Over the last 18 months, I’ve had many experiences from my dual vantage points as a hospital anesthesiologist and an academic leader. I’ve listened and learned, argued and advocated. I’ve helped move people and programs across the city and online to ensure academic and patient care continuity in the face of incredible strain on our system.
I’ve had difficult conversations and made tough decisions week over week; and by way of my training and experience, I’ve cared for very sick COVID-19 patients and helped many residents learn to do the same with care and compassion. My colleagues and I know this is the most difficult work we may ever do in our lives. And the story isn’t over yet.
There is much left to examine of the toll this pandemic is taking and the scale of inequity it has revealed. And yet, supported by a loving family, an established career and some of the best colleagues a person could have, I know I am extremely fortunate.
Today I want to share with you some thoughts on how we can create a better future for education, research and care that builds on the best of what we’ve learned through COVID-19.
The pandemic forced healthcare teams to prioritize – and re-prioritize – what we had to do (and what we couldn’t do) based on the best available information at any one time. I would argue that these constraints led to a new level of interdependence and respect for our interprofessional colleagues. Physicians learned directly from nurses, respiratory therapists and physical therapists, such as the value of proning our sickest patients. Colleagues from the humanities and social sciences generated important insights from socioeconomic and geographic data. Ethicists stepped up to help us weigh the ramifications should we reach a point where access to critical care was to be triaged.
I am so thankful we never had to put those protocols into effect.
The consistent focus on the importance of team-based solutions is good for physicians like me. I was trained at a time when the deference to senior physicians was sacrosanct, a practice that we know has left not only individual scars (or worse) but also served to further entrench rigid and exclusionary norms. These are the systems being examined, dismantled and rebuilt with the principles of equity and inclusivity embedded into everything we do in education, research and care.
Our working groups across the Toronto Academic Health Science Network (TAHSN) are redoubling efforts to integrate Indigenous education and anti-racism work and to develop shared principles and support pathways for learners facing mistreatment at any point in their education. The last 18 months have only underscored the need to ensure our teaching faculty have access to the tools and resources they need to support the learners, as well as their own wellbeing.
The Toronto Hospital Education table – a pandemic-initiated gathering of GTA colleges and education institutions providing hospital-based health professional education – is now a permanent extension of the TAHSN Education Committee, recognizing the impact of wide-scale collaboration in supporting and advancing the interests of all health professions learners in their clinical education at sites across the GTA.
I’m seeing this collaborative goodwill at work at the highest levels. Hospital CEOs have shown a willingness to come together to hammer out collective solutions since the earliest days of the pandemic: from harmonizing infection control protocols and PPE standards to streamlining continuing education and vaccination policies. The level of cooperation and integration has been impressive. And there is more ahead, particularly in the domains of research and technology.
Our partners know we need a collective investment in secure, robust technology platforms to enable our goals in education, research and patient care. That citywide commitment extends to ambitious research collaborations as well, such as in neuroscience and infectious diseases.
For all the undeniable suffering this pandemic has wrought, I am profoundly hopeful for the future. The work in team-based care, inclusive educational environments, and robust new platforms ahead in research and technology will set the stage for generations of Temerty Medicine faculty, staff and learners to come.
The commitment to respectful, productive collaboration is our post-COVID advantage. Let us not squander it.
Professor Patricia Houston
Acting Dean | Vice Dean, Medical Education | Interim Associate Dean, PGME
Temerty Faculty of Medicine
