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Christopher Sankey, MD, FACP, SFHM, discusses a typical day in hospital medicine and the fluidity of medical careers
Christopher Sankey, MD, FACP, SFHM
Director, Program in Hospital Medicine, Yale School of Medicine
Co–Firm Chief, Hospital Medicine Firm, Yale New Haven Hospital
Associate Program Director, Traditional Internal Medicine Residency Training Program, Yale New Haven Hospital
— MEDICAL SCHOOL —
The Ohio State University College of Medicine (class of 2002)
— RESIDENCY —
Yale New Haven Hospital Traditional Internal Medicine Residency Program
— CHIEF RESIDENCY —
Yale New Haven Hospital Traditional Internal Medicine Residency Program
What is your current position?
I am the Director of the Hospital Medicine Program at Yale School of Medicine and Co–Firm Chief of the Hospital Medicine Firm at Yale New Haven Hospital. I am also the Associate Program Director of the Traditional Internal Medicine Residency Training Program at Yale New Haven Hospital.
Where did you attend medical school and postgrad training?
I attended The Ohio State University College of Medicine (class of 2002) and completed my Traditional Internal Medicine Residency at Yale New Haven Hospital. I also completed my Chief Residency at Yale New Haven Hospital, Traditional Internal Medicine Residency Program.
Why did you choose to become a physician?
My father died suddenly when I was 6 years old from an aortic aneurysm, and from that time forward I knew I wanted to be a doctor. I never considered anything else!
What field of internal medicine did you select and why?
I chose hospital medicine, which was a happy accident. From the beginning of my medical training, I was drawn to high patient acuity and the inpatient setting. Hospital medicine was still a fledgling field at this point, and I didn't have much exposure to it during my residency training. I originally matched in a pulmonary/critical care medicine fellowship. At this time (2005), fellowship matches occurred more than a year ahead of the intended start date, and during this interval I met and married my wife. Because she still had medical training in psychiatry to complete in New Haven, I gave up my fellowship spot and took a hospitalist job. After 3 months in this field, while attending a national hospital medicine meeting, I had an epiphany and knew that hospital medicine was my career! I was amazed to see the incredible heterogeneity and opportunity in the roles and niches available to hospitalists in clinical care, education, research, quality improvement, patient safety, efficiency, and throughput. I never considered any other field from that point forward, and that was more than 15 years ago.
Please describe a typical day in your practice.
One of the most rewarding aspects of my job is that there really is no such thing as a typical day. The schedule of a hospitalist exists in two main states: “on service” and “off service.” “On service” refers to time I spend working clinically in the hospital. When working clinically, I care for patients as part of a team that consists of either medical trainees (a variable combination of residents, interns, and medical students) or physician assistants and nurse practitioners.
These days are spent speaking with and examining patients, communicating with consultative and outpatient clinicians, calling and updating any family members or other contacts as requested by our patients, writing progress notes, and thinking about/looking up clinical questions that arise. “Off service” refers to the time I spend not working in the hospital, and this is variably filled with scholarly, educational, leadership, and administrative roles. Hospitalists have come to fulfill many different roles in hospitals and health systems. I am an Associate Program Director of our Internal Medicine Residency Program and direct our inpatient educational curriculum. I advise and mentor students and medical residents. I run an elective rotation in hospital medicine for internal medicine residents. I am a member of our department's diversity committee and our health system's antimicrobial stewardship advisory panel. I write and publish manuscripts on clinical medical cases and present at national meetings.
What are some of your special interests professionally?
Medical education is my greatest professional interest. I initially concentrated on education via the presentation and publication of clinical cases. More recently, I've focused on curricular development and educational quality improvement which I've been able to operationalize as an Associate Program Director of Yale's Traditional Internal Medicine Residency Program for the last 5 years.
I'm also very involved here at Yale in the promotion of hospital medicine careers, hospital medicine faculty development, and mentorship of interested students and residents for careers in hospital medicine.
Apropos of my interest in critical care and high patient acuity, I have also done a lot of work in inpatient clinical deterioration. I led the Yale New Haven Hospital Rapid Response Team (RRT) for 5 years and have published on the relationship between the duration of intensive care unit (ICU) transfer and patient mortality.
What are your interests and hobbies outside of medicine?
Being a husband and a father is my greatest joy! My son is 13 years old, and my daughter is 11. My wife is also a physician. We enjoy traveling, hiking, and movies. Playing tennis is my hobby, having played since age 9 and competitively in high school and college. I play mostly doubles now. I also enjoy birdwatching, an activity for which I've had more time since the rise of COVID-19. My wife and I are also connoisseurs of international crime drama shows.
What advice would you like to share with medical students, or what do you wish someone would have told you while you were in medical school?
I wish I had received more advice regarding the expected plasticity and fluidity of medical careers. I presumed everything was set in stone, and that decisions I was making in medical school (and subsequently) were irrevocable. It is also very common as a student to assume that everyone around you has everything figured out, and as such we often don't understand that uncertainty in career decisions is normal. In medicine (the career, not the specialty), we all evolve, grow, change, and this is developmentally appropriate—it is not a defect! Diverse learners follow diverse trajectories, and it is quite common to end up in a different mindset than when you started medical school.
Which talent would you most like to have?
I wish to speak fluent Spanish, and fortunately this is attainable! In addition to allowing me to communicate more effectively with many of my patients, it would help at home given that my wife was born and raised in Mexico City and we are trying to raise bilingual kids.
What do you consider your greatest achievement?
My marriage and my children. There's no professional award or recognition that comes close!
Who is your hero of fiction?
Yoda, of the Star Wars series. He is a teacher, mentor, and coach. He is humble and understated. He professes the importance of introspection and advises learners to “live in the moment” without distractions from past or future.
What is your motto in life?
“All I want is what I have.” This reminds me that life is short, and experiences and people are far more important than seeking to obtain “stuff.”