About NOSM Education Research Communities

NOSM Internal Medicine

NOSM's Internal Medicine residency offers comprehensive training combining learning in the larger urban centres with rotations in Northern Ontario.  Based out of both Northeastern and Northwestern Ontario, this hands-on program provides for a unique residency opportunity that will expose you to the most expansive variety in learning opportunities. 

Curriculum

The program includes core rotations in Internal Medicine and subspecialty rotations selected to incorporate a diversity of experience and proficiency in subspecialty areas integral to community based practice but less commonly emphasized in traditional Internal Medicine residency programs.

Based on the resident's personal learning plan, the content, sequence of training and schedule of movement between teaching sites may vary.  Residents are required to provide their own vehicle and it is strongly recommended that residents have a laptop computer.

Core Program Clinical Rotation Outline

TB - Thunder Bay
SUD - Sudbury
SSM - Sault Ste. Marie


PGY-1

  • MCTU (TB and SUD) – 4 blocks
  • Cardiology TB and SUD – 1 block
  • Community Cardiology SSM – 1 block
  • ICU (only available in SSM) – 1 block
  • Nephrology – 1 block
  • Emergency Medicine (TB and SUD) – 1 block
  • Subspecialty Selectives – 4 blocks  

PGY-2

  • MCTU – 4 blocks
  • CCU (Ottawa) or ICU (SUD and TB)  - 2 blocks
  • Community GIM – 1 block
  • Subspecialty Selectives – 3 blocks
  • Electives – 3 blocks

PGY-3

  • MCTU – 4 blocks
  • CCU or ICU (whichever not done in PGY-2) – 2 blocks
  • Community GIM – 2 blocks
  • Subspecialty Selectives – 3 blocks
  • Electives – 2 blocks    

ICU in PGY-2 or PGY-3 must be done as a two block rotation 

Community GIM is offered in Huntsville, North Bay, Parry Sound, Sudbury, Thunder Bay and Timmins


Subspecialty Selectives:

Residents are strongly encouraged to do one rotation in each of the following subspecialties in addition to the required rotations listed above. Program approval is required if any specific subspecialty rotations are NOT going to be completed. 

  • Endocrinology TB and SUD
  • Gastroenterology TB and SUD
  • Geriatrics TB and SUD
  • Hematology SSM and TB
  • Infectious Disease SUD and TB
  • Medical Oncology SSM and TB and SUD
  • Nephrology TB and SUD
  • Neurology TB
  • Respirology TB and Ottawa
  • Rheumatology SUD and TB  

Electives:

  • Electives can be done in any subspecialty at any academic institution. The resident is responsible for arranging these rotations.
  • 1 and in some cases 2 elective blocks can be used for research. There must be a deliverable at the end of each of these blocks.
  • With program approval, up to 2 elective blocks can be converted to do a second rotation in a subspecialty selective. 

Scholarly Activity:

All residents MUST complete a scholarly activity. It may be done longitudinally or during elective research blocks as outlined above.


PGY-4

After completing the three core years of Internal Medicine, residents may choose to continue in a 4th year of NOSM General Internal Medicine.  Previous residents have been successful in either route - completing 4th year NOSM General Internal Medicine, as well as applying to subspecialty fellowships at other institutions.

The fourth year NOSM General Internal Medicine program will be designed to meet the particular interests of applicants.

The fourth year of training in Internal Medicine consists of 13 blocks of four weeks duration. There are five mandatory blocks. Elective rotations should be balanced and tailored to the individual resident’s needs and future practice. Rotations can be set up at centers outside of NOSM, with approval of the program. The final rotation schedule must be approved by the site and/or program director.

Mandatory Rotations:

  • MCTU – 2 blocks as junior attending; Residents are encouraged to do one rotation in Sudbury and one rotation in Thunder Bay
  • Community GIM – 2 blocks; to be done in two different NOSM communities
  • ICU -1; Must be completed in a closed ICU; Suggested that it is completed in a NOSM community

Elective Rotations:

  • Cardiology – strongly recommended to complete one or two blocks 
  • ICU – Strongly recommended to complete a second block
  • Endocrinology
  • Gastroenterology
  • Geriatrics
  • Hematology / Oncology
  • Infectious Disease
  • Nephrology
  • Neurology
  • Respirology
  • Rheumatology
  • Other rotations can be completed with program approval.  

