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Med School Minutes
Med School Minutes is where we discuss all things related to medical education. Provided by Saint James School of Medicine, this podcast tries to educate students on selecting and successfully completing a medical school. Our topics are fun and educational, and our hosts are knowledgeable and fun.
Med School Minutes
Med School Minutes-Ep. 55 | Residency Secrets from Insight’s DIO w/ Dr. Asim Saeed
Want to know what makes you stand out in residency applications? Insight Hospital’s Designated Institutional Official, Dr. Asim Saeed, shares insider advice on rotations, sub-internships, and what program directors actually look for. He also talks about his journey from the Caribbean to leading Graduate Medical Education in Chicago—and why passion, not paycheck, should drive your path in medicine.
💡 In this episode:
• How to make the most of your sub-I rotation
• The key traits PDs notice in strong candidates
• Balancing hospital leadership and family life
• Why physician leadership matters more than ever
📘 Learn more about Saint James School of Medicine: https://sjsm.org/
#MedSchoolMinutes #ResidencyMatch #IMG #CaribbeanMedicalSchool #InsightHospital #GraduateMedicalEducation #InternalMedicine #SubI #SaintJamesSchoolOfMedicine
Hello, and welcome to another episode of the Med School Minutes Podcast, where we discuss what it takes to attend and successfully complete a medical program. This show is brought to you by St. James School of Medicine. Here is your host, Koshik Gua.
SPEAKER_02:Welcome to another episode of Med School Minutes where we talk about everything MD related with a focus on IMG specifically Caribbean students. Today we have one of our own, Dr. Asim Said. He is currently the designated institutional officer at Insight Health, where he oversees the various academic programs and has many more initiatives to come in the years. Without further ado, let's welcome Dr. Saeed. So thank you so much for being on our show, Dr. Saeed. We really appreciate the time. I know you're incredibly busy with everything that's constantly going on in the medical education as well as the hospital landscape across the board. So why don't you uh give us a quick background about yourself?
SPEAKER_01:Yeah, no, thank you so much for having me, Kochik. I know that uh we've been talking for quite some time, and so stars finally aligned. So I'm so happy to be here. I wish I was at your studio. But um, quick background, you know, my name is Dr. Asim Saeed. Uh, I'm an internist by training. I did a sleep medicine fellowship. Um, I actually trained at uh Weiss Hospital, which uh just recently shut down. Um so we're kind of sad about that. But in Chicago, uh, raised in Chicago. Uh I went to school in the Caribbeans, came back, did my rotations over here, and then got residency over here, and then from there on um I got more into the um hospital medicine, hospitalist medicine, and also got into the administrative side of things. And then uh passion of mine was always medical education, and you know, I joined Insight in 2021, and uh here we are today. Right.
SPEAKER_02:So just out of curiosity, I know you know, I speak to a lot of physicians, but uh very few of them always focus on administration or uh graduate medical education. Uh you seem to have taken a different route, but uh is there a particular reason why you chose graduate medical education and administration uh over being a hospitalist?
SPEAKER_01:Yeah, so I mean I'm still a hospitalist. I still do I still do that clinically, but what I think you know it's kind of like finding your niche, right? And I think that kind of goes back to like the role models that I had and and the experiences that I had. Um, but I can tell you what got me into the GME side of things was being a Caribbean grad, going through the struggles of getting into residency and um doing the rotations, you know, at least here in Chicago, and seeing the type of quality of rotations that were out there. And, you know, I did do a family medicine residency for a year, and then I switched over to IM, which was career suicide. But having gone through those experiences um really got me to see that there is a whole different side of it, you know. Um and so for me, that really garnered my interest. And going down the administrative side of things, you know, the way I trained, the way I learned, the role models, the teachers that I had, was, you know, it sparked an interest as far as like I love to see how things work. And by seeing how things work, I got more and more interested. Um, I would see problems and I wanted to find solutions for that. And so that's what got me in the whole administrative side of things, solving those problems. Um, for the GME side of things, it was always a passion for me because uh I realized very early on I learn better when I teach. Okay, me s it keeps me sharper, keeps me smarter. And so uh when I joined Insight, the opportunities were there to bring back the residency programs and start the education programs back up, and that's what pushed me into the GME world.
SPEAKER_02:Okay. So you mentioned you something that you just said was that moving from family medicine to uh uh um an internal medicine role was career suicide. Yeah. Okay, why why do you say that?
SPEAKER_01:Well, think about it. You're a foreign grad, right? You you get through the system, you're lucky, you match, right? Right. You do a year of family medicine, you decide, hey, this is not for me. Okay, most people would just ride it out. Right. Um it's incredibly hard now with one year under your belt, one year of CMS funding used, and you want to switch careers mid path, right? Okay. Um, finding a program that's willing to accept you, absorb you, um, some of your credits will transfer, they won't transfer. Uh, most people are it's very difficult to make that jump being a foreign grad, but I think I was successful and I was very lucky actually to do that.
SPEAKER_02:Okay. And you mentioned that you're lucky. Is that because there were people who helped you? Was it entirely something that you figured out on your own? Where did you have any mentors during that period?
