Policy Statements

Science and Technology
Health Human Resources
Medical Education

Science and Technology

Canada currently occupies a global leadership position in terms of public investments in health research. In order to maintain and enhance this position, Canada must continue to make increased investments in all areas of health research.

The association of Faculties of Medicine of Canada (AFMC) is very supportive of the need for a national science and technology strategy to help Canada set national priorities and to ensure a national competitive advantage. We believe that as we develop and implement our national strategy, particularly one which directs resources to priority areas, there is a need for careful deliberation in order to maximize the impact of our vision and minimize any unintended negative consequences.

The need for balance

Canada must invest in the entire spectrum of health research. While biomedical and clinical research is vital, health services research and broader social science research as it relates to health is also critical for the health of the nation. Innovations in health services delivery, for example, can save lives as well as money.
A balance must be struck between the funding of basic and applied research, both of which are essential in order to achieve the government's goals. While the latter is most obviously tied to the commercialization agenda, it cannot be forgotten that great discoveries and innovations also stem from investigator-driven, basic research. It is essential that as we increase the targeted nature of our research funding enterprise that we do not do so at our own peril.
Priority research areas identified in any focused strategy must take into consideration both current and emerging research areas that are on, or just below, the horizon. The latter is particularly important to recruit and retain the best and the brightest researchers - those most likely to be conducting innovative, groundbreaking research with enormous potential for return.
Canada must continue to make investments in science and technology that are balanced between funding for researchers, direct and indirect costs of the research they perform, operating grants to support infrastructure purchased through research grants, and research networks. Ensuring the right balance, derived through consultation with a broad cross-section of the Canadian research community and considering international comparators, will enhance research opportunities for Canadian scientists and allow them to stay in Canada while remaining at the leading edge of their fields.

Efficiency

Canada must work to ensure that its research granting processes are efficient, transparent, and designed to guarantee research excellence. Well-integrated and aligned programs across the granting councils will lead to an efficient grant application system that recognizes that research often crosses disciplines.
Any modifications to the current system must retain effective processes of peer-review in order to ensure transparency, international competitiveness and the highest quality research.
In order to maximize efficiencies to Canada's research granting processes, researchers need to be made aware of any revised grant application procedures and any newly integrated funding systems in a timely fashion. Researchers may well need to be given a period of time to adjust their work to new granting processes; this will be particularly important in order to ensure the continued excellence of submissions.
Canada makes significant health and health-related research investment through various mechanisms other than the Canadian Institutes of Health Research (CIHR). The Canada Foundation for Innovation (CFI), Canada Research Chairs program, National Centres of Excellence (NCE) and National Centres of Excellence - New Initiatives Programs (NCE_NI) as well as NGOs such as Canada's health charities, the Canadian Health Services Research Foundation (CHSRF) and others need to be closely aligned to ensure that all possible synergistic effects are maximized and that duplication of effort is avoided.

Evidence-based ROI assessments

Canada must continually assess the returns on our considerable investments in science and technology. We believe that any assessment of these returns must be evidence-based, employing useful, relevant, and equitable metrics and indicators that take into account the time frame for research impact to be realized. Research has both short-term and long-term effects and as such, much of science builds on findings from the past. Impacts cannot be measured effectively using short timeframes; the impacts of research must be measured over decades rather than over shorter periods of time.
Canada spends a substantial sum of money every year on initiatives and programming in the name of "knowledge transfer" or "knowledge translation" (KT). These investments are being made despite a virtual absence of a coherent national conceptual framework for KT or significant evaluation criteria to measure its potential impacts. While AFMC believes that knowledge transfer is an important area of activity for Canada, we must develop a conceptual framework and logic model to assess the value we receive as a nation for these expenditures.

Engaging the public

The Canadian public must be educated about the importance of science and technology investments to both Canada and the global community. This public education must include information about the role of universities and other institutions of higher education as places of research as well as education.

Attracting Students

Canada must do a better job in encouraging students to study life and biomedical sciences, particularly at the post-graduate level. Financial incentives and modifications to the Canada Student Loans Program are needed in addition to the proposed enhancements to the Canada Graduate Scholarships program. Support should also be enhanced for those students pursuing simultaneous training in research and business.

Private sector engagement

AFMC is supportive of an increased role for the private sector in Canada's research enterprise. As the government develops new programs and strategies to achieve this, such as the proposed changes to the NCE program, transparency and effective communication will be essential to reassuring the research community. The processes by which the private sector will identify and lead new research initiatives must be developed in consultation with current research leaders and be made clear to everyone at the point of implementation. In addition, the relative level of influence of the private-sector advisory board on the implementation of the business-driven funding initiatives by the granting agencies must be clarified.
AFMC supports the inclusion of business and community representatives on the granting councils' governing bodies. In order to ensure the protection of intellectual property, existing federal policies must be reviewed to ensure that they don't impede S&T collaborations and technology transfer. There is also a need to ensure that intellectual property policies are congruent between researchers' institutions, to further support collaborative research. In addition, the rules and guidelines which would be applied to ensure IP protection must be transparent and clear to all parties involved.

Health Human Resources

By all accounts, Canada has a health human resource problem. In order to solve our problems in a sustainable fashion, Canada needs a health human resources strategy that goes beyond addressing individual crises in clinical sub-specialties (e.g. oncology), specific work environments (e.g. hospitals), or geographical areas (e.g. under-serviced areas). We must address Canada's health human resource needs at a systems level.
There are many opportunities for governments to be creative in addressing Canada's health human resource challenges. Inter-professional practice, scope of practice changes, the use of physicians' assistants, and other innovations are all potential areas that should be explored. There is no avoiding the fact, however, that Canada will need to increase the total number of people working in the health system in order to resolve its health human resource challenges. We must find ways of increasing the absolute number of health professionals working in the system, including doctors that are working in this country.
Even conservative estimates conclude that Canada needs to increase the number of graduating physicians from 2500 to 3000 in order to meet current needs. This can be done in a variety of ways including the creation of additional faculties of Medicine in this country. The effects of additional faculties, however, will take a minimum of 6 years to be realized. Strategies must be developed to address the problem in the shorter term; strategies aimed at repatriating Canadians studying abroad and increasing, where appropriate, the number of international medical graduates practicing medicine in Canada.

Medical Education

Canada has an excellent medical education system. In order to remain at the leading edge, Canada must continually assess medical school curriculum to ensure that it is responding to the changing demographic realities of Canada. We must also continue to innovate in areas such as e-learning, distributed medical education and inter-professional education.
Canada must ensure that our medical education system is appropriately resourced. This means not only providing funding for the right number of medical students, but also ensuring that adequate funds are available to ensure that the necessary infrastructure and teaching resources, including clinical teachers in the community, are available.
In order to ensure a health workforce that reflects Canadian demographic realities, Canada must do a better job at ensuring that medical school is accessible to a greater number of Canadians from lower socioeconomic strata, rural communities, ethnic and linguistic minority communities, as well as our first nations, Inuit and M�tis communities. This means putting strategies into place that deal with the real and perceived financial barriers to medical school and ensuring our medical school curriculum is such that it meets the needs of our diverse society.