Listen here:
YouTube
Spotify
Apple Podcasts
This episode was produced by Annie Nguyen, Reanna Dona-Termine, and Ashley Tam, hosted by Annie Nguyen, and graphic by Callista Wu and Claire Sun.
Time Stamps:
0:00 Introduction to White Coats & Rice: An APAMSA Podcast
0:57 Speaker and Event Introduction
2:40 Dr. Grace Kajita: Support, Simplicity, and Presence
8:39 Dr. Indu Partha: Attitude, Business, and People
14:25 Dr. Nolan Kagetsu: Policies, Time Off, and Work-Life Balance
18:42 Dr. Caroline Park: Balance, Teamwork, and Growth
25:56 Q&A From Audience
27:00 Navigating Conflict in Residency: Strategies for Professional Growth
32:33 Common Pitfalls and How to Avoid Them
36:38 Endurance in Medicine: Sustaining Passion and Well-Being
41:00 Finding Our Voice: Asian Identity in Medicine
50:48 Closing
Full Transcript
0:00 Introduction to White Coats & Rice: An APAMSA Podcast
Annie: Welcome everyone to the 6th 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 Preparing for PGY-1 Event, where doctors Grace Kajita, Indu Partha, Nolan Kagetsu, and Caroline Park share insights on navigating the transition to residency. These four program directors provide concrete advice on making a great impression, choosing the right program, and managing the challenges of intern year. Whether you’re preparing for PGY-1 yourself, or simply looking for professional development tips, this event is for you! Let’s dive in!
0:57 Speaker and Event Introduction
Annie: So thank you everyone for coming today. we’re very excited for this event, brought to you by our Leadership Committee. We hope that we can provide some meaningful insights on how to best prepare for PGY-1, or just in general, how to navigate your journey in medicine, since everyone here might be at a different stage. Um, to do this, we’ve gathered the most incredible panel, Um, to help share their tips with you. And just as a brief overview of the events, we want to start with a presentation where each of our panelists will share their insights, and then we’ll open up to all of you for a Q&A. Um, this event is definitely for you guys, so don’t hesitate to ask questions. You can drop them in the chat. You can also just raise your hand or unmute. Um, we just want to make sure that you get all your questions answered. So without further ado, I wanted to introduce our panelists. We’re going to start with doctor Grace Kajita. She’s an internal medicine program director at the Albert Einstein College of Medicine. We have Doctor Indu Partha an internal medicine associate program director at the University of Arizona, Tucson. Um, we have Doctor Nolan Kagetsu, a former radiology program director at Mount Sinai. And last but not least, Doctor Caroline Park, the trauma medical director and former fellowship program director at UT southwestern. So, big round of applause for everyone. And just before we get started, as Doctor Partha mentioned, if any of you are comfortable turning on your cameras, we would love to see your faces. It’s nice to talk to other faces. Um, okay. So I’ll go ahead and share my screen.
2:40 Dr. Grace Kajita: Support, Simplicity, and Presence
Annie: We’ll start with the presentation, and we’re going to hear first from Doctor Kajita.
Dr. Kajita: Thank you so much for that great introduction, Annie, and it’s really a pleasure to be with all of you again. I think this is my second APAMSA event and I’m really excited for all of you. I don’t know where everyone is at this point in the process, but I’m going to address a common concern that lots of people have coming into residency. One thing I do want to do before I start is just sort of say a little bit about myself. I’m a general internist. I currently work at the Montefiore Medical Center in the Bronx, at one of the smaller internal medicine residency programs, we’re primarily international medical grads. But I used to work at NYU. Everyone always has the same questions, so please feel free to stop me if you can’t hear anything or also to ask questions afterwards. Now, yes, that’s me on my– on this slide. It’s not a great photo. This is one of the reasons why we don’t turn on our cameras when we do these things right. But I’m going to make a point about this at the end of my sort of three major bullet points. And what you’re going to see on the slide is that I’m not talking about stuff you should read or learn or skills necessarily to get better that going into residency. And while, that’s really important. And I understand you’re worried about this, I’m going to talk about some of the peripheral things about your life outside of the hospital, because that really needs to be worked on or cared for just as much as preparing for the academic stuff. So when people ask me, should I review EKGs or chest X-rays? These are sort of the questions I ask them. So for starters, and by the way, you will get some amazing pointers from the other slides that are to come. I’ve seen the slide show, so I’m excited for that as well. So medical school is really different from residency because it’s still at school. And remember that when you go into residency, the expectations are more along the lines of a job. So your work day is different, your downtime is different. Your ability to connect and just hang with people is completely different. One thing throughout everything is that we know you’re outstanding academic achievers, but you also in this space, need to make time to connect. Refresh. Stay close to the people who’ve supported you throughout this journey. So my first point is please establish your support network before you start your residency. And what does that mean? Who are your people? Who are the people who keep you supported that you could call, you know, anytime something is going on? Sometimes it’s a mix of family and friends and mentors. Identify those people. Then make a clear cut plan on how you’re going to stay