Hamilton

This week I was in Hamilton visiting McMaster University where they have the Mohawk programme. This degree in Radiation Therapy differs significantly from the Michener programme as the students are able to select direct from high school to enter into the medical sciences course. This year they had 600 students apply for the 150 places, so competition is high. They attribute this partly to the excellent marketing they receive at a grassroots level, but also to the name of the course, by having 'medical' the course seems to gain the precedence it deserves. After a year of the medical sciences course students then specialise into a specialist stream:
- Radiation therapy (only a cohort size of 24 students)
- Radiography
- Ultrasound
By doing this the students do have a chance during year 1 to become fully informed regarding the 3 disciplines and this seems to ensure students are able to make informed decisions. It became apparent as well that when students started the medical sciences course they were doing so to study radiography or ultrasound as they had never heard of radiation therapy, however when it came to choosing, more students apply to do radiation therapy than the other two specialism. Adopting this strategy in the UK would require a huge change in practice, however it does appear to be a successful strategy in reducing attrition within the specialism as there appears to only be the loss of students in the first year. They certainly don't observe the issues we sometimes see with students having made the wrong career choice and switching between the health care courses offered.
It was also incredibly interesting to see the competition for the radiation therapy course being so high and as a result of this only the most academically advanced students get selected. As McMaster don't have interviews this could be a risky strategy to adopt as from experience academia doesn't always translate into an excellent radiotherapy student due to the skills required in clinical. When discussing this with the lecturers it did become apparent that they do quite often have to provide extra support sessions for students who struggle with their interpersonal skills and communication. A simple interview process could possibly eliminate this, however interview processes are extremely resource intensive and this is why McMaster couldn't warrent doing them.

Odette Cancer Centre

Hi Everyone,
So I have been in Canada now for 3 weeks and this week has been particularly insightful. I have visited Odette Cancer Centre in Toronto, a lovely department, with a relaxed intimate environment. At Odette I met with the Clinical Radiation Manager, the Education Manager, the Clinical Co-ordinators, the Clinical Educator and the 1st year students. Everyone was extremely helpful and supportive of my visit and provided me with valuable information regarding their experiences of student training from a variety of perspectives. It was a positive experience to be able to discuss with the first year students about their decision to enter into the RT profession and how they specifically heard about Radiation therapy. As with other students I have spoken to, the general consensus was that they stumbled upon RT by accident, either through searching the Michener website or by failing to gain the GPA required for medicine and then looking for an alternative health care profession. None of the students had ever heard of radiation therapy previous to their research into health professions, which highlights the poor professional identity within Canada.
The students did establish that finance issues were a large concern. Many had researched the final salary received by a radiation therapist and looked at the course fees, which by my standards are high at $7,300 but are still the lowest within U of T.
The students did clarify that because of the financial commitment they make to the course, even if they were to experience any doubts during their training they wouldn't be able to withdraw. This was especially the case for those students being supported by their parents. Of the students I spoke to they all but 1 had already completed an undergraduate degree and so already had debts of approximately $25,000.
None of the students had experienced any negative clinical experiences and were actively enjoying their clinical placement, relishing the opportunity to link clinical and academic knowledge. They commented on the supportive nature of staff and how they felt integrated into the team. The management was particularly supportive of education from the grass roots level through to advanced practice and this did seem to have a positive impact on staff and their commitment to CPD was evident through the research being undertaken and those who were doing further study.
Odette due to it's close locality to PMH seems to be the second most popular option for students to want to train at. It is therefore encouraging to see the support mechanisms in place for the students and the programme support from the Clinical Co-ordinators.
On to Hamilton next to visit McMaster University, which will be great to see the contrast between the two programmes.

Personal Experience

Hi all,

I was thinking that to date my blogs have been very work/research orientated and for those of you who aren't in Radiotherapy, I wouldn't blame you for being bored after the second sentence. So I thought I would write a more personal update and let you know how I am doing in Toronto.

So Toronto is an amazing city! It is interspersed with lots of parks and water features and it is so clean and safe. The first weekend I had here I was up really early and was going on a run around the city and didn't have to think twice about going out on my own with my I-pod blaring. I was shocked to see that the homeless people in the city literally sleep on the streets. It appears that where ever they feel tired then that is where they will lie down and sleep. I approached St. Trinity's church to see if they needed any volunteers (I get lonely on the weekends) and so this Saturday I am helping them with their drop in clinic for the homeless, which should be an experience.

