Internal Medicine — Rotations
MTU
Medical Teaching Unit
EPAs mapped to this activity
For residents in TTD
| C5. Performing the procedures of Internal Medicine | When Possible |
| F2c. Managing patients admitted to acute care settings with common medical problems and advancing their care plans - Part C: Handover | Optional |
| F4a. Formulating, communicating, and implementing discharge plans for patients with common medical conditions in acute care settings - Part A: Discharge plan documentation | Optional |
| F4b. Formulating, communicating, and implementing discharge plans for patients with common medical conditions in acute care settings - Part B: Discharge plan communication | Optional |
| TTD1. Performing histories and physical exams, documenting and presenting findings, across clinical settings for initial and subsequent care | Required |
| TTD2. Identifying and assessing unstable patients, providing initial management, and obtaining help | Priority |
For residents in F
| C5. Performing the procedures of Internal Medicine | When Possible |
| C8. Caring for patients who have experienced a patient safety incident (adverse event) | When Possible |
| F1. Assessing, diagnosing, and providing initial management for patients with common acute medical presentations in acute care settings | Required |
| F2a. Managing patients admitted to acute care settings with common medical problems and advancing their care plans- Part A: Patient Assessment and Management | Required |
| F2c. Managing patients admitted to acute care settings with common medical problems and advancing their care plans - Part C: Handover | Priority |
| F3. Consulting specialists and other health professionals, synthesizing recommendations, and integrating these into the care plan | Priority |
| F4a. Formulating, communicating, and implementing discharge plans for patients with common medical conditions in acute care settings - Part A: Discharge plan documentation | Priority |
| F4b. Formulating, communicating, and implementing discharge plans for patients with common medical conditions in acute care settings - Part B: Discharge plan communication | Priority |
| F5. Assessing unstable patients, providing targeted treatment and consulting as needed | Priority |
| F6. Discussing and establishing patients’ goals of care | Priority |
For residents in C
| C1. Assessing, diagnosing, and managing patients with complex or atypical acute medical presentations | Required |
| C11a. Supervising junior learners in the clinical setting - Part A: Teaching | Priority |
| C11b. Supervising junior learners in the clinical setting - Part B: Running the Team | Priority |
| C4a. Assessing, resuscitating, and managing unstable and critically ill patients - Part A: Patient Care | Required |
| C5. Performing the procedures of Internal Medicine | When Possible |
| C6. Assessing capacity for medical decision-making | Priority |
| C7. Discussing serious and/or complex aspects of care with patients, families, and caregivers | Priority |
| C8. Caring for patients who have experienced a patient safety incident (adverse event) | When Possible |
| C9a. Caring for patients at the end of life - Part A: Symptom Management in End of Life | Priority |
| C9b. Caring for patients at the end of life - Part B: Discussion about transition away from disease modifying treatment | Priority |
For residents in TTP
| TTP1a. Managing an inpatient medical service - Part A: Overall Patient Care | Required |
| TTP1b. Managing an inpatient medical service - Part B: Interprofessional Care | Required |
| TTP3. Assessing and managing patients in whom there is uncertainty in diagnosis and/or treatment | Required |
| TTP5. Initiating and facilitating transfers of care through the health care system | Required |
| TTP6. Working with other physicians and healthcare providers to develop collaborative patient care plans | Required |
| TTP7. Identifying learning needs in clinical practice, and addressing them with a personal learning plan | Required |
