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Patient-centred care focus of new Longitudinal Integrated Clerkship Pilot

Toronto, September 16, 2014

By Kaylea Forde

Dr. Karen Weyman and Matt Speckert review a patient's medical history
Dr. Karen Weyman, a staff physician and the Longitudinal Integrated Clerkship faculty lead at St. Michael’s, and Matt Speckert, a third-year medical student, review a patient's medical history. (Photo by Yuri Markarov)

St. Michael’s is piloting a new curriculum for third-year medical students allowing them to follow patients from admission to discharge.The program, known as the Longitudinal Integrated Clerkship (LInC) Pilot, is the first of its kind at a Toronto teaching hospital.

Seven students from the University of Toronto’s FitzGerald Academy were accepted to study under this pilot, which focuses on patient-centred care on a longitudinal basis.

These students will follow patients through all phases of their diagnosis and treatment, across clinical services including family medicine, internal medicine, surgery, obstetrics and gynecology, pediatrics, psychiatry, anesthesia, dermatology, emergency medicine, ophthalmology and otolaryngology. They will accompany their patients to follow-up appointments during their year of training

Unlike the traditional block clerkship program, which has students changing services and preceptors every two to eight weeks, LInC students will be paired with the same preceptor for the year and will weave in and out of services

“This model provides a new approach to hands on learning,” said Dr. Molly Zirkle, the director of the FitzGerald Academy at St. Michael’s Hospital. “Our students are able to follow a patient over the course of their medical journey directly seeing how the integration of care affects a patient’s experience.”

If a patient arrived in the Emergency Department with abdominal pain and needed surgery, the LInC student could follow the patient from the ED to the operating room and then continue to be involved during the post-op care.


“This model provides a new approach to hands on learning,”
said Dr. Molly Zirkle, director of the FitzGerald Academy at St. Michael’s Hospital. “Our students are able to follow a patient over the course of their medical journey directly seeing how the integration of care affects a patient’s experience.”

“I was drawn to the LInC curriculum because of the variety of care environments I could be in over the course of a day,” said Matt Speckert, a LInC student. “It excites me to think that my day could start in the family medicine clinic and end in the operating room instead of having to wait until my surgical rotation to experience what it’s like to be in that setting.”

Another aspect that sets the LInC curriculum apart from the block clerkship model is the allocation of white space time, which students can use toward flexible self-directed clinical time, to attend appointments with patients or academic development.

Both programs have their advantages and provide the same quality of education,” said Dr. Zirkle. “They have the same objectives, exams, curriculum content, preceptors, clinic time, patient encounters and procedures. Our students will be just as prepared for their fourth year no matter which route they chose. We do, however, feel the LInC will give a window to the patient experience that will be very meaningful for students”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.