in touch with them, meaning maybe you want to call them once a week, but if you’re working nights, you’re not going to be able to call them at the same time. So adjust that plan, but don’t let it go, because the more you lose contact with those people, the more isolated you’re going to feel. And residency is a really hard time to feel isolated. So think about your people. Secondly, and I think you guys are of a generation where you do this really well. Simplify your life, okay. Take out the extra stuff and the things that are a hassle, even if they seem cool. Just to make it easier again. You’re kind of. You kind of have a working life now, right? So your time is going to be really, really busy. You come home from the day, you’re going to be tired. So if you, for example, I’m in New York, you think I’m going to be working in the Bronx, but it’ll be really cool to live in Brooklyn. I tell all the interns, please don’t do that. You wouldn’t be miserable with that commute. You’re going to fall asleep if you’re driving. Think about keeping it simple, at least for your first year. Now, I know some of you really have a preference because you want to stay close to family. That’s okay. Or for other reasons. But try to allow yourself plenty of time to do things outside the hospital and outside of work. And by that, I need you also want to make everything as automatic as possible. Your bank payments, your student loan payments, everything. When you prepare a meal, make extra, bundle it so you have leftovers to take for lunch the next day or to have for dinner the next day. Keep it simple if it means a food delivery service. That’s okay too. But set that all up before you start residency, because if you can-, or work on it along the way, it just makes it easier when you have fewer things to worry about. Finally, under this point, remember that you’re just going to be sort of a little bit out of water at the beginning, even if it’s your medical school or a program affiliated with your current medical school. Assume that everything’s going to take longer than it needs to take, right? So just schedule it for double the time. Don’t overbook because that leads to a lot of disappointment. Yes. You think you can go hang out with your friends at a bar after a long call, but you’re also going to do your laundry beforehand? Keep it real. Okay. Finally, and this relates to that point I mentioned earlier about turning on the cameras or seeing each other. Be kind and be present to yourself, your patience to everyone you work with, and show kindness to the first person you see. It’s the person who is assisting patients at the door, the greeter, security guard, whoever it is. Eye contact is amazing. It makes such a difference. Especially since we’re Zooming so many things. Even turning on the camera during the Zoom will make you feel a little more connected to your teachers, your colleagues. And all of that will definitely, although it might feel like a hassle at a time or you’re having a bad hair day, really, people don’t care. Just be there for everyone else. And that’s basically what I have to say. And so I’ll pass it on to my colleague if that’s okay.
8:39 Dr. Indu Partha: Attitude, Business, and People
Dr. Partha: Wonderful! Thanks so much, um, Annie, for the invitation and Grace. It is a pleasure to hear your tips. I, um, cannot agree with them more. Um, so helpful and really so relevant. I am Indu Partha and I am also a general internist. I am a primary care physician by training and passion. And I am one of the associate program directors with the University of Arizona College of Medicine in Tucson, and heading up the ambulatory education side of things for our internal medicine residents. And I really do need to echo what Doctor Kajita said is, you know, we aren’t really here to tell you about what books you should be reading and what you know, learning you need to do to be a successful resident. Because truthfully, that’s what residency is there for. We’re there to educate you. We’re there to train you. We can teach you how to be smarter, but we cannot, um, in– teach you how to have more integrity, more humility, more compassion and more enthusiasm. And those are the qualities that I would love to see you all bring to your respective residencies when you get there. Um, I’ve kind of broken it down to what I thought might be helpful tips for you all as you prepare for residency. And honestly, if you’re earlier in clerkships, I think these are helpful tips as well. Um, and I’ve broken it down into kind of the approach to your attitude to the business and to the people. So in terms of the attitude, this kind of speaks to Doctor Kajita’s. Um, advice to be connected to um. Be integrated with the people around you. Um, and what are your bring– what you’re bringing to the table each and every day. Cannot highlight enough the need for you all to ask for help and feedback and learn how to do so early. Um, think about what you’re bringing to your team, to your junior residents, to your faculty. That energy is very contagious, and what you bring spreads like wildfire and a great attitude. You know, you’ll be working hard regardless, but having a positive, um, not unrealistic attitude, but just a positive ‘we can do it. Let’s work together’ attitude can really go a long way to, um, making residency a lot more fun, a lot more enjoyable, and I might say easier. Um, one of my favorite sayings is water your flowers, not your weeds. Um, this is sort of, put your attention into the places that are giving you back what you need, but also learn how to focus on the things you do well, not always focusing on the things that you do poorly. Um, and really highlight those and spend time growing those passions, um, both clinically and personally. Don’t speculate. Ask and clarify. You know, don’t think ‘I think this is the diagnosis for this