Core Program
Resources
The Internal Medicine Training Program consists of two tertiary hospitals and one community hospital in Winnipeg. A brief description of each hospital is given below. The catchment area includes all of Manitoba and parts of Northwestern Ontario, Saskatchewan, Nunavut and the Northwest Territories (approx. 1.5 million people). The large catchment guarantees that residents receive a variety of clinical experience from a diverse patient population. The University of Manitoba is well known for the diverse pathology of its patients.

Hospitals
Health Sciences Centre
Number of beds - 800
Number of emergency patients/year - 40,815
Health Sciences Centre is a tertiary care referral centre formed in 1973 through an amalgamation of the Winnipeg General Hospital, the Women's Hospital, the Children's Hospital of Winnipeg and the Rehabilitation Hospital of Manitoba. As a result, the Centre provides trainees with exposure to a wide range of acute and chronic medical problems, as well as to virtually all specialty and subspecialty areas of medicine. Major renovation and expansion was completed early 2007 with a new Emergency Room, new ICU's, and new operating rooms. This hospital serves a large core population and is the major referral centre for northern communities.

St. Boniface General Hospital
Number of beds - 600
Number of emergency patients/year - 37,000
SBGH is the second largest hospital in Winnipeg. St. Boniface Hospital has a full range of specialty and subspecialty services and departments in its role as a major tertiary care referral centre. It has maintained a strong commitment to serving as a community hospital for the surrounding area. Renovations are currently in the works, with upgrades to many wards already complete.

Grace General Hospital
Number of beds - 281
Number of emergency patients/year - 25,255
With roots now more than 100 years old in Winnipeg , the Grace General Hospital came to its present site in 1967. First a rescue home for women and children and then as a maternity hospital, the Grace today provides surgical, mental health, medicine and emergency programs as well as physiotherapy, occupational therapy, pharmaceutical, laboratory and diagnostic imaging services. The newest addition to the Grace is its west wing, which was completed in 1994.

Wards
Medicine Clinical Teaching Units (CTUs) accept admissions from all medical subspecialties. There are essentially no subspecialty wards with the exception of Cardiology. This means that time spent on medicine CTU's is a broad exposure to all areas of internal medicine. All subspecialty rotations are a combination of inpatient consultative work and outpatient clinics, with minimal inpatient 24 hour coverage provided by the subspecialty (with the exception of Cardiology). 

Faculty
Program faculty consist of both full-time and part-time members in all Royal College recognized internal medicine subspecialties including general medicine, infectious diseases, respirology, cardiology, nephrology, endocrinology, rheumatology, haematology/oncology, immunology, gastroenterology, geriatrics, hepatology and critical care. Sub-specialty training programs are available in all of these areas.

The Academic Half-Day
The Academic Half Day is a period of protected teaching time that is scheduled every Tuesday afternoon. The Half Day content covers core Royal College objectives. Faculty from each subspecialty teach a comprehensive curriculum of content knowledge at a level appropriate to a general internist. The sessions are a mix of didactic and case-based lectures and present clinical approaches and the latest evidence surrounding a topic. Small group discussions are increasingly utilized for curriculum delivery with faculty supervision.

In addition, residents in each PGY level are responsible for some curriculum delivery to enhance presentation skills. For PGYls, this is in the form of a Case of The Week, PGY2s Landmark Clinical Trial Reviews, and PGY3s Journal Club. All residents are responsible for preparing and performing two physical exam topics every month with PGY4 GIM residents providing guidance and feedback.

Semi-Annual Resident Retreats
Each fall, the residents will gather together for a weekend fall retreat. This is usually held outside of Winnipeg from Friday to Sunday. Some time is allotted to cover core content (discussions on career planning, CMPA, etc.), with the remainder reserved for recreation and team-building exercises. All costs are covered by the program.

In the spring, residents will meet together for a half day and night at a local restaurant. Again, some core content will be covered. Costs once again are program covered.

While the retreats provide an opportunity to review important topics for resident training, they are also an excellent opportunity to spend time with your fellow residents and have some fun.

Resources for Residents
A Residents' Room is found at HSC and SBGH. This is furnished with a selection of resource books in all subspecialties of Internal Medicine, and serves as a 24 hour in-hospital library and informal meeting place for residents.

