Bioethics is a vital and unique component of medical education for residents. A defined bioethics curriculum is a requirement for accreditation by the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada and ethics competency is integrated in several of the CanMEDS roles which frame current medical education in Canada. In 2001, a needs assessment survey of the then 67 postgraduate programs at the University of Toronto was undertaken by Alex Levin, Martin McKneally, Scott Berry and Charles Kassarjian to gauge the University’s response to the 1995 RCPSC and CFPC mandate and to identify strengths and challenges in bioethics education. The survey found both faculty and residents unanimously felt bioethics was important and should continue to be part of the curriculum. A majority of residents indicated that they felt bioethics training was as important as the other facets of their clinical education, however, ranked comparison of ethical issues showed discordance between the curriculum topics and what the residents reported as ethical issues they most often faced in their practice.
Current research, supported by a two year grant from the Association for Surgical Education, uses focus groups and interviews with bioethics coordinators and residents, as a qualitative study of the ethics training within the surgical specialty programs at the University of Toronto. The objective is to further assess the delivery of postgraduate bioethics education and to identify avenues for improvement, in particular a resolution of the gaps between the formal and informal curriculum. Currently, bioethics topics and teaching modalities are usually selected by the teachers reflecting what they feel their trainees need to know. There is a body of research suggesting that such curricula may not completely reflect the issues that residents actually face, leaving an important gap between what these trainees are being taught and what they need to learn in their daily lives as physicians-in-training. We intend to develop a better understanding of what surgeon teachers think they should be teaching their residents about ethics and what residents feel they should be learning, and why each group feels this way. We hope to improve bioethics teaching with curriculum recommendations that reconcile the needs of both groups. This will also guide us in future efforts to create evaluation strategies designed to ensure that graduate physicians have learned what they need to know, and have acquired the skills that will allow them to deal effectively with the ethical issues they face.