Dr. Gerry Uswak is a man with many passions. He prefers the north of Canada to the south. He’d take the country over the city any day, and has two acreages, one outside Saskatoon and one near Oliver, B.C., where he can breathe the clean air. He loves his John Deere 4230 tractor. Uswak and his wife MaryAnn rescue dogs, old racehorses, donkeys and ponies because “there are lots of animals, who need good homes, and there are not enough good homes to go around.”
But that’s his private side. On the public side, as dean of the College of Dentistry, he is no less committed to what he believes. Since he was first named to the position, Uswak has been an outspoken advocate for his college, for where he believes it needs to go to ensure the people of Saskatchewan are well served by the dental professionals it graduates.
At the same time, he has tried to improve the fit of dentistry in the institutional structure of the University of Saskatchewan (U of S).
It has been an uphill road but Uswak has never wavered in his commitment to doing what he believes is best for the college, its faculty and students, and the university. Nor has he pulled any punches along the way.
“If I say something, it’s because I think it needs to be said. Sometimes it works, sometimes it doesn’t. Sometimes in endears you to people, sometimes it pisses people off but it’s who I am, and you have to be true to yourself.”
At the end of June, Uswak will leave the dean’s office after announcing last year his decision to step down part way through his second five-year term. In a wide-ranging interview for Recall, he talked about what brought him to the College of Dentistry, the challenges that came with the job and his optimistic vision for its future.
Uswak grew up in Winnipeg, in a family that stressed the value of education. “There was a school in the inner city we’d drive by and on this big stone wall it said knowledge is power. My father would always stop and point it out. He said, ‘don’t be like me’—he was in the heating trade—‘get an education and do something good’.”
After high school, Uswak entered the University of Winnipeg where he studied for two years before realizing “everybody who was getting into professional programs went to the University of Manitoba, so I switched. I applied for medicine, I applied for dentistry, I got into dentistry, I didn’t get into medicine so here I am.” After graduation, Uswak did a general practice residency at the U of M and, when not on call, worked in a general practice. In considering his next move, a two-week externship he’d done in fourth-year dentistry proved pivotal.
That experience took him to northern Canada, on what he thought would be his only trip there “but we probably did more dentistry in those two weeks than we did in all of fourth year. It was meat and potatoes dentistry, and it was for people in need.”
Uswak moved to the north with the U of M’s outreach community dentistry department. “I flew around what’s now Nunavut, the Keewatin zone, all the communities on the west coast of Hudson Bay … with everything I needed—tools, consumables. I had seven big aluminum boxes that followed me everywhere I went.”
It was during that year he made the decision to pursue a dental public health specialty at the University of North Carolina.
Back in Canada, in 1994, Uswak headed north again, this time to Iqaluit on Baffin Island, as regional dental health officer, then director of regional programs. In addition to running dental programs, he also had responsibility for audiology, mental health and variety of other services in addition to doing pediatric dental surgery. That was followed, in 2002, by a move to Inuvik in the Northwest Territories, to the position of CEO of the Inuvik Regional Health and Social Services Authority, which has Canada’s most northerly hospital.
THE CALL OF THE SOUTH
In 2005, it became clear Uswak and his wife needed to move south to be near aging parents, and that meant finding a job. It turned out to be “one of those magical things.
“I hadn’t cracked the want ads of a dental journal in forever but when the decision was made to move to Saskatchewan, I went to the Canadian Dental Association journal and opened it to the back pages and dammed if there wasn’t a dental public health job there. It was meant to be I guess.” Uswak said he always wanted to be in a university setting, to teach and do research, “all the good things a faculty member does.” The last thing he imagined was a move into administration but barely a year later, in 2006, that’s exactly what happened.
“That was a time in the college’s history when there had been a series of acting deans,” heexplained. When that positioncame open again, “I didn’t even apply someone put my name in. Over time, people deselected themselves and I think it was just me left on the list. I did a formal presentation to faculty and the interview thing, and there I was, boom, the acting dean.”
That lasted two years before Uswak had a conversation with the university provost of the day. “What I said was, you can only have people acting for so long if you want to see change. This place has been status quo forever and we don’t need any more of that. We need to go out and search for a dean, and again, I was successful.”
The move from acting dean to the permanent position was seamless, Uswak said, because “I didn’t act as a caretaker. I didn’t care that I was in an acting role. I think the only difference between me acting and me as dean were those couple of years that allowed me to understand what my environment was.”
The environment Uswak referred to is one characterized by an underlying tension, a low-level conflict between the original mandate of the college and the expectations placed on it as part of the University of Saskatchewan. Managing those often-competing interests has been a hallmark of his time in office.
