Francesca: This is Francesca from the Smart Growth Rocket Podcast by topclassedge.com. More people than ever are making big leaps to their goals, carving their own paths, and being really successful in the process. And on this show, I talked to these bright, shiny successful professionals and entrepreneurs to discuss the ideas, the opportunities, and the strategies they’re taking advantage of so we can all be happier and wealthier. All right, so today I’m super excited to have Dr. Ariel Gershon here with us today. So a little bit of an introduction, Ariel Gershon completed his medical school training in 2019 at the Schulich School of Medicine and Dentistry. You also completed the specialist program in Pathobiology at the University of Toronto, and you’re currently a pathology resident at the University of Toronto, is that all correct?
Dr. Ariel: Yeah, I actually recently changed from pathology to medical genetics, so now I’m a resident in medical genetics. I went to med school at Western and I did my undergrad in Pathobiology and kind of like Biochemistry, and right now I am at U.T. I spent the last three years studying anatomic pathology and I’ve switched over now to more of a medical geneticist residency, out of sick kids. I’ll tell you a few things that I’m interested in and that I’m working on. So one thing is I’m really passionate about medical education, I think lots of medicine if you are academically minded can be very rewarding, there’s lots of teaching, and lots of learning going on. People say that medicine is like lifelong learning or like the arts take a long time to learn and so there’s lots of teaching opportunities part of it.
So when I was a medical student, I was teaching my fellow medical students physical exam findings. It’s like how to interpret your observations about the patient. So like, you can listen to a heart and like identify where the heart sounds are and what the murmurs are, what does it mean? I was teaching all that to medical students when I was in my senior year as a medical student, and then as a resident, I had been teaching at basically every level. I teach high school students as well, most recently through a company called MEDSKL. And I’ve also been teaching medical students in residence online, through Zoom and all stuff. We have like a global community of learners who join us every month to learn from a different specialty. So that’s a MEDSKL, It’s pronounced med skill or med school if you want.
Every single month I work with a different resident from a different specialty and then we learn what it’s like to live that life day to day, but also the actual content of it. So last month we did trauma surgery and we had a general surgery resident from U.T. who I worked with long ago when I did the rotation through general surgery. We learned things like when should a patient who has had penetrating trauma, when should they go to the operating room and when should they not. What are the signs that help you do that? And so, we had over 50 medical students join the lecture, and also we had like a quiz game. So every single month we are working on different specialties and the goal is to have a community of medical students who are learning from each other and learning from residents. And this whole thing was kind of inspired when COVID started, lots of things took a hit.
Obviously, people’s personal lives and work were affected all over the world but in medicine and I think in medical school so much is reliant on like physically being in person and like learning things from residents and mentors. So I wanted to find a way to do something to contribute to that, without physically having students be in the place that they used to be. So I think that’s like the biggest thing, the other thing I’m really interested in is the history of medicine, which is things like Hippocrates and like how medicine evolves over time.
Francesca: Wow! It’s different projects because of medical school and residency, cause that’s not enough.
Dr. Ariel: Lots of ways to be busy, lots of interesting things out there.
Francesca: You mentioned that you work with high school students, you work with medical students, and maybe some pre-med students as well. So if you wouldn’t mind telling our audience a little bit of your insights into what is a day in life like, let’s say a university student versus medical school versus your day-to-day now in residence.
Dr. Ariel: If you asked me about the university, I think what it looked like for me as I took like five courses at U.T. and they would be like, some would be physiology, some would be biochemistry, and so lots of multiple-choice tests, lots of essays. What I was doing then was like listening to all the lectures and trying to memorize all of the important things that were being thrown at me. And so I developed a few ways that made sense to me, but every student should learn for themselves what works best for them. I think flashcards worked well for me for many of my courses before getting to the interview and all that stuff. There’s like a whole process but the things that are very, very important are your GPA and your MCAT, and so learning how to study and getting a good GPA. You can learn in high school how to be an effective student and increase your GPA but you really have to sharpen that skill very quickly in university as well.
And then in medical school, things change very differently in every school in Canada, and I think most in the US have moved to a pass-fail system. So you are gonna be in the classroom for the first two years of medical school learning things similar to what I learned in high school, which was like a lot of physiology and some biochemistry. The goal now is to pass, anything higher than a pass doesn’t really matter for your course. And I think pass, for me at Western University was something like 60%. So it’s not that it’s easy, but it’s just like the pressure is different. Like you wanna study and do well because you know that your patients will benefit from you, knowing lots of things.