SPEAKER_01:So I did. I did I did have some help. I did have some uh some mentors. Um, and it wasn't like you know, right up front that there was like, hey, do this. I okay, I had a I made a decision. I mean, the program I was at was a very, very malignant program. And so it was very I I found myself just unhappy, uh, just unhappy with life, unhappy with the way things were. Um and so a couple of people had left the program at the same time, attendings had left as well, too.
SPEAKER_03:I see.
SPEAKER_01:And so I needed to make a conscious decision that do I stay here and suffer or do I go and do something about it? And so I started talking to area programs. Uh my old PD was semi-supportive. Um, and you know, a lot of those programs were like, no, we can't, or let's see, and you know, back and forth. Um, and so then I started talking to um one of my uh my outgoing chief, actually. And he was really, really, you know, mentoring me, helping me out with that, and you know, kind of pointing me in the right direction. And so it just worked out for me that one of the residents that was coming in to Weiss at the time had a visa issue. Okay, and he just missed it. And so they gave me a shot. Okay. I interviewed with I interviewed with them, I met them. Um it it it actually went really, really well, and it was really funny because um the program director said, if I call your old PD, what are they gonna say about you? And this was like the moment of honesty, right? So um so I said, Look, that program director is gonna say this, this, this, this, all negative things about me.
SPEAKER_03:Right.
SPEAKER_01:And he goes, Okay, that's fine. He called me back a week later and said, Everything you said, your program director said.
SPEAKER_03:Okay.
SPEAKER_01:He goes, I appreciate that type of honesty. And he said, I'm gonna give you a chance. And he let me take that spot as a prelim. And uh I absolutely killed it. I mean, it was a great opportunity. Absolutely killed it. They actually opened up uh categorical spots for me so I can stay as a second and third year as well.
SPEAKER_03:Okay.
SPEAKER_01:Um, you know, it was it was great, it was the best thing ever. Rest was history after that point, yeah.
SPEAKER_02:Awesome. So, why did you want to choose or move from FM to uh IM? I know it was it and obviously you mentioned there were uh some issues with the actual program, but uh your with your original program, but was there a career viewpoint that you had that which is why you wanted to make the switch?
SPEAKER_01:Yeah, so I actually enjoyed the inpatient medicine side of things a lot. I really, really enjoyed that. Um, I wasn't really too big of a fan of outpatient, and not that anything's wrong with outpatient, but I just like I like to see results. I like to keep moving quickly, right? Um, and I found it really fascinating because in real time, you have a patient that's sick, you know, you can make key difference, key workup, key movement. You're interacting with different specialists, you're coordinating that care, you're solving those problems, you get the patient stabilized, and then they're being discharged. I really enjoyed that, but in the family medicine program, they were very uh outpatient heavy, clearly, because they're family medicine, but I realized that they didn't have a too good of a structured inpatient medicine uh rotations. I see. And I found myself just gravitated towards that, constantly struggling to be like, I want to do more, I want to do more. Um, and that's where I realized internal medicine was better for me. Uh, was a way better fit for me.
SPEAKER_02:Right. And um it seems like obviously you've made the transition which uh you have uh dubbed as career suicide, but in your case, obviously it is most certainly hasn't been, because um you're quite the celebrity when it comes to the medical education world. A lot of people know you. Uh, a lot of people have talked about emulating you and what you've done for Insight as a whole. If I'm not mistaken, before you joined Insight, I don't think that they had any residency program. Is that right?
SPEAKER_01:No, so Insight never had any residency programs.
SPEAKER_02:Right. So you basically brought the entire GME and graduate medical education side into Insight with your um when you started there.
SPEAKER_01:Yep.
unknown:Yep.
SPEAKER_01:And I started I started with Insight April of 2021 is when I joined them when they made the announcement that they're acquiring Mercy Hospital. Um, I came on as a consultant, and then I became their transitional CMO, and they wanted me to you know stick around, and I said, Well, I'll stick around under one condition. And they're like, What's that? I said, Well, Mercy was always an academic center, right? Multiple residency programs. I want to bring those residency programs back. And they said, Okay, you can do it. Okay. So uh we uh we had a really awesome team. We had Dr. Rizwan Moyedin, we had Yvonne McCauley. Um, it was the three of us in the boiler room, race against the clock, what they thought would take five years, we were able to do it in about 16 months, brought the program back, and at that point I said, you know, I am now gonna switch from CMO and just be solely focused on the GME side. Um, did the GME thing, still in the GME thing, but then of course my roles have just kind of gotten uh more responsibilities, let's say, across the hospital system.
SPEAKER_02:Right. So one thing we've noticed is that obviously you have a whole myriad of uh um designations at Insight. One of them is DIO. What exactly is a DIO?
SPEAKER_01:So DIO is designated institutional official, right? You are essentially the representative of ACGME, responsible over the GME programs, making sure that they stay in compliance with ACGME.
SPEAKER_03:Right.
SPEAKER_01:So you administer out all the programs on behalf of ACGME, you report to ACGME. Um, you're kind of that conduit between the hospital and ACGME.
SPEAKER_02:Okay. I see. And um, you know, typically, as I was mentioning earlier, whenever we speak to students, they're always about, oh, I want to be a hospitalist, I want to make this big paycheck, etc., etc. But nobody really has seems to have taken the administrative role. That being said, most of the um foreign grads in particular, when they do go down this road of um uh administration and GME, it seems like there's they tend to find a lot more success. Uh, what are you what are your thoughts on that?
