Episode Transcript
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Speaker 1 (00:01):
Hello and welcome to
another episode of the Med
School Minutes podcast, where wediscuss what it takes to attend
and successfully complete amedical program.
This show is brought to you bySt James School of Medicine.
Here is your host, kaushik Guha.
Speaker 2 (00:20):
Hello everyone and
welcome to another episode of
Med School Minutes, where wetalk about everything MD related
, with a focus on internationalstudents, specifically Caribbean
students.
Today we have a very interestingguest.
His name is Dr Stavros andafter finishing his MD, he's
chosen a path ofentrepreneurship and dedicated
(00:41):
his career to really helpingstudents realize their dreams of
making it and passing the exams.
He has over almost two decadesof experience managing and
handling and helping students dobetter in step one, step two
and step three, and he'sessentially an expert on the
(01:05):
exam.
So we're here to talk to himabout what the changes in the
structure of the exams in bothstep one and step two are and
generally.
You know his passion and hischoice to not really practice
medicine but go into a fieldwhere he is still involved with
(01:25):
medicine but at the same timehelping students as much as they
can.
So, without further ado, let'swelcome Dr Stavros.
Thank you so much for joiningus.
Dr Stavros, why don't you giveus a quick background?
This is how we always start ourpodcasts.
We always request our guests togive us a quick background
(01:48):
about themselves.
Speaker 3 (01:51):
Well, hi everyone.
I'm Dr Stavros Vujiculus.
Born and raised in New York.
I went to biochem, ManhattanCollege undergrad in
biochemistry for years and thenI went to the Leavitt School of
St James Med School chemistryfor years.
And then I went to the LeavittSchool of St James Med School.
I did realize, as I wasprepping for the board exams,
that I had a certain purpose,certain goals, certain calling.
(02:11):
And then I then worked on USMLEprep because I realized that,
no matter what I did, it wasvery challenging to pursue these
exams and do very well right.
All of us have had issues inthese and unfortunately, your
career, your future in medicineis dictated and basically set in
stone because of these scoresright.
(02:31):
So what I did was, from beingin medicine, I realized I had
more of a passion to work withstudents and physicians to crack
the code and help them pass theboard exams.
So 15 years later, I'm on myfifth company as far as adapting
to how the USMLE adapts right.
So we adapt to better ways toprep our students.
(02:53):
And now I'm here talking to youtoday to make sure that all our
students out thereinternationally and in the
States know as much as possiblefor step one, step two.
So then it makes it easier forthem, so they they don't have to
settle for less.
They can then shoot for thestars and achieve their goals
and whatever residency they want.
So here I am today to providemy knowledge of 15 plus years so
(03:15):
you guys can all profit and bebetter physicians for improving
our health care right soessentially they're, uh, twofold
, uh, we're killing two birdswith one stone, so to speak, by
talking to you, dr Stavros.
Speaker 2 (03:28):
Well, one is we're
talking about.
So obviously, you went through,got your MD and everything, but
then you chose to be a serialentrepreneur, completely aside
from running a regular practice,and you chose to go into this
route.
We definitely want to pick yourbrain a little bit about, once
(03:50):
you get an MD, what can you dowith it other than practice
medicine?
Again, I mean I just becausefor a lot of our students it's
like I just my only alternativeis to become a hospitalist, but
that isn't true, obviously, asyour hospitals, but that isn't
true, obviously, as your um, uh,you're like a shining example
of that, and and you're not justthe only one we have several
(04:11):
physicians who's gone on tostart various consulting
companies that actually consultwith hospitals entirely admin
purposes, etc.
Etc.
So we want to talk a little bitabout that.
And the other aspect is,obviously, with 15 plus years of
experience with five companies,as you said, uh, you have
adapted to the changes in theusm.
If there is anybody who I wouldconsider to be a expert of at
(04:36):
the usm exam, it is definitelyyou, because you've been seeing
the changes first time from thetime you took it, it to the time
when there were two types, twoCS or step two exams then
becoming one, then eventuallybecoming a very involved exam,
and then you know, the step onepass, fail, going away.
(04:59):
So let's start with you andlike so let's start with you and
like what alternatives do youthink or what would you advise
students?
Because you know, unfortunatelymedicine is such an involved
practice, like you pay so muchof money, you invest so much
time, a lot of people just don'tthink that beyond becoming a
(05:22):
hospitalist or beyond practicing, I don't have alternatives.
Speaker 3 (05:31):
What would your
advice be to that student?
Well, I mean, it's a greatquestion.
I'm happy we're talking aboutit.
I myself I'll go back a secondso then we can move forward with
this question.
I realized through my rotationsand my studies not only did I
love prepping and teaching, butI realized that there was more
for me than just being in thehospital.
So I was honest to myself and Iwas very lucky that I was
really enjoying what I was doingand prepping students.
(05:52):
But students now need to realizethat you focus hard, you go to
school, like you said, youinvest, you get into residency
if you choose residency.
And then what do you do?
After?
A lot of times, people I'veseen doctors not finish
residency.
They jump out of residency andthey what do you do after?
A lot of times, people I'veseen doctors not finish
residency.
They jump out of residency andthey go.
Well, I can't even finish it, Idon't know what to do now
because they were so intosurgery, anesthesia.
(06:12):
So what I can say to ourstudents now watching, listening
and watching now is you got tobe honest with yourself and say,
okay, am I choosing internalmedicine because I love it, or
maybe I'm in love with the idea.
Or am I going to surgerybecause I love it, but do I
really know what surgeons do?
And other times people are like, hey, I burn out, I'm done, I
do not want to continue medicine.
(06:33):
So if you have an MD, well, yeah, there's, you can be a
consultant.
There's many different avenuesout there to say, well, okay, I
went to school, I finished mymedical degree.
Either you finish residency ornot, are you licensed or not.
So it all depends, right, ifyou're licensed, you move on to
consulting different companies,pharmaceutical companies, versus
(06:54):
you finished MD.
And then you say, well, you canthen venture into certain
specialties that can use yourknowledge right.
Four years in medical school isa lot, guys.
Right.
Two years in classroom?
You a lot guys.
Right.
Two years in classroom you gettwo years of rotations.
People can use that knowledgefor their advantage in yours, in
any, in majority of specialtiesout there in business.
Speaker 2 (07:13):
Um in this vein.
I actually wanted to talk aboutthis.
Uh, this is one of our partnerhospitals.
Um, they the cfo reached out tome very recently and they have
a program where they trainfinancial analysts.
And they called me up.
(07:35):
The CFO called me up and he'slike you know, I really want to
have MDs come for this program.
And I was like, but they'reMD're MDs like why would they go
into finance?
And he's like, well, you know,I'll have you know that.
And the CFO was like I'm an MDfor our MBBS from India.
(07:55):
I came to the United Statesseveral years ago and I didn't
match the first attempt and Ineeded money.
So I started working here.
And he's like I, you know, and,and billing and finance, it's
not in a hospital.
It seems like it's a verydifferent function.
So I'm an CPA, so I, you know,know a lot about working in
(08:18):
corporate America and being inconsulting and stuff like that.
But it seems like finance andhospital serves a very different
purpose.
In most companies, finance isquote unquote a back office
function or it's a cost center.
You're not necessarilygenerating revenues.
But in a hospital, finance canactually generate revenues and
(08:38):
correct me if I'm wrong fromyour experience, dr Stavros, but
he said that he feels the mostsuccessful financial
professionals within a hospitalsystem are MDs, because they
understand, they know how tocode certain ailments in a
certain way that boost theperformance of the hospital and
(08:59):
make it look better in the eyesof, say, medicare, medicaid,
different governments and stufflike that.
And he's like it's just easierto train because you know if
somebody comes in with asuperficial ailment but they
have something underlying, afinancial.
A cpa who has no medicaltraining is not really going to
(09:19):
understand that, sure, whereasan md does, and to me that was
very surprising.
So this particular trainingprogram it starts off with like
a resident salary but withinabout two years you become a
full-blown financial associateand then you're kind of on a
track for a CFO position.
