Guest blog by Marek Radomski, Vice-Dean Research

I would like to thank the dean for an opportunity to share news from the Office of the Vice-Dean Research (OVDR).

Over the early months of my appointment, the OVDR team has been working on a number of fronts to support the research community in the College of Medicine.

It became clear to me, right from the very beginning, that the funding of our basic and clinical research in the College of Medicine would be a very urgent and challenging task. Recent turmoil around the Canadian Institutes of Health Research (CIHR) application process, low rate of success for the University of Saskatchewan, and the fact that our provincial funding is the lowest in Canada highlights the need to mobilise available resources in our university and college to support our faculty and graduate students in their research endeavours.

What have we accomplished so far to increase funding opportunities for our faculty?

• We planned and carried out the College of Medicine Research Awards (CoMRAD) grant scheme. The scheme was initiated thanks to the foresight of our dean and the leadership of Steve Milosavljevic, the acting vice-dean research. We funded 28 out of 66 applications to the tune of $693,691. It is important to emphasize that basic and clinical researchers equally benefited from this scheme and 40 per cent of funded applications went to early career researchers.
• In collaboration with the Office of the Dean of Graduate Studies, we will shortly be announcing the College of Medicine Graduate Awards (CoMGRAD) grant scheme to increase funding opportunities for our existing pool of graduate students.
• We have engaged with the Saskatchewan Health Research Foundation and are working on a bridge grant scheme to increase the rate of success of College of Medicine researchers in Tri-Council competitions such as CIHR grants.

During introductory meetings with the departments, clusters and individual faculty members, I promised to conduct an external review of the status of research in the College of Medicine. As you may remember, the objective of the external review is to help us reflect on the College of Medicine research Strengths, Weaknesses, Opportunities and Threats (SWOT). I am very happy to report that this promise will very soon become a reality as the review and the site visit will take place next week from October 31 – November 1, 2016.

Our reviewers are all distinguished biomedical academics who work for Canadian and American medical schools. Indeed, Dr. Gail Annich, MD; Dr. Gautam Chaudhuri, MD, PhD; Dr. David Thomas, PhD; Dr. Lorne Tyrrell, MD, PhD; and Dr. John Wallace, PhD, bring a wealth of high personal academic achievement, experience and interdisciplinary expertise, ranging from basic research via clinical research, to successful research and development.

A good academic practice employed in the external review process is to prepare the self-assessment document and make it available to reviewers prior to the site visit. The OVDR team is leading the process of preparing the self-assessment document which includes an analysis of indices of research-relevant output as well as individual SWOT assessments from departments and clusters. I would like to take this opportunity to thank all of you who have been involved to date in the preparation of this very comprehensive document.

The second element of the review is the site visit. We are planning for reviewers to meet with a cross-section of the research community in the College of Medicine and tour our research facilities in the Health Sciences Building and on the U of S campus. At the end of site visit, the reviewers will be asked to brief us on the main findings of the external review and will later submit a formal report with a SWOT analysis and recommendations.

The ultimate goal of the external research review is to consider its findings when designing the 2017‑2022 College of Medicine Strategic Plan. The OVDR team is delighted to contribute to this process.

I feel that the outcome of our external review and the preparation of the 2017-2022 College of Medicine Strategic Plan will be important factors in increasing the research fortunes of our college. Of course, the findings, recommendations and documentation of the external review will be made available to the College of Medicine community and relevant stakeholders.

Andre Picard’s headline in yesterday’s issue of The Globe and Mail states: Saskatchewan should declare HIV-AIDS public health emergency.

The article was precipitated by the courageous call for action by a group of Saskatchewan physicians and CoM faculty members and their coalition of patient and clinician colleagues. These physicians include Dr. Steve Sanche, Dr. Kris Stewart, both infectious disease specialists, and Dr. Ryan Meili, family physician.

Picard writes, “The rate of HIV-AIDS in Saskatchewan, particularly in First Nations communities, is so high that the province should declare a public health state of emergency.”

In fact, the HIV infection rate in Saskatchewan is 13.8/100,000 which is almost double the national rate of 7.8/100,000. Even more troubling is the rate among our Aboriginal population on reserves, where the rate is 64/100,000. And these are all likely underestimates, as, although testing has increased somewhat, many at risk people remain untested.

