Leaders in Medical Education: DocOssareh, YouTube Medical Educator



right hello everyone my name is Shiv I'm the co-founder of osmosis today we have the great pleasure to speak with dhaka sorry who is a neuro resident at university of southern california and most famous for his very popular youtube channel which has over 40,000 subscribers and has been seen millions of times so doc thanks so much for joining us I'm really glad you were able to take the time out of your intern ear to do stuff thanks for having me it's an honor great so um you know this is as you know the leaders in medical education interview and we chose to feature you as a leader in medical education just given the huge impact you've had and so many students who've watched your videos I really would love to hear first of all how you got interested in in medicine kinda what your journey to this point has been sure I mean one thanks for telling me I'm a meat you know I'm being considered in this leader of medicine group I just always thought of myself as some kid with a camera on YouTube playing around when it came to medicine I I was quite lucky I would say I had a very like friendly upbringing my parents really sweet but then just unfortunate I mom got quite sick when I was quite youthful so I just spent a lot of time during elementary and middle school taking her to all of our appointments kind of helping her get our medications like fixed out and I think one thing you do as a child is you find role models whether they're your parents or people you work with or for professionals you see somehow you something attracts to you I think a lot of kids probably get interested in athletes and sports for whatever reason I really didn't and for me I think just seeing such a heavy medicine integration and I you just kind of got me excited about the field because I realized there are really good people doing really nice things for my family and trying to help my mom get better so that at a young age has kind of made the physician role to me sound like a really amazing profession something I wanted to do in college I got really lucky I went from being just like an average caught you know high school student to going to really a great college at st. Mary's it was small it was accurate Catholic liberal arts college it was super small community and that's where I really got to kind of find my niche that I did want to serve people I did want the medicine and that I did love science so I got quite lucky I got to see real practice of Medicine quite early on and I got to see how positively affected my mom and then in college I really did get nurtured and kind of supported into going into medical school that's awesome in it and so you end up going to UC Irvine correct correct right and then and during those four years that or actually you spend a couple more years because you did your MBA is well I'd love to hear about your decision to pursue the joint degree – right so UC Irvine you can do the classic four-year MD degree they do have a five-year MD MBA program where you do three years of med school so you'll do the first two basic science one year of clinical your third year you'll go off to business school for a year and then come back you'll do your fourth year finish that up and then do another half year of MBA and then that finishes up to five years and you graduate with you know the next class was when you're below you originally with both an MD and MBA and for me I would say you know the MBA is it's not for everyone you have to have some inclination to perhaps want to work more classically maybe in hospital administration or for me you just wanted more business experience so you could understand how healthcare works and how you can have more of a role in changing how healthcare is in the future and for someone like me who does do the YouTube channel is interested in medical education having an MBA always only gonna help because medical education kind of the changes have been at a higher level um you know my point I'm helping like one student at a time whoever launches the video but if you want to like work for a school or work for a team or a company having some managerial skills can only help yeah no I definitely I definitely agree that's very similar to my experience in Business School as well and what it's given me but I would I would push back and argue that you've you know one student at time watches your video but at this point tens of thousands have already benefitted from it so it's more Act I think than an individual school could have in the time you were able to do it and actually that's a good transition point – I'd love to hear how you got interested in medical education specifically and then decided to even create a YouTube channel I mean I would I wish I had like ass like a really clever or well thought out answer of I always knew I was going to be an academic and I always I was gonna do medicine and medical education but in reality I was a quite poorly focused high school student getting in trouble mediocre grades who just didn't have direction you know just a person who was bored and then in college I really got excited about school like I was studying all the time I was really interested in schoolwork and that was like a really big transition to go from being like perhaps they've lost high school student to a really focused and driven college student and right around that paradigm shift is when I created the YouTube channel I realized that like a lot of my friends back home I would call them and tell them hey here's what I'm doing in school here's what my mentors in college and professors are teaching me like look how cool this is and look at how now I can focus for longer periods of time err how I can study more effectively or I'm even studying in general you know versus goofing off and I was doing that originally by just like calling a few of my friends and keeping them all up to date and then I