Mary Cushman, MD, MSc: Why I Chose Hematology
||Professor of Medicine
Division of Hematology/Oncology
University of Vermont College of Medicine
Q: When was the moment you chose hematology?
A: In my first year of my hematology/oncology fellowship at the University of Vermont - during which I intended to become a breast cancer researcher - I was exposed to the hematology consult service and was totally intrigued by the problems that patients faced. Soon after, I accepted an invitation to be a fellow on an NIH training grant in hemostasis and thrombosis. Over the course of that two-year research fellowship it became clear to me that I had found a home and a passion for research in vascular disease and thrombosis. I made a hard decision not to finish my oncology training. Twenty years later, I am a benign hematologist and loving every day of it!
Q: Why do you think it is important for people to get involved in this field?
A: Hematology covers a wide breadth of topics that relate to both malignant and non-malignant diseases. This wide spectrum makes hematologists important in advancing the research and treatment of patients with many diseases. Engagement of the best and brightest clinicians and scientists in hematology will result in improvements in health care across the spectrum of disease, ranging from cancers to bleeding disorders, vascular diseases and more. Therefore, is it essential that we grow the number of hematologists to meet these needs.
Q: In your experience, what is the most difficult or challenging aspect of becoming a hematologist in the United States?
A: Most people believe that a hematologist must be an academic physician and that a hematologist cannot survive in a clinically-based practice if they are not active researchers. In my experience, this is not true. This concept presents a barrier to some trainees who might love the idea of becoming a hematologist, but feel that they desire a career in clinical practice, or fear that they might not 'survive' as an academician. As care becomes specialized, there is a grave need for physicians focused on hematologic conditions in the community setting, in particular in my field of thrombosis and hemostasis. In many cases this must, by financial necessity, be combined with some work in oncology or other areas. However, any community hematologist/oncologist with a solid hematology focus will be highly sought after by patients. Of course, we also need more academic hematologists; it seems as though most institutions are recruiting and many have difficulty finding people. For this reason, I believe there are great opportunities in hematology.
Q: How do you feel advances in technology (recent or past) have helped you along the way, be it in your studies or in general practice?
A: For me, the advances in information availability and transfer have revolutionized how I approach patient care and research. I work in research teams including scores of investigators from across the country and around the world. The efficiency of communication afforded by the internet, and the technology allowing high throughput data analysis and interpretation, such as in the field of genetics, has been revolutionary. In general practice, the advent of the electronic medical record now allows us to apply high quality consistent health care and we are only beginning to tap the potential of this technology. Of course, research in this area is also critical to allow us to determine the most creative and effective methods for this. As chair of the ASH Subcommittee on Quality of Care, I would love to see more researchers pursuing work in hematology quality-of-care and outcomes, which could be facilitated by the electronic medical record.
Q: What do you find to be most rewarding about a career in hematology research?
A: While it is very rewarding to make a new discovery that impacts patient care or provides new hypotheses to explore, for me the most rewarding aspect of my work has been the creation of networks of people working together on a hypothesis. The synergy that occurs in this setting is amazing to experience, and most of all, the friendships are enduring and are a very important part of my life. As a result of this type of research environment, I have been able to mentor people from various disciplines who are at my institution and at other institutions working with my colleagues. Seeing mentees grow and develop into independent scientists provides a huge degree of satisfaction and accomplishment!
Q: Finally, what advice might you have for a younger person who will be pursuing a career in this field?
A: The most important thing starting out is to identify a mentor who can help you to succeed. You must wisely choose a person who is successful, generous of their time and resources, passionate about mentoring, who is funded (if you are looking to do research) and who is going to be willing to let you experience success and get the credit for your work. It is also important to be flexible. When I started out I thought I wanted to be a breast cancer researcher. However, the best research training environment in my institution at the time was in thrombosis, so I chose that area for a fellowship project. This led to a very successful training experience and to my first job (and a lifetime of work I never anticipated).