ÐÇ¿Õ´«Ã½

Dr. Chan: What is a sun gate moment? How is an emergency medicine doctor like a jack of all trades? What's it like to join the US Air Force a week before starting third year medical school, and how does it feel to know you've matched for residency months ahead of your classmates? Today on Talking Admissions and Med Student Life, I interviewed Jessie, a fourth-year medical student here at the University of Utah School of Medicine.

Announcer: Helping you prepare for one of the most rewarding careers in the world, this is Talking Admissions and Med Student Life with your host, the Dean of Admissions at the University of Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Well, another great edition of Talking Admissions and Med Student Life. I have a great guest today, Jessie. Do you prefer Jessie or Jessica?

Jessie: Jessie's fine.

Dr. Chan: Jessie.

Jessie: Yeah.

Dr. Chan: Fourth-year medical student?

Jessie: Fourth year.

Dr. Chan: How does it feel to be a fourth-year?

Jessie: It's awesome.

Dr. Chan: Is it the best year of all the four years?

Jessie: So far, yeah. It's been really nice. It's actually sort of weird because I have a lot of time off. So I don't really feel like a student currently. But I go back clinically on Monday. So I'll be back to being a student again.

Dr. Chan: All right. Well, let's start in the beginning.

Jessie: Okay.

Dr. Chan: Why medicine? When did you decide to become a doctor?

Jessie: So I have no medicine in my family at all, like no nurses, nothing. I come from a family of engineers and educators. I was really interested in the sciences. I always wanted to do the whole science route and whatnot. I actually explored a lot of different fields of medicine for a while trying to decide what it was that I wanted to do. I worked in physical therapy. I worked with a bunch of PAs, MPs to try to decide if I really wanted to go to medical school because it's a big decision, right?

Dr. Chan: Yeah, it's a huge decision. Yeah.

Jessie: It's like, "Is that really the route I want to go down?" And then, officially, I decided that's what I wanted to do, applied to medical school twice.

Dr. Chan: We'll talk about that.

Jessie: Yeah. It's been a really great decision. It was not an easy decision, but definitely one that I don't regret making.

Dr. Chan: What were some of the activities you were doing before med school to help prepare you for med school?

Jessie: I worked at a physical therapy clinic. I worked at Planned Parenthood for a few years. I ended up being the research coordinator for the State of Utah for Planned Parenthood. I did some undergraduate research. I actually trained alligators to walk on treadmills, did a National Geographic documentary through that.

Dr. Chan: Wow. Like normal alligators or baby alligators?

Jessie: So alligators actually only grow to the size of the enclosure that you keep them in. They were like adult alligators, but they weren't very big. From snout to vent, they were like probably three, four feet.

Dr. Chan: It sounds like they were sad alligators.

Jessie: They were probably not the happiest of alligators. They lived in Utah. I can't imagine how that was exciting.

Dr. Chan: How did you do that? What was your trick?

Jessie: You build an enclosure around them, so they really have nowhere to go, which sounds really terrible now that I say it out loud.

Dr. Chan: That's okay.

Jessie: And then you just walk the treadmill. So it's a lot of just having them walk on the treadmill and train to keep doing that, so keeping them in that enclosure and keep the treadmill running.

Dr. Chan: I hope there was some science. Some sort of question.

Jessie: We were looking at a ventilation study. We actually liked glued this ventilatory mask over the top of them. They actually have a muscle called the diaphragmaticus muscle, which we assume is like the human diaphragm. Surprisingly, it did not change tidal volume at all. So that was sort of what we were looking at is did it really affect that and what that muscle actually is used for.

Dr. Chan: Wow. If I recall correctly, you also played football.

Jessie: I did. Yes.

Dr. Chan: Okay.

Jessie: Yeah, women's semipro tackle football.

Dr. Chan: It's pejorative to say powder puff.

Jessie: It is. This is semipro, NFL rules.

Dr. Chan: Educate me.

Jessie: Yeah. So powder puff is sort of what you play in high school. You dress up and pretend like you're . . . you switch roles and the boys play the cheerleaders and whatnot. This is not that. Then there's also like lingerie leagues. This is also not that.

Dr. Chan: This is full-on tackle.

Jessie: Full-on tackle.

Dr. Chan: I remember very clearly didn't you show up to med school in a knee brace?

Jessie: Second look day, yeah.

Dr. Chan: Yeah, you blew out your knee. I remember that.

Jessie: Second look day I was on crutches. I blew out my knee.

Dr. Chan: That's right.

Jessie: I was a little worried because we did the scavenger hunt.

Dr. Chan: Your competitive juices were flowing.

Jessie: Exactly. It was really hard for me not to want to run on these crutches.

Dr. Chan: Okay. And then you applied twice.

Jessie: I did. Yeah.

Dr. Chan: Speak to those who may have not gotten in the first year. What would you recommend? What was your mindset?

