was going to die. I mean that’s basically what it was. I mean I never thought about that so it opened my mind to hey, what is out there? So my teachers in elementary school told me about college. And so she said the first thing is get through high school, then go to college. And so I told them that what I was interested in is diseases like [Inaudible 00:07:20], and I wanted to do something about this. So I said I think I do want to become a doctor, how do I do that? And that’s how I started reading about college. That was my first step. To know that I wanted to pursue medicine, is what are the steps to get there once you realize you have a passion for the human life. And how can you make this world better for everybody? You might not understand that it’s medicine, or it’s nursing, or it’s pharmacy, but you have that. So how do you get there? And so I think that’s talking to other people, especially the role models. Unfortunately my mom and dad are not educated, so I didn’t have that at home, so my first role models were my teachers, my counselors. So I think that’s how it started.

Dr. Ryan Gray: So your first step really was an unfortunate situation with the civil war, coming to the states, which is very fortunate, and then realizing the opportunity. I think it’s amazing when you grow up in the states, you’re born here, you take everything for granted and you’re like, ‘What? You go to school? You live longer than- you live through diarrhea? You live through the flue?’ And you’re like, ‘Wow.’ It’s amazing what can hit you when you realize that there’s a whole life in front of you.

Anna: Yeah.

Learning About Diversity & Seeking Mentors

Dr. Ryan Gray: So you talked about mentors and role models. Obviously you’re coming from El Salvador not speaking English, so you needed to learn that. How did you initially find a mentor who- and maybe you never did, who looked like you, who was doing what you wanted to do, spoke like you. Did you try to seek out somebody like that?

