Guest blog by Dr. Trustin Domes, Director of Admissions

Earlier this week we announced a renewed approach to MD admissions in our college.

Over the past few years, the admissions team and a broad range of stakeholders have looked at our processes with a focus on ensuring we attract a strong applicant pool. We are ultimately striving for successful candidates who will be the best trainees for our province and who will find success and fulfillment of their own aspirations in our program. In other words, we have developed a more robust approach to make sure that applicants are a good fit for us, and we are a good fit for them.

After an external review of MD admissions in 2019 followed by a visioning retreat in early 2020, stakeholders strongly endorsed that those admitted into the CoM medical doctor program should have a strong personal connection to the province, that we need more diversity in our processes and applicants, and that we need more data to drive our decisions going forward.

In response, an admissions renewal committee was created, composed of five subcommittees, with the task of evaluating and operationalizing the proposed recommendations. The committee was diverse, with broad representation from across the province and included medical students, residents, faculty, staff, patients, the Division of Social Accountability, Indigenous Admissions, our Regina campus, the University of Regina, the Saskatchewan Medical Association, First Nations and Metis Knowledge Keepers, and Métis Nation–Saskatchewan.  Each subcommittee focused on a different priority area to be considered for selection to the program.  These priority areas are academic preparedness, diversity, communications skills/emotional intelligence, Saskatchewan “connectedness,” and professionalism.

Based on the admissions renewal and admissions committee work, the following changes to MD admissions have been recently approved through all university governance processes:

• submission of short personal essay(s)—opportunity for applicants to share their background and relevant experiences
• participation in a panel interview
• minimum entrance average requirement of 80% for all applicants (a lower average of 75% for Saskatchewan-residents had been introduced when there was a shift to a four-year degree requirement in consideration of a smaller applicant pool; the applicant pool has increased now to historic levels and this new threshold would not have significantly disadvantaged the last four years of matriculants)
• implementation of an Indigenous Admissions Circle, which will increase Indigenous representation and add a more holistic and cultural lens to the admissions process for Indigenous applicants; the goal is increasing the number of Indigenous applicants and students in the program, and strengthening our college’s response to the Calls to Action of the Truth and Reconciliation Commission (TRC)
• introduction of an Indigenous studies prerequisite beginning with 2024 applicants, also a response to the TRC Calls to Action
• the Diversity and Social Accountability Admissions Program (DSAAP) will be expanded by transitioning it from an opt-in program (where applicants had to meet a strict financial threshold) to an opt-out program where all applicants will have the opportunity to respond to the DSAAP questionnaire and a DSAAP index will be calculated based on those responses
• the Saskatchewan resident and non-Saskatchewan resident pools will be eliminated and applicants will be assessed through a Saskatchewan connectedness index based on admission factors linked to continued practice within the province; the goal is to admit more applicants that have a greater chance of practicing in the province after completing their medical studies

Existing requirements of a four-year degree, the MCAT exam and participation in multiple mini-interviews will continue.

I want to thank everyone who offered feedback and participated in our admissions renewal process. This critical and time-intensive work helped us to collaboratively arrive at new processes and procedures that are evidence-informed and strategically aligned.

Our admissions team is excited to begin implementing these new changes! Our goal is to admit a diverse incoming medical school class that will not only be successful in our program but will also reflect the patients that we serve in Saskatchewan, will have a propensity to develop leadership capacity and will have a desire to serve the province as future physicians. I believe we are well on our way to achieving these important goals in medical education and, ultimately, delivery of care for Saskatchewan.

Guest blog by Dr. Meredith McKague, Associate Dean Undergraduate Medical Education, and Dr. Kent Stobart, Vice-Dean Medical Education

A great deal of change was necessary in the USask MD program, in the healthcare system and in the broader university, to navigate the pandemic. Our top priority in UGME was keeping learners, staff and faculty safe, while working to find effective ways to continue delivering education and keep graduation timelines on track. And as we navigate now to our “new normal,” we are using the feedback of our learners, faculty and staff to create a teaching and learning environment that benefits from both tried and true practices and what we’ve experienced these past few years.

One area of potential misinformation we want to address is speculation that the pandemic served to reduce the cost of delivering the USask MD program. This was not the case, mainly due to increases in small group teaching due to group sizes being reduced to better enable physical distancing, as well as PPE costs. Faculty time previously spent on in-person lectures was instead used to create pre-recorded lectures or to live-teach, virtually. (There were few instances where previously recorded lectures were re-used over the past two years.)

