2025 DFCM 5 Yrs Self Study Report

2020 2025

DFCM

SELF STUDY

2020–2025 Self-Study Report

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DFCM Self-Study Report 2020–2025 We wish to acknowledge this land on which the University of Toronto operates. For thousands of years it has been the traditional land of the Huron-Wendat, the Seneca, and the Mississaugas of the Credit. Today, this meeting place is still the home to many Indigenous people from across Turtle Island and we are grateful to have the opportunity to work on this land.

Design Trajectory Brands Inc.

B

Department of Family & Community Medicine, University of Toronto

Table of Contents 1.0 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 About Us . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Vision, Mission, Values. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Department Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Looking Back to 2020: Navigating the COVID-19 Pandemic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

By The Numbers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Five Years At An Inflection Point: Moving From Crisis To Hope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Our Commitments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 COMMUNITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 RELATIONSHIPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 LEADERSHIP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Principles of Equity and Social Accountability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Summary of Recommendations From 2020 Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Chair’s Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 2.0 PEOPLE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Faculty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Learners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Staff. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 3.0 EDUCATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 UNDERGRADUATE EDUCATION Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Looking Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

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POSTGRADUATE PROGRAM Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Looking Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 GRADUATE STUDIES AND ACADEMIC FELLOWSHIPS Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Looking Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 GLOBAL HEALTH EDUCATION Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Looking Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 FACULTY DEVELOPMENT PROGRAM Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Looking Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 EDUCATION SCHOLARSHIP Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Looking Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 OTHER KEY EDUCATION PRIORITIES Maternity Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Supplemental Emergency Medicine Experience (SEME) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

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Department of Family & Community Medicine, University of Toronto

4.0 RESEARCH. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Introduction to the Research Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Looking Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Highlighted Partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 5.0 QUALITY AND INNOVATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Looking Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 6.0 RELATIONSHIPS, PARTNERSHIPS, SOCIAL ACCOUNTABILITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 INTERNAL INITIATIVES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 DFCM Patient Engagement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Indigenous Leadership Circle (ILC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Black Health Advisory Table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Office of Health System Partnerships (OHSP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 EXTERNAL RELATIONSHIPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Cognate Departments, Extra-Departmental Units, and the Dalla Lana School of Public Health. . . . 131 Teaching Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Program Partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 The College of Family Physicians of Canada (CFPC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Ontario College of Family Physicians (OCFP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Community Health Centres (CHCs). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Partners for Social Accountability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Ontario Health Regional Leadership Collaboration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 INTERNATIONAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Africa Health Education Collaborative (AHC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Toronto Addis Ababa Academic Collaboration in Family Medicine (TAAAC-FM) . . . . . . . . . . . . . . . . . . . 137 World Health Organization (WHO) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 World Organization of Family Doctors (WONCA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Emerging Partnerships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

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7.0 ORGANIZATION & FINANCIAL STRUCTURE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 8.0 LONG-RANGE PLANNING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 9.0 NATIONAL + INTERNATIONAL COMPARATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 10.0 SITES AND DIVISIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 Academic Divisions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Care of the Elderly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Clinical Public Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 Emergency Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 Hospital Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Mental Health and Addiction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 Palliative Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 SITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Fully Affiliated Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Humber River Health (HRH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 North York General Hospital (NYGH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 Scarborough Health Network. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Sinai Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Sunnybrook Health Sciences Centre (SHSC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Toronto East Hospital Network-Michael Garron Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Trillium Health Partners – Credit Valley. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Trillium Health Partners – Mississauga . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 Unity Health Toronto – St. Joseph’s Health Centre (SJHC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 Unity Health Toronto - St. Michael’s Hospital. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174 University Health Network - Toronto Western (UHN-TWH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 Women’s College Hospital (WCH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 Centre for Addiction and Mental Health (CAMH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Community Affiliated Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Georgian Bay General Hospital (GBGH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Oak Valley Health (Markham & Uxbridge). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 Orillia Soldiers’ Memorial Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183 Royal Victoria Regional Health Centre (RVH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184 Southlake Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 University Health Network – Rehab. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 PGY2 Mid-Ontario Sites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 4

Department of Family & Community Medicine, University of Toronto

INTRODUCTION 2020–2025 Self-Study Report

5

We have a duty to take on the biggest challenges facing the healthcare system. To answer them, we need a new plan, new energy, and newschool thinking.

6

Department of Family & Community Medicine, University of Toronto

ABOUT US The Department of Family and Community Medicine (DFCM) at the University of Toronto is proud to be one of the largest academic departments of family medicine in the world. We are home to a World Health Organization Collaborating Centre in Family Medicine and Primary Care. Our community is made up of motivated, kind, and generous academic family doctors, scholars, and staff who share a bold and inclusive vision for the future of family medicine.

We are rooted in the excellence of our institutional home.

The University of Toronto (U of T) is recognized globally for its research impact and academic strength. It was ranked among the top five universities in the world in the 2025 NTU Rankings for research performance in medicine. This places U of T alongside institutions like Harvard, Stanford, Oxford, and Johns Hopkins. The Temerty Faculty of Medicine, Ontario’s largest medical faculty, is a national leader in medical education and research, and plays a pivotal role in shaping Our department is incredibly distributed and diverse—geo- the country’s health workforce. It is the largest contributor graphically, with teaching and clinical sites across Ontario, of newly trained physicians in Canada, and DFCM is one of and professionally, through our many Divisions and the the largest of its departments. wide-ranging skills and passions of our people. Our scholarship spans the range from small-scale quality improve- At DFCM, our daily commitment is to “the patient of today ment to multi-centre randomised trials, from educational and the patient of tomorrow.” As clinicians, we strive to lead curriculum evaluation to public engagement on the future in the delivery of excellent primary care and to help shape a of primary care. This diversity is our strength, allowing us health system that meets the needs of our communities. As to respond to the evolving needs of our communities with educators and scholars, we are preparing the future workagility and energy. force and answering the critical questions that will ensure family medicine and primary care are even stronger for our children and grandchildren.

Introduction

2020–2025 Self-Study Report

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Vision

Mission

Outstanding primary care for all, powered by world-leading research, education, and innovation.

We deliver the world's best education for family doctors and propel knowledge, systems and teams to help people and communities thrive.

Values Our mission and vision are underpinned by a set of shared values that guide our decisions, relationships, and impact: f Integrity in all our endeavours. f Commitment to innovation, academic, and clinical excellence. f Lifelong learning and critical inquiry f Promotion of social justice, equity, diversity, and inclusion. f Advocacy for accessible and quality patient care and practice. f Multidisciplinary, interprofessional collaboration, and effective partnerships. f Professionalism. f Accountability and transparency within our academic communities and with the public.

WHY

Ultimately, our aim in everything we do is to work towards family and community health.

Family and Community Health

WHAT

High Quali ty

unity mm

lationsh Re

Lead ips

ship Co er

Research

a Educ tion

We assess and prioritize our actions, concentrate our energy, and focus our strategic intention using three lenses: community, relationships, leadership.

HOW

l Care nica Cli

The core tools of our work are education, research, and high-quality clinical care.

8

Department of Family & Community Medicine, University of Toronto

Department Reports See some of the Department’s key documents from the past five years.

First, we feature the Strategic Plan, which has served as a guiding framework for our priorities and initiatives.

Next, you’ll find the Family Medicine Reports, which provide stories and insights into our progress, achievements, and areas of focus across education, research, and clinical care.

NEWSCHOOL THINKING

COMM UNITY RELATION SHIPS LEADER SHIP

UNIVERSITY OF TORONTO FAMILY MEDICINE REPORT

2021

Stronger Together: Caring Through Crisis

2022–2027 DFCM Strategic Plan

2022-2027 Strategic Plan

Family Medicine Report 2021 2024–2025

Family Medicine Report

2023

Family Medicine Report

Family Medicine Report 2023 Introduction

Family Medicine Report 2024-2025

View the 2020-2025 Self-Study Appendices

2020–2025 Self-Study Report

9

LOOKING BACK TO 2020: NAVIGATING THE COVID-19 PANDEMIC When the COVID-19 pandemic was declared, the Department of Family and Community Medicine (DFCM) at the University of Toronto, like all clinical academic departments and everyone else around the world, found itself thrown into a rapidly evolving crisis. As clinicians, our faculty members were propelled into a new universe of demands. And as educators and scholars, we quickly learned that our work could not just pivot; it needed to be totally transformed to meet the moment.

We didn’t wait. Our leadership team began a series of regular meetings to facilitate communication, coordination of response, and mutual support–one that we would go on to evaluate and publish on. This closeness and mutual support formed a strong foundation for the many overnight changes that were to come.

educational resources, a pandemic-specific electives catalogue, and the transition of all core days and events to virtual formats. Residents also gained novel clinical experiences through redeployment and COVID-specific roles, building competencies in public health, virtual care, and adaptability.

Our clinical sites pivoted swiftly to virtual care, even as we realized that many of our patients, especially seniors, newcomers, and those in low-income communities, lacked the technology or ability to access it. So we adapted. We developed new protocols for outreach, testing, and in-home monitoring of patients who were sick enough to require our care but hopefully stable enough to be able to avoid hospitalization. We created COVID-19-focused goals-of-care guides and end-of-life symptom management kits. Our faculty members and learners brought the full range of family medicine care to people who needed our ongoing services while simultaneously standing up assessment centres, outreach testing teams, online resources for people managing symptoms at home, and more.

Our staff, of course, were immediately sent home to work remotely, and a set of supports for their well-being were put in place that ranged from laptops and equipment being brought to their homes to frequent updates on the state of lockdown to–eventually–online group cooking classes and social events Our home visit teams, made up of family doctors, nurse to maintain morale and a sense of team solidarity. practitioners, pharmacists, and care coordinators, stepped in where others couldn’t. In 2020 alone, DFCM clinicians We understood that we needed both to learn to provide made over 2,500 house calls, often to patients who were too family medicine education virtually and to educate our train- frail or isolated to seek help outside their homes. We cared ees on how to provide effective virtual care. We developed for people like Buzz, a 90-year-old patient who contracted a “just-in-time” virtual care curriculum grounded in adapt- COVID-19 and was too weak to go to a testing centre. Our ive expertise, with modules on virtual primary care, medico- team swabbed him, monitored his oxygen levels, and suplegal considerations, and care for vulnerable populations. ported his family’s wish to bring him home to die peacefully.

Additional initiatives included a website of supplementary 10

Department of Family & Community Medicine, University of Toronto

As vaccines became available, our faculty members and trainees were at the forefront of efforts to vaccinate elders in long-term care facilities and played a leading role in Operation Remote Immunity—bringing COVID-19 vaccines to remote Indigenous communities in Northern Ontario through partnerships with Indigenous leaders and health organizations. DFCM faculty also advanced Black health equity initiatives, collaborating with community partners such as TAIBU and the Black Physicians Association of Ontario to improve access to care and address systemic barriers through education, research, and advocacy.

our leaders chaired provincial and national committees and drove collaborations that informed health policy, reinforcing family medicine’s role in equitable, evidence-based care during a global emergency.

All across the board—from learner, staff, faculty, researcher, and leader—DFCM stepped up to address the COVID-19 pandemic.

But the cost was high.

DFCM in

NUMBERS

The emotional and physical toll on our people was profound.

We collaborated with our bilingual faculty to develop We were stretched thin, professionally and personally, tryCOVID-19 resources for patients in multiple languages, in- ing to care for others while navigating our own fears and cluding Arabic, French, and Hindi. fatigue. By late 2021, with a tremendous vaccine rollout beginning to slow and exhausted faculty facing the long tail We also turned to research and academic leadership. DFCM of deferred chronic disease management, screening for faculty contributed to the Ontario COVID-19 Science Advis- cancers and other illnesses, and a cohort of learners whose ory Table, authoring briefs that underscored the vital role of in-person contacts had been dramatically less than their primary care in pandemic response. We studied how family predecessors, we knew that a new approach to the next doctors, nurse practitioners, and allied health profession- phase would be necessary. als adapted—taking on new roles and innovating to meet community needs—helping shape provincial strategies and We pledged to rebuild with intention, centring wellness, highlighting the value of strong primary care systems. We equity, and sustainability. We are still on that road, and havalso launched CanCOVID, a national network dedicated to ing achieved a great deal–as you will read in these pages– evidence-informed pandemic response. Beyond research, there is more still to be done.

Introduction

~2,300

1,300+

400+

50+

18

4

FACULTY MEMBERS

FAMILY MEDICINE RESIDENTS YEARLY

CORE TEACHING SITES

LEARNERS

STAFF

INTEGRATED COMMUNITY STREAMS

40+

TEACHING PRACTICES, FROM RURAL TO URBAN CENTRES 2020–2025 Self-Study Report

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FIVE YEARS AT AN INFLECTION POINT: MOVING FROM CRISIS TO HOPE Five years ago, DFCM—and the discipline of family medicine in Ontario—was in crisis. We were in the midst of a global pandemic, navigating a departmental leadership transition, and trying to support a demoralized workforce. Family physicians across Ontario were retiring in record numbers, and many who remained were burnt out—feeling underappreciated by the public, unsupported by government, and undervalued by the health system. With the increase in retirements and as a result of many other factors, 2.5 million Ontarians found themselves without a family doctor or primary care team, unanchored from a medical home.

Our department achieved remarkable things during the pandemic. We transitioned rapidly to virtual teaching and care, maintained the excellence of our training programs, and continued to support our learners and communities. But the sense of exhaustion was palpable, and a mounting narrative of crisis in the discipline of family medicine was taking hold across the system. Within our community, faculty members expressed a growing sense of disconnection, with academic responsibilities often perceived as additional burdens on already-full clinical plates.

The leadership transition with a new incoming Department Chair offered a natural opportunity to pause, reflect, and ask: How can we rebuild and further strengthen our DFCM community? What is our role in rebuilding our discipline? We chose to use the process of developing our strategic plan not only to chart a concrete course of action for the next five years, but also to intentionally strengthen our ties, renew our shared identity, and deepen our commitment to one another. As we repeatedly said throughout the process, “the antidote to burnout is common purpose.”

Our strategic planning process was designed to be inclusive, transparent, and energizing. It was designed to be a conversation. In total, we engaged about 500 people, including faculty, learners, staff, external advisors, and patients and caregivers. We convened leadership circles, representing DFCM leadership from the trainee level to the level of the Chair; international experts in the field of academic family 12

medicine; patients, families and community leaders; and Indigenous DFCM faculty and learners. We created collaborative wiki documents that were open to all faculty and learners for their contributions, conducted a department-wide survey, and held 12 workshops, each on a different topic, to gather input from across our ecosystem. Many elements of the plan were built directly on the recommendations of our prior external review, while also incorporating new priorities that emerged from deep listening and reflection.

When we launched the five-year plan in the fall of 2022, we felt that its visual beauty and its substantive force with actionable commitments gave every member of our community something to be proud of. The plan was an articulation of a shared renewed commitment to our collective work ahead. And today, three years into its implementation, we find ourselves in a much stronger position—both as a department and as a discipline. Even amid tremendous tensions—including the ongoing ripple effects of the pandemic and the challenges faced on university campuses during the war in the Middle East—we have modelled a culture of decency, mutual support, and shared purpose. We continue to show up for each other and for the people we serve.

This approach has enabled us not only to weather the storms, but to lead through them. Our faculty have been leaders in calling attention to the crisis in family medicine in Ontario and across Canada, and we have contributed meaningfully to the evolving solutions. Through massive educational expansion, research partnerships with the public, and system leadership at every level, we have begun to restore a sense of agency and optimism among family physicians.

As we move forward, we remain committed to the vision and values that shaped our strategic plan. With the final 18 months of our plan cycle on the horizon and at the moment of this five-year external review, we are proud of what we have achieved, curious about what we can learn, and committed to continuing to build a stronger, more connected, and more impactful future for family and community medicine.

Department of Family & Community Medicine, University of Toronto

Our Commitments Our strategic plan outlines clear commitments across three lenses— community, relationships, and leadership—and is grounded in our core tools: education, research, and high-quality clinical care. Under each of the bullets below, we have made very specific and measurable commitments, and we are monitoring our progress and evolving as the needs shift and change over time.

In total, the plan includes 54 specific commitments which can be reviewed in detail on our website, www.primarymatters.ca, and are also found in the appendices to this self-study.

Community

Relationships

Leadership

f Invest in community partnerships across our Education, Research, and Quality & Innovation work. (There are four specific commitments under this commitment.)

f Maximize our impact and visibility through deepened engagement across the Temerty Faculty of Medicine, Dalla Lana School of Public Health, and the University of Toronto. (There are four specific commitments under this commitment.)

f Elevate our position as a socially accountable, equity-focused academic leader for our faculty, learners, and staff. (There are 10 specific commitments under this commitment.)

f Expand and enhance the community-based experience of learners. (There are three specific commitments under this commitment.) f Optimize patient and community health outcomes by supporting, connecting, and upskilling healthcare providers. (There are five specific commitments under this commitment.)

f Connect and support the DFCM community of learners, faculty, and alumni. (There are four specific commitments under this commitment.) f Build and sustain more collaborative relationships with our patients and communities to guide our work. (There are three specific commitments under this commitment.) f Amplify the voice and unlock the academic potential of community sites and faculty in the community in order to better represent the needs and perspectives of those they serve. (There are three specific commitments under this commitment.)

f Lead and inform health system improvement, working collaboratively with local and global health system partners.

(There are eight specific commitments under this commitment.) f Empower our faculty, staff, and learners to prioritize personal leadership by embracing and adopting practices that promote their well-being and that of their colleagues in order to foster excellence in care, education, and scholarship. (There are three specific commitments under this commitment.) f Support the self-determination of Indigenous health leaders and communities. (There are four specific commitments under this commitment.) f Help scale health technologies and innovations that enhance patient-practitioner relationships. (There are three specific commitments under this commitment.)

Introduction

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PRINCIPLES OF EQUITY AND SOCIAL ACCOUNTABILITY DR. DENISE O’NEIL GREEN: EMBEDDED EQUITY AND SOCIAL ACCOUNTABILITY EXPERT AT DFCM 14

Department of Family & Community Medicine, University of Toronto

In 2023, the Department of Family & Community Medicine (DFCM) made a bold and uncommon move by embedding Dr. Denise O’Neil Green—a globally recognized leader in equity, diversity, inclusion, anti-racism, and transformational leadership in universities—directly into the leadership of our department for a one-year term. This was not just a consulting engagement, but a time-limited leadership appointment that allowed Dr. Green to work closely with faculty, staff, and learners to advance principles of equity and social accountability in a sustained and collaborative way. Dr. Green joined our senior leadership meetings, met with front-line faculty and staff, and became a temporary but fully-engaged member of our team to help us accelerate principles of equity and social accountability work and build capacity to sustain our commitments beyond her term.

DFCM Strategic Plan Priorities on which Dr. Green consulted and helped to lead:

With over 30 years of experience across academia, government, healthcare, and business, Dr. Green brought a visionary approach to this work. Her work was informed by over 30 coffee chats with individual members and groups from the DFCM community, which surfaced key themes around onboarding, promotion, departmental culture, and support for marginalized groups.

Leadership (L.1.2) - Establish a staff role focused on improving and expanding internal Equity, Diversity, Indigeneity, Inclusion, Accessibility (EDIIA) practices starting with collecting and analyzing equity-based data and determine ambitious, quantitative goals.

Community (C.3.3) - Establish and convene a Black Health Advisory Table.

Relationships (R.1.1.a) - Integrate already developed systems and practices, such as e-learning and equity and social accountability practices. practices developed through Temerty Office of Diversity and Inclusion.

Leadership (L.1.1) - Dedicate resources and supports to recruitment, retention, and promotion of learners, faculty and staff from equity-deserving communities and ensure that the environment they join is safe, supportive and respectful.

Leadership (L.1.3) - Prioritize equitable healthcare, anti-racist, and anti-oppression approaches by offering menFollowing her term, Dr. Green has now joined DFCM as an torship, training and continued professional development for Adjunct Faculty Member, continuing her connection to the learners, staff and faculty tied to accountability. department and its mission.

Key Principles of Equity and Social Accountability Advancements And Suggestions During Her Term f Black Health Advisory Table (BHAT): Established terms of reference, developed the team with formal governance and leadership integration, and began regular meetings. The BHAT continues its work under the leadership of Drs. Melanie Henry and Onye Nnorom. f Principles of Equity and Social Accountability Data Collection Committee: Formed to align with Indigenous leadership and HR, with a focus on trust-building and strategic data use. This work is ongoing under the leadership of Dr. Jeff Kwong and Professor Mahan Kulesagaram. f Faculty Development Recommendations: Addressed barriers for racialized women, mentorship gaps, and inclusive promotion practices. This has resulted in a concerted set of

Introduction

initiatives across faculty appointments, promotions, wellness, and faculty development. f Website Content Review: Proposed a dedicated Principles of Equity and Social Accountability page with strategic goals, definitions, and support resources. Implementation of this recommendation is underway. f Leadership Model Update: Suggested a Distributive Principles of Equity and Social Accountability Leadership Model with six guiding principles for departmental leaders. This model has been incorporated.

Read more about Dr. Green’s time embedded with the DFCM in her report.

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SUMMARY OF RECOMMENDATIONS FROM 2020 REVIEW This section outlines the Department of Family and Community Medicine’s (DFCM’s) progress in addressing recommendations from the previous self-study.

The tables below summarize key suggestions from the 2020 external reviewers, summary of the DFCM’s previous Chair’s initial responses, and the actions we have taken in the years to follow. View the complete reviewer comments and the Chair’s responses from the 2012-2020 review.

UNDERGRAD SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

The demise of the longitudinal integrated clerkship is unfortunate. We recommend consideration be given to a longitudinal experience in family medicine integrated into the block rotation system.

Though the longitudinal clerkship was discontinued, we are continuing to advocate and seek opportunities for pre-clerkship exposure to family medicine.

An overarching goal of the Undergraduate Program is the promotion of family medicine as the career of choice for medical students. Various initiatives have been launched to increase opportunities in family medicine during pre-clerkship. These include the Family Medicine Longitudinal Experience (FMLE), which is now a required course for all second-year students, and additional longitudinal experiences in family medicine such as the Family Medicine Immersion week, Family Medicine Community Longitudinal Leadership Enrichment Opportunity (FM-CLLEO) and the Gagnon scholarship (additional details in the Undergraduate Medical Education section of self-study).

We have increased efforts to recruit Family Medicine Learning Experience (FMLE) preceptors and succeeded in recruiting more than 200 community preceptor recruits. We support FMLE preceptors through the Preceptor Resource Webpage and the PLANK match system.

We introduced the Family Medicine Community Longitudinal Leadership Enrichment Opportunity (FM CLLEO), giving early medical learners a chance for a longitudinal placement with community-based family physicians focused on quality improvement and prevention interventions in vulnerable populations.

16

Department of Family & Community Medicine, University of Toronto

The Lester and Jean Gagnon Summer Student Scholarship provides a seven-week paid opportunity for firstand second-year medical students to explore careers in family medicine. As part of the program requirements, students must opt into either the FM-CLLEO program or the Education Scholarship Accelerator Program (ESAP), which focuses on education scholarship.

DFCM should pilot additional methods of assessing clerkship progress beyond multiple-choice examinations.

Regarding assessment of clerkship progress, a family medicine specific Objective Structured Clinical Examination (OSCE) has been replaced with a broader clerkship OSCE. DFCM will continue to advocate for sufficient family medicine content in the OSCE to ensure that family medicine competencies are effectively assessed.

In 2021, a new Blueprint for the Family Medicine Clerkship exam was developed. The exam was also converted from all multiple-choice questions (MCQ) to having some MCQ questions and part Clinical Decision Making (CDM) Questions. In 2024, as per direction from the MD program, the exam was converted back to being all MCQs to reflect the types of questions that the students would encounter on their Licentiate of the Medical Council of Canada (LMCC) exams.

SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

The success rates on the College of Family Physicians of Canada (CFPC) should be tracked as an additional metric of quality for DFCM.

Information on success rates from the certification examination in family medicine is provided, and U of T success rates typically exceed national averages.

In response to the review suggestion, we receive our spring and fall exam results and the Program Director and Associate Program Director-Assessment review results and report confidential data to the Postgraduate Medical Education (PGME) Committee on how DFCM residents are doing nationally. We provide feedback on how to help support any exam preparations by site Program Directors. DFCM PGME graduates have been consistently at or above the national average for all CFPC board exams for the past five years.

Faculty should consider investing a portion of resources (if given) by the Ontario Ministry of Health into additional PGY3 positions in the DFCM.

The program would welcome additional PGY3 positions to expand our Integrated 3-Year Programs (I3P) in Leadership and Enhanced Skills, as well as offer new opportunities and prepare for the lengthening of the family medicine residency program.

We have expanded additional PGY3 positions without additional funding provided by the Ontario Ministry of Health in response to the review recommendations.

This has been spread between palliative care, emergency medicine, sports medicine, and addictions.

This was an additional increase of eight positions in 2020-2024, with an increase planned for additional two PGY-3 positions in 2026-27, for a total of 10 additional PGY3 positions. More information can be found in the Postgraduate section of the report.

The MD program introduced Entrustable Professional Activities (EPAs) in 2023. The students are required to complete six EPAs during their six-week rotation. After the full implementation of EPAs, the Family Medicine Clerkship also lost our other type of unique clinical assessment tool – the FM-CEX – as per the direction of the MD program.

POSTGRAD

Introduction

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CONTINUING EDUCATION SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

Consideration could be given to rationalizing and describing some continuing education programs in a different way; a more in-depth review of these programs is likely warranted.

Our Academic Fellowships and Graduate Studies program remains extremely active and effectively pivoted to a virtual format during the COVID-19 pandemic. We will continue to look for ways to meet learner needs most effectively, and an in-depth review is worthy of consideration.

Over the last two years, Academic Fellowship and Graduate Studies (AFGS) has completed a program evaluation of students and alumni and we have consulted with international and local hospital partners to redefine the needs of students and institutions. These learnings will support the rationale for degree level change with the School of Graduate Studies.

There is redundancy in the Master of Science in Community Health-Family and Community Medicine (MScCH-FCM) and Master of Public Health-Family and Community Medicine (MPH-FCM degrees). Our family physician faculty are primarily drawn to our MScCH Health Practitioner Teacher Education (HPTE) degree and our advanced standing MPH-FCM degree. There was some consideration in eliminating the MScCH-FCM degree and focusing on the MPH, however, this would eliminate the one-year training option for allied health professionals as well as our international partners.

Our program evaluation and consultations support conversion of the MScCH to a hybrid degree with increased focus on primary care and interprofessional content. We plan to submit a proposal to the School of Graduate Studies and Dalla Lana School of Public Health. Our goal is a 2027 launch. In the meantime, we have developed a new graduate level course in Team Based Primary Care that will become a core requirement in the redefined MScCH degree. Additional preparation for degree-level change has included successful conversion of the core research methods course to hybrid delivery design and maintaining an online policy course.

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Department of Family & Community Medicine, University of Toronto

OTHER EDUCATIONAL ACTIVITIES SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

The wide scope and robustness of the faculty development activities may require a more distributed leadership structure.

Restructuring of the faculty development (FD) portfolio into its discrete components is under discussion and will likely be rolled out in 2022. This will permit growth in programming and reach in key areas including wellness and resilience, mentorship, awards and academic promotion, and will foster new and innovative faculty development offerings.

The vast faculty development (FD) portfolio was restructured in 2021. In addition to the existing leads for FD education scholarship and Health Professional Educators, four new leads were introduced: Faculty Appointments and Junior Promotions, Faculty Wellness, Awards Grants and Funds, and Mentorship.

The Faculty Development Program Director (FD PD) now oversees the work of each of these six leads, as well as the committee of FD leads from each site and division across the DFCM. The main work of the FD PD is organizing and running all central FD activities, including the BASICS Program for New Faculty, the Leadership MasterClass series, and the annual DFCM Conference. Novel FD programming is developed in response to evolving faculty needs, for example through the Equity Grand Rounds series.

New and important work has been undertaken in the FD portfolio to align with accreditation standards and ensure that teachers are assessed, recognized, and supported in their development.

The Office of Education Scholarship is a strength, not replicated elsewhere.

Consideration should be given to recruiting more BIPOC educational scholars and studying the impact of various new initiatives and curricula in equity, diversity, and inclusion and anti-racism.

The Office of Education Scholarship (OES) is an exceptional departmental asset that can assist and promote the evaluation of educational efforts in EDI, anti-racism, Indigenous health and social accountability, as recommended by the reviewers.

The OES team has actively advanced Principles of Equity and Social Accountability since 2021 with the funding of many equity and social accountability-focused projects through the Art of the Possible grants.

This included the evaluation of educational efforts in EDI, anti-racism, Indigenous health and social accountability, as recommended by the reviewers, as well as alignment with the departmental strategy to strengthen commitments to socially accountable education scholarship.

Recruitment of more BIPOC educational scholars was done with the addition of an Education Scholar at Large for Principles of Equity and Social Accountability to catalyze departmental activities in education scholarship and equity and social accountability. This Scholar served as a resource to the Social Accountability committee and continues to provide leadership on equity relevant education scholarship.

The OES Person Centered Care research pillar also advances inclusion in medical education by conducting research that promotes inclusive medical education practices in admissions and assessment.

Introduction

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Consider a more structured and standardized onboarding process for faculty taking on leadership roles, as well as faculty development for specialty teachers of family medicine learners.

A more structured approach to onboarding new leaders is a helpful recommendation that can be addressed through expanded mentorship programming.

In our BASICS Program for new faculty, our session leads are all academic leaders from across the department that allow new faculty to see leadership in action right from the start in their role as teachers. There is a session on academic careers with a focus in leadership in academic family medicine.

Further, at our newest sites, specialist teachers who will teach our family medicine learners participate in the mini-BASICS new faculty orientation. The intention is to build relationships, foster open dialogue, and encourage collaboration between family physician and other specialist teachers of our family medicine learners.

The Leadership MasterClass series provides a unique opportunity for evolving leaders to learn from DFCM’s expert family medicine leaders with diverse skills, experience, and perspectives for faculty taking leadership roles.

For women physician leaders (not just in our own department but globally) the DFCM offers a unique course: Advancing Women’s Excellence in Family Medicine (AWE-FM), which connects local and global FM leaders.

In addition, faculty leaders are supported through the DFCM mentorship program for ongoing longitudinal support on their leadership journey.

Developing a more focused mission statement for the Physician Assistant (PA) Program that emphasizes preparing health professionals to meet the needs of underserved communities.

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The Consortium of PA Education’s mission is built on a foundation of social accountability, particularly to rural, remote, and underserved communities and there is an opportunity to engage northern physicians to better understand the value that Physician Assistants bring to patient care, quality, and access.

Department of Family & Community Medicine, University of Toronto

The PA Program has transitioned to the Vice Dean, Medical Education portfolio in preparation for its move to the Scarborough Academy of Medicine and Integrated Health (SAMIH) in July 2026. We are working closely with the SAMIH team to support the transition, one which makes sense for the program and for our department.

LEARNER WELLBEING SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

Resident leaders identified a culture of responsiveness, caring, and proactive attention to wellness from staff and faculty. All patient-facing learners with whom we spoke have been immunized against COVID.

Learner wellbeing is a top priority, and DFCM will continue to share and amplify Temerty Medicine support tools and resources to focus on the health of our learners through regular group and individual discussions and support where required.

Residents are introduced to wellness resources during orientation and can access them throughout the program. These include the Postgraduate Medical Education (PGME) Office of Learner Affairs, the Professional Association of Residents in Ontario (PARO) 24-hour helpline, the Physician Health Program, the Learner Experience Unit, and online wellness guidelines and policies.

The PGME program developed and launched the Foundations block in July 2025 for incoming PGY1 trainees, in response to Continuous Quality Improvement survey feedback around residents feeling they needed a greater orientation to the Postgraduate Residency Program. This included core curriculum developed and delivered regarding Wellness as well as related to Social Accountability, that received high satisfaction rates from residents, particularly regarding building connection and fostering collaboration.

Supporting learner wellness is essential at all levels of DFCM learning. In addition to supports provided to undergraduate learners by the Temerty Faculty of Medicine, the DFCM developed the DFCM Red Button in 2021. This tool is a quick-access resource that helps learners navigate challenging situations — from health concerns to safety issues.

Introduction

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QUALITY IMPROVEMENT SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

Consider how the DFCM Q&I Learning Health System approach can be generalized to promote greater integration of clinical practice improvement and research across specialties with academic credit for this applied form of scholarship.

The concept of a broadly integrated learning health system, whereby multiple elements grow and coalesce for collective impact, is being contemplated. This will benefit from clear articulation and discussion.

Over the last five years, the Q&I program has grown its learning health system approach. Specifically, we have a robust, common patient experience survey that the DFCM facilitates among all teaching sites. Results drive local quality improvement and aggregate results have contributed to peer-reviewed research.

The Q&I program also partnered with the Research Program to develop CareCanvas, an audit and feedback dashboard that provided clinicians and clinics with data from electronic medical records and other sources. CareCanvas was paused due to challenges with UTOPIAN, which are described in detail in the Research section. The transition to UPLEARN should improve options for sites to engage in Q&I activities with a model being tested at Unity Health (St. Michaels Hospital). This is now being discussed with site chiefs to explore operationalization of this model that does not need sharing of data beyond the site.

Q&I also continues to partner with researchers to bridge disciplines, for example, through a new collaboration to implement advanced access.

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Department of Family & Community Medicine, University of Toronto

RESEARCH SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

Consider having a flexible pool of funds to support pilot studies and other forms of seed funding for research projects of young investigators.

Further support from a librarian and qualitative research expertise would also be appreciated.

The interim Vice-Chair has conducted an environmental scan to study research program models in selected departments of family medicine nationally and internationally, which will inform the evolution of DFCM’s Research Program and the selection of the next Vice-Chair.

We have initiated seed funding in the form of awards for those participating in the new Ideas 2 Proposal (I2P) program. I2P participants have access to dedicated funds for new projects and access to central staffing and mentorship resources.

Some DFCM-affiliated scientists offer seed funding and salary support to early-stage faculty through their own grants or philanthropic support.

The new Waddington Family Awards Program has dedicated funding set aside for research staff time to support funded researchers at community-based sites.

All funded investigators have annual generative reviews that include mentorship on grants, publications, sponsorship, and provision of mentorship to others.

They are also advised on Research Program services available to them.

All faculty with a U of T identification can access the central library in person or online. They have remote access to the online database for articles, software to sort and store literature, access to Covidence for systematic reviews, and consultation regarding literature searches if needed. Funding a departmental librarian would be duplication of services.

The current Associate director has PhD level qualitative research skills and is available to faculty to mentor and collaborate on appropriate projects.

The ten-year anniversary of UTOPIAN is an opportunity for a more formal and systematic review.

Introduction

The Research Program, including UTOPIAN, would likely benefit from a focused review of its strategic direction and activities.

Since the last report, we undertook a full and formal external review of UTOPIAN in response to this recommendation. Following the review, as we were preparing to implement the recommendations, UTOPIAN was paused and then subsequently discontinued as a result of system-level challenges (details available here).

We have introduced a new initiative called UPLEARN to advance our primary care practice-based research and learning networks (PBRLN) goals in a refreshed way that is less dependent on the use of EMR data while we await system-level solutions to these challenges which lie outside the control of our department.

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We suggest a more structured approach for early-career and adjunct faculty to help with career advancement, as well as more dedicated administrative support for CVs, updates, and preparing promotion materials.

Achieving academic promotion at junior and senior levels is of considerable importance to DFCM faculty members, and the creation of a faculty lead for appointments and promotions, reporting to the Vice-Chair Family Doctor Leadership, will support new efforts toward academic advancement through mentorship, coaching, and workshops.

The Faculty Development Program offers “Learn, Teach, Thrive,” a series of events to support the diverse needs of faculty across the trajectory from initial appointment through to senior promotion.

As well, the Appointments and Promotions team hosts regular workshops for faculty interested in pursuing promotion.

See the Research section of the self-study for the processes we have instituted to help early-career and adjunct faculty advance their career. These efforts include Research Rounds, access to methodological support and guidance, regular and detailed emails about funding opportunities through the research listserv, and inclusion in retreats such as our recent and interactive Research Program symposia in 2025.

RELATIONSHIPS

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SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

Cognate Department Chairs expressed a wish for the new Chair to be a partner with them, with several ideas about the forms these partnerships could take (ex. joint educational programs).

Expanding our partnerships across clinical practice, education, research, quality, innovation, and international programs with other disciplines and departments in Temerty Medicine, and across other faculties and institutions, will be important for DFCM.

Our Strategic Plan outlines a commitment to maximize our impact and visibility through deepened engagement across the Temerty Faculty of Medicine, Dalla Lana School of Public Health, and the University of Toronto.

Through our Divisions, our Office of Health System Partnerships, and work with TFoM Extra-Departmental Units, we now have well-developed partnerships with many of the cognate departments, which are described in more detail in this self-study; most of these are indeed in the education realm. The relationship between our Chair and the other cognate chairs has been one of true and growing partnerships, which also reflects a growing culture of partnership across Temerty Medicine leadership.

Consideration should be given as to how DFCM could contribute to Ontario Health Teams.

DFCM faculty members and teaching sites have been active in the development and implementation of Ontario Health Teams (OHTs). These contributions will expand as OHTs mature into integrated systems of care.

We are very proud of the work our department is now doing in the health system, including with Ontario Health Teams but also well beyond, through our Office of Health System Partnerships, which is a major area of focus in our strategic plan and a unique initiative in academic family medicine. For example, this year, the OHSP led the first primary care census of family doctors/nurse practitioners in the City of Toronto to better understand the current physician supply and support local human resources. The results of the survey will support primary care planning and inform OHT development and regional clinician engagement. Further details about the exciting work of the OHSP are in the Partnerships section of this document.

Department of Family & Community Medicine, University of Toronto

ORGANIZATION AND FINANCIAL STRUCTURE SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

There is a perception of inequity in the distribution of financial support across all sites, particularly sites without an academic alternative funding plan.

Recent work by a finance working group sought to remedy some disparities but remained challenged by the highly complex arrangements and variability in funding resources existing across DFCM and its multiple sites. This matter will require further consideration by the new Chair.

Over the past four years, DFCM has reviewed our distribution to teaching sites. As a first step, we sought to ensure distribution to our community sites was more equitable. Concrete changes in distribution to these community sites occurred and laid the groundwork for the distribution of funds to new community sites during our most recent expansions at Humber River, Georgian Bay, and Orillia.

Calculation of distribution of funds continues to be a function centrally at DFCM and is based on assumption of AFP and careful analysis and review with DFCM finance and Postgraduate Directors who identified the disparity.

Recent announcements of FM expansion, possible increase in funding levels, increase to preceptor funding along with the appointment of a new DFCM Business Director, position DFCM to conduct an extensive review of distribution to its sites and central resources.

DFCM will conduct a comprehensive internal and external scan to align our strategic plan, central resources and develop a strong funding distribution model that is predictable centrally and for our teaching partners.

While funding is never sufficient for the level of support we would wish for, we believe that the combination of small funding re-allocations, additional dollars for sites that are expanding, and concerted advocacy for additional funds from government have helped with the perceptions mentioned by the reviewers in the last review.

Members could benefit from thinking through what it is about the family medicine department’s mission that could attract donor support.

Introduction

Philanthropic support will continue to be important for DFCM. Endowed Chairs should be sought to support the DFCM Chair and Vice-Chair Education positions. This matter will require further consideration by the new Chair.

The Chair has been actively working with Advancement to pursue other sources of revenue and advocacy is ongoing across the medical faculties of Ontario to increase funding to levels that reflect the cost of delivering a medical education. Our strategic plan is an excellent vehicle for engaging with donors. Recent donations such as the Gagnon Fellowship and the endowed Chair in Indigenous Health speak to the compelling message we have been bringing to donors.

The superb TFoM Advancement team tells us that we have the largest number of large asks out to donors of any department in the faculty.

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The effect on the provincial budget post-COVID is a potential threat to financial stability. Additional support in IT might be of use given the additional pressures of online work.

This matter will require further consideration by the new Chair.

The transition of our IT supports to MedIT, a central resource in the faculty of medicine, has ensured greater stability in this realm. MedIT has now taken over all IT functions for all departments in TFOM, and budget has been transferred centrally to account for this.

LONG-RANGE PLANNING

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SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

DFCM would benefit from consolidating its many strengths and articulating more clearly which communities it seeks to serve, as there is a lack of community advisory councils and community engagement.

Suggestions regarding the need to articulate which communities DFCM seeks to serve and greater clarity regarding the department’s vision and mission would be beneficial and help guide decisions in future strategic planning. The department is contemplating the establishment of an equity committee with representatives from our sites and divisions to share ideas, reach out, and contribute to the needs of communities.

We have made Community, Relationships and Leadership the cornerstones of our 2022-2027 strategic plan. The plan was developed with multiple community leadership circles deeply engaged. We established a Vice-Chair for Community and Partnerships, whose mandate includes advancing principles of equity and social accountability alongside building strong relationships with the communities we serve. We have also launched and aggressively grown our Patient and Family Advisory program, as outlined in this self-study in more detail.

The commitment to EDI is certainly well understood at the departmental leadership level and is aligned with the Faculty’s commitment in these areas.

Development of metrics and evaluation of these efforts will be important.

Equity, diversity, inclusion, anti-racism, Indigenous health and social accountability are priorities for DFCM and will continue to be areas of focus and integral to our work.

Significant process has been made on principles of equity and social accountability. Please see the section on the work of our embedded expert, Dr. Denise O’Neil Green, the launch of the Black Health Advisory Table, the Indigenous Leadership Circle, and the nascent faculty survey to collect equity and social accountability data among faculty.

Department of Family & Community Medicine, University of Toronto

The fairly frequent turnover in chairs, all of whom are talented individuals, has left DFCM longing for some stability. The new department chair might well be found amongst internal candidates who have a good understanding of the complexity of this department.

There was no comment about this suggestion.

Our current Chair, Dr. Danielle Martin, is now four years into her five-year term.

NATIONAL AND INTERNATIONAL COMPARATORS SUGGESTIONS

INITIAL RESPONSE

SUBSEQUENT MEASURES

It has a strong reputation in Canada for its innovations, generosity, and leadership in family medicine venues. Internationally, it is known for its academic fellowship programs, its program in Ethiopia, and its contributions to the WHO and WONCA.

The Department is proud of its reputation and contributions locally, nationally, and globally and will strive to continue to be seen as a leader in education, research, quality of care, and innovation.

As a WHO Collaborating Centre, DFCM can continue to provide valuable contributions to global primary care.

The Department continues to be proud of our strong reputation. We continue to be a WHO Collaborating Centre. In 2025, DFCM hosted the Starfield Summit— the first ever held outside the United States—marking a historic milestone. The Summit produced The Starfield Statement, a global call to strengthen family medicine, and A Call to Action for the Canadian Government, urging support for global primary care leadership. It also launched a collaboration with WONCA to co-develop advocacy and policy resources, which will be refined at the WONCA World Conference in Lisbon.

Introduction

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OTHER CONSIDERATIONS

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SUBSEQUENT MEASURES

SUGGESTIONS

INITIAL RESPONSE

There is considerable opportunity for greater synergy among DFCM programs and people.

More structured community input and advice will help define the mission of the department and strengthen efforts in equity and inclusiveness.

Important strategic directions and areas of attention in the coming months and years include EDI as well as social accountability efforts that will include reaching out to our communities and patients to seek input on our programming, clinical services, and strategies.

Our Strategic Plan was developed through an inclusive process that brought together diverse voices from across the department and community. It was a collaborative conversation designed to define our mission and priorities collectively, ensuring equity and inclusiveness were central to the plan. Our engagement with Dr. Denise O’Neil Green on principles of equity and social accountability has strengthened our work in this area considerably. The launch of the Black Health Advisory Table and the Indigenous Leadership circle have offered more structured ways for important voices to guide our work, as has the Patient and Family Advisory input.

A well-articulated plan for e-learning, digital health, and artificial intelligence, which interfaces with the Temerty Centre for Artificial Intelligence Research and Education in Medicine (T-CAIREM) program will help make the case for philanthropic support, and define the unique contribution of family medicine to this endeavor.

Important strategic directions and areas of attention in the coming months and years include virtual care, AI in family medicine, education technologies and e-learning strategies.

This work has been launched with our new Digital Health Committee (DHC), led by Dr Raj Girdhari.

Strive to articulate how your many assets may contribute to other initiatives of the Temerty Faculty of Medicine and the university, and other key stakeholders such as the Ministry of Health.

We are expanding our continuing professional development programs, professional development offerings, and Global Health initiatives. In addition, we are exploring the development of a Family Medicine PhD program to promote research growth.

The DHC provides leadership and a community of practice for DFCM-affiliated sites and faculty on issues related to the use of digital tools in clinical practice and education. The DHC is committed to faculty development to further support faculty with responsibly integrating AI into their teaching and practice, and to provide a forum for discussion on this emerging topic.

One example of the DHC’s work is implementation and evaluation of AutoScribe, technology that is helping reduce administrative burden for family physicians.

Department of Family & Community Medicine, University of Toronto

Our Strategic Plan emphasizes increasing DFCM’s presence and connections across the Temerty Faculty of Medicine, the Dalla Lana School of Public Health, and the University of Toronto. This includes enhancing research collaborations and opportunities, strengthening existing partnerships, and increasing representation and the role of family medicine across diverse settings. Our new Office of Health System Partnerships has become a leading team in the health system at the local and provincial levels.

CHAIR’S REPORT I trained in this department as a resident 20 years ago, and throughout my career and journey as a health system leader, my identity as an academic family doctor and a member of this great department has been core to my self-conception.

I think many Department of Family and Community Medicine (DFCM) faculty members feel this way: academic contributions, whether an afternoon once a week with a medical student or a Canada Research Chair, are a throughline for our careers and an important part of our identities.

When I joined the DFCM leadership team as Chair nearly five years ago, I was bowled over by the incredible talent of our teams and saddened by the sense of overwhelm and disconnection in the culture of family medicine in Ontario, including inside our department. I can’t take credit for what has happened since—an alchemy of post-pandemic investments, renewed interest in our discipline at all levels of govof the largest investments in Indigenous Health in the ernment, and the fundamental culture of decency built and history of the Temerty Faculty of Medicine. sustained by my predecessors has propelled us to where we f Strengthening community partnerships: The are today. Our challenge was never excellence, but in 2021, I restructuring of our leadership team and the launch of understood that my primary task as a leader was to help this a new Vice-Chair of Community Partnerships represent incredible group of people actually see themselves as a team our commitment to lead efforts to build a more socially and apply their skills together to a common set of goals. accountable and community-driven agenda in all we do. We have increased the size, scope, and support At a strategic level, in addition to setting stretch goals for for our Patient and Family Partners program to deepen existing work and consolidating and restructuring aspects engagement; launched the Black Health Advisory of it, our plan sets out three areas of focus that, while not Table (BHAT) to advance the Black Health agenda; entirely new, reflected the needs of the moment and have and are exploring collaborations with community required significant effort and energy: organizations and Community Health Centres (CHCs) f Deepening our commitment to reconciliation: Key to co-create approaches to our work that will be initiatives include the establishment of the Indigenous more embedded in the community. The launch of new Leadership Circle (ILC), the acceleration of cultural and expanded education sites outside the downtown safety training, the opening of a new Indigenous Health core, in neighbourhoods such as Scarborough and Space, and the commissioning of murals that honour northwest Toronto at Humber River Health, and the new Indigenous cultures. These initiatives ensure that the Waddington research fellowships for community-based department is a safe space for Indigenous faculty and researchers are just a few examples of this commitment. learners and honours the territory on which we work.

In addition, the expansion of our Patient Partners We were also proud to announce the establishment network has led to the inclusion of patients and families of a new $5M endowed Chair in Indigenous Health, in every area of our work, from leadership searches reinforcing our long-term commitment to Indigenous to our twice-annual retreats, in addition to education, leadership into the future. This donation represents one research, and quality improvement and innovation.

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f Establishing the Office of Health System Partnerships (OHSP): The creation of the OHSP signals our commitment to leading transformative change within the health system—both locally and globally. Through OHSP, we aim to embed academic family doctors in system leadership, opening opportunities for our amazing faculty members and learners to help shape the direction of primary care in Toronto, across the province and the country, and around the world. We believe primary care becomes stronger and more sustainable when the university partners meaningfully with the health system to tackle complex policy goals—such as improving patient attachment, building interprofessional teams, and enhancing clinicians’ work lives. This includes adopting technologies and processes that enable better-quality care while fostering an environment that supports joy and professional fulfillment.

Of course, this work has been achieved in tandem with big and exciting new work in each of our core areas:

Education (led by Vice-Chair Dr. Shirley Lee; previously by Dr. Risa Freeman) DFCM has expanded education significantly over the past five years, adding six new residency positions in 2023 and eight more in 2024 at sites like Humber River Health and UHN’s Toronto Western Hospital. We also introduced new streams in Midland/Orillia and Uxbridge/Markham, increased capacity at Scarborough Health Network, Orillia Soldiers’ Memorial Hospital, and Royal Victoria Health Centre, and added six Enhanced Skills spaces in areas such as 30

emergency medicine and palliative care. Looking ahead, the government has set a goal for us of creating 40 additional residency positions to further strengthen family medicine training and meet growing patient needs. This massive expansion is demanding tremendous effort on the part of our education teams, who are actively recruiting and training new faculty, establishing new rotations in communities across the province, and putting in place creative ways to ensure that our extensive education programs do not preclude the development of a strong sense of local community and connection among learners.

Research (led by Vice-Chair Dr. Peter Selby) DFCM’s research program has continued to advance priorities in primary care, public health, and health system improvement, supported by research funding that grew from $10M in 2019–20 to over $22M in 2023–24. During this term, we launched UPLEARN, a “living laboratory” connecting over 2,000 family physicians to drive clinical and health services research, strengthen collaboration, and improve care for patients and providers. The commitment in our strategic plan to grow research capacity at our community sites and among community-based researchers is demanding new ways of thinking about research capacity-building, including through partnerships with Community Health Centres and front-line community clinicians who bring the realist perspective to research questions. To lead this work, we appointed Dr. Aisha Lofters as the inaugural Waddington Family Community Research Capacity Building Program Director; provided funds for faculty, clinician scientists, and senior researchers; and developed a training program to help clinical faculty develop their ideas into fundable proposals including seed funding.

Department of Family & Community Medicine, University of Toronto

Quality and Innovation (led by Vice-Chair Dr. Tara Kiran)

ciprocal learning of international work. We also had the honour of bringing dozens of international colleagues to Toronto, as we hosted the first-ever Starfield Summit outside DFCM’s Q&I work has advanced system improvement over of the United States. the past five years by embedding patient voices in our department and fostering collaboration with patients and Operational Excellence (led by Vice-Chair families in our work. The program hired DFCM’s first-ever Dr. David Tannenbaum and Director of Patient Engagement Specialist to strengthen partnerships Planning and Operations Brenda Chow) and co-design initiatives with patients. It also launched a COVID-19 Community of Practice, which regularly connects Throughout a time of fiscal constraints and uncertainty, we hundreds of primary care providers across Ontario to share have put in place new structures and staff roles to support strategies, adapt to evolving challenges, and shape new our expansion and new work. We have been intentionmodels of team-based care. Dr. Tara Kiran also led the na- al about succession planning and offering opportunities tional OurCare initiative, engaging thousands of Canadians for our faculty to grow their leadership skills. We have ofto share their experiences and priorities for primary care. fered flexibility to staff through hybrid work while ensuring The resulting OurCare Report provides actionable recom- that in-person meetings and opportunities for connection mendations to improve access, equity, and quality in primary and celebration continue. We have renovated our physical care across Canada, and the province is now using these space and rethought our model of physical space use. We recommendations to help guide system change. have onboarded a fantastic and skilled new Director of Planning and Operations after over 20 years with the same perCommunity and Partnerships (led by son in this role, ensuring a smooth and successful transition Vice-Chair Dr. Melanie Henry) to support our staff.

In addition to the community work highlighted above, including the hiring of the new Vice-Chair of Community and Partnerships and advancing local and provincial partnerships, the DFCM deepened collaborations globally. We had the honour of celebrating our 15-year relationship with Addis Ababa University (AAU) in Ethiopia, with whom we worked to establish Ethiopia’s emergency medicine residency program. A new partnership with Kwame Nkrumah University of Science and Technology (KNUST) in Ghana has allowed a growing number of clinical faculty to experience the reIntroduction

As we reflect on these achievements, what stands out most is the collective effort that made them possible. Our department’s strength lies in its people—their commitment to excellence, collaboration, and innovation. Together, we have built a foundation that not only meets today’s challenges but positions us to lead boldly and partner with humility to support the future of family medicine and primary care.

Dr. Danielle Martin Chair, Department of Family and Community Medicine 2020–2025 Self-Study Report

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PEOPLE 32

Department of Family & Community Medicine, University of Toronto

The Department of Family and Community Medicine (DFCM) at the University of Toronto is one of the largest academic family medicine departments in the world, with over 2,300 faculty supporting learners across clerkship, residency, and graduate programs, as well as in our research, quality improvement, and innovation programs. Our vibrant community also includes more than 1,300 learners and about 50 dedicated staff members. Together, our faculty leaders, clinicians, researchers and staff form a strong and committed network across a broad geography and an incredibly diverse range of interests that reflect the reality of modern family medicine in Canada.

Use of Human Resources Since the last external review, DFCM has continued to create and hire positions as new programs are created and existing programs expand. Planning for administrative support is done in collaboration with Vice-Chairs and Program Directors, taking into consideration administrative responsibilities and changes in technology. Currently, our department is lucky to have the appropriate complement of staff for the management and support of all Department programs. In terms of faculty renewal, DFCM continues to look for ways to improve our leadership structure. In the last five years, this is demonstrated by the fortification of leadership through Associate Program Directors and addition of new positions responsive to the needs of society and stakeholders.

People

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DFCM ORGANIZATIONAL CHART: FACULTY

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Department of Family & Community Medicine, University of Toronto

People

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ADMINISTRATIVE

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Department of Family & Community Medicine, University of Toronto

People

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LEADERSHIP DFCM benefits from strong leadership and expertise in major areas of education, research, quality & innovation, and community & partnerships. We are proud to be the home of a World Health Organization (WHO) Collaborating Centre on Family Medicine and Primary Care.

The work of the Vice-Chair, Community and Partnerships touches all portfolios in DFCM, and entails close collaboration not only with community partners, but with internal leaders in education, research, health equity, and quality and innovation.

In each of our major portfolios, leadership positions are filled Leadership and Equity with knowledgeable and skilled educators and researchers.

This includes Vice-Chairs who are nationally and inter- As part of our department’s commitment to principles of nationally recognized as thought-leaders and innovators. equity and social accountability, the DFCM launched the Equity Grand Rounds series in 2024 to create space for Over the past five years, all of our education programs critical conversations about systemic discrimination, health have been strengthened by the addition of Associate Pro- equity, and social justice in healthcare. These sessions gram Directors. This enables our programs to expand and are open to all members of the DFCM community—faculty, thrive thanks to greater collective expertise and more stable learners, staff, and community partners—and are designed leadership. It also creates a pipeline of future senior leaders to foster reflection, learning, and action. in our department. These programs are exemplars within the University and across Canada for their commitment to Each session features expert speakers, community leaders, innovation and evaluation systems that are informed by best researchers, and individuals with lived experience, offerpractices in learning science and respond to the needs of ing evidence-informed insights and practical strategies for the University and society. change. The series has become a key platform for advancing equity within the department and beyond, with strong Leadership Expansion engagement across our community.

Since the last external review, the DFCM has added more than 400 new faculty members. With these new additions, the DFCM has added nearly 40 new faculty leaders, including a new Vice-Chair Community and Partnerships, Dr. Melanie Henry. The former roles of Vice-Chair, Family Doctor Leadership and Vice-Chair, Global Health and Social Accountability have shifted into a more distributed model that has allowed growth of the ongoing commitment to these priorities across all our programs.

To date, Equity Grand Rounds sessions have addressed a range of timely and important topics, including: f Addressing Antisemitism in Healthcare f Black Health and Anti-Black Racism in Healthcare f Freedom of Expression and Academic Freedom f Islamophobia in Healthcare Settings f Anti-Indigenous Racism in Healthcare

Looking ahead, we are planning a session focused on Muslim, Arab, and Anti-Palestinian Discrimination. This session The creation of the Community and Partnerships portfolio in will continue our commitment to centring marginalized 2023 was a priority articulated in our strategic plan as part voices and equipping our community with the knowledge of DFCM’s commitment to grow community partnerships and tools to advance equity in all aspects of our work. across our education, research, and quality and innovation work. In this role, Dr. Henry has a broad scope to build and Leadership and Innovation steward partnerships with community organizations and groups, public health units, and other health system and Launched in 2022, the New Horizons Speaker Series was social service organizations and associations—especially created to spark bold, forward-thinking conversations about those serving equity-deserving communities—to promote the future of family medicine. The series invites influential better health outcomes. voices from diverse sectors outside family medicine—including public health, politics, the arts, and community activism—to challenge conventional thinking and inspire innovation within the DFCM. 38

Department of Family & Community Medicine, University of Toronto

Each session features a dialogue between Dr. Martin and a f “Good Listening is Healing: A Remedy for Healthcare guest speaker, offering fresh perspectives on the evolving Burnout,” with Frankie Abralind, Co-founder, The Good role of family physicians in a rapidly changing world. These Listening Project conversations are designed not only to provoke thought but f “The Forces Shaping Health and Society,” with Dr. Sandro also to equip DFCM leaders with new ideas, frameworks, Galea, Dean, Boston University School of Public Health and inspiration to lead with vision, courage, and creativity.

