Table of Contents

Executive Summary 1

The Changing Planning Environment 4

Accomplishments and Challenges 5

Integration: Making Integration Work: City-Wide Recruitment 7

Strategic Priorities Revised 10

Research 11

Education 12

Quality 13

Faculty 14

Funding & Infrastructure 15

Revised Short Term Goals 16

Looking Beyond Our Planning Horizon 18

Conclusion 19

Appendix 1: Strategic Planning Goals 2005–2010 20

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Executive Summary
It has now been almost three years since the Department completed “Collaborating for Excellence”, the strategic
plan for 2005–2010. At that time we articulated six overarching goals: achieving greater integration; enhancing
research; enriching teaching programs; advancing quality and patient safety; attracting and supporting faculty
members; and developing new sources of support for our academic activities. I am delighted with the
outstanding progress of the Department. We have created a superb Website, implemented City-wide grand
rounds, started Professors’ Day, implemented a Mentoring Program, and created new endowed Chairs. We have
enhanced our support for the Eliot Phillipson Clinician Scientist/Clinician Educator Program allowing us to
train future faculty members. The Department underwent a successful Royal College accreditation and we have
implemented new rotations in the community for our residents. These are but a few examples. We should all
feel proud of the remarkable progress made in this relatively short period of time. Now it is time to reflect on
our strategic plan and modify or re-focus it where necessary.

During the last three years both the internal and external environments have changed, new opportunities have
appeared and new challenges have surfaced. In October 2007, the Department held a one-day planning retreat
with 90 faculty members and external stakeholders. The goal of the retreat was to assess our progress to date in
our strategic goals set out in 2005 and, in light of changes in the environment, to revisit and update those goals
(Appendix 1). In addition, the retreat was designed to allow division heads to share successful strategies in their
divisions so that these approaches could be disseminated across the Department.

Dean Catharine Whiteside and Jeff Lozon, CEO at St. Michael’s Hospital, set the stage by describing some of
the important changes in the environment and discussing their views of opportunities for the Department. One
theme highlighted was the opportunity for enhanced collaboration across the Toronto Academic Health Science
Network (TAHSN) supported by a cohesive voice on the local, provincial and national stage. For example,
TASHN can advocate federally for enhanced support for CIHR or provincially for scientist career support. The
emergence of the LHINs will also facilitate city-wide approaches to clinical care. Jeff Lozon concluded “our
collective strength is in our individual best interest”– a theme consistent with our Department’s approach.

The main foci of the retreat was city-wide recruitment. Many of the Department Division Directors (DDD)
had identified challenges in recruitment; their goal is to make our Department successful in attracting the best
faculty members to Toronto. We defined the principles that should guide recruitment: excellence of the
candidates; alignment with strategic priorities of the division, hospitals, research institutes and DOM; clarity of
job descriptions and the process for the candidate; fairness; and professionalism. We have identified specific
actions to put this into practice. Overall, our collective view is that coordination of recruitment in a city-wide
process will allow us to compete for the best faculty members and meet the strategic goals of our stakeholders.

We all agreed that joint recruitment between the hospitals and common credentialing are important to our
future. While we have focused on recruitment, the DOM recognizes the need to ensure retention of excellent
existing faculty. This can be done through efforts to demonstrate that our faculty are valued and to provide
support for rejuvenation and revitalization throughout their careers.

Overall the retreat confirmed our commitment to the original goals articulated in our strategic plan
“Collaborating for Excellence 2005-2010”. We are on the right track. Through the process of reflection, we
have modified our goals or added new ones in each of our core themes.
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This report serves as a supplement to our original document which still describes accurately the Department of
Medicine goals and strategic priorities. Effectively communicating our progress to faculty, students and staff, as
well as our partners and alumni, is a very important piece of the strategic planning process and we will
endeavour to improve our communication strategies to augment the Website, city-wide rounds and Department
newsletter, Medinews.

I am personally very proud of the progress we have made in the DOM over the last three years and I am excited
about our plans for the future. We have benefited significantly from expert guidance from our external
consultant, Helena Axler, throughout the planning cycle. Our keynote speakers are our partners; their
contributions inform us, promote engagement and enhance communication and collaboration. I would also like
to recognize the tremendous efforts of the Strategic Planning Management Team, particularly Charlie Chan,
Kevin Imrie, Conrad Liles and Laurie Morrison, and members of their respective workgroups, who continue to
work diligently advocating and promoting our planning goals while methodically overseeing their
implementation through short-term and long-term planning phases. I am confident that the goals detailed in our
strategic planning document, Collaborating for Excellence 2005-2010, together with the revised and new goals
emerging from this process, will be accomplished under their stewardship.

Wendy Levinson, Chair, Department of Medicine

Sir John and Lady Eaton Professor and Chair of Medicine

Vision Mission Values

International leadership in
health research, education and application and
patient care.
Through the discovery,
communication of knowledge
we prepare future physician
leaders, contribute to our
communities and improve the
health of individuals and
populations locally and
globally
• Innovation, critical
inquiry and self-
evaluation;
• Respect for diversity in
culture and perspectives;
• Partnership and
collaboration;
• A supportive and
collegial environment;
• Accountability to our
community of scholars
and to the public.
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Immediate Priorities: Core Themes

Integration

• Implement our brand identity

• Develop a coordinated city-wide recruitment strategy
• Develop generic recruitment template to engage stakeholders and partners in strategic recruitment

Research

• Implement an internal grant review service for junior faculty members

• Review and refine the job description and support for “clinician investigators”
• Promote and assist the development of a “Clinical Research Centre” to support clinical research across the
University of Toronto

Education

• Create a web resource for educators

• Create a budget to support educational scholarship
• Foster opportunities for interactions between educational scholars in the DOM

Quality

• Develop benchmarks of academic productivity

• Formalize administrative leadership for the quality program

Faculty Development

• Evaluate the mentoring program.

