Summer 2017 (Volume 27, Number 2)
Dr. David Robinson
What do you believe are the qualities of a good educator? How do these apply to you?
The things that I note about a good educator are depth of knowledge, passion about the subject that inspires learners, flexibility and clarity in delivery, and an understanding of and interest in the students. How this relates to me is a mystery.
Can you recall a teacher in your own past who inspired you and directed your own course into education?
Many, but the most memorable is my wife, Enid Brown, who was a highly-respected Instructor at the University of Winnipeg. She was a key person who’s “teaching style” I emulated and still do to this day. She made hard things seem easy and inspired her students.
In addition to clinical teaching, you’ve held a number of education positions including Program Director for 10 years and Undergraduate Medical Director for Rheumatology at the University of Manitoba for more than 15 years. From your vantage point, how has the nature of medical education changed?
Boy has it ever changed. Love it or hate it, post-graduate education has changed from being an apprenticeship-type experience to being much more “professional” with stricter accreditation standards, development of CanMEDS, restrictions on duty hours, and many more changes to come with competency-based programs. Undergraduate education has moved from didactic lectures and note-taking to self-learning and on-line material. Most of the medical students now skip out lectures to learn at high speed online. Adapt or perish!
You have a great interest in rheumatic diseases in First Nations and participate in outreach clinics with First Nations groups in Manitoba. How does the presentation and epidemiology of rheumatic diseases differ in First Nations?
Rheumatic disease, particularly RA has a unique biology in First Nations. This includes unique genetics, young age at presentation, high titers of autoantibodies and a predilection for larger joints. In 2017 these are easily surmountable with our current medications. Unfortunately, geography, social determinants of health, and First Nations’ complex relationship with the health care system means we still see the natural history and destruction of these diseases. It is very rewarding to make a difference in these communities.
It is noted time and again that there is a disparity in access to quality healthcare for First Nations groups. Why does this gap in access continue to exist and what steps must be taken (by government and leaders) to eliminate this gap?
Gaps in care continue because of geography, social determinants of health and the historic disenfranchisement of First Nations. Outreach clinics definitely help narrow this gap. In the communities I visit, everyone who wants care can receive it, although many have competing life priorities. There are still huge deficits in things like access to physiotherapy. The dialogue the CRA has developed with the federal Non-insured Health Benefits (NIHB) program has definitely streamlined access to medications for our rheumatic disease patients. There are several more jurisdictional roadblocks that need breaking down between provinces and the federal government. Long-term solutions will only come with adequate funding of education in First Nations communities. Elimination of the gap will truly take a generation or more.
What do you most love about living and working in Manitoba?
Great colleagues and fascinating work. Family ties. The City of Winnipeg is not too big and not too small. Awesome summers. Cottage country is close by – and you can afford to own one.
As a respected teacher-educator, what would your advice be to a prospective rheumatologist?
Find a mentor – maybe a couple. Be willing to explore less common practice settings (um – like in Winnipeg, for example). Specialize in something – even if it's only a tiny piece of your practice. It will make it more rewarding. Have fun. Rheumatology is a great gig.
You are marooned on a desert island? What book would you like to have on hand with you?
Dummy’s Guide To Boat Building.
What talent do you have that is not utilized successfully in your workplace?
Stand-up comedy. No one seems to get the jokes.
If you had one free hour each day how would you use it?
Exercise. Either that or drink the other half of the bottle of wine.
David Robinson, MD, MSc, FRCPC
Department of Medicine,
University of Manitoba
Dr. Joanne Homik and Dr. Cory Baillie presented Dr. David Robinson with his award.