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Johns Hopkins Postbac Programs: An Interview with the Director [Episode 264]

About the Johns Hopkins University Postbac Program [Show Summary]

For many future doctors, the simple step between college and medical school is not so clear cut. For various reasons, some sudents will choose to attend a pre-medical post-baccalaureate program to help boost their skills and experiences and to help them get into medical school. Dr. Alex Tan is the director of the Johns Hopkins postbac program for premed career changers and founder and director of the postbac Health Science Intensive (HSI) program. Her approach to the premed experience is thoughtful and is strongly influenced by her passion for guiding students to med school and to better self-exploration.

Interview with the Director of the Johns Hopkins Postbac Program [Transcript]

Linda Abraham: Postbac programs for physician wannabees can make all the difference between rejection and acceptance for academic enhancers and career changers. Let’s learn about the two postbac programs offered by Johns Hopkins University from their director, Dr. Alexandra Tan.

Dr. Tan earned her BS at the University of Central Arkansas and then went on to get her PhD in Biology at Johns Hopkins in 2009. Somewhere along the way, she got bitten by the premed postbac educational bug. She became director of Johns Hopkins post-baccalaureate pre-medical program for career changers in 2012 and founded and became director of the Johns Hopkins post-baccalaureate Health Science Intensive program, also in 2012. Her approach to postbac education is highly analytical and data driven. She’s been working to identify objective predictors of success in the medical school admissions process and develop tangible steps that help students achieve that success.

Linda Abraham:  Let’s start with the basics, what is the post-baccalaureate pre-medical program at Johns Hopkins and who is it for? [1:59]

Dr. Alex Tan: Sure. So, postbac programs, in general, for anybody who isn’t familiar, are essentially programs that are designed to give students an extension of their undergraduate time to accomplish a particular set of goals. There are two types of postbac programs. They are classically called career-changer programs or academic enhancer programs.

The premedical program is a career-changer program, which means it’s essentially designed for students who need that extra time to be able to complete the lower division science classes. These are students who haven’t had the year of biology, general chemistry, organic chemistry, and physics. More specifically, Hopkins, in general, is true to its reputation for being very strong in research. We certainly care a lot about leadership and independence and support for our unique, individual students. So, this program also encompasses a lot of those other qualities, as well.

Linda Abraham: Okay, so the postbac pre-medical program is for career changers. What about the Health Sciences Intensive? How is it different, both in its structure and its outcome? [3:28]

Dr. Tan: Sure, yes, that’s true. In both cases, the students have the same goals. That’s very true. As I said, there are two kinds of programs. The Health Science Intensive program is categorically considered an academic enhancer program, which essentially means that you’ve had the biology, the general chemistry, the organic chemistry, and the physics courses, the associated labs, and all of that completed.

So, postbac programs vary a lot, if you just look at what they accept and nationally what they look like. But, generally speaking, students who are eligible for one program would be ineligible for the other one and vice versa. So, the academic enhancer programs nationally are going to have some version of upper division courses of advanced science courses and opportunities for students to demonstrate their academic prowess in a science classroom.

But, on upper division or graduate level classes, the HSI program, in particular, is a graduate level program. The students are exclusively taking graduate level courses. But, you’re right – a lot of the outcomes and goals are largely the same.

One pretty significant difference between the two programs, though, is that career-changer programs, nationally, could be a two-year program or it could be a one-year program. So, it’s a lot of classes to complete. The way that would be closest to an undergrad completing the classes would be a two-year program, so that’s the level of the pace of studying and comfort that most students are familiar with, having gone through the US education system. When you compress that into a one-year, as we do with the postbac premed program, our career-changer program, it doesn’t leave a lot of time for a lot of other things. But, in return, you get to move through the process more quickly.

The HSI program, the academic enhancer program, it’s still a one-year program, but it’s closer to the typical pace of an academic setting, which means that it also allows students a lot more time for personal exploration, building on the application they have as far as experiences are concerned, exploring topics of social justice, advocacy, research, community health, innovation, any topics that are of interest to them. There’s a little more time in the HSI program to focus on those things.

Linda Abraham: Is it a two-year program?

Dr. Tan: It’s a one-year program, still. Because of the amount of coursework, it’s just a little more relaxed.

Linda Abraham: I believe with HSI, you also get a degree, right?

Dr. Tan: You do, yes. You get a Masters of Science degree in Biotechnology. Typically, career-changer programs are certificate programs, because they’re undergraduate level.

