Overview of the Upcoming Curriculum Changes

About the MD Program

The University of Toronto has been educating physicians since 1843. Each class consists of 259 students. The MD program prepares students for every kind of career in medicine. The University of Toronto’s MD program is fully accredited by the CACMS-LCME accrediting bodies through 2020. The first two years (the preclerkship) involves learning about all aspects of medicine in classrooms, laboratories, with patients and in the community. The third and fourth year (the clerkship) involves learning while working in the hospital and in doctors’ offices and other clinics, from physicians and other health care team members. For more information on the U of T MD program, visit the MD Program website.

Rationale for the changes

This is one of the most significant changes we have made to the way we deliver medical education over the past two decades. This curriculum renewal will ensure our program is at the forefront of medical education and is responsive to the needs of our students. The evidence-based changes we are making are supported by the latest medical education literature, and developed through broad engagement with curriculum developers, assessments specialists, faculty developers, department and hospital leaders, our teachers, recent graduates, current students, as well as the education research community.

This approach is supported by recent medical education literature, including the Future of Medical Education in Canada (FMEC) MD Project Report, Lancet Commission Report 2010 and Carnegie Report 2010, among others. Multiple medical schools, in Canada and around the world, are pursuing substantial curricular revisions in keeping with these recommendations.

There are many factors driving changes in modern medical education, and almost all Canadian and most American medical schools are developing new curricula in response. These factors include a focus on ensuring students learn in an integrated way, underscoring the connections between basic science, clinical medicine, public health and other disciplines, while also allowing the flexibility to pursue individualized interests such as research, public health and other pathways.

For additional information regarding trends in medical education, see the special communication in JAMA Internal entitled Medical Education Part of the Problem and Part of the Solution by Catherine Reinis Lucey, MD (September 23, 2013). 


Key elements

The Foundations Curriculum will prepare students to practice medicine within the current and ever-evolving health care environment. It strives to meet these challenges through the following major elements:

  • Application of knowledge to virtual patients demonstrating real-life clinical problems through extensive use of case-based learning in a small group with a faculty member.
  • Clinical medicine content that is closely integrated with relevant clinical skills (history-taking and physical examination), and with basic and social sciences, as well as community and public health.
  • Carefully selected eLearning materials. More online content allows students to learn at their own pace and provides flexibility to pursue interests that complement their medical education, such as advanced research as part of our MD/PhD program or our Comprehensive Research Experience for Medical Students (CREMS) program.
  • A programmatic assessment program designed to ensure students are proficient across diverse professional competencies, including each of the CanMEDS roles. The new assessment model will involve frequent lower-stakes assessments with feedback and individualized coaching designed to support learning.
  • Lectures, though considerably reduced in number, will provide context for integrated content throughout the entire week’s learning activities, across various learning modalities. This may include small, expert-led group seminars, case-based learning, small-group discussion and shadowing. Students will be introduced to content through online materials and other resources both in advance and throughout the week to allow greater depth of content exploration in class.
  • Longitudinal learning will also be emphasized through time dedicated to teaching areas such as leadership, medical ethics, and interprofessional education.

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