Dr. Jane Lea is one of the co-instructors for SURG 518: Surgical Care in Canada’s Rural and Remote Indigenous Communities with Global Comparisons. Read on to learn more about Dr. Lea’s path to pursuing otolaryngology, involvement in BC First Nations communities and top advice for students interested in global surgery!
Why did you pursue a career in medicine?
I was late realizing medicine was the right path for me, and I had a circuitous route to medicine. It wasn’t something I ever thought that I wanted to do. I did my undergraduate degree in exercise science, thinking that I would go down a physiotherapy or kinesiology route.
I completed my undergraduate degree at George Washington University in Washington, D.C.– I went there to play soccer on a scholarship. My whole life was all about soccer, all I wanted to do was play soccer. After graduating, I took two years off to pursue soccer and played for the national team squad and semi-professionally. All I really did was train, and medicine was not in the forefront of my mind.
But during that time, I realized that the money I was receiving to play soccer was not quite enough to make ends meet. I started working as a ward clerk at the Emergency Department at Mount Sinai Hospital in Toronto, checking in emergency patients and inputting their demographics. In the first year, I got involved with pneumonia research as a research assistant through chatting with one of the emergency doctors. The research required me to take a course on phlebotomy, and I realized the procedural aspect was something I really liked. From there, I got into medicine– I transitioned from ward clerk to research assistant at Princess Margaret Hospital with one of the radiation oncology doctors and then I applied to medical school. At that point, I still wasn’t a hundred percent sure about medicine and I applied to a lot of different programs, including physiotherapy.
When I first entered medicine, I thought I wanted to specialize in Orthopedics because of my athletic background. However, throughout medical school and residency my interest in head and neck anatomy led to the realization that I wanted to work on the smallest bones in the body instead (in the ear) and given the size of my biceps it was a much better fit as they were easier to operate on!
Sometimes I look back and think, I have no idea how I ended up becoming a doctor. It was just something that evolved without me really pushing for that path. Sometimes, it depends on who you meet, and I think that really was the case for me. It was those who I met, and those that made time for me and took time out of their day to care.
What attracted you to otolaryngology?
I really love the diversity in Otolaryngology. I realized that I like to operate using the microscope on very fine structures, which is how I ended up in ear surgery. I liked microvascular surgery as well; intricate small spaces are what I found most interesting.
In retrospect, the path toward Otolaryngology-Head & Neck Surgery was largely due to mentorship; all the Otolaryngologists that I met were happy and their enthusiasm for the field was contagious, and I think that was a reason why I gravitated to apply to Otolaryngology. My interest in ear surgery then led me down the fellowship sub-specialization route.
Are you currently involved in any research projects or projects in general?
I am involved in a diversity of projects, but the project I am most passionate about is setting up a surgical coaching program for staff surgeons. After residency and fellowship no formal support system helps you along the path of continual improvement as a staff surgeon and I am trying to change that culture by initiating a surgical coaching program at Providence Health – this project helps me bridge my passion for sport and coaching to medicine.
In addition, I enjoy participating in quality improvement initiatives. I recently completed the physician led quality improvement program and with the help of the program initiated several projects to improve access to care and quality of care for those with hearing and balance disorders in the province of BC.
I am also involved in various clinical research focused on hearing loss (primarily cochlear implantation) and projects related to disorders of the vestibular system. In terms of global surgical research, I am involved in a study on hearing loss prevalence within remote First Nations communities.
Could you tell us more about the work you do with the First Nations population in B.C.?
The outreach I do with the First Nations population in B.C. started about eight years ago after I finished my fellowship. My initial exposure to global surgery was as a resident with outreach to Ethiopia, followed by travel to Uganda in my fellowship and then Guatemala as a staff surgeon.
I experienced internal conflict traveling abroad because I was aware that there was just as great of a need at home. It shifted my perspective on how I wanted to do outreach and I started to explore what I could do within my province within the remote and rural populations or marginalized populations that struggled with access to care. During that same period of time, I was reading more about Canadian history, specifically regarding the history of Indigenous peoples in the country now called Canada; I started the process of uncovering the void that was not taught to me in history class in school. The more that I read, the more I became passionate about helping Indigenous patient populations and communities. I struggled coming to terms with some of the truth of how our country has become what it is now and the intergenerational trauma from colonization, residential schools and Indian hospitals, as well as a multitude of other atrocities. To be honest, it was genocide. For me, this was where I felt that I could maybe do something small to help.
A lot of rural and remote patients travel long distances, driving 15 hours or taking ferries or flights for a 15-minute appointment. It seemed more cost effective for specialists to do the traveling and see many patients during a visit versus multiple patients and family members needing to take time off work and undergo extensive travel. Also, it gave me the privilege of seeing some of the most beautiful parts of our province and the unique experience of working and being a visitor in a remote First Nations community. It has been an enriching process for me and I’ve learned a great deal; hearing personal accounts from patients about the impacts of residential schools has been a difficult but impactful truth to process.
The best part of my job is collaborating with First Nations communities. We partner with the community to find out what they want and need from us so we’re not going with our own agenda. We do different things in each community outside of direct clinical care depending on the needs identified (educational sessions for family doctors/noise induced hearing loss prevention programs for elementary schools/hearing screenings and ear checks in schools).
I sometimes wonder if part of my passion for First Nations health is related to guilt about Canada’s history and the inherent role that I and my ancestors have had on Indigenous peoples over the last several hundred years. There is an intergenerational issue– just imagine if your kids were taken from you. The whole cultural impact of that, and the impact on the family unit for future generations. I can’t imagine being a mother and have my child taken from me against my will. There are so many things that were just so wrong, and it has turned into a passion for me.
Outside of your practice and research, what do you enjoy doing in your spare time?
I can’t play soccer anymore because I have essentially wrecked my knees, so I’ve had to find other ways to be active that doesn’t hurt as much. Now, I do a lot or road cycling and gravel cycling, which is where I spend most of my free time. I also have two dogs and I love spending time with them and my family, hiking in nature. I have a wonderful family and I’m happiest when I’m home with my family because they are beyond awesome.
What is your number one advice to someone who would like to pursue global surgery?
Make sure that when you think about global surgery, you don’t negate the needs of your home community. Global surgery doesn’t have to be outside of your province or your country. A lot of people talk about humanitarian or international health, and it gives the wrong impression that you have to leave your home to have an impact. It really is just about reducing inequalities throughout the world and you have to look at inequalities that are happening at home as well. Consider rural, remote, marginalized or disadvantaged populations at home, and think about what you can do to help them. I think that’s an integral part of global surgery.
Can you share a highlight of SURG 518?
For me, it’s about the personal growth that I’ve experienced teaching the course. There have been some incredible students in that course that have helped my personal growth. Specifically, the family physicians that are involved that have Enhanced Surgical Skills– the way that they share their experiences has really educated me about how rural medicine is carried out. That been a great learning experience for me. I’ve also learned a lot from my co-instructors, Dr. Nadine Caron and Dr. Melanie Morris. Having First Nations instructors in the course has been insightful and I’ve learned so much from their contributions on the online discussion platform. As much as I am teaching the course, there is so much growth that has happened for me by being involved.
Do you have anything else you would like to share with us?
The Master of Global Surgical Care is a great and diverse program. I’ve taken SURG 510 as a student about eight or nine years ago, before the Master program existed, and that triggered my interest in global surgery in a more academic way. Had the Master program been available back then, I likely would have taken it.
View Dr. Jane Lea’s full biography here.