Stephanie, OB/GYN PA - Maternal Fetal Medicine
Stephanie is a McMaster PA Graduate, and Canadian Certified Physician Assistant working in Obstetrics and Gynaecology.
Stephanie opens up about her background, the path that led her to become a physician assistant, and her fulfilling role in high-risk obstetrics.
Discovering the Passion for Healthcare
Stephanie's journey in healthcare began early on, during her undergraduate studies at Western University. Majoring in physiology and delving into pharmacology courses, she knew she wanted to be part of the medical world. Her natural curiosity and desire to help others led her to shadow physicians, including obstetrics and gynecologists. It was during this time that Stephanie found her interest in maternal fetal medicine, where she could make a meaningful impact on the lives of mothers and their unborn children.
"I had a great opportunity to shadow some physicians, actually some obstetrics and gynecologist physicians as well. And I was actually able to have the opportunity to do some research in entry during growth restriction and was able to get a publication out of that actually. So I think I was well equipped going into the PA program with all of that background," Stephanie explained.
Deciding to pursue a career as a PA
With a multitude of healthcare career options before her, Stephanie considered each possibility carefully. She contemplated the arduous journey to becoming a medical doctor but realized that the long hours might not align with the lifestyle she envisioned. Other professions, such as genetic counseling and nursing, also caught her attention.
Stephanie stumbled upon a profession she had never heard of before—the physician assistant program. Intrigued by its potential, she embarked on further research and discovered that there was a Canadian program as well. The allure of becoming a physician assistant, with its unique blend of medical expertise and flexibility, resonated deeply with Stephanie.
"In trying to pursue what I wanted as a career, one night looking through the internet, trying to figure out what would be good for me, I kind of stumbled on the idea of the physician assistant program," Stephanie recalled.
Stephanie’s Experience in McMaster’s PA program
1st year PA School: Mastering the Art of Self-Directed Learning
During her time at the McMaster PA program, Stephanie discovered a passion for self-directed learning, an aspect that initially made her apprehensive. Coming from a didactic undergraduate background, she had little experience with problem-based learning. However, Stephanie quickly found that the flexibility and self-scheduling of the PA program worked remarkably well for her.
"I loved it. I was a little nervous about the self-directed learning aspect of it, because coming from an undergrad that was very didactic, I had no experience with problem-based learning... And being able to self-schedule myself and study and work when it was best for my personality and my lifestyle, I think really helped with that," Stephanie shared enthusiastically.
Gaining Practical Experience through Longitudinal Placements
Stephanie's PA journey included exciting longitudinal placements (LPs) that allowed her to gain hands-on experience in various healthcare settings. Her first LP was with a practicing PA, Deniece O'Leary, in a family clinic. Although it was early in her training, Stephanie's exposure to patient care under a PA's guidance left a profound impact on her.
"My first LP was actually with a fellow PA, Deniecee O'Leary, in the family clinic that she was at, I was able to get some, my first real hands-on experience with some patients, even though it was just taking some small histories or practicing my examination skills, it made a big difference early on," Stephanie recalled.
Stephanie's other LP experiences included time with EMS, gaining insights into pre-hospital care, and an inspiring rotation in obstetrics and gynecology, where she explored the realm of fertility.
2nd year of PA SChool: Clinical Clerkship
The second year of the PA program, known as clerkship, proved to be an eye-opening experience for Stephanie. Working alongside real-life patients and witnessing clinical scenarios firsthand accelerated her learning and retention of medical knowledge.
"Clerkship was an eye-opening experience as well. I always tell people who are in the PA program now that you're gonna learn at such an accelerated rate in clerkship compared to what you're doing on your own reading about it," Stephanie explained.
Exploring Elective Rotations
Stephanie strategically chose elective rotations that aligned with her interests and offered opportunities to explore different medical specialties. In maternal fetal medicine, she gained valuable insights and impressed her future employers.
"I did four weeks there. And it was a great way to get an introduction to an area of medicine that I was very interested in. And it almost acted, I think like a preliminary job interview. So my bosses now got to know me as a student and see different aspects of my personality if I worked with the team, and hopefully, you know, that lands you with a job, and for me, it did," Stephanie said.
Apart from maternal fetal medicine, she delved into internal medicine subspecialties like endocrinology and cardiology, as well as a neurosurgery elective that challenged her in an area she considered her weaker suit.
Stephanie’s Experience with the PA Job Hunt
As graduation approached, the uncertainty of where she would work loomed over Stephanie, a common experience for many PA students. Despite the stress, Stephanie remained open to relocating for the perfect job opportunity.
