Thriving or Surviving with Dr. Andrea Simpson

“Do the things now, incorporate those changes into your life. Don't constantly be putting things off, waiting for a better time to come, because things only get more complicated as you go” - Dr. Andrea Simpson

In this episode, we sit down and talk to Dr. Andrea Simpson, an obstetrician and minimally invasive gynaecologic surgeon, about her journey with family planning and family building during clinical fellowship and as a staff physician. We talk about strict daycare policies, balancing late nights and young kids and everything in between!

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Contact Information

Dr. Andrea, MSc., M.D.

Email: Andrea.Simpson@unityhealth.to

Twitter: @AndreaSimpsonMD

Dr. Simpson is an obstetrician and minimally invasive gynaecologic surgeon at St. Michael’s Hospital. She is an assistant professor at the University of Toronto and completed an MSc. in Health Services Research at the Institute for Health Policy, Management and Evaluation. She is an Adjunct Scientist at ICES. 

Her research interests include access to health services, improving clinical care pathways, early endometrial cancer/endometrial hyperplasia and obesity, as well as issues pertaining to physician health and wellness. She is active in both postgraduate and undergraduate medical education and has won a number of teaching awards, including the St. Michael’s Hospital Student Experience Award in recognition of an exemplary effort and ongoing commitment to supporting a superior student experience, Dr. Frederick R. Papsin Award in recognition of outstanding contributions to teaching, leadership and mentoring to the residency program, and the Anthony Cecutti Award for most outstanding chief resident at St. Michael’s Hospital. She holds a Physicians’ Services Incorporated New Investigator Grant and a CIHR Early Career Investigator Grant.

#Clinicalfellowship #MIGS #UniversityofToronto #Parenting #OBGYN #Daycare 

Transcript

Radha Sharma: Welcome to Season 1, Episode 1 of Family Planning for Docs - Thriving or Surviving. This podcast is an extension of our platform at www.familyplanningfordocs.com, a website created for Canadian medical trainees to highlight useful information about family planning and a medical career. Our group has a mission to inform medical trainees about their options regarding family planning. While navigating training, career, and personal life.

Radha Sharma: Our research has demonstrated that personal stories are highly impactful, and we hope to provide access to a diverse number of stories, to current trainees on our podcast we hope to capture the stories of medical professionals who have navigated the training process and a medical career while planning parenthood, parenting, and the support along the way.

Radha Sharma: In this episode we have Dr. Andrea Simpson, an OB/GYN at St. Michael's Hospital, and an assistant professor at the University of Toronto. We are thrilled to have you on our Podcast today and thank you on behalf of our entire team for taking the time to share your story here.

Andrea Simpson: Thanks so much, Radha.

Radha Sharma: I'm going to start with the first question today. Can you tell us a little bit about your job? What does a day in the life of an OB/GYN look like?

Andrea Simpson: Sure. So I'm an academic obstetrician gynecologist, and minimally invasive gynecologic surgeon at St. Michael's Hospital and UofT. And I'm also a clinician investigator. which means that about 50% of my time is devoted to research. I have a very busy practice. Life as an OB/GYN is very busy. So in a typical week I would spend a day or 2 in the clinic, a day in the operating room, and then a day on call, and then the rest of my time would be spent on research activities.

Radha Sharma: Sounds like it's a busy schedule there.

Andrea Simpson: Absolutely.

Radha Sharma: Can you tell us a little bit about how many years of training It took you to get to where you are now?

Andrea Simpson: For sure. So I did my undergraduate degree at Western University, and then I came to the University of Toronto for medical school. Medical School was 4 years followed by a 5 year Residency in OB/GYN, and then 2 years of fellowship training. When I was doing my fellowship training, I concurrently completed a thesis based Master's degree and I also had my first child during fellowship and masters.

Radha Sharma: The goal of the podcast is to chat with you and others about how you fit family planning within a medical career. If you feel comfortable answering, what inspired you to start a family and have children?

