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Episode 121 鈥 Natalie, third year medical student at University of Utah School of Medicine

Apr 03, 2019

鈥淚t鈥檚 no secret that I love surgery, I鈥檝e loved surgery since before medical school.鈥 Natalie comes from a family of surgeons but wasn鈥檛 sure that she would take the same path. It wasn鈥檛 until after withdrawing from an acceptance to law school, and moving to Utah for art and snowboarding that she realized her true passion was to become a trauma surgeon. We discuss how that journey transpired, the similarities between surgery and art, and finally how Natalie plans to use her social media as a means to educate and positively influence people on the subject of healthcare.

Episode Transcript

Dr. Chan: What do ballet and surgery have in common? How does one go from law school to a life of art and snowboarding? What's it like to finally find your passion in medical school? And what's it like to be an Instagram influencer and see the world for free? Today, on Talking Admissions and Med Student Life, I interview Natalie, a third-year medical student here at the University Of Utah, School Of Medicine.

Announcer: Helping you prepare for one of the most rewarding careers in the world, this is Talking Admissions and Med Student Life with your host, the Dean of Admissions at the University of Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Well, welcome to another edition of Talking Admissions and Med Student Life. I've got another great guest today. Hello, Natalie. How are you?

Natalie: I'm good. How are you?

Dr. Chan: Good. So third year.

Natalie: Third year.

Dr. Chan: All right. However, before we go into third year, let's start at the beginning. What motivated you to go to medical school? Why did you want to be a doctor? Where did that start?

Natalie: My dad's a surgeon, and I kind of grew up around medicine. I've a lot of uncles that are in medicine, particularly in surgery. And my grandfather was a surgeon. So it's kind of something that was just common in my household. So I knew I had an interest in it when I was younger, but I took a little bit of time after college to kind of make sure that I enjoyed it and I wasn't just going into it because I felt like I was obligated because of having so many people in my family in medicine.

But I really love kind of this mesh of being able to combine academics and art. For me, that's kind of what medicine is. It's this, like, perfect combination of the two, and those are two things that I'm really passionate about.

Dr. Chan: If I remember correctly when you applied, you have a very strong art background, right, because I remember photography and dancing, if I recall.

Natalie: Yes, I did ballet for my whole life. So draw, paint, take pictures, kind of everything.

Dr. Chan: So would you say with your family being in the ORs, it's like kind of like a ballet with your hands?

Natalie: Yes, that's great. No, it's definitely . . . I mean, one thing that I loved about ballet and one thing that I find similar between ballet and operating is it requires a lot of discipline. And it kind of fluctuates between being really intense and being really relaxed. And it's kind of this performance and you have to be on your game and you have to be focused on what you're doing. And I really like that aspect of it.

Dr. Chan: So it sounds like it wasn't just one moment. It was a series of moments that helped you decide to become a doctor.

Natalie: Definitely, yes. It wasn't just one thing.

Dr. Chan: Okay. So you start, and then you went through your undergrad, and then did you do pre-med reqs in the undergrad, or did you do that post-bacc, or . . .

Natalie: So I did a post-bacc. I actually was set up to go to law school. I took the LSAT, applied to law school.

Dr. Chan: I didn't know that. All right.

Natalie: And decided I really never actually wanted to be a lawyer. I think I just kind of liked the idea of picking something and working towards a goal more than the actual idea of being in law. So I decided I don't want to do that, pulled my applications and acceptances, moved to Utah, and . . .

Dr. Chan: So you got into law school.

Natalie: Yes.

Dr. Chan: I didn't know that. Was that hard to walk away from?

Natalie: No. There was no passion behind it, so it was just kind of something that sounded good I think more than anything, looking back at it. Yeah, I moved to Utah and snowboarded and didn't work and my parents thought I was crazy and went off the deep end, but eventually kind of decided for myself that medicine is something that I really wanted. And it did combine kind of those two passions of what I wanted in a career. And then I went and did a post-bacc and applied years after I graduated.

Dr. Chan: So what kind of activities did you do to help you prepare for that application process? I mean, what were you engaged in? I remember you did quite a bit.

