It (still) Takes a Village

How we do what we do.

One of the greatest challenges we face in the accreditation process is convincing the outside world that we’re actually doing what we claim to be doing.  Accrediting councils and review teams, themselves made up of medical school Deans and Associate Deans, are well aware of the needs and challenges involved in recruiting committed and capable faculty leaders.  They recognize that our needs in this regard are no less than that of much larger schools, and have trouble reconciling that reality with the number of core academic faculty.

With that in mind, it’s useful to periodically review our governance structure and recognize those who provide key leadership in all the various domains required of a fully functioning medical school.

I last did this about a year ago.  At that time, I provided an article on this site describing the various positions and people who are so integral to the growth and ongoing quality of our MD program.  The past year has brought changes to our MD Program leadership structure, both in terms of its organization and faculty assignments.  In fact we’ve carried a rather extensive review of our governance structures and key responsibilities, recently reviewed and approved by School of Medicine Council.  It seems an appropriate time to review both and update all our faculty and students.

In terms of overall organization, we have developed a number of key leadership positions, termed Directorships.  Each of these carry responsibility for a discrete component essential to the overall mission of the program.  The general responsibilities are described below.

directorships

In many cases, Directorships have evolved from positions that existed previously, but in different forms.  Many were previously described simply as committee chairs.  It’s become clear over the years that the scope of responsibility and need for ongoing oversight has gone far beyond simply chairing a monthly meeting.  The Director designation is a more appropriate recognition of the effort, expertise and scope of responsibility required.  So, with that introduction, we’ll review these positions.

H_Macdonald_7472_

Director, Undergraduate Admissions

The complexity of our admissions process has increased dramatically over the past several years.  In addition to the 4300-plus applications to our MD Program, the Admissions Committee now has additional responsibility for admissions to our MD-PhD, QuARMS and International programs.  Each brings its unique challenges, and continuing scrutiny to ensure they reflect appropriate values and fairness to all applicants.  Hugh MacDonald has chaired our Admissions Committee for several years through these transitions, and I’m most grateful that he will be continuing in the Directorship role.

Director, Accreditation

The oversight and guidance of our accreditation related efforts is a continuous responsibility, that will be escalating as we move toward our full survey in March of 2015.  In addition to guiding our local processes, that individual serves as our representative at national and international accreditation committees. John Drover has been capably filling that role for the past 3 years and will be continuing to do so.

Director, Student Assessment

Michelle Gibson has recently assumed this role, previously carried out capably by Sue Chamberlain.  This Director is responsible for establishing policies, processes and oversight of all assessment activities within our program.  Having recently completed her Masters in Education, Michelle brings considerable expertise and practical experience to this role.

Director, Teaching, Learning and Innovation

Screen Shot 2013-05-24 at 3.57.52 PMPerhaps the biggest change (and challenge) undertaken by our faculty over the past few years has been the introduction of new and innovative teaching methodologies.  Our Director of Teaching, Learning and Innovation (and committee) are responsible for developing policy, processes and oversight that will guide the introduction and delivery of teaching methods.  We have also charged that group with developing methods to assist faculty in realizing scholarship opportunities as they provide their teaching.  Lindsay Davidson will bring a wealth of knowledge, experience and innovative energy to that position.

Screen Shot 2013-05-24 at 4.08.16 PMDirector, Course and Faculty Review

Over the past few years, we have developed a comprehensive process for continuing review of all our curricular courses.  We are in the process of expanding that process to provide more targeted and relevant feedback to all teaching faculty.  Andrea Winthrop has been integral to this process and will be continuing as Director.


Director, Student Affairs

One of the key changes involved in this governance renewal has been to develop a position that would provide oversight and coordination to our Student Wellness/Counseling, Career Counseling and Academic Counseling portfolios.  I’m very pleased that Renee Fitzpatrick has taken on this challenge and is already developing proposals to augment our Learner Wellness program.

vanwylickDirector, Student Progress, Promotion and Remediation

This complex and critical portfolio requires a combination of astute administrative skill and sensitivity to the needs many needs of students who struggle with various challenges.  Richard VanWylick has been chairing our P&P Committee with great skill for several years, and will be taking on this Directorship, which better recognizes the expertise and effort required.

