In 1988, a conference on medical education was held in Edinburgh, Scotland.
The resulting Edinburgh Declaration on Medical Education opened with the statement:
"Thousands suffer and die every day from diseases which are preventable, curable or self-inflicted and millions have no ready access to health care of any kind. Such facts have produced a mounting concern in medical education about equity in health care, the humane delivery of health services, and the cost to society. (...)
The aim of medical education is to produce doctors who will promote the health of all people - not merely deliver curative service to those who can afford it or those for whom it is readily available.
That aim is not being realized in many places despite the enormous progress that has been made during this century in the biomedical sciences. This problem is not new, but prior efforts to introduce greater social awareness into academic medical schools have not been notably successful... "
(World Conference on Medical Education, Edinburgh, August 1988)
The SIM curriculum forms our response to this challenge. It discusses the context of medical practice in the 21st century:
- It reviews patterns of disease you will encounter in your future practice;
- It introduces public and population health, and outlines the social determinants of illness;
- It discusses Aboriginal and international health issues;
- It outlines the Canadian health care system, and introduces alternative therapies;
- It includes a foundation course in epidemiology and statistical methods; this introduces the theme of critical appraisal of the medical literature and evidence-based medicine;
- It reviews medical ethics and the law.
In brief, it covers all the topics relevant to a physician's career that lie outside the human body.
These topics are covered under the Medical Council of Canada's learning objectives. Note: these topics ARE on the Medical Council's Qualifying Exam (the MCCQE). Furthermore, these topics form part of the requirements for a medical curriculum as specified by the Committee on Accreditation of Canadian Medical Schools. Finally, the Association of Faculties of Medicine of Canada has specified its version of learning objectives for this component of your overall curriculum. We have included these within the SIM curriculum.
SIM runs through the first three (pre-clerkship) years of the curriculum. In years 1 and 2, there is one session each week; often a panel discussion, sometimes a lecture, and sometimes small group workshops or a community visit.
In year 3, SIM occupies six two-hour blocks within the mandatory selective, given four times per year.
While the scope is extremely broad, the topics can be grouped under three main themes. The content for each theme is spread across years 1, 2 and 3.