Changing Course: A Doctor’s Journey from Family Medicine to Infectious Diseases

Buddy Creech: [00:00:12] Hey, everybody, this is Buddy Creech with Let's talk ID. I'm really excited today to be joined by Dr. Sam Peterson, who's a native of Wisconsin who went to the University of Wisconsin-Madison for undergraduate training before moving to Chicago to attend medical school at the Chicago College of Osteopathic Medicine. Now we're going to get into this. It sounds like she is a Green Bay Packers fan who stayed in the Chicagoland area to complete family medicine residency at Franciscan Health Olympia Fields. It was during this time that she worked on the front lines of the Covid-19 pandemic, and that's what really inspired her to complete additional training in internal medicine at Olympia Fields and then to pursue, ultimately, a career in infectious diseases. Her clinical interests include antimicrobial resistance and stewardship. LGBTQ medicine and clinical education. Outside the hospital, Sam can most likely be found biking on Lakeshore Path, running through the park, hopefully not with a Packers jersey, at a local noise rock show or enjoying new restaurants. So Sam, thank you for joining us today. We're really excited that you're here.

Sam Peterson: [00:01:18] Thank you so much for having me.

Buddy Creech: [00:01:20] We're going to start with the low hanging fruit. How does one survive as a green Bay Packers fan in Chicago? I think that's what everybody wants to know right now.

Sam Peterson: [00:01:29] Yeah. So I've been fortunate because they have been really good since I was born, basically. And so I feel like being the better team, you know, just on a simple statistical record. And, you know, stats don't lie. Right.

Buddy Creech: [00:01:44] [laughs]

Sam Peterson: [00:01:44] So I feel like that alone, it gives you a bit of an edge. You know, you can sit there and be like, yeah, you know, I know we didn't make it to the Super Bowl this year, but statistically we still did a lot better than the bears.

Buddy Creech: [00:01:53] So this is incredible. This is so aggressive. This is a great way to start a podcast, because we're just going from top rope right out of the beginning. I will say this I'll try to do a better job of clock management than our friends in Chicago did at the end of some of their games this year. And, uh, and we'll go from there. So I'm heaping on primarily because the Titans have the number one pick because we were terrible this year. That's okay. There's always some other season to to root for. I'm excited to have you here because one of the things that we want to be able to do within IDSA and the PIDS society is we love to tell origin stories. We love to figure out how people got from point A to point B, so that we can use that information to try to to encourage young folks to go into our field. We have this workforce issue that we continue to address in different ways, whether that's improving compensation, bragging about what many of us experience is a really foundational and good work, life integration where we're getting to do exactly what we want to do with, with the balance needed to care for our family and friends and other interests that we might have. But everybody gets there a little bit differently. And I think part of your story was the pandemic. So can you hum a few bars about what that looked like, what drew you in and what that looked like at the time?

Sam Peterson: [00:03:14] I like sharing my story, especially with students, because it shows you can really have a lot of different paths in medicine. It doesn't have to be so cookie cutter kind of the way it kind of seems to be. So when I first was in medical school, I actually right out of med school, I matched into anesthesia, and I quickly realized that was not really the field at all for me. I actually ended up switching after that year into family medicine. I kind of realized I really appreciated the connection with patients. I was doing a lot of inpatient work and actually found I liked that a lot more than the anesthesia part of what I was doing. So I actually ended up switching to my family medicine residency, which was also in Olympia Fields near in Chicago, and I really enjoyed it. It was definitely more of what I was looking for, that patient interaction, and it also encompassed so many different things in medicine, kind of the jack of all trades kind of feel, which I really liked that too. So I was just happy moving along in residency, and then in my second year of training was 2020, which we all know was the harbinger of things to come. So I remember I was working in the ER as a second year family medicine resident, and things were starting to get real, and eventually I was asked to help out with different services, including the infectious disease team.

