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University of Calgary marks 25 years of medical training.

The University of Calgary Faculty of Medicine celebrates 25 years of innovative medical training in October. Its 3-year degree program has produced more than 1450 physicians since the first students entered the medical school in 1970. A reunion for former staff and students is planned for Oct. 12-14.

Alberta↗

The Medical Skills Centre at the University of Calgary Medical School.

The aim of the Medical Skills Centre at the University of Calgary is to provide a predictable learning environment and standardized teaching methods in the area of clinical skills teaching. The centre uses volunteer patients and trained actors for all levels of medical education and evaluation. A computer database enables easy access to groups of patients and varying medical issues. This article describes the organization and operation of the Medical Skills Centre and notes a variety of courses which use the unique facilities of the centre.

Academic Medical Centers↗

Cardiovascular medicine at the University of Calgary: a vignette of recent history.

On September 14 and 15, 1989, a symposium entitled 'Surgical and nonsurgical management of cardiovascular disease' jointly sponsored by the University of Calgary and Foothills Hospital was held to help mark the one year anniversary of an expansion of percutaneous transluminal coronary angioplasty and cardiac surgery services in Calgary to include an academically oriented program at the Foothills Hospital. This program complements and adds to the clinical program which has been active for many years at Calgary's Holy Cross Hospital. This occasion is an opportunity to review the remarkable progress and development over the past 20 years of cardiovascular medicine at the university and in the city of Calgary.

Alberta↗

Developing a "clinical presentation" curriculum at the University of Calgary.

Currently, medical curricula are structured according to disciplines, body systems, or clinical problems. Beginning in 1988, the faculty of the University of Calgary Faculty of Medicine (U of C) carefully evaluated the advantages and disadvantages of each of these models in seeking to revise their school's curriculum. However, all three models fell short of a curricular structure based on current knowledge and principles of adult learning, clinical problem solving, community demands, and curriculum management. By 1991, the U of C had formulated a strategic plan for a revised curriculum structure based on the way patients present to physicians, and implementation of this plan has begun. In creating the new curriculum, 120 clinical presentations (e.g., "loss of consciousness/syncope") were defined and each was assigned to an individual or small group of faculty for development based on faculty expertise and interest. Terminal objectives (i.e., "what to do") were defined for each presentation to describe the appropriate clinical behaviors of a graduating physician. Experts developed schemes that outlined how they differentiated one cause (i.e., disease category) from another. The underlying enabling objectives (i.e., knowledge, skills, and attitudes) for reaching the terminal objectives for each clinical presentation were assigned as departmental responsibilities. A new administrative structure evolved in which there is a partnership between a centralized multidisciplinary curriculum committee and the departments. This new competency-based, clinical presentation curriculum is expected to significantly enhance students' development of clinical problem-solving skills and affirms the premise that prudent, continuous updating is essential for improving the quality of medical education.

Alberta↗

Gender, family status, and career patterns of graduates of the University of Calgary Faculty of Medicine.

In 1986 the authors sent a questionnaire to 745 physicians who had graduated between 1973 and 1985 from The University of Calgary Faculty of Medicine. The survey obtained information on the graduates' status as parents, the "breaks" they had taken from their practices, and the hours per week they devoted to direct patient care, in order to observe what relationship the graduates' gender and status as parents had on the other variables. The women were far more likely to have taken breaks for parental leave, but the differences in the frequencies of breaks taken by the men and the women for other reasons were less striking. The women were working fewer hours in direct patient-care settings, and those women who were parents and under 35 years old spent fewer hours on patient care than did the men (from all age groups) who were parents. The authors discuss their findings in terms of the impacts of age and cohort effects and the possible lessening of gender-based differences in present-day physicians' practices.

Age Factors↗

Development and evaluation of a Research Project Program for medical students at the University of Calgary Faculty of Medicine.

