Back to the Future: Our Early Entry to Medical School Program (QuARMS)

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What’s True and What’s Not

The School of Medicine is currently in the process of accepting applications for a two year, entry level educational initiative which, if successfully completed, would lead to admission to the first year of the MD Program. This initiative, dubbed QuARMS (Queen’s University Accelerated Route to Medical School) by governance committee co-chair Dr. Mike Kawaja, would be the only one of its kind in Canada. Students admitted to QuARMS in September 2013 would enter the MD Program, if successful, in September 2015, joining the class of Meds 2019.

Although it would be unique in Canada, this approach is certainly not novel. In fact, direct entry is the most common approach in many parts of the world, including Australia and most European nations. North American medical schools, including Queen’s, admitted students directly from high school until the early 1970’s. The factors that led to a shift to delayed entry included the increasing demand for medical school positions, the increasing emphasis on basic science preparation, and the demise of common examinations at the secondary school level.

This initiative, which has been under development for approximately two years, has attracted considerable attention across the country and has raised a number of questions among our student body. This led to a very well attended Town Hall recently during which Dr. Hugh MacDonald (QuARMS governance committee co-chair) and I answered a number of questions and accepted a number of very helpful insights. It was suggested that it would be appropriate to follow up that discussion with a newsletter to the entire student body to provide further clarification. I thought it might be best to structure this as a number of questions that seem to be arising repeatedly, and to make it available to faculty as well as students.

1) How many students will be admitted?

A maximum of ten students will be admitted each year. They will be part of the 100 ministry funded positions and not increase the overall class size.

2) How will they be selected?

The application process is linked with two scholarship programs, the Queen’s University Chancellor’s Scholarship and the Loran Scholarship. The Chancellor’s scholarship program invites every high school in Canada to nominate a student who has demonstrated a combination of academic accomplishment and community involvement. This is a well-established program. We are inviting students applying to that program to indicate interest in QuARMS. The Loran scholarship is a national level high profile scholarship which provides undergraduate funding for students who demonstrate a similar combination of academic accomplishment, social awareness and community involvement. These applicants will be similarly invited to apply to QuARMS. From these two sources, a group of 50 candidates will be invited to Queen’s for a series of interviews and encounters with faculty and students that will result in a ranking list that will be used to guide offers of admission.

3) What program will these students undertake?

These students will undertake a two year program with a combination of courses, seminar work and community projects. The intention is provide these students foundations in all of the component competencies that we recognize as essential to the practice of medicine and which are developed within the MD Program. This provides an opportunity to develop a premedical curriculum which is more relevant, integrated and linked to the MD Program. It also provides an opportunity for these students to learn in what we believe will be a more effective manner and one more consistent with the collaborative and lifelong learning that will required of them as physicians.

4) Is there an intention for this program to grow beyond these ten students and to replace our standard application process?

No. We recognize that it is the uncommon student who is sufficiently aware at the high school level to make a valid career decision regarding medicine. We do not wish to close off medical school to individuals who come to that decision later in life.

5) Who will oversee this program?

A governance committee has been established and co-chaired by Dr. Hugh MacDonald of the Department of Surgery and Dr. Michael Kawaja of the Department of Biomedical Science. Dr. Jennifer MacKenzie is in charge of the curriculum and is a member of the governing committee. Other members of the governing committee include the Associate Dean for Undergraduate Medical Education, three faculty members and two students.

6) Will all students in this program “automatically” enter medical school?

Students within this program will have to be academically successful and meet standards established by the governance committee. If they meet those standards they will enter the first year of the MD Program after two years. We anticipate that some students will either not achieve those standards or decide in the course of this program to undertake an alternative career.

7) Why are we doing this?

I feel there are a number of advantages to this initiative.

  1. A small number of students are aware and ready to undertake medical training early. We believe this provides them an opportunity to complete their training in a shorter period of time.
  2. This initiative addresses, to some extent, the socioeconomic disparities in admission to medical school in that it provides entry after a shorter period of time with less overall expense. We hope this will make medical education available to students who might not otherwise consider the option.
  3. It provides an opportunity to develop a premedical education that is more appropriate and aligned to medical school without the highly competitive and stressful environment that sometimes accompanies premedical education.
  4. It provides an opportunity to begin the development of core qualities and competencies essential to medical practice such as collaboration, communication and lifelong learning, qualities that are sometimes challenging to provide for students who have come through a traditional premedical education.

This is, and will remain, a controversial undertaking. It represents a significant break from convention and is somewhat uncharacteristic of a school that has tended to avoid controversy, and been described by some as being “on the leading edge of tradition”. In the final analysis, the leadership of our school and most faculty and students comprising it’s main decision making body felt that the potential of this rather bold and “back to the future” approach outweighed the risks and effort required. Appropriately, it was a characteristically medical “risk/benefit” analysis that carried the day. So, let’s buckle up, we’re in for an interesting ride.

Anthony J. Sanfilippo, MD, FRCP(C)
Associate Dean,
Undergraduate Medical Education

4 Responses to Back to the Future: Our Early Entry to Medical School Program (QuARMS)

  1. Sean says:

    Was any consideration put into the the socio-emotional effects of the program on the students admitted? For example, is there not a possibility that the classmates of these 10 individuals who are also vying for medical school would show contempt to these students, or consider them elitists? What about the undergraduate medical students, whose ages range from 21-26, who are all of a sudden in a class with this special group of 19 year olds? And can you guarantee that this group of 10 won’t feel incredibly overwhelmed about being so young in a professional program without the maturity and worldliness that an undergraduate degree provides?

    I wish the Town Hall on this had been better announced.
    Thank you!

    • M. Ruth (Bell) Tatham says:

      I entered Queen’s Meds in Sept. 1948; my 18th birthday had been in August, three weeks earlier. About a third of my class was comprised of WWII veterans, most of whom were nearly 10 years senior in age to me. Was that overwhelming? There were five girls in my class. All of us practiced medicine after graduation, after at least four years of post-grad study, and our academic histories through all this were good to excellent. NOONE during those 10 or so years made me feel I was held in “contempt”, nor have I since felt that. Indeed, I have retained a close and warm relationship with many of them, young and old.
      I spent a total of five years in Public School, the first two in a one-room village school.
      All in all, Sean (et alia) it’s what and who you are that makes a good physician, as long as you are exposed to a well-rounded education from socially-conscious mentors, throughout..have a sense of humour, and love your work. MRT

      • Thanks Rurth, for sharing that experience and perspective. Although my class (Meds ’81) entered after the premed program, students could apply after two undergraduate years, and so our class was split between those younger students and the rest who’d completed primary or advanced degrees. It’s never been an issue, and we’ve enjoyed the same experience and continuing closeness you describe.

    • Hello Sean, and thanks for your candid commentary. Certainly we gave considerable thought to what you describe as the “socio-emotional” impacts. In the final analysis, we recognize that our classes have always been very diverse, including students with backgrounds ranging from 3 years of undergraduate humanities to advanced degrees in very specialized fields of science. This diversity, I believe, has only enriched our classes. I believe the qualities we select in our medical students will promote inclusion and acceptance rather than “contempt” for people from diverse backgrounds. Finally, I can no more “guarantee” that these students won’t be overwhelmed than I can for any medical student, but I can assure you that we will be very scrupulous in our selection processes and I doubt that chronological age will be the main cause if problems do arise.

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