Thriving or Surviving with Dr. Peter Ferguson

“The first thing I’m going to say, and this is what I encourage to all our residents, is to ensure that you do set aside prioritized time.” - Dr. Peter Ferguson

In this episode, we chat with Dr. Peter Ferguson, an Orthopedic surgeon and Chair of Orthopaedic Surgery at the University of Toronto. We talk about his perspectives balancing fatherhood and residency 20 years ago, the evolution of medical training policies in support of family planning, and the work that’s still left to do. We hear about his own challenges and support systems as a parent, and his encouragement for residents to prioritize family. 

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Contact Information

Dr. Peter Ferguson, MSc, M.D.
Twitter: @Toronto_Ortho
Email: Peter.ferguson@sinaihealth.ca

Dr. Peter Ferguson is an Albert and Temmy Latner Professor, Chair of Orthopaedic Surgery and an Orthopaedic surgeon at the University of Toronto. He was the former program director for Orthopedic Surgery at the University of Toronto. His research interests include tissue engineering techniques, wound healing and biomechanical modeling of metastatic lesions in long bone. 

Transcript

Radha Sharma: Welcome to season 1 episode 17 of Family Planning for Docs - Thriving or Surviving. This podcast is an extension of our platform at ww.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. 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 supports that they had along the way.

Radha Sharma: In this episode we have Dr. Peter Ferguson. We are thrilled to have you on our podcast today and thank you on behalf of the entire team for sitting and chatting with me today.

Peter Ferguson: Thank you for having me. 

Radha Sharma: Amazing. So we'll start with the first question, what does a day in the life of Dr. Ferguson look like?

Peter Ferguson: Yeah, so there's no doubt, it's jam packed full of activities. So I would say, an average day starts with me getting up, I live just north of the city, so I get up about 5:30in the morning, have breakfast and coffee with my wife. Usually I arrive at the hospital by around 7 o'clock AM. There's usually teaching rounds for our residents and fellows and students that go till about 8:00 AM. And then most days there's clinical activities, either surgery or clinics that occupy my time from about 8 am to roughly 4 PM or so, and then several days I have administrative meetings, academic meetings, you know various different other commitments that you know can take me to around about 6 PM. It certainly used to be, pre-covid, that a lot of these meetings were done in person downtown. COVID has obviously introduced us to this new era of virtual meetings and so a lot of the times these meetings are virtual, which you know does make it a little bit easier to commit to attend, and also, you know, I am able to do meetings in the car getting home, or sometimes from home as well. But that's my typical day

Radha Sharma: Sounds like it's very jam-packed, as you said before. 

Peter Ferguson: It is. 

Radha Sharma: And how many years of training did it take you to be where you are now, for our listeners that may be interested?

Peter Ferguson: The same sort of training entering medical school. Certainly I did 3 years undergraduate, 4 years medical school. I did a 5 year Orthopedic residency. But in addition to that, I was in what's called in Toronto, the surgeon scientist training program. So I did a 2 years Masters degree in the middle of my residency. So it ended up being 7 years of Orthopedic residency including the Masters, and then one year of clinical fellowship. So, the total amount of post secondary education is about 15 years.

Radha Sharma: We know that you're involved in a lot of leadership positions and you know, roles outside of just your clinician role. Can you talk to us a little bit about some of the leadership positions you've either held in the past or currently have now?

Peter Ferguson: Sure. So I love teaching. Teaching is, you know, one of the things that I think sets academic surgeons and and academic physicians apart from community surgeons and physicians a lot of the time. It is the most appealing, sort of component of my job is being able to teach students, residents and fellows. I guess about 13 years ago, 14 years ago. Our chair approached me because we were starting a new educational platform within orthopedics sort of highlighting competency based education which people probably know a little bit about now, and asked me if I would head this up. So I became the associate program director in orthopedics specifically with a portfolio that involved looking after our pilot competency based stream residents. And at the time there are only 3 residents a year. This was the first surgical training program in the world as far as we're aware that sort of focused on a competency based rather than a time based approach to education. So I did that for a couple of years, and then I was asked to be the program director which I did for another 2 and a half years, and then the chairs job in orthopedics became available, which I applied for and I've been doing for the last 10 years. I have one more left in my 10 year. So really, it's education that has been what has driven me in my sort of administrative pursuits over the last several years.

Radha Sharma: That's amazing. And I know as a University of Toronto student myself, the faculty are very passionate about teaching. And that definitely reflects in, I guess, the competencies of the residents and students. 

Radha Sharma: So, as you know, our goal of the podcast is to chat about you and others about how they’ve fit family planning and family building while also balancing this amazing medical career. What inspired you to start a family? Was it something that was modeled for you earlier in your life, or something that came later in your career?

