Pooja: I remember at the time I was very rigid on what I thought I wanted to do, and then I took some time away from the world of research that I was in, in undergrad, and I realized, yeah, I do want to do other things. And I think that time was essential for me because it allowed me to kind of enter medical school with a way more open mind.

Casey: Absolutely like the emotional maturity that sometimes just comes with time and more experience. And so if you are taking a gap year for that reason, I think it doesn’t even need to be more shadowing or volunteering or clinical things, it can be something traveling abroad or something like that. It doesn’t even have to be medicine related. It’s just more of, let me get more life experience and street smarts. That can be really helpful and just also help make you more adaptable.

Pooja: The path to becoming a doctor is a whole range of things: exciting, confusing, anxiety-inducing, and gratifying, probably all at the same time. And the truth is that no matter how isolating it may feel, you’re not in it alone. Welcome to Pursuit of Practice, your go-to space for expert advice, real stories, and the kind of support that shows you what trusting the process actually looks like.

Hi everyone and welcome back to Pursuit of Practice. Today we’re talking to you about gap years, the decision to take one, and the potential for moments that challenge you, teach you, and shape your path in medicine. Today I’m joined by Casey, who has taken gap years both before and during medical school. She’ll share the choices she made, the surprises she encountered, the lessons she learned, and her advice for everyone listening. Whether you’re thinking about a gap year before med school, considering one during your training, or just curious about how a pause can fuel personal and professional growth, today’s conversation is packed with insights drawn from real experiences.

Now, without further ado, let me introduce our co-host this week, Casey Kuka. Casey has worked as a peer tutor in science, math, and Spanish for over a decade. She has also been a tutor and instructor with Blueprint since 2020, and her favorite part about tutoring is the opportunity it allows her to get to know her students as individuals and strategize ways to best help turn their weaknesses into strengths. She recently completed her third year of medical school at Case Western Reserve University in Cleveland and has spent the last year in Philly as a Benjamin Fox Orthopedic Research Fellow before her fourth year of medical school. Her friends would describe her as adventurous, disciplined, and whimsical, and in her spare time, she can be found rock climbing, trail running, or planning her next travel adventure. Casey, thank you so much for joining us.

Casey: Thanks for having me. I’m super excited to be here.

Pooja: Yeah, we’re excited to have you. So today we’re going to start by looking at what people ask on Reddit about gap years. All right? So this is our a feature. We’re trying to come up with the name for it, to be honest, but right now I’m kind of going for debunk Reddit or something. We’ll come up with a creative name. Maybe one of our listeners will come up with a better name and tell us. But first up, before we talk about the actual Reddit post, I want to talk a little bit about what is considered a gap year. So let me just go ahead and read this post.

So it’s from Behind Champion, I think is the username, but it says, what is a gap year? And the user asks, I keep hearing different definitions from different people. Would a gap year be applying May of your senior year of college and going through the cycle while not enrolled in undergrad? So for 2025 college grad, apply May 2025, matriculate fall of 2026. Or, this user also asks, is a gap year graduating and working for a year and then applying that following May and going through that cycle? So for a 2025 college grad, apply May 2026 and matriculate fall 2027. So Casey, what do you think?

Casey: Yeah, so I mean, those would both be considered gap years. To me, a gap year is any time you’re taking off between college and medical school. And I think what I did was the latter, right? I graduated and then I spent a year studying for the MCAT and then the following year is when I applied. So if you want to not take any gap years, you would be applying in your junior year of college, because that means you would graduate and then just immediately start medical school. So both of those would count as gap years. I think it’s anytime in between, just taking a break from your formal education.

Pooja: Got it. Okay, so that makes sense. So the formal definition is a gap in formal education, but it seems like the difference between the two options that this person kind of included is that there would be one-year gap if they applied the same year that they graduated. So graduate fall sorry, 2025, they graduate, then apply that same, I guess, summer, and then they matriculate the next year. But then if they were to apply a year after they graduate, they would inherently be taking two gap years. Is that correct?

Casey: Exactly, because for many reasons, the med school application process is an onerous one. It’s a long one. It takes a year to apply, which is crazy. So if you are waiting to apply your senior spring, you have to go through that whole year-long process before you actually matriculate.

Pooja: Got it. Okay, that makes sense. So we have another Reddit post that we’re going to talk about in a little bit, but for now, I want to talk about a couple of questions about you and your experience, Casey. So from what I know and from what you described, you’ve taken gap years both before and during medical school. So I kind of want to talk about both of those experiences. So let’s start with before medical school. What motivated that decision?

Casey: Yes, I was always interested in medicine. I took the pre-med classes during undergrad, but I was never fully sold on the idea of it, and I had never pursued the typical pre-med activities where you’re exploring clinical experiences and doing a lot of shadowing and maybe volunteering at a hospital. So I didn’t really have a strong reason for why I was interested in medicine. And by my senior spring, I decided, I think I am interested and I want to take this more seriously. So I completed the pre-reqs, but I still need to take the MCAT and kind of beef up my resume, because maybe we’ll talk about this, but I think it’s important to do things that interest you and not necessarily do things to try to get into medical school, but to some extent you do need those clinical experiences to say to kind of ground your answer of why medicine in something clinically related.

So essentially my senior spring, I was like, well, I do want to do this. I don’t want to spend my senior spring studying for the MCAT. So at that point, I kind of had to mentally accept that I was going to take two gap years because like we talked about, I would have had to apply then and I couldn’t because I didn’t have an MCAT score yet. So I committed to doing spending that first year studying for the MCAT, working in a clinical job. I ended up getting a job as a medical scribe, which I’m happy to yap about endlessly because it was awesome and I highly recommend it. I tried to get research jobs. I tried to get lots of different things, but the scribing is just what worked out.

And then I also worked as a rock wall manager, and then the year I was applying, that was COVID 2020. So I ended up also picking up a lot of other odd jobs just because as a scribe, I was non-essential personnel and they ended up keeping me there at the hospital, but I took on jobs at like, I worked at a whole foods, I worked at an Amazon warehouse. I was doing all sorts of things during COVID. And yeah, it was just quite the experience. So once I’d taken the MCAT, I had a lot more flexibility in my schedule too. So it was kind of fun to dabble in different areas. Now I’m going down rabbit holes now, but so that’s how I ended up taking the two gap years because I essentially, I needed to study for the MCAT and then I needed to build up my resume a little bit. And then it was kind of nice to have that second year to say, all right, I did the MCAT, I applied, and now I can also kind of enjoy life a little bit. Not that med school, you can still enjoy your life in med school, I will maintain that, but having an unstructured schedule, it’s kind of fun to enjoy that a little bit.

Pooja: Yeah, no, absolutely. So it sounds like you kind of made a lot of those two years that you took before medical school. And it kind of sounds like the motivating factor was one, the fact that you had taken a little bit of time to make the decision of finalizing like, yes, I want to go to medical school, and you wanted to set up the best application you could with clinical experiences and with your MCAT score. And it sounds like it ended up being worth it because you got a lot more than you kind of asked for with all the unstructured time that you were able to have.

Casey: Yeah, I would absolutely say so. I would say a lot of people now are taking gap years for various reasons. And I’ve never met anyone who regretted taking a gap year. I think there’s always the thought of like, oh, I’m losing a year of salary, right, down the line. But y’all, you got the rest of your life to work. Explore things now. I feel like it also helps to give a little bit of perspective going into medical school and not I think I was also definitely a little burnt out by the end of undergrad and it was nice to have that time off because by the time I did matriculate and start medical school, I was really excited and hungry to study again, which I cannot say would have been true if I had started right after I graduated. And I kind of saw that in some of my classmates who did go right through. Like kudos to them, like super impressive to apply during your junior year of college and get all that together in time and just go straight through. But they’re also a little burnt out and I think it helps to kind of go into med school with some resilience in that respect of like, okay, I’m fresh, I’m ready to like really learn this information and buckle down again and be a student again.

Pooja: Right.

Casey: So that’s another reason having that break is really nice.

Pooja: Yeah, I completely agree. And I also feel like we could talk about this a little bit later too, but I constantly hear the argument of, oh, you lose a year of salary. And I’m like, in the grand scheme of things, out of the number of years you’ll be working, it is a very small percentage. So yeah, I completely agree that is not enough of a reason to do it. Also just because your well-being is more important.

Casey: Exactly, your well-being and your personal growth and development. I think it’s huge to have. I don’t think you can put us a salary, a number on that of just like the experiences you can have outside of medical training, which is its own, you will have your own personal professional development in medical school and like things that will change you, but I think outside of that as well, it’s important to explore other areas and just learn how to relate to many different kinds of people. I think it really helps to be a well-rounded medical provider.

