Path to Medicine: From Healthcare Professional to M.D.

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This month on UMich Med Mosaic, we meet first-year medical students Santi Herrera Alzate and Ani Kamel from the University of Michigan Medical School. Both students, along with our host Mackenzie Kay, decided to pursue a medical degree after working in other health care-related roles. They share their compelling reasons for making this life-changing decision, their unique paths to medical school, and how their previous experiences have enriched their journey. Join us to hear their stories and learn more about making this career transition.

Transcript

Mackenzie:

Hi everyone, and welcome to UMich Med Mosaic, a medical student-run podcast we've created to shine a light on the diverse backgrounds and experiences of our students here in Ann Arbor. I'm Mackenzie Kay, a first-year student at the University of Michigan Medical School. I wanted to start this podcast to build community through hearing the stories and experiences of my peers, and as an avid podcast listener, I feel passionately about podcasts as a medium. I'm so happy and grateful to be here at Michigan. Through these conversations, we hope to show that there is a no one-size-fits-all definition of a medical student. Whether you're a current or prospective medical student, we hope that you feel inspired by these narratives.

So hi everyone, welcome back to UMich Med Mosaic. This is episode two. In this episode, we're exploring the experiences of medical students who have worked in the medical system and other professions like nursing, midwifery, PA, or EMS, before making the decision to pursue medical school. I'm sure we'll have the opportunity to talk more about this later, but I used to work in emergency services as an EMT and later as a paramedic before coming to U of M, and I found the framework of care and the relationships that I developed to be actually quite fundamental to my decision to continue my training.

So on the show with me today, we have Ani and Santi, two lovely M1s who both have some pretty cool backgrounds to share today. But before we get into all of that, I wanted to do a little icebreaker and talk about life here in Ann Arbor. So I was thinking maybe if we're willing to share a favorite place or treat in Ann Arbor that you like to go.

Santi:

Well, Ann Arbor is a lovely town because of all the trees and the nature. So there's a trail, is it the B2B trail? It runs along the river and it's a beautiful place to go for a run and clear your mind. So I really enjoy that. And I love sushi, and I've tried a lot of the sushi places, so I guess I'll plug a sushi place, like bang for your buck. There's a place called Sadako, which has great prices and the sushi is also delicious.

Mackenzie:

I'll have to check it out. I love sushi and I haven't quite found my favorite spot yet. What about you, what's your favorite spot, Ani?

Anastasia:

Santi literally stole what I was going to say. I love going for runs down the B2B trail, specifically Gallup Park because it's right next to the lake or the river. It's really nice. It's calming. And then I actually can bike there from my house to school. So in the early mornings when it's not completely covered in snow and ice, there's a nice mist over the river and it's just really pretty and calming. But I don't know, I feel like I haven't explored enough restaurants to give a favorite, but I like going to a different coffee shop every Saturday and just checking out what the vibe is. Last week I went to York, and it's cute. There's people out, there's actually people in the world exploring things. And I'm like, "Oh look, other humans."

Mackenzie:

York has good cocktails too.

Anastasia:

I saw, they had a full bar and everything.

Mackenzie:

Yeah. No, York is pretty tasty. I think my favorite place is Spun, it's a knitting store. I'm a huge knitter. That's my big stress hobby. In fact, the more stressed I am in school, the more sweaters I knit. So that's something about me. And so I am a part of a knitting group, actually two knitting groups, and both of them are run through Spun. And so I go there quite often. It's right next to where the farmers market is and it's my favorite place to go. So Santi, let's start with you. Do you want to tell me a little bit more about what you did before coming to U of M?

Santi:

Yes, thanks. So I've actually had a couple of careers before I made it here. Initially I started chemistry in undergrad and I became a medical technologist or medical laboratory scientist, and I did a flow cytometry. And when I did that I started assisting hematopathologists with the collection of bone marrow biopsies. At the time I had a young family, I had a one-year-old son and I was looking for a way to get into the clinical space. Actually PAs started doing the bone marrow biopsies for the pathologists, so I got introduced to the profession.

