Mock accreditation – how did it go?

Since this was a practice run, I have to compare it to marathon training where one does at least three or four “long runs” (32 kilometres) in the few months prior to the marathon. If those runs are easy then you would never finish the 42.2 kilometres of a marathon. If they are tolerable, then you would not do any better than you did in your last marathon. And if they are hard (or even better, really hard) then you are likely to have a successful marathon or even a PB (personal best).

When it comes to accreditation, we are planning for a PB!

So, as many know, we had a “mock accreditation visit” from February 5-8—from Sunday evening through Wednesday at noon. Dr. Tom Marrie, former dean at both the University of Alberta and Dalhousie who guided both schools off probation, and Dr. Cam Enarson from University of North Carolina, who has done 37 full accreditation visits over his career, did the work! They were incredibly thorough (tough, even) and tremendously helpful.

As a reminder to all, our full accreditation visit is October 29 to November 2, 2017. The process, as dictated by the Committee on Accreditation of Canadian Medical Schools (CACMS), began with a medical student-led Independent Student Analysis (ISA) 18 months before the visit. Our students were extremely engaged and did a great job on the ISA in the spring of 2016.

The next step was populating the first draft of the Data Collection Instrument (DCI), which is a series of questions and data requests regarding each of the 12 standards subdivided into 94 elements.

An Accreditation Steering Committee led six task forces that then divided up the 12 accreditation standards into key areas of focus – administration, admissions, curriculum, educational resources, learning environment, student services – and reviewed the DCI. An iterative process followed by which issues uncovered were fixed, the DCI was updated and a draft submitted to our mock accreditors in mid-December 2016 for review. This process of continuous improvement will continue. For example, Faculty Council passed some policies on admissions just last week which will require an update to the DCI. We have until mid-June to rewrite and polish our DCI before submitting the final version to CACMS.

A mock has never been done before at our college but has become standard practice at all Canadian medical schools over the last three years. Other medical schools have found it invaluable—and all have found it terrifying, as they discovered work yet to be done.

The mock was a dress rehearsal, a fact finding mission, and a reality check. All three are important. An external review by people we employ to find all the gaps that we may be blind to is incredibly valuable. I joked on the final day of the visit that if Tom and Cam were here to find all of our weaknesses, we got incredible value for money!

Let me expand on the reality check. If the real visit were next week, we would have a negative outcome. The accreditors reminded us that this isn’t an exercise in how far we have come; it is an exercise in determining if we meet the standards on the day of the visit.

Overall, I am optimistic. While I now know we still have an incredible amount of work to do—in fact, more than I thought—the good news is we know where to focus our efforts.

On the positive side, Tom and Cam were fully aware of the scope of the transformation underway at the CoM and felt we were going in the right direction. In fact, they noted that we are at a turning point and for the first time in many years the CoM has the potential to be the medical school Saskatchewan deserves! They thought we had the right team in place with: UGME leadership; department heads; the dean’s office; unit, course and clerkship leads; faculty; and staff. They were very complimentary of our faculty, staff and learner engagement in the visit. They were also very positive about the support and commitment from the health regions.

So in summary: right direction, unique opportunity, great team and great engagement.

On the negative side, while our visit logistics worked perfectly for the accreditors, there is work to do on the internal logistics. (On behalf of the team that was working very hard and rapidly behind the scenes, our apologies for some of the confusion in our communication and scheduling.) Also, our DCI had gaps, from broken hyperlinks, to some missing information or weak responses. We took copious notes, and these will all be fixed.

Another challenge is communication. The mock accreditors said not enough people knew and understood all the things going on at the CoM in terms of changes that have been made and processes and progress on accreditation.

So count on plenty more accreditation and CoM progress updates.

While all who met the team were very engaged, more preparation is needed. But it is on the accreditation team and dean’s office to ensure every individual and every team who meet with the accreditors in the fall have the preparation they need. Our team has learned a lot about visit organization, and we will improve. We already are making plans for assisting everyone in their preparation for the real visit early in the fall. We will ensure you are ready. And if you don’t think so, call us on it before the visit.

Some of the remaining issues we must address are big. Not all our students know where to turn in cases of mistreatment and are not entirely confident their concerns will be addressed. We will fix this! Let me assure all students the CoM, UGME team, faculty and staff are committed to a safe learning environment. Let me be clear: this is a very big accreditation issue!

I believe, and the mock accreditors confirmed, our greatest strength—other than great faculty, staff, and learners—is the transformation underway at the CoM. However, accreditation is a data-driven business and so our greatest challenge is having data that demonstrates the transformation is succeeding. This is big, so we will need your help, especially from our students, as we will be doing a follow-up student survey.

