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The Premed Years

A Science, Health and Fitness podcast featuring Ryan Gray and Allison Gray
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The Premed Years is a 2x Academy of Podcasters Award nominated podcast. Started by Ryan Gray and his wife Allison, who are both physicians, it is another means of bringing valuable information to premed students. Interviews with deans of medical schools, chats with trusted, valuable advisors and up-to-date news, The Premed Years podcast and are the go-to resources for all things related to the path to medical school. We are here to help you figure out the medical school requirements. We will show you how to answer the hard questions during your medical school interviews. What is a good MCAT Score? What is the best MCAT Prep? What the heck is the AMCAS? What is the best undergraduate program? What is medical school like? What do you do to volunteer and shadow? Get your questions answered here.


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345 episodes
345 episodes

Recent Episodes

352: How This Doctor Encourages and Mentors Minority Students
From a small HBCU to emergency medicine to organizing conferences, Alden joins me to talk about encouraging and supporting underrepresented minorities in medicine.
351: A Canadian Nursing Student's Quest for Medical School
Session 351 Our guest today is proof that it's not impossible for nontrads to get into Canadian medical school. It may be hard, but it's not impossible. When Anita moved to Canada, she realized she was ready for a new start. She takes us through her journey from nursing, to the MCAT, to a Canadian medical school. Please also be sure to check out all our other podcasts on the Meded Media network as we try to help you along your path. Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points. [01:36] Interest in Becoming a Physician Anita moved to Canada in 2013 from Brazil when she got married. At that time, she worked as a journalist for six years, being her first degree. Her background involves working in social media, marketing, and web content for companies. At 18, she thought medicine was only for smart kids. Having moved to Canada and feeling she was in a quarter-life crisis, Anita finally decided to pursue medicine after a few months of research, making a spreadsheet, and doing introspection. Brazil has a different school system where you go from high school to a six-year program. They didn't have to show any grades from high school and they only had to take one exam. The kids in high school who were going for medicine were taking all the tutoring. Not only thinking that she wasn't smart enough, but she also didn't want to put in the time. So she just wanted to go straight to something. She just didn't initially see herself as a doctor. Anita had an emotional talk with her husband about wanting to go to medical school. At that time too, she was volunteering at a hospital. She loved the idea of delivering babies. [Related episode: Why Do You Want to be a Doctor? You Need to Know This!] [09:58] Going to Nursing School During that conversation with her husband, she was told how difficult it was to get into medical school in Canada. So she had to figure it out herself.  Living in Montreal, she walked straight to McGill University's office and asked about the process. She didn't even know what the MCAT was at that time. Her GPA was required so she had to go back to her transcript. It was way below what was needed. Obviously, Anita had to go back to square one. She thought about going to midwifery school or a nursing school. She learned that as a midwife, you're on call 24/7 while as a nurse, you work in shifts. By January 2014, she started taking prerequisites for nursing. She continued volunteering. She read books about nursing and talked with nurses in the hospital. She realized the great side of nursing in terms of spending a lot of time with patients.  She also realized that as a nurse, her job would be important. At that time, she still thought she wasn't going to be a doctor. So it basically took her a year and a half to get into nursing. In nursing school, she had to re-learn how to be a student. She also found out she was good in sciences because she was led to believe she wasn't when she was still applying for college at 18. The whole time was a self-discovery process for her. This was more of a confirmation that she could also be good at the sciences. It wasn't until the end of second year that she got that confidence back. Then she began considering getting into medical school knowing she could be a competitive candidate. She also started doing research and looking into medical schools. [Related episode: From Nursing to Premed: A Story of Lost Confidence] [20:22] Taking the MCAT and Retaking the MCAT Anita admitted to not respecting the MCAT as she should have. She didn't study a lot. At that time, she attended an info session at McMaster University in Ontario. And there she found out they would only look at the CARS score. She was in her third year at this time. So she decided to try taking the MCAT. She also wanted to overcome the hurdle of fear of taking the MCAT. She heard of some people who gave up on medical school because they were afraid to take the MCAT. And she knew she couldn't let this happen. Working full-time, doing internship in public health that summer, she picked a date and place in June for a test scheduled in September. During the week, she studied for an hour in the morning. Anita used the Princeton Review CARS Textbook and signed up for their online resources. She also bought the AAMC questions. She did questions and studied every day for a month and a half. Then she began taking timed exams. Her focus was only on CARS. She did test some biology and psychology background. So she went in and took it. She took the MCAT twice because she wanted to do better on the other sections to open up her possibilities. The first time, she got 129 in CARS. She thought her background in writing and journalism helped.  