Computers with Internet and e-mail access are available at both sites in the Residents' Room and on all Clinical Teaching Units. The University subscribes to a large selection of electronic journals, which are easily accessible from home or the Residents' Rooms. The Library and Department of Medicine provide the web-based UpToDate for all residents and faculty. Residents' Rooms are also equipped with access to MKSAP questions.

All residents have access to PubMed-based document delivery and clinical librarians to assist with literature searches. A Medical Library (Neil John MacLean Health Sciences Library) is found attached to the Health Sciences Centre, for easy access to many print journals.
 
Conference Leave 
Each resident has the opportunity to attend a yearly conference and access funding for conference related costs. Additional funding is available to residents who present research at a conference. For those residents presenting projects there is a continued commitment to cover all costs.


 
ACADEMICS

Curriculum
The program consists of three core years. Each year is divided into 13 four week periods. The program is designed to provide residents with a broad clinical experience to attain the knowledge, skills, and attitudes to practise internal medicine in an exemplary manner. There is an emphasis on becoming a strong clinical physician. As residents progress through the program, they assume increasing responsibility under appropriate supervision with the flexibility to be self-directed in defining their own educational needs. Ambulatory care is emphasized in our program to expand the patient spectrum upon which to learn. 

PGY-1 (core)
Clinical Teaching Unit Intern- 8 weeks
Clinical Teaching Unit Resident- 4 to 8 weeks
Cardiology Wards - 8 weeks
CCU 4 weeks (or in PGY2 year)

Night Float – 4 weeks (2 two week blocks)
Elective Subspecialty Rotations** - 20 to 24 weeks periods
Vacation - 4 weeks

PGY-2 (core)
Clinical Teaching Unit Ward Resident- 16 to 20 weeks
Coronary Care Unit - 4 weeks (if not done in PGY1 year)

Medical ICU – 4 weeks (or done in PGY3 year)
Elective Subspecialty Rotations** - 16 to 20 weeks
Night Float – 4 weeks (2 two week blocks)
Vacation - 4 weeks

PGY-3 (core)
Clinical Teaching Unit Ward Resident - up to 8 weeks
Medical Intensive Care Unit - 8 weeks (or 4 if one block done in PGY2 year)
Night Float - 2 weeks
Senior Rotation* - 24 weeks
Elective Subspecialty Rotations** - 10 to 14 weeks
Vacation - 4 weeks

* The senior rotation includes ambulatory care clinics (8 weeks, plus one 'continuity clinic' which runs the entire 6 months), the general internal medicine consult service and screening in the emergency rooms (16 weeks).

**Elective Subspecialty rotations are offered in every subspecialty of internal medicine and related fields. It is possible to do elective rotations in other provinces. The residents may also do a 4-8 weeks of research elective(s) in place of doing a subspecialty rotation. Opportunities are available for doing rural internal medicine electives in several smaller Manitoba communities, as well as short visits to the Northern Medical Units in remote health centres in Manitoba and Nunavut.


RESEARCH

Residents are required to present a clinical vignette or clinical investigation in each of their Core years at the annual departmental Resident Research Day, open to residents and fellows. There are opportunities to become involved in research in every area of internal medicine. Many faculty members are actively engaged in research and interested in supervising and corroborating with residents. One to two subspecialty rotations can be devoted purely to research, allowing dedicated time to both clinical and basic science endeavours. Residents from Manitoba have presented and won competitions at large meetings, including national ACP conferences.


RESIDENTS

The residents in the program come from a diverse array of backgrounds. The largest proportion are University of Manitoba grads, with representation from most programs around the country and a few schools from abroad.

The residents often socialize outside of work and many of are on recreational sports teams together (like Ultimate Frisbee and Sponge Hockey, etc.). Other organized activities within the program are discussed elsewhere - retreats, etc. Outside the Internal Medicine program, the resident’s professional association (PARIM) sponsors many gatherings for residents from all programs with food and beverages throughout the year. There are usually two formal evenings sponsored by PARIM per year, and numerous informal events. 



WINNIPEG

Lifestyle
Winnipeg is a friendly, multicultural city of approximately 800,000, situated in the centre of Canada. It is a fairly laid back city with a friendly atmosphere, and plenty of cultural diversity.

Winnipeg is home to the Royal Winnipeg Ballet, the Winnipeg Symphony Orchestra, Manitoba Opera, and many theatre companies including Rainbow Stage and Manitoba Theatre Centre. Recently, the architecturally renowned Canadian Museum of Human Rights was opened in Winnipeg, the first national museum outside of Ottawa. We are also known for our variety of excellent restaurants serving food from all parts of the world.

