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Harjit: Oh.

Leen: Sorry.

Harjit: This is very high, so let me just fix this, bros.

Leen: Also, Chloe smells really good all the time.

Harjit: Oh, my God, Chloe always smells good. We smell you. If you can look fabulous, you smell fabulous. Okay.

Chloe: Thanks.

Harjit: So today in the studio we have Leen Samha. We haven't talked for a minute.

Leen: It's been a while, right?

Harjit: Yeah, it's been a minute.

Leen: Yeah.

Harjit: Also on today's episode we have a guest, and it's actually a classmate. I think the reason that we're doing this episode today is this is a story that I feel like really exemplifies courageous character. I thought it was something that I was so grateful to have heard and I wish that everyone can hear it. We're really happy you're here, J.

J: Thank you so much. I'm really excited to be here.

Harjit: So kind of on that courageous note, I think that we're all here in support, so Bushra and Margaux are also in the studio today because we all felt like this story has impacted each one of us, and that's why we want to be here and we want to have this conversation with you. So we're so thankful you're in the studio.

I want to start out with kind of how you were introduced into my life. I remember that you had put up a Facebook post. I think it was like the end of the semester. You have experienced failure, and if anyone ever needed to reach out to you, that you were available to give your experience.

And I think that was such an act of bravery because you put out your truth in a space that you know you could have been judged in so many ways, but you were vulnerable. And that really got me thinking that if I ever, ever, ever needed to talk to J, I could talk to her. Like she was there for me.

I kind of wanted to first talk about your experience of what happened to you and why you chose to speak out about it.

Failing Medical School

J: Well, I'm really glad that it touched you in that way because that was really my intention. The biggest thing that happens if you fail something in medical school is that you immediately feel like you don't belong or you're not good enough and there's a lot of shame. And when it first happened to me, I, of course, did not share it with anyone.

So what happened to me was I failed the final for the end of a unit, and because of that failure and because my overall grade in the course wasn't passing, that automatically sent me to a committee to be evaluated in terms of whether or not I would continue in medical school.

So that was a really terrifying time for me that interim between failing the test and that committee. And because of the nature of medical school, it was right into the next unit. So I was sort of trying to deal with this very difficult new unit while trying to figure out what exactly was going to be the consequence of this failure.

I'm kind of heart on my sleeve kind of person, and a lot of people noticed that something was a little off with me. And that's the thing that always gets me is, you know, when people are kind to me and are supportive of me. And it means a lot to me and it comes out my eyeballs.

So, you know, a few people that I trusted and liked sort of were saying, "You don't seem like your normal self. What's going on?" And somehow, I found the bravery to tell them that I had failed my final and that my position in medical school was really in jeopardy.

And when I did open up to people that way, I received nothing but kindness and support. And a lot of people were really surprised because I think I put off this persona of being confident and competent. I talk some pretty mad game.

Feeling that support was really important to me, but the thing that was most helpful was that as I started to open up to more people, people told me about their own stumbles in medical school, and especially one of my good friends. He told me about what had led him to be in my class, because he was originally in the class above us. And he was sort of my guiding force through figuring out everything that I needed to do to go through that process.

So one of the things that you have to do is you have to write a personal statement that you will read to the committee, and he helped me draft that. He helped me with his own experience and how his words were perceived.

And it is a very stressful circumstance. You basically go into a room and there are a lot of administrators and course directors and people that you really want to . . . people whose respect that you want as a medical student. For some people it was, you know, their first impression of me, so not the greatest first impression.

But you read your statement. They basically look at everything that you've done in medical school, where you are on the histogram compared to your peers. I'll be honest. I viewed medical school very much as a marathon and not a sprint. And so I kind of said to myself before each test, "Okay. I could be really miserable, study a lot more, and probably do 10%, 15% better. But I know that I have a good enough grasp of this that I'm going to be okay." And so I was pretty much at the bottom of the histogram on every test, and I think that that looked very worrisome to everybody who was on that committee. So I got asked a lot of questions about that after I gave my statement.

