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This episode was produced by James Chua and Ashley Tam, hosted by James Chua, and graphic by Callista Wu and Claire Sun.
Time Stamps:
00:00 Introduction to White Coats & Rice: An APAMSA Podcast
00:52 Introduction to Dr. Neel Singhal
01:24 Day in the Life of a Neurocritical Care Physician Scientist
03:57 Why Neurocritical Care?
05:16 Evolution of the Practice of Neurocritical Care
06:48 Neurocritical Care at UCSF
07:51 The Various Roles of a Modern Physician
09:44 -Omics Research in Medicine
12:11 Recommended Experiences to Pursue Neurocritical Care
13:22 How to Find Mentors
14:33 How to Stay Grounded
16:09 Having a Partner in Medicine
18:03 Maintaining Relationships and Friendships While in Medicine
19:37 The Role of Research in Work-Life Balance
20:45 How to Be Present for Your Family
23:39 Taking Care of Yourself
25:44 Intramural Sports and Friends Outside of Medicine
26:43 Taking Vacation Time and Traveling
29:20 What Would You Have Done Differently?
31:02 Taking Advantage of Free Time Before Residency
32:45 Closing: What is One Thing that Brought You Joy Today?
Full Transcript
0:00 Introduction to White Coats & Rice: An APAMSA Podcast
Annie: Welcome everyone to the 5th episode of the Asian Pacific American Medical Student Association Podcast. From roundtable discussions of current health topics, to recaps of our panels with distinguished leaders in the healthcare field, to even meeting current student leaders within the organization – this is White Coats and Rice. My name is Annie Nguyen, a postbac at Stanford University, and a member of the Leadership Committee at APAMSA. I’ll be your host for today!
This is our Ask Me Anything Series! Each month, we spotlight an extraordinary physician who shares their insights on medicine, life, and everything in between. This is your chance to ask questions, hear their stories, and learn more from their incredible experiences. Whether you’re curious about their journey, their day-to-day, or their views on the future of medicine, nothing is off the table. Let’s dive in!
00:52 Introduction to Dr. Neel Singhal
Annie: Today, we’re speaking with Dr. Neel Singhal, a physician scientist at UCSF specializing in neuro critical care. Dr. Singhal earned his medical degree and doctoral degree in neuroscience from the Perelman School of Medicine. He then completed a residency in neurology and a fellowship in neurocritical care at UCSF. He is a member of the Neurocritical Care Society and American Heart Association, and his research focuses on improving the diagnosis and treatment of neurological emergencies, including stroke and traumatic brain injury.
01:24 Day in the Life of a Neurocritical Care Physician Scientist
Annie: Dr. Singhal, we’re very excited to have you here today. Thank you for being here. if you could start with just a brief introduction about what a day in your life looks like.
Dr. Singhal: Thanks so much for having me and happy to be here and impart any wisdom or lack thereof that I’ve learned over the last many, many years in academia. At this point, although I don’t feel that old when I look back at the calendar and see how long I’ve been in medicine. It’s it’s been most of my life at this point, um, or more so than when I was a kid. A little bit about my day looks like I would say, I finished my training, my fellowship in 2015. So I’ve been out of training, just for about ten years, and I would say year-to-year of what I do in a day or what I do over a calendar has changed somewhat. I would say right now I’m reached somewhat of an optimal state for at least you know, what I want to do. About two thirds of my time is protected for research, and then about one third of my time is clinical work. On an average week I’ll see patients half a day a week, and then the rest of the have reserved for research and administrative activities. One week out of every two months or so, I’ll spend the entire week in the hospital. You know, in terms of rounding on patients and the neuro critical care unit or neurology services. On a day to day running a lab for those of you that have worked in labs, I do a lot of the things that you’ve seen your PIs do. I would say I spend a two days, writing, whether it’s papers or grants. Writing is a never ending thing that you continually evolve with how good you are at it and how quickly you can do it. I spent a lot of time analyzing data. I still have a very small research group. you know, two and a half full time personnel and three students, and while they’re busy generating a lot of data, I end up doing a lot of the analysis. I do a lot of mentoring of the people I have, helping them write their grants, helping them write their papers. I do some experiments every now and then, especially if I’m onboard new undergraduates. And a lot of meetings, like to facilitate collaborations, to facilitate clinical care of the clinical programs I’m involved in, some meetings for fun, like academic talks and, clinical talks and things like I’ve come to the point where I feel like I have a pretty good balance of the things that I enjoy.
