May 20, 2020

TRANSCRIPT

Dr. Chan: How does COVID-19 impact one's clinical clerkship experience? What do you look for in an MD-PhD program when applying to various schools? And what's it like to be an MD-PhD student? Today on "Talking Admissions and Med Student Life," I interviewed Claire a third-year medical student here at the University of Utah School of Medicine. Helping you prepare for one of the most rewarding careers in the world.

Announcer: This is "Talking Admissions and Med Student Life" with your host, the Dean of Admissions at the University of Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Welcome to another edition of "Talking Admissions and Med Student Life." I've got another great guest today, Claire, future Dr. Bensard. How are you doing?

Claire: I'm doing well this wonderful Monday morning.

Dr. Chan: And then where are you exactly in the curriculum? Because you've had a longer journey than most, for obvious reasons which we'll talk about. But where are you exactly?

Claire: Yeah. So I'm in my seventh year, technically, at the University of Utah, but I'm in my third year of medical school.

Dr. Chan: And let's talk about, you know, what's going on right now. What rotation were you on and how did that come down when like people were asked to leave and, you know, how did that unfold in your eyes?

Claire: I was on my OB/GYN rotation and I was started on OB. And so I was through two weeks of my days on labor and delivery. And I was really enjoying it. The residents on OB were phenomenal. They were incredibly communicative. They were great teachers. And so when all of this started happening and we started seeing uncertainty across the clinical setting, they were very upfront with us about, "Look, we're going to be reducing our interaction with patients. We're going to be reducing our interaction with other providers. This probably is going to affect you guys. We're going to try really hard to, you know, maximize your experience but just be prepared that something might change."

So in a way, we had that preparation to know that our experience in OB/GYN might not be the same as everybody else's who had already gone through it. And so when we got pulled that Friday, so at the end of my second week, that we were told we were going to transition to a virtual curriculum. It kind of like made me like, kind of balk inside because I was thinking, "Well, how do you deliver babies virtually? How do you learn about . . ."

Dr. Chan: I hadn't thought about like that. That's a great point.

Claire: And I think part of it is because I teach wilderness first responder through the University of Utah. And one of the things we talk about is like how to manage an expecting mother if she happens to be, you know, hiking and go into labor. And a lot of the folks that I teach are just like, "Well, okay, like this video that you showed us doesn't really explain the actual process." And now that I've actually seen it, I realized how poor the virtual environment can be in terms of something as visceral and hands-on as a delivery or, for instance, in surgery or any of those other really hands-on, technical procedure-driven fields.

Dr. Chan: Wow.

Claire: But even then I will say that I think the OB/GYN leadership, our clerkship director, Tiffany, Dr. Tiffany Weber, did a phenomenal job of getting us access to all sorts of virtual curriculum, so videos, surgical videos, wonderful lessons, and resources so that we felt confident. At least I felt confident opting in to take the shelf as opposed to waiting to take it.

Dr. Chan: Yeah. Claire, I want to dive more into that, currently what's going on, because I know you've done some really amazing work and efforts. Let's go in the time machine. Let's go back. You know, well, how old are you? Where were you? I mean, like what happened? Like MD-PhD, when did that first enter your mind? Like where did that dream come from to not only be a physician as well as a scientist? What was this like high school, or is it undergrad or was it before high school? Like, when did that first enter your mind?

Claire: I'm a little bit of a funny case because I knew I always liked medicine and I always liked people. I loved interacting with people and hearing their stories and I loved always trying to fix things and trying to help people that way. My father is a physician. He's a trauma surgeon. Like in high school, I was like, "Yes, I'm going to be a doctor. I'm going to go to med school. It's going to be great." And then as I went to college, I rebelled a little. I got very interested in engineering, again, fixing things, solving problems. And I got really interested in tissue engineering.

And so that's where I started into the research lab, working actually in cartilage tissue engineering in the lab of Stephanie Bryant and at CU Boulder. And I had a blast. I loved it. And then I took a cancer biology class and I loved that and I wanted to do cancer biology research. And I did an undergraduate research project with Dr. Joaquin Espinosa again at CU Boulder. And I started thinking, "Maybe I'm going to go to grad school, maybe even get a PhD." But then I had also through college, again, kind of like nurtured this love of medicine.

I got my EMT. I worked as a wilderness first responder. I was a camp counselor that took kids on trips. So I got to fix all manners of scrapes and bruises. I was really kind of hitting this decision point of when everybody was applying in my junior year of college. I was like, "I don't know. I don't know what I want to do." And I went to a panel, and to be honest, I did not even know that an MD-PhD combined program was a thing until this panel in my junior year of college.

