Hossein Jadvar, MD, PhD, MPH, MBA, a tenured professor in the Department of Radiology at the Keck School of Medicine of the University of Southern California (USC) in Los Angeles, talked with Carolyn C. Meltzer, MD, about her career in science and academic leadership. Dr. Meltzer became the Dean of the USC Keck School of Medicine and the John and May Hooval Dean’s Chair in Medicine on March 1, 2022. In this position, she oversees the operation and academic affairs of 26 basic and clinical academic departments and 16 major research institutes that sponsor training of more than 1,200 medical students, resident physicians, and graduate students in more than 70 specialty or subspecialty programs each year. She was recruited from Emory University School of Medicine (Atlanta, GA), where she served as the William P. Timmie Professor and Chair of Radiology and Imaging Sciences for 15 years. At Emory she also served as the Executive Associate Dean of Faculty Academic Advancement, Leadership, and Inclusion and as the Chief Diversity and Inclusion Officer. Dr. Meltzer has conducted research in multimodality imaging evaluation of neuropsychiatric disorders, Alzheimer disease, brain structure and function in normal aging, and cancer.
Dr. Jadvar: Could tell me about your career journey? What made you interested in a life of medicine and science, and what propelled you toward leadership in academic radiology?
Dr. Meltzer: I was always interested in science and math and was also a very visual person. Even early on, I played competitive chess, seeing the moves on the chessboard and always thinking about how to solve problems. As a teenager, I would often read about the brain. I was fascinated by behavior, mood, and the workings of the brain—and how little we knew. At college, I decided that I was interested in medical school. I couldn’t decide whether I wanted to be a neuroscientist or a physician. I spent a summer doing student research in Chicago, helping in a translational lab at Michael Reese Hospital (which closed in 2009). There, a distant relative invited me to her home for dinner. She and her husband were lovely people. It turned out that he was Robert N. Beck, who developed one of the first PET scanners at the University of Chicago. I had been reading about PET imaging and spent much of the evening asking about his work. He showed me scans that helped in understanding the inner workings of the brain. This was in the early days of functional imaging, and this moment was very influential in my life. When I went on to study at the Johns Hopkins Medical School, I volunteered as a control subject for a PET imaging study to make some money. This was one of the earliest such studies using a neuroreceptor tracer. I ended up working for these scientists and then spending another year on a PET research fellowship. These experiences fueled my excitement about brain imaging, particularly nuclear medicine and neuroradiology, which led me eventually to board certifications in both fields.
Carolyn C. Meltzer, MD
Dr. Jadvar: Did you know Henry N. Wagner, Jr., MD, and the group in nuclear medicine at Hopkins?
Dr. Meltzer: Absolutely. Henry Wagner was leading nuclear medicine when I was a medical student and resident physician, and I worked with him. Just an extraordinary person.
Dr. Jadvar: Please tell me what propelled you to leadership in academic radiology, becoming a department chair and now our dean at USC?
Dr. Meltzer: Serendipity, as for many of us. In my first posttraining attending role at the University of Pittsburgh, I was thrust into an interim leadership role after a senior faculty member suddenly departed the institution. I was only 2 years into being an assistant professor and really was just flying by the seat of my pants. I didn’t know much about leadership and management as a field or as a science, something that could be studied. I don’t think many people did at that time, outside of the business world. In medicine, if you were good at your research or clinical care, then often it happened that you were asked to run something. I was working in the PET center and ended up being its medical director. I really enjoyed bringing people together, trying to have an impact, listening to lots of viewpoints, and having some say in how things are done to achieve the best possible outcomes for patients, staff, and students. I later had the opportunity to become a fellow of the Executive Leadership in Academic Medicine program (Drexel University School of Medicine; Philadelphia, PA), where I really learned leadership skills that reinforced what I had figured out the hard way and taught me to evaluate what worked and didn’t. I became a lifelong student of leadership. I take it as an incredible opportunity and responsibility and have found that my approach is most aligned with the servant leadership model. I’ve been fortunate that people have wanted me to work with them. I am truly honored to be here at USC as the dean.
Dr. Jadvar: Let’s talk about mentors. As you know, good mentors have a major impact on one’s career. I can personally attest to that because I had many good mentors who influenced me. Who were your mentors that you want to acknowledge in your personal and professional life?