3:57 Why Neurocritical Care?
Annie: So this balance and having your hands in a bunch of different places sounds really exciting because you get some of the clinical input as well as some of the maybe less exciting administrative stuff, and then you have all your scientific endeavors. Was this structure something that attracted you to this specific line of work, or what was it that attracted you to neuro critical care?
Dr. Singhal: I would say that, really for me, and it might be different for different people that you ask. But for me, I was really driven by the content more than anything else. I didn’t think so much about what my life would be like, and if I had thought more about what my life would be like, I think I would have been wrong, because I wouldn’t have exactly known how either clinical care would evolve or labs would evolve as well, or differently as they have. But I was really just content driven, you know, for better or for worse. I just really enjoyed working in the intense environment of the ICU. I really like thinking about the brain. I mean, ever since I was a kid and my mom was in college while I was a kid, bringing home psychology textbooks, like the stuff about the brain just always kind of fascinated me, and I’ve just always been drawn to it. And in college, that was cultivated in med it was just the, the content, the teamwork, talking with patients, helping patients deal with devastating brain injuries, helping families come to terms.
5:16 Evolution of the Practice of Neurocritical Care
Annie: How do you feel like the field of neuro critical care has changed the course of your practice? Where do you see it going?
Dr. Singhal: Neurocritical care in particular, is an example of a field that’s pretty young compared to other, more established fields. And because it’s so young, it’s practiced differently at different places. And in terms of practice, I don’t mean the actual content, I just mean kind of like what the structure of your day is. For some neuro critical care it’s very embedded within neurosurgery. And, you know, you’re really, really hand in hand with the neurosurgeons a lot. And in some programs, it’s a little bit more like you’re practicing neurology in the ICU– how we practice it here’s a little bit of we do some stroke work and some neurosurgical work and some more straight up neurology, sort of a good mix. You know, when I was inspired to go into neuro critical care is when I was in medical school at Penn. But the way that the unit is set up there is kind of very different from the way that it’s set up here. One thing that’s evolved in ICUs, not just neuro ICU, but other ICUs the strong contributions NPs and PAs to the critical care practice, so it really allow for these larger– for you to practice in larger units, taking care of more patients with more staff, but still sort of being able to do a good job because you have really well physician extenders to some, to some degree. So I think the practice has changed in many ways. And it’s different in many ways because of just depending on what institution you’re at.
6:48 Neurocritical Care at UCSF
Annie: Are there certain things about the division at UCSF that really drew you in, aside from being able to do research?
Dr. Singhal: I think being able to do the research is a big part of it. At a lot of places around the country, when you’re practicing something technically intense as, like, surgical specialties or practically intensive, as many medical specialties are, the program really benefits from having clinicians that are really focused on the clinical. But at places like UCSF or academically focused places, we just have an abundance of intensivist and neuro intensivists. Look at the whole state California or look at all the non big cities in California, and maybe there’s like one or 2 or 3 neuro intensivist in those cities, Fresno or, Reno or upstate California, there’s very few, but then you look at the big cities, the big academic centers we have like a dozen, just here at UCSF and, if you include the whole Bay Area we have so many, so it really gives us the time that we need to, know, devote to clinical care, but then also to extend the capabilities of clinical care with research.
7:51 The Various Roles of a Modern Physician
Annie: For those who are interested in neuro critical care, do you believe that research is an experience that is essential for their training? Or are there other skills and experiences that would be very helpful?
