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PGY4/5 Subspecialty Residency Training Program

Program Overview

The Western General Internal Medicine (GIM) Residency Training Program aims to prepare general internists for academic or community practice. Our program supports learners to tailor their training according to their specific career goals. Upon completion, residents will be well positioned to undertake leadership roles in both community-based settings or academic environments.

Western offers a Royal College of Physicians and Surgeons of Canada accredited GIM subspecialty residency since 2014.  The curriculum has transitioned to Competency by Design (CBD) model and residents will have completed all mandatory learning experiences in the first 18 months of training. Our flexible trainee-centred curriculum allows residents in the latter part of their PGY5 year to pursue selective learning experiences that are consistent with their transition to practice plan.

Some examples of additional expertise past graduates have pursued during training include clinical fellowships (e.g. POCUS, OB medicine, thrombosis, ambulatory cardiology, bariatric medicine, etc.) and advanced degrees (e.g. MBA, MMed, MQI). Residents also have many in-training opportunities for participation in teaching undergraduate and postgraduate medical curriculum.

  

Program Highlights

Western GIM offers a robust academic learning environment. Residents have many opportunities to participate in educational and research activities.

Formal Learning Activities:

• Resident Academic Half-Days: These occur bi-weekly and cover high-yield core GIM areas. Time is protected for attendance and sessions are held by GIM and subspecialty faculty.
• GIM Journal Club: Monthly sessions held at local restaurants from September to June where both faculty and residents provide critical appraisal of emerging evidence relevant to the practice of GIM.
• GIM Seminar Series: GIM Faculty and resident led seminars occurring twice per block discussing case based GIM topics.
  
  

Internal Medicine Point-of-Care Ultrasound (POCUS): Western is recognized as a leader in IM POCUS, with multiple GIM staff certified through the National Board of Echocardiography.  We fund our residents to participate in the Canadian Resuscitative Ultrasound course, after which they then undertake a Critical Care US block. Additional training in IM POCUS can be obtained through elective rotations or through either a 3- or 6-month fellowship.

Scholarly Project: Residents will engage in mandatory scholarly work as part of their training. They are supported by the division through close mentorship with research faculty and a dedicated research assistant. Additionally, through Western’s Centre for Quality, Innovation, and Safety (CQUINS), our residents are   Projects are presented at GIM Resident Research Day and prepared for submission to CSIM if desired.

 

Curriculum requirements

• CTU Junior Attending (2 blocks)
• Perioperative and Consult Medicine (2 blocks)
• Community GIM (1-2 blocks)
• Longitudinal Clinic (weekly half day clinics over 2 years)
• ICU (1 block)
• Obstetrical Medicine (1 block)
• Diagnostic Testing (1 block)
• Critical Care Ultrasound (1 block)
• Palliative Care (1 block)
• Ambulatory Clinics (2 blocks) more info...
• Scholarly project (Research more info... and/or Quality Improvement more info...)

 

The above blocks are generally 4 weeks in length but GIM-supervised rotations can be split into 1-2 week intervals depending on trainee needs and scheduling.

Elective rotations are tailored to meet the career goals of the individual trainee. Common elective choices include: additional ICU or community rotations, non-invasive cardiology, or ambulatory sub-specialty rotations. Other examples include but are not limited to:

• IM POCUS
• Addictions
• Haematology / Thrombosis
• Urgent Neurology
• Ambulatory Cardiology
• Research / Scholarly
• Community LHIN Hospitals including Chatham, Stratford, Sarnia, etc.

 

Selection Criteria

Residents enter the 2-year General Internal Medicine program through the CaRMS MSM match. Each applicant’s file is reviewed and evaluated using the following information; performance during IM residency, letters of reference, research experience, and other information as available. Suitable candidates are offered structured interviews with a faculty member from the Division of General Internal Medicine and a PGY4/5 GIM resident. The applicants are then ranked, and positions offered through the CaRMS match.

GIM Journal Club

Dinner event scheduled once a month at a local restaurant 

Two recent journal articles are selected for presentation by the trainees and their assigned faculty
Topics covered: perioperative medicine, obstetric medicine, updates in general internal medicine, quality improvement in medicine, medical education, health systems research and patient safety.

GIM Seminar Series

Scheduled twice a month virtually 

Trainees are paired with a faculty member and are responsible for delivering the seminar (with support from the faculty member).

Topics are varied and address subjects relevant to the practice of Internal Medicine.

Trainees receive feedback on their presentation.

Academic Half Days

Scheduled twice a mont h
Topics covered: perioperative medicine, obstetric medicine, patient safety, preventative medicine, diagnostic testing, subspecialty topics, research statistics and practice management

Royal College Exam Preparation

Program facilitated: trainees have the opportunity to complete a mock MCQ exam in the style of the Royal College exam, and receive feedback 

Canadian Resuscitative Ultrasound Course (CRUS)

Scheduled for two days in July
This course hosted by Western Sono provides you with hands-on experience to learn and practice the basics of Point of Care Ultrasound. More information on the course can be found on their website here.

This course is financially covered by our GIM program.

Longitudinal GIM Clinics

Scheduled weekly.

Over the course of their two-year training program, all trainees are paired with a GIM faculty member. Our residents attend a weekly, half-day longitudinal GIM clinic where patients are seen and followed by the trainee (with faculty supervision). This allows our residents to provide continuity of care and to develop outpatient consultative and management skills. This also provides exposure to the intricacies of an outpatient practice.

CSIM Conference

Scheduled annually

Funding is provided for our residents to attend the annual Canadian Society of Internal Medicine (CSIM) conference.

Research and Quality Improvement

All trainees are highly supported with their QI/research projects. This includes a dedicated QI curriculum through Western’s Centre for Quality, Innovation, and Safety (CQUINS), where our residents are systematically taught and guided through each step of their QI project.

Additionally, feedback and guidance on their individual QI/research projects are provided in the form of monthly Research Lab Meetings. At these virtual sessions, residents can present their scholarly work progress and receive feedback from peers and faculty.

As well, residents will have access to a dedicated research assistant.  Faculty supervisors and mentors are available for both research and QI projects.

All trainees receive protected time to complete their QI curriculum and project. Additionally, residents can choose between a 1-month research block or a longitudinal style research experience spread over two or more blocks. Additional research and scholarly blocks can be arranged at the request of the resident.

Resident projects are presented at GIM Resident Research Day and formal feedback is obtained to prepare for submission to CSIM if desired.