Dr. Meltzer: There are so many. J. James Frost, MD, PhD, MBA, was one of my mentors in PET. My first mentor in the PET world was Dean Wong, MD, PhD. Dean took me on as a student and was really my first influential mentor in science and medicine. R. Nick Bryan, MD, PhD, who was at the time the chief of neuroradiology at Johns Hopkins, has been like a second father to me through my whole career. I consider him one of the most influential people in supporting my career and my personal life. I adore him and his wife, Jean, and we keep in touch. I can call him anytime and know that he’ll always give me his honest opinion. Charles F. (Chip) Reynolds, MD, is another mentor who was in psychiatry at Pittsburgh when I did neuropsychiatry research. Also, Steven T. DeKosky, MD, who was chair of neurology and led the Alzheimer Disease Research Center at the University of Pittsburgh.
Dr. Jadvar: Tell me about your parents. Was anybody in medicine or in math? How did you become interested in math?
Dr. Meltzer: My mom was a secretary and had a high school education. My dad was an immigrant from Greece. He wanted to be a physician but moved to the United States with no resources and ended up going to optometry school and becoming an optometrist. I was the kid who, like him, loved math, science, and taking things apart and putting them back together. He always wanted me to go into medicine and encouraged a belief that I could do whatever I wanted. He passed away about 5 years ago—an incredibly generous and supportive father.
Dr. Jadvar: Any siblings?
“…our most creative ideas come from…having people with different perspectives, different educational backgrounds, different life experiences, and from different fields working together. All the easy things that an individual contributor could do alone have been done.”
Dr. Meltzer: I have an older sister, who also became an optometrist.
Dr. Jadvar: I want to focus a bit on your life as a clinician/scientist. You have received several prestigious awards for your research, including the Gold Medal and Distinguished Investigator Award from the Academy for Radiology & Biomedical Imaging Research and the Outstanding Researcher Award from the Radiological Society of North America. Can you tell me a little bit more about your research in brain imaging? What were your findings?
Dr. Meltzer: I’ve had a couple of paths in my scholarly work, and one was in technology development. When I was engaged with PET imaging at Johns Hopkins and had done a year of research fellowship and worked throughout my residency in radiology and fellowship in neuroradiology and nuclear medicine, I kept up with research in Jim Frost’s lab. One of the technologic barriers to making quantitative assessments in PET imaging was the challenge of partial-volume averaging of the signal. I was interested in normal aging and Alzheimer disease. Comparing quantitation of receptors or any other measurements in a brain that had significant atrophy with those from a more age-appropriate brain was very difficult, because of partial-volume averaging of cerebrospinal fluid and brain tissue due to the low spatial resolution of early PET images. I became very interested in how to do those corrections and published my work developing a new method (J Comput Assist Tomogr. 1990;14:561–570). This initially received little attention, although eventually it became something of a landmark paper in the field. I also worked on coregistration of MRI and CT with PET. My early work focused on technology development, including evaluation of the first human combined PET/CT scanner at the University of Pittsburgh. I also worked to acquire an early prototype human PET/MRI scanner at Emory for validation. The scientific questions for me were always around brain aging, sex differences in aging, and susceptibility to neuropsychiatric diseases and disorders such as late-life depression and eating disorders. A key project was evaluating serotonin receptor density in depression and implications for therapeutic effectiveness.
Dr. Jadvar: I gather that at Pittsburgh you came into contact with David Townsend, PhD, in PET/CT and the work of Chester Mathis, PhD, and William Klunk, MD, PhD, in developing 11C-Pittsburgh compound B amyloid scanning.
Dr. Meltzer: Absolutely. David Townsend was the codeveloper of the first PET/CT scanner. He asked me to lead that first clinical evaluation of the first PET/CT scanner, opening a huge door for me. Same with Chet Mathis, who had codeveloped the 11C-Pittsburgh compound B tracer.
Dr. Jadvar: You are a neuroradiologist and a nuclear medicine physician. As you know, there have been incredible strides in molecular imaging and radiopharmaceutical therapy, especially with the recent approvals of new theranostic agents for precision imaging and treatment of patients with cancer. The Lancet Oncology Commission report on the Cancer Moonshot initiative (by former President Barack Obama and led by then–Vice President Joe Biden) identified and discussed nuclear medicine imaging and theranostics as priorities in fighting cancer. What are your thoughts on the future of translational theranostics, and how can we support this important priority that was also identified by the Cancer Moonshot Blue Ribbon panel?
