Medical school in Canada
Encyclopedia
In Canada
, a medical school is a faculty or school of a university that trains would-be medical doctors and physician assistants usually offering a 3- or 4-year Doctor of Medicine
(M.D. or M.D.C.M.) degree and 2 year Physician Assistant
degrees. Although presently most students enter medicine having previously earned another degree, the M.D. is technically considered an undergraduate degree in Canada.
in another field, often one of the biological sciences. However, not all medical schools in Canada require a bachelor's degree for entry. For example, Quebec
's medical schools accept applicants after a two-year CEGEP
diploma, which is the equivalent of other provinces' grade 12 plus the first year of university. Most faculties of medicine in Western Canada
require at least 2 years, and most faculties in Ontario
require at least 3 years of university study before application can be made to medical school. The University of Manitoba
requires applicants to complete a prior degree before admission. The Association of Faculties of Medicine of Canada (AFMC) publishes a detailed guide to admission requirements of Canadian faculties of medicine on a yearly basis. The 2010 guide is available at http://www.afmc.ca/pdf/2010AdBk.pdf
Admission offers are made by individual medical schools, generally on the basis of a personal statement, autobiographical sketch, undergraduate record (GPA), scores on the Medical College Admission Test
(MCAT), and interviews. Volunteer work is often an important criterion considered by admission committees. Medical schools in Quebec
(Francophones and Anglophone alike), the University of Ottawa
(a bilingual school), and the Northern Ontario School of Medicine
, do not require the MCAT. Some schools, such as the University of Toronto
and Queen's University
, use the MCAT score as a cut-off, where sub-standard scores compromise eligibility. http://www.md.utoronto.ca/admissions/information/faq.htm#mcat http://meds.queensu.ca/undergraduate/prospective_students/method_of_selection Other schools, such as the University of Western Ontario
, give increasing preference to higher performance http://www.schulich.uwo.ca/education/admissions/medicine/documents/FAQs20080930.pdf. McMaster University
strictly utilizes the Verbal Reasoning section of the MCAT to determine interview eligibility and admission rank. http://www-fhs.mcmaster.ca/mdprog/selection_process.html
The annual success rate for Canadian citizens applying for admission to Canadian medical schools for the academic years 2001/02 to 2005/06 ranged from 26.3% to 29.2%. http://www.afmc.ca/pages/publications_admission.html Just over 2500 positions were available in first-year classes in 2006/07 across all 17 Canadian faculties of medicine. The average cost of tuition in 2006/07 was $12,728 for medical schools outside of Quebec; in Quebec (for Quebecers only), average tuition was $2943. The level of debt amongst Canadian medical students upon graduation has received attention in the medical media. http://www.cmaj.ca/cgi/content/full/169/5/457 http://www.cma.ca/index.cfm?ci_id=10026669&la_id=1
and the University of Calgary
, where programs run for 3 years, without interruption for the summer. The first half of the medical curriculum is dedicated mostly to teaching basic subjects relevant to medicine, such as anatomy
, physiology
, pharmacology
, genetics
, microbiology
, ethics
, and epidemiology
. This instruction can be organized by discipline or by organ system. Teaching methods can include traditional lecture
s, problem-based learning
, laboratory sessions, simulated patient
sessions, and limited clinical experiences. The remainder of medical school is spent in clerkship. Clinical clerks
participate in the day-to-day management of patients. They are supervised and taught during this clinical experience by residents and fully licensed staff physicians
. Typical rotations include internal medicine
, family medicine
, psychiatry
, surgery
, emergency medicine
, obstetrics and gynecology, and pediatrics
. Elective rotations are often available so students can explore specialties of interest for residency training
.
Some medical schools offer joint degree programs in which a limited number of interested medical students may simultaneously enroll in M.Sc. or Ph.D.
programs in related fields. Often this research training is undertaken during elective time and between the basic science and clinical clerkship halves of the curriculum.
