Can Learning Medicine Actually Be Fun? - Andrew Berg and Saud Siddiqui of SketchyMedical

Dr. Rishi Desai: Hi, I'm Rishi Desai. Today on Raise the Line, I'm happy to be joined by Saud Siddiqui and Andrew Berg, co-founders of SketchyMedical. Founded in 2013, SketchyMedical is a powerful visual learning platform that helps students master concepts through fun and informative video sketches that enhance visual memory. Thank you both for being with us today. How are you doing? 

Andrew Berg: Thank you, Rishi. Doing well. Excited to be on the podcast. 

Saud Siddiqui: Yes. Doing great. Thanks for having us. 

Dr. Rishi Desai: Awesome. All right. I'd love to hear just about your back story. How you got into medical education and what kind of sparked your interest in SketchyMedical in the first place?

Saud Siddiqui: Sure. So, when we started Sketchy we were really, I'd say, just solving problems that we had ourselves as medical students. We started in 2013, as you said. Around that time, we were actually second-year medical students. We were getting through what medical students get through which is learning tons and tons of complex information in a short amount of time, trying to commit that all to memory, and being able to apply that on exams and really beyond. As we tried different study techniques and different study methods, nothing really worked well until we stumbled upon this way of learning. It was something that we really use ourselves and taught each other and later decided, "Why don't we share this with other students? Share this experience that we're having. Other folks may benefit from it." That's really how it started. It was just kind of sharing what we were doing ourselves as students. 

Dr. Rishi Desai: So, just playing off that, when you say you were doing it together, walk me through that specifically. Saud, you would draw a character to help you remember something and then show it to Andrew, or he'd show you one? How did that go? 

Saud Siddiqui: Yes. There was a basement we actually studied in at UC Irvine which had whiteboards all over it. And so, naturally, we go up to the whiteboard and use it. When we needed to memorize a certain virus, for example, we would create a story kind of based on the name of the virus, and then create a character and use jokes and humor. It is really in this group setting of creating these characters and this artwork. It didn't look as good as it does today, definitely. It was just kind of stick figures almost on a whiteboard. I think Andrew still has some of the first sketches we did on sheets of paper in a notebook. But that's really how I did it. We were in a group and would just build a scene together. I'd say it was almost like a last resort trying to get as much info as you can into our heads before the exam, kind of the night before. It stuck surprisingly well, so we just kept doing it. 

Dr. Rishi Desai: Now, there's a lot of learning science that, obviously, underpins what you're doing. I'm just curious how much of this was doing it, like you said, out of almost desperation to learn it versus how much of it was having known about that science and thinking like, "Hey, there's this cool tool. Let me apply that tool and see how it goes."

Andrew Berg: Actually, we had no idea about any of the research that underpins our methods. This was purely born out of us really feeling like we were on a treadmill. As soon as we learned a new bug, we'd forget some of the older bugs. It was late one night when we started some of these pretty irreverent sketches that really stuck. I think one of the things that we realized is the sketches did take a long time to come up with. We really tried to weave it all into a narrative together in the topics that we got in microbiology that we were able to create sketches for. Those we did really well on. The rest where we didn't have enough time to create sketches for, we really felt like we were behind. The study group that studied with us definitely benefited from us sharing our sketches and learned from it even though they weren't part of, necessarily, the creative process. And so, that really was what gave us the idea of "these really work."

The only downside that makes them not really useful for studying in real time as a med student is that the creation process takes a really long time. "So, why don't we try throwing a video up on YouTube to see if other students across the country would find it useful too?" That was kind of the genesis of the initial idea. The initial plan was for Saud and I to do the drawings ourselves. I think that we would have had a wildly different response if that happened in that we would have no response because our drawings are terrible. But it was just through sheer coincidence that we actually met Brian, the third co-founder of Sketchy. We were at a Starbucks and sat next to him at a table. We were planning our sketch and looked over and saw Brian had these beautiful drawings. At that point, we're like, "Okay, Brian. You've got to team up with us." That was what led to the first sketch which was 'Salmonella'. 

