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Episode 99 – Candus, Fourth Year Medical Student at University of Utah School of Medicine

Feb 07, 2018

"Time is going to pass anyways. What you want to do with that time is more important than how long it's going to take you." Candus was two classes away from receiving her bachelor's degree in physical education when she realized it wasn't what she wanted for a career. We talk about her journey through education that eventually led her to the path of medicine, and how she coped with feeling lost after discovering the specialty she had been pursuing as a medical student didn't match her expectations. She shares her thoughts on why joining the US Army was an easier decision than applying to medical school and finally, how she navigated changing specialties after residency interviews and travel plans were already set in place.

Episode Transcript

Dr. Chan: What happens when you are two classes away from receiving your degree in physical education and realize it isn't for you? How do you cope with finding out the specialty that you were preparing for in medical school doesn't meet your expectations during your third-year rotations? Why was joining the Army an easier decision than applying to medical school? And finally, how do you navigate a change in specialty once residency interviews and plans are already set in place? Today on "Talking Admissions & Med Student Life" I interview Candus, a fourth-year medical student here at the University of Utah School of Medicine.

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

Dr. Chan: Well, welcome to another edition of "Talking Admissions & Med Student Life." Got a great guest today. Candus, how are you doing?

Candus: I'm doing well. How are you?

Dr. Chan: Fourth-year student?

Candus: Yes.

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

Candus: Phenomenal.

Dr. Chan: Why?

Candus: Because you finally have some freedom and choice to do what you want with your life.

Dr. Chan: All right. Let's start at the beginning. Let's go back. Let's go into our time machine.

Candus: Okay.

Dr. Chan: What did you do that helped prepare you for med school? What kind of activities were you doing before you got here?

Candus: To be completely honest, med school was not always my game plan. It's kind of something that I stumbled into, which I know sounds ridiculous. I was going to school to be a P.E. teacher, and that actually got me a lot of the volunteer hours and leadership experience and whatnot like that that I needed. And I ended up teaching at a middle school for a year and realized very quickly that that's not what I wanted to be doing with my life because watching kids kick soccer balls across the street so that they can run off campus to go get it in somebody else's yard was not super fun.

Dr. Chan: Why P.E. teacher? Why was that . . .

Candus: I wanted to coach. I did track for nine years, and I loved it, and I still do. I still coach, actually. I am going to a track meet tonight.

Dr. Chan: Cool.

Candus: And that just seemed like the easiest way to get into coaching.

Dr. Chan: So P.E. teacher, P.E. teacher, and then was it kind of an internship like you did like at school or you actually worked full-time as a P.E. teacher?

Candus: No. It was just a course. One of the courses that they have you do here is just going out to teach. You teach an elementary school, and then middle school and then a high school and then you do your internship.

Dr. Chan: Okay. And then you knew right away this wasn't your life?

Candus: Yeah. Mm-hmm. After I was done with that middle school course, literally the next day I changed my major.

Dr. Chan: Okay. And then why medicine? Where did that come from?

Candus: I first went into athletic training because I thought like the anatomy and the physiology of the body were really interesting. I was really interested in like helping athletes kind of maintain their health so that they can stay competitive and get more competitive. All of that jazz. Then I realized that the athletic training room is super boring and it wasn't everything that I have wanted in my life and I kind of just like kept stepping it up until I ended up in med school.

Dr. Chan: You're jumping ahead a bit.

Candus: I mean, that's basically what happened though because like then I considered nursing, but I was . . . that didn't sound fulfilling to me. And I considered P.A. school but they wanted like seven years of real-life experience before they would even like consider you as an applicant, and so I just ended up here.

Dr. Chan: Were you volunteering in the community?

Candus: I mean, I was volunteering coaching at the time. That's where I got most of my coaching. Once I started getting more interested in the healthcare field, I started volunteering at the Utah AIDS Foundation. And then just to kind of like up my hours a little bit more, I was volunteering at a senior center just down the street from my house.

Dr. Chan: Do you feel those type of activities were helpful? Do you feel that . . .

Candus: I feel like the Utah AIDS Foundation was super, super helpful.

Dr. Chan: Why?

Candus: It kind of teaches you how to talk to people in like a sensitive manner. Because I was a counselor there and it was like counseling people on how to keep themselves healthy.

Dr. Chan: So people from different walks of life?

Candus: Yeah.

Dr. Chan: Different cultures, different backgrounds, you know?

Candus: Yeah.

Dr. Chan: So you applied, you got in, what was the biggest surprise in medical school, looking back?

Candus: I feel like the further you get in education, the more you realize that you don't know. So like I feel like I've been in school almost my entire life, and I have honestly never felt like . . . I now realize that there are so many things out there that I don't know now and I likely never will know. I think that, like, the humbling experience, I guess, has been the most surprising.

Dr. Chan: It sounds like you've self-actualized when you know you don't know.

Candus: I suppose so.