Dr. Meltzer: Theranostics is an incredible tool for being able to target specific molecular markers, not only for diagnosis but also for treatment. Under the bigger umbrella of synthetic biology, precision health, and cell-based therapies for cancer, such as CAR T cells and beyond, we’re entering an age of precision in being able to diagnose and treat disease, particularly cancer. We know that individual molecular markers and rapid mutations can really affect how a cancer behaves. Being able to look at the molecular profile of individual tumors, the patient’s genetic biologic makeup, and many other relevant parameters, coupled with increasing computing power, creates the opportunity to turn big data into actionable knowledge about how we can be more precise in treating patients.
Dr. Jadvar: Exactly. I want to switch gears now toward your distinguished service record in academic radiology. You have received notable awards, including those from the American Medical Association, Association of University Radiologists, American Society of Neuroradiology, and American Association of Women in Radiology, from the last of which you received the Marie Curie Award. I want to focus especially on this award, which is given to an individual with outstanding contributions to the advancement of women in radiology and radiation oncology. What are your thoughts on receiving this award? Where do you think we are now in academic medicine with regard to sex equity, and what are the remaining barriers in empowering women, especially in leadership positions? How many women are deans of medical schools in the United States?
Dr. Meltzer: About 20% of department chairs are women, a percentage that varies a little by discipline but remains low, even in fields where most of the physician workforce may be women, such as pediatrics and obstetrics/gynecology. The percentage of medical school deans who are women is slowly moving up and is now at about 25%. But this is not where we need it to be. It was initially thought that these percentages would catch up to parity as a result of a more robust pipeline of women coming into the field. But with medical schools at 40%–50% women now for 20 years or more, we’re still not seeing the proportional dramatic increases that we should see with more sex parity in tenured and leadership positions. This is something I’ve been passionate about my whole career. When I went to medical school I was very much in the minority, and I’ve been the first woman in many of the leadership positions to which I’ve been fortunate to be appointed. That shouldn’t keep happening. I was very much honored by the American Association of Women in Radiology when I received the Marie Curie Award. There are so many other deserving individuals who are trying to make sure people from groups historically underrepresented in medicine and science benefit from having our voices at the table. That has been a thread through my whole career: a strong focus on equity and on creating inclusive environments where we can come together and have better ideas. The American Medical Association award was specifically for the work I did on unconscious bias training and mitigation for physicians in the health-care environment. This is important work that still very much needs to be done. We’ve come a long way but not as far as we should have. The current challenges to women’s reproductive health further indicate that there’s still a lot of sex bias in every walk of life.
Dr. Jadvar: Am I correct that one of the things you did at Emory was look at compensation for women faculty, where you made changes?
Dr. Meltzer: When I first became a department chair, I asked to see the compensation plan, because I couldn’t really figure out why some faculty were paid X and others Y—salaries seemed highly variable. When I analyzed the data on assistant professors (the largest group and, one would think, the most uniform), there was a nearly statistically significant difference between men and women assistant professor salaries. I had to be transparent about it. I let the department faculty know we had a problem and that we were going to go to a compensation plan that was equitable and metrics-driven. In the absence of intentionality around equity, these patterns form as a result of our inherent and systemic biases.
Dr. Jadvar: Speaking about equity, you’ve been the chair of the Radiological Society of North America Committee on Diversity and Inclusion and also Chief Diversity and Inclusion Officer at Emory. Can you tell us about some of your activities in diversity, equity, and inclusion and why attention to this is important?
Dr. Meltzer: It is now well known that our most creative ideas come from (the literature is quite clear in this) having people with different perspectives, different educational backgrounds, different life experiences, and from different fields working together. All the easy things that an individual contributor could do alone have been done. We now strive to tackle the most complex problems in human disease, which require a diverse and inclusive team approach. An environment that makes us all feel like we belong and can freely express ourselves is particularly critical. In my own leadership roles, I’ve always worked to flatten organizational hierarchy to make sure that we bring voices—all voices—to the table and that we check ourselves and hold each other accountable. We must also embrace grace and cultural humility, because although bias is a part of our human experience, we can learn from each other. That’s been integral to my leadership throughout my career. It also requires intentionally striving to be reflective of the communities we serve, at both junior and senior levels. I’m in a new community now for the last year that looks different from the community I was in in Georgia. I am thankful that many leaders here feel strongly that we need to keep working to make sure that those we train and those we put in leadership positions reflect the rich diversity of the communities we serve and in whom we want to build trust.
