Accreditation: what happens now?

Guest blog by Kent Stobart, Vice-Dean Medical Education

I’m pleased to say that “what happens now” is in fact already happening. Several people are progressing on the work we have before us to ensure a successful accreditation outcome this fall. There is still a great deal to do, however.

First, though, I want to emphasize some basic, but very important, messages with regard to UGME accreditation:

  • Our program is not on probation.
  • Our program is fully accredited and always has been.
  • We are confident that we will not be on probation after the 2017 full site accreditation visit.
  • For the 2017 accreditation visit, our goal is to achieve a full eight-year accreditation, the best possible result – we are shooting for a “PB” (personal best), as the dean wrote in his recent blog just after the mock visit.
  • Our ultimate goal, however, is a quality UGME program, and accreditation is a means of keeping us accountable and structured in achieving our goal.

Please help your college out by sharing the above messages at every opportunity!

Also, some further clarification regarding our college’s accreditation history: we have been on accreditation probation twice in the past, but we are not on probation now and haven’t been since October 2015. Probation does not mean “not accredited.” It’s a warning status that indicates accreditation is at risk. Medical education programs remain fully accredited when on probation, but must work to resolve the accreditation issues that have resulted in the probationary status. Thus, though we have been on probation twice in the past, our school has always been fully accredited.

Now, back to the work we have to do between now and the full visit.

That work will include improvements in how we do things and we will be sharing these improvements and our progress towards a successful accreditation visit with you on a weekly basis. We will also be doing more to prepare all our visit participants well in advance of the visit. Ensuring that our students have current and useful information to support their success and that our faculty have the information and resources needed to do their jobs are part of this work. We can’t achieve this in a vacuum, though—we need your help. If there is a problem, we need to know.

Generally, much of the information that supports our students and faculty in their roles is found on the college website as well as in One45. For students, important information to be familiar with to support your success in the UGME program includes curriculum information, program and learning objectives, the Student Information Guide and the Student Guide to Clerkship, syllabi and student policies. For faculty, knowing curriculum information and processes, program objectives, collegial processes and policies and procedures are key areas that support your success. Undeniably, we have ongoing improvements to make in our processes and how we communicate with you to support your roles.

So, how are we approaching the accreditation-focused work of the next several months?

We have a plan in place and people identified to lead all of the areas of work.

There are some clear priorities we must set, as we have a pressing deadline to meet: we must update and submit our Data Collection Instrument (DCI) by June 19, 2017.

Our students have played an important role already in our post-mock work with their recent completion of a Modified Student Survey. The level of participation from our students—80 percent!—was extraordinary given the timelines involved, so a huge thank you to all our medical students for your support through completing the survey. It will supplement the Independent Student Survey (ISA) completed last spring by providing updated information from our students in key areas.

We have an Accreditation Executive Team (AET) that is meeting to discuss and update progress three times a week from now until the accreditation visit, and is composed of: myself; Athena McConnell, assistant dean quality; Pat Blakley, associate dean UGME; Marianne Bell, accreditation specialist; Greg Power, chief operating officer; Sinead McGartland, Senior Project Leader; Alyson Rees, executive assistant to the dean; and Kate Blau, communications specialist. The dean joins us at these meetings, as well.

Focus areas for improvements and leaders for each have been identified. They are:

  • Curriculum Improvements – Regina Gjevres, assistant dean curriculum
  • Learning Environment/Student Services – Bindu Nair, assistant dean student services
  • Educational Resources – Meredith McKague, assistant dean academic
  • Faculty – Sheila Harding
  • Admissions – Barry Ziola, director, admissions
  • Administration – Greg Power
  • Modified Student Survey – Athena McConnell
  • Student Improvements Resulting from the ISA – Pat Blakley
  • Quality Accreditation Visit – Sinead McGartland

Our June submission deadline is approaching fast! That means you may be hearing from one or more of our focus area leads or others as we work together to ensure we have solid information pulled together in the DCI. Please, support all requests effectively and efficiently and be sure to ask for more information if you need it, in your work to respond.

We have identified certain accreditation elements as critical and we will tackle these first. Next, we will focus on elements deemed urgent, followed by those deemed high priority. Communication about progress towards our accreditation visit will be shared with you through weekly updates in our college e-news, in this blog, through monthly Medical Student Updates, and through college website news stories that will serve to highlight involvement of different participants in this work. General information is also provided on the UGME accreditation web page on our college website.

