Sep 25, 2019

Dr. Chan: How does the love of science fiction inspire an interest in research and medicine? What's it like to establish an LGBTQ awareness in high school with no administrative support? How does one rise above their challenges to become a mentor and inspiration to others? And finally, what is a great strategy for choosing an MD-PhD program? Today on "Talking Admissions and Med Student Life," I interview Laurel, 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: Okay. Well, welcome to another edition of "Talking Admissions and Med Student Life." I have another great guest today, Laurel.

Laurel: Hello.

Dr. Chan: How are you doing?

Laurel: I'm doing great. How about yourself?

Dr. Chan: Just moved here?

Laurel: Yes.

Dr. Chan: Incoming students?

Laurel: Incoming student.

Dr. Chan: All right, we're going to get into that. But I want to go back to the beginning.

Laurel: Perfect.

Dr. Chan: All right. So what point in your journey did you start thinking about medical school? Or to give a sneak peek to the listeners MD-PhD?

Laurel: It's interesting, because there's been a lot of little tiny milestones that all contributed to one inevitable decision. I always tell people I actually got into science, so I could write sci-fi, which is slightly different from what I'm actually going to be doing as a physician scientist. But it did . . .

Dr. Chan: That you know of.

Laurel: That, I know, of right? But I think I've always been very scientifically minded, very curious. I, in middle school, won eCYBERMISSION science fair, best application of math, science, and technology. And it's always been something I've been drawn towards. And for a long time, I thought that I would be a biomedical engineer or something in that vein, because the conceptual side really about appealed to me. But then when I got into high school, came out as queer, joined a lot of community organizing endeavors, I realized that the humanity of people was going to be more important to me in the long run than the application of concepts, and I realized that there was a lot more I could do at the intersection of research and medicine and people than being a materials engineer or something of that nature.

Dr. Chan: Interesting. So there's a lot to unpack?

Laurel: Yes. Sorry.

Dr. Chan: So let's go back. So you grew up in Georgia?

Laurel: Yes.

Dr. Chan: How was it growing up in Georgia? Or were you like Atlanta or were you like more kind of rural?

Laurel: I was metro Atlanta.

Dr. Chan: Okay.

Laurel: I was the epitome of the suburbs. My dad commuted into the city to work in a skyscraper, and I grew up in a very lush neighborhood with trees and the park and everything.

Dr. Chan: Okay.

Laurel: So . . .

Dr. Chan: It was like the south, but urban south?

Laurel: Yeah, it was interesting. Food was great. I will never complain about Southern food.

Dr. Chan: Coca-Cola.

Laurel: Yeah. But I did grow up in Forsyth County, which is affectionately or not so affectionately referred to as the Four Whites County, because the KKK drove out every person of color in the 20th century. And so there's a lot of cultural and social context for the situation I grew up in. Where I was pretty oblivious about it until I wasn't anymore. It's the county where Oprah came in the '90s and ate at a restaurant, and it was a big deal to have a public black figure come in and participate in our community.

Dr. Chan: I did my residency in D.C. And I had a lot of friends who grew up in the South and North Carolina, South Carolina. And, you know, like, they all worked in D.C. So they're all, you know, they were woke, but when I would talk to them sometimes, they would tell like a lot of stories growing up about like, they were taught about the Civil War in a very different way from a different . . .

Laurel: Oh, yeah. The War of the Northern Aggression.

Dr. Chan: The War of Northern Aggression. So like yeah. It's like wow, it's very different. And to this day, like, it's kind of, it's interesting, because like, we would go down to North Carolina, the Outer Banks. Have you ever been to the Outer Banks, you know what I'm talking about?

Laurel: Mm-hmm.

Dr. Chan: Like yeah, gorgeous beaches. And it's just interesting, like, how, like, it's just different. And yeah, it was just fascinating to kind of hear their stories and kind of experience the South. Now I grew up in Utah. So I didn't really know any about this until I went . . . well, I knew about the Civil War, but like, I didn't realize, like, there was such a divide, and some, so . . .

Laurel: Yeah, the . . .

Dr. Chan: . . . there was like a cultural . . .

Laurel: The history's still very tangible in interactions. And I think that's hard for people who are outside of the South, where they, of course, know about the Civil War, and they know about the civil rights movement, but they don't realize that it's been a generation since some of the most pivotal shifts in the South. And then I actually I grew up I had my pediatrician was a black woman. And so, for me, I grew up with the mindset that healthcare is a inclusive space, I guess. And in reality, that's not necessarily the case in a lot of spheres. Particularly health outcomes for women, health outcomes for people of color, health outcomes for LGBTQ individuals.

And so it's, I think that my upbringing was, of course, instrumental because it was my upbringing, and here I am. But I think that I simultaneously have this immense well of optimism because of the really incredible resilient people I grew up around and received support from, but also I have cultivated an awareness of where the system doesn't work. And where there's a lot to be done, which is why I decided to pursue a career as a physician scientist, because it's important to me to both be a physician who can practice and who can interface with people and be the doctor that marginalized communities deserve, while also being able to conduct the research too on a wider scale, improve people's health care experiences.