Jessie: So I think all of us applying to medical school, we've excelled and succeeded in so many different areas. That's like a blow. You're like, "I didn't succeed in this avenue that I tried really hard for." So it was a lot of pooling my resources and saying, "Where can I improve? What is it that I didn't do the first time that I can improve on to do the second time?" Working with my premed advisor was something that I was like, "Oh, I can do this on my own." I don't recommend that. Talk to your premed advisor. That was huge. We actually sat down and kind of hashed through things.

Dr. Chan: What kind of feedback do you remember getting?

Jessie: It was diversity in the activities that I was doing. I was apparently working with a lot of similar populations for a lot of my different things. So it was like, "Do some work with kids, do some work with elderly," and different things like that. And then also just making sure that I went through and edited things really thoughtfully. I got an editor who sat down and read through my personal statement, read through all the things that I had put on the application.

Dr. Chan: Clean up the grammar a bit.

Jessie: Exactly.

Dr. Chan: Made sure ideas are coming through.

Jessie: Exactly.

Dr. Chan: Great. Yeah. Wow. Cool. Then you get to med school.

Jessie: Got to med school.

Dr. Chan: Most surprising thing about med school?

Jessie: Most surprising thing about med school is . . . that's hard.

Dr. Chan: For the vast majority of people who have not been to med school.

Jessie: I don't know. That's a really hard question. The most surprising thing is probably what a community it ends up becoming. That's sort of the point of White Coat Ceremony, right? They're sort of bringing you into the fold and you are now part of this community.

Dr. Chan: Part of the club.

Jessie: It's very true. The attendings, you never really feel like just a first year or whatever. People are totally willing to listen to your ideas, totally willing to treat you like an adult, and you're like, "I'm a student, but I'm also part of this community," and it's really impressive how much you get to be a part of that. It's very cool.

Dr. Chan: Would you say that extends obviously to your classmates, just kind of meeting people, second look day, orientation week?

Jessie: Yeah, very much so. I'm one of the ambassadors for the School of Medicine now. I'm actually the co-president. So I've been selecting our new ambassadors. So reading through these applications have been really cool. They're sort of echoing that same sentiment. They're like, "I've been here for six months and people really value what I have to say and our class, the camaraderie within the class is really impressive." It's really nice to hear that even from the first years and still feel that sentiment.

As a fourth year, you sort of lose touch with all the other fourth years because we're off interviewing, we're off on a whole bunch of different elective rotations and all these sorts of things. So when I run into my classmates, no matter who they are, it's really exciting and you're like, "Oh my gosh, I missed you. We spent so much time together." That's really fun. Even through these all four years, even people that aren't my best friends, that I don't hang out with outside, it's really fun to see them. You build this bond with your classmates that's really impressive.

Dr. Chan: That's awesome.

Jessie: Yeah.

Dr. Chan: How hard was it?

Jessie: It's hard.

Dr. Chan: Is it the hardest thing you've ever done, would you say?

Jessie: Yeah, it is. Not for the reasons that you would think. Like academically it's hard, sure. It's definitely a struggle, and there's a lot of hoops you have to jump through. I think that's a lot of what this whole route is, is a lot of hoop jumping, especially now.

Dr. Chan: I think you've created some more hoops for yourself.

Jessie: I have created more hoops for myself, yes.

Dr. Chan: We'll talk about some of those big official military hoops.

Jessie: Oh my gosh, yeah, I created too many of those. Yeah, there's a lot of hoops, and it's a lot of hoop-jumping. I think emotionally it's really challenging to learn . . . it's a new skill to try to learn to kind of balance everything. I'm a firm believer of I want to be a doctor, I want to be a physician, but I also want to have a life that is outside of medicine. So I make sure that's a balance that I try to maintain, and that's something that can be really hard to keep sight of through this whole process. It's sort of consuming.

Dr. Chan: Where would you study, at home, library? What was your secret technique?

Jessie: Outside. For me, I had to be outside in the sun. So all of my board studying was done on a blanket outside with my dog in the sun as much as humanly possible. I bought a bike desk so I could be doing exercising while I'd be studying too.

Dr. Chan: Interesting. What does a bike desk look like?

Jessie: It's basically a stationary bike with sort of a platform on top that I could set my computer on and write. So I got the extended sides, so I could have the computer and ride at the same time. So that was good.

Dr. Chan: So you pedal and study?

Jessie: Yeah. I pedal and study and watch videos, take notes.

Dr. Chan: You're doing that outside, or is the bike inside?

Jessie: I'd rotate, inside, outside. The bike was inside and then the outside in the sun.

Dr. Chan: Fascinating.

Jessie: It kept me sane.

Dr. Chan: All right. What did you like more, the first two years of med school, where it was more classroom-based, or did you like the last two years, where it was more like clinic, hospital-based?

Jessie: Definitely the last two years.

Dr. Chan: Why?

Jessie: I think most of us go into medicine because we like working with people. We have this drive and desire to work with people, to help people. That's the most clich� answer ever. I would never write that on an application. Don't put the, "I want to help people," on your . . . it is clich�, but it is true. I think that's a lot of what we go into medicine for. So I actually wrote a lot through my first two years. I kept a journal. I called them my sun gate moments. I don't know if you remember the story from the White Coat Ceremony. I'll tell it because you had a lot of those . . .

