A look back

Thinking back to early March of this year is more of a strain on the memory than it should be. So very much has happened in such a short time. It’s hard to believe that only four months ago, we were all heading into our normal places of work and study, visiting stores, restaurants, bars, all kinds of public places, often multiple times daily, without giving it a second thought.

The reality behind these changes remains of primary importance, of course. Many people became critically ill with COVID-19, and globally, the number who have died from it is staggering. The circumstances are grave, indeed. This blog is by no means a suggestion that we are out of the woods, or even on our way out of the woods. That is still some time away, and requires some pretty significant achievements in science, as well as continued changes in human behavior.

In this blog, though, I do want to recap some of the truly significant efforts and transitions that have been made at the CoM. Most of us don’t like change, and we tend to push back when it’s forced on us. So all that has happened in a few short months really is amazing, and in no small part is due to the incredible responsiveness of everyone on our team (and beyond!) in making some big, previously unimagined adjustments in your work, studies and lives. These times we’ve been through together have been tough, but we have pulled together and supported one another, and that’s made it easier than it might have been.

Toward the middle of March, and inside of less than a week, we went from communicating some early changes to campus activities at USask and our college, to sending almost everyone home. Our team planned and supported how we would shift what we could for our learners to remote access. Our Year 3 and 4 clerkship students were barred from clinical learning. While our Year 4 clerks were minimally impacted given the timing, our Year 3 clerks suddenly found themselves removed from almost all their learning. And what they did next was impressive and inspiring. They volunteered in multiple ways to help patients and healthcare workers, to do their part as best they could, outside of clinical medicine. They helped gather PPE, they played a big role in contact tracing, they supported isolated senior citizens, they fundraised for La Loche and other northern communities.

In postgrad, our residents continued to play their important dual role as learners and workers in our health system, in alignment with their level of training. Many volunteered to transition to other areas of care to support the greatest needs. Our learners received amazing assistance and support from our UGME and PGME teams, and many others.

Our medical faculty were also on the frontlines of care, ensuring that they, their teams and facilities were prepared. Researchers stepped away from important projects, many of which were critical to progress in tenure and their career path aspirations. Many members of faculty, and all of our staff suddenly found themselves working from home while trying to stay connected with one another and, remotely, keeping the college moving forward in our mission and our own important roles related to the pandemic.

Beyond all that, our team was part of many other initiatives: our faculty provided public health and medical expertise to support pandemic decision making; education and information was provided to the health system and beyond by our Continuing Medical Education Division; a new program of online support for people with Multiple Sclerosis, Parkinson’s disease and spinal column injuries was offered; Dr. Hassan Masri provided weekly Facebook videos answering COVID-19 frequently asked questions; Dr. Carrie Bourassa was named Indigenous health lead for Canada’s national COVID-19 Immunity Task Force; Dr. Malcolm King assisted with improved mask design for pre-symptomatic COVID-19 patients; and Drs. Joyce Wilson, Kerry Lavender and Cory Neudorf received funding through the CIHR’s rapid response program for COVID-19.

Our research and graduate studies teams worked to support researchers and graduate students through changes and difficulties. We worked together to create an online spring 2020 graduation celebration that we hope filled some of the gap of our usual convocation and banquet celebrations. We found additional virtual ways to support and participate in PRIDE week.

These truly are among the most unusual times most of us have experienced. We have learned important lessons about what we can do when pressed, as well as things we could and should have been doing all along. Our return to a “new normal” needs to be thoughtful and we do need to embrace some permanent change for the better.

As we start a new term, we have gained valuable insights and experience that will guide our continuing efforts to lead improvements in the health and well-being of the people of Saskatchewan and the world.

The vital role of our residents

As frontline caregivers, our residents are essential members of the healthcare workforce as well as learners. This dual role means they were significantly and directly impacted by COVID-19.

Our residents have risen impressively to the challenge. While managing the impact of the pandemic on their own learning, many residents volunteered for additional work in high-risk situations, including the intensive care units and teaching our undergraduate medical students. While some of the residents had to self-isolate, others pitched in to address the gaps in clinical coverage.

