Dr. Jaume Mora had a chat with KIDS Barcelona member Lidia Martínez about the medical career, vocations and patients’ handling

Jaume Mora is Paediatric Oncologist, an authentic rara avis within the medical ecosystem. On the late 90s, he had to leave Spain in order to pursue his dreams: he was granted a fellowship and headed to the US because, at that moment, it was the only country offering an educational programme on the specialty he wanted to study. Holding a PhD in Medicine, he is currently the Scientific Director of the Oncology and Haematology Area of Sant Joan de Dèu Barcelona Children’s Hospital.

Lidia Martínez is currently doing her Bachelor’s Degree on Biomedical Engineering at the Pompeu Fabra University. She has also been a member of the KIDS Barcelona group for two years now. Read the interview she recently had with Dr. Mora.

- I would love to study Medicine and combine clinical assistance and research. Could you give me any piece of advice on this matter?

- If you want to be a doctor and do both clinical activity and scientific research, I am sorry to tell you that there is no such double-degree in this country. However, in the US there is a programme called MD-PhD combining both types of training. It is a very intense programme; I know that because I took it myself. The option you have in here is to do your MD and explore which research areas you like the most during those years. Maybe on your third year, once you have done the most basic training, you could sound out which science topics you are most interested in and you could use summer breaks to do internships in a lab. The MD is highly basic. It is just the door that will let you go through a longer path and find the research area you will be trully passionate about.

- Speaking of the Medical Degree, do you think it is properly focused concerning a real assistance practice?

- As I said, the MD is very basic and medical research is too broad to tackle. That is why residencies were invented. During the MD you only lay the foundation of the building. This foundation must be solid, whether you want to build a skyscraper or a small house by the sea. During the residency you will have to choose if you want to live by the sea, see the whole city from your penthouse or maybe own a quiet country house.

- Is research a matter of attitude?

- Of course it is. There are a lot of people out there that never ask questions to themselves. People who are constantly asking questions have a real vocation for research, not those who get brilliant grades. This is a problem because there are plenty of people taking a MD that are academically excellent but not curious at all.

- What skills (other than empathy) should a good doctor have?

- The most important thing to do is to be able to help people using your technical skills. This involves determination, being always there for the patienst, having a huge working capacity, having a willingness to study and learn throughout your whole life…

- Does having empathy mean that you are affected by other people’s feelings?

- No, being empathic means that you are able to understand other people’s feelings, but these are not supposed to affect you. For instance, you must be able to understand why a patient may treat you badly in a certain moment. He/she is not doing it because he/she is a disrespectful person, but because he/she is not feeling well at all. You should not take that personally. This is empathy: walking in somebody else’s shoes.

- Do you agree that empathy-related skills should be taught during the MD?  

- No, I do not think so. Studying medicine gets more and more complicated every day because science and technology are continuously developing and it is very difficult to keep up with all the new discoveries. Besides, this rapid development affects doctor-patient interaction. There is too much knowledge to be condensed in a 6-year degree. As I stated before, the aim of the MD is to acquire the foundation. You really start practicing the medical career during the residency. Being a doctor is not like being an engineer: you earn you degree on Engineering and the next day you are ready to be in the labour market. You need much more time for this in the medical career.

- Why did you go to the Memorial Sloan Kettering in Nueva York?

- I had to do my specialty training in the MSK because we did not have such programme in Spain. First I took my MD, then a four-year specialty in Paediatrics and when I finished I went to New York to do the Paediatric Oncology “super-specialty”, which lasted three more years: one year at the clinic and two years performing research. So you have an idea, I first entered a laboratory when I was 30 years old. When I returned to Spain I was already 35 and that was the moment when I treated a child with cancer for the first time. It is a long road...

- All the Paediatric Oncologists in Spain have passed though all those phases?

- No, most of these Paediatric Oncologists did not have a proper training in this area, I am afraid. This lack of training should end. In this context, Sant Joan de Déu is making a big effort to build a great Paediatric Oncology Specialty training programme here.

- In Paediatrics, many childhood-related illnesses are treated following adult parameters. There are many associations at the European level stating that this situation cannot go on like this any longer…

- Because paediatric hospitals originated many years ago, our structures are still subjected to old patterns and they are not often adjusted to modern necessities (they are too old-fashioned). The Spanish medical specialties were institutionalized during the 1970s; before this, we had no residencies and no Medical Internal Residence exam. In the paediatric field we are still a bit in the 1970s, we nearly have the same specialties. Back then a Paediatrician was good for everything. Many of the conditions affecting children are never present during adulthood, so it turns essential to offer a specialized attention to this community (as patients’ associations are constantly claiming).

- You work hand-in-hand with children and families. How do you deliver bad news?

- Patients have to understand doctors no matter what and this is achieved by delivering helpful information to them. Whether they are good or bad news we need to tell the truth, a truth that helps the patient.

- And do parents always want to know the truth?

- I need them to know the truth in order to help them. Sometimes doctors give unnecessary technical data that may only make thing worse for the patient. For example, hard scientific terminology will not help a parent understand his/her children’s condition, but if I tell that parent that his/her child has a malignant tumor that was originated in a certain region of the body generating a series of symptoms, I am helping this parent to understand his/her child’s disease. I will be helping that parent too if I explain the available and effective treatments for that condition. If I think that the disease does not have a cure, the first thing I must do is to be totally sure about this before giving this information. Once I am sure about this, I must make him/her understand that, although I cannot cure his/her child, I will help him/her live as good as possible by any available means.

- Thank you very much, Dr. Mora.

- My pleasure. And good luck with you career!