D.O. or Do Not: The Osteopathic Physician's Journey for Premed & Medical Students

Episode 46: Ariel Nassim D.O. Sports Medicine Physician

May 11, 2021 Season 1 Episode 46
D.O. or Do Not: The Osteopathic Physician's Journey for Premed & Medical Students
Episode 46: Ariel Nassim D.O. Sports Medicine Physician
Show Notes Transcript

Dr. Ariel Nassim is a sports medicine physician at Nassim Medical in New York. He graduated from New York College of Osteopathic Medicine and completed his internal medicine residency at the Icahn School of Medicine at Mt. Sinai Beth Israel. He also completed a sports medicine fellowship at Drexel University College of Medicine. In addition to his regular practice, Dr. Nassim has worked with several professional athletes at various sports events, including the US Open and Pan American Games. He is even scheduled to be on Team USA’s medical staff at the upcoming 2021 Olympics.

Hosted by Madli Vahtra 
Edited by Thomas Jasionwski

My name is Dr. Ian Storch. I'm a board certified gastroenterologist and osteopathic physician,

and you are listening to DO or do not. If you're interested in joining our team or

have suggestions or comments, please contact us at DoOrDoNotPodcast.com. Share our link with

your friends and like us on Apple Podcasts, Facebook, Twitter, and Instagram. We hope you

enjoy this episode. Hi, my name is Madly and I'm a third year medical student, and you are listening

to DO or do not. Today, I will be interviewing Dr. Ariel Nassin, a sports medicine physician

at Nassim Medical in New York. Dr. Nassin graduated from New York College of Osteopathic Medicine and

completed his residency at the Icahn School of Medicine at Mount Sinai, Beth Israel. He also

completed a sports medicine fellowship at Drexel University College of Medicine. In addition to his

regular practice, Dr. Nassin has worked with several professional athletes at various sports

events, including the US Open and Pan American Games. He is even scheduled to be on Team USA's

medical staff for the upcoming 2021 Olympics. We hope you enjoy this episode. Okay, so thank you,

Dr. Nassin, for coming on today. I'm going to start by asking you to kind of describe what your

normal day looks like. So my normal day starts around 6 30 a.m. I get out of bed, usually out

of the bath house by 7 a.m. I pray every morning actually at home. So I usually take a few minutes

of prayer every morning before I get started and I will go straight to at least one hospital where

I usually admit patients from our practice. It'll range anywhere from two or three patients up to

five, six patients. Occasionally I'll have a second hospital to go to as well and then usually get to

the office by 9 a.m. to start office hours. I'll see patients till about 5 30 or 6 in the afternoon

and then about an hour of phone calls or now virtual telemedicine visits and then wrap up and

I usually get out of the office by about 7 30, 8 o'clock and get back home. Okay, and when and how

did you become interested in medicine and what kind of led you to decide you wanted to become a

doctor? Yeah, so my father's an internist so I always admired what he did serving our community.

You know he had a very important role for a lot of his patients who turned to him during tough

times. I was always an athlete growing up as well so I kind of took what I saw in my father serving

the community and kind of helping from that and being someone's physician and my love of sports

and kind of figured out how to combine them to go into primary care sports medicine. So now I'm able

to do both ends. I deal with the sports population and with my sports medicine background working

with some professional teams the Olympic team and also serving as a general practitioner for a lot

of patients in my community people I've grown up friendly with the family with and it's been very

rewarding to kind of go into it and kind of follow my dad's footsteps in that sense.

Yeah and where did your father go to medical school? So he actually lived in Venezuela for

about 30 years. He was born in Iran, moved at about five or six years old to Venezuela

so he ended up doing his medical school down there. It was only after he married my mother

and he finished his internship down there is when they decided they wanted to move to America

and then they came out here. So he did all the most of the schooling down in Venezuela where his

family was. Well that's very interesting. Did you ever consider applying to a foreign medical

school like him? I did. You know for him it was a little different. His was not a foreign medical

school as was an actual medical school where he grew up so for him it wasn't really going abroad

it was staying abroad. For me you know I did apply you know I applied to the some of the Caribbean

schools. I applied I was very close to going to a school called Technion in Israel and you know at

the end of the day I got I had the opportunity to go to NYCOM or now it's NYITCOM in Old Westbury

so it ended up working out for me and I really did weigh out all the pros and cons. You know I

think in it nowadays when you look at MDs versus DOs many of the people that are aware of the

differences realize there's not much difference and I had to do a lot of my own due diligence.