For our actual visit participants, we will provide you with significantly more time, support and focused preparation. Watch for information coming directly to you via email—as few and as streamlined as possible; we have several improvements already planned here—that includes save-the-date information, invitations with automated RSVPs for both preparation sessions and actual visit meetings, and orientation materials. With some exceptions, actual visit participants will be primarily those who participated in the mock accreditation visit last month.

Finally, questions can be directed to me, to Athena McConnell and to Pat Blakley, as well as our focus area leads and any member of the AET.

I thank the dean for providing space to me for this message.

Creating and Supporting Safe Clinical Learning Environments – What Can I Do?

I was invited to speak at the Dalhousie Postgraduate Medical Education professional day for program directors and program administrators. The title above was one of the talks I was asked to present.

What is the “learning environment?”

The “learning environment” has been defined as “everything that is happening in the classroom or department or faculty or university.”1,2

In our work, where at least two-thirds of our medical education takes place in the clinical setting, our learning environment extends to the entire province. In fact, we have a responsibility to ensure our students have a safe learning environment anywhere—even when taking electives out of province.

So if that is the learning environment, what is a safe learning environment? For me, a safe learning environment is a place you (or your son or daughter) would like to go to medical school. I believe excellent clinical education is dependent on a safe clinical learning environment.

In my talk, I divided the characteristics of a safe learning environment under five headings: Physical, Program, Learning, Clinical, and Behavioral. I provide here my presentation from that day.

Physical includes obvious things like safe house calls by residents, for example. Program includes things like fair and transparent promotion policies. Learning includes things like learning objectives that are attainable. Clinical includes very important principles, like appropriate graduated responsibility and supervision of learners.

The Behavioral heading gets complicated and the discussion at my talk in Halifax developed into a long list. I believe many of us of a certain age were exposed to teaching techniques that are unacceptable today.

I recall an experience in my clerkship with a supervisor who was a fan of scotch and jazz. Tradition was for the house staff to gather in his office late on Friday afternoon, share a “wee dram;” give an assignment to the two clerks to find an obscure piece of trivia about jazz; and share plenty of male jocularity! The irony was that he was an incredible clinical teacher, but the behavior was inappropriate even then. (I am not that old!)

Accreditation is highly dependent on student feedback through the Independent Student Analysis and the Canadian Graduation Questionnaire. Historically, the CGQ documented both locally and nationally that about 30 per cent of students reported mistreatment over the course of four years. The Association of Faculties of Medicine of Canada no longer provides the national comparator on the basis of the fact that zero mistreatment is the only acceptable goal.

Unfortunately, we are not yet down to zero. While the pre-clinical learning environment is not immune, most reports are in the clinical environment. The source is most often clinical faculty but also includes hospital staff, residents and fellow students.

The most common form of mistreatment is public humiliation. This could be shaming over an incorrect diagnosis or public fact-based questioning of increasing difficulty. I include a link to my previous blog on “pimping.” Distressing to me were incidents of racially based comments directed at students.

I know the vast majority of faculty abhor any form of student mistreatment. On the other hand, I am also sure some instances are unintended and that sometimes people are simply unaware of their impact on learners.

We encourage students to come forward with concerns and we guarantee their confidentiality. We can only fix what we know about.

I believe the CoM must be proactive in eliminating mistreatment. I believe it is incumbent on all of us to work every day to ensure our students have the educational experience we would like to have ourselves.

Among my final words at Dalhousie was that we all must be prepared to speak truth to power in addressing these issues.

The CoM has plenty of experienced faculty who can provide faculty development or lead workshops for departments, etc. We have invested more in Faculty Development and welcome the opportunity to assist in making this college a place where zero tolerance for mistreatment is not simply a belief, but also a result.

As always, I look forward to your feedback.

[1] Genn JM. AMEE Medical Education Guide No. 23 (Part 2): Curriculum, environment, climate, quality and change in medical education – a unifying perspective. Med Teach. 2001;23(5):445–54.  [PubMed]
[2] Roff S, McAleer S. What is educational climate? Med Teach. 2001;23(4):333–34.  [PubMed]

Maximizing the Impact of Lectures

Two weeks ago, I undertook a course at the Harvard Kennedy School in Cambridge, Massachusetts. HKS is Harvard’s school of public policy and public administration. I’ve had the good fortune to now have completed five professional development programs at Harvard University over the last six to seven years—some at the medical school, but others affiliated with the business school, the education faculty and now two at HKS. I must say I have experienced some of the best classroom teachers in my life at these programs.

This time the course was Leadership Decision Making. As many of you may know, I have quite an interest in the neuroscience of decision making, especially as it applies to how we teach diagnostic reasoning. This course used the same fascinating research to review how leaders can optimize decision making. One very interesting aspect was an afternoon in their Decision Science Laboratory that provided me feedback on my own decision making.

