What To Look For In A Psych Program (Season 2 Wrap)

Preston: [00:00:00] It's still the inside of the hospital at the end of the day, and it doesn't really matter what state you're in, 

Margaret: and it's still a really interesting job with people and not just the inside. 

Preston: So dark. Sorry. Yeah, that sounds, that sounds really negative. It is. It is an, it's an interesting, intellectually stimulating and wonderful job, 

[music]: how to be patient 

Preston: and welcome back to How To Be Patient, the podcast where we teach you how to do things.

One of those things is being patient. Today I'm joined by my co-host Margaret Duncan. Hi guys. She's here just about every time. I don't think there's a time where she's not been here. 

Margaret: And this is sadly the last episode of How to Be Patient. 

Preston: Season two. 

Margaret: Yeah, 

Preston: the last episode of our second season. Yeah, it's, it's a bit nostalgic, but we're coming to the end.

We've learned a lot and I'm excited for today's episode because we're. We'll take the time to debrief that whole season. But before we do that, we're gonna kind of dive into some of the [00:01:00] match statistics and actually how to approach the match from an applicant's perspective. Since when this airs, it's gonna be around, I think, mid-November.

So a lot of people are gonna be either on the horizon or or in the middle of interview season. 

Margaret: Good times, guys. 

Preston: Yeah, and I do not envy them at all. I did not like being an applicant. I, it's just, it's exciting to think about where your future could be, but it's just exhausting being on parade all the time.

Margaret: You just hear so many like, horror stories of the match that I feel like the entire year was just like anxiety or waiting, and my match year was also 2020 into 2021, so it was extra anxiety provoking and new. 

Preston: So were, were you one of the first like virtual COVID classes? Like COVID interview cycles? I 

Margaret: was, I was the first, yeah.

Preston: Oh, trail bros. Trailblazer. 

Margaret: You were the, you were the second. 

Preston: Uh, I think I [00:02:00] was one after I was 2020. Me 2, 20, 23. Oh wait, you're, 

Margaret: I, oh, I forget. You're two years behind me. Your wisdom and intellect always makes me, you know, because I just seem older. 

Preston: So what was that like for you? What that first cycle? 

Margaret: It all switching?

Mm-hmm. 

Preston: Well, 

Margaret: my two personal story right off the bat is that my dad had had a recurrence of the glioblastoma, uh, in April of 2020. So we shut down in March. We found that out about my dad in April, 2020. And so he was getting more treatments and had had like two surgeries over the summer. So it was actually great for me that interviews were virtual and I loved, I think like the average people had spent on travel for the match was.

Somewhere between eight to $10,000 depending on how people budget. And it's a 

Preston: bonkers amount. And And it almost feels like pay to win. 

Margaret: Yeah. Oh, exactly. A hundred percent. And I am not somewhat, you know this, I love a good routine. I am a bit of a homebody. And so the idea of going stability your own bed.

Yeah. So the idea [00:03:00] of going to like 20 interviews afterwards, everyone's always been like, oh man. But that was like the best part. That's when you really get to know everyone. I, I don't know, I didn't like med school interviews that much and I was pumped to just have my one virtual day to be able to ask questions and to kind of just like I was about to say, hit it and quit it.

And that's not the right verage there, but it worked out for me. I'm sure I would have a very different story if I did not like the residency I matched into and it didn't, or if I like, was not in psychiatry. 

Preston: Yeah, I resonate with that. It is sometimes nice to just check in quickly and get, get a vibe. And in the vibe you get virtually it's, it's imperfect, but you can still get an idea.

And I think it would suck to like fly all the way across the country to almost immediately kind of know this is not it. Like, like, oh gosh. Like have you ever gone out, gone on a date [00:04:00] and no. Like, you know, within the first 30 seconds that this probably shouldn't have been a thing, it could have stayed on the apps.

Yeah. And you're just like, oh, well let's, you know, three more hours will have a nice time. I guess. Like, let's try to do this. It's, it's like bad if you fly out to the program and you're like, oh, that was a catfish. Like, well, 

Margaret: and you're like, I can't make any enemies here. 'cause who knows when I'm gonna run.

Like, who knows who I'm gonna run into again? Or like, if this might matter, I. I just know I would show up nauseous and tired, and then you get back to rotations on Monday and in fourth year would've been my fourth year if it wasn't COVID. 

Preston: Mm-hmm. 

Margaret: Uh, that just, that was a no for me. But was yours entirely virtual or was yours different?

Preston: Yeah, my, mine was all virtual. The, I was referencing like back from med school interviews when you'd fly out to them, but I actually, I never had that experience with residency. So the, the virtual interviews were, I mean, they're fine and full disclosure, like I didn't do many of them on the civilian side because I was [00:05:00] doing the military match.

Margaret: Right. So 

Preston: I did, I had two main interviews at the military programs and then I kind of like, I got applied to a and I interviewed at a couple psych programs and then I found out I'd matched active duty. So I was just like, okay, I'll just withdraw from ERA A completely. 

Margaret: When did you find out that you matched for active duty?

Preston: Uh, late December. 

Margaret: Okay. So you find out early. 

Preston: Mm-hmm. Must be nice. Yeah. So I had, I had actually a couple interviews scheduled for January and February, and I just canceled them. 

Margaret: We so did your school. Our school still did the opening, the envelope in front of the auditorium of everyone. And I know it's a horrible idea and so many people match day.

It's such a mixed bag in terms of happier, sad emotions, but it was kind of awesome opening it in front of your entire class and then announce Wash u always does a video about this every year. And I've seen the 

Preston: videos. Yeah, it's so I could wait. I could probably find you, 

Margaret: uh, maybe 

Preston: Is it just a compilation or did they live the whole thing?

I dunno if they put everyone 

Margaret: in [00:06:00] it. I think it's like they put like 10 people in it as the, as you make the 

Preston: top 10. 

Margaret: I didn't, sadly, 

Preston: you know, psychiatry, underrepresented, the 

Margaret: acting wasn't there. If they only knew now that I'd have a podcast, they would've ruined the day. They, 

Preston: they should have put the pyrotechnics up and then you could like fake cry when you open, open the letter.

Praise the Lord. Um, okay. Anyways, um, wait, you did have a walk up song. Back to the topic though. 

Margaret: You did have a walkup song for the Oh, that 

Preston: is cool. Back to the, the topic at hand today, which is not our historic Yes. Match experiences, but the current match happening right now. And, and if you're a student listening and you're trying to navigate it, I think there's a lot of talk that you've been hearing about how psychiatry is becoming a lot more competitive and I guess I would like to say that that's true and also not true at the same time.

Like it, it is true that for the 13th year in a row I was looking at these stats today, this amount of psychiatry applicants have increased. So there's this For 

Margaret: last year or for this year? 