And this particular gentlemanis a CFO for 50 different
(09:44):
hospitals right now.
Speaker 3 (09:47):
I mean that's very
impressive.
And the reason I mean andthat's it's nice that we're
sharing this knowledge because,you know, when one of my
previous companies, we wereemploying physicians to be
coaches and mentors, and most ofthe people all 500 applicants,
520, actually they were allAmerican students who graduated
or either finished residency orin the middle of they just
(10:08):
dropped out, and they're allAmerican grads from top
university programs.
That's why I say this, becausethey're burning out, right.
So what did all those 520people do?
Reached out to me to get a paycut from 450, 350, 250 to less
than000, $250,000 to less thanyou know, roughly $80,000 to
$100,000 for a coaching position.
So well, you're giving up allthat opportunity, all that time
(10:30):
invested in your life.
Speaker 2 (10:32):
Yes.
Speaker 3 (10:33):
You're happy.
You see, that's what peopleneed to understand Right, right
right.
If it's one of you that, hey, Idon't want to continue.
Yeah, there's a lot ofcompanies that, for example,
short-term disability, long-termdisability insurance companies
instead of having someone whohas no knowledge of medicine,
they say, well, we'll hirenurses and or MDs to consult and
be like the head of thedepartment to say, well, if
(10:55):
someone has a back issue, theyhad a herniated disc do they
need four weeks or 12 weeks?
Well, if you don't know thereason behind, are they standing
versus sitting in theiroccupation?
Right, wait, they have otherrisk factors.
Maybe they need 10 weeks.
So you see, men, empties, Ineed it everywhere.
It's just up to the individual.
Do you want to practicemedicine?
(11:16):
Or hey, I'm just tired, I'mburnt out.
I want to have a family, I wantto see my wife, my husband, my
kids and unfortunately, in thesystem, even though it's a
beautiful system, you work inmany hours and it's not for
everyone.
It isn't.
I've seen the numbers.
So that's why you have to havean option to go elsewhere right.
Speaker 2 (11:34):
So, uh, tell me about
this decision, because the
decision that you took, like, asyou said, while you're doing
your rotations, you realizedthat this was you wanted to be,
stay involved in teaching, andeventually you kind of came back
.
That takes courage, and how doyou?
Because you know, as youpointed out, it's a big
investment, it's an investmentof time, it's an investment of
(11:54):
money primarily these are thetwo biggest factors and it's
almost like oh hey, I've alreadyinvested so much of time and
money, I don't care about mymental health, I don't care,
care about what I want.
It's just, I'm already downthis path and I'm going to keep
barreling down it, which, youknow.
I mean, there are a lot ofmental health issues that
physicians are facing and that'sbeen exasperated over the last,
(12:17):
you know, three, four years,during the pandemic.
How did you manage that decision?
Like, what kind of a supportsystem did you have?
Did you go through a lot ofcounseling?
Did you uh talk to a lot offriends?
What were the steps that youtake to really realize that
decision?
Because I talked to a lot of umstudents who are brilliant
(12:40):
students, but they're kind of atthat cusp that you're talking
about is, you know I don't knowthat I wanna do this for about
three, four more years.
You know I'm kind of done, butI also wanna have a meaningful
life and I wanna be, but at thesame time I don't know what to
do.
How do you make that decision?
And their biggest thing is I'vealready invested.
I'm almost there.
(13:00):
There's light at the end of thetunnel, but that's the light I
don't want to walk towards.
Speaker 3 (13:05):
Well, you know well,
just to add to that.
That's why, when you arepreparing for step one, step two
maybe pursuing medicine,instead of focusing on something
that you have a passion forthat maybe you just heard about
you need to take this rotationseriously to say, well, I want
to be OBGYN, I want to do, let'ssay, peds or surgery.
I will invest my time now inmedical school to see, hey, is
(13:27):
it for me?
Because you might love the ideaof being an OB, a guy and
physician, but maybe when youfind out the hours are that long
, you don't want to do that.
So that's why a lot of students, they have that love, they get
in and they drop off right.
Speaker 2 (13:39):
For me.
Speaker 3 (13:41):
I realized and this
goes back and goes into my roots
and this is why I do what I dotoday it stems from passion for
medicine.
I was a pioneer in my familyParents love them, they did
everything for us, for me and mysister Not in medicine, so I
was the first person to pursue.
I realized in the hospitalsthrough St James, in the amazing
(14:08):
rotations, working 60, 70-hourweeks, I realized some
specialties were for me and somewere not.
And if I had, maybe as theschool did everything for me,
but the physicians I worked with, they did everything for me too
.
But I realized later that if Imaybe had a different experience
in, let's say, er versussurgery, I would have gone down
that path.
Instead I said I don't want tobe stuck in the hospital 80 hour
(14:28):
weeks writing notes, seeingpatients being exhausted, maybe
not possibly having a marriage,maybe losing my wife, a lot of
people I know.
I saw the statistics ahead ofme and I'm like well, I love
medicine, yeah, but I alsostarted doing the coaching,
mentoring on the side and thatstarted blowing up.
(14:49):
So I said, well, I can continuemedicine or I can pursue my
actual passion, which is stillin medicine, but then make sure
doctors get into the professionitself Right.
Speaker 2 (15:00):
Right, right Right,
not easy.
Speaker 3 (15:02):
My friend.
It's it's a lot, it's's noteasy, it's it's a little luck to
see what you get into and risk.
So that's why that's what Itook.
Speaker 2 (15:10):
So you know this is a
big debate that is always in
our offices.
So in my opinion, I shouldpreface this by saying that
there's truly four realprofessions in this world.
No, no, disrespect to otherfolks but there are four real
professions in this world.
No disrespect to other folks butthere are four real professions
in this world.
(15:31):
One is farmer, one is teacher,one is engineer and one is
doctor.
Everything else is fluff.
Mind you, I'm a trained CPA, somy point is that with these
four professions you can buildcivilizations, sure, and you
don't need anything else, andeverything else kind of follows.
(15:55):
Keeping that in mind, I alsothink entrepreneurs have a very
important role, but that is once.
Things are like you know, in aneconomy like the USA,
entrepreneurship is very wellrespected.
But you've been both.
You've been a physician andyou've been an entrepreneur.
In your mind, obviously,there's definitely some synergy
that you're a physician who's anentrepreneur, but in your mind,
(16:15):
which one has more of a let'scall it flex, if you will, being
an entrepreneur, being aphysician it being an
entrepreneur, being a physician.
Speaker 3 (16:30):
Well, I mean, for me,
I've been blessed with doing
both.
But again, the reason why I saythis is because I work with so
many doctors and students nowthat are in residency and they
hit certain, certain specialtiesand then they're stuck because
they go.
Well, I invested my time inpediatrics.
I don't want to be apediatrician.
What do you do now?
That's challenging, right?
So I come up with a family ofall business family, father,
(16:51):
mother, all the Greek familiesthat I know, my cousins no one
was a doctor, all in business,so I was fortunate to also have
that in my roots.
Exposure.
Now, that being said, a lot oftimes doctors want to be
businessmen.
They can't, the businessmencan't be, doctors.
They have to learn it right, youhave to practice it.
But the way I look at it is, Ipersonally have much more
(17:14):
freedom, much more because,again, I love what I do right, I
can work from anywhere.
I had a morning webinar beforewe got on this podcast 150
doctors and students.
Step one prep those individuals.
My passion is to help them passstep one to hopefully get to
where they need to be right tobe a better health care system
in the states, right.
So for me, I love business, butI was able to merge both
(17:37):
business and medicine and justbeing business software and not
enjoying the medicine medicalaspect of because I love
medicine.
Guys, I love it.
Yeah, I just don't want to bein the hospital working 80 hour
weeks anymore of course.
Speaker 2 (17:48):
Of course.
I mean, that makes completesense.
But that's very interesting.
They say that.
So, um, the main flex is thatyou are a physician entrepreneur
as opposed to.
