Internal Medicine
Curriculum
Our curriculum uses the Royal College of Physicians of Canada Competency-by-Design (CBD), which is a competency-based curriculum.
Residents go through stages of residency. In each stage, residents focus on gaining competency in specific tasks, called Entrustable Professional Activities (EPAs). Once they gain competency in all of those tasks, they move to the next stage.
Stages
Transition to Discipline (TTD)
EPAs
Foundation of Discipline (F)
EPAs
- F1 Assessing, diagnosing, and providing initial management for patients with common acute medical presentations in acute care settings
- F2a Managing patients admitted to acute care settings with common medical problems and advancing their care plans- Part A: Patient Assessment and Management
- F2b Managing patients admitted to acute care settings with common medical problems and advancing their care plans - Part B: Communication with Patient/Family
- F2c Managing patients admitted to acute care settings with common medical problems and advancing their care plans - Part C: Handover
- F3 Consulting specialists and other health professionals, synthesizing recommendations, and integrating these into the care plan
- F4a Formulating, communicating, and implementing discharge plans for patients with common medical conditions in acute care settings - Part A: Discharge plan documentation
- F4b Formulating, communicating, and implementing discharge plans for patients with common medical conditions in acute care settings - Part B: Discharge plan communication
- F5 Assessing unstable patients, providing targeted treatment and consulting as needed
- F6 Discussing and establishing patients’ goals of care
- F7 Identifying personal learning needs while caring for patients, and addressing those needs
Core of Discipline (C)
EPAs
- C1 Assessing, diagnosing, and managing patients with complex or atypical acute medical presentations
- C2a Assessing and managing patients with complex chronic conditions - Part A: Assessment, Diagnosis, and Management
- C2b Assessing and managing patients with complex chronic conditions - Part B: Patient Education/Communication
- C3a Providing internal medicine consultation to other clinical services - Part A: Patient Assessment and Decision-Making
- C3b Providing internal medicine consultation to other clinical services - Part B: Written consultation note
- C3c Providing internal medicine consultation to other clinical services - Part C: Oral Communication with referring physician
- C4a Assessing, resuscitating, and managing unstable and critically ill patients - Part A: Patient Care
- C4b Assessing, resuscitating, and managing unstable and critically ill patients - Part B: Interprofessional Care
- C5 Performing the procedures of Internal Medicine
- C6 Assessing capacity for medical decision-making
- C7 Discussing serious and/or complex aspects of care with patients, families, and caregivers
- C8 Caring for patients who have experienced a patient safety incident (adverse event)
- C9a Caring for patients at the end of life - Part A: Symptom Management in End of Life
- C9b Caring for patients at the end of life - Part B: Discussion about transition away from disease modifying treatment
- C10 Implementing health promotion strategies in patients with or at risk for disease
- C11a Supervising junior learners in the clinical setting - Part A: Teaching
- C11b Supervising junior learners in the clinical setting - Part B: Running the Team
Transition to Practice (TTP)
EPAs
- TTP1a Managing an inpatient medical service - Part A: Overall Patient Care
- TTP1b Managing an inpatient medical service - Part B: Interprofessional Care
- TTP2a Managing longitudinal aspects of care in a medical clinic - Part A: Overall Patient Care
- TTP2b Managing longitudinal aspects of care in a medical clinic - Part B: Collaboration and Efficiency
- TTP2c Managing longitudinal aspects of care in a medical clinic - Part C: Patient survey
- TTP3 Assessing and managing patients in whom there is uncertainty in diagnosis and/or treatment
- TTP4 Providing consultation to off-site health care providers
- TTP5 Initiating and facilitating transfers of care through the health care system
- TTP6 Working with other physicians and healthcare providers to develop collaborative patient care plans
- TTP7 Identifying learning needs in clinical practice, and addressing them with a personal learning plan
- TTP8 Identifying and analyzing system-level safety, quality, or resource stewardship concerns in healthcare delivery
Teaching Activities
Rotations
- Endocrinology and Diabetes
- CCU
- Nephrology
- Hematology
- MTU
- Respiratory Medicine
- Neurology
- Rheumatology
- ER
- Gastroenterology
- ICU
- Infectious Diseases
- Medical Consultations
- Community Medicine
- Geriatrics
- Allergy and Immunology
- Dermatology
- Hematological Oncology
- Obstetric Medicine
- Oncology
- Palliative Care
- Longitudinal Clinic