SPEAKER_01:Um I would actually back it up and say, first of all, don't do anything for a paycheck. Okay. Do do and the reality is this, do something that you're passionate about, right? Right. If you're passionate about something, it's no longer a job. And the rest will all follow. I think I remember, you know, even growing up as a kid, I was always chasing cars and basketball games and you know, um, you know, doing whatever a kid would be doing. But you know, I was always told just focus, everything else will chase you. And so to see that there's you know, FMGs that are now getting into the administrative side, getting into the GME side and fighting and being very successful, it's because they're passionate about it, and that's why they're gonna be successful. Otherwise, you're gonna hate getting up in the morning and hate going to work. I think um I think you know the administrative side of things uh came because again, I like to solve problems, I like to learn, understand things. Um, from the entrepreneurial side, people that do have success, you can't just start a business and not know anything about it. You have to really understand everything from the ground up and all the moving parts. And I think it's that um curiosity, wanting to learn, understand, and solve things is what now gets you into the administrative side of the hospital. It's so much more beyond, hey, patient comes in, they're in a bed. What's happening in the background? Is lab firing, is imaging happening, nursing shortage, this thing. You know, you have to look at all those components to make sure it runs smoothly. So I think um I think it's I'm glad to hear that foreign grads are getting more involved.
SPEAKER_02:Right. And but I do want to point something out. This is my personal observation that typically most hospitals, their C levels, don't actually have practicing physicians. I think inside success is uh having somebody like you at the helm of the administration, at the helm of uh GME, the kind of and you being the DIO. I think that that seems to have converged, and we're seeing more and more physicians getting into that role. But however, it's still very subdued. And every time I speak to physicians, they're like, Yeah, I'm really not interested in administration. Um is there a reason? And do you think it's more of an advantage to have physicians, licensed physicians like yourself, being part participating in administration as opposed to having a bunch of NBAs? Uh a point to note is that uh Mercy, the hospital that you guys took over, was entirely the C level was entirely um MBAs and not physicians. Right. Um and whereas with Insight and with a lot of other hospitals, I feel like there's a change happening. Are you uh do you think that there is a change afoot, or is this just uh you know happening in between and then things will go back to with MBAs running the show?
SPEAKER_01:No, I definitely see a change taking place. I am uh a big advocate for physician leadership. I think that it's important that being a physician, being a practicing physician, you understand all the moving parts within the system, within the clinic, within the floor, within the ORs, right? Um, and there's a fine line between making, and I call them the beam counters, um, but there's a fine line between when you make a decision, you have to take into account the clinical aspect of it, right? The beam counters are only going to see the bottom line at the end of the day, right? And and there's a there's a purpose for it, and you know, they work very hard and they bring a lot of value to the table. But many times than not, sometimes it's okay to lose that money, sometimes it's okay to eat that cost because our ultimate goal is good patient care outcomes, right?
SPEAKER_03:Right.
SPEAKER_01:And that's where I think having that physician leadership there really makes a difference. It really helps, you know, orientate us in the right direction, come together, and um, we will have success. And that's the thing I like about Insight is that there were very big proponents on having physician leadership. We are known and we are physician operated, and our goal should always be good patient care outcomes first.
SPEAKER_02:Right, right. Did you uh while you were trying, you know, starting off your career, uh, did you have any pushback being a physician trying to get into administration? Was there uh sort of a club, if you will, that you have to have an MBA or you have to do this or you have to do that to get into administration, or was it kind of smooth sailing for you?
SPEAKER_01:Um it was a bit smooth sailing for me. I think I definitely think if I can go back in time, I would definitely do an MBA or an MHA. Okay. I think that would have been really, really valuable. Um I still sometimes think about it, but I remember when I when I first started my uh I have a hospital consulting and staffing business. I had one. Right. I just graduated residency, came out, finished my fellowship, started a clinic, massive overheads, you know, right. And um, again, just in that boiler room, figuring it out. And I was working at some of the hospitals in the area, and you know, whenever issues would come up, I would with the administrators, talk to the administrators, and I'd always come up with solutions and start kind of diving into things with them. I think that's what really started that relationship. Um, and they were actually telling me, you know, you should consider going getting an MBA and things like that. Um, regardless, I very early on noted that you know, all the hospitals were watching metrics, you know, Wednesday, return to acute, hospital required infections, CUDI, caughty, all that great stuff, right? And um those things were really, really important. And so as a hospitalist on the floors, I started focusing on those metrics.
SPEAKER_03:Okay.
SPEAKER_01:How do I how do I start now changing those metrics and improving the outcomes? And across the board, I was just crushing it. And the administration was sitting with me saying, What are you doing? I said, I'm just doing what I was trained to do, right? Um, and I think that's where I had found my niche. And at that point, I you know formed my own uh company, um, worked with the uh administration over there. They gave me a small hospital in central Illinois. Okay, and they said, Hey, turn this place around. So we took their, I mean, it was like a small hospital, maybe like 40 beds.
SPEAKER_03:Okay.
