Success in Medicine

Dr. Hardeep Singh is Co-Chief of the Health Policy, Quality, and Informatics Program at the Michael E. DeBakey VA Medical Center and Baylor College of Medicine. --He is a patient safety researcher and Professor of Medicine, and is committed to researching and developing resources to promote patient safety and diagnostic excellence in clinical practice. --His research on how to improve missed or delayed diagnoses has impacted many, and his research on how to improve the use of electronic health records (EHRs) has been used as the basis for policy changes by the Center for Medicare Services (CMS). He has also worked with the World Health Organization on patient safety issues. --One of the things that struck me during our conversation was how his career has been so mission-driven, starting with his observation of missed diagnoses during his years of practice as an internist in rural East Texas. Those experiences inspired him to seek out a research career, and later helped guide his efforts to impact policy. --At the same time, although he is very mission-driven, he describes how important perseverance and discipline have been throughout his career. --For anyone struggling to make an impact in an area about which they are passionate, his career path is inspiring. In this episode, he shares the story of how he transitioned from clinical practice to a research career. Although he has a storied career now, his early failures are an important part of his story. --As he explains, it took him several years and 12 failed grant applications before he was finally able to move into his career as a researcher. --When I asked him what kept him going, he described his passion for the area of patient safety, but he also emphasized the importance of perseverance and the discipline to keep submitting grant applications. --He is also deeply committed to translating research findings into policy change, and he talks about the associated challenges. --He describes several ways in which his groups' research findings have been used to guide policy and practice. --He and his colleagues developed a checklist for health systems on how to implement and use EHRs more effectively. In 2021, this work was adopted by the CMS as a quality measure to assess implementation of the EHR. --For students or physicians who are seeking to impact the systemic forces shaping medical care, this is an inspiring episode.

--This was an enlightening and inspiring conversation with Dr. Lavannya Pandit, a Physician-Scientist at the Baylor College of Medicine. --Dr. Pandit is a clinician who also performs scientific research. She is a Pulmonary Critical Care physician on staff at the Michael E. DeBakey Veteran's Affairs Hospital in Houston. She is Director of the Pulmonary Hypertension Program there and serves as an Associate Professor at the Baylor College of Medicine. --Her research centers on the physiologic and molecular mechanisms of pulmonary vascular disease. --Her mission is to advance understanding of vascular disease. --In this episode, Dr. Pandit describes her work, which is focused on serving her patients, particularly the veterans who have fought for our country. As a scientist, she also spends time applying for competitive grant funding, mentoring, reviewing, and conducting research. --An overview of physician-scientists has noted that their numbers in the United States are decreasing rapidly for several reasons. However, clinicians who are closely involved in understanding the challenges of a particular disease have important insights into research questions. --In this episode, Dr. Pandit describes her path to becoming a physician-scientist and provides advice to medical students. More on Dr. Lavannya Pandit Published research by Dr. Pandit

Dr. Monica Huang is a Diagnostic Radiologist and researcher in the area of minimally invasive breast cancer treatment with cryoablation. This episode provides some great insights into crafting a career that connects deeply to your mission. Dr. Huang began her career as a faculty member at the Baylor College of Medicine, and later was in private practice for over a decade. She then returned to training to complete a fellowship in breast imaging at the MD Anderson Cancer Center. In speaking with her, it is clear that she has a deep commitment to developing minimally invasive treatments for breast cancer, and she is now the founder and Director of the MD Anderson Cancer Center, Department of Breast Imaging Breast Cryoablation Program. This episode also provides some great insights into how a physician can overcome burnout. Although Dr. Huang was in a very successful private practice, she felt that she was getting burned out. This was not due to the amount of work, but rather because her goals had changed. She found herself wanting to change the world a little bit, and specifically the world of breast imaging and breast cancer treatment. She explains that working through that process has made her practice of medicine ultimately stronger. She worked to evaluate several areas: What were the sources of her discomfort? What brought her satisfaction? What could she change? Was there something new she could add? This process ultimately led her to return to training and now, as a faculty member, she treats breast cancer patients with minimally invasive treatments while running clinical trials. About Dr. Monica Huang

