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Episode 95 – Rebecca, Fourth Year Medical Student at University of Utah School of Medicine

Dec 13, 2017

“You’re not alone and, if I did it, you can too.” Depression can be something students experience in medical school, but not many talk about it. MS4 Rebecca sat down with me to have a very candid conversation about her experience of struggling with depression. We talk about wellness and how it is different for everyone, and why it’s important to be able to recognize when it’s time to seek help. She shares the difficulties of being in medical school, and finally, we discuss the resources she sought out for help that are available here at University of Utah School of Medicine through the Medical Student Wellness Program.

Episode Transcript

Dr. Chan: What does wellness look like as a medical student? Why is it important to recognize when you need to ask for help? How do you approach handling depression and medical school at the same time? Finally, what type of resources are available to medical students here at the University of Utah School of Medicine?

Today on "Talking Admissions & Med Student Life" I interview Rebecca, a fourth year medical student here at our school.

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

Dr. Chan: Welcome to another edition of "Talking Admissions & Med Student Life." I've got great guest today, Rebecca. Hello.

Rebecca: Hi.

Dr. Chan: Rebecca comes to us today just wrapping up her third year at med school and just thinking about life as a fourth year student. And then we were just talking a little bit before I turned on the pod about wellness. So let's just dive right into it. What is wellness?

Rebecca: Wellness, that means different things to different people. One thing that I've had to remember about wellness not just in medical school, but in life is that when I'm looking at . . . I can't compare my wellness to somebody else's wellness. I look at some of my classmates and I think, "Wow, they have it together. Everything's amazing in their life. Why is it so hard for me?" But I have to remember, I'm looking at their highlight, I'm looking at their best face in public and comparing it to my worst day in private type of thing.

And personally, for me wellness meant there's a lot of different facets. You can talk about social wellness, your social life, your academic life, your spiritual life, whatever is most important. And I actually recently went through kind of an exercise with myself and I was looking at those different aspects, and I was just kind of thinking really objectively what is the most important to me at this moment and it switches.

Currently, I have no problems or questions in my spiritual life, and so that's not something I'm working on. I feel confident in my academic skills, which is not how it's always been the case in medical school, but I, like you said, I'm just starting fourth year. So I feel like, "Wow, I've gotten this far." And there's times I did not think I could, but I'm here. And so, all the sudden I'm starting to gain confidence in my skills as a medical student and my school's moving forward as a future physician. So that feels good.

What I'm personally working on it now it's kind of like the social piece. I feel like I've kind of struggled with that a little bit in medical school, and then kind of a subset of the social piece is also is intimate relationships, whether they'd be family relationships or romantic relationships, and things like that.

Dr. Chan: What do you mean by social piece?

Rebecca: Well, so I mean medical school is very, very difficult, very time consuming, very challenging, and there's times where you have more free time than others. And going into fourth year I'm realizing my fall schedule is going to be a bit demanding. There are some hard electives that I need to take and do well on. But spring semester, I'm going to have a little bit more flexibility, and I'm kind of realizing, "You know what, I could have treated myself and my friends a little bit nicer during med school." This is on hindsight of course.

Dr. Chan: Do you feel you're mean to your friends?

Rebecca: I don't feel like I was mean. I feel like it's . . .

Dr. Chan: Or you just didn't nurture the friendship?

Rebecca: I didn't nurture some of the friendships, and it kind of makes me sad. I didn't prioritize some people that I should have prioritized, but that's something. That's just kind of like a life balance skill that I'm going to need to learn going forward.

Dr. Chan: When you started medical school, were you thinking about this wellness concept, or did it just kind of creep up on you?

Rebecca: It kind of creeped up on me in a big way. I wasn't thinking of like, how can I take care myself. It was all the sudden I'm in medical school, and I feel like, yes, medical school puts a lot of pressure on you, but I was putting a lot more pressure on myself than I needed to. I was very nervous about everything, every test, every assignment more so than I needed to be. I just needed . . . I had proven through my undergraduate course and through my standardized exams, and through everything that you need to do to get medical school, I had proven that I could be there, and I should be there, but I didn't trust that.

