This month we say goodbye to our graduating residents and welcome the incoming residents. It is such a busy and rewarding month! RIO Day was a resounding success. Thanks to Dr. Liz Muggah, Chandra Landry and the team. Every year the quality of projects and presentations rises. Many of the papers are publication ready and I encourage supervisors to assist our residents in submitting. Many graduates are looking to the next stage of starting practice and may leave this important work behind. I hope you can take the time to help them go the next step. This work should not be lost! Dr. Daniel Myran and Dr. Jillian Bardsley provide an excellent example – their FMRSP, which received the CT and Pat Lamont Award in 2017, was published in BMC Medical Education this month!
Dr. Elise Azzi was showered with honours and will be in the running for the Murray Stalker Award. Congratulations to Elise! There are calls to better prepare our residents to engage in effective leadership. We certainly see examples of exceptional leadership among our Chief Residents.
Leadership in complex adaptive systems (CAS) was the topic at the recent CFPC Forum. As faculty, we all play leadership roles in many different contexts, and understanding and modeling our leadership skills in these systems takes work! I like the quote that "Complex systems are, by any other definition, learning organizations." I came across this quote on Wikipedia, a great example of a CAS. There are many critics of Wikipedia and yet this is an accessible, constantly changing resource that has both excellent and not so excellent resources.
CAS are in contrast to ordered systems and chaotic systems by the relationship that exists between the system and the agents which act within it. Primary care is a good example of a CAS. Although we have hopes that guidelines and rules will help us avoid the chaos of competing evidence, we know that these cannot avoid the complexity of our patients! The uncertainty and individual actors (patients, physicians, team members and residents) ensure that no one encounter is reproducible!
So how does leadership come into this? As a Department of Family Medicine training a diverse group of residents for their futures, our ability to guide them in their own and our roles as leaders will equip them to deal with the evolving nature of the health care system. I encourage us all to examine our roles and skills as leaders and to keep learning as leadership evolves in complex systems. We know that we need the relationships of teams, shared goals, diverse opinions and a commitment to better outcomes: whether this be in our programs, our clinical practices or our communities. You may be interested in reading a paper by Susan Lieff  a geriatrician at Baycrest and faculty developer who has taken an interest in leadership. I look forward to working with you as we address the constantly changing nature of our work.
- McElroy, Mark W. (2000). "Integrating complexity theory, knowledge management and organizational learning". Journal of Knowledge Management. 4 (3): 195–203.
- How to Lead the Way Through Complexity, Constraint, and Uncertainty in Academic Health Science Centers. Lieff SJ, Yammarino FJ. Acad Med. 2017 May;92(5):614-621.