| TTP8. Identifying and analyzing system-level safety, quality, or resource stewardship concerns in healthcare delivery | Required |
Competencies covered in this activity
| 1. Practise medicine within their defined scope of practice and expertise | ||||||
| 1.3. Apply knowledge of the clinical and biomedical sciences relevant to Internal Medicine | ||||||
| 1.3.8. Pharmacology as it relates to pharmacokinetics, pharmacodynamics, mechanism of action, routes of delivery and elimination, and adverse effects of medications | ||||||
| 1.3.8.1. Analgesics | ||||||
| 1.3.8.2. Antimicrobials | ||||||
| 1.4. Apply knowledge of the following systems, clinical scenarios, conditions, diseases and therapies applicable to Internal Medicine, including the manifestations, investigation, and management | ||||||
| 1.4.1. Cardiac | ||||||
| 1.4.1.1. Symptoms | ||||||
| 1.4.1.1.1. Chest pain | ||||||
| 1.4.1.1.2. Dyspnea | ||||||
| 1.4.1.1.4. Syncope | ||||||
| 1.4.1.3. Disorders | ||||||
| 1.4.1.3.1. Acute coronary syndromes and their complications | ||||||
| 1.4.1.3.3. Congestive heart failure | ||||||
| 1.4.1.3.4. Coronary artery disease | ||||||
| 1.4.2. Vascular | ||||||
| 1.4.2.2. Findings | ||||||
| 1.4.2.2.1. Peripheral edema | ||||||
| 1.4.2.3. Disorders | ||||||
| 1.4.2.3.1. Hypertension | ||||||
| 1.4.3. Respiratory | ||||||
| 1.4.3.1. Symptoms | ||||||
| 1.4.3.1.1. Acute and chronic dyspnea | ||||||
| 1.4.3.1.2. Cough | ||||||
| 1.4.3.1.4. Wheeze | ||||||
| 1.4.3.3. Disorders | ||||||
| 1.4.3.3.1. Bronchial asthma | ||||||
| 1.4.3.3.2. Chronic obstructive lung disease | ||||||
| 1.4.3.3.3. Interstitial lung disease | ||||||
| 1.4.3.3.5. Pneumonia | ||||||
| 1.4.3.3.7. Pulmonary embolism | ||||||
| 1.4.4. Gastrointestinal and hepatobiliary | ||||||
| 1.4.4.1. Symptoms | ||||||
| 1.4.4.1.1. Acute and chronic abdominal pain | ||||||
| 1.4.4.1.3. Nausea and vomiting | ||||||
| 1.4.4.2. Findings and investigations | ||||||
| 1.4.4.2.1. Ascites | ||||||
| 1.4.4.2.4. Abnormal liver tests | ||||||
| 1.4.4.3. Disorders | ||||||
| 1.4.4.3.2. Acute and chronic diarrhea | ||||||
| 1.4.4.3.3. Bacterial peritonitis | ||||||
| 1.4.4.3.6. Upper and lower gastrointestinal bleeding | ||||||
| 1.4.4.3.7. Esophageal | ||||||
| 1.4.4.3.7.4. Varices | ||||||
| 1.4.4.3.9. Small and large intestine | ||||||
| 1.4.4.3.9.5. Irritable bowel syndrome | ||||||
| 1.4.4.3.10. Hepatic | ||||||
| 1.4.4.3.10.1. Acute and chronic hepatitis | ||||||
| 1.4.4.3.10.2. Cirrhosis and its complications | ||||||
| 1.4.4.3.12. Pancreatic disease | ||||||
| 1.4.4.3.12.1. Acute and chronic pancreatitis | ||||||
| 1.4.5. Renal | ||||||
| 1.4.5.1. Findings and investigations | ||||||
| 1.4.5.1.1. Acid-base disturbances | ||||||
| 1.4.5.1.2. Fluid and electrolyte abnormalities | ||||||
| 1.4.5.1.3. Hematuria | ||||||
| 1.4.5.1.4. Proteinuria | ||||||
| 1.4.5.2. Disorders | ||||||
| 1.4.5.2.1. Acute renal failure | ||||||
| 1.4.5.2.10. Renal complications of diabetes, hypertension, and rhabdomyolysis | ||||||
| 1.4.6. Endocrine and metabolic | ||||||
| 1.4.6.3. Disorders | ||||||
| 1.4.6.3.2. Diabetes mellitus: type 1 and type 2 | ||||||
| 1.4.6.3.2.1. Complications of diabetes including retinopathy, neuropathy, vascular disease and ulcers | ||||||
| 1.4.7. Neurological | ||||||
| 1.4.7.1. Symptoms | ||||||
| 1.4.7.1.2. Altered mental status and disorders of consciousness | ||||||
| 1.4.7.1.3. Dizziness and vertigo | ||||||
| 1.4.7.1.4. Syncope | ||||||
| 1.4.7.3. Disorders | ||||||
| 1.4.7.3.4. Dementia and delirium | ||||||
| 1.4.7.3.6. Meningitis and encephalitis | ||||||
| 1.4.7.3.10. Peripheral neuropathy | ||||||
| 1.4.8. Hematologic | ||||||
| 1.4.8.1. Findings and investigations | ||||||
| 1.4.8.1.1. Anemia | ||||||
| 1.4.8.2. Disorders | ||||||
| 1.4.8.2.3. Hypercoaguable states | ||||||
| 1.4.8.2.11. Venous thromboembolic disease | ||||||
| 1.4.8.3. Therapies | ||||||
| 1.4.8.3.1. Anticoagulant therapy | ||||||