There is no doubt that we have had great financial support from the province in the past, but the accreditors made it clear that we are still in the middle of transformation. We are all aware of the current provincial fiscal challenges, but we have conveyed to our government partners the need for a restoration of required funding, and are in constant discussions with them about the college and its critical role in the health care system of the province. However, it was clear to Tom and Cam that if the needed financial support is not available that the transformation and accreditation will be difficult to achieve. This is really big!

And finally, we need to abandon our humble Saskatchewan ways. We were told it is time to assert our excellence and emphasize the things at which we are really good. I will give you a good example.  On the elements for diversity and social accountability, I was asked on Sunday how many Indigenous faculty we have, and while I knew personally some of our Indigenous faculty, I could not answer the question. So on Monday I asked Val Arnault-Pelletier if she would match our list of 73 self-identified First-Nation and Metis medical graduates with our list of faculty appointees. I now know we have one PhD and 21 MD Indigenous faculty appointees, and a number of them are in leadership positions! Tom and Cam were blown away by this information and emphasized we have lots to brag about. Now is the time to start.

I thank Tom and Cam profusely. We are really in their debt. I need to thank and compliment Dr. Athena McConnell, assistant dean quality, and Marianne Bell, accreditation specialist, as well as Dr. Pat Blakley, associate dean UGME and Dr. Kent Stobart, vice-dean education and the great team that backed them up. You know who you are.

Most importantly, I thank all who participated in the mock accreditation. Your engagement is inspiring.

However, the work ahead is daunting. Accreditation is our collective first priority after our patients, learners, and research! There will be more requests for information, opinion, surveys, policy development and meetings. We have all been working on multiple high priority initiatives over the past few years and are entering a time period through the fall where we will have to focus our efforts on UGME accreditation. I am committed to removing barriers for our entire CoM team to work on this, as our highest priority. I am also counting on all of you and know that, when asked, you will step up to the plate and be the great team players you have been leading up to, and during, this mock visit.

Remember, while success in marathon running depends very much on the individual, accreditation success depends on a team effort. As I’ve said many times, it’s a team sport! Thank goodness for that, as we will need many contributing to the work ahead, and we have a great and committed team.

I think of teaching, research and patient care as the fun parts of our collective work. A PB in accreditation will free us all up to have more time for the fun stuff!

And, as always, I am here to listen.

 

 

 

 

 

 

 

 

 

 

 

 

A week of progress… and back to accreditation!

Last week was an exciting week here at the College of Medicine. The week started with introductions to my new boss! Dr. Tony Vanelli will join the University of Saskatchewan as our new Provost and Vice-President Academic in August. He comes to us from the University of Guelph where he served as the very highly regarded Dean of Engineering for two terms, and prior to that was at the University of Waterloo. We got to interact over a day and a half at a U of S senior leadership summit. Tony is very interested in the CoM and anxious to learn more over the next six months to support us on our journey to be one of the best Canadian medical schools.  The University and the CoM have had incredible support from both Acting Provosts, Ernie Barber and Michael Atkinson, but I know both are thrilled to pass the baton to a new permanent leader in the Provost role. This is an important step forward for the U of S.

On Wednesday night I was on hand with our President, Peter Stoicheff, and our Board Chair, Lee Ahenakew to welcome the Prime Minister Justin Trudeau to the U of S, the Health Sciences Building and the CoM. The town hall was extremely interesting to observe as the PM responded to a variety of questions with some appropriate emphasis on Indigenous concerns, although some controversy arose regarding some of his comments. On the other hand, the town hall was less raucous than some were across the country.

Even more important on Wednesday evening was the Faculty Council support for two major policy initiatives at the CoM. First congratulations to Dr. Keith Ogle on receiving support for the Policy and Procedures for the appointment of medical faculty. While our transition to a One Medical Faculty model as part of an overall united One Faculty model has been well discussed here in the past, this step was an important formal step in realizing this ambition.

Further congratulations to our Admissions Committee and Dr. Barry Ziola as Faculty Council voted to support a new admissions policy that designates six of our UGME seats for students from socio-economically disadvantaged background. The evidence is that the average family income of a Canadian medical student is at least 3 times that of an average Canadian family. I recall many years ago doing a CaRMS interview and being amazed by this individual’s academic prowess, grade 12 piano by the Royal Conservatory of Music, provincial tennis championship and stellar list of volunteer contributions. I knew two things for sure: this applicant would be an incredible doctor, and this applicant was rich! I recall thinking I wonder how many bright compassionate people never get the chance, and this is a big step towards fulfilling our mandate to be socially accountable and in ensuring our student body reflects the people we serve.