Dr. Jennifer Lerner, the leader and founder of the course, was an incredible teacher and an inspiring leader. Jenn is a professor of Public Policy and Management at HKS, with a PhD in Psychology from U of C – Berkeley. She describes her role as scholar/practitioner and has held numerous roles advising leaders at the highest levels of government, business and military, around the world. The other faculty were equally impressive, and the 60 participants were fascinating people from around the world.

Part of our preparation for the course was a reference (I’ve provided a link below). Jenn surprised me on day one, when she appealed to all participants to not use laptops. Her reasons included the obvious distractions that these tools entail, but primarily focused on the research that shows students taking notes on laptops retain less material than those who do it the old-fashioned way!

Careful perusal of this paper will reveal that there is more to it than that. The evidence is that most people can type faster than they can write but written notes outperform laptops! While overall pen and paper notes outperformed laptop notes, in fact within and across both groups, note takers who took concept-based and summarizing notes outperformed learners who took verbatim notes.

So we should do all we can with our pedagogy to avoid conditions that promote verbatim note taking.

As with most blogs for the rest of this year, I will bring you back to accreditation of our undergrad program. One area of student concern that was very clear to our mock accreditors was the issue of lectures. The two concerns raised were those lectures where the slide deck was not available before the lecture and those that were not recorded.

Making the slides available before the lecture allows students to prepare for the lecture and actually plan their note taking. The research clearly shows that the opportunity to reframe the content, move from words to concepts and summarize the material leads to deeper learning. Furthermore, we know one of the reasons students attend lectures in person or by viewing a recording is concern that material in the lecture will be on the exam. In those lectures where the students know there is no recording, they are obliged to revert to verbatim note taking.

We also know that students doing review of recorded lectures are predominately doing focused repetitive review of specific segments of the lecture, usually on complex topics and often to complement the notes taken in the lecture. This review is done as much by the students who were in the room as those who were not.

I do know it is disheartening as a lecturer to work hard to prepare a lecture and deliver it to a sparsely populated room. However, students tell me that the prime driver of lecture attendance is actually a well-designed unit or course where all the curricular components—including the lecture—tie together and, most importantly, an excellent lecturer who cares about the students. They all speak glowingly of the hematology module as an example of excellence, and they asked our accreditors why all units or modules could not learn from that module.

Recall that we do not make lectures mandatory and there are many quite legitimate reasons for being unable to attend a lecture. Besides, students always have options. Just Google “YouTube, heart failure.” Wouldn’t we all hope they were watching our lectures?

I know that it is at our faculty member’s discretion to pre-circulate lecture slides and/or record the lecture. However, our students have repeatedly put forward this request. I think there is research supporting the benefits of both of these best practices in providing lectures and lecture materials. I would appeal to all faculty members to consider our students wishes and honour their beliefs in what is best for their learning.

The Pen Is Mightier Than the Keyboard: Advantages of Longhand Over Laptop Note Taking

As always, I welcome your feedback and my door is open!

Improving rural healthcare

I had the pleasure of attending a national summit on February 22, 2017 in Ottawa dedicated to improving healthcare access and equity in rural communities in Canada. The event marked the launch of the Rural Road Map for Action, which provides 20 recommendations to enhance rural healthcare.

It was held at the award-winning Wabano Centre for Aboriginal Health, which provides a wide range of medical clinics, social services and support, and youth programs for Ottawa’s nearly 40,000 Aboriginal people. I really was impressed by their facility, which was a beautiful space, but also really reflected their vision statement:

We envision a world in which all First Nation, Inuit and Métis people have achieved full and equitable access to the conditions of health including: pride in ancestry, cultural reclamation, peace, shelter, education, food, income, a stable environment, resources, and social justice. And where the gifts and wisdom of First Nation, Inuit and Métis cultures are recognized as valuable, distinctive and beautiful.

The Wabano Centre was a superb venue for a very productive day that united national leaders in education, practice and human resource planning, as well as physicians of rural and Indigenous communities.

Advancing Rural Family Medicine: The Canadian Collaborative Taskforce was created in 2014 as a joint taskforce of the College of Family Physicians of Canada (CFPC) and the Society of Rural Physicians of Canada (SRPC). Key leaders on this taskforce include our own Tom Smith-Windsor, SRPC President, and Kathy Lawrence, CFPC Past-President.

