Episode 29, Part 1: Pulling Back the Curtain! Medical School Questions Answered.

Kristen: Welcome back to Cancer Uncovered. This is Kristen Wynn, program manager at the Live Strong Cancer Institutes, which is part of Dell Medical School at the University of Texas at Austin. Hook Em horns. This set of episodes is really, [00:01:00] If you’re at all interested, even just a tiny bit in attending medical school, your guides for this episode, Rachel and Brooke, who you’ll meet in just a moment, are two of the leaders of the oncology student interest group here at Dell Medical School, which is a student club full of medical students on campus who are interested in learning more about cancer.

Rachel and Brooke break down the very basics of medical school for us and give us their. As people who are in the middle, or in Rachel’s case, nearing the end of their medical school journeys. The whole point of these two next episodes are to get really clear about what it takes to get into medical school, what medical school is like, how fun it is, how hard it is, how expensive it is, and we’re holding nothing back, letting you know everything you might want to consider.

If you’re thinking about medical school, I want you to make a special note before we dive. And highlight [00:02:00] a theme that you’ve heard repeatedly if you’ve been listening and learning with us for a while, and that is this. We purposely want you to hear Brooke and Rachel’s unique experiences, but you’ll hear them say this, and I want to make sure that you catch it.

There is no one way to get to where you want to go. People enter the medical field. In many ways, medical school is one way to get there and the medical school path. Very different for everyone. So take a deep breath, listen to their stories, and know that medical school is for you too. Yes, you, if that’s what you want to pursue.

Brooke: Thank you. I’m excited to be here. I’ve never been on a podcast before, so I’m a little bit nervous, but I’m excited. Uh, my name is Brooke Upchurch. Um, I grew up in Houston. Um, then I went to college in Southern California at U S C, so I moved to Austin from med school, from la and I know everyone’s gonna make fun of the way I just said it.

[00:03:00] La. I, um, before coming to me school, I got my master’s in Global medicine and I, right before actually I was working in an ice cream shop and had a workout studio along with like a lot of actors and writers and Sure.

Rachel: Actors and such.

Kristen: I can’t remember if you told us this already, but what year are you in in medical

Rachel: school?

Brooke: Um, I’m a third year. So three of four.

Kristen: And then you explained a little bit what you were doing prior to medical school. Was that an intentional time for you? So you went to grad school and then you were like, hold the phone. I’m gonna go do this for a little bit. Is that a gap

Brooke: year? Sort of. So I, um, had the opportunity to start my master’s program while I was still in my undergrad.

So the spring of my senior year, I was finishing up a couple of undergrad courses, but I also started. Masters. And then because of the accelerated program, it was only one calendar year. So then I took classes over the summer and started [00:04:00] working at the ice cream shop then. And then also took finished up in the fall, and then after that ended in the fall, I still had.

Five or six months left on my lease five or six months before medical school was gonna start. So I decided to just stay out there and finish out my lease and got the other job at the workout studio and like nannying and you know, this, that or the other.

Kristen: What did you do in undergrad? What’d you get your degree

in?

Brooke: My degree was in neuroscience. Nice. I’ve always loved the brain and I like to joke that it was like kind of like half philosophy and very like, what is consciousness and the limits of the mind? And then half like the brain is a computer and here’s how you work it. Uh, it was fascinating. A fun little mix.

Yeah.

Kristen: Yeah. That’s great. Let’s jump into our med school 1 0 1 type of questions. No, no judgment here. I didn’t know many of these things until I started working at the medical school five years ago. There was so much, I think so much of us don’t know and we’re kind of afraid to ask. So that’s where these [00:05:00] questions came from.

Um, I’m

Brooke: all about the, there’s like this, we joke that it’s like the black curtain, like all the stuff that like happens behind the curtain, that everyone just acts like they’ve always known. Not true. I’m definitely big fan of op. Open the curtain. Open the curtain.

Kristen: Just open it, open the curtain, ask all the questions.

So yes, this is what this episode is. It’s opening the curtain. Maybe we’ll retitle this episode. Something about just open the curtain. How long does medical school take

Brooke: it? It varies a a little. You have to, to go to medical school, you have to have an undergraduate degree. In the US it’s four years of undergrad, and then medical school itself is four years, um, in the United States as well.

