Why Medical Education Is Broken, And How We Can Fix It with Dr. Paul Tran

“At the end of the day, who cares how good you are at giving feedback if it falls on deaf ears or doesn’t improve outcomes?”

Dr. Paul Tran is a pediatric gastroenterologist, award-winning medical educator, and the creator behind Elementary School — a digital platform using storytelling, mentorship, and a healthy dose of cringe-worthy dad jokes to transform how we teach and train future doctors. He’s built a community on TikTok, Instagram, and Substack dedicated to making medical education more real, more human, and a lot more fun.

On this episode of How I Doctor, Dr. Graham Walker talks with Paul about why medical education is overdue for a shakeup — and how to actually pull it off. They unpack why outdated hierarchies persist, how changes like pass/fail boards and virtual interviews have upended the residency match, and what it really means to treat trainees as future colleagues instead of cheap labor. They also dig into Paul’s practical tips for better feedback, navigating the hidden curriculum, and using social media as an antidote to burnout.

Here are four big takeaways from their conversation:

1. Treat Trainees Like Colleagues, Not Underlings

“One of the things that I think about is the fact that you view medical students as just a student, so much so that students say that ‘I’m just a student.’ … That is an artificial hierarchy and structure … We have to treat them as future colleagues.”

Paul argues that the entrenched hierarchy in medicine keeps students and residents stuck in a subordinate mindset instead of growing into confident, collaborative doctors. By acknowledging trainees as tomorrow’s colleagues, educators build trust and accountability from day one. It’s a simple shift that changes how we teach and how well we care for patients together.

2. Medical Training Takes Too Long and Costs Too Much

“It is too expensive. I’m still paying medical student loans. They’re probably gonna follow me the rest of my life at this rate. I have no idea how to get out from under that black cloud.”

Paul is candid about the financial burden and length of training, especially for physicians who don’t want to pursue research careers. He argues that mandatory research, excessive time in training, and ballooning debt load young doctors with stress and delay real-world practice. He wants a system that respects different career paths and stops treating debt like a rite of passage.

3. How to Uncover a Program’s Real Culture

“I have a two-part question that … shines a spotlight right away: ‘What is your idea of an excellent resident? … And how often do you see that in your program?’”

With virtual interviews here to stay, figuring out whether a residency truly supports its learners is trickier than ever. Paul’s favorite question cuts through generic answers and reveals the gap between a program’s ideals and its reality. He tells applicants to get specific because you deserve to know what kind of training environment you’re really stepping into.

4. Meet Learners Where They Are - Even on TikTok

“People don’t open TikTok to learn. They come to be entertained. If I can sneak in a lesson while they laugh — that’s a win.”

Paul knows that medical students spend time online to unwind, not to study. That’s why he wraps quick lessons in humor and storytelling that stick. His sketches spark curiosity, tackle unspoken truths about training, and prove that education doesn’t have to be stuffy to be effective.

Connect further with Paul on TikTok, Instagram and YouTube

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Transcript

Dr. Paul Tran:
Dr. Walker, what is your idea of an excellent resident and what are the traits? What are the actions that they do? Paint a picture of the excellent or perfect resident, and then you answer. And then, that second part is, how often do you see that at your program? And I think it really is like, "Oh, are they describing in an ideal or are they describing someone that they have a picture of because they've worked with them regularly?" And I think that tells you a lot about the culture of also dynamics between an educator and a trainee.

Dr. Graham Walker:
Welcome to How I Doctor, where we're bringing joy back to medicine. Today, I'm joined by Dr. Paul Tran, a pediatric gastroenterologist, medical educator, and creator of Alimentary School, a content platform built on TikTok, Instagram, and Substack, dedicated to transforming medical education through mentorship, motivation, and humor. Paul practices at Phoenix Children's Hospital while serving as the co-director of the pediatric clerkship and doctoring program at the University of Arizona College of Medicine in Phoenix. He's also this year's winner of the Outstanding Educator Award. What sets Paul apart to his commitment to real world educational impact. He's using storytelling, humor, and digital outreach to engage younger learners, coach future learners, and rethink how we do feedback. As a fellow lover of bad dad medical puns, I just had to tell our listeners that his medical education newsletter is called Advances Tolerated, which is just chef's kiss bad. Medical education, I think, is probably the most important topic today, and so I'm extremely excited to hear Paul's perspective. Dr. Paul Tran, welcome to How I Doctor. Thanks for being here.

