The Practicum

Dr. Jennifer Wilson is a comprehensive family physician in Uxbridge, Ontario. She is a Lecturer at DFCM, mentoring medical students and residents in her community practice and Uxbridge Hospital. Dr. Wilson is the Director of International Partnerships at the Leyaata Hospital in Ghana and Faculty Lead for a collaboration between the DFCM and the Kwame Nkrumah University of Science and Technology in Ghana. Dr. Wilson completed the MPH-AS(FCM): Master of Public Health - Advanced Standing in Family and Community Medicine with a Collaborative Specialization in Global Health in Summer 2024.

Supervisor: Dr. Mahan Kulasegaram

The objective of this practicum was to create and operationalize the organizational plan for the co-creation and submission of a manuscript documenting the KNUST/U of T collaborative in partnership with KNUST and the Office of Education Scholarship, DFCM, and Office of Vice-President International at U of T.

Abstract

The Africa Higher Education Health Collaborative (AHEHC) initiative embarked on a transformative five-year collaboration with Kwame Nkrumah University of Science and Technology (KNUST) and the University of Toronto (U of T) to co-create continuing education programs geared towards augmenting the proficiency of primary care practitioners in Ghana. While upholding core principles within the AHEHC framework, emphasizing respect, inclusivity, equity, reciprocity, ethics, dynamism, and stewardship, seven teams of U of T and KNUST faculty engaged in collaborative efforts to design, administer, and evaluate five in-person "short courses" in Ghana on Palliative Care, Quality Improvement for Health Professionals, Pre-hospital Emergency Care, Community Emergency Care, and Emergency Preparedness and Response to Epidemic-Prone Diseases to approximately 100 Ghanaian primary care professionals. This paper describes the principles and methods of co-creation, highlights lessons learned, and proposes that this co-creation model can strengthen primary health care in Ghana and ultimately transform health systems in Africa.

Princess Ruhama Acheampong¹, Mahan Kulasegaram², Marie-Therese Ndiaye³, Kofi Akohene Mensah¹, Wilberforce Owusu-Ansah¹, Ellis Owusu-Dabo¹, Joseph Owusu¹, Jamie Rodas², Katherine Rouleau², Jennifer Wilson², Olivia Wilson⁴

¹ School of Public Health, Kwame Nkrumah University of Science and Technology, Ghana, Africa

² Department of Family and Community Medicine, University of Toronto, Toronto, Canada

³ Office of Vice President International, University of Toronto, Toronto, Canada

⁴ School of Medicine, University College Dublin, Dublin, Ireland

Dr. Rosemarie Lall completed her MPH-AS(FCM): Master in Public Health - Advanced Standing in Family and Community Medicine at the DFCM in Summer 2024. She worked on her Masters part-time while in full-time comprehensive practice in Family Medicine in Scarborough. She teaches family medicine residents and medical students at the Scarborough Health Network (SHN) site of DFCM. Scarborough has a dispersed model where students are taught by preceptors working in their community clinics. She is grateful for all the teachers and students she has met during this Master's journey.

Supervisor: Dr. Melissa Graham

This project is a description of my involvement with vested stakeholder groups to recruit and retain more family doctors to the underserved community of Scarborough, Ontario. Skills acquired in the MPH program were applied to solve real world problems.

Abstract 

Scarborough is an underserved community with 100,000 ‘unattached’ patients who do not have access to family doctors. It is the selected site of a new medical school, SAM-IH (Scarborough Academy of Medicine and Integrated Health).

Over the course of the last few months, several stakeholders have started to collaborate on how to recruit and retain more family doctors in Scarborough. Stakeholders include University of Toronto (SAMIH working groups), DFCM (central and Scarborough), Scarborough Health Network (SHN) leadership, SHN foundation, patient partners, family medicine residents. The challenges faced are insufficient doctors practicing comprehensive family medicine, recruiting and retaining enough medical doctors to teach and mentor the upcoming students of SAMIH.

The Scarborough site graduates doctors interested in staying locally to open up practices, but many of them are internally trained medical graduates, who because of the return of service (RoS) contractual obligations with the Ministry of Health (MoH), cannot stay in Scarborough. Scarborough is acknowledged as a high-need, underserved area but not considered part of a RoS geographical area.

Through this practicum and using skills learned during the MPH program, I created an annotated bibliography of resources; and with learnings from the leadership training, policy and other courses, was able to meaningfully participate and in some case lead conversations in working groups. The stakeholders generously allowed me to be the principal in drafting a demonstration project and briefing note. The plan is ultimately to submit these to MoH for consideration. The proposals outline reasons why the MoH should consider Scarborough a “vetted” RoS, and strategies to enable this undertaking

Dr. Susan Deering is a Family Physician in the MPH-AS(FCM): Master of Public Health - Advanced Standing in Family and Community Medicine program who will be graduating in October 2024. Susan works in the Veterans Centre at Sunnybrook Health Sciences Centre as a primary care provider and wound care consultant. In addition to care of the elderly and chronic wound care, her current area of teaching and research focuses on the human health impacts of climate change.

