Become Yourself to Lead - Dr. Tom Hurtado

(upbeat music) - First season six here, we're trying some new things. And I first want to say that Elise Van Damme and Poy Gilmore are part of Realm D, they're Realm D facilitators, and they are passionate about the podcast, which to me is a thrilling thing. And so they are going to start co-hosting. - Yeah, so we just had a conversation today with Tom. - We were really curious what was the thing that lit the flame to forming Realm D and then taking it from the University of Utah to this national level AMC rise. I think we hit some really deep topics in this episode. - Yeah, we got back from rise about two weeks ago. And in that time period, you know, we were able to see kind of what Realm D had become. And so we want a little bit of that back story and we're really excited to share it with you all. (upbeat music) - Hi everyone. The podcast room looks a little bit different today 'cause we have me, Elise, and Poy, who are both MS2s. And then we're joined here with Tom. We're just gonna jump right in. So Tom, everyone who meets you can see that you have this incredible fire for professional identity formation with the medical students. How did you get there? - Yeah, I think that is going to cause me to reflect a little bit, but to start off, I think for me, I took a very non-linear path into higher education, into academic medicine. And I think when you do that and you're navigating your own twists and turns, I think that you start to pay attention to like how you are reacting to different experiences. So I'll get more specific. You know, when I was in my undergrad, I was drawn to humanities. And I actually felt very frustrated because college was always a goal. My mom was very big on higher education and pursuing education in large part because her parents were farmers from rural Utah. They never went to college. In fact, when I graduated from high school, my grandparents received honorary high school diplomas we graduated together. But all of their kids, including my mom, went to college. Very important goal, I get to college and I started feeling like I did not want to go to college to pursue a vocation. And I don't know where that came from. When I was in my undergrad and pursuing these courses and interests, I saw people around me like jumping into the business school or jumping into engineering or they seemed to have these almost like they had it figured out or something. And I was like, I don't have this figured out. And also, I felt like I wasn't going to college for a vocation. I wanted to think differently. And so I landed in humanities, which is very much like, yeah, you're going to think differently and you're going to have to go to grad school. If you want to do anything, at some point. But I've just resonated with feeling more humanized and looking at history through the lens of the arts. Like you're not only looking at what politically was happening but what's happening in literature, what's happening in the visual art and just how people are reacting to these different moments in time and looking at it through the lens of what art was being created. I just loved that. And I had a band in college, a music group and we started performing and I just loved that too. I love being a college student and a musician like that made sense. I had no idea where that would go. - Do you think that that helped you build your strengths, the innovator? - In all of the things that I've done, there's always been this, you're kind of making something out of I kind of want to say nothing because like my career was not handed to me, you know? There wasn't like a linear part of that. So I think maybe innovating and wanting to innovate came out of that. I mean, when I was promoting my band, you're always having to like jam your foot in the door to get something like to get a show, to get a gig, to get a paid opportunity, to get in front of people. And so I think there was always like a fight to make that happen. - I love this connection to the humanities and how you're exploring. It seems like, you know, all of these features of something that's inside of you, right? At what point does this really extend to people who are around you? - So right after college, I mean, I've told this story before I had kept going with my band. I tried working in corporate America. I was doing like some corporate sales thing and I just, it was soul sucking. I was like, I can't do that. So like corporate America was crossed off the list as focusing on making the most money I could for both myself and a corporation did not feel right to me. So I started touring and managing my band and we had some success with that, but it was always like a real grind, like all the time. Like you're churning your own butter all the time. Like you're trying, you know, you always had to have something going and I think that was really hard to feel creatively inspired while having to just like completely always be working so hard for every little thing you could get. Also it felt very self-focused, like self-promoting and I didn't, that didn't totally align with me either. I think I love playing music I still do as you both know. I stopped enjoying the like self promotion of being a musician. What ended up happening is I went back to higher education as kind of a temporary fix where I was a contracted employee in higher education. I started working with students and they needed to monetize their radio station, their newspaper, it was at the Salt Lake Community College and I started selling stuff using the sales skills I had attained to help them keep these things going, like to give them radio experience or to give them. And I think that's where it clicked in that I wanted to benefit learners. And I happened to fall into that job and I was a contracted employee and then they were happy with what I was doing and then the university of Utah reached out and said, you know, we've heard about what you're doing. We think you'd be a good fit for something we're doing up here and then I moved up to the U and did that for several years. But I think that's maybe where I started to see that working with learners and working in higher education was great. And you