In a bold move to address the pressing shortage of family doctors in Canada, the government of British Columbia has tasked Simon Fraser University (SFU) with establishing a medical school focused on primary care. This initiative comes at a critical time when an alarming 6.5 million Canadians lack access to a family physician or nurse practitioner for their regular medical care. The new medical schools, including those spearheaded by SFU and Toronto Metropolitan University (TMU), aim to revolutionize medical education by emphasizing team-based care and extended placements.
Team-based care, which integrates professionals such as pharmacists and physiotherapists, is seen as a cornerstone of this new approach. Dr. David Price, dean of SFU's medical school, expressed concerns that traditional rotations may not fully prepare medical students for the complexities of family medicine.
"What we're trying to do is produce medical students who are more likely to go into primary care specialties" – Price, Dr. David Price, dean of SFU's medical school
Dr. Teresa Chan from TMU echoed these sentiments, advocating for longer training periods to cultivate a deeper understanding of primary care.
TMU plans to implement six-month placements for its medical students, providing them with essential hands-on experience in team-based care environments. The College of Family Physicians of Canada supports this model, highlighting the benefits of continuity and accessibility for patients. Moreover, several studies indicate that both patients and healthcare systems reap significant advantages from having a dedicated family doctor.
Dr. Mike Allan of the College of Family Physicians of Canada emphasized the comprehensive nature of care provided by family physicians.
"That is where the family doctor thrives" – Allan, Dr. Mike Allan, CEO of the College of Family Physicians of Canada
The current physician shortage has been lamented as "beyond sad and frustrating" by Dr. Allan, who sees team-based care as a path to better, more inclusive healthcare.
"In a team-based care environment, we're providing, I think better care and we're providing more comprehensive care and we're allowing more patients to be seen" – Allan, Dr. Mike Allan, CEO of the College of Family Physicians of Canada
However, the challenges facing medical education are deeply rooted. Dr. Tony Sanfilippo, a cardiologist and professor at Queen's University, highlighted systemic issues hampering progress in addressing these needs.
"Our system for medical education and for producing doctors has not evolved with the needs of society" – Sanfilippo, Dr. Tony Sanfilippo, cardiologist and professor of medicine at Queen's University
The introduction of these new medical schools aims to transform training by focusing on team-based care and addressing the shortage head-on. Dr. Preston Smith, inaugural dean of P.E.I.'s new medical school, is actively involved in recruiting physicians to the province, emphasizing the rewarding nature of family practice.
"One of the big things about trying to recruit medical students to want to do family medicine is to see the joy of family practice" – Smith, Dr. Preston Smith, inaugural dean of P.E.I.'s new medical school
The urgency for reform is underscored by a 2019 U.S.-based study finding that an increase of just 10 family doctors per 100,000 people could extend life expectancy by over 50 days.
TMU's innovative approach further breaks traditional molds by not requiring applicants to possess a science background. Instead, they seek to nurture well-rounded physicians capable of thriving in diverse healthcare settings.
Despite these promising developments, it's clear that new medical schools and federal initiatives alone cannot swiftly resolve Canada's primary care crisis. The complexity and magnitude of the issue require sustained effort and collaboration across various sectors.
Dr. Price points out that changes in patient care demand adaptations in training methodologies.
"A patient visit doesn't take the 10 or 12 minutes that it used to" – Price, Dr. David Price, dean of SFU's medical school
As the landscape of healthcare evolves, the role of family physicians becomes increasingly vital. They are equipped not only with clinical skills but also with an understanding of patients' broader life contexts.
"When I graduated from medical school, there [were] two types of insulin and maybe one type of oral drug to reduce blood sugars" – Price, Dr. David Price, dean of SFU's medical school
Dr. Chan reassures that shifting focus in training does not disadvantage any group but rather equips all with foundational knowledge.
"It doesn't really put anyone at a true disadvantage because everyone's going to know a little tiny bit" – Chan, Dr. Teresa Chan, dean for the School of Medicine and vice-president of medical affairs for Toronto Metropolitan University