realized I was like well there is YouTube and I do have this really cheap Sony camera I'm like why don't I just record the stuff and then all of them can watch it at once instead of me trying to make phone calls and you know just try to be more efficient and that's kind of how the YouTube channel started I just wanted to originally give back to my friends all the benefits I was getting from going to college because we had all kind of goofed off in high school together and now I was like guys like oh it's great stuff I'm learning and I'm kind of moving in a better direction I might just watch the videos and you know and I always say in all the videos I'm like it's my biased and never humble opinion but just check them out if you want I'm trying to adopt the advice but then you know I was getting feedback from viewers from all over the world at some point saying like hey thanks for your videos and I was like who are these people and that's when I kind of got the idea of wow people actually care about these things I'm not the only student in the world who's trying to do better and then I was like I should just make some more videos on things I'm doing at school and benefiting from I'm like I'm at a really good college I'm getting great mentorship I really should be sharing this and YouTube was a really easy to use platform where I just I would you know I would hit record I would talk and I'd hit off and I just upload I never did you know much editing and that was how it started to grow on its own that's really awesome that sounds very similar to kind of Sal Khan's story where you know as you probably know from Khan Academy that he then ever intended for it to become this huge organization but he was just kind of just to teach his nieces exactly yeah that's awesome when did you start like kind of how was that growth trajectory I mean was it the first few months you basically was just your friends but then you're getting discovered and how did you go to 40,000 users and three million views sure I think in the beginning it was it would say I was probably one of the few people on YouTube who were really talking about medicine and who were really talking about I know and call it like cousin YouTube at the original point was for a lot of fun videos like people would go to YouTube to relax and to enjoy entertainment cats playing piano as people you know skateboarding and breaking legs like that was like what but then like when I started to put more serious things on YouTube that was like a really big barrier because I because because I realized it's going to be really tough for me to get to take an entertainment fun platform and try to make it into something serious like that was my biggest worry at first how am I going to get people who are you know resting on the couch or taking a break from work on YouTube to want to now focus and think about something quite serious so in the beginning it you know it was a it was a really aggressive steep curve and I realized I just had to do very focused advertising so I would like go to you know student doctor Network or some med school forums or like undergraduate Facebook groups at my school and just be like hey guys look at his channel and I think from there people just kind of caught on and shared with their friends and it was more of a social growth among friends of how the channel grew very cool and and were there particular kind of videos that you felt were inflection points like when you covered specific topics oh yeah I mean to this day or a most popular video is the guide to the medical to the physical examination I think that one has like eight hundred something thousand views that one that one that one I did during the first year of med school with one of my colleagues and we just we just I mean I probably half the reason I didn't neurology I just love the physical exam and I was like how fun would it be if we like did the physical exam we put it on YouTube we gave it our own goofy spin but we of course like focus on the content because I remember being a first-year med student trying to learn the physical exam not having like a lot of I mean there was like no offense to Bates but like there was like some base and New England Journal videos but they were so stiff and I didn't like you know I didn't I didn't feel like I was learning well and I was like let's just make our own video where we're learning in school and hopefully some other med students can catch on and after I made that video the channel just really started to explode that's awesome that's really really great I've seen seen a couple and they're super entertaining like like most of your channel the videos I've seen but but I gotta say like I think when it comes to like what made the channel kind of grow after that was I realized the videos where I just give what I call common sense advice seemed to do the best like I recently posted a few videos and one has like four times the view of all the other videos I posted in last month and that's like four core strategies to learn more effectively so these kind of broad topics of like you know how do you make the first year of med school completely manageable like how do you not get caught up in the details how do you make studying for step one not an insurmountable thing how do you take better notes when you're in college like these kind of basic things that I think you want to hear from upperclassmen are the ones that did the best and that's kind of the theme the channel took over I'm just here to give you advice I'd give my little brother you know just take it for what it's worth ya know that makes a lot of sense it's almost counterintuitive because it's it's you'd imagine that the secret the the tips and tricks that nobody hears would be the ones that get most popular but I think some extent people just want to want you know reassurance to something oh yeah absolutely yeah and and so you know you mentioned that you're still posting