By Gloria Onwuneme, medical student, University of Nottingham, UK
Dr. Arefa Cassoobhoy is the Senior Medical Director at WebMD; the Senior Medical Correspondent for Medscape, where she also hosts the video series Arefa MD’s Morning Report; and an internal medicine doctor at the Clarkston Community Health Center.
Dr. Cassoobhoy obtained a Bachelor of Science in medical anthropology (1994), before receiving an MD/MPH joint degree scholarship from Emory University Medical School and the Rollins School of Public Health (1999). She is board certified and completed her residency in internal medicine at Emory University.
When did you first decide to become a doctor? Why?
I first thought about becoming a doctor in high school. I think it was a very natural fit for me because I enjoyed the sciences, I knew that I wanted to help people, and I enjoyed talking to people.
How did you choose the medical school you attended?
There were three big considerations. One was cost. The other was getting in to the best medical school I could in the US. I didn’t know which specialty I wanted to enter, but I wanted the best chance of furthering my career after medical school. The third was being in a place that would allow me to have a strong support system. I chose Emory Medical School, which allowed me to stay in my home state of Georgia, and was one of the best medical schools I got admitted to. It’s an expensive school, like most medical schools in the US, but this was outweighed by all the plusses.
What surprised you the most about your medical studies?
I didn’t realize how intense and fast medical school would be. I thought college was fast and intense! Medical school was at another level, which did catch me off guard. It took me a minute to realize that I would have to study every single day, and that I couldn’t fall behind. I realized I was going to need to reach out for help, and utilize resources I hadn’t needed in the past.
What do you wish you had known when you started medical school?
I’d advise students to hit it hard from the very first day, and study smart. Understand what the learning objectives are for each class and rotation, in preclinical and clinical years. Appreciate what the professors want you to get out of time with them. Understand key concepts and work to integrate them. Another element to this: have faith that it will all come together. While you’re studying topics seemingly in isolation, you’re building networks. Each time you revisit a topic, you will take a slightly deeper dive in your understanding of it, and you will go broader so you can see the relationships between topics.
Why did you decide to specialize in internal medicine?
Part of the process involved eliminating other choices. I wasn’t ready to specialize when I finished medical school. I felt I wanted to broaden my general knowledge. For a while, I wanted to go into obstetrics and gynecology. I loved delivering babies and was interested in surgery. It felt like it would be a good fit, but honestly, when I was making that decision 20 years ago, I didn’t think I wanted a lifestyle long-term that required overnight call.
The other career pathway I looked at was pediatrics. But I soon found that I valued the professional distance I could establish with adult patients. With kids, I was getting attached so easily! My choices ultimately came from being honest with who I am as a person. I like working with adult patients in the clinic setting.
Has being an internal medicine physician met your expectations? Why?
Absolutely! There are so many options with internal medicine, and I like seeing a wide range of patients. My first job was in an academic setting, so my patients were very complicated and were under the care of several specialists. It was great training. My next position focused on primary care for women veterans, and that was very fulfilling.
What’s the most rewarding thing about being an internal medicine doctor? What’s the most challenging thing?
A few years into primary care internal medicine, I realized that seeing patients back-to-back, all day long, five days a week, was hard. For me, being a good physician means listening to my patients, coming up with a plan that works for them, and making sure I haven’t missed anything. So being constantly on like that was actually pretty tough. I wanted to find a better balance to my professional career and not burnout.
For a few years, I worked part-time, leaving me with more time at home. When I did that, I remembered how much I loved patient care. My favorite thing about primary care is the one-on-one with the patient. My least favorite part was having to do that for 25 patients a day, five days a week. But internal medicine is such a flexible career, that it didn’t take a lot to shift into a different environment.
Could you tell me more about how you got involved in medical communications?
During medical school I did a joint degree programmed, which allowed me to take a year out for a Masters in Public Health. So once I started working part-time as a clinician, I wanted to get back to the world of public health in some way.
I lived close to my alma mater, and it turned out that another mother at my children’s school was the pediatrician for WebMD. All the content for WebMD is created in Atlanta, so there’s a big office here. When I talked to her more, I just loved what she did and wanted to get in on the action. At the time, they needed freelance doctors in the community to read articles. This is because everything on our site is reviewed by physicians every two years. When I started, I would receive batches of articles that I could read and work on from home. I then quickly worked up to a point where I would do clinical medicine for 20 hours a week, and WebMD articles from home for my other work hours. I loved it! I would read the articles, while wondering if the articles were answering the questions that my patients might have about the subject.