know, my parents, my mom was a higher, she was a librarian. She worked in higher education her own career. She was very supportive to law students, graduate students. And I think that interested me. My stepdad was like a higher ed administrator, worked in the, for 42 years at a college. And so I think I grew up around that. I mean, I was literally like growing up on a college campus and could feel learning going on and see my parents in that space. And you know, I didn't end up doing what they did in their career, but I think there was that idea of, oh, being around learning and learning environment is really cool. Really curious, it sounded like you had a bad experience, you know, working with, you know, corporations and helping them find money. Whenever you accepted this job, were you anticipating that you were gonna have this spin on it? Where, you know, you were gonna be able to, you know, play a, a bigger role that was a little bit closer to your heart? Was there a certain amount of dread there? Because you knew that you're out there trying to help this, like, this other kind of corporation make money? How'd you come to make that decision and feel good about it? Is it something you anticipated on the front end? Do you understand? I didn't anticipate it. Are you saying when I started working in corporate America, did I anticipate how I would feel about it or when I shifted to higher education? Yeah, whenever you started working in corporate America and then whenever you, you know, because even higher education at its fundamental core is a business too, right? Yeah. And so in both instances, there is this money factor. Yeah. And it sounds like what really drives you is, you know, this attraction or this gravity to humans, you know, humanism. You studied humanity. Yes. And so how have you held both of those things in both your hands at the same time? I think it's the, in this nonprofit world, which obviously still is about money in budgets. And I mean, it always, you know, you always need resources and there's always going to be scarcity. I just felt like if I'm going to be working for something, it has to also be for someone, for people. I think eventually I landed on, there's a story about this. I landed on this idea of seeing people develop being more valuable to me than, I guess, other elements of work life. Everybody needs money to survive. And I get that and I'm not going to paint a picture that, that, you know, you need to be compensated well for what you're doing. Like that's not what I'm saying. But what are you doing in the time that you're working for someone? What other forms of compensation are occurring as a result of that effort? What I started to notice is so I was working in supporting student-created media at the U. I had transferred from Salt Lake Community College and I ended up doing a one-off project with the student government undergraduate students at the U where they wanted to create an academic planner which was an actual hand-printed academic planner and they wanted to hand it out for free to all students and they approached me and said could your team basically sell advertising into this planner and then we'll hand it out for free to all students. And I said I think we could do that and we did and it totally worked. It was like the synergy of you know businesses want to promote their services to college students and in exchange for that them putting an ad in the planner we could print it for free and hand it out. So we did that and it was great. It was like a neat little project but what I noticed is that the student when we were done the student who was assigned to work with me on it had this real look of pride in the fact that she learned about 25 things about herself and things that she didn't know she could do by doing this little planner project. She was involved in graphic design, she was involved in setting up how we would monetize it. She had to figure out what to include that might be helpful to students in terms of resources and information and was learning how to communicate with other people in relation to getting this product off the ground and then got to see it come to fruition. And when that happened I remember mentally saying whatever just happened between me and the student and the student growing I want more of that. And I pivoted my career I went like I immediately looked into higher education administration as a masters degree I started interviewing people I had a couple colleagues that pointed me in the right direction and then I applied and I applied late but they told me that the application had been reopened so I paid the little application fee I applied late and then they sent me an email and said we actually decided not to review applications. And they said you know you're not rejected but we're not going to allow you to be in this application cycle and I remember thinking to myself well could I have the fee back because you didn't even review my application and then I jumped in as a non matriculated student because I could take up to six credits as a non matriculated student and I ended up doing a leadership class like a seminar course so pretty high up in the program about leadership and I met a faculty member who is still one of my mentors today named Jack Newell who was a former president of a college and had done some things in student affairs for several years here and was a beloved faculty member and a complete out of the box thinker around leadership. And so I did that class I loved it I had I wrote my first leadership creed in that class I hung in with like all these people who were further along in the program and then I reapplied and I got in but it was solidified me we've never talked about this at least it really solidified me because I was kind of angry yeah it solidified me in saying why do I want to do this and then I had this class that sort of confirmed to me that it was the right direction and then I applied for a position in the student government office where I had just advised that student they told me know that the job I had applied for didn't fit but that they thought that in the future other things might open up I thought they were being kind but six months later they