In your third and fourth year of medical school, it’s very practical, like you are actually in the rotations with the doctors who you’re trying to become like and collecting reference letters and trying to impress and take care of patients on the team. It requires a lot of different skills, but you kind of develop them over time. As a resident, you’re just gaining more and more responsibilities. And the idea with medical education is that you start off as a medical student who likes to know some things but maybe is not really allowed to do anything. Like you can’t prescribe medications and you have very limited things that you’re able to do. For example, you might learn how to like tie knots and stuff in medical school and then you could suture somebody who had a laceration on the foot or something. But then as you progress as a resident to get more independence gradually. But always there’s somebody looking over you who’s kind of double-checking you. And then as your competence grows and you’re more confident, eventually there are few and fewer things that you need oversight. And then after five years, you’re a specialist. And then throughout the whole time, you need to know how to reflect on yourself, on how to learn things quickly and efficiently.
Francesca: I believe you mentioned earlier on that you were originally pursuing pathology and you’re now switching over to medical geneticist or something along those lines. So I’m wondering what the sequence of events was that caused you to kind of follow that path.
Dr. Ariel: So when you’re done four years of medical school, the next thing that happens is you go to residency and so it can go up to like 8- 9 years. So if you wanna do neurosurgery, you finish your four-year medical students and then you do like 6- 7 or sometimes nine years of extra training on top of medical school. When I was doing the whole process of choosing my specialty, I was really interested in understanding the basics of human disease and I wanted to understand many different diseases, which I thought made pathology a good choice. And I was gearing up to become a forensic pathologist, which was like, you do autopsies and you like try to investigate why people die and you come up with a cause of death and a manner of death.
And I think all of that is really interesting but I realized halfway through my residency that like day to day what I wanted to be doing was gonna be much different in forensic pathology. And the things that were really interesting is when somebody died unexpectedly and we could find a reason that helped other people, which I realized was 90% of the time not gonna be the case in forensic pathology. So I was trying to just like modify what my day-to-day was gonna look like. So I was a medical geneticist, which is another five-year specialty. It’s one, I wasn’t really thinking about it in medical school, but I discovered kind as I was like doing my residency and these are specialist physicians who are experts in heritable diseases and genetic diseases.
Down Syndrome is an example of a genetic disease where there is an extra chromosome, and so a medical geneticist and also other doctors will be able to do some of this, but medical geneticists are really like, they own the whole thing. They’ll be able to like see an infant or a newborn even and kind of make an assessment. On their physical exam and kind of look at a baby and kind of understand, is there anything going on in their genes? There is a particular look that patients with Down syndrome will have, they have a specific morphologic exam.
That’s what, a geneticist or even a pediatrician would be able to say, they can see different features on the face that look kind of like Down Syndrome. And the reason that happens is that just like people are related to each other in the same family, they have the same facial features, people with certain genetic conditions have similarities between them, even though they’re not genetically related to each other, but they still have some features look similar to each other. And so down syndrome is one example, but there are thousands of genetic syndromes like that, that the medical geneticist is the expert of putting together, you know, what the person looks like, and then all their lab results and all the anatomy that could be, could have pathology, I guess. And then putting it together to make a diagnosis that makes a difference for that patient, but also to the patients. What I was seeing in anatomic pathology, which I was doing, was very narrow, and I think in genetics I get to like broaden my scope a little bit and have a different set of tools that I like sharpening. But it’s one of those things that is very hard to feel out.
If you asked me in high school or undergrad, even in med school, what medical genetics was, I wouldn’t have had a great idea of what their day-to-day is like or what their scope of practice is, but easily I could have figured that out in high school just by like shadowing a couple. It’s the same thing as if you wanna shadow any physician in high school, you can actually get a really good idea of like the beginning of an idea of what it looks like. But even then you need to have an appreciation of being on the actual rotation every day, it really is like a deep kind of thing to figure out what doctors do every day. Lots of experience as well as reading, I think we’d go into that.
Francesca: So something interesting that I wanted to pick up on a little bit was, you’d mentioned that if you wanted to learn a little bit more about this, like medical genetics is something that you sort of picked up I guess as you were, doing your pathology residency. I’m wondering if a high school student, or even let’s say a pre-med student wanted to get a little more familiar with a specific role or anything like that. How would they go about approaching a professional in that field to shadow them?