Preston: Mm-hmm. Yeah, for [00:07:00] 2025 last year. We don't, I era eras is actually tomorrow as we're recording this, so we don't know yet.

Oh wow. Oh yeah, you're right out soon. So the ballpark, there's like 1800 MDs that apply around 1300 dos and I think somewhere between three and 500, um, international med medical graduates. The match rate last year was around 84%, which is pretty low for psychiatry. I think like traditionally it was like 95 or like 90 plus.

So there's like a lot of more stress around it and I know stories of people that have had like great psychiatry matches, but also people with no red flags that seem to be doing well and somehow still ended up not matching. And a lot of us kind of, I think a product of a system that doesn't know how to handle the influx of applicants that they're getting.

I think psychiatry had a way like to do things for a long time and now it's like, oh, I don't know how to filter people like other programs do. 

Margaret: Mm-hmm. Mm-hmm. Yeah, I mean I think that's a problem in [00:08:00] psychiatry, but also a problem of demand in medicine in general, especially as quickly as health systems are changing, that there is this demand for psychiatrists now more than there was before, as well as with the reduced stigma, kind of perceived good quality of life with the job.

The influx of applicants. I mean, we talk about this in child psychiatry all the time as well, that there's not an on-ramp for the increased need. Um, which I think is also just part of this, the matching problem in general. 

Preston: Mm-hmm. Yeah. And the problem with changing any of these systems is it's like fixing an airplane while it's flying and we're figuring out our best way to make these adjustments, but we, we overcorrect we under correct.

And there just ends up being like issues in like the amount of personnel flowing in and out. 

Margaret: Mm-hmm. 

Preston: Um, but I, I do agree that I think Gen Z especially, 'cause now we're entering like almost like majority Gen Z applicants 

Margaret: mm-hmm. 

Preston: In [00:09:00] into intern year. And there's less of a stigma around mental health and people value their free time a lot more.

Mm-hmm. People like the variety that psychiatry provides them and they're kind of like. Less obsessed with this idea that like psych is not real medicine and they don't harbor like a lot of the prejudices that maybe the older generations did. And that's reflecting in their applications. So it's, it's, it's all for good reasons and I hope that we, you know, end up accommodating for it, but mm-hmm.

If you're a psych applicant and you're listening to this, this is not gonna be one of those episodes where we tell you all the ways to be competitive and be one of those 84% that match. I'm sure you have enough people in your life telling you that. And there are enough websites and subreddits that you can go down.

I think student doctor networks 

Margaret: still up. 

Preston: Yeah, it is, it still exists, unfortunately. 

Margaret: Nightmares. 

Preston: Uh, yeah. I was, so, I was researching for this, this pod I saw, I came across SDN and I was like, oh my god, my, my heart rate. So, um, the purpose of today is actually for us to come alongside you and, and be a little [00:10:00] elf in your ear telling you what to look for and what not to look for as you start to interview your programs.

'cause remember, psych programs are not only interviewing you, you are interviewing them. So we're gonna take a quick break and when we come back we'll start going into things to look for in these psych programs. And then after that we will debrief our podcast in our own luggage. In the meantime, 

Margaret: we'll be right back.

Preston: Margaret, are you ready to break down what psych programs like to showcase or pretend that they have? 

Margaret: Yes. I feel like one of the biggest things, because as you guys know who listen, this podcast, psychiatry is pre paradigm and therefore there are lots of requirements in the training for psychiatry. But different residencies have different ways of just barely meeting those requirements or making you almost a specialist in them, which is probably true in other residencies as well.

But in psychiatry you can, [00:11:00] there's quite a lot of flexibility and so I think one of the biggest things I remember looking for and thinking about was. How does this program value teach and give you time to learn therapy skills? Mm-hmm. How much of a, like, quote unquote biologic program is it, we can get into that.

And how integrated is it with people doing research, having even just colleagues who are kind of very, very much wanna be full-time research clinicians rather than clinicians who've done a little research. Uh, so the split of things in psychiatry residency, not like, not even to get into inpatient, outpatient stuff, but just the split of the focus and what's valued in terms of what a psychiatrist does I found was so different across programs.

Preston: Mm-hmm. And actually, can you touch on that a little bit more? The bio program versus therapy program, what that even looks like and where that might be located. 

Margaret: Yeah. I mean, I think in an ideal world, and bear some of this in [00:12:00] mind that I interviewed five years ago, so, um. 

Preston: Our, our, I entered two years ago, and even now, I feel like my perspective is a little dated.

Margaret: Yeah. We were doing lobotomies when I was just kidding. I think, I think again, a lot of places like to say during the interview day or in their slides or on their website, that they equally value psychotherapeutic approaches as well as biological underpinnings and mechanisms of mental illness. Right.

Everyone. Mm-hmm. Loves to put that sentence in there. Everyone loves to say they love collaborative, integrative, holistic, mental healthcare. 

Preston: Love to talk about how much they love, not singling out a modality. 

Margaret: They love to talk. How about their justice and trauma oriented as well. So 

Preston: mm-hmm. 

Margaret: Those are buzzwords.

I love those buzzwords. If they're outrightly, like we hate therapy, probably a bad sign 

Preston: in general. I yet I've yet to see that, but yeah, it'll be good. 

Margaret: Um, so the websites are full of. A [00:13:00] bunch of things that may or may not be true. The interview days are slightly more true than the websites when it comes to, I think biology I, and this is my WashU maybe showing because WashU is so MD PhD heavy for med school.

Mm-hmm. And how integrated it is. I think biologic understandings from my experience comes from how closely tied is the research department with the clinical department in the residency programs you're looking at like, do they have a robust research side? Um, and then secondarily, how, where are the didactics and how much supervision is there in terms of giving you a good framework for basic kind of neuropsychological processes.

And then psychopharmacology in. Algorithmic organized way. So that's what I would think of as things that I would had looked for as a biological program. Those two things. So I'm curious what you think, I guess a 

Preston: way to make, to like clarify that or to be more concrete about it is like to actually see if [00:14:00] they have a neuroscience department, if they have a neuropsychology department, and if they're, do they have labs signs of collaboration between these departments?

Yeah. Yeah. Because there are programs where like they have this great neuroscience department and like for some reason they don't really talk with the psychiatrist. Mm-hmm. Like the psychiatry department, they kind of like are almost like ships in the night. And sometimes like they can be more closely related to behavioral neurology and, and I think a lot of this can just be from the politics of the institution who's friends with who.

But a lot of that can kind of come down to affecting how you get to retrieve your education. 

Margaret: Yes. 

Preston: And sometimes you might be like, oh, they don't even have a neuroscience. Curriculum or department, they, they do they even have a neurology residency? 'cause there, there are community programs that aren't necessarily attached to universities that will like have access to that.