Dr. Chan: Excellent. We're still going to unpack somewhere what you said sci-fi.

Laurel: Yeah.

Dr. Chan: So we say sci-fi and like, I got like, I don't think I've ever talked about sci-fi, on the podcast, when you start thinking about sci-fi. I'm thinking about "Star Trek Next Generation," because that's how old I am. You know, and this is like pre-Comic Con days. Pre-Battlestar. Well, they had the old "Battlestar Galactica." But yeah, I just remember my friends and I were like, we'd have these deep discussions about what a photon torpedo is, again, this is before the internet. So now I think like you can, like connect with other people who like, would help this discussion. But I just remember, I was just a super nerd in junior high, high school. And I would eagerly you know, I just know that like "Star Trek Next Generation" was always every Sunday, 6:00 to 7:00. And that was like, that was the time. So I'm curious. Like, what was your sci-fi? What was your passion? What?

Laurel: I'm a reader.

Dr. Chan: Okay.

Laurel: I would say, although like, like many people in my position, I'm a reader who struggles to find time to read. So that's the tradeoff there. And so, I growing up, I wanted to be the next Michael Crichton, and everyone knows "Jurassic Park," but not as many people know about the books he's written about the . . .

Dr. Chan: "The Andromeda Strain"?

Laurel: Yeah, yeah. You know, the disease and the genetics and . . .

Dr. Chan: Went to medical school but never practiced.

Laurel: Right. Yeah, exactly.

Dr. Chan: Right. But he was a phenomenal writer. Yeah.

Laurel: Yeah. And so I wanted to be the next, you know, at first I thought Michael Crichton. My New Year's resolution for this year is to read all the Hugo Best Novels written by women. And so now I'm realizing I don't want to be Michael Crichton. And I think they're really incredible women who have slayed the game who people don't necessarily recognize. I'm obsessed with Connie Willis, who does historical fiction in a time travel . . .

Dr. Chan: Oh, cool.

Laurel: . . . context. But so yeah, I read everything I could get my hands on. And I figured if I could pursue science, I could tell these compelling stories that had real world implications to people who I think there's this, I think a lot about this sort of White Tower of science, where there are a lot of people who think, "Oh, well, I'm not interested in science, or I don't understand science." And they kind of already removed themselves from the situation. And they think, "Oh, they're scientists and lab coat somewhere, who are figuring out something, and they'll communicate it to me eventually."

Which I think is a real problem, because then you have people who don't have, you know, you look at stuff with climate change, and with vaccinations, and you have people who don't have the framework to even have that conversation, let alone participate. So that's what I wanted to.

And honestly, I'm still really interested in, I did a science communication internship at the Marcus Autism Center in Atlanta, where I basically worked on how can I make visual communicative presentations for families whose children have just been diagnosed with autism? How can we communicate the complexity of the genetics and of the research that's going on in the center, to these parents who are just worried about the wellbeing of their kids?

And so I don't know, how the fiction writing side of things will go. But I think the emphasis on communication to people outside of my field and who . . . and it's something that I've always I have been involved in, like trans advocacy for years. And it's something where I write letters to people, and I write speeches to people and that sort of . . .

Dr. Chan: Well, books are another way to communicate ideas. So it sounds like if you are, like, with the many hats you are wearing and will wear. But if you become author one day, that could reach the next generation.

Laurel: Right.

Dr. Chan: Yeah, that can reach . . .

Laurel: Perspective.

Dr. Chan: Yeah, it can reach more people. You know, it's like I tease people in my office, sometimes, like, just the millennial generation, you know, like, there's a different way of communicating information, there's a different way of receiving information, and I'm not sure where we're going with that as a culture. But I do know that it's like, it's a very powerful way to give young people like this love of science.

And I personally, I don't care if it comes from like a TV show, or a book or a blog, or the gram, or whatever. But if you can somehow communicate that love of science, because we have, like, Laurel, you're right, we have so many issues, problems facing our country, like, talk about climate change, and, you know, so like how do we communicate this to others? And how do we . . . because like, I'm not sure we're going to fix it. But I hope, like, the generation that comes after us will start fixing it. I don't know, like, I'm older than you. So I have less optimism, like I'm not sure, like, we're going to solve it. But we need to inspire the next group to help address it. I don't know.

Laurel: Lay down rules.

Dr. Chan: Yeah.

Laurel: Yeah, I think it's funny how you talk about the different ways of sending information, I was talking to a friend who's applying to medical school right now, who was complaining about character limits for essays and told me, "That's like five tweets." And I had never even like conceptualized a personal essay is really, that's five tweets about yourself. And so I think it's . . . I don't know, I think I'm optimistic in that with the social media is a double-edged sword, but you have people who are, like you said, more connected, who can find their communities and don't necessarily have the option of being unaware, they could still be uninformed. But at least if you're venturing forth into the world, you're probably going to encounter at least some of these ideas.

Dr. Chan: Yeah.

