The Short Coat: An Inside Look at Getting Into and Getting Through Medical School

The Sheriff of Sodium investigates the state and future of medical training. If you’ve wondered how well the system that trains future doctors works, or about what factors really determine which medical students get into the most competitive residency programs, this episode is for you. M1 Fallon Jung, M2 Jeff Goddard, and M4 AJ Chowdhury get deep into these issues with a very special guest – Dr. Brian Carmody, known on his blog and YouTube channel as “The Sheriff of Sodium.” Dr. Carmody, a pediatric nephrologist by training, closely analyzes and shares data-driven perspectives on medical education, pulling on threads to understand whether the current medical training system is truly functional, fair, and efficient, examining factors like student debt burdens, physician shortages projections, and why people cheat on licensing exams. Like any good sheriff, Dr. Carmody is skeptical, especially about ideas like future physician shortages, and how schools report residency match outcomes.

Listener Eden is looking ahead to how she'll finance medical school as someone who is in the disadvantaged category of applicants. One option she asked us to talk about is the Health Professions Scholarship Program offered by the US military, and she wanted to hear from someone who is in that program. M4 Wilson Fitzgerald gave us the details, some ideas about what it's like to be a physician in the military, the sacrifices he's decided to make to take advantage of the program, and how it's working out for him so far. PA faculty member Jeremy Nelson, M2 Fallon Jung, and M3 Happy Kumar helped discuss why it might not be a great idea to wait to start medical school so that you have time to save up tuition. And Dave pulls out a bunch of reels he's been saving in his drafts because he doesn't think they're any good. Spoiler alert: they should have stayed in his drafts--but you can see them on our Instagram anyway!

Life’s grey areas, offered up for internet discussion Sometimes, you need someone to tell you if you’ve crossed the line. That’s why Reddit’s Am I The A**hole subreddit exists. M2 Holly Hemann brought some med-school themed samples for MD/PhD students Miranda Schene, Faith Prochaska, and PA2 Julie Vuong to react to. How compatible is MMA fighting and med school? Is it okay to get a secret horse? And isn’t an Eagle Scout the same as a doctor when you get right down to it? Let’s talk about all that! From the discussion: Admissions: https://www.reddit.com/r/AmItheAsshole/comments/10sjyd2/aita_for_almost_ruining_a_friends_med_school/ Scope of Practice: https://www.reddit.com/r/AmItheAsshole/comments/emu7yf/aita_i_said_my_husband_shouldnt_try_to_help_sick/ The clinical years: https://www.reddit.com/r/AmItheAsshole/comments/gf82i0/aita_for_letting_medical_students_observe_when_im/ Financial aid:

Project 2025 is the name of a project that hopes to serve as a blueprint for a future conservative administration that would promote natural family planning methods and reduce insurance coverage for certain contraceptives. M1s* Fallon Jung, Taryn O'Brien, and Gizzy Keeler (who are--boop boop boop!--leveling up to M2s), with help from Curriculum Manager Billie Ruden, discuss what that might mean for training MDs, where they'll be willing to go, and why it's not just OB/Gyn aspirants paying attention. Meanwhile, congress will consider a bill to make permanent several telehealth changes that were enacted to ease the healthcare crisis during the COVID crisis. KFF.org releases a helpful primer about the US healthcare system everyone should know about, and a scandal at the NIH further jeopardizes trust in science.

On this episode we welcome guest Dr. Joshua Trebach, an emergency medicine physician here at Iowa. This past spring he posted on X that medicine must "lose the mentality of thinking its okay to be miserable for years (or decades) to justify it being 'finally worth it' in the end." We couldn't agree more--live now, not later! Which is why PA2 Julie Vuong, M2 Fallon Jung, and MD/PhD student Madi Wahlen are each finding ways to reject that mentality. Indeed, medical education is changing, perhaps slowly, to reinforce the idea that just because medicine can be a difficult life doesn't mean that you should obsessively look forward to the day it gets better. That day is a long way away, so do what you can (what you must) to be who you want to be even as you're drinking from the firehose. Also, we answer one of listener Mohamed's questions on how he can jump right into his first year this fall with his eyes on patient advocacy.

It's easy to forget from our ivory tower that many Americans don’t get beyond high school, making it less likely their kids will. Those kids who do are at a disadvantage compared to peers with college-educated parents. First-generation medical students are even rarer and face more challenges. These students, like PA1 Julie Vuong, M1 Amanda Litka, MD/PhD student Faith Prochaska, and M1 Holly Hemann, bring valuable perspectives to medicine, understanding a wider range of patient experiences and health determinants. This week we discuss their challenges, the impact on their future practice, and how learning medicine highlights (somewhat uncomfortably) their own families' health struggles. And while some medical schools are going tuition-free, this hasn’t increased low-income student enrollment or primary care graduates...and seems to have done some harm.