Dr. Chan: Was medical school harder? Was it the hardest thing you have ever done?

Candus: Oh, yeah. Definitely.

Dr. Chan: What was hard about it?

Candus: Just forcing yourself to do the same redundant studying every single day, because you like miss a day or two and you fall so far behind that it's just really hard to get caught up.

Dr. Chan: Did anything come easy?

Candus: I thought like physical exams and interacting with people was probably the easiest part of med school.

Dr. Chan: When did you learn . . . you know, going back to when you know you don't know, when did you have that aha moment? Because I think a lot of students start medical school and they feel like they're going to learn everything. But what you said is very wise because I think what happens is people realize you can't do this alone. You need help. That's the consulting system, that's why we work in teams in hospitals, so when you did you have that aha moment?

Candus: Honestly, it was like during week one of med school.

Dr. Chan: Okay. Wow.

Candus: We were having, I think, some conversation, I don't even remember what the lecture was about, but everybody kept using the word prophylactic, and I was like, hmm, no idea what that means. I'm just going to like pull out my cell phone here and Google it in the back of the classroom.

Dr. Chan: Hope no one was watching over your shoulder.

Candus: Yeah, exactly.

Dr. Chan: Yeah, why is Candus doing that?

Candus: Exactly. And everybody was just using this word like we use the word tomato, and I was like, hmm, yup, I have a lot to learn.

Dr. Chan: Yeah. Yeah. Wow. So it sounds like you like fourth year. Did you like the first two years or did you like third and fourth year better? Because there's different philosophies. First two years is more classroom-based, more tests. Third and fourth year are more in clinics and hospitals.

Candus: I think the first two years was probably more of what I was expecting because I feel like by the time you make it to med school, you know how to go to class, you know how to take a test, prepare for all of that. It's kind of like . . . it gets boring and redundant, but it's what you know by the time you get here. Third year was like that experience when you're a little kid, and you're trying to learn how to swim and your parents just kind of like toss you in the pool. That's exactly what I felt like third year.

Dr. Chan: Well, I think we try to teach a little bit of how to swim, but I do recognize, yeah.

Candus: Right. They were like, they were . . . I don't know. Yes, they do teach you how to swim. Like, hold your breath when you're underwater, but you kind of figure out a lot of things on the fly in third year. And I liked it from the standpoint that we weren't in the classroom and that was great because it was just so nice to like get up and be doing things and using the knowledge that we had been working to gain. That was like really, really great. But, at least for me, putting a face to all of the diseases and all of the illnesses and all of the injuries that we had been learning about was really hard for me. Like, it made me realize that medicine wasn't as like glorified as I had always thought it was.

Dr. Chan: Why?

Candus: I just really hate giving bad news, and I feel like medicine is a lot of giving bad news.

Dr. Chan: So you were in the room when people learned they had cancer or things like that?

Candus: Yes.

Dr. Chan: How was that?

Candus: It was hard. It was really hard. I will admit that there were multiple, multiple days when I wanted to go home and quit.

Dr. Chan: Really?

Candus: Yes.

Dr. Chan: What kept you going?

Candus: I signed a military contract that would have been very hard to get out of.

Dr. Chan: We'll talk about that. We'll talk about that. All right. So I assume, you know, watching doctors break bad news . . . Were you the one breaking bad news or were you watching other people break bad news?

Candus: I think I did a few times.

Dr. Chan: Interesting.

Candus: But for the most part, it was other doctors.

Dr. Chan: You must have witnessed different styles.

Candus: Yes.

Dr. Chan: So, you know, without revealing names, I mean, what was something, like, that . . . you really, just impressed you? What was another time that just, wow, like this was not handled the right way?

Candus: A time when it was not handled the right way?

Dr. Chan: Well, you know, let's do a positive one and . . .

Candus: Positive one first?

Dr. Chan: . . . and not so positive one. Yeah.

Candus: Okay. So a positive one. I thought it was really nice when like attendings would sit down next to their patients and have the whole family in the room and be like, look, this is the situation that we're in. This is what we have found so far which is likely pointing to this scenario, and these are the options that we have moving forward. And these docs would like really take their time in the rooms with the patients and, I mean, this would be like maybe an hour or two visit.

Dr. Chan: Wow.

Candus: And they would like really answer every question that the patient had, answer every question that the patient's family members had, and just really make sure that everybody knew what was going on and knew their options and felt comfortable. I mean, as comfortable as you can with the situation.

Dr. Chan: I remember, yeah, I remember similar . . . you try to get everyone in the room.

Candus: Right.

Dr. Chan: I remember there were times when, you know, uncle, sister, daughter, son, they would be like on the other side of country but you try to have them like Skype in or call in, and just, you know, just to listen in because like, yeah, you're right, there's like a flood of questions. And rightly so, you know, because people are very scared and worried. So it sounds like a really good technique.

