Faculty development practices in Canadian medical schools.

Twelve Canadian medical schools that had an organized faculty development program were surveyed to evaluate the extent to which such programs were used and to estimate their effectiveness. Common practices included sabbaticals and programs designed to improve instructional skills. The main problems included underfunding, poor participation and inadequate instructor evaluation.     

Limitations on diversity in basic science departments

It has been over 30 years since the beginning of efforts to improve diversity in academia. We can identify four major stages: (1) early and continuing efforts to diversify the pipeline by increasing numbers of women and minorities getting advanced degrees, particularly in science, technology, engineering, and math (STEM); (2) requiring academic institutions to develop their own "affirmative action plans" for hiring and promotion; (3) introducing mentoring programs and coping strategies to help women and minorities deal with faculty practices from an earlier era; (4) asking academic institutions to rethink their practices and policies with an eye toward enabling more faculty diversity, a process known as institutional transformation. The thesis of this article is that research-intensive basic science departments of highly ranked U.S. medical schools are stuck at stage 3, resulting in a less diverse tenured and tenure-track faculty than seen in well-funded science departments of major universities. A review of Web-based records of research-intensive departments in universities with both medical school and nonmedical school departments indicates that the proportion of women and Black faculty in science departments of medical schools is lower than the proportion in similarly research-intensive university science departments. Expectations for faculty productivity in research-intensive medical school departments versus university-based departments may lead to these differences in faculty diversity.     

Status of nutrition education in Canadian dental and medical schools.

To investigate the present status of nutrition education for dentists and physicians in Canada, we conducted a survey of the nutrition education programs in 10 Canadian dental and 16 medical schools in the academic year 1982-83. Seven of the dental schools and seven of the medical schools had a separate course in nutrition. The average duration of these courses was 22 hours for the dental schools and 26 hours for the medical schools. Nutrition education was integrated with another discipline in 4 of the dental schools and 11 of the medical schools. The average duration of this type of instruction was 14 hours for the dental schools and 18 hours for the medical schools. Six of the dental schools and eight of the medical schools employed a nutritionist/dietitian to provide instruction in nutrition. We recommend that courses in basic and applied clinical nutrition be incorporated throughout the curricula of Canadian dental and medical schools, and that personnel trained in clinical nutrition be employed to provide instruction in this area.     

Too Few,Too Weak: Conflict of Interest Policies at Canadian Medical Schools

Introduction

The education of medical students should be based on the best clinical information available, rather than on commercial interests. Previous research looking at university-wide conflict of interest (COI) policies used in Canadian medical schools has shown very poor regulation. An analysis of COI policies was undertaken to document the current policy environment in all 17 Canadian medical schools.

Methods

A web search was used to initially locate COI policies supplemented by additional information from the deans of each medical school. Strength of policies was rated on a scale of 0 to 2 in 12 categories and also on the presence of enforcement measures. For each school, we report scores for all 12 categories, enforcement measures, and summative scores.

Results

COI policies received summative scores that ranged from 0 to 19, with 0 the lowest possible score obtainable and 24 the maximum. The highest mean scores per category were for disclosure and ghostwriting (0.9) and for gifts and scholarships (0.8).

Discussion

This study provides the first comprehensive evaluation of all 17 Canadian medical school-specific COI policies. Our results suggest that the COI policy environment at Canadian medical schools is generally permissive. Policy development is a dynamic process. We therefore encourage all Canadian medical schools to develop restrictive COI policies to ensure that their medical students are educated based on the best clinical evidence available, free of industry biases and COI relationships that may influence the future medical thinking and prescribing practices of medical students in Canada once they graduate.     

Career development of McMaster University medical graduates and its implications for Canadian medical manpower.

A study was undertaken of the career paths and decisions, and the factors influencing the decisions, of the first six graduating classes of McMaster University''s medical school. Climate and geography, preference for urban or rural living and influence of spouse were the factors that most influenced the location of practice, although the graduates who moved to the United States considered economic factors important too. Nearly one third of the specialists were practising in the United States. Personal challenge and positive clinical experience in the field were the major influences on choice of medical field. Graduates entering a specialty were more likely than those entering primary care to consider encouragement of others, a positive example set by medical school faculty members, working hours and research experience in the field as important influences on their choice of medical field. Data are needed on the career decisions, and the factors affecting them, of the graduates of all Canadian medical schools if Canadian medical manpower planning is to be realistic.     

