Innovator:
Cornell’s Medical Dean, Antonio Gotto
by
Jacob M. Appel
Much
humor has developed surrounding the relationship between physicians
and attorneys. From the medical man’s point of view, “doctors
heal the poor and the sick, while lawyers sue them.” So it is
a breath of fresh air to hear such a prominent physician as Cornell
Medical College Dean Antonio Gotto admit that he once wanted to
serve at the bar. “It was a point of contention between me and
my father,” he explains. “I wanted very much to become a lawyer.
But in my family there were only three acceptable occupations:
You could become a physician, you could teach, or you could go
into theology. So on this one, my father won.”
“I’ve
never regretted my choice though,” he adds.
Gotto’s academic credentials place him at the cutting edge of
science. After completing his undergraduate work at Vanderbilt
University, he won a coveted Rhodes Scholarship to Oxford and
earned a doctorate in biochemistry before taking his medical degree.
In England, he studied under Nobel Laureate Hans Krebs. Prior
to becoming the Dean of Weill Medical College of Cornell University,
he studied lipid disorders and coronary heart disease risk at
Baylor College of Medicine in Houston, Texas.
Medical education was decidedly different when Gotto attended
medical school: “Back then, senior physicians would offer anecdotes
from their practice and students would learn from them. Now we’ve
shifted from anecdote based medicine to evidence-based medicine,”
he says. Cornell’s curriculum emphasizes problem-solving skills.
“It’s not enough to think about knowledge, we need to think about
outcomes.” While many physicians demonstrate that they’ve learned
from ongoing training at professional conferences, few actually
apply that knowledge in their practices. “We emphasize problem-based
learning characterized by small groups and self-teaching with
an emphasis on how to acquire information. Medicine is voluminous,
and one of the challenges our students face is not being able
to know everything,” says Gotto. He concedes that such an approach
is “hit-or-miss” and that some topics may not be covered in depth,
but points out that Cornell students’ board scores rose significantly
after the school changed to its more progressive curriculum.
Gotto stresses the humanistic aspects of medicine. He’s brought
actress Catherine Chalfant to discuss her role in the Pulitzer
Prize-winning play, Wit, about a woman dying from cancer, and
Sophie’s Choice author, William Styron, to speak about his ongoing
struggle with depression. A new program permits medical students
to visit the Frick Museum to examine paintings with an art historian
and a medical school faculty member. “It sharpens the power of
observation,” says Gotto.
Another trend under Gotto’s tenure had been the globalization
of medicine. Currently over half of third- and fourth-year students
take a two-month elective abroad. Gotto, a long-time advocate
of international education and a former member of the Rhodes Scholar
Committee, began a US-Italy program in cardiovascular medicine
when he was teaching at Baylor. He founded the Office of International
Medicine and transferred the US-Italy program to New York. He
has also developed an affiliation with the American hospital in
Istanbul, and recently, Cornell made headlines by entering an
agreement to open a medical campus in the Persian Gulf Emirate
of Qatar. Taught by Cornell faculty, the program will confer Cornell
degrees upon the students. Gotto emphasizes that this will substantially
improve healthcare in the region.
“We’re
known as a research institution, but more than forty percent of
our graduates go into primary medicine,” explains Gotto. Fifteen
percent are in the competitive MD/Ph.D. program that utilizes
the resources of Cornell, Rockefeller and Sloan-Kettering. “We’ve
also established a program in family medicine,” notes Gotto. It
is currently the only family medicine program in Manhattan.
Despite his extensive accomplishments, Dean Gotto is quick to
point out his humble origins. “My great-grandfather was a stone
mason from Genoa,” he reminisces. “He came here one hundred four
years ago and helped build the Tennessee State Capitol.” It seems
building, whether monuments or a medical school, must run in the
blood.
Jacob
Appel, a Harvard Law student, is also completing a Ph.D. at Columbia
University.
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