Andrea Simpson: Yeah. So I think I always planned to have children. For myself, I didn't feel prepared in residency. I didn't feel quite ready just from a personal preparedness standpoint. I have been with my husband actually since undergraduate and we got married when I was a second year resident. I think, because I was in the field of obstetrics and gynecology, I was acutely aware of issues related to age-related fertility decline. So, I knew I didn't want to delay long, but I also was motivated to finish my residency sort of in line with my peers that I had started residency with. So, completed that after 5 years, and then early in fellowship, we decided to pursue family planning. So, it was something that I always wanted to do, and always planed to do but I found it difficult to understand how it would fit into residency, and from a personal preparedness standpoint, I decided to start my family after residency.

Radha Sharma: It sounds like residency wasn't the suitable time. But you decided to have kids during your fellowship. Were there any challenges that you experienced while you were planning parenthood? 

Andrea Simpson: Yeah, so I found fellowship to be a really good time to have my first child. You don't have your practice yet, you don't have to look for locum coverage and so forth. I was a clinical fellow, not a Royal College fellow, in minimally invasive surgery. So there are limited supports available for clinical fellows in order to support parental leave. Unlike residents who are under PARO, there is no protected parental leave time as a clinical fellow. I was in the fellowship at St. Michael's Hospital, and of course, all of my fellowship director and colleagues, were very supportive of a family plan. They all have children as well, which I think is very unique in surgical training programs. So they were very supportive of me, taking time off. You know, not having to worry about locum coverage because I didn't have my own practice yet, and then returning to the fellowship so that I had a few more years of training before ultimately starting my own practice. So I think those were the sort of favorable aspects about having my first child when I was a fellow. In terms of challenges. finances are a huge challenge. A time of life where you're just sort of coming out of all of your acquired debt from training. My husband and I both fully paid for our own education. So this was an obviously financially challenging time for us before I was in practice. For that reason, with my first child we had her in daycare when she was 5 months old when I, you know, returned up to help with the transition. When I returned to my fellowship training, she was 6 months old.

Andrea Simpson: Daycare hours can be quite restrictive for physicians. Even with daycare like our daycare pick up, it was strictly by 6 pm. And there were, you know, financial penalties for being late. So I actually remember a situation when I was pregnant with my son. So, my daughter, I had in fellowship and my son, I had in my first year of practice. My daughter was still in daycare when I was pregnant with my son. And there was a day that I was kind of pressing to get to the daycare on time. I was 36 weeks pregnant, and I was sprinting down the sidewalk, and a man pulled up next to me and said, I'm also trying to get there on time like, did you want me to give you a lift because I think he felt so bad for me. So I jumped in the car with him, and as we were driving realized that we were not going to the same place. And it's kind of a funny story in retrospect, because I essentially got into the car with a stranger, because I was so panicked about getting to daycare on time. But anyways all ended well.

Andrea Simpson: I think you know now, when I have my son, we transitioned to having a full time caregiver and that has made a huge difference in terms of supporting my busy OB/GYN job and everything and ensuring that we have reliable child care.

Radha Sharma: I was just gonna follow up on a little bit about the support systems that you have in place. I know you talked a little bit about having access to a caregiver. Can you tell me more about that or any other support you found helpful as a busy OB/GYN?

Andrea Simpson: Yeah. So, having a caregiver was like, I think, the single thing that my husband and I did, that we felt was the most helpful in supporting our careers and our children.

I also do have a very supportive spouse so I think that has also been essential. Certainly, an important aspect when you choose your spouse is to make sure that you have someone who understands that it's taking on 50% of the child rearing responsibilities. and that was something that we certainly discussed like, well, before we got married.

Andrea Simpson: So those are probably the 2 biggest things. We've made other adjustments. I think a lot of it sort of happened during the pandemic as well, where I made some adjustments to my working hours just to suit the family needs a little bit better. So you know, like starting clinic a little bit later, so that my husband and I can commute into work together, and spend time with our kids in the morning. So there's been smaller things that we've done to help accommodate everything. But I would say those are probably the big ones.

