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Join Stephen J. Foley, a medical student, as we dive into the intriguing parallels between the world of baseball and the field of medicine. Discover how skills from the baseball diamond translate to the hospital wards, and explore the importance of adaptability, versatility, and teamwork in both domains. Stephen shares personal anecdotes and insights that shed light on the unique dynamics of medical training, all while drawing captivating comparisons to America’s favorite pastime.

Stephen J. Foley is a medical student.

He discusses the KevinMD article, “September in medicine: scouting season for future doctors.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Stephen Foley. He is a medical student, and today’s KevinMD article is titled “September in medicine: scouting season for future doctors.” Stephen, welcome to the show.

Stephen J. Foley: Thank you, Kevin, it’s a real pleasure to be here.

Kevin Pho: So let’s start by sharing your story and journey to where you are today.

Stephen J. Foley: Yeah, fantastic. So of course, thanks again for having me on the show, happy to be a part of the great work that you’re doing on KevinMD.

As far as my story and background, I’m the oldest of three, growing up in a small town outside of Boston, Massachusetts. I’ve always kept New England close to my heart as my home. Studied at Worcester Polytechnic in Worcester, Massachusetts, and research and volunteering at the free clinics there just inspired me to pursue medicine down the line. And now I’m in my fourth year at University of Vermont, I’m applying to internal medicine residency and hoping to serve the New England community when I come back.

And as far as my general background with medicine, I really just enjoy teaching, mentoring other students, the second years, third years, everything like that. And personally, I’m frequently exploring new music, science fiction novels, and just like to explore the outdoors. Burlington, Vermont is great for that.

Kevin Pho: So I’m an internal medicine physician myself. So what are the things that led you to pursue internal medicine for a potential residency?

Stephen J. Foley: For me, internal medicine has always kind of been the broad exposure to a lot of different pathologies. Things that are really enjoyable for that is seeing a little bit of everything and having a chance to do some hands-on medicine, some procedural medicine along the way. Tried to get exposure through research and through different teaching opportunities in the mainstays of internal medicine, like cardiology and pulmonology, things like that. Just been really exciting to dip my toes into a lot of different areas of medicine.

Kevin Pho: All right, so let’s talk about your KevinMD article, and it makes that connection between baseball and medicine. It’s titled “September in medicine: scouting season for future doctors.” So tell us what this article is about.

Stephen J. Foley: Yeah, this is a really interesting article to put together. As I was compiling my residency application in September, I was starting to think about, it really just reminded me of the process of seeing a lot of athletes in high school getting scouted for college sports and things like that.

We talk a lot about the experiences and the grades that we get and the evaluations that we have from our mentors during medical school, and it reminded me of putting together statistics and the awards that baseball players might have as they’re compiling a scouting report. And even doing an away rotation in Boston, it feels like you’re doing an audition at training camp, auditioning with the team to see how you can fit into their scheme.

But with this year’s class being a little bit more of an approach towards holistic review, taking into account subjective evaluations, I think I was really trying to reflect more on the traits that I get from baseball and how they apply into medicine.

And so experiences that really stood out for me that I talk about in the article is like being called up from the outfield and being called in to pitch on a really high stakes game. And that can really be like a crucible for when you learn if you’re a person who can handle those opportunities, if you can be composed, and if you can adapt to really high stakes situations.

And so from my experience as both a baseball player and as a medical student, I’ve been trying to gain and develop some attributes that can speak to my ability to be a future physician, whether that’s flexibility, composure, technical skill, and just the ability to have that work ethic in practice and be prepared for those types of opportunities. So I encourage medical students to take that route, to accept those challenges as they come up, and when they’re called up to the big leagues to be with the physicians, whether you’re internal medicine, surgery consults, things like that.

But this became an occasional way for explaining the different hierarchical roles within the medical team, like with family and friends outside of medicine. Sometimes medical students can have a variety of stories, if they’re in the corner of the OR feeling like they’re not really involved in the action, if sometimes residents and fellows have you doing more of an observing role than an active role with seeing patients. You can really feel like you’re on the outside, in the outfield, and not really close to what’s going on.