Sessions to Date: f “Building Narratives of Hope,” with Marshall Ganz, Senior Lecturer in Leadership, Organizing and Civil Society, Harvard University f “Will AI Fix or Fracture Family Medicine?” with Professor Enid Montague, Northwestern University f “Hockey and Healthcare,” with Katherine Henderson, CEO, Hockey Canada f “The Future of Healthcare,” with Olivia Chow, Mayor of Toronto f “What if What You Know About Lands and Bodies is Wrong?” with Professor M. Murphy f “Bringing Creativity to Our Work,” with Sarah Polley, Oscar-winning screenwriter and director f “What Can Peer Counsellors Do That Family Doctors Can’t?” with Dr. Ruth Heisey, Dr. Bjug Borgundvaag, and peer counsellors from the BETTER Women program f “How to Better Serve Communities,” with Dr. Kwame McKenzie, CEO, Wellesley Institute f “The Role of Technology-Enabled Virtual Care in Ontario’s Future,” with Dr. William Cherniak and Dr. Tara Kiran f “From the Clinic to the House of Commons,” with The Honourable Carolyn Bennett f “Prevention in Place,” with Medhat Mahdy, President and CEO, YMCA of Greater Toronto

Transitions of Leadership

Professor David Tannenbaum served ably as Interim Chair from April 2020 to September 2021, following Professor Michael Kidd’s departure to help lead the Australian pandemic response in March 2020. Dr. Tannenbaum has remained a key part of the department’s leadership team as Vice-Chair, Operations, providing continuity and support throughout this period of growth.

After a period of frequent transitions in the Chair position, the DFCM has experienced renewed stability and momentum since September 2021, when Professor Danielle Martin was appointed Chair. Her leadership has been guided by Primary Matters, our strategic plan that was built over the first year of her term and has shaped the department’s priorities and direction since then.

Under Dr. Martin’s leadership, DFCM has expanded significantly and deepened its impact in primary care—locally, nationally, and globally. The department has also benefited from the continued friendship and support of Professor Michael Kidd, who returned from Australia to participate in the DFCM Conference this year, reflecting the strong and lasting connections among DFCM’s leadership community.

Left to right: Dr. Shirley Lee, Vice-Chair, Education; Dr. Melanie Henry, Vice-Chair, Community & Partnerships; Dr. Tara Kiran, Fidani Chair, Improvement & Innovation and Vice-Chair, Quality & Improvement; Dr. Peter Selby, Vice-Chair, Research; Dr. David Tannenbaum, Vice-Chair, Operations People

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FACULTY

Over the past five years, the DFCM has grown and expanded our scope and our impact. Between 2020 and 2025, ~900 new faculty appointments were made, including 217 appointments in 2024, as we met the challenge of further expanding our training programs by opening new sites and building new partnerships with community family physicians.

41 per cent are adjunct faculty (<20 per cent). The DFCM also has 112 non-physician faculty who contribute to research, education and administration, of which approximately 60 are Health Professional Educators (HPEs).

With ~2,300 faculty members, the DFCM is well-positioned to advance its mission in clinical care, education, and research. Our academic department is constantly evolving with approximately 150 new faculty members every year, and a 45 per cent growth in the past five years. The vast majority of our faculty are Clinician-Teachers (95 per cent).

Of those, 73 per cent are at the rank of Lecturer, 21 per cent Assistant Professor, 4 per cent Associate Professor, and approximately 2 per cent at the rank of full Professor.

DFCM faculty appointments are managed either through affiliated hospital sites or through divisions/programs for community-based teaching. Non-hospital-based faculty are reflected in aggregate graphs by rank and appointment type rather than by site, contributing significantly to the Lecturer and Adjunct categories. This dual structure ensures broad engagement in teaching across both institutional and community settings.

We are so grateful to our Clinician-Teachers—busy clinicians who give their time and energy to help train the next generation. Twenty-eight percent of our Clinician-Teachers are full-time faculty (>80 per cent of time spent in academic work), while 31 per cent are part-time (20-80 per cent), and

Faculty Composition and Rank Progression

DFCM faculty span a wide range of academic ranks, with the majority serving as Lecturers. Progression across ranks demonstrates the department’s commitment to faculty development and academic advancement. The appointments and promotions team hosts regular workshops for faculty interested in pursuing promotion.

DFCM’s 2021 (left) and 2025 (right) Senior Promotions: Full and Associate Professors 40

Department of Family & Community Medicine, University of Toronto

FACULTY BY RANK

*2025 data is as of September 2025. 2020 data is from December 2020.

Number of Clinical Faculty by Appointment

Number of Clinical Faculty by Rank

Non-Clinical Faculty by Appointment Type

People

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Diversity and Demographics

a broader range of identity dimensions for faculty. The insights gained from this initiative will help inform approaches DFCM continues to prioritize diversity in its faculty recruitment. to fostering equity in appointments, promotions, leadership With respect to gender diversity, between 2020 and 2025: searches, and other processes. This work takes time and f New female faculty consistently outnumbered new trust-building. On a macro level, the number and diversity of male faculty, with the highest representation in 2024 our faculty has increased over recent years.

(138 female vs. 79 male). In Canada, 49 per cent of family physicians are male versus 51 per cent who are female. Looking Ahead f The department also recorded a small but important presence of new faculty identifying as non-binary or As DFCM continues to expand, the focus will remain on: another gender. f Supporting faculty through transparent promotion pathways f Enhancing faculty development programs Additionally, for the first time ever, the Data Collection Work- f Strengthening inclusive hiring and retention strategies ing Group through the Office of Education Scholarship is f Promoting interdisciplinary collaboration across divisions working towards a survey to collect demographic data beyond gender to advance our principles of equity and social Find more DFCM faculty information in the People section of accountability mandate. Co-chaired by Dr. Jeff Kwong and the appendices.

Dr. Mahan Kulasegaram, this work is focused on collecting

FACULTY BY SITE 2025

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Department of Family & Community Medicine, University of Toronto

LEARNERS DFCM Learners 2020-2025

PROGRAM

2020-2021

2021-2022

2022-2023

2023-2024

2024-2025

2025-2026

FMLE

265

264

272

259

276

293

Clerkship

268

270

263

269

259

276

Electives

159

153

144

136

129

Unavailable

Selectives

64

107

108

125

181

Unavailable

PGY1

168

171

169

180

182

191

PGY2

205

183

197

191

195

194

PGY3

4

8

8

5

2

4

Enhanced Skills

61

57

53

55

60

56

MPH (FCM)

1

3

4

6

1

4

MPH-AS (FCM)

4

12

1

3

1

4

MScCH (FCM)

8

7

3

4

1

1

MScCH (HPTE)

20

20

14

12

15

8

Undergraduate

Postgraduate

AFGS - Masters Programs

AFGS - Continuing Education Programs Academic Fellowship

1

1

1

0

1

0

Medical Education Fellowship

0

0

0

1

1

1

Clinical Teacher Certificate

6

10

5

4

4

2

Clinical Research Certificate

4

3

1

4

5

0

INTAPT

5

2

0

2

1

1

2025 acceptance is ongoing People

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The DFCM is committed to preparing future family physicians for comprehensive primary care in a rapidly evolving healthcare landscape. Through our Pre-Clerkship, Clerkship, Postgraduate Residency, and Enhanced Skills programs, we equip learners with the competencies needed to serve patients, communities, and society effectively. Graduate opportunities—including Master’s programs, Fellowships, and teaching certificates—further support career advancement and leadership development for health professionals.

consultation with the Family Medicine Patient Advisory Committee (PFAC). Annual programming includes a dedicated health equity day, and continuous collaboration with PGME supports anti-racism, Indigenous health, and climate-informed care initiatives. Feedback from the Continuous Quality Improvement (CQI) survey (2022–2024) shows strong learner endorsement of principles of equity and social accountability training, reinforcing DFCM’s commitment to creating a safe, supportive, and socially accountable learning environment.

In responses to our CQI survey from 2022–2024, learners conA major priority for DFCM is the expansion of our training sistently endorsed strong program support for principles of footprint to better serve diverse communities and meet equity and social accountability training, with more than 80 growing healthcare needs. Recent additions include our per cent agreeing or strongly agreeing. new teaching sites at Humber River Health (2023), Uxbridge, and the Midland-Orillia stream (2025), which features a PGY1 The Family Residents Association of Toronto Indigenous rotation co-developed with Indigenous partners. (FRAT) The Integrated Communities Stream will expand to Alliston in 2026, and the first PGY3 Emergency Medicine program PREPARED BY FRAT PRESIDENTS DR. YASMIN DINI AND has launched in Barrie. A doubling of the size of our Scar- DR. DARIYA DARVIN borough program is planned in the coming few years as the The Family Residents Association of Toronto (FRAT) repreUniversity of Toronto builds out a full new medical campus sents all Family Medicine residents to DFCM. It is composed in Scarborough. These targeted expansions in communities of chief residents, PGY1, and PGY2 representatives from where the need for primary care is great reflect our commit- every teaching site, as well as resident delegates to a wide ment to social accountability. range of internal and external committees. FRAT is overseen by two co-presidents, who also serve as co-chief residents Learner wellness and inclusivity are central to our education- for the Family Medicine program. Each month, approximateal philosophy. Competency reviews are conducted through ly 80 members convene to discuss issues related to resident an equity lens, with gender-inclusive language and ongoing wellness, central curriculum, and site-specific concerns.

FRAT in a meeting with Dr. Jane Philpott, leader of Ontario’s Primary Care Action Team, and Dr. Liz Muggah,Senior Clinical Advisor, Primary Care, Ontario Health

44

Department of Family & Community Medicine, University of Toronto

FRAT Structure

FRAT Presidents

Site Chief Residents Committee Reps Social Reps Exeternal Reps Internal Affairs PGY1 Reps

Strengths FRAT’s strength lies in its integration with DFCM, ensuring the resident voice is present at every level of departmental decision-making. Representatives sit on key DFCM committees such as Curriculum, Evaluation, Integrated Communities, and Quality Improvement; as well as the Residency Program Committee (RPC). Externally, FRAT maintains representation with the Ontario College of Family Physicians and the College of Family Physicians of Canada.

PGY3 Reps Environmental Health Lead Indigenous Health Lead Social Accountability Lead Wellness and Safety Reps

Challenges Since the pandemic, FRAT has sustained a virtual format, which limited in person opportunities for learning and social engagement. However, 2026 will mark the first in-person DFCM Practice Management central programming since the pandemic, a milestone in rebuilding resident connection and community.

The geographic vastness of our program has long posed a challenge; however, the introduction of hubs this year has helped the orientation block foster greater cohesion, and FRAT also connects residents across all sites, fostering col- this approach will be extended to future social initiatives. laboration beyond individual training environments. Social representatives organize site-wide socials, wellness initia- Current and Emerging Initiatives tives, and the annual retreat.

Building on its foundations, FRAT is leading several initiatives that both respond to current needs and shape the Core Day planning is another hallmark: co-presidents or- program’s future direction. This year, FRAT is focused on ganize two annual sessions of central, resident-driven revitalizing the elective database to ensure it reflects each curriculum to complement site-specific Academic Half site’s strengths and learning opportunities, supporting inDays. In addition, FRAT has championed revitalized Prac- novative approaches to studying through centralized retice Management sessions, which prepare residents for in- sources, and advancing wellness initiatives that address dependent practice; financially, organizationally, personally, burnout and work-life integration. Our work also emphasizes and professionally. equity and accountability by embedding Indigenous Health, EDI, and Social Accountability perspectives into central deAnother important strength is the diversity of our resident cision-making, while fostering leadership development to body. International Medical Graduates (IMGs) bring a prepare residents not only as clinicians but as advocates, wealth of global knowledge, cultural insight, and clinical collaborators, and system leaders. perspectives that enrich discussions and patient care. At the same time, Public Health residents strengthen our cap- Through these efforts, FRAT continues to amplify resident acity to integrate population-level thinking with family medi- voices, foster community, and shape the future of Family cine training, blending prevention, health promotion, and Medicine training in Toronto. community-level strategies into clinical education. Together, these voices broaden the scope of FRAT’s leadership and Further details on learner opportunities are provided in the enrich the learning environment across all sites.

Education section.

Find more DFCM learner information in the People section of the appendices.

People

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STAFF

Over the past year, DFCM has continued to grow and evolve and the staff complement has changed along with the needs of the department. Our team includes approximately 50 appointed staff members, along with a number of temporary staff who support our operations during peak periods.

In response to changing public health guidelines and the evolving COVID-19 landscape, we transitioned from a fully remote work model to a hybrid arrangement, with staff now working in the office two days per week. This shift has been well received, supporting both productivity and work-life balance, and helping foster greater collaboration and connection among team members.

This year also marked a major leadership transition within our administrative team. After 22 years of dedicated service to DFCM and 38 years with the University of Toronto, Caroline Turenko retired from her role as Director of Business Administration. Caroline’s leadership was instrumental in guiding the department through significant growth and transformation, and her legacy of mentorship and strategic insight continues to shape our work.

We were thrilled to welcome Brenda Chow as our new Director of Planning and Operations on September 2, 2025. Brenda brings nearly a decade of experience in administrative leadership at U of T, with a strong background in finance, HR, space planning, and IT. Her thoughtful, collaborative approach and deep commitment to the university’s mission have already made a positive impact.

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Department of Family & Community Medicine, University of Toronto

Staff Wellness The DFCM Staff Wellness group began in 2020 during the COVID-19 pandemic, when Holly Downey and Megan Parry (then Global Health and Social Accountability Program Coordinator) launched virtual wellness initiatives to support staff during the pandemic. Over time, the team evolved to include Ancy Jacob (2021), Linna Liu (2023), Thanusha Rajathurai (2024), and most recently Alyshia D’Cunha (2025).

The current team—Holly, Ancy, and Alyshia—continues to champion staff wellness and connection.

Formed to strengthen camaraderie among colleagues who had never met in person, the group promotes physical and mental well-being, encourages balance, and fosters a positive, connected workplace. Meeting regularly, they organize wellness activities and share opportunities from across the University.

Early initiatives included Eat, Chat, Grow sessions, virtual exercise challenges, cook-alongs, gardening and wellness channels, and holiday-themed events like pumpkin carving and gingerbread building. As staff returned to the office, the focus shifted to in-person coffee breaks, the annual U of T Step Challenge, and seasonal wellness and exercise events.

Popular offerings have included the DFCM Bake-Off, potlucks, and outdoor walks in summer.

Feedback from staff surveys (2021–2024) shows continued enthusiasm for the variety of activities and appreciation for the sense of community they build. The team presents regularly at staff meetings, welcomes new members, and remains committed to making wellness a valued part of DFCM’s culture.

HUMANS OF DFCM

CAROLINE TURENKO

After an illustrious 22-year career at the Department of Family and Community Medicine (DFCM), Caroline Turenko retired as the Business and Administration Director in October 2025.

People

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EDUCATION 48

Department of Family & Community Medicine, University of Toronto

Dr. Carolyn McQuarrie instructs former resident Dr. Alia Dharamsi (right) in the emergency department.

Education remains at the heart of the Department of Family and Community Medicine’s (DFCM) mission. Over the past several years, we’ve significantly expanded our programs, deepened our commitment to learner support, and embraced innovation in how we teach and train future family physicians. Our goal is clear: to make family medicine a compelling and inspiring choice for learners at every stage of their journey.

of the discipline. Our Postgraduate Program prepares residents to be safe, effective, and comprehensive family physicians, with enhanced skills training available for those pursuing focused areas of practice.

Graduate and Fellowship programs now offer even more pathways for learners to develop expertise in teaching, leadership, research, and clinical. Across all levels, we’ve prioritized wellness, equity, and mentorship—ensuring DFCM’s educational offerings span Undergraduate, Post- learners feel supported, valued, and equipped to thrive. graduate, Academic Fellowship and Graduate Studies, Global Health, Faculty Development, and Education Schol- While the COVID-19 pandemic brought significant challenarship programs. Each is designed to reflect the evolving ges, our current message is one of growth and hope. We’ve needs of our communities and the healthcare system. We emerged stronger, more connected, and more committed have grown in size, scope, and impact—reaching more than ever to shaping the future of family medicine through learners, offering more diverse training experiences, and education that is inclusive, responsive, and visionary. strengthening our leadership and administrative infrastructure across all sites.

All University of Toronto medical students continue to receive foundational family medicine training, and our Undergraduate Program has expanded its clinical and elective opportunities to better showcase the breadth and relevance Education

OVER 1,300 LEARNERS ANNUALLY ACROSS PROGRAMS 2020–2025 Self-Study Report

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UNDERGRADUATE EDUCATION

suburban, and rural areas of Ontario. These diverse teaching sites offer learners exposure to a wide range of care models and interprofessional teams, enriching their clinical education.

The rotation begins with a seminar series, after which students transition to clinical placements in family medicine Introduction teaching units, community-based physician offices, or a combination of both. In addition to their clinical responsibilOver the past five years, the DFCM’s Undergraduate Program ities, students attend site-specific seminars and complete has continued to grow in scope, adaptability, and innovation. online modules designed to reinforce their learning.

We’ve implemented curriculum changes aligned with the renewed MD Program structure, including enhancements to As part of the clerkship, students complete a scholarly prothe Foundations Program, expansion of virtual and hybrid ject focused on either evidence-based research or advolearning opportunities, and strengthened longitudinal family cacy. Topics have included access to medications, refugee medicine experiences in year 2. These changes were imple- health, addiction, health literacy, food security, infant nutrimented to advance the program goals of delivering excellent tion, and social isolation. education, designing and developing scholarly innovations in healthcare, and promoting family medicine as the career DFCM faculty remain deeply engaged in Undergraduate curchoice for medical students. riculum innovation, assessment strategies, and educational research. The Undergraduate Education Committee (UEC) The DFCM Undergraduate Program delivers mandatory meets regularly to review and improve educational processclinical experiences for all MD students in their second and es, with strong student representation from clerkship years third years, followed by selective and elective opportunities and the Interest Group in Family Medicine (IgFM), as well as in the fourth year. junior and senior residents. Recent expansions—including a new teaching site at Humber River Health and increased During the core family medicine clerkship, students train in rural capacity through Rural Ontario Medical Program both community and hospital-based practices across urban, (ROMP)—have further enhanced training opportunities.

~290 enrolled per year in the MD undergrad program with a projected 303 class size with Scarborough Academy of Medicine and Integrated Health launch (compared to 260 in 2020) 50

~285 thirdyear core clerkship placements in 2025

~100 fourthyear electives in family medicine per year

12 Greater Toronto Area and eight distant and rural sites for clerkship

~100 fourthyear selectives in transition to residency in family medicine

Department of Family & Community Medicine, University of Toronto

Undergraduate Committee Structure

Clerkship Teaching Sites

MAP LEGEND

1

Mount Sinai Hospital, Sinai Health System

2

Unity Health Toronto, St. Michael’s Hospital

3

Sunnybrook Health Sciences Centre

4

Toronto Western Hospital, University Health Network

5

Credit Valley Hospital, Trillium Health Partners

6

Markham-Stouffville Hospital

7

Mississauga Hospital, Trillium Health Partners

8

North York General Hospital

9

Women’s College Hospital

MAP LEGEND

10 Scarborough Health Network 11 Michael Garron Hospital 12 Unity Health Toronto, St. Joseph’s Health Centre 13 Humber River Health 14 Royal Victoria Regional Health Centre 15 Southlake Regional Health Centre 16 Headwaters Health Centre 17 Georgian Bay General Hospital 18 Orillia Soldiers’ Memorial Hospital 19 Collingwood General and Maine Hospital 20 Stevenson Memorial Hospital 21 Ross Memorial Hospital Map data ©2025 Google Terms

Education | Undergraduate

5 km

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Highlights Learner Feedback Family and Community Medicine continues to receive strong ratings from clerks across key areas, including Organization and Resources, Entrustable Professional Activities (EPAs), Feedback and Learning Experience, e-Modules, Responsibilities and Opportunities, Learning Environment, Overall Experience, Workload, and Facilities. Most items consistently score above 4 out of 5, with the learning environment and supervision often rated 4.7 or higher, indicating clear strengths. EPA-related feedback is also positive: 64 per cent of clerks rarely face challenges finding assessors, 86 per cent report effective feedback, and 92 per cent say preceptors are aware of EPAs. Student comments highlight high-quality teaching and overall positive experiences, though some note scheduling challenges, outdated course handbooks, and overlapping seminar content.

View Temerty Medicine’s Family Medicine learner ratings from 2020-2025.

The DFCM Undergraduate Clinical Program is consistently rated highly by students.

Course Evaluations Formal student feedback is gathered by completion of online course evaluation forms prior to the students’ final evaluation with the hospital program director. The overall course rating has been consistently high.

OVERALL

2019-20

2020-21

2021-22

2022-23

2023-24

2024-25

4.3

4.41

4.34

4.35

4.45

4.58

5-point scale: 1 = Poor, 3 = Good, 5 = Excellent

Rate the quality of your educational experience in your clerkship rotation

Teacher Effectiveness Scores/Learner Assessment of Clinical Teacher The table below shows teacher effectiveness scores (TES)/ learner assessment of clinical teacher (LACT) scores over the last five years at all sites.

OVERALL

2019-20

2020-21

2021-22

2022-23

2023-24

2024-25

4.6

4.65

4.71

4.73

4.71

4.75

5-point scale: 1 = Poor, 3 = Good, 5 = Excellent

Teaching Effectiveness Score / Learner Assessment of Clinical Teacher

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Department of Family & Community Medicine, University of Toronto

Principles of Equity and Social Accountability Principles of equity and social accountability guide the selection of committee members and physician leads, ensuring diverse representation and inclusive leadership.

MD students and residents are actively involved in key decision-making bodies, including the undergraduate education committee, clerkship committee, and award panels, allowing their voices to shape all aspects of the program.

DFCM faculty develop inclusive assessment tools and educational technologies to support learner success; student feedback is regularly incorporated to improve the learning environment. Evaluation tools have been updated to reflect inclusive language, and the program works closely with the Office of Learner Affairs to ensure accommodations are implemented as needed.

The Family Medicine Longitudinal Experience (FMLE) program has evolved in response to recommendations from the prior review to integrate principles of equity and social accountability for learners. Through engagement and collaboration with Black and Indigenous Health Leads to create a new stream that offers students a safe, identity-affirming experience by pairing them with faculty who share aspects of their identity. Collaborations with Dr. Onye Nnorom and the Black Medical Student Association support preceptor recruitment and training for this initiative.

In clerkship, students learn inclusive LGBTIQ2S terminology, participate in advocacy projects, and engage in patient-centered care through seminars like Motivational Interviewing.

Further, since 2014, the Undergraduate Program has implemented three iterations of an experiential Health Advocacy Project in the family medicine third-year clerkship. For the project, students identify a patient for whom social factors impact health, and they develop, implement, and present an advocacy plan. Evaluation data has been collected from students and faculty. Principles of success and pitfalls to avoid while implementing a health advocacy curriculum during clerkship have been shared widely. This initiative is important because it equips future physicians with practical skills to address social determinants of health, fostering a more holistic and equitable approach to patient care.

Wellness & Wellbeing Supporting learner wellness is essential at all levels of DFCM learning. In addition to supports provided to undergraduate learners by the Temerty Faculty of Medicine, the DFCM developed the DFCM Red Button in 2021. This tool is a quick-access resource that helps learners navigate challenging situations — from health concerns to safety issues. For undergraduate learners, it introduces a culture of support and transparency early in their training, showing that help is available and that wellness is a priority in family medicine education. At the end of each academic year, learner feedback is reviewed to identify challenges and inform program improvements.

U OF T MEDICAL STUDENTS TO SHOWCASE ADVOCACY EFFORTS

Third-year students in the University of Toronto’s MD Program have been sharpening their advocacy skills to help patients — from improving access to care for those without phones to making medical spaces more inclusive for gender-diverse people and helping others navigate vision and dental care.

Education | Undergraduate

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Increasing Interest in Family Medicine as a Career One of the overarching goals in the Undergraduate Program is the promotion of family medicine as the career of choice to our MD students. A variety of innovative initiatives have been launched to attempt to increase exposure and interest in family medicine in the pre-clerkship. These include the Family Medicine Longitudinal Experience (FMLE), which is now a required course for all second-year students, and optional experiences such as the Family Medicine Immersion week, FM CLLEO and the Gagnon scholarship (more on those programs below).

The main goals of the FMLE Program are: f Experience clinical care in the community-based primary care setting. f Develop an appreciation of the significant role of family physicians and the importance of primary care within the healthcare system. f Learn about important issues in our healthcare system such as physician distribution, physician remuneration, primary care reform and social accountability. f Have an opportunity to apply the skills acquired in the Integrated Clinical Skills Course in the ambulatory care setting, to conduct a supervised office visit in person or virtually.

Additionally, the Interest Group in Family Medicine (IgFM), a student-run group, has grown and flourished under the leadership of Dr. Lauren Payne as the Student Leadership and Engagement Lead.

For faculty, the FMLE Program acts as a gateway to other teaching opportunities in DFCM. Many of these faculty go on to teach in our elective and selective programs. Some have gone on to attain hospital-based appointments and serve as teachers in our core clinical clerkship and postgraduate An example of an event organized by the IgFM is FM101, programs. FMLE has recruited more than 200 community which includes a keynote speaker and panel of family doc- teachers over the last five years. tors. The event showcases the breadth and scope of family medicine at the very beginning of medical training and has FMLE updates since the last self-study: had rave reviews from attendees.

FMLE PRECEPTOR RESOURCE WEBPAGE These new pre-clerkship innovations are being evaluated f In 2024, the FMLE office, under the leadership of Dr. in a scholarly way to understand their impact on interest in Jane Chow (Undergraduate Recruitment Coordinator family medicine and future choice of family medicine as a and Faculty Development Lead), began work on an career. We look forward to the results of these evaluations.

FMLE Preceptor resource webpage. The site is part of a larger strategy of the FMLE administration to move The Family Medicine Longitudinal Experience toward more central and cloud/web-based supports for (FMLE) faculty.

The Family Medicine Longitudinal Experience (FMLE) is a DEVELOPMENT OF THE NEW FMLE MATCH SYSTEM mandatory community-based clinical experience. The pro- f One of the biggest changes for the FMLE in the past five gram offers 1:1 preceptorship and longitudinal exposure to years has been the development of the FMLE Match family medicine. Students schedule six half-days with the system, in partnership with engineers from PLANK (more same preceptor in their clinical offices and participate in a information about PLANK in Undergraduate Partnerships mixed model of observation and participation with patients. section) in 2023. The system reduces the administrative and preceptor burden and improves match results for the learner.

DEVELOPMENT OF FMLE 101 AND RESIDENT RECRUITMENT AND PRECEPTORSHIP f As we grow in class size, the FMLE continues to rely on the participation of our DFCM Postgraduate year 1 and 2 (PGY1 and PGY2) residents to meet our student placement needs. Over the last five years, resident preceptorship and participation have greatly increased. Resident recruitment and site training process is more streamlined with the introduction of our new annual “FMLE 101” presentation.

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Department of Family & Community Medicine, University of Toronto

Increasing Generalism in Pre-Clerkship

Family Medicine Community Longitudinal Leadership Enrichment Opportunity (FM The DFCM led the development of the Toronto Generalism CLLEO)

Assessment Tool (T-GAT) in 2021—an evidence-informed tool designed to evaluate the presence of generalist prin- Led by our Office of Health System Partnerships and with ciples in pre-clerkship curricular materials and to guide en- support from OntarioMD, this initiative offers early medical hancements in generalism content. learners an innovative and focused brief longitudinal placement with community-based family physicians. Students The T-GAT was used to conduct a comprehensive review learn to use EMR data to identify patients overdue for preof the U of T Foundations curriculum (the first two years of ventive care—such as immunizations and cancer screenthe MD program). Detailed feedback was provided to cur- ing—and assist physicians in delivering these interventions riculum developers, resulting in strengthened generalist over at least three clinic days. representation across course materials. Other universities, including the University of Manitoba, are now using T-GAT. Learners also gain procedural skills through simulation and hands-on experience in underserved communities. The proBuilding on this foundational work, DFCM launched a nation- gram aims to foster interest in family medicine and support al study titled “A Cross-Country Check-Up: Assessing Gen- physicians in improving preventive care delivery. eralism in Canadian Pre-Clerkship Case-Based Curricular Materials.” This initiative aims to quantify the integration of Students and preceptors shared overwhelmingly positive generalist principles in case-based learning across under- feedback, with several students newly inspired to consider graduate medical programs in Canada and to offer targeted Family Medicine as a career. recommendations for improvement.

See the Google Map of the FM CLLEO location.

Family Medicine Immersion Week

The Family Medicine Immersion (FMI) Week offers first and second-year medical students an early and engaging opportunity to explore careers in family medicine. The week combines interactive seminars, hands-on skills training, and clinical observations, balancing didactic learning with practical experience. Students rotate through clinical skills workshops where they practice procedures such as injections, suturing, cervical exams, and newborn delivery.

Assessment in Core Clerkship

Over the past few years, the Clerkship Mastery Evaluation (ME) has undergone key improvements to enhance its alignment with national medical standards and improve assessment quality. In 2021, a new exam blueprint was developed to better reflect the Medical Council of Canada Qualifying Examination (MCCQE) framework. This involved extensive faculty training in blueprint design and crafting Clinical Decision Making (CDM) questions. Then in 2023, the MD ProFMI Week also emphasizes mentorship and career explor- gram requested that all Mastery Exercise assessments shift ation, and incorporates community-based observerships, to a multiple-choice format. As a result, a dedicated team where learners shadow family physicians in their practices, of faculty exam writers now contributes to a growing bank offering exposure to primary care settings across the city. of high-quality multiple-choice questions. These questions are rigorously reviewed and revised before and after each exam, contributing to strong reliability and validity scores.

The MD Program’s latest course report also recognized the strength of this assessment.

MEDICAL STUDENTS WORK ALONGSIDE FAMILY DOCTORS TO HELP PATIENTS TAKE CONTROL OF THEIR HEALTH Education | Undergraduate

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In addition to exam updates, improvements were made to the evaluation tools used for clerkship projects. Specifically, the rubrics for both the advocacy and evidence-based projects were revised to make them clearer and easier to use. These changes help streamline the marking process and support more consistent, constructive feedback for students.

Addictions Medicine Conference

A new one-day in-person conference has been introduced to enrich student learning in addiction medicine. This event is paired with shadowing opportunities in both outpatient and inpatient settings, giving learners a comprehensive view of clinical practice. The conference includes keynote Finally, a new evaluation aims to determine if site-specific speakers with lived experience, panels featuring addiction differences influence student performance during their core medicine specialists, and interactive sessions that encourrotation. The goal is to optimize learning experiences and age active engagement and reflection. guide future resource planning. Results are expected to be published in fall 2025.

Lester and Jean Gagnon Scholarship

Family Medicine Electives Primer A new resource called the Family Medicine Electives Primer was developed to support students preparing for their electives in family medicine. This tool is designed to help students navigate their learning experiences more effectively.

Interprofessional Healthcare Providers, Formal Curriculum Half-Day Experience Most training sites have now implemented formal clinical learning experiences led by health professional educators (HPEs). These structured interactions have helped learners gain a deeper understanding and appreciation of the roles played by Interprofessional Healthcare Providers (IHPs). By observing interprofessional collaboration in action, students report feeling more prepared to work effectively with IHPs and recognize the value of HPEs as educators. This exposure has enhanced their ability to contribute to high-quality, patient-centered care.

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Program

The new Lester and Jean Gagnon Scholarship Program, supported by a generous donation that started two years ago, provides a seven-week paid opportunity for first- and second-year medical students to explore careers in family medicine. This program combines clinical exposure, mentorship, and leadership development, offering students handson experience in both academic and community settings, so that medical students can develop a strong professional identity within the field of family medicine.

Scholarly Innovations in Education Over the last five years, the DFCM Undergraduate Program has developed and studied a number of scholarly innovations in education. Many of these innovations have received Art of the Possible Education Grants, a DFCM Office of Education Scholarship initiative that provides seed grants to DFCM education programs and faculty members to support academic education initiatives that will benefit a DFCM program.

Department of Family & Community Medicine, University of Toronto

Challenges Over the past five years, the department has faced several challenges in Undergraduate Education. A wave of retirements among family physicians across Ontario has reduced the availability of preceptors, while the COVID-19 pandemic further strained clinical teaching capacity. During the twoyear disruption, many curriculum projects were paused, and community preceptor numbers declined to levels that have yet to fully recover. Despite these setbacks, the department ensured a smooth transition to virtual and hybrid care and then back to in-person care, prioritized student safety with PPE, remained focused on maximizing clinical learning, and continued to advance family medicine training with new curriculum ideas and scholarly work, as well as managing learner expansion.

(FMTU) sites remains a persistent concern. The expansion of medical schools has driven a rise in enrollment numbers, intensifying the demand for clinical rotation placements and making it increasingly challenging to ensure every clerk is matched to an appropriate site. In response, the department has focused on increasing the preceptor pool by expanding faculty appointments, particularly at strategic locations, in anticipation of the new Scarborough Academy of Medicine and Integrated Health and its associated training needs.

As of the 2021-2022 academic year, the FMLE stipend was increased by the Government of Ontario per student per block, which was vital to ensuring the continuity of the program and as an acknowledgement of appreciation for our outstanding U of T preceptors. As new medical schools continue to open Securing adequate funding for community preceptors and across the GTA, it is important to ensure we can stay comclerkship preceptors at Family Medicine Teaching Unit petitive as the demand for preceptors increases.

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Looking Ahead The last few months have seen many leadership changes within the program. We have a new Vice-Chair of Education and a new Program Director for Undergraduate Education. In addition, we have a new Lead for the FMLE program, a new Clerkship Exam Lead, and several new Hospital Site Leads. We will maintain our excellence through these leadership changes as well as take advantage of fresh ideas and energy that they will bring to the program. It is the goal of our new team to implement key components of the DFCM Strategic Plan throughout our work.

In the next five years, we hope to continue to expand student interest in choosing family medicine as their first choice in careers at the completion of their medical school training.

Our ongoing scholarship projects will help to inform best practices on how to do that, as will increasing exposure to meaningful family medicine clinical experiences through programs such as FMLE, Family Medicine Immersion Week, and the Gagnon Mentorship Scholarship Program.

Learner feedback has identified challenges in understanding the various practice models that family doctors work in, the complexity of how Family Health Teams work alongside these practice models, and now the introduction of Ontario Health Teams. Questions about compensation, administrative burden, and leadership opportunities were also prevalent in student feedback. As a result, we are piloting a new seminar that will address the following topics: 58

f Review the role family doctors within the healthcare system f Funding models in primary care f Addressing the reality of the FM crisis in a historical context f Primary care reform/Innovations (i.e., what is being done to fix the system?) f Highlighting the opportunities for leadership in an FM career As the MD program expands, our team is committed to maintaining the high standards of education across new training sites. Research initiatives such as “Clerkship Clinical Rotation Factors: Effect on Student Performance” will guide this process, while our Physician Recruitment Lead plays a key role in growing community-based clinical learning. Sustainable funding for community preceptors remains essential to ensuring consistent, high-quality experiences for all students.

We also continue to embrace innovation, leveraging technologies like AI to enhance learner evaluation and curriculum delivery. To further strengthen our scholarship efforts, we aim to secure dedicated support—such as a research associate—to help organize, lead, and publish our scholarly work, maximizing the impact of our academic contributions.

Department of Family & Community Medicine, University of Toronto

Partners Clinical Training Sites

PLANK

f DFCM partners with 21 hospital and community sites across Ontario, including Humber River Health, Markham-Stouffville, Midland-Orillia, Uxbridge, Barrie, Orangeville, Port Perry, and Alliston. f These partnerships provide diverse, high-quality clinical experiences for students in urban, suburban, and rural settings.

f The FMLE program and DFCM partner with engineers at PLANK to develop and maintain innovative matching applications that enhance the student experience.

Rural Ontario Medical Program (ROMP) f In collaboration with the ROMP, DFCM supports and funds student placements in rural communities for core clerkship rotations.

Emerging Collaborations f The emergence of new medical schools, such as the one at Toronto Metropolitan University (TMU), introduces the challenge of potential of increased competition in attracting learners. f At the same time, it presents exciting opportunities for collaboration, shared learning, and advancing the discipline of family medicine together.

Various Donors f Generous donor partnerships support meaningful student opportunities, including the FM-CLLEO and Gagnon Fund, which provide funding for research and clinical experiences.

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POSTGRADUATE PROGRAM Introduction The University of Toronto’s Family Medicine Postgraduate or Residency Program is one of the largest and most diverse in Canada, offering a comprehensive two-year training experience accredited by the College of Family Physicians of Canada.

The program accepts both Canadian and international medical graduates through the CaRMS matching process using Postgraduate Medical Education’s (PGME’s) Best Practices in Application and Selection (BPAS 2.0), which emphasizes equity, transparency, and standardized processes.

The program features multiple geographic training streams: the Greater Toronto Area, Barrie/Newmarket, Midland/ Orillia, Integrated Communities (which combines one GTAbased year and another year in a different community), and Uxbridge/Markham. Each stream includes unique combinations of hospital-supported Family Medicine Teaching Units (FMTUs) and community-based preceptor models, providing residents with exposure to a wide range of clinical settings and patient populations.

In the past five years, the Postgraduate Program has expanded the number of teaching sites to include Humber River Health in 2023, and the Midland/Orillia and Uxbridge/ Markham streams in 2025. These new sites seek to provide primary care to unattached patients, with a significant proportion being from the Indigenous community. In the Midland/Orillia stream, there is a Postgraduate Year 1 (PGY1) core Indigenous rotation, which was co-developed with Indigenous community partners. This expansion reflects a key priority in the Department of Family and Community Medicine’s (DFCM) strategic plan to advance equity, diversity, inclusion, and Indigenous engagement through distributed education and community partnerships.

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With over 18 teaching sites—four more than our previous self-study term—and an internal post-match process that allows residents to rank their site preferences, the program emphasizes flexibility and learner choice, welcoming approximately 200 new family medicine residents per academic year. Residents have access to either horizontal or block rotation schedules (depending on their training site) and to a rich array of electives to support individualized learning goals. The curriculum is competency-based and includes innovative tools such as the Family Medicine Medical Expert Assessment of Progress (FM-MAP) to support formative assessment and professional development.

Academic excellence is a hallmark of the program, with consistently high certification exam pass rates and integrated pathways such as the optional Integrated 3-Year Programs (I3P), which offer advanced training in areas like leadership or enhanced skills.

The program fosters a supportive, learner-centered environment through initiatives like the Family Medicine Residents Association of Toronto (FRAT) and maintains a strong focus on resident wellness, mentorship, and work-life balance.

This structure ensures that graduates are exceptionally well-prepared for comprehensive, community-responsive family medicine practice across a wide range of settings.

Program Objectives The overall goal of the DFCM’s Postgraduate Residency Program is to provide residents with the skills to practice family medicine anywhere–provincially, nationally, and internationally. Our learners often go on to become leaders in education and research, as the program ensures that graduates are exceptionally well-prepared for comprehensive, community-responsive family medicine practice across a wide range of settings.

Department of Family & Community Medicine, University of Toronto

Team Structure The Residency Program Committee (RPC) advises, assists and makes recommendations to the Postgraduate Program Director on policy and procedures regarding the resident training program, including: selection of residents, educational design, policy and process development, safety and resident wellness, assessment of resident progress, continuous improvement, and resident engagement.

The RPC assists the Postgraduate Program Director in planning, implementing, organizing, supervising and evaluating the DFCM’s two-year Postgraduate Family Medicine Program to ensure that the Standards of Accreditation, as set out by the College of Family Physicians of Canada (CFPC), are met.

The following subcommittees manage various aspects of the program and curriculum: f Joint Curriculum and Evaluation Committee f Awards Committee f Internal Match Committee f Policy Committee f Resident Progress Review Committee f Teaching Practice Committee f Maternity Care Group f Family Medicine Resident’s Association of Toronto (FRAT) Education | Postgraduate

Program Snapshot f Program length is two years; residents can opt to apply to the Integrated 3-Year Program (I3P) or an Enhanced Skills program f 409 PGY1&2 learners in 2025-2026 compared to 362 postgrad learners in 2021-2022 f Program Director is Dr. Stuart Murdoch f Program Administrator is Lela Sarjoo f Approximately 2,300 faculty members at DFCM who are active in all levels of DFCM education

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Curriculum Design and Delivery

Category 1 programs are designated by the CFPC as programs leading to a Certificate of Added Competence (CAC).

Across all 18 teaching and integrated community sites, the Category 2 programs are intended for learners to gain addiDFCM Postgraduate competency framework is built on: tional experiences in research/scholarship or in areas of inf CanMEDS–FM 2017 roles (Family Medicine Expert, dividual interest. Category 2 programs do not lead to a CAC. Communicator, Collaborator, Leader, Health Advocate, Enhanced Skills programs occur after the resident has gone Scholar, Professional) through the two years of Postgraduate Residency. f The College of Family Physicians of Canada’s (CFPC) Professional Profile & Four Principles of Family We also offer the Family Medicine and Enhanced Skills Medicine (FAM-ES) Integrated 3-year Program (I3P), as suggested by f Triple C curriculum (Comprehensive, Continuity-based, reviewers from our last self-study. The program is open to Centred in Family Medicine) PGY1 residents at U of T only. The FAM-ES program integrates PGY3 content (either Palliative Care or Sport & ExerProgressive levels guide the 24-month cise Medicine) alongside core Family Medicine during the residency: PGY2 and PGY3 years of training. f Resident Readiness (first month): Foundations Block focused on transitions, wellness, and early clinical skills. f Essential Competencies (throughout two years): Core skills delivered through longitudinal and block rotations, Academic Half Days (AHDs), and Core Days.

Z Domains of practice covered by the Essential Competencies (all fully mapped to CanMEDS-FM roles): Women’s Health & Sexual Health Maternal/Perinatal Care Pediatric & Adolescent Health Care of the Elderly & Frailty Mental Health & Addictions Musculoskeletal & Sports Medicine Emergency & Urgent Care In-Hospital and Transitional Care Palliative & End-of-Life Care Men’s Health Public & Population Health (including immunization, environmental health) Surgical & Procedural Skills Social Accountability & Health Equity — new domain, 2026 f Enriched Competencies (throughout two years): Advanced skills tailored to residents’ targeted interests and career directions, which can be achieved through electives or high-volume exposure in areas of interest.

Z Areas can include, but are not limited to: Addictions Obstetrics Transgender care Dermatology f Enhanced Competencies (optional, following two-year residency): Optional electives and scholarly work that support individualized career goals.

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There are 17 Enhanced Skills programs divided into Category 1 and Category 2: Category 1: f Addiction Medicine f Anesthesia f Care of the Elderly f Clinician Scholar f Emergency Medicine f Palliative Care f Sport and Exercise Medicine Category 2: f Adolescent Medicine f Breast Diseases f Education Scholar f Global Health and Vulnerable Populations f HIV Care f Hospital Medicine f Intellectual and Developmental Disabilities f 2SLGBTQ Health f Low-Risk Obstetrics f Women’s Health DFCM’s educational offerings are also enhanced by our Academic Divisions, which provide an academic home for family physicians and other primary care providers practicing comprehensive care and developing enhanced skills in family medicine. We now have six Divisions, compared to two during our last review. These Divisions allow DFCM to unite academic family physicians working in focused practice to support collaborative education and research.

They are focused on areas of practice that are integral to comprehensive educational programming and crucial to the future of family medicine. Read more information about our Academic Divisions.

Department of Family & Community Medicine, University of Toronto

Assessment Integration

Reviewing the Learner

Competencies are directly linked to progress reviews, field We collect feedback on residents through multiple channels: notes, In-Training Evaluation Reports (ITERs), Family Medicine Medical Expert Assessment of Progress (FM-MAP) 1. Competence Committees (at each teaching site) performance, and Resident Practice Profile (RPP) data—enUse multiple data sources (field notes, ITERs, FM-MAP suring real-time tracking and responsive adjustments. scores, RPP dashboards, progress reviews) to: Z Evaluate resident progression relative to Reviewing the Program expectations.

Z Make formal promotion recommendations twice We collect feedback from residents through multiple channels: annually (PGY1 → PGY2 and graduation readiness).

Z Submit recommendations to the Residency Program 1. Centralized Surveys and Feedback Processes Committee (RPC) for final approval.

Z Continuous Quality Improvement (CQI) Survey Z Assess CFPC exam readiness based on (Annual) demonstrated competencies.

Led by CQI Lead Nasreen Ramji.

2. Resident Progress Review Committee (RPRC) – Distributed to residents at each site in May/June.

Escalation Process Results are shared with sites for self-comparison Residents may be referred to the RPRC if they show signs and broader DFCM benchmarking. of difficulty, including: CQI team conducts site visits to support CQI Z Concerning ITERs or mid-rotation feedback. initiatives.

Z Patterns in field notes or FM-MAP data.

Data is reviewed centrally for curricular Z Performance concerns raised by site directors, innovations (e.g., Foundations). faculty advisors, or progress review discussions.

Z Family Medicine Longitudinal Survey (FMLS) Administered at PGY1 and PGY2 levels.

Created by CFPC; we add customized questions and manage dissemination.

Z Temerty “Voice of the Resident” Survey (Every two years) Captures data on learners.

Informs program quality and improvements to the learning environment.

Sites provide protected time for completion.

2. Resident Evaluations of Training Experience Z Evaluating Rotations Residents can submit evaluations at the end of each rotation.

For multi-site or longitudinal rotations, separate evaluations can be submitted for each site/ subrotation.

Z Evaluating Faculty (Learner Assessment of Clinical Teaching – LACTs) Completed after a rotation with a faculty member.

Minimum of three evaluations required to generate a LACT report.

Includes qualitative comments.

GRIT AND GOALS: DFCM RESIDENT DR. HAYLEY WICKENHEISER ON THE TEAM SPORT OF EMERGENCY MEDICINE

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MAP LEGEND

Postgrad Teaching Sites 1

Mount Sinai Hospital, Sinai Health System

2

Unity Health Toronto, St. Michael’s Hospital

3

Sunnybrook Health Sciences Centre

4

Toronto Western Hospital, University Health Network

5

Credit Valley Hospital, Trillium Health Partners

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Markham-Stouffville Hospital

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Mississauga Hospital, Trillium Health Partners

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North York General Hospital

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Women’s College Hospital

MAP LEGEND

10 Scarborough Health Network 11 Michael Garron Hospital 12 Unity Health Toronto, St. Joseph’s Health Centre 13 Humber River Health 14 Royal Victoria Regional Health Centre 15 Southlake Regional Health Centre 16 Georgian Bay General Hospital 17 Orillia Soldiers’ Memorial Hospital 18 Oak Valley Health - Uxbridge Hospital Map data ©2025 Google Terms

5 km

GTA stream: f Humber River Health f North York General Hospital f Oak Valley Health - Markham Stouffville Hospital f Scarborough Health Network f Sinai Health - Mount Sinai Hospital f Sunnybrook Health Sciences Centre f Toronto East Health Network – Michael Garron Hospital f Trillium Health Partners – Credit Valley Hospital f Trillium Health Partners – Mississauga Hospital f Unity Health Toronto – St. Joseph’s Health Centre f Unity Health Toronto – St. Michael’s Hospital f University Health Network – Toronto Western Hospital f Women’s College Hospital

Other elements of the program f Teaching Practice Rotations: All residents complete two consecutive four-week blocks in 36 rural/underserved Ontario communities (e.g., Moose Factory, Lake Erie), acting as most responsible physicians (MRPs), working with interprofessional teams, and delivering care in resource-limited settings. f Integrated Communities Stream (ICS): Introduced as a replacement for the rural program, ICS combines one GTA-based year with a year in a community hospital in Port Perry or Orangeville, focusing on underserved populations, newcomers, and patients facing housing or food insecurity. A new site in Alliston will be added in 2026. f Rural Northern Initiative: In partnership with the Ministry of Health, this initiative offers core and elective rotations in Northern Ontario, exposing residents to resource-limited contexts and emphasizing system navigation, interprofessional collaboration, and community-responsive care.

Map data ©2025 Google Terms

Barrie/Newmarket Stream: f Royal Victoria Regional Health Centre – Barrie f Southlake Health – Newmarket Midland/Orillia Stream: f Georgian Bay General Hospital - Midland f Orillia Soldiers’ Memorial Hospital - Orillia Integrated Communities – Uxbridge Markham: f Oak Valley Health - Uxbridge Hospital 64

Department of Family & Community Medicine, University of Toronto

1 km

Accreditation The program undergoes regular accreditation cycles at the external and internal levels: f The DFCM Postgraduate Program successfully passed external accreditation in 2020. We submitted our response to the two-year Accreditation Progress and Outcomes Report (APOR), and our next submission—the Action Follow-up Report (AFI)—is due in November 2026. f Underwent internal review at the site level this past winter (2024-2025). f Undergoing internal review at the central FM level in January 2026. f Renewed our World Organization of Family Doctors (WONCA) accreditation in February 2025.

Highlights Expansion

Data from the College of Family Physicans of Canda Family Medicine Longitudinal Survey (2019-2024) survey “How prepared do you feel to begin independent practice as a family physician?” f High preparedness overall: Across 2019–2024, between 82–89 per cent of graduates rated themselves as “Prepared” or “Very Prepared” for practice. f Upward stability: Results were consistent year-to-year, with a slight upward trajectory noted between 2019 (82 per cent) and 2023 (89 per cent), sustaining at 87per cent in 2024. f Strengths identified: Graduating residents particularly reported confidence in: Z Comprehensive primary care delivery.

Z Managing complex chronic disease.

Z Communication and collaboration skills.

The Postgraduate Program opened a training site at Humber River Hospital in 2023, with the site graduating their first PGY2s in June 2025. Three new sites opened for the 2025-2026 academic year: Orillia Soldiers’ Memorial Hospital (Orillia), Georgian Bay General Hospital (Midland), and Markham-Uxbridge which was done in collaboration with Indigenous patients.

Oak Valley Health Hospital in Markham Stouffville. f Expansion of the program to include a Midland-Orillia stream, which seeks to provide primary care to We also conducted the first PGY3 expansion in Barrie with unattached patients, with a significant proportion being emergency medicine in Barrie (Royal Victoria Hospital) as from the Indigenous community. In this stream, there well as two more teaching sites announced for Scarborough is a PGY1 core Indigenous rotation, which was coby the Primary Care Action Team. developed with Indigenous community partners.

Indigenous Health Experiences Since the 2020 accreditation cycle, the DFCM has demonstrated a strong and sustained commitment to Indigenous health education through: f Mandatory San’yas Indigenous Cultural Safety Training for all PGY1 residents. San’yas Indigenous Cultural Safety Training is a program designed to foster critical reflection and knowledge around the impacts of colonization, anti-Indigenous racism, and systemic inequities in healthcare delivery. f Thoughtful planning of an Indigenous Health Education Workplan, co-developed with community partners. f Expanding clinical learning opportunities in Indigenous health, including urban electives, remote community placements through the Rural Northern Initiative, and community-based Teaching Practices serving Education | Postgraduate

Through these efforts, Indigenous health and cultural safety are embedded as core elements of residency training.

Social Accountability Competencies Survey results indicated that fewer than half of learners viewed social accountability as an important element of curriculum renewal, underscoring the need to strengthen engagement.

In response, the program’s leadership collaborated with the Vice-Chair of Community and Partnerships to draft competencies for a Social Accountability domain of competencies that residents will be evaluated on. The Vice-Chair of Community and Partnerships developed these competencies through a rigorous process involving patient partners, the Health Equity Committee, the Residency Program Committee (RPC) committee, and health professional educators.

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The draft competencies were reviewed by Postgraduate Resident Wellness & Wellbeing Program leadership and members of the ILC and will be presented to the RPC for final review. The goal is for these new Resident wellness and safety are foundational to the DFCM competencies to be fully integrated into the program in 2026. residency program, guided by the DFCM Resident Wellness Guide and embedded in program governance through the Continuous Quality Improvement (CQI) Residency Program Committee (RPC). Wellness updates are framework a standing agenda item, and many sites have designated wellness officers. Dr. Kim Lazare represents DFCM on the As planned in the previous self-study, the Postgraduate Pro- PGME Wellness Subcommittee, ensuring alignment with gram has fully implemented a five-step Continuous Quality central policies.

Improvement (CQI) framework that systematically integrates feedback, monitors outcomes, and drives program improve- Residents are introduced to wellness resources during ment. Areas for improvement are identified through multiple orientation and throughout the program, including: data sources, including surveys, field note and assessment f The DFCM Resident Wellness Guide data, progress reviews, and stakeholder feedback. f The DFCM Red Button and PGME Yellow Button for anonymous support Since the last review, we added a CQI lead to the Postgrad- f A dedicated Foundations Block wellness half-day uate team that runs the annual survey, interprets the data f Flexibility for leaves (e.g., parental, mental health) and and disseminates results to central leadership and site dirdeferred start dates ectors/admins, conducts site visits, etc. f Social events hosted by Family Medicine Residents Association of Toronto (FRAT) and Professional This fulfills requirements in the Accreditation Standards Association of Residents of Ontario (PARO) to foster and allows for continuous improvement to occur in the resicommunity dency program. f PGME Office of Learner Affairs (OLA) f PARO’s 24 hr helpline Foundations Block f Office of Learner Experience (OLE) f Indigenous Student Services and Supports In response to some CQI survey feedback around residents f Black Health Advisory Table (BHAT) provides resources feeling they needed a greater orientation to the Postgradfor Black students uate Residency Program as they transitioned from medical f Physician Health Program school, the Postgraduate Program developed and launched f Resident wellness guidelines, PGME policies and guidelines the Foundations Block this July 2025.

Resident feedback is actively gathered through the CQI surThis block consists of both central- and site-level initia- vey and FMLS, informing curriculum and support planning. In tives to introduce the residents to the main principles of 2022–2024, over 80 per cent of residents consistently agreed the program, begin professional identity formation, and they felt safe and supported in their learning environment. productive struggle. Sites provided residents with family These results affirm the program’s commitment to a positive medicine clinic, debrief sessions to discuss patient cases, culture, supported by faculty professionalism workshops and site-provided courses. The central DFCM Postgraduate and wellness leads.

Program planned centrally-run courses such as Serious Illness Communications Education, Physical Exam Skills, Graduates also report strong supervision structures: acWellness, Social Accountability, and Prescribing, where fa- cording to the CFPC FMLS Exit Survey (2019–2024), 87–93 per cilitators consisted of health professional educators such as cent had identified mentors guiding their development, and pharmacists, faculty members, recent graduates, and cur- 85–90 per cent rated supervision as Excellent or Very Good. rent residents. This curriculum initiative was conducted in collaboration with the site directors, and site administrators Diversity of opportunities received high satisfaction rates from the residents.

The DFCM Family Medicine Residency Program offers We plan to conduct Foundations again in 2026. training across urban, suburban, rural, remote, and even international settings, including academic health science centres, community hospitals, interprofessional clinics, and specialized community health sites.

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Department of Family & Community Medicine, University of Toronto

Challenges Further expansion and capacity-building: The DFCM has been instructed by the Government of Ontario to add 40 additional positions to the Postgraduate Residency Program by 2028, as part of the work underway to try to increase access to primary care. This expansion is important for our communities and will require hard work to implement. The program has taken steps to accommodate this expansion, but will need to collaborate with the government and our training sites to ensure we can expand more and build capacity.

Technological systems: We need to ensure that our technological systems are adequate to support the demands of our curriculum delivery, learner and program assessments, keeping educational materials up to date, etc. Opportunities for innovation are limited by our current technological structures.

Sufficient financial support: Our training sites require ongoing financial support to continue to achieve excellence.

In an environment where supports to the university and the department have not increased for many years, it is difficult to continue to grow and innovate within fixed budgets.

Looking Ahead We are continuing to work on capacity-building and expansion efforts to meet our 40-seat expansion requirement by 2028, and we remain on track to achieve this goal.

Following the success of the Foundations block this year, we aim to further enhance this novel curriculum initiative to better meet the evolving needs of our residents.

