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Messages from the Chair

 

Dr. Howard Bergman MD, FCFP, FRCPC
Chair, Department of Family Medicine
Professor of Family Medicine, Medicine and Oncology
The Dr. Joseph Kaufmann Professor of Geriatric Medicine

Exciting Times in McGill Family Medicine (June 2013)

It was a little over a year ago when I first became Chair and sent out my first message to you.  I must say that I am as excited and as enthusiastic today as I was last April.  I have had a chance to meet many of you and to get to know the Department and appreciate even better now the time, dedication, expertise each of you contributes to the excellence of our Department.

A lot has happened in the past year for which we can be very proud.  First, we passed perhaps the most important test of all: the accreditation process.  This is a process and an evaluation by our peers.  Although we have not yet received the final written report, it is quite clear that we have passed this test with flying colours.  While the program does not examine all aspects of our Department and concentrates on the residency training program, there is no doubt that all the programs and divisions and units contribute to the excellence of our residency training program and to our very successful accreditation.  The equally important test was the recent CaRMS match.  With only one unfilled spot in all the 84 spots available, we passed this test with flying colours, demonstrating our increasing attractiveness to medical students.

Our research activities and strengths continue to grow in a very important manner.  Our Department has taken a leading role in the creation of the Quebec Knowledge/Research Network in Primary Care.  At the same time, we are laying the foundation for our own McGill Research Network in Primary Care which will begin in our three Montreal Units and progressively expand to all our Units and in fact to GMF's outside of our university base.  This year we have two new FRQS chercheurs-cliniciens. This is an extremely competitive competition for salary support for clinician and PhD scientists.  We now have a total of 8 chercheurs-cliniciens and 7 PhD researchers in our Department.  The new FMOQ program, which allows researchers to bill for their time in research, will further enhance our capacity to expand and increase the excellence of our research program.  Ultimately through collaborative and participatory research, we want to improve the organization of services as well as our clinical interventions.  Finally, our researchers have been very successful in some major team grants in the past year.

In the “be careful what you wish for category,” under the new Undergraduate curriculum reform, all medical students will spend one half-day twice a month for ten months in the office of a family physician.  This program, known as the McGill Longitudinal Family Medicine Experience, has been a major undertaking: we need to place 187 medical students!  And thanks to the work of the Undergraduate committee and our staff, we are very close to this goal.  What is most exciting about this is that most of the physicians that have accepted medical students in this program are in the community, not attached directly to our Family Medicine Units.  We hope this will be the basis for a very exciting network with strong two-way communication, learning from each other how to improve care, teaching, and research.  I would also like to add that the Annual Refresher Course for Family Physicians now attracts over 400 community-based physicians.

Our research Master's (MSc) in Family Medicine continues to be one of the unique programs of its kind in Canada.  The number of Master's students continues to grow and we hope to be able to attract our residents into the Clinician Scholar Program and then into the MSc.  As well, we hope to be able to structure the program to allow for family physicians in practice to enroll in the MSc.  We have been designated as an adhoc PhD so our faculty will be able to continue to supervise PhD students.  Concerning our MSc, we had an accreditation visit with the view of transforming our MSc program presently under Experimental Medicine into an independent Master's Program.

In the area of Global Health, we continue to have very exciting projects in Africa and Latin America with several large international team projects.  At the same time, our research and intervention program in indigenous health continues to grow. We have undertaken discussions with several places in China concerning the training of Chinese family medicine residents.

Finally, we have tried to improve and simplify our administrative structures, as well as our means of communication. We are presently working on revamping the website with the help and support of the Faculty.

There continue to be important challenges.  And they fall into the category of “Be careful what you wish for: “Family Medicine is at the heart of the healthcare system; Family Medicine is critical to our healthcare enterprise" (Dean David Eidelman) and there is increasing recognition of the importance of primary care community-based research.  These are important expectations that we need to meet.

