Medical Education Program Highlights Our UME program mission is to develop generalist physicians as socially responsible leaders, collaborative decision makers, and lifelong adaptive learners. Our program uses a distributed model with core learning at London and Windsor campuses, and clinical learning delivered across affiliated community sites throughout Southwestern Ontario. Our model of curriculum delivery provides students with exposure to diverse patient care experiences, interprofessional and longitudinal learning, and the impact of social determinants of health in rural and urban communities. Using a competency-based medical education (CBME) structure, assessment activities measure student achievement of key and enabling competencies and Entrustable Professional Activities (EPAs). With our focus on competency rather than time, students are offered options for advanced or parallel learning aligned with future career goals. Experiential learning begins in year 1, including early primary care clinical care experiences, team-based research, service learning, and quality improvement (QI) projects. All students are assigned an academic coach to support individual academic success and cultivate learners’ growth mindset. Program evaluation is carried out by program leaders in collaboration with a student evaluation team. Our admissions process is responsive to our commitments to diversity, social responsibility, and accountability, with practices in place to support increasing the number of Indigenous matriculants, those from lower socio-economic backgrounds, and those from rural locations. In response to the Truth & Reconciliation Commission of Canada’s Calls for Action, we have integrated Indigenous health and cultural values across all 4 years under guidance of our Indigenous Health Curriculum Task Force. The school is hiring an Indigenous leader in residence to guide these initiatives. Our curriculum integrates skill-based training in intercultural competency, human rights, and implicit bias to ensure graduates develop culturally safe health care practices. Student professional identity, professionalism, personal success, and wellness have been embedded in the longitudinal Professionalism, Career, and Wellness course. One day each week is set aside for independent learning and pursuit of clinical or scholarly activities of personal interest. Curriculum Curriculum description Our curriculum is composed of integrated semester courses covering core basic, clinical, and social sciences across organ systems and the life cycle. Particular emphasis is placed on embedding the social determinants of health and health care systems within a rich context of a patient/family-centeredness lens. Clinical decision-making and personal identity development are supported in clinical skills, experiential learning, and small-group learning throughout years 3 and 4 clerkships and clinical immersion. Following the introductory Foundations of Medicine course, the Principles of Medicine I, Principles of Medicine II, and Transition to Clerkship courses prepare students with knowledge, skills, attitudes, and behaviors necessary to begin clinical immersion. There is a 20-month immersion in clinical learning during years 3 and 4 beginning with the yearlong integrated clerkship course, followed by 16 weeks of electives. The clerkship learning experiences are delivered in London, Windsor, and across 60 sites in Southwestern Ontario. Critically, the curriculum prepares medical students at key transition points in the Transition to Clerkship (end of year 2) and Integration and Transition (end of year 4) courses. The complexity of assessment and management is elevated in these case-based active learning courses, with higher-order learning expectations for competencies and EPAs. The 4-year Professionalism, Career, and Wellness and Experiential Learning courses support achievement of the professional, leader, and scholar CanMEDS competencies. The curriculum is designed to graduate competent generalists prepared for the next stage of training, with particular preparation for competency-based postgraduate residency programs in Canada. See Supplemental Digital Appendix 1—Curriculum Structure—at https://links.lww.com/ACADMED/A960. Curriculum changes since 2010 Since 2010, we have implemented stepwise innovations in learning, assessment, outcomes, evaluation, and QI. In September 2019, we launched our CBME model, and are currently in a 3-year transition from our legacy systems-based curriculum, created in 2008. Overall goals for this curriculum renewal include: Improving health care provision using an outcomes-based model Aligning with best practices of Canadian CBME Supporting and measuring students’ demonstration of the competencies, knowledge, skills, and attitudes necessary to meet the needs of the diverse Canadian population we serve Preparing graduates for continual lifelong learning Our curricular objectives align with Canadian standards including: CanMEDS 2015; the Medical Council of Canada assessment blueprint; and Association of Faculties of Medicine of Canada (AFMC) EPAs. Assessment Our competency framework is derived from the 2015 CanMEDS roles: medical expert, communicator, collaborator, leader, health advocate, scholar, and professional. Each role is defined by key and enabling competencies measured in stages across years 1–4 and assessed within the program before graduation. Each student also demonstrates achievement of all competencies by graduation using an electronic portfolio and dashboard. Achievement of competence in 12 defined clinical tasks is also assessed longitudinally with the AFMC EPA observed assessments across all 4 years using developmental markers (milestones). True to our CBME model, assessment for learning is carried out using a multifaceted system of frequent, formative, and low- and no-stakes assessments. Students are expected to monitor academic progress on formative assessments and in achieving key and enabling competencies monthly with their academic coach. Where appropriate, students develop learning plans to address their gaps or individual learning goals. We focus on effective and timely feedback to facilitate student developmental progression to reach GME entry competence. See Table 1—Key Competencies and Assessment Methods.Table 1: Key Competencies and Assessment MethodsParallel curriculum or tracks The Schulich Medicine MD program has legacy and evolving parallel tracks available to students: Legacy: MD–PhD program: For the past 20 years, cohorts of 3 students are admitted to this stream and complete their PhD with a Western University faculty in foundational and clinical sciences. Their PhD studies are pre-year 1 or after year 2 of the MD program. MD–MSc oral and maxillofacial surgery program: One student is admitted annually to this 6-year program. Candidates for admission must already possess a DDS or DMD degree. Acceptance includes admission into the oral and maxillofacial surgery, medical, and graduate studies programs. Planned: Western University certificates in special interest areas such as global health Joint master’s degrees: MD–MBA, MD–MPH, and MD and other Western University master’s programs Parallel certificates or master’s degrees with University of Windsor for Windsor Campus students Expansion of MD–PhD offerings available across multiple faculties such as