Podcasts about so victor

Victor Barstow, downsized from a great human-resources job at a Baltimore business, is eking out a living selling shoes in a mall … wondering how he'll send his daughter to college … when he gets a long-shot chance to compete for the top job at an elite hiking-boot company up north. So Victor dives into meeting a farcical series of demands from the quirky owners of the boot company … striving against some fairly odd characters. It's kind of a hero's quest, with witty observations from our hapless hero. We ask Richard Bader, who titled his first novel Booted, what the quest is about:  “The underlying theme is that Victor is a man who is trying to do well by his kid. He's trying to restore his career, his job, in order so that he can send his daughter to college.” See omnystudio.com/listener for privacy information.

Rose and Cobalt are trying their darndest to get back to Celadon City but this darn train keeps having problems! So Victor suggests they go to the Pewter Museum to kill time and to see his Aunt Patricia. Join Jake, Josh, and Alan in this detoured episode of Pokemon World Tour United.Patreon: patreon.com/heyjakeandjoshEmail: PWTpodcast@gmail.comTwitter: @PWTpodcastShop: teepublic.com/user/heyjakeandjosh

Rose and Cobalt are trying their darndest to get back to Celadon City but this darn train keeps having problems! So Victor suggests they go to the Pewter Museum to kill time and to see his Aunt Patricia. Join Jake, Josh, and Alan in this detoured episode of Pokemon World Tour UnitedPatreon: patreon.com/heyjakeandjoshEmail: PWTpodcast@gmail.comTwitter: @PWTpodcastShop: teepublic.com/user/heyjakeandjosh

EP:22 The $45 Million Medical Debt with Victor Martinez Welcome to Debt-Proof Living with Mary Hunt. Today's episode is brought to you by Mvelopes. That's M, like Mary, v-e-l-o-p-e-s. Mvelopes uses the tried and true envelope budget system. All in one easy app. Give every dollar a purpose. Mvelopes.com.  And now, here's Mary.    Mary Hunt: [00:00:28] Hi, and welcome to another episode of Debt-Proof Living. I am so happy that you joined me again today, and guess what we're going to talk about? Debt. Yeah, that's really what we talk about a lot. How to get out of debt, how to stay out of debt and live a life where you are not bound by all of the trappings that happen so we get into debt. So, um, many of you have, have read Debt-Proof Living. You've been with me for many, many years. So I just want to do a little bit of a review talking about debt and what it does to our lives. You know, basically it takes away our options and the deeper in debt we become, the fewer options we have. That's really, really scary, but the good news is that you can get out of debt. You know, my story, you know, that I got out of an awful lot of debt. I am,  I'm just so struck by the fact that these days debt is so easy to get into, and I'm not talking about emergency kinds of debt. I'm talking about credit card debt, you know, I just don't have the money today. I'm sure I'll have it next week. So I'll just put it on a credit card. That's probably the most, most dangerous because it's so easy to get into. Society has, our culture has really put a stamp of approval on it. But then there's other kinds of debt. There's a student loans, student loan debt, which has become very, very popular. And, and then there's, you know, buying a new home and then you've got the home debt and then you've got all kinds of things. You know, I hear from people all the time who are having trouble paying their property taxes. So they put that on payment and then they put their, their, uh, federal income taxes that they owe on payments. Cause they just don't have haven't and pretty soon it just, it builds. It's crazy how debt can take over our lives. And for a lot of people, when they're in this kind of situation, there's things called medical emergencies. That's what we're going to talk about today is medical debt. How does that affect their lives? You know, statistically, I can tell you this. If you look it up, if you Google it, you're going to find out that medical debt is the leading cause of bankruptcy in our country. Well, you can kind of figure that out because if people are already in debt, boy, getting hit with a big 30, $40,000 medical debt, and really be the straw that tips over and puts you into that horrible, horrible situation of, of bankruptcy having to make those kinds of choices. Um, one estimate is that more than one in four Americans have trouble paying a recent medical bill. I can understand that. Um, And, and sometimes those medical bills get pushed because not paying them is not going to give you a consequence as great is not paying your rent or not paying your car payment. And some research says 32% of American workers have medical debt. And over half have defaulted on it. That's not good for a medical industry in this country to having people default and having to go through all of that kind of thing. So the last stats statistic I'm going to tell you is that among Americans with medical debt, 15% owed $10,000 or more. That is a huge heavy, heavy burden. I've got the most exciting news to tell you about a great, great story. I read about this in the paper. I did, and it hit the news big time and the headline was a church, a church paid off medical debt of many of their parishoners. It hit, it hit every news station and it was just fantastic. I read about it and I was so,  I was so excited because I wanted to know more, you know, all the questions. How did the church choose who got to have their paid off? How did that happen? I mean, did you have a lot of new members all of a sudden? So here's the exciting part. I don't have to wonder. And you don't either, because today my very special guest, from Cincinnati, Ohio is Victor Martinez. He is on staff and the Community Development Director for Crossroads Church in Cincinnati, Ohio. And I have a feeling you're just going to love hearing from him. Welcome, welcome Victor! So glad to have you today on my podcast.    Victor Martinez: [00:04:55] Thank you. Very excited to be here with you today.    Mary Hunt: [00:04:58] Um, I just want to set this up and then you're going to tell us all about it, but I've got a million questions. I'll, I'll try to control myself, Crossroads received some BIG media coverage in February. I just told you about that. I loved it. Crossroads Church was able to work in their community to get more than $45 million of medical debt forgiven in their area. I want you to tell me all about it. Can you just set this up for us a little bit? How this came to be, how you got involved, how you happen to be on staff there and all of that. We want to know all of it, Victor.    Victor Martinez: [00:05:40] Yeah, absolutely. Um, well, I'll, I'll start with a little bit of the background of, um, how did I come about to be in this team? So, um, I'm not a pastor, I'm not a social worker by trade. I went to school for engineering. So I graduated with a mechanical engineering degree and I worked several years in the corporate worldand as an engineer, making diapers and making also cleaning products like, like Swiffer, um, and that kind of stuff for a company called Proctor&Gamble. And about a year and a half ago, I moved to actually work on staff full time at Crossroads Church. And at that point, then my job became  looking for opportunities in which we can be part of helping our city with different things. And medical debt is something that is not only affecting our city. Like you share some of these statistics. It's actually affecting our entire nation. And it's unfortunate, because for most of the debt, and I'll say maybe all of the medical debt. We don't choose to get sick, it's just happens to us. So it's just very difficult situation. And, um, we heard of a church in Indiana. Actually, we saw it on the news. that they wiped out $4 million of medical debt. And we actually thought, well, how much debt does the people in Cincinnati do people in Cincinnati, half. And we found out that actually $65 million of medical debt and just the city of Cincinnati alone. And we felt we needed to do something about it. So we talked with our senior leaders, our Senior Pastor Brian Tome. He was super excited. He wanted to make this happen very quickly. So we got to work on it.  Alright, this    Mary Hunt: [00:07:19] brings me to a big question here. The church helped to pay off medical debt to the tune of $45 million. Does that mean that Crossroads Church has a bank account with that much extra money in it. And you just wrote out checks to all these people's debtors.    