Jul 11, 2018

Dr. Chan: What is more difficult, applying to medical school or applying for a residency? Why is it important to be flexible? How do setting low expectations create less disappointment as a spouse of a medical student, and what is the Medical Student Alliance? Today on Talking Admissions and Med Student Life I interview Annie, spouse of a recent graduate 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 of Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: All right. I have another great guest today on our podcast Talking Admissions and Med Student Life. Hello, Annie. How are you?

Annie: Good. Thank you.

Dr. Chan: And now Annie is not a medical student, but she's married to one and we're going to talk about that. All right. So does he prefer Peter or Pete? Did you clarify this before you came over here?

Annie: He . . . with everyone he goes by Pete and I have always called him Peter.

Dr. Chan: Okay.

Annie: But now we have a son named Peter, so Pete's great.

Dr. Chan: Fantastic, okay. So let's start in the beginning. Like how did you meet Peter?

Annie: We actually met in junior high school.

Dr. Chan: Oh, okay.

Annie: We sat in English class near each other, and he always likes to say that I remember the guy who sat on the other side of him, but I don't remember him. So we met, yeah, in eighth grade and kind of went through junior high and high school together always knowing each other. And then struck up a relationship senior year of high school and kind of started hanging out. And then dated, yeah, for a while and . . .

Dr. Chan: So this is very prophetic. So if you were together since senior high school, you must've made decisions together where you're going to undergrad.

Annie: Yeah. So he . . . I actually wanted to go up to Utah State, had a scholarship up there but felt like I needed to be down at BYU, and he had signed with UVU. He was playing baseball there. So I knew if I went to BYU, I would be closer, and so I went there. He went to UVU. We dated for a year, and then he was off to serve an LDS mission for two years where we wrote letters back and forth and . . .

Dr. Chan: Where did he go?

Annie: He went to New Jersey.

Dr. Chan: Okay.

Annie: Yeah, somewhere in New Jersey.

Dr. Chan: All right. So you didn't have to worry about the letters getting lost in the mail per se?

Annie: Not really, no. And now . . .

Dr. Chan: Sending care packages were reasonable rates, yes?

Annie: Yes. Yes, they were. And yeah, now you can email. Back then the rules were a little different with missionaries. So we wrote physical letters, and I was looking through the book the other day and it was so fun to see like, "Oh, my gosh. We have a lot of history."

Dr. Chan: That's awesome.

Annie: So yeah, it's fun.

Dr. Chan: And then so when did you get married?

Annie: So we got married in December of 2010.

Dr. Chan: Okay.

Annie: I was able to graduate that same month and work through his undergrad, and then, yeah, we always kind of knew that medical school would be the plan.

Dr. Chan: Well, yeah. So that was my next question. Like so when did that . . . I mean, was that clear back in junior high school? Did Pete start talking about med school?

Annie: No. His dad's a doctor, and so I knew he always was interested in the field. But when he got back from his mission, he, you know, kind of dabbled in other things to make sure it's really what he wanted. And so I think it was maybe six months to a year after we were married that he for sure decided that medical school was the plan.

Dr. Chan: Okay. And do you come from a background of medicine or healthcare?

Annie: No. My brother actually just finished his residency or . . . yeah, finished his residency this last year. So he's just a couple of years ahead of us, but that's the only one from my family. I mean, you know, I have like great uncles or something but . . .

Dr. Chan: Well, the reason I was asking is, you know, it sounds like Peter comes from a background of medicine. When this discussion . . . when the decisions were being made, did you have any hesitation? Like, "Oh, you know, like there's . . ." Because there's an image of like physicians. And maybe like you gleaned some knowledge from Peter's family, but, I mean, were you hesitant at all?

Annie: No. His parents were very open about what it was like for them and that it wasn't an easy path. And so . . . but I knew I always said, "Whatever makes you happy. I want you to be happy. I want to be able to stay home and take care of kids." That's kind of what I always wanted to do. And so I wanted him to be in a profession where he was going to be happy and make enough money that he could support us that I could be home. So if doctoring was it, then that was great with me.

Dr. Chan: Right. So like you're all in? Like, "Oh, this . . . we're getting on the medicine train. It's leaving the station." All right. So he starts applying to schools. If I recall correctly, you know, he got into other schools, but he eventually ended up here.

Annie: Yes.

Dr. Chan: Like help us . . . like walk us through that. Was that really stressful?

Annie: It was.

Dr. Chan: Or was it more stressful applying to medical school or is it residency or is it just all different sorts of stress?

Annie: Totally medical school. We were talking the other day about the MCAT, and he said, "That was the hardest." I mean, and you think back to step one and step two and all those tests that you continue to take, but I think the MCAT was the first and it was really scary and, you know, we wanted the best score so that he could get into the best school and, you know, that was best for us. So we were actually waitlisted here at the U. And we were headed to Kentucky of all places and it was out of state tuition and it was really expensive, but I have family there so I was really excited.

Dr. Chan: Oh, okay.

Annie: I was excited to be near my brother and my nieces and nephews and so . . . anyway, we were putting it all in there and kind of waiting to hear back, and then we came to second look day, we heard I think right before, the day before second look day.

Dr. Chan: Yes, I remember that, yeah.

Annie: And I was able to come that year and come see it, and that really solidified for me that this would be a great place.

Dr. Chan: So our gain was Kentucky's loss.

Annie: Maybe. I don't know.

Dr. Chan: And we'll talk more about that when I . . . when you start interviewing for residency programs if he ventured forth out there. Okay. So you get into the U. And then you . . . did you guys move closer to campus? Because I remember you were originally . . . you know, you were down in Utah County.

Annie: Yes. We were down there for his undergrad, and our families are down there. He had some grandparents who were leaving on an LDS mission and were leaving a house up here in Salt Lake and asked us to take care of it. So that was another draw for the U was that we would have free housing for 18 months while they were gone. Well, free but, you know, we had to take care of the place and stuff.

Dr. Chan: That's awesome.

Annie: It was really nice.

Dr. Chan: So jumping from undergrad where, you know, both you and Peter are studying, it's fairly busy. Was it a big jump up into the medical school? I mean, like did . . . like what were his hours like? You know, were you seeing him far less? Did it just seem much more intense? Like how would you describe that?

