Foundations Curriculum structure
The Foundations Curriculum runs throughout the first two years of the MD program. There are three major dimensions to the Foundations Curriculum: courses, components, and themes. An important feature of the Foundations Curriculum is that each week has a full day that is unscheduled, and available for self-study, and special activities such as clinical skill development.
There are five courses in the Foundations Curriculum. Each course contains four components that run throughout. Longitudinal themes are interwoven throughout the entire curriculum.
Introduction to Medicine: 11-week unit at the start of first year
An introduction to the basic and social sciences relevant to medicine, to cognitive science, to clinical skills and community health
Concepts, Patients and Communities 1: 25 weeks in first year
An instruction on health and the diagnosis and treatment of disease relevant to all of the body’s systems, and includes a consideration of all of the major themes (described below)
Concepts, Patients and Communities 2: First 16 weeks of second year
A continuation of Concepts, Patients and Communities 1 (see above for description)
Life Cycle: 9 weeks in second year
An instruction on health and disease from conception, antenatal development, birth, infancy, childhood, adolescence, aging, and for patients who are dying
Chronicity and Complexity: 11-week conclusion
A consolidation of the program with emphasis on chronic disease management, and complex problems with preparation for clerkship
Throughout each course, there are four components through which content is delivered. These components include:
Toronto Patient-Centered Integrated Curriculum (TOPIC)
In TOPIC, content is delivered through lectures, workshops, eLearning materials, anatomy labs as well as student-led and faculty-led case-based learning (CBL) sessions. In CBL, students work through a patient case in small groups of 8 – 10 students in two sessions each week: the first one is on their own, the second is with a tutor who is a faculty member. The majority of the faculty tutors are practicing physicians based at one of the GTA teaching or community hospitals. Over the 72 weeks, the cases introduce students to all aspects of clinical medicine. Each case describes a medical problem in a patient (or occasionally a family) and offers students the opportunity to learn material in a clinically relevant way while introducing them to the scientific and humanistic foundation for the theory and practice of medicine.
Learning about the cases is supported through carefully selected eLearning materials. Each week is introduced by a half-day during which a small number of lectures provide context for the issues addressed during the week. Another half-day consists of expert-led seminars or workshops which serve to provide further context and content. Every few weeks, there is a multi-disciplinary summary lecture to help pull it all together for students.
Many of the weeks include specific instruction on the longitudinal thematic issues (described below), such as medical ethics, leadership and collaboration with other health professionals.
Integrated Clinical Experience (ICE)
ICE occupies two half-days per week. One half-day provides students with instruction in groups of six on how to take a patient’s history and perform a physical examination, which is a continuation of the Art and Science of Clinical Medicine (ASCM) course.
The second half-day for ICE provides students with opportunities for early clinical exposure in a variety of settings, include doctors’ offices, hospitals, community health agencies and home care visits. Throughout the Foundations Curriculum, students will be able to prepare for clerkship by spending time in clinical placement shadowing opportunities.
Students will spend a half-day every three to four weeks in a small group with a tutor in Portfolio. Portfolio focuses on two types of activities:
- Students will reflect on their previous experiences and their experience as first- and second-year medical students and the resulting effects on their professional development.
- Guided self-assessment: students will compile their formal assessments and the student’s reflections and develop an individualized learning plan related to these assessments to ensure students are staying on track, and receiving help where it is needed.
Health Science Research (HSR)
HSR was introduced in the 2015-16 academic year, and will continue in the Foundations Curriculum. It provides students with tutorial and eModule-based learning on two major topics:
- How to participate in health research projects.
- How to apply the findings of health research to patient care.
The course will also introduce students to well-known researchers working at the University of Toronto through its HSR Grand Rounds series.
Multiple thematic elements run throughout the two-year Foundations Curriculum, and provide integration longitudinally. There is content related to the themes delivered during the case-based learning integrated with the other issues addressed in the case, as well as dedicated sessions at other times to explore the themes in more depth. These themes are organized in three major categories:
Themes related to priority population groups: These themes address the needs of groups which often have not received sufficient attention in the health care system, and include: indigenous health, health for those identifying as LGBTQ, geriatrics, and global health.
Themes related to CanMEDS roles: The curriculum is organized around the seven CanMEDS roles of a physician, and several of these are amplified by dedicated theme-based teaching, including: the role as leader, as collaborator (with other health professionals), as health advocate, as professional, and as scholar.
Themes related to specific content areas: These are topics that students have identified as needing particular attention, partly because they do not necessarily fit well with either the systems-based or the life-cycle frameworks we are using, and include: medical imaging, pharmacology, and humanities.