The taskforce worked collaboratively over the last two years leading up to the summit and the launch of the Rural Road Map for Action, which outlines four directions that aim to:

  • reinforce the social accountability mandate of medical schools and residency programs to address healthcare needs of rural and Indigenous communities
  • implement policy interventions that align medical education with workforce planning
  • establish practice models that provide rural and Indigenous communities with timely access to quality healthcare
  • institute a national rural research agenda to support rural workforce planning aimed at improving access to patient-centered and quality-focused care in rural Canada

The summit focused on how the recommendations can be translated into actions that are coordinated, comprehensive, measurable and sustainable. The aim is to engage all stakeholders in applying these recommendations to future policy-making and planning, as well as to identify roles in addressing issues related to healthcare equity for rural Canada.

The College of Medicine had a prominent role in the day. In addition to the leaders mentioned above, we were very well represented in a video about rural healthcare and rural education shown early in the day. I can also say we are making progress or have already implemented some of the recommendations.

I highly recommend you check out the road map document and look at the 20 recommendations. As always, I would love to hear your feedback.

One Medical Faculty

Last night we marked a major turning point in the journey to make the College of Medicine one of the best medical schools in Canada and a pillar of healthcare in Saskatchewan, with Faculty Council’s support of our proposed new policy and procedures for the appointment of medical faculty at the University of Saskatchewan. Further to this step, the policy will proceed through the required approval path at the university level.

As you will recall, a major premise of The Way Forward is that the university recognize that “(medical) faculty represent a unique category of university appointees.” As many also know, the College of Medicine has been seriously handicapped by a historic and deeply embedded town-gown divide and structural inequities—these contributed to our total physician engagement in the academic mission of teaching and research being about half of that at similar-sized medical schools.

The good news over the last few years is that more and more of our physicians have become more engaged with the CoM at our two main campuses in Saskatoon and Regina and throughout the province. Many have stepped up to important leadership roles. This is likely primarily because physicians know that their practice, quality of care and professional satisfaction are enhanced by engagement in teaching and research. Repeated surveys of students and residents demonstrate over 75 per cent want an academic component to their career. And increasingly our graduates and residents are staying in Saskatchewan and taking up faculty appointments. This is all good!

Last night’s support is one step in formalizing the recognition of all medical faculty as equal colleagues in supporting the mission of the CoM. In fact, we know that 1,500 (more than half) of the province’s doctors have appointments with the CoM. In the new model, this is a university appointment. Given appropriate qualifications and circumstances, these medical faculty can apply for and hold research grants and supervise graduate students in addition to medical students and residents, and we will work with the university to facilitate further opportunities for these faculty members in this area. The model provides equity with all university appointees.

However, confusion remains, as many are still rooted in the historical language. One of the defining characteristics of the new model is that compensation is separated from appointment. All medical faculty will follow the same procedures for appointment with the U of S and all appointments will have the same rights and privileges. However, there will be several models of compensation.

Those who choose an Academic Clinical Funding Plan (ACFP) will have defined annual compensation and defined academic and clinical deliverables for which they will be accountable to the CoM and the health authority through their department head. The real advantage for them is that the compensation for academic and clinical time is equal. If they choose to leave the ACFP and go to fee-for-service (FFS) or other compensation models they will retain their appointment and look to the CoM for one of the other compensation schemes. The health authority appointment is not linked to the university appointment in any way. On the other hand, one does need to do clinical work to do clinical teaching!!

Others who want to remain in an FFS model, but want to do substantial academic work, may choose to enter into a contract with the CoM. Reasons for this—not the least of which is FFS rates in some specialties—include partnership obligations, group dynamics or simply personal preferences. These contracts will also have defined academic deliverables and, as in any contract, there will be accountability for those deliverables. While this compensation will be fair, there is no guarantee the CoM will be able to match FFS rates in all contracts. That is simply the reality of university funding.

Finally, the vast majority of our faculty who primarily do clinical teaching will receive compensation through a stipend model done on a fee-for-service basis. We have had widespread consultation with these clinical teachers. We have proposed rates that are at the middle of the range across the country. We continue to work on the administrative efficiency of this process and the timeliness of payment. Unfortunately, further improvement is largely dependent on improving our information systems, which is also in our work plan.

Remember, this is all a work in progress. There is great interest in ACFPs and we hope to see a number of existing faculty move to ACFPs in the next six months. Limitations here are the work required to develop these on an individual basis and, of course, funding. Please bear with us as we work with our partners in the health authority and the Ministry of Health. All are in agreement that the ACFP will be an increasingly important model for both the university and the health system as we move forward. Many new graduates prefer this model, with its inherent predictability and the protected time for academic work.