. 'Match Day' usually occurs in March http://www.carms.ca/eng/operations_future_match_e.shtml, a few months before graduation. The length of post-graduate training varies with choice of specialty. Family medicine is a 2 year program accredited by the College of Family Physicians of Canada
(CFPC), and third year programs of residency training are available in various areas of practice, including Emergency Medicine, Maternal/Child, Care of the Elderly, Palliative Care or Sports Medicine. All other medical specialty residencies are accredited by the Royal College of Physicians and Surgeons of Canada
; most are 5 years long. Internal medicine
and pediatrics
are 4-year programs in which the final year can be used to complete a fellowship
in general internal medicine or general pediatrics, or used towards a longer fellowship
(e.g., cardiology
). A few surgical residencies, including cardiac surgery
, neurosurgery
, and some general surgery
programs, last 6 years. Subspecialty fellowships
are available after most residencies. Family medicine programs often offer an optional third year of training in such fields as emergency medicine and care of the elderly (as opposed to Geriatrics
, which is a subspecialty of internal medicine).
There are subtle differences between how residency training is organized in Canada as opposed to the United States. For example, M.D. graduates proceed directly into their residencies without the intermediate step of internship. However, this difference is somewhat superficial: for many residencies, the first postgraduate year (PGY1) in Canada is very similar to a rotating internship, with 1-2 month-long rotations in diverse fields. On the other hand, in Canada the graduate is often committed to a subspecialty earlier than a similar American graduate.
Some subspecialties are organized differently. For example, in the United States, cardiac
and thoracic surgery
are rolled into one fellowship (cardiothoracic surgery
) following residency in general surgery
. In Canada, cardiac surgery is a direct-entry residency (equivalent training can be obtained by pursuing a cardiac fellowship following residency in general surgery, but this route is far less popular). A fellowship in thoracic surgery can be pursued following residency in either cardiac or general surgery.
Unlike the United States and United Kingdom, in Canada there are no national guidelines for residents' call schedules or work hours. However, each province in which residency training takes place negotiates such details as part of a collective agreement between the authority and the provincial professional association of residents. An example of this is the Provincial Association of Internes and Residents of Ontario (http://en.wikipedia.org/wiki/Professional_Association_of_Internes_and_Residents_of_Ontario).
(CME) schemes. Examples of CME activities include attendance at conferences, participating in practice-based small group learning, and taking courses such as advanced cardiac life support
.
The CFPC program for family physicians is called MAINPRO, short for 'Maintenance of Proficiency.' A certain number of credits must be obtained over 5 year cycles. There are different classes of credits depending on whether the CME activity is considered accredited (e.g., attending accredited workshops or conferences) or non-accredited (e.g., teaching medical students, preparing research papers for publication, reading scholarly journals).
The Office of Professional Affairs of the RCPSC is responsible for a mandatory maintenance of certification (MOC) program as part of its strategy of continuous professional development linked to each Fellow’s professional practice. The framework of CPD options includes a broad spectrum of learning activities linked to a credit system. All Fellows submit their completed learning activities through MAINPORT, the RCPSC learning portfolio. Fellows of the RCPSC must submit a minimum number of credits per year (40 credits) and over a 5-year cycle (400 credits) to maintain their membership with the Royal College and their right to use the designation FRCPC or FRCSC.
That instead gives way to more time.
(MCCQE), which is administered by the Medical Council of Canada
and organized as a part-multiple choice, part-short answer computer-adaptive test
. Upon completion of the final year of medical school, students are awarded the degree of M.D. Students then begin training in the residency program designated to them by CaRMS. Part 2 of the MCCQE, an Objective Structured Clinical Examination
, is taken following completion of 12 months of residency training. After both parts of the MCCQE are successfully completed, the resident becomes a Licentiate of the Medical Council of Canada
. However, in order to practice independently, the resident must complete the residency program and take a board examination pertinent to his or her intended scope of practice. In the final year of residency training, residents take an exam administered by either the RCPSC or the CFPC, depending on whether they are training for specialty or family practice. They are then eligible to apply for full licensure with their provincial or territorial medical regulatory authority (i.e., provincial college).
(CMA), the AFMC carries out accreditation surveys and rules on the accreditation status of all of the undergraduate medical programs in Canada, as well as all university-based continuing medical education. The Liaison Committee on Medical Education
, jointly administered by the Association of American Medical Colleges
and the American Medical Association
, also accredits Canadian medical schools. The M.D. and M.D.C.M medical degrees are the only medical degrees offered in Canada listed in the WHO/IMED list of medical schools.
