Early steps in reopening medical education clerkship

I have a few messages for this week’s blog.

First, as a Maritimer my thoughts have been with those in Nova Scotia since news broke Sunday of the tragedy there. We at the CoM and in Saskatchewan have tremendous compassion and understanding for what Nova Scotians and the Maritimes are going through, with the terrible toll of the Humboldt Broncos bus crash still deeply felt here after two years. And we have a number of people on our CoM team who are from the Maritimes, as well. So our thoughts are very much with our fellow healthcare learners and workers and first responders in Nova Scotia.

On behalf of everyone at our college, I extend heartfelt condolences to all who are suffering from this incredibly painful loss.

I want to also provide a brief update on our undergraduate medical education clerkship program and where we are at in planning for “reopening” clerkship.

In this vein, as you know, earlier today Premier Scott Moe shared details of a careful, gradual approach to reopening Saskatchewan services and businesses that was developed with Dr. Saqib Shahab, chief medical health officer. Important context from this plan for us all: even as some businesses and services begin to reopen, requirements for physical distancing, personal hygiene and cleanliness, and appropriate use of protective equipment remain in place for at least many more weeks. I encourage you to visit the plan website and read the plan document.

The province’s plan will certainly inform all of our own planning, including for clerkship. In that regard, a significant amount of work has already taken place. Earlier today we had a meeting where proposals developed by two working groups—one composed of our clerkship students, the other of the educators and directors leading clerkship curriculum—were shared with our medical education leaders and will be used to develop a plan for how and when undergraduate clinical education resumes.

Of course, the pandemic is expected to be with us for the foreseeable future and any plans we make must be flexible, as changes with changing circumstances must be expected. More information on our clerkship plan will be shared as it unfolds.

The good news is, as our premier said, we have reason to be cautiously optimistic about the spread of COVID-19 in our province. Continued diligence and thoughtful planning will enable us to make some progress on returning to some aspects of our previous approach to clerkship and other areas of learning and working. It’s important for us to recognize that what we are planning for is a new normal and we need to adjust our expectations with that in mind. This is true for our plans for clerkship, and all our plans for our work of the future.

As always, I welcome your thoughts.

COVID-19 impact on research

Many adjustments have been made to where and how we are working in the past month. With this blog, I draw attention to the difficult circumstances of our researchers—our faculty researchers, graduate students and postdoctoral fellows.

For this group, our campus and other facilities are critical to the progress of their work. So, similar to learners who can’t be physically present in clinical settings, most or all work for our researchers is stopped at this time. Their projects, some of which may have been on the cusp of a significant breakthrough, are halted. For our graduate students, as I mentioned in my earlier blog on learners, this stop to projects comes also with delays in graduation for some and managing difficult financial realities for many.

Processes are underway for determining facility access for projects related to COVID-19, and of course some access has been ongoing for some COVID-19 work at VIDO-Intervac and with testing in some of our laboratory facilities, and for projects involving care of animals. But for the majority of our researchers, projects are halted and they won’t gain access to facilities until that time when we begin our return to campuses and other facilities.

We have  a number of our researchers involved in the critically important COVID-19 efforts at USask, like Scott Napper, professor of biochemistry and senior scientist at VIDO-Intervac. Maureen Anderson, assistant professor in community health and epidemiology, worked with the dynamic modelling team providing evidence to inform Saskatchewan’s pandemic decision-making in real-time, a collaboration with USask’s Department of Computer Science. Gary Groot, associate professor in community health and epidemiology and surgery, is working with Jim Barton, associate dean of continuing medical education, and a team that’s been gathering and vetting information on the science of the COVID-19 virus to inform provincial leaders in their planning and decision-making. I know you join me in thanking these members of our team for their work.

These efforts focused now on COVID-19 are a reminder that under normal circumstances, on a daily basis, our researchers are engaged in knowledge creation and discoveries that the world needs—important work that our researchers are passionate about, and to which they are passionately committed.

I am not suggesting that the physical distancing measures and changes in access to our facilities are not the right things to do—we know they are and that the safety of our people is paramount and comes before other considerations. But I do want to bring attention to the significance of this change for our researchers, this loss of momentum, this stop to incredibly important work.

As you can appreciate, it is particularly ironic to have, at the very same time, public recognition broadening for just how important science, knowledge creation and discovery are to our collective safety and wellbeing. That said, we know this public awareness is a good thing ultimately for science, and certainly has brought the incredibly valuable work of our population health experts and biomedical scientists to the forefront.

Similar to many, my own awareness and understanding of population health, immunology and the nature of viruses is expanding. I’ve become quite immersed, while working out, in This Week in Virology podcasts. Perhaps it’s my inner nerd speaking; I find them fascinating. I expect many of you are accessing new sources of information related to the pandemic; I welcome you to share here information you are turning to and finding helpful.

So with this message, I ask you to join me in acknowledging and recognizing our researchers at the CoM for their valuable contributions—those engaged directly in work now on the virus, but equally those who are removed for the time being from their work on underlying causes, treatments and cures for so many areas of health: cancer, heart disease and stroke, HIV-AIDS, multiple sclerosis, mental illness, cystic fibrosis, and so many more.

Coming days at the CoM

I wanted to share some current thoughts for how our college is operating today in light of the pandemic, and what we expect in the coming days and weeks.

Increasingly we are seeing the need to continue with our critical actions of physical distancing, practicing proper hygiene, staying at home as much as possible, and self-isolation when required. The Government of Saskatchewan’s release of COVID-19 modelling for Saskatchewan yesterday as the basis for health system planning (it is not a prediction), underlines this need to continue with current measures.

In short, we are in a holding pattern for now. I am sure you will appreciate that we cannot plan with great certainty, especially farther out. We do know that for the moment and likely until at least July, we are continuing with learning, teaching and working remotely.

