The network - Towards Unity For Health

INTERNATIONAL HEALTH PROFESSIONS EDUCATIONMEDICAL EDUCATIONConsortiumfor Longitudinal Integrated CurriculaThe Northern Ontario School of Medicineand learning core clinical competenciesas a parallel stream to the standard teach-(NOSM) is the first new medical schoolacross multiple disciplines simultaneously.ing hospital-based clerkship model. Inin Canada in over 30 years. A joint initia-Generally, all major medical disciplines areAugust 2006, NOSM hosted a workshoptive of Lakehead University in Thundertaught concurrently in a developmentalwhich brought together representativesBay and Laurentian University in Sudburysequence that integrates clinical medi-from six of those medical schools in North(two regional centres more than 1000cine with its biological and social scienceAmerica. Last year, a follow up three-km apart), NOSM was established withunderpinnings. Students develop meaning-day workshop of this group plus others,a social accountability mandate to beful continuous relationships with patientsknown as the Consortium of Longitudinalresponsive to the needs of the people andand with clinical teachers. Motivated byIntegrated Curricula (CLIC), took place incommunities of Northern Ontario.their intense relationships with individualBoston. CLIC is a growing internationalpatients, students develop a strong sensenetwork of medical schools committed toLongitudinal Integrated Clerkshipof professionalism and social account-improving the quality and effectiveness ofD E C E M B E R 2 0 0 8NOSM is the first medical school in theworld in which all third-year medicine studentsundertake a longitudinal integratedclerkship.In four-year medical programmes, studentsin the third year make the transition fromprimarily classroom learners to clinicians.ability. They observe the full course oftheir patients’ medical illness and recovery(when possible), learn about the challengesof navigating the healthcare system,and extrapolate to populations whenapplicable. Through longitudinal relationshipswith mentors, they receive frequent,clinical education. The workshop was hostedby the Cambridge Integrated Clerkshipof Harvard Medical School.In 2008, there have been two CLIC events.As part of the International conferenceCommunity Engaged Medical Education inN E W S L E T T E R N U M B E R 0 2 | V O L U M E 2 7The standard model involves the studentsrotating through sequential blocks (clerkships),each of which provides concentratedlearning in a specific clinical discipline(Internal medicine, Surgery, Paediatrics, etcetera). A longitudinal integrated clerkshipinvolves the students in learning thecore clinical disciplines integrated togetherover a prolonged period of time.The NOSM third year is the ComprehensiveCommunity Clerkship (CCC), in which studentslive and learn in one of 12 large ruralor small urban communities in NorthernOntario outside Thunder Bay and Sudbury.The students are based in family practice,where they meet patients and follow them,including into specialist and/or hospitalcare. Supervised clinical experience is complementedby direct teaching from localand visiting specialists and family physicians,as well as by distance education.developmentally appropriate feedback.This approach lends itself to urban andrural settings, to community and tertiarysites, and to advantaged and disadvantagedpopulations.STUDENTSDEVELOPMEANINGFULCONTINUOUSRELATIONSHIPSWITH PATIENTSAND WITH CLINI-CAL TEACHERS.the North in June, there were three CLICHothouses and the annual CLIC Meetingin November was hosted by the Universityof California at San Francisco. This CLICMeeting was attended by 90 participantsfrom 25 different medical schools,many of whom are planning or have juststarted longitudinal integrated clerkships.Highlights of the programme includedkeynote addresses on Future Directions forLongitudinal Integrated Clerkships: WhatRole for Residents and Residency Training?and Longitudinal Integrated Clerkshipsin the Future of Undergraduate MedicalEducation, as well as a panel discussioninvolving former and current longitudinalintegrated clerkship students. In addition,there were multiple parallel workshop sessionswhich explored a diverse range oftopics from professional identity developmentto research questions and initiatives.Roger Strasser | Founding Dean,The CCC is one of many models of longi-Northern Ontario School of Medicine,tudinal integrated clerkships. DifferentCLICCanadamodels share common elements: compre-A growing number of medical schoolsEmail: roger.strasser@normed.cahensive patient care over time; continu-offer models of longitudinal multi-ing learning relationships with clinicians;specialty integrated third-year clerkships16