Toronto Metropolitan University advancing a community-driven and inclusive model of care
When Toronto Metropolitan University (TMU) launches its School of Medicine in the summer of 2025, it will usher in a bold, new medical training model – one that’s focused on experiential learning, interprofessional education and clinical skills training in both community and hospital settings.
“Our vision for this new school is very much aligned with what TMU stands for, which is making sure people feel like they belong, and that we’re creating a school that is well integrated and accountable to its community,” says Teresa Chan, vice-president, medical affairs at TMU, and dean of the School of Medicine. Located in Brampton, Ontario, the school will have 94 undergraduate seats and 105 postgraduate positions yearly.
The new school’s curricula address the urgent challenges of primary care and generalist physician shortages in Ontario and Canada, where an estimated 6.5 million Canadians are without access to a regular family doctor or nurse practitioner. Along with creating a program that trains doctors in family medicine, the new school aims to ensure equity in health care through medical education based on the principles of social accountability, equity, diversity, inclusion, accessibility and reconciliation.
TMU plans to achieve this goal in two ways. The first is through the adoption of an innovative learning model that includes learning health systems. The school will also emphasize teaching skills around health systems science and leadership to ensure that graduates can shape the system that matches their values.
Secondly, TMU will aim to create a network of academically oriented, integrated health centres. Essentially, these will be community-based environments where students will be trained in interprofessional care and practice, and where they’ll be exposed to a diverse patient population and to novel ways of providing care while also supporting the research, innovation and scholarly ambitions of the school.
Steven N. Liss
Vice-President, Research and Innovation at TMU
“We’re hoping to have clinical spaces where we can try new things,” says Dr. Chan. “Can you imagine patients coming in for their next visit, and they might have to check in through a different way or communicate with a doctor using a new device? We want to make sure we have systems in place that allow people – patients, doctors and learners – to engage in health-care innovation and maybe even have our learners leading quality improvement projects that allow them to take leadership roles early in their career and see that they can make change.”
TMU also plans to draw on its extensive body and ecosystem of health research focused on health equity – work that has already influenced health-care policy in Canada and beyond.
“The trajectory and growth of our entire research enterprise has been scaling significantly and accelerating in various areas of health,” says Steven N. Liss, vice-president, research and innovation at TMU. “Our overall health strategy, which goes beyond the medical school and encompasses the entire university, is very much oriented towards community health and the gaps in health and health care.”
Brampton – home to the third largest immigrant population in Ontario and fifth largest in the country – emerged as a microcosm of health inequity during the pandemic, with rates of COVID-19 infections significantly higher than the provincial and national rates.
Vice-President, Medical Affairs at TMU, and Dean of the School of Medicine
“What transpired in Brampton during COVID reflected the gaps in our ecosystems for health-care delivery and the population not being served well by the health system,” says Dr. Liss. “Having our new medical school located in this highly diverse community will allow us to produce a new generation of doctors whose medical training is grounded in community health that’s equitable, socially accountable and inclusive of everyone in our diverse patient populations.”
Examples of TMU’s groundbreaking research in community health and equity include studies into the stigma that often surrounds people with mental health issues and conditions such as HIV.
One recently completed project, which looked at HIV vulnerability among heterosexual Black men, was notable in its integration of rating scales for masculinity, everyday discrimination, questions about access to primary care and qualitative interviews that provided critical contexts of the experiences and perspectives of heterosexual Black men and communities.
Professor and Research Chair in Urban Health at TMU’s Daphne Cockwell School of Nursing
“So then we’re able to analyze the data and show that people who have no access to primary care are less likely to be tested for HIV,” says the study’s lead, Josephine Wong, professor and Research Chair in Urban Health at TMU’s Daphne Cockwell School of Nursing. “Similar to other conditions, delayed diagnosis and delayed treatment of HIV is very detrimental to the individual as well as to the community in terms of transmission.”
Like most of TMU’s health research, Dr. Wong’s work engages community stakeholders and team members from disciplines such as sociology, anthropology, psychiatry, social work and primary care.
“Meaningful engagement with community stakeholders is critical to reducing health disparities through research following the principle of ‘nothing about us without us,’” she says.
With TMU’s rich body and ecosystem of community health and health equity research – combined with its bold model of medical education – Canadians can look forward to a new generation of doctors whose clinical skills are rooted in critical social values.
“We want to develop our medical students as health-care leaders who have equity in their hearts and the know-how to manifest it into reality so that they can create better health systems for people,” says Dr. Chan. “I believe we’ve carved out a really great way forward.”
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