Shit Med Students Say, An Interview With The Creators

Left to Right - Emily, Alessa, Annie

Emily Silverman, Alessa Colaianni, and Annie van Beuningen are members of the Johns Hopkins School of Medicine class of 2014. They are also the creative genius behind the viral video "Shit Med Students Say" and are the reason I now ask all my patients if they have bombastic diarrhea.

They where nice enough to take some time out and answer some questions about surving med school with a sense of humor.

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I thought Hopkins was a place for serious students, the who's who of serious gunners, how are you guys so funny and laid back?

EMILY: I don’t know about gunners. But we are nerds. For instance, I’ve had no trouble finding classmates who share my love for Ocarina of Time and Battlestar Galactica.

ALESSA: Oh, that thing about Hopkins being the who's who of gunners is a total myth. Ha ha ha (dismissive/uncomfortable laugh). Now if you'll excuse us, we have to go print out decoy notes with mistakes on them to throw our classmates off our knowledge trail. Right after we cure cancer in our secret labs.

ANNIE: Because the gunners here are great fodder for comedy.

How did you guys get the idea for the movie?

EMILY: When “Shit Girls Say” came out, it just seemed like a given.

ALESSA: We all loved "Shit Girls Say" and Em texted me during class suggesting that we make one for med students. We spent the rest of the class writing a script via text message.

ANNIE: We're bad med students and do things like watch every rendition of "Shit Girls Say" on YouTube rather than study the ins and outs of pseduopseudohyperaldosteronism.

How do you guys find time for this type of hobby in medical school?

EMILY: Before starting med school, I promised myself I would find a way to keep my creative side alive. Making videos is a fun way to do that, especially when you have hilarious friends like Annie and Alessa.

ALESSA: It keeps me sane. You can spend every second of your time studying during med school and still not feel like you're learning enough, and eventually you get to the point where you don't feel like a person anymore. That's not healthy. For me, it's been important to cultivate my non-medical interests as a way of staying human.

ANNIE: Studying all the time is just not feasible for me. I get to a point where I'm no longer productive or actually remembering what I'm trying to learn. Keeping up with other hobbies is a great way to break up the studying routine.

What are your medical interests?

EMILY: The only rotation I’ve done so far is pediatrics, and I loved it. But who knows. One thing I know for sure is I want to be involved in medical education. We’ve had such excellent teaching here at Hopkins, and I want to be a part of it someday.

ALESSA: I have no idea. I like everything.

ANNIE: I change my mind all the time. Right now I'm still at the point where everything is interesting to me.

Any plans for future projects?

EMILY: I’m sure we’ll make something again when inspiration strikes. As for the long term, I’d love to incorporate the arts into my career somehow. If anyone has any bright ideas, let me know!

ALESSA: Nothing in the works right now, but if you ever need someone to do voice-acting or weird accents, please call me. I’m not kidding.

Now that you finished your first two years in Medicine what do you wish you would have known before you began?

ALESSA: Turns out all those viral structures I ignored during pre-clinicals are super- important for Step 1… womp womp…

EMILY: Take notes on your laptop! Then, when it’s time to study for boards, you can Ctrl + F all the stuff you’re confused about. Brings back memories. Plus you’ll have the notes forever. ANNIE Pay attention to the acid/base disorder lectures during renal - lots of people actually have these. And CHF. Learn about CHF.

Medical Student and Ultramarathoner: An Interview with Brad Harris

Anyone thinking about a marathon during medical school? This guy eats them for breakfast!

Brad Harris is a 3rd, soon-to-be, 4th year medical student at Loma Linda University. When he is not rocking the wards he's probably in the mountains, pushing his lactate threshold to the limit.

Tell me about your last race?

My last race was the Old Goat 50 miler on March 24. It was a trail race on 75% singletrack trails in the beautiful coastal Santa Ana Mountains. It was a tough course with 13,000 feet of climbing. Ninety-five percent of the course was either going up or down. The physical side of running an ultra race proved to be much easier to train for than the mental side. At some points in the race all I wanted to do was stop and stretch, just so I could have a good excuse to stop running. By the end it became a battle to find motivation to finish. Overall, it was great experience and a good challenge mentally. I finished with a smile on my face.