But most research in Canadian faculties of medicine is performed not by clinicians, but by professors of the basic sciences relevant to medicine and their graduate students and post-doctoral fellows.
Often these researchers obtain funding from the Canadian Institutes of Health Research
, or from private sources such as pharmaceutical companies.
As in the United States, postgraduate trainees are referred to as 'residents,' not 'registrars.' Occasionally the word 'intern' is used colloquially to describe a PGY1 trainee who is not in the first year of a Family Medicine residency program. The term "intern" is not to be confused with 'internist,' which refers to a fully licensed specialist in general internal medicine.
Although the terms 'consultant' and 'attending' are widely used and universally understood, most Canadian trainees refer to their fully licensed preceptors as 'staff' physicians or surgeons.
Clerkship - Level medical students are referred to as 'clinical clerks' or 'senior medical students,' although some name badges use ambiguous language such as 'student doctor.'
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
, a medical school is a faculty or school of a university that trains would-be medical doctors and physician assistants usually offering a 3- or 4-year Doctor of Medicine
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
(M.D. or M.D.C.M.) degree and 2 year Physician Assistant
Physician assistant
A physician assistant/associate ' is a healthcare professional trained and licensed to practice medicine with limited supervision by a physician.-General description:...
degrees. Although presently most students enter medicine having previously earned another degree, the M.D. is technically considered an undergraduate degree in Canada.
Admissions
Generally, medical students begin their studies after receiving a bachelor's degreeBachelor's degree
A bachelor's degree is usually an academic degree awarded for an undergraduate course or major that generally lasts for three or four years, but can range anywhere from two to six years depending on the region of the world...
in another field, often one of the biological sciences. However, not all medical schools in Canada require a bachelor's degree for entry. For example, Quebec
Quebec
Quebec or is a province in east-central Canada. It is the only Canadian province with a predominantly French-speaking population and the only one whose sole official language is French at the provincial level....
's medical schools accept applicants after a two-year CEGEP
Cégep
CEGEP is an acronym for , which is literally translated as "College of General and Vocational Education" but commonly called "General and Vocational College" in circles not influenced by Quebec English. It refers to the public post-secondary education collegiate institutions exclusive to the...
diploma, which is the equivalent of other provinces' grade 12 plus the first year of university. Most faculties of medicine in Western Canada
Western Canada
Western Canada, also referred to as the Western provinces and commonly as the West, is a region of Canada that includes the four provinces west of the province of Ontario.- Provinces :...
require at least 2 years, and most faculties in Ontario
Ontario
Ontario is a province of Canada, located in east-central Canada. It is Canada's most populous province and second largest in total area. It is home to the nation's most populous city, Toronto, and the nation's capital, Ottawa....
require at least 3 years of university study before application can be made to medical school. The University of Manitoba
University of Manitoba
The University of Manitoba , in Winnipeg, Manitoba, Canada, is the largest university in the province of Manitoba. It is Manitoba's most comprehensive and only research-intensive post-secondary educational institution. It was founded in 1877, making it Western Canada’s first university. It placed...
requires applicants to complete a prior degree before admission. The Association of Faculties of Medicine of Canada (AFMC) publishes a detailed guide to admission requirements of Canadian faculties of medicine on a yearly basis. The 2010 guide is available at http://www.afmc.ca/pdf/2010AdBk.pdf
Admission offers are made by individual medical schools, generally on the basis of a personal statement, autobiographical sketch, undergraduate record (GPA), scores on the Medical College Admission Test
Medical College Admission Test
The Medical College Admission Test is a computer-based standardized examination for prospective medical students in the United States and Canada. It is designed to assess problem solving, critical thinking, written analysis, and writing skills in addition to knowledge of scientific concepts and...
(MCAT), and interviews. Volunteer work is often an important criterion considered by admission committees. Medical schools in Quebec
Quebec
Quebec or is a province in east-central Canada. It is the only Canadian province with a predominantly French-speaking population and the only one whose sole official language is French at the provincial level....
