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The Baylor College of Medicine Resonance Podcast is a student-run podcast aimed at showcasing the science at Baylor through the eyes of young professionals. Each episode is written and recorded by students who have a passion for research and the medical community. Guests on the show include both clinical and basic science research faculty who are experts in their fields. We hope that whoever listens in gains new insight into the exciting world of biomedical research.
Gianni: Hi and thanks for listening to resonance podcast, a podcast run by medical and graduate students at Baylor College of Medicine, where we interview clinicians, faculty, and researchers about their work in an effort to promote health, education and ingenuity. My name is Gianni caldera. I am a fourth-year medical student at Baylor College of Medicine, who just recently matched into radiology. And with me today I have Mr. Aaron.
Aaron: Hi, I'm Aaron. I'm a third-year medical student Baylor College of Medicine.
Gianni: And then we also have Sydney, who's a first year.
Sydney: Hi, I'm Sydney. I'm a first-year medical student at Baylor College of Medicine.
Gianni: And today, Aaron's going to be leading us through an interview with Dr. Galant Chan. She's the program director here at Baylor College of Medicine in internal medicine. So Aaron, you want to just tell us a little bit about Dr. Chan and how this episode sort of came together.
Aaron: Yeah so, Dr Chan is an assistant professor in the infectious disease section of the Department of Medicine. She has a particular interest in HIV prevention and the care of immunocompromised patients. She actually started her medical training here in Houston, where she earned her MD from Baylor. And then following that, she went to complete her internal medicine residency at Columbia University in New York. And then after that, she also completed an infectious disease fellowship at the University of Washington in Seattle, before returning to Houston to join the Baylor faculty. She recently took on the role of the internal medicine residency program director, succeeding Dr. Richard Hamill, who has also been a previous guest on the podcast. Her research and clinical interests include disparities in HIV/AIDS and STI prevention and treatment, medical education, and health advocacy among queer patients in our community. And so today, we will be talking about all of those aspects, and then also just tracking her journey through medicine and her career as well to see what kind of insight she can give us about medical education and
her role right now.
Gianni: That sounds great. I'm excited. Let's go ahead and dive right in.
Aaron: And we are back with Dr Chan, thank you so much for coming today. Dr Chan, how are you doing?
Dr. Chan: I'm doing great. Thank you so much for having me.
Aaron: Of course, it's all our honor. So we were just chatting a little bit earlier, but I know that you were a med student here. How is walking back into the med school and seeing how things have changed? How is that experience for you?
Dr. Chan: Yeah, I came back to Baylor about eight or nine years ago, and I did remember that it was, it was great. I mean, a lot of things are the same, and a lot has changed as well. So, it's always fun to go back and visit the old stomping grounds and figuring out which faculty were still here from when I was a medical student, which residents had stayed on, which students had stayed on. So that was a lot of fun.
Gianni: One of the things I wanted to ask was just how the physical building has changed since you were last here, and kind of generally like, how is the space different?
Dr. Chan: I think there's more in terms of things that are student oriented. So, you know, I think back when I was here, there was maybe just less in terms of student-centered space. Obviously, a lot of the offices, labs, things like that are very similar, but I'll say it's nicer. Yeah, I think there are improvements.
Aaron: For sure, it's true, because we were even talking with Sydney before, and walking into the auditorium, they have all these recording things and microphone things.
Dr. Chan: That is even newer, that's been, you know, since I got back as faculty, those have been changes.
Aaron: I mean, it's even when we, Gianni and I were there, we didn't have that, so it's really nice. Sp can you just take us back to that point where you were a med student? Can you tell us a little bit about, maybe a little bit about what you were thinking about going into medicine? What inspired you to be a doctor?
