Member Spotlight/Interview - Karl Santiago, MD

Posted on September 17, 2021

Maine Track Class 2020 - pictured left to right; Drs. Donohue, Rogers, Ezzio, Paul, Larmon and Santiago

Interview with Dr. Karl Santiago, MD – Pediatric Primary Care Physician and Maine Track Alumnus

Karl Santiago, M.D. is a board-certified pediatrician working at Pen Bay Pediatrics. He attended Tufts University School of Medicine as a member of the Maine Track Program. He then completed his residency in Pediatrics at Maine Medical Center.

Thomas LaJoie, M’24: Dr. Santiago, thank you so much for taking time to speak with me. For our readers, let’s start with a little bit about yourself, what your original connection to Maine is, and how you became interested in the Maine Track program.

Karl Santiago, MD: I’m very glad to be here. My first connection to Maine is my wife, who grew up in Brewer. At the time that I was applying to medical school, she said to me, “Hey, there’s this new program called the Maine Track at Tufts!” One of her high school friends was in the very first class to go through the Maine Track program, and he had told her that he had had a blast. Being from California, I was very skeptical. And at the time I was living and working in New York City, so I had no picture in my head of what medical training or living in Maine could look like.

The more I thought about the challenges of practicing medicine in a rural state, the more I became interested, both in the sense of what I could learn from Maine, and what I could offer. So, I applied (I was very upfront that I didn’t yet have a personal connection to Maine), and to my surprise, they invited me for an interview. I still remember my interview day like it was yesterday because it was the best interview experience I had – most of all because of the people. How involved the fourth-year medical students were in the admissions process illustrated to me how much training and trust the program’s leaders and instructors had put into their students. They were comfortable with them being a part of selecting the future of this program, and I said to myself after that I wanted to be just like these students at the end of medical school. Thankfully I was accepted, and lots of great things have happened since!

TL: That sounds like a lot of changes in your life, and I’m impressed by how you seem to have shifted so well into your role here in Maine as a pediatrician when I’m sure that even 10 years ago you wouldn’t have thought that this was your path. Thinking more about that transition, what surprised you when you returned to Maine as a medical student after spending your first couple of years in Boston?

KS: I think I was surprised by how well the Maine Track cohort got along as a group. They were my favorite people to be around – many of whom are still my closest friends. We’ve gone to each other’s weddings, seen each other starting to raise families. It’s rare to meet people like that, and for me, it happened in Maine.

Another thing I was surprised by was how involved the Maine Track faculty and staff were, and how much they were willing to invest in us starting from our first day of Orientation. Even when we were still in our first and second years in Boston, they guided us all the way through and knew each of us so well. I say I was surprised, but I hope that every student has that experience no matter where they go to medical school. Honestly, it made it easier to see myself working in Maine long-term because I wanted to be a part of that team.

With regards to Portland, I was surprised by how multicultural it was. Before moving there the beginning of my clerkship year, I didn’t realize that I would be working with people and families of so many different ethnicities and backgrounds, and it was an awesome place to train become a doctor, especially during residency.

TL: As a medical student who just moved back to Portland, that is so good to hear, and I am excited to learn more about your residency. I’m curious, at what point did you develop a passion for Pediatrics, and what influenced your decision-making in that process?

KS: Before medical school, I had worked for two different Pediatrics departments in New York City – one affiliated with New York University and the other with Cornell. My work was primarily with Pediatric Emergency Medicine physicians as a Simulation Specialist -- helping to set up simulation-based training (like how to place an IV or perform a LP), or larger scale events like mass-casualty simulations with multiple simulators. These were my first health care jobs, and I thought that working with Pediatric doctors was the best. Their passion for the population they took care of made an impression on me. And many were master educators, so just by being around them, I got to soak in what it took to be a good communicator, how to convey complex ideas, and how to lead cohesive teams. One of those pediatricians even became my mentor, and even today, I still apply the skills I learned from him.