Her optimism and proactive approach in seeking job opportunities even before graduation exemplify her determination to find the ideal path in her healthcare career.
"So it was a really big unknown at first. As I think it is with all PA students where you're gonna end up afterward, and there's a little bit of stress with that... But I kept an eye out for any job opportunities that came up after I graduated. And I even kept an eye out before school even ended, just to see if there was something that I could apply to even before graduating," Stephanie shared with a sense of eagerness for the future.
Fulfilling Dreams in Maternal Fetal Medicine
Stephanie's dedication and perseverance paid off when she graduated from the McMaster PA program. Her passion for maternal fetal medicine led her to pursue her dream job, where she could provide specialized care to expectant mothers facing high-risk pregnancies.
"I fell in love with Hamilton when I was there. I really liked the outdoorsiness of it, but still a big city, so I wanted to stay. And it just so happened that when I graduated, there was a great job opportunity that was actually my dream job in maternal fetal medicine. So I took that job there, and it ended up working out really well." Stephanie joyfully shared.
Maternal Fetal Medicine (MFM): Bridging Medicine and Pregnancy
Working as a PA in High Risk Obstetrics/MFM
Stephanie's role as a physician assistant in maternal fetal medicine places her at the heart of a subspecialty within obstetrics and gynecology. This field focuses solely on pregnant patients who often face additional medical complexities, whether maternal or fetal in nature. The cases she encounters vary widely, ranging from rheumatologic diseases in expectant mothers to genetic anomalies in the unborn children.
"Maternal fetal medicine is a subspecialty of obstetrics and gynecology that really focuses on obstetrics only... So an example of a maternal pathology that we see a lot is rheumatologic diseases and pregnancy. Many young women have things like lupus, for example. Some people have cardiac pathologies, whether it's something congenital that the mom themselves were born with or something acquired later on in life," Stephanie elaborated.
Working with a Distinct Patient Population in MFM
The patients Stephanie cares for in maternal fetal medicine present unique challenges due to their pregnancy status.
Pregnancy itself often adds complexity to medical cases, which can be unsettling for other care providers not specialized in obstetrics. As a result, maternal fetal medicine PAs like Stephanie serve as crucial liaisons between medical management and the complexities of pregnancy.
"The big obvious thing is that they're pregnant. So a lot of time pregnancy is a big black box for a lot of care providers... Where maternal fetal medicine comes in is that we bridge that gap between the medicine and the pregnancy," Stephanie explained.
PAs in MFM: A Multi-Faceted Role
Stephanie's role as a physician assistant in maternal fetal medicine is multifaceted, encompassing both outpatient and inpatient settings. In the outpatient clinic, she spends significant time with new consults, conducting comprehensive histories, physical examinations, and ordering essential diagnostic tests like obstetric ultrasounds. Her dedication to patient education and counseling shines through as she guides expectant mothers through their high-risk pregnancies.
"I have, I think, a pretty unique role as a PA in maternal fetal medicine because I not only get to do outpatient, but I also get to do inpatient... I'll see usually new consults that come in. So I get to spend a lot of time with these patients doing histories and physical examinations... Sometimes people aren't even sure why they're here in the high-risk clinic, so I have to really start from scratch with that," Stephanie shared.
In the inpatient setting, Stephanie rounds on patients admitted due to medical or obstetric complications, adjusting their management plans as needed. Her involvement extends to assisting with cesarean sections, being present during deliveries, and handling undifferentiated cases in the triage unit.
Embracing Variety and Making a Difference
The dynamic nature of maternal fetal medicine is one of the aspects that Stephanie finds most exciting. Every day brings a diverse array of cases, ranging from specific pregnancy complications to complex medical conditions. The unpredictability keeps her engaged and on her toes, ready to tackle any challenge that comes her way.
"The big thing that gets me excited I would say is the variety that I see. Going into work, not really knowing what to expect keeps me on my toes and keeps it enjoyable," Stephanie shared.
However, it's the impact she can make on her patients' lives that truly fulfills her. The unique position of maternal fetal medicine during such a pivotal time in a couple's life allows her to provide guidance and support, making a positive difference in their pregnancy journey.
"The other thing that I really like is the patients that I see. I really value my role in being able to sit down and talk to patients and explain things. Maybe take a little bit of time to explain things even a second or third time until people understand. And I really value that I can come to work and make a big difference in someone's life," Stephanie reflected.
Navigating Emotional Challenges
While maternal fetal medicine is a deeply rewarding field, it also comes with its emotional challenges. Stephanie acknowledges that the nature of high-risk obstetrics means dealing with difficult news and emotional situations. Patients may receive upsetting diagnoses or face unexpected outcomes, leading to emotional strain for both patients and healthcare providers.