Victor Martinez: [00:07:38] Yeah, absolutely not. No. Like most churches our pockets are not super deep. There's a few things that happened here. So one is, uh, we partnered with an organization called RIP Medical Debt and they have been working with a lot of organizations on paying off medical debt for individuals that, um, many of them are not able to pay it off. And they are able to purchase , and so acquire debt for a ratio about one for every hundred dollars of debt, they, they're able to purchase it for $1. So 1:100 is, is the ratio. So that's one aspect. That we don't have to invest $46 million to get rid of $46 million of medical debt. And then the other, the other aspect is that really, um, we didn't usethe budget of the church for doing this. This was really the people in our community that stepped up to give of their money, to come alongside  folks that are, we're not able to pay their debt, to pay it off. And I think that's really the, the thing to highlight in the story is the generosity of, of people. Um, when, when we know that there are people that need help, that are hurting our community really just, just rallied around them. So it was very beautiful to see that.    Mary Hunt: [00:08:56] That's amazing. So you were able to, in essence, I suppose, just putting it simply to negotiate the debt for these people. So if they owed a thousand dollars, the hospital or the doctors were willing to accept $100 to pay that off, is that, is that what you're saying?   Victor Martinez: [00:09:19] Yeah. And that's typically how there's this industry works in terms of, um, when hospitals or places find out that people are not able to pay the debt. They will go and sell this to a collections agency. Um, so if we're in debt, we probably have seen a letter in our mail or two that say, Hey, you owe this debt. This is how much you have to pay. It affects your credit and all that kind of stuff that, you know, I'm pretty sure that, you know, a lot about. So in a similar way, this organization, RIP is able to purchase this debt, but instead of going after people to ask them to pay for it, they go after people that actually can pay it for other people. And that's what we did.  Mary Hunt: [00:10:00] I imagine it was Christians helping to with the Bible tells us where to bear one burdens. So that is a beautiful thing. Can you imagine if our whole health system was based on that, that those who are healthy, I guess technically that's how insurance works, the healthy, uh, cover the costs of those who are sick. But that's truly amazing.   Julie Emerson: [00:10:26] Let's take a quick break for just a minute. Hi, I'm Julie producer of Debt-Proof Living with Mary Hunt. You know, many of us have the experience in our lives of living paycheck to paycheck and many people. I know it well, have a difficult time following a budget. But not managing our money as a leading cause of stress in our lives.That's why Mvelopes created a simple, affordable envelope budgeting program that just works. Mvelopes helps you take control of your future by giving every dollar a purpose, every dollar, a purpose, people who use Mvelopes see monthly savings of 10% of their spending within six weeks of getting started and they report less anxiety. Now, currently Mvelopes is extending their free trial to 60 days for all of their subscriptions. So there's never been a better time to start on a new path. Just click the link in the show notes and sign up today. Risk-free .Okay. Now let's get back to our conversation.    Mary Hunt: [00:11:32] Now I've got some other questions for you. Alright. I'm sitting in a service and I know that Crossroads Church is huge. You have multiple campuses and a big organization. So here I'm just picturing myself sitting in this beautiful big auditorium. Personally way down by my debt situation. And I read in the, in the bulletin or in the program, or I hear someone from the platform say that we're going into this campaign or this event where others are, we're going to reach out and we're going to bear one another's burdens and we're going to help pay off medical debt. My ears would perk up and Whoa, that would be so amazing. So how did you decide who would be qualified or who would be eligible for this program or was it open ended and anyone who had debt? It would be paid off. I don't quite understand that part.   Victor Martinez: [00:12:40] Yeah, absolutely multiple things here. One, uh, I think to answer the bulk of the question, which is how to, how do we know who we're going to bless? Um, we, we didn't know who, who was going to receive a blessing. So this information is confidential and we didn't have access to it. We just knew that there was an amount of money that was outstanding in debt out there. This is where our partner RIP Medical Debt comes in and they handle all that portion. And. So we, we, we determine, Hey, we have different campuses in different location. We want to see what's in debt around these locations. And we're just going to see how much we fundraise and how much they were able to pay off. And that's how it was. So, um, In the case of that, there were somebody who had medical debt, for example, in our community, that said, Hey, can I, can I be a part of this? Which had happened. Which it happened. Um, We were not in a position to necessarily, like, purchase their debt just the way this program works. So what we did is we many years ago, Uh, we started a, um, place in Cincinnati called the City Link Center and it was with the intent of helping people get out of poverty, specifically, uh, fight generational poverty. Uh, so we have a lot of resources for folks that are going through different hardships to, to get some access to tools and help. So for those folks that were not able to be blessed through, through that program. We had an opportunity for, to come alongside them. And I think many times some of this debt leads to other challenges. So really the purpose of City Link there was to just partner with them, be there with them, for them to meet, uh, to help them with their needs.   Mary Hunt: [00:14:27] That is just wonderful. Part of my Debt-Proof Living program and what I've taught people and have led people out of debt. The absolute essence are these five elements of Debt-Proof Living and one of them is giving., How important it is that we all learn to give because that's what kills greed in our lives. And previous podcasts, my listeners know, if you've listened to The Seven Money Rules Series, part of everything you bring into your life, everything is handed to you. All of your income. Part of it needs to be given away. And that, that is amazing to me. That's the way one of the ways to stay out of debt is also in a way to get out of debt. And so, um, when I think of Crossroads Church teaching stewardship, that we should be givers. How important is that to your whole program at the church?    Victor Martinez: [00:15:24] Yeah, I, it's very important. Um, it's a big biblical principle. Uh, you know, the, the Bible is full of wisdom. There's just a lot of different topics that you could pick and you can, you can just get some good insights into, and for those of us that are believers, these, these wisdoms become principles of life and how we want to live. So one of them is. giving, to your point. Um, and we talk a lot about the principle of tithing, which builds discipline. You know, it's not just a faith thing, it's also a math thing. You know, it builds discipline in terms of how can, can we do this? Um, what also is you alluded to this it's this concept of us giving away the things that we have because ultimately eventually actually either we will give them more or when we kick the bucket, you know, they, they go away, you know, they go out to somebody else. So we, I say this is something that is true for. I will say that from my understanding of the Christian world. But even I see this in other faith expressions, how the importance of, of giving money out to other people and not even knowing what happens. And that was actually the context of this initiative. We were, we were talking about money. We spent six weeks talking about money in a church, which is it. We don't do often, as you can imagine, is a. It's a very interesting topic to have in the church setting. In that weekend in particular, where we announced that we were going to, to try to see how much money we could come up with. We were talking about the power of multiplication and how, when we give the blessings that we receive, when God, um, uh, from, from God specifically, When we give away, we have no expectation on what's coming back. When we do it for the, from the depths of our heart. And not because we think we're going to receive something, but just because, um, that's what we're called to do. We're called to serve the least of these. And, and I, and I think that's probably one of the things I've made this so impactful is that our folks really genuinely, from the core of their heart, they had a desire to bless other people because they know that they are blessed.    Mary Hunt: [00:17:38] My producer and I were talking before we started the show. And she told me that, um, well, first of all, I absolutely believe that it's impossible to out-give God. Giving is, is one of those things in our lives that we can't really explain how in giving we receive. But I know that proven it over and over and over again.  