Dr. Abbey Vandersall is the Vice President of Quality and Clinical Services at AMSURG, an organization that maintains over 250 ambulatory surgical centers (ASCs) across the United States. Her work encompasses patient safety and quality, as well as other areas that impact clinical care such as operations, strategy, policy, and government affairs. In this episode, she shares her journey from medical student to consultant to healthcare leader. One of the things that struck me about our conversation was how energized she was about innovation, strategy, and making a positive impact on patient care. She has a lot of wisdom to share for medical students. · One of her points that really resonated with me was that your passions at age 18 or age 30 may not be the same as those at age 50, because your passions change, your experiences change, and the world around you changes. It's important to recognize that. · When you’re thinking about career decisions, she encourages students to think: “What problem do I want to solve?" · She also recommends that students investigate areas that intrigue them. For herself, she was absolutely fascinated during a lecture on the business of healthcare in her third year of medical school, and she later explored a summer experience in consulting. · One final piece of advice that she shared to medical students was to not be afraid to reach out to people that you don’t know. She says that people are often far more willing to help than we would realize. AMSURG: https://amsurg.com/ Dr. Abbey Vandersall LinkedIn: https://www.linkedin.com/in/abbey-vandersall-md

Dr. Andru Zeller is a primary care physician who is focused on fair trade medicine. He founded the Simply Salud Clinic in 2004 as a family-centered, fair trade, integrative medical practice for people of limited economic means. Dr. Zeller completed a family practice residency, followed by a fellowship in rural health. He talks about the strength and power of medicine, but also some of the challenges, especially the cost of healthcare faced by patients of limited economic means. This inspired him to develop a practice focused on fair trade medicine. The clinic is a sustainable business, and continues to serve himself, his family, and his community. In this episode, he speaks about his mission as well as the associated challenges. He has been very intentional about how he wants to make an impact in healthcare, and he has developed several innovations. To learn more about Dr. Zeller and the Pain Scan System, please see these links: Simply Salud painscansystem.com

Dr. Pooja Varshney is a Pediatric Allergist and Immunologist at the Dell Children’s Hospital in Austin Texas. She is an Associate Professor of Pediatrics at the Dell Medical School at the University of Texas Austin, and is Director of the Dell Children’s Food Allergy Center, a clinical research center of distinction. She is the principal investigator on clinical trials that are studying the prevention, diagnosis, and treatment of food allergy. Dr. Varshney has a busy clinical practice, along with teaching and research responsibilities. She conducts clinical research and also teaches students and residents at the bedside and with didactic lectures. One of the things that struck me about our conversation is that when it comes to her field, she “sometimes feels so lucky – I love everything about it“. She specifically highlights the long-term relationships with her patients, and the ability to follow them throughout their childhood. In her particular field, she also finds the scientific aspects to be fascinating, with an explosion of knowledge in the basic science and clinical aspects of food allergy. When I asked her how she handled such a busy practice, she highlighted several important strategies.

Dr. Pooja Varshney is a Pediatric Allergist and Immunologist at the Dell Children’s Hospital in Austin Texas. She is an Associate Professor of Pediatrics at the Dell Medical School at the University of Texas Austin, and is Director of the Dell Children’s Food Allergy Center, a clinical research center of distinction. She is the principal investigator on clinical trials that are studying the prevention, diagnosis, and treatment of food allergy. Dr. Varshney has a busy clinical practice, along with teaching and research responsibilities. She conducts clinical research and also teaches students and residents at the bedside and with didactic lectures. One of the things that struck me about our conversation is that when it comes to her field, she “sometimes feels so lucky – I love everything about it“. She specifically highlights the long-term relationships with her patients, and the ability to follow them throughout their childhood. In her particular field, she also finds the scientific aspects to be fascinating, with an explosion of knowledge in the basic science and clinical aspects of food allergy. When I asked her how she handled such a busy practice, she highlighted several important strategies.

Dr. Stephanie Cotell is a dermatologist in private practice in Columbus, Ohio. She has been in practice for over 25 years, and as she says, “I love my job." This episode provides a great overview of what it is like to practice general dermatology. Dr. Cotell practices mainly medical dermatology, with some procedural dermatology and cosmetic dermatology. In this episode, she highlights several aspects of dermatology practice that she particularly enjoys. As reports continue to be released about physicians who are seeking non-clinical careers, I was so glad to highlight the experience of a physician who has been a happily practicing clinician for years.