Dr. Chan: Oh gosh, what inspired me to be a doctor? So, I will say it probably wasn't a single thing or a single person. Growing up, I didn't know anyone who was a doctor, or none of my friend's parents were doctors, so it wasn't something that was like a singular focus since I was a kid. I knew that I loved ninth grade biology class, and so at that point, the only careers that I had been exposed to were, okay, I'll be a biology teacher. And then in high school, there was a program to shadow a bio researcher at Rice. So I did that and thought, okay, I'll be a biology researcher. And then it wasn't until college that I met other people who knew doctors or wanted to be doctors. And I remember, the premed society there would get together and watch ER, and then, you know that I would sit there and think, “oh, this is something else that you can do with this really strong interest in biology.” And how the human body works, and molecular and cellular biology, that was something I was really interested in. So it wasn't until college that I figured out I wanted to go to medical school. It actually wasn't until a little later in college, like third year or so. That's how that started. And then I will say that my experience at Baylor was amazing, like that was really part of the reason why I decided to come back as faculty. But it was while I was at Baylor that a whole new world opened and I got to learn about different, the community as a whole. I think growing up in Houston, I maybe knew a certain subsection of the Houston community, but didn't really get to see how really big and great the city is until I got to medical school and got to take care of patients, be exposed to different populations. And it was really during that time at Baylor that was formative, I think, in building my interest in public health, and eventually that's what led me to infectious diseases. So I remember I worked with Dr Parkerson, Dr Shandera, who's one of the folks who reported first case of HIV/AIDS in the United States. I went to, I participated in Houston shoulder to shoulder, and went to Honduras on a couple of trips with that group, with Dr Parkerson, Dr Spann, who was the head of family medicine at the time, and Dr Khan, another family medicine faculty, and got to work with Baylor residents who went, Baylor students who went and yeah, it was an amazing experience. So, getting to see public health in real life on the ground led me actually to public health school first, before I went into residency and fellowship.
Aaron: Oh, really. It's really interesting. I love to ask that question, because people have such different stories about how they came to medicine, and it seems like you grew up in Houston, and you got to experience in that way. But, medicine wasn't really on the radar until college, but then, this world opening up, coming to Baylor, seeing the community through the lens of being a doctor, and then even further, looking out into the world of how can infectious disease impact people's lives? That's, that's pretty amazing.
Dr. Chan: Yeah, that's one thing I've learned in my career, not that I'm that far along, but I will say that a lot of things have happened serendipitously, that your career can take twists and turns and not necessarily end up exactly where you thought it would be. You know, even if you're looking at, well, what did you think when you were 10, or what did you think when you were 20? What did you think when you were in med school? What'd you think you'd be doing? You know, at each point, I'll say that unexpected twists and turns happen many times for the better, and provide opportunities, challenges that I think push us to step a little bit out of our comfort zone sometimes and move forward.
Aaron: Yeah, I think that the idea of leaning into the serendipity of things, medicine is such a long path that sometimes there are experiences, if you keep your eyes open, it'll tell you exactly where you need to be. And so, especially when you're talking about, like infectious disease, and you talked about some of your mentors and HIV/AIDS care, when you were a med student, did you always know that you wanted to be, that you were interested in infectious disease, or were you kind of leaning to the serendipity there as well?
Dr. Chan: Yeah, maybe I was more directionless than other medical students these days, but I'll say that Baylor, my experience at Baylor was when I found my love for public health. That's really what grew from those trips to Honduras, from working with the communities here in Houston, and so that led me to public health school, and that's when I found that infectious diseases was a specialty that very naturally blended with my interest in public health. And it really wasn't until residency that I decided to go into infectious disease fellowship. It, you know, even along the way, I'll say it wasn't always a direct, straight path, like I said in college, I wasn't decided on medicine, so I actually took a year after college to do AmeriCorps, and worked with lower income communities in Boston at that time. And then even after medical school, went to public health school. After residency, I worked as a hospitalist, an academic hospitalist, where I did residency, and loved it. Loved general internal medicine. And I'll say that really, part of my love of infectious diseases is that overlap with general internal medicine.
Aaron: I feel like that's a theme, especially I know at the VA, a lot of the ID doctors actually work as hospitalists as well, and that's something that's kind of unique. I don't know. We haven't seen many other systems, but it does seem like the interest in infectious disease kind of overlaps with internal medicine, and even what you're saying is like public health as well. And so that's really interesting. So you finished med school Baylor. You went to public health school. Did you stay in the TMC for that as well?
Dr. Chan: No, I went up to Columbia, to Columbia, which is also where I did residency.
Aaron: Okay, and what kind of experiences did you have at Columbia that kind of echoed some of the experiences that you had here in Houston?