Dr. Ariel: It’s a nice thing to do and depending on where you are applying. I think in the US there is an expectation that you do lots of shadowing but in Canada, the culture is the opposite completely. They almost don’t want you to do shadowing. It almost doesn’t have a place on the application, and they don’t really look at it the same way at all. So, whether or not you need to do shadowing is something you can decide, but I think it is actually good to know for yourself. So how do you actually do it? The way that I did it was like I actually like contacted my pediatrician who hadn’t treated me for a while, and I just asked them, if could I work in there or just like observe what they do for a couple of days.
So at the University of Toronto, there’s like a mentorship program that’s a formal thing that you can apply to and then I did that and I was able to like find another doctor who I spent probably five hours with, which was actually a long time spread over like months. I work in that same mentorship program as a mentee and I have students who join me for like virtual clinic stuff. For anybody who wants to do it, you shouldn’t be shy and you can just like cold email a bunch of people. In the worst case, they’ll tell you no and then maybe they’ll say no, but another person is.
There are lots of programs outside of just emailing individual doctors. There usually are career programs at your university where they can like try to hook you up with people for shadowing. Depending on where you are, it’s not like required that you shadow a lot. As much as it is, you should like reflect on what you really wanna do every day. There’s something about medicine, I think, beyond the actual day-to-day that every doctor has to do and every doctor kind of deals with. So just because you see a doctor who has a certain lifestyle or something like setup doesn’t mean that. That’s exactly the same for everyone, but there are a few things that are very common, like dealing with patients is a very common thing that doctors do.
Francesca: Of course. So on July 19th, I see here that you shared a chest x-ray image and you asked for the next best steps in that particular scenario and it seems to have summed a good number of students, a good number of people. So my question is, why wouldn’t you want to use a chest tube here?
Dr. Ariel: So this actually came from the trauma surgery teaching that we did last month, so it was in July. The classic thing in medical school is you would see a chest x-ray and there’s something called attention pneumothorax, which is when the lungs are supposed to like oxygenate your blood, that’s their main job. If you squished one lung with like blood or with air that’s not supposed to be there and can’t work anymore, that’s a dangerous situation for many reasons. The biggest reason is if you had something in the chest that was like expanding and squishing the lungs, it also is gonna squish the hearts and then you’re not gonna have blood pressure anymore, your heart won’t work anymore and you can die.
That’s the concept of tension pneumothorax. The people who get tension pneumothoraxes, this is like a classic thing you will learn in your first or second-year medical student. There are many different kinds of people, there are some genetic diseases. The main situation that we see them is like trauma, and so that’s why it came up in this general surgery, trauma surgery a month. If you just look at the image, it can look very similar to a tension pneumothorax so that’s the key to like be thinking about whenever you see this kind of image, think like could this actually be bowel and not air?
Francesca: Awesome! I love that. Two last questions for you. What are you setting your sites on next? And let’s say the next coming months or even the next year or so?
Dr. Ariel: For MEDSKL, we are doing anesthesiology, probably this August. We’re gonna be learning about how anesthesiologists keep people alive and comfortable during surgery, which is a huge task. I think every medical student in Canada is gonna spend at least two weeks doing it. We are learning how to actually like excel in anesthesiology as well so we’re gonna be doing some advanced stuff for medical students. Beyond that, I’ve been doing a few events with my wife on EG Med Prep, which is an Instagram account that I highly recommend for people who are interested in learning about what it takes to get into medical school and that’s anything from like editing your personal statements to thinking about how to write the MCAT or how I stand out at the interview.
And so we’re probably gonna be doing a free event on how to interview for this upcoming cycle for the Canadian schools. I also learned about how to do well on the MCAT through EG med prep and so that’s something that I think almost a hundred people attended. So that’ll be the next kind of thing and then, there are a few other things but for the history of medicine, we have a few interesting guest speakers who are gonna come and talk about the history of pathology to our medical students. There’s lots of interesting things that happened in the past in pathology.
Francesca: Great. And where can people find more information, either about you, about MEDSKL or about anything that you’ve talked about today?
Dr. Ariel: I will plug my personal Twitter, which I just use for medical education, so that’s @GershonMD. And so I usually post things related mostly, for medical students but anybody who’s interested in learning about medical education stuff. The Instagram that my wife runs is @egmedprep on Instagram, I’m sometimes consulted there, I kind of do my own thing about MCAT stuff, and I’ve also worked as an MCAT tutor in the past. They can find me in those two places and I think there is also MEDSKL Instagram which I will talk about that is @medskldotcom, we post about our events there. So that’s three different things that I’ve plugged in 10 seconds, very efficient.
Francesca: Very efficient, I love it. Thank you so much, Ariel, for joining us today.
Dr. Ariel: Awesome. Thank you so much for having me!
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