My father wasn't very familiar with osteopaths at that point even though he was in practice for a

very long time so for him it was a learning process but we both very quickly realized I can do

anything I was planning to do going 15 minutes away from home to NYCOM rather than you know going

abroad and having to come back and you know always having that foreign medical grad sticker on my

resume. So thankfully I've been able to map out everything I wanted to do in my career early on

and then I was able to weigh it out looking at the difference of going to an osteopathic school

versus an allopathic school and I realized very quickly that I can get wherever I wanted to go

just by going nearby at an osteopathic school and it's worked out great. I mean I really got

everything I looked for plus some by going to NYCOM in Old Westbury.

And since there aren't any osteopathic physicians in your family how did you first hear about the

DO career path? Yeah there's some friends that I had that went through it a few years ahead of me

and I saw where they were going. Many of them ended up in allopathic residencies. A lot of them

were getting fellowships and I realized it was a medical school so close to home that I just I did

my own homework. I did my own research. I went and visited the school. It was getting so much more

competitive going to the allopathic schools in New York where I live that I had to look at some of

the alternatives. Thankfully you know I had a good option so close by but it was a learning curve.

You know unfortunately I think it's there's a lot of misunderstanding about the osteopathic

profession still even though we have so many people you know when you talk about the physician

to the president is an osteopath currently. So there's people at all levels of society

in the osteopathic world who are doing great things and can get really any position they want.

I'm sure if we look I don't know but I'm sure we've had surgeon generals who are osteopaths.

It's the kind of thing that I just it became very clear very quickly as I did my research

that osteopathic was the way to go for me when I was comparing it to some of the other options I

had available at the time. So unfortunately I did poorly on my verbal section of the MCAT and I

remember that was really my limiting step. I had the GPA. I had a lot of other credentials

to look at some of the MD schools in New York but when it came to interview season that my verbal

section was the one thing really weighing me back and what happened is that I quickly had to realize

that you know I take a year off I can retake tests to try to improve my resume but that was

a year that could have potentially been quote unquote wasted if I wasn't going to do something

very productive with it and really my goal was I knew what I wanted. I wanted to do an internal

medicine residency. I wanted to do a sports fellowship. I knew that very early on. Once I

realized that you know an osteopathic school so close by can get me to exactly those places I

wanted to get to I realized why waste the year let's get to it and I knew I had a competitive

enough application for NYCOM so I was able to get right in and thankfully the rest is history.

Yeah and then how did you like NYCOM? What was can you just talk a little bit about your experience

there for instance like any special extracurricular activities any research that you did any interesting

mentors or colleagues that you met while you were there? Yeah so I mean it's like many of the

osteopathic schools is a very big student population we had about 300 students in our class when we

started probably ended with about 270 at the end of the fourth year. I happened to go into it from

the very beginning into a problem-based learning curriculum so there was an application process

within the school to all the applicants that got accepted to get acceptance into a smaller group.

It was about 30 or 32 students that got accepted to a problem-based learning curriculum that was

really small group based. We still had access to all the lectures everyone else would go to but

we had exams on different timelines. We is essentially its own school within the school

that allowed us to develop a lot of close relationships with all of our friends in that

program. A lot of close mentoring I had with some of the mentors I got there some of the doctors

that we had in that program. You just develop much more of a personal relationship with them

rather than going into the lecture halls and sometimes much more impersonal there and the

inability to sometimes get in closer to teachers. So I love that part of it you know those are the

first two years and then really the third and fourth year was me really creating a lot of my

own curriculum in terms of where I wanted to be. I knew which hospitals I wanted to look at for

residency so I was I had the opportunity to really do some of my rotations at those hospitals.

