Clerkship Courses - Year 3

Ontario’s response to the COVID-19 pandemic continues to evolve. Changes will likely occur as the province and its municipalities adjust to new data about the virus. In these circumstances, please be advised that the manner of delivery of courses, co-curricular opportunities, programs and services is subject to change, in accordance with university policies. The University thanks its students, faculty, and staff for their flexibility during these challenging times as we work together to maintain the standards of excellence that are the hallmark of the University.

Detailed Learning Objectives, Content, and Materials are Available on Each Course's Website (UTORid Login Required): 
https://meded.utoronto.ca/medicine/courses

Contact Information for Each Clerkship Course: 
http://www.md.utoronto.ca/clerkship-course-directors-and-administrators

 

Transition to Clerkship [TTC310Y]

Course Director: Dr. Clare Hutchinson
Course Duration: 2 weeks

The three-week Transition to Clerkship (TTC) course prepares students for clerkship through a variety of learning activities which include simulations, online modules, academy and campus-based seminars and shadowing sessions, with an emphasis on intrinsic CanMeds skills (teamwork, collaboration, health advocacy) as well as specific medical expert competencies. TTC core curriculum activities consist of both large and small group interactive learning sessions, and several required online learning modules. Three Academy Days take place on each of the three Wednesdays in the course, and as well as the first Friday morning. These incorporate some registration tasks (e.g. mask-fit testing, computer systems training) along with practical skills (order writing, managing violent patients). The third-year Dermatology course also takes place within TTC.

Anesthesia [ANS310Y]

Course Director: Dr. Anita Sarmah
Course Duration: 2 weeks

The two-week Anaesthesia course is based on a 'flipped classroom' model. Students are required to complete seven e-modules where faculty is available via a discussion board. The rotation includes two days of simulation training at Sunnybrook Health Sciences Centre. The first day includes a comprehensive training on IV skills, airway management and fluid responsiveness using ultrasound. Case scenarios are used to teach ACLS protocols and communication skills during critical events in a simulated operating room. During the exit simulation day, the students rotate through preoperative, intraoperative and postoperative scenarios that reinforce the content in the e-modules and work through integrated cases that highlight module content. For clinical shifts, you are assigned to a faculty staff member in the operating room, labour floor, pre-admission clinic, or pain service where one on one teaching is provided. You assist in all aspects of anesthetic care. There is no overnight call.

Dermatology [DER310Y]

Course Director: Dr. Perla Lansang
Course Duration: 1.5 Days

The Dermatology course is held within the Transition to Clerkship (TTC) course. Clerks attend a patient viewing day, complete online modules, and submit a clinical note. In addition to the aforementioned course work, course materials in the form of a syllabus and online atlas are provided to you, covering all the topics that they are expected to learn during their Dermatology course. The entire course content is posted on Blackboard. 

Emergency Medicine [EMR310Y]

Course Director: Dr. Laura Hans
Course Duration: 4 weeks

The four-week Emergency Medicine course commences with three days of hands-on workshops and seminars utilizing simulation, skills-based teaching, and case-based interactive sessions. These sessions provide opportunities to acquire essential knowledge and skills in preparation for clinical experience, and cover topics that include medical imaging, airway management, cardiac dysrhythmias, trauma, ultrasound, toxicology, chest pain, wound management, and splinting. Students are then placed at one of the ten Emergency Departments in the Greater Toronto Area to complete 15 shifts, including up to two weekends and three overnight shifts. During the clinical experience you function as members of an interprofessional team and are assigned one or two preceptors with whom at least half their shifts occur. Each clerk spends half a shift with members of the interprofessional team. You learn to manage many types of patient problems that present to the Emergency Department, including exposure to core emergency medicine cases. There are additional opportunities to perform basic procedures (intravenous insertion, venipuncture, foley catheter insertion, NG insertion, ECG) and observe the triage process. 

Family & Community Medicine [FCM310Y]

Course Director: Dr. Azadeh Moaveni
Course Duration: 6 weeks

The six-week Family and Community Medicine course begins with centrally delivered core seminars for the first two days. Core seminars include: orientation, family violence, motivational interviewing, global health, palliative care and geriatrics. After core seminars, the students go to their respective sites to start the clinical portion of the rotation. You experience family medicine at a family medicine teaching unit or a community family physician’s office or a combination of both teaching environments. A small number of rural placements are also available through the Rural Ontario Medical Program (ROMP) . The course exposes students to various comprehensive care models and strives to have students learn in an interprofessional environment. You also participate in site-based seminars and complete e-modules. 