Anna: No and I didn’t know- I’m told I got to California that I was different, that I was Hispanic. And so I didn’t know, understand race differences. So to me I thought we were all the same, so I didn’t seek for anybody like me. But I thought if my core values of respect for my teachers, so I knew that there was a position that they wanted the best for me, so I should listen. And so I think that that was- going with your core values, what do you believe in and seek those values. And to me at that young age, that’s what it was. Now after this goes into an interesting part of my life where my mom was a victim of domestic violence so she didn’t speak for herself much. She was a homemaker, she is- I mean she was, she works now. But my dad not having- he had a first grade education, he didn’t know how to read and write so he wasn’t really there to help me with schoolwork, and he also believed that women were beneath men and didn’t believe in education. And so he wasn’t obviously a person that was going to support me to go to school, so he said that health education are for the rich people, it’s not for you, and you should work. So that was his thing, you have to work. So knowing all these opportunities in California and the United States I realized that that wasn’t the case, that’s what we do in Salvador, we work, so this is different. So I knew- I felt like he’s wrong so I didn’t really listen to him on that, so I relied on my teachers. But why I bring that up is important because the role modeling that you do not see at home you tend to seek sometimes indirectly with the people around you, and you have to be paying attention to those cues. And so I think that’s what I did. What I wasn’t getting at home I was looking for in other people who had a position of maybe leadership. It might be a police officer, a profession a doctor in that case, it doesn’t have to be just a teacher. Moving forward my dad thought that we didn’t have enough money, and so here I am thinking, ‘Hey why don’t we have money? If we’re in the United States why are we starving here? It’s a different type of poverty, Dad what’s going on?’ Right? So I mean I was made fun of at school for not dressing well, made fun of- obviously I’m Hispanic so they would call me illegal and different other things. But going back to the poverty issue I didn’t understand why we were so poor but in a different way compared to my classmates. So the reason I didn’t know then, but then at sixth grade, when I was in sixth grade, finishing sixth grade, my dad said that we needed to go back- my two sisters and I and my mother, go to El Salvador for a vacation. And so we did, got on a plane, went on vacation, and I was going to start seventh grade. What was I, like twelve or thirteen, or whatever- probably twelve. And getting to El Salvador and not learning- having everything in the states and going back to El Salvador and looking at, ‘Oh my gosh, what is-‘ I mean I remembered vaguely my experiences there, but then they became real and I realized I need to get out of here. This is not a place for me. Sure I want to see my grandma, my grandpa, because most of my family died in the Civil War. And so anyway, long story short, it’s September, I mean it’s toward the end of August and it’s been a month and I am asking my mom, ‘Hey when are we going back to the states?’ And we had to start school soon and school was a priority, I knew what I wanted to do, I wanted to go to college and become a doctor. I’m like, ‘I need to get on this,’ right? So my mom said, ‘I don’t know, your dad has not said anything about that.’ And so I said, ‘Okay well let me ask.’ So I called him and he tells me, ‘Well you’re not coming back ever.’ And he said, ‘You’re illegal.’ And so a parent who you trust has sent you to a third world country knowing very well you’re illegal, you have no way of coming back. I felt my whole dream just shattered and I get tearful when I think about that because it’s now what do I do? I’ve never going to be a doctor. How am I going to pay for school? I mean everything just hit me. And so the first- when you encounter a situation like that, and going back to your question, just to give you the background, is that at that moment when I thought everything was shattered, you have to go again with your core values and your main necessities. Maslow’s Hierarchy of Needs, food and water, right? So I said, ‘Well I’m in El Salvador, how am I going to feed myself? My dad is basically saying you’re not coming back, and $100 he’s sending us, basically it’s not going to be sufficient for my sisters and my mother.’ So I said, ‘Well I need to feed myself and I need to feed my sisters and my mom, she’s never been able to work,’ I said I need to get a job. And so interestingly- so here I am at twelve, around that age, twelve looking for a job in a third world country, and I go to a pharmacy because that’s my interest, medicine. So I go to this pharmacy and yes, I’m guilty, I told them I was a little older to get a job, I told them I was fifteen. And I told them, ‘Hey I speak English, you have some travelers, people that come here, and they might speak English.’ And I want to be a doctor, I’m interested in medicine, so I get the job. So here I am in the pharmacy in a third world country at the counter getting prescriptions and not knowing what they mean, but the owner of the pharmacy believed in me, and that’s key. You have to be sensitive about the people in those positions who again, at the position of creating change, position of leadership. And so that pharmacist, name is Lucy but we call her Luchy, she tells me, ‘This is how you read a prescription. And this is what we do. I can read you the prescription, walk you through, and this is how you mix certain medicine,’ and blah, blah, blah. So she tells me and I’m fascinated, how does this work? So I thought I wanted to be a pharmacist at that point. Maybe I should be a pharmacist, and maybe the doctor is just seeing patients, but what about maybe if this is more interesting? So anyway so I’m here at the pharmacy and she tells me that after a few months of working there that she noticed that I’m very dedicated, I’m hardworking, and would I like to go to a class to learn how to type prescriptions? And I said, ‘Sure.’ Like how to make the labels of the medication labels. I’m like, ‘Yeah.’ So I go in, the point there is take advantage of every opportunity. So yes, send me there, sign me up, I’m there. So I go there, I learn how to type, and then the next step was reading the drugs facts and comparison book, in Spanish of course, what are drugs for? And then when I was reading about which- I’m going to step back a bit. I was curious about medication, and this is kind of funny, is you put a starving kid there- I mean I’m going to school early in the morning like 7:00 to 2:00, then go to work from 3:00 until 9:00 at the pharmacy. So I’m at the pharmacy, it’s a kind of slow day, and I see this medication in liquid form that smelled good, and I said, ‘Well I wonder if it tastes good.’ And so yes, I tried some medication. I didn’t know what it was but one of them tasted good, I don’t know what it was so I said, ‘Maybe I should try another one, a different kind.’ And so I did. Well that one was like phenobarbital so it made me sick. So then that’s why I became curious of, ‘Hey how does this work? Why did I feel that way?’ So yeah I started reading about the side effects and all that. So my curiosity led me to that. Thank goodness I didn’t kill myself. So yes I took opportunities of learning about what I was doing at that time that was important for me to get to the overall goal. And so it might not be my goal then and there to be a pharmacist, but how can that help me to be a doctor? Take the opportunity to learn and take that with me because I know I’m going to move forward, and be the best I could be at that job. And so that was key for me; integrity, hard work everywhere. Even if that’s not the job that you’re going to stay in forever, but it’s going to be a stepping stone to your next. So I had a lot of- now Lucy the pharmacist was my new role model there as you can see, and so I asked her those questions about, ‘What about being a pharmacist? What about being a doctor?’ And so she gave me her input and I didn’t tell her then but I was like, ‘I think I still want to be a doctor. I think that I like that patient interaction in the pharmacy but I also like to learn about the medication so I think a physician has both.’ So it turns out that going back to my story is that she saw in me that need to learn, and so she invested in me. So what she did for me was tell me, ‘Do you want to go back to the states?’ And I said, ‘Yeah I’m trying to save money to go back.’ And she said, ‘Well let me find out about your situation at the embassy of the United States in El Salvador,’ and so she did. And so having a mentor, having people- not officially a mentor, I didn’t know what it was called then, but I knew that she took interest in me and my future. And so she did, she looked up some information and gave it to me, I went to the embassy. Now thinking about it twelve, thirteen years old and going to the embassy, I took my mom because they wouldn’t believe me, they’d kick me out. I’m like, ‘Mom, let’s go.’ So we take a bus, three hour bus ride with chickens and all on the bus, and found out that my dad had started the application process for the embassy program because of the Civil War, and how he stopped that process because obviously he didn’t have money. Well it turns out that we could pick up that process in El Salvador at the embassy, and so I decided with my older sister we need to work and we need to fix our situation and get back to the states. But we made a pact- I have two sisters, my youngest sister is two years younger and my older like I said is one year. Said we have to stick together and if we go back to the states, none of us is going to be a failure. We’re going to be successful and we’re going to get a degree, and we’re going to have to help each other. We’re doing it now and we should continue, we should not forget this experience, and so we did, and so we worked together. The little one of course- I always tell her, ‘You were useless, you were too young.’ But we basically- it’s fair, she was too young, but my older sister worked at a clothing store at the counter and measuring just like- just different things like cleaning and stuff like that, selling products. But she worked, and we figured out what we needed, we went through a checklist and then after two and a half years of being in El Salvador with the help of my pharmacist boss, we ended up qualifying for everything. My dad, who I knew didn’t want us to come back, I lied and I don’t feel bad about it. I know it was bad but I told him that- I basically was a spokesperson I guess of my family, so I told him that we need some documents for a scholarship in El Salvador so that he can help- his documents will provide some information for our green card for us to come back to the states legally. And so he bought it, and so the point is that I didn’t tell him the truth that we were going back because he didn’t want us back, and I didn’t understand why. Well we get everything done in El Salvador in two and a half years, and let me go back to health. So I’m going to school and I’m noticing that the teachers there, their goals for us as students were to work, to get married, were completely different from what I was hearing in the states about college. And I said, ‘What is going on?’ So it was very different. So I didn’t see- even though they wanted the best for me that’s what they thought was best for me, but I didn’t believe that so I didn’t cling to that, so I continued with my mentor- unofficial mentor, the pharmacist. So but my grades were important there, and that was one thing is that I realized that in order to be a doctor you needed to be a good student. I knew that because my teachers in the states had told me that. So I didn’t take for granted that, ‘Oh my life is over because I’m in El Salvador, but whatever I do now is going to affect my future. So your grades, whether it be English in ninth grade, is going to affect you on your MCAT. Your chemistry class in high school is going to affect you on your MCAT. So I didn’t see that then, but I was able to see it looking back. Anyway my dad didn’t know we were going to show up, so here we are, we get all our luggage, get on the plane from El Salvador to California and we go back to our place, our house. Turns out we knock on the door and- well we don’t knock but basically go to our place and my dad has a family that we didn’t know about, and it all made sense. He had two families and so it was too expensive and it made sense why we were always poor. So basically he told us, ‘I didn’t ask for you guys to come, just leave.’ So again, my sisters and my mom were alone in the states, he provided no support. And you go back to your core necessities. Here we are again in the states, we need to feed ourselves, what do we do? Get a job. So realizing what your needs are, and you realize you have to get a job, but you have to make sure that that’s not going to get in the way of your goals of becoming a doctor, in my case. So you have to get a legal job basically, that’s the reality of things. So I tried and I thought it was legal, I went to a pharmacy that said Help Wanted in downtown L.A. and he tells me- by that time I’m fourteen- thirteen or fourteen, and he tells me- about fourteen, he tells me- the boss says, ‘Sure, how much do you want to get paid?’ And I said, ‘Whatever you want. I just want a job, I want to work and I want to go to school.’ He said, ‘Okay, how about $10 a day?’ I said, ‘Okay sign me up.’ I was so happy. And I said, ‘Man $50 a week,’ you know? And I can go to school, I thought that was great. But it turns out that I couldn’t go to school because he wanted me to work eight hours. So then I realized well- I tell the school that I can’t go to school in the morning but can I go to school at night? And they said, ‘Well you’re not old enough because you have to be sixteen or have a problem like being pregnant or some other type of situation to go to those after school programs.’ So the idea here is you have to find yourself thinking you’re in a bad situation. How can you make this work for you to get to your overall goal? And how can you keep believing in yourself when you encounter with [Inaudible 00:29:07]? How can you remain true to your core values, your dreams? And so I didn’t know it then, I’m reflecting on it now, and I think those were the- that I was sensitive to those things. I knew I wanted to be a doctor, I knew what my situation was, I knew I had to stay in school, I knew I had to get good grades. And so that’s important for me to say. Now going to the part where I get a job at $10 a day and not being able to go to school, turns out I go back to my mom and said, ‘Mom I got a job,’ and my little sister again- I tell her she was useless, she was still going to school. But really I’m joking, she was too young to work to help us, but my older sister, she also got a job and she was lucky to get $25. Now I’m looking at it saying, ‘Wow they sure ripped us off.’ But my dad used to come home- come to my- he knew where we were, but he used to come and demand that we give him the money. So here we are again making $10 a day, $25 a day, and my dad comes and wants that money. How do you overcome that? Well you stand up for yourself. I said, ‘No I worked hard for this, and you can’t come and take our money,’ basically. And so we realized you have to protect those that are not able to protect herself, in that case my mom. She wasn’t able to stand up for me and I thought I had to stand up for our family. And so I did, and my dad tells my mom- she’s telling me to leave, she’s telling me to get our money, and I need it because I have bills or whatever. And turns out I was a bad person and I get kicked out of my own place for standing up. I didn’t understand why, why was that wrong? But I knew it was the right thing to do for my family. So sometimes what seems right might be seen as wrong by other people but it doesn’t mean you’re wrong. So step back away and realize what your intentions are, what’s your objective? My objective was don’t take advantage of people and standing up for that. So I ended up going to the jewelry place where I worked and said, ‘Hey I just got kicked out. I can’t find a place at $10 a day.’ There was a man who was older than me there and said, ‘You can stay at my place.’ And I said, ‘Wow thank you.’ And he was like much older than me so again in my culture the older you are, you have to respect. So I did, and I said, ‘Thank you.’ So I go there, and the sad truth is that he took advantage of me. He raped me and I ended up pregnant. So here I am fourteen years old, in a situation where I’m now pregnant, I’m working for $10 a day- well actually I got a raise, I was at $20 or $25.

