Discover the inspiring journey of Dr. Song, a second-year internal medicine resident whose path to medicine was shaped by personal health trials and a rich tapestry of cross-cultural experiences. She shares how childhood health challenges and a fascination with the contrasting medical landscapes of China and the U.S. fueled her passion for better patient care. Join us as Dr. Song opens up about her evolution from aspiring journalist to dedicated physician, with invaluable insights for international medical graduates and a heartwarming story about a 90-year-old practicing doctor.
Our conversation explores universal challenges in medical training, the crucial role of research, and the rewarding yet rigorous life of a resident. Dr. Song provides a candid account of balancing patient care with continuous learning and preparation for future career pathways, whether diving into subspecialties or beginning a practice. In addition, we encourage you to be part of our growing community by tuning in every Monday and sharing your thoughts and questions. Stay connected and inspired as we illuminate the human side of medicine through Dr. Song's stories of resilience and dedication.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:01):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant and the creator of
Shadow Me Next.
It's my goal to introduce youto incredible members of the
healthcare field and uncovertheir unique stories, the joys
(00:23):
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-med student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
I don't want you to miss asingle one of these
(00:44):
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
Me Next, where I'll give yousneak previews of our upcoming
guests.
This is episode eight of ShadowMe Next and I am so pleased to
introduce you to Dr Judy Song, asecond-year internal medicine
(01:05):
resident with a multifacetedbackground in public health and
health informatics.
Dr Song shares how her ownhealth challenges as a child
inspired her to pursue medicine.
She discusses the importance ofresearch in the field and
provides insights into thecomplexities of electronic
health records and thedifference between medical
training in China and the US.
(01:26):
She has great advice foraspiring physicians, especially
international graduates, andshares her touching story of a
90-year-old doctor who stillpractices medicine.
This is Shadow Me Next with DrJudy Song.
Hi, dr Song, thank you so muchfor joining us on Shadow Me Next
.
How are you today?
(01:47):
I'm doing great.
How are you, ashley?
I'm really really good.
Thank you so much for beinghere with us and for taking the
time out of your incredibly busyschedule.
We so appreciate it.
So, dr Song, if you could tellus about let's go back to the
beginning and tell us about whatfirst sparked your interest in
medicine.
Dr. Song (02:08):
Yeah.
So like many other people maybesome people are sick in their
like family or face some kind ofchallenge medically themselves,
and I have a pretty similarkind of story.
So when I was in middle school,I was sick a lot I have a lot
of GI symptoms to the point thatI was absent from school for
(02:31):
like even months, and at thetime no doctors really know
what's happening at the time.
And from that point I wasthinking oh, one day, if I could
choose, I want to be a doctorand I would probably do a better
job than what they did.
So that's really how everythingstarted.
Ashley (02:50):
That's incredible.
You know, personal experiencesare such a hard thing, obviously
when we are the patient and alot of times we do receive
excellent care and it'sfantastic.
But sometimes we don't receiveexcellent care, or maybe it's
like bedside manner or therapidity of how fast you got
your diagnosis or how thediagnosis was explained to you.
(03:12):
So I think that personalexperience, helping us determine
that that is what we want to do, that medicine is where we want
to be, is so hard, but it'salso so good and I think it
makes us a really phenomenalprovider.
So were you always sure thatyou wanted to become a doctor?
Or perhaps were you consideringother fields in medicine?
Dr. Song (03:36):
I changed my mind all the time.
Yeah, when I was really little Iwanted to be like a journalist,
I wanted to be a writer andthen, like you know, later on I
was sick in hospital all thetime.
So I got interested intomedicine and my best friend in
high school her whole family,she comes from a family full of
(03:58):
doctors and you know I justhappened to know her so well and
know more about medicine fromher side.
And then, like, I went tomedical school in China and the
whole practicing kind ofenvironment and patient
physician relationship was notideal at all.
So at a time it kind of shiftedmy confidence in really
(04:22):
actually practicing in China andI just saw a lot of problems,
not really in the clinical fieldbut more of a policy and health
literacy kind of perspective,and that kind of inspired me to
get my master in public healthin the US and currently I'm a
second year resident in aninternal medicine program.
(04:44):
And currently I'm a second yearresident in an internal
medicine program.
So I would say that from when Iwas a little girl up till now I
changed my mind so many times.
Ashley (04:55):
I'm so glad to hear that other people are, you know,
unsure too, because I thinkpeople just expect us to wake up
one day, when we are in highschool or middle school even,
and say this is the career pathfor me, this is what I'm going
to do, and then they neverfalter.
Every single medicalprofessional that I've spoken
(05:15):
with so far has said it's been ajourney, right, and it's been a
journey to even get to thepoint where you realize what you
want to do and how you want topursue that.
So tell me a little bit aboutresearch.
Is research something that isrequired in order to become a
physician?
Dr. Song (05:33):
Yeah, so in my home country or in China, it is a
must.
They even have thoserequirements for how many
publications you need to havefor you to go to the next level.