Annie: Yeah. So when he was in his undergrad, he held a part-time job. I was working full time, but he actually . . . we had one child at that point, our daughter, and he would actually take her so that I could go into the office and work some time because I worked from home, but I would go into the office and he . . . I would say it was more like half and half of what we spent with our daughter. He spent half the time, I spent half the time. We had time together in the evenings. And so that was a huge change when we came to medical school, because that is not how it was. I transitioned out of working when we moved up here, and so I was home full time with our daughter. And he was at school full time. So I don't know if you want to hear like scheduling.

Dr. Chan: Yeah. I mean, like was it possible with the young child at home for him to study at home?

Annie: Yeah.

Dr. Chan: Or was he more of a library studier and then . . . like how many hours was he putting in a week?

Annie: So I'd have to calculate those hours, but his daily schedule was he . . . we had a little study at home, so he would leave before our daughter was up, which was smart because, you know, once the baby's up it's harder to leave. So he would leave before we woke up. So, you know, between 6:00 and 7:00 a.m. he would head out of the house, come to campus, study all day and then he . . . we knew that we could expect him home by 6:30, and that's when we had dinner together as a family and he would help me get our children down.

We had one child for a while, and then we had another. So he would help me get them down during first and second year, and then he would go back to studying. So we would have him between 6:30 and 8:00 was family time, and then once our daughter was down, he'd go back to it and put in a couple more hours that night before bed. So yeah, he was putting in a lot of hours, but I think the key . . .

Dr. Chan: Yeah, it sounds like a lot more than undergrad days.

Annie: Oh, for sure. Yes, a ton more. I think the key for us was just that we knew we could count on him for those. He said, "I will be home at 6:30." And I said, "I will have dinner ready and then we'll spend some time with our daughter and you help me get her to sleep," or our son when he arrived as well. "Help me get them down for bed and then you can go back." And so that was pretty typical. Just a couple of hours with him every day.

Dr. Chan: What did you do on the weekends?

Annie: On the weekends, as long as it wasn't a test weekend, he would usually say, "I will take off one night of studying." So a Friday night or Saturday night so that we could have a little date night whether it was out or in or whatever. So, yeah, he did that. He studied all day. Saturday was just like every other day to us. But then we decided that . . .

Dr. Chan: So he was out of the house though? He would come up here? Yeah.

Annie: Yes, he would, yeah. It was hard if he was home. We had a little study that had glass windows for a while so our daughter, you know, could see him.

Dr. Chan: And the children somehow do not realize that you need to study. They're like, "Let's play. It's time to play."

Annie: Yes. "Why are you here and not playing with me?" But then we moved and didn't even have a study in our next apartment, and so, yeah, he would just come to campus. It was just easier for him to focus while he was on campus. But then we decided together that Sunday would be a family day and a day for religious worship for our family. So yeah. He never studied on Sundays, and that was really nice. It was the one day that we knew we had all to ourselves as a family and . . .

Dr. Chan: Because a lot of the tests are on Monday. Not all of them, but I think most of them are probably on Monday so yeah.

Annie: And that made for a very stressful Sunday night, because he would start thinking, "Oh, my gosh. I spent the whole day with my family. I haven't even looked at what, you know, I'm supposed to do." But that was just a commitment that he felt like he wanted to make and . . .

Dr. Chan: Yeah. Would he start studying after the kids went to bed on Sunday or no?

Annie: No.

Dr. Chan: Okay, all right, all right.

Annie: No. He would get super stressed.

Dr. Chan: Because again, I've talked to various people with different interpretations. Sometimes it's like, "Oh, after the kids go to bed or when the sun goes down . . ." Kind of like, you know.

Annie: Yeah. Well, it's just whatever works for you, and that was kind of what . . . you know, I don't . . . he may have randomly at . . . sometimes, you know, if he really felt ill prepared but he would get stressed whether he was prepared or not. And so I just kind of took it upon myself to say, "Okay. Try to distract him, you know. Let's do something fun. The kids go down. You know, let's hang out. Let's watch a show. Let's do something so that you're not focusing on this test that you have tomorrow."

Dr. Chan: I love that, Annie, because I think inherently, you know, in relationships the other partner picks up signs and cues regarding stress and going through medical school is fairly stressful.

Annie: Yes, it is.

Dr. Chan: So like what were some of the things? You know, you kind of mentioned some, but like what were some of the things you did to help alleviate that stress?

Annie: You know, we . . . well, we laugh about it, but on Sunday nights I would always say, "I will give you a stress relieving massage." So we'd put the kids down. I'd rub his shoulders, scratch his head, whatever he needed, you know, and we'd laugh about it because . . .

Dr. Chan: Put on a little Enya.

Annie: Yes, exactly. Some mood, you know, music. But I don't know that that really relieved stress, but he knew that I was trying. And so I tried to distract him talking about other things and just remind him that, "Remember this is a commitment that we've made and you may feel stressed about tomorrow morning, but I am very grateful that you spent the whole day with us, with me, with the kids, with our families," that we would go and see on Sunday sometimes. So I'd just try to remind him and say, "You know, you actually are prepared. Remember you studied all Saturday and you studied all week." So just try to relieve that stress for him in any way because . . .

Dr. Chan: So I like how you said kind of distract him, so doing different type activities that were not necessarily medically related. So yeah.

Annie: Yes, for sure.

Dr. Chan: Did you help him study at all? I mean, did you like help like with flashcard creation or kind of quiz him, or would you kind of take the book and kind of . . . you know what I'm saying?

Annie: Yeah, no, totally. He would make his own flashcards. He felt that that was part of the studying and getting the knowledge ingrained, but he would help . . . he would hand me flashcards or like sheets of paper that he wrote tiny little things. And I can't pronounce anything, you know. I'm like, "This just makes me feel like an idiot when we're studying. I'm helping you study, but I'm like . . ." I start saying the word, you know, and he finishes it for me so maybe that helped, but yeah, I did quiz him when he felt like he needed it. And that was another fun way to spend time together, but he could still be studying and help me feel part of the loop, you know, of the things he was doing.