(Francophones and Anglophone alike), the University of Ottawa
University of Ottawa
The University of Ottawa is a bilingual, research-intensive, non-denominational, international university in Ottawa, Ontario. It is one of the oldest universities in Canada. It was originally established as the College of Bytown in 1848 by the Missionary Oblates of Mary Immaculate...
(a bilingual school), and the Northern Ontario School of Medicine
Northern Ontario School of Medicine
The Northern Ontario School of Medicine is a medical school in the Canadian province of Ontario, created through a partnership between Laurentian University in Sudbury and Lakehead University in Thunder Bay...
, do not require the MCAT. Some schools, such as the University of Toronto
University of Toronto
The University of Toronto is a public research university in Toronto, Ontario, Canada, situated on the grounds that surround Queen's Park. It was founded by royal charter in 1827 as King's College, the first institution of higher learning in Upper Canada...
and Queen's University
Queen's University
Queen's University, , is a public research university located in Kingston, Ontario, Canada. Founded on 16 October 1841, the university pre-dates the founding of Canada by 26 years. Queen's holds more more than of land throughout Ontario as well as Herstmonceux Castle in East Sussex, England...
, use the MCAT score as a cut-off, where sub-standard scores compromise eligibility. http://www.md.utoronto.ca/admissions/information/faq.htm#mcat http://meds.queensu.ca/undergraduate/prospective_students/method_of_selection Other schools, such as the University of Western Ontario
University of Western Ontario
The University of Western Ontario is a public research university located in London, Ontario, Canada. The university's main campus covers of land, with the Thames River cutting through the eastern portion of the main campus. Western administers its programs through 12 different faculties and...
, give increasing preference to higher performance http://www.schulich.uwo.ca/education/admissions/medicine/documents/FAQs20080930.pdf. McMaster University
McMaster University
McMaster University is a public research university whose main campus is located in Hamilton, Ontario, Canada. The main campus is located on of land in the residential neighbourhood of Westdale, adjacent to Hamilton's Royal Botanical Gardens...
strictly utilizes the Verbal Reasoning section of the MCAT to determine interview eligibility and admission rank. http://www-fhs.mcmaster.ca/mdprog/selection_process.html
The annual success rate for Canadian citizens applying for admission to Canadian medical schools for the academic years 2001/02 to 2005/06 ranged from 26.3% to 29.2%. http://www.afmc.ca/pages/publications_admission.html Just over 2500 positions were available in first-year classes in 2006/07 across all 17 Canadian faculties of medicine. The average cost of tuition in 2006/07 was $12,728 for medical schools outside of Quebec; in Quebec (for Quebecers only), average tuition was $2943. The level of debt amongst Canadian medical students upon graduation has received attention in the medical media. http://www.cmaj.ca/cgi/content/full/169/5/457 http://www.cma.ca/index.cfm?ci_id=10026669&la_id=1
Curriculum
Medical school in Canada is a 4-year program at most universities. Notable exceptions include McMaster UniversityMcMaster University
McMaster University is a public research university whose main campus is located in Hamilton, Ontario, Canada. The main campus is located on of land in the residential neighbourhood of Westdale, adjacent to Hamilton's Royal Botanical Gardens...
and the University of Calgary
University of Calgary
The University of Calgary is a public research university located in Calgary, Alberta, Canada. Founded in 1966 the U of C is composed of 14 faculties and more than 85 research institutes and centres.More than 25,000 undergraduate and 5,500 graduate students are currently...
, where programs run for 3 years, without interruption for the summer. The first half of the medical curriculum is dedicated mostly to teaching basic subjects relevant to medicine, such as anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...
, physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
, pharmacology
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...
, genetics
Genetics
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....
, microbiology
Microbiology
Microbiology is the study of microorganisms, which are defined as any microscopic organism that comprises either a single cell , cell clusters or no cell at all . This includes eukaryotes, such as fungi and protists, and prokaryotes...
, ethics
Medical ethics
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.-History:Historically,...