Furthermore, we are not even coming close to reaching treatment goals as “in Saskatchewan, once again, the HIV-AIDS death rate is 3.1 per 100,000, four times the national average of 0.7 per cent. Most troubling of all may be the fact that, last year, three babies were born HIV-positive in Saskatchewan, even though mother-to-child transmission is entirely preventable.”

Drs. Sanche, Stuart and Meili, in today’s Star Phoenix, call on the province to adopt the UNAIDS 90-90-90 strategy. Star Phoenix reporter Charles Hamilton includes in his story, “The United Nations recommends increased testing so 90 per cent of people with HIV know their status; making sure 90 per cent of those patients receive the proper anti-viral drugs to treat the disease; and ensuring that 90 per cent of those people have “repressed viral loads” so infection doesn’t spread.”

These CoM faculty physicians are not the only ones calling on the province for action. Canada and Saskatchewan were in the spotlight in July at the 21^st International Aids Conference in Durban, South Africa. Dr. Stuart Skinner, an infectious disease specialist and CoM faculty member in the Regina Qu’Appelle Health Region (RQHR), advocates for improved HIV testing and care in an earlier article in The Globe and Mail.

Dr. Alex Wong, another Infectious Disease Specialist, researcher and CoM faculty member in the RQHR presented The Developing World in Our Own Backyard: Concentrated HIV Epidemics in High Income Settings in 2015 at the International AIDS Conference on HIV Pathogenesis, Treatment and Prevention in Vancouver. According to Maclean’s Magazine, he sometimes calls this presentation Africa on the Prairies.

What these physicians are saying is incredibly important for the people of Saskatchewan, those at risk for or suffering from HIV-AIDS and our Aboriginal communities, which are disproportionately affected by this horrible disease. They are also being incredible role models for our learners.

CanMEDS, our national medical curriculum framework, was first advanced by the Royal College of Physicians and Surgeons and is increasingly being adopted around the world as the basis for medical curricula.

One of the seven essential roles of physicians is that of health advocate. As stated by the Royal College, “As Health Advocates, physicians contribute their expertise and influence as they work with communities or patient populations to improve health. They work with those they serve to determine and understand needs, speak on behalf of others when required, and support the mobilization of resources to effect change.”

The CoM has had a long history of advocacy, starting with our first dean, Dr. Wendall McLeod, who was a great supporter of Tommy Douglas and the birth of Medicare in Saskatchewan. Our college is replete with current demonstrations of health advocacy: our Global Health Certificate, our Making the Links program, our Department of Continuing Medical Education and our Division of Social Accountability with our refugee health conference this spring, and many more examples. Our students demonstrate the same commitment to advocacy with their student run clinics, SWITCH and SEARCH, and the amazing student led conferences on Global Health and Health Innovation and Public Policy.

Kudos and thanks to all of these physicians for their work in health advocacy and thank you for being such excellent role models for our students and residents. It is moments like this that I know we are a great medical school and an incredibly important asset to Saskatchewan.

As always, I welcome your feedback and thank all for their commitment to the CoM.

First and foremost I would like to welcome our new medical students and residents. The new academic year is always refreshing, and I have always been especially energized by the excitement and enthusiasm of first-year students and residents. This year, I had an opportunity to speak to our new Aboriginal students as well as the whole class of 2020. All had a wonderful welcome to the college and the Aboriginal students heard from Michif Elder Norman Fleury and First Nations Elder Louise Halfe about connection with their community.

As I have just come back from my 35^th medical school reunion, I emphasized to the whole class what a wonderful journey they were on with the classmates around them and the important role they will play as clinicians, leaders and team players in the future Saskatchewan healthcare system. In that regard I was really pleased to see today’s headline in the Star Phoenix: Next decade could see the rise of homegrown Sask doctors and the great interview with Dr. Joanne Siverston, alumnus, Prince Albert physician and SMA Vice-President.

I also reminded the students that the Olympics come around quickly and, despite the hard work in front of them, when the Japan summer Olympics open they will have been residents for a month! And I pointed out that all of us at the College of Medicine and our healthcare partners are here to see them succeed.

I hope you all have had a great summer of rest and renewal. I certainly did. It started with a northern Saskatchewan fishing trip with Dr. Keith Ogle, our vice-dean faculty engagement, which included flying in to his lake on a DeHavilland Beaver (built before I was born) and a fabulous and highly successful introduction to fishing Northern Pike.

The medical school reunion back in the Maritimes was an excellent opportunity to reconnect with some wonderful friends, including a class mate I discovered I could now keep up with who was easily the best runner in our class! Around the reunion, we packed in visits with family and friends, Atlantic salmon fishing on the Miramichi and time at beach-side resorts in PEI and NS. It was a great summer.

