Undergraduate clinical education in internal medicine at Canadian medical schools.

Abstract

To document the characteristics of the clinical education in internal medicine of undergraduate medical students at Canadian medical schools. A five-part questionnaire was sent in 1991-92 to the individuals responsible for supervising the internal medicine clerkships at all 16 Canadian medical schools. The questions were related to (1) tutors, hospitals, and inpatient clinical experiences of internal medicine clerks; (2) ambulatory care experiences; (3) evaluation methods; (4) "junior clerkships" (i.e., clinical courses that precede the clerkships); and (5) supervisors' opinions about changes needed to improve the clerkships. Responses were received from all schools. There was surprising uniformity in clinical education across Canada. Clinical education methods have changed very little over the past decade. In the opinion of the clerkship supervisors, there were too few committed clinical tutors, little evidence of use of newer evaluation methods, and inadequate ambulatory care instruction. The study results suggest that the clinical education in internal medicine of undergraduate medical students has changed little despite numerous calls for reform.