Where MedEd Tuition Goes? This Resident Has a Surprising Answer [Episode 331]

Podcast: Play in new window | Download | Embed

Subscribe: Apple Podcasts | Spotify | Android | TuneIn

Interview with Dr. Daniel Barron, MD/PhD, resident physician at Yale University and writer for Scientific American [Show Summary]

Dr. Daniel Barron is Chief Resident at Yale’s Neuroscience Research Training Program and Clinical Neuroscience Research Unit. In today’s episode he shares the various twists and turns in his med school education and career that helped him determine what he wanted to do. He also discusses his controversial article for Scientific American on where your med school tuition dollars really go.

Dr. Barron discusses his path to a career in neuroscience and shares his thoughts on the cost of medical education [Show Notes]

Our guest today is Dr. Daniel Barron. Dr. Barron grew up in Texas, and studied neuroscience and philosophy as an undergrad at UT. He then pursued his MD/PhD there. His research focuses on brain disease, and he is currently the Chief Resident at Yale’s Neuroscience Research Training Program and Clinical Neuroscience Research Unit.

Can you tell us about your background outside of medicine? Where you grew up? What do you like to do for fun? [2:00]

I grew up in many places, primarily in Texas, but also in Maryland and Utah, where I went to high school. I spent a lot of time in the countryside and really didn’t consider science until my sophomore year in high school. My biology teacher was a huge influence. I found the course really captivating and ended up doing well in it and then decided to pursue more science classes. As for what I like to do for fun, I have a two-year-old son and a hobby of mine is repairing old things. I recently fixed up an old sailboat, and we went on a sail yesterday. It was great.

You seem to have been attracted to neuroscience and been fairly directed all along in college. How did you select neuroscience and psychiatry? [4:35]

I remember my senior trip just after graduating high school, and I was reading a book that talked about a lot of neuroscience experiments. There was one in particular where monkeys would have nerves severed in their arms, but could eventually use their arms again. It was fascinating to me to know that by a matter of will these monkeys convinced neurons to grow. I was also interested in why people have the motivations, desires, and thoughts that they do. The first class I signed up for in college was neuroscience. It was taught by Michael Brown and was the hardest class I had ever taken. It was really difficult, but also really interesting. My first exam I got a low C which wasn’t very promising. I went to talk to him about it, and he gave me in retrospect some good therapy and then I went back at it. I started doing neuroscience research at the same time and really enjoyed it.

The decision to go into psychiatry wasn’t until my fourth year. I initially thought epilepsy was fascinating – seizure disorders, changes in consciousness, and looking for brain damage in epilepsy. I also thought I would go into neurosurgery when I studied in Bologna, and after observing I went all the way through to surgical intervention. I decided the lifestyle of a neurosurgeon wasn’t something I could endure. With psychiatry what I enjoyed in my rotation was a lot of exposure to patients whose world view was changed by treating specific symptoms in their cognition.

What was the hardest part of the med school and residency application process for you? [9:31]

I remember one conversation in particular with a guidance counselor in undergrad. I had real interest in research but also in interacting with patients. I had heard about MD/PhD programs but also that they were extremely competitive, and found it really deflating. The counselor said, “yes it’s competitive, but you need to be a competitor.” Once I perceived myself as a competitor it got a lot easier.

Essay writing was interesting, I had friends who were much better writers help me with that. With the MCAT, I am a terrible multiple-choice test taker, and I took the MCAT three times. The first time I got a 24, then a 28, and finally a 31. I probably would have taken it again but I ran out of time. The first time I didn’t know review courses existed. I finally found a copy of a Kaplan review book and went through that, and it was really helpful.

Did you take a gap year or go straight from college to med school? Are you happy with the decision? [13:34]

I went straight through. I moved to San Antonio a month before classes started and didn’t know what to do with myself. With MD/PhD programs you get to sample a lot of different labs. One of my interviewers was at the Brain Imaging Institute (BMI). I had peripherally heard of Magnetic Resonance Imaging, but didn’t know much about it, and he was at the BMI and they had multiple scanners, cyclotrons, head scanners, and I kind of fell into that and had my first lab rotation there. I didn’t stay with my advisor from my first rotation. Peter Fox was the director, and we got along well and he ended up being my dissertation advisor. A lot of how your grad school experience goes depends on your advisor, and today we are good friends.