Sam Peterson: [00:04:30] And oddly enough, I actually knew the attending there because I was a medical student at this hospital. So I thought, hey, I know this ID doctor from, gosh, probably five years ago. She's a fantastic person. I would love to help out on her service. And I'm also was kind of excited to be in the middle of a pandemic. Like, you're a doctor, that's what you want to do, right? That's that's exciting. So I'll never forget it was May of 2020 and I'm working seeing so many patients on our list, all with Covid, and it was definitely frightening. But at the same time, it was really exciting, I guess in a weird way, to be a part of this because, you know, you're reading these different papers, preprints on what's coming out and what's available, and we're seeing this happen all in real time. We're all coming together to kind of work on this. We're getting papers from different countries and trying those things and our little Olympia Fields to see if this might work. So it was really exciting. Dr. Azad, who is the attending I was working with, I think she saw that. And I, you know, at first it was a slog. It was a lot of work, but I was excited.

Sam Peterson: [00:05:31] I would show her this paper and I'm like, hey, can we try doing this? I remember when recovery came out and I said, hey, let's start putting people on steroids now. And I remember these things happening. One day she said, hey, we need to find a way to get you into an ID fellowship. And I said, yeah, that's great, but I'm a family med person. I was starting my third year in residency, about to finish up. I was actually chief for Family Med two. So I was like, that's great, but it's kind of like, you know, pipe dream at this point. And she actually reached out to the ABIM for me to figure out the logistics, the details. And when they got back and said, you know, it would only be another really just another two years of internal medicine to be qualified. I thought, hey, if I don't have to do my intern year over again, I think I'll go ahead with that. So I finished up my family medicine residency, took my boards, got certified. I did another two years of internal medicine residency at the same program, and eventually I matched to do an infectious disease fellowship here at UIC, University of Illinois at Chicago, here, just down the road. So that kind of, in a nutshell, encompasses my unique journey to get here.

Buddy Creech: [00:06:38] I think that's really helpful. You know, it's interesting, as we look back during the early stages of the, of the pandemic and, and what followed, you've got this one cohort of individuals like you who were really inspired, motivated, energized by what you were able to contribute during that. There's another group who I think also experienced that. But maybe either because of stage or the particular events that were challenging for them, we actually saw a lot of folks leaving ID and leaving other disciplines within medicine, like critical care, because of how difficult the pandemic was. And then you've got everybody in between. Where yes, it was exciting, yes, I was burned out and we're working through it still kind of thing. But it's just interesting to me that there is not one size that fits all. There's not one path that fits all. And sometimes it's just nice to see someone go at it a potentially different way to say it is attainable, even if there are some different paths to get there. I assume that was intimidating at times or that was unclear at times. Do you want to - I don't want to hear deep dark like inner thoughts here, but I'm just wondering, like that had to be a little intimidating to come to the end of your training and be like, yeah, let's just, let's just run that back. We'll do some more.

Sam Peterson: [00:07:53] It definitely, it wasn't like I just woke up one day and I was like, yep, I'm going to do this extra, you know, four years of education. It definitely was something I wrestled a lot with because I thought, yeah, I'm potentially giving up. I could be an attending start right away. Just get on with my life. But I also remember there was so much about ID that I really enjoyed, and it wasn't just the pandemic, but it was kind of like what you were talking about before, about having a little bit more freedom in your day to day, your work life balance. And of course, my mentor was telling me about all the other perks of ID as well. She's a part of the infection control, infection prevention, antibiotic stewardship. Telling me about how ID often has, you know, kind of a seat at the C-suite table, you know, really gets to be involved with a lot of decisions that hospitals have to make. There's also public health. There's a lot of global travel. And I love, you know, the global aspect of ID. So there was so much more than just the pandemic that I was really interested in. And the more people I talked to other physicians, other people who helped me with this decision, they said, you know, it's it's another four years. It's a commitment. But if you look back on it, the kind of freedom that can buy is really priceless. And, you know, if you don't like it, it's only four years. But to me, that was a very worthwhile investment for sure.

Buddy Creech: [00:09:06] You know, but it's interesting. We say it's only four years. Four years is a lot when you've got all of the years leading up to it and that follow depending on where you are in training. But but you know, this raises an interesting element, because one of the key distinctions between adult ID training and pediatric ID training is that we really only have a three year process. And if you want to do peds ID, there is not any way to get it in two years. And we're really having these sort of existential conversations around if our workforce is not as robust as we would like it to be, would shaving off that year actually make a big difference. And certainly for those who may be coming at the entry point to ID with some either gaps in training or taking time off to do other interesting things, taking gap years, doing other residencies, coming from international training settings, every year does really count. And so we have to make sure that, you know, pedagogically it's the right thing to do. And if it's not, then we need to realize that there's probably value added in shortening training.

