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Research has been one of Dr. Marie Bernard's key interests since she decided - after starting her undergraduate career at Bryn Mawr - that her childhood dream of becoming an interpreter at the United Nations was unlikely to become a reality.
"My French with an Oklahoma accent did not cut it," says Dr. Bernard, who grew up in the Sooner State. Not long after that realization, however, she discovered both satisfaction and success in medicine and medical research. In the latest in a very long list of notable accomplishments, Dr. Bernard was appointed Deputy Director of the National Institute on Aging in October.
But the path to the No. 2 post at the agency that leads federal aging research efforts didn't always take the direction she anticipated, she notes. Though her new job focuses on research - her first love (after French) - her career has, at other times, focused primarily on patient care, education, or academic development and administration. All of these experiences, she says, have helped prepare her for her new role at the NIA.
The daughter of two physicians, Dr. Bernard earned her MD at the University of Pennsylvania School of Medicine, and completed her residency at Temple University Hospital, where she was chief resident. She held several positions at Temple's School of Medicine, starting as an Instructor in Medicine, then serving as Associate Professor of Medicine in the Division of General Internal Medicine, Director of Medical Clinics, and Assistant Dean for Admissions. In 1990, the University of Oklahoma recruited her to build its geriatrics education and research programs. Until her move to the NIA, she was the founding director of Oklahoma's Reynolds Department of Geriatric Medicine, which launched in 1997. At the time, it was only the third department of geriatrics in the nation. In addition to founding and directing the department, Dr. Bernard also served as Associate Chief of Staff (ACOS) for Geriatrics and Extended Care at the Oklahoma City Veterans Affairs Medical Center.
Dr. Bernard's research, which she has pursued in addition to administrative and other roles, has focused on nutrition and functioning in older adults, with particular emphasis on ethnic minorities. She has published widely on geriatric care, nutrition, medication issues and health problems among minorities. She was a member of the NIA's National Advisory Council on Aging, and chaired its Minority Task Force. She has also been a member of the American Geriatrics Society's Board of Directors, President and Chair of the Board of the Association of Directors of Geriatric Academic Programs, and a member of the Institute of Medicine committee that wrote the groundbreaking "Retooling for an Aging America: Building the Health Care Workforce," released in April. Among the committee's key findings: The nation's healthcare workforce is too small and unprepared to meet the needs of its rapidly growing population of older adults.
The AGS talked with Dr. Bernard about careers in geriatrics shortly before she took over as the NIA's Deputy Director:
Q: Why did you choose geriatrics, rather than some other medical field?
A: Early on in my medical career, I found I was most interested in older patients, who have more complex health problems and more life experiences than younger ones. My distant past may have contributed as well. When I was young, my grandparents had a significant role in my upbringing. My parents were physicians - they were both in residency when I was born - so my grandparents had a lot of responsibility for me until about age five. So that may have subconsciously affected my choices. But I was very conscious of the fact that I didn't' find young patients nearly as interesting as the older ones.
Eventually, my interest led me to complete a mini-fellowship at the Geriatric Education Center (GEC) of Pennsylvania. The mini-fellowship was an epiphany for me. Prior to doing that, I thought that I knew geriatrics because I was skilled in diagnosing and treating hypertension, diabetes and other conditions common among older adults. The training at the GEC opened my eyes to the fact that there is a lot more to the care of the elderly - particularly the focus on function and quality of life, geriatric syndromes such as dementia and malnutrition, and interactions within geriatrics interdisciplinary teams.
Q. You've said that serving as founding director of the Oklahoma geriatrics department has been your greatest professional accomplishment. What made you decide to leave Oklahoma for the NIA?
A: Well, I really had to think about it because I was very happy at Oklahoma; I had opportunities to be very creative developing the department there. I think that what was appealing about the NIA position was the opportunity to have a broader impact. I've been interested in research all of my life and am looking forward to the opportunities and challenges ahead. The responsibilities at the NIA are quite broad.
Q: What's your advice for recent graduates contemplating careers in healthcare?
A: Follow your interests, the things that get you energized and excited. Figure out what you really like and pursue that.
People always talk about coming up with five- and 10-year plans and trying to envision what they want to be -- not just career-wise but both professionally and personally. And that has motivated me throughout my life. I've been a single parent of two children since my son was a year old and my daughter was five. That was a big part of how I thought about my life - and I wanted my career to fit with that. You need to do that sort of thing.
At the same time, once you decide on a plan, you have to be flexible when opportunities arise. When I started at Oklahoma, it was with the idea that I'd focus on research. But when the opportunity to take on various other leadership and administrative roles came along, such as serving as ACOS for Geriatrics, and directing the Oklahoma Geriatric Education Center, they felt like a good fit. There was something appealing about the opportunities presented, even though they were not in my five-year plan. They served as a foundation that positioned me to provide leadership as the department was developed. So, I advise people: try to envision what you want your future to be and go for it but still leave yourself open to new opportunities.
Q: A lot has been written about financial disincentives to pursuing careers in geriatrics. Any thoughts for those considering the field?
A: I would say to young people coming into the field: You hear a lot of doom and gloom about how there's not much funding for research, how you don't get paid appropriately in geriatrics. But the pendulum swings back and forth. This might be where things are now, but it's going to swing in the other direction. I'd also say something one of my mentors used to say: Smart people always find their way around barriers. If it's something you really want to do, don't let the money be a barrier. There are ways of making it happen, even though the budget may be tight. This is a great field. It will be the field to be in because of the coming "silver tsunami" - the wave of baby boomers who will start turning 65 in 2011. We boomers will be demanding better care, and better research. Young people will be well positioned for a long and productive career if they go into this field.
Q: What sort of leadership opportunities are there in geriatrics these days?
A: You can do virtually anything. You can be a department chair, a division/section chief, or a professor if you want to be in academia. You can be a medical director of a clinic or hospital system or health system. You can be a researcher or a clinician. You can be the dean of a college. The doors are wide open. There are so many things you can do in this field.
Dr. Bernard was interviewed for this story prior to assuming her new role as Deputy Director of the NIA.
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