As a guest speaker on the Osmosis podcast, Raise the Line, Dr. Sahil Mehta shares insights on what premeds can do to increase their appeal to medical schools and the importance of being certain it is the profession students want to pursue.
Transcript from the Osmosis Raise the Line podcast:
DR SHIV GAGLANI:
Hi, I’m Dr. Shiv Gaglani, and today on Raise the Line, I’m happy to be joined by Dr. Sahil Mehta. Dr. Mehta is the founder of MedSchoolCoach and nationally-known as one of the premier experts in medical school admissions. He has guided thousands of successful medical school applicants, and is also a practicing physician in Boston, where he specializes in vascular and interventional radiology. So Dr. Mehta, thanks so much for being with us today.
DR SAHIL MEHTA:
Thanks, Shiv. Really appreciate the opportunity to talk to you guys.
DR SHIV GAGLANI:
So you’re a physician and a successful entrepreneur. Let’s wear the first hat first; what led you to a career in medicine and then specifically radiology?
DR SAHIL MEHTA:
So I was an engineer in college. I always thought I was going to be an aerospace engineer because I thought it was the coolest thing in the world. But then when I got through engineering, I realized that the aerospace engineers don’t actually design the entire rocket ship. They just design like one little bolt on it. And I decided that that wasn’t really for me. And so I was a lost soul. I was going through all kinds of things. At some point I was thinking about studying for the LSAT. I bought an LSAT book. I was like, “Oh, patent law. That sounds cool. I like technology. That’s interesting.” And at some point I was like, “Consulting. That sounds interesting.” Because all my friends were going into consulting. And so I was exploring around, in all honesty, for a long time.
I had a family member who was so enamored by her job. She loved it. She said it was like the coolest job ever. She’s a couple of years older than me and I kind of digged and I was like, “What do you do?” She was a marketing person, and her job was awesome to her. She went and made all these great marketing campaigns. At the end of the day, her overall goal was to sell more deodorant than the other company. And I was like, “Wow, this is somebody who really loves her job. The job sounds cool. But at the end of the day, her job is to sell more deodorant than the other guy.” Right? Like how do I feel about that? For the right person it’s phenomenal, but I just didn’t feel like I was connecting with that. I didn’t feel like I could go to a job where at the end of the day I wasn’t really feeling satisfied, I didn’t really feel like I gave back, I didn’t really feel like I made a difference in a person’s life.
So that’s sort of what led me down the medicine path a little bit. My father was a doctor and so that was one of the reasons why I thought I would never go into medicine because he was a doctor. I was like, “Forget it. There’s no way I’m going into that profession.” But as I started to explore it and thought more, it came down to at the end of the day, if I can come home and be really happy with what I did, if I can feel like I made a difference in somebody’s life, that’s pretty cool. And that’s an interesting thing.
Then of course with that, there’s so many interesting things within medicine. We’re at the cusp of phenomenal growth in medicine if you think about what we can do today, compared to what we could do 20 years ago, compared to what we could do 50 years ago. Like the next 50 years, I mean, it’s just going to be crazy in terms of what we’re going to be able to do. So I really felt like medicine was the perfect combination of technology, applied science, feeling good about yourself, and teaching which I love to do. So it all kind of came together and I said, “Okay, I’ll go to med school.”
DR SHIV GAGLANI:
Once you got into medical school, I’m curious, how did you navigate which specialty to choose and then wind up ultimately choosing interventional radiology?
DR SAHIL MEHTA:
So, similar story. I was again a lost soul in med school and I wasn’t sure what I was going to go into. I explored a bunch of different specialties. I came into med school thinking pediatrics was what I was going to do. I love kids. I love taking care of kids. I thought it was fun. But then when I got onto my general pediatrics rotation, I was like, “Ah, you know what, this isn’t really for me.” For some people, again, it’s awesome. They love that stuff, but it wasn’t for me. I loved interacting with the kids, but I didn’t like thinking about the amount of kilojoules in a formula or whatever it is that general pediatricians think about. So I was like, “Pediatrics is not for me.”
