Obesity care education in Canadian medical schools: A multi-site qualitative study.

A healthy lifestyle is fundamental for the prevention and treatment of cardiovascular disease and other noncommunicable diseases (NCDs). Investment in primary prevention, including modification of health risk behaviors, could result in a 4-fold improvement in health outcomes compared with secondary prevention based on pharmacological treatment. The American Heart Association (AHA) emphasized the importance of lifestyle in its 2020 goals for cardiovascular health promotion and disease reduction. In addition to defining “cardiovascular health” based on criteria for blood pressure and biochemical markers (lipids and glycemia), the AHA Strategic Planning Committee further identified lifestyle characteristics of central importance: nutrition, physical activity, smoking, and maintenance of a healthy body weight.1 The World Health Organization estimated that ≈80% of NCDs could be prevented if 4 key lifestyle practices were followed: a healthy diet, being physically active, avoidance of tobacco, and alcohol intake in moderation.2 To support healthy lifestyle initiatives, major changes are necessary at the societal level to improve population health. Numerous strategies might help to create a culture that promotes and facilitates healthy behaviors, including creating laws and regulations, mounting large-scale public awareness and education campaigns, implementing local community programs, and providing individual counseling.3 Physicians are uniquely positioned to encourage individuals to adopt healthy lifestyle behaviors: Approximately 80% of Americans visit their primary care physician at least once a year. Physicians directly communicate with their patients during clinical encounters across numerous settings, and research indicates that patients highly value recommendations provided by their physicians.4,5 However, data further indicate that lifestyle counseling does not routinely occur in physicians’ offices, thereby representing a lost opportunity. Physicians report that they perform lifestyle counseling during ≈34% of clinic visits.4 Patients, in turn, report an even lower frequency of physician lifestyle counseling. For example, obese patients reported receiving physical activity and …

Is medical education hazardous to your health?

A study of innovative practice in medical education in Europe has been repeated in Canada. The results of the Canadian study compare very favourably with the overall results of the European study, and show a high level of innovation among the five medical schools participating in the study. Access to MEDLINE is available to students at all the participating Canadian medical schools and at the vast majority (94%) of European medical schools. Compulsory courses on literature searching by computer are provided by 60% of the Canadian medical schools compared with only 32% of European medical schools. Programs for computer-based learning are currently used in all the Canadian medical schools. In contrast, they are used in only 60% of European medical schools, though a further 22% are planning to introduce them in the future. All the Canadian medical schools have courses in evidencebased medicine, communication skills, and community-based medicine. The majority (80% in each case) have courses in cost-effective medicine, geriatric medicine and preventive medicine. Courses in each of these six topics are also provided by at least two thirds of European medical schools.

Undergraduate ophthalmology education in Canadian medical schools: a cross-sectional survey

The AAMC has provided a resource to medical schools for implementing curricular change in lesbian, gay, bisexual, and transgender (LGBT) health education. However, studies have identified that many health professionals who do not feel comfortable in their ability to provide quality care for LGBT patients do not perform complete sexual histories routinely and/or harbor bias towards these patients or their sexual practices. This situation underscores the continued need for further education on this topic. Based on a needs assessment survey of medical students and faculty, we developed a 1-hour didactic lecture to provide instruction on how social determinants of health impact the care of LGBT patients. Students were not required to have any prerequisite knowledge for the session. A content expert in LGBT health taught the lecture using Microsoft PowerPoint in a traditional medical school lecture hall. The lecture was given to 180 third-year medical students. A total of 63 students (35%) responded to the retrospective pre- and postlecture survey. After the didactic lecture, students reported a statistically significant change in their knowledge of the lecture objectives. The didactic lecture was able to increase students' knowledge of how social determinants impact the health of LGBT patients. The lecture can be incorporated into a longitudinal curriculum on LGBT health. Additional work and research are needed on increasing comfort in faculty teaching.