And the questions are of a nature that you have no way of knowing because they're asking you about things that they're concerned about, like, "How are you going to do on Step 1 if, you know, this is what you've done in medical school? Do you think that you still have the potential to be a good doctor even in light of all of this?"

Harjit: These are very identity questions.

J: Yeah, absolutely. Yeah, I think that, as medical students, a lot of our sense of identity is tied up in the accomplishments that we've had to have in order to make it this far and our sense of our own competency and our ability to understand medicine and provide care for patients.

So these questions were very distressing for me. And then after they've asked their questions, you wait in another room for the decision. So the decision came that I would . . . the decision was made that I would not be continuing with my medical school class and that I would need to repeat the course. And because of the way that the courses are done I couldn't repeat the course until the following year. It was about October, and I was basically told that I was done.

And, of course, you have the option to appeal, but your appeal is based on the decision being arbitrary or capricious. You know, in the end, I only appealed one aspect of the decision that was made. They decided that they wanted me to take the end of Year 1 exam over again and that I had to pass it with, you know, my now current class. And I said that I believed that was arbitrary because I had already taken that exam and passed it. So I got that part of my probationary status taken out.

I said that I was still willing to take the exam because it was good practice for Step 1 and I wanted to see how my review was going, and that's what they decided I would do for the year, would be to review the materials from the prior year.

And they kind of gave me the option of attending class with the current class, but I elected not to do that because I thought it would be really odd to show up to class with the "You're below me." and say, "Oh, yeah, I'm here, I'm auditing this class." You know, it's a really small community. You notice when there's a new face in the crowd. And I didn't totally know how I would handle that.

Doubting Yourself After Failure

Harjit: So Jessa, what was . . . sorry, I'm going to kind of take you back. In this process, I'm pretty sure there was a moment where you questioned things, like, "Is this the right path for me?" Could you talk a little bit how you felt in that space before you even were going up to the committee?

J: You know, it was actually never a question for me if I would go in front of the committee. Before I went in, I thought, "Oh, this is just one final exam." And the circumstances around why I failed, it was because I had a close friend and he was going through a really hard time with his family and I kind of stepped up and took responsibility for some of the things in his life to use his burden, and a little bit too late I realized that I had overextended myself.

You know, I thought that just this one final exam wouldn't prevent me from continuing in medical school. I was so naive. So I thought that . . . I really thought that I was going to be able to retake the exam and continue on with the rest of my class. I really didn't think that it was going to be . . . I didn't think the decision that they made was going to be the outcome.

Harjit: So what did you do for that year when you were waiting to join the class? I'm pretty sure that must have been really difficult.

J: It was really a gloomy time for me. So, when I started in medical school, I was also in a dual degree program, and because I had been put on the suspension, an academic suspension, that automatically triggered a review of me in that dual degree program. And that review kind of dragged on for many months.

And so, during that time, I felt really stuck. I felt like I couldn't move forward and try to pursue something else or, you know . . . when I was studying all of the things that I had learned in the past year, it was really emotionally difficult for me. It brought up all of these questions about whether or not I would be able to actually pursue my dreams.

I'd like to say that I did a lot of things during that time, but I really didn't. I tried to maintain my sanity and engage in yoga, which I love. And I do have to say that the wellness program that we have here really supported me. I don't think that I would have gotten through everything without the support from the wellness program. I was able to see a therapist weekly and sort of talk about everything that had happened and really process it.

So I studied. I did yoga. I waited for this decision about my future to be made, and ultimately, the decision was that I would not be continuing on in that dual degree program. And that was the point that really made me question continuing in medical school.

I had gotten married right before beginning of my second year, and then we decided we would do our honeymoon a year later. So it was actually on my honeymoon that I had to sit down and make a decision about what I was going to do. And the reason that I had to do it at that time is because that's when the official decision about not pursuing the dual degree program came in.

