Wil Santivasi, M.D.: Departing physician describes Teacher of the Year award as an incredible parting gift

Dr. Santivasi (I ’18, PLM ’20) says getting a Teacher of the Year award for hospice and palliative medicine from the Mayo Fellows’ Association is an incredible parting gift. He’s leaving Mayo Clinic in July 2021 for a position at Duke University in Durham, North Carolina. His wife, Cecilia Kelly, M.D. (I ’16, N ’19, NNM ’21), completed a fellowship at Mayo Clinic, and the couple is relocating for career opportunities and to be closer to family.

“I’ve only been teaching for two years and was deeply humbled and overwhelmed to get the award. I try really hard to set the right tone and role model the right things, and this is confirmation that our time together meant something to the trainees. It’s the most gratifying thing to happen to me since I’ve been on staff.”

Dr. Santivasi came to Mayo Clinic in 2015 for internal medicine residency, followed by a fellowship in hospice and palliative medicine. Mayo Clinic was one of his last interviews. And he canceled the others after that.

“By the end of the interview day, I concluded that I couldn’t work anywhere else if Mayo would have me.”

“By the end of the interview day, I concluded that I couldn’t work anywhere else if Mayo would have me,” he says. “I sensed the commitment to doing the right thing every time, taking good care of people and putting a priority on education. I have mixed emotions about leaving Mayo but am excited for the future.”

Dr. Santivasi wasn’t always on a path to palliative care. He thought he’d be a hematologist specializing in lymphoma. In the first years of residency, he realized that what he really liked was providing supportive care. “I had to say the path I was pursuing wasn’t for me.”

Palliative medicine is a newer field. It’s offered board certification for 20 years and fellowships for only 15. “Other physicians regard palliative medicine as a mysterious black box. They want to use the tools their training has given them to help patients live longer and better. However, sometimes the circumstances of illness are that the patient may not be at that point — may be at the end of life. And no further dialysis, chemotherapy or transplantation will change that path. It’s a hard position for a physician to be in and can cause moral distress.

“I and my palliative care colleagues ask what the patient needs from us — pain control, nausea control, help with coping, help for their family members. I have the best job in the hospital because I can always contribute something. I can help to alleviate symptoms, process with the patient what they’re going through, bear witness to their experience, and just sit with them and not run away.”

Dr. Santivasi says part of his job is to support members of the medical team through the grief. “Physicians grieve too. It’s part of the human condition, not a sign of weakness.”

“Taking care of the team, as well as taking care of patients, is a gratifying part of the job. This work is purposeful and meaningful.”

He says literature shows that residents find palliative care clinical experiences challenging and disorienting from their other experiences. “It’s a different kind of challenge from being on call every fourth night. It’s direct exposure to tough things in life. I make sure to offer structured opportunities to debrief and make sure everyone on the team is OK. We reflect on ethics, moral distress and equity in medicine in terms of how we care for patients. Taking care of the team, as well as taking care of patients, is a gratifying part of the job. This work is purposeful and meaningful.”

When asked who he has modeled his teaching style on, Dr. Santivasi cites Jay Szostek, M.D. (MED ’05, I ’08, CMR ’09), Division of General Internal Medicine at Mayo Clinic in Rochester; Amy Oxentenko, M.D. (I ’01, CMR ’02, GI ’05), chair, Department of Internal Medicine at Mayo Clinic in Arizona; and the Division of General Internal Medicine’s Tom Beckman, M.D. (ADGM ’00), Karen Mauck, M.D. (ADGM 01, CLRSH ’03), Adam Sawatsky, M.D. (I ’10, CMR ’11), and Molly Feely, M.D. (MED ’94).

“They all trained me,” he says. “I have modeled my teaching after characteristics of their teaching and made it my own.”

Dr. Santivasi says requesting feedback from trainees has been important to him. “I’m new in this role and growing in my skills and want to know what’s effective and what I should do differently. The trainees have given me incredibly thoughtful answers that make me a better educator and physician.”

“I couldn’t ask for anything better as I start my next chapter. What I did resonated with the people I did it for. I made a difference.”

As Dr. Santivasi phases out of Mayo Clinic and onto his next career move, he describes the Teacher of the Year award as an incredible parting gift. “I couldn’t ask for anything better as I start my next chapter. What I did resonated with the people I did it for. I made a difference.”

Comments from trainees

• “Dr. Santivasi is one of the best teachers I have had in my entire medical education career. He expertly balances patient care and education time, even on busy services. He prioritizes giving and receiving learner feedback and asks for and highlights learner education goals. He emphasizes the need to debrief emotional patient and family encounters and makes time for learner and team well-being. He role models the need to take time for wellness.”
• “He is an excellent palliative care provider, able to provide education on complex medical interventions.”
• “He is humble and approachable and demonstrates respect for learners and other team members. His ability to lead, support and education the team is remarkable and especially impressive in a newer consultant.”