reached out and said hey this is a position that based on your interview and your skill set we think you'd be good for we're creating it it's brand new it's to advise the student government on their communication and how best to promote their their events and the things that they're doing and I created the role I jumped they I ended up getting hired lengthy interview process was hired and then I started advising students on communication but it was deeper than that you know when I was a musician and I'm jamming my foot in the door to to have these experiences to go to students and teach them how to promote the services in the events they're providing it's not that different and when they needed to book national acts and think about security and and how to work in the how to promote a show I've been doing that for years you know so it's like it's just interesting to me how everything that you learn even in a non-linear path will serve you at some other point in your life like we always think well that experience doesn't directly connect to this experience so what's what how's this come how's this going to impact me but it's not like that it's like oh yeah I'm still using all these things and I'm doing it in a higher education setting bigger than that is I'm not promoting myself anymore I'm here to be a part of these students having developmental experiences and they're not in the classroom they're outside of the classroom and because they're more opt-in experiences they are very like meaningful experiences in hindsight that all makes sense as it's happening I'm like okay I just took a pay cut to start a master's program and go down a path that I can see that I like and I can see the reasons why but I wasn't just 100% sure what I did know is that I would take a pay cut at that moment in my career to have more of what happened with me and that student and what ended up happening is that blew up in terms of I was having that experience with 200 students who were doing lots of different projects and I was in that role of advising which means the students in the driver's seat and you're there to help them and shape it but you're more of a guide you're not trying to control what happens you're trying to open up a space to see what they want to do and hopefully help create experiences that help that happen yeah I think that really emulates what you do for us up here at the medical school and beyond that also at rise were you ever scared in those moments it's you went through this path that was very non-linear almost on purpose did you ever face any fears I think I totally did you know I think there's a lot of we talk about medical students having imposter syndrome and also feeling a lot of anxiety about like all the choices that we that you're presented with the paradox of choice how many options can a medical student pursue that would be okay for them like the ambiguity of that is pretty mind-boggling like you could be a family physician you could be a pediatrician you could subspecialize you could you could go surgical I mean there's just so many ending points that could work I've always had belief like one of my top five strengths is belief so this idea of like believing in myself and believing in other people and like that really is a core thing and so I think that I started to exercise belief in the face of imposter syndrome in the face of anxiety or the stresses of at that time I mean I had family had kids you know my wife's in art historian like we're in fields that are not going to immediately present viable options for you and I don't mean that is a slight to them I think I think the arts are underfunded I think they're undervalued I think that the humanities is going through a really tough time being viewed as something that's that's valuable and and I think people are overlooking the formative benefits of it in light of the fact that you don't have a distinct return on investment vocation immediately handed to you when you're done with that study so yeah I mean and people kind of freaked me out too because like I would get that what are you going to do with that I don't know if you've had this question before where you're studying something like what are you going to do with that and she's like feels like a dagger to your heart it's like it's like you have assessed me in five minutes of conversation and the first thing that you do is like stab me in the heart with what are you going to do with that and I'm like trying to figure it out I don't know I know that I love humans and I love being around humanizing spaces that I want to do things that give back and that allow me to almost witness the developmental mental process the developmental process of someone who I have the privilege to work with it doesn't feel that far off from medicine in some ways other than like the knowledge base needed to treat but I'm just saying like I feel like I have some shared experience in terms of really caring about people and wanting to serve them in a way that's not self gratifying I'm really struck by this idea that all of our experiences can be taken and help propel us forward even if they're not in necessarily what they feel like a very linear way as I'm hearing your story it makes sense that you are where you are now and so it's weird because I can look back and it feels like this this path that if I laid out for you at the very beginning, it could seem linear, but the ambiguity at every step of the way, the fact that the path you took, I think is unique. It doesn't really conform to that, you know, direct linear path, at least the way that we would call it that way. And so again, I'm really struck by this idea that we can look backwards and find what seems like, you know, a pretty direct path to where you are now, even though it does take all of these turns as you're living each of those experiences. Yeah, I mean, part of what we're trying to do, I think, in medical school too, and part of rise was this idea of helping people look for themes in their own life by telling that story. Like, however messy or nonlinear it is, you start to make meaning out of your story. And then you start to own that story and you start to, I think, feel empowered by that