The Faculty’s first Regional Associate Dean, Vancouver Island, steps down after 10 years of nurturing medical education from Victoria to Port McNeill.
Like many a job candidate, Oscar Casiro had to meet – and try to impress – a whole array of people when interviewing to be the first head of the nascent Island Medical Program. But one of those encounters is as vivid for him today as it was 11 years ago.
“They put me in a room with 50 physicians in Victoria and left me there, while one person from the search committee sat in a corner taking notes,” he recalls. “We sat there for two hours. The doctors didn’t try to persuade me that this was a good place to come. In fact, they were giving me all the reasons why this wouldn’t work and why I shouldn’t come.”
The head of the search committee, Joanna Bates, then the Senior Associate Dean, Education, met him at the Vancouver seaplane terminal upon his return from the Island. She had heard about the exchange. “Have we lost you?” she asked.
“This is like mission impossible!” he told her. “But that actually makes it more interesting!”
That reaction, as much as anything, reveals why Dr. Casiro was selected to lead UBC’s expansion of undergraduate medical education and residency training to Vancouver Island – and why he was so good at it.
“He had vision,” said Kathy Gaul, the Foundations of Medicine Course Director and a University of Victoria Associate Professor who helped plan the Island Medical Program. “He wasn’t afraid of stepping into the unknown.”
Overcoming fears
At the time, Victoria was a magnet for physicians seeking to practice tertiary care medicine without having to be part of a teaching enterprise. So a large portion of the medical community was openly skeptical, and even hostile, to bringing medical education program to the Island.
“We were quite negative about all this,” acknowledges Ian Courtice, an anesthesiologist who was President of the Medical Staff Association for South Island at the time.
Dr. Courtice and other physicians feared that teaching would be an untenable burden on an already overloaded health care system. They dreaded the politics and the hierarchy. And they resented that clinical faculty traditionally didn’t receive much recognition or compensation for their efforts.
But Dr. Casiro, in addition to his willingness to take on a “mission impossible,” had other attributes going for him, starting with the fact that he was not from here. A native of Argentina, he did a pediatrics residency in Israel before moving to Manitoba, where he became an associate dean.
Dr. Casiro made the most of that opportunity. Having lived in three countries, with three languages and three cultures, he knew how to navigate unfamiliar terrain.
“You have at least three cultures here – the UBC Vancouver culture, the UVic culture and the Island medical community culture,” he says in the office at UVic’s Medical Sciences Building that he will vacate this summer. “And they all speak different languages. I was confident I could bridge those differences, because I had done it before and wasn’t fazed by it.”
Dr. Casiro also brought an instinctual knack for negotiating and finding common ground among various parties. He invested a lot of his time employing his gentle demeanor in one-on-one meetings, lunches and dinners, many of them obvious efforts at making peace, allaying fears and rallying support.
“Oscar works tirelessly at making relationships,” says Jatinder Baidwan, the Executive Vice President and Chief Medical Officer of Island Health, and a Clinical Assistant Professor in the Department of Family Practice. “He gets out there and gets to know people. When he asks you to do something, a lot of people feel really uncomfortable saying ‘no’ to him. They find the time to do it. They know he’s doing the right thing, so they want to help him. And that’s incredibly powerful – far more powerful than a stick or a carrot.”
Creating win-win situations
“You know what he wants, but he doesn’t put his immediate needs ahead of yours,” says Dr. Courtice, who became a Clinical Assistant Professor, and whose daughter is graduating from the program this month. “Oscar is better at creating win-win situations than a lot of people in medical politics or administration. Most people say they aren’t entirely sure how he does it, but he seems to get what is needed for the medical students and residents.”
Today, the fruits of all of those attributes and hard work are obvious. The Island Medical Program is now firmly ensconced in the academic and medical community. Its graduates perform as well – and sometimes better – than their peers at the Faculty’s other sites. The Island is now home to about 100 Island-based medical residents, with another 100 rotating through each year. Departments that once refused to teach students are now clamoring for them. The head of undergraduate education for UBC’s Department of Psychiatry is based in Victoria, a testament to the decentralization of authority. And UVic’s Graduate Program in Neuroscience, which Dr. Casiro nurtured as Head of the university’s Division of Medical Sciences, has grown to 30 students.
During a sabbatical starting in July, Dr. Casiro, 64, plans to document the lessons UBC learned from its experience in distributing medical education, through a visiting position at the Faculty’s Centre for Health Education Scholarship. Beyond that, he is unsure – he will continue to live in Victoria with his wife, Malca, though he might spend more time in Vancouver, not only to help with educational issues, but to enable his successor, Bruce Wright, to make his own mark.
At the welcome event for the newest group of Island Medical Program students in January, Dr. Casiro quoted the words of Ralph Waldo Emerson: “Do not go where the path may lead, go instead where there is no path and leave a trail.” The words were meant for the students, but he might as well have been talking about his past decade’s work.