Not all of them were osteopathic hospitals certainly my internal medicine rotations my

surgery rotations were done at you know a big university hospital nearby and I think that also

helped in terms of me being able to put better things on paper better recommendations coming

after the fact when I was applying for my residency programs. You ask about extracurriculars

probably one of the more proud things we had was we were back-to-back intramural championships

for basketball at NYIT. So we actually beat some of the undergrad teams and some of the former

division two basketball players they had on their teams when the medical school team went up against

them in the intramurals. You know the dean of the school at the time was very happy that we were

able to bring home intramural championships in basketball for him. Oh that definitely sounds

like a lot of fun and then coming down to applying for residency how did you ultimately choose your

program? So for me it was a combination of things one was maintaining a very high level of training

in medicine and then secondly was also where I wanted to live. I realized that you know you're

spending three years of your life somewhere you better make sure that it's somewhere you want to

be. I had never lived in New York City I currently live in the suburbs I grew up in the suburbs about

30 minutes outside of Manhattan but I always wanted to experience living in New York City and

really I had plenty of good options there. Beth Israel was one that I thought even from college I

was eyeing it I had people friends that had done residency there went on to do some very good things.

I was lucky enough you know it was my first choice and I got it and it's part of the Mount Sinai

health system so it really came with some strong backing in terms of a big academic center behind

it but it was also community hospital feel to it. Again it was a big residency we probably had 50

residents our first year 15 of which were prelims but you know I had some great relationships I

built there and I had a fantastic program director and Daniel Steinberg who really he never had a

resident that wanted to do sports medicine and he opened up a lot of doors for me or really I should

take say took down a lot of barriers for me being that you know I guess I proved myself in my first

year of internship and he says he would support me in whatever I had to do to get the best fellowship.

He was kind of instrumental in pointing me in certain directions even though he had never

experienced a resident going through this to get to sports medicine he really was able to find

contacts and people he knew in the industry that could mentor me during those years of residency

and really help me in terms of getting the experiences I need to get to the best fellowship

possible. And then what during your residency was your experience or do you feel that your

experience was any different because you were a DO? Not at all you know I think you know people

need to be aware of what they want to accomplish in life you know if I'll say if someone wants to

do orthopedics at Mass General I don't know how many osteopaths or they're taking it Mass

General for orthopedics so that's why you got to know the end product that you're looking to get to

and I knew what I wanted I knew that Beth Israel took osteopaths regularly at the time you know

we probably had some of our best residents for osteopathic my year we probably had close to 10

or 15 osteopathic residents at least if not more so they were aware of what osteopathic students

and their training in medical school entailed they understood what a COMLEX score should be

you know they were able to compare it to USMLE because they've had experience with it

so I say if someone wants a specific specialty they want to end up in a certain hospital for

certain programs you know you got to look and see have they experienced osteopaths before have they

taken osteopath residents before and if they have they have something to compare to they'll also

understand what to expect from that and you know very often nothing different from an

allopathic applicant in my case wanting to do sports medicine I had if anything an upper hand

because of our manual training you know we were more used to putting hands on a patient when you

know or musculoskeletal medicine sports medicine orthopedics you have to use your hands much more

I knew where I wanted to get to and I made sure that going to an osteopathic program was not

going to hinder me if anything I think it helped me throughout my training because of what I looked

to do but again I think you know anyone considering osteopathic schools needs to keep that in mind you

got to have the end in sight it's not only about I want to become a doctor you know everyone wants

to be a doctor but there's a lot of different routes to getting there I say you have to know

where the finish line is and then once you know what the finish line looks like then you work

backwards to say what does it take to get to each step and you'll realize that you know in many many

specialties osteopathic schools is not going to hinder you at all but for you know that small

percentage of specialties at specific hospitals you know someone's life goal is to do certain things

they have to look into it and see is that going to hinder me again I would say for 98 to 99 percent

of things people want to do in medicine it's not going to hinder them at all it's just something

to keep in mind and again having the end in sight helps you because you can work backwards and just

make sure that going to the osteopathic programs is not going to hinder you in that process that

the programs you're looking at know the osteopathic candidates what they've done for them in the past

where they've gone on to after going through those programs and that will all help if you have that

in mind yeah I think that's excellent advice to like kind of set your your ultimate goal and then

kind of work backwards I think that's a great way to go about it and then can you talk a little bit

more about your fellowship both the application process and the fellowship experience itself

and also just discuss where you went for your fellowship sure so the application process the

residency you mean to your fellowship program fellowship so uh you know fellowship was a little

tougher because while I wanted to stay in New York for my residency there were plenty of programs

in the area in New York where I lived when it came to sports medicine fellowships and again

specifically talking about primary care sports medicine there was really not very many options

there was probably a handful in New York many of which I didn't look at just based on the

type of program I wanted to be at where there was some professional sports coverage high division

one collegiate athletic experience so I really opened up and looked across the country at

different programs I ended up in my fourth year I did an away rotation at UConn which was you know

one of the premier programs in the country for sports medicine there was my mentors mentor was

