Faces of U of T Medicine: Thomas McLaughlin

Dr. Tom McLaughlin couples his passion for medicine with his interest in health system leadership. The U of T MD graduate will soon finish his paediatrics residency at The Hospital for Sick Children, but his studies aren’t over yet. McLaughlin was recently named a recipient of the prestigious Frank Knox Memorial Fellowship, which will see him return to the classroom this fall at Harvard University. The prestigious Knox Fellowships are selected on the basis of character, the promise of leadership and a devotion to the democratic ideal. It provides funding for students from Australia, Canada, New Zealand and the United Kingdom to conduct graduate study at Harvard University. McLaughlin spoke with writer Erin Howe about his hope to improve health equity for children and how his time at U of T Medicine influenced his plans for the future.

What are you looking forward to doing in the next chapter of your training at Harvard University?

I’ll be using my fellowship award to earn a Master in Public Policy (MPP) degree at the Harvard Kennedy School of Government. The program will really focus on skills in program and service analysis, and change implementation. My focus will be on health systems leadership – essentially, learning the skills to bring about positive change to healthcare delivery in clinics, hospitals, and healthcare systems.

What drew you to this area?

I’ve always been interested in the big picture that surrounds our individual patients and affects their health. Residents in our program often work in a free clinic for refugee children, and I can recall, for example, a child with severe asthma whose parents were afraid that filling a prescription for puffers would mean the government would deport them. There are so many things like this we can’t cure with a prescription pad — poverty, poor housing, and lack of education, to name a few — and they can have a profound impact on health. As doctors, we tend to focus mostly on the patient in front of us, but we also need to work within our health systems, government offices, community centres, and schools where social policy determines health.

Even on a very granular level, policy implementation skills are helpful for on-the-ground medical teams. The skills that might allow someone to analyze and implement a government program are the same as the ones needed to open a new clinic, to reorganize a call schedule, or implement an educational change.

What do you hope to accomplish

There are relatively few doctors who can seamlessly move between clinical medicine and program analysis and implementation. As a result, I’m really drawn to issues like these where child health interfaces with health and social policy.

In pediatrics, the complexity and acuity of medicine has changed dramatically in the past generation. This raises new, unique challenges in children’s hospitals and in the broader health system. At the same time, we live in a country with immense inequities in terms of access to care and health outcomes for children. In British Columbia, for example, where I grew up and I’ll be returning to after my masters to work at BC Children’s Hospital, there is a large, underserved aboriginal community and a large, distributed population served by many community hospitals and a single children’s hospital in one corner of the province. How can this health system best serve the needs of children? How can a children’s hospital be organized best to deliver high-quality care to many very complex and sick children? How can a children’s hospital integrate its specialty care with other hospitals hundreds of miles away?

I can’t say exactly what issues I’ll become most involved in over my career, but I know we need strong advocates, with both clinical and policy knowledge bases, who can face questions like these and develop effective evidence-informed health policy solutions. I’m hoping my time at Harvard will help equip me with the skills to face these challenges.

You served as President of Resident Doctors of Canada (RDoC) and were on the board of directors for Professional Association of Residents of Ontario (PARO). How have these experiences shaped you as a physician?

These roles were an eye-opener on how very high-level policies like educational standards, resident contracts, and licensing requirements really impact the day-to-day lives of people — in this case residents. Residents notice when their organization earns them a salary increase, or advocates for management of duty hours and fatigue.

These experiences were also leadership training like nothing else! If you can deliver a policy proposal in person to 17 deans of medicine, or mobilize a hundred volunteers from coast to coast, or create a 1.5-million-dollar budget, it equips you with skills that you can use in a meeting with a patient’s family, or in advocating for services for a patient.

What is your favourite thing about the Faculty of Medicine?

I think the thing I’ve really loved has just been how driven people generally are towards excellence. The Faculty is filled with people who are constantly striving to be at the top of their game, whether it’s in clinical medicine, education, research, or advocacy. It’s wonderful to be in a community where everyone is pushing themselves, and supports others who do the same.

On a more lighthearted note, my other favourite thing is probably the annual medical school musical, Daffydil. I played the trombone in the Daffy band for a couple of years in med school, and still try to watch it when I can.