It’s so important for medical students to share their stories [PODCAST]

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“As a medical student, you find potential patients everywhere. Whether you’re on an airplane or on a romantic dinner date, we’ve all heard those famous words, ‘Is there a doctor in the house?!’ Here are some of my favorite ‘patient’ encounters.

The best friend curbside. I was playing ball with my boys – that’s right FIFA on the PlayStation – when my buddy drops the question, ‘So listen man, you’re a doctor, right? I need some advice about my knee; it’s been killing me! I landed weird after jumping during soccer the other week, and now it’s been aching ever since.’

Assessment and Plan: 27-year-old man, clearly delusional as he thinks I’m a doctor, presents to FIFA night complaining of right knee pain. Obviously, he should rest, ice it, use compression, and elevate the leg, right?

He continued, ‘So I went to my primary care doc, and he told me to rest, ice it, use compression, and elevate the leg! Isn’t that the dumbest thing you ever heard?’ Uh oh, I couldn’t blow my cover, ‘Yeah totally … maybe you should get that checked out!'”

Daniel Azzam and Ajay N. Sharma are medical students and founders and editors-in-chief, Diary of a Medical Student.

They share their stories and discuss their KevinMD article, “As a medical student, you find potential patients everywhere.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have AJ Sharma and Daniel Azzam. They are medical students and co-authors and co-editors of Diary of a Medical Student. Daniel and AJ, welcome to the show.

Daniel Azzam: Thank you so much, Dr. Pho. We’re happy to be here and happy to share our voice and share the voice of so many medical students in our book.

Kevin Pho: AJ, we’ll start with you. So can you share your story and your journey to where you are today?

Ajay N. Sharma: Yeah, absolutely. So originally I’m from Canada, and I grew up there and then also in Sacramento, where I did my undergraduate training at UC Davis. I then migrated down to SoCal, to UC Irvine, where I’m now completing my MD/MBA degree at the School of Medicine and School of Business here. I’m planning to go to dermatology residency, and so I’ll be applying in around a month, which is a pretty exciting time, I think, for all of us. And it was also at UC Irvine where I got to meet, both in the classrooms and on the soccer fields, my good friend Daniel Azzam.

Kevin Pho: Fantastic. And Daniel, can you share a little bit about your journey and your story?

Daniel Azzam: Absolutely. So I completed my undergraduate training at UCLA in neuroscience, biomedical research, and Spanish. I then went on to pursue my MD/MBA, just like AJ, at the UC Irvine School of Medicine, where I’m currently finishing up my final year before following my dreams of pursuing an ophthalmology residency. I would say definitely the highlight of my years in medical school was when AJ and I co-founded Diary of a Med Student, which is a medical humanities nonprofit encompassing our new book, which compiles more than 200 stories from over 50 medical schools across the country. We just published the book this week on Amazon and Barnes & Noble, and our article on KevinMD is an excerpt from the book.

Kevin Pho: Wonderful. Let’s go right into that article, Daniel, “As a medical student, you find potential patients everywhere.” Now, for those who haven’t read that article, can you walk my audience through it and share the story of why this particular excerpt was the one you decided to share?

Daniel Azzam: So this all started when AJ and I were newly minted third-year medical students, and we were working long hours on our medicine wards. We had come home as roommates to our apartment exhausted, but the moment that we would look at each other and say, “You’re not going to believe the day that I just had,” that was when the excitement all came back to us. And so that really became our routine. We loved doing it; we looked forward to it every evening. We started sharing our stories with some of our classmates, and we were met with so many more of their stories in return. To all of us, this was therapeutic, and it made us feel that we were not alone.

And so that’s really when we started to dream. We wanted to create a safe space for med students across the entire country to reflect on their emotions and express them as the tales of joy, sorrow, humor, and inspiration. And really, that’s how Diary of a Med Student was born. We were blown away by the excitement that our project was generating, including garnering support from Sketchy Medical, OnlineMedEd, Boards and Beyond, and Dr. Abraham Verghese, and we decided to turn our project into a nonprofit, dedicating 100 percent of the proceeds to our scholarship fund for medical students.