Thomas Trojan so he was a program director up at UConn interestingly a few months after my rotation

he ended up changing over jobs and he went to Drexel University in Philadelphia so I did apply

across the country I spent four weeks really touring the country going to a lot of the different

programs I probably interviewed at about 15 or 16 programs I ranked about 12 or 13 of them

but at the end of the day it came down to you know my the mentor I wanted to train under was at

Drexel in Philadelphia thankfully I got where I wanted to get to the nice thing about was it

was also living in a fantastic city I happened to get married about three weeks before residency was

finished up so I say it was about a one-year honeymoon where we moved out to Philadelphia

away from our families had it one year just ourselves in a you know vibrant city amazing

food and so we really got to enjoy a new new place together whereas neither of us had ever lived

outside of New York prior to that the fellowship itself was incredible you know I got everything I

wanted I trained with some incredible uh orthopedic surgeons incredible primary care sports medicine

docs had tons of experiences at the professional level at the collegiate level and a lot of

musculoskeletal ultrasound training which I'm still using today you know I say residency and fellowship

is just laying the foundation and it's teaching you how to do things but it's really up to you to

go out and do it on your own after fellowship so I say they kind of gave me my wings and then

I've been able to thankfully fly after that and how was your experience looking for a job after

fellowship the negotiation was hard and you know I had to interview my mom and my dad who my mom

runs my dad's practice and they've never hired anyone prior to me as another doc to join the

practice you know I actually during fellowship I considered looking at other jobs back home and

some of the big hospital systems and one piece of advice my program director gave me at the time

he asked me he said what do you want to do five years from now and I said five years from now I'd

love to be in my dad's practice working with him and kind of expanding on the sports stuff and

adding that to the practice and so he said he says why waste your time going somewhere else and

you know that resonated because you get caught up during residency and fellowship seeing what a lot

of other people are doing and you know a lot of times you go to fancy health systems or hospital

systems or fancy practices with a lot of equipment it went back to that end in sight and you got to

really keep things in perspective so for me you know do I go and interview it some fancy practices

and have all these professional sports they're covering and things like that or do I go and join

my father which I ultimately want to be working with him in the long term anyway so he put that

into perspective he says why go waste two or three years right now doing something else just to get

those experiences or the professional sports and all that because you're going to start from scratch

once you go to your dad's practice and you change over and again I don't think everyone's as fortunate

to know where they want to end up five years down it was something I wanted to do I wanted to come

in and work with him I wanted to you know expand on his practice and you know long term be able to

work together the interesting thing is you know some of those practices I looked at during fellowship

to join ended up losing a lot of these contracts they have and you know going into my dad's practice

I had this thought of okay so I'm I'll practice clinically I'm going to be a community doc

I'll do internal medicine sports medicine and you know it may just not happen I won't have as many

of those big teams but within one year of joining my dad's practice I had two universities that I

was their team physician for I was invited to join the US Open tennis championships as one of their

doctors and since then you know I'm working with the Brooklyn Nets organization I'm one I'm the

team physician for their Long Island G League team I've worked with the US Olympic Committee

at the Pan American Games I should be going I'm invited to be a team physician at the Tokyo

Olympics this coming summer there was a lot of these things that opened up that if you asked me

when I first joined my dad I would have said I probably wouldn't have those opportunities

you know anyone who goes into sports medicine also realizes these opportunities come and they go

you know a lot of what's happened with these team coverages has become a money game and there's

a lot in terms of who's going to pay the team the most to give them coverage so I've learned to

appreciate my time working with all of them I'm honored to work with a lot of these organizations

but these also don't last so also when you're joining a practice whether it's hospital based

private practice based just realize a lot of the fancy things that comes with it may not always be

there so you got to make sure the environment you're working in is the environment you want

to work in so a lot can change in practices and hospital systems but I found being a part of my

dad's practice I have all the freedom in the world to do whatever I want take three weeks off to go

to Tokyo I dictate my own schedule I dictate everything about what I do in my practice and

none of that would have been possible if I was employed by another group so looking back you

know it's probably one of the best pieces of advice I've got from my program director to say

what do you want to be doing five years from now so don't waste your time doing other things just

work on building that up. So that's such a unique opportunity getting to work with all these

professional athletes you know both on teams and you know at all these Olympic Games and the

Pan-American Games can you share some of the experiences working with these professionals

and how your kind of day-to-day would look like with these teams compared to what you're doing now?