In addition to family medicine, learners can also explore areas including pediatrics, internal medicine, emergency, OB/GYN, psychiatry, geriatrics, addictions medicine, Indigenous health, LGBTQ2S+ health, and correctional health.

We remain committed to ensuring our curriculum not only prepares residents to practice anywhere in Canada and globally but also equips them to deliver socially accountable medicine. As part of this commitment, we will be implementing Social Accountability competencies into the Postgraduate curriculum in 2026.

Learners can also pursue placements to support underserved populations, like in shelters, refugee clinics, with In- We are also collaborating with the Indigenous Leadership digenous organizations, in youth mental health, and addiction Circle (ILC) to integrate Indigenous health-specific compeservices to foster socially accountable, equity-oriented care. tencies and electives.

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Partners In addition to our close ties with Temerty Faculty of Medi- Emerging Collaborations cine’s Postgraduate Medicine Education team to ensure we f The emergence of new medical schools, such as are continuously following their policies and guidelines, the the one at Toronto Metropolitan University (TMU), DFCM Postgraduate team also has close relationships with introduces the challenge of potentially increased the below. competition in attracting learners. f At the same time, it presents exciting opportunities Clinical Training Sites for collaboration, shared learning, and advancing the f DFCM partners with these hospital and community sites discipline of family medicine together. to provide diverse, high-quality clinical experiences for learners in urban, suburban, and rural settings: FRAT Z Georgian Bay General Hospital – Midland; Humber The Family Residents Association of Toronto (FRAT) is a River Health; North York General Hospital; Oak Valley close and essential partner to DFCM Postgraduate EducaHealth – Markham Stouffville Hospital; Oak Valley tion, ensuring strong resident representation in all aspects Health – Uxbridge Hospital; Orillia Soldiers’ Memorial of program planning and decision-making. With members Hospital – Orillia; Royal Victoria Regional Health from every teaching site, FRAT provides direct resident input Centre – Barrie; Scarborough Health Network; Sinai through active participation on key departmental commitHealth – Mount Sinai Hospital; Southlake Health – tees and regular collaboration with Postgraduate leaderNewmarket; Sunnybrook Health Sciences Centre; ship. Together, we co-create initiatives like Core Day, PracToronto East Health Network – Michael Garron tice Management sessions, and wellness programming that Hospital; Trillium Health Partners – Credit Valley reflect the evolving needs of our learners. This partnership Hospital; Trillium Health Partners – Mississauga allows us to build a responsive, inclusive, and resident-cenHospital; Unity Health Toronto – St. Joseph’s Health tered training environment that is strengthened by FRAT’s Centre; Unity Health Toronto – St. Michael’s Hospital; diverse voices and leadership.

University Health Network – Toronto Western Hospital; Women’s College Hospital.

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Department of Family & Community Medicine, University of Toronto

GRADUATE STUDIES AND ACADEMIC FELLOWSHIPS Introduction The Academic Fellowship and Graduate Studies (AFGS) ProZ MPH-AS(FCM): Master of Public Health – Advanced gram at DFCM has provided advanced and comprehensive Standing in Family and Community Medicine | 1 year professional development for practicing clinicians since 1990. degree – 10 courses It sees 30-50 learners each year, returning to explore academ- f Continuing Education: ic leadership, education, research, and scholarly training.

Z Clinical Research Certificate (CRC) – 4 module certificate | 1 year Programs are delivered collaboratively with the Dalla Lana Z Clinical Teacher Certificate (CTC) – 4 module School of Public Health (DLSPH), with administration housed certificate | 1 year in DFCM. Z Certificate in Academic Family Medicine – 4 module certificate | 1 year In alignment with DFCM’s strategic vision, AFGS programs Z INTAPT: Interprofessional Applied Practical contribute to a growing cohort of family medicine and health Teaching and Learning in the Health Professions – 2 professional education champions locally and abroad. Graducourse program (Fall to Winter) ates are equipped to examine the health trends in their communities and contribute to leadership and system planning Programs are designed for working professionals and coursein their contexts. Our recent survey of graduates highlighted based (non-thesis), with flexible full-time and part-time options that approximately 70 per cent of graduates go onto leader- and a unique experiential learning practicum component. ship roles in education, research, and clinical capacities.

Learners include family physicians, clinician educators, AFGS supports advanced faculty development both within early, mid, and late career faculty of interprofessional disciand external to the department. It offers graduate master’s plines, and international participants from countries such as degrees, continuing education (CE) certificates, fellowship Saudi Arabia, Thailand, Oman, Kuwait, Japan, and India— programs, and single course options that focus on both family creating a collaborative, rich learning experience and netand community medicine and health professions education. working opportunities for all students.

Offerings include: f Graduate Studies: Z MScCH (HPTE): Master of Science in Community Health in Health Practitioner Teacher Education | 1 year degree – 10 courses Z MScCH(FCM): Master of Science in Community Health in Family and Community Medicine | 1 year degree – 10 courses Z MPH(FCM): Master of Public Health in Family and Community Medicine | 2-year degree – 20 courses

Education | Graduate Studies and Academic Fellowships

Programs and courses are led and instructed by revered healthcare professional DFCM faculty across various disciplines.

Current 2025-26 academic year metrics: 10 program offerings (4 degrees, 2 fellowships, 3 certificates, INTAPT), 33 core faculty instructors, 86 active enrolled students (graduate & continuing education).

Over 217 primary care providers (162 family physicians) have completed a graduate degree through AFGS – most are DFCM faculty and have gone to take on clinical and education leadership roles, like program directors or site chiefs.

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Team Structure

Highlights 69%

Perceived impacts

y Leadership y Research y Teaching

y Improved confidenced y Feeling empowered to lead change y Understanding health systems y Broadened career paths

of participants described taking on new role(s) or opportunities

33%

prefer more virtual learning

Statistics based on 2025 scholarly program evaluation of AFGS 70

Department of Family & Community Medicine, University of Toronto

“...I certainly wouldn’t have been able to fly back and forth to Toronto to take courses... online learning was really helpful.” (P3)

31%

prefer more inperson learning “I was really glad it was in-person.

It was engaging and good for networking, meeting other people.” (P1)

MASTER OF PUBLIC HEALTH IN FAMILY AND COMMUNITY MEDICINE ADVANCED STANDING (AS) STREAM DEGREE GROWTH This stream was established in 2019 and continues to attract new candidates. It enables Canadian-trained physicians to complete a full Master of Public Health degree in one year. The program has seen continuous enrolment since its launch in 2019.

COURSE DEVELOPMENT: LAUNCH OF A NEW HYBRID CONTINUING EDUCATION CERTIFICATE: CERTIFICATE IN ACADEMIC FAMILY MEDICINE (FALL 2025) Launching in fall 2025, this accredited continuing education certificate offers advanced academic training in family medicine. Its design focuses on the core competencies in health professional education, scholarship, and system understanding—supporting faculty and leadership development for those not yet ready for the commitment of a graduate degree. This certificate was purposefully designed to offer both online and in-person opportunities to enhance accessibility of our programming to faculty outside of the GTA while maintaining opportunities to build relationships in-person across sites and within the central department.

SUCCESSFUL TRANSITION TO ONLINE TEACHING DURING THE COVID-19 PANDEMIC During the pandemic, the AFGS courses successfully transitioned to online delivery. This shift increased both recognition of the need for flexible learning and confidence in delivering fully online or hybrid degrees. Most instructors now offer both online and in-person learning opportunities within their courses.

CLOSE COLLABORATION WITH THE OFFICE OF EDUCATION SCHOLARSHIP (OES) COMPREHENSIVE ADMISSIONS EVALUATION (2017–2022) We work closely with the Office of Education Scholarship FOR INTERNATIONAL MEDICAL GRADUATES (OES) to optimize opportunities for graduate students to enOver five years, a comprehensive evaluation of admissions hance education scholarship skills in collaboration with the processes for International Medical Graduates was com- Essence of Education Scholarship program. The partnership pleted. The findings informed updates to eligibility criteria aims to fill an identified curricular gap in graduate studies and improved admissions procedures. and support robust enrollment in the Essence program.

DEVELOPMENT OF NEW COURSE: CHL8010H | TEAMBASED PRIMARY CARE: PRINCIPLES, PRACTICES AND TRANSFORMATIONAL CONCEPTS DFCM is leading the shift toward team-based care with CHL8010H, a graduate course that prepares learners to design and lead collaborative care models. Piloted in summer 2025, the course explores how interprofessional teams improve patient outcomes, enhance system efficiency, and reduce provider burnout. Delivered in a hybrid format, it supports flexible, engaged learning aligned with the future of primary care.

COMPLETION OF A SCHOLARLY PROGRAM EVALUATION PROJECT (2023–2025): SCHOLARS FOR TOMORROW A scholarly evaluation project titled “Preparing Primary Care Scholars for Tomorrow: A Scholarly Program Evaluation of the Academic Fellowship and Graduate Studies Program” was completed between 2023 and 2025. The project involved alumni surveys and interviews to assess curricular gaps and inform future program innovations. Findings are now in the reporting and dissemination phase, including a presentation at the DFCM conference.

ENHANCED AFGS PROGRAM VISIBILITY WITHIN DFCM Course Revisions The AFGS Program increased its visibility by sharing student Several existing courses were revised to reflect current practicum work within the department and online, promoneeds and improve accessibility: ting student research at the DFCM conference, and recognizing both instructors and students through the annual f CHL5622H | Patient-Related Healthcare and Public Policy awards process. in Canada was transitioned to a fully online format. f CHL5601H | Appraising and Applying Evidence to Assist Clinical Decision-Making is now delivered fully online. f CHL5605H | Research Issues in Family Medicine/Primary Care was adapted for hybrid delivery.

Education | Graduate Studies and Academic Fellowships

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Challenges

Partners

Enrollment and Engagement: AFGS is adjusting to changing Dalla Lana Schoxs(DLSPH): DLSPH is our academic partner enrolment patterns after the pandemic, including more part- for graduate degree programs. Together, we set admissions time learners due to increased clinical demands. and course standards, and they provide the public health foundation that underpins our degrees.

Program Development and Innovation: Evolving learner needs are driving requests for hybrid attendance, but tem- Affiliated Hospitals and Health Centres: We work with partporary restrictions from the School of Graduate Studies ners such as Unity Health Toronto, Trillium Health Partners, have slowed changes to online and hybrid delivery.

Sunnybrook Health Sciences Centre, Women’s College Hospital, and others to provide clinical and academic support for our AFGS programs. We are committed to training their faculty for leadership roles.

Looking Ahead

AFGS is advancing with a new vision for the MScCH (FCM) degree, exploring fully online and hybrid formats to improve access and reach. It aims to include senior medical trainees through collaboration, updated eligibility, and a stronger focus on interprofessional and primary care content.

International Collaborators: Our programs have supported primary care development in multiple countries (Saudi Arabia, Thailand, Japan, India, Ethiopia, China) through training of international fellows and graduate students. We have designed revisions of DFCM certificate offerings to meet international learners’ needs and implemented through collaborative delivery efforts in Canada and internationally.

As usual, course materials for all our programs will continually be updated based on evaluations, and we will explore Alumni: Temerty Alumni continues to support and promote potential new courses to support learner needs, like AI in our program offerings, and many former learners return to education.

AFGS to serve as course instructors or to take on leadership roles in their own contexts.

We also look forward to strengthening recruitment and supporting our faculty, especially as the DFCM continues to expand in size. We are working to reengage international partnerships and potentially develop new offerings to meet their evolving needs.

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GLOBAL HEALTH EDUCATION Introduction Global Health (GH) efforts at DFCM aim to strengthen primary care and improve health equity through education, research, advocacy, and clinical partnerships. With a focus on sustainable, community-responsive solutions, the program engages across all levels of education and works with international partners to address barriers to equitable care and training. It aims to improve health systems and the wellbeing of populations worldwide.

The DFCM is recognized as a World Health Organization (WHO) Collaborating Centre on Family Medicine and Primary Care— the first globally to focus specifically on family medicine. This designation means DFCM partners with WHO to support global efforts in strengthening primary care systems through research, education, and policy development.

GLOBAL HEALTH FACULTY Global Health Core Leadership spans both Global Health Education and Global Health within the Office of Health System Partnership. The GH “core” leadership team includes: f Dr. Katherine Rouleau Professor and Global Primary Healthcare Lead, Office of Health System Partnerships Director, WHO Collaborating Center on Family Medicine & Primary Care f Dr. Praseedha Janakiram Director, Global Health Education Global Health Education Lead in the Office of Health System Partnership and WHO Collaborating Center on Family Medicine & Primary Care f Mrs. Jamie Rodas Program Administrator Education | Global Health Education

In addition, the following individuals hold positions that include Global Health leadership: f Dr. Vanessa Reddit - Faculty Lead: CHL 5618H Family Medicine & Collaborative Interprofessional Primary Care in the Global Context f Dr. Leila Makhani - Global Health PGY3 Enhanced Skills Coordinator, Associate Lead, Toronto Addis Ababa Academic Collaboration-Family Medicine (TAAAC-FM) f Dr. Michael Bartucci - TAAAC-FM Advanced Clinical Skills Lead f Dr. Jennifer Wilson - Faculty Lead, African Health Education Collective (AHEC) and Kwame Nkrumah University of Science and Technology (KNUST)-DFCM Partnership Z AHEC Short courses faculty leads: Z Dr. Kirsten Wentlandt - Palliative Care Z Dr. Margarita Lam Antoniades - Quality Improvement Z Dr. Ian Drennan - Pre-Hospital Emergency Care Z Dr. Kimberly de Souza - Emergency Preparedness and Response Z Dr. Nour Khatib - Community Emergency Care f Dr. Kate Stead - Co-Chair, World Rehabilitation Alliance, Primary Care Working Group f Dr. Julia Alleyne - Co-Chair, World Rehabilitation Alliance, Primary Care Working Group f Dr. Megan Landes - Head of Division of Emergency Medicine f Dr. Archna Gupta - Assistant Professor, Research Scientist, Upstream Lab f Dr. Abbas Ghavam-Rassoul - Co-director InTaPT, former TAAAC-FM lead, former director DFCM Graduate program

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UNDERGRADUATE GLOBAL HEALTH FAMILY MEDICINE f Module 5C: Global Primary Care.

ENGAGEMENT Z Taught by DFCM faculty members Dr. Praseedha University of Toronto MD Global Health Education Program Janakiram and Dr. Leila Makhani, joined by Dr. (GHEP) Jennifer Wilson and international collaborator Dr. f GHEP is a Temerty Faculty of Medicine certificate Princess Acheampong (both since 2024). program for first- and second-year medical students.

Z 5C began with six learners. Participation grew more f DFCM faculty members Dr. Praseedha Janakiram and than threefold in the next year.

Dr. Leila Makhani contribute annually by teaching Z Learner participation: “Module 13: Global Primary Care” within the program. f The module has been offered from 2021 to 2025 and is 2023-2024 2024-2025 ongoing.

Post Grad Students 6 19 per year

2021

MD Students per year

2022

2023

2024

2025

f Module 19E: Teaching in International Settings Z Taught by DFCM faculty members Dr. Abbas Ghavam Rassoul (since 2015), Dr. Praseedha Janakiram (since 2015), Dr. Ashna Bowry (since 2017), Dr. Undergraduate Foundations Curriculum — Year 2: ComMichael Bartucci (since 2020), and Dr. Leila Makhani plexity & Chronicity Course (CNC), Global Health (GH) (since 2021). f The GH CNC course provides global health teaching Z Module 19E was selected from 26 Temerty Medicine to all second-year MD students (approximately 300 modules to receive the 2024 GHEI Module Award of students per year).

Excellence. f DFCM faculty contributors include Dr. John Ihnat, Z Learner participation: Dr. Jessica Osumek, Dr. Leila Makhani, Dr. Kate MacNaughton, Dr. Katherine Rouleau, Dr. Michael 20-21 21-22 22-23 23-24 24-25 Bartucci, Dr. Vanessa Redditt, and Dr. Praseedha Post Janakiram.

Grad f The course has been active and well-received since 2018.

21 13 10 12 11 Students per year POSTGRADUATE GLOBAL HEALTH FAMILY MEDICINE ENGAGEMENT Temerty Medicine Global Health Education Initiative (GHEI) Enhanced Skills Year in Global Health and Vulnerable is a Temerty Faculty of Medicine postgraduate certificate Populations (GHVP) program, which DFCM GH faculty members teach in. f GHVP is a 52-week enhanced skills residency available to two learners per year, designed to equip family physicians to address Global Health issues and reduce healthcare access barriers for equity-seeking populations. f Since 2009, 16 graduates have completed the program. f The program engages 19 DFCM faculty supervisors. f For 2025–2026, there are three PGY3 residents currently enrolled. f The Enhanced Skills Program Director is Dr. Leila Makhani.

22

10

8

Module 19E was selected from 26 Temerty Medicine modules to receive the 2024 GHEI Module Award of Excellence.

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17

19

Enhanced Skills Year in Global Health and Vulnerable Populations (GHVP) f GHVP is a 52-week enhanced skills residency available to two learners per year, designed to equip family physicians to address Global Health issues and reduce healthcare access barriers for equity-seeking populations. f Since 2009, 16 graduates have completed the program.

Department of Family & Community Medicine, University of Toronto

f The program engages 19 DFCM faculty supervisors. f For 2025–2026, there are three PGY3 residents currently enrolled. f The Enhanced Skills Program Director is Dr. Leila Makhani.

Highlights

GLOBAL HEALTH EDUCATION LEADERSHIP In 2022, DFCM created the Program Director role for Global CONTINUING PROFESSIONAL DEVELOPMENT & Health Education, reinforcing its commitment to global learnGRADUATE COURSES ing and collaboration. Global Health is now recognized as a Advancing Women’s Excellence in Family Medicine (AWE FM) key part of our education mission alongside Undergraduate, f This leadership program supports early to midcareer Postgraduate, Faculty Development, and Academic Fellowwomen physicians in family medicine to strengthen ships and Graduate Studies. leadership skills in clinical, team, and system domains. f The program delivers six interactive hybrid modules via WHO COLLABORATING CENTRE a virtual platform.

DFCM continues its pivotal role as a WHO Collaborating Cenf Co-chaired by Dr. Praseedha Janakiram and Dr. tre—the first globally to focus specifically on family medicine.

ThuyNga (Tia) Pham, with core faculty from Canada, Africa, Saudi Arabia, and Thailand.

LONGSTANDING ADDIS ABABA UNIVERSITY (AAU) f This course won the prestigious Temerty Medicine PARTNERSHIP Helen Batty Award 2023–2024.

Our 15-year collaboration with Addis Ababa University in f View the AWE-FM poster from the 2025 WONCA Ethiopia has led to impactful knowledge translation and exConference. change and national and international recognition. View a publication in the African Journal of Primary Healthcare and Toronto International Program to Strengthen Family MediFamily Medicine on the partnership. cine (TIPS / V-Tips) f This program is designed to enhance leadership in NEW WORK WITH KWAME NKRUMAH UNIVERSITY OF family medicine, health policy, and academic settings, SCIENCE AND TECHNOLOGY (KNUST) drawing on Canadian and global lessons.

The partnership with KNUST in Ghana has grown through f It went on hold during the pandemic, was restarted in successful short courses under the Africa Health Collabora2021 virtually, and is now on hold again, but is expected tive, gaining wide acclaim. to reactivate in the future.

CHL 5618H: Family Medicine and Interprofessional Primary Care in the Global Health Context f This course aims to foster a deep understanding of primary healthcare, interprofessional collaboration, and family medicine within national and global social policy contexts. f It is taught by Vanessa Redditt (lead), Katherine Rouleau, and Freida Chavez (Nursing).

DFCM WORLD ORGANIZATION OF FAMILY DOCTORS (WONCA) CONFERENCE PRESENCE DFCM has had a presence at the WONCA conference every year during this term, consistently contributing to global conversations on family medicine and primary care. In 2025, the department had its largest showing ever, with 19 posters presented and 111 Canadian attendees, many from DFCM. A standout moment was Dr. Danielle Martin’s presentation on the building community through building DFCM strategic plan.

Her talk drew attention to DFCM’s innovative use of strategic planning to build community in an academic environment, reinforcing our influence on the international stage.

15 YEARS OF A selection of the posters can be found in the Global Health DEVELOPING Education section of the Appendices.

EMERGENCY MEDICINE EDUCATION IN ETHIOPIA: THE TORONTO ADDIS ABABA ACADEMIC COLLABORATION IN EMERGENCY MEDICINE (TAAAC-EM) Education | Global Health Education

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STARFIELD SUMMIT LEADERSHIP Based on the foundational work of Barbara Starfield, the Starfield Summit is a two-day international gathering designed to advance policy, research, and advocacy in family medicine and high-quality primary care. It brings together a diverse group of global leaders, researchers, educators, and health system experts to explore how family medicine can strengthen primary healthcare systems worldwide.

FOCUS ON COLLABORATION AND ACTION Over two days, participants engaged in small group discussions and catalyst commentaries, all aimed at driving practical action. The Summit honoured DFCM’s 15+ year partnership with Addis Ababa University and acknowledged the shared challenges faced by family medicine globally. Discussions centered on how family medicine can optimize health system performance through the three components of the primary healthcare approach.

The DFCM hosted the 2025 Starfield Summit, marking a historic milestone as it was the first Starfield Summit ever held KEY OUTCOMES AND NEXT STEPS outside the United States.

The Summit produced several immediate outputs:

It was co-chaired by Dr. Katherine Rouleau and Dr. Pra- 1. The Starfield Statement, a collective call to strengthen seedha Janakiram, and the event was coordinated by the family medicine globally, which was already adapted by Office of Health System Partnerships.

Thailand for advocacy.

2. A Call to Action for the Canadian Government, urging GLOBAL PARTICIPATION AND DIVERSE EXPERTISE support for global primary care leadership.

The Summit welcomed 92 participants from 25 countries, 3. A collaboration with WONCA, with plans to co-develop with strong low- and middle-income country engagement, advocacy and policy resources, to be refined at the and included leaders in family medicine, nursing, rehabiliWONCA World Conference in Lisbon. tation sciences, pharmacy, research, education, policy, and health systems—as well as patient experts. Representatives from WONCA and the North American Primary Care Research Group (NAPCRG) also joined, reflecting the Summit’s broad reach and influence. The gathering intentionally included early- and mid-career professionals alongside senior leaders, fostering inclusive and meaningful dialogue across generations and disciplines.

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Department of Family & Community Medicine, University of Toronto

SUPPORT FOR THE WORLD HEALTH ORGANIZATION c. World Rehabilitation Alliance: As a WHO Collaborating Centre on Family Medicine and Drs. Kate Stead and Julia Alleyne co-chair a working group Primary Care, DFCM has contributed meaningfully to global on primary care and rehabilitation for the World Rehabilitaefforts led by the World Health Organization. These contrition Alliance (WRA) hosted by the WHO. butions span research, education, policy development, and Output: Inform the work plan of the WRA as it pertains to the advocacy, reflecting DFCM’s commitment to strengthening integration of primary care and rehabilitation globally. primary healthcare systems worldwide.

The working group has completed several key activities, a. Case study compendium (March – April 2024) including collecting case studies on successful integration Dr. Kate Stead led a team at DFCM to support the developof primary care and rehabilitation, developing a stakeholdment of a compendium of case studies for the WHO’s er presentation template, creating a policy brief and infoSpecial Program on Primary Healthcare (PHC). The group graphics/social media materials, publishing an article in the carried out multiple steps to populate this unique WHO WONCA newsletter, collaborating with the Noncommunicresource, which features searchable case studies drawn able Diseases (NCD) Alliance on advocacy initiatives, and from the grey literature and organized by PHC levers, geogpresenting at multiple conferences and sessions. raphy, and components. d. Primary Healthcare Leadership Course b. Literature Reviews: A number of scoping, realist and Dr. Danielle Martin provided initial conceptual guidance in rapid reviews have been carried out at the request of the development of the WHO Primary Healthcare Leaderthe WHO. Publication is pending for each. ship course and Dr. Katherine Rouleau contributed to the Z Social Determinants of Health interventions in the development and delivery of the course in her capacity as primary care setting in LMIC (February – May 2022) WHO consultant.

Z Integration of noncommunicable diseases in primary e. Expert contributions to WHO Regional activities care (Dec 2023-June 2024) Dr. Rouleau has contributed to regional WHO endeavours Z Conceptualization of MSPA in WHO publications as a technical expert including: (August 2024– June 2025) Z Panel presentation in collaboration with the Pan Z Evidence about Sexual and Reproductive Health as American Health Organization on primary healthcare presented in a selection of WHO primary healthcare progress in the Americas at the Canadian Public Health Case Studies. (2024-2025) Association Conference in Winnipeg (April 2025) Z Evidence about anti-microbial resistance as Z Workshop on addressing noncommunicable diseases presented in a selection of WHO primary healthcare in those most disadvantaged hosted by WHO Case Studies (2024-2025) Western Pacific Regional Office in Manila July 2024 Education | Global Health Education

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Challenges Securing sustainable funding for Global Health work is difficult, especially in the current geopolitical climate, while engaging faculty is increasingly complex given the intense demands of the primary care community in Canada. The decentralization of Global Health within the DFCM structure has created closer collaborations with other parts of the department but can present challenges for harmonizing activities and ensuring a coherent team working on global initiatives.

Looking Ahead STRENGTHEN AND EXPAND PARTNERSHIPS DFCM aims to build on existing collaborations—especially with KNUST in Ghana —and establish new partnerships focused on education, research, and advocacy to advance family medicine and primary care in other countries.

ACT AS A CONVENER AND KNOWLEDGE BROKER DFCM will strengthen its role as a convener and knowledge broker, working with stakeholders to create evidence-based resources and advocate for interdisciplinary primary care and family medicine.

For example, work is underway with Thai colleagues to ex- ALIGN LOCAL AND GLOBAL POLICY EFFORTS plore possible deeper collaborations in Thailand.

The still-new Office of Health System Partnerships (OHSP) represents an important platform for our department to RENEW WHO COLLABORATING CENTRE STATUS broaden its work in health system strengthning internationA key goal is to renew DFCM’s designation as a WHO Col- ally. Many of the issues the OHSP is working on locally such laborating Centre in 2026, continuing our global leadership as primary care attachment, integration of AI-based techin primary care. nologies in family medicine, and local health system infrastructure for primary healthcare, are also global priorities.

ENHANCE GLOBAL EDUCATION OFFERINGS In the coming years we hope to optimize the reciprocal conIn collaboration with international partners, DFCM will de- tributions of local and global policy initiatives to reinforce velop and refine professional development programs and shared goals in family medicine and primary care. needs-based education to support family medicine globally.

Discussions are in progress with both departments of family medicine and colleges of family medicine in Singapore and Thailand respectively, to develop co-created course offerings building on the rich experience and alumni network of the DFCM built through the in-person, hybrid, and virtual This information can be found in the International Partnerversions of the Toronto International Program to Strength- ships section. en Family Medicine and Advancing Women’s Excellence in Family Medicine. Additional education and continuing professional development course offerings are in early development to support advocacy for health policy change in family medicine, in close partnership with colleagues from low, middle and high-income settings.

Partners

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Department of Family & Community Medicine, University of Toronto

FACULTY DEVELOPMENT PROGRAM Introduction

LEADERSHIP MASTERCLASS The Leadership MasterClass series provides a unique opportunity for evolving leaders to learn from DFCM’s expert family medicine leaders with diverse skills, experience, and perspectives. Participation is by invitation from Site and Division Heads (one faculty member per site or division per year), and individuals may be at different career stages, engaged in a variety of leadership settings, and will have demonstrated both achievement and future potential. Through a small group and highly interactive format, the program intends to strengthen existing partnerships within teaching sites and divisions and increase representation, leadership, and the role of family medicine across diverse practice settings.

With over 2,300 faculty members—including Health Professions Educators (HPEs)—the Faculty Development (FD) program at DFCM is designed to support faculty in building skills across their academic careers as teachers, scholars, leaders, and administrators. DFCM has a long-standing tradition of excellence and remains committed to aligning its development initiatives with the strategic priorities of the department. This includes continually evolving how we train the next generation of primary care clinicians and academics.

DFCM CONFERENCE The annual conference is designed to support the growth and development of our faculty, learners, and staff with invaluable opportunities to network with colleagues from across the department and learn from the scholarly work of our team members. Each year, the conference planning committee works to develop a program to meet the diverse needs of our faculty members and, where possible, to further the department’s strategic priorities. This event provides a foundational experience to help faculty members present their The FD program is organized into three main branches: work as posters, papers and workshops, which helps set the f Central Faculty Development Offerings groundwork for them to then showcase their work at national f Local Faculty Development Activities and international conferences. Presenting at the conference f Portfolio Areas also offers faculty members the opportunity to build their portfolio for promotions. With keynote speakers, networking These branches work together to provide comprehensive sup- tables, poster presentations and workshop sessions, it is a port tailored to the diverse needs of our faculty. comprehensive educational experience for all participants.

Program Leadership f Dr. Allyson Merbaum – Program Director f Danielle Dudycha – Program Administrator

Central FD Offerings BASICS The BASICS Program for new faculty is an accredited, multiday orientation program for newer faculty members who have been teaching for one to five years, or for those who have increased their teaching load and need more support.

The program focuses on developing the skills and knowledge to help navigate common teaching situations successfully.

This program goes through a yearly review and modification based on evaluations and reviewing the workshops included. It covers foundational topics such as effective teaching strategies, effective feedback, assessment, professionalism and challenging teaching situations. As learners progress through the course, the material becomes more advanced.

Education | Faculty Development Program

LEARN TEACH THRIVE Learn, Teach, Thrive is a series of events offered centrally by the Faculty Development program to support the diverse needs of faculty across the trajectory from initial appointment through to senior promotion and everything in between. Portfolio Leads for Appointments & Promotions, Awards, Grants & Funds, Health Professional Educators, Mentorship, and Wellness organize a variety of events open to all faculty. FD Leads for community preceptors in the MD program (FMLE & Electives) and for rural preceptors (Teaching Practices and Integrated Communities Stream) also host events with topics targeted to the needs of these faculty members.

EQUITY GRAND ROUNDS (IN PARTNERSHIP WITH TEMERTY OFFICE OF INCLUSION AND DIVERSITY) The Equity Grand Rounds series was designed to deepen DFCM education offerings related to principle of equity and social accountability. More information can be found in our Principles of equity and social accountability section.

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Local FD Activities FACULTY DEVELOPMENT COMMITTEE: The Faculty Development Committee (FDC) includes representatives from all DFCM sites, divisions, and select programs. Meeting monthly, the FDC discusses departmental updates and helps guide central initiatives by identifying faculty needs. FD Leads support appointments and promotions, coordinate local awards committees, and contribute to faculty development programming both locally and centrally.

Portfolio Areas APPOINTMENTS AND PROMOTIONS Our academic department is constantly evolving, with approximately 150 new faculty members every year. The appointments and promotions team hosts regular workshops for faculty interested in pursuing promotion. f Faculty Appointments and Junior Promotions Lead: Dr. Debbie Elman f Site Appointments Administrator: Maryam Nafari f Divisions and Programs Appointments Administrator: Hiring in process f Promotions Administrator: Sarah Letovsky

MENTORSHIP Mentorship is key in helping faculty fulfill their professional goals, improve their job satisfaction, and build a supportive culture across our department. DFCM has over 100 faculty mentors with various interests in research, teaching, and career development. Much work has been done to continue building the roster of mentors, identify areas in need of immediate mentorship, increase access for potential mentees, create informal mentorship opportunities, run events to support areas of mentorship needed, and match mentees to available mentors f Mentorship Lead: Dr. Viola Antao f Mentorship Administrator: Jasvinei Sritharan FACULTY WELLNESS The DFCM has a faculty wellness committee, chaired by a Faculty Wellness Lead. The goals for this portfolio include exploring wellness needs for our diverse faculty and developing and implementing initiatives at the central department level as well as at the site level to enhance the well-being of our distributed faculty. This area has evolved substantially since its inception in 2021, as the wellness needs of faculty have evolved from post-pandemic burnout and lack of in-person connection with colleagues to increasing administrative burden for family physicians. A multi-dimensional approach has been undertaken with significant collaboration across the department, including the Quality & Innovation program through the Peers for Joy in Work program, as well as with the Digital Health committee in creating funding strategies for AI scribes as prime examples.

HEALTH PROFESSIONAL EDUCATORS DFCM recognizes the vital role of Health Professional Educators (HPEs)—non-physician faculty such as nurses, social workers, dietitians, and other allied health professionals—in training medical students and residents, and in supporting team-based primary care. To strengthen their involvement with our department, we actively engages HPE faculty and f Mentorship Lead: Dr. Navsheer Gill supports the growth of a Community of Practice (CoP) that f Mentorship Administrator: Jasvinei Sritharan fosters collaboration and shared learning. Ongoing research is exploring how DFCM can better integrate and support HPEs and their CoPs in educational activities, ensuring they have the resources and recognition needed to thrive in their roles. f HPE Lead: Serena Beber f HPE Administrator: Danielle Dudycha

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Department of Family & Community Medicine, University of Toronto

Highlights FACULTY GROWTH AND EXPANSION Between 2020 and 2025, DFCM welcomed 970 new faculty members, including 217 in 2024 alone, supporting the department’s expansion into new training sites and partnerships.

With a total of ~2,300 faculty members, and an average of 150 new appointments annually, DFCM has grown by 45 per cent over five years.

EQUITY GRAND ROUNDS Launched in 2024, Equity Grand Rounds reflect DFCM’s commitment to equity, diversity, and inclusion. These sessions bring faculty together to explore systemic issues and share AWARDS, GRANTS & FUNDS DFCM is proud to recognize and support the outstanding strategies for advancing equity in academic and clinical setwork of our faculty through a wide range of awards, grants, tings. and funding opportunities. Faculty Development funds help faculty present at conferences, publish in academic jour- FACULTY WELLNESS nals, and participate in leadership programs such as the Recognizing the importance of well-being, in 2021, DFCM New and Evolving Leaders (NEAL) initiative at the Centre for introduced the Faculty Wellness Committee to support menFaculty Development. NEAL candidates are nominated by tal health, work-life balance, and resilience across all casite chiefs or division heads and selected through an inter- reer stages. nal review process.

AWARDS AND RECOGNITION Our awards program celebrates excellence at every level— Notable recent recognitions include multiple inductees to from program-specific recognition to departmental Awards the Order of Canada, the Canadian Medical Association’s of Excellence and prestigious external honours. DFCM fac- Mentor of the Year, and multiple King Charles III honours. ulty are internationally respected, and over the past five years have received notable accolades such as the Order of ANNUAL AWARDS AND CELEBRATION EVENT Canada, the Canadian Medical Association’s Mentor of the Originally held in person, the Awards and Celebration Event Year, and multiple King Charles III honours. These awards transitioned to a virtual format during the COVID-19 panreflect the impact our faculty have in clinical care, educa- demic. This shift has significantly increased attendance, with over 110 participants annually. The event honours protion, research, and leadership. motions and award recipients, featuring presentations from Each year, our virtual Awards and Celebration Event brings distinguished winners and a video tribute to senior promotogether over 100 attendees to honour award recipients, tion honorees. promotions, and notable contributions. Highlights include presentations from distinguished winners—such as the See the DFCM award winners from 2021, 2022, 2023, 2024, Academic Family Physician of the Year—and a video tribute and 2025. to senior promotion recipients.

View other import faculty development documents from the span of the self-study term in the Faculty Development secf Awards Lead: Dr. Michelle Homer tion of the appendices. f Awards Administrator: Jasvinei Sritharan Education | Faculty Development Program

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Challenges Given the large, diverse, and distributed nature of our faculty, it can be challenging to ensure that all members feel connected to the central department and receive the support they need to thrive in their academic roles. As the department continues to grow, with new divisions and sites, the Faculty Development Committee also expands, which can make it difficult to maintain engagement, keep meetings relevant and action-oriented, and foster a shared sense of purpose.

Looking Ahead Looking ahead, the Faculty Development program is focused on several key priorities: ENHANCING TEACHING PERFORMANCE We will continue efforts to support teaching excellence by sharing teaching evaluation data and collaborating with site chiefs and divisions. Our goal is to encourage faculty to meaningfully reflect on this feedback—alongside other performance indicators—and take actionable steps toward improvement.

STRENGTHENING INTEGRATION OF HEALTH PROFESSIONAL EDUCATORS (HPES) We are committed to improving the involvement of HPEs in teaching and learning activities, both at the central level and within local contexts.

ADVANCING EQUITY IN ACADEMIC OPPORTUNITIES We will continue to explore ways to promote equity in awards, funding supports, leadership roles, and academic promotion processes.

Partners As part of Temerty Faculty of Medicine, the Faculty Development program works in close collaboration with several internal groups and committees to support academic growth and leadership across the faculty, including: the Executive Council of the Centre for Faculty Development, the FD Leads Committee, the CFD’s Awards Committee, the Education and Teaching Awards Committee, and Temerty’s Appointments Working Group.

ADAPTING TO EVOLVING DELIVERY NEEDS We aim to respond to the changing preferences of faculty and presenters regarding in-person versus virtual formats, ensuring our offerings remain accessible, relevant, and engaging.

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EDUCATION SCHOLARSHIP Introduction Education Scholarship is a core activity of the Temerty Fac- f Education Investigator Program – This program ulty of Medicine and the Department of Family and Community provides support for scientists to engage in theoryMedicine (DFCM). The Office of Education Scholarship (OES), driven research relevant to family medicine education. established in 2012, provides resources, guidance, consultaThe OES provides a research coordinator, which is tion, and mentorship to faculty and programs in adopting an evia substantial in-kind support for scientists. These dence-based, scholarly approach to family medicine training. awards have been held by Drs. Nikki Woods, Mahan Kulasegaram, and Sarah Wright In just over a decade, the OES has earned national and international recognition—including designation as a Leading STRATEGIC SERVICE FOR DEPARTMENTAL NEEDS Practice Indicator by the College of Family Physicians of Can- The OES contributes to DFCM’s strategic priorities by offering ada and commendation by the World Organization of Family expert consultation and scholarly evaluation for key initiatives, Doctors—affirming its role as a national exemplar in medical such as co-chairing the Equity, Diversity, Indigeneity, Inclusion, education scholarship.

Accessibility (EDIIA) Data collection group and providing consultation support for the pivot to virtual care. It also supports THE OES ENGAGES IN BROAD SYNERGISTIC AREAS OF curriculum development and facilitates award nominations, ACTIVITY TO SUPPORT OUR MISSION: SCHOLARSHIP while tracking scholarly productivity across the department. A CAPACITY BUILDING AND CREATING NEW KNOWLEDGE sample of OES-support projects can be found in the appendices.

We provide these services to build scholarship capacity: f The Better Together consultation service – Open to any faculty member who seeks advice, mentorship, and guidance in any stage of the education scholarship journey. f Art of the Possible (AoP) grants – For over 10 years, these formative grants have supported a diverse group of scholars across DFCM programs and sites. Each grant is accompanied by in-depth consultation and feedback from the OES. f Essence of Education Scholarship program – A free, longitudinal, highly mentored course where participants develop their own projects—often in preparation for an AoP grant or similar opportunity. f Embedded Scholars – Three scholars with protected time are embedded within DFCM to promote, consult on, and engage in education scholarship. f Celebration of Education Scholarship events and Journal Clubs – Well-attended opportunities to hear from local and external scholars, explore new ideas, and foster scholarly community and networking.

Education | Education Scholarship

Since its inception f 73 Art of the Possible grants awarded to Education Programs, Q&I, Global Health, Emergency Medicine, Palliative Care, Care of Elderly across 12 Sites f 18 Celebration of Education Scholarship Events f >40 Essence Participants f >400 consultations, coffee chats, and meetings to support faculty

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Highlights RECOGNITION & RESILIENCE f Named a Leading Practice Innovation in the 2020/21 Accreditation. f Maintained core programs during the pandemic while responding to emerging departmental needs and scholarly questions (2021–2023).

f Contributed to strategic scholarship efforts such as embedding learners in Community Health Centres, evaluating Q&I initiatives, and supporting the KNUST collaboration.

CELEBRATING SCHOLARSHIP f Introduced two new awards: Z Cynthia Whitehead Award for Education Scholarship Publications Z Dr. Risa Freeman Award for Excellence in Education STRATEGIC ALIGNMENT & GROWTH Scholarship f Aligned OES programs following the 2023 strategic plan f These awards celebrate both scholarly excellence and reflection, creating a clear pathway for newly engaged mentorship, reinforcing a culture that values education scholars to receive training, funding, and consultation to scholarship. actualize their scholarship projects.

OTHER PUBLICATIONS f In addition to scholarly publications, the OES also 1. Essence of Develop skills contributed to blogs and podcasts to broaden the reach Education with structure of its work and engage diverse audiences.

Scholarship and mentorship Z https://healthydebate.ca/2024/06/topic/undervaluedunderappreciated-family-physicians/ Z https://healthydebate.ca/2021/03/topic/teaching2. Consultation Refine and and-learning-to-trust/ with focus ideas Z https://healthydebate.ca/2022/10/topic/designingeducation with world scientists virtual-spaces/ and scholars leading experts Z https://healthydebate.ca/2024/08/topic/medicaleducation-gen-z/ Z https://sphinx.acast.com/p/open/ Funding + 3. Art of the s/689f783a436325e278a830bc/e/004c7124-3d47-4501suppport Possible for a 949c-7df023b9f944/media.mp3 Grant project Z https://paperspodcast.ki.se/2024/09/10/64-learnersgot-talent/ f Launched a redesigned website and created new communications, including informal “coffee chats” to PRINCIPLES OF EQUITY AND SOCIAL ACCOUNTABILITY foster accessibility and community. f Funded a limited-term Education Scholar role in Social Accountability, supporting curriculum development INNOVATION IN ENGAGEMENT aligned with equity and social accountability goals. f Leveraged virtual platforms for hybrid Celebration f Provided consultation for the Indigenous Elective of Education Scholarship Days and Journal Clubs, Experience and presented at the Indigenous Leadership increasing participation and accessibility across sites.

Circle (ILC). f Continued hybrid programming to reach faculty across f Supported the Vice-Chair, Community & Partnerships all divisions and locations. portfolio through consultation and project development focused on community-based learning and equity and STRATEGIC CONTRIBUTIONS TO DFCM social accountability leadership. f Supported key education initiatives including: f Advanced principles of equity and social accountabilityZ Outcomes of Training (OTP) response and retreat focused scholarship through the Person-Centered Care organization pillar and AoP-funded projects.

Z Family Medicine and Enhanced Skills (FAMES) f Co-chaired the Equity, Diversity, Indigeneity, Inclusion, program evaluation Accessibility (EDIIA) Data Collection Working Z Innovations in postgraduate education (e.g.

Group, contributing to a consultative approach for Foundations Block, FM CLLEO Project) demographic data collection.

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WELLNESS f Supported learner wellness scholarship through AoPfunded projects. f Consulted on wellness-related initiatives for CQI and the Foundations Block. f Promoted team wellness during the pandemic by reducing demands, creating connection opportunities (e.g., OES Cookbook), and hosting virtual celebrations.

IMPACT f OES scholars and projects received major awards, including: Z Dr. Lindsay Herzog – The College of Family Physicians Canada Early Career Award Z Dr. Nikki Woods – WXN Top 100 Women in Canada Z Dr. Cynthia Whitehead – Ian Hart Award Z Dr. Milena Forte – Sydney G. Frankfort Chair Z Dr. Mahan Kulasegaram – Temerty Chair, KIPRIME Fellowship, MCC Award Z Dr. Joyce Nyhof-Young – OISE Leaders & Legends Mentorship Award Z Multiple CAME Certificates of Merit Z ViCCTR – DFCM and ICRE “What Works” Awards f Disseminated scholarship through publications and presentations. f Influenced policy and practice within DFCM and beyond, including presentations at national retreats (e.g., CFPC OTP Curriculum Retreat). f Expanded presence across divisions and sites, supporting scholarship at new locations like Humber River and in emerging areas like Care of the Elderly.

Additionally, maintaining faculty wellness is an ongoing challenge. Balancing scholarly expectations with flexible timelines, limited meetings, and sustained mentorship is essential to supporting faculty engagement and well-being.

RESOURCING AND MEETING DEMAND FOR EDUCATION SCHOLARSHIP CONSULTATION, MENTORSHIP As the profile of Education Scholarship (ES) continues to grow within DFCM, so does the demand for consultation and mentorship—particularly around seed grants and project development. This demand is especially pronounced at clinical sites, where structural limitations such as staffing, time constraints, and resource availability hinder faculty engagement. Additionally, the increasing complexity of scholarly work and rising costs of conducting scholarship present ongoing challenges to sustaining and expanding ES capacity across the department.

CONTINUED ENGAGEMENT ACROSS THE DFCM DURING EXPANSION. Since the OES is centrally located, it limits our ability to proactively engage faculty across DFCM’s expanding network of sites throughout the province. Structural challenges—such as site size and practice organization—can make it difficult for faculty to find time and resources for scholarly activities.

Looking Ahead

EXPANDING CONSULTATION FOCUS As more scholars engage with OES programs, their needs are becoming more advanced—particularly around dissemination. While AoP projects are often presented widely, fewer are published. To address this, we’ve increased support for both traditional and non-traditional disseminTRANSITION OF PERSONNEL AND GROWTH ation strategies, including hosting a Celebration of EducaAs senior education scholars complete their terms of ser- tion Scholarship focused on dissemination, inviting journal vice, identifying and preparing new leaders to support con- editors, and integrating dissemination sessions into the Essultation, mentorship, and strategic direction in Education sence program.

Scholarship requires significant time and effort. While a growing pool of trained faculty exists, transitioning them INNOVATIVE SITE ENGAGEMENT MODELS into leadership roles remains a resource-intensive process. We are exploring collaborative models that engage clusters of training sites rather than individual ones. With central Most PhD and MD/PhD scientists affiliated with the OES support from DFCM, this approach could enable shared emhold part-time roles, with the highest commitment at 0.5 FTE. bedded scholars across sites with geographic or programThis reliance on external institutional support introduces matic ties, improving efficiency and impact. vulnerability, as stability depends on strong relationships with partner organizations.

Challenges

Education | Education Scholarship

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Partners

REIMAGINING AOP GRANTS As we mark the 10-year anniversary of the Art of the Possible grant program, we are enhancing its strategic focus through the Big Ideas Themes (Specialist Generalist, Big Data, Patient-centered Care), including expansions in Com- WILSON CENTRE prehensive Care and related training.

Most OES scientists and scholars have strong ties to the Wilson Centre, ranging from primary appointments to genSUPPORTING A GROWING DEPARTMENT eral membership. This partnership brings theoretical depth, With 18 training sites, we continue to prioritize strong rep- methodological expertise, and access to resources such as resentation and relationships with scholars across all loca- PhD trainees, presentation venues, and research networks. tions to ensure equitable support and engagement.

Future plans may include a structured approach to embedding Wilson Centre learners within the OES. STRENGTHENING EXTERNAL PARTNERSHIPS Education Scholarship Units in Other Departments CENTRE FOR ADVANCING COLLABORATIVE HEALTHCARE & EDUCATION (CACHE) Departments like Pediatrics, Medicine, and Psychiatry have OES has collaborated closely with CACHE through co-foundsimilar scholarship units. While informal collaborations ing team members and seconded researchers. While these exist, a formal structure—potentially at the TFoM level— collaborations have been opportunistic and individual-drivcould foster better coordination and shared learning. en, formalizing this relationship could strengthen joint efforts—especially as CACHE supports primary care reform COLLEGE OF FAMILY PHYSICIANS OF CANADA (CFPC) initiatives.

OES members contribute to national initiatives (e.g., Data Governance, FM-PROC), but a stronger presence within CF- WOMEN’S COLLEGE HOSPITAL & ST. MICHAEL’S HOSPITAL PC’s scholarly structures is needed. Advocacy from DFCM OES has shared an embedded scientist across these sites. leadership could help elevate OES’s role and support shared As personnel changes occur, we are exploring ways to goals in advancing family medicine education. maintain and evolve these partnerships.

The overview of our work plan for the next three years can CENTRE FOR FACULTY DEVELOPMENT (CFD) be found in our OES Strategic Response Document.

OES has collaborated with CFD scholars and continues to promote CFD programs and initiatives to AoP and OES memView a sample of OES-supported publications from this self- bers, seeking further opportunities for joint scholarship. study term.

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OTHER KEY EDUCATION PRIORITIES: MATERNITY CARE Introduction The Department of Family and Community Medicine (DFCM) SIGNIFICANT FM-MC PUBLICATIONS: continues to lead nationally in Family Medicine Maternity f Strategies to support maternal and early childhood Care (FM-MC), guided by a vision of outstanding primary wellness: insight from parent and provider qualitative care for all. Over the past five years, FM-MC efforts have interviews during the COVID-19 pandemic. Simpson focused on four pillars: building a community of practice, enAN, Baxter NN, Sorvari A, Boury H, Shore EM, Bogler hancing postgraduate training, supporting faculty developT, Campbell D, Gagliardi AR. BMJ Open. 2024 Jan ment, and advancing scholarship.

25;14(1):e079479. doi: 10.1136/bmjopen-2023-079479. f Glucagon-like peptide-1 receptor agonists during pregnancy and lactation. Zipursky JS, Bogler T, Maxwell C. CMAJ. 2024 Dec 15;196(43):E1413. doi: 10.1503/ cmaj.240768. f Omega-3 levels in prenatal supplements. American COMMUNITY OF PRACTICE: Journal of Perinatology. Scourboutakos M, Harper E, f 140 providers across 13 sites. Initiatives include: Kopec M, Rose L, Forte M. 4 Dec 2024. DOI: 10.1055/aZ Teaching Competence in Primary Care Obstetrics 2465-5163 conference. f Impact of postpartum physical activity on maternal Z Developing FM-MC Core Values document with the depression and anxiety: a systematic review and metaCollege of Family Physicians Member Interest Group. analysis. Deprato A, Ruchat S, Usman Ali M, Cai C, Forte Z Pan- Canadian study of over 2,800 pregnant people M.et al British Journal of Sports Medicine. November examining values underlying choice of pregnancy 2024. https://doi.org/10.1136/bjsports-2024-108478 care providers f A more comprehensive list can be found here.

Highlights

TRAINING & DEVELOPMENT: f Collaborated with Toronto Metropolitan University and the Society of Obstetricians and Gynaecologists of Canada to provide access to the ALARM course for our residents and third year family med OB fellows f Faculty-authored Teaching Perinatal Care: A Practical Guide (2022). f Ongoing faculty development workshops and mentorship programs, including: Z Annual refresher in pregnancy and birth conference Z Pregnancy care in the first trimester rounds Z Exercise in Pregnancy workshop and seminars Z Breastfeeding education workshop Education | Other Key Education Priorities

Looking Ahead DFCM will continue to foster collaboration, expand national partnerships, and support innovation in FM-MC education and scholarship.

140 providers across 13 sites.

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SUPPLEMENTAL EMERGENCY MEDICINE EXPERIENCE (SEME)

Introduction

Launched SEME Barrie in Fall 2025, hosting 6 fellows/year 88

The Supplemental Emergency Medicine Experience (SEME) program is an innovative fellowship administered by the DFCM and funded by the Ontario Ministry of Health. SEME is a three-month accredited continuing medical education (CME) fellowship designed to equip family physicians with the skills, confidence, and knowledge to provide emergency care in rural and remote communities across Ontario. In many communities across the province, family physicians are the sole physicians providing emergency care and ensuring that such care is accessible to all.

Since its inception in 2012, SEME has trained over 240 physicians, with 88 per cent continuing to practice emergency medicine years after graduation. SEME is a proven solution to address the province’s emergency medicine (EM) workforce shortage, especially in underserved areas.

Department of Family & Community Medicine, University of Toronto

Highlights

Challenges

PROGRAM GROWTH f Launched SEME Barrie in Fall 2025, hosting 6 fellows/year. f Training provided across 14+ U of T-affiliated sites, including ED, ICU, trauma, anesthesia, and pediatric EM rotations.

f Physician Burnout & Attrition: Ongoing stress and isolation in rural EDs contribute to provider burnout. f Limited Training Capacity: Growing demand for SEME exceeds current resources and faculty availability. f Funding Uncertainty: Current funding cycle ended in March 2025; renewal is essential to sustain and expand impact.

CLINICAL EXCELLENCE f Winner of the 2022 CFPC Continuing Professional Development (CPD) Program Award. f Fellows report significant increases in confidence and competence, especially in critical procedures like airway management, chest tube insertion, and point-ofcare ultrasound (PoCUS).

COMMUNITY IMPACT f SEME graduates practice in rural and remote communities, including Northern Ontario and Indigenous regions. f 52 graduates have successfully obtained CCFP Certification of Added Competence in Emergency Medicine (CAC-EM).

INNOVATIVE CPD INITIATIVES f Launch of the SEME Community of Practice (CoP) to support alumni through: Z Virtual rounds and simulation events.

Z In-situ training with Dynamic Simulation.

Z Faculty development and leadership workshops.

Z The SEME Refresher Series, including: Airway Day: Hands-on training and simulations for airway management and decision-making PoCUS Skills Day: Practice with ultrasoundguided procedures and diagnostic scans Procedural Skills Day: Refreshing and practicing both rare critical procedures and those common in emergency care

Looking Ahead EXPANSION PLANS f Increase SEME fellowships to 40 annually across Toronto, Thunder Bay, and Barrie.

STRENGTHENING THE SEME COP f Broaden CPD offerings, including traveling simulation programs, hybrid conferences, and exam prep support. f Enhance collaboration with Ontario Health and other provincial initiatives.

LEADERSHIP DEVELOPMENT f Grow the SEME executive team to include dedicated leads for CPD and CAC-EM exam preparation. f Create new physician leadership roles within DFCM to support distributed medical education.

Since its inception SEME has trained over f 240 physicians, with 88 per cent continuing to practice emergency medicine years after graduation.

Education | Other Key Education Priorities

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SEME Learner Reviews The SEME Program Met My Expectations in Enhancing My:

EM Clinical Skills Confidence in Providing Emergency Care

EM Knowledge Base Confidence to Work in a Rural ED Setting

The Overall Content of the SEME Program Enhanced My EM Skills:

% of respondents N=21

% of respondents N=21

Participant evaluations of Dynamic Simulation’s sessions Session Improves Interprofessional Team Dynamics & Communication

>75% 90

Session Allows for Reviews of Up to Date Recommendations & Guidelines

The percentage of this year’s SEME graduates who report they are “very likely” to work ER shifts in a rural setting in the next 12 months.

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RESEARCH Research

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INTRODUCTION TO THE RESEARCH PROGRAM The Department of Family and Community Medicine (DFCM) is home to one of the largest family medicine research programs in Canada. The DFCM Research Program’s overarching themes include equity, quality, and efficacy in primary care, encompassing a range of scientific methodologies and content areas. DFCM’s Research Program was established in 1995 to create a critical mass of family medicine researchers, provide faculty with protected research time, develop research excellence and productivity, and build an infrastructure that supports high-quality, impactful research.

itions in 2020. In 2021, Dr. Peter Selby led the Research Program as interim Vice-Chair of Research, and in 2022, he was selected as the Vice-Chair for a term of five years. Dr. Selby holds the Giblon Professorship in Family Medicine Research.

He is a Senior Scientist at the Centre for Addiction and Mental Health (CAMH) where he is the Principal Investigator (PI) of a learning health system called INTREPID Lab, which is focused on the intersections of innovation, nicotine, tobacco, research, education, programming, implementation science and digital health. He is cross-appointed as Professor in the University of Toronto’s Department of Psychiatry and DFCM provides a multidisciplinary and supportive environ- the Dalla Lana School of Public Health. ment for research, mentorship, and capacity building to nurture family medicine researchers from undergraduate medi- To align the administrative and reporting structure of the decine training to the senior faculty level. The core functions partment, we created a new senior research administrator of the program are to develop and support faculty with sal- position. In 2023, Dr. Tara Marie Watson joined DFCM as the ary stipends and pre- and post-award resources including Research Program’s Associate Director, assuming adminismethodological expertise in study design, analysis, budget- trative oversight of all program staff and operations including, REB expertise and access to working space, as need- ing those supporting UPLEARN, the relaunched PBRLN. The ed. In addition, the Research Program supports other DFCM Research Program is also supported by Senior Biostatistiprograms and senior leadership (e.g., patient engagement cian Dr. Rahim Moineddin, Biostatistician Dr. Chris Meaney, survey for the QI program, analyses for OES researchers).

Program Administrator Tara Jeyaram, and highly-skilled staff trained in data systems management, data analysis and The core program investment is in UPLEARN, the University visualization, clinical research, and research coordination of Toronto’s Practice- and Community-Based Learning and and project management. Three administrative positions Research Network, to advance all types of research and were eliminated to align with the needs of the program and scholarship with all DFCM sites and teaching practices. stabilize research positions instead.

