A physician educator shaping the future, one student at a time...
I did not grow up with dreams of becoming a doctor. I come from a family of engineers—education was essential; striving to excellence was a mandate. I thought I would go into engineering, but somewhere along the way I liked biology, so I went into medicine. I started my career at Madurai Medical College in southern India, and then came to the United States for residency training at the University of Louisville, Kentucky. In 1992, I followed my husband, Seshadri Guha, to Peoria to complete my second and third year of internal medicine training at the University Of Illinois College Of Medicine at Peoria (UICOMP) and OSF Saint Francis Medical Center (OSF-SFMC). Around the time I finished my residency, I joined the UICOMP faculty and was offered the position of clerkship director of internal medicine.
That was my first real stepping stone into academia and education. As clerkship director, I was responsible for overseeing the teaching, curriculum development and assessment of students during their third year of medical school. In addition to the administrative responsibilities, I was part of the ambulatory internal medicine faculty practice and supervised residents providing care to patients at OSF-SFMC’s inpatient and ambulatory settings. I discovered that it’s a lot of work to teach, develop curriculum and see patients—but that it is very rewarding.
In an effort to provide high-quality care to inpatients and enhance residency education and training, our faculty group decided to focus primarily on inpatient medicine. Thus, we became “academic hospitalists”—physicians whose primary focus is hospital medicine. We were one of the first hospitalist groups in Peoria. Since then, hospital medicine and hospitalist programs have expanded significantly.
Tell us about your passion for teaching and curriculum development.
A while ago, a former resident of mine wrote to me, “I don’t know if you remember me… but I will never forget a patient encounter we shared. This was a patient who was acting abnormal, and I wasn’t sure if the patient had an issue or was just making up stories and seeking attention.” He further recalled that—after some discussion, and despite some skepticism about the patient’s truthfulness—tests were done that helped confirm a diagnosis and save the life of the patient. “From then on,” he concluded, “I have never forgotten what you taught me that day: trust before you make assumptions about your patients.”
Such a letter reminds you what teaching is all about—making a difference! Teaching one student today who will care for thousands of patients in the future is important, and encouraging them to value the importance of teaching others is a multiplier that has a huge impact on our profession.
The same goes for the curriculum. We have introduced a lot of exciting and innovative curricula, both in the internal medicine clerkship and within our medical school. Peoria is truly leading the country in medical education in many ways. For example, in our second-year curriculum, we have decreased lecture time by more than half in three years, and replaced that “passive” learning time with team-based learning; small, case-based discussions; and simulation sessions at the Jump Trading Education and Simulation Center. The reward you get when you see that “aha” moment in the eyes of students is hard to describe.
Faculty development is another essential component that affects curricular enhancement and transformation. In 2008, I became director of the Caterpillar Faculty Development Fellowship program, which enhances the teaching, leadership, research and collaborative skills of junior faculty. In December 2015, we will graduate the seventh cohort of faculty scholars. Over the years, more than one third of the 45 “Cat Scholars” have advanced to positions of leadership in their respective departments and hospitals. Building faculty leaders, the curriculum and the teaching infrastructure of the future is something we have to do every day—it is just as important as training students.
What are some of the biggest accomplishments and challenges you have faced during your tenure?
Managing in the face of ever-dwindling resources to deliver an ever-higher quality of education and care—while finding resources to invest in the future and building the brand of the school—represents a daily challenge. Many people may not realize that we have more than 1,300 faculty members, and the vast majority are volunteer faculty who receive no pay to teach in addition to providing patient care. However, with more physicians retiring, the patient population aging and the workload increasing, maintaining this level of volunteerism will be difficult.
All of this comes at a time when state funding and reimbursements for medical care are declining, and investments in research are becoming scarcer. The significant financial burden placed on UICOMP has the potential to erode the teaching mission if we don’t act strategically. It is my responsibility to help lead efforts to better prepare the next generation of physicians, to advance healthcare delivery and enhance rural health in central Illinois, despite these hurdles.
Undoubtedly, my greatest accomplishment is reflected in the quality of the medical students we graduate each year. We expect them to learn critical thinking and huge amounts of scientific information; we expect them to communicate compassionately and effectively; we expect them to be professionals who recognize the human, financial and long-term impacts of their decisions; we expect them to work in teams and contribute to the missions of the organizations they will represent in the future. It makes me proud to support these students as they live up to these expectations. Candidly, I’d say that graduation is one of the most rewarding days in my life. Watching our students walk across the stage as physicians is a wonderful feeling. You feel that you have helped shape the future one student at a time… maybe in one life saved, maybe in one life changed. It feels good to have made a difference in this world! I am sure that many of my colleagues would agree.
As clerkship director, one of my greatest contributions was improving the learning experience of students during their internal medicine clerkship, which was the highest-rated clerkship in Peoria and the highest-rated internal medicine clerkship across all four University of Illinois College of Medicine campuses during my tenure. Recognizing the work done by the faculty, the Department of Internal Medicine received the Outstanding Department Teaching Award across the entire University of Illinois at Chicago system.
Another big accomplishment was enhancing “subinternship” curricula for students participating in internal medicine rotations during their fourth year. For this and other curricular innovations, I was awarded the Lou Pangaro Educational Program Development Award. This is a national award granted by Clerkship Directors of Internal Medicine. It was a true honor to receive this award at a national level from my peers.
