The Beginning, Medical School and Career Choices

Medicine is in Jay’s DNA. He was born at the Mayo Clinic in Rochester, MN, where his father was in training in pediatrics, and was named after his grandfather, who also practiced pediatrics. Attending the University of Wisconsin-Madison, Jay credits a good friend, the son of an attorney, with his decision to pursue a career in medicine. Both took courses that would satisfy criteria for applications to law and medical schools and then decided together that each would follow his own father’s career path. After his first year of medical school at the University of Wisconsin School of Medicine, Jay married Pat, and they moved to the Southwest for Jay’s internship at the University of New Mexico School of Medicine in Albuquerque. Their next move took them to Phoenix, AZ, where Jay served in the Indian Health Service, followed by his pediatric residency in the Phoenix Hospitals’ pediatrics program. While Jay enjoyed some aspects of pediatrics, he felt that something was missing.

What were the alternatives? Jay had completed an old-fashioned internship, rotating between specialties every 2 months. He had enjoyed obstetrics but was less interested in gynecology. So, he asked for advice from a neonatologist who told him about a new subspecialty called perinatology (maternal-fetal medicine) that would enable him to concentrate on obstetrics. He liked what he heard and decided to look for residency training in obstetrics and gynecology at hospitals that had established brand-new fellowships in maternal-fetal medicine. There weren’t many in 1974. He interviewed in Los Angeles, Minneapolis, Chicago, and, finally, as an afterthought, in Columbus, OH.

“I am not going to take ‘no’ for an answer”

That same year, while Jay served in the pediatric clinic at Maricopa County Hospital in Phoenix, he received a phone call that changed his life. On the other end of the line was the internationally renowned obstetrician-gynecologist–one of the founding fathers of the field of maternal-fetal medicine–Frederick P. Zuspan, MD, who had recently returned to his alma mater to chair the department of obstetrics and gynecology at The Ohio State University (OSU) College of Medicine. Dr Zuspan invited Jay to train in Columbus. Jay, in turn, explained that he had tentatively accepted an offer to train in Minneapolis, but Dr Zuspan vigorously replied, “I am not going to take ‘no’ for an answer today. I want you to think about this over the weekend. Call everyone you know and ask about me. I’ll call you back on Monday, and I know you will be coming to Columbus.” Consequently, Jay’s weekend was consumed by telephone calls, and the advice he received was consistent: “If you are given a chance to work with Fred Zuspan, that’s where you ought to go!” He, Pat, and their 1-year-old son moved from Phoenix in July 1975 and have lived in Columbus ever since. They were tempted several times to consider moves westward, yet chose to stay in Columbus.

Residency and fellowship training were the foundation for his enduring, fruitful mentor-mentee relationship with Dr Zuspan. Jay wrote his first academic paper with Dr Zuspan and has since authored or co-authored more than 200 published works. Mentored by both Dr Zuspan and Dr Moon Kim, a specialist in reproductive endocrinology and infertility, in Columbus and by Dr Edward J. “Ted” Quilligan in California, Jay rose from clinical instructor in the 1970s to hold the first Frederick P. Zuspan Endowed Chair in the department 2 decades later. Jay’s academic progress was spurred by Dr Zuspan’s announcement that Jay would lead OSU’s participation in a multicenter randomized trial, to be led by Dr Robert Creasy, which evaluated routine care vs intensive education for women at risk of preterm labor. This, Jay’s first randomized clinical trial, would be the trial by fire that defined the rest of his career. Jay recruited Ms Francee Johnson to be the nurse coordinator for the March of Dimes project at OSU. When the trial was over, they created the Prematurity Clinic at OSU that became the basis for future successful prematurity-related research projects that paved the way for membership in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Network in 1992, where he and Francee led OSU’s unit until 2016.

“I am not going to take ‘no’ for an answer”

That same year, while Jay served in the pediatric clinic at Maricopa County Hospital in Phoenix, he received a phone call that changed his life. On the other end of the line was the internationally renowned obstetrician-gynecologist–one of the founding fathers of the field of maternal-fetal medicine–Frederick P. Zuspan, MD, who had recently returned to his alma mater to chair the department of obstetrics and gynecology at The Ohio State University (OSU) College of Medicine. Dr Zuspan invited Jay to train in Columbus. Jay, in turn, explained that he had tentatively accepted an offer to train in Minneapolis, but Dr Zuspan vigorously replied, “I am not going to take ‘no’ for an answer today. I want you to think about this over the weekend. Call everyone you know and ask about me. I’ll call you back on Monday, and I know you will be coming to Columbus.” Consequently, Jay’s weekend was consumed by telephone calls, and the advice he received was consistent: “If you are given a chance to work with Fred Zuspan, that’s where you ought to go!” He, Pat, and their 1-year-old son moved from Phoenix in July 1975 and have lived in Columbus ever since. They were tempted several times to consider moves westward, yet chose to stay in Columbus.