Wow, it's a very differentsystem and I think here in the
United States people also expectyou to be familiar with the
(05:53):
whole academic world and doresearch.
At least you need to know whatto do and the whole system how
it works, especially when youwant to work in a more academic
kind of environment.
Medicine is such a wide anddiverse field, so I think with
the different kind of focus,there are definitely fields that
doesn't really like.
(06:14):
There are also different kindsof research, depending on how
you define it, but in general, Ithink it will be helpful for
people who's interested inmedicine or who's in the field
of medicine to do research,because you are sharing.
Ashley (06:30):
You know, in PA school for PAs, we are aware of
research, and some PAs areinvolved in research in their
undergraduate studies.
Some PAs are continuing to doresearch as PAs.
As clinicians, however, it'sfar less common.
The thing that just blows mymind is we still have to be very
(06:51):
well-versed in consumingresearch, right?
So our patients are relying onresearch and evidence-based
medicine, which comes from doingresearch and doing studies.
So I think it's something thatis so important and I am so glad
that our physicians are soactively involved, and I think
(07:12):
it's something that we'll seebecoming more prevalent in
physician assistant school andin practicing PAs because, like
you said, it's important to ourpatients that we're able to do
these things.
Yeah, I totally agree with that.
Very cool.
Now, did you get any othercertifications or any other
(07:34):
degrees other than your medicaldoctor degree?
Dr. Song (07:38):
I have a master's degree in public health.
I major in health education andbehavioral sciences.
I also have another master'sdegree in health informatics, so
originally I was thinking aboutpursuing a PhD in health and
grammatics and it is a wholenother story, but I still feel
(07:59):
like those really helped me somuch in navigating the general
medicine world.
Ashley (08:06):
Wow, you are amazing.
That is incredible.
So a master's in healtheducation and then gosh, health
informatics.
Now, what is health educationand what is health informatics?
Those are two words thatperhaps some people are familiar
with, but others might not be.
Dr. Song (08:23):
Yeah.
So I think health education isreally about empowering the
patients in any kind of ways youcan.
There are people focusing alldifferent kind of realms, like
education for school kids,educations for patients or
populations that are underserved, and developing phone apps.
What I was doing is wedeveloped computer games to help
(08:46):
advocate on management ofasthma, sexual health
applications, so it's a wholenew world.
I think it's super, super cool.
And for health informatics,especially beyond the year of
2014, there's this requirementthat all the health practicing
facilities need to start theapplications of electronic
health records, and that iswhere all the kind of data are
(09:10):
booming and we just have allthis massive information.
Data are booming and we justhave all this massive
information.
However, what to do with themand how to better utilize them,
it's a real question at a time.
So all kinds of research likenatural language processing, ai,
or even like secondary analysis, like use analysis for my
(09:30):
medication, we're currentlyusing for certain indications
for my medication we'recurrently using for certain
indications.
They could be possibly found tohave other indications where
it'd be helpful for preventingcancer or other purposes.
So at the time I just felt Itotally fell in love with the
research and I was so involvedwith all that and it was a
little bit you know off from theclinical practicing world for a
(09:52):
while.
Ashley (09:53):
Well, I could see how you could fall in love with that
sort of thing.
I mean, you mentioned AI.
Ai has just exploded right nowand I think it has such
fantastic applications, but atthe same time there's a lot of
fear.
Yeah, definitely, and theinformation overload, like you
said, is tangible and it's real.
Have you in your opinion?
(10:14):
Because you know we'll heareverybody talk about charting
and all of the information thatwe have available at our
computer and at our stations nowand we'll say kind of tongue in
cheek sometimes oh, I miss theold paper charting days where
you just you had what you hadand if you didn't have it, well
too bad, you know.
But in your opinion, have wemade huge advances with
(10:36):
electronic medical records?
What is the biggest benefit?
Dr. Song (10:39):
I would think definitely for data like
acquisition and like sharingdata, and you know, having
certain standard for data isdefinitely something that's
fundamental and that's the starsof everything.
But I would also argue that withthe application of vhr it kind
(11:02):
of creates new problems and thenfor different countries it's
also something very interesting,like I was born in taiwan and
in taiwan we have only one EHR,so you can imagine how easy it
is to pull data from one placeto the other because we have a
universal health system.
But here in the United Statesyou have all different practices
(11:24):
, all these commercial,different kinds of softwares you
use.
You have a free market,definitely, and people have
freedom and like through amarket and competition, you can
have more advancement and grow.
Everything has its differentsides but overall I think having
new technologies and new toolsand trying to figure out how to
(11:46):
work with it, that's how we pushthe field to go forward.
So I personally have no regretsand I experienced part of the
paper kind of failed kind of erawhen I was back in China and I,
to be honest, I don't miss that.
Ashley (12:01):
No, no, I agree with you a hundred percent.
You know it's so interestingwhat you, what you just
described.
