Terms of Reference
Purpose and Authority
The purpose of this subcommittee is to:
- Plan, implement, and manage Years 3 & 4 of the four-year UGME program across all sites, according to the policies, curriculum, and direction set forth by the Undergraduate Medical Education Committee (UGMEC), and in close collaboration with the Years 1&2 Curriculum Subcommittee, the Curriculum Integration Advisory Council, and the Student Assessment Subcommittee (SAS).
- Recommend to the UGMEC substantive changes to the Years 3 & 4 curriculum content, approach to implementation, and/or evaluation, as needed.
This subcommittee is made up of ex officio and appointed members.
The Faculty of Medicine's commitment to equitable and diverse membership on its committees and advisory councils guides its nomination and selection process.
- Associate Director, Curriculum, Years 3&4 (chair) (1)
- Director, Curriculum, Undergraduate Medical Education (vice-chair) (1)
- Director, Assessment, or delegate (1)
- Year 3 Rotation Directors (11): Anesthesia, Dermatology, Emergency Medicine, Family Practice, Internal Medicine, Obstetrics/Gynecology, Ophthalmology, Orthopedics, Pediatrics, Psychiatry, Surgery
- Site Directors, Year 3 Clerkship (4)
- Director, Integrated Clerkship Program (1)
- Course Director, MEDD 448 (1*)
- Director, Career Advising (1)
- Course Director, MEDD 419/429/449 (1*)
- Program Managers, Years 3&4 (5 individuals; 1 vote per site)
*For shared positions, all may attend, but they share one vote per position.
- One Assistant Dean (rotating among sites) (1)
- One Director, Electives (rotating among sites) (1)
- Four UGME students (ensuring two from Year 3, two from Year 4, and one from each of NMP, IMP, SMP, and VFMP) (4)
- Associate Director, Curriculum, Years 1&2 (1)
- One Curriculum Management Unit member (1)
- One Evaluation Studies Unit member (1)
- One Educational Assessment Unit member (1)
- One Office of Faculty Development member (1)
- One Student Affairs member (1)
- One MedIT member (1)
- Two Departmental Education Program Mangers (2)
- Departmental Educational Program Managers and Administrators.
Guests may be invited to join specific meetings or portions of specific meetings at the co-chairs' discretion.
Ex officio members are members by virtue of their administrative appointment.
Appointed students are appointed by the Medical Undergraduate Society at the request of the Faculty of Medicine.
Other appointed members are appointed by the chair.
Ex officio members are members as long as they hold their administrative appointment.
Appointed students are members for a one-year term.
Other appointed members are members for a two-year term.
Chaired by the Associate Director, Curriculum, Years 3&4. The Assistant Dean, Curriculum is the vice-chair.
Meeting Schedule and Administration
Normally meets approximately once per month and at the call of the chair.
All members, except corresponding members, are expected to attend all meetings in person or via videoconference or phone. Corresponding members may join at their discretion.
A Year 3 Senior Program Assistant from the UGME Program Office will capture meeting minutes. Minutes will be circulated to all members.
Records will be maintained in accordance with UBC and Faculty of Medicine records retention procedures.
Quorum and Decision Making Process
Quorum consists of 50% plus one of voting members, and the presence of voting members from at least two sites.
Decisions are made by vote, requiring 50% plus one of voting members present to pass. A tie vote will be recorded and escalated to the UGMEC for resolution.
Voting members may send an alternate if they cannot attend.
Lines of Accountability and Communication
- Takes direction from, and makes recommendations to, the UGMEC.
- Seeks advice before making recommendations to the UGMEC from:
- The Curriculum Integration Advisory Council regarding pedagogical implications; and
- The Regional and Resource Advisory Council (RRAC) regarding resource implications (human, financial or infrastructural).
- Works collaboratively with the Year 1&2 Curriculum Subcommittee and the Student Assessment Subcommittee.
- Reports to the UGMEC on an annual basis.
Representatives of this subcommittee liaise with other academic and administrative committees and advisory councils, as needed.
- Plans, implements, and manages operations of the Years 3&4 curriculum so that it is delivered effectively and comparably across all program sites. [8.7[i]], [6.7[ii]], [7.7, 7.8, 7.9[iii]]
- Makes operational decisions relating to Years 3 & 4 and informs the UGMEC, as needed.
- Receives recommendations from Departmental and Site Directors for changes to the curriculum, and makes recommendations to the UGMEC for approval.
- Ensures Years 3 & 4 learning objectives are appropriately mapped to the MD undergraduate exit competencies, in accordance with CACMS standards [8.2[iv]] and ensures they are disseminated [6.1[v]].
- Liaises with the Student Assessment Subcommittee to ensure that student assessments map to the appropriate UGME Program exit competencies. Changes in assessments are taken to the Student Assessment Subcommittee for approval. [9.6[vi]]
- Reviews annually the Mandatory Clinical Case List/Patient Encounters and Clinical Procedures, settings and level of responsibility for students in the clinical years. [6.2[vii]]
- Centrally monitors student completion of the Mandatory Clinical Case List/Patient Encounters and Clinical Procedures logging at a minimum twice annually. [8.6[viii]]
- Monitors adherence to Policy #10 – Scheduling Students in Required Clinical Learning Experiences. [8.8[ix]]
- Liaises with departmental counterparts in the post graduate programs to ensure residents are orientated to the students' learning objectives and the Mandatory Clinical Case List/Patient Encounters and Clinical Procedures for each rotation. [9.1[x]]
- Defines and periodically reviews the rule for student elective choices.