Candus: Yeah, that was something that I was very impressed with. And then on the flip side, there were other attendings that would just walk in and be like, yup, you have this. This is what I think you should do. Let me know what you decide. See ya

Dr. Chan: Did they leave you in the room to deal with the fallout, or were you supposed to follow them out or . . .

Candus: I followed them out. I wasn't going to lean that up.

Dr. Chan: So do you think they did it on purpose, or are they just not aware, or they just didn't want to deal with that emotion, or what do you think is going on?

Candus: I'm not sure. I have no idea. I think that those attendings had just become so, yeah, I've really, I . . .

Dr. Chan: Burned out or numb or . . .

Candus: Yeah. I think probably numb to the situation. Like, they have diagnosed cancer, or, like, told so many people that they were going to die that it was like not a big deal to them anymore. They had forgotten to look at the patient's point of view and realize that, yeah, okay, maybe you have diagnosed cancer 50,000 times, but this patient has never had that told to them before.

Dr. Chan: Were those the days you wanted to go home and quit? Or even when the doctors did a good job delivering news? Both times?

Candus: Yup. Both times. Kind of just randomly all over the place.

Dr. Chan: It's really rough. I know that med school, we try to . . . I mean, I think that you ask medical schools, I think that's one of our greatest fears, is that during the course of training, the students lose that piece of humanity. The ability to connect to someone, to be in the moment, to break bad news, to answer questions. I mean, that's like . . . you boil it right down to, that's like what medicine's all about. So it's kind of scary that there are some doctors out there that have lost that ability or just don't care.

Candus: Exactly.

Dr. Chan: So how do you as a student, because again, it goes back to modeling. I mean, ideally, like you should see really great behavior on all your physicians that you're around, though obviously, it's not happening. How do you as a learner, how did you as a student, how do you get through that? How do you survive that? How do you learn from that?

Candus: You just kind of . . . just like with anybody or any situation when you're like, whether it's interviewing a patient, whether it's writing a note, whether . . . it's really anything. You pick up things whether they're good or bad and you just say, hey, this is something good that I really liked. I want to do this in my practice. And when you see something that's bad, you just, also, take a note of that and say, hey, that's not something that I want to do. I need to make sure that I steer away from that pathway.

Dr. Chan: Okay. So there's two big areas that I kind of want to cover. The first is, when you started medical school, what kind of doctor did you want to be?

Candus: I wanted to be an orthopedic surgeon.

Dr. Chan: Because of the athletic training and the . . .

Candus: Yup.

Dr. Chan: Okay. Tell us about the metamorphosis, what happened?

Candus: Surgery day one, I quickly realize that surgeons do not have the same mentality about life that I have and they do not have a lifestyle that I wanted to have for the rest of my life.

Dr. Chan: So let's talk about the mentality.

Candus: Okay.

Dr. Chan: What do you mean?

Candus: They are very cut and dry, get the job done, type people.

Dr. Chan: Okay. And that didn't go for you? It didn't work for you?

Candus: Right.

Dr. Chan: Okay. And, so day one.

Candus: Day one. Literally by lunchtime.

Dr. Chan: So was it the rounding or was the OR or just everything?

Candus: It was really just . . . I feel like in medicine, you find the people that you click with and I just didn't click with surgeons.

Dr. Chan: Okay. So up in . . . The first two years in med school, surgery, surgery, surgery, and then boom, third year, rotate. Where was surgery, beginning of third year or . . .

Candus: It was like first half. Maybe like a third of the way in.

Dr. Chan: Okay. So you're getting really excited. Like, oh, this is . . .

Candus: This is going to be great. I'm so excited.

Dr. Chan: It's just like, to draw an analogy, it's like you on that middle school playground and the kids kicking the ball, and you just realized, whoa, this isn't for me.

Candus: Exactly.

Dr. Chan: So the surgeons would be the ones kicking the ball, and the ball would be the humanity. I don't know.

Candus: Sure.

Dr. Chan: Not to get too deep on this. All right. And then so you didn't just . . . you didn't like their attitude, you didn't like, you've mentioned the lifestyle, so talk about the surgeon lifestyle.

Candus: Surgeon lifestyle, I feel like is . . . I mean, and this is more probably resident lifestyle, but it's like wake up at like 3:00 in the morning, you're in the hospital at like 4:00 so that you can pre-round, get your rounds done.

Dr. Chan: Before the snowplows are even out, yeah . . .

Candus: Before the snowplows are even out. There is one day I had to drive up to surgery, and my car was literally like at a 45-degree angle the whole way up because there was so much snow and my Turbo car doesn't like snow.

Dr. Chan: Okay.

Candus: But yeah . . .

Dr. Chan: We're going to talk about that because I don't think you're going to have a problem with that in a few months.

Candus: Yeah. So you're up here, you're working before the sun's up every single day, and you take care of your patients in like a very, I felt like it was a very rushed manner, and then you're just standing in the OR for like who knows how long? I think I had like one 14-hour day in the OR.