And so, I immediately became very nervous about everything and it wasn't until about a year or two into it that I realized, "You know what, I'm kind of stressing myself out a lot more than I need to, and I need some outside help." And there is a medical wellness program here at the U and it has some different resources. There's a physician who oversees the wellness of the students. So if there's any mental health needs that maybe a required medication, we can go and see that physician. There's also several therapists that are licensed and ready to work with the medical students on whatever basis they need, and whatever.

Dr. Chan: So talk therapy?

Rebecca: Yeah, yeah, yeah. And so that was kind of the first thing I did is I believe it was for second year that I realized, "You know what, I need somebody in my corner that can talk me through this." And that's when I started the talk therapy through the medical wellness program. And so that was kind of the first thing.

Dr. Chan: Was it hard for you to make that step? So, just from my advantage point, from what I see, I think wellness is incredibly important. And I think your generation, the rising generation is much more open about talking about these things and recognizing it and discussing it. But there's still a slight sliver of stigma I would say.

Rebecca: Yes, yes.

Dr. Chan: And so I think the wellness program they do a lot of outreach, they introduce themselves, they do all these kind of fun, kind of little projects I would say, they have like noon meeting.

Rebecca: Free yoga classes.

Dr. Chan: Yeah, free yoga classes.

Rebecca: Meditation classes.

Dr. Chan: How to like cook healthy food for yourself classes. They track down the pets before finals.

Rebecca: Yeah. There's pet therapy.

Dr. Chan: Pet therapy. So, you know, what I know about it I think it's incredibly important. But for people to take that step I think is also incredibly important as well. So was it difficult for you?

Rebecca: It was slightly difficult. The reason I'm here today talking about this is because I want to kind of normalize my experiences. I feel like yes, while my generation maybe a little bit more open in talking about it, maybe not among medical students. We are all very driven. We're all very . . .

Dr. Chan: Type A.

Rebecca: . . . Type A. Some of us are more high-strung than others. I put myself in the high-strung group. Most people don't think that because I feel like I've gotten very good at this is the face I put out to the public versus what I'm actually feeling inside.

But I wanted to normalize and validate anyone who maybe is experiencing this. For the listeners if you're still in college, maybe you've already been feeling this in college, maybe if you're currently in medical school, wherever you're at in your training to say you're not alone and it's okay, and there are steps you can take towards a better quality of life while you're going through this journey.

And so, for me, I actually had in college again I was still high-strung in college. I definitely didn't know how anxious and uptight I could get until medical school, like I didn't realize there's like a new depth that I was going to reach. And I found that during third year, during clerkships which is clerkships happen during third year medical school, but I'm . . .

Dr. Chan: What would that look like? I mean, the high-strung. Are you talking about lack of sleep or . . .

Rebecca: Lack of sleep.

Dr. Chan: Disturbance in your appetite?

Rebecca: Yeah, yeah, yeah. So I'm talking about anxiety, but kind of hand in hand with things is also depressive symptoms. And during the course where we learned about the psychiatric illnesses, there's actually mnemonic that throughout the medical students called SIGECAPS. SIGECAPS stands for so "S" sleep, either too much sleep or too little. I was getting too much.

"I" is interest. The medical term for that is anhedonia that you'll learn, but interest meaning are you losing interest in things that you once enjoyed. And that was definitely me. I had lost my hobbies. I had lost touch with things that I felt like these are for fun rather than what I have to do.

"G" is guilt, and under guilt you can also kind of feel hopelessness or worthlessness. I definitely felt pretty hopeless about things.

"E" is energy. I had zero energy, it felt. For how much sleep I was getting I thought like I had almost no energy.

And then "C" concentration. One of the most important things a medical student can have is concentration. I did not have it.

Dr. Chan: Yes. You need to be focused. Yeah.

Rebecca: Yeah. You need to be focused and I was . . . I had it enough to get through my exams, to get through my studying, but it was hard. And it was like mentally it was taking a lot out of me because I couldn't focus and concentrate as much I need.

And then appetite, to keep going on the mnemonic, either too much or too little. I went too little. I actually lost a little bit of weight between the first two years in medical school not on purpose. It's just because I wasn't eating.