In many other jurisdictions, academically oriented groups of physicians have banded together over time to enter into group ACFP agreements with their university/health authority/province. For example, at Queen’s, virtually all of the physicians in Kingston are on the same AFP. The group ACFP is administered by a practice plan governed by the physicians. This model combines the independence and business models physicians are used to with the collegial trade-offs of clinical and academic work typical of an academic environment. I have made it clear that I would like to see our ACFP model evolve in that direction. In that regard we are developing such a model for the family medicine faculty in our two family medicine teaching units in Saskatoon and Regina.

As I said, this is a work in progress. Our goal is to meaningfully engage as many Saskatchewan doctors as possible in one appointment model and offer compensation models that are fair and transparent. Without a doubt, we have made mistakes already and we will continue to make adjustments. The province’s financial reality is one with which we must contend. But the goal of One Faculty is that we suspend the historic language and don’t listen to rumours – ask questions!!

As always, I welcome your feedback and I sincerely thank all who contribute to the CoM.

Happy Holidays!

I would like to wish everyone at the College of Medicine a happy, safe and restful holiday. I also want to thank you for all of your work during this very busy fall, and throughout 2016. We have accomplished a lot and the holidays provide a great opportunity to step away, rest and rejuvenate for an exciting new year in 2017—just around the corner.

We have made strides across many important initiatives, from UGME accreditation and college strategic planning to our biomedical sciences restructuring and building our research capacity. Our work to re-engage our alumni included a fall 2016 edition of Connective Issue.

We gathered and cheered resident and student achievements at events including the PGME Celebration Night, Fall Formal and the White Coat Ceremony. We worked and built relationships with our students serving on the SMSS. Although not completed, we have thus far navigated the student double cohort, thanks to the efforts of faculty, students, staff and partners in healthcare to make this as smooth as possible.

All in all, throughout the past year, working together we have developed stronger relationships across the college, and will continue to do so. We have much ahead of us, and I look forward to working alongside all of you in 2017.

But first, enjoy a very well-deserved break!

This Week at AAMC: Mourning and Resilience!

I wrote this blog in the Seattle and Vancouver airports as I returned home from the annual meeting of the American Association of Medical Colleges (AAMC), Learn Serve Lead 2016.  AAMC is the pre-eminent American meeting on medical education and research.

For me, personally, it was a profound week that combined the American election result, Remembrance Day (I still shiver thinking of the sacrifices made by so many Canadians, including an uncle, and of all those cold November 11 mornings I spent as a Boy Scout and Air Cadet!), and the death of Leonard Cohen. It is a good week to remember many of Cohen’s lyrics, but the one that stands out for me now is, “There is a crack in everything; that’s how the light gets in.”

My experience attending American medical education meetings has left me with the impression that many medical educators there lean to the Democratic side. But this meeting was remarkable! Attendees numbering 4,000—and the vast majority were in mourning!! Of course, we were also in a blue state on the left coast, so the newspapers and talk on the street also reflected the mood at the meeting. I said to some friends, “It feels like we are at a wake.” Since I am now acclimatized to Saskatchewan, the daily rain didn’t help!

The meeting began with a plenary by Doris Kearns Goodwin, an author, historian and scholar of American presidents best known for her biography of Lincoln: Team of Rivals. Lincoln was exceptional in many ways but this biography focuses on his leadership, and his strategy to hire his rivals to key cabinet positions. It is an interesting contrast to the current presidential transition underway! And while Goodwin led off with a historian’s confirmation that this election was truly an aberration, her message included many great stories and a reminder all politicians are people with histories, families and a dream of leaving the world a better place. I am sure the conference organizers had no idea their first plenary speaker would be so appropriate for the time!

Dr. Darrell Kirch, the president and CEO of AAMC and an academic leader I have always admired, was somber as he advocated that now more than ever it is important that academic medicine pursue its mission of caring and advocating for the marginalized and the underprivileged. He told an inspiring story of “White Coats for Black Lives,” that described advocacy led by medical students at the University of California, San Francisco. In paraphrasing a politician, he said, “When they go low, academic medicine goes high,” and quoted Lincoln as he called on academic medicine “to be the better angels of our nature.”

Another excellent plenary was delivered by Dr. Atul Gawande, well-known Harvard surgeon, researcher, author and columnist for The New Yorker, and advocate for patient safety. While he led off even more soberly with a definite opinion on the election, he quickly moved on to remind us of the complexity of medicine with 60,000 diagnoses, 6,000 drugs and 4,000 interventions! He described three stages of improvement, with the message that only the third one is proven to work consistently.