Dr. Chan: A 14-hour case?

Candus: No, I had an eight-hour case, but it was a 14-hour day.

Dr. Chan: Wow. Standing?

Candus: Standing. Mm-hmm. And . . .

Dr. Chan: I remember I got the stockings to help blood flow in the legs. It makes a huge difference because you stand so long. Did you . . .

Candus: I didn't get the stockings.

Dr. Chan: I remember I would kind of start doing different positions with my legs. And I remember I once I had looked up like the different ballet positions just to kind of . . . oh, my legs hurt so bad. It hurt so bad to stand. Yeah.

Candus: Yup. And surgeons brag about how long they can go without eating or how long they can go without going to the bathroom, and it's just insane the stuff that they're, that they pride in their life. It was interesting. It was very interesting.

Dr. Chan: Rubbed you completely the wrong way?

Candus: Yup.

Dr. Chan: All right. So how did it feel not to have a home? Like, you know, you're going to do surgery, do surgery, boom, not going to do surgery. I mean, what did that feel like?

Candus: I felt so lost.

Dr. Chan: Drifting?

Candus: Yeah. Just kind of like floating through third year after that. Just kind of like hoping that there would be something that I would like that I could see myself doing for like the next 40 or 50 years.

Dr. Chan: So a lot of med students have a choice number two, but I get the sense from you, it is more like audition at that point. Like, let's see what happens the rest of third year, if any of these other specialties call to me.

Candus: Yup.

Dr. Chan: So what happened next?

Candus: I think I had neurology next, and I did pediatric neurology over there, which was like so fulfilling and so painful at the same time because I loved working with kids so much. They're so great to work with, so much fun. I mean, when you get to go up to a kid, and you do a physical exam by, like, tickling their stomach, like, that was just amazing.

Dr. Chan: Yeah. I mean the surgeons weren't doing that?

Candus: No. Surgeons were not doing that. But then like you also see like these really, really bad TBI cases and . . .

Dr. Chan: Traumatic brain injury.

Candus: Right.

Dr. Chan: Yeah. Car crashes, falls, yeah.

Candus: And like these kids will never live the kind of life that they had prior. And like, cases like that were really hard.

Dr. Chan: And it's tough for parents to hear that, too.

Candus: Right.

Dr. Chan: Yeah. The agony of parents . . . Yeah. Because, you know, it's hard because like parents have hopes and dreams for all their children and . . .

Candus: Exactly.

Dr. Chan: . . . it's rough. Yeah.

Candus: Right. And you could see the pain in the parents' eyes as well. And, yeah, stuff like that was really hard to go home with. But I met one little girl who was coming in and she had . . . she was complaining of headaches for a really long time, and her mom brought her in, and we found out that, like, her father had been abusing her for a really long time and that was causing like a lot of depression and a lot of stress, and that was coming out as headaches. And like, so we got to help her kind of get her home situation straightened out a bit and keep her safe at home and all of that. And at that moment, I actually thought that I wanted to go into peds, and so I went down that rabbit hole for quite a while until I got to my very last rotation of fourth year and I realized that what I liked about that case specifically was the psych aspect. And it was really, really hard to like commit to psych at that point because I had already written my personal statement for peds. I had already applied to all of the peds residency programs that I could. I had everything lined up to go into peds but I just like knew that I had to go into psych.

Dr. Chan: First day you realized that or did it take a while?

Candus: No. It took me probably half the rotation because I wasn't even, I honestly was not even considering psych. It wasn't even on my radar.

Dr. Chan: So you were a very, very late convert?

Candus: Yes. Probably as late as you can go without being [inaudible 00:19:16]

Benjamin. It sounds like you were terrified at first.

Candus: Yeah. Yeah.

Dr. Chan: Was it because of the field of psychiatry or just because everything had already had been kind of set in motion for pediatrics?

Candus: I had already set everything in motion for pediatrics. Like, I already had my residency interviews lined up. Everything was scheduled. Like, hotel rooms were booked, flights were booked, all of that was taken care of. And part of it was like the reputation that psych has in the medical field, and everybody who is not in psych basically tells you that psych isn't really . . . Like you go to med school to learn all these things that you're not going to use in psychiatry.

Dr. Chan: I would say I do acknowledge that psychiatry is probably the most artsy and fuzzy of all the fields because there's all of these . . . there's like psychology and social. There's all of these other kind of little pieces to it, so . . .

Candus: So I think that was part of the reason why I was hesitant as well is because I didn't want to go to school for four years.

Dr. Chan: How did you work through that? I mean, were you talking to your family? Were you talking to psychiatrists? I mean, how did you wrestle with that?

Candus: I talked to one of the attendings that I was working with, and he planted a little seed in my mind and just said most people have a very negative aspect or a negative outlook on psychiatry, and if it's something you are considering, you should really consider it and not let other people influence your decision. And so I sat down, and I had a lunch with him and we kind of discussed all of this and he made me feel much better about . . . .