What did you like best about your medical school experience at UT? [16:03]

It was very practical. I really like that part. The anatomy class was incredible, and we had human dissection. Getting hands on experience dissecting, and feeling where the nerves were running was wonderful. They also were very pragmatic, centering around passing boards, which every student wants to do. Another thing I liked about my program was we had our own faculty advisor. He was very supportive, and we got along well. I can’t emphasize enough for you to go where you have the support and confidence of your advisor – it is so important.

What about the residency experience at Yale? [18:06]

It was wonderful, I got to choose what I did in the third year. Some rotations I didn’t want to do and were required, but even so that was important. I was also able to organize a six-month post-doc at Oxford. I had a small amount of funding from the med school and took a loan, and it was a wonderful opportunity. I don’t think I would have been able to do that at another school.

In addition to being a chief resident at Yale, you are also a writer for Scientific American and recently wrote an article about the punishing student debt you and your wife are dealing with. Does the fact that you are writing for SA stem from the fact that you are trying to pay down that debt? [19:43]

I actually started writing in med school before the debt thing hit me. In terms of being paid, I get paid $300 for each of them, which isn’t nothing, but clearly not worth the time I put into them, so I write for fun and really enjoy my editor there. I have a lot of leeway and can write about whatever I want.

Can you briefly summarize the main point of the article? [20:46]

It was a personal investigation of where my wife’s tuition money went. After we met with our accountant, using the same budget tools I was taught before graduation from med school, I was wondering how medical tuition was spent. I was really excited to talk to Robert Grossman at NYU who had made the announcement there would be no tuition at NYU for med students, so we started to look through things. We found that tuition wasn’t going for student education, but rather lots of non-educational related things. I was curious if this was the case at other schools and wanted to have those conversations. What I found is a focus on education quality as a surrogate measure for where tuition dollars go but it didn’t answer my question. I spoke with an economist at Harvard, and he very clearly agreed with Grossman, saying that medical school tuition wouldn’t support the teaching. We had a fun exchange on the economics of tuition. Schools will charge as much as they can without suffering in terms of their applicant pool. Even though regulated, regulators don’t have the power to regulate where tuition is going. People say tuition is skyrocketing, but no one is questioning where the money is going, and if it is spent educating the student, which at face value is why students are taking loans out.

What do you think is a fair price for med school tuition? [27:28]

I think people should be given enough information to make an educated decision. NYU is $55,000/yr before fees, but where is that going? If they said $40K of it goes to support a new library to improve student education then I would have to decide if I wanted to bankroll $160K for this library. Malcolm Gladwell discusses law schools and LSAT inflation. A good LSAT does not make you a good lawyer necessarily. You can make the same argument for the MCAT. The reason LSAT is important is top law schools rank applicants based on that and if you want to get a good job you have to get into a good law school, and you have to have a good LSAT score. All the aptitude tests are like that.

How do you see your career evolving after residency? [32:13]

I am a fourth year and will graduate in June. I am looking to do a fellowship in pain medicine. I like the interventional aspect as well. As I mentioned at the beginning, I like fixing up things and have enjoyed rotating through pain medicine. I want to continue brain imaging research and have been looking at bio marker development – signatures of disease, or symptom category which is centered in biology. There is a lot of funding right now to do that in pain. How what we relay shows itself in the brain.

What would you have liked me to ask you? [35:28]

For people thinking about applying – work hard but don’t take yourself too seriously. For me applying for residency was a lot of fun, and I also applied for a research track. Many residency programs have programs very specific to research. Some people apply to 40 programs, and I only applied to five. Be very targeted – thoughtful and intentional.

Subscribe:

Podcast Feed

Which program are you applying to?