• Promote training for mentors
• Create an Office of Faculty Development

Funding and Infrastructure

• Attract two additional Endowed Chairs

• Begin building relationships with DOM alumni

Dedicated administrative support will be assigned to this area to formalize and enhance the staff support required for a
professional and effective recruitment process.
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The Changing Planning Environment

Faculty of Medicine Perspective:
Catharine I. Whiteside, Dean of Medicine

Dean Whiteside provided the context of a changing planning “I don’t think there has
environment. However, first she congratulated the Department on its ever been a time when the
many successes in the past three years in research funding, recruitment, Department has moved
leadership on quality improvement and fundraising. She commended the forward in so many
Department on its commitment to following through on its goals and the
professionalism and leadership which it has demonstrated in driving directions and been so
forward its plan. effective...this in not just
the largest Department in
The Dean shared the Faculty’s new strategic plan and focused on three our Faculty, it is clearly the
key areas: Education, Research and Advocacy. The Faculty has most successful.”
championed, and provided leadership to advance, inter-professional team
care, simulation and distributed medical education. There are still many Dean Catharine Whiteside
challenges in education, including the integration of primary and
community care with specialty care, an increased emphasis on ambulatory care; international and global heath,
public health and health promotion. Health human resources expansion offers both a challenge and exciting
opportunity for the Faculty.

“Aggregate, Innovate and Translate” are the mantra for research in the Faculty. The Faculty’s leadership in
graduate education is its competitive advantage. There is a tremendous opportunity for the clinical Departments
to take leadership of translational and applied human research. Genetic epidemiology is a major focus that is
integrative across the Faculty and a targeted area for national leadership. Facilitating the convergence of human
subject research and commercialization infrastructure across TAHSN are challenges and priorities for the
Faculty. There are opportunities for leadership in public health scholarship and educational scholarship, and
growing needs for academic clinical leaders in international health and health policy. Increasingly, the University
is enhancing its role as broker and facilitator for the aggregation of investigators across disciplines, sites and
sectors.

Advocacy is a key aspect of the Faculty’s strategic plan. This includes advocacy for increased salary support for
investigators; increased funding at the CIHR level to balance operating funds with infrastructure and salary
support and realistic indirect costs and federal and provincial grants. The Faculty has aligned with the Council
of Academic Hospitals of Ontario to promote increased funding from all levels of government.

In closing, the Dean noted that the future includes the alignment of education and research with clinical
programs and greater integration and collaboration – key themes that have underpinned the Department’s
strategic plan, Collaborating for Excellence.
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Academic Health Science Centre Perspective:

Jeff Lozon, President & CEO, St Michael’s Hospital
In providing his perspectives of changes in the external environment, Jeff Lozon provided an overview of the
changing academic health science centre environment over the past 10 years, the impact of a Local Integrated
Health Network (LHIN) oriented environment and shared some key provincial and national trends.

Academic health centres have shifted from primarily independent, highly competitive actors to a more
networked and collaborative group. The Toronto Academic Health Science Network (TAHSN) provides a
mature vehicle for collaborative planning and a cohesive voice on the local, provincial and national stage.
Hospitals have made extensive investments in the academic enterprise at all levels and, in addition to their own
research institutes, several have educational centres and institutes within their walls.

Through the LHIN, the provincial government is now intensely invested in a local integrated services plan.
Toronto Central LHIN has a mandate beyond TAHSN. It is not yet clear how the LHINs will evolve at this
juncture, but they are community-oriented, a perspective that is reflected in their Boards, their focus and their
areas of priority. Academia has been identified as a priority of the Toronto Central LHIN but its commitment
and understanding of the interrelationship between teaching, research and patient care is still to be seen.

Mr. Lozon noted increasing competition from traditional and emerging sources across Canada and beyond. He
added that research initiatives are beginning to gel but face real constraints. A big challenge for Toronto is to
compete on a national level; TAHSN’s highly distributed organization makes this more challenging that in
other academic centres across the country. However, he concluded, “our collective strength is in our individual
best interest” and that we need to continue to pursue and support collaboration.

Accomplishments and Challenges

Dr. Levinson introduced the future planning for the Department by “If we can envision big
reflecting on the achievements of the first three years of the strategic plan, opportunities, go after and
as well as the challenges and opportunities facing the Department in the win them by working
years ahead. She noted the 2005 plan was ambitious, challenged by an together, it will set the
overarching goal to collaborate across a diffuse, multiple partner stage for enhanced
Department and academic health centre. Despite the challenges, much has
collaboration”.
been accomplished and she provided a brief update on the progress
against goals in the six areas of strategic priority.
Dr. Wendy Levinson
Integration: City-wide grand rounds have been introduced and there is
now a functional website allowing faculty and resident communication. Starting efforts have been made in
collaborative recruitment. A key priority, and indeed a major theme of this retreat, is to develop new ways to be
more effective and more competitive in attracting excellent people to Toronto. Integration and collaboration
remains a key priority for the Department; it’s success in this area will position the DOM strategically for
success in the five other priority areas discussed below.

