October 19 – An important day for Discovery

As many will know, I have put a lot of emphasis on the need to grow research here at the College of Medicine and in particular, the kind of research that will have a direct impact on the health care of the people of Saskatchewan. I want to emphasize here I recognize and value the crucial (and in Canada almost exclusive) role that universities and medical schools have in discovery and bio-medical research.

My background is of course rooted in clinical care, and I have been frustrated many times by the inefficiencies and barriers to patient-centered care that excellent clinical and health services research may solve.

Furthermore, I am all too aware of the need to demonstrate to our funders the “value-proposition” of a College of Medicine.

So, this is why I have put so much effort into assisting our university, health system, government partners and the Health Quality Council in getting an application completed for the Saskatchewan Center for Patient Oriented Research (SCPOR).

However, emphasis on application alone as public policy is seriously flawed. Basic and applied sciences are on a continuum and are absolutely interdependent.

Since I am a semi-serious music collector (especially Maritime singer song-writers), I am fond of using the following example with my friends to explain the value of basic research. The mathematics that allowed the development of the music compact disc (now itself obsolete), were in fact developed nearly 100 years ago -because a mathematician was following his own curiosity.

If Sony had gone out looking for this, we may still be waiting for the CD.

An example closer to home is the discovery of the structure of DNA by Watson, Crick and Wilkens over 60 years ago, and then the subsequent understanding of inheritance and protein production.

This was paralleled by the amazing curiosity-driven research and applied research in computer science that today allows us to do rapid genome sequencing. Modern life abounds with examples of how curiosity-driven research has enriched our communities and our lives.

So sometimes in my daydreams, I have imagined what I would do if I found a magic lamp somewhere in the Saskatchewan countryside…

One of my three wishes would be at least a quadrupling of the Saskatchewan Health Research Foundation’s budget. I am sure at least some of you have more interesting fantasy lives!!

However, I realize the principle funder of basic research is our federal government. So in that regard, I have questioned every federal candidate I could about his or her position on science, and the funding of basic research.

I must admit, despite the best efforts of some organizations like Research Canada, this discussion did not get the attention I had hoped.

Of the candidates I talked to however, there were some glimmers of hope. And of course I say this without endorsing any particular political perspective.

But I do hope October 19 is a good day for discovery research in Canada.

Preston

 

 

Intense week at the CoM

This past week has been a very intense week at the College of Medicine. I know the news at the start of the week was for many both surprising and concerning. I want to assure all that the CoM is moving forward and continues to vigorously pursue the goal of being the best “small medical school” in Canada producing excellence in medical, physical therapy and biomedical education, superb MD’s and PT’s for Saskatchewan communities and doing the research that improves care for Saskatchewan people.

I am very pleased that Brad Steeves, an experienced and highly regarded university administrator, has agreed to serve as Interim Chief Operating Officer at the CoM. Brad has worked at the CoM in the past and most recently has been the Director of Operations, Health Sciences and has been the leader with the Health Science Deans in building and operationalizing the Health Sciences Building. I am grateful to the deans and the staff at the Health Sciences Council in supporting the CoM at this time. I have to say I have been impressed at the way people at the U of S pull together to support each other.

It has been a very busy week. On Tuesday evening, I joined my colleagues from the Presidential Search Committee and our incoming president, Dr. Peter Stoicheff to celebrate the collaborative and collegial process that resulted in the successful selection of our new president. Peter has made it clear that he is highly supportive in seeing the College of Medicine succeed and I look forward to working closely with him.

Wednesday was an extremely busy day for me. In the morning I had presented to the University’s Board of Governors an update on the progress of the CoM. In the afternoon, I made a presentation to the Board of the Saskatchewan Medical Association. Building strong partnerships for the CoM is key to our success but as we transition to a provincial-wide One Faculty Model, it is essential that the organization representing our profession and the CoM work together. I am committed to that goal. As I pointed out to the board there are over 1400 doctors in Saskatchewan (and therefore over half SMA membership) affiliated with the CoM.

Late Wednesday afternoon I attended the farewell celebration for our outgoing interim president, Dr. Gordon Barnhart. Gordon came in at a time of great need at the University of Saskatchewan and did an incredible job of creating stability, calm and bringing us together as a community. Gordon had been tremendously supportive of the CoM as well as me, personally, as dean. I want to take this opportunity to extend our collective, profound appreciation for his great leadership.

Wednesday evening was quite exciting as I participated on a panel for a students and residents forum. I was joined by Dustin Duncan, Minister of Health; Greg Ottenbreit, Minister Responsible for Rural and Remote Health; Dan Florizone, CEO Saskatoon Health Region; Dr. Mark Brown, President SMA and Dr. Dennis Kendel, CEO Saskdocs. I was really impressed that all these individuals made themselves available for our students. This is truly one of the great benefits to working in Saskatchewan. I was even more impressed by the questions to this panel from our learners and the professionalism in which they interacted with the panel. While some questions were of direct interest to the learners such as residency positions, many of their concerns were actually advocacy for our patients which made me proud.

