Curriculum

Our Program has a strong academic curriculum which is presented in a flexible format according to the evolving needs of healthcare education. In addition to a comprehensive approach to general internal medicine, the academic curriculum also includes bioethics, evidence-based medicine, critical appraisal and communication skills. TIPS (Teaching Improvement Project System) is a mandatory course that develops communication and teaching skills. While our teaching staff is relatively small there is a wide range of academic and research interest represented and the small size of our program provides for close contact between staff and residents.

The first three years of the residency program are considered core training. The purpose of these three years is to build a firm foundation in the practice of internal medicine that will be supplemented by either: a) subspecialty training or b) an additional year of training in internal medicine in preparation for a community or academic practice in general internal medicine.

Clinical rotations are scheduled in 13 four-week blocks per year. Rotations will vary in length from 1/2 to 2 blocks, depending on the rotation.

Ambulatory care experience is available on most subspecialty rotations and is also available as a “2 half block rotations” during first and third year. During the block rotation, residents pre-schedule half-day or full-day clinics weekly with preceptors of their choice. Additional time on the ambulatory care rotation is used for follow-up of investigations, reviewing dictations and communicating with referring physicians, and to pursue evidence based answers to clinical problems seen in the clinic. Evaluation of residents on the ambulatory care rotation is encounter-based, with opportunity for formative feedback to be provided as patients are reviewed with the attending physician.

PGY-1

The current PGY-1 curriculum, has undergone revision recently for the transition to CBD which started on July 1, 2019. For further information on Competency by Design, please refer to this website.

The PGY-1 year focuses on the development of strong clinical examination skills and patient management skills. It also provides for extensive experience in emergency assessment and management of medical problems. Junior residents are responsible for the primary assessment of patients referred to Internal Medicine from the Emergency Department. A typical PGY-1 year is structured as follows:

• Multiple blocks Clinical Teaching Unit in which the resident works as part of a team comprised of: CTU Chief (faculty member), one senior resident, three to four junior residents, two senior medical students.
• 1 block Coronary Care Unit
• 1 block Neurology
• 2-3 block selectives
• 1 block Emergency Medicine

PGY-2

The second core year is designed to provide a wide range of experience in subspecialty areas as well as Sr. roles of Internal medicine such as CTU Sr. Two blocks of ICU will primarily be scheduled in PGY 2 year, and 7-8 blocks of subspecialty selectives or preceptorships. Three elective blocks will be primarily scheduled in the PGY 2 and PGY 3 year.

PGY-3

The third core year, residents will continue to gain experience and continue to improve their consultancy skills through a number of opportunities including CTU Sr., outpatient department, emergency room consults and subpsecialty rotations. These rotations occur at both Royal University Hospital in Saskatoon and the Regina General Hospital in Regina. One block of CCU is mandatory during the PGY-3 year.

PGY-4

This year is designed to prepare the resident for the practice of Internal Medicine in all its aspects. The PGY-4 year offers a reasonably flexible rotation schedule which will be tailored to meet the interests, career goals, and the CBD EPA’s for completion of training. The PGY-4 year is geared towards completing training in community-based Internal Medicine.

Subspecialty Training

Subspecialty fellowships are currently offered in Cardiology, GIM, Respirology, Rheumatology and Nephrology. Residents trained in our program have had extremely good success in obtaining out-of-province fellowships in the subspecialty of their choice. Chief Residents at both sites can offer guidance to gain resident perspective due to no electives this year.

Vacation

Each resident is entitled to 20 regular working days plus 6 consecutive days at either Christmas or New Year’s. At least two weeks of holidays will be taken as a scheduled block and the dates must be chosen at the time the resident schedule for the year is created. The remaining 2 weeks of holiday time may be taken during the course of the year upon approval by the rotation supervisor and Program Director. If residents prefer, all 4 weeks of holidays may be taken as a scheduled block or as two 2 week blocks.

Educational Leave

Residents are entitled to up to 7 days of paid leave annually to attend approved educational events (includes travel time). Each resident is provided with annual conference funding. Additional funding may be available to support travel costs with priority being given to residents traveling to present papers or research.