story, right? Whereas initially when somebody asked me when I was in those states of non-linearity, they're like, well, what are you going to do with that? I felt very discouraging, but now it's like, I have evidence that shows that, yeah, there was something to do with that. I didn't know. I didn't know back then. And honestly, there's parts that I still don't know going forward. We still don't know. The story continues that I worked with undergraduate populations for several years, like seven and a half years, in that advising role. And then I was promoted as an associate director and continued there, but sort of had a moment where I realized that I needed to do something new. I was in a very creative space where 150 to 200 students come in every year. They're elected into office. Some stay the same, a lot don't. And then they have a new student government administration and then they start doing their projects. So it's always like something new, like different, you know, every political administration comes in and has new ideas. Yeah. It did start to feel like there was something more for me to do. And I can't tell you why. In fact, my coworker, mentor who had been there longer than me, he left maybe a year and a half or two years before. And he just said, it's time. And I thought, yeah, I don't feel that way right now. And then it happened. And I'm like, it's time. I'm like, oh, that's what that feels like. And then I started casting a wide net. And this job came up for here. And I, you know, through my name and I had this interview with Dr. Stevenson. And it felt really good. And I could see that there were things maybe needed up here that I had experienced with. And also I could tell that the hierarchy, even I don't, I didn't fully understand it, but I could tell that the hierarchy of medicine needed some adjustment, like in terms of, like creating more experiences for students and empowering students to feel like they can connect, can connect with themselves more and do that student driven work that I had been doing with students for like seven and a half years. Like there's, I could tell that more of that could happen here. Not to say it didn't happen at all, but it's just like, oh, I think I could be involved in that. Yeah. It makes so much sense. Like when you're talking about where you came from and then how you got here, why you teach us all the things you do. And I'm just curious. It sounds like you already are talking about some gaps that you saw when you arrived at this job. I want to hear a little bit more about those and then how you saw real MD, how that came about to fill those gaps. So initially in my application, I talked about student leadership and I said, I'm really interested in student leadership. I'm interested in being involved in students developing in that way. The word I was using was leadership, but I don't think that's quite the word. I know it's part of what we're doing, but it's really not. So you have these inklings like and in my master's program, I studied specifically graduate populations who are working and are pursuing like their profession and how you create leadership development opportunities for them where that they could opt into. And so that was what I studied. That's what I wrote my master's, essentially my master's thesis about. I think the reason why I became interested in that topic was because when you are on the cusp of realizing your profession, so you're in graduate school and that is where it does start to connect to a vocation, right? You've narrowed, you're not in that undergrad space anymore. So you have narrowed, you've, for whatever the reasons are, you have picked kind of a career path. And graduate students are super busy. They're often working. They're often, and they have dependence. They have relationships. Your, your family's getting older. You have a lot of layers of life responsibilities. And so to me, it was very intriguing to say, what kind of experiences could you offer that kind of student, that kind of learner that could really impact where they go with their career? That was the question. And I don't think I had a fully fleshed answer in my master's thesis. I think I more understood that group more. And what those layers of life were. And anyway, when I got up here, I, I mentioned that. I mean, it's, it's obviously in my CV that that's what I had studied and that's what I was interested in. And so there was always some knowledge that I would do something like that. And I ended up talking to Dr. Lam. I said, hey, I'm really interested in, in student leadership and educating students on leadership. And I could tell there wasn't a program. There wasn't like an official program. There's some electives, but not an official leadership angle here. And Dr. Lam said, you should really meet Tony Si. He started about four months ago. And he comes from Michigan, MBA, but also worked at the medical school and was involved in leadership development. You should talk to him. And so we set up a meeting. And that's kind of like the game changing meeting. And I, I attribute so much of it to Tony actually. I mean, like I, you can see where my background is, but he has equally like a background. And where Tony is different than me is that he had already created these interventions and had gone through like the wilderness of trying some things and having it not go as well. And then pivoting and learning from that and then starting to create some really deeper leadership things. And he's the first person that said to me, Hey, Tom, medical school is really good at teaching knowledge and skills, but it's not good at meaning and purpose. I actually think through our collaboration, I think we started to realize that leadership, like authentic leadership comes out of the exploration of meaning and purpose. And that's where that started. But ultimately we said, Hey, let's do some leadership stuff. We tried to do an elective. We were denied the ability to teach an elective. And then Tony, as Tony is, like he's just like, you know Tony, Tony's like we committed. We are going to do this anyway. And we don't need to be given a classroom. Let's just set up a time and let's do this. And then that's where we met the