More precisely, in the next three or four years, we need to increase the number of residents from the present number of 84 to 103.  As we look to develop new sites (the Queen E. Family Medicine Group will be taking on 2 residents as of July 2013), we need to also consolidate our existing sites.  This is not an easy task.  With the Triple C, which we have been implementing at McGill for several years now, residents are spending more and more time in the Units. As well, the Units are helping train other healthcare professionals such as nurse practitioners, as well as taking on medical students either in the Longitudinal Experience or in the Clerkship.  In that context, Faculty Development is extremely important and an essential element of our work in education.

All this is coming at a time when resources are not expanding in the healthcare system or at the university.  It is important that we maintain the perspective that our Department is no longer a Montreal Anglophone department. We are a department with Units in various regions of Quebec functioning in both English and French.

Members of our Department continue to be very active at the university, involved in Faculty initiatives including the development of the Faculty's strategic research plan: the Postgraduate education program, the Undergraduate curriculum reform, the Faculty Leadership Council, the Centre for Medical Education, etc.  Many have won awards at McGill (see annex on p.4), as well as provincially and nationally.  At the same time, I would like to express my appreciation for the continued support from the Dean, as well as

from the Associate Deans and the Dean’s staff in the academic development of our Department.

As many of you know, we have begun strategic discussions in the Units, Programs and Divisions of our Department.  I do hope you are participating in these discussions which are a chance to step back from the usual and very important discussions on the daily operational issues that we have to deal with.  This is a chance to look at some of the more strategic objectives that we want our Department to take.  If you have not received the documents regarding these discussions, please let me know.  I would be happy to send them to you.  In the fall, we will be having a departmental retreat.  Unfortunately we will not be able to invite all members of the Department but we will need to find some way to involve all of you in the ensuing discussions.

I want to conclude by telling you about two very exciting recent events in which I participated. First, the Family Medicine Student Interest Group (FamSig) dinner.  FamSig brings together medical students with a strong interest in Family Medicine who in turn want to promote to other medical students the Family Medicine residency program.  There were about 40 students at the dinner who were at various points in their medical student career.  All of them were there because they were at least interested in finding out more about Family Medicine and many of them were already committed to a career in Family Medicine.  It was for me an extremely invigorating and inspiring experience to see so many bright, dynamic, and committed medical students with very varied future interests in Family Medicine, as clinicians, clinician-educators, or clinician-scientists.

Second, the Isaac Tannenbaum Annual Research Day.  This day brought together essentially all of our residents from our six Family Medicine Units.  The resident oral and poster presentations were of very high quality.  Many were excellent examples of practice-based research pointing to how practice can be improved by research.  The residents were interested and enthusiastic.  While some may have an interest in a research career, many others will certainly be able to participate in practice-based research which we want to develop with the McGill Primary Care Research Network.

Those students and residents are the future of Family Medicine and it was really great to see how the future is so bright!

 

June 2013                                                                                          Howard Bergman

 

Annex : Awards

Recipient

Year

Organization

Award

Marion   Dove

2012

CQMF

Excellence Award - Contribution to Family Medicine   Education

Marie-Renée   B-Lajoie,

2012

CQMF

Nadine Saint-Pierre Award (excellence &   leadership- students, residents)

Eve-Lynne   Kyle

2012

CFPC

Medical   Student Scholarships

Jennifer   Mitton

2012

CFPC

Leadership   Awards For Family Medicine Residents

Jessica   Lee

2012

CFPC

Family   Medicine Resident Awards For Scholarship

Yolaine   Yim

2012

CFPC

Leadership   Awards For Medical Students

David Lukow

2012

CAME

Research   Award for Best Poster Presentation (Runner Up)

Ann   Macaulay

2013

Government of Canada

Queen's   Jubilee Award

Lennie   Lalla

2013

AMFC

CAME -   Certificate of Merit Award

Charo   Rodriguez

2013

McGill

Richard   and Sylvia Cruess Faculty Scholar in Medical Education

It’s a perfect time to be in Family Medicine! (March 2012)

Dear Colleagues,

I am delighted and enthusiastic about taking on the daunting but exciting challenge of working with you in leading the McGill Department of Family Medicine. In accepting the Chair of our McGill Department, I know I can build on very important strengths developed in the course of our Department’s history under the leadership of its Chairs, in particular the tenures of Louise Nasmith, Martin Dawes and Miriam Boillat, as well as the previous and present leadership of our family medicine units and programs.

