Interview with Dr. Chase DiMarco

In today's interview, Dr. Chase DiMarco explains how physicians can earn extra income teaching medical students.

Chase describes how difficult it can be for medical students to find clinical rotations. Unfortunately, the process of securing rotations can also be very expensive.

Chase created Find A Rotation to solve that problem. It enables preceptors to connect with medical students searching for clinical rotations. Fortunately, it is also at a lower cost than current platforms.


Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.


Who Is Chase DiMarco?

Dr. Chase DiMarco holds an MS and an MBA. And he is an MD/Ph.D-candidate. Additionally, he is the Founder of MedEd University and the CEO of Find A Rotation, a clinical rotations platform.

There is an expanding number of international students every year. We need to focus on increasing the number of rotations available.

He hosts the Medical Mnemonist Podcast and Rounds to Residency Podcast. He is also co-author of Read This Before Medical School, published in 2019. Chase is a consummate entrepreneur, author, teacher, and businessman.

Earn Extra Income As a Preceptor

As a medical student in a non-U.S. based school, he personally experienced the difficulty of arranging rotations. The process was expensive and time-consuming. At times, the rotations fell through. Painfully, he was often unable to recoup the high fees he paid to the Rotation Agencies.

As a result, he decided to solve that problem. He created Find A Rotation to link medical students to willing preceptors at a much lower cost. And he has systems in place to ensure that arrangements are secure and reliable.

To try it out, go to FindARotation.com. Click on the Register for Free Button and sign up by clicking on the Preceptor Link in the right column of the sign-up window. Chase will do the rest.

Closing

Dr. DiMarco is a good example of a medical entrepreneur who developed a business to solve two problems: finding rotations for medical students and helping physicians earn extra income. You can register as a preceptor using the above information. Or you can contact Chase directly at chase@findarotation.com or on LinkedIn.


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Transcription PNC Podcast Episode 217

What Is the Newest Way to Earn Extra Income While Seeing Patients?

John: Today's guest is a very interesting chap. He's a physician who always seems to be creating new services or products to help his colleagues. And today he is going to describe a service that I really didn't even know existed or could exist. Although, now that I think of it, there's definitely going to be a need for this. Dr. Chase DiMarco, welcome to the podcast.

Dr. Chase DiMarco: Thank you so much for having me. This is going to be an interesting talk.

John: Yeah, I've been looking forward to this. Again, a lot of my guests serve two purposes. Number one, they're entrepreneurs. They're creating something which I think is very inspirational to the listeners. And then number two, the thing they're creating, the thing they're doing might actually be a service or product that my listeners could benefit from. This definitely falls into that category today. So, we're going to learn a lot, I'm sure.

To get started, why don't you share a little bit about your background and what you're doing now?

Dr. Chase DiMarco: Sure. That's always the tricky one because there are so many different levels. How far should I go back? Well, I guess the summarized version is that I went to a Caribbean medical school and that really enlightened me to different ways of doing things than maybe some of the physicians that went to US schools.

Well, there are gaps in all of medical education, all education in general, that could be filled. And the ones involving what I went through personally are vast. I would say that, as you mentioned, a lot of people just don't know that they even exist.

I tried to work on different projects that are going to help students through this process, through these gaps that they might run into. And a lot of US students do as well. From a lot of my colleagues, I've heard some of the same issues. Finding rotations in certain specialties or learning how to learn or just how to bridge those basic sciences to clinical sciences to residency. And that has been the focus of my books, podcasts, and now FindARotation for the clinical rotations' aspect of things. That's kind of the summary of all the different projects going on.

John: All right. Well, let's take a break here and talk about your podcast then. You have at least two. I don't know if they're both active right now. So, tell us about that.

Dr. Chase DiMarco: Sure. The Medical Reminisce was the first one I started back in the beginning of 2019. And it was kind of a self-exploration as well. I knew that I was having trouble with certain types of material. My memory has never been the best. There is so much material you have to memorize for the board exams, especially when step one was still a scored test, which it's going away from in the next few months. And it didn't seem to matter what materials I used, how many times I went over materials. I couldn't necessarily remember everything.

I started looking into different ways of learning. And that's really where this podcast came from. It's using more mnemonic techniques, advanced mnemonics, not just acronyms because those generally don't stick very well. You can use them for the next exam, but then you forget them unless maybe they're raunchy or violent or something like that.

And at the time, things like Picmonic and sketchy medicine were really becoming more popular. There is medicine and medical. I always mix it up. As visual representations of these mnemonic devices, memory palaces, visual markers. So, I started learning from a lot of them, from people that teach them mnemonic and from cognitive psychologists, and would have them on the show discussing how we learn, discussing different ways to implement these techniques.