Internal Medicine [MED310Y]

Course Director: Dr. Luke Devine
Course Duration: 8 weeks

The eight-week Internal Medicine course begins with an interactive, case-based seminar series for one and a half days. Additional seminars occur approximately once per week for the remaining weeks. Each clerk is assigned to a single Internal Medicine Team for the entire rotation. A sub-group of students may choose a dedicated ambulatory care experience for 1-2 weeks. Over the entire length of the course, there is a graduated experience with increasing responsibility. You have the opportunity to perform the admitting history and physical examinations on patients who present to the Emergency Room, and are asked to provide a provisional diagnosis and differential diagnosis, and to construct an investigation and management plan. You also provide ongoing direct patient care for your assigned patients under supervision. Later in the rotation, you carry up to six patients and have enhanced responsibilities for patients while on call. Support is provided by other members of the team, including the attending physician and supervising residents. You are also assigned to approximately six half-days in ambulatory clinics so that you have an opportunity to learn about how care is delivered to medical patients in this setting. 

Obstetrics & Gynaecology [OBS310Y]

Course Director: Dr. Dini Hui
Course Duration: 6 weeks

The six-week Obstetrics and Gynaecology rotation offers a variety of clinical activities related to all aspects women’s health care, including rotations in labour and delivery, inpatient antenatal and postpartum units, antenatal clinics, gynaecologic ambulatory care, inpatient gynaecology units, the operating room and the emergency department. In addition to clinical activities, you attend daily small-group teaching seminars on a range of obstetrical and gynaecological topics. Further to the seminar series, each hospital site also conducts its own set of teaching and/or grand rounds which you are expected to attend. Students are assigned to one of eight teaching hospital sites. 

Ophthalmology [OPT310Y]

Course Director: Dr. Jennifer Calafati
Course Duration: 1 week

The one-week ophthalmology course begins with a clinical skills review and orientation session. Throughout the week, you see a variety of ambulatory ophthalmology patients in eye clinics or in the offices of attending ophthalmologists. In clinic, you examine patients, which may involve taking an ophthalmic history and performing relevant ocular examinations, as well as formulating a differential diagnosis and management plan. Students may attend the operating room for a half day. You are expected to research each assigned patient’s disease using appropriate texts and journals and review course topics including: cornea and anterior segment (the red eye), lens and optics, glaucoma, retina, uveitis and inflammatory diseases, neuroophthalmology, oculoplastics and orbital diseases, paediatric ophthalmology and strabismus, and ocular emergencies and trauma. In addition, all students attend seminars on paediatric ophthalmology at the Hospital for Sick Children.

Otolaryngology – Head & Neck Surgery [OTL310Y]

Course Director: Dr. Allan Vescan
Course Duration: 1 week

The one-week Otolaryngology course includes site-specific teaching sessions and clinical experience in outpatient clinics. The remainder of the time is spent on the wards, in the operating room, on seminars and self-directed learning with otoscopy and nasal packing simulators and online cases. The rotation includes a series of online seminars, covering common and important topics in otolaryngology including hearing loss, vertigo, epistaxis, rhinosinusitis, emergencies, and head and neck malignancies. You are also given a paediatrics otolaryngology seminar, an Otosim seminar, and an audiology lecture at the Hospital for Sick Children. Attendance in the operating room is available to students and may be arranged at their Academy with the site director at the beginning of their rotation. 

Paediatrics [PAE310Y]

Course Director: Dr. Angela Punnett
Course Duration: 6 weeks

The Paediatrics course begins with a full day of orientation seminars and small group teaching sessions at SickKids. There is a second ‘day back’ for Neonatology teaching half-way through the rotation. In their clinical placements, students are exposed to a combination of ambulatory and inpatient paediatrics. Students are either in a paediatric setting at a Community Hospital for 6 weeks, or at SickKids on paediatric wards or in the Emergency Department for 3 weeks and in an ambulatory Paediatric practice for 3 weeks.  Additional learning resources include the Computer Assisted Learning in Pediatrics Cases (CLIPP) which offer comprehensive interactive cases that cover important core topics, web-based e-modules on core topics on Elentra and the Paeds-on-the-Go Handbook and Syllabus.

