A BRIEF OVERVIEW OF THE CURRICULUM AT THE NORTHERN ONTARIO SCHOOL OF MEDICINE
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A BRIEF OVERVIEW OF THE
CURRICULUM
AT THE
NORTHERN ONTARIO SCHOOL
OF MEDICINE
May 2, 2007
1Learning Medicine at the
Northern Ontario School of Medicine
A Curriculum for Northern Ontario
The curriculum of the Northern Ontario School of Medicine is grounded in its social
accountability mandate by “… providing undergraduate and postgraduate medical
education programs that are innovative and responsive to the individual needs of
students and to the health care needs of the people of Northern Ontario”. * This is the
foundation of the school and the reason for its creation.
The curriculum content is centered on the five Themes. They are:
• Theme 1 – Northern and Rural Health
• Theme 2 – Personal and Professional Aspects of Medical Practice
• Theme 3 – Social and Population Health
• Theme 4 – Foundations of Medicine
• Theme 5 – Clinical Skills in Health Care
These Themes are enhanced by a focus on the seven competencies described in
CanMed 2005, which are:
• Medical expert
• Collaborator
• Manager
• Health advocate
• Scholar
• Professional
• Communicator
In addition, a series of curricular “threads” run through the four-year curriculum. They
are:
• Aboriginal health
• Interprofessional education and work
• Health effects of social problems
• WSIB concepts/curriculum
• Dementia project
• Gender issues
• CMDA patient safety curriculum
__________________________________________________
* Principles and Framework for Working Arrangements Involving
Lakehead University, Laurentian University and the Northern Ontario
School of Medicine
2Our Curriculum: A Philosophy and an Approach
The curriculum at the Northern Ontario School of Medicine (NOSM) employs a case-
based approach to focus student learning. The emphasis is on self-directed learning
and the role of faculty tutors is to facilitate learning. In years 1 and 2, this model is
employed with the Case Based Learning Sessions (CBLs) and the Topic Oriented
Sessions (TOSs). In year 3, Virtual Academic rounds are utilized to bring small groups
of learners together to discuss cases from their personal clinical experiences.
Objectives and learning tasks are provided to guide study and to indicate the depth of
understanding required for successful completion of the module. However, the
curriculum demands significant self-directed work and study by the individual student.
The Phase 1 (Years 1 and 2) Curriculum
The curriculum is divided into eleven Case-Based Modules (CBM), in Phase 1 (Years 1
and 2). Six of these occur in Year 1 and five occur in Year 2 of the program. CBM 101
is four weeks in duration, while the remaining Modules are six weeks in length. All
information about the CBM is available on-line and provided in increments to the
students as needed for their learning activities. This material, along with other
scheduled learning activities and content information, will guide student learning
throughout Phase 1. Each CBM has a body system emphasis as outlined in the figure
below.
Module System Focus
CBM 101 Review/Introduction
CBM 102 Cardiovascular/Respiratory System
CBM 103 Phase 1 Gastrointestinal System
CBM 104 Year 1 Central Nervous System /Peripheral Nervous System
CBM 105 Endocrine System
CBM 106 Musculo Skeletal System
CBM 107 Reproductive System
CBM 108 Renal System
CBM 109 Phase 1 Hematology/Immunology
CBM 110 Year 2 Neurological/Behavior
CBM 111 End of life issues
*Yellow denotes an integrated community experience (ICE) away from the
Lakehead and Laurentian Campuses.
In years 1 and 2 there are five distinct types of learning opportunities at the School of
Medicine; large group sessions, small group facilitated sessions, structured clinical skills
sessions, laboratory sessions and Community Learning Sessions.
Large Group Sessions
Module Coordination Sessions (MCS)
Each week begins with a one-hour facilitated session during which students are
encouraged to raise any concerns about the instructional content of the learning
process. The session provides an opportunity for dialogue between students and
faculty.
3Whole Group Sessions (WGS)
These sessions are usually three hours in length and are scheduled once per
week as determined by the instructional demands of the curriculum. In a Whole
Group Session, the class is instructed as a whole by faculty of the School. The
instructional format includes traditional lectures, demonstrations, and large group
tutorial activities. These sessions are simultaneously video-conferenced
between campus locations.