What did you feel like after finishing a first 50 mile run?

HUNGRY! I subscribe to the theory that your body tells you what it needs through cravings so that meant that I ate nachos, chili, pancakes, gatorade, chocolate milk, salty potato chips, and grilled cheese all within the first 10 hours after the race. And it was all guilt-free eating. Of course, crossing the finish line was a lifelong goal for me and brought a tremendous feeling of accomplishment, but stuffing my face sure brought a lot of satisfaction as well.

When did you get into running?

My high school biology teacher got me into long distance running in 9th grade. I have since transitioned to more trail running. After moving to Southern California for medical school, I found the local mountain trails lots of fun to play in. Running has become a way of life now.

Ok, I know you like pain, was that what inspired you do pursue medicine?

One of the biggest reasons I first decided to go into medicine was to give back to my community. I've been very fortunate to get medical help when I've needed it most. I've been shown compassion and experienced how it feels to receive it. I look forward to being able to this on to others both locally and globally. Another thing that appealed to me about medicine was the opportunity to be a part of a community that constantly strives for excellence and works to improve peoples' quality of life. In addition, I really enjoy the mental stimulation that medicine provides. It's a challenging career that will always be evolving, changing, and making you think. As I started medical school, I became very interested in wilderness medicine and specifically high altitude medicine. I love the mountains so its a pretty natural fit for me. I look forward to incorporating as much medicine as I can into the things I love to do in the outdoors and giving back to the community.

One of my favorite quotes kind of says it all...

What we have done for ourselves alone dies with us; what we have done for others and the world remains and is immortal.

- Albert Pike

What types of races have you done in medical school?

While in medical school, I've done 2 big races (2010 Boston Marathon & 2012 Old Goat 50 miler), a few smaller races, and am constantly coming up with entertaining endurance challenges with friends on the weekends to challenge ourselves. My goal throughout med school has been to get out into the wilderness at least once a week to run, rock climb, or backcountry ski. Its a great way to clear the mind and a good motivation to be efficient with studying.

How do you keep up with medical school and have time to train at such a high level?

I try to maintain a focused yet flexible training schedule with a lot of variation, but some times school doesn't comply with my training schedule. Check out my guest post on Endurance Training During Medical Training.

Has your running life opened any doors in you medical career?

I've made great friends and met all kinds of interesting people that are in the medical field at races and while out training, but the most direct way that running has opened doors is that it provides an easy icebreaker to start up conversations with residents, attendings, and patients on a day-to-day basis. Its fun for me to find out what other people like about running and create a common bond. I've found that the shoes that people wear in the hospital tend to be a great conversation starter.

So what’s next for your running career?

My most important goals are to continue to stay healthy, push myself, and meet fun, interesting people through running. In addition to these goals, I keep a google doc chocked full of future adventures. It's a dynamic list that helps keep me focused and  keeps me dreaming. I highly recommend this type of adventure list to anybody that enjoys the outdoors.

A few running adventures on my short list for the next couple years include:

1. 100 mile trail race,
2. Running up Mt. Whitney,
3. Running the West Coast Trail in BC Canada
4. Running the Rim to Rim to Rim of the Grand Canyon.

How has staying connected to this passion helped you in medical school?

The biggest way running has helped me in medical school is it has allowed a time for me to clear my head and remember that life is much bigger than the current landry list of stressors I may be facing in my life.

A CEO & Entrepreneur Who Also Happens To Be A Surgeon; An Interview With Dr. Arlen Meyers

"Taking Care of Business Is Taking Care Of Patients." -Dr. Arlen Meyers MD MBA

When you ask most physicians what they do, the answer is expected to include their specialty and maybe a bit about a fellowship or possibly some research. With Dr. Arlen Meyers, it's not quite that simple. A professor of otolaryngology, dentistry, and engineering at the University of Colorado Denver, he is also cofounder, President and Chief Medical Officer of medvoy.com, a globally integrated, doctor to doctor referral platform. He has been named one of the 50 Most Influential Physician Executives of 2011 by Modern Healthcare and is currently serving as the founding CEO and President of the Society of Physician Entrepreneurs and Director of the Certificate Program in Bioinnovation and Entrepreneurship at the University of Colorado. This is just the tip of the iceberg; Dr. Meyers is working to radically change the way doctors do business. I was able to catch him for a quick chat.