This includes having designated leads at each site. Lastly, we also offer training and support for the next generation of The governance structure has been streamlined to have an researchers including the CSP. These varied activities are efficient decision-making committee that oversees and directs enabled by dedicated funds for research infrastructure, fac- the program. The new Research Executive Committee (REC) is ulty salary support and strategic use of donor funds (e.g., the comprised of the Vice-Chair of Research, Associate Director, Waddington Family Fund to advance the DFCM’s Strategic Dr. Andrew Pinto as UPLEARN Director (i.e., the lead of the Plan to double the number of community-based family medi- University of Toronto’s Practice- and Community-Based Learncine researchers). ing and Research Network), the Senior Biostatistician, and Dr. Aisha Lofters as the recently established Waddington Family Team Governance and Structure Community Research Capacity-Building Program Director. The REC, in turn, consults on programmatic matters and the selecAt the time of the previous review, the DFCM Research Pro- tion of faculty for awards with a larger Research Advisory Comgram was led by Vice-Chair Dr. Eva Grunfeld and Associate mittee (RAC), comprised of a number of primary care researchDirector Dr. Paul Krueger, who both retired from these pos- ers including several longstanding DFCM faculty members.

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Research Executive Committee (REC) Activities The REC meets bi-monthly to: f provide overall direction for the Research Program; f shape and achieve the research goals and objectives of DFCM’s Strategic Plan; f develop policies and procedures for reviewing the Research Program and its impact; f develop policies and procedures for conducting annual and five-year reviews of DFCM Investigator Award recipients, including periodic review of award criteria; f select candidates for DFCM Investigator Awards; and f develop strategies to support the career trajectories of DFCM Investigator Award recipients.

their respective site/division/other acceptable sources (e.g., from research chairs, other departments/organizations), complete annual internal reviews and, for the established researcher roles, five-year internal/external reviews to demonstrate that they are meeting the expectations related to research productivity and contributions to DFCM. View a full list of current DFCM-funded investigators.

Highlighting Some of our Star Researchers

Since 2021, we have had the following Canada Research Chairs (CRCs) and hospital-funded chairs in family medicine/primary care. In addition, we have protected time for research activities of the following leaders during the last DFCM Investigator Awards Program: five years. These research leaders are having tremendous impact across national, provincial and local systems relDFCM is home to internationally recognized researchers evant to DFCM including its divisions. whose work advances primary care and health systems worldwide. This program supports up to 30 research investi- f Dr. Rick Glazier, Scientific Director of the Institute of gators, providing them with protected research time.

Health Services and Policy Research at the Canadian Institutes of Health Research (CIHR), Senior Core A breakdown of the five Investigator Awards categories is Scientist at ICES, program co lead of INSPIRE-PHC; as follows: f Dr. James Orbinski, Principal of Massey College; f Dr. Onil Bhattacharya, the Frigon Blau Chair in Family 1. Clinician Scientists: Established researchers with a PhD Medicine Research Director, WCH Institute for Health degree or equivalent and ≥50% protected research time.

System Solutions and Virtual Care; 2. Clinician Investigators: Established researchers with f Dr. Bjug Borgundvaag, Director of Schwartz/Reisman at least a master’s degree or equivalent and <50% Emergency Medicine Institute (SREMI) at the Sinai protected research time.

Health System; 3. New Investigators: Researchers within five years of f Dr. Ann Burchell, research director for family medicine receiving their highest academic degree and interested at Unity Health and CRC in STI prevention; in becoming Clinician Scientists (maximum three-year f Dr. June Carrol Co-founder of Genetics Education award).

Canada Knowledge Organization (GEC-KO); 4. Graduate Research Fellows: Those completing a f Dr. Noah Crampton, CEO of Autoscribe; master’s degree or PhD (maximum two-year award for a f Dr. Sheila Dunn, Associate Director of Research, master’s degree and five years for a PhD).

Canada’s Contraception Access Research Team 5. Non-Clinician Research Scientists: Funding for those f Dr. Michelle Greiver, Gordon F. Cheesbrough Research with 80% or more protected research time.

Chair in Family and Community Medicine at NYGH f Dr. Liisa Jaakkimainen, Project lead of POPLAR, senior This program of Funded Investigators forms a critical pipecore scientist and scientific lead of the Primary Care line for developing research expertise within the DFCM. and Health Systems Program at ICES; f Dr. Tara Kiran, Vice-Chair Quality and Fidani Chair in These competitive research awards are designed to support Improvement and Innovation at DFCM; research activities and build research capacity in DFCM to f Dr. Jeff Kwong, Associate Director, Centre for Vaccine advance the practice of family medicine, nurture research Preventable Diseases, University of Toronto; interest throughout the lifecycle of a primary care research- f Dr. Bernard Le Foll, Chair in Addiction Psychiatry, er, and encourage them to share their expertise with the University of Toronto; next generation of investigators. Recipients must be active f Dr. Peter Selby Giblon Professor and Vice-Chair faculty members working to improve quality, efficacy, and Research DFCM and PI of INTREPID Lab at CAMH equity in primary care. Each award recipient is required to f Dr. Janet Smylie, Tier 1 Canada Research Chair in leverage these funds to obtain at least matching funds from Advancing Generative Health Services for Indigenous Research

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Populations in Canada and Director of Well Living House Applied Research Centre f Dr. Abhi Sud, Chief Scientific Officer at the Chronic Pain Centre of Excellence; f Dr. Catherine Varner, Deputy Editor of the Canadian Medical Association Journal.

Dr. Andrew Pinto is the Research Program Director for UPLEARN, the PBRLN situated at DFCM. He holds an applied Public Health Chair from CIHR on Upstream Prevention in Primary Healthcare and is the founding and current Director of the Upstream Lab. The lab Other notable research leaders at DFCM but who do not focuses on tackling social factors that impact health by inreceive funding for protected time from the central depart- cubating novel interventions that tackle social factors that ment include: impact health, rigorous evaluation of interventions, sharf Dr. Ross Upshur, Head, Division of Clinical Public Health ing findings widely and training “upstreamists” to become and Scientific Director at Bridgepoint Health from 2015 change agents. The Upstream Lab was founded in 2016 to to 2024; bring together a number of linked projects and initiatives. It f Dr. Meldon Kahan (Medical Director of Meta-phi, a is based in the MAP Centre for Urban Health Solutions at provincial program to improve care of people who use Unity Health Toronto. substances); f Dr. Jeff Meyers, the Bresver Family Chair at DFCM focused Dr. Aisha Lofters is the Inaugural Wadon the End-of-life Care and Medical Assistance in Dying. dington Family Community Research Capacity Building Program Director We have also created the opportunity for PhD faculty in the within the Research Department at the PA program and Paramedics in the ED program to have sciDFCM. She works closely with Dr. Peter entific appointments at UofT. Several PhD researchers at the Selby on leading the development of a sites or divisions are offered adjunct appointments to facilirobust research capacity-building protate their careers and collaboration with our core faculty. gram focused on community-based family physicians.

Promoting excellence in Research: The impact of supporting faculty from diverse backgrounds

Dr. Aisha Lofters is a family physician at Women’s College Hospital and Associate Professor with the DFCM. She is the Medical Director for the Peter Gilgan Centre for Women’s Cancers at Women’s College Hospital and holds a CIHR ApSeven notable examples from the current group of Funded plied Public Health Chair in Advancing Health Equity in CanInvestigators include the following: cer Prevention and Screening. Her research program lives at the intersection of health equity, cancer care and primary Dr. Tara Kiran has led a program of re- care, using a variety of research methods and with an emsearch evaluating the impact of primary phasis on community partnership. care reforms on quality in primary care in Ontario for the past decade. In 2022, Dr. Nav Persaud has dedicated his cashe launched OurCare, a national, public reer to narrowing the health gap beengagement initiative to co-create the tween the highest and lowest wealth blueprint for a stronger, more equitable brackets and to ensuring that everyone primary care system in Canada—a blueprint that can be used in Canada can afford the medication by government to inform and enact reforms, and by profesthat they need. Dr. Persaud is a Canada sional organizations and the public to advocate for change.

Research Chair in Health Justice.

In addition to being the DFCM’s Fidani Chair in Improvement and Innovation and Vice-Chair of Quality and Innovation, she is also a Scientist in the MAP Centre for Urban Health Solutions at St. Michael’s Hospital, and an Adjunct Scientist at ICES.

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He is leading the first-ever trial providing people with free access to essential medicines – quantifying the links between medication cost and health outcomes and bringing to light the unfair choices that millions of Canadians are forced to make about their health. He is also the Chair of the Government of Canada’s Committee of Experts to make recommendations on National Pharmacare. Dr. Persaud compares national essential medicines lists between countries.

Department of Family & Community Medicine, University of Toronto

Dr. Persaud is a scientist with MAP Centre for Urban Health Solutions in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital. He is a staff physician in the Department of Family and Community Medicine at St. Michael’s Hospital, and a professor in the DFCM. Dr. Persaud was named one of Canada’s Top 40 under 40 in 2017.

Dr. Karen Tu is Chair of Family and Community Medicine Research in Primary Care at University Health Network, Research Scientist at North York General Hospital, and Professor in the DFCM at the University of Toronto, with a cross-appointment in the Institute of Health Policy, Management and Evaluation. She also practices as a family physician with the University Health Network–Toronto Western Hospital Family Health Team. Dr. Tu earned her MD from the University of Toronto and an MSc in Health Policy, Planning, and Financing through a joint program at the London School of Economics and the London School of Hygiene & Tropical Medicine.

She has received significant support from the Rathlyn Foundation Primary Care EMR Research and Discovery Fund, which advances research using primary care electronic medical record (EMR) data in areas such as mental health and obesity, and supports data quality initiatives for the University of Toronto’s former practice-based research network, UTOPIAN. Dr. Tu founded INTRePID, a global network of family physicians and primary care researchers from 17 countries. INTRePID uses EMR and health insurance data to conduct international comparative studies, including its first major project on the impact of COVID-19 on primary care systems worldwide.

View select infographics from INTRePID’s research in the Research section of the appendices.

Dr. Noah Ivers is a family physician at Women’s College Hospital Academic Family Health Team and also leads a research program in implementation science at Women’s College Hospital. He is a full Professor in the DFCM at the University of Toronto. He holds a Canada Research Chair in the Implementation of Evidence-Based Practice. Noah’s research focuses on the use of data to drive evidence-based, patient-centred improvements in healthcare. He has conducted multiple pragmatic randomized trials, systematic reviews, and qualitative work on health services and quality improvement interventions.

He is presently the scientific lead of the Office of Health System Partnerships at DFCM. He contributes to the Patient-Partnered Diagnostic Centre of Excellence, an international initiative focused on reducing diagnostic errors and improving diagnostic safety.

The Centre emphasizes collaboration with patients, families, clinicians, and researchers to co-create solutions that make diagnosis more accurate, timely, and patient-centered.

Dr. Abhimanyu Sud is the inaugural Humber River Health Research Chair in Primary Care and Population Health Systems and an Assistant Professor in the DFCM at the University of Toronto.

A family physician and health services researcher, his work focuses on developing and evaluating clinical interventions to improve population health, particularly for individuals living with chronic pain, mental illness, and opioid use. He is a nationally recognized medical educator, co-chairs the Interprofessional Pain Curriculum at the University of Toronto, and contributes to national pain and opioid prescribing education programs.

Dr. Sud is an excellent example of a community-based family physician who returned to pursue a PhD under the supervision of Dr. Ross Upshur a senior faculty member and researcher.

The research program provided financial support to Dr. Sud for five years. Thereafter, Dr. Sud successfully competed for a clinician-investigator award and the Chair at HRH.

DFCM RESEARCHERS CELEBRATED AMONGST CANADA’S 50 MOST CITED PRIMARY CARE SCHOLARS LIST Research

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UPLEARN: THE UNIVERSITY OF TORONTO PRACTICE- AND COMMUNITYBASED LEARNING AND RESEARCH NETWORK In 2023, we decided to build on the UTOPIAN PracticeBased Research Network (PBRN) to transform into a PBRLN that expanded beyond data-driven research. Through a competitive process, we appointed Dr. Andrew Pinto for a five-year term as the Research Program Director to lead this transformation within the new reformed administrative structure of the research program.

UPLEARN Leadership and Governance

UPLEARN is overseen by Dr. Andrew Pinto, UPLEARN Director, with key operational support from Research Program staff including the Research Program Coordinator, Data Managers, and Research Officers. The Vice-Chair and Associate Director of the Research Program also provide support and recommendations in relation to UPLEARN is a “living laboratory” that connects over 2,000 UPLEARN’s external relationships and partnerships, funding family physicians across 15 academic sites affiliated with the management, and staff assignments.

DFCM throughout the Greater Toronto Area and beyond. It is dedicated to advancing clinical and health services research In addition, UPLEARN is governed by the Site and Community in family medicine to enhance the primary care experience Council (the Council), which plays a key role in shaping for both patients and providers, optimize resource use, and strategic priorities and guiding decisions on projects and improve population health. Building on more than a decade initiatives. The Council is composed of representatives of collective effort through the development of the University from 15 DFCM-affiliated sites, nine patient partners, subject of Toronto Practice-based Research Network, UPLEARN matter experts in areas such as research ethics and expands its scope beyond research to include: methodology, and the Research Program leadership team, all supported by UPLEARN staff. f Excellence in research f Practice support and quality improvement (QI) Key Milestones f Health professional education f Policy evaluation and impact Since its launch in September 2023, UPLEARN has strengthened f Community partnership and services relationships with DFCM-affiliated sites, deepened collaboration with peer programs, enhanced engagement UPLEARN is actively engaged in several research- and with patient partners, supported the development of emerging data-oriented networks. At the provincial level, it is part researchers, and advanced multiple research initiatives. of the Primary Care Ontario Practice-based Learning and Research Network (POPLAR). Nationally, UPLEARN is a In 2024, UPLEARN completed visits to each affiliated site, founding member of the Canadian Primary Care Research engaging physicians and site staff directly to help shape Network (CPCRN), the Canadian Primary Care Trials the network. Each site has since been assigned a dedicated Network (CPCTN), and a member of the Canadian Primary UPLEARN staff liaison. Nearly 200 faculty members, learners, Care Sentinel Surveillance Network (CPCSSN). and staff shared their interests and posed questions arising from their day-to-day work. This input is helping UPLEARN By fostering collaboration among primary care clinicians, foster stronger site and community collaborations and patients, researchers, and policymakers across jurisdictions, ensure that DFCM scientists are addressing these emerging UPLEARN plays a vital role in advancing a sustainable and important questions that matter to all of us. These Learning Health System – one that continuously evolves to insights are being shared through our newly launched deliver high-quality, evidence-based, and equitable primary newsletter, the UPLEARN Update, and will also inform the care to populations across Canada.

2025 annual reviews of DFCM Funded Investigators.

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UPLEARN has also been a key contributor to CareCanvas, f SPIDER: A pragmatic clinic trial assessing the a flagship initiative led by DFCM’s Quality and Innovation effectiveness of a Q&I-oriented approach to reducing Program (Q&I). Since the project’s inception, UPLEARN potentially inappropriate prescriptions among elderly has collaborated closely with Q&I, providing data analytics patients experiencing polypharmacy. View more and visualization expertise to support the development of information about SPIDER in the Research section of the the CareCanvas dashboard. This collaboration has since appendices. expanded to other Q&I-led projects, including consultations f INTRePID: An international consortium leveraging on research ethics strategies for the Access Dashboard and electronic medical record (EMR) data to conduct Coaching project. comparative studies on a wide range of primary care topics across sixteen member countries.

The UPLEARN patient partners group within the Site and Community Council has grown to include nine members from six To facilitate the review and approval of various support sites, with a goal of engaging at least one patient partner from requests, UPLEARN has also streamlined the project intake every site. These partners, alongside other Council members, process by creating a single intake form for anyone wishing continue to play a vital role in setting priorities and contributing to connect with UPLEARN for support. to a wide range of research activities and initiatives.

In January 2025, we launched the Ideas to Proposal (I2P) Course, enrolling 13 learners—11 family physicians and two residents from across our sites. The course is designed to build primary care research capacity by equipping earlystage investigators with the skills and knowledge necessary to transform a research concept into a well-defined research question and develop it into a competitive proposal. I2P also fosters mentorship connections between learners and DFCM-based researcher mentors to support the growth of primary care research and the development of research outputs. Three proposals received monetary awards thanks to the generous support of the Waddington Family Foundation. These projects aim at addressing a range of critical issues pertaining to primary care, such as equitable care access, continuity of care, and risk identification using advanced analytic methods.

UPLEARN Future Directions

UPLEARN is poised for continued growth and impact across five strategic areas. In the coming years, UPLEARN will continue to support CareCanvas and other Q&I initiatives, offer increasingly robust I2P courses for early-stage researchers, and strengthen partnerships with peer programs and networks. These efforts will enhance research capacity, support data infrastructure development, influence policy relevant to primary care, and integrate technologies to improve clinical decision-making and administrative efficiency. Together, these initiatives will reinforce UPLEARN’s long-standing commitment to excellence in family and community medicine research, education, and high-quality clinical care. UPLEARN is also innovating methods to meet new privacy and REB requirements to assist sites extract and analyse data locally for QI and be ready for broader sharing with the POPLAR network when As a “living laboratory” committed to advancing knowledge ready and authorized to receive data from sites. to improve primary care and health for all, UPLEARN continues to invest significantly in supporting clinical and health services research across the full research lifecycle– from grant application to post-award administration, from clinical trials to secondary data analysis studies. Over the past five years, UPLEARN has supported a range of research initiatives, including but not limited to: f CanTreatCOVID: An adaptive platform trial evaluating the clinical and cost-effectiveness of existing and emerging medications for SARS-CoV-2 (COVID) in nonhospitalized patients. f PREPARED: An infrastructure project aimed at enhancing surveillance and pandemic response, improving patient care and health system efficiency, accelerating the development of diagnostics, vaccines and therapeutics, and facilitating trial linkages.

Research

HARNESSING DATA TO DRIVE IMPROVEMENT:

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Highlights Research Productivity and Funding RESEARCH FUNDING: Family and Community Medicine Research Funding 25,000,000 20,000,000 15,000,000 10,000,000 5,000,000 0

2019-20

2020-21

2021-22

2022-23

2023-24

DFCM faculty are successful recipients of funds from a variety of peer-reviewed and non-peer-reviewed granting agencies. Accurate collection of such data is problematic because most grants are held at the host hospital. A new initiative has been implemented such that the information is automatically shared with the university on a 6 monthly basis.

More grant information can be found in the appendices.

Peer-Reviewed Publications DFCM faculty are productive in terms of publications and are well represented in national and international journals. Given the large size of the faculty, new mechanisms are being developed to capture publications by faculty who are not funded researchers. The latter are required to submit annual reports and are identified as researchers more explicitly.

Please see Table 1 for publication counts for a subset of DFCM researchers, i.e., the Funded Investigators.

DFCM faculty are productive in terms of publications and are well represented in national and international journals. Please see Table 1 for publication counts for a subset of DFCM researchers, the Funded Investigators.

Table 1: Number of Scopus-indexed publications, generated by N=27 DFCM Funded Investigators, between 2020-2025

Number of Publications

2020

2021

2022

2023

2024

2025

175

259

249

257

249

179

*The Scopus IDs for N=3 DFCM Research Program funded investigators did not return valid bibliometric data and were excluded from the analysis in Table 1. **Data was collected in summer/fall 2025, so not all 2025 publications are included.

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Table 2: Overall bibliometric statistics derived from Scopus-indexed publications, for N=27 DFCM Funded Investigators, aggregated over the years 2020-2025 ENTITY UofT DFCM

NUMBER PUBLICATIONS

NUMBER CITATIONS

PERCENT CITED

NUMBER TWEETS

NUMBER WIKIPEDIA CITATIONS

NUMBER POLICY DOCUMENT CITATIONS

1,368

15,982

80.1%

49,726

39

167

*The Scopus IDs for N=3 DFCM Research Program funded investigators did not return valid bibliometric data and were excluded from the analysis in Table 2.

The top 5 journals DFCM-funded investigators were most likely to publish in are listed below: 1. PLOS One (N=53) 2. BMJ Open (N=47) 3. CMAJ (N=37) 4. CJEM (N=36) 5. CMAJ Open (N=32) The top 5 most prevalent keywords associated with DFCM-funded investigator publications are listed below: 1. COVID-19 (N=112) 2. Primary Care (N=70) 3. Canada (N=45) 4. HIV (N=41) 5. Public Health (N=37) Table 3: Comparison of bibliometric statistics associated with Scopus SciVal indexed “Family Practice” research publications (2020-2025), from select academic institutions ENTITY

NUMBER PUBLICATIONS

NUMBER CITATIONS

CITATIONS PER PUBLICATION

CITED PUBLICATIONS (%)

FIELD WEIGHTED CITATION IMPACT

UofT

496

3,377

6.8

66.5

1.59

UBC

188

907

4.8

65.4

1.78

McGill

148

2,093

14.1

70.3

2.07

Harvard

236

2,849

12.1

76.7

2.48

U. Edinburgh

172

2,117

12.3

78.5

2.53

Research

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A few examples of Impactful DFCM Research f Persaud et al. (2025). Voucher for Healthy Foods and Diabetes Control JAMA. f Carroll et al. (2025). An Innovative Strategy for Collecting Family Health History: An Effectiveness-Implementation Trial in Primary Care Clinics. Annals of Family Medicine. f Butt et al. (2025). Healthcare Use in Individuals with and without Attention-Deficit/Hyperactivity Disorder: A Population-based Longitudinal Matched Cohort Study.

PLOS Mental Health. f Garrison et al. (2025). Antihypertensive medication timing and cardiovascular events and death: The BedMed Randomized Clinical Trial. JAMA. f Su et al. (2025). Association between medication adherence and cardiovascular outcomes in patients with both diabetes and hypertension in primary care settings in Canada: A retrospective cohort study. PLoS ONE f Kiran et al. (2024). Public experiences and perspectives of primary care in Canada: results from a crosssectional survey. CMAJ f DFCM & Ontario COVID-19 Science Advisory Table (2022) COVID-19 Science Table Briefs f D’Urzo et al. (2022). Primary Care Severe Asthma Registry and Education Project (PCSAR-EDU): Phase 1 – an e-Delphi for registrydefinitions and indices of clinician behaviour. BMJ Open f Stephensen et al. (2021). Changes in family medicine visits across sociodemographic groups after the onset of the COVID-19 pandemic in Ontario: a retrospective cohort study. CMAJ Open f O’Neill et al. (2021). Association between new-onset anosmia and positive SARS-CoV-2 tests among people accessing outpatient testing in Toronto, Ontario: a retrospective cross-sectional study. CMAJ Open f McIsaac et al. (2021). A pragmatic randomized trial of a primary care antimicrobial stewardship intervention in Ontario, Canada. BMJ Family Practice f See more DFCM Publications. f View DFCM’s full bibliometric data from 2020-2025.

As well as disseminating findings through publications, faculty are encouraged to share knowledge and address local issues through conference and symposia presentations, research reports, workshops, Research Rounds, and other professional channels as informal networks. DFCM researchers are also regularly quoted in local and national media.

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Examples: f DFCM researcher Dr. Catherine Varner is the deputy editor for the Canadian Medical Association Journal and is often quoted.

Z Rates of pre-eclampsia, hypertension in pregnancy up 40% over 10 years, study says for The Canadian Press Z Diagnosing Cancer in the ED ‘Becoming Routine’ in Canada for Medscape Z Virtual urgent care didn’t divert Ontario patients from ER visits during pandemic, study suggests for CBC f DFCM researcher Dr. Tara Kiran’s OurCare continues to appear in top health news headlines.

Z Ontario has more family doctors, but fewer are working in primary care, study shows for The Globe and Mail Z ‘Concerning:’ New research reveals trend that may be contributing to family doctor shortage for CTV News Z Toronto-based researchers want to hear from you about your experiences in healthcare for CBC

Family Medicine Reports DFCM shares annual Family Medicine Reports, which showcase stories and innovative research happening across the department. These reports highlight key projects, findings, and collaborations that advance family medicine and primary care research.

Explore the reports: f 2021 DFCM Family Medicine Report f 2023 DFCM Family Medicine Report f 2024-2025 DFCM Family Medicine Report RESEARCH ROUNDS AND SPECIAL EVENTS: The Research Program hosts bimonthly Research Rounds, an interactive, College of Family Physicians of Canada-accredited, in-person and online opportunity open to all family and community medicine and primary care researchers, faculty, residents, students/trainees, and staff. Invited keynote speakers include the Funded Investigators and research colleagues from across all DFCM sites to share their current research proposals, outcomes from funded studies, and/or new research practices and methods. Research Rounds usually include a research-in-progress presentation, which is often presented by investigators who are looking for feedback and mentorship from more senior investigators.

Department of Family & Community Medicine, University of Toronto

As of 2024, generously funded by the Waddington Family Fund, the Research Rounds series became accredited and has started to re-emphasize in-person engagement at events, fostering a culture of networking and socializing among family medicine researchers in the department. In March 2025, a special DFCM community site edition of Research Rounds was hosted by Humber River Health, featuring community health and equity-focused research presentations. This event was attended by over 50 participants in person and online.

In May 2025, a special half-day research symposium was hosted by DFCM Research titled, “Building capacity and community to help inform the future of family medicine research at DFCM.” The event was attended by over 40 in-person attendees, including current funded investigators and research site leads representing the DFCM sites. Presentations focused on each site’s research vision, capacity, and productivity. The event included hosting the 2025 Earl Dunn Lecture, a prestigious lectureship in primary care research and excellence. Presented by the Honourable Jane Philpott, this presentation was titled “Ontario’s journey to primary care for everyone” and was attended by an additional 60+ participants who joined the research symposium virtually.

A follow-up in-person research symposium with a focus on research collaboration across all DFCM sites has been planned for November 2025, titled “Ideas to action on building research collaboration across DFCM sites”.

DFCM-SUPPORTED RESEARCH AND EDUCATION INITIATIVES: Over the years, hundreds of DFCM-affiliated researchers have conducted high-quality, locally focused research with support from the central DFCM Research Program. This support—delivered through teaching, training, services, and resources—aims to improve quality, efficacy, and equity in primary care. The program also draws on the expertise and resources at each teaching site, guided by Family Medicine Chiefs, Research/Academic Project Leads, and others.

Research support services and resources: SUPPORT WITH BIOSTATISTICS AND RESEARCH METHODOLOGY: The DFCM Research Program offers biostatistics and research methodology support services for faculty, including assistance writing grant applications, designing studies, data management, data analysis, and dissemination of findings. For DFCM faculty, there is no cost for research support services related to core DFCM program activities.

Research

ASSISTANCE PREPARING GRANT AND REB APPLICATIONS: The DFCM Research Program offers voluntary internal peer review of research grant applications to help improve grant-writing skills and the overall success rates of peer-reviewed grant applications. The program also provides support with Research Ethics Board applications submitted through the University of Toronto’s automated My Research Applications platform.

RESEARCH MENTORSHIP: DFCM fosters dynamic reciprocal mentorship relationships leading to positive change both for the career development of the involved individuals and for the cultural development of the department. DFCM Investigator Award recipients are required to provide research mentorship. The Research Program staff also provide formal and informal mentorship and connect mentees with research mentors.

RESEARCH TRAVEL FUND AND PUBLICATION FEE AWARDS: These awards are available to support DFCM faculty to present peer-reviewed research at national and international conferences or have peer-reviewed research articles accepted for publication. In the last five years, the DFCM has supported five research travel awards to conferences around Canada and the world and 13 publication fee awards to support high-quality, open-access publications.

SURVEY SOFTWARE: Qualtrics is a secure, user-friendly, feature-rich, web-based survey tool that allows users to build, distribute, and analyze online surveys, collaborate in real-time, and export data in multiple formats. The Research Program previously provided Qualtrics access for DFCM faculty, staff, and learners.

In mid-2025, the Research Program shifted to providing survey support by developing a REDCap information sheet and directing researchers and staff to the University’s REDCap Office for relevant trainings and support. REDCap (Research Electronic Data Capture) is an established, cost-effective, secure web application for building and managing online surveys and databases, and is freely available to members of the University of Toronto community.

Research in Education The DFCM Research Program provides important opportunities for learners to participate in research. Below are key examples that highlight its involvement in shaping and supporting research in medical education.

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UNDERGRADUATE MEDICAL STUDENT OPPORTUNITIES: The Comprehensive Research Experience for Medical Students (CREMS) engages interested medical students to gain extracurricular research experiences in two structured programs. There is a 12-week Summer Program open to first- and second-year medical students, and a 20-month Research Scholar Program for first-year medical students.

At each site, RAP support is provided by a RAP Coordinator, Site Directors, faculty and an online resource. All residents also participate in regular teaching sessions relating to critical appraisal and the practice of evidence-based medicine.

The Clinician Scholar Program is part of the Enhanced Skills Program (PGY3). It provides residents with adequate knowledge, training and experience to enable them to pursue careers as clinician investigators under the supervision of DFCM research faculty.

POSTGRADUATE FAMILY MEDICINE RESIDENT OPPORTUNITIES: f The Academic Fellowship Program is a rigorous continuing education program intended to strengthen the practice Postgraduate education offers one-month research electof family medicine and primary care by developing the ives for family medicine residents, typically supervised by a leadership, teaching, and research skills of practitioners.

DFCM Investigator Award recipient.

Resident Academic Projects (RAP) are completed by all GRADUATE AND CONTINUING EDUCATION OPPORTUNITIES: residents in their second year and are often supervised by f Clinical Research Certificate Program, primarily for a DFCM Investigator Award recipient and/or other DFCM faculty, significantly enhances understanding, effective researchers. These projects can take the form of research, use, engagement and collaboration in research. quality improvement, education scholarship, or a communStudents complete two required courses that provide an ity-oriented primary care project. The specific objectives of introduction to research methods in family medicine and all RAP projects are to: primary care, a practicum for hands-on practice, and an elective. The Clinical Research Certificate is issued 1. Develop and precisely iterate a question that arises by the Office of Academic Fellowship and Graduate during residency; Studies.

2. Develop and submit a preliminary project plan; f There are also graduate courses attended by faculty, 3. Conduct a critical review of the relevant literature; graduate students and residents including, “Applied 4. Complete the specific objectives of the project chosen; Survey Methods for Healthcare Professionals” and 5. Reflect on findings and its implications for the resident “Research Issues in Family Medicine and Primary Care.” as a family physician, and for the discipline of family f Graduate studies can be pursued through the School of medicine; Graduate Studies either through the Dalla Lana School 6. Submit a final written report; of Public Health or the Institute of Medical Sciences 7. Present findings and respond to questions at the site situated in the Temerty Faculty of Medicine at the Resident Research Day; and University of Toronto 8. Consider additional opportunities for dissemination, f The investigator program offers salary support for those such as conference presentations or distributing pursuing research Masters ( 3 years) or PhDs ( 5 years) findings or tools to stakeholders. f The I2P program offered through the PBRLN described below with funding from the Waddington Family Foundation to help faculty develop research ideas into fundable proposals.

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Challenges The sunsetting of UTOPIAN UTOPIAN, the earlier University of Toronto Practice-Based Research Network, was a cornerstone of the research infrastructure at the DFCM. The DFCM had planned for it to play a key role in POPLAR (Primary Care Ontario Practice-based Learning and Research Network), to offer expanded opportunities for data collection and synthesis, allowing researchers to answer key questions in primary care across Ontario and improve quality of care through measurement. However, since our last departmental review, UTOPIAN was forced to undergo a major shift, bringing challenges as the department adapted to new processes and priorities.

Established in 2013, UTOPIAN was one of the largest practice-based research networks (PBRNs) in North America.

With a strong focus on electronic medical record (EMR) data, UTOPIAN systematically collected information from the EMRs of consenting primary care practices and transformed it into a de-identified standardized format stored in the secure analytic environment, the Data Safe Haven (DSH) repository. The authority to collect and use data was granted through research ethics approval under PHIPA Section 44. Over the years, the data supported numerous research and quality improvement (QI) projects, resulting in many publications, conference presentations, and new initiatives.

A recommendation of our last departmental review was to undertake an independent external review of UTOPIAN, to guide its future evolution. This review was conducted in 2022 by an impressive panel of 3 reviewers: Dr. Beth Coleman. Dr. Michael Green, and Dr. Robyn Tamblyn.

Varied internal and external groups also participated in the review, the details of which can be found in the full final review included as an appendices. The review outlined several key takeaways or recommendations for UTOPIAN, as follows: f To position itself to deliver excellence in research and quality improvement equally. f For the governance structure to reflect the emphasis on both practice-based research and quality improvement. f For the DFCM to renegotiate its relationship with North York General Hospital to ensure that UTOPIAN can deliver on research excellence and quality improvement for all participating sites and practices. f To conduct a cost and access analysis of in-house versus alternative data safe havens to reduce cost and increase adoption of best practices.

Research

As the department was preparing to implement the external review recommendations, in November 2022, the Information and Privacy Commissioner (IPC) of Ontario initiated an investigation of UTOPIAN in response to an anonymous complaint. During the time of the investigation, data extraction was paused. In May 2024, the IPC completed its review.

The IPC did not find any evidence to substantiate the complainants’ allegations and determined that the matter should not proceed to adjudication. The IPC also found that the University had provided proper notice to custodians regarding a 2023 data collection. In other words, there was no evidence of a data breach or wrongdoing. That said, the IPC identified several areas for improvement, including the need for greater transparency and communication with physicians and patients. The IPC also recommended a robust re-identification risk assessment, which UTOPIAN completed in full compliance within a six-month reporting window. With permission from the University of Toronto Health Sciences Research Ethics Board (REB), the DSH project was archived, and no new data were extracted into the repository thereafter. Existing data analysis studies with active REB approval were permitted to continue using the archived data until completion.

In the wake of the external review of UTOPIAN, and facing changes in privacy and REB standards, and in the absence of robust hospital and institutional support for community-based EMR data extraction, a decision was made to sunset the program. Many of the challenges for ongoing EMR data use will require system-level solutions that are beyond the scope of an individual academic department to resolve. These include the negotiation of data extraction from private EMR vendors at a reasonable price and frequency; appropriate structures for consent at the level of patients, clinicians, and practices; mechanisms to feed data back to clinicians in a de-anonymized manner to support quality improvement within practices; secure data housing and ethics oversight for data use for research; and the list goes on. These are challenges under existing research frameworks that do not contemplate community-based research in their design. However, while we work with provincial partners to build these systems, the need for a robust local PBRN remains. We are determined to continue to build our capacity for practice-based research and learning in spite of these challenges.

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Looking Ahead We created UPLEARN under a new leadership structure.

Although it builds on the collective efforts that created UTOPIAN, UPLEARN is expanding the scope of research to support additional key areas such as QI, education, policy change, and community engagement and moving beyond the earlier PBRN’s focus of EMR/administrative data as the sole modality of research.

More details can be found in the UPLEARN section of the self-study report.

RESEARCH FACULTY IN FAMILY MEDICINE Another key challenge is with respect to stipends we offer faculty, as these have not changed since the Research Program’s inception in 1995. Thus, the amounts offered have not kept pace with being competitive, especially if a community site does not have a conforming practice plan designed to support research. Moreover, the competing demands from clinical and personal time, coupled with the uncertainty associated with securing funding and roles as a researcher, diminish the pipeline for research being done by family doctors. Moreover, there have been instances of funded investigators who have a significant body of work but have been designated and are still evaluated like early-stage scientists without weighting contributions towards senior authorship, mentoring faculty, and students in research, and so on. There is also a gap in our program at the moment in being able to allow senior scientist designations. With pending retirements and the challenges of a clear pathway into a research career in comprehensive family medicine, plus the availability of jobs after training, it is difficult to develop and nurture new talent.

When the Strategic Plan was launched in 2022, it initiated new and important reflections and actions grounded in equity principles for the Research Program to consider. In particular, there were recommendations to cultivate and invest in new community-based research partnerships. An important example of actioning this investment can be seen with establishing the Inaugural Waddington Family Community Research Capacity Building Program Director. With this new leadership, and generously funded by the Waddington Family Fund, the Research Program has launched calls for new opportunities to mentor and protect research time for early-stage investigators at community-based sites.

These new awards include opportunities for Early-Career Investigators and Fellowships, with emphasis on attracting applicants from sites that may be outside of the Greater Toronto Area and working in community clinics and practices.

We are planning for the new investigators to commence their roles in January 2026.

With the launch of UPLEARN, the Research Program continues to advance toward being part of a sustainable Learning Health System. Over the coming years, UPLEARN will continue to expand its scope of projects supported across the areas of not only research but also QI, education, policy change, and community engagement. While primary care EMR data extraction remains a valuable resource for innovation and improvement in all these areas, UPLEARN will continue to support and collaborate with the provincial network, POPLAR, in its development and will also explore other feasible approaches to EMR data extraction and database maintenance. UPLEARN is committed to ensuring research capacity is built among faculty and residents who are interested and engaged in research, and as such will continue LEADERSHIP CHANGE to be a key partner in the evolution of the updated Ideas to Lastly, the Research Program’s Senior Epidemiologist is re- Proposal (I2P) course. tiring in early 2026. Due to the way such staff are appointed to the Temerty Faculty of Medicine, attracting top talent will In sum, our goal is to have more community-affiliated hospibe challenging in 2026. Regardless, we are committed to tals develop research capacity in family medicine. We have create further pathways into a research career for learners been developing partnerships focused on research, providand faculty by creating more funding opportunities aligned ing guidance, promoting applications to newly established with the DFCM’s Strategic Plan. chairs in primary care and facilitating grant submissions via the University. In addition, the new governance structure promotes succession planning for the Vice-Chair role within the department. We are reviewing the methodological expertise requirements of faculty with the Associate Director available to advise and collaborate with researchers on qualitative studies.

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Department of Family & Community Medicine, University of Toronto

Highlighted Partners Researchers have partnerships individually with members in their local hospitals, across departments in the Temerty Faculty of Medicine, School of Public Health, Information Science, Computer and Electrical Engineering, Biomedical Engineering, Social Work, Nursing, and Rehabilitation Sciences.

We have created partnerships with the Institute for Clinical Evaluative Sciences (ICES) including staff collaborations and service agreements to support faculty at their local sites.

DFCM Teaching Sites In addition to central resources, the DFCM Research relies on research expertise, resources and supports at each teaching site, under the direction of Family Medicine Chiefs, Research/Academic Project Leads and others. Researchers embedded at these sites are also partners with DFCM for a variety of projects, especially those involving data analysis.

DFCM Divisions We have several researchers, especially those in our Divisions, supported by specialty hospitals (e.g., CAMH supports Drs. Selby, Le Foll, Osnat Melamed and Scott Veldhuizan) or institutes (e.g., SREMI supports Drs. Borgundvaag and Varner), Palliative Care at Mount Sinai Hospital (e.g., Dr. Meyers), DLSPH (e.g., supports Drs. Upshur and Orkin) and Massey College (e.g., supports Dr. Orbinsky).

Research

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QUALITY AND INNOVATION

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INTRODUCTION The Department of Family and Community Medicine’s Who We Are (DFCM’s) Quality and Innovation (Q&I) Program exists to make primary care in Canada–and the world–even better than it is. In 2018, the program operated with a lean core team consisting of the Vice-Chair, Program Manager, and Program The program was founded in 2011 under the leadership of Dr. Administrative Officer. Since then, Fidani funds and departPhil Ellison, the inaugural Fidani Chair in Improvement and ment supports have enabled the addition of key leadership Innovation and Vice-Chair, Quality and Innovation, following roles, including a Q&I Faculty Development Lead, Q&I Data recommendations from a 2010 Quality Task Force. It was re- Science Lead, and Patient Experience Measurement Lead. branded in 2017 under the leadership of the new Chair, Dr. By 2020–2021, the program further expanded with the introMichael Kidd, to the Quality and Innovation Program to align duction of a Patient Engagement Specialist and a Research with the new strategic vision of “Advancing Family Medi- Officer to support measurement and special initiatives. Most cine globally through scholarship, social responsibility, and recently, in 2023, departmental supports made it possible to strategic partnerships.” appoint our inaugural Practice Improvement & Continuing Professional Development Program Directors, recognizing Under the leadership of Dr. Tara Kiran, Fidani Chair in the importance of this leadership to achieve our ambitious Improvement and Innovation and Vice-Chair Quality and In- goals as set out in the DFCM strategic plan. novation since 2018, the Q&I Program focuses on building leadership capacity in the primary care workforce, using Our core program team currently includes: and generating evidence to drive improvements, direct- f Dr. Tara Kiran, Vice-Chair Quality and Innovation ly supporting clinicians and teams, and fostering dialogue f Dr. Noor Ramji, Practice Improvement Program Director among government, clinicians, and patients to influence f Dr. Eleanor Colledge, Continuing Professional policy and practice. The ultimate goal is to improve health Development Program Director (currently in transition) outcomes and patient experiences, ensure safety and effi- f Dr. Margarita Lam Antoniades, Quality Improvement ciency, and promote equitable health for all while ensuring Education Lead provider wellness and maintaining costs f Erin Plenert, Q&I Program Manager f Marisa Schwartz, Administrative Officer f Kirsten Szymanski, Research Officer f Dr. Erica Li and Dr. Debbie Elman, Patient Experience Measurement Co-Leads

View a selection of Q&I publications in the Q&I section of the appendices.

Quality and Innovation

Leadership for these efforts is provided by Q&I Directors at each of the department’s 18 family medicine teaching sites, where they champion practice improvement and support quality improvement education.

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Highlights QI Education The Q&I Program has led the way nationally in the development of a comprehensive, longitudinal quality improvement curriculum that is contextualized for primary care. Driven by our Q&I Education Lead, Dr. Margarita Lam Antoniades, we continue to set the standard for quality improvement-focused educational initiatives for family medicine residents, family medicine physicians, teachers and educators, and community-based primary care clinicians nationally and internationally.

Members of PFAC at the DFCM BBQ. Dana Arafeh, Patient and Family Engagement Specialist, on the far left.

In the spirit of quality improvement, the curriculum has been revised regularly to include content on: f patient safety f patient engagement f equity f environmental sustainability

our Q&I Directors and in partnership with our colleagues in Ghana, developed a two-part Quality Improvement in Healthcare Course designed to equip leaders and managers of healthcare facilities with contemporary knowledge, skills, and attitudes required to improve healthcare quality to enhance clinical outcomes in service delivery.

The curriculum was updated to an e-learning platform prior to the declaration of the COVID-19 pandemic, which dramatically enhanced the experience for learners through its visual design and usability and offered embedded links to important articles, videos, and resources. All three of our Q&I self-learning e-modules for primary care physicians, family medicine faculty and teachers, and family medicine residents and learners continue to be made available at no cost to anyone interested in improving quality in primary care.

Patient Engagement

Additionally, as part of the Africa Higher Education Health Collaborative (AHEHC), faculty from DFCM are collaborating with the School of Public Health at Kwame Nkrumah University of Science and Technology (KNUST) to co-create and co-deliver educational programs to improve primary healthcare in Ghana. Dr. Lam Antoniades, alongside a number of

In 2022, she led the committee’s development, working with sites to recruit and interview more than 40 potential advisors and preparing terms of reference and orientation materials to enable their success. That September, the 16 selected patient partners—each from a DFCM teaching clinic and representing diverse backgrounds—convened for the first time.

In 2021, we hired our inaugural Patient and Family Engagement Specialist, Dana Arafeh. The role was initially funded half-time through the Fidani funds, with Dana spending the other portion of her time with Dr. Johnathan Maguire, Lawson Chair in Patient Engagement in Child Nutrition. The role is a unique one within the Temerty Faculty of Medicine and across Departments of Family Medicine in Canada. It has helped to strengthen patient engagement across the departFaculty development has also been strengthened through ment, embedding it into our culture and day-to-day work. quality improvement training opportunities, including scholarships for quality improvement certification through the In 2021, Dana collaborated with the Q&I program and DFCM Centre for Quality Improvement and Patient Safety (CQuIPS), leadership to conduct a department-wide needs assessand a new partnership with CQuIPS to co-create a Primary ment on patient engagement. Her findings were summarCare–focused Masterclass. ized in Patient and Family Engagement in the DFCM: Current State and Future Directions, which outlined the landscape QI EDUCATION BEYOND U OF T DFCM and key priorities for advancing engagement. Guided by Parts or all of our curriculum are now used at several med- this work, she focused on building capacity, strengthening ical schools including the Northern Ontario School of Medi- patient partnership in postgraduate education, and estabcine, Queen’s University, and the Aga Khan University cam- lishing the DFCM’s inaugural Patient and Family Advisory pus in Nairobi, Kenya.

Committee (PFAC).

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In 2023, the department recognized the impact of the role of Patient and Family Engagement Specialist by matching Fidani Chair funds to support Dana full-time. In this expanded capacity, she developed key resources such as the DFCM Patient Partner Compensation process and a comprehensive engagement roadmap. She has also provided over 50 consultations annually to internal and external partners on best practices for patient engagement, reflecting a department-wide commitment to culture change in this area.

PFAC IMPACT PFAC’s impact has been felt across DFCM, playing an important role in shaping departmental initiatives.

PFAC has contributed to quality improvement and family medicine education, including: f revising patient experience survey questions f co-creating knowledge translation tools such as infographics and videos to share the results with patients f interpreting survey data More recently, Dana has led collaborative initiatives, togeth- f sharing patient perspectives on AI scribes er with the PFAC, such as the Role of a Resident project, f sharing perspectives on revised mental health and which developed patient-facing materials to increase undersocial accountability competencies. standing of residents’ roles in teaching clinics. Alongside the PFAC, she has co-created workshops for the annual DFCM PFAC has also identified a widespread gap in patient underconference, contributed to optimizing our patient experience standing of the role of resident doctors and responded by survey, and supported the creation of a Social Accountability co-developing educational materials for teaching clinics. rotation for residents. Our pool of over 150 patient partners has also been deeply engaged in departmental initiatives, Their early and ongoing involvement has shaped major initiafrom renewing mental health competencies and informing tives, such as a new social accountability rotation for residents. the annual Family Medicine Report to sharing lived experiences at the Undergraduate Addiction Week conference.

View the Patient and Family Engagement in the DFCM: Current State and Future Directions report.

PATIENT EXPERIENCE SURVEY

PATIENT EXPERIENCE SURVEY 12,658EXPERIENCE total patients completed the latest survey PATIENT SURVEY 12,658 total patients completed the latest survey

The surveytotal is distributed analyzed twice 12,658 patientsand completed the latest survey a year.

We look at the results over timetwice to The survey is distributed and analyzed see what changes we need to make to give a year. We look at the results over time to The survey is distributed and better care. see what changes we need toanalyzed make to twice give a year.care.

We look at the results over time to better see what changes we need to make to give better care.

WHAT WE LEARNED WHAT WE LEARNED WHAT WE LEARNED 68% respondents know how a resident doctor differs 68% respondents knowfrom how aa family doctor compared 65%a in resident doctor differs to from 68% doctor respondents knowtohow the last survey family compared 65%a in residentthe doctor differs from a last survey family doctor compared to 65% in thehelped last survey This question us understand the usefulness of the resources shared to This question helped us understand the explain the role usefulness of the resources shared to This question helpedthe usrole understand the explain usefulness of the resources shared to explain the role

33% of patients reported needing urgent 33% of patients care compared with 16% in reported needing urgent 33% of patients 2020 care compared with 16% in reported needing urgent 2020 care compared with 16% in 2020

, ,

However, same day/next day access to urgent care However, same day/next has remained day access to stable urgent care However, same day/next has remained day access to stable urgent care

More information can be found in the Relationships, Partnerships, and Social Accountability section.

MEANINGFUL MEASUREMENT DFCM Patient Experience Survey Meaningful measurement is essential for data-driven improvement. In 2019, the Fidani funds supported the creation of the DFCM Patient Experience Measurement Lead role to develop a common patient experience measurement across all sites to inform improvement opportunities. Having a common survey would allow for local decision-making while also helping the DFCM identify and share best practices among sites. The first common patient experience survey was launched in the summer of 2020 to better understand the patient experience in primary care following the declaration of the COVID-19 pandemic, specifically in terms of access, timeliness, and continuity of care. To date, twelve iterations of the survey have been circulated to thousands of registered patients at each teaching site. The survey has been modified to include other key dimensions such as equity, accessibility for individuals with disabilities, and patient-centredness.

has remained stable

,

~13,000-14,000 patients complete the bi-annual survey

From the winter 2025 survey PATIENT-CENTERED CARE OUTCOMES

PATIENT-CENTERED CARE OUTCOMES 75% of patients always felt involved in decision making about their care and treatment PATIENT-CENTERED CARE OUTCOMES 75% of patients always felt involved in decision making about their care and Quality and Innovation

treatment 75% of of patients patients said always felt involved decision making about their care and 69% that their doctorinor nurse practitioner spent enough time treatment with them

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PATIENT EXPERIENCES WITH CARE SURVEY FINDINGS: WAVE 1 EQUITY DATA

The University of Toronto family medicine teaching clinics have been surveying patients to understand their care experiences and needs during COVID-19. The survey has been sent to patients every 3-4 month since June 2020. The healthcare teams at each clinic meet regularly to discuss the survey results and find ways to provide better care.

Data collected from the survey has been used to do a deep dive into equity in care, understanding how experience during COVID-19 varied based on patient sociodemographic characteristics. The findings from this were published in BMJ Open in 2022, “Sociodemographic differences in patient experience with primary care during COVID-19: results from a cross-sectional survey in Ontario, Canada.” Our team has also collaborated with Dr. Rebecca Etz in the United States, to include the novel Person-Centered Primary Care Measure into our survey, an inclusion originally piloted at our St. Michael’s Hospital site.

FINDINGS This is what we learned from you through our first survey done June to September 2020.

ACCESS TO CARE

VIRTUAL CARE

31%

% of patients who want care to continue through:

of patients waited or stayed away from the doctor’s office early in the pandemic

Phone Video

URGENT CARE

Email or Secure Messaging

17%

of patients needed urgent care because they were sick

58%

% of patients who are comfortable with the privacy and security of:

65%

Phone Video

of those who needed urgent care were able to book an appointment the same or next day

To increase its reach, the patient experience survey has been translated into French and simplified Chinese and patient-facing infographics have been developed to communicate survey results directly to patients.

83% 47%

Email or Secure Messaging

92% 95% 91%

From the fall 2020 survey

We see patients of different backgrounds at our clinic and ask questions in our survey to learn more about how care affects different groups. NOT EVERYONE FELT THE SAME WAY about urgent care, virtual care, and access to care.

Patient-centered Care Outcomes

Patients who told us they had financial troubles, poor health or were born outside of Canada: • Were more likely to need urgent care and were less likely to have received it • Were more likely to note discomfort with the privacy and security of virtual care and less likely to want virtual care to continue to be offered

WHAT ARE WE WORKING ON BASED ON OUR PATIENT’S ADVICE?

75% of patients always felt involved in decision making about their care and treatment.

Meeting everyone’s needs equally

Providing multiple options for care

69% of patients said that their or nurse practitioner spent enough time with them.

Making sure that virtual care meets the needs of newcomers, those with financial troubles or poor health

We will continue to work with you to provide care in the way you need

63% of patients said they are very satisfied with their care.

Learning from each other Have our clinics share how they are doing things so we can learn from one another to provide better care

From the winter 2025 survey

We understand this data does not represent everyone we see at our clinics. This is just one way for us to learn about your needs. Data for the analysis includes results from 7482 patients across 13 teaching clinics that completed the first survey. Keep sharing your ideas with us! If you have never been asked to complete one of the surveys, please make sure we have your email address on file. Your turn will come!

CareCanvas

Click here to learn more.

To complement our work on patient experience survey measurement, we advanced a broader culture of data-driven improvement through the launch of CareCanvas in 2022— an interactive online dashboard that provides at-a-glance electronic medical record (EMR) information to support patient care. The design of this first dashboard was a collaborative process, guided by Audit & Feedback theory and user-centred design principles. In April 2023, CareCanvas+, the clinic-level dashboard, was rolled out to all DFCM teaching sites, marking a first in Ontario by integrating EMR data, ICES administrative data, and patient experience surveys.

In parallel, development of an Ontario Health Team–level dashboard is ongoing to help identify population-level gaps in care. While these advances were made possible through grant funding and represent an exciting step forward, further CareCanvas development was paused due to unforeseen circumstances related to UTOPIAN, which provides EMR data for CareCanvas.

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OurCare Led by Dr. Tara Kiran, OurCare is a national initiative that engaged nearly 10,000 people between 2022-2023 in conversations about the future of primary care. The initiative culminated in the creation of the OurCare Standard, a set of six aspirational elements that articulate what every person in Canada should expect from primary care. The OurCare Standard is now the basis for Ontario’s new Primary Care Act—a first-of-its-kind legislation in Canada.

While not solely a DFCM initiative, OurCare reflects the department’s commitment to patient engagement and system-level improvement, and through the DFCM’s Office of Health System Partnerships, it is being used to engage with Ontario as part of ongoing efforts to shape the future of primary care.

Continuing Professional Development (CPD) The COVID-19 pandemic required rapid adaptation to evolving guidelines, uncertainty, and new ways of working. During this period, significant progress was made in strengthening physician support and capacity across our family medicine network.

COVID-19 COMMUNITY OF PRACTICE HITS MILESTONE SESSION AS IT HELPS PRIMARY CARE CLINICIANS NAVIGATE THE PANDEMIC

COVID-19 Community of Practice (CoP)/ Changing the Way We Work

and beyond the COVID-19 pandemic. The first tool, launched in July 2020, focused on diabetes care and was nationally disseminated through Canadian Family Physician. SubseIn April 2020, we launched the COVID-19 Community of quent tools addressed virtual visit integration, alcohol use Practice (CoP) with the Ontario College of Family Physicians disorder, and youth mental health—areas significantly im(OCFP). These bi-weekly virtual sessions quickly became a pacted by the pandemic. central forum for family physicians across Ontario to share expertise, innovations, and resources with up to 1,300 at- In spring 2021, the Department collaborated with the Ontendees per session. Now called the Changing the Way We tario College of Family Physicians (OCFP) to develop a free Work Community of Practice, the series remains active five e-learning series to support the COVID-19 vaccine rollout years later, consistently drawing more than 500 attendees, in Canada. The modules were designed to build knowledge and will soon celebrate its 100th session, reflecting its sus- and capability among family physicians and primary care tained relevance and engagement. professionals, serving as both a learning tool and an ongoing reference resource. Each module included interactive The program’s impact was recognized nationally with the 2023 features, references, practical tools, reflective questions, CFPC Continuing Professional Development Program Award. and short videos from the COVID-19 Community of Practice In the 2024–2025 year alone, 8,504 participants attended 15 for Family Physicians. Close to 5,000 family physicians and sessions, averaging 567 attendees per session, with the high- primary care professionals registered for the series, and est-attended session reaching 663 participants. Evaluation over 470 evaluations highlighted its effectiveness in increasresults demonstrate exceptional value: 98% of attendees re- ing participant confidence. ported that they value the overall experience, and 95% indicated that the content is relevant and applicable to their practice. Peers for Joy in Work

Virtual Tools

Recognizing the impact of the pandemic on physician wellness, we launched the Peers for Joy in Work program in the In May 2020, we partnered with the Centre for Effective fall of 2023, training 32 Peer Guides to support colleagues in Practice (CEP) to develop practical tools supporting a vir- addressing burnout and rediscovering joy in practice. Evalutual-first approach to chronic disease management during ation of the inaugural cohort showed that both Peer Learners Quality and Innovation

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and Peer Guides reported an increased likelihood of recommending family medicine as a career. Peer Learners also experienced greater validation, motivation, and joy at work, along with new strategies for managing work-life balance, while Peer Guides developed coaching skills they could apply to support colleagues in their own practice environments. The program is in the process of being transitioned to the Ontario Medical Association (OMA) for continuation at scale.

pital has developed a team-based pathway to attach new patients to the Family Health Team, prioritizing those who identify as Black, Indigenous, living in precarious housing, or experiencing poverty.

Many sites also emphasize amplifying the patient voice. At Sunnybrook Family Health Team, the team has identified that despite the inclusion of a patient-engagement module in the quality improvement curriculum for residents, patient perspectives were still absent from resident-led projects.

In response, they have implemented a change idea where all resident quality improvement projects would require the participation of a patient partner. This included an evaluative component where both residents and patient partners were able to provide feedback on their experience to ensure meaningful engagement moving forward.

“Joyful experience! It was a well organized program where our well-being was addressed by our own peers through the creation is further driven by optimizing team-based modof a cheerful environment, Innovation els, workflow redesigns, and emerging technologies. Several sites—including Scarborough Family Medicine Teaching mindfulness and fitful Unit, Women’s College Academic Family Health Team, and North York Family Health Team—have piloted an AI solution schedule.”