Thus, overall, while there were savings in other cost areas within UGME, the cost of teaching in the MD program in fact rose during the pandemic. Changes made to manage the pandemic did not reduce the cost of delivering the MD program.

Now, as we have transitioned back to more in-person teaching and learning in our program, we are testing a hybrid approach based on what we learned during the pandemic, leaning heavily on student and faculty feedback. The UGME office has received mixed feedback from students regarding online course delivery, with some preferring in-person learning entirely and others preferring a virtual approach where feasible for the content.

Thus, this current hybrid approach, with a mix of in-person and online learning, is being used and tested out, and supports what we have heard from MD students. It is very much still a new approach and we are learning as we work together to deliver a strong program. Faculty and course leads, building on the many changes made during the pandemic, continue to explore ways to creatively deliver content. We are committed to working with our learners and faculty to arrive at a sweet spot—the best possible delivery of our program to learners that ensures effective outcomes and offers reasonable flexibility for everyone involved. As always, there are various things that must be considered, including taking into account the range of needs and preferences of students and faculty, delivering a solid program and achieving strong learner outcomes, all balanced against sustainable program costs.

An area of success this year for learners and our program we would like to highlight is that our Medical Council of Canada (MCC) Qualifying Exam-1 results were slightly higher than the Canadian medical school graduate average, and we achieved very similar outcomes across our campuses and sites; this is a really important achievement as a provincial medical school delivering medical training to meet the needs of all of Saskatchewan. It’s important also as we expand the Regina campus this August to include 40 per cent of our first-year medical students; up to now first year for all seats in the program was delivered in Saskatoon.

We are also excited to be unveiling a renewed curriculum for the MD program this fall, so watch for more details on that at that time.

The pandemic has been a difficult time in so many ways for so many people. Our learners, faculty and staff have come together to support one another, and we have also seen some positive changes. We will keep working with learners, faculty and staff together as a CoM team to continue to improve our curriculum delivery in support of student learning.

In spite of the challenges to research productivity posed by the pandemic, the CoM has been able to celebrate many research successes in the past few years. Most recently, we had a number of very successful Canadian Institutes of Health Research (CIHR) grant applications in the Fall Project Competition, and I want to acknowledge those researchers and the important funded work they will be conducting.

Adding to his incredible career as the “father of agricultural medicine,” Dr. Jim Dosman is the principle investigator in a $1.4 million project over five years to examine what contributes to the mental wellness of Indigenous peoples in the home setting. More details on this work was provided in a recent USask announcement.

Dr. Juan Ianowski is leading a team of researchers, including from our college: Drs. Julian Tam, Asmahan AbuArish, Veronica Campanucci, and Chung-Chun (Anderson) Tyan; in a three-part project to advance understanding of cystic fibrosis. More information about this project, funded by $810,900 over five years, can be found in this USask article.

Also successful in recent CIHR funding Priority Announcement areas were Dr. Anil Kumar, with $300,000 for work in the area of infection and immunity (Early Career Research Support), and Dr. Deborah Anderson, with $100,000 for work in breast cancer research.

I’d also like to congratulate successful participants in one of our college’s internal research funding programs, and look forward to the successes they will have due to the support from ComBRIDGE, offered and coordinated by the Office of the Vice-Dean Research. Those successful researchers are: Drs. John Howland and Robert Laprairie, principle investigators with co-applicants Drs. Ian Winship, Christopher Phenix and Allen Chan; and Drs. Valerie Verge and Kam Chan, principle investigators with co-applicants Drs. Anand Krishnan, Jenna-Lynn Senger and Christine Webber.

While budgets are increasingly a challenge, providing internal support programs to help our CoM researchers achieve success continues to be an important priority of our college.

I know you will join me in congratulating these researchers on their recent successes, and in thanking all our researchers and those supporting them on their continued commitment through challenging times.

Guest blog by Greg Power, Chief Operating Officer

With this blog, it’s my great pleasure to introduce you to new college-level administrative staff awards being launched at the CoM. Three new awards will support our efforts to recognize, reward and thank our administrative staff for their critical role in the success of our college. Every day, staff support our learners, our faculty and our administrative leaders, and ensure the smooth running of our sites and offices throughout Saskatchewan.

