Queen's University Faculty of Health Sciences.

Abstract

Medicine Education Program Highlights In 2010, our primary focus within the School of Medicine was on undergraduate and postgraduate medical education. Fast forward 10 years and we now offer a complete 4-year undergraduate degree online in health sciences, an accelerated route to medical education, a combined MD with new graduate programs, and a graduate degree for health professionals. These programs provide a continuum of learning experiences from undergraduate students to clinical educators. A common thread for all programs was our move to a competency-based approach; taking an institutional approach to competency-based medical education (CBME) implementation has allowed for sharing resources and innovations across programs. In the undergraduate sphere, to complement our long-standing UME program, we launched the Queen’s University Accelerated Route to Medical School (QuARMS), which is a direct entry to the medical school program from high school, a first of its kind in Canada. We were also excited to launch our Bachelor of Health Sciences (BHSc) program, a completely online 4-year degree that provides prerequisites for a field in any of the health professions. Based on the success of this program, we launched an onsite format of the BHSc this past year. At the graduate level, we launched 2 interdisciplinary graduate degrees in health professions education and in health care quality. To address the needs of internationally trained doctors, we created the Graduate Diploma in Medical Sciences and the Professional Master of Medical Sciences through a partnership between the Department of Biomedical and Molecular Sciences, post-undergraduate medical education, and UME. This program has been specifically designed to assist medical school graduates who have not yet matched to a postgraduate residency program in Canada achieve their goals. We also created the Clinician Investigator program, which is an intensive, research-based postgraduate medical education program accredited by the Royal College of Physicians and Surgeons of Canada. It aims to develop clinician–scientist research leaders who will have the skill sets to achieve broad-based excellence not only in research but also as clinicians, supervisors/mentors, teachers, and academics. In addition, we launched a new combined opportunity wherein students can apply for the UME degree program and a master’s or Doctorate (MD–MSc or MD–PhD), which they complete concurrently. This allows for unique opportunities for medical students to obtain advanced research and translational skills. Our international reach has extended through teaching, research, and service, including the creation of international learning opportunities for both students and residents such as a family medicine rotation in the Falkland Islands. To further support our school, we have deliberately identified the need to place an emphasis on physician wellness. It has been embedded as a goal within our strategic framework for the School of Medicine. Many of these programs are offered in our newly built, state-of-the-art School of Medicine Building, one of the premier teaching facilities in North America. It allows for the integration of modern teaching methods, technology, and interdisciplinary practices to provide a truly exceptional medical training experience. In the virtual realm, we have developed Elentra, which is an integrated teaching and learning and data management platform. This platform provides a seamless interaction between all aspects of our programs, including curriculum mapping and programmatic assessment, and has all the functionality of a robust learning management system. Elentra has matured into a consortium, where 22 international medical schools or other clinical sites are maintaining and growing the platform. In addition, our Faculty of Health Sciences is home to many different national and international research hubs, including the Canadian Frailty Network and the Canadian Institute for Military and Veteran Health Research. Finally, in recognizing our responsibilities through the Truth and Reconciliation Commission calls to action we have revisited our responsibilities within the School of Medicine, including our admissions process, curricula, clerkships, support systems, and hiring processes, to be more inclusive for Indigenous peoples. We have also taken steps to redress historical inequities in our school. In 2018, the Queen’s Senate revoked a 1918 motion that banned students of African descent in our School of Medicine. Although black students were admitted as of 1965, the motion continued to exist. The school has taken steps forward including personal letters of apologies to family members of those affected, curricular changes, outreach, and a Medicine Admission Award for Black Canadians. Curriculum Curriculum description Since 2010, the provincial Ontario Universities Quality Assurance Council has monitored the quality of all university programs. At Queen’s University we developed the Quality Assurance Process (QUQAP) to address this monitoring and have built institutional capacity through additional criteria of curriculum mapping, assessment, and academic integrity, among other unique features of our process. As such, all our programs are required to adhere to the accreditation standards and to the QUQAP, and all have curriculum maps that are vetted internally and externally. See Supplemental Digital Appendix 1—Curriculum Map—at https://links.lww.com/ACADMED/A972. Curriculum changes since 2010 There are significant changes within our curriculum since 2010 including CBME, Indigenous perspectives woven throughout our programs, an emphasis on physician wellness, and scholarship/research. In addition, we launched the First Patient Program in 2016, which provides first-year UME students opportunities to interact with real patients, to learn empathy and skills they will carry with them throughout their academic and professional careers. Among other innovations, we have developed longitudinal clerkship rotations that allow our students opportunities to clerk in areas outside of our immediate area and in remote communities. Class size changes since 2010 Our class size has not changed significantly since 2010, with our UME intake typically 100 students (currently 108 admissions); however, what has changed is that all students in the past were post-undergraduate degree students, now our numbers include 10 QuARMS students and a pathway for Indigenous students to our medical school. Further, at the request of the Canadian Armed Forces, the Queen’s University UME program has completed arrangements with the Canadian Armed Forces to create up to 5 additional training positions in the Queen’s Medical Doctorate Program. Canadian Forces staff, who are supported and funded by the Department of National Defence, are eligible to apply for these positions and offers of admission will be made to