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S7E2: Breaking Through the Barriers of Medical School Admission

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S7E2: Breaking Through the Barriers of Medical School Admission

Feb 26, 2024

Between 2021 to 2024, there were 165,326 applicants to U.S. medical schools, with only 69,228—41.9%—successfully gaining admission. While medical school itself presents formidable challenges, the journey to gaining admission is an even greater hurdle. Various obstacles, including socio-economic privileges, and racial and gender biases, contribute to the lack of heterogeneity in matriculating classes.

Alizah and Austen engage in a conversation with Daryl Morrison, MD/PhD candidate at ÈËÆÞÖгöÊÓƵ of Utah School of Medicine, focusing on their experiences as first-generation pre-med students and discussing the path to medical school admission.

    Introduction

    • In this conversation, Alizah and Austen, together with guest Daryl Morrison, discuss the challenges and frustrations of medical school admissions, highlighting the need for greater diversity and inclusion in the medical field. They address the barriers faced by underrepresented communities and emphasize the importance of creating opportunities for all aspiring physicians.

    Personal Perspectives

    • Reflecting on Privilege: Alizah shares her frustration over the lack of diversity in medical school admissions, acknowledging her own privilege as a factor in her acceptance.
    • Empathy and Advocacy: The importance of recognizing privilege and advocating for underrepresented individuals who face greater challenges in accessing medical education.

    The Homogeneity Issue

    • Homogenization of Applicants: Concern over the homogeneity of medical school applicants, noting that the process often favors certain demographics, potentially to the detriment of patient care.
    • Expanding Diversity in Admissions: The need for decision-makers to prioritize diversity in admissions and program evaluations, highlighting the importance of communication skills and cultural competence in patient interactions.

    Navigating Pre-Med Life

    • Balancing Academic Demands and Social Responsibility: The group discusses the difficulty of addressing systemic issues while managing the rigorous demands of pre-medical education.
    • Coping Mechanisms and Toxicity: Coping mechanisms of ignoring systemic issues in medical education, emphasizing the toxic nature of perpetuating unnecessary challenges for future students.

    Encouragement and Hope

    • Validation and Encouragement for Applicants: Words of encouragement to medical school applicants facing adversity, acknowledging the difficulties they may encounter.
    • Optimism for Change: Hope for a future where medical care is more accessible and diverse, citing positive changes in medical school demographics as a sign of progress.

    Conclusion

    • Overcoming Adversity: Insights on resilience and self-belief, encouraging aspiring physicians to persevere despite challenges and doubters.
    • Empowering Future Physicians: The importance of real-life experiences and genuine motivations in pursuing a career in medicine, urging individuals to fight for their aspirations despite obstacles.

    This content was originally produced for audio. Certain elements such as tone, sound effects, and music, may not fully capture the intended experience in textual representation. Therefore, the following transcription has been modified for clarity. We recognize not everyone can access the audio podcast. However, for those who can, we encourage subscribing and listening to the original content for a more engaging and immersive experience.

    All thoughts and opinions expressed by hosts and guests are their own and do not necessarily reflect the views held by the institutions with which they are affiliated.

     


    Introduction

    Alizah: Austen, are you coming down with something?

    Austen: No, I'm not sick. I popped in a couple of peppermints and my body started freaking out.

    Alizah: Don't you love mints? I thought your body would be well-adjusted.

    Austen: Love them. Can't get enough of them. But I don't know why. These must be stronger than my normal mint supply. Jane Austen's Pride and Peppermints, in case anyone's wondering.

    Alizah: Okay. Well, I'll jot that down. As I said, I'm a new host to "Bundle of Hers," but more importantly, we have Austen, who is a co-host on "Bundle of Hers."

    Austen: Hello.

    Alizah: And then we have Daryl, who is an MD/PhD candidate, also one of our classmates, and she is just supremely intelligent about all things. How does life go for someone who is so smart? Is it hard to be around others, Daryl, when you know everything?

    Daryl: Stop.

    Austen: Are your knees buckling underneath the weight of your ginormous brain?

    Daryl: Cut that part out.

    Personal Perspectives

    Alizah: Yeah. Today, I kind of wanted to talk about matriculating classes and matriculating classes in medical school. I looked at some of the data and I just kind of want to get your initial reactions to this and what you guys feel about this.

