Work underway for new UPEI medical school as top health official raises concerns

With less than two years before the University of Prince Edward Island's Faculty of Medicine is set to open, officials say progress is being made to get school up and running — but the head of Health PEI concedes the timeline is ambitious and significant roadblocks remain.

The co-degree program — a partnership with Memorial University in Newfoundland and Labrador — was announced earlier this fall, alongside an expansion of UPEI's nursing program and health centre.

UPEI president and vice-chancellor Alaa Abd-El-Aziz said without the partnership with MUN, the timelines would be different. But currently, the plan is to welcome the first cohort of Island students in September 2023.

"If we needed to do the work alone, it probably would have taken us about five years," said Abd-El-Aziz.

"But working with Memorial, that will allow us to be able to provide a quality degree, and get the approval from the accrediting body, hopefully within two years."

The two universities have a long to-do list, with everything from facilities to faculty to establish.

Abd-El-Aziz said a request for proposals for the building that will house the faculty of medicine — as well as the expanded nursing program, the doctor of psychology program, and UPEI's health clinic, which will serve as a teaching site — has already closed.

In the meantime, multiple working groups are being established, according to Dr. Margaret Steele, dean of the faculty of medicine at Memorial University.

Steele said one is an accreditation group, which will advance the process of accreditation for the new co-degree, in which the two universities are developing a joint doctor of medicine degree.

It should take about 18 months through the Committee on Accreditation of Canadian Medical Schools, she said.

There's also a community engagement group that will work with hospitals, local physicians, towns and municipalities, regulatory bodies and the medical society. Community engagement should get underway early in 2022.

As well, there will be a working group to look at admissions requirements, and one to focus on faculty development, taking what is currently taught at Memorial and adapting it for the program at UPEI.

The new faculty aims to provide seats for 20 Island residents annually, including at least one seat for an Indigenous student.

But as MUN and UPEI work to get academic and administrative details in place, questions remain about how to avoid adding pressure to an already strained Island health-care system.

Steele said such concerns are normal.

"I think with every new school, there's always concern in the environment about how are the physicians going to manage, how are they going to integrate it?" said Steele.

"But I think that we would work with [physicians] and look at different techniques and things they can do to have the students in their practices."

'Extraordinary amount of work'

Health PEI CEO Dr. Michael Gardam concedes there are many details that still need to be worked out.

He said it's not yet clear what is required from the Island's health-care system to support the new program, and how long it will take to get those supports in place.

"I have always been very vocal about saying I support the notion of a medical school here because I can see the end result. I've worked in the end result my whole career, and it's lovely," said Gardam.

"But in between that end result and today, there is an extraordinary amount of work that needs to happen."

Gardam said work is underway to identify individuals and groups who need to be consulted and to organize meetings to determine next steps.

But he said even ahead of consultations with stakeholders in the medical community, it's clear more doctors, with an interest in academia, will need to be recruited.

He said additional infrastructure will be required, in multiple locations, to facilitate on-site learning in clinics and hospitals.

And he said administration needs to be established, to follow medical students through each step of training and evaluation.

"I think it's going to be a stretch," said Gardam.

"We are nowhere near that today, and so a lot of that has to be created. And I will say that the timeline to start taking students just two years from now is, in my mind, very ambitious in terms of us being able to pull all of this together."

Gardam said despite his support for a medical school on the Island, the required work will be happening in tandem with efforts to revamp various Health PEI operations, including work to fill health-care vacancies Island-wide, and retain the current cohort of health-care professionals — and that's stressful.

"There's no magic wand here to simply make this all suddenly connect together," said Gardam.

"There's 100 pots on the stove at once right now, and there's a lot of change, more change than I've ever seen in my career, happening all at once. And that's gotten people, I think, on edge to some degree."

Recruitment will be key

He added that people in the medical field are "already feeling all that pressure."

"You can imagine that they're not as welcoming as they might be if they were in a more stable system," he said.

Officials with UPEI, the Department of Health and Wellness, and Health PEI have confirmed no formal feasibility study was conducted in relation to establishing a medical school in the province.

In a statement to CBC News, officials with UPEI said a tremendous amount of research and consultation was done ahead of submitting a proposal to the provincial government for funding to help establish the faculty.

Gardam said steady and successful recruitment will be key, but accommodating a medical school is complex.

He said there are doctors currently within the Island health-care system who have come from larger centres and would be interested in being a preceptor and teaching. But if they divert 30 per cent of their time to educating medical students, that's less time for their patients.

"So if they're going to get into an academic stream, who's filling in behind? These are not minor roadblocks, these are very significant roadblocks," said Gardam.

Residency seats also a concern

He said in addition to establishing what's needed to support a faculty of medicine — work needs to happen now to make sure there are opportunities for those medical school graduates to complete their residency on the Island.

P.E.I. currently only has five residency seats.

Gardam said those seats alone aren't adequately funded, and that also needs to change.

UPEI and MUN would like to see the number of residents on P.E.I. increase to 20 over the next eight years. But residency seats are carefully regulated within Canada — so adding to what is already in place won't be quick, or easy, said Gardam.

"I do believe these are things that we can work on," he said.

"And I still am confident that we can get to the point we need to get to. I question whether we can do that within two years, and I know when I speak to doctors here, that is one of the biggest stumbling blocks they have."

President already hearing interest from doctors

Steele — who is also chair-elect of the Association of Faculties of Medicine of Canada — said nationally, there's excitement about a new faculty of medicine at UPEI, particularly for its unique co-degree model, said to be a first of its kind in Canada.

She believes that will help with recruitment.

Steele noted there are more than 40 physicians in P.E.I. who teach Island students from Memorial.

"And so we already have people on the ground who are interested and invested in teaching students," said Steele.

Abd-El-Aziz said since the announcement of the university's plans for a medical school, he's already started to hear from physicians interested in relocating to the Island to practice and teach.

"For a number of years, we have attracted outstanding people for the doctor of psychology program, and the veterinary medicine program. I see it going the same way," he said.

"We will be able to excite and attract doctors to come here, to work with us in building this medical school and becoming part of our medical system. And I think it is not going to be difficult at all. Actually, I have received about four or five resumes already without putting any ads out."

Abd-El-Aziz said he believes that in the end, by graduating Island medical students, they hope to better support health-care on the Island, and Island-led medical research, too.

"When you build anything new, of course, there will be lots of pressure, and we know that," he said.

$129M in provincial funding

Universities wishing to establish a new program are required to submit a proposal to the Maritime Provinces Higher Education Commission.

Officials with that group told CBC News that in order for a program to launch in the fall of 2023, they'd want to see that proposal by January of that year same year, at the latest.

According to UPEI, work on the proposal is underway, and the plan is to submit it next fall.

An estimated $129 million dollars in provincial funds, over the first six years, was announced in relation to the project in October.

That includes $50.7 million for infrastructure, $66 million for operating the new faculty of medicine, nearly $6 million for operation of the expanded faculty of nursing, and $6.5 million for the health and wellness centre.