Dr. Debbie Kelly – Leaving Clinical Practice for Industry (Podcast #4)

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’keefe@uphs.upenn.edu –

Dr. David Fajgenbaum: Lessons and Takeaways (Podcast #1)

Ryan O’Keefe, MS1

Penn Health-X had the pleasure of welcoming Dr. David Fajgenbaum MD, MBA, MSc to be our first seminar series speaker this semester. Dr. Fajgenbaum shared the story of his struggle with Castleman Disease, and establishing the Castleman Disease Collaborative Network (CDCN). He also shared some advice on becoming a physician leader. After his talk, we were lucky enough to interview him for the very first Penn Health-X Podcast, in which we delved into more detail. You can find the podcast here.

Check out the article recently published in the New York Times on Dr. Fajgenbaum and his work with the CDCN. On the podcast, we filled in some of the blanks in the narrative presented by the Times.

Also check out an article published on UPenn’s website about Dr. Fajgenbaum.

There were a few major takeaways we’d like to share here.

1. Having previous success running an organization certainly helps, but at the end of the day starting something great begins with an email

Dr. Fajgenbaum started National Students of AMF when he was still an undergraduate student at Georgetown. Dr. Fajgenbaum’s mother was found to have a brain tumor, and she sadly passed away shortly thereafter. In her memory, Dr. Fajgenbaum knew he wanted to start something using her initials – A.M.F – but didn’t yet know what that would be. He ultimately realized that there was a huge need for grief support for college students, and so he began the National Students of AMF, and watched as chapters opened up on campuses across the U.S. AMF, now an acronym for “Always Moving Forward”, is meant to help students through the process of grieving, and is still active and helping thousands.

Dr. Fajgenbaum agreed that having the experience of starting and growing a national organization later gave him the confidence to start the CDCN when he recognized there was a need in the research community. He mentioned that it definitely helps to have a series of small wins in your pocket to build up your confidence. But at the end of the day, starting the CDCN began with an email. And then another email. And then thousands more. Great organizations and accomplishments seem so stable, and we assume that only natural leaders who have innate knowledge of what they need to do can start them. We forget that most actually begin with just an idea, and a humble email.

2. Find your mentors, and then stand on their shoulders

Though Dr. Fajgenbaum was driven, intelligent, and desperate for solutions, guidance from mentors, and using some of their clout, was a necessity in establishing the CDCN. Dr. Fajgenbaum pointed to Dr. Arthur Rubenstein , and Dr. Fritz van Rhee  as two of his earliest mentors. When sending out the very first emails to physicians to invite them to be a part of the CDCN, he included both of their names. It was essentially the subtle email version of name-dropping. Even with the support and involvement of two prominent names in orphan disease research, he didn’t hear back from most of the people he reached out to. Imagine the response rate if he tried to do it all on his own. When it comes down to making your passion projects a reality, there’s no shame in flexing your network muscles and enlisting the help of those with prominence. In fact, doing so is what gives you the greatest chance of success.

3. Not everyone has access to a business education, but everyone has access to the internet and to books

If you want to be a physician leader in the H-MET space, or in any area of healthcare, you will need to learn some basic business skills. While Dr. Fajgenbaum opted to complete an MBA degree at Wharton, where he picked up some of these skills and was able to grow his network, not everyone has the opportunity to get an MBA, let alone at one of the best schools in the country. Yet, Dr. Fajgenbaum was adamant that if you identify the skills you need to practice, and have the drive, books may be all you need. Two skills that Dr. Fajgenbaum believe were critical to the success of the CDCN include knowing how to properly correspond with others (especially via email), and knowing how to negotiate.

Dr. Fajgenbaum mentioned the book Getting More: How You Can Negotiate to Succeed in Work and Life by Wharton professor Stuart Diamond, as one of his favorites. Those in medical school or interested in the sciences may believe that research and medicine are apolitical, and that everyone works together for a common good. I remember having those thoughts when I was in high school. I distinctly remember saying to myself “I want to go into a field that isn’t political – medicine.” That’s laughable and naive these days, but many laypeople and those early in their education – the bright-eyed and bushy tailed among us – still believe that this is how the research world works. Dr. Fajgnebaum mentioned that dealing with egos, differing interests, and money was something he was not nearly prepared to do. Understanding how to negotiate is critical. This includes creating win-win scenarios, and learning how to frame proposals in another person’s interest. If you haven’t yet read the classics, such as Dale Carnegie’s How to Win Friends and Influence People, or Robert Cialdini’s Influence: The Psychology of Persuasion  – why? There’s a reason they are timeless.

Beyond negotiations, when reaching out to physicians, Dr. Fajgenbaum always personalized the messages. Though this can be time consuming, especially when hundreds of emails need to go out, you improve the chances that someone will respond, no matter how busy they are. He mentioned that he would include references to their past research. It’s no surprise that people love discussing themselves and their accomplishments. Learning to stroke someone’s ego is not simply flattery, it’s a way to get someone to listen to you. You can have the best, most important idea out there, but if no one is listening, or replying to your emails, what good is it? You may think it boils down to “be a nice person”, but that’s the bare minimum!

Here are some great sources on how to get a reply from someone you’d like to speak with. It only took a few googles to find what I was looking for. That’s powerful.




Final Thoughts

You may be concerned that there isn’t enough time to read a few business books, or find the perfect mentors, or send the 300 emails to get your project off the ground. After all, they don’t test negotiations on STEP 1, and the coagulation cascade isn’t going to learn itself. Speaking with Dr. Fajgenbaum made one thing clear – you need to dig your well before you are thirsty. These skills may not seem entirely relevant, but when you have that great idea, or see an opportunity emerge, you want to make sure you have the resources and skills to go after what you want. Undoubtedly, starting anything is trial and error. But the more prepared you are, the less error.


– Ryan is a first 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’keefe@uphs.upenn.edu –