I often wondered as a fellow what the initial years of my first job would be like. How well would my fellowship prepare me for the challenges ahead? Would there be a lot of additional learning that I’d have to do? Would the learning curve in the first few years be just as steep, or steeper, as in the fellowship? As I have been in my role as a regional clinical chemist for just over a year, I think it’s a good time to take a moment to reflect on these questions.

Officially, my role is to serve as the sole clinical chemist for community hospitals in Edmonton and its surrounding municipalities. What exactly this entails, however, has been challenging to figure out. My first day was easy enough; I showed up at the Royal Alexandra Hospital and was asked to fill out paper work for a hospital ID, email account, etc. I was also shown to my new office and spent the rest of the day getting rid of old journals, books, etc. left behind by my predecessor. Over the next few days I was introduced to lab staff & pathologists at this site and was also contacted by lab staff from other sites to set up meet-and-greet visits.

It is safe to say that my first few weeks were spent being introduced to the different sites, completing safety & other instructional webinars, learning to use a variety of computer programs that I had never used before, and getting my bearings around Edmonton. I also put aside some time to think about what I’d like to accomplish in the first year of my new job. I set several goals for myself: (1) learn about the analytical aspects of testing at each site, (2) get to know the lab staff, (3) meet clinical staff, (4) start teaching at the university, (5) involve myself in at least one or two research projects, and (6) pass the oral part of the Canadian Academy of Clinical Biochemistry board exam. I also made one long-term plan: to be well versed in all aspects of the daily goings-on in every one of my twelve labs.

Over this past year, I have tailored many of my activities with these goals in mind. I’ve learned a lot about analytical testing by talking with technologists, reviewing monthly QC summaries, reading manufacturer’s IFUs, helping to design & evaluate method validations, and investigating unusual test results. I’ve also established relationships with many lab staff although I’ve some ways yet to go. Initially my approach was to spend half a day biweekly at my larger sites but I’ve realized that it’s better to spend a full day instead. I spend less time in transit and, more importantly, I am able to socialize with staff during lunches and breaks and this goes a long way in establishing their trust. Meeting staff at the rural sites has been more difficult since these sites are not accessible by public transport and I do not drive a car. Fortunately, the lead techs meet once a month in a more central location and I now join them for these meetings.

Meeting clinical staff has also been a challenging goal. My predecessor knew many clinical staff but he retired 8 months prior to my start date. The clinical chemist who is my mentor works at the university hospital and only has limited connections in the community setting. As the Royal Alexandra Hospital has a detailed staff directory, this is what I used initially to make contacts. However, the most promising approach I’ve discovered so far is to enlist the help of the Pathology & Lab Medicine site leads at each hospital. In this manner I’ve met a number of physicians at the Royal Alexandra Hospital and have several appointments with clinicians at other sites. However, I think it will take additional time and regular follow-up with these individuals to establish their trust and for them to consider me a knowledgeable & valuable resource.

While clinical responsibilities have fulfilled a large portion of my time, I have also been able to do some teaching and research. My teaching is mostly done in our local undergraduate Medical Laboratory Science program where I deliver lectures on chemistry- and toxicology-related topics. I was fairly lucky in that I was invited to participate in most of these opportunities instead of having to seek them out myself. My research work also developed in a similar manner; my mentor is passionate about research and invited me to work with him on a couple of projects.

So going back to the questions I noted at the beginning of my entry, I think that my fellowship prepared me very well for my first job. It gave me the foundation of knowledge, troubleshooting resources, and confidence I needed to successfully navigate this past year. I think that the learning curve has remained pretty steep but perhaps that will never really change. After all, there is always more to learn regardless of how advanced you are in your career.