Pooja: Yeah, absolutely, absolutely. So I want to switch gears a little bit and talk about the motivations for your gap year during medical school because to my understanding, you took like a little bit of a research year. So tell me a little bit about that and what motivated that decision.

Casey: Yeah, so this one I was very certain I wanted to do orthopedic surgery. I just didn’t really decide again, I’m slow when it comes to making a decision about what I want to do because I like to figure out exactly what I want and then I go and chase it really, really hard. And so I didn’t fully decide orthopedics until maybe the end of my second year, early third year because I was trying to be open, trying to explore lots of different things because orthopedics is awesome, but orthopedics is hard. It’s a long journey to go through residency. So I wanted to be really sure that’s what I wanted to do. So I didn’t really make that decision until kind of late in the game and so what I should have been doing was kind of pursuing more mentorship opportunities and sponsorship opportunities and this is a whole other thing, but there’s a difference between mentors and sponsors. But I think I wanted more of that mentorship and I need I wanted to make sure going into residency, I was coming in swinging and like ready with a really strong application. I felt like I needed more research to do that.

I’m also interested in a career in academics and I wanted more research experience. I wanted to be able to see a project through from start to finish. I didn’t really feel like I had those skills. So I wanted that dedicated year for doing that. I wanted that. And then we had in my profile that I can be a whimsical person. That’s one word my friends would use to describe me. So part of it was also just like being ready for a new adventure after three years of med school. I’ve had such a great time. I think every year of med school gets more and more fun. But the part of me that was looking at research year opportunities, I was kind of like, ooh, I can go anywhere in the country. I can apply to all these places, experience a different academic medical center, meet with new mentors from different places. So to me it was kind of the adventure opportunity. I think that also played into it. So I just applied to a ton of random things that were like listed on OrthoGate, which is just a website that has orthopedic opportunities. And you know, I just googling orthopedic research year opportunities, sent out my resume out into the ether, had a couple of interviews and then the one that I ended up with, like I just felt like the mentorship was going to be really valuable. They were I wasn’t being seen as a research monkey. I was being seen as someone they wanted to turn into like a really good future orthopedic surgeon. Like they were really invested in me and not just me getting their work done for them. So that was really important to me that it would also be not just a productive year, but a year where I felt like I had mentorship and I was being kind of guided on a path towards, you know, becoming the best orthopedic surgeon I could be. So all that to say, I did the research to like enhance my application and also to explore and kind of step away from the grind of medical school and grind in a different way for sure. Just essentially getting ready for orthopedic residency applications.

Pooja: Yeah, that makes a lot of sense. So it sounds like between the two years, like there was some differences, right? Like your years before medical school, you were getting ready to kind of create an application that would be good for applying to medical school, but it sounds like the gap you’re during was to prepare for the next step that’s kind of coming ahead. Like you knew you were going to be choosing a potentially competitive path and you wanted to make sure you had everything. But also like not even like put competitiveness aside. It sounds like you had a skill set that you wanted to develop before pursuing surgery as a residency.

Casey: Absolutely.

Pooja: Which I think makes a ton of sense.

Casey: Yeah, that was a that was a perfect summary of my ramblings. I think, yeah, the undergrad one.

Pooja: Oh my God, no.

Casey: The undergrad one was the motive was definitely, I don’t have a good application at this point. I need to get it up to stuff. The medical school one was, I know exactly what I want to do now and I think I’m competitive. Let’s make it even better, but I also have this skill set that I want to develop for my future career. So it was probably a little more maybe pointed. I don’t know if that’s the right word. It was it was definitely… I think the gap years before medical school was just I was just like, I just want to get into medical school. And this one was I want to like I have a career path now and I’m trying to enhance, you know, what I’m getting out of that path along the way.

Pooja: Yeah, that makes a lot of sense. Like putting in the time now will hopefully allow you to be a productive researcher while you’re a resident as opposed to having to figure out how to do that while also pursuing residency, which sounds literally like the hardest thing you could possibly do.

Casey: Yeah, that’s the other thing is like I want to learn how to operate in residency. I don’t want to be figuring out research stuff like that. To me, that’s silly. And like that is a part of residency for sure, and it’s an important part. Like we have to be contributing to the literature, but if I have extra time, I don’t want to be figuring out how to run statistical tests. I want to go and you know, see another scrub another case of a distal radius fracture, something going on, you know. Yeah, so that was kind of a motivating factor as well.

Pooja: That makes a ton of sense. Okay, so thinking about your pre-med gap years, you had a lot of experiences and I think it was really cool to hear about the differences in like your structured versus your unstructured time. Out of all of them, what would you say were the most valuable for you?

Casey: Oh, that’s such a good question.

Pooja: Thank you…

Casey: In terms of preparing for medical school and just like future career path, the scribing was immensely valuable. I was working at the Children’s or no, the Women’s Hospital in Chapel Hill, North Carolina, and I was on the OBGYN service, like so it was labor and delivery and inpatient gynecology oncology. And those were two specialties I wasn’t really interested in, but it worked with my schedule because the shifts were 5:00 a.m. to noon. And then I could in the afternoon work my rock wall job or study for the MCAT, you know, whatever was fitting in that day because I will say even that first year was it was shift work, so it was a lot of flexibility in my schedule, which I don’t know if we’ll go back to this, but if you’re planning a gap year, if you can have a flexible job that lets you work and study for the MCAT at the same time, perfect. But anyways, I think the scribing was extremely valuable because I was learning how to use the electronic medical record. I was learning a lot of medical terminology. By the end of that, I was like writing notes, writing H&Ps, like all things you’re going to be doing eventually as a third-year medical student. And I had a really broad knowledge base of things that like my a lot of my classmates who had not had that experience didn’t have, you know, going into medical school and I think it kind of helped give me a leg up. And not in terms of like competitive against my other classmates, but just not having to spend as much time figuring some of that information out. Like when I started clerkships, I was like ready to go, jumped in, started doing notes. I was like this is all familiar to me.

And so it really facilitated a lot of the clinical side of things once I got to that part in medical school and just having some of that knowledge base as well, just like some of the pathophysiology of like pregnancy and labor and delivery. Like we were learning it during my clerk my pre-clerkship stuff and I was like, oh, I already know a lot of like this. This is great. Like this is a week where I don’t have to study as much. Like wonderful, love that. So I think it was really valuable in that sense of and also just like I was working with the resident so closely, you could see what life was like for a resident. And it wasn’t necessarily the specialty that I wanted to do, but residency is hard no matter what specialty you’re doing. And I think just being able to see what their work life balance or lack thereof was like and then also see the attendings, just having that perspective of the day-to-day workflow of here’s what your life will be like for three to five to seven years depending on how long your residency is. It was good to have that and it was helped confirm my decision like, yes, this is hard, but there’s also there’s a lot of camaraderie.

It’s a lot of hard work. There’s some bad days, but there’s also really good days. And I think like to me, I was like this is the path I do want to take because I felt like coming into my job every day as a scribe, I was like on the outside looking in at like the you know, the team because that’s just, I feel like medicine can be hierarchical and you know, if you’re not in the club, you’re not in the club, but just like me watching them work every day and interact with each other and like getting to sort of be a part of that team, it really confirmed to me, I was like, this is absolutely what I want to do. Like it’s going to be hard and it’s going to be long, but it’s absolutely worth it to me. And I think that was really important to have going into applying and like going through interviews is having that fire in my belly, I guess of like, I really want this, because I think it’s it’s hard to make it through medical school if you don’t have that like sureness in yourself, like this is absolutely what I want to do.

And I think my enthusiasm, I think also came across in interviews of like I was really excited to be trying to go into medicine. So I think it helped to have that perspective, I guess, just have more of those experiences that I hadn’t had before and maybe a lot of people do if they’re doing more volunteering or clinical things during undergrad. But for me, having that extended time because I was, you know, that was like my full-time job essentially, like having that the reps of just like going in every day and seeing what the grind was like every single day was really helpful. It was really revealing and it was really helpful for me confirming my decision to be like, this isn’t even a specialty I like and this looks awesome. Like, I absolutely want to do this. So it just gave me a lot of confidence going into applying because it’s also an expensive process. So it just it really helped me like fully commit, like full send it. Let’s do medical school.

Pooja: Yeah, no, absolutely. I feel like half of the argument that you were making for scribing in particular, because I know you talked about how you had a lot of experiences and you were pursuing a lot of things, but scribing is ultimately what fit your schedule. I feel like part of what, and again, I am not saying this as someone who pretends to know about anything involving the admissions process, but I’ve just talked to some people about our admissions episodes, which you guys can listen to if you’re interested. But I’ve also talked to people at like my school in the admissions committee and it seems like half of the reason why they want you to do clinical experiences is for exactly what you just said.

