McMaster University Medical School

Michael G. DeGroote School of Medicine at McMaster University

Established	1965
Dean	John G. Kelton
Students	203 per year
Location	Hamilton, ON, Canada
Website	Michael G. DeGroote School of Medicine

The Michael G. DeGroote School of Medicine is McMaster University's medical school, located in Hamilton, Ontario, Canada. It is operated by the McMaster Faculty of Health Sciences. McMaster University's medical school accepts 203 students per year out of over 5200 applicants into the MD program. It is one of two medical programs (along with the University of Calgary) in Canada that operates on an accelerated 3-year MD program, instead of the traditional 4-year MD Program.

Currently, McMaster ranks 25th in the world and 3rd in Canada for medicine according to the Times Higher Education World University Rankings 2015.^[1] In 2012, McMaster ranked 1st in Canada and 14th worldwide in medicine, according to the Times Higher Education Rankings 2012.^[2]

The school received 5,271 applications for the Class of 2018 and had an acceptance rate of 3.8%.^[3] The average GPA of entering undergraduates in the Class of 2018 was 3.84 and the average MCAT Verbal score was 11.2, a score in the 95th percentile.^[4] Unlike many other medical schools, McMaster University's medical school does not drop any courses or years in their GPA calculation, as well as only uses the MCAT Verbal score in the MCAT component of their admissions calculation.^[5] Students also have to write the CASPer admissions test, developed at McMaster in 2012.

Founded in 1965, the school is acknowledged to be a world leader in innovative learning, testing systems as well as multinational trials and thrombosis research.^[6] Since its formation, the school invented the small-group, case-based learning curriculum which is now known as PBL or problem-based learning. In addition, the school was the first in the world to institute a 3-year M.D. program in 1965, with classes being held year round. In the 1980s, McMaster developed and coined the term "evidence-based medicine" as a way to approach clinical problem solving.^[7] McMaster also developed the Multiple Mini Interview (MMI) system in 2001 for medical school admissions which has been adopted as part of the admissions system in professional schools around the world. In 2010, McMaster developed the CASPer test for medical school admissions, which has recently been adopted at several medical schools across North America.

History

McMaster University had long been a target of proposals for a medical school. As early as 1892, Trinity Medical College in Toronto had sought affiliation with McMaster. In the 1930s, Dr. C.E. Cooper-Cole and Dr. Gordon Murray were invited to become the first professors of medicine and surgery at the university however the plans were later shelved.^[8] In 1956, Sir Francis R. Fraser, wrote the Fraser report and concluded that McMaster could feasibly host a medical school. At the same time, the Ontario government had expressed the opinion that Ontario would need an additional medical school by 1966. The main driving force behind the project was Harry Thode, at the time the vice president of the university and later the president. By 1965, the first dean of the new medical school John Robert Evans, was appointed. By 1966, the first five faculty members, John Robert Evans, William Walsh, Bill Spaulding, James Anderson and Fraser Mustard were recruited.^[9]

Facilities and teaching sites

St. Joseph's Hospital, Charlton Campus.

The school is located at McMaster University's main campus in Hamilton, Ontario, housed within the Michael G. DeGroote Centre for Learning and Discovery, a building built in 2004 and the adjacent Health Sciences Centre. The DeGroote facility is shared with the Centre for Function Genomics, Centre for Gene Therapeutics, Institute for Cancer and Stem Cell Biology Research, Robert E. Fitzhenry Vector Laboratory, Centre for Asthma and Allergy Research (Allergen) and North American Headquarters for West Nile studies, as well as the Bachelor of Health Sciences undergraduate program.^[10]

The Health Sciences Centre/McMaster Children's Hospital is a multi-use research facility and pediatric teaching hospital. The hospital is home to the second-largest neonatal intensive care unit in Canada, and the third largest child and youth mental health unit in the country.^[11]

The medical school currently operates three campuses; the main Hamilton campus, as well as the Waterloo Regional Campus and the Niagara Regional campus, located in Waterloo, Ontario and Niagara, Ontario respectively. All three campuses offer the same curriculum and lead to the same degree, but differ in patient populations and teaching locations.

McMaster's teaching hospitals are divided into two major hospital groupings: Hamilton Health Sciences, recently ranked 2nd in Canada among research hospitals and St. Joseph's Healthcare Hamilton.