Dr. Chan: For all the people who are listening who may not have been there . . .

Jessie: So one of the SBOs who was talking at our White Coat Ceremony . . .

Dr. Chan: Student body officers.

Jessie: Yeah, was talking about the hike into Machu Picchu. His family went on this hike. There's like two ways to get to Machu Picchu. You can do like the four-day big hike through the jungle, or you can take a bus and it's like a little 20-minute walk right up to Machu Picchu. And they accidentally walked backwards on the trail and sort of walked that back route up away from Machu Picchu but on that trail. The backwards up on the four-day trail. They came upon what's called the sun gate. There were a bunch of people hugging each other and crying. They're like, "What's going on there?" They realized it was the first time in that four-day journey these people were seeing Machu Picchu.

It's the first time you're seeing the route and your accomplishments. It's in sight. He was referring to med school and the White Coat Ceremony as your sun gate moment. It's the first time that you are seeing all of the things that you've been working for, for so long, but you realize you still have more to go.

So I kept this journal called my sun gate moments. I was like, "This is why I went into medicine, but there's still more to go," about like different encounters I had that reminded me of like, "Okay, this is why I went into medicine." That's kind of where I was talking earlier about how medicine is really challenging emotionally. So, by keeping these journals of these memories, I was able to refer back to these moments and was like, "Okay, this is really cool. I really like this."

Dr. Chan: Can you share some of your sun gate moments?

Jessie: Yeah. So we have these cool things in our first couple of years where they realize we go into this because we like working with people. So we have these what's called ELOs. It's our experiential learning opportunities. They put us in the clinic and you basically just shadow. But one of these opportunities I was working with this little, he was probably like six. I go in and I like take a history, probably really poorly because it was one of my second times ever taking it.

Dr. Chan: Plus six-year olds don't really have a lot to say.

Jessie: Yeah. So his mom is sitting there. Then I go out and I do my presentation to my preceptor. We go back in together and do a history physical on this little kid. As we're walking out of the room, he turns to me and he goes, "You're going to be a great doctor." I'm just like, "Oh my gosh," just losing it.

Dr. Chan: That's awesome. Did he give you a little high-five?

Jessie: He totally did. I'm like I don't know . . . we were with them the whole time. So I don't know if his mom set him up to this or whatnot, but I was like, "That was like the warm fuzzies. This was great." So that was one of my . . . it was really awesome. Then like just things you learn as you're like, "This is really cool. This is so fascinating."

Dr. Chan: I love this, a sun gate journal. I'll have to remember that. Yeah. I encourage you to keep that in residency and when you're attending.

Jessie: Yeah.

Dr. Chan: That's beautiful. All right. We have a lot to talk about.

Jessie: Yeah. Sorry.

Dr. Chan: What kind of doctor did you want to be before med school started?

Jessie: I thought I wanted to be a pediatric surgeon.

Dr. Chan: So tell me about the metamorphosis. What happened and how'd you change your mind? Was it third year that did it?

Jessie: It was a lot of things. Like I said, I come from a family of educators and engineers. So I love the surgery aspect of it, and I love building things and pulling apart. That's what we do in my family. We are weird and build things. So I really knew that I liked hands on and I didn't want to lose that.

Then during third year, you get this exposure to all these different fields and I was like, "I like all of this." I felt like in surgery, you end up almost hyper-specializing in a lot of ways now, and so you end up doing the same procedures over and over again, and I realized I really like diversity and I like new things and I'm sort of an adrenaline junkie. We can go back to the football thing.

Dr. Chan: You like hitting people.

Jessie: That's right.

Dr. Chan: Fumble!

Jessie: As fast as humanly possible, let's go. So that's sort of where I came upon emergency medicine. I was a little nervous because at our university, at our institution, we can't work in the ED until you're a fourth year. So I didn't get at a chance to do an elective as a third year. So I basically had to come to the choice of being an emergency medicine physician solely based on what I knew about it and then also just a little bit of shadowing.

Dr. Chan: I'd also counter most services, you end up going to ER to admit patients or evaluate patients.

Jessie: True.

Dr. Chan: Maybe a little bit, I guess.

Jessie: You get a little bit of taste that way. And on your surgery rotation, you do the traumas and things down there too.

Dr. Chan: Most services know the ER well because you kind of back and forth, back and forth.

Jessie: Yeah.

Dr. Chan: But you're right. Fourth years, they get to actually do a rotation in the ER.

Jessie: Yeah. That's the only time you get to be like a student in the ER. You get some exposure in other ways to it. Yeah. So I decided upon that because I liked the variety there. I liked the procedural base, and then I liked that it was sort of . . . you end up being the jack of all trades and I really liked that about e-med. You have to know a lot about everything.

Dr. Chan: So how'd it feel choosing to be e-med without ever doing a rotation in it? Was it kind of risky?