“This college has always been under some threat to its existence and I was aware of that prior to even coming here,” he said, adding he also knew of its stellar reputation for turning out dentists who are well trained, with far more clinical experience than most of their counterparts across the country.
The university’s Board of Governors approved the establishment of the dentistry college in 1966, and the first students were enrolled two years later.
Uswak said it is important to remember the government mandate was to increase access to dentists for residents of Saskatchewan, but there was also an expectation it would “do all those things that a college within a university does, including research.” And there’s the rub.
“Most of the faculty is dedicated to teaching and the clinical education side, they’re not researchers. You can’t have someone who is a superstar researcher, who is a teacher where every student claps at the end of every lecture and is a superstar clinician. That doesn’t exist; something has to give.” Uswak believes the numbers prove the college has fulfilled its provincial mandate, with almost 500 dentists currently serving the people of Saskatchewan. “The problem is, I think, that from the university perspective, there is that optic of, what about the other mandates of a fully-functioning unit on this campus, which means research?”
These are the two solitudes Uswak has been trying to unite. The creation of an associate dean research position last year was a big step; the next is finding the resources to hire PhD-prepared research faculty and establish graduate programs, but Uswak is well aware of the risks.
Having always focused on the quality of graduates, for the college to divert resources to research and clinical master’s programs could come at a cost to undergraduates. “If you start adding specialty programs, the more interesting patients are going to go to those programs leaving the students with less clinical experience.”
The solution, he believes, is the non-clinical dental public health specialty. It is more research oriented than other specialties but does not require access to the patient pool or costly lab equipment. “You do basic examinations of the oral health in a population, you collect epidemiologic data, you work on health policy, you do a variety of things that don’t require a lot of research infrastructure but you build that research core in the college (and) you are actually making things better for the province, the country and the world.”
So, how close is the college to finding the sweet spot where it can turn out high-quality graduates while also addressing the research mandate issue? Very, according to Uswak.
“It’s been a 10-year struggle to get to the point where we are but we’re undergoing curriculum renewal, which is fabulous because you cannot continue to do the things you did in 1974 in 2017. We received funding to bring in an external expert to look at the feasibility of doing the specialty program and graduate program in dental public health. A report was generated that said absolutely, it would be vital and vibrant.
The college is also working with the Levin Group out of Maryland, dental practice management consultants, to ensure the dental clinic is operated and managed like a high-functioning dental practice.
“There are all these balls in the air. The good thing is we’re close. The bad thing is I’m not going to be dean to see it all get accomplished.”
Last fall, Uswak decided it was time to move on. He said he could have completed his term as dean, “but then reality set in.”
That reality was the significant resistance he encountered on two fronts, one being curriculum renewal, the other a change to the college’s Faculty Council structure.
Faculty Council in the college consists of 22.5 full-time faculty members and about 70 part-time members, he explained, and each has a vote. Uswak stressed those community based faculty are essential to the education mandate of the college “but no other college has so much control in the hands of external people. I wanted to change that to make Faculty Council more representative of the people who work here full time all the time.”
The dean’s suggestion was to have only four voting part-time faculty representatives on council. It was a proposal that offended many people, he said.
“To be honest, the acrimony that was propagated by certain people was unprofessional. And the curriculum renewal has been a sore spot too. I was angry. I was incredibly frustrated and thought I don’t need to do this job any more. I can accomplish a lot of the things I want to do without being dean.
He said he has no regrets about the decision—“ I rarely regret anything I do.” He will continue to serve as dean until his replacement arrives in addition to taking on other projects “that are moving this college forward.” One is preparing for college accreditation next year, and for reaccreditation of the General Practice Residency and hospital dental service programs. “It would be unfair not to participate in that and hang it solely on the new dean.”
Even as he prepares to take a step back, Uswak remains confident the college will get where it needs to be, that the groundwork he has laid will see it emerge, eventually, with faculty members “firing on all cylinders,” with graduate programming in place, with a renewed curriculum that is based on effective pedagogy and integration, with a strong contingent of part-time faculty and with a dental public health research program that will be the envy of other schools.
But the to-do list is not yet complete: there needs to be, he said, a different kind of employment track for faculty who would love to teach full time in a clinical setting but have no interest in tenure and research. Term contracts could be an option. “The university is a great place to work for dental faculty but as dentists, we have solid alternatives.”
Progress is being made on all fronts, he said. “Is it at the speed I would like it? No, but at universities, everything moves at a glacial pace.”
As the future unfolds, Uswak sees himself settled into a new position, a hybrid between his original faculty job and that of dean. He will teach and do research but he will also keep a hand in the work of ensuring a bright future for the College of Dentistry. “I just won’t come to work every day and do it from this office.”