COLLEGE OF MEDICINE
DEPT. FAMILY MEDICINE TOWNHALL
PREPARATIONS FOR
FM EXTERNAL REVIEW
MARCH 14 & 15, 2016
Bruce D. Martin MD MSc CCFP FCFP
José François MD MMedEd CCFP FCFP
MARCH 2, 2016
ACCREDITATION
At its June 2014 meeting, the CFPC Accreditation decided:
‘Be it resolved that the Family Medicine program at the
University of Manitoba be granted the status of accredited
program with an external review to be conducted within 24
months (by June 2016).’
‘Be it resolved that the Family Medicine Enhanced Skills
program at the University of Manitoba be granted the
status of accredited program with an external review to be
conducted within 24 months (by June 2016).’
OUR CORE PROGRAM FM REVIEWERS
Dr. Louise Nasmith
UBC
Dr. Douglass Dalton
McGill
OUR ENHANCED SKILLS PROGRAMS REVIEWERS
Dr. Geoff Hodgetts
Queen’s
Dr. Daniel Grushka
Western
ACCREDITATION
Standards Areas not fully compliant / for improvement:
• Governance & Program Leadership
• Administration & Resources
• Resident Selection
• Family Medicine residency curriculum & academic program
• Program evaluation
• Resident assessment
• Educational environment
• Faculty evaluation
• Faculty development
• Research
Governance & Program Leadership
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Committee structure reviewed and solidified
Strategic Council with all-site and stream representation
Strategic plan developed to guide FM:
Smaller Executive Committee focused on department operational issues
Strengthened WRHA Primary Care relations with new FM Associate
Head, Winnipeg, Dr. Sheldon Permack
• Continued relations with rural/northern communities with Associate
Head, Distributed Education, Dr. Don Klassen
• Postgrad committee with 4 sub-committees
• Postgrad Leads to support Postgrad Education Director and
programming
Administration and Resources
• Significant turnover in staff since 2014 accreditation visit, with now
stabilized staffing.
• Central department staff now centralized at Bannatyne campus
• Full time FM Administrative Director focusing only on university
programming
• Space (CDS, KMC, Northern Connections)
• New funding model for distributed teaching sites
• Teaching expectations for alternately-funded Winnipeg physicians
• Continued work on full alternate funded model for NCMC physicians
• GFT forum working group reviewing GFT contracts and expectations
• Presently in review of job descriptions of Unit Directors and Education
Directors
Resident Selection
• College of Medicine-wide targets of 70% of positions to go to
Manitobans
• Based on work by Klassen et al, 2011 - retention of clinicians in
Manitoba is significantly impacted by completion of both
undergraduate and postgraduate training in Manitoba
• Improvements in resident selection process include use of z-scoring
• Post-CaRMS process regarding un-matched medical students clear:
– oversight of process at level of College of Medicine Postgrad office
– students must have applied to FM during first or second round of
CaRMS and must be deemed appropriate by family medicine to be
considered for post-CaRMS residency position
Curriculum
• FM Competency Framework based on CanMEDS 2015
framework, integrated with CanMEDS-FM items and Four
Principles of FM
• FM Competency Framework guiding document for development
of rotation objectives and academic curriculum
• QI curriculum standardized and being delivered across all
streams
• Defined core topics for behavioral medicine curriculum identified
and to be implemented by all Streams for 2016-2017.
• Core topics for academic curriculum (Academic Day, in-units
etc…) in development and to be implemented by all Streams for
2016-2017.
Curricular Evaluation
• VENTIS to support scheduling and monitoring of curriculum
• Within VENTIS all educational events to have evaluations linked
• Postgrad Curriculum Review Committee responsible monitoring
of academic and clinical curriculum
• New Program Performance Measurement Framework and Logic
Model defines data collected for program evaluation
Resident Assessment
• Revised Field Notes
• Revised ITARs linked to goals and objectives for all Family Medicine
and off-service rotations
• Approaches to resident progress monitoring in revision and to be
implemented for 2016-2017
• All tools (Field Notes, ITARs, Periodic Review of Progress) are
designed to integrate the CFPC’s Six Dimensions of evaluation and
CanMEDS roles.