Research: Our goal was to enhance the productivity and impact of our research. Annual research funding has
increased from $72 million to $105 million in just four years.
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Working together to attract matching funds, we have raised our endowment significantly to support the
clinician scientist and clinician educator programs, which secure a strong pipeline to our future. Short term
challenges include securing stable salary support for clinician-scientists, which requires joint advocacy and
support from TAHSN and the University. A longer term challenge is to achieve collaborative research across
our affiliated institutions.

Education: This has been an area of great accomplishments culminating in a successful accreditation earlier in
the year. The Department has taught, championed and evaluated CanMEDS roles and provided leadership in
the FOM in some of these efforts. DOM has developed a unified, common curriculum across all hospitals in
education for our core trainees and the POWER system has helped us evaluate much more effectively across the
entire educational endeavour. DOM has extended into the community to meet the needs for distributed
education, building new relationships with our community affiliated partners. Notwithstanding the many
successes, there are still educational challenges for the Department. A key challenge for the future is to enhance
educational scholarship. Today, and in the months ahead, we must question: how can we really push forward
and find leading edge ways to educate internists of the future? As a starting point, DOM has appointed a
Director of Educational Scholarship and is in the process of recruiting a PhD Educational Researcher to focus
greater attention on this important area.

Quality: The Quality agenda was in its embryonic stages when it was identified as an opportunity and a strategic
priority for DOM in 2005. We should all be proud of our accomplishments in this area. The Quality & Patient
Safety Program, developed by the Department, with support from the CEOs of our affiliated institutions, has
resulted in a very robust group of young and mid-career faculty working on quality improvement across the city,
developing benchmarks and sharing experiences. The University plans to develop a Centre for Patient Safety
Centre in collaboration with the TAHSN hospitals and there is opportunity for the Department to play a key
leadership role in this new effort.

While there has been significant progress in the Quality domain, there are still major challenges to address.
There are big gaps in what we know and what we do in the hospitals and clinics. As leaders in the Department
and in the hospitals, it is our responsibility to close that gap by looking at new and rigorous ways to study what
we do and how we do it to move the fields of quality improvement and patient safety forward. To provide
greater incentive for our faculty to pursue academic careers in this area, we must work on the promotion process
to recognize and help advance the careers of people who invest their time in quality and patient safety.

Faculty: This strategic priority area includes recruitment as well as retaining, nurturing and supporting faculty.
Concerted efforts have been made to recognize and reward people, including the Professor’s Days, the
Mentoring Program, Mentoring Awards and the Women Faculty Program, (designed to nurture the
development of women faculty). Under this strategic priority the DOM has led the web-based CV initiative to
facilitate building dossiers and preparing for the promotions process. Given that faculty is the Department’s
most precious resource, we will continue to focus our efforts on enhancing faculty satisfaction and retention.
Our challenge is to enhance our strategies for effective recruitment and this is the focus of our future work.

Funding and Infrastructure: Tremendous work has been done to reinforce our funding and infrastructure base.
There is greater clarity about how the Department uses its financial resources. We have raised six endowed
chairs and have enhanced the Clinician-Scientist Fund through a creative matching opportunity with the
University. However, demands on our resources are great – as are our ambitions.
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We must build on our own resources while continuing to seek new revenues to enhance what we can offer,
especially with respect to clinician-scientist support. A short term priority, and one that received attention at the
retreat, was to agree on shared principles amongst the practice plans so that we can achieve equitable and secure
support for all of our faculty.

Dr. Levinson concluded her report by applauding the faculty for their contributions in driving forward the
2005 strategic plan. She acknowledged the tremendous progress in each of the strategic priorities, but also
challenged the Department to tackle the outstanding issues and seize new opportunities which would maximize
the impact and success of the Department and its faculty.

Integration: Making Integration Work –

City-Wide Recruitment
Bringing the best people to Toronto was one of the key themes of the Keep the bar high, but if
planning retreat. In a survey which informed the planning retreat, someone great comes
Physicians-in-Chief and Department Divisions Directors specifically
highlighted the need for a city-wide recruitment process that would bring
along we need to grab
together the four key stakeholders – University Department, Department them – but (the recruit)
Divisions, Hospitals and Research Institutes, to establish an integrated can’t just be smart; has to
recruitment strategy in which all players would participate. play well with others”
In the current situation, often recruitment is done independently by any Retreat Participant
one of the four players, with little reference to the possible synergies with
other Departments, divisions and TAHSN institutions. There is a growing belief that an integrated approach to
recruitment would significantly increase the ability to attract the very best people to Toronto, and could be
streamlined to accelerate the recruitment process.

The recruitment session was informed by a panel presentation with Dr. Bob Hyland, Physician-in-Chief, St.
Michael’s Hospital, (SMH), Drs. Chris Paige and Art Slutsky, VP Research UHN and SMH respectively, and
Jeff Lozon, CEO, SMH. Drs. Hyland and Slutsky shared lessons learned from the recruitment strategies at
SMH which allowed them to bring in 80 new recruits in 8 years. Key success factors included: Strong
partnerships between the Hospital Department/Division, the Program, the Research Institute and Foundation
as well as the University Department. In all cases, the recruit must be discussed and endorsed by the University
Divisional Executive Committee before the Physician-in-Chief will get actively involved in the recruitment
process.

Drs. Charlie Chan and Conrad Liles provided stories of successful and unsuccessful recruitments to illustrate the
challenges and complexity of recruiting in Toronto.