patient’, um, yeah. ‘I think they are taking their medications all the time. I think this is what my program director means when they are telling me we have to do x, Y, and Z’. Just ask. Clarify. Don’t write your own narrative and story about what’s going on. Check in with others. If you’re having a rough day, hard time, chances are very, very likely that others are as well. This is how you guys all will work together. Um, and kind of hold each other’s hands through a tiring and rough time of life as being there for one another and check in. Hey. How are you doing? Can I help you? I need help. Can you help me? Um. Be a hand raiser. Again, this goes along with. Turn your camera on. Volunteer to do things. Be available. Be enthusiastic. Um. Any and all faculty are overjoyed when residents show up with enthusiasm and interest. Um, in the midst of their busy days, it’s speaking to the business of things as well. There is business to be done. Please get your paperwork done on time. Believe it or not, this is what program directors and APD’s discuss about their residents. Make sure you set aside time to study. Answer the emails that you get. Please don’t ignore those. It’s part of being a responsible adult resident, which you guys all will be. So please make sure you’re, um, being responsible and replying. And then first and foremost, you need to show up. Show up to conference. Show up for other people. You’re there to learn. And those conferences are important and have been prepared for you to learn. And lastly, don’t forget about the people. Build relationships with your peers. Uh, with your attendings. Learn about your patients beyond their illness. Find the senior residents you admire and emulate how they behave. Ask them, how do you do what you do? How did you learn what you learned? Um. Your chief residents are going to be working really hard on your behalf. Please treat them with thoughtfulness and respect. It’s not an easy job. Um. So do trust them. And lastly, assume positive intent first. It’s really easy when you’re tired and overworked to think, oh my gosh, everyone is kind of out to get me. But if you take a step back, assume a positive intent. Take away what you can from it and then put the rest aside. Um, I think it’ll do a lot towards keeping you happy and healthy as you get through your residency. Um. That is what I’ve got for you. Thanks for your time.
14:25 Dr. Nolan Kagetsu: Policies, Time Off, and Work-Life Balance
Dr. Kagetsu: All right. Thank you. Thank you everyone. Um, it’s great advice from my– my colleagues. Um, I’ll summarize some things. Um, just a reminder. You’re an employee, not a student. I think I forgot that one of my first days, because when I was sick, I didn’t just. I just didn’t show up. And then somebody said, you know, you’re not a student anymore, so, um. Yeah, I and so it seems obvious and stupid now, but whatever. Just saying that, putting it up there. Um, so sometimes different programs have different policies. So you just have to, um, clarify what the policy is at your place. When I was a program director, if a resident said, ‘oh, I have to have a dentist appointment’, I said, ‘okay, fine, that’s like a sick half day or a sick hour or something’. But some programs are more hardcore, if you will. And they say, oh, you get wellness days. So that way you can go to the doctor once a year. And it’s like, I’m thinking, that’s not very generous, but it is pretty common. So, um, I think certainly when you’re an attending, if you have a doctor’s appointment, colleagues will cover you and you’re not you don’t have to take vacation time to, to, um, have medical care. So anyways, I think the key thing is, um, figure out the expectations, the policies, so that you, um, whatever, um, don’t break break rules or or don’t mess up, whatever the culture is. Another thing that is interesting, some people, even for attendings, they you have to kind of get a sense of what personal days are. So personal days. Some people would say, oh, that’s only if I have a personal emergency, and if I want to take a personal day to go shopping, then that’s an abuse of the system. Um, I would say in some ways, personal days are like extra vacation days, and but you have to make sure that’s the culture of your organization. Like the way I used to run it is personal day is essentially like a vacation day. And, you know, if you had a genuine emergency, then you would essentially take an emergency vacation day. And if you had run out of vacation days and have an emergency, well, then maybe you can pay it back next year or something like that. But I think I, even some faculty I remember would essentially not use their personal days when– and for them it was not fair that people would use them. So I think it’s just a better place to be with, if you– if the PD says you know what your personal days are like PTO and use them or or lose them, frankly. And then for some of them I call– I had one resident that, um, you know, there was a scheduled exam that was going to be on Lunar New Year. And for her, that was a– one of the most important days of the year where she had to, I don’t know, you know, always saw her family. And so if there’s 1 or 2 days that are really important for you, I think the program director should try to accommodate, those 1 or 2 days. Um, and, uh, you know, maybe if 15 out of 20 are asking for Lunar New Year off, then obviously that’s going to be an issue. But or perhaps have some sort of lottery system, but I think it’s okay to ask for, um, perhaps 2– 2 holidays should, uh, not break the bank, if you will. I had one resident who for him, his most important day to have a personal day or vacation day was Halloween. And so, you know, for him, that would have been terrible if you did not have Halloween off. So we brought Halloween, and that’s it for me. Happy to take questions at the end.