Dr. Jadvar: You’ve been the dean of a major medical school within a large private research university for slightly more than 1 year. Can you describe the similarities, differences, and challenges you have encountered as a dean compared with your long experience as a chair of a major academic radiology department?
Dr. Meltzer: If I had come directly from being a chair, I would have encountered more things that were new. In the 15 years that I was at Emory, I always had at least one other leadership role. These were mostly in the dean’s office, including as Associate Dean for Research for 12 years. During the last 3 years I was there, in addition to being the chair of radiology, I served as Executive Associate Dean for Faculty and Chief Diversity and Inclusion Officer. I believe that these experiences of working not only in a scholarly domain but also in the clinical practice arena (and, of course, in radiology we interact with everybody) made it easier for me to work in the dean’s office, bringing people together around research, faculty matters, professional advancement, leadership development, diversity, equity, and inclusion. That combination of experiences has prepared me well to step into the role of dean. There are new challenges every day, but at this point in my career I don’t get easily flustered. I’ve seen a lot of challenges and try to take an inclusive approach in dealing with them, involving my executive team and stakeholders from all aspects of the institution and beyond, depending on the issue.
Dr. Jadvar: What advice do you have for young doctors considering a fulfilling career in academic medicine in general and in nuclear medicine in particular, especially our young women doctors?
Dr. Meltzer: It’s funny that you ask that today, because it’s Match Day. I just had the opportunity this morning to offer advice to our senior medical students about their journey ahead. I talked about the importance of lifelong learning. We’ve prepared them well for the next step, but information and knowledge in medicine and science are now increasing exponentially. I suggested that they embrace an ever-curious mindset. When doors open, they should step through with courage and creativity. One is never sure where something’s going to lead, so we need to explore and innovate. No career path is straight. I hope today’s students will challenge the way we’ve done things and bring their own passions to the table. In radiology and nuclear medicine, where technology is constantly evolving, we have to continue innovating. That’s certainly one of the aspects of imaging science that attracted me. I think it’s very exciting for those who are particularly curious, creative, and want to just keep learning and growing.
Dr. Jadvar: I want to ask about your love of photography. I didn’t know previously about your remarkable talent. As a serious amateur photographer myself, I can say that your work is truly exceptional. I believe that if you had not achieved an illustrious career in medicine and science, you would have had an eminent professional career in photography. How did you become interested in photography, and do you still have time to pursue this interest? Please tell me and our JNM readers about your story of creative imaging through photography.
Dr. Meltzer: Very kind of you. It goes back to my dad. He and I would always build things, take things apart, and look at the world together. I took after him in terms of being very visually oriented and excited about technology and science. He loved cameras, taking them apart, putting them back together, and trying different ones. He wasn’t a very good photographer, but he would say, “Well, I don’t think that I like this camera anymore. You take it.” So, I would go off and try it. Although I loved the technology, I especially loved looking through the lens. When I ended up in imaging, I already had this creative side where I loved looking at the world from different perspectives. Early on, I kept those 2 worlds very separate; nobody I worked with knew that I had this love of photography. Later in life I felt comfortable openly sharing this other side of me, and artistic photography remains very much part of my life. It doesn’t detract from my focus as a physician, scientist, and leader. In fact, I think the more I photograph the more I’m able to feel centered and bring my best self to my work. So, yes, I do continue to photograph. I do it in spurts when I travel. Or when there’s a crazy storm in the sky I’ll run out. But I do love it. It really is a natural proclivity for imaging scientists such as yourself who understand the magic of imaging in every aspect.
Dr. Jadvar: And you have a website?
Dr. Meltzer: It’s at carolynmeltzer.com.
Dr. Jadvar: I want to thank you again so much for taking time to speak with me and our JNM readers. Fight on and heal on!
Footnotes
Published online Jul. 13, 2023.
- © 2023 by the Society of Nuclear Medicine and Molecular Imaging.
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