Innovating to Educate Paediatric Consultant Generalists for the New Canadian Health Care

Responsibility for training general paediatricians in Canada lies primarily with the 17 paediatric academic health sciences centres with more programmatic emphasis on subspecialty training and less on preparing residents for general paediatrics. However, the greatest unmet demand in the paediatric workforce will be for consulting paediatric generalists. Here, we define the need for paediatric generalists and list deficiencies in current models to promote more consulting community general paediatricians. The limited presence of general paediatricians as role models reduces the potential for learners to better understand the role of generalists in our specialty. Nationally, we need to advocate for change in teaching models to guide the career choices of our graduates to meet societal needs through better mentorship and educational models that heavily include community-based paediatric consulting generalists. This will be essential to meet our responsibility of supporting primary care colleagues closer to home for our funders, patients and families

Social Medicine, New Medicine? A curricular integration driving deeper learning with the social drivers of patient care.

This article was migrated. The article was marked as recommended. In response to a curricular vision of improved social accountability, our Doctor of Medicine program launched a year-long integrated Social Medicine course designed and implemented for Year 1 medical school students. Our school is a moderate sized medical school serving a region of close to 2 M people in central Canada. The Schulich School of Medicine &amp; Dentistry Doctor of Medicine Program at Western University, London, Ontario Canada, is grounded in a four-year curriculum, each year comprised of up to 171 students with a clinical clerkship in Year 3. Our curriculum is delivered in a distributed fashion between two campuses approximately 200 km apart: London (133) and Windsor (38) learners.The vision of our leadership and learner partners was to provide students with an opportunity to concentrate early in their career on the impact of social, cultural and economic forces on medicine and patient care. Under the umbrella of this new Social Medicine course, we incorporated previous courses in population health, epidemiology, ethics and service learning to provide an exposure to cultural and societal roots; social inequalities; factors impacting treatment outcomes; ethical challenges and experiential community learning opportunities. This article, based upon our Short Communication, "Social Medicine, New Medicine? Redefining Social Medicine for Year 1 medical students", presented at AMEE in Barcelona, 2016, will discuss the origins of our course design as well as the rationale, objectives and caveats of this particular course.</ns4:p

In Search of Black Swans: Identifying Students at Risk of Failing Licensing Examinations.

PURPOSE: To determine which admissions variables and curricular outcomes are predictive of being at risk of failing the Medical Council of Canada Qualifying Examination Part 1 (MCCQE1), how quickly student risk of failure can be predicted, and to what extent predictive modeling is possible and accurate in estimating future student risk. METHOD: Data from five graduating cohorts (2011-2015), Schulich School of Medicine & Dentistry, Western University, were collected and analyzed using hierarchical generalized linear models (HGLMs). Area under the receiver operating characteristic curve (AUC) was used to evaluate the accuracy of predictive models and determine whether they could be used to predict future risk, using the 2016 graduating cohort. Four predictive models were developed to predict student risk of failure at admissions, year 1, year 2, and pre-MCCQE1. RESULTS: The HGLM analyses identified gender, MCAT verbal reasoning score, two preclerkship course mean grades, and the year 4 summative objective structured clinical examination score as significant predictors of student risk. The predictive accuracy of the models varied. The pre-MCCQE1 model was the most accurate at predicting a student\u27s risk of failing (AUC 0.66-0.93), while the admissions model was not predictive (AUC 0.25-0.47). CONCLUSIONS: Key variables predictive of students at risk were found. The predictive models developed suggest, while it is not possible to identify student risk at admission, we can begin to identify and monitor students within the first year. Using such models, programs may be able to identify and monitor students at risk quantitatively and develop tailored intervention strategies

Indigenous Student Matriculation into Medical School: Policy and Progress

Access to health care remains suboptimal for Indigenous people in Canada. One contributing factor is the longstanding undersupply of Indigenous physicians. Despite awareness of this issue, underrepresentation in medical schools continues. In 2002, Schulich School of Medicine and Dentistry (SSMD) policies were modified to enhance access for Indigenous students. This article describes our school’s continuing journey of policy and process revision, formative collaborations, early learner outcomes, and lessons learned towards this goal. In the first 10 years, SSMD matriculated 15 additional Indigenous students via this new stream. All candidates were successful in the undergraduate medical curriculum, licensing examinations, and residency match. The majority were attracted to primary care specialties, training programs affiliated with SSMD, and practices in southern Ontario. While the process and curriculum have revealed their potential, its capacity is not being maximized