Teach Your Trainees Well 

How did being chief resident (’98) shape your teaching style? 

The chiefs played a large role in the educational vision of MIR. And we were lucky enough at the time to have Dennis Balfe as program director. All the section chiefs back then were very education forward, and it wasn’t at the expense of the radiology or the science. For me it felt like being good at education wasn’t the pathway but actually part of the pathway.

At what point did you decide to pursue a leadership role in education?

I felt from an early stage that if I were teaching, I was better at doing radiology. You have to answer questions from trainees, and those questions are constantly making you better. I really loved the learning that came with teaching. And then this whole learning movement in education happened around us — both at the medical center and on a national level — where people started to realize there is potential in becoming a medical educator.

What qualities contribute most to a successful teacher? 

Empathy.

You’ve received multiple accolades throughout your career. Which one holds the most significance and why? 

For me, there are two that stand out the most: the Barnes-Jewish Hospital Neville Grant Award and the Caring Spirit Award. In those cases, it was recognition as being a good doctor. My vision has always been to allow the world to see what great physicians are at MIR. We’re bigger than just reading images. We’re people who can save lives. Every time we make a good call, it’s a tremendous way to honor all our mentors who passed away. I’m not making a good call because I’m awesome. I’m making a good call because I was taught to make a good call. 

What are some of the most memorable teachable moments in your career? 

Awards are one thing, but they only capture a small part of the picture. For me, one of the things that is always humbling and inspirational is reading out residents in the ER. Often they’ll be reading these really difficult cases — whether it’s an aorta about to rupture or something weird in the heart — and they get it right and say, “You taught me that.” It’s those micro moments that are so huge. 

How has radiology training changed since you joined the faculty? 

In academic teaching, I say three years defines a culture. If I talk to the residents about life before COVID, I might as well be talking about Pompeii before Vesuvius erupted. It doesn’t have much bearing on what their reality is. That means I’ve been here for about eight generations of teaching. 

It used to be that a resident was a pure apprentice, with learning on a job. Then, in the 2000s, the ACGME started changing the rules. First it was the core competencies, followed by milestones; then duty hour rules go into effect. And we started to see a blurring of the line between being a student and being an apprentice. 

There has also been disruptive technology. Nobody had cellphones when I was a resident, and we accessed the internet with dial-up modems. We’ve also gone from books to mostly online resources, with all the information available at your fingertips. Conversely, life has gotten more complicated. It’s more common now for two parents to be working. Time outside of work is limited, and people are grappling with how to handle all these things in a modern learning environment. 

How do you see radiology training changing in the next five years? 

I actually think it’s somewhat retrospective. In 2028, the American Board of Radiology is going to bring back the oral board examination. It sundowned in 2012, and what we’re going to see is a return to a need to publicly discuss cases in an oral format. At Mallinckrodt, we never left our unknown case conferences, and what we’ve noticed is that many other programs are asking us to tell them about our unknown cases. They want to bring this type of discussion back because they know it will help with oral boards. 

Also, because of COVID, we learned that remote teaching was possible — that you could have an attending sitting in another state, or even another country, and teach a resident in any program. 

What advice would you offer someone interested in pursuing a career as an academic physician?

Stuart Sagel used to say that being an academic physician is like running a relay race. You get a baton from your mentors, which is the knowledge, and you carry it throughout your career until it’s time to pass it on to the next generation. Then he’d say, “Don’t drop the baton.” 

Published in Focal Spot Fall 2024 Issue