I had so much gratitude for the students in that program for everything that they had given me. The nature of the program is such that when you're more of a junior student, you rely really heavily on the more senior students to guide you through all of the things that you have to do. And I was very aware of how much I was taking and not contributing, and so I really wanted the opportunity to pay that forward to the future students in the program, and it felt like a real dick move to take that and not give back.

When I got that decision, I knew that the students would immediately notice that I wasn't on any of the emails anymore, and I had to, for myself . . . no one told me I needed to do this. In fact, I was discouraged from doing this. I had to say thank you for everything that they had given me.

And as I was writing that email, my partner said, "Well, it's a great email, but you have to tell them what you're doing because that's the obvious question. You're not doing this. What are you doing?" And so that was when I made my decision.

And what ultimately drove me to continue in medicine was the fact that my difficulties that happened during the point in time where we're not doing the practice of medicine. And I knew that I enjoyed interacting with patients, and so I felt like I needed to see for myself whether this hang-up was something that would prevent me from being a competent physician or if this was just a temporary setback and that I could actually do this.

Supporting Each Other Through Failure

Leen: As a group of Bundle Of Hers, we found it really inspirational when you reached out on the Facebook page. And for students who are also possibly going through something very similar, you reached out as a role model, as a person of support, and we found that very inspirational. And it takes a lot of courage to do that, and it takes a lot of insight, I believe, to do that.

So we want to know what drove you to say, "I want to be a person of support for fellow peers and fellow students"? As well as, you know, the same goes for writing the email. You're very vocal about your experiences and that's very brave, and I think it takes a lot to want to do that. So we want to know kind of what was your process to say, "I'm going to put this out there for those who also need something like this"?

J: So I remember at the end of the first unit of first year, my class actually went through a lot of attrition. We lost a lot of students. And I remember coming back and seeing that there were people missing and wondering about them, but kind of feeling bad talking about it with other people because it really felt like gossiping, and it felt . . . it came from a place of concern, but it still didn't quite sit right.

I'm fairly exuberant and participatory, so I knew that people would notice that I was gone, and I didn't want them to have that feeling of wondering what was going on.

Once it happened, I made a Facebook post for my original class telling them everything that had happened, and I received so much love and support. And then over the course of that year when I was waiting, I actually had a couple of students reach out to me and ask me for advice when they were going through something similar.

When I joined my new class, you guys . . .

Harjit: Yay.

J: . . . I didn't initially want to say it because I didn't want that to be my first impression. And I knew that I wanted to share it, but I didn't know exactly how. Right after we took the final for the unit that I hadn't passed in the prior year, I was looking at the histogram and I noticed that there were one or two scores that weren't at that passing threshold and I said, "I need to tell my story. I need to be able to help anyone who might be going through this."

Because the biggest thing that I felt when I first found out that I was under review and may not be continuing was that I was so alone and that it hadn't happened to anyone else. And, you know, if it did happen to someone else, then they were just gone. It was sort of a medical school death sentence.

Harjit: Yeah. And as the Bundle Of Hers, I think that one reason we started this podcast is we wanted to write our own stories. So out of this whole thing, I think it's so beautiful that you were the one who took control in telling your story the way that you wanted to because it's authentic and it's honest, right? There's no room for "This is what I think happened" or "This is what I think could have happened." And I think that authenticity is what really shined through to all of us.

I just want to say I'm very, very thankful for you. I'm very thankful for who you are. I'm thankful that you're in my life even if I don't see you every single day, but I think it's people like you who really touch me and make me the person I am. So, thank you, J.

J: Well, thank you for saying that. Another reason that I wanted to share this was also sort of my own awkwardness, in that I . . . one of the great things about medical school, actually this is one of the great things and one of the worst things about medical school, is that I have met the people that I have always wanted to meet in my life. I've made some of the most profound and important friendships of my life.

