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New Curriculum Thoughts


Abramshunter

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I went to a town hall meeting last week about the new medical curriculum starting this year, and was surprised to learn a number of professors are against the changes. I also just came across this article which addresses some of the stuff brought up in the town hall:

http://www.montrealgazette.com/health/Medical+school+reform+causes+polarization/8230070/story.html

 

I was wondering if there are any current medical students/people with knowledge of the new or old curriculum that can comment on what they think of the upcoming changes?

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I went to a town hall meeting last week about the new medical curriculum starting this year, and was surprised to learn a number of professors are against the changes. I also just came across this article which addresses some of the stuff brought up in the town hall:

http://www.montrealgazette.com/health/Medical+school+reform+causes+polarization/8230070/story.html

 

I was wondering if there are any current medical students/people with knowledge of the new or old curriculum that can comment on what they think of the upcoming changes?

 

The article seems pretty accurate.

 

A change was much needed, this says it all:

 

"Also, the university was threatened with probation by some medical school accrediting bodies because of its practices, including insufficient promotion of independent learning, with 13 of 132 national standards not being met."

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Ulaval underwent such a change 6 years ago. The number of basic science lectures was cut in favor of clinical sciences. Also, the family med rotation was extended from 4 to 6 weeks. While the curriculum is amazing, some students finish med school with gaps in some basic science topics. It's not a big deal for most doctors, but fewer med students are interested in key areas such as pathology. The shortage of pathologists in Quebec is more severe than the shortage of family physicians, and it leads to delays in cancer dx and treatments. I'm not saying that the curriculum changes are the cause of this shortage, but we tend to forsake the basic sciences nowadays. The future gen of doctors will be made of technician mds, and they'll think that a deep knowledge of anatomy is not required. Who cares about the hyoid bone? Nobody cares until you get a consult for ''paratracheal pain'' when in fact it's a tendonitis of one of those muscles that are inserted on the hyoid.

 

Interestingly, UMontreal underwent this shift towards PBL and clinical sciences a long time ago (over 10 years ago) and they're changing their curriculum again, and guess what, they're introducing more basic sciences this time. Its cyclical. When in 30 years doctors won't be able to tell the difference between a beta blocker and an alpha agonist medication because they never had a proper lecture on autonomic receptors, then we'll be back to science heavy curricula.

 

Peace

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It's an interesting change, but personally I don't think it's as much about limiting basic sciences as people have been making it out to be. In my undergrad, I've taken lecture based courses and upper level "seminars" with 10-20 students. The best scientific methodology, techniques, and critical thinking I ever learned was from those courses so I think that 15 hours basic science lecture + 10 hours small group at McGill will be amazing. Yes, it will be more self-directed learning, but I bet most of us who got in tend to do more than just the bare minimum for a course.

 

Another point I like about the shift is that small groups are great for people who already have BSc's. I know Quebec also has MED-P, and maybe that will be more of an issue with less basic sciences, but I can tell you that I've learned about adrenergic receptors, the Krebs cycle, and extra ocular control of eye movements (all examples of what we might "miss" in the new curriculum) at least 2 - 3 times. I think that we still need to cover these in med school, but a greater focus on small group sessions that integrate the importance of these topics into clinical cases would be amazing. Med school should not be "undergrad 2.0" for the first two years.

 

That's what I'm thinking about it!!

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The new curriculum has pros and cons in my opinion. The lack of basic science course will have many drawback's in my opinion. Students coming in from cegep (half of the class no less) have a very limited anatomy, biochemistry, and physiology background as are those entering with a background in anything other than biological sciences. This will probably make understanding the concepts a lot harder and may have an effect on test scores down the line.

 

There are pros too though, it's nice to have clinical exposure right away. I think it really depends on what each candidate is looking for in terms of medical education. If they can study on their own and feel comfortable with limited class time than this new curriculum might be a good change.

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It's an interesting change, but personally I don't think it's as much about limiting basic sciences as people have been making it out to be. In my undergrad, I've taken lecture based courses and upper level "seminars" with 10-20 students. The best scientific methodology, techniques, and critical thinking I ever learned was from those courses so I think that 15 hours basic science lecture + 10 hours small group at McGill will be amazing. Yes, it will be more self-directed learning, but I bet most of us who got in tend to do more than just the bare minimum for a course.

 

Another point I like about the shift is that small groups are great for people who already have BSc's. I know Quebec also has MED-P, and maybe that will be more of an issue with less basic sciences, but I can tell you that I've learned about adrenergic receptors, the Krebs cycle, and extra ocular control of eye movements (all examples of what we might "miss" in the new curriculum) at least 2 - 3 times. I think that we still need to cover these in med school, but a greater focus on small group sessions that integrate the importance of these topics into clinical cases would be amazing. Med school should not be "undergrad 2.0" for the first two years.

 

That's what I'm thinking about it!!

