With warmer days upon us and outdoor activities starting to add a boost to our moods and general wellness, I want to use this blog to remind everyone to plan for some safe, physically distanced downtime for yourself in the coming months. We all need vacations, even if these are staycations this year. (On the plus side, coming from the Maritimes, I highly recommend Saskatchewan in the summer!)

For some, days have been extra-long, as we strive to maintain the many organizational needs supporting education, research and clinical service during COVID-19. This type of schedule is not sustainable, as I’ve experienced firsthand. I realized recently that I was exhausted and needed to take some time away. I made the Victoria Day weekend into a four-day mini-vacation of sorts, complete with many hours of outdoor gardening. This was a significant construction project resulting in raised garden beds. The construction was fun—moving four yards of topsoil less so! But now, between online meetings, I can go outside and check on what seeds have germinated. In the last two days, Swiss chard and beets have started.

Other ways I’m enjoying downtime include doing more cooking for Jane and Marie on the weekends. While I have no races to train for, I continue to enjoy my running. And I frequently watch my grandchildren on FaceTime.

We’ve all experienced a high degree of change in how we work, whether working remotely or due to changes in healthcare delivery. There has been stress and change in other ways, including work slowing down or transitioning to a different focus. These realities understandably come with stress and uncertainty. Add to that the changes in our communities and economy, with closures and new requirements for simple things like getting groceries, and this year taking breaks that help us with stress management and escape are especially important.

I encourage our administrative staff and faculty to get away, whether by actually going away from home if you can do so safely, or by ensuring that you find ways to make home purely a place of relaxation for periods of time. Whether this is in the form of some extra, shorter breaks from work, or by stepping away entirely for a few weeks of vacation, we all need this balance.

I encourage everyone to plan for and commit to vacation and breaks from work, and ask supervisors to support their teams in planning for this. It’s all too easy to let the demands of work take over, but we really can’t be at our best when we allow this to happen. We are doing right by our employer, colleagues, families and ourselves when we effectively balance work with time off.

So, another beautiful, sunshine-filled Saskatchewan summer lies ahead. We have had a tough spring and we all deserve some peace and relaxation. For myself this summer, I plan more landscaping projects, including my hobby from back in New Brunswick of growing roses. (Wish me luck!) As well, I am buying new golf clubs and hope to golf more.

What are you doing this summer? I’d love to hear about your plans or ideas for time away from work!

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:

• CoM/PGME resident wellness resources
• CoM PGME Resident Resource Office (Ph: 306-966-1669 or email gayathri.manoharan@usask.ca)
• CoM Faculty Development well-being resources
• USask faculty and staff wellness resources
• SHA mental health and well-being resources for healthcare providers
• RDoS resident wellness resources
• Resident Doctors of Canada resident wellness resources
• Saskatchewan Medical Association physician health program
• Canadian Medical Association physician health and wellness 
• Royal College of Physicians and Surgeons of Canada physician health guide

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

Our medical doctor Year 3 students return to clerkship on May 25, a date we arrived at working together with the Saskatchewan Health Authority.

That is coming up very quickly and—just as with our shift to learning remotely and stepping away from undergraduate clinical rotations in March—the efforts to coordinate and support this transition again show the dedication and stellar capabilities of our team. Thank you to all those students, staff, faculty and academic leaders, as well as our partners in the health system, who are working to make this happen!

Before we had a date, we had two working groups, one composed of learners, the other of staff and academic leaders, develop proposals for what this return could look like. Their work was exceptional, and positioned us well for the work that’s now been done by our clerkship committee on a clinical rotation plan that will enable our current Year 3 students to complete years 3 and 4 of their degrees for a June 2021 graduation and July 1, 2021, residency start date.

For our clerks and those working in the health system, as you know, much has been done in Saskatchewan’s health system already to address safety in the delivery of care in light of COVID-19, and our college will also be working with our learners, the health authority and other health system partners to align with safety measures for a safe learning environment and an excellent clinical learning experience. As with all areas of life right now, the return to clerkship is not a “return to normal,” but a return to the new normal since the pandemic became part of our daily reality.

As well, our undergraduate and student affairs offices will be working closely with our clerkship students to support their return and help address individual circumstances.

One of our college’s biggest commitments to our learners and our province is this continuous progression of learners through our undergraduate and postgraduate medical doctor programs every year. Keeping these physicians of the future moving through the ranks of undergraduate students, then residents, and ultimately licensed physicians, ensures we can support patient care and the health system today and tomorrow. It is certainly no less important in a COVID-19 world; I think most would agree that it is more important.

With that in mind, I can’t stress enough the need for our medical faculty around the province to be involved as teachers. We need you to take learners into your practices and clinics. Our students today are your physician colleagues of the future.

Finally, I just want to reiterate how impressed I am by our students, staff, academic leaders and faculty in these extraordinary and difficult times. I am thankful for your diligence and responsiveness, and incredibly proud of the resilience and excellence of our team here at the CoM.

We are increasingly seeing COVID-19 hitting racialized, socio-economically challenged people and communities harder than other population groups. We are witnessing this in reports from the United States, with the heavier impact of the virus in black communities, and in an article in the New York Times yesterday raising concerns about this disparity within Latino populations, and here in our own province among Indigenous and northern communities.