Natalie: Yeah, I started volunteering in the emergency department. I really liked that. It obviously was a good way to get volunteer hours, but also get exposure to the hospital and network with different physicians. And while I wouldn't really consider it direct patient care, it was nice to be able to interact with patients kind of on a non-medical basis. I also started doing photography in the hospitals for all the newborns, so kind of another way that I . . .

Dr. Chan: So you were the one that comes around to the room.

Natalie: That was me.

Dr. Chan: You know what I'm talking about?

Natalie: Yes.

Dr. Chan: What was that service called?

Natalie: Bella Baby.

Dr. Chan: Bella Baby. All right. How many people said yes and how many people said no?

Natalie: I don't know because we only got the names of people that were consented. So I don't know kind of how that screening process worked, but not that many people buy them.

Dr. Chan: Really?

Natalie: No.

Dr. Chan: So for people who don't know what this is, it's like after your baby is born, it's . . . I'm not sure what the verb is. But there's a service or there's opportunity.

Natalie: It's a service, basically in-hospital newborn photography, and they bring a little wooden bassinet and some fancy blankets. And usually, moms have some cute outfit that they pop their baby in. We'll take some photos in the hospital, like a lot of mom and baby photos. And some of them look really nice.

Dr. Chan: It's kind of a captured population because they're not going anywhere, right?

Natalie: Yes, exactly. And then we also provided a service for the unfortunate cases of fetal demise, where we would just do free photos of baby and mom, kind of in those few little hours that they have together.

Dr. Chan: Sounds really hard.

Natalie: Yeah, it was really sad, but it was nice to be able to provide that memory.

Dr. Chan: So volunteering, working in the ER?

Natalie: Volunteering.

Dr. Chan: Volunteering, doing some cool photography stuff inside a hospital. What else were you doing?

Natalie: What else was I doing? I was doing a lot of school because I was taking all of my prerequisites at one time, studying for my MCAT, of course. I had some church volunteer hours that I had been doing. I tutored a little bit. What else? I was coaching gymnastics. I was kind of all over the place. I felt like I was doing a million different things kind of in a million different directions.

Dr. Chan: So a well-rounded application.

Natalie: That's one way to put it.

Dr. Chan: All right. So then you start applying, and walk us through your decision-making process. Why did you apply to our med school? What other schools did you look at? How did you make where to apply? How'd you do that?

Natalie: Sure. So my application process was a little interesting. I started applying pretty broadly. Just made an Excel sheet of places that I thought I could live, which didn't really include . . . or it kind of included everywhere at that point. I just wanted to go to medical school.

I think I had applied to 17 programs for my primaries, and then in the middle of that, my husband got a job offer in Seattle. So we ended up relocating right after I submitted my primary application, and he had this pretty great career. So suddenly, the idea of moving to Kansas or Arkansas or somewhere where he couldn't do his work was a bit off the table. So I only actually sent in three secondary applications -- University of Utah and the two University of Arizona Schools.

Dr. Chan: Because you were from Arizona originally.

Natalie: Yeah, because my family was there.

Dr. Chan: Yeah. I remember you're the snowboarder from Arizona.

Natalie: Yes, that was me.

Dr. Chan: And you also did ballet and photography.

Natalie: And did ballet. Well-rounded applicant. So I basically just sent my secondary applications of places where I had a support system. I had friends here from when I lived here and worked here. And then I had family in Arizona. And honestly, didn't think I was going to get accepted just because the odds of getting accepted applying to three programs is pretty slim.

I had the intention of staying in Seattle and establishing residency there and applying to UW after that, but was very, very happy when I got accepted, especially to Utah. I love Utah. I mean, our med school is at the base of mountains. There's snowboarding here. It's photogenic. There's hiking, photography, climbing, everything you could think of.

Dr. Chan: I do remember you on your interview day. I remember you were very calm and serene. That played itself out during the interview process. And maybe it was all your dancing background, and, you know, I was witnessing right before you go on stage. And then once you're on stage, it's just like lights out, you know what you're doing.

