IFMSA 2018: international talks on universal themes
More than 800 medical students from around the world gathered in Montréal from August 2 to 5 for the Health Symposium of the International Federation of Medical Students’ Associations (IFMSA). The Québec Medical Association (QMA) is very proud to have been the main sponsor for the event, because it believes that medical students—the next generation of doctors—no matter where they are in the world, are the future of the profession. But also because this year’s progressive theme of social responsibility aligns with the QMA’s vision and mission.
An inspiring launch evening
On the opening night, Claudel P-Desrosiers, president of the Symposium and member of the QMA, delivered an inspiring message about the value of the IFMSA for aspiring doctors, not only as a venue for meeting new friends from around the world, but also as a way for members to develop and thrive together, and encourage and inspire one another. In short, it’s a springboard for future physicians to become leaders who understand that they have a social responsibility that extends far beyond population health.
The Symposium’s organizing committee.
Dr. Yun Jen, outgoing president of the QMA, elaborated on the social responsibility of doctors today: “Physicians are becoming increasingly sensitive to this new vision of medicine. The profession is undergoing a transformation. A new definition of professionalism is emerging. We, the physicians of today and tomorrow, have a dual responsibility towards the community, in addition to our individual responsibility towards our patients: we must make the most optimal use of resources and also focus on population health,” she stated. “We all have to work to ensure the sustainable development of our societies and the viability of our health care systems. Development that addresses present needs without compromising the future of upcoming generations. We must have a long-term vision that takes into account the environmental, social and economic aspects of the activities of this development. And medicine is part of it.”
Dr. Yun Jen addressed the themes of social responsibility and sustainable development.
The delegates also heard from Dr. Marcoux, president of the Canadian Medical Association, who spoke to the fact that medicine is evolving, and that physicians now and in the future have a critical role to play given the technological breakthroughs that have pushed the limits of what’s possible. Patients should be seen as partners, Dr. Marcoux added before reminding the young delegates that the future of the profession is now in their hands. To solve the problems facing their profession, they need to be willing to think outside the box.
Dr. Laurent Marcoux spoke about the redefinition of the medical profession.
The QMA and the CMA also led two joint workshops on the universal themes of medical assistance in dying and professionalism.
On Saturday morning, Dr. Yun Jen of the QMA and Cécile Bensimon, Director, Ethics and Professional Affairs at the CMA gave the 50-some future physicians at the medical assistance in dying workshop an overview of the ethical issues surrounding the issue, and a portrait of the situation in Québec and Canada.
Medical assistance in dying was a topic of interest for the delegates.
Does a physician have an obligation to preserve and protect the sanctity of life, or are they duty‑bound to listen to their patient’s needs and show compassion? Is the issue always black and white? In real life, a physician can fall somewhere in between these two extremes. In order to address the issue from an ethical perspective, the physician and the future physician need to determine their own positions based on their personal values. The notion of the patient’s autonomy was also discussed, and that of physicians’ right to conscientious objection.
How does this apply in everyday life for physicians in Québec and Canada? Both speakers clearly explained the provincial and national landscapes, and the legal grey area surrounding the issue. In fact, the law in Québec stipulates “imminent death” as a criterion for medical assistance in dying, whereas the notion of “reasonably foreseeable death” applies in the federal legislation. So, Québec is stricter than Canada, but federal law takes precedence over provincial law. This legal vacuum will need to be cleared up in court. For now, however, physicians in Québec are operating in a climate of uncertainty and misunderstanding. The next challenges facing physicians were also discussed, namely expanding medical assistance in dying to mental health patients and mature minors, and advance requests for assistance in dying.
Several participants expressed their concern about the physician’s role in this process, and the fact that little to nothing is said about the human side of medical assistance in dying in their faculties’ curricula. But the main message to come out of these discussions is that the way in which we see medicine is changing. The goal is not to protect life at all costs anymore, it’s to respond to the needs of the population.
On Sunday morning, Ms. Bensimon of the CMA and Dr. Abdo Shabah, QMA and CMA board member, spoke to some 40 delegates about medical professionalism. After describing the situation at the national and provincial levels, they defined the concepts of professionalism and social contract, and positioned the physician’s role with respect to public expectations. They also pointed out the difference between ethics, which are grounded in values, and a code of ethics, which governs practice and practice standards.
Participants understood that medical professionalism is being redefined and that they are part of the reflection process.
The QMA and the CMA believe that professionalism will be a key issue for the future of medical practice and our health care systems, which is why they have made it a priority issue. The CMA just made public its Charter of Shared Values, Code of Ethics, and Accountability Framework. For its part, the QMA has embarked on a provincial tour to talk to physicians about the issue and possible solutions, such as leadership and clinical governance.
The workshop participants all said they would like to hear more about leadership and see it covered more extensively in their curricula. “Leadership” isn’t only synonymous with “physician‑managers,” but also with “medical professionalism.” In answer to the delegates’ questions about how they can demonstrate leadership, the speakers gave several examples, such as taking courses on non-clinical topics, working on a project at their hospital, starting a new project, doing something innovative, or taking on a new responsibility. Again, the main message of this question period was that medical professionalism is being redefined, just as the way in which we see medicine is changing.