Advice to a medical student entrepreneur

Dear Susan,

Congratulations on your recent graduation from college. I'm sure you are thrilled to start medical school in August and are looking forward to taking a break this summer.

The usual commencement speech I'd give, had I been invited, goes something like this:

Given your interest in building the company you started in college, however, you?might want to rethink that vacation in Europe. You probably can't afford it. And then there are all those travel restrictions recently.

How about doing an internship with a VC company instead?

Now that the white coat ceremony is over, welcome to the tribe.

You see, while things are gradually changing for budding medical student entrepreneurs like you, don't expect that you will have neither the time nor support to pursue your entrepreneurial endeavors. Medical school is all consuming, so you'll need to squeeze in any extra time on your own. What is more, it is extremely unlikely that your medical school will offer the knowledge, skills, abilities and competencies you will need to be successful as a physician entrepreneur i.e pursuing opportunity under VUCA (volatile, uncertain, complex, ambiguous ) conditions creating user defined value through the deployment of innovation using a VAST business model to achieve the sextuple aims.

You will also need to think about paying off that debt. A?2017 survey?conducted by AMA Insurance indicates that 35 percent of medical students expect to have loan debt in excess of $200,000, while 21 percent indicated they will have between $150,000 and $200,000 in debt. It is no surprise, then, that 43 percent of students indicated that paying off medical school debt was their most pressing financial concern. Other significant financial concerns among students surveyed included providing for elderly parents (25 percent) and funding college expenses for children (21 percent). Still, the significant debt load can play directly into those secondary concerns. If you marry another medical student in debt, that further compounds the challenge.

According to the Association of American Medical Colleges, the class of 2022 graduated from medical school with an average debt of $205,037. This amount isn’t surprising, considering that a student with state resident status at a public institution pays an average of $39,905 per academic year for tuition, fees, and health care. A non-resident at a public school is charged $63,718.

Do you really want to borrow more money to get an MBA, and, if you do, how will that debt burden affect your future entrepreneurial activities?

Perhaps you should consider taking a digital health internship in a top tier digital health ecosystem like Prime Health in Colorado.

So, what should you do when your priority should be to pass that next biochemistry test or get a top score in Part 2 of the National Boards to get that orthopedic residency?

Here is some advice:

1. Do an internship with a startup this summer before you start medical school in the Fall and, if possible, between your first and second year of medical school. Here are some examples from medical student entrepreneurs. In fact, think about taking a gap year between undergraduate and medical school. But, since you don't know what you don't know, focus on getting education, resources, networks, mentors, peer to peer support and non-clinical career guidance before you offer yourself as someone who can actually add value to a company that would supplement some existing transferable skills.

2. Network as much as you can and find a mentor. A good way to do this is to join?The Society of Physician Entrepreneurs and attend local chapter meetings. If you think spending $80/yr is too much because "I am an out of state student with a lot of debt and really can't afford it", then remember two entrepreneurial truths, my little entitled darling: a) people don't value what they get for free, and b) never trust someone who does not have skin in the game. We're talking about the price of two cups of coffee a month.

3. Be sure to use social media aggressively to find like minded students around the world.

4. Take advantage of free MOOCs being offered in bioentrepreneurship, medical innovation and digital health.

5. Identify others in your class who are interested in biomedical and health innovation and entrepreneurship and start a special interest group or student club and invite members of your local cluster or ecosystem to speak at lunch and learn sessions.

6. Focus on getting education, access to resources, networks and mentors and experiential learning. Find out whether your school offers bioentrepreneurship workshops, courses or degree programs and rethink getting an MBA. You should also look into iCorps training.

7. Keep your head down and focus on medicine. Don't tell faculty or other students about your entrepreneurial endeavors lest they think you are not taking medicine seriously enough.

8. Factor in your entrepreneurial career objectives when it comes time to choose a specialty or employed or independent practice arrangement.

9. Be sure to complete a residency and several years of practice to understand the problems beguiling sick care and possible opportunities to fix them. It's called physician entrepreneur for reason.