18:42 Dr. Caroline Park: Balance, Teamwork, and Growth
Dr. Park: Um, I just want to say thanks to Doctor Kagetsu actually, because he reached out to me, uh, on Twitter and, uh, told me about this opportunity. So I think, number one, just, um, looking out for each other. I think that’s the really incredible thing about not only just, you know, us humans, but, um, you know, being in medicine, which is actually a pretty small world and kind of leaving all the other, you know, bits of advice that everyone has given you. If you think about it, you know, we’re going to be working 80 hours a week. You’ll be working 80 hours a week, which is really like that’s double the standard workweek, right? Like that’s crazy. Some people think about that and be like, that’s insane. That’s two jobs. And that’s the reason why I think it’s so important that you spend quality time. It’s not going to be a lot of time. It’s not as much as you used to have, but it’s really high quality and you’re very deliberate about the time that you choose to, you know, meet certain people or whether it’s for yourself or for other people. So, um, that’s just my little segway for my introduction. So, um, first of all, I’m really glad for Annie, uh, for, for pulling this together and all the other, uh, leaders in APAMSA. I’ve actually never been to an APAMSA event, so I’m super excited to be a part of this. I’ve actually been thinking that I have not been very good about being in, like, our own society of Asian-American surgeons, and like, that has been like my priority this year to be, like, more, uh, present, uh, because I really do think that it’s important that, you know, you guys look around your generation, you see mentors that look like you, right? Um, and so then you can kind of see, like what? What are their paths? How are they able to get there? Right? Like, I feel like that’s how people are more comfortable, um, sort of choosing those careers, right? Like. I was kind of intimidated about being a surgeon because I looked around and it was a bunch of white males, and I was like, how do I really fit in here? Right? And I think the more that I went through my clerkships and obviously residency, it changed. And so it’s, it’s become a lot more diverse and in fact, more women than men are. So background for me. I’m an acute care trauma surgeon, so I do both emergency general surgery and trauma. Um, I am now in Dallas. Um, so I trained in Boston and I’m actually from New York, so I’m jealous of all the people that get to enjoy New York bagels, because the bagels in Texas are terrible. Um, and then I train in Los Angeles for fellowships, so now I’m all over the country. I used to be the associate program director for the fellowship, and I am very good friends with a lot of the associate program directors for the residency as well. Um, so number one, uh, I’d say that, you know, when you are first exploring this new city because oftentimes you guys are moving towards totally different cities, different states, right? Like, explore that place before you have to hit there, like day one, right? Like, where is the hospital? How am I going to commute to get there? Like practice the commute, right. Whether it’s biking, walking, subway, car or whatever. Um, because you might find like, for example, in the snowstorm, when you’re parking on that street, you got to dig your car out of the snow, right? And that’s an extra 20 minutes. 30 minutes you have to factor in to your commute. Um, I personally, I was like, I pay more money just to get covered parking if I were in a snowy city. Um, so just get the lay of the land, you know, talk to the other, you know, people that live there now, whether they’re medical students or interns and be like, where do you live? Why do you like being there? Right. Like, just figure out that place. Um, and for anyone in residency, you’re going to be in a new rotation every month, every 30 days, 31 days. You’re going to be thrown into a completely different world. Pediatrics. Gastroenterology. Cardiology. Like, I think honestly, that’s one of the best things about medicine. You get to just experience. I think it’s almost like a new country. It’s a new language. You’re looking at different body systems. You’re learning the lingo of certain things, right. Vascular surgery, it’s all about pulse exams, circulation, inflow and outflow. And I think it’s really cool. I think that if you look into each rotation as being an expert in that field, like this month, I’m going to be a pediatrician next month. You know, I’m gonna be a gastroenterologist and really, like, immerse yourself in that. I feel like you can get your best shot of, like, thinking, is this the kind of life I want? Right? Um, some of you guys already know what you want to do, and that’s great. But I know a lot of people that change your mind as they’re going into medicine, so keep an open mind. Um. The other big thing that I learned was reaching out to the interns that are already on service and kind of like figuring out their hacks, right? Like, what’s the fastest way that you get information? Um, how do you print out lists? Like, how do you like, what’s the way that you build your electronic medical records, sign out sheets, right. Like everyone’s got a different way of doing things. And those little hacks that the interns give you are going to be gold. Um, and then the big thing, and I’m sure you guys have figured out as medical students and, you know, the staff figure this out to the attendings. We know when, um, you know, when people are working really well together as a team. And we can also feel at least like when there’s, like one person that just wants it all and doesn’t want to share with anyone else. And that’s just not helpful. Um, and because at the end of the day, it’s all about the patient, right? And I think that being a part of the team and not just being it’s me because you’re past already. You got through the gates. You’re now a doctor. Okay. Now you just focus on taking care of the patient. It’s not about winning anymore. Okay. Um, so the next thing I already kind of talked about, but just kind of like immersing yourself, you know? And if you’re like, I really want to be, you know, an interventional radiologist. Well, you know, go do that rotation. Ask them what their lifestyle is like. Like, I’ve had plenty of medical students ask me, like, I really love surgery, but gosh, like, these calls are so hard. And I tell them, like, that’s not my whole life. I don’t do this all the time. Um, that’s only half of my month. And the other half don’t even see me because I’m in my office. I’m like, running around the lake, like I’m doing other things. So our lifestyle is very different from what you see as a student, from what you see as a resident, from what you see a fellow, it is so a different hour that you have to wake up at the time that you go to bed and the kind of responsibilities you have. So don’t think that your experience as a med student is like, that’s what my life’s going to be, it will change. The last thing, I am very, very active. Um, I have a lot of hobbies, but I realized that when I became an intern that my 20 hobbies came down to, like, three hobbies. Right? So it was like I had some very, very, very selective about things that I really love to do. I love to bike. I love to run, and that was pretty much it. So I knew that it was are the only two things. If I had an hour on the weekend, I was going to do those two things. So be very, very selective about your hobbies and just pick the ones that like really, really mean a lot to you. Um, the other thing I was just going to say, just like, listen to your body. Like, you know, when you’re really tired and you just have to, like, say, okay, enough is enough. Those clinic notes, I’ll get to them, right? Like, I actually need to sleep. And I think the people who are, like, chugging the Red Bulls and the Celsius drink and all that stuff just to stay awake like it’s temporary, but you’re going to crash at some point. So, um, you’ll get a sense of like when you’re pushing yourself a little too hard and you’ll get a sense– you get a better sense of that. I think you kind of know, like when to kind of back off a little bit. But listen to your barometer. Um. That’s all I got.
