Core Internal Medicine Residency Training Program

From U of M Internal Medicine Wiki

The Core Internal Medicine Training Program is a Specialty Education Program which medical students enter into directly after graduating Medical School. It is a is a three year program. Core serves as the foundation for entering Subspecialty Education Programs.

The program is led by the Postgraduate Program Director - Core, advised by the Core Internal Medicine Residency Training Committee.

Resources

The Internal Medicine Training Program consists of our tertiary and community teaching hospitals in Winnipeg.

We have an extensive catchment area that is well known for the diverse pathology of its patients.

Hospitals

Wards

Medicine Clinical Teaching Units (CTUs) accept admissions from all medical subspecialties. There are essentially no subspecialty wards with the exception of Cardiology. This means that time spent on medicine CTU's is a broad exposure to all areas of internal medicine. All subspecialty rotations are a combination of inpatient consultative work and outpatient clinics, with minimal inpatient 24 hour coverage provided by the subspecialty (with the exception of Cardiology).

Faculty

Program faculty consist of both full-time and part-time members in all Royal College recognized internal medicine subspecialties including general medicine, infectious diseases, respirology, cardiology, nephrology, endocrinology, rheumatology, haematology/oncology, immunology, gastroenterology, geriatrics, hepatology and critical care. Sub-specialty training programs are available in all of these areas.

Academic Half-Day

see Academic Half Day - Core Internal Medicine

Semi-Annual Resident Retreats

Interro-01.gif We have a page for Spring Internal Medicine Resident Retreat; maybe we need a page for Semi-Annual Resident Retreat that links to the spring one and whichever other one there might be. Then the content from here should be integrated there. User:Ttenbergen 11:48, 2018 September 26 (CDT)

Each fall, the residents will gather together for a weekend fall retreat. This is usually held outside of Winnipeg from Friday to Sunday. Some time is allotted to cover core content (discussions on career planning, CMPA, etc.), with the remainder reserved for recreation and team-building exercises. All costs are covered by the program.

In the spring, residents will meet together for a half day and night at a local restaurant. Again, some core content will be covered. Costs once again are program covered.

While the retreats provide an opportunity to review important topics for resident training, they are also an excellent opportunity to spend time with your fellow residents and have some fun.

Resources for Residents

A Residents' Room is found at HSC and STB. This is furnished with a selection of resource books in all subspecialties of Internal Medicine, and serves as a 24 hour in-hospital library and informal meeting place for residents.

Computers with Internet and e-mail access are available at both sites in the Residents' Room and on all Clinical Teaching Units. The University subscribes to a large selection of electronic journals, which are easily accessible from home or the Residents' Rooms. The Library and Department of Medicine provide the web-based UpToDate for all residents and faculty. Residents' Rooms are also equipped with access to MKSAP questions.

All residents have access to PubMed-based document delivery and clinical librarians to assist with literature searches. A Medical Library (Neil John MacLean Health Sciences Library) is found attached to the Health Sciences Centre, for easy access to many print journals.

Conference Leave

Resident Travel Guidelines

Academics

Curriculum

The program consists of three core years. Each year is divided into 13 four week periods. The program is designed to provide residents with a broad clinical experience to attain the knowledge, skills, and attitudes to practise internal medicine in an exemplary manner. There is an emphasis on becoming a strong clinical physician. As residents progress through the program, they assume increasing responsibility under appropriate supervision with the flexibility to be self-directed in defining their own educational needs. Ambulatory care is emphasized in our program to expand the patient spectrum upon which to learn. Mandatory Rotations

Over the three years, core residents must complete 9 to 11 blocks on the general medicine Clinical Teaching Units (CTUs). Each resident will complete 2 blocks as a junior resident in their first year. Residents will begin rotations as a senior ward resident in January of their first year. Generally residents will rotate as ward seniors for 3 blocks during first year, 3 blocks during second year, and 2 blocks during third year. Residents will also complete a Community General Internal Medicine rotation during their first or second year.

Night float rotations are also compulsory and consist of two weeks of medicine consults coverage in the emergency room and back up for the CTUs. All residents are expected to complete 4-8 weeks of night float over PGY2/PGY3.

PGY1s complete two blocks in General Cardiology. A third block in the Coronary Care Unit (CCU) is required in PGY1/PGY2.

Two blocks in the Medical Intensive Care Unit are completed in PGY2/PGY3.

During their third year residents will do a 3-block rotation on the General Internal Medicine consult service. During this rotation they will also give Senior Rounds presentations, facilitate morning report, and participate in a weekly longitudinal clinic with a general internist.