Sam Peterson: [00:10:10] Absolutely.

Buddy Creech: [00:10:11] So a couple of things that you've said or a couple of ways you've said it, have really highlighted the role of a mentor in all of this, and that really resonates with me. I didn't know I was going to do pediatric ID. I came to Vanderbilt because my dean of students in Memphis said, Go to Vanderbilt, sit at Kathy Edwards feet and learn everything that she knows. And I was thankful I got to do that. And she has become, you know, my academic mother and I talked with her on the podcast here, and she talked a little bit about what it means to be a mentor. But can you talk a little bit about about the importance of mentorship? And then maybe what we ought to do is think about what it looks like now, as you begin to think about either near peer mentoring of folks that you're cohorted with, or even training up new folks as they think about it.

Sam Peterson: [00:11:00] Absolutely. I feel like the role of a mentor is exceedingly important, and it's something I didn't realize. I am a first generation doctor. So it's, you know, just becoming a doctor in itself is such a huge task. So having a mentor, you know, the whole way is such a huge asset. So for me, yeah, I feel the same. I did not obviously intend on going in this path. And I wouldn't be here talking to you right now about this journey if it wasn't for my mentor. So I'm exceedingly grateful for everything that she has done and still continues to do. She still looks out for me. And, you know, even now I can ask her questions. She's there for me. So I feel like, you know, having a mentor is somebody who really, it's not only somebody who advocates for you, but is somebody who can really show you the direction of what you might be afraid to go after, or what you might not think of even going after. So of course, during the pandemic, I loved ID. I actually loved ID as a student, but again, just didn't think, it was like, it was a great rotation, but I didn't see myself going into it partially because of the length of training with it. So I just was like, yeah, it's a great field. I loved it as a student, but I just didn't go after it. So to go so many years later in the middle of my family medicine residency, back to this thing that I knew I really enjoyed, to have somebody say, you should do this. that is valuable. That is so important.

Sam Peterson: [00:12:20] And I worked with other ID docs at the time who were also fantastic, but she was the only one to really kind of pull that out and to say no, like, you should really, really consider this. In fact, I'm going to talk to the ABIM for you, doing these things that yeah, I was just so grateful for really going above and beyond because she believed in that. She had that vision. So to have a mentor, I think is somebody who can not only advocate for you, but to see things in you that you might not be able to see for yourself and see kind of the best sides of you that you might just be like, yeah, it's another day for me. I'm just doing my thing. But a mentor might see that and say, no, there's something special about that and really capitalize on that. And I think that's it's so important to see that because there's so many people. I think I work with a lot of students and residents who I'm like, hey, you guys would be a great ID doctor. And I really hope that I can maybe pull a little bit out of them and really try to be proactive instead of just, you know, saying, hey, you did a great job, good job on your notes. But to really be like, hey, let's let's get you involved. Let's see how we can get you, you know, maybe a little bit more involved in a field like ID.

Buddy Creech: [00:13:25] Yeah. No, no, I hate to interrupt. I'm so sorry. I just wanted to say, can you riff a little bit more on what that looks like? Like, what are those first steps beyond just saying you did a great job, you're smart and you're thinking through the process and you're thinking like we might think in infectious diseases. Like, what's the next step? You mentioned maybe getting them involved in projects or getting them involved in other things. Are there some, I don't know, is there some low hanging fruit that you might encourage us on to say, man, these are easy ways to get folks involved?

Sam Peterson: [00:13:56] I think something for me, way back when I was a medical student, actually with Dr. Zayed, I think one of the things that was so exciting as a student on that rotation was you felt like you were really owning that patient. So giving folks, giving students patients and really like giving them autonomy. I remember as a student with Dr. Azad, she would really encourage free thinking and things like that. And so if you had a thought and you researched something or you looked up something and you said, hey, I want to try daptomycin on this, or I want to try switching them to another, you know, whatever. She'd be open to that and she'd say, okay, cool, let's try that. Giving students that autonomy to feel like they're really making a difference in patients instead of like, you know, hey, just do the notes and we'll talk about it later. But to really give them that sense of ownership is so important. So I think that's one thing, is really encouraging patients or students to own their patients and to really research and give them the autonomy to be like, hey, you're you're the doctor.

