Hands-on, case-based learning
Our undergraduate medical education provides an experience that gives you hands-on learning starting in first year. Students at Dalhousie Medical School have many opportunities to get real-life hospital experience early on, through the clinical skills components or by chosing an elective that offers additional hands-on learning.
The program is divided into three key sections, Med 1 and Med 2, followed by the clerkship. The first two years, Med 1 and Med 2, give you a basic foundation in medicine, including the anatomy and systems of the human body, while considering other important aspects of health care, from the philosophical and ethical to the practical.
The clerkship, consisting of two phases completed over two academic years (Med 3 and Med 4), gives you even more opportunity to apply your learning in a range of situations and fields. The Clerkship Review Committee reviewed the Med 3 and Med 4 curiculum in 2012 and proposed several recommendations. In response, four periods of teaching time (each 2 to 4 weeks in length) will be developed to help students transition from Med 2 to Med 3, and through the clerkship from Med 3 to Med 4, and subsequently, from Med 4 into residency. These sessions will incorporate Introduction to Clerkship and Critical Review and Mastery (CRAM).
Courses in our medical program do not have the typical academic structure; rather, you will take a variety of theme- and case-based units that focus on a particular area of medical training. See below for a more detailed description of Med 1, Med 2, and the clerkship, as well as descriptions of some of the units.
In Med 1, you’ll take part in dynamic group learning that requires your active participation. The objectives of the first-year units emphasize uncovering the issues of a particular case and understanding "why" and "how" they occur. Cases are used as vehicles that enable you to learn in a clinical context and to apply the first steps of a clinical reasoning process, which will be defined and further developed over the subsequent years of your undergraduate medical education.
A typical week in first year includes the following:
- tutorial groups – meet for 2 to 3 hours, twice a week
- lectures – attend between 3 to 5 hours
- patient contact experience – insight into the patient-doctor relationship, 3 to 4 hours
- elective – a class or experience of your choosing for one half-day
- laboratory – a 3-hour experience related to the cases under study
- Foundations of Medicine
- Host Defense
- Metabolism and Homeostasis
- Human Development
- Professional Competencies
- Clinical Skills I
- Rural Week
Foundations of Medicine
Foundations of Medicine provides the basics for further study in biomedical, epidemiological, social, and human sciences, including genomes, proteins and enzymes, cell structures and an introduction to cancers. Students are exposed to anatomy, histology, pathology, and pharmacology using evidence-based practice. Students also shadow a physician, a highlight of the unit, for a full day of clinical practice at a location within Halifax Regional Municipality (HRM).
Host Defense (Hematology, Infection, Immunity and Inflammation
A study of the complex systems pertaining to blood (hematology), infection, immunity and inflammation in the human body, Host Defence explores the cellular level of health in regional and global populations. Through collaboration, multidisciplinary teamwork, and laboratory medicine experience, students understand the international implications of localized deficiencies in the immune system that lead to infections and blood disorders
Metabolism and Homeostasis
Metabolism, the basic chemical processes that maintain life, and homeostasis, the balance of chemical processes in the body, are introduced to students through the integration of basic and clinical sciences. Oral medicine, nutrition, gastrointestinal health, and hormonal health (endocrinology) frame the understanding of two complex concepts and body functionality.
An area of study that is crucial across all years of medical training, Human Development explores the growth of the body from labour and birth to sexual maturity through genetics, embryology, the genitourinary system, and molecular biology. The study of sexuality, also a social concept, gives students opportunities to work through human sexual behaviour and its cultural contexts. Students also learn the fundamentals of patient histories, ancestries, and community responsibilities, as well as genital function and male and female physiologies.
Professional Competencies I
A year-long unit, Professional Competencies complements the content of block units by asking students to apply and contextualize medical knowledge within health-care systems and practice, including professional ethics, patient care, and lifelong learning. Students become aware of community health complexities and are encouraged to find best practices for the legal, social, and historical elements of medicine. Students also participate in the Health Mentors Program: group-learning with real-patient volunteers who suffer from chronic conditions.
During the last week of Med 1, you’ll spend one week observing a rural physician in practice. The opportunity allows you to reflect on the unique characteristics of a rural lifestyle and clinical practice. The purpose of this unit is to help you identify the characteristics of clinical practice in a rural setting, as well as health-care delivery and resource access/use in a rural setting. As well, you will be able to observe the determinants of health unique to the community in which you are located and reflect on how health-care delivery addresses or does not address these needs. You’ll also focus on physician wellness and lifestyle in a rural setting and identify the physician’s role in a rural setting, including leadership responsibilities.
