Electives

1.1. To state elective expectations regarding approved sites, duration, Clerk assessment forms and elective evaluations, the appropriate procedure for elective approval and change/cancellation requests, immunization requirements, as well as malpractice and personal insurance.

1.2. To outline the importance of additional electives with the understanding that Clerks need vacation time to support their mental, physical, and spiritual wellness.

1.3. To ensure compliance with Accreditation Standards:

ELECTIVE OPPORTUNITIES

The faculty of a medical school ensures that the medical curriculum includes elective opportunities that supplement required learning experiences, permit medical students to gain exposure to and deepen their understanding of medical specialties and pursue their individual academic interests.

• Standard 6.5a: There are opportunities for elective experiences in the medical curriculum particularly in the later years of the educational program that permit medical Clerks to gain exposure to and deepen their understanding of medical specialties reflecting their career interests and to purse their individual academic interests.
• Standard 6.5b: The medical school has policies or practices that encourage medical Clerks to use electives to pursue a broad range of interests in addition to their chosen specialty.

UGME: Undergraduate Medical Education.

CACMS: The Committee on Accreditation of Canadian Medical Schools (CACMS) was founded to act as the reliable authority for the accreditation of programs of medical education leading to the MD degree in Canada. The CACMS accredits complete and independent medical schools whose students are geographically located in Canada for their education, and which are offered by universities that are chartered and operated in Canada. (Reference

Summative assessment: The quantitative assessment used to measure students’ understanding and theoretical application skills after a predetermined period of instruction of a section, chapter, unit, module, or course.

Formative assessment: The assessment used formally and informally to monitor as well as support students’ learning progress during instruction of a course/rotation. It typically involves qualitative or narrative feedback (rather than quantitative scores) to focus on specific content details and aspects of performance.

CaRMS: Canadian Resident Matching Service.

AFMC: Association of Faculties of Medicine of Canada.

EPAs: Entrustable Professional Activities.

Preceptor: Experienced health professional with a faculty appointment.

This policy applies to U of S College of Medicine undergraduate students in their Clerkship years.

Clerks are responsible for arranging their electives. Electives may be completed at:

• University of Saskatchewan (home electives)
• Any accredited Canadian medical school
• Approved international sites.
• Other sites as approved by the UGME Year Chair.

Electives must be completed within the designated elective blocks. Electives scheduled outside of these blocks will be not approved.

Clerks will not be granted credit for an elective supervised by a member of their immediate or extended family, as well as anyone with whom they have a personal relationship or have another conflict of interest. Additionally, Clerks will not be granted credit for an elective with any physician providing care to them, or physicians with the Office of Student Affairs. https://medicine.usask.ca/policies/conflict-of-interest.php

Clerks are strongly encouraged to meet with a Career Advisor from the Office of Career Advising & Mentorship (OCA&M) prior to their electives application to develop a personalized learning plan for their elective year. Appointments can be scheduled here. Clerks can contact OCA&M (med.careeradvising@usask.ca) for questions about electives as they relate to their career planning.

All home electives must be scheduled through the U of S Electives Office. Electives cannot be scheduled directly with an individual preceptor or site as this impedes departmental scheduling and coordination of Clerks. Clerks looking for a certain experience must include this request in their elective form or speak with the Department Coordinator. Clerks must ensure pertinent information regarding each elective is current and accurate in One45. The Clerk is responsible for ensuring an Elective Assessment form is completed by the preceptor and submitted on One45 within 4 weeks of the elective end date. If no assessment is completed, then it will be considered a failed elective and no credit will be granted. The Clerk is responsible for completing the appropriate elective evaluation within 4 weeks of the elective end date and submitting it on One45.

An elective must be passed to receive credit. If a student fails an elective for whatever reason, they may be required to remediate, even if they have met the minimum requirement. Most electives are a minimum of 2-weeks in duration. Electives start on Monday (Tuesday in the case of statutory holidays) and end on Sunday (except for the elective week before CaRMS interviews which ends on Friday). Students must request the last Saturday/Sunday off at the start of an elective if travel time is required for the next elective.

5.1 Electives in Saskatchewan – Home Electives

Clerks must apply through SharePoint for all home electives. Application periods open 22 weeks in advance and remain open until 6 weeks before the start date. The application window will open on the Sunday at 7PM (Saskatchewan Time).

Elective SharePoint Site: here. 

