S5E24: Confessions of a Medical Student 2.0

Hạ: So like for this college reunion I'm going to, I'm re-emulating my college vibes because I'm already getting overscheduled and overcommitted. I don't know if I'm going to survive.

Lina: You will.

Mariam: I'm just kind of shocked that there are like college reunions. I thought that was only for high school.

Hạ: I guess like they're kind of I guess we do college reunions in the Northeast.

Mariam: In the Northeast. In a small school in the Northeast.

Hạ: Yeah.

Mariam: Okay, who's doing the intro? Welcome to "Bundle of Hers." We are in the virtual studio with Mariam, Ha, and Lina. Say hi, guys.

Hạ: Hello.

Lina: Hi.

Mariam: We have a really, really special episode for you all today, "Confessions of a Med Student 2.0." This is part two.

Hạ: Yeah, for like our listeners, just to keep you up to speed, Lina and I have just finished our third year of medical school. So we're done with our core clinical rotations. And Mariam has just taken step one and finished her preclinical curriculum, so she's going to be a clinical student next year, going to be like using that stethoscope.

Mariam: I know, for the first time. You guys want to hear a really funny story? I was doing like an OSCE physical exam practice, and I was trying to listen to the standardized patient's heartbeat and I couldn't hear anything at all. And because I was running out of time, I was like, "Okay, sounds healthy and normal." And then I talked to my preceptor, I was like, "I don't think my stethoscope works." Turns out and I didn't know this, it turns out you can turn them on and off. Did you guys know this?

Hạ: Yes.

Lina: Yeah.

Mariam: You can't just be like listening to a patient's heartbeat. And if you can't hear anything, you're not about to be like, "You don't have a heartbeat." You know what I mean? I guess like the number one thing that comes to mind like in this phase of my training as well, I'm so excited to finally learn how to use that stethoscope that was given to me on my first day of med school.

Lina: Aw, so precious.

Hạ: You're going to look so awesome. You're going to use that stethoscope so beautifully. All your patients are going to be like, "Wow, there's a future doctor right there."

Lina: It's the stethoscope that makes it official.

Hạ: It's also wearing this scrubs. For some reason, I don't really feel as much of like a doctor or like a doctor to be when I'm wearing my business casual. But when I'm wearing my scrubs, I feel really good about my future.

Mariam: They're super comfortable.

Hạ: They are. I've slept in them during my like 24-hour trauma call.

Mariam: Smart, smart. So you guys, I'm kind of curious, med student expectations versus reality.

Lina: Ooh, one of the biggest things, and it comes to mind especially with third year and being on rotations, is kind of studying everything and learning everything, you feel like you could eventually get a handle on things or figure out how to go about with the diagnoses and seeing patients and all. But it just always feels like you don't know enough and it's so different in like doing it practically versus just learning it. And I think there was just a lot of basically a learning curve to figure out how to kind of get into a place where I can apply all this knowledge that we have practically. It's definitely filled with a lot of like awkward moments, and I don't knows, and then after that, well, obviously, I knew that, but a lot of that I think.

Hạ: Lina, I really agree with you. If we had a meme, the expectations would be like "Grey's Anatomy," and then reality is going to be that dog in the coffee shop wearing a white coat with like a fire burning around him. A lot of times especially I feel like as med students to get to where we are we've had a bit more of a bigger locus of control, and I know that sometimes other like personal circumstances do arise. But I feel that when you get to medical school, especially clinical years, what you start realizing is that things can be so unpredictable.

When I go into a day at work, I never know what's going to happen, and I could read books and study and feel like I know all the knowledge so much. But at the end of the day, a patient encounter that I have might completely like throw me for a loop. And so it's really learning about how to be on your toes and also like embracing like that there's going to be some really great moments where you're going to feel really happy and feel like you're doing the thing, and then there's going to be some really like hard moments where you like end up crying after like a really difficult patient encounter or a really difficult situation. And suddenly a social worker swoops in from the middle of nowhere to give you therapy for 15 minutes. Totally not speaking from personal experience at that level.