Dr. Chan: Yeah,I would say that New York is a very, very different city than Houston, but it's similar in terms of size, diversity, the wealth of just the cultures and the communities that are there. It's really incredible to be able to meet patients who are from all walks of life, all over the world. That's something that's really similar between those two big cities. They are different types of populations. I would say, I think sometimes, the vibe of a city, of a hospital, of a medical center, can be very different. But of course, I have to say that I like Houston better. You know, I grew up here. This is what I'm used to, is the vibe of this city, so I love it, but it's different. And anytime you step outside of your comfort zone, you are kind of forced to learn in a way. And I loved that. So I really enjoyed my time in New York, and that's where I stayed as an academic hospitalist, too. I loved general medicine so much that, and I always felt like there was more to learn in general medicine. And so those years that I spent as a hospitalist, it was, of course, I loved the clinical care, but part of it was being in that academic center and getting to learn and attend morning report and talk with learners, talk with other faculty, and still get to learn on a daily basis. That was part of what was so exciting to get to stay in that environment.
Aaron: That's wonderful, I mean, to be able to continue to learn. I think that that's something that draws a lot of people to medicine. And I think that that's something that cannot be overstated, is that you're always in the state of not knowing what you don't know, because there's so many things out there to experience. And so you said that you're interested in, so you worked at this as a hospitalist. Was there a time during that, period that ultimately decided, where you decided that you wanted to be going to infectious disease fellowship? You had that experience in public health school, and then internal medicine residency, and then you were hospitalists where, where along those lines, if you start to think I need to get more training in this specific discipline?
Dr. Chan: Yeah, I think this is where I started having very specific mentors who really helped guide me in that path. So with this, like general interest in public health, I met a lot of folks at Columbia faculty in infectious diseases, even fellows who really inspired me with the work that they did. I ended up working on a number of public health projects, infectious disease projects, with mentors there, and I'll say they had a big role in inspiring me to go into a career in infectious diseases.
Aaron: and then after your year as a hospitalist, you went to University of Washington for your fellowship in Seattle.
Dr. Chan: Yes, all the way across the country, all the way to the other coast, I figured I'd missed the Gulf Coast and the East Coast, so I'm still missing the west coast, but it's another situation where I really wanted to see a new place, a new city, a new culture, a new program. And University of Washington has one of the largest infectious disease divisions in the country. There's over 100 faculty and a department of global health, that's also very large and vibrant, and so it was really a great place to train for infectious diseases.
Aaron: That's wonderful because you're kind of all over the place, we’re tracking your history, you went to Boston for college, and then back to Houston, and then New York, and now you're in Seattle for fellowship. And I read online, I saw this one, you might have had, an interview with local people talking about some work with HIV/AIDS prevention and treatment, especially among queer individuals. Is there something that sparked your interest in, especially immunocompromised care? Because, from our perspective as med students, it's kind of challenging, especially to learn about, but it's so important as well, and so is there a specific point during that fellowship where you develop that that kind of interest?
Dr. Chan: Yeah, I mean, it's a big part of infectious disease training is work with immunocompromised patients because of obviously, their risk for infection. And then the program at University of Washington has, like I was saying, they really have done a lot of the seminal work in terms of HIV prevention, for example, and again, some really amazing mentors over there who helped inspire me to go into that field. So Connie Celum, Jared Baeten, Matthew Golden, those are all senior faculty at University of Washington who were inspirational in their work in HIV care and HIV prevention and in public health. And so I think it has a lot to do with the individuals you encounter. That's why when you talk about medical students having that exposure to work with immunocompromised individuals or HIV prevention, I think it is something that, when you are rotating at certain hospitals here that you really can have exposure to those communities, to those patients, and really, I think, inspirational faculty too, who play a role,
Aaron: A big role. It seems like you have had the privilege of working with so many people who are like giants in the field, making sure that they are caring for large populations of people. And especially it's interesting because I was listening to Dr Hamill’s previous episode. He's been on the podcast as well and talking about how the HIV/AIDS crisis of the 80s and 90s brought a lot of people to infectious disease at the time, and we're kind of in a different era as well, because we have so many different treatments and prevention options for patients who have HIV/AIDS now, and so it's a very different world. How do you feel that the timeline has kind of changed with these new innovations, and how does that impacted your work?