In addition to these largely administrative roles, a number of Directorships are required to provide programmatic leadership;

Director, Year 1

The first year of our program introduces our students to a wide variety of material including Basic Science, introductory clinical medicine, Clinical and Communication Skills, Professional Competencies and Facilitated Small Group Learning.  It is also a time of considerable personal and professional growth for our students, during which they evolve their learning and interpersonal skills.  Michelle Gibson has been guiding Year 1 through our curricular transition process and, I’m pleased to say, will be continuing in this role.

blog-murrayDirector, Year 2

In second year, our students undertake more intensive learning within clinical medicine.  They are expected to not simply learn facts about various conditions, but to integrate that knowledge into cogent approaches to patient problems.  To do so, they undertake more small group approaches, more challenging FSGL cases, advanced Clinical and Communication Skills program, and integrated Professional Competencies.  Heather Murray, who has been active in the development of Scholarship in the curriculum, and its integration into Clinical Presentation courses, is very well suited to this role, and will be taking over from Lindsay Davidson who has been guiding Year 2 through our transition.

Director, Clinical and Communication Skills

This program, which runs through the first two years of our curriculum, is key to the development of our students as physicians.  It has benefitted over the years from the leadership of Sue Moffatt and Henry Averns.  The role requires a high level organizational and educational expertise.  I’m very pleased that Cherie Jones took on this role last year and has already brought considerable innovation to the both educational and assessment components.  Cherie would wish me to mention that components of the program are ably coordinated by a team of dedicated Course Directors, including Basia Farnell, Hoshi Abdollah, Laura Milne and Lindsey Patterson.

moffattDirector, Clerkship Curriculum

One of the major benefits of our curricular reform was to expand the clinical clerkship in a manner that would allow for the provision of three blocks within the clerkship dedicated to formal education on a variety of advanced clinical and professional topics.  Susan Moffatt has developed and coordinated the curriculum for those blocks, with capable assistance from Armita Rahmani and Chris Parker.  Sue’s dedication and extensive educational knowledge are evident in the quality of those blocks.

Director, Clerkship Rotations

Our clerkship consists largely of a series of clinical placements in the major clinical disciplines.  Although largely in Kingston, clerkship rotation options have been expanded dramatically over the past several years, to both expand our teaching capacity, and provide students experience in various contexts and systems. These include our Integrated Community Clerkships (in Perth, Picton, Brockville and Prescott), as well as rotations in Belleville, Oshawa, Markham and even Brisbane, Australia.  In addition, our students undertake about 18 weeks of Electives during the clerkship, intended to allow for career exploration and self-directed learning.  The coordination of these all these options requires a high level of organizational skill, sensitivity to student needs and attention to detail.  Andrea Winthrop has been very effectively coordinating and expanding this program since her return to Queen’s a few years ago.

Screen Shot 2013-05-24 at 4.17.46 PMCo-Director, QuARMS Program

Jennifer MacKenzie has developed and directed a de novo pre-medical curriculum for our QuARMS program which is highly creative, delivering competency based learning in a variety of creative teaching formats.  This program, and Jennifer’s continued oversight, will be key to the success of this exciting new initiative.

wilsonChair, Professional Competencies Committee

Ruth Wilson has generously taken on the considerable challenge of chairing our Professional Foundations Committee and coordinating the efforts of our Competency Leads.  Her steady leadership has guided and promoted the development and integration of those essential components of our curriculum.

In addition to these positions, our program relies on the contributions of about 40 Course Directors, Competency Leads and Discipline Coordinators.  These key people are listed in our MD Program Directory, which can be accessed here.

So how does all this fit together?  Most Directors work with committees that are charged with the various areas of responsibility, as well as the accreditation standards that relate.  Our MD Program Executive Committee brings together all the committees and Directors to provide integrated program governance.  The graph below illustrates these relationships and reporting structures.

MD-Program

In developing these positions, committees and organizational relationships, the underlying principle has been that “form follow function”.  Each one, with it’s associated responsibilities and inter-relationships, arises from a need based on the mission of our school – to prepare our students for success in postgraduate training and in their ongoing careers as highly successful and effective physicians.  In doing so, we’re guided by our need to meet and exceed all medical school accreditation standards.

