Educating medical students about musculoskeletal problems - Are community needs reflected in the curricula of Canadian medical schools?

Background: Musculoskeletal problems are a common reason why patients prese nt for medical treatment. The purpose of the present study was to review th e curricula of Canadian medical schools to determine whether they prepare t heir students for the demands of practice with respect to musculoskeletal p roblems. Methods: The amount of time spent on musculoskeletal education at each of C anada's medical schools was reviewed by surveying the directors (or equival ents) of all sixteen undergraduate musculoskeletal programs. With use of da ta from this survey and the Association of American Medical Colleges' guide to curricula, the percentage of the total curriculum devoted to musculoske letal education was determined. The prevalence of disorders related to the musculoskeletal system among patients of primary care physicians was determ ined on an international basis by reviewing the literature and on a local b asis by surveying all primary care physicians affiliated with the Universit y of British Columbia's Department of Family Medicine. Results: The curriculum analysis revealed that, on the average, medical sch ools in Canada devoted 2.26% (range, 0.61% to 4.81%) of their curriculum ti me to musculoskeletal education. The questionnaires completed by the direct ors of the undergraduate programs indicated widespread dissatisfaction with the musculoskeletal education process and, specifically, with the amount o f time devoted to musculoskeletal education. Our literature review and surv ey of local family physicians revealed that between 13.7% and 27.8% of Nort h American patients presenting to a primary care physician have a chief sym ptom that is directly related to the musculoskeletal system. Conclusion: There is a marked discrepancy between the musculoskeletal knowl edge and skill requirements of a primary care physician and the time devote d to musculoskeletal education in Canadian medical schools.