The awards are specifically for administrative staff (not learners, academic leaders or faculty). All administrative staff supporting the CoM are eligible for nomination. Whether you are a USask employee on the USask main campus or at another location, one of our Regina campus staff employed by the SHA, or one of our growing number of employees around the province in clinical locations, you are eligible. These awards add to—but do not replace—existing awards like the Sydney Inskip Service Award and those given out at unit and department levels.

We are starting with three awards, which could expand to more in the future. The awards process will follow a nominations and selection committee approach. More details, including a nomination form, are available on the CoM website.

First and foremost, I want to encourage everyone, including learners, to consider participating in the nominations process for any deserving administrative staff members on your teams, at your site, or who you have worked with or been supported by in some capacity. Through these awards, we want to recognize and showcase the breadth of support and leadership administrative staff provide to our college across all our Saskatchewan sites, departments, units and research teams.

I think we can agree that we don’t recognize this group within the CoM enough, and with these awards we hope to improve on that. Let’s celebrate our amazing staff!

Here’s a brief description of the three awards:

Living Our Values Award – awarded annually to a staff member who exemplifies one or more of the college’s values in their day-to-day work. The college values are: collegiality; fairness and equitable treatment; inclusiveness; integrity, honesty and ethical behavior; and respect.

Team Achievement Award – awarded annually to a team of staff members (two or more people) working together to achieve a goal that supports the College of Medicine strategic plan objectives. We recognize that teams can be formal and non-formal, and encourage nominations for any type of team, working towards any type of goal for the CoM.

Create-it Award – awarded annually to a staff member or team nominated for an achievement that may not fit within the scope of other awards. Nominators will suggest a fitting name for this award based on the achievements of the individual or team they are nominating. With this award, you might choose to recognize commitment to professional development, new work, leadership, or mentorship, for example. But this award gives nominators room to be creative and identify other achievements we should be celebrating!

Nominations are open now and the deadline for submission for the 2022 awards is March 18, 2022—so don’t delay. Fill out a nomination form and submit it any time before the deadline. As mentioned, more information, including the nomination form, can be found on the CoM awards web page, with reminders following this blog in the CoM E-News.

Thank you in advance for nominating one or more of our fabulous administrative staff members for an award!

Guest blog by Dr. Anurag Saxena, associate dean, Postgraduate Medical Education

In this follow-up to my December 2021 guest blog, I want to highlight the important work the Postgraduate Medical Education (PGME) office continued despite the many pandemic challenges also being managed. This includes our ongoing work to implement Competency-Based Medical Education (CBME), accreditation of all programs and the central PGME office, and the newly developed PGME strategic plan.

I’ll start with this great news: all our residency programs are accredited, with the next follow-up by regular review in November 2023. Currently we are engaged in internal reviews of all our programs, started in fall 2021 and continuing through spring 2022. This includes a review of the PGME office. Thank you to all our reviewers and the internal review team leads in engaging in this exercise, which is extremely important for continuous quality improvement of residency education.

Of course, identifying and addressing areas for improvement is an integral part of this work, but the primary intent remains striving for excellence. Upon completion of these internal reviews, the second phase will begin, to address areas for improvement and enhance the quality of our programs, both individually and collectively, under the leadership of the academic programs enhancement committee. We will be sharing the common themes and the emerging, leading and best practices identified in each program with all programs, so that we can learn from each other.
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The CAnERA accreditation standards can be found here: General Standards of Accreditation for Residency Programs and General Standards of Accreditation for Institutions with Residency Programs.

 CBME is now the norm in our programs, either formally in Family Medicine and most Royal College of Physicians and Surgeons of Canada (RCPSC) specialty programs or by incorporating its principles in the remaining handful of our programs where it hasn’t yet been formally adopted. It will be launched in Diagnostic Radiology in July 2022. We continue our work in transitioning to Elentra as the electronic platform for housing resident information and as an initial step for ultimate integration of curriculum and program administration on one platform. This transition exemplifies true collaboration between Elentra, our CoM and USask information technology professionals, CBD leadership and programs. We are continuing the work in ensuring implementation fidelity and evaluation of CBD components and outcomes.