Select “New Elective Request” to create an application. Please add the following information:

• Name
• Start date (must be a Monday); End date (must be a Sunday)
• Comments regarding how you want your application processed or preceptor preference. Please note that Clerks can request a preceptor, but it is not guaranteed that you will be scheduled with that physician.
• Top 3 specialty preferences, including location.

Select “SAVE” to submit your application.

Student Status:

• Pending (application has been submitted to Elective Coordinator)
• Accept elective offer
• Decline elective offer
• Cancel application

Clerks must apply at least 6-weeks prior to the start date. Clerks can only have 1 active home elective application for a given period. Please cancel the original application, by selecting “Cancel Application” under the “Student Status” section of the application form, before submitting a new application on SharePoint.

If an elective opportunity is extended, the Clerk will have 7 days to accept or decline the opportunity. Once the elective is accepted, it will be considered finalized, and the information will be added to One45. If an elective offer is declined this cancels your entire application, and no further electives on that application will be considered.

The Clerk is responsible for ensuring an Elective Assessment form is completed by the preceptor(s) and submitted on One45 within 4 weeks of the elective end date. If no assessment is completed, then it will be considered a failed elective and no credit will be granted. The Clerk is responsible for completing the appropriate elective evaluation within 4 weeks of the elective end date and submitting it on One45.

Please note, if you are completing an elective in Saskatoon or Regina, outside of your home site, please let the Clerkship Coordinator for that site know a few weeks in advance so they can set up SCM access.

 

5.2 Visiting Electives

5.2.1 12-2 Policy

• 12-week cap for visiting electives (Year 3 and Year 4 combined)
• Each elective must be a minimum of 2-weeks

Please note, international electives are included in the 12-2 policy.

 

5.2.2 Electives in Other Canadian Provinces

Clerks will apply for out-of-province electives on the AFMC Portal 2.0

(https://afmcstudentportal.ca/). Portal accounts will be created for all eligible students and Clerks will receive an account activation email from “InPlace Network”. Once the account has been activated, Clerks must complete the student profile with their personal and academic information and upload all required documents. All medical schools across Canada will use a capacity-based model to schedule visiting electives on the AFMC Portal. The application timelines will open 12 weeks in advance and applications will be processed through a lottery system.

Clerks are not required to provide the UGME office with confirmation of an out-of-province elective scheduled through the AFMC Portal. The elective information will be collected by the UGME office from the AFMC Portal and added to One45. The Clerk is responsible for ensuring that the information is correct on One45. If an elective is incorrect or missing, please contact ugme.electives@usask.ca. Clerks are required to complete an External Electives Check-in Form in their One45 To Dos for all out-of-province electives.

The Clerk is responsible for ensuring an Elective Assessment form is completed by the preceptor(s). Clerks must first set up a temporary account for external assessors by submitting a ticket https://teamdynamix.usask.ca/TDClient/33/Portal/KB/ArticleDet?ID=115d. Once the temporary account has been set up, the Clerk can then distribute the assessment to the preceptor(s) from their One45 To Dos. Clerks will be notified within 2 weeks of the end date of the elective if an Elective Assessment form has not been received. It is their responsibility to ensure the assessment has been completed within 4 weeks of the elective end date. If no assessment is completed, then it will be considered a failed elective and no credit will be granted. The Clerk is responsible for completing the appropriate elective evaluation within 4 weeks of the elective end date and submitting it on One45.

5.2.3 International Electives

Clerks are responsible for coordinating their own international elective. There are no set requirements on the location of the elective, but it must have oversight with an MD. The University of Saskatchewan has reciprocal agreements with the Royal College of Surgeons in Ireland (RCSI) and the Ludwig-Maximilian University (LMU) of Munich.

The minimum elective duration is 2 weeks with a maximum of 8 weeks. Clerks must submit the international electives application form to the Year Chair for approval at least 6 months before the start date of the proposed elective. The application can be found on the SharePoint site. A closer application time may be considered if the DSA pre-departure orientation from the Division of Social Accountability has already been completed; however, a minimum of 2 months prior to the start date of the elective is required. Clerks must meet with the Global Health Manager, Division of Social Accountability and participate in the DSA pre-departure orientation course, if they have not already done so. Participation is tracked. Please note that if the pre-departure orientation from the Division of Social Accountability has not been completed, this must be completed prior to the elective being approved.

