Teaching a New Generation of Health Care Providers

When Aatif Qureshi was a first-year medical student at U of T, the MPA began piloting integrated care programs to train future doctors how to deal with concurrent mental and physical conditions. Qureshi signed up as a volunteer and went on to join the research effort to help evaluate and eventually implement the innovative new programs.

As a volunteer, he participated in two programs. The first, called Getting to Know Patients’ System of Care (GPS care) had him and fellow students role play as care givers and patients with physical and mental health issues. The goal was to teach students like Aatif to better understand how these individuals navigate a complex health- care system.

He says the experience was humbling and illuminated the frustration for patients and their caregivers. “Each health-care provider is throwing different information at you,” says Qureshi. “I found the experience disconcerting. Patients with concurrent mental and physical conditions need much more support than what’s currently available in most health-care settings.”

The second program, Making Every Encounter Therapeutic (MEET), aimed to teach students essential communications skills that are healing in nature. This is critical for clinicians dealing with patients who live with co-occurring physical and mental health conditions. Through MEET, students like Aatif were exposed to real patients. The experience, he says, was eye- opening.

“MEET provided a great opportunity to learn about empathetic communications, an area of study that’s not traditionally offered in the medical curriculum,” says Qureshi. “These skills tend to be learned ‘on the job’ in a clinical setting. Clinicians and their patients will benefit from students learning these essential skills as part of their education.”

At the conclusion of the pilot programs, Aatif joined a team of MPA researchers at the Wilson Centre—a joint initiative between U of T and University Health Network, which aims to advance health-care education and practice through research. Supervised by Maria Mylopoulos, an associate professor of paediatrics and the Wilson Centre's Associate Director, Qureshi participated in evaluating the importance of GPS Care to integrated care training in medical school. The GPS Care pilot eventually expanded to become a mandatory requirement for medical students. In April 2017, more than 200 U of T medical students participated in the program.

The mandatory GPS Care course is one way that MPA has integrated medical psychiatry into U of T’s MD Program. Next year, in the new Foundations curriculum, second-year medical students will be taking a mandatory week of MPA courses dedicated to care for patients with both physical and mental illness.

“The MPA is a key opportunity to create future leaders in the health-care system, and address gaps in care,” says Sanjeev Sockalingam, an associate professor of psychiatry and MPA Director of Curriculum Renewal. “Through these MPA reforms in medical education, we are preparing students early on with the knowledge and approaches they will need to better care for their future patients with complex health needs.”

Qureshi is currently working with supervisors Dr. Mark Bonta, a lecturer in the Department of Medicine, and Adrienne Tan, an assistant professor of psychiatry, to see if there is a long-term opportunity for medical psychiatry to be a recognized area of focus at the Royal College of Physicians and Surgeons.

“Not all psychiatrists are comfortable with caring for a patient who also comes with some complex physical health needs,” says Qureshi. “And similarly, primary care providers or internists may not be comfortable in handling mental conditions.” This gap, he says, presents a great opportunity for the College to provide appropriate training more widely.

Qureshi, who is specializing in internal medicine, says that the MPA’s initiatives are a crucial first step in equipping medical students with vital skills that will treat this unique type of patient. “It’s going to help us become better at caring for our patients in the future.”