And then "P" is for psychomotor retardation, meaning you feel like you just can't move, you just can't get going. I'm not so sure that I felt that so much.

And then "Sm" the last "S," the second "S." The first "S" is for sleep, and then the last "S" is for suicidal ideation. And suicidal ideation, what I mean by that is just thinking about it. There's a whole spectrum of people, a whole spectrum that you can think of what does not living mean. Meaning all the way from passively like, "Oh, this is hard. I just don't want to be here. I wish I wasn't here anymore," to actively like creating a plan.

Like, so there's a whole spectrum and that's something that I definitely, there's some mornings I would wake up and I'm like I just wish that I didn't wake up. You know, I just like, "Why can't I just like quietly slip away in the night because I have to face another day, go another day in medical school." There was definitely days I had that.

So SIGECAPS, that's the mnemonic I've learned. I've also . . . there's also another one I heard that is DIGSCAPES because Batman is the broodiest and most depressed superhero and he DIGSCAPES.

Dr. Chan: Yes. A lot of trauma [inaudible 00:10:28]. Yeah.

Rebecca: So if you rearrange the order of all those, you also get DIGSCAPES, but anyway no more mnemonics. But that's . . .

Dr. Chan: So you learned this during second year?

Rebecca: Yeah, yeah. I learned that mnemonic during second year, and I had kind of already . . . what was ironic because it just didn't quite click. Even though I was feeling a lot of those things, I didn't realize I could look at all those symptoms and I was kind of so not connected with myself. I didn't realize I was having all those symptoms, like I met the criteria for what we call a major depressive disorder. I wasn't just depressed, but I was clinically . . . I had a clinical mental illness, and it was affecting my academic performance.

I was still passing. I was still doing just fine, but in retrospect I feel like if I had recognized it sooner and gotten more help sooner I probably would have gotten even better grades. I know I'm smart enough. I'm capable enough. But when you can't concentrate, when you're sleeping too much, when you feel hopeless about things, you definitely don't put your whole heart and soul into things, and I wasn't.

Dr. Chan: And what you said at the beginning, because it's multifaceted, I assume during this time your relationships were suffering as well.

Rebecca: Yes, yes. Especially during third year, there was a man I was dating, and frankly I was like head over heels in love with him, but he didn't know it. I wasn't communicating it to him. Our communication was terrible just because I was so stressed out with school. I was doing well day-to-day at school. So, during third year on the clerkships, when I'm on the wards, when I'm working with the surgeons, working with internal medicine docs, rotating to the different departments, when I was face-to-face with them, I was fine. I was putting all my energy into being bright and open, and wanting to learn, and wanting to be taught.

And they responded really well, but it took so much energy out of me that I was coming home, and I was just exhausted. I would have a 12-hour shift, and then I would come home and sleep for 10 hours. And so I wasn't leaving any time for me and him. And frankly, I was probably, I wouldn't say probably, I was mean to him at times. And I didn't realize how mean I was being to him because I was so stressed out. And it ended up, that relationship ended up not surviving third year. We actually broke up three days before my end exam in surgery. That was not my best exam score.

Dr. Chan: That wasn't a good time.

Rebecca: No, it was bad and surgery, the shelf exam is what they call it at the end of clerkships. So the shelf exam for surgery is known to be one of the harder ones. So I'm already facing one of the harder test and definitely my head wasn't in the game that day.

Dr. Chan: So during the first two years, because it's more classroom-based, I would imagine it's easier to access the wellness program.

Rebecca: Yes.

Dr. Chan: How did you do that during third year? Because third year, you're more committed to the hospital on rotation. Were you still able to get away for like these therapy appointments, or how did that work?

Rebecca: Not as much. So the first two years, I was going weekly. I knew exactly what my schedule was, I knew when my lectures were. So I was able to schedule weekly appointments, and I was able to schedule my weekly appointments several weeks out to make sure I had the time I wanted, the time slot.

During third year not so much. I was maybe getting in once every month, every six weeks, and the reason is because some of my hospital schedules demanded 12-hour days. And I can't make those therapy appointments, and sometimes I don't know the schedule well enough in advance to get those.

