Holiday greetings

I am sharing here a brief update on some activities and some highlights from around the college and the university before we embark on what I hope for all is a restful and rejuvenating holiday with friends and family.

As you may be aware, our USask president, Dr. Peter Stoicheff has been reappointed for a second five-year term. This is great news for our university as we continue to benefit from Peter’s strong leadership and its continuity. Peter has worked with and supported our college and I look forward to continuing this relationship.

I recently had the opportunity to travel to India for 10 days with Peter, and the dean of the College of Arts and Science, Dr. Peta Bonham-Smith, as well as other university colleagues, and my own superb guide, Dr. Anurag Saxena, our associate dean of Postgraduate Medical Education. We all participated in a two-day conference on post-secondary education where our president was a keynote speaker. The primary purpose of the trip was to explore potential collaborations, including student and faculty exchanges, and advance our reputation as a great place to study and advance one’s career.

Dr. Saxena and I visited four different medical schools, one other university, and a nursing college that Dr. Vivian Ramsden, one our Academic Family Medicine researchers, has collaborated with for more than 20 years. Overall it was a great learning experience and we hope it will advance our mission. A further plus: I loved the food, and even finished some dishes Anurag couldn’t!

On this note of collaboration, I would like to highlight one of the commitments of the university plan:

The second commitment in our plan is Boundless Collaboration. It ensures that we invigorate the impact of collaboration and partnership in everything we do through four strategic goals:

  • Enrich Disciplines
  • Align Structures
  • Embolden Partnerships
  • Experience Reconciliation

Now I would like to draw your attention to our CoM news website and the number of news stories that emphasize collaboration. There are many, including the collaborative opportunities with the new Jim Pattison Children’s Hospital, but first note the collaboration between our Cameco Chair in Indigenous Health, internal medicine specialist Dr. Alexandra King and biochemist, Dr. Linda Chelico, and this introduction to the story:

“Linda Chelico and Alexandra King genuinely like each other. It’s why they keep finding interesting ways to work together. That, and their mutual respect for the different expertise each brings to the union, plus their willingness to admit their own weaknesses and learn from one another.”

Another is a great story involving a respirologist, Dr. Julian Tam, and a physiologist, Dr. Juan Ianowski, with the introduction:

“Building their partnership took time and diligence, but from the start Juan Ianowski and Julian Tam liked each other and got along well. That made the difference. Together, they have overcome the inherent hurdles in partnering across biomedical science and clinical practice and achieved significant research success.”

There are many more great stories about our researchers, including neuroscientist and Multiple Sclerosis (MS) researcher, Dr. Valerie Verge, who was recently honoured at the 2019 Women Against MS Gala Luncheon. Epidemiologist, Dr. Nazeem Muhharjine, received the U of S Distinuished Researcher Award at fall convocation.

All of these researchers and many more demonstrate Boundless Collaboration and all four of the strategic goals outlined above.

I also draw your attention to the great work of our researchers recently recognized by the Saskatchewan Health Research Foundation (SHRF) at the 2019 Santé Awards in Regina. College of Medicine researchers took five of the eight SHRF Excellence Awards:

  • Kerry Lavender (PhD); Dept. of Biochemistry, Microbiology & Immunology— Top Establishment Grant: Biomedical
  • Paul Mick (MD); Dept. of Surgery — Top Establishment Grant: Socio-Health
  • David Kingston (PhD); Canadian Centre for Health and Safety in Agriculture (CCHSA) — Top Research Fellowship: Socio-Health
  • Francisco Cayabyab (PhD); Dept. of Surgery — Top Collaborative Innovation Development Grant: Biomedical
  • Juan Nicolás Peña-Sánchez (MD, PhD); Dept. of Community Health and Epidemiology — Top Sprout Grant

In other news, many of us in administrative and administrative leadership roles in Saskatoon have recently moved to the newly renovated A-Wing of the Health Sciences Building! The entire building project is now complete with the rejuvenated A-Wing, known by many of our alumni as the original College of Medicine Building. This space is now a truly inter-professional administration building, with the dean’s offices of the colleges of Dentistry, Pharmacy and Nutrition, Medicine, and Nursing co-located here.