But she mentioned that that your pastor and the pastoral staff kind of put out there a very unusual money back guarantee.   Victor Martinez: [00:18:07] Yeah.    Mary Hunt: [00:18:07] Can you tell us about that?   Victor Martinez: [00:18:11] Yeah, absolutely. It is. Um, it is an interesting and different concept for sure. But, um, yes, we did that also within the context of that series that we were talking, actually, it was inspired from a, from a book called The Blessed Life. And, um, we were inviting people to really explore the concept of tithing. Tithing is counter-cultural and the concept of giving, giving money. And we are going to receive more blessings sounds, counter intuitive. Like we are told in our, in our American culture that we just need to accumulate money. That's, you know, that's what it's designed for. So we just put it out there for folks to say, Hey, if, if really you're afraid that, um, this is not gonna work out. Then we want to make sure that you get to experience it first hand. So what we said is that if you want to explore tithing for three months, and at the end of three months, you see that there are no changes to your life. Some of them could be financial, but others things that are a little bit harder to measure, like maybe relationships improve, or maybe other things. If you don't see any of that, there's no need for, for us keeping your money. We will return it. And I will say that I am not maybe we, we returned money to one person out of the hundreds of people that tried it. Because people were experiencing life transformation when they step into that space   Mary Hunt: [00:19:33] God keeps His promises. He says I will bless you,    Victor Martinez: [00:19:37] Absolutely!   Mary Hunt: [00:19:38] So anyway, I want to stand up and share, this is the best story ever. I just absolutely love that. So Victor, tell me, um, did you and your team at Crossroads, uh, the size of your church alone tells me that you are very influential in that city.  And how, how does Crossroads reach beyond their campus to affect, to bless the community?    Victor Martinez: [00:20:03] Yeah, absolutely. Well, this COVID situation has been really interesting in the fact that we have been blessed in being able to share our what we know of, of the, you know, of our faith through mediums like social media or TV. So, um, we almost, we might today, who knows, be at over 500,000 followers on Facebook, for example.  When this all started we're maybe at 30,000., Which is, that it's, that in itself is just crazy. And a lot of those folks are people from all over the nation. In fact, that is a lot of people, the world that are just being able to, to see that. So, um, W we, we think we are, you know, we are giving the opportunity to really, um, bring good news and really share with, um, what does really following Jesus looks like, because with the same token, there, there are other things out there that are, unfortunately, not, that are positive that are, that are going on.  But that is let us one thing that it's one way that we're communicating across multiple people. But also since very early in our, in the foundation of the Crossroads, our Crossroads Church, we have always been looking at how can we bless people in other places. So we, we started a hospice in South Africa. It was the biggest at the time, for example, many years ago. And we, you know, our community put in a lot of money to make that happen. We still today, we invest hundreds of thousands of dollars in helping fight sex trafficking in India. And we have efforts in other countries,  Nicaragua, Bolivia. Uh, and I'm pretty sure I'm missing others. Puerto Rico. Where we're, we're really trying to make our resources available for, for those people to be able to, um, solve other basic needs, but also get to hear the good news. So. Yeah, that that's something that we're, we try very intentional beyond the, the United States, but also within the city, we have this example of medical debt. During COVID. Our community again contributed over $230,000 that were used for supporting medical professionals in our city so they have access to childcare, uh, at the beginning of this pandemic, when everything was being closed. Food for people that needed that. And I could go on and on. There's different examples. And every single time it has been our people saying yes to giving for the benefit of other people that they might not even know.    Mary Hunt: [00:22:35] Wonderful. It's just fabulous. And I think that that is carrying out what Jesus told us to do. Care for each other. Share the gospel. To care for those in poverty. The  widows, especially.  I'm thinking about he people who were so blessed having this amount just removed from the shoulders. Does, does Crossroads then have a program, a plan? I suppose many, many churches do have. um, where you're helping people learn to get out of debt and to stay out. Because debt is a horrible thief. You know the Bible says that the lender becomes the master of the borrower. That's a horrible position to be in. So can you tell us, I mean, you just didn't. I hope he just didn't leave the people here. They probably still come to your church and it wasn't a wonderful opportunity. It must be to help them then learn to manage money.   Victor Martinez: [00:23:34] Yeah, we have definitely programs to talk about finances and how to help people with their finances. Um, we're also, um, talk about it through the lens of, um, our faith. Also, we, we, we bring that to that conversation, like you said, you know, um, That is, it's a form of bondage. And in fact, one of the reasons why we're so attracted to doing this is because when we gave out the money, we didn't know who this was going to, the person that received the letter in the mail, um, they didn't know who paid this debt. And in a way we feel this is exact same thing that Jesus,did for us, even before we knew who he was, he paid our debt. And so we thought what a great opportunity to have really. Share what that, what that looks like in a physical, tangible way today. And that's what we tried doing. So, yeah.    Mary Hunt: [00:24:27] Fantastic. You know, I've, I've, um, been to Cincinnati a couple of times, myself. Usually it was a speaking tour too, or something like that. I don't really know anybody who lives here,    Victor Martinez: [00:24:38] well, I was goining to say... now you know me. So when you're around, uh, now you can claim that, you know, somebody,    Mary Hunt: [00:24:44] But, I'll tell you something. I know something very, very special about  your city...chili!   Victor Martinez: [00:24:50] Well, you put me in a tough spot in terms of that chili. This is a controversial topic. Um, yes, Chili is an important part of our city. I wouldn't say it's the highlight, but again, I was born and raised in Puerto Rico. Um, my concept of chili was different. so, you know, some people love it and some people don't, um, I've got, I've grown to like it at this point. So.   Mary Hunt: [00:25:13] That's good, that's good. Well, when I was there, that the host of the in fact I spoke at a, another church. It wasn't Crossroads, but Vineyard Church. And they took me out for, for a meal after the service. And they wanted me, to show, to show me, Cincinnati's s best. And so they, they preface this by, we're going to take you someplace and we want you to try something. You may not like it. That's okay if you don't like it. We just want you to know that we're really crazy about what they call Cincinnati chili, or I guess it's really Skyline Chili, which has become known as Cincinnati chili. I, I sat there and I, it looked fabulous. You know how it, how they serve at Victor. It's just, it's amazing. And my listeners, just  Google, Cincinnati chili. You'll know what I'm talking about. So I take a bite, because it looks all the world like spaghetti with meat sauce. It's served over noodles. And so I take a bite, you know, you want to be kind with your host and all.I'm in a public place. You take a bite at this, and it was such a shock because it was nothing what I expected, ever. I thought how can I get out of it? How could I not swallow? And how can I get out of this place fast? But the most remarkable thing happened. I took a second bite. I needed a second bite and I mean, by the third or fourth bite, well, you've got, gotta try Cincinnati chili. It's just absolutely amazing. I could not finish what was for the lunch. So I actually took it in a  to-go container and took it back to my hotel room, which was kind of silly because I don't believe I've ever eaten anything  I had left over in a hotel room. I mean, just honestly, the middle of the night I woke up and my salivary glands were going crazy and I got up and I reheated that in the microwave. And to this day, I tell you what. I love that stuff and I've learned. I ended out in the way I live in Colorado. We don't have skyline chili here, but I've learned how to make it myself...yes, because people, can we come over and ask, can we come over and have Cincinnati chili?  