Health research in Canada: a shifting paradigm.

A personal review of medical research in Canadian medical schools over the past 25 years reveals extraordinary contributions. Over this time, medical research evolved from a by-product of faculty members to a commitment that determines the future success of a medical faculty. The increasing competition for health research funding and the high standards created internationally have changed the way research is organized in our medical faculties. Current trends include a move toward group and thematic research, an increased role of research institutes and the development of strategic partnerships with industry. Because of the need for more planning and more critical and timely review of research efforts, the benefits of collaboration enhance the quality and competitiveness of a medical faculty. A broadened vision of the Medical Research Council and provincial foundations and the need to increase resources for research foreshadow even greater change.     

L'enseignement des sciences morphologiques dans 13 facultés de médecine canadiennes

A survey of teaching of morphologic sciences in Canadian medical schools has shown that few radical changes have taken place in most schools. The survey has also shown the following: (a) department chairmen have a major influence on teaching of morphologic sciences; (b) they are worried about the diminishing time alloted to them; (c) students, by their choice of electives, do not seem to share that worry; (d) lectures remain popular, as does disection in most schools; and (e) audiovisual methods, especially rediology, are becoming more popular but are not yet used on a very large scale.     

A Research Program in Medical Education in Canada

The current interest in medical education and the proposed expansion of medical education facilities have stimulated the development of a research program by the secretariat of the Association of Canadian Medical Colleges. The projects planned and now in progress include: (1) studies of the cost of medical education in Canadian teaching hospitals and medical schools; (2) a study of the basic medical science departments in Canada with special reference to the occupational careers of scientists who have received M.Sc. and Ph.D. degrees in those departments; (3) establishment of a student registry to facilitate prospective studies of Canadian medical students; (4) a survey of the residents in training in Canadian hospitals to obtain their evaluation of their training experience.     

The impact and effectiveness of faculty development program in fostering the faculty’s knowledge,skills, and professional competence: A systematic review and meta-analysis

BackgroundFaculty vitality is the main ingredient to enhance professional education and competence. Enriching the faculty vitality in key domains of teaching, assessing, research, professionalism, and administration is perceived to improve educational environment significantly and enhances the academic performance of learners. Faculty development program (FDP) has been considered as a stand-alone educational pedagogy in fostering knowledge and professional skills of faculty. However, few studies have provided objective reports about the impact of such programs in a healthcare system.MethodsThis research was conducted by selecting data sources of PubMed-Medline, Wiley online library, Cochrane library, Taylor & Francis Online, CINAHL, Springer link, Proquest, ISI Web of knowledge, ScienceDirect, EJS, EBSCO, Blackwell, Emerald and ABI Inform. This search followed a step-wise approach defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of 37 studies that explored the impact of FDPs on medical and allied health faculty’s professional development were selected.ResultsThis meta-analysis reported a mean effect size of 0.73 that reflects a significant and positive impact of FDPs in enhancing faculty’s knowledge and professional competence (z-statistics of 4.46 significant at p-value < 0.05) using the random effects model and forest plot.ConclusionThis article reiterates the incorporation of FDPs in all healthcare institutions for improving the academic performance of faculty with resultant enrichment of learners’ knowledge and skills.     

McGill makes Canada's first attempt to put medical curriculum in computerized format.

A member of McGill University''s Faculty of Medicine wants Canadian medical schools to collaborate to create a central repository for the best teaching materials. Dr. David Fleiszer fears that many individual efforts are being undertaken without an overall plan being in place. For its part, McGill is putting its medical-school curriculum on line over the next 2 years, and is collaborating with industrial partners to develop clinical simulations.     

Basic Training Program in Medical Pedagogy: a 1-year program for medical faculty.

In 1979 université de Montréal developed the Basic Training Program in Medical Pedagogy; the program has since been offered at two other Canadian medical schools. The learning activities are spread over an academic year so that the teachers are able to continue their clinical or research duties. The program, which follows a model of systematic instruction, comprises 17 self-instructional modules on basic educational topics adapted to medical teaching. The topics are related to four components of an integrated system: student needs and learning objectives, instructional methods, student evaluation and program evaluation. The instructional format is aimed at three levels--understanding, analysis and application--to which assignments and assessments are related. In addition to the modules, the program offers 15 half-day sessions for small groups (five participants and one instructor) to discuss aspects of the program, especially home assignments and the application of personal educational projects. A minimum of 100 hours of personal time is requested. The program''s main goal is that students be placed at the centre of the educational process. Of 215 participants since 1979, 171 (80%) have completed the program and reported high satisfaction. Issues related to any faculty development program are discussed.     

