Today, Dr. Roozehra Khan joins me to discuss the difficult parts of her premed journey, mentorship, burnout, and why she chose to make the transition to academic medicine. Rozy is @thefemaledoc on Instagram.
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[01:30] Interest in Becoming a Physician and Dealing with Comparison Culture
Back when she was a child, Rozy’s mom used to practice as a doctor in Pakistan. Growing up, she flipped through her mom’s books. One of them was a pathology book with all the pink and purple slides which she loved flipping through it. Since then, she just knew it was something she wanted to do.
The most challenging premed struggle she had was coming to terms with her extremely low scores and continuing to push forward. She then started to explore osteopathic medicine but her premed peers had a lot of pushback.
One of her friends is an osteopathic doctor and became her mentor whom she got to shadow. She knew there was stigma but didn’t see any difference. She decided she’d rather take the stigma than delay becoming a doctor.
Rozy was afraid of talking about her scores because she was embarrassed. But she shared snippets of it only recently on Instagram when she realized it’s important for premed students to realize.
Another reason she put it on there is because of the comparison culture among medical school that premed students have to be aware of. People think they should only be driven by stats. But you are more than your stats!'There's this comparison culture and they don't look at the real statistics of what's going on in medical schools and what the numbers are.'Click To Tweet
[08:23] Her Premed Struggles and the Application Journey
Rozy describes how challenging premed was. Some start it off because of the status but it’s not glamorous at all. And so it weeds out people.'At the end of the day, the actual profession isn't so glamorous and getting through all of the rigorous work isn't glamorous.'Click To Tweet
When looking at which schools to apply to, she applied to four DO schools and 12 MD schools. But she didn’t complete any of the secondaries for MD schools. So she only essentially applied to DO schools and she thought it was only crazy to only apply to four.
She decided not to pursue applying to the MD schools for various reasons. Aside from thinking it was a waste of money, she thought she wasn’t going to be taken seriously. She thought it was going to be harder for her to sell her journey to them. Not to mention, she thought she was a terrible writer.
Writing her secondaries was just so painful to her. Before, you would have to send them in paper. She had to send out copies of everything individually to each osteopathic school she applied. It was just a lot of hardwork.
Rozy recommends to students to prepare your secondaries ahead of time. Instead of waiting for secondary essays to roll through, start prewriting them now. (For a database of secondary essays and other pertinent information about different medical schools, go to secondaryapps.com.)
Out of the four DO applications, she got two interviews. She eventually got waitlisted at one school and got an acceptance to Touro College of Osteopathic Medicine. You only need one and you’re in. That’s it!
[15:00] The Medical School Journey
Rozy thought medical school was so much fun. She enjoyed her time during medical school, mostly because their school had an excellent curriculum. They had block scheduling with 10 exams in one week. So they had to take two tests per day, done three times a semester. Because of this, they were able to absorb the material over the course of five weeks.'Balance to me is everything and it's still a huge part of my life.'Click To Tweet
For the first two weeks of learning the material, she would describe it as just leisurely going through notes. Then she’d take the entire weekend off or fly home to LA and hang out with her parents.
The curriculum structure essentially worked well for her type of learning style. So the first two weeks of light load helped her balance her life. Unfortunately, not all schools are structured like this.
She went to Jewish school which has lots of holidays. She had five-day weekends all the time. It ended up they had more stuff to cover during the actual school days and summer days got cut shorter. That said, she liked this kind of balance.
She actually found out about Touro’s structure later. She didn’t initially realize how beneficial it was for her learning style until she got into rotations with Western University students. While Western had a test each week, Rozy likes how Touro would do ten tests in one week but five weeks to learn it all. However, this won’t work for severe procrastinators. It all depends on your learning style.'Medical students sometimes don't foster those mentorship relationships because they feel like they're bothering the doctor.'Click To Tweet
[19:13] Interest in Her Chosen Specialty and The Power of Mentorship
Rozy got interested in Critical Care during her rotations on her third and fourth year. She really looked up to the Critical Care attending physician at that time. He demonstrated a great deal of empathy towards his patients. He also emphasized the importance of dignity in the dying process. Unfortunately, this is something Rozy doesn’t see as often anymore.
When she became an intern, she did her ICU rotation and found how exhausting it was. Eventually, as she got better at just being a doctor, things got easier. She then visited the thought during her third year of residency.
At that time, you had to apply two years in advance if you wanted to go to fellowship directly. She would then have to take a gap year but she decided to apply anyway.
Seeing how their other attendings did not show empathy the patients and their families deserve just irritated her. This prompted her to keep going and not just stay being hospitalist.
