Thriving or Surviving with Dr. Stephanie Chan

“I’m just going to do what I can with what I have - which is a very engineering way to think” - Dr. Stephanie Chan

In this episode, we chat with Dr. Stephanie Chan, an ophthalmologist working in Ottawa, Canada. We learn about her journey having children as a resident and twins as a staff physician, the importance of compression socks in pregnancy and balancing personal life and career. 

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Resources: https://myparo.ca/, https://www.whattoexpect.com/maternity-products/health-wellness/best-compression-socks-for-pregnancy/

Facebook Groups: https://www.facebook.com/groups/CanadianWomeninMedicine/,  https://www.facebook.com/groups/1238307236179819/

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Contact Information

Dr. Stephanie Chan, B. Eng., M.D.

Email: drchan.bureau@gmail.com

Dr. Chan received a Bachelor of Engineering in electrical and biomedical engineering from McMaster University. She later received her medical degree from McMaster University before completing a residency in ophthalmology at the University of Ottawa Eye Institute at The Ottawa Hospital.

Dr. Chan's  work has been recognized on numerous occasions. She was the recipient of a Canadian Institutes of Health Research Health Professional Student Research Award as well as a Program for Interprofessional Practice, Education and Research (PIPER) Interprofessional Education Initiative Grant.

She has also had her work featured in a variety of publications and journals, including the Canadian Journal of Ophthalmology, the International Journal of Ophthalmology and Clinical Research, Canadian Family Physician, the Canadian Journal of Surgery, and McMaster University Medical Journal.

Transcript

Radha Sharma: Welcome to Season 1 Episode 8 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 in a medical career. 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 process on their own and a career while planning and the support along the way. 

Radha Sharma: In this episode we have Dr. Stephanie Chan. Stephanie, we are thrilled to have you on our podcast today. And we just want to give you a warm welcome and a thank you on behalf of the entire team.

Stephanie C: Thank you. Honestly, I think this initiative is so great, and I wish I had this when I was a trainee, because things were still pretty gray back then. So I'm glad to be a part of this.

Radha Sharma: Thank you. Thank you for being part of the work that we're doing. I guess I'll get started, Stephanie what does a day in your life look like if you were to explain to our audience members?

Stephanie C: So I finished my training 5 years ago. So I'm a full time ophthalmologist. I try to only work 4 days a week, and I tell all new grads to do the same, especially if you have kids. It's nice to have that day sort of aside in case one kid gets sick, then you can be with them, or if they have, like, an appointment at the last second. At least, you can shift your patients easily to that fifth day without overloading yourself. So typically I try to keep my schedule to a 4 day week and I try to keep my hours, you know, fairly standard as well. So I make a point of dropping my kids off at the bus stop in the morning. That does mean that I get into the OR about an hour later. But it means I do less cases. And thankfully, I work in a very supportive environment. So I'm allowed to do that. I'm allowed to come in an hour late for the OR and nobody yells at me. And yeah. So I drop my kids off at the bus stop in the morning. And I still have 2 kids at home, they're not old enough to go to school yet, so we do have a full time nanny, and so she picks them up from the bus stop. So I typically finish work at around 3:30-4. I bike to work as well, which I think is something I never thought that I would do, but I would encourage anyone out there to think about it. For me, it adds about 10 min to my commute but it's like an extra hour
of exercising that I wouldn't otherwise have and I live in Ottawa. So for me to get to work, I basically just have to follow the river and follow the bike path. So it's very safe. I never feel like I'm, you know, going to get hit by a car like, say, maybe downtown Toronto. But it's something that you know trainees or staff, or whoever ever wanted to try, I would highly highly recommend it, and I have an electric bike, because I don't want to get into work all sweaty and gross, either. I do have a shower, a shower was installed at my office as well, so I can take a shower if I want to. So yeah. So I try to finish around 3:30-4 and I bike home. So I'm home by 4-4:30.

Radha Sharma: Awesome. 

Stephanie C: So yeah, and then in terms of work. So I operate about one day a week, sometimes a bit more, depending on the weeks and then the rest of my days are in clinic

Radha Sharma: Cool. Thank you for sharing that. Yeah, I was gonna say, biking downtown. Toronto tends to be scary, so. 

Stephanie C:I agree it is a bit Dicey, for sure. 

Radha Sharma: Yeah, it gets a bit dicey, but it sounds like Ottawa, is definitely, and you probably see such nice trails as well when you're on your way. 

