PGY-5 Adolescent Medicine – University of Toronto
Hi! My name is Simone Lebeuf and I am a Pediatrician and second-year Subspecialty Resident (PGY-5) in Adolescent Medicine at the University of Toronto.
I grew up in Edmonton, Alberta and started in General Sciences at Grant MacEwan College and transferred to the University of Alberta to complete a Bachelor of Science in Psychology. I attended medical school at the University of Calgary and completed my core Pediatrics training at Alberta Children’s Hospital in Calgary.
Teens are resilient, creative, and endlessly entertaining! Adolescence is an intense time of transition both physically and mentally. My interest in medicine has always been in the biopsychosocial domain, as well as the Mind-Body connection. There is a lot of room for variety and growth in the field of Adolescent Medicine. It allows me to combine interesting medical cases, sexual health, and mental health.
What does a typical day of clinical duties involve?
A typical day depends on the rotation. We cover inpatient Eating Disorder ward several times per year, which entails an earlier start. Most of the time we are in the ambulatory setting and clinics will start around 9. Our program also has a lot of continuity-based learning, so there is constant variety every day!
What kinds of rotations (clinical, research) are required in your specialty/subspecialty/area of focused competence/enhanced skills program?
Adolescent Medicine is a Royal College-accredited specialty. From the Royal College Subspecialty Requirements, we must complete rotations involving, “general adolescent health, eating disorders, sexual and reproductive health, mental health, substance use and abuse, and chronic conditions. This experience must include inpatient, ambulatory, and community settings, and allow the resident to provide consultation as well as longitudinal care.”
Which of your personality characteristics have been particularly helpful in your field?
I think humour and flexibility are important. Humour, because otherwise teens will drive you crazy! Flexibility, because things don’t always go according to plan, and sometimes we just have to roll with resistance and stay in a more supportive role until a teen is ready for change. I like to collaborate with others, which serves well in understanding the goals of a patient, as well as working in a multi-disciplinary field.
What are the best aspects of your specialty/subspecialty/area of focused competence/enhanced skills program?
My favourite aspect has been building working relationships with youth! I’ve felt very lucky to get to know some amazing teens during my fellowship and hear their stories. I also really enjoy the multi-disciplinary aspect of Adolescent Medicine. We work alongside nurse practitioners, social workers, addictions counsellors, dietitians, child and youth counsellors, nurses, and psychologists, as well as healthcare providers from other areas of specialty, and I learn something new every single day.
What are the most challenging aspects of your specialty/subspecialty/area of focused competence/ enhanced skills program?
It can be frustrating to deal with abusive family dynamics or complex psychosocial situations that we are unable to change. There are also a lot of challenges navigating and accessing services for patients with mental health struggles.
What is one question you’re often asked about your specialty/subspecialty/area of focused competence/ enhanced skills program?
“What exactly IS Adolescent Medicine?” A lot of people assume it is Psychiatry, and it isn’t! We do address some mental health concerns, but it is more suitable to compare Adolescent Medicine to a Developmental specialty. It is a specialty that focuses on the development of adolescents and common health conditions that arise during this time period. Typically, we see patients aged 12-24, and manage eating disorder care, transgender health, substance use, sexual health concerns like STIs and contraception, chronic illness, and transition to adult care and street involved youth. The possibilities are endless, and the general focus can vary depending on your interests!
Can you describe the transition from junior resident to senior resident/fellow?
Overall, I was really excited about the transition from resident to subspecialty resident and was ready to take on a new role. I think the biggest challenge was writing the Royal College for my core specialty. Last year, I was trying to get research off the ground and learn about Adolescent Medicine. I was also studying for the Pediatrics Royal College Exam, so my attention felt split at times. We have an amazing Program Director and Division, so I always felt well-supported.
If applicable, can you describe your experience with the subspecialty matching process? What resources did you find helpful for this (e.g. choosing electives)?
There are very few training programs for Adolescent Medicine across Canada. I was able to do an elective at both Sick Kids and the University of British Columbia (UBC) in my second year of residency.
The subspecialty matching process can be stressful – in Pediatrics we start applying midway through second year, so making career decisions early on in your core training can be challenging. As well there are limited Adolescent Medicine spots across Canada, so it can be a fairly competitive specialty to match to. I was supported a lot by mentorship relationships with the Adolescent Medicine faculty at the Alberta Children’s Hospital.
Will you be pursuing further training or looking for employment? What resources are available to you for future planning?
I am in the process of looking for a job. Adolescent Medicine is an up-and-coming field, and there are lots of opportunities for both Academic and Community practice. My Division and Program Director have been extremely helpful in providing career advice both in formal settings such as Academic Half Day as well as through mentorship roles.
What are your academic interests (e.g. leadership activities, research)?
Based on my own life experiences, my main area of interest is the care of Pregnant and Parenting Adolescents. As well I have been involved in Physician and Trainee Wellness. I am also interested in Healthcare for Transgender Youth, Attention Deficit Hyperactivity Disorder in Adolescents, and Somatization Disorders.
What is your work-life balance like, and how do you achieve this?
I’m a Mom to a wonderful 11-year-old girl! When I am at home, I focus my energy on being fully present for my daughter. We enjoy travel, hiking and being active in nature, trying new food, and reading (for fun and for work). In order to manage balance being a primary parent and a resident/fellow I’ve had to be very organized and structured with my schedule. I also have had to learn to ask for help when I need it! I depend a lot on my family and friends. Adolescent Medicine allows for a well-balanced lifestyle, and that is one of many reasons I chose to pursue it!