1 week Ago By Special to National Post
This is an article that I wish was unnecessary to write, but following a thread of misinformed and misrepresented commentary around the launch of Toronto Metropolitan University’s (TMU) School of Medicine, I must. Let’s start with what we know about our health-care system today: millions of Ontarians have no family doctor. For those who do, it often means lengthy travel — 670,000 Ontarians live over 50 kilometres from their primary care office.
The more rural or northern you live, the greater that distance . People from diverse backgrounds and disadvantages suffer greatly because of cultural, financial and social adversities. There is a dire need for committed community-oriented family practice and primary care practitioners who will provide care to underserved patients and communities with culturally respectful medical care.
That is exactly what the TMU School of Medicine has been designed to do. Not only is the TMU School of Medicine the first new medical school in this country in decades, it is also the first dedicated to primary care specialties such as family practice and emergency medicine. Its mission is to graduate highly qualified physicians with the commitment, aptitude and capabilities to be of greatest service to those in greatest need.
To achieve this, the applicants must not only meet academic requirements, but a significant number must reflect the language, cultures, faiths and social and economic circumstances of those they will serve. Yes, TMU is purposefully building a medical school that better supports underserved communities because trying to combat deficiencies and inequities in care — a persistent and formidable challenge — requires intent. To be clear, committing to representation in the medical world does not equal graduating less-skilled physicians.
These are pathways for consideration — to provide opportunity for those who are historically disadvantaged in the application process. They are far from a guaranteed entry to medical school. The existence of equity pathways does not lower academic standards.
TMU’s required GPA is aligned with the cutoffs of many reputable Canadian medical schools and is actually higher than three of Ontario’s six medical schools. Further, GPA makes up only part of an evaluation system that requires students to show they are capable of learning academic content. For the same reason, TMU does not consider MCAT scores, which are remnants of an old system that is ineffective in predicting success or clinical performance.
Today, it is a barrier more than a relevant measure. (Many studies, including this from UCLA, this from Vanderbilt University and this from Göttingen, Germany back up this idea.) In fact, nearly half of Canadian medical schools have abandoned the MCAT, and another two use only a portion of it.
Focusing narrowly on GPA and MCAT in admissions misconstrues what the education of an excellent doctor truly entails. The school encourages and welcomes applications from well-rounded people who have demonstrated academic excellence and have diverse backgrounds and life experiences, and will select only those who are poised to become excellent physicians. In TMU’s first cohort, it is anticipated that over 5,000 students will apply for just 94 spots, an acceptance rate below two per cent.
To help train a medical workforce that serves the needs of society, the initial application process must look beyond grades to attributes such as communication, health and patient advocacy, collaboration and empathy. That is why TMU is emphasizing assessing the character of each applicant — which can be revealed through life experience. After scrutinizing applications, TMU will select qualified and promising applicants to conduct one-on-one interviews so candidates can speak directly about their aptitude and perspectives.
Change can be hard to accept. The chorus of voices impugning TMU’s approach are not new — I remember it from when I joined McMaster’s medical school in 1969. I was drawn to their model of changing how medical students are taught, with an eye to effective patient care.
At that time, detractors complained that people without a science background were being admitted into the school. I was one of them — I had a background in political science and economics. But we did just as well, because during that three-year program and five-year residency, we were rigorously trained, graded and focused on helping people in need.
Our first class at McMaster was as competent and distinguished as any other medical school. I would go on to a successful career as a hematologist. The TMU plan follows the trail blazed long ago by McMaster, with the added consideration of where graduates will hopefully practice medicine.
It has been thoroughly reviewed and approved by multiple bodies, including the Committee on Accreditation of Canadian Medical Schools. It’s unfortunate that public and social discourse, filled with emotional, reactive opinions, have overtaken genuine intent and understanding of the issue and a thoughtful, constructive policy. Education must constantly evolve to remain relevant.
Indeed, the way we teach many disciplines is undergoing necessary change to be more diverse and inclusive. Given the work, planning and rigour that has gone into the design of the TMU School of Medicine, I have full confidence Ontario will be well-served by the excellent results. Special to National Post Dr.
Andrew Padmos graduated from McMaster University Medical School in 1972. He was the CEO of The Royal College of Physicians and Surgeons of Canada, 2006-2021, and the Dean of Record for the TMU School of Medicine, 2021-2023.