1. You should do x (education)
2. You must do x (guidelines, regulation, etc.)
3. Systemize x

Gawande illustrated this point with his work on surgical checklists. One study in Scotland over four years showed a 26 per cent reduction in mortality with 9,000 lives saved – more than had died in motor vehicle accidents. But he brought us back to the present by noting that in the USA, surgical checklists had the lowest uptake in hospitals serving rural, poor and black populations! He described an initiative on a checklist for the prescription of opioids for chronic pain and noted that more people (often marginalized) are dying now from overdoses than from AIDS at that epidemic’s peak! His latest book, Being Mortal, is about end-of-life care, and he noted research shows few people are offered end-of-life discussions by clinicians, with the least likely to receive them being men, those without college educations and marginalized groups.

Overall, his message was that academic medicine can make a difference if we always uphold our values in our clinics, hospitals and medical schools. Read more about his perspective in this week’s short essay in The New Yorker: Health of the Nation.

There were many fantastic seminars and workshops about medical education, concluding with an incredible plenary on advocacy for mental healthcare by psychologist and Johns Hopkins Professor of Psychiatry, Dr. Kay Redfield Jamison. She has been both the co-author on the definitive textbook on bi-polar illness, Manic-Depressive Illness, and sufferer of the same since early adulthood. She has also written extensively for the public, including a memoir, An Unquiet Mind, which describes her experience with mania and depression.

She talked about the stigma of mental illness and described the history that any Johns Hopkins faculty member, staff or learner needing surgical care would seek out a Johns Hopkins surgeon, but those needing mental healthcare would go anywhere but Johns Hopkins due to the stigma of a mental health issue. Dr. Jamison talked about wellness and mental health in particular for clinicians and learners. She talked about how we all had to learn to deal with the paradox that we must all provide care and receive care, and made the link between excellent mental healthcare care for the clinician and patient safety.

Learn Serve Lead 2016 was a great educational meeting, but also a personal experience I will not soon forget. I was struck by three things: the shock and mourning that people were experiencing; the resilience in focusing on what we all can do now to improve healthcare; and the number of shared values with the College of Medicine and our great commitment to social accountability.

And now, I am really glad to be back home.

As always, I have an open door and welcome your feedback, discussion and debate.

Research capacity building underway

Guest blog by Marek Radomski, Vice-Dean Research

m-radomski

I would like to thank the dean for an opportunity to share news from the Office of the Vice-Dean Research (OVDR).

Over the early months of my appointment, the OVDR team has been working on a number of fronts to support the research community in the College of Medicine.

It became clear to me, right from the very beginning, that the funding of our basic and clinical research in the College of Medicine would be a very urgent and challenging task. Recent turmoil around the Canadian Institutes of Health Research (CIHR) application process, low rate of success for the University of Saskatchewan, and the fact that our provincial funding is the lowest in Canada highlights the need to mobilise available resources in our university and college to support our faculty and graduate students in their research endeavours.

What have we accomplished so far to increase funding opportunities for our faculty?

  • We planned and carried out the College of Medicine Research Awards (CoMRAD) grant scheme. The scheme was initiated thanks to the foresight of our dean and the leadership of Steve Milosavljevic, the acting vice-dean research. We funded 28 out of 66 applications to the tune of $693,691. It is important to emphasize that basic and clinical researchers equally benefited from this scheme and 40 per cent of funded applications went to early career researchers.
  • In collaboration with the Office of the Dean of Graduate Studies, we will shortly be announcing the College of Medicine Graduate Awards (CoMGRAD) grant scheme to increase funding opportunities for our existing pool of graduate students.
  • We have engaged with the Saskatchewan Health Research Foundation and are working on a bridge grant scheme to increase the rate of success of College of Medicine researchers in Tri-Council competitions such as CIHR grants.

During introductory meetings with the departments, clusters and individual faculty members, I promised to conduct an external review of the status of research in the College of Medicine. As you may remember, the objective of the external review is to help us reflect on the College of Medicine research Strengths, Weaknesses, Opportunities and Threats (SWOT). I am very happy to report that this promise will very soon become a reality as the review and the site visit will take place next week from October 31 – November 1, 2016.

Our reviewers are all distinguished biomedical academics who work for Canadian and American medical schools. Indeed, Dr. Gail Annich, MD; Dr. Gautam Chaudhuri, MD, PhD; Dr. David Thomas, PhD; Dr. Lorne Tyrrell, MD, PhD; and Dr. John Wallace, PhD, bring a wealth of high personal academic achievement, experience and interdisciplinary expertise, ranging from basic research via clinical research, to successful research and development.

