by Daniel McCabe
For the past few years, teachers in the Faculty of Medicine have been quietly at work on a project aimed at profoundly altering the way in which McGill's medical students learn their craft.
Using computers at home or at school, medical students will soon have access to a wide range of tools that will put them more firmly in control of their own education.
McGill has emerged as the country's top school for medical informatics, a new method of teaching that takes advantage of all the possibilities of the evolving electronic technologies to deliver a richer, more detailed training to medical students.
At a press conference last week, Dean of Medicine Abe Fuks announced that this effort is receiving a $3.75 million boost from the Molson Foundation.
So what does medical informatics mean for students? For one thing, heaving truckloads of notes home from class should soon become a thing of the past. Increasingly, notes from medical courses will be available on-line. A pilot program entitled "Molecules, Cells and Tissues" that covers four weeks worth of lectures will be available on-line in February.
Course materials will be increasingly issued on CD-ROMs and on a World Wide Web site with links to other schools' offerings. A student poring over oncology notes will be able to link up to related offerings at Université de Montréal or Johns Hopkins.
Notes Dr. Robert Kearney, chair of biomedical engineering and one of the Faculty's key medical informatics players, "This Faculty doesn't have to be all things to all people. We can trade areas of expertise with other medical schools. If another faculty is particularly good in a certain area, our students can have easy access to that."
In fact, Dr. David Fleiszer, a surgery professor and the Faculty's Assistant Dean of Medical Informatics, is spearheading the creation of a consortium of Canadian medical schools that will share computerized teaching materials-animated sequences, videos, stills and other forms of medical images and data.
Topics such as anatomy will soon be covered with the help of three-dimensional computer graphics-a marked improvement over flat textbook drawings. "When you're dealing with the human body and its various processes, there is so much that just can't be conveyed properly with lectures and illustrations alone," says Fuks.
One model for the future is a Montreal Neurological Institute computerized video that features a 3D image of a human brain. Viewers can make the brain rotate on their screens.
Cadaver dissections, the diagnosis of diseases, surgical procedures-eventually students will be able to tackle these subjects with computer simulations before they have to deal with them in real life.
"These methods will offer students the same sense of realism that pilots using flight simulators experience," says Fuks. "For some procedures, it's easier to try them out the first time on a computer than it is in a clinical situation."
The computers could also take on some of the "grunt work" of professors, suggests Fuks-passing on the detailed information about physiology that every budding doctor needs to master, for instance. Professors would then be freed to play more of a mentoring role with their students. "This should liberate much of their time to try out more creative techniques for teaching," says Fuks.
Medical informatics also neatly dovetails with the recent changes to the Faculty's curriculum, suggests Fuks. Students are now taught in smaller groups and there is a greater emphasis on self-directed learning.
"We don't want our students to be passive recipients of knowledge. We want them to be self-directed learners for their entire careers as physicians, and these techniques will help facilitate that."
With increasing computerization, students will have more power over what they learn and how they learn it. They can build their own multimedia libraries with CD-ROMs and selected "bookmarks" of educational materials offered on McGill Web sites and on sites from other schools.
Patients will also benefit from the University's involvement in medical informatics. Fleiszer, who is coordinator of the Montreal General Hospital's Diagnostic Breast Center, is currently developing an interactive program for patients that will provide information about breast disorders.
"Doctors don't always communicate well with their patients," admits Kearney.
He believes that by putting medical information on-line in an easy-to-digest manner, patients will be able to study their own diseases or ailments and become better informed about what their options are.
While Fuks is clearly enthusiastic about the direction his Faculty is headed, he cautions that the multimedia techniques will be used to bolster rather than replace the teaching methods his professors currently use.
"We're not about to turn our students into nothing more than computer hackers. There are some things, like how to talk to patients, that just can't be taught on a computer."