I became interested in academic Paediatric Endocrinology when I was a medical student. This decision was partly influenced by conducting research under the supervision of Professor Hilary Hoey, Head of Department of Paediatrics in Trinity College Dublin, and a leading figure in Paediatric Endocrinology in Ireland.
My work with her focused on studying the effects of treatment of patients with Turner syndrome with Growth Hormone with and without the anabolic steroid Oxandrolone, and we showed that in our group there was modest benefit of this combination in maximizing final height. In this stimulating environment, I excelled in my study of Paediatrics during medical school and was awarded the first prize in the final Paediatric exam [the O’Donohue Medal].
Few years later, I had the privilege of working with her again at a more senior level in the department of Endocrinology, Diabetes and Growth in Trinity College Dublin; in addition to regular diabetes and endocrine clinics, I was involved in managing patients in multidisciplinary obesity clinics where we delivered comprehensive clinical care and evaluated the various risk factors and complications that these children had. As this clinic was staffed by an exercise specialist, social worker, dietician, psychologist and a psychiatrist, it gave me the opportunity to deal first hand with these complex patients. Since then, I developed my interest in studying childhood obesity and its co-morbidities.
Following graduation and internship, I started my Paediatric training. The training program in Ireland is composed of two phases: General Professional Training and Higher Specialist training; at the end of this program I was awarded the Certificate of Satisfactory Completion of Specialist Training in Paediatrics that allows me to practice as an independent specialist in Europe. During the latter part of Higher Specialist Training, I did one year of Paediatric Endocrinology at the two largest academic Hospitals in Dublin. In addition to Professor Hoey, I worked with Dr. Colm Costigan, a Canadian trained Paediatric Endocrinologist and an exceptional teacher, mentor and person. He provided guidance that was essential for me to mature in my understanding of the complexity of the specialty. During my training, I also conducted two important studies; the first looked at outcomes in infants of diabetic mothers in the Coombe Women’s Hospital, a tertiary, 7500 births per annum Perinatal centre; we showed that due to improved maternal diabetes care, the outcomes in these infants were very similar to those born to mothers with no diabetes during pregnancy.
The second study looked at the neonatal hypothyroidism screening program in south of Ireland under the supervision of Dr. John McKiernan in University College Hospital in Cork, Ireland. We were able to show that the quality of care for these infants remained excellent over a 10-year period. This project allowed me to appreciate the importance of assessing the quality of service delivery.
I also recognized from an early stage the importance of being a good manager, delegator, communicator, mediator, leader, and collaborator. In order to strengthen my knowledge in the area of health care management, I enrolled in a one-year, part time diploma course that was offered by the Royal College of Surgeons of Ireland and the Institute of Public Administration, a body mandated with training the next generation of leaders in Irish healthcare system. This allowed me to improve my managerial, administrative and leadership skills.
During my clinical training, I found myself interested in understanding mechanistic details regarding disease causation. As a result, I approached my mentors at the time who offered me the opportunity to receive formal research training, and I chose to do this in one of the most prestigious research institutions in the world, St. Jude Children’s Research Hospital, Memphis, Tennessee. I embarked on a three-year full time research fellowship, during which I received excellent training in molecular biology and developed a far deeper understanding of the scientific process; my work was focused on understanding mechanisms of gene expression through the study of animal and cell models. This was a tremendously exciting and busy time that allowed me to truly grow and develop not only as a scientist but as a person. Following completion of my fellowship in St. Jude, I moved to Canada to pursue further training in Paediatric Endocrinology and to continue to do research. Again, I chose one of the top clinical and research establishments in the world, The Hospital for Sick Children and the University of Toronto.