Winter 2024 Worcester Medicine

Editorial

Worcester Medicine has been a trusted voice of our local medical community for nearly a century. First published as Worcester Medical News in 1937, it evolved into the version you’re reading today in 1990. The weight of this legacy is not lost on me. Over the past year, many of you have shared thoughtful feedback, particularly around the need for more practical advice for trainees and early career physicians. In the spirit of being your voice, this issue incorporates your input, and we hope it offers something useful as some of you navigate the next phases of your careers.

We all know that medical training leaves some gaps. There are parts to practicing medicine — managing finances, negotiating contracts, or even deciding what kind of career you want — that aren’t always covered in formal education. These things are often learned by trial and error, but I’ve long felt they shouldn’t have to be. One of my personal goals is to find ways to bring these conversations into medical training, and this issue ties into that endeavor.

In this special edition of Worcester Medicine, we highlight medical professionals who’ve walked different paths and share the lessons they’ve learned along the way. Drs. Magee and Zacharia write about starting their own private practices, covering everything from hiring and billing to choosing an electronic medical record system. Dr. Harvey Kowaloff provides a closer look at the executive side of medicine, reflecting on his time as Chief Medical Officer at St. Vincent Hospital. Dr. David Bader shares his experience moving into graduate medical education leadership for those drawn to teaching and mentorship. Dr. Rashighi offers a glimpse into the arduous but rewarding journey of an international medical graduate (IMG) in building a research lab as a dermatologist-scientist.

On the utilitarian side, Dr. Galletta offers a pragmatic guide to physician finances, while Dr. Hussain and I walk you through the complicated but important world of J-1 waivers, something many IMGs spend far too much time piecing together from scattered sources. Dr. Kristin Mattocks and Jose Casares shed light on medical training within the VA health system for those less familiar with this setting. In our pharmacy column, Drs. Gallo, Chan, and Pervanas discuss residency and fellowship options available to pharmacists after their doctorates.

Detours can open doors to unexpected and fulfilling paths in medicine. Dr. Sarah Petrides speaks candidly about pivoting from a potential tenure-track academic path after completing a PhD in American Studies to work in healthcare, going on to earn a practice doctorate in nursing. Her story highlights that healthcare careers are not always linear. Nor do they need to be set in stone, as Dr. Popkin writes in his perspective piece. He shares his own experience and dilemmas of choosing a fellowship during his internal medicine residency, balancing mentor advice with personal goals.

Beyond these individual experiences, we are seeing broader shifts in medicine that are reshaping how we practice. Home hospital programs and telehealth are expanding rapidly, driven by staffing shortages, bed scarcity, and demand for flexible care models. As medicine continues to integrate artificial intelligence, more physicians are exploring careers in informatics and digital health.

One thing I’ve come to appreciate is how much organized medicine can shape career paths. Whether through mentorship, advocacy, or committee work in professional societies, it’s often the place where ideas and inspirations take root. I hope this issue strengthens that groundwork and encourages you to get involved with the WDMS.

Thank you for continuing to engage with Worcester Medicine. I’m grateful to be a part of this community, and I look forward to what we’ll build together in the new year ahead.

Parul Sarwal, MD

Assistant Professor, Department of Medicine, UMass Chan Medical School

Internal Medicine Hospitalist, St. Vincent Hospital, Worcester