I was very glad to have the opportunity to speak with Dr. Srihari Gopal, who is a physician in the pharmaceutical industry and current Global Head at Regeneron. His work has encompassed multiple areas within drug development, from study design and research to regulatory filings to leading drug development teams. I have fielded a number of questions from students and early career physicians about the pharmaceutical industry, and as Dr. Gopal described his career, there were several aspects of his work that he highlighted as particularly meaningful and energizing. -He has really enjoyed learning and advancing the science of drug development, and has approximately 200 publications and 30 patents to his name. -He talked about the ability to make an impact on a wider scale with the work that he does, and how that is an aspect of his work that he finds very meaningful.-He is also on the cutting edge of medicine. The drugs that he is currently working on are those that we will be seeing in the clinic 10 years from now. In this episode, he provides some great advice for medical students and physicians who are interested in learning more about working in the pharmaceutical industry

This conversation with Dr. Brett Perkison highlighted several interesting aspects of both Occupational Medicine and career development. First, many medical students are simply not exposed to Occupational Medicine as a specialty choice. Learning about the different career choices within this specialty is interesting. Residents receive a Masters of Public Health during their training, and bring a preventive medicine and public health focus to their work. One of the themes I see in physicians who are energized at work is that they maintain a lifelong commitment to learning and development. As Dr. Perkison‘s career has developed, he has continued to nurture his interest in clinical care, leadership, and research. He currently serves as the Residency Program Director of the Occupational and Environmental Medicine residency at the University of Texas Houston. He also continues his research studies, including projects focused on the health of disaster response workers and diabetes prevention. About Dr. William “Brett” Perkison, M.D., MPH, FACOEM: Dr. Perkison is an Assistant Professor on faculty at the University of Texas School of Public Health, where he is the program director for the UT Occupational and Environmental Medicine residency. Prior to joining the UT faculty, he has had extensive experience managing occupational health services in both the energy and health care industries. During his career he has also been involved in leading disaster response efforts in the Houston area for numerous flooding events, including for Hurricanes Katrina, Ike, and Harvey. Occupational Medicine College Web Site: https://acoem.org/ American Board of Preventive Medicine: https://www.theabpm.org/ UT Occupational and Environmental Medicine residency website: https://sph.uth.edu/research/centers/swcoeh/occupational-environmental-medicine/ Link to Dr. Perkison's publications: https://www.ncbi.nlm.nih.gov/myncbi/1pa0ucD38iwAs/bibliography/public/

This conversation with Dr. Terri-Ann Samuels highlights the field of urogynecology/female pelvic medicine and reconstructive surgery. It was an interesting overview of the field, and Dr. Samuels also had some great advice for medical students, including an emphasis on lifelong learning. Dr. Samuels is a board-certified urogynecologist/female pelvic medicine and reconstructive surgeon. She founded her private practice Essentially You with a focus on surgical and non-invasive treatments for pelvic medicine conditions. She completed her residency in Obstetrics Gynecology and then a fellowship in Urogynecology. She is active in speaking on women’s health issues, and has been involved in international medical and surgical missions for many years, including fistula mission work in Kenya and Liberia. More about Dr. Samuels and her practice Information from the American Urogynecologic Society on the field

Dr. Munish Chawla is a Diagnostic Radiologist who later became a board-certified Lifestyle Medicine Physician due to his deep passion for the field. In speaking with him, I was really struck by the fulfillment he finds in this new field. He told me that reading a CT scan and making a diagnosis is gratifying, but the feeling of seeing a patient succeed with lifestyle changes was incredibly fulfilling. Another thing that struck me about his career arc was that he didn’t set out to change careers. He found himself interested in lifestyle medicine, and was initially just following his curiosity to learn more about it. Through the process, he also became very interested in behavior change. As he put it, he thought that once he shared information about the benefits of lifestyle change, that people would go out and make changes. Recognizing the importance of behavior change, he started studying coaching, Western psychology, and Buddhist psychology, in addition to mindfulness meditation. Dr. Chawla, with his wife, Internist Dr. Bandana Chawla, is also a founder of the non-profit Peaceful Planet Foundation. I attended their conference last year, and came away very inspired. For medical students and practicing physicians, his career arc provides some insightful lessons, while his experience as a practicing Lifestyle Medicine physician will be very helpful to those considering this as a career. Contact +1 713-592-8900 info@lifestyledocs.com https://embeelifestyledocs.com/ Specialties Available for Lectures Lifestyle Medicine Radiology

