The Flame asks Dr. Joseph Guileyardo, leader of the autopsy service for more than a decade, five questions about his time teaching at Baylor University Medical Center at Dallas (BUMC), and why autopsy is so indispensable to the medical education experience.
1. When and why did you decide to join the BUMC medical education faculty?
I was asked to cover the autopsy service through my private forensic consulting practice in 2004 because the autopsy facilities were undergoing renovations so they had to temporarily suspend the service at BUMC. So they asked me to do the cases. Through that experience, they asked me to go ahead and join the medical staff, where I’d also be a part of the medical education program.
I immediately sensed that BUMC was operating under a spiritual, altruistic principle that I found uplifting and refreshing. Furthermore, the cases were extremely complex and fascinating. Everyone associated with these difficult cases expressed appreciation with the answers we could provide, so it was just a good experience for me.
2. What makes autopsy such an important part of the medical education experience?
When someone dies suddenly, unexpectedly from unknown causes, both the patient’s family and treating physicians – whether they are in training or an attending – they are all uncomfortable with that situation. They need some peace and closure that objective answers can provide.
The big question that comes out of it as a medical education experience is whether anything could have been done differently to achieve better results and was anything learned that could benefit the next patient? That is what we’re always trying for. I think that’s why it’s important not only for medical education for those in training, but continued medical education for people in practice.
3. How has the way that you were educated influenced your teaching style, and how would you describe that style?
I was taught by role models who had a passion for pathology. They really had a love for the science of pathology that showed through. So I try to pass on my passion for the medical science of pathology as well. I can’t help but be enthusiastic about it because I do love to do it.
As far as my style, I see the people in training as peers and colleagues rather than me handing down proclamations from on high. These cases are complicated and difficult, and I approach it in a way where me and the people in training are going to work together to solve these problems as a team. The answers usually aren’t obvious, so it’s not like I’m a professor who has the answer from the start anyway.
I think I learn as much from the residents as I’m sure they learn from me because they come up with new ideas, and we all work together to solve these cases.
4. What do you enjoy most about teaching residents at BUMC?
I’ve enjoyed watching these people grow and transform into competent physicians. I’ve stayed in touch with them as they go out into the world, so to see them have some success and happiness is just tremendously gratifying. And that’s really what we’re aiming for: for them to be good doctors and to be happy in their life.
5. What sets the BUMC medical education program apart in regards to your specialty?
Here, the autopsy rate is good. We did more autopsies last year than in the past. The enthusiasm seems to be growing about what can be gained from doing autopsy both from the family’s point of view and the hospital’s.
We find things that the family needs to know because there could be conditions that affect other family members. And there is so much treatment at BUMC that we constantly need to evaluate these new therapies to see how effective they are. We do a lot of conferences with the internal medicine residents and several other groups, and they are so enthusiastic to learn whatever they can through these cases when the outcome was not as successful. They really are trying as hard as they can to learn something that can be used to benefit the next patient.