Dr. Chan: Yeah, I would say it's amazing, because before fellowship, when I was in residency, there were no pharmacologic interventions to prevent HIV. So it was the good old fashioned way, right? So, reducing risky behaviors, condom use, you know, things like that. And then the first medication to prevent HIV was approved by the FDA in 2012,
just in time for fellowship. So I got to work with some of the individuals I named there, all under a department headed by King Holmes, who recently passed away, who really is a giant in the field of STI and HIV prevention. But getting to work with those individuals at the time that a medication, a brand new medication, got approved to prevent HIV, is incredible. They've been working on an HIV vaccine for a very long time and has, but just having any pharmacologic intervention, right? I think is something that, I think it changes the game. So now that we've had over 10 years of experience with pre exposure prophylaxis and more options than ever in terms of what agents to use, I think it's definitely an exciting time to work in that area.
Aaron: That's pretty amazing.
Dr. Chan: I'm sure if I did ID fellowship 10 years before that, there's no way I would have been involved in HIV prevention, because it's just counseling on risk behaviors all day, right?
Aaron: I think it's important to kind of see the work of prevention as tandem to treatment. And sometimes people think that medicine should only be treatment, and that can be challenging as well. And so I'm kind of seeing when we lay out your entire career on the table, I think like this interest in public health, your experience with working with these diverse communities all over the world, all over the country, I think it kind of comes to a head, and really makes me feel comfortable that you're at the helm of a lot of this as well, of being able to treat a lot to treat a lot of these patients, because you have all these experiences.
Dr. Chan: Well, I really appreciate that. But I would say that there are many people across the country, but even you know here at Baylor, Dr. El Sahly, Dr. Atmar, the vaccine trials unit, who I think are doing the actual genius hard work.
Aaron: Well, wonderful. And so just continuing even further. So we've done fellowship. Now we're coming back to academia, coming back to Baylor. What kind of thought process did you have when you were accepting that first job, coming back to Houston, and what are some of the things that were on your mind when you were trying to when you were coming back here?
Dr. Chan: Yeah, that's a great question, because I think when you're in medicine, there's a lot of kind of just moving on to the next step, the next rung on the ladder. And after fellowship or residency, if you're choosing not to do fellowship training, the tables turn a little bit so that you are now the one who is trying to figure out exactly what you want, what you're looking for in a real grown up job right finally, right after training is done, and sometimes it can be a little disorienting. It can be a little bit overwhelming to think about, “well, I'm always trying to be what someone else is looking for.” And now finally, you're thinking about, “well, what am I really looking for in in my career?” And so ,the world is your oyster. You literally can go anywhere, apply anywhere. There's no match system anymore, right? And it's exciting. And at the same time, you have to do some really soul searching reflection on what you really desire for the rest of your career, and also knowing that you can always take those twists and turns in your path in your career, that it's not always a straight shot, and even if you decide you want to do one thing, that it's okay to figure out, “well, all right, maybe that's not exactly what I would do.” I'll say I was very lucky in that I landed at a place that I have found to be a wonderful place to work. I know that I was interested in medical education. I know that I wanted to do a lot of clinical care and be able to work with residents and fellows and students, and I just love the environment of a big academic center. So that narrows it down somewhat. And then geographically, my family was still in Houston. Plus, I remember how great it was to be a medical student here, so a lot of that drew me back to looking at institutions in the Texas Medical Center. And yeah, I'll say that among kind of top tier institutions that I felt like Baylor really prioritized education and really supported faculty in doing that. I think that's really key, that there are faculty, many faculty, who get protected time for education, both for medical students, residents, fellows, and I think that is important. You guys don't necessarily think about protected time when you're students or when you're residents, and even as a fellow, I didn't really think too much about it, but it makes a big difference in terms of what energy and efforts you can devote to something you're passionate about. So you can always be a full time clinician, and also work in a medical center, in an academic center, and teach residents and fellows and students, but having some time that's carved out specifically for education, I think was really key for me. Yeah, so I started out mostly working in clinical care when I got here, but kind of by the same serendipitous path that we were talking about earlier. You know, opportunities opened up, they became available, and I was very fortunate, I would say, to get involved in education, with residents, with fellows and students. And have really loved what my role has grown to be.
