Leaders in Medical Education

Dr. Deborah German, Dean of The College of Medicine at University of Central Florida

Osmosis Team
Published on Jul 22, 2016. Updated on Invalid date.

Dr. Deborah German, a physician, educator, and administrator, is Vice President for Medical Affairs at the University of Central Florida and the Founding Dean of the UCF College of Medicine. After receiving her M.D. from Harvard Medical School, she was a Resident in Internal Medicine at Rochester and a Fellow and faculty member at Duke, where she studied adenosine metabolism and s-adenosyl methionine metabolism in human leukocytes. She was Director of the Duke Gout Clinics and Associate Dean of Medical Education while maintaining her own private practice of Internal Medicine and Rheumatology. In 1988, Dr. German became Associate Dean for Students and then Senior Associate Dean of Medical Education at Vanderbilt University. Later, she served as President and Chief Executive Officer at Saint Thomas Hospital in Nashville and Senior Vice President and Chief Academic Officer for Saint Thomas Health Services, Ascension Health. Dr. German led a successful hospital turnaround and initiated service excellence and quality programs at the hospital that received national recognition, all while continuing to practice medicine.

How did you decide on a career in medicine?
I was always interested in helping others, and medicine and education were early interests. Early in my childhood I knew I wanted to be a teacher or a doctor. My mom still reminds me that as a child I would come home from school every day with a desire to play school.  As I grew older I became interested in helping others through teaching, practicing medicine and research. 

How did you first become interested in medicine and Rheumatology? How did you become interested in Medical education?
I was always interested in medicine and education. Early in my childhood I knew I wanted to be a teacher and a doctor. My mom still reminds me that as a child I would come home from school every day with a desire to play school!  Rheumatology became my medical focus for a number of reasons. I watched my grandfather suffer in his later years with severe osteoarthritis and was inspired to help others through direct patient care and research. I was always interested in research and did research in high school, college, and medical school. I admired the scientists and teachers I had along the way. I also enjoyed my relationships with the patients who had arthritis and immune diseases. They were the nicest people and inspired me to do more. In my early faculty years I was recognized as a good teacher and a good administrator and was given increasing responsibilities that led me to my current role.

What was/were the most memorable experience(s) during your medical education?
There were so many it’s hard to select one. 

I remember witnessing birth for the first time as a first-year medical student and being awed by the drama, teamwork, spirituality and frankly the brutal biological process of birth. I also remember my first patient in whom I diagnosed cancer, malignant melanoma. She was a 30-year-old teacher and pregnant with her first child.  We did all that was possible for her but in seven months we lost her. We delivered her baby and I remember her husband so grateful to us for what we had done. When I met him he had a wife. When I saw him last he had a daughter. There are tears and laughter in medicine.  There are so many teachable moments. 

As a third-year student I remember doing a thorough exam on a patient who had many admissions to the hospital for respiratory distress. I found an extra small toe, syndactaly, which others had missed on all the prior admissions. It led us to the diagnosis -- Lawrence Moon Bidel Syndrome -- that explained the recurrent problems and allowed us to manage them better. 

I did a rotation at the Walpole State Prison and will never forget the feeling when those many sets of doors were locked behind me as I walked in to take care of the inmates and the feeling that I could not get out as they whistled and hooted at the lady doctor. 

I volunteered at the Cambridge city free clinic and will always remember the 13-year-old girl who had a septic breast cancer that had eroded the right side of her chest. She had no insurance and was afraid to see a doctor and waited until it was too late.  

I am so grateful for all of these experiences as they inspire me to keep making medicine better. 

What were a few key steps in your journey from an aspiring medical student to your current position as Dean of the University of Central Florida College of Medicine?
I am the product of a wonderful Italian-American family and was raised to believe that in this country you are limited only by your dreams and your willingness to work hard to achieve them. As the first in my family to attend a four-year college, I felt a responsibility to take full advantage of the promise that is the American dream. I willingly took on challenges and responsibilities that no one else wanted. They were not glamorous jobs, but instead were considered service work. I love to serve others so I took them on with a happy heart.  I would work as hard as I could to accomplish my goal and as a result had no regrets if I failed along the way, because I knew I had done my best. When failure occurred, I always learned something valuable that could be applied to the next challenge. These service opportunities included helping the nurses with their work as a student and a resident and taking administrative jobs no one else wanted when the dean or chair asked for volunteers. As I achieved success in these less desired roles, there was recognition of my abilities. No job in the service of patients, students or the organization was turned down by me. Persistence and hard work are constant companions to success. That old expression about why people miss opportunity is pertinent.  Opportunity comes dressed in overalls and disguised as hard work. I was recognized by my chairs and deans as someone who would get the job done and after a while I was considered for the more sought-after roles. 