It's not one or the other, it'sboth.
That's, that's pretty cool.
Speaker 3 (18:02):
I can't, I can't, I
can't jump and go do something
like I might have real estatefamily, we have real estate
other things.
It's great, a lot of money.
There's no passion there.
My passion is medicine.
Right, right, right, right Iwas lucky to find this.
Speaker 2 (18:17):
Um, so tell us a
little bit about your companies.
You said you had five.
Can you tell us why you hadfive and what's?
Your latest company do, and canyou give us a little background
as to how many students you'vehelped and how long you've been
doing this?
Speaker 3 (18:32):
So to go back,
because I'm early 40s, let's say
right, 45 years old, I've gonethrough a lot, especially
through step prep, and this goesinto explaining a little later
the timeline of step, especiallythrough step prep, and this
goes into explaining a littlelater the timeline of step.
For anyone to grow and besuccessful, you have to adjust
and adapt to the times.
Um, those who don't, you cantell.
(18:53):
If you someone provides youadvice that isn't updated, it
won't work Right.
So the companies that I created, um, they're all based upon
step one, step two, and as wekeep learning and having more
success, we can then keepadjusting and adjusting to
different prep.
Nowadays, live in-personclasses aren't as popular as
(19:14):
they were 10 years ago 10 yearsago I had a live course in
Chicago 50 students every month.
Nowadays it's all remote, youyou see.
So keep adjusting and adaptingto the lifestyle of us.
We used to have step one, steptwo and step three, like you
mentioned.
Step two, csck.
I had a course specifically forcs.
(19:35):
We're working side by side withsaint james to implement that
in our studies.
And then the pandemic came, soright.
Nowadays my newest company isUSMLE Trainings, where we take
the technology of Zoom right,the connecting with everyone in
the world.
We have live webinars and makesure that your content is ready
for step one.
(19:56):
Right.
But also be a better test taker, because I realized through
working with tens of thousandsof students that you can learn
all you want, but if you don'twork to improve your test-taking
skills, you can study for yearsand then you don't pass.
Speaker 2 (20:10):
Talk to us a little
bit about that, because I have
actually noticed students whoare very, very good academically
and they're actually doingreally well in quizzes.
In class Teachers are like, wow, this guy's a great student,
they're definitely going to aceit, but when it comes to the
NBME they're not doing well.
And then you talk to them andthen you're realizing that they
(20:32):
have, like this crazy anxiety.
They're having the strategiesthat they're employing.
Again, I'm not an educator, butit just doesn't sound optimal.
So talk to me about this testtaking strategy.
Are you born with it or is thissomething you can develop?
Or, if you don't have it, areyou just?
You're never becoming a doctor.
Speaker 3 (20:53):
It's a skill like
anything else.
Whether you want to play asport, right, this is a sport of
sorts.
It's a skill and I know becauseI was in school St James, a lot
of universities, everyone doestheir very best, but we don't
really focus on working ontest-taking skills.
So, read the material, read thePowerPoints, learn the content,
yes, but then you have a USMLEexam which is very different
(21:16):
than anything else you've everdone before.
So that's why I realized thatif you don't adjust and expose
students like St James andeverybody else watching to the
question format doc, my friend,doc, whoever's watching reading
the material, you have to applyto the questions, like being in
the hospital, right, you're inclass and you go see patients In
(21:37):
class.
I give you PowerPointpresentation findings, right,
there's no connection.
So when you read a question,you have to be able to pull out
the findings and connect, so toanswer your question.
It needs a lot of time andpractice and that's why one of
the main reasons that we do whatwe do at USMLE trainings is hey
, you got to come to us withknowledge.
You're in medical school, right?
(21:57):
So, okay, you know the basics.
The problem is can you put ittogether in a question reading,
understanding and connecting andI see a lot of students
American students, international, caribbean.
The biggest common denominatoris test taking.
They study for a year, man,they'll memorize first aid.
They fail why test?
taking okay denominator allacross the board.
Speaker 2 (22:19):
Okay, um and um, as
far as, um, these uh test taking
skills are concerned, um, anddo you kind of help them, like
through drills, or is it likecounseling sessions?
What?
What does that entail?
Speaker 3 (22:38):
So we meet doctors
twice a day, morning and
afternoon, which is nice,because not only do we do now,
we work on accountability, whichis another issue that students
have.
They need a study partner, theyneed somebody by their side,
they need to be consistent anddisciplined.
So we meet them twice a day, anhour each time live and people
from all over the world jump onstudents and physicians and we
choose certain systems to attackfor the day.
(22:59):
So I have selected thesequestions, I go through one by
one, I highlight and show themwhat to do to attack the
questions, to save time, to bemore efficient and effective and
also to learn the material Like.
If it's something of concernthat I see students having
issues with, I always bring itup in our lectures.
(23:21):
So they're accountable, they'redisciplined, consistent and I'm
telling you, with a littlepractice, anybody can take the
test, but you have to practicetesting skills.
Speaker 2 (23:30):
Okay, how much time
would you recommend students
dedicate for, say, the step one?
Let's just talk about step one.
Good question Is it, like youknow, because we I recommend
that students should be studyingfor about eight hours at least
three months before the test.
Is that too much, too little?
What do you think?
Speaker 3 (23:57):
you think to answer
the question?
Because those who know me, Ican talk all day.
A typical student who hasdedicated prep right, for
example, st james, if you givethem three months of dedicated
prep, meaning nothing else butstudying yes seven to nine hours
, eight hours a day, threemonths should be more than
enough time to, okay, go thecontent, answer questions and
move.
But there's many variables,right, there's many variables
(24:19):
involved.
So the variables are are you agood student?
Do you do well in your basicsciences?
Are you able to sit in anenvironment that you choose to
study all day?
Or are you on YouTube, netflix,you go, hang out.
I mean, listen, we've all donethat, right, tiktok, now TikTok,
(24:40):
instagram, and then next thingyou know you're studying 10
hours, but you've only had twohours effective prep.
So what I realized is to answerthe question anybody who has
passed every semester in medschool, you know decently,
obviously you know B's,hopefully B's and A's, and you
have a good three months solidwith adjusting and checking out
(25:02):
where your weaknesses are andassessing.
There is no reason why youcan't.
But then there's people whohave issues with memory recall.
They don't know the content,they can't stay disciplined.
Then obviously, if you can onlygive four hours a day, you
still can't do it.
In three months it's going tobe a lot longer.
It's a sliding scale.
So, on average, three months,eight hours a day, it is a
(25:24):
decent approach.
It's just now.
You have to think about thevariables for every student and
then go from there.
That's all it is.
That's the honest, okay.
Speaker 2 (25:36):
So now go from there.
That's all it is.
That's the honest, okay.
So, um, now let's talk aboutthe test a little bit.
Obviously, you've taken thetest, uh, a couple of years ago
yourself, and then now, afterthat, you've kind of uh, built
five business businesses around,essentially, um testing and
testing patterns.
So, if anything, I don't thinkthat there is anybody who is as
well-versed with the USMLE Step1, 2, and 3 better than you,
(25:59):
because at some point in timeyou took these three exams, you
passed them for your own careeradvancement and then you started
businesses to help students,help students.
What in your?
If you can give us like ageneral timeline from the time
that you took the test, step oneand step two?
(26:20):
Let's focus on those two,because our students need to
finish those two before theygraduate, of course, of course.
And how has it changed sincethe time you took the test for
the first time to today, whenyou're teaching students?
We had the pandemic.
We saw like monumental changesin the exam.
Even USMLE has come out andsaid that they haven't, they
(26:42):
haven't made changes like thisin decades.
That they've done in the lastcouple years.
So why don't you talk to us alittle bit?
Speaker 3 (26:49):
about that, sure,
sure, sure.
So I mean, ideally before webegin.
A lot of students have asked mehey, you haven't taken the test
in 10 plus years.
How do you know?
Well, when we prep our studentsright, we see their success, we
see what works, what doesn't,we adjust, we adapt and then
eventually we come up with aformula that works for everybody
, right.