So the dates, the times I was able to go and see my therapist through the wellness program was the weeks that I knew I had nights. So I would get a hold of her as soon as I knew.

Dr. Chan: Nighthawk.

Rebecca: Yeah. And, you know, like my rotation ended at 7:00 a.m., my duties ended at 7:00 a.m. So I made sure I got the 8:00 appointment with her. So that was the times I was able to see her or if I knew a holiday was coming up or sometimes some clerkships the way they schedule you, you have like the half day before your final exams, and so I would try to schedule that morning. But the mistake I made is I knew going in that third year I wasn't going to be able to access those resources as much. But I didn't put something in their place.

And so I think that's kind of where third year got away from me. It's the momentum and the good things I had built during the second year of medical school going to therapy appointments, I didn't put something in their place when all the sudden they were gone. Instead I kind of fell back into my old habits of I'm super high-strung, I'm not connected to myself, I'm not realizing what's going on with my emotions, and not taking good care of myself mentally.

Dr. Chan: So if a third year student was pregnant or had diabetes or had some sort of issue or illness and they needed to go see a physician, I'm pretty sure the different teams will allow that student to go to that appointment.

Rebecca: Yes, yes.

Dr. Chan: Did you ever feel comfortable and talk . . . did you tell the teams what was going on or you kind of kept it to yourself?

Rebecca: I kind of kept it to myself.

Dr. Chan: Okay. So you never asked them specifically?

Rebecca: No, I didn't specifically. I feel like there was a time . . . luckily, I don't have any medical issues where I need to go to see a doctor regularly for medical stuff versus psychologic help. But I do know of classmates that they have sometimes it's an emergency and sometimes things that crop up, something that you're like, "I have this acute illness." And it was just a matter of talking to their team and saying, "I need to go do this."

And some teams were definitely easier to work with than others. It just depended on the schedule and it depended on your team. And that was . . . that's part of navigating third year. Not just navigating third year, but like someday navigating my full-time job as a resident and then someday as my job as an attending physician is just trying to figure out when can you fit in those moments in your busy work schedule.

Dr. Chan: Rebecca, during this entire time, thoughts about quitting, walking away from med school?

Rebecca: Yes. A lot of thoughts.

Dr. Chan: So tell me about those. I assume you would talk about that with your therapist.

Rebecca: I talked about that with my therapist. I also became really good friends with the Dean of Student Affairs, because he was the one that if I did want to walk away, he would help me handle a lot of the logistics of it.

Dr. Chan: Yeah, paperwork and stuff.

Rebecca: The paperwork and things. So I was very . . . I felt comfortable being very honest with him and kind of where I was at. And he knew that I was suffering from depression, that I was being seen by the medical wellness program. And I just had lots of really honest conversations with him and saying, "If I quit now, what does that mean? What does that mean for my grades? If I had to take a medical leave of absence, what does that mean?"

Because there was points where it was so bad that I really felt like it would be better for me to maybe just step away for a time. And if I could recover a little bit of mental and emotional energy, a little bit of mental and emotional juice I could come back.

And he always . . . we would take a look at my grades, we would see where I was at, we would see how I was doing, and he very gently and lovingly kind of encouraged me to keep going. He's like, "You know what, if there was . . . there's times when I tell students they need to step away, but I don't think that's where you're at. I know that's where you feel, but again it's up to you and I'm here to support you."

So I was very grateful that I had him as a resource, and so I talked with him about it. And of course, my therapist and occasionally I reach out to my parents. I love them to death, but at the same time they're not super helpful with that just because they've . . . I'm going to be the first physician in my family. My mom did graduate college with her four-year degree, but as far as like this amount of education and just like the demands and things like that.

Dr. Chan: The stress associated with it.

Rebecca: Yeah. It just doesn't quit, and I don't think . . . I don't know that the loans and the money that I've accrued kind of has taken at least in their mind, full effect of what that means. And I'm like, "No, I am in this much debt right now." Which was also a deciding factor for me too is there was that breakeven point where I was like, "You know what, if I get out now, I'm this much in debt, but I think I have a bachelor's degree I could go get a job doing X, Y, and Z. And I could probably pay it off and still be okay without accruing too much debt and not being . . . not having these loans to pay off forever that I actually didn't end up getting me a degree as an MD."