Like it is helpful and informative to know, this I do want this. I’m seeing other people do it and it looks hard, but I want it. Exactly what you said, like it is worth it. I think that is so important. So for people who are thinking about if they’re taking a gap year, what are you considering doing, I guess now as I feel like a strong argument for doing something clinical if you can fit something in your schedule.

Casey: Absolutely, I would totally agree. I’m very biased, but I would absolutely say, like you got to get on the front lines and see like, do I really like doing this? And I think a lot of it is also being honest with yourself too, because I think it can be hard to let go of that desire, right? Because I know I know people who have like been you know, full pre-med and then they actually got into it more and they were like, ooh, I don’t actually like this. Right. And like being honest with yourself because medical school is it’s hard. It’s hard even if you love it and it’s not going to be fun if you don’t like it. Yeah. So I think it’s important to like also kind of know yourself and be open to different experiences that you have and just reflect on how you feel in those experiences and like, is this something I actually like or am I gaslighting myself because it’s something I feel like I should like, if that makes sense.

Pooja: Right, no, that totally makes sense. That 100% makes sense. I completely agree with that.

Casey: And like not waiting until, you know, you’re doing your sub-I because I actually, I know someone, one of my friends from my school, he did a research year in Ortho. He was full Ortho bro. Did a research year in Ortho, started doing his sub-Is in Ortho, got through his sub-Is and said, you know what? Don’t actually like Ortho. Don’t actually like being in the OR. Kind of like chasing the maybe it was the perceived prestige of like having a surgical career. Realized he didn’t like it. Went and did a dermatology research year and is now applying dermatology and like doing a dermatology sub-I. So, wow. It’s never too late to change. I guess. But I think it would be helpful to have done that reflection at some self searching earlier.

Because again, it’s extra year of income lost and is that’s probably trivial in the long term, especially if you’re doing dermatology or orthopedic surgery, like whatever. But I think he’s now done like two or three gap years, which is like kind of crazy. But yeah, no, he’s awesome. He’s killing it. But I think having being able to do that soul searching early on can just help direct your path a little a little more. And you know, it’s not a bad thing to do that exploration. I think he has a lot had a lot of great experiences from his Ortho research and his sub-Is that he’s probably applying to dermatology now. So I don’t think there’s anything wrong with that exploration. Just to save others time, I think it would be nice if you had if you had done that reflection earlier, had that realization sooner.

Pooja: Yeah, no, that makes a lot of sense. So I think speaking of Gapier and medical school, I want to switch gears now a little bit to the gap year that you spent in medical school. I think right now you’ve returned into your fourth year, correct?

Casey: Correct. So I’m on doing sub-Is in Ortho now.

Pooja: Okay, exciting. So in terms of the gap year that you spent, I know that you did a research fellowship. Is there anything specifically about it that you think contributed most to your personal and professional growth?

Casey: Oh, absolutely. I think it’s called a fellowship, but now there’s so many. It’s just like a year-long research opportunity essentially where, yeah, I needed something to pay me to stay somewhere that wasn’t my med school. And so it’s it’s a fellowship for that reason because they paid me a stipend to live in Philadelphia for a year and do research. I think in terms of like personal development. So of course, professionally it was amazing because everyone was just coming at me with projects all the time and I was just be like, yes, yes, yes, I will do it. I will do it. Like I’m here to grind. But personally, I think it was also really valuable in terms of my future career because we got to also spend a day in clinic every week and we were also scribing and like we got to talk to patients, you know, get the history and we’d go and present them to the attending and then we would go and scribe and then we would write the note. So that was also super helpful.

I think personally though, it was nice to have the year of kind of it was a flexible schedule. Like we didn’t have to come into the office if we didn’t want to. It was very much like it was almost like my undergrad gap year in that sense where like I was working, but it was on my schedule, which was kind of nice to have because you don’t really have that in medicine. Your schedule is not your own until you’re an attending. So it was nice to have that year of just like picking when I was working and then getting to work at CHOP, at the Children’s Hospital of Philadelphia where I was just incredible because I called it orthopedic wonderland because everyone was so enthusiastic about what they were doing. It was really refreshing coming off of my third year clerkships where there’s a lot of jaded and burnt out people in medicine for valid reasons.

And so it was really refreshing to come and work somewhere where everyone was so excited about what they were doing, huge ortho nerds and just like really excited to help patients get better. And being around that was really refreshing. And the people I worked with, everyone was like on their A game, wanted to do their absolute best. And it’s really rare to find that kind of environment where everyone cares so much. And it just really pushed me to also always be trying to put my best foot forward, right? Like always trying to do exactly the right thing, being as detail oriented as possible. So it really challenged me to not just like learn how to do research, but learn how to do it well. And I feel like now I’m saying all this is more like professional development things. But I think…

Pooja: No, I think there’s an attitude that you developed, right? Like it became, it sounds like it was almost infectious. Like everybody was bringing their A game and so you were like, I am going to do the same. And I’m sure that now that you’re going into your sub-Is, you’re bringing that same attitude in. And I’m not saying that, you know, you may not have done it before, but now you have like an increased impetus to do so is what it sounds like to me.

Casey: Absolutely. Yeah. And then there’s also just like the relationships I formed with people there. Yeah. It was it’s really fun when your co-workers are not just your co-workers, but they’re your friends. They’re people you want to hang out with outside of the office. And Philadelphia is a super fun place to explore. I’m not a city person. I never thought I would be, but Philly was an amazing place to be for a year. The food is great. There’s great cycling and things to do all the time. So I just feel really fortunate that I had that opportunity. And now it gave me an idea of what I want in a residency program, right? Because I realized I was like, this is peak like work environment. Like this is what I want. Like when I’m on my sub-I, this is what I’m looking for is like, are they enthusiastic? Are they excited to teach? Does everyone want to hang out with each other? And there’s certainly places where I’ve been where I like was staying late on my sub-I because I’m like, I just want to hang out with these people. Like they’re really fun to be here on call with. Like I could go home, but also like kind of vibing right now. So I feel like it gave me that sense of like, this is what your work environment could be, which I mean, I’m going to be happy to get residency wherever, whoever wants to hire me, I’ll take it. But like having that sense of like this is what it could be was kind of eye opening in a way.

Pooja: It sounds like it kind of set the standard for you for what residency can look like.

Casey: Absolutely. Yeah.

Pooja: That’s amazing. I feel like that’s the encapsulation of what anyone what anyone would want during their gap year because it sounds like you grew in so many different ways and learned so much about both your clinical and your research goals and so, yeah, I’m that’s amazing. I’m so glad. I hope people who are listening hear that and see that can happen for them too. I want to circle back now to this actually, because I know you talked about how it’s like technically considered a fellowship because they paid you. Can you clarify for our listeners the difference between a sponsorship and a mentorship? Because you would alluded to that earlier. So can you just elaborate on that a little bit?

Casey: Yeah, I think, okay, so I think with what I what I was saying with the fellowship is it’s like a it’s a structured year program that they do every year. There’s three fellows that they award a stipend to. And there’s a couple different programs around the country that do that. I think there’s also research years where it’s more of an informal thing where you’re just working with an attending, maybe one attending one-on-one because I was working with multiple attendings at CHOP. There were like tons of different projects going in. So you might not necessarily be paid. It’s just like a research year opportunity. So I’m not I’m actually not sure if it’s formally a fellowship if they give you a stipend or if it’s just like they’ve formalized it as this is like a thing we do every year because the one I did has been going on for years. But with the mentorship versus the sponsorship, and this was something actually a mentor told me, and it’s also what kind of led me to do the research year was because I’m hoping to match at like specific places for residency. And it’s hard to do that in general. It’s especially hard to do that for Ortho. Like I’ll be grateful if I match anywhere for Ortho, but it would be great if I could match at like some specific places that I’m interested in. And I think with mentors, mentors are people who are guiding you and giving you advice and helping you like grow personally and professionally. I think sponsors could also be mentors, but they’re people who have ties and can help get you where you want to go. And I did not have sponsors and you need those, I think in orthopedics, unfortunately.

I’m sure any competitive surgical sub specialty, it helps to have people with connections that are in your corner. And I think that’s another reason I was doing the research year was because I had amazing mentors at my school, but they weren’t necessarily like well-connected people. And that’s what one of my mentors told me. He was like, I am not someone who could like, like people don’t know who I am because he was a fairly new attending. An amazing mentor, but he was like, I do not have the connections that would I you know, I could call a program director and be like, you should take her. She’s awesome. So that was a part of the impetus to do the research year as well was to get people who had those kind of ties in my corner and maybe give me another leg up, you know, outside of my application of having someone who knows everyone in the small world of Ortho and could say, she’s a really hard worker. She’s awesome. Like definitely consider her for your program sort of thing.