Our Postgraduate Medical Education (PGME) office, led by Dr. Anurag Saxena, has also done excellent work in supporting our residents and the health system, and navigating through these troubled waters. The PGME office quickly developed the plans and processes to ensure that residents could continue to support patient care and gain learning experiences. I’ve mentioned a number of times, but will say it again, our college is highly committed to training and graduating physicians for our province. The PGME team is doing its critical part very effectively in this important work.

Our PGME team has been quick to respond and strived to stay a step ahead, despite uncertainties. Focused on mitigating this pandemic’s adverse impact, our residents have been supported in many ways. This includes, voluntary exemption from clinical duties for high-risk residents, provisions for carrying over vacations, additional funding and resources for counselling and well-being initiatives, and support during on-call duties. Residents have access to additional funding and resources for COVID-19 and patient-oriented research. Our program directors are admirably leading individual residency programs to adapt to the continuing uncertainty and ambiguity, and providing alternate learning experiences to ensure timely completion of residency.

Our residents have worked through disruptions in training with both redeployment and delayed licensing, impacting their plans and careers. I am sure the tone of support and teamwork set by Anurag and PGME, which ensured that residents had input into decisions impacting them, played a role in our residents expressing appreciation for the support they’ve experienced. The Resident Doctors of Saskatchewan (RDoS) and PGME (and the CoM) are aligned and work together to navigate this crisis. We even heard from RDoS that our province is the best place to be a resident!

The integrated teams in our university and in the Saskatchewan Health Authority (SHA) have done an amazing job navigating the additional work and planning required to support transitions related to redeployment and licensing for those who were completing their training this year. All parties involved were doing this while, of course, also managing the added pressures and stress of the pandemic.

The system-wide work to support residents has included our clinical department provincial heads (who work for both the CoM and SHA), area leads from SHA, and residency program directors and program administrative assistants who work directly with residents “on the ground.” Our college’s administrative team leaders have been integral in supporting transitions to virtual learning, with agile responses to financial and human resource considerations.

These leaders are working cooperatively with many of our external partners including SHA, the SMA, College of Physicians and Surgeons of Saskatchewan (CPSS), other PGME offices in the country under the auspices of the AFMC and the national bodies (the Royal College of Physicians and Surgeons of Canada, the College of Family Physicians Canada, the Medical Council of Canada, and Federation of Medical Regulatory Authorities of Canada) on system issues around admissions, national certification examinations, licensing, and planned launch of Competence By Design. Dr. Kent Stobart, vice-dean education, leads in an exemplary fashion within and across organizational boundaries and creates conditions for the success of our PGME program. It has been a true team effort underlined by effective collaboration and impressive leadership.

Great work is being done to ensure continued support for resident wellness, with resources available from our college and university, SHA and RDoS. I share some details of these here:

Finally, kudos to our residents and all involved in supporting them in their important roles as learners and medical doctors!

Mid-Summer Check-in

I hope all are enjoying this beautiful Saskatchewan summer and getting some down time. I wanted to give you some brief updates.

First, I want to provide a belated welcome to our PGY1’s as they are now two weeks into their residency programs. I was in clinic on Orientation Day and pleased to see the new Family Medicine residents and especially pleased to see so many familiar faces.

We have had great success at seeing our own graduates choose our residency programs and that bodes well for the future recruitment by the Saskatchewan Health Authority of our graduates. And hopefully the new residents have all successfully survived their first few nights on call and their average daily heart rates are starting to trend back to normal!

Second, I would like to congratulate Dr. Troy Harkness and Dr. Terra Arnason from the CoM and Dr. Christopher Eskiw from the College of Agriculture and Bioresources for their success in the latest Project Grant round of CIHR. They were awarded $872,000 over five years and even more remarkably their project received a score of 4.59 and was ranked second among 54 grant applications. Congratulations to Troy and his team!

I would also like to point out that Troy thanks the CoM for the CoMBridge funding that he received last year that was instrumental in this tremendous CIHR success. Repeatedly researchers who have received CoM support have gone on to national success.

What many in the public do not understand is that local and provincial support to researchers is absolutely essential for success in the big national competitions. Researchers need immense amounts of preparation and preliminary data to compete on the incredibly competitive national stage. The Saskatchewan Health Research Foundation has very limited funding and thus this internal support to our researchers is essential to our research success.