At that time, I think I thought about medical school briefly, but PA seemed like a great route too. It was shorter and it allowed me to get into the clinical space. So I went to PA school in Florida where I grew up, and then I commissioned as an officer with the US Public Health Service while I was in PA school. And then through them I worked at a prison where I got to really start treating patients, and I fell in love with medicine even more. And then I got reassigned to the VA. And at the VA I had great physician mentors, which made me think about taking a step further within my career. And I guess being a PA in those settings is what drew me to go to medical school and continue.

Mackenzie:

Wow, that's an amazing story. How long were you a PA for ultimately?

Santi:

I did it for four years.

Mackenzie:

For four years, okay. And PA school, correct me if I'm wrong, is three years? Or two years?

Santi:

It can be. Actually it depends, yeah, it can be two to three years.

Mackenzie:

What originally drew you to PA school? You said you thought about med school then, what originally drew you to doing PA school at that point?

Santi:

Pretty much the fact that I had a young family. And going to medical school, I thought about it very briefly because I was like, it's four years of school and then another three or four years of residency. And it just looked like a long time to maybe take away from my life and not be with my family or to have an income and stuff, so PA school seemed like very reasonable two years versus potentially eight or more.

Mackenzie:

Are you still associated with the military?

Santi:

I gave up my commission with the US Public Health Service and I commissioned with the US Army Reserve in a program they have called the MDSSP, which is a medical student stipend program, which is a reserve commitment. But during school they pay me a stipend and I'll have some payback to the army after, but I do it just because I like uniform service, it's very meaningful to me.

Mackenzie:

Now Ani, same question. Will you give us just a little overview of your path to med school?

Anastasia:

I guess I started getting interested in the health care field when I was in high school. My brother was in an accident when I was younger, it changed the way my family looked at healthcare. We grew up in a very naturopathic kind of view, so they didn't really bring us to doctors or do a lot of health maintenance visits or anything like that. Viewed hospitals as skeptical places. And then my brother got into this accident when I was 10 years oldish and he had a traumatic brain injury, and the care that he received in the hospital was phenomenal. And he made a full recovery, amazingly, but he was in a coma for a while, and after that I think they just started trusting the healthcare field.

So it's really interesting, because I have 10 siblings, so the first half of us grew up with this herbal medicine botany kind of thing, and then the second half of us got more traditional going to the doctor regularly and getting all the vaccines and everything. So I was like, "Okay, cool. Healthcare seems cool. It obviously helped my brother a lot. Let me just see more about it." So I started scribing when I was in high school, and I was like, "Okay, cool. This is definitely something that I want to do."

So I just looked into everything, and I really wanted to become a doctor then, but I was like, "Oh, that's a lot of money, that's a lot of time." And I had pretty much no resources. We grew up really poor in a very, very rural part of New York, so I really had not a ton of guidance on how to go about that. And it just seemed like a risk I couldn't. I decided to go for nursing, and I worked as a nurse for seven years. So I got my bachelor's in nursing in 2017, and I did three years of med surg. tele medicine and four years of emergency medicine. It was fun, I loved it. Honestly, nursing is a great field. I feel like there's a lot of really interesting and cool things that you see.

And in the midst of that whole time I met my now husband, and he was a med student when I met him. So I supported him through his med school journey, and then he's currently in his fifth year of residency, so obviously still on the journey, almost done. But at some point I took a step back and I was like, "Oh, I can do this, and I still want to." And it's been 10 years since I first wanted to start doing this. And I've seen medicine. I know it's not glamorous. I'm not going in there with rose colored glasses. I know what it is and I still want to do it, so I might as well do it because I'm the only person holding me back at this point.

And my husband was super supportive and I'm grateful for him, because at the time when I decided to go back, we have a mortgage, we have a life set up, so I can't just stop working and be like, "Oh well, now we have these bills we can't pay." So he was able to pick up working more hours and help in that logistical side of things, and he's been immensely helpful with that. But I think it would've been a lot more difficult if I didn't have that support, but yeah, I'm very happy that I'm here now.

Mackenzie:

Yeah, something you both touched on, which is something that I can definitely relate to is when you get settled into a career, you definitely develop financial security at that point. The decision to then take on an additional financial burden to then apply to medical school, that's a real hurdle so I can definitely identify with that. I guess when you decided to actually make that switch, when you were like, "Okay, I'm going to go to medical school," how did the people around you react?