Pondering the future.

Despite growing tensions as the Canadian health care system evolves, the system will survive over the next decade and strengthen its societal objectives, sometimes dragging physicians along. With the shift of the intellectual centre away from the universities, research and researchers will find funding security but career insecurity in the private sector. The independent investigator will become rare as "big science" becomes the norm, and basic science departments will have a decade of confusion as they struggle for a new place in the renewed medical schools. The move toward problem-based, community-oriented medical education will be completed, clinical faculty will become salaried and the smaller numbers of graduates will be more controlled in their practices. Medicine as a profession will adopt a renewed philosophical framework and will broaden in its scope to the benefit of Canadians.     

A multicenter study of the awareness and attitudes of Egyptian faculty towards research ethics: a pilot study

The awareness and attitudes of faculty towards research ethics committees (RECs) and research ethics practices are largely unknown. Accordingly, we conducted a cross-sectional survey study involving various faculties (Medicine, Nursing, Pharmacy, and Dentistry) from four universities in Egypt. A large majority (> 85%) held positive attitudes towards RECs, but almost a third thought that RECs would delay research. More than half had not received prior training in research or medical ethics, but more than 90% thought that this subject matter should be taught to postgraduates. A large majority recognized the need for informed consent and confidentiality protections in research, but some held attitudes regarding certain research ethics practices that were questionable. We conclude that a curriculum in research ethics should be developed for university faculty and that further qualitative studies should explore the basis of several of the attitudes regarding practices in research ethics.     

Canadian and Landed Immigrant Applicants to Canadian Medical Schools for 1968-69

There were 2337 Canadian and Landed Immigrant applicants for the fall 1968 entering classes at Canadian medical schools. These applicants filed a total of 4579 applications.The results of this study show that there are regional differences in the quantity and quality of the applicant pool for Canadian medical schools. The study also shows that despite the fact that Canadian and landed immigrant applicants are filing more applications than they have in the past two years, there has been no appreciable change in the ratio of applicants to available places. A further point to be noted is that the participation of women both as applicants to and as medical students in the entering class of 1968-69 at Canadian medical schools was higher than in previous years.     

CMA membership survey: opinions on issues facing the medical profession

A sample survey of Canadian Medical Association (CMA) members, conducted in early summer 1985 and designed to provide information to help guide the association''s activities and policies, shows that most Canadian physicians support involvement in political activities both by CMA and by indivudual physicians. A majority wishes to maintain the concept of extra/balance billing, to pursue the position that the health care system is underfunded and favours medicare premiums and hospital user fees as the preferred methods for increasing revenue.Most respondents believe that the number of doctors in Canada is about right but would prefer any reduction to be achieved by cutting medical school admissions or reducing postgraduate training positions open to graduates of foreign medical schools.Most of those members who know of CMA policies on a number of health care issues agree with them and also find them useful, but a significant proportion are not aware of their content.There is support for compulsory payment of dues by all licensed physicians to both their provincial medical association and CMA. A majority would like more information on pharmaceutical products and additional membership surveys.     

Canadian-Trained Basic Medical Scientists, 1946-47—1963-64

The number of master''s and doctoral degree holders who obtained their degree in a basic medical science under the supervision of a Canadian medical faculty between 1946-47 and 1963-64 was obtained from the medical schools. Of the total degree holders, 69% are currently residing in Canada, 23% in the U.S.A., and the remaining 8% in overseas countries.Questionnaire returns from doctoral degree holders revealed that citizenship status at the time of graduation is positively related to migration; migration rates were lowest for Canadian-born and highest for landed immigrants and foreign students. Geographic mobility during training was also found to be a significant factor which increased the propensity to migrate. One-half of those who took further postdoctorate training in the United States are currently living in the United States, compared to 15% of those who received all their training in Canada. Information on current type of employment revealed that only a quarter of the Ph.D. respondents are in a basic science teaching position in Canada.     

Women in medicine: practice patterns and attitudes.