So that’s kind of what I was thinking of when I was mentioning like mentors versus sponsors because it’s something I wish I had known earlier in medical school. And I’m very happy with how things worked out. I’m so glad I did the research year. Again, like it’s probably one of the best decisions I ever made in medical school. But I think if you are not hoping to do a research year, like I don’t think it’s absolutely necessary to take a gap year in medical school. It’s a lot of fun. I would recommend it. But if you have that, if you’ve set things up earlier in your medical career of like doing research in the specialty you’re interested in, finding mentors and sponsors, like people who have some connections and can help get you where you want to go, you might not necessarily have to be taking that time off or feel like you have to take more time for your training. Not everyone has the luxury of just like going and gallivanting off for a year to do research. You know, like people have other, you know, things going on in their lives potentially or their families, they have reasons they want to just get through their training. So just like having that knowledge and starting earlier in terms of getting people in your corner, I think would be really helpful.

Pooja: Yeah, absolutely. And I’m so glad that you mentioned that too, because one of the questions that I had for you is looking back is there anything that you would have done differently? And it sounds like you would have tried to figure out, like not necessarily that would have changed your decision on taking the gap year for you specifically, but that you would have wanted to know that there is a difference, especially for surgical subspecialties. And I honestly think that this is kind of, it applies to everywhere. Like I’m applying internal medicine and I’ve kind of been told like similar things that it is always helpful to have somebody who knows people in your corner.

Casey: Absolutely.

Pooja: I think that’s true for literally any specialty regardless of how competitive it may be.

Casey: Absolutely. And it’s a little unfortunate because you know, there’s so many well-qualified people. It’s just hard to stand out now. Like everyone is amazing at what they’re doing. Like and I’ve met so many incredible people on my sub-Is. I’m like, wow, I’m so glad we’re going to be future colleagues or like, wow, I hope they end up here. Like, you know, like it’s just so many amazing people. So it you have to have something else, I feel like, to really help get your foot in the door at a program you’re interested in.

Pooja: Absolutely, absolutely. I couldn’t agree more. And again, it’s like we you said, unfortunate part of the system, but everybody’s amazing. And so you kind of have to learn a little bit about the game. And that’s honestly, truthfully, Casey, like this is kind of why we have the podcast in the first place because this is the kind of thing that like it’s the thing that no one tells you when you start medical school. And so I’m glad that you’re bringing that insight that you can only get by going through that experience. So thank you for sharing that.

Casey: Absolutely. That’s why I like to do these things because I’m like, I feel like I’ve been it’s like, you know, flying by the seat of my pants throughout this whole process. So if I can help give someone some insight earlier.

Pooja: I mean, listen, hopefully someone will start thinking about sponsorship a year earlier than we did and then it’ll our mission will be accomplished.

Casey: Mission accomplished, perfect.

Pooja: So I want to transition a little bit into because you talked about insights, I want to know during any of your gap years, so this is including the pre-med ones, including the med one, is there anything that you found to be like an unexpected challenge that you didn’t foresee coming?

Casey: Ooh, uh, I think, I mean, COVID, definitely.

Pooja: True, true, true, true, true, true.

Casey: But other than that, I think it was anything unexpected challenges.

Pooja: I mean, if you didn’t, that’s very slay.

Casey: Yeah. I’m trying to think because I’m sure there were. I think honestly, I think COVID kind of overshadowed anything else because there was just a lot of uncertainty of like I was doing the scribing job and then I thought I was going to get fired because like I’m not essential. like, you know, I’m I’m nice to have for sure. I can make your life faster and easier if you’re writing notes, but not essential to the operation. So that’s when I was like scrambling and looking for other weird jobs. So like I worked at an Amazon warehouse. That was horrible. So I switched to like a Whole Foods, which was more fun and I learned a lot about like cheese samples because I’d befriended the cheese guy and he would give me samples. Anyways, I think that was the big one because also my goal for the gap years was to have some fun. I think it’s important to make time for fun. You know, going back to the whimsical side of things. Like even during my research year, our mentors and sponsors, they were like, take vacation. You must take vacation. It’s like I went to Iceland for 10 days in the middle of my research year. 

Pooja: That’s amazing. 

Casey: Yeah, it was awesome. I went to Costa Rica later in the year. I got to do a lot of fun stuff. But during undergrad, my plan for my two pre-med gap years were first year grind, MCAT apply, second year, switch to maybe a more cush job. I really liked the scribing, but it was it got it got to be a lot with like, you know, the hours and everything.

Pooja: Yeah, 5:00 a.m. to noon is intense.

Casey: It’s pretty intense. Nothing compared to an actual resident’s hours, but at that time I was like this is a lot. And there’s also a point where you kind of as a scribe, you kind of reach a ceiling and I was like, this isn’t really challenging anymore and it’s it’s stopped being fun. Yeah. So that’s when I switched to doing I was I kind of transitioned to doing more of the blueprint tutoring. So I was very fortunate to like get to work with blueprint and do a lot of content stuff. But my plan for that second gap year while I was, you know, waiting for application stuff and interviews and everything was like, I’m going to travel. COVID was like, no, you’re not. So, um, I think I got to do some road tripping and stuff, but I guess that goes back to like the personal growth as well is just getting to explore my enjoy my hobbies, spend a lot of time with friends that I might not have necessarily done, formed a lot of really lasting relationships. That’s what I got to do during my research gap year as well. Like I was able to make time for that.

And I think that also helped me form a foundation of like good habits for going into medical school because I think it’s helpful to be able to prioritize your time very well and have some discipline and because I think in medical school, it’s easy to study all the time because if it’s pass fail, I mean it depends on your curriculum. For my school it was pass fail and I felt like I could keep going or I could I know enough. I could say I could stop. I feel like I’ve studied enough. Let me go and rock climb or like catch up with a friend. Like I don’t need to sit here and study all day. So I think being able to have built those foundations during my gap years of like finding that balance of how much do I actually need to work? You know, and then let me still make time for fun because I absolutely think in medical school, through residency, through all of it. Like even on sub-Is, I still make time to like work out or do one fun thing a day even if it’s for like 20 minutes. But I think having built those habits early on during my gap years was super, super valuable because going into medical school and like the more intense parts of it, I already had those healthy habits to fall back on.

Pooja: Yes.

Casey: So I think having had that time to develop those has been really, really valuable in terms of just like my mental and physical well-being and maintaining it during some of the more challenging and intense parts of medical training.

Pooja: Yeah, no, absolutely. I’m really glad that you mentioned that too, because I kind of wonder, I’m curious. Is there anything that you started doing during your gap years, either the med one or the pre-med one, that you started doing it and you were like, whoa, I wish I had started doing this from the very beginning of my gap year?

Casey: A really disciplined sleep schedule.

Pooja: Yeah, fair.

Casey: I will say that’s like I call that the secret to my success because if I can if I can maintain my sleep schedule, which isn’t always possible on like sub-Is and certainly not during residency, but if I’m super protective of that, I’m just a lot more productive if I just have enough energy in the day to be focused and get done what I need to get done. I think prioritizing that and it’s something I feel like a lot of people don’t prioritize. They’re like, oh, you know, I’ll just stay up super late and finish all this stuff. And it’s hard. It’s hard to build that habit. Like it takes a long time to get into a routine of like, I’m going to bed at this hour every single night. It’s really it’s challenging. But I think having that has helped me have the energy I need to like get what I need to get done during the day and not feel like I have to, you know, grind super late into the night because honestly, I don’t function well with not that much sleep. I’m getting better at it thanks to our over 24-hour call shift, but ideally if I don’t need to be staying up for 24 hours, that’s great. If I can get at least six to seven hours of sleep every night, we’re killing it. So that would probably be one thing is just being disciplined in terms of taking care of yourself because I think at the end of the day, as much you know, I love orthopedics, so excited to be going into it, love medicine. It’s still a job and you still have to take care of yourself to take care of patients.

And I actually someone, a scrub tech said that to me the other day on one of my rotations, he was like, like because I think the fellow was like, have you eaten today? And I was like, no, we’ve been in cases like for 12 hours. I haven’t had time to go and eat. And the scrub tech was like, get out. Go eat. You can’t take care of patients if you haven’t taken care of yourself. And I was like, wow. That’s super profound. You’re so right. I didn’t even think about that. Like, oh yeah, I can’t really take care of someone if I’m like vazoling because I haven’t eaten since 5:00 a.m. Right, right. 