    So from 2021 to 2024, there were 165,326 applicants to medical school. Out of those applicants, only 69,228 got into a medical school. So that means 41.9% of people get into medical school who apply. So the odds aren't in your favor, and that's even if you make it to the starting line of opening up the AMCAS portal.

    So I'm interested in what obstacles did you face in heading in this direction.

    Austen: This is a fun new thing that we do for the podcast now. What we are about to discuss and the views that will be shared are our own. They're not representative of the university and institutions that we may be a part of. So just getting that out there in the open before any words are exchanged.

    For me, a few of my identities, just so listeners know. I am Black. I'm mixed. My mother is wonderful and lovely, but she never went to college. My biological father didn't go to college. He went to college for a little bit. He never graduated. My stepdad, I consider my dad, he is wonderful. He did go to college.

    So I feel like I come from an interesting background where I have been around people who have successfully completed college. But if you look at my mom, for example, my mom completed high school and then she had kids pretty soon after. She had her first kid fairly young.

    And my mom has accomplished a lot. She is such a hard worker, and she is so dedicated to providing for our family, and she has just an amazing and incredible work ethic. I'm so grateful for her and the sacrifices that she's made. But it has made my journey to medicine kind of interesting. I feel like a lot of our classmates and a lot of people that we interact with, they're in medicine and they know a ton of people who are in medicine.

    You only go through this process really once. You go through medical school, and that's kind of it. But I think having people who can serve as points of contact for you, who have gone through this and can kind of change your perspective, I think that can be a benefit and definitely a different experience. Even if you might not feel it's a benefit, it's a different experience.

    I'll talk to my parents about what I'm doing in medical school or about applying to medical school and they have no idea what I'm talking about. I'll talk to them about the MCAT and they have no idea. My parents are realtors. They work hard. They are wonderful people. They know the value of hard work, but they don't understand what I'm doing day-to-day. They don't understand what I need to do to accomplish my goals.

    And so I think for a lot of my medical journey in that aspect, I've kind of felt like I've had to figure it out on my own. And luckily, I have wonderful friends that I can ask questions to. A lot of my friends are kind of following the same path, and so I had tons of questions for the people around me. But it also meant that I was asking questions to people who are oftentimes just as confused as I was.

    But I think it changed my medical journey just because I felt very alone a lot of the times, I think. It really made me think, "Okay, if this is a goal that I have, then I've got to know what is going on. I've got to really drive myself to do it."

    My parents aren't going to check in and be like, "Well, are you doing research?" They're not going to check in and be like, "Well, how's biochem going?" Most of the time, my parents didn't know what classes I was in. And I had a lot of siblings, so they had a lot of more pressing things to worry about. And that is fine. That is 100% okay and that didn't hurt me, but it really meant that I had to be on top of my learning. I had to be on top of my trajectory because there was no one else really holding me accountable.

    And then as far as being black in medicine, I mean, I went my entire ÈËÆÞÖгöÊÓƵhood without seeing a black physician. Like, never meeting a black physician. I think once you get to higher education, once you get to college even . . . And especially I went to a very white undergrad, and so I would look around and there were many times where I would be the only black person in a class, whether I was taking a more introductory science class, or when I got into biochem or genetics. I was often the only one.

    I'm proud of my identities. I'm proud of where I come from. But I think when you're navigating a system that isn't necessarily structured around your success, it can feel really isolating.

    What about you, Daryl? What's going on over there?

    Daryl: What's going on over here? Great question. Hi, for everyone listening. My name is Daryl. I am a white woman, native Vermonter, and have kind of moved across the country a few different times, which I think is relevant to some of this.

    So I grew up in rural Vermont, lower class socioeconomic status, super white state. My parents split up when I was 12, and then I moved across the country to live with my mom and her now husband, whom I had actually never met before. My mom also did not graduate from college, just like Austen's mom. So I can relate to that.

    And I definitely relate to a lot of the isolation that Austen was describing with her experiences, trying to figure out what to do with her life, what exactly was going on with medical school, and what really you need to focus on.

    Throughout this whole process, I have done a lot of self-reflection and thinking about my goals for life, where I would be best suited in terms of a career, what's going to support my happiness, and ultimately landed on this career path, which I didn't even actually know that MD/PhD was a career until I moved to Utah in 2019.