And then after medical school, in order to be an independent practicing. Clinician, you have to complete a board certified residency program. And those vary in length from, I think three years is the shortest to seven years is the longest. And yeah, so then when I say it all like [00:06:00] that, I’m like, oh wow, this is, here we go.

Yeah. Yeah. After residency there is, um, so residency is like when you. Choose to pursue a career in pediatrics or internal medicine or obstetrics and gynecology. That’s what like residency is. Mm-hmm. And then optionally, there are fellowship programs after most residencies that some people may choose to do to further subspecialize.

So for example, if you really love the gastrointestinal system, but you also love kids, you might do a pediatric residency. But then after residency, which is three years, You might choose to pursue a fellowship in GI or gastrointestinal medicine. Um, and then you would see pediatric gastrointestinal issues.

Kristen: Cool. Yeah. So it’s just getting it zeroed in that much more on on and really focusing in on what you want to practice. Exactly. Cool.

Rachel: Okay. Do you

Kristen: have to go to medical school right

Rachel: after undergraduate? Absolutely

Brooke: [00:07:00] not. So I took one gap year, um, during which I got my master’s and then also worked at the ice cream shop and stuff.

I have people in my class who. Like they don’t even consider them gap years because they had whole careers before they went back to medical school. Yeah. I think that going straight through, you’re super sure and it works out for you financially and all those things. Not at all a bad option, but I also definitely wanna make sure everyone knows there’s.

Nothing wrong. And I would even say perhaps some, several advantages from taking 1, 2, 5, 10 years in between. Um, because you really are each of those steps developing yourself as a person, which will then impact your, um, skills as a, as a physician and staff. So there’s, it’s, it’s, you know, 10,000 ways to skin a cat kind of situation.

Absolutely.

Kristen: I am going to let Rachel in. I don’t know how long she’s been there. I was looking at my questions, but she’s here.

Rachel: Hi,

Kristen: Rachel.

Rachel: Gosh. Hi, y’all. I’m so sorry. [00:08:00] I’m Rachel Gorum. I am from Capel, Texas, which is a small town near the DFW airport. I went to UT Austin for undergrad, studied neuroscience, and I also did a gap year where I worked as a medical assistant at an OB G Y N clinic.

And then I’ve been at Dell Medical School ever since. I am currently a fourth year medical student about to graduate and go on to the next phase of residency. Uh, okay. So

Kristen: you took a gap year after getting your degree at UT and then, and then came to Dell Med. That’s great. Oh, well, and you worked as some medical assistant, so that, I’m sure you learned a ton that applied to

Rachel: medical school in that gap.

Yes, I as a medical assistant and got to really understand what it’s like to work in a busy clinic, work with doctors and ancillary staff members, and that was a wonderful experience and get to just be one-on-one with patients. We

Kristen: had just [00:09:00] started on our sort of med school, 1 0 1 series of questions, and Brooke, I think aptly put it as like, Pulling back the curtain on all this stuff, right?

So there’s no silly questions. Um, so we’re getting a really good baseline here, and Brooke just told us how long does it take to get through medical school? And so she mentioned undergrad first, and then four years of medical school, typically in the us. And then residency can be three to seven years, and then fellowship after that to kind of really focus in.

Rachel, you’re in the middle of interviewing for residency, right?

Rachel: I am, I have my last interview tomorrow. This is great.

Kristen: It’s so exciting. So can you go ahead and I’m skipping ahead all sorts of steps here, but can you tell us h how that has been going?

Rachel: Yes, it’s been going really well. So this year, similar to the last two years, all of the interviews have been online on Zoom.

There are talks that that might stay the same. They used to actually be in [00:10:00] person where you’d have to fly out and. Put yourself up in a hotel or stay with someone nearby and visit the place in person, which obviously has its pros. But I have really enjoyed getting to do these online interviews and not have to pay money.

Yeah. As well as being able to meet a lot of amazing faculty and residents at these programs.

Kristen: When you interview, are you on Zoom for like a whole day? Like what does that look like?

Rachel: People have anywhere from maybe nine to 25 interviews, depending on what type of specialty you wanna go into. And yes, they’re typically all day on Zoom, so they start maybe 8:00 AM maybe, and at the latest, probably three or three 30.