PT:
Thanks so much for having me. It's a pleasure.

Rethinking Medical Education Culture

GW:

Well, Paul, let's talk a little bit about medical education. If you were given total power to not just blow up your med school, but all of medical education and rebuild it from scratch, what do you think you would do differently?

PT:
How long do we have? A couple of hours?

GW:
Yeah.

PT:
That will get me started on the outline, I think. I mean, I think it starts with a culture change and a mindset overall. One of the things that I think about is the fact that you view medical students as just a student, so much so that students say that I'm just a student. Residents, I'm just a resident, or you are the resident. We don't even refer to them by name sometimes. You're the resident, the fellow. That is an artificial hierarchy and structure that I think underlies this mindset, which is they are a station below us, they're a step below us, and they're not the future colleague that's going to work alongside of us, that's going to take care of our patient, share in that care, and heck, take care of us, take care of our family. So I think it starts right away with acknowledging that these are our future colleagues. We have to treat them as such. We have to train them as such because I want my future colleague to be really reliable, trustworthy, and ultimately good.

GW:
Paul, I have two reactions as you were saying that. One, I distinctly remember being on my general surgery rotation, having a day in breast clinic, and the breast surgery attending introducing me to the patient as, "This is a medical student." I mean, I'm wearing a name badge, but she certainly does not care what my name is. And then, my other reaction was really about you're totally right. The medical student actually, I think, may have more insight because once you get into residency and as an attending, I think we really truly lose the ability to remember what it was like to be a patient. I think med students have a foot in each camp still, and so they're able to actually still see that perspective that is, I think, almost impossible for us as physicians to really recall because it gets so driven out of us.

PT:
I think that's the key point. It's driven out of us, and I don't think anyone means for it to be. We don't go into attendinghood and the rest of our career saying, "All right. I'm going to be crusty now. I'm going to act a certain way."

GW:
I can't wait.

PT:
"I can't wait." No. It's all of these demands that are placed on us, navigating a system, navigating all the things that we don't know about in training. It stamps it out of you, which is really unfortunate. And you're right. Early on in the process, you have this really unadulterated view of the purity of medicine and learning and being able to take care of a patient and that compassion that's just naturally flowing. I mean, you're learning the language to be able to convey that compassion and empathy, but I think you do have to have that acknowledgement that yeah, they're a lot closer to where we once were.

Impact of Pass/Fail Step One and Virtual Interviews

GW:

Paul, I'm, gosh, 17 years out of medical school. There are a bunch of changes that have happened in the past 17 years that I've learned a little bit about from just talking with med students and mentoring them a bit. But step one is pass/fail. I think residency interviews are all virtual. I don't think that's changing, right?

PT:
For the time being, they're staying virtual.

GW:
Yeah. I mean, do you have a sense for how that has changed the way that it impacts medical students these days?

PT:
The pass/fail step one, that is now removing what was once another data point for programs. You had step one. You had step two. You had clerkship evaluations, letter of rec, research experience. You remove a pivotal objective measure. Now, just the mindset, even if it doesn't change anything from a program level, students are stressed out just as ever for that pass/fail step one. But now, there's so much weight on step two, so much weight on clerkship grades, and then it's just really shifted this focus on research no matter what.

GW:
Really?

PT:
No matter what the cost, it's research because you have to be able to compete. You have to be able to have some objective measure of your capability that this mindset of how incredible and how incredibly important these post Step 1 grades are and scores are. Doesn't align with the fact that clerkship and clinical teaching is the same. So you now have this hunger, this desire to improve, the same amount of time in many cases, the same amount of instruction, which is limited, the same limited rotation sites, and the same lack of deliberate preceptorship many times. I think that's funneling a lot of experience to the point where I don't think that we're doing a service to medical students because I think ultimately, we're just not improving our clinical training enough to meet this desire to improve your application. Then, one of the things about virtual interviews is that from an applicant standpoint, how the heck do you know the culture of a program when you can't shake hands?

GW:
I know. That's what I tell them. I feel like a boomer, but I'm just like, "I don't understand how you can get a sense of the program." I told somebody, "Oh, well, maybe you can try to go do a second look," and they said, "Oh, second looks aren't allowed or something at some programs." I was like, "That's literally how I chose my residency."