Dr. Singhal: Nowadays, in most fields of medicine, I don’t know if research is essential anymore because there’s so many roles for physicians, so many useful roles physicians can play, and research is just one of them. Even at places like UCSF, research is not, necessarily required for some specific job descriptions. Historically, places like UCSF and academic centers really benefit from having researchers around, and a lot of patients come to places like UCSF because of the research capabilities and the history of that. There’s just sort of no end to the, to the need that physicians could fill. There are so many skills that amazing administrators and leaders, clinical leaders have that researchers just don’t have the training and maybe don’t want to cultivate the skills necessary to do that. And having specialized administrators that can really put together excellent clinical programs is a skill unto itself. Education is another forefront where academic centers don’t necessarily need you to focus on research and over the last five years, there’s a late but growing recognition that just because you’re a physician doesn’t mean you’re a teacher. Places like UCSF and probably others have really invested a lot of time and money into teaching educations, teaching physicians how to be educators as opposed to just sort of handing them students and saying, you know, somebody taught you, so now you can teach they’re actually giving people training in how to be a good teacher. And then even within research, right, it’s not just basic science or clinical research, but is epidemiology, public health. There’s almost different niches to fill if you’re a physician.
9:44 -Omics Research in Medicine
Annie: So on the note of research, there was a question in the chat from Reanna about transcriptomics and genomics research in the neuro critical care setting. So any thoughts on that?
Dr. Singhal: One of the best examples the medicine field has for precision medicine is oncology. Oncology really had amazing progress in treating so many different types of cancers over the last 15 years and brought new things, new therapies to market for very specific cancers and have the promise to do so more. And not maybe not every field is going to benefit as much precision knowledge about the disease, but it can’t hurt. And I think we’re just at the surface of understanding the contributions of -omics like genomics or transcriptomics or proteomics other new -omics that people keep coming up with, and other omics that are that we don’t even know about, you know. And how that’s related to a specific patient’s disease. A lot of people say that progress in clinical research is slow because it takes evidence so long to accumulate about a treatment for example, in the in the world of stroke, one of the newest treatments since 2015 is something called embolectomy, where you can actually go in with a catheter and remove the blood clot if a patient has a specific kind of a stroke. And it makes such intuitive sense that this procedure would work because you’re taking out the blood clot and now they have restored blood flow. But there’s actually a kind of a long history of this procedure actually causing more harm than good when the devices were early and, even when the devices were, it wasn’t clear which patients would benefit from it, but then the science of radiology using specific radiology scans, you could define which population would benefit more from the procedure versus less. And it had to do with how much viable brain tissue they had. So that type of precision radiology really helped stroke advance. And similarly I think that type of precision-omics can help a lot of different fields advance, including neuro critical care. There’s so many controversies in neuro critical care that haven’t necessarily been answered by what people thought would be, definitive clinical trials. And the opportunity to have additional biomarkers from -omics that might really help specify the patient populations that benefit from a treatment or don’t benefit from a treatment.
12:11 Recommended Experiences to Pursue Neurocritical Care
Annie: So the generation of all these I agree, is very interesting. Sifting through all that data and finding these biomarkers is the next frontier, but there’s definitely a lot to sort. Are there specific skills or experiences that you would recommend for those who are interested in neuro critical care to pursue?
Dr. Singhal: Most places now have a neuro critical care rotation. Certainly having that rotation under your belt helps a lot. If you want to go into any critical care field, the rotation that actually helped me the most as a med student was anesthesia. Spending a month in anesthesia was the most helpful thing I can think of in medical school. Maybe just for one reason, it just really made you comfortable with more critical situations. If you ask the most intensivists what the scariest things are for them, by far and away airway issues and spending a month on anesthesia is by no means enough time to become an expert on airway, but at least it gives you some knowledge of like what you would need to know to help take care of patients airways when those crises come up. So anesthesia was a super helpful rotation for many reasons. The background that you get from neurology is obviously helpful. But then, you know, more specifically, putting that together in the critical care.
13:22 How to Find Mentors
Annie: You mentioned earlier that there are undergrads that you’ve mentored before, and it does sound like mentorship is very important to you. Do you have any advice on how to approach mentors in neuro critical care or the best way to find mentors?