That's gone on for quite a while now, and there are a lot of variations in the types of guests there from physician educators to these mnemonics trainers, to cognitive psychologists, and just kind of a fun way to learn more about how our learning works and effective learning techniques.

John: All right. Let's stop there for one second because I want to do a fun thing. I want to challenge my listeners to say medical mnemonics. Is that how you do it?

Dr. Chase DiMarco: Yes. Like mnemonics.

John: Exactly. That's worse than saying, I don't know, something else, chrysanthemum or something. So, medical mnemonics. Okay, go on.

Dr. Chase DiMarco: Yeah. A lot of people can't get that word and Google doesn't recognize it as an official word either, so it's perfectly fine. And then later that year I started the rounds to residency. It used to have a different name, but now it rounds to residency. And that really was trying to bridge sort of the basic science to clinical science gap.

That mostly interviews physicians that either currently do precept students or used to precept students and helps to give those clinical learners a little insight into all the different specialties into the different demographics of patients of geographies and what is expected from them.

Because that's just something that at least at the time didn't seem like it was really covered. At least for a lot of the students I know and have worked with, you finish your basic sciences, and then you're just kind of tossed into your clinical rounds and not necessarily know what to expect or how to do your best or how to stay motivated, how to ask for a strong letter of recommendation and all of these things that are very important for your residency.

That podcast really helps to guide them on some of the different terrain, different questions. And just with the hope of making them more prepared for their clinical rotations.

John: It kind of worries me when you talk about the second podcast and the need for going from that basic to the clinical because I think it has been almost 40 years since I did my first rotation and talk about being thrown to the wolves. I had no clue. I showed up at the VA and I was going to be on call every third night. I didn't even know I was going to be on call till the first day I showed up and they said, "This is what you're doing". And much less the clinical side. So, I think every bit helps to get that transition. That sounds cool.

Dr. Chase DiMarco: Yeah, there's definitely still a huge gap in a lot of schools, whether they be foreign or US schools. So, hopefully, that helps students that aren't really prepared for another.

John: Well, there's so much now available, whether it's blogs, there's a lot written, there are a lot more books. There are eBooks, there's all kinds of things that can help medical students and actually students getting into medical school, medical students getting into residencies. It's definitely a lot better than it was 30, 40 years ago. Now you were also the founder of MedEd University. Maybe you can tell us about that.

Dr. Chase DiMarco: Sure. That's recently gone through rebranding. It used to be freemeded.org. And if anyone listens to my old podcast or anything, you'll hear that term thrown around a lot.

But that was something I started with my first semester in med school as just a repository of information on websites, of free quizzes online, of YouTube videos that were very popular to act as a supplemental resource. And after a few years, I started being knowledgeable enough to start making my own content for it and have partnered with others that are now making content for it as well. So, the podcasts are kind of a part of that, so I started off there.

We have a new academy that's like Coursera or Udemy that allows any instructor that would like to join us, to host their courses for free, charge if they want to, and just act as sort of an online MOOC - Massive Online Open Community for just strictly healthcare education. So that is kind of the new direction that is going.

John: Okay. I never heard of a MOOC before, but that's a good one. Massive, now that's interesting. But I say this because actually one of my partners and I are in the process of opening a community for physicians. I should know a term like MOOC.

Dr. Chase DiMarco: It's mostly something that I heard used a lot when Coursera, some of those college-based university-based courses, were becoming freely available for the masses. So, Massive Online Open Courses because anyone can join them.

Now, ours is set up similar to that, but it's really closer to Udemy where you have independent instructors and whatever material they feel comfortable in teaching, or want to teach, want to get out there, we can help support them with tools, with free hosting and really just trying to help more educators in healthcare produce the content that they want to. A lot of people want to create a podcast or want to create a course, but there's a huge barrier to entry. So, we are trying to limit that and support them with our services.

John: That's very interesting. You're really into education, but definitely from an entrepreneurial point of view. It seems like every time maybe there's an itch you need to scratch for yourself, once you master that, you're going to share it with other people. That's a pretty common trait of an entrepreneur.

Dr. Chase DiMarco: Yeah. And I always say collaboration is much better than competition. We can do a lot more working together with similar goals than fighting against each other and trying to win on Google ranks or something along those lines.

John: Yeah. All right. Well, that's a good bit of background and these things of course are ongoing. I'll put links in the show notes to all of this if people want to check it out. Of course, many of our listeners are a little bit past the med school stage and residency, and now they're in practice. Many of them are looking for maybe something else to do or a side gig and that kind of thing.