When I was interviewing for PAschool, one of the questions
that I was asked was aboutuniversal EMRs, right, so, like
you just described, in Taiwan,how it's one system and every
single clinician in the countrywould all use that one system,
(12:25):
which, of course, in the UnitedStates is just unfathomable.
I couldn't even imagine it.
And so their question was whatare the benefits of this and
what are the negatives, what arethe cons?
And you just beautifullyoutlined all of those.
So thank you for howbeautifully you just put
together the answer, for itperhaps looked different from
medical school in the States,but maybe it didn't.
Are there any differences thatyou have kind of discovered
(12:58):
talking to some of your residentcolleagues now?
Dr. Song (13:02):
I feel like there's something definitely in common.
I believe that, no matter whereyou go in the whole world, any
students made it to the medicalschool are one of the smartest,
like the most dedicated,hardworking people you could
ever find in this whole world.
(13:23):
So the same amount of stressand the competitions they have
on a daily basis, I feel likethat part is probably the same,
but I think there's definitely adifference.
When you talk about theresources in a developed world
and a developing country andyeah, I would say that maybe in
(13:48):
my country what I realized isthat a lot of things really
depends on you.
You need to be superself-motivated and like
self-learning to, because thereare probably less kind of
universal like mentoring orguidance towards the very end of
what kind of positions you aregoing to become and when you are
(14:09):
thrown in a market or in thereal world to practice the kind
of expectations very differentfrom the expectations here in
the US.
Yeah, so I think I'm very, veryfortunate to be here to be
trained here.
Ashley (14:24):
We're so grateful that you are here and that you are
caring for patients here andhave the knowledge and the
background that you do.
So tell me about residency.
Did you get to choose theresidency that you wanted?
Are you kind of forced into itbased on your performance in
medical school?
How does that work?
Dr. Song (14:43):
I believe that when you apply for residency, they
definitely look at, for example,your step scores, your research
, voluntary activities.
They want to read your personalstatements to know what kind of
person you are.
I'm very lucky I'm matching tomy like I ran, the person I'm
currently at the first in mylist and, yeah, I'm just very,
(15:09):
very blessed to be here.
But I would say that differentprograms really value different
things, so drastically different.
They are academic, like auniversity-affiliated program.
They focus a lot on researchand they will expect you to have
an idea of what kind ofspecific focus you want, whereas
(15:29):
you have very community-basedprograms.
They are very down to the earth.
They want to make sure thatyou're able to handle certain
volume, have certainprofessionalism when you're
under stress and being able toperform.
So I would say that fordifferent programs they are
looking into different things.
Ashley (15:50):
It's just a never-ending selection, I feel like, for
medicine truly.
I mean, it begins in highschool, and then college, and
then medical school, and then itcontinues on and on, and then
you are, you're internalmedicine, correct, yes?
And then, once you become aninternal medicine resident, do
you then have to furtherspecialize?
(16:12):
Do you then?
Dr. Song (16:12):
have to further specialize.
So once you finish yourinternal medicine residency you
can choose to directly go startyour career as a hospitalist or
you can also work in primarycare and I know there are people
who choose to work at night andbecome a nocturnist.
And I believe there are likelocal jobs where sometimes
(16:34):
people do very specific thingsthat requires a background in
internal medicine.
On the other hand, youdefinitely have all the
different subspecialties you canchoose from for further
training, like cardiology, gi,endocrinology, infectious
disease, so on and so forth.
Ashley (16:54):
Wow, yeah, that's wow.
So many different pathways.
I love it.
So tell us, dr Song, about justwhat is a typical day look like
for you right now.
Dr. Song (17:24):
And you're going like maybe six or seven in the
morning doing chart prep and youpre-round and see your patient
and address like urgent needs ofthe patient and then between
eight or nine till 11 or 12,they're surrounding with the
attending doctors where we talkabout each patient's cases,
cases and there's teaching, forexample, like a very specific
case is how to manage bloodpressure or how to manage
pulmonary embolism patients andall sorts of things.
(17:46):
And for our program, every dayduring 12 to 1 we have a launch
lecture, so it's either a casereport or journal club where we
share about the latest journaland findings, where we do a
board prep together and then inthe afternoon we start admitting
new patients and then kind ofaddress the acute problems.
(18:10):
Yeah, and then pretty muchmaybe around five till seven,
depending on whether you're onthe early team, the late team.
Sometimes you need to stay tilllater to keep meeting new
patients, otherwise you can signoff to the next night team and
then you can go back home, studyor work on your projects and so
(18:31):
on and so forth.
Ashley (18:33):
The work doesn't end when you leave the hospital.
Oh, I guess that's a reason Istay working.
Dr. Song (18:39):
The work doesn't end when you leave the hospital.
Ashley (18:40):
I guess that's a reason I stay working.
Yes, what an exciting day,though.
I mean it seems like it's verymultifaceted, you know, and I
love the fact that you are ableto kind of join back up with
your colleagues for those lunchlectures and journal clubs and
board prep.
I think that's fantastic.
