During my training as an internist and neurologist, I struggled to achieve the ultimate trifecta of becoming a physician/scientist/teacher. Medical icons of the past such as Sir William Osler, James Parkinson, and Wilder Penfield exemplified this goal. It took years to realize that this laudable objective had become much more elusive in modern times and perhaps impossible.
Many thanks to David Weinstock, MD, Professor of Medicine at Harvard Medical School and oncologist at Dana-Farber Cancer Institute in Cambridge, MA, for commenting on his recent article published in the New England Journal of Medicine that addresses this issue (NEJM 2020;383 (19):1809-1811). Dr. Weinstock’s impeccable credentials make his article all the more persuasive.
Dr. Weinstock reluctantly concluded that it was humanly impossible, at least for him, to maintain optimal clinical skills while running an oncology laboratory searching for a cure for cancer. He admits to “feeling like a failure” at being unable to continue as a “triple threat” (clinician, researcher, and teacher). Finally, he realized, “Medicine is an art. Great artists obsess over their work; they practice to the exclusion of all else.” We agreed that primary care clinicians and other generalists face an explosion of knowledge to master that tasks even the most talented and dedicated practitioners.
Dr. Weinstock’s realization took courage to put into print for colleagues and students to see. Nonetheless, he felt obligated to share this new reality with current students who hope to become physician-scientists. He still encourages trainees to pursue a career as a physician-scientist if that is their passion. A physician-scientist is still “the best job that there is, but it’s a very long training process, and you’ve got to be in it for the journey, and you’ve got to get goosebumps every once in a while when you discover something….”
To put his advice in perspective, note that Dr. Weinstock trained for 18 years before getting his first job! Please join us for this 20-minute interview as we discuss how the practice of medicine and medical research has evolved since the days of Sir William Osler, James Parkinson, and Wilder Penfield--when physicians really could do it all.
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