 

Thanks for the thoughts everyone. Like you said Slipstream, students that have already take a lot of life science classes in undergrad should be okay with the changes. However, I do worry what it means for med students coming from other fields of study (music, engineering, history, etc), as well as Med-P students who haven't had as much exposure to life sciences.

 

It seems like it would be difficult to determine the right balance of basic science classes to teach in medicine, given the variety of backgrounds the students have. I almost feel like the best approach is to expand the prerequisite courses to include courses like basic physiology (PHGY 209/210 at McGill, for example, which the MED-P students already have to take), but this may also limit the pool of potential non-science undergrad applicants. I often hear that these students make good doctors due to their unique experiences, so we certainly wouldn't want to limit their ability to enter medicine if they choose to do so.

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Thanks for the thoughts everyone. Like you said Slipstream, students that have already take a lot of life science classes in undergrad should be okay with the changes. However, I do worry what it means for med students coming from other fields of study (music, engineering, history, etc), as well as Med-P students who haven't had as much exposure to life sciences.

 

It seems like it would be difficult to determine the right balance of basic science classes to teach in medicine, given the variety of backgrounds the students have. I almost feel like the best approach is to expand the prerequisite courses to include courses like basic physiology (PHGY 209/210 at McGill, for example, which the MED-P students already have to take), but this may also limit the pool of potential non-science undergrad applicants. I often hear that these students make good doctors due to their unique experiences, so we certainly wouldn't want to limit their ability to enter medicine if they choose to do so.

 

Med-Ps do not have to take physiology, actually, only bio 200 and 201. I myself did not take physiology and I'm grateful that it currently does not impair my performance during BOM. I don't know how well I would've understood with the new curriculum!

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I just want to point out that someone's background before medicine has nothing to do with how good he will be as a doctor. A lot of cegep students were a lot better and more competitive in both preclerkship and clerkship than phd candidates. The same can be said about people with non scientific background. I am talking about laval, the med school i went to, but having done rotations in every university in the province, it's pretty much the case everywhere. Theres no premed at laval and even then, cegep students were not at a disadvantage (55% of the class). However, even in the new curriculum, we learned about adrenergic receptor, krebs cycle and extraocular eye mvmts ;)

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Med-Ps do not have to take physiology, actually, only bio 200 and 201. I myself did not take physiology and I'm grateful that it currently does not impair my performance during BOM. I don't know how well I would've understood with the new curriculum!

 

 

My mistake, there were a bunch of Med-P students in physiology 209/210 when I took those classes so I assumed it was mandatory for them, thanks for clarifying.

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Given that there's a trend towards less basic sciences in med school, I'm wondering if problems that this could cause would be further exacerbated by greater enrollment from students of non-science backgrounds (e.g. music, arts, etc), which has also been greater in recent years

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  • 2 weeks later...

Another issue that I hadn't though about until recently – there's a new focus on increasing the number of family medicine physicians. So as part of that, we're going to be getting clinical experience in family medicine clinics. But does that mean that the lecture learning will also be more focused on primary care? I agree that we need more FM doctors, but I want to be able to experience everything in medical school so that I can make an informed decision for my specialty (FM or otherwise)... I agree with the new teaching style for the basic sciences, but I am worried that they might push too hard for FM and limit our exposure and choice within the specialties as well...

 

Thoughts?? Maybe I'm just being paranoid – senioritis at its worst! This is what I do instead of studying for finals now...

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Another issue that I hadn't though about until recently – there's a new focus on increasing the number of family medicine physicians. So as part of that, we're going to be getting clinical experience in family medicine clinics. But does that mean that the lecture learning will also be more focused on primary care? I agree that we need more FM doctors, but I want to be able to experience everything in medical school so that I can make an informed decision for my specialty (FM or otherwise)... I agree with the new teaching style for the basic sciences, but I am worried that they might push too hard for FM and limit our exposure and choice within the specialties as well...

 

Thoughts?? Maybe I'm just being paranoid – senioritis at its worst! This is what I do instead of studying for finals now...

 

My understanding is that the exposure for all the different specialties will not change, and will remain the same, however, instead of getting no exposure in the first year, you will now have exposure, and that is, in FM. I don't think this is gonna limit your choice for future specialties. However, this may give you an early indication that FM may or may not be for you.

 

my 2 cents ;)

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My understanding is that the exposure for all the different specialties will not change, and will remain the same, however, instead of getting no exposure in the first year, you will now have exposure, and that is, in FM. I don't think this is gonna limit your choice for future specialties. However, this may give you an early indication that FM may or may not be for you.

 

my 2 cents ;)

 

Yeah I was just reading through the curriculum overview and I think you're right. I had this discussion with one my friends and it got me thinking. But it really looks like early exposure to FM + exposure to specialities in "Transition to Clinical Practice" and Clerkship. McGill still has the most comprehensive clerkship structure I've seen, so I don't think there's reason to worry :D. I also forgot that we have "Physician Apprenticeship" where you get paired with an Osler fellow from any specialty to learn about being a physician, so the curriculum looks pretty solid. I can't wait to start!

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