So that's why, even though Ihaven't taken the test recently,
(27:10):
I feel that every student thatworks with us I've taken the
test because I see what worksand what doesn't.
Absolutely Way back when I tookit, it was a lot easier because
the structure was different.
It was more buzzwords, it wasmore.
If you can understand somephrases, you can recall the
(27:30):
information Resources were notas a large amount of resources
as we have today.
The technology was different,right, so we had few resources
versus now people have lots of.
They're saturated withresources.
But the exam itself has come toa point where it's getting
tougher because it's the waythey ask the questions.
(27:52):
They take a simple disease thatyou know about and they just
create such a way.
That's third order, it's notjust first order.
They actually have differentsteps that you need.
That you must know to get theright answer.
So that's why step one ischallenging.
They've changed it from scoresbecause we had scores back then
and little by little they keepadding, they keep increasing.
(28:14):
You good, yeah, they keepincreasing the passing score to
eventually fast forward to whenthey say hey, ladies and
gentlemen, we're going to gopass or fail.
So that's step one.
It used to be a score.
It used to increase the number.
Eventually Now they went from50 questions down to 40.
It's more challenging why?
(28:36):
Because you have to get morequestions right.
So step one is more difficultin many ways, specifically for
that.
It's not recall as far asbuzzwords, it's more of just
being able to connect the dots.
Speaker 2 (28:52):
So you're saying the
step one exam has become
conceptual, a lot moreconceptual than it was before,
and this change is relativelyrecent, or has it been on for
like, say, half a decade, 10years already?
Speaker 3 (29:06):
Or is it?
Speaker 2 (29:06):
just evolving every
year.
Speaker 3 (29:08):
You know it evolves
because, again, these questions
are written by MDs and PhDs allover the world.
Right, they've been created forthe purpose of the assembly.
So I would say in the lastmaybe six to seven years they
started bumping up the cutoffpoint to eventually changing the
style, the format of questions,to then allowing QBanks like
(29:29):
Uworld and BOSS to adjustbecause that's where we use
QBanks Right, right, right,right, test and fail.
Take it again ideally we wantto use a Q bank.
So step one got to a pointwhere when they decided to go
pass or fail, they did it toalleviate stress because a lot
of us out there, without a highscore on step one, your future
(29:50):
is over in certain specialties.
That's, that's how I grew up inmedicine right, right right
high in step.
You will never be a surgeon.
You have a passion, but,stavros, you will never be.
They chose to make it into passor fail.
Do you know?
Because of that, all thenumbers dropped.
You can go on uassemblyorg.
You can see the numbers havedropped, MDs.
Speaker 2 (30:11):
Americans.
By numbers dropped you mean twopeople are passing the test
okay and this is systemic acrossthe united states.
Even us schools are facing thesame thing, correct?
Speaker 3 (30:23):
so okay, because they
have it on usmorg.
It's american medical studentsinternational, which are foreign
, caribbean and international.
All their passing, the passingscores have all dropped,
including DO schools too, so andthat's accessible.
You know we can put the link atone point.
It's there, right, right.
Speaker 2 (30:40):
Sure, We'll do that.
So by how much do you thinkit's actually dropped?
Or how much, at least from yourexperience dealing with all
these schools and all thesestudents and teachers?
What do you think thatpercentage is?
Like ballpark.
Speaker 3 (30:57):
It doesn't have to be
accurate, but from your
experience, I mean when a testhas a 98% chance in the American
let's say American students andit goes down to like 94, when
the Caribbeans are 94 and thatgoes to 91, you might think 3%,
4%, 5% isn't that much.
But when you see a consistentdrop in passing scores all
(31:17):
across the board, and then whenI myself talk to medical schools
and students and they say, drStavros, most of my class can't
pass a comp exam, most of myclass can't pack in it, pass an
NBME, which is what we do andsponsor to pass a step well,
it's a nice safety net, butthere's a problem, isn't it?
right it's either the test isgetting more difficult, which it
(31:38):
is, but we, the community,medical school students programs
have to work harder to say okay, because everyone's dropping.
There's a reason.
We have to figure out what todo and a lot of people don't put
the time into prepping step onebecause they figure, hey, it's
pass or fail.
But yeah, the problem is, ifyou do fail my era back then if
(32:00):
you failed, you come back with ascore and you can prove
whoever's looking at yourapplication that this student
failed.
But now they came with a high,maybe 40 points higher than
average versus now.
If you fail once with a pass,you, if you fail, you come back
with a pass.
You can't show to the personlooking at your application that
(32:21):
you scored a 260.
Speaker 2 (32:22):
You see, that's why
it's it's important to pass on
first attempt but so it's funnythat you say that that students
are kind of not like justbecause it's pass or fail, the
amount of effort that they'reputting in seems to have gone
down.
Speaker 1 (32:41):
Yes, I can say yes.
Speaker 2 (32:43):
And we see that with
students.
It seems like a normal trendamongst at least our students is
that after they do well on theNBMEs, they go on vacation and
then they go together.
So they've been, it seemed.
No, but I'm actually being veryserious about this and I don't
(33:06):
know if you're seeing thisamongst your students I mean
because I'm localized to stjames students and it seems to
be a trend that a lot ofstudents are like hey, I did
pretty well in the comp, I needa breather, I'm going to go on
vacation.
And they go on vacation.
I would personally like and ofcourse I'm right around your age
(33:28):
In my time you don't go onvacation until your end goal is
met, which is step one.
Sure, you don't go on vacationuntil your end goal is met,
which is step one.
Sure, you don't go on vacationfor the nbmes.
And this is something thathonestly only happened after the
scoring went away.
We never saw this before.
Yeah, yeah.
And I'm beginning to think thatthis is the mentality like say,
(33:50):
hey, you know, I did reallywell.
I mean, uh, and the nbme givesyou some sort of a passing
percentage.
If you take the step within xnumber of days, you're gonna.
This is your probability.
If they see a high probability,they're like I'm gonna pass
anyway, so I'm gonna go onvacation, and they go on
vacation and they come back andthey've kind of forgotten
everything.
They're out of the groove, sure, and they're not doing well.
(34:10):
What's your take on?
Speaker 3 (34:11):
that before we
continue.
I think we look pretty good forour age.
We're aging very well, sothat's a good thing.
Props to us.
To go back to that, I have toadd some to that to what you
just mentioned.
Our generation, yes, we hustle,we grind, we go.
The difference is, I feel, thatthe discipline you know we work
(34:32):
hard.
Nowadays, I feel, those whowant to take a break it's either
a, you know they just they feellike it's a pass or fail but
also sometimes because they'reso stressed, they're so
exhausted and they're so burntout because maybe you know the
studying, the habits ofbalancing time management that
they need to take a break.
So in some instances peopleneed to kind of get get, but
(34:53):
when they come back, like yousaid, they're not in the zone.
I feel the pressure is gone andbecause of that they don't push
Like CS, which we'll discuss alittle later.
Speaker 2 (35:04):
There's no.
Speaker 3 (35:04):
CS.
Okay, so why buy a book for theCS exam?
Clinical skills.
Speaker 2 (35:08):
Okay.
Speaker 3 (35:09):
First thing, you guys
, step one is a foundation for
step two.
I have a student that justscored very high in step two 262
.
He worked really hard.
Caribbean student for step oneworked really hard, like you
guys out there, right duringrotations and BMEs and the
rotations and shelf exams.
He pushed hard.
He took four weeks, four and ahalf weeks to take step two.
(35:32):
You know why?
Because he did all the workfrom step one, huh for rotations
.
Trust me, anyone study on theweekends you don't study at
night.
His family was a beach but hegoes to me.
You know what I did.
I did what you told me to doand when I had ready for step
two, he now has the door openemergency surgery, anesthesia
why?
(35:52):
Wow is he invested and he gaveup a little earlier to now.
He's like yo the whole year.
I'm going to relax respectbecause I could apply for the
match with a high score.
Yeah, I'm easy.