Dr. Singhal: Yeah, that’s a hard question. sometimes you find a kind of by accident. You know, you just, come across someone in a clinical setting or a non-clinical setting and, you know, sort of clicks that, they’ve gone down the path that you want to go down and you want to learn from them, and they seem to be open to it. And that’s always those organic types cultivated relationships are sometimes always the most rewarding. But sometimes you’re not going to run across that by accident, and you have to kind of go out searching for it. You know, the power of a cold email when they’re not ignoring that tells you something about, someone’s openness to mentoring because a cold email might be the best way to put you in touch with someone who you truly feel like you could learn from. I would suggest that that email talk about what your interests are moving and just see if you can set up an initial meeting and talk more. What really comes through in the students that we take on often, are less the experiences they’ve had and more, you know, what they can commit.
14:33 How to Stay Grounded
Annie: You mentioned that this is a very intense, uh, specialty to pursue. Are there certain things that you did during your training to really maintain, like a strong sense of grounding, or what were the things that you relied on to kind of get you through it?
Dr. Singhal: Oh, that’s a sort of a multiple fold question. I was the type of person and maybe still and just kind of put my head down and do the work as efficiently as possible, and then, you know, go live my life. So on one it’s nice to silo the work and the non-work. There’s nothing that’s going to recharge you as much as leaving your place of work. But on the other hand while you’re in training, you’re working so many and there’s always pressure to work more hours, it’s difficult to, like, totally silo it, and it’s difficult to step away from it. It’s difficult to know when to say “no” to those things. It is important to, set up some sort of boundaries, although it doesn’t have to be perfect silos. It’s important to also, while you’re going through to not forget what motivated you in the first place. I interview a lot of students as they’re applying for medical school and I’m always so impressed with everything they’ve accomplished and everything they want to accomplish. And then I work with a lot of students on the wards, and sometimes you can tell the students on the wards are beat down and have forgotten the things that motivated them to go into medicine in the first place. So not forgetting the things you’re motivated and knowing when to say no or when to go home and then knowing what recharges you, is important. The things that might recharge you that’s different for and that’s changed for me from time to time as well.
16:09 Having a Partner in Medicine
Annie: So having a support system definitely sounds very critical for you. You had mentioned that you or we know that you have a partner in medicine. Can you tell us a little bit more about how this played out for you, or what kind of support this provided you?
Dr. Singhal: Yeah, yeah. I mean, we, we’re like the super dorky couple we met at a neuroscience conference. We met at– my wife and I met at Society for Neuroscience in 2006 and, uh, she was already matched to come out to San Francisco. We started dating when we were both in Philadelphia and training, and then she was already matched to come out here in 2009. And then I remember meeting with one of my mentors, uh, Steven Galetta, who’s at NYU and was at Penn before, and he has this thick New York accent that I’m not going to try to imitate. But he said, “you know, if you’re serious about the girl, go to San Francisco”. So I, I came out and did in a way, sub-I in San Francisco. Um, and, and loved it out here. Um, so it was, you know, sort of amazing and also serendipitous that we were able to go through residency, kind of at the same, go through fellowship at the same time, faculty at the same time, and although we’re both in neurology, my wife does pediatrics and she does epilepsy and she does education. Our department is 300 people. So it’s not it’s not like we really overlap in space or subject matter, but there’s sort of enough overlap in our universe that, it’s great. It’s great to have a partner in that. It can also, at some points in time, be too much to have a partner that’s in the exact same, you know, field as you. I think from the beginning of our relationship that we’ve always really not talked about medicine that much. Like, I think we both have this unspoken rule of, you know, there’s other things going on. and that’s naturally happened as we’ve had kids, you know, we have an 11 year old, a 9 year old, and a 4 year old where, like most parents, 80% of what we talk about is the kids at this point.
18:03 Maintaining Relationships and Friendships While in Medicine
Annie: What advice would you give to other physicians who are trying to manage their careers alongside supporting their spouse, who is also in medicine?
