.png)
Shadow Me Next!
Shadow Me Next! is a podcast where we take you behind the scenes of the medical world. I'm Ashley Love, a Physician Assistant, and I will be sharing my journey in medicine and exploring the lives of various healthcare professionals. Each episode, I'll interview doctors, NPs, PAs, nurses, and allied health workers, uncovering their unique stories, the joys and challenges they face, and what drives them in their careers. Whether you're a pre-med student or simply curious about the healthcare field, we invite you to join us as we take a conversational and personal look into the lives and minds of leaders in Medicine. Access you want, stories you need. You're always invited to Shadow Me Next!
Shadow Me Next!
8 - Similarities in International Medicine: One Doctor's Inspiring Path as an Internal Medicine Resident Physician | Judy Song, MD
Discover the inspiring journey of Dr. Song, a second-year internal medicine resident whose path to medicine was shaped by personal health trials and a rich tapestry of cross-cultural experiences. She shares how childhood health challenges and a fascination with the contrasting medical landscapes of China and the U.S. fueled her passion for better patient care. Join us as Dr. Song opens up about her evolution from aspiring journalist to dedicated physician, with invaluable insights for international medical graduates and a heartwarming story about a 90-year-old practicing doctor.
Our conversation explores universal challenges in medical training, the crucial role of research, and the rewarding yet rigorous life of a resident. Dr. Song provides a candid account of balancing patient care with continuous learning and preparation for future career pathways, whether diving into subspecialties or beginning a practice. In addition, we encourage you to be part of our growing community by tuning in every Monday and sharing your thoughts and questions. Stay connected and inspired as we illuminate the human side of medicine through Dr. Song's stories of resilience and dedication.
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
Mock Interviews: shadowmenext.com/mock-interviews
Personal Statement Review: shadowmenext.com/personal-statement
Free Downloads: shadowmenext.com/free-downloads
Want to request a guest? Shoot me an email: ashley@shadowmenext.com
Hello and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant and the creator of Shadow Me Next. It's my goal to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face and what drives them in their careers. It's access you want and stories you need, whether you're a pre-med student or simply curious about the healthcare field. I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations, so make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped, and follow us on Instagram and Facebook at Shadow Me Next, where I'll give you sneak previews of our upcoming guests.
Ashley:This is episode eight of Shadow Me Next and I am so pleased to introduce you to Dr Judy Song, a second-year internal medicine resident with a multifaceted background in public health and health informatics. Dr Song shares how her own health challenges as a child inspired her to pursue medicine. She discusses the importance of research in the field and provides insights into the complexities of electronic health records and the difference between medical training in China and the US. She has great advice for aspiring physicians, especially international graduates, and shares her touching story of a 90-year-old doctor who still practices medicine. This is Shadow Me Next with Dr Judy Song. Hi, dr Song, thank you so much for joining us on Shadow Me Next. How are you today? I'm doing great. How are you, ashley? I'm really really good. Thank you so much for being here with us and for taking the time out of your incredibly busy schedule. We so appreciate it. So, dr Song, if you could tell us about let's go back to the beginning and tell us about what first sparked your interest in medicine.
Dr. Song:Yeah. So like many other people maybe some people are sick in their like family or face some kind of challenge medically themselves, and I have a pretty similar kind of story. So when I was in middle school, I was sick a lot I have a lot of GI symptoms to the point that I was absent from school for like even months, and at the time no doctors really know what's happening at the time. And from that point I was thinking oh, one day, if I could choose, I want to be a doctor and I would probably do a better job than what they did. So that's really how everything started.
Ashley:That's incredible. You know, personal experiences are such a hard thing, obviously when we are the patient and a lot of times we do receive excellent care and it's fantastic. But sometimes we don't receive excellent care, or maybe it's like bedside manner or the rapidity of how fast you got your diagnosis or how the diagnosis was explained to you. So I think that personal experience, helping us determine that that is what we want to do, that medicine is where we want to be, is so hard, but it's also so good and I think it makes us a really phenomenal provider. So were you always sure that you wanted to become a doctor? Or perhaps were you considering other fields in medicine?
Dr. Song:I changed my mind all the time.
Dr. Song:Yeah, when I was really little I wanted to be like a journalist, I wanted to be a writer and then, like you know, later on I was sick in hospital all the time.
Dr. Song:So I got interested into medicine and my best friend in high school her whole family, she comes from a family full of doctors and you know I just happened to know her so well and know more about medicine from her side. And then, like, I went to medical school in China and the whole practicing kind of environment and patient physician relationship was not ideal at all. So at a time it kind of shifted my confidence in really actually practicing in China and I just saw a lot of problems, not really in the clinical field but more of a policy and health literacy kind of perspective, and that kind of inspired me to get my master in public health in the US and currently I'm a second year resident in an internal medicine program. And currently I'm a second year resident in an internal medicine program. So I would say that from when I was a little girl up till now I changed my mind so many times.
