Making History: Michelle Kang Kim, MD, PhD, is Cleveland Clinic’s First Female Chair of Gastroenterology

The appointment of Michelle Kang Kim, MD, PhD, as Chair of Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition is groundbreaking in several ways. Dr. Kim is the first woman to hold that position at Cleveland Clinic, and she is among the fewer than 10% of gastroenterology division chiefs nationally who are female.

While the specialty is making progress in terms of gender equity and diversity, gastroenterology remains a male-dominated field; only 19% of practitioners and less than 30% of trainees are women. Addressing those disparities and the challenges that result — from differences in compensation and promotion to a shortage of role models and mentors — are some of Dr. Kim’s many priorities in her new role. She is committed to the career development of medical trainees and junior faculty, especially women and underrepresented minorities.

She also is an active researcher and clinician who plans to continue those responsibilities at Cleveland Clinic.

Dr. Kim previously served as Vice Chair for Faculty Affairs for the Department of Medicine at New York’s Icahn School of Medicine at Mount Sinai, where she was a Professor of Medicine and Co-Director of the Center for Carcinoid and Neuroendocrine Tumors.

Dr. Kim has lectured nationally and internationally on carcinoid and neuroendocrine tumors and is known for her work in translational and epidemiologic approaches in assessing patient outcomes. She is interested in the epidemiology of gastrointestinal cancers, particularly cancer disparities that occur in underserved populations.

She is currently Chair of the Carcinoid and Neuroendocrine Tumor Section of the American Gastroenterological Association (AGA) and President of the Korean American Medical Association. She has served on multiple committees and panels for the AGA, the American Society of Cancer Oncology, the North American Neuroendocrine Tumor Society and the American Joint Committee on Cancer. She is also a former president of the New York Society for Gastrointestinal Endoscopy, one of the largest regional endoscopic organizations in the U.S.

“Dr. Kim is a brilliant researcher, top clinician and respected leader,” says Miguel Regueiro, MD, Chair of Cleveland Clinic’s Digestive Disease & Surgery Institute. “She is renowned for the management and study of neuroendocrine tumors. Dr. Kim is a talented mentor who has dedicated herself to mentoring and helping faculty with career advancement. She is dedicated to diversity, equity and inclusion and is involved in national GI societies leading this effort. Equally important, Michelle is a great person — down to earth and humble. I’m thrilled to have her join our department and Cleveland Clinic’s family.”

In a wide-ranging interview with Consult QD, Dr. Kim discusses medicine, mentoring, neuroendocrine tumor research, juggling personal and professional duties, and much more.

Questions and answers have been edited for length and clarity.

You were a well-established leader, clinician and researcher at the Icahn School of Medicine at Mount Sinai. Why did you decide to relocate to Cleveland Clinic?

Dr. Kim: I was at Mount Sinai for 17 years. I started right after my fellowship. It was an incredible place to learn and grow. But it was time for something different. Cleveland Clinic is an amazing institution. It has such a reputation for patient-centric care. To work at a place with that kind of commitment and mission is an honor and a privilege. More specifically, the Department of Gastroenterology, Hepatology and Nutrition is incredibly well-rounded, with tremendous faculty, staff, residents and trainees. It will be wonderful to take what’s already terrific and help it become even better — to really take it to the next level.

What are your goals as the new department chair?

Dr. Kim: My first priority is to make sure that patient care is consistent and of the highest quality across all Cleveland Clinic sites. Second is to advance the science of gastrointestinal health. We have so many talented researchers, both within and outside the department, who can potentially collaborate to ensure that we detect disease early and accurately and that we personalize care so patients receive the best treatments at the right time for their condition.

With your administrative duties, will you still have time to conduct research, care for patients and teach?

Dr. Kim: It will be a challenge, but I plan to do all of the above. My training is as a clinical gastroenterologist and my clinical practice in recent years has been dedicated to the care of patients with carcinoid and neuroendocrine tumors. The incidence of gastroenteropancreatic neuroendocrine tumors is increasing. We suspect a lot of that may be because we are doing more scans and endoscopies, but there also could be environmental influences we’re not aware of. I plan to develop a carcinoid and neuroendocrine tumor treatment and research program in concert with other clinical and scientific colleagues at Cleveland Clinic. Because of the relative rarity of the disease, and with the strengths already at Cleveland Clinic, we could be a destination for patients from across the country seeking care. I often get my best scientific ideas from seeing patients and the challenges they face. Teaching also fuels more questions for me in the clinic and the lab. Those activities are all synergistic, so I’m really looking forward to progressing with all of them while also overseeing the department.

You’re hoping to start a multidisciplinary clinic for patients with carcinoid and neuroendocrine tumors?

Dr. Kim: It’s still in early stages. Patients can get carcinoid and neuroendocrine tumors in many different locations — lungs, stomach, small intestine, pancreas, colon and rectum. Colleagues from all of these disciplines can participate in caring for patients. We just need to figure out how we can streamline that and make it an efficient process.

What are the key research topics involving carcinoid and neuroendocrine tumors?

Dr. Kim: In the last decade or so, there’s been a tremendous push to increase the rigor of studies and collaborative, randomized clinical trials to provide higher-level evidence demonstrating when patients should be treated with certain therapies. Fortunately, patients with carcinoid and neuroendocrine tumors often survive for many years. Understanding how best to sequence and integrate their treatments is the next challenge. Also, personalizing that care — understanding which patients, with which comorbidities, should be receiving a certain type of treatment — is going to be a big challenge. This is something we are particularly well suited to address at Cleveland Clinic.