Mariam: It's like that sounds way too specific to not be a personal experience. Anyways, yeah, it's always interesting to hear you guys talking about your experiences after third year, your clinical years. You know, just me only having finished second year, I had very, very limited patient interaction. It's mostly just classroom learning. And I think before I got into med school, my expectations kind of like were the reality. Like I knew I was going to study a lot. I knew I was going to like have a lot of anxiety about school and kind of like live in this bubble, which is kind of like the sad reality of medicine, right? You do kind of exist in this bubble especially the first two years. So I kind of went in expecting that, but of course, it's like always different when you actually experience it.

Something that I think struck me, and this is going to sound kind of dumb, but in retrospect it still struck me, like life still goes on, like things still happen in your personal life, and the new thing is like you kind of have to like figure out how to deal with personal life things while you're a med student in a lot of debt. So it's an interesting thing because that really shapes you. And I was just thinking about this conversation that I had with somebody who's been through the whole process and was just saying like you just kind of like lose yourself for a few years. And then you find yourself again after med school. And I was like, no, that's not how it should be.

But I think having the perspective of having just done the first two years of medical school, I can kind of see how people start to lose themselves a little bit. I'll just like reflect on my own experience, and I've talked about this on Bundles a lot, having you guys as friends shifted me towards like staying true to myself in this process. But yeah, first two years can be super, super intense. Did you guys think that seeing patients helped ground you a little bit more in this process?

Hạ: Yeah. Especially when I see like the patients from the communities that I want to serve. When I see those sorts of patients, it reminds me like yeah, this is what I'm going through. And it also kind of reminds me that for me, at least, I made a good decision in going this route because I think there are a lot of ways I could have served at the communities that I wanted to serve, even within the healthcare field, but being able to interact with them as a medical student has helped me go, yeah, this is kind of what I'm here for.

And it also gives me a lot of perspective too. I think perspective has been really important for me for grounding, especially as I've been navigating through third year, because sometimes it gets really hard. You're constantly evaluated. As an introvert, it really sucks having to jump from team to team, personality to personality, and having to adapt yourself to it. As a woman of color, sometimes it's even more frustrating to navigate it too because there's just, for the most part, I often don't relate to the residents that I see. The physicians I see, I don't see myself in their shoes in the future.

But when I have perspective from the patients and also when I have perspective from people like you all, or I really feel lucky that I've been able to study medicine close to home so I also have my family. It's helped remind me that there is so much more outside of this little bubble that med school creates for us and this little system that we think that is our one and only life. Those are the things that really help me push through and help me be able to weigh and like understand a lot of medicine a lot better. So when I feel like I'm getting evaluated by these really weird metrics that I'm not meeting, I just go, well, that's just one small aspect, one microcosm in a much greater universe, and I'm working towards that greater universe.

Lina: Yeah, I completely agree with you, Ha. I think it's very easy in the first two years, I guess like you said, Mariam, to lose yourself a bit. And that's because you kind of get into this system where it's constantly about grades and about like how well you do and the next step, the next test, the next exam, you know, all of that. Third year is not that it doesn't have those things, but it still has you being able to be around the community that you eventually want to serve and that you eventually want to be around to be a physician for, you know. And that's I think huge, at least for me. Like I was able to meet patients in my rotations that whether they're kind of from very similar backgrounds or similar experiences or POC patients.

And even though I was functioning as a med student, I still got patients telling me things maybe they've never told before or they've never experienced before just because they felt comfortable enough with me or in a place where they could share that information, and that really goes a long way, and kind of getting to experience a little bit of that, it's been a huge like, okay, this is so worth it. This is where I want to be. This is what I want to do. This is the type of eventually healing that I want to offer. And it just, yeah, it does ground you and it does give you more sense of, yeah, this is all worth it.

Mariam: Well, that's good to know because the first two years were . . . it's just a lot when it's a lot of book work, but I'm excited to eventually get to see patients.

Hạ: It will be. I think you'll have a fun time even though it will be very frustrating at moments.