Laurel: So I think there was this shift of, you know, universities have always been hot spots of advocacy and change. And that's why you have all these 22-year-olds who were historical figures, which is wild, being 22 now, but I think what happens now is you have people who leave those spaces who graduate, but who still have access through social media and community spaces to the same energy of change and commitment to reform. And so I know that time is a wheel, and it's cyclical, and it can be frustrating, and young people are always optimistic, and older people are typically more cynical, but I think that at least society, there's been a shift, you know, the boulder has been moved a little bit. And I think that hopefully, people will start to take some of the most pressing issues seriously, right. Does that make sense?

Dr. Chan: Yeah, totally. All right. Pivot. You've also mentioned coming out as queer.

Laurel: Yes.

Dr. Chan: What is that? What did that look like? What did that mean? How old were you?

Laurel: Yeah, so I grew up . . . my family belongs to the Mormon Church, or the LDS church, depending on your nomenclature. So I grew up in a pretty conservative Christian environment. And it wasn't until I got to high school that I met LGBTQ individuals and started to develop the language for what I was experiencing and who I was. And for me, I guess it was almost a good thing that I grew up in such a insulated environment, because I didn't actually ever really hear any negative stuff about the queer community, because it was just something that wasn't talked about. So it was hard, because I didn't have any conceptualization, any real language, but I didn't experience some of like the outward prejudice that a lot of other queer people from religious communities grew up hearing and internalizing. So it's kind of a toss-up, but I went to a very, very large public high school. And I think I've always been . . . trying to think of the least dramatic way of putting it. I've always been someone who is involved with the, like, the fringe, I guess.

Dr. Chan: The fringe?

Laurel: Yeah.

Dr. Chan: Not the French?

Laurel: Yeah, not the French.

Dr. Chan: Okay.

Laurel: The French are okay, but . . .

Dr. Chan: The fringe. All right.

Laurel: Yeah. So it was tricky, because some of the basically at my high school, we had a handful of outwardly queer students, and they faced a lot of discrimination, and like physical and verbal abuse, and that was something that I got involved. We started a gay-straight alliance at my high school, which was really tricky, because we did not have the high school administrative support. And we had to really fight for that. And it was basically being involved in these spaces where I identify as a trans person, I use they/them pronouns identify as non-binary, or trans masculine, which can take some more explaining at times.

But basically, being around other queer people and other trans people was a really empowering experience for me, especially individuals who were, and it sounds really simple, but I think it's significant. When you come from these spaces, individuals who were happy, who were established. One of my friends now, who's a few years older than me, is, when I was in high school, he had just graduated and was a trans man who was in a happy relationship. He's engaged now. And it's interesting now that I am that individual for some other people. I am a really happy, you know, openly trans person, I'd like to think I've been professionally successful to at least to a certain degree, and then I'm engaged with to a wonderful, wonderful human being.

And so it was hard. I left the LDS church when I was 16, and actually graduated high school at the age of 16, because there was some fallout from that with my family. And I ended up working full time at a pediatric dentist office, which was also really informative for making my clinical decisions. And ended up being really, really lucky and getting the Foundation Fellowship at the University of Georgia, which is the premier scholarship for our state flagship university, which allowed me to receive a undergraduate education, which was significant for me, because I didn't have my parents' support to pursue an education . . .

Dr. Chan: Sounds like you went through a lot through your teenage years.

Laurel: Yeah, it was an experience. And I think that's one of those things where I, so like I said, I'm 22 now. And I both recognize that like, temporarily, I'm somewhat inexperienced, but I've been doing my own . . . you know, I graduated high school six years ago, and I have had a mentality of I have to be independent and have resources for myself, for the past seven-ish years, or I'm not going to have the opportunities that I want. And I think that's a mentality that has been challenging, but also pretty useful in getting to the point that I'm at now, where I feel pretty confident going into a long MD-PhD program, because I've always had to be very exact about what do I want. What do I have the resources to pursue? And what can I do with that?

Dr. Chan: As you learned about who you are, as you, you know, you had talked about you learn the language.

Laurel: Mm-hmm.

Dr. Chan: What did that look like when you moved off to college? Because it sounds like you started to become a mentor. You started to be able to, like, grow even more as a person and then reach out to others, would you? Yeah.

Laurel: Yeah, I think that college was a really interesting experience, because . . .

Dr. Chan: Because we're talking to Athens, Georgia.

Laurel: Athens, Georgia.

Dr. Chan: University of Georgia.

Laurel: Yeah. Which is . . .

Dr. Chan: Two hours away from home?

Laurel: Yeah, like an hour and a half.

Dr. Chan: Yeah. Okay.

Laurel: Give and take.

Dr. Chan: All right. So you're still in the South.

Laurel: So I'm still in the South.

Dr. Chan: Probably had some friends and went there from high school?

Laurel: Yes, I actually . . .

Dr. Chan: Knew some folks, yeah.

Laurel: Yeah. The only person I interacted with from high school, though, was my now fiancÈ then partner, though. So it was kind of a fresh start in a lot of ways. My opportunity to where I was out from the beginning at my undergrad contacted the people at my scholarship, you know, was got involved with LGBT Resource Center, which was a remarkable experience. But it was at times it was really challenging, because I think there's this conceptualization of like what an LGBTQ person looks like. And for a lot of people that is a white cis gay man. Though I'm not that, sometimes people read me as that when I'm with my fiancÈ, which is very different from what I anticipate.