Hamilton General Hospital

The school is also affiliated with the following Ontario hospitals, where students rotate and train during their clerkship:

• Brantford General Hospital
• Cambridge Memorial Hospital
• West Lincoln Memorial Hospital
• Niagara Health System (Greater Niagara, Niagara-on-the Lake, Port Colborne Campuses)
• Oakville-Trafalgar Memorial Hospital
• Grey Bruce Health Services
• Norfolk General Hospital

Educational influence

The medical school is a pioneer in its teaching and admissions philosophies through the Program for Educational Research and Development, renowned internationally for grounding educational practice in evidence.^[12] McMaster created a revolution in health care training by pioneering the problem-based learning (PBL) curriculum, which has since influenced health care education worldwide. The instructional strategy focuses on student-driven learning, which occurs in groups, to foster critical thinking, higher retention, and stronger cognitive competencies including coping with uncertainty and communication skills. Most medical schools in Canada and more than 80% of medical schools in the United States now employ PBL in their curriculum, and many international universities are continuing to do to the same.^[13]

In the early 1990s, the School of Medicine developed the personal progress index (PPI) as an objective method for assessing acquisition and retention of knowledge for students in the medical program. The PPI is administered at routine intervals to all students in the program, regardless of their level of training, and plots students' increases in scores as they move through the program. Students typically score under 15% on their first write, and increase 5-7% with each successive write. Students are able to monitor the changes in their scores and receive formative feedback based on a standardized score relative to the class mean. Due to the overwhelming success and research supporting the use of the PPI as an evaluation tool, it is now used in Canada, US, Europe, and Australia.^[14]

In 2004, McMaster developed the multiple-mini interview to address long standing concerns over the standard panel interviews as being poor reflectors of performance in medical school.^[15] This format uses short, independent assessments in a timed circuit to obtain aggregate scores in interpersonal skills, professionalism, ethical/moral judgment, and critical thinking to assess candidates. The MMI has consistently shown to have a higher predictive validity for future performance than traditional interviews.^[16] Although, it may be argued that most of the validation so far has been done by McMaster and/or its affiliated for-profit company which constitute a conflict of interest and any result must be interpreted with caution. By 2008, the MMI was being used as an admissions test for the majority of medical schools in Canada, Australia, and Israel, as well as other medical schools in the United States and Asia.

In 2010, McMaster began using a computer-based simulated test known as CASPer as an admissions tool at the pre-interview stage. This is an assessment of interpersonal and decision-making skills that is more reliable, and predicts much more validity than standard autobiographical submissions. The test involves several video clips lasting 1–2 minutes in length, followed by situational challenges and self-descriptive questions that may or may not be related to the preceding video clip.^[17]

Admissions

Admissions into Canadian medical schools is highly competitive, requiring a bachelor's degree, a strong undergraduate grade point average (GPA), and strong scores on the Medical College Admissions Test (MCAT). Applicants are required to have at least three years of prior university education by the time of admission, and are required to write the Medical College Admissions Test (MCAT). They are also required to complete a 90-minute computer-based test to assess interpersonal skills and decision-making, called the Computerized Assessment Sampling of Personal Characteristics (CASPer)^[18]

The annual success rate for all applicants applying for admission to McMaster University's medical school is 3.8% and this rate is declining each consecutive year given the fixed number of available seats.^[19] The Michael G. DeGroote School of Medicine received over 5200 applications in 2014 for a class size of approximately 200 students, which is substantially more than any other school in Canada.^[20] The average GPA of entering undergraduates in the Class of 2017 was 3.83 and the average MCAT verbal score was 11 (95th percentile).^[21] McMaster University's medical school does not drop any courses or years in their GPA calculation. As a result, McMaster University's medical program reports an admission GPA that is cumulative taking all courses and years into account, which is contrary to many other medical schools in Canada that report and calculate their admission GPAs with the lowest courses or academic years dropped from the calculation.^[22]

Interview offers for Ontario medical schools are typically given in January and February. Given McMaster's rigorous pre-interview screening process, only 550 students are invited for interviews to compete for the 203 seats.^[23] Applicants go through the Multiple Mini Interview format, a 10-station interview circuit, to increase the validity and reliability of interview scores (see above).

Curriculum

The program is divided into two parts: the pre-clerkship curriculum and the clerkship curriculum, each spanning half of the three years. The pre-clerkship curriculum is divided into five medical foundations, where students meet with a faculty member twice a week in a small group setting for teaching. Learning is done using the problem-based learning approach, where students set objectives, complete independent research, and then use their small group sessions to teach others, ask questions, and challenge one another with the guidance of their tutor. Students also complete clinical skills and professional competencies training at this time. Students are not graded during pre-clerkship, evaluations are given at the end of each medical foundation, feedback from the students' tutors is given on tests and the PPI, personal progress index test provides the student a sense of their progress during pre-clerkship.