Achieving this, as well as all the other varied tasks required to operate our medical school requires tremendous dedication and commitment on the part of our faculty, which has never been lacking.  Three examples:

  • A need arose last Fall for people to chair our Accreditation Self-Study Sub-committees.  Those who came forward to provide fill these valuable roles are among the busiest people in our school: Leslie Flynn (Vice-Dean, Education), Iain Young (Vice-Dean, Academic Affairs), Stephen Archer (Head, Department of Medicine), Michael Adams (Head, Biomedical and Molecular Sciences), and Karen Smith (Associate Dean, Continuing Professional Development).
  • This term we are offering a re-vamped Term 4 Clinical Skills curriculum that provides full patient encounters with groups of two students observed and tutored by a two faculty members.  This has been creatively developed by Course Directors Hoshiar Abdollah and Laura Milne, and involves no less than 50 faculty members, 37 of whom are members of the Department of Medicine.  We have had full support of the Departments and their leadership in this initiative.
  • Our Admissions committee and administrative support personnel process increasing number of applications each year, and have developed increasingly complex methodologies to review those applications.  The committee itself, document reviews, MMIs and panel interviews require the active participation of about 160 faculty members, who give of their free time to assist in ensuring all applications are reviewed thoughtfully and fairly.  They work side by side with members of our first and second year classes, almost all of whom contribute to the process in various ways.

What’s the motivation of all these people: building a better school – their school – in which they are valued members, and in which they take pride.

A village indeed, and an impressive expression of our collective dedication to the education of our students.

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

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Singing the praises of our unsung heroes: Curricular Leaders in UGME

In our world of big names, curiously, our true heroes tend to be anonymous. In this life of illusion and quasi-illusion, the person of solid virtues who can be admired for something more substantial than his well-knownness often proves to be the unsung hero: the teacher, the nurse, the mother, the honest cop, the hard worker at lonely, underpaid, unglamorous, unpublicized jobs.

–Daniel J. Boorstin, US historian

I’d like to devote this blog article to talking about the props of our curriculum and program:  our Curricular Leaders.

And I’d like to feature some resources, especially the new Course Directors’ Community as a place for those leaders to find some support (https://meds.queensu.ca/central/community/coursedirectors)

A few weeks ago, on January 10, our Course Directors, Competency Leads, Year Directors and other curricular leaders took part in our semi-annual Curricular Leaders’ Retreat.  We had an action packed day, with workshops that actually included work time, with 10 different options throughout the day from which people could choose as well as 2 plenary sessions and a Be Tech Savvy, Teach Savvy finale.  The topics were: Narrative Feedback for Clerks, Ideas for SGL, Blueprinting your Course, Building a Quality Exam, Poll Everywhere, Remediation, Evaluating Complexity of Cases, Graded Team Assignments, Teaching Diagnostic Reasoning in Pre-Clerkship, and Presentations on Med Ed research colloquia.  We had lots of food, lots of breaks for discussion, and (I hope) lots of fun!  The slides, handouts and everything else from the day are posted on MEdTech in the Faculty Resources Community at https://meds.queensu.ca/central/community/facultyresources:retreats/january_10_2014

 
Dr. Sanfilippo kicked things off with a report that included some very telling videos:  Lucy and Ethel at the Chocolate Factory (http:/http:/www.youtube.com/watch?v=8NPzLBSBzPI), Spinning Plates while balancing on a ball (and jumping rope), http://www.youtube.com/watch?v=R3J-2UEPpPM and of course the iconic scene where the crew tries to turn the Titanic from the iceberg: “Why isn’t it turning?!”.  http://www.youtube.com/watch?v=78W-J3tpL6s

Lucy-Chocolate-Factory

The theme, of course, is the challenge of the role of the Curricular Leader—the art of coping with faster and faster deadlines, the skill of balancing and juggling clinical work, research and academic work, the delicate tension of steering a team and a curriculum and moving in time to avoid program icebergs.

This is the role of the unsung hero—the ordinary individual who finds the strength to persevere and triumph in the face of obstacles that may seem overwhelming.