which I'm really impressed with because earlier you were telling me before we started the interview that you are two weeks into your intern ear as a neuro resident how do you have time and where do you see the channel going now that you're ready yeah well I mean thankfully a neuro I'm lucky so like the first year of neuro is a prelim like internal medicine year and then you go over to do your three years of advanced neuro training but the hours are the same you get up super early and you get home quite late I think you know even throughout med school people were like you know shouldn't you be studying all the time how do you have time to make videos and I think it's you have to make the videos as you're going through the experience like when I was in the basic science years I made a tremendous amount of basic science videos and when I was in the clinical years I made videos on how to do well in the clinic and like during like board time I was like here step one here step two because the best time to make these videos is really when you're in the moment when you're experiencing it not you know a few months later and I think you just have to come you know I think it helps that I make a very you know usually a 10 minute video no editing just talking to the camera one take only every time because if I don't make the video now you're not gonna get that energy you're not gonna get that real advice that I want to share so I just have to make time for them and the way they make the channels you know that the videos are shortened to the point they're pretty easy to do ya have and and have you changed your style much since you've started you've upgraded passed a cheap Sony camera or yeah I have a DSLR now nice thanks to new Agra some website I got a good discount you know but I mean the big thing is I still have that same goofy intro everyone always comments on what's up YouTube like boy I think kind of that that thing is always there we always end with as always enjoy your studies but I think why you know I think one big idea I had for the channel was I don't want to make it feel like it's a lecture I don't want it I don't want you to think I'm talking to you and like trying to give you notes what I really wanted was the sense of like a cafe lounge or like couch conversation where you watch a YouTube video and you feel like you're talking to your friend and he's just giving you advice and I think that's done best with like minimal editing or essentially no editing I just talked to the camera I don't do takes I just think of a topic I just talk about it like I would to a friend who maybe a year or two younger than me and wants to know what to do and then that's it because that way I want the viewer to feel like they can engage and they can listen kind of casually like they would with a person in real life as opposed to like a formal lecture where I'm telling them things and editing up a bunch of different content that's awesome that's oh that's a great kind of and a way to stick stick stay true that to that style I think has really probably helped because I think some YouTube viewers really want consistency in channels they subscribe to exactly now you know given that you have so many subscribers I'm just curious have you you know you're sort of like a YouTube celebrity especially in this medical and health space have you ever had any med students come up to you at conferences or even in your residence well the first one is I was at the UC Irvine gym with my friend we were just lifting weights and like two or three guys came up to me and he's like are you that guy from YouTube and I was like yeah and like in the middle of the workout they made us like stop working out go stay on the corner and talk to them and just chitchat about what they're doing in school and it was just like they're like oh thanks a lot and you know we all exchanged numbers but it was just fun to think that even like in the gym or it even happened in like libraries and restaurants around UCI people just recognize you from the website like hey or don't you talk about stuff on the internet like you got a few minutes now and it's just it's just it's crazy to think that people kind of even recognize your face let alone wanna take the time to talk to you on the spot that's awesome yeah that's that's really cool even even in the middle of a chest workout people wanna interrupt that's awesome and so now you're probably transitioning to more resident level topics and is that is that your plan you're going to talk about me right so now I want to talk about intern year what you do on the wards what you do in the ICU cuz even two weeks in you're already learning the techniques of like how do you make intern you're better right because I member and it's like you know even two weeks ago the first like few days I was like you know you felt like you were swimming in water and you really had a life vest but now you kind of got the grips on it so you know hopefully in a month or two I can start making videos about what's intern year like what makes it a challenge and I think a really big part of what I want to talk about next is the social aspects of being a resident what's it like with your significant other what's it like not having sleep and being grumpy how do you control these things right because in one part in school you spent a lot of time just on content and just going to school taking tests but now comes this more you know adult social component of your you're doing work you have to learn but you also have to interact with a wide variety of people from all different backgrounds and do it elegantly so that's what kind of my new thing is how do you behave how do you influence people how do you behave in a way that makes people want to support you as opposed to just you know feel disgruntled by orders that's super beautiful and then I can speak to that you know from personal experience hello can you hear me uh hello can you