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Halsted's Hands - Julie Ann Sosa, M.D.
Julie Ann Sosa, M.D.Date: May 30, 2012
Associate Professor of Surgery and Medicine (Medical Oncology), Yale University School of Medicine
As an undergraduate at Princeton’s Woodrow Wilson School of Public and International Affairs, Julie Ann Sosa assumed she’d become a Ph.D. specializing in economics—until she wrote a book about labor economics and realized that, based on her predictions, she wouldn’t have a job. From there, she decided to do something “easier,” she laughs, “like medicine.”
During medical school at Johns Hopkins, she planned to enter internal medicine. But in September of her fourth year, she had an “unbelievably life-changing experience” while rotating through former Surgery Director John Cameron’s famed “GI Gold” service. “It was like being on a roller coaster,” Sosa says. “Now that I am an endocrine surgeon, I would diagnose it as a cortisol-catecholamine high.”
Today she directs the Yale Endocrine Surgery Clinical and Health Services Research Group.
Halsted’s Hands: Tell us about your work with health services research.
Sosa: We study factors that affect how patients do after surgery, in an effort to improve quality of care. We employ different methodologies, including cost-effectiveness and decision analysis, meta-analysis, survey work and secondary data analysis.
We also are studying novel methods of treating advanced and metastatic thyroid cancer. I do a lot of clinical trials, and not the ones that most surgeons do. I don’t test new technologies or devices. I’ve been the PI on drug trials for locally advanced and metastatic thyroid cancer. When people think of drug trials, they usually think of medical oncologists, but I feel strongly that there are malignancies for which surgeons are the best clinicians to run these.
Conventionally, there are no chemotherapies that work for thyroid cancer. The only other group taking care of patients is endocrinologists, and their only effective treatment historically has been radioactive iodine. Surgeons are in a unique position in this area to become leaders in developing novel medical therapies.
Halsted’s Hands: How did you develop an interest in this area?
Sosa: As a resident, I did two years of research through the Robert Wood Johnson Clinical Scholars program. They were two of my best years at Hopkins. Working with my mentor, Neil Powe [now at UC-San Francisco], allowed me to fuse the clinical science of surgery with my background in economics. I also worked with endocrine surgeon Robert Udelsman, who is now my boss at Yale, on early outcomes research.
Surgeons overall have been slow to recognize this as a legitimate area of research. Now it is one of the fastest-growing areas.
Halsted’s Hands: What is your advice to current residents?
Sosa: Keep an open mind. I have had chance encounters that if I had been closed to them may not have led me to who I am today. Also, look in and outside of surgery for individuals who can change you as people, become your advocates, and ultimately be lifelong friends and colleagues.