engineering and science Pedagogy Teaching and learning methods support active engagement in clinically relevant sessions delivered in alignment with program outcomes. Exposure to clinical decision-making begins early in year 1 and continues across all courses. Years 1 and 2 courses use case-based learning, characterized by weekly authentic clinical cases that are revisited and built upon throughout the week using inquiry-based learning methods aligned to course and program outcomes. Faculty-led small groups build communication, leadership, advocacy, and collaboration skills such as listening, questioning, and responding, while strengthening critical thinking and problem solving. Experiential learning opportunities as required learning include research or QI projects, service learning, and longitudinal clinical exposure building professional, scholar, communicator, advocate, collaborator, with medical expert. Large-group sessions are interactive with required advance preparation. Educators promote active participation within the large-group context, using questions directed to deepen learning, group discussion, and using audience-response systems to poll students in real time to assess for understanding. Traditional cadaveric dissection anatomy is delivered with small-group educators and faculty/health professionals. Team-based projects and reflections are grounded in patient care and experiences. Service learning is mandatory and offered in partnership with local community organizations. Global and regional learning partner sites offer students optional additional clinical learning over year 1, year 2, summer recess, and year 4. Optional self-directed clinical and research learning is supported by the school in London, Windsor, and our distributed education region. Standardized patients are used with small-group sessions in years 1 and 2 to develop clinical skills, and simulation is employed for some clinical learning in year 3 and across other courses. Clinical experiences All mandatory clinical experiences occur in clinical affiliates of the school or Canadian partners. Clinical learning before, during, and after clerkship is focused in affiliated London and Windsor hospitals, clinical health care affiliates, and community sites across Southwestern Ontario. Longitudinal clinical experiences in years 1 and 2, and our rural immersion week, occur in local family medicine clinics. QI projects and team-based chronic disease experiences are in clinical affiliates and community care sites. During years 1 and 2 and in summer recess, students are supported in undertaking clinical learning at local or regional sites. Students in year 4 are given 16 weeks of approved elective and selective clinical learning regionally, across Canada, or internationally. Curricular Governance A centralized curriculum governance model is led by the Curriculum Committee, responsible for oversight of all program learning including development, management, and evaluation of the 4-year UME curriculum. The Competence Committee reviews learner assessment and makes recommendations on progression and achievement of competencies. QI processes and initiatives are guided and monitored by our Quality Committee and Accreditation Committee. All committees include representation (where appropriate) from program and school leadership, courses chairs, clinical and foundational science faculty, student affairs, staff, and junior and senior students from London and Windsor. The Curriculum Committee communicates with the faculty and the school through a monthly newsletter and reports to the Executive Committee of Schulich Council. See Figure 1—Curricular governance structure.Figure 1: Curricular governance structure.Education Staff The UME Office, under the leadership of the associate dean, UME and UME manager, is responsible for the MD program. The UME Office is led by the manager and has 17 staff members who support students and teaching faculty in delivery of the MD program. Key positions include coordinators who are responsible for each of curriculum oversight, years 1 through 4 curriculum support, program evaluation, and educational technology. Our Windsor campus is led by the associate dean, Windsor, and a local manager with 16 administrative staff. Working in tandem with staff, UME has a number of faculty leads to provide direction and process oversight for assessment, QI, competency-based curriculum design, and population- and health-related topics. See Figure 2—Organizational chart of decanal positions.Figure 2: Organizational chart of decanal positions.Faculty Development and Support in Education All Schulich Medicine faculty are supported with faculty development activities sponsored by the school and Western University to advance their competency as educators and leaders. These include in-person and distance learning workshops and seminars aimed at improving teaching effectiveness, curriculum development skills, academic coaching, assessment, and small-group facilitation. Residents with teaching responsibilities are supported in developing skills as evolving educators through the Postgraduate Medical Education Office annual bootcamp for resident teachers, an intensive 2-day program including sessions on cross-disciplinary teaching skills. Attendees are encouraged to teach others in a “train the trainer” process. Residents may enroll at no cost in courses offered by our Continuing Professional Development Office. Faculty, residents, and students may enroll in a Masters of Health Professions Education or other education master’s and PhD programs through Western University’s Centre for Education Research and Innovation, in partnership with the University of British Columbia and Maastricht University. The Centre for Teaching and Learning at Western University offers educators training, mentorship, research, and innovation opportunities through seminars, courses, certificate programs, and other resources. For promotion and tenure, Western University recognizes contributions to education innovation, teaching, and leadership as equivalent to research contributions. Regional Campus The Windsor campus of Schulich Medicine has operated for over 10 years in collaboration with the University of Windsor, Windsor hospitals, clinics, and centers for patient care. The Windsor campus delivers the entire 4-year MD curriculum. Windsor has 38 students in each class of 171 first-year students. Resident presence in Windsor includes freestanding residency programs in family medicine and psychiatry, as well as resident rotations in pediatrics, medicine, emergency medicine, palliative care, obstetrics–gynecology, anesthesia, and some surgical disciplines. Educators, staff, and leaders from the Windsor campus are members of all, and cochair some, course and governance committees. Windsor personnel are engaged in curriculum innovation and ongoing improvement. Schulich Medicine partners with University of Windsor faculty members in the delivery of selected teaching and with respect to student research projects. Initiatives in Progress Our MD program is a part of an overall integrated medical education initiative, designed to better align the continuum of medical education (with a consistent CBME philosophy) and develop an integrated health and education network in Southwestern Ontario, supported by our distributed network and academy system.