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Dr. Chan: How does being a medic in Afghanistan inspire one to become a doctor? Why is it important to start both the admissions process and relationship building early? What is medical school like as a non-traditional student? Today on "Talking Admissions and Med Student Life" I interview Carson, a fourth-year medical student here at the ÑÇÖÞ×ÔοÊÓƵ 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 ÑÇÖÞ×ÔοÊÓƵ of Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Well, another great medical student, a fourth-year medical student. Carson, how are you doing?

Carson: I'm doing great. It's nice and sunny outside, so it's a good day so far.

Dr. Chan: And just a little bit about yourself, a fourth-year?

Carson: Yep.

Dr. Chan: And excited for the match, which is very soon.

Carson: Excited, apprehensive.

Dr. Chan: We're not going to talk about that just yet.

Carson: Sure.

Dr. Chan: I kind of like to build this momentum, just like . . .

Carson: Got to keep them waiting.

Dr. Chan: All right. So let's jump back a few years.

Carson: Okay.

Dr. Chan: When did you decide to become a doctor? Where did that come from?

Carson: So to actually become a physician was . . . it's going to sound clichÈ, but I was actually in Afghanistan when I decided I wanted to be a doctor, working as a medic. Going through high school, like, I'd done phlebotomy classes and stuff like that, knowing that I wanted to do something in medicine. Worked as a sterile . . . I can't even remember what it's called now but cleaning surgical instruments in the [inaudible 00:01:23].

Dr. Chan: A scrub tech?

Carson: Well, no, I wasn't a scrub tech. But it was a sterile tech, because I was the one cleaning them, packaging them . . .

Dr. Chan: The autoclave?

Carson: Yeah, yeah, all that stuff. And then worked in a lab, and then got an EMT when I joined the National Guard here in Utah and started working as a combat medic while in uniform. Deployed to Iraq and worked as a line medic there, and, you know, I was really happy with doing that. And then, got deployed again to Afghanistan and we had a very . . . the base that I was on kept getting rocketed all the time, and sometimes it made it so that, you know, the physicians couldn't actually get to the hospital where casualties were coming in just because they were sheltering in place and stuff like that.

And there was one casualty, very, very specific casualty that it seemed like it took days for the providers to get there. And just me practicing my skills that I, you know, was comfortable doing and doing what I knew just wasn't enough, and it's like, "Okay, I have to be able to do more." And that kind of started me down the road. I started looking into, you know, what does it take to get into medical school? I ordered some MCAT study prep stuff and had it delivered out there. And yeah.

Dr. Chan: Does Amazon deliver to Afghanistan?

Carson: Amazon doesn't deliver to Afghanistan, which is really . . . well, at least they didn't then. This was back in 2010, I think. Yeah, 2010, exact. But I delivered it to my house. And then from there, it's easy to ship anything to an APO. But yeah, that's where it started.

Dr. Chan: But I'm thinking Carson, like, let's jump back even further, like what prompted you to join the military? And then how old were you, and did you come from a family of military or . . .

Carson: My grandfather retired from the Air Force. My stepfather was in the Air Force, medically retired out of there. Actually, I was kind of peer-pressured into it a little bit.

Dr. Chan: Oh, really? Okay, let's hear it.

Carson: I mean, not peer-pressured, but I had a couple of . . .

Dr. Chan: Those recruiters cornered you?

Carson: No, my friends cornered me, which was horrible. I shake my fist at them every time I think about them now, just kidding. No, they had joined the Utah National Guard as electricians to work on helicopters, and I was like, "Oh, that's really cool. Like, you guys are doing some really cool stuff, and I want to be cool," was part of it, I'm sure. And then I wasn't in school at the time when I joined. I was 23, and I had just barely moved back to Salt Lake City from Boise, Idaho. And I was just tired of working 80 hours a week, and I was like, "Well, I know I want to do something. I need an education. I've been putting it off for years." I'd had a four-year gap in my undergraduate studies, and I was like, "Well, I can't pay for school without this job. But I don't want to be in this job. I want to be in school. So what else can I do?" And that's when the National Guard money started weighing in, because hey, you know, you can get money for school and they'll help. So that was, I say, you know, the biggest reason to join the National Guard. But like I said, I'm sure my friends had some play in it.

Dr. Chan: Were you aware that you could be deployed?

Carson: Yeah, I was aware.

Dr. Chan: Okay.

Carson: I mean, this was 2007. So, I mean, we'd been at war for six years already and stuff along those lines, so I knew it was . . .

Dr. Chan: Possibility.

Carson: Possible. But at the same point in time, you know, I enlisted as a medic. The unit that I enlisted into down in Riverton, which is just south of here, their medical unit, they set up a hospital. So I didn't think it was going to be any frontline work or anything along those lines. Typically, the hospitals are a little bit more reserved from what I knew at the time and held back a little bit. So, like, yeah, I'll be fine, not a big deal.