- Cardiology
Weekly Site-Based Lectures
- Stroke
- DKA & HHS
- Heart Failure
- COPD
- Hepatitis
- Meningitis/Encephalitis
- Shock
- Thyroid Disorders
- ACS
- UGIB
- Seizures
- SLE
- AKI
- ARDS
- Septic Arthritis
- Anemia
- Diabetes and complications
- Pneumonia
- Acid-Base Disorders
- Bronchial Asthma
- Hypertension
- Arrhythmias/ECG approach
- Rheumatoid Arthritis
- Headache
- CKD
- Chronic Liver Disease
- OSA/OHS
- Hypo/hypernatraemia
- FUO
Onboarding and Orientation
Research Course
QI & Safety Course
Old Senior Academic Day Lectures (Until Sep 2023)
- Pericarditis, pericardial effusion and tamponade
- Hypertensive crisis guidelines
- Valvular heart disease: case based
- Communication Skills: Conflict with Senior Physician
- Cardiomyopathy classification and management
- Infective endocarditis: diagnosis and management
- Functional and physiological basis of mechanical supportive ventilation: types of ventilators, SIMV, APRV, pressure support, volume support, noninvasive positive pressure ventilation
- Radiological imaging in respiratory diseases: CT/HRCT
- Pulmonary embolism guidelines
- Communication Skills: Case Base History Taking
- Updates in pulmonary hypertension: evaluation and management
- Approach to the patient with massive hemoptysis
- Approach to the patient with pulmonary nodules (types, DX)
- Physiological changes and adaptation during pregnancy
- Types of hypertensive disorders in pregnancy
- Drug safety in pregnancy and lactation
- Communication Skills: Preconception Consultation
- Common causes of altered state of consciousness
- Approach to the patient with increase intracranial pressure
- Polyneuropathy and mononeuroritis multiplex
- Case of the Month
- Approach to the patient with headache
- Indications and interpretation of neuroimaging
- Understanding the indications and contraindications of thrombolysis
- Communication Skills: Ethics (Case Based)
- Medical complications and systemic effects of cancer
- Common chemotherapy drugs and their side effects
- Indications, contraindications and complications of bone marrow biopsy
- Case of the Month
- Chronic liver disease: causes, complications, investigations, management
- NASH/NAFLD updates in management
- Celiac disease and other causes of malabsorption
- Biliary tract diseases: sclerosing cholangitis
- SLE, antiphospholipid syndrome, and lupus nephritis
- An approach to diagnosis and initial management of systemic vasculitis
- Pharmacological and nonpharmacological interventions for rheumatic diseases: side effects and risks of therapy
- Who should be referred for pre-op assessment? Cardiac and respiratory risk stratification
- Approach to multiple myeloma and other blood malignancies
- Management of neutropenia and immunosuppression
- Thrombophilia and venous thromboembolic disease
- Acute poising and intoxication
- Approach to glomerular diseases
- Approach to tubulointerstitial nephritis
- Hypertension causes and update in pharmacological treatment
- Systemic manifestations of renal diseases
- Psychological issues of aging
- Counseling patient in general health maintenance and screening
- Skin manifestations of systemic diseases
- Case of the Month
- Approach to the patient with bolus lesion (pemphigus, pemphigoid)
- Medications and therapies of common dermatological disorders
- Communication Skills: History Taking
- Bed Side Teaching
- Pituitary adenomas: functioning and nonfunctioning
- Thyroid malignancy
- Case of the Month
- Approach to patients with hirsutism and oligomenorrhea
- Oral and non oral therapies of diabetes
- Diabetes complications: approach to investigations and management
- Communication Skills: Medical Error
- Fever of unknown origin
- Infectious diarrhea
- Communication Skills: Taking Consent
- Bed Side Teaching
- Principles of infection control with emphasis on practice to reduce nosocomial transmission
- Communication Skills: History Taking (case based)
- Bed Side Teaching
Old Core Academic Day Lectures (Until Sep 2023)
- ECG interpretation: identify normal and abnormal rhythms
- Acute coronary syndrome: presentation, diagnosis, and management
- Pathophysiology, evaluation, and treatment of common dysrhythmia
- Congestive heart failure: acute and chronic, pathophysiology, diagnosis, treatment
- Communication Skills: Medical Encounter
- Interpretation of PFT, Acid-Base, Blood Gas
- Radiological imaging in respiratory diseases (or, How to read a CXR)
- Diagnostic features of ventilation perfusion scans
- Acute and chronic respiratory failure
- Asthma acute and chronic
- COPD classification and management
- Infections lung diseases: TB, pneumonia, fungal
- Communicating with the Patient and Family
- Neuroimaging
- Seizures and status epilepticus
- Cerebrovascular accidents: highlight in landmark trial
- CNS infections: meningitis, encephalitis, brain abscesses
- Diagnostic tests in rheumatic disease: what’s old, what’s new, what’s useful?
