Month: April 2019
Inaugural FHS Interprofessional Symposium on Leadership
Interprofessional education is a priority in undergraduate medicine, as it is in our fellow health professions programs in the Faculty of Health Sciences in the School of Nursing and School of Rehabilitation Therapy.
Early this month (or last month, if you’re reading this after Tuesday), we brought together over 300 students from nursing (fourth-year undergraduates), medicine (second-year undergraduate program), occupational therapy (first-year master’s) and physiotherapy (first-year master’s) at the Leon’s Centre for a one-day symposium with a particular focus on leadership.
A key challenge in creating interprofessional learning opportunities is coordinating time, space, and learning objectives of independent programs with different classroom and clinical schedules. A committee of representatives from four programs, including student representatives, tackled this challenge earlier this year, working collaboratively to create the program and learning activities for the symposium. The day included plenary speakers, interactive case studies, and a bit of fun along the way.
Our plenary speakers included Dr. David Walker, former FHS dean; Lori Proulx Professional Practice Leader -Nursing and Kim Smith Professional Practice Leader Occupational Therapy and Physiotherapy from Kingston Health Sciences Centre; and Duncan Sinclair, former vice-principal of Health Sciences
Students were seated in interprofessional table groups to engage in discussions around cases and use IP tools for decision making.
We’ve taken lessons learned from organizing this event as well as formal and information feedback from students and other participants to carry forward to the next iteration of the symposium.
Who decides when the job is done?
How would you choose to pay the people entrusted with fire prevention and control in your community? One would hope that, whatever the method, it provided those with the appropriate knowledge and skill the freedom to operate without interference in the interests of those in need.
Imagine a world where fire fighters were directed in their efforts by a pre-determined public policy edict that required them to stop their efforts after some defined time limit, regardless of the condition of the building or its inhabitants.
Sounds absurd, but this is exactly analogous to the concerns raised in an article that appeared in the Globe and Mail April 6th, “In Ontario, a battle for the soul of psychiatry” (https://www.theglobeandmail.com/opinion/article-in-ontario-a-battle-for-the-soul-of-psychiatry/).
In it, Dr. Norman Doidge describes his frustrations with a payment system that limits the number of encounters he can provide a patient.
While agreeing wholeheartedly with the arguments raised by Dr. Doidge, I would respectfully submit that the battle goes far beyond the practice of psychiatry. The concept that decisions about the nature and duration of any patient’s condition can or should be made on the basis of fiscal concerns and by individuals or groups under governmental influence should be seen by all physicians and their patients as repugnant. While government certainly has a responsibility to exercise fiscal oversight, it is (to use a contemporary metaphor) venturing far outside “its own lane”. Patients are individuals with unique illness experiences that cannot be conveniently categorized into tidy management algorithms. Doctors, of any specialty, must be free to undertake treatment for patients based on individual needs.
Doctors, in turn, must earn and safeguard that right. Our professional organizations should rise to the challenge posed by Dr. Doidge’s article with the same vigour that they have engaged issues of reimbursement, and the distribution of a few percentage points of income. Providing optimal patient care must trump income issues. Failure to do so rightfully condemns.
The profession and government should jointly recognize that the “covenant” between the government and people of Canada to provide universal, comprehensive health care is being broken daily, suffering death from a thousand cuts. Only with collective and collaborative recognition of that reality and engagement by a profession and government mutually focused on the interests of the people of Ontario can solutions even begin.
The fire fighters battling to save Notre Dame cathedral in Paris this past week didn’t stop their efforts until they had done everything possible. Those men and women were in a position of public trust that was not defined by the clock or budgets. Doctors are in a similar position of public trust which must be defended. I suspect Dr. Doidge will continue to care for his patient, but it will be despite and not because of our “system”. Our patients deserve better. We all deserve better.
(Portions of this article were published in the Globe and Mail April 9, 2019 as a letter to the editor)
I have no time…
By Adrian Baranchuk MD FACC FRCPC FCCS
Division of Cardiology, Kingston Health Science Center, Queen’s University
“A man who dares to waste one hour of time has not discovered the value of life.” ~ Charles Darwin, The Life & Letters of Charles Darwin
“I have no time.”
I have heard this sentence on several occasions.
I have heard this from my co-workers, staff, fellows, residents, nurses, and managers. I have heard this from friends – who used to spend long hours chatting, laughing and playing music – but now, they have no time.