Most of our Saskatoon-based CoM leadership and administration are now located on the third and fourth floors of the A-wing; this will support us as we advance collaboration and teamwork. I am particularly excited to have our research leadership team with us on the fourth floor and UGME and PGME close by on the third floor.

We have beautiful space which I hope you will have the opportunity to visit. I have changed up my own office with more inviting and informal seating, so you will have even more reason to drop by and provide me with your feedback on the college or anything else you might like to discuss!

On that note I would like to take this opportunity to thank everyone—learners, faculty, staff and partners—for all that you have done for the College of Medicine in 2019. On behalf of myself, my wife Jane, and (of course) our dog Murphy, I wish each and every one  of you a wonderful holiday season filled with peace and contentment, wonderful meals, and special time with family and friends.

Exciting times in biomedical sciences

Guest blog by Scott Napper (Lead, Undergraduate BMSC Program Development)

New biomedical science (BMSC) undergraduate majors are on the way for May 1, 2020. Changes are coming for the honours, four-year and three-year degree programs.

For the honours and four-year degree programs, there will now be a single biochemistry, microbiology, and immunology major instead of two separate majors—biochemistry being one and microbiology and immunology the other, currently. As well,  the development of two new majors: cellular, physiological, and pharmacological sciences; and biomedical neuroscience, replace the current majors of anatomy and cell biology; and physiology and pharmacology.

The current three-year options in the separate majors in each of: biochemistry, microbiology and immunology; anatomy and cell biology; and physiology and pharmacology, will be replaced by a single, unified three-year degree option with the major of biomedical foundations.

Within these new majors, updated content, new classes and an enhanced priority on critical thinking and multi-disciplinary training will serve to better prepare our biomedical scientists of the future. The new majors were formally approved by University Council in Oct 2019. Current students will have the option to continue with their current program through completion (encouraged for those entering their third and fourth years) or transition to one of the new offerings.

A significant new experiential learning opportunity has been offered since 2018-19, when the Course-Based Undergraduate Research Experience (CURE) classes were introduced. They are designed to provide students with an authentic research experience where they develop and test a research hypothesis. This is a considerable departure from traditional lab classes where students follow a prescribed list of experiments to gain competence in specific techniques.

Rather than prioritizing competence in individual techniques, CURE classes challenge students to think and function as independent scientists. On completion, students will be competent in the process of defining a testable hypothesis and designing experimental approaches to test the hypothesis. Students will also have gained valuable experience in planning and preparing their own reagents (substances or compounds added to a system to bring about a chemical reaction or to see if a reaction occurs), setting up and conducting experiments, budgeting of time and resources, scientific communication (both written and oral presentation) and being a productive member of a team.

The changes to our biomedical science program have generated considerable enthusiasm among our faculty and students. Enabling the success of our students ensures the success of our program, at the undergraduate level and in recruitment to our graduate research programs. In addition to higher-quality training, the new program—coupled with USask’s unique infrastructure, such as VIDO-InterVac and the Canadian Light Source—will attract more highly qualified students from across Canada.

A further benefit of these efforts to optimize the biomedical science programs is the closer working relationship growing between the CoM and the College of Arts and Science. The USask biomedical science program is somewhat unique in that the biomedical science departments are housed within the CoM, while the associated undergraduate degrees are offered through Arts and Science. Academically, each biomedical science major reflects nearly equal contribution of courses taught by faculty of each college. While the colleges have historically maintained a strong working relationship, recent united efforts by faculty and staff of both colleges have enhanced appreciation for the greater partnership opportunities that are possible. Ongoing collaborations between the colleges will further improve the program while epitomizing the priority in USask’s Plan 2025 of cross-college collaboration. In this regard, there are other exciting plans for the future!

A history of steady improvement and progress in USask’s biomedical sciences have aligned with these rapidly evolving fields of study. In July 2018, the five College of Medicine departments within the biomedical sciences merged to two departments. This new structure better supports collaboration and multidisciplinary work, as the perceived boundaries between the biomedical science disciplines are becoming progressively blurred. In 2009, a coordinated effort by all of the biomedical science departments resulted in the creation of a two-year BMSC platform that consists of six courses which provide a broad introduction to the biomedical science disciplines. This platform serves as a common foundation of all of the biomedical science degrees. Over the past ten years, the BMSC platform has been highly successful in providing students with a strong interdisciplinary foundation as well as enabling them to make informed decisions of a biomedical science major in their third year. The new platform will include seven common courses.