Or they might be able to like arrange relationships with local universities. But those are things to ask about or look for. 

Margaret: Yeah. [00:15:00] I will say as well, I guess maybe parsing out the biological into clinically excellent and research excellent would've been helpful for me to say. I think there's some overlap there, but I also think that there are programs that don't have as big of like a research department, but they have been the ones who have really been doing like a lot of qi thinking about how do systems work, putting it in place in a smaller system that they might be in who are mm-hmm excellent clinicians and there are excellent clinicians everywhere.

But I do think that that can kind of be parsed out as well. And maybe as a bigger question. Related to that is how does this prepare you professionally in terms of where you wanna end up? Mm-hmm. Um, in terms of all the many places that, that you could be in. 

Preston: So like how do you parse that out though? How, how do you parse out that they're excellent clinically that they have good qi?

Margaret: I do think that there's a bit of that that goes into the interview day that the way people talk about problems or the way people think [00:16:00] about issues within the institution. Like it's hard from one day to get that. Mm-hmm. But if you ask them, right, like they're gonna ask you like, what's a time you dealt with like a conflict or dah, dah, dah, dah.

A question I would ask during my residency interviews was something along the lines of what is a way that this program has grown in the last couple years and what is a way I would ask like the assistant program director, this or program director mm-hmm. Which is maybe a little uppity of me, but. How, how under your direction, queen or king of this program?

It's, so, it's, it's, I didn't say it that way, but where, where are you driving this program to go? Like, what do you want to say at the end of five years was like your legacy on the program. 

Preston: I'm surprised you didn't just say, why should I come here? 

Margaret: I think this is actually a good question. I think this is a good question.

No, no, 

Preston: it it, it is a good question. I'm just trying, some of us, I'm, listen, I went to med 

Margaret: school and I was like, I wanna do child psychiatry. So like, I was like being coached the entire time. Um, [00:17:00] so yeah, I about, I would ask a 

Preston: similar thing. Yeah. So I'll say like, what kind of. Feedback or changes have you implemented in recently into the program?

Mm-hmm. Because really, I'm trying to see, is this a program that doesn't care about you and will like, allow residents to basically change the whole program if they want? Mm-hmm. Or is it a program that like actively works with you and wants to do stuff with the residents? And what I've noticed is that the, that's what I perceived.

'cause I didn't, I haven't attended all these programs, but the more toxic programs will say something along the lines of, oh, well if you wanna see a change, we'll happily empower you to do or allow, allow you the opportunity to, you know, exact whatever you'd like to see done. Mm-hmm. And then you're kind of like, oh, and then, and then they frame it as like, it's an opportunity for you to participate and help out with the residency.

And it's like, oh, so you're just, you're not gonna do anything. You're basically telling me like, yeah, you figure it out and then maybe I'll let you do it. [00:18:00] Whereas there's other one, other program directors would respond. Oh yeah. Like. You know, just recently I redid the whole call schedule 'cause like we were really having a big problem with this and like, I'm actually really proud of like this new setup that we have.

Mm-hmm. And you can tell by the way they're talking about it that they have active projects on their mind. 

Margaret: Right. That 

Preston: show how invested they're in improving residents and that the specifics are great to look for. Because if they actually care, they're gonna know two or three projects or things they're doing to help residents off the top of their head.

And if they don't, they're gonna give you that vague runaround answer about how you're welcome to change whatever you want if you were to match here. 

Margaret: Right, right. No, I 100% agree that they'll be able to grab something quickly that's like pretty concrete and not like what exactly what you were saying of, you know, people have tried to do things differently before here and I support differences of opinion.

Mm-hmm. Like that gives you [00:19:00] nothing. 

Preston: Okay. It's, and. For interviewing the residents, it's getting better. Has to be like one of the greatest red flags that you can see in a program. 

Margaret: It's getting better, it gets better. 

Preston: Like you, you asked, you're like, how is the call schedule? It's, it's been getting better.

It's been getting a lot better. Uh, we had a lot of of concerns and we made changes and it's getting a lot better. And you're just like, wow. How, how much better is my question? It's, and how bad was it before? 

Margaret: I wanna come back to one thing. So I think we need to talk about the concrete question, which is money and call, which is the biggest thing you need to suss out during interviews.

Yes. From your end. But just to come circle back to the biologic versus psychologic, da da da. The thing, the green flags I would look for for programs. If you are someone who wants to go into psychiatry and get a relatively more robust therapy training, uh, depending on what kind of therapy you want to be trained in, we know I'm a little existential.

I like psychodynamic. I wanted that actively being taught, um, the [00:20:00] act. 

Preston: Taught and I 

Margaret: wanted to act actively being taught good. Good job. Uh, we're done with the pot, we we're done. I don't know that we can top that. Yes. Um, asking about when you start seeing therapy patients, is it some programs you start seeing them?

I started the beginning of second year. Um, other places you don't the third year. Um, and then asking what is the supervision model? So like second and third year, are you meeting once a week? Are there, is there a curriculum? Is there a specialized track that actually still exists? Um, versus just it, it lives on the website and nowhere else.

Mm-hmm. All of those things, I think. And then when you're in third year, if there's protected clinical time for it versus it goes somewhere else on top of what you're already doing. 

Preston: Like it's only an elective your third or fourth year if you wanna pursue it. 

Margaret: Yeah. 

Preston: And those are, those are also good questions to ask residents.

Margaret: Mm-hmm. 

Preston: Um, because. They'll [00:21:00] have a good idea of like how their therapy training is going. 

Margaret: Yeah. 

Preston: Um, and then in, in, so correct me if I'm wrong, but in general I've kind of heard that the west coast is more bio focused and the east coast is more therapy focused and you are stationed on the east coast. I'm, I'm in Texas.

I'm somewhere in the middle. What would you say about that statement? 

Margaret: I don't know that California's more bio at this point. I think that the East coast has really, uh, tr like it, I think I would say that. 

Preston: So you're just better at both. 

Margaret: No, I was gonna say the West Coast is better at like mind body therapies and third wave therapies generally, whereas a lot of historically the psychoanalytic and dynamic institutes have been in the East coast and shout out Chicago, although there is one, I think maybe in San Francisco as well.

I think they had the conference last year. So there's just like, you have to ask where the houses are and the houses. Mm-hmm. For third wave therapy, mindfulness based things, mind, body stuff are more in California, the Midwest is a little bit, just kind of less therapy in my [00:22:00] opinion. Can't speak to the South and Texas, honestly.

Preston: No. Yeah. The Midwest is just, it's RI love the Midwest Depress Depression Farm. Really? No. Um, 

Margaret: no. Trying 

Preston: to corral people into clinic. 

