Program Contacts

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Important Information

Applicants who successfully match to the NOSM Internal Medicine residency program will be required to home-base in the community/stream they've matched to (e.g. if you've applied and matched to the Internal Medicine Sudbury stream, Sudbury will be your home-base/location of primary residence).

While the core of the training will occur from the home-base location, opportunities will exist to experience different training sites throughout Northern Ontario, in discussion with the program director.

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General Instructions

Program application language: English

Applications will only be accepted through the CaRMS R-1 Main Residency Match application process.

Note: if applying to both streams, candidates are asked to submit the same supporting and reference documents in each application.

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Supporting Documentation / Information

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Review Process

Applications submitted after file review has opened on February 8, 2021

Supporting documents (excluding letters of reference) that arrive after file review has opened  on  February 8, 2021

Letters of reference that arrive after the unmasking date on February 8, 2021

Each application will be reviewed independently by the program director and another faculty member. Interviews will be offered to approximately the top 50-60 candidates between both streams.

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Interviews

Dates:

• March 9, 2021
• March 10, 2021
• March 13, 2021

Selection Criteria

Applicants will be considered by the program based on:

• demonstrated interest in Internal Medicine
• academic record
• strength of their references
• demonstrated strong interpersonal skills
• evidence of self-directed learning, reflective practice, professionalism, and resiliency
• desire to train in various clinical settings and with health care teams
• demonstrated interest/commitment to northern Ontario and/or rural (non-urban) training/practise
• suitability to northern Ontario educationally, professionally, or personally

Applicants are assessed through the following:

• A personal interview
  
  
• The review of the personal letter
  
  
• The review of performance assessments from clinical rotations in medical school and electives
  
  
• The review of letters of reference

Program goals

The NOSM Internal Medicine residency program strives to deliver a comprehensive clinical curriculum which includes core rotations in internal medicine and subspecialty rotations selected to incorporate a diversity of experience and proficiency in subspecialty areas integral to community-based practice.

Our program aims to equip our residents with the necessary skills/competencies to become well-rounded, general internists who are trained to deliver excellent, culturally respectful health care to patients in a wide variety of clinical settings, such as emergency and critical care units, inpatient wards, outpatient clinics, and community settings, including northern urban, rural, and remote communities.

We aim to provide our residents with ongoing support to meet the program training objectives, as well as their own individual learning/career goals. Our goal is that upon completion of training, our residents will be prepared to begin their careers as general internists in any setting, and/or be well-positioned to pursue subspecialty training to further meet their career goals.

 

Selection process goals

Through our selection process, our program aims to identify candidates who have a strong academic history with demonstrated competence and interest in internal medicine. We are seeking candidates who possess superior clinical communication skills and have the ability to relate to patients, their families, and caregivers with compassion, empathy, sensitivity and humility.

We are looking for candidates who possess the ability and willingness to work collaboratively (within and across professional domains) in a team dynamic to secure optimal patient outcomes, while exemplifying the highest standards of professional behavior -- inclusive of responsibility, respect, and self-awareness.

We are also looking to identify candidates who would be a good fit for our program. As a socially accountable medical school, accountable to the needs and the diversity of the populations of Northern Ontario, candidates best suited to the NOSM Internal Medicine Program are those with a vested interest in rural medicine, who can adapt and thrive in a hands-on, distributed rural residency program that requires flexibility and some travel away from their primary location of residence. 

We also believe that candidates who are resilient, can prioritize their personal well-being and work-life balance, and are also committed to self-directed learning, reflective practice, continuing professional development, and quality improvement, are well-suited to our program. Through our selection process we aim to identify and successfully match candidates who possess these attributes as well.

 

File review process

Evaluation criteria :

Elective criteria

Interview process

Interview evaluation criteria :

Information gathered outside of CaRMS application

Specifically, we may consider:
Social interaction during program related events
Communication with program administration
Social media
Unsolicited reference letters
Unsolicited email references
Unsolicited verbal information on a candidate's prior performance
Unsolicited feedback from colleagues and co-workers
Other : In keeping with the CanMEDs roles, please note that throughout the entire application and interview process, your interactions with NOSM personnel may be taken into consideration by the program in their selection process and ranking decisions.

Ranking process

The behavior(s) exhibited below during the interview process may prevent an applicant from being ranked by our program :
Unprofessional or inappropriate behavior   
Did not attend interview   
Interview performance was not competitive   

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Program Highlights

Since its inception, the Internal Medicine program has grown and developed in response to resident feedback. Northern Ontario offers residents a rare opportunity to develop the broad-based knowledge and skills of a true general internist, in an environment with a wide variety of patient problems, diseases and conditions. Residents gain skills quickly in an environment with high clinical responsibility backed up by strong support from preceptors.

With a diverse exposure to all subspecialty procedures and clinical scenarios, residents completing NOSM’s program can expect to practice as highly trained, competent and confident Internal Medicine generalist. 
 

• Unmatched opportunities to develop and learn technical and practical subspecialty skills early in your residency
• Unparalleled preceptor support with lower learner to preceptor ratios, often working solely with your preceptor
• Early integration as a key member of a health care team dedicated to professionalism, high quality patient care and excellent medical education
• Commitment to resident learning
• Self-directed, learner-centred training to meet your career goals
• Exposure to the culture and social fabric of Francophone and Indigenous communities
• Housing and support from NOSM for rotations away from primary residence
• Opportunity to participate in research under expert guidance
• