Alright, what is going on guys?
For those of you who are new here, my name is Dr. Kevin Jubbal.
I graduated medical school in 2017,
matched into plastic surgery and in 2018, I quit.
So last week, I showed you what my last day of residency was like.
It's kind of a trip for me to even watch that
because it's like such a mix of emotions.
And in this video, I'm gonna explain why I quit.
Now if you're too impatient to watch the whole video,
I think this makes sense if you do watch the whole video,
but if you just want to get straight to the chase,
it's essentially because I had two great options
and because there's only 24 hours in a day, I had to choose one.
It really just boils down to that.
Now there is a lot that went into this decision
and it was actually very hard for me to just say it in a linear fashion
because there's so many different things coming in at different times.
So I made a Notability note on my iPad.
I'm gonna be referring to this, while I talk you guys through it.
First of all, the structure of this video.
There's gonna be timestamps down
in the description, so you can jump to each part.
There will be four parts.
First, the four most common questions I get
and the brief answers to that.
Number two, some background information
that I think is important to understand why I quit.
Number three, the actual thought process
and the exercises that led to my decision.
And then number four, The Aftermath
and what comes next for me and for the YouTube channels, etc.
Alright, so first, the four most common questions.
The most, the number one most common question
I get is, "Why did you hate it?
"Why did you not like residency?"
"Why did you-- you must have quit because you hated it."
That's not true.
The reason I quit is not because I didn't like plastic surgery.
I think by far, I mean again, I am biased
but I think that plastic surgery by far
is the coolest, most innovative, sci-fi, exciting, beautiful field in all of medicine.
So it's not because I hated plastic surgery.
The next question is those who are not in medicine and they say,
"Why did you throw it all away?"
"You did pre-med, you got into med school,
you worked hard there, you got into residency
and now you're just throwing it all away starting from scratch.
That seems so counterintuitive.
Why would you do that?'
My answer to that is I'm not throwing it all away.
In fact, what I'm doing now requires me to have earned my MD
and have matched into a competitive specialty,
like plastics.
And number three, this one comes from people
who are usually in medicine,
although last week I was speaking to a lawyer,
she knows a lot of people in medicine,
and she was like, "What the hell?
Why would you quit Plastics?
What is wrong with you?
Like Plastics is top of the top!"
And I mean, I get what she's-- where she's coming from.
Because plastic surgery is very competitive.
Depending on the data set you look at,
it's either the number 1 or number 2 most competitive specialty to get into.
If you want to know more about which specialties are competitive,
I actually made a video today on the Med School Insiders channel,
going over the top 5 most competitive specialties.
And the fourth most common question I get is, "What happens to MSI?
You can't, you can't have quit residency and then still work on MSI."
I kind of see where that's coming from
but it doesn't... it doesn't make sense
because Med School Insiders
is about empowering pre-meds and medical students,
and helping them get into either med school or residency.
And our customers have been super happy
because we have the systems in place that produce amazing results.
And whether or not I'm in residency, that doesn't change anything.
Our company is not Residency Insiders. Right?
So, I'm not helping residents get into fellowship.
But based on, you know, excelling as a pre-med,
excelling in medical school,
getting into a super competitive residency like Plastics,
I haven't lost any credibility,
any experience, any expertise,
when it comes to what Med School Insiders does.
Alright, so part number two, let's go over some background.
I'm gonna keep this brief but it is necessary
to go over this to really understand why I quit.
Now, I like to think that this started in med school
when I started like essentially, my first significant company,
but people who know me better would argue I started sooner,
so I'll go over that.
So first in middle school, I was-- I used to draw cars.
I've been drawing cars since I was four years old
and I would sell them to other students
for their lunch money as like a sixth grader.
So that was like my first entrepreneurial venture,
if you will.
Soon after that, still in middle school,
I started making and selling these duct tape wallets,
which were like a thing back then.
I don't know why.
Then in high school, I started this tutoring company
with my brother called 'SummIT Up Tutoring.'
Essentially, he and I were tutoring other students
and, through word of mouth alone,
people heard that we were really good,
so we got a lot of customers.
