Mcmaster's Curriculum

[pugsanddoctors]

I know we'll probably receive more information come orientation, but I'm a bit confused as to McMaster's curriculum. What exactly is our first year like? So we'll have tutorials (any info on this past the group learning aspect would also be appreciated), anatomy lab and lectures? What exactly are horizontal electives, and how are they different from free electives, and when do we do them? 

 

 

[xkittens]

It's strange how Mac is so transparent with everything about their school except for the schooling itself. I barely have a clue about what I'm in for, but from what I understand each week we have two tutorials (PBL sessions), 2 lectures, anatomy lab (I don't think this one's every week) and clinical skills sessions. The horizontal electives aren't mandatory, if you feel like it you can get set up with a doctor in whatever specialty you want and you kinda follow them around for a few hours a week or whatever you negotiate with the doc. I'm sure you can see patients by yourself depending on the doctor and if you're capable. It's basically an informal shadowing/clinical opportunity so you can get exposure and explore different specialties, there aren't really too many assessments other than a basic checklist. 

 

http://www.smgh.ca/wp-content/uploads/2012/01/McMaster-Preceptor-Guide-How-to-Get-Involved.pdf 

This was the only document I could find on the subject, I'm sure the same guidelines apply to the Hamilton campus. 

[Birdy]

Have you guys seen the brochure put together for us by the reps? Click the link in your offer of admission email, it's on the page you go to. It's 16 pages and covers quite a lot about the curriculum. 

 

Even better because it's written by other students. 

[Organomegaly]

It's strange how Mac is so transparent with everything about their school except for the schooling itself. I barely have a clue about what I'm in for, but from what I understand each week we have two tutorials (PBL sessions), 2 lectures, anatomy lab (I don't think this one's every week) and clinical skills sessions. The horizontal electives aren't mandatory, if you feel like it you can get set up with a doctor in whatever specialty you want and you kinda follow them around for a few hours a week or whatever you negotiate with the doc. I'm sure you can see patients by yourself depending on the doctor and if you're capable. It's basically an informal shadowing/clinical opportunity so you can get exposure and explore different specialties, there aren't really too many assessments other than a basic checklist. 

 

http://www.smgh.ca/wp-content/uploads/2012/01/McMaster-Preceptor-Guide-How-to-Get-Involved.pdf 

This was the only document I could find on the subject, I'm sure the same guidelines apply to the Hamilton campus. 

 

Thanks for sharing that, was an interesting read

[xkittens]

Have you guys seen the brochure put together for us by the reps? Click the link in your offer of admission email, it's on the page you go to. It's 16 pages and covers quite a lot about the curriculum. 

 

Even better because it's written by other students. 

I've read it over, it's still not satisfactory. There was more information about the curriculum on that random PDF I found than was made available to us as future students. Compare that to this, which by the way is available to everyone, not just those accepted to UofT: http://www.md.utoronto.ca/Assets/FacMed+Digital+Assets/Undergraduate+Medicine+Education+MD+Program/Curriculum/Handbooks/Mar2015+Student+Handbook.pdf

 

Tl;dr: UofT publishes a 400 page document outlining their curriculum, Mac gives you 2 pages in short form.

[pugsanddoctors]

Yea, I saw that document in our email as well, but it seemed to have a more general overview/MF info than a detailed curriculum. I'm excited but would also like to know what I'm in for a little more specifically. But thank you for that link, and maybe I should go back and read that document again!

[bearded frog]

Feel free to ask any specific questions and I will answer them. I guess we did a bad job going over it on interview day

 

The mcmaster curriculum, much like other schools is divided into pre-clerkship, from August 2015 to November 2016, and clerkship, from then to April 2018.

 

Clerkship is actual placements in hospitals, and the curriculum is very customized to the roatation you're on. You have a defined number of core electives in the main fields of medicine (family, surgery, internal, pedatrics, psychiatry, obs/gyn, emerg, etc) and a defined number of elective blocks that you can either use to get more experience in any of these core experiences at your home insitituion, experience more specialized fields at your home instituation, or do visiting electives at other medical schools. The order in which you do your cores, and when you will have electives, is different for each student, as students are divided into streams and do everything at different times (so that there isn't 150 people doing emergency at the same time) How the streams are laid out and which one you will get you will not find out until May 2016. You will be able to see the class of 2017 stream schedule once you start to get an idea, but they switch them up a little each year so its hard to predict.