    So originally, like I said, I'm from Vermont. I moved to Colorado, graduated high school from an inner-city school there, took some time off, and then went back to school consequently back in Vermont at Middlebury College, which was super, super white school, straight up liberal arts. I was an ecologist while I was there. Kind of was really figuring out what my options were for schooling and for my future.

    Again, didn't have a strong scientific background in my family. My dad does house moving, which is essentially the restoration of old, old, old buildings in New England. I spent some time working with him.

    I was counseled by various mentors, for lack of a better term, during undergrad that I was not cut out for a career in STEM or medicine, that I didn't have the brains, I didn't have the drive, I didn't have what was required.

    Alizah: That is so wild to me because I cannot fathom anyone who is more qualified. Crazy that someone would say this to you.

    Daryl: It was pretty damaging, I'm not going to lie. I did not have the benefit of having a longitudinal, solid mentorship. Most of my mentors were men and perhaps that played a role. So yeah, I kind of didn't think that graduate school was for me.

    When I graduated from Middlebury and was working with my dad, like I said, I was ski patrolling. So I was kind of doing medically-adjacent things, but I wasn't really satisfied with that. I kind of just kept coming back to the realm of neuroscience and research and really just wanted to get connected again and also to get out of Vermont. I ended up visiting Utah a couple of times in the spring of 2019, skied here, and decided, "Why not? I guess I'll move to Utah. Might as well. What do I have to lose?"

    Effectively, on a whim, I drove out here and that completely changed my life. I ended up serendipitously interviewing in the lab that I worked in for three years before I got into this program. My mentor and boss, Dr. Aylin Rodan, who's an MD/PhD nephrologist here at The U, completely changed my life.

    I had always heard that mentorship and representation were extremely important, especially for women going into medicine, but that was not something I had directly experienced until I moved out here.

    I will never forget this conversation that I had with Aylin. Probably four or five months after I started, we sat down, and this was right after everything shut down during COVID. So really, I was drowning, trying to think about my future, and what was going to happen now.

    We're on Zoom and she asks me what I want to do with my life. And I said, "Well, I don't know. I've thought about science. I've toyed with the idea of medicine before, but these various people in my life have told me that this probably isn't the right path for me."

    She paused for a moment after I said that I had been counseled to steer clear of graduate school of any kind and said, "I completely disagree with that. I don't know why people told you that. I think that actually, you would be really good at this, this being a physician-scientist, someone who is working translationally across clinical research or basic bench science as I do, and also seeing patients."

    And as I mentioned before, I had no idea this career even existed until I met Aylin. When I looked her up for my interview, I did not realize that the letters after her name were a dual degree program that she had done and that her training had been this whole . . . It was this whole thing I had never known about.

    And so she really changed things for me. So for me, that was the moment where I was like, "Oh, maybe you're right. Maybe I can do this."

    And luckily, everything worked out for me. But I was not really committed to this until I received an interview offer from The U. And I ended up interviewing at two schools. But that was the moment for me where I was like, "Wow, this might actually happen. And maybe the medical system is a little bit different than I thought it was, at least in terms of admissions, because on paper, I am certainly not the typical applicant in a lot of ways."

    So yeah, that's a little bit about my story and how I ended up here.

    The Homogeneity Issue

    Alizah: I'm struck by how you talk about the typical applicant. Both of you brought in this idea of feeling alone in your application process to medical school. I also went to the same undergrad as Austen, and I was like, "Yeah, I'm going to be a doctor. I'm going to do that."

    And then I remember going into O chem in this building, which, honestly, I think should be torn down for safety reasons. But we had classrooms for O chem, maybe 200 to 250 big, and I was like, "No one here looks like me." It kind of just struck me. I wasn't even thinking about it consciously. I was like, "No one in this room that's trying to go to medical school like I am approximates pretty much any of the identities that I have."

    There were four of us in total, and we found each other real quick. I think that's just an anecdote of how my journey to medicine was. It was also very lonely and you kind of met friends along the way.

    But I can still remember hearing the front row talk about how their dad, their grandpa, and their great-grandpa were actually founders of the medicine practice in its entirety. And I'd be like, "Oh, shoot. That's not me at all." I am a Tongan person, and so my people had nothing to do with Western medicine as we know it.