This essay outlines the development and evaluation of the Research Project Program (RPP) ten years after its introduction into the medical curriculum at the University of Calgary. The RPP consists of two mandatory for-credit courses. Students have the option of conducting either two smaller independent research projects or one larger project over the two years. At the end of the second-year course the students complete an evaluation of the RPP in which they are asked to assess and comment upon various aspects of the program. The authors compared data available from years one (the class of 1990) and ten (the class of 2000) and found significant differences between the two classes' approaches to the RPP. Most of the class of 2000 (89%) carried out two-year independent in-depth research projects spanning a wide range of topics. Half of these projects involved individual collection and analyses of data using experimental methods; this represented a 2.25-fold increase over the first year of the program. In the class of 2000, 44% of students presented their results at a newly implemented research symposium; an additional 22% of students presented their results at local, national, or international meetings. Further, 59% of the class of 2000 had either submitted or were planning to submit their research for peer-reviewed publication. In contrast, none of the students of the class of 1990 formally presented their research, and only 11% planned to submit their research findings for publication. The RPP has evolved in the ten years since its implementation, but the authors believe the program continues to foster independent learning and analytic and problem-solving skills.

Alberta↗

Peptides in the gastrointestinal tract in human immunodeficiency virus infection. The GI/HIV Study Group of the University of Calgary.

The presence of immunoreactivity to the neuronal phosphoprotein B-50 and the peptides bombesin, calcitonin gene-related peptide, galanin, neurotensin, neuropeptide Y, somatostatin, substance P, and vasoactive intestinal polypeptide was examined in biopsy specimens from the duodenum and rectum of human immunodeficiency virus (HIV)-seropositive and HIV-seronegative male homosexual patients. The distribution of B-50 and the peptides was correlated with HIV serology, number of CD4+ lymphocytes, and the presence of HIV in biopsy culture. There was a very low incidence of enteric pathogens in both groups of patients. It was found that HIV-seropositive patients had a greater incidence of abnormal patterns of immunoreactivity (reduced intensity and/or density of innervation) in enteric nerves and enteroendocrine cells than HIV-seronegative patients. A reduction of substance P immunoreactivity was significantly correlated with reduced CD4+ lymphocyte count and HIV status; a similar trend was also seen for somatostatin and vasoactive intestinal polypeptide. Using B-50 as a marker, it was found that both groups of patients had altered patterns of immunoreactivity in rectal nerves. The findings of this study suggest that some of the clinical symptoms associated with HIV infection may be caused by a specific HIV enteropathy that influences enteric nerve and/or enteroendocrine cell function by altering the density of peptide immunoreactivity.

Adult↗

Gastrointestinal tissue cultures for HIV in HIV-infected/AIDS patients. The University of Calgary Gastrointestinal/HIV Study Group.

OBJECTIVE: To determine the prevalence of HIV in endoscopic biopsies from the esophagus, stomach, duodenum, and rectum of homosexual and bisexual men at various stages of HIV infection as part of a comprehensive study of gastrointestinal dysfunction in HIV infection. METHODS: After repeated washings and mechanical disruption, biopsies obtained from 58 volunteers were individually cocultured with pooled peripheral blood lymphocytes from healthy HIV-seronegative blood donors. RESULTS: HIV was isolated from at least one site in 40 out of 49 patients. Esophageal biopsies were most frequently found positive (46%), followed by duodenal biopsies (44%), rectal biopsies (43%), and gastric biopsies (27%). Recovery of HIV was not related to any gastrointestinal signs or symptoms. HIV was recovered in the biopsies both from asymptomatic patients with CD4 lymphocyte counts greater than 500 x 10(6)/l and also from patients with more advanced disease receiving zidovudine therapy. CONCLUSIONS: The entire gastrointestinal tract appears to be a target site throughout the course of HIV infection in homosexual and bisexual men.

Acquired Immunodeficiency Syndrome↗

Training for rural family medicine: a cooperative venture of government, university, and community in Alberta.