Dr. Ryan Gray: You’re rich.

Anna: Yeah! So now how do I go from this situation to a doctor, right?

Dr. Ryan Gray: Yeah how do you do that? You’ve overcome at fourteen, you’ve overcome more than anybody should have to overcome in a lifetime. And yet you’re still here thinking, ‘I want to be a doctor. I want to go and serve others, and it’s what I’m meant to do.’

Anna: Yeah.

Dr. Ryan Gray: How did you overcome that and take those next steps?

Overcoming Challenges and Moving Forward

Anna: First of all, I’m not making a plug here, but I didn’t know what pregnancy was. My parents are Catholic, they didn’t talk about birth control, I didn’t know what rape was, I didn’t know any of that. And so the first thing is again, what do I do with this alien basically growing inside me? I said now I have to provide for this human life inside me. And so thinking about- to overcome your situation you have to again go back to your core values, is protecting what you believe in, protecting the innocence. This is a person who’s living inside me that didn’t choose to be in this situation, and how can I make her life better- she turned out to be a girl, she’s 22 now. How can I make this better for her? How can I make it better for me? At that time being a doctor became more of a dream that’s untouchable basically. It’s sad, it was there but it was further away than it was, it just left my hands. And so realizing that I need to provide for her made me again say, ‘Well I can’t be a doctor but what else can I do?’ To overcome the situation I’m at, I’d have to look at the overarching goal right now is to protect her, protect myself, protect my baby, and provide the basic necessities. How can I get there? And so you go and look for resources. So I go to the prenatal appointments and said, ‘Well this is interesting. I’m interested in medicine and now I’m a patient.’ Well my first opportunity to live like a patient and so I’m on the other side but it’s okay, I’m learning, right? So learning about how do you get free food here when you’re pregnant? Well WIC, woman and her children. Take advantage of that, you’re going to save some money if you do that. But should you be on those services forever? The answer is no, this is something that is temporary, it’s something to get you through. Don’t get used to something that is providing the necessities you need right then to make it forever. So you have to understand it’s a temporary fix. So yes, learning about resources and learning what those resources are for and not taking advantage of them. So I would tell them that again, resources and mentors. So I’m going to a doctor, and I’m looking at that doctor and they’re saying things like, ‘Stay healthy, you’re going to need to do this,’ and yes, yes I’m a good patient, and yes this is important, I’m interested, and telling me to keep going to school. He’s telling me keep going to school so I said, ‘Okay.’ So I go to school, high school, and tell them I’m pregnant and they say, ‘You can’t come here anymore because you’re pregnant.’ Okay so the next is where can I go? He says, ‘Well you have to go to an all pregnant girl’s school.’ I’m like, ‘Okay sign me up.’ I go there, like yeah sure everybody is pregnant, but I said most of them were like gangsters, and you know drug issues. I was like, ‘God I don’t belong here.’

Dr. Ryan Gray: They didn’t have aspirations to be doctors.