What does it look like going onfrom here?
(19:01):
How much schooling is left foryou?
Do you have to take more tests?
What's next?
Dr. Song (19:07):
I think I still have around one and a half year in
this program.
And then after you finish theprogram, you need to take the
board exam for internal medicine.
Even if you are going into asubspecialty, you still need to
take the board exam for internalmedicine.
Even if you are going into asubspecialty, you still need to
take the internal medicine boardin order to take the
subspecialty board.
Up till this point, I thinkanyone who survived to the point
(19:29):
to be in the residency programare quite familiar with all the
standardized testing kind offormat and all that stress.
Ashley (19:37):
Yeah, no kidding, that is, tell me about stress.
It's the never ending testcycle too, that's for sure.
So, dr Song, do you have apatient encounter that you have
either experienced, either inmedical school or perhaps in
residency to, that reallyimpacted you and made you think
well, thank goodness, I am doingwhat I'm doing right now that
(19:59):
really impacted you and made youthink, well, thank goodness I
am doing what I'm doing rightnow.
Dr. Song (20:07):
Yeah, so, just on top of my head, one patient that I
think I'll forever remember himis in an outpatient setting, and
this is a gentleman in hisnineties, just a regular checkup
.
But what's special is that thispatient himself is also a
practicing doctor, internist.
He's with his wife.
And then his wife was saying,okay, so he's still practicing,
(20:28):
but I don't think that's goodfor his health, he's so old and
he should retire and enjoy life.
But then my patient was sayingoh no, this is what I wanted to
do, I will work till the verylast day, yeah, yeah.
So I felt like, uh, like,especially if you are in primary
care or in the outpatientsetting and you accumulate your
patient pool, you feel that youhave this connection with them
(20:51):
and it's really difficult to letgo.
It almost feels guilty if youstop helping them or something
like that.
And then from that patient,because he's a physician himself
, I just see that how much heloves it and his dedication in
it, and I think that's inspiringme and it's also encouraging to
(21:11):
see that, oh, as an internistis something, is a profession
that you can have for a lifetimeis something is a profession
that you can have for a lifetime, absolutely, absolutely.
Ashley (21:25):
And his dedication to his patients, and I know, on the
other side of things, hispatients are so grateful for his
continued care.
I cannot tell you the number oftimes in clinic where I will
have patients come in and arejust devastated that their
internal medicine physician ortheir family medicine doctor is
retiring.
They almost say, how dare they.
They're in their 60s and 70s,they would also like to enjoy
(21:50):
retirement too.
But I think you're right.
I think so often medicine it issuch a noble profession, but
it's also a calling and you getso much joy and satisfaction out
of helping people.
We don't become burnt out fromhelping people, which is why we
are in medicine.
You know there's other thingsthat cause burnout and you know
(22:12):
I mentioned those in episode oneand you know things like,
things like insurance andschedules.
Dr. Song (22:19):
I do it with taxes.
Taxes yes.
Ashley (22:22):
All of the logistics.
That is what causes healthcareworker burnout.
It's never the act of helpingpeople.
So I'm grateful.
I would love for you to stillbe enjoying your job when you're
90.
Maybe I'll reach 90 and I'llstill be enjoying my job too.
What do you find most rewardingabout your career as an
(22:47):
internal medicine physician?
Dr. Song (22:49):
I would say it's definitely building a connection
and knowing people's story andbe part of their life, because I
feel like it is something to dowith what I wanted to do when I
was little.
I wanted to do journalism.
I want to tell people's storyand in a sense that I'm just
generally, you know, interestedin human being and people and to
(23:11):
a lot of sense, I feel like asa physician, we try our best to
provide help and a lot of timespatients have their own concerns
, their different life kind ofscenarios and economic status.
Even we have the bestmedication, the best device, the
best procedure, whereas allthese advancement in medicine.
(23:34):
To be someone who reallylistens to your patient and
understand their value andexpectation and to help guide
them in this super, supercomplicated health system and
find whatever they need to helpthem, I think that role is
something I want to pursue andif I can make it that way, I
(23:55):
would feel very fulfilled.
Ashley (23:58):
That is incredible.
I love that.
I love that so much.
Well, dr Song, thank you somuch for taking your very
valuable time and speaking withme today.
I'm so inspired by yourdedication and your focus on the
patient.
Still, even though you havebeen through so much schooling
and have jumped through all ofthe hoops, I feel like you
(24:20):
really have not lost sight ofthe purpose behind this mission
that you're on.
So thank you so much.
Dr. Song (24:26):
Yeah, thank you actually for having me and I am
really grateful for having thisopportunity to share my story,
to share my story.
And one thing I really want toadd is that you don't really see
a lot of people like me beingsuper introverted, being an
international medical graduate,you know, speaking with an
accent, still having this dreamof pursuing medicine in the US.
(24:50):
So I just feel, like anyone outthere who's like me, who's been
a female, like a foreignmedical graduate, trying to do
this, you can do it.