So tomorrow mine is from 10 to two o’clock, and so it’s a shorter interview, which is great. As they give us those half days, which are really nice. And um, I’ll interview with usually two faculty members. Okay. And they’re about 25 minutes each. And also [00:11:00] get to join a morning report, which is kind of like the learning that happens during res residency.

You know, in med school you go to lectures and in undergrad you go to lectures and you know, sit in a classroom. And in residency you’re mostly working on the job. And so there’s sometimes. You actually get to sit down, have lunch and listen for 45 minutes to an hour to a presentation, a case or something like that.

And so I get to get a taste of what it’s like to experience that online. Yeah. So

Kristen: that feels way more like a two-way street of you’re also sort of checking them out and get a feel for it. That’s great. Next, after all of these interviews done, then you. Wait, and is there like a season where everyone claims their residents or, or there’s matching, right?

Can you talk

Rachel: about that? The match process is so interesting and can be anxiety provoking for sure. Something to know is yes. So you apply [00:12:00] to many, many programs, sometimes 30 to 40 to 50 programs if you’re in some of the more competitive programs, maybe up to a hundred, and you get a certain number of interviews, and then after all those interviews you ranked them.

So for every single interview you did, you ranked them 1, 2, 3, 4, 5. And you submit your rank list. So all interviews are done at the end of January. Um, they started actually in November. And so it’s been about three months of a process. Wow. And then in March, March 1st, I will submit my rank list, um, and the programs will submit their rank list.

So every person that they interview, whether that’s 600 or a thousand people, they will rank us one to, you know, a thousand. A computer system basically matches you. So you, it’s not like college where you can apply to 10 schools and maybe you get into five of them and then you get to choose and kind of work with your family.

It’s a little bit more of an interesting process. Basically, you just. They rank you and a computer matches you and you open up an envelope two [00:13:00] weeks later on match day, which is a very, very exciting day. Can be very high stress for sure, but you open up an envelope and that’s where you’re going. And there’s typically a big party your family’s invited.

Um, it’s a big med school production and kind of tradition.

Kristen: Well, congratulations. Almost being finished with the interview piece of it that is nerve wracking and exciting.

Rachel: Definitely very nerve wracking. It is something that it guarantees that more people get to get into residency, which is very nice, and they kind of get to take a break until I graduate in May and then start residency.

Typically they start mid-June with, um, orientation.

Kristen: So something that comes up for me too is you’re married, right? So how does this work for your. Partner, like your partner is ready to just go and take off with you, or are you gonna live separately? Like, what does that look like? This, these are big decisions, right?

These are big family

Rachel: decisions. That is a fantastic question and definitely like [00:14:00] listeners who are not married and or maybe not even dating anyone might not even understand what that’s like, but it is this something that a lot, a lot of people go through. And so my husband is not in medicine, he’s actually in the medical field, but not a doctor and not going through the same process as me.

Mm-hmm. And so, Essentially what he has to do is once I open up my envelope, he hits, he hits the ground running and starts looking for jobs. He do not wanna spend any time apart. I know a lot of people that do that, so sometimes not, not everyone can get a job or they can’t really have any sort of leeway between.

Their previous job and their next one in whatever city they end up. And so some, some people, their significant other stays behind some, um, they have a little bit of time apart. For us, I think we’re prioritizing being together. And if that means that he doesn’t have a job for a couple of months, then that’s okay and we reevaluate.

But more than likely we’re, I’m hoping to match somewhere that has ample opportunity for him. And so that’s where we kind of get to [00:15:00] work together and make sure that both of our interests. On the table for whatever we rank. And so maybe there’s a program that I love a little bit more than another program, but the other program has better job opportunities for him.

And so we kind of just make those decisions together and it really, um, I’m lucky to have someone that’s so supportive and I feel very free to make those decisions, but it can definitely be hard. Some, some other students are, there’s actually three of ’em in my class that are couples matching. So if you meet someone in med school, you fall in love and your significant other is also matching the same year as you.

You actually match together. So you both go to the same school. It’s almost like a separate process. You still interview at a ton of places. You interview at the same places, and hope that. They take you both? Yeah. And they, they know there’s like kind of a separate process for them to take couples rather than individual people.