Dr. Chan: That's great. That's great. Now when second year started, you know, my perception . . . I mean, the jokes I make, I make a lot of jokes in my brain. So, you know, first year of med school, you're going like 35, 40 miles per hour, and then second year is like 50, 60 miles per hour in terms of like amount of material and things you need to cover, and then there's like . . . there's a pretty big test at the end of second year. Did you notice a jump in the studying or the stress, or was it pretty the same as the first year?

Annie: You know, his schedule was the same whether . . . I know classes change from like morning to afternoon or the other way around. His schedule was the same. He was gone from home. So that didn't really change. I think our life circumstances changed. We had a baby like during finals week of first year. So I was dealing with a new colicky, you know, little baby, and so I think that circumstance changed for me. I was busier than just having one child. But yeah. I do . . . and I especially remember the stress of step one approaching and that was really stressful and, you know, you could tell he was more stressed and maybe studying a little more. But I would say his schedule still stayed the same. He was very good about making sure that I had those two hours in the evening and the kids had those two hours with him. So his stress level's probably higher, but the schedule for us seemed the same so . . .

Dr. Chan: So talking about schedule, third year. So third year has a whole bunch of different rotations -- surgery, psychiatry, family medicine, pediatrics -- and they all have different cultures, different start times, different end times. How would you . . . did you like the consistency over the first two years or, I mean, how did you feel about it?

Annie: So that was hard because just as you're figuring out something it changes on you, you know. And I think that was . . .

Dr. Chan: So you get a rhythm going, yeah. And then it switches.

Annie: And someone asked me the other day like, "Which year was the hardest?" And I really couldn't say. I just said, "Every time there was a change." You know, when something . . . you know, when step one was approaching and maybe his studying had to go to a little more, that was hard. And then from second . . . when third year started and the schedule's all different, that was hard. There was just these transition times of trying to figure out what worked. And third year that happens every six weeks almost.

Dr. Chan: Yeah, four to six weeks it switches, yeah.

Annie: It just totally switches. So that year we kind of shifted gears, and I had to really be better about being flexible. And we didn't have a newborn anymore at that point, which was nice so that I could, you know, just do things with my kids, and if he could come, great, and if he couldn't, then we just did without him and . . . it's definitely a test of your, you know, ability to be flexible and okay with . . .

Dr. Chan: Yeah, it can be very disruptive because you don't know . . . well, you kind of know when he needs to leave the hospital. I mean, when he needs to get to the hospital in the morning, but at night my experience has been it's very variable. You know, especially during the rotations where there are procedures or surgeries going on because some . . . you know, you don't leave at 5:00. You kind of stay in the OR until the case is complete and things can happen in the OR and things can drag on much later. And then you're kind of at the whims of the residents or attendings kind of, you know, you're helping out the team, so yeah. I can . . . and then the weekends are completely variable so . . .

Annie: Yes. Yeah, it can be like a regular weekday every day of the weekend, which can be hard. I think one thing that helped as we adjusted into that is that I realized that he would do his best to be home when he could, and as long as I trusted him on that, that it wasn't like he was staying longer than he needed to . . . I know there were times when he'd come home and say, "Some of my . . . you know, the attending or whoever said you can go, you're free to go." And some of his peers would say, "I'm going to stick around." Just because they wanted to go the extra mile and show that they were really committed. And I think that was great, and yet I appreciated that he said, "You know what? The attending said I could go. I do my very best. I put it all in while I'm here, but if he said I can go, then I have a family that I can go home to." And I appreciated that just because I knew that if he could be with us, he would be, and if he didn't feel like he could leave, then I trusted that and that that was his . . . that was what was best for his education. And so I think that helped me to just feel like if he's not here, he wants to be, but he can't be. And so we would just move on and be okay with that.

Dr. Chan: Did you start forming opinions based on, you know, his availability and if he was stressed or, you know, how tired he was? Did you just start forming opinions about these different fields of medicine?

Annie: Yeah, yeah, for sure. I think I was a little scared with how much he enjoyed surgery. Like, "Oh, no. Don't enjoy this."

Dr. Chan: All right. So I mean, let's talk about that, yeah. So what did he like about it and, yeah, how did that go like when he talked to you about that, yeah?

Annie: Yeah. One of the things that we really looked for when he was through the rotations we started realizing who he was surrounded with and how he got along with them. And there is kind of a culture in each little, you know . . . he would go to, you know . . . some things he thought he'd really like and he would go to and say, "Yeah, I really didn't get along with the people there. They weren't my people, you know."

Dr. Chan: They weren't his tribe, yeah, yeah.

Annie: Yes, exactly. They were great people, they were fun to work with, but he didn't feel buddy-buddy. They weren't his tribe. So I think in surgery, you know, a lot of times they're kind of that athlete type, where he, you know, he was into baseball and he got along with those types of people and loved that, and he loved the OR, working with his hands and he just thought it was so cool to see everything that's going on. But in the end he just thought, "You know, I could do this. I would love it, but I don't know that I have to do it." And if that wasn't the only thing that he felt pulled towards that I said, "Let's continue exploring then. Because that's a very hard road. And if that's not . . . if that was the only thing that you felt fulfilled by and you really wanted to do it, I would be supportive. But if it's not, then let's explore some of the other options."

So yeah. When he went to family medicine, we did a rural rotation in Kenab, Utah, and he loved it. He was . . . and we always knew that that was a big possibility because his father and his grandfather and possibly his great-grandfather I think . . .

Dr. Chan: And possibly his great-great-grandfather.

Annie: Right. I think it only went to his great-grandfather, but they . . .

Dr. Chan: Who was William Ostler.

Annie: They were all family medicine doctors. And so he was really pulled towards that and always grew up thinking that's what a physician was. And so I was excited that he felt very fulfilled by that.

Dr. Chan: Did he . . . it sounds like he might've felt torn during third year because he liked other fields that were not family medicine.

Annie: Yes.

Dr. Chan: So I assume there was a lot of discussion with you about this because it's about . . . this is about career choice. It's about path.

Annie: It is, yeah.

Dr. Chan: It's about the future.