And now we embark on an incredibly ambitious and important fall. As you know, much of the work of the last two years has been implementation of The Way Forward, leadership recruitment and faculty restructuring. This fall, we will complete a college-wide strategic planning process. We all know we want a highly successful College of Medicine, but what does that look like? What are our strengths? What are our priorities in education, research and community service? Your engagement is essential, and you will be hearing much more about this project.

You may have received an invitation to our accreditation launch event. A full UGME accreditation visit takes place at the end of October 2017. Like the silent phase of a fundraising campaign, many faculty and staff led by Dr. Athena McConnell (Assistant Dean Quality) and Kevin Siebert (Accreditation Specialist) have already been working very hard. The launch is an opportunity for all of you to get engaged in our accreditation preparation. As you have heard me say many times, accreditation is a team sport. The College of Medicine can only succeed in putting accreditation challenges behind us if all of you are involved. I hope you can come out to one of our launch celebrations on September 12 at our Regina and Saskatoon campuses. We are still working on scheduling an event in Prince Albert.

The team working on restructuring our biomedical science department and developing new undergraduate biomedical science programs based in the CoM will make important progress this fall. Substantial development of our “one faculty” model is underway and will lead to one pathway for appointment and promotion of MD faculty.

Following on last year’s successful College of Medicine and research awards (COMRAD), we will place increasing emphasis on research. In that regard, Dr. Marek Radomski has initiated an external review of our research programs and we will be visited by five internationally renowned medical researchers from October 30 to November 1, 2016. Their review and recommendations will be an important step in the advancement of our research agenda and will inform our strategic plan.

And speaking of research, congratulations to Dr. Deb Morgan on the $2.3 million Foundation Grant from the Canadian Institutes of Health Research that will fund research over seven years to improve dementia care resources for rural healthcare providers. This is very important work; it’s estimated that 47 million people in the world live with dementia.

So when asked, “What is going on at the College of Medicine?” my answer is: accreditation, accreditation, accreditation, strategic planning, biomedical science renewal, one faculty, research, research, and accreditation!! Did I mention accreditation?

Seriously, accreditation is simply superb medical education and research in the context of a great clinical setting. And we will demonstrate that to our peers with the 2017 accreditation visit.

All of the work and plans above are important, as are many other college initiatives (Aboriginal health, social accountability, simulation, Inter-professional Educational Initiatives, and more). I thank you for all of your hard work to date and look forward to your support, advice and engagement as we embark on this ambitious fall agenda.

As always, I invite your feedback.

I trust you are having a wonderful summer so far and have had, are having or will soon have some holidays complete with time to rest and rejuvenate. I have just returned to work this week after an amazing break and feel ready once again to take on the incredible opportunities and important challenges of our College of Medicine. I always am excited to see September come around to launch a new academic year and I look forward to all of us coming back together from the summer with renewed energy and fresh perspectives.

The reason this is so important this year is the CoM is embarking immediately—at the end of this month—on a college-wide strategic planning process in which all members of our community have a voice, should you choose to share it. I strongly encourage you to do so. Why? Because everything we have been through in recent years, which has been difficult and at times even painful, has helped set the stage for our college, now, to move forward in the best possible way.

I am looking for a shared commitment to doing this work together. With all of our community’s individual voices coming together to create a pool of knowledge and experience of the CoM, we have our best shot at creating a plan that will reflect the diversity of our work, needs and aspirations at a grassroots level—to ultimately elevate our students’ experience, our teaching excellence, and the reach and impact of our research.

The strategic plan development process will follow a rapid timeline – we plan to have the full college consultation and information gathering process completed between the end of this month and the end of this year. That’s just four months to gather a vast array of detail, input and knowledge from a large group—all of our faculty, staff and students. Accreditation requirements necessitate this timeline, but we will work to engage with you in this timeframe through a range of methods for you to share your perspectives and suggestions: focus groups, online surveys and other discussions and meetings.

