NORTHERN ONTARIO SCHOOL OF MEDICINE JOINT SENATE COMMITTEE FOR NOSM

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NORTHERN ONTARIO SCHOOL OF MEDICINE JOINT SENATE COMMITTEE FOR NOSM Report to Lakehead and Laurentian University Senates From: Joey Farrell, Chair Joint Senate Committee for NOSM January 6, 2009 The Joint Senate Committee for NOSM met on December 17, 2008. At the Joint Senate Committee meeting two items were approved by the Joint Senate Committee. Based on this approval, and the attached documentation, I would like to: 1. MOVE that the addition of Laboratory Medicine/Pathology and Diagnostic Imaging/Nuclear Medicine to the Electives Section of the NOSM Calendar-Phase 3 Curriculum Descriptions and the amendment to MEDS 5645 Social and Population Health be approved as presented.. 2. MOVE that upon the recommendation of the Joint Senate Committee for NOSM that, although registered with one University, NOSM students graduate with an M.D. degree conferred by both Lakehead and Laurentian Universities and that the M.D. Degree parchments signify award of an M.D. Degree of Lakehead and Laurentian with both Universities recognized equally on the parchment.

NORTHERN ONTARIO SCHOOL OF MEDICINE JOINT SENATE COMMITTEE FOR NOSM From: Joey Farrell, Chair Joint Senate January 6, 2009 Attachment #1 Recommendation from the Joint Senate: Document for Approval Calendar Phase 3 Curriculum Descriptions [amended] 1. MOVE that the addition of Laboratory Medicine/Pathology and Diagnostic Imaging/Nuclear Medicine to the Electives Section of the NOSM Calendar-Phase 3 Curriculum Descriptions and the amendment to MEDS 5645 Social and Population Health be approved as presented. Background/Rationale: Approved by Academic Council December 11, 2008 meeting (Carried Unanimously) Highlighted amendments attached in document.

Phase 3 Calendar Information [Amended Version] Curriculum Description Phase 3 General Description of Phase 3 Phase 3 (Year 4) is the last year of the undergraduate medical doctor program. A progression of the Comprehensive Community Clerkship (CCC) of Phase 2 (Year 3), students are provided with an in-depth experiential learning in the various specialties and sub-specialties of the practice of medicine. Through seven broad specialty core courses and 12 weeks of elective sub-specialty experiences, students will gain practical experience in women s health, internal medicine, surgery, children s health, mental health, emergency medicine and family medicine. In addition to learning within the NOSM teaching catchment area, electives offer students the opportunity to experience medicine in settings that might be further afield: within Ontario, the rest of Canada or the world. The focus of Phase 3 is on chronic and complicated in-patient medicine in the medical specialties and provides students with exposure to secondary and tertiary care of patients primarily in the larger communities of Sudbury and Thunder Bay. Other larger tertiary care centres in the North may also be learning sites. Students will observe, participate and care for patients requiring the attention of medical specialists in various disciplines and experience the delivery of a continuum of care which seriously ill patients receive in the North. The combination of core course rotations and electives will also provide students with important background knowledge which will help them choose a medical practitioner career path and successfully transition to the Postgraduate Medical Education Residency program. MEDS 5605 Northern and Rural Health Designed to continue to build upon and expand the knowledge and skills students have acquired to-date. The focus is on the development of knowledge of rural health within and beyond Ontario and demonstration of the knowledge and skills of socially accountable physicians. Students will continue to be required to translate their knowledge concerning rural and northern health into appropriate patient care and demonstrate an on-going commitment to understanding and responding to the health care needs of Aboriginal and Francophone communities and peoples in the North. MEDS 5625 Personal and Professional Aspects of Medical Practice Students continue to refine their understanding of professional issues. Topics focus on the historical development of medical specialties, the legal framework for the practice of medicine in Ontario and Canada, ethical issues related to medical errors and patient safety, physician advocacy, and laws and requirements around medical records and practicing medicine in a hospital. MEDS 5645 Social and Population Health Students continue to learn about the social and cultural perspectives on individual and population health, community and public health, occupational health and the social determinants of health. Development of critical appraisal skills through background reading and applying evidence-based medicine methods to patient and populations is emphasized. Various relevant epidemiological designs and statistics are introduced, discussed and applied. MEDS 5665 Foundations of Medicine Acquiring knowledge about and application of the basic sciences in the context of patient care will continue to be an essential part of student instruction in all settings.

