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Palliative Medicine Residency Program

The Palliative Medicine Residency Program at Queen’s University is a one-year postgraduate training program accredited by both the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada. The Program is designed to train physicians who will provide primary and consultant palliative care services, and to provide basic academic training for physicians who may seek academic careers in Palliative Medicine


Goals and Objectives of the Program

      1. To provide advanced training for physicians who wish to develop added competence in Palliative Medicine.
      2. To prepare physicians to provide secondary consultant level expertise to support other physicians and their patients.
      3. To provide basic academic training for academic careers in Palliative Medicine.

Successful residents will acquire a broad-based understanding of the principles, philosophy, and core knowledge, skills and attitudes of palliative medicine.  Using the CanMEDS format, Learning Objectives have been developed for the Program to satisfy the requirements of the Specific Standards Document.

Description of the Program

The Program provides an advanced training opportunity during which a high degree of clinical autonomy and independent scholarship is expected and encouraged.  Although the focus is primarily clinical, trainees are provided opportunities to develop skills to be effective educators and time to develop and complete a Scholarly Project.  Throughout the year, an evidence-based approach to learning and clinical care is emphasized.

The Clinical rotations include primary and consultative palliative medicine in both institutional and community settings.  The training year is comprised of both block rotations and longitudinal components.

The block components include three mandatory rotations of variable lengths and three elective rotations of 4 weeks each.

The mandatory rotations are as follows:

1.      Acute Hospital Inpatient Palliative Medicine Service

Five (4-week) blocks are spent as a member of the interprofessional team providing primary care to patients in designated Complex Palliative Medicine beds, and Consultative Services to patients and their families at the Kingston General Hospital (KGH), an acute care teaching hospital that services the population of Southeastern Ontario.  The five blocks are divided during the year to enhance learning, support graded-responsibility, and facilitate evaluation of the trainee’s progress. 

2.      Medical and Radiation Oncology

One (4-week) block is spent in each of Medical and Radiation Oncology at the Cancer Centre of Southeastern Ontario, an outpatient, tertiary cancer centre affiliated with KGH.  Trainees participate in the care of cancer patients attending oncology ambulatory clinics. 

3.      Palliative Care Unit/Community

Three (4-week) blocks are spent providing primary palliative care within the community and, as a member of the interprofessional team, managing patients admitted to the 10 in-patient beds at the Providence Care Hospital Palliative Care Unit (PCU). 

The longitudinalcomponents are all mandatory experiences and include: 

1. Weekly half-day Palliative Medicine Clinics at the Cancer Centre of Southeastern Ontario.
Trainees provide consultation and ongoing symptom management to patients referred to the out-patient Clinics.

2. Weekly Academic Half-days.
Trainees are freed from clinical duties a minimum of one half-day per week to attend formal teaching sessions, pursue self directed studies, and/or develop their Scholarly Project or presentations. 

3. Weekly Palliative Medicine Academic Rounds.
Trainees participate in the Rounds and are responsible for presenting regularly. 

4. Scholarly Project
Trainees complete an original Scholarly Project during the year, supervised by a faculty member. 

Teaching and clinical supervision of trainees is provided by faculty of the Palliative Care Medicine Program, including full time palliative medicine specialists, community-based palliative care physicians, and other health care professionals.  Individual Faculty Advisors provide guidance and support to trainees throughout the program year.  Evaluation includes self-assessment, direct observation, case discussions, and review of academic activities and scholarly project.

Cancer Centre of Southeastern Ontario

The Cancer Centre of Southeastern Ontario (CC-SEO)is an outpatient, tertiary cancer centre affiliated with the Kingston General Hospital.  It is a regional referral centre for medical oncology, radiation oncology, gynaecological oncology, pediatric oncology and surgical oncology. 

CC-SEO is well resourced with academic Medical and Radiation Oncologists who provide care to adult and pediatric patients with all tumour types.  Approximately 4500 new patients are seen per year.  Follow-up visits include radiation therapy and chemotherapy treatment visits.  For the Palliative Medicine resident who is not a specialist in Oncology, there is a one month rotation in each of Medical and Radiation Oncology. Residents attend ambulatory care clinics assessing patients to learn more about the natural history of different cancers, available treatment options, and complications of treatments.

Palliative Medicine Clinics

Five ambulatory Palliative Medicine Clinics are held weekly in the Cancer Centre of Southeastern Ontario. The clinics provide a consultation service for the management of difficult symptoms in patients who are followed by the CC-SEO.  Patients are seen in follow-up until their symptoms are well managed and then they are returned to the care of their family physician or primary oncologist.  Others are followed on an ongoing basis.  Approximately 250 new consults and 800 visits occur in the five Clinics annually.  The Palliative Medicine consultant works closely with the Oncologists, members of the Palliative Medicine and Supportive Care Program (e.g. social worker, dietitian, pharmacist) and Community Care Access Centre case managers in the management of patients.  The resident attends one of the clinics on a regular basis throughout the year.