This story takes on a more humorous light, reflecting on that feeling that we get as medical students when we’re going about our daily lives, and in different scenarios, somebody asks that famous question, “Is there a doctor in the house?”

Kevin Pho: Excellent. And AJ, can you tell me more about some of the other stories that are in the book? What are some general themes that you’re detecting from the medical students today?

Ajay N. Sharma: Absolutely. So I think what’s so unique about this book particularly is that it captures the feelings that we go through during our training at this time in history. And I say this time in history because I think everyone can appreciate how unique of a year 2020 has been, and I think that definitely reflects in our book as well. So in terms of some overall themes that you might see in the book, I think one of them obviously is the effect of the COVID-19 pandemic on medical training and how that’s affected the experiences that medical students go through, whether that’s good, whether that’s bad, whether that’s simply just different. It’s really interesting to see how that has affected training in today’s world.

And I think that similarly, the growing knowledge of inequalities in health care that often stem from systemic barriers and racial inequalities that have been around for so many years, I think that’s another theme that you’ll find is very prevalent in the book as well. A lot of experiences that medical students have that perhaps we ourselves can’t relate to are reflected in the book, and I think that’s what can be so valuable from reading the stories from other medical students. You really get the chance to see what they’re going through, how the current events have affected their training, and what it means to them to be a medical student and a physician in training.

In addition to overall themes that I think every medical school goes through, like imposter syndrome or feeling like they’re drowning in work, but also humorous things, like not knowing if you gave the right presentation or if you missed anything important when you’re talking to an attending or a patient, you also get to see how today’s society in 2020 has really transformed the medical student experience.

Kevin Pho: AJ, so could you give us a little bit of a sneak preview of one of the stories? How has COVID-19 specifically affected medical school training?

Ajay N. Sharma: I think we can all kind of appreciate what it might feel like when you see your first patient. Your first day of third year, you’re all dressed up to the nines. You got your tie sharp, your white coat clean, your chest out. You’re ready to go see that first patient when you walk through the door. But with the 2020 pandemic, your first patient isn’t through a door; it’s going to be through a webcam. And I think that difference is quite huge. When you’re in your first and second med school years, you don’t practice through Zoom, you don’t practice through FaceTime; you practice in person, because that face-to-face is so important in the doctor-patient relationship. So to hear a perspective in the book, for example, where a student’s first patient experience is through Zoom, and it’s through a webcam, I think it just goes to show really how much the pandemic has changed both the lives of patients but also the lives of students and doctors as well.

Kevin Pho: Daniel, can you share some of the challenges medical students are facing, and if some of those challenges are reflected in some of the stories that they’re sharing in the book?

Daniel Azzam: I think some of the challenging themes in general, being in the medical world, have to do with some of the things that AJ was touching on, which are really burnout. It’s a prevalent thing that we’re facing these days, and physician wellness has become so much more important. At the beginning of medical school, we found that people in their first year were often feeling this sense of imposter syndrome, feeling like they don’t belong there, everybody else is better than me, and just this negative monologue that’s going through their heads. And we found that a lot of the things that people are going through have to do with the fact that they don’t realize that everybody else is going through the same thing at the same time, and so many have gone through this before.

We found that many of the stories reflected a lot of general themes, in the anatomy lab, my first patient, and just really honing in on the early stages of medical school, about what does it mean to take care of that first patient that you experience. And then we found that a lot of the stories, especially from some of the older medical students, were really taking a step back and looking at the big picture outside of medical school, realizing that, “Hey, I’m a human. I have a personal life too.”

One of my favorite stories kind of takes you through the perspective of the partner, and it’s talking about how the partner never gets to see me, my partner always misses me, they wonder where I’m going to be, all of that. And then in the end, the funny little touch there is that the partner was actually the medical student’s dog. So it just kind of shows that we’re human; we have a life outside of medicine. And it was really touching for us to see that medical students are starting to really hone in on that and express that and share that with others.

