Aug 28, 2019

Dr. Chan: What's it like to move from Damascus to California when you've never been to the U.S.? How does Syrian culture differ from culture in the United States? How do you turn a feeling of helplessness into a passion for helping vulnerable patient populations? How does it feel to be starting medical school with your best friend from undergrad? And finally, how does one turn a fear of public speaking into a talent for teaching in large lectures?

Today, on "Talking Admissions and Med Student Life," I interview Fadi, a first-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 and Med Student Life," with your host, the Dean of Admissions at The University Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Well, welcome to another edition of "Talking Admissions and Med Student Life." We've got Fadi, an incoming student. Hello, Fadi.

Fadi: Hello, Dr. Chan.

Dr. Chan: We're so excited to have you. And you have a fascinating story. We were chatting a little bit because we had some technical problems. But, Fadi, let's start at the beginning. Where were you born?

Fadi: I was born in Saudi Arabia.

Dr. Chan: Saudi Arabia. And how long did you live there?

Fadi: I lived there my first four years of life, and then I went back to Syria where I come from.

Dr. Chan: Syria. And is there a city in Syria or . . .

Fadi: Yeah, Damascus, the capital.

Dr. Chan: Damascus, okay. Awesome. And then you grew up in Syria for many years. And then as I understand it, you left.

Fadi: Yes. I left in 2015.

Dr. Chan: What's that process like? I mean, was it stressful? Was it a lottery? I mean, how did that happen? Did you have family in the U.S.?

Fadi: Yeah. So I applied for a student visa after high school, and I was able to get the student visa. So I first came to the U.S. on an F1 visa, which is a student visa. And then in 2016, my family and I applied . . . sorry, interviewed to get the green card, which we applied for in 2003, so yeah, 13 years later . . .

Dr. Chan: It took 13 years, huh?

Fadi: Yeah, we were able to get the green card.

Dr. Chan: Why the United States? Was there a particular reason? Because I know there are a lot of different countries.

Fadi: Yeah, I have a huge family in California, my aunts and uncles, and their children and grandchildren. So it would be nice to, you know, be able to visit whenever.

Dr. Chan: So you've been to the U.S. before you . . .

Fadi: I have not, no.

Dr. Chan: Before this whole process, never set foot in the U.S.?

Fadi: No.

Dr. Chan: Fascinating. Did it give you anxiety or . . .

Fadi: Yeah, I mean, traveling to a different country, I was certainly nervous. It's the fear of the unknown. But I was also excited about being able to have better opportunities for education.

Dr. Chan: So where did you end up after Syria? Where did they send you to?

Fadi: So I was looking for affordable universities that are also good and I ended up in University of South Dakota.

Dr. Chan: South Dakota. So from Damascus to South Dakota.

Fadi: Yeah.

Dr. Chan: What's the capital of South . . . Bismarck? No, that's North Dakota.

Fadi: No, I think the capital of South Dakota is . . .

Dr. Chan: St. Pierre?

Fadi: No. I want to say Rapid City or . . .

Dr. Chan: Yeah. All my listeners in South Dakota are shaking their heads.

Fadi: I'm sorry. I don't know what the capital of South Dakota is. But I was in Vermillion, where the University of South Dakota is, in the southeast.

Dr. Chan: What was that like to kind of jump from two different cultures, two different systems?

Fadi: Yeah, it's . . .

Dr. Chan: And you were like 16, 17 when this happened?

Fadi: Nineteen.

Dr. Chan: Nineteen, okay.

Fadi: So it's interesting. A lot of people would assume that I'm going to have a culture shock because they're very different cultures, and they are, but I feel like . . . since Hollywood movies are very, you know, common and ubiquitous, every person around the world has an expectation of what the culture looks like. So I wasn't really, you know, shocked by anything, as in culture shock.

But I was fascinated by some things. I was fascinated by the buttons that open doors at the entrance of every building, which is . . . you know, out of all things, why would someone be fascinated by that? But it's not so much the technology as much as the concept of it. You know, if you're in a wheelchair in Syria, your life has basically ended. You know, you need someone to take care of you. You can't enter buildings because not all buildings have ramps. We don't have any equivalent of ADA regulations in Syria. So just the idea that you can be in a wheelchair here and still pursue an education or have a job is fascinating for me.

