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A Conversation with Eric M. Yoshida, MD
In this issue, HCV Next asks five questions of Eric M. Yoshida, MD, professor of medicine, former head of the division of gastroenterology at the University of British Columbia and current head of gastroenterology at the Vancouver General Hospital.
Eric M. Yoshida
Yoshida completed his undergraduate degree at the University of Western Ontario Science. After receiving his medical degree at the University of Toronto, he went on to the University of British Columbia Clinical Epidemiology for a master’s degree in health science.
Throughout his career, which includes being the past medical director of the liver transplant program of BC Transplant, Yoshida has published extensively. He is the current head of the BC Hepatitis Program.
On the national level, Yoshida is past president of the Canadian Association for the Study of Liver and serves as a member of the national governing board of the Canadian Liver Foundation.
Who has had the greatest influence on your career?
I was fortunate as a medical student at the University of Toronto in the early 1980s to be assigned to the clinic of E. “Jenny” Heathcote, MBBS, MD, FRCP, for 2 consecutive years. After that, I was able to arrange a senior year elective with her. Heathcote, who retired recently, was regarded as Canada’s top hepatologist. She introduced me to hepatology, but she also taught me the importance of being passionate about medicine and to not be afraid to advocate strongly for what is right. During my medical residency, I was very fortunate to be introduced to the liver transplant program that was in its infancy in British Columbia. Siegfried R. Erb, MD, FRCPC, a transplant hepatologist, and Charles Scudamore, MD, MSc, FACS, FRCSC, FRCS, a liver transplant surgeon, were the pioneers back then. They remain my colleagues today. I also learned about the value of kindness from Hugh Chaun, MA, BM, BCh, FRCP, FRCP(Edin), FRCPC, FACG, AGAF, who was one of the senior gastroenterologists when I was a trainee. He has always been like a mentor to me.
What was the defining moment that led to your field?
When I was a medical student and intern during the 1980s and a medical resident in the early 1990s, I saw a lot of patients with end-stage liver disease who had a very poor prognosis. There was not much the medical profession could do for them. Then the liver transplant program started and people could not only be saved, but return to a near normal life. Before, they were looking at certain death. That is emotionally very powerful. The fact that there are not enough liver donors around to save all those who need them is also very powerful, but in a tragic way. It means that every liver transplant is precious. Because of this, my colleagues and I are determined to fight hard to try and ensure that folks do not need to go through the liver transplant process.
What advice would you offer a student?
I would like to tell medical students that some greater power selected them for this mission, a mission to serve society and humanity. No matter how tough it gets, it remains an honor and a privilege to serve on this mission. Then I would like to tell the medical students that they should do what they are good at and what interests them and not to do things just because they think that is where the potential job openings will be or where the material rewards will be.
Have you ever been fortunate enough to witness or be part of medical history? If so, please explain.
I have been fortunate to witness and be part of the liver transplant process, the revolution in hepatitis B and C treatments as well as HIV and liver transplantation in Canada. I have also been part of a group that has demonstrated that members of the First Nations communities (in America, this group is referred to as “North American Indian” or “Aboriginal”) have an increased risk of autoimmune liver disease including primary biliary cirrhosis and autoimmune hepatitis. We were able to change the local medical culture, as previously the stereotype was that all First Nations with liver disease suffered from alcoholic liver disease, whether they disclosed it or not. These have all been very rewarding experiences.
What’s up next for you?
There is still a lot that needs to be done. We need to educate our medical colleagues about liver disease as well as educate our allied health care professionals and the public at large. On this front, I am working with the Royal College of Physicians and Surgeons of Canada in creating a Diploma in Hepatology. There are issues about access to the new treatments in hepatitis C and these include the need for hepatologists to advocate for their patients. There is always something that needs to be done better and for the sake of our patients, as well as for society, we need to discover how to make things better.