Interim Accreditation Review for U of T’s Medical School

Jun 22, 2017

The University of Toronto MD Program received a mid-term report card this week. The report provides feedback following the program’s interim accreditation review, a new quality-improvement process recently mandated by the Association of Faculties of Medicine of Canada.
The report was a joint effort by six internal working groups and an external reviewer, Dr. Robert Whyte, Assistant Dean for Undergraduate Medical Education at McMaster University’s De Groote School of Medicine. Whyte conducted a site visit at U of T in March.
The report found that the MD Program’s new Foundations Curriculum was implemented smoothly and has been well-received by students and faculty. It also noted other areas of strength, including diversity initiatives such as admission programs for Black and Indigenous students, the longitudinal integrated clerkship and faculty development to improve teaching skills.
“The external site visit and report were excellent learning experiences for everyone involved in the accreditation and quality improvement process, and they really highlighted the innovative aspects of our Foundations Curriculum,” said Professor Patricia Houston, Vice Dean of the MD Program. “We also gained a better understanding of where we excel and where we need to be better. And you can always be better.”
Areas that should be improved, the report noted, include program evaluation and quality improvement processes; student assessments in the clinical years; use of a competency framework to design and evaluate curriculum delivery and student assessments; student career counselling; and supports for faculty. Houston said the MD Program’s executive committee has already developed plans to address these issues and other areas that may not currently meet accreditation standards.
The report is entirely formative, which means results are for internal use and will not be communicated with external accreditation bodies.
Accreditation standards for Canadian medical schools have been simplified since U of T’s last full accreditation review in 2012. There were previously 128 standards, now there are 12 — each with several elements for a total of 93.
“The review process has been streamlined considerably,” said Christopher Jones, accreditation project manager for U of T’s MD Program. “Reporting on compliance with standards is easier and shorter, so the working groups can more quickly assess satisfactory progress and also identify any elements that need attention.”
One goal of the new interim review process is to limit the flurry of activity within medical schools as they approach their full accreditation review every eight years. “That swell of intensity can lead to a kind of institutional burnout, and a retreat from the goal of ongoing engagement with the quality improvement process,” said Jones.
Jones acknowledged that the accreditation process — including the interim review process — requires a major commitment of time and resources by faculty, students and staff. But he said the new approach seems to have fostered a day-to-day commitment among people involved with it, and he noted that the MD Program now has a large, core group with accreditation knowledge and experience who work well together.
Neha Janmohamed, a student representative in the working group on student resources, never felt her input was disregarded. “I was a bit skeptical when I began this process and I wondered if my voice would really be heard. But I was pleasantly surprised. Faculty and staff were very open to listening and took a genuine interest in the student experience.”
Janmohamed said she was able to give useful feedback on several student resources issues, from whether students felt comfortable in the company of patients and hospital staff to concerns about safe storage spaces for laptops and other valuables.
Janmohamed finished the MD Program this spring and will start a residency in internal medicine at University Health Network in the summer. She hopes to be part of the full accreditation review process in future, but this time with the voice of the resident.
“It’s a really rewarding experience and a great learning opportunity,” said Janmohamed. “It’s also a fascinating, behind-the-scenes look at medical education.”

Patricia Houston
Vice Dean, MD Program
Professor, Deptartment of Anesthesia