I don't give my secrets that I buy the spice packet online. So yes. Wonderful church. Well, at least two that I know of now many.   Victor Martinez: [00:27:35] Yeah. Many wonderful people. I think more importantly. And yes, a good chili. So we'll, I'll give you that.    Mary Hunt: [00:27:42] Next time I'm there, we're going out for chili.  Okay, Victor?    Victor Martinez: [00:27:45] Yes, we are.   Mary Hunt: [00:27:46] One last question for all of us. Where does, where does Crossroads go from here? What is on your radar? Where, where are you and where are you headed?    Victor Martinez: [00:27:56] Yeah. Yeah, that, that's a great, that's a great question. You know, our, our mission is a connecting seekers to a community of Christ followers that are changing the world. And, um, and that's what we want to do. We really want to change the world and, um, There are certain areas that we know we're called to right now. But we also, there's a bunch that will be going into, that we have no idea today. Um, we are, one of the things that I, I think, uh, you know, we will see soon is we're very committed to racial reconciliation. That's, um, that's an important topic, uh, today in our country and we are. We're increasing our investment in that area of bringing more people together to have a conversation, um, that hopefully leads to some healing.So that's one area for sure that we see. I don't think we're done with medical debt. So stay tuned for that. Uh, maybe you'll come back and talk again about what part two will look like. I don't know. I can't make a commitment on behalf of Crossroads at this point, but I see that. And I say, we, we will continue to invest in some of these places that I share abroad, fighting sex trafficking in India and locally, um, and other things. So, uh, we'll see what, what we'll bring. But one thing is for sure is that we will continue going. We will continue being the church, um, and we won't stop until we're done.    Mary Hunt: [00:29:23] I just thank you so much for being with me today. This has been wonderful. And I would just like to close with this . God's word tells us, tells us, if you will just trust me and that's the problem. I think that's why we're so hesitant to give. God says, trust me. Trust me and see if I will not open up the windows of heaven. He'll pour a blessing on you is that you cannot even handle. It will be so great. I think that, that you, Victor, your team and all the people, that church, that amazing church in Cincinnati, Crossroads Community Church, I think that you are testimony to God keeping his promise. It looks like a blessing has been poured out on you. And with that blessing comes responsibility and we just can't wait to see what comes out of this. Thank you so much for being here. Thank you for following the Lord and for being such a wonderful instrument of his grace and mercy. Thank you, Victor.    Victor Martinez: [00:30:26] Thank you,  Mary.  Julie Emerson: [00:30:30] Debt-Proof Living with Mary Hunt was created and hosted by, Mary Hunt. Produced by Julie Emerson, with Harold Hunt, Executive Producer. Save time. Save money. Every Day.  Make it easy on yourself! Become part of the community and subscribe for free at www.everydaycheapskate.com. That's where you will find all the ways you can follow Mary, Everyday Cheapskate, and Debt-Proof Living. Thanks for listening! 

Session 12 Dr. Chung is a solo private practice Facial Plastic Surgeon. He discusses his path through ENT residency and what he likes and dislikes about his job. Today's guest on Specialty Stories is a solo private practice facial plastic surgeon. It's a great specialty, super sub-specialized specialty of ear, nose, and throat surgeons, or otolaryngology. And Victor, or Dr. Chung, is going to join us and tell us all about it. [02:15] A Personal Choice to Be in Private Practice Dr. Chung practices facial plastics and reconstructive surgery as a subspecialty of otolaryngology; ear, nose and throat surgery. He considers himself as one of the rare breed of private practice, truly private practice solo by himself, the only physician in the office which is an interesting kind of hybrid situation. As a specialist, he is affiliated with a number of the hospitals in the San Diego area, however, he’s not officially on staff who who has to be in the hospital all the time. Nevertheless, he does consultation and coverage for call and operate at those sites. Out of all the fellows who graduated in his year, only two of them went into true private practice and are opening practices. The majority are either joining multi-specialty practice groups. He thinks even looking for academic jobs was a tradition that's fallen by the wayside. As to why he chose private practice, Dr. Chung had his personal reasons. He had phenomenal training and wanted to practice medicine the way he was trained to do. “When you become part of a bigger group or even as small as a partnership,  there's a level of compromise. Otherwise, there's no way for you to be successful.” He further explains that what he likes in private practice is having that freedom to practice without restriction in the sense of delivering care to the best of his ability that gets to order the more expensive supplies and equipment or employ a technique he knows well. So his choice was natural for him and he sees being in a personal situation that he could do it is a luxury. Although joining a bigger group or academics is not a complete compromise, Dr. Chung says that oftentimes, you find that your patient population or the group you're in will dictate your niche and your future. Then you may start doing things that don't make you necessarily happy anymore in medicine. You start doing fewer of the cases that you like to do or take care of the patients that you like. You can find that ideal situation in academics in larger groups, but it's just more challenging. Victor has been out in his own practice just over twelve months. It actually took him a number of months just to get his place set up which involved a lot of logistics as well as a lot of things they don't teach you in medical school, or residency, or fellowship about applying for business licenses, insurance, and all the other type of regulations that are necessary to own and run a successful and safe business. [05:36] His Interest in Facial Plastic Surgery Victor always knew he was going to do surgery when he was in medical school. He enjoyed the aspect of thinking, being hands-on, its culture, and the lifestyle. But honing into a particular specialty was tough. He was looking at a number of sub-specialties that operate in the areas of ophthalmology, neurosurgery, plastic surgery craniomaxillofacial, and the ENT subspecialty, which he found very appealing. “Even within a single focus of the human body, it was challenging. And although facial plastics is a sub-sub-specialty within it, it's still an integrated part.” You will go out in the community and meet physicians who are ENT-trained, but not fellowship-trained, but they are still practicing as facial plastic surgeons. This is actually encouraged by the overall academy. The types of procedures can be reconstructing cancer that may have been excised on just the skin level, but others are doing larger reconstructions or rhinoplasty and face lift based on their skillset and their comfort level. Victor adds that the specialty overall gives you all the skillsets you need, As an individual, you get to pick the things that you are comfortable with  or you really enjoy doing and focus on those. Additionally, you'll meet other physicians in your community who like doing the other procedures that you may feel less comfortable with or ones you don't like as much. Victor points out the good camaraderie that goes on there and you're a lot happier treating the disease states and doing the surgeries that you like to do. [07:50] Traits of a Good Facial Plastic Surgeon Victor explains that you need to be both left brain and right brain. On one hand, you need to be analytical, be very objective, and be able to understand proportions and direct measures and changes. On the other hand, you have to be someone who has an artistic component in how you think about things and how you view them. When Victor performs a rhinoplasty surgery, he is not only looking at this overall picture. So it's just not just a nose and a good-shaped nose, but he has the entire face prepped in the field exposed. He looks at the relationship of the nose to the chin, the forehead, proportions to how wide the eyes are, and that overall aesthetic. Moreover, as a confirmatory measure, he does all these different measurements as to how far the nose projects out, the angles, and those that are within accepted values. So you need to be able to mind both sides and not be locked into either one. It's right in the middle of your face, it's very obvious, so the stakes are a little bit