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If I Started Over In Medicine, I'd Do This (From A Cardiologist)

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The speaker, a cardiologist nearing the completion of his fellowship, reflects on his journey from medical school to becoming an attending physician and outlines the specific habits he wishes he had adopted earlier. He begins by identifying three critical mistakes that many students make: overloading their resumes with superficial experiences, becoming overly obsessed with grades, and neglecting the importance of personality. He argues that while a strong GPA is necessary for initial entry into medical school, it becomes less relevant as one advances in residency and fellowship, where programs assume all candidates are intelligent enough to handle the work. Instead, he emphasizes that likability, ease of working with others, and emotional intelligence become the deciding factors for competitive specialties. He illustrates this with the "3 AM test," suggesting that a program director would want someone pleasant to be around late at night rather than just another high-scoring applicant who lacks social grace. To correct these pitfalls, the speaker advocates for shifting from "resume stuffing" to building a cohesive professional narrative or "story mode." Rather than collecting random experiences to fill a CV, he encourages students to explore various interests early on and then double down on those that genuinely light them up, such as working in an ICU or shadowing specific procedures. This approach creates a unique story where every research project, volunteer role, and clinical experience connects logically to a central passion, making the resume easier for recruiters to understand within seconds. Alongside this narrative focus, he stresses the importance of perfecting one's learning and time management systems. He notes that while grades still matter for competitiveness, the ultimate goal is patient care, which requires deep pattern recognition and information retention rather than just test-taking skills. Therefore, students should develop efficient methods for studying, collecting knowledge for long-term use, and managing their time to avoid burnout as life responsibilities grow. Finally, the speaker highlights the underrated power of relationships and the necessity of constantly "cleaning one's lens" regarding career goals. He advises seeking out mentors who can provide guidance on practical aspects like contract negotiations, clinic scheduling, and avoiding pitfalls that only experienced physicians understand. These connections not only offer advice but also open doors to opportunities through networking. Crucially, he urges individuals to regularly reflect on what they truly want in their careers, questioning whether their reasons for pursuing a specific specialty or program are deep enough. If the answers lack depth, it is a signal to gain more experience and refine one's perspective before making major decisions. By maintaining this reflective mindset and focusing on becoming a well-rounded, likable person with a clear professional story, aspiring physicians can navigate their journey more effectively and find greater satisfaction in their chosen path.
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I graduated medical school with a 3.9 GPA, matched into my number one choice for internal medicine residency, got into cardiology fellowship, one fel a year, and just shined my dream attending contract. Now, if I had to start over, here's exactly what I would do differently. Hey friends, welcome back to the channel. Today, I am going to be breaking down everything that I wish I did more of and less of to get to the spot where I am now, which is just being 4 months away from graduating cardiology fellowship and starting my Big Boy job. It's been a long journey. It's been a lot of ups, some downs, and so hopefully you can learn from some of those big wins and failures from my end. Let's get into it. So, first let's break down the things that I wish I didn't do, things that you shouldn't do, things that I for sure did to some extent. And when I work with students more and more on the journey, I realize that is like the default mode. And at the end, I think all of us realize that was just a waste of time. Now, most of these are by no means revolutionary. And frankly, we're going to talk about more of how to do them correctly. So, we're going to get through them really, really quickly. Number one, do not resume stuff. I know particularly when I was in college, it seemed like the thing to do to get into medical school was to make your CV as long as possible without the least amount of depth. And so you would join all the organizations, do all the research projects, try to put in all the clubs and volunteer experiences. And that muscle feels like it has to continue in medical school and residency and in fellowship. But in reality, the further you go, the more you realize that you just kind of continue to do experiences that other people are doing on the journey. And thus, you just look more and more like everybody else, which is very superficial. And I'll tell you instead of what you should do, but even to get into a competitive specialty like cardiology, my game plan was by no means ré stuffing. And that worked to my betterment where I probably had a smaller CV, but more impressive one. So, we'll talk about how to do that correctly. Number two is stop being grade obsessive. I get emails all the time of students who want to improve their studying and thus really their grades because they want to get into a competitive specialty. And the first few years of medical school, you're so obsessed with your GPA and your scores on quizzes and tests. And granted, those are important, but when you become so obsessive, it turns you into this personality going into medicine, going through residency, where you're just output focus. You just want to know what your step one, step two scores, what your exam scores are, what your rankings are. And instead, I'll tell you how to do this correctly. But when you're at my face, when you're in