Annie: And figuring out . . . yeah. So we really tried to stay in tune with each other, to have him come home and tell me about his day and, you know, what he liked about the day. And I kind of saw a pattern that every time he had a great conversation with a patient is when he came home and felt like, "Oh, my gosh. This was the best day, is that I talked to a patient. I helped them through their problem." And so he would say, you know, family . . . people would say, "Well, family medicine is only this or only this." And he could say . . . and I could remind him that actually it's, you know, talking to people and helping them through their problems, whatever those problems may be. And psychiatry was a big pull for a while.

Dr. Chan: Oh, yeah. I remember talking to him about that, yeah.

Annie: Yeah, and he . . .

Dr. Chan: Well, there's a lot of psychiatry in family medicine. Yeah, yeah.

Annie: There is, yeah. Well, and I would remind him that.

Dr. Chan: Yeah.

Annie: You know, you can do a wider range of things. I think if he had went straight to family or straight to psychology he would've had a hard time because he wanted to do some other things too. And so I would remind him of that, that in family medicine there's a lot. You can even do OB. We explored that for a while because he was very interested in that, yes. There's procedures and there's counseling and, you know, a psychiatry aspect and all those different things so . . .

Dr. Chan: So a lot of discussions. How did the family weigh in at all, or did they keep good boundaries because . . .

Annie: His dad . . . yeah.

Dr. Chan: Okay. Because like, you know, like if you come from a legacy of a certain field . . .

Annie: Yes.

Dr. Chan: It's just different for people, and it's hard to kind of talk about it and navigate it and . . .

Annie: Yes.

Dr. Chan: And I'm not sure if they have like clinics that they envision Peter taking over one day or being in or being in . . . you know what I'm saying? So I'm just curious how that kind of played out?

Annie: We're in a good position because his dad's dad wanted him to come and join his practice. And his dad felt like he had better options other places, and so he didn't join his dad. And so he's very sympathetic to Pete in that way, in that he realizes that he didn't join his dad and so it may not be what's best for our family and for my husband Pete at the same time. They're all named Peter so it gets confusing.

He's very sympathetic to that, and he never wanted to put any pressure on . . . in fact, for a long time we were just like, "I don't know if he . . ." You know, Pete never knew. Like, "If I chose family medicine, would my dad want me to come practice with him because he never said anything?" And I think he was just waiting for Pete to make his own decision so that he didn't feel pressure at all. And once Pete was really all in on family medicine, then he said, you know, "If you want to come, you could join. You know, I'd be happy to have you." And he's been really nice about that.

So I think it's really open. There may be a place here. We'll see, you know, when we're done with residency if there's a place here. Or if there is somewhere else, then I think his family would be supportive of that. They're great.

Dr. Chan: Sounds like more decisions need to be made down the road. We'll see you . . . life is a winding road. We'll see what happens. All right. So third year is wrapping up. Peter's feeling really good about family medicine. You're feeling good about family medicine. What was your application strategy for residency? How did you guys approach that? How did you value certain things over others? What did you guys do?

Annie: So I was pregnant and due with a baby during interview season of fourth year, during residency interviews. So I went with him in July when I was largely pregnant. We went to the . . . there's a convention in Kansas City that all the family medicine programs . . .

Dr. Chan: The Super Bowl I call it, yes. Everyone is there from family medicine, yeah.

Annie: Yeah. And I knew that I wouldn't be able to go and scope out really things with him during the interview process, so I went with him to that and we had a list of things we wanted. He wanted a small community, because after going to Kenab in third year, we thought practicing in a rural community is definitely something that we could see our family doing. So we looked for those community based programs that were going to train him all the way around.

A lot of the other . . . some like academic programs focus more on research and maybe less procedures or, I mean, it just depends on the program, but we really wanted something that would give him a well-rounded training so that we could go anywhere and he would feel comfortable delivering babies or, you know, doing procedures or doing whatever if we were going to go rural.

Dr. Chan: So as a couple did you kind of go through all the booths together, or did you kind of like divide and conquer? You go your way and then you kind of, "Oh, yeah. I talked to them too. Let's compare notes." And oh, you know, and I know everyone's like pushing swag in your hands, I guess.

Annie: Yes. We got so much swag. We came home and gave it to our kids. But yeah, no, we stuck together. We had an idea of places that we wanted to see and locations that we were okay with and there . . . it's kind of nice because a lot of them . . . you know, all the Texas programs were down one aisle and all the Washington programs were down one aisle.

Dr. Chan: Oh, they recreated like the United States map that . . .

Annie: Well, it wasn't . . . yeah. I mean, sort of.

Dr. Chan: You could make that claim, Annie. You just say, "Yes. You know, they laid it out. It was the shape of the different states, the booths, you know.

Annie: No, that would've been cool though.

Dr. Chan: That would've been cool.

Annie: But no, they had all the whammy programs. So, you know, Washington, Idaho, western United States were kind of in one place, and then, you know, we went down the Texas aisle and we were interested in North Carolina for whatever reason. We've always thought that would be really cool to live there. So we went down and saw some of their programs. So we had an idea.

And we actually found some that weren't really on our list that we went and looked at. And so yeah, it was great to get a feel for going and talking and, you know, me being there, you really get a feel for how family friendly, and family medicine is great. I think almost every program's family friendly, but a lot of the people said, "Hey, if you're around and want to come to the interview, you are welcome. We will set you up with spouses for lunches so you can talk to them." And they were all very nice. And that helped us feel like, "Okay. These programs really are okay with us coming."

And one of our big questions was, "Do any of your residents have families?" Because we were pregnant with our third and we knew that we would be taking a family with us, and that was important to us that there were other residents, you know, who might be in our same position instead of just, "Oh, no, everyone here is single. You would be the only married guy with a family, you know." So that was nice to kind of get a feel for.

Dr. Chan: Awesome. So the big Super Bowl, the big events in July in Kansas City, and that really kind of . . . sounds like it helps kind of drive your decisions of, you know, what residencies to actually apply for. So how many did you apply for?

Annie: I think that we did 13.

Dr. Chan: Thirteen?

Annie: Yes.

Dr. Chan: Okay. So the interview offers start to trickle in. What was your strategy? Did you say yes to everything right away or . . .

Annie: So we put . . .

Dr. Chan: Or did you end up canceling some interviews or . . .

Annie: Yeah. I think we did. I think he did all the interviews. So I think five. I'd have to count them. Four or 5 of those 13 were in Utah so that . . .