Enter Dr. Arlen Meyers

What Does Your Job Entail

Basically, I have two lives. The first as an academic head and neck surgeon which involves teaching medical students, residents, staffing clinics, and all the other medical stuff. The other side of my life is all about bioentrepreneurship. My second world is about the research, education, and practice of bioentrepreneurship in medicine; specifically ENT surgery, and that’s how I spend my time.

What’s the secret to becoming an entrepreneur and a surgeon?

I don't think it's a secret, but I'd say you need to get up early and work your ass off (said with a grin). I don’t know what else to tell you. We only have 24 hours in a day, and we just choose to use them in a certain way.

When did you first develop an interest in entrepreneurship?

Well in retrospect, probably when I was 8 or 10, but I think I was too stupid to know that at the time. Fundamentally, my view on this is that becoming an entrepreneur is about 15% being hard wired to do it, and it’s about 85% getting the knowledge, skills, abilities, and work experience to make it happen.

What is your advice to physicians or medical students who are considering getting an MBA?

It's really quite simple. Basically you are going to get your ticket punched, and everyone’s going to say, “Hmmm, this doc is an MD MBA.” You’re going to meet a whole bunch of business minded people, and you’re going to learn some stuff. Those are the three reasons that you go to business school. Now, what opportunities will you have if you get an MBA? That’s always the real question.

Doctors who get an MBA basically are doing it for 3 main reasons:

1.They’re interested in furthering their education and getting credentials so they can be in a health service leadership position—VP for medical affairs, medical officer, president of the hospital, whatever.

2. They want to do it because they’re interested in health service research or strategy, so they want to run a public health office in their state or something like that.

3. They want to start a company or they want to be an entrepreneur.

My advice would be that an MBA makes the most sense if you’re in category 1. If you’re in category 2, you probably shouldn’t be pursuing an MBA. You should probably be doing a Masters in Public Health or Public Administration. And if you find yourself in category 3, you shouldn’t waste your time with an MBA; just go out and start a company.

Why did you decide to start the Society of Physician Entrepreneurs (SOPE) and what kinds of things does it do for physicians who are interested in entrepreneurship?

I started it because it needed to be done and no one else was doing it. The Society of Physician Entrepreneurs is a lesson in entrepreneurship and that is something that doctors are not trained to do. Basically, in order for you to start something to be successful, it has to satisfy three objectives: One, it has to be a big unmet market need. Two, you have to create something that satisfies that need in such a way that people are willing to pay for it. Three, you have create a business model so it sustains itself. We do not get trained about this stuff in medical school or residency.

To me, the biggest opportunity in US Health care reform is innovation. However the sad truth is that most doctors don’t get it. Remember the typical line, "doctors are terrible business people." Actually, I don’t think they are but that’s a whole another conversation. I want to fundamentally change that stereotype and SOPE is one way to make that happen. Our focus is not on practice management in the traditional sense, our focus is on innovation and on bioentrepreneurship. We want to show how to get a life science idea to market and change health care with your idea. It’s not how to squeeze another nickel out of your accounts receivable.

Do you have a book recommendation for our readers?

The one that I’m writing called The Life Science Innovation Road Map. You will hear more about when it is relased, I hope it will help doctors learn how to make there ideas a reality.

Medical Student By Day, Indie Author By Night

Brian Justin Shier is a 3rd year Medical Student at the University of Califonia Irvine School of Medicine. He plans to pursue a career in Hematology and Oncology.

As B. Justin Shier he is also the Author of the Zero Sight Series. The first two books in the series have been well recieved with loads of 5 start reviews on Amazon. As well as this high praise.

Top 5 in Kindle Contemporary Fantasy Ratings
--Based on Amazon reader reviews (September, 2011)

Top 10 in Hot New Contemporary Fantasy Releases for the Kindle
--Amazon (June, 2011)

I had the pleasure of chatting with Brian about medical school, writing, publishing, and finding time to make it all happen. He maintains an eclectic online journal at www.bjustinshier.com where many topics are discussed, including future releases of his book series.

Listen to our conversation below, right click to download an mp3 file.