A good academic practice employed in the external review process is to prepare the self-assessment document and make it available to reviewers prior to the site visit. The OVDR team is leading the process of preparing the self-assessment document which includes an analysis of indices of research-relevant output as well as individual SWOT assessments from departments and clusters. I would like to take this opportunity to thank all of you who have been involved to date in the preparation of this very comprehensive document.

The second element of the review is the site visit. We are planning for reviewers to meet with a cross-section of the research community in the College of Medicine and tour our research facilities in the Health Sciences Building and on the U of S campus. At the end of site visit, the reviewers will be asked to brief us on the main findings of the external review and will later submit a formal report with a SWOT analysis and recommendations.

The ultimate goal of the external research review is to consider its findings when designing the 2017‑2022 College of Medicine Strategic Plan. The OVDR team is delighted to contribute to this process.

I feel that the outcome of our external review and the preparation of the 2017-2022 College of Medicine Strategic Plan will be important factors in increasing the research fortunes of our college. Of course, the findings, recommendations and documentation of the external review will be made available to the College of Medicine community and relevant stakeholders.

Advocacy and HIV in Saskatchewan

Andre Picard’s headline in yesterday’s issue of The Globe and Mail states: Saskatchewan should declare HIV-AIDS public health emergency.

The article was precipitated by the courageous call for action by a group of Saskatchewan physicians and CoM faculty members and their coalition of patient and clinician colleagues. These physicians include Dr. Steve Sanche, Dr. Kris Stewart, both infectious disease specialists, and Dr. Ryan Meili, family physician.

Picard writes, “The rate of HIV-AIDS in Saskatchewan, particularly in First Nations communities, is so high that the province should declare a public health state of emergency.”

In fact, the HIV infection rate in Saskatchewan is 13.8/100,000 which is almost double the national rate of 7.8/100,000. Even more troubling is the rate among our Aboriginal population on reserves, where the rate is 64/100,000. And these are all likely underestimates, as, although testing has increased somewhat, many at risk people remain untested.

Furthermore, we are not even coming close to reaching treatment goals as “in Saskatchewan, once again, the HIV-AIDS death rate is 3.1 per 100,000, four times the national average of 0.7 per cent. Most troubling of all may be the fact that, last year, three babies were born HIV-positive in Saskatchewan, even though mother-to-child transmission is entirely preventable.”

Drs. Sanche, Stuart and Meili, in today’s Star Phoenix, call on the province to adopt the UNAIDS 90-90-90 strategy. Star Phoenix reporter Charles Hamilton includes in his story, “The United Nations recommends increased testing so 90 per cent of people with HIV know their status; making sure 90 per cent of those patients receive the proper anti-viral drugs to treat the disease; and ensuring that 90 per cent of those people have “repressed viral loads” so infection doesn’t spread.”

These CoM faculty physicians are not the only ones calling on the province for action. Canada and Saskatchewan were in the spotlight in July at the 21st International Aids Conference in Durban, South Africa. Dr. Stuart Skinner, an infectious disease specialist and CoM faculty member in the Regina Qu’Appelle Health Region (RQHR), advocates for improved HIV testing and care in an earlier article in The Globe and Mail.

Dr. Alex Wong, another Infectious Disease Specialist, researcher and CoM faculty member in the RQHR presented The Developing World in Our Own Backyard: Concentrated HIV Epidemics in High Income Settings in 2015 at the International AIDS Conference on HIV Pathogenesis, Treatment and Prevention in Vancouver. According to Maclean’s Magazine, he sometimes calls this presentation Africa on the Prairies.

What these physicians are saying is incredibly important for the people of Saskatchewan, those at risk for or suffering from HIV-AIDS and our Aboriginal communities, which are disproportionately affected by this horrible disease. They are also being incredible role models for our learners.

CanMEDS, our national medical curriculum framework, was first advanced by the Royal College of Physicians and Surgeons and is increasingly being adopted around the world as the basis for medical curricula.

canmeds-flower2

One of the seven essential roles of physicians is that of health advocate. As stated by the Royal College, “As Health Advocates, physicians contribute their expertise and influence as they work with communities or patient populations to improve health. They work with those they serve to determine and understand needs, speak on behalf of others when required, and support the mobilization of resources to effect change.”

The CoM has had a long history of advocacy, starting with our first dean, Dr. Wendall McLeod, who was a great supporter of Tommy Douglas and the birth of Medicare in Saskatchewan. Our college is replete with current demonstrations of health advocacy: our Global Health Certificate, our Making the Links program, our Department of Continuing Medical Education and our Division of Social Accountability with our refugee health conference this spring, and many more examples. Our students demonstrate the same commitment to advocacy with their student run clinics, SWITCH and SEARCH, and the amazing student led conferences on Global Health and Health Innovation and Public Policy.

