Chair's Column: Teaching and Learning in the Middle of a Pandemic

Teaching and Learning in the Middle of a Pandemic

This Chair’s Column will be brief – we all have much to do these days.

This may be the most difficult – challenging – time that you have ever, or will ever, experience in your lives. Toronto has not only deeply felt all five COVID pandemic waves, but we have now set the world record for the highest number of days in which schools have been closed – probably for overall lockdowns too. The pressure on you has been unrelenting, not just because of the lockdowns, but because YOU have been on the frontline day after day after day in the ICUs, on the wards, in the clinics and the emergency departments, shaping IPAC decisions and guiding Ontario Health and the federal government in your various advisory roles. Bottom line, you have been, and continue to be, critical to keeping the health care boat afloat during this pandemic. But it’s been two long years of this slog and you’re beyond tired – maybe even wondering if you can keep going. I understand this, and so does your department.

For those of you whose main academic focus is teaching, it has been incredibly challenging trying to balance the needs of learners with the constant pressures of patient care and managing the ‘at home’ front – particularly those of you in primary caregiver roles. Some of you are feeling less buoyed by your teaching activities. It seems that no matter what you do, it is not enough. The numbers of faculty members receiving lower than usual scores, and negative comments has increased. This includes award-winning teachers who have devoted themselves, and prided themselves, on their interactions with learners through clinical and formal teaching. This hurts, especially when borne of the pandemic. Especially since many of you are scrambling to care for patients on ‘resident independent’ wards while simultaneously attending on the CTUs and subspecialty wards, due to health care worker shortages.  

Those of you who are here to train in medicine – our residents and fellows - are suffering too. COVID has wreaked havoc on your training. There has been little opportunity for gathering, socially or in the context of bedside teaching, which is so important in building camaraderie and a sense of belonging. Many of you are studying for Royal College exams amid all this! Many are far from home, with little or no family or other supports to help you cope – rant, cry, talk with a friend, or just escape it all for a bit in a walk or ride. We also recognize that opportunities for teaching have become scarcer as faculty have been stretched with additional patient care responsibilities. We know this has affected your training experience and, for this, we apologize. We also want to thank those who have volunteered to help cover holes in clinical coverage!

Two years into the COVID pandemic, I and others have never been so frightened by the morale in the department. Despondency has crept in. Early faculty have been disproportionately affected – those with young families trying to build a successful academic career. Some are even questioning the viability of an academic medical career. But the middle of a pandemic is not the time to make major career decisions – the practice of medicine won’t always be like it is now. If you need to talk, or you need help, please reach out.  

So, what do we do now?

We are continuing to build greater capacity to support our teachers, hiring Dr. Tina Trinkaus as our new Lead, Valuing the Clinical Teacher, introducing new training for both residents and faculty on how to give constructive, useful feedback. We have pledged to demonstrate how much we value you, and we do.

For those of you approaching your Continuing Faculty Appointment Review (CFAR), please don’t worry - we fully acknowledge the impact of the pandemic on your academic progress. And NO, WE DO NOT EXPECT YOU TO MAKE UP the time you’ve lost.

To our learners, we remain firmly committed to building a kinder, happier, more supportive learning environment for you. But the practice of medicine is hard – if it were easy everyone would do it! Major changes have been made to on-call coverage requirements, the Internal Medicine Royal College Accreditation Task Force has been hard at work gathering and reviewing data and developing their recommendations to the department, hospital site reviews have been completed, and we have been working on health human workforce modeling to advocate for additional support for medicine and its specialties as the population ages. We will continue to work towards ensuring appropriate supports are in place to allow our trainees to be challenged in the clinical environment, while never feeling alone or unsupported, so they become the best doctors they can be.

Despite the stress of the pandemic, you, our faculty and learners, continue to amaze – you are the brightest, most inspiring, and talented bunch in the world – your efforts on behalf of your patients, and the province, nation and world, are truly outstanding. You should all be very proud of what you have accomplished over the past two years, against the odds. I know I am! While I have no crystal ball, I am certain that the pandemic, at least in its current form, won’t last forever – we will emerge and regain the joy of medicine. Until then, please be kind to one another because, after all, we are in this together.

Thank you for your relentless commitment to our mission.