residency, your scores don't really matter. And now being part of a few application cycles of evaluating people for residency and fellowship, the scores matter to some extent for me to understand how competitive you are. But the further and further you go into the journey, you'll quickly realize that people just assume that you're smart. Because if there's one pattern that I've picked up of reviewing applications for residency or a fellowship is that the further you get into this journey, the assumption is that you're smart enough to take on that next phase. And so rarely am I looking at somebody's step two score as kind of a decision maker if I think they're going to be a good fellow. Instead, I'm looking at a variety of other things again that we'll break down later in this episode. But the more grade obsessive you are, the more your personality changes into this person who is just very much focused into this kind of gunner mentality of I just need the grades. And that's unfortunately not the fact of it. There are tons of cardiologists that I work with that I think are brilliant, but I'm sure I may have had higher GPA than them. And that's not like it doesn't matter. the patients don't ask you your GPA for medical school. And so trying to be less grade obsessive and instead what we'll talk about in a second is really where you focus a lot. And number three, this is like huge because I think that this has helped me and my betterment when the grades may not have always been my favor. And that is don't ignore the personality factor. Again, the further and further you get into this journey, the assumption is that you are smart enough and capable enough to do that phase. So when you're getting into a residency, the assumption is you're going to be a good physician. When you're getting into fellowship, the assumption is you're going to be a good cardiologist. The question is, is that program the best fit for you? Versus in medical school, it makes sense where grades like MCAT and GPA have to take a bigger toll because you're just evaluating sheer more amounts of individuals who are trying to get into that first leg of medicine. But when you're in my shoes, you're only competing against like a thousand other people for significantly less spots. But the assumption is all of us are capable. Now, the difference when all of us have the grades and all of us potentially have the skills is how likable are you? Emergency medicine has this kind of 3:00 am task, which is would you want that person sitting next to you at 3:00 a.m. just to kind of chat and, you know, have conversations if if the night is quiet? And if that person just doesn't give you the quite the right vibe, then you may not be getting into your dream specialty or your dream program. And so really understanding that the personality aspect, frankly, how likable you are and how easy you are to work with matters a lot more the further and further you get into the journey. But that is a skill that takes many years to kind of understand where you rub people the wrong way, what kind of irks you, what kind of things make you successful, what environments you do well in. But understanding that personality factor is like probably number one the further and further you get into the journey. So those are the things that you shouldn't do. But now let's talk about the five things you for sure should do as much as possible. Now number one is understanding the concept of story mode. If you're a gamer in any sense of the world or if you've played any kind of role playing game, I love Pokemon growing up and so I'm using that as my example, but there's a story that you build upon where you have your characters and you make them stronger and you essentially move through the journey with progress kind of being the default setting of making it further in the line compared to what a lot of people do in medicine earlier on where you're kind of just building these superficial layers by resume stuffing that you end up being more or less the same person. So instead, focus on building depth through experiences and not just through the resume stuffing. And how do you do that? When you find things that you enjoy earlier on in college, you should explore as many things as possible, including non-medical things. But let's say you decide that you want to go into medicine or you're early medical student and you decide that these are the specialties that you're interested in. Get as much exposure through all of them as much as possible. Try your best initially not to pigeon hole yourself that I'm going to be a plastic surgeon and instead explore all the specialties that may seem like they may be related or are on the table of interest for you. Then as you do experiences, evaluate, does this feel like I should do more of this experience or did I get anything from this experience that I'm like, man, wow, like I really wish I could do that even more. And I realized when I would work with cardiologist or do anything cardiology related, I found that to be a repeat interest to the fact that my last rotation of residency actually rotated to work in the ICU of the cardiology service versus another service that I was not interested in. That was a big indicator to me that this was a specialty that I was actually interested in versus something, you know, that didn't really kind of peique my interest. And so looking for those experiences, saying like where do I light up? Where do I enjoy going to work? What type of things do I enjoy doing? doubling down on those and looking for more experiences very similar to those. And every time you do something slightly different, ask is that something that I would actually do on a Saturday morning in my own valition if it wouldn't show up on my resume? If the answer is yes, perfect. You're starting to find your story of what interests you, what piqus your interest. And the more you do that, you'll start to see that your resume becomes this kind of story mode and flow that if somebody is reading through it, and granted, people who are reading through your resume are glancing for maybe like 10 seconds tops. And so you really want to have a resume that's like