first students. And that's where real MD then was created in this co-created space was students really being, I think in the driver's seat about what they wanted to hear about. And the modalities that we would use. And the fact that it was opt in was a huge blessing in disguise, because I think if we had done an elective, it would have been for five, maybe up to five students. And it would have been fine, like for those five students. But when you have a large percentage of a couple classes coming, it's different. You know, it just starts being like, it starts having its own life. Yeah, I was going to say something about this whole idea of leadership, because I think that a lot of the times we can think about leadership as being very self-motivated. It doesn't have this. I'm serving others sort of idea. It's like I'm in leadership and I'm in charge. And you would talk to about this quote that leadership is becoming synonymous with becoming who you are. And I really liked that quote because your whole idea is leadership is more about reflecting on yourself and finding your strengths and seeing what you're good at and seeing how that can help others. And so I was wondering if you could talk a little bit more about that. Yeah, I mean skill acquisition, even now, like if you want to DIY learn something, you have like all of the all of this access to self-directed asynchronous free from Khan Academy to whatever else is on YouTube for basically so much. I mean, I don't think the issue about leadership is skill acquisition. I think it's knowing self and actually taking the time to identify what your values are, what you care about, how you want to do something that's bigger than yourself and to identify that even in a draft form like the direction for me was graduate populations and originally it was leadership development. And you know, I had to go through some stuff to even come to that conclusion. And then I get this job in academic medicine, working in student affairs, and my job is obviously all of this to supervise all of the services that happen for medical students from the moment they They matriculate to the moment they transition to residency. Deeper than that, you know, once I met Tony, it's like, "No, here's the deeper thing." And then once you find that out, then it's like, "What do I need to impact the system in this space?" And then you can go about the skill acquisition part. But the hard part was like identifying that. What the deeper reason is that I'm here. And that why starts to create something in your life, just the why, just like knowing what it is. It's like you start building something, and that's what Tony has done, you know. So Tony's been a huge mentor for me. In fact, he was like the coach I needed, that I didn't know I needed when I needed it, you know? And that, you know, because it was still non-linear to some degree at that point, because how do you build something out of nothing, you know, when it doesn't exist here, and you have some opposition, it's, you know, just structural, you know, trying to do something new, you're going to have some opposition. And then what does that look like to, on a grassroots level, start to co-create something with students? And so when did you know that real MD was special? And when did you know that, you know, this was something you could transfer into like a broader sense through the double AMC? Oh, wow. How did you do that? I knew it was special when we did that first couple sessions where it was Tony and I teaching, so we were generating the content, and I had an early conversation with the two or three students who showed up, originally it was two students and then slowly more students started to show up. I was talking about branding like an early version of that. And I think Tony was talking about some area of like organizing yourself, like planning, calendaring, which I know we're still, we still talk about this. Yeah. And I had a student, Eli Bunzel, who is now an orthopedic surgeon, came up to me after and basically said, I need to be involved in this. I want to help. I'm noticing that I'm going through the regular like day to day of the curriculum and the statement that I've told this before that he said that just really struck me in that moment was if you delivered this exact same session that you delivered today at 10 a.m. Every week at 10 a.m. every Thursday at 10 a.m. I would come back and I would listen to it. Why don't you ask me these questions? Anyway, I started to feel, I obviously felt some emotion because he said, he said the system will beat it out of you. And I'll forget it. And if I come back, I'll remember it. So I thought, yeah, we're, we're attaching ourselves to something that's like bigger than academic medicine, it's like underneath all of it. And so for me, it was like, okay, now tell me what else you need and why don't you, why don't you help us create it? And then, and then it like took off in that way. So I think that's what I knew was special. Now how to move beyond that into nationally doing it? Like this is the stuff, this is the nonlinear stuff. Like I don't, real MD had been around for a few years and it's fast forward to 2019. And I'm going as part of my student affairs role. I go with Dr. Stevenson and several people from the U to the National Learnserv Lead Conference of the Double AMC does every November. And I'm in a leadership session and it's geared toward faculty and staff and a scholar who's done a lot in the leadership space named Chip Shoba from Dartmouth was presenting with Christina Tushman who was a staff member over leadership development programs for like Deans and basically like academic medicine physician administrators. She's there and they're co-presenting on this topic about hit ability, which is like in baseball, like the ability to to hit the ball, the belief that you think you can hit the ball. It's essentially like a growth mindset session and how important in leadership, like that belief in your abilities and your strengths. So I'm resonating. It's like it's my jam. It's like everything that I love hearing about and I was struck, you know, it was different than all the other sessions. And so I go up to Christina and I thank