E01. I Got In…Now What? ft. Dr. Kyle MacDonald

For many aspiring physicians, receiving an offer of admission to medical school feels like the finish line. 

Years of hard work, uncertainty, and anticipation finally lead to that one moment. 

But what often receives less attention is what happens next. 

Because entering medical school isn’t simply an academic transition—it’s a personal one. 

Today’s conversation is about that experience: the excitement, the uncertainty, the expectations, and the reality of beginning the journey into medicine.

Guest Co-Host: Dr. Kyle MacDonald

Resources mentioned in this episode can be found on the USask College of Medicine Office of Student Affairs website: Student Affairs - College of Medicine | University of Saskatchewan

Beyond the Chart: Conversations in Medicine is a podcast dedicated to supporting learners as they navigate the journey into and through medicine. 

This podcast is brought to you by the Office of Student Affairs at the College of Medicine in collaboration with the student-led Wellness Task Force. 

Transcript

SPEAKER_00 0:00

For many aspiring physicians, receiving that offer of admission to medical school feels like the finish line effect. Years of hard work, uncertainty, and anticipation finally lead to that one moment. What often receives less attention is what happens next effect. Because entering medical school is not simply an academic transition effect. It's a personal one effect. Today's conversation is about that experience. The excitement, the uncertainty, the expectations, and the reality of beginning the journey into MetaSec. Welcome to Beyond the Care Conversations, a podcast dedicated to supporting learners as they navigate the journey into and through MetaTech. After conversations with physicians, residents, and learners, we'll explore the realities of medical training, the transitions, challenges, relationships, identity shifts, and moments of growth that so often go unspoken. My name is Jen Kinnell, and I'm your host. Thank you for joining us.

SPEAKER_01 1:18

Thank you for having me. Looking forward to it.

SPEAKER_00 1:20

Well, and let's start way at the beginning. Before you even entered medical school, what were you imagining it would feel like to finally arrive?

SPEAKER_01 1:28

I think we always have that imaginary uh idea of what it is, right? You've seen it on Scrubs, you maybe watched House, you think it's going to be hard work, but sort of fun and challenging at the same time. Maybe it's more manageable. Um yeah, just really rewarding. And I think you sort of have this like rose-tinted vision of what it could be or what it should be, um, which isn't always the case.

SPEAKER_00 1:55

Okay. Well, and if you could take me back a little bit in time for you personally, do you remember the moment you got that email?

SPEAKER_01 2:03

Yeah, it's um so back in uh in university, I was actually working at one of the discount grocery stores here in town, leaky roof, um, smelly produce, all that fun stuff. And I remember uh I was in the freezer unloading uh unloading pallets of nonsense and uh and I just was checking my phone because hey, work was boring and the email came through. So all of a sudden it was there. I remember reading it and going, oh, oh, like this is super exciting, and and jumping up and down and yelling. And the first thing I did was I called my mom at at work and uh and she didn't answer. So I ran over to the freezer and uh and the first person I saw was one of the uh old grannies that uh worked in the bakery. So I ran over to uh I think her name was Butch, and I ran over to Butch. I was like, Butch, I got into medical school, and she was so excited, and I remember just jumping up and down in the back room of the bakery with this old granny Butch.

SPEAKER_00 3:01

So and then you're excited and you're in the freezer album, and now you're in the bakery section. And hopefully your mom picked up her phone at some point.

SPEAKER_01 3:10

Yes, she did.

SPEAKER_00 3:11

And after the the excitement kind of settled, what thoughts or emotions came next for you?

SPEAKER_01 3:17

I think the next was more like the practical realities of the situation, right? Like I was born and raised in Regina, I did my undergraduate degree here in Regina. So at that point, you had to move up to Saskatoon for at least uh two years. So there was a little bit of stress, a little bit of anxiety, trying to find where to live, trying to figure out a new city. And it and it was my first time moving away from home as well. So I think the excitement sort of gave way a lot into sort of some stress, anxiety, a little bit of like still not hope, but excitement, I think would be a good word for it. Just the change is always a good thing. So just being hopeful, being excited that that you're gonna move up to a different pro or a different city and uh just start.

