Re-imagining Medical Education takes new approaches to undergraduate medical education at the U of C
By Salma Zein, December 29 2021—
The Re-imagining Medical Education (RIME) initiative through the Cumming School of Medicine, founded in 2018, aims to update the delivery of the undergraduate medical curriculum with the goal of creating more socially-aware physicians to better serve communities.
The Gauntlet interviewed Dr. Rahim Kachra, Clinical Associate Professor in the Department of Medicine and the Director of Teaching Innovation for Undergraduate Medical Education at the Cumming School of Medicine, and Dr. Joshua Low, a second-year internal medicine resident.
There has been a large body of research highlighting the importance of physicians demonstrating social accountability in order to create healthy populations — this change starts with medical schools through initiatives like RIME. RIME is based on the four main principles of spirality, generalism, centering patients and integration. Together, these four principles encompass the skills necessary for more socially aware physicians.
“I see it as an opportunity to improve the health of our society, the health of the communities in which we serve. And I think reframing medical education to put the patient at the centre of everything that we do is something that we can further refine from our current curriculum and to have students who are more accountable to not just the medicine, but also the social, structural and other contributors to a patient’s healthcare journey,” said Kachra.
“It was a really exciting idea as a medical student, when I first joined the project to say, ‘Maybe we could be leaders in this field, and maybe we could make this an even better and even more successful experience, create better doctors in the long run,’” said Low. “It’s exciting to say that we can make it better for the next people coming along and make it as good as it possibly can be.”
Initially, the RIME project was created in response to addressing how medical lectures could be improved. Much time was spent with students, faculty, course chairs, preceptors, community members and administrators to better understand the undergraduate medical education experience. The project soon grew beyond its initial goal, presenting an opportunity to refine the broader medical curriculum.
“There’s been an appetite to better adjust our curriculum to the evolving needs of society, and I think the time is just right to do it,” said Kachra. “The fundamentals of medicine, we still have to deliver, we’re still going to deliver. It’s just we’re going to do it a little bit differently and use core medical education principles as well as identifying some of the areas for refinement that we’ve seen through our process, and we’ll hopefully be able to deliver it in a different way.”
The last major change to the pre-clerkship medical curriculum occured in 2006. The new curriculum is feasible under accreditation standards and is set to be implemented in July 2023, however, as Kachra says, this is only just the beginning.
“When you look at the committee that accredits Canadian medical schools, the first standard involves the theme of continuous quality improvement, so we’re going to continue to try to improve the process,” said Kachra. “It doesn’t end once we implement, we’re just getting started on building out the core tenets of our curriculum, and the great thing about the methodology we’ve chosen, but [also] the opportunity that we have, is that it doesn’t end when we start the curriculum in July 2023. We’re going to continuously evaluate and refine the process, continually try to improve it, as quickly as we need to.”
Low mentioned that although there are many goals within medical education, the main goal remains the same.
“Medical education itself is, you can say it has many different goals, but the end of the line is a healthier population. So every improvement we make at this step hopefully echoes down to healthy populations in the end, that’s the ultimate goal,” said Low.
Any further suggestions to the proposed curriculum changes can be made through the form on the Re-imagining Medical Education (RIME) website. Kachra and Low welcome any stakeholders in the process who wish to be involved.