Psychiatry [PSS310Y]

Course Director: Dr. Carla Garcia
Course Duration: 6 weeks

The six-week Psychiatry course begins with centralized teaching sessions that occur on the first day of each rotation. The clinical experience takes place in a variety of settings including inpatient units, psychotherapy clinics, ambulatory clinics, consultation liaison teams, and emergency settings. An integral component of the course is interviewing patients and/or standardized patients with anxiety, mood, psychosis, cognitive, and substance disorders with focus on symptomatology, diagnosis, and basic treatment principles. All clerks will have exposure to psychiatric emergencies mostly by taking night and weekend on-call not exceeding one in five, until 11 p.m. Clinical experience with children and families take place during two half-days in a child psychiatry setting under the direct supervision of a child psychiatrist. Seminars are held weekly at each hospital site and include topics such as interviewing skills and dealing with challenging personality styles.

Surgery [SRG310Y]

Course Director: Dr. Jeremy Hall
Course Duration: 8 weeks

This eight-week course commences with a one-week centralized program, “Prelude to Surgery,” which provides an orientation and introduction to important surgical topics. The students then rotate through two three-week sub-rotations: one sub-rotation in General Surgery and the other sub-rotation in one of the other surgery specialties. The last week will comprise of attending the Central Seminars, debriefing and exam preparation sessions, and other administrative tasks. Students have input into their choice of sub-rotation specialties and are assigned to a surgeon preceptor for each of their sub-rotations. Students contribute to the admissions and daily patient care and attend the operating room and the clinic /office of their preceptor or team. The on-call schedule is one night in four. Call must be taken in General Surgery, Orthopaedics, or Neurosurgery. This provides them the opportunity to see patients in the ER as well as taking call to the ward and OR, where appropriate.

Portfolio – Year 3 [PFL310Y]

Course Director: Dr. Nirit Bernhard
Course Duration: Year 3 – Longitudinal

In third year, the Portfolio course continues to facilitate professional and personal development through guided reflection.  Portfolio encourages students to develop their knowledge of the six non-Medical Expert CanMEDS roles of Collaborator, Communicator, Leader, Health Advocate, Scholar and Professional. Through self and critical reflection of their clinical experiences in third year, students will learn to navigate and integrate these core competencies into their professional identities.  The various CanMEDS roles are incorporated throughout the six themed sessions which take place over the academic year. Examples of the themed topics include Patient Safety, Resilience and Wellness, Power Dynamic and the Hidden Curriculum, My First Patient Death and Humility and Uncertainty. There are two summative assessment components to the evaluation of Portfolio: the Process Component and the Written Component. The Process component consists of mandatory attendance at six small-group meetings, where the themed reflections are shared in student groups of approximately eight, with one resident (Junior Academy Scholar) and one faculty member (Academy Scholar). During the meeting, Scholars provide support in developing reflections on clinical experiences and their meaning and impact on personal and professional development. There are also two mandatory one-on-one Progress Review meetings with the Academy Scholar throughout the academic year where students have the opportunity to develop personal learning plans and reflect on the assessment data in their MD Program Learner Chart. The Written Component of the evaluation includes two progress review reports and the six thematic session reflections.  Three of the assigned reflections are marked anonymously with a pass/fail grade and formative feedback based on the Portfolio Assessment Rubric.  There are also two MD Program Professionalism forms completed per year.

Integrated Objective Structured Clinical Examination (iOSCE) [OSC310Y & OSC410Y]

Course Director: Dr. Stacey Bernstein
Chief Examiner: Dr. Giovanna Sirianni

The integrated OSCE (iOSCE) is a transcripted course which includes an Interim iOSCE and Final iOSCE. The Interim iOSCE is held after first 24 weeks of third year and includes six stations linked to the curriculum covered in the first 24 weeks of the year. The Final iOSCE is held after 48 weeks of third year and includes ten stations – six of which are linked to the 24 weeks of curriculum that a student has just completed, and four integrated stations reflecting the entire third-year curriculum.