But so it was something where I . . . so I was the I was the first trans person to be, I think, open in the Foundation Fellowship. I was the first out trans person, in the Foundation Fellowship. I was the first out trans person in the Dean William Tate Honor Society, which is the oldest honor society at the University of Georgia, which used to be an all men's honor society that they eventually opened to women's. And now it's open to non-binary people like myself, and they've had, in the years following me, I believe they've always had a trans person who has been admitted to the society.

So I think, for me, my undergrad experience was an exercise in constant visibility, and I think taking up space, because I hear it a lot people who say, "Oh, I've never used they/them pronouns for a person, or I've never met an out trans person, or I've met." You know, there's a lot of I've never, and my response is always two-pronged. One, you probably have, but you didn't know because there's still a lot of stigma. Unfortunately, I have the obnoxious confidence to deal with the fallout regardless, and two, now they have, so now they can learn and they can adjust. Life is one wonderful growing period.

And so my undergrad experience, I think, was a lot of it, like you said, being not just a mentor, which was a really wonderful opportunity. And I love, and I'm excited for people even a few years younger than me, because I think they have a lot of opportunity that I'm really grateful for, but I think being in a lot of regards, the first blank, so that the people after me felt safe and felt comfortable to pursue the same thing.

I was the 2018, Georgia Truman Scholar, which was a tremendous opportunity. And since then I've had several trans people from around the country, come to me for advice and applying and for comfort. And at least one of those individuals were successful the next year and becoming the Truman Scholar of their state. And they told me that . . . and it was a really wonderful conversation for me, because it was really rewarding of, you know, several years of real intentionality in my part, and being out and which wasn't always safe and, which wasn't always comfortable, and which wasn't always optimal. And this person told me that I'd given them the confidence to apply to be out, and then they received their recognition.

So I think that's . . .

Dr. Chan: And during this time, Laurel, you're in the middle of doing some really high quality research too, you know, and you're doing all these other, you know "normal activities."

Laurel: Yeah.

Dr. Chan: And all undergrads do and go through in preparing to apply to an MD-PhD program.

Laurel: Yeah.

Dr. Chan: I mean, so like, how did you do that? How did you start branching out? How do you find time? How do you balance all? Because like, how, you know, like, you've done so much like, how do you balance all those demands on your schedule?

Laurel: Oftentimes, I did not.

Dr. Chan: Okay.

Laurel: I will say my first thing is always I was really lucky, my now fiancÈ, then partner has been my rock. And not everyone is so lucky to have a behind the scenes person who, you know, cooks and does the dishes when you're studying and who drives you to volunteer opportunity. And so I'm really lucky where I have always had my other half to really support me through a lot of that, and I'm really, really grateful.

But I think for me, it was, I told you earlier, I've always been . . . I'm 100% committed. And for me, it was, I felt, you know, I had a period of time where I didn't think I was ever . . . I didn't think I was going to go to college. I thought I was going to be the valedictorian of my high school program and work minimum wage for the rest of my life, which was, is not necessarily a bad thing, but it's not representative of what I saw for myself for a really long time. And so I got to my undergrad experience, and I basically told myself, if I don't take advantage of every opportunity, then it's not fair to myself. And it's not fair to the people like me, who wanted to be in my position and weren't in my position.

And so I pursued a lot of opportunities rigorously, where the two research projects I had that were trans-related, were projects that I started that I approached people with a certain skill sense and said, "Hey, I want to do this research." And was able to conduct a two-year national study on trans students in university healthcare settings and work on metrics for gender identity for electronic healthcare records, and those kinds of opportunities mixed with, you know, I have two degrees and a certificate in interdisciplinary writing, actually, in case I want to write the sci-fi . . .

Dr. Chan: You will write the sci-fi.

Laurel: Yeah, it's on the to-do list. And so I think, for me, it was a lot of pursuit. I actively sought the opportunities. I organized a speaker's bureau, which is where LGBTQ students go into public spaces to tell their stories and kind of provide context to queer identities for . . . most of it was like budding professionals, so people who are going to be teachers, people who are going to be healthcare workers, so they could actually talk to LGBTQ people and inform themselves and prepare. But I will say that a skill that I've had to cultivate more so than a lot of others, is the ability to say no to things and to say . . .

Dr. Chan: I still struggle with that one.

Laurel: Yeah, you know.

Dr. Chan: It's hard, because like, doctors are frequently asked to sit on committees or see more patients, or stay a little bit later, or take on more cases in the OR so the ability to say no, is really hard, yeah.

Laurel: Yeah. And I actually I called 2018 was the year of no, or maybe not now is a better way of putting it.

Dr. Chan: Wow, I like that.