Radha Sharma: It sounds like there's a lot of adapting that is at play. There are different, not necessarily compromises, but things that you have to change about your schedule, that make a difference

Andrea Simpson: Absolutely. And I think that it's naive to think that you can, you know, not make these changes. Children are the biggest life change that anyone, regardless of your profession, ever experiences, and I think that as a practicing physician, you do have some flexibility in enabling you to incorporate those changes.

Radha Sharma: Were there any mentors or other resources that were accessible to you, when you were thinking about, you know how to fit a family with your career choices?

Andrea Simpson: Yeah. I did have very good mentors in my field, and I think that I'm very lucky for that.I don't think the same was true for physicians who wanted to practice 10, 20 years ahead of me. So I was very fortunate from that standpoint. Where I found their advice most helpful was in navigating issues around childcare and you know, understanding the benefits of having a full time caregiver. Also, how others have incorporated research and clinical practice and kind of, you know, bringing all those things together in the context of also having children. So I did have some excellent mentors along the way to really help me understand how to navigate and set up my practice.

Radha Sharma: I'm glad to hear that you had those resources and people available to you. Mentorship in other arenas of medicine can be so helpful, so It's nice to hear that there is that help out there.

Andrea Simpson: Absolutely.

Radha Sharma: You mentioned that you have 2 children right, a daughter and a son. Can you tell me how old they are?

Andrea Simpson: So right now my daughter is 5 and a half, and my son is 4.

Radha Sharma: Were there any unexpected challenges of being a parent to your son and daughter that you faced?

Andrea Simpson: I think, one of the biggest challenges. and I think this is probably true, for all parents especially when they're really young, adapting to their ever changing needs. And one of those things being, you know, making sure that they're sleeping through the night, especially when physicians do tend to take shorter mat leaves and go back to work fairly early. So I think that that was like a particularly unexpected challenge. My first child did have some difficulties with colic and that, you know, led to a pretty challenging and short parental leave. When I was heading back to work, I felt like she had just sort of adapted, you know, started to adapt a little bit more to sleeping through the night, and so forth.

Andrea Simpson:  And I think because she was so young, one of the other challenges was maintaining breastfeeding when I went back to work. And, she actually revolted a little bit, and would sort of refuse to eat all day at daycare, and then when I would come home, she would be up all night wanting to breastfeed. So, I think those initial challenges just with the transition back to work can be really tough. l did have very supportive colleagues, so that it did make it possible for me to continue to pump and breastfeed even after I went back to work. I found it much harder with my son when I went back and was no longer a trainee, I was a practicing physician. I actually breastfed for far less time with him, just because I found it was just so challenging to set aside time at work to pump and so forth. And my parental leave with him was similar, I took 7 months with him. So I think that you know the sleeping challenges, especially when you are in a field where you go back to work, and you're often working nights, and your partner is with the kids, and then also the feeding schedules and things like that and trying to maintain breastfeeding. Essentially, trying to do the things that we tell our patients to do.

Radha Sharma:  As your kids get older, are there different challenges that you’re facing? Obviously, the breastfeeding wouldn’t be an issue anymore, but what other challenges have you sort of faced?

Andrea Simpson: Yeah, you know, I feel Radha that I'm a little bit at a stage where I kind of don't know what comes next. When they're really young, they don't really have a concept of time. So from that standpoint, like they don't really you know, kind of push back when you are working overnight. They're kind of getting to a stage now where, when I go to do overnight call. They do say that they would prefer me not to be working overnight. My daughter often says, I wish you were the kind of doctor that didn't work overnight. I'm, you know, excited through these podcasts to learn about physicians in later stages with older children, and how those needs change because I do think that it's kind of ever evolving. And it's something that I think you know, with every stage you have to regroup and figure out how you're going to navigate those challenges. Currently, I think my kids have adapted very well to like understanding that I'm working overnight, but then I'm going to be home the next day, and so forth. One of the things that my partner and I have really had to change since we've had children is just limiting how many nights we are out in a given week, because it does like, you know, when you don't have children until you're a little bit older your lifestyle has adapted in such a way that you often are out at meetings and in medicine, I think we do a very bad job of always having meetings that occur at dinner time and so forth. So, yeah that's been one of the other challenges that we face. The pandemic also influenced this. Having more virtual meetings has made it more possible for me to participate in meetings I otherwise wouldn't have been able to and so forth.