All the friends or families orpeople I know who truly loves
the field, they will find a wayand they will find help with the
people surrounding them toprovide whatever they need to
(25:11):
make it to the end.
Ashley (25:14):
That is beautiful and it's so true.
There is a spot for you and weneed you desperately.
Medicine needs you, so thankyou so much.
Thank you so very much forlistening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
(25:34):
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
Any questions?
Let me know on Facebook orInstagram Access.
You want stories you need?
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant and the creator of
Shadow Me Next.
It's my goal to introduce youto incredible members of the
healthcare field and uncovertheir unique stories, the joys
(00:23):
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-med student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
I don't want you to miss asingle one of these
(00:44):
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
Me Next, where I'll give yousneak previews of our upcoming
guests.
This is episode eight of ShadowMe Next and I am so pleased to
introduce you to Dr Judy Song, asecond-year internal medicine
(01:05):
resident with a multifacetedbackground in public health and
health informatics.
Dr Song shares how her ownhealth challenges as a child
inspired her to pursue medicine.
She discusses the importance ofresearch in the field and
provides insights into thecomplexities of electronic
health records and thedifference between medical
training in China and the US.
(01:26):
She has great advice foraspiring physicians, especially
international graduates, andshares her touching story of a
90-year-old doctor who stillpractices medicine.
This is Shadow Me Next with DrJudy Song.
Hi, dr Song, thank you so muchfor joining us on Shadow Me Next
.
How are you today?
(01:47):
I'm doing great.
How are you, ashley?
I'm really really good.
Thank you so much for beinghere with us and for taking the
time out of your incredibly busyschedule.
We so appreciate it.
So, dr Song, if you could tellus about let's go back to the
beginning and tell us about whatfirst sparked your interest in
medicine.
Dr. Song (02:08):
Yeah.
So like many other people maybesome people are sick in their
like family or face some kind ofchallenge medically themselves,
and I have a pretty similarkind of story.
So when I was in middle school,I was sick a lot I have a lot
of GI symptoms to the point thatI was absent from school for
(02:31):
like even months, and at thetime no doctors really know
what's happening at the time.
And from that point I wasthinking oh, one day, if I could
choose, I want to be a doctorand I would probably do a better
job than what they did.
So that's really how everythingstarted.
Ashley (02:50):
That's incredible.
You know, personal experiencesare such a hard thing, obviously
when we are the patient and alot of times we do receive
excellent care and it'sfantastic.
But sometimes we don't receiveexcellent care, or maybe it's
like bedside manner or therapidity of how fast you got
your diagnosis or how thediagnosis was explained to you.
(03:12):
So I think that personalexperience, helping us determine
that that is what we want to do, that medicine is where we want
to be, is so hard, but it'salso so good and I think it
makes us a really phenomenalprovider.
So were you always sure thatyou wanted to become a doctor?
Or perhaps were you consideringother fields in medicine?
Dr. Song (03:36):
I changed my mind all the time.
Yeah, when I was really little Iwanted to be like a journalist,
I wanted to be a writer andthen, like you know, later on I
was sick in hospital all thetime.
So I got interested intomedicine and my best friend in
high school her whole family,she comes from a family full of
(03:58):
doctors and you know I justhappened to know her so well and
know more about medicine fromher side.
And then, like, I went tomedical school in China and the
whole practicing kind ofenvironment and patient
physician relationship was notideal at all.
So at a time it kind of shiftedmy confidence in really
(04:22):
actually practicing in China andI just saw a lot of problems,
not really in the clinical fieldbut more of a policy and health
literacy kind of perspective,and that kind of inspired me to
get my master in public healthin the US and currently I'm a
second year resident in aninternal medicine program.
(04:44):
And currently I'm a second yearresident in an internal
medicine program.
So I would say that from when Iwas a little girl up till now I
changed my mind so many times.
Ashley (04:55):
I'm so glad to hear that other people are, you know,
unsure too, because I thinkpeople just expect us to wake up
one day, when we are in highschool or middle school even,
and say this is the career pathfor me, this is what I'm going
to do, and then they neverfalter.
Every single medicalprofessional that I've spoken
(05:15):
with so far has said it's been ajourney, right, and it's been a
journey to even get to thepoint where you realize what you
want to do and how you want topursue that.
So tell me a little bit aboutresearch.
Is research something that isrequired in order to become a
physician?
Dr. Song (05:33):
Yeah, so in my home country or in China, it is a
must.
They even have thoserequirements for how many
publications you need to havefor you to go to the next level.
Wow, it's a very differentsystem and I think here in the
United States people also expectyou to be familiar with the
(05:53):
whole academic world and doresearch.
At least you need to know whatto do and the whole system how
it works, especially when youwant to work in a more academic
kind of environment.
Medicine is such a wide anddiverse field, so I think with
the different kind of focus,there are definitely fields that
doesn't really like.
