Written by: Dorothy Anne Galang Cabantan, DO
Introduction
It is our honor to feature Arthur C. Jimenez, MD, who previously served as Chairman and Medical Director of the Department of Rehabilitation Medicine at the Hospital for Joint Diseases (now known as the NYU Langone Orthopedic Hospital). Dr. Jimenez reflects on his personal and professional journey through Physical Medicine and Rehabilitation, highlighting the importance of family while navigating the peaks and troughs of a career in academic medicine.
“To me, family is really the best and most important priority. Friends, you may see when you have reunions, and the like. But when you are ill, it is your family who’ll be with you. I’ve already had 2 major illnesses – I was diagnosed with prostate cancer just before I retired. Luckily, I got it attended right away and I am now on my fifth year of remission. A year after I retired, I underwent open heart surgery. I’ve been through a lot, and my family has always been with me through it all.”
His remarkable leadership roles and notable publications in PM&R inspire our generation to lead with excellence. Let’s take a deep dive into his journey as one of PAPA ORG’s founding fathers.
What inspired you to pursue Medicine?
Believe it or not, I did not think of becoming a doctor when I was young. My dad wanted me to be a chemist, and he even told his friends that he’d send me to Germany to become a chemist. Deep in my heart though, I knew I loved numbers. So I thought, I’d probably do a profession that dealt with Math. Then, two of my friends at school wanted to become doctors, and so it struck me that I wanted to become one too, and joined them. Ultimately, we all enrolled at the University of Santo Tomas. And that was it! Perhaps, it was a twist of luck. In medical school, I served as President of our graduating class, which was comprised of 300 students. This was a huge task, and additionally this was during Martial Law – which posed some limitations in our leadership, but we were still able to accomplish our goals for the graduating class.
How did you discover Physical Medicine and Rehabilitation?
I interned at the Veteran’s Memorial Hospital. (And truth be told, it was because I wanted to taste the American canned goods that were being imported to their Nutrition department…that’s the honest truth!)
Anyway, at the time, Physical Medicine and Rehabilitation Medicine was in its infancy in the Philippines. During my oral board exams prior to graduation, one of my examiners was Dr. Ofelia Reyes, pioneer of PM&R in the Philippines (Read our PAPA feature about Dr. Ofelia and Dr. Tyrone Reyes’ story here.)
To earn honors for graduation, candidates needed 2 excellent grades from 3 of 3 examiners. Luckily, I earned excellent marks from all 3 examiners, and earned the Meritissimus distinction, going along with the Cum Laude honors on my diploma. That’s when Dr. Ofelia Reyes started telling me about PM&R.
How did you come to practice PM&R in the United States? Did you consider other specialties before PM&R?
At that time, my heart still wasn’t set on Physical Medicine and Rehabilitation, even after some exposure to it working at the Veterans hospital. While arranging my immigration papers for the United States, I knew that I would probably start residency in 1975, since there was a backlog for immigration applications at the time. Fast forward to the day after I celebrated my best friend’s move to the United States, I received a call at 7 am in the morning. My dad woke me up and said, “there is a medical director from Philadelphia who wants to interview you!”
Lo and behold, I got in. I made it as a rotating intern at Frankford Hospital in Philadelphia.
Back then – 1975 – malpractice lawsuits were raging all across the United States. There was a lot of litigation going on, and I, being an exchange visitor, was concerned and apprehensive about the future of medical practice in the US. My desire, at the time, was to go into either OB/ GYN, Neurology, or Internal Medicine, particularly for GI. I didn’t quite enjoy my OB/ GYN rotation, so I switched my focus to Neurology, then Internal Medicine.
During my internship, my sisters who lived in New York encouraged me to move and live with them there. Being in Philadelphia, I was lonely, having no support system (let alone know how to cook for myself,) so I decided to move to New York and live with my family.
I thought about my conversation with Dr. Ofelia Reyes, and I felt like it checked the boxes for what I wanted in a career. I was immediately accepted at Mount Sinai in New York, and I lived with my sisters for a few months. I’ll be honest though, I was a little disappointed, because I realized that some of my fellow residents were in rehab simply because they weren’t accepted to other specialties.
And boy, was I kicking myself – simply because I was already accepted into an Internal Medicine Residency program and I didn’t choose it because I lacked trust in my abilities. I was afraid of malpractice and litigation. It was during this time that I really started feeling the importance of being with family. I chose PM&R because I wanted to be a family person. This was a big factor in my decision. I knew that If I became a Neurologist or pursued training in a residency program far away, this would prevent me from spending time with my family.
