Faculty Spotlight: Ramzi Dudum, MD

 

Preventing Disease, Promoting Health

“In medical school, it was formative to learn how life expectancy can vary by ZIP code or metro stop,” said cardiologist Ramzi Dudum, MD, MPH. He wants to find new ways to improve heart health and health care systems for every patient.

Dr. Dudum grew up in San Francisco’s Outer Sunset neighborhood, not too far from UCSF’s Parnassus campus, and earned his bachelor’s degree in religion from UCLA. “I enjoyed learning about different cultures, people, and belief systems,” he said. With a persistent draw towards science, medicine was a unique opportunity to serve individuals in a patient-centered way. 

He completed his medical degree at George Washington University, where he worked with an inspiring clinical preceptor who happened to be a cardiologist. “I just loved the mechanisms of cardiology,” said Dr. Dudum. “The heart is a pump, and you can simplify its function down to those basic physics principles. It made sense to me.” During his medical school training, he was drawn to learn more about the risk factors of chronic diseases and their epidemiology.

That inspired him to earn his master of public health degree, with a focus on epidemiology and biostatistics, from Johns Hopkins University. It also brought him full circle, fueling his desire to become a preventative cardiologist. “Cardiovascular disease is still the leading cause of death in the U.S., and risk factors like obesity, diabetes, and hypertension are becoming more and more prevalent,” said Dr. Dudum.

He completed his internal medicine residency at Johns Hopkins Hospital as part of the Osler Medical Service. “It was a wonderful privilege to train in Baltimore, which has a rich interplay between the community and Johns Hopkins,” said Dr. Dudum. He solidified his interest in pursuing a career in preventive cardiology, by working closely with leaders in the field, Roger Blumenthal, MD, and Michael Blaha, MD, MPH, during his training. 

After completing his residency, Dr. Dudum trained at Stanford University for his cardiology fellowship, where he also served as chief cardiology fellow, and completed an additional year as a clinical scholar and postdoctoral fellow in the field of population health, delivery science, and implementation science. His mentors at Stanford included Fatima Rodriguez, MD, MPH, and David Maron, MD, two other leaders in preventative cardiology.

Translating Best Practices into Improved Care

During his time at Stanford, Dr. Dudum collaborated on projects to improve health at the population level. “Cardiology takes a rigorous approach to studying which treatment works best, but despite having high-quality evidence, the dissemination to clinic doesn’t always happen,” he said. “I’ve spent a lot of time thinking, ‘How do we do better? What types of systems-based practices can we enact to improve patient care?’”

Dr. Dudum was part of a multidisciplinary team that investigated ways to personalize cardiovascular risk predictions using “opportunistic screening” techniques. One of the risk factors for heart attack and stroke is buildup of calcium in the arteries of the heart. Physicians traditionally order a coronary artery calcium scan to detect and measure the severity of this calcium buildup. Because the heart is constantly pumping, this test uses a specialized technique that takes pictures of the heart during certain parts of the heartbeat cycle when the heart is not moving as much, which is more likely to produce a clear image of the coronary arteries.

“Obtaining a coronary artery calcium scan requires seeing a doctor who determines this is something that could be useful in your preventative care and orders the test,” said Dr. Dudum. “You also need to be able to afford the test or co-pay if it’s not covered, and then you have to make it to this additional appointment. There are a lot of conditional probabilities of who is more likely to get this type of test done.”

However, sometimes patients get chest scans for other reasons. These scans are not timed to a specific segment of the heartbeat cycle, and are more commonly performed. Dr. Dudum and his colleagues, including experts in preventative cardiology, imaging, radiology, AI and other fields, have used machine learning to sift through these existing scans. They wanted to see if they could glean useful information from these previously completed scans about other possible health conditions.

This approach could potentially help improve prevention efforts, particularly among patients who might have difficulty accessing the gold standard diagnostic of a coronary artery calcium scan. However, translating this finding into actual clinical use requires a thoughtful approach. He notes, “There’s a fundamental difference between the [traditional] screening paradigm and the opportunistic paradigm, and that big difference is something we’re thinking through. What’s the right way to study this? How do we use information that people weren’t looking for, but might impact their care?”

Dr. Dudum notes that these questions are nuanced and help to frame these conversations moving forward. He highlights the importance of multiple stakeholders, including patients, to guide this field moving forward.

He has appreciated being part of multidisciplinary teams working together to explore this new frontier. “Different health systems are approaching implementation in different ways, and it’s an exciting area to think through,” said Dr. Dudum. “[Famed basketball coach] John Wooden had a phrase, ‘Be quick but don’t hurry.’ I think this is one of those things where it behooves us not to rush.”

‘It’s a Privilege’

After completing his training at Stanford, Dr. Dudum was recruited to the UCSF Cardiology faculty in July 2024. “I was really impressed by the Division of Cardiology and its leadership,” he said. “I also loved all the people I had met and learned from. [Associate Chief of Cardiology for Research] Greg Marcus was one of my first research mentors in medical school, and we had kept in touch over the years.”

“It has been immensely gratifying to watch Ramzi’s development, and we are very fortunate to have recruited him,” said Dr. Marcus. “He is tenaciously industrious in a convivial way, and I can’t wait to see the wonderful things he will accomplish.”

Dr. Dudum has appreciated the warm welcome he and his large cohort of new faculty members have received. “I really enjoy the collaborative spirit, and everyone has been so supportive and helpful,” he said.

Dr. Dudum spends about half his time on research, and the other half caring for patients, both in the hospital and through the UCSF Cardiovascular Care and Prevention Center at Mission Bay. “I appreciate being there with patients and their families, helping them through a challenging experience,” he said. “I try to bring humanity to that experience, because my routine is oftentimes someone else’s most challenging day. I truly think of this work as a service-oriented field. It’s really a privilege to be there for our patients.”

He looks forward to collaborating with others at UCSF and helping patients to live healthier, longer lives.

Dr. Dudum enjoys cooking and exploring San Francisco with his partner, Kathryn, and two children. 

 

- Elizabeth Chur