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What happens when you ask ChatGPT to study every conversation you have had and tell you who you really are? One medical student did that, and what it told him changed how he sees his future in medicine. Jack Tiller is a medical student in an MD-PhD program, with doctoral work in neuroscience and neurodegeneration. This episode is based on his article “The reluctant achiever: Navigating identity in medical training,” published on KevinMD. You will hear why the AI labeled him a reluctant achiever, and how a single line about having many possible lives but only one timeline stopped him cold. Jack explains how board-exam burnout, perfectionism, and an identity built on achievement all came into focus. He talks about exploring careers beyond clinical medicine, from science writing to policy, and about using AI alongside therapy to understand his own thinking. Press play to hear how AI helped one medical student see himself more clearly, and why he is giving himself permission to imagine a life beyond the path he was told to follow.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Jack Tiller. He’s a medical student, and today’s KevinMD article is “The reluctant achiever: navigating identity in medical training.” Jack, welcome to the show.

Jack Tiller: Thank you so much. I appreciate being here.

Kevin Pho: All right, so let’s start by briefly sharing your story, then we’ll jump into why you decided to share this particular article on KevinMD.

Jack Tiller: Sure. I am originally from suburban Chicago. I have my bachelor’s degree in biology from a small liberal arts college, and then I completed my master’s in microbiology and immunology at Montana State University. I am now in my MD-PhD program. I am entering my fourth year out of hopefully seven. My PhD work focuses on neuroscience, specifically Alzheimer’s and neurodegeneration.

Kevin Pho: All right. And you talk about the reluctant achiever, a very interesting article. For those who didn’t get a chance to read it, tell us why you decided to write it, and then about the article itself.

Jack Tiller: For sure. I was a student journalist in college while I was also a biology pre-med. I love writing in my free time. It’s pretty much how I express myself and my emotions, and I started getting into writing in medical school just to process everything that was going on. And I love using AI tools. I’ve been using them for a few years now just to have them as a thinking partner, to organize ideas, to reflect on my time in medical school and everything that’s been going on.

And at one point I decided to ask ChatGPT to analyze different patterns in my thinking and the conversations we’ve had and all the chat histories we’ve had. And it created this sort of mock clinical case study, which I thought was fitting for me as a medical student. It’s pretty much just looking at who I am and the struggles I’ve gone through, and figuring me out and helping me figure out who I am and who I’m going to be, and how I’m going to get through this pretty hard time.

Kevin Pho: All right. So you went to ChatGPT, and through the history of all the conversations you had, you had it essentially analyze yourself. And what exactly did it come up with?

Jack Tiller: Yeah. So there were a few different differentials that I can mention. The one that it ended up settling on was that I just have chronic curiosity. It’s pretty much the simplest explanation, and I think also the most accurate, that I just have so many interests in so many different things, and that makes it difficult to be on this very difficult path of medical training and to have this very long career ahead of me when there are a lot of other things that are pulling my interest.

But I think it pointed out some interesting things about maybe experiencing a lot of burnout. A lot of these feelings were happening around this time last year when I took step one. It was a really tough time. And I think there’s also a part of me that’s a perfectionist. I think a lot of us in the medical field can identify with being perfectionists. And so the analysis pointed out that I sort of expect my life choices to align perfectly with what I value, and that that’s difficult when you have to commit to a single path and there are values that spread across multiple different potential paths.

And then of course there’s some fear of closing doors and really cool opportunities, and choosing one identity that might necessarily exclude others.

Kevin Pho: Now, when you first read this analysis from ChatGPT, did anything it said surprise you about who you thought you were?

Jack Tiller: That’s an interesting point. I think it just highlighted things that maybe I knew subconsciously, but nobody ever really came out and said to me. I never really had a lot of these conversations with people. I think the thing that was most surprising to me, and I’ll just read a line from it, that really shocked me, was, “The subject will likely continue experiencing the persistent sense that there are multiple lives they could live and only one timeline in which to live them.”

And that just really threw me for a loop, because it made me think so clearly that I have all of these different goals or dreams or interests, and that you just can’t do everything. You have to start making choices, and you have to figure out what the priority is. And seeing that, being told, for me, from this analysis that AI wrote, it was just the most crazy thing that I think I’ve ever really read, and the most eye-opening thing that has really helped me to figure out how I can live my life to the fullest while continuing down this path and having a successful career and a happy life.

Kevin Pho: Now, did you make any changes in your life after reading this analysis, after some reflection about what ChatGPT said? What kind of changes did you make, if any?

Jack Tiller: Yeah. I think the biggest thing for me was exploring alternative career options, just because of how stressed and burned out I was feeling from this traditional path of always doing the next step, the next step. It’s always been just climbing this ladder of undergrad, master’s, med school, PhD, and then residency, fellowship, maybe academic positions, and climbing the ladder. And it felt very restricting just thinking about that. So I wanted to give myself some room to think and to breathe.

So I have explored what are considered non-clinical career paths, things that I can go into either after graduation or even after residency, to see if there’s anything else that might feel more true to myself, whether that’s getting into science communication and writing, or even science policy and working for the government, or just being in some form of advisory role, whether that’s for startup companies, biotech, even working with courthouses or law firms to be a medical consultant.

So I’m just looking at other options to see if anything clicks, but still keeping residency and a traditional path on the table, because that is sort of what’s expected, and that’s the original plan I had. That doesn’t mean that has to be what happens, but I want to keep all my options open. We have four more years still before graduation, so there’s still plenty of time to learn and figure things out. And now that I’m in my PhD, I really have time to just enjoy the research and learn new things that I never would have had the time to do if I wasn’t in this dual degree program.