Mariam: Like what are your highs and lows from this that really stand out not just from third year, but I think the entire journey thus far? Let's start with the highs and we'll end with the lows because they feel like the lows are more fun to talk about. Honestly, like, it's not just med school, but like any intense program like you're always going to feel on edge, right? Like when I took my MCAT, I was like I just have to work hard now and then I'll be happy when I get accepted. Then I got accepted and I started med school, and then I was like, I just have to work hard now and then I'll be happy when I finish like this class. It's the same mentality, and I made a promise to myself to just start having more fun in the moment because I want to be happy during med school.

Somebody laughed at me for saying that. I was like I want to experience joy in med school. And somebody was like, "That's so stupid." I was like, "What?" But I'm like determined, right, to create that happiness for myself. And sometimes like we're really told not directly, but like in medicine, like it's kind of implied that we have to put our lives on hold, and then we eventually go through residency and become attendings, and then we live a good life, right? And that's not really fully guaranteed, right?

Thinking about like my highs in med school, I started to experience a lot more joy and happiness when I had my community, when I had you guys, and we would do like fun things together. And sometimes it came at the expense of like not doing as well on my exams. But then I learned that all you have to do is pass, which was great, but it's good because that's like what I needed to hear, right? We need to stay grounded in this process by having a good community because that's what's going to get us through, and so that was my high was meeting you guys and finding that community here.

Hạ: When I started med school actually, I was reflecting on it, but I remember my first semester of med school, it was pretty rough for me. Our first course, our first semester at our school was kind of a beast. And I had been like two years off. I wasn't in the like study grind mode, but also I just felt really lost. Actually, I felt like I was jumping from like group to group trying to find my people. And eventually at the end of that first semester, I was like, well, I'm not going to find my people and that's okay. It's not really built for people like me to find my people. Over like the course of the second year and now this third year, I really like found a good crew of people, and it's been really monumental in me like finding joy.

That's also been like really monumental and like allowing me to even laugh at like the very like not fun parts of third year, like the really ridiculous things. Some of my highs is just finding a good joke from like a really uncomfortable third year situation and then getting to tell people about it, and then having them laugh, and I go, "Yes." It's a cop-out answer because you said it so well, Mariam. But my highs are all like the times I've been able to spend with everyone.

Mariam: Yeah, but there's like something to be said about you specifically using humor as your coping mechanism because Ha is like the funniest one in our group, I swear.

Hạ: I try to be funny.

Mariam: You really do. Her puns are like on point.

Hạ: I also have amazing GIF selections.

Lina: She does.

Hạ: Interns who did not react to the beautiful GIFs I sent them. You know who you are.

Mariam: They're going to know exactly because Ha sends the best GIFs.

Lina: In order to just, you know, elevate this a little and not cop out.

Mariam: Heartbroken.

Lina: I'm kidding. I feel like I kind of gained a huge kind of sense of who I am and in a much better place just mentally with that as well. Med school's been very, very challenging. This year has also been very challenging and, kind of like you mentioned, Mariam, before, there's a lot of personal things that happen and you're kind of wondering how to keep on doing medical school with everything going on. And I've talked about in previous episodes of kind of the past couple years whether it's things with home or things here personally or even just school itself, it is really emotionally taxing on you. It can be a lot, but you're also kind of forced to stand up for yourself, stand up for your patients. You're forced to kind of be confident in who you are and what you bring because the system kind of I don't want to say bullies you into that, but in a way it does, because if you're not speaking up, no one else is.

And I feel I'm not in the best place, but I do feel like compared to where I was before third year and before just medical school as a whole, I am in a much better place when it comes to that. And that's also influenced by you guys and by my people around me. The amount of times I have come to you guys and be like this happened or this patient interaction happened, you guys gave me the power to go and do the whole competency or cultural competency training and it's things like that, you know?

Mariam: Gosh, this is mushy.

Hạ: We're always mushy. This is what happens when you get the throuple together.

Mariam: Have you guys ever like had this thing where somebody compliments you, or they say something really loving to you and you get really uncomfortable?

Lina: Yeah, that's you, Mariam.

Mariam: Yeah, that's me. Like, I know. It's not that I'm not accepting this, because I love this, but also I'm like tense, right? So what do you guys like want to manifest for the next year?

