Editor’s Corner
Replenishing the Ranks: We Need Some
New Hematologists …
O
NE OF MY ATTENDINGS once mourned that we – non-neoplastic
hematologists, that is – were the dinosaurs in the last days before
the asteroid hit. I was flattered that I, as a mere fellow, was included in the select soon-to-be extinct group. I was, and am still,
excited to pursue a career path that relatively few people seem to
find as inspiring as I do.
The longer I’ve lumbered along through my career, though,
the more I’ve come to the realization that we hematologists
have to evolve, or we really will face the fate of the dinosaurs.
We have to open up more viable career paths for junior trainees
or we won’t be able to attract the critical mass of successors we
will need to if we are to survive. We need to inspire trainees to
become hematologists. The time to do this is in medical school
or residency, since it is rare for a fellow to turn his or her sights
away from oncology and toward non-malignant hematology.
Plenty of people much smarter than me have been working on
the problem of recruitment and retention for years. In 2012 and
2013, the National Heart, Lung, and Blood Institute held workshops
on the future workforce in hematology research, the conclusions of
which have been published in Blood.1 I’d like to offer a few additional measures to help us spread the good word about hematology.
It Starts with the Medical Students
To attract new talent, we have got to make ourselves the coolest
specialists out there. We have to have the best-taught courses
and the most enthusiastic instructors – the people who show
how our specialty is the easiest to understand and apply.
Students are drawn to the things they are good at, so we
should strive to make them good at hematology. This calls for
hematologists who know how to educate.
To this end, I am eternally grateful that ASH has decided
to sponsor the Medical Educators Institute (MEI) to, essentially, teach the teachers how to teach, how to get funded to
teach, and how to show the value of their teaching. We will be
inspiring the folks whom we want to inspire the next generation of students to become hematologists. In my opinion, this is
supremely cool.
There’s More Than One Way to Be a Hematologist
To grow our ranks, we also have to demonstrate that there
are viable career paths for people who love hematology but
who don’t necessarily want to be R01-funded basic science or
translational investigators. Great kudos to the people who are,
though, as it’s getting harder and harder to become one of these
precious few, but this is definitely a topic for another day. Let’s
highlight some of the other career paths that hematologists
could be pursuing, including, but not limited to:
• Educators: Hematology and medical education go hand in
hand, which is another reason that the MEI is so interest-
2
ASH Clinical News
ing: It draws attention to a
career pathway for students
who want to be medical
educators. That ASH (and,
to my knowledge, no other
medical sub-specialty)
would sponsor such an
enterprise only serves to
emphasize that ASH places
a priority on medical education.
Alice Ma, MD, is an
associate professor in the
Department of Medicine,
Division of Hematology
and Oncology, at the
University of North
Carolina School of
Medicine in Chapel Hill.
• Systems-based clinicians:
ASH’s idea of the systemsbased hematologist is
brilliant. These individuals
would be funded by the
hospital to provide critical, hospital-based consultations on patients with complex
disorders of hemostasis, thrombosis, and cytopenias. They
could serve as medical directors for stewardship of costly,
potentially dangerous drugs for use in bleeding and clotting disorders (e.g., prothrombin complex concentrates,
recombinant activated factor VII, idarucizumab, recombinant porcine factor VIII, and clotting factor concentrates).
They could also function as arbiters of laboratory testing for
disorders such as heparin-induced thrombocytopenia or
atypical hemolytic-uremic syndrome. And they would be
primarily hospital system-based hematologists, rather than
community oncologists. (Editor’s note: For more information
about the role of the systems-based hematologist, see our article from the March 2015 iss