Anna: No, not at all. And the classes there- so now I’m fourteen and the classes were meant- and I hate to talk- it’s not talking bad but the reality of society that once you’re pregnant you need to go to a special school because you’re special, and then in that school the highest I guess- the enrichment courses were bank tellers type of courses. Cash register- not jobs- I mean they were jobs but not professions. And so what reduced the aspirations they thought a pregnant girl, that’s all you could do. And to me I was like, ‘Okay I guess they know better because they’re in a position of authority so I’m going to listen to them, sure. That’s all they can do for me so what is there that I can do in terms of health,’ because I was still interested in that. And so they tell me, ‘Well because you want to be a doctor you should go into being a medical assistant.’ Okay so I do that. So actually I’m going to backtrack. This is critical. Going back to my pregnancy, I delivered at this hospital called Martin Luther King Hospital in Compton, California. That environment, that’s where I was at during that time just to give you an idea. And to get to the hospital I had to take a bus- the metro, because fourteen years old taking a metro in labor, not knowing what labor was. I thought I was probably- I ate something like chorizo and eggs that was upsetting my stomach. And going to the hospital, and then I get there, and I’m a teen who’s pregnant and so the treatment I got was very different than what I thought I was going to get by the nurses. It was more like, ‘Here’s a gurney, get in here.’ ‘But I’m in pain.’ ‘Well you didn’t feel pain when you were getting that blah, blah, blah,’ thinking that the pregnancy was a choice, and how I was labeled like that. Important to mention that when I delivered it was a resident position who asked me, ‘What are you going to do after you’re discharged?’ I said, ‘Well I’m going to go to school.’ And he said, ‘What do you want to be?’ I said, ‘Well I’m going to go for medical assistant, or something like that, something in health.’ And he says, ‘Is that what you always wanted to do?’ And I said, ‘No I wanted to be a doctor.’ And he says, ‘What’s going to stop you from that?’ And I don’t know the resident, I didn’t know- and he was not Hispanic. Again he was- I believe now he was Asian. It’s not that he, ‘Here you’re Hispanic, I’m going to treat you and give you that pep talk that you need because we bond because of ethnic issues, or race, or et cetera.’ No he did it because he cared, he cared about the person I was. So he tells me, ‘You could still do it.’ And I believed him, and I’m glad I did. And so again in terms of how you overcome adversity is those people that are encouraging you to pursue what you dream of, what you think you’re meant to be in this life, you have to pay attention to this, and you have to believe in them, and you have to believe in yourself. So that was critical for me. So yeah I did the medical assistant thing and my sister, still working, we lived together, my two sisters and mom. And thank goodness for my mom that she never worked because she was able to take care of my daughter. So resources. I said well mom can’t work, but she can take care of my daughter. And so yeah, so she was able to take care of my daughter, I finished high school in this continuation school, and I did the medical assistant thing, and passed the certification. I went to one day of externship and I met the doctors and the medical assistants and they told me what I was supposed to do and I said, ‘Well this is not what I thought it would be.’ And I talked to my sisters, and by that time my older sister got accepted to college, and interestingly she didn’t know how she got accepted but she told me that her advisor filled all her applications for her- I mean helped her, so she had a mentor I didn’t know about, but yes it was someone who was interested in her, and she got accepted into college. And so I said, ‘How do you get into college?’ So she told me how to do it, and basically said, ‘This is how you do it, don’t bother me, I have tests coming so get your information. I’m here for you but I’m busy right now.’ So I did, and get this, I go and I apply for college, Cal State LA. Golden Eagle, shout out East LA. And the advisor tells me, ‘What would your major be?’ I said, ‘Well I want to be a doctor.’ She said, ‘Well there’s different ways to get there; biochemistry major, there’s chemistry, there’s biology, political science. I mean there’s different ways that you can get there but you’re never going to get there because you’re female, you’re a teen mom.’ At that time I was nineteen, at that time I had two kids. ‘You need to get a job. I’m going to sign you up for nursing.’ So I said, ‘Well he’s in a position of authority, seems like he cares about me, it’s related to health, it’s more than a medical assistant, sounds like a good deal. Okay, sign me up.’ So here I am in college in the nursing program, and I see around me other students that are not like me, they don’t have kids. But I had my experience with the patients as a student nurse, and I loved it. I said man, this is really nice. This is something that you learn in books about diseases, and then you go and you actually experience it and you make a change. I said, ‘Wow this is great.’ So I’m doing fine, and no problem going through like classes- and I’m telling you I’m working, I’m a single parent. I’m working for a pharmacy, still providing for my kids, pharmacy jobs all the time and still helping my mom. But the interesting thing is that I saw- this is critical for all premeds out there. I saw other students who were studying in the library with books; organic chemistry, physics, and I said, ‘Those are the classes for premeds. Man they’re so smart. Yeah he was right I would have never been able to be a doctor. I could never take those-‘ because I saw the open books. I said, ‘What the hell is that? It’s like a different language. Thank goodness I’m in nursing because I would have never been able to do that.’ And that’s how I talked myself out of becoming a doctor. I didn’t know then, I know now, it’s like I didn’t think I was smart enough. How dare I think that, right? Not being smart before trying. So anyway, so turns out do great in nursing school, I get hired- pass my boards in nursing, get hired at Kaiser Permanente- shout out there again for hiring me. It was in the family center care so we did labor and delivery and the partum and postpartum care and GYN-E post-op care, and it was excellent for me. It gave me that idea of the contact with patients- again the medicine, but it really made me realize there are doctors here, there’s residencies. I didn’t know really what a resident was until I was there. And said, ‘They do more than I do for the patient.’ I’m not belittling nursing, but what I’m saying is to treat a patient more comprehensively I had to understand what I really wanted to do with my life, and what I wanted for my patients to get out of my experience with them. And I sure did want to do more, not better but more. And so I realized I needed at that time, maybe I should go back to school and be a nurse practitioner. That’s close enough to being a doctor. Chemistry and physics, those are not the requirements for nurse practitioners. I said, ‘Let me look into that,’ and so I did go back and go into family nurse practitioner program again at Cal State LA. And the first class, the first clinical rotation as a nurse practitioner student, Dr. Silva who is a family medicine doctor in a low-income area, east LA, El Sereno area where I grew up, underserved area which that’s usually where- I mean at that time that’s usually where I was. He tells me, ‘Welcome, I’m here to help you,’ and he treated me no differently than he would treat a resident as a nurse practitioner. There was a PA student, Yvette, a wonderful person, and he tells me, ‘We’re going to go to the hospital and we’re going to round.’ And I said, ‘What is that? I mean like what would be my role there?’ I didn’t understand, but I’m glad he took me there to the hospital and do the rounds with him because I realized then, when he asked me this question. He said, ‘Did you always want to be a nurse practitioner?’ And I said, ‘No.’ He said, ‘What did you want to do?’ I said, ‘I wanted to be a doctor.’ And he says, ‘So why didn’t you do it?’ I said, ‘Well I’m old now. Like I have kids,’ and making all the excuses why not before addressing my fears, my real fears of failure. I understand that now, and he tells me, ‘Well I was in medical school and I had- I think I had three or four kids,’ he tells me that. Wow I didn’t know that you can do that. I didn’t know you can go to medical school and have kids, and have a life. And he says, ‘Well-‘ he went to UC Davis because there’s a lot of programs out there that can help people who are nontraditional, which means basically you don’t go from high school, to college, to college, to med school. And so he said, ‘You’re very smart.’ I mean he saw me work, and I’m not bragging about myself, but he knew that I had some potential. So I said maybe he’s right- and again, he’s a mentor. He believed in me, he was telling me what I needed to do to get to the next level. And so being very specific about what your needs are, what your goal is, and then when you’re in a situation, how can that environment help you to get there? To get to your goal? And so he was the one that time that became my mentor. So I’m having that mentor at every stage, I’m still not forgetting about the others, and I know when to tap- tap may be the wrong word, but when to consult with them. The opportunity arises. So selective mentoring, maybe? I don’t know. So Dr. Silva basically said something like, ‘You should look into that,’ and so I did. I know I’m taking a lot of the program’s time, so I want to cut to the important thing is that Dr. Silva- I told you about that PA student. I asked her, ‘Did you ever want to be a PA student?’ And she said, ‘No. I always wanted to be a doctor.’ I said, ‘What stopped you?’ She said, ‘I got a really bad MCAT score but I’m going to retake it and see how that goes.’ She was in her second year of PA school, so you need three years. So what she did, she took the MCAT again, and she applied to medical school, she got into medical school, she’s a resident now- I mean I’m sorry, she just finished residency, she’s officially an OBGYN doctor. We kept in touch. And so when I went back to school, when I realized that Dr. Silva was believing in me, and I hear from this girl who was a PA student, who’s about to graduate, who still wants to be a doctor, who’s pursuing that, I saw her as a mentor as well. And so yes, and my daughter at home who was at that time in high school says, ‘I’m looking into colleges.’ I said, ‘You can be anything you want to do,’ blah, blah, blah. And she said, ‘Mom you didn’t do it for yourself, you always wanted to be a doctor, and look you never tried.’ And she was absolutely right, and so I gave it a chance, I tried. And you know what? I owed it to myself, and I owed it to my patients, and that’s how I ended up applying to medical school with- this is legit. MCAT. Anybody premed, my MCAT score on the record- my first MCAT score- no one likes to talk about scores, but I will.

Dr. Ryan Gray: Let me guess- oh you said it, thirteen.

Anna: Thirteen. What were you going to say?

Dr. Ryan Gray: I was going to say fifteen.

Anna: No, thirteen.

Dr. Ryan Gray: Thirteen, okay.

