The new Northern Ontario Rural Medical School is to be developed to have a significant impact on the education, recruitment, and retention of physicians in rural and northern Ontario and Canada. It will be a collaborative partnership between Laurentian University, Sudbury and Lakehead University, Thunder Bay (1000 km apart), and will have a network of learning sites throughout Northern Ontario (almost 1,000,000 km2). The curriculum will be patient-centred, clinical problem-based, and systems-organised, with a significant health determinant focus, and Aboriginal health content and context. Small group learning will be used in a distributed learning network with advanced information technology support. The new Northern Ontario Rural Medical School will aim to graduate highly qualified physicians with state-of-the-art medical education, with enhanced knowledge, skills, and interest, in Aboriginal, rural, northern, and under serviced health care.
To test the assumption that knowledge, attitudes, and skills (KAS) in geriatrics are learned via exposure to elderly patients in nongeriatric clerkships. In the developed world, the proportion of adults > or = 65 years old will soon surpass the proportion of children
Many reports have emphasized the need to reform medical education to bring it into harmony with society's needs and expectations. Although much effort has been expended over several decades, many believe that reform initiatives have not successfully modified physicians' behaviors and attitudes. More recently, two major projects--Educating Future Physicians for Ontario and the Medical School Objectives Project--have identified physician roles and attributes necessary to meet societal needs. These efforts have provided a substantial framework upon which the content and conduct of a more relevant kind of medical education can be built. In order to implement real change, however, medical schools must (1) take the long view, making reform part of the entire continuum of medical education; (2) ensure that faculty physicians teach by example; (3) change student assessments to reflect new educational objectives; and (4) reallocate resources to support a changed curriculum.
The literature indicates that medical students require more comprehensive HIV training.
Medical students at the University of Toronto developed and implemented the preclerkship HIV elective (PHE) with the aim to increase trainee HIV knowledge, address important issues in HIV care, and prepare students to serve affected populations.
Developed in partnership with the Ontario HIV Treatment Network and in consultation with local AIDS service organizations and the University of Toronto Faculty of Medicine, the PHE was inaugurated in November 2008 as an elective supplement to medical curriculum content. Eighteen second-year medical students participated in the PHE, consisting of lectures, small group sessions, clinical observerships, community placements, reading assignments, and an HIV counseling and testing workshop. Participants completed a self-assessment of HIV knowledge prior to starting and after PHE completion.
Self-assessment scores of HIV knowledge among PHE participants significantly increased from 78.1% (pre-PHE) to 90.2% (post-PHE) (p?=?0.0016). Common themes from feedback on participant satisfaction included enthusiasm for small group sessions, clinical observerships, community agency placements, and the diversity of topics covered.
Student-run initiatives can supplement medical curriculum content and program feedback may be used to advocate for curriculum changes. Factors influencing success include student leadership and interest, community partnerships, and faculty mentorship.
Medical education on alcohol- and drug-related problems at the University of Toronto covers undergraduate, residency and graduate programs, a result of collaboration since 1959 between the university and the Addiction Research Foundation of Ontario. An undergraduate core curriculum, developed in the early 1970s, is offered in year 2; it has been supplemented by electives, selectives and comprehensive clinics. The undergraduate program is rated highly by students; since 1978, 3024 have completed the core program. Residency training started in 1974 and is available through electives lasting from 1 to 12 months in internal medicine, psychiatry, and family and community medicine. To date, 370 residents have completed one of these electives; 129 have completed graduate programs in which their theses concerned alcohol- and drug-related topics, and there have been an additional 13 research and postdoctoral fellows. Despite the progress, there is still a need to improve and expand the undergraduate and residency programs and to develop an effective program of continuing medical education. The goals should be to ensure that, as far as possible, all medical graduates from the University of Toronto have the knowledge, attitudes, skills and behaviours needed to contribute effectively to the prevention and treatment of alcohol- and drug-related problems in their chosen field of practice and to avoid problems from their personal use of alcohol and other drugs.
In 1999, Determinants of Community Health was introduced at the Faculty of Medicine, University of Toronto. The course spanned all 4 years of the undergraduate curriculum and focused on addressing individual patient and community needs, prevention and population health, and diverse learning contexts.