This week cemented for me the collaboration and teamwork that I have felt since joining the University of Saskatchewan. In a time where the CoM was facing a looming deadline and the task seemed unattainable, my team was joined by a team from our Central Admin led by Jeff Dumba, and worked tirelessly to achieve the goal. I am truly appreciative to all these folks who put aside their daily tasks and made the CoM a priority. I would like extend my heartfelt thanks to these people who I am extremely proud of and extremely grateful to.

Remember my door is always open and I am interested in your input.

I hope everyone has a restful long weekend and wish everyone a Happy Thanksgiving.

Preston

Shaping Biomedical Sciences

A vibrant, innovative undergraduate Biomedical Sciences Program is critical for our College of Medicine.

Such a program must have the breadth and depth for graduating students to be well prepared to enter any health science professional program, pursue health/life science research endeavors, or enter the workforce.

We train much of the biomedical workforce outside the professions and our undergraduate programs feed our graduate programs. I believe, as do many of our peer universities, an innovative Biomedical Sciences Program can do all of that.

We have long-debated the importance of developing medical scientists versus creating the practitioners with the perfect bedside manner. Obviously we will always need to both.

In creating a new undergraduate biomedical sciences program within the CoM, we must also establish the best academic governance structure. This will benefit not only a new biomedical sciences program, but also the many other academic activities currently managed by our existing five Basic Science departments.

With these two initiatives, I hope we can also review and revamp research intensiveness in the Basic Science departments, critically evaluate their service teaching mandates across campus, as well as current service operations within the departments by pursuing solutions for improvement in all these academic mandates.

I have asked Jim Thornhill, Special Assistant to our College and to the Vice President Research Office (OVPR), to lead this initiative on my behalf.

Many of you will be familiar with Jim as he has served the college and university in a number of roles. He was a faculty member and physiology department head, and the Associate Dean Research before his secondment to the OVPR over the past five years.

I have asked Jim to work openly and transparently with me, the CoM staff, the two Biomedical Standing Committees (Programs and Governance) to review, and eventually decide upon the undergraduate biomedical program and governance structure.

Importantly, I want the committees to reach their ultimate plan with the input of university officials, faculty, current and past students from the existing programs, but also learn from other universities having similar life/biomedical science programs in Canada.

I have asked all concerned if it is possible to have the new Biomedical Sciences Program(s) have its first class enrolled for September, 2017 and managed within its new governance structure. What programs and structures will do the most to enhance our research enterprise in the new world of research clusters and inter-disciplinary health research?

Obviously much work is ahead!!

Our goals in this work are two-fold: focus on student success, and grow our research intensiveness.

With respect to research intensiveness, over the next five years I believe we should aim for: 25% increase in the number of peer reviewed grants; 25% increase in the number of peer reviewed papers; 10% increase in the number of external research networks formed; 10% increase in the number of patents issued; and 25-50% increase in the number of biomedical undergraduate students conducting research projects.

Speaking of students, in the coming five years, I believe we can achieve a 25-50% increase in undergraduate enrollment; 10-25% increase in acceptance of these students to medicine or other health professional colleges; and a 25% increase in the number of students applying to graduate programs.

To date, I am pleased to report student surveys of current and past graduates of existing Basic Science undergraduate programs will be conducted through the Register’s Office in September. As well, a site tour to three Canadian universities with similar biomedical Sciences programs was arranged for three representatives from our standing committees for mid-September. This data will be gathered and analyzed by Christmas so an initial draft of the new Biomedical Program can begin in the New Year.

Extensive consultation of the draft proposal will occur in the college and across campus in spring 2016 and summer of next year, with a revised draft sent to Academic Programs and Priority and Planning Committees of University Council in October, 2016.

Importantly, I meet with the Biomedical Governance Committee in September to begin discussions of possible governance structures for the effective management of the Biomedical Sciences Program of the future.

Of course, all of this work must happen within the larger university context. As we plan for our own future, we must remain sensitive to the bigger picture.

The U of S is moving to an activity-based funding model. All of our medical programs, and even our graduate programs, have a fixed capacity. As we works towards our new model, we must consider how we will grow our basic sciences faculty. Our own undergraduate programs will enable a way to grow our budget in the future university budget model.

Please extend your support and ideas to Jim and the committees as they continue this important work.

Preston

 

 

Working together through transition

I have now met with many of our MD full-time faculty members individually, in four open information settings, and in four departmental meetings. As I hope you all know, I am happy to meet with any of our faculty – individually or in groups, and once or repeatedly as required.