Dr. Liles used multiple offer letters as a means of showcasing the lack of clarity around reporting relationships,
the confusing university-hospital-research institute relationship; and loyalty/identity conflicts. Roundtable
discussion followed the panel presentation with a dialogue around the principles which should guide
recruitment and retention, these included:
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Principles for Recruitment

Excellence

• Get the best people to Toronto

Alignment

• Strategic plans; tied to broader vision

• Programmatic fit with division, institution, research foundation, DOM/U of T
• Resource planning- financial resources; space collaborations; incomes; reconciled with programmatic
concerns and resources available
• Supportive environment that is ready and receptive to the new recruit

Clarity

• To the candidate – of the process

• Clear job descriptions and expectations aligned with the career goals of new recruits
• Efficiency of the recruitment – reduce complexity

Fairness

• Transparency (e.g. in reporting hierarchy, partnership matrix and funding sources and levels)
• Best interest of the recruit
• Long-term commitment philosophy
• Financially appropriate on a national level
• Same considerations for Clinical Educators & Teachers as for Clinical Investigators & Researchers
• Consistent with business model for the division

Professionalism

• Adopt approaches of successful businesses

• Collaboration
• Communication: honest and courageous between stakeholders

Retention can be guided by many of the same principles, with a view to refreshing and revitalizing staff at
various points in their career
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Mechanisms & Processes to Advance Recruitment Principles

Simplify and Clarify the Recruitment Process
• Unify and simplify the recruitment process
• Empower the DDD; discuss potential recruits at the Divisional Executive and put process in place for
recruitment and/or career development of potential new recruits
• Establish agreement between expectations at the University, Hospital, program levels; avoid multiple reviews
• Bring together all of the stakeholders or partners in one room to go over the potential recruit
background/CV to make decisions around the recruit
• Appoint a single leader/spokesperson for each recruit
• Strive for equity and security across practice plan; ensure that new recruits understand the details of the
practice plan and hospital arrangements
• Simplify offers and appointments: consolidate details of offer and multiple appointments into one letter with
standardized components
• Strengthen the identity of University of Toronto/DOM in the recruitment process

Provide a Supportive and Mentoring Environment

• Mentor residents and fellows for career choice that will fit the divisions/programs
• Develop entry/exit strategies that value the “professional” and the “personal”
• Demonstrate that recruits will be valued and supported
• Need to avoid unexpected, unpleasant surprises at 3-year review or promotion time
• Outline the process for junior faculty to promotion, e.g. start up, to grants to mid-career, outline what are the
steps and deliverables; what are the sources of salary support, who can help?

Be Strategic – and, if you must be opportunistic, be “enlightened” in your opportunistic recruitment

• Be proactive and forward looking
• Identify the research needs of the future and recruit there
• Pay more attention to societal issues on recruitment (chronic care, ambulatory care, multicultural care, etc.)
• Use programmatic approaches as challenges to recruit; encourage cross appointments
• Support cross-division and cross-hospital appointments; consider logistics of cross appointments beyond
dollars
• Establish an effective communication strategy to support recruitment
• Support with fundraising for endowment/chairs

Pay attention to retention

• Re-examine principles of clarity, alignment and fairness every three to five years
• Advance recognition and rewards
• Provide bridge funding for junior faculty, mid-career scientists as appropriate
• Establish chairs, endowments
• Provide support for rejuvenation and revitalization at various stages in faculty’s career
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Recommendations for a City-wide Recruitment Process

• All recruitment requests should first be presented to the Divisional Executive to achieve a cooperative, non-
competitive, approach and approval.

• Once the recruitment proposal is endorsed, and potential key stakeholders have been identified and
engaged, a “leader” will be nominated to facilitate frank and open communications between all
stakeholders. In addition to functioning as the central point of contact for potential candidates, this
individual will act as chief negotiator and broker between stakeholders and be the signatory for the letter of
offer.

• A generic recruitment template will be developed to ensure clarity, transparency, appropriate alignment of
resources and expedient decision-making. The template will require stakeholders and interested partners to
come together to achieve synergy between planning processes at the Divisions, Hospitals and Research
Institutes and to enable an appropriate match of resources to the best interests of candidates.

• A key piece of the template will be a letter of offer with standardized components that makes explicit who
is in charge of the recruit’s academic progress, salary arrangements and research funds.

• Dedicated administrative support will be assigned to this area to formalize and enhance the staff support
required for a professional and effective recruitment process.

“To compete for top recruits, the process must be

comprehensive and inclusive; but you must also respect and
adapt to the need for rigor and nimbleness.”
“Recruitment is both buying and selling... reputation and
collaborations are important in recruiting for academic
excellence.”
Colleen Keenan, Janet Wright & Associates

Strategic Priorities Revised – Core Themes

Implementation theme leaders led breakout group sessions to update goals and to tackle specific issues and
opportunities which could benefit from the collective wisdom of faculty. In the section which follows, theme
leaders provide a brief update of progress against goals and new short term goals for their areas which were
agreed upon by participants in the breakout group discussions. Collectively, the achievement of all of these
goals will guide the strategic activity of the Department for the next two years. New goals are presented in
bold typeface.
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Research
The research portfolio has undergone significant leadership change since the original strategic planning goals were
developed. A new Vice Chair, Research has been appointed and a new Department Research Committee has been struck.
In spite of a period of necessary reflection and adjustment, progress has been made against the original goals and in
February 2007, the short term goals were extensively revised. Recruitment and retention are key issues for the research
portfolio and recognition of this is reflected throughout the revised short term goals and immediate priorities.

