EDUCATING FUTURE PHYSICIANS FOR ONTARIO

In 1987, Ontario's physicians conducted a strike, ultimately not succe ssful, over the issue of ''extra billing.'' The fact that the Ontario public did not support this action reflected a major gap between the p rofession's view of itself and the public's view of the profession. In 1990, the province's five medical schools launched a collaborative pr oject to determine more specifically what the people of Ontario expect of their physicians, and how the programs that prepare future physici ans should be changed in response. The authors report on the first fiv e years of that ongoing project. Consumer groups were asked to state t heir views concerning the current roles of physicians, future trends t hat would affect these roles, changes in roles they wished to see, and suggestions for changes in medical education. Methods used included f ocus groups, key informant interviews, an extensive literature review, and surveys, including a survey of health professionals. Concurrently , interuniversity working groups prepared tools and strategies for str engthening faculty development, assessing student performance, and pre paring future leadership for Ontario's medical education system. Eight specific physician roles were identified: medical expert, communicato r, collaborator, health advocate, learner, manager (''gatekeeper''), s cholar, and ''physician as person.'' Educational strategies to help me dical students learn to assume these eight roles were then incorporate d into the curricula of the five participating medical schools. The au thors conclude that the project shows that it is feasible to learn spe cifically what society expects of its physicians, to integrate this kn owledge into the process of medical education reform, and to implement major curriculum changes through a collaborative, multi-institutional consortium within a single geopolitical jurisdiction.