Colin P. West, MD, PhD, professor of medicine, medical education, and biostatistics, Mayo Clinic, Rochester, Minnesota, and statistical editor of Academic Medicine
Describe your current activities.
I’ve been an associate program director for the internal medicine residency at Mayo for several years, with particular responsibility for resident scholarship. I work closely with residents in their continuity clinics as well. I also developed and direct the evidence-based medicine curriculum for Mayo Medical School and teach courses on systematic reviews and clinical decision-making in the Mayo Graduate School.
My research activities are oriented around medical education, including career plans and physician well-being. The latter area involves medical students and practicing physicians as well. I’m increasingly involved in collaborative contributions, such as Academic Medicine’s recent Review Criteria for Research Manuscripts, Second Edition.
Clinically, I am a general internist with a focus on coordination of care for complex patients referred into the Mayo system. I maintain a small continuity practice as well, but the bulk of my clinical activity is either working with residents or in the referral setting.
What gaps do you see in the current academic medicine scholarship?
For me, the main need in academic medicine scholarship is continued commitment to increasing the rigor with which educational research is conducted. The field is far beyond where it was even 10 years ago in this regard, but we need to press forward. I’m more concerned with academic research prioritizing high-quality research rather than promoting research in any particular area. I think the important questions will get addressed by engaged scholars, so we should make sure their work moves us forward with sound evidence.
Name two or three seminal Academic Medicine articles that everyone in your field should read.
It’s impossible to narrow the “must-read” list down so far, so I’ll just highlight a couple of papers I come back to personally again and again. The first is “Beyond curriculum reform: Confronting medicine’s hidden curriculum” by Fred Hafferty (1998;73:403-407). Despite shining a light on the dark side of medical training, we continue to struggle to strike the balance between growth-promoting educational stress and cynicism-promoting negative role modeling. In some ways, my research work on distress and burnout builds on Dr. Hafferty’s early recognition of the training environment as an intervenable source of adverse experiences for learners.
Another paper highlighting professionalism in medical training is Maxine Papadakis’s 2004 paper, “Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board” (2004;79:244-249). Although cited unprofessional behaviors were fairly uncommon, their link to future professional lapses affirms the importance of efforts to effectively promote professionalism as part of the medical education experience.
What issues will we be reading about in Academic Medicine in five years?
In keeping with my response to an earlier question, I’m less concerned with specific topics than I am with hoping to read methodologically rigorous, high-quality papers across all topics. I anticipate continued attention to training for competency and how we ensure competency as a basic standard while also aspiring to excellence. Perhaps I’m biased, but I also think we will see continued attention to physician well-being and efforts to turn the tide of negativity sweeping our profession. We are only recently beginning to appreciate the role of our systems of training and practice in these problems, but these insights should allow innovative system-based solutions to develop much like what the quality improvement movement has triggered for patient safety.
What books are you reading right now?
I don’t often read “serious” or work-related books, honestly. Recent authors I’ve been reading include Jo Nesbo, Cormac McCarthy, and John le Carre, and I’ve also been re-reading the Game of Thrones books.