By Lisa Ryan
Daniel V. Schidlow, MD, is the director of the Bioethics and Professional Formation course at Drexel University College of Medicine at Tower Health in West Reading, Pa. Schidlow served the College of Medicine as the Walter H. and Leonore Annenberg Dean and senior vice president of medical affairs for eight years, returning in 2020 after a sabbatical to serve as a professor in the Departments of Pediatrics, Pharmacology & Physiology, and Medicine.
Previously, he was interim dean and senior vice president of health affairs at the College (November 1, 2011 – June 27, 2012). Prior to 2011, Schidlow was chairman of the Department of Pediatrics and senior associate dean of the pediatric clinical campus. He also served as the physician-in-chief at St. Christopher's Hospital for Children. He has received numerous awards for his contributions to medicine and education, including the 2010 Lindback Award for Distinguished Teaching. He is the namesake of the Daniel V. Schidlow Transformational Leadership Award, which is presented annually to a faculty member who exhibits substantial leadership to transform and make change through example and articulates an energizing vision. Learn more about Schidlow here.
What interested you about teaching and now overseeing Bioethics and Professional Formation, which applies to any medical specialization, versus teaching about pediatrics specifically?
It's very interesting, because I taught physiology, as well as clinical medicine and clinical skills, which I think I would like to do again someday. The fact that I agreed to take on the humanities portion of the West Reading curriculum prompted me to become more knowledgeable about the content of a bioethics course. Now on a personal level, this is something that interests me organically, intrinsically, and it is something that I’ve confronted throughout my professional life. In my career, I have had to talk about death and dying with many young people, particularly earlier in my career, when there weren't the treatments that we have now for cystic fibrosis and other diseases. Every time, it was a very deep conversation and experience.
I was also confronted with a bioethical issue almost right out of medical school. It was a financial issue; a radiologist wanted to pay for referrals, to give me back a cut of their profit. When I began my job, I was sending patients to this radiologist simply because his office was the only one in the area that met my and the patients’ needs. At the end of my first month, I got a check in the mail from the radiologist’s office, so I contacted the office to ask why. They said, 'This is the arrangement we had with your predecessor.' My predecessor had this deal going. So here I am – I'm very young and of course I have no money, and I get a check. That's a bioethical issue. Of course, I returned the check. And I said, ‘I'm fine. You don't need to give me money to send patients to you.' Frankly, if this physician hadn't been the only radiologist in the area for me to send patients to, I would have stopped sending them. That's a vignette that I haven't shared with my students, but I might share it next time we have a discussion about referrals. The students are going to confront all of these things, not only with patients and other physicians. They're also going to have to confront honesty in data and research.
What lessons can students expect to carry from the course into their work as physicians?
The students are asked to read articles or watch video snippets in advance of the class session. They'll also read a medical case. Students are presented with real-life ethical dilemmas, the kind they would confront sooner or later as a medical student and later on as a physician or researcher. For example, the students might review the case of a person who cannot speak English very well, and as a physician, they need to arrive at a plan of treatment. How do they incorporate the person; how do they incorporate their family? How do they make sure that they're communicating well; how do they make sure that they are not, for instance, applying their unconscious bias in how they treat people? They dissect the case in terms of how best to approach it in an ethical manner and how to avoid unethical behavior.
In some cases, the ethical violations are blatant. But in research, for instance, there are nuances. What can be shared and what cannot be shared? We have a session on informed consent: How do you handle informed consent with people whose cultural background is different than yours? How do you make sure that they understand, and how do you make sure you're not exploiting their lack of understanding to the benefit of an investigator? How can you guarantee the patient's privacy?
A lot of this is about creating a set of behaviors based on commonly and universally accepted values. Many people bring their own values to the table. The people we accept into medical school have very strong values and came to school to take care of people, but they bring their own personal experience, their own religious values, their own conscious or unconscious biases, and so on. This Professional Formation and Bioethics course helps them become more self-aware, more aware of other people's situational biographies and of their backgrounds. In this day and age, we interact with people with lots of different backgrounds, and what works for somebody from a certain ethnic or religious background, doesn't work for another.
We cover almost the entire gamut of situations that students will confront as professionals, and this course is very early in the curriculum, in the first and second year. Early in their medical education, students are already going to be observing physicians and might see them doing something they think is ethically unacceptable, or on the contrary, ethically role modeling, and they will be able to recognize that. Once students go into the clinical years, they'll already have discussed and experienced a lot of ethical issues. And they’ll be prepared when they’re confronted in real life with clinical situations that will bring up ethical issues. This has been my first year teaching this course, and I'm very happy that we're providing this course early in the curriculum.
How will your past experiences in medical education and leadership – including your time as the College of Medicine’s dean and senior vice president of medical affairs – fit into or influence your new role? What aspects of medical education most inspire you?