 

What stream you get will have an effect on your residency application in a couple different ways, and some streams are more popular than others based on where the cores and electives lie relative to each other and the carms application due date. I can go into more detail but its not really relevant until next year as selections are done by lottery so there's no point in worrying about it at this point.

 

For pre-clerkship, the time is divided into 5 units, aka Medical Foundations (MFs), plus an 8 week elective block during the summer. MF1 (cardio/resp/heme) is roughtly from September to December and all campuses are in hamilton for this, then MF2 (gastro/endocrine) is till Feb, MF3 (nepro/repro) till April, MF4 (immuno/oncology) till end of June (roughly). Electives are July/August, where you are expected to do 7 weeks of elective and have one week holiday which you can arrange to be any week in that 8 week period. MF5 (MSK/nuro/psyc) is from Sept to Nov and goes into clerkship. Each MF is divided into subsections based on each topic, ie 3 for MF1 and MF5 and 2 for the other 3. Each subunit is roughly a month. Each week there are 2 tutorial cases that will cover topics in each unit. Each week there will also be multiple lectures (typically 2-6) a week, on monday and friday mornings, which are recorded and posted each friday, so attendance is optional. the lectures are on specialized topics relevant to the subjects which kind of summarize specific important things, or clinical/pathology conference sessions which kind of go through case reports of patient cases, given by multiple specialists and a pathologist to kind of connect things together.

 

There is also anatomy sessions along the way that will support each subunit, there was a week where we covered liver anatomy during gastro, for instance. The anatomy varies by campus so that will also play a factor. In addition to the 2 tutorial sessions, your tutoiral group for that MF will meet once a week with some residents for a clinical skills sessions where you learn and practice taking patient histories and performing physical exams. There is also standardized clinical skills sessions from faculty physicans and standardized patients every couple weeks which will cover a specific exam to ensure that you are hitting the importnant points and get the opportunity to perform it on an SP. Every tuesday morning there is typically an hour long professional competeincies lecture followed by a two hour small group session. Each week is on a different topic on the non-biological aspects of medicine, ie ethics, medical decision making, talking to patients, breaking bad news, LGBT health, global health, aboriginal health, etc.

 

In terms of performance evaluation, there are three Content application exercises (CAE) aka "tests" per MF. These are written tests the whole class takes at 8 am for an hour. Typically 5 questions, they cover concepts from tutorial and lectures. These are marked by your tutorial group tutor, and are basically does not meet/meets/exceeds expectations. The score doesn't mean anything, but its taken into consideration by your tutor when they do your end of MF evaluation. You are also evaluated by your clinical skills preceptors but it doesn't mean anything and is again taken into account by your tutor for the end of MF evaluation. The evaluation also considers your group performance.

 

Youre also evaluated by the professional compentencies faciciltators, on your performance in procomp tutorial, as well as the occasional "PIE", which i forget what it stands for, and is bascially same as the CAE for procomp. There are also two "reflections" which are short 400-1000 word essays per MF that are read by your facicilators but not directly evaluated. There is a "summer project" but since we haven't done it yet I can't really say much about it but it seems that its considered by your procomp facilitators much like anything else.

 

There were anatomy bellringer quizzes for the class of 2017 but they weren't marked so Im not sure if its going to be the same this year. There is a muliple choice inventory test you do every once in a while but its only to track your own progress and isn't considered for your transcript. The same goes for the 3 offical osce exams I think.

 

Anyways I think that basically covers it. Again feel free to ask specific questions and I will do my best to answer.

[MrSchwartz3]

Wow, that was great and extremely informative, thank you bearded frog! 

[pugsanddoctors]

Thanks for that great answer bearded frog! So how would you describe the studying/learning environment? Should we be expecting to be studying for the majority of our free time after scheduled lessons/rotations, or would you say there's a fair amount of time for socializing and hobbies? 

 

Thanks a bunch again! 