Dr. Chan: And I perceive . . . and again, I've never been to the Middle East, nor have I been to Syria, but I've been to South Dakota. Very wide open. Not a lot of people. Was that a big jump too? Because I imagine Middle East, there's a lot more people in a very kind of smaller, tight space. I mean, did it feel weird to not . . . I mean the lack of crowds. I just imagine, you know, Syria a lot more crowded, or am I misperceiving it?

Fadi: No, there are areas in Syria that are less crowded. I mean, there are rural areas. There are urban areas. But it's true. Damascus is the capital, so millions of people live there, and it's a really big city. I moved to Vermillion. So just to put it in perspective, the population of Vermillion is less than the enrollment at The University of Utah. So, yeah, it was an interesting move.

And, you know, I come from a small village in Syria originally, which I used to go to every summer. So I also know what to expect in such a setting, but it's also interesting. I feel like every place has its ups and downs, you know? A city has more opportunities, but a rural area is more calm and peaceful and has clean air, which is, you know, still a very true comparison between Salt Lake City and Vermillion. Opportunities versus calm, peaceful, and clean air.

Dr. Chan: Did you know anyone in South Dakota? I mean, did your family go with you?

Fadi: No.

Dr. Chan: So you were by yourself? Wow.

Fadi: Yeah. I arrived there alone.

Dr. Chan: It's colder though in the winter.

Fadi: Yeah. I mean, it depends on how you define colder. If negative 30 degrees is cold, then yeah.

Dr. Chan: I define that as cold. That sounds frigid, subzero, Arctic.

Fadi: I was just kidding. It is very cold.

Dr. Chan: And it sounds like you just picked South Dakota because, would I dare say, the cheapest or the most affordable? You kind of alluded to that.

Fadi: Yeah, it was the most affordable university if I did not want to go to a community college. It was probably the most affordable university for its ranking. It's also a very good school.

Dr. Chan: Fascinating. And then when did . . . going back, what was it like growing up in Syria?

Fadi: I mean, before the war, it was normal. I had friends. I used to go to school. People used to go to their jobs. Everything was good. I mean, I never had the idea of going outside. But, you know, when the war started, everyone starts looking for opportunities outside because you can't guarantee that tomorrow is going to be just like today. You never know what the future is holding. So if you're able to find an opportunity elsewhere, that was an opportunity someone wanted to take.

Dr. Chan: It sounds like a lot of people . . . just from what I know, and we're not going to go into the details, but I think globally you look at conflict and it starts creating this uncertainty, and strife, and unrest. Again, you know, I've felt very lucky in my life. I've never lived through circumstances like that. But when I read people . . . you know, it becomes like, "How do I get from point A to point B safely?" And then food supplies start getting . . . you know, then prices start going kind of wonky.

So not only from a personal safety standpoint, but then you start thinking, "What am I going to do for my career? Is the infrastructure starting to fray and come apart?" So it sounds like a little bit . . . it sounds like it definitely started happening in Syria.

Fadi: No, that's true. I mean, we were just talking about this before we started the podcast, that it got a little safer towards the middle of 2018. But right now, people . . . I mean, at least in my area where I grew up in Damascus, people are not afraid for their lives anymore because the war kind of ended there. But it's all the financial aftermath. Everything is more expensive. You know, $1 was 50 Syrian pounds before the crisis. Now, it's 600, while the salaries did not change. They're still in Syrian pounds. So people there are earning 12 times less than they used to before the war. So it's just the financial aftermath, you know? Like, lack of fuel, lack of electricity, lack of sometimes medicine.

So yeah, it creates uncertainty, as you said. Are you sure that you have a good future in such circumstances, and when does it end? So yeah, that's one of the forces that pushed people outside.

Dr. Chan: Did you start thinking about becoming a doctor back then? I mean, when did that start in your life?