Laurel: Because I really did, I did a lot of things. And I really enjoyed all of those experiences. And I wear a lot of hats, and I love a lot of things. And I have a lot of interests. And so that's what's difficult for me, because people say, "Do what you love." And I love a lot of things. And so I had to start prioritizing, you know, where am I doing the best work? Where am I doing the most work? And also, where am I having the healthiest balance between? Because like I said, I think that I wanted to seize the moment, and I carpe diem myself into a corner. And I think I had to realize that it's better to do a few things and be a healthy, sleeping, eating meals individual than to try and do a million things, and kind of evaporate, I guess, as an individual.

Dr. Chan: So you're working hard. You're doing all these different activities. Your fiancÈ, what's his name?

Laurel: Peter.

Dr. Chan: Peter, he's helping you out doing the dishes.

Laurel: Doing the dishes.

Dr. Chan: Telling, "Laurel, you can do this, you can do this." So just to kind of give reference, a frame, like, when you started applying, how many programs did you look at? How many did you . . . you know, and like, what was that? What was your thought process? What was your kind of strategy?

Laurel: So don't make fun of me. You asked how many programs did I look at. I looked at all of them.

Dr. Chan: Okay.

Laurel: My freshman year I made a spreadsheet of every MD-PhD program in the U.S.

Dr. Chan: Wow.

Laurel: And I went through all of them. And I did it.

Dr. Chan: It's like 90, a 100 or . . .

Laurel: Yeah, a little over 100.

Dr. Chan: Yeah. I feel bad. I don't know the exact number because these things fluctuate, yeah.

Laurel: No, but it's variable. And it fluctuates.

Dr. Chan: Yeah, it fluctuates. Yeah.

Laurel: Right. And so I took out the ones that weren't an established program, so they were some where you can go to medical school, and then sometimes you can take a break in the middle . . .

Dr. Chan: Right, a new program.

Laurel: Yeah, you can get, you know, and you can maybe get your PhD in the middle. I'm like that's a lot of variability for a doctorate. Took out the ones that weren't fully funded, because eight years of loans is a little intimidating to me, and basically did a tiered system where I narrowed down the programs, which I also had to be really, really intentional. Because I was paying myself for application fees. Although I did have some support. I have a physician I shadowed who paid a couple of my secondary fees, which I'm still very grateful for. But it was something where I read somewhere that the average number of medical schools people applied to is like 20.

Dr. Chan: Yeah.

Laurel: And . . .

Dr. Chan: It's kind of a number we toss around.

Laurel: That's horrifying to me, because that's, you know, hundreds, if not thousands of dollars. And I already, you know, I paid to take the MCAT out of pocket. I didn't take any prep courses for the MCAT, because I did not have the finances to do that. I had a scholarship to allow me to attend college. I had enough money for housing and food. That was my stipend. And that was it, you know, so I worked Actually, I did work a lot through my undergrad to have any kind of money to have any sort of flexibility with. And so I was very, very, very critical when I was looking at programs, which you should take as a compliment.

Dr. Chan: So strength. Were you looking for, like any particular fields? Or were you looking at geography? Or were you more looking towards established?

Laurel: I looked at everything.

Dr. Chan: Okay, everything. All right.

Laurel: Like I said, there's tier system and rankings and, you know, different pages on the spreadsheet. And so I basically figured out I could pay to apply to seven or eight places. And so I took out every place that didn't haven't, like I said, establish MD-PhD program that was competitive and funded and looked to actually prepare physician scientists.

And then I looked at field specific. So I have, I love genetics. It's always been probably my scientific field of choice. My scientific degree is in biochemistry, but that's because I was doing research with biochemical tools investigating congenital disorders first three years of my undergrad. So genetics has always been my first love. And so I looked at places with good programs for genetics, personalized medicine, and so forth.

I looked at medical schools that had opportunity for tele-health and rural-health, because my field of interest is transgender health care, and I want everyone, I want every trans person to have access to health care, and not just the people who can travel to San Francisco. And then when I did all that, I had about 15-ish schools. And then I looked at geography and I said, "Okay, where can I see myself living for eight years?"

Dr. Chan: Eight to nine.

Laurel: Yeah.

Dr. Chan: Or maybe 10 years yeah.

Laurel: Yeah, a hot minute. And I am very, very . . . I'm very picky about where I live, because I grew up in the suburbs. So I grew up in the land of convenience. And I couldn't walk everywhere, but you could walk a little bit, but you could also drive anything, and it was just . . .

Dr. Chan: You just start sweating.

Laurel: Right, right.

Dr. Chan: Yeah, because it was in Atlanta.

Laurel: Oh, yeah.

Dr. Chan: Yeah.

Laurel: And also, of course, cost of living because I did the whole poor college student thing, and I don't recommend it. I did the whole . . .

Dr. Chan: Ramen noodles four times a week.

Laurel: Yeah. Ramen on top of a turned over a cardboard box as a table. And I was, you know, I was happy. I was lucky to be there. But it was hard. And so there are certain MD-PhD programs, which I won't name by name, but I'm sure you can guess where they are where they have stipends that's really not enough to cover the cost of living and so people still take . . . you either take out loans or you do nothing for eight years.