Dr. Singhal: Maybe even though I have a lot more years on you guys, um, you know, maintaining any kind of relationship, whether it’s a marriage or a friendship or whatever it might be, it’s like a lot of work, right? You know, being a– being a son or daughter, you always have to put in work into maintaining that relationship. And, and there are times when you’re just going to have to apologize because you are going to have a lot of other demands on you. And sometimes you just have no choice, you chose this path where I’m going to be a resident and working eighty hours a week for four years. And, uh, it it just happens to be that in, you know, March, I have to work, you know, 80 plus hours a week, and I just don’t have time to hang out with my brother or hang out, go see my parents or, you know, hang out with my spouse as much. And, and the people in your life, in some ways have to accept that you have to apologize for it and offer, you know, support in times that you can or make small, uh, bits for bits of support in the ways that you can when you don’t have time. Um, Yeah, for better or for worse, going down the path of residency will sacrifice the time that you have for other things, and the people that are going to be closest to you are going to understand that. But some people may not.
19:37 The Role of Research in Work-Life Balance
Annie: So setting realistic expectations, knowing what to expect and taking accountability. Those are definitely very helpful pieces of advice. Oh, we have a question on the same note from Reanna. Do you want to unmute?
Reanna: How do you manage kids during your training and or career? And how do you ensure your present for your family? And then finally, do you feel like the aspect of research helps your work life balance?
Dr. Singhal: I think research definitely helps. I’ll go with the last one first. I feel like research definitely helps the work life balance. That, you know, the thing about having kids is that it’s unpredictable when they’re going to need extra help or, you know, parents around or not. And, um, especially when they’re young, it’s just a lot of, like, brute force parenting where you have to be there for them, like when they’re infants and they’re sick and they can’t go to school. And, so it’s so unpredictable to have a little kid and research is predictable in that it’s never an emergency. So it’s the more time you have carved out for research or flexible time. That’s not patient care, the easier it is to manage your work life balance.
20:45 How to Be Present for Your Family
Dr. Singhal: Um, Um, how can you be present for your family? Yeah, I, I think for me, that’s evolved over time. Like being an intensivist is both good and bad for the family. It’s good because, uh, what’s considered an academic workload for an intensivist or even a full time intensivist is not actually working every single week of the year. You know, like most hospitalist jobs are like 22 weeks out of the year, 20 weeks out of the year. Um, so you’re actually fairly available, right? As long as it’s not one of those 20 weeks out of the year, you’re pretty available the rest of the time to have flexible work life balance. But then you have to have arrangements on those weeks where you’re not present at all or like you may be totally ransacked even when you are home because of phone calls or having to look at images on the– on your EMR because people are sick and need your help. So how can you ensure that your present for your family, um, that evolves over time. Uh, when your kids are young, uh, when your kids are young, they’re going to need you more, and you may have to cut down your clinical workload. Um, or you may have to change your job a bit. I mean, one thing, I actually transitioned my job in 2022 to be less at the county hospital and more at the VA hospital, uh, because at that point, we had a third kid and I was going to have more responsibility at home. So kind of signed up for a five year, you know, period of time to be more at the VA and less at the county. Um, so that’s, that’s been great. You know, instead of working like 8 to 12 weekends a year, I’m only working like, you know, 3 or 4 weekends a year. So, you know, that’s a huge difference when it comes to like going to soccer games and being with your family. So, so even within one institution, you can cultivate your job, uh, such that, you know, I was at UCSF this whole time, but I just kind of focused more on one hospital, less on the other. Um, know, hopefully if you’re in a good spot, hopefully this flexibility in how you can structure your job. And then managing kids during training, I think that’s the hardest, actually, because you really don’t have much flexible time in training. Um, I don’t know how my co-residents, we had our kids at the end of our training, uh, so it didn’t impact us. But my co-residents who had kids, like, I just don’t know how they did it. It’s ,it’s really hard. Like, you– need you need help. You can’t do it on your own. Uh, whether that help is family or somehow paid or a combination. Um, I would say it would be expecting too much. I think having a kid in training, it’s definitely possible, people do it. Um, I don’t think people can get it done without help, though.
23:39 Taking Care of Yourself
Annie: Fantastic insights. Thank you so much. So far we’ve covered balancing clinical care and research. Now we’ve talked about being a spouse and also being a parent. Um, the last thing is how you’ve managed to take care of yourself in all of this. Um, because you definitely can’t take care of others if you’re not sustaining, you know, your own well-being and everything. So are there certain things that have, you know, kind of helped keep you sane or are the things that you rely on?