I have heard this from close family members who have exclaimed, “I have no time.”
Finally, I have heard this sentence – the same four words – said by myself. It has become part of the dialectic armamentarium that I use upon invitations – “I have no time.”
Time has become a valuable commodity.
As academicians, our job descriptions specify the “time” allocated to different roles: (i) “time” for clinical work, (ii) “time” for teaching, (iii) “time” for research. We call the latter “protected time.” The notion that our time is “protected” is comforting. We are protected. Our “time” is protected.
The structure of our life is built around time; it accepts different metrics, depending the cultural background, the level of education, and the earnings and savings.
It is “time” for you to move to your own house.
It is “time” for you to further your career.
It is “time” for you to get married and start a family.
It is “time” for you to retire.
Although time can provide structure and discipline, it has become a regulator of our abilities to do something during our life.
Inadvertently, or not, we also use time to structure the life of others, such as family members, employees, or trainees. The ability to guide – or manipulate – someone by regulating the time they spend under one’s supervision is more powerful than any other form of intervention, such as encouragement, motivation, salary, or recognition. Nothing compares to the impact that “time” regulation has over our actions, either voluntary or mandatory.
In that sense, we self-allocate “time” to activities that we perceive as meaningful or enjoyable, such as going to the gym, conversing with partners, reading a book, et cetera. Violating this principle is a trigger for anxiety and frustration. The feeling of guilt that we experience when doing something that we perceive is in place of another timely activity – despite being part of human emotions – is a source of discontent.
There is not a generalized approach to using “time” wisely – it is individualized. We go through life, with more or less success, defying our own chronometer to do some of the things that we have dreamt, and we allocate the “time” that we speculate we have to reach those goals.
Few years ago, I found myself overwhelmed with work. My mentor called from the other side of the Atlantic and I responded without much enthusiasm. The wise man of only 83 years of age recognized my exhaustion and told me, “You sound too busy…you are doing too many things at the same time…you should slow down.” Rather than taking the advice with sincerity and consider reducing my workload, it agitated me. I replied, “What do you want me to do? I have no time.”
I said “I have no time” to my 83-year-old mentor who has, from a statistical point of view, much less time than me to accomplish his dreams.
There was a period of silence on the phone line. Some say that more than 23 s of silence between two individuals is the most tolerable duration before one of the two individuals breaks the moment with a comment; after about 10 to 12 s, I said “are you there?” He replied, “I was wondering whether you have time to think?” I have not forgotten this phrase since it was spoken many years ago.
When did I lose my capacity for contemplation? When did I sacrifice my ability to enjoy doing nothing? The “dolce far niente” (“sweet doing nothing”) that the Italians have immortalized. Albert Einstein said, “Time is an illusion.” Does the perceived lack of time represent the absence of illusions? How do we regain, in this world of immediacies, the ambition of living in a world of illusions? How relevant, for the creative process of enjoying your life (and be productive) is to have illusions?
While Mahatma Gandhi taught us that “there is more to life than simply increasing its speed;” Benjamin Franklin has counteroffered that “lost time is never found again.”
If we live in this world with a constant perception of not having “time,” how are we going to construct memories that at some point may be our only companion in life? Are we losing the ability to contemplate? Does this affect our ability to relate to our patients if we have no time to connect with them?
One of my other mentors – after consultation with a patient in the hospital ward – once asked me what book the patient was reading. “I have no clue” was my immediate answer, all the while skeptical about how this would relate to patient care. I did not understand at the time that our ability to contemplate and have holistic views will aid us as physicians to relate to the patient, which is a skill that is of immense value.
Where do ideas come from? How do we connect an idea with the creative process and the systematic work flow to move it into action? How does an idea move forward into realization?
Apparently, “time” is the key that regulates this process. Time is the precious commodity that we all want to attain – despite where we live and work, and how our family is structured – and we are all “offered” the same total amount every day.
So far, we have not been able to create “time.” We have not succeeded in having 25 h in a day. We have to resolve the enigma of how to distribute our efforts and energy throughout the same amount of minutes and seconds in a day. A strict 24 h per day.
I would like to teach my students to use their time wisely so as to enjoy their life and balance their ambitions. I want my students to be happy, and help them evolve not only as great scientists but also happy and content individuals. I want my students to have time to contemplate and think freely as such that time is not a factor that regulates their decisions.
I only wrote this piece today because I had convinced myself that I had no time before.