Excellence and the clinical/learning environment

Leadership Matters – Part III

If you have followed my last two blogs (Inspirational meeting and Equity, diversity and inclusion), you will know I recently attended the Association of American Medical Colleges (AAMC) Annual Meeting, Learn, Serve, Lead 2019, and wrote about the inspirational nature and content of the meeting. Many AAMC leaders and speakers spoke out strongly on issues of equity, diversity and justice and called leaders and faculty, staff and learners to activism and advocacy. My second blog in this series of three called on senior leaders to be accountable for advancing equity, diversity and inclusion.

Another theme at AAMC, as in past years, was the joint responsibility of medical schools and the health care system to provide an excellent clinical and learning environment for our medical learners, staff and faculty. I have spoken frequently about the fact the clinical environment and the learning environment are inextricably linked and the quality of care is reflected in the quality of clinical education and vice versa.

The speaker at the last plenary session was superb. Dr. Amy C. Edmondson, the Novartis Professor of Leadership and Management at the Harvard Business School, delivered an amazing talk, Fearless: Creating Psychological Safety for Learning, Innovation and Growth. A review of her biography documents her expertise in organizational learning, innovation and teamwork. Her most recent book is titled The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation and Growth.

Now I know, as does Dr. Edmondson, that psychological safety for some has become a buzz phrase, and some think it is being overused. So, early in her talk she reiterated what psychological safety was not: about being nice; touchy-feely; a license to whine; freedom from conflict; and so on. However, she used logic and evidence to clearly argue that there was no tradeoff between high standards and psychological safety, as illustrated in the following graphic, and argued that it is incumbent on all leaders to expect both excellence in work and excellence in the working and learning environment.

One of the key challenges in our environment is the historical and current hierarchy of academic medicine. In 2007, Darrell Kirch, AAMC president emeritus, called for academic medicine to move from a culture that was hierarchical, autonomous, competitive, individualistic and expert-centered to a different culture that is collaborative, team-based, service-based, mutually accountable and patient-centered. In this talk, Dr. Edmondson illustrated we still have a long way to go!

One fascinating illustration about the importance of leadership in determining the work and learning environment was a study she co-led (Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams). Like any great speaker and scientist, she used evidence to link hierarchy to psychological safety to clinical outcomes. I am sure you all can picture this argument being built, but just to be clear, higher levels of hierarchy led to worse communication and teamwork and was associated with worse clinical outcomes as well as lower workplace satisfaction.

As one might expect, the study demonstrated overall significant differences of levels of hierarchy from physicians to nurses to respiratory therapists across the 44 neonatal intensive care units studied. However, further analysis revealed that some units were flat! That certainly also implies some units were even more hierarchical. (You might be interested in The World is Flat by Thomas Friedman, copyright 2005. Recent events may belay that idea, but I digress!)

So, what was special about the units that were flat? Detailed analysis was done and many factors were considered. In the end, the only common factor in the units where the pecking order did not, in fact, exist was the presence of inclusive unit leaders. Leadership matters!

I need to clarify my ideas on leadership. By virtue of the organizations of which we are all a part, we have positional leadership. But much of what I have read about excellence in leadership in organizations is that leadership is something everyone does. The custodian on the word can change a clinical outcome by speaking up. The learner will challenge the consensus on teams and often be right.

For me, this study and Dr. Edmondson’s talk illustrate that all positional leaders must be inclusive, collaborative and must welcome feedback and dissent. More importantly, it illustrates the importance of front-line leadership and the importance for our patients and our learners that we provide inclusive, respectful, collaborative leadership.

So, as always, I invite your feedback here on my blog. I would also be happy to hear from you face-to-face, and would welcome the opportunity to attend your department or unit meeting and travel to your community.

