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TABLE OF CONTENTS

DEANS WELCOME ..................................................................................................................................................4 MESSAGE FROM THE ASSOCIATE DEAN ............................................................................................................5 MESSAGE FROM THE ASSISTANT DEAN YEAR 1 & 2 (PRECLERKSHIP) & YEAR 3 (CLERKSHIP) .............6 MESSAGE FROM THE ASSISTANT DEAN RESEARCH .....................................................................................7 MESSAGE FROM THE DIRECTOR OF STUDENT AFFAIRS .................................................................................8 MISSION STATEMENT..............................................................................................................................................9 GOALS, OBJECTIVES AND OPERATING PHILOSOPHY ................................................................................... 10 THE CURRICULUM ................................................................................................................................................ 15 INTRODUCTION........................................................................................................................................ 16 CURRICULAR CONTENT ............................................................................................................................ 16 TEACHING METHODS IN CLINICAL PRESENTATION CURRICULUM....................................................................... 17 LECTURES .............................................................................................................................................. 17 SMALL GROUP SESSIONS .......................................................................................................................... 18 CLINICAL CORRELATION ............................................................................................................................ 18 CLINICAL PRESENTATION .......................................................................................................................... 19 LONGITUDINAL COURSES ................................................................................................................................... 24 MEDICAL SKILLS PROGRAM ....................................................................................................................... 24 FAMILY MEDICINE CLINICAL EXPERIENCE (MDCN 330 AND 430) ..................................................................... 25 POPULATION HEALTH - YEAR 1 (MDCN 340) ............................................................................................... 25 APPLIED EVIDENCE BASED MEDICINE - YEAR 2 (MDCN 440) .......................................................................... 25 ELECTIVES ............................................................................................................................................................. 26 SUMMER (PRECLERKSHIP) ELECTIVES (MDCN 402) ...................................................................................... 26 CLERKSHIP ELECTIVES ............................................................................................................................. 27 INTERNATIONAL ELECTIVES ....................................................................................................................... 27 ELECTIVES IN RURAL/REGIONAL ALBERTA ................................................................................................... 27 GLOBAL HEALTH INTEREST GROUP............................................................................................................. 28 CLERKSHIP ............................................................................................................................................................ 28 CLERKSHIP STIPEND ................................................................................................................................ 28 C A N A D I A N R E S I D E N T M A T C H I N G S E R V I C E ( C A R M S ) ............................................................. 30 CARMS TIMELINE .................................................................................................................................................. 31 PERSONAL LETTERS ........................................................................................................................... 33 MSPR ................................................................................................................................................... 35 TEMPLATE FOR CONTENTS OF THE MSPRS................................................................................................... 35 CARMS AND CAREER ADVISE MEETINGS FACULTY CHECKLIST...................................................................... 48 PRE-CARMS MEETING PREPARATION FORM ................................................................................................ 49 REQUEST FOR RELEASE OF THE MSPR ............................................................................................... 51 PERMISSION TO RELEASE MCC LICENSING EXAMS PART L & LL RESULTS ................................................... 52 REFERENCE LETTER ................................................................................................................................. 53 CURRICULUM VITAE ............................................................................................................................ 54 PROFESSIONALISM .............................................................................................................................................. 56 A GUIDE TO PROFESSIONAL BEHAVIOUR FOR STUDENT PHYSICIANS ................................................................. 56 UNIVERSITY OF CALGARY MEDICAL SCHOOL STUDENT CODE OF CONDUCT ........................................................ 59 THE STUDENT PROFESSIONALISM COMMITTEE TERMS OF REFERENCE ............................................................... 60 STEPS TO RESOLVING ISSUES OF UNPROFESSIONALISM .................................................................................. 62

LEARNING EXPERIENCES ................................................................................................................................... 65 ATTENDANCE .......................................................................................................................................... 65 SMALL GROUP SESSIONS .......................................................................................................................... 65 SMALL GROUP ATTENDANCE POLICY - UPDATED MARCH 2013 .......................................................... 65 BEREAVEMENT POLICY ....................................................................................................................... 68 ATTIRE ................................................................................................................................................ 68 INDEPENDENT STUDY TIME................................................................................................................. 69 CLINICAL CORRELATION .................................................................................................................... 69 SHADOWING EXPERIENCES ........................................................................................................................ 72 THE MASTER TEACHER PROGRAM .............................................................................................................. 73 IN CLASS PRESENTATIONS ........................................................................................................................ 73 VISITORS................................................................................................................................................ 73 COURSE QUESTIONNAIRES ........................................................................................................................ 74 PRESENTATION OF PAPERS AT CONFERENCES OUTSIDE OF U OF C ................................................................... 74 ACADEMIC ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES .................................................................... 74 REMEDIAL WORK ..................................................................................................................................... 75 RECORDINGS .......................................................................................................................................... 75 HEALTH SCIENCE CENTER LIBRARY SERVICES .................................................................................. 76 EVALUATIONS ....................................................................................................................................................... 78 PURPOSE OF STUDENT EVALUATIONS ............................................................................................... 78 PREPARATION OF EVALUATIONS ....................................................................................................... 78 FREQUENCY OF STUDENT EVALUATIONS........................................................................................... 78 TYPES OF FORMAL STUDENT EVALUATIONS ...................................................................................... 79 CONDUCT AT EVALUATIONS ............................................................................................................... 82 SECURITY OF EVALUATIONS ............................................................................................................... 83 PERMISSION TO DEFER AN EVALUATION ............................................................................................ 83 SPECIAL REQUEST FOR DEFERRAL TO PRESENT ACADEMIC PAPERS ................................................................. 86 STUDENT REVIEW OF WRITTEN EXAMINATIONS ................................................................................. 86 THE STUDENT FILE .............................................................................................................................. 88 EVALUATION RESULTS ....................................................................................................................... 88 GRADING SYSTEM ............................................................................................................................... 89 CONSEQUENCES OF AN UNSATISFACTORY PERFORMANCE ............................................................. 90 EXAM RE-WRITE SCHEDULE ................................................................................................................ 91 DISTRIBUTION OF RESULTS ................................................................................................................ 92 REAPPRAISALS AND APPEALS PROCESS FOR UME EVALUATIONS .................................................... 92 ASSOCIATE DEANS TESTS (ADTS) 1- 3....................................................................................................... 98 THE MEDICAL SKILLS (MS) I AND II OBJECTIVE STRUCTURED CLINICAL EVALUATIONS (OSCE) .............................. 99 CLERKSHIP CERTIFYING OSCE ......................................................................................................... 101 PEER FEEDBACK SELF ASSESSMENT PROCESS ............................................................................... 101 THE MEDICAL COUNCIL OF CANADA (MCC) EXAMINATIONS ............................................................. 101 PROMOTION ...................................................................................................................................... 102 LOCKERS, ORANGE MAIL TRAYS , ICLICKERS AND STUDENT FAXES...................................................... 104

DEANS WELCOME Welcome to the University of Calgarys Faculty of Medicine. You have worked hard to become students in our MD program. We want you to continue successfully on the career path youve chosen, which is why were providing you with this road map. Our hope is that the overview and information our UME Student Handbook provides will help you navigate successfully through the next three years. You have chosen to study at an innovative medical school, one offering patient-centered learning and hands-on experience, introduced early in your training; one offering on-the-job training in both rural and urban settings throughout Alberta; one grounded in solid basic science; and, as you likely know, one of only two medical schools in North America distinguishing itself by offering a three-year MD program. Were proud of your medical school and hope you will be too. Innovation is important to us. I challenge you to be innovative in your approach to learning. Be open to thinking critically about what your teachers and classmates are presenting. Be mindful of what the medical profession you are entering into can offer you, but also be equally aware of the responsibilities you are taking on. Working as a physician is both a privilege and an obligation to our society. You will give and gain medical knowledge throughout your career. I encourage you to share what you will learn with those who will come behind you. Your course load will be heavy and the learning curve is steep in Medicine. However, please take a long range view of your learning experience and take advantage of the many opportunities in the Faculty that are not part of your formal curriculum. Special lectures and events occur frequently, often with notable guests, including Nobel Prize winners I assure you that you will remember your experience when you attend these special events and listen to leading experts on research, health policy or medical affairs. Many students find this exposure to be stimulating and potentially influential in their ultimate choice of careers. Welcome to the Faculty of Medicine community. No doubt the next three years will be among the most challenging of your lives. We intend them to also be among the most rewarding. Work hard, have fun, and welcome to the University of Calgary.

Jon Meddings, MD Dean, Faculty of Medicine University of Calgary

MESSAGE FROM THE ASSOCIATE DEAN It is with great pleasure that I welcome you to the beginning of your excellent adventure. Most physicians vividly recall their medical school experience as a time of intense work and personal growth. They also recall the lifelong friends they made and the fun of going to medical school. I am excited for you as you begin this journey. Please consider this Student Handbook as a guide and policy reference. I would ask that you become very familiar with the content. Everything that is found within these pages is there for a reason: from outlining the philosophy of the medical school, to a description of the curriculum, to supports that have been set up to help you should you run into academic or non-academic difficulties. One section of the handbook requires particular attention. The section on Professionalism deals with responsibilities that you will have as medical students and the expectations of the medical school, indeed of our profession, as you progress through the school. Most of what is found on professionalism is common sense and while my intention is not to sound heavy handed I would gently remind you that your behaviors both on and off the wards not only reflect upon you but on the medical school and the profession. Thanks for keeping that in mind. One thing I know for sure - the UME team, from Course Chairs to Program Coordinators, to the administration are all passionate about providing you a high quality educational experience. I want you to know that we take that responsibility very seriously. Again..Welcome!

Bruce Wright, MD, CCFP, FCFP Associate Dean Undergraduate Medical Education

MESSAGE FROM THE ASSISTAN T DE AN & YEAR 3 (CLERKSHIP) Welcome to the University of Calgary Faculty of Medicine!

YEAR 1 & 2 (PRECLERKSHIP)

As a graduate of this program and now a faculty member directly involved in planning your educational experience, I am very proud of our medical school. The University of Calgary Medical School has remarkably dedicated faculty, progressive curriculum and excellent students! Medical school is an intense period, both in terms of acquisition of knowledge and skill, and in development of long-lasting relationships with colleagues and supervisors. This manual is designed to help you negotiate the practical elements of your program. I encourage you to read it in detail and refer back to it throughout your 3 year program. By entering medical school, you have joined a profession with the primary goal of helping people. You will be expected to interact directly with patients in varying degrees of distress, and to rapidly develop communication and examination skills that will permit you to become a part of their care team. Despite the recent explosion of technology, the direct patient contact will always remain a key element of the training and practice of physicians. Inevitably, your program will include a series of evaluations. The faculty works hard to ensure these are of high quality and has established a number of processes for the preparation and review of examinations. One of the sections in this manual relates to student evaluations, and describes the specific policies and procedures. I hope you will find the UME team approachable. We encourage student input and consider students key members of all the administrative committees. Many changes have arisen as a direct result of constructive student feedback. Welcome to our profession!

Pamela Veale, MD, MSc, FRCPC Assistant Dean, Pre-clerkship Chair, Curriculum Design and Implementation Committee (CDIC)

MESSAGE FROM THE ASSISTANT DEAN YEAR 3 (CLERKSHIP) & RESEARCH

Welcome to medicine at the University of Calgary. Being selected to study and practice medicine is a great honour and is your reward for years of dedicated study. Our profession is equally honoured to have been chosen by the intelligent and industrious group of students in your class. Over the next three short years you will acquire experiences and friendships that you will treasure and that will shape who you will become, both professionally and personally. Our medical school curriculum is planned and coordinated from the Undergraduate Medical Education (UME) office. The associate and assistant deans are a small part of a large team in the UME office. This team includes experienced administration staff and educators, all of whom play a key role in our curriculum. We believe that our curriculum is exciting and innovative. It is also being modified continuously. This process of curricular reform is partly based upon input from students and staff and we hope that you will continue the tradition of providing feedback on the curriculum. Another important source of data for curricular reform is research in medical education. We have an active research program within our curriculum and a team of trained researchers with experience in medicine, psychology, statistics and research design. Todays medical school curriculum incorporates the findings of research on your predecessors. We hope that you will participate in education research projects designed to make our medical school even better. To maintain and improve the quality of teaching within our medical school we have an active faculty development program. We also have an innovative Master Teacher Program in which faculty members who are considered to be among our best teachers are given protected time to allow them to increase their participation in the curriculum. Thanks for picking the University of Calgary medical school. We are proud to have you in our program and look forward to sharing the next three years with you.

Kevin McLaughlin, MBChB, MSc, PhD Assistant Dean, Research Undergraduate Medical Education

Message from the Director of Student Affairs


Welcome to the University of Calgary Medical Faculty! Although it has been over 27 years since I was a student, I remember clearly the trials and triumphs of the journey into medicine. Having a daughter currently studying medicine in a different Canadian city, I also have firsthand experience of the ups and downs of being a medical student of your generation. As you progress through your studies, you will share your excitement and achievements with your friends and family. You will feel great when you attempt your first procedural skill or take your first patient history alone. On the other hand, if you are experiencing difficulties in any aspect of your life, from academic concerns to personal issues, please do not hesitate to drop by our office. Our door is always open for support and guidance. No problem is too insignificant; we are here to help you before it becomes too big for one person to handle alone. Being a family physician for the past 25 years, first in solo and later in group practice, I can share my personal experience with you regarding front line primary care. Common things are common, however as a family physician I never know what is waiting for me in the next patient room. At the Office of Student Affairs, we are here to offer career advice and help you explore all your options. If you have questions regarding a dynamic career in Family Medicine, I would be delighted discuss them with you. Finally, as a member of the Master Teacher Program in the Undergraduate Medical Education Department, I look forward to being your preceptor in the near future!

Patrick F Lee MD, CCFP, FCFP Associate Director, Student Affairs Master Teacher Department of Family Medicine University of Calgary

Mission Statement

University of Calgary Faculty of Medicine

MISSION STATEMENT
An innovative medical school committed to excellence and leadership in education, research and service to society.

THE UNIVERSITY OF CALGARY FACULTY OF MEDICINE Undergraduate Medical Education Program

Goals, Objectives and Operating Philosophy

Goals, Objectives and operating Philosophy Goals The Undergraduate Medical Education Program at the University of Calgary strives to: 1. 2. 3. 4. 5. Be an innovative and progressive three-year program that educates its students to become compassionate, competent and well-rounded physicians prepared for supervised practice. Provide an environment that fosters collegiality, ethical practice and professionalism among students, faculty and allied health professionals to produce future physicians capable of working cooperatively within a team of health care providers. Facilitate the acquisition of clinical problem solving skills through the use of clinical presentations as the foundation of its curriculum, early contact with patients and integration of basic and clinical sciences. Prepare students to remain competent throughout their career, being able to appraise new scientific medical information and thoughtfully modify their practice accordingly. Maintain an active learning environment by incorporating research opportunities, scheduled independent study time and a balance of traditional and innovative instructional modalities, including, but not limited to: small group learning, problem based learning, interactive lectures, simulated patient encounters and bedside teaching. Communicate clear performance expectations to students through the use of outcome based objectives assessed in an ongoing fashion with formative and summative evaluations.

6.

Approved by Curriculum Committee: 99/12/03. Reviewed by Curriculum Committee 04/02/20 Revised by Undergraduate Medical Education Committee 10/04/09 th Revised by UMEC June 4 , 2010

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Educational Objectives A student at the time of graduation will be able to: 1. 2. Demonstrate the basic science and clinical science knowledge and skills necessary for the supervised practice of medicine, and use knowledge efficiently in the analysis and solution of clinical presentations. Evaluate patients and properly manage their medical problems by: a) Conducting a comprehensive medical history and thorough physical examination; reliably eliciting appropriate information in the history and detecting abnormal findings on the physical examination. b) Correctly identifying the patient's medical problems. c) Applying an appropriate clinical reasoning process to the patients problems. d) Formulating and implementing a management plan to deal effectively with these problems. Apply a comprehensive patient-centered approach in the evaluation and care of patients including sensitivity to cultural and spiritual beliefs, attitudes and behaviours. Demonstrate knowledge of the fundamental concepts of disease prevention and health promotion for individual patients and populations and incorporate them into treatment plans as appropriate. Communicate and interact effectively with patients, families, medical staff and others involved in the delivery of health services. Describe and apply high ethical principles and standards in all aspects of medical practice. Exhibit appropriate professional behaviour. Formulate clear clinical questions and apply an evidence-based approach to solving these questions. Demonstrate self-directed life-long learning skills.

3. 4. 5. 6. 7. 8. 9.

10. The curriculum must introduce students to the basic principles of clinical and translational research, including how such research is conducted, evaluated, explained to patients and applied to patient care.

Approved by Curriculum Committee: 99/12/03 Reviewed and approved by Curriculum Committee: 04/02/20 Approved by Faculty Council: 04/12/08 Revised by Undergraduate Medical Education Committee 10/04/09 th Revised by UMEC June 4 , 2010

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Operating Philosophy The program will support the goals and objectives of the Undergraduate Medical Education Program and will be characterized by: 1. An innovative three-year program with clinical presentations as the foundation of the curriculum. The curriculum provides: a) An approach to clinical presentations. b) Development of knowledge, skills and attitudes required to approach clinical presentations. c) Experiences in a balance of clinical settings with clinical presentations in ambulatory, emergency, long term and acute health care delivery situations. Objectives for each clinical presentation developed by faculty and containing a clinical reasoning pathway and relevant diagnostic classification schemes. A curriculum that integrates basic and clinical sciences, which are introduced in an organized fashion as they relate to the clinical presentations. A curriculum that maintains an active learning environment with more than 25% of scheduled instructional activities spent in small group, interactive learning sessions. Small group case based learning sessions that provide an essential and unique learning activity for the students. These sessions promote: a) Creation of an approach to clinical problem solving. b) In depth analysis of the objectives and content of clinical problems presented in the course. c) Diagnostic classification schemes and their active reinforcement in solving clinical problems.

2. 3. 4. 5.

6.

7. 8. 9.

d) Correction of student misperceptions. e) Development of communication and collaboration skills. Early and ongoing exposure to real, standardized and simulated patients to increase relevance of course material; demonstrate appropriate professional behaviour, and to emphasize the importance of communication skills. Electronic access to educational materials relating to the curricular content. Opportunities for students to explore medical topics in greater depth than presented in course work including, but not limited to, involvement in research, selection of clinical electives and completion of individual course projects Independent study time (IST) so that the student can actively process knowledge and construct their understanding. In order to facilitate this deeper approach to learning, scheduled IST of an average of three halfdays per week is organized within the pre clerkship curriculum. This time is intended for: a) Preparation for small group learning. b) Completion of assigned reading. c) Study around course objectives and presentations. d) Pursuing research or career sampling opportunities (time permitting). IST may be exchanged to facilitate scheduling of clinical correlation sessions and other small group activities which are dependent on clinic schedules not determined by UME.

10.

An assessment and feedback process that: a) Measures clinical problem solving, medical skills, professional behaviour, and general content knowledge. b) Clearly communicates performance expectations through the use of outcome based learning objectives. c) Includes peer assessment of the attainment of educational and professional objectives. d) Provides students with an examination blueprint. e) Provides ongoing formative and summative evaluations throughout the three years of the curriculum. f) Actively facilitates ongoing program evaluation.

Approved by Curriculum Committee: 99/12/03. Reviewed and approved by Curriculum Committee: 04/02/20. Approved by Faculty Council: 04/12/08. Revised by Undergraduate Medical Education Committee 10/04/09. th Revised by UMEC June 4 , 2010

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Faculty and Student Responsibilities: Students and Faculty are expected to adhere to the policies and procedures of the Undergraduate Medical Education Office which should be read in conjunction with general University of Calgary Professional Standards. The Office of Equity and Professionalism has a Professional Standards for Faculty Members and Learners in the Faculty of Medicine at the University of Calgary document which can be found online at: http://medicine.ucalgary.ca/equity/

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UME

The Curriculum

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The Curriculum

YEAR I (AUGUST MARCH)


Aug - Oct Course 1 Oct Dec Course 2 Dec - Jan Winter Break (2 Weeks) Jan - Mar Course 3 Mar Apr Spring Break (2 Weeks) April & July 1st Year Rewrites/Deferrals (2 Offerings)

MEDICAL SKILLS PROGRAM (AUGUST MARCH)

POPULATION HEALTH (AUGUST MARCH)

FAMILY MEDICINE CLINICAL EXPERIENCE (AUGUST MARCH)

YEAR II (APRIL FEBRUARY)


Apr - June Course 4 & Family Medicine Clinical Experience MEDICAL SKILLS PROGRAM APPLIED EVIDENCE BASED MEDICINE June Introduction to Clerkship Jul - Aug Summer Electives Aug Oct Course 5 Oct Dec Course 6 Dec Jan Winter Break (2 Weeks) January Course 7 February Integrative Course

CLERKSHIP MANDATORY ROTATIONS PSYCHIATRY (6 wks) PEDIATRICS (6 wks) SURGERY (6 wks) OBSTETRICS & GYNECOLOGY (6 wks) INTERNAL MEDICINE (10 wks) FAMILY MEDICINE (6 wks) EMERGENCY MEDICINE (2 wks) ANESTHESIA (2 wks) ELECTIVES (10 wks) December H O L I D A Y (2 weeks) February National Resident Interview Period April Clerkship OSCE May C O N V O C A T I O N

In addition, up to 18 clerks will participate in the Rural Integrated Community Clerkship (32 weeks with one rural preceptor, 12 weeks in Calgary)

(2 weeks)

(2 weeks)

Course 8 Comprehensive Clinical Skills Curriculum for Clerkship (Longitudinal over 48 weeks)

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The Undergraduate Medical Curriculum at the University of Calgary


Introduction When the University of Calgary Medical School was founded in 1970, the Systems-Based curricular model was adopted, and produced highly qualified physicians over its 30 years of existence. Building on the strengths of this curricular model, the University of Calgary Medical School modified its curriculum in the mid 1990s to what is called a Clinical Presentation curriculum. This innovative model, which has now been adopted by over 15 other medical schools worldwide, aims to organize teaching around the 120+/- 5 ways a patient can present to a physician. These Clinical Presentations can take the form of historical points (e.g. chest pain), physical examination signs (e.g. hypertension), or laboratory abnormalities (e.g. elevated serum lipids). This structure thus takes the over 3200 diagnostic entities known in medicine, and organizes them within the framework of the finite (120+/-5) ways patients present to their physicians. When the Clinical Presentation curriculum was adopted, University of Calgary faculty members were asked to develop their course objectives in a logical and structured fashion. What spontaneously emanated from the minds of these skilled teachers were classification systems, unique to each Clinical Presentation, that have subsequently been called schemes. These schemes provide scaffolding onto which basic and clinical sciences knowledge can be both structured and integrated, while also aiding in clinical problem solving. This use of schemes, or clinical problem-solving pathways, has been widely supported in medical education and cognitive psychology literature, including studies originating at the University of Calgary. The clinical presentation curriculum teaches the basic science and clinical knowledge pertinent to each clinical presentation and provides an approach to the solution of the clinical problems. The schemes for all 120 Clinical Presentations have now been compiled into one book, the University of Calgary Black Book, which will be given to you upon entering medical school. Each class will be expected to continue the process of modifying and improving the new editions of this compilation.

