Academic Calendar - 2024

Western University Academic Calendar. - 2024
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DOCTOR OF MEDICINE (MD) PROGRAM


Program Requirements and Progression

Program Requirements and Progression

The Doctor of Medicine (MD) Program in the Schulich School of Medicine & Dentistry is a four-year program. The program is divided into integrated years of learning offering curriculum from large and small group, laboratory, simulated, team and experiential work placed learning.

Year One and Year Two courses involve case-based learning in teams; laboratory experiences in basic and clinical sciences; small group learning; simulation learning; individual independent study; interactive large group learning including team-based learning; lectures; project-based experiential learning and supervised clinical learning experiences. The curriculum is designed to provide foundational learning in the basic and clinical sciences for application in Year 3 and 4 clinical educational experiences. Students are required to complete all course requirements offered including semester-long integrated courses and longitudinal year-long courses.

Year Three is a 52-week single course Clerkship completed as an integrated clerkship where learners serve as active members of clinical care teams in the following medical disciplines: Family Medicine, Medicine, Obstetrics & Gynaecology, Paediatrics, Psychiatry, Anesthesia, Emergency Medicine and Surgery. Within these disciplines there are additional elective learning options. Students learn from and work under the direct supervision of faculty and postgraduate resident physicians. Year 3 students are given graded responsibility in assessment, diagnosis, investigation and management of patient care in acute and chronic care settings, both inpatient and ambulatory, within health care facilities at associated clinical affiliates (hospitals, clinics, physician offices) in London, Windsor and across the distributed education network. Students are assessed in a competency-based process requiring satisfactory achievement of Medical Expert and Professional competencies and no concerns identified in the progression of achievement for the other five core graduation competencies – Communicator, Collaborator, Scholar, Advocate and Leader. Each student learning experience is unique, but each is required to meet rotation and course objectives. Each student in Year Three must complete a Community rural or regional rotation for a minimum of four weeks in the distributed education Southwestern Ontario region.

Year Four is divided into two single term courses consolidating prior learning. Term One Clinical Electives (16 weeks) consists of eight 2-week blocks of primarily clinical educational experiences selected by the student in any area of medicine in line with the expectations for diversification of elective experiences. Students may complete research-based experiences with appropriate notice. Clinical Electives may be completed at the Schulich School of Medicine & Dentistry, other Canadian medical schools, or in carefully selected international medical schools. Year Four Term Two, Transition to MD (16 weeks) is a mix of independent, small and large group learning ensuring that the knowledge, attitudes, and skills that underpin the required clinical-decision making and problem solving skills for transition to postgraduate medicine education have been achieved.

Curriculum Overview

Year One Courses
Year Two Courses
 Foundations of Medicine  Principles of Medicine II
 Principles of Medicine I  Transitions to Clerkship
 Clinical Skills (Medicine 5139)  Clinical Skills (Medicine 5246)
 Professionalism, Career and Wellness
Experiential Learning
Year Three Course
Clerkship (Medicine 5475)
Rotation: Family Medicine Core
(4 Weeks)
  Rotation: Medicine
(8 Weeks)
Rotation: Obstetrics & Gynaecology (6 Weeks)
Community Rural or Regional Rotation
(4 Week)
Rotation: Paediatrics
(6 Weeks)
Rotation: Psychiatry
(6 Weeks)
  Rotation: Surgery
(8 Week)
Rotation: Family Medicine Plus (4 weeks) Rotation: Acute Care (EM & Anesthesia)
4 weeks
Year Four Courses
 Clinical Electives (Medicine 5401)  Transition to MD (Medicine 5402)

Program Regulations

Attendance
It is expected that students will attend all scheduled educational experiences.

Attendance is mandatory for sessions as defined in the course syllabus and all clinical learning. Mandatory attendance is required for: all Small Group Learning; Interactive Large Group/Consolidation Learning; Simulation; Clinical learning; Laboratory sessions; project learning, assessments and other sessions as defined in the course syllabus. At the discretion of the Vice Dean or course faculty lead, certain sessions (i.e., collaborative interfaculty learning) may be identified as mandatory. Failure to attend mandatory sessions without prior approval will result in remediation of incomplete learning objectives and assessments. Recurrent failure to attend mandatory learning will be reviewed as a Professionalism breach and will be addressed under MD Program processes and considered as part of progression. Attendance in all clinical and non-clinical learning in Year 3 Clerkship and in Year 4 Clinical Electives is mandatory. Failure to attend scheduled clinical learning in any year will result in remediation of and/or a grade of “Fail” on a rotation, elective or course. The student attendance policy can be found on the MD Program web page.