Sam Peterson: [00:14:53] And as a third year medical student, there's nothing more exciting than that, right? You're like, I am calling the shots here. Uh, so I think that's one thing I really try to do is encourage students to think through it and to be like, what would you do? What are you thinking right now? And to make them feel like they're really driving the bus with their ownership of the patient. And beyond that, yeah. If there's any projects, you know, research projects, things they can get involved with, I always encourage students to go to society meetings for whatever they're interested in as well. I remember as a student, I would be a part I would go to those meetings because they were free a lot of times. So I always tell students I'm like, they're free, and sometimes you can get some fun swag, and more importantly, you can learn about stuff and get connected. So those are some of the things I like to try to do owning the patients, getting involved with research, case reports and then also if they're really interested, going to society meetings as well.

Buddy Creech: [00:15:43] This is incredible. I mean, if I look back at what really changed my trajectory, I think I can map those back to everything that you just said. The best advice I got during medical school as a third year from an ID doc was, I need all of you to pretend like you're not students. I need you to pretend like you're the last person and the only person who's going to see this patient today. And so that means I want all the data. But I really want to know what you're planning to do. And he really took it as it's my job to make sure you don't suggest something that could actually go sideways, but we're going to think through why that might or might not work. And it was liberating as a student because then I wasn't a data gatherer. I was a data generator, a data processor. And I was thinking about what would I do if I were the only one here? And I loved that. I loved that model. And then the very first thing I worked on with Kathy was as a resident, we did some of the early licensure studies for linezolid, and she couldn't go to the investigator meeting. So she sent me and here I am talking with people who are giants in staph aureus, and I'm like, I'm getting lunch with them, or I'm, you know, going to the coffee bar with them.

Buddy Creech: [00:16:58] And I'm thinking, what is going on right now? And then for me, because I trained in Memphis, St. Jude, for the last two and a half, three decades, has hosted a meeting there on campus that students and others attend for free. And it's a remarkable way to be with other like minded folks. So this is really helpful. And and maybe this is a time to make sure that, that we know folks are aware of, of a lot of efforts through IDSA, SHEA and PIDS and HIVMA to really get students and trainees at these meetings. It's like a family reunion and a science fair all rolled up into one. And it's lovely. This is great. So what does it look like now that you've been the recipient of mentoring? What are you most excited about and what are some of the what are the things you're already learning about what it takes to be a mentor on your side of trying to get folks interested and trying to to get them from point A to point B, like, like your mentor helped you do?

Sam Peterson: [00:17:52] One thing, I'm not shy at all with my story. I know it's very unusual, but I always tell students that and they kind of relax a little bit knowing that, hey, it's not all going to be cookie cutter. You match into residency. And it might be for a lot of people. Most people it is, but it allows them to breathe a little bit and to be like, okay, this person did a very random, weird trajectory. I can do that too, if I really needed to. So I always, you know, I'm not shy with my story. And the other thing is I love teaching. I think that's kind of one of the things that a lot of good ID doctors are fantastic teachers. So for me to pass along what my mentor taught me, she was a fantastic teacher. Again, she's a phenomenal mentor. She is a mentor in every definition of the sense. One of the big things that she was a big part of was teaching, and she was always such a fantastic teacher, and that's something I always like to pass along as well. She's so inspirational with that. Unfortunately, my last year in internal medicine residency, I actually got "resident of the year" because I was so active with teaching students and it's just a huge passion of mine. So that's one thing I really like to pass along is, you know, doing lectures, just doing chalk talks, things like that. I've actually contributed to the IDSA Chalk Talk program that's been going on as well. So I think if I were to boil it down into what I actually can do on a day to day basis to mentor others, one big thing is just teaching, because we really that it's such a way we can give from ourselves and to show, you know, our passion, but also to give back to students, to residents, things like that. So I think just teaching is a huge thing.