Yeah I mean it sounds fancy it sounds exciting which it is and I absolutely love taking care

of some of the professional athletes and you know the Olympic level athletes but you know the

funniest thing is that something a lot of people don't realize once you're in an exam room with

someone it comes back to the same doctor patient relationship and you know some of the I was out

in Colorado Springs at the Olympic training facility and I remember there was someone who

came in he wasn't feeling well from the morning time I had no idea who he was you know I walked

in I was told it's a male athlete who's not feeling well. I took care of him spent about

30 minutes evaluating him diagnosed him got him started on treatment and it was only after he

left about 30 minutes later I had people coming up to me saying I can't believe that was him and I

said who was that and they I realized he was a gold medalist at the previous Olympics he's a four-time

world champion I mean you hear all these things and I'll say he was one of the most down-to-earth

people I've ever met so it's really it changes because what people see from the outside is all

this glam and all the glory but once you're taking care of them it really still comes down to that

doctor patient relationship and I find that it's very important to keep that distinction you know

you can't be a fan when you're taking care of them I've learned you you be a fan when you're

watching on TV and when you're taking care of them it's really it's it's a job it's a it's really a

duty to kind of be there as their physician so it sometimes you you could potentially compromise

the care you're providing if you think too much about who they are as professionals so they're

really my patient when I'm taking care of them and I try to keep that in mind anytime I'm having an

interaction with them you mentioned earlier that you kind of knew that you wanted to do sports

medicine early but I'm also curious if you can go back and with what you know now if you could

choose a different specialty would you choose anything else well I don't know about my whole

life it was probably closer to my junior year of college and I realized what I really wanted to do

but um you know looking back at it I don't know if I would really change much you know I've been

I've been blessed you know I have parents who are very supportive throughout the entire process

we had plenty of luck which at the end of the day we put in the hard work but it comes down to you

know the blessings and the luck that we we get and I would say I I got lucky along the way to be able

to do a lot of the things that I did and I had some very very supportive people around me who

made it easy to kind of do well I don't know if I would have changed anything you know thank god I

absolutely love what I do right now I love the people I'm able to work with I think it's looking

back at it you know being able to do medicine and then adding the musculoskeletal component of it

going to Nikon and getting some manual training which I'm able to use in my day-to-day sports

practice you know these are all things looking backwards everything kind of fit right or maybe

I'm just looking at it like it fit right you know you can always look back and say oh I wish this I

wish that I can't believe I didn't do well on my MCAT and imagine what school I could have gone to

but looking back at it you know I've been able to get to exactly where I wanted to get to and be

able to do some very cool things and work with some really incredible organizations and people

and you know I hope to be able to do it for a long time I don't know if I would have changed

anything you know I think I've had some great experiences at Nikon I've had great residency

experience my fellowship was incredible you know since that time you know four and a half five

years since you know things have been thank god very very good to me and I hope to be able to

continue to do that and I hope to continue to train the next generation too you know I just had a

osteopathic student here that's finishing up his fourth year when we were just talking about whether

he would join our practice or not so I'm hoping we can kind of mentor that next generation help

them in the process and I told them the same thing I'm telling you right now is like I told

look at the end in sight see what you want to do ultimately and you know now you get to put the

pieces in place to get to that point yeah and then one thing that makes DOs unique is that we

are trained in osteopathic manipulative medicine are you able to use this in your sports medicine

practice yeah so I think it's just like anything else a tool you know I there are some practices

that you know every day they're using OMT in my case you know I had the training I probably did

not use it much at all during my residency given I went to an allopathic program but interestingly

enough I had an MD mentor and fellowship and he went on his own and he learned osteopathy and he

practiced OMT during our clinics so this is an an MD who realized the benefit of manual medicine

and when appropriate he would use it you know I think the biggest problem with implementing it is

the time it takes so I don't use it as much as I would like to I find that I use it more when it

comes to family and friends after hours or at home or when my wife's neck is hurting her and I have

the skills to be able to do it for someone but what happens is it takes it takes time unless the