Dr. Singhal: As a kid and in college, um, I never really thought about, like, health or wellness that much. And that’s because I was already doing it without knowing it, probably like I was already super, you know, I was super into sports. I was always, like, playing a sport. Always. Um. You know, we’ve kind of signing up for different teams and staying super active, uh, you know, socially with friend circles and things. And then as you get deeper into your career or professional life, you kind of forget how important those things are to you. Or maybe you never realized how important those things are to you. And it’s like, well, well, I’m just, you know, I’m not going to really have time to play in that soccer league this year or I’m not going to worry about going for a run, you know, today. But, um, when those things are missing from my life, um, because life gets busy, uh, definitely, you know, realize that those are the things that recharge me, you know, like staying active. Um, not forgetting about social engagements with friends and, you know, you know, hosting dinner parties or going out with friends. And, and then it’s like, yeah, as things have evolved, it’s, you know, more like hanging out with my kids, taking them to the beach, uh, watching their basketball games, things like that. Um, those those so, yeah, in some ways, you got to kind of think about, okay, what are the things that really made me happy when I was younger? Am I still doing those things, or did they drop out of my life for some reason, and should I go back to them or not? So yeah, for me. You know, playing sports. Watching sports. Definitely.
25:44 Intramural Sports and Friends Outside of Medicine
Annie: Can you tell us a little bit more about how you found little pockets or people or groups for these sports when you were transitioning from different areas?
Dr. Singhal: Yeah, yeah, yeah, definitely. In my um, most cities have, you know, have different ways to like, meet up for, for leagues or gyms, I would say like joining gyms and joining, you know, joining sports leagues that you find online. You know, those are ways that my friend circle grew, I think, during training, um, serendipitously came across a lot of friends that weren’t in medicine. And that was also really, uh, an important part of staying grounded is having a lot of friends and outside of medicine as well. Kind of forgot about that when I said that earlier. Yeah. I had I had roommates who weren’t in medicine and that, um, expanded my friend circle to a much larger friend circle outside of medicine. And that kind of helps remind you of what life is like outside of medicine.
26:43 Taking Vacation Time and Traveling
Annie: Always good to have those reminders for sure. Uh, one thing that you had mentioned, um, when we talked previously was traveling. So that was something that you have tried to make time for. Are there specific destinations that are your favorites, or how has travel changed now with your kids?
Dr. Singhal: Yeah, yeah. I think, um, traveling is actually, you know, for friends I have outside of medicine, it can be hard to find time to travel because there’s there’s always, like, something going on in high pressure fields. And the good thing about medicine is that often, you know, you can, because because the culture has evolved, you can take two weeks off. Or if you don’t take that two weeks off, people are like, you know, why aren’t you using your time? And especially now a lot of places, you know, you can’t just keep accumulating vacation. You have to use it. Um, you know, UCSF we get four weeks off. So we’re pretty good about using that whole four weeks. Um, yeah, when you don’t have kids, that’s great because you can just travel off season and go to amazing places. And that’s what I highly recommend. During residency, traveling was great because it was just me and my wife, and we could go off season and, you know, take advantage of cheap flights. Um, so we had amazing trips before we had kids. As we had kids, we had less amazing but also fun, but also fun trips that were more local. Although this summer we did our first, um, trip to Spain with three kids. So we’re still trying to we’re still we still have the travel bug and trying to pass it on to them. Um, so totally possible to travel with kids. Um, you just got to work your way there and your parenting patience and skills.
Annie: Do you have any tips for that? Specifically traveling with kids, especially when quite young.
Dr. Singhal: Yeah, yeah. Hard to give a blanket tip because every kid is different. But I will say that when the kid when kids are from like eight months to two, it’s just so hard to travel with kids, even though it’s free for this, even though it’s free for them to travel. It’s like, oh my gosh, short plane flight, much better than a long plane flight. And yeah, I saw someone put in the chat– to bring an extra person. Yeah, I think it’s all hands on deck sometimes. But once they get to iPad age, then, uh, they are happy to, they’re happy to watch the iPad for three hours when you usually, when I usually limit their screen time to much, much less than that. Mhm. Okay. Pro parenting tip right there. Yeah.