Stephanie C: It is, it is. It's really pleasant, you know. You're like biking by the river. There's like the Canada geese, and they have their little babies, you see them grow up. And it's yeah. It's nice. 

Radha Sharma: That's lovely. You mentioned that you finished training 5 years ago was it?
Can you walk us through kind of the timeline? How long did it take, I guess, from your undergraduate degree to where you are now?

Stephanie C: Oh, boy, okay. So I did an undergrad in engineering actually, way back. Actually, I initially wanted to be an astronaut, which is what I really wanted to be. So I did engineering. And then I worked for about a year. and then I decided that you know as much as I loved engineering, I didn't love the job that I had and so I went into medicine. I went to McMaster. I don't know if they still do this. But back then they accepted anyone. You didn't have to do a bunch of like MCATsand things like that back then. So that's how I got into Mac. and I did med school at Mac for 3 years, and then I did my residency here in Ottawa, where I'm from. And so during residency, I had my first 2 kids and so my residency was 6 years instead of 5. So I took, I think I want to say 8 or 9 months for the first kid. And then I think I took 4 to 6 months, maybe 6 months for the second. So I fell back, in the end, I fell back one full year. 

Radha Sharma: As you know, the goal of our podcast is to chat, you know, to you and others about why they wanted to have a family in the first place, how they've kind of fit these 2 beautiful things - being a parent and also being a physician - and have that kind of interlace with one another. What inspired you to have a family?

Stephanie C: Honestly, I think you know part of it is age, you know. And I've experienced this. It's a lot harder to have a pregnancy later on. I would say my last pregnancy was definitely much tougher than my first and you know, that's just kind of how the timing worked out, I think, in terms of logistics. There are a lot of advantages to having children in residency because I've had kids in residence and out of Residency is, I can honestly tell you, sort of like the pros and cons. So the pros when you're a resident is that you don't have any patients that you are looking after. So you don't need to worry about hand over and about patients falling through the crack, about patients just not coming back to you. Things like that, so those are the more logistical aspects. You're not paying for an office like in my case I have my own office. So you're not paying overhead on an office either. You can kind of just cut ties and go, which is really really nice and not something that I really appreciated back then. What makes it tough, though, is, you know, your co residents because it is an added burden for your co residents. When a resident leaves, it means that they end up having to take on more call and more clinics. And so that's sort of the negative aspect. So I would say, like in terms of the load that mat leave can take it, I would say, probably falls more on your co residents, which is never ideal either. Especially if you know you get along with your co-residents. You don't really want to do that to them, either. But at the same time, you know there is no ideal time. So you know it is what it is. So that would be the disadvantage also. The other disadvantage, too, is that you're not in control of your schedule. And so, as a resident, you’re tied to whatever staff or clinic, or OR and you kind of have to follow those times. You can't be like me, like 5 years later I can come into the OR like an hour later, and that's acceptable. So you're not as much in control of your schedule.

Stephanie C: But one thing that I will say my residency program did do for me, which is really helpful, was when I came back after my second they allowed me to come back part time which was great, especially because I was breastfeeding, and, like, you know, everyone's, you know, breastfeeding journey is going to be different, and I don't want to shame anyone who chooses not to breastfeed or anything like that. But for me it was really important to breastfeed my children. So it was nice to be able to work part time, because then I didn't really have to pump at work. I could just come home and feed my baby. So there was that advantage in terms of residency. In terms of being of being on staff, you do have more agency. You do have more independence. So I felt terrible. With my last pregnancy. I had twins, and I didn't know this, but like 2 babies, means twice the hormones. So the morning sickness was awful, and I remember - I walked into my clinic one day and I was like, “Okay, ladies. From now on I need to finish at one”. “Where are we going to put your patients?” “And I was like, I do not know, but I'mleaving at one o’clock because I feel terrible”. So that was, you know, one advantage that I could have as staff is that I could control my schedule.

Stephanie C: I also had colleagues, though, who were very supportive, and so a lot of my colleagues, you know, took on patients for me during my mat leave, or I was able to hand them over to their primary care while I was away. So that was helpful, but still, like a logistical difficulty, so to speak.


Radha Sharma: Yeah, I was gonna ask you along the lines because you mentioned in residency, people have to kind of pick up the call shifts, or like, pick up patient care when you're away. So how was that experience? How did you navigate I guess, communicating to your co-residents. How did that process look like?