higher. [09:28] Other Specialties in Mind Victor had not picked his residency specialty until very late in the process. He had gone through most of the clinical clerkships of my third year thinking that he was leaning toward orthopedic surgery as just a specialty within surgery. He didn't think he was going to do general surgery, but he knew it was some sort of surgical hands-on one. At that time too, interventional procedures were getting big. Interventional radiologists and cardiologists have very hands-on and very three-dimensional stereotactic type specialties as well. But thinking about which one to hone in on, Victor wasn’t exposed to it until the last quarter of the third year clinical clerkships. And it did turn around having interacted with some very stimulating cases as well as with nice residents and attending physicians who were open to sharing what they were doing and allowing him to participate. If you’re considering ENT, Victor recommends that you see if you're okay with boogers and earwax and all those bodily fluids. If you have no problem with them then you'll be okay. He explains how people have aversions to different things. So you have to pick what you’re comfortable with seeing everyday. You can't just base that purely on a good experience. You need to figure out what is the day-to-day kind of drudgery. “Pick what you are comfortable with seeing day to day, because if you don't like your day to day, you're not going to enjoy the highlights any more.” Victor tells students all the time check out the really dizzy patient that is struggling and you can't get a good exam on, but you still try to figure out how to treat them. It’s really, really tough sometimes to figure out if they're surgical or non-surgical, and yet they can take up more than a full appointment visit. So regardless of your specialty, be sure to examine, find those highlights, but also find what are the low points and if you're okay with those. [12:20] Patient Types and Typical Day in the Life of a Facial Plastic Surgeon Victor sees all kinds of patients, which is something that keeps him captivated and stimulated in his specialty. His patients range from very minor, very cosmetic to no medical emergency about it whatsoever, there's no urgency, it's purely elective, the changes are super subtle, super small, there's no life threatening thing that you're changing. Nevertheless, people gain quite a bit of benefit from them. Their attitudes change and their self-esteems improve with the subtle thing that bothered them that maybe no one else noticed. Moreover, Victor still participates in general ENT call. He does tracheostomies for people who have lost their airway or reconstructions for people who have lost major tissue from skin cancers or other disease or trauma. These are very drastic changes to improve someone's function and there's very little cosmetic aspect of that. So Victor likes that spectrum and he doesn’t see himself giving up on doing all those things. Overall, he likes the full gamut of complexity and simplicity because you can gain benefit for your patient on both ends. Being new in his practice, every day for him is pretty variable at this point in time. The idea is a clinic, a private-based practice, and so the majority of his patients would be seen in the office setting in a combination of consultations, follow-up visits, minor procedures, injections- injectables. Those types of visits are all in the office. “As the trends go, more and more surgeons are doing things in the office.“ Typically, a surgeon in his specialty will have block time or days set aside where they would be operating, maybe two days a week being in the operating room doing a number of cases. But the majority of them would be on the outpatient setting so most of those patients are going home. A select amount would be seen in the hospital as an inpatient and seen on multiple visits in the hospital before they're released. Moreover, Victor stresses how a lot of students and doctors don’t realize the business side of it. You can fill an entire day with administrative tasks, but it is about prioritizing and compartmentalizing. In his case, he picks one night a week where he does it until late of night and he doesn’t go home until everything on the administrative side is done then for the rest of the week, he sets up tasks and completes as many as he can. But when those tasks pile up, they will get all done on that one day. Otherwise, you can get pretty overwhelmed going from task to task to task so it's nice to have some structure in your day. [15:35] Taking Calls As a plastic surgeon, you don't have to take a lot of calls. It actually depends on where you are geographically located. Some hospitals require you to take a certain amount of call depending on the size of the call pool and how busy the hospitals are. But Victor is not required to take any call whatsoever, but it also depends. He explains that there are some financial compensation at some sites while others don’t so it's just part of requirement-maintaining privileges. Although there is no requirement in the San Diego area where he is practicing, Victor is participating. In terms of the percentage of patients he sees ending up in the operating room, his goal is close to 100%. He has seen surgeons who are well-established and basically they are turning patients away. “You want to get to that point in your career where you are selecting patients who they're the most appropriate, that you can exercise and perform the best surgeries for the best results.” Victor has patients who are not good candidates and he tells them that they are not appropriately going to be surgical patients. But he enjoys the fact that he gets to educate a lot of the patients coming in. He spends over an hour in his consultations with patients giving them all the facts including the raw details and the scary things that can happen in surgery in order for them to make an informed decision. At this point, he doesn’t feel that half of them are going to the operating room because they're just still in that information gathering stage. But as careers progress and you become very well known for particular surgeries or techniques, a lot of patients coming in have already done their homework and research. Especially with the availability of resources on the Internet, they've done their background on you. They know where you trained, they know what technique you do, and they've come specifically for that technique or procedure, and that ratio of conversion is much higher. [18:10] Work-Life Balance Victor describes having a good work-life balance whenever he chooses to have a good work- life balance. And that is very different from a lot of other physicians who are at the beck and call of their pager or their schedule, and therefore they don't have the same freedoms as he does. He can choose to work incredibly long hours or he can also choose not to be working those hours based on his specialty. There are still emergencies and so he won't operate for weeks before he goes out of town and out of the country on vacation, but that's the only limitation. Nevertheless, he can choose within his personal setting to take time off to tend to himself and his health. However, he is also participating in community volunteering and spends time with his wife which he thinks are two very important things. “When you start sacrificing your own personal health, your interpersonal relationships, then you're not going to be as healthy of an individual and therefore not a good doctor over the long run.” You're just going to get burned out, and that's an increasingly common phenomenon. Victor adds that good diet, nutrition, exercise, health maintenance, time with family, downtime are all things that should be scheduled and be consciously part of your day-to-day instead of things that are added on if you have time. [20:35] Residency and Fellowship Before you graduate to an otolaryngology head and neck surgery residency, it used to be an early match, and for many years now it's on time with everyone else's. It’s basically a five-year program which has an intern year but it's considered an integrated intern year. Typically at the same institution that you're doing residency, it does have general surgery components and rotations, however, increasingly more focused toward an ENT residency. The elective months would be Anesthesiology. You'll be in the ER and you'll be doing surgical ICU, all geared toward skillsets that will be beneficial for your residency versus a standalone general surgery or where you are on rotations that are purely dictated by the general surgery department. This is commonly seen in orthopedics and other surgical subspecialties. After which, there will be four years of ENT training. This may involve time at a children's hospital, at a VA institution, maybe a research block, but you'll be rotating through different sites and every year you're increasing your skillset. You're learning about all the systems, the