Lester S. Duplechan, MD is Division Chief of Physical Medicine and Rehabilitation and Associate Professor of Neurology and Rehabilitation at the University of Cincinnati College of Medicine (UCCOM). Discover Lester's path to leadership – in his words.
My journey back to academic medicine has been over a decade in the making.
I started my career as a junior faculty member at my residency alma mater, Emory University. Somewhere in my PGY3/4 years at Emory, the teaching bug inoculated me. Fellow residents noticed that I enjoyed making non-medical analogies for hard to understand concepts in electrodiagnosis, anatomy, and musculoskeletal medicine in particular. My mentor, V.R. Rao, MD always expected the most of me and my effort- instilling an ethos of study, teaching, and treating all patients with compassion.
My wife was recruited to her dream job as a dermatopathologist in Cincinnati, so I followed her the next year to the Queen City (I’ve always joked that she was the superstar, I was the “player to be named later” in the trade deal).
After 3 years serving as faculty, and later as interim residency program director, I accepted a private practice opportunity in outpatient musculoskeletal and spine. After a few years without educational and research formalities, I was pleased when the residency program reached out to add my practice to the resident musculoskeletal rotation in 2006 — having missed the intellectual challenges of teaching and education. Teaching is in my blood. In 2016, I was recruited back to UCCOM by our chair of Neurology; again, excited at the possibilities of collaboration and diversity of thought. I merged my practice with UC Health and was appointed Division Chair of PM&R.
My clinical practice continues to evolve based on my multiple interests, and with the changes in medicine and technology. A typical day may include acute care consults in the morning, followed by spine interventions and dynamic ultrasounds in the afternoon. I added musculoskeletal and neuromuscular ultrasound to my practice 11 years ago; initially as an adjunct to electrodiagnosis, but it became so enticing that I became certified in Diagnostic Musculoskeletal Sonography (RMSK). I’m proud to say that 3 of my former residents have also become RMSK certified.
The AAP has been instrumental in easing my re-introduction into academic medicine, after 15 years in private practice. I was concerned that I might be too seasoned to be accepted for mentorship and guidance - too old for the “young faculty professional development track”. The Annual Conference in particular has been conducive to networking with other department and division chairs, teachers, and mentors. I have found other members to be very approachable and willing to assist, often offering pointers and guides without being asked. As a result, I am in my fourth year as a volunteer on the Membership Committee. I’ve been able to meet and develop relationships with chairs and program directors almost seamlessly. As a result of AAP networking, four Midwest PM&R Residency programs have developed a Reciprocal Education Program that allows all residents to attend one-day courses in areas such as Musculoskeletal Hands-on Ultrasound, Spinal Cord Injury, and Spasticity Management (at no cost). As chairs and residency program directors, we realize that no single program has it all; but in collaboration we can all provide great educational experiences for our medical students, residents, and fellows.
The PM&R faculty at UCCOM has been instrumental in incorporating diagnostic ultrasound in the medical student curriculum. Our faculty and residents are preceptors for diagnostic ultrasound labs for evaluation of the wrist and shoulder for MS-1 students.
On the education program side, I have been impressed with how the AAP provides programs for resident and medical student research and practice with presentations. Our recent conference in San Juan, PR was a case in point. After I completed a talk on the sonographic findings of posterior hip pain, I was approached by medical students, residents, and seasoned physicians about new methods of evaluation and treatment - one of whom was a well-published book author whose literature I have followed for many years.
Administratively I can lean on other PM&R leaders for guidance on how to balance the clinical, research, and education missions with the business of medicine. It is great to see PM&R chairs and their business administrators sitting together at meetings — learning how to improve their departments.
The broad and growing scope of PM&R practice continues to challenge me into deeper and more complete understanding of post-acute care. I feel blessed and privileged to continue to grow as a clinician, teacher, and mentor - and I’m just getting started.