As it leans into transformational education per its new strategic plan, the University of Ottawa Faculty of Medicine is shaping its medical students to be solutions-focused, socially conscious physicians before they even cross the graduation stage.
Case in point: a new, competition-based assessment, part of the Faculty’s curriculum renewal, requiring students to jump into the roles of various health care stakeholders in an unscripted debate of today’s complex medical challenges.
They’re honing their ability to explore different viewpoints within health care, considering and understanding the perspectives of the various stakeholders. Together, they search for mutually satisfactory solutions to providing comprehensive care, and work collaboratively to achieve them.
The skill will be critical as they become practicing—and practice-changing—physicians in an evolving medical landscape.
Solutions start with medical schools
The lack of primary care is, of course, one such medical challenge in Canada. Medical schools are a logical place to begin addressing the challenge, equipping graduates to be a part of the solution in meeting the critical need for increased accessible, community-based primary care.
Dr. Dominique Elien Massenat, who develops content related to social determinants of health and public health within the Faculty’s undergraduate medical education (UGME) curriculum, says the Faculty of Medicine is stepping up to be part of that solution.
“Our medical school has been very strategic and thoughtful in our recent curriculum renewal,” she says. “Through innovation in our content and teaching methods, our graduates are well positioned to tackle modern health care challenges.”
“Through innovation in our content and teaching methods, our graduates are well positioned to tackle modern health care challenges.”
Dr. Dominique Elien Massenat
— Content developer, MD curriculum
Social accountability integral to medicine
Medical curricula are evolving well beyond simply the foundational science and clinical sciences, now delving more deeply into what’s needed to build an effective health care system.
“There’s a movement to integrate ‘medicine and society’ even more within our clinical curriculum content,” says Dr. Elien Massenat, who develops content specific to UGME’s Medicine and Society (SIM) curriculum in the English stream. “This means course content not related to the human body—covering homelessness, human trafficking, evaluating population health, and countless other topics of current societal relevance.”
Integrating these concepts into the delivery of medical care—part of the Faculty’s social accountability mandate—is a critical piece of the overall primary care puzzle.
“We don't see social accountability as a separate thing within clinical teaching, but rather as integral,” explains Dr. Elien Massenat.
“It’s vital that students, our future doctors, see the patient beyond a clinical diagnosis, to see them as a person with a social context that influences their health,” she says. “That type of information can inform clinical diagnosis and decisions about how to better support their patients, leading to improved outcomes.”
Knowledge into action
Enter the “wicked problem” project competition, developed by Dr. Elien Massenat and colleagues Dr. Laura Muldoon, director of UGME’s medicine and society pillar, and Dr. Sophie De Roock, French stream lead for the MD curriculum’s SIM content.
Integrated into the MD program’s SIM Unit III this past January, the competition asks students to apply their new knowledge in a presentation performed live and unscripted on video, through the lens of a complex medical scenario—or, a “wicked problem.”
“Learning is an active process,” says Dr. Muldoon, explaining that it is critical to incorporate new programming and teaching methods that stimulate heightened intellectual engagement.
“The new assessment format is an opportunity to demonstrate a thorough grasp of SIM-related concepts, important at this stage in their learning, as well as their ability to apply them to real concerns in health care,” she says.
“Learning is an active process. The new course format is an opportunity to demonstrate [students’] ability to apply SIM-related concepts to real concerns in health care.”
Dr. Laura Muldoon
— Director, medicine and society pillar, MD program
Thinking on their feet, students are challenged to consider the health care system broadly, the contributions of other health care disciplines, and how to practice within an interdisciplinary team. They’re also displaying what they have learned thus far about vulnerable populations, their responsibility as physicians, and the context of their patients’ lives.
Their ability to synthesize and apply their knowledge in an off-the-cuff format is assessed by a team of evaluators, all invited for their involvement and expertise in either undergraduate medical education or primary care.