"One of the big challenges, I would say on a day-to-day basis is sometimes it's not, you know, the happiest area. Sometimes there's very bad news to give about a pregnancy that's not going as expected or even a stillborn baby. So sometimes it is hard," Stephanie admitted.
Despite these challenges, Stephanie maintains a resilient perspective, understanding that her dedication and the positive impact she brings to her patients' lives outweigh the difficulties faced in the field. She finds solace in knowing that her role makes a meaningful difference during a critical and sensitive time for expectant families.
A Harmonious PA-MD Collaboration
Stephanie's work closely aligns with the maternal fetal medicine specialists, forming a collaborative and supportive team for high-risk pregnancies. While some may perceive that subspecialized areas might diminish PA autonomy, Stephanie emphasizes the advantages of working closely with experts in rare medical conditions and genetic complexities.
"With a more subspecialized area, sometimes PAs lose a little bit of autonomy, but I don't think it's a bad thing. Because I'm working very closely with people with extra training and a wealth of knowledge and information about sometimes very rare conditions and presentations" Stephanie explained.
The dynamic collaboration between PAs and MDs in maternal fetal medicine ensures comprehensive and patient-centered care, benefiting mothers and their unborn children throughout their high-risk pregnancies.
Collaboration and Growth: The PA's Impact in Maternal Fetal Medicine
Meeting the Growing Need for Maternal Fetal Medicine
With the growing demand for maternal fetal medicine services, the addition of physician assistants has played a crucial role in ensuring timely and comprehensive care for pregnant patients. Stephanie believes that the increasing need for these specialized services may be influenced by factors such as women delaying pregnancy until later in life or developing comorbidities at a younger age. As a tertiary center, their clinic often receives patients from various regions, necessitating efficient and accessible care.
"I think when the PAs came on, it was at a time where there was a bigger and bigger need for maternal fetal medicine. Adding on the PAs has allowed our clinic to accommodate that need. Being a tertiary centre, we can't say no to people who are coming from far and wide needing our hospital for various reasons. So adding PAs has allowed the service to see patients in a timely fashion, which you have to when they're pregnant because you can't have a six-month waiting list," Stephanie expressed.
Furthermore, the inclusion of PAs in maternal fetal medicine has helped distribute the workload among a larger team, alleviating the burden on other healthcare providers and ensuring comprehensive care for all patients.
Management and Medication Initiation
In maternal fetal medicine, patient management is a key aspect of Stephanie's role as a physician assistant. While prescribing medications during pregnancy is less common due to the unique considerations of the condition, Stephanie plays a pivotal role in initiating management plans and counseling patients about their treatment options.
"We do a lot of management with patients. Medications themselves are not as common with pregnancy, so there are only a few select medications that we do use... I'll talk to a patient about the medications and start that initiation process," Stephanie explained.
A Residency-Like Experience with Long-Term Benefits
Drawing parallels to a resident, Stephanie concurs that working as a PA is akin to having a resident who never leaves the practice. The enduring presence of PAs allows them to observe the intricacies of patient care, learn the preferences of different specialists, and contribute to the continuity of patient management.
"I would definitely agree with that statement that a PA is very similar to a resident... When a PA is there more long term, you can see how each different specialist maybe has a certain preference in ways in that you would manage patients, and being there long term, you can pick up on that a little bit more," Stephanie reflected.
She also highlighted the key difference between OB/GYN residents and PAs in the surgical domain. While residents focus on surgical training, Stephanie's role revolves around being a first assist during procedures—a distinction that complements and enriches the collaborative environment.
Strong Collaborative Relationships with Allied Health
Within the healthcare team, Stephanie fosters robust connections with nursing staff and other allied health professionals. Her familiarity and tenure in the field have led to seamless interactions, making her a reliable point of contact for various concerns.
"I think we interact very well with other allied health... They know they can page me, and I'll always answer. So I think that's been helpful to them. We work closely with dieticians especially with our diabetic population and with the physicians, of course, as well," Stephanie affirmed.
Staying Current in Obstetrics and Gynecology
In the ever-evolving field of obstetrics and gynecology, staying up-to-date with the latest research and guidelines is crucial for providing the best care.
Stephanie ensures that she remains well-informed by being an active member of the Society of Obstetricians and Gynecologists of Canada, where new research and guidelines are frequently shared.
"I am lucky enough to be a member of the Society of Obstetricians and Gynecologists of Canada, and they post a lot of new research and guidelines all the time. So I try to keep up to date by reading that," Stephanie explained.