Pooja: Yeah, it seems counterintuitive. But no, that makes that makes a lot of sense. That’s that’s awesome. I guess now that we’ve kind of talked about lessons that you kind of learned during your gap year, things that you want people to kind of protect and maintain, you know, obviously, chiefly their personal well-being and their ability to protect their own, like, I guess, not safety, but their own mental and well-being hygiene, if that makes sense. Like their mental and sleep hygiene. How would you compare the benefits and the drawbacks of taking a gap year? Because we kind of talked about like one of the biggest misconceptions, which is that it’s a year taking away from your income or whatever. But what do you think are the drawbacks of taking a gap year before, let’s start with before med school. What are the drawbacks of taking a gap year before medical school?

Casey: Hmm. I mean, I feel like that is a that is a valid concern, right? It is taking away a year of your future salary. I just think in the grand scheme of things for me personally, I don’t think it’s that significant. I think the drawback is you have to find I had to find something that I could, you know, work and make money and find somewhere to live and sometimes it’s nice to have the structure of school. Just like here’s what you’re doing every day. Someone’s telling you what to do. With a gap year, you kind of have to you have to you have to set your own schedule and be proactive about finding those opportunities, which I think can be challenging. Because it did take me some time to find a position because like I said, I applied for research stuff, I applied for, I think other clinical thing, medical assistant stuff, but coming out of undergrad with a biology degree, I have no skills. I didn’t do that much research either. So ultimately I ended up with the scribing, which I’m super grateful for, but I think it’s it’s hard to set up things sometimes, especially because again in undergrad, certainly didn’t have any mentors or sponsors. So if you had connections that could help you get some sort of position for that gap year, I think that would be great because I think what could be a drawback is you could spend the initial part of the year kind of floundering and trying to find something to do and like fill your time.

So, I don’t know if that’s so much a drawback necessarily, because that’s part of the exploration process maybe. But I think that would be one thing is like if you’re like someone who’s used to having such a structured schedule in undergrad and then having to go and kind of find those opportunities to fill your year and fill out your resume and also make time to maybe study for the MCAT if that’s what you’re doing. That can be challenging for sure. And I don’t know if that’s necessarily a drawback, but it’s it’s certainly something to consider is you definitely have to be kind of take the initiative to find those opportunities and that can be a challenging and frustrating process for sure.

Pooja: Right. Right. Yeah. No, that makes that makes a lot of sense. And I also think that one of the things I also want to address is, you know, in terms of the whole discussion about gap years and not, I think there are some people who have extenuating circumstances, right? So like if you’re on student loans and you can’t afford to start paying back your loans, so you have to kind of continue being a student. That is an extenuating circumstance in which, you know, that is a very important factor to consider. And I just I wanted to mention that as well because I do I do know some people who were debating taking a year and decided against it because of their student loans and because of the fact that they couldn’t afford to like start, they couldn’t afford to start paying them off until they had like doctor money, which is so real. It’s so fair. But yeah, I think that’s an important factor to consider as well. So I want to ask you a little bit about now the benefits and drawbacks of a gap year during medical school. So like what are the drawbacks of that one? Because I think that one is more contested, I found.

Casey: Totally. It’s also becoming a more popular option just as, you know, as residency gets more and more insanely competitive, just people looking for a way to kind of stand out. But I think honestly, one of the big drawbacks for me was I didn’t get to graduate with my original med school class. And for me that was kind of a bummer. Like some of my best friends now are from that medical school class and I was really so excited to like open my match day envelope with them, like graduate with them. Yeah, I’m going to get emotional talking about it, but I was like, we’ve been through the gauntlet with these people and I’m so excited to like, you know, see us all go off on our own ways together. But we’re still in touch. They’re all in their intern year now and we still make time to chat with each other. But I think that was one drawback is, you know, the people that you’ve been you’ve spent the last three years with in like such intense circumstances and situations, you don’t get to graduate with them.

Luckily, I have friends in my new class and a lot of people actually from my old class took gap years as well, but that was a drawback for me. 

Pooja: An important one too. 

Casey: Yeah, absolutely. And I think again, the argument could be made you’re again, losing another year of salary and you do have to still pay tuition. At least at my school, we still have to pay a very small portion of our yearly tuition, but you still have to pay tuition. So like that kind of offset some of the stipend I was getting. So that is something else to consider is like you are still, at least I was still technically a student at my medical school.

Pooja: Okay.

Casey: And for that to take place, I still had to pay like a percentage of the tuition. So that’s another thing to think about is like if you’re already, I know, I’m already super in debt, hurray, you’re going to be a little more in debt even though it’s offset by the stipend, but it was still kind of like, oh man, this is cutting into my Philadelphia money. But so that’s that’s something else to consider. I don’t think every school is the same in that respect, but for me that was another thing to consider.

And then the fact that I had to move, you know, I was moving to a completely different part of the country after I had been in Ohio for the past three years. So moving is annoying. So that’s just something else to for me it was worth it. I’m like, hurray, like yay, exploring, whimsical we. Again, something else to think about because that’s a lot of more, you know, more planning. I had to I had to so back to back too because I finished clerkships, took step two, was moving to Philadelphia, you know, you had to pack during all of this. So just a hectic time. So just things to like, you know, have be planning for and consider as well of like how that’s going to affect you and like how feasible that’s going to be for you because I was also looking at opportunities that were like across the country. So like if I ended up on the West Coast, that would have been way more challenging because I could just drive from Cleveland to Philadelphia and you know, U-haul all my stuff over there. But if it had been out somewhere in like California or something, that would have been a lot more challenging, like still doable, but just things to consider of like, you know, the costs you might have you might incur like in terms of money and time of like getting that all set up. For me it was absolutely worth it. Like again, would do it again in a heartbeat. Best decision ever. But those are certainly things to consider.

Pooja: Yeah. Yeah. No, absolutely. So it sounds like a lot of the factors that are drawbacks for during medical school is personal. So like related to your own financial situation, related to your own family situation, if you if you have children, if you have a significant other that is drawn to a specific location, like can you actually move? Or if you’re in a specific school, like can you actually take that year? So it sounds like although there are a ton of benefits, the drawbacks seem to be more personal than professional.

Casey: Yeah, at least for me they were. I think there’s really no professional drawback that I can think of. If you’re taking a gap here unless you do it and you’re you don’t do anything productive, that’s bad. But like you got to crank some stuff out for sure. You want to be careful about the opportunity you’re choosing. You want to make sure whoever you’re working with, you’re going to definitely be productive. I know that can happen too is sometimes you get something set up and really not being as productive as you need to be because if a school sees you took a year off to do research, they want to see that you did some research. So being really careful about, you know, if you’re interviewing for positions or looking for positions, seeing if there’s any prior folks who have done either that fellowship or worked with that attending before, looking at that attending’s productivity and making sure that, you know, you’re going to get a couple papers out of this year at least.

Pooja: Yeah, no, that makes a lot of sense. And I appreciate giving an objective metric too, because I think the whole definition of what exactly is productive in a research world can be can be can be confusing.

Casey: It could be. No, yeah.

Pooja: Yeah, because like what exactly does like more papers mean, more presentations or whatever. So I appreciate you giving a number. Just like a couple, like two or three, it sounds like, right? Or good?

Casey: Yeah, I mean, that’s also that’s going to get me onto a rant of like quality versus quantity because there’s this push to like turn out a bunch of stuff. So I think if you if you publish like 50 papers, people are going to raise their eyebrows because that’s impossible first of all. And second of all, like what’s the quality of that research and how involved were you? Like is your name just on a bunch of stuff? Because I think the goal also is you’ve done the work for the research and you can talk about it and you can talk about it with a lot of knowledge and in depth and you know, you can talk about the technical parts of it and hopefully with some enthusiasm because hopefully it was a project you really like. So I think I’m a proponent of quality over quantity. If you get like three or four papers out, you know, some abstracts, some posters hopefully, I think that’s great and it’s all stuff you can speak to. And if you get more than that, that’s just icing on the cake. I think the key is that you’re able to talk about it and that you were significantly involved in it. Because there’s certainly projects that I think I someone just needed my name on something to be able to like present it. I don’t know what happened, but they put me up they put my name on a project that I had no involvement in. And that did not that is not on my CV. I that did not go in my residency applications. I was like, if someone asked me about this, I have no idea what this project was. Like I’m not just adding it as like a number on my CV.