[Edict]

Feel free to ask any specific questions and I will answer them. I guess we did a bad job going over it on interview day

 

The mcmaster curriculum, much like other schools is divided into pre-clerkship, from August 2015 to November 2016, and clerkship, from then to April 2018.

 

Clerkship is actual placements in hospitals, and the curriculum is very customized to the roatation you're on. You have a defined number of core electives in the main fields of medicine (family, surgery, internal, pedatrics, psychiatry, obs/gyn, emerg, etc) and a defined number of elective blocks that you can either use to get more experience in any of these core experiences at your home insitituion, experience more specialized fields at your home instituation, or do visiting electives at other medical schools. The order in which you do your cores, and when you will have electives, is different for each student, as students are divided into streams and do everything at different times (so that there isn't 150 people doing emergency at the same time) How the streams are laid out and which one you will get you will not find out until May 2016. You will be able to see the class of 2017 stream schedule once you start to get an idea, but they switch them up a little each year so its hard to predict.

 

What stream you get will have an effect on your residency application in a couple different ways, and some streams are more popular than others based on where the cores and electives lie relative to each other and the carms application due date. I can go into more detail but its not really relevant until next year as selections are done by lottery so there's no point in worrying about it at this point.

 

For pre-clerkship, the time is divided into 5 units, aka Medical Foundations (MFs), plus an 8 week elective block during the summer. MF1 (cardio/resp/heme) is roughtly from September to December and all campuses are in hamilton for this, then MF2 (gastro/endocrine) is till Feb, MF3 (nepro/repro) till April, MF4 (immuno/oncology) till end of June (roughly). Electives are July/August, where you are expected to do 7 weeks of elective and have one week holiday which you can arrange to be any week in that 8 week period. MF5 (MSK/nuro/psyc) is from Sept to Nov and goes into clerkship. Each MF is divided into subsections based on each topic, ie 3 for MF1 and MF5 and 2 for the other 3. Each subunit is roughly a month. Each week there are 2 tutorial cases that will cover topics in each unit. Each week there will also be multiple lectures (typically 2-6) a week, on monday and friday mornings, which are recorded and posted each friday, so attendance is optional. the lectures are on specialized topics relevant to the subjects which kind of summarize specific important things, or clinical/pathology conference sessions which kind of go through case reports of patient cases, given by multiple specialists and a pathologist to kind of connect things together.

 

There is also anatomy sessions along the way that will support each subunit, there was a week where we covered liver anatomy during gastro, for instance. The anatomy varies by campus so that will also play a factor. In addition to the 2 tutorial sessions, your tutoiral group for that MF will meet once a week with some residents for a clinical skills sessions where you learn and practice taking patient histories and performing physical exams. There is also standardized clinical skills sessions from faculty physicans and standardized patients every couple weeks which will cover a specific exam to ensure that you are hitting the importnant points and get the opportunity to perform it on an SP. Every tuesday morning there is typically an hour long professional competeincies lecture followed by a two hour small group session. Each week is on a different topic on the non-biological aspects of medicine, ie ethics, medical decision making, talking to patients, breaking bad news, LGBT health, global health, aboriginal health, etc.

 

In terms of performance evaluation, there are three Content application exercises (CAE) aka "tests" per MF. These are written tests the whole class takes at 8 am for an hour. Typically 5 questions, they cover concepts from tutorial and lectures. These are marked by your tutorial group tutor, and are basically does not meet/meets/exceeds expectations. The score doesn't mean anything, but its taken into consideration by your tutor when they do your end of MF evaluation. You are also evaluated by your clinical skills preceptors but it doesn't mean anything and is again taken into account by your tutor for the end of MF evaluation. The evaluation also considers your group performance.

 

Youre also evaluated by the professional compentencies faciciltators, on your performance in procomp tutorial, as well as the occasional "PIE", which i forget what it stands for, and is bascially same as the CAE for procomp. There are also two "reflections" which are short 400-1000 word essays per MF that are read by your facicilators but not directly evaluated. There is a "summer project" but since we haven't done it yet I can't really say much about it but it seems that its considered by your procomp facilitators much like anything else.