Ashley:I'm so glad to hear that other people are, you know, unsure too, because I think people just expect us to wake up one day, when we are in high school or middle school even, and say this is the career path for me, this is what I'm going to do, and then they never falter. Every single medical professional that I've spoken with so far has said it's been a journey, right, and it's been a journey to even get to the point where you realize what you want to do and how you want to pursue that. So tell me a little bit about research. Is research something that is required in order to become a physician?
Dr. Song:Yeah, so in my home country or in China, it is a must. They even have those requirements for how many publications you need to have for you to go to the next level. Wow, it's a very different system and I think here in the United States people also expect you to be familiar with the whole academic world and do research. At least you need to know what to do and the whole system how it works, especially when you want to work in a more academic kind of environment. Medicine is such a wide and diverse field, so I think with the different kind of focus, there are definitely fields that doesn't really like. There are also different kinds of research, depending on how you define it, but in general, I think it will be helpful for people who's interested in medicine or who's in the field of medicine to do research, because you are sharing.
Ashley:You know, in PA school for PAs, we are aware of research, and some PAs are involved in research in their undergraduate studies. Some PAs are continuing to do research as PAs. As clinicians, however, it's far less common. The thing that just blows my mind is we still have to be very well-versed in consuming research, right? So our patients are relying on research and evidence-based medicine, which comes from doing research and doing studies. So I think it's something that is so important and I am so glad that our physicians are so actively involved, and I think it's something that we'll see becoming more prevalent in physician assistant school and in practicing PAs because, like you said, it's important to our patients that we're able to do these things. Yeah, I totally agree with that.
Ashley:Very cool. Now, did you get any other certifications or any other degrees other than your medical doctor degree?
Dr. Song:I have a master's degree in public health. I major in health education and behavioral sciences. I also have another master's degree in health informatics, so originally I was thinking about pursuing a PhD in health and grammatics and it is a whole nother story, but I still feel like those really helped me so much in navigating the general medicine world.
Ashley:Wow, you are amazing. That is incredible. So a master's in health education and then gosh, health informatics. Now, what is health education and what is health informatics? Those are two words that perhaps some people are familiar with, but others might not be.
Dr. Song:Yeah. So I think health education is really about empowering the patients in any kind of ways you can. There are people focusing all different kind of realms, like education for school kids, educations for patients or populations that are underserved, and developing phone apps. What I was doing is we developed computer games to help advocate on management of asthma, sexual health applications, so it's a whole new world. I think it's super, super cool.
Dr. Song:And for health informatics, especially beyond the year of 2014, there's this requirement that all the health practicing facilities need to start the applications of electronic health records, and that is where all the kind of data are booming and we just have all this massive information. Data are booming and we just have all this massive information. However, what to do with them and how to better utilize them, it's a real question at a time. So all kinds of research like natural language processing, ai, or even like secondary analysis, like use analysis for my medication, we're currently using for certain indications for my medication we're currently using for certain indications. They could be possibly found to have other indications where it'd be helpful for preventing cancer or other purposes. So at the time I just felt I totally fell in love with the research and I was so involved with all that and it was a little bit you know off from the clinical practicing world for a while.
Ashley:Well, I could see how you could fall in love with that sort of thing. I mean, you mentioned AI. Ai has just exploded right now and I think it has such fantastic applications, but at the same time there's a lot of fear. Yeah, definitely, and the information overload, like you said, is tangible and it's real. Have you in your opinion? Because you know we'll hear everybody talk about charting and all of the information that we have available at our computer and at our stations now and we'll say kind of tongue in cheek sometimes oh, I miss the old paper charting days where you just you had what you had and if you didn't have it, well too bad, you know. But in your opinion, have we made huge advances with electronic medical records? What is the biggest benefit?
Dr. Song:I would think definitely for data like acquisition and like sharing data, and you know, having certain standard for data is definitely something that's fundamental and that's the stars of everything.
Dr. Song:But I would also argue that with the application of vhr it kind of creates new problems and then for different countries it's also something very interesting, like I was born in taiwan and in taiwan we have only one EHR, so you can imagine how easy it is to pull data from one place to the other because we have a universal health system. But here in the United States you have all different practices, all these commercial, different kinds of softwares you use. You have a free market, definitely, and people have freedom and like through a market and competition, you can have more advancement and grow. Everything has its different sides but overall I think having new technologies and new tools and trying to figure out how to work with it, that's how we push the field to go forward. So I personally have no regrets and I experienced part of the paper kind of failed kind of era when I was back in China and I, to be honest, I don't miss that.