Dr. Chan: How many times did you go over?

Carson: I went twice. In 2008 . . . well, years, 2008 I went to Iraq, and that was with a unit out of Washington State. And then in 2010, I went to Afghanistan with that actual unit I enlisted into here in Utah.

Dr. Chan: Which was better for you?

Carson: They were both great.

Dr. Chan: Okay.

Carson: So Iraq has . . .

Dr. Chan: Because sometimes, like, when I talk to vets, they say like, "Oh, this happened . . . Iraq . . . " Like there's a huge difference between the [inaudible 00:05:33].

Carson: Yeah, so I mean, some big things happen in Iraq. I mean, I call it the fun deployment, because I was part of a cavalry troop. So we were out on the roads driving around all the time, going from place to place. And I was working as a line medic, so . . .

Dr. Chan: What's a line medic?

Carson: So a line medic is someone who's forward with the people out doing the boots on the ground, that kind of work.

Dr. Chan: So a World War II example is they have the little cross on their helmet?

Carson: Sure.

Dr. Chan: Okay.

Carson: I mean, I really like "Band of Brothers," and I really like those red crosses on the helmets, but I would never wear a red cross on my helmet.

Dr. Chan: Okay.

Carson: But, yeah, out there with . . . you're forward with whoever it is.

Dr. Chan: Again, just to really simplify it, and I feel bad. Like, if someone gets hurt, do they really scream, "Medic"?

Carson: You'd be surprised.

Dr. Chan: Okay.

Carson: Yes.

Dr. Chan: All right. And whatever you're doing, you drop everything and run.

Carson: Medic or doc, something like that. Yeah, drop what you're doing and go running. That part's fairly accurate.

Dr. Chan: Fair, okay.

Carson: But yeah, I mean, Iraq was, you know, I call it the fun deployment. It really had the opportunity to build some really strong connections with some people I was with, because, you know, we were out running around, getting shot at, doing all sorts of fun stuff. Well, getting shot out wasn't fun, but you know what I mean?

Dr. Chan: Wasn't as fun.

Carson: It wasn't as fun. No, that wasn't as fun. It was a little scary the first time, and then about after the 30th, it's like, "Meh, there's armor on these vehicles, it's fine." And then I call Afghanistan the educational one.

Dr. Chan: Okay.

Carson: So I was still a medic. I was a more senior medic, and so I was kind of responsible for helping train some other medics and making sure their clinic runs smoothly. And since I had some more experience, I was allowed a little more leeway with what I could do, because there's a very, very well-known "see one, do one, teach one" mentality within military medicine. And if your providers are comfortable with you doing something, you know, check in with them, "Hey, I'm going to do this," and you get the sign off, go for it.

And I got to . . . at first, it was just working in the outpatient clinic, and then it was as a like supplemental staff to the trauma bay. So when more patients came in than they could handle, then I would sneak my way onto a bed and work there. And then I would see the individuals or casualties come in and go from the trauma bay to the operating room, and I would peek my little head around the corner and be like, "What's going on in there?" And then that turned into me weaseling my way into there, and then working as a circulator. And I got the excellent opportunity to first assist on a couple of cases, and it just kind of built. So it was very educational. And I think that's actually why I fell in love with surgery actually, which we'll probably talk about later. But yeah, super great exposure, super great experience.

Dr. Chan: And how much schooling had you finished during this time?

Carson: So I was about halfway through my undergraduate career.

Dr. Chan: Okay. And during your deployments, are there online classes available?

Carson: Oh, sure.

Dr. Chan: Because sometimes like, you know, I've had other vets come through, and there's that joint services transcript. So I get the sense there is some educational lessons that can be done even if you're in some foreign country. So tell me about that. Carson: So the joint services transcript from my understanding is basically a transcript of everything that you've learned or all of the classes or courses that could potentially translate into university credit.

Dr. Chan: Oh, I see. Okay.

Carson: So for myself, since I went and got an EMT-B and then continued that out with what we call whiskey training from the medic field, a bunch of those hours, actually none of those hours transferred over to this university, to the undergrad university here in Utah, but at other schools that could have transferred and counted for some general education electives. I think I got four hours for physical education that transferred over onto my transcript. But outside of that, like I tell my soldiers going through deployments, like when you're off, you're off. Make sure you guard your off time, because there's always going to be work to do, but if you're off, you're off.

Dr. Chan: There's always something to do.

Carson: And there's always the opportunity. I mean, you can take online courses, you can do whatever you want. Well, not whatever you want, but I mean, if you want to take an online course, there's nothing stopping you.

Dr. Chan: Okay, okay. And had you taken the pre-med reqs before you left, or was that something you needed to do afterwards?