Natalie: Oh, that's good to hear, because I was probably a little panicked on the inside. But I only got one interview and it was here. So I didn't really know what to expect and didn't really get any sort of practice run, so to speak. But it was good.

And after I interviewed here, I mean, everybody I met was awesome. And I remember talking to the . . . I think they were second-years at the time that we went to lunch with on interview day, and just everybody was so nice and seemed to really love the program. And obviously, I wanted to come here when I applied, but I remember, after leaving interview day, I really wanted to come here. I was very happy when I got accepted.

Dr. Chan: Cool. So you start medical school and, if I understand the story correctly, you had to move away from your husband for a while.

Natalie: Yeah. So we lived in Seattle when I got accepted. We had been there for about a year. And so he had a career up there and didn't have a job here. So I moved here by myself. And we did the long distance marriage thing for the first semester of medical school.

Dr. Chan: So school starts, and would it be safe to classify you as a nontraditional or did you feel that . . .

Natalie: I think I'm pretty nontraditional. I had a psychiatry degree . . . not psychiatry, sorry, psychology degree and was pretty involved in political science and things like that as an undergrad student. Pretty much avoided science like the plague as much as I could as an undergrad.

Dr. Chan: So how was it as a nontraditional student, you know, doing your post-baccs, kind of making the move towards medicine a little later in your life? How was it first semester in med school? Like super hard? Super easy? I mean, how would you describe that experience?

Natalie: It was interesting. I think, in some ways, it was harder than I could have imagined. And in some ways, it was easier. It's nice because most people are in the same boat. I think the hardest part was just kind of the information overload. And I truly didn't know how to study until medical school. I thought I did. But the way I would study for undergrad and even for my prerequisite courses was just entirely different than how I had to study in medical school to be effective.

Dr. Chan: How would you qualify that? I mean, what was different about studying for med school compared to undergrad courses?

Natalie: You just have to be really efficient. I mean, I think if you count up the number of credit hours, so to speak, that you take your first semester, it's probably akin to like two semesters of undergrad work. And so you just have to be pretty cognizant of how you're using every hour that you're studying. Whereas before, I'd be laying in bed, crack open my textbook the night before an exam, try to skim it, and then go in and take a test and be successful. I found out the hard way on my first test in medical school that doesn't really work so well. So I think that that was kind of the biggest challenge for me, was just figuring out, "How do I learn all of this information in so little hours that I have in a day?"

But it was nice . . . I think what was a little easier was knowing that I had this group of classmates that were all in the same boat and everyone was super supportive, and people would study together and kind of share information and share study guides. I don't think I expected that. I thought going into it it'd be a lot more cutthroat, kind of like you hear in the movies or maybe even hear at some other schools. And it definitely wasn't the case here. And I think that that made kind of that transition a lot easier than it could have been somewhere else.

Dr. Chan: How many hours do you think you were studying a week?

Natalie: Oh, that's so hard because I feel like, especially coming off of studying for Step 1, my memory might be a little skewed. I mean, I'd go to school anywhere from four to eight hours a day, depending on the day, and then I would basically just go home and study until I fell asleep. I made a lot of flashcards. They got better over time.

And I can't say that first semester . . . you know, if I was studying for eight hours, I'd say probably four of those were actually effective, but I definitely got better at that throughout med school. And by the time I was, like, mid-first-year, pretty well into second-year, I wasn't really going to class that often. So I'd wake up at 7:30, get to the coffee shop by 8:00, and just sit there and watch lectures from the day before, and then usually study until like 5:00 or 6:00, and then call it good for the day.

Dr. Chan: Were you involved in any interest groups or causes or different outside activities during the first couple years?

Natalie: Yeah, I did something called Anatomy Academy. So we would go over to I think it was a seventh grade class, my first year in medical school, and each week we would teach some sort of lesson to a group of seventh graders about anatomy. We had a day where we taught about heart health or lung health or, you know, dental hygiene, things like that. So I did that for my first year.