 

There were anatomy bellringer quizzes for the class of 2017 but they weren't marked so Im not sure if its going to be the same this year. There is a muliple choice inventory test you do every once in a while but its only to track your own progress and isn't considered for your transcript. The same goes for the 3 offical osce exams I think.

 

Anyways I think that basically covers it. Again feel free to ask specific questions and I will do my best to answer.

 

One question, for your first 7 week elective block after first year, what do people usually do? I'm guessing you can't really properly do electives since you don't have clinical experience right? So do people just do research or is this the time when people go abroad to their electives? 

[Rorzo]

One question, for your first 7 week elective block after first year, what do people usually do? I'm guessing you can't really properly do electives since you don't have clinical experience right? So do people just do research or is this the time when people go abroad to their electives? 

The preceptors know how little clinical experience you have and they work with that no matter what elective you choose. I know people who went abroad and I know people who stayed in the GTA doing everything from family medicine to plastic surgery.

[Organomegaly]

For the 7 week block of electives, can you only do those at Mac affiliated placements?

[xkittens]

Also how much elective time do we get before CARMS, not including the 7 weeks between MF4 and MF5? Does it differ from person to person? 

[Edict]

The preceptors know how little clinical experience you have and they work with that no matter what elective you choose. I know people who went abroad and I know people who stayed in the GTA doing everything from family medicine to plastic surgery.

 

So if you did decide to stay in Canada would the medical schools allow you to do proper clinical electives? In that case, would you use those reference letters for CaRMS or will they be pretty useless since you probably aren't capable enough that the doctors can write you a good one.

[oh atoms]

So if you did decide to stay in Canada would the medical schools allow you to do proper clinical electives? In that case, would you use those reference letters for CaRMS or will they be pretty useless since you probably aren't capable enough that the doctors can write you a good one.

I'm kinda confused about these being proper electives too at other institutions cause some of the schools I've checked, including one international, stipulate that applicants have to be in their final year or in clerkship. Unless I'm missing something? :S

[bearded frog]

Thanks for that great answer bearded frog! So how would you describe the studying/learning environment? Should we be expecting to be studying for the majority of our free time after scheduled lessons/rotations, or would you say there's a fair amount of time for socializing and hobbies? 

 

Thanks a bunch again! 

 

It's going to vary from student to student, based on their own learning style and their background. Everyone needs different amounts of time to work on different things. I would say that for most people there is plenty of time for socializing, exercising, personal time, netflix etc. Some people will sruggle with different units more than others, dome units are more dense than others, there is occasionally stuff like the OSCE which requires a little more prep time than usual, etc.

 

Those that have degrees in anatomy, biochem, etc will also probably have to spend less time than people with backgrounds in humanities. fine arts, law etc.

 

One question, for your first 7 week elective block after first year, what do people usually do? I'm guessing you can't really properly do electives since you don't have clinical experience right? So do people just do research or is this the time when people go abroad to their electives? 

 

Almost any specialty is avaliable. For electives at McMaster it's basically identical to a clerkship elective. Your preceptors will know you haven't done msk/neuro/psych but that doesn't mean you can't do an elective in those. A psych elective for instance would probably be a good introduction and help you when doing it later on in MF5. You can do research for part or all of it too. Many people do go abroad. In general its a good first experience to clinical medicine on a full time basis, and its what you make of it. You can use it as just getting used to life in the hospital and seeing how the health care team interacts, and learn the administrative stuff so that you can hit the ground running in clerkship, or you can assist with surgeries and round on patients, its up to you what you want to choose.

 

For the 7 week block of electives, can you only do those at Mac affiliated placements?

 

Mac affiliated ones are the easiset to do. There are international ones that are relatively easy to do as they have an affiliation with Mac as well. Technically you can do anything anywhere for the most part as long as you have a MD to supervise you. You could cold call a hospital in China and see if they'd let you tag along, I'm sure. However generally physicans in Canada can't just take anyone for an elective, as there are rules in each province's college about what pre-clerks can do and cannot do, and each hosptial/region has their own rules.