(06:14):
There are also different kindsof research, depending on how
you define it, but in general, Ithink it will be helpful for
people who's interested inmedicine or who's in the field
of medicine to do research,because you are sharing.
Ashley (06:30):
You know, in PA school for PAs, we are aware of
research, and some PAs areinvolved in research in their
undergraduate studies.
Some PAs are continuing to doresearch as PAs.
As clinicians, however, it'sfar less common.
The thing that just blows mymind is we still have to be very
(06:51):
well-versed in consumingresearch, right?
So our patients are relying onresearch and evidence-based
medicine, which comes from doingresearch and doing studies.
So I think it's something thatis so important and I am so glad
that our physicians are soactively involved, and I think
(07:12):
it's something that we'll seebecoming more prevalent in
physician assistant school andin practicing PAs because, like
you said, it's important to ourpatients that we're able to do
these things.
Yeah, I totally agree with that.
Very cool.
Now, did you get any othercertifications or any other
(07:34):
degrees other than your medicaldoctor degree?
Dr. Song (07:38):
I have a master's degree in public health.
I major in health education andbehavioral sciences.
I also have another master'sdegree in health informatics, so
originally I was thinking aboutpursuing a PhD in health and
grammatics and it is a wholenother story, but I still feel
(07:59):
like those really helped me somuch in navigating the general
medicine world.
Ashley (08:06):
Wow, you are amazing.
That is incredible.
So a master's in healtheducation and then gosh, health
informatics.
Now, what is health educationand what is health informatics?
Those are two words thatperhaps some people are familiar
with, but others might not be.
Dr. Song (08:23):
Yeah.
So I think health education isreally about empowering the
patients in any kind of ways youcan.
There are people focusing alldifferent kind of realms, like
education for school kids,educations for patients or
populations that are underserved, and developing phone apps.
What I was doing is wedeveloped computer games to help
(08:46):
advocate on management ofasthma, sexual health
applications, so it's a wholenew world.
I think it's super, super cool.
And for health informatics,especially beyond the year of
2014, there's this requirementthat all the health practicing
facilities need to start theapplications of electronic
health records, and that iswhere all the kind of data are
(09:10):
booming and we just have allthis massive information.
Data are booming and we justhave all this massive
information.
However, what to do with themand how to better utilize them,
it's a real question at a time.
So all kinds of research likenatural language processing, ai,
or even like secondary analysis, like use analysis for my
(09:30):
medication, we're currentlyusing for certain indications
for my medication we'recurrently using for certain
indications.
They could be possibly found tohave other indications where
it'd be helpful for preventingcancer or other purposes.
So at the time I just felt Itotally fell in love with the
research and I was so involvedwith all that and it was a
little bit you know off from theclinical practicing world for a
(09:52):
while.
Ashley (09:53):
Well, I could see how you could fall in love with that
sort of thing.
I mean, you mentioned AI.
Ai has just exploded right nowand I think it has such
fantastic applications, but atthe same time there's a lot of
fear.
Yeah, definitely, and theinformation overload, like you
said, is tangible and it's real.
Have you in your opinion?
(10:14):
Because you know we'll heareverybody talk about charting
and all of the information thatwe have available at our
computer and at our stations nowand we'll say kind of tongue in
cheek sometimes oh, I miss theold paper charting days where
you just you had what you hadand if you didn't have it, well
too bad, you know.
But in your opinion, have wemade huge advances with
(10:36):
electronic medical records?
What is the biggest benefit?
Dr. Song (10:39):
I would think definitely for data like
acquisition and like sharingdata, and you know, having
certain standard for data isdefinitely something that's
fundamental and that's the starsof everything.
But I would also argue that withthe application of vhr it kind
(11:02):
of creates new problems and thenfor different countries it's
also something very interesting,like I was born in taiwan and
in taiwan we have only one EHR,so you can imagine how easy it
is to pull data from one placeto the other because we have a
universal health system.
But here in the United Statesyou have all different practices
(11:24):
, all these commercial,different kinds of softwares you
use.
You have a free market,definitely, and people have
freedom and like through amarket and competition, you can
have more advancement and grow.
Everything has its differentsides but overall I think having
new technologies and new toolsand trying to figure out how to
(11:46):
work with it, that's how we pushthe field to go forward.
So I personally have no regretsand I experienced part of the
paper kind of failed kind of erawhen I was back in China and I,
to be honest, I don't miss that.
Ashley (12:01):
No, no, I agree with you a hundred percent.
You know it's so interestingwhat you, what you just
described.
When I was interviewing for PAschool, one of the questions
that I was asked was aboutuniversal EMRs, right, so, like
you just described, in Taiwan,how it's one system and every
single clinician in the countrywould all use that one system,
(12:25):
which, of course, in the UnitedStates is just unfathomable.
I couldn't even imagine it.
And so their question was whatare the benefits of this and
what are the negatives, what arethe cons?
And you just beautifullyoutlined all of those.
So thank you for howbeautifully you just put
together the answer, for itperhaps looked different from
medical school in the States,but maybe it didn't.