And it got to the point where we're like,
"We need to study for our own classes,
we can't tutor like 15 students every week.
That's just not possible."
So to scale, we actually looked to our friends
who were performing well and said,
"Hey will you tutor for us?
We'll give you customers, you pay us a commission."
So essentially, we hired tutors to help us with our high customer load.
Now in medical school, I totally fell in love with plastic surgery.
It's this beautiful, amazing, high-tech, super innovative field,
and I got interested in health care start-ups, biomedical innovation.
Now my medical school didn't have any dedicated bio-medical incubators for students.
So, I decided to make one and I did all this research--
Again, this wasn't for like credit or anything,
I was just really passionate about it.
So I read textbooks and I read primary literature,
and I decided to model this incubator after Stanford's Biodesign.
So what we do is, we take medical students,
business students and engineering students,
put them on these interdisciplinary teams,
give them the resources and mentorship
and help them create healthcare start-ups.
So this thing like took off.
It was really really exciting, actually.
I remember flying back from Cape Town
to give a presentation to Janet Napolitano,
who is the president of the entire UC system.
I mean it was like, it was wild!
We secured funding.
We were in multiple different news articles.
The engineering podcast interviewed us.
It was wild.
It was awesome times.
Soon after that in October of 2016, I started Med School Insiders.
And that was a lot of fun
because for the first time,
I felt like all the lessons that I had learned
over the past eight years,
you know, between college and med school,
I was finally able to share them with other people.
And in a way that like, you know, before
when we were doing tutoring in high school,
that was like small-scale
but now I was reaching thousands,
millions of people.
And the most rewarding part was I would get these messages
or these comments or these emails saying,
"You know, I was struggling with my classes
or I wasn't in a happy place"
or all these different issues, "but hey, after watching your videos,"
like even my first ever video on study strategies,
"now I'm just like crushing it."
And I be like like f*** yeah, dude.
More power to you
and that was a lot of fun.
That was-- I didn't realize how exciting
and rewarding that aspect alone would be.
Okay, now one more thing about the background.
Before starting residency,
there were a lot of people who
kind of felt that I was more of an entrepreneur than a surgeon.
One of the residents I worked with during an away rotation,
he didn't say this to me.
He said this to another resident but I found out after I quit.
He was like,
"Yeah, I don't think Kevin's gonna make it through residency
because he has all these interests outside of surgery
and if you're going to go through a surgical residency,
surgery has to be like your life."
And then there was also my friend's dad, who is a venture capitalist,
also didn't say this to my face
but he was like, "Yeah", this-- again, this is a venture capitalist,
so like his entire career, the last 30,
40 years have just been finding and investing entrepreneurs.
So the first day I meet him,
he doesn't say this to me
but I find out later that...
After that first day, he was like, "Yeah, Kevin's an entrepreneur!"
And again, as a VC, they say, "You bet on the jockey not the horse."
So he knows the personality type.
He knows-- He knew very quickly that I was an entrepreneur at heart.
Okay number three.
The thought process and the actual decision.
This is probably what you guys care about the most.
So I'm walking to the OR.
June 30th, 2017.
Chair of department is there and one of my senior residents,
and first day, they gave me the scalpel
and we're doing Dupuytren's contracture release.
It's like this, this hand contracture.
And there were like, "Yeah, just don't cut any nerves."
and I was like, "What, this is wild!"
And I love operating.
It was just-- There's this thing about operating where you get into flow.
The time just flies by.
There's this-- You see this issue
and you use your hands to solve that problem.
It's-- I just couldn't imagine myself doing anything other than surgery.
It just... it's just so cool.
Now, as you can imagine, surgical residency is challenging.
And at the same time, I was balancing Blue LINC,
the biomedical incubator as well as Med School Insiders,
as well as being a resident in the hospital
as well as studying when I went back home.
So, there was a lot to do and not enough time.
There just weren't enough hours in a day.
Okay, so you guys may be wondering right now.
"Well, I got a friend, I got an uncle, I got a cousin
who, you know, as a resident, also doing a lot of things."