My second year, I tutored a little bit. I was a president of the surgery interest group. Also helped around something called Future Doctors where high school students will come here once a month and we will put on a four-hour workshop for students with some sort of hands-on . . .

Dr. Chan: Suturing.

Natalie: . . . usually a dissection, suturing. Yeah, exactly. And then we would have some faculty member give a lecture on a topic somewhat relevant to what we did that day. So that was really fun.

And then we also have student-run clinics. So I'd go volunteer at the Midvale Clinic and try to take a history, do a physical, things like that.

Dr. Chan: So it sounds like life was pretty busy.

Natalie: It was, but it was . . . I mean, it was awesome. It's super fun. You're finally doing something that you love. And it all kind of feels relevant to where you want to be in the end as opposed to undergrad where sometimes you're just going through the motions in hopes of getting where you want to be. It felt a lot more relevant.

Dr. Chan: And then that lack of passion for law, was that passion just that much more intense during med school, and I daresay your love of surgery? Did that just resonate with you?

Natalie: Is it obvious?

Dr. Chan: Well, we're going to talk about that.

Natalie: Yes. It was so much easier, I think, to do this than it had been to do school in the past just because it's truly something that I love. And I think that is one of the things I wasn't expecting coming into medical school, or one of those things that made it a little easier than I was expecting, was just that I truly have loved everything that I've learned and all of my rotations. Even if it's something that I knew wasn't going to be applicable to me in the long run or a specialty that I knew I didn't want to go into, it's just really cool to be learning about the human body.

Dr. Chan: Did you ever feel you hit the wall and wanted to maybe take a break or give up?

Natalie: No, not that wall. I think that I've hit little walls along the way. There are days where I'm just sick of studying or I'm sick of not seeing my husband or I'm sick of having to turn down invitations to go to weddings or things like that, but I've never felt like it hasn't been worth it, if that makes sense.

Dr. Chan: Yeah. All right. So third year starts, you're very pro-surgery.

Natalie: Very pro-surgery.

Dr. Chan: Did anything happen during third year that it just solidified your choice or were you tempted by another field or . . . you know, how has third year unfolded, I guess?

Natalie: Well, it's no secret that I love surgery. I've loved surgery since before medical school. And I think that third year has definitely solidified that choice for me. There was a time where I had a little bit of interest in emergency medicine. Not necessarily that I wanted to go into it, but I just really loved the people and it was a really fun learning environment those first couple years in medical school because there's just such a variety of different things coming in. So I spent a lot of time in the emergency department in my first and second year, but kind of always found myself wishing that I could go with the trauma team.

Dr. Chan: "I want more traumas. I want more gashes and lacerations to sew up." Is that what you're secretly saying inside yourself?

Natalie: Yeah. So it was nice to be on the other side of that fence. As a third-year medical student, I rotated on the trauma surgery service and loved it. I'd heard some things from some people about it maybe being not the most fun experiences as a med student, so I was a little hesitant to choose it, and I'm super glad I did. It's been probably my favorite month of medical school. I found myself really excited to wake up at 3:00 in the morning every day and eager to stay late and sad to go home.

Dr. Chan: How early are we talking about and how late are we talking about?

Natalie: I'd probably wake up at like 3:45, 4:00 in the morning. I definitely woke up earlier on OB/GYN, so it wasn't terrible. And then we would have sign-out around 6:00, so we'd be done with that around 6:30, and then I'd stay late and write notes some days. Or if I knew that there was a case going and there wasn't another student staying that night, then I would just stay and scrub that case to get more OR time. So usually, I'd be home by 7:00, but I was there until 9:30, 10:00 sometimes.

Dr. Chan: And that's a pretty normal day, pretty typical schedule?

Natalie: Yeah.

Dr. Chan: 2:45, 3:00-ish to 9:00?

Natalie: No, I'd wake up at like 3:30, 4:00-ish. And then I'd usually be home by 7:00, but there were days where I would stay later.

Dr. Chan: But when you come home, did you feel like you had like the energy or the spirit to study or have Natalie time? How would you navigate that? What did you do?

Natalie: That was really hard.