Our physicians too are delivering more care virtually, but of course our residents, medical faculty and some of our staff are attending our hospitals and other healthcare facilities, looking after patients, while learning and adjusting to new realities, approaches and safety measures. To this group: you are our colleagues and our learners, and we are keenly aware of the challenges and difficulties you are facing. Alongside everyone in Saskatchewan, we are thinking of and thanking you each and every day.

We are committed to supporting your efforts on the frontline by doing our part to stay home, practice appropriate hygiene, and do all in our power to stay well.

For all who are learning and working remotely, our new methods of staying connected will continue for the near future. With our learners, we will continue to update you with communications from your program offices, as well as with virtual meetings including town halls, small group work, and meetings with student and resident leaders. And we continue with online teaching and learning, and meetings, and various virtual administrative meetings, as our college moves forward in its mandate as much as possible apart from our physical facilities at our campuses and sites around the province.

So I offer words of encouragement to everyone at the CoM. Maintain a strong commitment to the necessary processes and approaches we’ve adopted. Use the virtual tools we have at our disposal to stay connected and stay positive and healthy. Help is available to all—our learners, faculty and staff—if you are struggling personally, through our USask resources and within our college, and via your supervisors. Do not hesitate to reach out if you need support.

Finally, on a separate note, I want to congratulate Dr. Melissa Just, who the university named this week our incoming interim provost and vice-president academic. She joined USask as dean of the University Library in February 2017 and has provided exceptional leadership in that role, and brings a strong background with extensive experience in academic and research libraries, including within a medical school, at a variety of major American universities. I am looking forward to working with Melissa in the days ahead.

As always, I welcome your feedback. Stay well.

Staying connected with our learners

With my blog this week I want to reach out in particular to our learners with some words of support.

As well, I want to share how our learners in different programs and years are continuing with their education and training.

So first, some words to our learners: the college, and our leaders and staff in your respective programs appreciate your patience and commitment in adjusting to the many changes in education delivery caused by COVID-19. We know you have many questions and we have received many of those from you; CoM leaders, faculty and staff are working very hard to provide answers where we have them, and support you in various ways. We all need to hang in there, continue to stay connected in safe ways, and help one another out with understanding and patience.

As you know, the primary effort for all of us right now is the one we are each making to protect our health and that of others. That does not mean all else stops, and in as many ways as safe and reasonable, we continue to move ahead. Our college is committed to advancing learners through their programs in a safe manner; this work is more important than ever.

Second, what is happening with our learners now?

Our programs and offices are in contact with students, responding to inquiries and providing updates. Leaders in our School of Rehabilitation Sciences, graduate studies, undergraduate and postgraduate medical education offices, at our Regina campus and other sites, and in all our departments are maintaining connections with their respective learners, answering questions and providing support. As we learn new ways to do so, we are working to maintain and bring normality to how we connect with learners.

Medical education learners – undergraduate

Our approach to the undergraduate medical education program during COVID-19 is based on three principles: learner well-being; completion of education/clerkship and graduation on time; and public health obligations.

Our Year 4 MD students have completed their clinical work and will graduate on June 4, 2020. They will join residency programs as usual, with about half staying in Saskatchewan programs and the rest joining programs in other provinces across the country.

Our Year 3 MD students are in a particularly challenging time, as they have had to step away from clinical learning since March 16. They will return to complete Year 3 when conditions are improved both in terms of safety and availability of a broad range of clinical learning experiences. Right now, we don’t know when that will be, and recognize how difficult this uncertainty is for these students. In the interim, we have begun planning for how this return of Year 3 students to clinical learning can best be managed, the starting point for charting a path toward successful completion of Year 3 and developing a plan for Year 4 for the MD Class of 2021.

Year 1 and 2 MD students are currently participating in lectures and completing assessments remotely, and participating in small group sessions through videoconferencing. Their Clinical Skills courses have been postponed for reasons of safety and availability of learning experiences, and course leaders are working on redesigning these courses for later delivery.

We have begun holding regular virtual town halls with our undergraduate medical students and will continue to do so, and are in close contact with student leaders. Our Office of Student Affairs is available to all undergraduate medical students needing support.

Medical education learners – postgraduate

In postgraduate training, our residents are being supported by their departments and our postgrad office on processes for possible redeployment if necessary to areas of need, and provisional licensing for those in their finishing year. This might mean a shift of timelines with regard to program completion for some, but our residents continue their critical roles in patient care, working and training in clinical settings, with the appropriate precautions and safety measures in place aligned with their levels of training.

Graduate students

Our graduate students also face big changes and challenges, with financial concerns related to part-time work and summer job availability, while continuing their studies. The vast majority are unable to access university buildings and facilities to continue research projects. Know that our college is actively engaged in this issue and working with USask on solutions. This week, I joined CoM Vice-Dean Research Marek Radomski and Assistant Dean Graduate Studies David Cooper at a meeting with our CoM Graduate Student Association. We continue to advocate for our graduate students and are staying in close contact with the College of Graduate and Postdoctoral Studies.

Master of Physical Therapy (MPT) students

The School of Rehabilitation Science (SRS) is supporting its students and working to minimize any negative impact on their academic progress. Our faculty there are teaching remotely and students are participating in online classes and examinations focused on the theoretical components of learning objectives. Laboratory content and evaluation have been deferred until students can return for face-to-face delivery. Clinical placements have been cancelled and the school is working diligently to manage the impact. Our MPT research projects have been modified so students can continue their research remotely. SRS faculty and staff maintain close communication with students, and are offering additional material via webinars and promoting wellness activities during this time of physical isolation.

Finally, and once again, I thank our learners, faculty and staff for your efforts of these recent weeks to stay committed and connected.