SPEAKER_00 4:06

So well, and if if I could have been like a fly on the wall and I'm following you around during that first week of medical school, what would I be seeing?

SPEAKER_01 4:14

The first week was was always interesting. I remember sitting in the big lecture hall, and and at that point we had 88 other students. So you don't really you knew a couple of them from maybe undergrad, but I actually didn't know a lot of them. So you're still trying to figure out like, oh, who are all these other classmates? Who who could you be friends with? You're like trying to trying to be a little bit more self-conscious about like what you say and how you act because you don't really know what's going on. The first two days back then, and I don't know if it's still like this, but it was just all classroom-based orientation stuff, policies, procedures. So you're trying to trying to just understand what you've gotten yourself into, right? How you have to when the exams are, how how the exams work, how the college works, right? The first week was also probably too much party. Uh there was uh a lot of like icebreakers, lots of uh lots of going out and just meeting everyone. But uh, but I also just remember like trying to adjust to living away from home was also just like a big theme that first week. Like, hey, having to go to the grocery store and and buy my own groceries and I have to make my own meals now and and all of that. So definitely was just a big transition. And and I remember just feeling overwhelmed and excited and yeah, trying to fit in and self-conscious. It was it was great, but no, it was actually it was it was really great. Uh that first week was a lot of fun, but uh, but yeah, there was just so much going on.

SPEAKER_00 5:46

Well, and fast forward by a couple more weeks towards sort of the end of that first month, are there any moments that still kind of stand out in your mind today about this big transition you're putting yourself through?

SPEAKER_01 5:58

Yeah, like one of the one of the things that I I remember the most actually is that first week, one of the like first academic classes we had was anatomy. And um the thing with the college and getting into medicine is a lot of people come from Saskatoon's physiology pharmacology background. So a lot of them have done a lot of the basic classes, they've done anatomy already, they've done some physiology. But I remember sitting in the anatomy lab, and basically the guy was like, Okay, guys, here's the list of bones you have to memorize in the human body. Uh, and they more or less walked around to the different tables and just dumped this big box of bones out onto the table. And I remember just being completely overwhelmed, um, just being like, oh my God, I don't even know what a bone is. And now you're asking me to try and memorize all this stuff. And yeah, just that sense of overwhelm. Um, and especially I think comparing myself to classmates who have done the anatomy background, because of them were like, Oh yeah, I already know this stuff. And they left within like 20 minutes, and I was sitting there for the full three hours trying to trying to figure it out. So I think that was one of like the big ones that sticks out is just realizing this is actually gonna be a lot, and uh, and just that comparison piece, I think, as well.

SPEAKER_00 7:12

Oh, well, yeah. And as the months kind of go on, would you say that there was a moment, Kyle, when you realized, okay, yeah, med school is definitely gonna be different than what I kind of thought?

SPEAKER_01 7:24

Yeah. I think I think that bone lab was definitely one of the big like, oh, this is this is a lot more than I expected. But one of the other big ones was I remember our very first exam was around histology. So looking at slides and looking at the cells and things under microscopes. And I came from a chemistry background. I did a chemistry degree, I loved chemistry, and all of this biology histology stuff was just so foreign to me. And I remember actually I I failed that first exam um of histology. So I think that was when it sort of like really hit that oh, this is this is gonna be a challenge. This is gonna be like something you have to work your butt off, and uh you have to really study and find a better balance. I just remember getting that first exam result. And yeah, just feeling disappointment and self-doubt and all of that. But yeah, I think that was one of the other big moments that uh really stood out in that first sort of couple weeks of med school.

SPEAKER_00 8:28

In terms of, I mean, you'd moved away, you're living in a new place, you're doing a pretty hard program here. What surprised you about maybe the emotional side of starting med school?

SPEAKER_01 8:40

One of my roles right now is um working with student affairs and and helping med students out. And I think the reason I'm so attracted to that is because there's this huge emotional side to medicine that doesn't ever get talked about. I was very unsure of myself. You have this imposter syndrome that creeps in, you have all this self-doubt. I mean, I I felt like an imposter not knowing all the bones right off the bat. I I failed the first exam. I was living away. So, like definitely the self-confidence took a big hit. And at that point, you're also trying to meet people and you're trying to fit in. So you're not really too sure who you can talk to, who you can trust. So the emotional aspect was was definitely there as well and uh and and hard to deal with, I think, in that first first sort of couple months.