And that really wasn't appealing to me, because like I said, I've worked really hard the past two years to have time for myself and to do nice things for myself. And I came from a place of very, very intense financial insecurity. And so to me, I'm still developing the skills to like, I deserve to buy myself lunch if I want lunch sometimes. And yeah, so I picked eight programs, and then applied to those. The final deciding factor was geography. But each program I applied to was a long, long journey of evaluating and contacting people.

Dr. Chan: Of the eight, how many did you get interviews?

Laurel: Two.

Dr. Chan: Two. Okay. All right. And so obviously, one was Utah.

Laurel: Yeah.

Dr. Chan: You don't have to talk about the other one. But like, what was it like? Because like, you know, again, from my vantage point, when I look at the MD-PhD, it's a little different because they fly you . . . it's like a two-day interview process. The first day you interview with kind of the PhD side, the second day, the MD side. But then they usually schedule activities, you're kind of like hanging out with these people.

Laurel: You're wooed.

Dr. Chan: Yeah. And some of these people you're going to see again, some of them won't.

Laurel: Yeah, there's like a circuit. So you might see them at another school that you interview with. It's this interesting dance as it were. So yeah, what was it like to interview? And like, then, like, you know, your entire life is kind of sunk into this application. And then you go through various people have read it in various depths. So you're getting kind of interesting questions, random questions? Like, what was that like from yours now looking back, I mean?

Laurel: I would say first, it was exciting, because I recognize MD-PhD programs are . . . med school is competitive. And then you add MD-PhD, where it's fully funded and . . .

Dr. Chan: Yeah, extremely competitive yeah.

Laurel: So I was . . .

Dr. Chan: They're taking a bet, you know, like they're putting . . . .

Laurel: Yeah, like they're gambling.

Dr. Chan: Yeah, they're putting all their money on you, "We're going to pay for you to come here."

Laurel: Right. And so I was excited, because I was very worried I wasn't going to get in anywhere, because I wasn't playing the numbers game right. But you're supposed to apply. And everyone I told me was like, "Oh, you need to apply to more places." And I was like, "You can give me money if you would like, and I will apply to more. But this is what I'm working with." I think actually ended up applying to seven places. I think I came up short, actually on the last one. So I was first I was like, thrilled, because like, one of the biggest pieces of advice I got applying for MD- PhD in especially because I was so financially cautious was don't apply somewhere if you don't think you would be happy to go there.

Dr. Chan: Good.

Laurel: And so I got these, you know, a couple of interviews, and I was like, "Perfect, I did it." Because my whole mentality, which is maybe young, naive confidence and what I want to do is specific trans health, I think that was probably was my biggest issue with my applications, because it's not neuroscience. It's not anatomy. It's not really a an established field at different universities. So I think that was the issue talking to people. They liked me, they didn't like what I wanted to do, necessarily places where I didn't get an invitation to interview because they were like, "We just don't . . ." You know, you're gambling already on this person and they didn't know where to put me basically.

Dr. Chan: We don't know if we have a lab established . . .

Laurel: Right, right.

Dr. Chan: . . . that would fit with what your vision is. Yeah.

Laurel: Yes. Which I understand, because that's why so many MD-PhDs, you know, it's already a struggle to merge the clinical practice with the research. And so it's already an issue, and I was just throwing a wrench into that. So my thought process with interviews is I felt like if I could, if I could just get there. And if I could just talk to people and just like, help them see my perspective that it would work, you know, because I'm so passionate about what I do. And it's so important, and somebody needs to do it where I was enthralled to have an invitation and to talk about what I love, and like you said, get weird questions. But generally, every person I talked to had, read my application was very . . .

Dr. Chan: What I mean by weird questions is like your research can be interpreted by different people.

Laurel: Right.

Dr. Chan: So sometimes the MD-PhD people like, I have heard. Again that's kind of not my world. But sometimes some of the PhD folks, they really asked detailed questions about research.

Laurel: Yeah.

Dr. Chan: Yeah, it's almost like they try to stump you.

Laurel: Right, yeah.

Dr. Chan: Like did you really, you know.

Laurel: Yeah. Like translational I've got some translational questions like my bio-chem lab, in a different context, which I really I had to think about, because especially because it's been, I did my bio-chem lab, for the first three years and then my PI left the university, so I hadn't done that for a year. Well, not . . . anyways. But so it was really interesting, because I think, even just with medical school, the whole song and dance is so interesting to me, because it's something you work immensely hard for the privilege of being in the room. And then all of a sudden, it's about you. And it's, you know, we . . .

Dr. Chan: This is your moment.

Laurel: This your moment.

Dr. Chan: This is your time to shine.

Laurel: Exactly.

Dr. Chan: Yeah.

Laurel: And so for the University of Utah MD-PhD interview, they set up activities, we went out to eat, people were so nice, everyone was so nice. And so it was fascinating, because I think I was ready to claw my way like into the program. And then people were very receptive. And I don't know if I will get in trouble for saying this. But one of the people who interviewed me during my interview basically said like, "I don't want to grill you, let's just talk." And that was wonderful to me. Because I think I had the survivors' mentality of like, I've got to nail this, right. And it was really reassuring to feel like, it was me the person who was being considered not just the application. And that's something that I always have . . . I keep my eye on, because I think it's easy to turn students into applications, as opposed to like human beings. So I don't know if that makes sense.

