Ask A Current Macmed Student A Question

[MacMed2018]

Ask away ... about Mac Med !

[IMislove]

You lovely people marking CASPer, or is it a mixture of y'all with the company who organized it? Just was curious as to who the make up was. Thanks for taking the time .

[medhope15]

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[freewheeler]

1) After having been through the interview process at mcmaster, how would you recommend to prepare? 

 

2) What are your impressions of the way the curriculum is structured and the delivery (I have heard lectures occur in Hamilton but are broadcast out to the regional campuses, problem-based learning approach, small tutorial groups, etc.)?

 

3) What are some strengths or weaknesses about the school (academically, socially, administrative, etc.) that you are aware of after attending the program and institution that you were not aware of prior to attending the school and experiencing the program firsthand?

[medhope15]

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[xkittens]

I don't wanna steal macmed 2018's thunder so I'll answer the patient exposure part because my experience might've been different. 
History taking is taught in the first week of class, and depending on your clinical skills preceptor you can get patient exposure within the first month of classes (as was the case for me). You can also do horizontal electives starting the second month of school, and this is where you can get tons of patient exposure, depending on your preceptor/your skill level/ the nature of the specialty of course. I've interviewed and done physicals on a lot of patients by myself in horizontals already. 

[MacMed2018]

You lovely people marking CASPer, or is it a mixture of y'all with the company who organized it? Just was curious as to who the make up was. Thanks for taking the time .

 

As far as I'm aware, they are even MORE desperate this year for raters ... so it's definitely not just the McMaster community grading CASPer anymore.  

 

See this website... http://takecasper.com/rating/how-to-become-a-rater/

[MacMed2018]

1. Is it competitive to stay in Hamilton vs the other sites? How are locations determined?

2. Is it possible to do electives outside the Hamilton area - say in a downtown Toronto hospital? or in the US? or even abroad? (for interest and experience)

3. Can you give us an idea of a typical week during the preclerkship training - what time does your day start? hours in lecture vs small group vs free study time vs whatever else they schedule for you? And with this, are lectures mandatory? I've noticed a trend in some med schools towards more flexibility (be it by having video lectures / eliminating mandatory attendance or just really streamlining on the classes previous students evaluated as less useful), how is Mac? Do you have free time to study and pursue other things such as research work? I'm looking for a program that provides strong education but with a balance to give me freedom to continue research work or even if I wanted more study time to prep for board exams.

4. How early do you get patient exposure (learning interview / assessment skills, going into a hospital and shadowing an MD or practicing skills on actual patients)?

5. I've always had this assumption that many people at Mac specialize in family medicine (perhaps bc most family MDs I've met went to Mac), would you say there are any trends in terms of specialty programs of choice?

 

thanks!!!

 

1. We were told that your site preference doesn't play a role in the admissions process.  I'm not sure what you mean by how are locations determined?  There are three campus, Hamilton, Niagara and Waterloo and you pick your preference during the application process.

 

2. I'm only in my first year, so maybe a second/third year can chime in .. but as far as I'm aware ... YES!

 

3.  In terms of schedule, it's very flexible.   Here's some info, taken directly from our MF1 guide which will answer most of your questions:

 

GENERAL LEARNING OBJECTIVES

Understanding how oxygen is acquired, transported and used by the body is the broad learning objective of MF1. Learning is driven by a sequence of concept- based tutorial problems supplemented by large group sessions, clinicopathology conferences, anatomy sessions and bedside clinical skills encounters. A multitude of other resources are available in the form of faculty, paper and electronic-based references and laboratory. The following details the different components of MF1 along with specific learning objectives:

ATTENDANCE

While McMaster’s program is intended to be “self-directed”, this does not mean that there are no mandatory requirements.

The following activities are mandatory:

1. Tutorials

2. Clinical skills sessions, both those you have with the clinical skills preceptor assigned to your tutorial group and the Wednesday morning Clinical Skills Practice Sessions in the Centre for Simulation-Based Learning

3. Pro Comp. The entire session is mandatory. If there is a Large Group Session as part of a Tuesday morning session, both LGS and tutorial are mandatory.

