– Ryan O’Keefe, MS2 –
It was great to speak with Dr. Kelly more in-depth, after she came to speak for the Health-X seminar series. Before I jump into the major takeaways from our discussion, a quick background.
In medical school at Columbia, Dr. Kelly was choosing between orthopedics, endocrinology, and ophthalmology. After a rotation, she chose ophthalmology and did her residency in Atlanta. She then came to Penn where she jumped back and forth in a number of roles within the Penn network of hospitals. After 11 and a half years of practice, Dr. Kelly was put in touch with someone at GlaxoSmithKline who showed her all of the opportunities in pharma for those with an MD. She joined the company to help work on an ophthalmology drug which ended up not panning out. She then moved to the pharmacovigilance department at GSK where she was able to work on more than just ophthalmology drugs. Last year, she was contacted by a headhunter and was recruited to lead to pharmacovigilance department at Spark Therapeutics, where she is today.
I was struck by few things during our conversation.
1.) It’s not uncommon to be torn between many specialties, and in actuality, many doctors would be happy doing many different things!
From the vantage point of a first-year medical student, it was a breath of fresh air to know that many people have trouble narrowing down their choice of what residency to do. At places like Penn where we are fortunate enough to learn from those leading their respective fields, it can feel like all of the attendings and PI’s had a single calling which they knew of from birth. It’s hard to imagine rock stars like Carl June not knowing he wanted to go into immunotherapy research, and yet there was certainly a time and place where I’m sure that was a tough decision.
A generalist at heart, it’s tough to accept that I would probably be happy practicing many different types of medicine. Sometimes the medical training pipeline can make it seem like there is only one perfect fit for you, and it’s on your shoulders to find out which. Yet, the I reject the idea that I will find the perfect clinical match. In fact, we would do well to think of Dr. Kelly and how she chose ophthalmology not because it was the only thing she could ever see her doing, but because it felt right. While she was able to bring her expertise as an ophthalmologist to both GSK and Spark, she has had to develop many new skills, and continue to learn. Flexibility, and the ability to pick up new knowledge quickly are skills that will transfer well into any endeavor you take on. Be an expert, but don’t lose your adaptability.
2.) Those who choose to ultimately pursue opportunities outside of clinical practice may still really enjoy working with patients!
I’ve noticed there is a stigma that people who end up leaving clinical practice either don’t care about patients, or secretly (or not-so-secretly) disliked clinical practice. While this is undoubtedly true for some people, after talking with Dr. Kelly, it became clear that some leave clinical practice because they are ready to take on different challenges. Furthermore, if they end up working in other sectors of the healthcare space, they are able to bring a clinician’s perspective, and advocate on behalf of the patient experience. Dr. Kelly was drawn to GSK in part because she could improve the standard of care for many more patients by helping to develop an effective drug. Whether you are directly or indirectly benefiting the care of patients, you are an important part of the drug supply chain.
3.) All the flashy scandals aside, industry isn’t by default the “Dark Side”
I think Dr. Kelly put it best when she said that there are good and bad people who act accordingly in all facets of life. Are there selfish actors in the drug development world? Of course. But is the research community, or the clinical world only full of angels working solely for the greater good? No way – they just don’t have as much publicity and capital at stake.
It’s easy to point fingers and create simplistic bad guys in our minds when we think about the monster that is the U.S healthcare system. The gene therapies at Spark, where Dr. Kelly currently works, will undoubtedly cost tons of money – maybe even close to (or above) a million dollars. Yet they are potentially curative, one-time therapies for diseases with either no standard of care, or treatments that significantly reduce the patient’s quality of life. Even if you believe that the insurance industry or pharmaceutical companies are evil, money-hungry corporations, shouldn’t we want people like Dr. Kelly taking her experiences and passion for patient care into the conversation? Maybe you could be the voice for both doctors and patients at such companies, changing the discussion from the inside. With MD’s on the sidelines, I wouldn’t expect much to change on its own. Things are far from black or white, and I always try to remind myself when I frame problems within the system as having good guys and bad guys.
4.) Hopping off the clinical train can be tough, but you have to make sure you’re staying on for the right reasons
When deciding whether or not to pursue a new opportunity, or continue along on the path laid out before you, Dr. Kelly insists we must be critically self-reflective and determine whether we are afraid to make a change simply because of inertia. Pursuing opportunities and projects – especially those in the H-MET space, like starting a company, consulting, or working in hospital administration – often lead clinicians to leave practice, or only see patients part-time. This can be a harrowing decision, especially because after a number of years, clinical practice can be so comfortable in terms of income and lifestyle. It’s not always easy to determine whether we are scared to do something because of inertia, or because it’s a genuinely poor choice.
Dr. Kelly shared that she knew it was time to make a change when she couldn’t wait to tell her friends and family about the opportunity to work at GSK. Sometimes it’s something you just know. Other people will need to do an elaborate cost-benefit analysis and have long conversations with people who know them best before they decide to make a change. However it is you approach making tough decisions, be wary of turning down opportunities out of fear. You may look back and regret it.
– Ryan is a second year medical student at the Perelman School of Medicine. He is the co-VP of curriculum for Penn Health-X, the co-host of the Penn Health-X podcast, and founder/editor-in-chief of the Penn Health-X blog. You can contact him at ryan.o’firstname.lastname@example.org –