So she got in for the following year. In fact, she “stalked” their program director for several months. She told him that she hadn’t signed the hospitalist contract yet. So if anyone dropped out for that year, she was available. Good thing someone dropped out so she got in.'People drop out of fellowships all the time for various reasons.'Click To Tweet
Rozy stresses the importance of mentorship and students may be hesitant in fostering mentorship relationships thinking they’re bothering the doctor. But as an attending herself, Rozy loves getting feedback and follow-ups. This inspires her to keep on going and make a difference.'Medical students sometimes don't foster those mentorship relationships because they feel like they're bothering the doctor.'Click To Tweet
Attendings get burned out too. Teaching takes a lot. But it’s very rewarding for attendings to see their trainees succeed or to see that they’ve impacted them in some way.
[25:16] The Impetus Behind Her Instagram Presence
It all started in 2014 at a time when she didn’t want to be a doctor anymore. Rozy was so burned out after fellowship that she decided not to be a doctor anymore. She was going to rekindle her love of web development.
Rozy read Facebook COO Sheryl Sandberg’s book, Lean In, that came out in 2013. She resonated a lot with it especially about women in the workplace.
She wanted to apply this to women in medicine so she started the blog called FemaleDoc.org (now FemaleDoc.com). She intended to create a social network for women in medicine to connect on a deeper level and talk about workplace issues.
Not getting much traffic, she looked to social media marketing where she stumbled upon Instagram. At the same time, she continued doing different lectures at national conferences. She noticed at the end of the lecture, that everyone wanted to know very specifically what she did.
So she figured putting out a blog to talk about her experiences and advice. Hence, @thefemaledoc came and her Instagram just exploded.
[28:55] Overcoming Burnout
There are two aspects of burnout. One of them is the systemic burden where physicians just aren’t taken care of, and other healthcare providers for that matter.
Another aspect is the individual recognition and understanding self-care. Doctors are trained to just go, go, go and that’s it! If you weren’t studying 24/7 then you’re doing something wrong. So you have to do more. And this whole culture is ingrained in you that you forget to take care of yourself.'The culture gets so ingrained in you, especially when you're starting as a premed.'Click To Tweet
Moreover, the night shift is insane. But since she’s been a resident, they changed the hours and the restrictions. This has gotten a lot better though. But critical care and ER physicians have the highest rates of burnout at 55%.
Rozy admits that while she is very well-versed in burnout and published on burnout, it still creeps up on her. Once she gets out of the situation, then she realized she had gone through burnout. The symptoms can be so subtle. It could be in the form of not getting good sleep. But it was burnout.
Consequently, Rozy made dramatic changes and choices. Several people make decisions based on their finances but she didn’t do that because she didn’t care.
The first job out of fellowship, she negotiated to have no night shifts, and on a 7on/7off shift model. Eventually, she came out of her burnout having had plenty of rest in between. Back in her fellowship days, they were on call every three days for 27 hours and did this about 8 months a year for two years. It was just too much!
Now coming into academic medicine, she took a huge six-figure pay cut but knowing that it was an exchange for a better life. But others decided to continue to work like a dog to make money to be able to keep up with their lifestyle. She decided that wasn’t as much important to her as rest is.'My rest was much more important than a fancy lifestyle.'Click To Tweet
[33:55] Bias Against DOs
Rozy doesn’t think anyone even notices that she’s a DO even if she’s attending. This whole DO thing is something premeds and medical students keep alive. But once you’re in residency or fellowship, no one’s paying attention. People just stop caring. Rozy thinks that most of the time too, people just probably assume you’re an MD.
The decision of many students not to apply to DO schools can be because of the status and culture for the most part.
Coming from a Pakistani-Indian background, it was a big stigma. People would ask her parents what school she went to. It was very status-driven. But at the end of the day, all she wanted to do was help people. After a while, people just stopped asking.'There weren't opportunities that went missed because I'm a DO.'Click To Tweet
All this being said, it can be painful to hear people talk about your school or that you’re not really going to be a doctor. But you realize people are still going to criticize what you’re doing because they don’t want to see you succeed.
Another thing Rozy noticed premeds and medical students do a lot is worry about stressing out about residency and fellowship. Try getting into medical school first. At least, open up the door to that path.
Until now, she doesn’t understand why students say they don’t want to be a DO. Although it’s mostly just status. You need to get over that.
[39:26] Final Words of Wisdom
Rozy chose to keep going and apply and go through the learning process. Her motto is: Done is better than perfect.
A lot of students tend to push back years hoping to make this perfect application. But just start applying and you will learn what is necessary. You basically learn from the process. So just do it!
Lean In by Sheryl Sandberg