Dr. Chan: It was the big reveal. Like, "Oh, you can combine both of your loves into one program." Yeah.

Claire: Yes. I mean, particularly in all my dad's surgical colleagues that are close family friends, they do research but they kind of were this accelerated, like they wanted to get through their surgical training. Not a lot of them have a dedicated, like research training in the sense of a PhD or a degree. But a lot of them do research. I was thinking, I was like, "Well, I am an MD. I'm definitely going to do some research." Which we see high-quality research across the board coming from MD run labs. So it was more that I had really found this love of research in the cancer field that provoked me to say, "Hey, this combined degree program sounds awesome. It sounds like exactly what I want. I want to be well trained in medicine. And I want to be well trained in PhD level science."

Dr. Chan: And the length of the program didn't dissuade you. It's like anywhere from 7 to 12 years. I don't know.

Claire: It can be.

Dr. Chan: Yeah.

Claire: Yes. It is a long road. And I think part of that was, in college, I was a pretty efficient person in college. I took a lot of credits. I also raced mountain bikes, and so it didn't really scare me that it was a long program and that there was a lot of work entailed. I think in my head I was like, "Oh yeah, I'll definitely be on the shorter end. I'll be on the seven-year program." But things quite never work out.

Dr. Chan: I'm not allowed to talk about the seven-year because like that's like Valhalla. It's like the Viking conception of heaven, no one . . . everyone dreams about it, but I'm not sure too many people actually get there.

Claire: Very true. And, you know, people even say like, "Oh, well, if you do a computational PhD, it'll be shorter." And that's not true either. It totally depends on the science that you do and whether or not you're lucky. One of my favorite mentors is Dean Tantin. He's a professor of pathology. He said, "If you want to do a three-year PhD, you better plan for two years because you know about a year's worth of work is going to go wrong." And he said the same thing, "If you want to do four years, you got to plan for three years."

I've gotten very good mentorship along the way, but the length didn't scare me. And it was something that I thought was a really good investment. And part of this was coming from talking to a lot of MDs who also run labs. They had a startup process. It took them a couple of years to get their feet wet in research and really understand how they wanted to run their lab, how to get grants. And so I figured I would get that done in a mentor-guided environment while getting my PhD.

Dr. Chan: So you went to CU Boulder. You're living your life. You're doing all that you need to do. How do you start winnowing down what programs to apply to? What was your thought process? I mean, what do you look for in a combined MD-PhD program?

Claire: So I made a list. I had different aspects of training that were really important to me. One, I knew I wanted to stay academic because I love the idea of being on the forefront of medicine, of delivering high-quality care to very rare cases and being able to like learn from that and to work with other tertiary centers across the nation that do the same. So I knew I wanted to stay academic. So I wanted to find a really vibrant academic setting that had an undergraduate campus attached to it.

And the reason for that was I wanted to have the ability, when I did my PhD, to mentor undergrads. And I got a chance to do that while I was doing my PhD in Jared Rutter's lab. And that was really important to me was finding somewhere that had undergrads available to learn like I did at CU, that they love research and to really culture that passion. And then part of it is too, is that in this training we're always teaching. We're always learning and we're always teaching. And so I thought it would be really valuable to also have that as a part of my training so that I would learn how to teach effectively in multiple different environments.

So number one, academic center attached to an undergrad campus. Then number two was kind of more of the, again I'm thinking about the length of the program. "Like where do I want to live for about 8 to 10 years? And let's plan on the decade. Where do I want to spend a decade?" I kind of drew back on my interests outside of medicine and outside of science. I'm a pretty outdoorsy gal. I love to hike and ski and mountain bike, and I have a dog. And so those are attributes of the city in which this academic center was situated that the kind of had to meet my needs.

So I was looking for something that was close to the mountains or at least some sort of outdoorsy spot or a good park system, and then somewhere where I could actually find a house with a yard. I didn't want to have to live in an apartment, and I didn't really want to live in a concrete jungle, especially because I tend to have dogs that are more like working breeds. I have an Aussie lab right now.

Dr. Chan: They need their freedom. Yes.

Claire: He does. He needs squirrels to bark at. So that was kind of another attribute. I was like, "Where's the city?" And then I think the third part that I'd gotten very good guidance from folks as I was applying is that you'll find your fit, so interview around. But you'll find programs where the student body really inspires you. You'll meet professors that you really jive with and you can kind of see how well connected the community is. Like, do they have kind of an open-door policy, or is it more of a you have to email and set up a meeting?

