Neil W. Schluger, M.D.,Teaches Students to Put their Patients First

Dr. Schluger, who became dean in August 2023, after an international search by a committee led by Alan Kadish, M.D., president of New York Medical College and Touro University, and Kelly A. Hutcheson, M.D., M.B.A., professor and chair of the Department of Ophthalmology, speaks from personal experience. The internationally recognized pulmonologist, researcher, and educator entered medicine never anticipating the distinguished career he would enjoy. His career has taken him to some of the world’s most medically under-resourced countries to care for patients, develop programs, and teach fellow physicians, and it has evolved, in part, from his willingness to think outside the box as he explored the various ways—as a clinician, lab scientist, and public health advocate—that he could put his medical degree to work. “I do not want students to come here thinking of medicine as a vocation, or that all they need is to learn vocabulary and how to manipulate instruments,” he says with a warm smile. “I want them to think about what it means, in the fullest sense of the word, to be a physician.”

Family Ties

Dr. Schluger is reflective and disarmingly candid. Born in Brooklyn and raised in Queens, New York, he earned his bachelor’s degree in biology from Harvard College in 1981 and his medical degree from the University of Pennsylvania four years later. Asked about his professional trajectory, he offers with neither hesitation nor apology that he never made a conscious decision to become a doctor. Rather, he followed the footsteps of his father. His brother also became a physician, as did his wife, her brother, and her father. Three of his four children would also follow in the footsteps of their parents and become physicians.

He notes that his career in medicine began taking shape three months before he even started medical school, when a report appeared in Morbidity and Mortality Weekly Report about five men in Los Angeles who had a mysterious infection that would later be recognized as AIDS. “When I came to New York to train at St. Luke’s Hospital in 1985, it seemed like everybody who was coming in for treatment had AIDS,” he recalls. “Amidst fear and uncertainty, nobody was sure what to do, but people realized there would be a lot more than medicine involved in dealing with the epidemic.”

The Big Picture

Dr. Schluger completed a three-year fellowship in pulmonary and critical care medicine at the New York Hospital-Cornell Medical Center in 1992. He then joined the faculty at New York University School of Medicine and worked clinically at Bellevue Hospital, on the famed Bellevue Chest Service at the height of widespread tuberculosis (TB) in New York.

As AIDS devastated New York City and the world, the TB epidemic was also gaining steam. The effectiveness of the preferred treatment, Directly Observed Therapy (DOT), depended on clinicians being able to closely monitor patients to ensure that they took all their medications at the prescribed times. But, while directing the DOT program at Bellevue, Dr. Schluger realized that TB patients almost always had numerous coexisting morbidities and other life complications that prevented them from complying with their therapeutic regimens. Language barriers alone hindered efforts to effectively convey the importance of following the DOT protocol with patients who came from 39 countries and spoke 13 distinct languages. In addition, poverty, homelessness and/or substance use disorders frequently prevented patients from adhering to their TB treatment. “My colleagues and I would talk about their lack of housing or their alcohol abuse and how we could help to get them back and forth to the clinic so they could take their medication,” Dr. Schluger recounts. Gradually, he began to consider that taking TB medicines might not have been the most important thing for these patients, compared to finding a place to sleep or food to eat. “That is when I realized that when it comes to medicine, nothing occurs in a vacuum.”

Lifelong Learner

During his fellowship at Cornell, Dr. Schluger spent considerable time training as a scientist in renowned basic science laboratories at Rockefeller University and the National Institutes of Health. In Rockefeller University’s Laboratory of Medical Biochemistry and in the pulmonary branch of the National Heart, Lung, and Blood Institute, Dr. Schluger encountered his newfound appreciation for science, something he hopes all medical students will experience. “If you do not think science is great, then think about the drugs that have been developed for HIV,” he says fervently. “I grew up at a time when we watched people die from this untreatable disease, and now patients are surviving on one pill a day,” he exclaims. “Because amazing science was done, there are now drugs that might make it possible for people with cystic fibrosis to lead normal lives. And hepatitis C is now curable too,” he adds.

In the ensuing years, he accepted a series of prestigious academic and clinical appointments, including as chief of the Division of Pulmonary, Allergy and Critical Care Medicine at Columbia University Irving Medical Center, where he was also professor of medicine, epidemiology, and environmental health sciences. He was also director of the Population and Global Health Track for the Scholarly Projects Program at the Vagelos College of Physicians and Surgeons at Columbia University, and co-director of the educational program in global and population health at the school. In 2020, following his 22 years on the faculty at Columbia, he became the Barbara and William Rosenthal Professor and Chair of the Department of Medicine at New York Medical College and director of the Department of Medicine at Westchester Medical Center.

Dr. Schluger spent a great deal of his research career with the Tuberculosis Trials Consortium, an international collaboration sponsored by the U.S. Centers for Disease Control and Prevention, which he chaired from 2000 to 2016. He also taught internationally, including in India, Thailand, Zimbabwe, and Israel.

All of this led to his greatest achievement in global health: the co-founding, in 2013, of the East Africa Training Initiative (EATI), a two-year fellowship training program in pulmonary and critical care medicine and the first program of its kind in Ethiopia and the broader East African region.

With funding from the Swiss Lung Foundation and Vital Strategies, a non-profit global public health organization that designs solutions to pressing health problems, Dr. Schluger and a team of physicians and public health officials developed the curriculum based on the standards of the Accreditation Council for Graduate Medical Education to train pulmonary critical care fellows. Their goal was to develop a sustainable program with an all-volunteer faculty that would remain onsite in Ethiopia until they could train a sufficient number of Ethiopian physicians.