Students will be expected to recall, understand, and apply knowledge of the basic sciences learned from the first three years. Review of anatomy, physiology, biochemistry, microbiology, genetics, and immunology will be encouraged and assessed. Pathology, pathophysiology, pharmacology, and therapeutics will be the subjects heavily emphasized and assessed. MEDS 5685 Clinical Skills in Health Care In-depth experiential learning and exploration of the medical specialties and subspecialties, research or the human sciences, through a series of core medical and elective rotations. Successful completion of Clinical Skills in Health Care is accomplished by obtaining a mark of Pass throughout all rotations. MEDS 5710 Internal Medicine The four week internal medicine clerkship incorporates the objectives of general internal medicine as well as some of the sub-specialties of internal medicine. The content of the internal medicine clerkship builds upon the diagnosis, treatment and management of patients in the in-patient and out-patient setting. MEDS 5711 Surgery The four week surgical clerkship is intended to provide the clerk with an understanding of the broad principles of surgery and the basics of many of the individual surgical specialties as a foundation for post graduate training. Learning is focused through objectives and patient encounters in the out-patient and in-patient environment. MEDS 5712 Family Medicine The family medicine clerkship requirement can be satisfied in one of two ways: A two-week elective as part of the twelve week elective requirement in which students gain further experience in the specialty of family medicine in the out-patient and appropriate in-patient settings. Students who do not select family medicine as a twoweek elective will satisfy this requirement through a series of longitudinal experiences carried out weekly in three other rotations. MEDS 5713 Women s Health The four week women s health rotation provides students with the opportunity to acquire knowledge and skills necessary for the diagnosis, treatment and management of the gynaecological patient. Students will participate in the admission, management and follow through of obstetrical cases with a focus on in-patient care. MEDS 5714 Children s Health The four week children s health rotation is an experience in which students will have an in depth experience in acquiring the knowledge and skills necessary for the comprehensive evaluation of pediatric patients from the neonate to the adolescent. Students will have a focused experience in which they will be learning about common and important pediatric principles as well as common and emergent problems in the hospital, ambulatory and community settings. MEDS 5715 Mental Health The four week mental health rotation is designed to provide students with the opportunity to learn and acquire skills necessary to take a proper psychiatric case history, to examine psychiatric patients, and to develop management and treatment plans. Students will expand the knowledge they have acquired from experiences in the first three years to better understand the roles of a variety of therapies in the treatment and management of out patient and hospitalized patients and will better understand how mental health issues and psychiatric problems are managed over time.

MEDS 5716 Emergency Medicine The four week emergency medicine rotation provides an in depth experience for students in the context and milieu of large city hospital-based emergency departments. During this period students expand their knowledge of triage in the emergency setting, will sharpen their history and physical exam skills in wound management and will learn to quickly identify procedures required for extreme emergent situations. Phase 3 Electives A total of twelve (12) weeks of approved electives in medical specialties, medical subspecialties or medical research or the human sciences is required in Phase 3. Electives must be a minimum of 2 weeks although 1 week electives may be approved in rare circumstances. All students must take electives in a minimum of three (3) different Canadian Resident Matching Service (CARMS) categories. Elective experiences are structured educational opportunities that allow medical students to explore the specialties and sub-specialties of medicine as well as explore their career options. Each elective experience includes an identified set of objectives, learning program, faculty supervisor and assessment and evaluation plan approved by the student advisor and the Associate Dean, Undergraduate Medical Education. MEDS 5750 Elective/Medical/Specialty MEDS 5751 Elective/Surgical/Specialty MEDS 5752 Elective/Women s Health /Specialty MEDS 5753 Elective/Children s Health/Specialty MEDS 5754 Elective/Internal Medicine/Specialty MEDS 5755 Elective/Mental Health Medicine/Specialty MEDS 5756 Elective/Family Medicine/Specialty MEDS 5757 Elective/Research MEDS 5758 Elective/Human Sciences MEDS 5759 Elective/Laboratory Medicine/Pathology/Specialty MEDS 5770 Elective/Diagnostic Imaging/Nuclear Medicine/Specialty