Dr. Rishi Desai: That's incredible. I think one of the things that -- and I'm sure you've heard this from a lot of folks and I'll just say this for everyone to hear as well -- you do so beautifully is create a joyful experience. Opening up a new chapter to learn something brand-new is typically a pretty daunting scary experience for people, but I think watching something that unfolds in a story-like way with beautiful illustrations that are goofy and funny kind of sparks joy. I'm curious whether you've heard that feedback from students, but also, if you've heard that kind of feedback from faculty. How do they see it and does that feel for them like it's the right feeling to be having or if they feel like, "No, that's not actually quite the right feeling that should go with these learning experiences"? 

Saud Siddiqui: We've found that same effect, and I've noticed that as well, where students actually enjoy learning again once they started using Sketchy. It's kind of bringing that joy back that I think gets lost kind of when folks are going through more and more rigorous education. We actually surveyed our students and found that not only was Sketchy effective, but the majority of students also found that it was making them feel less stressed. So, about sixty-five percent had said that, and sixty-seven percent had said that they felt more confident using Sketchy. Not only are we providing an effective learning technique that gives them the ability to memorize and recall, we are also doing it in a way that they actually enjoy the experience and are getting the feeling that we hope that they would get out of it. 

Dr. Rishi Desai: The healthcare system is so broad and your background is as medical students. How did that extend as you started reaching out to other types of clinical students? Nursing students or PA students? What sort of response did you see? Were there any differences that you wouldn't otherwise have expected?

Saud Siddiqui: Yes. I'd say that expansion is really starting now in a sense. We've spent most of our focus really on medical and that was really where we started. That was our core, and I think we applied this learning technique really well to medical education. But there's no reason that it can't be applied to really anything that needs to be learned. And so, what we're doing is really starting out with some of the adjacencies. As you mentioned, PA school is one, pharmacy school is another, undergraduate education is another, and I think that a lot of these students are really going through some of the same feelings that medical students are. That feeling of being overwhelmed having to memorize mountains of information in a short amount of time, but not really given the tools to do that effectively. So, what we've seen so far is that there's actually a lot of excitement for some of this new content that we're putting out later this year. MCAT is a great example, where we have a beta actually running right now and students are using it. They are really excited about it. They want to use whatever we have today because their MCAT is coming up. There are medical students telling them about it. One of the quotes was, "I would retake the MCAT just to use this." So, there's a lot of excitement I think that we're seeing in some of the other verticals that we're excited to apply our Sketchy technique to.

Dr. Rishi Desai: You set me up, so I'm going to ask you now...would either of you retake the MCAT, if you could, using Sketchy? Would you go through that process again?

Andrew Berg: No. Absolutely not. That's firm (laughs).

Saud Siddiqui: I kind of want to take a random exam that's not even medically related if we have a Sketchy for it just to pass using the technique. 

Dr. Rishi Desai: It's a good point. Have you effectively scaled that into other non-medical domains? How has that gone? What has that experience been like? 

Andrew Berg: Yes. So, I'd say MCAT feels like a very near adjacent to medical, but really, the content is completely different. Teaching physics or organic chemistry really requires us to rely on a lot more of our subject matter experts and our faculty that are bringing us the curriculum. And so, we're working on ways to really help streamline and just really create better content by partnering with them. Some of that might involve bringing people into the Sketchy writer's room, and really being more a part of the creative process. People that might not even consider themselves as creatives. But I think when you put people who are experts into a room with a bunch of creatives and artists, good things happen. That's kind of what we're figuring out right now. Since we started it as med students the core of Sketchy relied on a lot of people who had subject matter expertise, or relative subject matter expertise in medicine, but as we branch out, that might not be the case. So, these are pretty fun experiments we're running right now. In MCAT, it looks like we're doing a pretty great job, so we're really excited to show that to MCAT test-takers. 

Dr. Rishi Desai: I'm curious about the voice. I don't mean the actual narration of it, but I mean the tone. Do you feel like a single Sketchy has had equal reception, let's say, from a nursing audience as compared to a PA audience? Or, have you found that, actually, it needs to be different in a particular way? I'm just curious to know how that expansion has gone.

