Reminiscing on residency: Dr. Amy Gajaria originally thought she's have a career in journalism

When Dr. Amy Gajaria began her undergraduate studies at Montreal’s McGill University, her plan was to be a print journalist. It led her to pursue a bachelor’s degree in English literature and psychology. “I always loved science but I wanted a liberal arts degree to really learn how to think and analyze and be creative,” says Dr. Gajaria. Years later, Dr. Gajaria says those fundamentals she would have used as a journalist—interviewing people, hearing someone’s story, and understanding their narrative—have helped her in her career as a child and adolescent psychiatrist at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ont. Dr. Gajaria spends most of her week doing direct clinical work through the Substance Abuse Program for African Canadian and Caribbean Youth (SAPACCY), a CAMH program that provides support and counselling to African- and Carribean-Candian youth that are dealing with problem substance use and mental health concerns. Through her clinical work, she sees about 20 to 30 kids a week, over the span of three days.“Like in journalism, I’m able to listen to and understand their stories, but I’m also able to incorporate biology and medicine, and actually intervene,” she says.It was directly after her residency, through the University of Toronto, where Dr. Gajaria is also an assistant professor and does research at the Department of Psychiatry, when she learned she enjoyed working directly in communities. One of her first postings as a child psychiatrist was consulting for the Black Creek Community Health Centre, a community health centre (CHC) in the Humber River-Black Creek ward of Toronto, where the median annual household income ($73,000) is $11,000 below the city average ($84,000), according to the City of Toronto’s 2021 census profile. Her career also brought her to Nunavut, where Dr. Gajaria first did rotations as a resident and then joined as a staff psychiatrist in 2018. Over the last five years, Dr. Gajaria has continued her visits to Iqaluit and the Qikiqtani General Hospital on Baffin Island two-to-three times a year. There, she provides inpatient treatment and urgent care, to a primarily Indigenous community with limited child and adolescent psychiatry available. “Even working downtown Toronto, psychiatry is one of the few areas of medicine where we don’t have the finding,” says Dr. Gajaria. “You have to remember to separate work and maintain boundaries, because there’s a limit to the mental health system and what we can do as professionals.” She says it’s something she has been learning since completing her residency in 2017.Dr. Gajaria is also the inaugural associate director of equity, diversity and inclusion for the Department of Psychiatry at the University of Toronto.1. What is the biggest thing that residency taught you about being a doctor? Residency helped me understand that people—physicians and patients alike—can have the misunderstanding that psychiatry has nothing to do with other fields. People have the misconception that psychiatry isn’t connected to physical health or other medical issues like neurology. As a psychiatrist, it’s important to know how those other fields work, how physiological symptoms and other pathologies or specialties can work together with psychiatry so that you can challenge your own beliefs. It’s also important in psychiatry, because I work with a lot of young people that might not have trust in the system, and ask me a lot of questions about medical staff or primary care. While I wouldn’t give them advice on it, I know enough to sort of say ‘this is when I think you should see someone else or seek care, and I can help them to navigate that system.’I don’t think I had appreciated that part of it in medical school, building that foundation and appreciation of other fields outside of my own, but I saw in residency just how important that foundation, and knowledge, of other specialities is for providing holistic care to patients.2. What is something you've learned further along in your career?I’ve learned a lot about myself throughout my career. It’s helped me learn and accept that I’m a person who cares very much about relationships and connection. Human personal connection is so meaningful and sustaining, it's really driven me in medicine. I always joke that when I did my surgery rotations, I would try to talk to the organs, to get a person’s story about what it means to have this operation for them.I think, especially in academic medicine, it’s really easy to get swept up in things like promotions and awards and what your colleagues think. I have a patient whose mom emailed me a picture of the dog they got, and it’s moments like that that bring me perspective and remind me who and what I do this for. 3. What is your number one tip for residents?My advice would be to have something outside of residency and medicine. Something that helps you build self-esteem that isn’t tied to your job or studies. In my second year of residency, I campaigned for Olivia Chow in her first run for the mayoral election, and I also ran the Toronto Island Sprint Triathalon with one of my best friends. We spent eight or nine months training, and I had the goal of finishing and not finishing last, and I was able to do both of those things. Having something outside of medicine really helped me to build perspective, because I had a few really important things going on and I was less, kind of, attached to everything. Residency can feel like it’s your whole life, and it can be really difficult and draining if you don’t have something important outside of residency that is also meaningful and gives you a sense of purpose and confidence. I still continue to swim and stay active to this day, because having something outside of medicine can give you meaning.

Reminiscing on residency: Dr. Amy Gajaria originally thought she's have a career in journalism

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