How to Evaluate Residency Programs

PT:

How do you know how people act when they can act any way they want or any appearance of perfection in that 30-minute Zoom? In that 20-minute Zoom interview, I can wear a mask. No problem.

GW:
I'm real good at that. Yeah.

PT:
Yeah. So I think what it means is we have to empower learners to then ask tough questions to really determine the culture of a program. I call it pushing at the pressure points of a program. Instead of saying, "Hey, what's the culture of your program," the answer 99.9% of the time is great. Yeah, we support our residents. Yeah. What's the best part about the program? The people. Yeah, yeah. They're not going to talk about the things that are really hard.
So I have a two-part question that I think is a killer. It shines a spotlight right away, and people are scared of asking it because they're like, "Oh, no, I don't want to step on any toes." I'm like, "If you don't ask it now, when are you ever going to find this out?" It's great. I'll pretend I'm interviewing with you. I'm like, "Dr. Walker, what is your idea of an excellent resident, and what are the traits? What are the actions that they do? Paint a picture of the excellent or perfect resident," and then you answer. And then, that second part is, "How often do you see that at your program?"

GW:
Oh, wow. Yep.

PT:
And I think it really is like, "Oh, are they describing in an ideal or are they describing someone that they have a picture of because they've worked with them regularly?" And I think that tells you a lot about the culture of also dynamics between an educator and a trainee.

GW:
You get that little one-two punch in there.

PT:
Oh, yeah. Oh, yeah. That's the combo right there.

Obsolete Traditions in Medical Training

GW:

Paul, you love to joke on TikTok. Yeah, one of the TikToks I'm just thinking of was you were saying there's two phases of your medical training. One is learning the Krebs cycle, and then the second is forgetting the Krebs cycle. I don't want to lead the witness too much on this question, but what are some traditions in medical training that are obsolete or harmful, and why can't we just let go of them?

PT:
Oh, man. You set me up. This is a slow pitch for one of my favorite things to rail against, which is this institution called Feedback Fridays, which it's definitely-

GW:
I don't even know what that is.

PT:
Oh, okay. So it's definitely specialty-specific. It's way more prevalent on wards-based rotations and specialties, so pediatrics, internal medicine, even OB. But it's this concept that usually, you spend a week with an attending. They come on for a week at a time like a hospitalist.

GW:
Sure.

PT:
And generally, the last day with that attending is Friday. So you spend all week essentially going about your business, and as a medical student or even a resident, you're trying to impress, you're trying to learn, and you don't really get any feedback until Friday where there's this formal pomp and circumstance of, "Let's find a private place and march people out one by one to give private feedback." It always starts the same way, "How do you think you did," and people are following this formulaic regimen. But then, you hear things. Potentially, you may hear things for the very first time like, "Hey, your presentations suck, and I didn't hear any assessments, and I really need you to hear that." Well, then the attending goes, "Deuces," leaves, and you're like, "I never get to show you that I worked on it, improved," and you had all week to work on something and improve, and you lost that opportunity because you're hearing it at the very last minute.
I've likened it several times to this analogy of eating kale salad at lunch and then walking around all day with kale stuck in your teeth and no one tells you. And then, you see it at the end of the day, and you're like, "I talked to 30 people today, and no one told me." It's embarrassing to hear about it. It's way more embarrassing to find out. Ignorance is not bliss in that moment. So that's something that's obsolete that should go away.

GW:
I guess the other challenge is if you're in an academic place and you happen to get one of the weeks where it's an attending who works eight weeks a year because they're mostly like a researcher, you maybe get somebody that you'll never see again, maybe has a particular point of view about how things should be done, or they honestly don't want to, quote, unquote, "deal with the med student." They just want to talk to the fellow and get back to their research.

PT:
Yeah, that's right. I'm in and out. I'm only here for a short amount of time, but let's make this as painless as possible for everyone.

Is Medical School Too Long and Too Expensive?

GW:

Paul, another question about medical school. Do you think it's too long, too expensive, too broken, or is it all three?

