Feb 2, 2021
Why I Left UCSF Medical School (for now)
How my mental health journey as a medical student led me to pursue a wellness venture
“Why not?”
I was stunned. This was not the response I was expecting from my therapist. I had just told him about my startup’s rejection from YCombinator, and that the program had recommended my co-founder and I leave our graduate programs to focus fully on a new health startup company called shimmer.
After all, my therapist knew that my whole life I had been racing to become a doctor. My dad and grandfather are both physicians. As the only son in the family, I was fulfilling the legacy that had been set out for me long before I was born. The stars had aligned for my parents when their son was accepted to UCSF medical school.
After my first year and a half in the program, I had come to realize that while my path towards medicine was not an easy one, it was always the safe and familiar one. My therapist’s response and subsequent questioning made me think more deeply about why I had chosen medicine. As a doctor, I would help heal people, and I would also be financially secure.
When people asked me “why do you want to be a doctor” my answer was always “a lot of reasons.” And that was true.
My love of academics and clinical research played a large role: I’ve very much enjoyed my time exploring the complex world of AI and healthcare. But more importantly, I was driven by the ways illness and injury had touched my life: losing my fingers in a freak snowblower accident, my family and its battles with cancer, my friends and their struggles with mental illness. But these experiences could have pushed me in a number of directions, which I wrote about in my last Medium post.
Over time, I have discovered other ways to help people. In college, I learned I love to build communities. Two organizations I helped found — a student group for hospice volunteering and a science tournament for high schoolers — have since flourished: the latter now engages 700 high schoolers annually. In medical school, I helped develop MD++, which now helps over 600 medical students find non-traditional paths towards innovation in business, life sciences, and technology.
The pandemic has given me much time to think about the question: “why do I want to be a doctor?” And I’ve learned that my answer is increasingly less certain.
As the time for clinical rotations approached, these questions became more pressing, and my anxiety progressed similarly.
It almost seems selfish to take time off medical school, especially during a pandemic, when skilled doctors are needed more than ever. However, over the past few months, my anxieties have spiked and I have come to realize that, at least for now, addressing another public health crisis has weighed heavily on my mind.
Even before the pandemic, our mental healthcare system was already on the brink of collapse. Today, 1 in 5 Americans suffer from mental illness but there are only 106,000 licensed therapists. Our system has no proper way to support the growing number of Americans who need help and mental health clinicians have been at capacity for years. Just last year Kaiser Permanente’s mental health staff went on strike due to understaffing and overwork.
COVID-19 has pushed mental healthcare to its breaking point and beyond: since the pandemic reached the USA in March of 2020, anxiety and depression diagnoses have increased threefold, especially among young Hispanic and Black Americans. Because of my background in healthcare, AI, and entrepreneurship, I realized I could help people access the mental health resources they need. I just needed to commit myself full time to this endeavor.
As with many children of first-generation immigrants, mental health and wellbeing are new concepts for me. In China in the 1950s, mental health was not something that was discussed — other more immediate needs took priority, like food, shelter, and education. My maternal grandmother fled to Taiwan after the execution of her father and grandfather, while my father came to the US for a Ph.D. program arriving with nothing but a suitcase and $40 in his pocket.
Perhaps because of this, my family has not had the education or resources to address their own mental health needs and difficulties.
I first began to recognize the importance of mental health through my Uncle Tom who has Autism. He often talked to himself, had repetitive motor movements, and fought with others in the family. At family gatherings, there were always hushed whispers around having to take care of him and callous jokes made behind his back. I was assimilated into the stigma that surrounded mental health, and this was the world-view I brought with me as I entered medical school.
Between caring for patients and preparing for exams, medical school has placed me in stressful and emotionally-charged situations — I cried many times this year, often in front of my peers. On one occasion last year during a discussion group, while reading Michelle Yang’s narrative, “My Mental Illness Did Not Prevent Me From Succeeding, But The Stigma Nearly Did,” I found myself realizing parallels between the narrative and the recent suicide of a friend from my hometown in Minnesota.
Asian-Americans in school are three times less likely to seek mental health services despite being more likely to consider suicide, and my community, unfortunately, faced a similar loss. At that moment, I decided to start seeing a therapist.