Curricular Content After 10 years of experience with the clinical presentation curriculum, faculty and students recommended changes beginning in August 2006 that will further strengthen our curriculum. As of August 2006, the pre-clerkship curriculum was reorganized. Traditional systems with overlapping clinical presentations were linked into one longer course (e.g. Cardio-Respiratory, which share the chest pain and dyspnea clinical presentations). This reorganization was built on the strengths identified of the Clinical Presentation curriculum, while satisfying a number of practical and pedagogical concerns raised over the first 10 years of the Clinical Presentation curriculum. Highlights of the advantages are: Courses will be linked to graduation objectives and UME program philosophy of teaching, learning and evaluation. Linkage of courses will better integrate Clinical Presentations across systems (horizontal integration), emphasize schemes as a powerful knowledge organization teaching tool, and reduce redundancies. Summer elective time in the pre-clerkship was increased by 2 weeks to help address the difficulty faculty have in teaching during the summer. This also responds to student needs regarding better preparation for early career planning. Students will receive 2 weeks off during the clerkship year without academic penalty to attend CaRMS interviews. Teaching of procedural skills will start in Year I with additional instruction and evaluation time prior to entering clerkship, as part of a new introduction to clerkship course. Linkage of courses allows teachers to teach in a less concentrated time period, and presents less disruption to clinical responsibilities. Linkage will improve interdisciplinary cooperation and interaction. Significant change to the evaluation process, with reduced frequency of summative examinations in the pre-clerkship, increased frequency of formative examinations, and specific time allotted for faculty assisted review or independent study prior to each certifying exam for most pre-clerkship courses.

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Teaching Methods in Clinical Presentation Curriculum There are three key factors that influence learning and retrieval of information from memory (Regehr, Norman: Acad Med 1996). Does it have meaning? How is it encoded? (process, context) Has there been opportunity to practice its retrieval?

Teaching methods in the curriculum should reflect these lessons learned from cognitive psychology and the educational literature. The advantage of learning around clinical presentations is that new knowledge is added to some existing knowledge networks related to the clinical problems. As knowledge is always directed to better understanding or solving the clinical problem, it takes on significant meaning to a motivated learner. Gold Star teachers in our Faculty often present a real patient to the class during lecture to provide relevance and meaning to the knowledge learned up until that point. Students have universally rated these sessions very highly. The context that knowledge is stored in memory adds to the individual's ability to retrieve it. The probability and efficiency of retrieving information from memory depends on the similarity between the conditions of encoding and the conditions of retrieval. (A phenomenon referred to as encoding specificity.) It therefore makes sense to learn medicine as much outside the classroom as possible and as close to the clinical context as possible. Similarly, if the student is taught diseases of the liver and gallbladder in his/her preclinical years, it may become difficult to access the knowledge as patients present in the clerkship with a problem (e.g. jaundice) rather than a known disease. By "encoding" a classification system or problemsolving strategy (scheme) unique to each clinical presentation early in medical school, this problem would be lessened. Lastly, the effect of "practice" greatly impacts on memory. The greater number of times a piece of information is recalled, the easier it can be retrieved again. The more opportunities available to solve clinical problems, the greater the opportunity for knowledge to be gained and for a problem-solving strategy (scheme) to be enhanced. Learning in interactive small groups, bedside clinical correlation sessions, problem-based learning of the integrative course and the clerkship experience itself allows the student the opportunity to practice. The Curriculum Committee struck a working group to report on teaching methods most appropriate in our Clinical Presentation Curriculum. The most important feature of the Clinical Presentation Curriculum is the structuring of the content around a clinical presentation. As teachers present new content it is vital that they constantly refer to the relevant clinical presentations and demonstrate the usefulness of the new material (basic science, clinical) in solving these cases. Lectures Lectures are used primarily to 1) introduce and provide an overview of topics to cover, and 2) explain important and complex content areas. The purpose of a lecture at the beginning of a section or clinical presentation is to stimulate interest and provide a structure for the content material that will follow. In the Clinical Presentation Curriculum, this structure is the clinical problem-solving scheme. The lecturer may present cases at the beginning and demonstrate the use of the clinicalproblem solving scheme. Also the lecture is an efficient way to present concepts to a whole group of students and ensure some uniformity in their level of understanding. Completely new domains of knowledge can be introduced with the use of a lecture to provide rapid understanding of the basic concepts and their inherent structure. In order to refer to the appropriate clinical-problem solving scheme, lecturers need to know how their lecture fits into the evolution of the course. Ideally, lectures should be given by a small group of individuals who are active participants in the design of the course and who are able to relate the content to other segments of the course. At the very least, lecturers should receive, ahead of time, a copy of the clinical-problem solving scheme and the learning objectives that relate to their lecture topic and they should refer to the scheme explicitly during the lecture. Podcasts are made available for many lectures. However, sessions involving patient presentations are not podcast. Presenters may or may not consent to podcasts of their lectures.

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Small Group Sessions Student attendance at small group sessions is mandatory. Small group sessions should be used for students attempting to solve a clinical problem. The clinical problem should illustrate the use of a clinical-problem solving scheme. It is also used as an opportunity for students to learn additional content material not covered in other learning activities but considered part of the course objectives. A case should provide an opportunity for students to study independently and report to the group on their learning activities at a future session. The major reasons for small group learning include: 1) in depth analysis of content, 2) reinforcement of the clinical problem- solving scheme. Clinical problems studied in small group sessions provide a context for exploring new knowledge and reinforcing acquired knowledge. Once the clinical problem solving approach has been presented, small group teaching sessions allow students to acquire finer conceptual details in a more self directed manner. The group, the preceptor, the material provided and structure of the activity will guide the students in the desired direction. Learning requires repeated practice and opportunities to receive feedback. When adequately structured and lead by an effective facilitator small groups are an ideal format for this activity. The greatest difficulty in administering a successful course utilizing small group learning is the large number of preceptors required. This activity is best conducted when the group is no larger than 10-12 students. Preceptors are often unable to commit the large number of hours required to conduct small group problem-based sessions over the duration of a course. Preceptors are sometimes involved with a group for only one or two cases and it is difficult for them to adapt their teaching to the needs of the students at the time because they are not aware of what has been covered to date. In order to facilitate supervision of these sessions, the problem should be highly structured. As well as presenting the facts of the case, the problem should include learning objectives specific to the case and actual copy of the appropriate clinical-problem solving scheme and references. The working group has developed a structure of small group problem based materials for educators to follow. With the right tools, a content expert is not absolutely necessary and would allow recruitment of a broader range of preceptors for shorter segments of time. Also, case structure would improve uniformity of learning experience from group to group (this is currently a major source of frustration for students). It is proposed that the Office of Undergraduate Medical Education (UME) facilitate the compilation of problem/cases into the new format. As courses are prepared, the cases, their objectives, list of resources and names of authors would be presented to the UME office and the materials assembled including the appropriate scheme. These would be returned to the Course Chair and a copy would be kept in the UME office as a resource. Clinical correlation (Bedside) sessions will continue in each course with the primary goal of reinforcing with a real example the features of a clinical presentation. Knowledge learned in the context of a lecture or a small group session needs to be transposed to the clinical situation. The clinical correlation sessions allow students to review their knowledge with a real patient. Clinical correlations preceptors should receive the relevant clinical-problem solving schemes and learning objectives so they can identify appropriate patients for the sessions. They should also be aware of which presentations have been studied at the time of the session. Clinical Clerkship Course Chairs and sub-committees will need to be cognizant of the approach to problems developed in the first two years so that reinforcement and maturation of problem solving abilities can occur during the experiential time of clerkship. Sources of information for this overview of the undergraduate curriculum include: The Undergraduate Medical Education Office http://www.ucalgary.ca/mdprogram/ Undegraduate Medical Education Committee (UMEC) Curriculum Design & Implementation Committee (CDIC) Clerkship Committee Student Evaluation Committee (SEC)

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Clinical Presentation Definition of a Clinical Presentation: A clinical presentation must: Represent a common or important way in which a patient, group of patients, community or population actually presents to the physician and which a graduate would be expected to handle. Be important and substantive enough to warrant interdisciplinary input and cover a broad content area so that Faculty objectives can be met. Less substantive clinical presentations are probably best included under a broader category. For example, "epistaxis" is probably best included under bleeding tendency/bruising.

Course I: (Gastroenterology & Blood) Anemia/Pallor/Fatigue Bleeding Tendency/Bruising Elevated Hematocrit/Polycythemia Painful Limb Painful Swollen Limb Venous Thrombosis and Hypercoagulable State Abnormalities of White Blood Cells Lymphadenopathy: Generalized Splenomegaly Fever in the Immunocompromised Host Fever and Chills Weight Loss Difficulty Swallowing/Dysphagia Abdominal Pain Acute Abdominal Pain Chronic Abdominal Pain Hematemesis Blood in Stool Abdominal Distension/Mass/Visceromegaly/Ascites Jaundice/Abnormal Liver Enzymes Change in Bowel Habit

Course II: (Musculoskeletal/Skin/Rheumatology) Painful Limb Painful Swollen Limb Venous Thrombosis and Hypercoagulable State Intermittent Claudication Hair and Nail Complaints Skin Tumours, Benign and Malignant Skin Blisters Skin Rash (Dermatitis) Joint Pain, Mono-Articular (Acute, Chronic) Joint Pain, Polyarticular (Acute, Chronic) Regional Pain, Non-Articular (Hand, Wrist, Elbow, Shoulder, Spine, Hips, Knee, Foot Skin Lesions and Systemic Disease Skin/Immunologic Diseases Primary and Secondary Lesions (Structure & Function of Skin) Fractures and Dislocations

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Course III: (Cardiovascular/Respiratory) Chest Discomfort Loss of Consciousness/Syncope/Presyncope Palpitation (Abnormal ECG) Shock (Hypotension) Murmur Systolic Murmur Diastolic Murmur Painful Limb Painful Swollen Limb Venous Thrombosis and Hypercoagulable State Intermittent Claudication Cough and Dyspnea Cough and/or Dyspnea with Normal Chest X-Ray Cough and/or Dyspnea with Diffuse Chest X-Ray Abnormality Cough and/or Dyspnea with Pleural Abnormality Cough and/or Dyspnea with Local Chest X-Ray Abnormalities Cough, Dyspnea and Fever Hypoxia, Hypoxemia, Cyanosis Abnormal Serum Hydrogen Ion Concentration Metabolic Acidosis Metabolic Alkalosis Respiratory Acidosis Respiratory Alkalosis Hemoptysis Laboured/ Noisy Breathing in a Young Child

Course IV: (Renal & Endocrine) Renal Failure, Acute Urinary Retention/Obstruction Generalized Edema Abnormal Serum Sodium Concentration Hyponatremia Hypernatremia Polyuria Hypertension Pregnancy Associated Hypertension Malignant Hypertension Hypertension in the Elderly Hypertension in the Pediatric Age Group Abnormal Serum Potassium Concentration Hypokalemia Hyperkalemia Abnormal Serum Hydrogen Ion Concentration Metabolic Acidosis Metabolic Alkalosis Respiratory Acidosis Respiratory Alkalosis Dysuria Hematuria Hematuria, Extrarenal Hematuria, Intrarenal, Extraglomerular Hematuria, Glomerular Proteinuria Renal Failure, Chronic Scrotal Mass (Testicular Pain) Adrenal Mass 20

Tall Stature, Short Stature Neck Mass Hyperthyroidism Hypothyroidism Abnormalities of Blood Cholesterol/Lipids Abnormal Sexual Maturation Breast Abnormalities Gynaecomastia Breast Discharge Hirsutism and Virilization Hyperglycemia, Diabetes Abnormal Serum Calcium Concentration Hypercalcemia Hypocalcemia Menstrual Cycle Abnormalities Normal Cycle Hyperkalemia (Fatigue, Hyperpigmentation) Weight Gain/Obesity Course V: (Neurosciences & Aging) Muscle Weakness (paralysis, paresis) Numbness and Tingling Head and Spinal Injuries Speech and Language Disturbances Hemiplegia/Hemisensory Loss Aphasia Involuntary Movements Gait Disturbance (Ataxia) Dizziness and Vertigo Childhood Strabismus and Amblyopia Diplopia Diplopia Pupil Abnormalities Speech and Language Disturbances Dysphonia (Hoarseness) Coma (Impaired Consciousness) Seizures Seizures in Adult Acute Confusion (Delirium) Dementia, Memory Disturbances (Other Cognitive Changes) Pain Headache The Aging and the Elderly The Well Patient The Well Patient (The Elderly Patient) Dementia, Memory Disturbances Failure to Thrive Failure to Thrive (The Elderly Patient) Elder Abuse Falls Urinary Incontinence Dying Patient Ear Pain Hearing Loss, and Tinnitus Vision Loss Chronic Visual Loss Acute Vision Loss Eye Redness Red Eye Eye Injuries

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Course VI: (Childrens & Womens Health) Pregnancy Associated Hypertension Menstrual Cycle Abnormalities Normal Cycle Excessive/Irregular Blood Loss from Genital Tract Pregnancy st rd Pregnancy, Antepartum Care (1 and 3 Trimester Bleeding) Pregnancy, Intrapartum Care (Normal and Abnormal) Pregnancy, Postpartum Care Pregnancy, Obstetrical Emergencies Pregnancy, Unwanted (Contraception) Prolapse/Pelvic Relaxation Pelvic Pain Infertility Female Infertility Male Infertility Pelvic Mass Vaginal Discharge/Vulvar Itch/STDs/Sexually Transmitted Diseases Breast Mass/Pain Menopause/Amenorrhea/Oligomenorrhea The Infant, Child and Adolescent The Well Patient The Well Patient (Newborn Assessment, Normal, Includes Nutrition, Immunization and Milestones) Depressed Newborn (Intrauterine Growth Restriction, Pre-Maturity, Low Birth Weight) Cyanotic Newborn Neonatal Jaundice Infant with Multiple Malformations Sudden Infant Death Syndrome Ill-Appearing Neonate/Crying-Fussing Infant Problem Child Abnormal Behaviour and Development (Infant) Abnormal Development Abnormal Behaviour Abnormal Behaviour (Adolescent) Acutely Ill Infant or Child Poisoning Failure to Thrive Failure to Thrive (Infant) Seizures (Pediatric) Hypertension (Pediatric Age Group) Weight Loss (Eating Disorders) Childhood Communicable Diseases Child with Orthopedic Problems Mouth Problems (Pediatric) Vomiting/Nausea (Pediatric) Increased Risk of a Genetic Disorder

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Course VII: (Mind & Family Violence) The Sexually Concerned Patient Substance Abuse and Drug Addiction Substance Abuse (Performance Drugs) Substance Abuse/Drug Addiction (Adolescent) Suicidal Behaviour Suicidal Behaviour (Adult) Suicidal Behaviour (Adolescent) Panic and Anxiety (Anxiety Disorders) Psychotic Patient Mood Disorders Personality Disorders Insomnia, Sleep and Circadian Rhythm Disorders Weight Loss (Eating Disorders) The Family Family Violence Community Issues Interpersonal Stress and Conflict/Adjustment to Life Changes

Integrative Course Poisoning Multisystem Trauma/Burns Work-Related Medical Assessments

Population Health The Well Patient

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Longitudinal Courses
There are 6 longitudinal courses within the curriculum. They are: 1. 2. 3. 4. 5. 6. Medical Skills I (MDCN 320) Family Medicine Clinical Experience (MDCN 330) Population Health (MDCN 340) Medical Skills II (MDCN 420) Applied Evidence Based Medicine (MDCN 440) Medical Skills III Course 8 (MDCN 520)

Medical Skills Program The Medical Skills Program starts in the first week of the first year and runs throughout the undergraduate medical education program.

Philosophy statement: At the University of Calgary School, we endeavour to graduate caring physicians, committed to optimising the physical, mental, emotional, and social well being of each patient. Graduating physicians must have a broad foundation of medical skills in order for this goal to be achieved. The Med Skills Program is composed of 6 components and 2 sub-components: 1. Physical Examination Well Man Well Woman 2. Communication 3. Ethics 4. Global Health 5. Physicianship 6. Procedural Skills Ethics is aligned with Clinical Presentations taught in parallel courses. Because practising clinicians participate in these small groups, students may need to trade IST time for some of the hours formally scheduled for these sessions. This has not been a problem in the past. It is important however that sessions not conflict with other scheduled courses or clinical correlations time. It is extremely important that if students are unable to attend small group sessions, they personally communicate with their preceptor as well as follow guidelines outlined in the Attendance Policy. Preceptors willingly give of their valuable time to teach students, often cancelling their clinics. Failure to act professionally with preceptors is taken very seriously by the Associate Dean's office. Ethics, Global Health, Procedural Skills and Physicianship sessions usually have required pre-assigned readings that students find helpful for in-depth discussions that follow. The MCC Part I examination has numerous questions on Ethics, Law, Physicianship topics and Global Health. Refer to the MCC Website to review their objectives, which are very similar to ours. Med Skills objectives are located within the course Core Document.

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It is our objective that graduating physicians will: 1. skilfully communicate with patients through accurate history taking and sensitive delivery of information; 2. conduct appropriately through physical examinations in a respectful, efficient, and skilful manner; 3. approach diagnoses with the ability to extract critical information, a thorough knowledge of disease presentations, and rational use of laboratory tests; 4. consider the impact of culture, age, gender, sexual orientation, risk perception, and personal values of patients needs; 5. identify, define, and understand ethical issues in medicine, in order to provide health care in a morally responsible manner; 6. maintain skills for continuous education, and competence in obtaining and critically appraising new information from diverse sources; 7. recognize the importance of their own well-being, and employ effective responses to challenges, stress, and fatigue; 8. be skilled in accurate, responsible and respectful communication with other personnel involved in health care delivery; and 9. be resources to the community, and advocates of healthy lifestyles, safe environments, and public policies that are compatible with medical principles. Family Medicine Clinical Experience (MDCN 330 and 430) The goal of this course is to expose medical students to family medicine (to learn about the variety of patients and issues seen and how family doctors provide care), and to provide a laboratory in which students will be able to see real-life clinical links with their ongoing education. To achieve this goal, students will be paired 1:1 with family physicians and shadow them in clinical practice over a ten (10) month period. Students will also work on assignments to develop customized care plans for patients. Most students will be placed in Calgary, though a rural option will also be available Population Health - Year 1 (MDCN 340) Students will learn about concepts of health and disease as they apply to populations, communities and individual patients. The determinants of health and the distribution of disease within and between populations will be explored. The roles of health promotion, health protection and disease prevention will be presented. The students will learn about the evolution and function of the Canadian health care system in the context of current and historic challenges and international alternatives. Basic epidemiology and biostatistics as they apply to the core concepts of the course will be covered. Community experience with individuals and social / medical agencies is a core part of this course.

Applied Evidence Based Medicine - Year 2 (MDCN 440) Starting in April of Year II students participate in MDCN 440. It is scheduled for 4 hours on Tuesday afternoons. Students may need to trade IST time for some of the hours formally scheduled due to physicians clinic hours. It is very important however, that it not conflict with scheduled course time (clinical correlations, med skills, etc.) Students can choose 3 options: 1) Research; 2) Clinical Elective; 3) Directed Study. Details of each component are outlined in the Core Document with evaluation requirements. For students not pursuing a research project, clinical experiences are often arranged that allow for the opportunity for indepth study and "career sampling". Preceptor evaluations and critical appraisal reports are placed in the student files. Students devote one half-day per week to this course. This course offers a great chance to complete student research, pursue career options, or study in depth an area of medicine under preceptor guidance.

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Electives
Summer (Preclerkship) Electives (MDCN 402) The Summer Electives are mandatory elements of the undergraduate medical education curriculum. This is included to provide an opportunity for students to explore medical domains in a more in-depth fashion than is otherwise permitted in the core curricular components. It is also intended to allow students to develop their own specific interest and expertise and allow them to sample disciplines for possible career choices and residency training applications. This mandatory six-weeks of elective time is from end of June until August. Electives may be completed in centres other than Calgary. Students are encouraged to consider experiences in medicine in developing countries through the International Electives Program. Electives are mandatory clinical, laboratory or research experiences that must be evaluated by a preceptor at the end of the program. MDCN 402 Objectives (Clinical and Basic Science Research) The student will: Improve clinical history taking and physical exam skills (AB only). Broaden their exposure to medicine in general. Experience real time in a clinical discipline to assist in further career planning. Gain an appreciation (e.g. reading around cases, discuss patient management) for the most common clinical presentations seen throughout the elective. Gain hands on experience in basic science research. Further his/her on-going experience in a previous research field. For International Electives the student will: Gain an appreciation for medicine within a cultural context Learn to work with health care providers in an international setting

NOTE: Second year medical students are lower on the priority list than clerks and residents, so you should have some ideas for back-up plans. If the preceptor/department sets something up with you, then finds that they need to have a resident/clinical clerk, you will then need to find something else. Some preceptors want a CV with an outline of your current skills before they will even consider an elective, so keep your CV up-to-date. Summer Electives Planning Process Start the elective preparation process EARLY!! Summer Electives can be challenging to set up. Some institutions have extremely limited capacity for pre-clerkship students, so you need to plan early. Electives should be arranged 5 - 8 months in advance. The following steps can be used as a guide for setting up your Summer Elective. Steps for setting up a Summer Elective: Select an area of interest. (6-7 months prior) (Nov-Feb) Select a location for the elective. (6-7 months prior) (Jan-Feb) For international electives start setting them up early! (7-8 months prior) (Nov-Dec) Contact potential preceptors and/or institutions. (6 months prior) (December-January) Complete the online Request for Summer Elective form located in OLSER by end of April. Program Coordinator in UME will approve all requests online and send out confirmations via email. 6. Completed One45 Preceptor Evaluation Forms to the UME office. (Deadline: September) 7. For Rural Summer Electives, please contact Kelly McSweeny (220-4257 or ruralmed@ucalgary.ca) for assistance in finding a preceptor. Please refer to Summer Elective MDCN 402 Core Document for further details. 26 1. 2. 3. 4. 5.