Jessie: Terrifying. I was like, ";Am I doing this right?" I made sure in my schedule it was my first rotation after boards in my fourth year to make sure that if I needed to change this last minute, I could.

Dr. Chan: I thought third years could do electives, like do two-weekers or one four-weeker during third year?

Jessie: Not e-med.

Dr. Chan: Not e-med? Why is that?

Jessie: I don't know.

Dr. Chan: We should talk to someone in the Dean's office about this.

Jessie: We should. We have tried to change it multiple times. I've talked to multiple people.

Dr. Chan: I thought you could do almost anything during that.

Jessie: Yeah. E-med's like the only one you can't.

Dr. Chan: Is that more of a School of Medicine issue, or is that an emergency department issue?

Jessie: I think it's an emergency department issue.

Dr. Chan: It might be their own, yeah.

Jessie: I know that Dr. Stevenson has tried to advocate this for a couple times. Even Dr. Fix, I think, has tried to advocate for it. I don't know who's putting their foot down, actually.

Dr. Chan: The bureaucracy.

Jessie: That's right.

Dr. Chan: The man.

Jessie: Right, the powers that be, whoever they may be.

Dr. Chan: So you show up to your e-med rotation. Day one, you love it?

Jessie: I did.

Dr. Chan: Okay.

Jessie: Yeah. I was like, "Okay, this is really cool."

Dr. Chan: What do you love about it?

Jessie: I like that I can be kind of a calming force in someone's potentially worst day of their life. People don't show up to the emergency department because they're having a great day. So I like that people trust you and trust you to do really well, and I like that you can sit down and have conversations with people, even though it's fast-paced. I'm a big fan of succinct and brevity.

Dr. Chan: You have to immediately build their trust because you go from zero to 60 so quickly.

Jessie: Exactly. So I liked that and I liked the procedural stuff and I liked that you're juggling a bunch of things. The way I describe e-med people is we work hard and we play hard. There's very much a mentality and a personality that goes into emergency medicine, and I feel like I fit that pretty well.

Dr. Chan: So, obviously, I'm a psychiatrist, but part of my psychiatry training, I did one or two months in the ER as an ER intern at my hospital, Washington, D.C. I just remember you clock in at 7:00, and then before you know it, it's 7:00 p.m. You've done a 12-hour shift.

Jessie: Yeah, love that.

Dr. Chan: I remember there was always the issue of eating. You've got to remember to go eat.

Jessie: You don't do that in the ED.

Dr. Chan: They have like the nicest spreads of . . . people are always bring in food. People just eat in between seeing patients. I remember, "I have to use the bathroom," and I literally don't have five minutes to walk down the hallway and use the bathroom. I just remember holding it and going, "This is so fast-paced." I'm pretty sure it's the same here. When you log in, we had this system where we'd see every third patient. Every time I would log in to do orders and write a little brief note, I would just see my list grow bigger and bigger. They have the little timers of how long they've been waiting, like oh my gosh.

Jessie: Those are totally what they ding you on.

Dr. Chan: It's so busy, so busy.

Jessie: It is.

Dr. Chan: It sounds like it's the same out here.

Jessie: Yeah. The cool thing about it too is I love the ED because it's very much a team mentality. That's obviously . . . we can talk about the sports thing for days. That's like my mentality. I really value what everybody in the department brings to the table. The department can't function without every single person that's there, all the nurses, all the techs, even like the people, the cleaning staff are huge. The department can't move without every single one of those people. I don't see anywhere else in the hospital where everybody comes together for the common good kind of like they do in the department and I love that. That's something I really like about it.

Dr. Chan: I assume you watch some TV.

Jessie: I do.

Dr. Chan: What do you think is the biggest misconception of life in the ER versus what they show on "Grey's Anatomy," all that stuff? It seems like most of these medical dramas always kind of focused in the ERs.

Jessie: It's true. I think there's a lot more medicine that happens in the ER, rather than procedures.

Dr. Chan: I'm glad to hear that.

Jessie: If you watch "Grey's Anatomy," it's the surgeons that staff the ER. There's actually ER doctors, surprise. That's a real thing. But there's a lot more like medical complaints too. It's a lot of like we are not seeing MIs, like heart attacks all the time. We do see a lot of that, but we also are seeing a lot of like kidney infections or people having medication overdoses and all these different things that are more medicine and less trauma-based too.

Dr. Chan: I've noticed that. A lot of the dramas, there's a lot of trauma.

Jessie: It's mostly trauma.

Dr. Chan: There's a trauma team here. The ER docs kind of help the initial triage, but to a certain extent, they kind of step off. The trauma teams take them up to surgery.

Jessie: Right. We manage airway is a big thing. So we manage head of the bed, and then the trauma team manage everything else. We basically have neck-up in the ED for the traumas, and then the trauma team basically manages neck-down.

Dr. Chan: Another thing I think is fascinating about TV shows, there's always these like terrorist or security problems. I'm going I can't think of a more secure place in the valley than the ER because there's usually cops and security guards everywhere. Jessie: We actually had Secret Service in there the other day too.