The clerkship curriculum consists of rotating schedule, where students will move through various medical disciplines. These include Internal Medicine, Family Medicine, Emergency Medicine, Pediatrics, Surgery, Psychiatry, Obstetrics and Gynecology, Anesthesia, as well as a number of elective blocks for specialties of interest for the student. In their third year, students apply to the Canadian Resident Matching Service (CaRMS) for residency training after completion of the MD Program.

Students are allowed to take an enrichment year that can last up to a year. Students can pursue academic work during that period, including research. In addition, up to 40% of the time available for clinical electives. Students can also pursue a masters degree both at McMaster or other universities during that period.

International health electives

McMaster students have 24 weeks of elective time to pursue outside of McMaster. McMaster encourages students to participate in electives abroad. Most electives are organized through external organizations or through the students own arrangements, however, McMaster has agreements with different medical universities/cities for medical electives abroad. Currently, McMaster has arranged bilateral exchange agreements with the following universities and cities:

• Medical University of Graz - 2 spots
• Royal College of Surgeons of Ireland - 8 spots
• University of Limerick - 2 spots
• University of Sydney - 4 spots
• King George's Medical University/Shri Guru Ram Rai Institute of Medical & Health Sciences - 4 spots
• Lima, Peru - 10 spots
• Matangwe, Kenya - 4 spots

Residency

92% of McMaster graduates matched to a residency in position in 2014 which is above the national average of 90.8%.^[24] In addition, 58% matched to their first choice discipline and location.

Research

McMaster's Faculty of Health Sciences oversees $223 million a year in research, ranking it 2nd in Canada for 5 years in a row.^[25] McMaster's Hamilton Health Sciences hospital group is ranked 1st in Canada for researcher intensity with each researcher bringing in $711,000. It is also ranked 2nd in Canada in the top 40 research hospitals list.^[26] McMaster is considered a leader in clinical epidemiology and thrombosis research with names like Dr. Jack Hirsh, Dr. Salim Yusuf leading the way.

• In 1982, McMaster along with Western University developed WOMAC, a widely used scale to measure osteoarthritis of the hip and knee
• In 2001, McMaster organized and conducted the CURE trial which was the first trial to demonstrate the superiority of clopidogrel and aspirin versus aspirin alone in patients with acute coronary syndrome without ST segment elevation.
• In 2010, McMaster scientists discovered how to turn adult skin cells into adult blood cells^[27]
• In 2012, McMaster published the RIVAL trial which showed the positive benefits of percutaneous coronary intervention through radial access over femoral access
• In 2014, McMaster organized an international trial which demonstrated that corticosteroids, routinely given to patients after heart surgery, is harmful rather than beneficial and increases the risk of death by 15% 30 days after surgery
• In 2014, McMaster scientist Gerry Wright, discovered AMA, a fungus derived molecule which is able to disarm a dangerous antibiotic resistance gene^[28]
• In 2014, McMaster professor Gregory Steinberg showed that blocking peripheral serotonin increases activity of brown fat, leading to reduced obesity^[29]
• In 2014, McMaster professors Paul O'Byrne and Gail Gauvreau showed that anti-TSLP antibody reduces allergen reduced asthma responses^[30]
• In 2015, McMaster scientists discovered how to turn adult blood cells into adult sensory neurons^[31]
• In 2015, McMaster cardiologists and cardiac surgeons perform the first TAVI on a pregnant woman in the world

McMaster medical school is home to 30 research institutes including the:

• Population Health Research Institute
• Firestone Institute for Respiratory Health
• McMaster Stem Cell and Cancer Research Institute
• Farncombe Family Digestive Health Research Institute
• Thrombosis & Atherosclerosis Research Institute
• Escarpment Cancer Research Institute

McMaster initiated its M.D./Ph.D. program in 2007, accepting up to three students a year into the 7 year physician scientist program.

Philanthropy

In 2003, McMaster University Medical School received the largest ever donation to a university in Canadian history when Michael DeGroote donated $105 million to the medical school in the process naming it the Michael G. DeGroote School of Medicine. In 2014, DeGroote donated an additional $50 million to the medical school.^[32]

Charles Juravinski has donated over $43 million to Hamilton area hospitals including the Juravinski Hospital.