SPEAKER_01:Um, we took it from a one hospitalist program with an average census of about 13, took it all the up to about average census of about 32, turned it into two and a half FT hospitalist program with NPs, completely changed out in um all their metrics, um, retained a lot of patients, improved communication between PCPs. Um, it got so big that you know the system actually had me sitting on calls with other hospitals saying, What did you guys do differently? Okay, wow. So from there, we really started growing, and they gave us more hospitals and we started growing even more. We held interim uh directorship positions, leadership positions. Um, we of course staffed them out. We were doing uh hospitals programs, ICU programs, ERs. Um, we also got into some of the other specialties, and that's what really propelled me in the administrative side of things. I see. Um, and that's what our also, you know, the entrepreneurial side came in as well, too.
SPEAKER_02:Right, right, right. So, how long did this take?
SPEAKER_01:I mean, you make it sound as if like, oh yeah, it was you know not a big deal, but I mean obviously I can I can tell you, I can tell you it took me about two years to land my first big contract. I see. Where I got where I got that one test site, small little hospital, and I was able to blow it out of the water.
SPEAKER_02:Wow, that's that's awesome. Because you're you're making it sound as like, oh yeah, you know, I I finished my uh residency and then it's so easy. And I know for a fact that with everything happening in Chicago, with all the hospitals shutting down, I mean it seems like it's a flurry, and it's not just Chicago, it seems like all big cities seem to be struggling with. I don't know if it's an over concentration of uh hospitals, is it uh what's going on, but all the big cities, all the hospitals seem to be struggling a lot, except for say your hospital, which you came and you took over, uh, or insight rather took over a struggling hospital.
SPEAKER_01:And now we still have struggles every day, don't worry. Every day there's a new struggle. So, no, I think what it is is that you know, a lot of these safety net hospitals, um, they're gonna be struggling because you know you have you know the the challenging patient population, challenging payer mix, and I think it really comes down to thinking out of the box, being strategic, um, and just giving good medicine and okay, really stretching it. And so I think uh that is what allowed us to survive. I know there's other hospitals struggling, they've been in existence for many, many decades, but I think it's just started compiling on them. Then you have facility issues, infrastructure issues, um, loans, grants, all that great stuff, and suddenly they fold, right? Right, right.
SPEAKER_02:Wow. So I mean, obviously, there's so much to hospital administration that goes beyond the education of being a physician, which obviously you acquired those skills pretty much immediately after uh your residency, it sounds like. Or did you do anything during your residency to build up?
SPEAKER_01:No, so actually during my residency, um, you know, Dr. Sal Khan, she was the chair of medicine, she was my mentor. Um, Dr. Jeff Zilberstein, uh, he was the ICU director. No, I had some really, really good role models there. Terry Touie was there. Um, and I would spend a lot of time with them, you know, just kind of learning things and working through things. And I kind of got privy to, you know, what's kind of going on in the med staff or what's going on in the executive committee and you know what the uh the issues are, and then I started participating in like committees, um, learning more, figuring things out with Dr. Zuberstein, we're implementing new protocols, really kind of uh uh disrupting things actually. Um but it was those opportunities where I started learning how things work, how to figure it out, and that gave me that exposure. And I think that's what gave me a little bit of that confidence to like go into that.
SPEAKER_02:I see, I see. So um let's take a step back a little bit and talk about a little bit about your education. You obviously went to a Caribbean medical school, um, as you mentioned earlier, but as far as um the, you know, and and a lot of people say a lot of negative things, and yes, there are a lot of things in the news. Um, obviously, Caribbean medical schools tend to be regulated slightly less, but now I think that there are accreditation standards and things like that for all Caribbean medical schools, which is a great thing. But did you face any disadvantages to during your residency training, during fellowships, do during looking for a job, being from a Caribbean medical school?
SPEAKER_01:I think the only place where I felt it was when I spent some time at uh Case Western. Okay, that was the only time, and it wasn't like it was it wasn't like anything like they weren't impolite or anything, but you know, sometimes questions would come up and say, you know, why'd you go to Caribbean school? Uh I see. You're you're from here, right? Well, what happened? You know what I mean? Right. Um and I mean you're you probably will face that at some of these larger, well-established institutions, but other than that, I never really felt it. Okay, and I think it also comes down to confidence, right? Um it's the way you hold yourself and the way you conduct yourself, um, which is probably one of the biggest reasons why we love the fact that you know, over here we have the Caribbean students also rotating with you know, American MD schools, NDO schools, because look, you're all gonna take the same step one exam, right? You're all gonna be here. It's a great learning opportunity, and I think that also helps them with their confidence, right?
SPEAKER_02:Yeah, and that was kind of my next question. Why do you think this question comes up when physicians well know that this is a standardized test? You have to take three stand step one, step two, and step three to become a physician. Whether you're from Harvard, whether you're from a Caribbean school, it levels the playing field. Why is this even a question at all?