- Diffuse inflammatory connective tissue diseases: SLE, RA, vasculitis
- Disorders of stomach, esophagus
- Upper and lower GI bleeding
- Hepatic failure: acute and chronic
- Interpretation of diagnostic studies: peripheral blood smears, bone marrow, biopsy specimens
- Hemolytic anemia
- Transfusion reactions
- Interpretation of microscopic urinalysis
- Fluid and electrolyte abnormalities
- Acute and chronic kidney disease: etiology and management
- Management of chronic kidney disease complications: HT, anemia, mineral, metabolism abnormalities, electrolyte disturbances, volume overload
- Principles of oncology
- Oncological emergencies
- Malignancy screening
- Communication Skills: Medical Errors
- Interpreting the results of hormonal assays in stimulated and suppresses states
- Thyroid emergencies
- DKA/hyperosmolar ketoacidosis
- Calcium disorders: hypercalcemia, hypocalcemia
- Primary hyperparathyroidism: approach and management
- Osteoporosis investigations and management
- Formal geriatric assessment tools
- Geriatric polypharmacy
- Approach to the geriatric giants
- Conflicts with senior physicians and team communication
- Types of shock
- ARDS approach and management
- Evaluating volume status and choosing IV fluids
- Skin manifestations of systemic disease
- Dermatological emergencies
- Fever in hospitalized patients and hospital acquired infections
- Neutropenic fever and infections in immunocompromised patients including HIV
R1 Academic Day
- Approach to chest pain
- Approach to shortness of breath
- Approach to shock
- WHO Patient Safety Solutions
- Approach to GI bleeding
- Impact of medical documentation and handover in patient care
- Approach to anaemia
- How to Excel as a Resident
- Approach to AKI
- Approach to electrolyte imbalance
- Common Ward Calls
- Workshop: Resident Wellness
- Approach to diabetes emergencies
- Approach to thyroid fuction test
- Workshop: Critical Appraisal
- Approach to hyponatremia
- Managing opioids prescription
- Workshop: How to read ECG
- Approach to headache
- Approach to arrhythmia
- Medical Ethics
- Lab interpretation (CBC, RFT, LFT, coags, blood gas)
- Approach to calcium disorders and bone disorders
- VTE/Hypercoagulable State
- Ice Cream Rounds
- Receiving Feedback Effectively and acting on it
- Approach to decreased LOC/dizziness
- Workshop: Communication skills
- Approach to HTN emergencies
- Approach to chronic liver disease
- Workshop: CXR & neuroimaging
- Approach to Seizures
- Approach to Fever of Unknown Origin
- Workshop: Introduction to POCUS
- Approach to delerium and agitated patients
- Antimicrobial stewardship
R2 Academic Day
- Approach to abnormal LFTs
- Malabsorptive syndromes and diarrhea
- Hypoglycemia disorders
- Anticoagulation management
- Interstitial lung disease
- Antibiotic use and misuse
- Approach to joint pain (mono and polyarthritis)
- Pleural effusion work up and results interpretation
- Lipid disorders
- Heart Failure
- Inflammatory bowel disease
- Workshop: How to read PFT
- NASH - MASLD
- Approach to glomerular disease
- Approach to Hemoptysis
- Adrenal Disease
R3 Academic Day
- Infective Endocarditis
- Hospital Acquired Infections
- Sarcoidosis
- Dislipidaemia (Workshop)
- Osteoporosis
- Obesity
- Communications Skills Workshop
- Fasting and medications management
- Approach to patient with pericardial disease
- Ice-Cream Rounds
- CANMEDS role integration
- Pituitary Disease
- Screening (Workshop)
- HIV and complications
- Dermatology Emergencies
- Septic Arthritis
- Medical Ethics and professionalism (Workshop)
- Hemeoncology for internists
- Valvular heart disease
- Managing Hajj (workshop)
- Palliative care
- Comprehensive geriatrics assessment
- Common OPD scenarios (workshop)
- TB and complications
- Vasculitis
- Approach to peripheral neuropathy
- Data Interpretation (workshop)
R4 Academic Day
R5 Academic Day
- How to navigate R5 with no stress
- Role of a senior
- Communication skills work shop
- Exam orientation
- COPD/BA guidelines
- Cardiology MCQs and case discussion
- Pre operative assessment
- Consultation workshop
- Cases in geriatric medicine
- Neurology MCQs and case discussion
- Heart Failure guidelines
- Neurology MCQs and case discussion
- OPD oral scenarios workshop
- Gastroenterology MCQs and case discsussion
- Surviving sepsis guidelines
- Cases in Obstetric Medicine
- Emergency oral scenarios workshop
- Respirology MCQs and case discussion
- Pulmonary Embolism guidelines
- Wellness check-in
- Workshop: Case-based integration of CANMEDS roles
- General Medicine MCQs and case discussion
- Nephrology MCQs and case discussion
- Nephrology MCQs and case discussion
- Station 6 workshop (brief clinical scenarios)
- Hematology MCQs and case discussion
- Atrial fibrillation guidelines
- Exam Preparation (Workshop)
- Approach to the patient with painful joint
- Rheumatology MCQs and case discussion
- Latest ADA guidleines
- Endocrinology MCQs and case discussion
- Infectious diseases MCQs and case discussion
- Wellness check-in
- KDIGO guidelines
- Oncology MCQs and case discussion