10. At this stage of the game, stay fixed on being a problem seeker, not a problem solver. Start by developing your entrepreneurial mindset and practicing entrepreneurial habits.?Here are 10 crucial steps to becoming a "pre-entrepreneur".

11. Start to learn about the business of medicine particularly innovation, marketing, the use of health information technologies and business models.?

12. If you are not internally motivated to do this for some time, then quit now and save yourself a lot of heartburn.

13. Be a pioneer and lobby your medical school administration and faculty to incorporate innovation and entrepreneurship in to your curriculum. Make MD/MBA degrees obsolete.

14. Find your innerpreneur

15. Have a growth mindset and understand the differences between the clinical and entrepreneurial one.

16. Include badges on your Linkedin profile demonstrating education and training in the soft skills.

17. A?moment?of inspiration in medical school?can?take years to?see the light of day. Here are some things to consider?to help?bring your business dream into reality.?

Here's what it takes:

Instinct

There are some aspects of a successful innovator that simply cannot be taught. Just as some medical students have more of a natural aptitude for surgery, “it’s the same thing with entrepreneurship,” he said. “You have to be in some respects prewired to do this and we can teach you the skills to get it done.”

Vision

Problem-solving is a skill that is necessary to succeed in a clinical capacity. It’s also essential to flourishing in a business capacity. How do you see the world? Do you see problems or opportunities? Do you see the destination or the journey? How do you deal with failure and barriers? How good are you at networking and learning the hidden curriculum? How good are you at improvising and being creative?

Energy

Time is a commodity, and in medical school there’s not much of it. That is one of the biggest challenges toward pursuing entrepreneurship during medical school.

Make sure that you get the knowledge, skills and abilities and develop the competencies that you need that are practically possible given the time and effort required to be a successful medical student. You’re not going to be given a lot of wiggle room, because it’s hard being a medical student. But essentially you need education, resources, networks, mentors and whatever experience you can get in nonclinical career development.

People skills

At any level of innovation, the diversity of the people around you are an asset. For medical student entrepreneurs, seek opportunities and opinions outside of your medical school. Sick care cannot be fixed from inside.

Do your best to integrate and connect to the local ecosystem. Whether it’s digital health, or bio- pharma or med tech, most major cities have these bio clusters and science associations that you need to take advantage of. You need to get off the campus to do that.

Desire

In starting a venture, there will be setbacks. Those will far outnumber the instances in which one succeeds, particularly early on. The ability to absorb and rise above negative developments is key.

Fundamentally you have to be strongly internally motivated to do this. It’s very hard. It takes a lot of persistence. If you don’t’ have that inner voice egging you on, it’s pretty easy to get discouraged and quit. Many make it personal but don't take it personally.

Here are some other suggestions.

You should start taking care of your financial health just like you would take care of your personal health day one in medical school. Creating and following a risk management plan means educating yourself and getting the right professional help as soon as possible. The likelihood is that by the end of school , you will be burned out and somewhat cynical and unaddressed financial burdens will only add to the weight on your shoulders.

You should also consider taking a leave of absence, or a mid-gap year, to pursue your entrepreneurial dreams like these medical students.

Here are some more tips.

The good news is that several medical schools are rethinking medical student entrepreneurship education so you are lucky to be where you are at this time.

Remember,?you were not admitted to medical school because of your creativity. You were admitted because of your ability to memorize things, take standardized tests and conform. Simply put, you might not have what it takes to be a physician entrepreneur and , if you are, you will most likely fail. The fact is you simply might not have an entrepreneurial mindset or in the 1% who do. An entrepreneurial mindset is not the same as a clinical one.

Again, congratulations on your achievements. Hopefully, when you complete your residency and possibly fellowship training 10 years from now, the environment will be less hostile and more supportive of your initiatives. Please send my best regards to your parents, who, I'm sure, are enormously proud of you.

Arlen Meyers, MD, MBA is the President and CEO of the?Society of Physician Entrepreneurs on Substack and Editor of Digital Health Entrepreneurship