A Queen’s Elective Proposal

A few months ago I was denied a reading elective. I want Queen’s Medicine to update their elective policy to allow electives like these to be possible in the future. So here’s my pitch.

I’d like to see the criteria for non-clinical electives be expanded to allow for more exploration, and with less focus on deliverables. All electives should be opportunities for edification, personal growth, career exploration, and simply to have novel experiences whilst in medical school. I understand there is an imperative for electives to act as opportunities for CV gilding and for scoring reference letters, but I think this must be set in balance with allowing for more exploratory activities also.

Background

When I first pitched my elective, I was told the following:

… research electives are generally only granted to students undertaking projects that are part of ongoing research they have already participated in. This is because it is highly unlikely to accomplish anything meaningful from start to finish in two weeks.

I was asked to send a more detailed outline of my learning plan, which I did – and is essentially what I posted on my blog linked to above, with a preface describing my research background in Psychiatry and my interest in a future career in research. I got the following response (emphasis mine):

What you’ve proposed does not fit into what is expected from a research elective. It amounts to the kind of work one would do in preparation for a research project, sort of a process to generate ideas perhaps. While this is a vital part of many research projects, it would be part of the work one does leading up to a project, not the project itself. This is clearly an interest of yours, however given the nature of what you’ve proposed and that it is not part of an ongoing active research project, I will not be able to approve this elective

Of course I protested, and explained more about my rationale for wanting to build a stronger theoretical foundation to help guide me in selecting more specific research questions in the future. I also offered to rejig the elective deliverable to be work towards a review/depth paper intended for my neuroimaging colleagues to make it more clearly an extension of previous work. The response was essentially the same, with the following bits I’ll highlight:

One of the underlying requirements for research electives is a distinct outcome, which usually amounts to a journal article, a poster or a presentation, and sometimes all three. There have been quite a variety of research electives over time, ranging from running actual data gathering to collating data, along with other outliers. […] What you’ve proposed is certainly a worthy endeavor, however it does not fit the majority of the parameters for research electives.

Fair enough. I moved on.

Current research elective criteria

From what I can see, the authoritative source for the Queen’s Medicine policy on electives appears in these policy documents posted on their website:

1. Policy CC-06 v6: Clerkship Electives v6 for the class of Meds 2020
2. Policy CC-06 v101: Clerkship Electives v10 for the class of Meds 2021 and subsequent classes
3. CC-06P v4: Clerkship Electives Procedure

None of these documents actually describe the criteria for research electives other than that they, like other electives, must be at least 2 weeks in length and must have a learning plan which is submitted in advance, etc. In the CC-06 v10 policy document there is the only description of what a research elective actually is, but it is vague: “Research electives allow for involvement in scientific or scholarly projects without involvement in clinical activities.”

I asked if there are additional documents I should be looking at with more criteria and was told there was not.

Going from the email exchange with the administration I posted above, I can state the following, I guess de facto, criteria for research electives at Queen’s:

1. Projects must be extensions of ongoing active research projects that students have already participated in before starting the elective.
2. The elective must have a concrete final product, e.g. a journal article, poster, presentation, but may also include data gathering or analysis.

Non-clinical elective criteria at other Canadian medical schools

I reached out to several other Canadian medical schools to find out what their non-clinical elective criteria are. Some answers are pending, but here’s what I found so far. I will update as I hear back. Here’s a summary table (see the full details at the end of the post):

School	Active Research	Deliverable	Duration
Queen’s	Required	Data, manuscript, presentation	2 weeks
Western	Not required	As above or also reflections	4 weeks
McMaster	Not required	Anything with preceptor sign off	1-9 weeks
Ottawa	Only 3-4th years	1-2 page report on experience	2-4 weeks
Dalhouse	[pending]		2+ weeks
Toronto	[pending]
NOSM		No formal research electives

Proposed changes to the Queen’s Research Elective Criteria

Most obviously, I’d like to see explicit non-clinical elective criteria stated in the Queen’s policy documents. As it stands, the only way students know what is acceptable is via bumping up against implicit criteria like I did.

So, here’s what I suggest as an amendment to Policy CC-06:

2.6.4 Research electives allow for the involvement in scientific or scholarly projects without involvement in clinical activities. Research electives must meet the following criteria:

1. Preceptors must approve the learning plan prior to submitting the elective for approval.
2. Preceptors may use their discretion to determine how to evaluate student performance during the elective. This may include, but is not limited to, completion of a draft manuscript, abstract or presentation, or an oral discussion to ensure the student’s learning objectives are met. The specific evaluation method must be included in the elective application.
3. After the elective is completed, students must submit a brief report (1 to 2 pages) describing the research experience.

That’s it. There is no mention of the requirement for continuing an existing project, and it is up to the preceptor and student to come up with an evaluation scheme. The text is largely borrowed from the McMaster guidelines. I stuck #3 in there because… well, it seems like something that might mitigate objections that a research elective should have concrete deliverables.

---