Dr. Chan: Yeah, yeah. I think it's hard. Because there's, as you mentioned, like, it's such a competitive process. There's so many people applying there is this day or days when you get to be interviewed. But essentially, everything that you do is kind of boiled down to this paper file.

Laurel: Right.

Dr. Chan: And then you have the interview. So then you get to meet the person in person. But still, people are forced to make decisions. You can argue with limited amount of information. And these decisions are very impactful. They change lives. And it's hard because I think all admission offices, all programs struggle with this is that we want the best students who will become the best doctors. But there's still growth that happens, life still happens, even more so an MD-PhD program, because it's longer.

Laurel: Right.

Dr. Chan: Yeah. So like Laurel, like, I remember calling you. I remember welcoming you to the program. And what I remember, and correct me if I'm wrong, but I think you were shocked. Because I remember you were quiet. You were happy. But also I think you were kind of taken off guard because you knew pretty early on.

Laurel: Yes, much earlier than I anticipated.

Dr. Chan: Yeah, and I think that, so just walk me through that. What started happening on your side? I mean, like were you like, "Oh, like this is great." Or like, "Oh, no, like, you know, now I have to make like, you know . . . "? Because like . . .

Laurel: Oh, no. Oh, it was . . .

Dr. Chan: . . . you know, you have Peter, you have like there's this move . . . yeah, life starts happening. So yeah.

Laurel: Right, yeah, I actually, that was another factor that I didn't mention, but was significant. Every place I applied to I sat down with Peter and I said, "Would you consider living here?" And so every single place I applied to was one where I had his A-Okay. And there wasn't any place that he said no to. But there were places I knew that he would say no to. Because I'm a suburb person, he is a city person. So they were places I looked at that were, you know, a rural medical school of, you know, 1,000 people in the town. And I knew that that wouldn't necessarily fly with him. But also that wouldn't . . . to me, it's not the best opportunity to see the most of medicine necessarily. So there were other considerations.

And you can take this however you will, but my first my non-Utah interview I had before Utah. And I went, and I had a great time. And I was like, "Wow, awesome. I'm so excited." And then my Utah interview happened a few weeks later. And I was like, "Oh, okay. So like, this is the school." And I felt really bad. Because I basically I told the people around me when I got home from the . . . because I knew with the first university, I wouldn't here until January based on the system. And so I got home from my Utah interview, and I told the people around me. And at that point, I think I was waiting to hear from like one or two more schools.

Dr. Chan: Yeah, like, "Maybe I'll get another interview offer." Yeah.

Laurel: Because there was other stuff that I could have gone to the medical school and not the MD-PhD program. But I basically I said no. And so basically, I came home from the University of Utah MD-PhD interview, and I told the people around me, "If I get offer from University of Utah, that's where I'm going." And then I got the call. What was it was like, two weeks later, maybe.

Dr. Chan: Yeah, yeah.

Laurel: And I think that's why I was quiet is because in my mind, I was like, "Oh, it's over. We're done. We did it." Which was oh, such a relief, because, you know, you spend years working for this one thing. And it was nice, because I was waiting on other things. And I basically was like, "Never mind, No, thank you." And then with the second look, I basically as soon as I had the date, so we bought tickets for myself and for Peter to come out. So he . . .

Dr. Chan: Had he ever been here before?

Laurel: No, he hadn't.

Dr. Chan: Okay.

Laurel: And . . .

Dr. Chan: Had he been west of the Mississippi?

Laurel: He'd been to California one time.

Dr. Chan: Oh, yeah?

Laurel: Yeah.

Dr. Chan: Okay, so it's a big jump like mountains and dry heat?

Laurel: Yes.

Dr. Chan: Yeah.

Laurel: And so that was something that was a little bit stressful because I have this, you know, this person in my life who I'm having to plan for both of us. And I told him was like, I think you're really going to like it. And he's generally . . . I make fun of him all the time for having commitment issues, which I guess he doesn't because we're engaged. But he's just a very deliberate person in certain ways. So sometimes I'll say, "Hey, we should go do this thing." And he'll go, "Oh, that could be fun." And I'm like, "It will be. It is fun." But that's just how he is. And so I was like, I really think you're going to like Salt Lake. And he was like, "Okay, I hope I do." And I was like, "Ugh." And so we came out for the second look experience. And it was funny. It was the . . . so we we're here . . . it was like Wednesday night, Thursday morning.

Dr. Chan: Yeah, they do it a little different for the MD-PhD students. They had you here longer.

Laurel: Yeah, it's a few more days. We went to Park City. It was the whole thing. But basically, it was like, the second night. We were in Utah. He was like, "Oh, so you have to come here?" I was like, "Yes." So he's job hunting right now for jobs in Salt Lake. And so . . .

Dr. Chan: Our economy is pretty good.