Small Group Sessions
Case-Based Learning (CBL)
Each week students meet with a facilitator in groups of no more than eight for a
two-hour session. Through a model of guided discovery, which is designed to
support self-directed research, students consider a complex case that directs the
learning for the module. Each module reflects six weeks of study and explores
instructional content related to the five themes. Prepared objectives guide
student learning during CBL sessions.
Topic-Oriented Sessions (TOS)
These two-hour facilitated sessions occur two or three times each week. The
TOS focus is on an individual patient, which students have met through the
module case. Using a problem-based learning format, students identify learning
issues, develop a strategy to acquire the necessary knowledge and share the
knowledge gained through independent research. As the week progresses,
information is revealed about the patient until the objectives related to these
sessions have been fully explored by the students.
Structured Clinical Skills (SCS) Sessions
These weekly three-hour sessions focus on instruction and practice in
patient/doctor communication and physical examination skills. Students meet in
small groups with a clinical instructor and practice their interviewing and
examination skills with simulated and standardized patients. The objective for
these sessions is to explore the knowledge, skills and attitudes defined by
Theme 5 of the curriculum.
Laboratory Sessions (LAB)
These three-hour sessions occur four times in every six-week module. Each
LAB session, students initially meet as an entire group for a WGS session.
Students are then required to meet in small groups to focus and work through
case studies based on learning objectives outlined and explained in the WGS
session. For each module, the LAB sessions focus on four sets of learning
objectives related to basic anatomy and histology, pathology, diagnostic imaging
and clinical/diagnostic skills.
Community Learning Sessions (CLS)
Each week there is one three-hour session dedicated to providing students with a
wide range of community-based clinical experiences. Observing and interacting
with patients under the guidance of a preceptor, students visit patients in their
homes, in hospitals, long-term care centers, doctors’ offices, pharmacies, rehab
centers, nursing homes, or other health service providers or organizations.
These experiences involve the content of all of the five themes and provide a
focus for interprofessional learning.
4Distributed Tutorial Sessions (DTS)
A Distributed Tutorial Session (DTS) is a session developed by a faculty member
related to specific learning objectives. It is conducted via electronic means either
synchronously or asynchronously. A DTS is analogous to the weekly Whole
Group Session (WGS) for on campus modules but incorporates instructional
methods appropriate to distributed or distance education models. The DTS is
usually implemented in the Integrated Community Experience Modules CBM
106, 108 and 110.
Self-directed Learning Cycle
The following diagram and accompanying narrative describe the cycle of self-directed
learning by students as a part of the TOS and CBL sessions. The diagram of the tent is
a visual analogy for the integration of the various student-learning activities in the NOSM
Curriculum.
The students’ own investigation is supported by
weekly whole group sessions. The students at
both campuses are linked by videoconference
during these sessions. Facilitators are faculty
who are content experts.
During clinical skills sessions, students will
receive instruction in communication skills,
interviewing and history-taking and a range of
other clinical skills. Students will work with
standardized and volunteer patients. Many
clinical skills are further supported by labs.
Community learning experiences are provided
to augment the learning in each module.
Typical week schedule in Phase 1 (Years 1 and 2)
Week X Monday Tuesday Wednesday Thursday Friday
9 – 10 Module Community Whole Group Structured Lab
Coordination Learning Session Session (WGS) Clinical
Session (MCS) (CLS) Session (SCS)
10 – 11 Case Based
11 – 12 Learning Personal Study
Session
(CBL)
12 – 1 Lunch Lunch with Lunch Lunch Lunch
Student Affairs
1–2 Topic Oriented Student Affairs Personal Study Topic Oriented Personal Study
2–3 Session (TOS) Opportunity Session (TOS)
(1 - 2:30)
3–4 Personal Study Personal Study
5NOSM Phase 1 Sessions at a Glance
CBL = Case Based Learning
TOS = Topic Oriented Session
WGS = Whole Group Session
SCS = Structured Clinical Session
CLS = Community Learning Session
LAB = Laboratory
SAS = Student Assessment Session
ICE = Integrated Community Experience
MCS = Module Coordination Session
DTS = Distributed Tutorial Session
Integrated Community Experiences (ICE) in Phase 1
In addition to the modules on the Laurentian Campus and Lakehead Campus, there are
three six-week Integrated Community Experiences in Phase 1 modules. They are CBM
106 in year 1 (Aboriginal), and modules 108 and 110 (Remote / Rural). It is important to
note that learning experiences in all five Themes continue during these ICEs. In many
important ways the ICE modules 106, 108 and 110 are similar to the other Phase 1
modules. They also differ in several important ways. The first two weeks are spent on
the home campus with a concentrated orientation, whole group and laboratory sessions,
which are difficult to deliver in the various community settings. This also allows time for
students to focus on their respective community and clinical activities. A typical ICE
week is shown in the figure below.