Dr. Chan: So like the pros and cons of continuing down this path?

Candus: Right.

Dr. Chan: Yeah. So how does it feel since making that decision?

Candus: Great. It feels awesome. No complaints.

Dr. Chan: I would argue, Candus, it takes a really strong person to kind of put the brakes on something that's already kind of been put in motion. Do you feel that?

Candus: Yes and no. I mean, I feel like I've already done that a few times in my life. Like I was literally two classes away from graduating with my degree in P.E. teaching, and I went a whole different route from there and . . . I mean, past my associate's degree courses, like none of my classes overlap so . . .

Dr. Chan: So you just ate a lot of credit?

Candus: Right.

Dr. Chan: What would you say to someone out there who's listening and might be at a similar inflection point? I mean, they're struggling, you know, going down this path or that path. A versus B.

Candus: Something that I've realized, and I'm sure this is like so cliché it's not even funny, time is going to pass anyways. So I feel like what you want to do with that time is more important than how long it's going to take you. And so like I could have easily said, well, getting my teaching degree will only take me another semester. I should just do that whereas it's like med school, I'm going to need at least another two years of undergrad and time to study for the MCAT, and then time to go to med school, and then time to go to residency, and then I'll probably have a job after that. But like the time is going to pass anyways. So you should pass the time doing what you think you will enjoy most or what you think you will get the most benefit from long term.

Dr. Chan: I like that. I think a lot of our decisions, like, what I call, like, micro decisions. We make these little decisions and then one day we wake up, and we're here, you know. That's our life, and we made a bunch of decisions that led us to this point. And, you know, I talked to a lot of people and they . . . .some of them are very enthusiastic about med school, some people are very conflicted and just sometimes there's ambivalence because like they feel pushed by their families to go to med school and I would like to point out, kind of like you said like, you know, all of our lives are different. We're all kind of headed in different paths, but at the end of the day, any job that's worthwhile is going to have built-in stress to it. So what you want to be doing in 10, 20 years because if you don't like where you are at now, you are really not going to like where you are at in 20 years so you should really start building a life towards making that goal, whatever it may be. And for some people, it's pharmacy school, nursing school, some people it's P.E. teaching. But I would, you know, I just think, I think it's beautiful what you said, you have to like make decisions and kind of come to this realization that time is going to pass.

Candus: Right.

Dr. Chan: Child psychiatry?

Candus: Possibly.

Dr. Chan: Okay.

Candus: Possibly. Not fully committed, but I haven't ruled it out.

Dr. Chan: All right. Let's talk about the other kind of big decision you made. So military, when did that kind of start entering . . . I mean, do you come from a military background?

Candus: So my dad was in the Marines, my grandpa was in the Air Force, so kind of.

Dr. Chan: Kind of. But, like, did you like visit them on bases . . .

Candus: No. No. No. My . . .

Dr. Chan: . . . and you'd go to air shows and stuff like or . . .

Candus: No. I wasn't that involved. It was just something that I've kind of always looked up to, and honestly, joining the military was a much easier decision for me than joining med, like going to med school.

Dr. Chan: Really? Why? Why?

Candus: It just like, ever since high school, it's something that I had been considering. I had like been talking to recruiters and whatnot throughout high school, and it was something that I actually like really wanted to do. But then I got a track and field scholarship.

Dr. Chan: So you didn't do ROTC?

Candus: No. I didn't do ROTC. But I got a scholarship, and it was basically like choose one or the other, and traveling the world to throw shot putt and discus sounded a lot more fun than marching and training to shoot people. So I went to undergrad on my scholarship, it took care of school and I kind of already told you how I ended up in med school and just . . . I think it was maybe like a month after I got accepted, I got an e-mail from the Army recruiter that was like, hey, I see that you're trying to do the med school thing.

Dr. Chan: How did he know?

Candus: I am unsure, honestly.

Dr. Chan: Oh, Big Brother.

Candus: I have no idea how. But he . . .

Dr. Chan: We do not tell them, so I don't know. Yeah.

Candus: Or maybe, I mean, it could have just been a spam thing that he sent to like everybody, and I was like, whoa, that applies to me. And so I started talking to him about it, and he helped me through the process. And I think applying to the military was probably the only thing I've done as far as like an application process goes that was harder than applying to med school.

Dr. Chan: Why? What was going on?

Candus: It took me eight months, just the . . .

Dr. Chan: Because they ask for a lot of information. I think.

Candus: Yeah. Like the application itself, I think, was like 46 pages long and then you have to go and pick up like every medical record you've ever had. And I wasn't the most graceful child, so I had to pick up a lot of medical records.

Dr. Chan: Lot of trips to the ER.

Candus: Yup.

Dr. Chan: Broken bones. Yeah.