Linda Abraham: Right. HSI is more for academic enhancers, right?

Dr. Tan: Yes.

Linda Abraham:  Linda Abraham: So, people who might have had the science courses, but didn’t do so well in them? [6:43]

Dr. Tan: Well, actually, that’s not necessarily true. Academic enhancer programs classically, thus the name, were originally designed for people who went through their undergraduate career and didn’t do as well as they should have. That’s definitely true. But the definition of that has changed as schools have gotten more competitive. We have students who, I’m sure, their mothers and fathers are very proud of them, but they’re not competitive for medical school. There’s definitely that piece and there are lots of reasons why that could be the case. We have a growing number of students who are working their way through school. They have a lot on their plate; it’s not that they’re not academically capable. It’s just that they’re exceedingly busy. Then, we also actually have students who academically are strong enough that theoretically they could probably get into medical school, but maybe not the schools they want to go to. So, you can have a student who could get into a medical school, but they want to do MD/PhD programs or some other combined degree program, maybe that’s more competitive, or maybe they just want to be more assured that they’re going to get into their top tier schools. So, we see more and more students pursuing academic enhancer programs for that reason.

Then, in addition, as economic things have changed in the world and there’s been more pressure on universities, we’re seeing the changing landscape of advising and the ability of students to get lots of hands-on, direct, very well-informed help to also be impacting students. Sometimes students just feel like they don’t know what they’re doing in the admissions process. They don’t understand what the expectations are. They feel totally lost in the process. Their advisors – and I’m not dumping on advisors; I feel for them – they feel very overwhelmed and unable to give each and every student under their care the level of dedication that students are hoping to receive.

Sometimes those students also will pursue an academic enhancer program because typically, certainly in the case of Hopkins, but typically, postbac programs tend to have a stronger, more hands-on, more direct advising component that helps those students figure out exactly what they need to do to be successful in that process.

Linda Abraham: What is different about HSI, as opposed to other academic enhancer programs? [9:09]

Dr. Tan: A couple of things. So originally, when I designed it, we were thinking about going back to the literature, really thinking about what medical schools want in premed students and really trying to address that much more directly, rather than it being a byproduct that students happen to go to medical school. I saw in the literature that there was definitely this emphasis on the sciences and the things that we expect everyone understands to be an expectation of premed students applying to medical school.

But, then there is also this other broad swath of characteristics that are part of that medical school expectation. They include leadership. They include professionalism, communication skills, some cultural competency, a dedication to service – all these other components that they want to see in students.

As an educator and somebody who has spent a lot of time in an educational setting, it occurred to me that we, especially for the sciences, expect students to be good communicators because they are surrounded with people that they must communicate with. We expect them to be culturally competent because they are surrounded by people who come from different cultures. But, we don’t necessarily do that with the sciences. If I said, we’re going to teach chemistry by just putting somebody in the presence of the periodic chart, people would think that was crazy.

So, I felt like those additional components, maybe there was a way to be more deliberate, to not hope that students get that stuff, but to deliberately, in a classroom setting introduce them to those topics, get them thinking, and more importantly discussing those topics, so that hopefully when we send them off to medical school, they feel more competent, they feel more capable, they feel more confident with those skill sets.

The HSI program, in addition to including a heavy dose of the science courses that everyone would expect and that you see in academic enhancer programs, there is also non-science courses that are included in the curriculum. That currently includes a leadership course, a communications course, and then we have a psycho-social determinance of health and implications on diagnostics course. So, that’s more cultural competency. I say currently because right now we’re looking in a new direction.

The other thing that we are starting to see with our students, truly organically, is that we have an unusually high number of really innovative students that are really eager to develop things towards social justice and change in the world, student organizations, lecture series. Some of them want to create nonprofit blogs for outreach, all sorts of things. They’re doing this totally organically. It’s not really part of our curriculum, but innovation and creativity is one of my favorite things, one thing that I find very professionally satisfying. Right now, we’re working on the question: Are there ways that we can build into the curriculum more encouragement for students and more support for students who are innovatively inclined, even to a small degree? The reason that we’re doing that is that certainly all of the sciences and all those things that are going to remain in the program are extremely important. I don’t want to deemphasize that.

Linda Abraham: No, they’re foundational.