PT:
Too long depends on where the curriculum is. It's not long enough when it comes to the clinical education. It's not long enough when it comes to skills that are very important as both a trainee and then as a physician practicing medicine. I think it's too long, both medical school and residency and definitely fellowship training, and I'm speaking about this as a pediatric subspecialist with pediatric fellowships in mind. It's too long when it comes to mandatory research or a research obligation when you're like, "I don't really have research interests. I don't see myself as a physician scientist. I really see myself as a clinician taking care of patients."
I think there is, from my sense and my training, a expectation of mandatory research that I think just doesn't fit everyone. It's not one size fits all. You need to appreciate good scholarship and appreciate what goes into it and appreciate the people who do it and not be forced to do it yourself because I think that does prolong training. And then, definitely, it is too expensive. I'm still paying medical student loans. I think they're probably going to follow me the rest of my life at this rate. I have no idea how to get out from under that black cloud, and it's stressful. I used to lose a lot of sleep about it.

Do We Teach Too Much in Med School?

GW:
Paul, as a educator and, certainly, you're way closer to medical education than I am, the preclinical knowledge only has grown and only grows every year. I think somebody has actually looked at the size of the USMLE Step 1 First Aid for the boards books and just shown that its page length has increased every couple of years, every edition.

PT:
Oh, yeah. Have that.

GW:
And so, I wonder, as somebody that works with medical students frequently, do you think that we truly need to keep teaching all of the things that we teach, or could some of that be passed off if you get to that level in your training?

PT:
Yeah. I mean, you're asking, do you need to learn about chloramphenicol or can you wait until you decide to be a chloramphenicologist to learn about chloramphenicol?

GW:
If you're going to be an infectious disease specialist, maybe it should be the ID attending who teaches the ID fellow or the resident, "Hey, yeah, there's this one drug that you may not use at all in your career because it has these side effects, but it's still good for this particular rare thing."

PT:
Yeah, I think you bring up a really good point, which is there is a lot that we learn outside of context that is way more helpful with the appropriate context. So I, in short, agree with you. I do think that we need to cull the amount and the depth at which we're teaching. The question that's really difficult, and I don't have the answer to and I don't think a lot of people have the answer to, is what. Cull what and what passes the threshold of being vital as foundational or fundamental? I see this as one of the most prevalent things in medical education, which is something that I use and I love this space-based repetition flash card app called Anki. I mean, I used it throughout medical school.

GW:
I am old enough that I did not use Anki. That's how old I am, Paul.

PT:
That's okay. That is okay. There is a dividing line beyond [inaudible 00:16:55]

GW:
I'm a pre-

PT:
You're pre-Anki.

GW:
Yeah, I'm a pre-Anki.

PT:
Yeah, it's BA, before Anki, and certainly after Anki. The prevalence of this is so interesting though because medical students are approaching this fire hydrant of information by sheer memorization because there is this huge emphasis on know all of this. So to know all of this, you have to have flash cards and masked repetition at an enormous rate to the point where now, you are sacrificing your depth and quality of understanding and critical reasoning instead for sheer recognition of concepts. And I'm like, "Leave AI. Leave applications for recognition. You need understanding. You need critical reasoning. You need to be able to synthesize all of these with clinical experience and judgment."

GW:
I agree with you. I think it is hard to know if you pull out this one piece from kind of foundational medical fundamentals, will that pull the rug out from you and mess up, knock the Jenga tower down because we didn't teach that neuroanatomy? Remember that one slice looks like Darth Vader? If people didn't learn that, do they need to know that? Is their medical education going to be screwed up that we're not going to have any neurologists or neurosurgeons anymore? I don't think so, but I don't do those full-time, so I can't say for sure.

Mentorship and Honest Feedback in Medicine

Paul, let me move to mentorship because I think it's another passion of yours. Tell us a story maybe of a moment that changed your career that maybe a mentor said something brutally honest to you or surprisingly kind or something that has stuck with you.