Peter Ferguson: Yeah, I think it's something that I always wanted. My wife and I, you know we've been together a long time. We met right when I finished high school. My wife was still in high school at the time, so you know, we're sort of high school sweethearts. And so from a very early stage, you know, we had thought that at some point in time we wanted to have a family. We were, you know, both came from family centric backgrounds and it's just something that when I, you know, was growing up that I always assumed that you know I would have kids and be able to, you know, hopefully pass on some of the things that I sort of gleaned from my own parents onto them. So it's just something that was just innate in my upbringing.

Radha Sharma: And in terms of a timeline, or planning for when you wanted to have children, when did you decide that you know, your wife and you were going to start having a family?

Peter Ferguson: I think it’s a little bit hard to plan for this. In fact, our eldest was a bit of a mistake. It happened not by plan but you know we're very happy that it did happen. I think that we had always planned to consider having children at some point during my residency. WhenI started Residency, I think I was about 25/26. And so, you know, I thought it was probably at some point during residency that would happen and it probably happened just a little bit earlier than I had expected.

Radha Sharma: And do you have just one child, or do you have other children as well?

Peter Ferguson: Yep, we have two. 

Radha Sharma: Amazing. And did you have both of them during residency then?

Peter Ferguson: Yes, so the thing that was, I think, fortunate, even though, was probably by accident rather than by design, is that we had both of our kids when I was in the lab doing my surgeon scientist training. So in fact, I would encourage if people are considering this and planning it, it actually is a really good time to do that, because I didn't have, at the time, the overwhelming clinical commitments. And you know it was very interesting when my my daughter was born 2 weeks into my first research year in July of my first research year and she was born I think it was on a Thursday night, a Friday morning, and I went back to work in the lab on the Monday, and my supervisor saw me, and he said, What are you doing here? I want you to go home. I want you to go home, and I want you to spend at least 2 weeks at home with your wife and newborn baby. And so that really impressed on me at that time for that value of, you know, ensuring that we take time with our, with our newborns and our sort of burgeoning families.

Radha Sharma: Hmm, and you know, we've had a lot of guests on the podcast that are at different parts of their training. Some of them, you know, are currently having children, or are residents themselves. Was there a paternity leave policy in place at that time? How did the residency programs go about, you know, navigating their students taking time off to family plan?

Peter Ferguson: Yeah. So at that time there was actually no policy. And and so I think that's one of the you know, significant beneficial evolutions over the last several years, are for these policies that are in place. So at that time there was nothing. Certainly, from a paternity point of view, I would say that it was almost unheard of, that people would take some time off. And so I think that that is, you know, certainly a significant accomplishment and achievement in advancement over the last several years is this opportunity for people to take an extended amount of time off, and you know, in the last sort of 10 to 12 years I've had a number of residents who have taken maternity, and particularly paternity leave off, and it's something that I strongly encourage our residents to consider.

Radha Sharma: That's really great to hear that the culture has changed quite a lot, and there's a lot of advancements, both systems wise, and then both on an individual level to support residents, and then, you know, physicians to be for that. So that's great. 

Peter Ferguson: That’s absolutely correct. 

Radha Sharma: When you think back to that time, were there any challenges that you experienced as a resident or as a new parent while also balancing this career?

Peter Ferguson: Yeah, I mean, I trained in a bit of an old school environment, right? You know, my training was over 20 years ago, and that was still in an era where you didn't go home post call. You know you would do one and 2 call for extended periods of time. There were no work hour restrictions, anything like that at all, and you know there's no doubt at all that that you know, and I'll bring up a quote from my my young son way back, that exemplifies this. But there, you know, there really was, you know, it was not as great an opportunity for us to sort of designate time for self. It was work first and family second, when I was starting my practice. So you know again, about 20-21 years ago, I would bring my kids in to round in the hospital with me and so my son at the time was about 4 or 5 and we did our ward rounds, and came down to my office afterwards, and my wife asked my son did you have fun, he said yes. Did you want to be, or do you want to be a doctor like daddy? And he said, my 5 year old says no, because then I'd never get to see my kids. 

Radha Sharma: Aw. 

Peter Ferguson: So it really struck me at that time that you know, out of the mouths of babes. Right? I mean, that's the true truth of things. And I think that that's been a significant improvement in the last several years, for sure that we're really focusing on resident and physician well-being and encourage people to take time, you know, with their families. you know I evolved over the course of my career to, you know, ensure that I did designate time for you know, for family activities. But during our residency I must say, and I must admit that that was difficult to do. It was difficult to navigate and dedicate time to the entire family.

Radha Sharma: And what were your biggest support systems at that time, as you were navigating those challenges? 