So I think as long as you’re producing things that you know, you were significantly involved in, if it’s only, I should say only it’s hard to get two or three papers published in a year. The publication process takes a long time. So as long as you got stuff like in the works, like I think by the end of my year, I had I’d written a lot of papers and but you know, it takes attendings time to review things too. So as long as you have stuff in the pipeline, you’re going to look super productive throughout residency too. That’s the other bonus. Research is the gift that keeps on giving. There’s all these databases that people are using that now they’re going to have my name on them, you know, whatever projects come out of them. But yeah, I think as long as you’re getting three or four quality papers out, some abstracts and it’s stuff you can talk about, I think I would count that as a productive year because it’s also like what did you get out of it? It’s not just what did you produce, but what did you learn from the experience? What are you taking away from it? And what are you going to apply in your future career?

Pooja: Yeah, and I’m glad you mentioned that too because I think that, you know, there are alternative things that you can do as like a gap year during medical school that aren’t just research. So like you can get another degree like an MBA or anything like that or I guess you can also do like a volunteer fellowship. You can do like an abroad program where you like do clinical work in a different country. There’s the world is your oyster, I think similar to when you’re applying to medical school, there’s a lot that you can do, but I think the emphasis on you have to do something that shows that you are goal oriented can accomplish that goal is really important. And that’s kind of what it sounds like you set out to do during your research year and that you were successful at doing so.

Casey: Absolutely. And I think that kind of makes me think of I think going into medical school, I thought my life was over. I was like, okay, just going to be grinding all the time, no time for anything else. And really what I’m learning is like medical training and a career in medicine in general, it’s what you make of it. I mean, there’s certainly there’s a lot of structure and there’s certainly things you have to do and your days are going to be busy and some weeks are going to be worse than others. But I think in terms of like the big picture trajectory of your career, once you’re an attending, you can kind of shape your practice how you want. You can work 90, 100 hours a week if you want to operate all the time. You can work 40 hours a week if you want to be in private practice and just do a couple cases every day and have clinic once or twice a week.

You can do a lot of picking your own adventure in medicine. There’s lots of like you were saying, there’s so many gap year opportunities or even it doesn’t even have to be a full year. It can just be like clerkship electives or you know, things you’re filling your breaks with during medical school and then in your actual career as an attending. Like there’s certainly you’re your practice, you can shape it as you want. You can do a lot of mission trips and you can do more like outreach or like policy things or research. It’s kind of like you can shape it as what you want it to be. And I think that’s something I didn’t realize going into medical school is like I was kind of like there’s this standardized like, you know, grind, you work, this is how much you’re going to work. It’s really up to you. And I think that’s just what makes it such an exciting career. So many opportunities.

Pooja: I agree. I agree. And I think there will be several episodes in the future where we talk about like the options of how you can kind of hybridize your clinical career with I like to call it like the MD plus options of things that you can do. Right? It’s not mine. This is like a slack channel that exists. It’s called MD plus. And it’s like people who are interested in like doing business stuff while also being doctors. So I’m stealing it from them, but I like it for kind of the catch all for anything else. Like you could do education, you could do policy, advocacy, research. The world is your oyster like you said. And I think it sounds like the research year or the gap year can be an opportunity for you to explore those things. And so for you, you were interested in academic medicine and so you wanted to explore that specific opportunity that you know is available for you when you become a physician yourself.

Casey: Absolutely. Yeah.

Pooja: Amazing. So, okay, I want to head back to Reddit because it’s my favorite place to be just kidding. But sometimes it is fun.

Casey: We all, we all lurk on Reddit.

Pooja: Yeah, we all lurk on it. We shouldn’t, but we should I think it’s everyone’s guilty pleasure, I think.

Casey: No, 100%.

Pooja: But I want to talk about this next question and I want to hear your advice for the student about the advice that they’ve received and specifically about, I think this post is about someone who’s saying like the gap here is a necessity. So I’m just going to read the post out loud and then we’ll talk about it. So it’s from CleeYour. I don’t know. That’s the username. But the topic is, has the gap here become more of a necessity than a choice? Specifically they say, med school applications are so competitive. I was told that I need an extra year to bolster my resume even with a 3.89 GPA, 100 hours of volunteering, 60 hours of shadowing, 100 clinical hours, and 70 hours of research. I also had a leadership role in my club and I tutor as well. I haven’t taken the MCAT, but I have been advised to take a gap year to do more shadowing, clinical hours, and get some quote unquote real research. In parentheses they’ve include my current research hours are psychological research. There’s no end parentheses. That’s a typo on their end. I’m just calling it out loud because I’m the worst. I know a lot of pre-meds who say they need the gap year to bolster their resume and I understand some people want the gap year to take a break from medical school, but is it now a need?

Casey: Wow, okay, I have so many thoughts about this. First, CleeYour, you’re killing it. So many hours. I don’t think I had that many volunteer hours or any like I’m like super impressed. Second, real research, psych research is still real research. That’s awesome. Yeah. And I actually think it makes you stand out a little more because it’s not so cookie cutter, like basic science research or, you know, clinical research. I think that’s cool. I think what and again, I don’t know anything about med school admissions, but I think what they do want to see is that you are genuinely excited to be pursuing a career in medicine. So I think if the hours that you have accumulated thus far have given you some experiences that you can talk about with enthusiasm and say, you know, here’s what I saw, here’s what I learned, here’s how I grew from this, because I think that’s what goes further is like the quality of those experiences and what did you get out of them?

I don’t think it’s so much acquiring more numbers. Like if you were sitting at a desk for volunteering and you’re like, you know, sitting at a computer and not doing anything, but you have 200 hours of that, is that useful versus if you have like 10 hours where you were volunteering with patients and you were talking to patients and seeing them and you know, you’re hearing a lot of stories and you’re seeing things that really touched you and made you think about things, you know, made you feel things, that is way more valuable in my opinion. Like I think being able to talk about it’s how you’re able to talk about your experiences and what you learn from them.

I don’t think the gap here is necessary unless you feel like you need more experiences to kind of flush out your idea of why am I doing this and what are the qualities that are going to make me a really good doctor that I took from these experiences. So for me it’s a lot more about the quality than the quantity of the numbers. And again, I don’t think it matters what kind of research you’re doing. I think doing research is showing that you’re like intellectually curious, which is a nice way to say you’re a nerd because if you’re going to med school, you’re a nerd. I’m a nerd. Yeah, we love it. We love the studying. But I think it doesn’t matter exactly what you’re doing is how you can talk about it.

Like honestly, I had the scribing experience and that was super important, I think for showing that I was, you know, committed to furthering my understanding of what clinical medicine was and that I was interested in it. But most of my med school application was about rock climbing. It was in my personal statement. I worked as a rock wall manager. like all my activities are rock climbing. I had some volunteering stuff. So like, but it was the skills I had taken from that I said, here’s what’s going to make me a good physician. Here’s what’s going to help me care for patients and be a good team player and a good leader. And I think it was more about, you know, those experiences I had and the richness of those experiences. I didn’t have that many shadowing experiences. I think I had maybe like 20 hours total, but they were they were really like intense. Like I was super busy during those shadowing experiences, but they got to talk a lot to the attendings. I saw a lot of things. And I feel like they were they were they were high quality. It was super high value time. I wasn’t just twiddling my thumbs like sitting in clinic waiting for things to happen. So I think all that to say it’s more about the quality of your experiences and if those hours have given you experiences that you feel you can talk about and show that you’re going to be an amazing doctor, I don’t think you need to feel like you need to take a research year just to get more hours because I do think there’s a point of diminishing returns where you’re like, well, why are we getting more hours? I know I want to be a doctor. I know why I want to be a doctor. Like we don’t need to keep shadowing. Let’s let’s get in and let’s start doing it ourselves.

Pooja: Yeah, no, absolutely. And I also will say that although I am not an admissions representative myself and I am by no means an expert in that, we do have some episodes with Holly Proffitt who is one of Blueprint’s admissions med school admissions advisors and she served on admissions committees and been involved with that before. She’s done our episodes one, episode four, which is our last episode, and then we’re recording another episode with her in a little bit, but she talks a lot about a similar thing that you’re describing, Casey, which is that quality over quantity is important and what’s more important than how much you did was about your ability to speak on it. So I think you’re absolutely right.

Casey: Wow, I feel super validated because that’s just me making things up. So I’m glad an expert…

Pooja: Yes. Yes. No, that’s I this isn’t this is a transitive property. So I’m not an expert, you’re not an expert, but Holly is and Holly told me, so I’m telling you.

Casey: I wish I had these episodes when I was like going through all this.

Pooja: Yeah.

Casey: That would be so helpful.

Pooja: I mean, listen, we’re doing residency applications soon, so maybe a lot of a lot of it translates, I think. A lot of the topics that pre-meds are worried about are the same things that med students are worried about. And I think you’d be worried about it again for residency and to fellowship. So it’s kind of just the same thing over and over again.

