In July 1983, as a new crop of Johns Hopkins interns were about to begin their 36-hour shifts, senior resident Susan Wolfsthal (Osler, 1980) was newly pregnant and “felt like garbage,” she recalls. “In those days, there were no parental leave policies in place, so we were secretive about such things.” When Wolfsthal finally told the assistant chief of staff that she was pregnant, his response was, “What are we going to do with you now?”
At first, Wolfsthal said nothing. Then, she responded that she’d do what Mary Newman (Osler, 1980) did six months earlier. In other words, both women—the first in their program to have babies—would work as long as they could and take off only 10 weeks for childbirth and recovery.
The two women had something else in common: Both chose careers in general internal medicine (Newman is a Johns Hopkins internist). “In my heart of hearts,” says Wolfsthal, “I always considered myself a generalist, but people would say, ‘Oh, you’re just doing general internal medicine?’ and I’d respond, ‘Yes—and with pride.’”
That self-assurance—and a passion for graduate medical education—sustained Wolfsthal as she built a career in internal medicine residency education. For the past 26 years, she’s served as residency program director in internal medicine and associate chair for education at the University of Maryland School of Medicine. She’s responsible for the clinical training of more than 130 residents every year and oversees 14 fellowship directors.
Wolfsthal has also been a principal investigator on several national grants to develop innovative programs in medical education. These include competency-based curricula and evaluation, evidence-based medicine and faculty development, among others. In addition, she co-directs the medical student course in physical diagnosis. Her teaching extends to residents’ daily conferences and supervision of trainees on the inpatient services and clinics.
Author of three books and more than 20 articles on graduate medical education, Wolfsthal has won multiple honors, including recognition by the Academy for Educational Excellence. She continues to see patients in her primary care practice and on the medical service at the University of Maryland Medical Center and to mentor trainees and faculty.
A Westchester, New York, native and daughter of European immigrants, Wolfsthal graduated from the University of Rochester in 1976 with a bachelor’s degree in biology. She earned a medical degree at the Johns Hopkins University School of Medicine in 1980 before beginning her Osler residency. Wolfsthal lives in Baltimore with her husband, William Keys, a neurologist. They have two daughters and two grandchildren.
How has your Osler residency shaped your academic career?
There was always a sense of teamwork and a common goal—to be meticulous, never sloppy. It was a wonderful experience, despite those crazy hours. When I wrote two self-study books with internal medicine questions and case studies, I drew from many themes from my Hopkins training and recreated interactions from the Osler service.
Who were your role models back then?
Carol Johns, my physical diagnosis instructor, taught me how to listen to the lungs and take a history. I loved cardiologists Ken Baughman and Steve Achuff; gastroenterologist Frank Herlong; cardiologist Bernadine Healy and, especially, general internal medicine physician Philip Tumulty. He was a rock star. We’d hang on his every word. I also learned a lot about infectious diseases from John Bartlett. These people loved to teach, cared about you and reassured you.
How does the internal medicine residency training at University of Maryland differ from Johns Hopkins program?
Our programs are more similar than they are different. We both strive to provide our residents with rich clinical learning opportunities across the breadth of internal medicine and ensure that we promote their wellness and a work-life balance. We set high academic standards and emphasize the importance of empathy, humanism and cultural sensitivity in the care of our patients. Ultimately, we both want our residents to feel that their training gave them the foundation for their careers as physicians.
How are you grappling with the growing demands on residents’ time?
It’s a struggle: The electronic medical reord is a good and bad thing. It’s a matter of getting used to it. The progress notes are more efficient and all the data feeds right in. We used to run after them to complete the chart, but getting people in and out of the hospital quickly doesn’t always work with complex patients.
What are you most proud of?
It’s similar to what we say about our families. I’ve graduated over 800 residents. I’m so proud of what they’re accomplishing, wherever they are. I’m pleased that we’ve transformed this residency to make ambulatory education more modern and creative, with more research, mentoring and a new wellness curriculum.