Oct 30, 2023

Chair’s Message: To three or not to three (October 2023)

Chair's Message, About DFCM
DFCM Chair, Danielle Martin, visiting CAMH

Dear Colleagues,

It has not been an easy autumn. Local and global events are deeply affecting so many in our DFCM community. As we all struggle to process what is happening and be kind to ourselves and those around us, our clinical and academic work continues. For many, that includes the excitement of new academic projects and the infectious energy of new learners who represent hope for the future of our discipline.

To our 176 new residents, welcome! You have joined—in my opinion—the greatest department of family and community medicine in the world. You have the benefit of tight-knit communities at your sites and all the opportunities that a large, distributed department affords. I hope to meet you all in due course, and until then will echo some advice from our Indigenous Education Lead, Dr. Sarah Park: As you are working your way through your rotations, consider which preceptors have a career and lifestyle you could see yourself happy in, and if you find someone whose approach resonates with you, stay connected.

We are all deep into an exciting academic year. Our postgraduate program is expanding to accommodate new residents, our Physician Assistant program is working towards doubling its intake, and we are forging ahead with the implementation of our strategic plan.

Amidst all this, discussions continue about expanding residency training from two years to three.

If you have not already done so, I encourage you to read this thoughtful Globe and Mail opinion piece from Dr. Risa Freeman, Vice-Chair of Education and Scholarship, and Dr. Stu Murdoch, Postgraduate Education Program Director. In it, they discuss whether an extra year would better prepare doctors for the breadth and complexity of family medicine and whether that extra year might make family medicine less attractive.

The issue is hotly debated, and there are compelling arguments both for and against the change. DFCM’s Drs. Giovanna Sirianni and Qin Yuan (Alis) Xu table some important considerations in this CMAJ commentary.

As educators, we know that we need to attract and prepare our residents to practice in a rapidly evolving environment and ensure that the system enables long and fulfilling careers.

We also know that continually improving family medicine training to provide the best possible education that reflects the ever-changing reality of health in our society is a fundamental part of our work.

But, if we want medical students to choose family medicine, and family doctors to stay in family medicine, we must fix the broader system.

As Risa and Stu explain, we all have the same goal—to save comprehensive family medicine and make sure that patients get the care they need when they need it. Education reform—in whatever form—is part of the solution, but not the whole solution, and will not be successful without broader health system change.


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