It's important to know two things.
So first in the US, there's an 80-hour restriction.
So the ACGME says, "Residents can work up to 80 hours a week on average."
Average over four weeks, and in other countries...
So in the EU, you know, the UK, other European countries,
there is a 48-hour restriction.
So they need to be working 48 hours or less.
I know in some other European countries, it's even lower than that.
And that's the direction that we should be going.
We-- Residents do not need to be working 80 hours to be effective doctors.
But that's a topic for another video.
And then secondly, it's surgical versus non surgical.
So on average, if you are in a surgical residency
like Plastics, Ortho, Neurosurgery, General surgery,
then you're gonna be working more hours than non-surgical
like anesthesia or emergency medicine.
Awesome specialties but you're not going to be working
on average as many hours as someone surgical.
So, if I was Anesthesia or Emergency Medicine
both of which I think are really cool interesting specialties,
will I still be in residency?
Possibly.
Hard to say.
Okay, so obviously, to balance all these things was intense to say the least.
I was told by multiple people that,
"Kevin, you are the most productive person I have ever met."
And I'd be, like, "Yeah thanks, you know, I try."
But I think they were probably thinking
like "No, no dude that's... you're a little bit too extreme.
You need to tone it down."
Like I had every single minute of my day,
like so surgically precise and so optimized.
When I would wake up,
I would use the toilet for ten minutes and then I'm like going through my emails.
My breakfast was optimized because when you're operating,
you usually don't eat for like most of the day.
I would ride my bike to work, I wouldn't drive.
Because by biking, I would actually, save about 60 seconds on my commute
because I live very close.
But more importantly, I would get my cardio in,
so I wouldn't have to spend time elsewhere doing cardio.
If I was waiting in line at the grocery store
or waiting for food at a restaurant,
I would pull out my phone
and start doing Anki flashcards.
Like it was, it was intense.
Next, The Decline.
So obviously, this is not sustainable.
I found myself getting sick, I wasn't as happy.
I felt like I was always working
because I was always working.
I was getting lonely.
You know, you work six days per week in residency
and during that seventh day,
usually it should be like hanging out with friends and relaxing.
I was just playing catch-up on Blue LINC or Med School Insiders.
I feel like the level of efficiency that I had
in med school was good and sustainable,
but in residency, it got to like too much of an extreme.
It was just trying to do too many things into a little time.
I don't think it was healthy.
I eventually realized that I couldn't--
I needed the help of some other people to realize this.
I realized that I couldn't sustain this for six years.
Plastic surgery residency is six years and something had to change.
Essentially what that came down to is,
I can't do both plastic surgery and entrepreneurship.
It's just not gonna work.
Now, if you guys don't already know, I'm a huge Tim Ferriss fan.
Listen to his podcast.
Read all his books.
And he has this TED talk,
it's called 'Fear Setting'.
And in this TED talk, he suggests you write three sheets.
First you write what you're afraid of doing at the top.
So for me it's like, "What if I quit plastic surgery?"
And then you have three sheets.
The first sheet you write what you fear.
"If I quit plastic surgery,
I'm afraid of A, B, C and D."
"How would I prevent these fears from happening?"
And "How would I repair these fears if they did come true?"
The next sheet was Benefits.
"What are the benefits of doing this action that you so fear?"
The third is, "The cost of inaction."
So essentially like Opportunity Cost.
"By not doing this action, what are you losing out on?"
So those are the three that he recommends.
I took it a step further and added two more sheets of my own.
One, was a Pros and Cons list.
So I had 'Plastic Surgery', 'Entrepreneurship'
and then doing both Plastic Surgery and Entrepreneurship.
And under each of these, I had two columns of 'Pros' and 'Cons'.
And I realized that by doing both Plastics and Entrepreneurship,
I was going to suck at both.
You-- I wanted to be an excellent surgeon and be an excellent entrepreneur,
but by trying to do both, I wouldn't be excellent at either.
And then the last sheet I made was notes.
Just a sheet to track all of the conversations
and various notes I've had over the weeks and months.
After spending several hours on that exercise, it became pretty clear.