That's where the next issue comes in, the next topic, which is something called FindARotation. Tell me what that is and what it provides and why you decided to start this latest venture.

Dr. Chase DiMarco: Depending on the background of most of your audience, they might be slightly aware of this and some might not have any idea what this is about. But basically, what happened for me and happens with a lot of schools, whether they be newer US schools or foreign schools, they have trouble finding affiliate agreements with hospitals to send their students for clinical rotations.

What a lot of them will do is hire third-party agencies, these rotation agencies to fill the spots. And of course, the problem with any sort of agency, with any sort of agent is they take a huge cut themselves.

I ended up using some of these agencies in my third and fourth years, and some of them through the school, some independent, because there are just limitations in which types of rotations or which locations that I wanted to try to practice in, to network with.

And actually, in the end, I ended up spending around a thousand dollars per week on some of these rotations. There was no cancellation policy and I ended up not even securing the last four or five rotations through one of these companies. And that's when I said there is definitely a better way to do this. These really come off in my mind as predatory. And a lot of companies do take advantage of foreign students because they need help and they don't have options. They don't have any power locally to do much. So, I said, "Well, what are some of the really big companies right now that help to really automate as much of the process as possible to reduce costs for everyone and allow more people to get involved?" And the ones that come to mind are Rideshare, Lyft, Uber, or something like Airbnb or VRBO.

These companies allow anyone with the right credentials to join their service. They don't need to set up their own company or set up their own website or try to compete for a share of the market. And by allowing more people to be crowdsourced and offer the resources that were previously untapped, you allow for cheaper affordable services for the client, in this case, the student.

The whole goal is in the past few years we've been doing R&D for this. I have been manually matching physicians to students free of charge, but obviously, that's not scalable. We've done a lot of different I'd say alterations and updates, and it'll allow physicians, clinicians to host their sites, whatever clinical site it is. They can set the requirements they need from the student, the types of students, the number of students, and whatever their compensation is. So, it's completely up to them.

It's meant to be as simple as renting out your house or a room on Airbnb or something along those lines. And then the students can go on and search by location, specialty price range, and find what's proper for them, what they want to. Whether it be a certain specialty that is too competitive that they can't get through their school. I know my school used to offer lotteries for competitive specialties. And also, if you're trying to find a certain location, this'll give you more of a variety of options than you might have through your local university.

John: It matches people up. I've seen this with services that match, let's say a physician looking for locums to a site. Again, try to cut the middleman out, try to get enough of a number of sites and physicians to make it work. But when it works, it works great. As you said, the costs are less, it's more convenient. You're doing the work of matching things up so they don't have to call a hundred people.

Let's just see how this would work. Just correct me if I go through this improperly, but we just go to findarotation.com. When we open that, we will see a landing page or sales page or whatever you want to call it, it's the homepage. And then there is some information you can look at and download some things, and then you can hit the "register for free" button. And then that takes you to the page that has signups for students and preceptors. And obviously, if you are a preceptor, then you should just put that information in, and then boom, you'll be in the system. And can then from that point, interact with you or whoever the system, and start to look for students to fill in rotations.

Dr. Chase DiMarco: Yeah. And they can go to the Preceptors tab. They can reach out through there or to sign up for the newsletter, be updated when there are updates to be had, contact me directly. And still, at the moment, I'm matching everyone individually, but hopefully, that'll become much more streamlined when the new one is released.

John: Okay. Now give us a little background on this. You've talked about why there's a need for this. What would be reasonable? We don't want people to go in there "Oh, good. I can make a couple of thousand dollars a week spending a couple of hours a day with a student". I mean, it doesn't seem to make sense to me. So, what would be reasonable? What is being paid now? If you're going to compete with those rotation agencies, I guess you call them, then they need to be competitive. So, what would you ask or expect a physician to do? Let's say I'm a specialist, there might be a bigger need for that. Tell us in more detail.

Dr. Chase DiMarco: Sure. There's a lot of variation, obviously, depending on which specialty it is, and also which geographic location you're in. Some cities and states are going to be more expensive. Sometimes the hospital you work for might have more paperwork that you have to go through and just the process is longer.

But from my experiences and those of other students that I know that have used these rotations in the past, there are occasionally some physicians that will donate their time for free. And that is definitely welcomed. We would love to have a host of physicians that are offering their services that currently accept students. And we can at least take some of the work away from them. So, they don't need to worry about the paperwork and the scheduling at all. It'll all be done in that.

But those that are looking for that extra revenue stream, again, depending on the specialty and other factors, usually a few hundred dollars per week is pretty normal. Say maybe $200, $400 a week for something like a private practice family medicine, and up to around $1,000 a week plus or minus for certain specialties.