Andrew Berg: It's something that we think a lot about, and I imagine you do as well with your content. Trying to establish maybe even like a character for who you want your voice to be. We toss around some ideas but we think of ourselves kind of like this -- Saud hates the term -- but like a maverick teaching assistant, maybe, who goes a little rogue, doesn't necessarily follow all the rules, doesn't take himself or herself too seriously, but can really speak authoritatively but still in like a near-peer type voice. We were founded with us being med students teaching med students, and so, we really want to embrace that near-peer model. But at the same time, we're bringing into the fold all of these experts, and so we can speak with more authority than I think we could have when we first started. So, it's an interesting blend. It's a tough thing to get just right, but I think it's a big part of who we are as a brand. It's kind of a core thought that we are constantly bouncing around playing with and experimenting with. 

I'm curious actually...I'll turn the question back to you since you're also very heavily involved in your content creation. How do you define your voice or how do you know if it's hitting or if it's not? 

Dr. Rishi Desai: Rishi: That's a good question. I think one of the challenges is the nursing model itself, as an example. It's a different model than the medical model, and sometimes, the words even that are used. Like, right now, in nursing there's a phrase ADPIE. In most medical schools, it's not a phrase that is taught. That is not a term that is known. In most nursing schools, you're not a nurse if you don't know what ADPIE is. And so, that's an example where framing it differently has been useful because the two cultures are quite different, but then, the core content is the same. Influenza is a virus. It doesn't change depending on the person, or who's taking care of the patients. 

It's a bit of both. We've certainly tried to make sure that we incorporate the cultural elements of healthcare, as well as the content elements of health care, so that it doesn't kind of exclude one or the other. As you said, it's a challenge. I like the rogue maverick idea. I think that's really cool. Maybe just to ask as a follow-up, is there a Sketchy of a rogue maverick that is in the videos themselves?

Andrew Berg: The main director of our PA curriculum has a sketch of herself appearing as an easter egg in a lot of the sketches. She's carrying a skateboard and has a pink mohawk. And so, I think that truly does embody the Sketchy educator. Somebody who can have fun with it, but she was also formerly the director of The Charles Drew PA program, and so has the authority, too, behind her. I'd say that's a great example of it. But no, I think in general, having more characters and relying more on creating characters that have goals and have personality will be the future of Sketchy, absolutely. Especially, as you can imagine, as we branch out beyond higher education.

Dr. Rishi Desai: A follow-on then is another audience, which is patients. With COVID-19, a lot of patients have questions about vaccines. Nowadays, people ask just off the cuff, "Did you get Moderna or Pfizer?" I'm not sure a lot of folks know any manufacturers of any vaccines other than the COVID-19 vaccine. That's just a really interesting level of detail that people have picked up on. And so, I'm curious. Is Sketchy aimed at patients or patient education? If so, how has that gone?

Andrew Berg: Not directly. Saud, feel free to jump in here too. It's certainly something we're interested in and we're very envious of your ability to reach patients, doctors, and maintain a voice I think that works for both. So, I think you've been a great example of achieving that. I think we are developing new styles to really show in an animated way. Like really break down the process and be able to explain things in, I'd say, more innovative and artistic ways. Right now, we're really very heavily set to teach people loads of content that's tough to remember. We're really leaning into the memory palace technique. I think for patients it's about teaching to a point of understanding, and we're kind of working behind the scenes right now developing new styles to do that. That's certainly a potential opportunity. I would say it's not something that we've made a real effort at yet, but we're excited to at least engage patients in interesting, fun ways. 

Dr. Rishi Desai: One of the things that I think is a huge strength of Sketchy is the fact that if you can make education more fun, that's great, but it also seems like it's much more efficient. Efficiency can also mean, at the end of the day, potentially less time in school. I'm curious if there's any anecdotal evidence or any evidence internationally or in some settings where you could actually shorten the length of time of training just by using some of these techniques that you guys are using? 

Saud Siddiqui: Yes. I'd say that there has been for a few years, at least. Not looking at the years of training yet, but really how people learn this stuff. I'd say more and more folks are almost finding that learning through a technique like Sketchy and learning it at double speed is almost the only way to do it. Folks are starting to skip lectures because of how much time they save with content like Sketchy. There was an article in STAT News about how students were leaving the classroom in droves and we were one of their "tour guides" really in getting through education. I think we're starting to see more and more of that where folks are not only able to learn more efficiently through Sketchy, but actually retain it better as well. And so, they only need to really learn it and kind of review it that one time and, actually, hold on to it and be able to recall it much more effectively. I think that can lead to needing less time to get through all this material. Obviously, I haven't seen it yet really at the macro level with med ed. But I don't think it's really impossible. I think there could be a world in which folks are getting through some of the material in a short amount of time. 