And so, okay. There’s processes in place. Yes. Thank you for sharing

Kristen: that. Thank you. That’s really, really interesting. So to go back, [00:16:00] go back to my list of questions, so I stay focused here. Brooke also talked to us a little bit about you don’t have to go to medical school right after undergraduate school.

There’s really no like, Ordered to how this has to go. Right. Everyone sort of has a different path. And so I’m gonna go on to the next question about, do you have to be a pre-med in undergraduate school to go

Rachel: to medical school? That’s a great question as well. So I was under the assumption you go to college and your major is pre-med.

And that’s what you wanna do and all your classes are geared towards that. I was really surprised when I had, when I got to UT Austin and I had to declare a major, and they had ones like biology and chemistry and you know, science-based majors and those are great, but you do not have to major in anything to be in pre-med.

And so some schools you do have to declare it on your transcript or whatever certification, your degree, and they have separate paths for that At uc, Austin, [00:17:00] you didn’t have to do any of that actually, and you basically, what I did was just, I picked my major, I actually changed it three times. I went from biology to biochemistry to neuroscience, ended up loving neuroscience and stuck with it.

Um, but I could have done anthropology or communications or business, however, The reason why a lot of people end up doing science-based pre-med majors, quote unquote, are because you have to take core prerequisites for med school. So you have to take bio and chemistry and physics and all of those classes in order to actually apply to medical school.

And a lot of those science degrees, they have that. Already within the degree. And so if you wanna major in something like business, absolutely go for it. You’re just gonna have to take a few more classes cuz you have to satisfy the requirements for business and for pre-med. Brooke, do you have anything to add to that?

Brooke: The o The only thing that I would add is if you, you know, go to undergrad and you’re not sure that you wanna do like med school stuff and you don’t fulfill some of those prerequisites. They [00:18:00] have program called programs called post baccalaureate programs or post backs. So say I had majored in English real plan, or for example, there’s, or a person in my class who was in fashion design before they decided to go back to medical school.

So they, they didn’t really take the sciencey classes and stuff when they went to undergrad, but then they decided that they wanted do med school. They did a post-back program, which is like an accelerated. Depending on how many classes you have to take, one or two years of just like you do chemistry, you do organic chemistry, you do all the classes that you need to apply to medical school, and then you’re like all set.

And schools don’t, medical schools don’t like hold post back programs to any kind of different standard than they do regular. So it, it doesn’t, like, it’s not at all detrimental to do so.

Rachel: Uh, do you have to

Kristen: go to medical school to work in the medical field?

Rachel: Another great question. So you don’t, and this was something that I also didn’t really realize.

I’m so glad that I’m on my path, [00:19:00] but I would’ve loved to know other paths. So the medical field is so broad, so like there’s. Even like clinical versus business side of the medical field versus all, you know, all sorts of things. But when you’re thinking about someone, if you wanna have interactions with patients and you wanna think about diagnoses and do procedures and you know, kind of do all the clinical things that you see on Grey’s Anatomy or whatever medical show that you love.

There are a few that I would tell you. So one is obviously being a doctor and that is becoming an MD or a do, and those are both medical doctors and those are just different types of schooling. What is D? What does do stand for? Another Great question. Those are doctors of osteopathic medicine. I would say the.

The difference between MD and DO is do school focuses a little bit more on, uh, the whole like whole person. So a lot of people go into primary care, um, they have a little bit more, uh, musculoskeletal classes and courses and they, [00:20:00] they teach, they teach you more about the whole body and like in a holistic way.

And yeah, people tend to go into primary care, you know, ortho type specialties and then you can really go into anything. But those just tend to be like the path that people take. Mm-hmm. Whereas MD is kind of that traditional allopathic, um, medical school and there’s really not a huge difference between the two.

I have doctors that are dos and doctors that are MDs, and I really don’t, there’s not a huge difference with the way they practice. We all have the same evidence-based guidelines and everything. Cool. Okay, so

Kristen: I fully interrupted you there. So, You can, you can become a Doctor MD or do, or, I feel like you were gonna say

Rachel: something else there.

So I would say other paths that you can go into that are more clinical paths are nursing, which you probably see in shows as well. Um, they’re the people at the bedside that really get to care one-on-one with the patients or in the clinics as well. There’s also physician assistants, which [00:21:00] are very, very similar to doctors.

