News at Medicine - June 2020 - Memo from Dean Margaret Steele: June 18, 2020  


Memo from Dean Margaret Steele: June 18, 2020  
June 18, 2020
The Faculty of Medicine has been in the news and on social media this past week regarding an issue with a learner. Neither the Faculty of Medicine nor Memorial University is able to comment on specific actions being taken in regard to an individual learner. To do so would be a violation of a learner’s privacy.

Let me state that the Faculty of Medicine is categorically against any form of racism, sexism, homophobia, transphobia, intimidation, or harassment of any description.
 
We value every individual regardless of race, color, gender, religion or ethnicity. This includes individuals who are Black, Indigenous, People of Color and Muslim. Furthermore, as dean, I am committed to taking action to ensure our learning and work environment is free from any form of racism, sexism, homophobia, transphobia, intimidation or harassment of any description.
 
Statements we learn and work by
 
The Faculty of Medicine, like all medical schools across Canada, abides by the statement on racial discrimination as set out by the Association of Faculties of Medicine of Canada (AFMC).  I, as the dean, am a member of the Board of Directors of AFMC and have strongly endorsed this statement. It states:
 
As the voice of academic medicine in Canada, we, the Association of Faculties of Medicine of Canada, stand against racial discrimination as well as all other forms of discrimination. The AFMC is committed to working with health partners to ensure that our environments are diverse, inclusive, culturally safe and foster equity. We will implement institutional change and lead in addressing systemic racism through education and curricular innovation, research and advocacy for equity, diversity and inclusiveness.
 
In addition, as detailed in our mission statement, we are committed to health equity for all:
 
Working in the spirit of partnership and respect, the Faculty of Medicine is committed to delivering integrated excellence in education, research and evidence informed care; meeting the unique health needs of our rural, remote and urban communities; and advocating for health, equity, Indigenous health and healthy populations.
 
Our policies
 
In terms of policy, as a faculty of Memorial University of Newfoundland (Memorial), we have an obligation to align our policies with Memorial. The Faculty of Medicine acknowledges that the use of appropriate language to define or describe particular behaviours in policies and procedures is crucial. That is why in the Respectful Learning Environment in Medical Education Policy and Procedure, Harassment is defined as per the Harassment definition included in the Respectful Workplace Policy, which is:
 
...comments or conduct which are abusive, offensive, demeaning or vexatious that are known or ought reasonably to be known to be unwelcome and which may be intended or unintended. Types of Harassment include Harassment based on Prohibited Grounds of Discrimination and Personal Harassment.
 
Memorial defines Prohibited Grounds as follows:
 
A human rights violation under Newfoundland and Labrador Human Rights Act, 2010 occurs when an individual is discriminated against because of one or a combination of the following prohibited grounds of discrimination (as amended from time to time): Race, Colour, Nationality, Ethnic Origin, Social Origin, Religious Creed, Religion, Age, Disability, Disfigurement, Sex (including pregnancy), Sexual Orientation, Gender Identity, Gender Expression, Marital Status, Family Status, Source of Income, Political Opinion.
 
The Respectful Learning Environment in Medical Education Policy and Procedure uses the term Harassment to include discriminatory behavior based on Race, Colour and Ethnic Origin, etc. This policy and procedure is currently being revised to incorporate feedback from a 2018 Unit Assessment, which was conducted at the Faculty of Medicine, and reflect the operational structures of the new Office of Learner Well-Being and Success. During this revision process, the Faculty of Medicine Policy Development Committee is committed to working with Memorial policy makers to advocate for including specific anti-racism language in its policies and procedures that address incidents in the learning and work environment.
 
If you would like to learn more about our policies and procedures, you can visit our website: https://www.med.mun.ca/Medicine/Policy/Policies-Procedures.aspx.
 
Our work so far
 
As mentioned above, a Unit Assessment Report was released in 2018 after concerns were raised about the Faculty of Medicine’s learning environment including allegations of bullying, intimidation, harassment and sexual harassment. There were 39 recommendations in the report. A Unit Assessment Working Group was established to review and implement the recommendations, comprised of faculty and staff members that reflect key leadership positions within the Faculty of Medicine as well as learner representatives from the doctor of medicine (MD) program, postgraduate training programs and graduate studies.
 