  • During their third year residents will do a 3-block rotation on the General Internal Medicine consult service. During this rotation they will also give Senior Rounds presentations, facilitate morning report, and participate in a weekly longitudinal clinic with a general internist.

Elective Subspecialty Rotations

Elective subspecialty rotations are offered in every subspecialty of internal medicine and related fields. Out-of-province elective rotations are available. The residents may also do a 1-2 periods of research electives in place of doing a subspecialty rotation. Opportunities are available for doing rural internal medicine electives including a formal experience in Dauphin, MB.

Research

Residents are required to present a clinical vignette or clinical investigation in each of their Core years at the annual departmental Resident Research Day, open to residents and fellows. There are opportunities to become involved in research in every area of internal medicine. Many faculty members are actively engaged in research and interested in supervising and corroborating with residents. One to two subspecialty rotations can be devoted purely to research, allowing dedicated time to both clinical and basic science endeavours. Residents from Manitoba have presented and won competitions at large meetings, including national ACP conferences.

Residents

The residents in the program come from a diverse array of backgrounds. The largest proportion are University of Manitoba grads, with representation from most programs around the country and a few schools from abroad.

The residents often socialize outside of work and many of are on recreational sports teams together (like Ultimate Frisbee and Sponge Hockey, etc.). Other organized activities within the program are discussed elsewhere - retreats, etc. Outside the Internal Medicine program, the resident’s professional association (PARIM) sponsors many gatherings for residents from all programs with food and beverages throughout the year. There are usually two formal evenings sponsored by PARIM per year, and numerous informal events.

Winnipeg

See our Lifestyle page for information about life in Winnipeg.

DISTINCTIVE FEATURES OF THE MANITOBA PROGRAM

Morning Report

Residents run Morning Report every weekday from 7:30 to 8:15. The goal is to provide interactive Royal College style case-based discussions to junior residents on the CTU and Night Float services with an emphasis on core internal medicine concepts. Attending physicians frequently attend Morning Report to contribute to discussion. There is also a focused handover from the prior night.

Senior Rounds

Occurring every Friday at noon, these rounds are given by an R3 on their senior block to a group of attendings and senior residents. Topics surround a specific clinical question and the evidence behind the answer.

Emergency Summer Series

Throughout the summer, sessions are held a few times a week from 12-1pm with attendings giving lectures on common medical emergencies/urgencies.

Grand Rounds

Held every Tuesday morning, guest speakers and local faculty present topics related to their area of expertise.

Resources for Residents

A Residents' Room is found at both teaching hospitals. This is furnished with a selection of resource books in all subspecialties of Internal Medicine, and serves as a 24 hour in-hospital library and informal meeting place for residents. Both community sites also have space and resources for resident use including books and computers.

Computers with Internet and e-mail access are available at both sites in the Residents' Room and on all Clinical Teaching Units. Also accessible on these computers are patient lab data and radiology. The University subscribes to a large selection of electronic journals, which are easily accessible from home or the Residents' Rooms. The Library and Department of Medicine provide the web-based UpToDate for all residents and faculty. Residents' Rooms are also equipped with access to MKSAP questions.

All residents have access to PubMed-based document delivery and clinical librarians to assist with literature searches. Medical libraries (Neil John MacLean Health Sciences Library) annexed to the Health Sciences Centre and the Carolyn Sifton Library at St. Boniface Hospital are accessible for easy access to many print journals.

Night Float

"On-Call" requirements and the Night Float System

Residents do not do one in four in-house call while on general medicine rotations at the two teaching hospitals. Instead, they will do two weeks of "night float", working from 7:00 pm to 8:15 am five days a week. The advantage of this system is that it removes most call responsibilities from residents running the Clinical Teaching Units; they are more available for their patients and housestaff during the day, and have more time to teach and study. As well, there are less "guest call" requirements for residents on subspecialties.

In-house call will be covered in a traditional one in four manner on cardiology (two periods), coronary care unit rotations (one period) and as a PGYl intern on the Clinical Teaching Units (two periods in PGYl). The intensive care unit has a one in four call schedule (two periods). The remaining subspecialties require from home call. Residents will cover a few weekend days a year for general medicine while on subspecialties as "guest call".

When sited at the Grace Hospital (both community based), the ward resident will be responsible to stay until 2300 when a clinical clerk is on call. This would occur two or three times per week and does not include weekends. As a PGY3 on Senior Block, residents provide in-house back-up until 2300 on weekdays and 2000 on weekends one to two times a week, and subsequently back up junior residents at both teaching sites from home.

Contacts

For further information regarding the Core Internal Medicine Training Program please contact:

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