Uncommon Student MD talks with Brian Shier

9 Reasons For Physican Burnout, And One Way To Avoid It

"The burnout epidemic amongst our physicians is a predictable result of the medical training and the generally accepted definition of “success” amongst doctors."

-Dr. Dike Drummond MD Founder of TheHappyMD.com

Dr. Dike Drummond is a Mayo trained Family Practice Physician who has experience in medicine, coaching and personal improvement, and business development. His expertise in personal change was developed over 15 years as a family practice doctor and 8 years as a business coach working with physicians and startup entrepreneurs.

When I met Dr. Drummond, we discussed the reasons why so many physicians get burned out. He asked me how most doctors measure success? “Do they have a busy practice?” The answer popped out of my mouth instantly; it was almost a reflex. This is something you hear all the time. “She is doing well, working in a busy practice,” or “his surgery schedule is booked solid; he must be doing great.” This seems to make sense; after all, we are doctors, and doctors are busy. However using this one tool as your main metric of success can become a recipe for disaster. Unfortunately, this is not the only reason physicians get burned out, but the good news is, there is a solution.

Enter Dike Drummond

What follows are 9 facts about the practice of medicine that lead directly to burnout. The good news is you can do something about it.

1) Being a Doctor is Stressful. Period

The "most stressful" professions are those characterized as having a high level of responsibility and little control over the outcome. We are not selling widgets in medicine. This is a tough job that saps our energy every single day.

2) We Work with Physically and Emotionally Sick People All Day Long

Our days are filled with intense encounters. We spend our time treating sick, scared, and hurting people. In addition to the physical ailments, there are many emotional needs that come with any illness. Physicians do not receive proper training on creating boundaries; our energy can be severely tapped by these emotional needs alone.

3) Balance, What Balance?

Medicine has a powerful tendency to become the “career that ate my brain." Pushing all other life priorities to the side is something that we have ingrained into us during medical school and residency. As we get older, with more family responsibilities, the tension between work and our larger life is a major stressor for many. Training on healthy boundaries would help here too and is rarely available.

4) A Leadership Role with no Leadership Skills

You graduate into the position as leader of a healthcare delivery team without receiving any formal leadership skills training. By default we learn a dysfunctional "Top Down" leadership style. (Medicine and the military are the only professions where the leaders "give orders.") This adds additional stress.

5) The Doctor is the Bottleneck

The team can only go as fast as we can, and we are often behind schedule. Pressure mounts to perform at full steam all day long.

6) Who's Paying for This?

The financial incentives are confusing at best. The patient is often not the one paying for our services, and many of them receive their care with no personal investment on their part. You may have to deal with over a dozen health plans with different formularies and referral and authorization procedures ... of which the patient is blissfully unaware.

7) Medical Practice is A Lawsuit Waiting to Happen

The hostile legal environment causes many of us to see each patient as a potential lawsuit. This fear factor adds to the stress of all the points above.

8) Politics and "Reform" Political debate drives uncertainty about what our careers will look and feel like in the future.

All the pundits share the same complete lack of understanding about our day to day experience as providers in the trenches of patient care. There is no track record of common sense. We simply don’t know what to expect.

9) Things Eventually Get Stale

The ten year threshold when your practice suddenly seems to become much more of a "mindless routine" losing its ability to stimulate your creative juices each week is a shock. All of a sudden it seems as if medicine is “no fun any more."

The Solution

Keep your connection to "WHY" we are a doctors; to your Purpose.

The quality of this connection varies day-by-day; however, it is a source of immense power and endurance when the connection is clear. As physicians, we must deliberately work to keep that connection alive and well. When you have invested over a decade of your life in medical training, it's easy to feel stuck when you think your reason for becoming a doctor is gone or not possible. It's imporant to remember you have a great skill, with more opportunities than you probably know. Keep searching out and pursuing the opportunities that ignite your passion, and do not be afraid to ask for help. Sometimes another perspective can open your eyes to opportunities you did not choose to consider. 

When you notice the three cardinal signs of Burnout

     1) Exhaustion

     2) Cynicism (especially in men)

     3) Questioning the quality of your work or whether you make a difference in the world.