Carson: That's something I needed to do afterwards. I actually started working on a biology degree at Utah State ÑÇÖÞ×ÔοÊÓƵ in 2002. Like I said, I took a multiple-year gap to go work, and then had the realization I need to get back into school. And that's when I kept going on that biology degree path. And then coming back from Afghanistan is when I really hit the pre-med reqs really hard.

Dr. Chan: Was it hard to walk away from military? Or what did you think about? Because I know there's [USUHS 00:10:20] and . . . there's all these kind of different paths to becoming a doctor within the military.

Carson: Sure, yeah.

Dr. Chan: I'm just curious how you ended up choosing your particular path, yeah.

Carson: So luckily, I haven't had to walk away yet, which is great. I'm actually still a combat medic in the Utah Army National Guard, which is great. I turned 13-years army old last month, and it's actually been really good. National Guard is part-time, you know, one weekend a month, two weeks a year. I'm air quoting here for whoever can't see because sometimes it's a little bit more than that.

Dr. Chan: Just a little bit more sometimes.

Carson: Just a little bit more sometimes. But they've worked with me very well. Schools worked with me fairly well to make sure that I can do that because I actually really do like it. I did apply to Uniformed ÑÇÖÞ×ÔοÊÓƵ, interviewed there, was waitlisted. I mean, but ultimately, Utah is home, so I was happy to come back to Utah.

Dr. Chan: Okay, all right. So you're going through the application process, tips, advice you would give to those out there? Looking back, would you have done anything differently?

Carson: I would have started a lot earlier.

Dr. Chan: Okay.

Carson: That's probably . . . Yeah, the number one tip is start early. Before I was accepted to medical school here, I was in graduate school at Tulane working on a master's degree.

Dr. Chan: Yes. I remember when I talked to you on the phone, you were right around Louisiana.

Carson: Yeah, I was in Louisiana. I'd just gotten back to Louisiana from Germany, but yeah, running around Louisiana. And I had gone to the pre-medical advisor there. Even as a graduate student, they were willing to help, which was awesome. And one of the things that they had said over and over, have everything ready to go so when you can click the button, you click the button, because, you know, first off, no one likes to, you know, procrastinate and stress at the last minute. Some people in my family would say that if I didn't procrastinate, I'd get nothing done, which was probably right at some level, but start early.

If medicine is something that you really want to get into medical schools where you definitely want to go, build the relationships with the individuals who can help you there . . . help you get there, excuse me, early. I mean, being on the admissions committee here as a student member . . .

Dr. Chan: As a fourth year.

Carson: . . . as a fourth year, right, sorry, some of the greatest things that I see, that I enjoy seeing are extremely long shutters . . . Wow, that was a weird word, extremely strong letters of recommendation from professors from wherever who really know the individual that they're proffering the letter for. It lets us know that it's not just, you know, someone that you went to ask at . . .

Dr. Chan: Some template, yeah.

Carson: Yeah. It's not a letter that I'm going to worry about finding different pronouns or anything along those lines because it's a copy and paste job. And, I mean, put your nose to the wheel. I mean, getting into medical school is a hard job. And then completing medical school is a hard job, and just get ready for it. Tell yourself, "Hey, it's going to be hard. It's going to suck for a little bit, but it's worth it."

Dr. Chan: How did you end up at this program at Tulane? What was kind of decision making that went into that?

Carson: Yeah, so . . .

Dr. Chan: Because I get asked this question a lot about . . .

Carson: Should I get a master's degree?

Dr. Chan: Yeah. Like, kind of post-bacc master's degree programs? And it's very controversial in the pre-med world, so . . .

Carson: Yeah, so to be completely honest, I didn't get into medical school . . .

Dr. Chan: The first time you applied.

Carson: Yeah, the first time I applied, yeah. My GPA wasn't horrible. I thought that I could use some more work in science just to kind of bolster that GPA and give me an opportunity to find some more letters of recommendation. And I really wanted to show to the committee that I was continuing forward momentum that because I got to know I didn't, you know, stick my head in the sand and sulk or something . . .

Dr. Chan: And feel sorry for yourself.

Carson: Yeah, and then just reapply next year and have the same questions asked, "Well, you know, what has he been doing?" That could have some demonstrable evidence that I was still working towards that goal.

Dr. Chan: Okay, great. So I guess I'm curious, like I got a series of questions in my mind, like, when you started medical school, do you feel your undergrad and your master's program prepared you academically? Or do you feel like oh, this is like a whole new ballgame? Do you understand what I'm saying?

Carson: Yeah, absolutely. So I think that part of my graduate school, a lot of it helped me.

Dr. Chan: Okay, good.

Carson: Because my master's is in cell and molecular biology. So understanding signaling cascades, all sorts of random stuff like that really helped in some of the courses to the point where I probably didn't study as much as I should have. I felt a little overconfident, but I got that confidence from taking those courses.

Undergraduate school, to be completely honest, I don't know. I think for me personally, and it's going to sound kind of weird because I'm an older . . . I was an older candidate, but it took graduate school for me to kind of grow up to realize that, you know, it's not just go to class for three hours and then go hang out with friends and then whatever, but it's actual work.