Using MCAT Score in Application

Anna: So what do I do then? I said, ‘Well let’s see, no I’m not going to apply with a thirteen. I think I can do better than that.’ But I hear go to AAMC guys, seriously, this is one thing. You have to use your resources. Go online, you are a good resource, anything that is going to challenge you to be better. So looking at those resources and looking at what are the average scores? How can you be competitive? Which are the programs that are going to offer what you need, and who are going take you for what you have to offer? So like family medicine programs that have loan forgiveness programs, et cetera. The point is MCAT scores, a thirteen, how do you move from there? So yes, you can do better, right? So you have to think about it- I get passionate about this, sorry. You have to think about it- you have three chances to apply to medical school. Think about it that way. The first time you apply, you apply with a low MCAT score. Okay, you get rejected. The second time you apply, you probably have a little better score, but the fact that you got rejected the first cycle, then that hinders your application on the second chance. So on the third chance most schools has something that says, ‘We discourage you from applying if this is your second cycle applying.’ So you have to think about it before you actually take the MCAT. If your practice scores are not above or average, or close to the average, I mean don’t apply unless you have other things to help you with that. In my case, I didn’t get accepted with a thirteen, I re-took it and I got a 22. So is that good? No it’s not good, but it’s not good for other people that are used to seeing the average of 30, 35. But for you, you have to look in your situation. What’s your experience with patient care? What adversities? What leadership roles? That could boost your MCAT score quite a bit, so you have to look at the whole package that you are, so you have to believe in yourself to make that claim, to make that claim that your MCAT score does not define your acceptance into medical school. And how can you do that? Well I said it all along in my story. Fighting adversity, being the leader, sticking up for the people that can’t, taking advantage of every opportunity, being a good student, having those grades, and you can make a case for yourself and then apply to the programs that are researcher programs. And then when you get the interview, you’d better be ready to practice because that’s an opportunity to sell yourself as a doctor that you are going to be. Not that you’re dreaming or people told you- that you are going to be. And so the questions that they’re going to ask you are critical for you to understand how you’re going to answer.

Preparing for Interviews

Dr. Ryan Gray: Yeah how did you prepare for your interviews?

Anna: With my mentors. So I went with my mentors who wrote my recommendation letters, they believed in me to write- and by the way, you have to ask them whenever you ask for a letter, ‘Write a strong recommendation letter.’ So I went to Dr. Saks, he was an OBGYN, I loved Dr. Saks. He was a physician- he’s retired now, at Kaiser, an OBGYN doctor. So I met with him and we went over questions. He said, ‘The first thing is about your MCAT score, they’re going to see your 13, they’re going to see your 20, what are you going to say?’ So I said- this was honestly my answer. I said, ‘You know I work as a nurse in the labor and delivery area, postpartum, et cetera. When there was an emergency, a C-section that was bleeding, or antepartum bleeding, the first thing that came up was the patient, and not an MCAT score. And to me that was more important to have a physician to care about the patient, but no one’s talking about saying, ‘Okay who has a 35?’ You know?

Dr. Ryan Gray: Paging all 35’s, please report.

Anna: Yes. Yes who got that o-chem highest score? No that wasn’t the case. And so that’s how I prepared myself. So I said, ‘Okay how am I going to put myself in a situation where my weakness in the application which was the MCAT score does not reflect a weakness on my character as a person. So mentors, also the online resources, your website, AAMC is one that I used a lot.

Dr. Ryan Gray: Alright so I have a question.

Anna: Sure.

Dr. Ryan Gray: So last week’s podcast episode as yours is going out, was a discussion with Kaplan and talking about MCAT scores, and how that relates to board scores, and success in medical school. And it’s usually the biggest hang-up for medical schools, is they see this 22 and they go, ‘You’re a great nurse, you’re in NP school, you obviously are successful. But are you successful enough to pass classes in med school? To pass the boards?’ Did you struggle in med school? Did you struggle in step one of the boards?

Anna: Did I struggle in med school? No. I’ve never failed a class, I passed step one, and I passed it with a good score. But I have to tell you, I thought I was going to mess up. I thought I was-

Dr. Ryan Gray: Everybody thinks they’re going to mess up.

Anna: But here is the key. That school that you’re applying to has a lot of resources, and so that’s where you go and you look for resources. So in med school you take your first module, your first rotation, you have to see what do they offer for people who, like me, are very scared of failing? Because I feel like I’m going to fail. So I did that, there’s a lot of programs, there’s a lot of resources out there.

Finding Resources

Dr. Ryan Gray: I think it’s probably the dozenth time that you’ve brought up resources, whether it was WIC, or mentors, or resources at medical school. When I start talking to students that work with me, and I help them with their applications, and we talk about their past performance and how poor it was, if it was, it always seems like the number one thing was that they didn’t go out and seek help from the resources that were available to them.

Anna: Yes.

Dr. Ryan Gray: Why do you think you were able to just easily go out and seek resources, yet all these other students out there, a majority of other students out there don’t do it? Do you think it’s a fear of acknowledging that they’re not smart enough, or good enough? A fear that they need help? Or is it they just are naive and don’t know?