- Reviews and approves new electives offerings and periodically reviews the existing inventory of UBC electives for ongoing quality assurance. [6.5[xi]]
- Ensures an effective system for electives advising is in place. [11.2[xii]]
- Ensures extramural electives, particularly at non CACMS/LCME accredited schools, are reviewed and monitored. [11.3[xiii]]
- Monitors, in collaboration with the Student Assessment Subcommittee(SAS):
- Direct observation of history taking and physical examination by faculty; [9.3[xiv]]
- Provision of timely mid rotation assessment for rotations longer than four weeks [9.7[xv]]; and
- Submission by clinical supervisors of all summative assessment elements so that students can receive final grades within six weeks of completion of the rotation. [9.8[xvi]]
- Promotes respectful learning environment, and identifies and promptly addresses student mistreatment and other violations of the Faculty's Professional Standards. [3.5[xvii], 3.6[xviii]]
- Reviews and endorses evaluation reports from the Evaluation Studies Unit (ESU) on the educational experiences in Years 3 & 4. Assigns responsibility for action on accepted evaluation recommendations to the appropriate individuals/units. Follows up on the actions taken to address these recommendations. Reports on the implementation status of program improvement recommendations to the UGMEC. [8.5[xix]]
- Coordinates with departments to ensure clinical faculty teachers in Years 3 & 4 are assessed by students and receive regular and timely feedback on their teaching. [8.5]
- Consults with other stakeholders (e.g., SAS, Educational Assessment Unit, Curriculum Management Unit, MedIT, Office of Faculty Development (OFD), Library Subcommittee, Years 1&2 Curriculum Subcommittee) regarding the implications of proposed curricular changes prior to making recommendations or approvals.
- Informs OFD of current and emerging requirements to prepare faculty to deliver curriculum and assessment within Years 3 and 4. Provides input on specific offerings and activities.
- Reviews proposals and evaluation plans for Years 3 & 4 curriculum pilots and innovations and makes recommendations for approval to the UGMEC. Reviews evaluations post-implementation, identifies required changes, and recommends transition from pilot to operations, or not, to the UGMEC and the RRAC.
- Establishes working groups for specific projects as required, with the chairs of the working groups drawn from the membership of the Years 3&4 Curriculum Subcommittee. Non-members may be invited to join these working groups. The Years 3&4 Curriculum Subcommittee will review the recommendations of the working groups and determines next steps.
- Ensures Years 3 and 4 curriculum components comply with relevant CACMS accreditation standards and UBC policies.
- Reviews the Terms of Reference for the Years 3&4 Curriculum Subcommittee in June of each year.
This version of these terms of reference has been approved by the UGME Committee on February 19, 2018.
[i] 8.7 Comparability of Education/Assessment
A medical school ensures that the medical curriculum includes comparable educational experiences and equivalent methods of assessment across all locations within a given required learning experience to ensure that all medical students achieve the same learning objectives.
[ii] 6.7 Academic Environments
The faculty of a medical school ensure that medical students have opportunities to learn in academic environments that permit interaction with students enrolled in other health professions, graduate, and professional degree programs, and opportunities to interact with residents in clinical environments and with physicians in continuing medical education activities.
[iii] 7.7 Medical Ethics
The faculty of a medical school ensure that the medical curriculum includes instruction for medical students in medical ethics and human values both prior to and during their participation in patient care activities and requires its medical students to behave ethically in caring for patients and in relating to patients' families and others involved in patient care.
7.8 Communication Skills
The faculty of a medical school ensure that the medical curriculum includes specific instruction in communication skills as they relate to communication with patients and their families, colleagues, and other health professionals.
7.9 Interprofessional Collaborative Skills
The faculty of a medical school ensure that the core curriculum prepares medical students to function collaboratively on health care teams that include health professionals from other disciplines as they provide coordinated services to patients. These required curricular experiences include practitioners and/or students from the other health professions.
[iv] 8.2 Use of Medical Educational Program Objectives
The faculty of a medical school, through the curriculum committee, ensure that the formally adopted medical education program objectives are used to guide the selection of curriculum content, to review and revise the curriculum, and to establish the basis for evaluating program effectiveness. The learning objectives of each required learning experience are linked to the medical education program objectives.
[v] 6.1 Program and Learning Objectives
The faculty of a medical school define its medical education program objectives in competency-based terms that reflect and support the continuum of medical education in Canada and allow the assessment of medical students' progress in developing the competencies for entry into residency and expected by the profession and the public of a physician. The medical school makes these medical education program objectives known to all medical students and faculty members with leadership roles in the medical education program, and others with substantial responsibility for medical student education and assessment. In addition, the medical school ensures that the learning objectives for each required learning experience are made known to all medical students and those faculty, residents, and others with teaching and assessment responsibilities in those required experiences.
