Medical school SOS
Published Wednesday November 18th, 2009
Reform: Following sanction, Dalhousie's faculty of medicine undertakes rigorous curriculum review
SAINT JOHN - Dr. Tom Marrie began his new job as dean just as the faculty of medicine at Dalhousie University found itself under a dark cloud.
The third oldest medical school in Canada, the Dalhousie faculty had long been considered one of the most prestigious institutions in the country until a U.S. accrediting body put it on probation earlier this fall.
Marrie, who took the top post in July, says the direction has given his faculty the opportunity to come back stronger than ever, just in time for next fall's opening of Dalhousie Medicine New Brunswick, the school's new satellite wing in Saint John.
"It's similar to how you do business," he said during a recent editorial board meeting with the Telegraph-Journal. "You continue to do the same thing for 20 years, you might find yourself out of business. It's the same with us. So we've taken this opportunity to find out what's going on elsewhere."
The Liaison Committee for Medical Education based in the United States reviewed 132 standards at Dalhousie and found it was "non-compliant" on 17. Dalhousie has two years to prove it can make changes.
In reaction, Marrie said his faculty of medicine quickly assembled 20 different groups comprising 200 people to look at different parts of the curriculum.
The people include faculty teachers, doctors in private practice, average citizens, "as diverse an audience as possible," said Marrie.
The review is meant to be thorough, and as such, includes two groups at opposite ends of the spectrum.
One crew is looking at how much basic science should be put in the core curriculum. Over the past 25 years or so, medical schools have started to emphasize better communication skills and how to show empathy to patients. In so doing, they have strayed somewhat from the core sciences.
"When I went to medical school, you had to do biology, you had to do some chemistry courses, you had to do physics," said the greying Marrie. "Now you can come into medicine without ever having seen biology. That puts you at a bit of a disadvantage."
With advances in medical science, Marrie said the knowledge base turns over every three years. A modern-day physician is expected to read a minimum of one hour each day just to keep up.
"Science has rocketed ahead, the new diagnostic tools are with very sophisticated technology," he said. "For instance, there is a lot of heavy emphasis on genetics. But if you don't understand that as a doctor, how do you advise your patients?"
A group looking at the polar opposite is a crew led by Dr. Ron Stewart, the director of medical humanities at Dalhousie. An emergency room doctor who practised most of his career in the U.S., Stewart is examining what's described as the art of doctoring.
Marrie said the ideal practitioner is someone who is more than just a academic versed in the sciences.
"Do you really look after your patients, do you advocate for them, do you get them to see a specialist as quickly as they can?" he asked. "We spend a lot of time teaching how to break bad news to a patient. So it's the art of being a doctor."
The groups began reporting back this week, and Marrie expects the findings to be introduced into the first two years of the medical school curriculum. The third and fourth years won't change much, he said, because they are still apprentice-based, with undergraduates shadowing doctors in the field.
Among the people reviewing the curriculum are a number of physicians from New Brunswick.
Dr. John Steeves, the associate dean of Dalhousie Medicine New Brunswick, said it was an example of how the new satellite campus would help build on the strengths in Halifax.
"The New Brunswick initiative has not only been good for New Brunswick, but for Dalhousie," he said. "Because it has given us an opportunity to critically look at some of the things that we do at Dalhousie that we haven't critically looked at - and people become energized to make changes that they might have let sit for a big longer."
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