So, I had an inkling that I would end up becoming a pediatrician. That said, during my third-year clerkships, I tried to be in situations where I couldn’t just work with kids – I guess I wanted to prove to myself that I really wanted to do Pediatrics. I was in the Maine Track’s Longitudinal Integrated Clerkship program in Portland, and Thursday afternoons were my regularly scheduled time for Pediatrics – that was always my favorite day of the week. My Pediatrics preceptor was Dr. Stephen DiGiovanni – even back then, I remember his passion for training future Pediatricians that one of the most important things that we do for the health of our patients is helping them and their caregivers develop resilience in the midst of health and social stressors. Doing a longitudinal clerkship for nine months allowed me to see kids – and sometimes entire families – more than once and watch them grow. Throughout that experience, it became more and more clear to me that I was going to be a pediatrician.

TL: That sounds like a great opportunity, and it makes me excited as a current Maine Tracker who is interested in Pediatrics. I was wondering what you wish you had known more about in terms of support and career development while you were going through that process. Are there any tips or ideas that you could share about working in Pediatric Primary Care in the early stages of your career?

KS: I’ve always known that Pediatrics – and in particular primary care – is the most efficient field of medicine, because it focuses on setting the stage for kids to live healthy lives far after they’ve graduated from our care. But in practice, the work of a pediatrician can sometimes be overwhelming and feel inefficient. When I was an intern, I didn’t realize how much mental health was going to be a focus of my practice, and I wasn’t sure how I would approach those needs everyday. Even now, everyone in Pediatrics is being faced with levels of mental health need that are perhaps greater than anticipated – and not just because of the COVID-19 Pandemic.

I think that with training and experience, you will get comfortable addressing just about anything, including mental health issues or social determinants of health. You also learn how much more you can accomplish in the service of your patients by asking for help from your colleagues, as well as seeking the expertise of other professionals who work with children and families. Having teammates you can share ideas with and who’ll collaborate on projects is a must.

Another lesson I’ve learned is to invest time into building relationships with patients and their caregivers. Trust is proportional to time. Taking the time to listen can sometimes seem inefficient, but I always come back to the fact that what I’m doing is building good relationships and learning things about them that will make my advice more helpful to them. Pediatricians have a lot of knowledge to offer, but without trust, it won’t matter to our patients. Over enough time, the trust that I build will hopefully help to support patients and their caregivers through some tough times.

To sum it up, I think it is important to recognize that Pediatrics is much more than the medicine we practice and prescriptions we write; it’s about building healthy relationships with kids and their caregivers in order to provide preventive care in its highest form.

TL: Thanks so much for that insight, I would agree that when I think of Pediatrics, I think a lot about the rapport that you have to develop with not just the patient, but their caregivers as well. Thanks again for joining me today for an interview. As someone who is interested in Pediatrics, I have been fortunate enough to get involved with the Maine Chapter of the American Academy of Pediatrics. To wrap up our interview, do you have any tips for the MAAP in terms of how we could support medical students interested in Pediatrics?

KS: Any opportunity where medical students can serve families with diverse backgrounds can be very formative. For example, as a student and resident, I worked with refugee families and families seeking asylum, trying to help them set up their lives in a new place. These experiences affected me a lot: I knew very little about different cultural perceptions about health as it pertains to kids, and how unimaginably hard it must be to start over in an unfamiliar place. The importance of Pediatrics is very clear in situations like these. I think having the MAAP help medical students to work directly with families could serve as a great window into the world of Pediatrics. One obvious way of doing this would be community service. Medical students go into school with a service mindset, and I think that having a structured program that connects what they’re learning with the real world is always rewarding. It also puts values of diversity, equity, and inclusion into action.

In terms of supporting learners at all levels, I believe that right now our greatest need is to continue developing strong frameworks that help all of us become more comfortable recognizing and addressing mental health issues and social determinants of health. This also means helping trainees learn how to work with their local ecosystem of community resources. My hope is that developing these skills as early as possible will feel empowering and eventually lead to better outcomes for their patients. I also hope these efforts will contribute to stronger community support ecosystems and even fight burnout down the road.