ICE Week for Year 2
Monday Tuesday Wednesday Thursday Friday
9 -10
FLEXIBLE TOS FLEXIBLE FLEXIBLE
FLEXIBLE
11-12 DTS
12 – 1 Lunch Lunch Lunch Lunch Lunch
1–2
FLEXIBLE
FLEXIBLE FLEXIBLE FLEXIBLE FLEXIBLE
3–4 MCS
4–6 CBL
TOS
□ Fixed Session
The only sessions that are fixed are the TOS, CBL, MCS and DTS, as they will involve students
and faculty at different sites facilitated by telecommunication.
□ Flexible Session
Clinical – Five ½-day sessions per week
Community Learning Sessions – One ½-day per week
Structured Clinical Skills - One ½-day per week
Personal Study – 7 hours per week
6The Phase 2 (Year 3) Curriculum
The Phase 2 (year 3) Comprehensive Community Clerkship (CCC) at NOSM provides
students with clinical experiences away from the main campuses of Sudbury and
Thunder Bay. Students assigned in pairs to primary care practice settings, live and learn
as small groups of up to eight learners in one Northern Ontario community for an eight-
month period. The communities of Kenora, Sioux Lookout, Fort Frances, Timmins,
North Bay, Sault Ste. Marie, Parry Sound, Bracebridge, Huntsville, and Temiskaming
Shores will host CCC learners.
The aim of the Phase 2 curriculum is to provide academic and professionally relevant
learning opportunities that, through small group sessions and clinical practice, exemplify
reflective learning and comprehensive interprofessional care. Furthermore,
opportunities to care for patients in a safe and efficient manner are enhanced by the
clerkship’s prolonged duration, which promotes continuity of care. The student will
increase their knowledge of medical care through clinical encounters and through the
socio-cultural context in which the patient and their family cope and adapt to their health
care needs. This social and intellectual process will be encouraged through continuous
interaction with community-based faculty members.
The CCC experience will enhance the NOSM learner’s personal and professional
development. Additionally, the nature of the course work and the learner-centered
environment will promote critical thinking and life long learning skills. The CCC will
provide an opportunity to enhance knowledge, skills, and attitudes conducive to an
understanding of medical practice in remote, rural, and/or underserved communities and
contrast that with urban practice. The learner will observe the skills and attributes of
health professionals in stimulating environments, furthering their consideration of career
choices including clinical practice and research.
As in the first two years, the five Themes (courses) continue through the Phase 2 (year
3) clerkship. Additionally, Theme 5 (Clinical Skills) is subdivided in to the disciplines of:
• Child Health
• Women’s Health
• Internal Medicine
• Mental Health
• Family Medicine
• Surgery
Rather than specific sequential rotations in each of the disciplines, students will engage
in parallel exposure to these areas of medicine.
Although the community-based faculty member provides direction for the student in
achieving their learning goals, ultimately it is the responsibility of the learner to maintain
a high level of motivation and a self-directed approach to their learning. Much of this
learning will be opportunistic and they are encouraged to engage in, and navigate
through, specific learning objectives wherever possible.
As the learning is family focused, the students are to identify families early in the year
and through informed consent processes, follow them through an illness/wellness
continuum. Under the community preceptor’s guidance, students will examine a range
of psychosocial and multicultural contexts in which the family interacts with other
members of the health care team and health related organizations and services.
7This experience will form the basis of personal research and reflection exercises rich in
experiential data that extends beyond the boundaries of clinical medicine. Some of
these experiences will enhance the students’ clinical practice and may influence their
values and beliefs about the way they behave as a physician.