I was told to apply to a lot more places. Again, because option two of like I really wanted a city and a program to fit my lifestyle, I decided on my applications that, "You know what, I'm only going to interview places that I would actually move to." So New York City went out the window. L.A. went out the window. San Francisco while beautiful and having a lot of beautiful access also was a little bit tough for me to think about. So I really kind of restricted myself to programs in the inner Mountain West and also some in the Midwest but more to the North, like Wisconsin and Michigan. And then I also looked in the Pacific Northwest, so because Portland and Seattle does have a little bit better kind of flows to their cities. I have to be honest, I completely forgot about Salt Lake City. I'm from Denver. I thought that Denver was the biggest, best city in the West.

Dr. Chan: Oh, yeah. Like the whole Denver-Salt Lake City rivalry. You're stumbling into it. I love it.

Claire: Yeah. And so I didn't even think about it. And I happened to be interviewing . . . I was actually interviewing in Oregon. And somebody said, "You know, you sound like you'd be a great fit at the University of Utah. Did you apply there?" And I said, "The University of Utah has an MD-PhD program?" So obviously I had overlooked some things, and that's why I think it's really important to, you know, really take a big look at places and really look at the map well because that was something that I didn't do a great job of. And look at where I ended up.

So I was very fortunate because this was an early interview. And so I was able to meet all the deadlines to apply to the Utah MD-PhD program and get in on one of the last interview dates. So very fortunate. Very, very fortunate because it worked out really well. And when I think about all the other programs that I interviewed at, I enjoyed them. You know, it was kind of I could see myself there. But I noticed some interesting quirks about either the way the MD-PhD students kind of presented themselves and how connected they were. And then I came here and I could not believe how hospitable it was.

I couldn't believe how interconnected the community was. Everyone knew everyone else. And that was MD-PhD students in their eighth year talking to the first years, to the professors, to the assistant professors. And people really wanted you to find your space and your home. And I just felt incredibly welcomed. I felt like I fit in very, very well. It was a group of people that I knew wanted to see me succeed. And it was a group of people . . . Oh, sorry, go ahead.

Dr. Chan: And as long as we're being honest, Claire. Like, I started this position in 2012 and you were actually one of the first memories I have with the MD-PhD program, because I just kept on hearing about, "Oh, Claire Bensard, we need to get Claire Bensard." Claire Bensard this, Claire Bensard that. And I just remember like, "Wow, like this is like a rockstar." And I remember back then the program was smaller, and I think it's really grown over the years. And I think you have been very instrumental in that as far as like recruiting and like getting the word out and like, you know, befriending and helping answering questions.

Because like we're interviewing a lot more people from the MD-PhD program. But yeah, one of my first memories of the MD-PhD program is Claire Bensard this, Claire Bensard that. Everyone seemed to fall in love with you and just really wanted you to come here. It sounds like that was reciprocal. Like you are feeling Utah love too.

Claire: 100%. I mean, I fell in love with this place and with the people. I mean our program administrator, Janet Bassett is just the heart of the program. And you could just tell she really cares about everybody, but that also comes through in how everybody in the whole training process of the graduate school, as well as on the medical school side, you felt that. It felt like everybody was really invested in the students' success. And also the students were really empowered to reach out to experts. Experts were not on a pedestal. They were not unapproachable.

I didn't realize how important that was especially in an academic setting, because that's how great ideas are born, when you get the chance to talk to somebody and kick around an idea over coffee or like as we walk around our beautiful campus. It was really just kind of one of those things where I just my eyes opened and I was like, "This is the place. This is where I want to go. Oh my gosh, I hope I get in." And I still remember to this day, I was working as a research tech. So I took a year off between undergrad and college or undergrad and an MD-PhD. And I was working in a research lab. And I was sitting at my desk analyzing PCR. And the director called me and said, "Claire, we've got a spot for you." And I just started screaming. I was like, "Yes, yes, yes. When can I move? I'm coming. I'll see you in June."

Dr. Chan: So you get here, Claire. How is that jump from undergrad to med school? I mean, was that an easy transition for you? Or like was the amount of work, amount of material, is it something that you were able to keep up with, or did you have to kind of redo your studying skills? How was that for you?