Margaret: No. Although I will say I feel like Northwestern, if I remember correctly, has pretty good therapy training and then other places, I, I, this is just a special shout out to Northwestern that they do.

Uh, but yeah, again, I, I think you also have to ask, like, this is something for the very few of you who listen to this podcast and are applying into psychiatry outside of the program that you're looking at, look and see if the city you're applying to has a psychoanalytic institute. If you're interested in other training.

'cause you can get most places where they're Psychoanalytic Institute, they have a relationship with all the residencies in psychiatry there. And you can. Add that to your training one night a week and it's, you can be nerdy and enjoy it and add stuff to your plate, but I, I do think that's something I'm so glad I did last year and it's because it was in Boston.

Like there is an [00:23:00] institute here, which I would not have known my when I was applying to think about that. 

Preston: Yeah, absolutely. And I'm speaking of being nerdy and hanging out, I think I, I kinda wanna move on to the residents next. So, so questions to ask the residents are kind of how to, to judge like the vibe of the culture of the program.

Margaret: Yeah. What do you think? 

Preston: Um, so I think this is a common theme, which is asking questions where people can provide specifics rather than kind of vague runaround answers like I mentioned before. So one question I would ask a lot is, what do you guys like to do to hang out together? Or, or what do you guys do to like, relax?

And you can find out pretty quickly if. They all kind of hate each other and no one really talks. And the best they can come up with is like a photo from the residency barbecue like 14 months ago. And they're like, yeah, you know, this is love that God, this, this, you know, there was barbecue and we were all [00:24:00] together here.

And then you're like, okay, but like, what about during the week? And they're like, eh. Sometimes some people try to get drinks. 

Margaret: We see each other at the wave. You're like, 

Preston: okay. And then, then another program, you talk to them and they're like, oh, you know, I'm on a, so we're, we have a soccer team. We play every Wednesday.

We're always hanging out and like, we do this thing at my friend's house. Um, the program director likes to play softball, so he'll host like a softball thing at his house, and then he makes ice cream. Like, like you, you can tell really quickly that they have all these events and stuff they're doing and they're active and they're, they have a community that they've created and they like to hang out with each other.

That is like such a green flag. 

Margaret: Yeah. 

Preston: And. And I guess like as if you're an applicant, you're kind of asking these questions. You can just kind of sound genuinely curious like, oh, so like, what do you like to do for fun around here? Like, like what's nice if, if they say things like, oh, it's, it's got 

Margaret: pizza.

Preston: Yeah, it's pizza drinking. Well, I was gonna say, it's, it's a big city with a small town [00:25:00] vibe and there's tons of breweries. You, you need to not accept that as an answer. Like actually start to dig into specifics because there are so many places that are gonna say that 

Margaret: unless you don't care that community's in your residency.

Like if you're, that's 

Preston: true. I, I assume that people would want community. 

Margaret: I assume that too. I think most people do, but I also think there are people like who train in New York or Chicago or Boston or LA that like have other communities there already, but mm-hmm Probably it's good if like people tend to like each other just for day-to-day workflow, regardless of if you wanna hang out with them on the weekends.

Preston: Yeah, and I guess I was saying that more as a proxy, like you don't have to hang with each other on the weekend, but whether or not you like each other enough to hang out as an idea of how toxic or friendly the work environment likely is. Yeah. Because in places where people like do like bristle with each other when they have to interact, like that's just an uncomfortable work environment.

It's probably not one where you're gonna train your best. 

Margaret: Yeah. Have you interviewed at places like that? 

Preston: No. A lot [00:26:00] of this I would say is like mo, mostly like secondhand. 

Margaret: Yeah. I feel like the, the one thing I noticed when I was interviewing was there was a program where it just seemed like everyone was exhausted, but not like at each other.

I will say in terms of like depending on what life stage you're at, I remember asking someone like, well, yeah, I don't know people in the area for a program I'd interviewed at and they were like asked a similar question of, do you guys hang out? How do you make community? Like how, you know, have you settled in here?

And someone goes verbatim quote, oh, I think. I think this other resident made a friend on Bumble Friend recently, and I was,

this is two thumbs down for me on that one. 

Preston: Yeah, that's, that, that is tough. 

Margaret: Should we talk about what the world runs on, which is money and time on call? 

Preston: Yeah, let's talk about that. 

Margaret: Do we wanna take a break or no 

Preston: show? No. Show me the money and then we'll take a break. 

Margaret: Show me the money. So the money [00:27:00] is actually easier than a lot of these other questions because usually they have to have a GME that tells you what your salary will be.

You should also look into if you're unionized or not. Um, that can matter. Or if they're in the middle of unionizing or if people have struck, struck, gone on strike recently. Stroke, um, something. No.

Um, all things you might wanna know saying a fair 

Preston: wages, 

Margaret: find out if your health insurance is good. That's something you should ask the residents. 

Preston: Mm-hmm. 

Margaret: That because you're probably gonna need therapy. 

Preston: Yeah. And then I hate that we have to like bring this up, but parking and food 

Margaret: 100%. Yeah. 

Preston: Like you can, you can kind of wonder and muse about like all the curriculums and everything on the website, but sometimes at the end of the day, it's just like your, the low levels of your Maslow's hierarchy of needs.

And you're like, if I wanna get food on call, I'm [00:28:00] gonna be paying through the nose and we'll even be available and am I gonna have to pay for parking at like the place where I train? Yes. And, and hopefully the answer to like both of those things is, uh, no, you won't have to pay. And yes, there's food available 

Margaret: when you're in those like awkward residency dinner things the night before your interview day clock in on the, the person who seems.

The second most cynical and notice what they respond to questions. 'cause I find they're the like most accurate predictor. Um, 'cause they're not so cynical, right? They're not so cynical. They didn't sign up for these dinners at all. And so some places forced YouTube, but most places ask, so they did show up.

They're not the most cynical person in the room who probably was forced to be there. But their reaction to things like if you ask is it affordable to live here? What's it like navigating this training without a car? Their face will tell you the reality of what's 

Preston: going on. 

Margaret: Mm-hmm. [00:29:00] 

Preston: Yeah. Like you'll see, you'll see the reaction the first couple seconds when they're like, and then they'll be like, you know, there's a like, okay, time to time to put on my parade face and tell you that like, yeah, it can be affordable for everyone and there's lots of housing, blah, blah.

Yeah. 

Margaret: Um. Totally agree with you in terms of those like are we getting fed? Is lunch provided when we're on service or like lunch talks? Other things like that. Um, call, find out how often you're on call. Find out what the duties from the residents are when you're on call. Big difference of rounding on a 20 person unit versus rounding on a 40 person unit versus rounding on a 20 person unit while you're on consults and you have an ED that's averaging six new consults a day, so mm-hmm.