Gianni: So can you speak a little bit to what it looks like when you're training medical students versus residents, and do you almost view residents as more just like advanced, kind of grown up medical students, or is the actual training itself fundamentally different in your eyes, and what's your thought process when you're communicating with the medical student versus a resident?
Dr. Chan: It's like peds and internal medicine. Are they just little adults?
Gianni: Yeah, I couldn’t think of a way to say it, but that's exactly.
Dr. Chan: Yeah, no, that's hilarious. But no, I would actually say that to me, it's not so clear cut of a boundary. And education is very much, to me, an individual connection. So when you're talking about, for example, rounding on a wards team or on a consult team, and you have your medical student there, and you have your resident there, and you have your fellow there, I would say that a lot of it has to do with meeting the learner where they are. So I think that sometimes our mistake is to make that broad assumption that medical students are just less advanced. The resident is at this level of advancement, and the fellows at this other level. And the first thing I like to do is really to try to figure out where each person is. So that means, I think talking with them individually about what their goals are, for what they want to learn, where they think they are, kind of sussing out a little bit in your discussions with them how advanced their medical knowledge is, how advanced their clinical reasoning is, medical decision-making and data gathering, like all of those processes that go into our work as physicians, interpersonal skills, right? All of that communication skills, their professionalism, where they are, and then trying to meet them where they are, in order to get across a particular concept. So to me, it's not so much broad categories of well, all med students, I start here, all residents, I start here, and all fellows, I start here. There's more overlap than you think. There really is. And I think that that's normal. That's okay to have that variation, even amongst third year med students versus fourth year med students, that variation interns coming from all over the country, all over the world, really. And there's a huge amount of individual variation, and to me, that's probably where you get effective learning, is when the teacher, per se, is able to connect with that learner at their level, on their level. So and then, honestly, that goes for patients too.
Gianni: Yeah, I was going to say it sounds like the same way, you might have a patient with a different understanding or knowledge base and background. So, the first step is just acknowledging, asking for understanding, and kind of assessing where people are at just in general.
Dr. Chan: Yeah, I 100% agree with that. And so I think that's probably, that's where to start.
Aaron: Yeah, it seems like a lot of the approach is more individualized, just seeing where people are, where they are, I see a lot of this kind of conversation about medical education and also being a physician is, kind of this generational difference. If you had talked to doctors 20-30 years ago, it might have been a different approach. And so, do you see that, as a physician earlier in her career, do you see that overlap between medical education and also in patient care, like that philosophy carrying over in both ways, or is it a little different in your mind?
Dr. Chan: Yeah, there are obviously environments, in large group environments where you can't necessarily take that individual approach, but I think that now those large group environments we're finding are less high yield than they were before. There are so many places you can get good information to build your medical knowledge, and it's not necessarily sitting in a giant auditorium all the time and listening to the to the teacher at the front of the classroom. And so, I do think that now there is more of an emphasis on smaller groups, on more individualized teaching, more space for that. So I think it's a good thing. There's certainly a lot to be said for the community that's built when learners come together. So I don't want to take away from that, but in terms of actual modeling and transfer of some of those key skills, like clinical reasoning, like how to handle very specific situations, I do think that kind of individual learning is really key.
Gianni: I think that's true of like, just the education system in general, beyond medical education, I think a great interview or speech is Khan Academy, the founder did a TED talk. I don't know if you've seen it, but he talks about individuality and the ability of Khan Academy to give that to students, and how the system, how we have set have it set up, is kind of almost fundamentally flawed in that way that, like everyone, there's this standardized approach, and everyone is kind of going about things at the same pace, and it made me think of that, and how there's room for individuality, I think at most education levels, all throughout, wherever you are in life, or wherever your student is.
Dr. Chan: Yeah, I did see that, and it's really interesting because, before we had electronic methods, the only way you could get knowledge, information out to a large group of people is to stand in front of a large group of people and say that information, right? That was the only thing. Or you could mass mail something to people, right? Like, that was the only way to do that. And now there are so many ways to disseminate good information. So then, really, it's about trying to individualize that approach, no longer just kind of, “all right, well, I guess we have to teach to the kind of lowest common denominators,” how you know what teachers thought before. Like in a classroom, you just kind of had to try to teach to the lowest level of student there, because if you're trying to include a large group, that's how you're able to give that information, but I think no longer. So, I think in medical education, that's in education in general as a whole, and I would say in medical education, it would it would behoove us to keep up with the times and to try to innovate in that type of more specialized, individualized education.
