For the past 25 years, Tom Jacobs, M.D., professor of clinical medicine, has rarely turned down an opportunity to teach. Despite the fact that he runs a thriving endocrinology practice upon which he is almost entirely dependent for his income, Dr. Jacobs has devoted literally thousands of hours to training medical students and house staff over the years and he has done so largely without compensation.

Each newly minted M.D. is the product of many hours of faculty teaching efforts. While much

Photo: Charles Manley

Rheumatologist Ralph S. Blume was the longtime physician of the late Thelma Ewig, an ardent supporter of medical education.

of the foundation of medical knowledge is learned in lecture courses, clinical skills are learned in the clinic and at the bedside with individual attention to each student, resident, or fellow. Katherine Nickerson, M.D., associate professor of clinical medicine and vice chair of the Department of Medicine, estimates that the Department of Medicine provides 60 percent of the faculty time involved in teaching medical students. Indeed, a 1992-93 study, published in the New England Journal of Medicine in January 1996, revealed that full-time faculty members in Columbia University’s Department of Medicine devoted on average 137 hours per year to teaching, most with little or no compensation.

Tuition dollars and other sources do not come close to covering the true costs of undergraduate and graduate medical education. That same article calculated that the Department of Medicine received less than $16 per hour to cover its faculty’s efforts in educating students and residents. Those dollars largely provide salary support for course directors and support the infrastructure for the residency program.

The problem is the same at medical centers across the country. As hospitals increasingly compete for limited research and patient-care dollars, fewer doctors can afford to be generous with their time. Clinical education has been getting short shrift.

For this reason – and to honor physicians like Dr. Jacobs and the values he embodies – philanthropist Thelma Ewig was moved to provide a $9 million bequest to support clinical education within the Department of Medicine. Her appreciation of the importance of clinical education grew from a decades-long relationship with her personal physician Ralph S. Blume, M.D., clinical professor of medicine. “Thelma Ewig recognized that medical education is dependent on clinical faculty’s mostly voluntary efforts,” Dr. Blume says. “It would be wonderful if this great step she took to help educate physicians was followed by more generosity, because the need remains very high.”

Income from the bequest will be awarded as $30,000 prizes to individual faculty members selected by committee for their outstanding contributions. (See sidebars for this year’s recipients.) The monetary awards will be granted to four junior, four mid-career, and four senior faculty members each year, for periods of three years, two years, and one year, respectively.

“Ms. Ewig’s bequest is a huge boon to the Department of Medicine,” says Dr. Nickerson, who served as a member of the selection committee, along with Dr. Blume and David Brenner, M.D., professor and chairman of medicine. “The grant is significant both in terms of its dollar value and also as a symbol of the role philanthropy now plays in the formation of our nation’s doctors. Strategically, it allows the department to foster innovation among young doctors, free up teaching time for overextended mid-career faculty, and recognize the contributions of those, like Dr. Jacobs, who have given so generously of themselves over the years.”

—Eva Marer


Ewig Award Recipients
TOM JACOBS, M.D.
Professor of Clinical Medicine

Photo: Charles Manley

Tom Jacobs

Teaching credits: To name a few: Chief of Section, Pathophysiology Course; Lecturer in Pharmacology; Preceptor, Medical Clerkship; Chief of Service Rounds; Attending Physician on the Medical Service; Preceptor in Endocrine Clinic; Attending for the Endocrinology Consult Service; also takes resident and intern reports whenever requested to do so.

Why he teaches:"I learn so much from students and other attendings. When I give a talk to students or housestaff or to my peers, I have to be prepared. If possible, I try to pick a topic that I don’t know a great deal about, to deepen my own expertise."


Favorite recent lecture: Discerning evidence of torture in persons seeking political asylum and exploring how physicians get involved in the torture of others.

Typical student comment: “He never gets ruffled. His presence in the room is calming to students and patients. Despite being a specialist, he can teach on anything, and his fund of knowledge is seemingly endless. An inspiration.”

Take-home points: “You should think as hard as you can about your patient’s problems, care about what happens to them. And when teaching, especially at the bedside, be willing to make mistakes in public.”

How he’ll spend the money: “I think my wife has already spent it. If not, it will go toward next year’s malpractice insurance.”

The real payoff? “Sometimes there’s a great moment when you ask a question about a sick person that hasn’t been asked before, and thereby advance that person’s care.”

Proud moment: “Learning that my former student, Dr. Nell Eisenberg, has also been named a recipient of the Ewig award.”