Santi:

I wanted to ask you actually really briefly, if you could tell us about how your career journey, because I know you also, as you've mentioned you were out in the professional world.

Mackenzie:

I went to undergrad at Wellesley College out in Boston, and I did my major in women's and gender studies. And when I went to college, I knew I was interested in health, but I didn't really know what form it was going to take at that point, and I came to college feeling really burned out and lost. And so I actually made the decision after my first year to take a gap year and just really explore that interest in healthcare. I had some family stuff going on at the same time, so just everything lined up. And so I took a year off and I decided to get a EMT certification, and at the same time, I had some family members that were living abroad in the Middle East, in Doha, Qatar. And so with that EMT certification, I actually went and worked in a trauma center out there for a year.

And then I came back and I worked in emergency medicine in Boston for the next, oh boy, six or seven years. After a couple of years I went to paramedic school. I worked as a paramedic until the COVID pandemic, and I stayed until 2021 in Boston. And then I moved abroad to Norway, did a master's in international community health. And at that point I was at this turning point where I was like, maybe I want to pursue healthcare from a academic standpoint. I want to actually study health, not practice patient care. I didn't really quite know. I loved being a provider. I actually loved emergency medicine just because of the privilege of being able to see patients actually specifically in their home environment, and being an advocate for those things. I think every other aspect of medicine, you don't get to see patients at home. So there's just a lot of things that you miss, a lot of clues about how they live and what things are important to them, and who they have in their lives.

I was really nervous to give that up. I really loved that. And so when I was in my master's, I really thought I would continue exploring community-based providers from an academic standpoint, and talk to them about that framework of care. And just really do a PhD and pursue medicine from that standpoint. But then I realized I really missed being a provider. I really missed being a clinician and I wanted research to be an integrated part of my medical career. And so for me, the easiest integration is with medicine, with the MD. And so that was the decision for me, it was a really easy decision. And I always knew I wanted to be a physician. It was in the back of my mind, I just was really scared to pursue it. Just because I did not study any of the right things in undergrad, I had to go back and do all those courses, and that really scared me, the idea of having to do that.

I worried that I was too old to go back to school and do it. So I think there was, like what Ani said, I was the biggest obstacle that I was facing, it wasn't really anything else. But then when I decided to do it, I just jumped in and here I am. So just know to those listening out there, it's never too late. You can go on a crazy path and still end up at University of Michigan if you want to.

Santi:

I think that helps. Your unique experiences make you a better medical student. Whatever that may be, you don't have to be on this rigid path to medicine. I think when you take these different paths, as a whole person, they make you more well-rounded in a way. Well, I think your experiences are super cool, especially the international experiences that you've had, very cool.

Mackenzie:

Thanks. But back to my question, and I'll say it again.

Santi:

I recall your question actually.

Mackenzie:

Oh, you recall it?

Santi:

You said, when I told people that I was going to medical school, how did they react? Is that correct?

Mackenzie:

Yeah.

Santi:

I'll give you a few different viewpoints. When I told some of my attending physicians, they were like, "Oh yeah, man, go ahead. Yeah, that's cool." Because I told them, I was like, "Hey, I'm taking some pre-req courses and I'm going to take the MCAT." But then after I finished all those courses and took the MCAT, a few of them were like, "We didn't think you were going to do it." Because they're like, "You have a family." And they're like, "A lot of people talk about that are already in here," they're like, "Yeah, I'm going to do the MCAT and I'm going to take these courses." And it just gets left at that being said, so they were a little surprised.

When I told my mom, my mom and my wife are the closest people to me in my life. When I told my mom, she's always believed in me, even when I don't. She's like, "You can do it." She doesn't put any limitations on me and she really thinks I'm really capable, sometimes maybe too much confidence in me, but I really appreciate her support always. She was super supportive. And my wife, she's also super supportive. Initially we had a really pretty well established life. We had settled into Florida, so she had some questions about what is this going to do for our family? We have kids. We had a plan to have more children. But she's also always believed in me and supported me, and she's like, "You know what?" She's like, "If this is what you want to do, you have to go for it or it's always going to bother you."

