Op-Med is a collection of original articles contributed by Doximity members.
Name: Justin Dubin, MD
Education: Rutgers Robert Wood Johnson Medical School, Johns Hopkins University
Areas of Expertise: Urology
Current Position: UMiami Urology Resident
1. Why did you choose urology?
It may sound cliché, but I think that Urology, in many ways, chose me. Coming out of college, I was hired to work as a Clinical Research Coordinator in the Department of Urology at Weill Cornell Medical School in Manhattan. I honestly knew nothing about Urology when I was hired but over the two years working there I fell in love with it. What I love about Urology is that you really get the best of both worlds: you get meaningful experiences through outpatient procedures and patient interactions in clinic, as well as a rich surgical experience in the OR.
2. What is the last journal article or piece of research that significantly changed how you practice?
I think that the Holy Grail in Urology is to have a screening test that is both sensitive and specific for prostate cancer and also minimizes the morbidity of diagnosing the disease. This quest for better tools to diagnose clinically significant prostate cancer includes everything from genomic testing to MRI fusion biopsy. One of the more important studies on the topic is by Kasivisvanathan et al in the NEJM titled, “MRI-targeted or standard biopsy for prostate-cancer diagnosis,” which shows that the use of risk assessment with MRI before biopsy and MRI-targeted biopsy was superior to standard transrectal ultrasound-guided biopsies in at risk men who had not previously undergone biopsy.
3. How has technology impacted urology in the past several years?
In my opinion, Urology is one of the most technology-forward specialties. From pioneering robotic surgery with the Da Vinci robots to utilizing complex genomic data for the development of new cancer biomarkers to creating new MRI-fusion guided biopsies, Urology has been at the forefront of pushing technology to improve patient care. One of the most exciting aspects of Urology is getting to work with the newest, and let’s be honest here, coolest technology around.
4. What are your research interests?
Since starting here at UMiami I have been doing a lot of research in men’s health, sexual health, and infertility. I am very excited about my current projects, as to my knowledge we are the first institution to work with subjects in the adult entertainment industry. We recently had an abstract submitted looking at erectile dysfunction in male adult entertainers and will be submitting the manuscript shortly. We are also starting a project looking at female sexual dysfunction in female adult entertainers. I feel it is an important and understudied population that we can learn a lot about.
5. Outside of your daily practice, do you have any personal or professional projects that you’re passionate about?
I personally believe that all physicians would benefit from exploring their creativity by embracing the arts in one form or another. For me, I have always been passionate about film. In high school I used to write and create films and submit them to competitions. After college I started a film podcast, twoguysonemovie.com, with one of my best friends. We have been doing weekly films reviews for the last 8 years and it is something that I love doing and don’t see myself stopping any time soon.
6. What is a common misconception that other clinicians have about urology?
I think that one of the most misunderstood things about Urology is that people think it is specialty run by men with a focus on men. This is absolutely not the case. Both men and women have bladders, ureters, kidneys, and urethras so we serve many women. Over the last few years, more and more females have started specializing in Urology, and about 30% of current Urology residents are female. UMiami is definitely embracing the increase in female interest, as the last two incoming classes have been 66% female! I am excited for the future of Urology and the direction that the field is going in.
7. Who are your mentors?
At each step in my life I have found that I have had different mentors that have played important roles in my progression as a researcher, as a physician, and most importantly, as a person. My parents are, and will always be, my most important mentors. They have instilled me with the values that I have and made me the person I am today. In college, working under Dr. William Earnshaw at the University of Edinburgh I learned how to think like a scientist and a researcher. Dr. Edward McFarland at Hopkins gave me my first exposure to surgery and helped guide me to a career as a surgeon. As a clinical research coordinator at Cornell, Dr. Shahrokh Shariat and Dr. Doug Scherr introduced me to the world of Urology and clinical research. They were major reasons why I fell in love with Urology. Currently at University of Miami, Dr. Ranjith Ramasamy, has played a significant role in my progression as a Urologist and has been a key mentor in supporting my current research endeavors.
8. What’s the best advice you’ve ever received?
When I first started working as a Clinical Research Coordinator at Cornell, I felt overwhelmed with the job and the plethora of new information I had to learn. It was becoming apparent to my attendings I was getting stressed out. I remember very specifically Dr. Shahrokh Shariat telling me, “Develop a healthy approach towards stress relief. As you go into medical school and beyond, life will be stressful and it is important you develop the right habits now so they become second nature later on.” I took that to heart and focused on going to the gym or going to the movies as main stress relievers. Even now during residency, I find that going to the gym or simply watching a movie helps relieve the day’s stresses and no matter how busy I am, I make the time to do the things that make me feel better. I recommend that everyone develop a healthy form of stress management. Physicians live stressful lives, which mostly focus on taking care of everyone except for ourselves. It’s important to take a step back on occasion and make sure we are taking care of ourselves as well.
9. Can you talk more about the “Socratic Paradox” you gave a MED Talk on?
The Socratic Paradox is based on the phrase, “I know one thing, that I know nothing.” So we have Socrates, literally known to be one of the smartest minds in the history of man, saying that in the spectrum of knowledge in the world, even he knows nothing. The problem I often see with physicians is that we often suffer from overconfidence in our decisions and skills, which in the long run can lead us to more closed mindedness. By understanding the paradox and accepting the fact that we do not know everything, we open ourselves to incredible opportunities. We are motivated to collaborate with others, think outside the box, and challenge the status quo of medical practice. Quite simply, only after acknowledging that we don’t know anything, do we actually start to learn everything.
10. How do you motivate patients to do what’s best for their health?
I think the best thing you can do is first and foremost listen to them. Understand their situation and show empathy for what they are going through and understand the possible barriers to achieving our health goal. Often times, the biggest barrier is education. I find taking the extra 5 minutes to listen to them and then explain in layman’s terms what the situation is, why we want to do what we are going to do, and what the results should be once we do it, make all the difference. Listening is the key to motivation and the best part is you build a richer patient relationship because of it.
11. What is the biggest challenge or obstacle in urology?
The biggest challenge as a Urology resident, in truth, is really the biggest challenge that any physician faces: preventing burnout. Medscape’s January article shows that 42% of doctors reported burnout. As physicians we all struggle to find balance between our professional lives and personal ones. It is imperative that we as physicians take note of our colleagues’ mental and physical health and support one another. We are all in this together and if we cannot take care of ourselves, we will never be able to help those who need us the most.
The Doximity Dialer for my phone has without question made my life easier. Gone are the days of using *67 to hide my phone number. The Dialer provides me with a fast and easy way to make work-related calls while preserving my privacy.