But I kept sticking with it, and it kept working out. Like I said, sometimes I was passing by the skin of my teeth, and other times I was like flourishing and it just depended on how well I was taking care myself at that point. It definitely correlated. The times I was taking better care of myself I did a lot better with my grades.

Dr. Chan: I know there are other students with depression, with anxiety. Did you reach out to them? And like were there support during these times, or was this mostly just you, your therapist, between the student affairs?

Rebecca: Yeah. It was mostly me and my therapist. And that was my personal choice. I didn't feel comfortable. I knew that if I was in the middle of a really bad depressive episode, whether it be for one day or a couple of weeks, depending on how long it was lasting, if a friend reached out to me, I don't know if I'd be able to support them, because I was stressed out about the same test that they were. I was worried about the same things that they were.

And so I was worried for me personally putting that on somebody else. If you talk to one of my other classmates, I know there's others who suffer from depression and anxiety. Maybe they have a different take. Maybe they were able to reach out to classmates, and they did find the support they need. I don't know, but that's not what I chose for myself.

Dr. Chan: Okay. All right. So third year comes to an end. Is it like emerging from the tunnel a bit or . . . just walk me through that.

Rebecca: It's surreal. It's super surreal. Third year is so intense and it's so intense for so long. It started I want to say June 12 last year for us, ended May 26. So for nearly 11 months, almost 12 months we're in this really intense . . . the way I explained it to people that were non-medical was imagine being at your new job for an entire year. You're on a team, maybe for two weeks you finally start get the hang of things you feel like you got it, and then they bounce you to another department. So you're at a new job for an entire year, and you never quite get your feet under you.

And you go through this transition where it's super alarming and you don't quite know what to do with it as a third year medical student, and all the sudden at the end of the year all the ambiguity is fine.

It was really interesting in my last clerkship, they're like, "What team are you going to be on tomorrow?" I'm like, "I don't know. I'm going to show up. I'm going to find out. It will be fine." "You mean you haven't looked at the cases? You don't know what patients you're going to see?" "No, but I've been studying this topic. So, you know, it's probably going to be a patient that hopefully has either one of these diseases. And I've already studied that so hopefully I'll know the pimp questions that the doctor throws at me are or I'll know the indications for whatever surgery we're doing."

And all of a sudden, you're kind of okay with the ambiguities. That was kind of an interesting transition towards the end of third year to all of a sudden seeing myself being okay with all of those things that stressed me out beginning of third year. But it definitely feels like emerging from the tunnel. So third year ends, and then I took a few weeks off to study for step two. So now, all of a sudden not being super busy, not working 10-hour, 12-hour days, not working 6 days a week, all of a sudden now having all this time in front of me I'm still studying, but not being super busy like that it feels odd. It feels really odd.

Dr. Chan: A good odd.

Rebecca: A good odd. Now, I'm looking at starting my first elective of third year in a few weeks, and it's going to be a big one. It's going to be difficult and hard. And so I'm like, oh, great. I have to get back into that mode now that I've transitioned from super intense clerkship mode, I'm going to have to go back into that. But I'm looking forward to it.

Dr. Chan: How was your psychiatry rotation? Was that a really good experience? Was it surreal? How would you describe it?

Rebecca: It was a really great experience.

Dr. Chan: Why?

Rebecca: For me personally, I'm considering child psychiatry as my specialty. So I loved it for that aspect. I was very, very lucky . . . actually no, I'm not going to say . . . I'm going to take that back. I was about to say I was very lucky with the attendings I got, but that's not that true because what I've heard from most of my classmates is everybody loves their psych rotation because the attendings and the residents that you work with are just really, really, really great people. I mean, that's what they're going into is like wellness, mental health, and wellness. And so they themselves just seem to be really solid people, and I just felt really part of the team. I felt really taken care of. I had a great time with the teams I got put on.