I want to thank those who have attended these sessions. I have listened very carefully, and would like to use this blog to emphasize some key messages and respond to some of the concerns and feedback I have received.

You are wanted, needed, valued

First and foremost, I want to be clear that we want and need all of you – current MD USFA members, as well as the 1293 Saskatchewan MDs with clinical appointments – to be engaged with the CoM.

Our college presently has approximately 50-60 MD full-time equivalents doing the teaching, research and administrative work. Our peers have at least twice as much MD time invested in their medical school.

This is our fundamental challenge as a college.

I still hear language like “the CoM is trying to get rid of people.” Nothing could be further from the truth. To be successful, our college needs everyone engaged.

Second, I truly value the great contributions of our faculty.

I took on the role of acting Vice-Dean of Faculty Engagement with the very intentional and strategic goal of getting to know our faculty. I have come to know many of you, and am absolutely impressed by your commitment to our learners, your research, your patients and our CoM.

I have heard many of you say you have felt blamed for past problems, and you now interpret the voluntary severance offer as further evidence of that blame.

If, in my efforts to explain where we are going, you have heard blame from me, I apologize. This is not my intention.

I know the past has been difficult for you and for the college, but the change process we are on now is both necessary and complex. The challenge we face is the historical engagement structure, and the number of MDs at the CoM. Our challenge is certainly not the individuals committed to the CoM whom I have come to know and respect.

About ACFPs: a fair and transparent system of remuneration for all MD work

Recall, that well before I got here, the decision was made to no longer hire physicians to tenure track university positions.

It was obvious to me that the province, the academic health science centres, and the CoM had to deliver on the long-promised provincial ACFP if we were to grow MD academic time in the college. I put great effort and time into moving the ACFP forward, and our hospital and provincial partners responded.

Increasingly, ACFPs are the preferred method for engaging academic physicians across the country.   Are ACFPs perfect?   No. No single ACFP is going to be perfect, but it is the only model to provide equal compensation for teaching, research, and clinical care.

Looking ahead, I was concerned about the increasing inequity between current MD USFA members and newcomers, as the latter would have more protected academic time and, in some specialties, more income than their more established colleagues.

I hope you will see the transition packages as incentive to explore alternative ways to continue your engagement with the CoM.

About timelines and deadlines

Many have expressed frustration over the timelines. I must emphasize the “spirit” of the agreement is to work toward a firm deadline of April 1, 2016.

The October 31, 2015 date is, in effect, a necessary milestone for expressions of interest to give the CoM and our partners the information we need to ensure adequate capacity for development of the ACFPs, or other arrangements, for all interested faculty.

This means if a faculty member expresses interest in transitioning to a new relationship with the CoM through an ACFP, they must indicate so by October 31st, but they will have until March 31st to work out the details.

The biggest over-arching concern I have heard is the capacity of the “system” (the academic health science centres, government, health regions, and the CoM) to deliver the ACFP. We have heard your concern loud and clear, and are in process to hire two additional qualified staff members to work full-time on ACFP’s over the next year. We will get this work done.

About research – grants and graduate students

Some very important concerns have been raised. Our researchers have questioned their ability to hold research grants with a clinical faculty appointment. Important groundwork in this regard was done with the research policy passed by the Board of Governors in December 2014, which allows physicians appointed in clinical departments to hold research grants.

I have the University’s commitment that physicians holding clinical appointments will be recognized by the university, and will be able to hold research grants. This change was needed long before this transition, as the intent all along has been to provide protected time for research to some people signing up to ACFPs.

To address another misconception: the ACFP will only pay for teaching and clinical work and is limited to a low percentage of academic work. In fact, the ACFP is designed to be flexible, and will support MD clinical faculty who even spend the majority of their time with research and academic work (up to 75% in exceptional circumstances).

The ACFP will provide for all three of our important missions: clinical care, teaching and research.

Another concern is the ability for MDs in clinical faculty appointments to supervise graduate students. The university is committed to ensuring faculty who already supervise graduate students can continue this important role, and new MD faculty with appropriate skills and experience will be able to do the same.

All for one…One for all

There is no doubt this is a critical point in the history of the CoM at the U of S.

We are no longer one of the smallest Canadian medical schools, able to survive with a small number of full-time MD university faculty.

We are now a much larger medical school at a growing U15 university in a thriving province.

We must engage most, if not all, of the doctors at our academic health science centres and across the province. Our peers in Winnipeg, Halifax, Kingston, and throughout Canada have this model. This is our necessary goal, and the one we will all work towards.

Medical schools have always succeeded because groups of physicians came together in their belief that academic medicine would improve care to their patients, their own careers and their communities.

I have great confidence in this community of physicians to do the same. That is why I came here and am excited to work with each and every one of you to that end.