So I've been lucky to have the support of great people. And even as I mentioned, my attendings, they never told me that they doubted me. And the whole time that I was going through with preparing to go to medical school, there were some great supporters for me. And giving me study resources and encouraging me, and even helping me with my shifts. Because as I was taking some pre-reqs I was working the overnight shift, and then I'd have to go to class at eight in the morning. So they were always finding whatever way they could to help me during those times, so I really appreciate it.

Mackenzie:

Yeah, that's awesome. How about you? How was it for you?

Anastasia:

I was a little nervous to tell my coworkers, especially because there's this, I don't know, if you ever go down Reddit rabbit holes, there is this weird separation between nursing and doctoring as if we're not on the same team, but we really are. And I've actually never seen it in reality, no doctor's ever been mean to me about something because I'm a nurse or something like that. But no, all of my nursing buddies were extremely supportive. Obviously my husband was super supportive, he's my number one supporter. And my parents, initially, 10 years ago when I initially told them I was thinking about going to med school, they were like, "Well, how are you going to do that and have a family? How are you going to do that and also do traditional women stuff?" Which is how we grew up.

But when I told them more recently that I wanted to go back, they were like, "Yeah, do it. That's amazing." And they're super proud of me. And every week we chat and they tell me how proud they are, and it's really sweet. I feel like I'm surrounded by a bubble of love, which is really nice.

Mackenzie:

That's so beautiful.

Anastasia:

But then I feel like some people in your life don't like to see you succeed, and when that happened, you just let those people go. But I'm not going to say that it wasn't a reality, I definitely lost a few friends along the way.

Mackenzie:

Something that I love to hear from both of you is just how amazing your families have been in supporting you along this winding journey, your parents and your partners. I feel like that's so essential to be able to have longevity in this career.

Anastasia:

And how did your people react?

Mackenzie:

My people were amazing. My ambulance company was so cool, I have to say. It's in part, I think, due to the culture of maybe Boston's medical community. I left to go get my masters, they were so supportive about that. And then when I decided to go to medical school, a lot of them texted me and were like, "I'm so proud of you, so excited for you." And so yeah, it was very supportive from my co-workers. And then my parents, they were so funny. Because I think they had always known, I'd taken this really long winding path and they had always known that this would be where I'd end up, but they were just waiting for me to realize it myself.

So they were like, "Finally."

Anastasia:

Finally.

Mackenzie:

I know exactly. And they were like, "Gosh."

Anastasia:

God, you finally saw the light. Okay.

Mackenzie:

No, quite literally, I think my mom was just rolling her eyes at me for the last eight years. But no, I wouldn't do it any other way, because I think my experiences and the path that I've taken have been interesting and exciting, and have taught me a lot of things. And I definitely emotionally wasn't ready to go to med school at 22. There's no way, I would be a terrible doctor.

Anastasia:

Oh my God, I feel so much more mature now.

Mackenzie:

I really admire people who go straight through. In fact, that's going to be our next episode. But I admire the emotional maturity and the knowledge of self to be able to do that. It wasn't me. And so for me, I really needed that time and that exploration to be absolutely certain in my decision. And so for my parents, they were like, "Oh, thank goodness you finally got there. Your frontal lobe clicked in. We're proud of you."

So no, similar to you guys, they've been my biggest cheerleaders. I call them every three days being like, "Oh my goodness, it's so hard." And they're like, "You've got this, you got this." So yeah, they're amazing.

Santi:

Shout out to parents.

Mackenzie:

Shout out to parents. Santi, you were talking about having to take some pre-reqs to apply to med school. How much extra work had to go in to switch careers?

Santi:

Yeah, I think I took two physics courses. So I think it was physics one and two that I didn't need for PA school. And actually I also took calculus, which I guess I didn't need to take and I only found out when I applied. So I was like, "Okay, I took an extra class."

Mackenzie:

You're that much better at math.

Santi:

Well, I really enjoyed those courses. But it's challenging, because I had a full-time job, I also had collateral officer duties as a US Public Health Service officer and I had a family to take care of. So it was definitely a challenging time, but I'm really thankful for those experiences and I guess all the hardship that we all went through. I know you guys also are kind of non-traditional, so I know you must've been juggling multiple things. And that taught me some things about how to study more efficiently and how to utilize my time really wisely.