Fadi: It's really hard to pinpoint the moment when I decided that I wanted to be a doctor, but I can trace the roots to a very young age. I mean, I come from a culture where they teach you from a very young age that you can either be a doctor, an engineer, or a failure, you know?

Dr. Chan: Those are the three options?

Fadi: Yeah, you have three options, plenty of options. Pick one. But, you know, I don't think that cultural influence was one of the big reasons I decided to become a doctor. Because as I started growing up and started learning a little bit more about life, I understood that a job is something that you're going to be doing for somewhere around half of your life expectancy. So, if you're surviving that rather than enjoying that, then you pretty much wasted your life.

So I wanted to do something that I'm really interested in, something that I wanted to do. And when the war started, just all the death that was going on . . . you know, I'm one of the lucky ones that did not lose a family member or a close friend, but I have close friends who lost family members or close friends. So, it was in the vicinity, all of this . . . you know, I was just lucky not to have died. It was very random.

So I kind of mentioned this in my personal statement. I felt helpless because, you know, there was nothing I could do as a high school student in such circumstances. So it just created this feeling that I don't want to feel helpless again. I want to feel useful. So, that's kind of my selfish reason of why I want to be a doctor.

But other reasons came as I had my experiences as an undergrad. When I came here, it was kind of clear for me that I wanted to go either for an MD or a Ph.D., because both ways would equally . . . maybe not equally, but, you know, both ways would lead me to a position where I can improve the human quality of life.

So my experiences just . . . you know, I did research as an undergrad. I worked with people. I worked with patients. And I just realized that I'm more committed to working with patients, although I really enjoyed research and I know I want to keep doing research.

Dr. Chan: So it sounds like you've had this dream for a while. There's no specific aha moment.

Fadi: Mm-hmm.

Dr. Chan: But do you think you would have stayed in Syria and become a Syrian physician if the war never happened? Is that a tough question?

Fadi: It is a tough question because, you know, even before the war, some people would go to medical school in Syria and then do their residency outside. So that was an option. It was just not in my mind as a high school student. But who knows? Maybe by the time I got to med school and finished med school I would have specialized somewhere else. But yeah, I think I would have finished medical school in Syria.

Dr. Chan: Okay. Interesting. All right. So you get to South Dakota. You're doing good. How did you end up in Utah? Because, again, it's a fascinating journey, Fadi.

Fadi: So my sister finished medical school in Syria and came to the U.S. to do her residency. So she was doing medical rotations and research in a couple of places. And the plan was wherever she gets in for residency I'll transfer. And she got into The U for the radiology program and I transferred here to live with her.

Dr. Chan: Cool.

Fadi: Yeah. So I transferred here after my sophomore year. So I came here for my junior year at The U. And then . . .

Dr. Chan: And your sister is the only person you knew in Utah?

Fadi: Yeah. I basically moved here to live with her.

Dr. Chan: So your education just kept on going further west?

Fadi: Yeah.

Dr. Chan: Whence the mountains. Sorry I interrupted. Go on.

Fadi: No, that's okay. So I moved here, I lived with her for a year, and then she got married and moved to live with her husband in Michigan. So she transferred to Wayne State, but I stayed here.

Dr. Chan: That's good. And then what did you get your degree in?

Fadi: Biology.

Dr. Chan: Biology. So what kind of activities did you do to prepare yourself for the med school application outside of biology? Because I know you've been very involved in research, but I know you've done some other cool things, too.

Fadi: So most of my experiences have just felt like one led to the other, and I feel like for me that's the right way to do it. When you start medical school, you're told that it's really competitive so there are some boxes you need to check. And I'm guilty of starting my journey with box-checking, because I did not know better. But even the experiences that I had trying to check boxes were very eye-opening, and they were all important for me as an immigrant trying to learn more about the culture in the U.S. and trying to learn English.

So I can give you an example of how one experience . . .

Dr. Chan: Sure, yeah.

Fadi: . . . led to another. So, in my freshman year, I had a speech class. And when I was giving my first speech, I realized that I have a problem with public speaking. I would just, you know, get nervous. I would turn red and my heart would start beating. And I felt like, "I need to solve this. I can't carry on like this."