Dr. Chan: We're talking six days a week, or are we talking seven days a week on this?

Natalie: It depends. So the first week in, I didn't realize that I got a day off, so I came in every day and my Sunday was my first 24-hour call shift. So I think I worked like two weeks straight on accident. I wasn't mad about it, obviously. It's what I want to do. Sorry, what was the first question?

Dr. Chan: How do you study or how do you have Natalie time, kind of like wellness?

Natalie: There was not really any Natalie time. I feel like I would take a bath at night and that was my Natalie time. But studying was hard. I mean, you come home and you're tired. And then you have to prep for the next day. You have to read up on any cases that you're going to be doing, or if you're in clinic, you need to know why your patients are going to be there, look at any pathology and imaging that may have populated.

And then sometimes, if I had a sick patient or a patient I was a little concerned about, I'd check their chart at night too and make sure that they were doing okay.

So by the time you'd be done with that and actually be able to study things that you needed to know for your shelf exam, it'd be like 10:00 at night. And then you look at how many hours you're going to have to sleep and when you needed to wake up, and that got pretty difficult.

I don't know, some days I was better at studying than others. But the nice thing is, especially on trauma surgery, a lot of it is general surgery, so studying your patients was studying for the shelf in hindsight.

Dr. Chan: I remember during my surgery rotation how . . . it's very physically demanding. You stand for hours.

Natalie: All day.

Dr. Chan: I remember just getting leg aches. And then someone tipped me off that you have those compression stockings or . . . I'm not even sure what their official term is.

Natalie: Yeah, they're compression socks.

Dr. Chan: Yeah, the socks that go . . . they're tight socks that go up past your knee and it helps with circulation, and they really work. I remember I got some and going, "Oh, yes." My legs aches were not nearly as rough.

Natalie: On the days that I wouldn't wear any sort of compression sock, I'd come home and have like bilateral pitting edema up to my shins just from standing for so many hours during the day.

Dr. Chan: So sometimes people ask me, "Why is it that you have to go in so early?" Well, because OR time is very precious, and the OR usually opens 6:00 to 7:00, kind of in that range.

Natalie: Yeah, it first starts usually at like 7:30.

Dr. Chan: Yeah, but you need to go and see all the patients from overnight, from the day before. As opposed to other disciplines where they can show up a little bit later and see their patients later in the morning, that is time that's dedicated to the OR. So it's almost like there are two activities going on.

Natalie: The nice thing is . . . I mean, so you as a medical student pre-round, or go see all your patients before your resident and your attending and before you round as a group. And so, sometimes, I'd wake up a little earlier if I wanted to kind of chart pre-round on my patients at home without actually going to the hospital.

Especially if I knew I was going to need to pick up a new patient the next day, sometimes pre-rounding on a completely new patient that you haven't taken care of can take a while. So I'd usually do that from my bed before finally getting up and driving to the hospital to go see them.

Dr. Chan: Did you enjoy all types of surgeries, or did you feel yourself kind of more gravitating towards general surgery or ENT or neurosurgeon? I guess my question is what kind of surgeries have you been exposed to and where do you feel your people are? Which discipline are you kind of headed towards?

Natalie: I came into medical school really passionate about cardiothoracic surgery, cardiac surgery in particular. That's still definitely where I feel like I'm headed. I know that I like sick patient populations. I like complex patients. I know that I want patients that I'm managing kind of perioperatively in the hospital as opposed to just on an outpatient basis. So kind of that trajectory alone, I can cross off a few different specialties.

And I really fell in love with trauma and acute care surgery also. So because of that reason, I'm going to do a general surgery residency and then a fellowship after. General surgery is great, but I don't see myself doing just general surgery as a career. I'll definitely want to specialize and I really want some sort of ICU patient management in my future.

Dr. Chan: Okay. And what attracts you to those types of patients? Is it just the sickest of the sick, or what do you think? Why ICU? Why trauma?

Natalie: I like the adrenaline. I definitely like knowing that you kind of always have to be aware of what's going on with your patients. I like that, even in something that might be routine, things could go wrong at any given point. It kind of helps me stay focused. My mind wanders a lot. And so it's nice to have something that anchors it in that present moment.