Its Our monthly roundup of news from the margins of medicine! M1s Fallon Jung and Taryn O’Brien, M2 Jeff Goddard, and MD/PhD studnet Riley Behan Bush are on hand for our monthly news roundup. Including news that presidential candidate and anti-vaxxer Robert F. Kennedy’s brain was ‘eaten’ by a worm and his love of tuna sandwiches. Virtually all healthcare providers globally suffer from a clinical psychiatric disorder. Beethoven really liked lead-sweetened wine, which is probably why he was so sick and deaf. And a Tesla Cybertruck owner smashed his own finger with his vehicle’s frunk to prove that his vehicle’s frunk couldn’t smash his own finger. And can we guess what the shitty life pro tip from Reddit is? Plus lots more observations and revelations from the margins of medicine!

“I honestly have had the most relaxing time I’ve had in forever, and for anybody who’s like, that’s ridiculous, just wait.” The most charitable definition of a hot take is a position taken in order to generate conversation. The more usual definition is a position taken to create controversy (and clicks). Dave asked his co-hosts to come with some hot takes, and it’s up to you to decide which definition they’re using, but PA1 Conner Lieser and M1s Radha Velamuri, Amanda Litka, and Sri Nandakumar offer their hot takes on how hard med school is, the admissions process, shadowing, advice from more advanced students, and more. [Dave's co-hosts were all doing medical student things on our usual recording day, so enjoy this previously released episode!]

M1s Fallon Jung and Alex Nigg, M2 Jeff Goddard, and MD/PhD student Riley Behan Bush hear listener Megan's request for more news on critical healthcare changes from our overlords in the courts and the government. Riley shares insights from her lab work as she works toward finishing her PhD. This episode unpacks the FTC's move to ban non-compete clauses for doctors, a pivotal Supreme Court case on Idaho's abortion policies, and new consent requirements for performing invasive procedures that I guarantee you didn't know were being done on anesthetized people.

Medicine isn’t always kind to its disabled practitioners, but let’s change that. In 2023, a group of Iowa med students founded our chapter of the Medical Students With Disabilities and Chronic Illness, a group “working to remove barriers for students and professionals with disabilities, increasing representation of diverse perspectives in medicine.” M1 Holly Hemann, MD/PhD student Faith Prochaska and PA1s Olivia Quinby and Julie Vuong discuss their lived experiences as students navigating disability and chronic illness. They illuminate the essential support systems, the process of securing necessary accommodations, and the powerful sense of community among students facing similar challenges. And they look critically at how these personal experiences enrich the medical profession and underscore the urgent need for inclusivity in medical training. Their personal stories of coping with PTSD, ADHD, daily vestibular migraines, and celiac disease show how these experiences are shaping their medical journey. They also discuss what colleagues present and future can do (or must do better) to understand and support those who face barriers due to their physical and mental conditions.

It’s a freestyle episode…can’t we just have a rambling conversation? Sometimes it’s nice to just sit down and have a rambling conversation. That’s this episode, with MD/PhD students Madi Wahlen and Sahaana Arumugam and M3s Jacob Hansen and Jacob Lam. We discuss the non-weighty topics of why people don’t know they shouldn’t stare at a ball of fusion in the sky, niche online community drama, a Texas transplant surgeon accused of manipulating transplant lists, everyday things that might not be things someday, why Dave doesn’t yet want an electric vehicle, the co-hosts plans for their futures beyond seeing patients, and so much more that is barely relevant to medical school. If you don’t like this kind of episode, do we have a solution for you--https://theshortcoat.com/tellus!

Occupational Medicine offers a great lifestyle, scope mix, and early-career satisfaction. Matthew Kiok, MD, MPH tells us he's found the perfect specialty. Occupational Medicine is one of those careers we're exploring in our sleeper specialty series--those which you might not immediately think of when you're considering a career as a physician. Dr. Kiok tells M1 Fallon Jung, PA1 Julie Vuong, and M2 Jeff Goddard that he has great work-life balance and a satisfying scope of practice. He makes a difference in peoples' lives by keeping them safe in their workplaces or assessing work-related injuries, even testifying as an expert in court. His experiences highlight the unique challenges and rewarding moments in his chosen career and insights into the complicated relationship between doctors, employers, and employees. He offers advice to those considering a similar career path--and he even gave us his email address if you want to ask him more about it! What a guy!

Are you better off as a surgeon or in palliative care? MD/PhD student Jacqueline Nielsen, M2 Hend Al-Kaylani, and M1 Fallon Jung play with personality to see if their path toward choosing the right medical specialty should be dependent on their personality traits. From the introspective nature of psychiatry to the rapid decision-making required in emergency medicine, Dave and crew explore how tests like The Big 5 or Meyers Briggs might influence their specialty choices. Some question the scientific validity of most personality testing, but the Big Five has some evidence behind it, so Dave also created a custom GPT to analyze their test results and suggest best (and worst) specialties for all of them. This episode also touches upon the broader implications of these choices on personal satisfaction and professional success in medicine. Also, we ponder our consumption of news and its impact on mental health and the Kate Middleton mystery's hold on the world.