Ripple Effect

Before the program’s launch, the country had only one pulmonologist for its 110 million people. More than a decade after its founding, the program has trained the first generation of pulmonary physicians in the country and established an academically oriented pulmonary division at Ethiopia’s leading public hospital. To date, it has graduated 25 specialists, including two pediatric pulmonologists and two physicians from Rwanda and Tanzania, who have assumed leadership roles at hospitals across East Africa. At Black Lion (Tikur Anbessa) Hospital, Ethiopia’s largest public hospital and its main teaching and referral center, patients can now access advanced pulmonary services, including bronchoscopy and pulmonary function testing. The hospital’s chest clinic sees more than 500 patients monthly, while medical ICU capacity has grown substantially, and critical care ultrasound is widely used. “Ethiopia is one of the poorest countries in the world and there was nothing we could do to change that, but the impact of the program has been magnified in many ways,” Dr. Schluger says.

By increasing the country’s capacity to train pulmonary health providers, the EATI program has dramatically increased accessibility to pulmonary health care, which has improved health equity. This sequence of improvement, starting with program development, which fueled education and training, and led to increased service delivery, health care access, and better patient outcomes, is what Dr. Schluger means when he refers to physicians “creating something lasting and sustainable that could lead to something bigger.” It is the kind of experience that has made his career so fulfilling, and that he wishes for all the College’s medical students.

“Students come to medical school for all the right reasons, idealistic, and ambitious,” he says. “Our goal is to keep their excitement going by exposing them to clinical medicine as well as basic science, public health, and health policy, and to give them opportunities to interact with people so they can see all sorts of varying careers in medicine.”

Dr. Schluger’s career, which exemplifies such variety, has earned him numerous accolades, including, most recently, recognition as a Crain’s New York Business 2023 Notable Health Care Leader and Westchester Magazine’s 2024 Health Care Hero. He has authored more than 200 articles, chapters, and books, which have appeared in The New England Journal of Medicine (NEJM), The Journal of the American Medical Association, The Lancet, and The Lancet Respiratory Medicine, among other leading journals. He is an associate editor of The American Journal of Respiratory and Critical Medicine, and a past president of the American Lung Association of New York. He also has written and edited several editions of The Tobacco Atlas, the definitive work describing the extent and consequences of the global epidemic of tobacco use, published by the American Cancer Society and Vital Strategies, where he serves as both a trustee and senior advisor for science.

During the COVID-19 pandemic, Dr. Schluger became an important voice as the lead author of the May 7, 2020, NEJM article, “Observational Study of Hydroxychloroquine in Hospitalized Patients with COVID-19,” which, using data from an observational trial of 1,400 patients who took hydroxychloroquine, debunked claims about the drug’s ability to beat the virus.

Health Equity For All

In his office, gazing at a display of photographs that he has taken during his decades of global health work, Dr. Schluger ponders the term “global health,” which has encompassed so much of his career. He offers a thoughtful explanation, emphasizing that global health entails more than traveling around the world to see patients. “Global health is about justice, and justice means everyone is treated the same,” he asserts. “Everyone in the world deserves the right to live in a healthy environment with equal access to high quality care.”

With steady emphasis, he notes that the practice of global health must involve reciprocity among participants who share the knowledge, skills, and experience needed to create not only a more sustainable health care system but also more effective patient care. “Whatever we do is a two-way street,” Dr. Schluger says. “The places where we send our students should benefit as much from the work they do as our students benefit from being there.”

Describing his long-term dedication to global health is one way that he hopes to motivate and guide students toward medical careers that unfold in unexpected and wonderful ways. Another is the weekly discussion group, “Reflections on Medicine,” that he hosts for students who want to learn about and share their own perspectives on medicine. He uses these discussions to impart his own experiences and suggestions, not to mention wisdom, which he is happy to share.

“All human beings care about the same thing: health and safety for themselves and their families,” he says. “But there is so much that goes on culturally, socially, and economically that has an impact on people’s health. Although medicine is at the heart of what physicians do—what we do is important—it is far from the only thing that’s necessary for people to be healthy.”

The Whole Patient

What it takes to be healthy, in Dr. Schluger’s view, is as multidimensional as what it means to be a physician. “As physicians, we go to work every day to make people’s lives better in some way, and it is a privilege to be able to do that,” he says. “We have status and respect and make generous incomes. Yet, there is an unwritten social contract that we get this status only as long as people think we are working in their best interests. Because, when it comes to medicine,” he says, “the most important person is the patient.”

To care for patients most effectively, a doctor must understand the circumstances of their lives. This, Dr. Schluger explains, is why he is working hard to raise students’ awareness of the relationship between medicine and public health, as well as science and policy. “I want students to be exposed to great clinicians at the bedside and in the operating room. I want them to work in laboratories and communities. I want them to learn to use not just their skills but also their compassion to make patients better,” he says.

Medical students appreciate Dr. Schluger’s vision. “Dr. Schluger is a true advocate for students and a tremendous asset to the NYMC community. Not long after his appointment as dean, he readily met with members of the SOM Student Senate to partner on goals for the year and to offer his support of our efforts. He has also prioritized his time to offer invaluable advice regarding residency applications to our class,” says Katherine Lo, SOM Class of 2024 and president of the SOM Student Senate. “He is truly committed to the success of our students and institution, and we are grateful to have him as our dean.”

If Dr. Schluger can help students carve out meaningful medical careers by conveying his vision, then he will have achieved the bulk of what he set out to do when he assumed the position of dean. “I chose to become dean of the School of Medicine because I knew it was a unique opportunity to make an impact on somebody’s career.”