PT:
It's a moment that's all three. It was brutally honest, it was kind in its honesty, and it has definitely stuck with me. It seems innocuous, but I'm a very loud personality. I'm a jokester. I like to be the class clown. In my first year of fellowship, I was all about the endoscopy suite, so the procedure room where we do endoscopies, and I was procedure focused, and I loved it down there. I lived and breathed that. Every time I was down there, I was playing video games. I wanted to do that for the rest of my career. So I grew really close with the staff, grew really comfortable very quickly, and I remember every attending that watches you and scopes with you has a different style and has a different set of preferences. I would calibrate and try to match whatever they wanted technically.
I remember just feedback on evaluations, not to my face, of course. It was written months later that was essentially like, "You are unprofessional. You're unprofessional in the room." It rocks you to your core when you think you're doing a good job, and then you find out later on that you're not. Even if it's not really about your actual performance, it's about your personality. Maybe it hits even harder, but I had a mentor pull me into his office, and he essentially was like, "You know how to knock it off." I'm like, "What do you mean? I'm not going to change who I am?" He said, "I don't need you to change who you are. You don't need to change who you are. I'm not saying that. What I'm saying is you need to calibrate to the personnel around you. You need to calibrate to the environment around you."
That was the kindest thing that ever happened in that year, I think, which it was like no one needs you to change who you are. You just need to know when to turn up the volume, when to turn down the volume appropriately. I say it now. When people ask me about social media, I'm like, "The volume of your megaphone, it's all about calibration to the audience and your stage of training and your platform." I think that's a lesson that's really stuck with me in multiple domains, not just clinically, but professionally, academically, and then now in the real world.

GW:
I love that term, calibration. I mean, I think it applies to just the practice of medicine. When you walk into a room with a new patient, this is one of the things I love about emergency medicine, I'm constantly having to recalibrate. And it's like it has to go as fast as possible where I'm like, "A joke is going to make this person feel much better and a joke is going to make that other person think I'm not taking them seriously."

PT:
Yeah, absolutely.

GW:
Paul, you mentioned earlier about kind of the dynamic and the hierarchy being a challenge in medicine and that we should think of medical students as our future colleagues, which I love. How do you square that with the mentor-mentee relationship that you do have more knowledge in many ways than this med student does? And then, I guess my other wrinkle is do all of us being more digital, does that impact mentorship as well?

PT:
One of the things that I think you can really think about as a anti-hierarchy is more depth of experience and insight as a coach. Coaching is really interesting because I think the literature distills coaching down to being able to diagnose, observe, and then communicate blind spots to someone, ultimately with the goal of them seeing their own blind spots. So if I am working with a student who may or may not be a mentee, I ultimately don't want to just tell them things. I don't want to just hand them fish. I want to teach them how to fish. I want them to be more discerning and have developing insight into the things that they are doing that could be improved or not, so that ultimately, when our time is done or if I'm not with them, they can be like, "I see what Paul was talking about. I recognize now that this feels this way. This feels this way. This was incorrect. This was correct, or this was superficial. This was more comprehensive. I'm going to go this route." And it's their kind of insight and self-realization of that process.
So what we should do really is think about more of a coaching role, and it's like I am just trying to observe for things that may be blind spots for you, and I'm going to out those blind spots to you. You choose whether to act on those blind spots or not, and I might have to communicate sometimes where those blind spots are pivotal, "Hey, this blind spot could actually hurt or harm someone. Very important that you urgently address this."

Modern Approaches to Giving Feedback

GW:

Paul, I grew up in the age of the hamburger method of feedback.

PT:
The sandwich.

GW:
The sandwich. If listeners don't know, the shit sandwich. Give somebody a nice positive feedback and then give them the thing that they're supposed to work on that you actually are meaning to tell them, the whole reason you're giving them feedback, and then you give them another layer of positive feedback. I hear that's falling out of favor. Do you have other frameworks or methods that you like to use giving feedback to medical students or residents?