Gianni: Yeah, I think especially with all the resources that students have available to them now, and the ability to share resources with one another, and you talk about all of these third party resources that are available, that are fantastic, and the ability to individualize all of that, I think, is something really unique and exciting about medical education over the last, you know, 10 years or so.
Dr. Chan: Yeah, I couldn’t agree more.
Aaron: I mean going off of that as well. Dr Chan has taken over the role as program director for internal medicine. And so how do you see a lot of this, like personalization, individualization, like democratization of education, kind of bleeding into graduate medical education now. I mean, I think that the philosophy for a lot of graduate medical education has always been See One, Do One, Teach One when you're in the hospital. But how does this individualized take, bleed into your now philosophy for as the program director?
Dr. Chan: Yeah, that's a great question. I think that is something that I've wrestled with over the last couple of years, since I've taken on that role. I think part of the, part of my the gift that I received from Dr Hamill before me is that he built a very solid residency program that, he was Program Director for 16 years. And in that time, he built the foundation of an incredibly, like a great residency program that really strong clinical training, a really great curriculum, involvement of a lot of faculty, and really built a very strong program, and I think with a gift like that, when someone hands over something like that, besides it being an incredible honor, it's also, I think I have the privilege of taking some risks, I will say. And because of that very strong foundation, I'm not having to worry about, “oh, are we in compliance with this? Or are we fulfilling the basic minimum requirements of an internal medicine residency program? Are we going to get in trouble with ACGME?” You know, those kinds of things Dr Hamill has figured out, we're a great program. So then, I get to work on the icing on the cake. I get to think about, “well, we're already a great program, how do I make it a really great program? What are the things that we can experiment with try to do that will take it to the next level?” And so, there is some inherent risk to that, to try something new that hasn't been done before. But I think also the rewards can be really great, and especially if you take those risks, in a way that's thoughtful and takes into account input from residents and faculty and other people who are involved. I think those risks are well worth taking. So I'm speaking kind of abstractly, I guess, but even, even small changes, like with noon conference. Traditionally, at almost every internal medicine residency program, you have noon conference every afternoon for an hour, and that's something that we've done away with, we've actually decided to do it once a week, separated into an intern group and an upper level group. And that speaks a little bit to what I was talking about earlier, more specialized kind of education that, rather than the whole residency program, gathering in one big group, and over COVID was over zoom right, for an hour, sort of half paying attention, half putting in orders, half answering calls, half, you know that kind of thing. Now we have separate sessions. So at each hospital, separate in person sessions for upper levels and interns with their pager covered so that they aren't distracted by calls and having to put in orders and things like that. They sit there, they eat lunch, they get to engage with other, with their peers at their PGY level, and learn about a specific topic. So it's more of a small group setting. And so that's just one concrete example of something that's different than anything we've done before, but the idea was developed with the chief residents at the time, resident input at the time, faculty input at the time, in order to try to come up with something that would work best for everyone, and to also try to give them that kind of protected time for specialized education.
Aaron: That's really interesting.
Gianni: So speaking about some of like the innovation that you were talking about, one of the things that came to my mind, we just had the match cycle, and we talked a little bit about that, but with all these applications programs are getting and this new emphasis on holistic review, if AI isn't already playing a role in in application review, how soon do you think that that will be if, if at all, will be implemented as a way like screening applications or helping your resident selection in the future, if it's not already being implemented?
Dr. Chan: Right, yeah. So for our recruitment process, I guess I can be transparent in that we do not utilize any AI in the screening process. It is still good old-fashioned faculty on the selection committee who review every application, every one of those 1000s of applications that we receive gets reviewed by one of the faculty on the selection committee. And yeah, but to your question about when I think AI will play a role. I think eventually AI will play a role in everything we do so that is
Gianni: I guess do you know of any programs that are already using it, or is this something, am I making a bigger deal out of it than it already is? I guess is my question.
