The NMSA was privileged with the opportunity to attend the Canadian Federation of Medical Schools (CFMS) Conference and Spring General Meeting in Montreal, Quebec on the weekend of April 15, 2016. The CFMS is the professional student organization for medical school students in Canada; it has 14 member schools, with over 7500 student members. The primary mandate of the organization is to support advocacy, education, global health and student affairs among medical school programs in Canada. This is the second year the NMSA has been invited to attend the conference, representing the students (as well as the profession as a whole) of naturopathic medicine. We had representatives from both of the Canadian naturopathic medical schools in attendance: from Boucher Institute of Naturopathic Medicine, NMSA Chapter President Sophia Vathracoulis; from the Canadian College of Naturopathic Medicine, Tiffany Cheung (NMSA-CCNM Chapter Integrative Medicine Chair) and Maxwell Crispo (NMSA Integrative Medicine Fellow).
The Friday of the conference began with opening addresses from various organizations affiliated with the CFMS. The mental health of medical students was a common theme addressed by the speakers and was a widely-discussed issue throughout the conference weekend. According to recent research presented by the Federation Medicale Etudiante du Quebec (FMEQ), 1 in every 6 medical students contemplates suicide, and 1 in every 5 medical students admits to being harassed or intimidated by students or professors. We had the opportunity to delve into these topics in more depth in the afternoon, as all students split up into smaller working groups to discuss the most relevant issues in conventional medical school education. In one of these breakout sessions focused on student mental health, the FMEQ results were referenced and the potential underlying causes of these attitudes were discussed. This was a great opportunity to see the similarities between the experiences of naturopathic medical students and conventional medical students, but also how they differ. While the general stress of heavy academic schedules is akin to all medical school students, it is important to note that the school community is a common cause of mental health anguish in conventional medical schools but actually seems to be a positive aspect for naturopathic medical students (mental health research from CCNM tells us that naturopathic medical students are more affected by feelings of over-work and loneliness/isolation and look to their school community as a supportive resource). It is hypothesized that much of this difference is due to the competitive atmosphere that has been traditionally bred into medical school programs (students competing for grades and residencies, bias and deterrence among teaching faculty and supervisors, etc.). We were able to discuss more about this stereotyped culture and learned more about how medical schools are moving away from that paradigm. For example, many medical schools are now moving to pass/fail systems (no graded evaluations) to help eradicate the peer-to-peer competition for marks. The University of Alberta also presented the model for their school’s mental health week, which has proven to be very successful in the last few years. One of their events is an intimate open mic night in a safe space that allows students to speak/present/perform regarding their experience with mental health; these initiatives have helped to foster more supportive, collaborative cohorts and school community.
Another working group discussion focused on global health initiatives. One of the main points addressed was how to increase student awareness and interest in global health initiatives. One impression taken from this is that the majority of med school students fall into a rhythm of constant school work and striving for residencies and specialties that are limited to hospitals in large Canadian cities; the time and interest of students wanting to engage in global health efforts are minimized. This is not just limited to global/international opportunities, but nationally within Canada; many students are not interested in practicing medicine (especially family medicine) in rural Canadian communities that are under-served by healthcare. In fact, some medical schools are now offering paid incentive for students to do shadowing shifts in these under-serviced communities. Is this the most effective strategy for bringing more medical doctors to these areas?…Of course, we know that there are many Canadian NDs who see the opportunity in practicing in these communities; in the western provinces (because of their broad scope of practice) many of these NDs are becoming the sole primary care physician in these communities. A large part of this breakout session allowed us all to discuss how we can increase awareness of these opportunities and address the obstacles to them.
A final working group topic focused on mentorship opportunities for medical school students. The group, as a whole, acknowledged the benefit a professional mentor can have in supporting the academic career of a medical school student. While many students would be interested in such opportunities, the number available to students is limited and most medical schools do not have programs affiliated with the institution that supports these initiatives. Through discourse, the conversation evolved to discuss just the general concept of shadowing and precepting, at which point, the idea of interprofessional shadowing was brought up. While some medical schools do offer the opportunity to shadow other medical professionals and health care workers, from the other students’ responses, it seems that the majority of students do not know about these possibilities and that they can be easily overlooked due to students wanting to focus on what they will be doing as medical doctors and what is directly relevant to them. This allowed us the chance to tell students more about the precepting requirements for ND students and that we see value in shadowing other professionals other than NDs, because it gives us insight as to what those professions actually do and helps us to learn how to communicate inter professionally, ultimately giving us a better understanding of how to treat our patients who may be seeing a number of different healthcare professionals concurrently.
After the working group discussions, the keynote speaker, Mr. James Hughes, Deputy Minister of Social Development, addressed the future of healthcare in Canada and the responsibilities of future healthcare providers. Acknowledging the current burden on the public healthcare system, Mr. Hughes focused his talk on the social determinants of health. He emphasized the fact that there are so many public health issues and barriers as a result of these predisposing factors and that these are what need to be addressed for creating and maintaining a healthier Canada and the world. Referencing a section of the Hippocratic Oath, Mr. Hughes proposed that doctors have a responsibility to their patients to learn about, understand and address these issues. It was a well-received speech that invited students to respond with support and questions to further discussion.
The second day of the CFMS primarily consisted of caucus, elections, and presenting and passing resolutions. As non-members, we could not actively participate in these events but were still present as guests. While many of the resolution proposals were very specific to the CFMS organization and members, it was valuable to learn more about their process to compare and add to the development and evolution of our own in the NMSA. There were a number of resolutions proposing lobbying for changes to curriculum education at the member schools. One of these proposals identified the need to better incorporate education surrounding human trafficking in Canada for the purpose of being able to more competently recognize and treat these populations.
At the conference, we were able to meet with several members of the CFMS executive and were able to reach out to representatives in interprofessional education at several of the schools with the opportunity for future correspondence.
Max Crispo is a third-year student at the Canadian College of Naturopathic Medicine and has served as the NMSA Integrative Medicine Fellow. Max believes the NMSA is essential for the development of ND students and the profession as a whole, bringing many opportunities to students who may not otherwise have access to them. Max is an eclectic person with a vast array of personal interests, believing we should always be open to trying new things and never stop learning!