Season 2, Episode 1: Hacking med school, meeting Paul Farmer, and acing USMLE Step 1/2/3 with Dave Larsen

*You can skip ahead & Listen to the FULL interview RIGHT HERE!

Doctor Dave Larsen

When I was in medical school, our dean shared this book to the entire med school with an email saying “we don’t usually do this, but …” Here’s a screenshot of the actual email from February 2016, to which we owe today’s podcast episode conversation.

actual Google Groups email post from GUSOM Dean Cameron Jones

[1:00] Guest Intro. The bio copied directly from Dave’s Amazon author page:

David Larson (MD) is an integrative medicine physician, leadership seminar facilitator, entrepreneur, and new author. A native of San Diego, he ventured out east for college to study Business at Brown University. Filled with wanderlust, he spent a year in Pamplona, Spain on a Fulbright Fellowship and then went on to live in rural India, serving in the Public Health sector. He then attended USC School of Medicine and graduated with highest distinction, earning the Alpha Omega Alpha merit scholarship. He is currently in his final year of postgraduate medical training at UCSD, pursuing not just 1, not just 2, but 3 residencies in Family Medicine, Psychiatry, and Integrative Medicine.

[4:00] How long did the writing & publishing process take?

I actually began this process with a presentation to my 4th year medical school class. They found the learning tips and tricks super-helpful, so kept encouraging me to put it into book format. I put a poster up on my wall that says “Done is better than perfect.”

poster quote that Dave kept on his wall while writing a book from 4:30 to 6 AM every morning during residency

During summer 2015 I was chosen to be an audience speaker, on the main stage, at TED: you’re probably familiar with TED talks. That was the push, and even though I was really busy, I got up every morning and wrote from 4:30 AM — 6 AM. I wrote the book in a Word document, had my wife and a friend edit it, converted it to a MOBI format, and then just uploaded it to Amazon.

[9:00] What’s it like to run a Facebook forum since launching your book?

People fundamentally want to know how to make electronic flashcards to reinforce rapid learning of class material. [iFlash → Anki] So now I’m just trying to put out the best resources to help make that happen.

One day soon in there, I’ll post my TED talk: which was very well-received because we adjusted the lyrics to Cyndi Lauper’s Time after Time and added medical + physiology vocabulary in ~5 minutes.

[17:00] Biggest feedback you’ve gotten so far?

Amazing to hear from med students who were at risk of burning out find a way to live their life, do things for fun, cultivate relationships, and still exist as a human being. I’ve been there, I was burnt out, and was also desperate to find more time — anywhere. My story got published in KevinMD too:

“While contemplating the logistics of dropping out, I made a deal with myself that I would try my hardest to find a better way of learning this, and if that didn’t work, I’d cut my losses and look for a new career. I started by interviewing tons of medical students and new residents, I scoured the online student forums to find the best practices, I bought books on how to study in medical school, and then I tried out every strategy I could find…
After about three months of putting the best rapid-learning practices to use, my time spent on all medical school related activities dropped from 16 to 18 hrs per day to 2 to 3 hours per day, and despite this, my understanding of the material seemed to exponentially improve. … When the time to study for the USMLE Step 1 exam came around, I used these same techniques, and I was blown away to score in the top 99.7th percentile…
While I was grateful to have my knowledge of medicine and grades improve, what I am most grateful for was the shift in my state of being. By studying smarter, I was able to create more free time to live a healthier and more balanced life; spending time with loved ones, exercising, volunteering, and enjoying hobbies outside of medicine. With this shift, my burnout disappeared and was replaced by an inner sense of wellbeing. I found that as I took action to live a balanced life in line with my own deepest values, I not only enjoyed my free time, but also really enjoyed my time at school more than I ever had before.”

[21:30] What was the first big scare for you like?

I worked really hard in college to get a 3.6 GPA, I’m not a genius by any means. During the first 3 months into med school, I remember taking Core 1 and Core 2 classes, studying 15 hours a day, and then getting that first test back and it was only a 72%. That’s when I realized, something had to give.

[24:30] Mark Twain, Michael Crichton, Tim Ferriss, Paul Farmer — how did you come to see these people as role models?