25:56 Q&A From Audience
Annie: Okay. Thank you so much for each of those insights. I hope that someone on this call was able to take something with them. Um, I know that I personally am pretty far away from this step, but I think that in general, there are some very useful tips here on how to navigate medicine and how to take care of yourself while doing that. Um, so before we jump into questions, I just wanted to see if, um, anyone is if anyone is uncomfortable with us recording the Q&A part of this. Otherwise, good to go. Okay, perfect. So now we’re going to open up the floor for questions. Feel free to drop them in the chat. Or you can, like our panelists said, be brave. Um, unmute turn on your camera and ask anything you’d like.
27:00 Navigating Conflict in Residency: Strategies for Professional Growth
Donna: Uh, hi, I’m Donna Tran. I’m a fourth year. I’m going to psychiatry. Uh. Super excited. I had a general question. Um, can you give your tips on, like, when you don’t get along with your co-residents, either in your cohort or outside of your cohort? Um, and attendings, like, how do you handle those kinds of conflict? Especially now that I’ll be PGI one at the bottom of the totem pole. Again, not like med students, but you catch my drift.
Dr. Kajita: Um, I’m happy to start. Uh, because I’m feeling talkative tonight. That is a great question. Right? Like, who do you go to? Like, you don’t want to be the person who’s, quote, high maintenance or ratting people out. You also, um, don’t want to have that kind of conflict, right? And can I just say something, even though you’re quote at the bottom of the totem pole or the– we don’t say that anymore, but if you’re at the bottom of the ladder, you know, you’re really you’re just as important. In fact, you’re one of the hardest working members of the team. So please don’t diminish your role as a PGY-1. Um, my suggestion would be that, um, usually, um, feel out when you start a program, your chief residents. They are a great place to start because usually they’re doing extra work to support all of you guys. Feel them out and check in with them. The other thing is, if it’s an attending conflict, you can sort of ask your colleagues, I’m not sure. And sometimes I’ll tell you now that’s the way the attending always is, right? But don’t bottle it up. Right. Think about it. Take it home. Think. Sometimes people are having a bad day. You can sit with your discomfort for a little bit, but if you know it’s impacting your work, please, um, reach out to someone. And there’s so much more I can say about this, but I want to leave it for other people to talk.
Dr. Kagetsu: I’ll just make a comment. Uh, hopefully your hospital has an ombuds office, so depending on the issue, uh, reach out to the ombuds office and they can deal with– help you deal with issues, uh, confidentially and impartially and all that sort of thing. Um, but, yeah, it’s a good question.
Dr. Partha: I would just add, I, I totally agree. Donna, I think unfortunately, this is a reality. You know, we don’t get along with everybody. Um, and if it is causing issues with patient care in your day to day well-being, you know, first and foremost, you might want to see if there’s an ability for you to just sit down and chat with the person, like, um, we all have different communication styles. It might just be a matter of saying, hey, just want to let you know a little bit of something about me. You know, you might think I’m kind of slow or you seem to be– I know I might be a little slower, but I work. I need to process things. I appreciate that we’re, we have a time constraint, and I can see that you would like me to be faster. So, um, you know, can we work on something? Because this is the way I work? And and just kind of putting it straight out there, if it’s sort of obvious why you both are clashing is just to say, you know, we’re going to be working together. I really want this to be a positive working relationship. This is how I work. How do you work? Can we figure out a way to, um, work together? And because inevitably, you guys will be back in contact again in a residency program. Um, but as others were saying, there should be a process if it’s actually really, um. An unhealthy situation. Chief residents. Associate program directors, program directors, etc. should be able to help.
