Primary Care, Academic Medicine, and Medical School Rankings: An Interview With Dr. Kenny Lin [Episode 321]

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Interview with Dr. Kenny Lin, family practitioner, medical school faculty-member and blogger [Show Summary]

Dr. Kenny Lin is a graduate of Harvard, NYU Medical, and Johns Hopkins, and today is on faculty at Georgetown Medical, Johns Hopkins, and Uniformed Services University of the Health Sciences. In today’s episode Dr. Lin shares his thoughts on medical school, public health, a critique of medical school rankings, and more!

Dr. Kenny Lin shares his thoughts on primary care, academic medicine and medical school rankings [Show Notes]

Now I’m thrilled to introduce our guest, Dr Kenny Lin. Dr. Lin earned his bachelors in history and science from Harvard and then went on to NYU to earn his MD and to Johns Hopkins a little later for an MPH. Today he is a family practitioner, professor at Georgetown University School of Medicine, the Uniformed Services University of the Health Sciences, and Johns Hopkins. He also has a blog where he writes about health and medicine and in one post med school rankings. We’ll be talking about that a little later.

Can you tell us a little about yourself? Your background and where you grew up. [1:55]

I grew up in suburban Maryland and both my parents are immigrants from Taiwan. I don’t actually live far from where I grew up now. I come from a family where there were already a few doctors on my mom’s side. My mom is a pharmacist, but two of her siblings are doctors and my grandfather was a fairly prestigious neurologist in Taiwan, and consulted for Chiang Kai Shek before the revolution in China.

How did you get interested in medicine? [3:33]

When I was in high school I did some volunteering at the local hospital where my mom worked. I worked in the post-op recovery room, bringing patients drinks and stuff like that. The other volunteering job I had there probably foreshadowed my dual career, which was working in the PR department, designing ads, promoting the hospital, writing news blurbs and so forth, which I found really enjoyable.

I was a history major at Harvard and wanted to stay away from the traditional premed path like biology, as I wanted to get a more varied experience. In the short term doing that made me feel a bit out of my league starting first year med school, but long term I feel like it really helped, as I can relate to my patients better, feeling comfortable talking with them about politics, history, and other things that are not science-based.

Why did you pursue an MPH in addition to the MD? [6:29]

Part of it was I had a period where I worked for the federal government with people interested in public health, but also in my practice I realized that it is less efficient to change things one-on-one than it is to change things overall. For example, you can council an individual to lose weight, but if the environment they are living in has less nutritious foods available, and no place to exercise safely that is not practical. What I was hoping to do was promote health via policy. At the time I was doing this it was when the ACA was being debated and there was a lot of excitement about that, with calorie labeling and things like that. So it was about public health and benefitting patients in total.

Can you tell us about your blog and why you decided to write it? [9:06]

I started it because I took a science writing class and people asked why I took it. I had a mentor who had a medical advice column many years prior, which I really liked the idea of. People said, “You should just write a blog to get your message out and talk about whatever you want, be your own editor.” The only people reading it originally were the few people in the class and family, but despite having virtually no audience I still enjoyed it. I wrote twice a week, certain things about health reform, preventive medicine, and the numbers started ticking up. I think that at its peak I probably had a few hundred people logging on to read it. I figured that was enough for me to keep this going.

You’ve gone through medical training and taught physicians in training. What do you think premeds and med students don’t think enough about as they begin their training? [12:40]

When I interview prospective students I joke that I don’t know if I would have accepted myself were I to apply today. I had very little life experience, and what’s great is a lot of people are taking gap years now. Students who succeed in med school tend to have had those experiences. Most people in med school were top of their class before attending med school, but everything gets exponentially tougher. It is about putting your head down and getting through, and those with the more diverse life experiences adapt better.

What would you have done differently in your medical training as you look back on it? [15:36]

If I had known early on I was interested in public health I would have probably done my training differently. There was no soft science when I did med school, and it would have been nice if I had taken some classes in that. I probably would have gotten that degree in med school or right after residency as opposed to learning on the fly.

What was one of the best steps you took as a physician in training? [17:02]

I went to med school in New York City, so all of my rotations would naturally be urban, but I deliberately went after a suburban rotation as well as one in Indian Health Service, which was quite rural at a reservation in New Mexico. It was very different, but getting that experience pointed me more toward family medicine. In an urban environment it tends to be specialist-focused, but my experiences kept my mind open to primary care.

You wrote a thoughtful critique of the U.S. News Med School rankings. Can you summarize? [19:14]

I had read an article in Journal of Academic Medicine with the idea that rankings are kind of arbitrary since often they are based on things like high MCAT scores or high GPAs, and by selecting schools with the highest scores as the best schools you mis-portray “success” in the field by selecting those who do really well on tests. It got me thinking about what are the qualities needed to be a good doctor. It is harder to take into account character, or to measure grit or implicit bias, but these types of things are critical to being a good doctor. I think U.S. News should incorporate other things into their rankings, and schools shouldn’t pay so much attention to the rankings, instead focusing on creating the types of doctors they want to come out of the school.

What criteria should premeds or the public at large use to evaluate medical schools? [23:47]

Make sure to look at the percentage of people who go into primary care vs subspecialties. You want to go to a school where graduates go into your areas of interest.

What advice do you have for premeds and med students? [27:38]

For premeds I would encourage them to enjoy their undergrad experience and don’t do more than the minimum requirements unless they want to. Pursue your passion. For students in med school, the curriculum is much less flexible, but some of my best experiences were extracurricular. I contributed to a literary magazine, and was in a club that went to a local school that did experiments with 3rd graders, so remember your humanity. These days also there is a lot more opportunity to do clinical work which is really helpful. Essentially, make time for other interests.

What do you wish I had asked you? [30:24]

Why I decided to go into academic medicine. I enjoy both reading for pleasure and research in general. If you are in fulltime practice it is hard to keep up on journal reading, but it is part of your job as an academic, and I also enjoy teaching. The pay is a little lower, you sometimes get criticized with “you are in your ivory tower,” and I only see patients halftime as opposed to 4-5 days a week, but the variety is what I like most about it.

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