Are there any differences thatyou have kind of discovered
(12:58):
talking to some of your residentcolleagues now?
Dr. Song (13:02):
I feel like there's something definitely in common.
I believe that, no matter whereyou go in the whole world, any
students made it to the medicalschool are one of the smartest,
like the most dedicated,hardworking people you could
ever find in this whole world.
(13:23):
So the same amount of stressand the competitions they have
on a daily basis, I feel likethat part is probably the same,
but I think there's definitely adifference.
When you talk about theresources in a developed world
and a developing country andyeah, I would say that maybe in
(13:48):
my country what I realized isthat a lot of things really
depends on you.
You need to be superself-motivated and like
self-learning to, because thereare probably less kind of
universal like mentoring orguidance towards the very end of
what kind of positions you aregoing to become and when you are
(14:09):
thrown in a market or in thereal world to practice the kind
of expectations very differentfrom the expectations here in
the US.
Yeah, so I think I'm very, veryfortunate to be here to be
trained here.
Ashley (14:24):
We're so grateful that you are here and that you are
caring for patients here andhave the knowledge and the
background that you do.
So tell me about residency.
Did you get to choose theresidency that you wanted?
Are you kind of forced into itbased on your performance in
medical school?
How does that work?
Dr. Song (14:43):
I believe that when you apply for residency, they
definitely look at, for example,your step scores, your research
, voluntary activities.
They want to read your personalstatements to know what kind of
person you are.
I'm very lucky I'm matching tomy like I ran, the person I'm
currently at the first in mylist and, yeah, I'm just very,
(15:09):
very blessed to be here.
But I would say that differentprograms really value different
things, so drastically different.
They are academic, like auniversity-affiliated program.
They focus a lot on researchand they will expect you to have
an idea of what kind ofspecific focus you want, whereas
(15:29):
you have very community-basedprograms.
They are very down to the earth.
They want to make sure thatyou're able to handle certain
volume, have certainprofessionalism when you're
under stress and being able toperform.
So I would say that fordifferent programs they are
looking into different things.
Ashley (15:50):
It's just a never-ending selection, I feel like, for
medicine truly.
I mean, it begins in highschool, and then college, and
then medical school, and then itcontinues on and on, and then
you are, you're internalmedicine, correct, yes?
And then, once you become aninternal medicine resident, do
you then have to furtherspecialize?
(16:12):
Do you then?
Dr. Song (16:12):
have to further specialize.
So once you finish yourinternal medicine residency you
can choose to directly go startyour career as a hospitalist or
you can also work in primarycare and I know there are people
who choose to work at night andbecome a nocturnist.
And I believe there are likelocal jobs where sometimes
(16:34):
people do very specific thingsthat requires a background in
internal medicine.
On the other hand, youdefinitely have all the
different subspecialties you canchoose from for further
training, like cardiology, gi,endocrinology, infectious
disease, so on and so forth.
Ashley (16:54):
Wow, yeah, that's wow.
So many different pathways.
I love it.
So tell us, dr Song, about justwhat is a typical day look like
for you right now.
Dr. Song (17:24):
And you're going like maybe six or seven in the
morning doing chart prep and youpre-round and see your patient
and address like urgent needs ofthe patient and then between
eight or nine till 11 or 12,they're surrounding with the
attending doctors where we talkabout each patient's cases,
cases and there's teaching, forexample, like a very specific
case is how to manage bloodpressure or how to manage
pulmonary embolism patients andall sorts of things.
(17:46):
And for our program, every dayduring 12 to 1 we have a launch
lecture, so it's either a casereport or journal club where we
share about the latest journaland findings, where we do a
board prep together and then inthe afternoon we start admitting
new patients and then kind ofaddress the acute problems.
(18:10):
Yeah, and then pretty muchmaybe around five till seven,
depending on whether you're onthe early team, the late team.
Sometimes you need to stay tilllater to keep meeting new
patients, otherwise you can signoff to the next night team and
then you can go back home, studyor work on your projects and so
(18:31):
on and so forth.
Ashley (18:33):
The work doesn't end when you leave the hospital.
Oh, I guess that's a reason Istay working.
Dr. Song (18:39):
The work doesn't end when you leave the hospital.
Ashley (18:40):
I guess that's a reason I stay working.
Yes, what an exciting day,though.
I mean it seems like it's verymultifaceted, you know, and I
love the fact that you are ableto kind of join back up with
your colleagues for those lunchlectures and journal clubs and
board prep.
I think that's fantastic.
What does it look like going onfrom here?
(19:01):
How much schooling is left foryou?
Do you have to take more tests?
What's next?
Dr. Song (19:07):
I think I still have around one and a half year in
this program.
And then after you finish theprogram, you need to take the
board exam for internal medicine.
Even if you are going into asubspecialty, you still need to
take the board exam for internalmedicine.
Even if you are going into asubspecialty, you still need to
take the internal medicine boardin order to take the
subspecialty board.