SPEAKER_00 9:32

Well, I think a lot of students kind of compare themselves to the people around them. What would you say your relationship was with the whole idea of comparison, especially in those first few months?

SPEAKER_01 9:43

I think it's natural, right? We're we're social creatures like humans are, and uh, I think med students are also competitive creatures. So we uh what do you like to we like to compare, right? Oh, how did that person do? Oh, am I doing as good as they are? And and that comparison definitely plays in. Um, I think it feeds in a lot to sort of that imposter syndrome that I don't belong here, that I that I somehow got in by a mistake. And uh and yeah, I just remember that being very heavy those first sort of couple months of of med school. It's just feeling like, holy crud, what have I gotten myself into? How am I supposed to get through this? Like it it was it was a lot.

SPEAKER_00 10:27

Did you ever start to realize that maybe some of my classmates are carrying around some of the same imposter syndrome, those same like doubts or uncertainties?

SPEAKER_01 10:37

Looking back and having talked about it now with some really good friends I've made in school and uh and students, it's it's so incredibly prevalent. Um did I realize that back during those first that especially that first year? I I don't think I did. You really feel alone and isolated, which is which is a problem, right? Uh, but a lot of people feel it, and uh and I think the best thing you can do about it is trying to find the people that you trust and you fit in with and talking about it, right? Um the best thing to do with that feeling of imposter syndrome and the feelings of those comparisons is to be open and honest and uh and talk about it openly. And I think by doing that you uh you realize that you're really not alone. And that's what I I try to encourage people to do or students to do now, especially is find a group of people you trust, go out for a coffee, go out for a beer, and just make sure you have some time to decompress and talk about how you're actually feeling and doing in school because I think that's really important, but it's hard, especially in that first year.

SPEAKER_00 11:43

You talked about, you know, looking around that classroom and sort of wondering, okay, where do I fit in here? How did you find the people that you could lean on for support?

SPEAKER_01 11:52

That's a good question, actually. Is I still am really good friends with uh a handful of my med school classmates. And uh and if you would have asked how we met, uh I don't actually really remember, to be honest. I think there was a bit of, oh, I think I recognized this guy from Regina, so we hung out a little bit with that.

SPEAKER_00 12:16

Well, and did you eventually have some moments where you were like, actually, yeah, I do belong here in medicine. I actually am at home here.

SPEAKER_01 12:24

Every once in a while. I I feel like I still have moments even now. I mean, I I graduated med school, I'm almost 10 years into practice now, but I still feel like I have moments where I'm like, oh, I don't belong here. I got in by mistake. So those imposter syndrome feelings, I I don't think ever quite leave, but I I do remember like the pro skills is what we call it, listening to people taking their stethoscope or like using your stethoscope, taking their blood pressure. Um, I really remember enjoying that. And uh and I I I remember talking with some of my other classmates and the people you're in your your little skill groups with. And I remember some of them just struggling with certain skills. So I found I really liked that part of the school. Maybe that's when I more felt at home, but uh but yeah, there's still there's still days where I feel like I don't don't belong.

SPEAKER_00 13:17

Well, and uh looking at the parts of you that felt the most challenged when you started medical school, what has happened with those parts?

SPEAKER_01 13:27

The pressure and some of the self-doubt. I don't think it ever truly goes away, but I think you get better at managing it, to be honest. I think I've read a lot about imposter syndrome. Um I've started seeing a really good like therapist, counselor who's uh who's spectacular. And the big thing she keeps coming back to is you have to give yourself some grace and you have to be patient and kind to yourself. But uh but yeah, it's it's hard, right? It's um it's challenging.

SPEAKER_00 13:58

Well, and would you say that looking back, there are things now that you understand about that first year medicine version of Kyle that might have been kind of hard to see at the time?