Dr. Tan: Yes, absolutely. We do spend an immense amount of time on that. But, I also think that in order to apply those sciences, you have to think about, “Okay, I’m going to create a drug for this particular disease that my patients are suffering with and here’s how I’m going to tackle that,” and the science foundation and all of that is really, really important for these future physicians to be able to do that. But, the ability to be able to look at something and say, “That is a problem and it’s a problem that I can solve,” is a very important quality for, really, anybody professionally, but certainly future physicians. They’re tackling an incredibly changing world. We have to arm them to be able to not just look at those things and say, “It would be great if that would change, but I don’t know how to do that.”

So, the goal is to evolve as the needs of our students are evolving and it looks like we have a lot of students who want to change stuff. We’re looking to further support them.

Linda Abraham: You’re encouraging them, really, to take initiative?

Dr. Alex Tan: Yes, absolutely.

Linda Abraham: What is the application process for these two programs? [13:59]

Dr. Tan: It’s a pretty typical application. If you go to the website, I know we’ll be talking about that later, it’s a pretty classic online application that in many ways mimics the American Medical School Association application, the classic AMCAS application. It has all the components that you would expect. There’s a personal statement essay. There’s a request for a resume or experiences, your medically relevant experiences, references, all those sorts of things.

There is one slight difference for the HSI application. We have two oddity additions. One is there is a second essay. It’s called Different This Time, and we included that because we found in the early iterations, students wanted to write their personal statement about how this time it was going to be different. That’s not what we want in a personal statement, so we wanted to give students an opportunity to set out a plan about what their goals were for the year and how this year was going to be different, how they were going to grow and learn and improve, and separate that from their essentially, Why Medicine, classic personal statement.

Then, the second thing we added, I think this coming year we’re going to make it optional because I don’t want it to be an obstacle for students, but we’ve been playing with a video component to the application. So often, when you sit on admissions committees, you get these paper applications and it makes the students feel very two-dimensional, which is misleading. So, we included the video component. It’s very open-ended for students, just a short video, just so we have a human being that goes with the application, which helps us to think more humanistically and holistically about the person and the application that we’re reviewing.

Linda Abraham: So, you’re planning to make the video component optional? [15:53]

Dr. Tan: Right, we’ve had it as a required part of the application and we have found it to be exceedingly helpful. But, we have gone back and forth about whether there are students that are not applying because they’re intimidated by that and how to tackle that and we’re in discussion about it. One possibility would be to eliminate it as a requirement. Then, if students were intimidated by that, they didn’t have to do it. But, then just to make a compelling case for why it would be a good idea for students to do, so that they feel encouraged, but not required.

Linda Abraham: It’s an increasingly common component in business school admissions and job interviews.

Dr. Tan: Yeah, and they’re great. Students do amazing videos. I haven’t seen one yet that I didn’t just love. They do great stuff. It’s wonderful to watch, but I wouldn’t want anybody to be overly self-conscious.

Linda Abraham: You’ve done a lot of research on what are the predictors of success in medical school. I know you approach that in a very analytical PhD research-driven way. What are the predictors? What has your research shown? [17:04]

Dr. Tan: I’m still working on it. It’s a work in progress and we’re still trying to pull it apart and think more carefully about it. The thing that I have found is that, honestly, this is something that if you read more into the published literature, it seems somewhat obvious, although students don’t think it’s obvious. I think when you look at the data, you will see that the metrics, the GPA and the MCAT score, and all of those pieces that give medical schools a certain sense of comfort that they’re not dooming you to failure when they accept you to medical school, is an important part of the review that medical schools are doing. That’s not in dispute. It’s important.

But, I think also that students overemphasize that component in schools in this country and universities in this country, because we also emphasize classes and academic excellence, I don’t necessarily think that we dissuade students from that perspective as much as perhaps we should.

But, there is a huge other component to the application that is important. Those are the things that you learn from being a citizen of the world. You learn from being in a professional setting. You learn from having disagreements and interactions with other people, from having personal failures, and from just knowing yourself and understanding your path in the world and what that looks like for you. I think that students really don’t spend enough time thinking about that component and I think that has a lot to do with students not being successful in the application process.

One example would be if you talk to students about how they select the medical schools that they’re applying to, they seem very confused by that question. And generally what they will tell you is some version of, “Well, I’m applying to good schools,” or, “I looked at the U.S. News Reports list and I picked these schools.” There is no component of it that has anything to do with their fit with the particular schools. The school, in contrast to that, that is all they think about. They are thinking about the fit of the student with the school. For example, what I tell my students in terms of an analogy so that hopefully that makes more sense is that if you’re going on a date…

Linda Abraham: I was just thinking that’s where you were going.

