Q&A with Carrie L. Byington, M.D.

LPOC:    What was your and your family’s experience with health care growing up in Texas?

Dr. Byington: I grew up in a rural region of South Texas near the Mexican border. My family members worked hard and yet, when it came to health care, there were gaps. I lost several family members to cancer, which was advanced at the time of diagnosis. I now recognize the many health disparities that existed in my hometown and that still exist in South Texas and other regions where Latinos live and work.

LPOC:    When did you first decide you wanted to be a physician and why?  What was it that interested you about becoming a physician?

Dr. Byington: I wanted to be a doctor when I was about 4 years old. I loved helping people, and I loved science.

LPOC:    Were there challenges that you faced going through your education and into and through medical school?  If so, how did you overcome those challenges?

Dr. Byington: There were challenges. Growing up in rural Texas, I did not have women physicians as role models. I needed to convince my family and often my teachers that taking science classes would be good for me. I grew up hearing phrases like, “Mijita, girls don’t like science” or “Women can’t be doctors”. Getting permission to waive the typing requirement so that I could take calculus was a challenge in high school, though sometimes I wish that I could type

LPOC:    What was your initial goal for becoming a physician and what did you first want to do as a physician?

Dr. Byington: In the beginning, my goal was to be a clinician and to practice where I could be of service. During medical school, it quickly became clear to me that Pediatrics was the field for me. Children have so much potential and our interventions early in childhood lead to better health over the course of a lifetime. In college I studied microbiology and during my medical training, I was able travel and work in medical settings in Peru and Argentina. All of these experiences and time with a trusted mentor convinced me that specializing in infectious diseases (“ID”) was right for me. ID has shown me again and again that we are all connected and that we all need access to health care. The COVID-19 pandemic has made that clear around the world.

LPOC:    What led you toward the direction of administration and the path you have taken?

Dr. Byington: I never anticipated a career in administration and was a clinician, and educator, and an investigator before I began administration. My mentor, Dr. Ralph Feigin, encouraged me to pursue academic medicine during medical school. He said to me, “Carrie, the way you make a difference in children’s lives is through research.” This statement and my experience performing research with the CDC during the measles outbreak in Houston, TX in 1989, changed the trajectory of my career. After my pediatric residency, I completed research training and a pediatric ID fellowship at UCSF. I became an academic physician caring for patients and conducting research.

In 2005, I was diagnosed with breast cancer and could not see patients for about 1 year. I had a lot of time on my hands and became an active mentor to fellows and faculty in pediatrics. I realized that clinician scientists needed a strong mentoring infrastructure in order to be successful. When I recovered, I asked my Chair if we could build such an infrastructure in our Department. He said yes, if I would lead it. That was how my administrative career began. I realized through this work, that I love building programs and improving the environment through new resources or policies for colleagues and patients. Over time, I have taken on greater responsibility and today lead the University of California Health System, the largest academic health system in the US.

LPOC:    As the first female in this type of position, were there challenges that you faced?  If so, what got you through those challenges?  How did you push through them?

Dr. Byington: One of the biggest challenges has been frequently being the only woman in the room and pretty much always being the only Latina in the room. Learning to interact confidently and not let imposter syndrome hold me back has been a challenge. I am always super-prepared for every meeting and practice before I go into board rooms and negotiations. My family is my greatest strength and often support me through these practice sessions. I have learned that I often have ideas that are different than the status quo and that it is OK to express these ideas. In fact, it is a good thing. A diversity of ideas is more likely to lead to success when dealing with challenges or hard problems. Some of my ideas have led to new diagnostic technology, better patient outcomes, and a more inclusive academic environment.

LPOC:    What are you goals for your current position – especially related to growing a more diverse physician workforce in California?

Dr. Byington: There is so much opportunity in California to build a strong and diverse health workforce. We live in the largest and most diverse state in the nation. We also have the finest public system of higher education in the world in our state.

I am interested in working across the education and training continuum to create a clear pathway for students from undergraduate to medical school, to residency, and beyond. I would like to shorten the training for physicians through competency-based rather than time-based education when possible. Coordinated programs that encourage service and are tied to loan reduction would lower the overall cost of training and offer opportunities to more diverse students.

I believe in the capacity of students to do extraordinary things and believe as a state we can benefit from accelerating programs for some students and encouraging them to stay in the state by offering them meaningful experiences to serve in their communities. It will take a coordinated effort with the state and other stakeholders. The University of California system is the right platform for developing innovative programs to deliver the excellent health workforce that matches the demographics of our state.