And then on Thursday we had the wonderful announcement of the recruitment of Dr. Michael Levin to the Chair in MS Clinical Research. Dr. Levin comes to us from the University of Tennessee and is an accomplished MS neurologist and clinician scientist. Dr. Levin joins Dr. Valerie Verge in the Cameco MS Neuroscience Research Centre, Dr. Katherine Knox in PM&R and other neuroscience researchers at the U of S. Furthermore the CoM and the health region have been successful in recruiting Dr. Ilia Poliakov, a neurologist who just finished an MS Fellowship at U of C. We will also be recruiting an RN and a Nurse Practitioner to further enhance the care in the MS clinic. Almost overnight we will revolutionize MS care and research in the province!

While the CoM took the lead on the recruitment this could only come to pass with incredibly important partners including SHR and the MoH. Of huge importance was the MS Society, the community of MS patients and their families and friends and the Saskatchewan Health Research Foundation. However the endowment that underpins the Chair was raised by Saskatoon City Hospital Foundation ably led by its Board and the ever enthusiastic CEO, Mr. Steve Shannon. Thank you!

I find this story very inspiring as this money was raised in the community, at events, and one small donation at a time. The province of Saskatchewan has the highest MS rates in the world and this is a perfect example of working with the community to be a socially accountable medical school and change care for MS immediately here, and through our research around the world.

Finally, this Sunday evening we start our mock accreditation. We will be visited by Dr. Tom Marrie, my former dean at Dalhousie University, and Dr. Cam Enarson from the University of North Carolina. This visit is an essential step in our preparation for the full accreditation visit October 29 – November 3. The ‘mock’ will serve as a dress rehearsal for many. We have dramatically increased the team of faculty and staff supporting UGME and most have not been through an accreditation before so rehearsal is good. But more importantly it is a fact finding mission. We already know of things that must be fixed by the fall and have been working very hard for two and a half years on those. By engaging experienced accreditors to do a rigorous review we hope, to paraphrase Mr. Rumsfeld, find the gaps in accreditation standards that are the unknown unknowns.

So as I have said many times accreditation is a team sport and we look forward to your active participation in the mock accreditation. More importantly we will need to all work hard together with the feedback from our mock accreditors to prepare for the fall.

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

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

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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.

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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.

Working Together on our CoM Strategic Plan

I trust you are having a wonderful summer so far and have had, are having or will soon have some holidays complete with time to rest and rejuvenate. I have just returned to work this week after an amazing break and feel ready once again to take on the incredible opportunities and important challenges of our College of Medicine. I always am excited to see September come around to launch a new academic year and I look forward to all of us coming back together from the summer with renewed energy and fresh perspectives.

The reason this is so important this year is the CoM is embarking immediately—at the end of this month—on a college-wide strategic planning process in which all members of our community have a voice, should you choose to share it. I strongly encourage you to do so. Why? Because everything we have been through in recent years, which has been difficult and at times even painful, has helped set the stage for our college, now, to move forward in the best possible way.

I am looking for a shared commitment to doing this work together. With all of our community’s individual voices coming together to create a pool of knowledge and experience of the CoM, we have our best shot at creating a plan that will reflect the diversity of our work, needs and aspirations at a grassroots level—to ultimately elevate our students’ experience, our teaching excellence, and the reach and impact of our research.

The strategic plan development process will follow a rapid timeline – we plan to have the full college consultation and information gathering process completed between the end of this month and the end of this year. That’s just four months to gather a vast array of detail, input and knowledge from a large group—all of our faculty, staff and students. Accreditation requirements necessitate this timeline, but we will work to engage with you in this timeframe through a range of methods for you to share your perspectives and suggestions: focus groups, online surveys and other discussions and meetings.

Why are we embarking on this planning process now, and on this timeline? We are at the natural point in time, in terms of our planning cycles. The President has initiated a process to renew the vision, mission and values at the U of S and will be embarking on a new 8 year strategic plan. Our 5 year plan that will take us from 2017 to 2022. will fit into that plan. Currently, our School of Physical Therapy is developing its own five-year plan. Starting in 2013 the College did tremendous work creating the strategic vision document, The Way Forward which in many ways was primarily a strategy for restructuring the College of Medicine. We have worked very hard over the last 2 years and most of that plan has been done or is well underway. It is now time to set our aspirations on what the College of Medicine can do to become one of the best medical schools in Canada and a College all of us can be proud

At a high level, the next four months will look like this: during September, two task groups will cover the areas of teaching and learning, research and innovation, as well as separate engagement forums to review and discuss clinical care service and community engagement, governance and partnership, and administration. If you are interested in participating in any of these discussions please let us know. In October and November, these task groups will lead engagement forums for your participation, including visioning and prioritization events, focus groups, and so on. Ultimately, we will arrive at a draft plan early in 2017 that will need to be ratified by the College of Medicine Faculty Council.