And I love the complexity of the patients and having to manage different comorbidities and really think through, "If this happens, I need to be prepared to do X, Y, and Z." It keeps it interesting. There's a lot of spontaneity, especially in trauma surgery, knowing that even though you don't have any scheduled cases for the day, something could come in, and you could be in the OR an hour later.

Dr. Chan: Last question about this before we switch topics. Thoughts about being a woman going to surgery, kind of the culture that may or may not exist within certain surgery departments. What would you say to that?

Natalie: That's a great question. I definitely think I have minimal exposure to it. I mean, I've only been a med student for three years now, but I've definitely had my fair share of backhanded passive aggressive comments about being a female wanting to pursue something like CT surgery or trauma surgery.

But I've also found a lot of support. There are a lot of really wonderful physicians here that are very passionate about women in medicine, both female physicians and male physicians. So I've been really grateful for that and kind of finding those people that are really . . .

Dr. Chan: Those champions or role models.

Natalie: Yeah. There are a lot of those here, which has been really great. That said, I mean, there's still . . . we've come a long way from what I've heard about training back in the day, but I definitely think that there's still quite a way to go. I think, unfortunately, surgery is kind of the specialty that lags a little bit more than some of the others, especially things like orthopedics or CT surgery where women are very much a minority.

Dr. Chan: They're the distinct minority. You look at the national numbers, they're much smaller than men.

Natalie: Yeah. I think generally surgery kind of generally speaking, is getting better. There are many more female surgeons now than there were, you know, 15, 20 years ago, but there are still specialties that are a little behind in that.

Dr. Chan: Do you think you get more backhanded comments from individuals outside of medicine or within medicine?

Natalie: That's a good question. I think . . .

Dr. Chan: Because surely your family, your friends know about your dreams of becoming a surgeon. You haven't really hidden this in any way. So I'm just curious if this is more of a problem within our ranks, or is it something that's also kind of out in the public?

Natalie: I definitely think it's . . . at least from the things that I'm thinking of currently, within medicine, there's kind of this idea that because I'm a woman, I'm going to want to have children and I'm going to want to be a mother. Not to say that I don't, but also not to say that I do just based solely on my gender. And I think a lot of people make the assumption of, "Oh, how are you going to have a family if you're going into surgery?" without knowing whether that's something that's in my personal goals or not. So a lot of comments like that.

Dr. Chan: Interesting. Do you do respond to that or do you just kind of . . . How do you handle that? It just depends on the moment if you kind of confront the person or correct them? I don't know. It's hard.

Natalie: It is hard and I think it's especially difficult being a medical student. I don't really . . .

Dr. Chan: Because all these people, you might need them for a letter of recommendation or networking.

Natalie: I don't think those are the people I would go to.

Dr. Chan: Okay, they're different people. All right.

Natalie: No, it's hard. I mean, medicine is a small world and you never want to say or do something that's going to reflect poorly on you even if it might be in your best interest. Sometimes those two things don't always coincide. Usually, I just let it go because I don't really feel like I am at a place on this hierarchical . . . I don't know how to say that word.

Dr. Chan: Hierarchical.

Natalie: Hierarchical totem pole to really be able to call an attending out on a comment like that, which I think kind of adds to it being frustrating because . . .

Dr. Chan: It's very disempowering.

Natalie: Yeah, it is.

Dr. Chan: It almost sounds very . . . it's kind of like a trope. It's kind of like a sitcom. You read about this stuff, and it's actually happening. What's going on?

Natalie: Sometimes I just can't help but laugh because it's crazy that some people still think like that, I guess. But for the most part, I would definitely say that the good supportive people far outweigh the negative people.

Dr. Chan: Good to hear. All right. Can we pivot?

Natalie: Let's pivot.

Dr. Chan: I want to talk about it. Okay. So I know some things about you, Natalie. I don't know all things, but I know some things, and I've heard that you have a following.

Natalie: That sounds very cult-like.

