A Canadian perspective on training and career support in Family Medicine

NormanWendyVWendy Norman is the CIHR and PHAC Chair in Family Planning Public Health Research, and Associate Professor in the Department of Family Practice at the University of British Columbia

 

As a career offering diverse experiences, challenge and intense satisfaction, academic family practice surely cannot be beat. Many of us may have begun our academic practice early in our career, particularly those of us who were biomedical clinicians-scientists. However, for me the journey to a full academic career, as maybe more typical for family practice clinician scientists, developed over several decades.

Although my early practice-only years in a BC coastal fishing village, accessible only by ferry or float plane, came with long hours and difficult decisions, I found the thrill of providing cradle-to-grave care, managing emergencies, anaesthetics, deliveries, or our local 4-bed ICU, to be deeply satisfying. Within a few years the joy of teaching was added to that of patient care. At first, through clinical training of residents and medical students, and eventually including lectures, course and program design, I found teaching experiences enhanced my own learning and bore the promise to extend high quality care beyond my reach as an individual physician. But now becoming immersed in research has topped all!

If you have a research bent, you may relate to the challenge, yet profound satisfaction I have found through developing and answering questions that are key to improving the care we provide our patients. Family practice health systems and services research is an exciting field with exceptional potential to advance the health of populations. I think I’m not alone in finding that being a clinician-researcher is fulfilling; this is not only a really interesting career but also very concretely reinforces that academic clinician-researchers can make a difference, through local, national and international impact.

Do our societies, institutions and disciplines support family medicine clinicians to undertake research training and embark on successful clinical academic careers?  In my view this is the big challenge for our discipline and for health and academic institutions, not just in Canada but in many of our peer countries. I’m very much looking forward to grappling with this important issue at the upcoming meeting: “Clinical academic careers in Family Medicine”, a pre-conference day prior to the annual meeting of the UK Society of Academic Primary Care (SAPC) in Dublin next month.  Dr. Tom Fahey has convened academic researchers and research funders from several countries to share best practices and reflect on gaps and opportunities to advance academic careers among primary care physicians.

Our Canadian perspective will present on both training and career support. In addition to encouraging traditional graduate degrees as a foundation, several programs tailor researcher training to family physicians. Success in family practice research that can be incorporated to advance care and improve health may require exposure to key concepts such as:

  • building and managing interdisciplinary teams
  • integrating health system and policy decision makers within your team
  • Grant Generation for research and for salary support
  • the ongoing importance of mentorship, peers and networks, and
  • Optimizing knowledge translation and uptake

Stellar Canadian examples are Western University’s Transdisciplinary Understanding on Research-Primary Health Care, TUTOR-PHC program, originally founded nearly 15 years ago as one of the CIHR’s Strategic Training in Health Research STIHR programs; Newfoundland’s Research Skills for Rural and Remote physicians “6 for 6” initiative; or the College of Family Physicians of Canada’s Clinician Scholar Program (CSP) offering advanced research training through 7 Departments of Family Medicine across the country. Canadian career and research funding programs will be presented by Dr. Robyn Tamblyn, Scientific Director for the CIHR, Institute of Health Policy and Services Research, a sponsor of this conference day. Supporting family physician researchers to succeed in academic positions remains a challenge across the country, but training and funding opportunities afforded by these programs are making a difference!

I quite look forward to discussions among the international experts gathered. In particular, I’m excited to understand delegates' reflections on gaps and opportunities we recently explored at the Future of Medical Education in Canada  (FMEC) conference on “Clinician Scientist training and career support”, held in February at Western, and on initiatives of the College of Family Physicians of Canada’s Section of Researchers recent “Blueprint for Research Success”. Blueprint initiatives currently rolling out include: a community of practice; national primary care research advocacy; and conferences and resources to define, connect, serve and meet the needs of family medicine researchers. FMEC conference attendees highlighted a plethora of career “pipeline” support issues and discussed key steps for a national strategy to address the issues. The opportunity at the SAPC international forum to present and discuss our Canadian experiences and those of several peer nations will undoubtedly fuel our progress to advance best practices supporting successful academic family practice careers.

Not long ago, Barbara Starfield demonstrated the key role for family medicine and primary healthcare to improve the health of our populations. To reach this goal we need to understand how best to support family medicine and primary care clinicians to undertake research training and embark on productive academic careers. International exchange of experience and best practices, such as those I look forward to at the Dublin Clinical academic careers in Family Medicine meeting, could take us one step closer to realizing this promise.

Editor's note: This is the second in a series of 8 blogs about international collaboration in strengthening primary care research, ahead of the #SAPCASM2016 conference in Dublin, Ireland

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