Mackenzie:

And how was it remembering the courses that you had taken before for PA school, like the bio-sequence and the chem-sequence and the bio-chem-sequence? Was that okay for you?

Santi:

Yeah, to be honest, being a PA helped me with the MCAT prep as well. Because the MCAT, some of the way that it's designed, it's bio-chem or even organic chemistry, but it's based around medicine. So there was actually some instances where I was biochemically or organic, based on the orgo material. I was like, "I don't know what this means." But it was a sickle cell question and I was like, "I remember we gave hydroxyurea for sickle cell." So having clinical experience helped me make these correlations to that very foundational stuff that gets asked on the MCAT, and made it easier in a way.

Mackenzie:

Everyone should see him in review sessions. He knows all the answers.

Santi:

I know some.

Mackenzie:

Did you have to take, Ani, any extra courses?

Anastasia:

Yeah, I had to take about two years of courses. I think from 7 A.M. to 11 P.M. I was doing stuff, there was no time of the day when I was not busy for that period of time. And then also studying for the MCAT. I think while working and going to school I had to stretch out my MCAT studying, because I couldn't put the amount of hours that you need to put into a short amount of time.

Mackenzie:

I decided to do a post-bac program, so I smushed all of my classes into one year. And so it was 8 A.M. to 4 P.M. every single day, all of the classes. So yeah, biochem, physics, all of it all in one year. And MCAT class, we were learning physics and then studying for the MCAT at the same time. The post-bac year was crazy, but I did end up picking up a job during. But it was part-time, I worked 15 hours a week. I couldn't imagine working full-time and studying.

Anastasia:

I had the job down to part-time at some point, especially because I was working until 3 A.M. in my first job and then had classes at 8 A.M. So I was like, "I can't do that."

Santi:

Yeah, some days I'd work till six and then I'd have a test at nine. So I'd sleep in my car for two hours, and then I'd wake up, drink a cup of coffee, take the test, go home, sleep three or four hours and then take care of my kids and then work again. But it's okay, because it teaches you so much resiliency to go. Going through hard things is good for you, it makes you appreciate everything even more. This is a tough year, but I don't mean to downplay it. It's extremely difficult. And I'm many times stressed out and working really hard, but when I think about the hardest moments that I've gone through, sometimes I don't have a job right now really so this is like vacation. In a way because I just have to study, I don't have to work and study so it's nice.

Anastasia:

I feel the same way.

Mackenzie:

I agree. It is such a privilege to be able to just take it all in and learn as much as you can, and just really dive into the material and get really interested. I completely agree. Which actually is a great segue. How has M1 been for you? How's the transition been back to school?

Anastasia:

I think the first few months were definitely a lot more challenging, and now I found my stride. And I think there's a difference, there's a shift in mindset. Because in undergrad you pretty much have to learn everything that they're teaching you and you're hoping to get hundreds on every test. You're hoping to get the highest score you possibly can. So with it being pass fail at 75, if you get a 90, that's amazing, that's great, but it's not going to show up on your transcript. It's not going to make a huge difference.

So it's shifted my studying. So I am not trying to just remember discrete facts, I'm trying to remember what I need to know for clinical year. And if I miss a few obscure discrete facts, I'm okay with that as long as I'm getting the big concepts that I think are going to be important for my future doctoring. But I think I had to shift from being if I wanted to study 24/7, I could. Do I want to? Absolutely not. I don't. I don't want to study 24/7. I want to be able to enjoy my life as well. And you can, you can have that time.

Mackenzie:

For the most part, we have a very highly remote program, which a lot of people find really great because it's very highly flexible. For me, I've struggled a little bit, to be perfectly honest, just because I was not of the Zoom school generation. So I am not used to being on my computer all the time. I actually miss having a teacher. I love having a teacher.

Anastasia:

I like asking questions in class, and you can't do that over Zoom.

Mackenzie:

Exactly. I have so many questions.

Anastasia:

It keeps me engaged, it keeps me not falling asleep.

Mackenzie:

No, exactly. I have so many questions, and I love asking questions. So yeah, how has it been?

