Angus Rae MB, FRCPC

Issue: BCMJ, vol. 51, No. 3, April 2009, Pages 104-105 Letters

It is no secret that the university Faculty of Medicine and clinical practitioners who are currently clinical faculty teachers/mentors do not always see eye to eye.

What is the problem? Most of us enjoy and benefit from the company of learners, and since we remain short of doctors it is vital that we train more.

Who are clinical faculty and who “owns” them? Clinical faculty provide two-thirds of the teaching/mentoring needed to produce competent general practitioners and specialists; without them the medical school could not function. They owe primary allegiance to their patients; if anyone owns them it is society at large. They are certainly not owned by the Faculty of Medicine.

It is extraordinary therefore that the Faculty of Medicine, without first discussing the contents with them, sent a contract to clinical faculty ac­companied by a letter asking them to either agree or resign. The meaning of this terse request remains unknown.

Would this be tolerated in other professions? We are in dire need of doctors; why frighten willing teachers away?

Equally worrying to many are rumors that clinical privileges in several regional hospitals will become contingent on agreeing to teach and even research. Given the university’s insatiable quest for research publications to increase its international ranking, if clinicians are required to contribute in order to keep their clinical position, the danger is obvious.

Although with a mutually agreed working arrangement most clinical faculty would be enthusiastic teachers/mentors, the pressure to research is ominous. As reported on 17 February 2009 in the CMAJ, “The potential for patients to be coerced into participating in trials or be subject to undue influence is considerable…”

The CMA, concerned at this pressure on clinical faculty, passed Resolution 21 at their meeting in August, 2008 stating they “… will work with provincial/territorial medical associations to inform faculties of medicine, provincial/territorial ministries of health and regional health authorities that the linking of hospital privileges of attending physicians to the requirement to teach and conduct research is unacceptable…”

The UCFA/SCF ( is the only group trying to get justice and respect for clinical faculty, but we need much more support if we are to prevail. With an agreed, not an imposed, contract most would happily enroll and get on with expanding our medical school in harmony with our colleagues in the university.

Other countries have settled this problem; why can’t we?

—Angus Rae MB, FRCPC
Clinical Professor Emeritus of Medicine
BCMA Section of Clinical Faculty

Angus Rae, MB, FRCPC. Angus Rae MB, FRCPC. BCMJ, Vol. 51, No. 3, April, 2009, Page(s) 104-105 - Letters.

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