As always my door is always open. And furthermore so is the blog – please engage in the discussion.

Preston

Patient Safety and How We Work with our Health Regions

I will never forget the moment I sat facing an experienced and shaking general surgeon as a young Chief of Staff for a large regional hospital.  The surgeon told me he had just cut the common duct! Showing my age, this was in the very early days of laparoscopic surgery. The surgeon had recently taken a short course on laparoscopic cholecystectomy, and this was his tenth case or so.

As I sat there, my thoughts were torn between the devastation to the patient  and their family, and the impact on my colleague in front of me.  But most importantly – what had we done to prevent such an incident?

Who cut the common duct that day?

I would maintain many of us were holding the instrument:

  • The company that provided the short course and “certification of competence” had a role.
  • We as a hospital had a role in providing the privilege to do that surgery.
  • The entire system had a role in our limited capacity to monitor the implementation of medical or surgical innovation.

But for sure, the patient was harmed, and the surgeon was alone on that day!

For me, this launched a major, lifelong clinical and academic interest in patient safety, and how the safety of all – patients and healthcare providers alike – is essential in our work.

Fast forward a few years.  A trusted colleague and I were doing a workshop for PGY1 FM residents on coping with adverse outcomes in our careers. Towards the end of our session, one of our best residents tells us the story of the first night on call in clerkship on Medicine.

In keeping with the “Swiss cheese” model of medical error, a scheduling error and an illness resulted in two clinical clerks (JURSI’s here) and one PGY3 Medicine resident to cover the entire tertiary hospital for the night. The resident was busy in ICU, and after some delay, the JURSI’s are sent to assess a patient who is short of breath. They recognize the diagnosis of congestive heart failure (the admitting diagnosis), but given their limited experience, fail to recognize the gravity of the situation. As things deteriorate, more calls to the resident by the nurses ensue.

As anyone who has done this in the middle of the night knows well – the patient arrests before the JURSI’s get any help.

So what happens next?

The resident arrives, runs the futile resuscitation and says to the clerks, “there are two more admissions to do – let’s go!”

And now, in the workshop two years later, I am supporting the resident  truly processing this traumatic event for the very first time. For the first time for this resident, we are teaching both the signs of impending arrest, and how we deal with our own frailties as providers.

So now let me take you to the launch of the Patient Safety initiative at Saskatoon Health Region. If you have not already had the chance, I suggest you watch this short video about Logan.

I have had the privilege of being invited by the CEO of SHR, Dan Florizone, to participate on the Oversight Committee for this incredibly important initiative.  We have been meeting with a talented group of colleagues every Tuesday morning at 7:30 for over a month. Our group is ably led by Petrina McGrath from SHR and Susan Shaw from SHR and the CoM.

While I believe SHR is very brave in the open and transparent approach to such an important initiative, I can also state unequivocally that the approach is overwhelming supported by everything written about patient safety since the publishing of “To Err is Human” in 1999.

For me personally, it is tremendously exciting to be back in the “system” and contributing directly to an initiative improving patient care.

More importantly, I believe this is where academic medicine is meant to do its greatest work – enhancing patient care. I am particularly impressed at the work of our department heads and our faculty on this initiative, and look forward to the opportunities for our residents and learners to participate.

As my examples illustrate, it is absolutely essential for the CoM and our health education systems to be part of this initiative. While our education programs must incorporate the latest in patient safety, this is also a tremendous opportunity to do research.

My own personal interest is now diagnostic error (stubbornly sticking around 7-11% despite modern diagnostic tools) and how we teach diagnostic reasoning in medical education.  This is a subject for another whole blog.

What SHR is truly doing is changing the  culture here on patient safety. And that is a journey health education and healthcare must travel together.

As always I am interested in your feedback and my door is always open.

Preston

MDs at the CoM – Shaping our future

Earlier this month, I announced Dr. Keith Ogle has agreed to take on the role of Special Advisor to the Dean on Faculty. As most will be aware, the U of S has made an offer to practicing MD members of USFA to transition to alternate means of engagement with the CoM. So there is a lot of change, and this is a critical period for our college.  The future model of MD faculty at the CoM is for us to design.

Over the last year, I have come to know many of the MDs who make great contributions to the CoM, as I acted in the role of Vice-Dean of Faculty Engagement. However, we now need more MD leadership and even more physician engagement as we work our way through this change. Keith has valuable past experience, previously as a faculty member and department head in FM, and more recently in clinical practice at St Paul’s. He is widely known in our MD community.

One of my challenges over the last year has been finding time to reach out to all of my colleagues throughout the province. Keith will work with me to extend the reach of the CoM across Saskatchewan.