Santi:

Yeah, I would say that I really highly appreciate having everything remote, it just makes me so much more efficient with my time. Sunday and Monday I finish all the lectures for the week, and then the rest of the week I just have to review. And I feel a lot less pressure like that. I appreciate the amount of in-person sessions that we have. I think it's nice to see my classmates, but I like that a majority of the learning this year is remotely. I can watch things at one and a half speed and go at my own pace. So we still have Piazza to ask questions, and when I do have a question with all this modern technology, I just ask the GPT, U-M GPT, which I use.

Mackenzie:

There are people who evangelize about this, and there are huge benefits to it too. I do really appreciate being able to sleep in as much as my body needs to, and being able to set my own schedule. And I can take my lecture to the gym and watch it while I'm on the treadmill. I do appreciate all that stuff, but I do think that it was a flip in my study strategy. It was, once again, me learning how to learn again.

Anastasia:

I feel like I definitely had to adapt to it, because it's not what I was used to. But also there's so many hours of lectures, and I don't like sitting for that long. I'll just take my lectures and go on a walk, I'll just go for a two-hour walk and I'm great. And then I'll be reviewing, and all of a sudden I get a picture of a lake in my head and I'm like, "Oh, I guess I was walking past that lake when this came up in the lecture."

Mackenzie:

Do you feel excited for clerkships?

Anastasia:

Oh yeah, I like working with patients.

Santi:

One of the reasons I came here is because I think this is the shortest pre-clinical that I found. So I really think that you learn the most from the patients and from seeing the diseases in person, though this knowledge we're gaining now is so fundamental. When I think about diseases and when I've actually seen a patient with dermatomyositis, you can read about that so much, but when you actually see that patient and you remember how you treated them, it just makes you know that disease so much better. So I really appreciate that our curriculum is set up that way.

Mackenzie:

No, it's so true. The way that I know certain things, for example, I'll never forget like the EKG presentation for a pulmonary embolism because I've seen that in person. I think you do need those clinical correlations to really cement the things that we're learning in person in our heads. And I think it's so nice to have multiple data points or points of contact with this information. So we're getting first pass in our M1 year and then we get second pass next year when we're seeing it in person, and then we'll do a third pass before we take step one. And so we're going to hopefully know things super well. And Santi, you're going to have seventh pass because you've seen everything.

Anastasia:

I feel like what Santi said, you can read about something but it hits totally different when you actually see it. And also we're presented a lot of information very matter-of-factly, like, "Oh, this is the third leading cause of death in America." Then you see somebody with it and you're like, "Yeah, they're really sick. Their quality of life is down the tank. This is more than just words on a page, they're really impacted by this." And I feel like it's hard to see that through words on a page.

Santi:

The fact that we have one year pre-clinical and then core clerkships for one year, but then our third year is so freed up. Well, we take the step exams, you could do that in the beginning of the third year, but then we have so much of third year to explore the specialty that we're interested in that we can do a bunch of sub-Is earlier on than some other places where you do two years of pre-clinical and then the third year's your core clerkships. And then you don't have that much time I feel like to prepare for maybe a really competitive sub specialty if that's where you're going into.

So the way that Michigan is set up, I feel like we have much more time to do that. And then I feel, which we're not there yet, but I'm always looking ahead, but it decreases the likelihood that you'll have to take a research year or something to prepare for something like that because some people do it in other programs. Which you still have the option to do that here at Michigan if you desire to, but I feel like that really sets us up to explore the branches part of our curriculum, it really sets us up to explore our interests and then to prepare for residency than if we had a longer pre-clinical.

Mackenzie:

I know I'm going to be indecisive and that I'm going to agonize over my decision for what residency to pursue, what specialty to pursue. I know, it's already front of mind and we are eight months into... And so I am so grateful for that extra time. Do you guys have any idea of maybe what you're interested in?

Anastasia:

I don't know.

Mackenzie:

To put on the counselor hat, it's okay.

Anastasia:

I know. I have a love hate relationship with ER. I love it. I love the people who work there. I like helping people in emergencies, but then I go home and I'm like, "Oh, there are so many ways I could die." And then I'm like, "Why do I have so much anxiety?" And now that I'm not working in it, I'm like, "Oh, I could drive in this car and not think about it crashing."