I used to have lunch with medical students all the time. I remember this one very bright student said, 'Dr. Schidlow, can I ask you a question? What has been the best part of your career?' The best part of my career has been taking care of patients and their families, the bonds we created with one another, and the joy of applying what I know to the art of diagnosis. The second-best part of my career has been teaching. There is this aphorism in medicine, “See one, do one, teach one,” but to me teaching is deeply ingrained in my DNA. My father wanted to be a teacher, although he didn't get to be. I'm married to somebody who was medical educator, and I'm a medical educator. I think it’s incredible to get to share knowledge and experiences in the hope that your experiences will help others, particularly medical students, gain a clearer view of themselves or what they want to do. I believe life is all about growth; you have to be growing continuously, and I love to help people grow, whether they're students or faculty, residents, whatever. I like to help people with their careers, and medical students come in enthusiastically: They want to learn, they want to make a difference, they want to take care of people, they want to know what you've done and what you've seen. To me, teaching medical students is a way to fulfill a vocation of service.
As someone who has overseen the education and professional development of medical students for many years, what do you feel the West Reading environment – the community and the campus – offers to students?
The West Reading Campus was an idea that was generated in the Dean's Office while I was Dean, with my colleague Dr. Valerie Weber, who was then senior vice dean of educational affairs. We went to Reading with President Fry and sat down with hospital leadership to discuss our ability to send students for their clinical education. That quickly evolved into developing a regional medical campus, but truly it is the College of Medicine, just in a different location. Although, it's in West Reading, it's the same school.
Reading is an ideal place to create a very exciting environment. We're going to have a brand new medical school building that is really designed with students in mind, that's a mile away from a spectacular, 700-bed, modern hospital where very high-quality medicine is practiced. The medical school is also close to a museum and to a school of health professions, which will present an opportunity for interactive education with other fields. Reading is also home to a diverse population; students will have opportunities to work with underserved populations, and there will be openings for some more rural experiences. The West Reading Campus presents the entire spectrum of experiences that a good medical education needs to provide. The fact that it is more concentrated in this smaller environment, where there is a very strong sense of community, is extremely exciting. It’s an ideal place to have this medical school develop further.
In my role, I will be coordinating some electives and humanities grand rounds; for the latter, we'll be bringing in a speaker or having a particular activity for the students. In many ways, the program there will mirror the program in Philadelphia. In fact, bioethics sessions are going to be at the same time, to my understanding. West Reading will also have some offerings that will not be available in Philadelphia, and vice versa. For instance, we are in the planning phase with the Reading Museum to establish an art observation for the medical students there, and a couple of programs at the planetarium next to the museum. There's also a big arboretum nearby, and it's all across the street from Reading Hospital. We're in the process of imagining possible activities that will use community resources offered by these local organizations.
What do medical students get from being able to tie the humanities, or non-medical sciences, into their medical education?
Many people have come to believe that observing art, looking at a piece of art and trying to capture the emotions and the pathos of the work, will open up a student to a better understanding of the characteristics of human emotion and human suffering. It will also increase the perceptiveness of the medical students. This can be done in many ways; it doesn't always have to be visual. It helps with, for instance, trying to capture what a patient or a family member is telling you and trying to understand the emotion that is behind it. As I like to call it “trying to hear what's not being said” – to read in between the lines and to see what is not obvious.
In my view, what is particularly interesting about certain paintings is that not only do you have details that pertain to each person in the painting or each part of the painting, but then you have the gestalt of the entire painting, and how it impacts you as a composite. And I equate that to walking into the room of a patient who is sick in the hospital and who is surrounded by family, or going to a home where someone in the family is sick. In a way, the first impression in a medical setting is like seeing a painting and its scene. By analyzing how a piece of art impacts you emotionally, and what you think is going on in that piece, it helps you become a better observer and connector with patients and families. After all, in medicine the first part of the physical exam is observation; it's the first element of a good physical examination.
What aspects of medical education are important for future doctors right now?
I think currently training physicians should know about personalized medicine and population health. With the development of genetics and the genetically focused therapies, I think we're getting into more personalization rather than a one-size-fits-all approach. Population health is very important because we need to be focusing on preventing disease, taking populations at risk and trying to avert the onset of disease by managing them. We could be doing better in that area. I also believe that a strong foundation in interdisciplinary teamwork, collaborative problem-solving and very strong ethical formation are very important.
What are your overall thoughts on the College of Medicine’s new four-year regional medical campus in West Reading?
Drexel University College of Medicine at Tower Health is, in my opinion, one of the most significant organizational enhancements that we have taken in many years. I think it will cement a very strong and mutually beneficial relationship between our College of Medicine and the medical community in West Reading. It will help enhance health care education in the area and ignite collaborations with surrounding schools. It will be a source of increasingly important interdisciplinary education for the medical students, as well as other local students. The fact that the students are going to be invested in a community such as West Reading, a smaller community where it will be easier to feel embedded right away, will promote them staying on for training and service in the Berks County community. It is a very exciting chapter. I'm personally extremely proud to have been part of the establishment of this, to have spearheaded the initiative, and I am personally very committed to its success. I will be spending approximately one-third of my time there, doing things that I love that will hopefully enhance the student experience. It is my hope that my work may also help connect the college and the student body to the local community, such as with the humanities program. The concentrated campus experience will be wonderful.