those who qualify. Assessment Our UME program adheres to the CanMEDs Framework, which identifies the 7 roles of a physician, and each of these are mapped to Entrustable Professional Activities (EPAs). See Figure 1—Entrustable Professional Activities.Figure 1: Entrustable Professional Activities.Parallel curriculum or track Aside from the traditional route to our UME, we have 3 parallel curricula, all new since 2010. QuARMS: Developed in 2013, QuARMS is Canada’s only 2-year accelerated-entry premedical program, designed to reduce training time and the overall expense of medical training, as well as provide collaborative premedical experiences/training. Each year 10 students enter this program directly from high school and spend the first 2 years enrolled in an undergraduate degree program while also participating in an additional curriculum focusing on communication skills, critical thinking, the role of the physician, community service learning, and scientific foundations. They are then eligible to enter the first year of the MD curriculum. MD–MSc and MD–PhD: The combined MD–PhD and MD–MSc programs provide benefits to both scholarship and to the professional development of physician–scientists by allowing better integration of clinical and research training experiences and providing better opportunities for fostering translational research. Our programs are in keeping with the strategic directions of both the Canadian Institutes of Health Research Strategic Plan and the government of Canada’s Science and Technology Strategy, which emphasize the need for providing increased trans-sectorial and multidisciplinary training, building research excellence, translating knowledge into practical applications, and deepening the pool of highly skilled individuals. Curricular Governance As noted above, all academic programs at Queen’s University are monitored through the QUQAP provincial quality assurance mandate. However, our Queen’s Senate delegates to local programs the authority over all aspects of their educational programs. For example, within undergraduate medicine, the UME Curriculum Committee is delegated to have authority over all components of the MD educational program. The Curriculum Committee has both responsibility and authority regarding the design, content, implementation, and ongoing review of the program. This adheres to the CACMS/LCME Accreditation Standard 8: Curricular Management, Evaluation, and Enhancement. As well, the Curriculum Committee adheres to CACMS/LCME accreditation Standards 6: Competencies, Curricular Objectives, and Curricular Design; 7: Curricular Content; and 9: Teaching, Supervision, Assessment, and Student and Patient Safety. There are a number of subcommittees and individuals that report to the Curriculum Committee, including the Student Assessment Committee; the Teaching, Learning, and Integration Committee; and the Course and Faculty Review Committee. The School of Medicine is situated within the Faculty of Health Sciences at Queen’s University, which also includes the School of Nursing and the School of Rehabilitation Therapy. See Figure 2—Organizational chart.Figure 2: Organizational chart.Faculty Development and Support in Education The Faculty of Health Sciences includes the Office of Professional Development and Educational Scholarship (OPDES), an integration of continuing professional development, faculty development, education scholarship, and global health. OPDES conducts needs assessments and consultations, develops educational programs based on identified needs, develops online programs and courses, accredits and certifies programs on behalf of the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada, and conducts educational research and program evaluations. OPDES offers programs for a diverse audience of health care professionals, has significant expertise and experience in the accreditation of learning activities for health professionals, and is a Committee on Accreditation of Continuing Medical Education accredited provider. The scope of this unit is to provide support and services to all 3 schools: Medicine, Nursing, and Rehabilitation Therapy. Further, we have multiple noncredited and credited programs for faculty. An example of a noncredited program is our Fellows in Educational Scholarship Program, which was designed to build individual expertise in educational scholarship and to create an identified cadre of faculty, graduate students, and residents who will advance the educational programs in the Faculty of Health Sciences through participation in educational scholarship. Individuals participating in this 2-year program focus on either a scholarly investigation of an educational issue or the development of an innovative educational program/curriculum. In 2020, we launched the Master of Health Professions Education program, a 2-year, part-time, interdisciplinary course/competency-based program for clinical educators. All courses are team-taught by a health professional and educational specialist and geared toward learners from all health professions. Role of teaching in promotion and tenure Our clinical faculty are promoted through the Queen’s Senate, under the Statement on Promotion Policy for Geographically Full-Time and Adjunct-1 (non-Bargaining Unit) Appointees of the Faculty of Health Sciences. There are 4 ranks: lecturer, assistant professor, associate professor, and professor. Promotion is based on teaching, research and scholarship, and administrative and professional service. The promotion package includes the curriculum vitae, teaching dossier, and other evidence. The following criteria are for each promotion category: Assistant: should be a good teacher and show evidence of the successful initiation of research and scholarly work. The appointee’s participation in the operation of the department, the university, or contributions to the profession may be taken into consideration. Associate: should be a very good teacher, carrying a reasonable teaching load. The appointee’s research and scholarly work should show high quality as judged by experts in the appointee’s field of specialization. Contributions of the appointee to the operations of the department, the university, and the profession will be taken into account. Professor: must either combine distinguished scholarly work with very good teaching or continuing high-quality scholarly work with exceptional contributions in teaching. The appointee will have made a contribution to the successful operation of the department, the university, and the profession. The ability to intersect theory and practice as fully integrated in all aspects of our School of Medicine highlights our intentionality to provide a multifaceted approach that is competency based. There have been significant strides in the past 10 years. Queen’s University School of Medicine has undergone substantive shifts in admissions, curricular innovations, faculty support, and administrative processes.