SPEAKER_01:I I don't know if it necessarily completely levels the playing field because you know, being an American grad, you know, you're going to an established university that has its own hospital, that has very developed departments, your network increases. You know, I'm interested in radiology, my chair of radiology knows this guy over here, right? So like things can just flow a lot more easier, right? You come as a foreign grad, you're unknown, you're unproven, right? Um, and even comes down to your letters, right? So if I get a letter from someone that went to UIC and I used to work at UIC, and I go, Oh, I know Jeff Silverstein, I just give him a call. Jeff thinks you're a good guy, you know what I mean? But you're coming as a foreign grad, you're giving letters from community doctors that people don't know about, or bringing letters from your home country, and I can't verify that. I don't know anything about that, right?
SPEAKER_02:I see.
SPEAKER_01:You know, someone says, Hey, you know, he trained at uh at Midwestern, I'm like, okay, well, you know what, that's a great school. I know that they're gonna produce good students. So I think those are gonna be the disadvantages. However, I think this is the land of opportunity. You come in, you pass your exam, you get some rotations, you start, you know, networking, getting your name out there and putting in the time and effort. You know, hard work will never go unrecognized.
SPEAKER_02:Right.
SPEAKER_01:Ever, right? And I can tell you, I have friends who have done surgery residencies. I have friends that are um doing, you know, they're interventional cardiologists, they're at Ohio State University. You know, hard work never goes unnoticed. If you're passionate about it and you're willing to work hard and be consistent about it, you will succeed.
SPEAKER_02:Okay. So, what about like most Caribbean schools have rotations in US uh uh programs, especially if you're an accredited program, you're probably sending them to ACGME hospitals, like for example, Insight. Um so once the rotations are done in US hospitals, uh other than a true IMG who is has no ties to the United States as such. Uh, do you think that that equals the uh playing field to a certain extent at all?
SPEAKER_01:I think it's definitely closed the gap.
SPEAKER_03:Okay.
SPEAKER_01:Definitely has closed the gap. Um, and I think that it's actually probably the biggest difference maker you can have. I see. That'll give you the added edge. I I don't think it's gonna, I don't think that gap is gonna be fully closed yet because you know the American schools here, you know, if you're from if you're an American graduate, you're gonna get a residency spot. Right. Yes, we all know that. You could be you could probably be a problematic, horrible student, and still somehow manage to graduate, and you'll probably find a residency program in Timbuktu, and you'll be fine, right? Uh for us, we'll be happy for a residency program in Timbuktu. Right. Um, but I think that's where the difference is that going to a good school, uh, doing your rotations in good places, get really gathering, learning and getting good experience and getting good exposure and expanding your network, that's where it's gonna make a big difference.
SPEAKER_02:Got it. Um, as far as your education was concerned, and the fact that you did study in the Caribbean, did you find any particular advantages of going to the Caribbean? Great weather. Yeah. Yeah, that's true. The weather is always, but it rains every day pretty much in all the islands.
SPEAKER_01:Yeah, well, I mean, for me, it was like I went to um Unibe in Santo Domingo, and that's a full-fledged developed country. I mean, it's beautiful out there.
SPEAKER_03:Okay.
SPEAKER_01:So I think the challenges were one was you know, being away from home, right? Being away from family, um, coming to this new country, learning Spanish, um, power always going out, things like that, you know, looking for making sure the AC is working. But, you know, once you finally get acclimated into it, I think uh it was a great experience. I I absolutely loved it. I got to not only learn medicine, but live in another country, uh, learn a whole new language, have a whole newfound appreciation for an entire culture. Um it was great. And then not to mention the beaches. I mean, who could beat that?
SPEAKER_02:Right, right, right. Um, do you think I know you mentioned that earlier that uh during your residencies and even during the interviews, there was a certain degree of confidence that you exuded. Do you think that traveling internationally and all these experiences that you just mentioned about making sure the there's electricity to put on the air conditioning, learning a new language? Do you think that that all built in to that background of confidence at all? Sure, I think so. Okay.
SPEAKER_01:Experiences that definitely shape you and force you to mature and grow up, yeah.
SPEAKER_02:Okay. Well, that's interesting that you use the words force you to mature and grow up, because um, yeah, not all students are they might be it might be a postgraduate degree, but they're not mature, I can tell you. So, in that regard, I think that that's very interesting. So, one thing I do want to zero in on is the fact that you did a fellowship. When did you decide to do a fellowship?
SPEAKER_01:So, back then, when I was in residency, um, I was working very closely with Dr. Zilberstein. Uh he was our uh ICU director, and uh he's now in New York and he's doing some amazing things, right? And you know, I was always fascinated by ICU. I loved the ICU, it was medicine on steroids.
SPEAKER_03:Okay, yeah.
SPEAKER_01:You know, I I'm like a total action junkie back. I was an action junkie back then. I mean, I was ready to place lines and intubate and you know get in and do all sorts of procedures. Um, and so for me, I was really leaning into going into doing pulmonary critical care. Interestingly, because I spent that time with Dr. Zilverstein, you know, he was willing to help me out and you know get into uh UMBC in Maryland as well. I actually wanted to stay in Chicago, and my other mentor, uh Umar Latif, who's now the CEO of Rush, um, he was saying that, hey, you know what, maybe consider Rush, come in over here. And so I started off with sleep medicine, uh, hoping to get into pulmonary critical care over there. And of course, I only applied there. And that year, and they were all just like, oh yeah, you know what? You're in, they're high-fiving me. And that year they matched in everyone from outside of Rush.