SPEAKER_01 14:09

There's lots. I think the big one is is just realizing that you're only as alone as you make yourself, which is which is almost a paradox, right? Because you feel isolated, so then you probably isolate more, but that's usually the wrong answer. So so trying to reach out, trying to try to find, yeah, that group of people you can you can feel supported with is key. But looking back, I really wish I would have engaged maybe some more with student affairs at that point, if I could have gotten like a really good mentor or someone to help me through some of those challenges. I think having a I think everyone should have a therapist. Um, I tell that to patients all the time. I tell that to uh to my wife and uh to all my friends and the students is I think it's just useful to go and be able to talk to someone in a carefree, judge-free environment. But yeah, like that that first year, Kyle, I think was putting a lot of pressure on himself. And when I talk to students now, particularly about their first year and about I see how much pressure they're putting on themselves. I think that's one of the things I try to reassure them is that yes, you do belong. You're not gonna get kicked out of the program, you're not gonna fail, you still are gonna be a doctor at the end of this hall. We just need to figure out how to get make you successful, right? So I think you're your worst enemy in first year med school, to be honest.

SPEAKER_00 15:33

Oh no. But like there are also pluses too, right? And I and it's obviously not just that first year, but moving through med school, would you say that there was ever something that turned out better than you expected it would?

SPEAKER_01 15:46

It's a great job, honestly. Like I I love what I do, even on some of the really crappy weeks in the middle of winter. You go to work when it's dark, you come home when it's dark, uh, but just the ability to go and talk to people in the hospital and try to put together the pieces of the puzzle and then explain things to them in language they understand. And then every now and again you get a challenging case where you actually have to sit down and you you almost feel like you're putting the puzzle together or something where you're trying to figure out, okay, well, what could I have missed or what's the next step, or what antibiotic do I choose next? So the job is spectacular. Um, it's just it's a really difficult journey to get there sometimes, especially through school and residency, but it just keeps getting better and better, honestly.

SPEAKER_00 16:38

There is light at the end of some of those tunnels.

SPEAKER_01 16:41

Oh, yes, absolutely.

SPEAKER_00 16:43

And therapy sort of helps with this. And sometimes it might be a little daunting to approach one of the offices that, you know, student services. Oh, do I do I really need this? Or am I just, you know, am I ready to actually reach out for help? But looking back at your early few months, you did pull through them, Kyle. Um, what was it even at that time that helped you feel grounded?

SPEAKER_01 17:03

I think a lot of it was probably just perseverance and just being stubborn. Um, just realizing that, oh, well, obviously studying in this way isn't working. So I'm gonna have to try and change up how I'm studying and try a different way. Um, and just bulldoze your way through it. Um, I think helped me sort of persevere. I think the other one is just trying to learn from your colleagues and classmates as well. Uh, some people learn best through flashcards, some people reread the PowerPoint, some people take notes on paper and pen, some people retype notes. So just trying to figure out how to study and and leaning on your classmates for that as well was super helpful. And being like, hey, I'm really having trouble with histology. Like, how did you guys approach this? And they're like, oh, don't worry about X, Y, and Z. Try one, two, and three instead. So just stuff like that was was helpful, but uh, but wasn't always obvious, I think, to begin with.

SPEAKER_00 18:02

And were you ever able to help people back, like with that chemistry background?

SPEAKER_01 18:06

You know what? That's the funniest part is I can't think of very much chemistry that comes into play in in med school, um which is a bit of a shame, but uh uh I'm sure there is uh somewhere, but I found a lot of um more of the professional skills, just just getting out there practicing, um sort of motivating or like bugging your your pro skills group to hey, we're gonna go and practice Tuesday evening, like you're gonna come with me and we're gonna go do blood pressures on each other, right? Or we're gonna go check each other's ears out. So there was a little bit of like motivation that way that I I think I helped out with. But yeah, definitely like from the academic side, I remember struggling and having so having a tough time finding my footing.

SPEAKER_00 18:52

So who was it or what was it that would you say made the biggest difference in helping you find that footing?

