Brysen Keith, DO, PGYII, Shares His Experiences and Gives Advice to Residents 

Dr. Brysen Keith is a PGYII at Miami’s Jackson Memorial Health Center. While he is someone who fits the mold of “taking the road less traveled,” that is the only mold he fits.  

With a dual degree in biology and environmental engineering and a master’s in bioengineering, and with experience in surgical device consulting and design, this resident didn’t follow the traditional path to medical school. He also hasn’t followed the traditional curriculum in medical education, choosing the “1+3” program at A.T. Still University School of Osteopathic Medicine in Phoenix, Arizona. The concept values the idea of absorbing experiences and education by becoming immersed in the clinical setting early on and provides a valuable opportunity for students to receive hands-on training quicker than with the typical “2+2” model.  

As a young doctor starting out, what is Dr. Keith’s advice for up-and-coming osteopathic internal medicine physicians?  

“There's a big difference in how medicine was traditionally practiced and viewed 40 or 50 years ago. It was a time when whatever the doctor said was what was going to be done and there was no questioning it – versus now!  I think it's very much a two-way street, especially with the advent of the Internet where you have so much information,” ponders, Dr. Keith.  

Yet, while he believes there are many aspects of medicine that are changing for the better, there are still many hurdles for want-to-be, new, and established physicians to overcome. His first concerns are the financial barriers faced by underrepresented minorities who hope to become physicians. “It’s tough to break into medicine. Number one is the financial aspect of it. Just taking the MCAT can be up to $400 a pop and there’s a high cost for medical school applications too! I probably spent over $2,000 alone on my med school apps,” he said. 

As a resident in one of the country’s largest hospitals serving immigrants and others who can’t afford medical care, his heart is in advocating for the traditionally underserved. Yet he is also concerned for his peers who don’t fit into the stereotypes of being a physician.  

While he has seen movement in the right direction, as a gay man he is sensitive to the biases that exist. “Ironically enough, gay white men are the only minority that is well represented in medicine” he says. “There’s an interesting study that I read about why there are so many physicians and lawyers who are part of the LGBTQ community. It is thought that because growing up we were probably more marginalized and maybe not the most popular kid in school, so we gravitate to positions in fields that inherently have a lot of respect built into them.” 

Mental health is not only something he has been concerned about, but it has also been the center of his advocacy work through organizations like the NBOME where he focuses on the stress of licensing and testing. Yet, he recognizes that mental health concerns aren’t just a worry for students. 

“The unfortunate reality is that medicine is very taxing and there's a lot stacked against physicians leading to all sorts of reasons behind physician burnout. The impact I would like to make from an advocacy standpoint would be to try to make light of those big systemic issues that make medicine stressful. I want to look for novel ways to address them. I know that if you asked ten residents if they would recommend someone go into medicine now, nine out of ten would say no! I think that's very enlightening. I very much love what I do, and I am really good at being intentional about when I leave the hospital. I don't take work home, and I know exactly what I need to do to make sure my mental health stays where it should be. But I think I'm in the minority especially as residents go,” he said.  

How does a student or resident combat feelings of inadequacy or burnout early on?  

“I would say probably the best way is finding a mentor who is part of the community you identify with, and who can share some of their hard times with you and understand how they view different things. I think that is important.”  

Dr. Keith is encouraged that many colleges of medicine (COM) do a good job of linking people up with potential mentors. He suggests students be proactive to find out about those programs at their COM and connect to other physicians through an ambassador program. He believes that other places to find camaraderie are professional organizations, like the ACOI.  

“You're only going to reap benefits out of being a part of this organization and other DO-specific organizations. I encourage residents and students to get involved because there are a lot of changes coming, especially in the field of osteopathic medicine! For the longest time osteopathic medicine was very much like an old white man’s club. Today, the reality is that the newer generation, the newer physicians in practice are much more diverse. I think it's very important to be an advocate for our generation of physicians because there are a lot of very significant differences in opinion on important issues in healthcare right now and a lot of topical things that I think are really important for the younger generation to be very loud and proud about.”  

He credits one of his favorite reads, a book called “Range,” by David Epstein as something that inspires him. The book recognizes that individuals with a variety of experiences are the ones who truly thrive in a world that overemphasizes early specialization. It's something that I carry in the forefront,” he says. “I never want to be that person who is so narrowly focused that they treat every problem the same way.” 

“In America, we often teach kids at a very young age to be one-sport specific. But if you look, there are studies that show that most professional athletes are actually multi-sport athletes, and it is because they are multi-sport athletes is why they're so good at one sport! That translates to a lot of different things, including medicine and how certain subspecialties can treat different pathologies inappropriately. It goes with this idea that if your only tool in the toolbox is a hammer, then every problem starts to look like a nail. It is very evident in medicine especially from a physician standpoint, that to have a wide variety of experiences since, after all, you're treating patients who come from a variety of experiences and backgrounds.” 

“Personally, I think it is very important to be true to who I am so that I can be the best physician I can be to my patients, and to let them know that I create a safe space within our relationship. I also think it's important from both a mental health perspective and a life perspective to be aggressively true to who you are!”