Professionalism
The MD Program is a professional degree program. The expectations for personal professional behaviour, outlined in the Statement on Professionalism and other School documents, relate to all required curricular learning and any interaction with peers, faculty, staff, patients, families and community. Any breach will be addressed under the Assessment and Appeals Policy and the Statement on Professionalism and may result in a grade of Fail, remediation dismissal.

Immunization
On Admission and for annual clearance, students are required to provide immunization documentation as it relates to COFM Immunization and Screening and Blood Borne Viruses policies and the Schulich Medicine & Dentistry policy on Blood Borne Viruses.

The COFM policy applies to all medical learners (undergraduate medical students and postgraduate residents and fellows) attending an Ontario medical school and performing clinical learning activities in Ontario. Undergraduate medical learners who do not comply with the immunization and health prevention policies may be excluded or suspended from all clinical learning or have the offer of admission rescinded in the interest of patient safety. Medical learners undertaking international clinical learning will require additional assessment, and potentially prophylaxis and immunization against infectious diseases specific to that learning environment. The MD Program, School and Western University International have processes that support safe learning outside Canada and explicit timelines to follow for pre-departure preparation and disease prevention.

Additional immunization may be required by other Canadian clinical sites; the MD Program, School or by provincial mandate in response to a health care outbreak for students in clinical learning during their study in the Program.

Police Checks
Students enrolled in the MD Program are engaged in many areas of patient care, including vulnerable sectors (i.e., infants, children, adolescents, special needs adults, seniors, and patients with mental health conditions) during their learning. To fulfill legal obligations that support patient safety, students will be required to submit their police record checks and vulnerable sector checks upon admission to the Program prior to beginning Year 1 studies and at the beginning of Year 3 and Year 4. These must be completed independently by the learner and submitted to the Learner Experience Office. Students are not permitted to commence their studies in Year 1, Year 3 and Year 4 if they do not submit or update required documentation of a clean police and vulnerable sector check. Students must consult the Admissions Office (for Year 1) and the Learner Experience Office (Years 2,3,4) about processes to follow in the event of a failed check. The Statement on Police Checks for Undergraduate Medical Students is found on the MD program website.

Time Limitation for Completion of the MD Program
The Doctor of Medicine (MD) Program is a full-time, four-year professional academic program. Students on request to the Vice Dean Undergraduate Medical Education may be granted a leave of absence while enrolled in Program studies. The MD program must be completed within six years of the original date of enrolment.

Under no circumstances may (a) a student withdraw and re-enter Program studies or (b) exceed the maximum program length of six years. A student who fails to complete the program in six years, for any reason, must withdraw from the MD Program.

Students enrolled in dual degree programs such as the combined MD-PhD program or MD-MPH (or similar tracks) will require additional years to complete their degrees. It is expected that the maximum time for completion of each dual degree will be adhered to as outlined in the Program syllabus. Failure to comply will result in either withdrawal of enrolment from the dual degree track (without completion of the parallel degree) and/or the MD Program studies.

Assessment

The principal function of student assessment in the MD Program is to provide feedback to support students learning and achievement of competence. All assessment activities are aligned with MD Program graduation competencies and the key competencies at defined stages (i.e. years) to ensure achievement before entering postgraduate medical education.

For the purpose of reporting, and consistent with all English-language Canadian medical school practices, the MD Program standard for progression is a Pass/Fail grade for each course. Percentage grades may be used in specific assessments to provide learner feedback on the achievement of knowledge, skills, attitudes and, progress. Student professionalism throughout all aspects of the curriculum will constitute an essential assessment outcome in each course of the MD Program (see Professionalism above).