PT:
Yeah, there are studies actually on third-year medical students that show the quality of the feedback sandwich, and I don't want to misquote, but I remember that students perceived that the feedback sandwich, the traditional model, was the best feedback. Their perception was that was helpful, but when looked at a rubric objectively, it did not improve outcomes. So for me, at the end of the day, what I'm so passionate about and the feedback literature talks about a lot is who cares how good the feedback is? Who cares how good you are at giving feedback if it falls on deaf ears or doesn't improve outcomes? Because at the end of the day, it's about the person who's receiving the feedback actually changing because of the feedback. There are a lot of models now of what's called bidirectional or conversational feedback. This is a give and take. This is a dynamic process. It is not a delivery. You move from unidirectional delivery to bidirectional conversation.
So people have it right by saying, "What did you think about that?" You asked for reflection. You then give observations, "What I saw was this," and then you talk about it. "I saw this. What do you think? Do you feel like you felt the same?" "No." "Why or why not?" And you have that dynamic process. So a lot more conversational. I tell learners all the time to negotiate these like a hack for if you're working with a preceptor, even if it's one shift, a half day in clinic, or a full month. You just say first day, "Hey, what's bare minimum? What do you expect of every single student who comes in? What do you want us to leave with?"
And then, you ask for exemplar, "Hey, the best medical students, kind of like the residency culture, the best medical students, what do they do? The best sub-I, it's the level above." The best residents, "What do you see them doing," and then you pick a goal in between. You can't shoot for the exemplar because that's a level above you. Don't shoot for minimum. Shoot for something in between. Work on that. Consistently ask for feedback on that. If I want to get my presentations better, "Hey, how was that presentation," after every presentation, how was that? How was my assessment there? How was my assessment there? I feel like I tried to work my prioritized differential there, and it was really hard. What do you think about that? Very quick. And at the very end, cement an action plan by asking for advice.

GW:
That's great, Paul. I think I've learned from my colleague, Ingrid, shout-out Ingrid Lim, that if we normalize giving feedback as well, invest in the beginning like set the expectation that, "Hey, every day we work together on shift, we're going to do feedback at the end of the day," so that it doesn't feel like the person's in trouble for being called into the private room to do feedback. It's just like, "Well, that's literally what we do. We work a shift, and then we sign out, and then we do feedback, and then we go home." And so, just normalizing it so that it doesn't feel like, "Hey, Paul. Can we talk privately? Oh, Paul's in trouble." If we make it feel like, "Hey, we can always learn. We can always get better, and so every day we're going to work together, we're going to just talk privately for two minutes at the end of the day before we head out," then it doesn't feel as scary when you say, "Oh, hey, it's time for feedback now."

PT:
I love that we have to normalize it because it should be a regular daily part of learning and working as a professional.

The Importance of Observing and Coaching

GW:
I remember working with one of my favorite social workers who's now a family practice doctor. Hi, Michelle. She and I had rehearsed. We're going to go in and talk with this family about goals of care, and then I don't even remember this, but afterwards, we talked, and she said, "Graham, what did you do? We said we weren't going to go that route." And I said, "What do you mean? I don't remember saying that at all." And so, we all have these blind spots. We all have these areas that we don't even know that we said something or that we missed something. We can all always improve. I mean, that's hopefully the goal. The beauty of medicine is there's always ways we can get better and deliver better care and give better answers for our patients, too.
I think the other thing is we often also don't know what the med students and the residents don't know. We only have our own lived experience of what happened to us in med school, what we were taught in med school, and so often, it's helpful to just be a fly on the wall. Sometimes I'll just listen outside the room to what the resident is saying and how they're talking with the patient. Sometimes I duck my head in so I can eyeball the patient and see sick or not sick. But then, it's also nice to just listen and hear how they approach the patient, and I'm like, "Oh, wow, this person's really compassionate. They're very thoughtful in the way that they've approached this patient." So I learned stuff from the residents I work with all the time.

PT:
Can I challenge you, Graham?

GW:
Please challenge away.

PT:
Don't listen outside the room. Listen in the room. Go in with them. I-

GW:
Paul, I don't want to make them feel-

PT:
Like they're being scrutinized?

GW:
... like I'm second-guessing them or I don't trust them. I guess that's something I could work on too is just saying, "Hey, I'm not there to second-guess you. I'm just here to learn from you, or I'm here to see how you interface with the patient."

PT:
I think when you say that, if you say, "Hey, after a certain point, really after med school, you don't really have anyone watch you anymore."

GW:
I know it's crazy. Yeah, yeah.