Clerkship Electives Electives are an important mandatory element of our undergraduate medical education curriculum. They are included to provide opportunities for students to explore medical domains in a more in-depth fashion than is otherwise permitted in the core curricular components. They are also intended to allow students to develop their own specific interest and expertise and allow them to sample disciplines for possible career choices and residency training applications. Sessions will be held throughout the curriculum to provide advice and counselling to students regarding elective choices and strategies. Electives can be taken at the University of Calgary, at other sites or abroad. Students in their final clinical year must diversify their elective time and complete electives in at least two different disciplines (as defined by CaRMS) with the inclusion of the preclerkship Summer Electives in that total. International Electives An elective experience in a developing country, even for a relatively short time, can be a rewarding and satisfying experience for a medical student. Exposure to different cultures, health care delivery systems and health problems are an important part of the overall educational experience for the future physician. The International Elective Program provides students with an opportunity for cultural exchange in a health care setting. In a developing country one tends to see health and disease in a broader perspective and begins to appreciate that to improve medical health, problems cannot be dealt with in isolation. They must be combined with efforts to deal with poverty, malnutrition and illiteracy. Faculty members and students returning from overseas visits invariably describe a heightened awareness of the importance of health and related social issues and report that the experience assists them in seeing health problems in our own society from a different perspective. Recognizing that health and education of health professionals are global issues, the Faculty of Medicine has encouraged our students to do elective in developing countries. Over the past 16 years, the Faculty has established partnerships in several countries such as Thailand, Philippines, Malaysia, Mexico, Chile and China. Students planning an International Elective may either choose to go to a country where the Faculty has established contacts, or they can find their own contacts and arrange an elective in that location. Requirements - Students at the end of their first year could utilize their summer elective time in the summer to provide an experience of 4 weeks. Funding for international electives is ONLY provided for electives in the developing world. The minimum duration to ensure a worthwhile educational experience is 4 weeks. Longer periods are preferable if they can be arranged. Clerkship electives should have identified preceptors (both in Canada and in the host country) to help plan an adequate clinical experience. Some students choose to do a defined project in some aspects of community medicine (e.g. immunization rates). Others opt for a supervised clinical experience in a primary care setting or a specialty experience (internal medicine, surgery etc.) in a larger hospital. Primary health care electives will receive priority for funding. Val Matwick in the Deans Office can help you organize these electives (inhealth@ucalgary.ca ). Global Health & International Partnerships Office Website: www.ucalgary.ca/ghealth **Click on Funding Tab (http://www.ucalgary.ca/ghealth/funding) and scroll down to Medical Students Electives Electives in Rural/Regional Alberta A learning experience in rural or regional Alberta is always rewarding. Rural electives, shadowing, regional based clerkship blocks and the Rural Integrated Community Clerkship (RICC) are some of the learning opportunities available to you outside of the metro area. The Office of the Associate Dean, Rural Medicine, Distributed Learning and Rural Initiatives (DLRI) coordinates all rural and regional learning opportunities in Alberta and assists the Family Medicine and Rural Interest Groups in funding other rural/regional experiences. Many courses, such as MED 330 or MED 440, can be completed in rural areas. Financial support for rural/regional experiences can include mileage, food & accommodation expenses, depending on the rotation. Students always return from rural opportunities with stories of how they were appreciated as early career physicians and the one-on-one learning environment. If you are seeking more autonomy as an independent learner, a rich environment to learn from patients and a place to gain confidence in numerous procedural skills, contact Kelly McSweeny (220-4257 or ruralmed@ucalgary.ca) for assistance. The Rural Interest Group and the Family Medicine Interest Group work together to present events throughout the year for those interested in generalist careers or regionally based subspecialties. Contact your 2013 class rep or fmig@ucalgary.ca for information on these events. Rural Medicine - more than meets the eye! 27

Global Health Interest Group If youre interested in an international elective, particularly in developing countries, these students might be able to help you! They have contacts for a number of Calgary physicians who work abroad with a variety of organizations. Some of them will be invited as speakers this year, which is a great opportunity to meet them and hear about what they do. Even if they arent able to take you, they are a great resource and will probably be able to put you in contact with some of their colleagues. Contact your current class representatives for more information.

Clerkship
The clinical clerkship year consists of 54 weeks of mandatory rotations, as well as 2 weeks of holidays over the Christmas break, and 2 weeks away in February for the National Interview Period for residency. Early in second year, the Clerkship Electives Core Document and a U of C Medical Electives Catalogue are posted in OSLER for second year students to assist in planning and setting up elective time. A group session for the students will be held early in second year to discuss career planning and strategies for optimal use of elective time and to discuss strategies for selection of clerkship rotation schedule. Applications for out of town electives often need to be arranged four to six months in advance. A session on setting up electives will be held in early in second year to assist in the application process. Students are given the opportunity to rank their choices of preferred rotation order in the one45 System. The assigned scheduling is done with the criteria to be determined prior to running the algorithm in one45. All 24 rotation choices need to be filled. For further details on the clinical clerkship year please refer to the Clinical Clerkship Policies & Procedures Document that can be found in OSLER or on the UME website. Excerpts from the current Clinical Clerkship Policies & Procedures Document are included as Appendix A of this handbook for your interest.

Clerkship Stipend Students entering the clinical clerkship receive a stipend over a period of 48 weeks only totaling around $4,681.00 for the clerkship year. This stipend is funded by the Government of Alberta and comes through Alberta Learning. Stipends are currently applied to Canadian eligible undergraduates only. The stipend is administered by Alberta Health Services Calgary Zone and begins in March of the clerkship year and ends in February of the following year. This stipend is a one time 48 weeks only payment and not offered during an extended or repeat clerkship year. If a student takes a leave of absence, depending on the amount of time away, the stipend is discontinued until the student returns to their studies at which time the remaining balance is paid.

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UME

CARMs (Canadian Residency Matching Service)

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C a na di a n Re s i d e nt M a t c hi n g S e r vi c e ( Ca RM S )

June 14th, 2012: CaRMS Application Workshop Large Group Session with CaRMS and Undergraduate Education Office - Interactive session to review the CaRMS web-based application process, the process of securing good reference letters, writing personal letters, developing and formatting a curriculum vitae. At the session CaRMS results from the previous year are reviewed. Student questions regarding paperwork and anything to do with the application process is addressed. About CaRMS

CaRMS - The Canadian Resident Matching Service is a not-for-profit organization that works in close cooperation with the medical education community, medical schools and residents/students, to provide an electronic application service and a computer match for entry into postgraduate medical training throughout Canada. CaRMS provides an orderly and transparent way for applicants to decide where to train and for program directors to decide which applicants they wish to enroll in postgraduate medical training. To this date, CaRMS administers the matching process for: postgraduate Year 1 entry (R-1) residency positions; Year 3 Family Medicine - Emergency Medicine residency positions; Medicine subspecialty residency positions; Pediatric subspecialty residency positions; as well as the Canadian access to the US electronic application system for postgraduate medical training (ERAS).

Where Are We? Our office is located at: 171 Nepean Street, Suite 300 Ottawa Ontario, K2P 0B4 Telephone: (613) 237-0075 Toll Free: 1-877-CARMS-42 (1-877-227-6742) Fax: (613) 563-2860 E-mail help@carms.ca For complete information, you can access the CaRMS web site at: http://www.carms.ca What Do We Do? CaRMS provides an orderly way for applicants to decide where to train and for program directors to decide which applicants they wish to enrol in postgraduate medical training. The match is carried out using a computer program that, in only a few minutes, makes a series of decisions that would otherwise require hours of time for both applicants and program directors. This system guarantees that decisions about residency selection will be made by both applicants and program directors by a specific date, without pressure being placed on applicants to make decisions before exploring all options.

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CaRMs Timeline
Timetable for the first iteration of the 2013 R-1 Main Residency Match August 15, 2012 (12:00 ET) Online request for registration opens Online request for registration opens for international medical graduates, United States medical graduates and prior-year Canadian medical graduates (current-year Canadian graduates are automatically registered by their medical schools). CaRMS encourages reading the basic criteria, provincial criteria and program descriptions sections before registering. August 31, 2012 Program descriptions available for review Program descriptions for the 2013 R-1 Match are available for applicants to review. NOTE: The program descriptions may be altered occasionally and should be referred to regularly. The program description must be approved by the postgraduate dean's office before any updates can be considered official. The program description's status is indicated at the top of each page, and the time of the last update is at the bottom. September 4 to 5, 2012 Token distribution begins All verified applicants are e-mailed their tokens. Use your token to complete the registration process and log into the CaRMS online application system, which opens September 5, 2012. If you request registration after September 3, 2012 you will be sent your token within three (3) business days, or contacted by CaRMS for further information. September 5, 2012 (12:00 ET) CaRMS online application opens The CaRMS online application opens for 2013 R-1 match applicants. Applicants use their token to complete the registration process and begin their CaRMS online application. October 10, 2012 (12:00 ET) Program selection opens Applicants are able to begin selecting programs to which they wish to apply, starting on this date. Applicants are encouraged to thoroughly read the program descriptions to ensure they have all of the required documents. November 23, 2012 (17:00 ET) to November 29, 2012 (12:00 ET) CaRMS online application closed Online services are closed for preparation of file review. Applcants will not have access to their application during this time period.

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CaRMs Timeline
November 29, 2012 (12:00 ET) File review begins Programs begin reviewing applications. CaRMS online application re-opens. January 19 - February 10, 2013 National interview period Interviews for current-year Canadian medical school graduates from out-of-town universities are conducted during this three-week period. Interviews for applicants at their own schools and for international medical graduates are coordinated separately with no national specific time period. January 31, 2013 (12:00 ET) Rank order list (ROL) period begins The rank order list (ROL) system opens to applicants and programs for online ranking. CaRMS recommends that you do not wait until the last minute to enter or finalize your rank order list. February 13, 2013 (17:00 ET) Program rank order list (ROL) deadline Programs must submit their rank order lists by 17:00 ET. February 19, 2013 (16:00 ET) Applicant rank order list (ROL) deadline Rank order list deadline. This is the only deadline in the CaRMS match year - applicants must have their rank order list properly submitted into the CaRMS system by 16:00 ET or they will be automatically withdrawn from the first iteration. CaRMS recommends submitting your rank order list well before the deadline and printing your e-mail confirmation. If you do not receive an e-mail confirmation, you may not have properly submitted your ROL. Check your junk mail if one doesn't arrive in your inbox. If you make any changes to a submitted ROL, you must submit the list again.

Tuesday, March 5, 2013 (12:00 ET) MATCH DAY Match results are available at 12:00 ET.

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PERSONAL LETTERS
Key Components of the Personal Letter Accompanying the CV to CaRMS
Be personal. Letter is a preliminary interview. Demonstrate you are able to look at yourself analytically. State why you want to get into the specific area (use personal experiences to help electives/research). Provide support for why I am the right person for your program (evidence from past experience; analysis of the residency program and your fit). State what characteristics you have that will make you do well in this field. Include a personal vision where do you see yourself going (career goals). Be sure letter harmonizes with CV. Stick to required length. Proof read carefully (include peer review).

Personal Letters to Program Directors Attesting to your Interest in their Program Most programs require students to write a personal letter indicating interest in their specialty and their university. This letter is your chance to present your case as a candidate. The letter should be accompanied by your resume. It should be typed.

Deadline for the letter Programs, particularly those that have a large number of candidates, are strict about their deadlines, often refusing to consider late applications. However, should your career plans change during the academic year and you want to add new programs after all the deadlines have passed, phone the program director's office to see if you can be considered. Exceptions may be made.

How important is the letter? For most programs, this is the MOST important piece of written documentation that they will review. For some programs, this letter will determine whether or not you are offered an interview.

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To quote one program director, "We feel students should be able to coherently tell us why they want to enter our specialty and train at our site. If they cannot take the time to present themselves effectively with a typed letter, we do not feel we need to take the time to interview them." From a program director's secretary, "we consider all personal letters, even if they are short and handwritten. The files we do not consider are those who did not send personal letters at all. We assume they have no real interest in our program and those files are skimmed over briefly and those students are not invited to interview. Sending no letters is the worst thing they can do!"

What should be in the letter? In preparing the letter, read any guidelines on the CaRMS Website that the program has provided. If there are no directions, review the directions that other programs in that discipline have provided for suggestions. Content should including the following: reason for that career choice preparation you have done for that career reason for that location for training

What else can you include? previous relevant experience areas of expertise and interests significant personal accomplishments personal strengths and weaknesses special circumstances for consideration, i.e., family personal attributes that "fit" you for this career pursuits out of medicine future plans work history and elective experience outside interests the type of community you plan to practice in

How long should it be? Check the CaRMS website for guidance. Follow the directions given. Two pages is probably the maximum that any program will want to read.

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MSPR
The MSPR is the official Faculty of Medicine report on your performance in this school, and is required by all postgraduate programs as part of the material on which selection decisions are based. The MSPR is a confidential assessment of the students performance in the M.D. Program. It is not a letter of introduction. It is provided only to interested parties external to the Undergraduate Medical Education Program of the Faculty of Medicine at the request of the student or the Associate Dea. A copy of the letter will be proveded to the student in December after the ltter has been submitted to CaRMS. In addition, all postgraduate training programs participating in the Canadian Resident Matching Service require Letters of Reference from individual physicians (usually three) who (you think) can write authoritatively and favorably about your suitability for postgraduate training in their residency training program. While many other medical schools' MSPRs are primarily a record of marks obtained in evaluations, our policies do not allow us to release marks, and since you must be "Satisfactory" to have got where you are, the academic component of the first two years is rather brief. It has been the practice to mention major academic difficulties encountered along the way. Much of the space is taken up with reports from clerkship preceptors. We feel that this is the most useful indicator to residency program directors of a student's potential performance in a clinical setting. We try to be selective in the comments we use: strengths are emphasized, but we cannot ignore negative comments, particularly if they occur repeatedly. The entire process is a balancing act. We want our graduates to get the positions they apply for, and so our letters are as positive as possible. However, if every single student is indiscriminately identified as outstandingly excellent, our credibility is questioned and ultimately detrimental to all students. Frankness is important. If there is a deficiency consistently identified by preceptors, it needs to be mentioned. Credibility demands that the MSPRs be a confidential document. The letters are composed by members of the Office of the Associate Dean (Undergraduate Medical Education) after an interview with each student. These interviews are 30-60 minutes long for CARMs and Career Advisement only. This allows for confidential counselling regarding the number of programs to apply to and what would be a good "back-up" discipline if a student did not match to their first choice. At the time of the interview, students are asked to sign a "Request for Release" form. This is to protect the author of the MSPR and the opinions s/he expresses against litigation. This has no sinister implications and this policy was instituted on the advice of the University lawyers. All MSPR drafts are reviewed by the Associate Dean (Undergraduate Medical Education). Any anomalies are referred back to the author or verified by the information in the student's file or on the interview report form. All letters are produced on a word processor, which means that each letter is a signed "original". We understand that our MSPRs are highly regarded by residency program directors and this may be particularly important in determining the success rate of applicants from "Pass/Fail" schools. Our experience is that most of our graduates have been very successful in obtaining one of their first three choices of post-graduate programs.

THE ASSOCIATE DEAN SIGNS ALL MSPRs


Template for Contents of the MSPRs
The next page outlines the format for the MSPR and is followed by a sample MSPR.

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23456_Bilbo Disclosure Form: Medical Student Performance Record (MSPR) University of Calgary Medical School The MSPR provides an overview of the academic and clinical performance of a student while attending medical school at the University of Calgary. The MSPR is not intended to be a letter of reference or recommendation. The MSPR is an assessment of the students performance in the MD program. It is not a letter of introduction. It is provided only to interested parties external to the undergraduate programme of the Faculty of Medicine at the request of the student or the Associate Dean (UME). Letters are retained for 5 years following student graduation, according to the policy of the Faculty of Medicine. Thus, the student will be provided with a copy of the letter in December AFTER it has been submitted to CaRMS. As there are differences in evaluation and reporting systems among Canadian medical schools the Associate Deans of Undergraduate Medical Education have agreed to provide a disclosure form to help the reader understand how a particular school evaluates and reports student performance. Note: The Faculty of Medicine will inform program directors if there is a significant change in academic or professional performance at any point during or after the residency selection process. 1. Characteristics/accomplishments of the student including academic background: Demonstrated leadership, research activities, honors, awards, work experience or other extracurriculuar activities are not described in the MSPR as this information is contained within the students curriculum vitae. As our students are evaluated on a satisfactory/unsatisfactory basis, with an emphasis on collaborative learning, our students do not receive academic or other awards based on grades. 2. Medical School Information: 2.1 The University of Calgary Undergraduate Medical Education Program is a 3-year Program. 2.2 Pre-clerkship Curriculum (18 months of instruction): Organized into 11 individual courses with content delivered according to 120 clinical presentations. A summer elective period consists of 6 weeks in year 2. Horizontal courses include Medical Skills (Communications, Physical Examination, Procedural Skills, Ethics, Physicianship, Global Health), Population Health and Applied Evidence-Based Medicine. 2.3 Clerkship (54 weeks total): 8 mandatory rotations (Anesthesia, Emergency Medicine, Family Medicine, Internal Medicine, Obstetrics & Gynecology, Pediatrics, Psychiatry, and Surgery. Course 8: Comprehensive Clinical Skills Curriculum for Clerkship runs longitudinally during the clerkship year. There are 10 weeks of elective time in the clerkship year. 2.4 University of Calgary Longitudinal Integrated Clerkship (UC-LIC) (54 weeks total): 32 weeks rural integrated experience in Anesthesia, Emergency Medicine, Family Medicine, Obstetrics &

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Gynecology, Psychiatry and Surgery, 12 weeks in Calgary including 4 weeks each of Internal Medicine, Pediatrics and Surgery and 10 weeks of elective time. 3. Evaluation of Student Performance: 3.1 Pre-clerkship Curriculum: End-of-course certifying evaluations are mandatory and students are certified as either Satisfactory or Unsatisfactory. A student who does not achieve the minimum performance level in any one course per year is allowed a rewrite, and if successful on the rewrite, the first attempt is not reported in the MSPR. Unsatisfactory performance in two courses requires an appearance before the Student Academic Review Committee (SARC). These students are generally required to either repeat the year or withdraw. All cases that go before SARC, and its recommendations, are outlined in the MSPR. 3.2 Clerkship: At the end of each clerkship rotation, students are rated as either Satisfactory or Unsatisfactory. Clerks must participate in all components as defined by the clerkship, must be satisfactory on the final the In-Training Evaluation Report (ITER) and must pass the final written examination for an overall satisfactory rotation. Completion of the rotation logbooks is also mandatory. All rotations have either a formative written or clinical skills test. Failure of any component of a clerkship evaluation is reported in the MSPR and usually results in a student being rated as Satisfactory with Performance Deficiencies when the component is successfully remediated. All rewrites and required remedial work during clerkship are documented in the MSPR. Students who are deemed deficient in two clerkship rotations are referred to SARC and its recommendations are documented in the MSPR. 4. Student Professionalism: Unprofessional behaviour is initially addressed in a meeting with the Assistant and/or the Associate Dean of Undergraduate Medical Education. If necessary, the student is directed toward appropriate remediation. Additional breaches of professionalism require the student to appear before SARC. Any such appearance is documented in the MSPR. 5. Preceptor comments contained in the MSPR: Comments are edited for length or grammar, but not significantly for content. 6. Academic Progress of the Student: 6.1 Pre-clerkship Curriculum: Narrative information about overall performance is included, and comments are generally not course-specific. In keeping with a Satisfactory Unsatisfactory grading system, marks or class rankings are not provided. 6.2 Clerkship: Narrative evaluation about each mandatory clinical clerkship and elective rotation is included. Rotations are presented in chronological order. In keeping with a Satisfactory Unsatisfactory grading system, marks or class rankings are not provided. 6.3 All extensions, leaves of absence, gaps or breaks in the students educational program are included, as are any disciplinary actions directed by SARC. 7. What is included in the transcript regarding Unsatisfactory Performance: 7.1 Pre-clerkship Curriculum: Students receive credit (CR) for courses if successful on the initial exam or the first re-write examination. All cases of unsuccessful performance that go before SARC are noted on the transcript. In cases where a year is repeated, performance in each course during the unsuccessful year is reported including the failures (F). In some situations, when a year is repeated, a student may not have rewritten any examinations.

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7.2 Clerkship: Transcripts only include the courses a student is registered in as course performance is added to the transcript at the end of the clerkship year in May. Key to Abbreviations MSPR: Medical Student Performance Record SARC: Student Academic Review committee CR: F: Credit Failure

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O ffice of t h e Asso ciate Dean Undergradu at e M ed ical Edu cat ion Health Sciences Centre G701 3330 Hospital Drive NW Calgary, AB, Canada T2N 4N1 T 403.220.3843 F 403.270.2681 Em ail: wrightb@ucalgar y.ca November 14, 2012 CONFIDENTIAL Re: Bilbo Baggins It is a pleasure to write this letter in support of the application of Bilbo Baggins for a position in your postgraduate residency program. Bilbo Baggins entered our three-year Undergraduate Medical Education Program on July 28, 2010. It is expected that Mr. Bilbo will complete the requirements of the MD degree on April 19, 2013 and will receive the MD degree from this University on May 9, 2013. This Medical Student Performance Record is a confidential assessment of the students performance in the MD program. It is not a letter of introduction. It is provided only to interested parties external to the undergraduate program of the Faculty of Medicine at the request of the student or the Associate Dean. MEDICAL EDUCATION: Our faculty uses a satisfactory/unsatisfactory evaluation system; therefore, I am unable to provide marks or class standings. During preclerkship I can assure you that Mr. Bilbo has encountered no difficulties on evaluations of knowledge and clinical skills. His performance has been satisfactory overall. In addition to the clinical presentation courses during preclerkship, Mr. Bilbo participated in the first-year Population Health course, which included satisfactorily completing a community correlations project. During the second-year course, Applied Evidence-Based Medicine, Mr. Bilbo participated in either a Clinical Elective, Directed Study Elective, Research Elective or a combination of Clinical & Directed Study electives. SUMMER ELECTIVES: During second year, Mr. Bilbo completed his summer electives.

Summer Elective: Pulmonary Medicine

Overall: Satisfactory ITER: Excellent Category: Clinical Duration: 3 weeks Location: Peter Lougheed Centre Preceptor: Dr. D. Helmersen

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim.

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Summer Elective: Endocrinology

Overall: Satisfactory ITER: Category: Clinical Duration: 3 weeks Location: Foothills Medical Centre/Libin Cardiovascular Institute/Diabetes Hypertension & Cholesterol Center Preceptor: Dr. C. Jones

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque.

Summer Elective: Infectious Disease

Overall: Satisfactory ITER: Excellent Category: Clinical Duration: 1 week Location: Foothills Medical Center, Peter Lougheed Center Preceptor: Dr. H. Rabin

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis.

Summer Elective: Anesthesia

Overall: Satisfactory ITER: Excellent Category: Clinical Duration: 2 weeks Location: Peter Lougheed Centre Preceptor: Dr. N. Donnelly-Warner

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. CLERKSHIP: The following information is collated from several performance indicators in Mr. Bilbos clerkship rotations. These include written exams, OSCEs and In-Training Evaluation Reports (ITERs) which are completed by preceptors involved in student teaching and collated by a Principal Preceptor at each site. A students Overall score can contain the following results: Incomplete, Unsatisfactory, Satisfactory with Performance Deficiencies and Satisfactory. The ITER Performance for Electives reflects the score from the ITER, and scaled in the following, ascending order: Unsatisfactory, Satisfactory with Performance Deficiency, Satisfactory Good and Outstanding Top 10% of the class. The ITER Performance for Mandatory rotations reflects the score from the ITER, and scaled in the following, ascending order: Unsatisfactory, Satisfactory with Performance Deficiency, Satisfactory Good and Outstanding Top 10% of the class. The Written Exam score can contain the following results: Satisfactory or Unsatisfactory. Below are the results for Mr. Bilbos rotations so far.