Clinical Responsibilities & On-Call:

The PGY-4 is generally expected to function at the level of a junior consultant not at the level of a senior medical resident.

Call for core rotations should be 1 in 4 to 1 in 5 (5-7 calls per 28 day block)

Rotation Objectives:

Specific rotation objectives are defined for all core and strongly recommended rotations.

For all elective rotations, the resident is expected to develop objectives based on their own learning goals. These require preceptor and program approval. Objectives must be received by the program 4 weeks prior to the start of the rotation. In addition to the resident developed objectives, there are also general objectives that will apply to elective rotations.

Procedural Training:

Training in the following procedures can be arranged. The resident must identify this goal prior to the beginning of their academic year.  

  • Exercise stress testing
  • Ambulatory ECG monitoring (e.g. Holter monitors)
  • Pulmonary Function Testing
  • Bone marrow biopsy and aspiration  

If the resident requires training in other procedures due to a need in their expected community of practice, the program may be able to accommodate.

Procedures requiring more extensive training (e.g. echocardiography, endoscopy) are now included in the scope of a subspecialty GIM fellowship and cannot be accommodated in our PGY-4 IM year.  


Academics

Academic half day sessions occur weekly, on Wednesdays, throughout the year during protected time from clinical duties. Academic half days are on a 2 year topic rotation. During blocks 1-3 of each year academic half days focus on Internal Medicine emergencies to provide an overview for new residents. Residents will also have the opportunity to participate in educational rounds, presentations, journal clubs and rounds through the Ontario Telemedicine Network.

Residents from both sites meet a minimum of 1 time each year for OSCE and other teaching sessions.

Simulation – Each year, NOSM residents gather for a weekend course designed to teach an approach to various clinical scenarios, including code leadership and core procedure skills with the help of new simulation lab and other modern technologies.

OSCE – Residents are given the opportunity each year to participate in a formative OSCE delivered in the same format as standard national certification and licensing examinations for the purpose of exam preparation and structured feedback on clinical skills by practicing physicians (including several certified Royal College examiners) in a non-intimidating setting. 

Purpose of American Boards – Each year, all NOSM Internal Med residents write the American Board of Internal Medicine (ABIM) Qualifying Exam with the goal of promoting self-awareness of strengths and weaknesses within the wide spectrum of Internal Medicine. This test also offers residents an excellent opportunity to witness their own progress on a yearly basis as they progress from PGY1 through PGY3 and helps them prepare for the Royal College examination written in PGY4.

Residents will participate in an evolving research curriculum. They will also have access to a Physician research advisor dedicated to Internal Medicine Residents, a research assistant, and a Research Librarian.  All residents will do two four-week rotations in research or scholarly activity. Residents are expected to complete a research project and present their research at the Resident Research Day.  Expert guidance and funding is available to provide high quality research experiences.  In consultation with the Program Director, elective time can also be arranged for research.

In addition, residents will be offered the option of ATLS during the fourth year. The anticipated outcome is of a well-rounded generalist trained to provide a broad range of services which are in high demand in community based General Internal Medicine. The program will give the resident additional skill sets that might not typically be available to General Internal Medicine residents. Versatility and flexibility are the hall marks of true generalists and will be the basis of NOSM’s fourth year program. 


Resident Handbook

Internal Medicine Resident Handbook 2015-2016

Please note that an updated handbook will be provided to incoming residents upon commending the program. 

How to Apply

To apply to NOSM's Internal Medicine program, visit the Canadian Resident Matching Service (CaRMS) website at www.carms.ca and select the Northern Ontario School of Medicine's Internal Medicine residency program description. 

Contact 

Dr. Kim Tilbe
Program Director
NOSM Internal Medicine Residency Program

Melanie Desloges
Coordinator, Postgraduate Specialty Medicine
Tel: (705) 662-7103 
Email: melanie.desloges@nosm.ca

 

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