ear, the nose, the throat, the different types of surgeries, seeing patients in clinic, and operating as well. But as you go through each year, your level of responsibility, and then as a Chief, you'll be running the service teaching and mentoring junior residents, and before you graduate you'll apply to a fellowship. This is typically within your fourth year. There are a number of fellowships you can pursue such as pediatrics, neuroethology, head and neck cancer, microvascular reconstruction, facial plastic reconstruction, and sleep medicine even. So the fourth year is an application that goes in around January through March and you interview between March and end of May, and then you'll match to a one-year fellowship program that would go after your graduation from your ENT residency. [23:37] An Alternative Route to Facial Plastic Surgery Outside of ENT Victor explains that if you wanted to just do plastics in the face area, you could definitely reach that goal through an alternative route, which is through plastic surgery. There are two pathways through plastic surgery. The first one is to complete general surgery and then apply to a plastic surgery program. The second one is an integrated plastic surgery program that you match right out of medical school knowing you're doing plastic surgery and that has a general surgery component to it. These programs are typically longer with research years as well. Victor believes it can last as long as seven years to finish those residencies. And then most individuals who want to operate in the face area will go ahead and do an additional fellowship on top of that. “You can reach the same goal in a sense, the same practicing setting, but you'll just have other skillsets bringing to that job as well.” [25:00] Competitiveness in Matching Victor describes matching in ENT has gotten to be one of the more competitive subspecialties to match. “I think all of the surgical sub-specialties have gotten difficult because it's just a pure numbers game, just from any type of academic application.” Kids are applying to more colleges. College students are applying to more medical schools. Medical students are applying to more residencies. Even when he was applying, he met people who applied to every single ENT residency in the country just to play the numbers. And so it's more applications on the Residency Director's table to leaf through and make a selection. In Victor’s case, they had a pretty small program. Only two residents are accepted per year, and maybe thirty people were applying per spot. Some programs only have one resident while big programs have four to five residents. And although some may say thirty people may not be a lot, but each one of those individuals have published research, phenomenal USMLE Step 1 score, letters of recommendation from the Chairman, have done research rotations, have really stacked their binder full of accolades. There’s now an ENT student interest group that starts guiding students from the first day they get to medical school. And so it has gotten increasingly competitive to apply to any of these residencies. Victor feels ENT has a popular swing recently. It had a big swing before he applied, but it's always been up there along with the other types of subspecialties that are maybe competitive to get into. [27:32] How to Be a Competitive Applicant Victor outlines that in order to be competitive goes down to all the basic things that everyone is always striving for. This means maintaining good grades regardless if you're a pass or fail system. Getting into AOA as another marker on your application showing that you stand higher in your class than other students. Then the USMLE Step 1 score. Before it was just about generally trying to get in some research but if you can get on a research project that is related to the residency that you want to apply to, that can only help more. Publications, participation, posters, presentations, attending meetings, getting involved in the department, attending conferences because there's always academic conferences every week within that department. Just make a personal connection with the attendings in that department. All of those things can make you more visible and create a level of investment, not necessarily to get you accepted into your home school's department, but also, they may be invested in getting you into their alma mater, or another program that they're aware of that would be a good match for you, or a geography that you're interested in. “It is a time investment because you're spending so much time already studying and trying to do all those basic things. But by investing yourself personally, that will give you an additional edge.” But there's also a gamble. Victors knows of people who've done that and then decided they wanted to actually do a different specialty too so you're not locked into it. But if you know early on, that will behoove you to create those. Create that rapport, create that link to those individuals early so they can really get to know your medical school career. [30:12] Osteopaths and Subspecialty Opportunities Victor says there are only very few osteopathic ENT physicians out there. He has interacted with some and they're all great, but within the world of facial plastic surgery, it is still a very small community. He thinks the majority are going down the MD path. However, the individuals operating in the head and neck facial area is growing. There are oral surgeons who perform cosmetic facial plastic procedures. There are general plastic surgeons who do those and there are those in the field of oculoplastic surgery who want to do face lifts and rhinoplasty. There are dermatologists who want to do more surgical procedures in the face. Then there are general surgeons, other surgeons who take cosmetic courses and get boarded under the Board of Cosmetic Surgery and perform those. “There is an increasing number of individuals out there who have not gone down a traditional path of training and are performing those procedures.” In terms of subspecialties available after ENT, there is a phenomenal opportunity to sub-specialize, not only by pursuing a fellowship but also many departments are strong in all fields within otolaryngology. It's not a necessity to have a fellowship training because it's not as formal. There isn't a required board certification for all the subspecialties, not all of them are ACGME certified either. You can pursue a fellowship in facial plastic and reconstructive surgery, head and neck cancer with or without microvascular reconstruction, pediatric otolaryngology, otology or neuroethology that involves an ear surgery, sinus rhinology, laryngology professional voice. If an individual has graduated and they've had strong training, they can go out and they can become a sub-specialist. They can focus their practice doing laryngology professional voice in an area that needs it and provide that care at that subspecialty level without fellowship as long as they're adequately trained and have a desire to pursue those patients. But Victor says this is rare. Most times, even those who are really focused, even nationally known for a particular field, those guys are always interested in doing other aspects of ENT as well. Some are doing more trauma, some may be doing head and neck cancer or they may be doing endocrine surgery but they're known for voice. They may be filling other roles within their group practice. Most of the otolaryngologists that Victor has met often miss doing other aspects, but find that, there’s no one else who's stronger in ear surgery so a lot of the ear cases go to that surgeon within the practice. Or someone else really enjoys sinus surgery, is savvy with it, is up with the latest techniques, and so that practitioner in that group will see more of those patients. But each and every one of the ENT doctors in that group is less likely to solely focus on a subspecialty and only, only do that. Most of the times it will be a little bit more well-rounded and be doing multiple aspects of ENT, but not necessarily all of them. Victor concludes it's getting tougher and tougher to be in overall general unless you're in a more remote area where there's fewer practitioners around. [35:06] Board Exams, Certifications, and Pass Rates Victor illustrates the board exam as consisting of a written and an oral exam component. The current format are separate examinations. At one point in time, they were done on the same setting, but currently you will take the written exam. I, it is a computer-based test that is administered in September following your June/July graduation from residency, and that is a multiple choice format test that tests all the aspects of ENT medicine and surgery. There is a pass/fail threshold for that test, and those who pass may go on to the April exam which is currently administered in Chicago. There are five rooms with a number of three or four modules in each one, and it's basically a mock simulation