Leaders in Medical Education

Dr. Robert Johnson, Dean of New Jersey Medical School

Thasin Jaigirdar
Published on Feb 1, 2015. Updated on Invalid date.

Dr. Robert L. Johnson is the Dean, Professor of Pediatrics, and Director of the Division of Adolescent and Young Adult Medicine at the New Jersey Medical School of Rutgers, The State University of New Jersey. His clinical research interests focuses on adolescent physical and mental health, adolescent HIV, adolescent violence, adolescent sexuality and family strengthening. He also chairs the New Jersey Governor’s Advisory Council on HIV/AIDS and Related Blood Borne Pathogens, the Newark Ryan White Planning Council, and the Board of Deacons at Union Baptist Church in Orange, N.J. He is a Fellow of the American Academy of Pediatrics and a member of the Board of the Division of Behavioral and Social Sciences and Education at the National Academies of Science. We are very excited to feature him today in our Leaders in Medical Education Series!

How did you get interested in medicine? Can you share a bit about your background?
I remember at the age of 9 responding to a question about what career I wanted to go into and I said I wanted to be a doctor. I don’t know where that came from, but it stuck with me. I have had no desire to do anything else other than that. Eventually I became dean of a medical school. My career destination is certainly not what I intended when I was 9. Back then I wanted to be a missionary doctor.

My interest in Pediatrics stems from the happenstance of my assignment to a Children’s Ward during a summer program at the end of my second year in medical school. Looking back I realize that I was especially drawn to illness that affected the older children and teens.

What are some changes you would like to see in how Physicians are Trained Today?
I have a number of suggestions:

  • We need to develop programs that respond to the country’s healthcare needs. That means expanding our capacity to provide primary care. As the Affordable Care Act takes hold we are quickly seeing that we lack the number of providers we need to respond to the demand. To meet that demand, our training programs need to produce more Primary care Providers.

  • We need to enhance the capacity of all physicians to recognize and respond to mental health issues. This capacity not only includes the diagnosis of mental illness as a primary presenting problems but also the ability to understand how mental health affects the presentation of illness and the patient’s ability to respond to treatment.

  • We need training that teaches providers how to work as members of healthcare teams. In practice no physician works alone. We rely on a system that involves an array of other healthcare professionals (nurses, advanced practice nurses, pharmacist, physical therapist, dentist, etc.) who work together to assure the best outcomes for our patients.

  • We need to train future physicians in the Business of Medicine. The physician in the current environment needs to understand and know how to work with a dizzying assortment of health business skill sets - healthcare financing, health law and regulation, compliance, contracting, human resources, “et cetera ad infinitum. “

What changes would you like to see in Healthcare in the United States?
I would like to see healthcare equally available to all people. I’m a proponent of a single-payer system. Healthcare should be available at low cost or free to everyone. Further the system should be managed and controlled by accountable public entities to maximize quality, minimize waste and control cost. Our current system fails to provide universal access and the management and control is beyond public influence.

How did you get involved in Medical Education?
It just happened. Every dean is the top educator at his or her school. Ultimately we are judged by the education we provide. Why it happened in my career? I just don’t know. Teaching seemed like a natural thing me. I teach my patients, residents, medical school students, other physicians and the public. The leap from educating my patients and the public to running an educational enterprise and setting educational policy on a local and national level (Pediatric RRC, COGME) is another one of those career opportunities that I grasped when it was presented.

What is it like being a dean of a Medical School?
As a Medical School Dean at an Academic Health Center you are the CEO of a big business. Typically you are responsible for a large multispecialty clinical practice, a multimillion dollar research enterprise, a graduate, post graduate and undergraduate medical education program, and productivity and welfare of thousands of patients, employees and students. I manage through a staff of the Senior Associate Deans and Directors who have direct line responsibilities.  A typical day involves a series of scheduled meetings which address each of those management areas. Invariably however the ordinariness of this routine is interrupted by the demands of the “crisis of the day -” unexpected HR issue, operations issue, legal issue, criminal activity, etc.

Another big piece of being a dean is giving advice. People want information from you on how to do certain things.

I also practice medicine and I continue to do research. My day starts very early. I’m generally up at 4AM to exercise and I am at my desk by 7 AM. My day usually ends 12 to 14 hours later.

Do you have Advice for individuals thinking of a career in Medicine?
I have several pieces of advice:

  • In pre-med the most important skill to master is reading. Efficient reading and comprehension is key to the consumption and mastery of volumes of written material you will face in medical school. The preparatory course that contributed the most to my success in medical school was English.  Science of course is important, but even becoming successful in acquiring scientific information requires reading.

  • Make a career plan that is flexible enough to allow you to take advantage of opportunity.

  • Be prepared to take judicious risk when opportunities present themselves. Everything I have achieved was a result of preparation and the courage to go in a different direction.

  • Master organization. This career places great demands on your time. I have found that efficient time management has been essential to prevent it from becoming overwhelming.

Do you have any final thoughts you would like to share?
The only other thing I want to say is that I think medicine is the greatest career in the world. Right now, with all of the changes going on in medicine, some physicians have gotten very discouraged. In the past Doctors had a lot of autonomy. Today they are inundated with paperwork, regulation, documentation requirements and government control. Some of these changes are burdensome, but in my experience many have improved the delivery of care.

The most exciting thing about healthcare is the ability to provide it, to resolve someone’s pain, and to make their lives better. That’s the reason why I still see patients. I have 6 patient sessions a week and it’s the high point of my day - to sit down with a teenager or young adult and help them resolve a problem and make their life better. There is no other feeling like that.

However if you don’t like medicine, it will kill you. It’s an all-consuming activity, 24/7. You cannot easily walk away from it. Money and prestige may keep you in the game, but if you don’t thrive from the practice of medicine it will burn you out. So don’t step out on the path to this goal unless you are sure you want what’s  at the end of the journey.