Five Years in Review

Richard Reznick

A few months ago I had a conversation with our Dean, Catharine Whiteside. She wanted to know whether I was prepared to seek a second term as Chair of this great Department. It is hard to believe that it has been five years on the job. These last five years have been an incredible odyssey. If you had asked me five years ago would I have been able to predict some of the seminal events of my time as Chair, the answer would have been no.

So many challenges and so many things to be proud of! To paraphrase Collins, the success of any organization is all about getting the right people on the bus. In our case, there are about 10 buses! Our faculty consisting of clinicians and scientists is strong and getting stronger each year. We currently have approximately 220 full time clinicians, 30 part time clinicians, 55 adjunct faculty, and 25 research scientists. In the last five years you have seen your Department grow through the recruitment of 50 new surgeons and scientists. We have recently instituted a policy that will see all new recruits to our surgical faculty as the successful candidate in a formal search process. We have entered into 31 practice plans. Our postgraduate programs have increased in size and now there are 11 residencies which train in excess of 200 future surgeons in any given year. We have operationalized a plan for our fellowships which now train over 175 surgeons from 15 countries. We have extended benefits to our surgeons in terms of family health coverage, day care and critical illness insurance. We have in excess of 45 million dollars of external funding, surpassing the aggressive benchmarks we set for ourselves in our last strategic plan. We have doubled the size of our skills lab, developed a new innovative curriculum for our medical students, and more vitally engaged our partially affiliated teaching hospitals in our Department. We are about to embark in a proof of principle study to model and test an innovative postgraduate curriculum. So when Dean Whiteside asked if I would consider seeking another five years, I quickly responded,"Are you kidding, I have the best job in the world!"

Last year I announced the inception of two new programs in the Department, one offering day care for our faculty and another offering benefits to those who don't have them through other sources. I am pleased to report that both programs are off the ground, and many faculty have availed themselves of these benefits. We are now expanding the Day Care Program to include a new facility closer to faculty who work at Sunnybrook.

This past year we have introduced a new benefit to all full time faculty under age 57. Hopefully no one will have to use it, but in the event that a faculty member develops one of 22 critical illnesses, he or she will receive a lump sum benefit of $60,000.

With the introduction of the new clinical faculty policy we have worked hard at insuring that all 31 of our practice plans are consistent with one of our three departmental templates. I am pleased to report that this past year has seen the first wave of accountability reports which encouragingly show a transformation from previous financial management to one that is better structured to reward academic efforts. This two-and-one-half-year challenge has proven extremely important. We are about to be the beneficiaries of additional AFP monies, 30% of which are earmarked towards teaching and research. It is your Chair's position that the academic AFP monies become part of the re-distribution pool that is modulated through annual academic performance appraisal. This recommendation has been discussed at our finance and senior executive committees and will now be brought to our 31 groups in the form of a business summit to be held this fall.

What I remember most of the last five years is the hundreds of hours of speaking with our faculty, often just catching up with business, frequently giving solicited or unsolicited advice, and occasionally peering deep into the meaning of academic life. I remember well, early in my chairmanship, meeting with an older surgeon who I did not know well. His involvement in our academic world had been somewhat peripheral. It was a humbling moment for me when this surgeon became overtly sad, and with cracking voice, told me he wished he could have relived part of his life. He felt he could have accomplished so much more. I reassured him of the value and his accomplishments of looking after thousands of patients, but there was no consolation in my inept words, no comfort in my reassurance of the meaningfulness of his work. He honestly felt he had failed in his personal mission.

I remember, as we all do, the magnitude of SARS as it rocked our city, paralyzed our medical world, and reminded us of the inadequacy of our medical knowledge. Humbling moments!

What has also been striking over the last five years is the sheer volume of work. D.R. Wilson, Bernie Langer and John Wedge warned me of the marathon that typifies a Chair's term. Well, they were right, but I would suggest that the analogy is more aptly characterized by a tsunami. Just when one finishes with one wave of work, a second and even bigger wave hits.

However, the image that has been most powerful is the incredible talent of our Department. The surgical expertise is astounding. Images of Mark Cattral performing a liver transplant, David Rowed removing a brain tumour, Vern Campbell resecting an aneurysm, Mark Peterson doing his first endovascular repair, Joan Lipa restoring form and function after cancer, Jack Langer leading a team separating conjoint twins, Yaron Shargall doing a MIS lobectomy, Jeff Gollish replacing a knee...these are the enduring images.

Finally, in reflection of our academic mission I am staggered by our faculty's dedication to teaching, their devotion to research and their strong desire to embrace the academic ideal. Indeed, as I look over the last five years we have had tremendous growth in our peer reviewed funding and in a sparkling jewel of our Department -- our Surgeon Scientist Program. In fact, this past year we expanded this program to embrace a more eclectic approach to scholarship, and in so doing have created a new program called Scholarship in Surgery. As an inaugural experience, we have three surgical trainees actively pursuing their MBA, gaining skills they will hopefully bring back to the Department.

Over the last five years I have traveled often and widely. This aspect has been a wonderful part of the job as I have the privilege of representing the Department as well as visiting and learning from others. I can honestly report that I come back from virtually every trip confident and energized. Energized to carry on our course and follow our strategic plan. Confident that we have so much to be proud of, that University of Toronto Surgery stands amongst the best Departments in the world.

On a personal note, I would like to thank all in our Department for their support in my term as Chair. I have received nothing but encouragement from you and nothing but support for new initiatives. I have certainly worked harder than ever before, but each moment has been filled with important challenges and most importantly a deep respect I have learned for the caliber of individuals in this Department.

Richard K. Reznick
R.S. McLaughlin Professor and Chair