4. Concept Application Exercises and PIEs

 

Tutors, clinical skills preceptors and LFs are asked to keep track of attendance. If students must miss a mandatory activity for a valid reason, they must follow the MD Program Leave of Absence policy which can be found in this Handbook and on Medportal. This policy requires them to submit a written Leave of Absence request and have it approved first by the tutor or preceptor and then by the MF Director and MD Program Administrator. Forms are available online on Medportal and in the MD Program office

Approval for Leaves of Absence should not be granted lightly. If a student misses more than 10% of the mandatory activities in any evaluation period, they must be given an “Incomplete” evaluation on the end-MF evaluation and consequences will follow. There is no discretion for the tutor in this regard. This is one reason for being strict about requested Leaves – if a student is forced to miss sessions due to illness or emergencies and has already been granted a Leave for some other reason, s/he may inadvertently end up missing more than 10% of the mandatory activities in that evaluation period with unfortunate results.

Groups should ensure that they discuss the attendance requirements early on so there is no confusion about the mandatory nature of tutorials and clinical skills sessions.

COMPONENTS OF MF1

Tutorials

Tutorials are the central forum for learning throughout the curriculum. Your tutor will act predominantly as facilitator. However, tutors come from a variety of backgrounds and clinical experiences, so most will be able to provide some content expertise as well. In addition, they will be provided with a Tutor Guide to allow them to help you focus your problem-solving energies. However, you should not rely on the tutor to steer you. It is expected that you and your colleagues will share responsibility for knowledge acquisition.

Large Group Sessions

Large Group Sessions are scheduled most Friday mornings, with some Mondays and Wednesdays and are an important component of MF1. They supplement your tutorial learning by providing focused and in-depth information on a variety of concepts. Some will speak to topics not covered in the problems, but considered essential learning. Speakers have been chosen not just for their expert knowledge but also for their engaging styles and unique perspectives on a variety of healthcare topics. Many have international reputations in research and education, while maintaining a clinical practice. These are valued members of the McMaster University academic community. The lectures have been specially sequenced to coincide with the tutorials whenever possible, but on occasion, a LGS will appear out of sequence due to the need to accommodate the speakers’ busy schedules.

While Large Group Sessions are not mandatory, attendance is highly recommended. The material covered is core curriculum and students may expect to encounter questions based on LGS on the CAEs.

Usually, Large Group Sessions will be videotaped and posted for viewing on Medportal but the Program does not warrant that this will happen or when it will happen. Not all lecturers consent to be videotaped, sometimes there are mechanical problems that prevent videotaping and sometimes the technical staff are very busy and have other priorities which may delay the posting of our lectures.

Students who do not attend LGS assume the risk that the lecture will not be recorded or that it will be posted some weeks after the lecture has taken place. Please do not rely on viewing any lecture online.

Please be advised that the Program staff is well aware that students want the lecture slides before the lecture. Be assured that we do everything we can to make sure this happens but often, the lecturers are preparing their talks at the last minute and they do not provide the slides until after the talk. Please don’t harass the curriculum assistant about this.

Clinicopathology Conferences and Topics in Pathology

The Clinicopathology Conference (CPC) is a longstanding practice where clinicians are informed of the pathological findings that may have accounted for the clinical features of their patients. Such findings may be in the form of surgical specimens or autopsies. It is the most efficient way of learning the pathophysiologic process of diseases.

CPCs will occur at intervals, approximately once every 3-4 weeks throughout the entire preclinical curriculum. The format will be that of modified classic CPC. Instead of having an expert clinician didactically analysing symptoms, signs and investigative findings, students may be called on to discuss the relevant clinical features with guidance from the expert. This interactive approach will better facilitate active learning. The pathologic findings and/or pathophysiology will be presented by a staff pathologist. Topics selected for the CPCs are usually those less covered by the group tutorials, with some integration of learned knowledge from previous medical foundations.

