Leaders in Medical Education: Dr. Peter F. Buckley, Dean of the Georgia Regents University Medical College

buckley4Dr. Peter F. Buckley became the 26th Dean of the Medical College of Georgia at Augusta University in 2011. A psychiatrist and expert in schizophrenia, Buckley is also a Professor of Psychiatry, Pharmacology and Radiology. He is currently serving as Interim Executive Vice President for Health Affairs for Augusta University and Interim Chief Executive Officer for AU Medical Center and AU Medical Associates.

Buckley serves as a member of the Administrative Board of the Council of Deans (COD) of the Association of American Medical Colleges (AAMC) and also chairs the COD Fellowship Program. He is a Distinguished Fellow of the American Psychiatric Association and served on the association’s Workgroup on the Role of Psychiatry in Healthcare Reform. He is also a Fellow of the Royal College of Psychiatrists and served as Chair of the PanAmerican Division. Buckley is a past President of the American Association of Chairs of Departments of Psychiatry. He serves as a member of the Data Safety & Monitoring Board of the National Institute of Mental Health. He is former Chair of the NIMH Interventions Committee for Disorders Related to Schizophrenia, Late Life, or Personality, and regularly serves as Chair for various special emphasis panels. Buckley also serves on the Maintenance of Certification committee for the American Board of Psychiatry and Neurology. He has served as a reviewer for the Liaison Committee on Medical Education (LCME) and as a reviewer/panel participant for the National Academy of Medicine (NAM). He is a member of the Executive Committee of the International Congress of Schizophrenia Research.

 

How did you decide on a career in medicine?
I was fortunate to come from a family with a legacy of doctors. Both my parents were doctors and I also had an aunt and uncles who were physicians and my grandfather was a medical school dean. All that said, my family’s influences was more by modeling and enthusiasm and my relatives were keen not to convey any pressure to me to follow ‘in the family tradition’. I was particularly influenced by my father, a family medicine physician who gave so selflessly to his patients and his community.  He was revered by his patients and did great good for mankind. He was – and continues posthumously – to be a great role model for me.

 

What were a few key steps in your journey from an aspiring medical student to your current position as Dean of the Georgia Regents University Medical College?
Careers are funny things – a mixture of carefully planning of ‘next steps’ and just plain serendipity!  I trained in Dublin Ireland and was powerfully influenced by my attendings.  I entered psychiatry residency directly upon medical school graduation (unusual, as many people ‘shop around’ first to gain additional varied experiences before deciding where to specialize).  After residency and fellowship (in schizophrenia research), I emigrated to the U.S. to join the faculty at Case Western Reserve University (CWRU).  I also became medical director of 3 state mental health hospitals, gaining administrative experience early on in my career.  After 8 years at CWRU, I was very fortunate that Darrell Kirch, MD, current CEO and President of the Association of American Medical Colleges and then Dean of the Medical College of Georgia, appointed my as chair of the MCG Department of Psychiatry.  After 10 years as chair, I was again fortunate to be appointed as MCG Dean.

 

What is the greatest difference between the clinical side of medicine and the administrative side?
There are, of course, intricately interrelated in academic medicine.  Deans inevitably spend a substantial portion of their time on clinical issues.  Inevitably, the clinical services is an important part of the financial aspect of running a medical school.  Also, of course, faculty activity in the clinical education, and research are responsibility of the Dean’s and Chair’s offices in allocation of time and effort. No matter how involved one is administratively, it’s still important to remain clinically active.

 

What does an “average” day look like for you?
“Average days” are, not surprisingly, variable. I spend a lot of my time recruiting people – interviewing potential faculty, supporting other recruitment searches across the university.  Inevitably, I spend substantial time in meetings of various sorts – hospital meetings, clinical practice meetings, research meetings, educational leadership meetings, presidential leadership meetings, addressing university-wide administrative issues.  There are also 1-on-1 meetings with researchers, educators, departmental chairs etc. Often, there are university and/or community events that the Dean attends on behalf of the students, faculty and the medical school.  Finally, due to the team I work with, I’m fortunate to be able to continue to do clinical research and so this is also part of the mix.  And then, of course, there are myriad of evening and weekend commitments. How it all comes together in any given day is managed by an experienced and excellent administrative assistant.  Managing such a hectic and variable schedule is really complex – I gave up trying years ago and now I just show up where I am told to be!

 

What was/were the most memorable experience(s) during your medical education?
My clerkship through psychiatry – 6 weeks – was way ahead the most memorable and influential part of my medical education.  I was captivated by how interesting mental illnesses were and also I had a profound concern for the human loss and disability of mental illness.  Also, my teachers were very encouraging of my initial interest.  I know that other medical students found this rotation in psychiatry  not as interesting as I did and, of course, they went on to become internist, surgeons, ophthalmologists, etc.  Now, as Dean, I find it encouraging and gratifying that our medical students today each find their own passion and career focus.  It’s a great experience to discover one’s passion and future care in medicine and the influence of mentors can be profound.

 

What do you think is the biggest challenge facing physicians today?Doctors face many challenges – implementation of electronic medical records, shifting in healthcare funding from care reimbursed on volume to care reimbursed on quality, incorporation of social media and mobile-health into clinical care. All that said, the biggest challenge is still to preserve and advance the patient-doctor relationship.  The good news is that, while lack of time and increasing technologies are potential obstacles to this time-honored expectation for individual care, the shift in consumerism is now driving much more patient-centric approaches and greater focus on patient satisfaction.  Technical competency as a doctor does not equate to being a good doctor.  The patient experience can be improved by greater access, attention to communication, empathy, and the basics of a good experience at all levels of the patients visit for care.

 

There is an enormous debate these days as to whether resources should be primarily allocated to fighting diseases or the distal causes of diseases. What are your thoughts on this issue of proximal causes versus distal causes?
‘Proximal versus distal focus’ is a great question and it is a real dilemma for all of us.  I recently heard a provocative quote from Ms. Maureen Bisognano, CEO of the Institute for Healthcare Improvement (IHI), that “people who work in healthcare have 2 jobs: to do the work and to improve how the work is done”.  And so, we have got to continue to provide excellent care for people with chronic illnesses white, at the same time, we need to shift towards preventative and precision medicine. Just as healthcare funding is gradually shifting from volume to value, we as a healthcare profession will need to shift toward precision medicine and population health.

 

What are most the important facets of an undergraduate’s application to medical school from an admissions perspective?
Holistic review is key to both equitable decisions about admissions as well as developing a future physician work force that is competent, culturally sensitive and congruent, engaged and sophisticated.  There is always a balance between intellectual competency and ‘emotional intelligence’/empathy. We can’t trade off ‘smart doctors’ for ‘kind doctors’ – we need both.  It still seems important to note, however, that the MCAT scores are the best predictor of future success. The problem is that is not and does of itself produce a well-rounded, empathic physician. No matter how you put this together, holistic review is the key to success in putting together a great medical student class.  Finally, as Fisher vs US Supreme Court ruling affirms, we have the obligation and opportunity through the admissions process to develop a physician workforce that is of like ethnic and cultural context to be able to meet the healthcare needs of a diverse, American population.

 

How do you foresee medical education changing in the next few years?
Inevitably, medical and educational technologies will be a key development.  This approach not only improves the efficiency and delivery of medical training, it also is consonant with more active learning. Inter-professional education will also be a major focus of training. Clearly, as personalized medicine moves forward, education about population health will be another major part. Medicine will continue to be an enthralling career with continuous learning. Being a medical student and learning all that is required today to become tomorrow’s great doctor is a big task… but also, a great joy.  Medicine – and being a medical student – is, and will always be, very cool!

 

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