Why are we embarking on this planning process now, and on this timeline? We are at the natural point in time, in terms of our planning cycles. The President has initiated a process to renew the vision, mission and values at the U of S and will be embarking on a new 8 year strategic plan. Our 5 year plan that will take us from 2017 to 2022. will fit into that plan. Currently, our School of Physical Therapy is developing its own five-year plan. Starting in 2013 the College did tremendous work creating the strategic vision document, The Way Forward which in many ways was primarily a strategy for restructuring the College of Medicine. We have worked very hard over the last 2 years and most of that plan has been done or is well underway. It is now time to set our aspirations on what the College of Medicine can do to become one of the best medical schools in Canada and a College all of us can be proud

At a high level, the next four months will look like this: during September, two task groups will cover the areas of teaching and learning, research and innovation, as well as separate engagement forums to review and discuss clinical care service and community engagement, governance and partnership, and administration. If you are interested in participating in any of these discussions please let us know. In October and November, these task groups will lead engagement forums for your participation, including visioning and prioritization events, focus groups, and so on. Ultimately, we will arrive at a draft plan early in 2017 that will need to be ratified by the College of Medicine Faculty Council.

The outcome of this work will be a new vision, mission, values and priorities for the CoM. At that stage, there will also be tremendous opportunity (and a healthy dose of encouragement from myself and other leaders across the college) for your involvement in the very important work of implementing our plan and its deliverables. The implementation of our college strategic plan will be decentralized in nature, with broad participation and support an absolute necessity.

We will be sharing information about the planning process through: high level information targeted primarily to external audiences on our website through a CoM Strategic Plan page, more detailed internal information and content to come later, and likely through further blogs, as well as various reminders, dates and news through our internal, weekly E-News.

I’ll close by reiterating how much I hope for your involvement and input in, and support of, the planning process I’ve outlined here. Working together now to shape the next five years in the history of the CoM will be well worth the effort!

As always, I welcome your feedback.

As I mentioned in my October 2015 blog, Shaping Biomedical Sciences, when we started this project, a biomedical sciences program managed by the College of Medicine (with options/streams to ensure students, upon graduation, are well prepared to enter health professional programs, pursue research endeavours, or enter the work force in their area of specialized training) is critical for our college. There are so many avenues for Saskatchewan to be a leader in the biomedical sciences, and this is our opportunity to be creative and stretch ourselves.

Nearly a year of hard work, meetings and much discussion culminated recently with a vote by the faculty of the Division of Biomedical Sciences on their governance model going forward. As many of you know, the biomedical faculty voted on whether it would move toward a two-department or school governance structure for the future. The vote was in favour of the two-department model, with nearly 70 per cent making that choice. This provides a clear decision by the faculty for a two-department model, and we now begin the work to make this happen.

Conceptual departments, under working only titles of Department of Cellular and Integrative Biomedical Sciences and Department of Microbial and Molecular Biomedical Sciences to enable discussion and understanding, will enable faculty members an opportunity to self-identify which of the two proposed departments they would be likely to join.

In terms of next steps, the Biomedical Governance and Programs committees will begin to flesh out details of the restructuring and the undergraduate program streams. It goes without saying that we need the continued commitment and involvement of our faculty in this work. A Notice of Motion is expected to go forward to the College of Medicine Faculty Council and when that motion has been debated and approved, the next step would be for it to go forward to University Council for approval.

As we move forward with developing the structure to more effectively support these goals, it’s important to note that our current undergraduate and graduate students will be able to complete their programs, which will continue to be honoured and valid, and we certainly need our faculty and staff to reassure all current students of the value of their existing programs.

I want to extend my appreciation to everyone in the basic science departments for your work and commitment to this process over the past nine months, as you’ve organized and participated in many consultations, discussions and town halls. I look forward to continuing to work with you as we take our Biomedical Sciences program to a new level.

We have reached a significant point in our journey toward a new conceptual model of physician engagement in the CoM’s academic mission. May 31 marked the deadline for those approximately 130 faculty members involved in the transition that we began last August. This transition, as you know, involved a voluntary severance package for eligible CoM faculty members in-scope of USFA, with the option to move to new forms of engagement through an Academic Clinical Funding Plan (ACFP) or contract.

I am aware of how varied in nature this process has been for those faculty members involved; that it has been relatively straightforward for some, and has been very difficult for others. People are at different stages of their career and have their own unique set of goals and preferences. We are one team, but within that we are individuals whose situations and choices are unique.

The nature of an ACFP (or contract) is such that the work since last August needed to be carried out on an individual-by-individual basis. This created challenges, as many know. It meant handling communication with care and consideration to ensure appropriate privacy of those directly involved.