Supervisor: Dr. Ross Upshur

The goal of this project was to develop a workshop to help Family Medicine residents develop skills and confidence in counselling older adult patients regarding their health risks due to global warming.

Abstract: 

As global warming continues unabated, the impacts on human health also continue to rise. Climate change has been called by many experts the biggest public health emergency we are facing at this moment. As a result, it is imperative for clinicians to be prepared to counsel their patients about their health risks due to climate change, so that patients can be better prepared to protect themselves.

This project evaluated several foundational topics:

1. What climate change and health teaching and competencies have already been incorporated at the undergraduate and graduate levels of medical training
2. What is known about health and climate change counselling is being done by Family Physicians, including barriers and facilitators
3. What is known about the impacts of global warming on older adults, as an example of a group that is particularly vulnerable to the impacts of global warming

Academic and grey literature was reviewed, analyzed and presented in a summary and two annotated bibliographies; these were used as the foundation to develop learning objectives for an interactive workshop for Family Medicine Residents. The workshop focuses on how Family Physicians can incorporate counselling about the health impacts of global warming, using heat-related illnesses and air pollution as examples of possible risks. Case examples focus on the vulnerable older adult population. The workshop includes interactive elements such as case studies, small and large group discussions, polls, and role plays.

Dr. Dena Sommer is a student in the MScCH (HPTE): Master of Science in Community Health in Health Practitioner Teacher Education program, and is anticipating graduation in the fall of 2024. She is an adjunct lecturer at the University of Toronto and works as a Geriatrician at Baycrest Hospital.  Her clinical work and teaching are centered around general Geriatric Medicine, and scholarly work is focused on undergraduate education on the subject of older adults.   

Supervisor: Dr. Thirumagal Yogaparan

Using Delphi methodology, our study aims to create and validate a comprehensive set of learning objectives to be used by curriculum developers across Canada to enhance undergraduate medical education in the care of older adults. 

Abstract 

Despite an aging population with increasingly complex medical needs, the care of older adults is underrepresented in the curriculum in many medical schools across Canada. The Canadian Geriatrics Society recently published a comprehensive list of competencies for graduating medical students using the Aging Care 5Ms framework (https://canadiangeriatrics.ca/Aging-Care-5Ms-Competencies). This current project builds on the previous work, aiming to develop and validate learning objectives to be used by educators across Canada in the creation of educational programs to address these competencies. This ongoing study uses modified Delphi methodology to validate learning objectives by a panel of experts with national representation. In three planned survey rounds, learning objectives are rated by the panel, with revisions based on panel member feedback carried forward to the panel in subsequent survey rounds. Our anticipated outcome will be a complete, validated list of learning objectives that can be modified and applied at the local level to create Geriatrics curricula for medical students in Canada.

Dr. Jutamas Saoraya is an emergency physician and intensivist at King Chulalongkorn Memorial Hospital, Assistant Professor of Emergency Medicine at the Faculty of Medicine, Chulalongkorn University, and a Core Team Member at Chulalongkorn University International Medical Program (CU-MEDi), Bangkok, Thailand. In 2023-2024, she completed the MScCH(HPTE): Master of Science in Community Health in Health Practitioner Teacher Education program, DFCM. Her career intention is to provide the best care for critically ill patients, provide excellent education for next-generation health professionals and to advance knowledge of emergency medicine and resuscitation.

Supervisor: Dr. Dominique Piquette

This project examines medical students' experiences during elective ICU rotations, focusing on their impact on professional development and identity.

Abstract

Exposure to critical care during training in a medical school is increasingly recognized as essential, though the nature and extent of this training varies globally. The intensive care unit (ICU) offers unique learning opportunities, such as interdisciplinary teamwork and advanced communication skills. However, ICU is a challenging learning environment due to its chaotic, stressful, and potentially emotionally traumatic nature, and may present, due to  time constraints, limited support for medical students. While previous studies highlight students’ perceived clinical gains, little is known about how ICU rotations shape their professional identity and approach to care. This project aims to explore the experiences of medical students during elective ICU rotations at three university-affiliated centers, focusing on the roles of physicians (e.g., communicator, collaborator) and the transformative impact on their professional identity. We have recruited medical students for semi-structured interviews, and the deidentified interview transcripts will be analyzed using a thematic analysis. The results will provide critical insights into the benefits, challenges, and long-term effects of early ICU exposure, helping educators optimize these rotations within medical curricula. Our findings will guide medical schools in structuring ICU rotations to enhance learning and mitigate potential risks, ultimately improving medical education and professional development.