To demonstrate the value of an integrated, longitudinal approach to the efficiency of delivering a public health curriculum.
Time-series comparing the curricular change over two periods of time.
Undergraduate medical students from 1993 to 2009.
Using a spiral curriculum, the educational materials are integrated across all 4 years, based on the concept of medical decision making in a community context.
This study compares measures of student satisfaction and national rankings of the University of Toronto with the other 16 Canadian medical schools for the "Population Health, Ethical, Legal, and Organizational aspects of the practice of medicine" component of the Medical Council of Canada Qualifying Examination Part 1.
The University of Toronto has been ranked either first or second place nationally, in comparison to lower rankings in previous years (p
Providing health care services in rural communities in Canada remains a challenge. What affects a family medicine resident's decision concerning practice location? Does the resident's background or exposure to rural practice during clinical rotations affect that decision?
Cross-sectional mail survey of 159 physicians who graduated from the Family Medicine Program at Queen's University, Kingston, Ont., between 1977 and 1991. The outcome variables of interest were the size of community in which the graduate chose to practise on completion of training (rural [population less than 10,000] v. nonrural [population 10,000 or more]) and the size of community of practice when the survey was conducted (1993). The predictor or independent variables were age, sex, number of years in practice, exposure to rural practice during undergraduate and residency training, and size of hometown.
Physicians who were raised in rural communities were 2.3 times more likely than those from nonrural communities to choose to practise in a rural community immediately after graduation (95% confidence interval 1.43-3.69, p = 0.001). They were also 2.5 times more likely to still be in rural practice at the time of the survey (95% confidence interval 1.53-4.01, p = 0.001). There was no association between exposure to rural practice during undergraduate or residency training and choosing to practise in a rural community.
Physicians who have roots in rural Canada are more likely to practise in rural Canada than those without such a background.
Cites: N Engl J Med. 1993 Apr 1;328(13):934-98446141
Cites: Can Fam Physician. 1995 Jun;41:993-10007780331
Cites: Can Fam Physician. 1995 Jun;41:974-67780326
Admissions committees face the daunting task of selecting a small number of candidates who are most likely to succeed in medical school from a large pool of seemingly suitable applicants. While numerous studies have shown moderate correlations among measures of academic performance, predictors of the non-cognitive domain (e.g. interpersonal, communication, ethical) remain elusive, in part because of the absence of a sound criterion measure.
We examined the utility of several cognitive and non-cognitive criteria used in the admissions processes in predicting both cognitive and non-cognitive dimensions of the licencing examinations of the Medical Council of Canada (LMCC).
Predictors included: undergraduate GPA, undergraduate science GPA, an autobiographical letter, scores from a simulated tutorial, a personal interview and the MCAT. Of specific interest was the relation between measures of communication and problem-exploration skills as assessed during the admissions process and Part II of the LMCC Examination, a multi-station OSCE.
Undergraduate GPAs were found to have the most utility in predicting both academic and clinical performance. Scores derived from the simulated tutorial did not predict future performance. The MCAT Verbal Reasoning score and the personal interview were found to be useful in predicting communication skills on the LMCC Part II.
The results have implications for any school that uses the interview as an admissions tool.
With the burgeoning role of distributed medical education and the increasing use of community hospitals for training purposes, challenges arise for undergraduate and postgraduate programs expanding beyond traditional tertiary care models. It is of vital importance to encourage community hospitals and clinical faculty to embrace their roles in medical education for the 21st century. With no university hospitals in northern Ontario, the Northern Ontario School of Medicine and its educational partner hospitals identified questions of concern and collaborated to implement changes. Several themes emerged that are of relevance to any medical educational program expanding beyond its present location. Critical areas for attention include the institutional culture; human, physical and financial resources; and support for educational activities. It is important to establish and maintain the groundwork necessary for the development of thriving integrated community-engaged medical education. Done in tandem with advocacy for change in funding models, this will allow movement beyond the current educational environment. The ultimate goal is successful integration of university and accreditation ideals with practical hands-on medical care and education in new environments.