Dr. Chan: Did you feel that was an issue at all being a non-traditional student and being older than the average classmate? You know what I'm saying?

Carson: You know, I didn't think it was until a medical school that I interviewed at asked me how I felt about being so much older than every other applicant. And part of me kind of went, "Wait a minute, I'm not sure they can ask that."

Dr. Chan: Yeah, they're not supposed to.

Carson: But, yeah.

Dr. Chan: But I can ask you that in a podcast right now because it's all retrospective.

Carson: For sure, for sure. You can't kick me out now Dr. Chan. You already accepted me. I didn't think it was a problem getting into class. I mean, we all kind of, for whatever reason, social explanation you want to, all kind of tend to gravitate to those who are like us, right?

Dr. Chan: Yes. People self-select, and there's, I think our school is really great for non-traditional students. I think there's a lot of people in their 30s, 40s who are here, so . . .

Carson: Exactly. And that was, I don't want to sound vain or anything along those lines, but walking into class going, "Yes, I'm not the oldest one here," was kind of, it's kind of nice. Because, I mean, I was 32 when I started medical school. But no, I don't think age really hurt me in any way.

Dr. Chan: What kind of activities were you doing, Carson, for a couple of years, like in terms of research or community service?

Carson: Yeah. So admittedly, I probably didn't do as much research as I should have. Community service, I was volunteering with . . . backup here a little bit. I actually enjoy education. So spending time with Anatomy Academy and young physicians and stuff along those lines, just helping expose high school and elementary and junior high school students to medicine and to the sciences and stuff along those lines was where I spent the majority of my time.

Dr. Chan: Okay. And then, you know, the first couple of years, the preclinical years, you know, what I know about you then, if I'd asked you, I probably would have heard surgery or emergency medicine. Would that have been accurate? Were you kind of leaning that way?

Carson: Yes, surgery and emerge . . . I can't talk. Surgery and emergency medicine were probably tied for first.

Dr. Chan: Okay. So let's talk about third year. Well, how was your third year? What did you start off with? What was your experience?

Carson: I describe third year in like three separate sections. The beginning of third year was horrible for me, at least I felt so. I felt like I didn't know what I was doing. I had no idea about anything like what medicine was. I felt like, you know, my hair was on fire just standing around saying, "This is fine." But I learned a lot in the first three blocks.

Dr. Chan: What were those three?

Carson: So they were neurology, surgery, and internal medicine.

Dr. Chan: Okay, some pretty heavy hitters there. yeah

Carson: Yeah, pretty heavy. And I kind of wanted . . . it's actually neurology, internal medicine, and then surgery. I knew I didn't want to go into medicine. So I kind of wanted to use medicine as a warm-up for surgery, so that's why it's kind of stacked that way. But it was super busy. I felt extremely inefficient, like I didn't know anything, and that I was being tolerated. And that was just an internal feeling. That wasn't anything that I experienced out on the wards or anything along those lines.

And the next couple of blocks, things got better. Knowledge-base and how to operate in a hospital was a little bit better. I was feeling a little more sure of myself. I knew I didn't know all the answers, but that was okay, because no one's expecting you to. And then the last third of third year was just, I had fun. It was great. Actually, one of my funnest rotations was psychiatry.

Dr. Chan: Okay.

Carson: I was over a UNI.

Dr. Chan: Tell me.

Carson: Yeah, I was going to say. I'm sure you'd love this, just over at UNI just having a blast because while, obviously, I'm not worried about all the medical problems in the background, but there are things that still play into it and lead to disease processes, and it was just really, really fun. I really enjoyed it.

Dr. Chan: Yeah, it's like, I would argue, you know, like each discipline, each field has its own culture.

Carson: Oh, sure.

Dr. Chan: And each discipline has kind of its own patient population to a certain extent, and there's just these personalities among the different doctors and the nurses. And something I've heard, you know, over time, with talking to a lot of students is like as you pick a field, you kind of have to find your people and like what's kind of this culture you want to submerse yourself in? So kind of like third year is kind of like a tour, right? You're going to be a psychiatrist for six weeks, a pediatrician for six weeks, and how does that make you feel? And how do you do? You know.

Carson: Yeah, exactly. I mean, that's kind of something that I was thinking in the back of my head when you started talking there for a second was that that third year like really opened my eyes to the different cultures. And once I saw the different cultures, I mean, I will unabashedly say that I stopped trying to fit in because I had found my people in the surgery world. And that doesn't mean, you know, I was walking around, you know, trying to be a jerk or anything along those lines, but it was just, "All right, there's something here to learn. I don't really fit in here. I kind of feel like an odd duck, but that's fine because there's . . ."

