Going to med school at 32 can feel like a door that has already closed. For Dr. Lally Pia, then a single mother working in a donated body program, it started with a colleague's question, a rejection and a second try. She tells Jeremy Van Wert how she nearly quit, finished over six years and became a child and adolescent psychiatrist.
ᛉKey takeaways
- Dr. Pia was told by a fortune teller as a baby that she would be a doctor, then spent years in detours before medical school became possible again.
- A colleague asked whether she had thought about med school again, she answered that she was 32, and he offered to write a letter for her.
- Dr. Pia was rejected first, applied again and got in, which she says left her screaming with joy in her car.
- She nearly quit less than two years in, and her mother's calm response helped her choose to finish by splitting the program over six years instead of four.
- Jeremy's view is that big goals get done by cutting everything into smaller bits and then cutting the overwhelming bit smaller still.
- For anyone facing a big goal, Dr. Pia suggests asking what truly makes you happy, then listing what stands in the way.
ᛃ Moments in this one
ᚠMed school at 32: the question that reopened a closed door
Dr. Lally Pia was working in a donated body program at UC Davis when a pediatrician she prepared bodies with asked if she had ever thought about med school again. She told him she was 32 and asked if he was kidding. He was not. He said UC Davis takes older students and offered to write her a letter.
She says it sparked something that night. She had wanted to be a doctor and put the idea away because life had not allowed that path. She was rejected at first, then applied again and got in, and she says she was screaming with joy in her car.
ᚢA fortune teller, Ghana and a green card that went wrong
Dr. Pia was born in Sri Lanka. When she was six months old, she says, her father took her to a fortune teller who said she would be a doctor of doctors. She grew up in Ghana, where her friends came from many countries, and she never quite felt she belonged to one place.
The economy worsened, her family left for America, and she stayed behind for her final exams. Political unrest closed the universities, so she gave up waiting and went to the embassy in Accra. There she was told her father had applied for her before she turned 21, but she was now past it, and fixing it could take a year or two. She had no money and nowhere to go.
ᚦA year of waiting in Wales and starting over in America
Friends hosted her in Wales for about a year and a half. She could not work, so she volunteered as a church organ player and took long walks. Her fear was that she was wasting her life.
In the U.S. she returned to school at UC Davis and then married a man she calls a big mistake. A phone call in which he said he had accepted a job in England showed her they were not communicating, and she decided that night to go a different way.
She was a single mother with two small children and no home of her own. She says she was scared and had to apply for public assistance, and she remembers the county workers as the warmest, most compassionate people. If you are in a season of starting over and want a guide, Jeremy offers individual therapy and coaching.
ᚨWhat working in a donated body program taught her
A lab job feeding research rats did not suit her, so she took a job running UC Davis's donated body program. It paid $300 more a month and gradually let her leave assistance, which she calls a huge accomplishment. It was also emotionally heavy, and she had nightmares within a month.
She nearly gave notice, but her supervisor said it was hard for anyone and asked her to stay. She asked for help and hired a former Baskin-Robbins coworker named Bob, who later became a nurse. She also gave tours to students and says she learned that a body keeps teaching after death.
ᚱWhy she almost quit medical school and what her mother said
Medical school was crazy, Dr. Pia says. She was surrounded by people who had always been top of their class and was raising two children on little sleep. The work was not too hard, she says, but the sheer volume was, and she would fall asleep reading to her kids.
Less than two years in, she decided to quit. UC Davis offered more time through a split program. She told her mother, expecting pressure to push on, and her mother said, "That's okay, Lally. You're smart. You'll find something else to do."
That changed her mind. She split twice and finished in six years, and she is glad, because she found smarter ways to learn. Jeremy notes that the way to accomplish a huge thing is to cut it into small bits, and if a bit overwhelms you, to cut that into a smaller bit.
ᚲResidency, the Match and a husband who said go
Dr. Pia chose child psychiatry, which meant a longer residency. She did not get the program near home through the Match and was placed in San Mateo. She planned to turn it down, but her husband Tim told her she was throwing away what she had trained for. He said he would look after her daughters, who were not his children, and she would be a mom on weekends. She did that for three years.
She counts about 11 years of training from the start of med school to the end of child psychiatry. People who want company on a long road like that can find real conversation and live Fireside Chats in Thriving Spirits, the Mindful Mutiny community.
ᚷHow her own story shapes her work with children and families
Dr. Pia sees patients aged four to their twenties, three days a week. She spends five or ten minutes on medication, usually does a two-hour first evaluation with the child and parents, and speaks with the child alone. She tells nervous parents she does not like to medicate kids unless everything else has failed.
Her values are to alleviate suffering and to treat the whole family. Jeremy and Dr. Pia also discuss screens and instant gratification, and she worries that a lack of warm social connection may be lowering empathy in children. She also says children do get better, which keeps her motivated.
ᚹAdvice for anyone facing a big goal
Dr. Pia reads from her memoir, The Fortune Teller's Prophecy: if you fall into a dark well, hunt for a handhold, and always lead up and into the light. For people deciding whether to swing at a big goal, she suggests looking inside and asking what truly makes you happy, then listing the obstacles, whether time, money or support.
She also suggests listing what you dislike about where you are now and talking it through with a therapist, a parent or someone you trust. She says a single session with a therapist helped her feel it was okay to leave her marriage. If you are weighing a late start or a major decision, you can book a private 30-minute conversation with Jeremy.
This is one person's story and isn't medical advice. If you or someone you know is struggling with their mental health, please reach out to a licensed professional or your local emergency services.
ᚨ Questions people ask
Is it possible to start med school at 32?
In this episode, Dr. Pia says she was 32 when a colleague asked her about med school and that UC Davis takes older students. She was rejected first, applied again and got in. This is her experience, not a guarantee for anyone else.
How do you start over after a major setback?
Dr. Pia describes taking one step at a time, accepting help and gratitude for the people who supported her. Jeremy says to cut a huge goal into smaller bits, and cut it smaller again if it overwhelms you.
What does a child and adolescent psychiatrist do?
Dr. Pia describes her work as medical management plus a lot of listening to the child and family. She does a two-hour first evaluation and works with a team of therapists.
Why did Dr. Pia almost quit medical school?
She says the volume of material was overwhelming while she raised two children on little sleep. UC Davis offered a slower pace, and her mother's calm support helped her decide to finish over six years.