Program Overview

Welcome to the internal medicine residency training program website. The Queens program is fully accredited by the Royal College of Physicians and Surgeons of Canada and was reviewed October, 2011.

Our core program currently trains 54 residents with approximately 80 (FT, PT, adjunct) faculty in the department of medicine. The program is predominantly based at Kingston General Hospital (KGH) which serves the city of Kingston and a large catchment area of Southeastern Ontario. KGH is a tertiary care referral hospital for the region and provides the highest standards of health care.

We have implemented a number of changes to the program over the last several years in a process designed to improve the educational experience for the residents.

• Acute general medicine training is provided on 4 traditional clinical teaching units (CTUs) which expose the residents to the fundamentals of inpatient care. Residents are responsible for emergency room consults and admissions, and each team provides medical care for approximately 20-25 patients on the medicine wards and in the step down unit (Davies 4 ICU). Each team has a cap of 12 new patients per call night.
• A separate CTU E / Medicine Short Stay Unit (MSSU) is a unique rotation that provides complimentary training. This team staffs a 10-14 bed medical short stay unit where the expected length of stay is <72hours. They provide care in a high-volume, rapid turn over unit with specially trained nurses. This team also covers Emergency room consults from 7.30am until 1pm daily when the regular CTU call team takes over. The CTU E team helps staff and triage patients 'over the cap'.
• Subspecialty training is based on rotations through inpatient consultation services and ambulatory clinics. Residents rotate through each of the major specialties and have a number of selectives and electives available for additional experience as desired.
• Training in intensive care is currently scheduled as an introductory Airway/ICU block in the PGY1 year, and then 2 blocks of the PGY2 year. Experience in managing critical care patients is vital before residents become PGY3 in the program. Residents receive simulation training and a separate educational curriculum during their ICU blocks.
• Longitudinal clinics in general medicine are introduced in the PGY2 and run until the completion of the PGY3 year. Residents are divided into 4 groups and matched with one of the GIM Attendings. They remain with this preceptor for 2 years and are expected to attend clinics regularly over this time in order to obtain a true continuity experience. 
• Night Float shift (R2/R3) in the ER from 10pm-8am (+2hrs for handover) for acute Medicine call.
• Hospitalist Service (CTU H) for ALC patients decanted from CTU (no residents)

The program is committed to providing a high quality educational experience throughout the 3 years of training in preparation for the Royal College Exams and the practice of medicine.

 Curriculum

Our goal is to provide our trainees with experience in all the major disciplines of internal medicine. The program is designed with a system of graded responsibility and differing types of call from the PGY1 to PGY3 years. The PGY1 year is focused mainly on inpatient ward experiences (CTU and Cardiology) but also involves some consult rotations, ER, Airway/ICU training and Community Medicine rotations. The PGY2 residents serve as team leaders on the CTUs, complete their ICU training, a night shift block and consult rotations. The PGY3 residents supervise patient care and teaching on the CTUs and have significant responsibility for the acutely sick patients on the Davies 4 ICU. They also complete GIM peri-op consults and other medical subspecialty consult services. 

 
Sample schedule:

PGY1	PGY2	PGY3
CTU	Allergy & Immunology	Elective
Palliative Care	ID Consults	CTU
CTU	Elective	Gastroenterology
Cardiology ward	ICU	Selective
Selective	ICU	Hematology Consults
CTU	Rheumatology	CTU-E
Subspecialty	CTU	Nephrology
Community Medicine	Respirology	GIM consults & clinics
ER	CTU	Cardiology / CCU
CTU-E	Medical Oncology	CTU
Elective	Night Float	Endocrinology
CTU	Elective	CTU
Airway/ICU	CTU	Neurology

 PGY4

We guarantee all our trainees 4 years of training. The PGY4 year in general internal medicine is structured with the career goals of the trainee in mind and their schedule is created with the PGY4 program director. All trainees MUST apply for any subspecialty programs through the nationally run PGY4 CaRMS match.

Research / Scholarly Activity

Queens has many active research programs and residents are encouraged to join with a mentor to complete a research project. Elective times are availab le for research blocks and residents who take this opportunity are expected to present at the annual resident research day. Evidence of other scholarly activities (e.g. Grand Round presentations, quality assurance project, case report, abstract presentations at national meetings) are a required part of training.

Benefits

Conference Attendance

Residents have up to 7 days of educational leave each year and the department will help fund one conference a year.

Vacation & Days off

Residents are entitled to 20 days (4 weeks) vacation per year, plus 5 days off over Christmas or New Year and one floating day. We allow an additional 5 days off for interviews for the PGY3 residents. Holiday days worked can be claimed back as a lieu day within 90 days.