Ice Fishing

1. Fishing for a Longitudinal Integrated Clerkshipat McMasterJonel Miklea, MD CCFPAsst Prof, Undergraduate Program DirectorDept of Family MedicineMcMaster UniversityHamilton, ON, Canada

3. Locations Shelters Fishing equipment Modern ice fishing Dangers Contests Current Fishing Conditions References Ice Fishing

5. Canada Finland Estonia Latvia Norway Russia Sweden Ukraine Germany USA Flinders Minnesota USF Harvard UBC Calgary Edmonton NOSM …and soon McMaster Location

7. Shelter = ice shanty, ice shack, fish house, bobhouse, or ice hut. LIC will be sheltered in our 2 distant campuses; Niagara campus and Kitchener/Waterloo Shelters

9. Ice saw Skimmer Heater Fishing rod Lures Buy in from faculty, deans and community Interest among students Budget Fishing Equipment

11. Power drills Flashers (sonar) Snowmobiles Evidence: students perform as well or better than colleagues in traditional clerkship programs graduates overwhelmingly choose primary care specialties in rurally based programs, at least 50% of grads choose rural practice locations Modern Ice Fishing

13. Walking - 10cm (6cm) Sleds, Snowmobiles - 12cm Light cars - 25cm Frostbites, CO poisoning from fish-house heaters Student’s anxiety re exam performance, Exam structure Administration - central Equitable experiences Program evaluation Dangers

15. Catching a big fish, no matter what the species, is always a thrill, and it usually requires exceptional fishing skill. Improved resiliency Comfort with uncertainty Patient-centred care Contests

16. Current fishing conditions

17. Concept-oriented Multidisciplinary Problem-based Practice for transfer Simulations in clerkship Streaming COMPASS

18. STUDENTS: Mandatory 6 week at the beginning of Med School or optional 12 weeks FACULTY: teaching Clinical Skills, Precepting 6 week Mandatory FM, strong presence in Professional Competencies Pre-Clerkship FM Experience

20. Effective Communication Professionalism and Role Recognition Self Awareness and Self Care Lifelong Learning Social and Community Context of Health Care Moral Reasoning and Ethical Judgment Clinical Examination Professional Competencies Domains

21. FM Clerkship = 6 week rotation 6-7 half days/week with FM clinical preceptor integrated with other teaching activities Total # students 182: Local 108 & Rural 76 1 tutorial per week Daily evaluations & Key Feature Exam Family Medicine Clerkship

23. 4 half days of Palliative Care 3 half days of Early years 2 half days of Global Health 1 half day of Care of the Elderly 2 half days FM Selective 2 half days of Complementary/Alternative Medicine Integration

24. 50% of our students choose FM as a career choice National average 32.5% Our Success

25. November 2011 distant campuses Niagara and Kitchener Waterloo 8 mo in FM, 1.5 month ward based Peds, 1.5 month ward based IM and 2 month elective More to share at the 2010 Global Community Engaged Medical Education Conference, Barossa Valley LIC Pilot at Mac

26. Fishing: Gruenwald, Tom and Genz, Dave (1999) Modern Methods of Ice Fishing LIC literature: Paul Worley Gwen Halaas Lucie Walters Molly Cook References

27. If students have their clinical training mainly in hospitals, especially tertiary care hospitals, they will get the message: ‘this is what disease is and this method for investigating it, is themethod of medicine.’ If they never care for a patient at home, the message will be ‘the home is no place for a physician.’ If they are taught mainly by specialists, they will get the message: ‘this is where authority, prestige, and power lie.’ Ian McWhinney Many men go fishing all of their lives without knowing that it is not fish they are after. Henry David Thoreau Conclusions

37. Thank You!