Why I’m Returning to Medical School

Ten years ago, I left medical school at Johns Hopkins to pursue a question that had obsessed me: Could you get a doctor online? It was the riskiest decision I had ever made, and one that not only worried my parents, but frankly gave me heart palpitations.

At the time, my co-founder and I had just started working on a learning platform called Osmosis.org, which was how we and many of our classmates passed our own exams at Hopkins. The vision was to make medical education more effective and enjoyable by incorporating evidence-based techniques such as the flipped classroom and test-enhanced learning; delightful user experiences and machine learning-enabled personalized recommendations developed by companies like Facebook and Netflix; and new content formats such as short videos given how quickly the world became more visual and digital.

Our experience since taking the plunge and leaving medical school is perfectly captured by this quote from Bill Gates: “Most people overestimate what they can do in a year and underestimate what they can do in ten years.”

What began as a side project used by our class of 120 medical students would grow beyond our wildest dreams to reach well over 3 million students around the world—enough to fill 25,000 lecture halls at Johns Hopkins—and across all health care professionals programs, including nursing, physician assistant, pharmacy, and dental care, and even patients and their family members. Ultimately, this reach and impact led to our successful acquisition of the 140-year-old medical and scientific publisher, Elsevier, known for titles such as The Lancet, Celland Grey’s Anatomyand which has been a perfect match both from a cultural and growth perspective.

While I had a wonderful time and learned a tremendous amount “in the real world” growing Osmosis from two to 100 employees and 0 to 200+ institutional partners, my original goal was to become a doctor – which was first forged in a hospital in South Africa – kept hanging on by a thread.

Given the scope and successful exit of Osmosis, I surprised many of my friends earlier this year with my decision to trade the tech Patagonia vest for a short white coat by going back to Hopkins Med as a third-year medical student. The choice was the culmination of months of thinking that ultimately boiled down to these six reasons:

