Why medical students should not let medicine define them [PODCAST]

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“Doctors are indeed noble for what they do. Their work is undoubtedly physically intense and emotionally taxing. But the notion that they are ‘superhuman’ and ‘different’ from the rest of society is exactly the trap that we fall into the moment we don our white coats as medical students. It is because of this trap that we get tunnel vision and let mistakes during our medical school training define our self-worth. We forget that there is a world outside of our flashcards, PowerPoint slides, exams, and clerkships teeming with people, adventures, and stories that, if we so choose, we can enrich our lives with, intellectually, physically, and spiritually.

There’s a reason depression, anxiety, and burnout is disproportionately higher among medical students and physicians. In fact, nearly 400 physicians commit suicide a year, the highest of any profession. Might it be because we are anchored to one thing and one thing only? Those of us who pursue medicine have built our entire personhood around the goal of becoming a doctor. If that is all that is meaningful to us, should we really be surprised at the statistics on mental health?”

King Pascual is a medical student.

He shares his story and discusses his KevinMD article, “Why medical students should not let medicine define them.”

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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 King Pascual. He is a medical student, and he wrote the KevinMD article “Why medical students should not let medicine define them.” King, welcome to the show.

King Pascual: Thank you, Kevin.

Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today?

King Pascual: Sure. Where to begin? So I’m a third-year med student at George Washington University in Washington, D.C. As far as about me, I’m originally from the Philippines. My family and I immigrated to the United States in 2003, to Texas actually. I went to high school here and eventually went to college at Brown University in Rhode Island, where I majored in biology and ethnic studies.

After that, I kind of had a little bit of a non-traditional path. It wasn’t a straight, linear path to medical school. I spent two years teaching in the South Bronx through a program called Teach For America, so I taught high school science in New York for two years while also getting a master’s in education. And then I kind of wanted to explore another field, namely the startup and health care innovation field. So I ended up moving to D.C. for a health care innovation fellowship, where I spent a year launching a startup, a health care startup for stroke patients, and that kind of got me going with the whole medicine as a career path. So I spent a year doing startup work and another year doing another health care innovation role in D.C., and I eventually matriculated at George Washington. So that’s where I am now.

Kevin Pho: Excellent. And from your years as a high school science teacher, what are some of the lessons that you’ve learned there that you could bring forward during your medical education journey?

King Pascual: Actually, there’s a lot, right? It was my first job right out of college, and you’re thrown in there to really just learn on the spot and figure out solutions to the many problems that the students are facing in the classroom and the system as a whole is facing outside of the classroom. So I think one of the things I took away from it is that I had to be comfortable with the discomfort. I had to just embrace the fact that there are going to be some roadblocks there, and it’s going to be up to me to have that mindset to find a solution in a calm and efficient way.

That took some time to really practice, but that really translated well into, for instance, clinical rotations my third year. You’re thrown into the wards and you don’t know what’s going on, but you really just have to be comfortable with not knowing. You have to be comfortable with the uncertainty and discomfort and trust in the process that you’ll find a way to accomplish what you need to accomplish.

Kevin Pho: So let’s transition now into your KevinMD article, “Why medical students should not let medicine define them.” Now, for those who haven’t read that article, can you just walk my audience through it and maybe share a story of why you decided to write it?

King Pascual: Yeah. So I think it’s really borne out by the four years that I worked in different fields before matriculating into medical school. When I wrote that article, it was, I think, the first semester of med school, and I really had to kind of ground myself and tell myself, “OK, now you’re in med school.” You hear all of these people around you already starting to study for Step, and it’s just like two months in, and you can get really bogged down by all the type A personalities.

I told myself, if I’m not careful, I can fall into that tunnel-vision mentality where I’m just going to do everything medicine and define myself as a med student. And if I don’t think of anything else outside of medicine, that’s going to be very, very harmful to who I am. And who I am is someone who is not defined by just one field. I see value in a bunch of things, and I thrive in thinking outside of the box. I thrive in defining myself in more ways than one, and I have passions outside of medicine, and I wanted to not lose sight of that, because that’s part of the self-care that I think a lot of medical students don’t really prioritize.

You’re more than just your exam. You’re more than just your test, right? You’re more than just a flashcard or a PowerPoint. And it’s so easy to lose sight of that when you’re in med school. So it’s kind of like an existential exercise for me, almost, just as much as it was a public service announcement to the med students out there. But yeah, that’s where it came from.

Kevin Pho: So you wrote that article a couple years ago, and now you’re in your third year. So what are some examples of some of your interests outside of medicine?

King Pascual: Yeah. So I mentioned that I worked in startup, and I actually launched a sleep hygiene startup about a year and a half ago. I created a device that essentially prevents you from snoozing in the morning and reduces your usage of your mobile phone at night. So it’s a lock, a modified lockbox. I call it Early Birdie, the world’s first sleep hygiene trainer. Over the past year and a half, I managed to prototype it using our school’s 3D printer, manufactured 40 samples with a manufacturer in China, and patented the design. I just have it on the side as a little pet project. I enter some startup pitch competitions when they are available.

So that’s one thing. Aside from that, I’m passionate about music. I upload maybe one or two covers on my Instagram every couple of weeks. And I enjoy cooking and writing, obviously. So a couple of things in the works.