Candus: Mm-hmm. All of that. And then I had to get like . . . so I was born with a cataract, so I have some bad vision in my left eye, I had to get a waiver saying that she's going to be a doctor, we don't actually need her to have depth perception, so it's okay that she has that flaw. Just like a bunch of stuff like that. Plus, it's the government which is really slow, so that adds time. Always.

Dr. Chan: Why Army? Did you, like, even entertain the others?

Candus: I did. I actually wanted Air Force, but the Air Force recruiter at the time like wouldn't give me the time of day. Like, I contacted him, I was like, hey, this is the situation I'm in, this is what I'm looking for. And he was like, that's nice. And I knew that this was going to be a long application process and I needed somebody who would help me.

Dr. Chan: Yeah. Someone who is engaged and was able to kind of, yeah, help you. Because it sounds very burdensome on some level. Yeah.

Candus: Yeah. Yeah. And so, and my only other option was the Navy, and I don't think I could stand being on a sub for that long.

Dr. Chan: Okay. So, Army, and then they . . . So did you get . . . did they pay for all four years or was it, because it took eight months, did they not pay for the first year, or how did that work out?

Candus: So I ended up signing the Friday before we started med school, so they paid for the entire four years in med school. I also got like a stipend every month to help pay for food and rent and all of that, and . . .

Dr. Chan: You had to do basic in between first and second year.

Candus: Right. So I did basic officer leadership course in between first and second year, which was fine. It was a six-week course . . .

Dr. Chan: Where were you at?

Candus: . . . out of Texas. Out in San Antonio.

Dr. Chan: Great weather, right?

Candus: So great. Nothing like a heat storm and lots of humidity.

Dr. Chan: Is it like the image of like just bunk beds and just in a big room or . . .

Candus: No.

Dr. Chan: Because it was all officers, you go . . .

Candus: It was officers so . . .

Dr. Chan: They treat you a little bit better?

Candus: Yeah. I actually got my own hotel room which had like a kitchen and a nice bed and TV and all of that. And then we spent three weeks in the field, and you were sleeping on cots and giant tents but, I mean, the tents had air conditioning in.

Dr. Chan: That's nice. And you're meeting med students from all across the country?

Candus: Yeah.

Dr. Chan: Okay.

Candus: Yeah. Med students, dental students, and vet students.

Dr. Chan: Interesting. Interesting.

Candus: Yup. And the funny thing was is none of us had any idea what was going on as far as military lifestyle, and we had a bunch of sergeants walking around who were, technically, lower rank than us but trying to be the big bad ass sergeant and tell us what to do but they can't really because we're higher rank than them. So, like, we would screw up, and they would just walk over to us and be like, excuse me, I need you to not do that. And I'd be like, all right.

Dr. Chan: Well, it sounds like there's a . . . it's entire culture, right?

Candus: Right.

Dr. Chan: And like if you're not familiar with the culture, you're going to . . . It's obvious people are going to make mistakes, right?

Candus: Right.

Dr. Chan: Marching, saluting.

Candus: And they had to teach us how to do all of that very basic stuff.

Dr. Chan: Again. Again. And again.

Candus: Right. And I mean, that wasn't bad considering like everything that I had gotten from the military. But, also knowing that that was like my last summer off, and everybody else in my class was having fun and travelling the world and enjoying life was a little bit hard to deal with but, I mean, now that I'm at the end of med school, and I have money in my savings account and no debt, it's totally . . .

Dr. Chan: It's a good feeling.

Candus: It's totally worth it. Yeah.

Dr. Chan: Now, you mentioned earlier if you had tried to drop out, what would have happened? Would they have immediately just assigned you . . . I mean, do they like . . . Were they just like, okay, well, if you're not going to do med school, whereas you owe us two or three years, so you're going to . . .

Candus: Right. So I signed a four-year, like, contract when I . . . or I guess I didn't enlist, but when I signed up with them, I signed a four-year contract. So I would have owed those four years back for sure. Plus, they make you pay back any money that they gave you with interest, so I would have had owed them all of my money for med school plus the stipend money plus . . .

Dr. Chan: Plus time.

Candus: Plus time.

Dr. Chan: So they hit you double.

Candus: Yeah.

Dr. Chan: They want time and the money.

Candus: Yes.

Dr. Chan: Okay. So it's a strong, strong disincentive from . . .

Candus: Yeah.

Dr. Chan: Okay. All right. So let's talk about match. So there's the military match, and then I guess like they call it the civilian match?

Candus: Yup.

Dr. Chan: Did you ever think about doing the civilian match? I mean, what was your strategy around this?

Candus: So it kind of depends on what you're going into. If you're going to apply just military, you are ordered to do both. So I'm going into psych, not a super competitive area as far as the military goes, so there's no like, they don't sponsor civilian spots because they don't feel like they need that many psychiatrists. Whereas like for an ED doc, they need a ton of them, and so they only have I think like three different facilities that they have military residency spots for, but they realize that, hey, we need more than what we can train, so they provide basically sponsorships for military residents to do a civilian residency.