Dr. Chan: And I was opposite, like, I obviously chose to become a psychiatrist, but I liked visiting the surgeon world, but just it was really different. Like oh, yeah, you know, because we got to get at the hospital so early to do all the rounding because the OR opens at 7:00 and everyone has to get to the OR on time, and, you know, it's this cascade effect, and then, you know, you're operating, and all this stuff is happening on the floor. You know, just . . .

Carson: People are poking their head and saying, "What about this?"

Dr. Chan: Yeah.

Carson: Absolutely.

Dr. Chan: You know, I remember just watching surgeons operate and returning pages because like there's a scrub nurse. Like she would hold the phone while, you know, and like the doctor would be giving orders. It was just like, "Wow, this is a lot of multitasking," a lot of stuff going on.

Carson: Yes, there's definitely a lot of stuff going on. But, you know, I definitely appreciate it and enjoyed my time on the other rotations, because like I said, there was something to learn. And really, I think when people start thinking about their specialties, as long as they kind of keep that in the back of their head, there's, you know, there's something to learn here that it makes everything tolerable.

Dr. Chan: Did the pace remind you of your medic days? Or is it completely different? You know what I'm saying, like?

Carson: Pace of third year or . . .

Dr. Chan: Pace of the hospital, you know, just the way things operate, and how there's somewhat of a hierarchical nature to things, and . . .

Carson: Yeah, so the hierarchical nature definitely reminds me of it. There's not an attending physician that I don't call sir or ma'am, for better or worse, just because that's . . .

Dr. Chan: Interesting.

Carson: . . . how it works. And yeah, the hierarchical nature definitely reminds me of my medic time. I would say some services, like the pace, anyway, some services more closely resemble it than others. But no, I'll call it the ring structure of medicine is very harkening to those days.

Dr. Chan: And so it sounds like the hardest part for you was the beginning. And do you think it had anything to do with those first three rotations or is much more just like you transitioning from a second year to third year?

Carson: I think was more of the transition.

Dr. Chan: So anything could have been first and it could have been a little rough?

Carson: Yeah, I'm sure I could have had psychiatry first, and I'm sure I would have enjoyed it. It would have been like, "What am I doing here yet I know nothing?" But no, I think it was just getting in, getting acclimated to the pace, learning how to be flexible, because I think a lot of, well, at least for myself, I don't want to speak for a lot of other people, but I tend to try and find patterns and figure out how things work as far as like stepwise fashion and things along those lines, just because that's how it makes sense in my mind. It's a mystery why, you know, I'm going into surgery, right? And so learning how things flow and everything along those lines. And you switch to another service where the flow is completely different, and it's like, "Wait a minute, there was just a rug underneath my feet. I felt it there a second ago, and now it's gone." But just learning to be flexible, because no matter what you're going to get it just might take a couple of minutes.

Dr. Chan: Did you flirt with any other field, or once you did your surgery rotation, you're all in?

Carson: Yeah, so I've done a lot of surgery rotations, and I still love surgery. Anesthesiology is a sneaky one.

Dr. Chan: Oh, yeah, other side of the table.

Carson: Other side of the table here. The physiology is amazing.

Dr. Chan: You get to kill people and bring them back to life because . . .

Carson: Exactly, it's great.

Dr. Chan: Yeah.

Carson: I shouldn't say it's great. You know what I mean.

Dr. Chan: Yeah, I know.

Carson: The physiology is great, the medicine is great. The pharmacology is confusing but still great. And all the anesthesiologists I spent time with were really awesome about, you know, explaining what was going on, and we'd have a lot of table talks and stuff along those lines. But at the end of the day, I mean, I can't even count the number of times I'd be talking with my anesthesia attending and then find myself peeking over the curtain, seeing what was going on on the other side and be like, "Oh, they're getting ready to do this," and wanting to be like, "I can get that for you. Let me, you know . . ." But anesthesia is sneaky.

Dr. Chan: So you flirted a bit.

Carson: I flirted.

Dr. Chan: A little footsie, a little footsie.

Carson: Yeah, just toeing the line a little bit, just trying to see where it's at.

Dr. Chan: Okay. And you mentioned other surgery. Which ones did you end up doing?

Carson: So I have done plastics, vascular surgery, and foregut bariatric.

Dr. Chan: Wow, that's kind of a diverse group of . . .

Carson: . . . and then a trauma surgery rotation.

Dr. Chan: Okay. Which one did you like the most?

Carson: Yes. I like . . .

Dr. Chan: C, all the above.

Carson: Yes.

Dr. Chan: Okay.

Carson: I liked them all for different reasons.

Dr. Chan: Okay.

Carson: The first one I did was the trauma service. And I loved it because it was kind of . . . it took me back to the days of operating in the trauma bay.

Dr. Chan: Cars crashes, gun shot wounds . . .

Carson: Absolutely.

Dr. Chan: . . . falls.

Carson: Tons of blunt trauma.