I will also be launching an internal search this fall for a Vice-Dean of Faculty Engagement. Keith will support the VDFE as we continue with the transition to a one faculty model, inclusive of all those MDs contributing to the CoM.

As I have previously outlined, one of the main reasons for our challenges is that – as compared to our peer medical schools – we have had far fewer MDs involved with the CoM. To solve this problem, we must reach out to all of the MDs in our community.

I am struck at times by the history that divides the CoM from our medical community. While alumni take great pride in their alma mater, after entering practice, many see themselves on the outside. In fact this is not a Saskatchewan-only problem, but it may be more pronounced in some circles here.

Across the country, a model of distributed campuses has been adopted entirely by MD faculty who never planned on being “academics”. In 2003 there were 16 medical schools on 16 campuses. Now there are 17 medical schools on 29 campuses.

All four years of UGME and some PGME programs are being successfully taught by what we would call ‘community faculty’ in Prince George, Kelowna, Victoria, Regina (years 2,3, & 4), Windsor, St. Catherines, Waterloo, Thunder Bay, Sudbury, Sagueny, Chicoutemi, Saint John and Moncton. All of these cities – with the exception of Victoria – are smaller than our two campus cities.

Before trying it out in those cities, many MD’s said they could not see it working. In 2003, one year before the first students, the Victoria Medical Society voted against the new campus of UBC Medical School. Many in these towns were quoted as saying they chose to practice there to get away from the medical school.

I watched the Dalhousie campus in Saint John get started by a substantial group of early adopters. Within a year or two, many naysayers were now asking why they were not being given teaching opportunities. Both experienced and new practitioners have repeated this pattern at all of these campuses. In fact, we know 70% of Canadian medical school graduates now want to have teaching and research as part of their careers.

We also have evidence that doctors who teach are more up to date, and it is reasonable to assume their patients also benefit. We know doctors who teach report greater career satisfaction, and are more likely to stay in their communities.

I also recognize our CoM must be better integrated with hospitals and health regions if it is to be seen as relevant to most Saskatchewan physicians. Therefore, I have recently agreed to work on the Oversight Committee for the upcoming Patient Safety initiative. I am very excited to be involved as I have done lots of patient safety work in the past, but even more so as it allows me to get to know more about our provincial healthcare system. More to come in a future blog.

Faculty engagement is not just for our MD faculty. We have nearly 100 faculty members in basic sciences, medical education and CH&E who are all incredibly important to the mission of our CoM. In a future blog I will provide an update on the work our basic sciences colleagues are doing to restructure the basic sciences.

So, I look for your input and advice as we continue to build on faculty engagement at the CoM.  Please engage with Keith as he assumes his new role. And as always my door is open and dialogue on my blog is encouraged.

Preston

Meetings with MD faculty

As promised, I have been meeting with faculty members since the announcement of the transition incentive package. Overall, these have been great conversations, and faculty members have had lots of questions – in most cases about details of the package.

However, one underlying theme running through these conversations is the impression the university wants people to leave their academic roles. Nothing could be further from the truth!

My most important message to everyone with an interest in the CoM is we want to retain everyone who is committed to a career in academic medicine. Our ultimate goal is many, many more academic clinicians.

As noted in my last blog, the vision is a One Faculty model; with More Faculty; built on engagement and compensation strategies that ensure Fairness and Accountability.

I would like to remind us of the entire context.

In 2013, the CoM agreed to The Way Forward. The decision to no longer hire MD’s to tenure track positions was made in June, 2013. In the larger context, virtually all of our Canadian peers had gone in this direction decades ago.

We are already well on our way to a One Faculty model. Virtually every faculty appointee who I talk with supports this philosophy.

75% of our graduates and residents want a career that includes teaching and research. This is a sign of success – our graduates have enquiring minds and know the value of scholarly pursuits. Furthermore, the demands of patient care are so great that our academic work needs to be spread across the broader medical community. The days when a small select group of doctors can run the medical school are long gone.

So we are already well on our way to a One Faculty model. Six physicians have signed on to an ACFP since the spring, with approximately twenty more in development. Since my arrival, we have signed multiple contracts with community MD faculty appointees: five to take on leadership roles, and nearly twenty for teaching roles in the UGME and PGME curricula.

If we simply allowed attrition to be our only strategy for transition to the One Faculty model, the process would take much too long. I could see in several years we may still have approximately 100 faculty members and maybe 100 or so people signed up to the ACFP.

Of course one challenge in our profession is the diversity of compensation, but I could see great inequity developing, as some faculty members in some disciplines could be at a great financial disadvantage as compared to the ACFP.

This incentive package is an opportunity for all members to take a look at their own circumstances, consider their own academic and clinical career goals, and choose what is best for them.

I have talked to some who are making great academic contributions. They can continue to do so, under an ACFP, or under a contract with the CoM. For most in this situation, going to an ACFP should not change their actual daily work life.