SPEAKER_01 18:59

I think a lot of it was probably trial and error and trying to figure out what works best because the the big thing with med school is it's it's basically university on on steroids. It's there's so much coming at you so fast, so so quick that sometimes the skills you developed in university that got you through. Like I was very much a pen and paper, take my notes in a notebook, rewrite them, and just with the amount of material, it just wasn't possible. So um so just trying to adapt and try different study skills, trying to figure out how you study, um, was super, super useful. I think the best way I did that was, yeah, just talking, talking with like family, well, not family, talking with friends, talking with classmates, trying to see how they were studying. But then I also remember I don't think Dr. Gilmour was part of student affairs, but she was sort of the histology director. And she was like, Oh, if you're if you're having trouble with like histology, why don't you like come to my office and like work through it? So I think there was a little bit of like informal mentoring there as well. That that really paid off. So yeah, I think just reaching out, asking for that help, trying to help with that adjustment and trying to figure out how to study in med school is a huge piece of this all. And probably just, yeah, there's all sorts of supports. You just need to need to be brave enough to ask for, which isn't always easy.

SPEAKER_00 20:29

That brave piece, it keeps kind of popping back up. And um can can you take me back for a second? How did that conversation with Dr. Gilmore happen? Like, can you rewind me back in time? Like you fail histology, you're like, oh, this is terrible. Then what happened?

SPEAKER_01 20:46

Uh then I'm pretty sure I got an email from her being like, Hey, I I noticed you didn't pass like the first exam or whatever. Like, do you want to come and set up some office time and like work through the content and try to figure out like where you're struggling? And and at that point, because I I don't think I knew any better, I was like, Oh, I guess I have to do this, right?

SPEAKER_00 21:06

It doesn't sound optional.

SPEAKER_01 21:08

Yeah, exactly. When it was entirely optional, but she was just such a lovely person, and she just had she was so passionate about about cell biology and histology that I was like, oof, you really love this stuff. But uh, but yeah, she just reached out and I think it was just sort of taking that step and saying, Yeah, okay, I'll I'll go and I'll play ball and see see what I can learn. Um, and just try to learn from her and learning about histology and realizing that it wasn't really the content I was having issues with, it was just the fact that yeah, I just how I was studying wasn't working.

SPEAKER_00 21:45

Uh okay, we're gonna play the go back in time and hindsight's 2020 game here. But if you could have given yourself a little tiny bit of advice before that first day of med school where you rolled in, you're like, oh my god. Goodness, what am I doing here? What do you wish someone had told you before that first day?

SPEAKER_01 22:05

That's a really good question, actually. My my first thought was you belong here. Don't let like the imposter syndrome thoughts about you don't belong here rule your life, which I definitely think they did in that first year. I think ask for help between there's student affairs, there is academic support team. Even just finding a med student or a resident in in one of the older classes or the classes above you to help out would be super helpful. And I think just don't isolate and try to talk and share those experiences because I think a lot of people don't want to talk about sort of mental health and wellness and all of that in in school because it's competitive and it's you're always comparing yourself. So I think just by trying to remind yourself to be open and honest and uh and encouraging previous Kyle to do that might have helped a little bit faster.

SPEAKER_00 23:04

Well, and it's funny because today Kyle is a student services advisor, and we'll actually we'll put a link in our show notes so that if you want to get in touch with Kyle, you can. But in sort of general, what would you say new students kind of spend too much energy worrying about?

SPEAKER_01 23:21

I think new students, they're sort of their own worst enemy, if you will. One of the other interesting jobs I have right now is is working with the family medicine residency program around assessments. So I've done some reading basically around how you learn, which is which is sort of an interesting topic. And and essentially to learn, you have to push the students or the resident outside of their comfort zone. You have to, you have to challenge them. And that can be really, really scary. I think a lot of the times when students feel challenged, when students feel like they don't know what's going on or that they're it's maybe not coming naturally, they take that very personally. And that's not at all the case, is is that's part of learning and developing sort of your professional identity and learning who you are. So I I sort of always joke when I when I'm talking with some med students that they're sort of their own worst enemy because they're always like, oh my God, I failed this exam, or I'm struggling with this content, and I'm never going to be able to match into whatever specialty I want, and I'm never gonna pass medical school when I don't deserve to be here. And a lot of it's just trying to reassure them that yes, you deserve to be here. The content is challenging, but we just have to figure out how to make it work with your brain, how to make it work with you, right? And I think a lot of that's just trying to be calm, trying to be reassuring and sharing stories like this, right? Hey, everyone struggles. We just aren't always open with those struggles.