Claire: I think my sister and my mom would probably say that, in general, I definitely love to learn. I do have a hard time sitting down and being very dedicated about my studying. I tend to like to study in kind of short bursts because then I tend to get like kind of like, "Ooh, what's over here. Ooh." Like, "Someone to chat with." So I like, I have a really hard time studying like in the library, for instance, because people walk by and I always want to say hi to them. So I have to be like kind of in this zone to study.

I would say that the jump, the material, the first year of medical school is geared to ramp us up. So we started in our phase one unit where it was fast pace, but it was a nice overview. And so that was really helpful for me because I was coming from a very solidly molecular biology background. I'd never taken anatomy. I had never taken physiology. And so it was really good for me to kind of get up on par with some of my classmates who were anatomy TAs in undergrad. It was very helpful to have that kind of balance.

And so I found that really manageable, and it also helped me learn how to study in medical school what was really important. It was important to get the facts down, just finding some sort of like either question bank or a flashcard system so that I could test my knowledge randomly. But then also I love to read textbooks. I'm a little bit odd that way. And then I would also just make sure that I had my time to read.

Dr. Chan: It sounds doable. It was doable. You've kind of alluded to it, but with your PhD did you come in thinking you would do X but then turned out to do Y? I mean, how did you arrive? I mean, I know there's kind of a way, as I understand it, you rotate in different labs, you get exposed to different mentors and different science, but ultimately it's your decision about which lab to join and pursue your PhD work. And summer before med school starts there are some rotations. And then I know there are some more in between first and second year. But ultimately I think you're supposed to choose after your second-year med school. How did that process work for you? How did you go through it?

Claire: So I'm definitely the dinosaur version of this because we have changed. And so now people get a lot more rotations, and that was something that they took kind of from our experience. It used to be that you would spend a whole summer in one lab, so you'd only get two rotations. And if you can think about the University of Utah, how many wonderful research labs we have, you have to be very selective and kind of do your homework about, "Oh, like maybe I should go to a couple of lab meetings before I commit to rotating in this lab."

So my experience was, you know, it kind of felt like I had two shots to find a lab. There was an option that if you weren't totally sold on your first day, you could do a third after the second year, but it was kind of like a year matching into that one. So you're going to be joining that lab. That was kind of an intense part of the program was finding your PhD home. I got good advice again, and I think that also kind of came down from the more senior MD-PhD students. They said, "You really want to find a project you like, like you're interested in but it doesn't necessarily have to be this is my life's work. This is my 100% passion. I'm going to always do this. I'm always going to work on something like this."

They said, "Find a place that you enjoy the project but really that you enjoy the professor who leads the lab. That they are an excellent mentor, that you connect well, that you could see yourself." If something, let's say, for instance, I'm not speaking personally here, that you knock something over and maybe lit your lab notebook on fire, that you'd feel comfortable telling that person that happened. And maybe in the course of that event, that's some very valuable samples that took about six months to create were ruined. Like, you have to have that kind of relationship, somebody that you feel completely open, open communication and you trust 100%.

Dr. Chan: And vulnerable. Sounds like being vulnerable.

Claire: Yeah, being very vulnerable, because getting a PhD is really that process. You are wrong a lot. You're wrong all the time. And experiments fail all the time. So it's, one, about being vulnerable and also about building resilience.

Dr. Chan: So which lab did you end up picking? Which discipline?

Claire: Again, I had this kind of funny background. I did cartilage engineering. I did cancer biology. And I thought, I was like, "Oh man, this is my time to swerve. I could try anything." So I decided to do a rotation in metabolism in a yeast biology. Like they use yeast as a model organism and that studied different metabolic transporters and enzymes. And this was with Jared Rutter. And I thought, "You know what? I think this is going to be a really fun rotation. I really liked the lab. I really liked Jared, but I think metabolism is just really going to help me for my first year of medical school, because I keep hearing about this Krebs cycle that I have to memorize."

So like I'm just going to get a leg up. So I rotated in that lab and I really enjoyed it. And there were two MD-PhD students who preceded me in that lab, who had started pivoting away from yeast and started moving kind of up the chain of model organisms. So they were working in cell lines, and they were starting to get a mouse project going. And so, and then I thought, "Okay, that was a great rotation. I probably won't join that lab." And so then I did another rotation where again I swerved because, again, I always liked medicine and I liked kind of outdoorsy things.

So I thought maybe I'd really like muscle. And so I did a project with Gab Kardon, who's a wonderful PI, studying congenital diaphragmatic hernia in mice. And this is a wonderful skill set because I learned how to work with mice. I'd never done that before. And then I also learned a lot about muscle and muscle stem cells. And surprisingly, this all kind of comes back and they all kind of came back. All these skills I learned in my rotations helped me in my final PhD project and my thesis. So I was kind of coming down to that decision point.