Dr. Tan: Yeah, if you’re going on a date with someone and the date doesn’t work out, you don’t end the date thinking, “I am a horrible person. I am undate-able. I should just give up on dating because it’s over. My life is over. I might as well just go live in a box.” Generally speaking, people don’t make that assumption. If they go on a date and it doesn’t work out, they think, “Oh gosh, I didn’t have a lot in common with that person. They liked this. I liked that. I didn’t realize that they were… I need to be more specific about how I select people or where I go to find people” or whatever your criteria is. The fact that I don’t mesh with somebody who enjoys a lot of sports doesn’t make me a horrible person. It just makes me someone who shouldn’t date someone who’s very into sports. I think that students don’t think of admissions that way. They take every rejection very seriously, but then they also don’t do that characteristic selection where medical schools are definitely thinking about, “Is this person the kind of person that we want to be a physician? Are they interested in medicine because it is a service profession? Do they understand the field and know what they’re getting into?” Generally speaking, that’s the generalized, “Are you a good date, period?” But, much more of the selection criteria, particularly during the interview process, but in the secondaries as well, and certainly to some degree in the primary application, is about all of the nuanced difference between this school and that school.

One thing that I’ve found very interesting about sitting in on medical school admissions meetings is that there isn’t a lot of conversation about, “This kid is going to be a great physician someday, but not at our medical school.” It’s not an issue of dispute that they are a good candidate for medicine. The dispute is, is this place the best place for them, which I found very eye opening, that a lot of it is much more about, “Yes, but at this institution or other places?”

One way that we’ve really been able to help students be more successful in the application process is just to force more conversation or encourage more conversation about the specificity of fit, really understanding what they want in a medical school, what medical schools want in a student and really getting to know themselves to a level where they can really have those deeper conversations about that. I think that that makes a significant difference.

The other thing that I think makes a significant difference is that there are some things that are just tried and true good advice, like, applying early and having letters of recommendation from people who actually know you, that you will hear from any advisor that are obvious good suggestions that, frankly, I don’t need data to support. But, I have. I’ve talked to deans of medical schools about this, as well, and it really is a lot of specificity. So, in terms of the data, that level of, “Yes this, but not that,” is hard if it’s really based on individuality, and so I think to myself, that the challenge of medical school admissions is trying to fit those nuanced pieces together.

Linda Abraham: We also emphasize, in advising out clients, the importance, if it was specific medical schools, especially in terms of the secondaries and the interview component of medical school applications. Some of the qualities that you were talking about sound like self-awareness, maturity, and resilience. [23:22]

Dr. Tan: Absolutely, no question. I can’t tell you what’s important to you. You have to tell me, and if you don’t know, then you have to figure it out, absolutely.

One of the things that I really appreciate with working with this particular population versus younger populations – I taught high school years ago – and one thing I’m really grateful to not have to do anymore is that I can really hold my students accountable for being adults, and being mature, and really doing that level of self-exploration.

I also think it’s really important for being happy professionally, that you need to know what you need to be happy and successful. You need to define success, not look it up in a dictionary. I think that’s really important, because otherwise, how will you know when you get there?

Linda Abraham: Yeah, you’ve got to know where you’re going. How do the Johns Hopkins postbac programs either nurture or foster those qualities in the programs that you run? [24:29]

Dr. Tan: One thing is that we have a year-long advising course that our students participate in. We have a curriculum for it. We have a number of assignments, and it’s a very comfortable format for people who are eager to be in an academic environment, and we lay out all of our objectives and all of our goals for students, so that they understand where we’re going and what we’re trying to accomplish, and I think that helps students build a sense of trust that we’re going to be able to help them achieve their goals if they just stick with us. I think that’s important, because I think that we all have a tremendous ability to grow as people, and do that level of self-exploration and self-knowledge, and all of that, but I think we have a lot of fear about doing it, or uncertainty, and certainly I have had students say, “Yeah, but, how is this going to help me get into medical school?”

We try to build an infrastructure that helps students understand that we are heading towards the goals that they want, and that they need to stick with us, and we will get them there. Through the process of starting with very easily accessible questions, we just talk about things like, talk about somebody who was impactful in your life. Talk about a situation that you were really happy, a favorite book, a superpower you wish you had. We, from a back door almost, start accessing a student perspective, and we basically act as – what’s a good word? – an interpreter of a student’s internal dialog. A lot of times, students are very good at telling me who they are, but they’re not good at listening to themselves telling them who they are.