Dr. Chan: Fights, drunk fights, yeah.

Carson: Good knife and gun club stuff.

Dr. Chan: Yeah.

Carson: The hours were horrendous, lead long, but I loved it. I thrived. The general surgeons were great. I learned a lot from them. Next one I went to was vascular surgery. Again, very long hours, but it taught me new approaches to stuff, because a lot of vascular surgery is all done endovascular now. So seeing some of the advancements in EVAR and TEVAR and stuff along those lines, I felt that, you know . . .

Dr. Chan: Little toys now.

Carson: Exactly, like my head would explode on every other case, like you can do that? Foregut bariatric was really awesome because I think there's a really on the bariatric side, people who, you know, you can help a really awesome patient population, who, for whatever reason, you know, really need some help, and you can do that, and you can be there for them. And I really liked that one because it wasn't just, "Okay, come in for surgery, we're done." It's a very long, drawn out and involved care process where those surgeons are plugged in with those patients forever.

And, you know, we'd have patients who were, you know, 11 months out and have an issue and guess who's taking care of them? We are, because that's where the service that they belong to. And then plastics was just mind-blowing as well.

Dr. Chan: Yeah. The whole concept of reconstruction, yeah.

Carson: Sure. I mean, I will be 100% forthcoming say, "I'm totally naive thinking about plastic surgery." I'd never really thought about in the past. I thought it was going to be a lot of, you know . . .

Dr. Chan: Cosmetics.

Carson: Rhinoplasty, augmentation things along those lines. And I didn't see a cosmetic procedure until the last week I was on the rotation. The very first case I was on was a woman who had a fungating mass on her right shoulder down to her chest wall. And so she had a forequarter amputation done where they took off her right arm right at the base. And we, I say we, I mean, I was in the room, I didn't do any of the work. But the surgeons actually took a flap from her anterior thigh and actually hooked all the tubes and everything up, all the vascular supply . . . I shouldn't say hooked all the tubes up.

Dr. Chan: No, no, but I like it. I like it. You're talking like a surgeon, yes.

Carson: I do know some words that make me sound smart sometimes. But hooked all the vascular supply up and closed her, and then I followed her in the hospital for a couple of weeks, and she's back at home now.

Dr. Chan: Wow, that's amazing. It's amazing what they can do. Yeah. I know I like to make fun of surgeons and surgery, but I think they do a phenomenal job and . . .

Carson: Yeah, I mean . . .

Dr. Chan: It's a hard life because the OR is long and there's a lot of risk involved.

Carson: Sure. Sure.

Dr. Chan: But we need people to be surgeons.

Carson: I mean, at the same point in time, if you can watch someone rebuild . . . I mean, if you can rebuild a pelvis from a fibula, that's an awesome skill to have.

Dr. Chan: So you're going through this experience, Carson, and you're definitely surgery.

Carson: Definitely surgery.

Dr. Chan: How did you pick which path on surgery for fourth year? Because you have to submit your residency application.

Carson: Right.

Dr. Chan: What was your thought process? How did you do that?

Carson: So my thought process is that I'd seen a lot of general surgery just from my time in Afghanistan and the trauma service, which is a general surgery service when there's not trauma going on here. And seeing other surgical services kind of out in the periphery, I will say in the periphery, but obviously they're working just as hard, and wanting to know what I could do past general surgery. So I applied to general surgery and . . .

Dr. Chan: How many programs did you apply to?

Carson: Seventy-seven.

Dr. Chan: Okay.

Carson: A bunch.

Dr. Chan: A bunch.

Carson: A bunch.

Dr. Chan: A bunch.

Carson: But here in academic center, we're very, very lucky because we have a lot of extremely specialized individuals for foregut bariatric, colorectal, plastics, vascular surgery, etc., cardiothoracic, on and on, and I wanted to expose myself to those other subspecialties. So I just started whittling through them. The ones that I thought were most interesting. Vascular, foregut, plastics were the top of the list. And that's everything that I could squeeze in with all the other requirements.

Dr. Chan: I see, okay. So you applied to 77 programs. Did you do any away rotations?

Carson: I did not.

Dr. Chan: Okay.

Carson: General . . .

Dr. Chan: What was kind of your philosophy going into that?

Carson: Yeah, so I sat down with one of my advisors, and we looked over everything and just the general gestalt is that general surgery is not one that you need to do an away rotation. There's definitely others that you 100% have to. Emergency medicine, you have to do an away rotation, but you don't necessarily need it. If there's someplace that you 100% absolutely want to go, I don't think it hurts you. And that was the same advice that I got. I don't think it hurts you. But if you're going to go there, you need to go there under the assumption that you're going to work your tail off. And you're going to walk out of there with an honors in the course and letters of recommendation that have, you know, written in gold ink, basically.

And I don't want to say I didn't want to put the stress on myself, but let's be real, medical school can be expensive. And having to travel to another state, afford lodging, and everything, that played a very large part into it, so . . .