And then there's the obvious thing of how many weekends are you on call, but those weekends can be very different if you're on like a high acuity [00:30:00] unit or hospital versus it's kind of chill and you work for a few hours, then you're just hanging out at the hospital call's. Never fun. Mm-hmm. But those things can make a huge difference.

Preston: And maybe I'm saying this a little bit of Stockholm syndrome 'cause my program is a little bit like relatively call heavy. I wouldn't say that call's like ultimately a thing to minimize. 'cause there are some programs that you can finagle where it's like, oh, you know, we have a little bit of home call, but ultimately there's kind of nothing.

Those exist, you know? Yeah. They're, they're unaware. They're like, they're podunk programs where, um, the volumes is very little and you don't, you do want some call, like, you, you want experience holding the pager, managing stuff on the weekend, acting alone. Like, I hate being, I would like make fun of people that would make statements like this, but I did learn how to be better and more assertive on call.

Margaret: Yeah. 

Preston: So it's, it's really just kind of a, like finding a healthy balance. Like, you don't want to get slammed. 

Margaret: Right. 

Preston: And that's unnecessary, not helpful, but also like, do, [00:31:00] do you have a hospital that's like gonna help you learn? 

Margaret: Right. I also think you don't wanna come out of training afraid to work at a number of places.

Mm-hmm. Right. Like. Ideally, again, you don't wanna train somewhere where you're being so it's so much that and there's no support that it feels impossible. But I came out of residency and ours was, I think actually similar to yours of like six to seven weeks of nights a coup second and third year, and then, uh, I don't know, like 12 or 13, 20 fours a year.

Preston: Yeah. So ours is broken up into like overnight shifts, which don't count as 20 fours and then full blown 20 fours. So it comes out to being about 20 total call shifts. 

Margaret: Do not have weeks of nights. 

Preston: No. Our second year we have weeks of nights. My third year I don't though, so I have a total of 

Margaret: ours Got worse third year.

We're like, what's going on? Yeah. We 

Preston: have, we have four weeks of nights [00:32:00] I think. 

Margaret: Are we saying my co my program was heavier? 

Preston: Heavier? Uh, maybe, yeah, maybe you got it harder. 

Margaret: Um, but I will say after being brutalized by third year and coming out of like big academic hospital where it was like consult service was bumping, I was in the sick u everyone was coming off of Sedex and it was like, psychiatry, what are we doing?

Mm-hmm. They're gonna punch a nurse, they're on the sedex and like anesthesia's asking you at the end of third year with a combination of outpatient and then just like the amount of nights, and we, we do cl three months, second year, a month, first year and three months, third year. Um, I did leave third year and was like, I'm tired, but I feel like if I have to work in an inpatient or consult setting, I am ready to, like, I can have 10 consults happen a day and, and live to tell the tale.

Um, mm-hmm. So, sorry, this is a tangent guys, but I, I. I do think it helps to hear people talk about why call might matter [00:33:00] because I left third year with so much less anxiety about what I could see. 

Preston: Yeah. And, and I feel similarly too, like I did I guess less consults than you. I did two weeks of consults my intern year, and then I had two months of consults, uh, second year.

You do a ton of consults 

Margaret: here. 

Preston: Yeah. 

Margaret: Yeah. 

Preston: Um, so, but even then I still feel pretty comfortable. Yeah. Yeah. If I was run those situations, you, you have months and then on top of that, every time you're on call, you're handling consults. So, okay. Tangents aside, I, I kinda wanna get to the final part, which is you have all these factors.

You did, identified some red flags, you identified some green flags, but ultimately, like how do you like rack and stack what you prioritize or, or weigh your options? Um, I, I have a bit of a, a soapbox on this, so I'll start with it. Do it, start out with soapbox and then I'd love to hear yours get on the soapbox.

So. I filtered through something, I, I call them like static factors and dynamic factors. But hold your horses. We're not doing risk factors for suicide. We're just [00:34:00] talking about your program. 

Margaret: Hold drugs. The 

Preston: basically static factors I saw as things that are not likely to change when you start residency. So that is like the climate of the place that you're in, the cost of living of the city, like where you are in like proximity to family.

Those are all things that you know are gonna like still be around when you show up. And then the dynamic factors, which all might still be positives, but are things like the curriculum, the call schedule, the program director even, even to an extent the culture of the program. So there were, like, I interviewed at one place that I thought was like, I really liked the program director.

I wasn't so sure if I liked the place. But then I kind of found out, like from a resident after our interview that he was leaving next year and actually, like if we were to go there, he wouldn't be there anymore. Like, well, if you pick a, a program solely based on the program director and how much you like adored them and you're like kind of sacrificing being close to family or somewhere else where you [00:35:00] would've loved to live, there's always a possibility they retire two years into residency.

And then you spend the next two years just kind of like stuck with where like the, the circumstances that made you wanna join are like no longer relevant in any way. So I would always recommend to prioritize those static factors that can't change over the dynamic ones. Mm-hmm. And, and that's, that's actually what I ended up doing when I was picking my residency.

I was like, you know, I, I want to be in a, a larger city where I'm gonna be around like other young people and there's like activities and things to do and there's a, an airport close by. Mm-hmm. And I kind of like, I almost like made that, I took that as a priority over a lot of the. I think small nuances in the programs that I saw.

Margaret: Hmm. Yeah. So you're saying the kind of things you can count on will be there, get to weigh a little bit more than things that are maybe a little bit less steady or less consistent? 

Preston: Yeah. Like for example, let's say your whole, your family lives [00:36:00] in California and you like this California program, but you're not so sure about like, their call schedule or Yeah, maybe, maybe their program director or something.

But you love this program director, but they're on the other side of the country. Mm-hmm. You know, and they're in Maryland and you kinda like their curriculum. Well, it's really tough because there's, there's a huge possibility, or not a huge possibility, but there's a possibility that you move, fly out to Maryland where you know no one, and then all, all of a sudden stuff changes overnight.

Margaret: Mm-hmm. 

Preston: There was like, like didn't NYU completely like revamp their entire call schedule, like after a match. I's like, I'm not sure. Double. Yeah. But yeah, I need to fact check myself now. But that's 

Margaret: happened. But there are, like, I've known multiple places that's happened. Yes. 

Preston: Yeah. There's huge overhauls in your schedule and, and people keep those cards close to their chest until after you match and then they can be dumped on you.

But you can count count percent being close to family will be close to family, you know, so I would advise that person if, if a lot of other factors are kind of even between those [00:37:00] two programs, absolutely pick the California program because you can count on, like the location is not gonna like change it up on you after you start there, but you can't count on those other things.