I have been very impressed by the competence, enthusiasm, dedication and collegiality of the members of the Department that I met in the past weeks. Our Department can be very proud of its strengths in undergraduate medical education, resident training and faculty development, as well as in research, global and public health. We have created the first Master’s program in Family Medicine research in Canada, and are part of the development of an interdisciplinary McGill PhD program. It is a testimony to your collective efforts that this year we matched 100% in the first round of CaRMS!

We live in a complex and rapidly changing environment. Demographic changes are characterized by the aging of the population and important pockets of vulnerable populations. Chronic disease, in the context of the aging population, is recognised as the main driver of mortality and morbidity resulting in increased complexity and multi‐morbidity. There is a clearer understanding of the impact of socio‐economic and environmental factors and of the importance of health promotion and prevention. Global health is no longer the health issues of others. They are shared issues of the developed and developing world. Finally, technological developments have created new hopes and expectations in what has become to be known as personalised medicine or personalised healthcare.

We also live in a rapidly changing healthcare system where care has moved from institutions to networks of care, often community‐based; from a single professional, generally a physician to many health care professionals; with increasing expectations, knowledge and involvement of patients, families and communities. There is a growing preoccupation with costs and performance leading to increased government intervention, control and reforms. Medicine and our health care system have become increasingly complex and interdependent.

Through all these rapidly changing demographic and epidemiologic changes, there is one clear consensus: primary care, and in particular Family Medicine, is the foundation for a sustainable health care system capable of meeting the needs of the population. The Family Medicine Group (FMG ‐ or Groupe de médecine de famille ‐ GMF) model, designated as Medical Home by the College of Family Physicians of Canada, has become the basis for primary medical reform in most provinces and countries around the globe. It is based on these cornerstones: interdisciplinary group practice; assuring accessibility, continuity and quality of care for an identified population; evolving remuneration; and IT infrastructure.

Family Medicine and the continued development of the Family Medicine Groups have become a priority of the Quebec Ministry of Health and Social Services (MSSS). Although this has not always resulted in the addition of sufficient resources, it is clear that the support for primary medical care is very high on their agenda. The government has increased – in both absolute terms and relative to other specialties – the number of slots for trainees in Family Medicine and the number of Family Medicine Units, while increasing responsibilities in undergraduate medical education.

The MSSS and the Fonds de recherche du Québec‐Santé (FRQS), in collaboration with the Canadian Institutes of Health Research (CIHR), have announced a major initiative and investments in primary care community‐based research – identifying mental health and aging, including chronic disease, as priority themes –and designated the four university Departments of Family Medicine in Quebec as leaders in the initiative. This is part of a larger Canadian and Quebec strategy on Patient‐oriented Research (SPOR).

Dean David Eidelman has clearly indicated to me that, building on the existing strong base in our Department, the development of Family Medicine as a premiere academic discipline at McGill from an education and research perspective is a priority for the Faculty of Medicine. We have his support to expand our strong contribution to the Faculty at all levels and our strong presence in health care reform, education and research in Quebec. The Dean has asked our Department to play a leading role with our colleagues from other Departments in developing the McGill strategy for the SPOR initiative. A very exciting opportunity through this initiative is the creation of The McGill Primary Care Community‐based Network for Care, Education and Research based in our Family Medicine Units.

You, of course, know the expression: Be careful what you wish for! That is why a very important short‐term priority is the carefully planned integration of the increasing number of residents and sites, as well as the new undergraduate programs, recognising that this comes at a time when all the units have increased clinical and teaching loads without the necessary increased resources.

In the coming months, I plan to meet with all of you and work with you in identifying the key strategic issues for the Department over the next 5 years. I am excited and enthusiastic about working with you; so please never hesitate to contact me directly.

It is a perfect time to be in Family Medicine!

Howard Bergman

See also the Message from the Dean of the Faculty of Medicine and the Message from the Interim Chair of the Department of Family Medicine welcoming Dr Bergman in his new position