Public health in Mozambique, hospital administration, public policy, and private industry were all career paths that a panel of alumni never imagined they would take. But their careers after medical school went in unanticipated directions, recounted four alumni who spoke on a panel at this year’s reunion. In reflecting on their time at Yale, the panelists agreed that the Yale system gave them the freedom to explore their own interests.

Nancy Angoff, M.P.H. ’81, M.D. ’90, HS ’93, associate dean for student affairs, who introduced the panelists, told her own story of entering medicine as she neared 40, delayed by the notion of her day that women had no place in medicine. Her unusual path inspired her to become dean of student affairs so that she could help students follow their dreams and bring their lives to “fulfilling conclusions.”

But discovering that satisfying conclusion is not so easy, as the panelists’ stories demonstrated—for several of them, life is still unfolding, even years out of medical school.

By “a stroke of luck,” Helen Smits, M.D. ’67, had the chance to pursue a career in global health after dreams of practicing medicine abroad. For many years she worked in administrative roles and then in the forerunner of the Center for Medicare and Medicaid Services during President Carter’s administration during President Clinton’s first term, while longing to learn more about medicine outside the United States. But while teaching at New York University, Smits met the prime minister of Mozambique, who was also a physician and was seeking someone to teach in a new public health program at the Universidade Eduardo Mondlane, the oldest and largest university in the country. Though Smits spoke no Portuguese, she accepted the challenge and ended up being the madrinha, or fairy godmother, of the program, where she taught from 2002 to 2004. Since retiring, Smits has worked for the health care initiatives of several charitable institutions.

Peter N. Herbert, M.D. ’67, HS ’69, said that a decade after his graduation from medical school, he was still trying to figure out what to do with his life. He had spent many years in research, first as chief of the clinical service at the National Heart, Lung, and Blood Institute in Maryland and then as a professor of medicine at Brown. He enjoyed his years at Brown, where he did research at every level of biological organization from protein sequencing and enzymology, isolated organ perfusion, and metabolic ward nutrition research, to epidemiology. But when he realized “[he] wasn’t going to win the (Nobel) Prize,” he gave up research. He spent the next nine “most exciting years of his life” at the Hospital of St. Raphael in New Haven. establishing a new model for teaching internal medicine. He is now chief of staff and senior vice president for medical affairs at Yale-New Haven Hospital. His son says that the only good advice Herbert ever gave him was, “If you get into Yale (School of Medicine), you must go.” The son graduated with the Class of 2003.

Jessica Herzstein, M.D. ’83, M.P.H. ’89, FW ’89, said that as global medical director for a company that manufactures gases and specialty chemicals, she never knows what she will be focusing on from day to day. She entered industrial medicine after a fellowship in occupational and environmental medicine and several years as an assistant professor at Yale, when a physician she respected retired and recommended his job to her because of her interest in toxicology. Since 1998 she has has strived to ensure that Air Products’ 18,000 employees in over 40 countries work in safe conditions and are educated about seeking treatment and making lifestyle changes to prevent illness. Her work in preventive health has taken her to many countries, especially in Asia, to support best practices in health care in other cultures. She has developed an expertise in preventive health care and is a member of the United States Preventive Services Task Force. The task force makes evidence-based recommendations about screening procedures and other preventive services. Though counterintuitive, screening often does not lead to improved health. Herzstein is interested in how to communicate the science to different audiences in order to improve prevention and treatment practices.

Vivek Murthy, M.D. ’03, MBA ’03, said that, since graduating from medical school, his life has been a “series of surprises” marked by “inflection points.” But returning to Yale for the reunion, he said, was like “coming home again.” He was inspired to practice medicine at an early age after observing the “mutual healing process” between his father, a family physician, and the father’s patients. But Murthy’s entrepreneurial spirit has kept him from settling down to practice medicine. As an undergraduate at Harvard he started a peer education program called VISIONS Worldwide, Inc., in which American students were trained to teach students in India about HIV/AIDS, and Swasthya, a community health partnership in rural India which trained young women to be health educators and basic health care providers for their communities. After graduating from Yale with joint medical and business degrees, Murthy founded TrialNetworks, social networking platforms for clinical trials that enhance communication, collaboration, and overall efficiency of the trials. “We help trials run faster and better so that treatments can get to patients earlier,” Murthy said.

As an advocate of health care reform during the 2008 presidential election, he and other doctors, including some Yale classmates, started Doctors for America—a grassroots organization “to give physicians a voice” in policy-making. He now serves on the National Advisory Group on Prevention, Health Promotion, and Integrative and Public Health, which seeks to develop a national strategy to make preventive health a foundation for the country. “This means not only bringing a greater focus on prevention to our clinical and community health services, but it also means ensuring that health promotion is a part of how we designed our policies on housing, education, defense, commerce, labor, and more,” he said.

Murthy said he is now looking for a new project, and is grateful to Yale for nurturing his explorative nature. He is presently an attending physician and instructor in medicine at Brigham and Women’s Hospital in Boston.

The panelists agreed that the School of Medicine created an environment in which students have the freedom to direct their own development. Murthy noted that Yale challenges its students to “think about the world we wanted to create, not just passively inhabit.” So although they wished that the curriculum had included more electives in preventive medicine, or leadership, or business, they emphasized the importance of preserving time to explore, which Angoff calls the “jewel in the crown of the Yale system.”