An optional Internal Grant Review Service is needed to support young investigators (those at the Assistant Professor level
within the first five years of appointment). This functional service will be designed to improve grants for those individuals
who want to have their work reviewed while avoiding the pitfall of placing too onerous a task on senior faculty. The
service will be administered via DDD offices. To allow sufficient review time grants will be submitted six weeks in
advance. Grants that would be eligible are those over $50,000 per year. Two reviewers per grant are recommended and
reviewers should be selected by the PI and DDD in consultation with each other. It may be possible to link this review to
consideration of bridge or seed funding in the future.

Career support for junior and senior investigators is having an adverse impact on the retention of Clinician-Scientists.
Many of the career support awards from the CIHR have evaporated and no career awards are routinely available from
CIHR beyond the level of young investigator. Alternative strategies, including advancement activity to secure Endowed
Research Chairs, will be aggressively pursued. A high priority is the re-definition of the job description of the Clinician-
Investigator. Being neither a Clinician-Educator nor a Clinician-Scientist, these individuals are not eligible for many career
support awards. There is an urgent need to define, consider career support mechanisms and set concrete goals,
expectations and milestones for these individuals so they know exactly what is necessary for their career development and
success.

A longer term priority is the development of a UT Clinical Research Centre to support clinical trials as well as
infrastructure support for large scale population studies. The Centre would facilitate clinical trial development, clinical
trial support in terms of data collection, management and storage as well as the creation of repository systems for clinical
specimens. The Centre will be both physical and virtual with beds that can be staffed to accommodate overnight stay for
patients enrolled in trials. A UT Clinical Research Centre provides a unique advancement opportunity for the Department
and this will be aggressively pursued.

To actively foster mechanisms for city-wide collaboration, we will seek support of extra-Department units as a key way to
achieve this goal. Seminars and workshops can bring like-minded investigators together; from diverse disciplines, divisions
and institutions. Empowering DDDs to serve as facilitators or sources of information to foster collaboration is also a
strategy we will pursue.

–Conrad Liles, Vice Chair, Research

Short term goals to enhance attractiveness, productivity and impact of research
• Develop guidelines for appointment and support of PhDs
• Re-structure the Clinical Sciences Division at MSB
• Facilitate development of new teams of collaborators for submission of innovative Team Grants
• Develop stable funding for Clinician-Scientists
• Develop optional Internal Grant Review Service for Junior Faculty
• Review and re-define the position of Clinician-Investigator
• Advocate, facilitate and develop UT Clinical Research Centre
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Education
We have accomplished a great deal in education over the past two years. Through our strategic planning
process, we identified advancing educational scholarship as a major priority for the next two years and this was
the focus of discussion for the education break-out group at the retreat. We have already begun laying the
foundation for this work. This past year we introduced a position of Director of Educational Scholarship and
currently are in the process of recruiting a PhD Educational Researcher. While involvement in teaching and
program administration is essential for the delivery of education, the work is not of itself inherently scholarly.
The challenge is to turn such work into scholarly activity. We have identified three areas of scholarship:
Scholarship in Teaching, Scholarship in Administration, and Educational Research.

Scholarship in Teaching involves turning what we do day-to-day into work that will impact others. A key
measure of impact of such activities is dissemination, which could include presentations at meetings and posting
material on teaching repositories such as the MedEd portal, a central repository created by the AAMC. This site
allows people to submit and access material centrally thereby facilitating meaningful dissemination. In addition,
through the act of downloading materials, they are required to provide feedback and thereby achieve peer-
review. The DOM will advocate for increased use of this tool, or similar tools, and generally promote
engagement amongst its members.

Scholarship in Administration presents a different challenge. Our programs are constantly innovating,
introducing new curriculum or restructuring to better teach or evaluate; however, these initiatives are often not
planned and conducted in a “scholarly” way. There are several reasons for this including the DOM size and
sheer volume of work administering programs, unfamiliarity with how to search the medical education literature
to identify work that has been done before and the overall lack of comfort with educational research methods.

A small but growing number of individuals in the Department are engaged in a systematic program of enquiry in
education. This path requires advanced training and significant commitments of time as well as engagement and
support from agencies such as the Wilson Centre. Such individuals are critical to advancing scholarship within
our Department and need to be supported. They are an important resource for other educators and need to be
engaged in our evolving community of educators.

Short term goals to enhance educational scholarship include developing a central list of information on funding
opportunities for educational research and increasing the visibility of faculty development opportunities to
further enhance skills, including the Teaching Scholars Program and the Clinician-Educator Program.

To further promote this platform, consideration will be given to amending educational administrator job
descriptions to include a requirement to make the program scholarly; implying dissemination and peer-review.
This would increase the prominence of the individual who is the program administrator, advertise the program
and enhance the image of the Department that supports the program.

A final and essential requirement to advancing scholarship is financial support. This needs to be enhanced in
two ways. Firstly, support for the Educational Development Fund (EDF) needs to be continued and enhanced.
The EDF, run by the Education Deans at the Faculty of Medicine, provides modest funding to support
scholarly projects. These funds need to be matched by the Department. The process of approving applications
at the Departmental level needs to be enhanced to further improve the quality of applications.
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A second important type of funding is stipend support for individuals engaging in the full spectrum of scholarly
work to protect time for them to conduct these activities. A budget will be provided to the Director of
Educational Scholarship for both types of support. Our new short term goals are specifically related to
advancing Educational Scholarship in the Department.