Dr. Rishi Desai: We have something in common. We both are teaching companies, and one of the core things that we like to do is kind of fill knowledge gaps. I'd like to open it up to both of you to kind of share something with us that you think is a common knowledge gap. Maybe it's about medical education, medicine, medical school, or whatever the topic may be. Pick a topic you enjoy and let us learn. 

Andrew Berg: I think one is this concept of learning preferences. There's this VAK model that arose, I think in the 1970s, that taught that some students were visual learners and some were auditory. I think that's been completely debunked as a myth and really has no bearing in any of the evidence. So, I think one of the gaps or misconceptions is that some students think that they are visual learners, some think that they aren't. But really, if you think about it on the evolutionary scale, verbal understanding and speech are relatively new. Verbal memory also is a relatively new development then, but it's been millions of years of evolutionary pressure to be able to remember where your food came from and remember where the predators are. And so, all of this bears out as you keep digging more and more about visual memory and visual learning. 

So, I would say one teaching point would be that we're all visual learners. If we can translate what we're learning into that visual language, I think it speaks for itself. That's one of the things in starting Sketchy that was a surprise. Saud and I, when we first released 'Salmonella', we thought we would be making an explainer video after that to say, "Don't freak out. This is visual memory. Trust us. This works." But then, all of a sudden, it started taking off. We really didn't make an explainer until this year. So, that's been incredible. I think it's just something where you've got to try it. Let it soak in. Maybe think about what you learned a week or two later and see if it sticks, because it's pretty remarkable. I think there are two goals for us: it's to make it fun and to make it more memorable and speed up learning. That fun aspect is harder to be objective about and to judge, but we found that the more fun we're having when we're creating content, that translates into more fun the students are having and very likely more effective as a learning tool. Saud, I don't know if you have anything to add there. 

Saud Siddiqui: I mean that's a really good one. I know that definitely surprised us and can almost feel a little counterintuitive because of the way that we're taught through education. Folks are encouraged to lean into their learning method when really, there probably are different types of learners. And so, I'd encourage folks to try really everything and kind of see what works for them. I think even if they feel like they may not learn visually, as Andrew said, everybody, is a visual learner. 

Other misconceptions or myths. Number one, I'd say, the vaccine does not have a microchip. So, everybody please get the vaccine. That's one. Two, really leaning more towards some of the entrepreneurs in the audience and folks that may be thinking about putting their own solutions out there into the world -- and I think you and Shiv probably had similar experiences as us -- I'd say that once a company grows to where we're at today, it looks like we had this all planned from the beginning and kind of knew what we're doing and had this course charted out. But really, if you look at the story of Sketchy and where we started, it was really something that we discovered, found value in, shared with people, and put on the world. We had no idea where it was going to go. I'd say for anybody out there listening that has something that has helped them that can help others, something of value that they can share with the world, just put it out there and keep pushing. We put this together in medical school. I think there's a myth out there that you've got to pick one or the other. Build a business and leave med school or stay in med school and I'll build a business. But you can do both. It's just about putting in the time and you can do it the way that you want to do it. I think we're a good example of that. So, those are some words of advice there to people listening. 

Dr. Rishi Desai: That's awesome. I think that there are a lot of folks or entrepreneurs in the audience, so I appreciate you sharing that insight because I think that there is a lot of fear that if you don't have a clear map, then you shouldn't go on your journey. Clearly, that doesn't make sense. 

I will also say that I've always found it interesting that so much of our brain is dedicated to vision. We have a whole lobe. We've even named it: the occipital lobe. There are few other things that we do that get a whole lobe of your brain dedicated to it. So, clearly, visual-spatial learning has been with us for millennia and is not going anywhere. So, I think that's a really powerful point. I do want to also thank you both for joining us today and for sharing your wisdom. 

Andrew Berg: Thank you, Rishi. This is a lot of fun.

Saud Siddiqui: Thanks, Rishi.

Dr. Rishi Desai: Awesome. Well, I'm Dr. Rishi Desai. Thank you for checking out today's show. Remember to do your part to flatten the curve and raise the line. We're all in this together.