It’s important to know that our curriculum runs as well as it does because of our 37 Course Directors, 6 Competency Leads, 10 Directors, 5 additional Committee Chairs, 3 Integrated Clerkship Site Leads, 8 Regional Clerkship Discipline Reads and 3 Learner Advocates in Regional Education.   And an Associate Dean extraordinaire, too!

Our Course Directors have a new role description.  In addition to carrying out the specific roles of clerkship or preclerkship Course Directors, there are these 10 general roles:

  1. Provide orientation to and mentoring of new faculty members, ensuring cohesion of all course teaching/assessment.
  2. Ensure that the assigned course objectives are taught within the course.
  3. Review sessional content and ensure that there is appropriate integration among the learning events within the course and with other courses as applicable.
  4. Ensure that teaching methods are varied and appropriate to the course objectives in accordance with the Teaching Methodology Policy (CC-10)
  5. Ensure that assessment strategies are in accordance with the Student Assessment Committee Policy (SA-05) and the Student Assessment Practices and Procedures.
  6. Oversee the course, provide content for the course’s Web site and review the Web site, ensuring that the information on it is correct.
  7. Complete the course review process with the Course and Faculty Review Committee.
  8. Engage in professional development.
  9. Identify faculty development needs in the course through the CFRC course directors’ survey and to the Educational Development Team and Year Director.
  10. Identify information and resources relevant to courses.

The full UG Course Directors’ Role Description can be found on our new Course Directors’ Community at https://meds.queensu.ca/central/community/coursedirectors:course_director_role_description

It’s one thing to state the roles in a document; it’s another to enact them.  At the last retreat, curricular leaders had asked for some time to network, and to give each other tips about being a Course Director or Competency Lead.  We were able to build this into the retreat, and half an hour later, we have some results to show you.

Here are the Tips and Traps curricular leaders shared with each other at our recent retreat.

retreat 1

Tips:

  • Develop objectives for themes, such as oncology, throughout curriculum, as it spans from 1st to 4th year
  • Use MEdTech:  Curriculum Search Function and other functions will let you see what is covered in other courses, which allows building on previously taught material and avoidance of unnecessary overlap
  • Use keywords or tags to ensure all material gets picked up in a MEdTech search
  • Ask for help – you will get it!  Communicate.  The Education Team (Sheila Pinchin, Eleni Katsoulas, Theresa Suart and Alice Rush-Rhodes) will come to sessions, help you plan, search for links, etc.  Your Program Assistants and Curricular Coordinators will also help in many ways.
  • Your course should have defined goals, objectives, curricular content and you should an overall picture of your course and related curricular components
  • Remember your courses/clerkship rotations are not designed for becoming a specialist in that discipline; breadth and depth need to be appropriate
  • Deal with student issues personally and quickly (professionalism & ethics)
  • Balance between micromanaging and some flexibility
  • Assessment Tips:  Write exams before course starts and tweak as needed; Blueprint immediately after course is completed
  • Use team work to design (or redesign) the curriculum—to have objectives assigned to your course, to link to other parts of the curriculum, to integrate competencies, interprofessionalism, etc within your course

The Integrated Clerkships contributed these specific ideas, but they’re actually useful for all courses:

  • Be guided by expressed student needs
  • Students enjoy exposure to other disciplines
  • Find great teachers and keep them enthusiastic
  •  Expose students to real professional dilemmas (but don’t overwhelm them), e.g. ethical issues re EOL conversation
  •  Expose students to ethical interaction w/ industry (relate to C Courses)

 “Traps”

  • Micromanaging;  rigidity, square pegs and round holes
  •  Communication—try hard to communicate with other course directors, with Ed Team, with faculty in your course, with students, with MEdTech, with Curricular Coordinators…
  • Not being able to see the big picture, i.e. what is concurrent, before & after in the curriculum
  • Time management for prep and delivery is more extensive than originally thought
  • If the work is unrealistic, it is unrealistic. Tell someone you cannot make the deadline. There may have been an error.
  • Relative & accidental invisibility of good programming (Eg. History of medicine, often ignored in accreditation)
  • Some patient-based issues get accidentally ghetto-ized, eg. (1) women in repro only (2) palliative care for oncology cancer only