    As a person of color, this space has never been a place of safety, health, and wellness. And then as a woman, these classes were predominantly full of men. I think the attitude was kind of "get through it." And it's okay if you hear men saying these things about how you'll get into medical school easier. Just bite down and go through it.

    And I felt quite the opposite. I was like, "Oh, if I were a white man, I feel like this would be much easier for me," whereas they would explicitly tell me, "Oh, if I were a person of color, a woman, it'd be easier for me to get into medical school."

    Austen: Which is interesting and . . . I don't know. It's sad. I mean, we went to the same undergrad, but even after undergrad, I was working in an anatomy lab at a graduate school and there were students from another medical school. Not our medical school, but another one. And I remember one of the students commenting and being like, "Yeah, well, The U hates white men, so that's why I didn't get in."

    I had already been accepted at the time and I didn't say anything about that because I was like, "Well, I don't want to give this guy more reason to think that I got in at his expense and only on the basis of what I look like." It's sad. It's not a fun place to be.

    Alizah: But the stats for race are astonishing, and these come straight from the AAMC. People that are getting accepted, so you have Pacific Islanders, 57 applied in the last 4 years and 19 got in. For Black or African American applicants, 39% of applicants got in compared to the average of 41.9%. It's different for race.

    Austen: It's different for race as far as applicants go and then if you look at the profession as a whole. If you look at the medical profession, if you look at the active physicians right now, I want to say it's something crazy . . . It's like 0.1% of active physicians identify as Hawaiian natives or Pacific Islanders. And then I think it's 0.3% are American Indians or Alaskan natives. And then it's like 5% are Black. You go through, and you look at these statistics and it can be disheartening. But that's the reality that we live in.

    Yeah, it's definitely interesting. I feel like the facts, if you look at the data, I think it's easy to think that the world is against you or that the system is against you. And then when you look at the data, sometimes that's validated depending on your identities. But sometimes that's not actually the case and it can help kind of change our perspectives, I think.

    Alizah: Yeah, I agree.

    Daryl: Just on the note of the incredulity that people express about medical admissions, I find it very interesting for me. I'm obviously very much a white woman. Cannot relate to the race thing at all. But people always find it really interesting when I tell them about my background and how I came to be in this position, because people kind of just assume that my parents are doctors. They assume that I come from a scientific family. They assume that I'm from an affluent background where I received the same education as my peers. And that certainly is not the case.

    I have had a good education, but I have also had to work really hard for that, and I have very much taken my own path. I find it interesting how surprised people are by how successful I am and the place that I find myself in at this point in my life, given what I have been through in my life, given the trauma that I have experienced and carried with me, given the neurodivergent nature of my brain and the things that I've experienced.

    It's interesting to me because as someone who has not always known that they wanted to do this and someone who has considered various other careers, and in fact had other careers, I never really thought of doctors as people who were on this pedestal, an empty vessel, "Let me tell you all of my woes and have you fix things for me."

    I had a really idealized sense of what the medical education system would look like and the kinds of people I would be surrounded by in medical school and the types of doctors that would be trained at this point in time.

    And so it's just been really fascinating for me as a person who I think comes with a really different perspective on medicine to interact with my peers who come from that more traditional, "My parents are doctors, my parents are scientists, my parents are engineers, and this is kind of the expectation within my family."

    So, yeah, just the exposure to different perspectives and the surprise with which people kind of interact with me when I tell them a little bit about myself has been really fascinating for me. And I think it says a lot about the shortcomings of medical education as it stands now.

    The fact of the matter is our patient population in this country and across the world is not reflected in the statistics of race, gender, and socioeconomic status held by physicians. And that's a disservice, number one, to our patients.

    It's actually interesting, I've gotten a few emails over the past few weeks from people who are at my undergrad institution or people who have recently graduated looking for advice about applying to medical school or thinking about MD/PhD and how I came to this conclusion.

    I think it's really interesting for me because my advice pretty much across the board to people is to just do what you are interested in and do what you like to do and don't check the boxes that everybody else is telling you to check. And yes, that worked out for me, but it does not work out for the majority of people.

    I've been struggling with this a lot lately, just the moral dilemma between counseling folks to do things the way things have traditionally been done to get into medical school, pay to play the game, whatever, and telling people to buy into their individuality and to showcase that, to really figure out for their own reasons why they're doing this and to capitalize, again, on their individuality.