“This method of engaging the students teaches critical thinking and shapes them to be solutions-oriented physicians,” says Dr. De Roock.
The group presentation involves a specific real-life scenario—this spring, a debate at a medical conference—with students playing various roles including health advocates, collaborators, leaders, scholars and other professionals.
“In exploring the gamut of viewpoints, students are building their skill set to clearly communicate a problem and possible solutions, as well as debating those solutions, to the public, their patients and other players in the medical field,” says Dr. De Roock. “Students are encouraged to use what they’ve learned to reflect on their ways of practice with their future patients, and when they will be working within the current health care system, all while highlighting the importance of health equity and social responsibility.”
Students don’t always have this opportunity when studying a cell or a disease, says Dr. De Roock.
“As future medical graduate, they'll be involved in presenting and standing up for their values and contributions—say, at a conference, or on a panel for a community,” she says.
As an added benefit, the live, on-the-fly reasoning enables a true assessment of learners’ competency in applying course content, a shift from students merely writing essays.
Better care in continuity
As an added consideration to this year’s assigned wicked problem, students are challenged to incorporate patient-centred care.
The long-term relationship between carer and patient is a central tenet of family medicine.
“Being patient-centred implies you understand where the patient is coming from, such as their cultural, financial, and social context, which can help you understand underlying factors of the patient’s condition,” explains Dr. Elien Massenat.
“There’s better care in continuity,” she continues. “With episodic care like walk-ins, the patient and physician may not have that pre-existing relationship; information may be lost between doctors and errors made, and patients lose their sense of being followed.”
Transformational education
Next year, the team hopes to introduce a truly live presentation before a panel of experts—to engage the students in live feedback sessions, further their presentation skills, and enhance their ability to promote an idea they support.
The Faculty’s approach to transformational education goes beyond simply acquiring knowledge or skills. It’s changing the way learners think and see the world, inspiring personal growth, critical reflection, and a deeper sense of purpose or responsibility.
“Our new approach to the MD curriculum is developing students’ systems thinking—that is, understanding how components of a system interact to affect the outcome while understanding the role of the primary care physician,” says Dr. Elien Massenat.
“Learners are empowered to become change-makers in their lives, in their professions, and in their communities.”
This year’s winning projects
The 2025 wicked problem project crowned a winning team in each of the French and English streams of the MD program.
Francophone stream:
Réinventer la médecine familiale – Trouver un équilibre entre continuité des soins et accessibilité pour remédier aux inégalités en santé (Reinventing Family Medicine: Finding a Balance Between Continuity of Care and Accessibility to Address Health Inequalities)
Team members: Marguerite Beaudoin, Marie-Pier Dupuis, Heddy Hermes, Marie-Sophie Huard, Sarah Lapolice and Wardat Sehabi
Summary: With longer waiting lists and increasing pressure on medical clinics, Réinventer la médecine familiale proposes a clear response: modernizing our primary care model without abandoning the basic principles of family medicine. Rather than going back to episodic care, the project calls for a three-part practical strategy: strengthening interprofessional teams, integrating artificial intelligence to reduce the administrative workload and adapting care to local realities. By making continuity, quality and the human connection central to care, we can truly respond to health-care inequalities.
Anglophone stream:
Preserving Principles or Meeting Demand? Rethinking Family Medicine Amid Canada’s Primary Care Crisis.
Team members: Jessica Brown, Riley Cousins, Theo Liu, Hala Mahdi, Ervis Musa and Aleeza Qayyum
Summary: With millions of Canadians lacking access to a family doctor, the health care system is under pressure to shift toward episodic, walk-in-style care, threatening the core principles of family medicine: continuity, comprehensiveness, and long-term relationships. We argued for preserving the foundational values of family medicine through two key interventions: 1) assigning patients to local physicians by region to ensure universal access and reduce inequities, and 2) expanding direct-entry family medicine programs at existing medical schools, paired with a commitment to serve in the region where training is received.