 

The other medical schools generally do not take pre-clerks for electives. I think NOSM does (did?). We are fully insured and licenced though, so in Ontario, if you know a doc that will take you, you can pretty much go anywhere. However, if its a hosptial in Toronto/Ottawa/Kingston etc, that usually takes students from their own school, you generally cannot officially go there, unless the doc will take you under the table, as those schools frown on you "taking opportunity from their students". It does happen, but theres always rumours that if you're discovered they will blacklist you from electives there in the future. Some provinces you can get temporarily licenced through the province's college directly, but some places will only take you for observerships. I think this is the case for BC/Yukon. There are some people in my class in BC right now I think.

 

But to answer your question, no you are not limted, but in practicailty most are Mac affiliated or international.

 

Also how much elective time do we get before CARMS, not including the 7 weeks between MF4 and MF5? Does it differ from person to person? 

 

There is a lower limit, ie everyone has a minimum of 10 weeks (I think). All streams have a bunch of electives after carms deadline. However some streams will have a couple weeks more. More importantly is how many weeks of electives there are before CARMS but after your core rotation in your specality of choice, as some schools only take visiting electives from students who have done their core rotation in the speciality. This might be able to be waved since it's a three year program, but you will obviously look a little better on visiting elective if you have some background in the core. This is much more limited, depending on specalty desired, with only a couple streams per speciality being optimal.

 

So if you did decide to stay in Canada would the medical schools allow you to do proper clinical electives? In that case, would you use those reference letters for CaRMS or will they be pretty useless since you probably aren't capable enough that the doctors can write you a good one.

 

Mac affiliated electives will be proper see patients/do procedures/srub in surgery/have powerchart access electives. Everything else will vary by local policy and could be limited to observership only (But that counts for Mac requirement purposes). You can probably ask for a letter (to be prepared next year as we don't have access to the CARMS template yet), however you will probably want to wait until clerkship as you will be more experienced and capable. A good strategy would be to do an elective in something you're interested in, and when you do it as a core or again as an elective you can already build upon that experience and hit the ground running so to speak, so that you can get a good letter from that experience.

 

I'm kinda confused about these being proper electives too at other institutions cause some of the schools I've checked, including one international, stipulate that applicants have to be in their final year or in clerkship. Unless I'm missing something? :S

 

Yeah most places will have rules about taking pre-clerks so you won't be able to go through them for these electives, you'll have to wait for clerkship or look elsewhere. But you can always do whatever it is in Hamilton for that elective, and be more experienced when you are eventually able to properly do that elective in clerkship. In terms of fourth-year requirements for electives, there is some flexablity since Mac is a three year program, and the requirement could be after doing your core rotation in that elective, or waved entirely. The MD off staff for electives can contact schools directly and explain Mac's situation for you in that regard if you run into trouble.

[osteogeek]

As a general rule you don't want CaRMS reference letters from pre-clerkship electives... no matter how you slice it, you just won't be as good as a clerk, and you won't be able to get a great letter (there may be exceptions, but not often). When you're applying to CaRMS, you want to only include great letters - eg it would be great if your letters said you were already working at a resident level, etc - that just doesn't happen in pre-clerkship because you haven't learned enough yet. 

 

Pre-clerkship electives are a great time to rule in/out specialties, travel and do an elective abroad, or try something that you're interested in but don't think you'll end up doing long-term. You also have a breadth requirement where you have to do electives in at least 3 specialties during med school, the post-MF4 electives are a great time to satisfy that requirement since in clerkship you'll want to gear your electives towards your specialty of choice. 

[xkittens]

Do you know which countries people have gone to for their electives? I looked up universities in the UK and they only seem to take "4th year" students. If you go to a non-english speaking country, is there really any point other than having a chance to travel? It sounds like you won't get to do much if you can't talk to patients. 

 

Ps thanks for answering all our questions you guys are awesome

[thestar10]

International electives you mainly observe unfortunately. Most of the European med students don't see patients alone and have a much more limited role. They also have different training.

I would say McMaster students in post MF4 are equivalent to year 4 students overseas and clerk are equivalent or greater in training to year 5-6s.

[Edict]

Do you know which countries people have gone to for their electives? I looked up universities in the UK and they only seem to take "4th year" students. If you go to a non-english speaking country, is there really any point other than having a chance to travel? It sounds like you won't get to do much if you can't talk to patients. 

