Chapter 14: The Center for Advanced Biomedical Imaging: an Opportunity to Realize a Vision of Imaging for MD Anderson
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Description
After a brief discussion of his role as Deputy Chair of the Department of Nuclear Medicine, Dr. Podoloff tells the story of the Center for Advanced Biomedical Imaging (CABI). He explains that in 2000 conversations with Dr. John Mendelsohn [Oral History Interview] and Joe Hogan, the head of GE Medical resulted in a deal to develop CABI. This was also a recruitment incentive for him to take on the role as head of the Division of Radiology. Dr. Podoloff explains his vision for imaging at MD Anderson, referring to the image below. Dr. Podoloff then explains why he wanted to take the position of Division Head and create the Center for Advanced Biomedical Imaging. He notes that he had the support of both Dr. Mendelsohn and GE Medical.
Identifier
PodoloffD_02_20150423_C14
Publication Date
4-23-2015
City
Houston, Texas
Interview Session
Tacey A. Rosolowski, PhD, Oral History Interview, April 23, 2015
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the Institution; Career and Accomplishments; Professional Values, Ethics, Purpose; Building/Transforming the Institution; Leadership; Industry Partnerships
Transcript
Tacey A. Rosolowski, PhD:
All right. OK. So now we are officially recording. And I’m Tacey Ann Rosolowski. Today is April 23rd, 2015 and the time is about seven minutes after 10:00. And I’m in SCRB 3 on the South Campus or Research Park of MD Anderson with my second interview today with Dr. Donald Podoloff.
Donald A. Podoloff, MD:
Podoloff.
Tacey A. Rosolowski, PhD:
Podoloff. My apologies. Thank you for correcting me. Good to have that at the head of the interview session to remind people, including me. (laughter) And so thanks for agreeing to spend the time again this morning.
Tacey A. Rosolowski, PhD:
And we were going to talk about administrative appointments today. And I have a list going back to the beginning. And I don’t know how important some of them are. But I did want to ask you, because I noticed that from ’86 to ’95 you were education coordinator for resident training. And that caught my attention because last time you mentioned that you were very proud of the fact that you trained so many people. So education seems to be an important part of your sense of mission here. So I wondered if you would talk about the taste of education at MD Anderson that you got in that particular role, education coordinator for resident training, and then how your education contributions evolved.
Donald A. Podoloff, MD:
So in the Department of Nuclear Medicine, which is what that assignment referred to, in addition to being the deputy chairman, I was also the coordinator for resident education. I’ve always enjoyed teaching. And in both radiology and nuclear medicine a lot of the teaching is done by apprenticeship. Basically somebody sits next to you. You show them what’s on the image that you’re looking at. And then after a while you start letting them look at the images themselves without you present. And then you check them, and that’s—
Tacey A. Rosolowski, PhD:
Last time you showed me some of those images and how—I could imagine it would take a lot of practice and eyeballs-on experience to really understand how to do that.
Donald A. Podoloff, MD:
You have to train your eye. There’s a very interesting study that was done a long time ago that compared the eye movements of experienced radiologists to residents. And the difference was that the residents, their eyes were all over the place when they were reading, but the experienced radiologists read like a raster across and down. So without even knowing anything about that, that must be what’s going on during the training phases, that you learn to control your eye movements in a systematic way so that you see everything that’s there.
Tacey A. Rosolowski, PhD:
Do some people never get it?
Donald A. Podoloff, MD:
Yes.
Tacey A. Rosolowski, PhD:
And why do you think that is?
Donald A. Podoloff, MD:
It’s a brain-eye thing that you either have the gene or you don’t. There’s a big difference between—I always tell this to internists because I was an internist before I was a radiologist. It’s a big difference from looking at a film and interpreting the film. And it takes a different skill set. That’s why radiology programs are four years long. So in that role—the impetus for doing that role had to do with—the residents evaluated us. And I used to get very high resident grades. They liked the way I did what I was doing. So I decided to take that on.
Tacey A. Rosolowski, PhD:
So it didn’t exist before you did it.
Donald A. Podoloff, MD:
It did, but it was done less formally.
Tacey A. Rosolowski, PhD:
I see. OK.
Donald A. Podoloff, MD:
And the entire graduate medical education system has evolved from 1986 to now. It’s a much more formalized curriculum. There are milestones that have to be met, otherwise you’re not considered to be a successful candidate. So it requires a fair amount of investment of time on the part of the education coordinator. But it wasn’t an onerous role. It was something I enjoyed doing. And I got to know the residents. I really enjoy talking to young people. I believe there’s no such thing as a stupid question, there’s only an ill-informed answer. And you learn a lot when you teach, you really do.
Tacey A. Rosolowski, PhD:
How so?