Kevin Pho: Now, I think what you said really resonates with me, because if you read KevinMD and listen to my podcast, one of the things that I always like to promote is that physicians are more than our degrees. And as you know from a lot of my prior guests, physicians have, like you said, so many more lives than just clinical medicine. And I think that mindset sometimes takes getting used to for those in the midst of medical training, because like you said, it’s very linear, right? Even from the pre-medical stage, you just have one step after the other, and there just isn’t a lot of opportunity to go off that path.

Now, you’re obviously in medical school, and it’s been a while since I’ve been in medical school. When talking to your other professors, other academic physicians, or even your classmates, how common is it to think outside that linear path? Did what ChatGPT said just validate what you previously believed subconsciously? Are a lot of other people looking for paths outside of clinical medicine to really explore some of their other selves? What’s it like now, currently, in medical school?

Jack Tiller: Yeah, for sure. I honestly would say I’m a pretty unique person in this situation. I do talk about it with friends and other medical students all the time, and I think maybe I’m just a late bloomer. Everybody questions changing their life or dropping out or whatever it is, because it’s hard and exams are hard. But everybody still knows they want to be a doctor and they want to treat patients. And I came into medical school knowing that wasn’t really what I was interested in.

I did a research master’s before this. I came in knowing that if I was going to do a residency, it was going to be pathology. I think that’s a really good fit for me. It’s still working with medicine and helping patients, but not necessarily being the patient-facing doctor. And then there’s much more flexibility for research, and to still have some innovation involved.

So for me, I think it’s a little different. But I also have a tendency to always question everything all the time, and I think it can be a bit exhausting, and everybody else is just more confident. I don’t know. I would say, though, that it doesn’t seem as common. So just this last graduation cycle, I think there were maybe a few students who didn’t go into a residency because they didn’t want to. It’s not the most common. Again, I think it’s because when you go to medical school, you expect to then go to residency. You have to go to medical school to go to residency, but you don’t have to go to residency if you go to medical school, and I think people sometimes forget that.

You obviously won’t be licensed or board certified, so you won’t be able to work with people, but there are so many other career paths out there that require, or would really benefit from, this type of education. And I think there’s sort of limited exposure to those options. So I’m really grateful that I have the time to look into stuff. And honestly, at this point, I think I still will do a residency. I love medicine and I love learning, and pathology seems like a great fit. Obviously, we’ll still give it some time.

But yeah, so I think it is pretty rare, but I hope that if anybody ever has thoughts or concerns or doubts, that it’s OK to explore other options. But still be mindful of the path that you’re on, and if you really need help, try to talk to someone, because you never know what people might say. People might be able to have good advice to help you out.

Kevin Pho: One of the labels that you use in your piece was the reluctant achiever. Why did you choose that, or why that label, and why did that resonate with you?

Jack Tiller: Yeah. So I believe the wording also came from the analysis, and I just resonated with it when I first saw it. I think the part that really stood out to me the most was being able to excel on the current path but still feeling a little unconvinced that this is the path for me. So being able to do well in school and get good grades and get into really competitive programs, but still not being entirely sure if that’s the path for me, or just doing it because it feels like that’s what everybody else is doing, or that’s what I should be doing.

So it was interesting, because I think, in all honesty, it really does sum up the article, that phrase reluctant achiever. And I think it could be a little too intense, so maybe it’s a little bit of a clickbait title. Because, again, I like medicine, I like science, I like learning, but I’m sort of realizing that I’ve attached so much identity to achievement. And that’s what I’ve been going through with this article, of being able to enjoy who I am and appreciate who I am and not needing to rely on achievement to feel like I matter or that I’m enough. And so I’m questioning the things that I’m doing to make sure that it’s healthy habits and not just because I’m seeking attention and achievement.

Kevin Pho: Now, for your other medical school colleagues who may be listening to you now and reading your article, what’s the main message you want them to come away with?

Jack Tiller: Ooh, that’s a great question. Well, the biggest thing with this article, I think, was the use of AI as a tool to help better understand myself. I know there’s a lot of controversy about AI right now, and whether it’s good, whether it’s bad, how much you should tell it about yourself, how vulnerable you should be, because that’s information that is then potentially out there in the world. But I appreciate honesty and being open, and I think people should embrace these tools to learn about themselves and, eventually, to help their career and their patients in any way.

Tools like this can help us see patterns in our thinking that we can’t see, and that other people might not be able to see. Obviously, if you need help, see a therapist. Therapists are great. But even then, a therapist won’t know everything about you, and there are things that people won’t always share with their therapist because they might be afraid of some kind of judgment. With AI, it’s easy to just mind-dump all of your thoughts. And maybe that’s not OK, I don’t know, I guess. But it’s something that’s worked for me, and it’s something that’s helped me to process my thoughts and my emotions, and I think I’ve been able to really grow and develop more than I’ve ever been able to.

Kevin Pho: We’re talking to Jack Tiller. He’s a medical student. Today’s KevinMD article is “The reluctant achiever: navigating identity in medical training.” Jack, let’s end with some of your take-home messages that you want to leave with the KevinMD audience.

Jack Tiller: Yeah. So I would just say, be who you are. Don’t let others influence who you are or what decisions you make, and just don’t be afraid of judgment.

Kevin Pho: Jack, thank you so much for sharing your perspective and insight, and thanks again for coming on the show.

Jack Tiller: Thank you so much for having me.