DR SHIV GAGLANI:
We won’t tell Rishi, our chief medical officer who’s a pediatric ID attending. So hopefully he won’t listen to this episode about that (laughs)
DR SAHIL MEHTA:
(laughs) Yeah. Don’t let him know! But listen, pediatricians, I give all the credit in the world to them, but I just can’t do it. I couldn’t do it. If you just let me play with the kids, I’m good. But the other stuff I wasn’t really interested in. But it came down to, at the end of the day, I really wanted to do something where I felt like I could make a quick impact in somebody’s life. I liked the sort of surgical aspects of things. I like being able to get in there, make an impact, move on. So I explored different specialties and I’ll tell you the quick anecdote of how I came to interventional radiology. This was like the second year of med school, and we were going through a lecture on portal hypertension varices and they were talking about a TIPS procedure. The TIPS procedure is a procedure essentially where you’re able to create a new pathway for blood to flow. I was sitting there and they were talking about how the mesenteric system, when you have varices and when you have liver disease, you get varices that eventually bleed.
And there’s this procedure where you could go in through the neck, create an entire new pathway for blood to flow and then essentially put a bandaid on a person’s neck and tell them that they’re good to go. I was like, “Whoa, whoa, whoa, what just happened here? What were we just able to do? That was awesome.” So I got super excited and I said, “Okay, you know what, maybe this is where I want to be.” That’s sort of how I ended up down the route of interventional radiology and that procedure — again, I distinctly remember sitting there in the med school lecture and being like, “Whoa, that’s pretty sick.” It’s something I do every day of the week now and it’s pretty cool. It’s still cool to me that I can essentially, through just a tiny hole in the neck, be able to create an entire new pathway for blood to flow through the body.
Interventional radiology has been this awesome field for me because it’s one where I can use my hands. I’m very technical. I do procedures. I see patients. I follow them up long-term or some of them I follow up short-term. It’s not like diagnostic radiology. I’m not necessarily put away in a corner and not interacting with patients or physicians. It’s very much like a minimally invasive surgical field and the amount of things that we can take care of, the amount of procedures we can do from somebody who says, “Hey, I have varicose veins and my legs don’t look good in a bikini. Can you help me?” To the guy who’s dying on the table in that very instance, we take care of that entire spectrum. And I think that’s very cool about interventional radiology.
DR SHIV GAGLANI:
Totally. It reminds me of one of my favorite quotes from Arthur C. Clarke which is, “Any sufficiently advanced technology is indistinguishable from magic.” The way you described the TIPS procedure, it sounds that way. We also had another guest on Raise the Line, David Fischel, who’s the CEO of Stereotaxis, which is also a very cool robotic minimally invasive surgical company that maybe you’ve seen in the past. So switching gears from your career as a physician to your career as an entrepreneur and founding MedSchoolCoach, we’d love to hear that backstory and then transition right into how COVID has maybe increased demand because we’ve seen that med school applications are up about 20% this year relative to last year. So we’d love to hear how you founded it and then what COVID has done to the business.
DR SAHIL MEHTA:
So I founded it out of a passion project almost. I exceeded what I should have been able to do in a med school application sense from my own personal application. I did fine in college, I did okay on the MCAT, it wasn’t a great score by any means whatsoever, yet I was able to get into some really fantastic schools at the end of the day. And I realized I was able to do that because of the way I was able to present myself, put together an application, put it together on paper. Actually, this was during medical school, which is 15, 20 years ago at this point when we started. I distinctly remember helping some of my friends who were applying to medical school. I would look at their personal statement and say, “Oof, this is really rough. This is what you’re going to apply with? Are you sure?”
DR SHIV GAGLANI:
Any names on this call, or…? (laughs)
DR SAHIL MEHTA:
(laughs) No, I shouldn’t name any names. But I looked at it and we sort of worked together and we kind of really transformed it. And I realized, “Oh, this is something. There’s something to this.” People don’t necessarily always know how to sell themselves. And it’s a hard thing to do, right? It’s a hard thing to talk about yourself. It’s hard thing to synthesize four or five years of work into a 5,300 character personal statement at the end of the day. But that was something that I was able to do pretty well. And so I started doing that. I said, “Oh, you know what? There’s maybe an opportunity in here for a little business.” So I basically started this little business, and that’s all it was. I was helping some students get through. I love teaching. I love doing that. So it was kind of fun. I was mentoring those behind me.
