Divisional Reviews 2019

In 2019 the Divisions within the Department of Obstetrics & Gynaecology undertook individual Divisional Reviews. This was done as a pre-amble to the Department-wide review that is to be conducted in early 2020.

Dr Christian Becker from the University of Oxford was invited to review the Division of Gynaecologic Specialties.

WHAT IS GOING WELL WITH THE DIVISION?

The goal of the Division was to bring clinical academics of different backgrounds and interests together to foster collaboration, improving the scientific output and to create a social presence within the Department.

The research output had increased significantly since the Division was founded.

Recent faculty additions are beginning to pay off as those new members have been successful in acquiring external grants and boosted collaboration between divisions.

WHAT COULD WE BE DOING BETTER?

Showcase the ongoing scientific work, potential and assets.

Take part in translational science meetings to foster scientific exchange and collaboration.

Further engage the team members by holding more regular meetings.

The Department invited Dr. Douglas Wilson from the University of Calgary to conduct the review for the Division of MFM.

WHAT IS GOING WELL WITH THE DIVISION?

MFM division members are providing high quality clinical evaluation and care for the complex maternity patient. The Perinatal Epidemiology Research group has a national/International presence and significant research productivity. A new Methodology Journal Club for fellows and advanced trainees was developed. A postgraduate program for Enhanced Obstetrical Skills for Family Physicians was developed at Surrey Memorial Hospital.

WHAT COULD WE BE DOING BETTER?

The Division should pursue strategic planning among the MFM division members to explore a collaborative care model that integrates prevailing models of MFM care. This should accommodate an ambulatory consultative and diagnostic service with a full-time provincial consultative service and sited labour and delivery management for high-risk patients.

Further to this, the Division should consider financial models that will serve the provincial clinical mandate while preserving and optimizing the academic missions of education, discovery, and knowledge translation.

Exploration, discussion, and negotiation with the Health Authorities and the BC Government, around the creation of a Provincial MFM Program and a service agreement that will support it.

We invited Dr Joseph Hudgens from Eastern Virginia Medical School to conduct the review.

WHAT IS GOING WELL WITH THE DIVISION?

The constant evolution of surgical practice in gynecology, highlights the importance of development of new motor skills as a priority for professional development. This is especially challenging in minimally invasive surgical techniques. The Division has identified increasing the proportion of minimally invasive surgeries, or technicity Index, as a priority for both individual surgeons and institutions. The main obstacle to maintain competency is the availability of mentors. The Continuing Surgical Education Program is a preceptor program for practicing physicians developed to meet this need. To ensure sustainability of CSEP, the Division Head is building capacity by developing a pool of trained faculty, who can travel and provide mentorship to champion surgeons in distributed regional centers. To address anatomical and motor skills, the Division has organized three UBC CPD accredited MOC Section 3 workshops with internationally recognised faculty. These hands-on simulation courses have been well attended and extremely well received with excellent evaluations by the attendees. Success can also measured by the distances attendees have travelled to attend, many have travelled from the furthest reaches of BC.

WHAT COULD WE BE DOING BETTER?

The distributed nature of the Department is the major challenge, especially in terms of communication and effective collaboration among the members. Only 49 out of 152 of General Division members work in academic hospitals in the immediate Vancouver vicinity. This has a tendency to limit access to rounds and other educational and research activities available through the Department. The majority of members practice mainly in small to average size community hospitals with a large geographic distribution across the Province.

The Department invited Dr. William H Kutteh from Vanderbilt University Medical Centre to review the Division

WHAT DOES THE DIVISION DO WELL?

The Recurrent Pregnancy Loss Program has the potential to become one of the leading clinic research sites in North America and the industrialised world.

The Division has contributed significantly in the pilot phase and the estab­lishment of the outpatient hysteroscopy services at BC Women’s Hospital.

The trajectory of the research program is strong with increas­ing and continual funding from multiple outside sources.

The development of a Master’s Program in Clinical Embryology is visionary and timely.

WHAT COULD WE BE DOING BETTER?

Feedback of the fellowship program should be routine.

Provision of basic fertility services should be included in the program not only for appropriate patient care, but to enhance the education of learners at all levels.

Recruitment of a mid-career scientist to boost the division aca­demic mandate and ensure adequate succession as senior re­searchers in the division are close to the age of retirement.

The Department invited Dr Robert Coleman from Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston to review the Division in July 2019.

WHAT DOES THE DIVISION DO WELL?

An undisputed global leader – particularly in the setting of endometriosis and endometriosis-associated cancers, low-grade serous ovarian carcinoma and endometrial cancer.

OvCare and its leadership and personnel are uniquely situated and resourced to continue to drive global discovery of biologic processes of disease.

WHAT COULD WE BE DOING BETTER?

The current faculty complement is providing care outside of standard metrics acceptable for safe clinical care and attention to training and research. There is a need for two more full time faculty members.

Despite its success, OvCare’s scientific discoveries have far outpaced clinical research endeavors or programs to take advantage of these findings. Programmatic investment and development of a clinical trials program is necessary to complement the research lines of discovery.

With respect to the Fellowship program, clinical exposure to coordinate post-operative medical oncology care is variable by faculty and missing prospective, clinical research opportunities. Exposure to basic science is variable and left up to the trainee for funding.