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We undertook the PGME’s new strategic plan development this year. This process involved extensive stakeholder consultation through surveys and focus groups. This work commenced with assessing the current state (i.e., progress on the previous strategic plan, PGME’s key contributions to the CoM and SHA strategic directions, SWOT analysis), updating existing priorities and drafting new ones, validating and refining the strategic priorities, and highlighting areas of alignment and potential collaboration. We look forward to building on these conversations and emerging partnerships as we move this important work forward.

I would like to thank all of the residents, faculty, staff and leaders and the working group members who informed and developed the plan. A very special thank you to Catherine Delaney, CoM project manager, for her highly effective facilitation of this strategic planning process. The final version of the plan, approved by the PGME planning committee, includes an updated vision, mission and set of strategic priorities and affirms our alignment with the CoM values and principles. The key strategic directions are shown below, and more plan details can be found on our website.

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That we have been able to complete all these important areas of work while navigating the many challenges of the pandemic speaks to the many great people involved directly and in supporting roles in medical residency in Saskatchewan. Thank you to all our residents, program directors, program administrators, administrative team staff, department heads, senior academic and administrative leaders and of course, the PGME unit staff. It indeed takes a village to offer residency education. It is a privilege to work with all of you.

I would dearly have liked to be writing a different holiday message from the one I shared last year. But as you know, circumstances continue to be quite similar to that time, with a few important exceptions. Most of us are at least double vaccinated and some triple vaccinated, now, and we have also gotten much better at following our other important pandemic safety measures.

With the Omicron variant spreading in alarming fashion in the world, we do need to continue to be cautious. Physical distancing, wearing masks, keeping our bubbles small along with making use of rapid testing are all in our tool kit and we are certainly becoming experienced users of all of them! So my first and foremost message to you is to continue to be diligent about pandemic safety measures.

If we each make this important commitment, we will also help alleviate the heavy burden being borne by our healthcare workers. And that’s who my second message is for: to our learners, faculty, staff and all on the front lines of care: we are thinking of you, our college supports you, and across research, teaching and clinical settings we continue our important work to alleviate and solve the challenges of this pandemic.

I thank the entire College of Medicine team—all our learners, staff and faculty—for all your efforts of the past year at a time when I know you were managing change and uncertainty both in your work and personal lives. Together, we have ensured that the CoM has moved forward on delivering education and training, an impressive range of discovery through research, and on prioritizing equity and diversity. I thank you for supporting one another through this and staying committed to our medical school vision and mission.

I wish you and yours a safe and peaceful holiday season, and that all find time to rest and step away from the concerns of the world.

Guest blog by Dr. Anurag Saxena, Associate Dean, Postgraduate Medical Education

In this guest blog I wish to highlight the impact of COVID-19 on residency programs—particularly on residents. Imagine a resident who has just finished an overnight call after a day’s work and is called back to provide coverage because other colleagues are either sick, or have tested positive for COVID, or are not available for other reasons. Or, imagine a resident who could not complete a critically important learning experience out-of-province because of travel restrictions and now may not complete residency on time. These stories are real and true for many residents.

Since the beginning of the pandemic nearly two years ago, our residents’ well-being and learning have been adversely affected. In addition, increased demands for clinical care—sometimes beyond their residency programs—have been placed on them. This has meant navigating turbulent changes to their residency, including reduced access to some learning experiences (e.g., reduced opportunities for procedural competencies and off-service rotations, and canceled mandatory and elective learning experiences), uncertainty around national examinations, concerns about on-time completion of their residency, and licensure.

At the same time, they were asked to engage in increased provision of clinical care within and beyond their programs (additional work, increased and back-up calls, re-deployment) while also working through the system of ensuring personal protection (PPE, vaccination). The adverse impact on personal well-being is hard to assess, but it has been immense when you consider areas like personal risk, and negative impact on physical, mental, emotional, social, financial, environmental, occupational, and spiritual well-being. These impacts were experienced while adjusting to pandemic-related, external and required measures. I am sure every resident has at least one story they are likely to pass on to the next generation!

Throughout this period, our residents have demonstrated courage and empathy in caring for patients,  while engaged in their own learning and bravely attending to their own well-being. It has not been easy and we cannot count on individual resilience alone—and we know that.  Our residents have told us that their primary level of support comes from within their own residency programs, followed by the PGME office. We will enhance our efforts in our programs and through work with individual residents to ensure we provide meaningful, proactive measures and responses that are based in care and concern.

