Have you heard of the national campaign Choosing Wisely Canada? The goal of this campaign is to increase awareness of health professionals about the importance of making judicious and appropriate choices in medical testing and prescribing. The campaign has created the opportunity for conversation between national associations of specialists, medical faculties, health professionals, patients and the Canadian population at large.
The need for this campaign stems from the increasing number of possible tests, treatments and procedures that are available. Unfortunately, it is often easier and faster for a physician to order a certain test or prescribe a certain treatment rather than explain to the patient why it would be better to do nothing. Not only do unnecessary tests and treatments not improve health care quality, but they can actually be detrimental to our patients. Overprescription of antibiotics that increase resistance or exposure to radiation for unnecessary imaging are just a few examples.
Did you know that this campaign is also aimed at clinical clerks and medical students? In November 2015, Choosing Wisely organized a Leadership Summit where two medical students from each of Canada’s 17 medical schools participated. The STARS (Students and Trainees Advocating for Resource Stewardship) program was created as a result. The goal of STARS is for the students to launch local campaigns to increase awareness among medical students about Choosing Wisely and to include students in this conversation.
Students from across Canada created a list of “Six Things Medical Students and Trainees Should Question.” Among these is notably “Don’t suggest ordering tests or performing procedures for the sole purpose of gaining personal clinical experience.” From the start of clerkship we suggest investigations and treatments. This Choosing Wisely principle reminds us to think about the relevance of each test or procedure for each particular patient that we encounter. As preclinical students, we can already engage our teachers in a discussion of the indications, cost, advantages and disadvantages for each test and treatment presented in our lectures.
Not only do students have a role to play in the Choosing Wisely campaign, but the information in the campaign is very useful for our medical education and training. For example, there are free information packages available online on many of the hot topic clinical principles that students are often questioned (aka “pimped”) about during their clinical rotations. You’ll find articles (under the section “The Lists”) about many topics including the appropriate use of benzodiazepines in the elderly (see “Geriatrics”) and the indications for packed red blood cell transfusions (see “Hematology”).
Choosing Wisely is not only geared to physicians and medical students, but also to the patient who has an important and central role in their health. The campaign “More is not always better” was created specifically to address these issues with our patients. Patient pamphlets are available for many different frequently prescribed tests and treatments. Don’t forget to share this information with your patients during your clinical rotations. You will help your patients, and your supervisors will be impressed!
Moreover, the Collège québécois des médecins de famille (CQMF), in collaboration with the Quebec Medical Association and the College of Family Physicians of Ontario, will offer a new continuing medical education program, “Practising Wisely.” These sessions will be directly aligned with the principles of Choosing Wisely, in order to implement better management of health care and counter the effects of overdiagnosis and over-medicalization. More information to come.
To learn more about the STARS program or to connect with STARS students at your medical school: STARS@choosingwiselycanada.org.
For all questions or to participate in the Choosing Wisely campaign: firstname.lastname@example.org.
For more information including “The Lists” and the “Six things medical students and trainees should question”: http://www.choosingwiselycanada.org/recommendations/medical-students-and-trainees/.
Fourth Year Student at the Montréal campus of Université de Montréal
Member of CQMF’s Comité de la relève
Fourth Year Student at McGill University
Member of CQMF’s Comité de la relève
The Comité de la relève takes this opportunity to invite you to participate in CQMF’s Assemblée scientifique annuelle (ASA) on May 25 and 26, 2017 at the Palais des congrès de Montréal. Medical students and clinical clerks are welcome at this conference and can attend many relevant talks. It is also a great opportunity for networking with family physicians from across Quebec. You can also apply to present a poster on primary care research or a related field. Please note that all conferences and talks are given in French but questions in English are welcomed.