An integrated curriculum teaching preparatory clinical skills at a traditional medical school

In 1991, the Liaison Committee on Medical Education stated that medical schools must be responsible for designing and managing a coherent and coordinated curriculum. With respect to preparatory clinical skills, there have been no reports in the literature of an integrated and longitudinal approach to curriculum design or a description of a medical school with the administrative and educational structure to implement one. This Article describes such an effort at McGill University's Faculty of Medicine. Various advantageous features are described: (a) a subcurriculum committee and an administrative structure to oversee the project, (b) early introduction to patients, (c) a comprehensive small-group program, (d) the use of ''near-peer'' teachers, and (e) a process of faculty development. The longitudinal integration of these features is particularly noteworthy because the overall curriculum at McGill has been based largely on the traditional Flexnerian model of medical education consisting of approximately 2 years of small group lecture-based basic and clinical sciences followed by 2 years of preclinical and clinical clerkships. An evaluative survey regarding the impact of this program on the students is included.