Heated rhetoric or Holy Grail?

JAW’s editorial in December entitled “Paranoia, gut feelings, and the UCFA” (BCMJ 2006;48[10]:488) warns that the medical school could fail to reach its potential unless the Faculty of Medicine (FOM) and clinical faculty teachers reach a working relationship consistent with the norms of 21st century society.

Although we are short of doctors, many of those we have throughout the province would welcome the opportunity to teach medical students and residents, enriching them with their own experiences and, in turn, being enriched as the learners strive to keep abreast of advances—a form of mutual CME. If we could enlist them, we would have the potential to develop one of the most active, vibrant, and productive medical schools in the country. But there is a snag.

These professionals make a living attending patients and are often hard-pressed because of capped incomes, rising overheads, and increasing demands; furthermore, good teaching takes time and time is money. Many potential teachers would be reluctant to enroll if it meant losing income or using family time to attend their patients long after the learners’ day is done. Our salaried colleagues in the Faculty of Medicine would not consider such a sacrifice.

If clinical faculty teachers were treated with respect as equal partners with their salaried colleagues and, like them, enjoyed similar rights, including a written renewable contract, a third-party dispute mechanism and a guarantee of compensation for costs and teaching time they would, in all probability, queue up to enlist.

That this is self-evident should be a “no-brainer” to anyone living after the time of Charles Dickens, but for reasons about which we can only surmise, the FOM is dragging its feet. In the past, several excellent teachers have left Vancouver for Surrey, Richmond, Victoria, and Kelowna to avoid contact with the FOM. This is a tragedy. We should be proud of and support our medical school and help it achieve its glittering potential, the Holy Grail of international recognition, which is well within its reach. But unless the FOM changes its approach and accepts the right of clinical teachers to modern working conditions, the expanded school will falter and could fail, to the detriment of every British Columbian.

JAW’s editorial warns of the danger of a standoff and of the heated rhetoric between the FOM and the UCFA (University Clinical Faculty Association), which represents many of the more active clinical faculty teachers, and urges the protagonists to bury the hatchet. Only secure, unthreatened, and respected clinical faculty will do a good job, but if discontented, their learners will suffer.

Fortunately the BCMA has entered the fray at the invitation of the UCFA, and perhaps we can look to the future with optimism. The FOM may fear losing power if it concedes rights to clinical faculty teachers, but on the contrary, together with an enthusiastic, respected clinical faculty workforce, its influence over the training of doctors will be enhanced. Let’s dump the heated rhetoric and go for the Holy Grail; the UCFA and clinical faculty are ready. The ball is squarely in the FOM’s court.

Angus Rae, MB 
Clinical Professor Emeritus of Medicine UBC
Past President, UCFA

Angus Rae, MB, FRCPC. Heated rhetoric or Holy Grail?. BCMJ, Vol. 49, No. 1, January, February, 2007, Page(s) 9 - Letters.

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