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Elective: General Internal Medicine Consult Service

Overall: Satisfactory ITER: Excellent Duration: 2 weeks Location: Foothills Medical Centre, Calgary, AB Preceptor: Dr. K. Zarnke, J. Gilmour

Comments: Dr. K. Zarnke: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam. Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Dr. J. Gilmour: Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam.

Elective: Gastroenterology

Overall: Satisfactory ITER: Good Duration: 2 weeks Location: Foothills Medical Centre, Calgary, AB Preceptor: Dr. M. Raman (Kothadanaraman)

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis.

Elective: Emergency Medicine

Overall: Satisfactory ITER: Excellent Duration: 2 weeks Location: Queen Elizabeth II Hospital Preceptor: Dr. T. Peebles

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque.

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Elective: Cardiology

Overall: Satisfactory ITER: Good to Excellent Duration: 2 weeks Location: Foothills Medical Centre, Calgary, AB Preceptor: Dr. D. Isaac

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam.

Elective: Emergency Medicine

Overall: Satisfactory ITER: Excellent Duration: 2 weeks Location: Foothills Medical Centre/Peter Lougheed Centre/Rockyview General Hospital, Calgary, AB Preceptor: Dr. C. Carey

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam.

Elective: Obstetrics and Gynecology

Overall: Satisfactory ITER: Excellent Duration: 2 weeks Location: Stanton Territorial Hospital Preceptor: Dr. B. Guthrie

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam.

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PEDIATRICS

Overall: Satisfactory Written Exam: Satisfactory Duration: 6 weeks Mandatory Location: Peter Lougheed Centre, Calgary, AB ITER: Satisfactory - good Rotation: 1 week

Pediatric Inpatients Preceptor: Dr. K. Klym

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam.

Pediatric Gastroenterology Preceptor: Dr. J. deBruyn

Selective Location: Alberta Children's Hospital, Calgary, AB

ITER: Satisfactory - good Rotation: 1 week

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam.

Pediatric Emergency Preceptor: Dr. T. Kodeeswaran

Selective Location: Pediatric Emergency

ITER: Satisfactory - good Rotation: 2 weeks

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla.

OBSTETRICS & GYNECOLOGY

Overall: Satisfactory ITER: Outstanding - top 10% of the class Written Exam: Satisfactory Duration: 6 weeks Location: Foothills Medical Centre, Calgary, AB Preceptor: Dr. A. Mahalingham

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque.

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INTERNAL MEDICINE

Overall: Satisfactory Written Exam: Satisfactory Duration: 10 weeks Mandatory Location: Foothills Medical Centre, Calgary, AB ITER: Outstanding - top 10% of the class Rotation: 4 weeks

Medical Teaching Unit Preceptor: Dr. P. Gibson

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim.

Intensive Care Unit Preceptor: Dr. J. Waechter

Selective Location: Foothills Medical Centre, Calgary, AB

ITER: Satisfactory - good Rotation: 4 weeks

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend.

Nephrology Preceptor: Dr. W. Wang

Selective Location: Foothills Medical Centre, Calgary, AB

ITER: Satisfactory - good Rotation: 2 weeks

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis.

Medical Teaching Unit Preceptor: Dr. T. Pederson

Mandatory Location: Peter Lougheed Centre, Calgary, AB

ITER: Satisfactory - good Rotation: 4 weeks

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla.

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SURGERY

Overall: Satisfactory Written Exam: Satisfactory Duration: 6 weeks Selective Location: Foothills Medical Centre, Calgary, AB ITER: Satisfactory - good to Outstanding - top 10% of the class Rotation: 2 weeks

Orthopedic Surgery Preceptor: Dr. R. Korley, R. Buckley

Comments: Dr. R. Korley: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Dr. R. Buckley: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis.

Thoracic Surgery Preceptor: Dr. S. Grondin

Selective Location: Foothills Medical Centre, Calgary, AB

ITER: Outstanding - top 10% of the class Rotation: 1 week

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam.

General Surgery Preceptor: Dr. E. Dixon

Mandatory Location: Foothills Medical Centre, Calgary, AB

ITER: Outstanding - top 10% of the class Rotation: 3 weeks

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque. Etiam vel justo a urna rutrum fringilla. Ut eget nisi at justo pharetra vestibulum quis vel enim. Donec adipiscing odio vitae ipsum accumsan a elementum ipsum scelerisque. Pellentesque eleifend pulvinar justo, a scelerisque ipsum volutpat ut. Pellentesque semper bibendum aliquam.

ANESTHESIA

Overall: Satisfactory ITER: Outstanding - top 10% of the class Written Exam: Satisfactory Duration: 2 weeks Location: Rockyview General Hospital, Calgary, AB Preceptor: Dr. N. Donnelly-Warner

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis. Ut scelerisque ligula eget dui blandit aliquet. Etiam non sapien libero. Aenean eu augue purus. Sed ac nibh neque.

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FAMILY MEDICINE

Overall: Satisfactory ITER: Outstanding - top 10% of the class Written Exam: Satisfactory Duration: 6 weeks Location: Calgary Northeast, Calgary, AB Preceptor: Dr. R. Geonzon

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus.

EMERGENCY MEDICINE

Overall: Satisfactory ITER: Satisfactory - good Written Exam: Satisfactory Duration: 2 weeks Location: Foothills Medical Centre, Rockyview General Hospital, Peter Lougheed Centre, Calgary, AB Preceptor: Dr. J. Vipond

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis.

PSYCHIATRY

Overall: Satisfactory Written Exam: Satisfactory Duration: 6 weeks Mandatory Location: Peter Lougheed Centre, Calgary, AB ITER: Satisfactory - good Rotation: 5 weeks

Adult Psychiatry Preceptor: Dr. J. Taggart

Comments: Nullam sit amet dui facilisis mi viverra volutpat eget eu tellus. Aliquam mattis mollis turpis, sit amet aliquam metus commodo quis.

Child Psychiatry Preceptor: Dr. J. Taggart

Mandatory Location: Alberta Children's Hospital

ITER: Satisfactory - good Rotation: 1 week

Comments: Nullam sit amet dui facilisis mi.

During his remaining clerkship time, Mr. Bilbo will complete the following rotations: Anesthesia (2 weeks) Elective: Anesthesia (2 weeks)

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Elective: Cardiology (2 weeks) Family Medicine (6 weeks) Psychiatry (6 weeks) Surgery - General Surgery (3 weeks) Surgery - Orthopedic Surgery (2 weeks) Surgery - Selective (TBA) (1 weeks) All students in the final year must satisfactorily complete a summative clerkship clinical skills evaluation (OSCE) prior to graduation. All students in the final year complete the Comprehensive Clinical Skills Curriculum for Clerkship. This is a longitudinal course over 48 weeks of the clerkship year. Learning experiences have been designed to ensure that identified "must see" clinical presentations are covered in one of the following formats: simulation, standardized patients, or virtual patients. The curriculum includes a combination of didactic, small groups and simulation learning experiences. SUMMARY: The Medical Student Performance Record provides an overview of the academic and clinical performance of a student in their years of medical school. It is not intended to be a letter of reference or recommendation. If there is any further information you may wish to have or specific questions concerning Mr. Bilbo to which I might respond, please do not hesitate to contact my office. Yours sincerely,

Bruce J. Wright, MD CCFP FCFP Associate Dean Undergraduate Medical Education BJW/ns

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CaRMS and Career Advise Meetings Faculty Checklist Discipline choice (2 or more preferred disciplines) Location (apply broadly) Is this high risk? o Distribution of positions o Strength of application o Other factors Reference letters check programs for specifics CV, personal letter and interview workshops Reassurance!! Questions you cant answer send email to PV. If necessary, Ruth Malus can book second appointment for student with PV or BW.

MSPR process o o o o o o o o Compiled from evaluations, no subjective statements NO UNIQUE CONTRIBUTION PARAGRAPH One failure with successful rewrite in years 1 and 2 not included Proofread within UME at least twice Signed by Dr. Wright ITER comments directly quoted almost always (specific criteria for exceptions) Students who have been to SARC meet with BW Students receive copy of their letter after they have been sent to CaRMS (before interviews)

Students who are concerned about a specific comment and would like it reviewed by the MSPR committee should send an email to Ruth Malus. The student needs to indicate the rotation name (IM, Surgery, O/G, etc.)

Consents o o o MSPR release form Survey of program directors one year post graduation (for our program evaluation) Permission to release MCC results to U of C (for our program evaluation)

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University of Calgary Clerkship


*indicates a mandatory response

Evaluated By : evaluator's name Evaluating : person (role) or moment's name (if applicable) Dates : start date to end date

Confidential Pre-CaRMS Meeting Preparation Form

1. Academic Performance (Years 1, 2 & 3). Were there any problems (including SARC appearances)?

TO BE COMPLETED PRIOR TO YOUR INTERVIEW

2. Did you have any interruptions in training (including Leave of Absence):

3. Summer Elective Describe your experience or project and provide project titles where applicable in each of the following:

4. Clerkship: i) List in order your completed mandatory clerkship rotations and electives.

ii) List in order your remaining mandatory clerkship rotations and planned electives.

5. Career Choices: i) What are your preferred disciplines? (eg. Fam Med, Gen Surg, etc)

ii) List the programs (locations) you are applying to:

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iii) Do you have limitations on location of training? (eg. Spouse works in specific city, caregiver for family member, etc)

No Yes
Comments:

7. Who will be writing your reference letters?

8. Specific questions you wish to discuss with your interviewer.

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REQUEST FOR RELEASE OF THE MSPR I request the Office of the Associate Dean (Undergraduate Medical Education), Faculty of Medicine, The University of Calgary, release to the party or parties named on this document the current version of my official Faculty of Medicine Medical Student Performance Letter (The MSPR). I acknowledge that I have read, understood, and agree to the following conditions under which the letter will be released. 1. I recognize that the MSPR is provided only to interested parties external to the undergraduate program of the Faculty of Medicine at the request of the student or the Associate Dean (UME). A copy of the letter will be provided to me in December after it has been submitted to CaRMS. 2. I understand that the letter is compiled from my summative/certifying evaluations according to UME policy. Results under appeal will be reported as pending with an updated letter provided once the appeal process has been completed. I have been given the opportunity to review my evaluation record in my UME file and/or on One45. I accept that the MSPR letter has been, and any updates will be, prepared in good faith and without malice as an objective assessment of my performance in the MD program of the Faculty of Medicine. I, therefore, undertake not to bring, now or in the future, any type of legal action against the University of Calgary, any of its administrative officers, or individual members of the Faculty of Medicine with respect to any statements of fact or opinion contained within the MSPR or subsequent updates to it, or with respect to any actions taken by the parties to whom release is authorized in this document as a result of the receipt of my MSPR or subsequent updates to it. My signature on this release form authorizes the Faculty of Medicine to update my MSPR as new evaluative information is received and to release updates of the letter without my further approval to the party or parties named in this document, or upon my specific written request to the party or parties listed in my written request. The terms of this release apply to any updates.

3.

4.

______________________________________ (Students Name) Please Print ______________________________________ Signature _____________________ Date ____________________________________ Witness

Aug. 2012

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Undergraduate Medical Education

PERMISSION TO RELEASE MCC Licensing Exams Part l & ll Results

The MCC Part l & ll exams are national measures of ones knowledge and clinical skills, respectively. Both, UME and our accrediting bodies (CACMS/LCME) require that students who are provided with different learning/training experiences (e.g. longitudinal vs. block clerkships; variation in class size) meet the required learning objectives and have equivalent educational experiences. . The purpose of this letter is to obtain your consent permitting the Medical Council of Canada to forward to us (University of Calgary Medical School) the results of your MCC Part l & ll exams so that we can use these results as part of our ongoing program evaluation. All results will be used in aggregate form and no individuals will be identified. These results will be used only for quality assurance purposes. . **************** I acknowledge that I have read, understood and agree to the above text. My signature on this release form authorizes the Medical Council of Canada to forward my MCC Part l & ll results to the Associate Dean, UME, Faculty of Medicine, University of Calgary.

___________________________________ Students Name (Please Print) ___________________________________ Students Signature _______________________ Date _____________________________ Witness

Aug. 2012

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Reference Letter

Name: ______________________________

GUIDELINES FOR REFERENCE LETTER FOR POSTGRADUATE MEDICINE TRAINING APPLICANTS ACCOMPANYING THE CV TO CARMS
Type and duration of Referees contact with student. Cognitive skills and knowledge. Problem solving and patient management. Self directed learning. Behaviour and attitudinal skills. Communication skills and working relationships Ability to work in a team.

* * *

Refer to each Program on CaRMS Website for individual program requirements. Refer to Website for number of references required (usually 3) Refer to Website for background requirements of referees (e.g. 2 letters must be from an ophthalmologist).

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CURRICULUM

VITAE

MEDICAL STUDENT (Name) CURRICULUM VITAE*


Personal Information
Address/Phone

Education
Date/Degree/University

Honors and Awards Research Experience


Include Date/Title/Preceptor (if project is "ongoing" say so) Presentations National/Local Publications (Abstract/Peer Review)

Clinical Electives (include Block Elective)


Date/Duration-# of weeks/Discipline/Preceptor/Location Include 1-2 lines describing experience (if space allows) Include electives planned but not yet done

Committees and Leadership Extra Curricular Interests and Activities


Volunteer Work during medical school Sports, music, clubs, etc.

Other
e.g. relevant work experience

*Keep CV to a maximum of 3 pages

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Class of 2013

Professionalism

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PROFESSIONALISM
A Guide to Professional Behaviour for Student Physicians Upon entering medical school, new students are rapidly faced with situations that may be novel to them and may require a re-evaluation of the students stand on an issue. This guide to professional behaviour is an attempt to help the student physician to deal with the myriad of complex and potentially controversial situations that will inevitably arise. Ethics and Morals are words that convey an amorphous sense of an individuals core being; these elements of an individuals character are gradually formed over the course of a persons lifetime and are modified by the stresses of experience. They cannot be learned from a textbook or in a lecture theatre. They are the products of an infinite variety of cultural, social, familial and interpersonal influences that every human being integrates in his or her own fashion. As future doctors, you have a particular responsibility to evaluate carefully and to assess your own values and ethical systems, because your decisions seriously affect other peoples lives. Few other occupational or social groups function from such a standpoint. As future doctors, you are sometimes expected to fill shoes that may feel too big rather early in your careers. The purpose of this document is to get you thinking now about some of the issues you may face in the continuum of the next few years of medical school and the practice years that follow. A second purpose is as a reference to use in dealing with issues that are not clearly defined as black or white, but that require some thought and self-evaluation. You will probably find that your level of understanding of some of the items in the GUIDE will change with time and experience that is a sign of growth; for along with all the academic growth you will experience over the course of your years as a student physician, there comes a great deal of spiritual growth that is necessary for you to become a competent and humane physician. Relationships with Colleagues 1. Student physicians should realize that their colleagues have a diversity of knowledge and background. Each will bring his or her own expertise to bear on a problem and recognize that, whatever the emphasis; colleagues share a common goal of becoming effective and humane physicians. 2. Student physicians should give criticism or feedback to colleagues considerately and constructively. In turn, they should accept criticism graciously, using peer assessment as an important part of the evaluative process. 3. Motivation for medical education should be the aspiration for excellence rather than for external recognition, prestige or financial reward. Student physicians are expected to establish their own educational goals and standards, which should exceed the minimum levels of performance required by the Faculty. 4. Achievement of educational goals should be assessed by self- and peer-evaluation in addition to formal certifying evaluations. 5. Student physicians, together with faculty, are responsible for establishing a supportive environment of cooperation in their learning endeavours. They should refrain from any behaviour that obstructs or detracts from the learning opportunities for their colleagues. Many of the areas covered in this document may raise issues for group discussion among students and with faculty. This is encouraged and can be used as another learning resource.

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6. Student physicians must be vigilant in their concern for the physical and emotional well-being and professional conduct of their colleagues. Where concerns surface and the subject of concern do not respond to a discussion of the problem, the concern(s) should be raised confidentially with appropriate authorities. Self-destructive behaviour or breech of the standards of the profession supercedes an individuals right to privacy. Hold in confidence opinions expressed to you about colleagues, junior or senior. Use discretion in deciding if the nature of these opinions necessitates raising them with the subject. 7. The relationship between student physicians and faculty members should be one of collegiality. The junior members should respect the superior knowledge and experience of their seniors who, in turn, should appreciate the limitations of their juniors but respect their desire for knowledge. Should this relationship break down, either junior or senior should be prepared to approach the other and discuss the problem. 8. As partners with faculty in the educational program, student physicians are obliged to provide feedback about all aspects of the curriculum in order that it may be continually improved. Conversely, the Faculty is obliged to provide student physicians with as much information about their performance in meeting the objectives of the MD degree. 9. In a clinical situation where the student physician objects to either the practical or ethical aspects of patient management, the student must always defer to the physician who is responsible for care of the patient. The collegial relationship should permit subsequent private discussion during which the students concerns can be resolved. Relationships with Patients and their Families 1. Clarify your status as a student in medical school. Dont give the patient unrealistic expectations of your abilities or title. 2. Show consideration for the feelings of the patient; do not cause unnecessary emotional or physical discomfort. 3. Perform on patients only those procedures that are appropriate, taking into account the nature of the problem and the comfort and safety of the patient, colleague or bystander with the appropriate supervision when necessary. 4. Appreciate that the patient is assisting you in your education as well as requiring your best efforts at excellent care. In recognition of the patients contribution to the relationship, reciprocate by providing extra attention in the form of support, explanation or even just a sympathetic ear. 5. Know your limitations and seek help from others more skilled. Recognize that professional behaviour is dictated by law and the regulations of individual institutions and organizations, as well as by ethical considerations. 6. Ensure that your behaviour is not influenced by the patients ethnic origin, age, gender, cultural background or value system, except where these factors specifically have medical significance. 7. In the event of an ethical conflict with a patient, which has ramifications for patient care, the student physicians responsibility is to refer quickly and efficiently to a colleague who does not perceive such a conflict. Your ethical code must not be imposed on patients. 8. Refrain from inappropriately divulging confidential information concerning patients.

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Intellectual Honesty 1. From the University of Calgary Calendar: Intellectual honesty is the cornerstone of the development and acquisition of knowledge. Knowledge is cumulative and further advances are predicated on the contributions of others. In the normal course of scholarship these contributions are apprehended, critically evaluated and utilized as a foundation for further inquiry. Intellectual honesty demands that the contribution of others be acknowledged. To do less is to cheat. To pass off contributions and ideas of another as ones own is to deprive oneself of the opportunity and challenge to learn and to participate in the scholarly process of acquisition and development of knowledge. Not only will the cheater or intellectually dishonest individual be ultimately his/her own victim, but also the general quality of activity will be seriously undermined. It is for these reasons that the University insists on intellectual honesty in scholarship. The control of intellectual dishonesty begins with the individuals recognition of standards of honesty expected generally and compliance with those exceptions. Intellectual dishonesty may take many forms, e.g. unauthorized use of material in examinations and tests and unauthorized copying of the work (published and unpublished) of others, falsification in the results of reports and laboratory experiments and use of commercially prepared essays in place of ones own work. 2. Intellectual dishonestly in a student physician has serious implications for quality of patient care. For example, cheating on evaluations as a student may evolve into such behaviour as a physician who cheats by reporting as negative the results of procedures that were actually omitted. Before entry to the medical profession, a student may have felt able to justify intellectual dishonesty by the flawed rationalization that it was a means to an end (i.e. entry to Medical School). Such thinking is absolutely unacceptable in a student physician. The end now is not the MD degree but excellence in patient care, and intellectual dishonesty at any stage of medical education detracts from attainment of the goal. Student physicians have extraordinary obligations to maintain the highest standards of integrity. Society and the Profession demand nothing less, recognizing the serious consequences of dishonesty in a physician.

3.

4.

More detailed and important information regarding medical ethics will be provided during the Medical Skills Course. Students are also required to follow the Canadian Medical Association Code of Ethics In 1998 the Calgary Medical Students Association, the student body and the Curriculum Committee of the Faculty of Medicine approved the Student Code of Conduct. Following its approval, the student body developed the Student Professionalism Committee to provide a mechanism to enforce concerns raised regarding student professionalism. The primary focus of the Student Professionalism Committee is to prevent problems/difficulties related to ethics and professionalism and to be supportive of students who may be experiencing/encountering problems, difficulties or obstacles relating to these matters.

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University of Calgary Medical School Student Code of Conduct As a student in the Faculty of Medicine at the University of Calgary, I assume the responsibility for the health and well being of others. This undertaking requires that I maintain the highest standards of ethical behaviour. Accordingly, I have adopted the following as principles to guide me throughout my academic, clinical and research work. I will uphold both the spirit and the letter of this code. Honesty I will maintain the highest standards of academic honesty. I will record accurately all historical and physical findings, test results and other information pertinent to the care of my patient to the best of my ability. I will conduct research in an unbiased manner, report results truthfully and credit ideas developed and work done by others. I will admit to errors I have made. Confidentiality I will regard confidentiality as a central obligation of patient care. I will limit discussions of patients to members of the health care team in appropriate settings. I will respect the privacy, rights and dignity of patients. Respect for others I will not discriminate on such grounds as age, gender, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, sexual orientation, disability or socioeconomic status. I will interact in a considerate manner with all others providing patient care. I will uphold, protect and promote a classroom atmosphere conducive to learning. I will provide feedback in an appropriate manner and language. I will not subject my peers to unwanted romantic or sexual overtures. I will treat institutional staff and representatives, as well as faculty and patients, respectfully in all circumstances. Responsibility and Accountability I will set patient care as the highest priority in the clinical setting. I will recognize my own limitations and will seek help when my level of experience is inadequate to handle a situation. I will not exploit my relationships with my patients or their families for educational, emotional, financial or sexual purposes. In my demeanor, use of language and appearances, I will conduct myself professionally in a health care setting and in the classroom. I will not use alcohol or drugs in any way that could interfere with my academic, professional and clinical responsibilities. I will respect the reputations of members of the health care team including my classmates; however, I will report unprofessional conduct to an appropriate group or individual. I will not misuse faculty resources, e.g., computers. I will inform the appropriate people when I am not available to fulfill my responsibilities. I will arrive to teaching sessions, including small group sessions, on time and take responsibility for my share of work. Expectations of Faculty, Residents and Fellows I have the right to expect clear guidelines regarding assignments and examinations as well as to have testing environments that are conducive to academic honesty. I cannot be compelled to perform procedures or examinations that I feel are unethical or beyond the level of my training. I have the right not to be subjected to romantic or sexual overtures from those who are supervising my work. I have the right to be challenged to learn, but not abused, harassed or humiliated. I have the right to expect prompt, frequent and constructive feedback from faculty and supervisors. I have the right to have my research contributions appropriately represented and acknowledged.