They have different schooling and are taught different things and just have kind of different levels of care. Um, but they get to. Pretty independently, they have to have a physician supervising them. But otherwise, besides really just checking them off and making sure everything’s going okay, PAs are pretty independent.

Yeah. Um, and they’re amazing in the clinics. And then if you wanna go further in nursing, you can be a nurse practitioner, which is also very similar, um, to a doctor as well. They get to practice independently. Besides all of that, you could be a medical assistant where you get to check patients in and kind of really be that one-on-one person to do blood draws and all sorts of fun procedures.

Um, and then beyond just the clinical side of medicine, there are so many ways to help in the medical profession, whether that’s. The administrators that are helping the business of the hospital run, whether they’re the front desk staff that is welcoming the patient and making them feel heard and seen, as well as people that are [00:22:00] researching about these diseases.

Um, if sci, if you love science that maybe. Clinical and like patient care is not your thing. Maybe you wanna contribute to the amazing clinical studies or basic science studies that, um, are developing new drugs and helping the future of medicine. Um, and so there’s plenty of things to do within the medical field.

Um, besides becoming a doctor, I would say being a doctor is, Probably the longest path and it’s, it’s very special. And something that now being a fourth year, I’m really, really happy that I did. But, um, just knowing about all the other options is so important because while being a doctor, I think is, was the right thing for me, it’s not the right thing for everyone.

And. That’s something that you can weigh for yourself as you go throughout your journey. You can, you know, hit up against, you know, try one path and you’re like, no, I don’t like that. I have plenty of friends that maybe, like they were even nurses before they came to med school and they’re like, Hey, I actually wanna be a doctor and, you know, doesn’t matter that I’ve already done some schooling.

I’m gonna come [00:23:00] back and I’m gonna, I wanna become a doctor. You know, people have done the opposite where they start going to med school, they’re like, Hey, I don’t know if I like this. I’m gonna go and get my, you know, Business degree in, like in do be a hospital administrator or yeah, just go do something.

And so it, it’s, it’s exciting that you’re not bound by anything, you know, you can kind of make this journey your own.

Brooke: I learned recently that the healthcare field is the single largest employer in the entire United States, so I like 20 million employees. Wow. Um, I think that just goes to show, uh, like Rachel said, there’s so many ways to get involved.

Pretty much any field that you’re interested in teaching, you can become a. A nurse teaching like Absolutely. Nurses social work is a huge role. Mm-hmm. Like pretty tech, healthcare, tech, pretty much any, any field that you are interested in, you can give it a healthcare bend, uh, and find yourself in the healthcare industry.

Yeah, absolutely.

Kristen: I think something that came to mind when you were [00:24:00] mentioning that, I guess at the time that we’re recording, Those in clinical practice have been through a lot recently. We’ve all been through a lot in the last three-ish years with Pandemic Life. And so, you know, we were just, I was listening to something on the news about the previous strikes in New York where the nurses were like upset and not working right.

And so, As students, um, who are working towards this profession, and Rachel, you’re, you know, you’re about to depart from the medical school part of this onto the next stage. What goes through your head with that? Like, is that something that you’re stressed about? Is that something that you look forward to being part of the change?

Right? Like how, what’s your perspective on sort of, I guess there’s always been stress and upheaval in medicine, but you know, how do you deal, how do you deal, how do you deal with this? Either way. Brooke, you wanna start?

Brooke: Um, sure. Uh, I think it’s a, it’s a, it’s a working. [00:25:00] Method. Yeah. Um, work in progress for sure.

I’ll start by just speaking about like some of the, like the nerve strikes and stuff that people may have seen in the news and just every, everything that has happened. I think physicians are not immune from, you know, the trauma and stuff that they faced over the last few years, but really it’s like a lot of the nursing and the certified nursing assistants and people who clean hospital rooms that have really faced a lot of.

You know, danger and under-appreciation and stuff for years, including, you know, exacerbated by the pandemic. And those are officer professions that are, have not historically been paid super well. And I think that, uh, from the. Future physician side of it. I think it’s really, um, wonderful to see when physicians are really supportive of those workers who are advocating for safer environments for themselves and better pay and such because the physician is kind of like they’re, at the end of the day, they are a member of a team.

