Medical authors I have been reading

In several blogs over the years, I have talked about what I am reading and in return many of you have been generous in sharing books you have found inspiring and entertaining. I always get more reading done this time of year because in warmer weather it is hard to golf or run and read! I realized that four of my most recent books were all by medical authors, and all very relevant to our times, our profession and our role as medical educators. I suppose it is a bit of a busman’s holiday, but so be it. I highly recommend all these books.

Many of you will already have read Dr. Jillian Horton’s book: We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing. Horton is an internist on faculty at the Max Rady College of Medicine at the University of Manitoba and recipient of the 2020 Association of Faculties of Medicine of Canada Gold Humanism Award.

No less than Alan Alda states, “Her writing is brilliant. And the story of her burnout as a medical doctor is just heartbreaking enough to keep you longing for the resolution you know is coming.”

Two themes are common to all these four books (you’ll find the other three titles below). The first are the challenges of the culture of medicine that include the competitive and hierarchical nature of the profession, as well as the sexism and racism experienced by its members—and how all of this harms both us and our patients. The second theme is hope! It comes through in all four books and in the case of Horton’s book, in the form of authenticity and humor.

I was in Nashville, Tennessee for the American Association of Medical Colleges (AAMC) annual meeting, Learn, Serve, Lead, in November and while there picked up Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU by Dr. Wes Ely. He’s a pulmonologist and critical care physician in Nashville, holds an endowed chair in medicine, and is a physician-scientist at Vanderbilt University Medical Center.

I found this an inspiring story of a physician who used passion for the people he cared for every day, research and evidence, perseverance and a remarkable ability to challenge orthodoxy to ultimately change ICU care around the world. While he and his story were new to me, I quickly learned he is legendary among ICU doctors, and I highly recommend his story.

The third book is Black Man in a White Coat, by Dr. Damon Tweedy. Tweedy is graduate of Duke University and a psychiatrist at Duke University Medical Center. The first chapter starts with how early in his first year of medicine he was asked by a professor who noticed him between lectures, “Are you here to fix the lights?”

I read this book as part of the CoM Division of Social Accountability’s Journal Club; it was their choice for Black History Month. I learned about the dual challenges of being black in a largely white profession and the disproportionate health burdens faced by black people. I learned even more in the book club discussion, and highly recommend the book club to everyone at the CoM.

Oprah said about this book, “In this fascinating, heartbreaking memoir, Tweedy documents his experiences as an African American doctor in a medical system that can be ‘just as sick as its patients.’”

The last book is Long Walk Out of the Woods: A Physician’s Story of Addiction, Depression, Hope, and Recovery, by Dr. Adam B. Hill, a pediatric palliative care physician (I’ve always thought this must be the toughest job in medicine). He works at Indiana University’s Riley Hospital for Children.

Dr. Christine Moutier, Chief Medical Officer for the American Foundation for Suicide Prevention, says of the book, “Exposing the stigmatizing and illogical aspects of the culture of medicine when it comes to caring for our own, this book has the power to transform an already shifting culture and should be required reading for all the professionals in the medical field.”

I like the “already shifting culture” in this last quote because it points to the second theme I identified: hope. Despite the weighty nature of all these books and the challenges in medicine that they expose, I finished every book with a sense of hope and more ideas of ways in which I can contribute to change for our profession and our patients. All four authors clearly love their profession and are passionate about patient care.

As I said, I recommend all four books and look forward to your thoughts on these as well as your suggestions for others. As always, my door is open and I am always happy to talk with faculty, staff and learners about our College of Medicine (or running, golf, the Raptors, Blue Jays, or even the Leafs)!

MEDICAL EDUCATION: Curriculum renewal and more in the MD program

Guest blog by Dr. Meredith McKague, associate dean, Undergraduate Medical Education

The team in Undergraduate Medical Education (UGME) and Student Services in the CoM is doing a lot of amazing work. Often, this work is taking place behind the scenes, as is true of so much that happens at our medical school. With this blog, I’d like to highlight an important area of work, curriculum renewal, and where we are at with various aspects of it.

For pre-clerkship (Years 1 and 2 of the program), curriculum renewal is in full swing. These incredibly important, foundational first two years of our program have been revamped to further integrate biomedical sciences into the Foundations in Clinical Medicine blocks focused on each of the major body systems, and to increase opportunities for students to develop clinical reasoning and evidence-based medicine skills through case-based learning.  We have run the first term of the Year 1 renewed curriculum successfully and will introduce a renewed Year 2 in 2023-24.

Our clerkship (Years 3 and 4 of the program) team and curriculum committee are busy planning for renewal of the clerkship curriculum, with a curriculum retreat that just took place just over a week ago that was focused on that topic.