Working in an academic center also provides her with the opportunity for continuous learning through weekly rounds focused on obstetric topics. These rounds allow her to delve into various subjects related to obstetrics and gynecology, ensuring she stays informed on the latest advancements and practices.
"Being in an academic center, there are weekly rounds that happen. People go over different topics as it relates to obstetrics." Stephanie shared.
Additionally, Stephanie takes the initiative to research specific topics or conditions related to her patients' cases. This proactive approach ensures that she is well-prepared to provide the best possible care for each patient she sees.
"Of course, I go home and read around certain patients that I know I'll be seeing in the clinic if I know it's something that I haven't seen before." Stephanie added.
Attending conferences is another valuable method Stephanie uses to stay abreast of the latest developments in her field. She highlights several conferences held at Mount Sinai Hospital in Toronto, where maternal fetal medicine specialists and experts from tertiary centers across Ontario present talks on various topics in obstetrics and gynecology.
Tips for Aspiring PAs Interested in Maternal Fetal Medicine
For PA students aspiring to pursue a career or an elective in maternal fetal medicine or obstetrics and gynecology, Stephanie acknowledges that opportunities may be limited, given the relatively small number of PAs in this specialty. However, she emphasizes the significant impact PAs can make in this field and encourages students to seek advice and guidance from experienced PAs, like herself, who have firsthand knowledge of working in this area.
"It's a little bit difficult because there's not very many PAs in this area. So I think there's a lot of questions over what a PA can and cannot do. Can a PA be useful in this area? And the answer is yes," Stephanie assured.
She further urges students to engage with their preceptors and find creative ways for PAs to contribute effectively in the clinic setting. Despite the challenges, Stephanie's four years of experience in maternal fetal medicine demonstrate that PAs can play a vital role in this specialty, making a positive impact on patient care and outcomes.
"My advice would be seek advice, email me. I'm always there to help people who want to get into this area of medicine as well. And chat with your preceptor, be creative in ways that a PA can work in the clinic because I've seen firsthand that it can," Stephanie encouraged.
Dispelling Misconceptions about PAs
As the physician assistant role is still relatively new in Canada, Stephanie often finds herself explaining what a PA is and what she does to patients and other healthcare providers. She understands that providing a clear and concise explanation is essential in helping others understand the value of her role.
"When I'm asked what a PA is by whether it's patients or other healthcare providers or what can we do? I usually give a brief explanation of what I do and how I work," Stephanie shared.
However, Stephanie recognizes that actions speak louder than words when it comes to demonstrating the impact of the PA role. Building rapport with patients and showing them the knowledge and skillset she possesses is key to gaining their trust and proving the value of PAs in healthcare.
"I think if a patient is not really sure if they haven't had an experience with a PA before, telling them, you know, what my credentials are only gets you so far. I think sitting down and talking to a patient and getting a good rapport with them and showing them that you have the knowledge and the skillset to treat them and gaining their trust from that perspective is the best way to go about that," Stephanie explained.
Contentment in Choosing the PA Path
Reflecting on her journey as a physician assistant, Stephanie is unequivocally satisfied with her decision to pursue this career path. While she was initially interested in becoming an MD, she ultimately chose the PA route for various reasons, and she couldn't be happier with her choice.
"I am. I've spoken to a lot of people in other careers and every career has its pros and cons, but I'm very happy with my decision. One thing when I first started looking at medical careers, the MD route was something that I was really interested in, and I ultimately chose PA, and I'm very, very happy about that for a couple of reasons," Stephanie expressed.
The lifestyle aspect played a significant role in her decision. As a PA, Stephanie doesn't have to do call shifts, which has a positive impact on her mental well-being, especially considering her previous struggles with the demands of long hours during clerkship.
Additionally, she values the opportunity to work in a highly specialized field without incurring extensive debt or investing many years in specialized training.
"The fact that I don't have to do call shifts as a PA really impacts my mental health. The other thing is I am able to practice in a very sub-specialized area without having to go into a lot of debt and a lot of the years of life that it takes to be that type of specialist," Stephanie affirmed.
Final Notes
Stephanie's journey as a physician assistant in maternal fetal medicine showcases the vital role that PAs play in the ever-evolving landscape of healthcare. Her dedication to patient care, continuous learning, and adaptability in a specialized field highlights the immense value that PAs bring to medical teams.
Despite the relatively new introduction of PAs in Canada, Stephanie's passion for her profession and her ability to build trust and rapport with patients demonstrate the profound impact that PAs can have in providing comprehensive and compassionate care.
