10 Questions from an Interview
with Richard Reznick
Current Surgery Chair to Assume the Role of
Dean of The Faculty of Health Sciences at
Queen's University
 Cheryl and Richard Reznick |
Q1: Why are you leaving and going to
Queen's University in July as the dean of
the Medical School?
A: This is one of the greatest surgical
departments in the world, with spectacular
talent in all disciplines and
wonderful programs. I have been the
chairman for nearly 8 years. I think
that during the next two years I would
participate in incremental changes,
not transformative ones. We are all
restless to some extent; restless for change, restless for a new challenge.
Eight years ago I was offered the opportunity to become dean at another
medical school but took this job instead. So I've thought a lot about what
it means to be a dean. I feel I am now poised and ready for a dean's role.
The orbit of a dean is different; there is more involvement with government,
with the boards of all the affiliated hospitals, and an opportunity to serve
as the point of contact for the university with the Ministries of Education
and Health. The enterprise is more complex; it includes all the basic science
disciplines, and the deans participate more on the national stage. The 17
deans of medicine in Canada meet regularly and advocate for the research
enterprise on a national level.
Q2: Can you give some examples of opportunities you have
had to participate in transformative change?
A: I had the opportunity to revamp the licensure examination
for physicians in Canada, introducing the OSCE
exam. I was given the opportunity by Alan Hudson and
Arnie Aberman to form the Wilson Centre. The Wilson
Centre is now a research centre - its subject is education,
but it is a research centre with significant publications,
grants, eleven scientists and twenty graduate students per
year. We have trained 30 surgeons to the Masters level in
Education, many in skills-related activity. Brian Hodges
is doing a spectacular job as director, expanding the programs
I was privileged to start as the first director. Allan
Okrainec and his international telesurgery program is a
product of this focus, populating a new concept in international
training (Teaching Minimal Access Surgery in Africa Using Skype, The Surgical Spotlight, Winter 2009)
In the Wilson Centre, our checklist project on communication
with Lorelei Lingard led to significant changes
in the operating room and formed the basis for the
international surgical checklist project, so well executed
at the University Health Network by Bryce Taylor and
his colleagues and at other sites throughout the world.
(see Surgical Spotlight Winter 2009) [All surgical readers will
enjoy Atul Gawande's recently published book "The
Checklist Project", in which Atul gives appropriate credit
to Lingard and Reznick as initiators. Ed]. The important
lesson from this project is that it is not enough to learn
the motor skills required for performing an operation - it's
critical to know how to make it all work safely.
I am extremely proud of our Surgical Skills Centre at
Mount Sinai Hospital. This centre, under the leadership
of Helen MacRae and stewardship of Lisa Satterthwaite,
has become known world-wide. It has been a fantastic
addition to our surgical education programs.
The new concept of a Competency Based Curriculum for
training surgical residents being developed in the orthopaedic
division is the most exciting project I have had
the opportunity to work on in my twenty-year career.
It is currently at the proof of principle stage, but will
potentially compete with the Halstedian model dominant
throughout the world. Its goal is to meet the current
challenges we face in training by creating a very different
educational model. If we are to train surgeons who are
better than we are, we will have to change, and change
fundamentally.
Q3: I know you don't like the word legacy because it is
too pretentious. For the moment, what would you say best
describes your most important contribution?
A: I believe my most important contribution is helping
to establish surgical education as a bona fide academic
focus. Twenty years ago 98% of surgical chairs would
have discouraged a young faculty member from pursuing
education as an academic route. Today, almost all surgical
chairs would be supportive.
In the microcosm of the department, my most important
contribution has been to be the glue binding the department
together. I've cared about each faculty member,
and worked hard to help them. I think that if they were
asked a two part question about caring and helping, they
would probably answer 'yes' to both. Importantly, all our
division heads and surgeons-in-chief do the same thing.
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Q4: How did that come about?