How do you build a career on the cutting edge of medicine? For Dr. Caitlin Sutton, Division Chief of Maternal-Fetal Anesthesiology at Texas Children's Hospital, it involves pursuing your professional passions-- even when you receive unsolicited negative feedback from colleagues. Our conversation was a good reminder for me that working on the cutting edge of medicine means that very few people have done what you have done. And that means that others may not be able to envision it--and may even discourage your chosen career path. Texas Children's Hospital is one of the pioneers in fetal surgeries (in which surgery is performed on a fetus while in utero), and Dr. Sutton administers anesthesia during these procedures for both the fetus and the mother. She is one of a very small group of anesthesiologists across the country who can do so, having completed fellowships in both obstetric anesthesiology and pediatric anesthesiology. For medical students, Dr. Sutton provides a great overview of what it is like to work as an anesthesiologist. Her passion for her work comes through when she talks about how fulfilling it is to make patients feel safe and comfortable during life-defining moments.There are also some great career insights in this episode. As she says, “it takes a village to pursue any medical career." Although she faced negative feedback about her career choices early on, now she can’t imagine a better job for herself, and she advises students to go for what they want. Dr. Sutton is also a clinical ethicist, a field that we touch upon here and that we plan to delve into more deeply in a later episode.Dr. Caitlin Sutton, Division Chief of Maternal-Fetal Anesthesiology at Texas Children's Hospital

Dr. Guo is a Professor of Rehabilitation and Integrative Medicine at the MD Anderson Cancer Center. As a rehabilitation physician, she works with cancer patients at all stages of their therapy to improve their function and recovery. She also brings an integrative approach to her care: later in her career, she went back to school to become certified in medical acupuncture for physicians, a treatment she is now able to provide for her patients. When I asked her what she finds most energizing about her work, she focused on the fulfillment of seeing patients regain their function, as well as the ability to use her creative problem-solving skills to help patients overcome their challenges. She also described the support she receives that helps her continue growing and learning. Dr. Guo is a full Professor at the MD Anderson Cancer Center. She is certified in medical acupuncture for physicians. https://faculty.mdanderson.org/profiles/ying_guo.html

There are several insights shared in this episode with Dr. Anthony Brissett which really struck me as important for career longevity. Dr. Brissett is a facial plastic surgeon and ENT physician. He wears a lot of hats, including responsibilities in clinical care, research, teaching, administration, and increasing responsibilities related to his medical non-profit organization. He is very mission-driven, which has led him to devote much time to humanitarian work. His work in many countries around the world, from Ukraine to Rwanda, has focused on providing surgical care to patients as well as "developing capacity", in which he has worked to strengthen medical training programs locally. He continues to grow in his clinical practice as well, developing a new area of focus within facial aesthetic surgery called cultural preservation. Another item that struck me about our conversation was how he gets it all done--always a key question when a physician wears so many hats. He spoke about collaboration, and the African proverb that says that "If you want to go fast, go alone. If you want to go far, go together." He's also very structured about his work week, as well as very persistent in asking for the resources he needs in order to provide the highest quality patient care. I'm struck by how many of the physicians I speak to who are energized at work combine these two facets of their career. They are very mission-driven and focused on their values, while at the same time place a strong emphasis on the practical side of getting things done. Dr. Brissett is a board-certified facial plastic surgeon and otolaryngologist. He is a founding member and board member of Casa El Buen Samaritano, which provides free healthcare services. He also travels across the world to provide surgical care, including Ukraine, Rwanda, and multiple other countries. He is the Director of Facial Plastic and Reconstructive Surgery at Houston Methodist Hospital, as well as Professor of Clinical Otolaryngology, Houston Methodist Hospital/ Weill Cornell Medical College.

Dr. Sejal Desai is double board-certified in Family Medicine and Obesity Medicine, and one of the things that really comes through in this episode is the deep connection she feels to her work as an obesity medicine physician. In fact, she calls Obesity Medicine “happy medicine“, and she describes how happy she was that she discovered this field well into her career as a family medicine physician. She speaks about her deep passion for preventative medicine throughout her career, and how extra training in obesity medicine, followed by board certification, has helped her make a significant impact in her patients’ lives. This insight, about connecting deeply with one’s purpose, helps her stay energized and fuels her passion for helping patients with obesity overcome challenges and make long-lasting lifestyle changes. Dr. Desai is a double board-certified physician practicing in Houston, TX. She has been in practice for almost 20 years and has been specifically working with patients who struggle with the disease of obesity since 2013. She is the Founder and Medical Director of Tula Medical Weight Loss & Wellness, a comprehensive, evidence-based approach to weight loss and maintenance. She also serves as a board member for HOPE (Houston Obesity Partnership for Excellence), a GOLD Panel Speaker to educate healthcare providers about rare genetic diseases of obesity, is a member of the Obesity Medicine Association’s membership committee, and volunteers in her community to educate adults and kids on the benefits of lifestyle intervention for chronic disease prevention. Tula Medical Weight Loss & Wellness - www.tulawlw.com American Board of Obesity Medicine - www.Abom.org Obesity Medicine Association - www.obesitymedicine.org

