Beyond the Dome: Katrina Armstrong

Chair of medicine and physician-in-chief, Department of Medicine, Massachusetts General Hospital

Published in Aequanimitas - Fall 2016

On a winter day in 1987, after wrapping up an interview at the Johns Hopkins University School of Medicine, Yale University undergrad Katrina Armstrong headed outside to catch a taxi to the train station. But with a blizzard underway, none were to be found. Suddenly, a car pulled up alongside her. The driver—who had just interviewed her—insisted on taking her to the station. A few days later, Armstrong received a package with the gloves she’d left behind in his car, along with a handwritten note.

That experience, recalls Armstrong, convinced her that Johns Hopkins is a place that fosters good will—and clinched her decision to accept a spot in the medical school. Four years later, the Alabama native matched in the Osler residency program and married her med school classmate Tom Randall, now a gynecologic oncologist in Boston. From 1995 to 1996, she served as Longcope assistant chief of staff, and made enduring friendships.

From the outset, Armstrong embraced academia and research. In 1996, she joined the University of Pennsylvania as a physician-scientist fellow in the Division of General Internal Medicine. She became a faculty member there in 1998 and was appointed chief of the division in 2008.

A world-renowned investigator in medical decision-making, quality of care, and cancer prevention and outcomes, Armstrong also served as associate director of the Abramson Cancer Center and co-director of the Robert Wood Johnson Clinical Scholars Program at Penn. In addition, she led the Penn Center for Innovation in Personalized Breast Cancer Screening.

In 2013, Armstrong was appointed chair of medicine and physician-in-chief at Massachusetts General Hospital. In 2014, she was elected to the Institute of Medicine. Armstrong and her husband live in Boston and have three children, ages 21, 18 and 15.

How has your Osler training experience influenced your career?

When I recruit house staff, I often tell them that their residency experiences will be the most formative of their lives. The Osler program certainly set the compass for who I am professionally. Learning how to be a great doctor brings so many lessons that are critical for leadership in academic medicine. Maybe most importantly, how really listening can help you walk in someone else’s shoes and make a better plan of care. I learned early on that sometimes as a resident, that just means putting on your white coat, walking into the room and doing the best you can. Even if you don’t have all the skills, you’re all the patient has at that moment.

What stands out about your time in the residency training program?

Having David Hellmann as my program director: He is an incredible role model for the importance of the human part of patient interactions. The time I spent working on the HIV inpatient service had a big impact also. Back then, the AIDS epidemic was devastating East Baltimore, but I worked with a team that inspired both meaning and joy—even humor. Increasingly, my leadership role involves enabling others to succeed, and I remember how many great mentors from the Osler service have been there for me every step of the way.

Your first day on the job at MGH was April 15, 2013—the same day as the Boston Marathon attacks. How did that tragedy affect you, especially with regard to your new role?

It enabled me to see MGH come together in an extraordinary way to respond to the need of the community—a remarkable performance, with each person doing anything they could, such as clearing the emergency room to make it possible for the bombing victims to receive the best possible care. Given what that response meant to the Boston community, it was so much better to have participated in the event than to have come after it.

What do you see as the most important skills to develop in new trainees?

As time goes on, we’re understanding biology in a completely new way, using new tools and the internet. We have the opportunity to teach trainees new skills, but teaching them how to listen to patients will always be a mainstay.

What are some of your greatest challenges?

I’d say it boils down to recognizing what I don’t know—including a whole new set of acronyms!—and trying to get real information about how to support faculty members and trainees to make a difference.

What do you love about your job?

Getting to work with young people at all stages on new ways to have an impact, and helping some of the most dedicated and talented people in the world pursue their dreams—all of which revolve around improving health care and reducing suffering. I also love working with some of the best leaders in academic medicine. Together we’re taking on big challenges: bridging medical care and discovery, creating new models of care delivery, and transforming the diversity of the medical system and workforce.

Interview by Judy F. Minkove