Fellows-in-Training Newsletter

Fall 2001

An interview with Dr. Marie Bernard, Professor and Chairman, The Donald W. Reynolds Department of Geriatrics, University of Oklahoma College of Medicine.

Q: Tell me about your road into the field of Geriatrics.

Reuben: I did my medical school training at University of Pennsylvania School of Medicine. I did my internal medicine housestaff training at Temple University School of Medicine, where I stayed to serve as a chief resident. After completing my chief year, I joined the General Internal Medicine faculty at Temple University School of Medicine, where I stayed for ten years. Halfway through my tenure at Temple, my section chief asked me to write a grant (as he tended to do every year or two). This time the grant involved geriatrics, and required that I interview the director of the Geriatric Education Center of Pennsylvania, Bernice Parlak. Ms. Parlak would only allow the interview if I agreed to be involved in their mini-fellowship, a 40-hour intensive training program, with a year of follow-up activities. I agreed reluctantly, as I thought I knew all about geriatrics, given the older patients that I cared for. Of course, the grant application was not funded - you are unlikely to be successful with grant applications if you do not have experience with writing them. However, I did participate in the mini-fellowship. It was a life changing experience. I came to realize that there was a lot more to geriatric care than I had learned in my residency training, and a lot more professionals with whom one needed to work than I had been trained to do.

When the first offering of the certificate exam was provided in 1988, I "grandmothered" in. Two years later, University of Oklahoma made me an offer I could not refuse. It allowed me to work on geriatric educational and research programs, while returning to my home state where quality of life could be expected to be excellent for my two small children.

Q: What type of goals did you set for yourself throughout your career?

Bernard: That is a tough question. As I recently discussed with my college-aged daughter, one can initially make very clear goals and objectives. However, there is a need to be flexible, and not so totally fixed on those goals and objectives that you cannot take advantage of opportunities as they arise. For instance, at the point at which I was made "an offer I could not refuse" at University of Oklahoma, I was actually quite comfortable in my role at Temple University School of Medicine. Taking the advice of a mentor, I had taken advantage of administrative opportunities as they arose, and had developed to the role of medical director of the outpatient clinics, course director for the physical diagnosis course, and assistant dean for admissions at the medical school. However, I knew that my overriding principle was to provide a good quality of life for my children. Thus, when University of Oklahoma offered the opportunity to move back home, with new career opportunities in geriatrics, I took advantage of it. It was not necessarily part of my 5 or 10-year plan. However, it met the test of my ruling principle - care of my family.

Q: How did you manage your goals?

Bernard: I first established my philosophy for life. I then developed my goals, and pursued those opportunities that presented themselves. I took advantage of mentors as I came across them, although I cannot claim that there was any one professional mentor who dominated my selection of career options. In fact, the mentor who advised that I take advantage of all opportunities as they arise may have given poor advice - that can lead to one being quite scattered. In my case, it worked out, as I built a dossier of administrative experience that led to my being appointed the Director of Geriatrics Activities for the Department of Internal Medicine at University of Oklahoma, when I was first recruited. It also allowed me to transition into the position as Chairman of the Department of Geriatric Medicine when it was established in the fall of 1997.

Q: What do you think makes a successful research fellow?

Reuben: I just met with one today. He came to us with a PhD in epidemiology in addition to internal medicine training. He did a clinical year, then in his second research year he authored three manuscripts, that's 3 in a year. The papers were based on secondary data analysis;; nevertheless, they were all original research. Although not all successful fellows meet this standard, organization and productivity are good signs of success.

Q: What do you see as key components to success?

Bernard: A key component of success is knowing oneself, and what one ultimately wants from life. In my case, I wanted to have challenging and interesting work that would still allow me to be a good mother and provider for my children. Activities that did not allow me to be as available to my family as I deemed necessary were eliminated.

Q: As chairwoman of the Department of Geriatrics, you must be very busy. What are your secrets to effective time management?

Bernard: I have surrounded myself with some very competent people to whom I can delegate a number of responsibilities. I have also not held myself to the standard of other professional women from prior generations - I am not the exemplary homemaker and entertainer of my mother's generation. Finally, I make a daily list of the things that need to be accomplished, prioritized from A through C, and am happy if I get most of my A priorities completed.

Q: As a member of the AGS Education Committee, what is your opinion on the current status of geriatric medicine training? How can it be improved?

Bernard: I think geriatric medicine training is strong, with a number of capable individuals being recruited to the field. The big challenge is regaining funding for most programs for more than one year of training. Fellowship programs on the coasts have not necessarily been as challenged by the shortening of the accredited training period as programs in the midsection of the country. However, I believe all fellowships have had deterioration in the ability to train academicians, due to the shortening of the accredited period. Granted, the goal was never to have individuals who wanted to be practitioners forced to stay beyond the first year. However, I think the unintended consequence of the change has been for very bright and capable individuals to be deterred from obtaining additional training, particularly as clinician educators, due to lack of funding. I think this could be remedied by designating a portion of the Medicare funds for education specifically for the training of geriatric medicine fellows beyond the first year.

Q: Currently many fellows are deciding which paths to take regarding their futures in the field of geriatric medicine (academic vs. clinical). It is often a difficult decision to make. Is there any advice you may have that would help in their decision process?

Bernard: I think it again comes down to what you like. Some people are energized by the one-on-one interaction with patients and families, and shun the "academic game." They thus should spend their time exclusively in clinical settings. Others like the challenge of interacting with learners at various levels, and the need to be the expert on a topic for a talk or a research project. They should thus pursue the academic route. The one thing that is clear is that there is need in both arenas, and geriatricians should not find themselves with a shortage of job options.

Chau: Thank you very much Dr. Bernard.

Chau: Thank you very much Dr. Reuben.