Dr. Thao Galvan is a pediatric and adult transplant surgeon, in the division of abdominal transplantation. She is an Associate Professor of Surgery at the Baylor College of Medicine, and operates at Baylor-affiliated hospitals and Texas Children’s Hospital. She is also an award-winning educator, health policy scholar, and researcher. In this episode, she shares what a week in the life of a transplant surgeon looks like, from spending many hours in the operating room, to traveling across the country, to working on the logistics of arranging transplants. She is frank about how hard it is, but also shares some of her strategies and insights on how to be successful in such a challenging field while continuing to grow in her career and care for her young family. One of these strategies that Dr. Galvan discusses is how she has embraced a growth mindset, and how she continues to learn and grow with her surgical skills as well as her teaching skills. She discusses how important it is to maintain a cohesive unit with her team in and out of the OR, and how one of her goals is to "keep the train moving" and still keep it playful. https://www.bcm.edu/people-search/nhu-thao-galvan-21685 https://www.texaschildrens.org/find-a-doctor/nhu-thao-nguyen-galvan-md-mph

In this episode, Dr. Amy Paller shares some of her insights and strategies behind her long and impactful career as a clinician, translational researcher, and Professor and Chair. One of those insights is that in order to succeed as a researcher, it takes a village. She advises students that success in research depends on a great team, as well as mentors and funding. For her own career, she has found that a diversity of interests, passion for her work, and time with family has helped fight burnout and has kept her energized. Dr. Paller currently serves as the Chair and Professor of Dermatology, Professor of Pediatrics, and Principal Investigator of the NIH-funded Skin Disease Research Center at Northwestern University’s Feinberg School of Medicine. An author of more than 350 original publications, Dr. Paller is an NIH-funded investigator with a focus on genetic disorders of the skin and cutaneous immunologic disorders in children, including atopic dermatitis and psoriasis. Dr. Paller has also directed the Pediatric Dermatology Clinical Trials Unit at Northwestern for the past 20 years, and has been the lead investigator on several landmark trials in pediatric skin disease. Apart from her significant contributions to clinical dermatology and translational research, Dr. Paller has been a teacher and mentor to many students, residents, and researchers, many of whom are now at institutions across the country and globe.

How can you best prepare for the USMLE Step 2 exam? In this episode, we continue our conversation with Dr. Ryan Downey, test performance coach and expert in educational assessment. Dr. Downey discusses three of the “highest utility,” or most effective, active learning techniques he teaches his clients. Internally referred to as the “Three T’s of Active Learning,” these techniques – Test yourself, Talk it out, and Two (or more) channels – are evidence-backed techniques that help medical students learn material faster and retain it more deeply. Resources More information on test performance services offered by MD2B Diagnostic Dr. Ryan Downey’s background Article on relative effectiveness of learning techniques: Dunlosky et al., 2013 Article on the science of learning: Weinstein et al., 2018 Blog post on active learning techniques

With the Step 1 exam now using Pass/Fail scoring, the numerical score on the Step 2 CK exam is even more important than ever. How can you be sure that you’re preparing for the USMLE Step 2 exam in the best way possible? In this episode, we interview Dr. Ryan Downey, test performance coach and expert in educational assessment. Dr. Downey discusses some of the key strategies he used to help his client “David“ boost his Step 2 scores from 208 on his practice exams to an official Step 2 score of 260. The key to test success is a personalized study strategy that works for each individual client. Using the results from David’s Diagnostic Intake Assessment, which is a proprietary tool developed by Dr. Downey and Dr. Samir Desai, David was able to change the way he studied to incorporate more use of self-assessment, more active learning strategies, and more practice with clinical reasoning tools. Resources More information on test performance services offered by MD2B Diagnostic Dr. Ryan Downey’s background