Before or after a CPC there may be a short lecture on a specific topic in Pathology. These topics may be in the area of Anatomic Pathology, Medical Microbiology, Clinical Chemistry, or Hematopathology and they may include items such as factors governing the accuracy of laboratory tests, laboratory utilization, investigation of anemia etc. The ongoing exposure of students to these topics gives the backbone for the future practice of Medicine as well as more insight when they do the tour around the laboratories during their preclinical months.

 

Clinical Skills

In the Clinical Skills program for MF1, each tutorial group will be assigned a Clinical Skills Preceptor who will guide them through the topics listed below. In addition to the strong emphasis on developing skills around the medical interview, students will have sessions in communication skills during Pro Comp, employing the Calgary-Cambridge methodology.

The MF1/MF2/MF3 Family Medicine Experience

As part of the core curriculum, undergraduate medical students will be placed in a Family Medicine clinic in the community during their MF1, MF2 or MF3 block. This provides students with an introduction to Family Medicine as well as an opportunity to experience working in a diverse clinical setting. Students are paired with a physician for a mandatory 6 weeks which works out to be approximately 1 half day per week or 18 hours in total. Students also have the opportunity to extend their clinical experience by an additional 6 weeks which is considered an elective.

During the Family Medicine Orientation, administration will gather information for the match process. At this time, each student will receive a manual outlining the details of their clinical experience including evaluations, contact information and information regarding WSIB. Students will be notified of their placements within two weeks of the Family Medicine Orientation and will be expected to contact their assigned Family Medicine Supervisor immediately to work out the details of the clinical placement. Supervisor and student evaluations need to be completed and returned within 1 week of completing your placement. Student evaluations will be incorporated into your student file.

 

4.  We are paired into clinical skills groups starting in MF1 and depending on your preceptor, you may or may not see real patients.  Mine is great and she demonstrates on real patients every week but I've heard from other classmates that their preceptors do not teach using real patients so it can be hit or miss.

 

5.  You can do a lot more than just primary care but a large portion of mac grads traditionally go into fam practice.  However, it's a good place because pretty much all residencies are available regardless from derm to plastics to family med to radiology etc ...

[MacMed2018]

1) After having been through the interview process at mcmaster, how would you recommend to prepare? 

 

2) What are your impressions of the way the curriculum is structured and the delivery (I have heard lectures occur in Hamilton but are broadcast out to the regional campuses, problem-based learning approach, small tutorial groups, etc.)?

 

3) What are some strengths or weaknesses about the school (academically, socially, administrative, etc.) that you are aware of after attending the program and institution that you were not aware of prior to attending the school and experiencing the program firsthand?

 

1.  I prepared for the interview using all the resources I had which included: family, friends, med school friends, school career counselling and professional help.  Because I was fortunate to have all of these resources including professional help, my formal interview prep began immediately after I received an invite and occurred weekly up until 2 weeks before my actual interview.   I found brainstorming with other applicants helped in terms of sharing ideas.  Afterwards, I would run it by people who had been through the process (med students etc..) for feedback because let's face it ... other applicants trying to help each other is in general ... like the blind leading the blind..  I knew a few people in the class of 2017, 2016 so they were able to "drill" me in between my professional interview sessions.  My major weakness was role playing stations so that is really what I focused on with my paid sessions in addition to what my admissions consultant thought were additional deficiencies. I'm not saying that you need to go out and pay for professional help but for me, it was what I needed.  However, if you are going to pay for professional help ... please please please ask lots of questions  and get a feel for several companies because this is largely an unregulated industry and there are many companies who will simply just take your money and not deliver !!!!  Time management is also key for the MMI so make sure you practice under time constraints.  Don't blab too much and don't feel like you have to explore every damn alternative .. lol.

 

2.  Overall, I'm happy with the curriculum so far but ask me again next year and I may have a different outlook!  I feel the flow is very laid back and there are minimal formal lectures.  I'm happy with my tutor and my group but I know others who aren't so once again this can be hit or miss...Also, if you don't thrive on self directed learning, then this may not be the program for you.  There is more self directed learning that I'd like but this was something I knew going into the program.  It's also 11 mo of the year so you don't get summers off but the upside is you're done in 3 yrs.

