Roshan Sethi, MD is a PGY3 in Radiation Oncology at Harvard. He is also the co-creator of the new medical drama The Resident on Fox and a screenwriter for the upcoming film Call Jane. His other writing credits include Black Box and Code Black. He completed his undergraduate studies at Yale and received his medical degree from Harvard Medical School.

SW: When did you first become involved with the entertainment industry?

Dr. Sethi: In 2009, when I was a first-year medical student, there was a show made about Harvard Medical School called HMS. I reached out to Amy Holden Jones, the writer, and asked to be a consultant. I sent her a lot of ideas for the show and eventually she invited me to become a consultant in an official capacity. After that, we did eight pilots together, and eventually her show Black Box went to series on ABC. I began working with one of the writers on the show, Hayley Schore [co-creator of The Resident], and we wrote a sample that got us an agent. She staffed us on a show called Code Black on CBS. At the end of intern year, I took a year off before starting my Radiation Oncology residency. And at the tail end of my year off, I wrote a version of The Resident with Amy and Hayley for Showtime. They eventually passed, but months later, after I had returned to residency, Fox picked it up.

SW: How do you manage to juggle your clinical duties with your TV responsibilities?

Dr. Sethi: My program, Harvard Radiation Oncology, gives me a lot of flexibility. I get time off to go to meetings and set. But it really is very difficult. I get up early every morning and write. That’s when I do most of my writing. I write very fast and have a writing partner, which makes things easier, but it’s still very stressful.

SW: What is a typical day like for you?

Dr. Sethi: I get up really early, like 4am. I write like a crazy person, usually in the hospital cafeteria, and then I spend the rest of the day as a resident.

SW: Do you see any parallels between medicine and entertainment?

Dr. Sethi: They’re so different, but writing and medicine are both about understanding people. And as doctors, we tell stories all the time, in rounds and in notes and when we talk to each other casually about patients.

SW: One of the main characters on The Resident is an Indian American and another is a Nigerian immigrant. What are your thoughts on diversity and representation in entertainment?

Dr. Sethi: In medicine I’m surrounded by Indians and Asians and Nigerians, and there’s so much diversity. The cardiac ICU is like India. But on TV, how many Indian doctors can you name? They are few and far between. Why is that? I once worked with a director who was casting for a cab driver role and he wanted someone with a turban, a long beard, and an accent. When I asked him why, he said it’s realistic because so many cab drivers are Indian. Because that’s the priority – being realistic. When it comes to medicine, where does that need for ethnic realism go? It has a lot to do with the fact that most content is created by white people, so they naturally create the world the way they see it. And they see Indians in cabs.

I will say, however, that it’s something everyone is eager to change. There was no pushback from the studio, network or producers to casting an Indian or Nigerian doctor character on The Resident.

Grey’s Anatomy was a revolution in terms of diversity on TV. Half of that cast was minority doctors, and nothing was ever made of the fact that they were minorities. And now a whole generation has grown up watching that show, and people of color can imagine themselves as physicians in a way they might not have from watching other shows.

SW: Do you have any other creative projects in the works?

Dr. Sethi: During that year I was working for Code Black, I started writing features with Hayley. We’ve now written eight movies. Three are in active development. We almost exclusively write about women and minorities. Three of the movies are period biopics about different women in science. One of them is about Kalpana Chawla, the first Indian to go into space with NASA. Another is about Rosalind Franklin, who had her work stolen by Watson and Crick. And the other is about a woman who worked in the Jane Collective, which performed underground abortions in the 60s before Roe v. Wade was passed.

SW: When will we get to see them?

Dr. Sethi: Not for a while. Call Jane, the movie about abortion, has Elisabeth Moss and a director, and will hopefully be shot this summer. The others are not as far along. It’s very hard to get non-comic book movies made.

SW: Devon went to Yale, then Harvard for medical school. You also went to Yale and Harvard for medical school and are currently a resident. Is The Resident art imitating life?

Dr. Sethi: [Laughs] He has my Step 1 score, too! But that’s where any resemblance ends. I think I’m more like Conrad. I’m pretty blunt, direct and forceful.

SW: You bring medicine into the creative field through your writing. Are there ways that you bring creativity into your practice of medicine?

Dr. Sethi: I don’t know that I bring creativity, but I will say that screenwriting is constantly useful as a physician. In screenwriting you work to put subtext underneath the dialogue to make it more interesting. It’s the same thing in a medical encounter because people rarely say what’s on their mind. I’m always trying to decipher the subtext in patient dialogue. We never get taught in medical school and residency how to really hear patients.  I find this particularly interesting in conversations about cancer. If someone asks, “How big is the tumor?” they really (ultimately) want to know, “Am I going to die?” And you have to find a way to answer the question beneath the question.

SW: What do you think sets The Resident apart from all of the other medical TV shows?

Dr. Sethi: I think it has a point of view, in particular about medical error. At times it does go too far. At the end of the day, it’s a dramatic network show. But I admire it for having something to say. There has been some negative feedback from doctors. Some is valid, some unfair. Someone once emailed me and said that that residents don’t wear ties. And I was literally sitting in the hospital wearing a tie, reading his email. I wanted to send him a photo of myself. But I read everything that’s written about the show and I try to understand how it can be better.

A lot of the criticism has focused on whether the show makes patients afraid of the hospital. I hope it makes patients advocates for their care. They should question if every test or intervention is truly necessary. We shouldn’t be afraid of patients asking those questions. We shouldn’t be afraid of being accountable.

SW: Do people at work – colleagues or patients – know about your TV writing?

Dr. Sethi: Patients do not, because it never comes up. And, anyway, nobody wants a doctor who is a screenwriter. But my attendings let me go to LA and my co-residents cover for me while I’m away, so they all know. I am very grateful to the people in my program who make it possible for me to write.

SW: How do they react?

Dr. Sethi: A lot of my co-residents watch every single episode. I get a lot of texts when the show is airing from people who want to give live feedback.

SW: What’s the most powerful moment you wrote into The Resident?

Dr. Sethi: I really like that the first CPR you see on the show doesn’t end positively. It’s important for people to know CPR doesn’t always work and, even when it does, it doesn’t work in the larger sense.  Believe it or not, most of what people know about CPR comes from TV.

SW: Who are your role models?

Dr. Sethi: My mom, because she is the ultimate hustler. She was an immigrant to Canada and accomplished whatever she wanted by sheer effort. She’s a general practitioner. My twin brother and I worked in her walk-in clinic. We wore matching outfits and sat at the front desk. When someone walked in, we would chorus, “Welcome to Dr. Sethi’s office.” People would ask, “Is he in?” and we’d say, “She. She’s our mom.” We were basically just there to be little feminist twin boys.