I loved Doctor Paul Farmer’s method of working in Haiti instead of sitting in a medical school classroom, walking around doing medical flashcards with his girlfriend in between working with people who genuinely needed medical help ASAP and were going to die if he wasn’t there helping them. He would just fly back to Boston to sit down at Harvard Med School, take the mandatory tests, buy the next semester’s worth of textbooks, and then immediately leave again for Haiti.

Author’s note: this book changed my life and inspired me to serve the needy of the world with any gifts I develop, not just afterwards but during, so I hope it has similar effect on you too.

[28:00] Why did you write the section on big-picture goals and word-smithing?

Computer analogy: there’s an operating system and then programs. Most people are just looking for a specific program to use (this or that method), but I think it’s worth spending more time on upgrading the actual OS: actually asking yourself if you can push the boundaries of what’s possible.

Full disclosure: According to a classic technique, I’m trying to attract medical students with the title based on what they THINK they want at first, give them that, but then also give them what will actually be most USEFUL. The writing style was totally unintentional but Wayne Dyer is one of my favorite authors, may have been an influence, and I don’t care that much about actual grammar or MLA formatting.

[36:30] I took the survey you sent to our group. Do you have enough time to finish building out the course you want to?

The initial gut answer is of course not. And look, I have 2 dogs + 2 cats +a family + a house + great waves outside. Everyone has 24 hours in a day. Plenty of things I used to think were not possible are totally possible, so that forces me to keep asking it and applying it to more of my assumptions now.

The pie-chart paradigm Dave was referring to: happens to also be a quote made famous by Sec. Rumsfeld

I set aside 90–120 minutes at a time, whenever possible.

Also, on the where-to-study question, follow these guys at the world memory championships. It’s not a secret that novel stimuli help us make better memory associations, so it’s not necessarily a great tactic to always study in the same place. And you’re not going to be a doctor who gets to just sit down in the same cubicle/office and learn every day; every patient is different, every hospital is different, you’re going to be moving and changing on-the-fly and will always have to be able to adapt to the situation.

[41:00] What’s your favorite song to listen to while studying?

I use a Spotify playlist called Ambient house or Techno house.

[42:30] What’s the biggest revolution coming in medical education?

FOMED: free, open-source, medical education. Emergency med has really taken the lead on this. Students who try to consume info in a post-prandial food-coma will follow the steepest trajectory on the Ebbinghaus forgetting curve and basically learn nothing from all the time they’re putting into studying while exhausted and unable to pay attention.

in 1885, Hermann Ebbinghaus collected data to plot this exponential forgetting curve


*starting at [47:30]

  • Whose face pops into your head when you hear ‘The Ultimate Doctor’? definitely Paul Farmer: incredible doctoring, great mentor.
  • What is the coolest new medical technology you’ve seen recently? Electronic flashcards, for education, it’s really going to change the game.
  • What single daily HABIT is most key to your success? Other than surfing, it’s been organizing my workflow into these bursts: 90-minute chunks with diversified tasks, keeping it light-hearted, and working with most of my time on what I really love to do. “Multi-tasking is dead, long live batch-processing.”
  • Which book do you recommend to friends most often? The Power of Intention by Wayne Dyer. The human potential movement is great, I listen to it every 3 months, probably at 40–50 times so far.
  • What has been your biggest failure? Making decisions where I placed the power outside of me: like too much pressure to choose the right med school, best residency, etc.
  • my Inspirational Quote: I met the Dalai Lama, and he often says “My religion is kindness.”
Listen at [55:00] for my story of how I met the Dalai Lama too
  • What single mentor have you learned the most from? My mom, she’s a dermatologist with a super-high cancer cure rate. And besides that, she’s the ultimate model of a physician practicing with joy. They don’t buy into the 60–80 hour work week, and instead sacrifice income for balance and happiness.
  • If you could have a billboard anywhere, what would it say? “What’s worth living for?” → I’d have a hacker install that to pop up on everyone’s computer and smartphone.
  • What single thing do you want people to remember about you? I’m glad to just be myself and want people to know that I REALLY care.

Here’s how to get in touch with Doctor Larsen.

  1. Buy his book on Amazon (link above) & leave a review
  2. Request to join the Facebook group Medical School 2.0
  3. Implement everything he’s teaching in there
  4. Then I’m sure he’d love to include you as a successful case study!

Hey Ultimate Doctor, I’m truly honored that you read all the way to the end.

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