And then that eventually just kept on growing, kept on growing, kept on growing to the point where now we have hundreds of advisors, hundreds of tutors, we do MCAT, we do admissions consulting, we do USMLE. We’re sort of able to help people through the entire spectrum. It’s been a very cool journey to see where this company, which I founded and ran out of my basement — and by basement I mean like six different basements across seven different apartments — is now turned into this real organization, this really fantastic organization with thousands of students who’ve gone through with us pretty much on a yearly basis now. And so it’s been a lot of fun.
The great thing about entrepreneurship is that these are skills and things that you do not learn in medical school, right? These are not medical school-related things, yet they’re so applicable to medicine on an everyday basis. So I’m in this cool position where I can actually take both of my jobs and almost combine them. It meshes into kind of one at the end of the day, because I can take a lot of what I learn on the MedSchoolCoach side and apply it to how we run a practice. And I can take obviously the medical side and apply it to mentoring students and helping them through the process of taking the MCAT, getting into med school, and everything else that they have to do.
DR SHIV GAGLANI:
Yeah, and it was super gratifying. I was on your site the other day and noted over half a million hours tutoring and helping with personal statements, 12,000 students at least, it’s probably growing quite a bit. To that second question then of how has COVID affected the demand for MedSchoolCoach given how many people are applying. Can you give our audience a sense of how many people actually apply to medical school each year? How many spots are there? Those kinds of basic stats that I know you’re intimately familiar with.
DR SAHIL MEHTA:
Sure. So in any given year, there’s about 50,000 or so people who apply to med school and about 20,000 seats. These are approximate numbers, but in 2019, it was like 53,000 and 21,000 students, so you’re talking about a percentage of around 45% of people who get in, 55% who get left out. So medical school is, unfortunately, or fortunately depending on how you look at it, one of the most competitive things that you can do and apply to, right? It’s not like college where there are really competitive schools and then there are a lot of schools that aren’t. In med school, really every single school in the country is super competitive in its own way. When you have only this limited number of seats and all these students applying, it certainly puts pressure on students to do a lot of activities, make sure their grades are great, all those kinds of things. COVID has really thrown a little bit of a wrench into this.
We’re seeing an increase of around 20% of applications this year. Schools are reporting in AAMC and AACOM — which is the osteopathic organization that runs the AACOM application — they’re seeing a 17 to 20% increase as well. So you’re seeing a lot more students put in applications. Some of that may simply be because students are applying to more schools, right? In the uncertainty of COVID, people are applying to a bunch more schools. People are realizing that they don’t have to maybe fly everywhere for interviews like they used to so people are applying to even more schools than they normally would. But you also had a group of students who were left out of whatever they were planning to do for that gap year. And then you had another group of students who maybe normally would have taken their MCAT a little bit later and applied the following year. This year everybody took their MCAT later and so everybody was late on the MCAT because of all the cancellations. So people were just deciding to go ahead and apply.
All that said, we won’t know the exact numbers until next year when AAMC publishes them, but schools have reported. AACOM has reported that there’s a substantial increase in the number of applicants to medical school. I mean, that puts a strain because there’s not an increase in seats. As you know, the seats don’t increase at the same pace at all. Seats increased by 1-2% per year or so. Every couple of years there are new schools added. And there’s been a conscious effort in the last few years to certainly add new schools, particularly those focused around primary care and some of the more underserved areas, but it’s nowhere near a 20% increase in the total number of students. That definitely leaves students in this super-competitive process already potentially applying for an even more competitive process at the end of the day.
But I think what you’re actually going to see is probably even more competition as we get further into the next three, four years because I think you’re seeing a renewed interest in medicine. For a time period where in the past it’s been computer science, finance, those kinds of things where a lot of the brain drain has gone — not to say that really smart people don’t go into medicine — of course they do. But with the COVID situation, with how much healthcare professionals have been in the spotlight, how much public health professionals, how much infectious disease docs have been in the spotlight; I think you’re only going to see more and more people interested in these fields and these careers over the course of the next three, four, or five years.