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*Approved by the U of C Medical Students in the classes of 2006, 2007 and 2008, May 10, 2006. The Student Code of Conduct was developed in 1998 and outlines the expectations of a medical students behaviour in both clinical and academic settings. All incoming students are made aware of this document through a professionalism workshop early in their first year and in the annual Introduction to the Profession of Medicine Ceremony. The Code of Conduct is a living document which is updated and modified by students. The Faculty of Medicine has also adopted (as of 2008) a Professional Standards document, entitled Professional Standards for Faculty Members and Learners in the Faculty of Medicine at the University of Calgary. This document is an additional outline of professional standards and expectations for faculty and learners. This document, in addition to the recent appointment of an Associate Dean for Office of Equity and Professionalism, establishes the seriousness with which this Faculty of Medicine treats the very important topic of professionalism. The document is available on the Faculty of Medicine website The Student Professionalism Committee Terms of Reference The Student Professionalism Committee (the SPC) is a student committee which works to resolve concerns and provide student input about professional behaviour in the medical school. The SPC may receive complaints about professional behaviour from community members, faculty or students as a potential alternative to a complaint being made to the offices of the UME or Student Affairs. Specifics on the complaint process are discussed below. The idea for the SPC peer review process originated with the development of the Student Code of Conduct in 1998. The Code of Conduct guides the SPC in determining whether behaviour is unprofessional or concerning, The Student Professionalism Committee (the SPC) is composed of two students from each of the three classes. Students are elected for a three year term at the beginning of year 1. Members of the SPC also act as class representatives for meetings with faculty committees. Process for SPC Involvement: Complaints or concerns about unprofessional behaviour of students or faculty members may be made to the SPC by Students, faculty or community members (Complainants). Complaints may be made to the SPC by contacting one or more members of the committee in person or in writing. If in writing, it may be delivered personally or directed to the medical school email address of a committee member. Upon receipt of the complaint, one or more members from the SPC will consult with the Complainant about the appropriate initial action to be taken. The Complainant will be updated upon completion of the SPC involvement, or as may be appropriate if the matter is ongoing. . If necessary, the Student Professionalism Committee will confidentially consult with other class representatives. In the event SPC receives two legitimate complaints about a matter which remain unsatisfactorily resolved, the SPC may, if deemed appropriate, forward its concerns about the matter to the Office of Student Affairs. In all instances, the SPC shall use its best efforts to maintain the confidentiality of the concern and the parties involved. In certain instances however, such as where the matter is deemed appropriate required to be referred to Student Affairs, the confidentiality of all parties may not be maintained. The SPC review process is designed to make an individual aware of his/her behaviour, its impact upon others and to provide guidance to that individual without punitive repercussions. In general, the SPC serves to facilitate resolution of concerns about professional behaviour. It does not serve a surveillance or policing function, nor is it concerned with matters of an academic nature. Historically, students have expressed concern that unprofessional behavior may go unaddressed after concerns are brought to the SPCs atttention. This is never the case, but the confidentiality of the student involved is always protected during the process of assessment and management of the unprofessional concern. Thus, students will not be informed in any detail about the repercussions of their colleagues unprofessional acts. Although, every effort is made to resolve issues of unprofessional student behavior without involving the office of undergraduate medical education, this is not always possible. In cases where a student is brought to the attention of the associate or assistant dean of undergraduate medical education, the concern will be carefully scrutinized.

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Depending on the issues involved the student may require to appear before the Student Academic Review Committee for his/her unprofessional behaviour. The Undergraduate Medical Education office will endeavor to provide all possible supports to the student to ensure that future unprofessional behaviors do not recurr.

Documentation: As matters brought forward to the SPC are often of sensitive nature, keeping confidential records is of utmost importance. All complaints and resolutions will be documented for a file, however in such a way that the complainant and subject of the complaint cannot be identified. This file will be handed on to the next years SPC members for the purposes of education, and tracking activity. In the event that a complaint is judged by the SPC to require faculty involvement, the documents identifying parties involved will be handed over if necessary.

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Student Professionalism Committee


Steps to Resolving Issues of Unprofessionalism

Concern brought forward to one or more members of the SPC


Meeting with concerned individual (the complainant): - Discussion of concern - Suggestions made of how to resolve concern

Student Professionalism Committee involvement: - One or more SPC members meet with the subject of complaint

No Student Professionalism Committee involvement: - Individual resolution - Review with the complainant

No resolution of concern

Resolution of concern: - review with complainant

Involvement of Student Professionalism Committee Executive Resolution of concern: - review with complainant No resolution of concern

Refer to UME

refer to Student Affairs Committee

No resolution required as per complainant and SPC

Refer to other appropriate committee

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Descriptors of Unprofessionalism As part of the prerequisite clinical competency for the University of Calgary, Faculty of Medicine, students are expected to demonstrate professionalism. Since most of the attributes of professionalism cannot be tested on a written examination - patterns of behaviour, as observed throughout the continuum of training and within the educational environment - play an important role in making these determinations. The following descriptors serve to identify behaviour that is unacceptable for meeting the standards of professionalism inherent in a graduate of the University of Calgary, Faculty of Medicine.

Unmet Professional Responsibility Needs continual reminders about fulfilling responsibilities to patients, teachers, University staff, and to other health care professionals. Cannot be relied upon to complete tasks. Misrepresents or falsifies actions and/or information, for example, regarding patients, self, laboratory tests, etc. Lack of Effort Towards Self-Improvement and Adaptability Is resistant or defensive in accepting performance feedback that is critical. Demonstrates inability to self-assess, as judged by failing to make changes to correct performance failures. Resists considering or making changes to appropriate feedback. Does not accept responsibility for errors or failure. Is overly critical and/or verbally abusive especially during times of stress. Demonstrates arrogance in dealing with peers, patients, nursing staff, teachers and University staff. Diminished Relationships with Patients and Families Lacks empathy and is often insensitive to patients' needs, feelings, and wishes or to those of the family. Lacks rapport with the patients and families. Displays inadequate commitment to honouring the wishes and wants of the patient. Diminished Relationships with Teachers and Health Care Professionals Demonstrates the inability to function within a health care team. Lacks sensitivity to the needs, feelings, and wishes of fellow students and of the health care team. Inappropriate conduct in class or small group teaching sessions.

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UME

Learning Experiences

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LEARNING EXPERIENCES
Attendance Attendance is mandatory at (a) certifying and formative evaluations, (b) learning experiences at which patients will be present, (c) small group learning experiences and (d) throughout clerkship. The reasons for (a) are obvious. A student who is absent from an evaluation without cause will be graded "Unsatisfactory". The reasons for (b) are, first, that patient contact gives you an experience that cannot be duplicated by independent study and second, as a courtesy to the patients who have given freely of their time in order to improve your medical education. Not withstanding the above, any instructor may take attendance if he/she wishes at any learning experience. In some cases evaluation is based on student participation, and in such cases, failure to attend may result in an unsatisfactory course evaluation. e.g. Integrative Course, Medical Skills Course. Small Group Sessions Most courses offer a series of small group interactive problem-solving sessions. Attendance at these sessions is MANDATORY for all students. The dynamic of these sessions requires active participation from students and therefore, preparation for the topics to be discussed is essential. Also, most leaders of small group sessions are volunteer faculty who have cancelled clinics or significantly rearranged their busy schedules to help medical students learning. Remaining respectful of this, it is expected that students will endeavor to be on time. Students should attend the small group session scheduled for their designated group. Students are randomly grouped into small groups at the beginning of Year 1. Students are expected to remain in their assigned group for the duration of Year 1 and 2.. These groups are once again randomly grouped at the beginning of Year 2.

SMALL GROUP ATTENDANCE POLICY - UPDATED MARCH 2013

1) Expected Attendance Rates Students are expected to attend 100% of small groups offered by each course. These small groups include problem solving, case based sessions, simulated experiences, anatomy or laboratory groups. They include sessions presented in the longitudinal courses of Medical Skills, Population Health and Applied Evidence Based Medicine. The UME recognizes that unexpected events do occur in students lives, which would constitute justifiable reasons for absence from a small group session (such as personal illness or family member requiring care, religious holidays, unexpected transportation issues, physician appointments, child care issues). Therefore, the UME allows for students to be absent (without documentation) for up to 20% of a given courses small group activities, to accommodate such unpredictable events. Documentation will not excuse you from these sessions below without prior approval. In some special situations attendance may be expected to be 100% as student evaluation often occurs by attendance and participation. Such small group sessions include Communications, Physical Examination, Physicianship, Integrative Course, any patient based or standardized patient based learning event. The UME also recognizes special circumstances where, with proper documentation, modifications of these expectations can occur.

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Communications

100% Mandatory Attendance

Ethics

100% Expected Attendance

Global Health

100% Expected Attendance

Students are required to attend all mandatory sessions. Excused absences are permitted and must be approved by the Assistant Dean or Program Supervisor in UME with required documentation. If excused, Program Coordinator will reschedule student in another session if possible. Any unexcused absences will result in a letter to the student file outlining consequences of missing the mandatory session. No additional sessions will be scheduled for missed sessions. Students are allowed to miss up to 20% of mandatory small group sessions without documentation. Excused absences are permitted and must be approved by the Assistant Dean or Program Supervisor in UME with required documentation. No additional sessions will be scheduled for missed sessions. Students are allowed to miss up to 20% of mandatory small group sessions without documentation. Excused absences are permitted and must be approved by the Assistant Dean or Program Supervisor in UME with required documentation. No additional sessions will be scheduled for missed sessions. Students are required to attend all mandatory sessions. Excused absences are permitted and must be approved by the Assistant Dean or Program Supervisor in UME with required documentation. No essay will be required for excused absences. Any unexcused absences will result in a letter to the student file outlining consequences of missing the mandatory session. In addition, an Essay will be required for missed sessions. This is part of the Evaluation requirements for this Unit. No additional sessions will be scheduled for missed sessions. Students are required to attend all mandatory sessions. Excused absences are permitted and must be approved by the Assistant Dean or Program Supervisor in UME with required documentation. If excused, Program Coordinator will reschedule student in another session if possible. Any unexcused absences will result in a letter to the student file outlining consequences of missing the mandatory session (see Small Group Attendance Policy for further detail). No additional sessions will be scheduled for missed sessions. Students are required to attend all mandatory sessions. Excused absences are permitted and must be approved by the Assistant Dean or Program Supervisor in UME with required documentation. If excused, UME will reschedule sessions if possible at the end of the class year. Any unexcused absences will result in a letter to the student file outlining consequences of missing the mandatory session. Excused absences are permitted and must be approved by the Program Coordinator or Program Supervisor. Students missing a clinical core session should join another group to make up the required hours. Students are required to attend all mandatory sessions. Excused absences are permitted and must be approved by the Assistant Dean. Any unexcused absences will result in a letter to the student file outlining consequences of missing the mandatory session. Students are required to attend all mandatory sessions. Excused absences are permitted and must be approved by the Assistant Dean There are 5 small group sessions that are offered in the AEBM Course. Students absent from any session will loose 2 marks per session.

Physianship

100% Mandatory Attendance

Physical Exam

100% Mandatory Attendance

Procedural Skills

100% Mandatory Attendance

Clinical Core/ Bedside Teaching

100% Mandatory Attendance 100% Mandatory Attendance

Integrative & Introduction to Clerkship Courses

Patient Presentations

AEBM

100% Mandatory Attendance 10% Weighting Towards Final Mark

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2) Sign in Process Students will sign in for small groups for themselves only. A sign in sheet will be distributed in the small group session to be handed to the preceptor or student leader for collection by the UME Program Coordinator. It is expected that the sign up sheet will be completed by one half hour into the small group session. Students arriving later than that will not be allowed to sign in.

3) Consequences of Inadequate Attendance: Students who have attended less than 80% of small group sessions in one course will receive written notification from the Undergraduate Medical Education office regarding their attendance record. A copy of the notification will be submitted to the student file to confirm to the Administration that the student received appropriate notification. An offer will be made to the student to visit with the Office of Student Affairs if they are having difficulties that may be contributing to their performance so that help can be provided. Students who have less than 80% attendance in two courses are expected to visit with the Director of Student Affairs, Assistant Dean Undergraduate Medical Education or the Associate Dean of Undergraduate Medical Education to review their attendance record and discuss the situation. A remedial plan must be agreed upon and students will be reminded of the consequences of further attendance or professionalism concerns. A note with the agreed upon plan of action will be placed in the students file. Such notes are not included in the students Deans Letter (Medical Students Performance Report). Should a student demonstrate poor attendance in three courses he/she must attend a Student Academic Review Committee meeting. The committee will be required to consider an allegation of unprofessional behaviour. The SARC Committee has very few options to consider when a student is under review. They can declare the issue: a) unjustified and the student will be permitted to continue his/her academic program without any adverse notation on his/her academic record; or b) justified, and recommend to the Dean that : 1. the student be allowed to proceed with the program and undertake a specified remedial program, or 2. the student be suspended for a defined period of time following with reassessment and lifting of suspension may be considered, or 3. the student withdraws from the academic program. No matter what the decision may be from the SARC Committee, any visit to SARC must be mentioned in the Medical Student Performance Report (previously called the Deans Letter) written for the CaRMS Match. The Terms of Reference for the SARC committee are included in the student handbook.

NOTE: Please note that the inadequate attendances listed above are cummulative in Year 1 & 2.

4) Sign in Policy It is inappropriate for students to sign in for other students at small group sessions and it is equally important that it is inappropriate for students to ask or threaten another student to sign in for them when they are not planning to attend. Any such action would be considered dishonest as per the

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Student Code of Conduct and a meeting would be required with the Assistant or Associate Dean of Undergraduate Medical Education with a note to file. Students would be reminded of the serious nature of their actions. A second incident would result in a visit to the SARC Committee. 5) Who do I notify if I cannot attend a small group session? The Student Code of Conduct makes the following statement, I will inform the appropriate people when I am not available to fulfill my responsibilities. It is therefore expected that students who are unable to attend a small group session will notify the Program Coordinators by e-mail within twentyfour hours of the session to notify them of a students absence and the reasons for the absence. If a student knows well beforehand that they will not be able to attend a small group session it is greatly appreciated for the Coordinator to know this information. This is particularly important for situations where a number of students are absent at the same time. Prior notification may allow for consolidation of small groups and respect for preceptors time.

6) Other It is recognized that balancing Med 440 clinical encounter sessions with clinical correlation sessions and physical examination sessions from the med skills course can pose challenges for students working to accommodate the busy schedules of clinical preceptors. The administration will continue to monitor these challenges and revisit this issue at a later date should it become problematic. Medicine 440 sessions, clinical correlation and shadowing appointments are not considered acceptable reasons to miss small groups.

NOTE: In all absences it is the responsibility of the student to follow up on missed material.

BEREAVEMENT POLICY Time away/missed assignments or exams due to the death of a friend or family member. A student who needs time off from medical studies or misses an assignment or examination to attend a funeral or for bereavement, must complete the student portion of the request for deferral of term work form and submit it to the Associate Dean. Supporting documentation must follow the request. This documentation must be either in the form of a letter from the funeral home, a copy of the death certificate, or if the student is a participant in the services and is listed in the funeral service program, then a copy of the program would suffice. In the case of a deferred examination, the policies for deferred examinations would apply with approval for the request dependent upon the above documentation. Approval for the request will be determined by the Associate Dean, Undergraduate Medical Education or his/her designate. Students submitting a request to attend a funeral or for bereavement will be encouraged to meet with Student Affairs for counseling support or to access the Physician & Family Support Program services. ATTIRE It is expected that the dress and deportment of student physicians will be in accordance with the expectations of their patients and the clinical setting. Students are asked to remember that the expectations of patients may be quite different from the current dictates of "fashion". Some jewellery, including body piercings, may be determined to be inappropriate for the professional setting and role of the student physician, and in such cases the instructor may require the student to remove the jewellery. In all patient areas, student physicians must dress appropriately (e.g., no jeans), wear a white jacket or coat, and wear their identifying badge. This policy also pertains to standardized patients and patient

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presentations before a whole class. For whole class presentations, the student course representative will contact the instructors to determine the patients' preference. If a patient prefers the students to wear white coats and name tags, the students will comply. Due to the admittedly subjective nature of what constitutes appropriateness, students are advised to consult with individual preceptors to determine in advance each preceptor's expectations regarding personal presentation.

INDEPENDENT STUDY TIME Teaching effectiveness depends not on what the teacher does but rather on what the student does. A significant objective of our school is to prepare students to continue learning after leaving the classroom and the university. In medicine, most student learning occurs outside the classroom. Ask any clerk, resident or alumnus! At the University of Calgary we do not see students as passive recipients of teaching rather we see them as actively processing knowledge and constructing their own understanding. In order to facilitate this deeper approach to learning (rather than rote memorization), scheduled independent study time of three half-days per week (average)is organized within the curriculum. During this time students usually (i) prepare their small group assignments either working alone or in teams, (ii) do assigned reading, (iii) study around objectives or if time, (iv) pursue research or career sampling opportunities. No interstitial curriculum can be scheduled into IST unless formally approved by Curriculum Design and Implementation Committee. Formal times for Clinical Skills, Clinical Correlations, Med 330 and Med 440 sessions may be exchanged for part of IST scheduled time. This is often necessary to meet the schedules of clinician teachers. The absolute amount of IST time per week is not compromised when these arrangements are made. IST is available to students up until the end of January in Year 2 of the program. In the 3 year no specific IST is set aside in Clerkship rotations.
rd

CLINICAL CORRELATION INFORMATION AND RESPONSIBILITIES FOR PRECEPTORS AND STUDENTS 1. Preamble Throughout the development of the Undergraduate Medical Education curriculum, clinical correlation has been consistently rated highly by students and graduates. The clinical correlation experience or Clinical Core provides an early opportunity for patient contact, a window into the patient experience of illness and disease, and a strategy for integrating various aspects of medical education. The sessions provide context and meaning to the historical information and physical findings described in course material. The primary goal of Clinical Core is to reinforce the features of a clinical presentation in a real patient.

2. Learning Objectives General learning objectives for all Clinical Core sessions are as follows: Observe the preceptor as a role model for professional behavior, communication and empathy. Correlate clinical cases with basic and clinical sciences learnt in the classroom. Develop skills in history taking, communication and physical examination. Identify and describe abnormal findings, in contrast to the normal physical exam findings stressed in the Medical Skills Course, and correlate these abnormal findings with the underlying disease process.

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Identify and describe aspects of the illness experience, and correlate these experiences with the underlying disease process. Develop the skills and knowledge necessary to navigate health care delivery environments such as hospitals and clinics.

Course specific learning objectives for Clinical Core in the setting of this course are as follows: (Course Committee to populate as appropriate) Please bear in mind that due to the structure of the Undergraduate Program, students will not yet have had an introduction to all areas of medicine. At the time of this experience, the students will have completed the following courses: (Undergraduate Medical Education to populate as appropriate)

2. Benefits from Clinical Correlation sessions Interaction with real patients increases student motivation to learn the required knowledge and skills of the course being studied. Demonstration of clinical presentations and their causes at the bedside correlates classroom work (basic and clinical sciences) with the real world. The importance of history and physical examination in solving clinical problems is clearly demonstrated. Reinforcement of problem-solving skills occurs through the use of schemes (problem-solving pathways, classification systems). Clinical reasoning skills are demonstrated and developed There is an opportunity to appreciate abnormal physical findings. Understanding of the impact of illness on a patients life and family is developed. The student can begin to learn to navigate the systems and culture of the health care setting, such as acute care hospitals. Students have an opportunity to take on appropriate roles and behaviors necessary to function as a clinical learner.

4. Implementation of Clinical Correlation Sessions Small groups of 4-6 students will accompany a clinical preceptor to take histories and examine patients demonstrating clinical presentations taught in the course. Clinical Core groups are the same ones as for the Communications and Physical Exam components of the Medical Skills Program to avoid scheduling conflicts. Cases are not meant to be standardized across student groups because the patient population available varies day-to-day. Only a limited number of clinical presentations can be addressed. These sessions are not meant to be all-inclusive. Clinical Core is scheduled in the timetable in specific slots. These are placeholders and sessions may occur in these timeslots or in independent study time. Sessions may not be scheduled during other learning activities (such as lecture or small groups). Student group leaders from each Clinical Core group will develop with the preceptor an acceptable schedule at the beginning 1 of each course, preferably by the third day of the course .

Courses may require other deadlines for students to contact preceptors to facilitate scheduling

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5. Number of Sessions The number of sessions of clinical correlation in each course will be determined by the course committee with the following guidelines: A minimum of 3 sessions (2 hours each) is expected in each pre-clerkship course . These sessions will be divided as follows: a. Session 1: emphasis on history-taking b. Session 2: review of focused physical examination relevant to the course c. Session 3: abnormal physical findings Courses may schedule more hours (up to maximum of 2 hours per week of course) if desired in order to cover a broader range of clinical presentations. Courses seeking to provide fewer than 6 hours of clinical correlation require approval at CDIC. Normally, courses will be required to provide an alternate clinical experience with patients to justify such requests.
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6. Preceptor Responsibilities Preceptors are asked to identify appropriate patients for Clinical Core from their or their colleagues practice; patients can be hospital in-patients or clinical out-patients. Preceptors can hold the Clinical Core sessions with in-patients on the hospital wards, with clinical outpatients in existing clinic time provided the students can be closely supervised, or alternately, with ambulatory out-patients in the Medical Skills Centre (rooms must be booked ahead, parking is provided for patients). Preceptors are to guide students and allow them to participate in the conduct of a history and physical examination with a patient under the preceptors care or the care of one of his/her colleagues; the patient case will then be discussed with the students in the context of their acquired knowledge to date.

7. Student Responsibilities Student attendance is mandatory at Clinical Core sessions, as per the Faculty of Medicine Attendance Policy. Each Clinical Core group will select a student leader who will be responsible for: a. acting as a liaison between the preceptor and the Clinical Core group b. establishing, with the preceptor, a mutually agreeable time and meeting place for the Clinical core sessions at the beginning of the course c. ensuring there is no conflict between Clinical Core sessions and other scheduled UME curriculum demands, such as lectures and small group sessions d. providing the preceptor with student evaluation forms Students are expected to demonstrate professional behavior which includes: a. arriving on time for Clinical Core sessions b. bringing appropriate equipment (eg white coat, stethoscope, reflex hammer, notebook, etc.) to each clinical core session. c. wearing professional attire (ie. No jeans or T-shirts) as described in the student handbook d. respecting patient confidentiality e. being respectful of patients and preceptors f. not bringing food or drinks to any of the sessions

Exceptions: Medical Skills, Medicine 440, Integrative Course, Introduction to Clerkship

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8. Student Evaluation The student leader or UME course coordinator will provide the preceptor with the evaluation forms that are to be completed and submitted to the UME office by the preceptor. Students will be evaluated on: Professional behavior Appropriateness of interactions with patients Attendance, preparation and participation in sessions Preceptors will also be asked to provide comments if concerns about student performance are apparent. The evaluation form and process will be periodically reviewed and approved by the Student Evaluation Committee (last done in 2009).

9. Preceptor Evaluation Students will also complete a preceptor evaluation at the time of their end of course survey.

10. Alternate Clinical Correlation Experiences Courses that wish to offer clinical experiences that differ significantly from the criteria described above will require prior approval by CDIC.

