I studied medicine at a great medical school, the Hadassah Hebrew University Medical School. Like many other leading institutions around the world, the school strived to graduate physician leaders who were also physician scientists. It was (and still is) a leading hub for academic medicine. But as a medical student, I remember distinctly that this did not make sense to me. True, I pursued a Masters degree in neurobiology (and graduated with honors). But I am not sure I did it for any other reason than it was the right thing to do. I could see how obtaining a degree could differentiate me and advance my career. But I definitely did not recognize the long-term value this degree might have on my clinical medical practice.
Fast forward twenty-five years. I have been very fortunate. Today, I practice medicine in one of the worlds premier institutions, Massachusetts General Hospital. In fact, it is the flagship medical center affiliated with the Harvard Medical School. And to many, including myself, that means a lot. Though I have been at this grand institution for well over a decade, I still feel in awe every time I enter the campus. My usual path to my office takes me through the old Bulfinch building, the original hospital. It was in this very building that ether was used for the first time to anesthetize a patient to allow a vascular procedure. The procedure was performed at the Ether Dome on the 4th floor of the building. And it so happens that I am a vascular physician. The ties to history could not be more tangible.
What is Academic Medicine Anyway?
Most doctors practice pure clinical medicine. This means they see and treat patients. Of course that is a great calling. But academic medicine is a bit different. Here, we combine clinical care for patients with teaching of medical trainees and with medical research. In fact, when you practice at an academic medical center, you commit to partake in all these elements.
Academic Medicine Benefits Patients
Some patients might find receiving care at an academic medical center annoying. First, your doctor might ask you to allow trainees to listen in on the visit. They might even want to examine you. Also, often you are approached about this research study or another. Not everyone likes this.
But in my opinion there are several advantages that far surpass any disadvantages. It is not by chance that patients will go to great lengths to receive care at a major academic medical center for any condition that is not straightforward.
First, academic medical centers tend to attract talent. It is common to find international physicians and doctors who have graduated far and wide at major centers. These talented individuals often have unique skills. So they are able to implement their knowledge to help patients. I can attest firsthand, that my colleagues make me better every day.
Next, having trainees around forces you to be at your best behavior. It is the classic Hawthorne effect. These trainees watch your every move and usually ask pointed questions (sometimes even while we are still at the patient’s bedside). If you want to avoid embarrassment, you should know what you are doing and you should be able to answer those questions properly.
Finally, major top tier academic medical centers will usually allow you some freedom to pursue your interest. Even if this is not lucrative or even if it is not the most efficient thing to do. These centers may have a large endowment, or a mechanism for internal grants to help spark ideas. In fact, they strive to stay at the cutting edge and want us to succeed.
Research and Teaching Make me Better
I am the Director of the Vascular Medicine Fellowship program. And I also host trainees from other services who join our service to learn more about vascular medicine. As part of our everyday practice we round with our trainees and we mentor them through clinical and career challenges. To do this properly, I have to stay up to date in my field. I need to remain thoughtful about the needs of my trainees and about how to promote them. If I am lucky, I also get to collaborate with them on projects that excite them. All these make me better every day.
I am also fortunate to direct a vascular imaging core laboratory, VASCORE. Through this lab and also through collaboration with many brilliant colleagues in my institution, I get to conduct clinical and outcomes research. I have learned over the years to appreciate this research. In fact, I do not even know if it helps to promote me to the next appointment. But I do know that every project I partake in makes me understand that topic that much better. For example, my research on the subject of deep vein thrombosis and pulmonary embolism. And then I can bring my knowledge to the bedside to benefit patients. I have learned that reading about something in a book is not the same as thinking about a problem, tackling it on my own or with a team of colleagues. You really get to understand a disease after you met enough patients who need your help and after you studied ways to improve their care.
For me, even if I did not understand it at first, academic medicine turned out to be the right fit!