Stephanie C: I mean, it's funny, like the guilt that we placed on ourselves, and it never really stops to be, even when you're a parent, if anything, it's worse. But certainly I felt, you know, I felt guilty for my co-residents for having to take on this extra work. but I had co-residents, and who were actually very supportive, and I think it was helpful that a lot of my co residents were women, and so, you know, they were very supportive of me. I remember when I was talking with her, and then she was like, you know I was like I told her, look, I'm sorry. I know it's been really tough with me being away, and then she would look at me, and she was like Steph, it is your God-given right to have children. I was like Whoa! I was like, thank you, you know, and I never even thought of it that way. but that's how strongly she felt about it. And it was so. It was nice to have supportive co-residents like that. There are always going to be co-residents who are maybe a little less supportive because at the end of the day residency is really tough, and to have to take on extra work. And you know there were people who were like, Oh, you're going on, mat leave. They thought I was like going on vacation and I had to be like no man, I'm looking after a child, so. 

Radha Sharma: It’s not like you’re going to Mexico. Very different

Stephanie C: So. But yeah, I mean, you know, it is what it is.

Radha Sharma: Thank you for shedding some insight on that as well, because some of our guests have had their children in residency, and I've noticed that we haven't really talked about that aspect of you know - How do you kind of navigate talking to your co residents? So I think people in this podcast will find that helpful as well.

Radha Sharma: You mentioned that, before we even got started, that you know, you wish you had something like this when you were kind of going through the process. What sorts of supports did you find helpful at your time? Were there mentors or people that you leaned on, you know, resources that you had accessible to you?

Stephanie C: Yeah. So I remember, like, in terms of the logistics, there was like the PARO website, and back then Ottawa was one of the only universities where, if you took some time off you had to make it up, whereas other universities didn't have that. So I think that was a big impetus for me to have 2 kids and take a full year off, because I'll make up the time as well. 
So there's the PARO website. I had like a program administrator, I guess who was very supportive. And the other thing, too, is that I was not the first person to have children in residency. There have been a couple of people before me, probably the most noteworthy, Dr. Setareh Ziai. She started the Canadian Women in Medicine group, I guess, or conference organization, and so she was a couple of years ahead of me, and she had 2 kids as well, so there was precedence at least. So Setareh was, you know, a big help. I had other mentors as well along the way. The CWIM mommy Facebook group is also very helpful because it's all people who have had to manage mat leaves and things like that. And they'll have tips and tricks. And so one trick that really helped me was when I went on my mat leave during my time as I was a staff like when I was running my own office, I was like, what do I do with my employees like? Do I have to pay them for like the 6 months that I'm away.  Somebody posted this and they're like, well, what you can do is just put them on EI so they still get paid, you know 55%. And then when they come back to you well, then, you can give them a little bonus like a retention bonus, which would sort of sort of help that cost there. So yeah, having the CWIM website and the mommy Facebook groups. And yeah, mentors are very, very helpful. I would say, one of my strongest mentors is someone that I work with now. And she was like the second woman ever in ophthalmology, in Ottawa and so she kind of she'd gone through all of the big hoops already. So having her was very helpful as well.

Radha Sharma: That's amazing. I'm glad to hear that you had that support system kind of there. I know it's not the case for a lot of women. But I'm hoping, you know, with resources like our website and some of the resources that you mentioned, which we will link in the show notes from today's episode as well will help kind of, you know, create more accessible ways to find that information, because I can't even imagine how stressful it must be - you don't even know kind of the policies that are in place to support you. So yeah.

Radha Sharma: So how many children do you have in total?

Stephanie C: So I had 2 kids in residency. And then I had twins when I came on staff.

Radha Sharma: Awesome. And what were some unexpected challenges of being a parent, I guess since you've been through it a couple of times, maybe as like a new parent, and then having twins - what was that like?

Stephanie C: So honestly? My first kid? She was a really good baby, you know she was like a good sleeper, a good eater, just like a very easy going kid. Which is probably the reason why I was like, oh, I could probably have a second and be okay. My second child was not. She still doesn't sleep well. And she's very, very active, and she takes up a lot of my attention and time for sure. So I think it's it's tough, because, like, you know, you don't know what kind of baby you're gonna have, and it makes all the difference right like for my first, like, I was nowhere near as sleep deprived as I was for my second. My second, like I felt awful because I was so sleep deprived. I ended up sleeping with her, which you know is a big no, no, you're not supposed to sleep with your child. But I ended up sleeping with her because there's just no other way I could survive. So yeah, I was definitely in survival mode back then

Radha Sharma: Is it better now?

