1. Fishing for a Longitudinal Integrated Clerkship at McMaster Jonel Miklea, MD CCFP Asst Prof, Undergraduate Program Director Dept of Family Medicine McMaster University Hamilton, ON, Canada

3. Ice Fishing Locations Shelters Fishing equipment Modern ice fishing
Dangers
Contests
Current Fishing Conditions
References
Ice fishing is the activity of catching fish with lines and fish hooks or spears through an opening in the ice on a frozen body of water. Ice anglers may sit on the stool in the open on a frozen lake, or in a heated cabin on the ice, some with bunks and amenities.

4. My god son and I fishing at lake Simcoe, Ontario in February 2009

5. Location Canada Finland Estonia Latvia Norway Russia Sweden Ukraine
Germany
USA
Flinders
Minnesota
USF
Harvard
UBC
Calgary
Edmonton
NOSM
…and soon McMaster
Of note is that Minnesota has both Ice fishing and LIC

7. Shelters
Shelter = ice shanty, ice shack, fish house, bobhouse, or ice hut.
LIC will be sheltered in our 2 distant campuses; Niagara campus and Kitchener/Waterloo
These are dragged or trailered onto the lake using a vehicle such as a snowmobile, ATV or truck

9. Fishing Equipment Ice saw Skimmer Heater Fishing rod Lures
Buy in from faculty, deans and community
Interest among students
Budget
Skimmer - remove new ice as it forms

11. Modern Ice Fishing Power drills Flashers (sonar) Snowmobiles Evidence:
students perform as well or better than colleagues in traditional clerkship programs
graduates overwhelmingly choose primary care specialties
in rurally based programs, at least 50% of grads choose rural practice locations
Power drills
Flashers (sonar)
Snowmobiles
The name of the game is mobility, for today’s modern ice fishermen
Sonar = provides depth information, indicates presence of fish, displays movement of fish
There is plenty of evidence for modern day LIC:

13. Dangers Walking - 10cm (6cm)
Sleds, Snowmobiles - 12cm
Light cars - 25cm
Frostbites, CO poisoning from fish-house heaters
Student’s anxiety re exam performance, Exam structure
Administration - central
Equitable experiences
Program evaluation
Some people take the risk and walk on only
Accreditation

15. Contests
Catching a big fish, no matter what the species, is always a thrill, and it usually requires exceptional fishing skill.
Improved resiliency
Comfort with uncertainty
Patient-centred care
As you may know…There are numerous Ice Fishing Contests throughout the world. There seem to be almost a contest going in between traditional and LIC students but the students going through LIC show

16. Current fishing conditions
At McMaster

17. COMPASS Concept-oriented Multidisciplinary Problem-based
Practice for transfer
Simulations in clerkship
Streaming
With the beginning of the new millenium, McMaster MD program has developed further its MD school curriculum, with COMPASS, which stands for concept-oriented, multidisciplinary, problem based, practice for transfer, simulations in clerkship, streaming…
That’s a mouth full!

18. Pre-Clerkship FM Experience
STUDENTS: Mandatory 6 week at the beginning of Med School or optional 12 weeks
FACULTY: teaching Clinical Skills, Precepting 6 week Mandatory FM, strong presence in Professional Competencies
Family Medicine faculty have a very strong presence within the medical school at every level from teaching clinical skills to teaching ProComp.

20. Professional Competencies Domains
Effective Communication
Professionalism and Role Recognition
Self Awareness and Self Care
Lifelong Learning
Social and Community Context of Health Care
Moral Reasoning and Ethical Judgment
Clinical Examination
More than 50% faculty teaching ProComp are GPs. This is a 16month, half a day per week,mandatory longitudinal experience for McMaster medical students.

21. Family Medicine Clerkship
FM Clerkship = 6 week rotation
6-7 half days/week with FM clinical preceptor integrated with other teaching activities
Total # students 182: Local 108 & Rural 76
1 tutorial per week
Daily evaluations & Key Feature Exam
2011 class = 182 students, 20 based in KW and 15 based in Niagara Campus

23. Integration 4 half days of Palliative Care 3 half days of Early years
2 half days of Global Health
1 half day of Care of the Elderly
2 half days FM Selective
2 half days of Complementary/Alternative Medicine

24. Our Success 50% of our students choose FM as a career choice
National average 32.5%

25. LIC Pilot at Mac November 2011
distant campuses Niagara and Kitchener Waterloo
8 mo in FM, 1.5 month ward based Peds, 1.5 month ward based IM and 2 month elective
More to share at the 2010 Global Community Engaged Medical Education Conference, Barossa Valley
4-5 half days/wk of FM, half day Obs/Gyne, half day Surg, half day Allied health, 2 half day Academic, 1 day perweek & 1 w/e permonth ER

26. References Fishing: LIC literature:
Gruenwald, Tom and Genz, Dave (1999) Modern Methods of Ice Fishing
LIC literature:
Paul Worley
Gwen Halaas
Lucie Walters
Molly Cook

27. Conclusions
If students have their clinical training mainly in hospitals, especially tertiary care hospitals, they will get the message: ‘this is what disease is and this method for investigating it, is the method of medicine.’ If they never care for a patient at home, the message will be ‘the home is no place for a physician.’ If they are taught mainly by specialists, they will get the message: ‘this is where authority, prestige, and power lie.’
Ian McWhinney
Many men go fishing all of their lives without knowing that it is not fish they are after.
Henry David Thoreau

37. Thank You!