    I think that the people who are most hurt by the system right now are those who would make the best doctors, people who have unique experiences where they can relate to people who are not like them, or people who have had different experiences than them.

    I think that the kind of archetype of the doctor nowadays and the archetype of the medical student, again, is a huge disservice to all of our patients. How do you relate to someone who comes from a totally different background than you, who doesn't have the educational benefits that you have, who doesn't have the same financial security, who has had to worry about having a roof over their head, who has had to worry about where their next meal is coming from, who has to worry about whether or not they can walk safely in their own neighborhood at night? How do you even begin to relate to someone when you have not had any experience or even exposure to people who are different than you?

    And there are plenty of people who come from underserved backgrounds who want to be doctors and want to go to medical school, who don't have the paper stats that the, for lack of a better term, traditional applicant has.

    And I think that these people who check all the boxes on paper and have good test scores and have all the research and have all the connections end up making maybe not the best doctors, and at the very least, not the doctors that we need.

    Austen: Yeah, I think that's fair. I was visiting my parents. I was back home, and I was talking to someone who works at Georgetown ÈËÆÞÖгöÊÓƵ. She goes to church with my mom. We were talking about the application process, and she was talking about how she loved the fact because of COVID they had to switch to Zoom applications or the Zoom interview process. And she said that it was because they had such a more diverse applicant pool.

    For those who may not know or who haven't applied yet, applying to medical school is unfortunately not only a long and stressful process, but a very expensive one.

    And so what this woman was telling me was that because they switched to Zoom interviews, they were able to get tons of applicants who could attend the interview without having to worry about the cost of flying, without having to worry about the cost of taking off a ton of time from work so that they could make the interview, without having to worry about the cost of lodging while they're away.

    And so although COVID was horrible and there were so many negative things that came out of that experience, I think she appreciated the fact that because the medical community was forced to change and adapt, at least her institution was able to have a more robust pool of applicants who were able to attend the interviews.

    I think that's one of the things that we don't really talk about very often, is we have . . . Just like you said, Daryl, there are so many people who are qualified and maybe they don't look like every other applicant, but that's not a bad thing. That could be such an incredible strength for all of these applicants, for all of these people who want to become physicians and who want to serve different segments of the community.

    At the end of the day, the best physician is going to be the physician that you trust, the physician that you can be honest with, the physician who is going to trust you and advocate for you.

    If your lived experiences prevent you from doing that for every single patient that you see, regardless of their background, regardless of your background, then that's where we run into issues.

    So by expanding the applicant pool, you're only enriching this well of resources that future patients can pull from and rely on.

    Navigating Pre-Med Life

    Alizah: You both are so eloquent. I'm like, "Ugh." But you guys mentioned criteria to apply. How do you capture that? And as a personal statement, who knows if they read those before they look at your MCAT score, right?

    Daryl: Well, they don't most of the time. That's the thing, is all these schools, they have cutoffs. If you don't have a test score of XYZ, your application is thrown out and doesn't ever get looked at. It doesn't pass across someone's desk.

    One of my hot takes, which I hope is not that hot of a take, is that this really should be competency-based. If we are assessing people based on their test scores on a nebulous multiple-choice exam, it should be competency-based. Set a cutoff score. Everybody hits that cutoff score. Great. You are qualified to be here to take our multiple-choice tests.

    In reality, there is nothing about the MCAT or Step 1 that determines how good of a doctor you're going to be, whether or not your patients are even going to feel comfortable with you, and if you're going to . . . It says nothing about your success as a physician.

    And yes, these tests are absolutely necessary. We need to learn all this material. Completely agree with that. But I don't think that delineating between a person who gets a 505 on the MCAT versus a 520, or whatever, tells you anything.

    In fact, there are many studies out there that have been run. It has no predictable value on whether or not folks are going to complete medical school, whether or not they are going to become successful physicians, or complete residency. In fact, the data that I've seen suggests that the higher your MCAT score, the less likely you are to complete your training.

    And not only that, but it's racist. The stats on the race of doctors and the gender of doctors and where they're from, most people are of European descent. And that tells me that there has not been enough action to reverse the harms of centuries of colonization and genocide and hurt. And it's a disservice, again, to everyone in this country, regardless of the color of your skin.