I have talked to others who – while enjoying bedside teaching of students and residents – do not have an active research program, and have little interest in more educational roles. Those individuals may find the transition incentive and either FFS or a health region position to be more attractive. These physicians too are needed here at the CoM as clinical teachers.

So as you look at your options, remember the CoM and the U of S wants to retain and even grow your academic contributions. Take your time, discuss with peers and professional advisors, and rest assured the College of Medicine and I value your academic contributions.

As always, my door is open.

 

One Faculty

As I write this blog I sit looking out on beautiful and sunny Lake Waskesu while taking a break from the discussions at the Dean’s Retreat. I am confident the University is on an upward trajectory as we head into a new academic year and welcome a new class of future MD’s and graduate students.  Having sat on the Presidential search committee I am excited about the leadership of our incoming President, Peter Stoicheff, and within the CoM I am equally excited about the leadership of our new Vice-Dean Education, Kent Stoubart, and our soon to be chosen new Vice-Dean of Research.

I returned Sunday night after a great 3-week vacation in the Maritimes and on the last Saturday celebrated with family and friends a wonderful and joyous wedding where my youngest daughter married her childhood sweetheart. Thanks to all of the warm wishes and congratulations from so many of you. I have to say despite loving my previous 56 years as a Maritimer, after experiencing rain on about 15 of the 22 days I was there made me realize how much I loved returning home to Saskatchewan and sunshine!! (The sun did shine for the outdoor wedding.)

This is an important moment at the CoM as seen in today’s announcement on the offer being made to our MD faculty who are part of the University Of Saskatchewan Faculty Association.  This is an important step in the process of restructuring the College of Medicine as planned in The Way Forward.  And it is an important step toward our goal of being the best “small medical school” in Canada and eventually one of the best overall, while serving the people of Saskatchewan better than any other school serves its constituency.

For me this step is part of a plan that brings us towards the goal of one united MD faculty, more MD’s actively engaged with and supporting the CoM and finally ensuring both fairness to MD faculty and accountability for the resources we are provided by our university, health regions, government, citizens and each other. My advice to the team that negotiated this package was that the transition must be optional, fair, transparent, and attractive and I believe this package achieves those goals.

One Faculty. Over the past 15 months I have come to know many of our MD faculty and have come to value and respect their contributions to the CoM. What I see is a love and passion for the CoM, our learners and research. And this love and passion is equally found between both the MD members of USFA and those who are designated community faculty appointees. Increasingly the academic contributions and the quality and quantity of scholarly work are also found on both sides of this historic divide. While this divide is both historical and structural it is no longer about academic commitment and it is imperative that we make room now for our MD faculty to become united under one umbrella of engagement with and contribution to the CoM.

More Faculty. I have repeatedly, and in multiple venues, presented the data that show our medical school compared with all of our peers, is running on substantially less time from MD faculty. This is multi-factorial and in part due to the overall shortage of MD’s in Saskatchewan, but it is also largely structural. Our successful peers have in place structures and compensation schemes that allow the majority of the MD’s in the academic health science centers (SHR and RQHR) to be actively engaged in their medical school on an equitable basis and they are ahead of us in engaging MD’s in smaller and rural settings. Using CIHI definitions we have around 70 – 80 FTE’s of MD time at the CoM while our peers are around 150 FTE’s.  My goal in restructuring the CoM is to have many more MD’s actively engaged with the CoM and passionate about teaching and research.

Fairness and Accountability. The University decided two years before my arrival to stop recruiting MD’s to tenure track positions.  I saw immediately the need to complete the implementation of the Academic Clinical Funding Plan and was supported tremendously in that goal by SHR, RQHR and the Ministry of Health. As this package was developed I also saw that for many of our faculty, their current compensation would not be competitive with the ACFP.  We have already signed up 9 doctors to the ACFP who have the benefits of working with clearly defined academic and clinical deliverables and very competitive compensation. My goal has been that faculty members have an attractive incentive to transition to the ACFP where they can continue to do the academic work they love.

I recognize that while our current resources are excellent, we will eventually require more resources if we are to meet our goal of being one of the best medical schools in Canada and the one that serves its province better than any other. To be deserving of that investment we must demonstrate to our funders and our public that we hold each other accountable for the delivery of our entire academic and clinical commitment.

While I believe the ACFP will eventually be the choice of many (and for sure the majority of young faculty) I would reiterate we would continue to engage with others on the basis of contracts and stipends. But, regardless of compensation scheme we are will now be all part of another step toward becoming one faculty with a shared commitment to our learners, our research, our patients and our College of Medicine.