• Implementation of VENTIS, a web-based,
custom-designed PGME tool to centralize,
manage, and support resident registration,
scheduling, learner & faculty assessment,
program evaluation, and reporting functions
Education Environment
• Surveillance tool - Resident end of rotation evaluations,
including feedback on mistreatment in the learning environment
• Monitoring of educational environment by Associate Dean
Student Affairs for Postgrad, Dr. Michael West
• Core PGME session - Learning Environment
• Wellness Website
• Speak Up Card:
“Have you personally experienced or witnessed
discrimination or other challenges in your
Learning Environment. We Are Here To Help . . .’’
Faculty Evaluation
• All GFT have yearly performance appraisals
• Joint WRHA/U of M FM faculty performance appraisal process
being rolled out across nil-salaried Winnipeg region with 3 core
components:
– reflection on performance;
– performance conversation with designated physician leader;
– personal learning plan
• VENTIS to facilitate collection and collating of feedback on
teaching to faculty
Faculty Development
• Faculty development resources enhanced – Preceptor Toolkit,
documentation of Competency Framework
• College of Medicine faculty development opportunities include:
– Yearly faculty development day in September
– DFM faculty development seminars
– Problem-based faculty development modules from McMaster
available to any site
– Department of Medical Education faculty development
activities: lunch hour sessions, HamLET
– Funding to attend medical education conferences available
to GFT through College of Medicine GFT fund
Research
• Growth in research grant funding:
– 2012 research grants totaled $299,000)
– 2015 research grants totaled $2.85 million
• Manitoba Primary Care Research Network (MaPCReN) is part of the
Canadian Primary Care Sentinel Surveillance Network (CPCSSN)
• Manitoba Primary and Integrated Health Care Innovation Network
(MPN) is part of SPoR network.
• Approach to allocation of research time within the department being
reviewed by a GFT working group
• Research resources in rural and bilingual streams:
– 1.0 EFT PhD in Brandon Satellite Program hired in 2015
– 0.2 EFT faculty in Bilingual Stream hired in 2015
Enhanced Skills Programs
• Associate Director Enhanced Skills Programs presently vacant
and being filled by Postgraduate Director. Recruitment for
position will occur after accreditation visit.
• Newly appointed Assistant Directors for ES Programs
(Anesthesia, Sports and Exercise Medicine, Cancer Care)
• Strengthened ESP Subcommittee communication and
relationship with PGME – Associate Dean, PGME and
Postgraduate Program Leads newly added as members of
Subcommittee
• Enhanced program assistant supports to Enhanced Skills
Program
• Enhanced collaboration between departments of FM and
Anesthesia to support FP-A program resulting in expansion of
program
FINAL THOUGHTS
Challenges:
 Staff turnover
 Getting agreement on things in a historically decentralized model
 Short timelines
 Implementation VENTIS curriculum management system
 Financial climate
 Competing clinical teaching needs – other healthcare learners
Facilitating factors:
 Engaged faculty dedicated to ensuring best education for
resident
 Support from Postgraduate Associate Dean and Dean
 Recognition of strategic importance of family medicine
FM PROGRAM – CURRENT PRIORITIES
• Enhance FM resources to support PGME learners and teachers
• Complete roll out, implementation and adoption of VENTIS
• Implement new Competency Framework and map educational
activities for each domain, how they relate to the 99 Priority Topics/ 65
Core Procedures
• Review construct of clinical curriculum and identify potential
improvements (i.e. half-day backs, short clinical exposures during
family medicine time etc…)
• Complete work on Resident Educational Support and Assessment
framework (i.e. competency coaching)
FM PROGRAM – CURRENT PRIORITIES
• Collect data over time using new Performance Measurement
Framework and Logic Model and evaluate success of initiatives
• Promote and develop research
• Continue focus on resident wellness/safety/learning environment
• Continue building strong, positive working relationships with training
partners
• Continue focus on retention of Manitoba
graduates and needs of our communities
Family Medicine, a provincial resource
FAMILY MEDICINE TOWNHALL
EXTERNAL REVIEW PREPARATIONS
QUESTIONS?