Initiatives under the Unit Assessment, meant to improve the learning and work environment in the Faculty as a whole, include:
 
  • Increasing communication and visibility of services through the creation of the Faculty of Medicine Professionalism and Mistreatment website which provides resources, policies and contacts pertaining to professionalism and mistreatment for learners, faculty and staff.
  • Policy creation and revision to clarify content and align with Memorial best practices. All policy concerns raised in the unit assessment are being addressed by the Faculty of Medicine Policy Development Committee.
  • Reconstitution of the Office of Student Affairs to the Office of Learner Well-Being and Success which will provide services and supports to both medical learners and residents.
  • Creation of a new faculty position of Assistant Dean, Faculty Wellness, Equity and Professionalism to provide a leadership focus on supporting, improving and advancing equity, professionalism and the health needs of faculty.
  • Creation of a Professionalism in Practice online learning module, developed by the Office of Professional and Educational Development for clinical learners and clinical faculty. Two other modules are being developed: one for MUNFA faculty and graduate students, and another for staff.
  • In order to obtain feedback from the Faculty of Medicine to appraise the learning and working environment, a mistreatment survey was disseminated in March 2019 to all learners, faculty and staff. The survey included items assessing policy awareness, professionalism training, and experiences of mistreatment and sexual harassment and the reporting/response of such incidents. Mistreatment was categorized into physical mistreatment, verbal mistreatment, power mistreatment and ethnic mistreatment. Undergraduate medical learners, postgraduate learners, graduate learners, staff and faculty were invited to presentations of the survey results and asked for their perspectives on the data and any suggestions they may have given the results of the survey. The data collected will be used to inform decision-making processes and to contribute to the evaluation of policies and interventions implemented to enhance the learning and work environment. Moving forward, it is anticipated that this survey will be sent biannually to all learners, faculty and staff interspersed with qualitative research.
Our Unit Assessment Working Group is continuing its work as a Culture of Excellence Project Team as part of our strategic plan, Destination Excellence, which will establish an accountability framework and process to monitor and evaluate the action plans.
 
Other initiatives include:
  • On June 15, 2020 the Faculty of Medicine hosted a Physician Discussion on Race, Diversity, Medicine and a better tomorrow with host/moderator Dr. Boluwaji Ogunyemi, clinical assistant professor of medicine (dermatology). This session was for faculty and more sessions are being planned for learners. This open discussion is intended to serve as a safe space for colleagues to engage with their peers in discussing the issues of race, ethnicity, diversity, minorities in general and as they relate to medical practice. The objectives are to learn examples of the role that race and racism play in the history of medicine; to discuss diversity in medical training and the physician workforce; and to discuss the role of physicians as community members and how to contribute toward a better tomorrow.
  • Hiring of an Assistant Dean of Social Accountability.
  • Faculty of Medicine managers, including our Senior Management Committee, have received Implicit Bias Training through Memorial’s Employment Equity Officer.
  • To further our commitment to equality in health care education, the Faculty of Medicine is actively working towards addressing the recommendations in the joint commitment to action on Indigenous Health developed by the AFMC. Pathway programs are offered to recruit members of Indigenous communities into the medical profession and educational opportunities are also being offered to medical students and learners to increase their ability to provide safe health care for Indigenous patients, their families and communities.
Curriculum changes
 
Through normal accreditation procedures, we have brought proposed curriculum changes to the attention of the Curriculum Oversight Working Group, which has been has been asked to:
 
1.        Identify all current curriculum which covers the concepts of:
  • racism and personal bias;
  • illnesses which are prominent amongst Black, Indigenous and People of Colour (BIPOC) groups; 
  • acknowledgement of medical studies which were conducted amongst BIPOC groups in the absence of appropriate health ethics; and
  • acknowledgement of health disparities and inequities amongst BIPOC which are not biological in nature.
2.        In consultation with the appropriate stakeholder groups, create a proposal to incorporate those concepts above, which are not currently taught in the doctor of medicine curriculum, under current or revised objectives and ensure curriculum is both inclusive and diverse in its delivery.
3.        Present the revised curriculum proposal to the appropriate Phase Management Teams for discussion and to the Undergraduate Medical Studies (UGMS) Committee for approval.
 
The new Assistant Dean of Social Accountability will be part of the UGMS Committee to review this commitment on a regular basis and will work with program directors in Postgraduate Medical Education to do the same.
 
The work cited above, shows our commitment to health equity and professionalism in medical education. As the dean and a health care professional, I personally stand behind each of these initiatives as well the Faculty of Medicine value as stated in our strategic plan, Destination Excellence, to: Act and lead with integrity and professionalism.
 
Our commitments going forward
  • We pledge to remain committed to the AFMC principles outlined above.
  • Through the Office of Social Accountability, we commit to working together with the MedSoc Equity, Diversity, & Inclusivity Committee to advocate for anti-racism actions in our learning and working environment and to promote accountability in our actions.
  • We commit to including anti-racism/cultural diversity content in our curriculum and anti-racism/ cultural diversity training during orientation week for incoming learners and in onboarding for new staff and faculty.
  • We commit to working with Memorial University policy makers to include specific anti-racism language in its policies and procedures that address incidents in the learning and work environment.
  • We commit to reviewing our medical curriculum to ensure sensitivity to cultural and racial topics or themes.
  • We commit to ensuring our learners, faculty and staff have access to resources and training on equity and diversity.
If you have any questions regarding any of the statements above, please contact me at DeanofMedicine@med.mun.ca.

Sincerely, 

Margaret Steele, HBSc, MD, FRCPC, MEd, DFCPA, CCPE, FCAHS
Dean of Medicine
Professor, Discipline of Psychiatry