Dr Estelle Ouellet

Tuesday, February 25, I had the chance to speak with Dr. Estelle Ouellet, Chief Resident of the Department of Psychiatry at the McGill University Health Center (MUHC). I discovered a generous and remarkable woman with a singular and impressive career. In fact, it was after having completed a college diploma in human sciences, as well as a bachelor’s degree in economics and a master’s degree in public administration at Queen’s University, that she was recruited in Ottawa by the Department of Finance under the Harper government. Dr. Ouellet subsequently tried to find her way in two other departments before finally starting medical studies at the age of 28.

Can you explain the path that led you to a career change, and the steps you had to follow?

After all my academic and professional career, I did not feel useful and I was no longer stimulated by what I was doing. I decided to go on a trip with my brother, and I had several thoughts. It was the latter who encouraged me to go to medicine. He believed more in me than I believed in myself. I was pretty stressed not knowing if this plan was going to work. I told myself, however, that I was still quite young, that I had no family and therefore that the collateral damage would be less if my new plans did not work. So I signed up for the prerequisite course at the University of Ottawa while working alongside the ministry. My goal was to check if I was still able to study, and I was delighted to find that this was still the case.

So I completed the prerequisites for my admission and applied wherever I could. To my surprise I was admitted everywhere! Coming from Montreal and being uprooted too often for my studies and work in the past I decided to opt for the University of Montreal.

Initially, I intended to practice family medicine, but during my internships, I discovered that I did not feel at home there. I had left my old profession because I did not feel useful there and I did not want to relive the same thing. It was during my internships in psychiatry that I realized that it was in this area that I was finally going to feel useful. Finding my way gave me the energy to do the three more years that this specialty required.

One of the things I like about psychiatry is that this specialty is not over-governed by guidelines. Each diagnosis has its particularity because they are essentially syndromes. Knowing the life course of patients is essential to formulating a diagnosis, and to help them, it is necessary to succeed in making contact. Each patient is a challenge in itself, and helping people with mental health issues is very meaningful to me.

What were the biggest challenges you encountered during your transition from the social sciences to medicine? What is your greatest achievement?

I was very concerned during my pre-med with my “difference”, whether in terms of age, my educational background or my socio-economic background. The medical cohorts are very homogeneous and I found it difficult to develop a sense of belonging. This feeling of “difference” has accompanied me over the 12 years that my journey has lasted, but I accept it more now.

I used to perform very well both at university and in my work. I encountered difficulties at the start of my medical studies. While the narcissistic wound of not being the best was digested fairly quickly, the fear of failure was a great source of stress throughout my journey.

During my first studies, I especially developed a capacity for global analysis and made little memorization. Learning concepts such as molecular cascades was difficult because I was critical that these concepts would not be useful in my clinical practice. So I found it difficult to have to memorize things that I found unnecessary.

My biggest achievement is finding my way. I am proud to have found the job that gives meaning to my life and that makes me feel useful even if at times the way to get there was difficult.

What are the impacts of your social science journey on your daily practice?

I think the social science side means that the social economic determinants of health are already well assimilated in my practice. When I see a patient, it is natural for me to inquire about work and family … I believe that the concrete impact of my studies in social sciences is my critical sense. I have a historical perspective on the liberal profession of medicine. I have a critical sense in relation to corporatism which is deeply rooted in the medical profession in Quebec. I have been involved in MQRP (Quebec Doctors for the Public Plan) since the start of my residency, and on a daily basis I therefore do activism at work, among other things by not using my title. In addition, I have a great deal of listening to other health professionals, such as physiotherapists and occupational therapists during times when we work as a team. I believe that it is not necessarily the doctor who must manage everything during her meetings. I think that’s how my journey in social science translates into everyday life.

Do you think other health professionals could benefit from more social science training?

Yes totally! The pure sciences should, in my opinion, be taught in a different way. The DEC in natural sciences should make it possible to integrate a critical aspect into learning. The way social science is taught today is good for future doctors.

It should be remembered that in the other Canadian provinces, medical students have previously completed a baccalaureate. They were able to have other experiences and develop their skills differently. Although the DEC in natural sciences deals with subjects that may be important for medicine, it covers other subjects that they are not, and does not deal with other subjects that could be beneficial such as sociology, politics and anthropology.

I am of the opinion that CEGEP could be used in a more beneficial way for future physicians by allowing them to develop their skills and critical thinking.

What are the challenges for women in medicine in 2020?

I think that, as in all professions, the greatest challenge for the future female doctor is motherhood. Starting a family and occupying a position of authority for a woman is still a challenge in 2020. Maternity requires a moment of career break, which can make it more difficult to reach managerial positions. Equity is not achieved in all couples and therefore for the moment some men can afford to be less present at the family level to favor their career.

The desire to take good care of children, to perform well at work and to keep a good balance of life requires women to be superwoman. An additional challenge for doctors is that they are self-employed. Maternity leave therefore requires additional planning. We have to find people to replace us, to follow up on the files of our patients on maternity leave. We must also consider that residents who have children must take a one-year break and therefore lose their cohort, do not consolidate their learning during this time and do not practice. There are also no gradual returns in all residency programs, which can make return difficult.

I admire the women who have children at the residence. In my case, these aspects played an important role in my decision not to have children during the residency. It is important to know your limits, but of course everything is a matter of choice and compromise.

If you had a piece of advice for young women who are in a situation similar to what you have experienced, what would it be?

The important thing is to find your way and be good at what you do. We must also have a certain resilience in the face of our study, that is to say that we must agree to learn certain things even knowing that they will not be useful.

For young women and men who experience as much stress as me during my pre-clinic: if I could have concentrated my energy on the tasks to be accomplished one day at a time rather than investing in my fear of passing my exams, to make negative predictions, I think I could have done more than survive. I just recommend taking it one exam at a time, one step at a time.

The doctorate in medicine puts a lot of pressure on students by asking them to excel in multiple different spheres. Medicine is like an Ironman, you can’t sprint all the way. It is important to plan your curriculum step by step, measure your expectations for your studies and yourself and allow yourself time to adapt. It is also important to accept that certain learnings seem of less importance to see ridiculous, it is necessary to see its learnings like a rite of passage and not to lose energy to be shocked against its imposed rituals.

Finally, in terms of this feeling of difference that has accompanied me for so long … I would say to these young women that the difference is not serious, everyone has their own ways of learning and being. The more different people there are on the different paths, the better medicine will be.

Following the end of her residency, Dr. Ouellet will continue her career in psychiatry by starting a fellow in the mental health pavilion of Sacré Coeur, Albert Prévost, in strategic family therapy. She is heading for a position at the relational and personality disorders clinic. She plans to teach alongside her practice and continue to get involved in administrative positions.

The interview ended on an excellent note and very good advice. I wish Dr Ouellet great continuity and success in her next projects.