And that aside though it was interesting, it was interesting and a little bit surreal talking to these patients because by this point I'd recognized my psychiatry clerkship was actually the second to last for third year. So, by this time, I'd realized how far away I've gotten from my emotional and mental wellness, and I had taken big steps to get back to it. And so by the time I got to psychiatry it was really interesting sitting there and being able to objectively listen to these patients and their experiences. And I kind of felt I just . . . especially the teenagers I worked with who were suffering from major depression, it was little surreal listening to what they were saying and I'm like, "That's what I feel." Like, "I feel the same way."

And also, I thought I was not alone and I still kept it professional, and there was a role I was serving. And I was the student doctor and they were the patient. And so I kept that professional boundary there, but at the same time it was really introspective on me and I felt I made some good headway as far as kind of, again, getting back to what I feel it should be a baseline for me as this is my emotional baseline is. And hopefully I can stay above my emotional baseline in a good way rather than get below it, which is I dipped below it many times.

Dr. Chan: Now, thinking about the next steps, thinking about your residency whatever you choose to go into, do you feel that one of the criteria when you start looking at these different programs would be a really good wellness program associated with the residency?

Rebecca: Possibly. That's definitely going to be one of the questions I'm going to ask as I'm going out on interviews is what kind of support do the residents get, whether it's through an official program, or maybe it's just a general attitude of the program, that we take care of our residents. So something formal and informal.

Currently, I don't have a . . . I don't feel swayed either way, like I have to have a formal program or an informal one, but I do . . . I'm probably going to go with the feel of the program. That's going to be a big deal for me. That was what helped me make my decision about where I went to medical school is I went for the feel of the program not just, "Okay, objectively here's all the pros and cons of the program." But how did it feel when I was there, how did it feel when I was meeting the people, how did I feel when I was meeting the medical students.

And I'm going to even more so do that for residency is just go, "This is where I feel like I'm going to belong and where I'm going to thrive and hopefully do really well, and get a great education so I can be someday a really great physician."

Dr. Chan: Well, Rebecca, I have no doubt you're going to be an awesome physician, and I'm glad you're here. I'm glad you're willing to come on and share your story.

Last few minutes, let's talk about some other stuff. You just got back from somewhere. Where were you? What were you doing?

Rebecca: I was in Southern Utah.

Dr. Chan: Okay. Let's give a shout out to these people. All right, okay.

Rebecca: So I'm an alumnus of Southern Utah University, and I went through the Rural Health Scholars Program. And that is the pre-health program that I joined to provide me the frameworks that I could navigate the undergraduate waters to get into medical school. And since I have left SUU, they've also expanded to some other college campuses, including Dixie State University. And they were holding a summer healthcare exploration camp for high school students at Dixie. And this is actually a camp that I have done every year for the last five or six years.

Dr. Chan: Did you do it as a high school student?

Rebecca: I didn't do it as a high school student.

Dr. Chan: That would really complete this whole [inaudible 00:26:44]. Okay.

Rebecca: That would have been awesome having done it as a high school student and then coming back as a . . . I did it as a counselor in college and then now, I've . . . usually they just take college students as the counselors. But I've loved it so much and I was so embedded in the Rural Health Scholars Program while I was there that every year that I've asked to come back during medical school they've agreed to let me come back. And so not only was I a counselor to the high school students, I was kind of the counselor to the college students while I was down there.

Dr. Chan: You were the only med student down there?

Rebecca: Yeah. So I was the med student, and then all my co-counselors were the undergraduate students who are hoping to get into medical school in the next year or two. And then we were the counselors to all the high school students that were there exploring all these healthcare careers. We were having lots of really cool workshops for the kids. We had respiratory therapists come in. They're on the mannequins with the babies, learning how to intubate children. They teach them how to use an incentive spirometer. We had an EMT workshop just talking about what it's like to be an EMT, this is what we do on the ambulance.

And nursing, the nursing was actually one of my favorite workshops. They had the kids doing algebra. We were having to calculate dosages of oral medications for children, learning how to weigh babies and measure their head circumference, and then also listening to heart sounds, and things like that. Just a really cool program, really cool summer camp for these kids.

And then for me as a counselor, it's a great time to see these kids and what they want to do with their life, and being able to provide them with a little bit of direction and answer their questions, because I've been where they've been at.