I was like, "Oh, I need to quit Plastic surgery residency."
Like damn!
That is, that is extreme!
And obviously, I did not act on that.
I wanted to not rush into anything,
not do anything foolish
because once you quit, you cannot go back.
Especially with Plastic surgery residency
because again, it's one of the most competitive specialties.
It has a surgical, like culture so it just wouldn't fly.
So I sat with it and every day, every night for weeks and months,
I would have this journal, a paper journal not a phone because again,
all the optimization and having that backlight would keep me up at night,
so I had a paper journal at night
and I would have this scale,
"How much do I want to do entrepreneurship?
How much I want to do plastic surgery?
If I could only choose one."
And every single night it was Entrepreneurship.
It was never on the side of just doing Plastics.
So I also did this eulogy exercise
from Steve Covey's, 'Seven Habits of Highly Effective People'.
Now essentially, what I learned from this exercise
is that I want to make the largest positive impact that I can in the world
and I felt that entrepreneurship was the avenue
through which I was much more likely to be successful in doing that.
And with Plastic surgery, yeah, I would be helping people
it would be... I think I would be a great surgeon
and I don't mean to sound cocky when I say that.
I think that I had the skill set
that would be conducive to being a great surgeon
and I cared about my patients.
I think I had good bedside manner,
I think, like I have, I'm great with my hands.
I've been doing drawing or fine, like tiny model cars and everything
since I was a kid, so my motor skills were there.
In fact, when I did my away rotations
in Plastic surgery, at least one attending at each institution,
sometimes even the program directors or the chairs would comment
that I was operating at a skillset beyond my years,
like, "Why are you operating at a...
at a second or third year resident level when you're a fourth year med student?"
So I loved that, but that was-- my ego was getting in the way.
I was like, "Oh, I'm gonna be this great surgeon,
I'm gonna be so good with my hands",
but ultimately, I would make a bigger impact if I'm doing business
and helping the world through entrepreneurship.
So I kind of had to let the ego die a little bit when I said,
"You know what, being a surgeon and entrepreneur would be badass
but I got to choose one and I think what's best for the world
and ultimately what I think would be best for me
because of that, is entrepreneurship.
Now, a lot of you right now are probably thinking that,
"Damn, Kevin is crazy!"
And I mean what I did is not reasonable.
A lot of startups fail, a lot of like,
like the safer thing to do would have been to stick with Plastic surgery residency,
to become a plastic surgeon, help people live a great life,
like everything's taken care of.
That's the safe path, it's a good path.
But doing entrepreneurship, while it is riskier, I am betting on myself,
I believe that I have what it takes to essentially come out on top.
So I spoke with a lot of mentors before I made the decision
and a lot of those mentors were surgeons that were in Plastic or other specialties.
And I was surprised by how many of them actually supported my decision.
I was surprised by how supportive my program was.
I can't say enough kind things about my program because they were,
like my program director, the institution at large was very supportive of my decision
and overall, I was really just impressed by the grace with which they handled it.
Now okay, Next Steps, what I want to do.
So, my long term life vision, my long term,
like what I want my mark to be on the world
is essentially eliminating medical student
and resident burnout depression and suicide.
It's this huge issue that we have,
the US, like medical education training system is so broken
and then we tell the med students and the residents,
like, "You guys need to take better care of yourselves",
which is, it's this huge issue,
I want to work on it.
It's gonna take me years, if not decades
to make meaningful progress there
but that's what I want my legacy to be.
As for Med School Insiders,
I'm still gonna be producing regular videos
every week on the Med School Insiders channel.
I will also be producing videos on this Vlog channel
and I'll still be doing like 'A Day in the Life',
so I'll be making sure that they're relevant to you guys.
It's not gonna just be me
like traveling the world and things like that.
I'm still very passionate about productivity, efficiency, medicine, these things.
Anyways, that is it for the video.
Thank you guys so much for watching.
I'm sure you still probably have some questions,
so leave them down below
and I'll do my best to answer them in the coming weeks.
Thank you for watching
and I will see you guys in that next one.
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