clinical case. They're integrating some technology CT scans. They used to give you photographs but now you can get a computer screen and you can flip through a couple slides of a CT scan, or lab tests, or histopathology, and you went through a case from, say, the patient presents as a child or an adult who had a car accident, or someone who's lost their voice, and then you ask questions, you proceed through the case, and you gain points based on your questions and responses. Then hey tally those up and then once you've passed both of those components then you're board certified for ten years. Through that ten years, you're doing maintenance certification through online modules every year, and then at the tenth year, you're re-certified again. So that is the board certification process for otolaryngology. You can also get board certified in neuroethology sleep and facial plastic surgery, and those consist of both of a written exam, an oral exam, and in some cases collecting case reports of patients that you've operated on in the first couple years of practice. The pass rates are pretty high for both exams. Although Victor doesn’t know the exact number, he thinks it’s less than 10% fail because there's quite a bit of preparation for these exams. [38:10] Working with Primary Care and Other Physicians Victor still gets to work with primary care physicians whenever he sees more of the general ENT type patients. He used to give a lecture to family medicine residents about HIV manifestations in the head and neck, and it's shockingly common, and this is from sores on the lip, to frequent sinus infections, to ear infections, skin lesions, lots of different changes in the head and neck area, and a primary care can pick them up if they're looking for them, and make the appropriate referral for both HIV specialists, infectious disease specialists, as well as an ENT doctor to get involved. So that's one of the things Victors thinks that can be missed, and it frequently is missed, but then can be detected and really initiate early care at that primary level. Other specialties he gets to work closely with depends on Victor personally. There could be dermatologists if they're removing skin cancers. This is the closest in his personal practice. However, there are a lot of ENT specialist surgeons who work with the head and neck cancer doctors that will interact with medical and radiation oncologists, the ear doctors. The neuroethology training will interact with neurosurgery for skull-based surgery. In the Intensive Care Unit where you're doing larger surgeries, the head and neck cancer surgeons will see patients again, admitted to the ICU for laryngectomy or tracheostomy management. “A fair number of patients are generally on the healthier side, and a number of procedures we’re doing are for improved quality of life, for better breathing, better functioning.” Victor adds that there is a close connection with ENT doctors in general with primary care doctors for sure. Absolutely, and oftentimes there's an unfair and sort of inverse ratio. There's tons of primary care doctors and you get a lot of their patients into ENT specialists and there are just very few ENT doctors available. And even with jam-packed schedules, there may be months' long wait lists. But all the time, he’d talk to primary care doctors who really need to get someone in urgently they will always make their best effort to get those in and not have them on the waitlist. [41:35] Special Opportunities Outside of Clinical Medicine Victor says there's always lots of research going on with the basic science level looking at wound care, tissue healing, in addition to the types of different injectable products, hyaluronic acids, botulism toxins. There's a lot of these things called PRP, Platelet Rich Plasma, and other types of different materials that are being injected for stability, safety, efficacy, improving them. There is a number of possibilities to pursue research and development of these types of products. Those who are more interested in the business side can become Chief Medical Officers for healthcare related corporations. There's actually a very small and probably should be more encouraged politically active doctors. “There's always lots of different opportunities that you can springboard from your specialty.” There are a lot of different opportunities based on what you're interested in. But there is always that idea of you're giving up that patient interaction and that normal typical doctor schedule, but maybe it's for more regular hours when you're becoming an executive in a corporation. [43:55] What He Wishes He Knew Then “One of the major deficiencies in a doctor's education is the business side.” Victor attended Tufts Medical School and they had a great health professional MBA integrated program that didn't really hold you back from graduating under four years. Although he didn't participate in it, he still thinks it should be part of more the regular curriculum. There are great doctors that can no longer practice because their practices get shut down and closed. Other individuals who have some phenomenal skillset and need to get out there, if there's this barrier that they can't set up their business and they don't think it's possible, or even you don't necessarily have to be a small business owner, but as a component within even an academic group or a multi-specialty group, if you don't understand the metrics of and the financial side of it, you can't practice effective medicine if you're running at a loss, and you're going to get shut down, and then what happens to all your patients? Hence, Victor thinks the economic side of medicine really needs to be a core component in addition to biochemistry, genetics, anatomy, and physiology because it's inevitable. Medicine has become more and more business. It may not be desired to be that way, but it's a reality and physicians really need to understand how to run it effectively and how to protect their business so they can continue to give great care to their patients. [46:05] The Best and Least Liked Part of Being a Facial Plastic Surgeon Victor loves the fact that he has the ability to look at something that a lot of people think they understand well, and bring just another level of understanding, another level of treatment to it. For example, when people talk about breathing through their nose, some may attribute it to allergy while others to structural issue like a deviated septum. Victor stresses that alone takes a higher level of understanding of nasal physiology, and the anatomy, and diseases that affect it. But a lot of really well trained people will stop at that point and they may treat the allergy, they may fix the deviated septum, and the patient still has a breathing problem going on. This is where Victor comes in and he loves understanding the true nuances of the facial structure. He says having that ENT background gives him the understanding of all the functionality, all the moving parts, all the components that need to work day-to-day being normal. “The additional training in facial plastics gives me the side of the aesthetics but also the skillset to create that structure, to improve the functionality while maintaining overall looks.“ Victor claims his best results are noses that have just gone away. The patient no longer notices that it's stuffy or they have difficulty breathing through it when they exercise, and they no longer stare in the mirror and look at their nose that they feel is so prominent, and some people feel like it makes them ugly. And so the greatest success for him is to see patients to have their nose essentially disappear and just be in harmony with the rest of their face. It's still their nose, it's not a beautiful or fantastic looking nose, it's just their nose. He loves the fact that they don't even have to think anymore about picking up a spray bottle, or an allergy pill because their nasal passageways are nice and open, and so they just go about and they do normal tests every day without a thought in their mind. Victor describes it as one of the pure joys of doing it that he notices and that the patient no longer has to worry about anything anymore. On the flip side, Victor thinks trauma is tough but there's a great opportunity to really make a major improvement. Someone breaks their jaw, or shatters their eye socket, but there is a limit of what the end result can be because of the nature of the original trauma. You can always make improvements but you can't really get them to a truly better place. “There’s a major psychological component related to trauma, so even with an improved physical state, mentally there's still a deficiency. There's still a pathology going on.” Victor thinks maybe a multi-specialty kind of care type of thing can get someone who's come back from major trauma to really get them healthy again, because mentally or physically there are just limitations from just those initial insults that they can't really get back to