Sam Peterson: [00:19:26] And then just continuing to work with students, with residents, in addition to teaching  them, just looking through and seeing if they have questions or any ways that we can be supportive. Getting them involved with case projects, case studies you were kind of mentioning, you know, you're you're attending your mentor, getting you involved with, like these bigwig meetings. I remember once Doctor Azad, my mentor, I think I was at like, an infection prevention or control meeting, and it was kind of the same thing. And somebody was asking me about, like, c-diff rates and things like that. And I think I was like, coming off a night shift, and I was kind of like, I felt very out of my wheelhouse. But it was really cool to be involved. And I felt like, hey, these people are looking at me. Now I really need to be the one to step up. So in addition to teaching, really getting folks involved in whatever way we can just to show them and to make it feel like, hey, you're the one in charge of this. You're the one that people are looking up to. It kind of. It gives you a little bit of sense of urgency and importance, and I think that can really be helpful for some people to be like, oh, this is what it's like. And it's kind of cool. And a lot of people look up to you for that.

Buddy Creech: [00:20:28] Gosh, I love this. And I'll tell you, one of the things that you said that really resonates with me is this idea of story or narrative. You know, there's such a callback to to more ancient either techniques or ancient ways of doing things, whether that's going a little bit analog and listening to records or whether it's going further back. But I just think about the power of story as it's framed human civilization and human development for a very long time. And, you know, it's interesting. I think there are plenty of our students and trainees who have a narrative that's in their head about what ID looks like or what their careers in medicine might look like, or whatever it might be. And I think sometimes I am guilty of giving them little nuggets, little data points, little whatevers. And it and it they sort of become these just ping pong balls that float in the current of their, of their narrative, of their story, of what they have in their mind. But it doesn't do anything to reroute that current or reroute that river. And what we've really got a chance to say is, well, let me tell you my story.

Buddy Creech: [00:21:34] Let me give you a different narrative that might resonate with you in some kind of way. And for a lot of us, that is, we didn't have it all together. We didn't know what pathogen we wanted to eradicate when we were four years old. We may have had either gaps in training or like you, I'm the first in my family to go to. I was the first in my family to go to college, much less be be a physician. And so this idea of not being able to be what we can't see. There was a lot of help from folks showing me and telling me their story. And I just think that's really important. As we get in front of students, whether that's taking 2 or 3 minutes out of a of a chalk talk or out of a PowerPoint presentation and saying, can I just tell you why I do what I do and how I got there? And maybe that's more helpful than we would ever really understand.

Sam Peterson: [00:22:24] I totally agree. And I remember one thing when I was a student is I would always ask folks, hey, why did you go into this specialty? What do you like about it? What do you not like about it? And I think it's so important. And obviously sometimes we'll have a really good mentor or a really bad mentor, you know, different attendings we work with throughout medical school. But just to know somebody's journey, I think is so important and to learn from that, just to kind of see, hey, maybe this is something that I could see myself doing. I think that's a fantastic thing, is sharing stories.

Buddy Creech: [00:22:54] Well, and I love how the multiple choice test answer just keeps growing, which is, how does one become an infectious diseases specialist? Choice A might be go to school, go to internal medicine residency and become an ID doctor. Now the second one might be go to school, do a pediatrics residency, and then enter peds ID. Then you've got med peds, but now option like N or P or somewhere way down the list is go be an anesthesiologist for a year, flip to family medicine, endure a pandemic, do a modified internal medicine residency and then go ID in a town that is completely, violently opposed to your hometown football team. And the answer is all of the above are incredibly good ways to become an ID specialist. And that's pretty fun. Not many other groups get to say that. Well, Sam, thank you for for spending time with us today telling us your story. This is what we do as we think about workforce development, as we think about encouraging each other. Your story is not just compelling for trainees. It's compelling for any of us who are going a certain direction, and different forces move us into another with the help of mentors and with the help of peers and stories like this. Maybe that gives us the courage to take some steps and to take some leaps that we might not otherwise do, because it's going to work out. And maybe that's an encouraging word during a time of a lot of uncertainty right now at a variety of levels. So, Sam, thanks for spending time with us today.

Sam Peterson: [00:24:35] Absolutely. It was great talking with you, Buddy. Really appreciate it.

Buddy Creech: [00:24:37] Well, thanks for joining us today for Let's Talk ID. If you want more information about what it looks like to be a mentor, how to share your story, please feel free to reach out. You can do that with me personally. You can certainly go to our IDSA and PIDs websites to look for ways that you can be involved, not only to tell your story, but to be a part of someone else's story as well. So until next time, this is Let's Talk ID. Let's talk ID is produced by the Infectious Diseases Society of America, and it's edited and mixed by Bentley Brown.