As we struggle to generate yet-another new vision statement, it may help to reflect on what we have already been doing. We are assured "there is no plan in the President's office nor the VP-Academic's office." (One wonders if maybe it is in the VP-Finance's office?) Taking that assertion at face value, we have no plan, therefore we are engaged in a series of stressful focus groups and consultations that have yet to be productive of a PLAN.
THERE IS A PATTERN
Perhaps it is a conundrum akin to Berkeley's: "does a tree that falls make a sound if no one is around to hear it." That is, can there be a pattern of changes without a plan? (And, if so, then what do we need with planners, but I digress.)
We do indeed find a pattern of changes, and institutional data paint it clearly, as shown in these figures.
The data in the following figure represent the number of faculty FTEs (full-time equivalents) in a couple of campus units over the last decade plus, using F1989 values as a baseline. That is, did a unit prosper or suffer in size since 1989? Growth is shown by percentages above 100% and decline by values below 100%. To avoid visual clutter, only three units are shown, one of the worst-case scenarios (Education), the campus average, and the best-case scenario (Medicine). (The dataset with other Faculties is available here, as a tab-delimited spreadsheet file that you can import into Excel or whatever -- Source: http://www.fp.ucalgary.ca/oia/Facts/01-02FB.pdf, pages 80-82, 176-181)
The campus grew about 10% in FTE faculty. Some Faculties were fairly stable or mixed with no clear pattern, a few others grew slightly (e.g., Engineering and Nursing), and a few declined somewhat (e.g., Kinesiology and Social Science). However, the Medical School grew by 40% since F1989. The change for Medicine is even more striking if one goes back one more year, to the F1988 data, where there was almost a 50% gain from F1988 to F1989, so that from F1988 to now the Medical School has doubled.
I call that a PATTERN. If it happened without a PLAN, so be it (but then let's concede we don't need planners, nor focus groups!).
When one looks at the latest iteration of the Academic Plan Advisory Group (Feb. 5, 2003), it is replete with "Health and Wellness" and examples of new programs involving Medicine. It seems quite fair to say that what we are doing is not so much developing a plan, but rather just endorsing what we have been doing for the past decade or more.
The following figure depicts a different type of change, namely how involved these faculty FTEs are in terms of graduate degrees. This is simply a unit's number of graduate students (full-time) divided by the number of faculty FTEs, again depicting a couple of extremes and the campus average (full data here).
What we see here is that the supervision load has grown about 50% over the decade campus wide, moreso in some units, but it continues to lag in Medicine. Again, patterns, whether there was "a plan" or not. Interestingly, for the best and worst-case units shown here, the same number of full-time students are involved, just over 350, what differs is the faculty FTE invested in each. In the worst-case there are 90 faculty FTEs involved with 368 full-time graduate students, in the best-case there are 405 faculty FTEs involved with 364 full-time graduate students (and the 405 are on the higher salary grid, further exacerbating the cost-ineffectiveness).
These patterns raise a question about realizing certain goals. Several times of late we have heard of an objective to grow the graduate student representation until it becomes 20% of total enrollment. So, to over-simplify perhaps, from these two Figures it looks like we have invested 40% more resources (FTEs) into a unit that is slow to grow to meet that 20% goal? (Oops, would a plan have prevented this?)
It is said that the Medical School gets "only 13%" of its budget from the University. (This figure comes from variou sources, and seems likely to be correct.) As a percentage 13% sounds modest, but actually the more relevant question is how the actual dollar figure compares to that for other Faculties. The OIA data (p. 191) show about 22 million (net) to the Medical School (which -- if 13% -- means the Medical School budget is about 200 million, just as a guesstimate). Social Sciences also gets about 22 million; Sciences gets 28 million, so "only 13%" actually amounts to a tie for the second largest amount among Faculties, but with no contribution to general undergraduate experience, and at best a very expensive and labor-intensive increment toward the 20% graduate student goal.
Another point that is frequently made is that "'most' positions in the Medical School are on soft money." Just what is "most" -- 50% plus one, or what? (And could we see the books on that?) One casual, unofficial number I have heard recently is that "only 30" are not soft money, which seems ridiculously low. Then there is the "gotcha," the future liability whereby soft-funded but tenured positions often mean that the position has to be covered by hard funds if/when the soft money disappears (especially when there is a perceived prospect that the person can get big grants?). Nonetheless we can ask a question: What does one get for the 22 million in each case? I think the bargain is quite clear in the Table that follows.
|Social Science||Medical School|
|Funding||$22 million||$22 million|
|Faculty FTEs||235||30? (405 max)|
(+ 427 post-MD)
I suspect there are other units on campus where the faculty to graduate student ratio is low (i.e., around 1.0) who would like to grow by hiring three new faculty for every two additional graduate students, but it is hard to credit that as a realistic way to reach the 20% goal. Elsewhere on campus, even replacement faculty are hard to come by, and when a replacement is forthcoming the position is reset to a (cheaper) newPhD level. The new PhD will need some years before being able to recover the supervision load of the lost senior faculty person, so it is hard to imagine much progress in the near-term. Even replacing senior faculty losses with new senior faculty will only maintain the present percentage, so shifting FTEs into a unit where one faculty FTE doesn't even cover one student does seem to be going in the wrong direction if you are trying to grow the size of graduate programs.