Students are encouraged to take ownership of their learning as they begin to think and
act as critically reflective practitioners, an attribute central to safe, and rewarding medical
practice. Students are given opportunities to work in partnership with patients and their
families, with appropriate supervision and support. To this end, it is anticipated that they
will develop, and practice patient and family centered care.
Activity Duration
Orientation 1 Week
Comprehensive Community Clerkship 14 Weeks
Holiday Break 3 Weeks
Comprehensive Community Clerkship 16 Weeks
Review and OSCE 2 Weeks
Description of Phase 2 Instructional Sessions
In year 3, Phase 2, there are two distinct types of learning opportunities during the
Comprehensive Community Clerkship (CCC): explanatory sessions, which provide
didactic instruction specific to the core clinical disciplines; and experiential sessions,
which provide clinical experiences in a variety of settings.
Explanatory Sessions
Discipline-Focused Sessions (DFS)
These sessions are three hours in length and are scheduled as determined by the
instructional demands of the curriculum. In a Discipline-Focused Session, the class is
instructed as a whole by faculty of the School. The instructional format will include
traditional lectures in order to review key concepts and issues related to the objectives
that are mapped to the cases that will be discussed and presented in small group
discussions.
Virtual Academic Rounds (VAR)
Students meet twice weekly with a facilitator in groups of eight for two 3-hour sessions.
Through a model of guided discovery, students identify learning issues, develop a
strategy to acquire the necessary knowledge and share the knowledge gained through
independent research by considering cases identified from their clinical experiences in
the community. Each case discussion will be divided in two 1½ hour segments. Early in
the week, in the first 1½ hour segment, the case is presented and the objectives are
reviewed. The objectives are then discussed and presented in a subsequent 1½ hour
session later in the week. The sessions explore specific objectives which have been
selected to guide discussions related to the student’s case presentations. The
objectives of the discussion are related to all five Themes.
8Experiential Sessions
Primary Care Sessions (PCS)
On a weekly basis, five half-day sessions provide opportunities to develop and refine the
students’ communication and physical examination skills and management approaches
under the supervision of experienced clinicians. Students participate in the care of 2 to 4
patients per half day session. Using available resources, including electronic texts and
evidence-based materials, students are to conduct independent research regarding their
patients and utilize their findings as part of the clinical encounter reviews they will be
discussing with their faculty members. Supervising faculty members will also review the
students’ findings and suggested management plans.
Specialty Enhancement Sessions (SES)
Each week’s schedule includes two three-hour sessions dedicated to providing students
with a wide range of clinical experiences related to the six core disciplines of Family
Medicine, Surgery, Internal Medicine, Mental Health, Child Health, and Women’s Health.
Students will examine patients and assist with the management of their illnesses or
conditions under the guidance of health care professionals. These sessions will include
participating in surgical assisting, specialty clinics, physician’s offices and a variety of
hospital and community-based programs related to the core clinical disciplines. These
experiences will explore the content of all of the five Themes and provide an opportunity
for interprofessional learning.
In-patient rounds, ER and Obstetrical Care Sessions
Students are to participate in the daily care of in-patients as directed by their site
coordinating teacher. Emphasis will be given to continuity of care. It is anticipated that
the student will have participated in the patient’s admission and will subsequently follow
the patient in the continuity of care within the community. Emergency Room and
Obstetrical Care Sessions will be assigned by the site coordinating teacher and
student’s participation in the care of patients will be supervised by a supervising faculty
member.
Logging Clinical Encounters
While not all the specialist services may be present at each individual CCC site, students
will nevertheless have the advantage of encountering patients over time and in different
stages of care, therefore experiencing the realities of continuity of care. Students will
observe and record their learning opportunities, which arise from personal interaction
with patients, families, and communities, in an electronic log. Benchmarks for specific
numbers and types of clinical encounters and clinical procedures have been established
by the Phase 2 Committee. The electronic logs of individual students will be reviewed
on a regular basis to assist students in achieving their objectives.