Dr. Chan: Yeah, I do not know of any programs who utilize AI in the recruitment selection process, although I will say that it's not always something people are transparent about. So in general, I would say residency programs play it a little close. They don't necessarily, in general, people are not necessarily transparent about how they recruit residents, and that's probably because it's a competitive process, right? So everyone has their own formula for success, and we think we have ours.
Gianni: Also, once it's out there, there's no getting it back.
Dr. Chan: But I honestly think that, yes, AI is going to play a role in everything we do, including recruitment, education, patient care, all of it. So yeah, for sure.
Aaron: I'm picking up a couple of themes. Here is the idea of individualization, the ideas of transparency, also like standing on the shoulders of giants, taking risks. Do you see these kinds of themes being something that you can use in order to change the way that medical education, the state of medical education is heading? I mean, we're talking about AI. We're talking about all these kind of threats to the ideas of the integrity of the physician. And so how do you see these risks and your role in as the program director, in being able to mitigate some of these challenges or address some of these challenges?
Dr. Chan: Yeah, it's interesting that you asked the question that way, I guess you can also see them as really opportunities. And I guess that's the perspective that I have, that I really like I was saying, one of the benefits of having this really strong foundation in terms of a residency program is the freedom, then I have to take those risks. So incorporating AI into medical education is certainly something that I think is on the horizon. It's being done and so I'm happy to be someone who works to support that and to implement that. I know we have students and residents and fellows who are interested in AI, and I do think it's a matter of small advances at a time, it's not going to be this giant wave that changes the program entirely in one day, but at the same time, I think it would be kind of like ostrich in their head in the sand kind of thing, if we don't incorporate technology and new methods for education. AI, I think if utilized in the right way, can really improve education, and improve patient care, and it's not so much about, I don't see it as a threat to the integrity of being a physician so much as maybe helping take away some of the parts of being a physician that maybe we don't enjoy as much. So that's one way to utilize it to our benefit, or to really reduce human errors, right? Because we're all human. So I think that is, yeah, that's, to me, it's an exciting area, and if again, done thoughtfully, that the risks are worth taking.
Sydney: Are there any specific opportunities or changes you see yourself making to the residency program, like in the next couple of years, like more concrete changes that you see happening?
Dr. Chan: Yeah, I mean, I think that. Well, I'll start by saying that many of the changes that have happened in the last couple of years since I've become program director have been the direct result of getting that input from residents. Oftentimes, we do regular check ins with the residents to see how things are going. We do a yearly program evaluation committee meeting with the residents to figure out what are some bigger, long term changes that they want to see. And based on that, we've developed things, besides the new conference change that I was talking about, but even just a complete restructuring of wards teams, a night float system, getting rid of 24-hour call, having actually more subspecialty exposure earlier on in residency, so in intern year. Those are all changes that have happened in the last couple of years, as a direct result of those discussions with residents. So if I were to look forward for the next couple of years, I would say that it really would stem from what the residents have to say about how things are going right now. So as things evolve, residents get new ideas, and I love that. I love hearing feedback and different approaches from different residents. Having said that, I will say that probably a big part of my vision for the program is more community and connectiveness. There is, I think by the nature of the program where residents are at different hospitals and really rotating at a large number of clinical sites, hospitals and clinics, that I really want the faculty and the residents to all really feel a bit more a part of the Baylor community altogether. So that means more connection and communication with residents, but also with the faculty at each of those hospitals, the hospital leaders at each of those hospitals, development of, again, it's not development of the actual resources, because I think Baylor has so many resources. There are so many opportunities, but I think that a lot of times the residents don't get direct connections to those opportunities because they're focused on their wards team at the VA or they're focused on their cardiology team at St Luke's. And so when you're focused on the day to day, you don't necessarily take a step back look around you and see all of the opportunities that Baylor and the Medical Center have to offer. So you know we have the Dan Duncan Cancer Center, and we have so many research opportunities in all of these different areas. We have IQuESt, we have just so many different areas where our faculty and graduate students and maybe students and other individuals in the Baylor community are doing really great work that our residents don't necessarily have direct connections to, and so part of my vision is to be able to build that community and connection. So partially it's to improve the feeling of community within the program, but then also part of it is very concrete benefits in terms of career opportunities and mentors and research projects and all of that. So yeah, I think that's always a big challenge with a big program with a lot of different sites.