Coming from a Humanities background, Anita thinks that even if English is your second language, but if you have a good command of the language, then maybe you would find CARS to be easier. Moreover, Anita believes that doing a lot of questions has helped her a lot. Different courses have different strategies. But ultimately, you have to figure it out on your own. Figure out how your brain works. Take notes of what works for you. Spend time figuring out your own system. Figure out how you can finish on time and increase your accuracy. [Related episode: How Can I Score Higher on my MCAT Retake?] [28:53] The Application Process The first year she took the MCAT, she applied to McMaster and didn't get anything. She figured it was going to be useful no matter what since she wanted to see the application system. She wanted to learn how to draft her application. The second year, she applied to six schools and her spreadsheet kept growing. She looked at different schools. Most schools have different stats for out of province. Anita filled her spreadsheet. Her second MCAT score improved but her CARS went down by one point. She did self-study. She couldn't apply to some schools because of the cut-offs but she applied to the ones she could apply to. So it all came down to six schools in Ontario and four out-of-province schools. She used her previous application references and she was simply keeping things organized and had everything in on time. Post-submission consists of the waiting game. Medical schools will just send you a receipt of your application. For most schools, you won't hear until January. Once you choose which schools you're going to send your application to, you immediately have access to whatever extra each school wants from you. It's the same process in the U.S., just a different timeline. The schools in Ontario opens on July 15  and you have until October 1. There's also a sketch which includes a list of your most important experiences. Basically, all the secondary stuff is there, but it's just right away there for you. The AACOMAS application here in the U.S. has that built-in right now. But there are only a handful of schools that utilize that. For most schools, secondary applications are still separate. [Related episode: 4 Things You Need to Do Now to Prepare For Your Applications] [35:13] The Interview Process and Acceptance Anita started hearing from schools as early as December and the others in January. She wanted to take the MCAT again to increase her chances in some schools. But her husband advised that she waited and so she did. By early February, she got the email that she got an interview. She was elated. After the interview day, she found out she got accepted after two months. It was a tough process and a stressful time for her. She had a coach to help her out for her interview.  The interview was very nice. She enjoyed the school and the people. She went through the MMI. She describes it as going somewhere you hear about for a very long time and then you finally find yourself there. When she came back home, she felt like having PTSD. From feeling very confident out of it, her confidence began to go down as the two months spread. Finally, she got an acceptance through an email. While waiting, she did cycling classes which she found very helpful in dealing with stress and anxiety. She went to spinning class everyday. And while waiting for the shower, she checked her emails on her phone and read the great news! [45:00] Final Words of Wisdom Some days are great and some are terrible. Figure out what you can believe will help you achieve your goal. If you choose to believe, you're going to have more motivation. Believe you're a doctor and you're doing what you need to fulfill your potential. Choose to believe that and you're going to get in because you can't predict the future. Eliminate self-doubt in your head and this is going to help you motivate yourself. Your patients are waiting for you. Not everybody has the drive to go through this process. And if you have a drive and you want to be a doctor, you owe it to your society to become a doctor. So just keep pushing! Links: Meded Media
350: What Matters Most to a Physician and Best-Selling Author
Session 350 Dr. Marty Makary is a world-renowned surgeon and author. He joins me to talk about the purpose of medicine, the medical establishment, and how to be consciously disruptive. For more resources to help you on this journey, check out Meded Media. Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points. [00:26] The Modern Day Hippocratic Oath Every 50th episode, I recite the Hippocratic Oath written in 1964 by Dr. Louis Lasagna. Hopefully, reading this oath can give you a bit of motivation as you remember why you're doing this and so you'd have the drive to continue forward. The Hippocratic Oath is something you decide during the white coat ceremony when you start medical school and you're given a white coat by the medical school. This is something you should hold near and dear to your heart. Today, I'm reciting the modern-day version of the Hippocratic Oath. Hippocratic Oath- Modern Version “I swear to fulfill, to the best of my ability and judgment, this covenant: I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.” [04:00] Understanding Today’s Healthcare Back on today's episode, Dr. Makary is a chief at the Johns Hopkins Eyelid Transplant Center at Johns Hopkins Hospital. Today, we're talking about the book he wrote, The Price We Pay: What Broke American Healthcare – and How to Fix It. This is an amazing discussion on healthcare. You need to understand this for your medical school interview or as a future physician. You don't have to know everything about this. But at least try to understand it from a superficial level. [Related episode: How to Start Thinking About Improving the Healthcare System] [06:04] A Little Background About Marty Marty chose to become a