Dr. Chan: I'm going to ask you some very specific questions about cults now. No. So I think this ties into your art background and your photography skills. So before I turned on the pod, I was asking you, "Can I ask about this? What's going on with this?" And I'm not even sure what adjective or verb to attach to it, but I think you have a very large following. So what would you like to share? Where did this start? How did it start?

Natalie: I honestly don't even know. I get asked that a lot. So when I moved to Seattle, I did a little bit of my post-bacc up at UW, but a lot of the time, I just spent traveling around and taking photos and posting them on social media, Instagram in particular. And there's a very large group of, I guess, social influencers or content creators up in the Pacific Northwest that have very large social media followings, and are just really talented artists and photographers.

And so I kind of became friends with those people through the art community and we would go out and travel and take photos. And eventually, that led to a pretty big Instagram following and . . .

Dr. Chan: And what kind of numbers are we talking about? How many followers do you have?

Natalie: I don't know. Maybe 50,000, 60,000, something like that.

Dr. Chan: That's a lot.

Natalie: So then eventually, companies started asking me if I wanted to go on free trips or drive their cars, and I'd get paid to travel and hang out with my friends and take photos and document it.

Dr. Chan: So backing up, how does that work? Do they just email you and say, "Hey, can we chat?"

Natalie: Yeah, sometimes.

Dr. Chan: Or do they contact you through social media channels, or do they 'gram at you and then you 'gram back at them? So what does this look like?

Natalie: Usually, it's through email. My email addresses on my Instagram profile. And a lot of times, for a bigger company, they'll contact you through an agency. So an agency will contact you and say they have a client that's interested in working with you and ask to set up a phone call to discuss details, something pretty vague like that.

And so then you hop on the phone and talk to people and figure out kind of what they're wanting and the time commitment it's going to involve, and then you tell them how much you want to get paid. And then there's a little back and forth between negotiations, or sometimes they're okay with it, which usually means you didn't pitch it high enough.

Dr. Chan: Yeah, lessons learned.

Natalie: And then you go on a cool trip or you they send you a product or something.

Dr. Chan: It must be a great feeling on some level . . .

Natalie: It was fun.

Dr. Chan: . . . to have this entity, brand, company, firm, whatever, reach out to you say, "Hey, you know, we want you to do this for us." I mean, did it feel good?

Natalie: It was fun, especially at that point in life where I didn't have really much going on. It was kind of this waiting game of seeing if someone wanted to accept me into their medical school. So it passed the time. I met really great people. Yeah, it was really fun. It's definitely slowed down since starting medical school. I've still done a few big jobs, but you just don't have the time.

Dr. Chan: Well, does your medical school . . . I mean, that makes you unique. I would dare say . . . again, this is not my area of expertise at any measure, but there are not a lot of medical students or residents or even attending physicians who have large followings. I don't know. When the companies contact you now, is that kind of built into it, like, "We kind of see that you're in med school," and blah, blah, blah, or is it very separate?

Natalie: I try to keep them pretty separate.

Dr. Chan: Okay. Why?

Natalie: I don't know. I feel like I don't ever want someone to think that I'm suggesting medical advice to a patient or some sort of medical equipment or something because I'm paid to do it. So I try to keep the two pretty separate.

I mean, I definitely talk about my medical school experiences and process emotions through social media, so I'm grateful for that. It's kind of become like a journal almost over the last couple years, and medical students that are applying will reach out and ask for advice all the time. So that's really fun and I enjoy . . .

Dr. Chan: You can do a little consulting side business. I like it.

Natalie: I enjoy talking to people that are passionate about medicine, and social media is a way to, I think, kind of network to people otherwise you wouldn't know or have any sort of contact with. So that's been really cool.

But yeah, other than that . . . I mean, if certain companies reach out, I won't work with them, or if it's something that could remotely be perceived as medical, I won't. I don't mix those two.

Dr. Chan: What's your dream company?

Natalie: Oh, man.

Dr. Chan: Which is the one like, "I would love if this reaches out to me"?

Natalie: I really like working with airlines. Those are usually really fun.