, and epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
. This instruction can be organized by discipline or by organ system. Teaching methods can include traditional lecture
Lecture
thumb|A lecture on [[linear algebra]] at the [[Helsinki University of Technology]]A lecture is an oral presentation intended to present information or teach people about a particular subject, for example by a university or college teacher. Lectures are used to convey critical information, history,...
s, problem-based learning
Problem-based learning
Problem-based learning is a student-centered pedagogy in which students learn about a subject in the context of complex, multifaceted, and realistic problems...
, laboratory sessions, simulated patient
Simulated patient
A simulated patient, standardized patient or sample patient , in health care, is an individual who is trained to act as a real patient in order to simulate a set of symptoms or problems. Simulated patients have been successfully used in medical education, nursing education, evaluation, and...
sessions, and limited clinical experiences. The remainder of medical school is spent in clerkship. Clinical clerks
Medical clerkship
In medical education, a clerkship, or rotation, refers to the practice of medicine by medical students during their latter years of study. Usually, the first half of medical school trains students in the classroom setting, and the second half takes place in a teaching hospital...
participate in the day-to-day management of patients. They are supervised and taught during this clinical experience by residents and fully licensed staff physicians
Attending physician
In the United States, an attending physician is a physician who has completed residency and practices medicine in a clinic or hospital, in the specialty learned during residency. An attending physician can supervise fellows, residents, and medical students...
. Typical rotations include internal medicine
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...
, family medicine
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...
, psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
, surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, emergency medicine
Emergency medicine
Emergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...
, obstetrics and gynecology, and pediatrics
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
. Elective rotations are often available so students can explore specialties of interest for residency training
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
.
Some medical schools offer joint degree programs in which a limited number of interested medical students may simultaneously enroll in M.Sc. or Ph.D.
Ph.D.
A Ph.D. is a Doctor of Philosophy, an academic degree.Ph.D. may also refer to:* Ph.D. , a 1980s British group*Piled Higher and Deeper, a web comic strip*PhD: Phantasy Degree, a Korean comic series* PhD Docbook renderer, an XML renderer...
programs in related fields. Often this research training is undertaken during elective time and between the basic science and clinical clerkship halves of the curriculum.
Post-graduate medical education
Students enter into the Canadian Resident Matching Service (CaRMS) in the fall of their final year. Students rank their preferences of hospitals and specialties. In turn, the programs to which they applied rank each student. Both sets of rank lists are confidential. Each group's preferences are entered into a computerized matching system to determine placement for residency positionsResidency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
. 'Match Day' usually occurs in March http://www.carms.ca/eng/operations_future_match_e.shtml, a few months before graduation. The length of post-graduate training varies with choice of specialty. Family medicine is a 2 year program accredited by the College of Family Physicians of Canada
College of Family Physicians Canada
The College of Family Physicians of Canada is a professional association and the legal certifying body for family medicine in Canada. This national organization of family physicians was founded in 1954 and currently numbers over 25,000 members....
(CFPC), and third year programs of residency training are available in various areas of practice, including Emergency Medicine, Maternal/Child, Care of the Elderly, Palliative Care or Sports Medicine. All other medical specialty residencies are accredited by the Royal College of Physicians and Surgeons of Canada
Royal College of Physicians and Surgeons of Canada
The Royal College of Physicians and Surgeons of Canada ' , French: Collège royal des médecins et chirurgiens du Canada, is a national, private, nonprofit organization established in 1929 by a special Act of Parliament to oversee the medical education of specialists in Canada...
; most are 5 years long. Internal medicine
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...
and pediatrics
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
are 4-year programs in which the final year can be used to complete a fellowship
Fellowship (medicine)
A fellowship is the period of medical training in the United States and Canada that a physician may undertake after completing a specialty training program . During this time , the physician is known as a fellow...
in general internal medicine or general pediatrics, or used towards a longer fellowship
Fellowship (medicine)
A fellowship is the period of medical training in the United States and Canada that a physician may undertake after completing a specialty training program . During this time , the physician is known as a fellow...
(e.g., cardiology
Cardiology
Cardiology is a medical specialty dealing with disorders of the heart . The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology...
). A few surgical residencies, including cardiac surgery
Cardiac surgery
Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...
, neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
, and some general surgery
General surgery
General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, soft...
programs, last 6 years. Subspecialty fellowships
Fellowship (medicine)
A fellowship is the period of medical training in the United States and Canada that a physician may undertake after completing a specialty training program . During this time , the physician is known as a fellow...
are available after most residencies. Family medicine programs often offer an optional third year of training in such fields as emergency medicine and care of the elderly (as opposed to Geriatrics
Geriatrics
Geriatrics is a sub-specialty of internal medicine and family medicine that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician, or...
, which is a subspecialty of internal medicine).
There are subtle differences between how residency training is organized in Canada as opposed to the United States. For example, M.D. graduates proceed directly into their residencies without the intermediate step of internship. However, this difference is somewhat superficial: for many residencies, the first postgraduate year (PGY1) in Canada is very similar to a rotating internship, with 1-2 month-long rotations in diverse fields. On the other hand, in Canada the graduate is often committed to a subspecialty earlier than a similar American graduate.
Some subspecialties are organized differently. For example, in the United States, cardiac
Cardiac surgery
Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...
and thoracic surgery
Thoracic surgery
Thoracic surgery is the field of medicine involved in the surgical treatment of diseases affecting organs inside the thorax . Generally treatment of conditions of the lungs, chest wall, and diaphragm....
are rolled into one fellowship (cardiothoracic surgery
Cardiothoracic Surgery
Cardiothoracic surgery is the field of medicine involved in surgical treatment of diseases affecting organs inside the thorax —generally treatment of conditions of the heart and lungs .-Cardiac / Thoracic:...
) following residency in general surgery
General surgery
General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, soft...
. In Canada, cardiac surgery is a direct-entry residency (equivalent training can be obtained by pursuing a cardiac fellowship following residency in general surgery, but this route is far less popular). A fellowship in thoracic surgery can be pursued following residency in either cardiac or general surgery.
Unlike the United States and United Kingdom, in Canada there are no national guidelines for residents' call schedules or work hours. However, each province in which residency training takes place negotiates such details as part of a collective agreement between the authority and the provincial professional association of residents. An example of this is the Provincial Association of Internes and Residents of Ontario (http://en.wikipedia.org/wiki/Professional_Association_of_Internes_and_Residents_of_Ontario).
Continuing medical education
Both Canadian specialty colleges participate in mandatory continuing medical educationContinuing medical education
Continuing medical education refers to a specific form of continuing education that helps those in the medical field maintain competence and learn about new and developing areas of their field. These activities may take place as live events, written publications, online programs, audio, video, or...
(CME) schemes. Examples of CME activities include attendance at conferences, participating in practice-based small group learning, and taking courses such as advanced cardiac life support
Advanced cardiac life support
Advanced cardiac life support or Advanced Cardiovascular Life Support refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.Extensive medical knowledge...
.
The CFPC program for family physicians is called MAINPRO, short for 'Maintenance of Proficiency.' A certain number of credits must be obtained over 5 year cycles. There are different classes of credits depending on whether the CME activity is considered accredited (e.g., attending accredited workshops or conferences) or non-accredited (e.g., teaching medical students, preparing research papers for publication, reading scholarly journals).
The Office of Professional Affairs of the RCPSC is responsible for a mandatory maintenance of certification (MOC) program as part of its strategy of continuous professional development linked to each Fellow’s professional practice. The framework of CPD options includes a broad spectrum of learning activities linked to a credit system. All Fellows submit their completed learning activities through MAINPORT, the RCPSC learning portfolio. Fellows of the RCPSC must submit a minimum number of credits per year (40 credits) and over a 5-year cycle (400 credits) to maintain their membership with the Royal College and their right to use the designation FRCPC or FRCSC.
That instead gives way to more time.
Evaluation
During the final year of medical school, students complete part 1 of the Medical Council of Canada Qualifying ExaminationMedical Council of Canada Qualifying Examination
The Medical Council of Canada Qualifying Examination is a two part professional exam sponsored by the Medical Council of Canada. It is an essential part of becoming a Licentiate of the Medical Council of Canada ....