M1 Fallon Jung, PA1 Olivia Quinby, MD/PhD student Faith Prochaska, M2 Jeff Goddard, and special guest Dr. Peter Kaboli dive deep into the heart of rural medicine. We kick off with a candid discussion about growing up in small towns and how these experiences shape our understanding of community and healthcare. Dr. Kaboli, an expert in rural health with the Veterans' Administration, shares his insights into the nuances of rural medicine. We explore the multifaceted challenges and rewards of practicing medicine in rural settings, from the importance of forming deep connections with patients to navigating the scarcity of healthcare resources. Telemedicine, workforce issues, geographic barriers, and the digital divide are central to the art of medicine in small towns and on county roads, sometimes requiring innovative approaches to healthcare delivery.

Speaking up for your patients will have profound impacts. Short Coat Savannah’s previous work in mental health settings exposed her to situations where she had to report abuse. She left us a message at 347-SHORTCT asking us to talk about patient advocacy. MD/PhD student Riley, PA1 Faith, M1 Jeff, and M3 Happy–along with some of our faculty–look at what doctors actually do to advocate for their patients in that situation, as well as other more common situations. Plus, Jeff licks an elephant to right an old wrong.

Dave hosts a weird cocktail party for his co-hosts, M1s Fallon Jung and Taryn O'Brian, MD/PhD student Jacqueline Nielson, and M3 Chirayu Shukla. The group dives into a variety of topics: surreal dreams, spring break plans, which celebrity they would replace one of their organs with, book recommendations, personal stories, and AI-generated songs about Menards and Chirayu's curtailed tennis career.

Dave hosts a weird cocktail party for his co-hosts, M1s Fallon Jung and Taryn O'Brian, MD/PhD student Jacqueline Nielson, and M3 Chirayu Shukla. The group dives into a variety of topics: surreal dreams, spring break plans, which celebrity they would replace one of their organs with, book recommendations, personal stories, and AI-generated songs about Menards and Chirayu's curtailed tennis career.

An alumni of CCOM and SCP returns to prove: you can do it! MD/PhD student Miranda Schene, M2 Jeff Goddard, and M1 Fallon Jung visit with alumni Teneme Konne, MD, now a second-year resident. They start by smacking their foreheads over AI-generated images in a recent medical journal, unpacking the rigorous demands of peer review and its pivotal role in scientific accuracy. The conversation then shifts to Dr. Konne’s journey in medicine, and the broad responsibilities of family medicine practitioners beyond clinical care. The resilience and growth he achieved during residency offer a comprehensive insight into the realities of becoming a doctor. Key moments include discussions on medical misinformation, the integral role of primary care physicians, and the personal and professional evolution experienced through residency. It wasn’t completely smooth, but he did it! And the crew discusses Medscape’s Physician Lifestyle & Happiness Report 2024.

Understanding others begins with asking questions. M3 Jacob Hansen, and M1s Taryn O’Brien, Alex Nigg, and Fallon Jung consider recent studies highlighting the ineffectiveness of traditional implicit bias training and the disparities in medical care for children of color. Jacob successfully finished Step 1 and the co-hosts tap him for some of his insights from clinical rotations, particularly learning he won’t be pursuing a career in surgery. Dave tries to understand an important aspect of med student culture using his Gen X brain: memes, including their potential as educational tools. We Want to Hear From You: YOUR VOICE MATTERS! We welcome your feedback, listener questions, and shower thoughts.  Do you agree or disagree with something we said today?  Did you hear something really helpful?  Can we answer a question for you? Are we delivering a podcast you want to keep listening to?  Leave a message at 347-SHORTCT (347-746-7828) and we’ll put your message in a future episode (use *67 to be an “Unknown caller”). Or email theshortcoats@gmail.com. We want to know more about you: We do more things on… Instagram: https://www.instagram.com/theshortcoatYouTube: https://www.youtube.com/theshortcoat You deserve to be happy and healthy. If you’re struggling with racism, harassment, hate, your mental health, or some other crisis, visit http://theshortcoat.com/help, and send additions to the resources there to theshortcoats@gmail.com. We love you. Music provided by Argofox.  License: bit.ly/CCAttributionDOCTOR VOX – Heatstroke:

Happy Valentines Day! MD/PhD student Faith Prochaska, and M1s Taryn O'Brien and Fallon Jung share how they navigate relationships amidst their hectic schedules. With quizmaster Jeff Emrich from student financial services, they play The Just Married Game and discuss their personal plans, the balance between work and personal life, and their insights into relationships in med school through a series of questions answered by their partners--can they guess what their partners think of them? The group also touches on the impact of medical school on their personal lives, highlighting the importance of communication and support in maintaining strong relationships.