So, those of us that I workwith and those of us listening
now talking, if you think passor fail is nothing, you might
just pass, barely pass, but thenit catch you later for step two
(36:15):
.
I'm telling you it will.
So if you take anything out ofthis podcast, is if you really
want it, that bad.
You know you work hard and notwe'll like.
We discussed other options inmedicine but, yeah, the past
fail has alleviated the pressurefrom us, which that was the
goal to do.
But everyone's like, oh, Idon't have to study that much, I
just got to pass the thing,okay good.
(36:35):
You get caught later.
I've never seen it otherwise,it always happens.
Speaker 2 (36:40):
So I want to talk
about this a little bit more in
the sense that so, for example,most Caribbean schools follow.
So there are two ways to do acurriculum right A subject-based
or a system-based.
Yep, and most Caribbean schoolstend to follow a subject-based
(37:04):
approach, including St James.
But St James is a littledifferent because we have a
hybrid where we do a review in asystem format Correct in a
system format Correct In yourexperience and I would say 80 to
90% of Caribbean medicalschools follow a subject-based
or they're following somethinglike us, which is kind of a
hybrid mixture of both.
(37:25):
Yeah, and the reason we do thishybrid is because we feel like
once you teach everything on asubject-based, the system kind
of brings it all back.
That's it.
But in your mind, is there aparticularly more advantageous
approach versus between subjectand system?
Speaker 3 (37:46):
Everyone learns
differently.
What I realized is from themajority of students I've worked
with and myself when I wentthrough curriculums, especially
St James subject is the best.
Because when you're sitting,when you start in medical school
for the first time because thisis cool, you start in medical
school for a reason you getreally confused.
When you take a system likecardio and you hit everything
(38:10):
within cardio because it's all,it's broken down that way versus
you go little by little, youlearn anatomy first, histology,
embryology.
You can appreciate thebiochemistry of things, you can
appreciate microbiology, thebacteria, the viruses and all
the bugs and drugs, and thenwhen you get to systems, oh
(38:30):
we're doing cardio, yeah, youknow, you learn the cardio.
But then when you go over micro, you say but I've been exposed
to micro, I've been exposed tothe bugs.
So now I can appreciate thedifferential of a cardiological
disease.
Okay, interesting, the personhas or, like respiratory person
has pneumonia.
But then now I can understandwhy the pneumonia he has is
(38:50):
actually tuberculosis, because Idid it before, which then I
know why it's TB, what drug weprovide, what's the mechanism of
action and so on.
So I've realized for themajority, system is not for
everyone.
It's usually subject first andthen hit the systems hard to
bring it all together.
Others do it the other way, butit's more challenging that way.
(39:12):
I think it's more challenging.
Okay, well, it's morechallenging.
Speaker 2 (39:14):
Okay, Well, that's
good to know.
So the other question I didhave for you and this is kind of
a big debate, especially amongmedical students I love the
thing, let's go.
Medical students don't want totake the NBME because they think
, oh, I don't want to take theNBME Without passing step one, I
want to be able to do clinicals.
St James, we don't allow that.
You have to take past the NBME.
(39:35):
If you get a passing score onthe NBME, that is the only time
you are allowed to take step one.
If you clear step one, that iswhen you're allowed to go into
clinicals.
Most of our clinical partners,like the hospitals they're all
teaching hospitals they mandatethat the students have step one.
It's not like if we wanted,wanted to, we could even send
(39:56):
students without step one.
However, there are, like youknow, there I think you know
this, dr stavros there are over75 caribbean medical schools.
Only about 20 are accredited um.
So the ones that aren'taccredited um tend to just push
students into clinicals.
Let them slide in and then a lotof students are like and we've
(40:19):
had students transfer out Goodstudents come and say, hey, you
know what?
I don't want to go through thegrind of step one, I want to
start clinicals right away.
So I'm going to go to anunaccredited school because you
know they're promising the sunand the moon and everything in
between and because of that I'mgoing to ace it.
I'm going to get into clinicalswithout step one.
(40:40):
I'm going to finish clinicals,and then I'm going to take step
one and step two together.
What's your thought on that?
Speaker 3 (40:46):
so I want to mention
something.
Um, this is from my experienceand and I can say what I want to
say.
Usually it parallels, if notreally the same as what I see,
with student success.
The best way to approach thisis to struggle and push now to
(41:06):
pass step, because if you don'ttake the NBME, clearly you don't
know if you're going to pass orfail.
Fine, those schools that don'treally require NBMEs.
You fail once or twice.
I hope everyone understandsthat even if you fail once or
twice, some states in thecountry will never give you a
license.
Some states in the country haverequirements to say okay, you
(41:28):
come to my state, we want firstattempts only.
There are other states thathave limits of four attempts and
six.
There's a website I'll provideto you guys you can put on.
So that's that, so you can getlicensed elsewhere.
But some states will never giveyou a license if you failed one
of the exams.
That's that.
Let's go to jumping over.
(41:48):
Okay, we decide to tellstudents you know what.
You don't need to take the NBME.
Forget about the step Startrotations.
They go through rotations, theylearn.
Now step two clinical knowledge.
They finish everything.
Your school is happy, meaningwhoever's school is doing this
and now the students are stuckI'll say the word stuck for a
reason to go back and learn stepone and step two.
(42:10):
One and step two.
I have very few students, veryfew, that were able to attack
one and two together in this, inthis form.
If this, in this new way of ofdirecting students, because it
they lose, they lose hope,eventually they go.
I finished my rotations, I paidfor my tuition, my everything,
(42:32):
everything's good.
Now who's going to help me?
I got to go back and learneverything again after a year
and a half of rotations.
Right, it's two years Two yearsyeah.
And then a year of electives.
So it's two years of learningclinical knowledge.
And some will say well, I cantake clinical knowledge first,
step two and then step one.
Okay, the chances of passingstep two are higher because
(42:54):
you've just finished rotations.
But that's step one, guys.
Without that step one you'renot going anywhere.
And I would say, 90% of peoplethat I know that have attempted
this style, this routine, havenever finished step one.
They've done step two.
Step one has been theirnightmare and because of that
they eventually jump out andthey do something else in
medicine.
Speaker 2 (43:14):
Right and I think
because of that, recently
relatively recently the NBMEactually doesn't allow that
anymore.
They don't allow you to take.
You have to go sequentially.
You have to have a passingscore in step one.
But I think that that's recentand when you're telling me this,
it kind of makes sense thatthey introduced this, because a
lot of students must have donethat.
(43:34):
They probably took step two andgot stuck in step one.
They don't have step one, theyjust have step two.
So you think it's not a goodidea to do that, right.
Speaker 3 (43:44):
Well, we'll probably
get emails, Guys, I get that.
But you have to understand onething the reason why we take it
first of all NVMEs.
I don't like First of all NBMEs.
I don't like, I'll be on record.
I like them for what we usethem for.
I just feel all the schools,including St James we need to do
something better about helpingstudents adapt from QBanks to
(44:05):
NBME.
Even I, when I do them, I'mlike wow, these are not easy.
When you're doing a QBankreading questions, they spoon
feed you everything.
Ok, nbmes are meant to do twothings.
They give you a 200 questionexam, the first 100 questions.
You don't have a break.
The questions are very short,two lines, bare minimum.
(44:25):
They go what?
But the QBanks are threeparagraphs and they're 40
questions.
They figure, if you're able toanswer a 200 question exam and
give you the bare minimum andyou can still get it right, that
means you know the concepts,you know the foundation of
medicine, which that means youwalk into the actual exam, where
they have 40 questions insteadof 50 and they have three
(44:47):
paragraphs instead of two lines.
It's you're going to pass right.
That's the whole concept behindmbmes.
So, yeah, those who are failingin bmes, it's not, it's been,
you're going to pass, right?
That's the whole concept behindmbmes.
So, yeah, those who are failingin bmes it's not, it's usually
concept, but it's also they'renot exposed to the way the
questions are right.
