News at Medicine - March 2019 - The dean of medicine talks #FutureNL

The dean of medicine talks #FutureNL
March 28, 2019
As part of a Gazette special feature, #FutureNL, Dean Margaret Steele answers questions about what the role of improving health care in our province takes in that future.
Dr. Margaret Steele, dean, Faculty of Medicine
  1. What do you see as the biggest health-related challenge facing Newfoundland and Labrador?
The biggest health-related challenge facing Newfoundland and Labrador is the health care needs of our aging population. By 2036, Newfoundland and Labrador will have the oldest population in the world and as people age, they are more likely to have more complex and chronic illnesses which places a burden on the individual, their families and the health care system.
  1. What role do you think your unit should play (or is playing) in improving health care in the province?
The vision of the Faculty of Medicine is “Through excellence, we will integrate education, research and social accountability to advance the health of the people and communities we serve.” As such we are very much committed to educating learners to meet the health care needs of the population.

We are providing learners early in their education with exposure to rural and underserved areas in the province and we continue to offer these opportunities throughout their education. We have won the Society of Rural Physicians of Canada (SRPC) Keith award seven times for producing family physicians who ten years after graduation from their family medicine program are still practicing in rural and underserviced areas. This year we have won the SRPC Rural Medical Education award for the second time for the medical school which excelled in producing graduates headed for a career in rural medicine.

Our graduate students and faculty are researching questions that matter for the people of the province in areas that are of high importance to the Province such as multiple sclerosis, neuropsychiatric disorders, infectious disease and immunological disorders, cardiovascular diseases and genetically based disorders such as colorectal cancer. As well, some of our researchers are involved with the Canadian Longitudinal Study on Aging. 
  1. What specific programs or initiatives in your unit are contributing to improved health care?
Translational and Personalized Medicine Initiative: Quality of Care. In this program best practices are disseminated to physicians around important topics such as the appropriate use of medications (i.e., antibiotics) and diagnostic tests (e.g., CT scans). This program not only influences physicians to deliver best practices care, but in doing so, also reduces risks such as cancer as a result of repeated exposure to such modalities as CT scans.

In the past four years, we have been training family medicine in a “streams” model in Western, Central, Labrador-Grenfell and Eastern Health. Family medicine residents spend the majority of their two years in these regions.

For almost ten years, we have had an Aboriginal Health Initiative with an advisory board that includes representation from all Aboriginal communities in Newfoundland and Labrador. This initiative includes programs for high school students interested in pursuing health professions, pre-medical education support, designated seats for admission to the undergraduate medical education program, development of curriculum and support for Aboriginal students. This program not only supports Aboriginal students to enter medicine but also teaches non-Aboriginal students about cultural sensitivities and the health care needs of Indigenous Peoples.
  1. What changes do we need to make as a province to improve our health?
We need to actively increase health promotion, prevention and education so people are engaging in healthy lifestyles such as leading an active life, eating well and avoiding high risk behaviors such as excessive alcohol consumption. In addition, individuals should learn how best to access the health care system.

The second area is developing a robust provincial primary health care system with interprofessional teams that include the patients and their families to provide the best care possible.

We also need to build capacity in the community by moving away from acute care medicine to care that is delivered in people’s communities and homes, if possible.