Ashley:No, no, I agree with you a hundred percent. You know it's so interesting what you, what you just described. When I was interviewing for PA school, one of the questions that I was asked was about universal EMRs, right, so, like you just described, in Taiwan, how it's one system and every single clinician in the country would all use that one system, which, of course, in the United States is just unfathomable. I couldn't even imagine it. And so their question was what are the benefits of this and what are the negatives, what are the cons? And you just beautifully outlined all of those. So thank you for how beautifully you just put together the answer, for it perhaps looked different from medical school in the States, but maybe it didn't. Are there any differences that you have kind of discovered talking to some of your resident colleagues now?
Dr. Song:I feel like there's something definitely in common. I believe that, no matter where you go in the whole world, any students made it to the medical school are one of the smartest, like the most dedicated, hardworking people you could ever find in this whole world. So the same amount of stress and the competitions they have on a daily basis, I feel like that part is probably the same, but I think there's definitely a difference. When you talk about the resources in a developed world and a developing country and yeah, I would say that maybe in my country what I realized is that a lot of things really depends on you. You need to be super self-motivated and like self-learning to, because there are probably less kind of universal like mentoring or guidance towards the very end of what kind of positions you are going to become and when you are thrown in a market or in the real world to practice the kind of expectations very different from the expectations here in the US. Yeah, so I think I'm very, very fortunate to be here to be trained here.
Ashley:We're so grateful that you are here and that you are caring for patients here and have the knowledge and the background that you do. So tell me about residency. Did you get to choose the residency that you wanted? Are you kind of forced into it based on your performance in medical school? How does that work?
Dr. Song:I believe that when you apply for residency, they definitely look at, for example, your step scores, your research, voluntary activities. They want to read your personal statements to know what kind of person you are. I'm very lucky I'm matching to my like I ran, the person I'm currently at the first in my list and, yeah, I'm just very, very blessed to be here. But I would say that different programs really value different things, so drastically different. They are academic, like a university-affiliated program. They focus a lot on research and they will expect you to have an idea of what kind of specific focus you want, whereas you have very community-based programs. They are very down to the earth. They want to make sure that you're able to handle certain volume, have certain professionalism when you're under stress and being able to perform. So I would say that for different programs they are looking into different things.
Ashley:It's just a never-ending selection, I feel like, for medicine truly. I mean, it begins in high school, and then college, and then medical school, and then it continues on and on, and then you are, you're internal medicine, correct, yes? And then, once you become an internal medicine resident, do you then have to further specialize? Do you then?
Dr. Song:have to further specialize. So once you finish your internal medicine residency you can choose to directly go start your career as a hospitalist or you can also work in primary care and I know there are people who choose to work at night and become a nocturnist. And I believe there are like local jobs where sometimes people do very specific things that requires a background in internal medicine. On the other hand, you definitely have all the different subspecialties you can choose from for further training, like cardiology, gi, endocrinology, infectious disease, so on and so forth.
Ashley:Wow, yeah, that's wow. So many different pathways. I love it. So tell us, dr Song, about just what is a typical day look like for you right now.
Dr. Song:And you're going like maybe six or seven in the morning doing chart prep and you pre-round and see your patient and address like urgent needs of the patient and then between eight or nine till 11 or 12, they're surrounding with the attending doctors where we talk about each patient's cases, cases and there's teaching, for example, like a very specific case is how to manage blood pressure or how to manage pulmonary embolism patients and all sorts of things.
Dr. Song:And for our program, every day during 12 to 1 we have a launch lecture, so it's either a case report or journal club where we share about the latest journal and findings, where we do a board prep together and then in the afternoon we start admitting new patients and then kind of address the acute problems. Yeah, and then pretty much maybe around five till seven, depending on whether you're on the early team, the late team. Sometimes you need to stay till later to keep meeting new patients, otherwise you can sign off to the next night team and then you can go back home, study or work on your projects and so on and so forth.
Ashley:The work doesn't end when you leave the hospital. Oh, I guess that's a reason I stay working.
Dr. Song:The work doesn't end when you leave the hospital.
Ashley:I guess that's a reason I stay working. Yes, what an exciting day, though. I mean it seems like it's very multifaceted, you know, and I love the fact that you are able to kind of join back up with your colleagues for those lunch lectures and journal clubs and board prep. I think that's fantastic. What does it look like going on from here? How much schooling is left for you? Do you have to take more tests? What's next?