I encourage all who are offered this package to take your time, discuss with your peers, get professional advice as needed and discuss with your leaders. Please feel free to call or visit me to discuss. My door is always open. No matter what your choices are my goal is to retain all of the current MD USFA members as active contributors to the CoM and I sincerely believe that for the majority this transition to a new model of faculty engagement will in the end see us all in a better place.

Reflecting on accomplishments

I sit on the deck of a cottage at White Point Beach Resort in Nova Scotia, enjoying the cool North Atlantic fog rolling in, the sound of the waves, the smell of the salt air and a fine NS sparkling wine (Nova 7 by Benjamin Bridge – highly recommended). We are back in the Maritimes to vacation, see family and old friends, and see our youngest daughter get married. I hope all of you take the time to get the rest and relaxation you deserve. I don’t plan for my second year to be any less busy as together, we move the CoM forward.

In that regard, I would like to highlight the activities that occurred as our school year came to a close.

Following the UGME accreditation visit last May, we have already begun preparations for our next full visit that is scheduled for 2017.  A number of working groups have been struck, and you will be hearing more from Athena McConnell and Kevin Siebert as this work amps up over the coming weeks.  We will hear back from the accreditors this fall on the outcome of last May’s visit, but let’s remember the real target is 2017.

In the meantime, I have diverted my attention to the PGME visit in December and am meeting regularly with Anurag Saxena to review preparations. I would like to thank the Program Directors and Administrators for the hard work already done preparing the PSQs that are due to the Royal College in early September. As always, I am interested in feedback as we prepare for this important event in the late fall.

As you saw earlier, we announced a new Vice Dean of Education, Dr. Kent Stobart, who I believe will bring great strength and leadership to our education team when he joins us on September 1. I would like again to commend and thank Gill White for the tremendous work he has done, and I am thankful he is willing to stay on as our Associate Dean in Regina. Gill is truly the face of the CoM in Regina and has done an outstanding job building our presence there.

In that regard, Gill has led the way in establishing important initiatives in Simulation and Faculty Development. Moving our simulation plan forward is essential as we have a way to go to catch the national leaders. Gill has recruited Dr. Neil Cowie to lead simulation and Dr. Mendez has recruited Dr. Cole Beavis to lead on a Surgical Skills lab and program. Many thanks to these people for stepping up to the plate.

As we engage more faculty in our academic mission and expand our efforts in Faculty Development, I am pleased Dr. Kalyani Premkumar has taken on this role. As I’ve said before, a one faculty model is essential for the CoM’s success, and a comprehensive faculty development strategy helps to support all faculty across the province.

In the last two weeks, we had interviews with two final candidates for the Vice Dean of Research, inviting a broad group of researchers and stakeholders. I hope to have an announcement when I return in August and someone in place by January 1, 2016.

Dr. Gordon McKay has done a tremendous job as our research lead, so I am sorry that he has decided to step down from this role. I am extremely grateful for his hard work, pleasant and professional collaboration and his unwavering support to me, but I certainly do understand his desire to spend more time with his family. I will shortly announce an Acting VDR to support our researchers in the interim.

Searches for Unified Heads in Pathology, Obstetrics and Gynecology, and Medicine all are nearing closure with ongoing interviews of a strong slate of candidates in each. I hope again to have announcements upon my return or early in the fall. As Dr Alanna Danilkewich will finish in June of 2016, we will be starting a search for the Head of Family Medicine in September.

Faculty are also busy on the committee for internal searches for assistant deans of curriculum, student affairs, and PGME. These should conclude in September.

We are launching an internal search for a Vice Dean of Faculty Relations. As you will recall I took on this role and was richly rewarded by coming to know well many faculty members. As we move forward on the vision of a one faculty model, there is lots of work with faculty to be done. All faculty engaged in our academic mission at the CoM deserve a senior leader fully devoted to their interests. I hope all may give some thought to this role or encourage a colleague who may be well-suited.

Our project on restructuring our basic science programs and governance is well underway and ably supported by Jim Thornhill and Sinead McGartland. I thank those faculty members and department heads who are taking up this work.

Finally, our joint submission with Health Quality Council to CIHR for the Saskatchewan Center for Patient Oriented Research went in the first week of July. This took tremendous work by many people but could see as much as 34 million dollars from the federal government to support Patient Oriented Research coming to Saskatchewan. Thanks to all, but I need to single out the hard work of Beth Horsburgh.

So as you can see the school year ended with what I feel is a growing sense of progress and momentum.

My old boss always said enjoy your summer because we will do even more next year. I sure hope so!!! 🙂

Enjoy your summer!

Preston

June wrap-up

June seems like a blur to me, as there have been an enormous number of activities, projects and events all squeezed in before the summer break. I will endeavor to cover for you a brief summary of what I and your hard-working colleagues have been up to.