Speaker 2 (45:01):
So what I'm hearing
is that it sounds like the step
one exam has become a veryconceptual exam.
So essentially, if you go andmemorize entire u world and
emboss and your uh, first aid,yada, y, yada, you're probably
not going to pass because youdidn't understand anything right
.
Speaker 3 (45:19):
Well, back then when
I was taking it, we had
something called buzzwords.
We had certain resources thatwe memorized, because it was
like that Now you can memorizeanything you want.
If you're a photographic memory, fine, you'd be passing
everything.
It's very hard to memorizeeverything because even then
(45:40):
they need you to connect.
If you don't connect, you can'tpass.
Speaker 2 (45:43):
That's all it is.
Speaker 3 (45:43):
Gotcha, gotcha,
they've adjusted it.
Speaker 2 (45:47):
Now talk to me about
step two.
Step two also has had a lot ofdramatic changes.
Why don't you walk us throughwhat the changes have been in
the last decade?
Speaker 3 (45:55):
So step two had two
brackets clinical skills,
clinical knowledge.
Clinical knowledge was thebasic exam that teach to see
what you know in your rotation.
So you go through all the coressurgery, gen, surge, pediatrics
, OB-GYN, family psych, peds andthen you take a test.
That test is going to see whatyou know.
(46:16):
Fair, that's also challengingin itself.
The CS exam, clinical skillswas something that I mastered
that I loved that I was teachingto doctors all over the world
because there were fivelocations in the country where
you have to fly in if you werenot in the States.
Philadelphia was one of them.
Chicago was another Five.
You know, you come in, you see12 patients.
(46:37):
They were actors.
They weren't real patients butthey would test your skills.
They had a huge list of like ascore report, like a checklist
empathy, sympathy, medicalknowledge, I mean everything and
people would fail maybe theirEnglish part or their bedside
manner part.
So that was very challenging,but it actually was one of the
(46:59):
best exams because it brought toattention that you need to not
only know medicine but you needto know how to handle the
patients.
Right, OK, Right.
So the pandemic came.
It was on hold.
They froze it, Everything froze.
For a while it was on hold,they froze it.
Everything froze for a while,and they thought about possibly
going to an online version andeventually fast forward.
(47:22):
They released a statement thatthey were fast forward.
They released a statement onone morning and it said ladies
and gentlemen, we've decided topull the license exam completely
off our list, so you don't haveto take it anymore.
Ok, so that was out One lessexam for everybody.
Problem was, though, that peoplewere going through rotations,
not really checking theirclinical skills, and then now,
(47:43):
to this day, I'm inrelationships with many
different residency programs,family program directors, and
they've told me they go.
Our candidates are not asstrong as they were in their
clinical skills, and that's acombination of the exam and
virtual rotations.
I mean, I know we maybe havedone them a lot of us.
We had to to move on most ofthe students that I know have
(48:05):
but you can't learn through thecomputer, you have to be
touching the patient.
You got to be hands-on, right.
So the clinical skills wassomething that was a huge blow
in the community, was good forstudents, but now we see the
blow Students are not working onclinical skills.
They don't really know what todo and how to do it, so it's
challenging.
Speaker 2 (48:26):
Okay, and what about
CK?
Ck was always the knowledgeportion, but are you seeing I
mean, I believe even that testhas changed are you seeing
reduced pass rates in ck as well, like you're seeing in step one
?
What's your experience with?
Speaker 3 (48:40):
that.
So the ck exam now is is thebiggest, biggest exam to focus
on because once you pass stepone, again step one is important
because if you don't pass, youautomatically can't license in
some states fair and and granted, when you pass with a P, you
still on the same level witheveryone else.
It's a mean if it pass.
Now step two has its highlight.
(49:00):
Now it's famous like oh well,now you have to score very high,
mm-hmm.
So the pressure was taken offof step one, now it's on step
two.
Before step two really wasn'tthat big, it was like not step
one was a pressure.
You know, emily, I feel changedit up and just put the pressure
on step two.
So step two is more challenging.
Step two is eight blocksinstead of seven.
So you might think it's nothing.
(49:21):
But if I asked you to run amarathon and when you finish say
, all right, run five more miles, I don't know.
I don't run marathons, I run5Ks.
Same concept.
Speaker 2 (49:31):
You do seven.
Speaker 3 (49:32):
Now let's do 40 more,
right, Wow?
So, and step two is is allabout learning the stuff in the
hospital.
So at the end of the day, thepressure's gone.
From step one, you still got topass it.
Now step two, you got to scoresuper high or else you can't get
into some specialties.
That's more challenging becausethat's what they require, so
they just shifted the pressurearound.
(49:52):
It is challenging because whatif you don't have a strong
rotation?
What if you go and yourpreceptor isn't teaching you
everything?
It's up to you to go home andstudy.
Right, I didn't study, I wouldgo home and relax.
Speaker 2 (50:04):
Personally, I'm like
I don't want to keep reading.
Speaker 3 (50:06):
I'm tired.
It catches up to you.
So, it's a lot of pressureeverywhere and that's why now,
with step two, doctors I workwith yes failing.
I don't think people fail steptwo as much because they're
working hard on step one.
Right Transition over those whodon't do well are those who
perhaps are not in medicalschool anymore.
They're trying to come to theStates and they're just on their
(50:27):
own in a living room and it'shard, right?
I mean, if you're by yourself, Imean we have each other.
We're on zoom now talking.
You know, virtually right,there's our home all day
studying.
I don't know about you, but ifyou don't have a certain support
system, cabin fever, yeah, oh,you're gonna drop fast.
And those are the ones that Iusually see fail because they go
.
I can't do it, I don't knowwhat to do anymore there's no
guide right.
(50:48):
That's where I come in that's,that's awesome.
Speaker 2 (50:50):
So I mean so
generally, it sounds like I mean
, we've always been talkingabout how the US is really
trying to increase the number ofphysicians, sure, by
introducing, by merging of DOand MD, then introducing so many
new DO schools, sure, et cetera, et cetera, allowing, you know,
investing more in residenciesfor IM and FM, et cetera.
(51:13):
But on the flip side, theymight be increasing the
opportunities, but they're alsotightening the clamps, it looks
like, from the step one and steptwo portion, because they're
not letting.
They want better quality tofill those more positions that
they're creating.
Speaker 3 (51:28):
Yes, and for those
out, we need to know this, that
USMLE used to have six attempts,now it's four, so it's six.
So, people, we need to knowthis.
That USMLE used to have sixattempts, now it's four, so
you're six.
So, people, unfortunately.
You know, I get it.
You were tired, exhausted,issues happened.
You took the test, somebodypassed away in your family, I
understand right.
But at the end of the day, ifyou fail four times, you're out
of the system completely.
(51:49):
They figured if you can't passthe first three or the first
four, the chance of getting atenured residence or slim to
none, unless you know somebodyvery well.
Even then it's not going to besuccessful.
So that's the risk.
Yeah, the tight end of theclamp.
It's medicine.
Guys, you're applying for a jobin a top university or a
possible program that you areone day helping people with
(52:11):
their health.
They're going to come to you,dr.
Yeah their lives.
Yeah, their lives Sure Lives, ofcourse.
So it is challenging, it'sdoable.
You have to navigate well orelse it's very hard to get in,
that's right.
Speaker 2 (52:23):
I always tell people
that actually, both
entrepreneurship as well asmedicine, these are not
professions, these are lifestylechoices.
Oh, lifestyle, a thousandpercent.
A thousand percent, okay, yeah,and because it seems like it's
like the amount of work thatgoes in, the amount of time that
goes in to both of theseprofessions, depending on what
kind of an entrepreneur you are.
(52:44):
But this is not nine to five.
If you are looking for a nineto five and work-life balance,
what would you say Like thisparticular?
You know, I think a bigbuzzword nowadays, especially in
the workforce across the board,is, oh, work-life balance.
What would you say to somebodywho would comment or make those
(53:04):
comments, especially in the?
And at the same breath, they'resaying I want to be a physician
.