I didn't want to feel like I was hiding something from everybody, because it felt very much like a subtext that maybe everyone would be thinking something or wondering something, or maybe everyone would know, but it wouldn't have been directly from me. So it would have been something that was a taboo topic, and I wanted to take that taboo out of it. I didn't want it to dictate my interactions with other people.

Harjit: That's so powerful. Say it again.

J: The not dictating part?

Harjit: Yeah. I just think that statement is so powerful.

Normalizing the Conversation Surrounding Failure

Leen: I mean, that's very relatable in the sense when you get to med school . . . I mean, before med school we're kind of our own individual person, right? We all have our own different dreams and we come in saying, "Okay, here's my dream and they accepted it and now I'm in." And then you get to med school and you realize now you're part of a little community and everybody's stories start tying together, and we all become so close that it really does hurt when something like this happens, and it hurts for everybody.

Part of it is we built such a close relation to this person and this happened to them and then we throw it back on ourselves and we say, "Oh my gosh, this is our biggest fear of medical school." This is something that I think . . . you know, this is our worst nightmare and someone else is going through it. That could have been me, and now it's a friend of ours.

And I think when we're this tightly connected in medical school, we all kind of feel it, and I think that's what you were saying with the gossiping kind of thing coming up. And I think it might be even a way of relief for us to talk about it. But we don't talk about it enough. We don't talk about it out loud. We don't talk about it for everybody here and outside who's looking in to hear about as well.

How can we normalize this topic? How can we make it seem like . . . not even seem. How can we make it be something that we can all communicate about and bring to light and be able to address and connect and make it safe for everyone to feel, "Med school's hard and this can happen, but there is a support here and this is something we can all relate to and bring to light"? What would be some ideas or what do you think about normalizing the topic?

J: Well, I have to say that I love how much attention imposter syndrome has gotten, especially recently, because this whole experience felt like, "Oh, I'm an actual impostor." It was like the syndrome became reality, that I had been found out that I was inadequate and I couldn't do this.

And so I think that, in medical school, it's so easy to fall into the trap of seeming really with it and competent and sort of putting up that shield and being strong. That desire to appear competent can really push the reality out of the light. I wish that I knew how to make that better, and I guess by sharing that's my hope, is to empower people to share the times that they've struggled and may have been found wanting in some way.

Recovering From Failure and Moving Forward

Leen: So we come into med school with all these dreams and, you know, aspirations of what we want to be, and then something strange happens to us here where we get funneled into thinking of the system. We think of the numbers. We think of the histograms. We think of class rankings. And it almost, to some extent, can jade us.

But I think what's very powerful about your story is that what you fell back on was your dreams. You got tangled in the numbers and you got tangled in the histograms and even the committee asked you questions towards that. But what you fell back on was, "My dreams are stronger than this. My dreams are stronger than my place on a histogram."

And I think that is very different than a person who only thinks of the numbers and then goes to meet patients, because patients don't understand these things. Patients don't know numbers. Patients don't know class rankings. Patients want to know that they have someone who they can connect with, someone who's down to earth, and someone whose dreams pushes them to be a better person to care about their care.

And I think that very much embodies what you've done for us as an inspiration, and for your reaching out to our class, I think that very much brings us kind of back to earth as a class and we say, "Oh my gosh, let's stop being jaded about this. This is what we're really here for, and she did it. Her dreams pushed her through."

So I think that's a very . . . you're very inspirational in that sense. So thank you so much for sharing your story with us and bringing that out for us, because honestly if we went through med school and we didn't hear a story like this, we'd get worried ourselves. We'd be like, "We have to be in the numbers to be a doctor," when that's not true at all.

