Oct 29, 2020

I3P Residency builds clinical and advanced leadership skills

Education, Grad Studies & Fellowships, Residency, The Office of Education Scholarship, About DFCM
Dr. Michael Taglione and Dr. Vivian Tam

Dr. Michael Taglione and Dr. Vivian TamFor aspiring family doctors and health system leaders, meeting the needs of patients at an individual and systemic level requires both clinical and leadership skills. Those looking to develop these skills in parallel, should consider the DFCM’s I3P program.

Launched in 2018, the Integrated Three-Year Family Medicine Residency Program (I3P for short) integrates advanced leadership learning into the family medicine curriculum.

The program has two academic components. First, residents develop core competencies in comprehensive family medicine leading to certification with the College of Family Physicians of Canada. Second, they earn a University of Toronto Master of Science degree in System Leadership and Innovation, currently offered through the Institute of Health Policy, Management and Evaluation.

Rather than completing two years of family medicine training and then having the option to do third year focused on a specific area, I3P residents extend their clinical training by one year to develop advanced leadership skills alongside their clinical practice. This integration allows residents to develop a deeper understanding of the healthcare system, the challenges it is facing, and how to improve it.

The I3P program currently has two graduates and three active residents, Drs. Vivian Tam, Michael Taglione and Anson Dong.

DFCM spoke to Drs. Tam and Taglione, to find out more about their experience of the program.

Why did you choose I3P?

Dr. Taglione: I applied for I3P because of its focus on training residents to solve complex health systems problems at a leadership level. Upon graduation, I hope to practice comprehensive family medicine where I can focus on the individual needs of my patients while also addressing the systemic issues that impact my ability to provide care. I believe this program is crucial in preparing me for that future.

Dr. Tam: Learning that I could pursue the I3P changed what I wanted my residency education to look like – I thought it was so valuable to be able to learn about macro-level health system issues alongside learning to practice clinical medicine. Together, you get a much better sense of the context you’ll be working in, as well as the challenges and changes to expect. Through I3P, you gain the tools you need to be a health system leader and I’m very excited to put our skillset to use when we graduate.

How has the I3P training helped advance your career goals?

Dr. Taglione: Combining Master's classes with hands-on practicums gives you a better understanding of the health system and solidifies the knowledge and skills required to create systems change. Doing this alongside residency training creates a holistic program that is most realistic to a future career where both patient care and health systems work is prioritized.

Dr. Tam: If I were to name one overarching goal in my career, it would be to work towards health equity and to mitigate some of the social justice issues that are the root cause of so many of our patient’s illnesses. I don’t have one particular pathway in mind, but the I3P has prepared me to pursue this goal in a number of ways. The core courses have helped me build skills in areas such as recognizing potential areas for improvement in healthcare, designing innovations, and program planning and evaluation. Meanwhile, through “build your own adventure” style practica opportunities, I’m working in healthcare consulting and public policy development. For this I’m working with students from the business and public policy schools, learning from them has been one of the best parts of my experience so far!

What unique experiences has I3P enabled?

Dr. Taglione: Through one of the course practicums, I was able to work on the application and creation of an Ontario Health Team. This was eye-opening. I worked closely with stakeholders across the spectrum of healthcare, from home services, to hospitals, to long-term care facilities. I gained a much stronger appreciation of the intricacies of the system and was able to meet leaders actively making changes to improve the local health system at large.

During my time on practicum I led the creation of, and now chair, the Virtual Care in Primary Care team. This aims to support primary care adopt and use virtual care, an area that has exploded since the COVID-19 pandemic started.

Dr. Tam: My practica have without a doubt been some of the most valuable professional experiences I’ve had to date. The first was a re-election campaign for a candidate I really admire, building a policy platform and drafting public statements in addition to canvassing in the community. Spending time on the campaign trail I learnt a lot about policy and politics, particularly when it comes to representing the views of your constituents while maintaining your own core set of professional values. My second is in evolution because of COVID, but I’ve been able to work with one of the VPs of Unity Health. Just having conversations with a senior hospital leader has been eye-opening!

Who would you recommend the I3P program to?

Dr. Taglione: If you foresee yourself wanting to improve the health system in which you practice while still serving individual patients as their primary care physician, this program is for you.

Dr. Tam: I3P is suitable for anyone who is looking to understand, and then hopefully improve, the health and healthcare system as a whole. I3P allows you to appreciate the broader context that your patients are navigating and enriches the clinical care you provide. It also exposes you to the complex realities – budgetary constraints, demographic change, sociopolitical factors – that shape the system you work in and gives you the tools to see the system’s strengths and opportunities. A big plus is building a personal and professional network of colleagues with similar interests from across residency and graduate programs at U of T!

The I3P program will be accepting applications for new students to enroll in the program in mid-November. For more information email Dr. Tannenbaum at david.tannenbaum@utoronto.ca.