David Braley, owner of the BC Lions, donated $50 million to the medical school in 2007 to build the Braley Health Sciences Centre, a human embryonic stem cell library and an endowment fund.

In 2011 and 2012, the Boris Family donated a total of $41 million to McMaster University Medical School and St. Joseph's Healthcare Hamilton to found the Boris Family Centre in Human Stem Cell Therapies, establish two chairs in Blood and Neural Stem Cells, found the Boris Clinic, fund alcohol addiction research and buy a surgical robot.

Notable alumni

Notable faculty

• James Fraser Mustard, CC, Chair of Pathology (1966-1972), Dean of Medicine (1972-1982), discovered the effect of aspirin in reducing myocardial infarction rates, founder and president of the Canadian Institute for Advanced Research
• John Evans, CC, Dean of Medicine (1966-1972), President of the University of Toronto, Chairman of the Rockefeller Foundation and Director of the Population, Health and Nutrition department of the World Bank
• David Sackett, Chair of Clinical Epidemiology and Biostatistics (1967-1994), founded the first department of Clinical Epidemiology in Canada, wrote Evidence-Based Medicine: How to Practice and Teach EBM now in its 4th edition and Clinical Epidemiology: How to Do Clinical Practice Research now in its 3rd edition
• Howard Barrows, Assistant Dean for Residency Education (1971-1980), pioneered problem-based learning at McMaster which has now spread all over the world
• Arnold Johnson, Professor of Cardiology (1974-1983), performed the first cardiac heart catheterization in Canada, founder of McMaster's Department of Cardiology
• John Coleman Laidlaw, Professor of Endocrinology (1975-1986), Dean of Medicine (1981-1985), founded the Institute of Medical Science at University of Toronto
• Moran Campbell, Chair of Medicine (1968-1975), inventor of the Venturi mask
• Jack Hirsh, Professor Emeritus of Medicine (1973–Present), winner of the Canada Gairdner International Award in 2000 for discovering the effectiveness of heparin in deep vein thrombosis and the discovery of low molecular weight heparin
• Charles Gordon Roland, Hannah Professor of the History of Medicine (1977-1999), President of the Canadian Society for the History of Medicine and noted authority on Sir William Osler
• John Bienenstock, Dean and Vice President of Health Sciences (1992-1996), characterized mucosal mast cells and bronchus associated lymphoid tissues
• Salim Yusuf, Professor of Medicine (1992–Present), world's second most cited researcher, prolific clinical trials physician in cardiovascular diseases
• John G. Kelton, Dean of Medicine (2001–2016), Dean and Vice-President of the Faculty of Health Sciences (2001–2016), hematologist and expert in heparin-induced thrombocytopenia
• Dave Williams, Professor of Surgery (2008-2011), Canadian astronaut and physician, Director of the Space and Life Sciences Directorate at the Johnson Space Center
• John Basmajian, OC, OOnt, Professor of Medicine (1977-1986), pioneer in electromyography and biofeedback
• Stuart Lyon Smith, Professor of Medicine (1967-1975), Leader of the Ontario Liberal Party, Chairman of the Science Council of Canada
• Donald Acheson, KBE, Visiting Professor of Medicine (1977), Chief Medical Officer of the United Kingdom and coined the term "Benign Myalgic Encephalomyelitis"
• Richard Whitlock, Assistant Professor of Surgery (Present), performed the world's first transcatheter aortic valve implantation on a pregnant woman
• Paul O'Byrne, Dean of Medicine (2016–Present), Dean and Vice-President of the Faculty of Health Sciences (2016–Present), respirologist and expert in allergy induced asthma

In popular culture

• In 2015, McMaster's medical school was part of an eight part international documentary series entitled Canada's New Doctors, by Al-Jazeera and Companion Media and Culture Co. in China, examining the topic of how to best train medical professionals
• In 2012, McMaster medical students starred in a one-hour documentary by OMNI Television called M.D(iversity)^[38]
• In 2009, The Rick Mercer Report filmed a segment about McMaster University, visiting the medical school to see its new clinical skills models
• In 2004, The magazine Saturday Night published a report on PBL and McMaster Medical School's innovative curriculum

Notes and references

External links

• Tour of the Faculty of Health Sciences
• Evidence Based Medicine - British Medical Journal

Coordinates: 43°15′40″N 79°55′00″W / 43.261054°N 79.91678°W / 43.261054; -79.91678