I'd done my two rotations, and I just felt like metabolism really started to intrigue me. I kind of came back to really wanting to study cancer biology, really cancer initiation. And so I talked it over with Jared, and he was really excited about supporting me in this project of studying how our stem cells, especially in the gut and the colon, how they initiate metabolically in order to support a brand new cancer. And so we kind of came up with this project, and the best about this, as I told you that I did this rotation because I wanted it to like learn, master, and then never think about the Krebs cycle again. My entire PhD centered on the connection of that pathway with the rest of the cells metabolism.

Dr. Chan: So you know the Krebs cycle like the back of your hand? You could like, yeah, you're probably dream about it and sleep about it.

Claire: Yup. Isocitrate, yeah, like all the way around all the different offshoots, how the cell doesn't really always run in a circle. It kind of sometimes runs backwards and forwards and siphons things off as it needs. And I loved it. I thought that was a really fascinating thing. It kind of married all of my interests. Like I love to cook. I love to think about how do we like to do things in our daily lives to be healthy. And there's a lot of things in the media about, you know, don't eat this, it could cause cancer, don't eat that, it could cause cancer. And that was really actually testing like, well, if you change how the cell itself eats, how it metabolizes things, does it become more likely to become cancer? And we were able to kind of peek into the answer of that question. So that was really fun.

Dr. Chan: Is that your main hypothesis? You know a lot more about this than I do. It's been years since I've studied the Krebs cycle. So I mean, like from a 30,000-foot view, what was your research on? I mean, how does it apply to kind of the broader scope of medicine or in science, I guess?

Claire: So what we kind of studied was let's take healthy colon cells, so the cells that line your large intestine. There's little stem cells in them. They regenerate very much like our skin, but it's on the inside. And so what we did was we actually altered the way that cell handles its metabolites. So when it sees a molecule of sugar and it says, "Okay, I'm going to do this with this molecule of sugar," we've actually changed the pathway so it can't go down one route. And so it's, "I can do all this other stuff with sugar, the sugar molecule, but I can't use it in the Krebs cycle."

And so then that actually that kind of metabolism, that kind of program looks a lot the normal stem cell. So we effectively gave stem cell-like metabolism to the entire colon lining. And then we just watched and we asked whether or not that would predispose a mouse with this kind of genetic mutation in its gut to form colon cancer. Like every good PhD student, you get a little antsy. So you decide to add a couple of little extra things because you don't want to wait for the entire length of the mouse's life. So I had two models where I had one, which I called the Western diet where I kind of fed the mice some carcinogens and gave them a couple of bouts of diarrhea. Then I looked to see if they had formed colon cancer or not. And it turns out that our genetic mutation giving the lining of the gut a more stem-like or more regenerative type of metabolism promoted the formation of cancer. So it's kind of a double-edged sword. You're really good at regenerating but you might form cancer.

Dr. Chan: So this taking the next step forward, this could have implications on how we treat colon cancer or like diet modifications, because I know there's a lot of pop sciencey stuff around this.

Claire: Yeah. So I guess like kind of my dream goal would be to prevent the formation of colon cancer. So understanding the process of initiation means that then we can block initiation. So the easiest way to think about that as well, if we had a molecular target, could we drug it? But then you think about that, like the risk to benefit ratio, we're going to end the number needed to treat. We would have to effectively put something in the drinking water. And people already balk at having fluoride in their drinking water. So that probably wasn't going to be a valuable solution.

So it's really on that second point of the question you asked. It's really on, how does this inform what kind of cancer forms and what are its susceptibilities? So what's really interesting in the practice of oncology now is how folks are thinking about attacking a cancer cell. One is through . . . In chemotherapies, there's kind of two flavors of chemotherapy. Some attack a cell that is dividing, and some attack a cell based on its metabolic program. And sometimes those things kind of overlap. And so we're really interested in figuring out, "Well, how does having this background metabolic program inform the cancer and make it somehow vulnerable?"

I like to think of it as like a highway construction project. So if I've blocked one part of a highway, you have to divert and go around. But that might be slower. That might also come with its own problems. Maybe there's a pothole and maybe we can make that pothole bigger and we can stop the cancer from going forward and becoming even more malignant or metastasizing. So that would kind of be where I would think about going next with this project.