SPEAKER_03:Okay.
SPEAKER_01:And they're like, Oh, you know, just stay, be a hospitalist here and uh um, you know, do research and things like that. And I think at that point, I kind of felt like, you know what, I've been in school for a very long time, I've been training for a very long time, uh, and I just made the switch and said, That's fine, I'm not gonna pursue it any further.
SPEAKER_03:Okay.
SPEAKER_01:It was still a great experience, it was an amazing experience. You know, I got to be in uh a large system, uh, got to learn a lot, got to meet a lot of people, and you know, I I do like sleeping, and so sleep medicine made sense, you know. Right.
SPEAKER_02:Um, but do you think if you hadn't done your fellowship? You would be in the same position uh from a career standpoint, whether you did a uh uh fellowship or not. I think so. Okay.
SPEAKER_03:Yeah.
SPEAKER_02:So, how important do you think is a fellowship in the career trajectory of most physicians?
SPEAKER_01:I think a fellowship is important if you're passionate about that specialty, right? Okay. Don't go after that specialty because it seems glamorous. Okay. Don't go after it because, like, oh, it's cool to be the cardiologist. Um, go after it because you're genuinely passionate and interested in it, right? Um, my brother-in-law, he's an endocrinologist. And um this is a guy that just had stellar, stellar marks. I think he was like the second highest USMLE step one score in the history of UIC medical school. Wow. Yeah, yeah, yeah. So while his whole family was like, Oh, my son's gonna be interventional cardiology, another one was like, nope, he's gonna be a neurointerventional specialist. Um, he kept saying, I want to do endocrinology. Right. So I would joke with them and I would say, you know, that's not a real competitive uh uh specialty to get into back then. I can walk into that in a second. And he just held strong. And then I came to the realization someone as brilliant as him that's passionate about endocrinology is gonna do a lot to advance that field, right? You know, and so people like that, uh, I use him as an example all the time. If you are passionate about it, go and pursue it. Fellowship is always a great thing because you're gonna learn a whole lot more, it's further investing into yourself. Uh, personally, back then in the rush days, you know, I was married, um, you know, life was now starting to catch up, living the student life way too long. If I wasn't in that situation, I probably would have stayed stayed in there a little bit longer and done done another fellowship or so, you know.
SPEAKER_02:Oh, wow. Okay. Wow, that's awesome. Um, a lot of students cite during fellowship that, hey, I'm just not gonna make enough money, so I'd I'd rather become, you know, go straight to working. Is there truly a financial difference when you're pursuing a fellowship versus when you're not pursuing a fellowship?
SPEAKER_01:Yes and no.
SPEAKER_03:Okay, right?
SPEAKER_01:Um you're talking about financially just kind of you know, like salaries. Oh, okay. Again, I guess the fellowships that are gonna be competitive are the ones that are gonna be procedure based, which are the ones that are gonna make a lot more money, right? And so people are pursuing it because of the the financial uh um goals they can achieve, let's say, right? But I um I'm gonna disagree with them. Okay, don't look at the statistics, right? Um if you're passionate about something and you're good at it, everything else will fall into place. Money, you know. I I don't think you should going back, I would say don't make your decisions based on potential salaries. Because if you want to make money, you don't need to be a doctor. There's a lot of other things you need to do, you know?
SPEAKER_02:Yeah, no, I mean, and and this is something that I've always pointed out. I think the trajectory that we're on, um, like with residency and physician salaries, really not moving a whole lot in the last 10-15 years. Whereas other professions seem to have really ballooned a little quite a bit. And but at the same time, it sounds like uh people who are really successful um tend to really, really enjoy what they're doing, but not just in medicine, almost every field. So I think that that's really, really important. And and you're absolutely right. If you wanted to make money, there's so many things that you can actually pursue. And I think that that's truly the difference between a physician and say other professions where most physicians, most, not everybody, but most physicians who are in it, they're truly passionate about it because they're looking for that opportunity, they're making a lot of sacrifices, a lot more than most professions, I can tell you that. Right. So, um, speaking of sacrifices, I I have noticed one thing, and I've obviously had the pleasure of knowing you for uh a couple of years now, for at least four or four to five years. Um, you seem to have a very well-balanced life. You have a beautiful family, uh, you're moving um from a career standpoint, you're moving insight into a completely new um era, if you will, with graduate medical education. Um, you've become quite the mover and shaker in medical uh generally in medicine and hospital administration in Chicago. Um how do you do it? Like, how are you managing this time? Because most physicians that I know of and I speak to, um, something's giving, something doesn't work, somewhere there is uh uh a weak link. But with you, I just saw you in person, you're looking great. I and you said you're you're working on yourself, you're uh doing strength training and and physical. How are you getting so much of time? We all have 24 hours in the day.