AMSPDC: An overview of its history and evolving mission

ABSTRACTInterprofessional education (IPE) is being increasingly recognised and prioritised in undergraduate medical education. While efforts are underway to integrate IPE into health professional curricula across Canada, the state of IPE in Canadian medical schools remains unclear. This study aims to assess the current practice of IPE in Canadian undergraduate medical curricula. An online survey was distributed to IPE directors (or designees) of all Canadian medical schools. The survey gathered details of the IPE experiences offered, curriculum structure, and perceived barriers to the programmes. The survey was completed by 12 of 17 Canadian medical schools and revealed that IPE is generally well represented in Canadian undergraduate medical education curricula. Reported barriers to IPE efforts included scheduling and funding limitations. By comparison, student interest was one of the least commonly cited issues. It would appear that students and faculty are interested in advancing the state of IPE in undergraduate medical education. The results of this study are crucial as IPE continues to evolve as a component of undergraduate medical curricula across the globe.

Application of a reverse consultation model for pediatric obesity care: A quality improvement initiative

Studies have described poor transfusion medicine (TM) knowledge in postgraduate trainees. The impact of undergraduate medical TM education on postgraduate knowledge is unclear. Canadian medical schools were surveyed on the number of hours dedicated to TM teaching and topics covered by curricula during 2016-2020. Postgraduate trainees attending Transfusion Camp in 2021 completed a pretest of 20 multiple-choice questions. The survey results and pretest scores were compared to evaluate the association between undergraduate medical TM education and pretest scores. The survey was completed by 16 of 17 Canadian medical schools. The number of hours (h) of TM teaching were <2 h (25%), 3-4 h (25%), and >4 h (50%). Twelve of 19 Transfusion Camp topics were covered in ≥50% of schools. Eleven medical schools provided ethics approvals/waivers to include trainee pretest scores in the analysis (N = 200). The median pretest scores by medical school ranged from 48% to 70%. No association was found between number of TM teaching hours and average pretest scores (p = .60). There was an association between higher postgraduate year level and individual pretest score (p < .0001). The analysis by topic demonstrated questions where trainees from different schools performed uniformly well or poorly; other topics showed considerable variation. Variation in quantity and content of undergraduate TM teaching exists across Canadian medical schools. In this limited assessment, the number of TM teaching hours was not associated with performance on the pretest. This study raises the opportunity to re-evaluate the delivery (content, timing, consistency) of TM education in undergraduate medical schools.

To the Editor: Over the last several decades, it has become evident that the biomedical model of health is insufficient for providing equitable care that considers the structural determinants of health and well-being. To deliver patient-centered care, medical students are now being taught the complex interplays between health outcomes, social hierarchies, and various forms of oppression. However, despite the World Health Organization describing climate change as the greatest global health threat of this century, 1 medical school curricula often do not encompass any teachings in this area. Without an appreciation for climate justice, medical students will be unprepared to support patients whose ill health is driven by the oppressive systems underlying climate change. Greenhouse gas emissions have numerous downstream impacts on the environment, the global economy, and human health, which disproportionately affect vulnerable populations such as children, those in racial/ethnic minority groups, and lower-income communities including many in the Global South. 2 According to a 2019 analysis, the health care sector was responsible for 4.4% of annual global carbon emissions. 3 As medicine is firmly grounded in the principle of nonmaleficence, neglecting to address the climate crisis is both unconscionable and paradoxically violates one of the core ethical principles of medicine. To address this gap in medical education, we partnered with the Centre for Sustainable Health Systems at the University of Toronto to host a 6-part webinar series and certificate program on sustainability in medicine. This series had more than 270 registered participants from 8 Canadian provinces. Medical students were well represented among participants, engaging on topics ranging from sustainable practices during a pandemic to advocacy approaches for climate action, and many participants shared ways in which they are advancing the global climate action agenda at their own institutions. Furthermore, a Canadian medical school took notice of our efforts and asked for our assistance in implementing sustainable medicine discussion points in their undergraduate medical curriculum. We are invigorated by the positive response from our colleagues and hope that further trainee-led efforts will continue to inspire ambitious action to build a more equitable future for all on local, national, and international stages. As medical students, we have the power to create change in academic medicine. Throughout our medical school journey, we hope to use our newfound privilege as members of the medical profession to further raise awareness of the health inequities associated with climate change and to better advocate for climate justice. Acknowledgments: The authors thank those at the Centre for Sustainable Health Systems for their guidance and support throughout this process. They also thank Rebecca Wang, a medical student at Temerty Faculty of Medicine, for her assistance in developing the webinar series and certificate program.

