Mcmaster Program

[Guest Ck]

Hello, I am wondering why Mcmaster has a 3 year program for med-school and many other eastern and western schools have four years? Do they pack more into their program? Once completed do you know any less then someone who has spent 4 years at another school?

 

Thanks for you help.

 

Ck

[Guest Shidi]

I am not sure. Perhaps they have a much more rigorous program that enables you to learn more in a smaller amount of time. Or maybe you don't get holiday breaks *shudders*. Maybe someone at Mac knows?

 

Chris

[Guest Ian Wong]

Less breaks! Seriously though, I'd be interested in hearing what their time-line looks like for the three years.

 

At UBC, we have three months off after first year, and another three months off after second year (although you need to do a 4 week rural elective in that time period). There's an additional 2 weeks off in the summer after third year.

 

Ian

UBC, Med 3

[Guest Uche]

I've spoken to some people at Mac Med and they told me they get two breaks a year, each two weeks long. They work throughout the remaining 11 months.

[Guest Chirashi]

Dear Ck,

 

Many traditional medical curriculums are four years long, with the first two years spent learning basic scientific/medical knowledge (eg. normal human anatomy/physiology and 'disease state' pathophysiology), and the final years spent in clinical clerkship (rotating through different areas of medicine). This time can also include several months of vacation time during the summer, to which Ian has alluded.

 

At Mac, we essentially cover the same medical knowledge, but the timeline we follow, as well as the format of our learning, is different.

 

As you may have heard, Mac follows a problem-based, self-directed approach to learning which involves considering clinical patient scenarios from day one. During the first 1-1/2 years, we rotate through three-month 'units', which are generally based on organ system (eg. cardio/renal/resp, or neuro/psych/msk) and spend much of our time in a tutorial setting, learning along with 4-5 colleagues and a tutor (usually a physician). We set 'learning objectives', which arise from 'issues' we identify that are pertinent to the patient problem we are currently considering. The problems are designed to elicit a whole range of issues ranging from basic science knowledge (eg. anatomy, physiology, pathophysiology) to more clinically-relevant learning (disease states, diagnostic tests, and therapeutics) to other important population and psychosocial issues. The second half of our training is a rotating clinical clerkship similar to that of other medical schools.

 

Other important activites in which students participate are specific sessions in clinical skills (taking a history and physical exam), pathology, anatomy, communication, and 'large-group' talks. The timing and nature of these sessions is largely determined by the particular patient problem which the group is working on, and the objectives which need to be met.

 

 

Part of being a fully-accredited medical programme means that the McMaster curriculum is planned so that a McMaster student will spend an equivalent amount of time in academic learning and clinical experience hours as compared with any other medical school in Canada. What that means for a three-year programme is that something has got to give for the schedule to balance! Therefore, we don't get three-month summers. =\ Instead, we get 2 separate two-week breaks, one during the winter holidays, and one in the summer.

 

So the programme IS intense. Having said that, one very positive benefit of the curriculum at McMaster is the amount of elective time we get (time in which we are able to participate in clinical or research experiences of our choosing, in an area of interest). We get weeks and weeks of block elective time during the summer (7 weeks), winter (4 weeks) and clerkship (~8 weeks). Many students use this as an opportunity to travel to distant, exotic places to get some sun, relax and have fun, and to get valuable learning experiences at the same time. Last summer, a number of my classmates travelled internationally to the Netherlands, Ireland, Poland, Italy, Uganda, the Dominican Republic, and Australia.

 

We are also able to set up 'horizontal' electives (which run concurrently with our other learning activities) right from the beginning of our training. This is a great way to develop clinical acumen, make learning more exciting and meaningful, and to assess career interests.

 

 

Hopefully, this brief description of the components of the Mac curriculum helps to elucidate how and why we have a 3-year programme for medical school.

 

At first, it may seem impossible or even ridiculous to believe that a medical student could complete properly in three years what many others do in four. However, the key to remember is that when all is said and done, we end up spending the same amount of time in school (less vacation).

 

There is also a fundamental difference in the way learning occurs: In a true problem-based, self-directed environment, learning is not a linear process of comprehensively moving from point A to point B. Rather, it involves becoming adept at learning how to learn, utilizing a variety of resources, continually self-evaluating, being aware of one's competencies and (especially) deficiencies, and constantly filling in those gaps through focused, relevant learning.

 

This can be very exciting, since it offers flexibility, and lends a significance to even the most basic science knowledge through the context of a clinical patient problem. It can also be nerve-wracking and downright scary, since the learner is constantly challenged to take responsibility for his or her medical education, and the eventual goal to become a competent and compassionate physician.

 

 

Doubtless, this noble aspiration to become a 'good' physician is the common bond shared by medical students across schools and curriculums. It is clear that the paths we take may vary markedly, but ultimately, it will be our commitment and drive toward this vision that will define us as doctors.

 

Best wishes,

Michael

[Guest Ck]

Hello Michael, thank you for your explanation of how a 3-year med program works. It has answered most of all the questions I had . Mac is the school I believe I really want to go not only because of where it is located but because I have heard it has a great reputation for it's medical program.