NORTHERN ONTARIO SCHOOL OF MEDICINE JOINT SENATE COMMITTEE FOR NOSM From: Joey Farrell, Chair Joint Senate January 6, 2009 Attachment #2 Recommendation from the Joint Senate: Document for Approval Joint MD Degree Motion: MOVE that upon the recommendation of the Joint Senate Committee for NOSM that, although registered with one University, NOSM students graduate with an M.D. degree conferred by both Lakehead and Laurentian Universities and that the M.D. Degree parchments signify award of an M.D. Degree of Lakehead and Laurentian with both Universities recognized equally on the parchment. Background/Rationale: Approved by Academic Council December 11, 2008 meeting (Carried Unanimously) Supporting rationale attached

Background Information regarding the recommendation from the Joint Senate Committee for NOSM to the Laurentian and Lakehead University Senate for: A joint MD Degree of Lakehead and Laurentian Universities Background: In January 2006, a Relationship Agreement was signed between Lakehead University, Laurentian University and the Northern Ontario School of Medicine (NOSM). There are a number of statements in the relationship agreement which make the intent clear that a joint degree was the expectation for NOSM students at graduation. Although this was indicated in the relationship agreement, this item was not referred to the Senates at that time thus the current motion. After reviewing the relationship agreement, background information provided by the Dean of NOSM, hearing from a current student of NOSM, the Joint Senate Committee unanimously supported the recommendation. Additionally, we learned that a joint masters degree is offered between Saint Mary s University and Mount Saint Vincent University and that both universities are indicated on the degree parchment, illustrating the existence of a similar combined degree. Combined degrees are also conferred at other Ontario Universities. For your information, included below are statements from the relationship agreement relevant to the role of the Senates, the awarding of a joint MD degree upon graduation, and statements related to communications with the accreditation bodies and the government during the set up of NOSM as a not-for-profit corporation, as a Faculty of Medicine of Laurentian and Lakehead Universities. Section 2.4 - As a not-for-profit corporation, NOSM is not in itself an academic body. Not-forprofit Corporations cannot grant degrees; only universities grant degrees. N OSM gains its academic status through the authority of the Senates of the two Universities. NOSM is the Faculty of Medicine of Lakehead and the Faculty of Medicine of Laurentian. Consequently, NOSM has a dual governance structure like that of the Universities with corporate governance provided by the NOSM Board of Directors and academic governance exercised through the Senates of Lakehead and Laurentian. Section 4.1 - NOSM students will graduate with an MD Degree conferred by both Universities... Section 4.4 NOSM students are to be registered as Lakehead students if they begin their studies at the Lakehead campus of NOSM and as Laurentian students if they begin their studies at the Laurentian campus of NOSM. Mechanisms will be put in place to ensure that in all other ways NOSM students are treated the same by both Universities including equal access to library and other resources through both Universities... Section 4.8 Arrangements for the production of transcripts are to be developed through cooperation between the Registrars' Offices of the two Universities. Transcripts produced for NOSM students would designate both Universities consistent with students undertaking single undergraduate and post-graduate medical education programs. Section 4.13 -... The MD Degree parchments will signify award of an MD Degree of Lakehead and Laurentian with both Universities recognized equally on the parchment. Section 7.2 -.. Although registered with one University, NOSM students will graduate with an MD degree from both Universities and will be treated, as much as possible, consistently by both Universities... Accreditation Bodies: From the very first communication with the Committee on Accreditation of Canadian Medical Schools (CACMS) and the Liaison Committee on Medical Education (LCME), the message has been that NOSM is a single school of medicine with a single curriculum and with each class undertaking the same program, albeit geographically dispersed. Correspondence from CACMS and LCME refers to the MD program of the Northern Ontario School of Medicine. CACMS and LCME expect NOSM students to be treated the same including at the point of graduation.

Government: The Ontario government, through the Ministry of Training Colleges and Universities (MTCU), mandated that the Northern Ontario School of Medicine is a single medical school for the whole of Northern Ontario under the academic auspices of the two host Universities. December 18, 2002 was the date on which the documents were signed activating the formal establishment of NOSM as a not-for-profit corporation.