Linda Abraham: They may also be not very good at controlling what they tell themselves about who they are.

Dr. Tan: Yeah, and I think that if we ask them, like if I ask a student, “Who are you?” I’m, frankly, probably not going to get a very good answer. I’m going to get some manufactured, “This is what I tell people.” Particularly for the career changers, who have a personal identity that in many ways is wrapped up in another field. That can be an exceedingly hard direction for them, because they aren’t quite at a point where they see themselves as future physicians. They want to be physicians, but they aren’t like, “I’ve tried to be a physician my whole life.” They’re not quite there yet. You have to ask them what seem like silly questions, just to head them down that road and get them thinking about what’s important to them, and what would they like to accomplish, and where do they see themselves down the road, without actually asking them, “Where do you see yourself in 20 years?” which is an incredibly scary question, even for me. To ask a student that question and expect an authentic, real answer, I think is asking too much.

Linda Abraham: What do you see as the big advantage to students who invest in a formal postbac program, like the ones that you are the director of, as opposed to doing informal postbac programs, taking classes? [27:37]

Dr. Tan: If you’re talking about informal postbac programs just as students who are taking classes, I think honestly the academic component of what’s expected for a postbac student is, it’s pretty easy to figure out. You can look at the prereq list from medical schools, you can piece that together. You can, if your academic grades are not where they should be, maybe you’re just retaking classes that you didn’t do well in, or whatever. It’s pretty straightforward, and I don’t think most of the time that is the piece that’s difficult for students.

I think the most frustrating, confusing part of the process is everything else. Even very practical things, like what should be included in a personal statement. How do I think about a list of target medical schools to apply to? I need to talk to somebody about my MCAD score. What do I do now? I’m struggling with the CARs section. What do I do now? What’s the difference between using Dr. Smith versus Dr. Peterson for a letter? Should I do this? Should I do that? What’s included in a secondary? Can you look at my experiences? How do I handle the most meaningful prompts? Those things are the parts that hang students up and force them into a position where they’re trying to make the best decision they can, but, they simply don’t have enough information.

I think the benefit of a postbac program is that, as I said earlier, often though not universally, postbac programs are going to have access to hands-on academic advising. That’s certainly not true of all postbac programs, but it tends to be a larger component of postbac programs.

Really, what you’re getting out of those programs is, yes, absolutely, the ability to take classes, and then somebody to talk to about your classes, sure. It’s also everything else. Which experiences should I pursue? Should I do research, or should I not do research? Do I need to do community health? Having somebody to ask those questions, and being able to trust the information you’re getting, I think, is totally invaluable.

Linda Abraham: Big difference.

Dr. Tan: Yeah, it absolutely does. Definitely, that’s an advantage to postbac programs. I do know, in talking to just general students, not necessarily just mine, but at conferences and things, that sometimes students do have access to their undergraduate pre-professional advising office after they graduate as an alum. Not true at every university, but some students do. If you have access to that through an undergraduate office, and you feel like you’re getting adequate support, yes, you can absolutely do it through just taking classes somewhere, because you are getting that information some other place. Doing it through a postbac program wouldn’t be necessary, but there are lots of students that either feel like either they don’t get access to the pre-prof office for some amount of time after they leave, or maybe yes, they do theoretically, but them and hundreds upon hundreds of other students. Or, they in some way feel like it’s inadequate if they’re at a university where their advisors are generalists, or it’s a small institution where it’s not somebody…

I, for example, do nothing but advise students who are premed. That is my sole job. It’s really hard to stay on top of advising if you’re doing all of the prehealth fields plus law, plus people wanting to do PhD, plus people who want to teach, plus people who want to do everything under the sun, much less across multiple fields and not just in the sciences. If people have those kind of advisors, they might feel like they really need somebody who is dedicated to this and knows what they’re doing.

The other advantage is that, certainly our programs, but there are others that do this, do offer a committee letter, which really simplifies the letter submission process for applying to medical schools in a lot of ways.

Linda Abraham: Most postbac programs, especially the academic enhancers, but I think it’s going to apply to the career changers also, they take the postbac one-year program, they complete it, then they apply, and then they have a year before they actually start medical school. That’s typically called the glide year. What do you recommend they do during the glide year? [31:51]

Dr. Tan: One thing that we recommend from the very beginning with students is, so often students are focused on their goal being getting into medical school. Which is not entirely accurate. It is a goal, a short-term goal, but it is not the goal.