Hạ: I want to manifest being more comfortable with being myself within the clinical environment. I think that a lot of times when you're switching from service to service and for me, like I'm pretty like introverted. It's like I'm very like different in the clinical environment compared to what I might appear in the podcast or like when I'm with you all. I think it does me, the rest of my team, and like my patients a disservice to not be like my 100% or try to be like as authentic as I can be, bring my personality into things.

And I was reflecting, I just remembered I just got out of my surgery clerkship, right? And as you all know, but as the listeners don't know, my first four weeks on general surgery were pretty miserable times for me, and I felt like kind of just stilted in my like ability to really be myself and to function as I wanted to be. And so I'm hoping that I can find a way to still bring in bursts of myself as I navigate all of this because I really don't want the system to take away like my light and my fire and my wicked sense of humor. So manifesting being more myself in clinical environments.

Lina: Ha, I would also manifest that for you because you're amazing. People need to see that. I think for me, I talked a little bit about kind of the confidence and kind of speaking up for yourself and speaking up for other people. And I feel kind of this common thing that I've seen throughout third year is just kind of getting evaluated on not speaking up enough or even just when I'm like giving my opinion about something, my tone just goes up, a little bit up as if I'm asking a question instead of saying an opinion because I'm always like, oh, no, they probably know better than me. And I think I just want to get into a better place of believing in myself and having that confidence to speak up more and to just be myself as well and speak up for the things that I want to speak up about. So I want to manifest that for next year.

Mariam: Oh, I love that. I think I was going to say something pretty similar. I guess one thing I would want to manifest, just like full disclosure, the first year especially, and somewhat of the second year, I think I put a lot of my life on hold for this process. And it's really easy to do that. So I think like a low for me was realizing that, you know, I hadn't talked to my family in a long time and hadn't visited them or I hadn't reconnected with my friends back home in Georgia or, you know, I hadn't taken time for myself to take care of myself in the way that I should.

Next year is going to be really, really challenging because I'm going to be working crazy hours. But I think what I want to do is really and this is like a huge challenge, but I'm going to manifest that I'm going to put a lot more energy into my loved ones and just generally taking care of myself because there's always going to be an excuse to like neglect those things, but it's not worth it I think at the end of the day. So I'm going to manifest feeling more connected to the people in my life and to myself.

Lina: I think one other thing worth mentioning is us being on this season or like being on Bundles for the first time. What do you all think?

Mariam: I think the biggest thing I learned is that I really hate listening to my own voice. But other than that, you know, 10 out of 10 experience. You guys, it's been really cool to be able to do this podcast with you.

Hạ: I'll say I never imagined that this would happen because like true confession is that I'm like original listener. I was told about it, when Bundles was just launching, by Bushra's sister, who I knew actually, so I've been a longtime fan and it's been pretty amazing being able to be a part of these conversations and to grow with y'all and I'm really happy I could join it with you, Mariam and Lina, because you know, you're my soulmates, throuple energy.

Lina: Bundles has been really healing and therapeutic for me, and I've just loved the conversations we've had and the opportunity to have these conversations. Kind of the feedback we get from many of you and many of my friends of like, oh, like this episode or that episode has been so good to hear. It's been a really, really good experience. And I'm excited for the next season.

So thank you everyone for listening. This has been the "Confessions of Medical Students 2.0." There will be one more episode by Leen and Margaux and Harjit, also similar confessions of residents, and that will conclude this season of "Bundle of Hers." And we will be very excited to come back next season and hope to share more and also kind of be there.

Mariam: We should celebrate.

Hạ: Yeah.

Mariam: Let's go get cake tonight or something.

Hạ: I'm flying out to Boston, remember?

Mariam: Yeah, but you can go get cake in Boston and we'll FaceTime you.

Lina: Yes.

Hạ: Okay.

Mariam: I'm just craving cake, guys.

Hạ: Sounds Gucci. All right. Thanks to all of our listeners. It was great to be here and to do this.

Mariam: We'll see you next time. Bye.

Hạ: Bye-bye.