Margaret Steele is the Dean of Medicine and a Professor of Psychiatry at the Memorial University of Newfoundland (MUN)
Jim Rourke is a Professor of Family Medicine and a former Dean of Medicine at MUN
Ian Bowmer is Executive Director of the Medical Council of Canada and a former Dean of Medicine at MUN
Desmond Whalen is a resident in the Department of Family Medicine at MUN
This year marks the 50th anniversary of the Faculty of Medicine at Memorial University of Newfoundland (Memorial). The first Memorial doctor of medicine (MD) class graduated 23 students in 1973, following its establishment in 1967 with the support of the government of Newfoundland and Labrador, the Government of Canada, and the university. The goal of the faculty has always been to improve the health of the people of Newfoundland and Labrador (NL). This past year we have been celebrating the significant contributions that our learners, staff and faculty have made to the health of the people of NL and beyond.
From 1973-2017 Memorial graduated more than 2,500 MDs. The class size initially stabilized at 54-60 and then, in 2013, increased to 80 students (60 from NL, 10 from New Brunswick (NB), four from Prince Edward Island (PEI), and six others from across Canada) to better meet the needs of the province and region.
Of the 1,666 Memorial MD graduates from 1973-2014 listed in active practice in Canada, 40 per cent are located in NL and 16 per cent are in NB, PEI and Nova Scotia. Overall there are 666 graduates listing family medicine and of those 257 practice in rural areas.
The focus of Memorial’s postgraduate (PG) residency training programs is training generalist physicians in both family practice and other Royal College specialty programs. Since its inception, Memorial’s undergraduate and postgraduate programs have utilized educational opportunities in every practice location in the province. It was one of the first faculties of medicine in Canada to establish a longitudinal rural family medicine residency (NorFAM) at the Northern Family Medicine Unit in Goose Bay, Labrador.
Due to its focus on training physicians for rural practice, Memorial has been a frequent Society of Rural Physicians of Canada Keith Award winner for having the highest percentage of graduates in rural practice 10 years after graduation. Almost all the current Canadian trained family doctors (85 per cent) and specialists (75 per cent) in NL are Memorial MD graduates. Most of the remainder received their PG training at Memorial. The university hopes to continue this trend, owing in part to the increased class size established in 2013. Memorial’s MD and PG medical program outcomes will be published in an article in Canadian Family Physician* and two articles in the Journal of Rural and Remote Health [1-3].
In addition to MD graduates there are more than 300 masters and PhD graduates studying at the Faculty of Medicine; as many graduate students as medical students. We offer graduate studies in neurosciences, cardiovascular and hypertension, oncology, genetics, inflammatory and infectious diseases, clinical epidemiology, public health, and health ethics. The portfolio for the health-related research in our faculty has had exceptional growth over the last five decades leading to a diverse tapestry of pivotal discoveries in medicine.
Focusing on the health of Newfoundlanders and Labradorians, research and scholarship has touched many fields including cellular/molecular biology, genomics, epidemiology, as well as social sciences and humanities. Examples include a neuroscience discovery that cooling mice with acute stroke injured brains helped them with recovery which has led to clinical applications all around the world and a novel discovery that could lead to new treatment for the hepatitis C virus and its destruction of the liver.
Memorial has developed a successful research model to integrate biomedical research. Multidisciplinary teams assess the clinical and population problem to discover the root causes and develop solutions and knowledge that can address the problem at the patient, community and population health level. For example, Newfoundland and Labrador’s founder population has resulted in clusters of genetic diseases including sudden death and blindness and multiple cancers.
The discovery of the root cause of sudden cardiac death and subsequent evaluation of life-saving implantable defibrillators at Memorial was reported as one of the most significant in Genome Canada’s history.
This method is being applied to develop novel approaches from studies using real-world data for the discovery of the basis for complex diseases such as colon cancer and von Hippel Lindau disease that are highly prevalent in our province; fundamental and basic neuroscience investigations directed at determining the basis of neurodegenerative diseases; and studies relevant to improving the health of Indigenous populations. As new methodology, technology and analytics become available, we plan to use such tools in innovative ways to improve the health and well-being of the population of our province and Canada. We foresee progressive expansion of our research enterprise as we embark on a new journey in the future of our school.
Memorial received the Association of Medical Education of Europe Aspire-to-Excellence Award for Social Accountability in 2014 for engaging, partnering with and responding to the needs of its communities. Memorial has been a leader in developing programs to ensure admission of Indigenous, rural and socio-economically disadvantaged students. From the outset, the curriculum emphasized experiential learning and was very distributed, involving teaching sites all over Newfoundland and Labrador, Atlantic Canada and indeed the rest of the country. Memorial’s pioneering development of telemedicine beginning in 1979 has supported Newfoundland and Labrador’s distributed medical education and practice and its use has spread around the world.
The future is bright for the Faculty of Medicine at Memorial. Over the last 12 months, we have gone on a journey of strategic discovery. We have engaged over 500 people including learners, faculty, staff, community members and partners. We have listened, collaborated, reflected and learned. Our new strategic plan, Destination Excellence, signals our commitment to integrated education, research and social accountability, and uniting the diverse talents of our learners, faculty and staff to accelerate the faculty’s collective impact on the communities we serve. The strategic plan recognizes the need for innovation and change and motivates us to think, prepare and act in new and different ways, sharing our vision ‘Through excellence, we will integrate education, research and social accountability to advance the health of the people and communities we serve.’
[*Rourke J, O’Keefe D, Ravalia M, Parsons W, Duggan N, Moffatt S, et al. Pathways to Rural Family Practice at Memorial University. Canadian Family Physician Médecin de Famille Canadien 2017 in press]
Dr Iain J Robbé
It is disappointing to read this article from Memorial’s Faculty of Medicine which seems to select only the strengths and to ignore the weaknesses there. Specifically, there is no mention of the challenges presented by the apparent weaknesses in the learning environments for anaesthesiology residents (1), internal medicine residents (2), and learners in the MD program (3,4) including allegations of bullying, intimidation, harassment and sexual harassment.
Amongst learners and faculty, there is scepticism about the award for alleged excellence in social accountability and an understanding why an application for excellence in student engagement was aborted (5).
For all the strengths in Memorial’s Faculty of Medicine, it would show important self-awareness to acknowledge there are weaknesses in the education environments that need to be addressed urgently.
Dr Iain J Robbé
Clinical Medical Educationist
Declaration: I had a part-time appointment as a Clinical Assistant Professor/Visiting Professor in the Division of Community Health and Humanities, Faculty of Medicine, from the fall of 2012 to the fall of 2017. I decided not to apply to renew my appointment because of my concerns about the negative learning environments in the Faculty and the lack of meaningful responses to those concerns which I had raised with the Faculty management.