Kevin Pho: We’re talking to Daniel Azzam and AJ Sharma. They are the co-founders and co-editors of Diary of a Med Student. AJ, I have a lot of medical administrators and medical educators who listen to this podcast. From a medical school perspective, do you have a message for them? Are there any areas of medical education that could be improved today?

Ajay N. Sharma: I think that’s the really, really important question, Dr. Pho. I’ve had some great experience working with medical administration. I was humbled to serve as class president for four years in my medical school training, and I think with that experience, I was able to appreciate both sides: what it’s like to be a medical school administrator and the challenges they go through, while also the challenges of a medical student and what they go through. So I think what’s really, really important is to understand that the most important patient is yourself. And what I mean by that, and how that can relate to medical administrators, is that the students have to be supported and have to feel well and healthy in order for them to succeed, both academically and also with their patients.

So I think a lot of schools have the right intentions in scheduling different activities for wellness, for example, wellness lectures or wellness events that are mandatory, in the attempt to improve morale and to improve the overall feelings of medical students. And I think, again, those are very well-intentioned, but sometimes it adds perhaps just more hours to a very busy schedule of a medical student’s day. I think what would be extremely helpful is to have maybe one or two days of leniency, where if a medical student really needs to take a day for personal issues or personal reasons, the medical schools themselves are very supportive of that. They understand that life goes on in medical school, and things don’t stop just because you have Step 1 coming up in a couple months, or your exam, or your shelf exams coming up the next day.

So I think if administrators and medical education can really just understand that medical students do have so much on their plates, and sometimes simply just a rest day is needed, I think that can be so valuable for medical students across the country in improving their wellness and morale, and really at little or few costs to the medical schools as well. I think medical schools are doing a great job. I think medical student wellness and physician wellness is something we’re learning a lot more about, but I do think that there’s room to grow, and I think that we’re all on the same page in wanting to create the best new crop of future doctors that we can.

Kevin Pho: And Daniel, you’re in your last year of medical training. What kind of advice do you have for people who are just starting their medical journey, or even aspiring medical students?

Daniel Azzam: I would say remember that we’re all in this together. You’re not alone. One of the things that we learned was that burnout is a very real thing, and one of the best things that we believe you can do to prevent that from the earliest stages is to lead a purpose-driven life. We found that part of what helps us to find purpose and draw meaning out of every interaction that we’ve had in medical school, and everybody we meet, is really training ourselves to reflect on all the experiences we’ve had, and to remember to reach out to others.

Here at Diary of a Med Student, we are always free to chat with you. Reach out to us at [email removed by the editor]. We really want our book, and we want people to continue sharing how they have in our book. We want to spark a powerful domino effect of change in medical education across the country, making physician wellness a core competency for doctors in training.

Kevin Pho: And my final questions to both of you. AJ, we’re going to go first. What’s your take-home message that you want to share with the KevinMD audience?

Ajay N. Sharma: I’d say my take-home message, Dr. Pho, is to not be afraid to share your story. There really are a lot of people you can lean on, whether that’s friends, whether that’s family, whether that’s your medical school administrators, whether that’s even a couple of random guys from UC Irvine medical school, where you want to email Diary of a Med Student. Know that you’re not alone, and that by sharing your story, you can really feel like a burden is off your shoulders and that you can move forward with the most positive experiences in medical school and your life. So don’t be afraid to share your story. Reach out and ask for help if you need it.

Kevin Pho: And Daniel, do you have a take-home message?

Daniel Azzam: Yeah, absolutely. I would just add: Always pause and reflect. Try to think about how you feel from your interactions, and try to take home the lessons that you can from those. Always remember that you’re not alone, we’re in this together, and there is a therapeutic value and a unifying comfort to sharing your stories with others.

Kevin Pho: And Daniel, how can people reach Diary of a Med Student?

Daniel Azzam: Yeah, you can reach us at [email removed by the editor], or go to our website, www.diaryofamedstudent.com.

Kevin Pho: All right. Thank you to both of you for being on the show, and thanks for sharing your insight.

Daniel Azzam: Thank you so much, Dr. Pho. Have a good one.

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