I propose to the readers to exercise the search of finding time for what they really want to do with their lives. Perhaps allowing a few minutes a day to do what they did not find “time” to do lately.
Because the “time” that we think we do not have, is out there. It is a matter of learning how to grasp it and to make it ours.
It is time to do it.
To Sohaib Haseeb for editing the first draft. To Gustavo Bonzon for his translation into Spanish.
Creative Commons Image from: https://www.deviantart.com/mariana-a/art/She-saw-the-time-passing-by-new-350524188
It Takes a Village: Thanks to all involved in our Medical School Admission process
Over two weekends in March, over 500 applicants are invited to our school to undertake interviews, the final phase of our medical school admission process. They have been selected from over 5,000 who submitted applications.
That process, designed by our Admissions Committee, is the product of much thought and deliberation, with the goal of fairly and objectively matching the aspirations and attributes of applicants to those required to assure success not only in medical school, but in the practice of medicine and service of patients.
The process is a massive undertaking, requiring the participation of no fewer than 179 of our faculty and virtually all members of our first- and second-year classes. In fact, our admission process is the most resource intensive activity undertaken by our school.
Each year, I’m amazed and grateful for the willingness of our faculty and students to give of their time and energy for this purpose. File reviews and interviews are both carried out after regular work hours and on weekends, requiring sacrifice of precious personal time. Why do they do it? They recognize, I believe, that this admission process is critical not only to our success as a school, but for the future well-being of our profession and the society we serve.
Our applicants are also impressed. They consistently comment on the effort, which brings credit to our school and demonstrates a learning environment where faculty and students work together in mutual dedication to our school and profession.
I would like to recognize and extend sincere thanks to all the faculty members involved, who will be listed below. The numbers indicate those who filled multiple assignments. I’d like to particularly note the contributions of Drs. Fred Watkins and Mariana Silva, who were both involved in all aspects of both the File Review and Interview process.
I’d also like to thank our first- and second- year classes. I’d initially thought about listing them as well, but quickly realized that was unnecessary since there was essentially no one to exclude! Their presence and support of applicants speaks volumes about their support of our school, and confirms to me that the process is working well. Special thanks to first year president and vice-president Andriy Katyukha and Victoria-Lee Kim who organized their class events and made no fewer than eight presentations to applicants.
Finally, I’d like to recognize three individuals who deserve particular recognition, our Assistant Dean of Admissions, Dr. Hugh MacDonald, Admission Officer Rebecca Jozsa, and Admissions Assistant Rachel Bauder. They oversee a very complex process that ran flawlessly.
Faculty Members Involved in the Admission Process
Amy Acker (2)
Sussan Askari (2)
Allan Baer (2)
Lysa Boisse Lomax
Mark Bona (2)
Rozita Borici-Mazi (2)
J. Gordon Boyd
Cheryl Cline (3)
Ken Collins (2)
Robert Connelly (3)
Christine D’Arsigny (2)
Alexandra Di Lazzaro
Jennifer Flemming (3)
Kan Frederick (2)
Tom Gonder (2)
Mike Green (2)
Richard Gregg (3)
Andrea Grin (2)
Dianne Groll (3)
Andrea Guerin (2)
Karen Hall Barber (2)
Marisa Horniachek (4)
Robyn Houlden (3)
David Hurlbut (4)
Felicia Iftene (2)
Omar Islam (4)
Mala Joneja (2)
Cherie Jones-Hiscock (4)
Sarosh Khalid-Khan (3)
Faiza Khurshid (2)
Alenia Kysela (3)
Kirk Leifso (3)
Athen Macdonald (2)
Gillian MacLean (3)
Paul Manley (2)
Sarah McKnight (2)
Stephen McNevin (2)
Alex Menard (2)
Anne Moffat (5)
Benvon Moran (2)
Raveen Pal (2)
Stephen Pang (2)
Armita Rahmani (2)
Benjamin Ritsma (2)
David Ruggles (3)
M. Khaled Shamseddin (2)
Mariana Silva (9)
Marco Sivilotti (2)
Yi Ning Strube
Rob Tanzola (2)
Naji Touma (2)
Jessica Trier (3)
Todd Urton (3)
Janet van Vlymen
Maria Velez (2)
Ashley Waddington (3)
Ami Wang (4)
Fred Watkins (9)
Shayna Watson (2)
Hasitha Welihinda (2)
Gavin Wood (3)
David Yen (3)