Dr. Chan: So you applied to 77. Are you comfortable sharing how many interviews did you go on?

Carson: Not enough.

Dr. Chan: Not enough.

Carson: Yeah. I think that's the answer that, and pretty much everyone will give you.

Dr. Chan: Okay, all right.

Carson: Yeah, not enough.

Dr. Chan: So you went on not enough interviews?

Carson: Yes.

Dr. Chan: What's going on out there on the interview trail? What was your experience? Are some programs asking you, "Hey, we want to see you stitch," kind of like . . .

Carson: I'm lucky.

Dr. Chan: Okay.

Carson: No one asked me that. I've heard horror stories from other individuals who actually interviewed at places that I wanted to, but didn't get the opportunity to interview at, where they were taken into the operating room and . . .

Dr. Chan: Really? Wow, a lot of pressure on that.

Carson: Yeah, I don't know what I would do. I mean, I'm nervous enough sometimes.

Dr. Chan: Watch you scrub in as fast as you can.

Carson: Yeah, exactly.

Dr. Chan: Ooh, you missed a spot, yeah.

Carson: See, that's a trick though because you're supposed to spend a specific amount of scrubbing, so that's where they try and get you.

Dr. Chan: I'm sure all the doctors we've ever seen have always hit that mark.

Carson: Exactly, not at all. I want to say that someone was asked to tie, which is fine. I will say that if you're thinking about going to surgery, start now because it is a very perishable skill and sometimes when you're under pressure and people are staring at you, you are all thumbs and that's not good in tying suture.

But, you know, my experience on the trail was pleasant. It was fun. I met people from across the nation who I don't want to say were just like me, but we kind of had the same mentalities, had the same goals, and . . .

Dr. Chan: What kind of questions were the residency programs asking? Did they talk about what happened here in med school? Are they talking about, you know, your military service? Like what kind of things would come up?

Carson: Both. Kind of a mix. There were some interviewers at different places that, I don't want to disparage anyone, but it almost seemed as though that they had no idea who I was. And we did a very abbreviated, this is who I am, this is my story. One of the advisors here, I mean, I'm sure you know this, you know, you need to have, you know, a two-minute story about yourself . . .

Dr. Chan: The elevator pitch.

Carson: Yeah, exactly. So I got to practice my elevator pitch a couple of times. Some interviews only focused on my military service, which was great. I can talk about military service all day if somebody wants to hear about it. I'm sure they were yawning as soon as I left the room, but whatever. Very few actually asked about my medical school experience, actually.

Dr. Chan: Interesting.

Carson: I would get it seemed like generic questions. How's school been? What have you liked? What have you enjoyed? But then they'd come with a curveball. And it was just some of the toughest questions right out of the book. It's like they asked you the easy questions first just to . . .

Dr. Chan: Kind of soften you.

Carson: . . . kind of soften you up, and then it's . . .

Dr. Chan: Were they like, what is surgery?

Carson: What are your deepest, darkest fears? Stuff like that.

Dr. Chan: Oh, so it's more like . . .

Carson: No, that was like . . .

Dr. Chan: Oh, I started to say like, was it like surgical trivia questions? Like . . .

Carson: No. No pimping or anything like that. But, you know, what's your greatest weakness? And, I mean, we all sit back and talk, you know, think, well, if I'm asked this.

Dr. Chan: I work too hard.

Carson: Yeah. They don't want to hear that, not at all.

Dr. Chan: Spend too many hours at the hospital, yeah.

Carson: It seems like every answer I gave, which I was genuine and saying, you know, I think I'm weak in these areas, I would get push back, "That's not a weakness, that's everybody. What else?" Just like I have no idea how to appease you right now. That's how I feel, I'm sorry.

Dr. Chan: Well, to kind of transition, Carson. I mean, the match is a little under a month.

Carson: Less than that. March 20th.

Dr. Chan: How are you feeling? What's the emotional kind of . . . to me, like, as I talked to the students, it's just an emotional roller coaster, right?

Carson: It is.

Dr. Chan: And the internet is fantastic, but I think it just causes more panic on certain levels. And I'm sure you've checked out all these websites and, you know, and everyone in your classes, you know, who is also going into gen surg. So, like, how's it feel right now? What's going on?

Carson: So to be completely honest, I haven't really gone online.

Dr. Chan: Okay.

Carson: I've told myself it's going to be what it's going to be, and I don't need to worry myself. So I've kind of detached myself from that. Listen to the Dean of Student Affairs here and, you know, his pitch and the information that he's provided, the data he's given. And I found that satisfactory enough to be able to say, "I'll accept that, and that's great because I can't really change anything at this point in time." But you're absolutely right. It's a totally emotional roller coaster. Can't even say it right now, like choking up about it.