Dr. Song:I think I still have around one and a half year in this program. And then after you finish the program, you need to take the board exam for internal medicine. Even if you are going into a subspecialty, you still need to take the board exam for internal medicine. Even if you are going into a subspecialty, you still need to take the internal medicine board in order to take the subspecialty board. Up till this point, I think anyone who survived to the point to be in the residency program are quite familiar with all the standardized testing kind of format and all that stress.
Ashley:Yeah, no kidding, that is, tell me about stress. It's the never ending test cycle too, that's for sure. So, dr Song, do you have a patient encounter that you have either experienced, either in medical school or perhaps in residency to, that really impacted you and made you think well, thank goodness, I am doing what I'm doing right now that really impacted you and made you think, well, thank goodness I am doing what I'm doing right now.
Dr. Song:Yeah, so, just on top of my head, one patient that I think I'll forever remember him is in an outpatient setting, and this is a gentleman in his nineties, just a regular checkup. But what's special is that this patient himself is also a practicing doctor, internist. He's with his wife. And then his wife was saying, okay, so he's still practicing, but I don't think that's good for his health, he's so old and he should retire and enjoy life. But then my patient was saying oh no, this is what I wanted to do, I will work till the very last day, yeah, yeah.
Dr. Song:So I felt like, uh, like, especially if you are in primary care or in the outpatient setting and you accumulate your patient pool, you feel that you have this connection with them and it's really difficult to let go. It almost feels guilty if you stop helping them or something like that. And then from that patient, because he's a physician himself, I just see that how much he loves it and his dedication in it, and I think that's inspiring me and it's also encouraging to see that, oh, as an internist is something, is a profession that you can have for a lifetime is something is a profession that you can have for a lifetime, absolutely, absolutely.
Ashley:And his dedication to his patients, and I know, on the other side of things, his patients are so grateful for his continued care. I cannot tell you the number of times in clinic where I will have patients come in and are just devastated that their internal medicine physician or their family medicine doctor is retiring. They almost say, how dare they. They're in their 60s and 70s, they would also like to enjoy retirement too. But I think you're right. I think so often medicine it is such a noble profession, but it's also a calling and you get so much joy and satisfaction out of helping people. We don't become burnt out from helping people, which is why we are in medicine. You know there's other things that cause burnout and you know I mentioned those in episode one and you know things like, things like insurance and schedules.
Dr. Song:I do it with taxes. Taxes yes.
Ashley:All of the logistics. That is what causes healthcare worker burnout. It's never the act of helping people. So I'm grateful. I would love for you to still be enjoying your job when you're 90. Maybe I'll reach 90 and I'll still be enjoying my job too. What do you find most rewarding about your career as an internal medicine physician?
Dr. Song:I would say it's definitely building a connection and knowing people's story and be part of their life, because I feel like it is something to do with what I wanted to do when I was little. I wanted to do journalism. I want to tell people's story and in a sense that I'm just generally, you know, interested in human being and people and to a lot of sense, I feel like as a physician, we try our best to provide help and a lot of times patients have their own concerns, their different life kind of scenarios and economic status. Even we have the best medication, the best device, the best procedure, whereas all these advancement in medicine. To be someone who really listens to your patient and understand their value and expectation and to help guide them in this super, super complicated health system and find whatever they need to help them, I think that role is something I want to pursue and if I can make it that way, I would feel very fulfilled.
Ashley:That is incredible. I love that. I love that so much. Well, dr Song, thank you so much for taking your very valuable time and speaking with me today. I'm so inspired by your dedication and your focus on the patient. Still, even though you have been through so much schooling and have jumped through all of the hoops, I feel like you really have not lost sight of the purpose behind this mission that you're on. So thank you so much.
Dr. Song:Yeah, thank you actually for having me and I am really grateful for having this opportunity to share my story, to share my story. And one thing I really want to add is that you don't really see a lot of people like me being super introverted, being an international medical graduate, you know, speaking with an accent, still having this dream of pursuing medicine in the US. So I just feel, like anyone out there who's like me, who's been a female, like a foreign medical graduate, trying to do this, you can do it. All the friends or families or people I know who truly loves the field, they will find a way and they will find help with the people surrounding them to provide whatever they need to make it to the end.
Ashley:That is beautiful and it's so true. There is a spot for you and we need you desperately. Medicine needs you, so thank you so much. Thank you so very much for listening to this episode of Shadow Me Next. If you liked this episode or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday, as always. If you have any questions, let me know on Facebook or Instagram Access. You want stories you need? Any questions? Let me know on Facebook or Instagram Access. You want stories you need? You're always invited to shadow me next.