Examinations and Assessments

Regular examinations are an essential component of our training program — both to allow assessment of the resident’s progress in knowledge acquisition and to assist residents in preparing for certification examinations. Examinations take a variety of formats, including:

• ACP In-Training Exam: this is a comprehensive multiple choice examination set at the expected PGY-2 level. Individualized feedback is provided to each resident that allows him or her to assess progress in knowledge acquisition and to compare their standing with a large group of other residents at the same stage of training. Areas of strength and weakness are identified. Residents are expected to write this examination annually during the PGY-1 to PGY-3 years of the program. Fees for the examination are paid by the program. This examination is not used for promotion or evaluation purposes in the program but is used as a self-assessment modality.
• Oral examinations are held regularly throughout the program.
• A mandatory OSCE examination for PGY-1’s is held annually.
• A mandatory OSCE examination for PGY-2’s is held annually.
• A mandatory OSCE examination for PGY-3’s is held annually.
• A mandatory Clinical Scenario examination for PGY-2’s and PGY-3s is held annually.

In addition to formal examinations, evaluations of clinical performance are completed by preceptors at the end of each rotation. Overall, resident performance is reviewed and summarized by the Competency Committee as outlined by Royal College requirements.

Research

The goals of our resident research program are:

• To promote interest and develop skills in research in Internal Medicine
  
• To acquire skills in interpretation of clinical research
  
• To provide opportunities for residents to explore and understand different types of research
  
• To provide opportunities for residents to acquire research and presentation skills
  
• To provide opportunities for residents to publish their research

Research Expectations

PGY-1 Year:

First year residents are expected to identify an instructive clinical case and complete a verbal presentation of the case as part of Resident Research Days. Faculty mentors provide guidance in choosing and writing up cases. Prizes are awarded for the best three case reports and residents are encouraged to submit case reports for presentation at regional or national meetings.

PGY-2 Year:

PGY-2 year residents are expected to complete a quality assurance project and to present their work as a poster presentation or podium presentation during Resident Research Days. Collaboration with other residents is encouraged. Prizes are awarded for the top three poster presentations.

PGY-3 Year:

PGY 3 The completion of a research project during the PGY3 is optional.
A research facilitator with specific skills and interests in research and biostatistics is available to assist residents in identifying potential research projects and identifying appropriate mentors. Limited funding is available to support selected research projects by application to the Department of Medicine Research Committee.

Seminars & Academic Program

• Morning Report is case base discussions around the cases admitted overnight.
  
• PGY 1 Foundations seminar series are held during academic half days from July to November/December. They are videoconferenced to Regina. This is protected education time and attendance is mandatory for all residents.
  
• Core Internal Medicine PGY 2/3 Academic Half Day are held Tuesdays 12:00 — 1:00 pm and Thursdays 2:00 — 5:00 p.m. They are videoconferenced to Regina and St. Paul’s Hospital. This is protected education time and attendance is mandatory for all residents.
  
• Grand Rounds are held on Wednesday’s at 12:00 to 1:00 p.m. Attendance is MANDATORY for residents in the Internal Medicine program. They are videoconferenced to Regina and St. Paul’s Hospital.
• Training in learning styles and teaching skills is an integral part of our program. In addition, PGY-1 residents are required to complete the 2 day TIPS (Teaching Improvement Project System) Course. Assessment of teaching and presentation skills is also an integral part of the program.
• Quality Improvement Rounds (Tuesdays) — sessions will be scheduled throughout the year and are presented during AHD. These will be led by PGY 2 and PGY 3’s. They are videoconference to Regina and St. Paul’s Hospital.
• PGY 1 Internal Medicine Bootcamp is held at the beginning of residency to introduce Competency by Design medical education training to the incoming PGY 1 residents.
• PGY 1 residents will be part of the PGME led RaPID (Resuscitation and Procedural InterDisciplinary) curriculum which is scheduled throughout the year and is mandatory for all PGY 1 residents in Internal Medicine. The curriculum includes high fidelity simulation sessions, ultrasound simulation sessions and central venous line insertion simulation sessions.
• Transition camp for PGY 2 and PGY 3’s are held in May and June. They are designed to assist in-coming PGY 2 and PGY 3 residents in making the transition to their new roles and responsibilities — supervising, teaching and evaluating Junior members of the team.
• A resident retreat is organized annually. The retreat is a combination of social events, educational sessions and discussions about the program. Recent retreats have included Practice management seminars and personal development themes.