9Year 3 CCC Weekly Schedule
TIME Monday Tuesday Wednesday Thursday Friday W/E
8–9 In-patient In-patient In-patient In-patient In-patient OB/ER
9 – 12 Virtual Primary Care Primary Care Virtual Academic Specialty OB/ER
Academic Session (PCS) Session (PCS) Rounds (VAR) Enhancement
Rounds (VAR) Session (SES)
12 – 1 Lunch Break
1–5 Primary Care Primary Care Specialty Primary Care Self Study OB/ER
Session (PCS) Session (PCS) Enhancement Session (PCS)
Session (SES)
7 – 11 OB/ER OB/ER
Consults
NOSM Phase 2 Sessions at a Glance
VAR = Virtual Academic Rounds
PCS = Primary Care Session
SES = Specialty Enhancement Session
OB/ER = Obstetrics and Emergency Room consultations
Orientation to the Comprehensive Community Clerkship (CCC)
The Year 3 academic year includes an initial one-week orientation period to ensure that
students are familiar with particular skills, roles, and procedures prior to entering the
clinical environment. The Clerkship orientation will also provide outlines of the roles,
responsibilities, and expectations of students during the clerkship period. While many of
the hands-on aspects of the orientation will be conducted at the clinical sites,
supplemental material will be provided by means of Discipline-Focused Sessions.
Once students are at their sites, they will be oriented to the clinics and hospitals in which
they will be learning in order to facilitate their integration into the work environment.
Introductions will be made to the faculty members with whom they will work, and to the
health care and administrative staff, to help make them feel like part of the team. It is felt
that the social aspects of this experience are important because the learning
environment encompasses much more than readings and formal instruction. Students
make career and practice location decisions based upon the relationships they develop
with physicians and other health professionals while learning in clinical environments.
Students learn to care for patients from observing patient-physician interactions and
from informal interactions with staff and community members.
10Phase 3 Program Description (March 2007)
RATIONALE
Phase 3 is a progression of the clerkship from the smaller distributed community
hospitals throughout northern Ontario experienced in Phase 2. It provides an exposure
to secondary and tertiary care of patients in the larger communities of Sudbury and
Thunder Bay.
The overall purpose of this last phase of the undergraduate curriculum is to expose
students to the various specialties and the subspecialties, which will lead to fulfilling of
the graduation requirements of the LCME/CaCMS. It will allow students to observe,
participate, and care for patients with problems addressed by specialists in various
disciplines. It will allow students an opportunity to experience a continuum of care which
seriously ill patients receive in the north.
It will also provide students with an opportunity to experience through core and elective
experiences various specialties which they may choose to pursue as career choices in
their postgraduate years. Through core rotations in seven broad specialties, students will
be provided with a thorough background in medicine and surgery. Through electives,
students will experience medicine in different settings outside the traditional geographic
area taught by NOSM. Finally it will provide an important background of knowledgewhich
will allow students to graduate and transition into the PGY 1.
The development, implementation and curriculum for Phase 3 must be consistent with
the academic principles which are the foundation of the Northern Ontario School of
Medicine. These principles are:
Interprofessional
An important feature of the school is partnership, participation, collaboration,
coordination and shared a decision making with other members of the Healthcare
team. A team approach is essential in the complex world of health care.
Integration
This involves coordination, partnership and interaction to create a meaningful
learning experience for students, residence, faculty, and staff.
Community Oriented
NOSM students will integrate into and learn in most communities throughout
northern Ontario. This will lead to a pragmatic understanding of the dynamics of
the north and create meaningful partnerships between northern communities and
NOSM.
Distributed Community Engaged Learning
This is an instructional model that allows widely distributed human and
instructional resources to be utilized independent of time and place in community
partners with NOSM across the north.
11Generalism
This is a broad, holistic view and approach to activities, values and knowledge in
education, organization, and patient care activities.
Diversity
Is a valuing and recognition of the richness and diversity of all cultures of
Northern Ontario. It recognizes the importance of this diversity to our lives, and
our learning.
OBJECTIVES
Learning objectives will continue to be the cornerstone upon which the NOSM curriculum
is built. The five NOSM themes will continue to have emphasis in Phase 3. These are:
• Northern and Rural Health
• Personal and Professional Development
• Population Health
• Foundations of Medicine
• Clinical Skills in Medicine
Specific learning objectives for all of these themes will be clearly spelled out to students
as the curriculum progresses. Further details will be elaborated on later in this
document.