Dr. Chan: Wow. Claire, this is amazing. Like I've just learned so much. Jumping back.

Claire: So fun.

Dr. Chan: I just want to pivot, just jumping back like to the med school part, was it hard? The way I kind of see things is, you know, you start med school and like you're with your classmates and you're in the classroom and all these small group discussions and clinical exam and like all that type of activity. And then for you to essentially step off and do research, like how was that like transition away from your classmates, I guess? And then vis-‡-vis, like I think almost all of them have graduated and moved on to residency.

Claire: Oh, yeah.

Dr. Chan: I mean, you knew it was coming, but I don't know if that made it any less difficult to say see you later or goodbye to a lot of your classmates. I mean, how would you approach this? How did it go?

Claire: Well, and I always like to highlight this too. This was back in the era of mandatory attendance at the U. So I really knew my class. Well, we sat through every lecture together. You know, people were always in the room. Like we had 100 people in a lecture hall every day. And so it was really hard to watch folks go on into clerkships and rotations and figure out what they want to do. And I think part of that was that I realized that that day would come for me. I stayed apart of what they were going through and maybe tried to collect a few little tidbits of things of how to be successful. But then also just to celebrate with them, that they had reached this milestone that they had worked so hard for.

And that really just culminates in match day, which was just so much fun to watch all my classmates match and be excited and see where they were going. And then I've stayed in touch with quite a few, and some have even stayed in Utah. We've stayed really close, and they've been great mentors to me as I transitioned back. But I think it was also because I had chosen to do an MD-PhD. Leaving medical school, it was hard, but it wasn't as hard because I was really excited about getting started on my PhD. And I got to kind of integrate and meet a whole new host of people in the graduate school side and different journal clubs. And then I also still had my people.

The MD-PhD program itself it kind of became more of my home. And those are the folks that I knew I was going to spend the next, you know, six years with.

Dr. Chan: And then you alluded to it, Claire. But like the reentry back into the third year, how was that? Was that smooth? Was it difficult? You know, again, like, you know, you're just kind of jumping into rotations. I know they have a class with some like breakout sessions, but I don't know if that can truly prepare anyone to like okay, to go from nothing to all of a sudden you're a third-year student on busy rotation. So how was that transition for you?

Claire: I thought it was okay. It's definitely challenging. And I think that I was fortunate that in my lottery picks for my clerkship schedule, I kind of eased myself into third year. Actually my paper or my thesis was done, defended, done, but my paper hadn't been accepted yet. So I did two weeks. Actually my first two weeks of third year were still in the lab. So I had a two-week research elective to try and finish up my last experiments. And then I kind of had bubbling in the background, I had this paper manuscript that I was editing and figures that I was, "This is all through."

But then I decided to actually do a two-week elective in pathology, in forensic pathology, because I figured this would be a setting in which I could ask lots of questions. I would be able to learn a lot about different pathology that I would see in the actual hospital space, but it would be a little bit less pressure. And then I would also get a chance to kind of review my anatomy. So I was very strategic about picking this elective.

Dr. Chan: Was it like CSI Salt Lake City?

Claire: It was. Everybody I've talked to that has also done this elective, you kind of get immersed into the crime beat and you start like following the news really closely and be like, "Oh, I'll probably see. I'll see that."

Dr. Chan: There's a body in the reservoir up there. They found a body in the desert. Yeah.

Claire: Yup. Mm-hmm. Surprisingly Lake Powell, because it's so deep, it's like a refrigerator. So they actually recovered a gentleman who had fallen off of his houseboat unfortunately and passed away. And he was like remarkably well-preserved because it'd been like . . . he was at the bottom of Lake Powell. That was an interesting standpoint from, you know, just learning about how the human body reacts to different environmental stresses.

Dr. Chan: So forensic pathology, and then what was your next couple rotations?

Claire: And then I had neurology, which is a little bit on the shorter side. So it's about four weeks. I mean, that is like fast. You have to be able to study efficiently. But it was two weeks of inpatient and two weeks of outpatient. And this was great for me because it allowed me to kind of dip my toes into how both of those services, how do they work, and how to prepare for them. And then it was also a little bit more narrow. Now, while neurology touches all parts of the body and the physical exam is all over, so really kind of getting my physical exam skills back, it was very focused on processes of nerves and the brain. That made it very kind of, again, like it was able to kind of put it in this box and study really hard for it and ultimately like do okay in my exams.