Increasing numbers of women are entering medicine in Canada. In 1959 women accounted for 6% of the medical school graduates, but by 1989 they accounted for 44%. Although there has been little systematic investigation of the impact of this increase on Canada''s health care system, there are grounds for believing that female physicians bring with them distinctive values and interests, which may be reflected in the way they conduct their professional practices. We used data from a recent national survey of 2398 Canadian physicians to examine differences between women and men in their practices and their attitudes toward health care issues. Significant differences were found in the organization and management of the practices. Women preferred group over solo practice and were overrepresented in community health centres, health service organizations and centres locaux de services communautaires in Quebec. One-third of the women, as compared with half of the men, were in specialties. Even after adjusting for differences in workloads the incomes of the women were significantly lower than those of the men. Only minor differences were observed in the assessment of the health care system and alternative modes of organizing health care services. We believe that the differences were due to the double workload of women as professionals and family caregivers and the powerful socialization effects of medical education. As women overcome their minority status in the medical profession, differences between the sexes may become more apparent. Thus, the extent and effects of the progressive increase in the number of women in Canadian medicine should be assessed on an ongoing basis.     

Rapid evolution of microcomputer use in a faculty of health sciences.

OBJECTIVE: To assist with educational planning we surveyed health sciences faculty members in 1989 to determine their use of microcomputers, desire for further instruction and perceptions on what microcomputer services should be provided for students. The 1989 results were compared with those of a similar survey performed in 1986. DESIGN: A self-completed, mailed questionnaire, with up to three reminders. SETTING: Faculty of Health Sciences, McMaster University, Hamilton, Ont. PARTICIPANTS: All full-time (FT) and part-time (PT) faculty members were sent the questionnaire; over 80% of the FT and 65% of the PT faculty members responded in 1986 and in 1989. RESULTS: The proportions of faculty members who used microcomputers increased significantly over the 3 years, from 71% to 87% among FT members (p = 2.2 x 10(-8)) and from 48% to 69% among PT members (p = 4.9 x 10(-8)). There were significant increases in the use of many of the applications, especially database and filing uses (from 10% to 41% among FT members [p less than 1 x 10(-9)] and from 6% to 34% among PT members [p less than 1 x 10(-9)]) and on-line access to bibliographic databases (from 7% to 37% among FT members [p less than 1 x 10(-9)] and from 3% to 18% among PT members [p less than 1 x 10(-9)]. These changes occurred mainly through individual initiative and voluntary continuing education. CONCLUSIONS: The extraordinary rate of adoption of microcomputers attests to their perceived usefulness. Curriculum planners need to consider how the success of microcomputer applications can be evaluated objectively and how successful applications can be integrated into educational programs.     

Projections of Graduates from Canadian Medical Schools, 1970-81

This paper sets forth the projections made by the various Canadian medical schools of first-year undergraduate enrolment through 1977-78. Non-Canadian enrolment and student attrition are discussed and some assumptions are made concerning their levels up to 1981. In conclusion, a set of projections on Canadian and landed immigrant graduates from Canadian medical schools during the period 1970-1981 is offered. The national projections are broken down by medical school and province.The results of this paper indicate that Canadian medical schools will graduate 1019 Canadians and landed immigrants in 1970, 1052 in 1971, 1064 in 1972, 1113 in 1973, 1250 in 1974, 1342 in 1975, 1377 in 1976 and 1480 in 1981.     

Emergency Health Services Informational and Educational Programs: Development and Present Status

The development and present status of the Emergency Health Services (EHS) national and educational programs are discussed. Instituted in 1951 for medical and dental practitioners at a military school at Camp Borden, professional civilian indoctrination was later assumed by EHS at Canadian Emergency Measures College (CEMC). The federally sponsored courses there are now specialized; provincial EHS authorities undertake general indoctrination. Courses for graduates in pharmacy and nursing are also offered at CEMC. Hospital Disaster Institutes have been held across the country since 1954; Public Health Disaster Institutes, since 1966. Schools of Hygiene include the subject in graduate programs. Some years ago, three medical faculties introduced undergraduate teaching in mass casualty care; now, encouraged by the Association of Canadian Medical Colleges, a larger number are doing so. Several faculties of Dentistry, all faculties of Pharmacy, and 132 of 177 nursing schools teach apposite aspects. Professional journals have published many articles on this subject; this, for example, is the fourth Emergency Health Services Symposium presented by The Canadian Medical Association Journal.