Harjit: I 100% want to say I 100% agree with what you're saying, Leen, because I think you are choosing to center your story over numbers, and I think a lot of us lose sight of that. And when you shared that story, it really helped lift that burden off of my shoulders, and now I'm just like, "I want to be a doctor because I'm passionate about this. Yeah, my numbers might not be the greatest, but that's okay."

It takes a lot of courage, but also wisdom on your part for having that understanding when you're already in a place that is so alone, so low. It's the truth. It's so low because that's kind of like the stereotype around it.

Leen: It's a stereotypical rock bottom, right? But you didn't make it that way. You pushed yourself out of it and you were able to, you know, grab hands as you went up and pulled other people with you up there.

J: I think I might have tunneled.

Leen: Tunneled?

Harjit: What do you mean by that?

J: The idea of rock bottom to me implies that you have to go up the way that you fell down. And I really kind of tried to figure out a new way through it as opposed to just getting back to where I was, which wasn't what I wanted to do. I wanted to come out of this someplace that was different.

Leen: That is inspirational.

Harjit: That's so great. So, J, you're obviously a different person because of your experiences and what you went through when you first started med school to where you are now. And in the beginning of this episode, you kind of mentioned that, you know, you really didn't focus on the numbers. Is that something you still believe in, or in what other ways have you changed your perception?

J: So I would say that I still very much emphasize wellness. I've modified RuPaul Charles' quote, some of you may be familiar with it, "If you can't love yourself, how in the hell are you going to love somebody else?" And I have sort of changed that for myself. If you're not taking care of yourself, how in the hell are you going to take care of somebody else? Can I get an amen?

Harjit: Amen. Amen, sister.

J: But that part has always been with me in a very strong way. I think that I said it to myself a lot more during that first year and bit. And through all of this, I've really started to believe it. Because espousing it is one thing, but really internalizing it is another.

I would say that through this I have learned a lot more compassion for myself. I think that, as med students, we're all kind of hard on ourselves. We are demanding of ourselves and we expect the best. Since all of this has happened, I am more willing to let things go. Instead of lying in bed at night mulling over some dorky thing that I said, I can let that go a little more.

I've also learned a lot more compassion for other people, which I think has really translated into patient care. I think that I have been very fortunate in the life that I've lived. I have a lot of privilege and I hadn't ever really messed up like that before. And so seeing how that mistake had such a domino effect on everything else in my life, it has made me understand patients more when they come and their life is in shambles and they can sort of look back to a pivotal moment where something that was only partially or not even in their control affected them deeply. So I think that it has given me a lot more perspective, and it gave me a better ability to empathize.

Harjit: I think that's very beautifully said. I don't know who has or who has not experienced what you have been through, but it's really powerful to hear it from your voice. I'm pretty sure those moments that you had are something that no one else has gone through because they're very unique to you, and I just hope you continue to always share your story in the way that you want to.

I know that our listeners . . . I just want to say that I know all of us have been through things that really shape us, and failing is just a part of life and all of us have experienced some type of failure in one way or another. But I think it's really important to remember that when, you know, you can share something like that, you don't know who else you can reach. You reached out to all of us. So thank you, J.

J: Thank you. And I, of course, always want to continue to reach out to people. For anyone who's listening, who's in med school, who's having a hard time, and maybe they don't know what to do, I want to encourage you to reach out to Bundle Of Hers and they can get you in touch with me if you are having a hard time. I would love to help anybody who's going through a hard time the way that I was helped when I was going through a hard time.

Harjit: Thanks so much, J, for extending that olive branch, or extending that offer is maybe a better term. You know me. I'm always confusing things.

J: This is war.

Harjit: Okay. So that was so great. J, I love hanging out with you all the time. It was such a great conversation, and we're grateful for all of our listeners. If you have any thoughts or questions you are welcome to direct message us. Until next time. Chloe? Oh, Bushra is here. Maybe we should make her say bye-bye.

Bushra: You do it.

Harjit: No, you do it.

Bushra: Just do it.

Harjit: Bye-bye. That was so bad.