Dr. Kajita: To be clear, the other thing I wanted to point out is that conflict is part of working with other people. But let’s be clear if it’s harassment, please report it. Period.
Dr. Park: Yeah. The only thing else I would add is that, like, you know, if it’s related to a patient, like, you know, obviously like take care of the patient first, unless it’s something that’s completely egregious, like, you feel like the patient’s life is in danger. Um, and I think there are some things that we have, you know, discussed as a high reliability organization. Those are things that you make here. But, you know, asking things like, hey, can I ask a clarifying question, you know, did you mean to do this? Or like, I just want to understand, like you want to do this, you want to administer this medication for this thing, you know, and just repeating it and, you know, maybe that will maybe that person would be like, oh, no, that’s definitely not what I meant. Um, and so it’s just kind of allowing the opportunity for them to maybe, you know, rethink what they said. Um, what I’ve heard some other people say, it’s like if someone says something like, really insulting, uh, I know other people have said, can you please repeat that again? And they usually don’t, because they realized that it was something that was just not appropriate at all. Um, and that’s, I think, some way of kind of asking people politely, um, to kind of address the question if it has to be in a public place without like, you know, having it escalated to something else.
Donna: Thank you.
32:33 Common Pitfalls and How to Avoid Them
Annie: Those were some wonderful responses. Thank you guys. Um, we did have some questions submitted to our RSVP. So the first was what are some common pitfalls in intern year and how can I best prevent them? We did touch on some of these earlier, but if you guys have anything to add.
Dr. Kagetsu: Oh, I’m just thinking one of my residents asked me you were a program director for 15 years. What advice do you have? So I said, you know, every day is a job interview. And, like, I don’t know if that’s what they wanted to hear, but it’s kind of true that, you know, um, and in fact, these days and that given given the toughness of the job market, some of the residents that, um, end up working at the place where they did residency, I recommend they do a fellowship elsewhere. But then you come back with this kind of secret knowledge and can be an attending. So we have had former chief residents end up working with us. And I would say, you know, um, consider a, um, a leadership position, like a chief resident.
Dr. Partha: I would say one of the biggest pitfalls that I’ve seen, again, speaking in internal medicine is time management. You just do not have the time that you did as a student. Um, so figuring out that nice balance between I want to spend time with my patients, get to know them, but I do not have the, um, time that I had as a student so quickly realizing that you want to get your time management skills under control sooner rather than later, rather than waiting too long when you’re kind of struggling because you’re too embarrassed to say, I need some help here. So probably pitfall number one is not knowing how to ask for help soon enough.
Dr. Park: One of the more memorable things that I had as an intern, I was talking for a friend at a hospital I had never been to for a week, and I, um, was late to sign out in the afternoon, and I just didn’t have all the numbers because I’d been running around all day. And the chief resident just, like, humiliated me in front of everybody. And I still remember that day. And you know, the lesson I took away from that was could I have been more efficient? Absolutely. Um, but as a chief resident, did I do that to somebody? Absolutely not. And I think you just learn, you know, there are just certain things you just won’t be able to do. And just don’t lie about it. Just you didn’t get it done. And you think about it when you go home and you’re like, how could I have done to make that better? Right. Observe other people. Right. How are they doing it? Like some people might, you know, make their lists a certain way. They might do checkboxes. They do, you know, whatever it is, it’s like– kind of gauge, like what’s going to work for you, right? Like, you might have a system as a for the medical student. Um, so I think for the med student, fourth year is a great year to start refining those things. Like what technique works for me? Do I like the multi-tip pens with all the colors and the color system works for me by whatever. Like if you figure out a system that works. Well, I think the biggest thing is that you will make a mistake at some point. Okay. And it’s just going to happen, right? Something’s got to happen at some point during your intern year. And I guarantee you every single year that you are a physician and it happens to everybody. Okay. The question is, is what do you do about it? And do you have a safe place to talk about that? Right. So don’t like bury it inside of you and say, I’m a terrible person and I’m not good for this job. There’s a reason why I’m sitting in this conference right now is the reason why I care about it, is to do that like you got here for a reason. So don’t forget that.
Dr. Kajita: I think that’s we’re all great. And right now I don’t have anything else to add.
36:38 Endurance in Medicine: Sustaining Passion and Well-Being
Annie: Okay. I’m going to ask a second question and then we’re going to open it back up. But the second was how can you stay the course throughout the length and the rigor of training mentally, mentally, physically, etc.?
Dr. Kajita?: Um, if I may, I think this goes back to something that Dr. Park said it’s just kind of checking in with yourself, right? And I think that as part of checking in with yourself, don’t compare yourself to other people. Right? Be honest with yourself and remember that you’re doing this for your patient and yourself, and you just can’t do it well unless you leave something in the tank for yourself. So if that means that you have to tap out, that’s okay. If it means that, um, you need professional help. That’s okay. Um, but definitely, um, don’t ignore the signals that your, your emotions and your body are sending you.