Radha Sharma:I guess on the flip side of things, what would be the best thing about spending time with your son and daughter when you do get to see them?

Andrea Simpson: It's just endless joy watching your kids grow and learn, and their worlds become bigger. And I think that that for me was something that I never had really appreciated before I had children. But as they get older and you watch their minds develop, they start asking you questions. And you know, talking to you about the challenges that they're facing at school and so forth. It's just it's so rewarding having that relationship with them.

Radha Sharma: That's so beautiful. I love to hear the way that everyone kind of describes that growth, like seeing your child move through the stages. Obviously I don't have children yet. But, it seems to be a common theme so far. So I'm glad to hear that you have those experiences with them. 

Andrea Simpson: Absolutely.

Radha Sharma: We always ask our guests, if you had a magic wand somehow, and could go back and change anything about your life, what would it be? And why?

Andrea Simpson: yeah. So I don't know that I would change the timing of having children. I think that I, you know, did put a lot of thought into this when I was a trainee, and as I planned my career path and I'm very glad that I didn't delay any further and had my children when I did.

Andrea Simpson: I think the one thing that I wish going back that I could change would be, sometimes in medicine, you're constantly looking for the next stage. I just need to finish medical school and then I’ll start looking after myself a little bit better instead of studying all the time. I'm just going to finish residency, and then, I'll start going back to the gym and incorporating wellness activities into my life again. I'm just gonna get through fellowship as soon as I have a job, I'm gonna do better. So I wish that I had come to that realization sooner that you have to change these things now. Every stage has its challenges and there is flexibility, and you have to figure out how you're going to make it work for yourself then. So I think that would be the biggest thing that I wish I could change if I were to go back and do it all over again because it only becomes harder to incorporate these self-care things. as your life becomes fuller.

Radha Sharma: I  think I needed to hear this specifically, I'm sure myself and other trainees have this concept of delayed gratification that once we get to the next stage, then we'll go to the gym and eat healthy. So, it's comforting to hear that those self-care things should be implemented along the way, and you shouldn’t wait for those things that have an open slot, because there might not be an open slot.

Radha Sharma: As you reflect on your story here, are there any pieces of advice you would give to your younger self either about self-care stuff or anything else? 

Andrea Simpson: Yeah, no, I think that would be the advice I would give to my younger self. Do the things now, incorporate those changes into your life. Don't constantly be putting things off, waiting for a better time to come, because things only get more complicated as you go.

Radha Sharma: And is there any advice that you have for other medical trainees that might be listening to this podcast today?

Andrea Simpson: Yes. So I think when it comes to family planning, and family building, there is no perfect time. Do it when it's right for you. But it does get harder as you get older, and don't just think about the challenges around getting pregnant, because that's only one piece of the whole puzzle, or having a child, it's actually more about what the long term game is. How old a parent do you want? How many children do you want to have? And how do you want that to look in the context of your whole career? I think often we focus very much on just the birth and you know those initial phases. But that’s your child for their whole life and for the rest of your life. So I really think that thinking about how you want things to look at the end of the day is really going to be important advice for trainees.

Radha Sharma: I love that piece of advice. My mom always said, growing up that you're not just going to be having a child, that's going to be a person. So I feel like it kind of goes along the same lines looking long term and ahead rather than just in this moment right now.

Radha Sharma: In the name of the podcast I do have a final question for you. Andrea, are you driving or surviving?

Andrea Simpson: Radha, it depends on the day. I would say, I have some days where It very much feels like everything is thriving, everything's going well, and then I have some days that are quite the opposite, and it can really vary from day to day. So, I can't say one or the other, but it's ever evolving.

Radha Sharma: I love this honest response here, Andrea, that it's not just one or the other. It can actually fluctuate day to day. We just want to give another thank you on behalf of the podcast. It was an absolute pleasure chatting and hearing about your journey planning parenthood and being a parent. 

Andrea Simpson: Thanks so much for having me

Radha Sharma: You can find our guest’s contact information in the notes from today's show. This is Radha signing off.