29:20 What Would You Have Done Differently?
Annie: Um, as we come to a close, we just have some general questions to end with. Um, are there any things that you would have done differently in your medical journey if you could go back in time?
Dr. Singhal: I probably didn’t, um, really confront my weaknesses as much, and I might still not, um, you know, I know that one of my main weaknesses is not asking for help when I need it. Um, not asking for mentorship when I need it. Not. Uh, getting the collaborations. Not spending the time on cultivating collaboration, and instead just putting my head down and doing the work. I think I know those are my weaknesses. And, um, if I maybe really appreciated it, um, some of those things earlier. I think, you know, especially in the research world, I would have, you know, I could have maybe set myself up for better success or better collaborations. Uh, earlier. The general piece of advice surrounding that is, yeah, I think, you know, reflect hard about, you know, what your weaknesses might be, what your blind spots might be. And, you know, really, really try to face it head on. Like and critically. It’s hard. And I still don’t know if I do it correctly, but that would be one piece of advice. And then yeah, things that I would–
Annie: I think you were saying that there’s always so many opportunities that you can pursue, and, uh, saying no can also be really hard. Um, have there been certain things that you’ve tried that have made saying no a little bit easier?
Dr. Singhal: No, I still struggle with saying no.
Annie: Totally real life journey then. Okay.
31:02 Taking Advantage of Free Time Before Residency
Dr. Singhal: But yeah, yeah. You know how to say no. Um, know, you want to say no as positively as possible when you do have to say no. Um, and then you just also have to realise that some things you can’t say no to. There’s a lot of unwritten curriculum in moving up the ladder in a hierarchical place like academia. And sometimes if you say no to the wrong thing, you know, they may not ask you again. Um, so, yeah, there is yeah, that’s talked about a lot now, but it wasn’t before. But yeah, there’s a lot of unwritten curricula in academia. Most important advice is, um, yeah, really enjoy that free time that you have before internship. It’s not the last free time you’ll ever have because residency is more humane now, but also has vacation. But it’s still a really, just nice part time in your life to really, like, just sit. Kind of sit back on your laurels a little bit and enjoy everything you’ve accomplished. Um, without much responsibility. In my fourth year, I got so much out of going abroad in the Spring, um, had an opportunity to to practice medicine in Botswana and South Africa and like, learned so much independence from that, that carried over to internship. Like, I think I was a mediocre MS3 and I was like a decent MS4. But then I became like a really good intern. And I think a lot of it was because I spent like two months abroad at the end of my fourth year, which was like super fun, but also like, just really increased my confidence clinically.
32:45 Closing: What is One Thing that Brought You Joy Today?
Annie: That’s an incredible experience. Wish we could learn more about that! Um, but the one thing we always love to end on with each of our speakers in this series, um, has been focusing on one good thing that happened today, kind of what you were saying. It’s really important to step back to enjoy this whole process, um, and to really be grateful for each day. So is there one thing that has happened today that you’ve been very excited about, or one thing that brought you a lot of joy?
Dr. Singhal: Today was an interesting day of reflection for me because of this phone call, but also because I had, um, a meeting with another mentee. Um, so, yeah, it was kind of like a good chance to step back and, you know, think about, uh, and also I had a conversation with the premed person as well. So I had, like, uh, a lot of self-reflection about, uh, how far I’ve come the last few years so that, you know, that’s kind of, you know, a similar point where many fourth year med students are as well.
Annie: I think it’s encouraging to hear that this self-reflection is something that has to happen at every stage. It never stops. You’re always learning, always growing. Perfect. Any last thoughts that you would want to share? That’s all that we have for today.
Dr. Singhal: No. Yeah. Thanks for all the great questions.
Annie: And that’s our latest installment in the Ask Me Anything Series! If you have a specific physician or speciality you’d love to hear from, let us know! You can reach us at professionaldev@apamsa.org. We hope you enjoyed today’s episode as much as we did and don’t forget to tune in next time. Thanks everyone!