Peter Ferguson: Yeah, I mean, look, I have a very understanding wife. She, you know she's been with me from the very beginning, and she knows how things work. She's seen how things work, and she accepts it. She understands it. We don't always like it and didn't always like it, obviously. But she understands that's what the commitment is. And you know, extended family as well, you know, very supportive. They've seen how hard I've worked over the years and ensured that we had opportunities to, you know, spend quality time, if it's not always quantity time, then certainly quality time together. You know, at work again I would say that certainly in surgery we're probably behind other other disciplines and other specialties when it comes to you know, sort of developing policies and ensuring that time is protected, for family activities and and parental leave that sort of thing, right? So I would say, you know, more recently, it's, you know, becoming quite clear that all these things are encouraged. But you know, encouragement isn't the same as implementation. And you know, I think that we've got a long way to go still, to ensure that you know, physicians in practice, surgeons in practice can take time off, still ensure that their patients are looked after, and still ensure they get a reasonable income during that period of time. Right? 

Radha Sharma: Recently I spoke with Dr. Elisa Greco, who is also the head of vascular surgery, and she was talking to me about how, you know, there have been more conversations about, you know, designated spots for parents to either breastfeed their child or you know, have that time allotted so that you're able to kind of balance both of your roles. Have you sat on any of those conversations, is that something that you hear, especially in a surgical specialty like orthopedics?

Peter Ferguson: Sure, sure, I hear it. I have not to date been certainly party to a lot of these discussions. I mean, you know we do have high level discussions at the Department of Surgery around prioritization and you know, development of task forces to try to develop, you know, policies to implement things. But it's really still in its infancy. I think, you know, probably the most important thing that I'm striving to do right now is ensure that people and you know, students, residents understand this is a priority, right? That you know they do have allies within you know the administration in our division who fully support sort of these decisions that they make right. If a resident comes to me and says, You know, here’s my situation. I'm gonna be having a baby 6 months down the line, and you know I want to, you know, plan my training so that I can do both effectively. I say to them, well, that's great. I'm delighted to hear that. Yeah, absolutely. Let's make sure that we've got flexibility in your training to ensure that you can both be a fantastic surgeon as well as a parent at the same time.

Radha Sharma: That's incredible, honestly, and I hope our listeners are taking note of the changes that are, as you said, still in their infancy. But I think, it takes time for those changes to be implemented and having people that are supporting you is so critical. So yeah, thank you for sharing your perspectives on that. You mentioned that you have 2 children, so how old are they now?

Peter Ferguson: They’re adults, 25 and 27. 

Radha Sharma: Okay, and are they close by to where you are in Toronto or?

Peter Ferguson: My son's very close by. He's, in fact, just down the hallway in his bedroom. He's the younger one. My daughter lives in Guelph, and she's going to be moving to Orillia within the next few weeks to take up - Her boyfriend has just been accepted to Teacher’s College. So they're moving there with the expectation of being there for a few years.

Radha Sharma: Amazing. When you think back to when they were younger, what were some unexpected challenges of being a parent that maybe you didn't, you know, expect at that time, and then kind of hit you like a truck?

Peter Ferguson: Oh, boy, that's a great question. I'll tell you an interesting story, you know, for example, of how sort of being out of touch to some extent, that affected me. So you know, my wife was the one who, obviously, you know, at that time, because of my commitments, and being out of the house so early as a resident, you know, did the day to day activities with our kids, got them ready for school and that sort of thing. Well, there was this one time where she was away on a trip, and I was responsible for getting the kids off to school. And so I made lunch for my daughter and made her a peanut butter and jelly sandwich. So I said, Oh, all kids love peanut butter and jelly. And you know, later that day we got this, I think my wife got a call from the school, saying, how are you sending your daughter to school with peanut butter? Don't you know kids are allergic to peanut butter, and you know it's like completely verboten and forbidden. And so these were the sort of things that I really wasn't aware of right? These are sort of new things that have come out certainly from since when I was a kid. And so it sort of impressed on me that, you know I've got to be a little bit more attentive and and alert to what the current challenges of bringing up kids and things are changing all the time. So that was a bit of an eye opener for me.

Radha Sharma: Thank you for sharing that story. I guess, because now they're adults, how have their perspectives on your career and knowing that, you know sometimes you won't be home, or, you know, sometimes their sacrifices to be made. How have their perspectives changed over time? 

