Focus on Internal Medicine Careers: Internal Medicine/Medical Education.
Following is an interview of Maj. Steven Durning, MC USAF, FACP, a practicing Internist and Associate Professor of Medicine at the Uniformed Services University of the Health Sciences (USUHS). Dr. Durning is the recipient of the American College of Physicians (ACP) Herbert S. Waxman Award for Outstanding Medical Student Educator. This award honors the late Herbert S. Waxman, MD, FACP, recently the ACP Senior Vice President for Medical Knowledge and Education. The award recognizes a physician, internal medical interest group leader, clinical clerkship director, program director, or faculty member who spends a significant amount of time teaching medical students. The award will be presented for the first time at the April 2005 Annual Session in San Francisco.
Dr. Durning is an Associate Professor in the Department of Medicine, Director of the Introduction to Clinical Reasoning Course for second-year medical students, and Faculty Advisor to Club Med, the USUHS Internal Medicine Interest Group. 2Lt. Javed Nasir, a third-year medical student at USUHS and the Military Liaison to the ACP Council of Student Members, conducted the interview.
IMpact: Congratulations on winning the inaugural Herbert S. Waxman Award for Outstanding Medical Student Educator. Having been involved with your nomination and working with you for several years, I am familiar with your resume, but our readers likely are not. Could you please briefly describe your training?
Dr. Durning: I am honored to receive the inaugural Herbert S. Waxman award! I went to college at Pennsylvania State University and received a degree in pre-medicine with a minor in business. Next, I attended the University of Pittsburgh School of Medicine from 1991-1995. Finally, I went on to complete an internal medicine residency at Wright-Patterson Air Force Base in Dayton, Ohio, from 1995-1998. I am a Board certified general internist.
IMpact: Why did you choose internal medicine?
Dr. Durning: I chose internal medicine for a variety of reasons. I feel that one of the distinguishing characteristics of internal medicine as a discipline is its breadth and versatility. Internists combine the attributes of a caring clinician, master diagnostician, expert in a variety of procedures, and medical consultant to other specialties. The scope of practice involves treating patients in the clinic, hospital ward, intensive care unit, in a hospice, and in a patient's own home or a nursing home. I enjoy seeing patients in these practice settings. The internist is the specialist who is often called in the hospital or clinic to aid in diagnosing complex adult patient presentations involving multiple organ systems. Internists provide advice regarding both wellness and disease. Long-term relationships with patients are also a core feature of practice that I likewise find very rewarding. Indeed, for me and many other internists, no two days are alike.
IMpact: How did you get involved in undergraduate medical education?
Dr. Durning: Upon completion of my residency training, I expressed interest in staying at Wright-Patterson Air Force Base as an attending, as I enjoyed the teaching opportunities I experienced as a resident working with medical students and interns. As a staff internist at Wright-Patterson, initially I was quite heavily involved in the internal medicine residency training program. When my colleague separated from the military to go into private practice, I expressed interest in serving as his replacement, as the on-site internal medicine clerkship director for the third- and fourth-year students at Wright-Patterson and Wright State University. I was fortunate to be selected for this position and served as the clerkship director for several years. Then I took a position at USUHS as the course director for the Introduction to Clinical Reasoning (Clinical Concepts) second-year medical student course.
IMpact: In addition to your duties as a clinician, researcher, and teacher, I know you are involved with leadership activities. Could you please describe some of the activities you are involved in with the ACP?
Dr. Durning: I have greatly enjoyed the opportunity to serve the ACP, and this organization provides numerous opportunities to lead and be mentored by exemplary physicians and scholars. Since I was a resident at Wright-Patterson, I have been involved with the Society of Air Force Physicians (SAFP), the Air Force ACP Chapter. I am currently serving as a member of the SAFP Board of Governors. After moving to Maryland to work at USUHS, I also became involved with the Washington, DC, Chapter of the ACP and have recently been selected to chair the Medical Student Committee and serve on their Governors Council. Involvement with the DC ACP Chapter has also afforded additional opportunities, including serving as the faculty mentor for the First and Second Annual Washington, DC, Steps to Success medical student meetings. This program was devised to give students from USUHS, Georgetown, George Washington, and Howard Universities the chance to learn about careers in internal medicine, meet mentors in internal medicine, and learn about research in internal medicine through participation in a poster competition. The DC Chapter is are also arranging experiences for medical students in outreach activities, such as shadowing at a local hospice and a tobacco prevention and cessation program with area public school students. Finally, as the Faculty Advisor for USUHS Club Med, I have also become involved with the Army and Navy Chapters of the ACP, as students at USUHS are from all three branches of service.
IMpact: Are there opportunities for research and teaching in this field?
Dr. Durning: There continue to be numerous opportunities for teaching and research in internal medicine. As a physician, you will educate patients on their medical conditions. If you would also like to teach medical residents and students, opportunities are abundant. At many medical schools, the majority of clinical faculty are internists or subspecialists. Teaching interns and residents involves setting up your practice within or near an internal medicine residency program. Likewise, many research opportunities exist in internal medicine, such as identifying outcome measurements for patient care, identifying ways to more effectively teach and assess medical students and residents, and conducting symptom-based research and meta-analyses.
IMpact: Do you have time for family or hobbies?
Dr. Durning: Absolutely. I have a lovely wife, Kristen, and two boys-Andrew (age 9) and Daniel (age 7). I have the chance to play with my kids after school, help them with their homework, see their sports events, and I often "step in" as their coach. I also have the time to pursue a variety of hobbies, like long-distance running. I am very content with choosing a career in internal medicine and medical education and value the time that I have for my family.
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