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Roshan Sethi on Med School Simpering and Making It in Hollywood

Radiation oncologist and director Roshan Sethi: confidence in medicine is mostly performance.

The book club is back, and M2s Anna Royer, Ellie Johnson, and Sofia Hueser, and M4 Alex Nigg all crowd around to grill an actual Hollywood director about his debut novel. Somewhere in Roshan Sethi‘s frontal lobe is a cyst, and it’s possibly why he is a reformed gunner, Hollywood writer/director, still radiation oncologist, and now novelist. Sethi is co-creator of Fox’s The Resident, and author of The Simp: A Novel Without a Hero, a new book built out of a viral job ad so horrifying nobody would claim authorship of it. What does it mean that Raj, the novel’s desperate, self-aware sycophant of a protagonist, reads less like a Hollywood assistant and more like a third-year on rotations? Sethi doesn’t dodge the comparison—he wrote most of Raj’s obliging, invisible, gunner-brained misery straight out of his own decade in medicine.

Sethi describes himself, pre-Hollywood, as ruthless enough to publish 15 papers in a single year for a career he’s since walked mostly away from–he still practices 9 weeks a year–and he does the math on what staying in medicine actually cost him: when The Resident got greenlit for a sixth season and syndication, he’d already turned the show down to finish residency, a decision one producer later priced at $12 million. Sethi traces a lot of that old ambition back to being closeted through college and medical school; the striving, he says, was never really about medicine, and coming out took most of the edge off it.

Also, what happens to a person’s personality over four years of medical school? Sethi’s answer: it gets slowly closeted right along with everything else, trained out of you until invisibility reads as professionalism. He tells the room the worst response to getting pimped isn’t “I don’t know”—it’s saying it apologetically, like you owe someone an explanation for not yet knowing something nobody expects you to know. Speaking of things that require confidence you don’t actually have: Sethi’s next film, The Surgeon, stars Michelle Yeoh as a retired surgeon taken hostage and forced to operate. Dave can’t wait. He even pitched Sethi on his own idea for a movie that’s not at all derivative, and though it will probably star Mark Ruffalo, Dave is available.

On representation, Sethi draws a sharp line between his two industries. Medicine has become more female and more Indian, Asian, and Nigerian over time precisely because it runs on an objective, if imperfect, filter that values whoever scores highest on the MCAT. Hollywood, by his account, has no equivalent filter: roughly 90 percent of the highest-grossing films are still directed by men; minorities in the industry get treated as diversity projects rather than talent, and there’s nothing resembling medicine’s blunt, if flawed, meritocracy.

Episode credits:

  • Producer: Dave Etler
  • Co-hosts: Anna Royer, Ellie Johnson, Alex Nigg, Sophia Hueser
  • Guest: Roshan Sethi, MD
  • Production: SCP Media Lab–Anna Royer, Cyrus Barati, Isa Perez-Sandi, Zach Grissom, Sarah Upton, Srishti Mathur, David Lee, and Jacob Thompson 

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