Prepared for UME Design/Implementation Committee by: Mr. Spencer McLean (Class of 2008), Dr. Peter Jamieson and Dr. Allan Jones Revised for Curriculum Design and Implementation Committee by: Dr. Pamela Veale April 2010

Shadowing Experiences Students may chose to use their independent study time to join physician preceptors in a variety of clinical settings. This activity is defined as shadowing if it is outside of formal curriculum activities, and is initiated by the individual student. The Undergraduate Medical Education (UME) Program is supportive of this activity and recognizes the value to students. Although this activity is not part of the formal curriculum, UME requires that the following criteria be met: Students are responsible for contacting preceptors and scheduling of sessions. Shadowing must not be organized during scheduled class time nor during clerkship rotations. Preceptor and student participation is voluntary. Students must inform the UME office of planned shadowing sessions in advance by sending completing the Shadowing Experience Form and submitting to Shannon Leskosky, Preclerkship Program Supervisor in UME at sleskosk@ucalgary.ca. The purpose of this form is to meet liability and workers compensation requirements. At all times, students are expected to follow the Student Code of Conduct. Additionally, as in all educational settings, faculty and students are expected to follow the Professional Standards for Faculty Members and Learners in the Faculty of Medicine at the University of Calgary. These standards are available on the Faculty of Medicine website at: http://medicine.ucalgary.ca/files/med/Professional%20Standards.pdf or from the Office of Equity and Professionalism. Students are to be directly supervised by their physician preceptor at all times.

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No evaluations are collected by the UME office. However, unprofessional behavior may be reported to the Associate Dean, UME. As in all clinical settings, students must wear their ID badges, white coats and professional attire. Students must use appropriate infection prevention strategies at all times. Prior to participation in a clinical setting, students must view the information regarding personal protective equipment and hand hygiene/washing video available on the following links:

http://www.albertahealthservices.ca/hp/if-hp-phys-hand-hygiene-policy.pdf http://www.albertahealthservices.ca/6426.asp http://www.albertahealthservices.ca/6422.asp


If an incident does occur, all accidents and safety issues must be reported to Occupational Health and Safety at 403-234-7799.

The Master Teacher Program During your next three years at the University of Calgary, you will be taught by literally thousands of physicians. However, there is a group of teachers that you will be encountering on a far more regular basis. They are collectively known as Master Teachers. Simply put, the Master Teacher Program was created because we ran out of teachers. From 2007-2009, our medical school class size had increased dramatically. In the same timeframe, the population of Calgary expanded to the point that the practicing physicians who typically perform the bulk of teaching in the medical school were struggling to deal with patient loads, let alone additional teaching responsibilities. Rather than sacrifice the quality of education by increasing the student to teacher ratio, the decision was made to hire a dedicated group of teachers that could fill in the gaps. Given the challenges of potentially being asked to teach any topic within any field of medicine, each Master Teacher has been selected to be a part of the Program because of their proven track record for excellence in teaching. There are now 41 Master Teachers who are paid a salary to teach throughout all three years of the UME curriculum. Master teachers teach on average 30% of the small group sessions. While some traditionalists feel that only an expert in the topic being discussed should be allowed to teach students, a prospective randomized trial has shown that students taught by Master Teachers achieve scores on their end-of-course multiple choice examinations that are equivalent if not better than those taught exclusively by Specialists. This highlights the fact that it is not only important to know what to teach, but it is equally if not more important to know how to teach. In keeping with the innovative nature of our medical school, this is the first program of its kind in the world. We would encourage you to use the members of the Master Teacher Program as a resource and conceive of ways in which to use their talents beyond their established roles as teachers, formal or informal mentors, research advisors and career counselors. We look forward to getting to know you over the next 3 years!

In Class Presentations Student should maintain respect for patients by remaining in the room for the duration of the presentation and refraining from eating or drinking while the patient is present. Visitors Persons not registered in the MD program are not permitted to attend any learning experiences or have access or review UME evaluations without the express permission of the Associate Dean (Undergraduate Medical Education) and the instructor of the learning experience.

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Course Questionnaires Students are asked for feedback regarding the UME program at a variety of intervals. These will take the form of session-by-session ratings, end of course surveys and year end questionnaires. The results of student feedback are used by individual teachers, course committees and UME administration as part of ongoing Program Evaluation and Curriculum Improvement. Student feedback is collected anonymously and rude or unprofessional comments may be deleted.

Presentation of Papers at Conferences Outside of U of C Students are encouraged to take the opportunity to present their research at conferences outside the University of Calgary whenever possible. Funding for travel to these conferences (if unavailable via research grant funding) is available through the Office of Undergraduate Medical Education as well as through the Students' Union. Applications for funding must be done well in advance of the conference, so please have everything prepared at least one month prior to the conference. When you are finalizing plans to attend a conference, make sure that all instructors, preceptors, and small group leaders are informed of your planned absence. If a presentation is going to conflict with a course evaluation, you must make alternate arrangements prior to the conference (see page 90).

Academic Accommodations for Students with Disabilities

The University of Calgary will provide academic accommodations to students who have provided documentation of disability to the satisfaction of the Student Accessibility Services to the extent that the accommodation does not cause undue hardship to the University of Calgary or lower the performance standards of any given academic program. Please refer to the Student Accessibility Services website at the following link for more information regarding mandated accommodations. http://www.ucalgary.ca/access/ If you wish to be assessed for a disability requiring accommodations, please contact the University of Calgary Student Accessibility Services at (403) 220-8237. Details outlining the necessary assessments and documentation required before exam accommodations can be granted are located on the University of Calgary website at: http://www.ucalgary.ca/access/students/register Students with pre-existing disabilities must be registered and assessed by the Student Accessibility Services before the first summative exam in Year 1. The student must provide the UME with the Student Accessibility Services letter at least 5 business days before the first exam. Students who request accommodations for a disability that the student did not delcare in the first year (ie. develops during medical school), will be required to medically defer all summative exams until the student is assessed by the Student Accessibility Services and the accommodation letter is provided to UME. Please note that any exam accommodations must be approved by the Associate Dean prior to implementation.

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Remedial Work Should you obtain an unsatisfactory status on an end-of-course evaluation, you will be expected to perform some type of remedial work. You may require faculty assistance with this. In most cases, faculty are sympathetic and will help students in this situation and give freely of their time, but an unsympathetic view may be encountered if a student is conspicuously absent from sessions, especially small groups, without a good reason. If you wish assistance in arranging this remedial work, please contact the Office of Undergraduate Medical Education.

Recordings From the University Calendar: 1. "Recording shall be permitted for individual private study only at the discretion of the instructor. For any other use, whether by duplication, transcription, publication, sale or transfer of recordings, written approval must be obtained from the instructor for the specific use proposed. Any other use of recordings constitutes Academic Misconduct and may result in suspension or expulsion." 2. "With the permission of the instructor, students may tape record lectures, provided that the student and instructor sign the appropriate Release Form. A copy of the Release Form shall be retained by the instructor and by the Department in which the course is offered." 3. "Students are cautioned that lectures, demonstrations, performances, and any other course material produced by an instructor are the intellectual property of the instructor. The Copyright Act and the law regarding confidences protect every original literary, dramatic, musical and artistic work, including lectures by University instructors. Any recording by students is permitted only for the purposes of private study by the individual student." 4. "Students are encouraged to make notes of classroom discussions, lectures, demonstrations, and performances in order to advance their own learning and to develop a record for purposes of private study. The ordinary process of taking notes is encouraged since this practice requires that students develop the ability to actively attend to the material under consideration and to quickly summarize pertinent information in a coherent manner. Electronic or mechanical recording of lectures discourages the development of these important skills. In addition, the presence of recording devices may inhibit frank and open discussion of course material in the classroom, or otherwise interfere with the proper academic conduct of the class." 5. "Instructors shall grant permission for electronic or mechanical recording of lectures to any disabled student who requires such assistance by virtue of a disability. In case of a dispute, the student's request for permission to tape record shall be directed to the Head of the Department in which the course is offered. The Department Head shall consult with the student, the instructor, and the Coordinator for Disabled Students before making a decision. The Department Head shall determine if there is a need to permit recording by virtue of the student's disability, and shall determine that the recording medium proposed by the student is appropriate to the needs of the student and in the context of the format of the course. The Department Head may impose such reasonable limitations on the recording privilege as may be warranted. The Department Head shall communicate his/her decision in writing, and if recording is authorized, the student and the Department Head shall sign the appropriate Release Form. A copy of the Department Head's letter and the Release Form shall be retained by the Department, and copies of these documents shall be given to the student, the instructor and the Coordinator for Disabled Students." 6. "In case of a dispute with respect to the decision of the Department Head, the matter shall be referred to the Dean of the Faculty in which the course is offered, and is appealable to the Student Appeals Committee in the Faculty, in accordance with the appeals procedures authorized by the General Faculties Council and outlined in the University Calendar."

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7. "This policy applies to all forms of electronic or mechanical recording of lectures, laboratories, tutorials, presentations, performances, electronic (computer) information, the duplication of course material, and to the translation of recordings or transcriptions of any of these materials to another form by electronic or mechanical means."

In addition, the Undergraduate Medical Education Program requires that students obtain written approval from Standardized Patients when they are present during recordings.

HEALTH SCIENCE CENTER LIBRARY SERVICES The Health Sciences Library connects you with information services, resources, and assistance to st support your learning, research, and clinical practice needs. We are located on the 1 floor of the Health Sciences Centre. They have: Computer workstations with access to University Library online resources, internet, MS Office, and laser printing Wireless internet access and wireless printing Self-serve scanning Bookable seminar rooms
The Health Sciences Library can be reached at 403-220-6855 or at hslibr@ucalgary.ca. Contact them to: Assist you with library research for your course assignments Enhance your skill in locating clinical literature to support evidence-based practice Recommend electronic books and clinical decision support tools for your practice Help you conduct comprehensive literature searches for your research projects or for systematic reviews Provide an orientation to the resources and services of the Health Sciences Library

More information about the Health Sciences Library is available through the Library tab in the OSLER dashboard or through the Librarys website at http://library.ucalgary.ca/branches/hsl Or just drop by the Information Desk - we want to help you succeed in your next three years of medical school!

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UME

Evaluations

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EVALUATIONS The following information is excerpted from: UME SEC Terms of Reference UME Policy for Development and Maintenance of Student Evaluations UME SEC policy for Reappraisals and Appeals of Student Evaluations

University of Calgary website http://www.ucalgary.ca/registrar/examfaqs .

PURPOSE OF STUDENT EVALUATIONS Student evaluations are governed by the Terms of Reference of the Undergraduate Medical Education Committee (UMEC). The Student Evaluation Committee (SEC) is a subcommittee of UMEC which shall develop policy on all matters regarding the planning, presentation and evaluation of the undergraduate medical curriculum, and regarding the evaluation of students. Student evaluations serve several purposes including: assessment of student performance and achievement of curricular objectives feedback to students and faculty regarding student learning needs program evaluation including identification of strengths and weaknesses in the education program Student evaluations should: be consistent with the goals, objectives and philosophy of the Undergraduate Medical Education (UME) program, meet accreditation requirements be guided by available research reflect realistic expectations for sustainability of quality examinations. be fair to all students regardless of individual background and/or demographics apply consistent evaluation standards to all students.

PREPARATION OF EVALUATIONS Evaluation development and maintenance is closely monitored by the Student Evaluation Committee. Examination psychometrics are reguarly reviewed to identify: item ambiguity and technical quality accuracy of examination key congruency with learning objectives and exam blueprint approval of overall MPL and standard setting procedures Content tested in a given evaluation may include any material previously covered in the UME curriculum, provided that this is reflected in the blueprint. FREQUENCY OF STUDENT EVALUATIONS The schedule of student evaluations is determined by the Office of the Associate Dean, UME. Generally, the certifying course evaluations are offered at the end of the individual courses. There are two offerings for rewrites & deferrals in each year of the MD Program. Each course and clerkship in the UME program must have one formal, certifying student evaluation. Each certifying evaluation may consist of one or more components.

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Each course and clerkship in the UME program should have a formative evaluation administered 3 approximately midway through the course . Courses or clerkships that are short in duration (less than 4 weeks) may not have sufficient time to provide structured formative evaluation, but should provide alternate means that will allow students to measure their progress in learning. Students must be notified at the beginning of the course regarding types and dates of all evaluation strategies to be used. TYPES OF FORMAL STUDENT EVALUATIONS Format of student evaluations is chosen to reflect appropriate assessment of learning objectives. Evaluation methods will be selected that aim to meet reasonable standards of objectivity, reliability and validity. In order to adequately sample the breadth of knowledge, skills and attitudes outlined in learning objectives, two or more evaluation components may be required for an individual course or clerkship. The most commonly used evaluation methods are the MCQ, peripatetic and OSCE exam. Various methods of student evaluation may be used as components of a course or clerkship evaluation. These may include measurement of student participation, completion of specified assignments, clinical reasoning questions, etc. All evaluation strategies used in UME should be approved annually by the Student Evaluation Committee. Generally, UME evaluations can be catetorized as either formative or summative. Formative Evaluations The purpose of the formative evaluation is to 1) to provide students with a sampling of the questionformat to be used on the summative evaluation and, 2) to allow students to monitor their learning progress. The formative evaluation should be similar in format and content to the final evaluation but will emphasize material covered up to the time of administration. Since the same preparation steps including blueprinting and development/review of question bank will be used to prepare both formative and certifying examinations, similar steps will be taken for each examination to ensure the security of the examination database. Formative evaluations may be samplings of certifying evaluations with briefer duration and/or demonstrations of examination question format. A blueprint will be provided to the students using questions on material covered up to the time of administration. Formative evaluations are considered mandatory educational activities. Students who do not participate in formative evaluations will be reported to the Associate Dean, UME. Student conduct during formative evaluations must follow University of Calgary evaluation regulations as would apply during certifying evaluations. Summative (Certifying) Evaluations Certifying evaluations will be designed to ensure that the student has satisfactorily met the objectives of the Undergraduate Medical Education Program. Individual evaluations should be based upon specific learning objectives for the relevant course or clerkship. Certifying evaluations may also contain content covered in previous courses and/or general topics outlined in the Goals, Objectives and Philosophy of the Undergraduate Medical Education Program. Each course or clerkship committee is responsible for preparing formative and summative (certifying) student evaluations. Each course and clerkship in the UME program must have a formal, certifying student evaluation. This evaluation should be a fair and representative sampling of the course/clerkship learning objectives. Blueprinting, development/review of question bank and standard setting are required. The certifying evaluation may have one or more components, but a single final grade is then compiled for each course.
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LCME Accreditation Requirement

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Multiple Choice Examinations Multiple choice questions should be written in the single best response format In general, the single response question tends to have better psychometrics than other formats. Most national examination bodies have moved to this question type or an extended matching format. Questions should aim to test higher level objectives such as application and problem solving rather than simple recall of factual material. Reliability of multiple choice examinations is dependent on several factors including test length and the quality of the individual questions. Locally prepared examinations should aim for a reliability coefficient of 0.7. This will generally require an examination length of 70-100 questions depending on the discrimination factor of individual questions. Validity of examinations requires appropriate sampling of course content as guided by the examination blueprint. High individual item discrimination is desirable; however, core items may have lower item discrimination.

Peripatetic Examinations The peripatetic examination questions must be included in the blueprint for the relevant course. The peripatetic component should be reflective of the allotted teaching time in the course, with a maximum of 20% contribution to the final grade.

Objectively Structured Clinical Examinations (OSCE) Reasonable reliability for well-constructed OSCE examinations can be achieved with approximately 9 stations. Longer evaluations may be required to adequately sample desired content area. OSCE examinations used as part of certifying evaluations should have 7-12 stations. In order to maximize reliability, preparation of OSCE examinations should include examiner and patient training, pilot testing of station questions and pre-testing of the scoring checklist.

Preceptor Evaluations Preceptor evaluations should include global rating of satisfactory/unsatisfactory performance and an anchored rating scale for specific desired competencies. Adequate space for comments should be available. Preceptor evaluations must be completed by an attending physician. Rotations that involve several preceptors should have a mechanism in place to compile input from all supervising attending physicians and residents. Courses are encouraged to use a format for preceptor evaluation that includes standardized Intraining Evaluation Report (ITER) ratings that are similar across courses.

Other Evaluation Methods Other methods of student evaluation may be used as components of a course or clerkship evaluation. These may include measurement of student participation, completion of specified assignments, clinical reasoning questions, online certifying examinations, small group iRATs (individual rapid assessment tool) and gRATs (group rapid assessment tool), logbook completion for clinical clerkship, etc. All evaluation strategies used in UME should be approved annually by the Student Evaluation Committee.

Blueprint The examination blueprint should be used to guide item development and selection to ensure congruency with educational objectives including weighting of content. A blueprint or table of specifications is required for each course and clerkship evaluation in the Undergraduate Medical Curriculum. The blueprint will be consistent with the Clinical Presentation Curriculum philosophy and thus should be organized by clinical

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presentations and reflect tasks to be evaluated. The basic blueprint should be distributed to the course chair, evaluation coordinator, students and teachers at the beginning of the course or clerkship. The expanded blueprint that includes the specific diagnoses/diseases to be tested should be available to the course chair and evaluation coordinator. Distribution of this version to students and teachers is encouraged.

ONLINE & PAPER-PENCIL FORMAT EXAMINATIONS: Examinations may be delivered using either a paper-pencil or an online format. Paper-pencil format: It is the responsibility of the student to submit exam bubble sheets in a condition that is readable by the optical scanning system. This requires each student to use the white-out (provided by UME invigilators) to fully delete all unwanted and stray pencil marks. Exam bubble sheets are considered legal documents that may not be altered by anyone other than the student. Failure of the student to submit a bubble sheet in a markable condition could lead to the student receiving a score of 0 for any items that are unreadable by the optical scanner. Failure of the student to submit a markable bubble sheet will not be considered grounds for appeal. Bubble sheets may not be altered in any way after being submitted for grading. Online format: Wherever possible, formative and summative mutliple choice exams will be offered using an online format. The reason for using the online MCQ format is to ensure that students have adequate experience with online exams in preparation for the Medical Council of Canada Qualifying Exam Part 1. Online exams may be self-ingivilated (such as the case with a take-home exam) or formally invigilated by UME staff (as would be the case with summative exams). Regardless of the formative or summative intent, all exam material is considered confidential property of the Office of the UME. Students are strictly prohibited against capturing, storing or circulating online exam materials, as such activity would be considered academic misconduct. Any student who becomes aware that an online exam has been saved or circulated is expected to notify the Office of the UME.

EXAM SCHEDULES & SEATING ARRANGEMENTS Exam schedules will be sent to students through the UME Office the week of the exam. The schedule will include date, time, location, and seating chart for the exam. Students must follow assigned schedule and seating during examinations. No switches between students are acceptable without prior approval from the Associate or Assistant Dean. Please note that this rule applies to all MCQ, peripatetic and OSCE Examinations. Student will be required to provide picture ID at all exams (including peripatetic and OSCE exams) and will be required to sign in at alll exams as well. No food or drink is permitted at examinations.

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POST EXAM REVIEW TEACHING SESSIONS: Many courses offer a post-exam teaching session following both formative and summative exams. The purpose of these sessions is for students to receive teaching on the exam content that appeared to be particularly challenging, and could suggest that important concepts were misunderstood by the majority of the class. These sessions are strictly intended to be learning opportunities, and are not the venue in which students may argue for MPL adjustments or alterations to exam content. The sessions will be moderated by student representatives who are tasked with the responsibility of ensuring that student conduct remains consistent with the expectations normally applied according to exam conditions (see Conduct at Evaluations, below). Students may not bring any bags, electronics, papers or other personal items into the post-exam teaching session. The post-exam teaching session is an excellent opportunity for students to learn from mistakes on the exam and it is the expectation that students be respectful of the time and effort that faculty invest in this teaching.

CONDUCT AT EVALUATIONS In certifying evaluations and formative examinations, we are bound by the University regulations. University of Calgary policies related to misconduct will be observed at sessions devoted to certifying evaluations. Candidates are strictly cautioned against: (i) speaking to other candidates or communicating with them under any circumstances whatsoever; (ii) bringing into the examination room any textbook, notebook, mechanical devices, or memoranda and materials not authorized by the examiner; leaving answer papers exposed to view.

(iii)

The penalty for violation of these rules is suspension or expulsion or such other penalty as may be determined. During certifying evaluations students may leave the room, one at a time, in order to visit the washrooms closest to the examination. There should be no more than two students out of the room at any time. Students should not converse with other students (even about trivial matters), should not distract their colleagues in the examination room, should not visit student offices or the student lounge, should use the washrooms closest to the examination room and, in general, should not remove themselves from the immediate area of the examination room. While invigilation of students behaviour outside the examination room may be conducted from time-to-time, students are expected to police this honour system themselves and to report to the Undergraduate Medical Education Office any instances of improper behaviour by their colleagues. Absolutely NO devices are allowed in the examination room or during the exam while excused for a washroom break. While the evaluation is in progress, students are required to follow the instructions of the invigilator who may temporarily forbid absences from the examination room in order to administer sections of the evaluation, which necessitate student attendance for proper performance (e.g., showing a series of slides about which questions will be asked). Regardless of overall grade, a course or clerkship chair should inform the Office of the Associate Dean or delegate directly if a student has demonstrated significant unprofessional and/or unethical behaviour during the course or clerkship.

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What is allowed in the examination room? You must bring: 1. Photo-id such as your U of C Campus Card or a Driver's License. . If you forget your I.D. card, but can produce an acceptable alternative I.D., e.g. one with a printed name and photograph you will be allowed to write the examination 2. Several sharpened pencils 3. An eraser 4. White lab coats to any examination of clinical skills (i.e. OSCE exams). You may NOT bring: 1. Calculators and any other electronic aids, as these are not permitted in any UME examination. 2. Cell phones, ipods, wireless access devices, headsets and other prohibited items.

SECURITY OF EVALUATIONS The questions and answers of all evaluations are secure. The copying of any formative or summative evaluation material by students is strictly forbidden, as is the possession of any evaluation material outside of the examination room. Students who discover any suspicious evaluation materials are expected to report the matter immediately to the Associate Dean (UME). When writing or reviewing evaluations all bags (back packs, purses, etc.) and books must be left in secured student lockers during examinations. Cell phones, ipods, ipads, laptops, and other electronic devices are not permitted in the examination room.

PERMISSION TO DEFER AN EVALUATION The following information is quoted from the University of Calgary Website: http://www.ucalgary.ca/registrar/examfaqs Please be aware: The Deferred Examination is the last opportunity for students to write a final exam. An unsatisfactory result on a deferred exam will require the student to complete a period of remediation, followed by a re-write examination scheduled by the Office of the UME. Approval of your application may affect eligibility for convocation and certain undergraduate awards. You are fully responsible for ascertaining whether the Faculty has approved or denied your request for a deferred final examination and where/whenyour deferral will take place.