So I applied to become a supplemental instruction leader. So I held help sessions for general chemistry during my sophomore year. I just felt like that's a job that would force me to hold three sessions every week lecturing or facilitating group learning for a group of students. So that's public speaking. I just decided to force myself into that fear.

And it worked greatly, you know? I started having about 10 to 15 students and I would get nervous, but it was like systematic desensitization. I was forced to be in that position, speaking publicly to students. And by the end of my second semester, I was having sessions with 80 students with no problem.

Dr. Chan: Wow. So you turned a weakness into a strength almost.

Fadi: Yeah, almost. And not only that, my initial goal was to solve my public speaking problem, but I realized that I have a passion for teaching. It's just that when I see a student getting it, this light bulb moment, I just feel so happy.

So when I transferred to The U, I applied to become a tutor. Because I was planning to start studying for the MCAT during my junior year, so I wanted something with less time commitment. So I did not do supplemental instruction. I did tutoring, which turned out to be very different.

As a supplemental instructor, I needed to explain things in a way that made sense to most of the students in my session, while as a tutor, I have one student, so if I don't explain things in a way that makes sense to this one person, then I've failed my mission. So there was much more diagnosis, if you will, as a tutor than as a supplemental instruction leader.

Dr. Chan: Well, I remember, Fadi, you had a very impressive application. I mean, I remember you wrote very passionately about helping vulnerable patient populations, had some great research, and then you had a cool story. Plus, you're a really good test taker too. You'd say that too.

Fadi: Kind of, yeah.

Dr. Chan: What compelled you to stay? Because it sounds like you didn't really have any connection to Utah anymore. I mean, I assume you cast a big net. How many schools did you apply to? Were you looking at Michigan to rejoin your sister?

Fadi: I applied to The U. I applied actually to 16 schools. I chose The U for so many reasons.

Dr. Chan: How many interviews did you get?

Fadi: Can we not talk about that?

Dr. Chan: Oh, okay. Well, at least one.

Fadi: Yeah, at least one. I mean, all you need is one acceptance.

Dr. Chan: All right.

Fadi: So I had so many reasons to go to The U, actually. First of all, the quality of education. So as an undergraduate biology major here, I was required to take upper-division biology courses. So I took Basic Immunology, which is a 5000-level class. And it was a taste of . . . or at least for me, it was a taste of what grad school at The U is like.

That class was simply fascinating. It was the best class I've taken in college, the most interesting class I've taken in college. We had about 12 professors. Each of them taught the topic that they do research on. So we learned about B cells from an expert on B cells, someone whose research is on B cells. We learned about T cells from an expert on T cells and so on.

So these professors, I mean, they were so confident and so passionate about what they're talking about, to a point where I felt like, "If this is what grad school education looks like at The U, then I would like to get some." I don't know if we can mention names, but . . .

Dr. Chan: Sure.

Fadi: . . . professors like Dr. Tom Lane, Dr. Dean Tantin . . . I really enjoyed attending these lectures. It just gave me the idea that the quality of education here, especially in grad school, is wonderful.

You know, I have other reasons to believe that the quality of education in grad school here is great. My PI, who is probably the best PI that has ever existed . . . shout out to Dr. Alana Welm. You know, I know she teaches in the medical school here as well. She teaches some lectures. So that's another reason to believe that the quality of education is great. Because I love Dr. Alana Welm. She's a great PI and, I believe, a great lecturer.

So that's the quality of education part. I also believe that if you want to go to such a difficult program, like a medical program, you need some sort of support system. So I only applied to places where I have family or friends. And it turns out that I'm starting in August with my best friend who is starting medical school here at The U together.

Dr. Chan: Who's your best friend?

Fadi: James [inaudible 00:20:00].

Dr. Chan: Okay. Did you meet him in undergrad or . . .

Fadi: Yeah, we met in physics lab probably my second day at The U.

Dr. Chan: That's good. So it sounds like you didn't know anyone here but your sister, but it sounds like you found a community.

Fadi: Mm-hmm.