But again, it kind of felt like I was taking off a little bit of a bite as opposed to having the whole cake in front of me. And then I was ready for the whole cake. Then I went into internal medicine. That was hard. It was a lot. I had to study. I think I set up my study schedule where I would come home every day and I would study for at least an hour to two hours, and then I would go to bed and I'd wake up and do it again. And that was every day that I was on service. And then when I'd have my days off, that would be at least six hours of studying. And then I did practice. I did four practice tests for that shelf exam.

Dr. Chan: And, Claire, you kind of alluded to it, but like you talked about with your PhD in science and the grad school part of your training, you kind of had to find your people, find your lab. Were you able to find that yet in third year? I mean, do you know what kind of doctor you want to be? Or are you still like a pluripotent stem cell and that's not been determined?

Claire: I think I have a very clear subset that I'm thinking about. So after internal medicine, I did my surgery rotation and I loved it. I think this has a little bit to do with . . . You know, so some folks kind of, you kind of think that, oh, if you're an MD-PhD, you're most likely . . . and this is true. I mean, you look at the stats, most people go into internal medicine, and then they kind of specialize from there. And I could see that path for myself. I could see myself going internal medicine to heme/onc and then continuing my work in colon cancer from that avenue.

I feel like I thrived, like I just completely blossomed in the OR. I loved the procedures. I loved taking care of those surgical patients. I loved the evaluation. It kind of brought back some of these when I was an EMT when we were doing our 24-hour shifts in the trauma bay. And I also loved the science of surgery. There's quite a bit in how we practice the art of surgery that is still very much under investigation. Again, I could do general surgery, become a colorectal surgeon, and still work with this patient population that I've worked with my PhD on.

But I'm also considering kind of a swerve again. I really enjoyed my vascular surgery rotation. And I loved that I was all over the body, in terms of there's blood vessels everywhere. And then actually the metabolism of blood vessels is fascinating. And then also the coagulation cascade. So another wonderful biochemical pathway for me to dive into.

Dr. Chan: It's like you just can't quit it. You just keep on going back to it.

Claire: That's kind of where I'm thinking. I think with a lot of my classmates, we were disappointed that we haven't been able to finish our third year the way that we had thought and hoped. And part of that for me is that I wanted to give my OB/GYN rotation a really good shake because it's again another kind of surgical subspecialty that has some really interesting clinical questions for research that all, again, can kind of center back on metabolism. And again, we can talk about pluripotency. And so I was kind of bummed that I didn't get a chance to finish that rotation out.

I'm still kind of putting that one a little bit on the board of, "Well, maybe I'm going to try and get through the rest of that rotation when we do get back to clinic." Maybe I'll completely surprise myself and end up applying OB/GYN. I think those are my three that I've really found myself loving that I couldn't imagine myself doing anything different. So general surgery or vascular surgery or possibly OB/GYN.

Dr. Chan: Wonderful. Well, Claire, like this has been great. And I guess I just want to take the last few minutes, you know, I've heard so much about your journey, but with the coronavirus, COVID-19, I know you've been very visible and very active in trying to help out. Can you just talk about some of your efforts? Because I think that would be very interesting to a lot of listeners out there.

Claire: Yeah. Thank you for bringing that up. So when we got pulled from clinic, we ended up with having, you know, all this free time. I'm used to studying only an hour to two hours every day after I'd been at work all day. And now I had all this dedicated time to study. And I also recognize that you could kind of see across the nation. Everybody was talking about how there were protective gear shortages. And Utah was a little bit . . . Like we only had a very few number of cases.

So I thought that this was an opportunity to create a stockpile of protective gear so that we could protect our healthcare workers when inevitably we would get kind of the spread of the virus and potentially have a surge. And then we kind of had this timing where we would be a little bit ahead of that, so people would still kind of be out and about and able to donate what they might have. So I took inspiration from other medical students across the nation who had also organized these kinds of drives. So we organized a four-weekend personal protective gear donation drive, where it was just drive-through drop off. Folks could just look through their garages or their homes, supply closet, see if they had any unused items, and then drop them off.

And I didn't realize how this would actually impact the community I think and our medical student community in kind of two ways. One was it kind of fed how I felt. Like I really wanted to be able to do something. And I could see the other medical students really were looking for ways like, "I need to be able to do something. I need to help. This is what I've been training for, and not only to help the patients but also to help my team, my provider team, the people that have been my mentors." And for me too, a personal connection. A lot of my friends are residents who are on the front lines. So it was really inspiring to be able to do that and provide an avenue with our volunteer base that people could volunteer to do so.