Although the number of COVID cases in Saskatchewan is on the decline, we are not out of the woods yet, and other pent-up demand will need to be attended to. We are all in this together and this is not the time to give up. When the intensity of the work decreases (we hope soon!) and possibly an easier pace can be achieved, there will be more time to assess the impact of the damage to well-being. This will be a high-risk period when it will be critical to look after ourselves. We all need to reflect and heal and not succumb to the accumulated stresses of these incredibly challenging years.

The responses from our people at various levels—programs, sites, central academic and administrative units, senior leadership, internal and external stakeholders—have been stellar examples of acting with thoughtful stewardship. Under the most trying of circumstances, the agile reactive responses and pre-emptive efforts to stay ahead of demands and challenges in healthcare and residency training sometimes involved changing course, while at other times it was necessary to hold steady as we went through severe turbulence.

Thank you to our program leaders (program, site and associate directors), administrators, department heads, and CBME personnel (Competence by Design leads, Curriculum Committee chairs and members, and academic advisors) for your remarkable efforts in holding the course. Our program leaders have ensured training was delivered through: innovations, utilizing non-clinical learning experiences and COVID and patient-oriented research; on-time completion of residency; and flexible approaches to manage challenges related to redeployment.

The transition to virtual care and virtual learning, and increased use of simulation, has not been easy and continues to be refined. The high intensity work involved in the accelerated CaRMS match process is worth noting. Our postgraduate program directors and program admins ensured fairness of the selection process while adapting to virtual interviews and compressed timelines. No one has buckled under pressure. The courage demonstrated in holding the line on protecting residents from excessive clinical demands speaks to true, people-oriented values and the need to integrate the dual aspects of patient-centeredness and learner focus.

The educational offerings from the central PGME office have continued. We have deliberately looked after: refining the programs to meet needs; improving the rigor of the virtual boot camp for new residents; our quality improvement program; RAPID program; referral program; and the recently adopted TIPS program. Further, the PGME team is working on expanding and increasing the relevance of program director and program administrator workshops and chief resident workshops.

Some leadership aspects have been essential to our journey through this. The senior leadership (both academic and administrative) at the College of Medicine (CoM) has been immensely supportive, trusting and proactive in ensuring work for long-term vision. The changes to policies and flexible approaches to affect systemic aspects (increased funding especially for well-being supports, including but not limited to counselling, and food while on COVID-related call), carryover of leaves and vacations, payout of unused vacations/leaves) were possible only with the trust and support of the senior leadership at the CoM and Saskatchewan Health Authority (SHA). The leadership at Resident Doctors of Saskatchewan (RDoS) and the joint work between RDoS and PGME has been an example of purposeful collaboration and unearthing that our interests are same. The collaborative work with the College of Physicians and Surgeons of Saskatchewan, the SHA, and the national colleges has been instrumental in managing risk, adapting to situations often in a very short timeframe and ensuring public accountability. The support and decisions from the Ministry of Health, the primary funders of PGME, have been timely, agile and undergirded by care and compassion.

Throughout, we have also managed to steadfastly hold our long-term focus for postgraduate medical education in Saskatchewan, as well. I will provide more details of that important work in a follow-up guest blog early in the new year.

Extensive work went into the creation of the CoM’s inaugural five-year strategic plan, released in 2017. The collaborative process was a first for us, and was highly successful in engaging so many—across our entire college and from stakeholder and partner organizations—to articulate the plan. Our 2017-2022 plan has served us well, and we have made progress in several key areas, specifically: we’re seeing strength in those foundations of faculty engagement and enablers, and in our research deliverables, and with all of our education programs fully accredited.

As we renew that plan to take us to 2025, which aligns with the university’s planning timeline, college leadership have acknowledged and agreed that much of the original content remains relevant to our ongoing strategic planning approach. With that in mind, we have updated the plan with small but significant changes in its content, to guide our work over the next three to four years. You can see this updated information reflected on the college’s strategic plan webpage. Here, I will highlight some of what has changed in this updated plan.

While the pillars on which we all work continue, as always, to be education and research, we are more concretely identifying the critical role of our social obligations in truly achieving success. The areas of our social obligations we have identified in the renewed plan encompass: Indigenous health; equity, diversity and anti-racism; social accountability; and growth and stability of Saskatchewan’s rural and remote physician workforce.