–Kevin Imrie, Vice Chair, Education

Short term goals to transform and enrich teaching programs
• Double resident-months in community
• Double educational scholarship (presentations and publications)
• Partner to develop faculty development to build education capacity in community
• Double stipends for educational roles
• Develop a community of educational scholars in the Department
• Create a web resource for educators
• Create budget to support educational scholarly work

Quality & Patient Safety

The Quality and Patient Safety Program, that has been initiated with seed funding from the Department Chair
and the CEOs of our affiliated partners, has been a great success and has been instrumental in seeding the
quality agenda in our Department. A funding program was established to support University-wide efforts to
improve quality of care. Teams meet on a monthly basis for educational sessions. To take the quality agenda to
the next academic level, it is important to identify champions within each division, create and promote
leadership training programs and nurture academic careers and scholarship in this area. Having successfully
demonstrated that city-wide collaboration is possible in this area, the time is ripe to facilitate the broader
achievement of this strategic priority across the Department and with its TAHSN partners.

Energy, wisdom, and advocacy will need to be invested to develop an academically viable career path to attract
and engage faculty in quality and patient safety. The creation of job descriptions, leadership positions and
promotion pathways will all be pursued as will a quality improvement and patient safety toolkit to disseminate
best practices and guide people to appropriate resources. Quality project presentations by residents, as well as
awards at research day events will continue in order to promote the quality agenda and to support evolving
career paths in this area. There are new opportunities for the Department in this area. The Faculty of Medicine
is planning to establish a Centre for Patient Safety in a model similar to the Centre for Faculty Development at
St. Michael’s Hospital. The Department is posed to take a leadership role in this new Centre. In addition, the
LHINs will provide a platform for collaborative efforts in Quality and Safety and the Ministry of Health is
presently sponsoring educational efforts in this area. Our faculty play a leadership role in the MOH efforts.

–Drs. Chaim Bell and Ed Etchells

Short term goals to advance quality care and develop performance measures in this area
• Continue and grow the Quality & Patient Safety Program
• Formalize administrative leadership for the DOM quality program
• Advocate, facilitate and develop an academically viable career path in quality
• Develop benchmarks of academic productivity
• Develop educational program for residents
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Faculty
Mentorship is the key priority in faculty development. For the past two years we have focused on recognizing
and valuing mentorship through a new awards program. Our priority for the next three years is to formalize the
structure of mentorship and ultimately recognize scholarship in mentorship in and of itself. Good mentorship
must be valued in the same way as good teaching; it must become a requirement to achieve promotion under any
of the three platforms. As a start, a new web-based mentorship program, supported by the WebCV and generic
across all institutions, has been developed to capture the hours and quality of mentorship and co-mentorship
provided at every level.

The program stimulates interactive dialogue between faculty members and their Hospital DDD, University
DDD, mentor and co-mentors through the use of annual activity reports and academic planning documents.
We decided an evaluation form was needed to make the process a bit more rigorous and evaluate the quality of
mentoring. While we acknowledge that evaluation may have mixed reviews by faculty, and will require further
consideration, if mentorship is to be valued and included in the criteria for promotion under all three platforms,
then there must be a way to evaluate it.

A faculty development program, comprising a formal training program and workshop series, is needed to help
DOM faculty understand the mentoring process through a variety of delivery methods and at different stages of
a faculty member’s career. It will provide training for mentors and also teach them how to separate from
mentees when the relationship is not working well. We need a shepherding capacity to inform faculty of
available faculty development resources. The website provides an introduction to Department resources but the
information provided is not sufficient to achieve a comprehensive understanding. A formalized Office of
Faculty Development, with dedicated leadership and administrative support, is required to promote and
advocate for mentorship at local and national levels and to increase visibility of the full range of faculty
development opportunities. The Office of Faculty Development could also provide a gateway to much needed
financial and retirement planning services through liaison with Human Resources Departments at the hospitals
and the University and formal linkage with the Centre for Faculty Development to heighten both the profile
and opportunities for faculty development in a number of areas which are of interest to our faculty.

–Dr. Laurie Morrison

Short term goals to retain, attract and nurture faculty

• Develop tracking & evaluation systems for mentoring
• Develop faculty awards in mentorship
• Develop recognition strategy for emerging leaders
• Improve communication for appointment and 3 year review
• Formalize and evaluate the mentorship program
• Enhance scholarship in mentoring
• Promote training opportunities for mentors
• Create an office of faculty development with dedicated leadership and administrative support
 Page 15

Funding & Infrastructure

During the last three years the DOM finance committee has made major changes to the DOM budget. This has
included clarifying the stipends associated with positions and increasing the stipends for educational leadership
positions. We have made the use of funds transparent to the Executive Committee which includes
representation from each of the hospitals. The budget now has a five year projection and a contingency fund.

In terms of fundraising, the DOM has been successful raising endowed chairs and supporting the Clinician-
Scientist/Clinician Educator fund. Many of these efforts have taken advantage of local opportunities. Now we
need to advance our efforts by articulating major goals and developing partnerships beyond our local ones. To
accomplish this, we will begin to build relationships with DOM alumni and develop strategic, department-wide,
fundraising goals. The potential overlap between Department, Faculty, University and our home-base hospital
foundations, will be addressed by developing overall guiding principles and policies to guide us on where to
channel resources and how to target donors to avoid competition and, hopefully, to find more opportunities to
collaborate with our partners in joint fundraising initiatives.

The practice plans of our fully affiliated hospitals fulfill the newly implemented Clinical Faculty Agreement for
conforming practice plan principles. One of our other major goals relates to harmonization of the practice plans
in an effort to support faculty members in an equitable fashion across the city. Open dialogue between the
practice plans on the Finance Committee facilitates this.