There are actually other data to question how a Medical School contributes to a university anyhow. Digging back into the archives for the data on Macleans magazine's annual rankings of universities provides a curious result. The overall rank of an institution can be rank-order correlated with the rank of that institution in terms of budget. This is a small way of assessing the notion that success overall is a function of the amount of money available. The outcome is not encouraging for Medical-Doctoral institutions. Specifically, nation-wide there generally is a lower correlation between a university's budget ranking and its overall rank in the Macleans ratings within the Medical-Doctoral category compared to the Comprehensive category (Table follows).
There is little here to support the notion that resources reallocated to the Medical School will enhance the general campus experience, especially for undergrads. In the case of UC specifically, the evidence is yet more troublesome (Table follows).
|UC Budget rank||7||10||4||2||3||7||1||8||8||10||8|
|UC Overall rank||14||14||14||12||12||10||12||13||11||11||10|
Of course, there are always quibbles with data, but collectively the PATTERN in these results is at odds with the notion that harvesting resources from the campus north of the TransCanada and planting them south at the Medical School will achieve any improvements in the general undergraduate experience. Further, it does not seem likely that such reinvesment would move in the direction of expanding our graduate profile to 20%, certainly not in a very cost-effective manner.
If this is THE PLAN, then the best evidence that it won't work is that we have been doing it for over a decade without success. We will end up with yet more of our limited resources allocated to a unit that contributes nothing to undergraduates in general, and which also contributes next to nothing to general graduate education. As for the big bucks from medical research grants, the trickle-down effect has yet to be materialize, as far as I can tell.
(Some of the same conclusions re undergraduate experiences were reached by Globe and Mail columnist Jeffrey Simpson re the 2003 Maclean's issue, and these conclusions were implicit in Pocklington and Tupper's book "No place to learn" (2002), althoug neither Simpson nor Pocklington-Tupper as specifically target the transfer to medical training as I do here.)
It is important to realize that:
This pattern derives from a SCHEME (or a SCAM perhaps, not exactly a PLAN) that has been in progress for over a decade, whereby politicians, federally and provincially, buy votes by funding health care above and beyond education in general. As a result, to get enhanced funding universities must find ways to attach to the medical industry teat. To the extent that universities are successful in this way, politicians have no incentive to change, nor does the taxpayer. And the medical industry laughs all the way to the bank. All seems well in the world at large. (One wonders though, will the taxpayers still love us tomorrow?)
The medical industry as a whole has been relentless, one might even say ruthless, in lobbying for taxpayer and other funds. And frequently more than a little disingenuous. "Saving lives" is a noble cause. I wonder, where are they saving them? Royal Bank? CIBC? How much interest are they getting? In truth, unless I missed the news story, I think we all still have a one-way ticket in life. When anyone talks about "saving lives," you might best grab your wallet.
"Improving the quality of life" is another noble cause. Of course, I've generally found the quality of my life improved by learning something new, so this is not a medical monopoly. However, those of us outside the medical industry must just face the fact that we have not been as effective at self-promotion, frankly we are pathetic by comparison.
Truth be told, the negative side, "relieving pain," is what actually sucks us into the medical industry's game. Maybe there is a lesson to be learned in that, namely, that relieving stupidity and ignorance ("wellness") is not as valued as relieving pain. Is it too bad that stupidity doesn't hurt more? Perhaps we should stop trying to make the world safe for idiots, thus making stupidity painful and thus noticeable when it is gone? Just a thought.
However, a conspiracy guy might note that governments, and the medical industry, actually seem to have a vested interest in maintaining rather than eradicating stupidity. Otherwise, who would pay those cigarette taxes, buy lotto tickets, play the VLTs, believe that affirmative action and equal opportunity are the same thing, believe that criminals will register their guns, and, most importantly, vote again for clowns who fail to deliver on their promises? Yes indeed, stupidity can be handy for some agendas. But who can complain, after all, health care is "free" isn't it? (What was that he just said about stupidity?)
The positive side, "health and wellness," is as tough a sell to the public for the medical industry as it is for the education industry. But then they don't need to beat their heads against that wall, they can make money on the down side. It's not health and wellness that works, it's pain-avoidance, and a dash of confusion about immortality. Likewise, there is a recipe that has worked for snake-oil salesmen of all eras: claim the credit for success, pass the blame for failure elsewhere. (Even the education industry is passably adept at this!)
In a nutshell, there is a pattern here, but the forces at work may not have much to do with local contemporary "plans," rather a far larger change in social and political priorities with regard to the public purse. Resistance may not be futile altogether, but it is necessary to realize just what the impetus for these patterns is before trying to change anything.
Things on campus may have to change, I'm sure they do. Things probably will never again be as some would like to remember, if they ever were that way. But I think two things need to be reiterated:
Make no mistake, some of my best friends are in the medical world (too many as I get older!), but these just are not interchangeable concepts.
Obviously we must do what we must do, but if we ignore these distinctions, my guess is that the "Pillars of Prominence" will indeed be built on a foundation of sand. Conversely, if we attack "the local messengers" who are trying to cope with this societal change we may be dealing with the symptom as much as the cause.