Casey: It never ends. You’re going to be always worried about standardized exams, applying for things, people evaluating you. It just it is what it is.

Pooja: Yeah, you just get better at being used to it, I think.

Casey: Yes, yes, with all the reps, you just you kind of habituate to it. It’s all about the reps.

Pooja: Absolutely. Is there anything else about that Reddit post, Casey that you think we should address before we move on to our final set of questions?

Casey: Oh, I think I think I ranted on all the things I was thinking about. The quality. The not dissing any other kind of research. It’s all valid research. Be enthusiastic, as long as you’re enjoying what you’re doing. And I think that’s why I’m such a big proponent of like, like there’s certainly a certain level to where you need to again, like do clinical activities and show your interest and get those experiences. But I think the bulk of your activities can be things you enjoy and as long as you’re getting something out of it, it’s just more fun to talk to someone who’s enthusiastic about what they’ve done. So even if it’s not, you know, exactly medicine related, if you’re passionate about it, it’s going to come across and like people interviewing you are going to really it’s going to be more fun to talk to you because, you know, you’ve just had a fun experience that you want to share.

Pooja: Yeah, no, absolutely. And I also will say, I think this may not be, I can’t, you know, read the mind of the advisor who was advising CleeYour about their application. But I do think that there is something to be said about the emotional maturity that a person has before they go into medical school. And I think that you know, there are a lot of things that contribute to a person’s emotional maturity, their life experiences, time, right? And I think sometimes, if you haven’t had the life experiences that kind of give you the emotional bandwidth that allows you to succeed in medical school, time can also do that. And so there are people who I’ve met and even I was kind of advised to take a gap year. And I don’t think it was funny. My advisor didn’t want to tell me this specifically, but I could tell that she was kind of getting at the, you should like grow up a smidge more before you go to medical school.

And I think it was totally fair. It was totally fair and sound advice. I did take a singular year and I did think that year made a difference. Like I remember at the time I was very rigid on what I thought I wanted to do. And then I took some time away from the world of research that I was in undergrad and I realized like, “Yeah, I do want to do other things.” And I think that time was essential for me because it allowed me to kind of enter medical school with a way more open mind than I would have if I had just gone straight through. So I think if there are situations like that, um, that may be underlying what you’re talking about, or what that admissions person was kind of talking about, but again, I can’t say for sure. But I do think it’s an important factor for people as well. Like are they emotionally ready to do medical school? Cuz it’s challenging in a lot of ways, honestly.

Casey: Yeah, I’m so glad you brought that up because that is something that I was also thinking about is like the emotional maturity and perhaps lack thereof I’ve seen in people who like went straight through. And I think it’s just having more time or more life experiences outside of the structured environment of school that you’ve been in for so many years. Right. It helped give me a little bit more of a better perspective too because like I feel like even the hardest days in med school, I was like, “This is still, you know, this is still an awesome job that I will get to do.” And I feel like some of my classmates are like, “Ah, I should have gone into like construction or something, you know, worked a desk job.” And I was like, “No, no, no, no. I you, you do, I promise, having done some of those jobs, you do not want to do that. This, you are sitting here getting to study in the air conditioning. I promise this is much better than some of the other jobs you’re talking about.” Which, that’s just like one small part of it. I absolutely like the emotional maturity that sometimes just comes with time and more experience. And so if you are taking a gap year for that reason, I think it doesn’t even need to be more shadowing or volunteering or clinical things. It can be something, you know, like people have done like Peace Corps or, you know, traveling abroad or, you know, something like that. Like it doesn’t even have to be medicine related. It’s just more of like, let me get more life experience and street smarts. I think that can be really helpful and just also help make you more adaptable because a lot of getting through medical school or I should say thriving in medical school is learning how to be adaptable because I also, I would say I was a very rigid person and you know, I’m very controlling. I want things a certain way and like learning to be more flexible and just kind of go with the flow and roll with things that are happening is and not lose your brain, like lose your mind when that happens, just being like, “All right, this isn’t, this isn’t perfect, but it’s fine. We’re going to make it through.” I think just developing that does take time and it takes some experience outside of, you know, a structured classroom environment.

Pooja: Right. I also want to transition a little bit now into the questions that we kind of have for you and I think you’ve kind of answered one of them already, but it’s about like activities, hobbies, or jobs that you think are especially valuable to pursue during a gap year. It sounds like from what you’ve said that anything that requires you to be adaptable and kind of like pushes you outside of the comfort zone that you’re normally in are valuable to pursue. Is there anything else?

Casey: Yeah, I think that, which isn’t like super tangible. I think customer service jobs, great. Because a lot of medicine is customer service. We had a, one of our lectures, I don’t remember what, he was talking about, but he was like, “Your patients are much less likely to see you if they like you.” So like honestly just being able to talk to people and relate to people, which is not easy to do if you haven’t talked to a lot of people because college is kind of a bubble. You know, you’re around a lot of peers who are probably more similar to you than you think. Certainly some, you know, you’ll certainly have unique classmates, but you’re not talking to a variety of people of different ages and different backgrounds and ethnicities. And I think working customer service jobs that are kind of putting you at the forefront of humanity sometimes, just being able to interact with people when they’re not at their best. I think is a really valuable skill to have going into medicine and being able to, I don’t know if I want to say like take control, but like be able to navigate a conversation with a patient and their family member. And I’m certainly not an expert at this. I have a long way to go, but I think having had experiences, it sounds silly, but like in a whole foods, just interacting with customers or at the rock wall, interacting with people coming in at the desk and helping train people and like teaching classes. I think just having those interactions with people are super important for kind of building those skills and kind of that emotional intelligence as well of like just working with other people and I guess more sensitivity too.

Pooja: Yeah, no, absolutely. Absolutely. Now, in terms of the gap year itself, how can people, I guess ensure that their gap year supports their long-term goals? Because I know you talked about how you had some goals for all three of the gap years that you’ve taken, but how can people kind of ensure that’s going to happen to them? Because I know one of the things that people worry about is kind of losing momentum. Like they have structured time, sort of like you said, they have structured time, then they’re unstructured and they’re worried about losing the momentum that they had when they had more structure in their time.

Casey: Totally. Yeah, I think it’s super important to have a plan. It starts with those goals. So for me, I mean it just started with like, I need, I need to take the MCAT. I need to do something clinical and I need to, I did some volunteering as well of just like little random things and then I need to also make money because the scribing, scribing pays like peanuts. So that’s why I was also working the rock wall manager job, because I was like, “I have to pay my rent.” So I think your goals and your needs, you need to like set up what your goals are. Like, “Okay, I’m going to take MCAT, I need to apply to med school.” And then I think trying to stay disciplined and rigid with those goals. So I just talked about being adaptable, but I think some things like you pick an MCAT date and you say, “This is the date, this is when I’m taking it.” Because I will say just doing a lot of tutoring, I see a lot of people let things get in the way and they’ll push it back and push it back and like it messes up your timeline. And I think it’s really important to try to be strict with yourself and say, “This is when I’m taking it. I am going to stick to this date as best as I can.” And of course, like sometimes life circumstances just come up and happen. But I think, to the best of your abilities, being strict with your goals and your timeline of like, you know, I know I need to apply to med school at this time, so I need my MCAT back at this time. And then you have to factor in what other considerations do I have? Do I need to work to support myself like I did? So I had to like find a job that would be flexible. So like with the scribing and the manager job, there were other people working in those positions where I could say if I needed, you know, if I needed a couple days where I was like, “I need to like really hunker down and study,” I could switch shifts with people. Like it was very flexible. So I was very lucky to be able to find jobs that would let me factor in some flexibility and say, “Okay, these are MCAT study days.” And I use that time as precious. I was like, “Okay, I’m not working today. I’m, you know, not making money today. I have to study for the MCAT today.” Like I don’t have a choice. Like that’s the reason. I don’t get to go gallivant and like have fun. Like this is the day to study. So kind of like building that self-discipline I think. And that was something else that was valuable with the gap years is saying, like this is what I know I need to get done in this time.

Pooja: Yeah.