It's, it's about like kind of hedging with certainty, I guess. That that would be essentially the, the concrete advice that Preston would offer you. 

Margaret: I'm just laughing because my answer is gonna be, so I had a notebook and I would, I think I actually had a spreadsheet and I had a notebook and I would write down just like a little bit after each interview day.

I think I interviewed at like 10 or 12 places maybe. Yeah. And. I did. My thought was during this process, whatever I felt about the entire day, um, nothing else was really changing in my life day to day this. And so the variables were so isolated compared to if I had visited in person that I was like, the only thing changing about my life right now is what I'm interviewing with.

So I was like, we're gonna trust the vibe. You [00:38:00] controlled all 

Preston: the factors in your Yeah. Your independent re gonna trust your variables. Just the program. 

Margaret: We're gonna trust the vibe. Um, what I ended up doing was the programs that I felt like I had the best conversations with, like residents, program directors, like the teaching faculty.

I picked the top three or four I was ranking and they did this thing that I don't know if they were supposed, you know, they like, kind of like, if you have any other questions, dah, dah, dah. And I reached out to them and those three programs, I said, Hey, my dad is very sick. I want to be very forthright what has happened when someone's had a parent get really sick and what, what kind of accommodations can be made.

I don't think that's necessarily gonna happen, but we also both know what this illness is, and it was both a logistical move as well as I wanted to see how they reacted. And I did not, I mean, I had the luxury of this at some point, right? Like this is a ballsy move. Mm-hmm. But I do not recommend to everyone.

Um, [00:39:00] but it comes with being neurotic and being like, I'm gonna be a child psychiatrist when you're a child yourself at 15. Uh mm-hmm. And the program I ended up with was one of those programs. Um, but all three of the programs honestly reacted super well. And we're like, concretely, here's what we've done for people.

Here's how we would support you. And so all three of the ones I liked were that way. I will say I finished my, the day, I think my third interview was the program I ended up being at, and Nikki interviewed me. Uh, the Nicki we had on the podcast for a couples therapy. And I remember getting off the phone after the last zoom of the interview day and calling my parents and being like, I don't know if that place just felt right.

And 

Preston: I mean, if I interviewed with Nikki, I'd probably say any place felt right. 

Margaret: I love her so much. Shout out Nikki. She listens to the podcast. Um, but yeah, so I don't know. I think I like what tried to be logistical, but I also very much wanted to trust my feelings, which 

Preston: No, no, no, it's great. Like I [00:40:00] very like left brain, right brain approach from either of us.

So Yeah. And listeners, ultimately this is a decision that you have to make. We're gonna yap at you and give our opinions. You're probably gonna have a lot of people lay their opinions on you. And some of the, some of the advice will be good, some will be bad. 

Margaret: I'll let you talk about that study that you like.

But I do think that regardless for many people, regardless of where you end up, you end up loving the place that you spend the most time and attention on. Even if you're disappointed at first. Um, and I think it give yourself compassion in this process and on match day, but recognize that, I don't know. I think there are a lot of really great programs and it's such a formative experience to train in psychiatry that so many people end up finding the process regardless of where they end up really, really beautiful and deepening.

Preston: Mm-hmm. It, it's a bit of a cliche, but the grass is greener where you water [00:41:00] it and, and where you take the time to, to invest in yourself. The, the study that Margaret's referring to that I like to reference is it was one on satisfaction for residents. I don't think it was specific for psychiatry, but essentially they, they interviewed Pat or residents, I'm so used to saying patients when I'm talking about a study, but they interviewed residents about how they felt about their match at certain time periods after match day.

So like on match day. Six months later, 12 months later, 18 months later. And there was a huge discrepancy between how people felt towards their program. Either like very strong negative feelings or very strong positive feelings with the, you know, the excitement or disappointment that comes with match.

But around 18 months, most levels of satisfaction were about the same. So whether you're ecstatic on match Day, whether you're distraught on match day, there's a good chance that a year and a half from now, you're probably gonna be in the same amount of either both like the, with the slog and the successes that come with training and being in residency [00:42:00] because you're showing up and you actually have to learn how to be a psychiatrist and all those things that she thought really mattered didn't matter as much.

And you know, it's, it's still the inside of the hospital at the end of the day. And it doesn't really matter what state you're in. 

Margaret: And it's still a really interesting job with people and not just the inside 

Preston: darkness. Sorry. Yeah, that sounds, that sounds really negative. It is. It isn't. It's an interesting, intellectually stimulating and wonderful job.

Like I do, I do like the job. I just, I'm, I'm being al like, almost like overly pragmatically. That sounds negative, but yes. Thank you Margaret. So, um, I think that kind of concludes everything I wanted to say about picking a program. Anything you want to add? 

Margaret: Um, I didn't write in my, or I didn't match at my number one, and I'm very glad I didn't, and I know everyone says that retroactively, but truly I'm very glad I didn't for a number of reasons without shade to any program.

Um, but just, it ended up being, again, [00:43:00] you, you end up growing into whatever kind of shell they put next to you after, after med school and it was the right shell for me. 

Preston: Hell yeah. So we're gonna take a quick break and when we come back we're gonna debrief just what season two was like for us, where we wanna go with season three, how we're feeling about the pod, and kind of read some stuff about how you guys are feeling about it.

So see you in a bit.

Okay. And we're back to debrief. Season two. Season two. Congratulations. Thank you for joining us on this ride and how do we like it? How'd you feel about it, 

Margaret: Preston? How do you feel about season two compared to season one? 

Preston: You know, I think I got a lot more comfortable in the camera. I got a lot more comfortable just kind of like engaging in the art of podcasting.

I also started like, I think I [00:44:00] was raising my standards for myself faster than I could like keep up with my own improvements. I'm trying very hard to like. So I would get like frustrated when I would listen to the episodes back. Um, that I would say like too much or I'm like laughing at my own jokes and like, I, if it's funny, I'll laugh.

Don't get me wrong, you know what I mean? But I'm like, I just said like, again, but listening to it back, I'd be like, Preston, it's not that funny. You know, like, get to the point, man. So a lot of that was like, a lot of that was improvements that, that I could be making. And so I think I was hard on myself.

It's still, I still enjoy what we do and I think it's great. So it, it was weird. The small minute stuff I think was, I think the downside of season two. And on the other hand, I thought the content was really good. I really enjoyed our therapy episodes. I thought we had wonderful and interesting guests. So we had like Drew Ramsey and Allison Stoner, [00:45:00] we had this great variety of people and topics and some of my favorite episodes, like the lithium episode was.

A really fun, deep dive for me to do. And I enjoyed kind of telling the story of an element in a way that wove into psychiatry, which is the vision that I had for a podcast when I first started making this. So I think overall it was, it was a step forward and it was cool to see the community start to form in a way, like our, our Instagram is up to 20, a hundred followers now.