     (Sounds like medical school and residency)

It's time for a break, some balance, to take really good care of yourself, spend some time with your family and even ask for support. You’ve earned it.

To learn more from Dike Drummond visit The Happy MD

Have The Power To Practice Medicine How You Want

Turning Healthcare Ideas To Action

Jessica is a fourth-year med student in the Tufts MD/MBA program and will be heading to Portland, OR, for residency in Family Practice. While in school, she has been involved in various consulting projects for hospitals, health clinics, and small health and wellness businesses. She is also the co-founder of the Ideas To Action series at Tuffs University. It is a speaker/workshop enrichment series for health sciences students interested in entrepreneurship and idea development. With a profound interest in entrepreneurship, her goal is to have the freedom to explore innovative ways to impact health and wellness. I was able to chat with her about her journey, and I thought it was definitely worth sharing.

How did you decide to go to medical school? 

My path was not at all conventional. When I was young becoming a doctor was something I said I would never do. Both of my parents are doctors and they actually told me not to go into medicine. The change happened while I was at Harvard studying psychology. I heard about the combined MD/MBA program Harvard had just started, and I loved the idea. I always had an interest in the world of business and innovation, but I also liked that medicine gave you the opportunity to directly change people's lives. However, these two worlds existed apart in my mind until that point.  Now I did not have to choose.  I could take both of my interests and turn them into my passion, so I became a premed student. Once I decided medicine was what I wanted to do, my parents were supportive; and my mom gave some great advice. She told me that if I was going to choose this career path, I had to make sure I had the power to practice medicine how I wanted.

When/how did you get interested entrepreneurship?

I guess it’s something that has always been with me. My family is very entrepreneurial, and so maybe it's just in my blood.

Tell me about Ideas To Action Series?

While in school, I found myself constantly coming up with ideas, but I really didn’t know what to do with them. I approached my MD/MBA course director about this, and he put me in touch with Don Lombardi, the founder of Institute for Pediatric Innovation. As I began to explore my frustrations about the life science entrepreneurial process, I realized a lot of other students might feel this same way; and Ideas To Action Series was born.

The format is simple. We have someone who is creative and/or innovative in healthcare talk about the process they used to go from a dream to reality. This gets the creative juices flowing. Then we start the workshop portion where everyone gets into groups to come up with a product or service that could be a solution for a current problem in healthcare. It is always fun to see the great ideas people come up with, and I am always impressed by the creativity displayed during these sessions. After brainstorming, the moderator takes some of the best ideas and goes through some practical ways to implement them in the real world. It’s fun to have ideas, but it’s even more fun to actually do something. Giving students tools that lead to action is our main goal with Ideas To Action.

Any Advice To Medical Students Who Want To Follow An Unconventional Career Path?

Being a student is actually the perfect opportunity to approach an individual or company and ask to learn what they do. At this point you are not seen as competition, and people will likely go out of there way to help you. During one of your breaks, seek out a doctor who is doing something you find interesting or starting up a company in health care and tell them you are very interested in what they do and would love to learn more. Ask to work with them for a week, or even for the summer, and see where it goes.

Any Non medical Book Recommendations?

The title is How to Talk to Anyone: 92 Little Tricks for Big Success in Relationships by Leil Lowndes.  I know it has the ring of a cheesy self-help book.  But for people like me (many of whom I imagine are in fact medical students) who get a little uncomfortable in networking situations, this is an awesome book for building a little social confidence.  It offers great tips for entering a gathering with self-assurance, making a positive first-impression, and connecting meaningfully with people. This is especially important for students who want to do innovative or alternative things and therefore need to talk to lots of different people, outside of the med school bubble, at conferences, workshops, and startup events.

9 Tips For A Great Interview

Okay, here's the honest truth: I am not a career counselor, HR expert, or business savant.

However, recently a friend emailed me and asked for some advice.  She had a number of interviews set up and was wondering if I could give her some tips on interviewing.  

I sent her the following email, and she later told me that she felt like the tips helped her and that the interviews went well.

So, for those who are curious, I've reproduced my tips below.  Her intervierws aere non-medical, but I believe these principles still apply regardless of your type of interview.

Remember, consider these tips at your own risk.  If you quote me, I'll deny I ever wrote them...

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