Up till this point, I thinkanyone who survived to the point
(19:29):
to be in the residency programare quite familiar with all the
standardized testing kind offormat and all that stress.
Ashley (19:37):
Yeah, no kidding, that is, tell me about stress.
It's the never ending testcycle too, that's for sure.
So, dr Song, do you have apatient encounter that you have
either experienced, either inmedical school or perhaps in
residency to, that reallyimpacted you and made you think
well, thank goodness, I am doingwhat I'm doing right now that
(19:59):
really impacted you and made youthink, well, thank goodness I
am doing what I'm doing rightnow.
Dr. Song (20:07):
Yeah, so, just on top of my head, one patient that I
think I'll forever remember himis in an outpatient setting, and
this is a gentleman in hisnineties, just a regular checkup
.
But what's special is that thispatient himself is also a
practicing doctor, internist.
He's with his wife.
And then his wife was saying,okay, so he's still practicing,
(20:28):
but I don't think that's goodfor his health, he's so old and
he should retire and enjoy life.
But then my patient was sayingoh no, this is what I wanted to
do, I will work till the verylast day, yeah, yeah.
So I felt like, uh, like,especially if you are in primary
care or in the outpatientsetting and you accumulate your
patient pool, you feel that youhave this connection with them
(20:51):
and it's really difficult to letgo.
It almost feels guilty if youstop helping them or something
like that.
And then from that patient,because he's a physician himself
, I just see that how much heloves it and his dedication in
it, and I think that's inspiringme and it's also encouraging to
(21:11):
see that, oh, as an internistis something, is a profession
that you can have for a lifetimeis something is a profession
that you can have for a lifetime, absolutely, absolutely.
Ashley (21:25):
And his dedication to his patients, and I know, on the
other side of things, hispatients are so grateful for his
continued care.
I cannot tell you the number oftimes in clinic where I will
have patients come in and arejust devastated that their
internal medicine physician ortheir family medicine doctor is
retiring.
They almost say, how dare they.
They're in their 60s and 70s,they would also like to enjoy
(21:50):
retirement too.
But I think you're right.
I think so often medicine it issuch a noble profession, but
it's also a calling and you getso much joy and satisfaction out
of helping people.
We don't become burnt out fromhelping people, which is why we
are in medicine.
You know there's other thingsthat cause burnout and you know
(22:12):
I mentioned those in episode oneand you know things like,
things like insurance andschedules.
Dr. Song (22:19):
I do it with taxes.
Taxes yes.
Ashley (22:22):
All of the logistics.
That is what causes healthcareworker burnout.
It's never the act of helpingpeople.
So I'm grateful.
I would love for you to stillbe enjoying your job when you're
90.
Maybe I'll reach 90 and I'llstill be enjoying my job too.
What do you find most rewardingabout your career as an
(22:47):
internal medicine physician?
Dr. Song (22:49):
I would say it's definitely building a connection
and knowing people's story andbe part of their life, because I
feel like it is something to dowith what I wanted to do when I
was little.
I wanted to do journalism.
I want to tell people's storyand in a sense that I'm just
generally, you know, interestedin human being and people and to
(23:11):
a lot of sense, I feel like asa physician, we try our best to
provide help and a lot of timespatients have their own concerns
, their different life kind ofscenarios and economic status.
Even we have the bestmedication, the best device, the
best procedure, whereas allthese advancement in medicine.
(23:34):
To be someone who reallylistens to your patient and
understand their value andexpectation and to help guide
them in this super, supercomplicated health system and
find whatever they need to helpthem, I think that role is
something I want to pursue andif I can make it that way, I
(23:55):
would feel very fulfilled.
Ashley (23:58):
That is incredible.
I love that.
I love that so much.
Well, dr Song, thank you somuch for taking your very
valuable time and speaking withme today.
I'm so inspired by yourdedication and your focus on the
patient.
Still, even though you havebeen through so much schooling
and have jumped through all ofthe hoops, I feel like you
(24:20):
really have not lost sight ofthe purpose behind this mission
that you're on.
So thank you so much.
Dr. Song (24:26):
Yeah, thank you actually for having me and I am
really grateful for having thisopportunity to share my story,
to share my story.
And one thing I really want toadd is that you don't really see
a lot of people like me beingsuper introverted, being an
international medical graduate,you know, speaking with an
accent, still having this dreamof pursuing medicine in the US.
(24:50):
So I just feel, like anyone outthere who's like me, who's been
a female, like a foreignmedical graduate, trying to do
this, you can do it.
All the friends or families orpeople I know who truly loves
the field, they will find a wayand they will find help with the
people surrounding them toprovide whatever they need to
(25:11):
make it to the end.
Ashley (25:14):
That is beautiful and it's so true.
There is a spot for you and weneed you desperately.
Medicine needs you, so thankyou so much.
Thank you so very much forlistening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
(25:34):
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
Any questions?
Let me know on Facebook orInstagram Access.
You want stories you need?
You're always invited to shadowme next.
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