clinic is built in a way time wise that you could spend that extra time to do the manual medicine

it just interrupts patient flow too much so when I find the patient who I really do think it would

benefit I'll put them into the schedule appropriately I'll have them come back and then

we'll work on that if I have a cancellation very often I'll just tell the patient to stay and I'll

work on them for 15 or 20 minutes you know so I say it's skills that I love having because I can

offer it when it's appropriate do I use it a lot probably not I think a lot of that is the limitation

of timing and insurance reimbursement you know a lot of times insurers don't necessarily reimburse

for the time you're spending doing OMT at the end of the day it comes down to finances as well if

you spend 30 minutes with someone treating them and insurance doesn't recognize that you've done

anything for them during 30 minutes that also becomes problematic I certainly have had patients

that do very well with it when I think it's appropriate and I'd say I sprinkle it into my

practice definitely not something on a daily basis when perhaps on a weekly basis or a bi-weekly

basis I'll have a patient that I perform OMT on okay and switching gears a little bit I just

want to ask a few a little bit more personal questions if that's all right starting with

did you take out any loans to go to medical school so I took out there was a few federally

subsidized loans that I was able to defer interest on for the four years so that made up a small

portion of it but other than that I was very blessed that I had parents who were willing to

support me through medical school you know I remember that day in my fourth year at the end

of the fourth year of med school where everyone was opening their envelopes with some tremendous

debt that they realized they were inheriting at the end of those four years thankfully I did not

have have that you know I was very very blessed that I had parents who were able and willing

to help me along the process and I guess I'm also paying it back now working in the practice and

helping them along the way as well I didn't have that and you know I keep going back to I was

blessed I was blessed because I didn't need to worry about picking a specialty to be able to pay

back some big financial debts you know I saw some of my colleagues who would have you know $400,000

in debt between undergrad and medical school and sometimes even more than that and some of them

were choosing certain specialties because they said they needed to pay back the debt and they

wouldn't be able to do that if they picked pediatrics or family practice or some of the

primary care specialties which I think is unfortunate you know I think medicine has

it somewhat backwards with how they reimburse you know some of the most important work is being done

at the primary care level we have a lot of sub-specialists and we don't have a lot of good

generalists and I'm hoping that the health system in our country can change a bit to start valuing

good primary care more than you know procedures more than diagnostics where a lot of the

sub-specialists are making more of the money essentially I think as soon as the money shifts

towards prevention towards primary care you're going to see way more people going into those

specialties hopefully people not having to make specialty decisions based on debt that they took

on just to go to medical school absolutely do you have any advice for current medical students

regarding the cost of their education you'll be okay you know it's easy to get very scared

it's very easy you know looking back that you know I I went to an undergrad that costs about

two grand a year so I finished my four years of undergrad with eight thousand dollars total

intuition that I had spent and that was a city school and looking back at it is one of the best

decisions I made you know my brother who went into real estate went to NYU and my parents also

supported him but they ended up spending close to 50 or 60 thousand dollars a year for him to go

for undergrad and you know on the on the whole spent probably 200,000 plus on his four years

of undergrad whereas for me it was eight or ten grand that's one thing I think people need to

keep in mind is you know a lot this goes back to what sounds nice or the big diploma on the wall

with you know an ivy league school very often you know it doesn't get you much further along

I have plenty of students I talked to who have the opportunity to go to a city school with

honors and a full scholarship and it's really a very selective program or they go to an ivy

league school and have to pay 50 60 70 thousand dollars a year and I asked and I said what do you

want to do and very often they say they give me an answer of something they can do out of both

programs and very often those honors programs at city schools or state schools you can shine even

more you stand out even more at those programs and that's something I you know I don't know if

our listeners are in that position as much but if I can talk to some high school seniors or

freshmen in college I would tell them that you know what matters is not so much the diploma on

the wall for most things it matters is in terms of where do you want to get to and what's going to

get you there and I know in New York the city programs the state programs are excellent

educationally so to go and you know spend multiples of that for your undergrad education

that's somewhere you can cut corners in a sense medical school is a little tougher I don't think

people have as much choice you know a lot of times it's these are the the few schools I got

acceptances to and you know even there there are some states medical schools that are a fraction

of the cost and if someone were to get into you know in our state downstate medical school you

know where it's going to be 15 or 20 thousand dollars a year in tuition rather than 60 for some