After dealing with the shock that followed my friend’s suicide, my therapy sessions eventually evolved into a recognition of my chronic and progressive generalized anxiety. In therapy, I learned about intergenerational trauma — my ancestors often struggled to survive, leading them to develop unhealthy coping mechanisms passed down generationally.
I hadn’t ever really considered the multiple jobs my parents worked, the new language they were forced to learn, or the historical atrocities they overcame. My therapist helped me contextualize and accept my anxiety within the framework of my parents’ hardships and lived experiences.
Though I have seen it in myself and my community, mental health issues are obviously not unique to Asian-American culture: since the pandemic began, the prevalence of mental health conditions has skyrocketed, and is highest among young Hispanic and Black Americans. Motivated by my personal experiences, I volunteered with SF homeless shelter’s mental health peer support group (before COVID hit and we had to close our doors).
Through my involvement, I was exposed to countless heartbreaking stories — I still remember when Fred (name changed for his privacy), who had worked all his life to become a nurse, became homeless after spending his savings on his father’s funeral. These experiences impressed upon me the importance of a welcoming space to share struggles and be heard, and how people from all walks of life sought that comfort.
While volunteering was rewarding, it still frustrated me to consider how many people were unable to access proper mental health care. But this experience helped me see the power of peer support, and just how much this scientifically proven model of care could help those who could not afford or access traditional therapy.
Over the past couple of months, the shimmer team listened to over 157 peer specialists, therapists, and patients to learn more about the problems people are struggling with. Our current system does not properly provide care for young underrepresented adult populations. This is extremely important, they are affected by mental illness at 50% higher rates with suicide being the 2nd leading cause of death among people aged 10–34.
Young adults are faced with two options: meditation apps ($10/month) or therapy ($150/session), neither of which responds to their unique developmental and cultural needs. I believe a key component to addressing the mental health crisis is to provide affordable and accessible models of care for young adults before they develop severe mental illnesses. Specifically, three things continue to bother me:
- Accessibility: Today, there are 50M adults who suffer from mental illness but only 106,000 therapists. The average wait time for therapy is 25 days, and 79% of youth and young adults do not access care. Therapy is expensive (~$150 per session) and younger underrepresented patients are less likely to be insured or have the means to afford care.
- Continuity & Support: Mental health is much like physical health: it requires continued evaluation and support rather than the current one-off nature of therapy. 40–60% of patients drop out of care after their first visit. Patients need supportive and engaging models of care they can turn to throughout their lifetime.
- Cultural and age competency: There is a lack of mental health services that support the unique cultural and developmental needs of young underrepresented adults (today, 86% of therapists are White). This is extremely important as 75% of mental health conditions begin by age 24. A lack of early intervention creates expensive consequences for our health system.
The pandemic has a silver lining: it has changed the way we interact with technology, and with it, much innovation has sprouted to help tackle our growing mental health crisis.
Shimmer is a public benefit corporation defined by our AI-driven support group software and by our focus on young adults. We make mental health more accessible by empowering those with lived experiences rather than using therapists, these coach-led groups are much more affordable and scalable.
We offer a platform where individuals can chat on voice or video whenever they need to and emphasize a journey of growth, rather than the one-off nature of current therapy.
Finally, we personalize the experience by matching people into groups that deliver tailored content, curriculum, and treatment options.
Our team envisions a world where mental health services aren’t locked behind 25 day wait times or $150 price tags. Where starting your mental health journey isn’t so confusing and people have a place to easily access longitudinal help. A place where you know your friends and family will have personalized and supportive communities to talk about the struggles they’re going through.
I recognize that this is a choice that comes with many privileges — I am fortunate that I have the financial and emotional support to do this. My therapist has been an incredibly important resource in helping me reach this decision. UCSF was generous and accommodating when I informed them of my plan to take a leave of absence, and my shimmer team has fully embraced my move to full-time.
As a medical student, I have learned many lessons about empathy and patient care, and my experiences with mental health motivate my desire to serve others in similar and often worse situations. I’m confident that if I do return to medicine, my experiences with shimmer will have led to a renewed vigor and passion for the discipline.
To truly help people and their mental health, I need to focus on it exclusively, professionally, and personally.
Though I do not know exactly what the future holds, I hope to apply my newly learned skills and my passion for medicine to advance health in my own and unique way.
Thank you for reading my story. Please reach out if you want to chat or learn more: jon@shimmer.care