However, what the public may not also realize is that provincial research funding is directly correlated with provincial health outcomes. A paper from the University of Calgary School of Public Policy by Zwicker and Emery entitled, “How is Funding Medical Research Better for Patients?”  is sobering reading for anyone from Saskatchewan or Manitoba!

We all know correlation is not causation but the authors quite clearly demonstrate that mortality from potentially avoidable causes and treatable causes is inversely correlated with provincial research funding. So as a socially accountable organization we must do all we can to support research.

Finally, and on a personal level, I can report our 40th wedding anniversary river cruise in Eastern Europe was incredible! Budapest and Prague are my new favorite cities and the concert on board by Jann Arden was incredible. We also had a few days last week in the Rockies with family and look forward to a family wedding in NB and some Miramichi salmon fishing in early August.

So I hope you all are having a great summer and remember my door is open and I value your feedback.

It’s all about kindness

I hope all are keeping as warm as can be during these beautiful but cold Saskatchewan winter days. My response when weather comes up (and it seems we talk about it a lot here in Saskatchewan) is remember—we have the best summers in Canada! Sometimes I add that the best thing about when I lived in Halifax was that you could be guaranteed summer would start by August 1!

A number of events and comments in the last few weeks have reminded me of the importance of mental health, and the work that needs to be done to support the mental health of ourselves and our families, friends, learners, staff and faculty.

First, we saw “Blue Monday” come and go, a popular urban myth without objective evidence. Of course, Seasonal Affective Disorder is a real mental health problem, and if the concept of Blue Monday encourages us to think about those around us that may be suffering, it may not be all bad. On the other hand, many myths about mental health are much more harmful.

This leads me to the next reminder— Bell Let’s Talk Day on January 31 saw 145,442,699 digital interactions and $7,272,134.95 raised. I will declare no conflict of interest and I will say the initiative to encourage discourse is great, but we must strive more to move to action on mental health.

Bell’s initiative has four pillars: anti-stigma, care and access, research and workplace health. Of course, all are relevant to a medical college. All of this reminds me of the very first public event I attended after arriving at the CoM in June 2014. I was at a banquet at the Bessborough. It was a lovely evening to be at an outside event but due to a thunderstorm quickly rolling in, the event was moved inside. Clara Hughes (Olympic medalist in both speed skating and cycling) spoke on mental health. I particularly recall her comments on the stigma associated with mental illness. Stigma is the number one reason why many people do not seek help.

The mind-body divide is well entrenched in western ways of knowing and contributes greatly to the stigma many of us attach to mental illness. There are more holistic ways we can think about health and mental wellness, and we can learn so much from Indigenous colleagues and learners in this regard. For example, “The medicine wheel represents the alignment and continuous interaction of the physical, emotional, mental, and spiritual realities.” (Source of quote/more information) In terms of the medicine wheel teachings, I acknowledge there are many teachings and many interpretations associated with the medicine wheel.

Concerning stigma, Bell Let’s Talk outlines five things that we all can do to end stigma: language matters; educate yourself, be kind, listen and ask, and talk about it.

And that leads me to the last event I participated in this week on mental health, which hopefully ties together some of the thoughts in this blog. I was fortunate to attend a banquet on Thursday night with Scott Livingstone and colleagues from the Saskatchewan Health Authority at Whitecap Dakota First Nation. The Saskatoon Tribal Council organized the event in support of the Walking Together Youth Gathering, an initiative on supporting Indigenous youth.

The keynote speaker was Jordin Tootoo,  the first player of Inuk descent and first player from Nunavut (Rankin Inlet) to play in the NHL (four teams from 2003 to 17). He is also celebrated for his contributions to Canada’s silver medal team in the 2003 World Junior Ice Hockey Championships. Jordin provided a powerful and inspirational talk about his journey from his childhood to present with a frank description of the trauma he endured and the challenges he suffered from mental health and addiction to alcohol. His talk was painful, tender and yet hopeful. And at the end he told some great hockey stories for all the Canadians in the room.

I will leave you with the following quote from Jordin that resonated powerfully with me:

“We all fight a fight nobody knows about – It’s all about kindness.”

So be warm out there, take care of each other, and as always, I am always open to your input and feedback.

 

 

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