COVID-19 underlines more than ever why we must face and challenge inequities in our college and beyond. At the College of Medicine, Research Equity & Diversity Specialist Erin Prosser-Loose and researcher Catherine Trask have started a study on how COVID-19 is impacting those already facing challenges related to equity and diversity. They have collected early data through a survey of our broader USask community, with plans to expand the scope to include national data in the coming weeks.

Erin is leading the study and recently walked our dean’s executive team through early findings.

The data showcases both positive and negative experiences. On the positive side, people have indicated they’ve felt well-supported with regard to information technology needs, and that mental health supports have been well-communicated. Teams are making excellent efforts among themselves to support one another, including through social connections like virtual coffee breaks.

Race-related issues included that some have found working from home has reduced their exposure to racism. While this was expressed as a positive outcome due to COVID-19 adjustments, it points to change we know is needed in our work environment. Also, racialized people expressed being disadvantaged in COVID-19-related changes impacting employment contracts and research opportunities. Some identified having witnessed racism against Asian people.

A gender-related issue identified by many was that primary caregivers, mostly women, are experiencing greater pressure managing childcare, homeschooling and work productivity.

A variety of work, career and financial impacts were brought forward. Pre-tenure faculty are concerned about research progress. It was expressed that tuition for online learning shouldn’t be as high as for face-to-face learning. International students are uncertain about their degree progress and are facing financial hardships. Rural and low-income students are disadvantaged due to internet access issues.

Generally, it was expressed that EDI and Indigenization are being sidelined because of COVID-19, with more conventional issues getting priority. Given how I opened this blog, this is clearly the opposite of what is needed now (and at all times).

Survey participants indicated that the causes of inequities being experienced were based most on power differentials, followed by race, then gender. Participants suggested solutions, including denouncing racism, acknowledging primary caregivers, placing health and wellness ahead of productivity, and extending promotion timeframes. From my own perspective, in particular we do need to denounce racism and continue work towards eliminating it; we must think about how we support and acknowledge primary caregivers, most often women; and our leadership team needs to further explore as a college how we can address issues highlighted by this survey.

Again, I do want to reiterate that information I’m sharing is preliminary. The survey is ongoing and different issues are likely to come up as the situation with the pandemic continues to change.

For our staff, students and faculty (and anyone at USask), if you haven’t already, please take the survey.

Some other information related to this blog topic:

• Data gaps on COVID-19 cases in Indigenous communities
• How to address equity as part of COVID-19 incident command

As the changes we are all experiencing with COVID-19 have now stretched into weeks, stress and anxiety are becoming an increasing challenge for some. Coping with staying at home, managing work and family together in that setting, and the many other restrictions associated with physical distancing are the reality for many. For others on our CoM team, going to work in our hospitals and medical clinics comes with a different set of challenges and causes for stress and anxiety.

This week, the university announced its workforce strategy due to COVID-19 and our college has begun working with supervisors and administrative employees on next steps. This is a stressful time and I remind you that university-supported services including the Employee and Family Assistance Program are available to all employees.

In light of all this, mental health is top of mind right now for many. I want to share some thoughts and resources (see end of this blog) that I hope you find helpful. Of course, I encourage you to focus on the things most useful to you in staying well and welcome you sharing those here, if you would like. Monitoring your moods, thoughts and feelings is especially important, and help is available should you need it through university and college resources, and through our health system.

In many basic day-to-day ways, our mental health is supported by work teams and colleagues maintaining contact and supporting one another virtually. Making time during video meetings for some lighter conversation and humour is helping with social connections and friendships. It certainly helps to see one another, laugh together, and share anecdotes from our lives. As one example, our dean’s office team shares information, humour, pet pictures, grandchildren pictures (I may have posted a few!), and messages of encouragement and support in our MS Teams group every day. This has been a valuable means of keeping us together as a team, along with virtual monthly meetings.

Some teams are having quick daily remote huddles, and colleagues and friends are including online coffee breaks in their schedules to ensure opportunities for the social connections we all value in the workplace. We are reminding one another to get outside for breaks, fresh air and sunshine; the weather has finally co-operated these last few weeks! Making time for exercise and relaxation is a big help in staying upbeat, and mentally and physically well.

Beyond that, at the individual level, more than ever before, our rule of thumb needs to be when we think of someone we know, we call or better yet, video call, to say hi and see how that person is doing. We can all play a role in reaching out to anyone we notice seems down or not themselves. Some of our team members are more isolated than others, and we need to keep this in mind and reach out and include one another in virtual group activities, meetings and through direct connections.

I hope everyone is benefiting from and extending support to colleagues, family and friends. I also share a variety of college, university and other resources here:

• USask student wellness resources
• USask faculty and staff COVID-19 wellness resources
• CoM Office of Student Affairs (undergraduate medical learners)
• CoM PGME Resident Wellness
• CoM Faculty Development COVID-19 mental health resources
• Physician wellness resources through CoM Continuing Medical Education COVID-19 website
• Indigenous Wellness – Morning Star Lodge website
• Government of Saskatchewan Mental health and COVID-19 page
• Strategies for Anxiety During COVID-19 with Dr. Helen Lowry, Department of Psychiatry
• Tips for helping others who are struggling
• Online course for managing mental health during COVID-19

As always, I welcome your feedback, including ways you are finding to stay well.