Chip too. And I said Christina, we're doing this thing at the U. I can see that the Double AMC is very focused on like higher education and administrator physicians and what do you think about doing something on a national level for students. What I'm saying is there's a real need for it and students are showing up and by that time, you know, it was like half the student body was opting into real MD on some level, right? From two students to half, just like, you know, by sheer noticing, you know, what they're interested in with their feet, you know, that's, you know, that's not a deep evaluation of what's happening, but it's like a basic one, like they're showing up. So obviously they don't get a grade for it. It's all opting stuff. So she said, here's my card and I thought I would never hear back from her. And then it took some time, but she ended up coming back. She hired someone by the name of Shira Kaplan, who is one of my all time favorite colleagues. And Shira and I started to build out with Christina and a focus group of our real MD students at the time. What rise would look like? So the students, we still are co-creating. The students are saying what they need, the Double AMC saying we're gonna create a space. And so in 2019, we launched the first MS2 rise 60 students showed up. And a lot of it was based on the real MD content that we had been doing. And then took some of the Double AMC content that they do very well and just like packaged it for a student audience, which we knew how to do. And we had been doing essentially a organic needs assessment co-created with students content thing for a couple years. And it was an amazing experience. And then you keep doing it and now it's one of my favorite things. I think this moment where you're presenting this idea is really interesting. It sounds like you've identified this need and you have this chance to kind of present what you're doing. Is that something that you went in hoping you were going to find? Did you prepare kind of to make this kind of presentation? This elevator pitch, did you have that in your kind of back pocket or was it just this natural kind of organic moment that presented itself and it just kind of happened? It's kind of common at the end of a conference presentation for people to come up and talk. I mean, it's kind of expected that you will network. I think the difference for me with Christina was, and maybe this is that belief piece, is that the intangible thing is what I'm asking her about and what I'm suggesting I really believe in. And I think in the world of trying to build your CV and stuff like that, there's a lot of trying to generate interest in doing things that you think you're supposed to be doing and generating interest around that. And I think the moment you're in a space where you're trying to accomplish the things that you think everybody else wants you to accomplish and you're trying to express or generate interest in that with somebody else, you're missing the key thing, which is, I really believe in this thing. You know, like when Eli said that thing to me, it hit me and it was like, I want to do this to benefit the people at my school and I can see that it's benefiting them and I want to amplify this, I want to see this go because I know and in my research and things like that, which I eventually pursued my doctorate, you know, around all of this, but even at that point, I knew that there was a gap. It was very clear to me that there was a gap. There was a gap in a national organization looking to provide this to medical students and to engage them earlier in this kind of content. And there was a gap in medical schools, which I really resonate with this struggle. It is very hard to create programming, meaningful programming that does not reside in the space of knowledge and skills that will help me become a physician. And if you're going to be in that space, you have to deliver something that gets right down to the core of something that the medical student thinks they need and also realizes that they need it even though they will not get a grade for it. So there has to be like some deeper reason, some deeper payoff. And I think when you are in the space of helping people figure out why they're doing what they're doing, it has a power to be more valuable than a grade or than a hoop you have to jump through to become a physician. And also not everybody is going to be into it. And I think I learned that you have to sort of accept that. Not everybody is going to get this right now. Sometimes you have to go through the fire of being in a residency and almost losing yourself and being burned out to realize, oh, this stuff that I thought was fluffy needs to be underneath everything. I can really resonate with that. Right off the bat in scope here at school, I just immediately felt drawn to Rulemdi, just because you always feel a sense of, you're not sure who you are, and it's a constant discovery, and I was yearning for that. And so I immediately felt drawn to it. And as I told you, it's been this island of sanity that you described over one of our leadership retreats over the weekend. I've always come back to it. And I think going to rise, maybe poor you can agree with this. I even realized how much more special it is because it's so unique to the you. It's, I feel, I truly feel like it makes the school who it is, you know, a school that really cares about you and wants to see you succeed for the reasons that you believe in. You have created that space, and I felt like it's just been so special. One thing that's so tough is getting medical students. And to some degree, maybe we all can relate to this, but myself especially to kind of look in and see where we are vulnerable and to accept and be willing to accept that. And so this idea of creating a space where, you know, people can be open to how fundamental meaning and purpose is in this journey, I think, is really, really special. And it does take a level of vulnerability. I mean, I think getting here into medicine and then the natural sort of process of going through all of the training pieces, preclinical, clinical, it doesn't naturally invite vulnerability. And I think I didn't quite understand that