Residency and fellowship training were the foundation for his enduring, fruitful mentor-mentee relationship with Dr Zuspan. Jay wrote his first academic paper with Dr Zuspan and has since authored or co-authored more than 200 published works. Mentored by both Dr Zuspan and Dr Moon Kim, a specialist in reproductive endocrinology and infertility, in Columbus and by Dr Edward J. “Ted” Quilligan in California, Jay rose from clinical instructor in the 1970s to hold the first Frederick P. Zuspan Endowed Chair in the department 2 decades later. Jay’s academic progress was spurred by Dr Zuspan’s announcement that Jay would lead OSU’s participation in a multicenter randomized trial, to be led by Dr Robert Creasy, which evaluated routine care vs intensive education for women at risk of preterm labor. This, Jay’s first randomized clinical trial, would be the trial by fire that defined the rest of his career. Jay recruited Ms Francee Johnson to be the nurse coordinator for the March of Dimes project at OSU. When the trial was over, they created the Prematurity Clinic at OSU that became the basis for future successful prematurity-related research projects that paved the way for membership in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Network in 1992, where he and Francee led OSU’s unit until 2016.

Becoming an editor of the American Journal of Obstetrics and Gynecology

After training together as medical students and residents at OSU, Fred Zuspan and Ted Quilligan followed parallel careers to eminence in academic obstetrics and gynecology, notably serving as the longtime co-editors-in-chief of the American Journal of Obstetrics and Gynecology ( AJOG ). They offered Jay an associate editor position at the journal. Jay was impressed with the responsibilities that come with evaluating the work of others. He especially enjoyed the collegiality of the journal staff. Jay noted that, from the beginning of his tenure, he was made to feel an equal with more senior editors. Jay credits Dr Zuspan and longtime journal Associate Editor Dr Steve Gabbe, then chair of the department of obstetrics and gynecology at OSU, with mentoring him in the editorial process at AJOG . “Steve was an excellent, hands-on editor who had a gift for reorganizing paragraphs and restructuring sentences to make them clear and simple,” Jay says. Throughout his editorial term, Jay enjoyed many significant opportunities to review the latest research in obstetrics and gynecology and to help investigators and authors bring their work to a larger audience. Remembering his own uncertainties as a new investigator, he was always quick to remind authors that they were welcome to call or e-mail their questions to him or the managing editors.

Jay became the AJOG Editor assigned to review publications garnered from the annual meetings of the Society for Maternal-Fetal Medicine (SMFM), a role he recalls as his most rewarding with both the journal and the society. He promoted the Fast Track option for rapid publication of papers arising from SMFM oral abstracts.

Jay considers AJOG unique in its balance of clinical and translational research. The balancing act can be tricky, but, he notes, AJOG pulls it off admirably: “The journal struggles successfully with the reality that clinical and translational research are essential to move our field forward… AJOG has always been the place to publish new ideas in obstetrics and gynecology.” Jay also played an important role in the evolution of AJOG from a printed version only to the current format, along with Tom Garite, Moon Kim, Ted Quilligan, and Fred Zuspan.

When asked to name the most memorable papers he has edited, Jay names three. The first was a major study by a talented investigator. While the work was among the best ever by this investigator, its presentation was unclear. He and the author spent months working on the manuscript that became an influential, much-cited article. The second was a 2003 publication that reported results of a randomized trial of vaginal progesterone vs placebo to reduce the risk of premature birth. After witnessing so many failed interventions, Jay was both cautious and hopeful in an accompanying editorial. The third is a study that compared pregnancy outcomes among women with a history of second-trimester miscarriages and early premature births. Tradition has long placed a boundary between miscarriage and premature birth at 20 weeks of gestation, but this article found common features that challenge the 20-week cut-off and became a highly cited paper.

Jay found the workload as AJOG Associate Editor substantial but never onerous. Selecting reviewers, going over new submissions and revisions, and, hardest of all, declining and accepting manuscripts became early morning traditions on Saturdays and Sundays. “Difficult” is a word he rejects to characterize his journal duties. “‘Challenge’ is a better word,” Jay says. “It is important to be fair and to make sure personal opinions do not influence what the journal is going to publish.”