Clerks must register with the International Student and Study Abroad Center (ISSAC). ISSAC requires all students to complete the Travel Safety Plan as well as provide emergency contact information and confirmation of insurance. If the elective is deemed to be in a high-risk area as per ISSAC criteria, the Year Chair (or designate) will be notified and the elective will be denied. Appeals of denied international electives can be made to the Dean of Medicine with a carbon copy (cc) to the Manager, Undergraduate Medical Education.

The Clerk is responsible for ensuring the UGME Office (Clerkship Coordinator) has received confirmation of registration with the ISSAC office as well as the Division of Social Accountability. Once confirmations and the international elective form are received, the elective will be considered for final approval. The Year Chair will give final approval or rejection of the elective application and Clerks will be notified of either status. For approved electives to be added to One45, the Clerk must email the official confirmation of DSA orientation completion from the ISSAC to the Clerkship Coordinator. Once submitted, the elective will be considered finalized. Failure to do so will result in the elective not counting towards the minimum number required.

The Clerk is responsible for ensuring that the elective information is correct on One45. If an elective is incorrect or missing, please contact ugme.electives@usask.ca. Clerks are required to complete an External Electives Check-in Form in their One45 To Dos for all international electives.

Clerks may be required to purchase additional malpractice insurance depending on the elective location (Refer to article 15. Insurance for more details). Extra funding opportunities may exist through the Division of Social Accountability in the form of research and travel awards. Please contact the Division of Social Accountability Office for inquiries and/or additional information.

The Clerk is responsible for ensuring an Elective Assessment form is completed by the preceptor(s). Clerks must first set up a temporary account for external assessors by submitting a ticket: https://teamdynamix.usask.ca/TDClient/33/Portal/KB/ArticleDet?ID=115. Once the temporary account has been set up, the Clerk can then distribute the assessment to the preceptor(s) from their One45 To Dos. Clerks will be notified within 2 weeks of the end date of the elective if an Elective Assessment form has not been received. It is their responsibility to ensure the assessment has been completed within 4 weeks of the elective end date. If no assessment is completed, then it will be considered a failed elective and no credit will be granted. Clerks who have completed an international elective are given the opportunity to submit an anonymous evaluation of their experiences within 4 weeks of the elective’s end.

The Clerk must participate in a post-elective debriefing with the Division of Social Accountability.

This meeting will include feedback on the elective learning environment, overall learning experience, and any challenges faced. The Clerk should notify the UGME upon their return from their elective. If the Clerk requires further supports related to experiences during their elective, these will be facilitated through the Office of Students Affairs.

 

5.2.4 Worker’s Compensation on Visiting Elective

U of S students participating in electives outside the province of Saskatchewan are not covered by the Saskatchewan Workers’ Compensation Board (WCB). The College of Medicine cannot guarantee access to the host province equivalency of Saskatchewan WCB, and therefore encourages you to maintain insurance sufficient to meet your needs. Workers’ compensation provides coverage based on the average industrial wage for students; we, therefore, recommend that all students traveling outside of Saskatchewan for electives, even those covered by some form of workers’ compensation, obtain additional accident and disability coverage that matches their expected income upon graduation.

The University of Toronto mandates that all learners acquire adequate accident insurance coverage. Clerks who have secured a visiting elective at the University of Toronto must contact

the U of S Electives Office (med.electives@usask.ca) within 6 weeks before the start date to ensure they have adequate insurance coverage.

Home electives must be cancelled by the Clerk at least 6  weeks prior to the start date of the elective. Please be aware that changing a 2-week elective to a 1-week elective is considered a schedule change and must be done at least 6 weeks in advance. To cancel a home elective, select “Cancel Application” under the “Student Status” section of the SharePoint elective application form. Clerks must also follow-up with the relevant Department Admin to verify that they received the cancellation notification. If a home elective is cancelled within 6 weeks of the start date, it will prompt a discussion regarding professionalism and may result in documentation through a Professionalism Report/Discussion Form. Exceptional circumstances requiring an elective cancellation will be considered.

6.2 Cancelling a Visiting Elective

Visiting electives scheduled through the AFMC Student Portal using the capacity-based model cannot be cancelled, except for unforeseeable reasons. If you must cancel a visiting elective due to extenuating circumstances , submit your request to med.electives@usask.ca and the U of S Student Affairs office. If the cancellation is supported, the U of S Electives Office will notify the host school of the cancellation, on behalf of the student.

Please note that electives done at international schools may have their own cancellation policy. Clerks will be expected to adhere to individual school’s guidelines and procedures.

