Doctors' training to take real life turn

by Gavin Wilson
Staff writer

The Faculty of Medicine has won approval for the most sweeping changes to its undergraduate curriculum since the medical school opened its doors in 1950.

When members of the Class of 2001 enter UBC this August their courses will have a new emphasis on ethics, social issues, critical thinking and computer and communications skills.

Courses will use a problem-based learning approach that integrates basic sciences and clinical studies to resemble real life situations more closely.

The new curriculum, which will also be taught to first- and second-year dentistry students, is a response to changes within the medical profession and in society as a whole, said Dr. Andrew Chalmers, associate dean of undergraduate curriculum.

"The old curriculum served us well, but dramatic changes in scientific knowledge, rising expectations in an era of decreasing resources and advances in our understanding of how adults learn have impelled us to make changes," he said.

As well as a firm grounding in the basic sciences, students can expect some of these innovations:

The new curriculum is the culmination of a process that began in 1992 with external reviews and surveys of students, graduates and faculty members, Chalmers said.

A key aspect is its case-based course work, which is an approach to learning already adopted at most North American medical schools.

Until now, UBC has taken a traditional approach that focused for the first two years on basic sciences such as anatomy and biochemistry taught independently by different academic departments.

"The amount of basic science taught was significant and not focused on clinical issues. Once learned, students sometimes forgot how to apply it in the clinic. Our new approach is a student-centred curriculum rather than a faculty-centred one," Chalmers said.

Working in small groups, students will learn the fundamentals as they apply to particular cases. They will be encouraged to define what they need to know and go to experts, the library and the Internet to find and appraise the information.

"If students learn the basic science in the context of a clinical setting, they will be much more likely to understand and retain that knowledge," Chalmers said, adding that there will still be labs and lectures where they are appropriate.

A system of regular evaluation will include weekly quizzes on the Internet to give students instant feedback on where their strengths and weaknesses lie.

Further curriculum changes will move the student clerkship to third year, giving them exposure to all areas of medicine before having to choose in fourth year whether to pursue family practice or a specialty.

The new curriculum will require some adjustments for faculty members as well. A Faculty Development Program is training instructors on how to write cases and act as tutors rather than lecturers, and multi-disciplinary teams are working together to develop new courses.

"I'm astounded people have been able to move so fast and so far," Chalmers said. "It has required a lot of energy and both faculty and students are to be congratulated on the work they've done."

The new curriculum drew praise from the newly appointed Dean of Medicine John Cairns, who is the former chair of Medicine at McMaster University.

"I have observed the strengths of the small group, student-oriented problem- and systems-based approach at McMaster for the past 20 years. The new UBC curriculum takes many steps beyond this. It will capitalize on UBC's recognized strengths and will become the most modern and forward-looking medical undergraduate curriculum in Canada," he said.