SPEAKER_01:Uh I would say tons of Adderall. No, I'm just no no, no, no, no. I I think first and foremost, uh, you know, my my wife, uh, she's been very, very supportive. Right. Um, I think that's what it really comes down to. I think uh in the beginning years, uh, when I got out, I mean, I was working non-stop, right? Working as a hospice, working on developing the business, things like that. And so I had a lot, a lot of support. Um, but I also started neglecting my health as well, too. Um now I've come to a point where you know you do have to focus on yourself. Your personal well-being is very important. You cannot neglect yourself. Um, so I have a routine, I have a schedule, uh, I stick to that. Um, I have a personal trainer, work out, take care of myself first, um, prayers, meditation. Um, and then again, having that schedule built out appropriately. Number two is, you know, I've also having put in that time, have now been able to build a great team around me that all work together. And I think probably the greatest thing out of all of this is that you don't look back and look at your accomplishments and what you've done, what you've pulled off. I think the real value was the team that we were able to build. But yeah, work-life balance is important. Uh, I work hard and play hard, so I do take a lot of vacations, but I also find it is great ways to like disconnect, spend time with the family. Um, and although also I would say set healthy boundaries. It's absolutely, you know, after you know, I got soccer practice later today, and that's also just as important to have to be there for my kids, right? So plan ahead and set boundaries. I mean, now at after hours, only a few people can get a hold of me. Okay. Anything else would have to wait till the rest of the day.
SPEAKER_02:Right. Awesome. And, you know, I mean, one thing I will say, and I don't know, maybe in the hospital setting it's different, but uh administrative work, as voluminous as it is, it is probably not as care uh critical as working in the ER. I mean, I don't know what your thoughts are on that. It depends. Okay, yeah, that's what I was thinking. In your case, you're probably overseeing some of the ER ac uh activity too.
SPEAKER_01:Yeah, no, I mean, I mean, critical in the sense of like this is a patient's care a patient care thing that you have seconds to decide and make a decision. Yeah, 100%. But even like on the administrative side, I wouldn't say as critical as you have seconds, but you know, it comes in waves, right? There's gonna be some super busy months and there'll be some slower months, but you know, I think if you are organized and stay ahead of it, um, you can get ahead of it.
SPEAKER_02:Right. So uh I want to move our focus a little bit to future students. And and one thing that um us at St. James School of Medicine has particularly admired about uh you and your team, um, and generally insight, is the fact that you're uh maybe not officially, but you you and your team are working hard to really focus on the best residency candidate, and are not really focused on, oh, you are not from the United States or you didn't go to school here. You really focus on the best uh uh uh candidates who will fit into your organization. And I think that that's uh so important, and that's as we talked about earlier a little bit, almost leveling the playing field, and you're doing what you can, and you and your team are uh doing what you can. So keeping that in mind, what kind of advice would you have for a student going to a Caribbean school right now at St. James, say, and they want to match into Insight? Because Insight is on everybody's radar, it's uh it's a great hospital, you guys are opening residency programs left, right, and center. You guys are managing the residency programs very, very well. What would your advice be to be a standout candidate at Insight and say working for you potentially?
SPEAKER_01:So I think the most important thing is to do your rotations here, uh, and not just you know, if you want ER or I am, you just come and do that one rotation. Uh do some of the other elective rotations as well, too.
SPEAKER_03:Okay.
SPEAKER_01:The more exposure that you have, the longer that we get to know you, the better it is. Um, I can tell you, pretty much everyone that has gotten a spot here is because they've been vetted out, they've been working with us. And um, you know, we recently took in um a St. James student to uh one of the ER programs. I mean, this guy was absolutely amazing. You know, he was on the medicine floors with me, super helpful, very humble, hardworking, first one there, last one to leave, always following up on things. Um, you know, you could see that he was genuinely interested. Okay, you know, and he was dedicated. Um, and so he did that rotation. I absolutely loved working with him. Um, he did a couple more rotations. Uh, he started participating in things, helping out. He would show up to uh the uh uh didactics, he even gave presentation, and so this gave him a lot of exposure, not just to the program directors, but also to you know other faculty members as well. And so uh, of course, naturally we would give him an interview and he crushed it at the interview. So, why would we not take someone that's tried, tested, and proven and committed? Um, we know what we're getting, you know what I mean?
SPEAKER_03:Okay.
SPEAKER_02:That's so, and um what about sub-eyes? Is that uh, you know, I mean, I know sub-eyes, audition rotations, these terms are thrown out very colloquially by everybody, including school administrators like us. Um, is there number one a difference? And number two, for your program in particular, I know you mentioned that they should do all of them, but do you think that there is a good opportunity for students to come and do a four-week rotation and potentially at least get an interview or something like that?
SPEAKER_01:Yeah, I think a sub eye is gonna be really important.
SPEAKER_03:Okay.
SPEAKER_01:I think you can use the term, yeah, it is almost like an audition rotation. Um, if you want to get interviewed, if you want to show the program that you're serious, if you want the program director to feel that, hey, this guy is genuinely interested in internal medicine, uh, a sub-eye will make a big difference. And I think when you do do a sub-eye, um, you're gonna be evaluated a lot more differently.
SPEAKER_03:Okay.
SPEAKER_01:The outcome is not, hey, does he pass or does he fail? Outcome is is he prepared for residency? And I think this kind of goes back to conversations that I would have with my old program director. Uh, you know, JAMA had published an article back then about Caribbean grads residency preparedness, right? Um, and a lot of other program directors have felt this way. The issue really comes down to is that you know, we know you can produce a score back then when you know step one had its had a score and everyone was like, Oh, I got a 95, I got a 99, you know. Yeah, but the the issue was that do we know you're prepared for residency when you hit the same button, right? And I think that's what a sub-year is really gonna do. A sub-eye is gonna show the program you're number one, interested. Number two, you are prepared for residency, and you're gonna be held to the standard of an intern. The expectations are gonna be at an intern level, your responsibilities are gonna be a lot more. Um, and so that's your time to shine. And some have done very, very well with that. And let's just say that maybe this isn't the program for them, that letter is gonna make a big difference, right?
SPEAKER_02:Right. So it it almost sounds like you know, we've always been of the opinion that if you get a sub-eye after four weeks or five weeks, whatever the sub-eye period is, uh, the student always invariably gets an interview. That's definitely sounding like not the case, right?
SPEAKER_01:I mean, if someone who did really well on their sub-eye, yeah.
SPEAKER_02:Okay, but if they didn't, the student basically said, Thank you so much for your time. Unfortunately, this is not, you know, gonna work out. So it's not true that everybody actually eventually does get an interview through a sub-eye.
SPEAKER_01:That's correct.
SPEAKER_02:Okay. And um uh generally speaking, if somebody were to come in and say they're not necessarily um internal or emergency medicine and they're potentially doing their residency in another Chicago hospital, but they say they want to come and work on your team specifically for you for you. How would that actually work? Meaning they want to rotate with me? Not necessarily rotate, they're already doing their residency somewhere else, but they want to come and become hospitalists at Insight, and they want to work on your team with under your leadership.
SPEAKER_01:Yeah, no, absolutely. Uh, we're always looking, we're always looking for uh for people to join us. Um and again, I think it's almost like kind of the way we're selecting, you know, the same kind of criteria we have for for residents is kind of the same way we're looking for the right fit of a physician to join our group. You know, you really have to be bought into the mission of the hospital. Uh, you have to be bought into that we care more about the social determinants of health, the patient care outcomes. That's our bottom line. Um, and you know, having the right person that understands that being a safety net hospital where resources are limited, there's gonna have to be, you know, there will be struggles. If someone's bought into that, we would love for them to join us. Um, the best way to go about that is reach out to me. You can reach out to the CMO, um, you know, set submit your CV over. And um, yeah, that's the way to go about it. I think in Chicago, though, it is getting a little bit harder to find jobs, especially like if we're talking about hospice. What I've noticed is that there aren't many postings for hospice jobs in the city of Chicago. It's all supply and demand because larger places, rather than going through the trouble of posting an ad on, you know, whatever the uh monster.com or jobs.com, internally they're filling it so much more faster. Like, oh yeah, you know what? Me and Koshik trained over here, and I knew this guy, and he's actually moving back to Chicago, and like, you know, and internally those spots are getting filled. I see. So I do think though it does make a difference training in the city that you want to be at. I think the fact that I trained in the city of Chicago because Chicago is home for me, right? It expanded my network rapidly.
SPEAKER_02:Awesome, awesome. And uh, I know we're coming up on time and you don't have much time uh left, but I do want to end with one question. What kind of a legacy are you hoping to leave behind both in medicine and in life?
SPEAKER_01:That's actually a really good question. Um the legacy I want to leave behind is that I've been able to help people. That's the legacy I want to leave behind. And I think that is something that starts with where I was inspired and how I was raised. Um even during my times of struggles and things like that, I would meet people and they would say, Oh my god, you're so-and-so's son, or that's your mom, or that's your dad. And they were selflessly always helping people. And help can come in many different forms. Help can just come from a smile, help can just come from a conversation, help can come from by teaching someone something. And so as I started progressing and advancing through my career, um some of the mentors that I had who also helped shape that, um, and going through the rotations that I went through, I set out to say, hey, you know, I would like to change the landscape here in Chicago in the medical education space. And so one day, if I look back and say that I was able to help all these people, you know, do well and be successful in medical education, I would say that I would feel happy and complete. And of course, more importantly than that, not only did I help those people, but now I've also helped many more patients have greater, better outcomes. So the legacy I want to leave behind is saying that I've been able to help all these people.
SPEAKER_02:Thank you so much, Dr. Say. That was very insightful to learn about the differences between um academia, being a hospitalist, and being in hospital administration. And obviously you've done it all. Uh, thank you so much. And as mentioned, you are uh quite the celebrity in the Chicago region when it comes to uh hospital and hospital administration. Um, I also want to point out that after Dr. Said initiated the educational programs and insight, we've had scores of students who matched into the um INSIT programs. And uh because of that, uh Dr. Said has taken the time to come and come to our studio and record a podcast, as well as later on uh in the month, he will be interested in addressing our students directly. Um so again, if you are interested in residency, if you want to get sub-eyes, definitely tune in for that webinar. But uh as always, do remember that there is no shortcut to becoming an MD. Thank you so much. And if you do really like our content, feel free to download us at any of your uh favorite platforms and give us a like and a follow. It goes a long way for us. Thank you so much.
SPEAKER_00:Thank you so much for tuning in to our show. We hope you enjoyed another episode of Med School Minutes. If you like our content, please follow us and receive notification when a new show is posted. This podcast is brought to you by St. James School of Medicine. For a video version of this podcast, please check us out on sjsm.org slash video.