A: During my first year, I met with every surgeon in the
faculty. I took University Rounds and Gallie Day seriously
to bind the department together, reminding us of
our unity. I tried to be present in some division every
week - at a dinner, a retreat, a fund raiser; providing the
departmental glue.
Q5: What are you proud of?
A: The department has come together more. There is a
sense of partnership, belonging and coherence around
sensible goals like the Spine Program, the Integrated
Trauma Program and the Bariatric Program. One hospital
couldn't provide these programs in their entirety, but
a consortium of up to five or six hospitals could. The
bariatric program in particular is proving that we can
work as a consortium of hospitals as "The University of
Toronto Bariatric Surgery Program". It's a unique entity
that we took to the government, and it was adopted and
funded on the strength of a collective and comprehensive
approach.
There is now near total compliance with our departmental
practice plans. This is bringing about a cultural change
to team practice instead of a solo practitioner mindset.
Eighty new surgeons and scientists have been hired out
of our faculty of 250. This has been incredibly rewarding.
We brought Humber Hospital, Trillium, Credit
Valley and North York Hospital into the University family,
enhancing the sphere of Toronto surgical training.
Our trainees need a breadth of experience that is best
provided across a spectrum of hospitals.
I introduced the mandatory search process in order to
bring all the right people together, so that when the
memoranda of agreement of new surgeons are signed, all
those necessary to help them reach their goal are at the
table and committed to their success.
Q6: What is the Karolinska prize (see Awards section) that you have recently received ?
A: The Gunnar Hoglund and Anna - Stina Malmborg
Foundation insightfully recognized that the Karolinska
celebrates excellence in science and medicine with the
Nobel prize, but medical education, the foundation
of these disciplines, is not similarly recognized. They
founded this prize to recognize contributions to medical
education. I will be the fourth person to receive it, shared
this year with Professor David Irby from the University
of California in San Francisco.
Q7: Who are the mentors and leaders you would like to
have acknowledged?
A: There are too many of them to list. I have been the
beneficiary of career advice from many wise teachers
and colleagues who endorsed and advanced my choices.
I have also had the benefit of a superb executive committee
in the Department and the remarkable common
sense advice of our associate chair Bryce Taylor.
Q8: How is the financial health of the Department?
A: We have been extremely fortunate to receive over
40 million dollars in grants thanks to Ori Rotstein and
more recently Ben Alman as vice-chairs for research. The
finances of our department have been good despite a
recession and constant pressures to contain costs. We were
the first department to hire an advancement officer and
this has helped keep the Department financially sound.
Q9: Besides the glue, what management techniques brought
the members of this complex Surgery Department on board
and developed such a cohesive feeling of unity and common
purpose?
A: I made it flat, not hierarchical. To get things done I
empowered people in their own territory. I think of my
job as that of helper - helping division chiefs run their
divisions or helping John Bohnen run his highly successful
accreditation effort. There are no uphill battles where
there are no hills, that's the advantage of a flat management
program. At the start of my term, I asked the
Banting office staff in our first meeting: "Do you know
who your boss is?" I made it clear that the answer is:
"Our two hundred surgeons. We are here to serve them".
Q10: Any closing thoughts?
A: Three words that come to mind are: privilege, hard
work and fun. It has been a privilege to serve as chairman,
the work has been hard and it has been fun [The
fun test is a very reliable measure of competence. The
only people who are having fun skiing the expert slopes
or performing complex procedures are those who have
the expertise to enjoy them. Ed.]
The support from my wife, Cheryl, has been dedicated,
constant and amazing. I have never felt pulled two ways.
Few people in the world experience that kind of support.
It was always "I'll be there" - never "why aren't you here?"
M.M.
Richard Reznick and I concluded that we would collaborate on this interview in lieu of his
final column. Richard, we thank you for all you have done for each of us. We wish you continued
success in the next exciting iteration of your remarkable career. Ed.
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