Stephanie C: No, I'm still in survival mode - and then I had twins right? And oh, my gosh, having twins is really really tough. Again, because, you know, at first I wanted to breastfeed them, and it's really tough breastfeeding twins, because, like as they get older you can't really breastfeed them at the same time, and kind of have to do one at a time. But then you're trying to like breastfeed one and like have this moment and the other one is just screaming because they want some too. So it's not as enjoyable as when there's just one child for sure.

Stephanie C: And then yeah, 2 babies twice twice the diapers, twice the trouble. They also egg each other on, which is something I've discovered as they've grown up. So I'm still in survival mode I would say but you know it's getting better. It's definitely better than it was, and it's getting better all the time. I think, you know, like, in terms of like, what kind of parent I am like, I started as a very hands-on parent like, especially when I graduated. I was like, I'm gonna you know, go to all of the kids' plays. I'm gonna take them out to all the kids' outings. I would literally cancel a day of clinic so I could make a cake for their birthday which is crazy if you think about it because I still have to pay for my office, I just still pay for my employees, and everything like that. But it was important for me to bake this cake, which was really not that nice of a cake in the end. So anyway. So I started off as that kind of parent. And now I'm a very like, I'm just going to do what I can kind of parent, because what I discovered is, I would take a day off to bring the kids to a school outing, and then the outing would get canceled or like the weather would be bad, and they would push that into another day. And so I just realized that I can't win in this. So I'm just going to do what I can with what I have, which is a very engineering way to think.

Radha Sharma: And what would you say is the best part of being a parent? I know there's so many probably amazing things. But what do you look forward to when you get to see your babies?

Stephanie C:  Honestly, it's amazing just seeing these human beings grow up and becoming people. I was saying the other day, I have no more babies. My twins are 3, you know, and they have their personalities, and they have their little quirks. And you know, it's just crazy. It's crazy that these people were in my belly, you know. 

Radha Sharma: Now they're fully their own person.

Stephanie C: Exactly.

Radha Sharma: We've been talking a lot about your journey. If you had a magic wand and you could go back and change anything about your journey is there anything that you would change? If so, why? If not, why

Stephanie C: So the one thing that I do regret during my pregnancies, and it seems like a small thing. But now it's become really important to me, is that I didn't wear the compression socks, and everyone told me to wear the compression socks, and I read everywhere to to where the compression sucks. But when you're big and hot, like, the last thing you want to do is wear compression socks. But what I didn't realize was that varicose veins are very painful. And so now I have varicose veins, and they're very painful. And like, if I get up out of bed too quickly, it's very unpleasant. And so now I have to wear compression socks pretty much all the time. 

Radha Sharma: Oh my gosh. 

Stephanie C: And so yeah. And so I tell everybody - just wear the compression socks or you will, you will regret it. But I don't know. I mean,. I had a twin pregnancy. So you know, with my first 2, I didn't have any issues, but definitely with the twin pregnancy I really regretted not wearing the compression socks. Because now, yeah, I'm living with this. And I wish I could go back and change that. I mean, if I had known, I don't know, it's tough to say, because, like again, I breastfed all my children. So I had to pump and I would say, like the pumps that are out now - like you can just slip into your bra, and they're so great, and they're so handy. I don't know if they were available when I had my first. But that was the other thing I was like. Oh, I wish I'd known about that, because I feel like I could have maybe gone on longer for my kids. I did almost a year for the first 2, and then for the twins I did 15 months, but I feel like I could have gone longer for the first 2 if I knew about those types of pumps. I forget what it's called now, I want to say, like the Elvie breast pump or something like that. But there's one that you literally just slip into your bra. You don't have to wear a special bra with it. Like I had the Medela pumps. And for those ones I had to wear like a special bra that would basically hold the flange for you. But this other one and I got it from my twins you can just slip right in, and it's so much more convenient, and so much less messy. So I wish I had that for the first 2. But yeah, those are the only things I would change. I mean, like I said, there's pros and cons of having kids in residency and out of residency. And I experienced both. Having kids in residency is probably easier. I guess it depends. I guess it depends on what kind of job you have. If you're someone with an office and overhead, it's definitely easier when you're a resident. But if you don't have office and overhead, it may be easier when your staff and you can control your schedule a bit more. So I guess it depends.

