Amber Deptola, MD is an associate program director of the Internal Medicine Residency. She completed residency at Washington University, served as chief resident and is now director of the Ambulatory Care Curriculum and co-director of the Teaching Physician Pathway. She was selected as the Primary Care Teacher of the Year by residents for the 2019-2020 academic year.
Abbye Clark: Tell me a little bit about why you chose your specialty.
Amber Deptola: I probably chose internal medicine based primarily on my interest in medical education. During my first two years of medical school, I found that the people that I really looked up to in terms of their teaching in the clinical space were those in internal medicine and pediatrics. But I found it hard not to take the pediatrics cases “home” with me. Medicine is also obviously a great specialty for teaching because there’s so much information to know, learn and teach. Just thinking about a differential for a presentation and thinking about having the opportunity to discuss those initial diagnostic and management decisions really excited me.
Clark: Do you believe in a work-life balance and what does that look like for you?
Deptola: I feel like this is probably getting at the debate between the terms balance and integration when we talk about work-life perspectives. The idea of balance is you’re doing one or the other at different times. The idea of integration is, realistically, we’re thinking about work and we’re thinking about our home life at the same time, meaning you can’t dully compartmentalize them. And I do think that sometimes you have to break down those boundaries to be happy and successful in both parts.
What I’ve learned is that there are different life or work needs at different times and my priorities have to adapt to meet that. Like when my son asks to play a game when I have a work deadline, I might need to tell my son that I can’t do it right now. But I will make the time to prioritize getting that time in with my son later that day or in following days. My dog was really sick last week, so home life went up on the priority scale and work needs went down. The reality is that we have to adapt to the needs in front of us. There are also duties in both places that we love doing and that really “fill our tank”, make us happy, and give us energy. So, it’s important to ensure we are making time for those things that do “fill our tank” and enable us to continue. And if that balance is off, it’s thinking, why is it off? And then how do I re-center? It’s probably a little bit of a balance and a little bit of an integration, and sometimes something loses, and that’s okay, as long as you find the time for each piece and prioritize as you need to you for your needs and for your family’s needs.
Clark: What has been the biggest challenge as a female faculty member in your specialty?
Deptola: I feel that probably the biggest challenge as a woman is how you gain credibility in leadership positions. Gender expectations/norms are real and unfortunately often mean women have to work harder to gain credibility in positions of leadership. Women are not assumed to be legitimate, experienced, able, as men often are. It’s not only how do you get a seat at the table—because actually I think getting a seat at the table is an important part of it – but once you’re at the table, how do you gain credibility? I’m a very introverted person, which may be surprising, which makes gaining credibility particularly challenging, since I’m not always going to speak my mind immediately. And on the other end, a female that is more aggressive in pushing their ideas may be perceived to be acting outside of gender norms, which can be interpreted to be “bossy” and frowned upon. So, gaining credibility while not breaking norms/expectations to a degree that is “offensive” is a challenge women constantly face.
Clark: Have you ever felt burned out and wanted to take a break?
Deptola: Yes! It’s like weekly in this pandemic! I think you need to know when you need to take a break. Just a few weeks ago we had a really rough half day for our clinic team. Every patient we saw had a horrible story, and we felt like there wasn’t a ton that we could do to really help. Often at the end of clinic days, I stay for an hour or two and I do email and wrap-up projects. But at the end of that day, I was like, “Eh! I’m done. I’m spent.” I’m not going to open my computer for the rest of the night. We have to allow ourselves those breaks. Because if you don’t allow yourself to process and be forgiving towards yourself, then at some point you’re definitely going to burn out. There is no way to sustain that way.
Clark: What are the major aspects of your job or work that you enjoy?
Deptola: I think it really comes back to connectedness and creativity. I love mentorship meetings! I love to hear about interests/needs from your co-residents that I can support. I really enjoy those aspects of the academic nature of my job. (I also enjoy) creating and building programs. I worked to build ambulatory didactics. Now I’m leading a team to build the EXPLORE curriculum. I really enjoy thinking critically about solutions to problems and areas of need and trying to meet the need by building something.
Clark: What were some key turning points or personal “Aha!” moments in your career that have made a huge difference on your journey to where you are right now?