Once I’d reviewed articles for a while, an opportunity opened up for a position as an in-house full-time doctor. I decided to just go for it, and had to then cut down significantly on my clinical work.
How does you work-week look now?
I now have clinic once or twice a month. At WebMD, I have a 40-hour week. In the WebMD editorial office in Atlanta, there are writers, video producers and editors, and more working for the company to produce the online news and information about health and wellness that you see. I’m on the medical team, and we serve as in-house physician consultants. I work at every level of content creation – from idea generation to publication. We also have about 150 freelance doctors that review material that might require a specialist doctor.
During the week I also do a video series of one-minute discussions of significant news topics for primary care doctors at Medscape. I spend a few hours choosing the topic with my editors, the script gets written, I edit it, and I get on camera to tape it.
How has your work in medical communications fed into your clinical practice?
I think my background training in anthropology and public health gives me a unique perspective. I don’t simply give my patients information that I think they should know. Instead, I really spend time figuring out what questions they have, and how I can help them get answers. In the clinical setting, I care about what the patient is asking, not just about what I need to say about treatment options or prognosis.
That thought process is a very good fit with WebMD. We’re constantly looking at the trends out there: What are the highest Google search terms for health topics? What questions do people with diabetes really want answered? What medium would make our content most effective—a slideshow, a video?
What’s the most rewarding thing about being in medical communications? What’s the most challenging thing?
Social media is fun and interesting. I get a lot of satisfaction seeing what other doctors are saying out in the world, and it’s a good way to keep up more easily with national and international trends. Having said that, it’s also an echo-chamber to some extent, where people you follow can wind up saying the same thing, and all you see is what you agree with. I find that challenging to navigate, but I love using social media to keep up with conversations around health.
How do you maintain a work-life balance?
I’m as intentional about my personal life as I am about my professional life. I think about my goals for my family. When I’m at home, I really try to be present. If I’m with my children, I try not to work on the phone. I stay organized with our schedules and with the things we want to accomplish. That involves incorporating exercise most days of the week, eating healthy, taking time to just have fun. The WebMD job is friendly in terms of respecting personal life, so weekend work is very occasional.
What of causes do you champion outside of work?
I have recently been getting more involved with refugee and immigrant health by working at the Clarkston Community Health Clinic in Atlanta. That work has been wonderfully satisfying and inspiring. I work with people who are all there to meet these patients’ unmet needs. Besides that, I’ve also recently joined my medical school’s alumni board, which I’m pretty excited about.
From your perspective, what is the biggest problem in healthcare today?
I’m fascinated with the intersection of technology and health. I don’t think of it as a problem, but it’s a challenge to keep developments going in the right direction. I’m in a great space to see how we can use technology to empower patients and facilitate better patient-provider interactions. That’s the area that really interests me, so I’m looking to see what happens.
Where do you see medicine at large in five years?
I currently see some of my patients via tele-health, to take care of simple medical issues over the phone. I’m interested to see where that goes. From an internal medicine perspective, so much of what we do involves taking a good history, so some medical issues can be addressed without a patient and provider being physically together.
I also just love the way the world is becoming smaller, and how that enables us to reach underserved communities in different ways. As an example: WebMD has a Health Heroes program. One of last years’ Heroes was a student working on scanners for diabetic retinopathy which could be used in underdeveloped countries.
Where do you see medical communications in five years?
WebMD is consumer-facing, so we relate everything to what the layperson would benefit from. We’re very engaged with patients on social media, and we often survey patients and healthcare providers to see how the two perspectives overlap and differ. I hope we can keep up, and improve, this kind of communication.
What is your final piece of advice for students interested in pursuing a career like yours?
In terms of advice for medical students, I think you need to look for something you find interesting and satisfying. You can do good in the world with any career, but it’s just really easy to see it and feel that you’ve made an obvious, tangible difference when you’re a doctor.
I haven’t mentioned yet how important mentors are. As a medical student, don’t try to go it alone; reach out to professors, attendings, and more senior students. Find out what their tricks are, how they amass knowledge and use it to take care of patients, and how they go home to take care of themselves and their families. You don’t have to have an agenda to reach out to a potential mentor and make a connection; it’s part of building a support network that goes beyond your family and close friends.
About the Author
Gloria Onwuneme is a Danish-born Nigerian who’s studying medicine at the University of Nottingham, UK. She has a strong interest in neurology and psychiatry, and a growing interest in healthcare innovation and medical entrepreneurship. In her spare time, she reads a lot, jogs sometimes, and she (thinks she can) write poems.