Most Canadian hospitalists are family physicians who have developed the necessary set of skills required to care for their complicated hospitalized patients through years of experience. In our ever-changing health care climate, with the complexity of patient care, the development of quality metrics and resource efficiencies as part of the everyday life of a hospitalist, there is a need for extra training opportunities. The development of key clinical abilities are needed for this role and often times there is insufficient time in our two year family practice residency to focus on the inpatient. The future viability of community hospitals is at stake, as fewer family medicine graduates complete their training and take up inpatient work with our community hospitals.
The goal is to develop enthusiastic family physicians that choose to work primarily in hospitals, while still adhering to the founding principles of Family Medicine while providing a multidisciplinary approach to patient care and having a vested interest in making hospitals run better. Future graduates will take leadership roles in addressing quality, efficiency, and cost effectiveness, by improving care processes from admission to discharge. The Society of Hospital Medicine in the United States developed a 51-chapter document in 2002 outlining the core competencies that were felt to be the necessary skills that all hospitalists should have. They used their core competencies to set expectations regarding the role of hospitalists, developing knowledge, skills and attitudes to have a successful and pivotal role in hospital culture. These documents have been reviewed and have assisted in planning a solid foundation for this program while helping to guide its future development.
The McGill Hospital Medicine Training Program is of a twelve month duration.
Rotations / Learning Sites
The training program will consist of 13 blocks of 4 weeks each, with the allotted vacation time as any PGY-3 year is required to provide. The training would take place at St Mary’s Hospital, the Jewish General Hospital and the MUHC, including Lachine General Hospital site, and possibly some McGill rural sites and is proposed as follows:
•3 blocks ward medicine, including 1 block Short Stay Unit (SSU)
• 1 block CCU
• 1 block ICU
• 2 blocks elective (outside the core hospital). Can be divided into 4 blocks of 2 weeks each
• 2 blocks consult service Internal medicine
• 1 block Scholarly Project
• 2 blocks shared care experience (Oncology, Neurology, Orthopedics and Pulmonary )
• 1 block selective which can be either Ward medicine, ICU or CCU
• Electives can be chosen from the following areas: cardiology, nephrology, neurology, endocrinology, GI, Oncology, palliative-inpatient care, radiology, ID, chronic care, ER,ICU, and rural hospitalization
Fellow Duties and Responsibilities
1) Patient care on whichever service they are scheduled, including admissions, discharges and daily rounds; To be supervised by the attending physician.
2) Whenever possible the R3 will take on the clinical and teaching responsibilities of a “junior staff” physician.
3) Attendance at departmental meetings when appropriate.
4)Attendance at Medical Grand Rounds
5) Prepare a talk to be given at Medical Grand Rounds
6) The R3s will be involved in supervising residents and students during the various rotations. Their involvement in direct patient care will vary from one rotation to another and will be commensurate with their level of training and experience.
7) During the last 2 rotations, the Resident will be expected to perform as a co-attending, with the same call (usually from home) and coverage (including weekends and holidays) as their staff, under the supervision of that staff.
Each resident will be required to complete a Scholarly Project (this could be a research project, a literature search and review presentation, a quality assurance review, development of a clinical tool etc.) under the supervision of a mentor. Also McGill Family Medicine has developed a series of webinars to teach research methodology to trainees
The site directors will serve as the One45 supervisors for the residents at their site. They will collate feedback from field-notes and rotation evaluations
R3s will be assessed with respect to their achievement of mastery of the core competencies outlined in Appendix I. Field-notes of their daily performance will be completed and collated to do a one45 monthly and 3 monthly evaluation.
For information regarding the program
benjamin.schiff [at] mcgill.ca (Dr. Benjamin Schiff)
Director Hospital Medicine Program
For information regarding the application process
enhancedskills.fammed [at] mcgill.ca (TBA)
Student Affairs Coordinator
All required documents need to be sent to:
Postgraduate Medical Education Faculty of Medicine McGill University
3655 Promenade Sir William Osler
Montreal, Quebec, H3G 1Y6