Inside "The Green Room"

| 28 April 2022

I want to take some time to talk about the many opportunities for innovation in education coming our way, and some of the challenges they may pose.

As I write this, I am just returning from my first in-person conference in two years — the Canadian Conference for Medical Education. There, I had the opportunity to talk to other leaders in medical education, including Dr. Eugenia Piliotis, recently appointed Associate Dean, Undergraduate Medical Education, Queen’s University, and family medicine department heads from across Canada.

For the first time in many years, Ontario is embarking on a fairly major expansion in undergraduate medical education. This includes the formation of a new medical school at the newly named Toronto Metropolitan University (formerly Ryerson University) and, here at Queen’s, 20 additional positions and plans to expand our partnership with Lakeridge Health. Our Queen’s-Bowmanville-Oshawa-Lakeridge (QBOL) site has been offering a highly successful and sought-after program for more than a decade, and family medicine will need to play an important role in the development and implementation of this new program.

Coupled with this is an expansion of residency training, with 30 new PGY1 entry slots coming to Queen’s, a considerable number of which will be in family medicine. In addition, the CFPC has, through the Outcomes of Training project, identified a need to extend the duration of family medicine residency training to three years, and is targeting 2027 for implementation.

These significant changes are exciting but also present challenges. While our program fared reasonably well in the recent CaRMS match, it is also clear that there is uncertainty among medical students about the sustainability of a career in comprehensive family medicine. Many provinces are experiencing unprecedented rates of retirement and a growing number of patients are without a family doctor.

Here in Ontario, the OCFP, through their #LifeWithoutaDoctor campaign, is highlighting the challenges that people without a family physician face. The campaign is intended to raise awareness of this issue in advance of the upcoming provincial election.

While I personally feel that both expansion of training numbers and the extension of training will be positive forces, it is also clear that these measures on their own will not be enough. Experienced family physicians and new grads alike are rightly concerned about the environment in which they will practise. Access to alternatives to fee-for-service, like the recently negotiated increase in access to FHO positions, will also help, but this remains restricted, and many provinces have no alternatives to fee-for-service. This needs to change, and quickly.

There is also a need to provide family physicians the tools they need to work effectively in teams, with the support of nurses and other allied health providers to meet the public’s needs for comprehensive care, including access to mental health care. Some ideas about how to do this are expressed in the CFPC’s “Access Done Right” working paper.

It is only by concerted efforts in all three areas — modernizing training, expanding training numbers, and reforming the practice environment — that we will be able to make the advances needed to serve Canadians’ needs and to make the practice of comprehensive family medicine a rewarding and sustainable career for all.

Dr. Michael Green

Department Head Blog

Publish Date

Thu, 04/28/2022 - 14:22

Inside "The Green Room"

Inside "The Green Room"

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