Leaders in Medical Education: Dr. Pamela Davis, Dean at Case Western Reserve University School of Medicine

casewA renowned physician and medical researcher, Pamela B. Davis, MD, PhD, became dean of the School of Medicine in 2007 after serving as interim dean during the previous year. In addition, she is senior vice president for medical affairs at Case Western Reserve University and holds the Arline H. and Curtis F. Garvin Research Professorship. A professor of pediatrics, physiology and biophysics and professor of molecular biology and microbiology at the university, she previously served as chief of the pediatric pulmonary division at Rainbow Babies and Childrens’ Hospital and as director of the Willard A. Bernbaum Cystic Fibrosis Research Center at Case Western Reserve University. Dean Davis received her BS in chemistry, summa cum laude, from Smith College in 1968. She earned her doctorate in physiology and pharmacology in 1973 and her medical degree in 1974, both from Duke University.

How did you decide on a career in medicine?
My grandmother, who took care of me when I was small while my mother worked, died a terrible death from breast cancer when I was 14.  I thought I was smart enough and disciplined enough to discover treatments that would prevent anyone else from having to suffer the way she did.  I wanted mostly to go into biomedical research – but I thought being a physician would inform what I did in the lab.   Though I changed from wanting to be an oncologist to working on cystic fibrosis as I advanced in medicine, the motive to change the course of a disease for the benefit of the patients was always there.  Subsequently, when I first went onto the wards, I learned that I did want to take care of patients and not just work in the lab for their benefit.

What were a few key steps in your journey from an aspiring medical student to your current position as Dean of the Case Western Reserve School of Medicine?
I did not set out to be a Dean – I set out to be a research leader.  As Vice Dean for Research, I was elevated rapidly to Interim Dean when a series of events made it necessary for the Dean to step aside.  Once I had solved some of the important problems that confronted us as interim dean, I felt I wanted to carry through the plans I had set in motion and applied for the permanent position. 

What is the greatest difference between the clinical side of medicine and the administrative side?
On the clinical side, all the parties generally have a common goal to cure or help the patient.  On the administrative side, the goals and directions may be quite different among the stakeholders.  Reconciling expectations is critical on the administrative side.

What does an “average” day look like for you?
I spend much of the day in meetings.  Usually I begin between 7 and 8 AM – meet with faculty, staff, sometimes students, individually or in a group.  Some days, I meet with the President or the Provost on more general university business.  I often have breakfast or lunch or dinner with potential donors to the School of Medicine.  Sometimes I meet with faculty we are recruiting.  In the evening, about 60% of the time, I have dinners either with key faculty, or recruits, or donors, or for special events arranged by the University or the Medical School.  “Free” hours during the day are spent responding to emails or other correspondence, taking phone calls, or reviewing financial reports, education plans, or research plans.    I still see a few patients.  Up until about three years ago, I also set aside time to meet with my lab personnel and review data.  However, with the departure of my last postdoctoral fellow and graduate student, I allowed my grants to expire and closed the lab.   Life is full, but it is very exciting  and a great privilege to have such variety and such opportunity.

What was/were the most memorable experience(s) during your medical education?
My first clinical rotation was a shocker.   My first patient was a 14 year old girl pregnant by her father.  I thought that only happened in Southern fiction.  My second patient was a 15 year old pregnant girl with abruptio placenta who was put back in the ambulance by two small hospitals on her way to Duke because, allegedly, they did not have a pint of A-positive blood. When she arrived, the baby was dead and the mom, nearly so, but we were able to save the mom.   Having been raised in the life of the mind and the lab before I hit the wards, I learned a lot about life very quickly.   However, the possibility of helping real individual people was striking and exhilarating….and these initial experiences convinced me that I did want to do clinical work as well as lab work. 

What do you think is the biggest challenge facing physicians today?
Providing superb care at reasonable cost challenges American medicine today. This is particularly important in our quest to reduce health disparities and to keep the population healthy.  For physicians, allocating their time to medicine as opposed to clerk-type work is increasingly important. 

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?
The physician is in a real quandary – he or she is sworn to help the patient in front of him, yet we know that many diseases can be delayed or prevented by early action and lifestyle modification.  I think we need to devote more resources to prevention, some part of this cost should be borne by insurance, and some by the government, but we absolutely must have the ability to heal the sick – and find new approaches to do so. 

What are most the important facets of an undergraduate’s application to medical school from an admissions perspective?
The academic performance has to be there as the baseline.  No amount of extracurriculars can make up for a record that leaves a question about the capacity to learn what you need to know to be a physician.  Beyond that, we are looking for demonstration of personal characteristics that will make a good physician – determination, perseverance, empathy, concern for others.  These can be demonstrated in a wide variety of ways (sports, public service, research, challenging life narrative and myriad more), but we must see some evidence of the person behind the paper. 

How do you foresee medical education changing in the next few years?
There will be less emphasis on memorization and more on the ability to think with the information that is so readily available in handheld devices.  CWRU is already teaching in that manner.  We will also be adopting the most effective learning methods for adults as demonstrated by the evidence. 

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