We have the opportunity to share best practices across the practice plans. An analysis is needed to determine
how the different practice plans have performed based on academic support provided over the last 10 years. We
will also need to develop shared principles to guide the different practice plans across the Department.

–Charlie Chan, Vice Chair, Finance

Short term goals to reinforce the funding and infrastructure base

• Adopt the new budget model of the Faculty of Medicine
• Allocate financial support to each division based on strategic plan
• Implement standardized salary support for educator roles
• Attract two additional Endowed Chairs
• Begin building relationships with DOM alumni
• Develop strategic, department-wide, fundraising goals
 Page 16

Revised Short Term Goals

Listed below are the revised short term goals and implementation priorities for 2008. The DOM
Implementation Committee will continue with its oversight responsibility. Designated leads for each area, with
strong support from their committees or faculty throughout the Department, will continue to be responsible for
achieving the goals identified for their respective areas. Attention will also be paid to greater clarity around the
expected outcomes for each goal and establishing effective indicators so that we can measure progress against
these goals.

Strategic Priorities
Revised Short Term Goals Implementation Priorities 2008
2005-2010
1. Achieve greater 1-1 Implement our “brand identity” 1-1 Implement our “brand identity”
integration across the 1-2 Implement the Web CV program in all 1-4 Develop a coordinated city-wide recruitment
Department and beyond hospital sites strategy
traditional disciplinary 1-3 Develop annual report to showcase 1-5 Develop generic recruitment template to
boundaries Division & Department success engage stakeholders and partners in strategic
1-4 Develop a coordinated city-wide recruitment
recruitment strategy
1-5 Develop a generic recruitment template to
engage stakeholders and partners in
strategic recruitment
1-6 Develop a letter of offer with standardized
components
1-7 Create dedicated administrative support
and develop expertise
2. Enhance attractiveness, 2-1 Develop guidelines for appointment and 2-5 Develop optional Internal Grant Review
productivity and impact of support of PhDs service for Junior Faculty
research 2-2 Re-structure the Clinical Sciences Division 2-6 Review and re-define the position of
at MSB Clinician-Investigator
2-3 Facilitate development of new teams of 2-7 Advocate, facilitate and develop UT Clinical
collaborators for submission of innovative Research Centre
Team Grants
2-4 Develop internal bridge-funding solutions
and advocate for intervention at the
Faculty of Medicine
2-5 Develop optional Internal Grant Review
service for Junior Faculty
2-6 Review and re-define the position of
Clinician-Investigator
2-7 Advocate, facilitate and develop UT
Clinical Research Centre
3. Transform and enrich 3-1 Double resident-months in community 3-6 Create a web resource for education
teaching programs 3-2 Double educational scholarship 3-7 Create budget to support educational
3-3 Partner to develop faculty development to scholarly work
build education capacity in community
3-4 Double stipends for educational roles
3-5 Develop community of educational
scholars
3-6 Create a web resource for educators
3-7 Create budget to support educational
scholarly work

Strategic Priorities
2005-2010
4. Advance quality care and
develop performance
measures in this area
5. Retain, attract and
nurture faculty
6. Reinforce the funding
and infrastructure base
Page 17
Revised Short Term Goals Implementation Priorities 2008
4-1 Continue and grow the Quality & 4-2 Formalize administrative leadership for the
Patient Safety Program DOM quality program
4-2 Formalize administrative leadership for 4-3 Develop benchmarks of academic
the DOM quality program productivity
4-3 Develop benchmarks of academic
productivity
4-4 Advocate, facilitate and develop an
academically viable career path in
quality
4-5 Develop educational program for
residents
5-1 Develop tracking & evaluation systems 5-5 Formalize and evaluate the mentorship
for mentoring program
5-2 Develop faculty awards in mentorship 5-7 Promote training opportunities for mentors
5-3 Develop recognition strategy for 5-8 Create an office of faculty development with
emerging leaders dedicated leadership and administrative
5-4 Improve communication for support
appointment and 3 year review
5-5 Formalize and evaluate the mentorship
program
5-6 Enhance scholarship in mentoring
5-7 Promote training opportunities for
mentors
5-8 Create an office of faculty development
with dedicated leadership and
administrative support
6-1 Adopt the new budget model of the 6-4 Attract two additional Endowed Chairs
Faculty of Medicine 6-5 Begin building relationships with DOM
6-2 Allocate financial support to each alumni
division based on strategic plan
6-3 Implement standardized salary support
for educator roles
6-4 Attract two additional Endowed Chairs
6-5 Begin building relationships with DOM
alumni
6-6 Develop strategic, department-wide,
fundraising goals
 Page 18

Looking Beyond Our Planning Horizon

The Department is well on its planning path and the strategic framework “How do we take our
developed in Collaborating for Excellence has served, and should continue to strength, stature and
serve, it well for the next two to three years. However, at the retreat we
challenged a small group of faculty to look “outside the box” and see if there
reputation to make a
were some significant, future-oriented issues that we should be identifying today greater impact on
which may have an impact in five to ten years down the road. The faculty issues of social
answered our question – with more questions! importance?”
How should we provide care in the future? Do we continue to operate as single Retreat Participant
providers to single individuals or should we shift towards a more systematic
approach? Some specialties have started to work in different models of care integrating allied health
professionals, looking at screening access to care and looking at screening in the community to identify early
diseases. Ontario has a chronic disease management strategy for diabetics. Can we learn from that? Should we be
looking at a Department-wide strategy for care of the elderly? How will we address the strong tide of the “silver
tsunami”?

