Chair's Column: The Toronto Advantage

Sep 5, 2017
Dr. Gillian Hawker
Gillian HawkerWelcome back! I hope you have had some much needed rest and relaxation over the summer months. 

For the residents, fellows and faculty members who have only just arrived, a very special welcome to Toronto and to our department at the University of Toronto. If you are new to Toronto, and possibly also new to Canada, I can only imagine how daunting this transition must be. We want you to know that we are here to answer your questions, show you around and ensure that you get what you came for from our wonderful University/department and this amazing city! 

I gave a presentation to our hospital foundations earlier this year. Many of the attendees were remarkably unaware of the stature of the University of Toronto, and our department, on the world stage. It made me wonder how many others, including our own faculty members and trainees, may also be unaware of the impact of the University of Toronto identity. For example, it is not uncommon at leadership search committee meetings for someone to ask, “Why would so and so (highly successful academic at top-notch other university) come here?” So we asked a few such folks — three senior department leaders and two PGY-1 trainees — to tell us why they chose U of T.

Not surprising, there are some common themes worthy of noting.

The University of Toronto Identity (Toronto Advantage)

Our university sits among the top in the world. The Faculty of Medicine currently ranks sixth in clinical medicine and is second only to Harvard in publication citations! Our faculty members are scientifically renowned and internationally recognized for their clinical excellence. We are a medical education powerhouse and among the top internationally in education scholarship. We are leaps and bounds ahead of the rest with respect to opportunities for training and scholarship in quality and innovation.

We are also rather unique in that we have only one Department of Medicine spread across six fully-affiliated teaching hospitals and more than 20 affiliated community hospitals and sites. We are large — comprised of about 800 full-time faculty members and a further 600 part-time and adjunct faculty members — which can be challenging. But, our size also means that there are endless opportunities for collaboration and innovation.

Our trainees — about 1000 residents and 450 fellows across 20 Medicine divisions — are the glue that holds us together. We consistently attract the best and the brightest, filling our residency spots in the first match. We train one half of Ontario’s and one-third of Canada’s internal medicine specialists.

We are major contributors to the generation and translation of new knowledge, resulting in better health outcomes for our patients. In 2015-16, members of our department received $176 million in research funding and 2,202 research awards. We currently have 15 Canada Research Chairs. We have 135 individuals completing advanced training in an academic field, including through our Phillipson Clinician Scientist and Clinician Educator Training Programs. Asfandyar Mufti, PGY-1 in Dermatology, says, “It is inspiring, not only to learn from the best, but to see the knowledge dissemination process in action!”

But you may not know where this all started. While professors of medicine at the University of Toronto existed back to 1887, prior to 1919, these professors were all full-time practicing physicians; they taught or did research in their ‘spare time.’ It was Dr. William Goldie — of the Goldie Awards — who proposed the establishment of a full-time professorship of medicine to provide ‘salaries’ so that academic clinicians didn’t have to support themselves exclusively via clinical earnings. His patients, Sir John and Lady Eaton, generously donated the necessary funds in 1919, and Dr. Duncan Graham was appointed the first Chair of Medicine in what was then the British Empire!

The Eaton gift was truly transformational for our department. It enabled not only the establishment of the Chair, but also major recruitment of ‘academic physicians’ who combined clinical skills with scientific training and experience to interpret scientific advances for students and practitioners. It also enabled major expansion of laboratory research, which enabled, among other things, the discovery of insulin in 1921 and its first successful administration to patients with diabetes — a wildly successful collaboration between the Departments of Physiology and Medicine! This spirit of collaboration — in truly translational and transformational research — that impacts people, is very much alive today.

The People

I often refer to myself as a kid in a candy shop. No matter what you are interested in, you can always find someone else who is working on it and happy to collaborate! I once embarrassed myself by contacting a colleague at Harvard for advice on identifying someone with expertise in phytoestrogens, which I was studying in osteoporosis. He informed me that the world leader in the field was none other than Lillian Thompson, PhD at U of T, in the Department of Nutritional Sciences!

The colleagues we work with here at U of T and in the Department of Medicine are truly remarkable people! According to Larry Robinson, Director of the Division of Physical Medicine & Rehabilitation, and former Vice-Dean at the University of Washington, “This type of expertise and collaborative spirit is not present at many other institutions.” Arno Kumagai, Vice-Chair, Education and former Vice-Dean at U Michigan, reflects, “I am constantly inspired by the critical mass of people who think clearly, creatively and deeply about what it takes to educate physicians and are willing to share their ideas without hesitation, the legions of clinician-teachers and educators whose passion to teach is part of the fabric of their professional identity…”

As a former U of T medical student, PGY-1 resident, Heather Evans, was impressed by the “...mentorship by physicians and scientists with outstanding international reputations,” and by the “strong sense of community,” and outstanding educational experience. Asfandyar Mufti similarly notes that, “…staff physicians and senior residents are enthusiastic and eager to teach.”

We have a pretty unique culture of sharing. It seems frankly ludicrous to outsiders — including members of other clinical departments — that anyone would hand over hard earned income to other members of their division/department to enable the other person to have “protected time” for research, teaching, education, quality improvement, and other forms of scholarship. But we do — collectively, through our practice plans; our members ‘donate’ millions of dollars to advance teaching and scholarship. It is truly amazing and something we should all be very proud of.

Toronto SkylineThe Place - Toronto

Finally, we are set amidst the vibrant and diverse community that is Toronto. Toronto is the third largest city in North America, known for its: world-class food scene; unique neighbourhoods; the Toronto International Film Festival (TIFF); Drake and the Toronto Raptors; the Toronto Blue Jays; and innovation and discovery along with the celebration of cultural diversity.

Roughly half of Toronto’s residents were born overseas. This was an important factor in Asfandyar’s choice of residency programs, stating that, “…training in Toronto allows for a unique opportunity to assess and provide care to a diverse group of patients with varying backgrounds. This feature trains clinicians who are well-suited to serve Canada’s diverse and rapidly growing population.” 
Toronto is also an excellent place to balance the stresses of academic medicine with outdoor activity. This is a great city for walking, running and biking, with oodles of tasty restaurants and cafes to ‘refuel’ along the way. Suggestions for walking and riding routes abound. I have personally done all the City of Toronto ‘Discovery Walks’. If you’re a history buff, you may prefer a self-guided tour of Toronto’s history or neighbourhoods or guided walks run by Heritage Toronto Tours. And, if you haven’t already discovered this, Toronto has a “hidden world of ravines” that are there for your pleasure (see City of Toronto Parks). As Heather Evans notes, for many of us Torontonians biking the Don Valley and waterfront trails are among our greatest pleasures.  

So, as you embark on this 2017-18 academic year, take some time — find the time — to look around you; sample what the University and the city have to offer. After all, this is probably why you chose Toronto.

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City, Creativity & Collaboration: Why Three Faculty Members Chose U of T