Dr. Chan: Interesting.

Jessie: Yeah. It was pretty fascinating. When the President was in town, I did not know this, but they actually staff a Secret Service agent in the ED in the event that the President would need to go to the emergency department.

Dr. Chan: I'm sure he waits in line with everyone else.

Jessie: I'm sure that's how that works.

Dr. Chan: So transitioning, another subject -- LGBT.

Jessie: Yes.

Dr. Chan: What's your experience in Utah?

Jessie: So I grew up in Utah.

Dr. Chan: Okay.

Jessie: I grew up in smallish town in Utah.

Dr. Chan: Can we name the town?

Jessie: Yeah, Logan.

Dr. Chan: Logan, good old Logan.

Jessie: Yeah. Logan's great, Utah State. It's actually not a small town anymore. I went back recently, it's huge. It's booming. It's crazy. I grew up in Logan, great town wasn't really out there because I didn't really know to be out there. I came out in college when I was here. I went to undergraduate here at University of Utah. I came out while I was here. I mean I've been back and forth to Logan.

Actually, Utah's been really great. The culture in Utah is very much a non-confrontational one, which sort of stems really well for that community and my community. I've never felt in danger, like I've never felt like anyone has threatened my safety or anything like that. I've never felt threatened because of my sexual orientation, which has been really great.

The school, it hasn't been an issue at all through the School of Medicine. It's a complete non-issue. There's obviously times when I choose not to be out, but again, it's not something that's . . . it's not generally like I'm trying to hide it. It's a time and a place. Work is not always a place for me to go talking about my partner, and I think that's probably true of anybody of any sexual orientation.

Dr. Chan: I notice there's an interest group, right?

Jessie: Yeah, kind of. This is sort of where it becomes a non-issue. There is an Allies in Medicine group, which is sort of for everybody. It's not just like the LGBT population. We have cool socials and things. So it stems the whole span of just like health care. So we've got people that come in that work down at . . . what's it called?

Dr. Chan: The hospital?

Jessie: No, the AIDS clinic that we have here. They're like health educators down there. I forget what the name of the clinic down there is.

Dr. Chan: Yeah, can't remember the name there.

Jessie: Yeah. Sorry. People from all over the valley that work in different facets of health care are just like allies for LGBT people in medicine and it's been really cool.

Dr. Chan: As Dean of Admissions, I get questions from time to time. There's a perception that because you're in Utah that you're not accepting. I always push back like well, the student body is very diverse, wide variety of opinions, wide variety of backgrounds, including LGBT issues and minority issues, like all these types of things. I feel, this is my own personal viewpoint, that the student body is large enough and the administration is supportive enough that everyone finds a home. As far as I know, they're, like you said, non-confrontational. People have been very accepting.

Jessie: Right. I can't think of a single issue where my sexual orientation has been an issue. I'm very out at school. Everyone in my class knows. It's not something I'm super vocal about. It's not something I'm hiding either. Every single person in my class would know.

Dr. Chan: Okay.

Jessie: Yeah. It's been a complete non-issue. I think that's the way it should be, right?

Dr. Chan: Yeah. Next, talk about hoops, military, when did this . . . help me understand.

Jessie: Oh my gosh. So I always thought about joining the military before medicine, before any of it. It was always something that was in the back of my head. My family is from the religious group in Utah as well. So they both have served, both my siblings, I apologize, have served religious missions for their church. So service was really big for me and something that I always wanted to serve too, but I was not a part of the religion that they are a part of.

So, again, I wanted to serve. Serving our country was something that was important to me, but medicine always took first priority. I always wanted to go to med school, and that was the plan and I was going to do it and I was like, "I can actually do both. I can make this a thing." I actually sort of did the non-traditional route. I joined in my third year, actually like the week before starting the third year of medical school. So I have a two-year contract with a two-year service commitment.

Dr. Chan: So they only paid for two years.

Jessie: Correct.

Dr. Chan: Would they have gone back and paid for your previous two years?

Jessie: They won't retroactively, yeah.

Dr. Chan: Okay.

Jessie: Which I don't think I would have wanted to do anyway.

Dr. Chan: Tell me about the ritual. There's Air Force, Navy, and Army. Did you talk to all three? How'd you come to that decision?

Jessie: I did. I don't feel like our school has a big military connection. There's not a lot of people up here trying to recruit you. I know a lot of other schools, there's like recruiters there all the time. Here in Utah, I didn't really even talk to a recruiter until I don't even know what day.

Dr. Chan: So it got really serious really quickly.

Jessie: Yeah. Then I was like, "I think I want to do this." I started reaching out to recruiters. I also have like no military in my family either. So I went with the branch that I think I could convince my parents to be okay with. Don't tell the Air Force I said that.

Dr. Chan: They had the nicest brochures.

Jessie: Basically.

Dr. Chan: Did they have this picture and then put on, "This is what you'd look like in the blues. This is what you look like wearing the greens."

Jessie: They did have that. But it was also like, "Where are you going to be the most safe? Where are you going to be less away from combat zones?"