Anna: I’m going to answer in two ways. One that I know about the resources is that they hear from other classmates how hard it is, how medical school is so hard that they get discouraged. And so going to look for a resource, and they see man it is going to be hard, it validates that it’s going to be hard when they look at- okay yes, you do need to do all these classes, yes you do need to get a certain score on this, and so it validates those fears, and they don’t want to confront those fears. And I think that when you go on Google and you look, ‘What is the average MCAT score for whatever school,’ and then it comes up 35, ‘Oh my gosh I’m not going to be able to do it.’ So what do you do next? Well most likely if you don’t want to confront your fears that you perhaps are not going to be able to do that, then you’re not going to tap into those resources, so the first thing is accepting yes, that’s what’s going to be required for me. I need to get a good score, and it’s going to be hard. How can I get there? That’s the next question. So accepting that- the first way of answering that question is accepting your fears once you realize that the resources are out there, and they’re going to confirm those fears. Accepting that. Second- and let me know if I don’t answer your question or if you don’t understand what I mean because I tend to go on tangents. But the second way to answer that question is believing that you’re too smart. You’ve gone through high school, you’ve got- without even studying you got good grades. You go to college and you only studied four hours for the final, midterm, and you ended up getting a B+ in ochem. Why do I need to go into resources? I’m good. And I’m going to take the Kaplan, or I’m going to take Princeton, and that signing up, it costs $2,000, that makes it seem like I’m paying $2,000 to guarantee a good score. So why do I need to tap into other resources other than what people- you know the more money I pay, that guarantees a higher score, not really.

Dr. Ryan Gray: I don’t have to put any work in, I paid the money.

Anna: Yes, exactly and so then they realize. I hope I answered your question.

Dr. Ryan Gray: Yeah, no that was perfect. What do you think- you talked about interviews and preparing for interviews. How many interviews did you go on?

Anna: I’m ashamed to say I only went to one, two- four interviews.

Dr. Ryan Gray: That’s amazing. That’s three more than a lot of people get.

Anna: But one was for- I’m not putting down Caribbean schools, no way. But one was a Caribbean school, two were in Puerto Rico- still a US school, by the way a lot of people don’t know that.

Dr. Ryan Gray: Puerto Rico are US schools, yeah.

Anna: And that’s how you go through resources and find out if it’s a US school, what are the MCAT score requirements? Guess what? They took-

Dr. Ryan Gray: A lot lower.

Anna: Yes.

Dr. Ryan Gray: Well there’s a reason for that and it’s because they still take the MCAT, and guess what? The MCAT is biased towards ESL students, which if you didn’t know, they speak Spanish in Puerto Rico.

Anna: A lot, yes.

Dr. Ryan Gray: So yeah.

Anna: And then Kansas.

Dr. Ryan Gray: Yeah. Okay and you’re at Kansas now?

Anna: Yes.

Dr. Ryan Gray: On your interview path, what was the hardest question that came up?

Anna: My MCAT.

Dr. Ryan Gray: Yeah, and answering that question?

Anna: And answering that question without- I have to make it clear, you cannot put yourself as the victim. ‘It’s because my mom, it’s because dad, it’s because I was poor, it’s because-‘ Even though in my situation being poor was a legit situation, but I couldn’t use it. You have to realize that because that’s not- when you treat a patient, you can’t say you [Inaudible 01:04:56] or something because you were poor at that time, or whatever. Basically that was the hardest question, and the most important question that they will ask you after that is, ‘Why do you want to become a doctor?’ Those are I think- and then the third one is, ‘Why our program?’

Matching Medical Schools with Your Core Values

Dr. Ryan Gray: Exactly. Why do you think Kansas took a risk accepting you?

Anna: By the way I don’t know if you looked at our stats at KU, but they take about 90% in state students. I’m out of state. They only take about less than 20% out of state, so you have to be very qualified I think in order for you to get an interview. And so first I have to tell you that I looked at the program, and looked at their internal medicine program, their family medicine program, and I thought what they believed in, the core values of what KU stood for were like mine, and so that’s how I ended up applying there. Their MCAT scores were higher than 22 as an average, but I felt like also they had programs that helped minorities. They had a minority diversity program, and so those were the reasons why I applied. Now to answer your question about why they took a risk. No they were not filling their quota of Hispanics there, that’s not true, or their female, that’s not true. What KU believes in is that you have to look at somebody the way you look at the patient. The overall patient, not just his hypertension, not just diabetes. And I think they looked at my situation and said, ‘Well how the hell did this girl get from having parasites in El Salvador to becoming a nurse, a nurse practitioner, and having to take care of now two kids who are probably the interviewer’s kids’ age? And so in terms of leadership, in terms of adversity, you want a doctor- they want to produce a doctor that’s not only going to practice medicine to the upmost standards, but they want to produce a doctor that’s going to be a leader in the community, a leader in change. They see the trends nowadays with health, they see the chronic illnesses, they see that so they take a chance- I think at least, I have not asked officially why in that way that you’ve asked me, but that would be interesting. But I feel that they want to produce a doctor that has the core values that they have at the same time, and they want to make sure that their patients at KU, but also the patients of the whole United States. Not only theirs.

Anna Looking to the Future

Dr. Ryan Gray: Now that you’re in med school, you’re finally realizing your five year old self dream, overcoming all these obstacles, what’s the future hold for you? What are you thinking about practicing? Where do you want to live in the world?

Anna: My daughter- my youngest one, my last one, she’s thirteen, Mia Jimenez, shout out to my little girl. She’s in California, and so a residency for me ideally would be California to be close to my daughter. Second would be at KU, Kansas, because what they invested in me and my education, and I am very grateful for that. I want to work for Kansas, I want to live in Kansas, and I want to practice in Kansas. In terms of specialty- well that’s if they take me. But the other thing is as applying for residency, sometimes you don’t get matched there, so out there, I’m not only selling for Kansas, but please take me anywhere. But the program that believes in my core values again, and I have to be comfortable with the program myself. And the specialty, I wanted to- I went into medical school thinking I wanted to do internal medicine 100%, I wanted to be a nephrologist. It changed last year to okay maybe internal medicine, but maybe hematology. Every rotation you take, sometimes it takes you to a different route. Then I look at my scores and I’m like, ‘Wow I’m very good in neurology.’ Well maybe I do want to go into neurology. Now here I’m graduating this year in 2017, and so here I am thinking, ‘Well what the hell do I want to do?’ I mean so you have to rank those, so right now I’m leaning towards- first choice would be internal medicine, do that first, and then look at what sub-specialties later. And my backup either neurology and OBGYN because I’m familiar with that and I enjoyed the rotation, I did pretty good on the rotation.