when I came here, but I really can see that now. And it's something that I think is changing. And I think we're involved in changing that. I didn't anticipate that I would be involved in that. Maybe on a local level, I could see that I would want to have engagement in it. And now I really see that I am involved in that. But, you know, naturally, I didn't see that. I didn't know that. I didn't know that about myself. I've always been able to express emotion, obviously, even in this podcast episode, you know, - End of the game, see you. - End of the game, see you. I mean, my boss or my team will say, like you're a boss who shows how you feel. You know, and I sometimes feel embarrassed about that. And other times, I'm like, I know there's power in it. And I know there's power in showing people that I'm showing you that that's allowed in this space. I'm opening it up. And so I think there's a lot of that. But I do have to push back a little bit on this idea that this, I know I'm very involved in this. And I know I represent it. And I know that I believe in it and that I give, I'm giving my life to it. Like I understand that. But it's not, if it were just me, I don't think it would do it. I think the fact, I think it's you. I mean, Tony and I were even having this text that that was like after the leadership retreat that we just did. We were commenting on the students who were there. And commenting on the power of that exchange. And it is that exchange. It's not the Tony or me or Brittany or anybody else, like individually believes in this thing. And it's sort of willing it into happening. It's the magic of us. I feel very privileged to represent it in certain spaces. And I feel very privileged to believe in something and see it grow. But I really would feel very weird if it was like this is you. It's not, it's like a real privilege to be in the space of co-creation, in meaning and purpose, and to see something grow out of that. I will push back on that as well. I think that although it is a give and take and we are working on this together, I think that without you, Tony, real MD team, there wouldn't be the space. I wouldn't feel as connected to you guys or my peers. You guys are making that space for that exchange. That's important to also realize that you guys are a huge part of this. I also want to go back to this idea of vulnerability. And at the AMC rise conference, the one focus group that really struck me was the one on fears. And how one of our medical students was talking about one of their failures and their fears moving forward. And how that created the space for all of us to talk about our fears and how they're actually really similar. Why do you think that we're so hesitant to share our fears? I think human nature doesn't want to appear weak in certain spaces. And so I think that regards whether you're a medical student or someone else, I think there is an desire to not. I think perfectionism is a hurdle we as humans have to grapple with. And then I do think in a high demand academic setting in which you're expected to perform at a very high level in your career all the time. I think vulnerability is naturally pushed out of that more than maybe other settings. Not the only setting, probably where that happens, but it's almost like it just gets amped up. I think there's maybe a myth around vulnerability being a show of weakness instead of strength. I think we're working to overcome that myth in medicine. You'll sometimes hear of somebody who gets up like a notable very high leadership, physician leader gets up and shares a vulnerability. And how powerful that is in that moment. But yeah, I think there is a lot of fear. I think there's a fear of failure. I think there's a fear of rejection. I think there's a fear of trying to uphold the even like the hypocritical oath and the desire not to make mistakes with patience and holding ourselves to such a high standard that we could lose ourselves. You could lose yourself in that. Yeah, this idea of putting your best foot forward all the time or trying to appear impressive or that's an empty fight 'cause there's no way to do it. There's no way to do it perfectly. It almost seems as though at the very least there's no way to do it perfectly or even to the standard that's been set alone, right? And I think that's one of the messages that I really gravitated to with real MD wasn't this idea that I could shed accountability for the position that I'm taking or even try to remove, you know, the burden almost of stepping into medicine, right? And accepting that responsibility fully, but being willing to accept the fact that I don't have to do this alone and that in the moments that I question myself and in the moments that, you know, I make mistakes that doesn't mean I'm not enough for this, right? And it doesn't mean that, you know, I have a cap on what I can be. And so it almost, it humanizes my idols, right? And allows me to see myself in them and it pushes me to portray myself as a human to the people around me too. In that process, we find something that's pretty magical. We connect and in those connections we're so much stronger than we are alone and we can go so much further than we can alone and we can think so much better together than we can when we're alone. And so all of medicine it seems is elevated by this. Whenever the fear is that by accepting all of these things, we're making ourselves and our teams weaker. And I love that idea. And I think in that, oh, yeah, in rise in that session, yeah, you're just, man, I wanted to cry. We've got to talk about it, but I wanted to cry and I wanted to sing and I kind of just wanted to hug everyone around me. - Yeah, in the fears in the fears session, yeah. - I also think there's a lot of-- - I was crying, by the way. - There's a lot of energy expenditure to try to portray ourselves in this perfect way. There's a ton of energy. I'm using energy to withhold my vulnerability. I'm using energy to make myself appear more like this than I actually feel like I am. I'm using, so I actually, a couple of years ago, I started thinking about the energy that I have that I can put towards something. I started doing this exercise. I think I did it with the student ones