Working together through transition

I have now met with many of our MD full-time faculty members individually, in four open information settings, and in four departmental meetings. As I hope you all know, I am happy to meet with any of our faculty – individually or in groups, and once or repeatedly as required.

I want to thank those who have attended these sessions. I have listened very carefully, and would like to use this blog to emphasize some key messages and respond to some of the concerns and feedback I have received.

You are wanted, needed, valued

First and foremost, I want to be clear that we want and need all of you – current MD USFA members, as well as the 1293 Saskatchewan MDs with clinical appointments – to be engaged with the CoM.

Our college presently has approximately 50-60 MD full-time equivalents doing the teaching, research and administrative work. Our peers have at least twice as much MD time invested in their medical school.

This is our fundamental challenge as a college.

I still hear language like “the CoM is trying to get rid of people.” Nothing could be further from the truth. To be successful, our college needs everyone engaged.

Second, I truly value the great contributions of our faculty.

I took on the role of acting Vice-Dean of Faculty Engagement with the very intentional and strategic goal of getting to know our faculty. I have come to know many of you, and am absolutely impressed by your commitment to our learners, your research, your patients and our CoM.

I have heard many of you say you have felt blamed for past problems, and you now interpret the voluntary severance offer as further evidence of that blame.

If, in my efforts to explain where we are going, you have heard blame from me, I apologize. This is not my intention.

I know the past has been difficult for you and for the college, but the change process we are on now is both necessary and complex. The challenge we face is the historical engagement structure, and the number of MDs at the CoM. Our challenge is certainly not the individuals committed to the CoM whom I have come to know and respect.

About ACFPs: a fair and transparent system of remuneration for all MD work

Recall, that well before I got here, the decision was made to no longer hire physicians to tenure track university positions.

It was obvious to me that the province, the academic health science centres, and the CoM had to deliver on the long-promised provincial ACFP if we were to grow MD academic time in the college. I put great effort and time into moving the ACFP forward, and our hospital and provincial partners responded.

Increasingly, ACFPs are the preferred method for engaging academic physicians across the country.   Are ACFPs perfect?   No. No single ACFP is going to be perfect, but it is the only model to provide equal compensation for teaching, research, and clinical care.

Looking ahead, I was concerned about the increasing inequity between current MD USFA members and newcomers, as the latter would have more protected academic time and, in some specialties, more income than their more established colleagues.

I hope you will see the transition packages as incentive to explore alternative ways to continue your engagement with the CoM.

About timelines and deadlines

Many have expressed frustration over the timelines. I must emphasize the “spirit” of the agreement is to work toward a firm deadline of April 1, 2016.

The October 31, 2015 date is, in effect, a necessary milestone for expressions of interest to give the CoM and our partners the information we need to ensure adequate capacity for development of the ACFPs, or other arrangements, for all interested faculty.

This means if a faculty member expresses interest in transitioning to a new relationship with the CoM through an ACFP, they must indicate so by October 31st, but they will have until March 31st to work out the details.

The biggest over-arching concern I have heard is the capacity of the “system” (the academic health science centres, government, health regions, and the CoM) to deliver the ACFP. We have heard your concern loud and clear, and are in process to hire two additional qualified staff members to work full-time on ACFP’s over the next year. We will get this work done.

About research – grants and graduate students

Some very important concerns have been raised. Our researchers have questioned their ability to hold research grants with a clinical faculty appointment. Important groundwork in this regard was done with the research policy passed by the Board of Governors in December 2014, which allows physicians appointed in clinical departments to hold research grants.

I have the University’s commitment that physicians holding clinical appointments will be recognized by the university, and will be able to hold research grants. This change was needed long before this transition, as the intent all along has been to provide protected time for research to some people signing up to ACFPs.

To address another misconception: the ACFP will only pay for teaching and clinical work and is limited to a low percentage of academic work. In fact, the ACFP is designed to be flexible, and will support MD clinical faculty who even spend the majority of their time with research and academic work (up to 75% in exceptional circumstances).

The ACFP will provide for all three of our important missions: clinical care, teaching and research.

Another concern is the ability for MDs in clinical faculty appointments to supervise graduate students. The university is committed to ensuring faculty who already supervise graduate students can continue this important role, and new MD faculty with appropriate skills and experience will be able to do the same.

All for one…One for all

There is no doubt this is a critical point in the history of the CoM at the U of S.

We are no longer one of the smallest Canadian medical schools, able to survive with a small number of full-time MD university faculty.

We are now a much larger medical school at a growing U15 university in a thriving province.

We must engage most, if not all, of the doctors at our academic health science centres and across the province. Our peers in Winnipeg, Halifax, Kingston, and throughout Canada have this model. This is our necessary goal, and the one we will all work towards.

Medical schools have always succeeded because groups of physicians came together in their belief that academic medicine would improve care to their patients, their own careers and their communities.

I have great confidence in this community of physicians to do the same. That is why I came here and am excited to work with each and every one of you to that end.

As always my door is always open. And furthermore so is the blog – please engage in the discussion.

Preston

6 thoughts on “Working together through transition

  1. All physicians are trained for 6- 10 years to practice medicine and with modest effort every one can teach the undergraduates. There is no comparable training for research which is aimed at generating New knowledge. Therefore very few clinicians at this institution pursue research. Research is however critical for our academic standing and to be classified as “A College”. Some members may have given up other secure options elsewhere, to stay and pursue that academicactivety.If the contracts are short term-three years, how would someone whose research requires much longer time to fruition and sustain be assured of their future academic career.?
    Some Canadian universities make special arrangement to allow clinician researchers the same level of freedom as they allow the Basic scientists-incorporate academic tenure without financial penalty so this important function can continue. How would that be done here?

  2. There appears to be uncertainty re the use of terms in the above information.
    “Three important missions – clinical care, teaching, and research”.
    Not sure how to understand “the ACFP will only pay for teaching and clinical work and is limited to a low percentage of academic work.”
    What does “academic work” refer to?

    • Academic work includes teaching, curricular design and implementation, learner assessment and program evaluation, research in all facets from grant writing to publication, education administration, research administration, some academic organization work, and scholarly activities such as case reports, book chapters, etc.
      I hope this is helpful.

  3. “I have the University’s commitment that physicians holding clinical appointments will be recognized by the university, and will be able to hold research grants. This change was needed long before this transition, as the intent all along has been to provide protected time for research to some people signing up to ACFPs.”
    To hold a grant will a MD researcher have to have both a clinical appointment AND a ACFP?

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