physician because of the level of respect and trust people have over physicians. Initially, he thought of being a missionary doctor. He found a lot of  "pontificating" in medicine but there's something appealing about the surgical field to him. He found the operating room to be a little intimidating yet cool. In his mind, the harder task in medicine is to listen to people, to diagnose, and to coordinate care while being a surgeon is the easier road. Marty explains that the reason to write a book is if you believe that there's a story that needs to be told that nobody else is telling. [09:45] Understanding Modern Medicine In medical school, there's a psychological conditioning that happens. People get to see the good side and bad side. It can be awesome and daunting at the same time. This got Marty interested in the subject of medical errors. Marty thinks that modern medicine today is missing the boat on so many important things – on food as medicine, meditation, and treating public health issues such as loneliness. Loneliness affects people's health. We don't talk about frailty and physiological reserves. Marty loves the students he works with at the Johns Hopkins Hospital who think about those things. They ask whether they can treat hypertension with yoga as the first line of therapy. Or whether they can treat arthritis with a low inflammatory diet or talk about the microbiome as a reason for abdominal pain. These are things that modern medicine has not been able to process or understand.  Our current system has this construct – since we don't have any studies on what you're asking and there's no evidence, therefore, it's not true. This is logical reasoning is not correct at all and it's been very dangerous. This is something we need to challenge. [14:30] Medical Conditions Our Society Has Created Society has created a whole host of conditions and medicine is in a rut where we can't talk about these root problems because of this kind of logic. Good thing our new generation of students is questioning a lot of the stuff we're doing.  For instance, the opioid epidemic is a manifestation of the manufactured crisis by the modern medical-industrial complex. It's one manifestation of the problem of too much medical care or medical errors. We need to disrupt this medical establishment that has told us to get in line and don't question this. [18:00] How Students Can Overcome the Challenges in Healthcare As a student, you want to link up with doctors you feel you have good chemistry with, not only with interpersonal skills but also, philosophical chemistry. Marty explains they like premeds and medical students watching them in surgery who are hyper communicators. They want those who ask a lot of questions and who are proactive. When his colleague does interviews, he wants to know if the student could at least talk about a sport as this is a sign of affability. Additionally, be able to identify mentors. Observe what others do when you're rotating at a hospital. Think big. Join an effort, cause, or movement. They need less robotic personalities and more people with passion. For instance, a group of students has started a movement called Restoring Medicine. These are gap year students, undergrads and premed students who are calling things out. They're part of the generation that believes in social justice that wants to have a sense of purpose in life. [23:24] How Can Hospitals Run If They Can't Money From Patients? Doctors and hospitals need to be paid for their services. But they're suing low-income patients for bills that they cannot afford. Most hospitals have a charter at their founding dedicating them to be a safe haven for the sick and injured regardless of one race, ethnicity, or their ability to pay. This is the great American heritage of our profession. Medicine has always been an open door, equal opportunity caregiver. But a significant percentage of Americans has lost trust in the healthcare system now. There are hospitals that make a lot of money who put liens in people's homes. Marty underlines the fact that physicians went into medicine for a unifying reason which is to help people. But where is that compassion? Hospitals don't pay taxes because they're nonprofit organizations dedicated to serving communities. However, what's happening now in American medicine is the business of price gouging, surprise bills, egregious markups, unnecessary medical care. It's a disgrace to the profession. Moreover, there is a need for students to know about healthcare literacy, not just medical literacy. This is the main reason Marty wrote the book, The Price We Pay. He wants to explain the problems in healthcare medicine and highlight the disruptors who are going to fix it. [Related episode: Setting Yourself Up for Financial Success, Starting Now] [28:40] Medicine is Still an Amazing Field Marty wishes to tell students who are interested in medicine that medicine needs their help. Medicine is on the brink of having its public trust eroded by these egregious, predatory billing practices, predatory screening practices of overtreatment, and problems ranging from overmedicating to spending 10 minutes with the patient in trying to address complex issues. Medicine is never intended to be like this. And this is the struggle right now. We need people now to go into medicine and stand up for what's right. We need people who believe in the mission of medicine in its great medical heritage. We don't have money for schools, education, and other important national priorities because of all the taxpayer dollars getting shunted towards healthcare. Marty mentions the movie The Big Short which does a great job explaining the banking crisis. The banks have told the public for years leading up to the 2008 crisis that banking is very complex so people have to leave it to them. But it wasn't complex. It was as simple as banks spending money they didn't have on toxic loans they should have never been giving out. Meanwhile, the independent rating agencies were being paid to give a rating. Hence, there's this conflict of interest and they're giving artificially inflated ratings. The system eventually collapsed. Marty believes this is exactly what's happening with healthcare right now. The money games are very fixable. The solution sometimes is embarrassingly simple. We need public transparency of the secret negotiated prices between hospitals and insurance companies.  