Now, granted that price also includes the agency's fee, which from our calculation is based on their numbers that are publicly available, it's about a third of the price. That right there makes it much more expensive for the students, unfortunately. Some schools will cover X amount per week as part of your tuition, but that's something that definitely needs to be discussed with them beforehand. And as soon as our new version comes out, we're going to try to form more of these partnerships, more affiliations with schools so that everything can be done more easily for the students.

John: Now, I have done some precepting in the past. I'm still working clinically very limited and I don't do any more precepting or teaching. Mostly I was with NP students, but my recollection was they had contracts. They had agreements that you have to sign and of course, have to provide them with some information so that they knew as a faculty, technically you met certain requirements, but they were usually fairly minimal. So, is the same thing applying in this situation?

Dr. Chase DiMarco: Generally speaking, yes. Especially in hospitals, they're all going to require certain types of documents to be signed. Some are pretty general and standardized. Some are very specific to that hospital system. The good thing is once a preceptor signs up, they can upload these documents and everything can be done electronically. The student or school in the future when we have school accounts, can upload any documents and send them to the preceptor.

And the preceptor or hospital can upload any of their documents, send them to the school or student and everything can be signed and documented very easily within the app. Of course, that's with the next version of it. So that's not available quite yet.

But hopefully with automating a lot of these e-signatures and the process in general, not having to print everything out, and also being able to keep records of everything, that really helps for students when they apply to residency and need proof of everything that they've completed.

John: Thinking ahead a year or two or three down the road, what do you think the scope of this would be in an ideal situation? I'm assuming that the demand for placement is going to continue. There is no other national free registry of any sort that will get people into those rotations apparently. What do you envision things looking like in a year or two down the road?

Dr. Chase DiMarco: The ability of this thing to really grow and expand is nearly exponential per year. The only thing close to this that we're aware of is VSLO - The Visiting Students Learning Objectives is what it's called and that's through AAMC. That system was really, really bad. And I know they've redone it recently and hopefully, it's better, but I've talked to dozens of physicians that used it for their schooling and never heard a positive thing about it. It was just clunky. It was usually outdated.

And even when you try to use the search criteria from them, it would always bring you to a separate website for that school, for that hospital and any kinds of fees and paperwork didn't translate. It just became quite burdensome from my understanding of it.

This can definitely replace something like that, but also there is an expanding number of international students every year. Current IMG, FMG foreign medical students, international medical students, and graduates make up something like 25% to 30% of the current physician working workforce. And the number is constantly expanding. And there is more competition between mid-level providers and MD/DO students.

There is still a lot of need for more clinicians. We need to probably focus on more ways to increase the number of rotations, increase the number of residencies and not decrease them. I think that it's going to prove to be so much easier. It's going to reduce hospital administration and school administrator time so significantly that there is no reason not to use it.

John: Excellent. I had a specific question about it as I was thinking about this and if I was in the position. Are there any sort of areas or workarounds or what do you have to do, let's say, if you want to be a preceptor and you want to make some extra money, but you're let's say one of a thousand doctors working in a large more or less corporate environment? Are there barriers to that? Do you leave that to the physician to figure out when doing a contract with the organization, and then they forward whatever fees to that doctor? Or have you even encountered that?

Dr. Chase DiMarco: Well, if I'm understanding the question right, there are a lot of different ways that a physician can be set up, as far as an independent contractor, work in private practice, working in a group setting. It does vary quite a bit, but let's say we'll take the hospital setting for instance. A lot of hospitals and university hospitals are some of the more strict ones that will have limitations. For instance, a lot of hospitals won't accept international students at all, or will only do so in a limited fashion.

But most of them do have a loophole where they will allow a physician to independently sponsor a student. You really would have to check with your institution or your group for that to see exactly how they work, but usually, there is a way around it. And it's becoming more and more common even for specialists to have independent practices and private practices. Those types of sub-specialties who it's been harder to find generally rotations are now leaving hospitals in greater numbers, which is providing more opportunities for students as well.

John: Well, certainly more care is being provided in the outpatient setting. Everything is moved out of the hospital compared to 10, 20, 30 years ago, for sure. So, you're going to need a lot of those rotations.

All right. I wanted to ask you. We're just shifting gears here to this whole entrepreneurial thing. What were some of the biggest challenges? You've done different things and this one seems to be potentially pretty complex. But if you were giving our listeners some advice, because I'm sure many of them have ideas or how to improve things, maybe this should be a business or it could be a business. So, what did you discover going through the process of the latest enterprise?

