Program Structure

The Department of Medicine at the University of Calgary offers training in internal medicine and its subspecialties including cardiology, critical care, endocrinology and metabolism, gastroenterology, general internal medicine, geriatric medicine, hematology, infectious diseases, nephrology, oncology, respirology, toxicology, palliative care and rheumatology. The department has over 350 faculty members representing a broad range of clinical and research interests. Residents may progress to subspecialty training following the three "core" years; such individuals tend to apply to programs across the country as well as local programs. There is an option to complete a fourth year of internal medicine training under the residency program "umbrella" after the core three years; this is different from the General Internal Medicine as the fourth year is not a recognized fellowship but does allow independent practice as an internist once complete.

The core 3 years in IM

The program is based on a thirteen block "lunar calendar," with the majority of rotations being four weeks in duration. During the first year, six blocks are spent on the internal medicine teaching teams, also known as the medical teaching units (MTU's). The remainder of the year is spent on subspecialty selectives. In the second year trainees spend 1-2 blocks in Critical Care and 3-4 blocks as a senior resident on the MTU. The remainder of the time is spent on subspecialty selectives, out of town electives or research blocks. There is also a rural internal medicine block scheduled at one of the four rural sites (Yellowknife, Red Deer, Lethbridge or Grand Prairie) with full funding provided through the Distributed Learning and Rural Initiatives Office.

The third year consists of 3-4 blocks as a senior resident on the MTU, 1-2 blocks of Critical Care and eight blocks of subspecialty rotations or electives/research. Each of the MTU teams is comprised of three or four PGY-1 residents (with representation from internal medicine, family medicine and other disciplines), two to three clinical clerks and a general internist preceptor. Of the nine MTU's in Calgary four have a senior resident as an assigned resident "ward senior" rotation. Each site has a home-base MTU ward and a MTU director. Night and weekend call on the MTUs is usually one in four model and we abide by the PARA contract. The senior residents also have an "Emergency Liaison" rotation as part of their MTU senior blocks and they function closely with all the local MTU's in the triaging of Internal Medicine patients from the emergency room.

Selectives include all of the subspecialties of internal medicine (which are predominantly consultation services), dermatology, neurology or community internal medicine in Lethbridge, Red Deer, Yellowknife or Grand Prairie.  Emergency Medicine, CaRTE (Calgary Resident Teaching Elective), and out of town "selectives" are considered as elective rotations and trainees are eligible for three electives over their core three years.  Trainees may also take up to three research blocks if they have well-defined project and a research preceptor. Night and weekend call on subspecialties is usually "home call" with the exception of CCU, ICU and Neurology. There is a Point of Care Ultrasound opportunity limited to 10-14 trainees per year.

Attendance in ambulatory care clinics is suggested in subspecialty rotations and there is also a formal subspecialty ambulatory block to allow for an additional and personalized experience. Additional ambulatory Internal medicine experience is also arranged through a formalized ambulatory Internal Medicine block.

The program is designed so there is a continuous evolution from a predominantly primary care role to that of a junior consultant. Responsibility for independent patient care and for functioning as a "teacher" progresses in a manner suited to the ability and mastery of clinical skills demonstrated by the individual resident.

A philosophy of independent self-directed learning underlines the program. Since it is impossible for any individual to master all of the knowledge in internal medicine, it is essential that skills be developed which allow the physician to access pertinent current literature easily, to analyze this critically and to adopt a pattern of self-directed learning which will continue beyond the completion of the program.