The CC-SEO uses the resources of ISAAC (Interactive Symptom Assessment and Collection) with touch-screen technology enabling all patients attending the CC-SEO to complete ESAS prior to their appointment.  The care team is provided with a cumulative print-out to assist with quality care.

Palliative Care Unit & Community

Providence Care Hospital Palliative Care Unit (PCU)

Providence Care Hospital is a rehabilitation and complex care facility that has ten dedicated palliative care beds (PCU).  Patients with advanced terminal illness who are unable to be cared for in other settings are admitted to the PCU for symptom management, psychosocial distress, and end-of-life care.There are approximately 150 admissions per year. The interprofessional team meets each Thursday morning with representatives attending from palliative medicine, nursing, occupational therapy, physiotherapy, social work, pastoral care, psychology, pharmacy, and the volunteer co-ordinator.

Community

The greater Kingston area has a population of 166,000, with 25 Retirement Homes, and 11 licensed Long Term Care Facilities.  Community services are exceedingly important and provide a rich educational experience for the resident.
The Palliative Care Medicine Program community physicians receive over 200 new referrals annually and provide approximately 1600 visits per year.

The Community Care Access Centre  (CCAC) is responsible for arranging and co-ordinating government-funded palliative care for patients in their homes.  The CCAC is highly supportive of activities that enhance learning opportunities for health care professionals.  They have a significant number of nursing case managers who are dedicated to the area of palliative care.

The Palliative Pain and Symptom Management Consultation Service (PPSMCS) is a regional community resource sponsored by the CCAC.  Two full time consultants (Kingston and Belleville) and one half-time consultant (Smith’s Falls) provide consultation by serving as resource persons to service providers.  They also offer case-based education and mentoring to staff in community agencies, long-term care homes, community health centres, and family health teams.

Hospice Kingston, which is co-located with the Palliative Care Medicine Program, provides a community focus and support to patients and families.  Care is directed at enhancing quality of life physically, emotionally, and spiritually.  They provide patient advocacy, caregiver support, skilled volunteers and Day Hospice services.

List of Past Resident Scholarly Project

Dr. Ave Ellaurie (2016-2017): Subjective Response to Treatment in a Palliative Care Clinic Specializing in Management of Advanced Dyspnea in Non-Malignant Population

Dr. Roddy Davey (2015-2016): Muscle Mass with Progressive Dyspnea in Advanced Cancer.

Dr. Jaimi Heidman (2014-2016): Palliative Care Pocket Book

Dr. Saneea Abboud (2014-2015): Exploring the Impact of Art Therapy on Ambulatory Palliative Care Patients with an Incurable Cancer Diagnosis

Dr. Kelly Parks (2013-2014): Assisted Death: Murder or End-of-Life Care.

Dr. Stephen Singh (2011-2012): Takotsubo Cardiomyopathy Secondary to Cancer Related Pain Crisis - case study.

Dr. Christina Quinlan (2011-2012): Financial Impact of Palliative Care Services - literature review; Palliative Care Referral Information Sheet.

Dr. Arnell Baguio (2010 - 2011): Developing a rational, step-wise, pharmacologic approach to bowel management for palliative care patients - literature review.

Dr. Desmond Leung (2010-2011): Cancer Cachexia: systematic review of medications used in its management.

Dr. Abdullah Suhail (2008-2010): Effect of Inhaled Nebulized Fentanyl Citrate on Exercise Tolerance & Exertional dyspnea in Patients with COPD

Dr. Rawabi Shaikh (2007-2008): Establishing home based palliative care in King Fahad Specialist Hospital Saudi Arabia

Dr. Natalie Kondor (2006-2008): Palliative Care in Prince Edward County: Addressing a Priority

Dr. Julia Wildish (2005-2006): Efficacy of Topical Opioids for the Treatment of Pain from Skin Ulcers: A Review of the Evidence

Dr. Lana Tan (2004-2005): Opioid Rotation to Methadone for Cancer Pain: A retrospective chart review

Dr. Areej Matar (2004-2005): A randomized, double-blind, placebo-controlled study of menthol for management of dyspnea

Dr. Desiree Dunn (2003-2004): Physician Burnout: A Palliative Care Fellow’s Recommendations for Prevention

Dr. Rafa Al-Shehri (2002-2003): A Comparative Descriptive Study of Palliative Care in Saudi Arabia and Palliative Care in Canada

