Roberto Leon-Ferre, MD. Assistant Professor of Oncology, Associate Program Director of the Advanced Breast Medical Oncology Fellowship, Mayo Clinic, Rochester, MN
I split my time between clinical care, research and education. My clinical practice is focused on the treatment of patients with breast cancer, and in evaluating patients in our Early Cancer Therapeutics Clinic (where we run phase 1 clinical trials for cancer treatment). My research is focused on evaluating immune responses in patients with breast cancer and how they impact outcomes or treatment efficacy. I also work closely with our Hematology/Oncology fellows and co-lead our advanced breast cancer medical oncology fellowship.
What were some of the projects you worked on while you were at Iowa and how did this work prepare you for your career?
I was introduced to the clinical care of patients with cancer and to clinical cancer research at Iowa. I had the fortune of having Dr. Mo Milhem as a mentor during my residency. The projects I worked on with him defined my career as an Oncologist. If you have ever interacted with Mo, you know that characterizing him as “unique” is very much an understatement. Mo taught me how to write a clinical trial concept to pitch new cancer treatment ideas to potential sponsors. He introduced me to how you should write a clinical trial protocol and gave me the opportunity to co-write one with him and an Oncology fellow. He meticulously thought about every little detail (not only from the science perspective, but also the mundane practical stuff that sometimes get little attention). Seeing how he basically grew the melanoma cancer practice at Iowa from scratch was one of the biggest sources of inspiration I had in my decision to dedicate myself to a career in Medical Oncology. In addition to being a stellar researcher, Mo taught me how to make patients with cancer laugh in the face of adversity. If you know Mo, you know his dry sense of humor is one of his biggest assets!
What was most valuable to you during your years at the University of Iowa?
I can truly say that I learned to be a doctor at the University of Iowa. Residency training is where you make the actual transition from “book knowledge” to “boots on the ground knowledge,” and it is also where you learn the human aspect of medicine. I could have not wished for better training and for better role models during these early stages of my career. The most valuable lessons I absorbed at Iowa were the multiple “lead by example” type of training moments that left a lifelong lasting impression on me and have shaped my practice to this day. More valuable than any didactic session (which were outstanding by the way), was the opportunity to see master clinicians and leaders at the bedside, in action. Seeing how they interacted with patients, how they thought through complex clinical scenarios to arrive to a diagnosis, and—more importantly—how they approached difficult conversations with patients and families, provided me with the armamentarium I still draw from on a day-to-day basis when accompanying my patients facing their cancer diagnosis.
What is one memory that stands out from your time at Iowa?
Iowa was my first home in the United States. I moved to Iowa from Ecuador with my wife a month after getting married. Due to visa restrictions, I could not enter the US more than 10 days before the start date of the residency. Cindy Batzkiel pretty much worked as our realtor helping us find an apartment from a distance. I did not have a social security number yet and of course, no credit history in the US which, you know, may be an issue if you are trying to rent an apartment, lease a car, etc. Dr. Scott Vogelgesang (Dr. V), the residency program director at the time, co-signed my apartment lease agreement to help us out and have a roof over our heads. That is the memory I have from Iowa: a tight family in which every member that takes care of each other. When you join that family, you are really a lot more than a “trainee.” From the first day, you get the sense that everybody there is trying their hardest to lift you up and make sure that you achieve your own definition of success, both professionally and personally.
What is something you learned at Iowa that you still use in your current role?
During my year as a Chief Resident, I had the opportunity to get a behind-the-curtains look at the machinery that makes the Internal Medicine Residency at Iowa such a wonderful program. Working side by side with Dr. V allowed me to see how he crafted a vision for the program, and taught me more leadership skills than any course on the subject. He really has people skills like no other person I have met. He has this ability to inspire everyone to work at the top of their abilities. When you work with so many people, at some point there are going to be conflicts. I witnessed multiple times how Dr. V masterfully mediated these situations and helped reach solutions that allowed everyone involved feel listened to and treated fairly. I find myself drawing from many of his lessons when working as part of a team composed of members with different roles, skillsets, and personalities.
Beyond practice, one of the roles that makes me the most proud and brings me the most satisfaction is teaching. I love seeing the spark in a learner’s eye when they finally grasp something that was confusing to them (and believe me, there are many aspects of cancer that even seasoned oncologists find confusing). I learned most of what I know about teaching from Dr. Suneja. I do not know of a person with such an innate ability to break down concepts to their essence, and to allow learners to peek inside his mind as he processes information. This is something I try to emulate every time I give a talk or teach at the bedside—not only with trainees, but also when educating my patients. I literally find myself thinking, “How would Dr. Suneja explain this during noon conference?”
How do you maintain a life-work balance in your current role?
I am very fortunate that my colleagues are very much family-oriented people. Even though I get to work with incredibly accomplished individuals, our group is in many ways resembling of the sense of community I first saw at UIHC. My mentors and colleagues are as interested in my family and personal life as they are about my academic life. I subscribe to the concept of work-life integration rather than balance. There are times when I need to weat my “work hat” more often, and there are times when I have to push work to the side to be a husband, a dad, and a son. One of my mentors always told me that after I retire, people will forget very quickly how little or how much I accomplished academically, but my family of course will always cherish the quality time I spend with them. With some exceptions, I try hard to dedicate the weekends fully to my family (perhaps with the exception of Monday deadlines for grants, which should be banned!). I have also learned that frequent, shorter 3- or 4-day vacations (rather than longer vacations once or twice a year) keep me from burning out and help make sure my kids feel I am always there, no matter how busy work may get at times. If I have had a stretch of time where work consumed more of my attention, I try to make sure I take a short break soon thereafter. This helps me keep my sanity, and also allows me to “refresh my soul” if I have had a tough stretch when patients don’t do as well as you hope they do.