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Ability to develop relationships with patients and preceptors key to St. Michael’s Longitudinal Integrated Clerkship program

Toronto, September 14, 2015

By Heather Brown

Andrei Szigiato and Marisa Lean-Carlyle
Andrei Szigiato and Marisa Leon-Carlyle, former LInC students review a patient's chart before her appointment. (Photo by Katie Cooper)

Seven third-year medical students from the University of Toronto’s FitzGerald Academy have closed the books on St. Michael’s first Longitudinal Integrated Clerkship (LInC).

The program, which was the first of its kind at a Toronto teaching hospital, provided these students with the opportunity to follow patients through all phases of their diagnosis and treatment, from admission to discharge.

Unlike the traditional block clerkship program, which has students changing services and preceptors every one to eight weeks, the LInC students were paired with the same preceptors for the entire year and weaved in and out of family medicine, internal medicine, surgery, obstetrics and gynecology, pediatrics, psychiatry, anesthesia, dermatology, emergency medicine, ophthalmology and otolaryngology.

“The LInC program provides students with the opportunity to learn medicine in the way it should be practiced, with an emphasis on the continuity of care,” said Dr. Jory Simpson, a surgeon and one of the preceptors in the LInC program at St. Michael’s Hospital. “In my practice, for example, a LInC student would be part of the initial consultation and diagnosis of breast cancer, assist me in surgery and then follow the patient while he or she received radiation or chemotherapy. Through each of these transitions, the student would be exposed to and interact with a multidisciplinary team, reinforcing the benefits that collaborative care can have on a patient’s experience.”

Other unique features of the program include:

  • Allocation of white space or self-directed open time to attend an appointment with a patient, or enhance skills in an area not typically covered in the rotations, such as diagnostic imaging or taking part in other academic development
  • Completion of an advocacy project

This year’s LInC students agreed that following patients over the course of their medical journey was the highlight of the program. Not only did this opportunity provide them with a better understanding of the health care system, but it gave them new insights into what it is like for a patient to hear a diagnosis for the first time, receive treatment or see how difficult it is for someone to advocate for themselves when they don’t know what to expect or may not speak English very well.

“I never imagined I would learn as much as I did,” said Andrei Szigiato, a LInC student. “My preceptors were excellent. I really appreciated how available they were to help answer questions, guide me through diagnoses, and how invested they were in teaching. The program allowed us to have the flexibility and freedom to explore many facets of health care, working with doctors, nurses, health discipline professionals and most importantly, learning more about the patient’s perspective. I look forward to applying the skills and knowledge I have gained as a result of the LInC program in my residency and future career.”

Due to its success, St. Michael’s is offering this curriculum again and eight new third-year medical students will begin following the LInC curriculum in early October. The curriculum is also being expanded to the other hospitals including Sunnybrook Health Science Centre, Toronto Western Hospital, North York General Hospital and Toronto East General Hospital.

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.