Imagine you’re a high school senior right now and for the last six months you’ve seen the incredible amount of work that healthcare providers are doing. You’re seeing nurses, doctors, everybody on the frontline treating this pandemic. You can’t help but be interested and you can’t help but be intrigued by medicine, is my feeling. So I think you’re going to get more people interested and more people into our profession at the end of the day.
DR SHIV GAGLANI:
I definitely echo those sentiments. It’s definitely what I’ve heard from other Raise the Line guests and I think it will be one of the few bright spots that come out of 2020, hopefully. One question I have for you is, I know there’s a lot of things people do to be more competitive as applicants. Obviously MCAT, volunteerism, research, et cetera. What are your thoughts around people actually demonstrating their interest in healthcare careers by becoming allied health professionals? So, for example, maybe a person becoming a nursing assistant or becoming a medical assistant or a scribe even before they apply to med school. Is that something that’s looked on favorably? Is that something that has no effect? What are your thoughts on that?
DR SAHIL MEHTA:
Listen, there’s no better way to explore the career of medicine than to be in front of a patient. That is, at the end of the day, what medicine is all about. And so if you are out there thinking through “is this something that I want to do?” — you can watch TV, you can watch Scrubs or ER, you can watch whatever. Does anybody watch Scrubs or ER any more? Probably not. There’s probably something new. But that’s what I watched when I was going.
DR SHIV GAGLANI:
I think Grey’s Anatomy is in like its 25th season or something too.
DR SAHIL MEHTA:
So you can go watch one of these shows, but listen, at the end of the day, nothing actually captures what it means to be a healthcare provider than providing healthcare. Right? And so these jobs like a nursing assistant, like a medical scribe, any of these things where you’re actually in front of a patient at a hospital, in a clinic, whatever it might be and understanding and interacting with people in the healthcare setting, is by far the best thing you can do to explore the career. It looks good obviously on the medical school application. You can prove to somebody that, “Hey, this is really what I want to do. I’ve done X, Y, and Z in order to get myself familiar with the career.”
And some of the things you’ve mentioned I think go even above and beyond shadowing, right? Shadowing has always been one of these things where medical schools want it. You want to shadow, you want to understand what a physician does, but a shadow to me is a fly on the wall, right? You’re that person in the back of the room who maybe is listening to the interactions, but you’re not actually there providing care. I think it’s a valuable experience, but medical schools want to see you take that step beyond, a step further, and actually take care of the patient, in some way. You’re not going to do surgery. You’re not going to prescribe medication. But you’re interacting with them, you’re holding their hand, whatever it might be. That is huge from an admissions committee standpoint.
The way you’re going to be able to craft your essays, the way you’re going to be able to talk about that in interviews, the way you’re going to be able to put that together in an activities list goes a long way in showing your true, genuine interest. And forget even about showing your true, genuine interest for a second to medical schools. You should know as a prospective student, prospective physician, “is this what I want to do?” Because too many people go into it or think they want to go into it because maybe doctors make a lot of money. By the way, that’s not true. Maybe it’s because they saw that cool episode on Grey’s Anatomy or House or whatever. 99% of that is probably medically inaccurate. So you’ve got to really get yourself into the mode to make sure this is what you want to do.
DR SHIV GAGLANI:
Yeah, totally. I mean, spot on. I can see why you started MedSchoolCoach and why so many people come to you. So I know we’re coming up on time, but I guess two questions I had for you: one is what do you think as somebody who’s advised so many current and future physicians are some of the lasting changes that will occur as a result of COVID or should occur as a result of COVID?
DR SAHIL MEHTA:
So I will tell you this based on experience from being in the hospital treating COVID patients in a big city that has a lot of medical centers. Pre-COVID, we stunk at communicating with each other. Post-COVID, we’re slightly better about it, which is to say there are things like access to EMR systems across different hospitals that are absolutely needed, right? A patient who goes to a hospital across the street versus our hospital, we don’t talk to each other, right? Our hospital communications don’t talk to each other. It’s hard to cooperate, but COVID has sort of taken down some of those barriers. Just to get in our hospital system, there’s now a little link where we can go and click on and see the hospital across the street and everything that’s going on for that patient there. So we’re able to communicate and it’s broken down some of these barriers that have been up for so long. So if there’s one positive, maybe that’s a positive.
