Op-Med is a collection of original articles contributed by Doximity members.
Name: Shikha Jain, MD
Education: Loyola University, University of Illinois College of Medicine at Chicago, Michigan State University College of Human Medicine, Drexel University, University of Chicago
Areas of Expertise: Thoracic oncology, Lung cancer, Gastrointestinal cancer, Colorectal cancer, Pancreatic cancer, Prostate cancer, Lymphoma, Bladder cancer, Testicular cancer, Hospice and palliative care
Current Position: Oncologist at Northwestern Memorial Hospital
1. Why did you choose Hematology/oncology?
This is such a special field to be in. Patients let you into the most intimate aspects of their lives, and often I have the privilege to help them through very difficult times. Advances in the field have led to our ability to cure patients, or help patients achieve a long term remission, who previously had no hope. I am also able to help navigate the transition into hospice and discuss end of life care for those who are not able to receive treatment, or do not wish to pursue therapy. It is a unique subspeciality because it allows for the development of the doctor-patient relationships and in most cases, requires continuity of care. The science has always fascinated me, but the patients and my ability to develop long term relationships with them and their families, is the main reason I chose this field. I am fortunate that I have found a career that enables me to pursue a field I am passionate about while helping people. It also allows me to incorporate my passions for public speaking, education and writing.
2. What area of your specialty is changing most rapidly?
Immunotherapy is revolutionizing the field of oncology. We are able to utilize a patient’s own immune system to treat a variety of malignancies, and this has been ground breaking. We have also been able to move towards more personalized care as we find molecular markers that can be specifically targeted in individuals’ tumors. It is an extremely exciting time in oncology with the plethora of new drugs being approved with results that would have been incomprehensible just a few years ago.
3. What are your research interests?
Currently my research is focused on improving patient care by looking at different barriers to the delivery of efficient and expedient care through obstacles at the pharmacy and prescriber level.
4. Outside of your daily practice, do you have any personal or professional projects that you’re passionate about?
I find myself the most animated and engaged when I am giving talks or providing education on different topics within medicine. Cancer is a scary word, and by educating people I feel I am able to make it a little less scary. Almost everyone has been touched in some way by cancer, whether they are a cancer survivor, or their friend or family member has been diagnosed with some form of cancer. With a little bit of knowledge I hope I can help people gain back some control they often feel they lose when the big “C word” enters their lives.
I have also recently taken up writing again, which I am finding is a great outlet for me. I tend to be struck by inspiration late at night on topics that range from politics and health care, to my children. Writing helps me organize and process my thoughts and allows me to express myself on issues that I believe have a major impact on all of us.
5. What is a common misconception that other clinicians have about hematology/oncology?
The most common comment I get from both physicians and non-physicians is “your job must be so sad!” and on many days it absolutely can be. But it is also inspiring, and uplifting. Cancer is a scary word, and we as oncologists try to make it a little less scary. It is such a special field within the world of medicine.
6. Who are your mentors?
I am extremely fortunate that I was born in a home with a built in mentor. My dad, Krishna Jain, is a vascular surgeon and he has been my mentor, my advocate, my teacher, and my sounding board. He has been my most constant mentor and without him, I would not be where I am today. His advice and guidance on navigating difficult situations throughout training and as an attending physician have been invaluable. I continue to go to him for advice and guidance. He is who I try to emulate when attempting to be an accomplished physician while achieving a successful work/life balance.
I have had several other mentors that have also had a significant impact on me. As a medical student, Dr. Mark Loehrke (a brilliant internist) helped me navigate complicated patient care situations, as well as helped mold me into an empathic physician and accomplished diagnostician. Currently I work closely with two phenomenal Heme/Onc docs (Drs. Regina Stein and Claudia Tellez) who helped me transition from the life of a fellow to life of an attending and they continue to guide me as I move forward in my career. As a female physician, I often face unique challenges and I consider myself extremely lucky to have two strong female mentors at this point in my career.
7: What’s the best advice you’ve ever received?
There are a few, so I don’t think I can pick just one. My top three would have to be: Love what you do and your job won’t feel like work; Make a good home/life balance a priority; Don’t take yourself too seriously, and don’t forget to laugh at yourself. I am lucky to have a great family support system that allows me to find a balance. And I never take myself too seriously because we only have one life, and finding the humor in it keeps me sane and centered.
8. What has been your most gratifying moment of being a clinician?
In oncology, we cherish the moments when our patients (especially those with aggressive disease) respond to treatment. I have a woman who thought she would be dead in 3 months from metastatic lung cancer. She is currently traveling the world two and a half years after her diagnosis as she continues her treatment. Patients share with me pictures of their grandchildren’s wedding that they thought they would not be alive to attend, or the birth of a first child that a patient thought he would not be around for. These are some examples of gratifying moments that make me love what I do. I also practice hematology with a focus on infertility/frequent miscarriages. Helping a woman achieve her dream of carrying a baby to term is an extremely rewarding feeling. I just saw a woman who after 5 miscarriages due to antiphospholipid syndrome is in her last trimester of a healthy pregnancy and has tears at each clinic visit.
9. How do you unwind after a challenging day?
With a 3 year old daughter and twin 3 month old sons, my unwinding comes from fun family time. I love creating family projects. I do love to run and find it is a great mental release for me. I started running in residency when I would come home from a tough day to try and release some tension. I found myself running longer and longer distances until I eventually ran my first half marathon in my last year of residency. I also make sure we as a family make time to get away. My husband and I love to travel, so we make time for family vacations. We both worked as internists in New Zealand prior to starting fellowship and cherished that time. We learned a great deal about ourselves while making great friends.
10. How do you motivate patients to do what’s best for their health?
I try to use personal experiences and positive reinforcement. I work with the patient to come up with a plan that would be feasible in the context of their lives. It is important to find ways to implement healthy life changes that will fit into their schedule, especially when it comes to exercise. There is no single plan that will work for every individual. I emphasize the importance of not giving up, even when they hit a bump in the road.
11. What is the biggest challenge or obstacle in hematology/oncology?
It can be very difficult to predict who is going to respond to therapy and for how long. With tumor markers, immunotherapy and molecular testing, we have been able to move towards personalizing treatment, but there is still a long way to go. Common questions asked by patients with metastatic disease are “how long am I going to be on this treatment?” or “how long do I have to live?” These types of questions are not always easily answered. We can quote statistics from studies and randomized control trials, but there are no absolutes. We often tell our patients that we aren’t fortune tellers and we can’t predict these things. Perhaps in the future we will be able to have a better answer for them. The cost of chemotherapy and other oncolytic and immunotherapeutic drugs, as well as the cost of imaging and testing in general is a huge obstacle in the field. Cancer care is exceedingly expensive, especially for the uninsured. No one should die from a curable cancer because they cannot afford it, but it happens.
Doximity is physician-driven which makes it very unique. I enjoy the high yield articles from the varying fields of medicine. Knowing how guidelines and practice changes in other fields is essential to being a good hematology/oncology physician.