Lynne Sears Williams is a freelance writer living in Calgary.
Canadian Medical Association Journal 1995; 153: 984-985
[résumé]
When the University of Calgary (U of C) medical school opened its doors in 1970, heart transplants were still a daring novelty, AIDS was a decade from entering the medical lexicon and Canada was just embarking on an innovative national health care program that we came to call medicare.
More than 1450 graduates later, the U of C's Faculty of Medicine is still the new kid on the block among Canada's 16 medical schools. Some might even say it's one of the brighter kids - last year U of C graduates scored among the top five schools on the Medical Council of Canada's national examinations.
Dr. Henry Mandin, the associate dean of undergraduate medical education, says that is not evidence that the U of C turns out better doctors. "It's more important to know how to find and apply information than to regurgitate it on an exam," Mandin said in an interview on the eve of the school's 25th birthday. "Having book knowledge doesn't necessarily make you a good doctor. Whether our students are in the top 2% of knowledge on an exam is irrelevant -- what's important is to be good communicators and ethical physicians."
Although the university boasts an innovative curriculum and 3-year medical degree, Mandin thinks its graduates "end up being pretty much the same sort of doctors as students from other schools. But if we can state they're happier getting there, that's good. And I can certainly say that."
The U of C hasn't taken up slogans such as "the medical faculty with a heart," but Mandin says parallel surveys indicate that twice as many Calgary graduates as graduates from traditional medical schools would recommend their faculty to a friend interested in studying medicine.
"Calgary teaches with a more integrated approach that makes sense and treats the students as adults," Mandin says. "Students are involved in the decision making instead of being spoon-fed. I think the faculty treats students a little differently and there's more interaction between faculty and students than there is in large classes. Our graduates say there is a higher index of satisfaction with their training than you find at more traditional schools."
The median age of students in the program, which accepts about 60 students each year, was 24 in a recent first-year class. As at McMaster University, the medical degree is completed after 3 years of 11-month terms. The school has instituted a problem-based curriculum instead of relying on systems-based teaching.
"Our curriculum is not ordered around disciplines and systems," Mandin says. "We organize our curriculum according to the complaints patients will have when they step into a doctor's office."
For instance, one of the courses at Calgary deals with headache. Mandin says that leading medical students through an ascending cascade of all possible causes of headache is an effective teaching method that allows students to translate knowledge into practical experience.
"Probably the level of stress of students is somewhat lower at our school than at other schools, and students have a better idea of why they're studying what they study. I think that the integration gives them a basic understanding of why they need the knowledge -- there's an immediate integration of clinical skills and science."
Mandin says the program emphasizes communication skills and ethics, with students seeing their first real patient within weeks of entrance to the medical program. "When you analyse patients' criticism of a doctor's treatment, most of the unhappiness can be traced to a doctor's failure to communicate adequately. Our students have excellent skills in communications."
The U of C was one of the first Canadian medical schools to employ standardized patients in the training of its medical students, using trained actors to simulate patients with medical problems. "That's where you get an idea of how a student might actually treat a patient," says Mandin. Standardized patients are now used to test graduates across Canada in the Medical Council of Canada's Part II examination. "So far, we have no statistics on how various schools are doing on the second part of the exam, but I predict ours are doing very well," says Mandin, who thinks the university has one of the best communications program in North America.
The medical faculty's reunion from Oct. 12 to 14 will feature a full slate of speakers, informative talks, social events and the first annual Dr. Mamoru (Mo) Watanabe lecture, in honour of the university's longest-serving dean of medicine.
Mandin, who has been with the faculty since its inception, says the list of speakers and events is of secondary importance to him. "I'm most looking forward to seeing our old students," he says. "I was here the day before the first student arrived, and I'm interested in seeing how they have done.
"The single most important determinant of how a school does," he adds, "is a function of the quality of the student more than the quality of the school."