their baseline. If he had to do it all over again, Victor would still choose to do facial plastics. He loves what he does and he says he’s excited to get up every day to go and see what comes through the door and he thinks this will stimulate him for years and years. At the same time, he would look for other additional skillsets such as check out a neuroethology fellowship as well as other things that would complement what he already does. Or he may get into facial nerve reconstruction therapies and then advance outside of that. Victor feels blessed to be able to do this. He could have gone a lot of other ways and would have been fine, but if given the opportunity to go about this again, he would still pick the same residency, the same fellowship, and focus on the same things. Maybe small little tweaks here and there, but overall, that same path has been really beneficial for him. It has really played to his strengths and it has given him the skillset to be a successful practitioner. [52:15] The Future of Facial Plastic Surgery Victor isn’t sure if any major changes are coming to facial plastics whether in the technologies or just fundamental shifts in the way things are practiced. He admits though of being on social media, a lot of people are becoming aware of new products and technologies at a much faster rate. The initiation of that first treatment is getting younger and younger. There are twenty-year-olds getting Botox to prevent wrinkles and people getting surgery at a younger age. But the largest kind of shift going on around a lot of focus on non-invasive therapies such as energy devices, like injections to dissolve fat. “There’s a little bit of oversell on those stuff that get marketed as quick and easy, and when they add on cheap, quick, and easy, those results don't ever really match the promises of the outcome that they get.” They're often short-lived and have unforeseen complications. They affect your ability to do things later. They burn bridges in treatment pathway. One of the things is injection rhinoplasty. People are putting fillers in their nose, but fillers in the nose in that skin area don't behave as well or in the same way as it does in the other soft tissues of the face. Victor has even seen disastrous things like blood vessels being blocked off, and whole areas of the skin and tissue on the nose enclosing. And that can happen in other areas of the face. It will heal and leave with some scarring, but if it happens on the nose or near the eye, then you've lost more function. Victor thinks it’s revving up toward these office procedures, and some are great, but then they're being expanded to use in replacement of tried and true therapies, and he thinks it'll surge but then people will see so many issues with it and then it will come back. There will be better technologies, there will be better equipment, there will be safer mechanisms out there, and all for the good. Victor adds that's how medicine has always been. There's always been sort of a pioneering technology, or thought, or philosophy, and then new techniques come out, and then they kind of push the threshold of risk and complication, and they back off, and then there's a new push as new developments come on the horizon. But that's how you progress, and improve, and come up with new therapies for diseases that previously never had any treatment. So it has to be done but just in a careful way and more informed way. [55:30] Final Words of Wisdom from Dr. Chung Victor’s advice to patients is to take some art classes. It's one thing to understand the anatomy, but if you can translate that anatomy and the structures from your brain to your hands, and using your hands, those are all good basic skills that can translate into being a better surgeon, and choosing when not to upgrade. Everyone will study hard and everyone will get a high score on the test, and everyone will strive to get that letter, but you need to find one or two things like sculpting, or drawing, or it might be music, or something to really keep yourself active and in a unique sense to keep yourself motivated. You may bond with some big name doctor one day who's going to write you a letter based on that unique activity that you do that not everyone else is doing. [56:55] Final Thoughts If you are interested in ENT, or otolaryngology, or even the specialty or subspecialty of facial plastic surgery, I hope this episode was interesting to you. I love these conversations, I learn so much from them even as a physician, so I know that you as a premed or a medical student are going to get a ton of great information from these conversations to help steer you in the right direction for your career. Links: www.TheShortCoat.com

The Most Grateful TurkeyThere once was a turkey, His name was Victor Ray.He had a bad reputation,As he lived on day by day.Why did everyone hate him?Believe me, they should.He was the most ungrateful thingThat lived in Grateful Wood.One day, this Victor RayHad a thorn stuck to his wing.But when Doctor Camel plucked it out,He left without saying a thing.The turkey strolled on.He walked like the wind.He was going to watch a movieAt the cinema on Rooster End.He found that there were no tickets leftWhen he saw a long legged goat.The goat said, “The tickets have sold out.We’re all in the same boat!But luckily, I ordered a few,Twenty-nine, at least!And I’ve got a spare one.I’ll give it as a gift, to you, from me!”The turkey just nodded.He strode into the movie hall.But when he sat down, he found that he was surrounded By goats that were big and tall.He saw the long legged goatIn the middle of the others.The long legged goat told the others to sit down.No one even looked at the turkey (No one even bothered).For the long legged goat knew The turkey was a bad one.He was hired by several othersTo get the killing job done. The goats were just pretendingTo ignore the turkey that was now fast asleep.When Victor Ray watches movies, he takes a nap,It’s a habit of his, thought the long legged goat, and it’s gonna make him weep!In the twinkling of an eye,The goats got to work.They made a little rustling noiseThat really startled the clerk.The clerk leapt out of his seat.He pulled out something red.It was sleeping droughtAnd it put the goats to bed.Victor was wide awake.He had seen the whole thing.He found a sword close to his neckThat fell to the ground with a cling.He suddenly realized his sins.He was ungrateful all the time!He went to find the clerk, but all that was left in the clerk’s placeWas a shiny silver dime.He picked the dime up. Then he read the words on it.“Go and apologize to everyone who’s helped you.I’ll give you a sign when you are done!”So Victor set off.He was going to say sorryTo everyone that ever helped him,And those people could fill a lorry!He went to Doctor Camel’s first, And Mrs. Badger on Apple Lane.Then he went to Mr. Elephant,Who had helped him find drugs that would rid him of pain.Then to young Tommy Kangaroo’s houseThe turkey did go.Then around old Professor Toad’s burrow and Jim Cat’s shelterHe hovered to and fro.Old Mr. Snake’s log pile,Ms. Rabbit’s hole.Soon, he had visited everyone,Excepting Harry Mole.He charged to the Mole’s house,And thanked him as quick as a flash.But he suddenly remembered the clerk,So back to the cinema he did dash.He called in the cinema,“Oh! Savior! Thank you!I’ve thanked everyone,Grumpy Old Mr. Eagle, too!So please show me a sign,Oh, please!”He suddenly stopped calling,For he saw someone in the trees.He saw a turkey crestAnd a turkey beak,And two bright turkey eyes,Above his turkey cheek.Victor recognized him at once.It was his father that had disappeared!He hugged his father, who had hopped into the window.“Oh father! It’s been so many years!”They got reunited,The happy couple.They really loved each other.They loved each other on the double!And Victor’s dad was a warrior,As you’ve probably guessed.So he taught his son martial arts,In both ways, Victor was best.最懂得感恩的火鸡从前，有一只火鸡，他的名字叫维克多•雷。他的名声非常不好，游手好闲，一天到黑。人们为什么如此恨他？这种感觉不是没有道理。因为他是感恩林里最不知道感恩的东西。话说有那么一天，维克多•雷的翅膀上扎了一根刺，骆驼医生帮他拔了出来，他扭头便走，也没说个谢字。火鸡继续前行，渐渐地，他脚下生风，他要到公鸡巷影城去看一场电影。到了影院，票已售光，这时，他看到一只长腿山羊。山羊说道：“票已售罄！咱们是同一条船上的，我的老兄。好在我提前订了几张，二十九张，不多不少。”这里还有多余的一张，送给你吧，谁叫你命好！”火鸡只是点了点头，接过票就往影院里走。他刚一落座，就发现一种现象，四周站立的全是山羊。他看到了那只长腿山羊，不偏不倚站在了中央。长腿山羊让大家坐下，没人正眼看一下火鸡。长腿山羊肚明心知，这只火鸡不是个东西。有人雇山羊把火鸡做掉。山羊故意装作不理不睬，此时的火鸡却已经睡着。火鸡看电影前有个习惯，他要先小憩一会儿，养养精神。山羊想着，心中窃喜，待会让你欲哭无门。说时迟来那时快，山羊一齐动起来。他们的动静可不轻，惊动了旁边的服务生。服务生他一跃而起，怀里掏出了一样红东西。那是一包蒙汗药，山羊一下全睡着。维克多他很清醒，整个过程看得仔细。脖子边上的杀人剑咣铛一声落了地。他认识到自己很犯浑，从来不知道什么是感恩。他要去找服务生，只见一毛硬币，不见了人影。他弯腰把硬币捡起来，上面的文字跃入眼里：“向你的恩人一一道歉，道歉完了，我示意你。”维克多把身离，他要去说“对不起”。帮过他的人可真多，绝对不止一卡车。第一站是骆驼大夫家，接着去苹果巷把獾太太找。然后便是象先生，他帮他弄到了止痛药。火鸡来到小袋鼠汤米的家门。在蛤蟆教授的洞前，在吉姆猫的窝边，犹犹豫豫，徘徊不前。老蛇先生的柴垛前，兔子太太的洞穴里，只剩下鼹鼠哈利的窝，他没有前去躬身赔礼。于是，他飞身前去，对哈利感谢万般。忽然想起服务生，又箭一般地返回影院。他在影院大声呼喊，“谢谢，恩人。谢谢，恩人。我已经挨个把门登，包括脾气坏的老鹰先生。请示意我吧，快示意我吧。”他突然变得很安静，林子里晃动着人影。他看到了火鸡的羽冠，和两只放光的眼，他看到了火鸡的嘴，还有火鸡的脸。维克多一眼就认了出来，那是他失散多年的老父亲。父亲跳到窗口，和维克多相互拥抱。“噢，父亲，真的是好久好久不见！”至此，父子二人，终于团圆。昔日彼此关爱， 如今倍加关心。维克多的父亲是名武士，这个你可能早已耳闻。他教给维克多搏击技巧，维克多成了彬彬有礼的武术达人。