Interview with Dr. Thomas Sisson, MD

Interview by Kyle Rodrigues

Dr. Thomas Sisson is a practicing pulmonary and critical care physician, a professor in the Department of Internal Medicine, and the director of the Department of Internal Medicine Physician Scientist Training Program at the University of Michigan. He also runs a lab where he conducts research on pulmonary fibrosis. He received his Doctor of Medicine in 1992 and completed internal medicine residency with a pulmonary and critical care medicine fellowship all at the University of Michigan.

Kyle: What does a good balance of research and clinical practice look like?

Dr. Sisson: When people are starting out being a physician scientist, the recommendation is to spend 80% of your time doing research and 20% of your time doing clinical practice. This can provide you with the best balance to be successful. To do research particularly at a place like Michigan, you have to have grant funding from the NIH. The competition for NIH grants is extremely high, so to be competitive you have to be spending a good amount of time on your research or else you might lose your opportunities without a grant. For me in my position, I am a bit more senior in my career so I am spending about a third of my time on research, a third on clinical practice, and a third on education and administration. I like this balance as there is something new everyday, and it keeps the job fresh. 

Kyle: By conducting research and practicing medicine, do you think that one area suffers due to lack of complete focus on it?

Dr. Sisson: Sometimes, I feel like if I spent 80% of my time on research, I’d probably be more competitive in terms of grant renewals and things like that. There’s always a trade-off, but for me I’ve accepted the trade-off of loving these other aspects of my job, so I don't want to shortchange them. One thing I would probably have done differently if I could do it all over again, is to have my research and my clinical practice, be a little bit more tightly aligned. I study pulmonary fibrosis in the lab, but then in my clinic I take care of patients with cystic fibrosis. So this means that I have to try and stay up in two pretty different areas. I think other physician scientists have done a good job of aligning their patient care and research, so that they can benefit each other. If you are seeing a patient with pulmonary fibrosis and then going to study it in the lab, I think that this can be very helpful in informing each other. Research and patient care don’t necessarily have to suffer at the expense of each other, but it does require a bit more energy to stay up in two fields.

Kyle: Are you keeping up with the scientific literature in your area of clinical practice, pulmonology?

Dr. Sisson: It’s essential to be a lifelong learner for being a physician or a researcher. As you get older, your work becomes busier with administration or teaching so it becomes increasingly difficult to keep up with the current literature. I think it is essential to be the best doctor you can be. I am fortunate to be at an academic center like the University of Michigan, where we have conferences twice a week. These are a great source of continuing education. I also look at research journals when clinical problems arise, and I attend conferences several times a year to learn the latest approaches to certain problems. There are areas, however, that you become comfortable with because you see them all the time. For example, I see cystic fibrosis patients the most, so I am “most practiced” and up to date in that area, but there are other areas that I have to push myself to be on top of.

Kyle: How do you handle some of the tougher parts of being a physician, like death and loss?

Dr. Sisson: As a pulmonologist, we do have to deal with this a lot. A lot of the death in the hospital happens in the intensive care unit, where patient’s conditions deteriorate and they may need life support. I really try to “leave work at work” so as not to be somewhat depressed. There are successes and other fulfilling parts of the jobs like taking care of patients for many years and seeing them thrive while developing strong bonds with them. The death in the ICU is tough, but we have to leave it at work or it would make the job too difficult to do. There are always cases that for whatever reason can affect one’s emotion so it is sometimes hard to leave at work, but I definitely try.

Kyle: How do you deal with mistakes in a clinical setting?

Dr. Sisson: It’s quite common that you second guess yourself and say, “I wish I made this medication change” or “I wish I started this treatment” or “I wish I did this with the ventilator”. I think it is really important to be self-reflective to be the best physician you can be, but it also can be tough. It’s a balance; you can’t be too hard on yourself because it’s going to affect your enthusiasm for the job or your mental health at home. It is ultimately important to have a balance, where you learn from your mistakes and try to be better in the next situation while not beating yourself up anytime something happens.

Kyle: For the MD-PhD program, what makes an applicant stand out to you when you review applications?

Dr. Sisson: Everybody’s application who makes it to our committee is outstanding. Applicants who really stand out generally have made their mark in some area of passion. That can be through research, service work, education, gap-year occupation, or some other area that can make an applicant unique. It can be an area that the applicant is passionate about and has made some type of difference in that particular area.

Kyle: What would you say to students who are deterred from the length (about 8 years) of the MD-PhD program?

Dr. Sisson: If you want to be a physician scientist, it is not absolutely essential to do an MD-PhD program. For reference, I do have a lab and I didn’t do a PhD, but I started doing research in my fellowship. Even though it isn’t essential, I would say that an MD and a PhD makes a student more competitive, because PhD training is more rigorous and will expose students to different tools that will allow them to be successful. The extra years, I think, are well worth the time at the backend when these students are running their own lab or applying for grants. It puts them in a competitive position. I also think there is value in the critical thinking that is learned from the PhD that can be applied to patient care as well. The key is that you have to have a passion for research going in.

#Sisson #pulmonary #physician #internal medicine