Linda Abraham: It’s a means to an end.

Dr. Tan: Yes, exactly. The goal is really something else external to medical school. It’s helping people. It’s starting a nonprofit. It’s pushing back the frontiers of science on some disease or critical state. Increasing access to a particular population or in a geographic area, or whatever it is. I think that, if you keep that goal in mind, and you recognize that we are the product of our experiences, and our experiences, and the order in which we have our experiences shape the way that we think about the world, then, you would recognize that you have a limited amount of time. My students do, anyway, before they go to medical school.

Then, after you attend medical school, there is a waterfall exodus from medical school, where you’re expected to do residencies, and fellowships, and whatever else you’re doing. Then, you’re a practicing physician, or you’re at a hospital, or a clinic, or whatever, and then all of the sudden, it’s kind of a weird time to do other things.

We tell students to think about any experience that they want to have before all of that stuff that they want to have, a field they want to understand, an experience they want to have, something they want to try out, anything like that, that would be frankly weird if you did it in medical school or beyond, your gap year is an excellent time to try that out.

For example, students who want to understand research better, because they’re not sure if they want to go whole hog into research in medical school, or as a physician, or not. It’s a good time to do research, certainly, and I have a lot of students that do that. Hopkins is a hub for people interested in research, and so we get a lot of that. We also have people who are interested in trying to understand how insurance plays a role in how patients access medical care. Maybe then, they would be involved in an insurance company, or an outreach group, or part of the hospital that deals with all the insurance bits and pieces. Once they’re a practicing physician, frankly, they need to practice medicine. That’s a weird time to say, “Wait, I’m going to go take a break and work at an insurance company. It’s invaluable in terms of going into medical school and thinking about, “What does this mean for me?”

We also have students who want to do international stuff, and they want to get a handle on the global landscape of healthcare.

All of those things are totally feasible. We have students who are working on language skills, working as translators in clinics, because they want to be bilingual, or more bilingual, or more effective in their language skills in medical school, because they want to go to medical school that has hospitals, or clinics, or populations that would be well-served by those skills. Really, any of that is fine. We do it in a very individualistic way.

You can absolutely use your glide year to fill in gaps if you feel like, “I’m a little light on community service,” or research, or clinical care, or, “I would really like to see what it means to do hospice care. I really want to understand end-of-life care,” or, “I’ve never really been in a surgical setting, so I’m going to do OB-GYN work, and see how that goes.”

All of that is totally fine, but usually we have students who have a wish list. They really have always wanted to blank, and they’re gap year is a good time to try that stuff out, before you frankly run out of time.

I’m sure you and I both have a list of things that we’re waiting, because now we’re at a point in our lives where it’s not a good time to say, “I’m going to go take a year and do this thing I always wanted to do.”

Linda Abraham: There’s also some things that I wanted to do, and I probably never will do, because I didn’t do them when I’m younger. That also happens.

Dr. Tan: I encourage my students not to do that. Many, many of my family members have done Peace Corps. I always wanted to do it, but it just never seemed like the right time, and now I have kids, so now I have to wait until the kids are out of the house. I can’t, now is not a good time. I can’t say, “Hold on to that for a minute.”

I have a student right now who’s considering doing Peace Corps. That would be two years. I have students who want to do Teach For America. They’re really interested in that. That’s a longer commitment. I have students who really want to focus in research. They maybe spend two years doing that. It’s more about getting to your destination and being grateful for the path there; it’s not about how quickly can I get to medical school.

Linda Abraham: Here, you talked a little bit about how you wanted to be, or considered at least, joining the Peace Corps at one point, but I have a different question for you. How did you, a PhD in molecular biology and biophysics, get so interested in premed postbaccalaureate education? [37:30]

Dr. Tan: My PhD is actually in the biology department. I was in the biophysics department, and I was doing molecular biology work. That’s why it’s written that way on the website. More directly, what I was really interested in is education and puzzles. Those are really my two great loves.

Linda Abraham: Thousand-piece? 5,000?

Dr. Tan: Yes. Even as a kid, actually, I was pre-vet until I started doing research as an undergrad, and I just loved the puzzle and the curiosity of research I just was fascinated by the concept that the textbooks that I had in class were full of the blood, sweat, and tears of hundreds, thousands of people, every day, who were working on problems that we literally did not know the answer to. I was just fascinated by that. That combined with the fact that, with the PhD, you get to teach in a university setting. I absolutely fell in love with that, and I thought for sure that I would do that.