started here. These are the interests I came from this and then I kind of developed my area towards this. And further further you go, the more and more you'll start to kind of find an area you'll park yourself in. If it's plastic surgery, maybe it's doing research in a very particular spot. If it's cardiology, maybe you really enjoy preventative work because like you're a former athlete and you enjoy working with athletes or people with really bad heart disease and you start developing a story there. And thus your research, your volunteer experience, all kind of surround experiences there. That's a story that's very easy to tell. It's very easy to sell yourself without being like overly egotistic. And so ask yourself, does your resume, if you just looked at it compared to your peers that you work with, does it look the same or does it look like I have something a little bit unique to offer? Because I've constantly focused on what really perks my interest. Now, before we get into tip number two, if so far you're finding a lot of benefit from these tips and you want more, check out the med school success guide where I have like a 100 plus tips of things that I wish somebody told me on my first day of medical school absolutely free. I'll link it down below. Number two is to perfect your learning and time system. Now, we talked about don't be grade obsessive, but grades still matter. I by no means could have gotten to this phase if my step one, step two scores, GPA were like not high enough because that would have dictated my competitiveness for the next step. And so grades by 100% still do matter. But in reality, again, either my attendees or my patients asking what my GPA was after I got to that phase. And so the expectation is is that you need to be a good learner and not necessarily just a decent test taker. And even more importantly now being just 4 months away from graduating fellowship. For me, it's about making sure I have a strong foundation and take care of patients because again, they don't care how I do on an A through D exam. They really want to make sure that I'm just very good at pulling information, pattern recognition, and taking care of patients. And so, the best way to do that is ask yourself, how do I learn and how do I do this as fast as possible to get the most amount of reps as possible? I teach as extensively in some of our programs. So, again, if you want any access to those, the Med School Blueprint is probably the one that I would go to the most. But the bottom line is you want to ask yourself how can you get information that you get from your lectures, your PDFs, wherever it is, flashcards, AI, and do as much repetition of those through question answers. Whether that's flashcards, practice questions, you pick your mode and doing as much of those as much as as quickly as possible. That was my system. Um, I talk about an if you're interested, I'll link down below a video that's now been checked out by like a million people plus on the system I used for majority of medical school. And since then, I've now converted to using Ramenode for a majority of my residency and fellowship. And so, I'll link that down below, too. But either of those two systems are great starters to figure out how to improve your learning system. Now, again, if you want more help, there's tons of free videos and episodes that we've made here on YouTube. So, I'll link down below those playlists as well. But you have to get your learning system down and it is a work in progress because how you learn your first year in medical school will be significantly different to how you learn where you are at where I am now, which is a cardiology fellow. really just acquiring knowledge as you go and retaining them. The second part of that learning system is collecting things that you've learned. While you think that you may only have to learn for tests, again, you have to learn for patient care. And to assume that your brain is going to remember everything all the time is like it's very silly. And I've come to the fact that like my memory is not as good as I gave myself credit for when I was taking the MCAT 10 plus years ago. And so it is good to have a system where you can just collect things as you learn them. I personally for the time being use RemNote where if I'm reading a PDF or a new paper or listening to a lecture, I will take those main takeaways and epiphies that I have during that moment, put them in a RemNote folder and then in the future if I'm ever taking care of a patient or I want to reference something or like think back to what I had learned, I can quickly search that up without feeling like I have to just store it in here. So the second brain concept is super important for your long-term learning and understanding. And then finally, your time system. If you want to be in any competitive specialty, you do have to get more done than the majority of your classmates. So that includes the research, the volunteering while still getting the grades, still being happy, and avoiding burnout. And that requires you to be a master of your time, understanding where each hour of your day is allocated to, whether it is school, whether it's homework and learning and studying for your test, whether it's going to be time dedicated to working on your next research project or your extracurriculars. But you can't just figure it out or hope that it's going to continue to sustain you for all, you know, these 10 plus years because now speaking as a dad, married, owning a home and all the other responsibilities that come with it, your life just gets busier. I am by no means what I thought I would be as a medical student, which is like this is going to be much simpler as a fellow. You just show up, do clinical stuff, and come home and enjoy time with your family. But life just has its ways of just filling every crevice of all the hours you have available. And it is your job to have systems in place of saying, "Nope, this time is for my workouts. This time is for studying. This time is for clinical stuff. This time is for family and practicing that earlier on when you're a medical student in training and now even as a fellow is going