Speaker 3 (53:09):
So those who know me
will know me well and I always
you know we always speak thetruth, right, tough love.
If you're in medical school andyou realize maybe you're
failing or you're strugglingsemester after semester, okay
you figure out why.
Right, eventually it has to be.
The individual Schools can dowhat they can.
They can't spoon feed.
(53:29):
They teach you the best theycan.
But I realize sometimesstudents go to school because of
family, because there's somepressure which I know.
They want the best for us, ourparents.
But hey, maybe it's not for me,maybe I don't want it.
Then you slide somehow, finishin med school, you get into
residency or you hope to get in.
You realize there's no passion.
You eventually will burn out,get exhausted, get frustrated,
(53:52):
not live your life, not loveyour life.
So I would say, if you'rewatching this now and you are in
medical school, you realize,man, it's not for me.
I, you know, I don't want tosay jump out, but maybe another
option would be beneficial foryou, because time is valuable,
right, it's your life, it's yourfuture.
And then, if you are inrotations, this is what I didn't
do, which I want you guys allto do now, when I knew I didn't
(54:14):
want to be a pediatrician, I didmy PEDS rotation.
I'm like, all right, I'm justgoing to go and get out.
But what if I put my heart andsoul into it, to expose myself
to all of it?
Maybe I would have been like,hey, wow, this is actually
pretty cool.
Versus yeah, I know, I don'twant to right.
So this is different stages,because the biggest thing I've
seen are doctors choosing aspecialty.
(54:34):
I have one guy, a couple ofguys that did internal medicine,
peds.
They got into residency Secondyear.
They want to get out.
I'm like what happened?
You knew?
It's no surprise they didn'tlove, they just didn't see the
sums.
They see the sums, they seethemselves doing it.
I have one anesthesiologist.
He finished anesthesiologynorthwestern love the guy.
(54:55):
He goes.
I don't want to practice likewhat.
I'm tired, tired.
Top university in the statesgreat guy, fine, you know.
Top residency northwesternchicago.
You're kidding me?
Untouchable.
He goes.
I'm good, I don't want to do it.
So something clicked, he.
I don't see myself living mylife, even if I'm making the
money to be doing this.
(55:17):
So I ask of you from now, see,talk to your doctors, talk to
your preceptors.
Now dig and say hey, what's adaily life in a pediatrician?
Right, right right.
Or a thoracic surgeon.
Do you know what that takes?
You should.
Speaker 2 (55:33):
It's a life if you
said life to us, not a job you
gotta love it guys or you're notgonna make it, you're not um so
, just out of curiosity, what isthis particular gentleman doing
, who was the anesthesiologistfrom northwestern good he.
Speaker 3 (55:47):
He was one of my
coaches at a previous company
for a while and then now he went.
East Coast to pursue specialtymore in admin.
So he has an easy ology.
He's board-certified, but he'susing his, his knowledge, his
education, his experience inmore academia and universities
(56:09):
need MDs too, guys so yeahthings have changed.
Things are like when I see aninflux of people coming to me
they want a job and they'releaving 400 to get a lower
salary to coach students, yeah,there's a reason why.
So, yeah, it could be anythingfrom burning out the program was
too intense time management.
(56:29):
They are, they were in lovewith it, but now they don't like
it, which we're human, right,we're not robots.
Speaker 2 (56:34):
So things change yeah
, that's a very good point.
We actually do a lot of workwith northwestern um and pretty
much in their medical schoolmost of the folks are actually
like physicians, like they havean md, they're board certified
but they're doing admin work.
So it's a very good point thatyou bring up.
So that truly is another avenuefor physicians to get into
(56:57):
academia and like their head ofresearch, for example.
If I'm not mistaken, she'sobviously an MD, but she's not
an active practicing MD from myunderstanding.
Speaker 3 (57:07):
But she's board
certified and like obviously has
a license and everything, butshe's teaching certified and
like obviously has a license andeverything.
But she's teaching and you andeveryone that I I meet you know
I travel a lot and they go to me.
Wow, you know I'm really youhave a wonderful passion, like
I'm just lucky because I lovewhat I do.
A lot of them like well,there's no grass isn't greener,
you just gotta.
You gotta water where the grassis and build it yourself, right
(57:29):
?
But a lot of people are like,you know, I I want to do more.
I have doctors who are OBGYN andthey started doing Botox
injections, so instead of sayingwell, instead of having all
that malpractice, I can getcertified, I can go to women's
homes, I can have my own littlespa and I can start doing
injections, make more money.
Because at that point they goto me, dr starvers I mean
(57:54):
starvers were friends they go.
I don't see my kids, I meanthey go.
I make a lot of money, I justdon't see my family.
So I've changed.
Now I will do different thingsto enjoy my kids and make more.
Yeah, that's, things areevolving now that's you know.
Speaker 2 (58:05):
I mean it's happening
and that's very interesting
because this is a littlephilosophical and we're going on
a philosophical tangent here.
But once I read, I kind ofremember I think this was Elon
Musk or a really famous personwho said the difference between
having a lot of money and beingrich is having control of your
time.
If you don't have control ofyour time, you're never rich.
(58:26):
Yes, if you're working, youknow 140 hours a week and you're
making a ton of money, you'renot rich because you're not
really being.
You don't have the time toenjoy that money.
Speaker 1 (58:42):
Yeah, you're right
100%.
Speaker 2 (58:44):
So it's a very good
point that you bring up.
They're working a lot and theyhave a lot of money, but at the
same time, you know what's thepoint.
Speaker 3 (58:52):
Now going back to
money, because you know money,
but at the same time you knowwhat's the point.
Now now going back to money,because you know money does make
, make, make the world go around.
Of course some people choosemedicine for the money.
Yes, they realize, residencythere's.
No, I mean, it's very little.
You'd be lucky to make six,sixty, five thousand a year.
Yeah, three years of residenceand a lot of people born in
(59:12):
medicine don't know that theycall your doctor.
Oh, easy, residency, you getvery little.
Yes, that's before taxes, andthen hopefully you get into good
specialty, hopefully you wantto pursue a certain University.
It's usually a business.
They have certain budgets, right, certain bats or an amount of
money to buy.
So then those who go in for themoney sadly to say, many of
(59:33):
them jump out.
They go, man, I can't do itlike, well, yeah, because you're
going in for the money, yourealize you're going to make not
the money that you wanted tomake.
So that's another.
It's like that's not a, it'snot, it's not the right, it's
not, it's not a solid passion tohave because you run out so
fast when you're not getting themoney that you really want to
have.
Speaker 2 (59:50):
The other point I
wanted to make with that
residency portion is that you'reworking up to 80 hours.
It's not up to 60 minimum.
Yeah, you're working 80 hours aweek and when you equate that
$65,000 to 80, it's belowminimum wage.
That's what you're getting.
Speaker 3 (01:00:07):
And you know I have
friends.
All of us have survived on that.
Whether we have investments,family support, loved ones are
cooking for us every day.
You make it work.
But think of it this way yeah,you know, after taxes you're not
making that much and you haveto pay rent again Again.
If you have a passion, though,you know you make it happy Like
I don't care, I'll eat mac andcheese every day, I don't care.
(01:00:27):
But those like well, you knowwhat, it's not for me.
Well then, you don't haveenough passion to go.
Because if you have a passion,like building a business,
starting from scratch, moving,taking what I knew from one to
build the next one, the strongerone, there's always risk, right
, but I have passion in what Ido, I'm confident in what I do
and I make it work.
You need confidence, you needto have that passion, or else it
(01:00:48):
will not work for you.
That's what usually happens.
Speaker 2 (01:00:52):
It's tough, that's
crazy.
So yeah, I mean, if you equatelike an 80-hour work week at
$65,000, that roughly equates toabout less than $15 an hour.
Yeah.
Speaker 3 (01:01:09):
And what happens is
and this is again, I love
examples I was working at CookCounty Rush University too, and
then I was with the Universityof Illinois surgical team Gen
Surge, general surgery and I waswith the chief five-year great
guy friends to this day.