What was it like founding a medical school? What challenges did you face and how did you work on overcoming them?
Founding a new medical school is both exhilarating and frightening. The challenges are too numerous to discuss in this format but examples include; deciding what kind of medical school it will be, who you will hire, what the curriculum will be, how you will assess what you do to attain excellence, what design your buildings will have to support your faculty, staff, and students, how you will create a culture of excellence, inquiry, and service, how you will secure the resources needed and manage them responsibly--the challenges go on and on. In such a large endeavor you organize timelines, budgets, personnel, and detailed plans for execution. You face each challenge with joy working as hard as you can to meet your deadlines and always aspiring to do each thing better than it has ever been done before. If you live this, your team will live it with you and the result is something more than any one of us could imagine.

What is the greatest difference between the clinical side of medicine and the administrative side?
At their foundation, both sides are very similar. To be an outstanding clinician, you need to be prepared and know your discipline and engage passionately with individual patients based on their needs. Communication skills and teamwork with the patient, their family and fellow healthcare providers is essential for success.  As an administrator, the same skills apply. Engagement, communication and teamwork are essential. Partnerships with good-will lead to outcomes that are not otherwise possible. In the clinical domain there is rarely an uninterested dispassionate patient as the work is personal. Sometimes in the administrative domain it is challenging to work with partners or colleagues who are not fully engaged, for whom it may be just a job. Then the challenge is to inspire them or to find a better partner. 

What do you think is the biggest challenge facing physicians today?
Medicine is changing so quickly and so powerfully that we all must become constant learners. We must identify new and better ways to learn well in real time. New technologies are changing everything. Physicians are so busy taking care of their patients that they are often slow to adopt new, available technology simply due to time constraints. We will need to work better as teams to make sure our patients don't fall through the cracks that our system creates. We are training the next generation of healthcare providers to effectively work in teams for the good of their patients. 

There is an enormous debate these days as to whether resources should be primarily allocated to fighting diseases or the distal causes of diseases. What are your thoughts on this issue of proximal causes versus distal causes?
We can create the greatest impact on health when we identify the causes of disease and focus our efforts and our resources on prevention. Prevention is always better – in terms of personal and monetary costs – than treatment. That said, we must continue to provide excellent care for those already afflicted – because in doing so, we learn things that ultimately help us find better solutions to disease. 

What are most the important facets of an undergraduate’s application to medical school from an admissions perspective?
Students must demonstrate that they have both a head and a heart for medicine, and that they have the ability to apply themselves to a goal and work tirelessly and with the passion to achieve it. Successful applicants have demonstrated excellence in scholarly and research work as well as service to others. We look for applicants with a diverse backgrounds and life experiences who have shown an interest in medicine and the ability to work well with others.  

How do you foresee medical education changing in the next few years?
I see more innovation in how we teach diverse students with a variety of learning styles and approaches to keep patients at the center of all we do. Today, at the UCF College of Medicine, we have a 98 percent digital library that allows students and faculty get information anywhere, any time, on any device. Our Anatomy Lab looks nothing like the lab where I studied during my first year of medical school. Innovation and technology have helped us educate students in a better, more engaging way. There are real, standardized and virtual patients. There will be real and virtual/electronic patient visits in the future and research may become part of every practice. Medicine is changing fast and so is medical education and we’re just getting started.

Do you have any final thoughts regarding the medical profession as a whole?
The medical profession is among the greatest professions. It has so many facets and all are significant, giving our lives meaning and purpose. The profession has evolved over the years in both positive and negative ways. It is our responsibility to keep the patient at the center of what we do and to help the profession improve. The young men and women who choose careers in medicine, nursing, pharmacy, and all of the health professions are extraordinary in every way and represent the best in our society. I am confident that if guided and empowered by us they will be able to build a better future for medicine and for health in our country.