    Alizah: Absolutely. I just wanted to emphasize it is a disservice to our patients. Because that's what I would hope, right? Those who really make these decisions and sit at those tables, my hope is that they do honestly care about people who do not live in their zip code. And that they want physicians who will work in those zip codes and want them to earnestly do so, right?

    Not "write your personal statement based off of that one time you went to some celebrity ranch in Jackson, Wyoming." You love rural outreach, right? I'm talking about someone who's deeply entrenched in this.

    I don't know. Maybe it's because it's personal for me, right? I have a nice zip code. I won't deny that. But I do know my dad's an immigrant from Tonga, and I drive past my grandparents' old house weekly. I know where we came from and what a struggle it was to even get the ground that we do have.

    I guess all this is to say I take it personally when these are kind of just questioning the validity of it. Well, it's right there. It's tangible when you look like me and you talk like me.

    Daryl: There's this sense of responsibility that I feel like is inappropriately placed on people from underserved backgrounds that's like, "Well, why don't we get more applicants who are people of color?" or, "Why don't we get more people from lower socioeconomic status?" or, "Why aren't we getting more out-of-state applicants?" And it's because there is zero accountability and accessibility on the part of schools to make things more accessible for people who maybe don't have the background that other folks do.

    I had never heard of the career that now I am training to do. If you don't know about it, and there's no representation and not even just an option for you to learn about different things that are available to you, then how are you supposed to take advantage of those things?

    You can have all the great programs in the world for outreach, particularly in rural areas, but until you make some reciprocal strides, people are not going to be able to take advantage of that.

    And a good example of a program that actually does something for people is the Native American Research Internship here at The U. The NARI and the MD/PhD program run an internship program for Native students to come and do research here in the summers. And they make that accessible for people who otherwise would not have that opportunity.

    That's where it starts. It's not on the part of the communities that we're trying to target to lift themselves up by their bootstraps. It's on the people who hold the power to disseminate that power, to break down these barriers, and to allow for people who are different to come into the fold.

    Alizah: That's so eloquently put, so sincere. I really appreciate, Daryl, you voicing these things. It means a lot to me.

    Austen, what were you thinking? I saw some thoughts swirling around.

    Austen: I don't know. I feel like the process of applying to medical school, and becoming a physician, a lot of the time creates a homogeneous group of applicants, whether it be a racially homogenized group or a socioeconomically homogenized group or whatever it may be. And I think that is to the detriment of our patients.

    And I think expanding however this is going to look . . . I don't know who the real thinkers and decision-makers are, but I hope that as they are evaluating their admissions process, as they're evaluating their programs, whether it be on the level of an undergrad institution or a medical school or a residency program, my hope is always that that's what's at the forefront of their minds.

    Just like Daryl said earlier, you could take a standardized test and you could hit it out of the park, but that doesn't mean that you'll be able to really communicate with a patient in a way that they understand. It doesn't mean that you'll be able to have a 45-minute interaction with someone if you're lucky. Forty-five minutes is a long time in the world.

    But it doesn't mean that you'll be able to leave an interaction with a patient and think, "You know what? I'm happy with the treatment plan that I made because I know that they understand it and I know that that's accessible for them."

    Alizah: I just feel frustrated because I know there are people from the neighborhoods that my grandma lives in or the neighborhoods that I visit. I know that there are smarter people out there and it frustrates me because they're not making it to the starting line of medical school.

    But I did because I have a stable socioeconomic status. I'm also half-white. Those things afforded me the privilege to attend medical school. There are people out there who would be phenomenal physicians and they're not making it here and I'm upset.

    Austen: I think it can be frustrating when you think about all of the people who deserve to be here. And that's not to say people who are in medicine don't deserve to be here. I want to make that abundantly clear.

    But I liked what you said about this isn't about excluding people from the table. This is about making a table large enough for everyone, because when you do, then everyone benefits.

    Daryl: Agree.

    Alizah: I don't know. It's just so hard to, I think, consider these things and then get right back to the grind of it. And especially in pre-med, these massive themes of life and systems, it's almost too big of an ask to be like, "Yeah, think about this while you try and get 100% yield on your chemistry experiment." It's like, "What?"

    Austen: I think that's a lot to have to consider. I think sometimes it's easy to just try to focus on what you need to do and not what you're trying to overcome.

