The case for PhD modernization in Canada Adalsteinn Brown (and Stephen Bornstein and Meg McMahon) Academy Health, New Orleans 26 June 2017
The Canadian Health Services and Policy Research Alliance (CHSPRA): Training modernization is a top priority Mission : Build and sustain an integrated pan- Canadian health services and policy research community that adds value to the health of Canadians and health services for Canadians.
CIHR-IHSPR identified building the next generation of leaders for Learning Health Systems as a top priority
Why mess with a good thing? (I) Convocation, University of Chicago, Canadian HSPR PhD Training is 1901 Strong HSR graduate training provided in • more than 20 universities and in related disciplines across almost every Canadian University Canadian HSPR PhD candidates • regularly win international awards for dissertation work • While Canada has the highest proportion of tertiary training, it has a relatively low number of PhDs Grudniewicz et al., 2014; Terrence Sullivan & Associates 2014; OECD, 2012, .
Why mess with a good thing? (II) Significant investments in HSPR have been made Pan-Canadian • investment to support research, build capacity, advance KT • Multiple funders and organizations invest in HSPR Coordination/alignment • of efforts and investments is starting to occur (new Alliance)
Why mess with a good thing? (III) Growth in HSPR Funding and Similar but Uncoordinated Growth in Applications in Canada PhD Training • Enrollment in HSR doctoral 1200 programs across the country has 1000 climbed The market has expanded as new 800 • doctoral programs are established 2001/2 600 (e.g., McMaster in 2008, and 012 Dalhousie in 2015). 400 2011/2 012 • “This growth and expansion in 200 capacity, however, has occurred 0 without strategic intent and in the $ # absence of systematic and ongoing analysis” Tamblyn et al., 2016; IHSPR 2016
Why mess with a good thing? (IV) or “Why don’t we have the health system we want?”
Our assessment of current PhD training built off of CIHR- IHSPR’s asset map & strategic plan Phases 1 & 2: Planning, Design and Implementation (Dec 2014 – Jan 2017) Working Launch Health Design phase Engage Group Training System Impact for funding potential host established, Launch Start- Modernization Fellowships opportunities: partner White Paper Up Grants Symposium competition working group organizations produced, competition meetings + March 2016 ($2.8 m = 39 Strategy (n=44) scanning Fellowships) released Fund Start-Up Planning: Design Health Fellows Funded Curriculum Environmental Grants Retrospective System Impact + inaugural Development scanning: pan- & Prospective Doctoral National Cohort ($1.5M 10 Meeting Canadian Awards meeting + Trainee Start-Up curriculum May 2017 competition curriculum pilot Tracking Grants) Phase 2, continued: February 2017 – Fall 2017) 8
Challenges in the Health Research Enterprise Reflect broader challenges in PhD Training Future trainees must be: Training Challenges: Research Leaders of Tomorrow Health Research is Evolving who can lead high-impact, multi-disciplinary Health research is increasingly complex, research in a rapidly evolving environment of interdisciplinary and global advancing technologies and globalization Leaders Across Knowledge Sectors Career Paths are Changing who can apply their scholarship and 51,000 PhDs and 6,000 Fellows in Canada. Most talent to lead innovation across (≈85%) do not secure a tenure -track position, yet not different sectors of Canada’s enough PhDs according to the OECD knowledge-based economy Expertise in Critical Areas is Lacking Experts in Critical Priority Areas Data-intensive research ● Indigenous health research who can establish and fill Canadian priority areas of specialized expertise and advance the frontiers ● Health-professional scientists ● Patient-oriented of science research ● Entrepreneurship and Innovation
What did we find in the phase 1 assessment? i. The HSR field in Canada has grown tremendously but without clear strategic intent or alignment with career trajectory trends; ii. Canada could do a better job harnessing its PhD-trained workforce for improved health system performance; iii. Pockets of innovation exist on which to learn and build; and iv. Health system organizations are keen to partner in training modernization efforts.
What did we do? The Training Modernization Strategy Strategic Oversight, Engagement and Communication 1 3 4 Pan-Canadian Curriculum Experiential Learning and Course Materials Opportunities 2 Enriched Competencies Access to New Funding New Grant Evaluation Linked to Curriculum and Criteria Competencies 5 6 Tracking and Social Media Marketplace 7
The Enriched Core Competencies Analysis & Evaluation of health & Professional Skills health-related programs & policies Analysis of data, Leadership, mentorship Research & evidence & & collaboration critical thinking Analytic Skills Understanding & Project comparing health Management systems & the policy making process Knowledge translation, Interdisciplinary communication & work brokerage Change management & Networking implementation Dialogue & Negotiation
Implementing the Strategy $1.5M investment Training Modernization Start- 10 Start-Up Grants funded Up Grants (Start date: March 2017) 12 Fellows supported New pan-Can curriculum $2.8M investment Health System Impact Funding for 39 Fellows Fellowship Awards 1 & 2 yr fellowships 44 partner organizations (Start date: September 2017) New national cohort Health System Impact Design phase. Doctoral Awards Stay tuned! (Start date: June 2018) Pan-Canadian Curriculum with enriched core competencies Student-Led Data Platform: Tracking Career Trajectories
Start-Up Grants: Building a foundation for pan-Canadian Training Modernization 10 dyads of university & health system leaders supporting 12 Health System Impact Fellows and co- creating a new pan-Canadian enriched curriculum U Montreal-INESSS Dr. Lise Lamothe Dr. Denis Roy Laval-CIUSSS-CN Dr. Elisabeth Martin Guy Thibodeau U of A – AB Health U of MB – MB Health Dr. Jeff Johnson Dr. Malcolm Doupe Ms. Kathleen Ness Ms. Jean Cox McMaster-CADTH Dalhousie-NSHA Dr. Lisa Schwartz Dr. Alice Aiken Dr. Tammy Clifford Waterloo-PHO Ms. Janet Knox Dr. Craig Janes U of C – AHS Dr. Heather Manson Dr. Brenda Hemmelgarn Dr. Kathryn Todd U of T – NYGH McGill-INSPQ Dr. Steini Brown Dr. Gilles Paradis Dr. Donna McRitchie Dr. Alain Poirier
Health system organizations are keen to partner in training modernization efforts
Better health, health care & health systems Embedded Professor Analyst Decision maker Scientist HSR Doctoral Training
Thank-you Adalsteinn D. Brown Co-Chair of CHSPRA Training Modernization Working Group Director, Institute of Health Policy, Management, and Evaluation; Dalla Lana Chair in Public Health Policy University of Toronto; and 4 th Floor, 155 College Street Toronto, Ontario M5T 3M6 Phone ( 416) 946-0911 Email adalsteinn.brown@utoronto.ca
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