The Integrated Clerkships have these concerns:

  • Work on faculty appointment which can be somewhat obstructive for some community MD’s willing to teach
  • Work on overextending expectations of a community, esp. with student wellness
  • Being overly-exposed to a particular [ethical] agenda
  • Ensure the sessions are aligned with Curricular Objectives
  • Ensure interdisciplinary objects are understood and taught

retreat 2

Now that this list has been compiled, it will go to our Associate Dean. There are some solutions already present through MEdTech, the Curricular Coordinators, the UG Educational Team, the Office of Learner Wellness, Bracken Library of Health Sciences, the Curriculum and Program Committees which are some of the resources that curricular leaders (and all faculty) can access.  We are also ably supported by the Office of Regional Education, the Office of Faculty Development, the Office of Interprofessional Education, and the Office of Health Sciences Education.

One resource is the new community for Course Directors built by the UG Educational Team.  It’s at https://meds.queensu.ca/central/community/coursedirectors

Courese Director 2014-01-20 at 9.33.22 AM

It contains information we’ve gleaned from interviewing Course and Year Directors, from  experience, and from consulting medical education literature.

One section we compiled with the help of Dr. Sue Moffatt contains the Course Director Checklists organized into Before, During and After the Course: https://meds.queensu.ca/central/community/coursedirectors:course_director_checklist

You may also find the Assessment Planning section helpful (tho’ there is still more to come) https://meds.queensu.ca/central/community/coursedirectors:assessment_planning

There’s a lot more:  from Course Planning to Student Roles, to the Curriculum structure and the Committee and Leadership structure.  Why not dive in and look around?

Our Curricular Leaders support the program through their hard and varied work.  They work diligently at aligning the triumvirate of learning objectives, teaching strategies and assessment.  They often teach a great deal in their courses, and are responsible ultimately for the assessment of the students’ progress.  They have huge communication responsibilities with Year Directors, Curricular Coordinators, in committees, and with their faculty members and students.  They are curriculum builders and adapters.  They, along with the faculty who teach in our program, are heroes in the work they do…

Typically, the hero of the fairy tale achieves a domestic, microcosmic triumph, and the hero of myth a world-historical, macrocosm triumph. Whereas the former–the youngest or despised child who becomes the master of extraordinary powers–prevails over his personal oppressors, the latter brings back from his adventure the means for the regeneration of his society as a whole.

–Joseph Campbell The Hero with a Thousand Faces

 

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Dick Cheney’s Medical Odyssey: Lessons about advances in care, and about our role as providers

I recently received and read with great interest a book entitled “Heart: An American Medical Odyssey”, co-authored by former American Vice-President Dick Cheney and his cardiologist, Dr. Jonathan Reiner.

In it, they provide both patient and physician perspectives on Mr. Cheney’s longstanding struggles with coronary artery disease, an illness that began with a myocardial infarction in 1978 at age 37, and progressed steadily through the years with several further infarctions, multiple cardiac catheterizations and angioplasties, stenting, coronary bypass grafting, recurring atrial and ventricular arrhythmias, implantation of a cardioverter-defibrillator, endovascular stenting and vigorous application of all available medical preventative therapies.  Despite all this, Cheney developed progressive cardiac damage and heart failure refractory to medications, eventually resulting in implantation of a left ventricular assist device, followed by cardiac transplantation, all of which appears to have been very successful in restoring him to good health.

bushRemarkably, most of this illness and treatment occurred while Mr. Cheney held positions of considerable responsibility and public trust over a 30 year political career, including serving as a Congressman, Secretary of Defense and Vice-President in the Administration of President George W. Bush.

Their book therefore provides a remarkable account of the numerous medical and technologic advances that have occurred within a generation and provide patients with this very common condition so much hope for more quality and length of life.  It also provides, particularly for students, a rather touching example of a very effective patient-physician relationship and how a skilled and caring practitioner is able to advocate and guide his/her patient through the myriad of emerging options as they become available.