    Daryl: I think that that's a coping mechanism for a lot of people, is to just not think about it, to think, "I went through this process . . ." And this is a pervasive thing across medicine, is, "I did this and now you have to do it too." It really doesn't have to be like that.

    I think that the whole toxic notion of, "This was hard for me, so now it needs to be equally as hard for everyone who comes after me," is to the detriment of everyone going through medical school.

    I don't think that you have to have significant trauma or have to have had a difficult life or a hard time getting here for that to directly affect you. I mean, why do we have to make it so hard for people? Why do we have to beat down students and make them feel like they are lesser than just because they are at an earlier point in their training or have not learned how to calculate an anion gap? Which, by the way, I don't know how to do that either. Some girls can calculate anion gaps and some girls can't, and that is okay.

    Encouragement and Hope

    Alizah: It is okay. There are so many factors that contribute to the dynamics of medical school and medical school admissions. And my fear is if medical school applicants listen to this, they're like, "Oh, gosh. The odds are stacked against me." I just want to validate that and be like if it feels like applying to school is hard, it is. It is really hard. And if it feels like it's especially more difficult for you than your peers, that's because it is more difficult for you than your peers.

    I don't know. I just want to say that to anyone who's applying to medical school or is thinking about doing something that they don't usually fit into or aren't necessarily the archetype, as Daryl said, chances are if you're on the right path, it's going to be uphill. Take heart, take courage, and if you're applying to medicine and you feel like you don't belong, you are so desperately needed.

    Austen: Speaking about this, what I feel like always gives me hope is that things are changing. Even at the beginning, during our white coat ceremony, they announced that we were the most diverse class in the history of the ÈËÆÞÖгöÊÓƵ of Utah, which if you look at our class, might be kind of concerning, but it reinforces that things are changing.

    I look forward to the day when everyone in our communities knows that they can go and get the care that they need, that they'll be heard, that they'll be listened to, and that there will be a physician who maybe doesn't know exactly what they're going through or may not look exactly like them, but is willing and able to empathize with them and willing and able to fight for them, go to bat for them, and advocate for them.

    Daryl: First of all, the haters are going to hate, and people are going to tell you that you can't do this. And if nobody has ever told you that you can't do something in your life, get ready because people will tell you that in medical school.

    Failing at things, and struggling with things, are not inherently bad experiences for you to have. Medicine is extremely difficult emotionally. It is a very taxing job regardless of what specialty you go into, even if you go into something where you're not dealing with terminally ill or difficult patients. Medicine is hard. It takes a lot out of you.

    If you are someone who has had difficulties and struggles and this just feels like another hurdle and you're never going to get there, you will. The more that you practice resiliency and the more that you practice self-love and can believe in yourself and see your worth, the better off you're going to be.

    And that's obviously easier said than done. I know that very deeply. But we need people in medicine who have had experiences that have shaped who they are, real experiences, and haven't just hopped on the train of, "I want a high-powered career. I want to make money. I want to be respected." Those are all great things. Most people, I think you'll find, want that in their lives.

    But if you truly want to make a difference in someone's life and you think that this is something you will be good at, fight for it and go for it. Don't let someone tell you that you can't just because they think that you're too stupid to get there. If I had listened to everybody in my life who told me that I was not smart enough to do this, I would not be here right now.

    Alizah: Mic drop. End of discussion.

    Daryl: That's all I have to say.

    Conclusion

    Alizah: It was really healing to listen to you both. And both of you, I think, are people that I wish I had met in my undergrad. It was really lonely, and it was really hard to go through that. To meet you guys now is so healing for who I was four years ago, and we're going to be fine.

    Daryl: We are going to be fine. I'm so grateful for both of you and I cannot wait to see what y'all do. I can't wait to come to match day for you guys. I am so excited.

    Austen: It'll be fun and terrifying.

    Well, should we wrap up then? Should we do a sign-off?

    Alizah: All righty. Thank you everyone for listening to "Bundle of Hers." Please find us on Instagram or our website, and tune back in two weeks to listen to Lilly and Mariam interview former "Bundle of Hers" Margaux about the interview season. It's going to be a good time. Bye.

    Host: Alizah Folau, Austen Ivey

    Guest: Daryl Morrison

    Producer: Chloé Nguyễn

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