Dr. Erum Raheel, Family Physician, Scarborough (Peer Guide)

First Five Years Community of Practice

aimed at reducing after-hours charting and administrative burden. The trial has helped identify implementation barriers and engaged a subset of preceptors in testing the tool.

More recently, with the leadership from our CPD Program Director and the Office of Health System Partnership (OSHP), we introduced the First Five Years Community of Practice, which now supports more than 400 early-career physicians through clinical development, systems learning, and peer connection.

“I appreciate the ongoing support/community with the University of Toronto even after graduating. There are so many logistical questions that come up after residency - having the built-in sessions makes it a lot easier to have formal (and more importantly, informal) conversations about what others’ experiences are like in practice and normalizing my own experiences,” says one First Five Years CoP participant.

Quality Improvement Leadership Across Academic Sites Quality improvement is a unifying focus across all 18 academic family medicine sites, underscoring a shared commitment to equitable, patient-centred care. Sites advance initiatives to improve access and outcomes in areas such as diabetes management, smoking cessation, incident reporting, and antimicrobial stewardship. Equity-focused projects address gaps in cancer screening and care for marginalized populations. For example, the team at St. Michael’s Hos112

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“I appreciate the ongoing support/community with the University of Toronto even after graduating.

There are so many logistical questions that come up after residency - having the builtin sessions makes it a lot easier to have formal (and more importantly, informal) conversations about what others’ experiences are like in practice and normalizing my own experiences.”

First Five Years CoP participant

Challenges NAVIGATING RESOURCE VARIABILITY ACROSS ACADEMIC SITES One of the most persistent barriers has been the variation in resources available to support Q&I work at local DFCM sites. Academic sites differ in the amount of protected time faculty have for improvement initiatives, with clinical demands often leaving limited capacity to step back and focus on improving care delivery. This imbalance has required us to think strategically about how to build Q&I capacity while recognizing the realities of frontline practice.

the cessation of data flows from UTOPIAN, the database of records from which CareCanvas built its physician and clinic-facing dashboards. While this delay has slowed progress, it has also underscored the need for stronger alignment between data infrastructure and Q&I priorities to ensure longterm sustainability.

SECURING LONG-TERM FUNDING AND SUPPORTING ENGAGEMENT Finally, securing ongoing funding remains a critical issue as we approach the 10-year renewal of our Fidani Chair support. Continued investment is essential not only for maintaining our Q&I initiatives but also for sustaining patient engagement efforts, which have become a cornerstone of our approach. Strengthening and expanding this work will require careful planning to ensure that both faculty and patient partners have the support they need to remain meaningfully engaged. Our department leaders are actively partnering with the Temerty Faculty of Medicine Advancement team to seek out donor support that might allow permanent endowment of this critical work.

RESPONDING TO THE COVID-19 PANDEMIC WITH FLEXIBILITY The COVID-19 pandemic further tested our ability to advance Q&I. While our program had focused on using data to improve clinical quality of care indicators pre-pandemic, we recognized this was not a realistic focus even a few years into the pandemic due to physician burnout and overwhelm. In response, we pivoted to initiatives like the Peers for Joy in Work program, which addressed wellness directly and reinforced our commitment to supporting physicians in ways that met their most urgent needs. This experience highlighted the importance of flexibility and responsiveness Together, these challenges have prompted us to adapt, inin our programming. novate, and advocate for the resources necessary to sustain Q&I and patient engagement across the department.

CHALLENGES IN SUSTAINING CARECANVAS They also serve as reminders that building a culture of conAnother major challenge has been sustaining CareCanvas. tinuous improvement requires persistence, collaboration, Following an exciting launch in 2022, the project was put and flexibility in the face of uncertainty. on hold due to unforeseen circumstances that resulted in

PHYSICIANS HELPING PHYSICIANS:

KICKSTARTING THE PEERS FOR JOY IN WORK PROGRAM

Quality and Innovation

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Looking Ahead Looking ahead, DFCM will deepen its commitment to evidence-informed practice and the advancement of equitable health outcomes for all. A central priority will be securing sustainable funding to support the Q&I Program and its longterm impact. In the last year, the program has also been pivoting from supporting practices to improve clinical quality of care for existing patients to supporting practices to optimize access and efficiency with the goal of ultimately being able to serve more patients. Optimizing practice teams to serve more patients and the public is critical in the context of over 2.5 million people in Ontario lacking access to primary care. We foresee opportunities to advance work in this area in collaboration with the Office of Health System Partnerships (OSHP) and Ontario’s Primary Care Action Team.

National Partners f The College of Family Physicians of Canada (CFPC) f Healthcare Excellence Canada (HEC) f Research team from Université de Sherbrooke f The Association of Faculties of Medicine of Canada (AFMC) Patient Partner Network f Other Departments of Family Medicine

International Partners

f University of California Department of Family Medicine’s Center for Primary Care Excellence in San Francisco, USA f School of Public Health at Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana Through sustained partnerships and the integration of Q&I f Aga Khan University campus in Nairobi, Kenya principles across education, research, and professional development, the department is well-positioned to champion Deliberate effort has been made to establish and sustain safety, equity, and excellence—not only within the Univer- international partnerships, recognizing that learning from sity of Toronto, but also as a national and global leader in global best practices, exchanging knowledge, and collaborprimary care. ating across diverse health systems strengthens our capacity to innovate, improve patient care, and advance equitable outcomes in primary care.

Partners

Patient Partners

Bridging gaps, building meaningful connections, and sharing expertise with the goal of improving quality are central to the work of the Q&I program. We, of course, work closely with other programs within the DFCM and collaborate with partners across the Temerty Faculty of Medicine to align efforts and amplify impact.

f Family Medicine Patient Advisory Committee & Patient Partner Pool

Provincial Partners

These partnerships have been instrumental in advancing the Q&I Program’s objectives. Through each relationship, our Program contributes expertise, co-creates meaningful initiatives, and leverages partner resources and perspectives to drive quality and innovation in family medicine over the past five years.

Our Program actively involves patients and family members through the Patient Advisory Committee and a pool of patient partners. These individuals provide vital insights, co-design initiatives, and participate in evaluating programs, ensuring We also continue to collaborate with numerous stakehold- that patient voices shape priorities and solutions for service ers, such as: improvement.

f The Centre for Effective Practice (CEP) f Ontario Health (OH) f Ontario College of Family Physicians (OCFP) f The Primary Care Ontario Practice-based Learning and Research (POPLAR) Network f The Centre for Quality Improvement and Patient Safety (CQuIPs) 114

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RELATIONSHIPS, PARTNERSHIPS, SOCIAL ACCOUNTABILITY Relationships, Partnerships, Social Accountability

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INTRODUCTION As part of the Department of Family and Community Medicine’s (DFCM) 2022–2027 Strategic Plan, a new leadership role was introduced: the Vice-Chair of Community and Partnerships. This role was created to deepen our commitment to social accountability and to foster meaningful, equity-focused collaborations across the health and social service sectors.

Dr. Melanie Henry was appointed to this position in 2023.

The Vice-Chair of Community and Partnerships functions as a key member of the DFCM leadership team, actively contributing to strategic initiatives and working collaboratively across portfolios. Central to this role is the advancement of equity as a core departmental priority, the cultivation of interdisciplinary and inclusive culture, and the strengthening of DFCM’s global reputation and local social accountability efforts.

Black Health Advisory Table. Her responsibilities are closely aligned with the strategic plan’s commitments, including: f Expanding community-based learning opportunities for medical learners f Embedding equity and advocacy into the curriculum f Building internal and external partnerships to support communities f Enhancing DFCM’s presence across the University of Toronto and affiliated institutions f Supporting initiatives such as the Summer Mentorship Program and the Patient and Family Advisory Council (PFAC) f Collaborating with the Office of Health System Partnership (OHSP) and the ILC to improve access and attachment for underserved populations

The following pages highlight key work and partnerships In leading Community and Partnerships initiatives, the Vice- that have been fostered through the addition of this role and Chair builds bridges across university departments and reflect the strong value DFCM places on these collaboradivisions, works closely with the Indigenous Leadership tions as central to our mission and impact.

Circle (ILC), and has played a key role in establishing the

INTERNAL INITIATIVES DFCM programs work collaboratively across all portfolios, fostering a culture of integration and shared purpose. This collaboration extends beyond departmental boundaries to include strong partnerships with the Temerty Faculty of Medicine, ensuring alignment with broader institutional priorities and leveraging resources for innovation and impact.

With the DFCM’s strategic vision to facilitate academic engagement, several structures have been established. The following highlights some key initiatives that support partnership and collaboration with: patients and families, Indigenous leaders, Black communities, and system policy makers.

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DFCM PATIENT ENGAGEMENT As mentioned in the Q&I section, in 2021 the DFCM hired its first Patient Engagement Specialist, marking a significant milestone in our commitment to embedding patient voices.

From the outset, our approach has been guided by a department-wide needs assessment, which shaped the strategic direction of patient engagement for the first three years.

Patient engagement collaboration has extended to beyond the department to Temerty Faculty of Medicine’s extra departmental unit Centre for Advancing Collaborative Healthcare and Education (CACHE), and beyond the University to national networks.

Highlights This year, we are celebrating the third anniversary of our Patient and Family Advisory Committee (PFAC), a first-of-itskind initiative at a department of family medicine. The PFAC was launched in 2022 and includes 16 members, representing almost all of our academic teaching clinics. With the creation of the PFAC it was determined that there were many more patient partners who wanted to work with the department, thus a much larger patient partner pool, currently 244 individuals strong, was formed. In addition to the PFAC, approximately 65 individuals from the pool are actively engaged in initiatives around the department.

by helping determine which stories to highlight, and to build community, they launched a patient partner newsletter, now led by our patient partners, which reaches 344 subscribers with an impressive 88 per cent open rate.

Patient partners have also contributed to DFCM’s scholarly efforts. Between 2021 and 2025, they: f co-authored five conference posters f co-led four workshops f supported the submission of a peer-reviewed manuscript.

Their work has been presented at f International Congress on Academic Medicine (ICAM) f Family Medicine Forum (FMF) f Centre for Quality Improvement and Patient Safety (CQuIPS) f North American Primary Care Research Group (NAPCRG) f DFCM Conference (2022, 2024, 2025) f National forums such as the National Health Engagement Network and the Patient Engagement in Medical Education Network.

View the Patient Engagement summary (2022-2025) by the numbers.

PATIENT VOICES IN ACTION Beyond the PFAC, patient partners from the broader pool have participated in a wide range of departmental activities, including the Digital Health Committee, the Starfield Summit, UPLEARN, the Physician Assistant Program, and resident quality improvement projects. Their involvement extends to leadership, where they have served on five selection committees and have attended four Executive Committee retreats to ensure patient voices are present. Patient partners have also shaped the DFCM Family Medicine Report PFAC members presenting at the DFCM Conference Relationships, Partnerships, Social Accountability | Internal Intiatives

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PARTNERSHIP WITH THE HEALTH PROFESSIONAL EDUCATION NETWORK DFCM is an active member in the newly formed Patient Engagement in Health Professional Education Network, a national community of practice soon to be affiliated with Association of Faculties of Medicine of Canada. We are one of the few groups in Canada advancing patient engagement in postgraduate medical education. Our tools and resources are being shared nationally, and we are contributing to a collaborative toolkit on patient engagement in medical education.

the University of Maastricht (Netherlands) to co-develop an international toolkit on patient engagement in medical education. This resource will include practical guidance on recruitment, diversity, and evaluation.

CONSULTATIONS AND RESOURCES To support faculty, learners, and staff, the Patient Engagement Specialist has provided 154 individual consultations since 2021. These consultations have addressed common topics such as recruitment, compensation, orientation, readiness, and evaluation, informing 44 new patient engagement In November 2025, DFCM patient partners will attend the Pa- initiatives across education, research, quality improvement, tient Voices Conference in Vancouver, which brings together and global health. leaders, faculty, and patients from across the country. DFCM will participate in three formats: Resource development has been another core focus for 1. Lead a workshop on patient engagement in medical the patient engagement program. These resources include education more than 12 tailored resources created to support both fac2. Contribute to a presentation on patient partner ulty and patient partners including: compensation practices in collaboration with the f Patient Engagement Toolbox Temerty Faculty of Medicine’s Centre for Advancing f Compensation framework Collaborative Healthcare and Education f Onboarding and orientation materials 3. Co-present a poster on the patient engagement process f Recruitment templates in the formation of social accountability competencies f Clinical resources for patients f Faculty-focused resources Through this network, our patient partners are also collab- f Patient-facing resources orating with colleagues at the University of Leeds (UK) and

From the Patient Engagement Toolbox 118

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Challenges and Lessons Learned While DFCM’s patient engagement program has achieved different experiences and backgrounds are offering flexible significant growth, several challenges have emerged along- meeting times, consulting patient partners about their availside valuable lessons. ability when planning events, providing accommodations, and implementing inclusive onboarding practices.

FACULTY AND PATIENT SUPPORT Many faculty members are interested in engaging patients EXPANDING REPRESENTATION AND ENGAGEMENT but require time, tools, and constant support to move from Although our patient partner pool is diverse, there are still intention to meaningful practice. Faculty readiness takes voices we need to capture, and many individuals remain time and benefits from structured supports such as intake missing from the table. Expanding our outreach and engageforms, compensation frameworks, guidelines, ongoing ment efforts is essential to ensure these voices are heard communication, and availability for consultation. Patient and valued. partners, many of whom are new to engagement in medical education and university settings, also have much to learn Over 250 individuals have applied to join the patient partner and require continued support. Having a dedicated Patient pool, demonstrating significant interest. Keeping the broader Engagement Specialist is critical to building trust, ensuring patient partner pool actively involved requires planning and continuity, and supporting both patient partners and faculty. available opportunities. Many patient partners in the DFCM pool remain less engaged with a desire to participate, due to limited COMPENSATION AND RECOGNITION available opportunities. Actively engaged patient partners have Despite having a compensation framework that is strongly consistently emphasized that clear roles and expectations are encouraged, institutional payment processes are not al- essential for meaningful engagement, a message that has been ways flexible for patient partners, especially for individuals echoed throughout patient partner evaluations. receiving disability benefits, which unintentionally limits diversity. We have found that it’s important to identify al- MAINTAINING FUNDING FOR PATIENT AND FAMILY ternative forms of recognition, such as awards or providing ENGAGEMENT SPECIALIST food at events. Engaging underrepresented communities, A key challenge moving forward is securing sustainable such as individuals whose English is their second language funding for patient engagement, including the Patient and or those from low-income backgrounds, requires tailored Family Engagement Specialist role and patient partner comoutreach methods, relationship-building over time, and in- pensation. We are actively working with Advancement to clusive practices. Some of the things that have helped us explore grant opportunities, cost-recovery models, and with high participation rates and hearing from patients with other strategies to ensure long-term support.

Looking Ahead Looking ahead, we hope to involve patient partners in more initiatives and to further expand their engagement within family medicine education. Patient partners bring more than just lived experience; their professional skills have greatly enhanced communications, education, evaluation, and project design across the department. To ensure long-term engagement and continuity, we are developing alumni pathways for PFAC members after their terms end.

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Our commitment also includes continuing to co-develop tools and resources in collaboration with national networks to advance patient engagement in medical education more broadly.

By partnering with other organizations, we aim to share best practices, standardize approaches, and foster innovation that benefits the broader healthcare education community.

Furthermore, we will consistently utilize post-initiative evaluations and feedback surveys to assess the effectiveness of our engagement strategies.

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INDIGENOUS LEADERSHIP CIRCLE (ILC) Introduction The Indigenous Leadership Circle (ILC) exists within the institutional contexts of the Department of Family and Community Medicine (DFCM), the Temerty Faculty of Medicine, and the University of Toronto. These institutions are located on lands that have been home to Indigenous peoples for millennia and are subject to national and international law regarding the rights of First Nations, Inuit, and Metis (FNIM) peoples, including but not limited to treaties.

Access to culturally safe primary care is a critical need for the more than 100,000 FNIM peoples living in Toronto and surrounding communities serviced by DFCM. As we draft this statement in 2025, we acknowledge the greater than 100,000 FNIM peoples living in the City of Toronto, one out of three of whom do not have a regular primary care provider.

This situation is in tension with the Constitution of the World Health Organization, which states that: “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition” (The Right to Health, 2008).

DFCM, Temerty Medicine, and U of T have committed to advancing reconciliation and addressing anti-Indigenous racism in all that they do. They also have committed to an equity-oriented and socially accountable mission. These principles ought to inform all DFCM systems and operations across the core DFCM work of program accreditation, upholding duties to learners, advancing research and quality improvement excellence, and advancing the departmental strategic objectives.

PURPOSE f Advance the social accountability of DFCM to First Nations, Inuit, Métis, and other Indigenous peoples and populations. f Increase the tangible social value of DFCM activities for these communities. f Align DFCM policies and activities with the principles of domestic law (Canadian Charter of Rights and Freedoms, 1982), international law (United Nations Declaration on the Rights of Indigenous Peoples, 2007), and Indigenous reconciliation policies and recommendations (Truth and Reconciliation Commission of Canada, 2015; National Inquiry into Missing and Murdered Indigenous Women and Girls, 2019).

AIMS f Align the number of Indigenous faculty and learners with the size and needs of Indigenous populations. f Address gaps in effective and culturally safe Indigenous primary care training opportunities, including patientand population-focused evaluation of these programs. f Allocate departmental resources more effectively to meet the unmet needs of First Nations, Inuit, and Métis populations.

SCOPE All decision-making and activities regarding and/or involving Indigenous peoples across the DFCM, unless otherwise delegated.

SUPPORTED BY f Dedicated Indigenous Coordinator (under consideration in light of the new funding from the Indigenous Health Currently, DFCM aspirations towards systemically equitable Chair) and culturally safe systems are not yet matched with exist- f Community Council (in development) ing systems. The ILC is working to help ensure these gaps f DFCM Executive (see governance and leadership diagram) are addressed.

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WAYS OF WORKING f Rotate chairing responsibilities for meetings. f Strive for consensus in decision-making, drawing on traditional Indigenous approaches to conflict resolution.

If consensus cannot be reached, engage mutually trusted voices from outside the ILC to mediate further discussions. f Ensure every member has the opportunity to share their views and perspectives, recognizing that everyone “holds a piece of the puzzle.” f Prioritize Indigenous voices and perspectives in all discussions and decisions.

Highlights CULTURAL SAFETY TRAINING FOR ALL RESIDENTS All family medicine residents are now required to complete San’yas Indigenous Cultural Safety modules during PGY1.

CURRICULUM DEVELOPMENT Collaboration with DFCM sites and leads on work relating to Indigenous communities, including: f Supporting expansion to Barrie and Orillia sites f Developing new curriculum, which includes Indigenous health f Reviewing Indigenous health content within Planetary Health e-modules f Collaborating with faculty on lectures related to Indigenous health STRATEGIC PLANNING AND RECONCILIATION Participated actively in the DFCM strategic planning process to ensure a focus on reconciliation and addressing anti-Indigenous racism throughout the department, emphasizing support for the self-determination of Indigenous health leaders and communities.

COMPOSITION OF THE ILC The ILC includes Indigenous and allied leaders from across the department: f Dr. Suzanne Shoush – Indigenous Health Lead f Dr. Janet Smylie – Indigenous Health Research Lead f Dr. Sarah Park – Indigenous Health Education Lead f Dr. Joel Voth – Indigenous Health Clinician ALLY ROLES WITHIN THE ILC f Dr. Katherine Rouleau — Director, WHO Collaborating Centre on Family Medicine and Primary Care f Dr. Danielle Martin – DFCM Chair

DATA COLLECTION AND IDENTITY VERIFICATION Guiding processes for collecting data on Indigenous learners and staff, including developing a protocol for verifying identity statements.

DEVELOPMENT OF AN INDIGENOUS HEALTH ELECTIVE Creating a clinical elective to enhance medical learner engagement with Indigenous communities in Toronto and Scarborough through Inner City Health Associates (ICHA) Indigenous clinics. The elective aims to foster learner development, build skills for working with Indigenous patients effectively, and improve access to high-quality care.

References: Canadian Charter of Rights and Freedoms, s 7, Part 1 of the Constitution Act, 1982, being Schedule B to the Canada Act 1982 (UK), 1982, c 11.

National Inquiry into Missing and Murdered Indigenous Women and Girls. (2019). Reclaiming power and place. The final report of the national inquiry into missing and murdered indigenous women and girls. The National Inquiry. https://www.mmiwg-ffada.ca/wp-content/uploads/2019/06/Final_Report_Vol_1a-1.pdf The Right to Health, Fact Sheet No. 31, (2008). Office of the United Nations High Commissioner for Human Rights. World Health Organization, Geneva, Switzerland. https://www.ohchr.org/sites/default/files/Documents/Publications/Factsheet31.pdf.

Truth and Reconciliation Commission of Canada, “Truth and Reconciliation Commission of Canada: Calls to Action,” (2012). https://exhibits.library. utoronto.ca/items/show/2420.

United Nations (General Assembly). (2007). Declaration on the Rights of Indigenous People.

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COLLABORATION AND ADVOCACY Liaise with learners and colleagues across DFCM, Temerty, and beyond (such at Royal College Indigenous Health leads) to advance equitable, safe healthcare for Indigenous peoples.

CREATION OF THE ENDOWED CHAIR IN INDIGENOUS HEALTH A $5 million gift will establish a permanent Chair tied to the Indigenous Health Lead role, strengthening the ILC’s leadership and sustainability. The ILC is currently working on plans to operationalize the gift, name the Chair, and establish priorities and the necessary staff supports.

OPENING OF THE INDIGENOUS HEALTH SPACE AND UNVEILING OF INDIGENOUS MURALS The new Indigenous Health Space is intended to be a welcoming, safe space for learners and staff to gather for quiet study time, to share ideas and meet, form mentorship connections, and nurture relationships. Artist Shawn Howe was commissioned to paint beautiful murals in the space and within the DFCM office. All furnishings and carpets will be sourced from Indigenous creators/companies.

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EQUITY GRAND ROUNDS ILC members led a session on anti-Indigenous racism in healthcare, sharing strategies for cultural safety and systemic change LEADERSHIP SPOTLIGHT: DR. SUZANNE SHOUSH As Indigenous Health Faculty Lead and a recurring beneficiary of the Equity in Primary Care Fund, Dr. Shoush has advanced opportunities for Indigenous learners and improved health-care outcomes for Indigenous communities. Her initiatives include: f Mentorship: Supporting Indigenous women entering family medicine and guiding them throughout their careers. f Academic Excellence: Completing a master’s degree in mathematical modelling at the Institute for Health Policy, Management, and Evaluation, focusing on disease and intervention spread. f Community Partnerships: Collaborating with Indigenous leaders in Orillia and Midland to integrate local health learning opportunities. f Curriculum Innovation: Developing an Indigenous health elective for family doctors in Toronto community clinics to enhance culturally safe care.

Department of Family & Community Medicine, University of Toronto

Challenges The ILC faces time and capacity constraints as members balance leadership roles, clinical work, and academic responsibilities. Coordinating initiatives and advancing new projects across a large department requires significant effort, and considering this work can be emotionally demanding, this must be also be considered when planning and supporting these efforts.

Looking Ahead The Indigenous Health Enhanced Skills Program is currently in development. Envisioned as a one-year elective, the program aims to deepen family medicine residents’ expertise in working with and advocating for Indigenous communities. Initial steps include engaging with preceptors, clinics, and communities that are well-positioned to teach and host learners.

Work is underway to establish robust evaluation tools and metrics for assessing competency in Indigenous Health. Drafting of core competencies has begun to ensure that graduating students meet the expectations required for effective and respectful practice in Indigenous communities.

The Indigenous health space is nearing completion, with efforts focused on finalizing furnishings to create a welcoming and culturally safe environment.

Planning is in progress for the establishment of a Chair in Indigenous Health, including discussions around the allocation of funds and potential administrative support to sustain the role and its initiatives.

DFCM OPENS NEW INDIGENOUS HEALTH SPACE AND ANNOUNCES NEW CHAIR IN INDIGENOUS HEALTH

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BLACK HEALTH ADVISORY TABLE Introduction

Composition

The Black Health Advisory Table (BHAT) was established in The Table consists of 48 members in total, including 2023, in alignment with the DFCM 2022–2027 Strategic Plan, residents, DFCM faculty, clinical staff, allied health profesunder the Community priority. sionals, and administrative staff. It is led by: f Co-Chairs Dr. Melanie Henry (Vice-Chair, Community Its purpose is to advance health in Black communities and and Partnerships) and Dr. Onye Nnorom (Black Health advise the Department on ways to support Black faculty and Faculty Lead). learners. Specifically, the BHAT works with the Black Health f Executive members Faculty Lead (BHFL) and the Vice-Chair of Communities and Z Dr. Oare Samuel Alufohai (Faculty) Partnership (VCCP) on matters regarding: Z Sador Bereketab (Medical student) f Black data governance Z Dr. Evonemo Esievoadje (Resident) f Black patient care Z Dr. Aisha Lofters (Faculty) f Black community partnerships Z Chantal Sorhaindo (Faculty) f Black faculty, staff and medical learner recruitment, Z Nkechi Ikeaba (Resident) engagement and career trajectory.

Z Nifemi Adeoye (Medical student) f Creating community along with learning and sharing experiences

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Highlights ORGANIZATIONAL STRENGTHENING The Table convenes four times annually, reflecting its commitment to shared leadership, accountability, and community engagement. Since its inception, BHAT has built a strong network of Black faculty, residents, learners, and staff, and has hosted regular meetings and events to foster community, mentorship, and strategic planning.

Early work focused on identifying broad priority areas, including Black data governance, mentorships, community partnerships, equitable patient care and access, education and representation, and visibility in hiring and leadership.

Since the establishment of the BHFL role in 2024, the BHAT has strengthened its internal organization by establishing an Executive Table and securing administrative support from DFCM staff.

MENTORSHIP AND SPECIAL EVENTS BHAT advanced the mentorship pipeline by engaging with the Black Physicians’ Association of Ontario’s Network for the Advancement of Black Learners. The Table also expanded its role in research and system design, partnering with faculty leaders to build Black health research capacity, convening a provincial meeting of Black academic leaders to explore collaboration, presenting at international and national conferences, and exploring innovative projects such as the Afrocentric Seniors program.

ronto who are curious about Black health, but also seeking some support and clinical mentorship.

At the provincial level, BHAT has engaged with several Black health organizations with a provincial or national mandate to address Black health. In May 2025, the Co-Chairs convened and participated in a provincial meeting of Black family medicine faculty, where consensus was reached on the importance of a unified network to support Black primary care physicians and learners. Engagement with organizations such as the Black Health Equity Lab, Ontario’s Black Health Plan Tri-Council leadership, Black Health Alliance, Black Physicians’ Association of Ontario, and the Black Health Education Collaborative reinforced the need for collaboration to ensure sustainability, mentorship capacity, and meaningful community-based research.

See BHAT’S one-year report from March 2025.

Challenges:

A key challenge was securing stable administrative and project coordination support. Recent improvements in administrative assistance have enabled BHAT to function more effectively, and of course long-term sustainability requires dedicated resources. Black health research, particularly in In addition, BHAT hosted some special events throughout primary care or through data governance, are opportunities the year, including a session featuring Dr. Notisha Massa- but require project coordination. quoi as a keynote speaker on Black health research, and a collaborative planning event with the Black Physicians’ Association of Ontario at their annual Black health symposium.

BHAT COLLABORATING PARTNERSHIPS The BHAT has actively engaged with partners across the department, university, and province. Notably, Dr. Notisha Massaquoi was invited to a special meeting to discuss Black health research. Dr. Massaquoi gave an inspiring keynote about her Black Health Equity Lab, which includes the phenomenal work that is being done to transform the quality of care and accessibility of safe care to Black folks with HIV. The BHAT Co-Chairs have also met with the Black Medical Students’ Association (BMSA) to explore the development of a Black stream within the Family Medicine Longitudinal Experience (FMLE) program. This option, explored by BHAT and the MD Program, addresses the needs of the growing number of Black medical students at the University of ToRelationships, Partnerships, Social Accountability | Internal Intiatives

Future Goals:

The BHAT aims to consolidate its leadership model and strengthen sustainability.

In the short term (2025-2026), priorities include redistributing responsibilities among the executive team and pursuing external funding opportunities through collaborations with academic and community partners.

In the long term (2026-2030), the BHAT seeks to secure funding for Black health leadership roles, expand research and mentorship capacity, and increase the recruitment, retention, and success of Black learners and faculty. Ultimately, the BHAT leadership is focused on ensuring long-term impact over the next five years and well into the future.

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OFFICE OF HEALTH SYSTEM PARTNERSHIPS (OHSP) Introduction The Office of Health System Partnerships (OHSP) is a solu- Together, we are working toward a clear goal: tions workshop within the DFCM. f Every person is attached to a responsive and highquality, publicly funded primary care team Established in 2023, OHSP brings people together to solve f Every primary care team is designed in partnership with complex problems, drawing on the collective expertise of its community.

2,000+ academic family physicians, researchers, health system leaders, clinicians, learners, patients, and community As a solutions workshop, we believe that by catalyzing partners to find bold, pragmatic solutions to strengthen pri- practical, data-driven thought leadership, we can shift how mary care and improve the health of our communities. healthcare systems work and how clinicians practice to improve the health of our communities.

Our work aligns with the following components of the DFCM strategic plan:

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C1.2

Improve access and attachment for communities most in need of care by collaborating with partner organizations.

R.2.3

Through the work of the OHSP and beyond, strengthen supports for graduates in their first five years of practice by offering extended mentorship, as well as additional CPD in order to provide early career guidance that meets a variety of needs

R.2.3

Through the work of the OHSP and beyond, strengthen supports for graduates in their first five years of practice by offering extended mentorship, as well as additional CPD in order to provide early career guidance that meets a variety of needs

L.2.1

Develop and sustain the Office of Health System Partnerships (OHSP) to focus on a) Covid recovery

L.2.1

Develop and sustain the Office of Health System Partnership (OHSP) to focus on b) Attachment to primary care

L.2.1

Develop and sustain the Office of Health System Partnership (OHSP) to focus on c) Health Human Resource Planning

L.2.1

Develop and sustain the Office of Health System Partnership (OHSP) to focus on d) Primary Care Engagement

L.2.3

Strengthen inter-professionalism and enable progress towards purposeful integrated and effective teambased care including exploring partnerships for developing new roles for unregulated primary care workers such as scribes, community health workers, peer support workers and others to grow a fit for-purpose primary care workforce.

L.2.5

Establish the role of Global Lead within the OHSP reporting directly to the chair to foster and oversee the development, integration and dissemination of primary healthcare-related innovations, and play a lead convening role to set an agenda with global thought leaders.

Department of Family & Community Medicine, University of Toronto

Our areas of focus include initiatives that are relevant at the local, provincial, national and international levels, aimed at: f Supporting healthy public policy through evidence synthesis, research and evaluation f Engaging with patients and communities as well as the workforce that supports them f Addressing care gaps and inequities for priority populations f Supporting health human resources planning and new approaches to education of the future workforce f Innovating in care delivery including through digital health and team-based care

FACULTY LEADS f Dr. Ryan Banach. Family Medicine Early Career Supports Lead f Dr. Ali N. Damji, Primary Care Collaborative Partnership Lead f Dr. Rajesh Girdhari, Digital Health Lead f Dr. Katherine Rouleau, Global Primary Healthcare Lead f Jennifer Shuldiner, PhD, Evaluation Faculty Lead f Dr. Jack Westfall, Senior Advisor, Health System Leadership f Dr. Karen Weyman, Education Lead f Dr. Catherine Yu, Engagement Lead

Read the OHSP Temerty Fund Narrative Report.

SUPPORT TEAM f Sydney Pearce, PhD, OHSP Post-Doctoral Fellow f Khalida Nasir, Research Officer f Shantel Walcott, Program Manager

The OHSP Team LEADERSHIP f Dr. Danielle Martin, Chair, DFCM f Dr. Tara Kiran Vice-Chair, Quality and Innovation; Fidani Chair in Improvement and Innovation, DFCM f Dr. Noah Ivers, OHSP Scientific Lead, Associate Professor, DFCM

OHSP’S RELATIONSHIPS f Ontario Health Toronto Region (OH-TR) f Ontario Health (specifically the Primary Care Action Table) f Canadian Medical Association (Healthcare Unburdened Grant program) f Ontario College of Family Physicians

Highlights LOCAL INITIATIVES

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HEALTH SYSTEM LEADERSHIP AND ENGAGING PRIMARY CARE PROVIDERS IN TORONTO (LEADS: DR. DANIELLE MARTIN AND DR. CATHERINE YU) The OHSP plays an increasingly prominent role in health system leadership and family physician engagement to support primary care planning, improved access and attachment to comprehensive primary care and other local priorities for improving care delivery. As the regional primary care lead for Toronto, the OHSP is instrumental in shaping the city’s annual primary care workplan, providing strategic direction, and ensuring that priorities reflect the evolving needs of our community.

The OHSP also supports enhanced preparedness for Toronto’s respiratory illness season by strengthening the integration of the primary care and public health sector needs in strategic planning, vaccine program coordination, and community engagement.

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2025 PRIMARY CARE CENSUS (LEADS: DR. CATHERINE YU, DR. NOAH IVERS) This year, the OHSP led the first primary care census of family doctors/nurse practitioners in the City of Toronto to better understand the current physician supply and support local human resource and capacity planning in the city.

Launched in February 2024, the initiative received 1,000+ responses by March 31, 2025, with a governance advisory table established to guide ongoing regional database maintenance. The results of the survey will support primary care planning relevant to provider supply, practice characteristics, and recruitment factors to inform Ontario Health Team (OHT) development and regional clinician engagement.

Lessons from this initiative will also guide future primary care censuses and health human resource planning, with preliminary results already shared with provincial leaders at Ontario Health to support broader planning efforts.

SUPPORTING NEW FAMILY PHYSICIANS (LEADS: DR. RYAN BANACH, DR. ALI DAMJI, IN PARTNERSHIP WITH CONTINUING PROFESSIONAL DEVELOPMENT IN THE QUALITY AND INNOVATION PORTFOLIO) Mentorship improves retention in family medicine by fostering professional development, enhancing job satisfaction, mitigating burnout, and building strong collegial relationships. It offers guidance on navigating clinical and organizational challenges and creating a supportive environment.

We are now entering our third year of offering the First Five Years Community of Practice. This monthly online series is designed for new University of Toronto graduates, U of T faculty, and Toronto-based family physicians in their first five years of family medicine. Offered for free, the sessions are engaging, highly practical, and provide valuable expertise from both speakers and peers. Each session is fully accredited for 1.5 Mainpro+ credits (totalling 13.5 credits).

Now in its third year of operation, the Family Medicine Jobs and Locum Opportunities website and newsletter continue to support new family physicians in their daily work as comprehensive family physicians. OHSP will continue to promote this service among job posters and new graduates.

ONTARIO HEALTH TEAM WELCOME PACKAGES Welcome packages play a key role in helping new family physicians transition smoothly into their practice and community by reducing overwhelm, fostering connection, and supporting both emotional wellbeing and professional success. These packages typically include essential information about the clinic, operational procedures, and the local area, helping physicians settle in quickly. They also support orientation with tips on billing, documentation, and efficiency, and facilitate team integration by introducing colleagues and assigning a peer mentor for ongoing support. By providing structured guidance and a warm welcome, these packages encourage engagement, demonstrate organizational support, and help new physicians feel valued and connected.

To provide a central hub for these important resources for early-career physicians, our website now hosts welcome packages for OHTs in the Toronto Region.

INSPIRING FUTURE HEALTH SYSTEM LEADERSHIP IN PRIMARY CARE (LEADS: DR. KAREN WEYMAN, DR. CATHERINE YU) Learner feedback has identified challenges in understanding the various practice models that family doctors work in, the complexity of how Family Health Teams work alongside these practice models, and now the introduction of Ontario Health Teams. Questions about compensation, administrative burden and leadership opportunities were also prevalent in student feedback.

To address these needs, the OHSP, in collaboration with DFCM’s So far, we have delivered 18 sessions, with 30–90 attendees Clerkship Undergraduate Education Program, developed a per session, covering a wide range of topics including the new seminar that will expose learners to the real-world appliuse of AI scribes in clinical practice, inbox management and cation of health system leadership in family medicine. forms, as well as financial planning and incorporation.

This new “Family Medicine in the Health System” seminar COMPREHENSIVE FAMILY MEDICINE LOCUM will play a crucial role in laying the groundwork for the other OPPORTUNITIES components of the MD curriculum by contextualizing the esLocum opportunities play a vital role in family medicine by ad- sential role of family medicine in the health system through dressing physician shortages, maintaining continuity of care, practical examples and first-hand reports from practicing and providing temporary coverage during leaves, retirements, primary care leaders influencing policy in Ontario. This or vacations. For physicians, locuming offers clinical variety, foundational knowledge will help learners appreciate and the chance to explore potential practice locations, and flexibil- be better equipped to navigate the broader context in which ity to support work-life balance and personal pursuits. These patient care occurs. roles also support physician retention and help bridge healthcare gaps, particularly in rural and underserved communities.

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This optional seminar is now offered at the beginning of Year With Ontario’s recent commitment of $1.8 billion over four years to ensure every resident has access to a family doctor 3 of the family medicine rotation. or nurse practitioner supported by a publicly funded team, The Family Medicine in the Health System seminar address- the province is taking a major step toward realizing the first element of the OurCare Standard. This initiative will be led by es the following topics: f The role of family doctors within the healthcare system Dr. Jane Philpott’s Primary Care Action Team (PCAT) and will require collaboration across the entire health system. f Funding models in primary care f Addressing the reality of the FM crisis in a historical context To support this transformation, a series of OHSP briefs will f Primary care reform/Innovations (i.e., what is being offer practical, evidence-informed steps to help implement done to fix the system?) the OurCare Standard. These briefs aim to provide actionf Highlighting the opportunities for leadership in an FM able guidance for improving access and quality in primary career care, using the Standard’s six elements as a framework. The HARNESSING THE POWER OF AI SCRIBE TECHNOLOGY TO goal is to create a roadmap that aligns with the aspirations REDUCE BURNOUT AND ENHANCE PATIENT CARE (LEADS: of Canadians and enables rapid, coordinated action across government, healthcare organizations, and communities.

DR. RAJESH GIRDHARI AND DR. CATHERINE YU) The OHSP, together with health system partners, is supporting By organizing policy topics around themes of sustainability, the implementation and evaluation of AutoScribe, a Canadian quality, and equity, the briefs will help ensure that Ontario’s AI scribe technology for transcribing patient-clinician conver- primary care system evolves in a way that truly reflects the sations in real time and enhancing medical record documen- needs and values of its people. tation. To date, the project has deployed 200+ AI Scribe licensIn 2025, we’ve developed the following policy briefs: es with 75+ offered exclusively to DFCM faculty members. f Retain existing clinicians practicing comprehensive longitudinal primary care OHSP’s evaluation aims to explore the effectiveness of AI scribes in Ontario. It will assess physician perceptions of f Expand the capacity of doctors and teams to serve more people AI scribe accuracy and reliability, and evaluate the impact on perceived physician burnout, satisfaction with clinical f Patient access to health records interactions, clinical efficiency, as well as perceived pa- f Promoting a primary care system that is accountable to communities tient satisfaction with encounters, experience, and quality f Recruit more early-career clinicians into primary care of communication.

DIGITAL HEALTH ENGAGEMENT AND ADVOCACY (LEAD: RAJESH GIRDHARI) This year, the DFCM Digital Health Education Subcommittee collaborated with the Temerty Centre for AI Research and Education in Medicine (T-CAIREM) Education Committee Faculty Affiliate to develop and distribute a faculty resource for teaching in an AI-enabled context. The committee is also in the process of planning a Faculty Needs Assessment relevant to AI in Clinical Practice.

SUPPORT THE DEVELOPMENT AND EVALUATION OF INTERPROFESSIONAL PRIMARY CARE TEAMS (IPCTS) (LEADS: DR. NOAH IVERS, DR. JENNIFER SHULDINER, DR. SYDNEY PEARCE) In response to staffing shortages and limited access to primary care in Ontario, particularly within equity-deserving populations, the Ontario government has invested $90 million to establish and expand Interprofessional Primary Care Teams (IPCTs). The IPCT model includes family health.

PROVINCIAL INITIATIVES

To ensure the success and scalability of this model, OHSP conducted a large-scale evaluation to examine how high-performing or “bright-spot” IPCTs have achieved rapid improvements in access, attachment, and equity. This study is now in its second year.

MAKING PRIMARY CARE FOR ALL A REALITY: A SERIES OF ONTARIO POLICY BRIEFS (LEADS: DR. DANIELLE MARTIN, DR. TARA KIRAN, DR. NOAH IVERS) The OurCare Standard outlines six aspirational elements that reflect Canadians’ collective vision for a sustainable, The objectives are to: high-quality, and equitable primary care system. These ele- f Determine whether the teams improved access and attachment to primary care, especially for equityments were developed through extensive public engagedeserving communities, without negative effects on other ment, including surveys, panels, and roundtables, and serve metrics related to quality of care (impact evaluation) as a guide for future government investments in primary care.

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f Understand how and why the new primary care teams achieved different outcomes and establish a generalized logic model and series of context-specific logic models; to inform a toolkit and measurement guide for spread and scale (process evaluation) f Provide data and insights to teams and government partners to identify and share best practices across teams on an ongoing basis (developmental evaluation)

INTERNATIONAL INITIATIVES GLOBAL KNOWLEDGE EXCHANGE AND COLLABORATION (LEAD: DR. KATHERINE ROULEAU) Building on decades of global collaboration and its long-standing partnership with Addis Ababa University, the DFCM hosted the Starfield Summit Toronto 2025 from May 12–15. To our knowledge, this was the first time the Summit was held outside of the United States. The initiative was led by Drs. Katherine Rouleau and Praseedha Janakiram (Program Director Global Health Education) with support from Dr. Jack Westfall. The Summit focused on the vital role of family medicine in enhancing PHC-oriented health systems and brought together 92 participants from 23 countries and six WHO regions. Experts from various disciplines including nursing, pharmacy, rehabilitation sciences, and patient advocacy joined forces to explore how family medicine can drive better health system performance globally.

Looking Ahead LOCAL INITIATIVES OHSP will continue to play a pivotal role in system thought leadership as the regional primary care lead, supporting the implementation of innovative practices across Toronto. We’ll also expand practice supports for early-career physicians to help them establish sustainable and effective care models.

PROVINCIAL ENGAGEMENT At the provincial level, the OHSP will continue to provide thought leadership to inform government discussions and policy development related to primary care in Ontario. The OHSP will provide recommendations to the province to support their efforts in achieving their strategic goals relevant to: f Develop an implementation plan for primary care objectives f Develop a primary care workforce strategy f Develop a monitoring and evaluation plan for Primary Care Additionally, the team is actively working to strengthen relationships with key professional organizations such as the Ontario College of Family Physicians (OCFP), the Ontario Medical Association (OMA), and other groups committed to improving primary care and supporting physician well-being.

Read more about the Starfield Summit.

NATIONAL CONTRIBUTIONS Nationally, the OHSP will continue to offer strategic insights MP3 COLLABORATIVE to guide primary care policy debates and reforms. The team Since 2024, the OHSP has participated as the sole Canadian is also committed to ensuring that primary care models remember of the MP3 Collaborative hosted by the Amerflect the needs and values of the communities they serve. ican Board of Family Medicine. The group consists of approximately 11 healthcare systems representing 15.6 million INTERNATIONAL COLLABORATION patients. It has focused on sharing strategies to tackle comInternationally, the OHSP will continue to support the World mon challenges in primary care. Central to their efforts are Health Organization’s efforts to develop evidence-informed four interconnected concepts: access, attachment, continupolicy guidance for implementing primary healthcare-oriity of care, and team-based care, which are essential comented systems. The team is also committed to supporting ponents of a high-performing health system. global knowledge exchange and collaboration to enhance the implementation and delivery of high-quality, PHC-oriDrs. Noah Ivers, Jennifer Shuldiner, and Sydney Pearce are ented primary care and family medicine. also leading a collaborative study with MP3, which aims to systematically identify and compare emerging strategies COMMUNICATIONS AND SCHOLARLY WORK that improve access and empanelment, focusing on chanIn addition to its operational and strategic efforts, the OHSP ges in team composition, scheduling innovations, and workwill focus on expanding the visibility and impact of our initiaforce integration. It will explore barriers and facilitators to tives and scholarly activities. This includes enhancing brand balancing access, quality, and patient attachment, while asawareness and promoting the dissemination of knowledge sessing the perceived success of these initiatives from the generated from our projects. perspective of primary care leaders. The findings will offer valuable insights for policymakers and healthcare leaders, helping to guide future improvements and promote the dissemination of effective practices across health systems.

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EXTERNAL RELATIONSHIPS The Department of Family and Community Medicine (DFCM) f Anaesthesia: We work together to support access to faculty plays a pivotal role in shaping family medicine leaderrural anaesthesia through a joint leadership appointment ship locally, nationally, and internationally. Our faculty actand educational and policy/advocacy initiatives. ively contribute to policy, education, and research through f Internal Medicine and its Subspecialties: Through the representation on numerous committees, councils, and Office of Health System Partnerships, we are exploring professional organizations. These collaborations strengthen integrated care pathways and central intake models academic family medicine and advance patient care across to reduce wait times for specialty care in partnership Ontario and beyond. with the new Chair of the Department of Medicine. Joint divisions and partnerships are active in Palliative Care, Cognate Departments, Extra-Departmental Emergency Medicine, Hospitalist Medicine, and Mental Units, and the Dalla Lana School of Public Health Health and Addictions. f Psychiatry: We have extensive joint clinical and Our faculty and learners have active academic work underacademic work through our core clinical site at the way in partnership with many of the other clinical departCentre for Addictions and Mental Health (CAMH) and ments within the Temerty Faculty of Medicine, every Exour Division of Mental Health and Addictions, as well as tra-Departmental Unit (EDU), and the Dalla Lana School of the STOP program that supports smoking cessation in Public Health. Just a few examples (many of which are deprimary care. scribed in more detail in this report) include: f Obstetrics and Gynecology: Through our Maternity Care Community of Practice and the PGY3 program in COGNATE DEPARTMENTS: Women’s Health, we collaborate on a wide range of f Pediatrics: We collaborate through the Lawson Centre education initiatives. for Childhood Nutrition, which focuses on advancing f Rehabilitation Science: Partnerships are in early stages research and programs to improve child health and as we explore opportunities related to interprofessional nutrition outcomes. team-based primary care reforms underway in Ontario and global work through the World Rehabilitation Alliance.

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EDUS: f Centre for Quality Improvement and Patient Safety (CQuIPS): partnerships with our Quality and Innovation program are described in the Q&I section of this report.

Our Chair Dr. Danielle Martin conducted the external review of this EDU. f Temerty Centre for Artificial Intelligence Research and Education in Medicine (T-CAIREM): Dr. Martin sits on the governance advisory board of T-CAIREM. f Wilson Centre: The Wilson Centre sits at the nexus of Temerty’s education community and advances the sciences of education. Dr. Cynthia Whitehead is the Director of the Wilson Centre and OES Scientist. OES team members are members of the Wilson Centre including several scientists and scholars; DFCM collaborates closely with the community to advance evidence informed education cross all of the DFCM portfolios. f Collaborative Centre for Climate, Health, and Sustainable Care: DFCM is the administrative home within Temerty Medicine for this Centre, and many of the education initiatives within it are being led by our faculty members. Read an update on the Collaborative Centre from the 2025 Executive Committee Meeting.

The College of Family Physicians of Canada (CFPC)

DALLA LANA SCHOOL OF PUBLIC HEALTH: We are a close partner in delivering all our Master’s programs through our Academic Fellowships and Graduate Studies program. Our new Division of Clinical Public Health will serve as the foundation for deeper collaborations. Many of our research faculty hold cross-appointments with DLSPH, where they teach, supervise graduate students, and actively contribute to its work—particularly through the Institute for Health Policy, Management and Evaluation.

Community Health Centres (CHCs) are comprehensive, community-governed primary healthcare organizations that deliver health and social services through interprofessional teams. With a strong focus on health equity, population health, and preventive care, CHCs primarily serve populations that face barriers to accessing care in other settings.

CFPC represents over 47,000 members and sets national standards for family medicine education and certification. It reviews and certifies continuing professional development programs and materials that enable family physicians to meet certification and licensing requirements. Current priorities include expanding residency positions, reducing administrative burden, and promoting team-based care. DFCM faculty have held leadership roles on governance, ethics, and faculty development committees.

Ontario College of Family Physicians (OCFP) OCFP supports more than 18,000 family physicians and learners in Ontario through education, advocacy, and leadership development. Key initiatives focus on improving access through team-based care, leveraging technology to reduce administrative tasks, and collaborating on programs like Practicing Well webinars with DFCM.

Community Health Centres (CHCs)

The DFCM is committed to expanding community-based learning opportunities and optimizing health outcomes by embedding family medicine residents and medical students Teaching Sites in CHCs. This approach enhances learners’ exposure to diverse communities and deepens their understanding of soWe have formal relationships with 18 affiliated teaching sites cially accountable medicine. that provide comprehensive clinical training. View site reports.

DFCM currently has two formalized CHC teaching sites with Program Partners the Scarborough CHC and Flemingdon Health Centre and we hope to expand. To advance this vision, we have launched Each of our programs collaborates with external partners an Academic CHC Project, which aims to: to deliver high-quality education and research. Explore pro- f Transform CHCs into academic centres affiliated with gram partnerships.

DFCM hospital teaching sites f Ensure consistent placement of residents and medical f Undergraduate Partners students in CHCs f Postgraduate Partners f Evaluate and monitor learner experiences at teaching f Graduate Studies and Academic Fellowships Partners site-affiliated CHCs f Faculty Development Partners f Education Scholarships We have collaborated with the Advancement Team to seek f Research Partners funding for this initiative, including submitting a Letter of Inf Quality and Innovation Partners terest to the Gloria Baylis Foundation. These efforts reflect 132

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our ongoing commitment to community engagement and to ing Unit. The collaboration focuses on providing learners with building a strong, equitable primary care system. exposure to equity-deserving communities in Flemingdon and Thorncliffe Park, while supporting integrated care models.

Although not all formal partnerships, currently, five of 18 teaching sites host learners who rotate through CHCs. Ex- Learner Participation periences range from short-term specialized clinic visits to Each year, the site hosts approximately seven postgraduate full-time daily clinical placements, providing exposure to di- family medicine residents and six to seven medical students, verse communities and socially accountable care. offering robust clinical experiences in community-based care.

Faculty Leadership f Dr. Melanie Henry f Dr. Jennifer Rayner f Dr. Catherine Yu Notable Projects f Handbook for CHCs Becoming an Academic CHC Authors: Dr. Jennifer Rayner and Dr. Melanie Henry

Faculty Involved Drs. Allyson Merbaum, Melanie Henry and Kulamakan (Mahan) Kulasegaram have contributed to scholarly work examining family medicine learner experiences in CHCs including, Flemingdon. Their research aims to expand opportunities for learners to develop competencies in caring for complex populations.

Notable Projects The primary scholarly output from this partnership is feaPanel Presentation tured in the ICAM 2025 abstract, and FMF 2025 Poster AbAcademic CHCs at Alliance Executive Leaders Meeting stract, which explores family medicine learner experiences October 24, 2024 Panellists: Dr. Melanie Henry, Dr. Avnish in CHCs and informs strategies for expanding communMehta, and Dr. Jennifer Rayner ity-based education.

ALLIANCE FOR HEALTHIER COMMUNITIES The DFCM began its partnership with the Alliance for Healthier Communities in March 2023, holding its first official meeting on May 24, 2023. Through this relationship, DFCM and the Alliance work together to expand learner placements, share best practices, and build capacity within CHCs to advance a model of socially accountable care.

Our collaboration with the Alliance allows us to: f Explore the CHC learning experience through educational scholarship f Educate CHC executives and managers about the unique requirements of medical learners to support increased learner presence in local CHCs f Partner with CHCs to collaborate on academic projects and dissemination FLEMINGDON HEALTH CENTRE AND MICHAEL GARRON HOSPITAL Lead Faculty: Dr. Catherine Yu Overview and Relationship with DFCM Flemingdon CHC has been taking on leaners from the DFCM since its inception 50 years ago and has been regularly taking learners from Michael Garron Hospital Teaching Site for quite some time. In the spring of 2022, Dr. Martin initiated discussions to strengthen connections between Flemingdon Health Centre and Michael Garron Hospital’s Family Medicine Teach-

SCARBOROUGH CENTRE FOR HEALTHY COMMUNITIES (SCHC) AND SCARBOROUGH HEALTH NETWORK— OFFICIAL CHC TEACHING SITE Lead Faculty: Dr. Avnish Mehta Overview and Relationship with DFCM Our formal partnership with SCHC began in 2023. This collaboration has strengthened academic integration by formalizing processes and encouraging new physicians to seek DFCM appointments. SCHC now has the IT infrastructure and streamlined onboarding systems needed to support medical learners.

Learner Participation At any given time, two DFCM residents are consistently placed at SCHC. In addition, several medical students have completed family medicine electives at the site, providing exposure to community-based care.

Faculty Involved Currently, four faculty members are engaged in teaching and supervising learners at SCHC. Future Plans The goal is to expand faculty presence and increase the number of residents. By July 2026, SCHC plans to host three residents, with one at each of its main sites.

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LOOKING TO THE FUTURE: VIBRANT COMMUNITY HEALTH AND SUNNYBROOK HEALTH SCIENCES CENTRE Lead Faculty: Dr. Karen Fleming Overview and Relationship with DFCM Vibrant and Sunnybrook officially came together on April 1, 2025. Since then, DFCM has worked closely with Vibrant, Sunnybrook, and the North Toronto Ontario Health Team (NT-OHT) to conceptualize the development of a second Family Medicine Teaching Unit (FMTU) in addition to the one at Sunnybrook. This FMTU would be embedded within Vibrant to provide learners access to a different model of care and improve services for equity-deserving populations.

The Vibrant Women’s Health Clinic also offers prenatal care, further enhancing community health services.

Learner Participation Learners have been engaged at Vibrant CHC since our launch of the Women’s Health Clinic at Vibrant in May 2023. Currently, the site hosts a weekly family practice resident, and clinical clerks attend RAAM (Rapid Access Addiction Medicine) clinics during their Family Medicine block rotations.

Notable Projects and Collaborations f Women’s Health Clinic – Provides prenatal care and serves as a training site for learners. f RAAM Clinic Integration – Clinical clerks participate in addiction medicine care during rotations. f Faculty Leadership in Addiction Medicine – Dr. Stephanie Zhou supervises family medicine residents and supports RAAM clinic learning. f Interprofessional Collaboration – Tom Nguyen (Social Work/Mental Health Navigator) contributes expertise in mental health navigation during Monday evening clinics. f Future Plans – Exploring the integration of an addiction medicine clinic within the Family Health Team to expand services and learning opportunities.

refugees. With an objective on increasing the number of primary care providers comfortable with accepting refugees into their practices, this event brings together leaders in refugee health and fosters collaboration among providers committed to health equity.

View the 2024 Refugee Primer poster for the DFCM Conference.

INNER CITY HEALTH ASSOCIATES (ICHA) This educational partnership provides medical learners— both residents and medical students—with clinical opportunities to understand and deliver care for people experiencing homelessness. Through these placements, learners gain firsthand experience in addressing complex health needs and navigating systemic challenges faced by marginalized populations.

COMMUNITY LEGAL EDUCATION ONTARIO (CLEO) This educational partnership supports medical learners by providing access to an online platform and collaborative academic half-day sessions. These sessions help residents understand health-harming legal needs, learn how to make appropriate legal referrals, and connect patients with community resources. Through this initiative, learners gain practical knowledge to address social determinants of health and advocate for patients facing legal challenges that impact their wellbeing.

Partners for Social Accountability WOMEN’S COLLEGE HOSPITAL FOR THE REFUGEE HEALTH PRIMER The Crossroads Clinic at Women’s College Hospital (WCH) is dedicated to serving refugee populations in the Greater Toronto Area and regularly receives inquiries from clinicians seeking guidance on managing unfamiliar medical needs and navigating the healthcare system for refugee patients.

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POSTAL CODEBASED CARE: TAILORED HEALTH AND SOCIAL SERVICES FOR THORNCLIFFE PARK

ONTARIO HEALTH REGIONAL LEADERSHIP COLLABORATION

Ontario Health (OH) is the provincial agency that oversees and coordinates Ontario’s healthcare system. Ontario Health Teams (OHTs) are local networks of healthcare providers supported by Ontario Health, working together to deliver integrated, patientcentered care in specific regions. The Ontario Health Toronto Region (OHTR) is one of six regional branches of Ontario Health.