He was married to a familyinternal medicine.
His wife was internal medicineat Cook County.
(01:01:30):
He was University of Illinoischief surgeon.
You're being student, right?
He goes to me.
This is what I was a city go,Stavros.
I gotta tell you man, I love mywife, but she always gets me,
gets mad at me because I don'tget home in time.
She's in medicine.
She's actually chief ofinternal at that.
Right, right, right.
He's chief of surgery.
He goes, honey, I can't comehome till I finish my surgery.
(01:01:54):
By the way, just came in 10minutes ago and I gotta have a
four-hour procedure even thendidn't understand.
So you see, it's tough like it'sno matter what passion,
sacrifice me and the rightperson.
You have to set it up the rightway.
It's not a sprint, it's a race,and if you don't have a support
system by your side, it'schallenging.
Guys, it really is a lot, a lotof obstacles to overcome every
(01:02:15):
day.
Speaker 2 (01:02:18):
So, dr Stavros, as
far as your agency is concerned,
your institution is concerned,helping students.
If any of our students arestuck, what would you recommend
they do?
How would they reach out to you?
Is there a circumstance whenyou look at a student and you're
like, yeah, this guy is beyondhelp, I can't help him?
Speaker 3 (01:02:40):
Well, I mean, I'm
sorry, Go ahead Sorry.
Speaker 2 (01:02:43):
No, so that's why
have you had?
Are you like rejecting students?
Are you willing to help anybody?
What's the like?
How do you?
Are you willing to help anybody?
What's the like?
How do you?
What should a student do?
When should they reach out toyou?
Speaker 3 (01:02:57):
So a couple of things
.
I'm always a believer ofproviding the best advice I
possibly can, and sometimeswe're not meant to work with
some people because they needmore prep, they need more time
to build the foundation, becausemaybe they're out of school,
right.
But if I, as long as I, can,provide some advice for them to
get on the right track, maybethey come back to me a year from
(01:03:18):
now, two years from now, maybenever, but at least they have
the right information, insteadof going online searching
different forums, which I like.
But you got to be careful who'sout there, because how can you,
how can you credit?
There's no credibility.
You don't know who's sayingwhat, where, how.
So usually medical students,first semester, second semester,
third, fourth, fifth, preparingfor step, little by little, is
(01:03:41):
the majority of doctors we workwith.
We work with doctors in theCaribbean international.
As long as you are in school,outside of school, and you want
to dedicate and sacrifice, wework with everybody.
Very few of them say hey, sayhey, I can't work with you,
unless, literally, they can'tdedicate an hour a day, which is
very rare, right, okay?
So if they visitusmletrainingscom, forward slash
(01:04:02):
step one, they can go to thewebsite.
They'll see my, my webinar,right, learn everything.
Reach out to us if you need to.
You'll talk to me on my staff,and if we feel that you need
prep now versus hey, you need tocome back to us.
If you need to, you'll talk tome on my staff, and if we feel
that you need prep now versushey, you need to come back to us
a few months from now.
This is why we do what we dobest and why all of our students
pass.
It's just given the rightguidance, the right support.
(01:04:23):
Okay, make sure they do well.
All right, yeah, I mean, that'sthe whole point.
You got to sacrifice right andnavigate.
Speaker 2 (01:04:28):
We'll do it for you
with right and, and you
mentioned that all of yourstudents pass um like.
Is there like an officialstatistic on that or?
Speaker 3 (01:04:36):
you know why they all
pass?
Because and I'm I, we all say,oh, guarantee the reason why
they all pass is if they andagain I'm honest, there's some
students I don't let I, I do not, I do not allow them to pat to
take the test because they cancome on and work with us for two
months but then they're notstrong enough.
I'm like, well, I dideverything I could and there's
(01:04:57):
no way I can sponsor you.
I can actually, you know,advise for you to take your step
one because you're stilllacking in X, y and Z.
So then you know, we provide alittle more support.
They keep working on theirweaknesses and then they go past
the test because this is theirfuture.
Right, I mean, I can't, I can'tallow somebody under my support,
under our team, to take thetest and fail, because when they
(01:05:19):
do, they can't license to somestates.
Their journey becomes much moredifficult and many of them are
like man, I got it, what am Isupposed to do?
I gave up my family and Ifailed.
So, yeah, I take it personal.
That's why those who work withus, you're not going in unless,
like you said, nbmes andassessments.
So I can honestly say no one hasfailed under the guidance that
(01:05:39):
I've provided, following theright resources and the
assessments that I need to havebefore you pass the test.
It might take six months, itmight take a year.
It might take two weeks.
The fastest I've done was fourweeks with a few students, but
again, they need to help peoplehear this ago I got to do it.
No, no, you need to have thefoundation right, you need to
know the medicine and I can showyou the test taking skills to
(01:06:00):
actually make you a rock startest and what's the best period
for them to reach out to you?
Speaker 2 (01:06:07):
is it MD for?
Is it MD 5?
Is it after they failed theNBME a bunch of times?
When is the best time for them?
Speaker 3 (01:06:15):
to reach out.
You can reach out to me after.
I would say this there's twoparts to this answer.
A, for those who are in MD3 and4, preparing slowly, knowing
that an MD5, st James and otherschools want you to take an NBME
to get sponsored for the step,don't wait to the end, come to
(01:06:35):
us, we'll guide you to make sureyou're on the right track.
Fine, for those of you who juststarted medical school last
week, last month, you know likeI don't want to listen to this
guy.
I'm not ready yet.
Oh no, no, I get it.
But with what we do is we alsohave a huge library of videos,
so okay what I, what I didn'thave as a student is I had
resources like right, you couldbuy videos, yeah, have the Q
(01:06:58):
bank, but no one does ittogether like this.
So I have some students.
Now they go to me.
Doc, I failed step one.
I failed my NBMEs watching yourvideo, going through glycolysis
cycle, using this question andteaching you the content behind
it.
I learned better that way thanwatching.
Videos are great, but nothingis clicking for me anymore.
(01:07:20):
So for those of you like membermd1, for example, do you know
what?
What classes you teach on md1too, was anatomy histology yeah,
yeah yeah.
So wouldn't it be nice forstudents to say well, I can
listen to my professors and mydoctors in St James, but I also
have a list of videos from DrStavros that I can parallel to
(01:07:40):
expose to questions, no pressure.
So then, when you get to MD3,you're like well, I've been
watching these for two semesters, three semesters, I'm getting
acclimated to the style ofquestions, which then increases
the chance of passing NBME,being more disciplined because
they're watching the videos, andthen your numbers rise because
they pass faster, they get intorotations faster, they get into
(01:08:00):
step two.
Speaker 2 (01:08:01):
We definitely want
that so it's a domino effect
right they don't see it, we do.
Speaker 3 (01:08:04):
They don't see that,
though.
That's the problem.
Speaker 2 (01:08:06):
Right, and that's the
thing.
Know, the whole concept ofquote-unquote privilege comes in
, and if joining an additionalprogram gives you that privilege
, why would you not take it?
Speaker 3 (01:08:21):
because then you
don't struggle for nbme and
again if you realize medicineisn't for you, please.
You know, and I advise a lot ofstudents, I mean truthfully,
they might be married, have kids.
Maybe they're doing it to makemoney for their loved ones other
times.
Man, it's not for you, that'scool, I mean, accept it.
But if you're in it and you havelove for it.
Well, let's get it done, let'spass the test and move on.
(01:08:41):
Just it's navigation, man, it'sall guidance and navigation and
support uh, thank you so muchfor these valuable insights.
Speaker 2 (01:08:48):
uh, if anybody of you
need to reach out to Dr Stavros
, his contact information willbe in the comments below.
And if you like the contentthat we're producing, give us a
like, give us a follow.
You can download our episodeson any one of your favorite
podcast providers, such asSpotify and YouTube.
(01:09:08):
And remember there's noshortcut to becoming an MD.
Speaker 1 (01:09:18):
Thank you so much for
tuning into our show.
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