PT:
So what if it was that? "Hey, I want to try something new where I want to give you some advice that maybe you won't get the rest of your career or the rest of training," and you could frame it like that. When I was a true clinician in clinic, I would have a three-step process with learners. The first patient that we saw was always together. I'm like, "I don't want you to go in and see the patient, the traditional model of go see the patient, get the history, and then staff with me. Just go in with me. Don't bring your laptop. Don't write a note. Watch me. Watch the questions that I ask. Watch my bedside manner. Watch my physical exam. Watch the way I deliver a plan and how I educate." That's number one.
Number two, the second patient, and it might be a couple patients like this, but the second stage is, "We go in together. I will scribe. You take the cognitive load off where you have to ask the right question and document. I will write the note, so efficiency is still there. The note's going to be done. I'm listening to you. Every single question that you ask, I can watch your bedside manner. I can watch the questions you ask, and then if there's any vital information, of course, I can jump in, but I try not to. And then, we excuse ourselves, go out of the room, and then I want you to flex your muscles. Then, give me a presentation. You don't have to do the subjective objective. I just heard everything. Give me what you think and what you want to do, the assessment and plan. Then, we go in together and then we move to the third stage, which is the traditional. Then, if you feel comfortable, go and get your own history." But I think this way, I think it enables them to see one, do one with me, do by themselves.

GW:

Paul, let me just ask you in our last few minutes about your social media journey. What made you decide to teach GI and do medical education plus humor all on social media together?

PT:
Honestly, I saw this gap where there were first and second-year med students talking about studying in the first and second years, and then there were residents talking about how their programs were, and there was not much in between. There was not anything for third-year students, sub-Is navigating residency applications, and then residency navigating just the clinical world. So I wanted to address that gap and create a lot of content to educate about it. And then, I realized, I think over time and consistent creation, that people are watching short form content, TikTok, Instagram, really to be inspired or entertained, not necessarily to learn. I'm not going on TikTok because I want to learn. I don't have the intention of learning. I might learn in the process, but I'm not going there with the intention of learning. Sketches, skits, humor, it's a great way to entertain, keep people engaged, and if there's a single question, a single piece of insight that comes out at the end of it, great. When you come back, because I hope you come back for the entertainment, I can then build upon it over time with that consistency.

GW:
Paul, part of the challenge, I think, when I am on TikTok or watching things on social media is sometimes the education, because it's so short, it feels incomplete to me. Am I thinking about this the wrong way, that in a new format that is intentionally as short as possible, there's some shortcuts that you have to take and that there's some danger or some risk there of giving incorrect information?

PT:
If you approach it with a mindset of, "I'm going to get comprehensive, full coverage." But what you do get, I think, is stimulation of curiosity because my hope is that a bite-sized pearl, something that's really short and sweet and concise, stimulates the curiosity for you to say, "Huh, I've never thought about it that way. I should look this and cement this, find other things that may be very closely related or in contrast to this, but this helps my network and my mental mapping."

Fighting Medical Misinformation Online

GW:
The more time I spend on TikTok and social media, the more important I think it is the representation from you and other creators showing physicians as knowledgeable people. I just see so much incorrect information online about health and wellness, and it seems like it spreads like wildfire. I just want to thank you for the work you're doing to try to give the right information out because it seems like it's an incredible challenge.

PT:
Thank you for saying that. My content and my audience is definitely more niche and focused on the education stuff, so in my domain, I don't have to deal with as much misinformation, disinformation as a lot of other creators, friends that I've made along the way. But I think there is a call to action, which is every single physician can improve the quality of their communication because at the end of the day, there are a lot of other people who may not have the credibility as you, the expertise, even the evidence, but they are compelling. They are concise. They are clear. They're great communicators to be able to stand a chance. We all have to develop our own communication skills. I think that is something that I want to see for every single colleague that I work with in the future.

GW:
I could not agree more. Paul Tran, where can people find you? What's the best place for people to find you on social and support the work that you're doing?

PT:
Well, thanks so much. I'm Alimentary School on TikTok, on Instagram, on YouTube. I am a part of a group called the Hippocratic Collective, where we want to try to amplify the voices of physicians and especially creators, artists in medicine. And then, I have a new YouTube game show out called The Four Humors, where I literally have people come on to play games because we can be a little bit less serious and laugh at ourselves a little bit more.

GW:
Well, Paul, that's Alimentary School with an A. Yeah, Paul's all over TikTok and Instagram and YouTube. Please check them out. Paul, it's been a pleasure. Thank you so much for being here.
Thanks for joining me today. For interviews with physicians creating meaningful change, check out offcall.com/podcast. You can find How I Doctor on Apple, Spotify, or wherever you listen to podcasts. We'll have new episodes weekly. This has been and continues to be Dr. Graham Walker. Stay well, stay inspired, and practice with purpose.