Michael's Musings #2 (07.July.2020) - "F" Is For Friends Who Do Fail Together
Failing Together, Redefining Premed Success, the Burnout Problem in Medicine, Curiosity Killing the Jack of All Trades and Boring People
Source: @Spongebob
Hey friend,
Let’s do something together!
I want you to log onto your social media of choice—Facebook, Instagram, Twitter, etc.
Now, scroll through the infinity pool and take note of your peers’ ‘wins.’
Here’s what I saw in literally 30 seconds!
Now, don’t get me wrong. I’m beyond happy for her. She more than deserves it and I’m excited to see what the future holds in store for her.
But, know that if you feel exhausted reading another success story, you’re not alone. Maybe Bailey just got accepted to UCSF Medical School. Steven won his powerlifting competition. Cat just got a job at the local emergency department as a scribe.
It’s hard to constantly be happy for your friends, especially if it's in direct contrast to how your week is going. You may have just received another medical school rejection letter. Maybe you’ve skipped an entire week of lifting because your lower back has been giving you problems. Maybe you’ve submitted yet another job application—it’s the 15th one this week without a glimmer of hope.
That contrast is powerful, especially if you’re alone with your thoughts. You have to comfort yourself and rationalize where the difference comes from. Some people will see the success stories and think: “they were born geniuses or have some insane willpower. I’m not lucky enough to have that so I’m doing just fine.” It’s comforting to explain our shortcomings with things out of our control. If we simply don’t have the same capacity for success, there’s nothing we can about it and so, we’re let off the hook.
Other people may start to bully themselves. They’ll tell themselves that they’re not smart enough. They believe that they’re not working hard enough. They just are not enough. It’s their fault. It’s comforting to retreat to sadness—misery can feel like home. Life can seem like it’s going 100 miles per hour all the time and when we feel sad, we finally stop. We look inwards and enjoy the stillness, even if it’s laced with melancholy. Sadness comes with a twisted comfort that makes it addicting.
Both situations are dangerous. The former builds an external locus of control; you’ll begin to live life out of the driver’s seat. Your successes and failures become predicated on luck, fate, or fairness. If you earned a poor grade on Organic Chemistry, it was because: “that professor was terrible. He designed his class to fail his students.”
The latter creates a vicious cycle of normalizing depression. Whenever you’re uncomfortable, you’ll be quick to default to sadness. After all, everything is your fault and there’s no point in thinking otherwise.
Unfortunately, both these scenarios are increasingly prevalent amongst premedical students. These young adults are subject to high levels of pressure. 60% of students who apply to medical school don’t get into a single school and often, Biology degrees don’t lend themselves to many professional alternatives. This pressure valve starts early, leading to significant rates of burnout and depression among premedical students.
There’s another side of the coin. On the other side of the social media success stories is the infinity pool of failures people never see. If you're having a down week, you’re not alone. In fact, if I were to create a CV of just my failures (here’s one of an esteemed Princeton professor), it'd probably be three times as long as my actual one. Here’s an e-mail we’re all familiar with:
Are you ready for the cliched, storybook ending?
Yes, I took that failure, channeled my inner redemption story, and OF COURSE, when I applied again, the infamous Student Stroke Team took me as one of their own.
Here’s proof …
… that I applied 7 times and never got in. If you looked at my social media, it doesn’t tell this story. All it says is “UCLA Medical Student.” Of course, since UCLA is the #6 medical school in the nation, I must’ve had the pick of the litter—schools were practically begging for me to attend their institution. Well, after spending an entire year applying to 30 schools, writing over 100 pages of essays and flying all across the country, here’s what I have to show for it:
Yes, red is my favorite color but no, it doesn’t mean they accepted me.
Two schools accepted me. That’s one short of having no choice for where I spent my next four years. That’s two short of having no place to call home for my medical education—joining the other 60% of unsuccessful applicants that apply every year.
And I'm not alone. My friend Nicolas, a UCSF medical student, and I publish two podcasts a week with eminent and current medical professionals. Every person, without fail, we interview has a favorite failure of theirs.
Sophia didn’t do well on her second MCAT retake. It led her to realize that she isn’t defined by her academic metrics and is now excited to start medical school in the Fall.
Dr. Cevallos didn’t make the basketball or football team after trying out three years in a row. He now head coaches the head Varsity Basketball team when he’s not serving as the clinical director for a Federally Qualified Health Center.
Nicolas wasn’t chosen to be a board member for the campus' CPR initiative. That opened up his time to help marginalized prehealth students learn Chemistry. He has continued his education/advocacy work and is now a UCSF Medical Student.
Being premed is already so difficult. I'm hoping that my story and those that we interview helps you realize how crucial, and more importantly, just how normal those bad days are.
🎙️ This Week on Pass the Mike
Pass the Mike is my solution to information asymmetry in the premed space. This podcast demonstrates to aspiring doctors that medical professionals are just like them. Not only have they failed exams and tore their hair out writing late-night essays, but they also enjoy lives outside of medicine—some referee basketball games and others are on quests to engineer the best chocolate chip cookie.
