“Stan” has returned to his psychiatrist, Dr. Thomas Ungar, for the second time in three months. His condition has worsened.

He is muttering his answers, in a low, slow tone. “Things have just gotten worse, I guess,” Stan said.

“How is your mood,” the therapist asked.

“I just … Yeah, it’s just not good,” muttered Stan. “So hard to feel good about anything.”

After a few more questions, Ungar formed a time-out sign with his hands, and turned to the crowd in the J.R.R. Macleod auditorium. “Is this the same as before?”

“No…” they droned.

“Okay, what’s different?”

“Body language,” suggested someone.

“It’s a whole different feel,” said Ungar. “In fact, I naturally lowered the tone of my voice to match it.”

He was addressing the two hundred-odd audience members who were attending the third seminar in this term’s mini-med school last Thursday evening, on the subject of stress. And while Stan, a so-called “standardized patient,” was actually an actor, the two doctors on stage, Ungar and Dr. Michael Evans were the real thing.

The former is appointed to the department of psychiatry, but also practices at North York General Hospital; the latter is in the department of family and community medicine, and runs the mini-med school course, which is now in its fourth year. Participants pay $195 ($105 for students) for six weekly installments of two-and-a-half hours, on topics such as stress, alternative medicine, and the digestive and respiratory system. Each seminar features Evans and a specialist in that week’s topic.

In fact, mini-med school is a Canadian creation, developed in 1989 by Dr. John Cohen, a graduate of McGill University’s medical school who now teaches and practices at the University of Colorado, in Denver. There are now over 80 of them throughout North America, by Cohen’s count. They have also spawned cross-overs, such as mini-law schools.

McGill was the first to pioneer mini-med schools in Canada, in 2001, but U of T followed suit the next year. When the Globe and Mail first wrote about U of T’s mini-med school, the program was flooded with about a thousand applicants-making it harder to get into than U of T’s real medical school, Evans quipped.

In the sessions, he strives to balance didactic elements-half-hour lectures with PowerPoint slides and handouts to boot-with question and answer sessions from the audience. “We’ve tried to introduce a lot of value adds,” said Dr. Michael Evans, explaining standardized patient Stan’s presence there.

The presenters were at their best during the question and answer sessions, fielding audience questions quite different from . They were quizzed on their take on the attention disorders ADD and ADHD-“This is one of the most politically-charged questions you can get,” Unger noted-and about borderline personality disorders. Evans fielded that question.

“You can think about this with people you run into,” he said. “Within one second, if you find youself falling in love with them, … or you want to rip their heads off within two seconds-your personality disorder o’meter goes way up.”

A handful of medical student volunteers, led by second-year Elissa Cucan, walked up and down the isles collecting slips of paper on which audience members had written questions for the two speakers. “It’s a good way for us to get an understanding of what people want to know,” said second-year med Stephanie Backman.

Attendees were mostly middle-aged. The keenest of them packed the first few rows near the front of the room, hanging on to Ungar and Evans’ every word, and occasionally talking back, or interrupting to ask some questions.

“Most of them tend to have post-secondary education, and are from a higher income bracket as well,” said Jessica Black, of the faculty of medicine’s continuing education office, who helps organize the event.

There was also a handful of high school students scattered throughout the room, some of them sitting alone, others in clusters with their peers. Most participants listened with rapt attention, as the simulated role play proceeded. Ungar was again asking the audience what he should inquire about next.

“Anything that I haven’t asked that I have to ask?”

“Suicidal…” an audience member murmured.

“Do you think he’s thinking about committing suicide? But how do I ask that?,” Ungar wondered. “What if I give him the idea?”

Ungar and audience members then pondered aloud other questions that might gently steer the conversation towards that topic.

“How about sex…” somebody else suggested.

“How about it?,” Ungar quipped mischievously, eliciting loud laughter.