Nevertheless, Marty is positive and sees this as an exciting time. He adds that the best part of his job as a surgeon is his students who come up to him and say something should be done. Being close to DC, his team gets to go to Congress and even the White House where they can get to talk to policymakers. They tell them about the stories of their patients and how they're being hammered right now. They plead that these policymakers listen to their stories. [Related episode: How Do I Know if Medicine Is Right For Me?] [34:24] Redesigning Healthcare In his book, Marty highlighted a guy working at a primary care clinic who questioned the practice of seeing patients for 10-12 minutes each patient. So he started a clinic that is now globally capitated. They're paid in a lump sum so they don't have to bill. It's called a relationship clinic. There are now a bunch of fast-growing primary care clinics around the country. Some of these are 20- to 30-clinic systems. They're growing like weeds and people love them because they're spending time with their doctors. The doctors love it because they can spend time getting into the real issues with their patients. Marty believes we can teach students how to take somebody with severe depression and treat it not with medication, but with community. Clinics like Iora Health, ChenMed, and Oak Street Health take talented individuals and teach them how to hold a patient's hand and care for them. Health coaches and navigators go to their homes. They meet at the community center and teach a cooking class. They have a yoga studio. We're now basically seeing people who say they can completely redesign medical care from scratch. They can make it better if they're freed from the bondage of billing, 10-minute patient visits that accounts for a lot of the overtreatment. Burnout rates in medicine are at record-high levels. That said, Marty would not let this discourage any student from going into the profession. Especially now, because there is a movement to reclaim medical care and to redesign healthcare from scratch. Marty thinks the cause of burnout is the lack of any followup or the loop being closed where the patient says "thank you" at the end of the process. But emergency room doctors don't get this. Patients want care close to them and we've got telemedicine. So there are a bunch of exciting, new ways of looking at care. [Related episode: A Burnout Story and What You Can Do to Avoid It] [41:00] How Students Can Get Involved Keep your passion. We need passionate students and with deep sense of purpose in going into medicine. If the idea of practicing medicine all day long sounds daunting, just remember that most people now are planning on some kind of hybrid career. You can be a physician and author. Or a physician and a podcaster. Messaging is very important. If we just keep writing in the medical journals, we're only talking to ourselves. But when you start writing on the Wall Street Journal or do a podcast, then we get the word out there. Marty is positive that things are going to get better. The past generation mourns the gold era of medicine. But medicine is still an incredible profession. If you're a premed student and really want to do this, follow your passion and get involved. [45:09] Marty's Books and Final Words of Wisdom Marty's first book Unaccountable was turned into a TV series, The Resident on Fox TV. They get set the issues of unaccountability in healthcare. In an attempt to educate somebody on the business of medicine from A-Z, Marty wrote the book, The Price We Pay. You will learn a lot of things about why healthcare costs so much. He also explains a lot of mythology, legend, and folklore as well as strong opinions that are not substantiated. Marty outlines two fundamental drivers of our healthcare cost crisis. First is the appropriateness of care. Second is the pricing failures in the marketplace. In terms of the appropriateness issue, there has been to much care. A concrete example is the opioid crisis. 50,000 to 70,000 people die a year from prescription opioids. He also explains "the middlemen of healthcare." Thousands of millionaires who are not patient-facing have been created by the healthcare system. With the $3.5 trillion we spend on healthcare, almost 1$-5$ in the economy are spent on healthcare. Ultimately, Marty recommends that you find a doctor you get along with. Don't be afraid to reach out to doctors. Create your own experience. Research about doctors to be mentored by. If you want to do research, type the doctor's name in and see if they publish and they've written any articles and whether they tend to put students on those papers. This tells you about someone's research productivity. Finally, see if you can get the opportunity to talk about the deep, underlying root issues of medicine with these physicians. See their passion and if it matches your passion. Whatever your passion is, there are ways to screen for it among doctors you talk to. Never underestimate the value of spending time with nurses, nurse practitioners, and physical therapists and EMTs. Do you know of books about the healthcare system that you like? Tweet me @medicalschoolhq. Let me know what your favorite book is. Links: Meded Media The Price We Pay: What Broke American Healthcare – and How to Fix It by Dr. Marty Makary Restoring Medicine Iora Health ChenMed Oak Street Health Connect with me on Twitter @medicalschoolhq
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Podcast Details
Nov 28th, 2012
Latest Episode
Aug 21st, 2019
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