Moreover, there are many important general objectives which are important in the
clerkship training of physicians in any medical program. NOSM clerkship objectives will
also include the following:
• Demonstrate the abilities and take a focused patient history and complete a
physical examination. This includes a psycho-social history, family history and
psychiatric examination.
• Provide a complete and accurate case presentation.
• Complete and maintain an organized medical record.
• Gain and expand knowledge of common acute and chronic problems across age,
gender and disciplines.
• Gain and expand knowledge of preventative health issues.
• Further develop interpersonal skills to enhance patient rapport and
communications.
• Continue to develop the skills of using Evidence Based Medicine to solve clinical
problems.
• Formulate a patient centered management plan including diagnosis,
investigations, treatment, and prevention.
12• Demonstrate an awareness of cost effective care when formulating patient
management plans.
• Continue to develop knowledge and sensitivity to the unique problems of
Northern Ontario.
• Continue to develop skills and attitudes for lifelong learning.
• Demonstrate respect for and appropriate use of other healthcare disciplines.
• Continue to develop and deepen awareness and understanding of the
CANMEDS roles. These include:
- Medical expert
- Communicator, educator, humanist
- Health advocate
- Learner/scholar
- Collaborator
- Resource manager
- Scientist
- Person
Program Design and Content
Students will be based primarily in Thunder Bay and Sudbury for the Phase 3 program.
Students are expected to rotate through seven core general specialties. These are
Surgery, Internal Medicine, Children’s Health, Women’s Health, Mental Health,
Emergency Medicine, and Family Medicine. Students will spend four weeks on each of
these core rotations with the exception of Family Medicine. Family Medicine will be a half
day longitudinal experience during rotations in children’s health, mental health, and
internal medicine. The alternative is for students to acquire the family medicine
requirement during a four-week elective experience.
The program will begin for E2005, after the third weekend in May, 2008. It will conclude
with LMCC review the last week of April 2009. With 24 students in Thunder Bay and 32
students in Sudbury, students will be divided into six streams which will run through the
year. Hence there will be four students per stream in Thunder Bay and six students per
stream in Sudbury. Two of the streams in Sudbury will have four students.
The intent of the core rotations is to expose students to inpatient and outpatient care
pertinent to these specialties. A number of important considerations are being taken into
account for these core rotations. These include the following:
• The focus will be on exposing students to complex care both in and out of
hospital for the core disciplines.
• For the core rotations, time will be spent on the hospital wards, physicians’
offices, specialty clinics, the emergency department, didactic academic half days,
and in clinical services i.e. fracture clinic/endoscopy etc.
13• It is expected that students will be part of Clinical Teaching Units. These will be
composed of a staff physician or physicians, residents, and clinical clerks. The
specific makeup of these clinical teaching units may vary depending on the
specialty involved, capacity of the specialty and organization which works best in
the core specialty for that particular Clinical Teaching Unit. Students’ time will be
portioned according to the functioning of the clinical teaching unit and student’s
needs.
• Exposure to residents and resident teaching is important to clinical clerks and is
mandated by the MCC. This will occur.
Students will also spend session time during the week in academic/didactic learning.
The form this takes will be dependent on the particular specialty. However learning
objectives will be clearly outlined for those specialties and these objectives must be
adhered to and will form the basis for learning and assessment. The time spent in
academic learning will be approximately ½ day per week.
Students are expected to take call with residents in the core specialties.
Students will be expected to track their learning experiences in a similar fashion to what
they have done in Phase 2. This will involve the use of PDAs or online. Specific types of
encounters for Phase 3 students and numbers are currently being developed.
Electives
Electives will comprise a major component of student’s time in Phase 3.The objective of
electives is to further develop, enhance and broaden students’ knowledge and
experience in medicine. It will allow them to explore an area of knowledge in more depth
than they otherwise might have received. It will allow students to explore specialties they
may want to pursue in a residency. Electives also allow students to spend time on
academic pursuits which might otherwise not be possible during the core rotations, ie/
publications etc. It also allows students to showcase themselves in other academic
centers where they might consider postgraduate learning. Electives may be done
anywhere that students so choose, provided they receive approval from the
undergraduate medical education office. It is important that students have a supervisor
for these electives. Furthermore a report will be required from students following their
elective experience. The guidelines which have been developed for Phase 2 electives
will continue to be applied to Phase 3, ie/ Types A, B, C and D electives.
