Council Award Recipient: Dr. Georgina Wilcock

Ask Dr. Georgina Wilcock, latest recipient of the CPSO Council Award, what she loves about her chosen specialty, obstetrics and gynecology, and her voice just lights up. “It has everything,” she says. “It’s primary care; it’s surgery; it’s preventative medicine; it’s providing care to women. It really is the total package.”

Dr. Wilcock became an OB-GYN in a slightly roundabout way. She was working towards a career in psychiatry at the time, but realized she needed a specialty that was much more “hands on” than what psychiatry offered.

To describe Dr. Wilcock as a “hands on” physician would be an understatement. She is a kind, compassionate, big-hearted doctor who sets a very high standard for care and safety when treating the patients in her community of Scarborough. She is also a firm believer in engaging patients in their own care and encouraging them to speak up if something doesn’t seem right. “You don’t find anyone more motivated than a pregnant woman,” she says. “She wants to make sure her baby is safe. So, I think it’s important to involve her in that whole process.”

Watch a video of her remarks 🎥 when she accepted the award at the September meeting of Council at the end of the article.

Dr. Wilcock is very proactive when it comes to implementing broader system changes to the hospital where she works, the Scarborough Health Network (previously the Scarborough Hospital), where she was chief of the OB-GYN department from 1998 to 2014. In every nomination letter she received for this award, colleagues were effusive about her commitment to safety improvement, better inter-professional collaboration, and overall quality enhancement for patients. As her colleague, Dr. Peter J. Azzopardi, wrote: “As chief, one of her most important roles was to address the quality of care of our maternity teams … We saw the benefits of her hard work in our quality indicators, but more importantly, our families had a better experience and felt more prepared to look after their newborn after discharge.”

Born and raised in Zimbabwe, Dr. Wilcock developed a passion for helping others and an interest in medicine at an early age — albeit in an unorthodox way. Her parents ran a hotel when she was growing up, but it offered much more than just a place for visitors to stay. Due to the lack of health care resources in the local community, the hotel also contained a clinic and became the place where people could receive medical care. Dr. Wilcock remembers her mom treating burns, patching up scrapes and cuts, and providing other first aid to whoever needed it, and it inspired her to pursue a career in medicine. “I saw a lot of suffering and so I wanted to find a way to help people,” she says.

She has never lost touch with some of the struggles of growing up in Zimbabwe, and often uses those lessons to empower the people she is treating.

Dr. Wilcock attended medical school in Zimbabwe, where she did two years of internship that exposed her to various disciplines and specialties. She followed her husband, a fellow physician, to Canada in the late 1980s. At the time, there wasn’t really a track into the profession for what were then called “foreign-trained” physicians, to the point where Dr. Wilcock believed that she wouldn’t be able to get a job at all. But she eventually found her way to a specialty in OB-GYN, due in part to the encouragement and mentorship of well-known physician, Dr. Denny DePetrillo. She says he was warm, welcoming, and refreshingly candid about the profession and what she needed to do to succeed. It’s an approach she now takes herself when mentoring others, especially fellow international medical graduates.

Dr. Wilcock began working at the Scarborough Hospital in 1994. She has also been teaching in the Department of Obstetrics and Gynecology at the University of Toronto since 2000 and has been an assistant professor there since 2017. She has also been the medical director of Scarborough’s Sexual Assault and Domestic Violence Clinic since 2018. Recently, she completed a Masters of Health and Safety at Queen’s University.

Along the way, Dr. Wilcock collected a number of awards for her research and teaching, including the Anglo-American Prize for Highest Achieving Medical Graduate (1986), the 1997 Residents Award for Excellence in Clinical Teaching Department of Family Practice, Scarborough General Hospital, and the 2011 Scarborough Hospital Family Practice Residency Program Lifetime Teaching Award. She can now add a CPSO Council Award to her list of honours.

For more than 30 years, Dr. Wilcock has brought an extraordinary blend of care, compassion, lifelong learning and continuous improvement to the medical profession, and it is no exaggeration to say that she is truly beloved among her patients, fellow physicians and support staff. One of the guiding principles of her career is a belief that everyone on a team — including the patient — should be empowered to speak up if they see a problem or a way of doing things better. She is very much a believer in making the patient a partner and collaborator in the safe delivery of care.