However, Mr. Cheney was far from the average patient.  Access to immediate state-of-the-art care was simply not an issue for him.  The book describes several episodes when he would be whisked away immediately by his support staff to hospitals where numerous highly skilled physicians were waiting to provide care.  He also had access to very efficient care at his place of work, where numerous specialists would often convene to advise as to various options available to him.  He was offered every therapeutic advance, and had the advantage of the counsel and care of leaders (often pioneers) of each of those advances.  In short, his story provides an illuminating and somewhat utopian example of what’s possible in the absence of the practical barriers most of our patients encounter.

All this can seem rather distressing to patients and practitioners who struggle with various economic and social access issues in order to take advantage of even standard care.  Perhaps most distressingly is the issue of cardiac transplantation, the treatment that effectively reversed what would have been the natural end of Mr. Cheney’s long struggle. Although highly effective, cardiac transplantation is a very limited resource.

As I reflected on all this, discussed it with colleagues and friends, and surveyed the internet for reactions, I experienced and encountered very mixed feelings.  The optimism and “good news” of Mr. Cheney’s story was counterbalanced with a vague sense of unease.  To many, it seems, the application of so much effort and resource to a single individual seems somehow cheney3unjust, unfair, and counter to some very Canadian values of universal and equal access to care.  Somewhat distressingly, there appeared to be an undercurrent of resentment fueled by the fact that Mr. Cheney is a very polarizing figure who’s persona is, shall we say, somewhat unsympathetic.  Certainly his experience has fueled the popular media that has taken umbrage and humour at his expense.  I suspect Dr. Reiner has also come under some criticism from colleagues in the medical community.  In the book, he provides a particularly poignant account of an interaction with a colleague who appeared to question the vigour with which he was pursuing end stage treatments for his patient.

It seems that this story provokes a visceral reaction in all of us.  For late night television hosts and the general public, this is a source of speculation and casual amusement.  But for physicians, it holds much greater significance.  It forces us to examine how we engage care on an individual level, particularly when confronted with “special” patients.  Advocacy is one of the most difficult lessons for medical students.  Its application to the disadvantaged is easy to understand.  The appropriate advocacy role for the patient who is demanding, unsympathetic and has the means to access above standard care is more complex and difficult.  Was Mr. Cheney’s care “reasonable”, particularly given the large number of Americans without access to even basic care?  Did he “jump the queue”?  How was he considered worthy of this new lease on life?  Was he simply too old, and should this option be reserved for younger patients?  Most importantly, should any of these considerations influence the care we provide any individual patient we encounter.

When confronted with such profound and emotionally charged questions, I’ve found it always helpful to return to the facts.

In Canada, the Heart and Stroke Foundation estimates the number of Canadians living with Heart Failure to be about 500,000, with about 50,000 new cases emerging per year (http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3483991/k.34A8/Statistics.htm). The annual mortality rate for patients with heart failure is about 10% with about 50% of patients surviving 5 years.  The same report indicates that 167 cardiac transplants were carried out in 2010. The major limitation, of course, is the availability of donor hearts, which remains very limited despite high profile campaigns to promote public awareness and expedite the transplantation process, summarized nicely in a June 2009 Parliamentary Report (http://www.parl.gc.ca/Content/LOP/researchpublications/prb0824-e.pdf).  The survival rate after cardiac transplantation was recently reported by Dr. Marc Ruel at the Canadian Cardiovascular Congress to be 86% at one year and 75% at 5 years (http://www.theglobeandmail.com/life/health-and-fitness/heart-transplant-survival-rates-improve-study/article558645/).  This figure is consistent with the experience of most Canadian and American transplant centres.

It appears, then, that we have a highly effective, but also very limited therapy that will never be adequate to the potential demand.  The situation in the United States will feature larger volumes but likely very similar proportions and restrictions.  In both countries the access to cardiac transplantation is a highly regulated and understandably controversial process.

What does our society have to say on this issue?

  • A comprehensive and excellent consensus document by Dr. Heather Ross and colleagues provides standards guiding the application of cardiac transplantation in Canada (Canadian Journal of Cardiology 2003;19:621).  With regard to use of transplantation for patients with end stage coronary disease, the document states:

“Patients with severe coronary artery disease (CAD), although it is an uncommon indication for transplantation, may beconsidered for cardiac transplantation if they experience Canadian Cardiovascular Society class IV symptoms not amenable to high risk revascularization and in whom maximal medical therapy has failed.”