Dr. Chan: I see. So the vantage is, at least for you, for doing a military residency, a military match, it does not impact the time commitment at all?

Candus: Correct.

Dr. Chan: Does it . . . I mean, I'm just trying . . . If someone had a choice, well, it sounds like the choice isn't even theirs, but if someone had to choose between a military residency and non-military, it sounds like they're just equivalent. It's not, it's no advantage?

Candus: Yeah. I mean, there are different things to consider. So when I signed, I signed with the four-year contract meaning that no matter what happens, I owe at least four years back. However, if I would have gone into say like neurosurgery, which has a seven-year residency, I would have owed the seven years back instead. So it's either . . .

Dr. Chan: Not eleven?

Candus: Not eleven. It's either the four-year minimum or the duration of your residency, whichever is longer, that you owe back.

Dr. Chan: So with you doing a four-year psych residency, you owe them four years. You don't owe them eight.

Candus: Right. Correct.

Dr. Chan: Okay. All right.

Candus: So another thing to consider is that like, so they do realize that some people have like family circumstances that are tying them down in one area and they can't leave to go do military residency somewhere else, so they have a few civilian spots that they will let you match into. But honestly, like that's probably the most competitive spot to try to get. So unless you have something that's really saying, hey, I need to be here, I really need this civilian position, then they basically won't give it to you. So I did not apply to a civilian spot because I didn't have that family circumstance.

Dr. Chan: And how many military psychiatric programs are there?

Candus: Two. At least for the army.

Dr. Chan: Okay. Washington D.C. and Hawaii?

Candus: Right

Dr. Chan: And you interviewed and did rotations at both?

Candus: Right. I spent a month in each area on an addition rotation, and I would recommend doing that to any place that anyone is really interested in going because you need to make sure that you like the lifestyle outside of the hospital as well.

Dr. Chan: What I find fascinating is both psychiatry spots, both military spots, but I would venture very different cultures.

Candus: Very, very different. Yes.

Dr. Chan: How would you describe it, at least from a fourth-year rotating med student perspective?

Candus: Up in the D.C. area . . . well, I mean, D.C. versus Hawaii, you have very different patient populations, was like the first thing that I noticed. Up in the D.C. area, it's more like vets and family members whereas down in Hawaii you're, I mean, there's a base for every branch down there, so you're working with a lot of like, enlisted people. A lot of like younger people down there. Up in the D.C. area, they are very show up on time, get your work done, get out. Like very time efficient, I guess would be the way to put it, and that's like not even a thing in Hawaii. Everybody is on Hawaiian time.

Dr. Chan: Mahalo.

Candus: Exactly. Exactly.

Dr. Chan: So you rotated at both, had positive experiences, but different experiences at both.

Candus: Right. I actually loved both places a lot. I would have been totally happy at either.

Dr. Chan: So how did you ultimately make your, because it's of the same process, right? Rank list.

Candus: Right.

Dr. Chan: I guess just, you just rank two programs.

Candus: So they make you rank at least five.

Dr. Chan: Really?

Candus: Yeah.

Dr. Chan: Okay. And so I . . .

Dr. Chan: But there is no . . . Why was three, four, five then if you . . .

Candus: They were all transition years for me.

Dr. Chan: Oh, I see. Okay, so that's kind of the backup.

Candus: But that's just how I did it. Other people . . . Like, I was considering doing peds as my backup just because I still really liked that. Other people do like orthopedic surgery and then psych as a backup or, you know, they mix it up. I know a couple people who did psych first and then like med psych as number three and then a couple of transition years. Or they'll do like family med or internal med as their, the bottom of the rank list.

Dr. Chan: Okay. So how did you . . . what was your strategy going into you rank list?

Candus: Well, I knew that I wanted to put psych as my top position, so that was one and two were easily taken care of. And for me, I liked being in the hospital just as much in both places. D.C. is a very research-focused area, and I'm not a huge research person, so that wasn't like super appealing to me, and I'm not going to lie, the lifestyle in Hawaii is just phenomenal.

Dr. Chan: Mahalo.

Candus: Yup. You can't beat it. While I was out there, I would leave all my scuba diving gear in my trunk and just like go hit the ocean, hit the beach, go diving, hiking, just like beach camping every day after work, and so I felt like work-life balance there was really, really nice.

Dr. Chan: Okay. So it sounds like Hawaii started to go up near the top.

Candus: Right.

Dr. Chan: So you submitted it in November-ish?

Candus: October 15th.

Dr. Chan: October 15th. Interesting. And obviously, it takes two months for the computer algorithm to run.

Candus: Yes.

Dr. Chan: So when did you find out?

Candus: December 12th, technically, around 11:00 at night.