I would again like to congratulate the Class of 2015 as we started the month with graduation activities. I complement again the remarkable accomplishments made by this class. It was very interesting to compare their pride in the CoM to that of the many alumni I met this last weekend at Highlights.

Earlier in June Dr. Tom Smith-Windsor organized a retreat on planning for Longitudinal Integrated Clerkships.  This was an excellent day with participation from faculty from across the province as well as government representation. You may have heard me describe this model of clerkship where students spend most or all of third year in groups of 2-4 in a small community covering the curriculum in an integrated and longitudinal format. These are spreading rapidly around the world because the results are quite remarkable. Students do as well or better on standardized testing, have better clinical skills, are more likely to choose generalist and rural careers and retain more of the compassion with which they entered medical school than rotation-based peers. We heard from well-known expert medical educators including Dr. Robert Boulay from Dalhousie, Dr. Jill Konkin from Alberta and Dr. David Hirsch from Harvard.

This week sees the submission of an application to CIHR for a Saskatchewan Support Unit under the SPOR (Strategy for Patient-Oriented Research). To achieve this goal the CoM has partnered with the Health Quality Council to co-host the unit. This is an incredibly important step in the process of growing the research here that impacts our healthcare system and our communities and the CoM has invested considerably to make this project a reality. Many people have worked hard on this project but particular thanks go to Dr. Beth Horsburgh and Dr. Gary Teare of HQC.

I was told when I got here that the dean’s office was like Hollywood because so many people were “acting”. Well I, and a large number of people, have been very busy over the last year to correct that. Thank you to the staff, especially Leslie Bousquet, and the entire faculty volunteers on those committees. I have been or continue to be chair for 13 searches. We have invested in expert help for some of the bigger searches, which has really paid off in the number and quality of our applications. We will shortly announce a Vice-Dean of Education and are, this summer, interviewing stellar short lists for Vice-Dean Research and Unified Heads in Medicine, Obstetrics-Gynecology and Pathology. The external interest in our College is remarkable and the internal interest is very encouraging.

On June 21-22 we hosted a Distributed Medical Education Retreat in Regina. This is part of our ongoing process of strategic planning for DME, which will result in a comprehensive plan this fall. We had approximately 60 participants from across the province and the opportunity to hear about the DME models in Alberta (Dr. Jill Konkin – U of A and Dr. Doug Myhre – U of C). Participants were from across the province including our two academic health science centers in Saskatoon and Regina, many of our regional partners, government leaders from both MoH and MAE, and residents and students. Much was accomplished as we continue on our journey to paint the province of Saskatchewan with learners in all areas and produce graduates that are keen to serve all of our communities.

Highlights 2015 was a great success with a great turnout and some fabulous speakers including Drs. Gill White, Dee Dee Maltman and Mike Kelly to name a few. The conference afforded me many opportunities to engage with alumni and hear their great stories and fond memories of the CoM. I must admit I will be glad when University Bridge is back as I made about 12 trips to and from the Sheraton in three days. One feature of Highlights was the debut of a short video about the CoM that we will use over the next year or so at alumni and donor events as well as any opportunity to promote our college. The following link leads to the video: https://vimeo.com/cinescapescollective/review/131702478/5a1fff76ef.

Another important piece of work accomplished this year was done with my colleagues around the Council of Health Science Deans. We will restructure to a Health Sciences Council and the university has invested in new leadership positions to advance our twin goals of interdisciplinary health research and inter-professional education. In that regard the Provost has asked me to take on the role as Vice-Provost Health while continuing on as Dean of the CoM. My role is to chair the Health Sciences Council and facilitate the kind of collaboration that will achieve these two goals. The 360 million dollar provincial investment in the Health Sciences Building and the ongoing substantial investment in our colleges have been based on the promise we will succeed in these goals of IDHR and IPE.  Success in these areas is also success for the CoM as it is for all of our peer health colleges and schools. I see this role as complementary to my role as your dean and rest assured you will continue to have my full-time efforts and commitment.

A bittersweet moment for me was an afternoon tea we had on Monday to honor Dr. Sheila Harding. Dr. Harding seems to me synonymous with medical education and UGME here at the CoM and I knew her reputation long before arriving in Saskatchewan. Sheila is stepping down in her role as Associate Dean for UGME after over 11 years. Now, in typical Sheila fashion, she will not be done until August 31 as she agreed to extend again for two more months until her replacement can start. Besides her boat will not be delivered until late summer!! Sheila has been an incredibly committed medical education leader who is passionate about medical education, students and serving well the people of Saskatchewan. She truly excels at her model of “servant leadership” and her national reputation in medical education is, I am sure, the strongest at our university. We have been very lucky to have her in these roles and my only hope is that after a well-deserved year of administrative leave and sailing we will find a way for Sheila to continue to make big contributions to our medical education mission.