Mr. Cheney would therefore certainly have met our Canadian criteria for cardiac transplantation.

  • Mr. Cheney had no condition that would disqualify him from consideration for transplantation.  Although he had many medical problems, they all related to his diseased heart.  In other words, he had no other life limiting issues.
  • According to all accounts, Mr. Cheney and his physicians utilized the standard referral processes available to them, through the United National Organ Sharing (UNOS) registry.  He waited 20 months for his transplantation, existing on a mechanical, externally driven assist device during that time.  This waiting time is reported to be longer than average.
  • According to UNOS, 332 people over the age of 65 received a cardiac transplantation in 2011.  To put that figure in perspective, approximately 2300 cardiac transplants are carried out annually in the US.  Dick Cheney was 72 at the time of his transplantation.

In addition, public figures like Mr. Cheney must necessarily live their lives under intense scrutiny.  As noted previously, his medical issues become public knowledge and the fodder for late night television hosts.  He also had to deal with his illness while undertaking major public responsibilities with their attendant stresses, and under continuing public scrutiny, which could be quite cruel (as depicted) and eliminated any possibility of privacy and continually questioned his competence.  Admittedly, all this was undertaken with full knowledge and consent.

It appears, then, that Mr. Cheney received a therapy for which he was qualified and for which he engaged a standard and well controlled process.  His physician, Dr. Reiner, provided excellent support, directing him to therapies available to him and ensured he gained maximal value from them.  I’ve no doubt that he provides similar efforts to the care of all his patients, even those for whom therapy might not be so immediately available for reasons beyond his or their control.  We should strive for no less for all our patients.

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

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Welcome in the new year with some great features from MEdTech

Happy New Year!  Our indispensable Special Curriculum Assistant, Alice Rush-Rhodes has put together 3 items in MEdTech Central that will save you time, and help you in your teaching.

Included are links to more detailed instructions.  If you have any questions please comment below.

This information is excerpted from the MEdTech Features page of the Faculty Resources community found here.  Additional FAQ and information is available on the linked page.

What do I have to complete on a learning event page?

You need to identify what you will be teaching including MCC presentations and curricular objectives.  A guide to completing a learning event page can be accessed on that page.

Learning event 2014-01-06 at 9.40.52 AM

Why do I need to know this?  Every faculty member is responsible for completing their own learning event page.  Most importantly, you can tailor your session to the curricular objectives for the course.   You can ask for help from your curricular coordinator or from Alice or Sheila.

How can I search for learning events on a certain topic or MCC presentation?

You can use the Curriculum Search tool or the Curriculum Explorer tool (both located under the Curriculum tab).  Curriculum Search lets you search by keyword and Curriculum Explorer lets you search by MCC presentation or curricular objective.  A video about using this function can be found here (look for the Curriculum Explorer video towards the bottom of the page).

Why do I need to know this?  If you’re teaching on a specific topic, it’s important to know what has been taught to students prior to your learning event.  It’s also important to see what they are taught later on “downstream” in the curriculum.  The search or explorer features will do that for you.  This way, you can avoid redundancy but plan to revisit some aspects (spiral curriculum) and link to future aspects.  It also gives you a heads up as to who is teaching about this topic, with a view to linking up with these faculty to discuss the thread of the topic.  E.g. Many of the faculty teaching in year 2 refer back to the Family Medicine Course’s approaches, or link to the Clinical Skills exams, etc. that relate to their topics.

Go to the Courses tab here.  All courses currently running (excluding clerkship rotations) will have a small icon beside their names (it looks like a piece of paper).  By clicking on this you can download a pdf of the course syllabus.  Included in this is a breakdown of the course hours by learning event type.

You can also click on “Download Syllabus” under the Course Navigation menu if you are already on a course page.

You can see the little syllabus icon in the image below.

syllabus 2014-01-06 at 9.26.56 AM

Why do I need to know this?  The syllabus is hugely helpful, especially for Course Directors.  It tells all faculty and students what the learning objectives for the course are, what the assessments are, etc.  It also lets you know the percentage of lectures, small group learning, labs, etc. that are present in the course.

 

 

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