Dr. Chan: Local programs, yeah.

Annie: Yes, local programs. And so I remember him putting his email on my phone so that his emails were coming through, and the second that he got an invite I would go on . . . because he was in a rotation where it was harder to get to his phone. So I would go on and schedule his interviews and so . . .

Dr. Chan: The power.

Annie: Yes, exactly. I was his secretary there for a week or two. So I went in and would schedule them and tried to figure . . . you know, we have like two or three programs in Texas, so I tried to get those in line with each other so that he could just have one flight down there, rent a car and drive around. So yeah. He got a bunch of interviews. I think we didn't end up cancelling any interviews. There were some that he thought, "You know, maybe I'm not as interested, but when it's already scheduled and . . ." You know, it'd be like one program down in Texas, and he was going for three. And so it's like, "Why cancel one when our flight's already . . ." You know? So and we didn't feel like we overdid it. I know we have friends who said that they applied to a lot more.

Dr. Chan: Well, I think there's just the anxiety that drives decisions because people . . . you know, and rightfully . . . it's a balancing act. So like people don't want to feel like, "Oh, I didn't apply enough." Because you need to apply . . . the more programs you apply to, the more likely you are to get interview offers, and the more interview offers you get, the more likely you are to match into the program you want to. So like there's like this algorithm that people tend to overshoot because I think that people are just very, very nervous about not matching, you know.

Annie: Yes. Well, and Pete got, you know, I think 12 interviews out of those. There was one place that didn't offer an interview.

Dr. Chan: Oh. That place, not so good. Yeah.

Annie: No, no.

Dr. Chan: This is Peter we're talking about. Yeah, yeah.

Annie: For whatever reason they didn't think he was an interesting applicant. I think he got waitlisted interview or something, so we only interviewed at 12. But yeah. That was . . . we interviewed at all of them and put . . .

Dr. Chan: And did you get to go with him to like at least the Utah ones?

Annie: I did go . . .

Dr. Chan: Because like there's usually a dinner the night before. It's an opportunity to meet like the spouses or families.

Annie: Yes. I think I only went to one dinner of one of the Utah programs.

Dr. Chan: Well, I hope Peter brought dinner back home to you. Yeah.

Annie: You know, so we had . . .

Dr. Chan: Or to-go order. Yeah.

Annie: Yeah, yeah. We had a daughter. I was just like up all night. You know, we had this brand new newborn, so it was a little harder for me to do anything. But I did go to an interview with him that was right before Christmas, and it was in Coeur d'Alene, Idaho, and so we dropped our kids off with my grandmother who's in Boise, and then we flew from Boise to Coeur d'Alene and so . . .

Dr. Chan: Yeah. Even though on the map it looks close, but that's actually very far. It's a really killer drive too. I've made that drive a couple of times, and it's not a straight shot. It's very windy, up and down and like 20 miles because you go through all these little towns. You have to drop down to 20 miles per hour and then, you know, so . . .

Annie: We're used to doing the trip to Boise though so . . . I have family there so . . .

Dr. Chan: That's a better straight shot, yes, yep.

Annie: So we went there, dropped our kids off, flew, went in for a day or two with our little two-month old attached to me and, anyway, we went. So I did get to go on that one interview. And then I went on a second look with him as well to one of our top programs that we were looking at in Indiana. And it was just far for us to be moving, and so we wanted to . . . I wanted to go and make sure that it was something . . .

Dr. Chan: Well, you were at our second look day for medical school. What does a second look day look like for a residency program?

Annie: It's different for every program. This program had specific days that they did, and they did like an Olympics. So they split you into teams, and you had a specific color you were supposed to wear and they had a big thing. They had a bowling night the night before and then Olympics the next day and . . .

Dr. Chan: Like Olympics as far as who can like remove this mole and stitch it up or like literally jumping into a swimming pool and swimming as fast as you can?

Annie: No, not even that. They called it the Olympics, but it was more like how many saltine crackers can you eat and, you know, like funny things. They put on like just like things that you make a fool of yourself, you know. Kind of minute to win it sort of things.

Dr. Chan: Oh, my goodness.

Annie: There was a taboo where you would . . .

Dr. Chan: Did they prep you ahead of time?

Annie: No.

Dr. Chan: Because if I showed up to . . . like I would think like, you know, people were wearing, you know, nice clothes and like it's a semi-formal event and . . .

Annie: No, no.

Dr. Chan: And then all of the sudden, like eat this, you know, we've all been there, Annie. Like I can devour a sleeve of Girl Scout cookies with the best of them, right. But like in front of other people . . . yeah, so . . .

Annie: We're like potentially . . . yeah. It was a little . . . I was . . . I actually had my daughter and I went and walked around the children's museum, so I missed some of it. But they told us that this is like a fun relay race kind of day, so wear tennis shoes and, you know, exercise clothes and they prepped us.

Dr. Chan: Did it help this program or not help this program?

Annie: They were a really fun program.

Dr. Chan: Oh, okay. Because I was about to say like, again, that's kind of different. It's a little on the weird side so, yeah.

Annie: And you get to know the people in a different way than you would in a more formal setting, but I think that was just their style. They like to be fun. Everyone there was fun loving, and so I think . . . some of the residents were like, they do it every year, you know. They were like, "Oh, this again?" And, you know, there was one girl on our team that was like, "I'm a poor sport. I'll admit it. I don't like coming, you know." And there were others that were like, they just live for this. It was so fun. Their team won every year, you know.

Dr. Chan: Well, you know, just jumping ahead a little bit. I hope Pete takes this knowledge, and he can maybe bring this to his residency program and just kind of . . .

Annie: Yeah, good ideas.

Dr. Chan: All right. So this is fascinating. Okay. So Peter's done with all of his interviews and like who's the keeper of the knowledge? Were you making an Excel spreadsheet? Was he taking notes? Like, you know, how did you come up with the list, the rank list? Like was it kind of multiple little just discussions over time, or did you have this one big meeting where it was like a date night and you just like talked about it, each program in depth? How did you guys do that?