In other areas, the UGME strategic plan was completed last summer. It identifies five priority areas:

  • Embed structural and systemic supports to achieve equity
  • Indigenous health
  • Support wellness for students, staff and faculty
  • Teaching and learning excellence
  • Community engagement and distributed medical education

Working groups focused on those five strategic priorities meet regularly to track progress in each priority.

In teaching and learning, as we have moved out of the pandemic, the program has developed a hybrid model for delivery of curriculum that builds on innovations developed in our pandemic response. Faculty deliver the curriculum in a variety of ways: in-person sessions, pre-recorded presentations, and remotely delivered presentations. We are working to support further active learning approaches in all sessions to optimize learning. In addition, our Academic Support team, made up of faculty, a staff specialist and members of the Office of Student Affairs, are continuing to develop new strategies to better support learners in achieving academic success.

Students’ performance on the Medical Council of Canada Qualifying Exam Part 1 (MCCQE-1) 2022 exam reflects the hard work of students and faculty. Our students taking the MCCQE-1 for the first time had a pass rate of 96%, higher than the Canadian Medical Graduate (CMG) pass rate of 93%, achieving a mean score of 260 compared to the national CMG mean of 258.

One of our exceptional teachers in the UGME program is Dr. Kelsey Brose, an assistant professor in the Division of Oncology. He just received the College of Medicine Excellence in Teaching Award. The annual award recognizes exceptional teaching practices and significant contributions to the teaching mission of the college. Congratulations, Kelsey!

The college recently announced more good news related to accreditation of our UGME program. Following the most recent January 2023 report, we have now earned the satisfaction of the accrediting body across all 96 elements they review, up from 93 in a 2020 update. No more reports to the accrediting body are required now until our next full site visit in 2026. This is great news, enabling us to focus fully on ensuring we are well placed for all elements for the 2026 visit—work that is well underway already.

The Student Services Career Advising and Mentorship team in UGME have been actively supporting students with elective planning—especially important with the resumption of visiting electives for our students in the Class of 2024. This team is also supporting students with the CaRMS residency application process, another highly significant aspect of medical school. And the team has provided increased support for students in all areas of training. Additional elective planning meetings, residency application review meetings, and residency application mock interviews were some of the expanded supports provided to students this year.

We are making great progress in UGME, and of course there is always a lot more to do. I thank all of the staff, faculty and students in our program for your excellent work and exceptional commitment.


Expanding the School of Rehabilitation Science

Guest blog by Dr. Teresa Paslawski, associate dean, School of Rehabilitation Science

The commitment to an additional 550 student seats across 18 healthcare training programs made by the Saskatchewan government on January 31 is a significant investment in the future of healthcare for the province. The announcement included funding for an additional 15 seats in the Master of Physical Therapy (MPT) program in the School of Rehabilitation Science (SRS) in the USask College of Medicine, taking the cohort from 40 to 55 students beginning with this fall’s incoming class.

Congratulations and thanks are owed to many people who were involved in this major step in the growth of rehabilitation training in our province—most notably the director of the MPT program, Dr. Cathy Arnold. Her leadership, attention to detail, and enthusiasm for this undertaking were instrumental in its success. Congratulations and thanks are also owed to the members of the school, college and central administration of the university for supporting the development and planning to allow this to happen. The timeline to welcome a 40 per cent increase in new students in the fall means there is much to be done before the start of the new academic year, but the positive impact on our province is well-worth the effort. We will work with our stakeholders to ensure that we maintain the same high MPT educational program standards.

The announcement also referenced expanding opportunities for Saskatchewan students in out-of-province programs, including speech language pathology (SLP) and occupational therapy (OT). SLP and OT services continue to be among the highest health and human resource needs in Saskatchewan, not just in healthcare, but also in education, justice and other areas. These long-standing workforce deficits in our province need to be addressed for the health and well-being of Saskatchewan.

Providing training opportunities for Saskatchewan students out of province is a welcome step in addressing these gaps in service. But there are many compelling reasons to develop our own training programs here in our province for these disciplines, including the enhanced value to all disciplines that occurs with training together to strengthen collaborative practice for more effective care. Data from the Canadian Institute of Health Information also tells us that students are most likely to seek employment where they have done their training. Ultimately, we will need Saskatchewan-based training for SLP and OT students to more effectively increase recruitment and retention of these clinicians in our province.

I am excited to be able to share with you that the University of Saskatchewan is actively working with the provincial government to refine proposals for Saskatchewan-based SLP and OT programs to expand rehabilitation programming here.

I want to thank the Government of Saskatchewan for responding to the needs of the province and initiating these steps that will help strengthen and stabilize Saskatchewan’s healthcare workforce. I look forward to working with the government and university on these exciting endeavours to address critical healthcare shortages in our province and to strengthen the important investments already made by the government in rehabilitation.