As we head into 2022, our context has changed, and we need to focus and carry out work in these areas, and respond to what our society needs from us—not only through the lens of a post-pandemic world and our role in helping meet Saskatchewan’s healthcare workforce needs, but through our acknowledgement as a college and society that we can’t claim success or achievement when we leave whole segments of people out and do them harm.

The leadership team of our college agrees that more concrete and intentional planning is needed to ensure we meet our important social obligations as Saskatchewan’s only medical school.

What hasn’t changed, is that our faculty, staff and learners—our team—is the foundation from which we will achieve success in these areas, as well as across our strategic directions. We have reduced the total number of strategic directions – our top priorities – from nine to seven. Those strategic priorities are: Strengthen Research Capacity; Quality Education; Social Accountability; Indigenous Health; Faculty Engagement; School of Rehabilitation Science; and Enablers. Two of the original priority areas—Distributed Medical Education and Health System Alignment—are positioned within Quality Education and Faculty Engagement, respectively, in the renewed plan. This approach enhances our strong commitment to our top priorities and will help us work together to achieve the best outcomes for our college.

A huge number of our faculty, learners and staff, as well as many members of partner organizations, helped us create our original plan, launched in 2017. That work, and the more recent work to renew the plan, has our college on solid footing as we head towards 2025. Thank you, team!

I hope you will take a few minutes to look through the updated strategic plan web page. As always, I welcome your feedback.

Guest blog by Dr. Manuela Valle-Castro, Director, Division of Social Accountability

On October 22, Saskatoon community-based organizations that deliver front-line services to people living in poverty―Quint Development, the Lighthouse, the Elizabeth Fry Society, Prairie Harm Reduction, OUT Saskatoon, the Saskatoon Poverty Reduction Partnership, the Westside Community Clinic, and the Saskatoon Housing Initiatives Partnership, among others―met at Station 20 West in an emergency community meeting to discuss the impacts on their clients of recent changes in social assistance.

They described a situation in which nonprofits are forced to compete with each other for scarce funds to deal with “Band-Aid” programs to address complex social problems, like poverty and homelessness, that are rooted in colonial policy, such as the reserve system and residential schools. They denounced the lack of provincial social support as a situation of “systemic neglect” to the most vulnerable. Almost 85 per cent of homeless people are Indigenous^[1]; many are residential school survivors; and many face severe health problems. For example, complications from diabetes lead to amputations, which in turn leaves people facing more barriers.

These clients are not supported to stabilize, throwing them into a cycle of housing crisis, eviction, and homelessness. The provincial government does not fund shelters for people if they are intoxicated, leaving those who are homeless and living with addictions to extreme suffering and sometimes death in the winter, as happened last year to the late Kimberly Squirrel.

The biggest casualties of this systemic neglect are the children of these families. Lacking adequate housing leads to family instability and results in too many Indigenous children disproportionately going into foster care (86 per cent of children in foster care are Indigenous in Saskatchewan). Family disruption is one of the main predictors of incarceration, poverty, overall poor health and short life expectancy.

The failure of our social systems to properly and proactively address these inequities is not just socially and politically unsustainable, but it also results in an extra burden for the health care system and law enforcement. It is economically unsustainable.

We are teaching our students that physicians have a role in advocating for the social determinants of health of a community. We teach them that housing and food security, along with the right to a clean environment are crucial for any individuals’ health. But physicians and their professional associations need to speak up and educate our provincial authorities on the impacts of clearly bad policy on the health of our communities, and on the unnecessary burden that housing insecurity and homelessness puts in our healthcare system.

According to the Royal College of Physicians and Surgeons of Canada:

Physicians are accountable to society and recognize their duty to contribute to efforts to improve the health and well-being of their patients, their communities, and the broader populations they serve.* Improving health is not limited to mitigating illness or trauma, but also involves disease prevention, health promotion, and health protection. Improving health also includes promoting health equity, whereby individuals and populations reach their full health potential without being disadvantaged by, for example, race, ethnicity, religion, gender, sexual orientation, age, social class, economic status, or level of education.

Social accountability means that medical schools also have a mandate to prioritize the health concerns of the communities where they are located, as well as to prepare students with a deep understanding of those health issues so they can effectively address them. Our college has taken on a moral and ethical responsibility to address the health disparities that affect Indigenous peoples and children when we put on our orange shirts and declared that “every child matters” on September 30. Let us live up to it.