  1. Helping patients directly is an incredible privilege that provides deep purpose. As I have written about in the book Success mindset, there is a natural tension between pursuing scale versus direct impact. While cultivating osmosis to millions of students has been incredibly fulfilling, I have missed the ability to help someone directly on a 1:1 level. This purpose is further elaborated by the nature of their problems: A healthy man wants a thousand things. A sick man only wants one.” (Confucius). Put another way, illness has a habit of clarifying for people what is most important to them. Healthcare professionals are privileged to be there for patients on what may be the worst day of their lives, with an open heart and the knowledge and skills to help them return to a state of well-being. Even at Osmosis, the initiatives that have given me the most satisfaction are those that have the most direct impact on patients, such as our focus on the often-ignored rare disorder community through Year of the Zebra. Fortunately, our simple and clear video style – although originally developed for medical students – has appealed to countless patients and family members, who have submitted thousands of comments like this one: “As someone who was diagnosed premature ovarian failure at the age of 14 it’s nice to finally know what’s going on because I didn’t understand a single thing my doctor was saying except the fact that I wasn’t able to have children. Many thanks for this I am glad to have a better understanding of it!” This desire to connect 1:1 with patients who have incredibly different life experiences and circumstances has already been validated in my first few weeks back at Hopkins, so I’m excited to rotate through the different services from pediatrics to neurology.
  2. Learning medicine has never been more engaging and effective. The main reason Osmosis succeeded is that we had “skin in the game” and literally put ourselves in our customer’s shoes. I am back to learning by osmosis daily and am confident bet my own medical studies on the quality and effectiveness of what we have created. Additionally, now that we are part of the Elsevier family, I have access to leading complementary resources such as the Complete Anatomy platform for anatomy review and surgical clerkship preparation, as well as ClinicalKey Student for thousands of USMLE practice questions and access to category-defining books such as Nelson Pediatrics. Plus, the human body is fascinating, so I’m excited to have the opportunity to resume learning about how we work.
  3. Raise the line“requires both clinical and entrepreneurial experience. Our healthcare system faces enormous challenges, from the massive global shortage of healthcare workers to the cost and inaccessibility of life-saving medicines. Over the past three years, I have had the opportunity to interview hundreds of managers for Raise the line podcast such as Dr. Sheila Davis of Partners in Health, who spoke on global health equity; Mark Cuban, who shared his team’s work to make drugs cheaper; Dr. Eric Topol, who discussed the future of artificial intelligence and digital health; Dr. Ashish Jha, who spoke about strengthening our public health system; and Arianna Huffington, who addressed the topic of supplier burnout. It’s clear that we need innovative models to “raise the bar” or strengthen our healthcare, so I’m looking forward to both seeing first-hand how concepts we discussed on the podcast are being applied in healthcare as well as building clinical experience to combine with my entrepreneurial background to hopefully contribute to these solutions.
  4. Doing difficult things can be deeply satisfying. Do one thing every day that scares you. The little things that make us uncomfortable help us build courage to do the work we do.When she wrote those famous words, Eleanor Roosevelt was channeling the Stoic philosophy of practiced discomfort that I have empirically found to be transformative. In recent years, however, I’ve noticed that I’ve mostly been practicing physical discomfort, from daily cold showers and a winter expedition plunging into icy water with Wim Hof ​​to running an IronMan and climbing Kilimanjaro to raise awareness of rare diseases. Going from running a 100-person company with plenty of autonomy to being at the bottom of the totem pole again and studying intensely as a medical student has already been a huge challenge – which is exactly why it’s worth pursuing. As I go through medical school, I am aware of (and reformulating) two feelings in particular: fear and frustration. Fear is an option for growthand one I’ve already experienced in simulated patient encounters, such as a recent one where a baby mannequin went into supraventricular tachycardia and we had to figure out how to respond within minutes. Frustration is an option for innovation – yes, it was frustration with how ineffective the medical education system is (eg hundreds of long and passive lectures) that led to the founding of Osmosis. Our healthcare system is full of room for improvement, so I’m excited to experience these frustrations firsthand again.
  5. Creating the future. Related to this last point, one of the most compelling reasons to go back to medical school at Johns Hopkins is specifically its leading edge research in some very exciting areas. Two that I will mention are artificial intelligence (AI) and psychedelics. The recent development and release of generative AI tools such as ChatGPT has captured the public’s attention, and Hopkins has a track record of applying AI to meaningful health problems such as detecting liver cancer and sepsis, as well as pioneering innovations in areas such as “organoid intelligence” and brain- computer interfaces. The other field, psychedelics, has recently undergone a renaissance due to the mental health crisis ranging from anxiety and depression to post-traumatic stress disorder and substance abuse. This resurgence was pioneered in large part by Johns Hopkins researchers at the Center for Psychedelic and Consciousness Research, which has published over 150 peer-reviewed articles and is actively running numerous clinical trials for conditions like OCD and anorexia nervosa, it’s a fascinating time to be a student again and doing electives with labs like these that create our collective future.
  6. Fulfillment of a personal and family dream. Last but not least, I have returned to medical school with the hope of fulfilling my personal dream, almost 30 years in the making since I followed my doctor father to the hospital he ran in South Africa. This excerpt from my original medical school essays is as true today as it was nearly 15 years ago, “My determination to become a physician was initiated by a sense of compassion, fueled by the excitement and promise of medical research, and strengthened by the realization that physicians can simultaneously contribute to individual patients as well as society at large through their leadership.” As with many dreams, it is not only my own, but also that of my family, who just two generations ago were refugees during the partition between India and Pakistan. That Philadelphia Business Journal captured this sentiment in my argument a decade ago when we had just left Hopkins the first time: “Osmosis expects to raise funding early next year, meaning Gaglani and Haynes will have to answer questions about whether they will return to medical school. Gaglani said venture capitalists who would invest in the company “don’t want to hear [we’re] going back to medical school, but our parents won’t listen [we’re] not going back to medical school.”

Together, these reasons painted a compelling picture for me to step down from the day-to-day operations of Osmosis—which is in the more than capable hands of the mission-driven team at Elsevier—to return to the Johns Hopkins School of Medicine. Although this is the current course, I have also lived enough to know that Mike Tyson’s famous saying that “Everyone has a plan until they get punched in the mouth” rings true. The last time I started medical school, I made it through two years before encountering a problem compelling enough to leave to pursue it full-time, and fortunately for me and many others, the result was osmosis. While I am keeping an open mind to this among other possibilities, I am grateful to already be back in Baltimore where I can hopefully “raise the bar” as a future healthcare professional.

Feel free to follow along on the journey via LinkedIn, Twitterand Youtube.

Why I’m Returning to Medical School

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