Mackenzie:

Always wear your helmets, folks.

Anastasia:

So do I want to do that till I'm 65? I don't know. I love it, but also it definitely takes a toll on you.

Mackenzie:

Yeah, I do think it's the things that you have experience in you have the deepest connection to potentially. I'm interested in women's health and I'm interested in emergency medicine, because those are the two places I've been. But I shadowed a GI and I had so much fun, that was the most fun ever. And I felt a little sparkly, but I was like, "Are the sparkles as big as the sparkles that I feel for OB-GYN?" I don't know. How about you, Santi?

Santi:

Based on the experiences I've had I've become really interested in urology, and at the VA there's so many patients with urological conditions. They had Agent Orange exposure. And there's a lot of older men, which when you get older as a man you're going to have prostate issues. So when I worked in the ER at the VA I had so many patients with urological issues, and so really got exposed to that and became really interested in it.

Mackenzie:

Yeah, I remember us talking before the podcast, and one of your decisions to switch from PA to MD was your desire to really go deep into research, go deep into the surgical aspects of urology. Am I right in that?

Santi:

So as a PA you get to help people in many ways, but there's some point where the physician has the outmost expertise because of the residency education and the length of their education. So that's what I'm hoping to accomplish is just to really become the outmost expert and make those ultimate difficult decisions.

Mackenzie:

No, that's fabulous. Really chasing this passion that you have, and really definitively knowing what you're interested in and the desire to become an expert in it, that's fabulous. I guess the last question that I'll ask you guys, just to wrap it up, maybe if you have any advice to give somebody who's in your position at the same time, what would you give?

Anastasia:

My advice would be if you really want to do it, just do it. What are you going to do? You get one life to live, and what are you going to do? Get to 80 years old and regret that you didn't do the thing. Just go and do it. It'll be fine. Things will work itself out. And if you're in healthcare before you're trying to switch, your experiences will help you a lot more than you think they will. People said that to me and I didn't really believe it, so I'm sure you're not going to believe it if you are listening to this, but it's true. It does help a lot.

Santi:

I'm just going to pretty much echo exactly what Ani said, and I'll frame it in my own words. I think if you have a dream, you should pursue that fully, fearlessly. You should just let that fire burn and follow that passion. And as she said, I thought about the same thing. I'm like, when I'm 80 years old, well, hopefully I live that long, but however old, and maybe I'm in my final days and I look back in my life and I'm like, did I absolutely give everything that I could and did I live as fully as I could? And I don't know at what point, maybe I'll stop succeeding, but I want to be able to tell myself that I absolutely did follow my dreams and I absolutely gave it everything that I could. And that's what I'd say, just follow your dreams.

And even if you look at a school like Michigan, which can seem like it's just such a huge task to get in because it's a really competitive school and wonderful people come here. But if you have a diverse set of experiences, even if it's not that you are the highest scorer ever, I think those experiences can make you really well-rounded. And you shouldn't be intimidated to apply to the school that you want to go to maybe because of where it ranks, because sometimes you underestimate yourself. And there's maybe some really unique things about you that a school like this can value and you can really contribute to it with your experiences, so that's what I'd say.

Mackenzie:

Here here.

Anastasia:

Absolutely.

Mackenzie:

I think with that, I want to sincerely, sincerely thank both of you for taking time out of your busy lives, very busy lives. We have a block exam coming up next week, balancing life, studies, family, and everything in between to be here today. Ani, Santi, it was truly a pleasure having you join me today in this conversation on transitions in medicine. And to our listeners, thank you so much for tuning in. We'll see you next time.

Anastasia:

Thank you so much for having us.

Santi:

Thank you, Mackenzie, you're awesome. Thanks.

Mackenzie:

If you loved today's conversation, share it with a friend. If you are a Michigan medical student and are interested in being a future guest, check out the class pages on Slack for open calls for episodes. UMich Med Mosaic is produced by the Michigan Medicine Department of Communication, in partnership with the University of Michigan Medical School. Find us and subscribe wherever you listen to podcasts. Thanks for listening, and we hope to see you soon.