hear me hey uh mo can you hear me oh okay yeah I can hear you can okay sir no worries I was saying that's super useful I'd be very interested in watching those videos too because so both my co-founder Ryan and I are he's married to a neuro resident UVA and I've engaged to an OB guy and resident of Hopkins and already kind of threw their eye seeing that transition and and seeing them learn how to do some of the things you're talking about how to interact with the collaborative care staff including the nurses and pas and pharmacists you know things that you don't learn in med school that you probably should which actually brings me to my next question which is you know your your YouTube channel is full of advice obviously but I'm curious if you had to boil things down to one or two things that you would like to change about say med school or even intern ear so far you know can you think not sorry to put you on the spot English for one or two things that you really would like to change if you could snap your fingers and do so yeah like when I think back to the first think the first two years of med school are just such a challenge for most students I mean I got lucky at UC Irvine I did well in the first two years I kinda like I guess I think the big thing was I had a good social network of friends who were all pushing each other and being supportive and when I think back to the first few years the biggest stress is everybody else you know everyone talks to you about how important step one is about how you got to be studying 24/7 so one thing I wish we could do is try to like take out that step one fear in students in the first two years because if you studied kind of like how you did in college I remember in college like studying was so much easier you just like you went to class you studied you try to get an A and then you went home like there were no one was worried about step one every day but it's like you go into MS one people are already buying first aid before they even learn how to study in med school I've heard even some med schools give their students first aid like during orientation at first year so one thing I'd like to change in the first basic science is let's not just you know let's not start doing you world too early let's not just study first aid let's try to learn our clinical medicine learn the foundation see how it applies clinically and then you can worry about first date a bit later or about step one that's a really big thing because every student I see is all they think about is step one which I know it's important it's part of your residency if I get it but you want to be a well-rounded physician don't just worry about the serious exams yeah I could not agree more I mean that was that was part of what turned me off of my first two year and a half basic science and also now in the position I'm in where we work with tens of thousands of students as well you know that I feel like over the last four years I've we've been growing osmosis it's just gotten worse I think there's just more things out there more pressure and even you know even the nvme admits that they really you know students should kind of de-emphasize step one viewed more as a learning opportunity that gets them to a certain level of knowledge as opposed to the end-all be-all of their careers right ultimately I think one of the things that made it most clear to my mind was you know we were paying fifty thousand dollars a year to go to Hopkins med and we had this lecture our second year med school by a Nobel laureate who helped us Carl Mears she helped discover telomeres that lecture people used to skip until they met at mandatory because they realized they were second-year some boards were only a couple months away and telomeres are not high yield for the board's that is completely the wrong way to think about it I did you know ultimately I wish that lecture was more clinically relevant because I'm not going on the PhD route and I'm right fathering telomeres myself that being said you know the reason you pay a lot of money I think to go to a school like UC Irvine we talked about war and white minute who's an assistant dean there is to find mentors and find really awesome role models and people to bring it back to where you originally got you're interested in medicine as opposed to just getting a you know to 60 on step one or whatever it is exactly or even that I mean that's the gold it's like you have a Nobel laureate you have someone who sinks very uniquely who has a very unique world view and now have the chance to go up after a lecture before lecture and get one-on-one time with this person where if you weren't at that school good luck even getting a phone call in you know it's like that's the duty you get to listen to people mean the basic science they often talk about their own research a lot but if you just take a moment and think oh this is in high-yield but also consider wow this person did something really creative they thought in a very unique way I can ask some questions about how did you think about it what's your way of organizing your thoughts because you can apply that to anything and that's the beauty of meeting really high end people that's all yeah couldn't agree more couldn't agree more so that that was your suggestion for improving medical school I'm curious have you you know you're just now a doctor and practicing do you have any thoughts on ways that you would improve say the healthcare system or or residency specifically sure I'll just a focus on the healthcare question there is I mean I think I got lucky because I got to see healthcare extensively from the consumer point of view up until I started med school right rather intensively I mean from like middle school all the way to the end of college like I was extremely involved in Mom's healthcare I went to all of her appointments I went with all these specialists I helped organize all her insurance work and I realized