Aaron: So the integration part, making sure that people have opportunities to see outside of what they're seeing like in the immediate future.
Dr. Chan: Yeah, because to ask busy residents to figure out where things are on their own, I think, is a big, that's a big ask. And I think as residency leadership, part of what we can do is kind of bring those resources to them.
Gianni: As we talk a lot about all these changes and innovation, AI and all that, all that stuff, what regarding the future of medicine, or the change over the coming years, what really excites you, and is there anything you're kind of worried about, or things that you're thinking we're going to have to figure out as a community of providers and what is your overall outlook on changes that you see coming?
Dr. Chan: In medicine, in general?
Gianni: Specifically in medicine, yeah, yeah, yeah.
Dr. Chan: Gosh, that's a big question. What am I worried about? I mean, I think there, there's always a lot to worry about if you want to hear the worrying sort, yes, you're the worrying type. I'd say top amongst those would be things like the distrust of the medical community and the scientific community that the general population, I see reflected in the general population, sometimes, especially when we're talking about public health issues. This goes back to my passion for public health, but it makes me genuinely sad to see
the distrust there is in the medical community sometimes, but at the same time, I think that it's our job to really build that trust, to not take it for granted, and so kind of holds our feet to the fire in terms of the communication efforts we have with our patients, with our populations that we're serving, and really not take it for granted the way it may have been in generations past, where if I'm the doctor, I know what's right, and everybody has to listen to me, right? That's, I think that's something that we don't have anymore. And in a way, it's Yes, something to worry about, but also maybe it's a blessing to force us. Yeah exactly, force us to take a good, hard look at what do we do, and why do we do it, how we communicate our thought processes and our decisions, and really earn that trust in the community as a whole. And I'm sorry I forgot the second part of your question.
Gianni: Oh, excitement, things that you're just excited about and that you think are going to come to fruition over the course of your career.
Dr. Chan: Yeah, I think that's one of the huge benefits of working with learners and with students and residents and fellows, is that energy. I will tell you that I'm not sure I would have gotten into medical school if I was applying now. I'm not sure I would have gotten into residency if I was applying now. But how bright and energetic and amazingly accomplished all of the med school applicants and residency applicants and fellowship applicants are, I'm just floored and incredibly impressed by the future generations. This makes me incredibly excited to be in this field. And I think that's one of the benefits of getting to work in this kind of academic environment is I love my job, and I love getting to see that energy and see that the vision I love, that younger generations now are also, I think that there's a little bit of irreverence, which is sometimes seen as a negative thing, but can also, in the same way, be a blessing in that I think it's a way to rethink how we do things and how education, how medicine is practiced moving forward.
Aaron: A big takeaway from this conversation is seeing a lot of these challenges, acknowledging them, but also turning them into opportunities of how we can improve, and really seeing it as rooted in a lot of the education, or the ability for the next generation to take some direction in that, and take a hand in that. And so I think that's very inspiring, and I'm very interested to see how that unfolds in the future as well. We're about at the end of our time together. Is there anything that you would like to talk like further about or where people can find your work if they're interested in hearing a little bit more about what you're currently doing?
Dr. Chan: Well, I'm always open to people reaching out to me. I love when Baylor med students and residents reach out to me individually. So I'll say that, I don't know if I'm allowed to share my email or something.
Gianni: You don’t want to get spam.
Dr. Chan: I would love to hear from people individually, honestly, my email is probably public on the Baylor website, but I love, I genuinely do love hearing from individual students and residents. I think, like I've said before, that that individual connection is key to that path in your career and in education, I think that individual connection is really key. So I will say that's probably the best way. I'm always happy to grab a cup of coffee with someone, and I just want to say thank you. I really appreciate the opportunity to talk on and on about myself, and no, really, to really just thank you guys. And I'm so thankful for the Baylor student community, and really the residents, they're all so great. So thank you.
Aaron: Well, thank you so much for coming today. We really enjoyed having this conversation. I think we learned a lot and got a lot of insight in the kind of work that you're able to do.
Gianni: And so, yeah, thank you so much. It was fun.
Dr. Chan: Thank you. It was a pleasure.