Summers in Winnipeg are filled with festivals including the Folk Festival (which is outstanding), the Jazz Festival, the Fringe Festival, and, unique to Winnipeg - Folklorama.

As Winnipeg is in close proximity to numerous lakes, parks and beaches, there is no shortage of places to camp, fish, and hike. The summers are sunny and very hot for the most part. This also makes ideal weather for many summer sports including ultimate Frisbee, football and running (through our numerous parks).

Winnipeg is also known for its cold winter months. The readily available snow allows for a variety of winter sports and gives an ideal setting for the Festival du Voyageur. We are also home to many professional and amateur sports teams including the Winnipeg Blue Bombers (Football), Winnipeg Jets (Hockey), Manitoba Moose (Hockey), and Winnipeg Goldeyes (Baseball).

Finally, Winnipeg has an affordable cost of living in Canada. It is easy to find a very nice apartment or house within 10-20 minutes of either hospital for a reasonable amount of money.


DISTINCTIVE FEATURES OF THE MANITOBA PROGRAM: 

Morning Report 
Residents run Morning Report every weekday from 7:30 to 8:15. The goal is to provide interactive Royal College style case-based discussions to junior residents on the CTU and Night Float services with an emphasis on core internal medicine concepts. Attending physicians frequently attend Morning Report to contribute to discussion. There is also a focused handover from the prior night.

Senior Rounds 
Occurring every Friday at noon, these rounds are given by an R3 on their senior block to a group of attendings and senior residents. Topics surround a specific clinical question and the evidence behind the answer.
 
Emergency Summer Series
Throughout the summer, sessions are held a few times a week from 12-1pm with attendings giving lectures on common medical emergencies/urgencies.
 
Grand Rounds
Held every Tuesday morning, guest speakers and local faculty present topics related to their area of expertise.
 
Resources for Residents
A Residents' Room is found at both teaching hospitals. This is furnished with a selection of resource books in all subspecialties of Internal Medicine, and serves as a 24 hour in-hospital library and informal meeting place for residents. Both community sites also have space and resources for resident use including books and computers.

Computers with Internet and e-mail access are available at both sites in the Residents' Room and on all Clinical Teaching Units. Also accessible on these computers are patient lab data and radiology. The University subscribes to a large selection of electronic journals, which are easily accessible from home or the Residents' Rooms. The Library and Department of Medicine provide the web-based UpToDate for all residents and faculty. Residents' Rooms are also equipped with access to MKSAP questions.

All residents have access to PubMed-based document delivery and clinical librarians to assist with literature searches. Medical libraries (Neil John MacLean Health Sciences Library) annexed to the Health Sciences Centre and the Carolyn Sifton Library at St. Boniface General Hospital are accessible for easy access to many print journals.



NIGHT FLOAT 
   
"On-Call" requirements and the Night Float System:

Residents do not do one in four in-house call while on general medicine rotations at the two teaching hospitals. Instead, they will do two weeks of "night float", working from 7:00 pm to 8:15 am five days a week. The advantage of this system is that it removes most call responsibilities from residents running the clinical teaching units; they are more available for their patients and housestaff during the day, and have more time to teach and study. As well, there are less "guest call" requirements for residents on subspecialties.

In-house call will be covered in a traditional one in four manner on cardiology (two periods), coronary care unit rotations (one period) and as a PGYl intern on the clinical teaching units (two periods in PGYl). The intensive care unit has a one in four call schedule (two periods). The remaining subspecialties require from home call. Residents will cover a few weekend days a year for general medicine while on subspecialties as "guest call".

When sited at the Grace Hospital (both community based), the ward resident will be responsible to stay until 2300 when a clinical clerk is on call. This would occur two or three times per week and does not include weekends. As a PGY3 on Senior Block, residents provide in-house back-up until 2300 on weekdays and 2000 on weekends one to two times a week, and subsequently back up junior residents at both teaching sites from home.



 
CONTACT INFORMATION 
  Program Director:
Dr. Carmen Hurd

Program Administrator:
Paulette Tougas

Chief Residents

 


CONTACT INFORMATION
Program Director (Dr. Carmen Hurd)


Program Administrator (Paulette Tougas)
Chief Residents