There are a total of 16 weeks of elective time in Phase 3 with 12 of those weeks
occurring in all streams before the second week of November. This provides sufficient
time for students to explore various specialties prior to the CaRMS match so they can
make career decisions. It also allows students the opportunity to obtain references for
the CaRMS match in a timely fashion.
14Potential electives in Sudbury/Thunder Bay can be divided into medical or surgical.
Potential medical electives include:
Neurology Nephrology Anesthesiology
Cardiology Oncology ER
Respiratory Medicine Endocrinology General Medicine
GI Infectious Disease Family Medicine
Rheumatology Geriatrics/Palliative Care Mental Health
Dermatology Intensive Care Children’s Health
Public Health
Potential surgical electives include:
General surgery Orthopedics
Urology ENT
Neurosurgery Cardiothoracic surgery
Plastic Surgery
15The following large table outlines the yearly schedule for Phase 3 as of March 2007.
WEEK DATE Stream Stream Stream Stream Stream Stream
1 2 3 4 5 6
May 5-9
1 2008 19-23 SX MH EL MED WH ER
2 SX MH EL MED WH ER
3 June 2-6 SX MH EL MED WH ER
4 SX MH EL MED WH ER
5 EL SX ER EL MED EL
6 EL SX ER EL MED EL
7 EL SX ER EL MED EL
8 July7-11 EL SX ER EL MED EL
9 ER EL SX EL EL EL
10 ER EL SX EL EL EL
11 ER EL SX EL EL EL
12 Aug4-8 ER EL SX EL EL EL
13 EL EL EL EL EL MED
14 EL EL EL EL EL MED
15 EL EL EL EL EL MED
16 Sept1-5 EL EL EL EL EL MED
17 EL ER EL MH EL CH
18 EL ER EL MH EL CH
19 EL ER EL MH EL CH
20 EL ER EL MH EL CH
21 Oct6-10 WH EL MH EL CH EL
22 WH EL MH EL CH EL
23 WH EL MH EL CH EL
24 WH EL MH EL CH EL
25 Nov3-7 MH CH MED ER SX WH
26 MH CH MED ER SX WH
27 MH CH MED ER SX WH
28 MH CH MED ER SX WH
29 Dec1-5 Is/Acad Is/Acad Is/Acad Is/Acad Is/Acad Is/Acad
30 EL WH CH SX ER EL
31 EL WH CH SX ER EL
32 WB WB WB WB WB WB
33 WB WB WB WB WB WB
34 Jan5-9 EL WH CH SX ER EL
35 EL WH CH SX ER EL
36 Is/Acad Is/Acad Is/Acad Is/Acad Is/Acad Is/Acad
37 Intervws Intervws Intervws Intervws Intervws Intervws
38 Feb2-6 Intervws Intervws Intervws Intervws Intervws Intervws
39 Intervws Intervws Intervws Intervws Intervws Intervws
1640 MED EL WH CH EL MH
41 MED EL WH CH EL MH
42 Mar2-6 MED EL WH CH EL MH
43 MED EL WH CH EL MH
44 CH MED EL WH MH SX
45 CH MED EL WH MH SX
46 CH MED EL WH MH SX
47 Apr6-10 CH MED EL WH MH SX
48 Review Review Review Review Review Review
49 Review Review Review Review Review Review
50 Review Review Review Review Review Review
51 May4-8 LMCC LMCC LMCC LMCC LMCC LMCC
52 LMCC LMCC LMCC LMCC LMCC LMCC
53
54
55
56
57
Several explanatory notes are required for interpretation of the above.
SX= surgery CH= children’s health [paediatrics]
MH= mental health [psychiatry] ER= emergency medicine
MED= internal medicine WH= women's health
EL= elective WB= winter break
Interviews= CaRMS interviews
Is/Acad= independent study/academic week
There are six streams in which there will be 4 students per stream in Thunder Bay and 6
students per stream in Sudbury. Two streams in Sudbury will have four students.
Students will have four-week rotations in the above core subjects. There will be an eight
week elective block occurring before the students submit their Ca RMS letter.