Dr. Chan: Okay. "Would you rather sleep in a jungle or on a base? Would you rather sleep on a boat or in the desert?"

Jessie: It was funny. I went up to a Navy recruiter and I was like, "All right, talk to me about the Navy. I don't know that I want to live on a boat." He goes, "You're all wrong right there. It's called a ship." I was like, "Okay." So I apparently am not meant to be in the Navy. It's called a ship.

Dr. Chan: FYI.

Jessie: FYI. It's called a ship. I actually have one of my really good friends did the Army route. She joined and did the four years.

Dr. Chan: So Air Force . . .

Jessie: Air Force, came upon the Air Force.

Dr. Chan: When did you do basic if you only did a two-year contract or whatever they call it?

Jessie: It's called COT, commissioned officer training. It's actually like the Senate has to approve you and things. You have to get like Congressional approval. Surprise. None of this I knew. It's a big black box, joining the military.

Dr. Chan: I'm sure it was a very small application, very short.

Jessie: Yeah. Oh my gosh.

Dr. Chan: A couple of pages.

Jessie: Yeah. Lots of signatures, lots of blood, all that. I did that. I actually had to jerry rig my schedule a little bit. So in order to do rotations during your fourth year, audition rotations with the military, you have to have gone to commissioned officer training. Most people will go between their first and second year of medical school when you've got that summer off. Off I say kind of loosely. I actually used my only elective time during my third year to go. So I went the month during when I was supposed to have electives.

Dr. Chan: Where is this?

Jessie: Where is . . . where was my elective?

Dr. Chan: Where was COT?

Jessie: COT, it's Maxwell Air Force Base in Montgomery, Alabama.

Dr. Chan: Great weather, I hear.

Jessie: It was January, so it was okay.

Dr. Chan: Okay.

Jessie: Most people go in like July in the summer and it's not fun.

Dr. Chan: So teaching you how to salute.

Jessie: Yeah.

Dr. Chan: Did you get to go up in airplanes and jump out of them, see if you can pass out at 20Gs?

Jessie: No real combat training. You learn a lot about . . .

Dr. Chan: The culture.

Jessie: Yeah, the culture of being an airman. It was really neat, actually. You leave COT feeling like you're actually a part of the Air Force, whereas before you kind of just feel like you're getting a paycheck for not doing a whole lot.

Dr. Chan: All right. So you owe them two years? How does this work?

Jessie: Kind of, I know. It's a little crazy. The military is year for year based on your scholarship, but also based on your residency.

Dr. Chan: We'll talk about residency.

Jessie: Okay.

Dr. Chan: So just segue into that.

Jessie: We can segue.

Dr. Chan: All right. So doing emergency medicine.

Jessie: I am.

Dr. Chan: Emergency medicine is still this weird field where most of them are three, but there's still some four.

Jessie: Yes.

Dr. Chan: Is it still that way?

Jessie: Some are transitioning back to four.

Dr. Chan: Really?

Jessie: So, Stanford, where I interviewed just became a . . . was a three-year and actually just came back to a four-year.

Dr. Chan: I'm sure the residents who are there right now are just ecstatic.

Jessie: It was funny, actually. They picked a class that were like innovators. I mean, they're in Silicon Valley too. So they're going to want to bring innovators into their school. That was sort of the reason they picked the residents they did is they wanted people that were willing to deal with uncertainty and change and whatnot.

Dr. Chan: I am just blown away that everything . . . this is the only residency where there's the three or four-year track. It just seems weird to me. Everything across the board . . .

Jessie: Yeah, it's like set and done.

Dr. Chan: Set and done. There's still like the three versus four-year camps battling it out.

Jessie: It is, yeah. Very interesting.

Dr. Chan: So, with the Air Force, do they have emergency medicine rotations that you did during fourth year?

Jessie: Yes.

Dr. Chan: Where'd you go?

Jessie: They have four programs for e-med. I went to Las Vegas, which is a joint program with Nellis Air Force Base and then UMC in Las Vegas. It's their training hospital down there.

Dr. Chan: Okay. Did you do all four, or you just did Vegas?

Jessie: I just did Vegas. I just did one rotation, and then I interviewed at all the other programs.

Dr. Chan: Okay, and you interviewed at all four. Military match is earlier.

Jessie: It is.

Dr. Chan: Walk me through your strategy. How did you do this? How did you prioritize?

Jessie: Yeah. So, for me, people who go into who joined the military tend to have one of two mentalities. They either want to be surgeons, or they want to be e-med people. So it's a really competitive field in the military. I was like . . . if I had decided on e-med before joining the military, I'm not sure I would have done this route. I was really worried that I had kind of pigeonholed myself and might not be able to match with the Air Force. I was really scared about all of this.

Dr. Chan: Help me understand, help us understand what's the advantage of a military match in e-med in Air Force as opposed to the civilian match, such as Stanford?

Jessie: I don't get a choice. That's the thing. That's the tricky part. The military, because I joined the military, they sort of control my fate in that way. So they can either . . . a couple of options, I can either go to one of four of their military programs. They can approve me for a civilian program, or they can say, "We're not training you in e-med at all."