Dr. Chan: Okay. So there are probably trips involved with that one.

Natalie: Yeah.

Dr. Chan: We're talking a little first class?

Natalie: Yeah. If Delta wants to reach out, I'd be okay with that.

Dr. Chan: So where have you traveled? Where have you gone?

Natalie: I recently just got back from Italy. Was in Italy for Christmas. We did France last year. Went to Indonesia the summer between my first and second year. Canada, Mexico, Aruba, all over this country. I did a trip to Austin this year.

Dr. Chan: Wow. And some of these companies are helping pay for that or fund that?

Natalie: Yeah.

Dr. Chan: To the point where it's close to free?

Natalie: Oh, it's always free.

Dr. Chan: It's always free? You've been to all these places for free?

Natalie: Yeah.

Dr. Chan: That's amazing. How long do you spend at these places?

Natalie: It depends. So I just did a job in Austin and it was in the middle of a rotation, so I was there for 48 hours because I didn't have much time. I went to Italy for a vacation with my husband over Christmas, and a lot of times, I'll pay for it up front and usually a company . . . I worked with a photo book company, and so I used the photos from the trip for their product. And then what I ended up making from that job paid for my trip entirely. So some of it is retrospective like that, and some of it is a company that is setting up the trip and they pay for everything.

Dr. Chan: But when you post things, that's still you posting it. It's not like the company posting it.

Natalie: No, it's me posting it.

Dr. Chan: You're retaining control over what gets shown on your feeds or channels or whatever you want to call it.

Natalie: Right. Yeah. And I won't work for a company that I don't believe in or support. I'm not going to talk about a product if I don't truly like it. And so, that's usually implied in whatever sort of contract that's being drafted between myself and a company, that if I don't like something, then I'm not going to post about it.

Dr. Chan: As you progress in your training . . . because I'm totally going with supposition, you're going to be a surgeon one day. You're going to be a great surgeon one day.

Natalie: Thank you.

Dr. Chan: Where do you see this kind of fitting in? Do you see this as kind of a platform and avenue? If we just pick on cardiovascular or cardiothoracic, like anti-smoking or pro-wellness, where do you see this going, or have you even thought about that?

Natalie: Yeah, I've definitely thought about that a lot. If I never get another Instagram job again, I'm not going to be sad about it. It's not something that I foresee being a career for me, of course, but I do want to be able to use my social media platform as a way to educate people about health or answer non-personal medical questions. Sometimes I'll post little things about, like, "What is a heart attack?" and just kind of explain medical pathology or terminology to someone that might be interested but didn't really know who to ask.

Dr. Chan: This is amazing.

Natalie: I don't know about that, but it's fun.

Dr. Chan: It just seems like you're so busy. You have all this . . . between getting up at 2:00, 3:00 in the morning, going to the OR, researching, learning about your patients, Instagramming, eating. Got to throw in some eating and sleeping.

Natalie: Sometimes eating and sleeping.

Dr. Chan: Eating and sleeping, throw that in there. Sounds like life is pretty busy, life is pretty full.

Natalie: It is busy, but it's fun. I truly enjoy it.

Dr. Chan: If you told your 5- to 10-year-ago self that you're doing exactly what you're doing today, would you have ever believed it?

Natalie: No, definitely not. Medical school is way cooler than I imagined. I knew I'd like it, but I didn't realize how much. And Instagram is just this weird thing that somehow popped into my life that I also wasn't ever really planning on pursuing, so it's worked out. I've gotten pretty lucky.

Dr. Chan: Cool. Natalie, we'll have you come back on the pod about a year when you're getting closer to your match and residency interviews and all that fun stuff. But I think people would like to hear, you know, where you're heading, where you're going.

Natalie: I'd like to hear that too.

Dr. Chan: All right. Well, thanks, Natalie.

Announcer: Thanks for listening to Talking Admissions and Med Student Life with Dr. Benjamin Chan, the ultimate resource to help you on your journey to and through medical school. A production of The Scope Health Sciences Radio, online at thescoperadio.com.