Dr. Ann Collins
1. Many associations face challenges engaging new and prospective members. How do you envision residents and first-fifteen physicians engaging with the CMA? What actions would you, as CMA President, take to accomplish this?
First of all, let me say thank you for your interest in this election process and for posing these questions. It has been my privilege to mentor at least four of the resident and student directors on the CMA Board over the last five years. I have learned much from them as a result of their enthusiasm and engagement.
What would I want from the CMA as a resident or a first fifteen doc? First of all, I would like for CMA to ask me what it is that I feel that I need to thrive in this profession. I would want to feel that the CMA values me as a member and sees me as an essential part of the future of healthcare in Canada. As CMA President, I would pledge to not only listen to our young doctors but to hear what they need and want, and to support them in carrying those messages forward.
I would want to feel supported and that I could at least be directed to sources for advice on money matters and practice management, or buying a home or practice real estate. I would want to feel that I had someone to turn to or seek out (in person or virtually) when I felt completely overwhelmed and like I had possibly made the wrong career choice! I would want to see what it looks like to have work/life balance or integration. We’ve all been there! As CMA President I would want to know that we are doing enough of this as an organization. CMA has the resources to support our young physicians.
Lastly, as a young doctor, I would want to come together with other young doctors who are involved with or advocates for the same issues that concern or excite me like AI, climate change, reconciliation or ending poverty. I might like to do this face to face, but I’m busy so that other communication platforms would work better for me. CMA already offers some options like Communities of Interest, but as CMA President I would ask: are we fully meeting that gathering need? Are there other technologies that could facilitate this?
2. In your view, what are the biggest challenges residents will face in the next 10 years? What are your proposed solutions to those challenges?
Without question, in my view, “finding work” in their chosen field will be a significant issue for residents in some specialties. Most of us likely know of at least one orthopaedic surgeon who has done two or more fellowships and locum work before landing a stable position. Given our aging and declining population, other specialties are likely to require fewer numbers as well. I believe this mismatch can be managed by a national strategy for physician resource planning. Then, medical students (and, yes even pre-med students) can make better-informed decisions on their specialty choices.
Another challenge, I believe, facing residents is to care well for their physical and mental health. Both are significantly impacted by the demands of their changing work environments and often by the debt they carry. I would say, strongly, that it is CMA’s role to advocate for programs and policies that address these issues. Part of that debt load has to come from the cost associated with the CaRMS process and multiple elective activities as its precursor and with no guarantee of a match! In my view, CMA needs to listen to its learners and bring together all involved parties to engage in a committed, solutions-based dialogue on how to revamp this system. Our learners should not be treated as pawns!
3. An increasing lack of alignment between the Canadian medical workforce and the healthcare needs of the general population has been well documented. What do you believe is CMA’s role in advocating for better alignment?
CMA should call attention to and raise awareness of this misalignment, in its role as the national voice for Canadian doctors and their patients. I believe this also speaks to the need to have a national convener to formulate a strategy for physician resources that will be required by our population for years to come. Yes, this is a provincial mandate, and governments could choose to do this, but physicians need to be at the table. With its current resources, I believe that CMA could facilitate these discussions and contribute by way of research and sound policy.
4. What do you perceive to be the main causes of burnout among residents, and what actions would you advocate for to correct them?
From my 20 years of teaching residents, I have learned that residency should not have a “one-size fits all” expectation. For many residents, it is a challenge to meet the demands of patient care (while learning and teaching), research expectations and the prospect of ever-looming exams. This all taking place with multiple teachers, in many different work environments and often with lack of sleep. This is the time when many wish to start a family life. Although this can all be very exciting, it can also take a considerable toll. Residency programs need to be open to the concept of flexibility: to allow for the diverse way in which individuals learn and manage multiple responsibilities. At the same time, there should be programs offered, from many levels, including the CMA, to support and mentor residents through this critical time in their career.
5. More than half of surveyed residents would locum outside of their primary province or territory of practice if no additional license applications were required. What steps would you take to create a licensing system that improves physician mobility and allows physicians to respond to dynamic patient care needs?
We certainly heard this expressed loudly and clearly by the residents present at the Halifax Regional Members Forum! “National Licensure” is an issue that requires strong consensus amongst all provincial and territorial licensing bodies, i.e. the colleges. Like any disruptive change to a long-held practice, the ask must continue to be made and strong rational provided. I know that CMA can align with RDoC (as it has in a collaborative statement) to convey that message to the Federation of Medical Regulatory Authorities (FMRAC). This can be argued as being good for patient care and good for physician wellness too.
I would advocate, as a start, for some standardization of licensing requirements between colleges, and that there be a central repository for all required documentation.