But a revelation that came up is that some of the best outfielders in MLB, Major League Baseball, the best outfielders really study pitchers and batters and watch every pitch that goes in, so they can predict and react to any play that comes their way. So I try to take that in, as far as it heightens my ability to predict scenarios that I might end up in, patients that I might see in the hospital, and use that to be a very prepared medical student going into my residency years.

Kevin Pho: So as you’re preparing yourself for these interviews, give us some examples that really showcase your flexibility as a medical student to do things outside the box, and can help you in this holistic process to applying to residency.

Stephen J. Foley: Yeah. So as far as preparing for residency interviews, I think the times that really come up the most is talking about experiences that are outside of my usual comfort zone. As a person applying to internal medicine, some of the stories that stick out are during surgery and working with the surgeons in a high stakes environment in the OR.

And a story that I love to tell my family and friends is a time where I’m just watching these vascular surgeries happen, and all of a sudden getting called into scrubbing on a below knee amputation. And that can be a very stressful or new experience for a third-year medical student just starting out rotations. And being flexible with being called up to the plate in that scenario and being able to work hands-on directly with those surgeons is something that was outside of my comfort zone, but something that I try and take with me, just being prepared to work in those environments moving forward.

Kevin Pho: So there’s a little bit of tension there, right? So a lot of medical students, like you said, they’re in a hierarchical structure, they do what they’re told, right? And sometimes it’s hard to speak up and seek out those opportunities that may not fit within the role. So talk a little bit about that tension, and how medical students can manage that tension, training in a hierarchical structure, about looking for opportunities outside the box.

Stephen J. Foley: Yeah, I think it’s really important to recognize that there is a hierarchical structure about the volume that a lot of medical students are able to see, as far as their patient load, the amount of control that they have over the treatment plans, and the amount of impact that they can often have on patients, whether they’re in the hospital or in the clinic. And recognizing that helps you really realize your opportunities to contribute when they come up. And I think that awareness is something that’s really good for medical students, to seek out opportunities.

But moreover, I think the really important point is to have this mentality of just showing up. In general, showing up prepared is something that’s going to really open up those opportunities for you. There are going to be rotations that a lot of medical students might find they’re not interested in going into, but showing up with enthusiasm and an open mind, and even just recognizing that those patients and those physicians that you work with all have something that they can teach you, and it’s always a learning opportunity, will help you work through that hierarchical structure so that you can adapt and find every opportunity that is available to you.

Kevin Pho: Now, one of the interesting connections that you made in your article was comparing catchers in baseball to physicians in medicine. So talk about those two roles and how they’re connected.

Stephen J. Foley: That’s a great question. And I was thinking about this early on, as I look at the physicians, as I was a first year medical student, second year, and doing more of an observing role, I saw the attending physicians were doing a lot of coaching and helping the residents and fellows get to perfecting their treatment plans and guiding them through the process of a day-to-day on the medical wards.

But really what I started to realize, when I look at the team dynamics of a baseball team, the catcher is really one of the more important roles, as someone who’s actually on the field. Coaches, they dress up in the uniform and they’re able to walk onto the field and talk to their players, but they really don’t have an active role of making plays like the nine players on the baseball field do.

The catchers really have the most vision. They can see the entire field, they can see everything that’s going on and recognize when unforeseen scenarios are about to come up. They really study the lineup, which again in my perspective is like the lineup of patients that you see on your day to day. And they really have the most impact as far as controlling the game and guiding the pitchers on what pitches to throw. When I think of physicians being the people who guide fellows and residents to really get to the end of their thought process and putting together the best treatment plan, so I see that communication, that collaboration between pitcher, catcher, and then the infielders, being a really tight circle between the physicians and the rest of the treatment team.

Kevin Pho: Now, as a former baseball player, tell us how that has influenced you outside of this mentality that you just articulated. Has that helped you through your medical school journey?

Stephen J. Foley: Yeah, it’s helped me to recognize that while sometimes we might feel a little bit isolated as medical students, and we might not have a lot of proximity to the action that’s going on with the attending physicians and residents, that it’s really just a joy to be a part of the game in general, just to be doing medicine on a day-to-day basis.