7.1 Diversity Requirement

Clerks must complete a minimum of three electives, each lasting a minimum of two weeks, in three different general areas (Year 3 and Year 4 combined). The general areas are: Anatomy, Anesthesia, Dermatology, Emergency Medicine, Family Medicine, Indigenous Health, Internal Medicine, Neurology, Non-Clinical, O&G, Pathology, Pediatrics, PM&R, Psychiatry, Public Health, Radiation Oncology, Radiology, Research and Surgery. Please refer to the “General Area Category” column of the elective summary table.

Elective diversity allows the Clerk to experience a broader scope of medicine and may help with residency preparation. In addition, The University of Saskatchewan College of Medicine abides by the AFMC diversification policy.

AFMC Student Electives Diversification Policy:

“Undergraduate programs recognize their dual responsibility to ensure students undertake a full educational experience that prepares them for any potential career choice, while also optimizing their ability to engage in the increasingly competitive postgraduate match process. Undertaking elective experiences exclusively in a single discipline is pedagogically unsound and fails to provide students with a full exposure to potential career options. Consequently, we commit that, beginning with the Class of 2021, student elective opportunities cannot exceed a maximum of eight weeks in any single entry-level discipline. An entry-level discipline is an Entry Route in the PGY-1 (R1) match. Each of these entry-level disciplines leads to specialty certification with either the RCPSC or the CCFP. Electives in subspecialties that are part of a PGY-3 (R3) match (such as the subspecialties in Internal Medicine and Pediatrics) are counted as separate disciplines. As such, electives in these subspecialties do not count towards the 8-week maximum in the general specialty”.

As such, the maximum time allowed in any one direct-entry specialty will be 8 weeks (Year 3 and Year 4 combined).

 

7.2 Noncompliance

Being outside the 8-week maximum in a specialty area (other than Internal Medicine and Pediatrics subspecialties), may put the student at a disadvantage when applying through CaRMS for a Residency position. If a student is found to have greater than 8 weeks in any one specialty (with the exception of Internal Medicine and Pediatrics subspecialty areas), the additional weeks will not count towards the minimum number electives required for completion of the electives course, and the student may be required to do remediation. Additionally, none of the comments from those electives will be allowed on the MSPR. The student may also be subject to a professionalism citing.

Please refer to the “8-Week Cap Category” column of the elective summary table. All students are responsible for counting their own number of weeks in each area. However, students should be aware that there will be random audits done to ensure compliance.

Please note that Year 5 is unique and while this year must abide by the diversity policy, their previous years’ electives do not count towards the maximum.

 

7.3 Socially Accountable Care Elective

During the electives course in either Year 3 or Year 4, students will be required to participate in a 2-week socially accountable care elective. This elective can come from any diversity category and will contribute to the overall diversity caps that the elective typically falls under. This elective allows students flexibility in identifying an experience that focuses on addressing priority health concerns of the communities they serve. We encourage you to be thoughtful and creative in choosing an experience that supports your future career plans and enhances your understanding of socially accountable care.

Elective opportunities can be chosen from existing electives (e.g., Indigenous Health, Addictions Medicine, Rural Family Medicine) or from an opportunity you identify within or outside the province.

Many elective opportunities could offer a socially accountable care perspective. For example, several electives are offered in rural and regional locations, serving special populations (e.g., Infectious Disease, ENT, Social Pediatrics, Child Psychiatry, Geriatric Medicine). Consider the impact of healthcare resources and patient needs for those struggling with access.

Review additional resources available on the Socially Accountable Care Elective SharePoint site, including the Guide to Designing your Socially Accountable Care Elective, the Conversation Guide, and a review of the Priority Health Concerns.

 

Application process:

Step 1: Secure an elective spot, either within Saskatchewan or out-of-province. Schedule your elective through the usual process, using the elective SharePoint site for home electives and the AFMC Portal for visiting electives.

Step 2: After securing an elective spot, complete the socially accountable care elective application. This application will be reviewed by the Year Chairs and the Division of Social Accountability (DSA) for approval. Please ensure you submit your application at least six weeks before the start date.

Link to the electives landing page: https://usaskca1.sharepoint.com/sites/ugme_electives

Under the Socially Accountable Care Electives section, you will find useful documents, including instructions on how to print your application form.

