Queen’s Family Medicine is turning 50 this year. In honour of the golden anniversary, we brought together leaders – past and present – to discuss the department’s evolution, impact, and achievements. The following is an edited conversation with former department heads Drs. Ruth Wilson (1991-2001) and Glenn Brown (2007-2017), and current head Dr. Michael Green (2017-present).
Q: How has the department changed over the last five decades?
Brown: The biggest change for me is size. When I was a resident at Queen’s, I'm guessing there were about 20 to 25 of us. To go from that to the very large program (close to 200) we have now is substantial. We always had community rotations, but they have expanded alongside the size of the program. Our number of patients per faculty member has really ramped up and we have increased clinical responsibilities in the community, including hospitals like Providence Care, where residents are part of a regular rotation. And we have really extended both training and clinical experiences by utilizing Kingston’s surrounding communities and partnerships in northern Ontario. We established our satellite units at Lakeridge Health in Oshawa, Belleville-Quinte, and Peterborough-Kawartha. The success of those units is a testament to the strength of family physicians.
Green: We are now moving forward even further with our growth at Lakeridge Health into a full, integrated regional campus with both an undergraduate presence and medical students, as well as residents, and a new program aimed at MD students who know they want to become family physicians. This furthers our vision of being a distributed department with a variety of thriving training hubs.
Wilson: Outreach to community and partnerships have been the key to the department’s growth. For example, the North Kingston Community Health Centre was established with support from our department, we have had a longstanding training and clinical role on the ground in Moose Factory on the James Bay Coast. Our impact internationally includes collaborations and exchanges in countries like Bosnia and Australia. Such opportunities enrich the lives of those who can participate. Each year, the department’s Centre for Studies in Primary Care hosts its Primary Care Research Day, at which residents from all four teaching sites present their research.
Q: What impact has Family Medicine had on research?
Green: We are above average when compared to other academic departments at Queen’s – for both publications and research funding. That started with the establishment of the Centre for Studies in Primary Care in 2000, and in Queen’s becoming a national leader in the use of electronic health record data with the Canadian Primary Care Sentinel Surveillance Network. Having two endowed research chairs has made a big difference in terms of support and prestige for the department. We had the first research chair ever funded by the Southeastern Ontario Academic Medical Organization (SEAMO).
Wilson: One major moment was the first time we received a Canadian Institutes of Health Research (CIHR) grant that led to a publication in the British Medical Journal about family physicians following patients with treated hypertension for up to three years. That clinical trial involved 50 family practices in southeastern Ontario and was ground-breaking family medicine research in Canada.
Q: What are some of the department’s milestones?
Green: Besides our growth in scholarly research and distributed training sites, we've been a very central part of the rollout of Kingston’s Ontario Health Team, providing regional clinical service. And we have developed a truly national residency program. Unlike a lot of programs where most trainees come specifically from their local university and reflect their local demographic, our program has such a strong national reputation that we have residents from all over the country.
Brown: Our growing commitment and contribution to the undergraduate health sciences program. We have always participated in clinical skills training and teaching, but we are playing a much bigger role including a popular Family Medicine course and ongoing lectures. It's an important foot in the door.
Green: I think our Falkland Islands program is an interesting development demonstrating that we're recognized not just locally but beyond. One of the strengths of Queen’s Family Medicine residents is their ability to work almost anywhere. When the Falklands, a remote British overseas territory off the coast of South America, found itself in need of medical professionals, we answered the call. Approximately six Queen’s family medicine residents per year have headed to the Falkland Islands from 2016 to present (except during the COVID-19 pandemic). We have become a preferred training site for a wide variety of learner needs. For example, our department has become a fixture for training the Canadian Armed Forces.
Brown: Our approach to community training is a major success story. Whether rural and northern Ontario, the Falklands or other remote regions, we make sure that students have the relevant hands-on skills that are important in these communities. The program has been highly successful in terms of providing experience for our learners, but also in terms of equipping them to meet the medical needs of patients across a variety of different situations and communities. Recently, that work extended to partnering on vaccination clinics in remote, northwestern Ontario during COVID-19. We put together teams of students, residents, and faculty in coordination with the Northern Ontario School of Medicine and government partners.
Green: COVID-19 was another critical period. We had to redeploy and support family doctors from our department in the community as it dealt with the pandemic and coordinated vaccination clinics.
Wilson: On the global health scene our contributions are subtle but longer lasting. We have often collaborated with countries where family medicine is not as strong as it is in Canada. From serving as external examiners in places like the University of the West Indies to helping countries develop their own exams, and from treating hypertension in rural Uganda to major contributions in Bosnia and Herzegovina, where we led the reform of their primary health-care system following the war in the Balkans.
Green: Our research work internationally includes collaborations in Australia and New Zealand on culturally safe care for Indigenous patients and community-based research in northern Thailand. We are also proud of the role we play in caring for patients in Kingston and the surrounding area. For example, we are the largest provider of day-to-day physician care at Providence Care Hospital, and we also have a large Family Health Team.
Wilson: From our developmental disabilities program to obstetrics, we make a difference in the lives of patients. At the end of the day, it’s all about the partnerships we’ve developed to improve health in our communities.
Green: We're known beyond our local area primarily due to our scholarly work and translating what we've done for innovation in education. We’ve also contributed strong national leaders over the years – both in family medicine and leadership in other organizations. The department’s impact has been local, provincial, national, and international.
Learn more about the Queen’s Family Medicine program.
This story originally appeared on the Queen’s Health Sciences website.