I was a little burned out as an undergrad, and so I took a break for a while and taught before I came back to school for my PhD. I absolutely loved my time at Hopkins as a graduate student, no question. It was absolutely formative.

I also learned pretty quickly that I didn’t want to be in a lab. I saw my esteemed faculty as spending a lot of time doing grant writing. That’s what you do before you get a Nobel prize. Once you get a Nobel prize, it’s way easier to secure money for your lab, but the tenure track path is really scary, and it requires an immense amount of commitment to being in a laboratory setting from dusk till dawn and beyond.

I looked around me, and I saw other people, like my husband, who are absolutely passionate about the research that they do and being in the lab. My husband would be in the lab constantly if we allowed it. I didn’t love it that much, and I figured that the luxury of having a degree that had lots of options was to figure out what I could be passionate about, and it wasn’t pipetting all day and all night. I was looking at other things that I really liked, and I started thinking about teaching, and I love the mentorship part of teaching, but I don’t love grading students. I don’t love assessing students and saying, “You are good, and you are bad, A, you know, C.” I don’t love that part. I also love writing. I spend a lot of time writing. I also love innovation, and finding new ways of doing things, and thinking outside the box, and just the fun of creativity.

I honestly just happened upon postbac. It was not an intentional choice, as wonderful things often aren’t. I loved it, because it was a mix of working with an older population that I could really engage in deep conversation and really push them to think deeply about their world, and what they wanted. There’s the educational component. I still would talk science with my students. I teach chemistry boot camp to my career changers. I talk research with a lot of my students. I’m still one foot in the sciences. But also, I can spend a lot of time having, frankly, more important conversations about, “What do you want out of your life?”

I’m really grateful that I ended up here. I spend a lot more time helping students think about their world, and I think that’s, honestly for me, better than talking about biophysics, and membrane protein association, which is what my thesis was on.

Linda Abraham: I don’t know anything about membrane whatever it is that you just said. My science background is very limited, and I’m probably exaggerating when I say that. I certainly know the satisfaction or working one-on-one with young adults and helping them achieve their dreams, figure out what their dreams are sometimes. That is something that’s very satisfying about my work, which is of course related to what you were doing. I can hear that really well.

Linda Abraham: What do you see in your crystal ball, besides what we talked about earlier?

Dr. Tan: Sure. The thing that I like about this question is the value that it potentially has for your listeners beyond getting to know me or the program, just thinking about themselves and their own world. The thing for me, about the concept of a crystal ball, is that it’s, there’s something very alluring about the what if and what could be for you, because usually when you see the image of a crystal ball, somebody’s asking, like, “What’s going to happen in my life?” That kind of world.

It’s an interesting metaphor for the role that advisors play. Certainly, I feel like I play to students. I feel students often come to my office and hope that I have a crystal ball image of what is in store for them and how they can accomplish it. I think students really want me to reassure them that they will be fine, and the path will be good, and they just have to keep going. I think the message is that we have to be able to do that for ourselves.

The more that I think about this concept of crystal ball, for me, I think it’s the allure of, it could be anything. When I first read this question, I thought, “Well, gosh, it could be anything in the world, anything I can imagine can be accomplished, and all we have to do is think about what it is that we want, and we can make it happen.” Which is my PhD talking, pulling problems apart, and anything is masterable or solvable.

I think that students don’t think of the world in that way. I think that there is a set of rules, and they’re supposed to follow them, and there is a keeper of information that will only give them the information if they do the right jig, or say the right thing, or know the password.

Linda Abraham: It’s almost a checklist approach.

Dr. Tan: Exactly. I think that is really harmful to students, that I can help students understand how the choices that they make can impact their future success, but frankly I’m not really telling them anything they probably don’t know, like if you don’t study for your classes, you’re probably not going to do well. Nobody is shocked by that advice. I think that, oftentimes, students need to feel like there is someone there who will tell them things that they already know.

To circle back around, I promise I am going somewhere. I think that, everyone is better off if they just take ownership for their own ability to assess themselves, to know that these are things that I need to work on, and these are places in my application that I need. I could do more, I could spend more time on my classes. I really need to do community service. I don’t really understand this concept as well as I should. I really feel self-conscious about the amount of clinical time that I have. I haven’t really been paying attention to this. I’m spread too thin. These are oftentimes things that students ask me, but they already know the answer to them.

