On the occasion of the 50th anniversary of 涩里番鈥檚 Department of Family Medicine, Health e-News sat down with three past Chairs, Louise Nasmith (1995 to 2002), Martin Dawes (2002 to 2010) and Howard Bergman (2012 to 2019), and current Chair Marion Dove (2019-present), for a candid question and answer session looking back on 30 years of triumphs and challenges.
Could you each share some of the highlights from your tenure as Chair?
Louise Nasmith: The real highlight for me was that the Department was laying some pretty strong roots in the Faculty of Medicine. The team with whom I worked was phenomenal. It was the beginning of a much stronger presence in the undergraduate curriculum, and the strengthening of postgrad, which continues to be one of the largest programs in the Faculty. Faculty Development became a model that was quickly transferred to the Faculty of Medicine and beyond. Most of my tenure was under Dean Abe Fuks, who was a remarkable supporter of family medicine and of me personally. I received a lot of mentorship from him.
I am proud that I put a lot of effort into building the ties with the other chairs of departments in Quebec, in the francophone medical schools. I think the fact that I spoke French helped. Together, we negotiated the tarif horaire, which was a huge change in the way our family medicine centre鈥檚 individuals were being paid from fee for service, but I think it really helped. I do believe that Martin, Howard and Marion continued these close working relationships.
Martin Dawes: We did. While my French isn鈥檛 as good as Louise's, our meetings were really productive in terms of negotiating, and working, with government to make sure they understood the implications of the laws and changes to the system that they were trying to put into place.
From the clinical delivery point of view, it was a really rewarding time. I inherited a legacy department at the Royal Victoria (Hospital) and a legacy department of primary care at the Montreal General (Hospital). They were orphans from the time when Queen Elizabeth Hospital closed down and everything got restructured. It was fantastic to see those two groups willing to give up space and take the risk to go back to the Queen E and restart primary care there as a GMF (Family Medicine Group). It has been fantastic to see it grow and become a strong residency program, strong undergraduate teaching program and re-establish itself as a centre for primary care. So there is pride in making that happen, working with the MUHC (涩里番 Health Centre), the government, with builders and with all the founding physicians and making it into a new GMF.
Howard Bergman: I always say that I, and each of us, stands on the shoulders of our predecessors, inheriting how they continued to progressively build family medicine into a very respected clinical discipline in our healthcare system.
Building on the work of Louise, Martin and Miriam Boillat, who was Interim Chair for two years 鈥� that's a long interim! 鈥� we became a very solid and respected academic department at 涩里番. As Martin mentioned, we got official recognition by the University and the government for our master's and PhD program. And with [former Dean] David EideIman's support, we built up the number of students and the number of tenure track positions for clinician-scientists. I think that's a very important accomplishment 鈥� I don't take credit for it, I'm part of the team that enabled it.
Marion Dove: I really appreciate the foundations that were laid by my predecessors.
Expansion is a big part of what's been going on since I became Chair. There's been a rapid and massive expansion of trainees so that we will train more doctors and have more family doctors. We are constantly opening new teaching sites, including the GMF-U at the MedNam Clinic in Lachine in 2023, the GMF-U in Vaudreuil in 2024, and in 2025, a GMF-U at the Lakeshore General Hospital. So these are three brand new teaching sites that have been added to the Department of Family Medicine's residency program and also train medical students.
We've also tried to increase the number of rural sites that take students, the number of clinics in Montreal and in the area near Campus Outaouais, which opened in 2020.
In terms of some of the other strengths, the fact that we're bilingual remains a strength. The links with research are growing stronger all the time. Currently we have about 60 graduate students in the Department of Family Medicine.
The collaboration Louise mentioned with the other family med chairs in Quebec has continued to be a strength. We currently meet once a month to talk about issues that are of mutual interest. I think this has actually become a model for the country.
When we compare to the rest of the country, I think Quebec's actually not doing so badly. Recently at a meeting at the College of Family Physicians of Canada, they talked about their new educational action plan and most of what we were talking about we do already in Quebec, for instance the fact that we already train all of our residents in Quebec in family medicine groups.
What are some of the challenges you faced?
Louise Nasmith: The government was going through its closure of hospitals. The biggest loss was the Queen Elizabeth Hospital, which had been a family medicine centre, and that required the relocation of faculty and residents. It was tough. It was really hard for faculty, a number of them had been there for many years. There was a lot of mourning because of losing not only the hospital but also the community and one another. I was at the Queen E, so I felt it as well. Some decided to go to Saint Mary's (Hospital Center) and some decided to go to the CLSC C么te-des-Neiges and the Herzl Clinic. Those units were incredibly welcoming.
Martin Dawes: The challenge was that only 20% of undergraduates were thinking about going into family medicine as a residency program. That was reflected across the country, but 涩里番 was really low down the list. It was hard work, but one of the things that I think we did quite successfully during my tenure was to have special interest groups within the undergraduate program that were really developed and strengthened by people within the department and which increased the numbers of people going into family medicine.
The other challenge was no one thought family medicine could do research. Obviously we have a different lens on that. I was really proud of the team led by Pierre Pluye and Charo Rodriguez, who put together a master's program, which then fed into the PhD program, which is unique in Canada and making such a huge impact.
Howard Bergman: For many years, family medicine at 涩里番, across Canada and around the world, was considered with a combination of pity and contempt. This has really changed over the years. I had several challenges as Chair, but one of the most interesting was changing the narrative in the department.
David Eidelman said to me, 鈥業 want family medicine to become as strong an academic department as medicine, psychiatry and surgery. They've been doing it for 100 years, we started more recently.鈥� Now we鈥檙e celebrating 50 years 鈥� and he delivered. The narrative now is that we have to deliver on these expectations, both from the university and the healthcare system.
Marion Dove: I became Chair in 2019, so the global pandemic really coloured at least half of my first five-year mandate. Students and residents were removed from rotations, and then they had to be put back on COVID services, and researchers had to come back from their sabbaticals. Borders were closed and research grants had to be completely reworked because people couldn't travel. People couldn't have face to face contact with patients or patient partners. There was all kinds of crisis management I dealt with in my first mandate.
A lot of what Louise, Martin and Howard have spoken to really resonates with what I've experienced as Chair of the department. The closures, pushing doctors into retirement and diminishing the number of trainees that happened in the mid 90s are definitely still having effects now in the sense that we don't have enough family doctors. As I mentioned, now we have a little bit the opposite challenge, with all our new teaching sites.
Where do you see the Department of Family Medicine heading as it embarks on its second half century?
Marion Dove: As we look ahead to the next 50 years, I see a department that is deeply committed to meeting the evolving needs of our communities, while continuing to grow as a leader in academic family medicine. Our focus will be on expanding and strengthening our distributed network of teaching sites to ensure equitable access to primary care training and services across the province. We鈥檒l also be deepening our commitment to research that is grounded in real-world practice and aligned with health system priorities, particularly around equity, aging, chronic disease and interdisciplinary care. With our graduate programs flourishing, our strong culture of collaboration, and our dedicated faculty and learners, I believe we鈥檙e well positioned to shape the future of family medicine 鈥� not only in Quebec, but nationally and internationally.
This interview was edited for length and clarity.