where they were really scared about what was going to happen with specialty and, yeah, frustrated with clinical evaluations, very common theme. And I said, what are you afraid of? Can we just say it out loud? Because I think if you do, you'll feel better. And so she said her fear, which is obviously the fear of like, I'm gonna go through this whole process and I'm not gonna make it. And maybe it'll be because of the specific thing today. I didn't have, I didn't actually know what I was doing. I was just like, maybe if you say it out loud, you'll feel better, but then she said, I feel better because I've been using all this energy to hold that in and not allow myself to say it out loud. Once I said it out loud, I feel like I can start working on it and dealing with it. And so kind of a resilience exercise, but I do think in my life too, if I'm using all this energy to appear a certain way or to fulfill the expectations of what I think everybody wants me to do for them and to meet this, whatever this personal expectation of perfection is, that energy is getting wasted. I understand why, but it's like, what if that energy went toward you asking yourself some questions that help you maybe understand your why? What if you start sharing your vulnerabilities and finding strength in that to continue to pursue your why? And what if that turns into a story that gives you more meaning to keep going when the non-linear path inevitably presents itself to you? What could happen, you know? And I think ultimately that's sort of what we're saying is, like the thing that you think is the thing is not the thing. The thing that you're putting the energy toward isn't gonna give you anything back, right? But if we could just redirect ourselves even in the slightest way to rather than holding up a fabrication of perfection to showing more of who I am, what could happen? And I think honestly that's what's underneath. Real MD, and I think that's what's underneath now, professional identity formation and this desire to carve out these spaces where we haven't been given space to open it up where it's been closed, to free people where they've been shackled, you know, to some idea and some way of being that we don't need anymore in medicine. That felt kind of like a speech. No, that was really powerful. I feel like you touched on all the things. I think I'll add something else that we were talking about over the weekend leadership retreat, but this idea of learning from each other's failures as well. And I think being willing to share those failures and having a space where that feels okay, then everyone benefits from it. Even though it's hard if you're the one going through it. Not only do you benefit in a skill mindset, but also just in relationships, 'cause you're like, I was there for you. You were there for me. We became closer through that. - Yeah, then we're redefining like, what does it look like to have a professional community? And not just some network transactional thing, but like these are people that I really love working with. These are people who will challenge me when I need it, who will listen when I need it. And I'll do the same for them. I think that that idea is also a big part of it. But I have to say that along the way, I think one of the things we talked about at Rise was this idea of sponsorship of people really sponsoring and being willing to connect to you and help you. And that this just doesn't happen because I believe it will happen. It happens because there's connections with people. And in that like human connection, something really cool starts to be built and grow. And the double AMC did that too. I don't have the ability to get in front of a national audience, but they believed in it. Shira believed in it. Christina did, you know, in those early days, and the double AMC continues to believe in it and create space for it. And I think the students believe in it, 'cause they go back to their campuses and we hope that, you know, they feel it and it resonates with them and they amplify it. Ultimately, it becomes a symbol or a model that increases maybe for everybody who participates in it, the realization that they might be able to do something, you know, which is kind of ultimately a thing. It's not like, hey, look at what we did. It's like, hey, look at what you could do. 'Cause ultimately, if it was just about tooting a horn, like, that's not what it's about. It's about hopefully students left rise feeling like there's something that you believe in and there's a path we all believe you could do it. - I definitely felt that. I think that's a good place to wrap up. I wanna plug AMC rise conference for any incoming MS1's and MS4's and next year it'll actually be in Utah and so we're actually so excited. A lot of us students wanna be involved and are going to be involved and of course you'll get to meet Tom. So if your school isn't sending people to rise, then definitely reach out to them. See if that's an option and if they are, then see how you can get involved because all of this really gets you through medical school and life. - Thanks for having this talk. It felt great to be interviewed. I wasn't worried about the questions. I'm like, you guys are gonna ask the questions. It was really fun and it's fun to have guest hosts, Elise and Poi, who are going to be involved in the podcast, going forward as well. So thanks a lot, that was fun. - Yeah, thank you. - The RealMD podcast is produced with a lot of help from a great group of people, including editors Ali Day, Kayle Campbell and Cameron Degra, as well as online content editor Kena Mehmet. Special thanks to Scott Singpil's Scope Radio and University of Utah Health. The RealMD podcast is part of the RealMD program at the Spencer Fox Eccles School of Medicine at the University of Utah, which helps medical students find meaning, community, and purpose during their training and future careers. Our theme song, Energizer Bunny, is by my son's band, Hurtado, you can find our podcasts on all major platforms. If you like what you hear, please follow us or subscribe. You can also help us grow by giving us a five star review and sharing an episode with a friend. Thank you for listening. (upbeat music)