Dr. Chase DiMarco: I would say at least for this one, the biggest issue has been just the app development itself. Anyone that has actually listened to me talking about this concept in the past few years will probably follow the chronological order of, "Oh, we're using a new company" because that constantly seems to be happening.

App development for most physicians, if they're talking to us a programmer or an engineer talking to us is kind of like us talking to a kindergartener about the intricacies of pathophysiology. There is just such a knowledge gap there. They'll always promise they can save the world and give you everything that you want. It usually doesn't end up being the case.

Due diligence and really finding someone in the know that you trust to help you out can save some of those headaches. And there are a lot of new alternatives now with this kind of piecemeal DIY app development software. I don't have a lot of experience with those. Obviously, if you need something very, very complex, like my idea, it's probably not going to work out so well, but if you have a simple platform or an e-commerce site or something along those lines, go easy first. And then if nothing else, you have a concept to bring to an app development team later on and they will be able to understand how it should work better.

John: Yeah. I recently sent an email talking about creating your own app and it used to be like, "Wow, let's just create an app. It's simple. You can learn how to do it, and you can make a lot of money". Those days are long gone.

I had one guest, Dr. Kirsten Limmer. She ended up developing her own app, but she had to do a lot of studying. And she used one of the sites, I think that you're relating and mentioned where it's kind of a combination of a course/limited consultation and they'll help you, but you really have to learn how to code at some level or you just farm it out and pay a lot of money. So, that's basically your choice at this point from what I understand.

Dr. Chase DiMarco: Yeah. I think bubble.io is one that's pretty popular right now. They do have some walkthrough tutorial videos to give you a basic understanding. So, you can go through that, see if you enjoy it. And if not, then you're not going to continue making something yourself.

But it's really hard finding a company too. The first one I went through was a recommendation from a company that I was working with at the time. When they gave me a "good deal", I thought, "Oh, awesome", because we know the same people. Just to find out that they really couldn't provide anything close to what they promised.

If you can find someone that does know, that might be able to explain certain things to you and translate your entrepreneurial idea into an engineering understanding, then that's a good way to go about it.

John: I've seen some people take the approach that they would basically partner with somebody as or like their chief technical officer or something. Although I have heard many people tell me that you should never have a partner in a business. So, you have to figure that one out, I guess, for yourself. My wife owns a business and she's like, "I will never have a partner. I want to make the decisions. And that's the end of that conversation".

Dr. Chase DiMarco: I tried to do that with a friend of mine that he's very knowledgeable about computers. He's basically a CTO at another company, but he doesn't know too much about app development. So, he was like, "Nah, I wouldn't feel comfortable there".

John: Yeah. That probably doesn't help much. Okay, we talked about FindARotation, how to find that, and how to sign up there. How about just getting a hold of you? What would be the best way? I think you gave me an email earlier.

Dr. Chase DiMarco: Yeah, chase@findarotation.com is fine to email any questions about that. Of course, any social media accounts for myself or for the company is perfectly fine. I usually get to them pretty soon if I see them. Chase DiMarco, FindARotation, MedEd University. I know there are too many things to mention.

John: Some people like using LinkedIn, some people like using email directly to you. Was it chase@findarotation.com?

Dr. Chase DiMarco: Correct.

John: Okay. They'll figure it out if they have questions, but I think if they're interested in being a preceptor, just sign up. It's working now, you're connecting students to rotations. So, if someone wants to make a little bit of extra money and enjoys teaching, this would definitely be something they can do. And particularly if they're thinking about it and they need to make a little extra money and why not.

Dr. Chase DiMarco: Exactly. And if the beta version app is glitchy, then just email me directly and I'll help you out.

John: All right. Well, this has been very interesting. Any closing thoughts before we let you go today, Chase?

Dr. Chase DiMarco: Well, I would just leave it with this. There was a huge need for this type of service prior to COVID and now with nearly two years of in a lot of instances, students not being allowed in hospitals still in many states, there is definitely a need for more individuals such as your audience to participate in this and to share their knowledge and wisdom. So, I definitely hope to see more of you participating.

John: Yeah. That kind of blows my mind. One of my kids is in nursing school and her clinical rotations have consisted of no patient care whatsoever for the last nine months. And I'm thinking seriously? Well, that's going to cause a real backup.

Dr. Chase DiMarco: Oh yeah. We have a couple of years.

John: It's been really fun. This is interesting. I love talking to physicians that are entrepreneurs. And so, with that, I'll just say goodbye.

Dr. Chase DiMarco: All right. It's been great sharing these ideas and I hope it's interesting. And thank you so much for having me on.

John: You're welcome. Bye-bye.

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