Yeah. And the [00:26:00] team works best when like, Everybody is fairly compensated. Everybody is safe and everybody feels safe, and that’s not the case. Um, when, you know, we have these really, really essential people who are part of the team, who are, you know, being left to not have the proper N 95 masks or being told to reuse gloves or, or, and things like that.

So I just really, I applaud all of those workers and everything that they have been through. I think that they set a great example as well for, for, for physicians as like how to be advocates for themselves and hopefully inspire more physicians to be a part of that too. But of course the, you know, it was really difficult for everybody on the healthcare team, and that includes physicians, although they do tend to be a little bit more fairly compensated for their time and.

There definitely was a lot of like, I guess, talk and stuff in the hospital. Just like it’s really, really difficult to live in an environment of uncertainty. Yeah. And it’s particularly difficult to, to learn with a brain that is full of [00:27:00] uncertainty. So I, you know, have really. Tried to focus on building community within both like my out of medical school community and leaning on friends and people to bring me kind of like back down to earth and back into the, you know, the bigger picture of things.

But then also building community within medical school with my classmates. But also, you know, I’ve met some nurses that I really got along with and have become friends with outside of, um, the clinical space and being able to have people who know what that experience is like and what it’s been like to process some of that.

Yeah. But then also having people who aren’t a part of it, um, to kind of deep, you know, forget and have fun and stuff. Um, absolutely. I hope that made sense. Yeah,

Kristen: absolutely. Absolutely. Thank you. Yeah. Rachel, how about you? How would you respond to that? What are, how are you responding to

Rachel: all of this? No, Brooke, you, you’ve said so many things that resonate with me and as someone who started their clinical rotations, like not only in the middle of Covid, so it was July, [00:28:00] 2020 when I started my very first rotation in the hospital as a medical student.

And I was thankful to, to like be a part of it, honestly. And at that point they had been fighting Covid for a few months and things were starting to get pretty bad in Austin, but also, Workers were getting a bit burned out because of the just insanity of that time. Um, and I actually got to rotate on the covid I c U in the very beginning.

And so as someone who’s never known anything different, I think that I’m a little bit. More set up for resiliency. Does that make sense? Because I don’t really know how it used to be before Covid. Mm-hmm. But from hearing stories and from my own, you know, previous experiences, not as a medical student, but you know, as a tech and things in the hospital, I know that this.

The pandemic, yes, it exacerbated issues, but more than anything, it brought out issues that have been happening for a very long time, like physician and healthcare professional burnout. Mm-hmm. Um, like, you know, [00:29:00] dissatisfaction with certain aspects of the job, like documentation and, um, you know, protocols and things.

Um, and then as well as, yeah, like fair pay and things like that as I’m going into residency is they’re, while physicians. Very well compensated by and large, you know, residency has had to take a very, a microscope to what these programs do with their residents and how they’re set up, you know, residency or residents.

They get paid very lean salaries for the amount of work that they do. So they have a lot of talk about. Since residents were honestly a huge backbone of the healthcare industry and really like held up a lot of hospitals during covid, it’s really given residents a voice and some power to make really positive changes about lessening the amount of 24 hour shifts and increasing pay, making sure that overtime is compensated or increasing ability to moonlight.

Where moonlighting is basically you take an [00:30:00] extra shift, um, that the hospital really needs you to take. But you get paid not as a resident, but as an attending, which is what you’re actually doing. And so, and the difference between that pay is really big and can make the difference with someone, um, who may be struggling during, during the pandemic or during inflation and things like that.

Yeah. So that’s, that’s all the things that are running through my head and it’s an ongoing process and an ongoing thing, but it makes me, um, hopeful. As someone going into this, that these conversations are being had.

Kristen: Thank you so much to Rachel Gorum and Brooke Upchurch for your time and your expertise.

Please make sure to catch part two of this episode coming out very soon. In the meantime, if you have questions for the Live Strong Cancer Institutes, you can email us at Live Strong Cancer Institutes DMed dot u texas.edu. You can find out more about the Lift Strong Cancer Institutes. Delm me.utex.edu.

You can also [00:31:00] follow our chair, Dr. Gail Eckhart on Twitter at s Gale Eckhart. Eckhart is spelled e c k h a r d t. In the meantime, this is Kristen Wynn for Cancer Uncovered. Thank you for listening and learning with us. We’ll see you next time for part two.