Dr. Chan: We need you as blank.

Jessie: We need you elsewhere.

Dr. Chan: We need you as a podiatrist.

Jessie: Or like just a GMO. It's like family med but . . .

Dr. Chan: What's a GMO?

Jessie: It's a general medical officer.

Dr. Chan: Is that a flight surgeon, or is that the old-school term?

Jessie: There is a flight surgery route too.

Dr. Chan: I've heard these terms.

Jessie: Those guys get to fly in planes, and the GMO officers basically just work clinics. Basically, it's like family med light for GMO because you're working with a bunch of usually young, healthy people.

Dr. Chan: So you want the military. You want to be one of the four.

Jessie: So I split my rank list.

Dr. Chan: Interesting.

Jessie: I ranked two . . . so, for me, because I had a two-year scholarship, all of the military e-med programs are three years. So, if I went to a military e-med program, I actually had to add a year to my contract. So I got a two-year scholarship and added three. I owed them three years of service.

Dr. Chan: Fun for you.

Jessie: Fun for me.

Dr. Chan: Once you invent that time machine, you can go back and change . . .

Jessie: Exactly. Was it worth it? Which of these programs is worth it to me to add a year onto my contract? That's sort of where I made that decision.

Dr. Chan: So, if you went to a civilian, you would only owe them two years.

Jessie: Correct.

Dr. Chan: Okay. Interesting. So you must have really liked the two military ones you ranked highly.

Jessie: Yes.

Dr. Chan: Why? What was appealing about them?

Jessie: So the four programs, there's three that are basically civilian programs that just have like a military contract with them.

Dr. Chan: Where are those?

Jessie: So Las Vegas is one of them. You train with UNLV at UMC and Nellis Air Force Base. The other one is Travis Air Force Base, which is partnered with UC Davis and then Wright-Patterson Air Force Base and they're partnered with Wright State.

Dr. Chan: Okay.

Jessie: And then the straight military e-med program, eight of the residents there are Army and eight are Air Force in San Antonio, Texas, at the San Antonio Military Medical Center.

Dr. Chan: That's considered the best?

Jessie: Yeah. Military e-med is like e-med plus a little bit because you sort of add a little bit of military medicine on top of it. So you're still getting all of the e-med training, but they add a little bit of military-type tactical stuff.

Dr. Chan: Do you do all your rotations in the San Antonio area, or do they fly you out to military bases and that's considered a rotation?

Jessie: So they don't fly you to military bases, but we have New York you go for a month for toxicology. You go to Miami for a month to do specifically only gunshot wounds. So you're basically called to every single gunshot wound in the hospital. And then you go to Houston to do peds and stuff. The reason for that too is because San Antonio is a big military population and so they want to make sure you're seeing enough diversity in the population as well to get all of those and see all the different things that you need to. So those are the four different programs.

Then the way that I ranked it, the two I felt really strongly about were UC Davis, Travis -- that's in Sacramento, California -- and then SAMMC, the one in San Antonio. Those are the top two that I ranked. Then I ranked civilian. Then I ranked the other two, which are still great programs. They're still civilian-trained programs, but either and/or not places I wanted to live, things like that.

Dr. Chan: So this is October-ish you had to submit your list?

Jessie: Yeah. My rank list went in October 15th.

Dr. Chan: Okay. When did you find out?

Jessie: December 13th.

Dr. Chan: How were you between October and December, calm, anxious? What was going on?

Jessie: No. I was a mess. I was like, "It's out of my hands." I don't think I slept at all for the month and a half, two months. It was really stressful. I couldn't control anything either.

Dr. Chan: It takes two months to run the computer algorithm, right?

Jessie: Apparently, yeah.

Dr. Chan: Computers are very slow nowadays. You have to get those note cards and feed them into the computer.

Jessie: It was so bad. So ACEP, which is one of the big not military but one of the national emergency medicine conferences was in the beginning of November. Apparently, all the military people met then and had already decided our fate by then, just hadn't released the results until December 13th. So it was common knowledge that our fates were decided, but we weren't going to find out until December 13th.

Dr. Chan: So how did you find out, phone call, email?

Jessie: Email. Or not even email, we like log in to a computer system that historically crashes.

Dr. Chan: Okay. It's getting pounded by thousands of people.

Jessie: Exactly, yeah. Wanting to find out where they're going.

Dr. Chan: Where'd you end up?

Jessie: San Antonio, Texas.

Dr. Chan: Congratulations. How does it feel?

Jessie: Amazing. I'm very, very excited about it.

Dr. Chan: Okay. I assume the program reached out to you later that day?

Jessie: Yeah. So I got a call from the program director. I had talked to some of the people that I interviewed with, some of the residents and whatnot, I texted them and I was like, "I'm coming to San Antonio." They're like, "We know, we're so excited." They called me. So I've gotten phone calls from residents. They already started a Facebook group for the residents, the incoming residents. So we're all chatting trying to figure out . . .