I think in terms of a crystal ball, the thing that I would love to be able to do for students would be able to empower students with their own crystal balls, to be able to figure it out for themselves, I think that is the holy grail of education – to not bequeath information to students, but allow them to be able to access it themselves without me needing to be present. Not sure if that made sense.

Linda Abraham: That sounds more like a goal, necessarily, than a crystal ball kind of, “This is what’s going to happen.”

Dr. Tan: Yes, I don’t know what’s going to happen.

Linda Abraham: Your crystal ball is cloudy.

Dr. Tan: It is. I think it’s cloudy for all of us, and that’s the point. Anything is possible.

Linda Abraham: Interesting concept. I’m glad you insisted that we address this question. I think part of education is conveying information, and I think everybody can, sometimes at least, benefit from getting input from a second person, but sometimes applicants or students, they don’t want to take ownership or responsibility for the life that they’re leading. And I don’t think it’s just limited to students and applicants. It’s older people, also.

Dr. Tan: Absolutely, and I do think that that’s one of those things that medical schools are looking for. You need to be able to take ownership. It’s nice to have somebody too, if there are obviously, in education, cases where you simply don’t understand, and you need somebody to explain quantum mechanics to you, or whatever. Obviously, it’s good to have someone who says, “Oh, well, this is how it works.”

I think that we spend a lot of time in education helping students with things that we should really be teaching them the tools of how to do it themselves.

In our programs, we spend a lot of time not just working on skills that are helpful for the application process, but just for life in general. Like when you’re working on the personal statement, you really should just be working on being a better writer, knowing what you’re trying to say, and understanding how best to communicate it. It’s not just about the personal statement. It’s about, how do I take this piece of information, and ensure that when it ends up on the other end, it is understood as I intended it? Do I even know what I’m trying to say? I find, a lot of times, sometimes students struggle because they don’t know what they’re trying to say. That’s a different problem.

Linda Abraham: Going back, the point that you’re making now about somebody taking responsibility for their actions and the life that they’re leading, I think it’s a quality that, in any field, will take you far. You don’t like people who play the blame game.

Dr. Tan: Absolutely.

Linda Abraham: That’s just not a fun game to play if you’re on the receiving end of it, or you’re the second party to it, and I think the quality is, the thought that occurred to me as you were talking about some of the qualities that lead to success in medical school, and that medical schools are looking for, yes. Fit was a really, really important quality that you mentioned, and that would be unique and different for each particular program.

A lot of those qualities are really virtues that will help anybody in life – whether it’s the lowest level in the hospital – I don’t know what that is, the guy who mops the floors, or the top administrator in the hospital, and all the physicians, nurses, clinicians in between – resilience, communications, what were some of the other? Self-awareness, maturity. Those are qualities that are definitely going to help anybody in life.

To the extent that Johns Hopkins nurtures those qualities, and helps applicants develop them, they’re not only preparing them for medical school, they really are preparing them for life.

Dr. Tan: Yes, I would hope so. Obviously, the program is designed to help students get into medical school, but Hopkins in general is about preparing the next generation of leaders to be citizens of the world. If I have a student who decides halfway through, they don’t want to go to medical school, I don’t view that as a failure, because I feel like the information we’re providing, and the education that they’re participating in is more than just going to medical school. It’s about thinking about the world. It’s about being a problem solver. It’s about engaging with other people in a meaningful way.

I agree, I think it is incredibly valuable for anyone, and honestly, I would hope that would be something that everyone would come through the door with, but honestly, it’s not. We see a lot of people who could stand to see some work on that, which is why we have those non-science components in the HSI curriculum, because maybe that’s asking too much, that everyone understand how to be a leader, and how to move a group goal forward, and how to effectively communicate. Maybe that is asking too much.

Linda Abraham: Or, maybe it’s just something that hasn’t been taught or learned prior to this school.

Dr. Tan: Yeah, that’s what I mean. It’s asking too much, because if we haven’t, as a country, decided that’s an important part of what we teach as undergraduate institutions, then it’s going to be spotty, whether students have that knowledge base or not.

Related Links:

The A-Z of Applying to Postbac Programs
• How Can a Postbac Program Help You?
• Johns Hopkins Post-Baccalaureate Premedical Program
Johns Hopkins Post-Baccalaureate Health Science Intensive (HSI)

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