 

3.  Strengths for me:  3 yrs vs. 4yrs.  Hospital on campus.  Decent amount of free time to pursue other interests.  Small group learning which allows you to get to know your classmates well and bond.   Curriculum is fairly well integrated.  Location Hamilton is great for outdoors and actually very scenic.   Cost of living is great compared to Toronto.

 

Weaknesses for me: no formal pharmacology course.  Many students feel like they're thrown onto the wards.  At times, I'd prefer having more formal lectures, because while self directed learning is important, I find myself at times getting overwhelmed and not necessarily learning as much as I would in the same time frame as I did in undergrad with lectures.  Of course this is only my opinion.  

[MacMed2018]

I want to echo the questions above. I'm wondering about how you feel with the 3 sites and lectures being broadcast. I've been in grad school where some learning was done this way, and personally I did not like it for many reasons - sometimes quality of broadcast was off and it's quite different actually having the speaker in front of you to ask a question (even to chat after the lecture), yes they try to repeat the questions to the broadcast audience, but it's not quite the same being in the actual discussion vs watching it on tv.

Also what is the quality of tutors like? I've heard from US programs that some schools have difficulty finding MD tutors (they would prefer to work than run a small group it seems). I've also heard Mac uses "community tutors" and it is not always a physician. Is this the case?

 

1.  I go to most of the lectures and watch the missed ones when they are available.  I find it's not a big deal for most of our class because the lecturers are VERY nice and approachable for the most part and welcome questions and correspondence if there are any issues.

 

2.  Quality of the tutors ... This is hit or miss.  Some of us really love our tutors.  Others, not so much.  The tutors are given a stipend (I think 5K for each MF) but that's a relatively small amount and most tutors do it because they enjoy teaching rather than the money.   Yes, it's true that some of the tutors are PhDs instead of MDs.

[MacMed2018]

I don't wanna steal macmed 2018's thunder so I'll answer the patient exposure part because my experience might've been different. 

History taking is taught in the first week of class, and depending on your clinical skills preceptor you can get patient exposure within the first month of classes (as was the case for me). You can also do horizontal electives starting the second month of school, and this is where you can get tons of patient exposure, depending on your preceptor/your skill level/ the nature of the specialty of course. I've interviewed and done physicals on a lot of patients by myself in horizontals already. 

 

No need to worry about stealing my thunder.  Feel free to join in

[MacMed2018]

Here's our MF1 Tutorial Schedule.  Hopefully no gets their panties all in a bunch about me sharing this.

 

http://www.pdf-archive.com/2015/11/12/mf1-tutorial-case-schedule-cl2018/mf1-tutorial-case-schedule-cl2018.pdf

[TwinTurbo]

Mac is my first choice! Thanks so much for sharing.

 

Do students feel disadvantaged not having a formal pharm course ?

[PurpleS]

Here's our MF1 Tutorial Schedule.  Hopefully no gets their panties all in a bunch about me sharing this.

 

http://www.pdf-archive.com/2015/11/12/mf1-tutorial-case-schedule-cl2018/mf1-tutorial-case-schedule-cl2018.pdf

 

I don't think anyone will mind you sharing this, but it might still be good to ask the admin for permission.

[Edict]

Mac is my first choice! Thanks so much for sharing.

 

Do students feel disadvantaged not having a formal pharm course ?

 

We don't feel disadvantaged because the vast majority of pharmacology you will learn on the wards. The minutiae of which drugs to use and at which dose is something you learn in clerkship rather than in pre-clerk. We learn the basic drugs and classes of drugs and there is a pharmacology lecture series that helps give more input. 

 

I also would like to add that even if the school taught you a whole list of drugs, its very difficult for you to actually remember that list by the time clerkship comes. 

[Organomegaly]

We don't feel disadvantaged because the vast majority of pharmacology you will learn on the wards. The minutiae of which drugs to use and at which dose is something you learn in clerkship rather than in pre-clerk. We learn the basic drugs and classes of drugs and there is a pharmacology lecture series that helps give more input. 

 

Yeah I was just gonna say, there is actually a lecturer who talks about pharmacology but these lectures are elective. they do give quite a bit of detail if you want to go to them.