Laurel: Yeah. And he's in journalism. And so there's several stations. There's, you know, there's a major newspaper. It's something where . . . that was another thing where I realized that not only it's a great place for me, but it's also a very good place for him, because some of the other places I considered and then the other place I interviewed and could have gone to, I think it would have been a lot more challenging to find an opportunity for him.

You know, because that's the thing, I don't want to be one of those . . . one of those doctors who like, is just dragging a second person. You know, I've always felt and I've always told him that even though prioritization is a little bit different professionally. We say I'm work, he's play. I still think I will always want to value his career as much as I value my own. And so it's nice, because Salt Lake is . . . I like it, which is good, because I live here now. But I think there's a really nice balance of it's incredibly livable, but it also it's a city, and it's, you know, a state capital. And it's an airport hub. And he does political journalism. And so it's something where I live a block from the state capitol. And so there is a lot of opportunity that there wouldn't necessarily be some of the other places I considered and the other place I considered, I suppose.

So, yeah. So that's good. I think the hardest thing is that both of us are Southern people moving to the opposite side . . .

Dr. Chan: The west. Yeah.

Laurel: . . . of the country. But I mean, that's life. I looked into the Rhodes Scholarship, which would have been across the ocean. And so I think I was emotionally prepared to go somewhere.

Dr. Chan: So Laurel, just this has been great. And just the last few minutes to kind of bring this back, and if you feel comfortable talking about it. You know, we have The White Coat Ceremony coming up. Really special day, that's where all the students receive their white coats. They get cloaked in or hooded . . . no, no, cloaked cloaked into the field of medicine, you get your white coat. And it's really powerful, you know, event. And I'm just curious, because you kind of talked about your family and you had a falling out, it sounds like?

Laurel: Yeah.

Dr. Chan: Will I get to see them at white coat?

Laurel: Yes.

Dr. Chan: Or I see some of them? Or like, I mean, how's that going? And as you kind of embark on this next stage of your career, you know, I'm just curious about that. Yeah.

Laurel: I had the opportunity, because I was independent, to really establish my relationship with my family on my own terms. And my family has come a long way, and has worked very hard to sort of meet me in the middle. And so at my white coat ceremony, my parents are going to be there, and Peter's going to be there. And they have a hard time, a little bit with sort of what I want to do in trans health. But they're very, very proud of how hard I've worked for it. And that I'm going to be a doctor. And you know, there's that side of things.

And so it is sometimes I think that queer people with family, you have to sometimes you have to, it's very much to prepare for the worst, hope for the best. And so it's very interesting. It's a little surreal at times that I, like you said, I've had this whole journey and went through a lot. And it was difficult. But now, like you said, I'm having a white coat ceremony and my fiancÈ and my parents are going to be there.

Dr. Chan: Yeah.

Laurel: And . . .

Dr. Chan: Along with all your classmates.

Laurel: Yeah.

Dr. Chan: It's like the Super Bowl. It's like a special day.

Laurel: Right.

Dr. Chan: All of your hard work. I mean, there's a lot of hard work to come. But also, I feel like white coat is a great signifier of all the hard work you've done.

Laurel: Right.

Dr. Chan: To get to this point.

Laurel: It's a milestone.

Dr. Chan: Yeah, it's a very prestigious to get into an MD-PhD program at such an outstanding school. Yeah.

Laurel: Mm-hmm. So it's kind of unreal. It's really exciting. And I think like you said, the thing that's the most exciting about it is it's a beginning. And there's so much left to come. And I'm very excited for it.

Dr. Chan: That's awesome. Well, I'm looking forward to meeting them. And yeah, I'm looking forward to meeting Peter too. So is he here now? Or is he . . .

Laurel: He's still in Atlanta.

Dr. Chan: Okay.

Laurel: He's got a job in Atlanta, and he's job hunting. I sent him . . . I'm annoying. And I look on a job hunt for him. And I sent him links. And I'm like, "Have you applied to this yet? Have you applied to this yet?" So he's spending his weekend, just applying to like 28 jobs that I sent him for Pioneer Day when I was at home, so but he should hopefully, when, you know, just needs one job. And then he'll be here.

Dr. Chan: Cool. Well, Laurel, we'll have to have you come back on the pod after school starts and things get settled. And like, I think people will be very interested to kind of hear your journey, especially like, you know, two years of med school. Four to five years of PhD . . .

Laurel: We'll see how it goes.

Dr. Chan: I'm trying to read your face right now.

Laurel: I'm shooting for quicker.

Dr. Chan: Okay, all right.

Laurel: I'm a go-getter.

Dr. Chan: Maybe like the precious three year?

Laurel: Yeah, right.

Dr. Chan: Two year? Yeah.

Laurel: Actually, I've already done my PhD.

Dr. Chan: Oh, okay all right. You're just working on so. Yeah, but I think people want to hear more about your journey because it's very fascinating. It's very beautiful.

Laurel: Thanks.

Dr. Chan: And it sounds like it's been hard, but it's been worth it.

Laurel: Oh, absolutely.

Dr. Chan: And you've grown a lot. So well, thank you, Laurel.

Laurel: 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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