Annie: Yeah, a little of each of that. After every program he would call me and we'd discuss it when he got home, and we kind of just naturally gravitated towards about five programs that we really knew were our top choices. And even beyond that, there was really, in the end there was really three that we were like, you know, back and forth, three, which order do we rank them? But really five programs and one night we just kind of gravitated that way. He did keep an Excel sheet, and, you know, I would put some input in it, and he did like a numerical ranking system. And so we looked at that, but we knew in the end we wouldn't go by the numbers, we'd kind of go more by our feeling.

So we took those five programs. We set out like the binder, folder things that they had given for us, and we had them all laid down on the floor and we kept switching the orders like, "Okay. So how do we feel about this one? And Pete, why is that one so high? Like when you talked to me after that interview, you didn't love it. So why in your mind are you coming back to it and ranking it so high?" And so we went back and forth a little bit and even I kind of was like set on one program and I was like, "He's going to come around. This is number one. I know he's going to . . ." And he didn't. He ended up saying no. That one ranked number two, which is funny because I was just certain that that's where we were going to rank . . . we were going to rank that program number one, and we would end up there but . . .

Anyway, he went to a second look at another program and loved that one.

Dr. Chan: No Olympics though.

Annie: No Olympics, no. And they didn't even have a formal second look. So he just said, "I'd like to come back for a second look." And they said, "Great.

Dr. Chan: As Dean of Admissions I know that well. Yes, yes.

Annie: Yes, yeah. And so he just said, "Great. We'll accommodate you." And he actually . . . his dad went with him on that trip.

Dr. Chan: Oh, fun.

Annie: Yeah. Because it was the place that I had already been and so . . .

Dr. Chan: Okay.

Annie: I had already seen it. So he went back with him, and they enjoyed themselves.

Dr. Chan: It sounds like a great movie in a way. Here's my dad. Yeah, that's okay. All right. So I'm okay. So you only ended up ranking five?

Annie: No, we didn't rank five. We just had a clear chalk line.

Dr. Chan: Okay. Because I was about to say like, "That's gutsy, you know." Yeah, okay.

Annie: No, no. We ranked every program that he interviewed at. So we ranked 12 programs. But there was just . . . for whatever reason we just had a clear five in our mind that we knew and even a clearer three. We knew four and five would be down there and that three would, yeah . . . we just had to order.

Dr. Chan: Did you have access to the list, the official list? I mean, would you log in?

Annie: I didn't. He had it on his phone, and he joked about just giving it to me and letting me do it and then being surprised.

Dr. Chan: There are some people that do that.

Annie: Yeah. I think if he had been really undecided [inaudible 00:31:55].

Dr. Chan: Every relationship is different. Every couple is different, yes.

Annie: No, he came home from one of his second looks and said, "This is it." And I said, "Okay. That's great. I'm happy with that." And so we ranked that one number one and then the other one number two and number three.

Dr. Chan: So it gets submitted.

Annie: Yeah.

Dr. Chan: You know, and obviously it takes a month to run the computer algorithms, which I totally think is hogwash, but, you know, I don't know why they make everyone wait a month. During that time, second thoughts, really anxious, or is it, you know, you guys are cool as ice?

Annie: Well, I think he felt, you know, anxious. There's always that like, "Oh, my gosh. I ranked them one and they said they would rank me one but did they, you know." And there's always kind of that, but we were comfortable with all our top three. A lot of the programs and most of the programs we interviewed at we thought we could be happy here. These are great programs. And the fact that we had a hard time numbering those three meant that we were going to be happy at any of our top three. And for family medicine that's very likely that you'll . . . I know for the U students, they will match in their top three.

Dr. Chan: Especially someone who's awesome as Peter. Peter is awesome. He's super awesome, yeah.

Annie: Well, we felt pretty good that one of those top three would be ours and even that our number one would work out so . . .

Dr. Chan: All right. So the Monday before match day he gets the email that he did match?

Annie: Yes.

Dr. Chan: Were you worried at all leading up that, or you felt pretty [inaudible 00:33:12]?

Annie: Not really.

Dr. Chan: Okay, all right, all right. So it's kind of a formality, yeah, okay. All right. So match day's on Friday. You guys sleep the night before, anxious or . . .

Annie: You know, I didn't expect to, but we were . . . he was tossing and turning and I was too. I just didn't sleep that well. It's kind of like the future just hangs in the air, and you can feel it and you just couldn't sleep that well. So we kind of tossed and turned all night.

Dr. Chan: All right. Match day. Who's there? Is the legacy of all these physicians there from his side of the family?

Annie: You know, Pete's grandfather passed away a couple of years ago, so he wasn't able to be there, but . . .

Dr. Chan: He was there in spirit, yeah.

Annie: He was there in spirit, yes. And his parents came, my parents came. Our kids were there. We wanted them there.

Dr. Chan: Eating sugar and going crazy with all the snacks? They had a lot of treats there. Yeah.

Annie: They had some, yeah. Yes. Yeah. So we were all there just ready and excited, and everyone I think knew what we had ranked number one, so they . . .

Dr. Chan: Oh, okay. So that wasn't a secret from the family?

Annie: Not really.

Dr. Chan: Okay.

Annie: I mean, initially I think Pete was like, "I didn't want to." But he felt pretty confident that it was going to . . . and even if it wasn't, we were okay with our families knowing that it was our second choice. I don't think we were worried about being too embarrassed or anything that we didn't get our top choice. They were all good programs.

Dr. Chan: Bunch of speeches and they cut the red ribbon.

Annie: Yes. Torture.

Dr. Chan: So what was Pete's MO? Did he just go up there, grab the envelope, come back? Did he open it on his own? Did he have you open it? How did that unfold?

Annie: No, he just went and grabbed it. He was holding our son. He went and grabbed it, came back.

Dr. Chan: Had your son open it? No.

Annie: No. No, no. He was just holding him, opened it and kind of said, you know, "There it is."

Dr. Chan: Okay. Very much matter of a fact, yeah.

Annie: Yeah, yeah.

Dr. Chan: Oh. I love that, Peter. All right, so, all right. So where are you guys going?

Annie: We're going to Coeur d'Alene, Idaho.

Dr. Chan: Coeur d'Alene.

Annie: Yes.

Dr. Chan: Awesome.

Annie: It's called Kootenai Health.