This non-hierarchical approach is common in the airline industry, one that tears down barriers and gives everyone a voice to identify problems in the interest of increasing safety. “In the airline industry, they engineer protocols under the assumption that pilots make one error every hour,” Dr. Wilcock says. “As someone working in health care, that resonates with me. But I know we’re still working on how best to handle mistakes. Feedback is so important, but so difficult. People often have a lot of trouble with feedback, but we need to get better at both giving and receiving it. I try to open myself to feedback to make myself better. I can see the fallout when something doesn’t go right and someone gets harmed, and that’s my motivation in medicine, to make things better. And it has gotten so much better over the years.”

This has certainly been the case at the Scarborough Health Network’s department of obstetrics and gynecology under Dr. Wilcock’s leadership. As Dr. Azzopardi wrote in his nomination letter: “Georgina eagerly embraced the MORE-OB philosophy of leveling the playing field so that any team member could point out concerns with either mother or fetus … She was very keen to lower our cesarean section rates and to eliminate any elective sections done before term. We made significant improvements and became one of the best performers among our peer hospitals.”

For all of Dr. Wilcock’s technical and leadership expertise, it really is her deep emotional intelligence and compassion for her patients that is so key to her success. She has never lost touch with some of the struggles of growing up in Zimbabwe and often uses those lessons to empower the people she is treating. “I often tell my patients, if I’m doing something wrong, make a fuss,” she says.

Dr. Wilcock also hasn’t forgotten what it’s like to be a newcomer to Canada. As another of her nominators, Dr. Carol Peng, put it: “In 2007, [Dr. Wilcock] used her position as Chief of Obstetrics and Gynecology to recruit staff who demonstrated cultural sensitivity towards the diverse community that we serve. In the ‘90s, English and French were the only languages spoken by our doctors in the department. Now the obstetrics/gynecology division of SHN can offer women care in both official languages, as well as Arabic, Bengali, Cantonese, Mandarin, Malayalam and Tamil.”

Dr. Wilcock is adding a second CPSO Council Award to her household: her husband, Ian Kitai, a pediatrician, was the recipient of one in 2003. Together, they have two children, both born while Dr. Wilcock was in residency. Both are grown now: their daughter is a corporate lawyer in England and their son works in communications for a financial company. When she has free time, Dr. Wilcock enjoys gardening, reading, volunteering for the Green Party and, especially, cycling. She is a member of Cycle Toronto and often goes on bike trips that involve 70 to 100 kms of cycling a day.

Video from Council

Video of Dr. Georgina Wilcock accepting her Council Award

CPSO Council presented the Council Award to Dr. Georgina Wilcock, an OB/GYN from Scarborough, Ontario at its meeting on September 23, 2022.

My patients are the workers of the city. They're the cleaners and the personal support workers. They serve your coffee at Tim's. They're married to Uber drivers and kitchen workers. And yes, at least one young woman caught up in gun violence. In other words, they form the essential threads creating the vibrancy and complexity that is our city, Toronto. Each of them has a story. I've been privileged to hear just a few. They come from all corners of the globe. I have Syrian patients who recounted the violence of the Russian army long before we witnessed it in Ukraine. Some have survived wars or ethnic conflicts or cleansings. Some have escaped horrible domestic abuse.

But many are just like me - women who left their homes and native lands, not because of great suffering or privation, but caring for love, or seeking a better life. All of them value living in a fairer society, where citizens have a voice and equal rights under the law. Their families have benefited from access to Canadian health and education. I've witnessed many of what I call "my babies" grow up to become entrepreneurs, nurses, engineers, doctors, teachers and mothers to a new generation.

From my very first day in Scarborough, I was motivated to provide the best level of care I could to all my patients. In many ways, I see myself in my patients. No, I didn't come from suffering or privation, but I did find myself in a new land as a lonely new mother, struggling to understand the system and provide for my family. Perhaps it's that mirroring, which motivates me to give a level of care that is respectful, and where women feel their voices are heard.