The other positive I think is the emergence of tele-health in this. I myself, in my own clinical practice, I get patients from Maine, I get patients from New Hampshire, I get patients from Vermont, I get patients from Connecticut, who used to have to drive three, four hours to come see me for clinical visits. Now the tele-health model is much more appreciated and much more available. Oftentimes I’ll see the patient for the first time for telehealth, I’ll see them for follow-up in telehealth, and the only time I have to see them physically in person is of course, when I’m doing the procedure on them. So I think the telehealth aspect — the ways that we’re able to communicate, the barriers that have been in place — are slowly starting to fade away. Now, I wish they faded away a lot quicker. I wish they were all gone and I wish we could just understand everything about every patient, no matter what hospital they walked into. But maybe that’s a silver lining in all this. Maybe that’s a silver lining of what’s happened here and we can use that to build forward.
DR SHIV GAGLANI:
Those are definitely some words that I would echo myself. My last question for you is the question that I think you get every day and you’ve probably answered more times than you can count, which is what advice would you give to somebody right now considering a career in healthcare? Maybe a young Sahil Mehta deciding not to go to law school, maybe to go to med school. What would you tell him?
DR SAHIL MEHTA:
So I would tell him a couple of things. Number one, it is a long, long road. Make sure that this is what you want to do. It goes back to what you talked about, Shiv, exploring the career, getting your experiences, making sure this is what you want to do. I just talked about the fact that it was 15 years ago or plus — I literally cannot keep track of when I started med school – it just takes a long time to get through your medical school, your training, your residency, your fellowship. And then finally you’re an Attending.
And by the way, it’s not like you’re the Attending and you’re partying on the beach. All of a sudden, life sometimes gets harder at that point. So it is just a very long grueling process where you’re going to see your friends who maybe did go to law school or went to consulting or went to finance getting six-figure jobs out of school while you’re still slogging away and working 90 hours a week for 40k because that’s what a resident’s salary is. You’ve got to like it at the end of the day and you got to make sure that this is what you want to do, because if it’s not, you’re going to be miserable. Right? So first, make sure you like it.
Second, if you decide you do like it, go all in because it’s actually a phenomenal career. I don’t know if I would have said that honestly, five years ago, seven years ago, 10 years ago. But I think I do say that today because at least for me, I found this really awesome place in my practice where I get to take care of patients, and they are so grateful for the care that they receive. I come home at the end of every day and I feel good about what I’ve done. I feel like I’ve challenged myself. I feel like mentally and physically I’ve put my skills to work for the betterment of somebody.
So if you decide this is for you, it’s awesome at the end of the day. Right? So go for it. Go all in. You can make it there. Don’t worry about the fact that you got a bad grade here or a bad grade there — there’s plenty of opportunities to make up for that. Medical schools at the end of the day are looking for great applicants, applicants who are interested in caring for patients. I’ve worked with applicants who have come to me when they’ve gone through the application process for a third or fourth time. They’re still struggling and we’re able to get them in eventually and they’re going to make phenomenal doctors, right? I can tell they’re going to make phenomenal doctors. Just because they struggled in Biochem in freshman year of college doesn’t mean diddly squat in how good a physician you’re going to be at the end of the day. So, for those of you out there who are in the process, thinking about going through the process, explore it. If you like it, go all in. It’s worth it at the end of the day.
DR SHIV GAGLANI:
Some great advice and also echoed by people like the Dean of Harvard Medical School who we had on the podcast, who would say the exact same thing. So, Dr. Mehta, thanks so much for taking the time to be with us today, and for not only doing the work you do at MedSchoolCoach, but also treating patients on a weekly basis as we mentioned at the beginning.
DR SAHIL MEHTA:
No problem. It was fun talking. I appreciate it.
DR SHIV GAGLANI:
And with that, I’m Shiv Gaglani. Thank you to our audience for checking out today’s show and remember to do your part to flatten the curve and raise the line since we’re all in this together.