(MCCQE), which is administered by the Medical Council of Canada
Medical Council of Canada
Medical Council of Canada ' is an organization that is charged with assessing medical candidates, evaluation of physicians through exams and granting a qualification called Licentiate of the Medical Council of Canada to those who wish to practice medicine in Canada.MCC is governed by a 51-member...
and organized as a part-multiple choice, part-short answer computer-adaptive test
Computer-adaptive test
Computerized adaptive testing is a form of computer-based test that adapts to the examinee's ability level. For this reason, it has also been called tailored testing.-How CAT works:...
. Upon completion of the final year of medical school, students are awarded the degree of M.D. Students then begin training in the residency program designated to them by CaRMS. Part 2 of the MCCQE, an Objective Structured Clinical Examination
Objective Structured Clinical Examination
An Objective Structured Clinical Examination is a modern type of examination often used in health sciences...
, is taken following completion of 12 months of residency training. After both parts of the MCCQE are successfully completed, the resident becomes a Licentiate of the Medical Council of Canada
Licentiate of the Medical Council of Canada
Licentiate of the Medical Council of Canada, commonly abbreviated as LMCC, is a physician that has either:* Before 1 January 1992: Passed Medical Council of Canada Qualifying Examination Part 1 and has completed successfully one year of postgraduate training or the MCCQE Part 2* After 1 January...
. However, in order to practice independently, the resident must complete the residency program and take a board examination pertinent to his or her intended scope of practice. In the final year of residency training, residents take an exam administered by either the RCPSC or the CFPC, depending on whether they are training for specialty or family practice. They are then eligible to apply for full licensure with their provincial or territorial medical regulatory authority (i.e., provincial college).
Accreditation
Together with the Canadian Medical AssociationCanadian Medical Association
The Canadian Medical Association , with more than 70,000 members, is the largest association of doctors in Canada and works to represent their interests nationally. It formed in 1867, three months after Confederation...
(CMA), the AFMC carries out accreditation surveys and rules on the accreditation status of all of the undergraduate medical programs in Canada, as well as all university-based continuing medical education. The Liaison Committee on Medical Education
Liaison Committee on Medical Education
The Liaison Committee on Medical Education is an accrediting body for educational programs at schools of medicine in the United States and Canada. The LCME accredits only the schools that grant a doctor of medicine degree; osteopathic medical schools are accredited by the Commission on...
, jointly administered by the Association of American Medical Colleges
Association of American Medical Colleges
The Association of American Medical Colleges is a non-profit organization based in Washington, DC and established in 1876. It administers the Medical College Admission Test...
and the American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
, also accredits Canadian medical schools. The M.D. and M.D.C.M medical degrees are the only medical degrees offered in Canada listed in the WHO/IMED list of medical schools.
Research in Canadian Medical Schools
Research is increasingly an integral part of Canadian medical education at each of the undergraduate, post-graduate, and independent practice stages of a doctor's medical career. The CanMEDS program of the RCPSC identified 'Scholar' as one of the 7 integral roles a competent physician plays.But most research in Canadian faculties of medicine is performed not by clinicians, but by professors of the basic sciences relevant to medicine and their graduate students and post-doctoral fellows.
Often these researchers obtain funding from the Canadian Institutes of Health Research
Canadian Institutes of Health Research
Canadian Institutes of Health Research is the major federal agency responsible for funding health research in Canada. It is the successor to the Medical Research Council of Canada. It aims to create new health knowledge, and to translate that knowledge from the research setting into real world...
, or from private sources such as pharmaceutical companies.
Language
In Canada, physician training is available in both official languages: English and French.As in the United States, postgraduate trainees are referred to as 'residents,' not 'registrars.' Occasionally the word 'intern' is used colloquially to describe a PGY1 trainee who is not in the first year of a Family Medicine residency program. The term "intern" is not to be confused with 'internist,' which refers to a fully licensed specialist in general internal medicine.
Although the terms 'consultant' and 'attending' are widely used and universally understood, most Canadian trainees refer to their fully licensed preceptors as 'staff' physicians or surgeons.
Clerkship - Level medical students are referred to as 'clinical clerks' or 'senior medical students,' although some name badges use ambiguous language such as 'student doctor.'