I.M. a Health Leader: David Skorton, MD

What inspired you to choose internal medicine?

Internal medicine is an incredibly intimate field. As internists, we form enduring connections with our patients, understanding their individual needs, values, and fears. This requires not only medical knowledge, precision, and innovation but also connection with and compassion for our patients. Heart conditions, which I often encountered in my practice of general internal medicine and cardiology, often carry significant emotional weight for patients and their families. An internist or cardiologist must be able to offer not just expert medical care, but also emotional support and guidance.

To me, internal medicine fosters a unique kind of human connection – one built on trust and understanding. We have the unique and profound privilege of walking alongside patients on their journey to health, offering hope, comfort, and care. This deeply fulfilling aspect of internal medicine is what drew me to the field.

Describe your internal medicine journey and how it has shaped your career.

The year after I completed my cardiology fellowship and chief medical residency, I had the opportunity to serve as instructor in internal medicine at the University of Iowa, and from there moved through the ranks and served as director of the division of General Internal Medicine. It was incredibly rewarding to mentor others, as I had been mentored myself. I focused on teaching the importance of continuity of care, preventive strategies, the vital patient-physician partnership, and an understanding of the limitations of medicine. I was glad to be part of the faculty in advancing the broad and diverse field of internal medicine, and I learned a lot from my colleagues there and from the students and residents. They inspired my ongoing passion for the entire discipline of internal medicine.

How has internal medicine training given you the skills, insight, and/or experience needed to become a leader?

Whatever specialty you choose within internal medicine, you will undoubtedly confront complex medical cases that require decision-making — often quickly, under pressure, and with limited information — which translates seamlessly into leadership.

Internal medicine also fosters strong communication and collaboration skills. Those entering the field will soon learn that no one individual — even if the most accomplished expert in their specialty — can solve every issue alone. As you engage with patients, families, and other health care professionals, you learn to listen actively, convey information clearly, and collaborate.

In my view, the greatest leadership lesson we learn from internal medicine is compassion. When you care for patients with serious illnesses or chronic conditions every day, you learn to cultivate trust, seek understanding, and consider the human impact of every decision — essential qualities for effective leadership.

I want to share an example from one of the most heartbreaking experiences of my career: the loss of six Cornell students to suicide within one year. The shock and grief were palpable throughout the campus community and my colleagues, and I knew immediate action was necessary to prevent further tragedy. We authorized the construction of barriers and safety nets on campus bridges, where several suicides had occurred. We collaborated with suicide prevention experts to provide research and resources. We circulated on-campus mental health services that aimed to reduce stigma and encouraged students to seek help. And we held space for open, compassionate communication to support a grieving student body.

I did not realize it at the time, but the skills I developed through internal medicine training were invaluable in navigating this time of unimaginable sorrow. The ability to act decisively, communicate effectively, and provide compassionate support were crucial in leading the campus through this dark period.

What advice would you share with medical students or trainees that are interested in a leadership role?

I often encourage medical school students, residents, and fellows to maintain the “beginner’s mind” that comes with being new to any field. This concept from Zen Buddhism is well captured by the monk Shunryu Suzuki: “In the Beginner’s Mind, there are many possibilities. In the expert’s mind, there are few.” This open, curious mindset is essential for cultivating the qualities of an exceptional healthcare professional and leader, including humility, curiosity, and compassion.

Our education is a lifelong journey, not a destination. Even after securing a diploma, certificate, or sought-after leadership role, we must be open to evolving our perspectives, challenging our assumptions, listening to the experiences and expertise of others, and embracing a continuous state of learning. These are the qualities of a strong leader.

In today's divided world, this approach is more important than ever. I discovered that I can learn from every individual and interaction, like a peer during my internship, a student when I was a college president, a dying patient and her family, and the cafeteria staff of a hospital. My best advice is to maintain a “beginner’s mind” by looking for opportunities to listen and learn from everyone you encounter – even in unexpected places.

What are your interests and hobbies outside of medicine and how do you balance your work and personal life? Anything you have learned along the way to pass on?

I have always loved to play the saxophone and flute! For a while, I took a few lessons from Charlie Young III, a Howard University saxophone and jazz studies professor and director of the Smithsonian Jazz Masterworks Orchestra. I find that making time for music — even amid a hectic schedule — not only serves as way to pursue my passions, but it helps me emotionally and, even, professionally. The time spent engaging with art helps me process what I have learned and look at my work challenges from a fresh perspective.

I would encourage anyone pursuing a career in medicine to study the arts and humanities alongside your studies of the sciences. Whether we are studying new languages, world history, or painting, the arts and humanities can develop a more complete understanding of the human experience, which is essential for providing high-quality health care. And for me, it has been a way to relieve stress and improve my mental wellbeing.

I’ll leave you with one final lesson I have learned: asking for help is a sign of strength, not of weakness. Internal medicine is just as demanding as it is rewarding. And as many of us discover, we must care for ourselves if we want to care for others. While there is sadly still a stigma surrounding mental health and wellbeing, the medical field and our country are making strides.

We all need help at various points of our career, and I hope the next generation of internists feels more comfortable asking for it. Your peers and colleagues are there to support you, and you can support them in return. And professional therapists or counselors can provide valuable tools and strategies for improving mental health.