Dr. Ryan Gray: So you ranked internal medicine programs first?

Anna: Yeah.

Dr. Ryan Gray: Yeah, okay so you match in March coming up. March, 2017.

Anna: I’m going to- we’ll see.

Dr. Ryan Gray: Match day is 2017. You’ll match, you’ll be fine. So you’re going through that whole process now. Go ahead.

Anna: Yeah I was actually going to say, actually I’m not applying for match 2017 this year. Because of my personal situation I’m going to match 2018. I want to do some research. I feel like the profession I’d go into, or my specialty, I want to be sure. I’m older so sometimes going into a residency program because you’re not too sure, and you’re going to commit yourself to a place where you’re going to have to live there for three years, and then realize that’s not what you want to do. Doing some research about it both in the field- and I mean clinical research in the field that I want to practice in. I want to take that time so I want to do match 2018.

Dr. Ryan Gray: Okay well if you haven’t yet, you should check our Specialty Stories Podcast.

Anna: Yeah.

Dr. Ryan Gray: Last week, again as we release this episode, last week was a nephrologist and two weeks before that was a neurologist. So help give you some insight into those worlds. Anna as we wrap up here, for a student that’s struggling, a minority student who comes from a low socioeconomic background, who has overcome obstacles like you’ve overcome and is continuing to doubt themselves, what do you tell him or her to motivate them to continue forward?

Words of Wisdom and Motivation

Anna: What has helped me before in those situations- and I’m not sure this would work for everybody, but I’m pretty confident that it might. And what helps me today is to tell myself that whatever chaos, whatever drama around you, whatever circumstances, adversity, it’s temporary. Key word, temporary. Whatever’s going on is going to pass just like a kidney stone. But no in all seriousness, it’s to consider the situation you’re in as a temporary situation because that makes you realize okay there’s something else to look forward to. In my case it was always what is the next step? You have to take time every day even in those situations where you feel down, low, sad, discouraged, to look at a positive. What is your goal? You have to give five minutes, two minutes to say, ‘I always wanted to be a doctor. Is this going to stop me? This is temporary. What are the resources? Who can I call?’ You cannot get stuck in there. If you do, you’re not giving yourself a real chance to be the best you could be, and you’re negating your patients of a good position if that’s your passion and if that’s your calling.

Final Thoughts

Dr. Ryan Gray: Alright again that was Anna sharing her story of her journey from growing up in El Salvador, and coming to the US, and all of the obstacles that she overcame. So thank you Anna for sharing your story. I know that it will help many students listening to this, listening to your story and understanding no matter what they’re going through, take that, and take that experience, and whatever you’re doing right now, and keep pushing forward towards your ultimate goal, and use those as little stepping stones. So thank you for that.

Alright I want to take a second and thank a couple people that have left us ratings and reviews in iTunes. If you haven’t done so, you can at www.MedicalSchoolHQ.net/iTunes.

We have one here from AmberDevi that says, ‘I don’t know where I would be without it. I stumbled onto this podcast a few months ago and it has shaped my life so much.’ Thank you for that, AmberDevi.

We have another one here from dochopeful that says, ‘For future docs, by docs.’ I think we should come up with a slogan kind of like FUBU, FFDBD, although that doesn’t really go that well. So I like that. It says, ‘Really the best. I stumbled upon this podcast and found an incredible resource and community at med school hangout on Facebook.’ Yes if you are not part of our hangout, go to www.MedicalSchoolHQ.net/group. We have over 2,000 amazing students in there helping each other every week. Or every day actually.

We have another one here from CheeseRVA that says, ‘Collaborative, informative, and downright awesome. As a nontrad premed student, this podcast has been an invaluable resource. The plethora of topics covered provides tremendous insight regarding the application cycle, what it’s like to be a physician / medical student, and has ultimately put a positive and motivational spin on the often tumultuous process of becoming a physician.’ Yes I think that is one of the biggest things. I actually had a phone call recently with the director of one of the more well-known postbac programs and he checked out my podcast, and he was- he liked the fact that the podcast is very motivating, and very positive, and encouraging. So that’s one of the things we try to do here. I will tell you the truth that medicine is not all happy and glittery, but there are some amazing parts to it and well worth it in the end.

Alright again www.MedicalSchoolHQ.net/iTunes if you have not left a rating and review, I would greatly appreciate that. If you live in or around the Orlando area, I will be in town February 18th for University of Central Florida’s Medical School Admissions Symposium. If you would like to go to that, go to www.USCFMSAS.com/maintenance. So the /maintenance tells me that their website hasn’t been updated yet, but that’s okay. If you can’t find that website go to our hangout, www.MedicalSchoolHQ.net/group and we’ll have information in there. I will- I don’t know if I’m speaking, I think I got in on this a little bit too late for speaking, but I will have a table there, and will hopefully have my podcast equipment there, and we can chat, and you can be on the podcast. And as always I’ll try to have a meetup after the symposium, we’ll go out and have dinner, and chat, and talk, and collaborate which is what I like to do.

Alright I think that’s it for this week. I hope you enjoyed and learned a lot from Anna’s story. I hope you have a great week, keep pushing forward no matter what obstacles are in your way this week, remember that the ultimate goal doesn’t matter how fast you get there, as long as you get there. Have a great week.