[vi] 9.6 Setting Standards of Achievement
A medical school ensures that faculty members with appropriate knowledge and expertise set standards of achievement in each required learning experience in the medical education program.
[vii] 6.2 Required Clinical Learning Experiences
The faculty of a medical school define the types of patients and clinical conditions that medical students are required to encounter, the skills and procedures to be performed by medical students, the appropriate clinical settings for these experiences, and the expected levels of medical student responsibility.
[viii] 8.6 Monitoring of Completion of Required Clinical Learning Experiences
A medical school has in place a system with central oversight that monitors, remedies any gaps, and ensures completion of the required patient encounters, clinical conditions, skills and procedures to be performed by all medical students.
[ix] 8.8 Monitoring Time Spent in Educational and Clinical Activities
The curriculum committee and the program's administration and leadership implement effective policies and procedures regarding the amount of time medical students spend in required activities, including the total number of hours medical students are required to spend in clinical and educational activities during required clinical learning experiences.
[x] 9.1 Preparation of Resident and Non-Faculty Instructors
In a medical school, residents, graduate students, postdoctoral fellows, and other non-faculty instructors who supervise, teach or assess medical students are familiar with the learning objectives of the required learning experience in which they participate and are prepared for their roles in teaching and assessment. The medical school provides resources to enhance and improve residents' teaching and assessment skills, with central monitoring of their participation in those opportunities provided.
[xi] 6.5 Elective Opportunities
The faculty of a medical school ensure that the medical curriculum includes elective opportunities that supplement required learning experiences and that permit medical students to gain exposure to and deepen their understanding of medical specialties reflecting their career interests and to pursue their individual academic interests.
[xii] 11.2 Career Advising
A medical school has an effective and where appropriate confidential career advising system in place that integrates the efforts of faculty members, clerkship directors, and student affairs staff to assist medical students in choosing elective courses, evaluating career options, and applying to residency programs.
[xiii] 11.3 Oversight of Extramural Electives
If a medical student at a medical school is permitted to take an elective under the auspices of another medical school, institution, or organization, a centralized system exists in the dean's office at the home school to review the proposed extramural elective prior to approval and to ensure the return of a performance assessment of the student and an evaluation of the elective by the student. Information about such issues as the following are available, as appropriate, to the student and the medical school in order to inform the student's and the school's review of the experience prior to its approval:
- Potential risks to the health and safety of patients, students, and the community;
- The availability of emergency care;
- The possibility of natural disasters, political instability, and exposure to disease;
- The need for additional preparation prior to, support during, and follow-up after the elective;
- The level and quality of supervision;
- Any potential challenges to the code of medical ethics adopted by the home school.
[xiv] 9.3 Clinical Supervision of Medical Students
A medical school ensures that medical students in clinical learning situations involving patient care are appropriately supervised at all times in order to ensure patient and student safety, that the level of responsibility delegated to the student is appropriate to his or her level of training, and that the delegated activities supervised by the health professional are within his or her scope of practice.
[xv] 9.7 Timely Formative Assessment and Feedback
A medical school ensures that the medical education program provides timely formative assessment consisting of appropriate measures by which a medical student can measure his or her progress in learning. Each medical student is assessed and provided with formal formative feedback early enough during each required learning experience four or more weeks in length to allow sufficient time for remediation. Formal feedback occurs at least at the midpoint of the learning experience. In medical education programs with longer educational experiences (e.g., longitudinal integrated clerkship, year-long courses) formal feedback occurs approximately every six weeks. For required learning experiences less than four weeks in length alternate means are provided by which a medical student can measure his or her progress in learning.
[xvi] 9.8 Fair and Timely Summative Assessment
A medical school has in place a system of fair and timely summative assessment of medical student achievement in each required learning experience of the medical education program. Final grades are available within six weeks after the end of a required learning experience.
[xvii] 3.5 Learning Environment/Professionalism
A medical school ensures that the learning environment of its medical education program is:
- Conducive to the ongoing development of explicit and appropriate professional behaviors in its medical students, faculty, and staff at all locations;
- One in which all individuals are treated with respect.
The medical school and its clinical affiliates share the responsibility for periodic evaluation of the learning environment in order to:
- Identify positive and negative influences on the maintenance of professional standards
- Implement appropriate strategies to enhance positive and mitigate negative influences
- Identify and promptly correct violations of professional standards
[xviii] 3.6 Student Mistreatment
A medical school defines and publicizes its code of conduct for the faculty-student relationship in its medical education program, develops effective written policies that address violations of the code, has effective mechanisms in place for a prompt response to any complaints, and supports educational activities aimed at preventing inappropriate behaviors. Mechanisms for reporting violations of the code of conduct (e.g., incidents of harassment or abuse) are understood by students and ensure that any violations can be registered and investigated without fear of retaliation.
[xix] 8.5 Use of Student Evaluation Data in Program Improvement
In evaluating medical education program quality, a medical school has formal processes in place to collect and consider medical student evaluations of their required learning experiences, teachers, and other relevant aspects of the medical education program.