Donald A. Podoloff, MD:
People ask you questions that you don’t think about, and it makes you think about new and different things. An untrained young person who comes into a radiology residency has a very unique and different perspective about things than say does somebody who has been in the field for ten or twelve years. And you can learn from that, and you can make adjustments to how you think and what you do. I’ve always thought that lifelong learning is like a two-way street. So that was the first administrative role after my deputy chair position. And what I did in that position is I basically ran the clinical service. So not dissimilar from what I’m doing as the medical director of CABI. If there’s a hands-on medical problem, something that needs to be resolved by somebody with an MD degree, during the acquisition or management of a patient who’s in your care for the imaging portion, they turn to the medical director or the clinical director for those answers.
Tacey A. Rosolowski, PhD:
Dr. Podoloff, let me just ask you a quick follow-up question on the resident training. Were there certain processes or formal things that you set in place during the time that you served in that role—because that was for nine years—that have lasted? Because you said it was very informal. How did it change after you had that role?
Donald A. Podoloff, MD:
I think we developed a template for evaluating milestones and what constituted a resident that completed what he was supposed to or she was supposed to do. I don’t think that existed in that formalized way before I had that job. Our education of residents over here is peculiar. Let me tell you how. Because we’re a categorical cancer hospital, ACGME does not allow us to educate interns or residents except if we’re connected to a medical school. So our academic affiliation is either with UT Houston and sometimes it’s with Baylor. But the formal tie is the UT System. So it’s the medical school here in Houston. And we don’t really control the residents. They visit with us. But what’s very different about the way we teach the residents from the way they might learn at a medical school is the attending staff do most of the work here. The residents either watch or are assigned apprentice duties, but they’re not primarily the interpreters of the film, even when they’ve been very very senior. That all changes when you get into fellowship. But for the residency, since it’s a medical school-controlled residency, they’re guests over here. And that’s unique and different. In most medical schools most of the work is done by the house staff, the actual reading. And then the attending comes in and checks it.
Tacey A. Rosolowski, PhD:
What are the pros and cons of that system?
Donald A. Podoloff, MD:
It’s a good learning experience, or a better learning experience, for the trainee. It leaves the academic physician free to do other things like publish and serve on committees and do that. It’s a little similar to what’s happened in colleges now where the teaching assistants do most of the stuff and the professors are off reading and writing. And if you look at how does an academic physician get from assistant professor to full professor, they don’t usually get it done on teaching. They get it done on original publication or seminal scientific work. Although there’s a trend now to change that, to reward the outstanding expert teacher in a manner similar to the way we reward people who publish a lot. That’s another transition that’s going on in medical education at this time. Because if you think about it, we’ve been educating people pretty much the same way since the nineteenth century. And it’s now 2015. So a lot of things have changed but the basic medical school organization is pretty much the same now as it was 100 years ago.
Tacey A. Rosolowski, PhD:
Do you see some ways in which that model is no longer serving the needs of students or of institutions?
Donald A. Podoloff, MD:
I don’t see that. But the ACGME has seen it and have mandated certain changes with respect to integrated curriculum. The standard two years of basic science followed by two years of clinical, it’s now all mixed up. And you start doing the clinical. I was just back at my fiftieth medical school reunion. And they took us on an education tour. And they do things in the clinical setting in the first year now. We waited for two years before we actually touched a patient, except for a physical diagnosis class that I think we all had in our first six weeks or so. Yeah, so that’s changed a lot. But the basic model hasn’t changed since the Flexner Report. And the Flexner Report, if I’m remembering right, came out in 1906. So it’s over 100 years old.
Tacey A. Rosolowski, PhD:
It’s pretty amazing.
Donald A. Podoloff, MD:
Yeah. So our missions at MD Anderson are clinical care, research, education. And most of that education that we control is done at the advanced fellowship level, not at the resident or intern level, although during the course of my career I have taught interns and I’ve taught residents.
Tacey A. Rosolowski, PhD:
Is there anything else you want to say about education right now before we go to your—
Donald A. Podoloff, MD:
I think I won some Teacher of the Year Awards in the course of that. But it’s always been a very rewarding experience to be around young people who have inquisitive inquiring minds. It keeps you young.
Tacey A. Rosolowski, PhD:
Sure. And do you feel that you have a perspective on different facets of radiology that you would like to see carried on?
Donald A. Podoloff, MD:
I’m not sure I understand the question.
Tacey A. Rosolowski, PhD:
Well, every theoretician, every researcher, practitioner has an approach. And I’m wondering what’s unique about your approach that you help impart.
Donald A. Podoloff, MD:
I don’t think there’s anything particularly unique about it. I think it’s pretty ordinary. You have a job to do and you do it. I do spend a lot of time talking to the younger students about medical ethics and economics, which I didn’t use to do in the past, because I think it’s very important that they understand that we’re in a significantly changing environment. OK. Yeah, nothing else really occurs to me right now.
Recommended Citation
Podoloff, Donald A. PhD and Rosolowski, Tacey A. PhD, "Chapter 14: The Center for Advanced Biomedical Imaging: an Opportunity to Realize a Vision of Imaging for MD Anderson" (2015). Interview Chapters. 742.
https://openworks.mdanderson.org/mchv_interviewchapters/742
Conditions Governing Access
Open