See also:
Inspirational Meeting – Leadership Matters Part I
Equity, diversity and inclusion Leadership Matters Part II

Equity, diversity and inclusion

Leadership Matters – Part II

This blog is more on the Association of American Medical Colleges (AAMC) Annual Meeting, Learn, Serve, Lead 2019, that I recently attended in Phoenix, and most importantly about the work of our CoM Diversity and Inclusion Working Group. As I noted in my previous blog, the audience at the meeting included medical education and healthcare leaders, clinicians and educators. We all benefited from amazing speakers, both from within and outside medicine, who talked about activism, advocacy and change and called on all to advance the fight against inequity, injustice and racism in academic medicine and the healthcare system. One recurrent theme was their call on leaders to be accountable for leading change towards greater equity, justice, and excellence in healthcare—and we were reminded that we will never have the last without the first two.

While many speakers emphasized leadership qualities like humility, curiosity and empathy, it was always in the context that good leadership is essential for success in any organization or enterprise. A number of the speakers talked about racism in the United States and the profound impact it has on health inequity. This included the plenary speaker, Bryan Stevenson, highlighted in my last blog. I was constantly reminded, of course, of our own challenges in Canada of racism and health inequity of Indigenous people. This extends to other groups in our college and country, including those with disabilities, those who identify as LGBTQ, and others.

Another great speaker was Dr. David R. Williams, Norman Professor of Public Health at the Harvard T.H. Chan School of Public Health. In his talk, Racism, Medicine and Health: We Must Do Better Than This, he too did a remarkable job of weaving data and stories together to illustrate the connections between race, socio-economic status and health (again it hit far too close to home!), and of equipping us with tools to change the narrative.

Dr. Williams reminded us of the innumerable ways in which racism is embedded in our culture and ourselves. Another speaker shared evidence that we are all prejudiced. And Dr. Williams reiterated how racism is based in both neuroscience and history, and some examples are truly ancient and some sadly current. Two data points stick in my mind. The first is that black Americans lag substantially behind white Americans in annual income (I must rely on my memory, but recall it was around 60 per cent), but when it comes to wealth for every dollar held by a white person, just seven cents is held by a black person! The second data point was that the pre-term birth rate for Latino women has risen since 2016—I will let that one speak for itself!

Another overriding theme of the conference was that when it comes to diversity and the challenges of racism, leadership must come from the top. Repeated stories of success in many organizations emphasized that senior leadership must be advocates for change on diversity and racism. I and the leadership of the CoM are committed to being nation leaders on advancing diversity and inclusion. In that regard I would like to highlight the work of our Diversity and Inclusion Working Group (DIWG).

The group was formed in 2017 and its membership includes faculty, senior leadership, and administrative staff, who (in accordance with the DIWG’s Terms of Reference) reflect greater representation of under-represented groups within the College of Medicine. The working group is charged with: developing a plan that aligns with the University of Saskatchewan’s Diversity and Inclusion Plan; putting the plan into action through the development of initiatives and projects to promote the diversity objectives indicated in the plan, and; operationalizing elements of the University of Saskatchewan Diversity and Inclusion Plan that may require unique operational processes due to the province-wide mandate of the College of Medicine. More information about diversity and inclusion in our college, including the just-released annual report of the DIWG, is available on our college website.

I would also like to highlight the work of our Research Equity and Diversity Specialist in the Office of the Vice-Dean Research, and the upcoming Balance and Belonging Speaker Series. Ensuring that the College of Medicine supports a research community in which everyone is represented and supported is vital for increased innovation, relevance, creativity, and impact. The Speaker Series, which offers three presentations over the course of the year, will also offer a Certificate of Attendance to attendees of all three sessions. This initiative is unique in comparison to other universities in Canada and demonstrates the commitment the College of Medicine has, not only to addressing equity, diversity and inclusion in our research, but also to improving inclusiveness and enabling our faculty and staff to feel more welcome and valued at work.

As always, I welcome your feedback.

We now have a full team on the Dean’s Executive with the addition of Dr. Marilyn Baetz as the Vice-Dean Faculty Engagement. I and the vice-deans of faculty engagement, research and education, and the chief operating officer all look forward to hearing from our staff, faculty and students from all backgrounds and groups you identify with—your identity is yours. We hope that identity includes the College of Medicine! And if not, that you will tell us what we can do to make that happen.

See also: Inspirational Meeting – Leadership Matters Part I