BackgroundDespite concussion now being recognized as a public health priority in Canada, recent studies—including our 2012 survey of Canadian medical schools—have revealed major gaps in concussion education at the undergraduate medical school level.MethodsWe re-surveyed all 17 Canadian medical schools using a questionnaire divided in two categories: (1) concussion-specific education (2) head injury education incorporating a concussion component to determine whether there have been any improvements in concussion education at the medical school level during the last five years. For each year of medical school, respondents were asked to provide the estimated number of hours and teaching format for each category.ResultsWe received replies from 13 of the 17 medical schools (76%). 11 of the 13 (85%) medical schools now reported providing concussion-specific education compared to 29% in our 2012 survey. The mean number of hours dedicated to category 1 learning in 2017 was 2.65 h compared to 0.57 in 2012, and the mean number of hours of category 2 increased to 7.5 from 1.54.ConclusionOur follow-up study reveals increased exposure to concussion-related teaching in Canadian medical schools during the last five years. Persistent deficiencies in a minority of schools are highlighted. These should be addressed by reiterating the importance of concussion education for undergraduate medical students and by developing clear concussion-specific objectives at the national licensure level.

BackgroundWomen’s health (WH) includes a broad array of concerns and challenges that affect health across the lifespan. Considerable research shows that women continue to experience disparities in access to and quality of care. Apart from surveys of medical trainees and faculty, little research and none in Canada examined medical curriculum for WH. This study assessed how Canadian medical schools integrate WH in their curriculum.MethodsWe used deductive and summative content analysis to describe instances and the nature of WH topics in program and course descriptions that were publicly-available on web sites of Canadian medical schools. We reported results using summary statistics and text examples. We employed a framework, tested in our prior research, that included mention of women’s health principles and practices relevant to any health concern or condition including factors (e.g. sex, gender, social determinants) that influence health, and access to or quality of care.ResultsWe retrieved 1459 documents from 16 medical schools (median 49.5, range 16 to 301). Few mentioned WH (125, 8.6 %), and the quantity of mentions varied by school (range 0.0–37.5 %). Pre-clerkship course documents more frequently mentioned WH (61/374, 17.3 %, chi square 43.2, p < 0.00001) compared with clerkship course documents (58/1067, 5.4 %). Core course documents more frequently mentioned WH (72/542, 13.3 %, chi square 29.0, p < 0.00001) compared with elective course documents WH (47/899, 5.2 %). Overall, documents more frequently referred to the WH domain of social determinants of health (88, 70.4 %). Few documents addressed women’s health (21, 16.8 %), sex or gender (19, 15.2 %), other considerations (15.2 %) or principles/components of women’s health (2, 1.6 %). Most documents that mentioned WH provided little detail about what those concepts referred to or how to optimize WH.ConclusionsBased on program and course descriptions, WH may not be well-integrated at Canadian medical schools, and future physicians may not be consistently exposed to the full breadth of WH. This reveals opportunities for enhancing WH in the medical curriculum. Future research is needed to engage stakeholders including women in developing, implementing and evaluating competencies and corresponding curriculum that reflect the full range of WH concepts and practices.

Commentary on: "Physical activity education in the undergraduate curricula of all UK medical schools. Are tomorrow's doctors equipped to follow clinical guidelines?".

Pharmacogenomics Instruction in US and Canadian Medical Schools: Implications for Personalized Medicine

This study aims to gain a better understanding of the current scope of headache education received in Canadian medical schools. The Women's College Hospital Centre for Headache at the University of Toronto, Canada, distributed a questionnaire to administrators and physicians involved in medical student education at Canadian medical schools and gathered information surrounding headache education. Overall, the degree of headache education varied between schools in regard to the hours of training that occurred and year the training took place. This survey provides an initial insight into the current standards of headache-specific education in Canadian medical schools.