But then the second part of that was that the community also wants to be able to help out. And we saw people clapping, cheering. So excited to drop off, you know, one N95 mask that they had bought years ago. Or even one woman, she just burst into tears. And she said, "You know, I'm a retired nurse, and I just can't even believe that it's happening. And I'm so grateful that you guys are doing this so I have a chance to give back."

And it was something like that, but I didn't realize how important it was for our community to be able to show how much they care. So it's been really, really heartwarming, and I've been completely touched by the generosity of the Greater Salt Lake area in running this donation drive. To date, we've collected over 1,300 N95 masks. And that's just one segment of all the things that we've collected but kind of that like hot ticket items that we think about.

Dr. Chan: That's great, Claire. And so you said it's been going on for four weekends. And where do people go and is it all over or can people still donate?

Claire: We're actually heading into our last weekend. So we hope to see you. It's going to be at Rio Tinto Stadium in Sandy. And we're going to be running Friday, Saturday, and Sunday, 12:00 to 4:00.

Dr. Chan: Is it you and the medical students, or is this another organization you partner with? Who's kind of taking part in it?

Claire: So it's driven by us. It's University of Utah medical students. We are the volunteers. We are the people that have organized this. But we have been so fortunate to partner with Real Salt Lake Foundation, as well as the Rio Tinto Stadium, in order to bring this kind of last big drive. And so we're really hoping people will be able to turn out. We have a big, large parking lot to use, so that'd be great.

Dr. Chan: How did you get in touch with them? I mean, like are you a big soccer fan, or it was just they were willing, or how did you connect with them?

Claire: So I started with reaching out to just a lot of different people. Yes, I do enjoy watching soccer, go U.S. Women's World Cup, go Royals and go Real Salt Lake. I really enjoy going to soccer games. But it was also just thinking about . . . I was looking very strategically on the map. I was like, "What would be some of the best places that we could run these drives? What are the things that are central that have good drive-throughs?" I just called them, and they got back to me and they were really excited about partnering and have just been so supportive throughout this whole thing. So the value of the cold call.

They bought in very early on, probably early April. And we've been having a couple of weeks to kind of plan and roll things out. So we're really hopeful that, one, we'll be offering the community, as they drive out, one of the white ribbons that you've been seeing around. We as medical students, we practice our sterile techniques. So these have been sterilely pinned and they will be available for the public to take a clean one. And then second is that Real Salt Lake, the foundation is planning on offering some sort of merchandise either at the time of we're able to have it packaged in a way that's safe for the public to take or to redeem later when this pandemic has passed. So look forward to that.

Dr. Chan: Well, Claire, I mean, you had to defend your dissertation. So I imagine doing a cold call with Real Salt Lake was easy compared to that. Right?

Claire: Yeah, it was, I don't know. Like, I wrote out a script and I had my mom read it.

Dr. Chan: For your dissertation? Your mom is great.

Claire: She's both.

Dr. Chan: Okay. I love it.

Claire: She said it was a little easier to get through the cold call.

Dr. Chan: Well, last question, Claire, what advice, what counsel would you give someone out there who was just like you? Like seven, eight, nine years ago, and just thinking about MD-PhD or thinking about medical school. What would you say to them? What counsel would you give to someone?

Claire: I would say reach out. Reach out to the people that you know that have followed this path. And if you don't know anybody, do the cold call. We as a community, as a profession are incredibly welcoming and want to hear from you and that's at all levels. You don't have to call the chair of the department but you can. But if you're interested in this, give your local students a call. Find out from them, connect with them, and figure out if this is . . . like shadow. I would have students come and just shadow in the lab to see if they liked it. So yeah, we're here. We want to be a resource for the next generation. I mean, the people that are going to take care of us.

Dr. Chan: Very true. Very true. Well, Claire, this has been fantastic. I'll have to have you come back on because I'm curious if you're going to pick gen surge or vascular surgery or OB/GYN. I think, yeah, the future is wide open, and we'll get through this COVID-19 pandemic and pretty soon you'll have your own match day, not too far away in the future.

Claire: Yeah. I'm looking forward to it. You know, if it has to be a virtual format, I'm okay with that. It's still reaching that milestone and being able to celebrate with all the people that I know. And sometimes a text message could be just as powerful as a hug.

Dr. Chan: Well, thank you, Claire. I appreciate your time. You take care.

Claire: Thank you so much.

Announcer: Thanks for listening to "Talking Admissions and 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 thescoperadio.com.

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