Peter Ferguson: The first thing I’m gonna say, and this is what I encourage to all our residents is to, ensure that you know you do set aside prioritized time. And I think when the kids see that, then they are probably, you know, more, more willing to accept. You know that there may be periods of time where you're just not available. Right? So you know. What did I do when my son was about 8 years old? He had been playing hockey, and then he said that he wanted to quit. And I said, Well, okay, well, what are you gonna do then? You know, we gotta do something with your time. And I said, Well, what if I coach? And he said, Okay, yeah. Then I'll play. And so for the next 10 years I coached. I coached hockey and I ended up coaching, he played on 2 teams. I coached both teams. And you know I realized that, you know, here was an opportunity for priority time. It was set scheduled opportunities.   made a conscious decision to sort of say, okay, regardless of what I was doing at work, and and you know, unless I was dealing with an emergency. But regardless of what I was doing, that was time for, you know, for my son, obviously my wife came to all the games, and so on. So I set that aside as a priority. If I was in a meeting, or if I had some commitment and I'd look at my watch, I'd say, okay, I have to go because I have to get to the arena to coach hockey. So I ensured that was a priority. So I you know, I think you know, maybe early on based on that quote that I said from my young son previously, they, you know, weren't weren't entirely understanding of what my priorities were, I think, because they saw me, you know, making some efforts to, you know, ensure that I spent some protected time with them. They came to understand that. yeah, that I do have obviously, these large commitments at work and they're willing to sort of meet me in the middle

Radha Sharma: Yeah, what has been the best part of being a parent to your adult children now, or your young children back then?

Peter Ferguson: So, I mean some of the activities that we do together, you know, have been amazing. We all love travel and the nice thing about being a physician is that you know you can travel a fair amount, you know you've got the wherewithal to sort of set your own schedule and be able to afford to take trips. So we just have phenomenal memories of traveling all over the world. I did my fellowship in the UK and so my kids were 3 and 5 when we went over there. And so we, you know, traveled all around the UK. We traveled to Europe, the Canary Islands, all kinds of things like that since we've been back, and I've been working, you know we've taken them on tons of trips oftentimes coinciding with conferences and meetings, but it's still an opportunity, you know, for them to see parts of the world that that they otherwise wouldn't get to see. So you know, been to Alaska a couple of times, all over Europe, to Japan, China like you name it. We've been almost everywhere with them. And it's just a phenomenal experience to be able to share with your kids.

Radha Sharma: We ask all our guests this, if you had a magic wand and could go back and change anything about your journey thus far, would you and why?

Peter Ferguson: I'm in some ways jealous of the priorities that we have set for our trainees today, and ensuring that time is set aside for family life and time outside of work right? So you know we've mandated to our trainees that they have to go home post call. I mean that’s the rule. in the past, it wasn't a rule, or if it was a rule, it wasn't enforced right? So we have said, look If we see you in the hospital post call you're gonna get asked to leave right? And it's not punitive. It's just to ensure that everybody's focusing on their on their health and well being, and part of that is attentive to their own families. So. I would say that if I had the opportunity to do it again, I would love to train today in a situation or in an environment where physician health and well being is really prioritized like it wasn't prioritized 25 years ago.

Radha Sharma: Is there any advice you have for those medical trainees that might be medical students or residents, or maybe even physicians that are early on in their career that you'd like to impart to our listeners?

Peter Ferguson: Yeah, I think, there are people that probably do still think that this is a bit of a taboo topic, right? And they don't want to bring it up with, you know, with their programs, with their supervisors, with their program directors, or anything like that. And I really want to sort of dispel the myth that you know, parenthood and attention to family is not valued by certainly people in the surgical disciplines. I think that that's very old school thinking. And so, you know, I really really would encourage people to have a very early conversation with people that are, you know, responsible for their training and you know, if somebody is entering training and and you know they're thinking at some point they, you know, want to start a family within a couple of years of entering training, they should have that discussion with their program director right off the bat. I'd say program directors are welcoming to these discussions. And there's no doubt that training today is flexible enough that this can be incorporated into it. I think that, you know this should be welcomed. This should be encouraged. I think starting a family during training, I don't think it's going to be much different than starting it during practice. A little bit in terms of the obligations, taking examination, that sort of thing needs to be considered. But you know, I don't think people need to sort of say, well, I'm going to wait till I get into practice to start a family right like I think if the time is right for you when you're a trainee, you should absolutely do it.

Radha Sharma: Our last question for you, in the name of the podcast, Dr. Ferguson, are you thriving or surviving?

Peter Ferguson: Ooh, that's a good, that's a great question. I would say, as a trainee and probably early in my career I was surviving. But I would say at this point in time now, that I've moved on to thriving.

Radha Sharma: This concludes episode 17. We just want to give you another thank you on behalf of the entire team at familyplanningfordocs.com. It was an absolute pleasure chatting with you and hearing your perspectives. You can find our guest’s contact information in the notes from today's show. This is Dr. Ferguson and Radha, signing off.

Peter Ferguson: Thanks very much.