 

i went to the resp one but couldn't make it for cardio because I had something else booked, so that's the only limitation there. 

 

but if you are interested in pharm and see that as an important learning objective for you in pre clerkship, you can attend these series. you will definitely learn it as a clerk. 

[Birdy]

Yes, you can definitely do electives outside of the Hamilton area. I'm working on arranging some time back home for next summer and we just got an email the other day about some international agreements Mac has. Plenty of students do international electives and I'm considering setting one up myself (though where I want to go can apparently be a bit harder to set up.)

 

Schedules are really quite interesting. I don't usually attend LGS (lecture) because the traffic and parking situation makes my normally 15 minute drive into an hour long commute in the morning so it's rather pointless to go when I can just watch at home on Friday. I'm one of many who does this.

 

I have tutorials Monday and Thursday evenings currently, though it'll be afternoons on those days in MF2. Combined with my evening clinical skills sessions, it means I actually have most of the day free most of the week so I just work on doing my tutorial prep and reading a lot. I do my own thing with anatomy so I fit that in during the week somewhere other than Wednesday afternoons.

 

I've just finished my family med experience (which was fantastic; I was seeing patients on my own from day 2) and I decided not to do any electives myself until after that, just as a matter of preference, so I'm about to start on setting some up.

 

My clinical skills preceptors are awesome; we were seeing patients pretty early as well, though a couple weeks after some groups. We were doing resp and cardio exams on real patients, taking histories, and presenting to our preceptors. They're PGY1s (I think most are) so pretty recently in our shoes.

 

Definitely don't feel disadvantaged at not having a mandatory pharmacology course (as THT mentioned, there is an elective we can take) because a lot of guidelines will change over time. I keep up with changes to recommendations through a variety of resources, but as has been mentioned already, we'll learn most of that on the wards.

 

Honestly, I didn't expect that I'd like the program as much as I do, but I'm someone who prefers being self-directed anyway.

[Harvestpro]

How do you feel McMaster prepares you for surgical specialities given that you do not have dissections but prosections.

[Rorzo]

How do you feel McMaster prepares you for surgical specialities given that you do not have dissections but prosections.

 

Anatomy can certainly be a weakness of the program, and like with many things at Mac it's up to you to make that deficit up on your own. I did dissection in undergrad and I am far less prepared for surgery than people who spent time with the prosections outside of assigned lab time, did horizontal/post MF4 electives in surgery, set up lab tutorials with the anatomy preceptors, and yet didn't have any dissection experience in undergrad. If it's something you want then Mac grads haven't historically had any major issues matching to surgical specialties when that was their goal, and regardless of which med school you went to there's going to be a steep learning curve in residency. If anatomy is a major concern Mac does have a dissection course, albeit with limited enrollment, or you could look into the more structured anatomy of the regional campuses 

[Organomegaly]

Anatomy can certainly be a weakness of the program, and like with many things at Mac it's up to you to make that deficit up on your own. I did dissection in undergrad and I am far less prepared for surgery than people who spent time with the prosections outside of assigned lab time, did horizontal/post MF4 electives in surgery, set up lab tutorials with the anatomy preceptors, and yet didn't have any dissection experience in undergrad. If it's something you want then Mac grads haven't historically had any major issues matching to surgical specialties when that was their goal, and regardless of which med school you went to there's going to be a steep learning curve in residency. If anatomy is a major concern Mac does have a dissection course, albeit with limited enrollment, or you could look into the more structured anatomy of the regional campuses 

 

Do horizontal electives. The cardiac surgery service provides ample opportunities for medical students to practice suturing. You can get sx experience if you want it. 

 

Formal anatomy education: it got better this year with more structured sessions and podcasts but in my opinion its still not a strength of the program. That being said, the anatomy resources are immense and the lab is great, with great teachers in it at practically all daytime hours. If you make it a learning objective, there's lots to learn in anatomy. 

[medhope15]

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[Edict]

Since the surgery question came up, I just wanted to know:

 

1. Do Mac students ever attempt to join UofT summer surgical program for med students (it's a couple weeks of practicing surgical skills). Is it feasible? I honestly would consider skipping any non essential material to spend a couple of weeks doing something like this (at UofT or elsewhere). Just curious if anyone has had success with doing any additional surgical prep.

