Expert Spotlight
During her career, Dr. Jean Gray, C.M., FCAHS, developed tools to better evaluate residents in training and championed mentoring programs for female medical students. Her determined leadership has benefited numerous organizations, including the Canadian Association for Medical Education, the Institute of Gender and Health at the Canadian Institutes of Health Research, and the Atlantic Centre of Excellence for Women’s Health. She is one of Canada’s exceptional medical educators and was recognized as such in 2005 with an Order of Canada.
Dr. Gray graduated from the University of Alberta in Chemistry in 1963 and Medicine in 1967. She joined the Faculty of Medicine at Dalhousie University and was the founding Head of the Dalhousie Division of General Medicine, Associate Dean of Postgraduate Medical Education from 1988 to 1996, and Associate Dean of Continuing Medical Education from 1996 to 2002.
As a Fellow of the Canadian Academy of Health Sciences, Dr. Gray has served on numerous boards and committees, in Canada and abroad. She has been a valued member of the CCA’s Scientific Advisory Committee since 2006.
Q: You’ve had a long and impressive career in medical education. Can you share one or two career highlights?
A: Although teaching medical and health professional students has always been a very satisfying component of my career, opportunities to provide leadership to the medical education community and to advocate for research into what works and what doesn’t work in the educational process really stand out for me. As a clinical pharmacologist who understands the need for critical evaluation of a product before it is given to humans, I always found it somewhat surprising that major educational initiatives could be introduced without any attempt at measurement of the outcomes. Some institutions would likely refer to me as a “thorn in their side” because of my repeated requests to evaluate their programs and to provide funds to do research into better ways to stimulate knowledge and skills acquisition and assessment. Today there is an atmosphere of critical evaluation of educational programs in this country that has put Canada at the forefront of the medical education community. Internationally, Canada is now recognized as a major site of educational innovation and assessment, particularly in medicine but also in other health professions. Gone are the days of identifying the teachers involved in medical education as second-class citizens, because contemporary medical education scholarship is now the equal of any other scientific section of the academic community, with grant funding available from several sources.
Q: When you began your post-secondary education, what kind of career path did you envision for yourself?
A: When I graduated from medical school, there were very few women in my class and an attitude that most of us were “taking spaces that could be used by men” because we would all get married and not practice medicine. All of my female classmates have had stellar medical careers, both in their own communities and in the wider world. I am very proud of them but I don’t think any of us had any idea how our careers would evolve when we completed the lengthy education and training required in medicine. I had strong support from the male faculty members in the pharmacology laboratories at the University of Alberta, UBC, and Stanford, with whom I worked as a student, as well as from the two heads of the departments at Dalhousie, where I held junior faculty appointments. This was very important because these definitely were stressful times that combined clinical care, teaching, and laboratory research with motherhood and family. The two department heads, in particular, kept pushing me out of my comfort zone but with support and assistance if I needed it, because they clearly saw something in me that I hadn’t yet discovered for myself. And I would be remiss if I didn’t recognize the incredible support provided by my husband as well as the loyalty of our long-term housekeeper.
One of my secret ambitions had always been to “write a book” and I was finally able to achieve that dream, thanks to the Canadian Pharmacists Association, which approached me to edit a book designed for community-based practitioners that subsequently became known as Therapeutic Choices. Initially, it was a lot of work with limited resources but, as the book became known and went through multiple editions, resources followed, including the opportunity to develop an electronic version called e-Therapeutics, which linked to numerous additional information resources. After six editions, I stepped back from the editor’s role but have continued to watch the interesting developments.
Q: Can you tell me more about the tools you helped develop to better evaluate residents in training and the mentoring programs you championed for female medical students?
A: Because of my concern that we were developing residency training standards but were not examining the impact or outcomes appropriately, I became very interested in the area of performance assessment. In 1996, I took a sabbatical at the University of North Carolina, Chapel Hill, and worked with the medical education faculty there to probe issues of performance assessment. There was a very limited knowledge base in the medical literature, but I discovered a treasure trove of information in the industrial psychology literature thanks to the help of my librarian daughter. That resulted in a review article about residency assessment that has now become a “citation classic” and an opportunity to influence the processes used in Canadian residency training programs, starting with our own programs at Dalhousie.
