$13-million boost will help Medicine's faculty & library
By Colleen MacPherson
"We knew that medical education was expensive ... How expensive it would turn out to be we little knew at the time ... Had the full extent of our undertaking been realized at its inception, the probability is that our embryo medical school would have died aborning."
The infusion of $13 million in new provincial money into the University's College of Medicine over the next six years will address the pressing issue of the College's current probationary accreditation status - but, according to the Dean, it will also have a notable impact on Saskatchewan's entire health care system.
In an interview with On Campus News in late June, after the dust had settled around the June 5 funding announcement, William Albritton said the support package from the Departments of Health and Learning will be "more than enough" to deal with the deficiencies identified in the College's last accreditation review that left the College on probation. A dozen shortcomings were cited, he said, 10 of which "have nothing to do with money". The funding package that starts with about $1.5 million in additional money this year is designed to address the other two - clinical faculty staff and library resources and staff.
If the agreed-to financial package remains unchanged (and Albritton pointed out the College must justify the new money yearly, just as it does for its operating budget), the College can expect to receive about $4 million in the second year, followed by annual increases of about $7.5 million in each of the following four years.
The accreditation bodies - the Committee on Accreditation of Canadian Medical Schools and the Liaison Committee on Medical Education - are expected back in Saskatoon for another look late this year or in early 2004.
The largest portion of the new dollars will be spent on clinical faculty staff, although the fact the College is in the middle of the University's Integrated Planning process means "we didn't want to identify specific positions," said Albritton. "We also didn't want to recruit clinical faculty that would mess up the Saskatoon Health Region's plans." (The region is currently involved in an update of its physician human resource plan.)
But the College will still be hiring into already identified priority areas and positions, a process Albritton said does not seems to be hindered by the probation status - "Top clinicians wish to be associated with medical schools."
While recruiting continues, he said the College plans to move toward establishing single academic and clinical heads for all departments. There are now three such headships for 11 departments but expanding that number over the next five years hinges on negotiating with the health region "what these single heads will look like".
Some of the new funding will also be targeted at part-time faculty. Currently, the College has about 650, most community-based physicians involved in student education, "but we would like for every physician in the province of Saskatchewan to be part-time faculty." This is a realistic goal, he said, but supervising students takes time away from private practice "so we have to compensate them". That already costs $1-2 million annually, he said, with another $3 million earmarked over the next five years.
In the Health Science Library, just over $1 million of the new funding will be used to increase collections, staff and technology. An additional $920,000 will be made available to extend the library resources to cover health regions in Regina, Saskatoon and Prince Albert areas, and another $465,000 to broaden access to health information resources to all Saskatchewan health care professionals.
The result, said Albritton, will be more information and resources available to physicians in their day-to-day practices across the province, and it will also enable those physicians to play an expanded role in the education of students. This, said the Dean, feeds directly into the College's goal of a distributive model of education with community-based faculty and training sites around the province.
"In the end, we will be successful if we can create a network of primary-care training sites around Saskatchewan that offer quality education in an interdisciplinary way with healthcare providers who are interested in mentoring, research and the training of students."
A major player in the development of the funding package, and in its ultimate success, is the Saskatchewan Academic Health Sciences Network, he said. It offers "the forum, focus and facilitation, if we can keep it together, that will result in very substantial changes to healthcare in Saskatchewan."
"There is a tremendous amount of talent in the health regions that is not being utilized because of conflicts between town and gown, and there's tremendous untapped potential because of the Saskatoon and Regina conflict. The Health Sciences Network was created because of specific problems between the College and the (Saskatoon) health region but it's vision is much larger now."
Prior to the establishment of the Network, the College had no means to address issues like distance education for its students and the various components that need to be in place to ensure an interdisciplinary distributive model is successful, "but we have to have the Network to make it work".
Albritton went on to talk about three short statements he made at the news conference announcing the funding package - "Medical schools cost money. Medical schools have value. Medical schools must be value added."
While he also said at the news conference that funding for the College "seems to have a life of it's own in Saskatchewan", he explained later that there is a lack of understanding that "the educational environment for medical students is so much bigger than the classroom".
While college budgets include bricks and mortar, equipment and faculty, many of the costs associated with educating doctors are not included, he said. When students train in a hospital, for example, "it costs that hospital money". When they are supervised by a community-based physician, that time is taken away from a private practice.
Medical schools cost money but many of the costs "are not acknowledged, let alone compensated."
Addressing the comment about value, Albritton said that in the case of the U of S College, its value is felt across the province because the presence of a medical school in this province, or any other area, "improves the quality of care to the entire population".
Not only do such institutions draw top faculty and clinicians, they are often the catalyst for the development of pre-eminence in particular fields related to the needs of the population it serves.
In the case of the U of S College, the additional funding to be made available over the next six years will support the development of pre-eminent programs in rural, Aboriginal and primary-care medicine. The infusion of new money will also help "align the College with national and regional plans for medical renewal".
And to be value-added, "we can't be sumps," he said. "If you give me more money, I have to give you more than what I'm giving you now."
The Dean agreed there is a limit to the amount of money that can be "pumped into the system ... (but) we don't have to put all the money into training physicians to improve the health of the population".
Medical colleges add value to the healthcare system through, for example, conducting research, analysing how care can be provided using different models, and "serving the needs of the province, not the needs of ourselves".
"We have to be sure that what the people of Saskatchewan get in return is more than what they invest."