 

2. How are surgeons/residents/fellows at the Hamilton hospitals in terms of allowing students to watch procedures? From current med students who are gunning for surgery specialties, I understand there are major advantages to spending as much time as possible shadowing / observing ORs as a med student (ie. going in after hours or on weekends; from what I hear from a former UofT student they seemed to be pretty open to keen students wanting to watch ORs and learn outside regular teaching time; my friend said a couple of residents let him shadow a night call in ER and even texted him when a transplant was coming in, as he really wanted to see the procedure). I know as students we will get lots of rotations and chances to "experience call", but if you are keen and want more opportunity, are people open?

 

1. I'm only a first year but I don't think so, not sure if you are referring to SEAD but if its SEAD then Mac students are not off during that time. We get June 27-Aug 19th to do post-MF4 electives and generally students just do electives abroad or at Mac. Some go back home to do observerships. 

 

2. It definitely varies by surgeon and by resident, we have a program called One Day Matters and you sign up for it usually pretty early on in like September of first year and you spend one day with a surgeon in a specialty sometime in November. I just did mine and it was a good experience, was able to scrub in and do a few things which was great. I don't think any of this changes between schools and in particular at Mac there is that added pressure I guess to figure out what you want to do early on. Its very self directed, people find preceptors to shadow by emailing them, through their clin skills preceptors or through coordinators. 

 

3. A few observerships are hard to set up and have lotteries or first come first serve. One is the labour and delivery shifts which fill up fast and the other is CTU (clinical teaching units) basically an IM elective for post-MF4. 

[Edict]

How do you feel McMaster prepares you for surgical specialities given that you do not have dissections but prosections.

 

If you just sit there and do everything you are told then McMaster certainly doesn't prepare you well enough for surgery (but you can say that for a lot of specialties as well). 

 

I did full body dissection during my UG and in my opinion McMaster's anatomy program even with the improvements they've made just doesn't come to par with what I experienced during my undergrad (note I did UG in a very anatomy focused program though), but even then the anatomy you learn at Mac is not much more in depth from what you might find in an UG anatomy course and med students aren't given any more privileges that are given to other faculty of health sciences students. 

 

However, they do encourage you to explore your options, and there is the one day matters program that allows exposure to a surgical specialty of your choice. 

 

The surgical interest group at Mac is also pretty active and brings in speakers and lectures to give students info and advice on surgery as an option. 

 

If you want to practice suturing, buy your own pig's feet, get some sutures from the hospital and start practicing etc. Grab a surgical textbook or go online and learn about different procedures etc. Email preceptors and look for research and/or observerships.  

 

I think at the end of the day it is very important that you take control of your own learning at McMaster, you need to be a go-getter, not a sit and do what you are told kind of person to succeed at Mac. I do think this is congruent with the successful physician, because at the end of the day someone who is self-directed is going to be better than someone who just follows the book and arguably McMaster really gives you a taste of that early on so that you can be better prepared for the real world where everything is actually very self-directed. 

[medhope15]

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[thestar10]

Thanks for the honest input.

Personally my dream is to be an MD and if Mac is the only option then I will take it, but it is really disheartening to hear that after a tough road to get into medical school, you will need to struggle with lottery systems and personal connections to learn basic medical skills like delivery and suturing. How does Mac get away with having what to me seems like a subpar program?  My only guess is the road to MD is so tough in Canada and most students are just happy to be in a seat so perhaps they fear speaking up or complaining ..

So most of what people are talking about is pre clerkship. At other schools they dont get anywhere near the practical exposure we do in pre clerkship. 

 

You deliver Babies. I've delivered around 20 or so....

You suture a lot. I've closed abdomens, uteruses, breast reductions, carpal tunnel etc..

 

Mac is fine but it;s different.

 

It's easy to criticize the anatomy but having done full body dissections they are kinda useless. Best way to learn anatomy is sx or radiology. If you want to learn it its easy but mac doesn't force you to do so.

 

Mac final year btw