Because of the two-week winter break, rotations at that time are divided. Students may
also choose to work at their core rotations over this week winter break. It is not
designated officially as “time off”. Is/Acad refers to an independent study/academic
week. The Is/Acad blocks of time are scheduled around the CaRMS interviews. There is
the potential to provide ACLS training or other academic sessions during this time. The
schedule is designed so that no core specialties are being duplicated by more than one
stream at a time. Students also will have an opportunity to experience some elective
time in most streams after the winter break.
The clerkship concludes on April 10, 2009 for E 2005. Following the clerkship there will
be a three-week period before the LMCC examinations. Review sessions will be
provided for students but attendance will be optional. The review sessions will be a
combination of didactic learning provided by faculty, LMCC review questions and a
question and answer format.
17Year 4 Weekly Schedule
The sample weekly schedule provided here is a sample week that could occur during a
children’s health, internal medicine, and mental health rotation. The family medicine
session included in the weekly schedule is only relevant to those students who chose
not to participate in a family medicine elective. The family medicine elective is not
mandatory. During surgery, women’s health, and E.R., the family medicine session will
not be included.
MON TUES WED THURS FRI
Ward Rounds & Ward Rounds & Ward Rounds & Ward Rounds & Ward Rounds &
Duties Duties Duties Duties Duties
Spec Clinic/OR Spec Clinic/OR Spec Clinic/OR Spec clinic/OR Spec Clinic/OR
LUNCH LUNCH LUNCH LUNCH LUNCH
Spec Clinic/OR Fam Med Spec Clinic/OR Academic Half Personal Study
Office Day Longitudnl Elec
DINNER DINNER DINNER DINNER DINNER
ER/ On Call ER/On Call ER/On Call ER/ On Call ER/On Call
Phase 3 as designed follows the original blueprint for NOSM, by providing a bridge to
postgraduate medical education and specialty training. During the weekly schedule,
students will have in-patient ward responsibilities and duties. Potentially these may be
done in the morning or whenever the clinical teaching unit decides. Time then will be
spent in offices/clinics or in the operating room depending on the specialty. Evenings
may potentially be an ER shift or spent on call in the hospital. It should be emphasized
that the weekly schedule will be completely flexible depending on the particular
specialty, needs of the clinical teaching unit, or the needs of the student. For example
students may not necessarily need to do ward rounds early in the morning. Furthermore
personal study time for example may be on a different day than Friday etc. The only
exception will be the academic half day which will be rigidly set depending on the
location ie/ Thursday afternoons.
18Student Guides and Online Resources
and the Health Information Resource Centre (HIRC)
In order to assist students in the case based learning sessions (CBLs) and task oriented
sessions (TOSs) during Phase 1 and the Virtual Academic rounds of Phase 2, student
guides containing learning objectives, cases, focus statements, learning tasks and
resources are available online.
HIRC
Through the affiliation with Lakehead University and Laurentian University, all students
of the Northern Ontario School of Medicine have access to library services and
resources on both university campuses. These services and resources include:
• Print resources in a variety of formats may be checked out; library card
applications are available in the libraries, or on our website, at
www.normed.ca/library/
• Pint / photocopying cards are available for purchase in the main university
libraries.
• On-campus, access to print, and networked computer access to e-resources.
• Off-campus, remote access to licensed e-resources
• Database instruction and on-going user support: a schedule of library-related
training sessions will be posted on our website.
• Other services include: document delivery/interlibrary loan; reference and
research assistance.
E-Resource Access
• While on-campus, all NOSM students have IP access to the HIRC’s
collections of electronic databases, journals and texts, and other biomedical
resources, and to the e-resources of our affiliated university libraries.
• Whether on-campus or off-campus, for access to the HIRC’s e-resources,
registered students may go to our website, at www.normed.ca/library, and
click on their choice under the Resources heading, or browse our iLink online
Catalogue. For access to the resources of our affiliated university libraries,
from the Resources heading, select the link to the Lakehead Resources, or to
the Laurentian Resources. Students are then prompted to enter their
NormedNet username/password.
During Phase 2, resources will be further augmented by community faculty members,
local health care facilities, specialists, and other health care individuals and resources in
the community.
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