Kudos and thanks to all of these physicians for their work in health advocacy and thank you for being such excellent role models for our students and residents. It is moments like this that I know we are a great medical school and an incredibly important asset to Saskatchewan.

As always, I welcome your feedback and thank all for their commitment to the CoM.

 

Great Summer – Busy Fall!

First and foremost I would like to welcome our new medical students and residents. The new academic year is always refreshing, and I have always been especially energized by the excitement and enthusiasm of first-year students and residents. This year, I had an opportunity to speak to our new Aboriginal students as well as the whole class of 2020. All had a wonderful welcome to the college and the Aboriginal students heard from Michif Elder Norman Fleury and First Nations Elder Louise Halfe about connection with their community.

As I have just come back from my 35th medical school reunion, I emphasized to the whole class what a wonderful journey they were on with the classmates around them and the important role they will play as clinicians, leaders and team players in the future Saskatchewan healthcare system. In that regard I was really pleased to see today’s headline in the Star Phoenix: Next decade could see the rise of homegrown Sask doctors and the great interview with Dr. Joanne Siverston, alumnus, Prince Albert physician and SMA Vice-President.

I also reminded the students that the Olympics come around quickly and, despite the hard work in front of them, when the Japan summer Olympics open they will have been residents for a month! And I pointed out that all of us at the College of Medicine and our healthcare partners are here to see them succeed.

I hope you all have had a great summer of rest and renewal. I certainly did. It started with a northern Saskatchewan fishing trip with Dr. Keith Ogle, our vice-dean faculty engagement, which included flying in to his lake on a DeHavilland Beaver (built before I was born) and a fabulous and highly successful introduction to fishing Northern Pike.

The medical school reunion back in the Maritimes was an excellent opportunity to reconnect with some wonderful friends, including a class mate I discovered I could now keep up with who was easily the best runner in our class! Around the reunion, we packed in visits with family and friends, Atlantic salmon fishing on the Miramichi and time at beach-side resorts in PEI and NS. It was a great summer.

Miramichi fishing

And now we embark on an incredibly ambitious and important fall. As you know, much of the work of the last two years has been implementation of The Way Forward, leadership recruitment and faculty restructuring. This fall, we will complete a college-wide strategic planning process. We all know we want a highly successful College of Medicine, but what does that look like? What are our strengths? What are our priorities in education, research and community service? Your engagement is essential, and you will be hearing much more about this project.

You may have received an invitation to our accreditation launch event. A full UGME accreditation visit takes place at the end of October 2017. Like the silent phase of a fundraising campaign, many faculty and staff led by Dr. Athena McConnell (Assistant Dean Quality) and Kevin Siebert (Accreditation Specialist) have already been working very hard. The launch is an opportunity for all of you to get engaged in our accreditation preparation. As you have heard me say many times, accreditation is a team sport. The College of Medicine can only succeed in putting accreditation challenges behind us if all of you are involved. I hope you can come out to one of our launch celebrations on September 12 at our Regina and Saskatoon campuses. We are still working on scheduling an event in Prince Albert.

The team working on restructuring our biomedical science department and developing new undergraduate biomedical science programs based in the CoM will make important progress this fall. Substantial development of our “one faculty” model is underway and will lead to one pathway for appointment and promotion of MD faculty.

Following on last year’s successful College of Medicine and research awards (COMRAD), we will place increasing emphasis on research. In that regard, Dr. Marek Radomski has initiated an external review of our research programs and we will be visited by five internationally renowned medical researchers from October 30 to November 1, 2016. Their review and recommendations will be an important step in the advancement of our research agenda and will inform our strategic plan.

And speaking of research, congratulations to Dr. Deb Morgan on the $2.3 million Foundation Grant from the Canadian Institutes of Health Research that will fund research over seven years to improve dementia care resources for rural healthcare providers. This is very important work; it’s estimated that 47 million people in the world live with dementia.

So when asked, “What is going on at the College of Medicine?” my answer is: accreditation, accreditation, accreditation, strategic planning, biomedical science renewal, one faculty, research, research, and accreditation!! Did I mention accreditation?

Seriously, accreditation is simply superb medical education and research in the context of a great clinical setting. And we will demonstrate that to our peers with the 2017 accreditation visit.

All of the work and plans above are important, as are many other college initiatives (Aboriginal health, social accountability, simulation, Inter-professional Educational Initiatives, and more). I thank you for all of your hard work to date and look forward to your support, advice and engagement as we embark on this ambitious fall agenda.

As always, I invite your feedback.

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