The Canadians are all really friendly and whilst sitting alongside the harbour it is easy to enter into conversation with passers by. Last weekend I met a guy with a golden retriever who got lots of cuddles from me, the dog that is not the guy! As you can tell I am missing George (my golden lab) a lot! I have been amazed by how many Brits are here, especially within Radiotherapy. Their stories are all similar....'I came over for a holiday and here I am 13 or so years on, with a stable career, married and with a family.'

I think the biggest think I have had to grasp has been the pedestrian system on the roads. I was a consistent jay walker for a number of days but now I have adapted and conform along with everyone else!

Now everyone who knows me well will know I do enjoy my food and it has been a pleasurable experience eating in Toronto. With a diverse multicultural population there is cuisine at my fingertips. I feel I am trying to work my way through them all. I have found a place that does the most amazing falafel and so embarrassingly they now know me by name, I blame the accent as I stand out like a sore thumb, but I have had many a falafel and at £3.00 you can't beat it as an evening meal.

I am looking forward to starting to move around next week, although I do wish I had listened to my husband when he told me I had over packed and now the thought of travelling with my cases is slightly concerning me. I am off to visit Mohawk University in Hamilton on Monday. It will interesting to see how the two University programmes differ and how they tackle student recruitment and retention issues.

So I am missing everyone terribly back home, but with my daily Skype calls and my daily fix Facebook it hasn't been as hard as I imagined and I think I am coping well. I just appreciate that I have been given an amazing opportunity and need to make the most of everyday!

Bye for now

Jo x

Princess Margaret Hospital Experience

This week I have had been visiting Princess Margaret Hospital in Toronto. On my first day I had 'the grand tour' around this impressive large oncology centre. Compared to UK departments the technology was significantly advanced and all patients were receiving IMRT and IGRT was a standard technique adopted. I was particularly impressed with the CT/MRI simulator suites and their use of SPECT. With 17 linear accelerators it is the largest radiotherapy department I have ever visited.

The facilities and services available to patients are similar to those in the UK, but everything appears to be on a much larger scale.

PMH has about 42 students and has a maximum of 32 students in at any one time. Due to the size of the department quite often there is only one student per machine. Students do get an IPE placement whereby they visit other departments within the hospital.

I met with Clinical Co-ordinators (CC's), whose role echoes those of our Professional Development Facilitators. They are employed by the hospital but have sole responsibility for educating the students, scheduling their time in the department and providing pastoral care and support. There is also the role of Clinical Educator who is solely responsible for educating clinical staff and promoting professional development.

It was interesting the issues which arose:

- It is very rare that CC's from PMH communicate with other CC's in other departments, to share best practice or discuss effective strategies in student support.

- There are 5 CC's, 1 full time and 4 who still work 20% of the time in the department.

- When CC's are working as a staff member they tend to distance themselves from students so that they can distinguish the two roles. They feel this helps students appreciate their knowledge more by seeing them in the 'Therapy Radiographer role'.

- The CC's have some form of training but no formal qualification in student education.

- The CC's put on lectures and tutorials but also work onset with students and facilitate integration of theory into practice.

There appears to be a lot of support available to students within clinical. There are the CC's, the reference therapists (similar to Senior 1's) who will be responsible for evaluating the student during their placement, a point person who will assist the student and review competencies, the student can also be allocated a mentor and a tutor if required and there is also a counsellor available if students require it.

There appears to be so many mechanisms for support available that students can gain a lot of feedback from various sources. Students are evaluated on a weekly basis and receive a feedback form from the reference therapist regarding their performance. It appears that if a student is having issues or wobbles then they are often able to be pacified by one source or another.

Speaking to the first year students was enlightening. It appears they still have similar issues to UK students; however the biggest factor was the financing. Students in Canada have to pay their own tuition fees of $7,000 a year. As they have already undertaken a year or more of another degree course they may already have a significant amount of student debt. 100% of the students I spoke to said that it wouldn't be an easy decision to quit because of the financial impact. They also appreciate the financial rewards of the job once they qualify.