| 1.4.8.3.2. Prophylaxis for venous thromboembolic disease | ||||||
| 1.4.8.3.3. Transfusion of blood products | ||||||
| 1.4.9. Musculoskeletal | ||||||
| 1.4.9.1. Symptoms | ||||||
| 1.4.9.1.2. Muscular pain | ||||||
| 1.4.9.2. Disorders | ||||||
| 1.4.9.2.10. Rheumatoid arthritis | ||||||
| 1.4.10. Immunologic | ||||||
| 1.4.10.3. Immunosuppression secondary to cancer and immunomodulatory agents | ||||||
| 1.4.10.4. Opportunistic infections | ||||||
| 1.4.12. Infection | ||||||
| 1.4.12.1. Disorders | ||||||
| 1.4.12.1.4. Clostridium difficile colitis | ||||||
| 1.4.12.1.6. Urosepsis | ||||||
| 1.4.12.1.9. Cellulitis and other skin infections | ||||||
| 1.4.12.1.11. Fever of unknown origin | ||||||
| 1.4.12.1.13. Fever in the hospitalized patient | ||||||
| 1.4.12.2. Therapies | ||||||
| 1.4.12.2.1. Spectrum of activity, adverse effects, and dose adjustments for antibiotics | ||||||
| 1.4.12.3. Malignancy | ||||||
| 1.4.12.3.2. Screening and prevention | ||||||
| 1.4.13. Medical aspects of specific situations | ||||||
| 1.4.13.1. Common medical emergencies | ||||||
| 1.4.13.1.1. Life-threatening cardiac, respiratory, gastrointestinal, metabolic, neurologic and other organ system dysfunction and abnormalities | ||||||
| 1.4.13.1.3. Shock, including knowledge and identification of the different etiologies | ||||||
| 1.4.13.1.4. Cardio-respiratory arrest | ||||||
| 1.4.13.1.6. Severe drug reactions including but not limited to anaphylaxis and toxic epidermal necrolysis | ||||||
| 1.4.13.1.7. Complications of chemotherapy | ||||||
| 1.4.13.1.7.1. Febrile neutropenia | ||||||
| 1.4.13.2. Peri-operative assessment and management | ||||||
| 1.4.13.2.2. Anticoagulants and anti-platelet agents | ||||||
| 1.4.13.2.4. Prophylaxis for venous thromboembolism | ||||||
| 1.4.13.4. Medical aspects of mental illness and addiction | ||||||
| 1.4.13.4.3. Effects and side effects of psychiatric medications | ||||||
| 1.4.13.5. Pregnancy | ||||||
| 1.4.13.5.3. Pre-existing medical conditions | ||||||
| 1.4.13.5.3.1. Hypertension | ||||||
| 1.4.13.6. The elderly | ||||||
| 1.4.13.6.1. Symptoms | ||||||
| 1.4.13.6.1.2. Depression | ||||||
| 1.4.13.6.1.3. Delirium | ||||||
| 1.4.13.6.1.4. Falls and immobility | ||||||
| 1.4.13.6.2. Disorders | ||||||
| 1.4.13.6.2.1. Dementia including Alzheimer’s disease, Lewy-body, vascular, and frontal lobe dementias | ||||||
Training experiences included in this activity
Transition to Discipline
Required1.1. Any inpatient medical (e.g., coronary care unit (CCU), intensive care unit (ICU), clinical teaching unit (CTU), subspecialty ward) service or emergency department
1.2. After-hours coverage for inpatients and internal medicine consultation to the emergency department
Foundation of Discipline
Required1.1. Internal medicine inpatient service
1.4. Acute care experience with patients presenting to emergency department
1.5. After-hours coverage for a broad spectrum of inpatients and internal medicine consultation to the emergency department
Core of Discipline
Required1.1. Internal medicine inpatient CTU. This experience must include being the team leader
1.2. Ambulatory care: clinic and/or day hospital. This must include experience with a broad spectrum of conditions as well as patients with complex disorders
1.5. After hours coverage for a broad spectrum of inpatients and internal medicine consultation to the emergency department
1.6. Experience with critically ill patients. This must include ICU, CCU, and internal medicine consultation to the emergency department
Transition to Practice
Required1.1. Inpatient Internal Medicine
1.1.1. Inpatient medical service in the role of a junior attending, e.g., CTU
1.1.2. Inpatient consult service in the role of a junior attending, including to emergency department
1.5. Experience with critically ill patients, in the role of most responsible physician, which must include experience with patients requiring mechanical ventilation and hemodynamic support (e.g., a level 2 or level 1 critical care unit)