Assessment throughout the Program curriculum will involve:

  1. Formative Assessment For Learning: These assessments are designed to monitor student learning, to provide ongoing feedback to students for students to improve learning. This feedback will enable students to identity their strengths and gaps/opportunities and target areas that need attention. Instructors will utilize feedback from formative assessments to recognize where students are struggling and to pre-emptively support student academic success. The assessments may take the form of verbal or written feedback; individual and group assignments; readiness assessments or written and oral examinations.
  2. Summative Assessment of Learning: Summative assessment in each course must be successfully passed for the student to progress to the next level of MD Program study. For these assessments, students may receive a numerical grade, which is a component of the overall course grade reported on the academic transcript as Pass/Fail.
  3. Assessment of Competence: Students will be assessed on their trajectory towards achievement of “entrustability with indirect supervision” on the twelve Association of Faculties of Medicine of Canada (AFMC) Entrustable Professional Activities (EPAs) which are tasks of a generalist physician required for graduation. Student professionalism will be assessed throughout the MD Program (see Professionalism above).

During Year 1 and Year 2

  1. Formative Assessment for Learning occurs via group participation; written readiness assessments; reflection; written or oral presentations; peer or other health learner group assessment; individual clinical patient care assessments; coaching; professionalism mentoring and feedback; simulation assessments, laboratory assessments and progress tests.
  2. Summative Assessment of Learning occurs in each course and requires satisfactory completion of all course requirements as outlined in the course syllabus and passing the end-of-course examination.
  3. Assessment of Competence: Students are introduced to EPAs during Clinical Skills and Experiential Learning with expectations relevant to the early stage of training.

During Year 3

  1. Formative Assessment for Learning occurs daily within the Clerkship course as the medical student interacts with patients, families, faculty educators, preceptors, residents and other health professionals in the clinical learning experiences. Assessments may include observed history and physicals, group participation; reflection; written or oral presentations; peer or other multisource feedback; individual clinical patient care assessments; coaching.
  2. Summative Assessment of Learning requires satisfactory achievement on all requirements and occurs at defined points in each Rotation as outlined in the relevant section of the Clerkship syllabus to Pass Clerkship.
  3. Assessment of Competence is integral in Clerkship with assessments in clinical care responsibilities demonstrating a satisfactory developmental trajectory towards achievement of the twelve EPAs. Students are responsible for working with faculty and resident supervisors to obtain assessments throughout their learning activities that demonstrate satisfactory achievement by the completion of Year 3. The Objective Structured Clinical Examination (OSCE) assesses students' mastery of the overall objectives of MD Program knowledge, clinical skills, professional conduct and clinical reasoning using simulated clinical settings and must be passed as a requirement for graduation.

During Year 4

  1. Formative Assessment for Learning occurs within a) Clinical Electives as the medical student interacts with patients, families, faculty educators, preceptors, residents and other health professionals in the clinical learning experiences and b) Transition to MD through small group participation, participation in and completion of course requirements, oral and written presentations and peer assessment.
  2. Summative Assessment of Learning in a) Clinical Electives requires satisfactory performance in all 8 elective rotations, including attendance and Professional behaviours and b) Transition to MD through completion of required learning modules; small group participation, assignments and a clinical selective as outlined in the syllabus.
  3. Assessment of Competence occurs in Clinical Electives and Transition to MD electives (where appropriate) with assessments in clinical care demonstrating satisfactory achievement of EPAs. Students are responsible for ensuring they have sufficient assessments that demonstrate satisfactory achievement of the graduation curricular competencies.

Progression

Satisfactory Progression
To satisfactorily complete each year, and to progress to the next year or to graduation, a student must meet the following requirements:

  1. For Year 1 and 2, students must satisfactorily complete all formative assessments and pass all summative assessments in the year, as defined by the Course Chair(s) and outlined in each course syllabus. Students must demonstrate and maintain a level of Professionalism as defined by the Statement on Professionalism.
  2. For Year 3, students must complete all formative assessments and pass each Rotation in Clerkship and successfully complete the OSCE. Students must demonstrate and maintain a level of Professionalism as defined by the Statement on Professionalism.
  3. For Year 4, successful completion of any required remediation for the OSCE is necessary to graduate from the Doctor of Medicine Program. Students must meet all other requirements for Clinical Electives and Transition to MD. Students must demonstrate and maintain a level of Professionalism as defined by the Statement on Professionalism
       a. Failure on the OSCE remediation will require a student to undertake additional studies in the MD Program and graduation will be delayed.
  4. For Graduation, students must meet the above requirements for all 4 years of the program. Each student must 1) have satisfactorily achieved the 23 MD Program Graduation Key Competencies that define the knowledge, skills and attitudes expected of graduating Canadian medical students, 2) demonstrate satisfactory achievement of the twelve Association of Faculties of Medicine of Canada (AFMC) Entrustable Professional Activities (EPAs), and 3) have demonstrated and maintained a level of Professionalism as defined by the Statement on Professionalism.


Conditional Progression & Remediation or Probation
A student who fails a course; a single rotation in the Clerkship; a Clinical Elective or does not meet the requirements for satisfactory completion as outlined in a course syllabus, may be provided with an opportunity for remediation at the discretion of the Competence Committee in consultation with the course committee and faculty lead. A remediation plan will be required. Remediation of a course, a single rotation in the Clerkship or an elective may only be provided once. A student who does not successfully pass remediation may be required to undergo probation or may be required to withdraw from the program. This may result in repeating a year of the MD Program.

Remediation and or probation plans will be developed for identified gaps and deficiencies in the domains of competence on an individualized basis following a standard process. This includes assignment of a remediation supervisor (assessor) and a mentor (no role in assessment). Remediation and/or probation is monitored by the Competence Committee.


Requirement to Withdraw
A student who has not met the requirements listed for "Satisfactory Progression" above or was not successful in demonstrating sufficient achievement and progression after appropriate remediation and/or probation shall be required to withdraw from the medical program for any of the following reasons:

  1. The student has not met the conditions listed under "Conditional Progression" and, therefore, is not eligible for supplemental assessment.
  2. The student has met the conditions listed under "Conditional Progression" but permission for supplemental assessment is not granted by the Competence Committee.
  3. The student fails a supplemental assessment granted under "Conditional Progression".
  4. The student is offered and completes a repeat year of supplementary learning and is not successful in progression.
  5. The student that has met the requirements under "Satisfactory Progression" may be required to withdraw under the University penalties for Scholastic Offenses or violation of the Western University Code of Student Conduct.
  6. The student has met the requirements under "Satisfactory Progression" but has demonstrated unprofessional or unethical behavior as defined by the Statement on Professionalism or the Policies of the College of Physicians and Surgeons of Ontario and the Canadian Medical Association Code of Ethics & Professionalism.
  7. The student has not met the requirements for Immunization and/or Police Record Check/Vulnerable Sector Screening resulting in suspension of clinical privileges and failure to complete academic requirements.
  8. The student has failed to remit tuition or student fees and has been sent to collection, resulting in the suspension of clinical privileges and failure to complete academic requirements.
  9. The student has met the requirements under “Satisfactory Progression” but has not adhered to the “Program Regulations” identified in this document, including (but not limited to) professional conduct.

Appeals
Students wishing to appeal a decision of the Schulich School of Medicine & Dentistry should refer to the Assessment and Appeals Statement which is aligned with the Senate Policy on Academic Rights and Responsibilities.

Grading Scales
The criteria for receiving a "Pass" grade will be clearly outlined at the start of each course in the syllabus. The key to this grading scheme is as follows:

PASS – Satisfactory completion of all requirements including formative assessments and a minimum of 70% on summative assessments as outlined in the course syllabus.

CR – Credit

FAIL - Did not meet the minimal acceptable standards and requirements for a specific course including a minimum of 70% on summative assessments as outlined in the course syllabus.

INC – Incomplete

IPR – Course in Progress

Definitions

Competence Committee – A committee made up of faculty members of Schulich Medicine & Dentistry representing various disciplines that reviews each student’s progress. This committee will reference all relevant academic work when reviewing each student’s progress. This committee meets at regular intervals throughout the 4-year curriculum. This committee determines progression of the student and makes recommendations regarding student progression and graduation to the Vice Dean, Undergraduate Medical Education.