of the private schools I would tell them I would say go to the state school cut how much debt you're

coming out of medical school with because it shouldn't affect that downstream decision making

which unfortunately has to you know some people take on so much debt between undergrad and medical

school that they're forced into picking higher paying specialties whether it is something they

want to do or not and that just adds pressure throughout the whole process you know because

now they have to do more sub-specialization now you're pushing off a real job even further down

the road you know they have to do three years of medicine three years of cardiology and then

interventional cardiology all because they were taking out a lot of debt and they thought that

they had to make a certain income to pay that debt back obviously not everyone thinks like that but I

think there's some undertones in the student population that that's this stuff certainly is

true I think people are making a lot of decisions based on how much debt they have or what they

think they have to make after they're all all out of training I say limit how much debt you come out

of school with I think it'll help you make you more comfortable and the majority of the time

you can get to the same exact place whether you went to those schools or you went to a much more

expensive private school definitely tell people to keep all that in mind when making decisions

how do you obtain a good work-life balance we said I have good work-life balance I told you I work

seven to seven I I think you have to be able to turn off what's going on you know I make sure

when I'm off I'm off you know when I get home I don't take work home with me I don't you know

I'll stay in the office late to make sure I get what I need done rather than going home and have

things lingering go home and try to do office notes from home I think it's really important

when you go home you have to give your full attention to you you know your spouse your

significant other your kids the people around you because they deserve it too you know my wife

has put up with a lot having to you know she's at home and she I'm out all day and you know

we had this discussion the other night how throughout quarantine I told her not much has

changed for me other than I put on a mask now when I see patients and for her a lot more has

changed you know she can't go to as many places restaurants are closed the kids are home from

school more often zooming on computers instead of going to school taking care of them at home more

things have changed a lot more for her so when I'm there I have to make sure to be there and if I

brought my work home with me if I was constantly doing work from home you know that's not fair to

anyone around me truth is in medicine it will never end if we don't want it to end you know I

can have patients all day all night but I have to draw lines and I make sure to take the time off

my weekends I make sure to take off I round every morning so Saturdays and Sundays I round in the

hospital to see our patients but I make sure that I go early morning I get out of it I make sure to

get back home so the majority of my day could be spent with my family because I don't see them as

much during the week and you know on the flip side prior to pandemic coming up you know I made sure

you got to take time off and we go on vacations and we enjoy make sure to enjoy some of the better

things in life and it's not all work no play you got to make sure to have that balance but certainly

I had to sacrifice you know do I work out as much as I used to maybe not but that's my prioritization

of you know a little less basketball a little less tennis and more family time because I have to make

some of those sacrifices as well but you need to especially now with what we understand physician

burnout and things like that if there isn't that balance if there isn't that time to turn things

off and just enjoy yourself it does take a toll we're in a serious industry you know especially

right now with everything we're seeing you know last night I had a close friend who's a patient

of mine who was hospitalized with COVID that takes a toll you know going to sleep at night

not knowing what's happening with our patients but with our friends our family it takes a toll

so it's important to have some of that balance and you know laugh and play and enjoy yourself and

you know just let loose is a very important thing that people need to keep in mind all through

training it's not only when you're in private practice or after your residency or fellowship

you know this is in medical school this is in residency all throughout that's an important

piece of advice I would give is you've got to make sure to enjoy yourself spend time with friends

spend time with family make it you know all through residency I made sure for my family

Friday night dinner was a very important thing so no matter what was going on unless I was actively

on a shift in the hospital I made sure to get home for that family dinner on Friday nights

that was important that's a big part of what kept me going is that once a week I spent time around

the table with my family you know obviously during the week when I had time I'd spend time

with friends you want to make sure to have those things built in because otherwise life gets busy

and you're never going to make the time for it otherwise okay so this might sound a little

interesting but what is your superpower and what I mean by that is can you tell us one thing that

has made you successful or one thing about you that has made you successful well it's good my

mom can tell you very well she said since I was about four years old I was extremely stubborn I

would I would pick what I wanted and I would wouldn't take no for an answer at four years

old it was about having coca-cola in the morning that that habit has changed I would say the one

thing that helped me get to where I am today is the fact that I was very goal-oriented I figured

out what I wanted very early very early relatively speaking you know I had a lot of you know as a

junior in college whereas most my friends still didn't know what they wanted to do third or fourth

year of medical school I knew what I wanted to do and where I wanted to get to very early on and