Training, recruiting, and retaining family physicians in rural areas are issues that have attracted the attention of governments, university training programs, medical governing bodies, and rural communities. In this article, the authors describe a cooperative venture between government, university, and community in the province of Alberta to train medical students and residents in rural areas. The Rural Physician Action Plan (RPAP) was developed in the early 1990s to improve the recruitment and retention of physicians in rural areas. The RPAP is coordinated by a committee composed of representatives of the Alberta government, the Alberta Medical Association, the College of Physicians and Surgeons of Alberta, and the faculties of Medicine at the University of Alberta and the University of Calgary. Residents in the University of Alberta Department of Family Medicine are required to do 20 weeks of blocktime training in a community practice, and under the auspices of the RPAP rural training sites were identified and rural rotations developed. Faculty development activities were developed for the community physicians who would host the residents. The RPAP funds 24 third-year residency positions, equally divided between the University of Calgary and the University of Alberta. Beginning in 1994, undergraduate medical students at the University of Alberta were required to complete a four-week family medicine rotation, with a majority of students being posted to rural training sites. The extent to which the RPAP has helped to recruit and retain physicians in rural areas is not clear. The provincial Ministry of Health evaluated the RPAP in 1995 and concluded that, at a minimum, without the RPAP the province would have suffered a net loss of rural physicians. The communities have been very accepting and supportive of the students and residents.

Alberta↗

Analysis of stress levels among medical students, residents, and graduate students at four Canadian schools of medicine.

PURPOSE: To assess stress in medical students, residents, and graduate science students at four Canadian schools of medicine. METHOD: Four schools with different curricula in three different parts of Canada participated in the study: the University of Calgary Faculty of Medicine, the University of Alberta Faculty of Medicine, the Dalhousie University Faculty of Medicine, and the McMaster University Faculty of Health Sciences. All the medical students, residents, and graduate science students at each school were surveyed in 1994-95. The three instruments used were the University of Calgary Stress Questionnaire, the Social Readjustment Rating Scale (SRRS), and the Symptom Checklist-90. Demographic data were compared across all four schools. Analysis of variance was calculated for all test-item scores, utilizing a four (school) by three (program) by two (gender) design, which were all between subject factors. Significant main effects were followed up by using planned comparisons (Newman-Keuls, with a probability level of p < .05). Significant interaction effects were followed up by using an analysis of simple effects. RESULTS: A total of 1,681 questionnaires were returned as follows: 621 of 1,304 (48%) from the medical students, 645 of 1,495 (43%) from the residents, and 415 of 829 (50%) from the graduate science students. There were significant differences between the three groups in the natures and degrees of stress, with the graduate students reporting higher levels of stress. There were significant gender differences as well, with the women reporting higher levels of stress. Overall, stress levels were found to be mild, based on the University of Calgary Stress Questionnaire and the SRRS. CONCLUSION: This study suggests that medical students and residents experience stress at levels that appear acceptable, but ongoing monitoring and the provision of appropriate support systems will continue to be important.

Adaptation, Psychological↗

International symposium on nitric oxide, cytokines and inflammation.

This meeting was presented by the Fundacao Oswaldo Cruz in conjunction with the University of Calgary and the University of California Los Angeles. The conference focused on novel aspects of the contribution of nitric oxide and cytokines to inflammatory processes, particularly the resolution of inflammation. Sessions featured lectures and symposia by many of the world's leading authorities on the basic science and pharmacology of inflammation, as well as lively, high-standard poster presentations by international scientists, including many young Brazilian researchers. One of the main topics was elucidation of the basic mechanisms and roles of cytokines in inflammation. Moreover, the therapeutic potential of new chemical entities (some derived from snake venoms) and drug targets was highlighted in symposia devoted to the resolution of inflammation, airway inflammation, protease-activated receptors and annexin-1. This report concentrates on potential novel therapeutic agents and targets in this complex and ever-evolving field, although many interesting presentations raised the possibility of new applications for drugs already in the therapeutic arena.

Animals↗