The University of Toronto redeveloped the first two years of the MD Program, traditionally called the pre-clerkship, which is now called the Foundations Curriculum. The new program was launched for students entering the U of T MD Program in the 2016-2017 academic year. Foundations features a highly integrated curriculum with clinical content from the beginning of medical school, early exposure to patients and the community setting, extensive use of online materials to support learning, and an assessment program designed to support learning.
The Foundations Curriculum will prepare students to practice medicine within the current and ever-evolving health-care environment. It strives to meet these challenges through the following major elements:
- Application of knowledge to virtual patients demonstrating real-life clinical problems through extensive use of case-based learning in a small group with a faculty member.
- Clinical medicine content that is closely integrated with relevant clinical skills (history-taking and physical examination), and with basic and social sciences, as well as community and public health.
- Carefully selected eLearning materials. More online content allows students to learn at their own pace and provides flexibility to pursue interests that complement their medical education, such as advanced research as part of our MD/PhD program or our Comprehensive Research Experience for Medical Students (CREMS) program.
- A programmatic assessment program designed to ensure students are proficient across diverse professional competencies, including each of the CanMEDS roles. The new assessment model will involve frequent lower-stakes assessments with feedback and individualized coaching designed to support learning.
- Lectures, though considerably reduced in number, will provide context for integrated content throughout the entire week’s learning activities, across various learning modalities. This may include small, expert-led group seminars, case-based learning, small-group discussion and shadowing. Students will be introduced to content through online materials and other resources both in advance and throughout the week to allow greater depth of content exploration in class.
- Longitudinal learning will also be emphasized through time dedicated to teaching areas such as leadership, medical ethics, and interprofessional education.
For more information on the Foundations Curriculum please see: http://foundations.md.utoronto.ca/
Students will be introduced to paediatrics early on in their training, with an emphasis on normal childhood, development, growth, nutrition, and health supervision. Some subspecialty paediatrics will be covered alongside the adult system-based weeks. Later on in their second year, students will have three weeks dedicated to paediatrics that will cover clinical problems from neonates to the adolescents. In the final few weeks, care of the child with multiple medical problems that needs transition to adult care will also be taught.
There are three major dimensions to the new Foundations Curriculum: courses, components, and themes. Each week has a full day that is unscheduled, and available for self-study, and special activities such as clinical skill development. The curriculum will feature a highly integrated program that promotes learning in context and includes extensive use of carefully selected eLearning materials to provide flexibility and support learning.
Preclerkship curriculum in paediatrics includes the following courses:
Toronto Patient-Centered Integrated Curriculum (TOPIC)
This curriculum is comprised of five courses running over 72 weeks throughout the first two years of pre-clerkship. Paediatrics is introduced in week 7 which covers topics including normal development, growth, nutrition, and several aspects of well-child care. Further learning on paediatric topics takes place in weeks 57-59 of the curriculum with an emphasis on core paediatric problems, ranging from neonatology to adolescence. Paediatric complex care and transition to adult care and is addressed in week 69. Content is delivered in interactive lectures, online cases, self-learning e-modules, and workshops. Longitudinal themes such as ethics, indigenous health, and others are incorporated into the weeks’ content.
Integrated Clinical Experience (ICE)
This course provides an introduction to clinical skills and begins in the first year of the curriculum. In the first year, students have one session in paediatrics focusing on the paediatric and adolescent history and developmental milestones. In the second year, there are four sessions. Small groups of three to four students are assigned to one clinical preceptor for hands-on clinical skills teaching which takes place at The Hospital for Sick Children or in the private offices of community paediatricians. The newborn session takes place at Mount Sinai Hospital, Sunnybrook Health Sciences Centre, or St. Michael’s Hospital. This course was formerly known as the Art and Science of Clinical Medicine (ASCM).
The goal of this course is for students to reflect on their experience as first- and second-year medical students, and the resulting effects on their professional development. There is a guided self-assessment where students will compile their formal assessments and reflections, and develop an individualized learning plan related to these assessments to ensure they are staying on track, and receiving help where it is needed. This course runs all four years of the MD program.
Throughout the Foundations Curriculum, students will be able to prepare for clerkship by spending time in clinical placement shadowing opportunities:
Observership and shadowing experiences, termed Enriching Educational Experiences, are available to all University of Toronto medical students from all years – but primarily intended for pre-clinical years. Enriching Educational Experiences (EEE) Program is a program that provides University of Toronto students with opportunities for self-directed clinical placements that focus primarily on early career exploration and help behaviorally explore different practice settings, specialties and contexts. The EEE Program is situated within the formal curriculum as part of the larger Integrated Clinical Experiences (ICE) Component.
EEE activities typically involve one or several half-day placements during which the student observes and selectively engages in delegated and graded responsibilities commensurate with the students’ level of experience and knowledge and at the supervisor's discretion.
The educational experience will follow the principle of delegated and graded responsibility. We recognize that most EEE will be of short duration, and thus the vast majority of these experiences will be observation only.
The EEE educational experience is governed by the University of Toronto Faculty of Medicine guidelines, which are based on the policies set forth by the College of Physicians and Surgeons of Ontario.
Students may request educational experiences with physicians outside of SickKids and outside of their formal Undergraduate Medical Education Program. Such requests are governed by requirements outlined in the CPSO Policy governing Professional Responsibilities in Undergraduate Medical Education College of Physicians and Surgeons of Ontario and may be limited to observation of clinical care only. These requests are negotiated with the supervising physician directly.
Department of Paediatrics Summer Programs
This is a ten-week experience for first and second-year University of Toronto undergraduate medical students with the flexibility to structure their experience with the assigned supervisor. During their summer experience, students will be expected to be involved in an original research project. Students will also have the opportunity to attend clinical activities organized by the supervisor. A lecture series will be organized by the program committee on career opportunities in paediatrics and various research topics. With the exception of those who participated previously, all first and second-year undergraduate medical students with an interest in paediatrics are eligible. Applications are sent to all first and second-year students in the fall.
This is an eight-week program that provides University of Toronto first and second-year undergraduate medical students exposure to a research experience in the broad field of social paediatrics, in order to study the importance of the social determinants of health (in health, disease management and outcomes, resource utilization) and encourage the role of child health advocacy. During their summer experience, students will have the opportunity to engage in an original research endeavour related to the field of social paediatrics. Students will also be given opportunities to participate in clinical activities. The clinical component will be organized at the discretion of the supervisor. Finally, a lecture series will be organized by the program committee running once weekly. Lecture content will cover key content areas in the field of social paediatrics and include discussion of career and research opportunities in this field. With the exception of those who participated previously, all first and second-year undergraduate medical students with an interest in paediatrics are eligible. Applications are sent to all first and second-year students in the fall.