to help you for sure. It's going to help me when I was in attending. I'm going to have to readjust at that point. But definitely re-evaluating how you learn, how you study, how you retain, and then finally how you manage your time and those systems that go into them. But understanding the systems that you have for learning and time management and constantly working on them has been such an undervalued skill and for me has been one of like the lowhanging fruits for me constantly to level up every time I move to the next phase of my journey. And number three, we talked about how personality matters so much. And so really you should want to focus on becoming personally better on the first phase is like just be a likable person. And that can be hard because sometimes you may just be an introvert where you just want to talk to people and that's okay. Being as a physician, you do have to interact with individuals. And so, you don't have to be the most popular person in the room. You just have to be easy to get along with. And that starts with sometimes just being interested in other people more than you are interested in yourself. Asking people how they are, asking the nurses how you can just make their lives easier, and just being a little bit conscientious, having that social and emotional intelligence of working with people over time. And I frankly have learned this by just evaluating how the most likable doctors interact with those around them and trying to instill just a bit of those in myself. You don't have to be exactly like your attendings. Add your own flavor to it. But on the flip side, I've also paid attention to those interactions from attendings and peers and vet students where I'm like probably didn't do that right boss. And understanding that like I don't want to do that or be like that individual. And so working on that personally, some of those skills that I think are super underrated but again have helped me are just being very calm and level-headed. Just being very chameleonike where you can just work with any personality. If somebody's a very type A individual, there's tons of those in medicine. And so instead of saying I don't like working with those individuals, understand how you can best accommodate to work and with that personality. If somebody is more reserved and needs a leader, then like ask how you can confidently in a friendly manner step up and do that. And so I've been in situations where I can be the calm head when there's tons of voices and just kind of get things done. But I've also been in situations where like no one is taking charge and I have to just raise my voice, be a little bit more assertive and people understand like now he means business. But rarely have I found that anyone's considered me to be be rude or disrespectful. And again, that comes with a skill that builds over time. But being personally likable is something that is just as important to work on as it is to understand cardiology or pick your specialty of interest over time. So ask yourself kind of what your interactions are with your peers, your attendings, and what kind of skills you want to take from those individuals who are probably doing those a little bit better than you at the time being and work on those. And hopefully that will make you pass the 3 a.m. test when you're at your next kind of application phase, whether it's residency or a fellowship or trying to get a job. You want to be likable. You want people to enjoy your company. And hopefully that means that you enjoy their company and then because you've learned how to adapt. Number four, super underrated. you hear about all this time, but relationships really do matter to be competitive in your future specialties. And so finding these mentors and relationships that can be used to help and improve your understanding of what to do next is super important. The silliest part of my medical journey is that I thought I understood what I had to do to get to the next phase. And then the more and more I talk with mentors that naturally have kind of come into my life and this been like I want to learn more from you is that you have no idea what you're doing. And the more I understand now, the more I understand how ignorant I was coming in as a first year fellow, as a resident, as a med student. And so really having somebody that you can just ask those stupid questions to of like what type of things should I consider now is like signing a big boy contract. What do I need to know in the financial aspects of my contract? What type of things should I not agree to or like look for? How should I arrange my clinic schedule? How do I get patients to see me? How do I make sure that like my schedule is flowing well where I'm not burning out? still can be attentive to my family. These are important things that people only understand after experience and thus you should ask those with experience and especially if you're earlier on experience and the journey. Your goal is to use those mentors who can ideally guide you to opportunities and guide you to do more of this to become competitive. If you want to do plastic surgery as example we've been using for this episode. You want to find somebody who is willing to take you under their belt or probably ideally a few people who can then say here's a research project or you can follow me for some shadowing. follow them shadowing and saying, "I enjoy doing this. Is there somebody else that you could think of that I could also follow?" And kind of having more people that can support you when it's time to just kind of push you ahead and saying, "Look at this applicant." And I found that to be very helpful in my journey, especially applying to fellowship where I could just say, "I am interested in A, B, and C. Could you use your connections and potentially reach out to somebody?" and within a day or two getting responses from that other party that I had no connections with just because the worlds get smaller and smaller in the field of medicine the further you go and so using your connections your relationships to one help kind of clear out this phase of like this is what you actually should be doing versus what you