What you need to know about teaching hospitals

Getting care at a teaching hospital

When I first found out I was pregnant, I didn’t actually have a family doctor. My first thought was to go with a midwife, but – fun fact – in Toronto, midwives aren’t easy to come by. I was wait listed at six different midwife clinics.

In the meantime, I went searching for a family doctor. I finally found one that would take me, but it was at a teaching hospital – admittedly something I didn’t know much about.

My experience there was a confusing one (the doctor seemed so young – and why were there cameras in the room?) but maybe if I knew more going in, it would have put my mind at ease.

I talked to Dr. Salvatore M. Spadafora, the Vice Dean of Post Graduate Medical Education at the University of Toronto, to set the record straight. Here’s what you need to know.

What is a teaching hospital?

“There isn’t a hospital in the entire province that doesn’t have some medical training days logged. Teaching can happen anywhere,” says Spadafora. But some hospitals, Like Women’s College Hospital or Sunnybrook Health Sciences Centre (both in Toronto) are dedicated learning institutions, where there are always students learning in-house. As a new patient, you’re told when you book your first appointment that residents will likely be involved in your care.

What is a teaching hospital?

“There isn’t a hospital in the entire province that doesn’t have some medical training days logged. Teaching can happen anywhere,” says Spadafora. But some hospitals, Like Women’s College Hospital or Sunnybrook Health Sciences Centre (both in Toronto) are dedicated learning institutions, where there are always students learning in-house. As a new patient, you’re told when you book your first appointment that residents will likely be involved in your care.

There are more doctors in house 24 hours

If you’re nervous about going to a teaching hospital, it might make you more comfortable to know that, typically, teaching hospitals have more doctors on call than at a non-teaching hospital.

“If there’s an acute emergency there tends to be more people on hand because there’s a complex roster of on-call,” says Spadafora. “There are a lot of people around at teaching hospitals. It’s a good thing for patients, in a lot of ways.”

The doctors can spend more time with the patients

The same logic applies here. Since there are more doctors in house, they can spend more time talking to you. “There are greater opportunities for patients to ask questions,” says Spadafora.

The residents may seem young – but they’re qualified

A good thing to remember is that the residents in the training system wouldn’t be allowed to practice if they weren’t ready.

“Their credentials are all checked,” says Spadafora. “Once they’re in residency, it means they have an MD, and many have a Masters or PhD. The minimum requirement is four years of prerequisites and four years of medical school.”  Essentially, they have all the qualifications – but until they’ve completed a successful residency (which is what they’re doing at the teaching hospital) they’re not considered practicing physicians.

The doctors that train the students are also responsible for making sure they’re capable. The ultimate goal? “To improve the health of the patient,” says Spadafora . “And to make sure they have the best care possible.”

There might be cameras in the room

This is the one that made me the most nervous. But the important thing to note is that the only people watching are the resident’s supervisors.  That’s a good thing – because it means they’re being trained properly.

“In order to ensure we’re training people to practice in multiple contexts, they need feedback. That’s the important part of training: direct observation,” says Spadfora.

Cameras usually tend to only be in family practice units. Also important to note: The cameras don’t record. So you don’t need to worry about your pap smear showing up on YouTube.

Asking questions will empower you

“As patients, we’re all human beings, so we have our anxieties,” says Spadafora. To put your mind at ease, you should ask questions and get as much information as you need to make you feel more comfortable.

“Patients have rights: To know who the person is, what they’re doing, what’s expected for their level.  If you’re not comfortable, speak to their supervisor until you have all your questions answered.”

Best questions to ask

1. Whether the doctor you’re seeing has got a team of healthcare professionals who are learning with them.
2. If the students are going to be involved in the care.
3. What the students are – and aren’t – capable of.

And finally, “Know that you have the right not to participate in teaching,” says Spadafora. “But you should also know that in most cases it harms your care rather than helps it to opt out, because no individual doctor is capable of it all.”

Related:
• 7 steps to make sure you get the best medical care
• Canada’s best medical care for women
• 10 things doctors secretly wish they could tell you