(75R-Pediatrics, 77F-Neonatology)

What is your hometown?

Boston, MA

What is your official title?

Executive Vice President of the American Board of Pediatrics

How/when did you become interested in science and medicine?

My initial inclination was more toward the humanities, art, and literature, until I began volunteering at a hospital in Boston. Although I always enjoyed science, it was the interpersonal relationships inherent in medicine that attracted me to it as a career.

What interested you to pursue a career in medicine and academic medicine?

I gravitated toward pediatrics as a medical student because children usually have isolated medical problems and there is a greater possibility of making a difference in a child’s life that would be long-lasting. I chose an academic career in neonatology because 30 years ago it was on the cutting edge of advances in the care of children and was not as narrowly focused as other subspecialties of pediatrics.

Please highlight your major career achievements, awards, discoveries, etc.

My education and leadership awards include the Accreditation Council of Graduate Medical Education’s Parker J. Palmer Courage to Teach Award, the James Taylor Teaching Award in the Department of Pediatrics at the University of Iowa, and the Association of Pediatric Program Directors’s Walter Tunnessen, Jr. Award. I am a member of The Gold Humanism Honorary Society.

I have served on the Residency Review Committee for Pediatrics of the Accreditation Council of Graduate Medical Education as its Chair during the period of time competency-based training was in its infancy.

I am currently Vice Chair of the Residency Review and Redesign in Pediatrics Project of the American Board of Pediatrics, which has led to a major initiative to foster, facilitate, and oversee innovative change in pediatric residency education through carefully monitored, outcome directed experimentation.

I have been appointed as the Executive Vice President of the American Board of Pediatrics.

Is there a teacher, mentor or UI Carver College of Medicine faculty member who has helped shape your education?

Dr. Fred Smith served as the Chair of the Department of Pediatrics when I was a junior faculty member. He was a strong personal mentor who fostered my interest in medical student and resident education and supported me in achieving my career goals.

How or why did you choose the University of Iowa for your education and medical training?

I moved to the University of Iowa for residency training based on a combination of personal relationships, as well as a highly regarded Department of Pediatrics in the early 1970s.

What kind of professional opportunities or advantages has your University of Iowa medical training provided?

I spent the majority of my academic career at the University of Iowa. I was supported by two department chairs and a division director allowing me to focus my efforts in the education arena. There were many role models who were outstanding clinicians and teachers who set high standards for patient care and personal and professional development, one of whom later became my husband. Fred Smith was instrumental in fostering my involvement in a volunteer capacity with the American Board of Pediatrics early in my academic career, which ultimately led to a change in career direction and appointment to the Board’s permanent staff as the Executive Vice President.

As a graduate of the UI Carver College of Medicine, what does being the recipient of the Distinguished Alumni Award mean to you?

I did not graduate from the College of Medicine, but completed my residency training in pediatrics and a portion of my fellowship training in neonatology. I then spent the majority of my academic career at Iowa, nearly 25 years in total. I have many close friends and colleagues at Iowa and receiving this award is very meaningful.

Please describe your professional interests.

Even while I was practicing neonatal-perinatal medicine, a major focus was teaching and mentoring residents and fellows. I have now been able to continue, in a sense, on a national level by my involvement in standard setting for training in general pediatrics and its subspecialties, all focused on the ultimate goal of improving the quality of care for children.

As an advocate and formative leader in undergraduate and graduate medical education, and the pediatrics specialty, what would you say has been the most important change in education that you have seen?

Nearly a decade ago the Accreditation Council for Graduate Medical Education (ACGME), the organization that sets standards for residency training across all of the specialties, embarked on an outcome project, which emphasized six core competencies and the actual accomplishments of a training program, rather than the process of training. Its goal was to enhance education so that future physicians are better prepared to provide patient care in a changing environment. The emphasis was on educational assessment by the use of measures to assess effectiveness.

What are some of your outside interests?

I enjoy visual and performing arts, travel and reading for pleasure.

Do you have an insight or philosophy that guides you in your professional work?

Listen more than you speak, respect the opinion of others, and give credit where it is due. And, of course, choose a job for which you have a passion so that you will love to go to work and the rest will follow naturally.

What is the biggest change you've experienced in medicine since you were a student?

One change has been an increased focus on an individual physician’s professional responsibility to improve quality of care. This has been coupled with an evolving understanding that we have a professional commitment both to the individual patient and to society that requires us to assess the quality of our care as individuals within a system and to continually strive to improve it.

What one piece of advice would you give to today's medical students?

Don’t count on having the same job 30 years from now. Follow the opportunities that arise. Many things happen by chance and one must be open to the possibilities of a change in career direction.

What do you see as "the future" of pediatric medicine?

Pediatric residency education was designed many years ago to prepare an individual to work in an ambulatory clinic, the general inpatient ward, the emergency room, and the delivery room. This model is becoming increasingly uncommon in practice and an unusual career aspiration of current residents. Thus, in addition to providing a foundation in general pediatrics, pediatric residency education should offer programs that prepare residents for the diverse and emerging health care needs of children and provide flexibility for multiple career options. There will be need for a comprehensive approach to children with chronic physical, mental, and developmental-behavioral disorders, as there is a shift in the causes of health related morbidity and mortality in children from episodic acute illnesses. There is an increase in cultural diversity in children and parents, as well as changes in the expectations of the pediatric workforce with a greater emphasis on family and personal priorities. In addition, pediatric health care is increasingly delivered by teams working in concert with patients and parents. Therefore, the residents and fellows of today must become skillful leaders, collaborators, and communicators.