So why change the curriculum?

Despite the successes we have enjoyed, we feel it is time to introduce significant changes into the first two years of the MD program, for a variety of reasons:

• For graduates to practice medicine optimally in the 21st century, substantial changes are needed in how medical education should be delivered.  The health care knowledge base is constantly growing, technology is becoming more and more important in health care, patient safety and quality improvement are emerging priorities, just to name three major forces for change. Numerous reports in the recent medical education literature have made this clear, including the 2010 Carnegie Report [1], the Lancet Commission [2], and the Future of Medical Education in Canada Project [3].  Multiple medical schools in Canada and around the world are pursuing substantial curricular revisions in keeping with these recommendations.
• Priorities in curriculum planning in the 21st century need to include:
  • A competency-based approach, which is one that focuses on ensuring medical students’ learning is based on what doctors need to be able to do
  • Flexibility for students to pursue special interests, such as public health or research during medical school
  • Integration of basic sciences with clinical learning, to enhance its relevance
  • Early clinical immersion
• Curriculum delivery has been found to be more effective if:
  • A more active learning approach is taken, with fewer passive lectures
  • There is carefully planned and increased use of technology
  • More community-based learning
  • Interprofessional education, in which medical students spend part of their time learning with, from and about health professional students
• Curriculum content needs to include:
  • Explicit teaching of cognitive sciences
  • Teaching to support the development of one’s identity as a professional
  • Learning to reflect on one’s experiences
  • Enhanced attention to prevention, public health and the health care system
  • Explicit teaching about patient safety and quality improvement
• Assessment of what students have learned should involve:
  • Using assessment to support learning with emphasis on feedback
  • Multiple lower-stakes assessments, rather than infrequent extremely high stakes examinations
• Preparation of teachers (“faculty development”) is critical to success.
  • A comprehensive faculty development program is needed for the new curriculum of the 21st century.

[1] COOKE, M. IRBY, D. O’BRIEN, B. EDUCATING PHYSICIANS: A CALL FOR REFORM OF MEDICAL SCHOOL AND RESIDENCY.  JOSSEY-BASS. 2010: SAN FRANCISCO.

[2] FRENK, J., CHEN, L., BHUTTA, Z. ET AL. HEALTH PROFESSIONALS FOR A NEW CENTURY: TRANSFORMING EDUCATION TO STRENGTHEN HEALTH SYSTEMS IN AN INTERDEPENDENT WORLD. LANCET 2010;376:1923-1958.

[3] ASSOCIATION OF FACULTIES OF MEDICINE OF CANADA. (2010). THE FUTURE OF MEDICAL EDUCATION IN CANADA (FMEC): A COLLECTIVE VISION FOR MD EDUCATION. OTTAWA, ON: AUTHOR. RETRIEVED FROM HTTP://WWW.AFMC.CA/FUTURE-OF-MEDICAL-EDUCATION-IN-CANADA/MEDICAL-DOCTOR-PROJECT/INDEX.PHP