The mentoring program for female medical students evolved out of personal experience. During my residency and junior faculty periods, I had two pregnancies in a time when no one had even thought about maternity leave provisions because there were so few women in medicine. My first child was born after I had been up all night on call. My second child was born on a Friday evening and, because there was no one to care for my patients, I returned to work three days later, early Tuesday morning. But I promised myself that no other female physician or student at our school would have a similar experience. Attitudes evolved, maternity leave became a reality, and it was time to examine other issues that women in medicine experienced.
In 1990 (the 100th anniversary of the enrollment of the first woman medical student at Dalhousie), I chaired a committee that developed a symposium to learn from the outstanding women in the medical profession, both past and present, in areas such as research, practice and the medical humanities. To focus everyone’s attention, we requested (and achieved nearly 100% success) that every guest speaker in the medical school that academic year should be a woman. The committee also commissioned an original play about Dr. Annie Hamilton (the first female medical student) and a book, with a Canada Council grant, entitled Petticoat Doctors, which outlined the history of the first 40 women to graduate from Dalhousie Faculty of Medicine.
Q: Throughout your career, you’ve been an exceptional leader, teacher, and role model. How did you approach mentoring younger researchers and health care professionals? What values do you most wish to instill in those following in your path?
A: Mentoring is not an issue of “instilling values” but rather of helping individuals to honestly assess their own strengths and capabilities and then using those as the guideposts for their careers. As my mentors did with me, I try to push my mentees a bit but with the knowledge that they will have support as they stretch beyond their comfort zone. My experience with both young men and women who come seeking advice and mentorship is that they still don’t really know what they want to do, whether or not they have the necessary background and skills to do it, and how they can focus their time and attention to achieve the goals they finally set for themselves. My role is to ask the gently probing questions that enable them to figure these things out and then to provide whatever assistance is necessary to help them achieve these goals in a timely fashion.
Q: You’ve agreed to provide some opening remarks on behalf of CAHS at the upcoming evidence-informed decision-making symposium, as part of CSPC 2016. What do you think are some important issues or ideas that you hope to see discussed at the symposium?
A: Over the years, I have worked with a variety of organizations, including the federal and provincial governments, in which policy has been formulated based on tradition or friendships, but not necessarily objective evidence. It has been gratifying to see the federal government move toward a careful assessment of relevant evidence through their support of the CCA and the various questions that are submitted for assessment, but there is still a lot of education necessary to assist decision-makers to understand the role of evidence in generating policy. Although the opening remarks will be a means of setting the stage, the real work will take place at this conference in the discussions and (dare I say it) at the coffee and lunch breaks. That’s where minds change and new ideas emerge.
Q: You have been a member of the CCA’s Scientific Advisory Committee since 2006, where you provide advice on the composition of panels and scientific insight regarding potential assessments. What attracted you to being a part of this aspect of the CCA’s process?
A: I love to learn and this has been the most amazing learning experience! I once likened it to going back to university to soak up knowledge but without the stress of term papers and exams. Interacting with assessment panels as a peer review monitor, both within and outside my own expertise, has been very instructive. And I have a chance to meet and talk with some of the extraordinary Canadians in academic areas such as history, economics, engineering, ethics, computer sciences, and other disciplines that I rarely encounter in my day-to-day life. Every aspect of this experience has been gratifying!
Q: Is there anything you are reading or watching for fun right now?
A: I am a voracious reader. I belong to two reading groups that meet once a month. The oldest is an all-male (with the exception of me and another women) group of physicians who tend toward nonfiction and the classics. At the moment, this group is reading John A by Richard Gwyn and we usually include a Shakespearean play each year, so Twelfth Night will be next month’s discussion. My other group is all-female, many of whom are members of the Royal Society of Canada, and their preference is for fiction. This group has chosen, for the forthcoming Canadian anniversary year, to read a book written by a female and/or Indigenous author from each province of the country, and this month Monkey Beach by Eden Robinson is our BC/Indigenous author selection. And believe it or not, since I retired I have discovered a passion for Charles Dickens and, because I have an ancient collection of the author that belonged to my grandfather, I have set myself to read his entire output. At the moment, I am more than halfway through!