Past and Current Palliative Medicine Residents

  • Dr. Jason Malinowski (September 1, 2001 - August 31, 2002)
  • Dr. Rafa Al-Shehri (September 1, 2002 - August 31, 2003)
  • Dr. Désirée Dunn (September 1, 2003 - August 31, 2004)
  • Dr. Areej Matar (January 1, 2004 - February 28, 2005)
  • Dr. Lana Tan (July 1, 2004 - June 30, 2005)
  • Dr. Julia Wildish (September 1, 2005 - August 31, 2006)
  • Dr. Natalie Kondor (July 2006 - Janurary 2008)
  • Dr. Rawabi Shaikh (July 2007 - July 2008)
  • Dr. Abdullah Al Suhail (July 2008 - June 2010)
  • Dr. Julie Bryson (September 2009 - June 2010)
  • Dr. Desmond Leung (July 2010 - July 2011)
  • Dr. Arnell Baguio (October 2010 - October 2011)
  • Dr. Stephen Singh (July 2011 - June 2012)
  • Dr. Maied AlShehery (July 2011 - June 2012)
  • Dr. Christina Quinlan (August 2011 - March 2012)
  • Dr. Hasan Khudairi (July 2013 - June 2014)
  • Dr. Kelly Parks (October 2013 - April 2014)
  • Dr. Saneea Abboud (July 2014 - June 2015)
  • Dr. Jaimi Heidman (July 2014 - June 2016)
  • Dr. John (Roddy) Davey (October 2015 - September 2016)
  • Dr. Alison Flanagan (July 2016 - July 2017)
  • Dr. Aveksha Ellaurie (July 2016 - June 2017)
  • Dr. Ryan Fisher (Fellow) (October 2017 - Present)
  • Dr. Alex Trussler (PM Subspecialty Program) (July 2017 - Present)
  • Dr. Daniel Robinson (September 2017 - Present)
  • Dr. Hasitha Welihinda (Fellow) (October 2017 - Present)

Application Process

2018 -2019 PGY3 Enhanced Skills - Palliative Care Application Information

Applications open: Monday August 21, 2017
Online Applications deadline: Friday October 6, 2017
Interview period: Monday October 9 to Wednesday December 6, 2017
Acceptance Notification: Thursday December 7, 2017
Deadline for Acceptance: Friday December 15, 2017

How to Apply
Complete the PGY3 Online Application Form. You are required* to upload the following documents to the online system:

  • Letter of Intent - one to two pages in length, addressing objectives and motivations for pursuing additional training;
  • A current Curriculum Vitae;
  • Three (3) letters of reference, one of which must be from your Program or Site Director.

* Please note: Reference letters may be mailed/emailed/faxed directly to the Department of Family Medicine:

Dana Doll, PGY3 Program Coordinator
Department of Family Medicine
Queen's University, Haynes Hall
115 Clarence Street
Kingston, ON K7L 3N6
Email: PGY3Programs@dfm.queensu.ca
Fax: 613-533-9301


The Program is open to applicants who have attained certification by the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada, or have completed the educational requirements for certification by one of the Colleges.  Foreign applicants must have equivalent credentials.  Applicants must also be eligible for licensure (Educational or Independent Practice) in Ontario.
Applicants must submit a letter of intent, curriculum vitae, and three letters of reference.  PGY3 applicant’s submissions are sent to the Department of Family Medicine prior to review by the Palliative Medicine Program Director.  Applicants from Saudi Arabia must forward their documents to the Saudi Arabian Embassy in Ottawa. Other Canadian and foreign applicants should forward their submission directly to the Program Director.
Members of the Queen’s Palliative Medicine Residency Committee review all applications and decide on those to be formally interviewed.  At the time of the interview, candidates have the opportunity to visit the site and meet with current Palliative Medicine residents.  Successful candidates are established by the Residency Committee based on the quality of the application and references.
For further information, please contact Dr. Ingrid Harle, Director of Palliative Medicine Residency Program.

Kingston General Hospital

The Kingston General Hospital (KGH) is a teritiary level acute care teaching hospital that services the population of Southeastern Ontario.  As a tertiary care hospital, it is fully resourced with access to all modern investigational and interventional technologies.  The Palliative Care Medicine Service at Kingston General Hospital is an interprofessional team of health care professionals and volunteers that provides primary palliative care for patients in 3 Complex Palliative Medicine beds, acute care consultation services and concurrent care for patients from all services who are in need of such expertise.  Consultations include symptom control as well as advice and support for psychosocial and spiritual concerns.  The interprofessional palliative care team, which includes a palliative medicine physician, advanced practice nurse in palliative care, social worker, volunteer co-ordinator, chaplain, and dietitian, meets on a weekly basis to discuss patients.  The Palliative Care Medicine Service sees a total of approximately 600 new patients annually and provides approximately 5000 visits per year.  Many referrals originate from Medical and Radiation Oncology, however, the spectrum is not specific to cancer care only.  Patients are referred for both consultation and concurrent care from Surgery, Urology, Gynaecology, Cardiology, Nephrology and General Medicine.