Dr. Partha: Um, I would add, uh, I forgot to mention I listened to a really great podcasts. If any of you listened to Hidden Brain, it’s wonderful. And there was an episode from September 2023 called Being Kind to Yourself that I highly recommend. So I think you can be, um, sustained in your career if you learn how to be kind to yourself, uh, to again, kind of tap on to what Dr. Park had mentioned, do things you love, take care of your body and your mind, and surround yourself with the people and the things that you love. Um, you know, nobody can do this by themselves. So rely on your friends, your family, your loved ones, whatever brings value and meaning to your life, whether it’s arts, religion, music, exercise, um, and choose a path that you can do on your worst day, is the best advice I could give you when you’re choosing what you’re going to choose for your lifetime. Um, and ask the people who have been doing it as Dr. Park mentioned, don’t imagine, oh, this is what it must be like. So I’m not going to do it or am going to do it. Ask the people who are doing it so you make a good choice. Um, because the road is long, the career is long. It’s a great thing. But also know that you can change your path a little bit as well. So you’ve got flexibility in this job. Um, so don’t feel like you’re going to be stuck. Um, but make– make as good a choice as you can when you start.
Dr. Kagetsu: It’s my turn. I have nothing to add. Good advice. Or although I could kind of joke and say choose a specialty like radiology and it’s not so stressful. But that’s what propagates a stereotype. But it’s kind of we kind of deserve it.
Dr. Park: Um, it’s not really advice. I just find it ironic that we have, like, been basically engineered to become perfectionists. And, you know, you kind of have to unlearn a lot of those, I don’t want to say bad habits, but I mean, to some degree they are because like you have, you know, been this way and been successful and that’s what made you so successful. But it can be also very destructive. And I think at some point you kind of have to know, like, okay, pushing myself too hard here, like I don’t have to be perfect for this one, right? Like I just have to do my best. So they’re very different things.
Dr. Kajita: Yeah. And along those lines, I think we tend to think of big ones as success and fulfilling. But sometimes it’s finding the joy in the small moments, like you’re having a really lousy day and this happens everywhere, right? You’re having a terrible day. But then there’s that one thing where you connect with someone. You realize that you change something just a little bit, and if you can find a little bit of joy in that, that will keep you going. And as Dr. Partha was saying, um, choose something that can give you those moments, moments of joy. Maybe it’s radiology. So. Find joy.
41:13 Finding Our Voice: Asian Identity in Medicine
Dr. Partha: Can I ask a question, Annie? I guess I’d be curious either for, um, the other panelists or some of the students. Uh, because this obviously is sponsored by a APAMSA and similar to Dr. Park, I hadn’t really been, you know, involved, um, the whole kind of Asian identity, South Asian identity as an Indian, I can say, can be a little confusing or mixing. Um, until I had done an event with Dr. Kajita and really enjoyed it. But I’d be curious how you all might feel that your Asian identity has impacted or not your medical path, or what do you think might be, uniquely a an experience that you all have had in as a person in medicine. Um, that someone who does not come from an Asian background may not be able to share.
Donna: Um, I just want to give a quick introduction, so. I’m sorry. That’s my dog. Uh, I’m Donna Tran. I’m the immediate past national president or her president is Joyce. She’s amazing. Um, but to answer one part of that question, we are working on expanding our alumni network and doing an outreach to see if we could kind of create a space for pan-Asian, um, physicians, because there isn’t really one, like there’s a national medical association, there’s a Hispanic association, but there actually really isn’t one on that scale for all Asian Americans. And so that’s something that we’re working on. And we actually have Dr. Kagetsu who’s one of our senior, uh, alumni advisory board members and also leads our faculty as well, uh, for APAMSA. So I would actually kind of put him on the spotlight. Sorry about that. I know you like it, though. Um, and for him to kind of answer that question since he, you know, obviously, you know, went to residency and did stuff before APAMSA, so, you know, came out.
Dr. Kagetsu: Thank you Donna. Um, you know, I, I actually kind of have, um, imposter syndrome for being called an APAMSA alum because it didn’t exist, and I wish it did, but I think there are like, you know, we perhaps some of us on the call have experienced this. You know, somebody would always mistake me for the other Asian, uh, student and, and that sort of thing. So, um, yeah, I don’t know, sometimes maybe we feel we’re invisible, I suppose. And, um, I think the founders comment that there’s kind of a stereotype that the students are just quiet and, and, uh, and perhaps that was a survival skill for some of us. And, uh, I think we we do have to, um, almost prove that, um, we’re not that quiet stereotype and and, uh, speak out when the, when the time is right and that sort of thing. So I think it is, um, in my part of the stereotype, maybe positive that, you know, we’re smart, smarter than the average student or something, but I don’t, I don’t– It would be interesting to hear, hear my colleague’s thoughts.
