EDUCATION AND TRAINING JAGS 51:544–548, 2003 © 2003 by the American Geriatrics Society 0002-8614/03/$15.00 Early Clinical Exposure to Geriatric Medicine in Second-Year Medical School Students—The McGill Experience Gustavo Duque, MD, Susan Gold, MD, and Howard Bergman, MD This study examined the effect of a curriculum change on early clinical exposure to geriatrics for second-year medi- cal students at McGill University and its effects on learn- ing and students’ appreciation of geriatrics as a subspe- cialty. Second-year medical students (N = 200) were exposed to a change in the curriculum involving the inte- gration of 10 weekly sessions into one integrated week in geriatric medicine. Students participating in 10 weekly ses- sions were Group 1 and students participating in one inte- grated week were Group 2. Students rated their rotation using two different scales. The students completed 12-item questionnaires during their feedback sessions at the end of the 10-week session experience or the integrated week. The first six items assessed the students’ appreciation of their improvement of knowledge in the subject of geriat- rics and aging. The second and third part of the survey (questions 7 and 8) included the students’ opinions about the quality of the instruction (teaching feedback) and eval- uation. Students in Group 2 found their rotation more ef- fective as a learning experience and expressed greater sat- isfaction with interaction with the tutors, community settings, and multidisciplinary team sessions. Grades ob- tained on final examinations showed a better and more- effective acquisition of knowledge by Group 2. The inte- grated week is a more-effective learning tool in the early clinical experience for medical students in geriatric medi- cine than 10 weekly sessions as the first introductory expe- rience to the field of geriatric medicine. J Am Geriatr Soc 51:544–548, 2003. he number of universities that include geriatric medi- cine (GM) in their curriculum has increased dramati- cally in recent years, 1 but the curriculum varies among uni- versities as does the time assigned in the curriculum to GM. There are different ways to introduce GM into the medical curriculum. A typical model introduces predefined topics each year of medical school. The first year might emphasize socioeconomic, psychological, biomedical and attitudinal issues or consist of a basic sciences introduc- tory course on aging. The second year experience serves as an introduction to clinical GM. 1 Third- and fourth-year clerkships help the students develop their fund of knowl- edge, improve their clinical skills, and generate an inte- grated and multidisciplinary care plan for their patients. There is evidence showing the effectiveness of this model of teaching in the acquisition of knowledge and skills in GM at medical schools. First-year medical stu- dents introduced to aging and GM have shown moderate to good achievement of the written objectives 2 and higher satisfaction with medical education. 3 An early clinical ex- perience that permits integration of basic and clinical sci- ences and basics of geriatric assessment has resulted in sig- nificantly improved clinical skills in subsequent clerkships, 4 with a high level of acceptance. This was considered a valuable learning experience and was successful in chang- ing some attitudes. 5 Finally, there is evidence showing that introduction of a clinical clerkship in GM is effective as a learning experi- ence. Seventy percent of medical students found the rota- tion to be educationally valuable, and a significant in- crease in knowledge was demonstrated. 6,7 At McGill University, several changes have been made in recent years. Until 1999, medical students’ experience in GM consisted of half a day per week for 10 weeks during their second year of medical school in a module called In- troduction to Clinical Medicine (ICM). During that half- day morning session, the students were taught the theoreti- cal basis of the major geriatric syndromes followed by a bedside teaching experience with emphasis on patient as- sessment and pathophysiology. Finally, during the last ses- sion after the 10th week, the students had a feedback session and evaluation. After 1999, this was changed to 1 integrated week in GM. The week consisted of one introductory half day with two lectures: one on basic sciences of aging and the second on patient assessment using videos and open dis- cussion as methodology. The students were then assigned to one of four hospitals at which they spent the rest of the week. Every morning, there was a small group teaching session in one of the four major geriatric syndromes (in- continence, cognitive disorders, falls, and medications) fol- lowed by bedside teaching on the acute geriatric ward. From the Division of Geriatric Medicine-McGill University, Montreal, Quebec, Canada. Address correspondence to Gustavo Duque, MD, Division of Geriatric Medicine, McGill University, 3755 Côte Sainte Catherine, Montreal, Quebec, Canada, H3T 1E2. E-mail: gduque@po-box.mcgill.ca T