Dr. Chan: Yeah, it sounds like you're pretty happy.

Fadi: I'm very happy here. And Salt Lake City is a beautiful place. The U is a great university and lots of opportunities.

Dr. Chan: And I would argue, you know, despite what's going on nationally in our country and across the world, I think Utah has always welcomed immigrants and people from different cultures and faiths in a way that makes people feel welcome. Do you agree or . . .

Fadi: No, I totally agree.

Dr. Chan: I don't know if you have any really cool or embarrassing Utah stories.

Fadi: No, I totally agree. It's a very welcoming community, you know? I do feel welcome here and I do feel like I belong.

Dr. Chan: Great. All right. So I'm not going to hold you to it, but if I had to make you pick right now, what kind of doctor do you want to be and why? Again, I'm not going to hold you to it. But I always like taking the temperature. It's like,"Oh, Fadi is thinking this. Fadi is thinking that." So what are you thinking?

Fadi: I actually think . . . you know, since my research is on breast cancer, I think I'm leaning towards oncology, but who knows. I believe that you cannot really make an informed decision on what you want to do for the rest of your life until you actually get a first-hand experience of that.

Dr. Chan: That's very wise. Not too many people feel that way, though. Well, a lot of people do, I guess.

Fadi: A lot of people say, "It's really cool to operate on a human being that's open in front of me and try to fix them." I mean, yeah, that sounds like surgery, but have you actually operated on an open human being in front of you? Have you seen how it feels? Until I do that, I cannot really say that I would like to do surgery. Yeah, the concept is so cool, but . . .

Dr. Chan: Plus, how does it feel when it's like 3:00 in the morning and you're lacking sleep and you miss some family event? Yeah.

Fadi: Aside from the lifestyle, it's just the material of the specialty itself. Am I really interested in it? Do I know I'm really interested in it before I've actually experienced it? I don't know. I would like to start medical school with an open mind before I . . .

Dr. Chan: That's what I preach to everyone. Have an open mind. You're going to be exposed a lot of different fields, and doctors, and different labs. It's beautiful and hard because you don't really have to "pick" until your last year in med school.

Fadi: My sister actually initially wanted psychiatry and she ended up in radiology. So that's where I learned my lesson that you never know.

Dr. Chan: You never know. Well, is she still happy with radiology?

Fadi: She's very happy.

Dr. Chan: Because psychiatry is great. We welcome all people into psychiatry. It's a different . . . yeah, I think the med school experience is informative and I think it helps most of the time, but interns start the residency and, you know, there's a group that doesn't like it and they switch. So there's some switching that goes around, even [GME 00:23:10]. It's harder to do, but it still happens.

Fadi: Makes sense.

Dr. Chan: Cool. All right. So, Fadi, any advice to someone listening out there and they're thinking about going to med school and they're not sure, or they're not sure what to do? What advice would you give them?

Fadi: I kind of mentioned this before, that, you know, there's nothing wrong in starting your journey with box-checking, but don't finish the journey like that. These experiences are just supposed to guide you into a direction you're interested in. You know, my supplemental instruction experience guided me to other teaching experiences.

So, you know, just do what makes sense for you. Don't do what looks cool for medical schools, because I'm sure medical schools can look deeper into your application and see, you know, who you are as a person, not just as an applicant.

And it does look like medical schools . . . I mean, you probably have much more insight on this. It looks like medical schools are moving away from just focusing on numbers, and they're moving more towards choosing applicants that are humans, people who are well rounded, able to speak to a person, and relate to them.

And that makes sense, because if you're just going to accept students who did well on exams, what if these people are not that relatable or not able to speak to a patient and make them feel at ease? You know, if it's just about knowing information and doing well on exams, you would have a computer treat these patients. But that's not the case.

So, yeah, just do experiences that make sense for you. And, you know, be a human, not just a test taker.

Dr. Chan: Yeah. Awesome. Well, Fadi, congratulations. We'll have to have you come back on as you progress in your journey to become a doc. I would just be curious to see how it's going the next few years. Thanks, Fadi.

Fadi: Thank you.

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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