Dr. Park: Uh, I did, I mean, I, I went to high school– elementary school. There weren’t a whole lot of people. I actually grew up in the Bronx. Um, and, uh, it didn’t have outside of, like, Korean school on Saturdays, I didn’t actually really have much interaction with, uh, Asian Americans, specifically Koreans. Uh, and so I think just like a lot of people, um, in my group, it’s like you tend to gravitate back towards that and you want to learn, relearn your language and all these things. And, you know, in your second, third, fourth decade of life, um, I find that I kind of do live to the stereotype in some ways. I am a little– I am actually a very big introvert. And, uh, I actually did not get the best scores in my surgery rotation because I was so quiet. Um, people kind of misinterpreted that as being disinterested, which is too bad. And so I kind of struggled with, like, how do I show my interest without, like, being the loudest person? And I still struggle with that. And I think it helps when you are an environment where people notice your hard work. Not everyone is like that. Not everyone has bosses that kick off for people who are like just going through the ride, doing a good job and doing the right thing. Um, and we can easily get lost in that so easily. So there’s a reason why there are not that many Asian-American surgeons in leadership roles. I think there’s a lot of reasons why we get passed up on the things. We either don’t seek them, we get passed up on things or whatever it is. Um, so I– for me, anyway, I think it’s the first personality thing, I think it’s a cultural thing and it’s something I’m still working on. Um, but, you know, I think unless we talk about it and we kind of approach other people like this, it just will continue to perpetuate.
Dr. Kajita: So I think I would echo what, um, the other panels said and Dr. Parker just put a comment in the chat box about the bamboo ceiling. Uh, there are many ceilings. And I think, um, you know, there’s an assumption, obviously, that certain obviously just stereotypes that go with race, ethnicity, uh, identity groups and you’re sort of saddled with those and you also have to acknowledge that some of those values are not necessarily bad things if you’re a little quiet. Right. And the other thing is that, you know, don’t always assume that I’m good at math. I was terrible at math. It brought death. Really. So. So it’s tricky, right? Because I think we struggle. Then also, what does it mean to be, um, uh, sort of, not your your voice not being heard or feeling underrepresented because I think sometimes Asians are not considered the classic model of underrepresented minorities, for example. So I think hearing from people I work with now, residents and so forth, I’m happy to see that a lot of that has changed. Um, but I still think that it is something that it is, um, something that I find hard when I see an evaluation. It’s like the too quiet thing. They’re thinking, okay with that, right? Um, and that part of it has not changed entirely, I think, to some degree. And that’s my two cents.
Donna: Yes, you’re all goals, I think everyone here can agree on that. You’re all goals for us. And if you would like to still stay involved just with, you know, at a med student level or even interested and, you know, seeing what, you know, a pan-Asian physician organization kind of looks like, please, um, just let Annie know and then she can, you know, give your emails to our appropriate, like, APAMSA student directors. Um, just because. Yeah, just because, you know, it wasn’t around when you weren’t in med school or you didn’t have a chapter. Uh, I think the goal for us is that, you know, advocating for health is, you know, a lot better in bigger numbers, right? And there’s just so much untapped potential in the, you know, power of numbers. And so just giving everyone on the same page, I think on the backdrop of COVID and anti-Asian racism has really brought everyone together. And so hopefully moving forward in the next few years, we’re going to be building that up. So yeah, please let her know if you’re interested in keeping in the loop for that. Even if you’re, you know, from different backgrounds, like even on national board APAMSA, we have a South Asian and Southeast Asian, LGBTQIA, women in medicine directors. Like we try to hit every target I can to be as inclusive as possible.
Dr. Partha: No. That’s wonderful, I guess. Um, it this the South Asian term, and this is how old I am, is kind of a new term. I was never South Asian, and growing up I was just Indian. Um, and so when I went to went to undergrad at Stanford many years ago, I was like, oh, there’s an Asian American student group. Of course I belong there. And I’d go and show up. And I was literally like, the only Indian there. I was like, oh, am I not Asian? Um, and there was not an Indian student group at that time, which sounds unbelievable in the Bay Area to say that now. But we started an undergrad Indian student group because there was a graduate student one, but those were mostly students who were international students. So it’s very interesting. And I find it– I think there’s a lot of commonalities between Asians of many backgrounds in terms of culturally and, um, how we’re brought up the whole ‘we’re great hard workers, and there’s many of us, but fewer of us’. My husband and I always laugh like we’re always the Indians and not the chief kind of thing. So, um, I think there’s a lot of great work, um, that can be done. And I’m excited that there’s all these really passionate students who are being motivated to do this. And it begs the question of just the science as well, like studying Asian American health and moving that forward. So kudos to all you guys for really, you know, not just talking about the change but making it so it is a privilege to be with you guys.
50:48 Closing
Annie: And that’s our latest installment from the Leadership Committee. If you have a specific topic or specialty you’d love to hear more about, please 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!