And then also it was a nice little three-day break from my study, from my step two study.

Dr. Chan: And so it sounds like Rural Health Scholars, it sounds like it's a track almost.

Rebecca: Yes, yes.

Dr. Chan: Okay. What other activities do they do?

Rebecca: Rural Health Scholars . . .

Dr. Chan: It starts in high school now and you go through college or . . .

Rebecca: It doesn't start in high school, but they definitely . . . they have this high school camp, and a lot of these kids are from rural places in Utah. And a lot of them are looking at like going to Southern Utah University, going to Dixie State University, going to Snow College, going to College of Eastern Utah where RHS has spots. And what RHS does is it's an enrichment program, it's not necessarily a club or anything like that. What it is, is you join and you pay your fees. And these fees go to what is some really cool, really cool resources being access to extra tutoring. So I definitely utilized those tutorings when I was going to like organic chemistry and my chemistry courses.

Access to mentors, so the college students that are now seniors that are entering medical school in the next year or two, they are mentoring the freshmen that are coming in saying, "These are the classes you need. This is what you'd be doing." They have a lot of really cool volunteer opportunities that are open only to Rural Health Scholars' students because local community organizations that know that Rural Health Scholars' students are responsible, and they're dedicated, they only let Rural Health Scholars' students come and volunteer at the organizations. And there's a lot of volunteer hours that you want to get prior to going into healthcare careers to put on your application for graduate school.

And my favorite thing about the Rural Health Scholars Program was the cultural immersion trips that they offered. I forget how many I went on, but I went stateside. So I had gone to Las Vegas and worked at the homeless shelters in Las Vegas with the Rural Health Scholars Program. I've gone to Shiprock, New Mexico toward Indian Health Services.

Dr. Chan: That's in the Four Corners area.

Rebecca: That's in the Four Corners area. Yeah. And did some volunteer work while we were down there with the boys and girls club. I had also gone international. The Rural Health Scholars had some agreements with international programs that provide volunteer work for college students to come and work at rural clinics. I went to the Dominican Republic. I went to Ghana in West Africa through the Rural Health Scholars Program. That was my personal favorite option that the RHS program offered while I was in college.

Dr. Chan: It sounds like it's really grown too.

Rebecca: Yeah. It's growing. It's a multi-campus.

Dr. Chan: Because Cedar City is growing, I mean, Southern Utah University is growing, Dixie State University is growing. So yeah, a lot of interest, a lot of events.

Rebecca: Yeah, yeah. And I forget what numbers, but the freshmen in the program is a little bit bigger every year. And so they're growing and expanding, and they're taking . . . the way I describe it is it's this framework that provides you, "Here's your to-do list. If this is your goal, here's your track, and here's the resources we're going to provide to help you get there," versus just like leaving you out in the wind to figure it out on your own. Because there's a lot. There's a lot of moving pieces that you want to put together to have a successful undergraduate career and to have a successful application to medical school or dental school or nursing school or whatever healthcare career you choose.

Dr. Chan: Cool. Rebecca, it's been fantastic to have you come on.

Rebecca: Thank you.

Dr. Chan: I'm going to have you come back in a few months because I think we want an update about what path you choose for yourself and where you end up.

Rebecca: Sounds good, sounds good. And just kind of in closing I just want to say in summary, anything I said, I hope students, especially ones who haven't started medical school yet hear my story and go, "Great. This is what med school is going to be like. Maybe I don't want to do it." That wasn't my point at all. I feel like I'm one of the kind of extreme examples as far as how at least emotionally difficult medical school was for me.

Everybody has their own personal struggle. Some people struggled with academics more than they did their own personal wellness. Some people struggled with their family relationships more than they did maybe their own emotional and personal wellness. It was more to just validate and normalize, I think I said that earlier, that you know what, you're not alone and if I did it, you can too.

Dr. Chan: I love that.

Rebecca: And if you want to do it, go ahead and go for it. Because it's scary, but you know what, it's just one day at a time.

Dr. Chan: Yeah. Well, thank you, Rebecca.

Rebecca: Thanks, Dr. Chan.

Announcer: Thanks for listening to "Talking Admissions & 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 Health Sciences Radio online at