Inspired by Jack Butcher’s “Transparency Time” series and by an unhealthy amount of Tim Ferriss podcasts, I decided to start my own “Tribe Of Mentors” type podcast to interview and explore the stories of other eminent and current medical professionals. Every Tuesday and Friday at 5 AM PST, a new episode will drop!
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Dr. James Cevallos (06/29)
In this episode, Nicolas had the pleasure of interviewing his best friend and father, Dr. James Cevallos. They talk about:
The road first-generation students must pave for themselves
How to find mentors and how to tell if they’re right for you
The importance of work-life balance after you complete your training
How to make an impact in your community
Nick learned a lot about the path ahead and he knows it’ll do the same for you.
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Sophia Nguyen (07/07)
In this episode, I had the pleasure of interviewing Sophia Nguyen, an incoming Midwestern University Medical Student. We talk about:
The not-often-talked-about negatives of being in a Sorority
Her pet chicken Bawk Bawk
Her professional basketball career
Her growing relationship with her family and culture
Sophia exemplifies work/life balance and if you’re struggling with handling your high ambitions with your desire to have a whole lot of fun, this episode is for you!
🤔 3 Thoughts
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Where Did Premeds Go Wrong Defining Success
In the essay The Price of Discipline, David Perrell captures a powerful sentiment about success. He writes:
Success shouldn’t be synonymous with how good you are at forcing yourself to do what you don’t want to do.
This stands in such direct contrast to how the premedical student journey often plays out. We have to study Organic Chemistry, knowing full well it has very little to do with the field. We graduate and enter a workforce primed to take advantage of gap year students, offering “3-month unpaid internships” or $12/hr medical assistant positions that require 2 years of Dermatology clinic experience.
This is what we’re supposed to do to become doctors?
What?
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Burnout in Medicine Is Bad—Like, Really Bad
What’s something that happens every day?
Maybe you call your significant other. Or you jog in the evenings. Or you religiously sip on a cup of coffee to start your day.
That same frequency--daily--is how often one doctor commits suicide in the United States.
Pause.
You read that right.
One day.
One suicide.
According to a 10-year systematic literature review presented at the 2018 American Psychiatry Association, the suicide rate among physicians is 28 to 40 per 100,000--double that in the general population. It’s the highest rate of any profession.
Burnout's consequences are harrowing for physicians and doubly so for their patients. In a study following 123 pediatric residents, depressed residents made 6.2 times as many medication errors per month compared to their non-depressed peers.
In full transparency, burnt out residents and non-burnt out residents made a similar made similar number of errors. Burnout is different from depression and anxiety but burnout-depression and burnout-anxiety relationships are significantly correlated. Burnout stands at the intersection of emotional exhaustion, depersonalization, and feelings of inefficacy. 1 in 5 medical residents meet depression criteria, and 3 in 4 meet burnout criteria.
I’m polishing up the final edits on this piece on burnout and have a couple of thoughts on how to curb it during our premed years. I’d love your input on it once it’s out!
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What’s the Whole Story?
Have you heard of these phrases?
A jack of all trades is a master of none.
Or perhaps:
Curiosity killed the cat.
From the benevolent hands of Redditors, I’ve learned that these aren’t the full phrases. In their entirety, the phrases are:
A jack of all trades is a master of none, but oftentimes better than a master of one.
And
Curiosity killed the cat, but satisfaction brought it back.
These purposeful omissions remind me of that one friend we all have—the guy that only tells the parts of the story that are beneficial for him. Skillfully, he leaves out all the damning evidence and you’re left with an incomplete world where there’s only one natural conclusion—to side with him.
For all the situations you’ll inevitably find yourself in going forward, ask yourself:
What’s the whole story?
💬 2 Quotes
On Optimizing for the Right Outcome:
“What is the real goal?
The real goal is not to “beat the market.” The goal is to build wealth.
The real goal is not to read more books. The goal is to understand what you read.
Don’t let a proxy become the target. Don’t optimize for the wrong outcome."
- James Clear
Whether you’re studying for the MCAT, preparing for recruitment season, looking to lose weight, or trying to break out of a rut, focus on the right outcome.
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On Boring People:
"Avoid Boring People"
- Josh Wolfe on David Perrell’s North Star Podcast
Three words. Two meanings. The play on words reminds us to: (1) not to spend time with uninteresting people and (2) be captivating and avoid boring others when you’re with them. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
❓ 1 Question For You
Are you being kind to yourself?
🙏 Infinite Gratitude
“Gratitude turns what we have into enough.” – Anonymous
Sometimes you just need to inhale a fat platter of Nachos. Ed and Han, thank you for being my battle partners.
I’ve been obsessed with old-school basketball recently. Big thanks to Coach Nick on this banger of a video exploring Hakeem’s Dream Shake.
To my dear friends: Cecilia, Antony, Tiffany, Hong & Sophia. Thank you for making quarantine feel a tad less lonely, and for confirming that none of us can multiply/divide by 12.
Thanks for reading!
P.S. Be sure to follow me on Twitter and Instagram for even more of my thoughts. I encourage you to reach out and ask me anything!