The outcome of this work will be a new vision, mission, values and priorities for the CoM. At that stage, there will also be tremendous opportunity (and a healthy dose of encouragement from myself and other leaders across the college) for your involvement in the very important work of implementing our plan and its deliverables. The implementation of our college strategic plan will be decentralized in nature, with broad participation and support an absolute necessity.

We will be sharing information about the planning process through: high level information targeted primarily to external audiences on our website through a CoM Strategic Plan page, more detailed internal information and content to come later, and likely through further blogs, as well as various reminders, dates and news through our internal, weekly E-News.

I’ll close by reiterating how much I hope for your involvement and input in, and support of, the planning process I’ve outlined here. Working together now to shape the next five years in the history of the CoM will be well worth the effort!

As always, I welcome your feedback.

Summer Blog

Despite two days of rain it is quite clear at the College of Medicine that summer is here as the halls are decidedly quiet.  As I eagerly anticipate vacation starting on Saturday, I wanted to take an opportunity to let you know about the CoM activities.

We have had an incredibly busy year – a fact I realized while putting together the report for my annual review with the Provost and Vice-President Academic. I won’t go through all the details but I would like to highlight three major accomplishments.

First our team is in place. We now have recruited three vice deans, a chief operating officer, four new department heads, two associate deans, two assistant deans, and an almost entirely new management team in the Dean’s Office.  I am really excited about the team we have in place. I believe our leadership bodes well for the future.

We have come through the faculty transition with 100 of our 130 USFA MD faculty making the transition to ACFP’s or alternate engagements with the CoM. Congratulations and thanks to the team of people from the college, the Saskatoon Health Region, the Regina Qu’Appelle Health Region and the Ministry of Health who led this work. It was an Herculean and incredibly complex task and, while difficult at times, I believe was done in a very respectful manner. Many things are good about the ACFP from a CoM perspective, especially the clear definition of academic deliverables. Having said that, much work still needs to be done to clarify deliverables, processes, governance, etc. The CoM is committed to working collaboratively with our partners, the unified department heads, departmental mangers (who have a crucial role in administering the ACFP) and the faculty participating with the CoM under the ACFP to ensure we maximize the service to our learners, our research programs and the academic careers of those MD faculty.

Late in June, Dr. Anurag Saxena, Associate Dean PGME, Dr. Kent Stobart, Vice Dean Medical Education and I attended meetings in Toronto with the accreditation committees of the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada. Overall our PGME accreditation was successful. Some programs have some work to do but there is already a plan in place to resolve any deficiencies and all of our programs are accredited.  Congratulations and thanks to all faculty, program directors, staff and residents who supported this effort. In particular, our PGME office staff received high praise from the accreditation team that visited. Kudos to Dr. Saxena and the PGME staff.

Much other work is underway as we continue to work on restructuring the Biomedical Science Division, which voted for a two departmental model, as we launch the Saskatchewan Center for Patient Oriented Research, as we develop our One Faculty model and, of course, as we continue the ongoing roll out of our new curriculum. The agenda we are on is truly ambitious but with the dedicated team of learners, faculty and staff at the CoM that I have the privilege of working with, it is an agenda I am confident that we will complete.

In late June, I had the unique opportunity to join a U of S delegation to northern Norway. The delegation included several USask leaders, Chancellor, Blaine Favel, Board of Governors Chair, Lee Ahenikew being among them. We visited Sápmi, the homeland of the indigenous people of northern Scandinavia and eastern Russia, who are known as the Sámi. We visited the University of Tromso, which has a medical school similar in size to the CoM and face similar challenges such as distributed medical education, clinical care in northern and sparsely populated regions and service to their indigenous population.

We visited the Sámi University College, the Sámi Parliament, and the northernmost community in the world with streets and a permanent population, Longyearbyen on Spitsbergen Island in the Svalbard archipelago, which also has a university center. The University Centre in Svalbard (UNIS) is the world’s northernmost higher education institution, located at 78º N. It is unique in that all students are required to do fieldwork in all of their courses and, to do so, must take a safety course and learn to use a rifle–that last is due to the polar bears!

Norway is indeed a beautiful country but the real purpose of the visit was to explore their service to the Sámi people. We learned a lot and found a real inspiration to continue on the mission of “indigenizing the university” as advocated by President Peter Stoicheff.

Well, as I said, I am looking forward to my vacation which starts Saturday as I go fishing up North for four days and then head to the Maritimes. I look forward to attending my 35th medical school reunion (how time flies!) in St. Andrews by-the-Sea, New Brunswick, salmon fishing on the Miramichi River and relaxing ocean side in Nova Scotia and PEI.

I hope you all enjoy your summer and have an opportunity to get some rest and relaxation. As always my door is open and I welcome your feedback.