The second year of your undergraduate medical education at Dalhousie will be somewhat similar to the first, in terms what typical weekly activities will be:
- tutorial groups – 2 to 3 hours, three times a week
- 3 to 5 hours of lectures
- patient contact experience for 3 to 4 hours, emphasizing patient-doctor relationships
- elective for one half-day
- 2 hours concentrating on critical appraisal or population health
- a 3-hour lab, relating to the cases under study
As with first year, the unit objectives in second year emphasize uncovering the issues in a particular case and understanding “why” and “how” they occur. You will further refine your ability to apply the steps of the clinical reasoning process to your activities and deciding on a management plan. In addition to Foundations of Medicine II, the units examine these topics and systems:
- Metabolism II
- Musculoskeletal and Dermatology
- Clinical Skills II
Professional Competencies II
- Electives – Med 2
Foundations of Medicine II
Jumping off from Foundations of Medicine, this unit explores the anatomy of the head and neck through labs and lectures to prepare students for further study in Neurosciences. Foundations of Medicine II also teaches students arterial diseases like atherosclerosis and emotional dysregulation, while exploring the causes, effects, and approaches to biases in physicians.
Neurosciences (Central Nervous System and Special Senses)
An interdisciplinary science, Neurosciences explores nervous systems and special senses that transmit and communicate cellular (neuron-based) information in the body, and how these systems relate to neurological and psychiatric disorders and conditions. Focusing on the central nervous system (spine/brain) and peripheral nervous system (limb/organ movement), vision and hearing, and mental/physical disorders, Neurosciences is a framework for understanding health.
After learning the basics of chemical processes in the body, Metabolism II provides the anatomical and physiological evidences for those processes in three interconnected systems. Diseases of the cardiovascular (heart/blood), respiratory (lungs/breathing), and renal nephrology (kidneys) systems are explored through case-based learning and anatomical dissection, as are the social, cultural, and lifestyle causes of such diseases and the physician’s role in treatment.
Musculoskeletal and Dermatology
This two-part unit focuses on the skeleton and organs (musculoskeletal) and the skin within which this apparatus is held (dermatology), and the diseases and conditions that affect both. Students work through approaches to investigate, effectively diagnose, and properly manage MSK-Derm by studying the development of diseases (pathogenesis) in the body and socially.
Accounting for the culture, context, experience, feelings, and expectations of the whole person under the patient-centered care model, with a focus on geriatric medicine (care of the elderly) and oncology (cancers), Integration explores the relationship of the physician to the patient and patient-family through ethical, social, and political lenses. Areas like health support professionals, health-care policy, end-of-life care, and professional collaboration are explored.
Professional Competencies II
Students are empowered to consider the interrelationships of culture and society on the health-care system in particular regions and demographics with professional aplomb and strong strategies for long-term care. Highlights of this unit include community-based projects and short-term residencies that expose students to the various reaches of the health-care system.
The Clerkship Review Committee reviewed the Med 3 and Med 4 curiculum in 2012 and proposed several recommendations. In response, four periods of teaching time (each 2 to 4 weeks in length) will be developed to help students transition from Med 2 to Med 3, and through the clerkship from Med 3 to Med 4, and subsequently, from Med 4 into residency. These sessions will incorporate Introduction to Clerkship and Critical Review and Mastery (CRAM).
The clerkship consists of two phases completed over two academic years. In Phase 1, which is 55 weeks long, clerks participate in a two-week Introduction to the Clerkship unit, followed by rotations in
- Internal Medicine (12 weeks)
- Family Medicine (6 weeks)
- Psychiatry (6 weeks)
- Surgery (9 weeks)
- Pediatrics (6 weeks)
- Obstetrics and Gynecology (6 weeks)
- Emergency Medicine (3 weeks)
In Phase 2, Med 4, which is 32 weeks long, there is a scheduled block that is designed for clerks to participate in 18 weeks of elective time. In addition, clerks will complete a three-week rotation in Care of the Elderly (CoE). Vacation time and Canadian Resident Matching Service (CaRMS) interviewing time can be scheduled around the clinical rotations. A total of three weeks of vacation can be taken during Phase 1, as well as two weeks at the end of Unit 1 and one week at the end of Unit 2.
Introduction to the Clerkship
This two-week unit is designed to refresh basic clinical and procedural skills learned in Med 1 and Med 2; introduce clerks to the hospital-based clinical clerkship behaviours, procedures and processes; and provide opportunities to learn and practice clinical problem solving in various settings. Introduction to the Clerkship is the last time during the Clerkship phase that class members will be together. All academic sessions are broadcast using Bridgit conferencing technology.
The Internal Medicine unit incorporates the objectives of general internal medicine, as well as the sub-specialties of internal medicine. Clerks will complete four weeks in General Medicine (A1), four weeks in a ward-based medicine sub-specialty (A2); and four weeks which must be at least 50% ambulatory care on a medicine sub-specialty (A3). As part of the learning experience, clerks will take in-house call for Internal Medicine.
The nine weeks of the Surgery unit are intended to provide the clerk with the broad principles of surgery and the basics in the individual surgical specialties as a foundation for postgraduate training. The clinical rotations are organized into three segments of three weeks each. All rotations are in Halifax, primarily at the QEII, but some experiences will take place at the IWK Health Centre.
All clerks will complete a mandatory three-week General Surgery rotation. Two three-week selective rotations can be chosen from the following nine specialties: Cardiac, Neurosurgery, Otolaryngology, Pediatric General Surgery, Plastic Surgery, Orthopedics, Thoracic Surgery, Vascular Surgery, and Urology. Clerks will be scheduled for call duty, as these are important surgical experiences.