 

Ps thanks for answering all our questions you guys are awesome

http://www.ed.ac.uk/polopoly_fs/1.137624!/fileManager/APPLICATION%20PACK%202016.pdf

 

Edinburgh says final or penultimate. You could perhaps say that you are a 2nd year by then.  

 

It is true more or less than you will likely be mainly taking histories, performing exams and doing more basic tasks. If you are lucky you'll be able to insert cannulas and do stuff like that. 

 

Does anyone know if McMaster helps facilitate global elective experiences? Do they help you contact global universities for electives or not. 

[thestar10]

http://www.ed.ac.uk/polopoly_fs/1.137624!/fileManager/APPLICATION%20PACK%202016.pdf

 

Edinburgh says final or penultimate. You could perhaps say that you are a 2nd year by then.  

 

It is true more or less than you will likely be mainly taking histories, performing exams and doing more basic tasks. If you are lucky you'll be able to insert cannulas and do stuff like that. 

 

Does anyone know if McMaster helps facilitate global elective experiences? Do they help you contact global universities for electives or not. 

 

Not even taking histories. You shadow the senior staff around in a group (what I've been told by my classmates). No clinical responsibilities whatsoever.

 

There is an official exchange program with staff to support it. Mainly in Ireland and the reviews from my class have not been great.

[osteogeek]

Off the top of my head, I remember Mac having partnerships in Ireland, Austria, Australia, and maybe Kenya? I didn't apply for an international post-MF4, so I didn't pay too much attention, haha. There should be an info session this fall where you can learn about the opportunities available. I also know of someone who arranged their own placement for post-MF4 in Ghana. As far as I know, most people who went abroad did so for the travel much more so than the clinical experience. 

[Edict]

Not even taking histories. You shadow the senior staff around in a group (what I've been told by my classmates). No clinical responsibilities whatsoever.

 

There is an official exchange program with staff to support it. Mainly in Ireland and the reviews from my class have not been great.

 

I know for a fact that they do take histories and perform exams even in pre-clinical years, skills taught from day one of medical school. Not sure about clinical years but I can't imagine clinical responsibilties being reduced.

[thestar10]

I know for a fact that they do take histories and perform exams even in pre-clinical years, skills taught from day one of medical school. Not sure about clinical years but I can't imagine clinical responsibilties being reduced.

Not looking to get into an argument but some of my classmates who did do international electives, only just followed the staff around and were not allowed to do anything. Others got to do more. There is some variation. The IMG medical students I've met on the wards have been mixed. Some are of equal skill to us CMG but I've also interacted with several IMGs who had never seen patients unsupervised before and were not at a skill level comparable to their placement.

 

I'm sure they teach histories/physicals but a lot of places outside of Canada/US are far more hesitant to have medical students take on unsupervised roles.

 

just food for thought when going international.

[Edict]

Not looking to get into an argument but some of my classmates who did do international electives, only just followed the staff around and were not allowed to do anything. Others got to do more. There is some variation. The IMG medical students I've met on the wards have been mixed. Some are of equal skill to us CMG but I've also interacted with several IMGs who had never seen patients unsupervised before and were not at a skill level comparable to their placement.

 

I'm sure they teach histories/physicals but a lot of places outside of Canada/US are far more hesitant to have medical students take on unsupervised roles.

 

just food for thought when going international.

 

I agree with this as well, in the UK, students aren't required or maybe even allowed to do a lot of things unsupervised, but i'm sure they take histories and do exams at the very least supervised. I have friends in the UK who got to take blood and insert cannulas in 2nd year out of a 6 year program on placement. They say its all there you just need to ask. Its also quite possible that they can be stricter on international students for electives, i.e. they might not let a canadian visiting student do a procedure but might let a british student do it. The UK just doesn't have the same culture of elective students "auditioning" for residency so doctors might find it a bit odd that visiting students want to take on so much responsibility and might not allow it. Foundation program is just based on your decile ranking, points allocated for research and a SJT test you write. Its likely not "in the curriculum" but keen students can definitely take on more responsibilities if they are looking.

 

At the same time I know people who just didn't bother showing up half the time and no one is going to force you to. If those people went on elective to Canada well we all know what would happen.