Radha Sharma: And I know you talked a little bit about things that you wish you had like compression socks, but is there any other advice you have for medical trainees? Maybe someone that's a med student or someone early on in their residency training?

Stephanie C: Yeah. Oh, it's funny. I met a med student actually who had her first in med school.
And we talked about, Now, it's like, you know, you're probably better off having your kids in residency, because at least you get a salary right then you're getting paid. Having kids in med school I feel like would be a double whammy because you're paying tuition, and you're not getting paid, and you have to take time off. So between med school and residency, I would definitely say residency is probably the way to go. So in terms of, you know advice for trainees out there - what I would say with residency, you know, as a system is that it's not really designed for women to have children right like it was literally designed for a time when people would be living in the hospital. Hence the name residency. So to have children in the residency, you're kind of - it's like trying to fit like a square peg and a round hole, you know, like it just doesn't work and you can try to like make that square more round to like fit into the hole, or the  hole can be maybe a little bit larger. So I think ultimately there needs to be some systemic change to better support women for having both children and being able to feed their children and take them to daycare and things like that. So one of the big challenges I had with residency was that you know we would have teaching at 6:30 in the morning, but daycares don't open at 6:30 in the morning. They don't even open when it's 6 or 7 sometimes they open at 7:30, so there is like no way I could have done residency without having you know my parents, my in-laws, and my Nanny help me. But it would be nice to see more systemic change to better support women and men who choose to have children in residency, which is kind of the optimal time to have kids. For those out there who are feeling discouraged, just know that it's not you. It's just the system. It wasn't designed for this, but you know. If you have good support, you will get through it. We've all gone through it and hopefully, I'm hoping that because so many of us have gone through it, though, that it will be better every time. Because we'll have paved the way, and we'll have shown the little tricks things like going back to work part time, you know. Maybe you can just do your rotation twice, but do half days right? Maybe you can use up your vacation time, your conference time. There's always ways to sort of I don't want to say, game the system, but optimize things to better support us. And so, having, you know, a supportive program administrator and a program director is very helpful for sure.

Radha Sharma: Thank you for sharing that wisdom. Yeah, there definitely needs to be systemic change. But I think part of it is hearing stories like yours and others, and the tips and tricks of how you all kind of navigated the system yourselves. It's really helpful, Stephanie, I know you said that sometimes you've been in survival mode, but part of the podcast is to ask you, are you thriving or surviving right now? 

Stephanie C: Yeah, my kids are still young. So I'm still in survival mode. But like I said, it's better than it was and I think it will get better as well as the kids get older, out of diapers, things like that. So yeah, I would say right now, I'm still still in survival mode. But I was thriving. I was thriving between my second and my twins. I didn't realize the advantages to spacing out your children. I think, like, when I was in residency, I was like, okay, let's just kind of - in my head - get this over with. So I had 2 kids, 2 years apart. You know there's no optimal time to space out your children, but I think one of the optimal times could be around 3 years, because for the first year, you know, you're pregnant. Essentially, you're pregnant. And then the second year you’re breastfeeding right? So it gives you another year to kind of recover from all of that, because breastfeeding was actually very taxing. I don't know if people realize that unless you've been through it. But every time I stopped breastfeeding I had a marked improvement in my energy, because I had so much energy going towards making milk. So if you have that year to kind of recover - and that was the year that I was thriving before the twins came - I think it's very, very helpful. And also now that I had twins like, you know, the reality is, I'm only one person, and I have to split my time equally between the 2 of them, and, you know, really like neither of them are getting the attention that they want for me. So I think if you space your kids out by a solid like 3 years, it gives you that time to sort of focus on that one child during your developmental stage before you kind of move on to the next. But honestly, I mean, you know, family planning is also a bit of a luxury like I'm sure there are people who, you know, try for many years, and can't have a second or a third, or whatever. And and so, you know I don't mean to shame those people either. I'm just saying, if you have the luxury of planning, I would say 3 years is probably more optimal in my experience.

Radha Sharma: Thank you for sharing that, Stephanie. This concludes episode 8. We just want to give you another thank you on behalf of the team. It was such a pleasure chatting with you about how you kind of navigated residency, and being a staff while also having children and being a parent. You can find a lot of the resources that we were talking about in today's show notes. And you can also find our guest’s contact information there as well. This is Radha and Stephanie signing off.