Medical school in Canada
In Canada, a medical school is a faculty or school of a university that trains future medical doctors and usually offers a three- to five-year Doctor of Medicine or Doctor of Medicine and Master of Surgery degree. Although presently most students enter medicine having previously earned another degree, the M.D. is technically considered an undergraduate degree in Canada. There are currently seventeen medical schools in Canada. Some faculties, such as Manitoba, McMaster, and Toronto, in addition to training would-be medical doctors, offer two-year bachelor's or master's degrees to train physician assistants.
As of 2013, approximately 3,900 students were enrolled in Canadian medical schools.
Admissions
Generally, medical students begin their studies after receiving a bachelor's degree 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 publishes a detailed guide to admission requirements of Canadian faculties of medicine on a yearly basis.Admission offers are made by individual medical schools, generally on the basis of a personal statement, autobiographical sketch, undergraduate record, scores on the Medical College Admission Test, and interviews. Medical schools in Quebec, the University of Ottawa, and the Northern Ontario School of Medicine, do not require the MCAT, as the MCAT has no French equivalent. 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. Other schools, such as the University of Western Ontario, give increasing preference to higher performance. McMaster University and the University of Calgary utilize the Critical Analysis and Reasoning section of the MCAT to determine interview eligibility and admission rank.
The annual success rate for Canadian citizens applying for admission to Canadian medical schools is normally below 10%. Just over 2,500 positions were available in first-year classes in 2006-2007 across all seventeen Canadian faculties of medicine. The average cost of tuition in 2006-2007 was $12,728 for medical schools outside of Quebec; in Quebec, average tuition was $2,943. The level of debt among Canadian medical students upon graduation has received attention in the medical media.
Curriculum
Medical school in Canada is generally a 4-year program at most universities. Notable exceptions include McMaster University and the University of Calgary, where programs run for 3 years, without interruption for the summer. McGill University and Université de Montréal in the province of Quebec both offer a five-year program that includes a medical preparatory year to entering CEGEP graduates. While Université Laval in Quebec City offers a four- to five-year program to all entering students, Université de Sherbrooke offers a formal four-year M.D. program to all admitted students.The first half of the medical curriculum is dedicated mostly to teaching the fundamentals of, or basic subjects relevant to, medicine, such as anatomy, histology, physiology, pharmacology, genetics, microbiology, ethics, and epidemiology. This instruction can be organized by discipline or by organ system. Teaching methods can include traditional lectures, 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. For example, while Université de Sherbrooke offers a M.D./M.Sc. program, McGill University offers a M.D./Ph.D. for medical students holding an undergraduate degree in a relevant field.
Post-graduate medical education
Students enter into the Canadian Resident Matching Service 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 positions. 'Match Day' usually occurs in March, 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, 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. A few surgical residencies, including cardiac surgery, neurosurgery, and some general surgery programs, last 6 years. Sub-specialty fellowships are available after most residencies.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 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 sub-specialty earlier than a similar American graduate.
Some sub-specialties are organized differently. For example, in the United States, cardiac and thoracic surgery are rolled into one fellowship following residency in general surgery. In Canada, cardiac surgery is a direct-entry residency. 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 Professional Association of Internes and Residents of Ontario.
Continuing medical education
Both Canadian specialty colleges participate in mandatory continuing medical education 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 or non-accredited.
The Office of Professional Affairs of the RCPSC is responsible for a mandatory maintenance of certification 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 and over a 5-year cycle 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.