What are your goals as associate dean of academic affairs?
UICOMP’s mission is to “Lead Collaboration to Improve Health.” My foremost goal is to educate outstanding physicians who will be well prepared to serve and provide effective, high-quality healthcare in Illinois and across the nation.
In 2017, the UICOMP will become a four-year campus. For the first time in our 45-year history, we will take responsibility for the first-year medical curriculum—a huge milestone that requires a lot of planning and work. Since the 1970s, the University of Illinois College of Medicine has been comprised of four campuses. The original Chicago campus has always been a four-year campus. The Peoria and Rockford campuses have trained students in years two, three and four, with their first year spent on the Urbana campus. Becoming a full, four-year program provides UICOMP with tremendous opportunities:
- Recruitment and retention of future physicians. A four-year campus provides better opportunities for longitudinal training, mentoring and peer support. Early exposure to clinical opportunities in Peoria can help recruit and retain students to become an integral part of the healthcare delivery system in central Illinois.
- Workforce and economic development. Expanding the campus requires additional faculty recruitment and staff support to teach first-year content. This has a ripple effect: not only will faculty participate in teaching, they will be involved in research and patient care and bring other expertise that will enhance healthcare delivery in the region.
- Curricular innovation. Having students assigned to a single campus provides the ability to implement significant curricular innovations. Simulation-based education can be introduced earlier, helping to better develop effective communication and teamwork skills, while encouraging students to integrate technology effectively with patient care delivery. Even simple things like learning how to communicate sensitively with a patient while simultaneously reviewing electronic health records can be practiced in simulated settings.
- Technology-enhanced medical education. We plan to build new, flexible learning environments that incorporate the latest technology to promote engagement, collaboration and new approaches to teaching.
Beyond your role as a physician educator, how have you contributed to the Peoria community?
My husband and I firmly believe that it is important to give back to the community. One of the events I am proudest of is Passage to India, a benefit for Easter Seals, which was born during a dinner conversation with a few friends at our home. Our goal was to raise funds for children with disabilities while maintaining a tradition of Indian culture and cuisine. In 2006, about 90 people attended, and we raised about $10,000. Over the last ten years, the event has grown significantly. In 2015, we welcomed more than 1,200 guests and raised over a half million dollars for Easter Seals children. In addition, the event now includes a leadership summit that brings international leaders to our community to discuss ideas and build collaboration among various business entities. The success of this event is attributed to the many volunteers who put in a tremendous amount of time and resources to make it a success. I’m very proud to be part of this team and of the impact it has had on Easter Seals and children with disabilities.
Another fun event we have been involved with is “Dancers with Heart,” a benefit for Children Hospital of Illinois (CHOI). This was a collaborative performance, with Indian dance by Mythili Dance Academy and ballet by the Peoria Ballet, which raised money for the congenital heart center at CHOI. It was a huge success, and we are in the process of planning our next event in 2016!
What is your secret to maintaining a balance between work and your personal life?
Recognize what is important to you and hold true to your values. Life is about prioritization and compromise. It should not be a running tally of who does what—that only makes you miserable! It is important to do the right thing at the right time for the right reasons.
I value my family and friends, and I’m very proud of my professional accomplishments, but if I had to give up my career for the sake of my family, I would. They recognize the importance of what I do, but they also recognize that I am always there for them if they need me.
Lastly, get help when you need help. Don’t try to do everything yourself. Whenever you can, outsource the things that don’t need to be done by you, and make time every day for family. The children grow up very fast, so spend time with them. Work is always waiting for you after they have left home!
Did you have a mentor in the early stages of your career?
My earliest mentor was my dad. He taught me the importance of hard work, the pursuit of excellence and commitment to doing what you are doing to the best of your potential. This has stayed with me to this day. My mom is an eternal optimist who encouraged me to see the good in people around me.
In my professional life, Dr. Sara Rusch, regional dean at UICOMP, has been a great mentor. I’ve spent many occasions in her office discussing work-life balance, talking about families and balancing the demands of teaching and emotional strains that come with caring for sick people. Dr. Rusch has always trusted me to do my job and encouraged me to pursue opportunities even when I was not sure of myself. She was always calm and collected in her approach. I have learned many a lesson from her that I have tried to pass on to others.
What’s the hardest life lesson you’ve had to learn?
Knowing that something is the right decision does not make it an easy decision. As a physician, it is hard to make some end-of-life decisions. I know this from personal experience: I had to do it with my dad when he was terminally ill. I’m a physician. I had all of the facts, but it was the hardest decision I ever had to make. I bring that experience with me when I talk to families about their loved ones in the hospital. Life teaches you that sometimes doing the right thing can be hard!
What advice would you give to young, up-and-coming women professionals?
Believe in yourself! Have confidence in your abilities and courage to do the things that are important to make a positive impact, however big or small, even if it seems out of your grasp! I would tell them to choose a career path for which they have passion and not do something “just because.”
I tell my students to think about what is going to make them happy beyond material things. What’s going to motivate you? Young women professionals always ask me about work-life balance, and when is a good time to start a family. There is no perfect time to have a family. You can plan, but when life happens, take it in stride; it is a part of your journey. Life is not a sprint but a marathon, so sometimes it might take a little longer for you to get to where you want to go. Life can have ups and downs, but that is what makes great moments and memories. iBi