Dr. Chan: Kootenai Health? All right. So tell us why. Sell the program. Why was this your top choice? What did you like about it? What did he like about it? What did you like about it, you know?

Annie: Well, I think what made it so perfect for us is just because of our story. We both grew up here in Utah. We thought for a while that we were going to leave for medical school, but then ended up staying. It's so wonderful to be near family. We've both grown up here though and wanted a little last adventure. You know, we felt like we could settle here, but we could like it elsewhere and we don't really know until we try it elsewhere. So we were really hoping, I think, to leave for a residency, just because it's three years for family medicine. We knew it could be three years gone and then if we want to come back, we can.

So we looked at programs all over the country, including the Utah programs, which was hard to not rank. They're great programs, all of them here in Utah, but we just felt like for a family we wanted to leave. But then we started looking at these programs in Indiana and Pennsylvania and they are far. And it's like, "Oh, my gosh." When we flew there, we know there's a layover. It takes a whole day to get there, and I thought about doing that with three kids on my own if he couldn't come. So Coeur d'Alene started looking better and better because it's close to home, close-ish, right.

Dr. Chan: Yeah. It's the west.

Annie: But yes. It's still in the west. But it's still a way from Utah, which is . . . not like there's anything wrong with Utah, but just for our circumstances we wanted to have a little adventure for our family so . . .

Dr. Chan: Lots of fine outdoor stuff to do up there. It's gorgeous. Yeah, yeah.

Annie: It's so gorgeous. We visited the week before Christmas, so it was cold. The snow had actually just melted, but they had had snow and, you know, not . . . it was still beautiful. The lake was still beautiful, the mountains there and so anyway, we loved it. And when he went back for his second look in February, again it was freezing, but he hiked around in the freezing cold weather and just loved it. It's beautiful up there.

Dr. Chan: I'm so excited. All right, Annie. Last few questions. This has been great. First question. As you look back, as people are listening to this podcast and their loved ones are going to go to med school, what advice would you give them? How do they support them as they kind of go through this journey, this process? That's admittedly very roller-coaster-ish, right? There are good days and bad days and peaks and valleys, and what's some advice you would give those people?

Annie: Well, looking back and especially through like this residency process and all through medical school I think my mindset was never that it was his experience. It's our experience. And I think that has helped me to not feel like, "Oh, he's off studying and enjoying and learning all these new things, and I am doing whatever it is that I'm doing." For me it's being home with the kids. For someone else it may be working their own job or being in medical school themselves. I know we have a lot of couples that are both in medical school. But whatever it is that you have that . . . his thing is not more important than my thing. This is our journey together. Medical school has been our experience. And I think that's helped me support him in that it's . . . I want him to do well. It's not that he's choosing medical school over being with me or anything. It's that this is our experience, and I want him to do well so that our family can continue to do well.

I think that's helped. It's hard. For us I think expectations have been a big deal. We didn't come in blindly. We had family come through medical school and residency and said it's hard. It's not easy. And I think talking to some friends we said, "Expectations are everything. If you set your expectations low that it's going to be super hard, then you can be pleasantly surprised when they show up a little bit earlier than expected or when they don't have to study quite as hard for a test." But we just kind of . . . I mean, low expectations but just that expectation that it's going to be hard. I think that's helped.

Dr. Chan: Did the discussion ever . . . I mean, and I know, I think this happens a fair amount. Did the discussion ever, kind of is like, "Oh, you know, maybe this isn't the right path. Maybe I made a mistake or . . ."

Annie: Honestly, all the time.

Dr. Chan: Okay.

Annie: And that's part of his personality.

Dr. Chan: Yeah, and what do you do? What do you do? Again, like all relationships, all marriages, you know, everyone's a little different. And I think there's always this tactic. You know, at least, you know, in my personal life. You either plan A, just listen, or plan B, you offer solutions, or maybe C, a little bit of both.

Annie: Yeah.

Dr. Chan: You know, and I think every couple kind of navigates this because sometimes you don't want to . . . like someone to like . . . they just want you to listen. You don't want them to like offer solutions, you know. So what would you do?

Annie: Well, I really can't offer solutions, you know. I'm not like, "Oh, well, you should go back in there and, you know . . ." I think I just have never gone through this.

Dr. Chan: I have this personal belief that Peter still can make it as a baseball pitcher, you know. So I don't know if that ever . . .

Annie: He might be a bit rusty after all these years, but . . .

Dr. Chan: It's like, "Oh, Pete, let's go down to tryouts, you know, with the Bees, yes."

Annie: No, I always . . . he . . .that's . . . Pete's personality is just he does have moments of self-doubt, and I think just listening to him, and then he needs a good reminder to say, "You know what? You're awesome and you're going to be okay."

Dr. Chan: Okay.

Annie: And there were lots of moments and, I mean, I hope people don't think that because you're going through this and you're questioning because it's a big deal. You're in a lot of debt. You know, we've moved our family up here. There's a lot of sacrifices that we've made and to say . . . for moments of him saying, "Oh, my gosh. This is not what I want, you know," that's scary.

Dr. Chan: Yeah, this was really hard, or this was . . .

Annie: This is hard work, yeah.

Dr. Chan: Yeah, yeah, it's . . . yeah. And to me it's like when you're like . . . it's not just like the academic. It's also just like watching people die.

Annie: Yes, yeah.

Dr. Chan: And dealing with jerks in the healthcare system or dealing with a very bureaucratic system and interacting with insurance companies. I mean, there's all these things that comprise the field. That's very frustrating.

Annie: Yes, and I think there were lots of moments when he just said, "Oh, dear, is this what I really want? And I'm kind of too far in now." But I knew. I had deep convictions that this is the only field that he would be happy in and that he would feel fulfilled in, and that helped me when he started questioning, to not feel like unsettled like, "Oh, my gosh. We moved our family and we have all this debt and he's questioning this." I knew that this is what he would be best at.

Dr. Chan: So you were kind of just . . . you were just very reassuring, right?

Annie: Yeah, I just tried to listen and . . .

Dr. Chan: Talk him down just a bit, okay. Let's not make any big decisions tonight, yeah.

Annie: Yes, exactly. Let's sleep on it and wait till the morning.

Dr. Chan: Yeah, let's not email the dean's office saying you want to withdraw from medical school.

