Ten years ago, I left medical school at Johns Hopkins to pursue a question I had become obsessed with: Can you get a MD online? It was the riskiest decision I’ve ever made and one that not only worried my parents, but frankly gave me heart palpitations.

At the time, my co-founder and I had just started working on it learning platform called Osmosis.org and that’s how we and many of our classmates took our exams at Hopkins. The vision was to make medical education more effective and enjoyable through inclusion evidence-based techniques such as the flipped classroom and learning to the test; wonderful user experiences and personalized machine learning-enabled recommendations pioneered by companies like Facebook and Netflix; and new content formats such as short videos given how quickly the world was becoming more visual and digital.

Our experience since taking the leap out of medical school is perfectly captured by this quote from Bill Gates: “Most people overestimate what they can do in one year and underestimate what they can do in ten years.”

What started as a side project used by our class of 120 medical students would grow beyond our wildest dreams to reach over 3 million students around the world – enough to fill 25,000 lecture halls at Johns Hopkins – and for all health professional programs, including nursing, physician assistant, pharmacy and dentistry, and even patients and their family members. Eventually this reach and influence led to our successful acquisition from the 140-year-old medical and scientific publisher Elsevier, known for titles such as Lancet, Celland Grey’s Anatomyand which was a perfect match from both a culture and growth perspective.

While I had a great time and learned a tremendous amount “in the real world” growing Osmosis from two to 100 employees and 0 to 200+ institutional partners, my original goal of becoming a doctor – which was first minted in hospital in South Africa – hanging in the balance.

Given the scope of Osmosis and the successful exit, I surprised many of my friends earlier this year with my decision to trade my Patagonia technical vest for a short white coat by returning to Hopkins Med as a third-year medical student. The choice was the culmination of many months of thinking, which ultimately came down to these six reasons:

1. Helping patients directly is an incredible privilege that provides deep purpose. As I wrote in the book Success Mindsets, there is a natural tension between seeking scale and direct impact. While raising Osmosis to millions of students was incredibly satisfying, I missed being able to help someone directly on a 1:1 level. This purpose is further deepened by the nature of their problems: “A healthy man wants a thousand things. The patient only wants one.” (Confucius). In other words, the disease has a habit of clarifying to people what is most important to them. Healthcare professionals have the privilege of being with patients on what may be the worst day of their lives, with an open heart and the knowledge and skills to help them return to a state of well-being. Even at Osmosis, the initiatives that have given me the most fulfillment are those that have the most direct impact on patients, such as our focus on the often overlooked rare disorder community through Year of the Zebra. Our simple and clear video style – although originally developed for medical students – has fortunately appealed to the countless patients and family members who have signed up thousands of comments such as this: “As someone who has been diagnosed premature ovarian failure at 14, it’s nice to finally know what’s going on because I didn’t understand a single thing my doctor said other than the fact that I couldn’t have children. Thank you very much for this glad to understand it better!” This desire to connect 1:1 with patients who have incredibly diverse life experiences and circumstances has already been validated in my first few weeks at Hopkins, so I’m excited to rotate through different services ranging from pediatrics to neurology.
2. Learning medicine has never been more interesting and effective. The key reason Osmosis succeeded was because we had “skin in the game” and literally put ourselves in the shoes of our customers. I’m back to daily learning with Osmosis and I’m confident I am betting my medical studies on the quality and effectiveness of what we have created. In addition, now that we are part of the Elsevier family, I have access to leading complementary resources such as Complete anatomy a platform for reviewing anatomy and preparing officers for surgery, as well as ClinicalKey Student for thousands of USMLE practice questions and access to category-defining books such as Nelson Pediatrics. Plus, the human body is fascinating so I’m thrilled to have the opportunity to continue learning about how we work.
3. “Lifting the line”requires both clinical and entrepreneurial experience. Our healthcare system has enormous challenges ranging from the massive global shortage of healthcare workers to the cost and unavailability of life-saving drugs. Over the past three years, I have had the opportunity to interview hundreds of leaders for Pick up the line podcast such as Dr. Sheila Davis Partners in Health who spoke on global health equity; Mark Cuban who shared his team’s work to make drugs cheaper; Dr. Eric Topol who discussed the future of AI and digital health; dr. Ashish Jha who talked about strengthening our public health system; and Arianna Huffington which addressed the topic of provider burnout. It’s clear that we need innovative models to “raise the bar” or strengthen our healthcare system, so I’m looking forward to seeing first-hand how the concepts discussed in the podcast are applied in the healthcare system, as well as building clinical experience to combine with my entrepreneurial experience, I hope contribute to these solutions.
4. Doing hard things can be deeply fulfilling. “Do one thing every day that scares you. Those little things that make us uncomfortable help us build the courage to do the work we do.” As she penned those famous words, Eleanor Roosevelt channeled a Stoic philosophy of practiced discomfort that I have empirically found to be transformational. However, in recent years I notice that I mostly exercise physically discomfort, from daily cold showers and winter ice water immersion expeditions with Wim Hof ​​to running The man of steel and climbing Kilimanjaro for rare disease awareness. Going from managing a company of 100 people with a lot of autonomy to being at the bottom of the totem pole again and studying intensively as a medical student was already a huge challenge – exactly why it pays to work. As I go through medical school, I pay particular attention to (and reformulate) two emotions: fear and frustration. Fear is an opportunity for growthand one I’ve already experienced in simulated patient encounters, such as a recent one where a baby dummy went into supraventricular tachycardia and we had to figure out how to respond within minutes. Frustration is an opportunity for innovation – indeed, it was a frustration of how inefficient the medical education system is (eg hundreds of long and passive lectures) led to the founding of Osmosis. Our healthcare system is full of room for improvement, so I’m excited to experience these frustrations firsthand again.
5. Creating the future. Related to this last point, one of the most compelling reasons to return to medical school at Johns Hopkins in particular is its leading research in some very exciting areas. The two I will mention are artificial intelligence (AI) and psychedelics. The recent development and release of generative AI tools such as ChatGPT has attracted public attention, and Hopkins has record applications of AI to significant health problems such as detection liver cancer and sepsis as well as pioneering innovations in areas such as “organoid intelligence” and brain-computer interfaces. Another area, psychedelics, has recently seen a renaissance in the face of mental health crises ranging from anxiety and depression to post-traumatic stress disorder and substance use disorders. This resurgence was started in large part by Johns Hopkins researchers Center for Psychedelics and Consciousness Research who have published over 150 peer-reviewed papers and are actively conducting several clinical trials for conditions such as OCD and anorexia nervosa. It’s a fascinating time to be a student again and to be doing electives with labs like these that are shaping our collective future.
6. Achieving a personal and family dream. Last but not least, I returned to medical school with the hope of fulfilling my personal dream almost 30 years in the making since I followed my doctor father to the hospital he ran in South Africa. This quote from my original medical school application essays is as true today as it was nearly 15 years ago, “My determination to become a physician was fueled by a sense of compassion, enhanced by the excitement and promise of medical research, and strengthened by the realization that physicians can contribute both to individual patients and to society at large through their leadership.” As with many other dreams, it is not only mine, but also the dream of my family who were refugees during the India-Pakistan partition just two generations ago. The Philadelphia Business Journal caught this feeling in my joke ten years ago when we first left Hopkins: “Osmosis expects to raise funds early next year, meaning Gaglani and Haynes will have to answer questions about whether they will return to medical school. Gaglani said that venture capitalists who would invest in the company “don’t want to hear it [we’re] i’m going back to med school but our parents don’t want to hear it [we’re] I’m not going back to medical school.”

Taken together, these reasons painted a compelling picture for me to step away from day-to-day operations at Osmosis—which is in more than capable hands with the mission-driven team at Elsevier—and return to Johns Hopkins School of Medicine. While this is the current course, I have also lived long enough to know that Mike Tyson famously said that “Everyone has a plan until they get punched in the mouth” sounds about right. The last time I started med school, I managed to get through two years before I came across a problem that was compelling enough to go pursue it full time, and luckily for me and many others the result was Osmosis. While I am open to this, among other possibilities, I am grateful that I am already back in Baltimore where I hope to “raise the bar” as a future healthcare professional.

Feel free to follow the journey via LinkedIn, Twitterand YouTube.