Leaders in Medical Education

Dr. Ruth Bush JD/MD, Vice Dean of of Academic Affairs at Texas A&M Health Science Center

Thasin Jaigirdar
Published on Mar 23, 2015. Updated on Invalid date.

Dr. Ruth Bush JD/MD serves as Vice Dean for Academic Affairs at Texas A&M Health Science Center. Dr. Bush is a specialist in vascular surgery, is director of the Vein Care Center at Scott & White Hospital and is Chief of Vascular Surgery at the Olin E. Teague Veterans Affair Hospital in Temple. She received her MD in 1992 and her MPH in 2005 from the University of North Carolina’s School of Medicine in Chapel Hill. She completed a general surgery residency at University of California Davis Medical Center in Sacramento and a Vascular Surgery fellowship at Emory University Hospital in Atlanta.

How did you get interested in medicine?

I’m one of these geeky individuals who decided early, actually in the summer between 8th and 9th grade, that I wanted to become a doctor. I watched some people around me with medical issues, specifically my father and I thought that I could have done a better job. I was very focused from that summer onward and didn’t consider anything else.

What had driven your interest in Vascular Surgery?

I entered medical school thinking I wanted to be an internist and specifically wanted to do cardiology. My first experience in internal medicine was not interesting. All of the patients were always sick and looked the same to me. When I did my rotation in surgery, that specialty  really clicked with me. Surgeons looked like the only people having fun, the field was active, and theywere making a difference in people’s lives.

Vascular surgery also made a lot of sense to me.  I had a good mentor when I was at UNC’s School of Medicine who was the Chief of Vascular Surgery. Vascular surgery is very well defined field and everything is mathematical and about physics because it is built around physical equations and mathematical models. This logic really appealed to me.

 I see that you have a JD and an MPH in addition to your MD. We now see many Medical Students getting multiple degrees. What are your thoughts on this trend becoming more of the norm than the exception? Also, out of curiosity, how has your JD degree complemented your Medical Career?

It does seem much more common now, especially with residents. I don’t know if it is becoming more the norm, but it has become more common place. I think it is because a lot of medical students are not going straight through from college to medical school and are instead pursuing other interests prior to embarking on their medical career.

I went back to school several years ago to get the law degree. In that time in my life I was running the residency programs at Cott & White/ Texas A&M. I was the ACGME Designated institutional Official and was also overseeing the undergraduate education component with medical school students.

Students and residents alike don’t get much training in healthcare policy, malpractice, how to stay out of trouble, and ethics. I wanted to be able to teach those subjects and expand the curriculum.

I haven’t taken, nor do I plan to take, the bar exam, as my plan has never been to practice law. However, having the degree has allowed me to incorporate principles I learned with how I approach legal and ethical problems with physicians, student, and residents.  There is only one other vascular surgeon right now has an MD/JD, who served as an advisor to me throughout the process.

I have given talks at the regional and national level on the legal aspects of  medical practice. I wish I had more time to study it, it is a completely different career, but a lot of principles do overlap. It is a very interesting field and has really complimented my career as a physician. It’s another variable that I can now talk about.

What has been the most gratifying experience of your career? How about the most challenging?

I have had a lot of gratifying experiences. From the surgical point of view, gratifying experiences happen very often when you see a patient you’ve operated on get discharged home and end up better off than when they came to you. It is the reason why people go into surgery, to see people do well.

The most challenging experience as a surgeon is to have somebody die following an operation. You have to ruminate on what you did and what you could have done better and what you can do to get back on the horse to do the operation again.

That’s interesting. What is the process like having to deal with the death of a patient? How does a Physician get back on track after one of those situations?

It can be pretty hard with a death in a surgery. The legal system and media will blame the doctor obviously. Most of us go to work planning on doing a great job every day. When an unforeseen event happens, it really weighs on us. Surgeons are meticulous and take pride in what they do. Most of us have big egos, and the first person we will blame is ourselves and try to figure out what we can do differently so that it does not happen again. A good physician steps back and analyzes every aspect and sometimes there is sometimes nothing you can find or change. So you have to get over this mental hurdle that you can do it and you are good and that you need to take care of patients.

How do you foresee medical education changing over the next few years?

Medical education will be more patient based and case based to teach students relevant information. Students these days are much different than they were 10-20 years ago. Students want to take care of patients from day one, not pour over a textbook. They want to see materials in action. I think medical education will become more patient centered. It may also be time that we start offering tracks in medical school to those who identify themselves as wanting to do primary care or take a different set of courses if they want to get into a specific specialty.

Furthermore, everyone in medical school and residency progresses at a different speed. We just assume they are moving at the same speed. Competency based education is more commonplace with our school’s Milestone project to move on to different things. Some students may progress a bit quicker or slower.

Medical education looks the same as it did for the last 20-30 years. However, one of the larger differences is that students have a lot more resources literally at their fingertips. Looking something up and utilizing evidence based resources is going to be commonplace.

I personally would really like to get the students out of the classroom. They don’t want to be there. It can be online or modular. In law school, we never went to class to discuss the textbook. We were to read the information and discuss the cases associated with the information. We were expected to have studied and  mastered the content prior to class and come ready to apply it. That message would work really well with today’s students.

What advice would you give college students considering a career in medicine?

It’s a great field. It is not going away. There will always be sick people. It is one of the most gratifying and scariest professions you are going to do because your patients come to you with blind trust.A physician has to maintain a high degree of honesty and integrity to live up to that trust. I think that it is a fabulous field. Keep your grades up, work hard, get a good advisor in college and go for it.