Annie: I don't know that he ever got to that point, but there were just hard times in him feeling that way, and I just reassured him, reminded him that this is the best thing and it's okay to have these days and feel like I'm not sure if I like it today. And that's okay. You're not going to like your profession every single day. You know you're going to have days of not being so happy with it. Hard days.

Dr. Chan: Well, I'm glad he has you as partner. All right. Last, let's talk about the Medical Student Alliance. Am I saying that right?

Annie: Yes.

Dr. Chan: The MSA.

Annie: MSA, yep.

Dr. Chan: MSA, all right. So let's . . . like what is this organization? What's your relationship to it and let's talk about it?

Annie: Okay. So the MSA, the Medical Student Alliance is organized under the UMAA, which is the Utah Medical Association Alliance. So it's like the spouses group of the UMA. And they do a lot of legislation and, you know, lobbying and that kind of thing, so they're involved in the policy and, you know, just trying to get the best things worked out for the UMA. And then . . .

Dr. Chan: When you say lobbying, so they're lobbying the state legislature or the med school itself or . . .

Annie: No, the state legislature which . . . I mean, and really I haven't been involved in that at all. I should be, but with three kids I keep busy enough. But there's lots of good just things, you know, when things are important to Utah that they go up there and lobby and make sure that what's best for the medical profession is what's happening up at the capitol. But beside that the student association . . . I mean, at a student level we just provide a support group. We're spouses and significant others. We get together, we have social nights, play groups for people with kids. We have a date night in February where we have a panel of doctors come and talk, and they just talk about strengthening marriage and relationships during the medical training because it's a hard time. And so yeah, I've made some of my best friends through the Medical Student Alliance and . . .

Dr. Chan: And this is open to men and women? Yeah.

Annie: It is. Yeah. We really haven't had that . . .

Dr. Chan: And do you have to be married or just okay a partner, significant other? Okay, all right.

Annie: It's predominantly wives that take to it. But that's just because that's who's usually interested in it the most.

Dr. Chan: Men tend to be lone wolves. Yeah, much to our detriment I guess you could say, yeah.

Annie: Well, and they . . . and we would . . . I do always get a few . . . I've done recruiting trips the last couple of years, and I do always get some medical students who are women who come and say, "I have a husband and I think this would be great for him." But I don't know if that's them saying this would be great for him, or if they would really be interested. You know, it's because it's never really turned into much, but all it takes is one husband to come and say, "Hey, I want to put together a pickup group, you know, where we go play pickup basketball or . . ."

Dr. Chan: Or play video games.

Annie: Yes, or play video games or have . . .

Dr. Chan: Sorry. I'm being very stereotypical here. I just had these images of like male activities.

Annie: Yes. Well, whatever it is.

Dr. Chan: We'll go watch that action adventure movies, yes, yeah.

Annie: Yeah. Our wives are studying. Let's go out and do something fun. So it just takes one and that's kind of the nature of MSA is that we pass on the presidency every year, and the board rolls over and everyone's in new positions. And so it kind of just depends on who's there and what they want out of it. I know in the past there's been cooking groups and book clubs and different things, and it's just whoever takes the lead and does it.

I came in as a second year. I coordinated the play groups because I had kids, and so every month we'd go out and do something fun, get out together and whoever wanted to come with their kids could come. The next year I was the co-president elect. So I was gearing up. I planned some of the big events and gearing up to be the president this year, and that's what I've been doing this year is being a co-president with one other wife, and we've just been . . . try to plan things and be a support group and do fun things and just be there for each other. It's a hard time and we all . . . it feels better when you have friends, you know.

Dr. Chan: Yeah. And I get like just like how med students reach out to upper classmen and women to kind of give them counsel, advice on the road ahead. I get the sense that with this, you know, if there's, you know, partners, spouses, husbands that if there's advice to glean like, "Oh, you know, you're about to enter third year, you know. This might happen or this might happen or you should kind of approach it like this."

Annie: Yes, exactly.

Dr. Chan: Yeah. So I see that incredibly valuable, you know.

Annie: Yeah. Well, and especially . . . I mean, when I . . . when we were looking at financial things . . . even I just would find someone who's been there and done it before like, "Okay. You have kids. We have kids." Oh, sorry. I just moved that microphone.

Dr. Chan: It's okay.

Annie: We have kids. We are trying to figure out, you know, how to navigate this and they . . . it's such a great resource. So friendships, just that, yeah, advice can be passed along. So it's, yeah, it's great. It's informal, it's fun and we just, yeah . . . it's a good resource that not very many people know about, so we'd like to get the word spread.

Dr. Chan: Yeah. I'm glad you can plug it, you know. And I think, you know, we're not in this alone, and I feel bad because like, you know, I've gotten feedback like, "Oh, you should start interviewing like significant others, spouses." And I just go, "Oh, that's a great idea, you know." So, you know, it takes a village to take . . . you know, when you treat patients and when you treat patients, it takes a healthcare team, it takes family as physicians become doctor . . . I mean, as medical students become doctors it takes so many people along the way, and no one does this alone. So the thing I'm sad about is Utah's loss is Idaho's gain, and I'm just so excited for you guys to have this like next chapter in your life, and I really hope you guys end up back in Utah too. Yeah.

Annie: We'll see.

Dr. Chan: And I do Idaho stuff a lot, so I haven't told Peter this yet though, but like I want to open up Coeur d'Alene for more of our med students to do rotations up there. So this is going to be my little tip of the spear, you know. Yeah.

Annie: That's great. It's a new program. It's fairly new, and I think that there's, yeah, a lot of room for that type of thing. I said that to Peter the other day, "I think you could come in and you have a lot to add to this new program. You have some great ideas and things." So I'm sure he'd be happy to get involved.

Dr. Chan: So I think that the danger's going to be when he graduates. They're going to, "Oh, would you like to stay?"

Annie: Well, I could see us up there. It's so beautiful. So we'll see.

Dr. Chan: Yeah, you'll have to cross that bridge when you guys get to it, but these are great options. This is great. The future is so bright. All right. Well, Annie, thank you so much for coming in.

Annie: Thank you. It's fun to be here.

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 Scientist Radio online at thescoperadio.com.

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