Introduction In 2022, DFCM’s Office of Health System Partnerships (OHSP) partnered with Ontario Health – Toronto Region (OH-TR) to implement a new model of health system leadership. Rather than appointing a single-family physician as regional primary care lead, OH-TR engaged DFCM OHSP to provide strategic leadership under Dr. Danielle Martin and Dr. Catherine Yu. Together, they guide primary care planning and regional engagement through a multi-level model that integrates strategy with implementation across the Toronto Region.

Over the past three years, this collaboration has enabled significant progress on health human resources planning, primary care supports, and partner engagement. The OHSP works closely with OH-TR leadership to co-develop annual workplans that address key health system priorities, highlighted below.

See the Ontario Health Toronto Region Workplan.

Highlights ESTABLISHED REGIONAL ENGAGEMENT STRUCTURES FOR PRIMARY CARE SYSTEM LEADERSHIP f Establishing and co-chairing the Primary Care Strategic and Operational Leadership Tables, which brought together OHT and Primary Care Network (PCN) leaders to align efforts across COVID recovery, health human resources (HHR), patient attachment, and OHT-based primary care engagement. f Leading extensive engagement with eight OHTs to surface local priorities and readiness, catalyzing early dialogue around PCN development and models of team-based care.

FROM COLLABORATIVE DESIGN TO COORDINATED ACTION: BUILDING HIGH-FUNCTIONING PCNS WITHIN OHTS ACROSS TORONTO In 2023-24, the DFCM OH-TR partnership transitioned from early engagement to coordinated, multi-partner execution.

With priorities co-developed and aligned across OHTs, DFCM faculty—led by Dr. Catherine Yu—took on a more central role in guiding strategy implementation. The work plan reflected a mature collaboration that combined provincial direction with local intelligence and leveraged growing trust among system partners. This included not only bilateral work with individual OHTs, but also regular convening of cross-regional PCN and human health resources (HHR) leaders to build shared approaches and troubleshoot challenges collectively. This work laid the foundation for the more formalized coordination structures that would take shape in 2025-26.

Key focus areas in 2023-24 included: f Structural Integration of Primary Care into OHTs: Dr. Yu provided guidance to help embed primary care within OHT governance. f Localized Solutions Through PCNs: DFCM leaders worked closely with OHTs to strengthen Primary Care Networks (PCNs) as vehicles for clinical integration and population-based planning. f Collaborative HHR Planning: Through partnerships with the Canadian Health Workforce Network and OH Analytics, the team co-developed regional methodologies to identify high-needs areas, inform comprehensive HHR plans, and expand capacity in OHTs. f Enabling access to primary care: The DFCM OHSP established the Family Medicine Jobs and Locum

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Opportunities platform to connect new graduates with employment opportunities across Ontario. f Analyzing and Synthesizing Evidence-Based Attachment Strategies for PCNs: The Attachment Best Practices Report (August 2023), co-developed by DFCM-OH Toronto Region, informed and enhanced the effectiveness of Primary Care Networks (PCNs). f Supporting Community-Based Family Physicians: Launched in summer 2023, the Family Medicine Community Longitudinal Leadership Enrichment Opportunity (FM CLLEO) offers early medical learners hands-on experience in family medicine while helping community physicians address preventative care backlogs using EMR data.

Challenges and Lessons Learned

CONTINUED DEVELOPMENT AND SUPPORT OF PCNS AND ESTABLISHMENT OF A PRIMARY CARE DATABASE Key focus areas in 2024-25 included: f Establishing a Primary Care Census and database for the Toronto Region: The primary care census, launched in February 2024, gathered 1,088 responses and established a governance advisory table to support ongoing database maintenance and primary care planning. f Toronto Region Primary Care Network Community of Practice: In response to feedback from regional primary care leaders, the DFCM established a PCN community of practice to develop a collaborative strategy for connecting all Torontonians to primary care within three to five years.

Limits of Local Action to Address Profound Macro-System Level Issues To achieve meaningful and lasting impact, local innovation must be supported by broader policy, funding, and structural enablers. Without alignment at higher levels of the system, local progress risks being isolated, unsustainable, or unable to scale. Recognizing this, we have actively engaged regional and provincial leaders at Ontario Health and beyond, ensuring our work is informed by—and connected to—emerging provincial directions. Wherever possible, we align our local initiatives with system-level strategies to maximize relevance, mitigate risk, and contribute to broader transformation.

SUCCESS FACTORS Regional Readiness to Embrace Transformative Leadership The region’s embrace of a new primary care leadership model reflects its commitment to innovation, enabling the DFCM–OHTR partnership to develop creative solutions and address complex challenges.

OHTs and PCNs at Varying Levels of Development OHTs and PCNs are at varying stages of development, which adds complexity to regional coordination and implementation efforts. Moving forward requires a flexible, relationship-based approach that respects each group’s unique context—often described as “moving at the pace of trust.”

This approach emphasizes the importance of meaningful Distributed Leadership in Action: Leveraging Expertise for engagement, building strong partnerships, fostering mutual System Impact understanding, and creating shared accountability, ensuring DFCM OHSP’s ability to unite diverse expertise and leverage that system transformation is both inclusive and sustainable. specialist networks strengthens collaboration, enables efficient task allocation, and drives innovative, comprehensive All of these lessons will inform our work by reinforcing a solutions for primary care challenges. team-based approach and, where appropriate, actively engaging frontline primary care leaders or guiding them on Building System Solutions Through a Scholarly, Academic when and how to engage directly. and Evidence-Informed Approach As an academic department, we provide a trusted, impartial All of these lessons will inform our work by reinforcing a platform for collaboration that fosters open dialogue, miti- team-based approach and, where appropriate, actively engates conflicts, and supports equitable, evidence-based pri- gaging frontline primary care leaders or guiding them on mary care planning and delivery. when and how to engage directly.

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INTERNATIONAL As one of the largest departments of family and community medicine in the world, and a designated World Health Organization Collaborating Centre on Family Medicine and Primary Care, the University of Toronto’s Department of Family and Community Medicine (DFCM) is uniquely positioned to foster meaningful global relationships. Guided largely by our Global Health team, we actively collaborate with international partners to advance primary care, strengthen health systems, and support capacity-building initiatives across diverse contexts.

Efforts are made to anchor all global health activities in partnerships that reflect our emphasis on building community, nurturing relationships, and fostering leadership—always in alignment with the DFCM Strategic Plan wherever possible. These partnerships embody our commitment to equity, knowledge exchange, and the shared goal of improving health outcomes worldwide.

f Community Emergency Care f Emergency Preparedness and Response to EpidemicProne Diseases Now in its third iteration, the Collaborative has equipped primary care practitioners with enhanced education and expertise in one of the five focus areas, strengthening capacity for high-quality care and emergency response.

Toronto Addis Ababa Academic Collaboration in Family Medicine (TAAAC-FM) Through the Toronto Addis Ababa Academic Collaboration in Family Medicine (TAAAC-FM), the DFCM works closely with Addis Ababa University (AAU) in Ethiopia to strengthen medical training and education. The primary goal of this partnership is to develop and sustain Ethiopia’s first family medicine training program, which was inaugurated in 2013.

Africa Health Education Collaborative (AHC)

This collaboration focuses on four key areas: delivering education offerings for AAU family medicine trainees, preHosted by the Office of the Vice-President International at paring DFCM faculty for partnership work, fostering faculty University of Toronto, the Africa Health Education Collabora- development and leadership at AAU, and advancing scholtive (AHC) aims to enhance primary healthcare across Africa arship, mentorship, and knowledge sharing. through workforce education, entrepreneurship, and innovation. As part of this initiative, the DFCM collaborates with The impact of this partnership has been significant. Over Kwame Nkrumah University of Science and Technology’s the past 12 years, more than 35 teaching trips have been School of Public Health (KNUST SPH) in Ghana to co-create delivered by DFCM faculty through TAAAC-FM. Today, over and deliver short courses on critical topics, including: 100 family doctors have graduated from Ethiopian residency f Palliative Care programs, and 10 AAU faculty members now lead the Def Quality Improvement for Health Professionals partment of Family Medicine at AAU. f Prehospital Emergency Care Relationships, Partnerships, Social Accountability | International

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Global Physician Leadership Cohorts: Advancing Women’s Excellence in Family Medicine (AWE-FM) The Advancing Women’s Excellence in Family Medicine (AWE-FM) program is designed to equip participants with critical leadership skills that support their professional growth and advancement in family medicine. It also fosters collaboration to address the unique challenges faced by emerging women leaders worldwide.

That definition is: the obligation to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve.

Refer to the Global Health Education section for a detailed overview of the scholarly work, courses, and activities we undertake in partnership with WHO.

World Organization of Family Doctors (WONCA)

This initiative features a six-module online program, co-created by an international steering committee.

The World Organization of Family Doctors (WONCA) invited DFCM to collaborate on developing resources that advance The program is co-chaired by Dr. Praseedha Janakiram and advocacy and policy transformation for high-quality primary Dr. Thuy-Nga (Tia) Pham, alongside an esteemed group of care worldwide. international collaborators: f Mrs. Jamie Rodas (Canada) A planning meeting took place during WONCA World in Lisf Dr. Meseret Zerihun – Family Physician, Souther= bon, where partners refined the framework for this collabAfrica; Former Department Head, Department of Family oration. This initiative reflects DFCM’s commitment to global Medicine, Addis Ababa University, Ethiopia health through partnerships that strengthen family medicine f Dr. Baraa Alghalyini – Vice Dean, College of Medicine, via education, research, and advocacy, and we look forward Alfaisal University, Saudi Arabia to continuing to collaborate with WONCA on this work. f Dr. Hathaitip Tumviriyakul – Head of Social Medicine Department, Hatyai Regional Hospital, Thailand Read more about DFCM’s showing at WONCA 2025. f Dr. Orawan Tawaytibhongs – Deputy Director, Bureau of Primary Care Support, Ministry of Public Health; Emerging Partnerships Director of Khaoyoi Hospital, Petchaburi, Thailand f National University of Singapore – Exploring adaptation Through these partnerships, AWE-FM exemplifies DFCM’s of TIPS/VTIPS to strengthen teaching and assessment commitment to global collaboration and leadership developin primary care education across Asia. ment in family medicine. f Hong Kong University – Engaging through the Lancet Commission on Primary Care co-chaired by HKU, where World Health Organization (WHO) DFCM faculty contribute expertise to global policy and research.

The DFCM maintains a strong and longstanding relationship f Thailand (Royal College of Family Physicians & with the World Health Organization as a designated WHO Ministry of Public Health, Bureau of Primary Care Collaborating Centre on Family Medicine and Primary Care.

Support) – Early discussions to share best practices This status reflects our global leadership in advancing priand support capacity-building for family medicine and mary care and our commitment to supporting WHO’s mission primary care systems. of strengthening health systems worldwide. Through this f Aga Khan University (Karachi) – Connected through the collaboration, we contribute expertise, research, and eduStarfield Summit to advance shared priorities in health cational resources that inform global policy and practice in system strengthening and family medicine education. family medicine. f Brazil (Universidade Federal do Rio Grande do Norte) – Partnership through a postdoctoral fellowship (2023–24) The DFCM also follows the WHO’s definition of “principles focused on research and knowledge exchange in family of equity and social accountability” for medical schools. medicine.

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ORGANIZATIONAL & FINANCIAL STRUCTURE Organizational and Financial Structure

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Introduction The Department of Family and Community Medicine (DFCM) has experienced tremendous growth since our last external review in 2020. With the recognition that primary care is a key priority, the Ministry of Health has authorized an expansion of the Family Medicine programs across Ontario as well as the opening of two new medical schools. DFCM has responded to the imperative to expand by increasing our support of learners and educators.

Directors. The WHO Collaborating Centre and the Indigenous Leadership Circle report directly to the Department Chair. All faculty leaders have a detailed job description that links back to key points in DFCM’s strategic plan, which allows a large and complex group of faculty members to be focused and to work together coherently. In turn, the faculty are supported by administrative staff, organized in roughly similar functional areas.

Organizationally, DFCM is structured in seven functional areas: Education, Operations, Quality and Innovation, Research, Community and Partnerships, the WHO Collaborating Centre on Family Medicine and Primary Care, and the Indigenous Leadership Circle. The first five areas are helmed by a Vice-Chair, who in turn, has Directors and Associate

DFCM currently has a total annual budget of ~$22M, of which ~ $15.2M is provided by the Government of Ontario to fund postgraduate education. An additional ~$511,000 is provided by the Temerty Faculty of Medicine (TFoM), and DFCM also has income from some endowments.

Highlights EXPANSION Ontario’s expansion of medical school enrollment and post-graduate training has resulted in huge growth in DFCM. The number of DFCM faculty members has grown from 1,562 to 2,249 from 2020 to 2025, an increase of 43%. Consequently, the number of academic leadership positions has grown to 101 from 68, an increase of ~49%.

Key changes include an expansion of the number of divisions within DFCM. In 2020, the Department supported two divisions, Emergency Medicine and Palliative Care. Today, DFCM supports six divisions. The new divisions are: Mental Health and Addictions, Hospitalist Medicine, Clinical Public Health (a partnership with the Dalla Lana School of Public Health), and Care of the Elderly. The increase in the number of divisions reflects these growing areas of interest in family medicine clinical practice as well as health system need, and the consequent need to form communities of education, research, and practice for physicians working in these areas.

Another new area within DFCM is the establishment of the Office of the Health System Partnerships (OHSP). The OHSP was formed to fulfill the ambitious goal of leveraging the university’s strengths to lead in health systems locally, nationally, and globally.

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In 2020, 42 administrative staff members were supporting DFCM. Today, there are 53 administrative staff members, an increase of ~26%. These numbers include five administrative staff supporting our Physician Assistant (PA) program.

The PA program will be transitioned out of DFCM to the Medical Education portfolio in the near future, as part of the newly established Scarborough Academy of Medicine and Integrated Health (SAMIH), which will bring together a number of allied healthcare professionals together in one space.

Currently offered as a Bachelor’s degree, the PA program will be restructured as a Master’s degree to align with similar programs.

ADAPTING TO THE PANDEMIC In March 2020, the global pandemic radically changed DFCM and how we operate. With very little notice, the entire department shifted into virtual mode. Fortunately, we were well placed to do so. Many staff already had laptops and those who did not were able to work using personal machines until a departmental machine could be issued. Although many processes were paper-based, OneDrive was already widely used prior to the pandemic and staff switched to using electronic storage of electronic documents rather than physical storage of paper documents. The IT staff had already started piloting the use of Zoom for classrooms prior to the pan-

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demic, and this application became the standard modality for meetings. A sense of community was maintained by setting up Teams channels as a way for staff to chat informally.

Prior to the pandemic, an informal social committee planned a series of wellness events for the entire team. During the pandemic, there was a shift to virtual social events, the most memorable of which were virtual cooking classes led by an enthusiastic staff member. As the pandemic waned, staff gradually returned to on-site work, following the safety protocols in place at the time. Staff coped admirably during the pandemic due to the great leadership of the Director of Business Administration, Caroline Turenko. Her meticulous planning, dedication, and care for all staff members made it possible for the department to function effectively throughout this turbulent time.

By 2022, staff started the transition from working fully remotely to working a hybrid schedule, first working on-site one day a week, then moving to working on-site two days a week. This schedule worked well with staff, allowing them flexibility while continuing to meet operational needs. Initially, staff chose their remote days, leading to a minimum number of staff members being on-site every day. More recently, staff shifted to working the same hybrid schedule, with the same two “anchor” days on-site. The adoption of anchor days made it easier to promote a sense of community by being more inclusive for on-site engagement activities.

STAFF PROFESSIONAL DEVELOPMENT There has always been an emphasis on the professional development of staff. Under the mentorship of Caroline Turenko, the Director of Business and Administration, staff were encouraged to seek out new opportunities and were advised to take on new roles, both internal and external to DFCM and to U of T. Even though this sometimes meant that valued staff members left DFCM, we ultimately believe that this turnover contributes to a healthier work environment by keeping staff challenged and engaged. Apart from this personal mentoring, structured mentorship programs are also available at both the institutional and divisional level, and staff have been encouraged to participate in these both as mentors and mentees.

COLLABORATING ACROSS DIVISIONS DFCM is deeply embedded in the community at the divisional level as well. Staff frequently connect with divisional counterparts in Academic HR, Finance, and Infrastructure and Planning. In addition, senior administrative leaders meet regularly with the CAO’s office, as well as other senior administrators in TFoM. These groups allow for the exchange of ideas and enhanced communication between the complex layers of governance at TFoM. Organizational and Financial Structure

OFFICE UPDATES AND NEW INDIGENOUS HEALTH SPACES A few minor renovations were completed since 2020 using residual capital funds. A large room, previously used as a library, was repurposed as a boardroom/classroom and outfitted with the appropriate technology to allow for hybrid meetings. The library was not well-used, and the new space allows DFCM to offer additional classroom space to support learners. In the last year, DFCM implemented one of our strategic goals to support the self-determination of Indigenous health leaders and their communities by building two new spaces for Indigenous learners, faculty, and staff: the reception area and a new Indigenous lounge. These new spaces represent a small but tangible contribution to DFCM’s ongoing commitment to advancing Indigenous reconciliation by centering First Nations, Inuit, and Metis peoples, leadership, and primary healthcare and public health priorities.

It is intended to be a place where First Nations, Inuit, and Metis faculty members, learners, staff, and community from the university and beyond can gather to advance work and nurture relations.

FUNDING In terms of funding, DFCM has received additional funding from the Ministry of Health for some of our postgraduate expansion, albeit at rates that have not changed for many years. Advocacy is ongoing across the medical faculties of Ontario to increase funding to levels that reflect the cost of delivering a medical education, and we continue to be hopeful that some increases will be forthcoming.

Funding for postgraduate education has increased by ~6% since 2020, but this increase is based on an expansion of the postgraduate cohort; the funding per resident remains flat.

We do expect an increase in funding per resident starting in fiscal year 2026, on a slip-year basis. However, funding from the TFoM has decreased during that same period, from ~$850,000 in fiscal year 2019-2020 to ~$511,000 in fiscal year 2024-2025. This is a decrease of ~40%, primarily as a result of TFoM reallocating a portion of the DFCM budget to fund shared services at the divisional level, notably information technology, which led to a small decrease in our staff complement to support that portfolio of work.

Fundraising and advancement work in partnership with the superb team at TFoM has yielded some support from donors, though more work remains to be done with respect to creative ways to seek alternative funding sources. DCFM recently received a $5M donation from a donor who wishes to remain anonymous to fund a Chair in Indigenous Health. This generous donation will allow DFCM to grow and sustain the work of the Indigenous Leadership Circle and the Indigenous Health Lead in the years to come.

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Challenges The explosive growth in the number of DFCM faculty members has presented DFCM with great opportunities and has increased our breadth of expertise and community reach.

However, it has been a challenge to provide sufficient administrative support for all of DFCM’s ambitious programs and projects. More work remains to be done to focus and prioritize core functions and activities rather than continuing to add to the already-full agendas of our wonderful team.

DFCM planning for activities without knowing the financial resources that will be available. This has caused us to have to draw down on reserves for interim funding and leaves very little room for contingencies. Furthermore, TFoM will be reducing funding to DFCM over the next five years to address a deficit at the faculty level. These financial pressures have made it difficult to provide adequate administrative support for the exciting growth of DFCM programs and portfolios.

Opportunities also exist to reconsider our structure: the administrative staff are organized as a flat structure with a large number of reports to the Director. This does not allow for sufficient growth and development opportunities for our staff, and prevents the Director from focusing sufficiently on strategic work. Ideally, additional people managers would be hired to manage functional teams within the administrative staff; the challenge will be finding and liberating budget to do so. With a new Business Director joining our team in Sept 2025, we have an opportunity to put fresh eyes on our structure and ask how we can better align our structure to our strategy.

To mitigate financial risk, the Chair has been actively working with Advancement to pursue other sources of revenue.

Most recently, as mentioned above, DFCM has been the recipient of a generous $5M donation for an endowed chair in Indigenous leadership. It is difficult, however, to raise funds for primary care. We continue to work closely with Advancement on opportunities. In addition, through its OHSP team, DFCM has recently been pursuing contracts with Ontario Health and other system partners to provide expertise for policy reform in family medicine and primary care.

Though a smaller revenue stream, these contracts provide the dual role of providing a new source of income to DFCM as well as raising our profile as thought leaders and experts Although the Ministry of Health will be providing addition- in primary care. Similarly, we are exploring potential global al funds for expansion, there is uncertainty about the exact partnerships in education and capacity building that might amount and timing for receiving the funds, which results in open doors to new, albeit modest, revenue streams.

Looking Ahead Resource challenges in academia are common. While challenging, they represent the daily work of academic leaders and do not diminish our enthusiasm for our mission. DFCM faculty and staff are dedicated and loyal, working diligently towards a shared vision to improve education, research, and partnerships in family medicine and primary care. Working together with TFoM, DFCM will seek to support our current and future learners, educators, and staff by maximizing the use of existing resources while seeking new partnerships to diversify its revenue streams. We understand that this is our mandate and we are committed to pursuing it together.

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LONG RANGE PLANNING Long Range Planning

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Over the past five years, the Department of Family and Community Medicine (DFCM) has focused deeply on community— supporting one another, rebuilding systems, and recovering from the profound impacts of the COVID-19 pandemic. This period has been marked by resilience, adaptation, and a shift toward a narrative of hope. We are committed to continue to strengthen our connections and expand our reach.

Strengthening Leadership and Strategic Direction The coming years will bring important opportunities for renewal and growth across the Department and the Faculty. With new Decanal leadership at the Temerty Faculty of Medicine (TFoM) and an external review of the Faculty underway, DFCM is poised to play a central role in shaping the Faculty’s evolving priorities.

Within DFCM, we continue to implement our Strategic Plan (2022–2027). 2027 will provide an opportunity to reassess our direction, reaffirm the enduring aspects of our shared vision, and ensure alignment with TFoM’s priorities and the evolving needs of our learners and communities.

Expanding and Innovating in Education Education remains central to DFCM’s mission. With the upcoming launch of the Scarborough Academy of Medicine and Integrated Health (SAMIH) and growth across all our education programs, we aim to balance strong central supports with vibrant local learning communities. Maintaining high standards and ensuring all learners benefit from DFCM’s infrastructure and collaborative spirit remains Job #1.

Undergraduate feedback has driven curricular innovations, including a new seminar series on the evolving landscape of family medicine—covering care models, funding, leadership, and system reforms. Research initiatives such as “Clerkship Clinical Rotation Factors: Effect on Student Performance” 144

continue to guide quality improvement, supported by physician recruitment and investment in community preceptors.

At the postgraduate level, we are refining the Foundations block to better meet residents’ needs and foster early identity formation as generalist family physicians. Social Accountability competencies will be introduced in 2026, alongside expanded Indigenous health content through collaboration with the Indigenous Leadership Circle.

Academic Fellowship and Graduate Studies (AFGS) is reimagining the MSc in Community Health in Family and Community Medicine, exploring online and hybrid formats to enhance accessibility and interprofessional learning, ensuring our programs remain responsive and forward-looking.

Advancing Education Scholarship and Faculty Development DFCM’s Office of Education Scholarship (OES) and Faculty Development programs will continue to advance a culture of academic excellence and reflection. Priorities for the coming years include strengthening teaching performance through systematic feedback and evaluation, promoting equity in academic opportunities, and expanding dissemination support for educational scholarship.

We are also exploring innovative engagement models that connect clusters of training sites, enabling shared embedded scholars and resources. The Art of the Possible (AoP) program, celebrating its 10-year anniversary, will be enhanced with new “Big Ideas” themes—such as comprehensive care, big data, and patient-centered practice—to align with emerging departmental priorities.

DFCM is also committed to building stronger connections with Education Scholarship units in other TFoM departments and enhancing our visibility within the College of Family Physicians of Canada’s (CFPC’s) scholarly structures.

Department of Family & Community Medicine, University of Toronto

These collaborations will help amplify our collective impact Globally, DFCM is building on long-standing international in advancing family medicine education nationally. partnerships while exploring new ones in Singapore, Thailand, and Tanzania. We will continue to strengthen ties Building Research Capacity and Community with Kwame Nkrumah University of Science and TechnolImpact ogy (KNUST) in Ghana and aim to renew our designation as a WHO Collaborating Centre in 2026—affirming our role The DFCM Research Program is entering a new phase of as a global leader in primary care education, research, growth, with a particular focus on supporting commun- and policy. Across all our international work, DFCM seeks ity-based research. The launch of the Waddington Fellow- to act as a convener and knowledge broker, creating eviships reflects a major investment in developing research dence-based resources, advancing primary care reform, capacity among community clinicians. Over the next several and aligning local and global policy initiatives. years, we have committed significant funding to provide salary support, mentorship, and training for community-based Ensuring Operational Excellence and researchers. This will help create thematically linked re- Financial Sustainability search communities across our sites, leveraging DFCM’s collective expertise and infrastructure.

Operational excellence and fiscal responsibility are essential to sustaining our mission. In collaboration with the new DirOur research and Quality & Innovation (Q&I) programs re- ector of Business Operations and TFoM’s Chief Administrative main deeply aligned with DFCM’s social mission. The Q&I Officer, we are implementing models that enhance staff career program continues to evolve from improving clinical qual- advancement while ensuring efficiency and accountability. ity for existing patients toward optimizing access and efficiency—critical work as more than 2.5 million Ontarians re- We are also working closely with Advancement to secure main unattached to a family doctor. In collaboration with the donor funds that will accelerate our ambitions in across all Office of Health System Partnerships (OHSP) and Ontario’s of our programs. These investments will help sustain DFCM’s Primary Care Action Team, DFCM will continue to lead efforts ability to innovate, adapt, and lead. to strengthen primary care capacity, access, and integration.

Our strength as a department is in the breadth and diversity Expanding Partnerships—Local, National, of our networks. As an enormous and distributed department, and Global there is “something for everyone” in DFCM – we offer a place of community and belonging for the myriad ways people can Partnership is at the heart of our department’s identity. We engage with their identities within academic family medicine. hope that our still-new Office of Health System Partnerships But this diversity must never come at the cost of shared purwill grow its leadership in system integration and primary pose. The past five years have been a time of responding to care reform, while seeking new opportunities to involve and then recovering from crisis, and rebuilding in a way that learners and trainees in its work. Collaborative initiatives are we believe has renewed that common vision. We imagine a also expanding with departments such as Medicine and Ob- future of even greater accountability – to ourselves, to each stetrics & Gynecology, focusing on shared areas of interest other, and to the communities we serve. like health leadership, reproductive health, and advocacy.

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NATIONAL + INTERNATIONAL COMPARATORS 146

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University of Toronto – Department of Family and Community Medicine (DFCM)

National University of Singapore – Yong Loo Lin School of Medicine

The University of Toronto’s DFCM includes 2,300+ faculty and 1,300+ learners across 18 hospital sites. It is recognized internationally for excellence in education, research, and clinical care, and hosts the WHO Collaborating Centre on Family Medicine and Primary Care.

NUS does not have a standalone family medicine department but offers a Family Medicine program within its Master of Medicine degree. The school admits 280–300 medical students annually and is Singapore’s oldest and largest medical school.

Areas for Improvement: Enhancing integration across its Areas for Improvement: Limited dedicated infrastructure for large network and addressing physician shortages in under- family medicine compared to other institutions. served communities.

Leadership: NUS exhibits leadership through interprofesLeadership: DFCM leads globally in primary care research, sional education, integration of digital health, and strong equity-focused initiatives, and innovative education models, in- research programs aligned with national health priorities. cluding distributed learning and Indigenous health partnerships.

University of British Columbia – Department of Family Practice (DFP) The UBC Department of Family Practice has over 5,000 faculty and staff, including 4,600+ clinical faculty across British Columbia. It supports 1,700+ learners across undergraduate, midwifery, residency, and enhanced skills programs. UBC ‘s DFP is a distributed program with four geographically distinct undergraduate sites.

University of California, San Francisco – Department of Family and Community Medicine

UCSF’s department includes 80 faculty and 48 residents, with a strong focus on urban underserved care and social justice. It is nationally recognized for innovative curricula and community partnerships.

Areas for Improvement: Scaling distributed training beyond urban centers and addressing faculty recruitment challenges.

Areas for Improvement: Reducing silos within its expansive department and improving integration of research and education. Leadership: UCSF leads in health equity, advocacy, and practice transformation, integrating quality improvement Leadership: UBC demonstrates leadership through equity-in- and social determinants of health into education. formed hiring, rural and Indigenous health initiatives, and expansion of postgraduate and midwifery programs to meet University of Sherbrooke – Department of growing demand.

Family Medicine and Emergency Medicine

University of Oxford – Nuffield Department of Primary Care Health Sciences

Sherbrooke’s department comprises 662 clinical teaching professors, 107 full professors, 255 residents, and 83 graduate students, supported by a small administrative team. It Oxford’s Nuffield Department is a leading global center for aca- emphasizes proximity and community-based training. demic primary care, with 600+ staff and students, with partnerships with 200 GP practices for medical student placements.

Areas for Improvement: Expanding research capacity and international collaborations.

Areas for Improvement: Balancing research excellence with clinical teaching demands and expanding global collaborations. Leadership: Sherbrooke champions social accountability and distributed learning, with strong ties to local communLeadership: Oxford drives innovation in evidence-based ities and innovative competency-based education. healthcare, digital health, and patient engagement, supported by major funders like NIHR and Wellcome Trust.

Read about our research HIGH IMPACT RESEARCH PROGRAMS IN comparators in this report: FAMILY AND COMMUNITY MEDICINE

National and International Comparators

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SITES AND DIVISIONS 148

Department of Family & Community Medicine, University of Toronto

The Department of Family and Community Medicine (DFCM) at the University of Toronto includes academic divisions and teaching sites. Academic divisions provide enhanced skills for learners to develop in addition to their family medicine training. Teaching sites are embedded in hospitals and community health centres across the region, providing clinical training and patient care for our postgraduate learners.

DFCM Teaching Sites

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Mount Sinai Hospital, Sinai Health System

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Unity Health Toronto, St. Michael’s Hospital

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Sunnybrook Health Sciences Centre

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Toronto Western Hospital, University Health Network

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Credit Valley Hospital, Trillium Health Partners

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Markham-Stouffville Hospital

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Mississauga Hospital, Trillium Health Partners

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North York General Hospital

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Women’s College Hospital

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10 Scarborough Health Network 11 Michael Garron Hospital 12 Unity Health Toronto, St. Joseph’s Health Centre 13 Humber River Health 14 Royal Victoria Regional Health Centre 15 Southlake Regional Health Centre 16 Headwaters Health Centre 17 Georgian Bay General Hospital 18 Orillia Soldiers’ Memorial Hospital 19 Collingwood General and Maine Hospital 20 Stevenson Memorial Hospital 21 Ross Memorial Hospital

Lakeridge Health Port Perry Map data ©2025 Google Terms

Sites and Divisions

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ACADEMIC DIVISIONS The Department of Family and Community Medicine’s (DFCM) educational offerings are strengthened by six Academic Divisions: Care of the Elderly, Clinical Public Health, Emergency Medicine, Hospital Medicine, Mental Health and Addictions, and Palliative Care.

A large number of DFCM faculty members provide clinical care and academic contributions in focused areas of practice in family medicine. They collaborate with those providing comprehensive care, and some also practice comprehensive longitudinal primary care themselves. These focused practitioners are members of the DFCM Academic Divisions, forming clinical and academic communities of practice.

CARE OF THE ELDERLY

The Division of Care of the Elderly (COE) is a small Division of the DFCM with 17 primary members, in addition to those with secondary appointments who also contribute actively to the academic mission, led by Dr. Sid Feldman. Clinically, many COE members continue to have office-based comprehensive family medicine practices while also working in domains more specific to the needs of older adults. Some division members work full-time providing comprehensive primary care only to older adults, in areas such as long-term care, geriatric assessment clinics, memory clinics, day treatment centres, post-acute hospitals, acute care of the elderly units, and home-based primary care to more frail seniors.

The Divisions of Emergency Medicine and Palliative Care have been part of DFCM for decades, while the four newer Divisions were created in more recent years—Hospital Medicine, Care of the Elderly, Mental Health and Addictions, and Clinical Public Health. Physicians in the six Academic Divisions participate in clinical care, teaching, research, quality initiatives, faculty development, community outreach Education and advocacy, health policy, and international work, and significantly enhance DFCM’s clinical reach, scholarship and UNDERGRADUATE EDUCATION contributions to the community.

A major emphasis has been on undergraduate medical education. COE members participate in providing education at Physicians belonging to an Academic Division may have pri- all levels of the Temerty Medicine undergraduate program, mary or secondary appointments at affiliated teaching sites, including formal lectures (e.g. fitness to drive; falls etc.) as or in some cases are community-based faculty members. well as a new two-week older adult medicine experience in Faculty in certain Academic Divisions–Emergency Medi- the fourth-year transition to residency. cine, Hospital Medicine, Palliative Care, and Care of the Elderly–hold key teaching and leadership roles in our PGY3 In addition, FM-COE preceptors support numerous learner enhanced skills educational programs in their respective placements at both academic and community sites. On a disciplines. The Divisions play important roles in operating national level, Division members contributed to the developthese programs; however, their administrative direction and ment of published competencies for undergraduate geriatric governance are the purview of the Enhanced Skills Program, education (the Aging Care 5Ms Competencies), which were which resides in DFCM’s Postgraduate Education Program. presented at the Canadian and American Geriatric Society annual meetings as poster presentations and published in Academic Medicine (2024).

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POSTGRADUATE EDUCATION The COE also supports education of family medicine residents at many core DFCM sites, and through rotations at Baycrest Hospital, in long-term care (LTC) homes, assisted living, post-acute care, and with home-based primary care teams. An innovative program helping residents learn how to conduct family meetings in LTC, for example, has been very well received by learners.

National Leadership Nationally, Division members hold leadership roles within: f The College of Family Physicians of Canada Care of the Elderly Members Interest Group f The Canadian Society for Long-Term Care Medicine f Choosing Wisely Canada (LTC) – focusing on antimicrobial stewardship and antipsychotic reduction f The Canadian Geriatrics Society (CGS) annual scientific assembly committee Another major Divisional focus has been on supporting the En- f The CGS Primary Care Special Interest Group. hanced Skills Care of the Elderly program and Family Medicine and Enhanced Skills (FAMES) program. Division members are Members have contributed to national clinical practice actively involved in resident selection, curriculum develop- guidelines on: ment, rotation supervision, and evaluation. Many of these pro- f Osteoporosis and fracture prevention gram graduates have gone on to join the Division as faculty. f Loneliness and isolation in seniors f Culturally appropriate dementia diagnosis QUALITY IMPROVEMENT AND PROFESSIONAL LEADERSHIP f Management of behavioural and psychological Local Initiatives symptoms of dementia Division members play key governance and leadership roles f Knowledge translation in bone health research. in Ontario Health Teams, focusing on coordinated care for older adults. This includes integrating specialized geriatric Planetary Health and Global Engagement services with primary care and innovative Neighbourhood Division members champion planetary health, submitCare Teams to support older adults in Naturally Occurring Re- ting recommendations on climate impacts affecting older tirement Communities (NORCs). Members are also advancing adults, presenting at national forums, and leading innovfrailty identification through electronic health record review. ative collaborations—such as “It’s Getting Hot in Here: Leveraging Primary Care Teams to Help Patients at Risk of In collaboration with the Toronto Dementia Research Alli- Heat-Related Illness.” ance, members are leading initiatives to integrate specialty and primary care for patients living with dementia and their Internationally, members participate in the Seniors Quality care partners, emphasizing co-design with patients and Leap Initiative, a consortium dedicated to improving LTC community family physicians. quality through shared learning and practice.

Division members also lead the LTC+ program, which connects acute care hospital hubs with local long-term care (LTC) homes to ensure residents receive care in the most appropriate setting. Other LTC-focused initiatives include improving the wellbeing of 2SLGBTQI+ residents and disseminating “Leading and Learning with Pride: A City of Toronto Toolkit for Supporting 2SLGBTQI+ in LTC.”

FACULTY DEVELOPMENT AND CONTINUING PROFESSIONAL EDUCATION Division members are leaders in faculty development and continuing professional education through initiatives such as: f Project ECHO Care of Older Adults, delivering over 40 sessions annually on community, LTC, and dementia care. f The Care of the Elderly Certificate Course (five-weekend program), now with over 300 participants.

Provincial Contributions f Collaborative Ontario College of Family Physicians At the provincial level, Division members have led the Prov(OCFP) webinars on osteoporosis and fracture incial Geriatric Leadership Ontario (PGLO) steering commitprevention. tee, which coordinates specialized geriatric services across Ontario. They have also consulted for The Institute for Safe Members regularly present at major conferences, including Medication Practices Canada on strengthening medication the Family Medicine Forum, and the annual meetings for. The safety in LTC and contributed to the Ontario Coroners’ Geri- Association of Family Health Teams of Ontario, Ontario Long atric and Long-Term Care Review Committee.

Term Care Clinicians, and Canadian Geriatrics Society. They also organize and teach at the Canadian Geriatrics Society’s Members played key roles in developing and implementing Resident Education Day and provide ongoing education for the mandatory LTC Medical Directors Course, led by the On- geriatric medicine and COE family medicine residents. tario Long Term Care Clinicians organization.

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Division members have received numerous teaching cies in residency training and fostering research on health awards recognizing their excellence and dedication to promotion and disease prevention within family medicine. medical education.

Residents in the Royal College of Physicians and Surgeons of Canada (RCPSC) Public Health and Preventive Medicine Research: program complete two years of family medicine training and write the certification examination in family practice before Recent research by Division members covers a broad swath continuing specialty training. of older adult medicine. Some highlights include published works in COVID support in LTC, specifically integrating LTC The COVID-19 pandemic delayed programming developwith acute care; nurse practitioner/physician models of care ment, and the Division remains relatively small with six facin LTC; supporting safe and healthy intimacy and sexuality in ulty members. Despite this, it has built strong partnerships LTC; and virtual primary care for people living with demen- with the Dalla Lana School of Public Health (DLSPH), collabtia. Education scholarship includes evaluating the impact of orating on the Master of Public Health in Family and Coma national geriatric mental health ECHO, in addition to the munity Medicine and the Master of Science in Community published geriatric competencies noted above.

Health (MScCH) programs, including Health Practitioner Teaching Education.

Advocacy:

Division members work tirelessly along with our older adult patients to support change. Key work has been in the areas of recognizing the disproportionate effect of the climate crisis on older adults, the devastating effect of COVID (emphasizing LTC), and the harms of loneliness and isolation.

Challenges and Opportunities: The Temerty Faculty of Medicine has recently made mandatory an older adult rotation for all undergraduate medical students. This is an exciting opportunity to garner interest in family medicine COE, but also provides pressure to meet the educational needs of all learners at all levels of training. While continuing our strong and successful roles in education, QI, and advocacy, we need to continue to grow research depth and skills of Division members. As the population of Canada ages, we remain optimistic that the Division of COE will continue to grow and play a key role supporting family physicians in caring for all older adults, providing care to some of the most frail and vulnerable members of our communities.

CLINICAL PUBLIC HEALTH

A conforming practice plan is currently under development.

If approved, it will allow physicians dually certified by the College of Family Physicians of Canada and RCPSC to join the Division, expanding membership and teaching capacity in public and population health. COVID-19 underscored the need for closer collaboration between family medicine and public health—a relationship few health systems have formalized. The Division aims to lead this integration to improve population health outcomes.

EMERGENCY MEDICINE

Emergency medicine (EM) is a fast-paced specialty that requires a broad base of medical knowledge and a variety of well-honed clinical and technical skills. DFCM’s Division of Emergency Medicine scope of activities are led by EM leaders in Ontario and Canada who deliver high-quality, innovative educational programs and research and scholarship.

DFCM offers a variety of opportunities to train in EM for MD students, residents, and practicing physicians looking to upgrade their skills.

Dr. Megan Landes is the Head of the Division of Emergency Medicine. She is an Associate Professor and Clinician Investigator at the DFCM and Attending Staff at the University The Division of Clinical Public Health, established in late Health Network. She is a global emergency medicine leader 2019 and led by Dr. Ross Upshur, supports scholarship at and scholar, and the founding Director of the Global Equity in the intersection of family medicine and public health. Its EM Centre in the Divisions of EM at the University of Toronto. mandate includes advancing core public health competen152

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Education UNDERGRADUATE The four-week EM clerkship course commences with three days of hands-on workshops and seminars. Students are then placed at one of 10 or more Emergency Departments (EDs) in the Greater Toronto Area to complete 13 shifts, including up to two weekends and two overnight shifts. Dr. Michelle Klaiman is the Course Director. Dr. Adam Kaufman is the Associate Course Director. During the clinical experience, students function as members of an interprofessional team and are assigned one to two primary preceptors with whom at least half their shifts occur. Each clerk spends half a shift with members of the interprofessional team. Clerks learn to manage many types of patient problems that present to the ED, including exposure to core emergency medicine cases.

a three-month, full-time, remunerated, comprehensive enhanced skills program in EM. The program, the first of its kind in Canada, has generated similar programs in British Columbia, with programs in development in other provinces. In its 12 years, SEME has graduated 242 family physicians. Dr. Eileen Cheung is the Program Director of the SEME program. Read more about SEME in the Postgraduate Education section.

FACULTY DEVELOPMENT The Division of Emergency Medicine, comprising over 450 faculty across 16 sites, is supported by Faculty Development Leads, Drs. Meeta Patel and Maria Ivankovic. Together, they spearhead initiatives that strengthen academic engagement, foster professional growth, and enhance connectivity across the Division. Signature achievements include the creation of the EM Division website, the launch of an informative quarterly newsletter, the establishment of Tri-Division Community POSTGRADUATE of Practice Rounds, and the development of the EM Awards Emergency medicine is an important part of the curriculum Program—initiatives that have significantly advanced facfor all DFCM residents. Each of the 18 sites ensures residents ulty recognition, collaboration, and career progression. develop skills and confidence to practice EM as part of their comprehensive family medicine careers, especially for those Faculty development offerings also include targeted sesresidents planning to work in smaller communities where the sions such as Teaching to Teach workshops for EM educaneed for family practitioners to practice EM is essential. tors, promotion-focused seminars, and tailored guidance to connect faculty with resources, mentors, and academic Family medicine residents can also apply for a third year opportunities. These efforts have cultivated a supportive and of training (Category 1) in Emergency Medicine. Dr. Amna high-performing academic community, driving both individKarabegovic is the Program Director of the Emergency ual success and collective excellence across the Division.

Medicine PGY3 Fellowship and Dr. Carly Ng is the Assistant Program Director. Dr. Jordan Shaw is the Barrie site Partners Program Director. The PGY3 fellowship training occurs at a number of community and teaching hospitals. Core rotations SCHWARTZ-REISMAN EMERGENCY MEDICINE INSTITUTE include: emergency medicine (five blocks, including two (SREMI) blocks of paediatric emergency medicine), trauma at St. Mi- SREMI Director Dr. Bjug Borgundvaag, Professor in the chael’s Hospital, anesthesia, plastics/orthopedics, ICU (two DFCM, and Research Director Dr. Shelley McLeod, Associmonths), CCU (one month), and ED Ultrasound (one block). ate Professor in the DFCM, lead Canada’s first and only instiLearners have one elective block to explore other interests, tute of emergency medicine. Based at Mount Sinai Hospital, such as toxicology, addictions, rural medicine, advanced SREMI is a partnership between Sinai Health and North York ultrasound, etc. The Barrie stream welcomed its first CC- General Hospital that aims to improve patient care through FP-EM PGY3s in 2025-2026, with most blocks being complet- the generation of new knowledge relevant to the care of ED ed at Royal Victoria Regional Health Centre. patients, and to translate that knowledge into practice.

The program is very popular, with 120 applications for 10 spots in Toronto and two spots in Barrie for 2025. Graduates have gone on to important leadership positions in emergency medicine, and indeed healthcare, across the country.

SREMI was established in November 2013 by a founding gift from the Schwartz/Reisman Foundation. SREMI includes a team of scientists, educators and staff, with expertise in research methodology, biostatistics, knowledge translation and dissemination. This infrastructure creates a vehicle to support sustained and stable funding for researchers and educators to conduct meaningful work on a long-term basis.

SUPPLEMENTAL EMERGENCY MEDICINE EXPERIENCE (SEME) SEME is an innovative program funded by Ontario Ministry of Health and delivered by the DFCM to provide family SREMI brings together some of Canada’s leading EM eduphysicians practicing in smaller and rural communities with cators and researchers, including members of our Division, Sites and Divisions | Academic Divisions

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who are working hard to improve the effectiveness and efficiency of EDs, train the next generation of ED healthcare providers and attract the world’s best and brightest minds in the field, all with the goal of improving patient care.

Since inception, the SREMI team have produced over 340 peer-reviewed publications, and have won 250 scholarly and research excellence awards. Additional DFCM faculty members as part of SREMI faculty include: Drs. Qassim Tejpar (Interim Chief, Mount Sinai Hospital ED), Kevin Wasco (Chief NYGH ED), Anton Helman (EM Cases Podcast), Don Melady, Howard Ovens and Catherine Varner.

TORONTO ADDIS ABABA ACADEMIC COLLABORATION IN EMERGENCY MEDICINE (TAAAC-EM) TAAAC-EM is a partnership between the two University of Toronto Divisions of Emergency Medicine (Family Medicine, Medicine) and the Department of Emergency Medicine at Addis Ababa University (AAU) in Ethiopia. Established in 2010, its intention was to foster the development of the country’s first EM Residency Program and to continue to support the growth of the specialty. Over the past 15 years, TAAACEM has trained over 100 EM Specialists, many of whom now practice and serve in leadership and administrative roles in 18 public hospitals across Ethiopia TAAAC-EM sends visiting faculty to teach and clinically mentor Ethiopian EM residents three times a year. Teaching trips cover a longitudinal, three-year curriculum including didactic teaching sessions, practical seminars, point-ofcare ultrasound (POCUS) training, simulation, and bedside clinical supervision. Each trip consists of two U of T Faculty and one senior postgraduate U of T resident.

TAAAC-EM also supports our Ethiopian partners through curriculum design and development, operational research training and support, and continuing professional development and leadership initiatives. The 10-year goal of TAAACEM is to assist in the graduation of a self-sustaining cohort of EM leaders at AAU who will continue to train future generations of Ethiopians, and spread their expertise throughout the region. In October 2013, AAU graduated the first Ethiopian EM physicians.

Dr. Julia Wytsma of the Division is one of the TAAAC-EM Co-Directors, along with Dr. Alexandra Stefan from the Department of Medicine. Many Divisional faculty members have volunteered for the Collaboration, in fact, over 60 per cent of the teaching faculty for TAAAC-EM are affiliated with the DFCM.

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HOSPITAL MEDICINE

The Division of Hospital Medicine (DHM) was established in 2020 to support the growing number of hospitalists working in academic centers who supervise and teach Department of Family and Community Medicine (DFCM) learners. Its mission is to strengthen the academic presence of hospital medicine in Toronto and Greater Area, advance education, and foster a connected community of practice.

Dr. Hedieh Molla Ghanbari serves as Head of the Division.

She is an academic hospitalist, Site Director for Hospital Medicine at Mount Sinai Hospital, and Assistant Professor at the University of Toronto.

She chairs the Division’s Executive Committee, a diverse group appointed by the Division Head that meets quarterly to plan Grand Rounds, guide strategic direction, and promote academic advancement. Members include: f Dr. Cary Fan – Faculty Development Lead f Dr. Simrran Gohal – Early Career Representative f Dr. David Esho – Education Lead f Dr. Sabrina Lim-Reinders – Rehab and CCC Lead f Dr. Richard Osborne – Comprehensive Family Medicine/ Hospitalist Representative f Dr. Tania Tajirian – Mental Health Lead f Dr. Yalda Karimi – Wellness Lead

Faculty and Community Engagement The Division currently has 50 appointed faculty members (primary and secondary appointments), though this underestimates the total number of hospitalists working across DFCM sites. Many hospitalists hold only a primary appointment within DFCM Family Medicine sites. This year, DHM has focused on ensuring that all hospitalists at DFCM sites also obtain an appointment within the Division.

DHM held its first divisional retreat in spring 2024, followed by a second in September 2025. These retreats bring together hospitalists from across sites to connect, exchange ideas, and strengthen our academic community. Highlights included a panel discussion on integrating comprehensive family medicine into hospitalist work and a keynote presentation on artificial intelligence in hospital medicine. The Division plans to continue hosting annual retreats to foster collaboration and professional growth.

Department of Family & Community Medicine, University of Toronto

With support from the Executive Committee, DHM is launchjunior and senior levels. ing its first quarterly newsletter to share updates, highlight 3. Sharing information on conferences, the BASICS achievements, and promote engagement across the Division. program, and professional learning opportunities within the Temerty Faculty of Medicine.

Postgraduate Education and Training

Family medicine residents are introduced to hospital medicine through core and elective rotations during postgraduate training. As patient complexity continues to grow, many residents interested in hospitalist practice pursue a thirdyear Enhanced Skills program in one of two streams: f Academic Hospital Medicine (12 months, Category 2) f Clinical Hospitalist Fellowship (12 months) The Academic Family and Hospital Medicine program prepares graduates with advanced inpatient clinical skills and leadership experience in education and research. The Clinical Hospitalist Fellowship, offered through Postgraduate Medical Education at three hospitals—University Health Network/Sinai Health System, Unity Health Toronto, and Sunnybrook Health Sciences Centre —trains physicians to independently manage complex medical patients in diverse settings while developing procedural expertise.

WELLNESS The Division introduced its first Wellness Lead, Dr. Yalda Karimi (CAMH), in 2025. Her work focuses on fostering community, connection, and wellbeing among hospitalists. The Division plans to launch its first wellness initiative in spring 2026 to further strengthen engagement across sites.

Quality Improvement and Research A growing number of hospitalist sites are engaged in quality improvement (QI) and medical education initiatives. At Sinai Health, a formal research program has been established with the recruitment of its first clinician scientist. Faculty across sites have presented their work locally, nationally, and internationally, earning multiple awards for excellence.

Key priorities include: 1. Ensuring DHM members are aware of QI training opportunities through regular communication.

2. Promoting collaboration among sites on QI projects and research initiatives.

3. Developing a Quality Improvement Day where members can submit and present posters showcasing their projects.

Each year, approximately 20 residents complete these programs. In collaboration with DFCM leadership, the Division is looking to develop an integrated Family Medicine–Hospital Medicine program that will allow residents to combine PGY2 and PGY3 training, fostering a more comprehensive and flexible family medicine career path.

A future goal is to appoint a QI Lead within the Executive Committee to further support and coordinate this work.

Postgraduate learners are supervised by faculty hospitalists from both family medicine and specialty disciplines (e.g., in- Challenges and Plans for the Future ternal medicine), gaining experience across a range of clinical areas including acute care, rehabilitation, wound manage- The Division maintains strong relationships with major hosment, complex continuing care, and oncologic medicine. pitals across the GTA, for example Sinai Health, University Health Network, and Trillium Health Partners. While many Faculty Development, Wellness, and of our initiatives and opportunities are outlined in previous Research sections, a key ongoing challenge remains building a cohesive community of practice where all members are aware FACULTY DEVELOPMENT of available supports and opportunities within DFCM. Faculty development within the Division is led by Dr. Cary Fan, who promotes educational offerings, coordinates promotion To address this, the Division has undertaken site visits seminars, and develops Grand Rounds topics relevant to across all DFCM locations to raise awareness and strengthhospitalist practice. The Division is also creating a Faculty en engagement. More than half have been completed, with Excellence Award to recognize outstanding contributions the remainder planned in the coming months. The launch of across academic and community hospitalist streams. the quarterly newsletter will further enhance communication and highlight achievements across sites.

Key priorities include: 1. Increasing awareness of DFCM awards available to Looking ahead, there are opportunities for collaboration with DHM members. other DFCM divisions on shared educational initiatives, par2. Promoting opportunities for academic promotion at ticularly in palliative care, mental health and addictions, and Sites and Divisions | Academic Divisions

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geriatrics. The Division also aims to explore how hospitalist tive in 2024 and 2025. Our division faculty supported students work can be more seamlessly integrated within family medi- in the development of conference material, participated in cine careers to support wellness and reduce burnout. career panels, delivered in-person teaching, and provided experiential learning opportunities for medical students.

As the Division continues to grow, we anticipate the need for additional support, including administrative resources, POSTGRADUATE funding for retreats and academic half days, and stipended A key recent initiative was the revision of the competenleadership roles within the Executive Committee. cies in Mental Health and Addiction for the family medicine postgraduate curriculum. This iterative process took place 2023-2024, guided by a working group of family physicians at diverse career stages and with varied expertise in mental health and substance use. A draft was created and continually revised following input from two panels of patient partners with lived experience as well as the Curriculum Committee and received final approval from the Residency Program Committee.

MENTAL HEALTH AND ADDICTION

The DFCM Division of Mental Health and Addiction (DMHA) To support implementation, Division members created and is the academic home of family physicians engaged in work delivered a faculty development workshop introducing the to support the mental health of our communities. revised competencies and offering practical teaching strategies. This was presented at DFCM Day in 2025.

Our Division has the following priorities: f Support a cohesive academic program in mental The Division also launched a unique “Primary Care Mental health and addiction by encouraging primary mental Health” clinical fellowship in 2023, currently offered to interhealthcare, undergraduate and postgraduate medical national trainees. Now in its second year, the fellowship ofeducation, continuing professional development, quality fers enriched training in psychotherapeutic techniques and improvement, and research in the areas of mental management of mental health conditions in a primary care health and addictions. setting. The Division is exploring opportunities to expand f Establish an identifiable community of practice among this training opportunity. faculty and learners across all DFCM sites. f Champion mental health and addiction care with a EDUCATION SCHOLARSHIP strong focus on access, stigma reduction, medical In the area of education scholarship, division members have home, and shared care. received the “Art of the Possible” grant from the Office of Education Scholarship twice in the past five years—Dr. Kim Under the leadership of Dr. Nikki Bozinoff, the Division of Lazare in 2021 for a needs assessment on teaching behavMental Health and Addiction has experienced significant ioural medicine in family medicine residency, and Drs. Sarah growth, increasing its membership from five official mem- Whynot and Nikki Bozinoff in 2024 for an ongoing qualitative bers to 49 over the last three years. Our Division’s cohesion study exploring the outcomes of the Enhanced Skills in Adhas grown during this time via regularly planned socials to diction Medicine program. support connectedness and a sense of belonging amongst our members.

Highlights of recent medical education publications from the Division include two studies that explore the training and Education preparedness of family medicine physicians in addressing mental health and addiction: The Division of Mental Health and Addiction has demon- f Ramdawar A, Bozinoff N, Lazare K. “Not doing it strated continued leadership in medical education across justice”: Perspectives of Recent Family Medicine all levels of training led by our Division Education Lead, Dr. Graduates on Mental Health and Addictions Training in Sarah Whynot.

Residency. J Med Educ Curric Dev. 2024. f Bassi J, Ramdawar E, Selby P, Stolarski K, Wyman J, UNDERGRADUATE Lazare K, Bozinoff N. “I Really Didn’t See a Lot of This in At the undergraduate level, the division has provided faculty My Training”: Family Medicine Residents’ and Recent support to the student-led “Addiction Medicine Week” initiaGraduates’ Experiences of Training and Readiness to 156

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Deliver Treatment for Opioid Use Disorder. Canadian Journal of Addiction. 2024.

FACULTY DEVELOPMENT AND AWARDS The Division of Mental Health and Addiction is excited to have expanded our portfolio by creating a role to lead our Faculty Development and Faculty Relations, led by Dr. Rachel Shour. While in its early stages, we are working both to foster representation and collaboration departmentally on the Faculty Development Committee and to ensure our faculty have a sense of community, an awareness of opportunities, and are appropriately supported in their professional goals.

To assist in this aim, we are excited to have initiated a quarterly newsletter to engage our faculty, celebrate successes, and ensure we are all up to date on Division-related events in the Department and within the broader community.

We are proud to have had two of our faculty receive senior promotion: Dr. Osnat Melamed and Dr. Nadia Minian. In addition, two of our faculty’s exemplary work have been recognized in their receipt of DFCM awards, one for Excellence in Teaching (Dr. Sarah Griffiths) and one for Sustained Excellence in Research (Dr. Bernard Le Foll).

In recognition of the distributed nature of our Division as well as the complex and often community-based nature of much of the work done by our faculty, we are in the process of developing Division-specific awards to acknowledge and celebrate the unique work done by our faculty.

mental health and addictions. This community of practice continues to grow, with participation increasing by 27% in the first quarter compared to the previous quarter.

On average, 167 participants attend sessions live, and recent assessments show that 93% of respondents find the sessions valuable for day-to-day practice.