^[1] “2018 Point-In-Time Homelessness Count Saskatoon, Saskatchewan” https://static1.squarespace.com/static/58dd630f3a0411286bd918ad/t/5d11464216f1d70001dfc3da/1561413186855/PIT+Count+2018+Report-web.pdf?fbclid=IwAR3hyap3K0WbTXzfmoT8fZCkacX_7qrbDvc3dtrsdYvE3dU2Bv6HT7NIzPs

Related news media articles:

• https://www.cbc.ca/news/new-social-assistance-program-fuelling-homelessness-in-saskatoon-1.6215506?fbclid=IwAR3c9z_PbBf8VruaNFchQrc5cHz6cBh6gHT5CLysuMeZBYU8UJyoxZ-FVy4
• https://www.cbc.ca/player/play/1968453187716?fbclid=IwAR3c9z_PbBf8VruaNFchQrc5cHz6cBh6gHT5CLysuMeZBYU8UJyoxZ-FVy4
• https://www.cbc.ca/news/canada/saskatchewan/anti-poverty-advocates-rally-regina-saskatoon-income-support-1.6227863?cmp&fbclid=IwAR0NV809GRHvqreTSZfCyrDfe0SWhItbSN1Pk_YtjOw7MoTe5hndhjpV6eA
• https://saskatoon.ctvnews.ca/saskatoon-protesters-take-aim-at-social-assistance-changes-1.5640838?fbclid=IwAR1T6RA_Qfk5N_2HkVcahl3YjuPu15i4ydf53fa7pQSVHJtnODADYOfRjLE
• https://thestarphoenix.com/news/local-news/everybody-sees-the-truth-reform-sought-amid-rising-homelessness?utm_term=Autofeed&utm_medium=Social&utm_source=Twitter&fbclid=IwAR0fXXiI-66KhEhoIVSPvwXcFWMurlBa7OxUVLV0y39Ad8MlQJzzus5xX8Q#Echobox=1635377443
• https://thestarphoenix.com/news/local-news/this-is-an-attack-on-the-poor-critics-slam-new-sask-social-assistance-program?fbclid=IwAR19XaRmuhwdE3i6rf1drfQTnBlwwNMi_BUNerOi5DZ9vxX-aIkrvXBELqM
• https://www.cbc.ca/news/canada/saskatchewan/camp-marjorie-fsin-1.6233476

Physicians are duty-bound to advocate for the health safety of the people of the communities they serve. It is in the Code of Ethics and Professionalism (Physicians and Society – clauses 37-44) of the Canadian Medical Association, and it is represented in three of the seven CanMEDS roles: health advocate, leader and professional.

It starts in medical school, where we teach advocacy to our students. So it is ingrained in all physicians from early in their training that as professionals they have an important role in advocating for the good health of not just their own patients, but the general public, as well. I believe that we wouldn’t want it any other way.

Our medical doctors are fulfilling their ethical obligation to the public through their advocacy and guidance on our pandemic response. And it seems reasonable that our doctors would be supported in this. For the most part, my experience has been that we doctors are supported in this advocacy role.

But as Saskatchewan struggles in this fourth wave of the pandemic, I am seeing more and more comments and conversations that suggest a lack of understanding of this professional duty of medical doctors. I think of the many physicians on the front lines of care, as well as public health experts and physician leaders, who, on top of all their other work, are doing media interviews—sometimes on a daily basis—to ensure that important information on the pandemic and how to stay safe reaches the public. Their efforts are heroic and deserve our support.

It’s a year since the Maclean’s magazine opinion piece by Canadian physician and writer Dr. Jillian Horton, about “staying in your lane” and the need for doctors to “flood the freeways,” was posted. She reminded us that non-objection is tantamount to silent agreement. As physicians, our role as health advocates compels us to voice our concerns, and I applaud our physicians, physician leaders and medical health officers for their advocacy and leadership through these incredibly hard recent days and weeks, and from the very beginning of this pandemic.

I also want to acknowledge the extensive advocacy and knowledge sharing efforts of our public health experts, epidemiologists and scientists. I extend my heartfelt thanks to all of you, as well as all healthcare workers on the front lines of care, including our medical faculty, students and residents, for all you have done and are doing.