I was stubborn about doing whatever I had to do to get to that point and I think that's goes back

to what we spoke about earlier you know have the end in sight obviously the target sometimes changes

a little bit sometimes a lot but as long as you have something you're trying to get to it's like

driving a car I know I need to get to exit 50 of the highway I then can plan what route I want to

take but if you just want to drive a car you know you're going to end up very lost at certain points

and you're not really going to end up anywhere so I'm stubborn and I kind of I go after what I know

I want and that's my superpower I guess you can say is that I've that allowed me to get to where

I want to get to today that's an excellent superpower who knew stubbornness would be

so powerful all right so we have a grand finale question for you here and that is what is the

best piece of advice you've gotten throughout your education that you always think of and would pass

on to other students so my junior varsity basketball coach had a saying he he says if you fail to

prepare you're preparing to fail and again he's probably going back and I don't know how many

times I'm going to say this on this podcast but you know having that end in sight you know if

you fail to prepare and you fail to have that ultimate goal in mind you're preparing to fail

along the road and I've had plenty of friends who you know switch specialties and so many things

can come along the way between undergrad and medical school and residency and fellowship

you know and it adds up when you keep changing course when you keep having road bumps hit and

you aren't prepared for them or you're not necessarily rolling with some of those punches

you end up taking much longer to get to your ultimate goal so I say prepare early create a

sort of life map for yourself you know the one year the five year 10 year 20 year goals

obviously not no one does everything exactly as they plan if I look back 10 years ago what my

life plan was perhaps it would be different than what I see today but but I had certain goals I

wanted to get to I had certain ideas of what kind of things I wanted to do experiences I wanted to

have and I think just preparing in advance for some of that helps along the way there's a saying

also that you know we plan and god lasts and and that's very true you know at the end of the day

we cannot plan everything but I'm talking about big picture stuff you know the type of specialty

the type of practice type of experience you want to have you know those sorts of things you can

have big picture goals and say how can I get there you know the process no one can predict

things are going to come up but having that and and a picture in mind helps you in terms of

creating that tapestry of how you're going to try to get there and then the experience is the most

important part you know people look at medical school undergrad and pre-med and residency as

these sometimes miserable experiences I was so overworked I wasn't sleeping I didn't have it

I had some of the best times of my life during training and it's because I went into it saying

it's going to be hard work and I'm going to have some nights that I don't sleep all that much and

exams that are going to be tough but when you go into it that open mind of you know this is part of

the experience you know working 80-hour weeks in residency is part of the experience submerge

yourself in some of that try to enjoy it as much as you can and like I said laugh along the way

create friendships along the way those are the things that help you through you know really

demanding work that you're all trying to get into and I think if you keep that in mind you really

you really work hard at it you're going to really see all the fruits of your labor come out of it

at the end of it but really don't forget to enjoy that road enjoy the process of going through

medical school going through pre-med all the application processes you know going to different

places interviewing with different people there's something to learn from everyone you meet and

everyone you experience along the road and you never know when those people come back up later

in life you know till this day I'll have people I call from 10 years ago because it happens to be

that they're in a certain specialty now and I had that relationship and I had might not have spoken

to them but the fact that I had some interaction some sort of connection with them years ago it

comes back up medicine is a small world really really do your best to enjoy the entire process

of applications going to schools whether you end up in an osteopathic school or not you know I

think this whole process of becoming a doctor is really a special experience it's a special

duty that you can have in terms of treating people in this world I think whoever goes into

it should really hold their head up high because they're really doing something noble and they

should always remember that every day of their practice. Yeah I think that's a really powerful

way to end this interview. Thank you again Dr. Nassim for taking the time to talk to me today

and for sharing some of your experiences I know our listeners are excited to hear about it and

I'm sure we'd love to hear more sometime. All right thank you so much. Thank you. Take care bye.

This concludes our episode of Do or Do Not. Send all inquiries comments suggestions and even let

us know if there's someone you want us to interview to do or do not podcast at gmail.com don't forget

to like us on Facebook at Do or Do Not podcast for updates. If you enjoyed our podcast please

share it with your classmates and administration. We have plenty of more interviews lined up and we

are excited to share them with you. This is Tianyu Sheng. Thank you guys so much for listening to Do

or Do Not.