PALLIATIVE CARE

The Division of Palliative Medicine is dedicated to advancing excellence in clinical care, education, research, and quality improvement for patients with serious illness and their families. The division fosters collaboration across disciplines and sites, ensuring equitable, patient-centred care and innovative approaches to palliative medicine.

The division is chaired by Dr. Kirsten Wentlandt and Dr. Ebru Kaya.

The leadership team includes: f Program Directors: Dr. Sarah Kawaguchi and Interim Leads Dr. Jonathan Ailon and Dr. Sarah Torabi f Education Lead: Dr. Alisha Kassam f Quality Improvement Leads: Susan Blacker and Dr. Lise Huynh f Research Lead: Dr. Breffni Hannon f Faculty Development Leads: Drs. Haley Draper and Nadine Gerbera f EDI Lead: Dr. Jenny Lau

CONTINUING PROFESSIONAL DEVELOPMENT (CPD) Here is a list of the key events and courses we organized and collaborated on for faculty: The committee also includes student representation, and all site leads are invited to participate, ensuring diverse perf Webinar for Faculty: Preparing for the Holidays: What’s spectives and shared leadership.

New, What’s True, and How to Create Non-Alcoholic Brews — Canada’s Guidance on Alcohol and Health Education f DFCM Day Poster Presentation: Charting the Course: A Patient’s Voyage Through the Rapid Access Addiction UNDERGRADUATE EDUCATION Medicine Clinic in Primary Care Undergraduate students are introduced early in their underf Webinar for Faculty: Dealing with Grief in Family graduate family medicine studies to palliative care (PC).

Medicine Week 61 is a full week of PC curriculum in Foundations includf DFCM Day Workshop: Adaptive Expertise: How to Teach ing lectures, self-learning modules, small group case study, the New Competencies in Mental Health and Addiction ethical cases, and clinical skills. In the third year of family f Webinar: The Role of Medication in the Management of medicine clerkship, there is an interprofessional PC seminAlcohol Use Disorder ar called Hillary’s Heart that includes serious illness comf Counselling and Psychotherapy Course: Five-weekend munication, advanced care planning, symptom management program led by faculty member Mel Borins and end-of-life care. During fourth-year clerkship, there is f CAMH Course: Buprenorphine Treatment for Opioid Use another PC seminar with a focus on interprofessional eduDisorder cation and collaboration. The fourth-year clerks participate f CPD Program: Practicing Well: Monthly webinars with with other health discipline learners in small group learnthe Ontario College of Family Physicians focused on ing on a palliative care case. Both PC residents and faculty Sites and Divisions | Academic Divisions

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actively contribute to the development, delivery, and evalua- The Grand Rounds group has hosted quarterly virtual sestion of palliative care lectures, online learning modules, and sions that have been well-received and well-attended, with workshops throughout the undergraduate curriculum. plans to further develop and enhance future offerings.

POSTGRADUATE EDUCATION Family medicine residents find substantial opportunities to explore palliative care during postgraduate training in palliative care, family medicine, internal medicine, psychiatry, and medical oncology rotations. Residents can also go on to complete additional training in palliative care through either the PGY3 enhanced skills program or the Family Medicine and Enhanced Skills (FAMES) program.

Both the PGY3 and FAMES programs aim to train physicians who will directly provide, build capacity for, and mentor other healthcare professionals in providing high-quality, equity-informed palliative care in multiple settings. These include community-based care, hospice care, outpatient, and inpatient work. The FAMES program allows residents to combine training in both palliative care and family medicine across their PGY2 and PGY3 years. Approximately five residents complete the PGY3 program, and one to two residents complete the FAMES program annually.

The Awards group has supported several successful DFCM awards seasons, with many faculty members being recognized for their outstanding contributions to clinical care, education, research, and leadership. In addition, an internal Palliative Care Division Award has already been established to further recognize outstanding contributions within our own community.

The Community Building group is developing a new DPC website to serve as a central hub for continuing professional development, faculty development resources, clinical site information, and equity and social accountability initiatives.

The Mentorship group is planning a formal program to support new faculty in areas such as education, research, and clinical practice.

QUALITY IMPROVEMENT The DPC has an active Q&I program with primary objectives to: f Promote and facilitate cross-site collaboration on quality improvement initiatives f Identify and measure palliative care quality indicators as it relates to program structure, palliative care delivery process, and patient outcomes f Use data/quality indicators to drive change f Support faculty development in Q&I knowledge and in engaging in Q&I work f Support resident and fellow education in quality and safety

For both undergraduate and postgraduate education, learners are supervised by dedicated family medicine and specialty faculty actively involved in the Division of Palliative Care (DPC). Faculty have diverse skills and practice environments; there are a large number of rotations/preceptors who have different focuses (hospital-based care, homebased care, cancer, non-cancer illnesses, marginalized populations, research, education, administration), which allows for exposure to diverse patient populations across care settings.

Work in the above-mentioned areas have been underway.

Some activities/outcomes over the past few years include the The overall goal of the program is to train physicians who creation of Q&I education resources for faculty, organization will directly provide, build capacity for, and mentor other of forums that allow faculty members to share Q&I work and healthcare professionals in providing high-quality, equity-in- ideas (e.g. rounds, conferences, retreats), active engagement formed palliative care to all patients through best-practice in Q&I curriculum development and delivery for palliative care palliative care teachings. trainees, and the organization of a multi-site working group, working towards establishing and measuring standardized FACULTY DEVELOPMENT quality indicators for the division of palliative care that are in The DPC’s Faculty Development Committee (FDC) continues alignment with national and provincial priorities. to focus on four key areas: f Grand Rounds RESEARCH f Faculty Awards The DPC has a growing research program that spans severf Community Building al sites. Its overarching goals include: the advancement of f Mentorship high-quality palliative care research in both malignant and non-malignant populations; to contribute to clinician trainThese initiatives aim to enhance professional development, ing in conducting and appraising palliative care research; strengthen connections, and recognize the contributions of and to use research to advocate for greater palliative care faculty across the department. access and resources.

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The current research priorities include: f Identifying common research areas across DPC f Hosting the biannual Barrie Rose Research Day in Palliative Medicine, with themes aligned with key research areas across DPC f Developing sustainable processes for capturing key clinical metrics across all sites to facilitate data sharing for benchmarking, Q&I and research purposes f Developing a new quarterly innovation newsletter to highlight DPC members’ publications and grants; communicate funding opportunities and conference deadlines; foster greater awareness of research, Q&I and innovation across DPC/DPM through a “spotlight” series f Strengthening opportunities for learners to engage in palliative care research

support the course, reflecting the depth of expertise and collaborative spirit that defines this partnership. This collaboration is expected to be sustained for the next five to 10 years, further cementing our role in advancing palliative care education in the region.

GLOBAL HEALTH We are proud to share the continued progress and expansion of our Palliative Global Health initiatives. A key development has been the establishment of the Palliative Global Health Working Group, which has brought together a diverse and growing team of faculty members actively engaged in a range of global health projects. This collaborative effort underscores our commitment to advancing palliative care globally, particularly in the context of primary care and health system strengthening.

To further strengthen our global impact, we have established an international collaborative of clinicians and researchers in palliative care, education, and primary care. This network is focused on conducting research that will inform best practices in palliative care education and service delivery. One of our key initiatives is a series of scoping reviews designed to provide evidence to guide the education of primary palliative care providers. This research is essential to shaping the future of palliative care education, ensuring that healthcare workers worldwide are equipped to provide compassionate, high-quality care to patients with serious illnesses.

Building on the success of our inaugural Basic and Advanced Palliative Care Short Course in Ghana in 2023, we were thrilled to return in 2024 and 2025 to offer more iterations of the course. This program, delivered in collaboration with Kwame Nkrumah University of Science and Technology (KNUST), is part of our ongoing commitment to co-create and co-deliver continuing education programs designed to enhance the skills and competencies of primary care practitioners in palliative care. In the last three years, we were able to send over 15 faculty members to Ghana to teach and

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In addition to this direct educational collaboration, we are also proud to be actively involved in the World Health Organization’s (WHO) Palliative Care Working Group, as part of the DFCM’S designation as a collaborating centre in primary care and family medicine. In this capacity, we are contributing to the development and implementation of the WHO’s plan to support global palliative care, which aims to improve access to palliative care services worldwide, particularly in low- and middle-income countries.

Looking ahead, we are excited to continue expanding our global palliative care efforts, strengthening partnerships, and engaging with international leaders and organizations to drive meaningful change in the field. Our work is grounded in a shared vision of improving palliative care access and quality for patients around the world, and we remain committed to advancing this mission through education, research, and advocacy.

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SITES DFCM includes a number of teaching sites, including 18 residency teaching sites—four more than in the previous external review term. Our sites span hospitals, community health centres, and academic family health teams, offering diverse clinical environments for training. This distributed structure ensures flexibility and learner choice, with residents ranking site preferences through an internal post-match process. In addition to these core sites, our academic network spans hundreds of family physician offices across an enormous geographic area, allowing learners to experience community-based rotations in a diverse variety of settings.

Our governance model of having all these distributed faculty members receive their faculty appointment through a site, a division, or a program (such as Undergraduate Education or Research) ensures that appropriate faculty support and oversight exist across the DFCM network. Therefore, our site leaders (Chiefs of Family and Community Medicine) often oversee and support the work not only of faculty working inside their hospital or family health team but also of distributed faculty members working in their neighbourhood or region. We believe this “hub and spoke” model is a strength of our distributed department.

Fully Affiliated Sites Fully affiliated sites are those that are part of the Toronto Academic Health Science Network (TAHSN). Members participate in health and biomedical research and teach undergraduate and postgraduate medical and healthcare professional students.

HUMBER RIVER HEALTH (HRH) SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Residents: 17 (8 PGY-1 and 9 PGY-2) f Faculty Members: 18 f Academic Department Chief: Dr. Priya Sood and Dr. Patrick Safieh f Quality Improvement Lead: Dr. Navsheer Gill f Faculty Development Lead: Dr. Gurpreet Mand f Academic Half-Day Leads: Dr. Tarin Arenson f Undergraduate Program Director: Dr. Neal Belluzzo SITE DESCRIPTION Humber River Health (HRH) operates across three sites and is one of Ontario’s largest community hospitals. Despite this volume, HRH was recognized by the Globe and Mail in 2025 for consistently having the shortest ED wait times in the province thanks to its state-of-the-art Command Centre and its relentless commitment to innovation. It is Canada’s first fully digital hospital. The Emergency Department sees about 133,000 visits annually, with 40,000 inpatient admissions, 398,000 outpatient visits, and over 4,600 births each year. There are 793 credentialed medical staff working within its walls.

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The Schulich Family Medicine Teaching Unit includes 5 core All core specialty rotations occur within HRH. faculty members who are also building new practices. They f Each resident is assigned a primary preceptor for the are members of the Humber River Family Health Organization two-year program and manages a defined panel of (FHO) linked with the Humber River Family Health Team (FHT). approximately 200 patients. Faculty provide continuity Temporary funding supports interprofessional staff (social and mentorship throughout. Interprofessional staff work, nursing, dietitian, Nurse Practitioners) while permacollaborate in teaching and care delivery. nent funding is pursued. Thirteen community physicians as- f The Family Medicine Teaching Unit (FMTU) offers sist with supervision 2–4 times per month. By 2026, there will diverse clinical exposure, including musculoskeletal be 8–10 core faculty and at least 13 community teachers.

(MSK), gynecology, palliative care, counseling, and minor procedures. Residents work closely with Family HRH’s program is uniquely supported by hospital and foundaHealth Team (FHT) and Family Health Organization (FHO) tion funding. It plays a central role in revitalizing primary care teams for complex patient management. access in northwest Toronto. Graduates are encouraged to f Resident wellness is prioritized through individualized remain locally connected through team-based practice. support, social activities, smaller cohorts, and an annual resident retreat. Feedback reflects high satisfaction CURRICULAR AND SITE INNOVATIONS: among learners.

The Schulich FMTU has a social accountability mandate built into its core mission from its inception, which manifests ASSESSMENT AND EVALUATION primarily through strict inclusion criteria: exclusively ac- The Teachers and Competence Committee meets regularly cepting unattached patients from the local community and to assess resident progress. Evaluations integrate feedback the most equity deserving geographies in Toronto. The vast from multiple teachers and healthcare providers to ensure a majority of patients are internally referred from within the comprehensive, balanced assessment. hospital, through the Emergency Department, Mother and Baby Program, and Internal Medicine Division. Patients are UNDERGRADUATE EDUCATION: also accepted from retiring family physicians and Health- HRH participates in the U of T Medical Clerkship Program care Connect.

(Year 3), with the goal of hosting 10–12 clerks annually. A dedicated Undergraduate Lead coordinates with the central The Humber River Health (HRH) Family Medicine Resi- program to ensure requirements are met. dency Program demonstrates exceptional commitment to learning and community care, supported entirely by hos- FACULTY DEVELOPMENT AND RECOGNITION: pital and foundation funding. Its mission aligns with HRH’s f Faculty development includes monthly meetings, local strategic goal to revitalize comprehensive primary care in events, and one to two major sessions annually. underserved areas of Toronto. The program features strong f Activities are informed by monthly and yearly faculty assessment and evaluation processes, a collaborative apneeds assessments, survey data (CQI Survey), and proach to Quality and Innovation projects—many of which resident feedback. As well, they work closely with the have been adopted by the hospital—and a dynamic mix of Postgraduate Director to develop and arrange local experienced clinician-educators and developing community Faculty Development events that address teaching faculty that together ensure high academic quality. Resident needs. Support is also provided for faculty applying for wellness is a central focus, supported through individualjunior and senior promotion. ized mentorship, retreats, and social engagement, fostering f HRH partners with a private event promotions organization a nurturing and high-performing learning environment. to deliver hybrid Continuing Medical Education (CME) programs. Twice-monthly grand rounds and Clinical Day POSTGRADUATE EDUCATION events attract hundreds of participants, with thousands f The HRH Family Medicine Residency Program began attending the multi-day Primed Conference. in May 2023, accepting its first 4 residents in July 2023.

The program expanded to 11 residents in 2024 and 17 QUALITY AND INNOVATION: residents in 2025. By 2026, it will train 18 residents (9 f The program follows the DFCM longitudinal Quality PGY-1, 9 PGY-2). Training occurs at the Schulich Family Improvement curriculum. The curriculum is mandatory Medicine Teaching Unit (FMTU) at the HRH Wilson site. for first-year residents. Residents complete a Quality f HRH hosts a horizontal Family Medicine residency Improvement (QI) project in PGY1 and a research program, the only postgraduate program at the hospital. project in PGY2 with a site faculty member serving as Residents receive priority for all learning opportunities. their research project supervisor.

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f Quality Improvement (QI) Lead and Research Lead (who is also the Primary Care and Health Populations Research Chair at HRH), mentor residents in their QI research projects. f Residents participate in Quality Improvement (QI) bootcamps and fests, aligning many projects with hospital initiatives. Primary Care and Health Populations Research Chair at HRH (supported by a research assistant).

RESEARCH AND SCHOLARLY ACTIVITY: f Between 2023-2025, faculty demonstrated robust academic engagement through peer-reviewed publications, active research, and extensive scholarly dissemination at local, national, and international levels. f Key themes included medical education, faculty development, learner assessment, quality improvement, and clinician wellness—reflecting a strong culture of scholarship and collaboration across teaching and research domains. f HRH engages in multiple scholarly activities, including resident research and faculty mentorship. Resident projects are presented annually at Research Day. SCHOLARLY ACTIVITY SUMMARY (2023–2025) PUBLICATIONS: f Mand et al., 2023 — “Identifying the exceptional learner in medical education: A doing vs. being framework.”

Medical Teacher. f Belluzzo et al., 2024 — “Barriers and facilitators for community-based family physicians to act as undergraduate medical supervisors in the postpandemic context.” Supported by the University of Toronto’s Art of the Possible Grant (project in progress).

Local Presentations and Workshops: f Schulich FMTU Faculty Development Rounds (2023– 2024): Series of teaching-focused presentations on effective instruction, feedback, professionalism, and managing learners in difficulty (Drs. Sood, Mand, Gill, Belluzzo). f Queen’s Office of Physician Education (2023): “Building a Teaching Dossier” (Dr. Sood). f University of Toronto DFCM Conferences (2023–2024): Z “The Exceptional Learner” (2023, Dr. Mand) Z “Navigating Your Career Path” (2024, Dr. Mand) Z “Peers for Joy at Work” (2024, Dr. Gill) f Grand Rounds & Faculty Development (2024): “The Exceptional Learner in Medical Education” presented at Humber River Health and Scarborough Health Network (Dr. Mand). f UofT DFCM Basics Program (2023–2024): Workshops on “Challenging Teaching Sessions” and “Faculty 162

Wellness” (Drs. Mand and Gill). f Peer Coaching for Joy in Work (2024): Collaborative research with UofT DFCM and Women’s College Hospital, supported by the OMA (Dr. Gill).

National and International Presentations: f International Congress on Academic Medicine (2023– 2024): Z “Essence of Education Scholarship: Creating an Introductory Course for Healthcare Providers” (Drs. Mand, Gill).

Z “Development and Implementation of an InterDisciplinary Faculty Development Program for a New FMTU” (Dr. Sood, poster). f Society of Teachers in Family Medicine (2023–2024): Z “University of Toronto DFCM CQI Program” (2023, Dr. Mand).

Z “Faculty Development for a New FMTU” (2024, poster, Dr. Mand). f STFM Spring Conference (2024): “Tips and Tricks for Teaching the High Performing Learner” (Dr. Mand). f Family Medicine Forum (2024): “Developing and Evaluating a Postgraduate Education CQI Program” (Dr. Mand). f Telfer Health Executive Quality Improvement (QI) and Patient Safety Program (2024): “Complex Adaptive Systems and Processes: A Practical Guide” (Dr. Colin Wilson).

NORTH YORK GENERAL HOSPITAL (NYGH) SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Credentialed Members: 299 f Faculty Members: 165 f Core Family Medicine Clerks: 24 f Family Medicine Residents: 30 f Executive Committee Members: Z DFCM Chief: Dr. Dani Manis Z EDISAN Lead: Dr. Allanah Li Z Wellness Leads: Drs. Amy Chan & Sara Pardisnia Z Long Term Care (LTC) Lead: Dr. Ann Li Z Continuing Medical Education (CME) Lead: Dr. Dahlia Balaban Z Undergrad Program Director: Dr. David Silver Z Palliative Care Education Lead: Dr. Desmond Leung Z Family Medicine Obstetrics Lead: Dr. Eva Knifed Z Quality Improvement (QI) Leads: Drs. Nathalie Gans, Michael Taglione & Jen Stulberg Z Faculty Development Lead: Dr. Jordana Sacks Z Research Lead: Dr. Karen Tu Z Family Medicine Teaching Unit (FMTU) Lead: Dr. Katie Ker

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Postgraduate Program Director: Dr. Kim Lazare North York Family Health Team (NYFHT) Medical Director: Dr. Lara Rosenberg Z Deputy Chief: Dr. Rebecca Cohen Z Primary Care Network (PCN) Co-Chairs: Drs. Maria Muraca & Rebecca Stoller Z Co-Chief Residents: Drs. Sauliha Alli & Mohamed Ghassan Alwafai Z Operations: Committee meets monthly; first inperson event hosted with leadership training, divisional reports, and wellness activities. Feedback was positive.

Z Z

SITE DESCRIPTION North York General Hospital is a popular training site for University of Toronto family medicine residents and MD students. It is a suburban community hospital in northern Metro Toronto with departments in all major fields of medicine: family medicine, internal medicine, geriatrics, surgery, obstetrics and gynecology, emergency, medical imaging, paediatrics, genetics and psychiatry. The hospital has approximately 80,000 emergency visits and over 7,000 obstetrical deliveries a year.

UNDEGRADUATE EDUCATION NYGH serves as a community-based teaching site for the DFCM, offering students a diverse and comprehensive family medicine experience. Learners are primarily placed in community offices within the hospital’s catchment area, supervised by two to three main preceptors, with additional exposure to the Family Medicine Teaching Unit. The program emphasizes variety and flexibility, matching students with preceptors aligned to their career interests whenever possible. Mandatory experiences include time in the Breast Diagnostic Centre, Diabetes Education Program, and palliative care home visits, complemented by a wide range of electives such as surgical assisting, sports medicine, breastfeeding clinics, and homeless shelter care. This structure ensures students gain insight into the breadth of family medicine while engaging with outstanding community physicians.

POSTGRADUATE EDUCATION NYGH is a key teaching site within the DFCM, offering a robust postgraduate residency program. The program hosts residents who follow a block rotation curriculum, providing structured exposure to diverse clinical settings. Residents benefit from elective opportunities—one month in the first year and three months in the second year—allowing them to tailor their learning to specific interests. As a community academic hospital, NYGH combines high-quality patient care with comprehensive training, preparing residents to excel in family medicine across varied practice environments.

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QUALITY IMPROVEMENT (QI) f Three QI leads are involved in resident curriculum and QI initiatives with Ontario Health Team/Family Health Team and NYGH f Leads: Drs. Nathalie Gans, Jennifer Stulberg, Mike Taglione.

RESEARCH AND SCHOLARLY ACTIVITIES f NYGH Cheesbrough Chair search is complete; faculty appointment being finalized before announcing widely. f Departmental research lead Dr. Karen Tu will bring prominent high-level primary care research to NYGH and foster and mentor department members in research. f Past Cheesbrough Chair, Dr. Michelle Griever, is volunteering for mentorship to support the department.

SYSTEMS INNOVATION f Ontario Health Team (OHT): Active participation with North York Toronto Health Partners and the Primary Care Network, led by Drs. Maria Muraca and Rebecca Stoller. f Primary Care Action Team (PCAT): Three proposals submitted, with two successfully funded. f New Family Health Team: Funding secured for the Get Well Family Health Team in North York. f Strong collaborations: with community partners, including the foundation, corporate donors, Community Health Centres, and Family Health Teams (FHT). f Many successful programs have been launched and are running to facilitate patient attachment and streamline chronic disease care: Z Chronic Disease Management (CDM) HUB Z North York Community Care Clinic (NYCCC) Z ACCESS CLINIC

SCARBOROUGH HEALTH NETWORK SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Chief: Dr. Avnish Mehta f Postgraduate Site Director: Dr. Jennifer McDonald – 29 residents f Undergraduate Site Director: Dr. Karthika Sithamparanathan – 22 clerks f Faculty/Professional Development Lead: Dr. Donna Vlahos f Quality Improvement (QI) Leads: Drs. Susanna Fung & Preeni Rathuge f Research/Academic Project Leads: Drs. Rosemarie Lall (Director of Family Medicine Research) & Nisha Ravichanidran (Director of Family Medicine Resident Research Projects) f Wellness Advisor: Dr. Janice Weiss 2020–2025 Self-Study Report

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SITE DESCRIPTION f Scarborough Health Network (SHN) is one of Canada’s largest urban community hospitals. It delivers innovative, high-quality patient care and advocates for our community’s health and wellness. f Location: Scarborough, east of Toronto (~600,000 population), highly ethnically diverse, including a large immigrant population f Hospital Network: Scarborough Health Network (SHN) – three hospitals (General, Birchmount, Centenary) serving ~1 million people f Teaching Program Mission: Inspire excellence in education, research, and leadership in family medicine within a diverse community f Mission: Improving lives through exceptional care. We believe in providing exceptional care to help patients and families achieve their best quality of life. f Values: Compassionate, inclusive, innovative, courageous

residents at SHN, family medicine residents gain extensive hands-on experience and play a vital role in patient care.

UNDERGRADUATE EDUCATION At SHN, the Clerkship Program includes 6 rotations of 6 weeks each, with 2–4 clerks per rotation. Clerks work with community-based family medicine preceptors in Scarborough, North York, and Markham, gaining exposure to a wide range of medical problems in family practice. The program is designed to build confidence, independence, and problem-solving skills.

Family medicine residents are encouraged to teach in the undergraduate program, leading seminars on topics such as domestic violence, motivational interviewing, and chronic disease management. Some residents also teach clerks during rotations and contribute to the formal curriculum.

FACULTY DEVELOPMENT AND RECOGNITION: f Annual needs assessment survey and discussions with CURRICULAR AND SITE INNOVATIONS: the Site Chief and Site Director determine topics for f SHN’s site strength is its community Family Medicine quarterly Professional Development Days. preceptors, who have varied and diverse “real-life” f Past topics include: community practices.

Z Managing residents in difficulty f SHN also has a 1:1 teacher: learner ratio, with Z Continuity in family medicine clinics dedicated Family Medicine and specialist preceptors.

Z Competency review f SHN prides itself in its flexibility to meet resident Z Applying improv techniques to medical education learning needs. We are focused on the residents’ f Biannual site visits with the Faculty Development Lead learning and career goals and have a dedicated provide opportunities for feedback and priority setting.

Academic Advisor/Wellness Advisor to support this. f Faculty development is supported through DFCM central f Residents also have the opportunity to work in both a rural programs, coordinated by the Faculty Development Lead. and urban environment with a diverse, global community f All new teachers complete the BASICS course within including a large new immigrant and refugee population, their first 2 years of teaching. allowing residents to have Health Advocacy roles.

QUALITY AND INNOVATION POSTGRADUATE EDUCATION f Comprehensive longitudinal Quality Improvement (QI) The family medicine residency program at Scarborough curriculum with mandatory practicum for first-year Health Network is learner-centered, offering both urban and residents. rural preceptor experiences with a strong focus on hands- f Our Faculty Q&I Group promotes practice-based on, community-based training. Each resident is matched Q&I activities, including our projects of increasing with a family medicine preceptor based on a pre-matching the achievement of targets in patients with diabetes, survey and participates in mini-practices to ensure continuincreasing screening for poverty in clinics, and ity of care. Residents also have the option for a rural rotation improving processes surrounding the provision of care in Bowmanville, which includes inpatient care, ER shifts, post-discharge from the hospital. nursing home visits, palliative care, and home visits. Spe- f Focus on patient-centered, relationship-centered care cialty rotations occur across SHN’s three hospitals—Genthrough the Simulated Office Oral (SOO) program, eral, Birchmount, and Centenary—where residents work which also prepares residents for the College of Family closely with specialist preceptors in diverse settings such Physicians of Canada (CFPC) Exam. as clinics, hospital wards, and emergency consults. Core ro- f The Health Equity curriculum addresses Social tations include Internal Medicine, Paediatrics, Family MediDeterminants of Health (SDOH), including Stand Up cine, Geriatrics, MSK, Obstetrics/Gynecology, Emergency, for Health workshops, and encourages residents to Palliative Care, and Psychiatry. With few other specialty experience the role of Health Advocate.

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f NEW 2024: HEALS rotation – Health Equity, Advocacy, Leadership, Social interventions residents and preceptors have the opportunity to focus on the social determinants of health that affect their patients and develop the knowledge, skills, and attitudes to meet the diverse needs of their current and future patient population.

geriatrics. Serving a highly diverse population from across the Greater Toronto Area, MSH and its Vaughan site care for patients from varied ethno-cultural backgrounds and all age groups. The Mount Sinai Academic Family Health Team (MSAFHT) provides comprehensive, team-based primary care to approximately 20,000 patients across both sites, supported by an interdisciplinary team that includes social RESEARCH AND SCHOLARLY ACTIVITIES: workers, nurses, midwives, a pharmacist, and specialists in Faculty research and scholarly activity are strong both in geriatrics and psychiatry. With accessible online booking clinical and educational research. The program produces and a strong commitment to research and scholarly intewell-regarded national and international scholarly activities gration, the program exemplifies innovation, inclusivity, and academic excellence in patient care.

Inspired by the culturally diverse population they serve, common themes of primary care-oriented research at SHN CURRICULAR AND SITE INNOVATIONS: include health equity, access to healthcare, and systems in- f Strong leadership and faculty with hospital, university, tegration. Our researchers are also examining the emerging and professional organizational roles. role of artificial intelligence in improving the quality and effi- f Innovation in program initiatives: Wellness Curriculum, ciency of primary care.

Ethics Curriculum, Family Medicine Longitudinal Survey, Triple C Curriculum SHN Scholarly Activity (2020 onwards): f Emphasis on professional identity, teaching excellence, f Grants: 10 PI/co-PI grants, 6 peer-reviewed, 4 non-peerand integrated care reviewed, 12 co-investigators f Publications: 51 peer-reviewed, 4 non-peer-reviewed POSTGRADUATE EDUCATION f Research Focus: Health equity, access to care, systems f Horizontal model: highly centered in family medicine, as integration, AI in primary care many of the off-service rotation preceptors are family f Research Leadership: Drs. Rosemarie Lall (Academic) & physicians, including teachers in Emergency Medicine, Nisha Ravichanidran (Community) Family Medicine, Obstetrics, Sports Medicine, and Palliative Care.

SINAI HEALTH f Residents inherit and manage a patient practice from a graduating resident, developing professional identity SITE LEADERSHIP AND OVERVIEW and continuity of care as well as patient-physician (NUMBERS ARE PER YEAR) relationships. f Residents: 13 PGY1, 12 PGY2, 1 PGY3 f Strong inter-professional collaboration and mentorship. f Clerks: 19 f Faculty provide comprehensive care and focused care f Chief: Dr. Erin Bearss in areas such as perinatal care, hospitalist medicine, f Postgraduate Site Director: Dr. Natalie Morson emergency, home visits, and women’s health. f Undergraduate Site Director: Dr. Yasna Mehdian f Strong primary maternity care program—residents get f Faculty/Professional Development Lead: Dr. Anita Greig an excellent primary care maternity experience in a f Quality Improvement (QI) Lead: Dr. Sakina Walji well-supported environment. f Research/Academic Project Leads: Drs. Milena Forte f Dedicated education team supporting continuous (Research Director), Dr. Bojana Petrovic (Project program improvement—in addition to the Site Director, Manager) and Dr. Sakina Walji (RAP) there is an Education Lead, Maternity Care Education f Wellness Leads: Drs. Natalie Morson & Erin Bearss Lead, Mental Health Education Lead, and a Resident f Education Director: Dr. Daniela Keren Academic Project Lead who has significant time f Maternity Care Education Lead: Dr. Sabrina Kolker dedicated to the residency program and its continuous f Mental Health Education Lead: Dr. Kristina Powles improvement.

SITE DESCRIPTION UNDERGRADUATE EDUCATION Mount Sinai Hospital (MSH) in downtown Toronto is a lead- f Faculty members are extensively involved in preing 442-bed academic health sciences centre recognized clerkship teaching, including Integrated Clinical for excellence in women’s and infants’ health, chronic disExperience, Case Based Learning, Health in ease management, oncology, emergency medicine, and Communities, and Portfolio.

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f Expanded longitudinal clerkship continuity so clerks are paired with the same preceptors during their rotation and “half-day back” sessions for near-peer teaching between residents and clerks. f Elective opportunities are now available at Mount Sinai.

FACULTY DEVELOPMENT AND RECOGNITION f Needs assessed via informal dialogue between the Faculty Development Lead and the academic team. f Community-based Department members’ faculty development needs are assessed by a needs assessment, focus groups, and ongoing email dialogue. f Opportunities are communicated via quarterly Professional Development newsletter, in addition to inperson discussions. f Group Faculty Development occurs quarterly through an evening of Professors Rounds held as an informal social event at a fellow colleague’s home whereby new and innovative Faculty Development concepts and themes are presented for dialogue.

QUALITY AND INNOVATION f Through the Family History Quality Improvement Initiative, clinicians reported that collecting family history information was particularly valuable for physicians, especially for new patients. This information is now being integrated into the rostering process for new patients. f Our residents contributed to multiple quality improvement projects, including establishing criteria for virtual appointments, streamlining urgent care bookings, improving follow-up for gestational diabetes, and standardizing resident documentation tools to support clinical care. f In response to safety report data, the Family Health Team collaborated with the Emergency Procedures and Acute Resuscitation Committees to develop a new Sinai Health Medical Emergency Response Policy, conducted team mock scenarios, and provided hands-on AED and oxygen training for all PGY1 and PGY2 residents. f Significant work continues in standardizing our electronic medical record (PSS) to reduce administrative burden and streamline care. Additionally, in response to ongoing vaccine safety concerns, nurses developed a new resident curriculum focused on hands-on immunization training, aiming to decrease incidents and improve patient safety. f Select Innovative Programs: Z Wellness Curriculum includes: HeArt Day for sharing and discussing artistic pieces, Medical Storytelling Rounds for fostering conversations, Resident Retreat for team building 166

Group Perinatal Care: resident-facilitated group sessions for providing prenatal care and education to patients Z Home-Based Interdisciplinary Primary Care for Seniors (HIPS) Program: home-based care for seniors, resident involvement in tracking patient progress during their residency, and work with the HIPS team on their Geriatrics rotation.

Z

RESEARCH AND SCHOLARLY ACTIVITIES: f The Research Program is dedicated to advancing excellence in primary healthcare practice and education through scholarship, quality improvement, and research. f Focus: maternal/newborn care, education scholarship, primary care genomics, contemporary family medicine. f Residents engaged in faculty-led or led their own independent research projects with faculty mentorship. f Expanded research team: Dr. Milena Forte (Director), Dr. Bojana Petrovic (Project Manager)—with the goal of growing the program.

SUNNYBROOK HEALTH SCIENCES CENTRE (SHSC) SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Learners: 27 residents f Faculty Development Lead: Dr. Rahul Jain f Postgraduate Site Directors: Dr. Purti Papneja & Dr. Mira Shuman f Chief: Dr. Karen Fleming SITE DESCRIPTION f Founded in 1967, one of the first academic family medicine departments in Canada and the University of Toronto. f Sunnybrook Academic Family Health Team (SAFHT) serves ~11,500 patients. f Strong primary care focus, with six divisions: Family Practice Unit, Palliative Care, Long-Term Care, Family Medicine Obstetrics, St. John’s Rehab Hospitalists, and Holland Bone & Joint Program Hospitalists.

CURRICULAR AND SITE INNOVATIONS: Learners can participate in unique programs such as: f Family Medicine Obstetrics: Comprehensive resident involvement through pregnancy to postpartum in a softcall model. f Procedures Clinic: Hands-on resident experience in minor procedures (CONNECT Clinic). f Bridging Care Clinic: Supports unattached patients discharged from the Emergency Department.

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f Vibrant Community Health integration: An additional teaching site and with administrative support off the Sunnybrook main capus. f RAAM Clinic: Rapid Access Addiction Medicine services. f EDI/Planetary Health: Equity, diversity, inclusion, social accountability, and environmental health initiatives. f Neighbourhood Care Team / Homebound Care: Integrated care for seniors in Toronto Housing Corporation buildings.

POSTGRADUATE EDUCATION: f Family Medicine residency emphasizes academic excellence, clinical reasoning, and holistic training. f Key initiatives: Z San Yas Training: a mandatory online module that ensures residents learn to provide culturally appropriate care to Indigenous peoples.

Z Virtual Care Competency Training Roadmap (ViCCTR): online modules that teach virtual care skills and clinical reasoning.

Z Ethics Curriculum: Case-based learning using the IDEA framework focusing on consent, capacity, medical errors, and end-of-life care taught by family medicine faculty, senior home-based program nurse, or ethicist. f Social accountability is cultivated in residents with their participation in: home-based primary care, allowing for collaboration with community partners, providing care under supervision to residents in the Toronto Housing collaboration buildings, working with Rapid Access Addiction Medicine (RAAM) clinics and shared care clinics to support patients, the Tory Trauma Program, and the Bob Rumball Center to support diverse patient needs. f Resident wellness initiatives: include dedicated social and wellness representatives to organize wellness activities and advocate for residents, virtual academic half-days, protected admin time, annual cottage retreats, wellness stipends to be used for wellness-based activities, and recognition for resident contributions to the department.

UNDERGRADUATE EDUCATION: f Core clinical rotations for 15–20 clerks per year. f Clerkship integrates inter-professional healthcare educators (nurses, dietitians, diabetes team), palliative care, RAAM clinic, and community-based experiences. f Faculty pre-clerkship teaching contributions include Toronto Patient-Centered Curriculum (TOPIC), Integrated Clinical Experience (ICE), Portfolio, Health Science Research, as well as clerkship courses such Sites and Divisions | Sites

as Transition to Clerkship, Electives, and Transition to Residency.

FACULTY DEVELOPMENT AND RECOGNITION: f Support for faculty as teachers, researchers, administrators, and leaders. f Programs for faculty development include Grand Rounds, DFCM Basics for New Faculty, DFCM Conferences, and Mentorship Network Committees. f For new faculty: co-developed Professional Development Plans, the “Your Academic Neighbourhood” orientation resource, and mentorship opportunities. f Numerous awards, promotions, and scholarly grants are celebrated at Sunnybrook, recognizing leadership and research excellence. f Focus on opportunities for faculty to develop academic identity, leadership, and scholarly productivity.

QUALITY & INNOVATION: f Quality Improvement Program (QIP) is submitted annually to Ontario Health and has included projects on diabetes care, sedative deprescribing, equity initiatives, environmentally sustainable care, and patient safety, with many of these projects leading to the development of tools and resources. f The Patient and Family Advisory Committee (PFAC) is involved in QI projects and sustainability initiatives, allowing patient voices to be amplified and considered in decision-making processes. f Resident Quality Improvement (QI) curriculum includes multiple modules and didactic sessions with 5-6 annual projects that foster inter-professional engagement amongst members of the family health team, including nurses, pharmacists, office coordinators, and diabetes educators. f Patient safety initiatives include “Doing it Better” (DIB) rounds with systematic evaluations to identify and rectify potential system issues. Topics include medication errors, vaccine errors, and delayed diagnoses. f Post-pandemic catch-up programs are offered for cancer screening and vaccines. f Ongoing patient experience surveys guide service improvement (e.g., phone access initiatives). f Division-specific Quality Improvement (QI) projects in palliative care, long-term care, St. John’s Rehab, and Holland Centre are currently working on addressing operational, clinical, and patient safety challenges. f Challenges: Limited access to shared Quality Improvement Data Support Specialist (QIDSS) and a lack of time for project leadership from faculty.

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f Opportunities: Greater dissemination of presentations, opportunities for residents to present their projects at conferences, and greater use of QIDSS to leverage cross-site QI expertise.

CURRICULAR AND SITE INNOVATIONS Innovative and Clinical Programs f Skills Training: Five-part procedural workshop series (Gynecology, Dermatology, Obstetrics, musculoskeletalMSK, Emergency).

RESEARCH AND SCHOLARLY ACTIVITIES f Simulation: Emergency Medicine Simulation Program, f Faculty and residents engage in research and academic held four times per year. scholarship locally, nationally, and internationally. f Teaching Development: “Teaching Residents to Teach” f In future years, we plan for residents to move their QI and Simulated Office Oral (SOO) Sessions. projects forward to a PGY2 research project or present f Interdisciplinary Care: Opportunities through South at a conference.

East Toronto Family Health Team (SETFHT) and other community programs

TORONTO EAST HOSPITAL NETWORKMICHAEL GARRON HOSPITAL

POSTGRADUATE EDUCATION Residents at Toronto East Hospital Network (TEHN)–MGH SITE LEADERSHIP AND OVERVIEW benefit from a community-focused, learner-centred environ(NUMBERS ARE PER YEAR) ment where education is prioritized, and training is supported f Chief: Dr. Catherine L. Yu by dedicated faculty and a wide range of clinical experiences. f Postgraduate Co-Directors: Dr. Rajani Vairavanathan & f Focus: Community-based, learner-centred education Dr. Adam Kaufman with dedicated faculty and personalized supervision f Undergraduate Director: Dr. Meera Shah (1:1 ratio), including 60+ full-time and part-time family f Site Education Leads: medicine teachers supported by specialists.

Z 840 Coxwell Ave. Site – Dr. Eleanor Colledge (13 f Training: Procedural skills workshops, simulation Family Physician Medical Doctors, 11 learners) sessions, hands-on training, including Advanced Z 1871 Danforth Ave. Site – Dr. Rachel Goldberg (12 Cardiac Life Support (ACLS) Program and Academic Family Physician Medical Doctors, 8 learners) Half Days. Also features Family Practice Half Day Z Flemingdon Community Health Centre (FHC) Site – Backs: Weekly sessions where residents manage their Dr. Denise Wong & Dr. Marina Aptekman (7 Family own patient panels at one of four community family Physician Medical Doctors, 7 learners) practice sites.

Z Health Access Thornclifee Park (HATP) Site – Dr. f Community Network: Includes Michael Garron Hospital Elaine Cheng (7 Family Physician Medical Doctors, (MGH), South East Toronto Family Health Team (Coxwell 2–4 learners) site & Danforth site), Flemingdon Community Health f Faculty/Professional Development Lead: Dr. Jackie Centre, Health Access Thorncliffe Park (HATP), and Bellaire Health Access Taylor Massey (HATM). f Quality Improvement Lead: Dr. Blaise Clarkson f Program Scale: 32+ residents trained annually; 450+ f Research/Academic Project Lead: Dr. Deanna Telner graduates, over half remaining within TEHN–MGH/DFCM. f Family Physician Obstetrics Lead: Dr. Stephanie Godard f Accreditation: Both South East Toronto Family Health Team (SETFHT) and Flemingdon Community Health SITE DESCRIPTION Centre hold full Accreditation Canada status. f Michael Garron Hospital (MGH) serves over 500,000 f Clinical Structure: Three 4-week Family Medicine people in East Toronto, one of Canada’s most diverse blocks in each of the first and second years, with a regions. continuity half-day during off-service rotations. f Hospital Stats: 529 beds, 651 physicians, 106,910 ER f Training Areas: Emergency, Obstetrics/Gynecology visits (+23% in 5 years), 2,603 OB deliveries annually, (Year 1 ward-based; Year 2 community).

23,026 inpatient stays annually. f Interdisciplinary Focus: Collaboration with allied health f Ken and Marilyn Thomson Patient Care Centre (2023): professionals such as psychiatric consultants, nurse 550,000 sq. ft., 215 inpatient beds, new outpatient clinics. practitioners, dietitians, chiropodists, and social care f New Carswell Family Centre for Medical Education providers.

(2023): new state-of-the-art hub featuring a large f Excellence: High learner satisfaction and top choice classroom, the Rands Family Simulation Centre, and among community teaching hospitals. Remains the #1 nine call rooms to support immersive training for future choice for Family Medicine training at a community physicians teaching hospital.

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f Base site for DFCM’s Integrated Communities Stream: PGY1 at MGH, PGY2 in rural settings. f Faculty Recognition: Multiple teaching and emergency medicine awards received by faculty.

UNDERGRADUATE EDUCATION f Capacity: 18 medical students annually across seven community sites. f Learning Model: Distributed, community-embedded education in equity-deserving settings serving patients with diverse health and social care needs. f Training includes clerkship selectives/electives in Emergency Medicine, Palliative Care, Family Practice, Obstetrics, and Seniors’ Outreach Clinics. f Sites: Flemingdon Community Health Centre, HATP, SETFHT (Coxwell/Danforth), Magenta Health, Albany Medical Clinic, VIVO Family Medicine.

f Green, Deering, Ng, Lee (2024): Collaborative publication on family practice treatment approaches to heat-related illness. f Lies, Kelly & Vairavanathan (2024): Collaborative publication on how simulation training improves resident physicians’ confidence in managing firsttrimester bleeding in the emergency department f Lies, Kelly & Vairavanathan (2024): Collaborative case report on post-partum headache presenting to the emergency department ART OF THE POSSIBLE EDUCATION GRANTS Faculty recipients include Drs. Bellaire, Lockyer, Lee, and Telner for education and research initiatives.

LOOKING FORWARD f Priorities: Strengthen family medicine program infrastructure, expand interprofessional teams, and FACULTY DEVELOPMENT AND RECOGNITION develop leadership capacity. f Regular needs assessments are conducted at each site by f Ensure that TEHN remains a leading site for communitythe Chief, Site Director, and Faculty Development Leads. based family medicine education. f Annual half-day Faculty Development Sessions and f Initiatives: Launch of Primary Care Access Clinic and Education Grand Rounds have been hosted since 2020. mentorship for future system leaders to sustain growth. f Priorities: Academic promotion, mentorship, foundational training (expectation to complete BASICs TRILLIUM HEALTH PARTNERS – CREDIT VALLEY program within 3 years of appointment), and workshops. f Upcoming initiatives: Local mentorship for faculty, SITE LEADERSHIP AND OVERVIEW annual professional development program reviews, (NUMBERS ARE PER YEAR) and an annual needs assessment to guide biannual inf Residents: 21 person workshops. f Clerks: 30 f Site Director: Dr. Nina Yashpal, (previously Dr. Kimberly PARTNERSHIPS AND COLLABORATIONS Kent 2022-2025, and Dr. Melissa Graham) f Partnerships: New collaborations with Toronto f Quality Improvement (QI) Lead: Dr. Ali Damji Metropolitan University (TMU) School of Medicine and f Family Health Teaching Unit (FMTU) Faculty Members: 16 UTSC Scarborough Academy. f Expansion: First postgraduate learners welcomed at SITE DESCRIPTION Health Access Thorncliffe Park (HATP) in 2025.

Credit Valley Hospital, part of Trillium Health Partners, is a major community-based acute care facility in. It offers a full RESEARCH AND SCHOLARLY ACTIVITY range of primary and secondary care services, with regionf Resident Projects: All PGY2 residents complete a al programs in renal, maternal-child, oncology, and clinical Research/Academic Project and present their poster at genetics. The hospital has 442 beds, a 30,000 sq. ft. ambuResearch Day. latory care centre, and handles hundreds of thousands of f Quality Improvement (QI) Projects: Team-based emergency visits annually. As one of three sites under Trilpracticum with poster presentations. Practicum lium Health Partners, it serves Mississauga’s diverse popuintegrates online learning, project design, and lation and provides comprehensive care from prenatal to implementation, concluding with a poster presentation geriatric stages, supported by interprofessional teams and reviewed by the QI education lead. robust teaching facilities for undergraduate and postgraduate learners.

PUBLICATIONS f Blom, Lee & Tai (2021): Collaborative publication CURRICULAR AND SITE INNOVATIONS: highlighting innovations in family medicine education f Introduced and expanded horizontal learning and interdisciplinary training. experiences in dermatology, adult and adolescent Sites and Divisions | Sites

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psychiatry, procedures, prenatal/women’s care, and palliative care clinics. f Integrated family medicine across hospital rotations (hospitalist medicine, palliative, emergency, obstetrics). f Developed the Newborn Assessment Team, improving early newborn care and connecting families to primary care—recipient of multiple awards and featured on Global News. f Piloted Home Visits and Long-Term Care (LTC) electives under Dr. Nina Yashpal and Dr. Sahra Gedleh, supported by an Art of the Possible grant and recognized for innovation. f Enhanced Palliative and Home-Based Care for patients diagnosed with malignant and nonmalignant conditions, as well as advanced neurologic diseases. This care allows for longitudinal learning, interprofessional collaboration and has been presented at provincial forums. f Strengthened bilingual care services for underserved French-speaking and newcomer populations. f Launched a Foundations Block for PGY1s to orient new residents to the family medicine teaching unit, emphasizing interprofessional collaboration and Electronic Medical Records (EMR) optimization and collaboration with a large range of interprofessional healthcare providers.

sional collaboration, leveraging the hospital’s regional programs in renal care, oncology, and maternal-child health.

Residents participate in structured learning activities such as academic half-days, case-based teaching, and procedural skills workshops, while mentorship and tailored electives allow customization based on career goals. This approach ensures graduates are well-prepared for comprehensive family practice in both urban and suburban settings.

FACULTY DEVELOPMENT AND RECOGNITION: f Significant faculty growth and recruitment of new leaders: Z Dr. Deema Couchman – Obstetrics and Gynecology teaching Z Dr. Ali Damji – Quality Improvement (QI) lead, former Primary Care Division Head Z Dr. Sahra Gedleh – Clerkship Site Director, Long Term Care (LTC) curriculum innovator and award recipient Z Dr. Karina Prucnal – Associate Program Director, DFCM 50th Anniversary Award recipient Z Dr. Melissa Graham – Program Director, Academic Fellowship Program, Postgraduate leadership award recipient Z Dr. Sandra Totounji – Academic Half Day Lead and bilingual physician Z Dr. James Pencharz – Ontario Health Team (OHT) Primary Care Lead, Regional Family Physician of the Year (2020) f Faculty actively engaged in leadership and professional development. e.g., New and Evolving Academic Leaders (NEAL) Program and Leadership Masterclass. f Appointment of Program Consultant Carleene Burrell, improving scheduling, communication, and faculty onboarding. f Site leadership evolved from Dr. Melissa Graham to Dr. Nina Yashpal (current Site Director). f Creation of an Executive Leadership Committee to align academic, hospital, and departmental goals.

UNDERGRADUATE EDUCATION The Credit Valley Hospital site offers medical clerks handson experience through the Family Medicine Teaching Unit (FMTU) and community practices near the hospital. Clerks rotate through two to three practices serving diverse patient populations and work closely with family medicine residents. Unique features include video cameras for observation and feedback, and a bilingual Family Health Team site for French-speaking clerks. Mandatory experiences include participation in a COPD clinic, a half-day in palliative care, and a prenatal clinic. While there are no formal on-call requirements, clerks may join preceptors for hospital duties, obstetrical deliveries, or home visits. The program emphasizes flexibility, encouraging clerks to share their interests PARTNERSHIPS AND COLLABORATIONS: so tailored learning opportunities can be arranged. f Strong collaboration with hospital specialists and Trillium Health Partners committees, especially within POSTGRADUATE EDUCATION geriatrics, palliative care, hospitalist and emergency The postgraduate curriculum at Credit Valley Hospital emmedicine. phasizes comprehensive family medicine training through f Increased cross-site collaboration with the Summerville a mix of hospital-based and community experiences.

Family Medicine Teaching Unit (FMTU) in psychiatry, Residents rotate through the FMTU and affiliated practices, addictions, and research. gaining exposure to diverse patient populations and a wide f Active participation in DFCM and Trillium governance scope of care, including obstetrics, geriatrics, chronic disbodies. ease management, and palliative care. The curriculum integrates ambulatory care, inpatient medicine, and interprofes170

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LOOKING AHEAD: f Planning for rotation redesign and primary care reform to improve patient attachment and system integration. f Future planning for a Women’s and Children’s Hospital at Credit Valley is underway, with leadership input into rotation redesign and curriculum development. f The residency program is set to play a role in primary care reform and attachment of patients in the community at large who have no access to a family physician.

The Family Medicine Teaching Unit (FMTU) aims to: f Continue aligning education with primary care system reforms f Sustain quality improvement through data and feedback f Expand community partnerships and innovative care models f Maintain its leadership role in family medicine education and community health f Our vision is to remain at the forefront of Family Medicine training, contributing to the health and wellbeing of our Mississauga community and beyond.

TRILLIUM HEALTH PARTNERS – MISSISSAUGA SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Residents: 20 residents (21 as of January 2026) f Clerks: 30 clerks f Family Medicine Teaching Unit Faculty: 12 f Faculty at the Summerville Family Health Team: 17 f Interim Chief: Dr. Abhishek Narayan f Interim Academic Lead Family Medicine Teaching Unit: Dr. Bachir Tazkarji f Postgraduate Program Director: Dr. Lina Al-Imari f Undergraduate Program Director: Dr. Evangeline Seganathy f Faculty Development Lead: Dr. Ammar Bookwala f Quality Improvement Program Director: Dr. Rosy Zafar f Physician Research Lead: Dr. Farhan Asrar f Academic Half Day Coordinator: Dr. Anu Joneja SITE DESCRIPTION Trillium Health Partners - Mississauga Hospital is situated in the heart of the city’s south end. Mississauga is the sixth largest city in Canada and is one of the most culturally diverse cities in the nation. The Family Medicine Teaching Unit (FMTU) at Mississauga Hospital is one of a five-site group called Summerville Family Health Team. f Located in one of Canada’s most diverse and fastgrowing regions, Mississauga Hospital serves a population exceeding 1.2 million with significant cultural and linguistic diversity.

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f The Mississauga Hospital site alone provides 827 acute, rehabilitation, and chronic care beds and houses a 24-hour Emergency Care Centre, which sees 96,000 ER visits annually. f The hospital offers regional programs in advanced cardiac surgery, geriatric mental health services, hepato-pancreato-biliary services, neurosurgery, palliative care, primary percutaneous coronary intervention, sexual assault and domestic violence, specialized geriatric services, stroke, and vascular services. f Home of the Colonel Harland Sanders Family Care Centre, Canada’s first hospital-based comprehensive women’s and children’s services hub. f One of the largest birthing centres in the region. f Provides rural residents the opportunity to teach and mentor the clerks.

CURRICULAR AND SITE INNOVATIONS: f Mississauga Hospital offers an exceptionally supportive and well-structured administrative environment. The Curriculum Committee integrates resident feedback into program design and assessment, ensuring continuous quality improvement. f Home Visits Program: Each resident is assigned two homebound patients at the start of residency and follows them throughout training. f Home Palliative Program: Runs in parallel with the home visits program, enhancing continuity of care for patients who become palliative. f Integrated Specialty Clinics: Memory and cognitive disorders clinic, COPD clinic, diabetes clinic, and psychiatry shared care clinic delivered within the teaching unit.

POSTGRADUATE EDUCATION f The Mississauga Hospital Family Medicine Residency follows a two-year horizontal curriculum emphasizing continuity of care. f Residents manage their own patient panels (~150 patients) throughout training, maintaining ongoing relationships while completing 8–12 specialty rotations annually. f The program integrates flexibility for personalized learning objectives and emphasizes real-world family practice experience. Specialty departments include emergency medicine, internal medicine, continuing care services, diagnostic imaging, neuro/MSK, obstetrics and gynecology, orthopedics, pediatrics, psychiatry, and surgery. f A new Heart House Hospice partnership will soon expand training in hospice and palliative care and provide access to long-term and hospice palliative care for the people of Mississauga.

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UNDERGRADUATE EDUCATION f The Mississauga Hospital provides a growing range of undergraduate teaching opportunities through collaboration with the Mississauga Academy of Medicine (MAM). f Residents and faculty teach medical students in Foundations, clerkship seminars, and formal undergraduate medical education curriculum, and mentor learners through the Transition to Residency Program and shared academic sessions. f The site fosters integration between undergraduate and postgraduate education through joint teaching, research events, and academic half-days.

QUALITY AND INNOVATION f THP’s Quality Improvement (QI) curriculum, part of the DFCM longitudinal program, trains first-year residents in practical QI methodologies and includes a mandatory practicum. f The Mississauga Hospital QI program, established in 2011, has produced numerous award-winning projects—most notably a 2024 DFCM Project Award for work on improving opioid documentation.

Residents collaborate with allied health professionals on interprofessional QI initiatives, contributing to both scholarly output and enhanced patient care.

Furthermore, our site is part of a larger family health team group, and the whole group has quality improvement metrics and a separate committee that enables our residents to collaborate with allied health professionals on several of their projects.

RESEARCH AND SCHOLARLY ACTIVITIES: Research at THP is actively supported, with faculty leading multiple evidence-based practice publications and grant-funded projects. Notable recent works by Dr. Bachir Tazkarji and collaborators have explored cannabis and selfharm, adolescent suicide screening, HIV prevention, and dementia caregiver education. Dr. Azza Eissa received a grant for developing digital tools to support advanced care planning with racialized communities.

PUBLICATIONS f Javeria Pervez & Bachir Tazkarji – What are the most effective screening tools for adolescents at risk of suicide?

Evidence-Based Practice, January 2024 f Mohamed Z. Atcha & Bachir Tazkarji – Is cannabis use associated with greater self-harm in patients with mood disorders?

Evidence-Based Practice, November 2023 f Tang H & Bachir Tazkarji – Is pre-exposure prophylaxis 172

effective and feasible for preventing HIV transmission in adolescent males?

Evidence-Based Practice, 2021; 24(12):33-34. doi:10.1097/ EBP.0000000000001397 f Andrew N. Rouble & Bachir Tazkarji – Is cannabidiol an effective treatment of anxiety in adults?

Evidence-Based Practice, June 2021 f Amy Reinhart & Bachir Tazkarji – In geriatric adults with newly diagnosed dementia, does psychoeducation for their caregivers decrease caregiver burden or result in clinical improvement in the patient’s dementia?