People comment, our close, close friend circle, they send messages with, with ideas for For pods, yeah. For episodes. And I'm gonna use them. Someone the other day said they wanted a Mercury episode after Lithium, and I said, say less. So whether you like it or not, there's probably gonna be a Mercury episode in season three.

Margaret 

Margaret: Psychiatry and Mercury. I'm actually gonna be sick that day. 

Preston: It's okay. I, we can do that. And then 

Margaret: you do another neuro episode. Let's, you know, bring on one of your neuro friends. [00:46:00] 

Preston: Yeah. Yeah, exactly. What, what did you think Margaret? 

Margaret: Hmm. It's kind of blended together for me in terms of this season.

I feel like ending residency, starting fellowship was kind of the time we've been filming it. We also were filming it, I think, right when we went to a PA and we've talked about this, the a PA conference that we were on a panel around like social media and advocacy and, and things like that in academic psychiatry and meeting people who actually listened to the podcast in real life was really exciting and, and kind of such a motivation to start out with the beginning of the season.

Mm-hmm. I think I don't listen back with, as you and I have talked about this offline, I don't listen back with as much of a critical lens as you do for yourself and. [00:47:00] I agree. I can stop saying like, as much for that commenter. Um, but I think there's also a question for us of, you know, some people are listening for this to be a lighthearted, natural conversation about something.

Some people are listening for straight, pure facts. Some people are best, the facts 

Preston: don't care about your feelings. 

Margaret: No spins.

Right? And some are coming for our guests. And so I think there's always this tension in creativity and in showing up in a public way. And this is true in the clinic too, of how do I ask myself to improve while at the same time recognizing that I am a certain sort of person and that is not for everyone.

Mm-hmm. Which I don't, I don't think that your critique of yourself is necessarily, not that I more just mean that for myself in reflection of. Improving [00:48:00] how concisely I speak with words or making things clearer, kind of thinking more in how we plan and being more creative. All of those things are things I'm driven towards to make better on my end for the podcast.

And then there are things that if someone was like, Margaret needs to get better about talking about neuroimaging, I'd just be like, you are just looking for a different person. Like, I'm just not that person. 

Preston: How do you be the best type of vanilla ice cream while acknowledging that some people are just gonna like chocolate question.

Yeah. Yeah. 

Margaret: But I do think psychiatry residency actually, you know, done well, makes you confront that question over and over. Like, you cannot be the right therapist for everyone. Mm-hmm. And it would be exhausting to try to be so, like, not just from a time constraint, but the, the longer that I'm in training, the more I realize that if I want this work to be sustainable, whether it's clinically or on this podcast.

Then that needs to stay pretty [00:49:00] close to who I am. It can't be a mask. And that's true therapeutically with boundaries. Mm-hmm. For me, I think it's true here too. 

Preston: Yeah. This, this should be an extension of ourselves and not another stage for us to try to perform on. And I think like sometimes, and you acknowledge that you're being recorded and I, I do feel like it's a stage, but I'm trying to kind of tear that wall down and just see this as what it's intended to be, which is almost a window in a conversation between two trainees, one soon to be attending who are like navigating life and learning about how to be physicians.

That that's, that's what we do. 

Margaret: Yeah. Well, and I said this to you when we started the podcast and you were, I wasn't aware that I was gonna be on the podcast yet. So a year and a half ago when you were talking about what you were thinking it was going to be like. And you had described that kind of, exactly that image of [00:50:00] being like, oh, let's go grab coffee after rounds.

And it's people, it's just you talking with other maybe a few years ahead of you trainees and shooting the shit a little bit, but also getting accurate information. Mm-hmm. Which is our goal. Uh, and I think it, I think it is that I think we can, as we were talking about earlier, sharpen some parts of it up.

Mm-hmm. And I think if people just wanted the most economic clear, concise sentences or discussions on things up to date is right there. But I don't think that's why people listen to us. Maybe to you, maybe not to me. 

Preston: No, I agree. And, and I think that vision that I first shared with you is something we get, are getting closer to and in some ways have arrived.

It's cool. It's, it's nice to see it take shape and I [00:51:00] think I'm, I've been saying that for a while, but we really kind of have started to get at least some footholds on this thing. 

Margaret: Mm-hmm. Mm-hmm. Yeah. Do you wanna go to viewers' comments? 

Preston: Yeah. So all that being said, uh, I wanna read off a couple comments and dms and things we, we've gotten over the years.

I'm 

Margaret: gonna pull up some of my, over the years, over the, the one year, not even one year of releasing episodes over the eight months. Yeah, yeah. For 

Preston: real. Yeah. I guess, yeah. Eight months, nine months. So, uh, here's a DM that we got on Instagram. I don't normally do this because I normally keep my inside thoughts inside.

On the off chance that you guys see this, I just wanted to say thank you for all you do. The work you're doing in the field with patients, educating yourselves and others, and your podcast media presence all make an impact somehow. I found the first episode of your podcast the day after it came out, and I've been a faithful listener ever since I've even re-listened to a couple of my favorites.

All of them, to be honest. It was very sweet. Thank 

Margaret: That's so nice. Thank you. 

Preston: Okay, then [00:52:00] we, then we got our more spicy one on you two. Love a spice this last week. Love a 

Margaret: spy. 

Preston: If these two eliminated, like from their mind dumps, the lengths of the episodes would be reduced by at least 30%, eliminate the inanity and the duration would re reduce by 70%.

I had a little trouble with this one because I just, I think I got confused by the math. Like is it the 70% reduced from the initial 30% reduction? So like that would put us at, I think about 20%. Or is it like he implying that it's like 30% and 70% is additive, so like the whole episode would then, you know, be 0% essentially.

Like 

Margaret: this is the anatomy they're talking about. 

Preston: Yeah. It might be, I guess that this is semantics and the giggles not a nanny and the giggles. Yeah. Take, take away the giggles and we have zero time. We have no content. 

Margaret: All right. That's all we got. You are a different show, sir. There's 

Preston: completely lack substance.

All right. Another one on YouTube. This was for our lithium episode. This was one of your best [00:53:00] episodes, two exclamation marks. Would love to see more episodes on Psychopharmacology and Mercury is coming soon. Worry not. That's when are we 

Margaret: using Mercury for a psychopharmacology process? Are you prescribing Mercury to your patients?

Don't wonder. They don't trust so nicely. I I see what 

Preston: you prescribe your patients. Okay. 

Margaret: I have one from, if it's on 

Preston: formulary, I'm using it. 

Margaret: I have ones from the Spotify comment section that exists. Um, I, someone commented this was on the history of burnout. Mid-career healthcare worker here, and I had to not burst out laughing mid reps, which we love that you guys work out during our podcast.