 

Thanks for your help if I have any more questions I know who to ask.

 

Ck

[Guest siz]

Good overview, thanks for that Michael. It's surprising how few people understand the program at McMaster. Often times the knee-jerk reaction is one of skepticism and mistrust due to a woeful lack of information. I hear this all the time from other med students and physicians alike...keep spreading the good word.

[Guest Ian Wong]

Just to give the other side of the coin, at this point in my med school training, I think I would be happiest with a four year program. The simple reason is that I think having those summers off in your first two years give you more flexibility in controlling the direction of your education. For instance, if you want to go travelling, here's your opportunity. If you want to explore research opportunities, you have three dedicated months in which to do work, especially during daytime hours, which is a rare commodity indeed in med school. If you want to spend a lot of time in clinical work exploring different specialties so that you can make some faculty contacts, or just have a more informed decision-making process when choosing electives, you have that ability. All of these options will only improve your resume when hunting for residency positions via CaRMS.

 

While the Mac folks have the ability to arrange electives early on, I still think that being able to dedicate several consecutive weeks/months towards an elective is going to sharpen your skills considerably more than having to split it up into perhaps one day a week over a longer period of time. Especially when you know that you'll still have a full year of clinical rotations in the hospital to back that up, as well as four months of elective time set aside in the Med 4 school year.

 

This remark isn't directed towards Mac specifically; I think the same about Calgary's program (the only other 3 year program in Canada). At this point in my career, as a medical student who really didn't know what specialty to pursue until the end of Med 2, I'm glad I had that full summer to explore my options. If I was a Mac student, I'd be awful nervous knowing that CaRMS applications are due near the beginning of Med 3. I'm envisioning how much more I would like either the Mac or Calgary programs if they simply took four years to graduate a student.

 

I made some other comments previously in the Calgary forum. I checked after making that post, and we do indeed only get two weeks off after Med 3.

 

pub44.ezboard.com/fpremed101frm16.showMessage?topicID=18.topic

 

Ian

UBC, Med 3

[Guest siz]

Ian, there's nothing stopping a Mac student from taking an extra "enrichment" year to do all of those things that you mentioned. In fact this is not uncommon, and I suspect the same option exists at Calgary as well.

[Guest Ian Wong]

That's a good option then. The only sticky point I can see with that is that taking an entire year off leads to quite a bit of degradation in retention of whatever materials you've learned in the previous year. If you take three months off in each summer (such as at UBC), you still retain a lot of that previous knowledge when you resume your actual med school classes. However, the enrichment option still looks pretty good to me on the face of it.

 

Ian

UBC, Med 3

[Guest Chirashi]

In fact, I am currently in the process of writing my proposal to do an enrichment year.

 

The purpose of the enrichment opportunity is to stimulate an interest in research and scholarly activity, with an aim toward attracting students to careers in academic medicine and medical research.

 

The remarkable aspect of this programme is the ability to continue to engage in any number of clinical encounters which the student arranges during that time. However, this experience was not designed to be a 'preclerkship clerkship'. Rather, the activities planned should be fairly consistent with a theme for the year, or a key question that the student is seeking to answer.

 

As an example, my enrichment year is centred around evidence-based medicine and health informatics. For the first eight months of my year, I will (learn to) lead a specific clinical research project. During that time, I have planned to allocate my research:clinical experience time in a ratio of 3:1 or 4:1. This means that every month, I will spend 3 weeks on my research project, and 1 week on clinical service. Alternatively, I may choose to reserve 2-3 clinical half-days per week to get more experience in my particular areas of interest.

 

I expect to spend the remainder of the time (four months) vacationing and pursuing various other clinical or research activities.

 

This represents a valuable self-directed learning opportunity for those who choose to take it. At present, however, the school will accept a maximum of ten students per year to participate in this programme.

 

 

I want to concur with Ian on an important point: Finding a specialty or area of medicine that one is passionate about, and then pursuing residency positions is among the most challenging and stressful decisions my colleagues and I have had to consider during our undergraduate medical career. While I believe that this is a universal dilemma faced by medical students across Canada (a reflection on the timing and nature of the CaRMS process), I agree that it becomes a more critical issue in a three-year curriculum.

 

Finding one's life calling is not usually an easy task, and certainly not one to be made hastily. I would encourage students to seize the opportunity to take advantage of McMaster's unique elective policy, and to keep an open mind.

 

Admittedly, there is a role for 'strategizing' for particular residencies. Even so, my observations of successful applicants to competitive residency programs has led me to believe that the best and most reasonable approach toward making oneself a first-rate candidate is to focus vigorously and unwaveringly on getting a well-rounded, balanced medical education. This includes academic excellence and clinical aptitude, but also nurturing those special qualities desirable in a physician and colleague: congeniality, compassion, and a sense of humility.

 

These are all achievable goals in the medical programme at McMaster, and really at any medical school, since they depend much more on the determination of the individual than on the details of a curriculum.

 

Michael