Evidence-Based Practice, June 2017 GRANTS f Approved Grant: Deliberative Dialogue to Co-design a Digital Technology to Facilitate Serious Illness Conversations and Advanced Care Planning with Racialized Populations in Primary Care – Dr. Azza Eissa f Art of Possible Grant: One since 2020

UNITY HEALTH TORONTO – ST. JOSEPH’S HEALTH CENTRE (SJHC) SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Learners and Faculty: f Residents: 24 f Clerks: 14 clerks annually f Faculty Development Lead: Dr. Judy Thompson f Quality & Innovation Program Director: Drs. Linda Weber f Quality & Innovation Education Coordinator: Dr. Anna Holland f Residency Research Coordinator: Dr. Alice Ordean f Chief, Department of Family Medicine: Dr. Daphne Williams f Postgraduate Site Director: Dr. Dana Newman f Undergraduate Site Directors: Drs. Sofia Khan & Kasy Soare f Faculty: ~70 DFCM faculty, 63 credentialed at SJHC (21 Academic Family Health Team (FHT), 42 communitybased) SITE DESCRIPTION f 426-bed community teaching hospital in West Toronto serving ~500,000 population. f Diverse patient population includes long-standing Polish, Ukrainian, Portuguese communities, newcomers, refugees, young families, and patients with mental health and addiction needs. f Academic Family Health Team (FHT) provides primary care to ~7,000 patients, 40% high-needs, staffed by an

Department of Family & Community Medicine, University of Toronto

interprofessional team including physicians, Nurse Practitioner (NP), pharmacist, social worker, mental health worker, dietitian, nurses, and Healthcare Aid (HCA). f Our Academic FHT’s strategic vision is to be ‘Leaders in collaborative, integrated, community-based academic primary care in Toronto’s west end.’

f Structured academic curriculum with seminars, resident input, robust evaluation. f Electives offered: PGY1 – one 4-week elective; PGY2 – three 4-week electives plus flexible rotations. f Resident voices are central: Monthly meetings with the Site Director, biannual 1:1s, and active participation in the Site Education Committee.

CURRICULAR AND SITE INNOVATIONS: Division-Based Educational Highlights: f Home Visits: Residents follow homebound patients; Care of the Elderly MD provides supervision. f Palliative Care: All-FM-staffed; provides core and elective learner training. f Addiction Medicine: Mandatory rotation, integrated research within this rotation. f Family Medicine Obstetrics: 13–16 Family Medicine physicians, strong low-risk delivery teaching, and fellowship opportunities.

UNDERGRADUATE EDUCATION: f Hosts 14 third-year clerks annually for core family medicine rotation. f Learning opportunities in community/hospital-based clinics, palliative care, addictions medicine, lowrisk Obstetrics, and home visits. (Including new site, Sherburne Health Centre, focusing on newcomer and trans health.) f Structured interprofessional involvement with nurses, dieticians, and social workers, as well as mentorship programs (Clerk–Resident mentorship). f Expanded Undergraduate Medical Education teaching: Clinical Skills (Year 1), Family Medicine Longitudinal Experience (FMLE), Family Medicine Week (Year 2), as well as electives in palliative and addiction care. f Achievements: Consistently above-average clerkship evaluations, multiple teaching excellence awards, and many clerks have returned as SJHC residents.

Site Strengths: f Strong learner support: small site size, close departmental relationships, and an effective Competence Committee enable early identification and assistance for learners in difficulty. f Resident teaching opportunities: Residents gain experience supervising clerks, supported by structured resident-as-teacher guidelines. f Balanced training: Well-designed rotations ensure strong exposure to core family medicine with minimal competition from other learners on specialty services. f Excellent learning environment: A welcoming community teaching hospital serving a diverse patient population, affiliated with a leading university. f Efficient administration: A modern online scheduling platform streamlines academic seminar coordination and time-off requests.

POSTGRADUATE EDUCATION: f Broad-based, community-oriented family medicine training; strengths in: Z Addiction medicine (mandatory rotations) Z Palliative care (hospital and community) Z Home-based primary care Z Low-risk family medicine obstetrics f Residents maintain continuity “mini practice” with a dedicated preceptor for 2 years, allowing for longitudinal care. f Dedicated Residency Research Coordinator and our newly created Q&I Education Coordinator ensure scholarly activity and practice improvement are integral.

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FACULTY DEVELOPMENT AND RECOGNITION: f Faculty Development needs are determined through residency program meetings, the Competency Committee, and staff meetings. f Quarterly faculty development sessions are tailored to site needs, with the help of U of T DFCM Continuing Professional Development programming. f Support for career growth: 7 junior promotions, 34 new faculty appointments (19 community-based) over 2020–2025. f Recognition and support for scholarly activity and teaching awards with an active awards committee.

QUALITY IMPROVEMENT (QI) EDUCATION & SCHOLARSHIP: f Mandatory longitudinal Q&I curriculum for PGY1 residents. Resulting practicum projects are presented at annual Q&I Fest. f New Quality Improvement (QI) Education Coordinator (2024) provides resident coaching. f Resident-led patient safety analyses of patient safety incidents. f Quality Improvement (QI) Pitch Party where PGY1 present their proposals with Family Health Team. f Some resident presentations have been given at the 2020–2025 Self-Study Report

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Association of Family Health Teams of Ontario (AFHTO) and DFCM Conference, as well as other venues.

Social Accountability & Health Equity: f Social Accountability/Health Equity Committee with resident participation drives equity-focused programming. f Learners contribute to health equity questionnaires, literacy programs, gender/sexual diversity initiatives, green clinic (accessibility work) projects, and Black History Month programming.

RESEARCH AND SCHOLARLY ACTIVITIES: f Resident/faculty research supported by the Residency Research Coordinator and the University of Toronto Practice- and Community-based LEarning and Research Network (UPLEARN) representative. f New Research Interest Group (RIG) to promote faculty collaboration and mentorship. f Research strengths: Addiction Medicine, Health Systems Research. f Resident/faculty peer-reviewed publications in addiction medicine, health equity, and public health.

Digital Health: f Training with AI Scribe, PrescribeIT, eReferrals, eConsults, and OCEAN patient communications.

LOOKING FORWARD: f Addressing space constraints and faculty burnout due to hospital deficits. f Major hospital redevelopment project in developing a state-of-the-art patient tower (~10 years) requiring relocation of the academic Family Health Team (FHT). f Goal: Consolidate two sites (Hospital and Roncesvalles site) into one renovated location to accommodate learners, faculty, and an expanded patient population. f Expand patient attachment (1,000–1,200 new patients) and interprofessional hires. f Future focus on research growth (possible Primary Care Research Chair in Addiction Medicine), digital health, equity-focused education, and wellness initiatives.

UNITY HEALTH TORONTO - ST. MICHAEL’S HOSPITAL SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Program Leadership & Learners: f Residents: 33 f Clerks: 30 f Chief: Dr. Karen Weyman 174

f Deputy Chief: Dr. Curtis Handford f Postgraduate Co-Site Directors: Drs. Melanie Beswick & Shelby Olesovsky f Undergraduate Site Director: Dr. Caroline Jeon f Faculty Development Lead: Dr. Abbas Ghavam-Rassoul f Interprofessional Education Lead: Dr. Chadwick Chung f Quality Improvement (QI) Site Director: Dr. Noor Ramji f Digital Health Lead: Dr. Rajesh Girdhari f Equity & Social Interventions Lead: Dr. Gary Bloch f Research Director: Dr. Ann Burchell f Academic Project Lead: Dr. Nav Persaud f Wellness Representative: Dr. Yuliya Rackal SITE DESCRIPTION St. Michael’s Hospital (SMH) DFCM delivers exemplary clinical care, education, research, and innovation in urban primary care. SMH is recognized as a leader in the areas of cardiovascular disease, trauma, and inner-city health. f Equity-focused care and social determinants integration are central to all activities. f Faculty, staff, residents, and patients collaborate to achieve excellence in teaching, quality improvement, research, and community engagement. f SMH remains a national and international leader in interprofessional education, primary care research, and socially accountable clinical programs. f Tertiary care teaching hospital in downtown Toronto serving high- and low-income populations. f Part of the Unity Health Toronto network (with St. Joseph’s & Providence Healthcare). f Largest Academic Family Health Team (AFHT) in Ontario: 270 staff, including 83 physicians, 7 Nurse Practitioners, serving >50,000 patients (~50% in lowest income quintiles). f Expertise in the following areas in response to local community needs: HIV care, addiction medicine, LGBTQ2S health, as well as specific care of homeless and under-housed individuals, care for those with significant mental health issues, homebound older adults, youth, and newcomer populations. f Five distinct clinics (residents assigned to one for their 2-year training): Z Family Practice Unit (61 Queen St.): Downtown core, diverse and complex patients such as newcomers, those experiencing homelessness, and those with severe and persistent mental illnesses.

Z WeST Clinic: Known for its HIV care (one of the largest in North America) and addiction medicine. Patients include the LGBTQ2S community, newcomers, homebound older adults, and those with severe mental illness. The site also houses the AFFIRM clinic, a gender affirming consultation service, and supports

Department of Family & Community Medicine, University of Toronto

the Home Visit Team, an interdisciplinary group supporting homebound older adults.

Z St. Lawrence Health Centre: Patients include older adults, homebound older seniors, newcomers, those with severe and persistent mental illnesses, as well as those with intellectual and developmental disabilities from local group homes.

Z Health Centre at 80 Bond St.: Patients from a highly diverse population and including newcomers, urban professionals, newcomers, underprivileged patients, as well as those with mental and physical health problems.

Z Sumac Creek Health Centre (Regent Park): The Newest clinic that serves Low-income newcomers, patients with severe substance abuse disorders.

Also home to the SUM Clinic Team, which provides substance use management using a variety of therapies for patients.

f Strong academic support from internationally renowned faculty for their academic achievements. f Program Enhancements: clinic-based surgical selective rotation, monthly procedural skills clinics led by our family physicians, shifting from a block to a horizontal model to improve the relational and management continuity experience for the resident, and a month-long orientation block (Foundations Block-now at all DFCM training sites). f Emphasis on resident wellness through resident wellness representatives, regular check-ins, mentorship, exam preparation (Simulated Office Orals practice sessions, mock Objective Structured Clinical Examinations), and career support from department members in the form of fireside chats with the Site Chief in PGY2.

UNDERGRADUATE EDUCATION f Core site for the University of Toronto clerkship program; 5–6 clerks per block.

Patient & Community Engagement f Residents supervise and teach clerks. f Patient Advisory Council (PFAC): 8 patient members; f Seminars and interprofessional teaching sessions run advises on communications, clinic flow, and social routinely with contributions from site faculty. Topics determinants advocacy. Three goals; include chronic disease, low back pain, motivational Z Developing patient-informed and patient-generated interviewing, addiction medicine, sexually transmitted communications materials, such as a patient newsletter. infections, and intimate partner violence.

Z Contributing to improvements in clinic flow and f FitzGerald Academy-core location for pre-clerkship space, including standardized accommodations undergraduate medical learning and provides for patients with disabilities and inclusive visual opportunities for residents to teach lectures and materials in waiting areas. seminars and demonstrate skills.

Z Collaborating with AFHT staff on advocacy initiatives f Elective opportunities for learning about social related to social determinants of health and creating determinants of health, equity, and inclusive care. roles for lived experience advisors on the team’s Social Determinants of Health Committee.

FACULTY DEVELOPMENT f Additional councils: Youth Council (12) and Older Adults f Quarterly mandatory Teacher’s Meetings are overseen Council (8) – co-govern social prescribing programs. by the Integrated Education Committee (IEC). Topics f Patient Partner Network: 136 members supporting cover interprofessional development. strategic initiatives, policies, and committees. f Site Faculty Development Lead offers individual mentorship, plans Teacher’s Meetings, and provides POSTGRADUATE EDUCATION learning resources to faculty. f Comprehensive care across all ages, life stages, and f The Integrated Education Committee (IEC) generates a conditions. yearly needs assessment via faculty surveys and utilizes f Residents maintain longitudinal patient practices and these findings, as well as resident/student feedback, to rotate in hospital and community clinics, working identify faculty development needs. collaboratively with their staff preceptors and the f Emphasis on advancing interprofessional teaching skills St. Michael’s Hospital Academic Family Health Team and DFCM education standards.

(SMHAFHT). f Graduates of the program work in academic family Interprofessional Education (IPE) practices, community practices (urban/suburban/ f Established the Interprofessional Education rural), urgent care facilities, long-term care Committee in 2005 to focus on enhancing collaborative facilities, specialized clinical care (HIV, addictions, competencies for health professionals and improving sports medicine, emergency medicine), as well as understanding of different health professionals. administrative and leadership.

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f Curriculum embedded in clinical, case-based learning with key principles being; Z Absence of hierarchical structures between health professions.

Z Development of initiatives through group consensus and cooperation.

Z Program content is driven by learners’ needs and the identification of curricular gaps suitable for interprofessional teaching.

Z Embedding education on collaborative competencies within clinical, case-based content.

Z Faculty support through education, development, and awareness of current evidence on IPE. Z A formal and evolving evaluative structure to continuously improve programs based on feedback from learners and instructors.

QUALITY IMPROVEMENT & INNOVATION f The Quality Improvement Program at the St. Michael’s Hospital site is nationally/internationally renowned and embedded into everyday practice, resulting in an exceptional learning experience in this area. f We offer a Longitudinal Quality Improvement (QI) curriculum for PGY1 residents with a mandatory practicum. f Team-based, interprofessional QI projects address patient-centered outcomes, equity, safety, and efficiency guided by the Quality Steering Committee. f Key initiatives of our Quality Improvement Plan: increasing cervical cancer screening, expanding collection of health equity data, diabetes management, dietitian support for children, safe hospital-to-home transitions, smoking cessation, and environmentally sustainable practices. f We have integrated digital health initiatives with the digital health committee, whose projects focus on online booking, AI-assisted scribing, eReferrals, and an asthma decision-support.

Innovative Programs: f National and global leader in integrating social determinants of health (SDOH) into primary care; serving Toronto’s downtown east, the team focuses on addressing health inequities through patient care, teaching, research, and community engagement. f During the COVID-19 pandemic, the team rapidly implemented wellness checks, community resource mapping, and financial support for vulnerable patients. f SEED for Seniors program in 2023—an innovative, donorfunded social prescribing initiative connecting isolated older adults to community supports, guided by a Community Advisory Council and Indigenous Wellness specialists.

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f Maintains unique partnerships with Canadian Medical Chiropractic College, Toronto Metropolitan University, Legal Aid Ontario, and Toronto Public Health, enhancing access to interdisciplinary and equitable care.

RESEARCH AND SCHOLARLY ACTIVITIES: f Largest primary care research program among Ontario family medicine sites. f The department’s mission is reflected in the research conducted by its members to improve health through advocacy, equity, and world-leading primary healthcare, teaching, and research f Areas: global health, social determinants, Indigenous health, HIV, chronic diseases, and medical education. f 2020–2024 achievements: Z $141M in new research funding across 163 grants.

Z 623 peer-reviewed publications, 1,039 presentations.

Z 706 media appearances. f Research informs policy and practice locally, provincially, nationally, and internationally.

UNIVERSITY HEALTH NETWORK - TORONTO WESTERN (UHN-TWH) SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Program Leadership & Learners f Residents: 39 (including 7 PGY3) f Department Head: Dr. Benjamin Kaasa f Postgraduate Site Director: Dr. Francesco Leanza f Undergraduate Site Director: Dr. Natasha Mirchandani f Faculty Development Lead: Dr. Amita Singwi f Quality Improvement Lead: Dr. Nitai Gelber f QI Resident Projects Lead: Dr David Kepecs f Research/Academic Project Lead: Dr. Catherine Ji SITE DESCRIPTION f Two Family Health Team (FHT) sites: Z Bathurst (West Downtown Toronto) Z Garrison Creek (St. Clair & Oakwood) f Serve collectively ~32,000 patients. f Neighbourhoods include Kensington-Chinatown, Little Italy, Trinity-Bellwoods, Little Portugal, Annex, St. Clair West, and Oakwood. f Diverse population: higher than average amount of seniors, immigrants (Mediterranean, Eastern European, East Asian), newcomers, and non-English speakers. f Academic focus: Pre-clerkship, clerkship, postgraduate, and enhanced skills; competency-based, CanMEDS-FM & Triple C aligned. f Team trains up to 24 family medicine residents and 7 enhanced skills family medicine residents at the

Department of Family & Community Medicine, University of Toronto

Bathurst site. As of July 1, 2025, the Garrison Creek site is training 8 family medicine residents a year.

CURRICULAR AND SITE INNOVATIONS: f Modern exam rooms with AV technology. f Multidisciplinary team made up of nurses, social workers, pharmacists, dietitians, chiropodists, health promoters, an Occupational Therapist, an RT, and a physiotherapist. f Services are primarily in English; interpreters are available. f Strong continuity of care and education via longitudinal resident patient rosters. f Flexibility for elective educational experiences tailored to resident learning goals. f Highly experienced, multidisciplinary faculty with research expertise. f Emphasis on communication, professionalism, reflective practice through Partners in Care (direct observation through live video recording) and Resident Reflection Rounds (skill discussion and development). f Dedicated research and quality improvement (QI) infrastructure supporting internal and external studies with rich research opportunities for residents. f Residents benefit from comprehensive mentorship, high-caliber teaching, and exposure to diverse patient populations.

UNDERGRADUATE EDUCATION f Faculty teach pre-clerkship courses at the Temerty Faculty of Medicine on a rotational basis. f 2024–25: hosted 24 third-year core rotation students, 21 fourth-year electives students. f Residents actively participate in Family Medicine Longitudinal Experience (FMLE)-working with students in the Family Medicine Clinics. f One of the pilot sites of Longitudinal Integrated Clerkship (LiNC) participates in summer student programs, which introduce undergraduate medical students to the specialty of family medicine early in their undergraduate experience. f Leadership in undergraduate education through faculty leads in courses and student engagement.

FACULTY DEVELOPMENT AND RECOGNITION: f Joint effort between the site Faculty Development Lead, Site Department Head, and Site Directors for postgraduate and undergraduate education. f Teachers are surveyed annually at Teacher’s Meeting to identify priority learning objectives for the year f Faculty development ideas brought from the Faculty Development representative, Department Head, or PG Site Director based on needs identified by residents (e.g., based on rotation and teaching evaluations, or feedback provided at Progress Reviews, by Lead POSTGRADUATE EDUCATION Residents or other meetings involving the Site Director f Horizontal (longitudinal) curriculum: Residents maintain and resident group). their own roster of ~150–200 patients over 2 years. f Teacher’s Meetings (~6/year) for all faculty for formal f 34 clinician teachers, 5 clinician investigators/scientists, learning, mentorship, teambuilding and professional 13 health professions educators. development. f Exposure to interprofessional Family Health Team f Faculty encouraged to engage in Continuing Medical (FHT) members, including a respiratory therapist, Education (CME) and recognized during Merit Reviews occupational therapist, physiotherapist, social worker, (granted 2 weeks to participate in professional dieticians, pharmacists, nurses, and nurse practitioners. development every year). f Educational program supported by a UHN-based f The Scholarship Committee supports faculty research Psychiatrist & Pediatrician involved in patient care. and educational scholarship. f Diverse patient population: professionals, young families, individuals facing mental health issues, QUALITY & INNOVATION addiction issues, chronic disease, low socio-economic f Longitudinal Quality Improvement (QI) curriculum for status, and resettlement challenges. first-year residents (mandatory, with practicum). f Additional FM experiences: Family Inpatient Service, f Residents receive dedicated QI project support Home-Based Care, Family Medicine Obstetrics, (research associates, data access, supervision).

Sports Medicine, Procedures Clinic, with an Addiction f QI projects often develop into publications or receive Medicine clinic to come in 2026. national awards. f Off-service rotations supported by specialists and family f Collaborative initiatives with Toronto Western FHT in medicine teachers: General Internal Medicine, Palliative quality and safety.

Care, Psychiatry, Emergency Medicine, Orthopedics, Rheumatology.

RESEARCH AND SCHOLARLY ACTIVITIES: f Well-established research program with 5 core clinician scientists/investigators.

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f Formal research program established in 2020 with a designated funded research lead. Supports physicianled research beyond clinical sites. f Focus areas: using data to support population health, vaccine effectiveness and safety, Indigenous health with a focus on chronic disease and tuberculosis, COVID impact on primary care, AI in primary care, health informatics, long COVID, and routine care (childhood immunizations, mental health, diabetes, hypertension). f Provides residents with rich opportunities for research projects, and there is a hope to expand the research program going forward.

Scholarly Activities (2024–2025) f Core researchers: 5 f Active research/Quality Improvement (QI) projects: 6 f Resident QI projects: 4 f Resident research projects: 4 f Active grants: 26 f Conference presentations: 15 f Peer-reviewed publications: 50

f Emphasis on academic integration, combining clinical care, education, and research. f Focus on ambulatory care and community-based comprehensive care, minimizing hospital stays. f The department embodies academic excellence by seamlessly weaving together clinical practice, education, and research to improve health outcomes for all. f Integrated education for Undergraduate Medical Education (UGME) & Post Graduate Medical Education (PGME) learners. f Strong focus on equity, cultural safety, and wellness. f Leading research program with high impact and resident involvement. f Innovative clinical programs addressing diverse and underserved populations. f Collaborative, supportive faculty culture fostering professional growth and mentorship.

Innovative Clinical Programs f Family Practice Maternity Care (“The Family Way” Obstetrical Group): Z Comprehensive multidisciplinary maternity care WOMEN’S COLLEGE HOSPITAL (WCH) provided to low-risk pregnant patients provides hands-on Obstetrical skills training for residents SITE LEADERSHIP AND OVERVIEW at multiple antenatal clinics in collaboration with (NUMBERS ARE PER YEAR) Mount Sinai and University Health Network. f Program Leadership & Learners f Crossroads Clinic (Refugee Health): f Residents: 27 (including PGY3s) Z Provides essential primary care for newly arrived f Clerks: 20–25 clinical clerks/year refugees; >7,000 patients served since 2011. A f Department Head: Dr. Dominik Nowak (2025–), formerly robust teaching and research program with over 41 Dr. Ruth Heisey (2014–2025) publications, 560 presentations, training over 250 f Associate Department Head & Medical Director: Dr. learners, and a biennial educational initiative. The Dara Maker Refugee Primer, brings leading faculty to share best f Postgraduate Site Directors: Drs. Melinda Wu & Bradley practices.

Lichtblau f Bay Centre for Birth Control: f Undergraduate Site Director: Dr. Nikita Patel Z One of Canada’s leading sexual and reproductive f Faculty/Professional Development Lead: Dr. Carrie clinics since 1973. The clinician team provides Schram patient care and learner teaching in reproductive f Maternity Care Lead: Dr. Diana Hsiang health, contraception, STI care, and abortion care. f Digital Quality Leads: Drs. Jonah Schermbrucker & f Gender Affirming Care Clinic (2025): Vanessa Rambihar Z Provides vital, inclusive, comprehensive care and an f Quality Improvement (QI) Lead: Dr. Susie Kim essential educational resource for learners and the f Research Director: Dr. Noah Ivers community. f Resident Research Lead: Dr. Sheryl Spithoff f Wellness Lead: Dr. Bradley Lichtblau Site Strengths f Safety Lead: Dr. Carol Kitai f Culture of collaboration and mentorship among physicians f Leaders in teaching, research, innovation, advocacy, SITE DESCRIPTION and health system change. f Leading Canadian academic ambulatory hospital, f Commitment to equity and inclusion, e.g., first Ontario globally recognized for women’s health.

Hospital to launch formalized Black Health Plan (2025). f Primary care population: >80,000 patient visits/year, f Specialists provide primarily ambulatory care, aligning diverse urban population. with family medicine training.

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EDUCATION (UNDEGRADUATE AND POSTGRADUATE) f A Cohesive and Integrated Training Environment: Residents have a “home base” at WCH, fostering a sense of belonging and enabling mentorship and continuity. f Learning Across Stages of Training: integrated postgraduate and undergraduate medical programs, medical students and residents learn together, and learners have the opportunity to further develop their pedagogical skills through the Teaching Residents to Teach program. f Prioritizing Resident Support: Weekly SOS (“Second Opinion & Support”) Rounds, which foster peer support. f Advancing Equity & Cultural Safety: Structured sessions for residents using Expect Respect and a Safe Education (ERASE) framework training to prepare residents to navigate challenging situations in clinical settings.

FACULTY DEVELOPMENT AND RECOGNITION: f Faculty development is a strategic priority, ensuring that clinician teachers and scholars are supported throughout their careers. f Annual needs assessment guides faculty development initiatives. f Accredited rounds are held to improve teaching, evaluation, and reflective practice. f Interdepartmental collaboration through joint rounds (e.g., Hidden Curriculum). f Tailored support for academic promotion and career development.

WCH DFCM Faculty Serving at the University of Toronto and Systems Leadership Roles: f Dr. Danielle Martin: Chair, DFCM, University of Toronto f Dr. Batya Grundland: Associate Postgraduate Program Director, Curriculum and Remediation, DFCM, University of Toronto f Dr. Noah Iver: Canada Research Chair in the Implementation of Evidence-Based Practice; Interim Vice-Chair Quality and Innovation (2023-2024), DFCM, University of Toronto f Dr. Aisha Lofters: Chair in Implementation Science, Peter Gilgan Centre for Women’s Cancers, Women’s College Hospital; Provincial Primary Care Lead, Cancer Screening, Ontario Health f Dr. Lynn Wilson: Vice Dean, Clinical and Faculty Affairs, Temerty Faculty of Medicine, University of Toronto f Dr. Dominik Nowak: President (2024-2025), Ontario Medical Association f Dr. Onil Bhattacharyya: Frigon Blau Chair in Family Medicine Research, Women’s College Hospital f Dr. Cynthia Whitehead: BMO Financial Group Chair in Health Professions Education Research, University Sites and Divisions | Sites

Health Network; Director, Wilson Centre for Education Research f Dr. Dara Maker: Board Director, Mid-West Toronto Family Practice Network f Dr. Kieran Moore: Chief Medical Officer of Health, Ontario f Dr. Viola Antao: Mentorship Lead, DFCM f Dr. Nicholas Pimlott: Scientific Editor, Canadian Family Physician f Dr. Hemen Shukla: PGME Faculty Lead, Internal Reviews, DFCM, University of Toronto QUALITY & INNOVATION f Quality Improvement (QI) curriculum: Mandatory for first-year residents with practicum. f Patient & Family Advisory Committee (PFAC): established and has been integrated into clinic leadership to guide clinic policies and co-design care experiences and collect Patient Experience Surveys. f Patient Experience Surveys collected social determinants of health data to improve equity and better understand and serve patients. f Led COVID-19 vaccine clinics for patients and the community, providing residents with invaluable experience in public health and advocacy. f Implemented online appointment booking and same/ next-day appointments to better serve patients based on feedback.

RESEARCH AND SCHOLARLY ACTIVITIES: f Internationally recognized primary care research program renowned for its applied work in partnership with health system decision-makers, including most recently supporting Ontario’s Primary Care Action Team led by Dr. Jane Philpott. f 4 endowed research chairs, 5 clinician-scientists. f Nearly 100 peer-reviewed publications in 2024. f Second-year resident academic projects contribute to a culture of inquiry, receiving mentorship from faculty. f Key research areas: advancing preventive cancer care, advance access for primary care patients to cancer screening (collaboration with Princess Margaret Cancer Centre), evaluating AI to reduce physician burnout, primary care supporting strong public health system, fostering clinician wellness (Peers for Joy in Work; a peer coaching model now being adapted for province-wide use), privacy in Electronic Medical Records (EMR), improving primary care metrics (CareCanvas; a prototype).

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CENTRE FOR ADDICTION AND MENTAL HEALTH (CAMH) SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) The Hospital Medicine Division at CAMH has cultivated a robust academic partnership with the Department of Family and Community Medicine (DFCM) at the University of Toronto. This affiliation has enabled CAMH to become a key teaching site, now supporting the education and training of more than fifty learners each year. These include undergraduate medical students and postgraduate residents from both first-year Psychiatry and Family Medicine residency programs at U of T, who gain valuable, hands-on experience in delivering collaborative, integrated care to medically and psychiatrically complex patient populations. f Chief Health Information Officer and Chief of Hospital Medicine: Dr. Tania Tajirian f Mission: Integrate physical and mental healthcare for inpatients with severe mental illness (SMI) to improve health equity and clinical outcomes. f Scope: Supports emergency department and inpatient care for over 550 patients, including long-stay psychiatric inpatients. f The Hospital Medicine Division Team: 17 family medicinetrained hospitalists, 1 Nurse Practitioner, interdisciplinary collaboration across all psychiatric units. f ~50 learners/year (medical students, psychiatry, and family medicine residents).

SITE INNOVATIONS SUMMARY: f Cancer Screening & Preventive Care: Z Improved access for long-stay psychiatric inpatients; colorectal screening rose from 4.9% → 33%, cervical from 35% → 63%.

Z Recognition: 2025 Canadian College of Health Leaders Award of Excellence in Mental Health and Addictions Quality Improvement given to The Division of Hospital Medicine’s Innovation Hub (DHM-IH) Team. f Operational & Academic Excellence: Z Experienced continuous academic growth in clinical, research, and creative professional activities.

Z Achieved zero vacancies for the first time, reflecting strong leadership and team stability.

Z Gained recognition for advancing integration of mental and physical health.

Z Expanded collaborations and quality improvement initiatives to attract top-tier talent.

Z Built a cohesive, sustainable academic environment at the forefront of health system innovation. f Quality Improvement & Digital Innovation: Z Advanced data-driven quality improvement through the Hospital Medicine Innovation Hub (DHM-IH).

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Integrated digital tools to streamline workflows.

Standardized protocols for Clozapine, DVT, COVID-19, and palliative care.

Z Developed informatics for falls, seizures, delirium, and chest pain monitoring.

Z Collaborated across departments on population health initiatives.

Z Z

Strategic Impact f Equity-focused care: Reverse integration ensures severe mental illness (SMI) patients receive preventive physical healthcare. f Operational and academic excellence: Stable team, enhanced hospitalist wellness, and strong research output. f System-level influence: Models and protocols inform regional and potentially national best practices for integrating physical and mental health. f Patient-centered outcomes: Improved preventive care adherence, reduced avoidable transfers, enhanced interdisciplinary collaboration.

EDUCATION f Division has cultivated a robust academic partnership with the DFCM. f Division takes ~50 learners annually (psychiatry residents, family medicine residents, fellows, and medical students). f Learners are supported through simulation-based training, accredited Hospitalist Medicine Academic Rounds, and monthly case reviews. f Highly rated electives and simulation-based learning programs.

PARTNERSHIPS AND COLLABORATIONS: Development of Partnerships and Collaborations – CAMH f Internal collaborations: Z Partnered with operational leadership, Professional Practice Office (PPO), pharmacy, laboratory and diagnostics, and education and simulation teams to advance reverse integration of physical healthcare within CAMH. f External partnerships: Z Collaborated with UHN, Sinai, Women’s College Hospital (WCH), and Joint Department of Medical Imaging (JDMI) to strengthen support for inpatients’ physical health needs.

Z Advocacy and stakeholder engagement over five years led to a formal CAMH–UHN partnership, enabling continued innovation in integrated care and clinical pathways. f Impact and significance: Z Work supports the development of national practice guidelines for integrating physical and mental healthcare.

Department of Family & Community Medicine, University of Toronto

Demonstrated evidence-based improvements in physical health outcomes among individuals with severe mental illness (SMI).

Z Contributes to a growing body of Canadian evidence supporting proactive physical healthcare in psychiatric settings.

Z

RESEARCH HIGHLIGHTS AND OUTCOMES: Publication Highlights: f Recommendations to Enhance Physical Health for Individuals with Severe Mental Illness in Canadian Healthcare Organizations. Healthcare Quarterly 26(1) April 2023: 38-44 f Strengthening the Delivery of Physical Healthcare for Adults Living With Serious Mental Illness – A Qualitative Description of Patient and Family Member Perspectives.

Health Expect. 2025. f Strengthening the Delivery of Integrated Care for Individuals Experiencing Serious Mental Illness- A qualitative description of health provider perspectives.

BMC Psychiatry. 2025. f Increasing Resuscitation Status-Related Goals of Care Discussions for Older Adults with Severe Mental Illness in a Canadian Mental Health Setting: A Retrospective Study. BMJ Open Quality. 2024.

Grant Highlights: f 2023: Catalyst CIHR Grant (Co-Investigator) – Strengthening the Delivery of Integrated Care in Specialized Mental Health Settings. Canadian Institutes of Health Research. ($148,733) f 2022: DFCM Faculty Development Initiative Fund (PI) – Enhancing Colorectal Cancer Screening for Patients with Severe Mental Illness. ($2,500) f 2022-2023: CIHR Planning and Dissemination Grant (CoPI) – Building a Plan for Embedding Preventative Cancer Screening. ($10,000) f 2023-2024: Cancer Screening QIP. Delivering Breast and Cervical Cancer Screening to Long-Stay Inpatients with Severe Mental Illness at CAMH. ($2,000) f 2021-2022: Cancer Screening QIP. Improving Colorectal Cancer Screening Amongst Chronic Stay Patients at CAMH. ($1,000) Award Highlights: f 2025 Canadian College of Health Leaders Award f 2020 College of Family Physicians Canada (CFPC)/ Canadian Psychiatry Association (CPA) Collaborative Mental Healthcare Award, multiple nominations for innovation and population health

Sites and Divisions | Sites

Community Affiliated Sites The DFCM also partners with community-affiliated sites that, while outside the TAHSN network, offer outstanding learning opportunities for our learners.

GEORGIAN BAY GENERAL HOSPITAL (GBGH) SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Residents: 4 (2 PGY1, 2 PGY2) f Faculty: 23 f Postgraduate Site Director: Dr. Jeff Golisky f Quality Improvement Lead: Dr. Jennifer Johnson SITE DESCRIPTION Georgian Bay General Hospital (GBGH), located in Midland, Ontario, is a key rural training site within the University of Toronto’s Department of Family & Community Medicine (DFCM). The site provides residents with comprehensive clinical experience in a community hospital setting, emphasizing continuity, versatility, and interprofessional collaboration across all aspects of family medicine.

Georgian Bay General Hospital remains a vital and dynamic site within the DFCM. Its combination of comprehensive rural clinical experience, dedicated mentorship, and community integration equips residents to provide high-quality, patient-centred care across diverse practice settings— rural or urban.

CURRICULAR AND SITE INNOVATIONS: Site Strengths: f Comprehensive Scope of Practice: Broad clinical exposure across Emergency Rooms, Obstetrics, Hospitalist care, Palliative care, and Procedures. f Longitudinal Mentorship: Two-year continuity with core preceptors enhances confidence and skill development. f Community-Based Learning: Strong integration with patients, healthcare teams, and community organizations.

POSTGRADUATE EDUCATION The GBGH residency offers a two-year longitudinal program, allowing residents to complete both PGY1 and PGY2 training at the same site under consistent mentorship. Residents are paired with one or two core preceptors to foster close supervision and professional growth. Training includes: 2020–2025 Self-Study Report

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f Longitudinal Family Medicine Clinic (3 half-days per week, PGY1–2) f Emergency Medicine shifts in GBGH’s Emergency Department f Inpatient/Hospitalist Care for acute and chronic conditions f Obstetrics with antenatal, perinatal, and intrapartum care f Procedures and minor surgery opportunities f Palliative Care community and inpatient f Indigenous Health experiences with local communities

OAK VALLEY HEALTH (MARKHAM & UXBRIDGE)

SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Residents: 18 (Markham) 2 (Uxbridge) f Clerks: 8-10 f Academic Chief: Dr. Donatus Mutasingwa f Postgraduate Site Co-Directors (Markham): Drs. Nadine Al-Aswad & Nathasha Dias f Postgraduate Site Co-Director (Uxbridge): Dr. Aisha Hussain f Undergraduate Site Co-Director: Dr. Megan Tan The program’s structure promotes continuity of care, pro- f Faculty Development Director: Dr. Gina Yip gressive responsibility, and clinical independence in a sup- f Quality Improvement (QI) & Patient Safety (PS) portive rural context.

Directors: Drs. Karuna Gupta & Kelly Forse f Research Director: Dr. Tiffany Tang UNDERGRADUATE EDUCATION f Global Health Director: Dr. Jessica Wong GBGH also serves as a teaching site for University of Toronto family medicine clerks, Northern Ontario School of Medi- SITE DESCRIPTION cine (NOSM) students, and learners from other institutions f Two-site community hospital with acute care, surgery, through the Rural Ontario Medical Program (ROMP). These addictions & mental health, maternal & child health, placements allow residents to develop their own teaching rehab, transitional & palliative care. and mentorship skills while supporting early exposure to f Serves a catchment of 400,000+ residents across rural family medicine for these future trainees.

Markham, Stouffville, and Uxbridge, and is proud that many graduates remain in the community as faculty, FACULTY DEVELOPMENT AND RECOGNITION: clinical leaders, and hospital contributors.

Faculty at GBGH are actively supported through DFCM’s f The Health for All Family Health Team (FHT), established faculty development resources, including workshops, menin 2010 as the Markham Family Medicine Teaching torship, and academic training. A key focus is on encourUnit (FMTU), anchors family medicine education at the aging U of T faculty appointments for local physicians to site through a robust interprofessional team including formally recognize teaching roles and strengthen academic physicians, nurses, allied health professionals, and engagement. Faculty are also involved in quality improvepsychiatry support. ment, scholarship, and teaching skill enhancement, ensur- f Uxbridge expansion (since July 2025) allows residents ing alignment with DFCM educational standards. to establish a mini practice, providing rural medicine exposure while maintaining links with Markham.

PARTNERSHIPS AND COLLABORATIONS: f Hybrid model: two years, hospital-based rotations, f Academic Connectivity: Ongoing linkage to U of T’s weekly Academic Half-Days, and Central Core Days. curriculum and academic supports despite geographic distance.

CURRICULAR AND SITE INNOVATIONS: f Interprofessional Collaboration: Embedded teamwork INNOVATIVE CLINICAL AND ACADEMIC PROGRAMS with allied health professionals and specialists in a f The Awards Committee recognizes faculty and resident small-hospital environment. achievements twice yearly. f Clear leadership structures and quarterly Executive LOOKING AHEAD: Committee meetings support a stable teaching culture. f Strengthen partnerships with Indigenous communities f Global Health Curriculum emphasizes Social and expand cultural safety training.

Determinants of Health (SDOH) and advocacy: f Increase faculty participation in research, scholarship, Z First-year residents develop expertise in one SDOH and quality improvement related to rural medicine. area. f Broaden exposure to virtual care and telemedicine as Z Monthly Lunch ‘n Learns with experts and part of rural health transformation. organizations for residents. f Expand leadership and mentorship opportunities for Z Optional final-year four-week health equity or residents. international elective.

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POSTGRADUATE EDUCATION f Community-based Family Medicine Teaching Unit (FMTU) emphasizing longitudinal, comprehensive family medicine. f Residents supervised by academic and community physicians with interprofessional support. f Residents manage their own patient panels 3 half-days/ week for continuity of care. f 18 residents at Markham, 2 at Uxbridge, including international medical graduates. f Uxbridge stream provides rural medicine exposure with selectives in women’s health, dermatology, psychotherapy, musculoskeletal (MSK), and pre-travel consultations.

UNDERGRADUATE EDUCATION f Core site for University of Toronto medical students since January 2013. f Supervises ~6 students/year for core rotations; electives also accepted. f Students work with faculty, residents, and an interprofessional team; attend Academic Half-Days and seminars led by residents.

RESEARCH AND SCHOLARLY ACTIVITIES Scholarly Activities (2021–2024) CATEGORY

2021/22

2022/23

2023/24

Publications

10

8

11

Presentations

157

209

191

New Grants

-

-

-

Conference Presentations

12

25

20

Journal Club

4

4

4

Global Health Lunches

7

6

9

Awards

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ORILLIA SOLDIERS’ MEMORIAL HOSPITAL

SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) The new Family Medicine Teaching Unit (FMTU) at Orillia Soldiers’ Memorial Hospital (OSMH) officially launched in July 2025, marking a major expansion of postgraduate family medicine training in Ontario. In its inaugural year, the site welcomed six residents: four first-year residents starting their training in Orillia and two second-year residents who FACULTY DEVELOPMENT AND RECOGNITION: completed PGY-1 at North York General Hospital. This initiaf Needs are assessed through regular committee tive reflects a strong partnership between OSMH and the meetings and annual reviews by Site Chiefs, Site University of Toronto’s Department of Family and Community Directors, and the Professional Development Director.

Medicine (DFCM), aimed at addressing physician shortages f The Professional Development Plan identifies career and improving access to primary care in the region. goals, support needs, and interest in DFCM programs by f Launch: July 2025 newly appointed faculty and is reviewed every three years. f Inaugural Cohort: 6 residents (4 PGY-1 residents starting f Faculty must attend DFCM BASICS and are encouraged in Orillia; 2 PGY-2 residents who completed PGY-1 at to attend other central programs.

North York General Hospital) f Supports academic advancement and scholarship. f Objective: Expand postgraduate family medicine f Conforming Academic Practice Plan (CAPP) supports training, address physician shortages, and improve faculty academic commitments with protected time for primary care access in the region academic pursuits, research support, and operational funding. The goal is to enhance continuing education and Leadership Team promote excellence in education and scholarly activities. f Co-Site Director, Dr. Erika Catford f Co-Site Director, Dr. Heather Laakso QUALITY AND INNOVATION f Chief of Staff, Dr. Kim McIntosh f Mandatory Quality Improvement (QI) curriculum for first-year residents; includes theoretical learning and SITE DESCRIPTION practical projects.

The Orillia FMTU is headquartered at the Friden Health and f Residents lead QI projects with interdisciplinary teams, Wellness Centre and focuses on delivering comprehensive supervised by faculty. family medicine training in a community setting. Residents will f Focus on patient safety: incident management, infection work closely with local family physicians and participate in paprevention, medication reconciliation, and reducing tient care that emphasizes continuity, accessibility, and comunnecessary tests. munity engagement. By training residents in Orillia and attachf Integration through the QI Committee, board ing patients through the Couchiching Ontario Health Team, responsibilities, and interprofessional meetings. the program aims to improve access to care and encourage graduates to establish permanent practices in the community.

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ROYAL VICTORIA REGIONAL HEALTH CENTRE (RVH)

CURRICULAR AND SITE INNOVATIONS Site Strengths f Committed faculty; residents supervised without SITE LEADERSHIP AND OVERVIEW concurrently seeing their own patients (NUMBERS ARE PER YEAR) f Residents act as Most-Responsible-Physician (MRP) for f Residents: 18 their obstetrical and palliative care patients f Clerks: 9 f Focus on professional identity formation, coaching, and f Faculty: 50 patient safety f Chief: Dr. Stuart Murdoch f Maximum teaching and consultation during specialty f Postgraduate Site Director: Dr. Melissa Witty rotations f Undergraduate Site Director: Dr. Chung Kit “Jacky” Lai f SIM Labs for hands-on procedural training across multiple f Faculty/Professional Development Lead: Dr. Jessie Weaver specialties, including Paediatrics, Cardiology, Trauma, f Quality Improvement (QI) Leads: Drs. Lauren Fruchter & Respiratory, Addictions, Toxicology, Neurology, Palliative Lynda Ekeh Care, Sports Medicine, Casting, Lumbar Puncture & Point f Research/Academic Project Leads: Drs. Anwar Parbtani of Care Ultrasound (POCUS), Resuscitation & Matthew Orava f On-site primary care for marginalized youth at Youth Haven shelter SITE DESCRIPTION f Integrated Ethics Curriculum addressing societal and f Location: Barrie, Ontario; suburban city north of Toronto clinical needs (~157,000 population) f Hospital: 460-bed acute care regional centre serving POSTGRADUATE EDUCATION Simcoe County & Muskoka (~500,000 population) f Curriculum: Horizontal training with oversight from f Family Medicine Teaching Unit (FMTU): Part of Barrie DFCM for curriculum delivery and assessment; mapped Community Family Health Team (BCFHT) with 90 to CanMEDS-FM roles physicians and 140,000 patients f Clinical Opportunities: f Clinical Model: Horizontal family medicine training; Z Residents are responsible for obstetrical and homeresidents manage their own patient panels in a bound patients under the supervision of specific multidisciplinary environment, with some of the Family Physicians with expertise in either Obstetrics teaching done by allied health team members, which or Palliative Care. include, but are not limited to, nurse practitioners, Z Opportunities to build on clinical skills, time pharmacists, diabetes educators, and lung health management skills, continuity of care, resource educators; a group of 26 supervisors, who supervise up management, advocacy for patient resource needs, to 4 residents during a shift. and to work with clinical teams, including IHP (e.g., f Facility: 10,000 sq. ft. custom-built “Rotary Place” Pharmacists, Dieticians, Occupational Therapists, adjacent to hospital, with fully equipped exam rooms Physical Therapists, registered nurses, Nurse Practitioners, and sub-specialists) Summary Z Intensive Care Unit rotation provides training on The Royal Victoria Hospital (RVH) Family Medicine program multi-system management, end-of-life care, and features a dedicated and enthusiastic faculty with diverse enhanced procedural skills. clinical backgrounds, offering residents broad learning exZ Public Health rotation: population health and periences across varied patient settings. With 26 supervising infectious disease exposure physicians focused solely on resident teaching, learners reZ Specialized clinics: Skin Cancer Biopsy, Suspicion of ceive continuous observation and immediate feedback. The Cancer-Diagnostic Assessment Program (SOC-DAP) Family Medicine Teaching Unit (FMTU) model mirrors reZ Simulation (SIM) Labs for procedural skills al-world family practice, with residents managing their own integrated into Academic Half Days patient panels and serving as Most-Responsible-Physicians Z On-site Mental Health Counsellor for real-time for obstetrical and palliative patients under full supervision. feedback on patient encounters The absence of other core residency programs ensures UNDERGRADUATE EDUCATION maximal teaching opportunities during specialty rotations. f Core clerkship: 3 blocks/year (3 clerks per block) RVH’s supportive learning culture emphasizes coaching f Undergraduates work directly with Family Medicine over judgment, fostering professional identity formation, reTeaching Unit (FMTU) faculty, allied health flective learning, and strong preceptor mentorship. professionals, and residents 184

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f Residents participate in teaching clerks through the “Teach the Resident to Teach” program f Academic projects presented by clerks during Academic Half Days f The Undergraduate Site Director works closely with the Site Director and the Program Administrator to develop balanced rotation experiences for all undergraduates.

FACULTY DEVELOPMENT AND RECOGNITION f Led by Professional Development Representative (Dr. Jessie Weaver) f The RVH Professional Development Representatives report monthly at the Site Residency Program Committee sRPC meeting to discuss programming, and to poll teachers for input into areas of specific interest for faculty development f Biannual offsite faculty retreats and ongoing professional development sessions (e.g., Teaching 101, Teaching and Learning Centre-TLC Modules) f The RVH department of Academic & Medical Affairs offered the following learning modules from U of T’s Centre for Faculty Development delivered as four evening seminars. Preceptors from all departments were invited to attend. All sessions were well attended and at full capacity. Modules included: Z TLC Module 1: Identify Learner Needs and Setting Objectives Z TLC Module 2: Making Learning Stick Z TLC Module 3: Managing the Teaching Session and Small Group Facilitation Z TLC Module 4: Feedback QUALITY AND INNOVATION f Longitudinal Quality Improvement (QI) curriculum with mandatory practicum for first-year residents f Multi-disciplinary patient safety group was established; Significant Event Analysis (SEA) was integrated into practice to identify and analyze patient safety incidents f Annual “Do IT Better Rounds” to review SEAs with the entire FMTU staff and residents f Patient Experience Surveys implemented f Multidisciplinary team project on Deprescribing PIP (potentially inappropriate prescribed) medications in the Elderly. f Development of a practice website for informed patient care and education by our FMTU RESEARCH AND SCHOLARLY ACTIVITIES: Scholarly Activity (2020–2025) f 7 publications f 13 presentations (provincial) f 9 presentations (national) Sites and Divisions | Sites

f 2 presentations (international) f 27 other presentations f 4 research (funded) f 3 research (non-funded)

SOUTHLAKE HEALTH SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) f Learners: 18 f Faculty: 16 f Site Chief: Dr. Mina Moussa f Faculty Development Lead: Dr. Milena Markovski f Undergraduate Site Director: Dr. Taylor Sedran f Program Director: Dr. Julian Manzone f Research/Academic Project Lead: Dr. Sean Haber f Quality Improvement Lead: Dr. Alis Xu f Clinical Pharmacist: Zoe Wong Site Overview: f Founded in 1924, now a 500+ bed regional hospital serving northern York Region and southern Simcoe County. f Offers tertiary care, regional cancer and cardiac programs, a Level III Trauma ED, Maternal Child Program (2C NICU), and Maternal Fetal Medicine clinic. f Southlake Academic Family Health Team (SAFHT) serves 24,000 rostered patients, including complex, vulnerable, and underserved populations. f Residents often continue careers at Southlake or surrounding communities.

CURRICULAR AND SITE INNOVATIONS: Site Strengths: f Strong learning environment with broad clinical exposure and a collaborative relationship with different specialties. f The competency committee meets regularly to assess resident progress, and resident evaluations incorporate the input of multiple teachers and healthcare providers to capitalize on the collective strengths of the teachers’ group as well as to minimize any potential learner/ teacher mismatches. f Residents have continuity of care experiences and are first in line for educational opportunities. f Faculty with diverse expertise, including ER, hospitalist, surgical assists, dermatology, gynecology, sexual health, and shelter care. f Prioritizes resident wellness through structured support, and the “Resident-of-the-Day” program allows residents to cross-cover for each other and builds collegiality among residents. f Minor Procedures Clinic allows residents to develop hands-on experience 2020–2025 Self-Study Report

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f Dermatology curriculum developed, expanded home visit program. f Emphasis on care for vulnerable populations and interprofessional collaboration.

UNIVERSITY HEALTH NETWORK – REHAB

SITE LEADERSHIP AND OVERVIEW (NUMBERS ARE PER YEAR) Leadership: POSTGRADUATE EDUCATION: f Faculty: 14 core family physicians actively engaged in f Horizontal, 2-year Family Medicine residency; only teaching and clinical care. postgraduate program at the site. f Clerks: 30 clerks (though not a core site) f Residents are assigned a primary preceptor and a mini- f Residents: 6–8 per year (PGY3 Hospitalist and Care of practice of 150–200 patients for continuity. the Elderly) f Collaborates with Southlake Academic Family Health Team f Chief of Division of Hospitalist Medicine: Dr. Sabrina Lim and allied health team, exposure to dermatology, gynecology, Reinders sexual health, minor procedures, and home visits. f Academic Lead: Dr. Cary Fan f Quality Improvement (QI) Lead: Dr. Nancy Xi UNDERGRADUATE EDUCATION: f Practice Plan Chair: Dr. Anjali Bhayana f 8–9 clerks/year rotate through Family Medicine Teaching Unit (FMTU) for core family medicine and SITE DESCRIPTION Transition to Residency rotations.

Toronto Rehab is a multi-site, internationally recognized postf Undergraduate Lead coordinates with the central program. acute care hospital providing specialized inpatient and outpatient rehabilitation, complex continuing care, transitional FACULTY DEVELOPMENT AND RECOGNITION: care, and long-term care. The Family Medicine Hospitalist f Led by a dedicated Faculty Development Lead who group works to provide inpatient care across the post-acute reports on central initiatives during on-site meetings. care sites, including rehabilitation, transitional care, reactif Works with the Site Chief to coordinate Faculty vation, complex care, and long-term care. They work with a Development events to address faculty needs. large multi-disciplinary team that includes physiatrists, nurse f Faculty Development Lead oversees Family Medicine practitioners, behavioral specialists, geriatricians, psychiaRounds for hospital and community physicians. trists, wound clinicians, physiotherapists, occupational therf Conducts annual needs assessments and uses apists, speech and language pathologists, respiratory therfeedback surveys to decide on local Faculty apists, dieticians, pharmacists, and nurses.

Development events and supports interprofessional education initiatives such as promotion applications.

Sites and Key Programs: f University Centre (550 University Ave): QUALITY AND INNOVATION: Z 148 beds f Residents engage in a longitudinal Quality Improvement Z Specialized inpatient rehab: stroke, acute brain (QI) project, or can choose to integrate their work with injury, multi-trauma, musculoskeletal, and geriatric SAFHT initiatives’ Quality Improvement Plan functional enhancement, cancer, and transplant f Regular check-ins with the Quality Improvement Lead Z Specialized Dementia Unit for long-term care patients physician preceptor to support resident projects. who require medical and behavioural management. f Adopted technologies to use as tools for advanced QI Z Outpatient clinics: Comprehensive Integrated Pain analytics, including Electronic Medical Records (EMR), Program, complex musculoskeletal (MSK) care online booking, an asynchronous messaging system f Rumsey (345 Rumsey Rd) (OCEAN), and AI scribe tools.

Z Provides outpatient cardiac prevention and f “Doing it Better” Rounds bring together physicians, rehabilitation as well as outpatient neuro-rehab IHPs, residents, and administrative staff to clinics. collaboratively identify and analyze significant patient f Lyndhurst (520 Sutherland Drive): safety events or near misses within our clinic.

Z 60-bed post-acute site dedicated to spinal cord rehabilitation.

RESEARCH AND SCHOLARLY ACTIVITIES: Z Spinal Cord Rehab is the largest program in Canada f Residents and faculty engage in clinical and for traumatic/non-traumatic spinal cord injuries educational research.

Z Provides inpatient, outpatient, follow-up care, f 2020–2025: 2 faculty journal publications, 7 poster adaptive technology, and specialized clinics presentations. f Bickle (Parkdale): 186

Department of Family & Community Medicine, University of Toronto

228 beds Provides inpatient rehabilitation services for patients requiring Light intensity/progressive rehab for patient conditions, including geriatric dialysis, frail elderly enhancement, transplant, and neurological rehab.

Z Complex continuing care for patients, including tracheostomy, gastric tube, dialysis, and persistent cognitive states.

Z 2 units devoted to transitional care units, and offers palliative care f Buttonwood & Hillcrest: Z Transitional Care Program (up to 100 beds) for longer-stay patients needing reactivation, awaiting housing, or long-term care Z Z

UNDERGRADUATE EDUCATION: Toronto Rehab Hospitalist Division takes an active role in pre-clerkship teaching, such as supplying tutors for pre-clerkship courses, such as the Integrated Clinical Experience (ICE), Case-Based Learning (CBL), Health in Communities, and Portfolio. f Bickle hosts full year Integrated Clinical Experience (ICE) students. f Bickle, Lakeside, and Toronto Rehab University are the main sites for Transition to Practice and geriatric/care of the elderly rotations. f Elective clerkship opportunities across all inpatient sites.

f Active involvement in research and quality improvement f Several publications and presentations by faculty over the last five years LOOKING AHEAD: f Recent expansion and program changes: Z Buttonwood & Hillcrest Transitional Care Program opened/reopened Z Bickle Progressive Rehab Program launched Z Low Tolerance Program expanded to include Guillain-Barré Syndrome rehab stream Z Post-acute care sites merged with Westpark f Opportunities: Onboarding new faculty, realignment of workflows, integration with DFCM strategic plans, and growth in comprehensive family medicine services.

PGY2 MID-ONTARIO SITES In 2023, the Department of Family and Community Medicine transitioned from its former Rural Program to the Integrated Communities Stream (ICS), introducing a new model that combines urban and rural experiences in a longitudinal format. Sites provide a unique opportunity to live and work in smaller communities while continuing a comprehensive horizontal curriculum.

f Program Model: Integrated Communities Stream (ICS), combining urban PGY-1 experiences with immersive POSTGRADUATE EDUCATION: rural/urban PGY-2 training f Active in Hospitalist PGY3 and Care of the Elderly PGY3 f PGY-2 Locations: rotations.

Z Alliston (Stevenson Memorial Hospital) f Residents are hosted for elective and geriatric Z Orangeville (Headwaters Healthcare Centre) rotations-Lyndhurst specifically hosts residents from the Z Port Perry (Lakeridge Health – Port Perry Hospital) Scarborough program for inpatient medicine rotations. f Training Structure: Residents spend 4–5 half-days per f Opportunities for longitudinal family medicine care in week in family medicine and rotate through geriatrics, long-term, complex, and rehab programs psychiatry, obstetrics, and internal medicine f Learning Environment: Close-knit, learner-centered, FACULTY DEVELOPMENT AND RECOGNITION: emphasizes broad clinical exposure, continuity of care, f The Academic Lead ensures that faculty receive and community health engagement University of Toronto onboarding and ongoing faculty f Goal: Prepare residents for independent practice in development needs are assessed through formal and diverse Ontario settings informal needs assessments. f Faculty participate in city-wide DFCM Division of Hospitalist rounds. f Engagement in the Toronto Rehab Balint Group for emotional reflection and wellness. f Collaborative wellness initiatives with physiatrist colleagues.

RESEARCH AND SCHOLARLY ACTIVITIES: f Quality Lead and core staff have developed Divisionwide CPD-certified rounds and case studies for faculty Sites and Divisions | Sites

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500 University Avenue, 5th Floor Toronto, Ontario M5G 1V7 e. dfcm.communications@utoronto.ca 188

Department of Family & Community Medicine, University of Toronto

dfcm.utoronto.ca