Kevin Pho: So like you said, the first couple years are almost consumed by studying for Step 1 and pre-clinical courses and all that. So I guess the question is, where do you find the time to run a startup and have some of these interests outside of medicine, because these pre-clinical years are so focused on medicine itself, right?

King Pascual: So I think time is definitely of the essence, and at some point, you have to draw the line. If you really want to go for, like, getting AOA and getting that 260 on your Step, then maybe you won’t have as much time as I probably did. So I knew what I wanted out of my pre-clinical years, and I knew what my limits were, and I was comfortable setting those boundaries early on. So I think that’s how I found and carved out time for myself, having realistic expectations.

But I mean, I feel like you can also excel academically and still find ways to excel in your hobbies and be more than just an exam taker. I think it just takes some planning and some self-care mentality. One should not feel like all they have to do is study for an exam and memorize a flashcard. There are a lot of things that you need to do and take care of.

Kevin Pho: Now, can you give us some examples from your circle, or from your classmates and friends, of other medical students who are also doing things outside of medicine as well?

King Pascual: Yeah, I mean, I think I’m fortunate enough to be in a medical school where there is a culture of doing things outside of the classroom. For instance, we have these scholarly concentration tracks that you can focus on during medical school. I’m in the integrative medicine scholarly track, but there’s also the entrepreneurial track, and there’s also community health and global health. And I see a lot of my peers volunteering in the community, also starting their own projects and startup ventures, and entering pitch competitions. So I think I can safely say that there are a lot of us in my med school that are venturing outside of the classroom and pursuing interests outside of medicine.

But specifically, my closest friends and I would, for instance, have jam sessions and play piano and pull out their guitars and just try to sing and perform whatever song comes to mind. So that’s one anecdote I can share.

Kevin Pho: So I want to focus more on that combination between medical school and entrepreneurship. I talked to a lot of medical students on this podcast, and a lot of medical students and physicians have written on my blog about that intersection. Now, for those students who have an idea, they want to do a startup, and they have a little bit of an entrepreneurial bent, what kind of training or resources can they turn to? Because that’s the question I get more often. It’s like, “Where do I start? I do want to focus on medicine, but I also want to kind of nurture this idea I have.”

King Pascual: Yeah, so I think that’s a great question. Offhand, I can tell you to take advantage of startup pitch competitions in your university. If they’re not offered in your university, then maybe look just regionally, because there’s about to be at least one startup pitch competition near you every couple of months. And while it may sound intimidating to enter something like that, it’s actually not as intimidating. You’re there in a safe space to share your idea. So that’s one piece of advice: Take advantage of those startup pitch competitions.

Second, if there’s a course in your university on human-centered design or design thinking, I think it’s a great, great way to just have a framework, an intellectual framework, to kind of iterate ideas in your head and then come up with the prototype in a short amount of time. Design thinking, human-centered design, is so translatable to every field, including medicine, and a lot of hospitals and institutions are actually making that a part of either their curriculum or just their overall way of improving things in the hospital. So that’s the second piece of advice I can give.

And third, one thing that I do is I write down ideas on a piece of paper if they come to mind, and then I type them up later in my laptop and I curate them. So little things like that could really just nurture your entrepreneurial bent, you said it, your entrepreneurial spirit. And those are practical things you could definitely do.

Kevin Pho: We’re talking to King Pascual. He’s a medical student, and he wrote the KevinMD article “Why medical students should not let medicine define them.” King, so this is the question I always ask medical students and physicians who have interests outside of medicine. There is a subset of physicians who only want their students to focus on medicine and medicine alone, and any interest outside of medicine, they won’t be considered real physicians in that case. So I guess my question is, what’s your response to people who ask you or think like that?

King Pascual: That’s definitely something that hits close to home. I have conversations like this with my friends, right? Like, “What’s the value in having someone, a med student, be all over the place and not technically skilled in one area?” And I want to kind of walk back and ask ourselves, well, let’s look at the earliest physicians ever recorded, right? During maybe the Renaissance, you would be hard-pressed to find someone who’s just doing medicine. If you were a physician back then, chances are you were also a philosopher, you were also a mathematician, you were also an artist.

So I think we’ve been misled to think that physicians are only supposed to focus on medicine when, in fact, since the beginning of the profession, what made medicine medicine is the combination of different fields. I think we need to go back to that mentality where medicine actually will be more progressive if you have different perspectives contributing to the table. It’s more productive for us as physicians to welcome different mindsets, different skills, different perspectives and experiences, because that’s what made medicine medicine today.

Kevin Pho: Great. And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

King Pascual: My take-home message would be to really just keep a big-picture mindset when you go to medical school and ask yourself: What is it that you want out of not just medicine but out of life? What would make you happy? And as much as possible, avoid having a tunnel vision when you’re in medical school. There’s more to life than just your Anki decks and your PowerPoints and your lectures. It’s hard to do that when it seems like everyone else is focusing on exams, but you would do yourself a great, great service if you keep a big-picture perspective on life.

Kevin Pho: Right. King, thank you so much for sharing your time and insight, and thanks again for being on the show.

King Pascual: Thank you. Pleasure.

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