My first job was at the department of clinical geriatrics at Slotervaart hospital. Your first job is always exciting. It is a lot to take in, an exhilarating experience. During my final internship at the clinical geriatrics department, I learned that this was the domain I wanted to pursue. I felt that geriatrics reflected what I thought the essence of being a doctor. In geriatrics, the patient is observed holistically, opposed to addressing a single organ system. We look from the somatic, psychiatric as well as the functional and social perspective. Therefore, I find clinical geriatrics an inspiring and challenging specialization. It is concerned with all sides of medicine and is centered around quality of life.
After a short while, I applied for my specialization. Back in that day, it was a national application program. I got a call from Erasmus MC if I was interested in a dual program, combining my training with a PhD program. I had always been interested in doing research. I have had a keen interest in understanding how the human body functions and how to improve health care. After I completed this program, I completed training to be an internist as well. Then I became staff-member at the AMC as internist-geriatrician.
dr. N. van der Velde
Nowadays I am a clinician as well as one of the principal investigators of the geriatrics department, focusing on falls and fracture prevention. Clinical questions are key in my research. I believe these questions are solved by combining clinical and translational research. For example, I study how certain genetic profiles predict medication-related falls. Thus, giving way for a better personalized fall prevention advice in the clinic, that can be tested in a randomized clinical trial. Though I find fundamental research interesting, I believe that in the end research must have clinical relevance.
Research within the field of clinical geriatrics is complex due to the heterogeneity of the population. Therefore, for example, a randomized controlled trial may not always be the best way to get useful results. Step-wedged RCT’s or really big cohorts can be more effective. In a step-wedged RCT, the patients are sequentially treated over a period of time and they are observed both as part of the control and of the intervention group. Geriatric patients are a good group to work with as overall they are motivated to contribute to research, are enthusiastic about the extra care they receive and that they are relatively compliant.
My research comes from my intrinsic motivation. I find it rewarding to help answer the pending clinical questions. I also enjoy supervising PhD students, which is inspiring and rewarding. Without this, research can be a hassle. There are many obstacles, thus endurance is a key attribute in research. Research is a time-consuming process, which for clinicians means that it continues after work hours. It involves ups and downs, but receiving a research grant or getting an article published is also highly rewarding.
I would advise students to get involved in research early on in order to see for themselves whether they actually enjoy doing research. There are a lot of enthusiastic scientists that can use your help. There is also a difference between different research groups, so if you joined one and it does not match, you can always switch to another. Also, a (research) internship in another country such as the United States can be very interesting and a valuable experience. Lastly, if you find out that you do not enjoy doing research, do not invest your time into a PhD just to get into a specialization, it will be a tough time if you do. Use that time to get clinical experience and develop other skills such as management; you will still be able to pursue your desired career path.
1997 Medicine, University of Amsterdam (MD)
2001 ANIOS Geriatric medicine, Slotervaart Hospital
2001 ANIOS Internal medicine, OLVG
2002 AGIKO Geriatrics (resident training for Geriatrician & PhD-training), Erasmus MC
2006 Master Epidemiology
2007 PhD: Title of thesis: Falls in old age: pills, the heart and beyond…
2009 AIOS internal medicine
2010 Internist-Geriatrician Erasmus MC
Current positions: Internist-Geriatrician AMC (since 2010), Head section geriatric medicine (since 2014)