Dr. Chan: Housing.

Jessie: Yeah.

Dr. Chan: Do you live on the base, or how's that . . .

Jessie: You can do one of two things.

Dr. Chan: Do you want to live on the base?

Jessie: I do not want to live on base. I don't. I actually want to buy a house. I want to adult a little bit. Wish me luck in that.

Dr. Chan: I think San Antonio is affordable.

Jessie: Yeah, it is, actually. Plus, the nice part about being military is I get housing stipends.

Dr. Chan: Okay.

Jessie: So if I don't live on base, they basically give me money to pay for my housing off-base.

Dr. Chan: Do you know your schedule already?

Jessie: I don't. I don't even know my report date yet. We're hearing rumblings that it'll be June 4th.

Dr. Chan: Okay.

Jessie: Just because they usually say the month of June is going to be like in processing and things like that.

Dr. Chan: So the military match is much sooner than the non-military match.

Jessie: Yes.

Dr. Chan: How does it feel to know your fate while all the rest of your classmates do not know their fate?

Jessie: I am realizing how much I feel like I need to like do between now and then, and I'm really glad that I have six months to do that, whereas my classmates will have like three.

Dr. Chan: What kind of stuff do you need to do?

Jessie: Like buy a house and like figure all that out. I still have some school to finish and whatnot too.

Dr. Chan: What rotations do you have left to do?

Jessie: I have put off most of them for this year. So I actually have a pretty busy spring semester. So I start back in the ICU Monday.

Dr. Chan: Fun times.

Jessie: I'm actually really excited about it too. I'm in the shock trauma unit at IMC.

Dr. Chan: Be great for a future ER doctor.

Jessie: Exactly. That's kind of what I've figured. I've actually stacked my spring semester to do more things that will help me in e-med, things that I think are going to make me a better e-med physician. So I'm doing like . . . I have advanced IMs still in February. But I'm going to do diagnostic radiology. I'm also doing anesthesia, so I can get in a bunch of intubations. Then I'll have some fun things in there too like wilderness med.

Dr. Chan: Fun.

Jessie: Then I'm doing a cool transgender health elective.

Dr. Chan: Interesting.

Jessie: I'm excited about that. I didn't even know it was an option.

Dr. Chan: I did not know that either. This is what I learn doing the pod.

Jessie: Yeah. I'm going to do a transgender health elective that looks at a bunch of different sides of transgender health interests.

Dr. Chan: So what does the future hold for you? Do you think you'll stay in Texas, or is it too soon to say?

Jessie: So I basically know that the next six years of my life are not my choice because the military. So three years in Texas, San Antonio, three years wherever I get stationed after that, which roughly ends up being one deployment still, maybe two. I have my fingers crossed for Germany, but we'll see. Who knows? My mind may change on that.

Dr. Chan: My old roommate was Air Force. They probably still have it. They have this point system, when you're new out of residency . . .

Jessie: No points. Yeah.

Dr. Chan: He got stationed in Turkey Incirlik. He talked about how everyone wanted to be in England or Germany.

Jessie: Yeah, your wish list. It's called a wish list or a dream sheet for a reason.

Dr. Chan: Yeah.

Jessie: They use the point system for the match too, actually, in military. You get ranked. How it works is you put in your rank list and they put in their point system. Then whoever has the most points gets their top choice and whoever has the next most would go down that way.

Dr. Chan: Awesome. Well, this has been great, Jessie. Last question. What kind of advice would you give to people who are listening who are thinking about applying to medical school or maybe applied and didn't get in the first time? What would you say to those people out there?

Jessie: Yeah. I think a lot of it is a lot of determination. It's deciding is this what you want to do and really asking yourself. It's a big commitment. If it's really not something you have your heart set on, don't do it. But if it is, perseverance is truly key in med school. People say all the time, "You must be really smart." I don't feel like I'm any smarter than anybody else. It's a lot of determination and a lot of perseverance. So just making sure if this is what you want to do, do it.

Make connections. I think life is a lot about what connects you make, who you know and working those systems and getting advice from people anywhere you can get it. So things like this, like podcasts are really helpful learning little tidbits here and there and networking. There's no way I could be where I am without the hundreds of thousands of people that have helped me get to where I am. So really value those relationships that you build with people.

Dr. Chan: Well, Jessie, it's been awesome having you on. I'm excited for you. The future is so bright. You're going to be down kicking it in San Antonio, maybe in Germany.

Jessie: Yeah, you'll have to come visit. Maybe in Germany, right? Could be.

Dr. Chan: I just know one day something will happen to me and I'm so glad I'll look up and you'll be in the ER taking care of me.

Jessie: Yeah.

Dr. Chan: Cool. Thanks, Jessie.

Jessie: Yeah. Thanks.

Announcer: Thanks for listening to Talking Admissions and Med Student Life with Dr. Benjamin Chan, the ultimate resource to help you on your journey to and through medical school, a production of The Scope ÐÇ¿Õ´«Ã½ Sciences Radio online at TheScopeRadio.com.