What is our competitive intelligence? Should we develop a niche, a competitive advantage, to make us more
attractive to students and faculty? Should we seek outside advice and look at ourselves from a different lens?

How can we exploit cross-disciplinary opportunities? We train in silos, but science is evolving across disciplines.
What should we be doing to take advantage of these opportunities?

How can we balance deferred retirement with new recruitment? A university-wide issue that is not being
systematically addressed is that of academics continuing to work over 65 years. We have very talented people
over 65 years who continue to enrich our human resource pool, but that in turn limits the financial resource
pool needed to recruit young faculty and promote succession planning. How can we achieve balance?

How can we be more engaged internationally? Toronto is named by UNESCO as an international multi-racial
society and it is important to reflect this in the face of our faculty. The opportunity exists; we have large
numbers of foreign medical graduates and faculty recruited from all over the world but we need to overcome
barriers to integration and take advantage of our international partners, locally and abroad. Increasingly,
universities around the world are forging significant links with other universities and academic Departments
overseas and this is something we too should explore. Should DOM we be establishing targeted international
partnerships?

How do we take our strength, stature and reputation to make a greater impact on issues of social importance?
Should DOM be tackling some of the tougher questions around public vs. private health care, health care
inequities, relationships with Pharma? Should we be holding forums, stimulating debate and coming up with
positions on issues that require open debate and discussion?

These and other important issues will need to be discussed as the Department looks ahead beyond the current
planning time horizon and prepares itself for new issues and opportunities in years to come.
 Page 19

Conclusion
Collaborating for Excellence has provided the Department with an effective framework to achieve its vision and
mission. We are on a purposeful path, having achieved many of our short term goals and making good progress
in each of our six areas of strategic priority. This mid-course planning retreat has enabled us to pause and reflect
on our achievements and to fine tune our broader goals, with new short term goals that will provide sharper
focus for the next two to three years.

Collaborating for Solutions has demonstrated the strong commitment of our faculty, TAHSN hospital partners
and other key stakeholders to work collectively and collaboratively to achieve our vision of “international
leadership in health research, education and patient care”.

Strategic Planning Management Team

Charlie Chan, Funding & Infrastructure
Shannon Coull, Advancement
Allison Hardisty, Strategic Planning
Kevin Imrie, Education
Conrad Liles, Research
Laurie Morrison, Faculty
Maureen Todd, Business & Administration

Keynote Speakers
Catharine I. Whiteside
Dean, Faculty of Medicine
The Changing Planning Environment-
University of Toronto/Faculty of Medicine Perspective

Jeff Lozon
President & CEO, St Michael’s Hospital
The Changing Planning Environment
- Academic Health Science Perspective
& Making Integration Work – City-Wide Recruitment

Bob Hyland
Physician in Chief, St Michael’s Hospital
Making Integration Work – City-Wide Recruitment

Chris Paige
Vice President, Research, University Health Network
Making Integration Work – City-Wide Recruitment

Art Slutsky
Vice President, St Michael’s Research Institute
Making Integration Work – City-Wide Recruitment

Appendix I
Strategic Priorities 2005–2010
1. Achieve greater integration across the
Department and beyond traditional
disciplinary boundaries
2 . Enhance attractiveness, productivity
and impact of research
3. Transform and enrich teaching
programs
4. Advance quality care and develop
performance measures in this area
5. Retain, attract and nurture faculty
6. Reinforce the funding and
infrastructure base
Page 20
Five Year Goals
1-1 Facilitate greater collaboration across divisions, Departments
and among affiliated hospitals.
1-2 Promote and support integration of information technology
and health information management systems across affiliated
hospitals
1-3 Achieve equitable and secure payments for all faculty members
across all divisions and hospitals.
1-4 Promote and enhance the profile of a unified Department
2-1 Enhance partnerships and interdisciplinary opportunities with
hospital-based Research Institutes and other University of
Toronto Departments
2-2 Increase research funding and infrastructure support for
scientists and a high impact research agenda
2-3 Promote, support and expand the Clinician Scientist program
2-4 Support translational research as a research priority of the
Department
3-1 Strengthen partnerships with and among fully affiliated
teaching hospitals to collaborate for excellence
3-2 Formalize relationships with network of community hospitals
to enhance teaching experience and placements
3-3 Increase exposure to ambulatory medicine
3-4 Operationalize CanMEDS attributes for all levels of training
3-5 Leverage new teaching modalities and technologies
3-6 Promote faculty development and educational scholarship
3-7 Enhance benchmarking and performance measurement in
education.
4-1 Champion the "quality agenda" within the Department and
promote leadership in this endeavour
4-2 Explore opportunities to collaborate with affiliated hospitals on
quality
4-3 Develop internal expertise for performance measures (including
benchmarking and health informatics)
4-4 Ensure the "quality agenda" is central to clinical training
4-5 Innovate, test and assess new models of clinical care and new
technologies
5-1 Recognize and reward the contributions of all faculty
5-2 Strengthen mentorship and career path development for all
faculty at various stages of their career
5-3 Intensify efforts for strategic recruitment of top calibre faculty
6-1 Develop and implement a diverse set of strategies to stabilize
and grow the Department's resource base
6-2 Identify and pursue local and global partnerships that will
facilitate achievement of the Department strategic agenda
6-3 Establish a dialogue and develop guidelines for managing ethical
issues with industry and government partnerships
Page 21