What research projects do you plan to continue in Cleveland?

Dr. Kim: One of my first steps will be to continue the development of a neuroendocrine tumor registry and biobank at Cleveland Clinic. We’ve been fortunate in recruiting a very high number of patients for this registry and biobank at Mount Sinai. With the volumes of patients we will see at Cleveland Clinic, we can easily do the same there. Another project of interest, which is funded by the Neuroendocrine Tumor Research Foundation, involves using digital image analysis of neuroendocrine tumors to predict outcomes. We are still in the early stages of our data analysis but I think we’ll have some very promising findings. I definitely look forward to continuing that work at Cleveland Clinic. I am also interested in understanding the epidemiology of gastrointestinal cancers and specifically in addressing disparities in screening for these cancers.

You’re the first female chair of gastroenterology at Cleveland Clinic. What does that mean to you?

Dr. Kim: It means a tremendous amount to me personally. There aren’t many women in gastroenterology; we make up less than 20% of the field. So when it comes to issues like promotions, leadership and gender equity, there are a limited number of people who feel comfortable raising questions about whether there is enough representation. I’ve received a tremendous number of messages not just of encouragement and pride, but also of thanks for being a visible female leader.

Did you know when you chose gastroenterology that the percentage of women practitioners was so low? And why did you pick that specialty?

Dr. Kim: I absolutely did not know when I was going in that the percentage of women was so small. I became more aware of it because, recently at Mount Sinai, 12 out of 12 gastroenterology fellows were women. That was a watershed moment. It was one class of female fellows, followed by a second class, and then a third, and we had never seen anything like it. So all of a sudden the conversation about equity was very different because we had so many young women in our training class. In terms of my reason for choosing gastroenterology, it was entirely because of the opportunities to treat and study a fascinating group of conditions involving everything from digestion to metabolism to nutrition. I very much enjoy collaboration, and gastroenterology provided ample opportunities for that.

You’ve written often about gender issues in medicine and medical training. One example you cited involves tactile instruction in endoscopy training. Can you explain?

Dr. Kim: This came to the forefront because we had so many female gastroenterology fellows in training, which made me reflect on my own training. In something as tactile as endoscopy, a lot of my teachers frequently put their hands on my hands or arms to show me things. They always did it in a way that was respectful and appropriate. But in the current age, there are questions about appropriate ways to touch people. In many ways, we’ve advanced because of this greater awareness. But I think there is some potential for lost teaching opportunities as well, if [an instructor] feels like they can’t physically demonstrate a technique or they don’t know how to have a conversation with a trainee who is not doing something correctly and needs to be shown. That’s a challenging conversation, and I wanted to bring awareness to it.

You’ve also written about how the childbearing years for female physicians coincide with the height of their professional training and how difficult that concurrence can be. What can be done to help young women in medicine deal with the simultaneous demands of parenting and professional advancement?

Dr. Kim: It’s challenging because the medical profession continues to evolve and parenting continues to evolve. And certainly in this era of COVID, all bets are off. It’s such a personal decision about when to have kids and how to ensure the welfare of your family while developing your professional career. There is no perfect way to do this. It’s a marathon. Being a parent, a physician and a leader don’t all have to be done at the same time. I encourage young faculty to do what they can not to set unrealistic expectations and to be kind to themselves. There are also practical accommodations that should be addressed, like scheduling flexibility, avoiding exposing a pregnant physician to radiation during procedures and providing access to breastfeeding facilities. We need to be sure that we’re making a challenging situation more manageable.

You helped conduct a survey that found one-third of female gastroenterologists have altered their career trajectory due to perceived hostile working conditions. That’s a startling percentage.

Dr. Kim: The data speaks for itself. It really highlights the importance of ensuring that we have a very diverse workforce to care for a very diverse population. I am looking forward to having not just a diverse staff, but diverse leadership, to ensure that we have all the voices at the table.

You’ve talked about the importance of having a mentor at key points in your career. Who has influenced you the most?

Dr. Kim: To list them all is probably beyond the scope of this interview. It takes a village. I can highlight a few people who have been very important in different ways. Dr. Richard Warner [Founder and Medical Director Emeritus of the Carcinoid Cancer Foundation and Retired Director of the Center for Carcinoid and Neuroendocrine Tumors at Mt. Sinai Hospital] was a very generous mentor in terms of teaching me about his experience with these rare and understudied tumors. Another is [Mount Sinai pulmonologist and clinical epidemiologist] Dr. Juan Wisnivesky, who was my research mentor for the past decade. No one has taught me more about developing as a scientist, a cancer epidemiologist and a health services researcher. Without his mentorship, my career would never have reached the heights that it has. Many of my female mentors have also become close peer mentors. One is [University of Puerto Rico gastrointestinal oncologist] Dr. Marcia Cruz-Correa, who I first met at an American Gastroenterological Association workshop 15 years ago and saw as recently as two weeks ago when we went to a concert in New York City. We’ve had conversations ranging from developing a scientific career to parenting, leadership, and even very granular things like organizing your day and how to allot time to high-demand projects. She continues to be an invaluable mentor and colleague.

Will you have time for mentoring in your new position?

Dr. Kim: I absolutely plan to. I feel a special responsibility to our trainees and people who are early in their careers. And I want to ensure that access to mentorship is uniform.

What do you enjoy doing in your free time?

Dr. Kim: I’m a classically trained pianist, although unfortunately I don’t have much time to play these days. I’m very excited by the prospect of seeing the Cleveland Orchestra in action and there are many musicians in Cleveland that I’m looking forward to connecting with.