Travel arrangements, vacation plans, weddings or other family events, employment situations, misreading the final exam timetable, and having three exams in a twenty four hour period are not considered reasonable grounds for deferring a final exam. If your exam schedule shows three final exams on the same calendar day (between 8:00 a.m. and 7:00 p.m. on one day) you are eligible to defer one exam of your choice to the deferral period. Deferred final examinations may be granted by the Associate Dean, Undergraduate Medical Education, to students who are prevented from writing the exam for the following reasons, only: Illness Domestic Affliction Religious Conviction

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Deferred examinations will be held in conjunction with the timetabled rewrite examinations for that academic year. A granted deferral examination will be the same test that would be given to students required to repeat a particular course examination. Students submitting a final examination for marking may not subsequently request a deferred final examination. Lack of writing a final examination does not guarantee approval of a deferred examination. The authority to grant or deny a deferred final examination is vested with the Associate Dean of the UME. Deferred final examinations will not be granted if it is determined that just cause is not shown by the student. How to Apply for a Deferral of an Examination A student who wishes to defer a final examination must first meet with the Associate Dean (UME) or Assistant Dean prior to the examination date to request an approved deferral. In the event of an intended absence due to religious conviction, domestic affliction, or health reasons which makes it physically impossible to write an examination, an Application for Deferred Final Examinations form accompanied by written evidence must be submitted to the Associate Dean, UME prior to the date of the final examination. In the case of health reasons, the accompanying written evidence must be a completed Physician/Counsellor Statement form. Deferred Mid Point Summative Exams (Preclerkship) A student who has deferred a mid point summative exam in preclerkship (Year 1 & 2) for legitimate reasons must understand that the weighting/percentage of this mid point exam will transfer to the final multiple choice summative exam at the end of the course. Illness - Physician/Counsell Statement If a student is ill the day of the exam, they must immediately notify the Associate Dean or designate in the Undergraduate Medical Education office of their situation before the start of the scheduled examination. All requests for deferral of a final examination due to health reasons must be accompanied by a completed Physician/Counsellor Statement form (http://ww.ucalgary.ca/students/forms). Letters from a physician/counsellor in lieu of a Physician/Counsellor Statement form will not be accepted. Students are encouraged to be responsible in making a request to have an examination deferred by seeing a physician/counsellor while the student has the physical or emotional problem rather than after recovery. This makes it more possible for professionals to do an accurate assessment. Students should be aware that there may be a charge for the medical assessment and documentation and they are responsible for the cost of this service. Illness that develops during an exam If, during the course of an examination, you become ill or receive word of domestic affliction, you should notify the exam supervisor, hand in your unfinished paper and request that it be cancelled. If physical or emotional ill health is the cause, you should report at once to a Physician/Counsellor so that subsequent application for a Deferred Final exam is supported. Please do not wait to consult a Physician/Counsellor. Should you write an examination paper, hand in the paper for marking and later present extenuating circumstances to support a request for cancellation of the paper or write another examination, such a request will be denied. Since there is a very short time period between the application deadline date and the writing of deferred exams, it is your responsibility to ascertain whether or not the Associate Dean or designate has approved your application and to obtain your deferral timetable.

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Students with a registered disability who require special arrangements for their final examination must contact the Student Accessibility Services. Religious Observance Students unable to attend a final exam due to religious observance must contact the Associate Dean of UME immediately after publication of the final exam timetable and at least two weeks prior to the first date of the final exam period. The authority to write on an alternate day within the final examination period is vested solely with the Associate Dean of the UME. If it is not possible for the exam to be written on an alternate day within the final exam period, students are eligible to defer a final exam to the official deferral period. The university reserves the right to require proof of religious observance, if necessary. If a mid-term test lands on a religious observance day, students must give two weeks notice to the instructor of the course. Religious observance does not preclude a student from meeting the requirements of the course or from having to meet deadlines for submission of assignments. Students who miss classes for religious observance must make up the material covered in the class on their own. The university reserves the right to require proof of religious observance, if necessary. Unforeseen Reasons Students absent from a final examination due to unforeseen reasons must notify the Office of the UME within 48 hours of the missed examination. Students who are eligible but do not apply for a deferred final examination by this prescribed deadline shall automatically lose this privilege. Students who have been granted a deferred final, but who do not show just cause within 48 hours of the examination for not writing at the prescribed time, shall automatically lose the privilege of further deferral in that course. Except in the case of a granted deferral, it is not possible to write an examination on any date other than the scheduled date. Your academic term does not end when lectures are over. It ends when your last final exam is written. Therefore, you are required to be available up to the last day of the final examination period, if necessary. Changes to dates in final examinations will not be accommodated.

Loss of Privilege Students who have been granted deferred finals, but who do not show just cause (within 48 hours of the examination) for not writing at the prescribed time, shall automatically lose the privilege of further deferral in that course. If a student does not appear for a scheduled examination without just cause, they will automatically be considered to have an unsatisfactory performance. A student may be refused permission (debarment) to write a final examination in a course, on the recommendation of the department concerned and with the concurrence of Associate Dean, UME in the following circumstances: 1. The student has neglected to do a substantial proportion of the requirements in a course or clerkship of which these are an essential feature. 2. The student has not officially registered in the course.

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Special Request for Deferral to Present Academic Papers The Faculty encourages student research and presentation of work at national forums and in peerreviewed publications. On occasion, such presentations fall on the same day as a final examination. If possible, all efforts should be made to change the date of presentation or the meeting to which abstracts are submitted to avoid a final examination deferral. To apply for a special circumstances deferral, the student must obtain prior approval from the Associate Dean or designate. Following this approval, the student will then make an appointment to meet with the Associate Dean (UME) or designate to review the situation. If the Associate Dean (UME) grants approval for the deferral, the student will be expected to write the examination during the timetabled rewrite examinations for that academic year, unless otherwise directed by the Associate Dean.

STUDENT REVIEW OF WRITTEN EXAMINATIONS Review of medical school examinations during the pre-clerkship years is considered to be a privilege. Disregard for examination review protocol or a breach in confidentiality of examination material may lead to a discontinuation of examination review practices. Students are strongly cautioned against trying to calculate their final grades during their review of any exam, as it is impossible for a student to accurately calcuate the final grade. The final MPL and questions for an exam are established by the Exam Review Working Group after the exam is closed for studentreview. Any MPL that students are provided before the official release of the marks is likely inaccurate. The questions that students encounter on any exam are not necessarily the questions that will ultimately count towards the final grade. This is because UME exams may contain a selection of questions that are being piloted for future years, but not counted towards the final result for the current year.

All UME staff are required to maintain strict confidentiality with respect to both exam content and student results. UME staff may NOT make any comments to students regarding exam items or discussions at the exam review meeting. Students wishing to make formal comments about the exam must do so via the formal feedback process. Students may NOT contact ProgramCoordinators or course instructors about exam items. All evaluation items are considered to be Confidential. As such, the Office of Undergraduate Medical Education has established protocol around examination review. All students will be expected to follow this established protocol.

Established Examination Review Protocol Packs and bags are to be left in secure student locker areas. Cell phones, ipads, ipods, laptops and other electronic devices are not to be used at the review stations. Note taking during examination review is not permitted. Anyone not registered in the Undergraduate Medical Education Program is not allowed to review these examinations without the express permission of the Associate Dean (UME).

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How to access an exam for review Following each written examination, in Years 1 and 2, a student may review the examination key (questions and answers) on the designated computers in the Health Science Center Library approximately 2-4 days after the examination has been written. The exam bank may be made available to students in one or both of the following ways: Desk Top Computers: As computer access is limited, advanced sign up by students is requested. The signing up to review examinations is done electronically online. A half-hour block is a suggested reasonable time for review. Examination review times will not be open during scheduled class times. The student optical score sheet answers will be available online once the student signs into the online review program. The comment sheet from the exam will also be made available for students reference during this exam review . These items are to be returned to the Undergraduate Medical Education staff member at the end of the review time. These items are not to be removed from the Office of Undergraduate Medical Education. Comments can be made online on individual examination items. These comments are expected to be in regard to the accuracy of answers and should be based on the core document course objectives and/or recommended textbooks listed in the course core document. UME Exam Laptops: Portable exam review centres will be established using rooms within the Health Sciences area if necessary. These exam review opportunities must be scheduled by the students in the same way that students must schedule time for the Desktop exam review. Identical expectations with respect to student conduct, invigilation and the opportunity for students to provide feedback on exam questions are applied to the portable review centres

Student feedback on exams is critical to the ongoing improvement of the exam bank. However, only feedback that is constructively offered may be of any use to the Exam Review Working Group.Appropriate comments from students about exam questions may include: Identification of ambiguities or errors in the structure or content of an examination item. Identification of questions that are not included in the course core document objectives. On short answer questions, answers that the students feel should be considered in addition to those answers provided in the answer key.

Inappropriate comments include: Personal comments directed at faculty/teachers or use of unsuitable language. This is a bad question. (Explanation of why the question is bad is needed.) Where did this come from? The MCCQE says (MCCQE is not a recommended textbook) Dr. XYZ said in class that we did not need to remember this information because we would not be tested on the information. (Although Dr. XYZ may not test you on this material, if the information is in the core document or in the recommended textbooks, the Course Evaluation Coordinator and Evaluation Committee may include a question relevant to this topic on the test) This was not in the course objectives. (Students can and will be tested on objectives from a previous course.)

Helpful hints when reviewing your exam: When referring to a quote from a textbook, please indicate the reference text name, the page number and paragraph where the reference can be found. The books listed in the course core document are the only books that will be considered as appropriate references when reviewing comments.

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Students are invited to submit their concerns regarding specific items to their course reps. The course reps should then provide this information to the Exam Review Working Group for further consideration.

It is important that students remember that feedback will be used to improve the exam bank for future years. However, students may not dispute exam content or the answer key for the current year. Any decisions made regarding exam content and answer keys are guided by a review of exam psychometrics, and not by student opinion.

THE STUDENT FILE The Office of Medical Education maintains a file for each student. Each file is a combination of the Students Admission documentation, first and second year academic documentation and clerkship information. Kept in the file are examination performance records for example student examination results, reports submitted by preceptors/instructors for Electives, Medical Skills, Integrative, and Clerkship rotations. Other items of interest pertaining academically to a student, e.g. awards, letters of praise, etc. may also be included. The file is accessible to a student for review during normal office hours but is not accessible to anyone else outside the Undergraduate Admissions Office and Student Academic Review Committee unless written authorization is provided by the student (e.g. Faculty Advisor). A student may have a Faculty Advisor, Legal representative or other representative accompany them when they review their file. Under no circumstances may any item from the Students File be destroyed or removed. Individual student results on formative evaluations will be included in the students permanent file, but will not be used to calculate final course mark and/or reported in the Medical Student Performance Record (MSPR). A student may request, or request a representative, to review their file by completing a Request to Review File Form and submitting it to the Undergraduate Medical Education Office at least 24 hours prior to reviewing the file. A student who has received a Notice to Appear before SARC is not required to submit a Request to Review File Form unless they would like a representative to review their file on their behalf.

EVALUATION RESULTS Results are reported only after analysis of the psychometrics according to SEC criteria. Decisions regarding adjustments will be made by the consensus of an Exam Review Working Group (ERWG) comprised of: 1. One SEC representative familiar with psychometric analysis 2. One or two course representatives (normally course chair and/or evaluation representative) One student representative. The role of the student representatives on this subcommittee is to assist in ensuring that the exam content has been reflected through the teaching or learning objectives. The student members of the subcommittee do not have the authority to represent specific student concerns or advocate for specific adjustments to final grades. 3. The UME course coordinator attends to ensure that recommendations of the group are entered into the master exam bank. Student representation is important to the Exam Review Working Group. However, student schedules (i.e. when student reps are away on electives) may make it impossible for students to attend the meetings. In such cases, the students may choose to send an alternate representative to the meeting. When this is not possible, the ERWG will proceed with its meeting, and will seek student input if necessary prior to the release of the final grades. There also may be rare times when the post-exam review is conducted by email (i.e. when few to no adjustments are required to the exam prior to the

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release of final marks). However, face-to-face post-exam review meetings are always the preferable option. Any changes resulting from the ERWG review, will apply to all students sitting the examination and evaluation scores re-calculated and all decisions are considered final. Normally, final student marks are calculated and distributed within 5 working days (and no later than 14 days) of the examination date. Occassionally, there may be instances (i.e. the MedSkills OSCE) during which it is in the best interest of the students to delay the release of beyond 14-days.

MINIMUM PERFORMANCE LEVELS (MPLS) The MPL for an examination is the sum of MPLs for each item on the examination. Members of the Exam Review Working Group identify the answers that a minimally competent student must or may know to be correct or incorrect responses. MPLs for items are based upon calculations related to these judgements. The overall examination MPL will be rounded down to the nearest whole number and student scores be rounded up to the nearest whole number according to accepted mathematical rules. Subsequent pass/fail decisions are final, regardless of student score proximity to MPL.

GRADING SYSTEM A Satisfactory/Unsatisfactory grading system will be used. Students cannot be declared Satisfactory overall based upon only some of the components of an evaluation. Students must be declared Satisfactory or Unsatisfactory in the complete (overall) evaluation. To obtain credit for a course, a student must be certified as satisfactory on the course evaluation by achieving a score at or above the minimum performance level (MPL) for the examination. Results from Year 1 and 2 will be reported as either Satisfactory or Unsatisfactory. Results from Year 3 will be reported as Satisfactory , Unsatisfactory, or Satisfactory with performance deficiency. Satisfactory means that the Faculty has determined that the student has met or exceeded the level of performance minimally acceptable for promotion. When a student receives a Satisfactory grade in the course concerned, the grade cannot be altered by any further changes made in the evaluation as a result of subsequent appeals. Unsatisfactory means that the student has not met the minimum performance level for the evaluation. A student who is unsatisfactory may wish to review their result sheet with the examination key to aid in recognition of areas of deficiencies and assist in planning remedial studies or to identify an error in the marking. Should a student feel that an error has occurred in the marking of a non-multiple choice question (MCQ) he/she may submit a Request for Reappraisal. Satisfactory with performance deficiency is used in Clerkship for the following situations. 1. Failure of one component of a clerkship evaluation with subsequent completion of required remedial work and satisfactory performance on rewrite of that component. 2. Overall rating of satisfactory performance in a clerkship rotation but with one or more specific areas of deficiency noted including professional and ethical behaviour.

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The purposes of identifying Clerks with these evaluation outcomes in a third category are: 1. Ensure student is informed of poor performance 2. To provide indication to UME Administration regarding weak student performance. This allows the Office of the Associate Dean to provide monitoring and intervention to these students during their clerkship training. 3. To allow opportunity for identification of problematic professional and/or ethical behaviour or of other weak skills that may not result in unsatisfactory overall rotation evaluation, but that must be corrected. 4. To ensure fair reporting of student performance in transcript records.

CONSEQUENCES OF AN UNSATISFACTORY PERFORMANCE Students will have two opportunities to demonstrate satisfactory performance on certifying evaluations. A student who is unsatisfactory on a certifying evaluation, with or without a completed Request for Reappraisal to the SEC, is required to write a repeat certifying evaluation or repeat OSCE. Notification of the time and place for this repeat evaluation will be provided by the Undergraduate Medical Education office following the release of the results of the final certifying evaluation. The repeat evaluation will follow the same due process as established for initial evaluations and the same Reappraisal process is possible. Sufficient time between evaluations should allow for necessary remedial work as determined by the appropriate course committee. Students with unsatisfactory performance on certifying evaluations shall appear before the Student Academic Review Committee (SARC) according to the criteria outlined in the SARC terms of reference.

During the First Two Years of the Curriculum A student who is Unsatisfactory on the first attempt on any two certifying evaluations in the first two years of the undergraduate medical curriculum shall appear before the Student Academic Review Committee. A student who is Unsatisfactory on any certifying evaluation in the first two years of the undergraduate medical curriculum and remains Unsatisfactory after the repeat evaluation shall appear before the Student Academic Review Committee.

Specific Expectations and Requirements Without exception, a student who is Unsatisfactory on the first attempt on any two certifying evaluations in one year of the undergraduate medical curriculum will be required by the Committee to repeat the year or withdraw from the academic program. Without exception, a student who is unsuccessful in a repeat certifying evaluation will be required by the Committee to repeat the year or withdraw from the academic program.

During the Third Year of the Curriculum A student declared Unsatisfactory on more than one clerkship rotation or any remedial clerkship rotation, or any repeat clerkship evaluation of knowledge, clinical skills, and/or professional behaviour shall appear before the Student Academic Review Committee. A student who demonstrates a Performance Deficiency in more than one clerkship rotation shall appear before the Student Academic Review Committee.

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A student declared Unsatisfactory on a clerkship rotation and Satisfactory with Performance Deficiency on another clerkship rotation shall appear before the Student Academic Review Committee. A student who declines to undertake mandated remedial studies for a Performance Deficiency or for a rotation that has been declared Unsatisfactory shall appear before the Student Academic Review Committee. A student shall appear before the Student Academic Review Committee if the Associate Dean declares the students clerkship performance Unsatisfactory, notwithstanding that the student may have received Satisfactory evaluations in all previous clerkship rotations. In clerkship, if a student fails one component of a course rotation, he/she is required to rewrite the failed component; if he/she passes the rewrite, the mark is changed from unsatisfactory to satisfactory with performance deficiencies. The Office of the Associate Dean (UME) will monitor evaluations and offer assistance when academic difficulties are observed. A student who is unsatisfactory on a certifying examination should meet with the Associate Dean or his/her representative within two-weeks of the result to discuss remedial plans. All students should be familiar with the policies for promotion outlined in the Terms of Reference of the Student Academic Review Committee.

EXAM RE-WRITE SCHEDULE Specific dates for all evaluations can be found in the timetable for each year. IMPORTANT: The re-write period may NOT be deferred for travel, electives or any other plans that the student schedules prior to an unstatisfactory exam result.

The First Year rewrites and deferred examinations have 2 scheduled offerings. First offering is scheduled on the last day of spring break before Year 2 begins. Course during this offering include, Course 1, Course 2, Course 3 Deferrals only, Medical Skills and Population Health. Second offering isscheduled for the first 2-days of the Year 2 Summer Elective period in Week 3 for Course 3 rewrites only. Students who rewrite will usually know their final mark for this repeat evaluation within 5 days of writing. The Second Year rewrites and deferred examinations have 2 scheduled offerings. First offering is scheduled in Week 1 of Course 5 (August) for Course 4 rewrites & deferred exams only. The second offering is the last day of Year 2 before Clerkship begins for Course 5, Course 6, Course 7, Medical Skills and Applied Evidence Based Medicine (AEBM). Students who rewrite will know their final mark within 5 days of writing. As the clerkship year begins immediately after second year finishes, the timing of rewrites is critical. The Clerkship Re-write and Deferral Examinations are scheduled pre-CaRMS in mid-October and the last week in April allowing for remedial and make-up time. Students with unsatisfactory performance on certifying evaluations may be required to appear before the Student Academic Review Committee (SARC) as outlined in the SARC Terms of Reference. A student who obtains an unsatisfactory rating on an evaluation is expected to meet with the Associate Dean, UME (or delegate) within 2 weeks of receipt of the relevant examination result. During preclerkship, the student is expected to organize a remedial program in consultation with the UME office to

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correct this deficiency prior to writing a repeat evaluation . This may involve use of independent study time. Failure to complete a prescribed remedial program is regarded as equivalent to failing the repeat examination. During the clerkship year, in the case of unsatisfactory performance, a period of remedial learning may be required piror to the rewrite examination. The relevant Clerkship Director and/or Evaluation Coordinator will be responsible for arranging the appropriate remedial learning. All students should be familiar with the policies for promotion outlined in the Terms of Reference of the Student Academic Review Committee.

DISTRIBUTION OF RESULTS Examination results will be distributed to each student via email to the students @ucalgary.ca address. Grades will be emailed only to an @ucalgary address. Paper copies of grades are not distributed to students. The emailed result will include the overall score and the examination minimum performance level. These results also indicate areas of strengths and weaknesses in each of the identifiable clinical presentations. Examination results will be kept confidential. Individual student results will be made available to: a) the student b) the students permanent file c) the students faculty advisor (this is accomplished by the student forwarding the emailed results to the advisor; any other distribution to the faculty advisor requires written consent of the student). d) the office of the Associate Dean, UME e) members of faculty committees responsible for student promotion and/or appeals. f) Course chair and evaluation coordinator for relevant course or clerkship. Anonymized group evaluation results may be released to the course chair and evaluation coordinator for the relevant course and to faculty responsible for program evaluation in the Undergraduate Medical Education Program. Individual student grades and class standings are not reported on student transcripts or provided as part of CaRMS applications.

REAPPRAISALS AND APPEALS PROCESS FOR UME EVALUATIONS Students who have not achieved the minimum performance level are given the grade Unsatisfactory. It is especially important that the student recognizes his/her deficiencies and takes the time to review the exam key within the scheduled exam review period. In this review, a student may identify an error or omission in the scoring process (non-MCQ) and has recourse to a Request for Reappraisal to the Student Evaluation Committee. Request for a Reappraisal/ Appeal are assessed by the Student Evaluation Committee. The results for an individual appeal will only apply to the student being assessed. The change in marking will not apply to or alter any other students mark, either within the Faculty of Medicine or under University-wide regulations. The Request for Reappraisal will only be accepted if it identifies errors or omissions in the scoring process (non-MCQ) that are inequitable to the student. Discrepancies over actual content of the evaluation or challenge of objectives not included in the core document would have been identified picked

In clerkship, if a student fails one component of a course rotation, he/she is required to rewrite the failed component; if he/she passes the rewrite, the mark is changed from unsatisfactory to satisfactory with performance deficiencies.

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up by the process followed at the post-examination meeting of the ERWG and therefore will not be further considered by the Student Evaluation Committee. Each request is independently assessed by the Exam Review Working Group and the results of the appeal will only apply to the student being assessed. The student will receive a revised print-out of their grades, marked Appeal. This print out will replace the first/initial copy (before the appeal) of the students marks. A students who is unsatisfactory, with or without a completed Request for reappraisal to the Exam Review working Group, is required to write a repeat evaluation or repeat OSCE. Notification of the time and place for this repeat evaluation will be provided by the Undergraduate Medical Education office following the release of the results of the final certifying evaluation. The repeat evaluation will follow the same due process as established for initial evaluations and the same Reappraisal process is possible. Students should be aware that the grade being reappraised may be raised, lowered or may remain the same. Decisions of this committee will be considered final unless appealed to the next relevant level of appeal according to the relevant terms of reference. Any appeal that is granted by the Student Evaluation Committee will be returned to the body that established the final evaluation in question. The original evaluating body would be expected to review the appeal decision, but would not be required to agree with the appeal decision, and may conclude that the original grade will stand. Students in this situation would have the option to pursue an appeal to the Medical Student Appeals Committee (MSAC) for a final decision. Students are encouraged to become familiar with the MSAC Terms of Reference, which can be found on the U of C website. Appeals may submitted related to: written evaluations and OSCE examinations ITERs, overall examination decisions remedial recommendations The reappraisal will not take place unless the student provides a detailed rationale that outlines where and for what reason an error is suspected. Students who receive a Satisfactory grade can not appeal.

