University of Toronto, Faculty of Medicine

Curriculum Management and Governance Structure ♦ The Undergraduate Medical Education Curriculum Committee (UMECC) has overall responsibility for the design, implementation, management, and evaluation of the undergraduate MD education program. ♦ The committee reports through its Chair to the Dean, and ultimately to the Faculty Council. ♦ The UMECC achieves its goal through oversight of the development, implementation, integration, and evaluation of the component courses of the Preclerkship and Clerkship, which have their own standing committees that report to the UMECC (see Figure 1).FIGURE 1:: Curriculum Governance and Management Office of Education ♦ The Vice Dean, Undergraduate Medical Education's office has overall responsibility for support of all aspects of the MD program. ♦ This includes the portfolios of Admissions, Student Awards, and Finances, the Faculty Registrar, Student Affairs, and Curriculum centrally, as well as the key partnerships with our affiliated institutions and academies. ♦ Approximately 70 individuals in core administrative positions now support the program. Financial Management of Educational Programs ♦ Limit percentage student tuition increases. ♦ Students with identified financial need receive a Faculty of Medicine grant to assist in the cost of tuition and living expenses, in addition to government loan programs. ♦ High-need bursaries for students in most financial need. ♦ The MD program at UT is supported through government grants, student tuition, physician practice plans, and affiliate hospitals. ♦ To our knowledge, we have never had a student not attend our medical school because of inability to finance their studies. Valuing Teaching ♦ Established in 2002, the Center for Faculty Development is a partnership between St. Michael's Hospital and the Faculty of Medicine UT. Its purpose is to advance faculty development by supporting educators and their organizations to promote excellence in teaching, research, education scholarship, and leadership with the goal of improving health outcomes. ♦ The promotion process at the Faculty of Medicine UT highly values teaching and education skills. ♦ Numerous faculty members have been promoted to Associate Professor and several to full Professor principally on the basis of sustained excellence in teaching. Curriculum Renewal Process ♦ As a result of rigorous self-study and continuous quality improvement, the UMECC approved a set of governing principles in 2008 to guide UME curriculum renewal. Key additional curriculum objectives included clinical relevance, explicitly linking all teaching to current medical practice. early clinical exposure. new evaluation systems for nonmedical expert roles, including portfolios. more flexible curriculum scheduling and individualized scholarly opportunities for students. shared contributions from clinicians and basic scientists. Learning Outcomes/Competencies ♦ The curriculum is governed by a set of overall goals and objectives that were developed 2003. ♦ The curriculum objectives are organized into seven categories based on the CanMEDS competencies (http://www.md.utoronto.ca/about/vicedean/goals.htm). New Topics in the Curriculum Since 2000 ♦ We have incorporated multiple team based learning modules throughout the medical curriculum where students learn about team work and are evaluated in teams. This begins in first year with several sessions on team work prior to the students completing the Harvard Business Carter Racing simulation case where they must work in teams and learn about team dysfunction and group think. ♦ The students also complete multiple team exercises in the second year (Determinants of Community Health) and the Canadian Medical Association leadership modules. In third year, the students undergo a two-day Lakeview web based simulation, which teaches about change management and process improvement while working in teams. ♦ The Surgical Clerkship at the University of Toronto makes extensive use of bench-top simulations. A five-day course is conducted at the start of the clerkship, which provides instruction and practice on both high- and low-fidelity models. ♦ Skills that are taught include suturing, knot tying, lumbar puncture, chest tube insertion, splinting/casting, as well as catheterization. ♦ In the third year of Clerkship, the students undergo a comprehensive module on patient safety and participate in the IHI open web-based course curriculum to ensure that they are prepared for their clinical rotation. Changes in Pedagogy ♦ Interprofessional Education is now a mandatory element in all stages of the curriculum. ♦ Full integration of technology into the student experience: All lectures are digitally captured and available for student access. All courses use a central learning management system. ♦Use of individual portfolios. Changes in Assessment ♦ The implementation of a Credit/No Credit transcription of grades for the MD program was implemented in 2009 (replacing an Honors/Pass/Fail grading system). ♦ Integrated OSCE for new clerkship model (beginning Fall 2010). ♦ Students will be required to track their own clinical experiences via a portfolio system. Clinical Experiences ♦ Affiliated with hospitals from one of the leading health sciences centers for research and education in North America (10 fully affiliated and 19 community affiliated hospitals). ♦ Longitudinal clinical experiences meet the needs of our Preclerkship students seeking greater clinical exposure (Family Medicine and Pediatrics). Regional Campus ♦ The Mississauga Academy (opening September 2011) will be a partnership between the Faculty of Medicine at the University of Toronto, University of Toronto Mississauga, Credit Valley Hospital, and Trillium Health Center. ♦ The new Academy will link with a vibrant community health care network and give students the opportunity to experience a wide range of general health care settings. Highlights of the Program/School ♦ Advanced student information system utilized in evaluation, scheduling, and teaching. ♦ Opportunity for community based teaching activities. ♦ Digital capture of lectures and curriculum material made available to students. ♦ Unique research program allowing students to gain valuable longitudinal research experience without interrupting their medical studies. ♦ Concurrent MD/PhD program. ♦ Wide range of community/outreach/service learning activities. ♦ Competency-based curriculum. ♦ Balance of science and humanism, and of hospital and community-based experiences. ♦ Nimble and flexible curriculum in response to changing societal needs and student characteristics.

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