So, I chose a field that would satisfy my need of being with family. Despite feeling depressed during my second year due to the above circumstances, I challenged myself and pursued leadership opportunities. I became Chief Resident at my residency program, and was ultimately hired as an attending physician at the Hospital for Joint Diseases, which was affiliated with Mount Sinai at the time.
How did your leadership roles in PM&R shape your practice and your view of the specialty?
I became the Director of the Pain Program at the Hospital for Joint Diseases (HJD) in 1982. It
was very successful, and I made a name for myself in the chronic pain program. Even though I was successful, I still had some doubts. You see, when it comes to your career you get to a point and think that whatever you have in life right now may not be the right path for you. I felt that I was somehow “stuck” in PM&R, because it wasn’t as challenging as I had hoped.
Eventually, I was named Acting Director of the Department of Rehabilitation Medicine at HJD in 1989. I told myself, okay, maybe I’d stay in this position for 2 years and then leave rehabilitation medicine to pursue another career. However, along with that appointment, I was asked whether I could start an inpatient rehabilitation program at HJD. With the guiding assistance of Dr. Erwin Gonzalez, then President of the American Academy of PM&R and Chairman at Beth Israel Rehabilitation in New York, I started the Inpatient Program at HJD in January 1990. In the following years HJD, after being an affiliate of NYU for several years, underwent a full integration process within the NYU system. I subsequently made it as a full Chairman of the Department of PM&R at HJD. My faculty appointment transitioned to NYU during which I became a Clinical Professor for the NYU Rusk Rehabilitation Department in 1999.
Of my roles, I also served as a hospital surveyor for CARF (Commission on Accreditation of Rehabilitation Facilities) since 1985. I surveyed almost one hundred rehabilitation facilities, for 35 years, during which I traveled and surveyed multiple hospitals in the USA – around 30 states – and to countries like Mexico, Canada, UAE (Dubai and Abu Dhabi), China, and Sweden. I was about to survey a rehabilitation hospital in London, England when COVID 19 prevented this from happening in 2020.
Did you encounter any challenges during your time as Departmental Chair in PM&R, and how did you navigate these?
Still, I felt that there was something lacking in my career even if I already was a Clinical Professor. I started having doubts and felt that I was only important to the department simply because I was running a good program and made money for the system. I felt that I could not contribute to the discussion of running the hospital. I thought that maybe, it was something about trust in myself, or maybe I was intimidated by the fact that I’m not White.
So this was one of the problems that I encountered – my feeling of being discriminated against sometimes. I don’t know if they did – but in my career, I feel like I’ve gone through these challenges. For instance, I had (on two separate times) two different chairmen/colleagues who challenged my position as Chairman of the Rehabilitation Department simply because they had candidates who belonged to the same ethnicity as they did and they wanted their friends to replace me. It came to the point where one of them hired a then prominent rehabilitation chairman/physician from a well known university rehabilitation program to evaluate our department and see how I was running it, to see if there were any grounds for me to be replaced. I was able to address the challenges posed towards me, on both occasions. I still remember how one of the chairs felt guilty for challenging me, so much so he invited me to speak and give a lecture with him in China. And we have become good friends since then! All in all, despite all the heartaches and headaches, I would say that I still had a good career and I have no regrets choosing PM&R. I retired in 2019, after exactly 40 years of being a Rehabilitation Attending in New York, New York!
Can you share some advice for medical students who are entering PM&R?
Have strong aspirations. You’ve had about 7-8 years of training prior to residency, and you have seen different hardships, all those sleepless nights. You should be aware that it’s not going to stop, even when you graduate from medical school. From there, you will not only encounter your personal problems, but other external problems as well. You may sometimes wonder if you decided on the right path or not. But look, you have already survived 7-8 years of hardship. Strengthen your aspirations further and see through it, remember that!
Sometimes, you will be criticized by your professors and you will make mistakes. Don’t be discouraged by these, because everyone makes mistakes anyway. Learn from those mistakes. For instance, look into the way you are studying and correct those studying habits. It is important to be aware of how you’re actually learning. Understanding your strengths and shortcomings in the way you study academia makes you accept who you are. Accepting who you are and learning from it is actually a very key component of developing leadership.
What is some advice you have for resident physicians pursuing PM&R?