Nonetheless, I continue to firmly believe that what we are moving toward is both better and necessary. We must have physicians across the province engaged with the college and involved in our academic mission. We must get to a place where academic time is safeguarded and appropriately valued, if our college is to survive and thrive. We have made an important step in that direction now.

Our transition team has been working very hard to support and inform our faculty members throughout this process, and those efforts were especially elevated in the days leading up to and after May 31. I have great confidence in this team and have seen firsthand their commitment and the lengths they have gone to in supporting and assisting our faculty through the transition. I extend a heartfelt thank you to our transition team members for your diligence and perseverance in this incredibly important work for the College of Medicine.

I also thank our faculty members for their perseverance through this process. Information wasn’t always available immediately for you, and in some cases, details are still being worked out. Your patience and faith in light of this is certainly appreciated.

Our work is of course not finished with May 31. We will continue to strive to engage physicians in Saskatchewan in the work of our college. Note that our transition team needs the month of June to ensure that the work associated with the May 31 deadline is completed and therefore won’t begin additional ACFPs until July. This team will remain in place as we move into the next stage of adding more and more detail to the new model. In addition to the transition team, don’t hesitate to take your feedback and questions to your UDH, and of course Keith Ogle, vice-dean faculty engagement, is also available.

I have heard from our UDHs and many of you that you want unification, you want to be included and you want to focus on our future. I couldn’t be more pleased to hear this, as I want—and our College of Medicine needs—those same things.

As always, I welcome your feedback.

The mandate of a medical school is the triple mandate of education, research and clinical care, all supported by adequate resources, engaged partners and effective administration. Still, occasionally, I hear that we are a small medical school and we cannot be expected to do it all, so why should we be trying to do (or grow) research?

Simple explanations—like our curriculum needs to be supported by biomedical scientists whose entire careers are devoted to research; or that UGME and PGME accreditation require that education be in an environment where research takes place; and learners must have the opportunity to participate in research—are not always convincing to politicians, hospital administrators running a deficit, or even some of our clinical colleagues.

Researchers I have known are motivated by an insatiable curiosity, a passion for research itself and a huge ambition to make that discovery that changes everything (or at least, saves lives or improves the lives of many)! Learners want to participate in research to maybe one day become a researcher or to enhance their CV in ways that will open other doors.  Deans and university leaders want to see rankings improve and reputations grow. Unfortunately, not all are swayed by these arguments for growing biomedical, clinical and population health research.

In medical schools there is a widespread belief that both education and research improve the quality of care and, thus, health outcomes. At the macro level, that is obvious. Though the greatest reductions in mortality over the last 150 years have been from population interventions like sanitation, clean water, improved nutrition and vaccines, all of these were due to research.

However, in the last 30 years our country has seen a steady decline in the national rate of avoidable mortality from 373/100,000 in 1979 to 185/100,000 in 2008. These improvements have been attributed equally to high-tech invasive treatment, pharmaceutical innovation and behavior change (e.g., smoking cessation), all of which are due to research.

Unfortunately, these national reductions in avoidable mortality are not evenly distributed across our country. We can all speculate on many reasons why that may be so.

One argument goes like this: “Fine—research saves lives; we will simply adopt others’ research.” Again, because “we are too small, or too busy clinically, or too resource-challenged to play in that game.”

What if you knew that the volume and quality of biomedical, clinical, and population health research done locally had a direct impact on the quality of care delivered to you, your children or your parents?

Zwicker and Emery from the School of Public Policy at the University of Calgary explain exactly that in their discussion paper, How is Funding Medical Research Better for Patients?, from August 2015. They compare provinces that have substantially invested in medical research (Alberta, British Columbia, Ontario and Quebec) with provinces that have not (Manitoba and Saskatchewan) and correlate that with reduction trends in mortality from potentially avoidable causes (MPAC).

The results are disturbing. At one point they argue that in 2011 Alberta had 62.2 fewer deaths per 100,000 people from potentially avoidable causes than Saskatchewan. And they are able to correlate these variations in the trends for reduction of MPAC with the provincial investment in research across six provinces. They appropriately point out the limitations to their study and concede that rates such as MPAC are multifactorial.

Much of the last 10-20 years in the world of health research has been preoccupied with the challenges of “translational research” and “implementation science.” These authors make an eloquent argument that local investment in research is an essential ingredient to the local adoption of health innovation and, in this case, reduction in mortality from potentially avoidable causes.

I highly recommend you read it. And the next time you have a great health system outcome, also thank a researcher!

As always, I welcome discussion and feedback.