I came to appreciate just how much of your medicine is about communication and the importance of communication. I know from first-hand experience how important and calming it is for a patient to hear words of healing or comfort in their own language. Where she herself is frightened during pain, soft words in a mother's tongue soothe more than opioids or tranquilizers. I've learned how every person wants to be heard and their wishes heeded. In short, clinical work has taught me the healing power of listening and thoughtful responsiveness.

But as I stand here today to receive an award from the College, I'm reminded that life is a narrow bridge, and the practice of medicine is an even narrower strip. Perhaps next year, I will be standing here facing a Discipline [hearing]. [audience laughter] I know I don't always get it right. We all err. The practice of medicine is fraught with dangers and pitfalls, which cause pain and suffering for patients, and we physicians are often the second victims. My awareness of the potential for pitfalls and errors in medicine led me to a fascination with the science and literature of patient safety.

Initially, through the MORE-OB Program, I discovered that shame and blame doesn't create safety, that most errors result from system issues, and there is a science, which points to an alternative practice, leading to safer care and medicine starting to embrace safety culture. We now routinely do our pre-op checklists, we do fewer post-op chapters and even fewer debriefs. We still tend to look to blame, and do not delve sufficiently into root causes of error. Although we are establishing databases that track our practice and outcomes, it's always important for us and incumbent on us to make that data as transparent as possible. An examined practice is a safer practice. We still have far to go. We've been slow to accept the idea that errors will always occur when humans are involved.

The airline industry engineers for pilots to make one error and now I'm not sure we still do that. I think we still blame. The other features the airline industry really draws me and fascinates me is the role of the co-pilot. Although decisions in care in teaching hospitals are often made by teams and teams of physicians working together, that's not so in the community hospitals. We are often very alone. As I look back at my practice, I know the constant presence of a colleague would certainly have made my decisions to practice easier. It would have kept my patients in a safer situation. Currently, we're not funded for the luxury of two caregivers in all high-acuity situations. But what value do we place on safe care?

When considering the airline industry, I wonder if there's a limit to what I learn from them. Human biology and sickness is not streamlined, dependable steel, traveling in straight lines where almost everything about the journey can be anticipated and controlled. Medicine is more chaotic and unpredictable, more like a wildfire. Much has actually been written on the skills and traits required to create safety and protect burning lands and the people who fight those fires. Those organizations need to be obsessed with dangerous situations identified. Risk is never underestimated, responses or practice continuous updating an honest, non-hierarchical communications are essential, there is situational awareness at all times, interpretation must not ever be simplified, all team members are free to question authority and safety is a concern, and teams that work together regularly are safer. The creation of resilience in teams is essential, and in healthcare, we will all benefit as we incorporate these theories of high-reliability culture into our practice. I do think we have far to go but we are making steps towards the provision of care.

So, in conclusion, I firstly want to thank the CPSO for its drive to support the development of safe and patient care. I also want to thank you for giving me, a foreign medical grad in 1989, a license, which has allowed me to learn and practice in a robust and excellent healthcare system. And I want to stop and thank my colleague and friend, Dr. Carol Peng. She initiated my nomination and drove it through. Thank you, Carol, for being a person who embodies the traits of a high-quality physician. You are trilingual, having learned Mandarin as an adult, when you realized that the language your patients required was Mandarin. You are so highly thoughtful, compassionate, and you embody resilience. Thank you to  Sabiha Patel — who's here, she's my Admin Assistant since 1997 — this will make me cry — for speaking to my patients in one of four languages, and in every language, always being so kind to absolutely everyone. Thank you two for your wisdom and endless support. And I can't forget to thank you for catching many of my errors over the years.

To my children, Sarah and David Kitai, the reason why we moved to Scarborough in the first place — apparently, I was going to work part-time [audience laughter] — for being challenging, insightful, wise and fun. You provided me with the most rewarding career in life, which is motherhood. And lastly, my husband companion and teacher, Ian Kitai, for all of your kindness, loyalty and support. I simply love you.