unless you have a real like you have the free time that I had like you know as college like that would make time to organize all of the appointments keep calling the insurance pushing for authorizations and granted we had a nice PPO and I was still doing all this work I mean the biggest hurdle that I see in health care is it's really not organized and it's by no means consumer friendly I mean the thing that I hate the most is like as an intern I get to see it patients come in they have some chief complaint they should come in through the IDI they get admitted to us we try to fix whatever acute problem they have and then we discharge them and we hope that on their own discharge I mean people feel sick not everyone has a strong social support network you need to do something to try to get people as organized healthcare ready outside of the hospital I mean we are very good at you come in the hospital we can repair you pretty well but once we send you out that discharge and you doing follow-up getting the right specialists on board being able to negotiate with insurance and pharmaceutical companies to get the medications you need to get the scripts you need to get the imaging done I mean that amount of interaction requires a good amount of understanding of how the healthcare system works and most people just are not that involved in healthcare so that's I think I think it's like a huge hurdle that no one's quite addressing on a hands-on technique of patients come in with problems and they they get lost to follow-up they get lost to proper follow-up or discharge planning because no one's helping them navigate the extremely complex system and that falls with two problems one yeah should be fixed extremely complex system that isn't all tweleve very well organized yes but until that gets done which I think will be quite a while in the interim we need to help people navigate the system by kind of you know third parties can just do it for them or some kind of government funding so that's you know patients don't go out and they come back in a month later to the hospital to say you know what I couldn't get in with cards and you know the insurance would let me get the MRI and back in with the same nausea dizziness I don't know what to do and as an inpatient you know physician or resident taking care of them you don't have the control or the time or even really the authority to go into the outside world and try to navigate the instincts for patients yeah I mean that is that is I think the MBA part of your understanding of the healthcare system has come out I really do wish that more medical students got more training and in the science of healthcare delivery because I think you know while while we're only one you know positions only one component of a very complex and increasingly kind of bloated system there are a really important bedrock especially those physicians who then wind up leading insurance companies and and hospital systems so so I think that's a really great insight you have on how to you know and under needs and challenges of healthcare one last question because I know you're busy and post call I don't want take up too much pressure is you've already kind of commented on this a bit with what you change medical how you change medical school but if you could you know there's you probably seen increasing reports about you know stress and burnout and Mariah will students in physicians you know what's a piece of advice that you've incorporated into your own life to hopefully avoid burnout and stress that I mean that ironically that question is that the core of what I try to teach people when people like reach out to me or once and kind of like specialized one-on-one talks the number one thing I tell people is ignore than all the noise and focus on this voice isn't like inside your own heart the there are tons of people who are gonna tell you what you should be doing how you should be doing it what you should be doing in medicine what you should be studying everyone's gonna give you advice and the problem is like if you think about that your brain can only take so much and everyone's advice unfortunately it's not going to be the best for you even if they have the best intentions you really have to you know try to ignore as much of the noise you can because there's gonna be you know nice people who are trying to help you and give you advice and that's great sometimes you're gonna fail it doing so and there's also gonna be students who are gonna be like you know unfortunately stressing you out who are gonna be telling you hey I just did four blocks for step one today and I read half of bully on you know just making stuff up or who knows what you have to be able to flush out all that noise and listen to your own heart and say okay I'm in the second year of med school I asked step one coming up should I be doing you world what should I be mapping out finding mentors who have your best interest in mind and can help you filter this noise to data ratio that's the key because you came into medicine frankly you want to help people you have a genuine interest in trying to make a positive difference don't get distracted by the minutia in the long run it will not matter but for now listen to your heart study what you need to it's fun clinical medicines exciting you already like it don't let other students or other people get in your way follow your heart and you'll be fine well I knew that based on your profile and all the YouTube videos I have seen that you would be a perfect candidate for leaders in medical education but this this interviews only kind of reaffirmed that and made it made it very clear that you are so I'd really like to thank you for your time and if you stick on for a few minutes I'm just gonna end the broadcast here but thank the audience for listening to this episode of leaders in medical education thanks a lot thank you

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