Something that I find interesting is that everyone's on that same roller coaster. It's just whether or not it's uphill or downhill at the same time. And occasionally you meet someone who's at the same spot. But it's nerve-racking, but at the same point in time, it's one of those things I can't do anything about it. So let me go read up on this anatomy so I can look okay in the OR tomorrow instead.

Dr. Chan: Are you the type of person that you allow your brain to like even entertain the idea that there is like a slim possibility you won't match, or do you not let yourself go there?

Carson: I'm the type of person that has a very large portion of my brain that will say, "You're not going to match."

Dr. Chan: Wow, wow.

Carson: Yeah. But again, what can I do? It would be very unfortunate if that were the case. I wouldn't say large. I'd say I'm about 60-40 right now, 60 I'll match, 40 I won't, which is frightening now that I think about it. But that much mental energy has gone to it.

Dr. Chan: But you start thinking about it then, but then, like, a part . . . to me like a way to kind of like modulate that is you have a backup plan. So are you the type of person that's just preparing yourself to like, "Oh okay, we'll I'm going to . . ." we call it the SOAP, the Supplemental . . . I can't remember.

Carson: Offer and Acceptance Program.

Dr. Chan: Yeah, okay, good. And are you someone that's like I just need to practice. I'll take anything. So you'll go to a different field that might be open outside gen surg? Are you the type of person like, kind of like in your past like you redouble efforts? Okay, I'm going to do more research and then redo the match next year and do gen surg for sure?

Carson: No, I have a plan, for sure.

Dr. Chan: Okay.

Carson: I am actually kind of the person who says, "Plan for the worst, hope for the best." So I am planning on SOAPing actually, and working towards that right now trying to make sure that my extreme phone speed dating skills are up and so that if I do get a phone call from a program, I'll be able to instantly turn on the . . .

Dr. Chan: The elevator pitch over the phone.

Carson: Yeah, yeah, exactly that interview switch with different letters and things along those lines, and then starting to kind of put together a plan of what happens after that, if that isn't successful. So there's definitely plans. I've definitely thought about it. But again, I don't want to get emotional or anything about it just because it's one of those if it happens, it happens. And I'll have a plan.

Dr. Chan: Well, Carson, what I know about you is you're a fighter. You're a survivor. You've accomplished so much. And again, I feel bad that like, this roller coaster is part of it. But you're going to be a great doctor.

Carson: It's life. I mean . . .

Dr. Chan: You're going to be a great doctor.

Carson: And I think that's something that I can . . .

Dr. Chan: You're in the worst spot now because it's ambiguous, and you're in this gray zone, and it's hard.

Carson: But, I mean, even really that same kind of emotional roller coaster has gone back. I mean, applying to medical school, am I going to get in? Am I not going to get in, right? I think that's some something that even medical school applicants experience. And suffice it to say is it doesn't go away, it just changes. So it builds character, that process. It builds character.

Dr. Chan: So does serving in the military and going on multiple tours just . . .

Carson: That's just fun.

Dr. Chan: Okay.

Carson: That's just fun.

Dr. Chan: Well, Carson, I really appreciate you coming on.

Carson: Absolutely.

Dr. Chan: Do you mind coming back on after the match and . . .

Carson: Sure.

Dr. Chan: No, not like the day of but like, you know.

Carson: Oh, I won't be here, so . . .

Dr. Chan: Have some time to process it, whatever happens.

Carson: Yeah, I actually won't be here for match day.

Dr. Chan: Oh, where are you going?

Carson: I'll be in Morocco.

Dr. Chan: For fun or for protecting our country in some roundabout way?

Carson: Yes. For anybody who is in the military who might be listening here, I don't want to sound very OPSEC-y. Sorry, I have to put that in there though.

Dr. Chan: Oh, thank you.

Carson: I will be in Morocco.

Dr. Chan: Okay.

Carson: Yeah.

Dr. Chan: All right. So they'll let you know via email then.

Carson: No, I've instructed someone to open my envelope and call me.

Dr. Chan: Okay. Do you have to like sign a form to give permission to someone or you just say, "Hey?"

Carson: I don't know.

Dr. Chan: Okay.

Carson: I mean, I told somebody with witnesses around that it was okay if they stole my envelope and call me.

Dr. Chan: And then they would call you immediately?

Carson: Yeah.

Dr. Chan: Okay. If it's 10:00 Utah time, what time is it in Morocco? Have you already figured this out?

Carson: I can't do math. I don't know.

Dr. Chan: I was just thinking you're going to get this phone call in the middle of the night, so, yeah.

Carson: No, it won't be in the middle of the night.

Dr. Chan: Okay.

Carson: Actually. No, it will not be the middle of the night. But it'll be fun. That will be great.

Dr. Chan: Well, Carson, I really enjoyed this.

Carson: Me as well. Thanks for having me.

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 ÑÇÖÞ×ÔοÊÓƵ Sciences Radio online, at thescoperadio.com.