REQUESTS FOR REAPPRAISAL OF WRITTEN EVALUATIONS AND OSCE EXAMINATIONS Criteria for reappraisal of written or OSCE 1. Requests for Reappraisal will not be accepted if the student has received a Satisfactory overall evaluation for the relevant course or clerkship. 2. Requests for Reappraisal will not be accepted for factors that have impacted on all individuals taking the examination. 3. A student who is unsatisfactory on an evaluation may request reappraisal only if he/she has identified scoring errors or procedural irregularities which may have adversely affected his/her assigned grade. Reappraisal requests cannot be directed against content of individual items. All certifying examinations are intended to reflect the course/clerkship objectives and the UME goals, objectives and philosophy. At the time of the examination, students may submit comments regarding individual questions on the comment sheets provided. These comments will be expected to identify ambiguities or errors in the structure or content of an examination item. The usual pre- and post-examination review process is designed to address these issues.

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4. Requests for Reappraisal will not be accepted for multiple choice examinations. Failure to transcribe responses correctly onto the examination paper or optical score sheet is an unfortunate student error, but is not an acceptable criterion for examination reappraisal. 5. Illness during the examination is not grounds for appeal or reappraisal. Policy regarding deferral of examination due to illness is documented in the University of Calgary examination policies.

APPLICATION FOR REAPPRAISAL OF WRITTEN OR OSCE 1. All Requests for Reappraisal must be directed in writing to the Director of the Student Evaluation Committee within 14 days of receipt of the relevant evaluation result. Such requests must describe the specific rationale for consideration of the Reappraisal. The Director of the Student Evaluation Committee will review these requests within 5 working days of receipt to determine if the criteria for further consideration are met as outlined below. 2. Acceptable requests will be heard by an SEC Reappraisal Subcommittee consisting of: a. Three (3) faculty members of the Student Evaluation Committee b. Two ( 2) student representatives from the Student Evaluation Committee. The committee will also include the student representative for the course being reviewed. c. Two (2) members of the appropriate Course/Clerkship Committee.

3. The required number of faculty members to form a quorum for a reappraisal meeting is five. The voting members will include the Exam Review Working Group Chair, Course Chair and Evaluation Representative of the course being reviewed, Director of the Student Evaluation Committee and one other faculty member of the Exam Review Working Group. The Office of Undergraduate Medical Education will inform the student who is appealing of the time and place of the appeal meeting. If a Request for Reappraisal needs clarification, only then will the student be invited to appear before the committee. After the student has withdrawn, the committee shall make the final decision on the Request. 4. Decision will be by secret ballot with chair only voting in case of a tie. Normally, this meeting will take place in conjunction with the next scheduled meeting of the Student Evaluation Committee (within 4 weeks of receipt of request). If necessary, the Director of the Student Evaluation Committee may call a special meeting of this Reappraisal Subcommittee to provide a timely decision. 5. Materials considered by the Reappraisal Subcommittee will include: a. The students written submission including rationale for request b. The original examination question and answer key c. A copy of the students original response d. A written recommendation from the marker/question author for scoring of student response The student will not be identified by name in the written documents. The minutes of the meeting shall include a summary of any Request that is accepted, identified by the Student ID number, only.

RESULTS OF APPEAL OF A WRITTEN OR OSCE 1. The decision of the Reappraisal Subcommittee may result in a grade that is higher, lower or unchanged when compared to the original grade. Decisions of this committee will be considered final unless appealed to the next relevant level of appeal according to the relevant terms of reference. 2. Any appeal that is granted by the Student Evaluation Committee will be returned to the body that established the final evaluation in question. The original evaluating body would be expected to review

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the appeal decision, but would not be required to agree with the appeal decision, and may conclude that the original grade will stand. Students in this situation would have the option to pursue an appeal to the Medical Student Appeals Committee (MSAC) for a final decision. Students are encouraged to become familiar with the MSAC Terms of Reference, which can be found on the U of C website. 3. In the event that there has been a process error, the Reappraisal Subcommittee may require reassessment of the student. Normally this will be conducted at the next scheduled rewrite time (years 1 and 2) or with the next clerkship offering of the examination (year 3). If this is required and the student does not complete this reassessment, he/she will be considered Unsatisfactory for the examination. 4. Results for an individual Request for Reappraisal will only apply to the individual student being assessed. The change in marking will not apply to or alter any other students mark, either within or under University-wide regulations. 5. The outcome of all Requests for Reappraisal will be communicated to the student in writing and to Office of the Associate Dean, UME. A copy of this letter will be placed in the students permanent file.

CRITERIA FOR APPEAL OF PRECEPTOR EVALUATION REPORT OF CLINICAL PERFORMANCE (ITER), OVERALL EXAMINATION DECISIONS, AND/OR REMEDIAL RECOMMENDATIONS The Student Evaluation Committee will consider only whether the evaluation process was conducted fairly and/or if recommended remedial work is reasonable.

PROCESS FOR APPEAL OF PRECEPTOR EVALUATION REPORT OF CLINICAL PERFORMANCE (ITER), OVERALL EXAMINATION DECISIONS, AND/OR REMEDIAL RECOMMENDATIONS 1. Appeals regarding ITER evaluations, overall evaluation decisions or remedial recommendations will only be accepted by the Student Evaluation Committee once the student has completed the course or clerkship in question and potential remediation recommendations have been made by the Departmental Course/Clerkship Committee and/or Associate Dean UME. Requests will not be considered from students who are Satisfactory overall. 2. All Requests for Appeal must be directed in writing to the Director of the Student Evaluation Committee within 14 days of receipt of the relevant evaluation result. Such requests must describe the specific rationale for consideration of the Reappraisal. The Director of the Student Evaluation Committee will review these requests within 5 working days to determine if the criteria for further consideration are met. 3. Appeals regarding ITER evaluations, overall evaluation decisions or remedial recommendations will normally be heard by the full Student Evaluation Committee minus the UME administrative representatives (Assistant and Associate Deans and UME Manager) and/or the involved Clerkship Evaluation Coordinator or Chair if a member of the Student Evaluation Committee. A minimum of 5 Student Evaluation Committee members must be present to form a quorum. In cases of appeals regarding clerkship rotations, the Director of the Student Evaluation Committee will ensure that a minimum of two members present have experience with ITER evaluation in clinical clerkships (normally past or present clerkship coordinators or evaluation representatives). If such experience is not available among the Student Evaluation Committee, the Director will request assistance from members of the Clerkship Committee (not involved in the contested clerkship) for the reappraisal meeting. Decision will be by secret ballot with chair only voting in case of a tie.

4. Normally, the appeal will be scheduled in conjunction with the next regular meeting of the Student Evaluation Committee (within 4 weeks of receipt of request). At the discretion of the Director of the Student Evaluation Committee a special meeting may be called of this Reappraisal Subcommittee to provide a timely decision. One hour is normally allotted for such meetings. If the student or faculty

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believe more time is required, a specific request must be submitted to the Director of the Student Evaluation Committee at least 14 days prior to the scheduled meeting. If a Request for Reappraisal needs clarification, only then will the student be invited to appear before the committee. After the student has withdrawn, the committee shall make the final decision on the Request. 5. The student may be represented by written statement and/or appear before the Student Evaluation Committee in person. Students are encouraged to bring their Faculty Advisor but must request approval of the Director to bring any other representatives (including legal counsel). Parties shall be entitled to have a representative appear with them, including legal counsel. A request for an additional witness, advisor, or representative to appear before the Committee on the student's behalf should be submitted in writing to the Director at least one week prior to the meeting. The Director will determine if the witness, advisor, or representative is appropriate and relevant to the matter to be examined. If the student elects to be accompanied by legal counsel, then legal counsels role will be restricted to acting as an advisor to the student. Legal counsel will not be allowed to participate in the meeting, beyond acting as an advisor to the student. More specifically, legal counsel will not be permitted to present to the Committee or question participants on the students behalf. Witnesses, advisors, or representatives other than legal counsel who are granted the right to appear before the Committee will be allowed to make oral presentations to the Committee and may be subject to questioning by the student and members of the Committee. In the event that any witness, advisor, or representative appearing before the Committee begins to address matters that the Director rules inappropriate, the Director may rule the speaker out of order and terminate their appearance before the Committee. Witnesses, advisors, and representatives appearing before the Committee will not be permitted to pose questions to other persons present at the meeting. The Committee and the Associate Dean may also be represented by legal counsel. In the event of a clerkship appeal, the Clerkship Director and Evaluation Coordinator are encouraged to bring a Faculty Support Person (normally a present or past Clerkship Director from another Department) but must request approval of the Director to bring any other representatives. The Director will request U of C legal counsel attend any appeal meetings if the student plans to bring legal counsel. 6. The Student Evaluation Committee will have access to the students clerkship documents from the specific department/rotation including all correspondence, Departmental Clerkship Committee meeting minutes, preceptor evaluation reports (ITERs), evaluations and examination results. The Departmental Clerkship Director and/or Evaluation Coordinator may prepare a written statement and/or appear before the Student Evaluation Committee. All documents must be submitted two weeks prior to the meeting. In the event that the two week deadline is impractical due to scheduling logistics, the chair may permit a deadline of no later than one week prior to the meeting. Additional documents may be considered at the time of the meeting at the discretion of the Chair. 7. The Student Evaluation Committee will decide whether the appeal should be upheld or denied.

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OUTCOME OF APPEAL If the appeal is upheld due to an apparent error in the assessment process, the Student Evaluation Committee may require reassessment of the student. This may necessitate completion of remedial work. If this is required and the student does not complete this reassessment, he/she will be considered Unsatisfactory. If the appeal is denied, the original result will stand and any applicable recommendation for remedial work will be required. Any appeal that is granted by the Student Evaluation Committee will be returned to the body that established the final evaluation in question. The original evaluating body would be expected to review the appeal decision, but would not be required to agree with the appeal decision, and may conclude that the original grade will stand. Students in this situation would have the option to pursue an appeal to the Medical Student Appeals Committee (MSAC) for a final decision. Students are encouraged to become familiar with the MSAC Terms of Reference, which can be found on the U of C website. Decisions of this committee will be considered final unless appealed to the next relevant level of appeal according to the relevant terms of reference. 8. The outcome of all Requests for Appeal will be communicated to the student in writing, to the Office of the Associate Dean, UME and to the relevant Course or Clerkship Chair. A copy of this letter will be placed in the students permanent file.

APPEAL OF OTHER EVALUATIONS Other evaluation strategies may be also used in the Undergraduate Medical Education program as approved by the Student Evaluation Committee. Requests for reappraisal or appeal of other evaluation types must be submitted to the Director of the Student Evaluation Committee within 14 days of receipt of the relevant evaluation result. The request must describe the specific rationale for consideration by the Student Evaluation Committee. The Director of the Student Evaluation Committee will review the request within 5 working days of receipt to determine if the criteria for further consideration are met. The Student Evaluation Committee will consider only whether the evaluation process was conducted fairly. Accepted requests for reappraisal/appeal of examination strategies other than written examinations and OSCE examinations will normally be heard by the full Student Evaluation Committee minus the UME Administrative Representatives (Assistant and Associate Deans and UME Manager) and/or the involved Course/Clerkship Evaluation Coordinator or Chair if a member of the committee. This meeting will be conducted according to the principles and processes outlined in the sections above. Any required modification to the reappraisal/appeal process due to the specific type of evaluation strategy discussed will be communicated to the student and the relevant course/clerkship chair in writing one week prior to the start of the meeting.

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ADDITIONAL INFORMATION ON UME EVALUATIONS Associate Deans Tests (ADTs) 1- 3 There are three mandatory formative examinations testing a students cumulative knowledge of objectives over time, rather than focussing on objectives restricted to only one course. The ADTs include approximately 180 questions and are modelled after the MCC to prepare the students for the Licensing exam. The ADT results have been shown to correlate very strongly with the MCC Part I. The Associate Deans test is mandatory therefore all students must participate. Policies of deferral and those related to misconduct are the same as for a certifying examination at the University of Calgary.

Please note that ADT 1, 2 and 3 are offered entirely online.

Students will have a one-month window of time during which to complete each ADT. The window of time for each ADT can be found in the yearly timetable. ADT1, 2 and 3 follow the current Online Formative Evaluation policy: This online format allows for a window of time (determined by the Office of Undergraduate Medical Education) during which students may access the exam questions at a schedule determined by the student. Students may access and complete the evaluation from any computer terminal that allows email access. During the exam window, students may repeatedly access the exam, which would allow the student to: practice or assess knowledge (during the initial formative exam written) engage in cognitive or meta cognitive activities to improve performance (reflection upon ones exam performance; reviewing the exam questions); repeat the process, in order to self-assess towards improved performance (i.e. the feedback coming from completing the same formative exam a second, third, fourth, or more times). Providing Access for an online exam: One day prior to the exam opening online, students will receive an email to their @ucalgary.ca address, providing instructions on how to use the system, a link to the exam, and a username. Students will also receive a second email providing the password (only good for current exam; new password is issued per exam). Separate emails for username and password are used to ensure students individual entry into the exam is not compromised by providing both pieces of information in the same email. The link to the system that is sent to students will not allow students to start the exam until the specified exam start time. Likewise, the link will not allow students to access the exam once the end time of the exam has passed. Only the official student email address (___@ucalgary.ca) may be entered into the system. No other email addresses will be used or accepted for students. Students that do not receive the pre-exam email by 1pm should email chan@ucalgary.ca. Access to an exam may be linked to completion of an evaluation of the course or curriculum.

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Student Conduct at Online Evaluations Students are expected to abide by the Student Conduct Policy of the UME. Students are stricty prohibted from capturing or recording questions in any way for either personal or widespread use. UME students or staff who discover any suspicious evaluation materials are expected to report the matter immediately to the Associate Dean (UME).

Deferral of an online ADT Deferral of an ADT follows the same process as for certifying evaluations, which is outlined by University of Calgary policy. A deferred online ADT must be completed within one-week of the close of the original exam window. If the examination cannot be written within scheduled date, the student must meet with the Associate Dean of UME.

Results of ADT 1, 2 and 3 Students will be able to view their score immediately. Individual student results will be included in the students permanent file, but will not be used to calculate final course mark and/or reported in the Medical Student Performance Record (MSPR).

The Medical Skills (MS) I and II Objective Structured Clinical Evaluations (OSCE) The OSCE experience is similar to that used by other courses throughout medical school and beyond. The assessment of skills is deemed very important to the requirements of a skilled, competent physician. The Medical Skills OSCE given in Year 1 and Year 2 is a formal certifying evaluation. The MS I and II exams are approximately 2-3 hours in length administered over two days. The exam evaluates the integration of skills learned in the Medical Skills course after first and second year. It is highly organized in order to process 160+ students. To accomplish this it is necessary to use up to 18 tracks of the OSCE stations. At each station there is a standardized patient (actor) and a physician examiner who uses a checklist to evaluate the student performance in areas such as Communication, Physical Examination, and Procedural Skills. Formal evaluation of Ethics, Global Health and Physicianship are conducted seperately as per the Medical Skills Core Document.

MS I and II Exam Day Reporting Instructions Students must report to the designated area at least ten minutes in advance of their scheduled OSCE evaluation time for each of the two days. Each day a member of the evaluation staff will meet students there to check-in each student. University identification cards (UCID) must be produced to facilitate this process. Students who fail to produce proper identification may be prevented from undertaking the evaluation. Once UCID has been verified, students will be moved to the staging area and provided with final examination instructions.

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Items Required for the Medical Skills Evaluation Students must wear lab coats and carry a University of Calgary identification card (as above). Students will require a pen/pencil, stethoscope, and reflex hammer. Note paper, clipboards and other tools or equipment necessary to complete the exam will be provided. No other materials (textbooks, backpacks, PDAs, cell phones, pagers, etc.) will be permitted in the exam.

MS I and II Results (Satisfactory/Unsatisfactory Performance) Performance in both exams must be deemed to be satisfactory in order for the student to receive course credit on their transcript.

Reporting of MS I and II Results Evaluations The results of MS I and II are generally released as soon as possible and within 14-business days. However, there may be circumstances during which the Exam Review Working Group needs additional time to review the results before release to the students.

MedSkills Remediation In the MS I and II Evaluation, students not meeting the overall MPL or the MPL in a particular unit are notified of the requirements for remediation and/or re-testing. The Unit Chairs determine what remedial work will be required. Upon completion of remediation, the unit chair determines if the student has successfully removed the noted deficiency and correspondingly informs the Associate Dean of UME. If a student is unsatisfactory overall in MS I or II, both remedial work and a successful re-write OSCE must be completed. No re-test is given to students that complete remediation for a particular unit and have been sucessful overall on the MS II evaluation.

Appeal Process for MedSkills See Appeal Process outlined in the Reappraisals and Appeals Process Procedures for UME Evaluations. Optical score sheets and videos are available for review by the student for a period of five days following notification of results. If a student appeals, the requirement to undertake remedial work or re-test is suspended pending outcome of the appeal.

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CLERKSHIP CERTIFYING OSCE The Clerkship OSCE covers medical skills from across all rotations. This is a certifying examination that students must successfully pass in order to be Satisfactory on Course 8 and before proceeding to graduation. Successful completion of this exam will require students to demonstrate a level of competence in history-taking, physical examination, interpretation of data, clinical decision-making and management of the patients complaint. Exam content will be guided by both UME clinical presentations and LCME objectives. The exam will be scheduled immediately following the end of the clerkship year in April. Presently, students are randomly assigned to write the exam over two days immediately following the end of the clerkship year in April, with the re-write exam scheduled for the last week in April. An unsatisfactory performance after the first attempt will require completion of the re-write OSCE, scheduled the last week in April. A satisfactory performance after either the first or second attempt of the OSCE will lead to a result of Satisfactory overall. Students that are unsatisfactory after two attempts will be required to complete clinical remediation. Successful remediation will lead to the result of Satisfactory with Performance Deficiencies. Students that are unsuccessful after remediation may be referred to SARC. Students that have been unsuccessful on a clerkship rotation and unsucessful after two attempts of the Clerkship OSCE may be referred to SARC. Current policy related to appeals apply to this evaluation. This is a certifying examination that students must successfully complete before proceeding to graduation. Students must wear lab coats and carry a University of Calgary identification card (as above). Students will require a pen/pencil, stethoscope, and reflex hammer. Note paper, clipboards and other tools or equipment necessary to complete the exam will be provided. No other materials (textbooks, backpacks, PDAs, cell phones, pagers, etc.) will be permitted in the exam.

PEER FEEDBACK SELF ASSESSMENT PROCESS A peer feedback process will be used to provide students information for self-reflection on non-cognitive domains such a professionalism. Medical student peers are in a unique position to assess each other in situations that a preceptor may not have an opportunity to observe. Peer evaluation has been shown to be an excellent method of providing students with formative feedback on their behaviors. Students benefit from learning how to give feedback as well as receive feedback. It is an LCME accreditation requirement that students receive feedback related to non-cognitive domains, such as professionalism and related behaviours. Similarly, it is the philosophy of this medical school that achievement of educational goals should be assessed by self- and peer-evaluation in addition to formal certifying evaluations. Participation in the Peer Feedback and Self Assessment process will be mandatory.

THE MEDICAL COUNCIL OF CANADA (MCC) EXAMINATIONS A graduating student may not practice medicine independently in any of the Provinces of Canada without first performing "satisfactory" on the examinations of the Medical Council of Canada. In fact some provinces will not allow students to start a residency without successfully completing Part I, e.g. Alberta. There are 2 parts to the MCC exams. Part I is an online 1-day exam offered at the end of Medical School. The first half is made up of approximately 200 multi-choice questions (MCQ) questions where as the second half is made up of clinical decision making (CDM) component. In 2013, the MCC is aligning the MCCEE fee structure with those of the MCCQE Part I and Part II. Starting in 2013, the MCCEE fee will be a comprehensive fee that includes the application fee. As a result, the 2013 fee will be $1,645 for all candidates regardless of whether they are first-time applicants or re-applicants. The University of Calgary students have performed well over the years with a 95% pass rate. Our aim is for 100% success with a class mean score in the top 1/3 of the country.

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The strongest predictor of success on the MCC Part I is a student's record on U of C course/clerkship exams and the results on the Associate Dean's formative exams. During the 3 years at U of C students participate in 16-18 certifying written end-of-course and clerkship exams. Students who are successful in all or fail 2 or fewer tests rarely, if ever, fail the MCC. Students who are unsuccessful on 3 or more tests have had significant difficulty with the MCC. Similarly success on the Associate Dean's tests correlates with a strong performance on the MCC. 1. The MCC Part II examination is a clinical skills exam offered after at least 18 months of residency. The cost of MCC Part II is approximately $2,150.00. Students graduating from U of C have also done well on this test. For more information on the MCC exams and the objectives being examined refer to the MCC Web Site: http\\www.mcc.ca

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PROMOTION On behalf of the Faculty of Medicine Council, Student Academic Review Committee (SARC) determines whether or not students should be promoted to the next stage of the MD program, and ultimately receive the MD degree. In accordance with The Terms of Reference for the Student Academic Review Committee (SARC) is a delegated body of Faculty Council responsible for the review and ratification of undergraduate medical student performance. SARC makes recommendations to Faculty Council and the Dean concerning the promotion of students and discipline related to the academic performance (knowledge, skills and professional attitudes) of students who, by reason of unsatisfactory performance, cannot be promoted. The Terms of Reference of the Student Academic Review Committee are located on the MD Programs website at http://www.ucalgary.ca/mdprogram/committees. Students experiencing any academic difficulty should refer to this document and become fluent with the Faculty rules regarding policies and procedure of promotion. Guidance regarding an appearance is available from Student Affairs, Faculty Advisors and the UME office.

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UME

Lockers Student Mailboxes iClickers Student Faxes

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LOCKERS, ORANGE MAIL TRAYS , iCLICKERS and STUDENT F AXES

Lockers Lockers are assigned by the Undergraduate Medical Education (UME) office. Locker assignments, lock combinations and iClickers for the Year 1 students will be picked up outside the UME office during Orientation week. Please note that using our locks and iClickers are mandatory and students will keep them for all three years. There is no charge for a locker, however, a fee of $10 will be charged for lost or damaged locks.

iClickers A $40 cheque is required for the iClicker. The iClicker will be used in various lectures and learning events throughout your program. Bring the iClicker to class as you would bring your laptop or pens it is a tool that should always travel to/from class with you. If your iClicker is left on outside of class, or turned on inadvertently by items knocking against it during transport, the batteries will wear out sooner. Battery replacement costs are the responsibility of the student. Registering your iClicker Before your first class, you must register your iClicker: Open a web browser (Internet Explorer, Mozilla, etc) Go to http://md.ucalgary.ca/icreg Input the required information: o First name o Last name o Student ID (This is your UofC ID#, found on the front of your UofC ID card) o Clicker ID (This is the barcode on the back of your clicker. Any time you see 0, use zero. There are no letter os!) Click submit

Orange Mail Trays Students are assigned mail trays for over-sized materials and notices/correspondence that do not require security. Students also use these trays to leave notes/materials for their classmates. The orange mail trays are located in the corridors on either side of the 700s classrooms.

STUDENT FAXES Students may use the fax machine in the UME Reception area to send and receive faxes for school business only. The fax number is: 403-210-3852

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