Deptola: One was the realization that I wanted to do medical education. When I was a second year, I was in a team-based learning (TBL) session and Dr. Amy Holthouser – who’s now the Associate Dean for medical student education at Louisville – was running the TBL. She is hilarious in addition to being a great doctor and a very skilled educator. One time, when I was a medical student, she wanted to point a part of a nephron out on the projector screen, but clicker pointers really weren’t widely available then. So, she grabbed this flagpole and dragged it across the stage and lifted it up to point at the part of the nephron. And I was like, “Yeah, I want to do medical education.” So, that moment of admiration was an “aha!” for me. I think the desire to do medical education really came before my realizing I wanted to do internal medicine.
The second was when I interviewed for chief residency with Dr. Dan Goodenberger over at the VA. During the interview I felt like those larger goals (of medical education) were reaffirmed, and I was like, “Okay, I’m reopening the space where I feel like I could pursue a medical education career.” Not only did Dr. Goodenberger give me a VA chief resident position, but we also established a mentorship relationship and I had somebody that was willing to give me the space and mentoring to learn new skills that were really critical for my early career. That has been extremely meaningful for me and is part of why I believe mentorship is so important for academic physicians.
Clark: What can we do to empower more women to join your field?
Deptola: I feel like internal medicine overall has pretty good representation in terms of women. In terms of leadership roles, internal medicine nationally could make some strides. I actually think at WashU women represent pretty well in many leadership roles, which is one of the reasons that I really like working at our institution, that that’s a priority. Having women in leadership changes the tone of some of the gender issues.
I think it’s important for women to identify with good mentors, people that hold jobs that they want to seek. And that doesn’t mean that men can’t mentor, I think that is important too. But I do also think that that female perspective is important. What opportunities are we creating to connect women with people that are in jobs that the more junior woman is seeking? What mentorship is available? And what are we doing to foster that? I think that’s really very critical and a foundational part of things like FWIM. And then some of the academic women’s network initiatives are targeting mentorship groups, where it allows that communication to happen more easily. Because sometimes it’s hard to do that yourself, to find those mentors, especially if you need somebody a little more distant from your everyday work, which is often the case.
Clark: What would you identify as one of the most challenging times of your career and how did you navigate it?
Deptola: When my dad was diagnosed with metastatic lung adenocarcinoma. My never-smoker, 57-year-old dad was diagnosed with metastatic lung cancer. This came as a huge shock because he essentially had no diagnoses before this; a really healthy, active, very busy guy. My immediate reaction was, “I’ve got to quit!” which I of course then recognized was probably not the right choice. Actually, my dad getting ill is what triggered my movement from the VA to WashU because I had that priority switch, to spend more time with my dad I needed my weekends protected. And to protect my weekends, I realized I couldn’t do that within the job that I had at the VA. And so I came over to Wash U. Sometimes when we confront challenges, either at work or outside of it, we need to pause, revisit, and sometimes we need to make a small or a very big change to be able to accommodate the changing needs. Life happens—regardless of how wonderful your career is—life happens. I got really good advice from multiple mentors in this moment (wonderful people who also allowed me to cry in their office), which I’m forever grateful for. It’s hard to make decisions when overcome with grief and emotion, so having people who can advise in those tough moments is really, really important. I feel like this experience, one I wouldn’t wish on my worst enemy, has allowed me to recognize that sometimes we need to pivot and that’s OK. And in those moments of chaos and rough times, you really want to have a good support system around you. I have found this experience helpful, too, in the advising and mentoring that I do.
Clark: What makes you most proud of yourself?
Deptola: My willingness to take chances. I tend not to be a super risky person, but over the past few years, I’ve decided to put (things that could fail) on the table and many of them have been successful. I think that’s important towards innovation, creativity and solutions to problems in healthcare and medical education. I’ve been proud of myself stepping outside my comfort zone a little bit, and it’s been good and helpful in many ways.
Clark: If you could give one piece of advice to a young female physician, what would it be?
Deptola: Be forgiving. We need to be self-aware and forgive ourselves at the right moments. And the other part is knowing yourself and understanding your values and making decisions based on those values. Because that’s how you are happy. Your career is understanding yourself and making decisions that support that understanding.
Dr. Abbye Clark is a second-year internal medicine resident with an interest in infectious diseases.