think and then two just opening those doors of opportunity which has been very helpful. So do not ignore networking and mentorship. Don't assume that everyone's going to be okay being your mentor. Um, everyone is busy, but constantly looking for those sources of guidance and direction and getting as creative as possible. And sometimes that means that we just have to give a little bit back to those mentors as well. By no means is a free relationship. Not everyone can just offer their time and guidance, but sometimes that just may mean somebody who is paying attention to when they talk about their kids or when they talk about their lives. Again, it's that personality factor of being likable. You're much more likely to be mentored by somebody who enjoys your presence versus somebody who's just there for the advice and the guidance. And then finally, clean the lens. Again, the further and further you get into the journey, the more and more you realize how silly and stupid you were earlier on of what you thought you wanted. And so having a better idea as you go of like this one question, what do I really want is super important because the further you get into it when you're applying for residency, when you're applying for fellowship, the real question that we ask when somebody leaves our room, when we're interviewing, is like, does this person feel like they have a good feel of what they want to do? And often the answer is no. Because again, you've been resume stuffing for the longest time, great obsessive, and your resume looks more or less like the applicant I just talked to who also doesn't understand what they want. And that's why exploring experiences and saying this is what I I realize I've enjoyed. I knew I liked cardiology, but I worked like working with my hands and so I did a few shadow experience in the Kath lab and I enjoy what they do even despite that they come in at 3:00 a.m. to put a stent in. I actually think that's cool. My colleagues may not think so. When you walk out of the room with those stories and those experiences, I'm like, cool. That person knows what they want to do. And so cleaning this lens of always asking what do you want to do? I knew I wanted to do cardiology but that answer has changed even within fellowship which makes sense. And so now when somebody asks me well what do you want to do as an attending? What do you want your clinics to look like? What patients do you want to take care of? When do you want your clinics? When do you want to do procedures? And I'm thinking about that and I'm like okay like I have to keep evaluating cleaning this lens. Some of that requires me to go back to my mentors to clear up this horizon of like what did you actually find to be important? Because they may say something that I didn't consider. But don't go through the journey of just assuming things and then realizing in the hindsight that you actually had no idea what you were kind of exploring. So ask yourself what specialty do you really want? What does that look like? Why do you want it? If your answer is not very deep, need more experiences. Ask yourself kind of why you want to go to a specific program. If your answer is not very deep, you need to clean the lens. When you're picking your first kind of jobs, when I was a hospitalist, I had a good reason of why I wanted to go to the specific hospital. Maybe not why I wanted to be a hospitalist. So, that lens needed to be cleaner because it woke me up to a new world of medicine that I wasn't ready for. If you want to know why I left that job, I will link a few of the videos that kind of break down the pros and cons. Keep cleaning the lens will allow you to be more satisfied next time you have to make a decision. Cuz the worst thing is when you go further and further down something that because you think that that's the only route that you're supposed to and you realize that if I had just asked myself these few questions, I would have just been happy diverting here or stopping here. And I think because I've been so reflective often just at the default of making these episodes and for YouTube that I have to think about what I want. This kind of journalistic mindset has helped me understand like where the lens needs more clearing. But I feel like a lot of my colleagues don't do that enough. And so for you to get the most out of it is to be competitive but then constantly ask what you want because there's no point of trying to run a 50-mi race if you knew that at mile 26 the destination is exactly what you wanted. But hopefully that running metaphor helps at least just one of you. Now, these are some of the big breakdowns of things that I wish that I did more of or I'm glad that I did. By no means are this kind of the end of all the tips and tricks that I have to offer. So, if you want all the free stuff, the 200 plus tips and advice, plus all the emails with all these kind of breakdowns of tips that I constantly am wishing that I gave myself on the first day of medical school, check out the med school success guide. Again, absolutely free. And if you want all of kind of the structured programs, how to study better, how to manage your time, how to be competitive in med school and residency going into fellowship, then the med school blueprint and all the programs that we've ever created will be included in one package. And every time we add something in the future, you don't pay anything extra. It just gets included. So check either of those two out. All of the videos and kind of episodes that I refer to will be linked down below. If you enjoy this, add your comments down below. Frankly, you don't even have to hit like and subscribe, but if you do, that'd be awesome. But I enjoy interacting with the comments and just understanding what questions you have on your journey. That's where I find the most benefit personally for this channel. And so let me know what questions you have, how how it can help you best on your journey. Thank you for making it to the end if you did. And as always, my friends, thank you so much for being a part of my journey. Hopefully as a little help to you guys on yours. I'll catch you guys in the next one. Peace.