1. Select “New Socially Accountable Care Elective” to start a new application.
2. Complete the form, including the elective dates, specialty, location, learning plan, and personalized objectives. To make reviewing easier, please label each objective with a number (#1) and leave spaces between objectives. You will also need to include the standard learning objectives from the syllabus for the specific elective opportunity. The electives syllabus is linked at the bottom of the form. Please copy and paste the objectives.
3. Select “Save”. The student status should automatically change to “Submitted”. To view your submitted application(s), click the “View Social Accountability Elective Request Status” button on the main landing page.
4. If revisions are required, you will receive a notification email from SharePoint. The Year Chairs and DSA will leave suggestions under the “Approver Comments” section. Please revise your application, including adding notes under the “Student Comment” section. To resubmit, please change the student status back to “Submitted” and select “Save”.
5. You will receive a notification email from SharePoint once your application is approved.

Step 3: Please print the form and bring it with you on your first elective day to discuss your learning plan and objectives with your preceptor.

Assessment: This elective will be evaluated in the same manner as other electives. The ITAR will assess your clinical performance and include confirmation that a mandatory discussion/debrief was completed with the supervisor regarding your experience and reflections on your learning plan. Further assessment of socially accountable care may be included on the Year 4 written exam.

A comprehensive approach will be assessed through these guiding objectives:

1. Identify personal learning objectives to support growth in knowledge and delivery of socially accountable care.
2. Identify the roles and members of the collaborative health care team including the patient and community representatives.
3. Engage in socially accountable care that prioritizes equity, freedom from discrimination, and person-centered and trauma-informed approaches to care.
4. Reflect on how the practice model of the chosen elective supports community needs, education/research, accountability, and/or advocacy.
5. Reflect on how health systems and organizational structures enable socially accountable care.
6. Reflect on how you achieved your personal objectives/learning goals.

Completion of all EPAs is mandatory and is a requirement to successfully complete the course. Failure to complete the required number of EPAs, at a level that is satisfactory to the Competency Committee, will have academic and/or professionalism consequences, including being ineligible for promotion. Further, if students are found to be missing EPAs, additional clinical time may be required to complete missing EPAs or demonstrate an acceptable level of clinical competency.

Please note the maximum amount of time away from a 2-week elective for any reason, in order to be considered complete, is 2 days (including statutory holidays). Please note that certain electives and shift-based electives may not permit leave. One-week electives can be counted towards the total number; however, they cannot be combined with a week of vacation and count as 2 weeks of electives. No time off is permitted during 1-week electives, and therefore, they are not offered on weeks with statutory holidays.

Clerks are responsible for arranging and covering the cost of their own housing during electives, whether they are in Year 3 or Year 4, and regardless of whether the elective is in-province or out-of-province.

All Clerks must have received their mandatory immunizations OR shown proof of immunity prior to the start date of all electives. This is generally required during the application process. Any Clerk not having met this requirement must report to the Occupational Health and Safety Office to update any missing immunizations. Immunization requirements are listed here.

For patient protection, all Clerks (who do not have medical contradictions) are expected to be immunized for influenza. Clerks will be advised of any updates to provincial or regional public health policies for Saskatchewan electives.

Additional immunization requirements (i.e. international electives) will be at the student’s expense.

All Clerks are required to have a current and valid N95 mask fitting. Your fitting is valid for 2 years.

External electives generally require a current criminal record and may require a vulnerable person’s check. These can be organized through the local Police Department. Please check the AFMC portal for individual school requirements. It is the student’s responsibility to provide the UGME and CPSS with any changes to the original Criminal Record Check submitted for Clerkship.

The Medical Student Exposure to Infectious and Environmental Hazards Policy and local health region/authority occupational health procedure can be accessed here. 

University of Saskatchewan Clerks are covered under the U of S CURIE insurance policy for up to 26 weeks of electives. This includes any contractual liability, professional and malpractice liability, cross liability, and tenant’s legal and employer’s liability arising out of their elective duties. Coverage applies to any electives taken within Canada.

This policy will be distributed to students as well as Department Coordinators and Site Directors.

The Academic Director, is responsible for providing oversight to the overall administration of the Clerkship Electives Policy within the College of Medicine.

The Manager, Undergraduate Medical Education, with the assistance of the Undergraduate Medical Education Office, is responsible for the implementation, monitoring, maintenance, and evaluation of the Clerkship Elective Policy within the College of Medicine campus in Saskatoon, Saskatchewan.

Clerks not complying with the procedures outlined above will have their elective cancelled and no credit received. Instances or concerns of non-compliance with the U of S Clerkship Elective Policy should be brought to the attention of the Vice-Dean, Education or the Associate Dean, Undergraduate Medical Education, within the College of Medicine.