Casey: And that was also helpful going into medical school too is saying, “Well, if I want to see my friend tonight and climb, I need to do this work right now even though it’s the last thing I want to do,” right? So I think developing that self-discipline is something that can come from the gap here and is also important to work on, and kind of be strict with your goals and say, “I know this is what I want, so I’m going to try to work as hard as I can to make things happen so that I can achieve those goals.” And again, like I feel like I’m coming from a very privileged place because I got, was very lucky. I got, you know, jobs that let me do that and I was able to stick to my study timeline. It doesn’t always happen, but I think doing the best you can to try to make that happen is really helpful. And having like a long-term goal in mind, like for me, even on the days when I didn’t want to study because of course, really where, where you can… it’s studying when you’re not motivated. That’s where the real, that’s where the real stuff happens. So anyone can study when they’re motivated. But if you’re sitting down and being consistent every day, no matter how you feel, that’s how you’re going to get where you want to go. And I think having a long-term goal in mind, like I’m a visual person, so I would, I would picture my white coat ceremony, like my first day of med school, I was like envisioning myself wearing that coat and that got me through every single day where I was like, “I don’t want to do 40 more UWorld questions and like get a 0% on them today. But I really, I’m excited for that white coat ceremony. I can’t wait to take a picture in my white coat.” And for some reason that got me through like every single day of studying when I was like, “This kind of sucks, but also look at what I can eventually be doing.” And I think having that long-term goal in mind, at least for me was really helpful in saying like, “Right now this kind of sucks, but it’s temporary and it’s for something bigger and better down the line.”

Pooja: Yeah.

Casey: It really helps to have that, some long-term thing to motivate you on the days when you’re not motivated.

Pooja: Yeah, it sounds like there’s sort of a duality to ensuring that you support your goals. There’s this like rigidity about having a goal and sticking to it and being able to be disciplined with yourself along the way. But then also an adaptability of being able to roll with the punches, being able to make changes if there’s some life event that gets in the way or there’s a new opportunity that is in line with your goals but you didn’t see coming and being able to take that on and adapt your routine in the way that you kind of balance your time to accommodate that new opportunity. So it sounds like there’s a little bit of a balance there that people should think about as they’re kind of navigating the gap year.

Casey: Totally. Just trying to prioritize consistency and like building the habit of like, “This is when I study, this is when I’m working,” and trying to stick with that.

Pooja: Yeah. Okay, amazing. So I have I have two more questions. I promise. I know you have been so, so informative and thank you so, so much for your insight. I wonder.

Casey: No, I love I love just someone letting me blab. It’s great.

Pooja: No, it’s listen, I’m here all week. So I wonder if there’s any like specific moment during any of your gap years that you think has made a lasting impact. Because I know I know not everybody has like a come to Jesus moment where they’re like, “Oh my God, like this is it. It’s going to change my life forever.” Um, but I wonder if you had anything that kind of feels close to that?

Casey: Oh, man. I think yeah, that was the thing too with like applying to medical school, there was never one moment where I was like, “Whoa, medicine, hooray.” Like it was just like an accumulation of all of my experiences. And I think it was similar with my research year. It was more of like, “This is all confirming that so far I’m making the right choices and like these are all things that I want to absolutely do.” I think there was one day in clinic that really made me be like, “Oh, this is why I want to do this.” It was like we had a patient come in. So I was working with a physician who does a lot of congenital hand surgery. That’s something I’m super interested in. I think it’s so cool. But that’s what he specializes in. He was seeing a patient who… it was like a prenatal visit because she’d had prior pregnancy losses for like fetal birth defects and everything. It was really sad. And they had found a hand anomaly on her ultrasound and um, so they were coming in because they were concerned like, “Are we going to have to terminate this one? Is this going to be something else that like we’re going to lose another pregnancy?” And just the way the doctor was counseling them, like just based on his expertise and knowledge. He’s like, “I think your child’s going to be, like this isn’t associated with other problems. Like they’re going to have a great quality of life whether or not surgery is pursued for the hand.” And the family like started crying. It was really emotional. And I was just like, “This is incredible, the impact that you can have like without surgery.” Like, of course, I want to operate. That’s why I want to do orthopedics. But like just the comfort you can provide to someone of saying like, based on what I know, like you’re going to have a healthy kid and they’re going to have a great life. And it was just really touching. And I’m still figuring out, I’m trying to still like figure out why. I think it was just the ability to like provide that comfort to someone and like that like a hope that they’re like, that’s why I want to do Ortho is like you can give someone a better quality of life. And the fact that he was able to reassure them that like not only is your pregnancy likely going to be viable, but also even with this hand anomaly, like they’re going to be okay. They’re going to have a great life like based on other kids who have these hand differences. It was just really touching. And it just, it was funny too because it was my very last day of clinic and I was like, “This kind of summed up the whole year of like, I absolutely can’t see myself doing anything else than this. Like this is awesome.”

Pooja: Yeah, yeah.

Casey: I don’t know if I answered exactly what you were asking, but like that was one moment…

Pooja: No, I think it is. What strikes me about that story is that it’s a moment where a physician was able to kind of meet someone where they were at and I guess really encapsulate how personal medicine is. Like I think that when a lot of us pursue medicine without having personal experiences of either us or someone we know being sick, it’s easy to kind of forget that the moment that you’re with a patient, although it’s just another day in the job for you is like a really meaningful part of their life and their life story. Like you’re kind of entering their world in a very important moment for them and you become like a main part of their life. And I think that’s a really beautiful thing. And we sometimes get numb to that because we kind of do it every day, multiple times a day.

Casey: Exactly. Yeah, it’s remembering that like it’s always new for the patient, even if it’s your 30th femoral neck fracture on call, but it’s new for that patient.

Pooja: Yeah, yeah, exactly.

Casey: It’s important.

Pooja: Agreed, agreed. Well, thank you for sharing that. Um, I guess final question is, what would you say to students who are unsure or nervous about taking a gap year? And if you have a different answer for the pre-med year versus the med school year, definitely share that as well.

Casey: Totally. I think, I mean in both cases, I would say try to talk to people who have done them. That was something I did at least for not for the gap year. The gap year’s pre-med for me were necessary. I hadn’t taken the MCAT. But for the med school one, I talked to a lot of peers who had taken a research year just to like hear their thoughts like would they do it again? Did they think it was worth it? Like did they find it helpful? Like just like picking their brain on what their experience was like. So I think if you have people you know or if you can find a network through maybe like your advising at your college or something, people to talk to who have done it, would be really helpful. I’m also happy to answer questions if you have them. Yeah. But um, yeah, I think that’s the big thing is like talk to people who have had the experience.

Pooja: Yes.

Casey: And if you have mentors, talk to them and have them, you know, see like, “Do you think this would be beneficial for me?” I think that would be my biggest advice is try to speak with people who have done this before.

Pooja: Yeah, absolutely. Absolutely. Okay, thank you, Casey. I want to run down just a couple of takeaways from today’s conversation, in case anybody’s zoned out. No, I’m kidding. For, for me, I feel like. Yeah, I mean, listen, listen. I don’t know what people do when they listen to podcasts. I feel like I’m like generally either like walking or running somewhere.

Casey: Oh, I’m never just sitting and listening. I’m always like, you know, I’m either, yeah, driving or doing chores, something half-distracted.

Pooja: Yeah. So I feel like the big takeaway from this for me is that there’s, you can do a number of things in a gap year, whether you’re doing, and also depending on when you’re doing it, you could be doing it before med school, you could be doing it during med school. I’ve even heard of some people doing it after med school, it all depends. But the gap year is only as good as what you kind of do with it. And even though it can look different from any person, like for you it was very research oriented because that was in line with what your goal was, but it seems like the core of it is that it should be in line with a goal that you set out for yourself. And that during that year, you kind of grow by working towards said goal and accomplishing it. And by being able to do that, you grow both professionally and personally because you kind of figure out how to balance a bunch of things at the same time and grow to kind of develop the seed of a career that you would want to have when you, you know, are a resident and beyond residency. Is there anything that you, Casey think is like the biggest takeaway from all of this?

 

Casey: Being open to new experiences and exploring. I think that’s a big part of the gap year is like you certainly have goals and things you want to accomplish, but be open and reflect on all of your experiences and really take the time to check in with yourself and say, “Is this, this is helping me reach my goal? Am I enjoying this? Like how do I feel when I’m doing this?” Because I think it’s really important to be checking in every once in a while with yourself and reflect on, is this accomplishing what I want and am I getting something out of this?

Pooja: Yeah, absolutely. Absolutely. Well, thank you, Casey. We have got a ton of episodes coming up about specializing, time management, interviewing, and so much more. So please make sure to like and subscribe on YouTube or wherever you follow us, wherever you get your podcasts, whether it be Spotify, Apple Music, or whatever else I don’t really know. But thank you guys all so much for listening to Pursuit of Practice brought to brought to you by Blueprint. And we will see you next time. 

This is a podcast created by physicians and medical educators, but is in no way to be construed as medical advice. All of the opinions shared are those of individual people and are not reflective of their associated institutions or of Blueprint Test Prep.

That’s a wrap on this episode of Pursuit of Practice. Remember, you’re not in this alone. Head to blueprintprep.com for MCAT prep courses, board exam prep, free resources, and more to support every stage of your journey to and through medical school.