Dr. Carol Teitz, professor of orthopaedics and sports medicine, was the first female orthopaedic surgeon at the UW. She is the new associate dean for admissions in the School of Medicine. Here she talks about her career and the UW’s approach to the admissions process.
Q. As an orthopaedic surgeon, why take on an administrative job in admissions?
A. I took this job because it was an exciting opportunity to contribute to the mission of the medical school, and in many ways it’s a culmination of many of my past experiences. In addition to seeing patients, I’ve taught courses in the medical school for 27 years and have served on many of the medical school’s committees as well.
This position is part-time and allows me to continue to teach in clinic, practice, as well as shift my emphasis to administrative work. So, it’s the right position at the right time.
Q. Do you have any concerns that an orthopaedic surgeon will be successful in improving the numbers of primary care specialists?
A. I’ve been told that this is the first time there’s been a surgeon in the dean’s office! I know that when I was in the process of interviewing for this job, there was some concern about how a surgeon could head the admissions process when one of our goals is to increase primary care. To some, there seemed to be some inconsistency there. Although I’m a surgeon, I’m very happy to take on the mission of the school and make that happen.
Q. What are your particular goals for this position?
A. In a nutshell, my goals are to improve the admissions process for applicants, improve the efficiency of the Admissions Committee, and to increase the numbers of students going into primary care, as well as the diversity of students.
The School of Medicine has a mission to graduate at least half the class in primary care and the other half into specialties and academic medicine. We also want to provide an opportunity for learners from all segments of society, and we have a particular responsibility to educate and serve diverse populations within the WWAMI region (Washington, Wyoming, Alaska, Montana and Idaho). Ideally, we’re trying to meet the needs of the region in terms of who we put out — both people who will take care of patients and people who will advance the knowledge of medicine.
Q. Are there any similarities between orthopaedic surgery and putting together an admissions process piece by piece?
A. Yes, this is a rather procedurally oriented role in a way. On one hand, I’m supposed to direct the big picture and have the mission in mind. On the other hand, how we achieve that mission involves many things that can be tinkered with.
You know, we have a good system and not too much of it is broken down. That’s a lot like sports medicine — we’re working with basically healthy patients with just a few things that keep them from doing what they want.
In admissions, the only major problem we’ve had is that the number of people going into primary care has dropped over the years. And, that’s not just about our school; it’s also about socio-economics. In our society being a primary care doctor is a challenge — the reimbursement rate is not that great, the lifestyle can be very difficult, especially in a small community, and more and more of the young people applying to medical school are looking for lifestyle options. They don’t want to work 100-hour weeks. [Residency programs now have an 80-hour work week restriction.] Who can blame them?
Q. How do you plan to increase the number of primary care providers coming out of the UW?
A. I’ve been meeting with the family medicine faculty here and with the WWAMI family medicine residency network and we’re talking about these issues. One of the things I’ve asked from them is to provide me with names of people willing to have pre-med students shadow them. I think a lot of times when students get turned on to medicine in the first place, it’s because of their early experience with medicine. So that if in high school or college you can spend time hanging out with a family doctor who’s having a good time, then I think that would help.
We are emphasizing to the Admissions Committee that we are looking for people with a particular interest in primary care, family medicine and pediatrics. We’re also sharing with the Committee research about predictors for who is likely to become a primary care doctor.
We’re also reviewing what we do in the curriculum. We’re looking at how to keep students enthusiastic about primary care. You know, when students first get here, they often say things like ‘I want to be a primary care doctor’ or ‘I want to practice in a small town.’ Somehow by the time they leave, they are a neurologist or a dermatologist or a radiologist. There’s nothing wrong with those specialties, but we need to do more about keeping students interested in primary care and service-oriented careers while they are here.
Another issue we’re dealing with is distribution of physicians. The WWAMI region is a huge geographic expanse with lots of rural communities. We look at how many doctors are in the WWAMI states and where they are located. If they’re all in the cities, then we’ve got a distribution problem. So, we’re trying to address all parts of the availability of primary care.
Q. How do you go about selecting students who will help you meet your mission?
A. Prospective students first complete a national application that’s sent to schools of their choice. Our Admissions Committee of about 120 people reviews those applications for grade points, medical college admission test scores, their personal essays, and an explanation of the candidate’s experiences and reasons for wanting to go into medicine.
The committee selects those who will be invited to be interviewed. After the interview, the executive committee, about 20 people, decides who will be offered admission.
Last year we had over 4,000 applications for 196 slots.
Q. Do rejected candidates get a second chance?
A. Dr. Werner Samson, my predecessor, did a wonderful job for a long time. He set up something that’s fairly unique, and that I will continue. He met with disappointed candidates who wanted to better their chances for another round. This summer, I met with six to eight disappointed applicants weekly to talk about what went wrong. Most of these candidates were pretty good, but they were just missing a piece or two — like they had never had any exposure to anybody in medicine, so they have this dream to be a doctor, but they actually don’t know what’s it’s like to be a doctor, for example. It’s more like somebody who’s five and says “Oh, I want to be a doctor.” They know nothing about the lifestyles of physicians or different types of medicine, how they’re practiced, what’s going on in the world around medicine, things like that. Most of these are fixable!
It’s a very applicant-favored process. We interview a ton of people. Last year we interviewed about 800 of 1100 applicants from the WWAMI region. We give them the opportunity for a re-interview, if there was a discrepancy among the interviewers; we talk to them if they didn’t get in, to help them get in the next time. We’re really supportive of the applicants here.
Q. Weren’t you the first woman orthopaedic surgeon at the UW? Why orthopaedics?
A. As a kid, I did a lot of sewing and putting furniture together and stuff like that. I loved putting things together and taking them apart — tinkering with things.
When I got to medical school and started doing rotations, I really, really liked surgery.
My mentor, a rheumatologist, suggested that I do my thesis with one of his colleagues, an orthopaedic surgeon. I did my thesis on arthritis and anti-inflammatory drugs.
I felt very comfortable among both the orthopaedic surgeons and the urologists I studied with at Yale. Then I came here to do a subinternship in orthopaedics and went to Oregon for urology. I found orthopaedics so much more fun and interesting.
One day during my subinternship here I was assisting in surgery, hammering down an intramedullary femoral nail, and Dr. D.K. Clawson, the chair of Orthopaedics, walked in on the case. It was a great moment. He asked me who I was and said he wanted to talk to me about coming here as a resident. At the time, there had not been a woman in the program. He was very enthusiastic and supportive of my residency. And, I’ve been here for 33 years.
Q. You really seem to understand the importance of developing a system that is highly supportive of students.
A. Yes, that’s why I want physicians to make themselves available to mentor some of our students. It will make such a big difference for them.
I definitely had wonderful mentors and I still have mentors. I now have mentors in my new role. Although I’ve held many administrative roles locally and nationally, I’m not specifically trained in administration. There are definitely lessons to be learned each day. So I’m a lifelong learner. That’s one of the attributes we look for in a medical student — a willingness to be a lifelong learner. You have to be, because medicine changes. I’ve also always learned a lot from my patients just as now I am learning from applicants to UW School of Medicine.