Resident Spotlight: Dr. Stephanie Lammers, Obstetrics and Gynaecology
As a fifth-year resident in Obstetrics and Gynaecology, Dr. Stephanie Lammers enjoys the surgical aspects of the program, as well as the special moments with patients that energize and refuel her.
In choosing the program, she considered the wide breadth of learning opportunities, the Department’s reputation for excellence in key areas, as well as being close to family and friends for support.
What has been the most rewarding aspect of residency?
As a surgical resident, it's tempting to say that the most rewarding aspect of my residency has been gaining technical skills and improving upon them. That has certainly been a major focus of mine. One of the best things about surgery is the way we can feel as though we've begun to master something, and then suddenly find a new nuance to improve upon. Few things have been more satisfying than practicing laparoscopic suturing in our own OBGYN skills lab near our call rooms and then applying that in the OR and noticing tangible improvement. It's a great feeling. Surgery is a well-suited profession for the sort of person who finds they get energized by a challenge.
But I also think about the moments that rewarded me by making my heart most full – refilling my tank, so to speak. It's the times a patient or patient's family have acknowledged me with a letter of gratitude. These usually come weeks to months after I encountered the patient. Sometimes they come from unexpected interactions; for example, one of mine was from a notably sad case of a second trimester pregnancy loss. The patient said something similar to the idea that I had restored her faith in seeking care at the hospital, and I remember that when I got her letter, it was great timing because I was so profoundly tired at the end of a 24-hour call shift. Her letter made me feel whole and energized and ready for another shift the next day. I don't know if patients know how much their appreciation can fuel us. It really can.
Why did you choose the School’s Obstetrics and Gynaecology residency program?
Firstly, I grew up in London – in Wortley Village more precisely. I loved my childhood there. I attended Western for my undergraduate degree in medical sciences and chose the MD program at Queen's University in order to experience a new city and centre.
When it came time to apply to residency and then rank programs in “the match,” I began to reflect on the value of being close to friends and family. Once I settled on OBGYN, I decided a five-year surgical residency would make it really challenging for me to continue to maintain relationships with those I loved if I didn't live close. For any medical students reading this, it's important when choosing a residency program to consider how to set yourself up for success by keeping a strong foundation of supports, however that best works for you.
Academically, the beautiful "B" tower of Victoria Hospital and the single centre element of the core OBGYN program in London really sold me. The staff OBGYNs and residents made wonderful impressions in my interview. I felt at ease and at home. Also, I was drawn to our 6:00 p.m. OR end times. It seemed to me like if I could get as much OR time as possible in my training, it would make me a stronger surgeon and have more skills to bring to my patients' care.
What the program’s biggest strength?
As mentioned, the intermittent 8:00 a.m. to 6:00 p.m. ORs that Schulich Medicine offers across its surgical programs is a great advantage. There are many other strengths including opportunities to learn forceps from attending staff physicians who are truly masters at operative vaginal delivery, and to learn vaginal surgery in a centre well known for excellence in this approach. The program graduates well-rounded residents who also gain enough experience in total laparoscopic hysterectomy to feel competent to offer this approach too.
My favourite part of the training in OBGYN here, however, is our shared team room and handover practices. When I come in to start my day as a chief resident, for example, I hear about all the active emergency room consults that need to be handed over, any emergency board cases and anyone returning for formal ultrasound that day. The night float residents are there to provide the handover, and all the residents on for day coverage are present as well, so that we can discuss and learn from each other with any interesting cases. I think that daily chance for discussion further expands our exposure and also keeps our patient care at its highest possible level. We also have a graduated system of residents on call at any given time so that senior residents can support and teach junior residents, and that both levels of residents can access experiences most appropriate to their learning levels on any given shift.
What types of cases and patient populations do you work with?
When I tell people I am an OBGYN resident, many of them think of this only as it applies in the birthing centre. We actually work with women of all ages regarding any concerns in a pregnancy, or outside of pregnancy regarding any concerns of the female reproductive tract. As residents rotating through subspecialties too, this includes women with high-risk pregnancies, but also gynaecologic cancers, infertility and women who suffer from incontinence or pelvic floor support concerns (prolapse). Sometimes we see women in emergency situations, such as ectopic pregnancies or ovarian torsions or bleeding miscarriages and sometimes we see them in clinic for a whole host of varying concerns.
We support women in preparing for healthy pregnancies and manage complications of pregnancy as they arise. And, of course, we deliver babies by vaginal delivery or operative vaginal delivery or Cesarean section, if indicated. We work with transgender men and nonbinary individuals, in particular as it relates to gender affirming surgery. We provide contraception counselling, treatment of genital infections and sexually transmitted infections, and screen for precancerous changes to the cervix.
What learning opportunities have you pursued as a resident beyond the clinical environment?
I like to start by saying that being a resident in the clinical environment is my role first and foremost. My patients come first. But in furthering the best possible patient care, many of us seek out ways to bolster our community in the form of research, teaching, and/or advocacy work. I leaned furthest into teaching in my residency. I marked reproduction assignments for second-year medical students for many years in a temporary TA-ship, organized teaching sessions regularly as a senior resident for my more junior residents – we called this "brown bag lunch” and it has been a longstanding tradition – and recorded a core lecture for the clerks when their teaching went online during COVID-19. I also represented my program by attending a "boot camp for resident teachers" in the form of a two-day conference as a PGY3. My current research project is supported by Dr. Taryn Taylor and is a critical interpretive synthesis reviewing the literature on the concept of speaking up in the health care environment.
So much of our time in surgical residency is spent in the clinical environment, though, that I'd like to place equal emphasis on the things I have done to maintain being a balanced human as a resident. I like to do everything I can to keep up my ability to empathize with my patients and in order to do that, I have to look after myself. I used to play volleyball every week, although COVID-19 disrupted that routine. So, I recently invested in a Peloton bike – if I'm overwhelmed or not feeling myself anymore after a long day, 45 minutes on the spin bike in my basement helps sort me right out. I guess my point is, take care of yourselves, no matter what you do for a living. You can't look after others if you aren't looking after yourself.
What do you enjoy most about living in the London region?
I live in a small community just outside London. It's the best – I smile at the cows grazing in fields on my way to and from work often. There's nothing like fresh air and being able to afford housing reasonably on a resident salary.
I am also always amazed when I visit anyone in Wortley Village at the way the community has changed since I used to wander around it as a child. It's always been a vibrant neighbourhood, but it’s expanded, and the sense of community continues to be unrivaled.