It was also interesting that due to the programme organisation that if someone fails a course repeatedly they then have to repeat the year and pay again for the year’s tuition fees. This can be seen as a motivating variable to pass academic components first time around, however students felt it was money making scheme by the university. It has been really interesting visiting PMH, I am visiting Sunnybrook tomorrow so it will be interesting to compare the two centres in terms of clinical support and training for students.

Recruitment

After visiting Michener yesterday I established the recruitment issues that they have. As a result they have produced some publicity DVD's. Just before I left the UK I was in the process of putting together our marketing DVD and so it is interesting how we are mirroring each other with our strategies.

Here are some links to their publicity:

http://www.youtube.com/watch?v=YGYD9GiChsw&feature=PlayList&p=40891E9AAD1B7BE6&playnext_from=PL&playnext=1&index=3

http://www.youtube.com/watch?v=gr7wOViuvq0&feature=related

http://www.youtube.com/watch?v=9s4DinRegIk&feature=related

http://www.youtube.com/watch?v=L_oo2Yd3A58&feature=related

I'm Here

Hi Everyone,

After an amazing send off back in Sheffield, I finally boarded the plane for Toronto Canada. Having never travelled on my own before the whole experience was new for me. I had a teary goodbye with Lee at the gate but I knew I was being given an amazing opportunity that only comes along once in a blue moon.

The flight was loooooooonnnggg! Due to the volcanic ash we were held back at LHR and then had to fly via Greenland and then had to await a slot at Pearson's International to land. But I finally touched down and was eager to get my luggage and head to the hotel. Unfortunately I had immigration to deal with first. They never let me through easily as I was born in the Abu Dhabi and always have lots of questions to ask. Unless of course I just genuinely look suspicious.

I am staying at the Metropolitan hotel in Toronto, which has the most amazing retro decor (not on purpose I may add) my radio alarm clock is definitely an 80's original. The location though is fantastic and I can see the lake from my window in the distance.

So yesterday was my first visit with Michener staff and students (The Michener Institute for Applied Health Sciences and University of Toronto, faculty of Medicine). Everyone was really friendly and interested in my project. I spoke at length with students about why they chose a career in Radiotherapy and if they ever 'wobbled' about their decision. They were amazingly open and articulate, with many saying that they stumbled upon radiotherapy by accident, because they didn't have the grades (GPA) to get into medicine, pharmacology or dentistry. Like many UK students they had never heard of radiation therapy prior to researching it as a career option.

Many of the students are post grad and have either completed a degree already or have undertaken a single year at degree level. They also fund themselves through their studies, which I do think makes them more dedicated to do well and achieve their degree. It was interesting to discover that the wages once qualified are much higher than in the UK at about £35,000, compared to our starting salary of approximately £21,000. Some of them did say that it was due to the financial rewards of the job that interested them. The job situation in Canada is not great at the moment with many places having job freezes or is staffed already. So the job opportunities are not what they used to be.

I met with the academic coordinator of the Medical Radiation Sciences program to discuss the current issues they have surrounding student recruitment and attrition. It was interesting that they also struggle to recruit. They usually have around 50 students on the Radiation Therapy Course and have really struggled recruiting over the past two years.

Students entering onto the course may not necessarily be placed on clinical in Toronto and this did cause many issues for students, as it does for our students when they aren't located in Sheffield. Interestingly though a student counsellor is used to decide on individual students circumstances and decide whether they need to move departments or not. As it is confidential the academics may not know the reasons why an individual student has to move clinical department. This takes a lot of pressure off of the course leader and clinical supervisors.

I could go on for hours about everything I have learnt today.....but breakfast is calling me.

Will blog again soon.

Jo

7 sleeps to go.........

It has just dawned on me that in a week's time I am heading to Canada. It seems such a long time ago now that I received the good news that I had been awarded the fellowship.

So this week is the important bit.......packing! I have already been window shopping for new practical luggage. Especially as I usually have a strong man in tow to carry my luggage for me, but alas travelling on my own has it's down falls. I have a horrible feeling I am going to have to limit the number of shoes I can take.

Hopefully this week I will get some time to finalise my itinerary. The fellowship stresses the importance of allowing time for some fluidity within the trip and this is something I am finding particularly hard. As a control freak, knowing I don't yet have a train book between the two legs of my journey is making me reach for the Calm tablets.

So I hope you will follow me on my journey and enjoy the stories I write from across the pond.