A Conversation with Dr. Carla Spagnoletti

“One of the things I remind myself of on a daily basis is the patient is the one who has to deal with the illness. It’s very important to acknowledge that there’s always emotion that comes along. It’s our job as physicians to hear them, understand them and help them process those emotions just as much as eliciting medical history from them.”

Bio

Carla Spagnoletti, MD is a Professor of Medicine at the University of Pittsburgh. She is the Director of the Academic Clinician-Educators Scholars Fellowship in General Medicine and the Director of the Masters & Certificate Programs in Medical Education at the Institute for Clinical Research Education. Her research focuses on patient-doctor communication, the patient experience, and professional development. She has received national awards from the Society of General Internal Medicine for her scholarship and mentorship in medical education and for her leadership accomplishments.

What are some major life events that helped shape your path?

“I can say that I wanted to be a doctor from a very early age,” Dr. Spangnoletiti began. “It was just sort of this idea that I had in my brain that wasn’t necessarily shaped by any particular event or any specific interaction with another doctor or with the healthcare system. There aren’t any doctors in my family, but I really liked science.”

Dr. Spangnoletti went on to major in pre-medicine at Penn State and as she points out, “You’re in big trouble if you don’t end up going to medical school with a major of pre-medicine.” She completed her medical school and went right into an internal medicine residency with a focus in women’s health.

At the end of her residency, she decided she wanted to stay in general internal medicine. “I was intrigued with the idea of staying in academic medicine. I just knew that I loved to be in the academic environment where things are fast paced and where there’s a multitude of resources. And most importantly, resources in the form of trainees. So students, residents, fellows, and faculty who are all around you and just wanting to constantly learn. I had the opportunity to do a general internal medicine fellowship with a focus on medical education at the University of Pittsburgh.”

For the past number of years, Dr. Spangnoletti has lived in Pittsburgh, and has had what she would describe as a “fulfilling and rewarding career.”

How can students, residents, and fellows better connect with personal mentors?

“I think that most people can benefit from multiple mentors,” Dr. Spangnoletti responded. “I think that it’s very important for students and residents who are doing any type of research, whether that be basic science research or clinical research or medical education research, so on and so forth to have one or more project mentors that can show them how to do it right and how to be methodologically rigorous.”

She continued, “I have mentors who I have met with on a very regular basis and other mentors who I’ve only met with once or twice, depending on the needs. And then the other really important type of mentor is a peer mentor. I think that peer mentors don’t get enough credit, or the idea of peer mentoring doesn’t get enough credit.”

As Dr. Spangnoletti points out, peers are often in a better position to understand where you are coming from or the types of challenges you are facing. “And so if you’re in that type of environment rather than a very competitive environment, I think that having one, two or more peer mentors as part of your mentoring network is really essential.”

What are the traits and habits of the most successful medical students, residents, and fellows that you have trained?

“Organization is important as a marker for success in one’s role, especially as a doctor. And I think students who work on their organization and perfect those skills before they move on to the next level are really setting themselves up for success as an intern and as a resident.”

Dr. Spagnoletti also admires those students who strike the right balance between being confidence and arrogance. She likes students who know what they don’t know and aren’t afraid to ask questions. “I think that it’s really dangerous to have a student or a resident who doesn’t have the insight into what they don’t know.”

“I always tell my students to make sure that they ask somebody or that they bounce their ideas off of somebody if they are not sure. And sometimes when you first start working with someone, it may take a little while to know whether they’re capable of identifying the things that they don’t know and whether they do go ahead and seek out answers for things that they don’t know.”

“And I guess the last thing, I think it is really important for students to not only set their own goals anytime they enter a new environment, a new experience, rotation, elective, clerkship, whatnot. But it’s also really important that they find from those they’re learning from.”

Pearls of Wisdom

1. Build a team of mentors, whether they be peers or seniors. Networking may be uncomfortable and you may face rejection, but it is key to developing yourself.
2. Set goals proactively at the beginning of each rotation, but be even more proactive about eliciting feedback from those you are learning from and working with.
3. As physicians we need to not only elicit medical history but also help our patients process the emotions that come with the illness.