Interview with Dr Saleem Razack
Pediatric Residency Program Director
McGill University

As increasing pressure is placed on physicians by an aging population, and by a critical shortage of community pediatricians and by the need to provide continual care for complex children while taking time to consult with family doctors, healthcare professionals are seeking ways to become more efficient with their time and demanding schedules. We spoke to Dr Saleem Razack, Pediatric Residency Program Director at McGill University to see how he manages his time and team.

GF: Dr Razack, please give us a glimpse of your regular workload.

Saleem Razack, MD: In the pediatrics program at the Montreal Children's Hospital/McGill University, we manage approximately 70 residents/month. This includes people of varying commitments. Some may be at the MCH for 4 weeks, some for 4 years. They have different skill levels and very different manpower scheduling systems, such as shift work in the Emergency Department and overnight on-call shifts. In addition to these challenges, we must also meet the requirements of the provincial collective agreement between medical residents and the Ministry of Health. Finally, we have residents from many programs in addition to pediatrics, and must meet each program's specific requirements for resident scheduling to accommodate teaching sessions, etc.

GF: It must take considerable time just to manage the flow of people and ensure they are in the right place at the right time?

SD: That's right, and it was taking too much time just to create their schedules. When done by hand, the process of generating an on-call schedule required approximately 60-80 manpower hours/month by our chief residents.

GF: Did you try anything to reduce that workload? Software technologies have come along way in automating repetitive tasks.

SD: We investigated several on-line solutions over the years, but always found the "rules-based scheduling" to be the lacking point. There are so many guidelines and parameters to take into account for each person and responsibility, and time off to rest, etc., and thus rules-based scheduling for us was a must.

We had looked into several scheduling systems in the market, and while some had the capacity to develop rules for scheduling, we found developing these with some suppliers' programs would require a steep learning curve, which takes even more time—and they were not that user friendly.

We found a system in Montreal developed by another physician called Chyma. They were known for strong technical support. We greatly appreciated the IT team's willingness to work closely with us to tailor the scheduling algorithm to our needs.

A schedule such as ours is almost like a living organism--constant care and adjustments were required in the beginning to de-bug problems as the program was piloted. We anticipated that this would be the case, and applauded the company's willingness to look at our needs and refine the program in an efficient and timely manner.

GF: When you consider the time spent to changeover to a new method of managing manpower, has this really helped you save time?

SD: At this point we are very happy with the product, and happy with the service we have received. We are beginning to see manpower savings, and anticipate that further planned refinements to the system will increase these benefits. We see other benefits such as easier post-schedule changes and the creation of on-line practice communities (which we did not anticipate), that show us that this tool has the potential to enhance residency education significantly.

GF: Thank you Dr Razack for taking time to speak with us.

SD: My pleasure.

Dr Saleem Razack is the Pediatric Residency Program Director at McGill University. Chyma Systems, based in Montreal, is part of IsaiX Technologies, a specialized training and consulting company which develops sales force effectiveness by employing coaching tools and competency models.