And while there’s some distance and maybe some communication that might be lacking between some of the medical students and residents at some points, it’s really important to note, at least from a medical student’s perspective, that you come on and off the field as a unit, as a unified force that’s there to help the patients. You’re a part of a team. And that’s what’s really interesting and attractive about internal medicine in general, is that there’s this really tight level of collaboration during rounding and later on throughout the treatment process, that you’re unified, you’re collaborating with everybody, and you’re on a shared mission to help the patients.

Kevin Pho: So it’s been over 20 years since I last went through residency, and you’re in your application process. So as far as you know, from your perspective, how has that application process evolved? You mentioned earlier that there’s more of a focus on the holistic components of an application. Go into more detail about that. What are residencies now looking for when they interview medical students?

Stephen J. Foley: Yeah, as far as the shift toward the holistic process, I mean, this is the first year that the entire class of medical students and applicants are going to be seeing a pass-fail Step 1 score. A lot of schools around the country are moving towards pass-fail clerkship grades.

Even though there’s still that element of subjective evaluations, I think those evaluations and those comments that advisors and preceptors can give to you are really important, because they show who you really are as you work as a team member with the rest of the physicians and residents, and how you interact with patients. That holistic review of those qualities that you can contribute to the team, and those traits and experiences that make you a better doctor, are going to be very important for the residency application season moving forward.

Kevin Pho: We’re talking to Stephen Foley. He’s a medical student, and his KevinMD article is titled “September in medicine: scouting season for future doctors.” So Stephen, for those medical students in their first, second, or third years, and they’re listening to you and they’re hearing about this holistic approach and how they need to step outside their comfort zones perhaps and integrate themselves in a team, share some of your highest yield tips with them.

Stephen J. Foley: Yeah, I think going back to the main message of this article as well, the two things that I can offer to be in a great position to take advantage of these opportunities and get out of your comfort zone is, first to be punctual, and then to be prepared.

Most of the opportunities in life just happen from showing up. Don’t make the mistake of missing opportunities to learn, to prove yourself, just because you arrived at the wrong place or the wrong time. For trainees, like I said, there will be specialties you’re not interested in, but really take those as an opportunity to get exposure to areas that you might not have. You might find something valuable from that that you can take with you moving into different rotations.

There’s also going to be good or bad days for medical students and trainees and physicians at any level. There may be patients who feel like they’re going through the revolving door in the hospital, in the clinic, but it’s important to just show up for your teams and for your patients with enthusiasm and an open mind, like I said, and commit to your best regardless of any outcomes on previous days.

Also as an important side note for showing up, a healthy home life really helps us as physicians to be the best that we can inside the hospital, and reduce the stress and demands from our daily lives. So it’s vital to prioritize showing up at home and being present, to maintain healthy relationships with family and the people who support us.

But as far as being prepared, just be prepared to respond when it’s your turn to get called up. I know the feeling of getting benched during a varsity baseball game because I forgot my cleats. I know the feeling of telling an attending that I didn’t perform a heart and lung exam because I forgot my stethoscope. But the point is to learn, adapt, and grow, and never make the same mistake twice.

Kevin Pho: And my final question, Stephen, tell us some of your take-home messages that you would like to leave with the KevinMD audience.

Stephen J. Foley: Yeah, a great take-home message, as far as this article, is reminding yourself of the joy that it is just to be playing the game in general. I think happiness comes from the practice of finding gratitude in all circumstances, good or bad. It’s my general life advice for anyone inside and outside of the medical field.

There are going to be times when you feel your efforts aren’t valued or influential, like you’re outside the action, you’re in the outfield and looking in on everyone else making an impact. But in spite of the pressure to feel discouraged, it takes real strength to remember your purpose doing this work that we get to do on a day-to-day basis. Remind yourself of the joy and fulfillment that it is to have those responsibilities and to treat patients, and then have that motivation to earn more opportunities, and transform that discouragement into gratitude for having the privilege of being able to do this every day.

Overall, the happiest people rejoice always, pray constantly, and in everything they give thanks.

Kevin Pho: Stephen, thank you so much for sharing your insight, perspective, and time, and good luck on the interview trail.

Stephen J. Foley: Thank you very much, really happy to be here.