That makes us feel cool. Uh, when the harmonica came out, only starting to get really focused on my own health and who would've thunk that they weren't lying about exercise. Love having y'all in my ears at XOXO and we love to be in your ears, listeners. 

Preston: Yeah, I need to do the harmonica back. That's how we'll we'll do the intros from, from now on.

It'll help you get motivated for your workout, [00:54:00] 

Margaret: how to be patient.

Um, okay. Okay. I have one. I have one from the Spotify comments, which I do read, um, which I also discovered through our podcast that these comments exist. So the suicide risk assessments episodes. Someone commented, I've already listened to this episode twice and it's the most engaging, real, and informative podcast on this topic.

I have listened to love these guys. Approved by another psych inclined. Margaret Margaret's. Shout out, shout out. Unite 

Preston: All Margaret's. 

Margaret: Another comment under that same section said, ask Margaret to predict the weather on Boston Marathon Monday, because the opening part of the episode was present being like, how likely do you think it'll rain in six months?

Margaret, would you bet your life on it? 

Preston: Yeah, that was, that was a pretty wild prediction. I, I was like, I don't know if this analogy is gonna stick home, but we're, we're gonna try it anyways. We love a sideways 

Margaret: analogy around these parts. 

Preston: Um, here's, here's one from YouTube. [00:55:00] So this was on our, our pain episode.

This one was so good. It would also seem, after discussion how pain could, could be in and out of itself. An entire podcast pain is so complex and complicated for all the reasons you address plus so much more. Preston honestly started off with, sorry. We suck at pain treatment. It is a great way to start with a new patient.

Being honest with all patients is key to getting buy-in and being able to work with them as a team. Pain is such an important topic and it really does need a better understanding of treatment. So well done. Margaret and Preston. 

Margaret: Love that. 

Preston: Thank you. Yeah. 

Margaret: So as you guys know, on our Instagram, we ask questions and get a lot of questions from you guys, and it helps shape how we format the episodes, how we talk to our guests in our upcoming season, which we are already starting to plan some exciting episodes for.

Uh, we can tell you a little bit about what's coming up. We'll be doing an episode on AI and brain development with a very [00:56:00] exciting guest. We also have a guest coming in who is an expert in gun violence and talking about reducing risk of gun violence very concretely and clinically. In healthcare settings and in talking to our patients, which is a conversation that is more important than ever and that I think many of us and what they know from their data doing this with many different trainees are afraid to have or don't know how to have.

Preston's gonna be doing a mercury poisoning episode. 

Preston: Preston's honestly gonna be off on this entire, like either history of elements slash neuropsych side quest and I'm just gonna be going in and out, but I'll be around the whole time. Don't, don't worry. And, and with that, I have to say this is one of my favorites that I've seen you guys make me look forward to Mondays.

Thanks again for another great episode. And I think that's the message we wanna resonate with all of you, that we look forward to Mondays too, 'cause we [00:57:00] listen with you and we are so grateful that you guys tuned in, guys in like a gender neutral way. Like guys, guys and girls, people of all genders. Turn tune in, Preston.

Well, I think, I think that's it, right? Any, any other wrap up to do 

Margaret: what, what are you hoping to have in the next season? Any role? Play ideas, any topics? 

Preston: I'm honestly, I can't see past this Mercury episode. I think my, I might just do three or four episodes on Mercury. 

Margaret: I'll be on sabbatical. During though. 

Preston: No, I think I, I'm excited for the role playing.

Um, I think I actually want to do some existential therapy episodes. Oh 

Margaret: yeah. 

Preston: I don't have too many ideas for guests. I think I've seen you as like the LeBron James of getting guests I love for our pod. I 

Margaret: love it. I'm thinking about, 

Preston: can you and you, and we wanna play to your strengths. 

Margaret: Do you wanna hear how bad it's gotten?

I'm thinking about getting a business card just like [00:58:00] you do. You wanna come on the spot? You're pretty good. Here's information. Yeah, but I interrupted you. What were you gonna say? 

Preston: No, I and I, I'm good at finding rabbit holes and things that, that fascinate me and, and bringing them back. I'm, I'm like a hunter gatherer, but instead of berries and like nuts, I'm just like, look at these facts I found about like lithium ore.

Margaret: And they do stick and you're like, 

Preston: very nice honey. 

Margaret: Like, you're so good. Good job. Good job, honey. Okay, now give, get back out there. People love that though. People love the lithium episode. They love the deep dives and there are things I have learned from your histories that have actually clinically mattered, but you will not get me saying that more than once to camera mark's like.

Preston: Unfortunately, I have learned from press and led episode. Unfortunately, I, 

Margaret: my respect grows for you with every episode. Which is hard 'cause you're a man with a podcast at the end of the day. Yeah, and 

Preston: unfortunately I'm like applying act on myself after our episodes. You're welcome. It's okay. You bring 

Margaret: up bad art.

Half. Half the episodes for this season. I've done my work on you already. 

Preston: Well. Thanks again for [00:59:00] listening. This has been our, our season two wrap up. You know, where you can find us to communicate, but we'll always say it at the end of the episode here. I'm on Instagram and TikTok at its prerow. Margaret is on Instagram and TikTok at Badar every day.

You can always reach out to us on Instagram at human content pods or at how to be patient. So those are like the two podcasts. Accounts videos are always gonna be on my YouTube at its prerow as well, but you can find us anywhere you listen to your podcast on Spotify or, or Apple Podcasts. You could also listen directly on our website, how to patient pod.com.

If you wanna reach out to us directly there, leave us a voice note or send us a message, we'll be reading those and we'll, we might start including them on the pod a little bit in season three. Thanks again for listening. We're your hosts, Preston Roche and Margaret Duncan. Our executive producers are me, Preston, Roche, Margaret Duncan, will Flannery, Kristin Flannery, Aaron Corny, Rob Goldman, and Shahnti Brooke, our editor and engineers, Jason Portizo.

Our music is Bio Mayor Benzi. To learn more about our program, disclaimer and [01:00:00] ethics policy, submission verification and life. Terms and our HIPAA release terms, go to How to Be patient pod.com or reach out to us at how to Be patient@humancontent.com with any questions or concerns. How to be patient is a human content production.

Margaret: See you next season.

Preston: Thank you for watching. If you wanna see more of us or if you wanna see, this is lilac. She's my cat. She's gonna be waving her hand at one of the floating boxes, which will lead to more episodes. Lilac Point to the other episodes. Lilac doesn't know what the internet is, but I swear they're there. They, they probably exist for real.

But in the meantime, I'm just gonna pet lilac and then I'm gonna go dance in the background[01:01:00] 

and.