As a resident, it’s a different story because now, you have a voice. For instance, you may find yourself arguing with your attending, other consultants, or maybe your fellow residents because you think that you know a little bit of what you’re talking about. There are times when your attending physicians and consultants will be very critical of you. Don’t get disappointed. You will actually learn more from your mistakes, than when you are correct. It’s human nature. Learn from your mistakes and vow to resolve/ remedy your deficiency. Additionally, do not regret some of your mistakes. Life has its ups and downs. I felt my “low” when I was a resident because I thought that PM&R was not as challenging as I had hoped. Look into your chosen career, and as to how you might feel yourself getting a stronghold on it, to push yourself forward.
What is some advice you have for early-career attending physicians pursuing PM&R?
As an attending, it’s a little different now because you will have life/ personal issues. You could perhaps have issues about getting married, having a family, financial matters. You’d have your attention divided by many things, and you may be affected by peer pressure. For instance, your classmates may be driving certain cars and their children may be going to certain schools. Your friends may be wearing expensive, branded clothing. Try not to be affected by these things. Save money for your future. Start early and save money for your retirement, because you never know! Right now, I can humbly say that I am more financially stable in retirement than when I was working. It gives me relief to take vacations 6 to 8 times a year, to have cruises like 4 to 6 times a year!
Additionally, enjoy being with your family! To me, family is really the best and most important priority. Friends, you may see when you have reunions, and the like. But when you are ill, it will be your family who will be with you. I’ve already had 2 major illnesses – I was diagnosed with prostate cancer just before I retired. Luckily, I got it attended right away. It is now my fifth year being in remission. A year after I retired, I underwent open heart surgery. I’ve been through a lot, and my family has always been with me through it all.
How did you become involved in PAPA and where do you envision our organization, say, 5 to 10 years from now?
A group of PM&R physicians including myself attended Dr. Tyrone Reyes’ inauguration in Spain when he became the President of the International Rehabilitation Medicine Association (IRMA) (Fun fact: he delivered his initial presidential speech in Spanish!) At around the same time, we felt that there was a need for the equivalent of a Filipino Rehabilitation Association in the United States. It all started in Boston…every year, a group of us Filipino physiatrists would meet up, until we eventually formed PAPA ORG. We also fostered close ties with PARM (The Philippine Academy of Rehabilitation Medicine), who would sometimes invite us to the Philippines to be speakers.
I am overwhelmed by Niña’s leadership, as well as yourself, Dorothy – your attention to this. I was actually becoming discouraged by our organization’s direction – as we were all preparing to retire and we didn’t see any developers, or successors to the organization we started, until Niña, and now you, came along. It’s really very impressive and encouraging to see PAPA in good hands. If there is anything that myself, Dr. Carandang, Dr. Balmaseda, and others can do for you, we will be more than glad to do that! If not for PM&R, I don’t think I would be in my current state – I’m enjoying my family, I’m enjoying myself, I’m enjoying life!
Final Thoughts:
They say, “the grass is much greener on the other side” – the other side being, post-match season for most graduating seniors entering residency. This is true to an extent, having gone through years of academic preparation with board exams, shelves, and navigating ERAS season with audition rotations, interviews, and finally making our rank lists of desired institutions. Is it always going to be a walk in the park though? Absolutely not. As Dr. Jimenez shares,
“You’ve had about 7-8 years of training prior to residency, and you have seen different hardships, all those sleepless nights. You should be aware that it’s not going to stop, even when you graduate from medical school (...) You may sometimes wonder if you decided on the right path or not.”
Medicine for most is a lifelong career, and for others, identified as a calling. But what happens when this career, or calling no longer piques our interest? Burnout can kill passion. What happens if it doesn’t challenge you enough?
“Life has its ups and downs. I felt my “low” when I was a resident because I thought that PM&R was not as challenging as I had hoped.” Dr. Jimenez offers his insight should we hit a similar wall:
“Look into your chosen career, and as to how you might feel yourself getting a stronghold on it, to push yourself forward.“
Both are sound points of reflection that deserve much thought, as does his advice for failing forward:
“Understanding your strengths and shortcomings in the way you study academia makes you accept who you are. Accepting who you are and learning from it is actually a very key component of developing leadership.”
Much can be learned from Dr. Jimenez’s legacy in leadership in academic medicine, and I would argue, his perspective on life as well: “If not for PM&R, I don’t think I would be in my current state – I’m enjoying my family, I’m enjoying myself, I’m enjoying life!”
And with this, Mano Po, at Maraming Salamat, Dr. Jimenez!
Additional References:
Jimenez, A. C. (n.d.). Arthur C. Jimenez. NYU Grossman School of Medicine. Retrieved from https://med.nyu.edu/faculty/arthur-c-jimenez
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