SPEAKER_00 24:53

Well, that feeling brave enough to actually type the email to the person who might be able to help you, or to walk through the door of student services and be like, I am struggling here, help. It feels like everything that you needed to get into medical school is set up against that. Like, oh, well, you're you're obviously you don't belong here if you need help. But now looking at the transition, even that you've made yourself, how different is the reality of being a physician practicing medicine from what you were imagining all those years ago in the in the freezer when you got that acceptance letter?

SPEAKER_01 25:26

I think there's there's parts of it that are similar. Um, but it's interesting because yeah, now I'm eight years, nine years into practice. So I'm sort of forgetting right now, but a lot of it's sort of become more routine. You've sort of seen a lot of like 80% of the job, um, the common things right now in the hospital. So so a lot of it's a lot more routine and a lot more boring. So it's just almost starting to become another job. So one of the things that that's similar to how I imagined it is yeah, when you do get something weird or wacky or wonderful, and you have to sit down and you have to read through your textbooks, or you have to talk it out with colleagues, or you have to call all the different specialists to try and figure out what's going on. Like putting the puzzle together, that that's sort of what I was imagining this was all like. But the uh the difference is, yeah, lots of it's just become more routine, a little bit more, dare I say, boring. Um but but I think just being reflective on that and finding the little gems or the little pieces, even in like the I don't know, typical pneumonia or a typical, I don't know, uh fluid on the lungs or something, right? If uh if those are the common things we always see, then then instead of being excited by the medicine, you have to find something else to be excited about. So maybe that's making a better personal connection with a patient, or maybe that's uh chatting with the nurse and uh educating the nurse and the nursing student who's on about, I don't know, COPD and smoking. Who knows? But there's definitely parts that are what I imagined, but a lot of it's I think becoming more routine now, which is which is an interesting sort of transition.

SPEAKER_00 27:11

Well, it also sounds like dealing face to face with patients is something that you really like.

SPEAKER_01 27:17

I would agree. Uh I I always joke that uh I went into family medicine because the medicine was whatever, but I really liked the talking with the patients and I liked helping their families understand what was going on and the communication side of things. And I think that's what really attracted me to family medicine to begin with. So now that I'm I'm working in the hospital, I mean I don't have a family clinic, but I still bring a lot of that sort of same ideas to my hospital care, I think, is trying to explain what the heck's going on in English or trying to break down very complex multi system, multi-organs are going wrong at the same time and trying to explain it to families. Like, you know what, grandma's pretty sick right now, and we're gonna try X, Y, and Z, but I'm pretty worried, right? So I think the talking and the relationship building is still what I enjoy the most.

SPEAKER_00 28:10

Oh, well, Kyle, thank you for just your sense of realism and your bravery and all this honesty that you've shared with us today. We really appreciate it.

SPEAKER_01 28:19

For sure.

SPEAKER_00 28:20

Kyle McDonald is a hospitalist at Regina's Pasqua Hospital. Yes, he's also a student services advisor, and we will put that link in the show notes so that you can find him. One of the goals of Beyond the Chart Conversations is to remind learners that becoming a physician, it's about a lot more than just acquiring knowledge. You also have to navigate uncertainty, build relationships, develop self-awareness, and grow into this professional identity over time. And so if you're listening to this and if you're entering med school and finding the transition harder than you thought it was going to be, just know that a lot of the feelings that we talked about today are feelings a lot of people share. You do not need to navigate them alone. Because belonging in medicine is not something you have to prove on your first day or even the first week or month. This is something you grow into over time. So just before we go, uh we end each episode with a few little reflections inspired by the Proust questionnaire. No right answers, no wrong answers, but maybe put these things in your mind. When did you first feel like medicine felt like home? What quality in yourself took longest to trust? What would your first-year medical student self be most surprised at to learn about you today? What has medicine taught you about being human? What do you hope people remember about you as a physician? Thank you for joining us for this episode of Beyond the Chart Conversations. And until next time, take care of yourselves and each other. I'm Jen Cannell. This podcast is brought to you by the Office of Student Affairs at the College of Medicine in collaboration with the student-led Wellness Task Force.