Dr. Chan: And how were you feeling between October 15th and December 12th? Feeling good? Feeling anxious or . . .

Candus: Ignorance is bliss.

Dr. Chan: Okay. Just like a black hole.

Candus: Yup.

Dr. Chan: You're okay.

Candus: I was like, well, everything is done. It's all out of my hands. I'm just going to go about doing whatever else I need to do at the time.

Dr. Chan: And then, did they call you, or did you, you know, how did you find out? Did they email you? Well, how does the military . . . .Does the marching band show up outside your door?

Candus: I wish. That'd be great. So what happens is they're supposed to release the results on our website which is called MODS. You just log on there and look it up, basically, is what supposed to happen. Which is what happened for the Air Force. Army, who is not quite as on top of their game, had technical difficulties and so they didn't like officially release the results until like 10 hours later.

Dr. Chan: Okay. I'm pretty sure their phones and e-mails were just burning up on that.

Candus: Oh, I'm sure.

Dr. Chan: I'm sure the applicants across the country were just wondering what's going on.

Candus: Yeah. I'm pretty sure my refresh button was also a smoking a little. I lucked out though, and the program director at the facility that I'm going to sent me an e-mail and let me know.

Dr. Chan: And there was not one second where you questioned if it was a fake e-mail?

Candus: I didn't, no.

Dr. Chan: Okay. Good.

Candus: Nope. I'm not going to lie. I did not.

Dr. Chan: Okay. Every once in a while I hear stories about people became very suspicious about, oh, like, is this a joke by one my friends? Is this the way . . . I didn't hear it through MODS, you know, so . . .

Candus: I mean, I got it directly from the program director sent to my civilian e-mail because that's how we had been communicating and I mean, she put my name in there and like directions on what I should be doing, instructions on what I should be doing, and when I should expect to show up and all of that so . . .

Dr. Chan: Do you even have like a, "Welcome to Hawaii," do you even have that?

Candus: Yeah.

Dr. Chan: All right. So how does it feel, Hawaii?

Candus: Oh, it feels so good. So good.

Dr. Chan: What was your initial reaction? I mean.

Candus: Honestly, it was like, oh, thank God. Because I was like freaking out that I didn't have any results for the first . . .

Dr. Chan: Ten hours.

Candus: Thirty-seven minutes, actually, is . . . they waited 37 minutes to send me the email.

Dr. Chan: Interesting. So they realized on their end, this thing isn't working.

Candus: I think so. But I'm not sure how . . .

Dr. Chan: Does the left hand and the right hand know what's going on.

Candus: Yeah. They weren't coordinated, I don't believe.

Dr. Chan: Okay. Interesting.

Candus: Which made me . . . so that was like the one time that I was kind of wondering if it was real because if the results hadn't been released to me, why did they have them?

Dr. Chan: So, relief. Joy.

Candus: Yeah. Really lots of relief.

Dr. Chan: Good. Does a part of you . . . So the military match happens earlier?

Candus: Yeah.

Dr. Chan: Most of your classmates are going to do the whole, you know, in an envelope, cut the ribbon. Do you wish you had that or are you glad that you found out now? I mean, like, what's your thoughts about that?

Candus: I'm glad that I found out early because I can kind of just like relax a little bit more now. Like all my classmates are still interviewing and still stressed and still worried and it's like nice to kind of be past that. But at the same time, it would have also been fun to like find out with more people.

Dr. Chan: I'm fairly sure, I can check with student affairs, I'm pretty sure you get to still go to match day, and I still think you get a little envelope up there.

Candus: I have no idea.

Dr. Chan: So I think you still have like a memento.

Candus: Okay. Yeah. I'm not sure. I haven't looked in . . .

Dr. Chan: And you can feign surprise, I guess.

Candus: I haven't looked into that.

Dr. Chan: Hawaii.

Candus: Yeah.

Dr. Chan: That's awesome.

Candus: I'm super excited.

Dr. Chan: So when do you have to report?

Candus: They haven't given me a date yet but we graduate in May 18th, and I start June the 1st, so . . . I've been told it's about three days or . . . no, it's one day for every like 300 miles that you're traveling, so it's about 2,500 miles away, so I'm expecting like a week to 10 days.

Dr. Chan: Are they going to stick your car in one of those like big transports and just take it across the ocean?

Candus: Yup. They send all of my stuff over there.

Dr. Chan: You get to keep your Utah plates out there?

Candus: For a minute.

Dr. Chan: Okay. Well, Candus, last question. Any advice for anyone listening out there thinking about going to med school, what would you say to them?

Candus: I would say to just know it's going to be tough. It's going to be tough for probably three and a half years, but it's totally worth it at the end if your heart's in it.

Dr. Chan: Beautiful. Beautiful. Well, I'll see you before you leave for Hawaii. But I want you to come back on the pod one day and tell us about your adventures out there.

Candus: Will do.

Dr. Chan: All right. Thanks, Candus.

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