“Refoundation” of the health system | The essential role of universities

On March 29, the Minister of Health and Social Services (MSSS) tabled his “Plan to implement the necessary changes in health” based on four pillars: human resources, access to data, information technologies and modernization of infrastructure.

Posted at 12:00 p.m.

For the faculties of medicine in Quebec, which train doctors and future health professionals, the “recovery” of the health care system must go above all through the training of the health workforce, the promotion of primary care education and investments in teaching and research infrastructure.

Training the next generation in healthcare: an emergency

The pandemic has highlighted the shortage of personnel, especially in nursing and medicine. While the lack of family doctors, the massive early retirements and the difficulties of access to primary care have been the subject of many public positions, it should be remembered that several specialties are also suffering from a glaring lack of staff.

Close collaboration between faculties of medicine and decision-makers is essential to properly plan the training of the workforce over the coming decades, in all sectors. Also, at the request of the MSSS, the faculties of medicine will considerably increase their intake capacity in their study programs: by 2025, the number of medical admissions will rise to 1,050 per year, or an increase of 26.5% since 2019. These increases, combined with the effects of the pandemic, will however cause a significant workload for our teams and our educational institutions.

Front-line medicine: a change of model is needed

Another aspect deserves our full attention to improve access to care: strengthening the first line through inter-professionalism. To do this, the training of the new generation of physicians and all health professionals must be carried out in close contact with stakeholders from all the disciplines that affect patient care.

This new pedagogical model will require a collective effort by the faculties, in concert with the MSSS, to further promote front-line practice and promote models of care based on a more sustained commitment from all health professions.

The “refoundation” will also have to rely on human potential and an organization of care more focused on benevolence. With this in mind, the faculties of medicine are already advocating more active patient participation – according to the patient-partner approach, where the latter becomes a central player, particularly in shared decision-making. This type of approach makes it possible to improve and humanize the care offered to the population, while contributing to the development of practices through social innovation and research.

Focus on research

In addition to training, let’s recall the role of universities and their faculties of medicine as drivers of change and innovation through basic, clinical and population-based research. Although the fruits of the work of professors-researchers are sometimes slow to reap, the fact remains that the creation of new knowledge is essential to meet the challenges of society.

Think of the RNA biology that underlies vaccines against COVID-19 or of the algorithms of artificial intelligence with multiple spin-offs, which were discovered after decades of labor in neutral and independent research places. Quebec’s scientific community must be able to count on universities to pursue research in areas that otherwise would not be supported by private enterprise.

Invest in infrastructure to accomplish the university mission

For two centuries, the faculties of medicine have been essential players in the health network in Quebec. The major changes that have occurred in medical practice thanks to advances in tertiary and quaternary medicine, initiated by our faculty, have enabled university hospitals to develop modern infrastructures. These recent developments have had a significant impact on the quality of training offered to our students as well as on the care provided to the population.

But a lot of work remains to be done to modernize all hospital and university infrastructures, which are too often obsolete. Improving training, increasing student cohorts and maintaining and developing research teams will require massive investments in our infrastructures.

We are therefore pleased to see that staff training is at the top of the 50 measures of the overhaul plan and that major investments have been announced for the modernization of the infrastructures of the health network. We believe it is just as essential that Minister Dubé take into account the needs of universities in his action plan and continue the dialogue with our authorities, in collaboration with the Ministry of Higher Education. Our mission is to build knowledge and pass it on to new generations for the benefit of society.

* The Dr Patrick Cossette is also president of the Conference of Deans of Quebec Faculties of Medicine of the Bureau de coopération interuniversitaire (BCI).

** Co-signers: Dr Dominique Dorion, Dean of the Faculty of Medicine and Health Sciences at the University of Sherbrooke; Dr David Eidelman, Vice-Principal (Health and Medical Affairs) and Dean of Medicine and Health Sciences at McGill University; Dr Julien Poitras, Dean of the Faculty of Medicine at Laval University.

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“Refoundation” of the health system | The essential role of universities


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