The power of community practice: hands-on experience key to MD Family Medicine program

Feature Stories | 03 Sep 2024

Dedication to community and personal experience are what drive the first students enrolled in the Queen’s-Lakeridge Health MD Family Medicine Program.

Many students say their own history with family physicians – or lack thereof – is what attracted them to the unique model for medical education, a first-in-Canada program specifically designed to address the shortage of family doctors.

Bronte Murcar-Evans' family doctor closed their practice when she was 21, which left her “feeling completely lost” and disconnected from the health system.

When Hafsah Sheikh’s family immigrated to Canada from Dubai in 2014, their doctor offered the “first connection” to their new community and country, offering guidance on everything from vaccines to where to buy groceries.

Mina Jordanides suffered a sports injury in high school and needed an X-ray. Lacking a family doctor meant an eight-hour overnight stint in the ER at an overburdened Toronto hospital for a procedure that only needed a quick referral to a clinic.

The three aspiring doctors are entering their second year in the new MD Family Medicine Program, launched in 2023. This fall, they are joined by 20 new, first-year students at Queen’s satellite campus at Lakeridge Health in Oshawa.

One of the hallmarks of their education is hands-on experience shadowing family doctors.

Throughout the six-year program, students are embedded in early workplace experiences in urban centres and small communities across the Durham Region and southeastern Ontario, including a weekly mentorship and a month-long rural community placement. Their training program also benefits from the wide range of medical facilities that are part of the Lakeridge Health system, including five hospitals. Students complete seven weeks of hands-on family medicine training in their first year alone, compared to just 10 weeks over the entire four years of a traditional MD program.

Students say that clinical experience allows them to apply what they’ve learned in the classroom as they interact with and help diagnose actual patients.

“I've had the opportunity to practice hands-on skills that you need to develop as a physician – skills you can only get better at by doing,” says Murcar-Evans. “Things like listening to hearts, listening to lungs, examining newborn babies.”

Learning soft skills is also key to the students’ clinical experience, including how to navigate difficult conversations with patients, says Liam Rautu, who also serves as the class president. “In real life, patients come in with a lot of information. Being able to decipher what is pertinent and what is not, and being able to synthesize that to form an effective plan and evaluation is a skill in-and-of itself.”

The program emphasizes the unique role family physicians play in our communities, including social accountability, assessing social determinants of health, and health care advocacy. Students saw that special patient-doctor relationship firsthand in their clinical work.

“I think the biggest lesson I’ve learned is the importance and the value that patients and families place in their family doctor,” says student Laura Vresk. “They recognize that their family doctor knows their history and considers all facets of their health and wellness.”

Students say one thing has been crucial to their learning experience: the prominent presence of practicing family physicians as faculty, curricular leads, mentors, and preceptors. “What really stands out are the faculty and tutors,” Vresk says. “They are all family doctors with experience in many different facets of family medicine.”

For Murcar-Evans, case-based learning in small groups is another cornerstone of the curriculum. “Everything you’re learning is put into context,” she says of the self-directed learning sessions. “For example, we were studying a case of heart failure, and we learned about the anatomy and function of the heart, and we helped relate it to what the patient was experiencing.”

Their cases often translate into real-life scenarios with patients in their clinical work, she adds. At the end of the day, those interactions are at the heart of family medicine.

They are what brought Rautu to the program to begin with. After his undergraduate degree at Western University, he worked in a family clinic as a medical office assistant and was inspired by doctors’ deep connections with their patients. Meanwhile, Vresk worked as a clinical dietitian on a multidisciplinary team for 15 years and was drawn to family medicine’s comprehensive approach to care.

For the program’s students, it’s all about having a long-term impact on people, families, and communities.

“It’s about forming meaningful relationships with patients,” Jordanides says: seeing young patients grow up, families evolve, and people go through different phases of their lives.

“I really want to make a long-term contribution and interact with my community… where I'm able to follow and serve people at different stages of their lives,” Sheikh says. “And I feel that family medicine truly integrates those two goals.”

In the immediate future, the passion and commitment of these students will continue to benefit patients as they train. In a few short years, their specialized training will be invaluable as graduates enter the workforce – helping ease a critical shortage on the frontlines of our health care system.

Listen to a feature on the program on CBC Radio's White Coat, Black Art.

The power of community practice: hands-on experience key to MD Family Medicine program

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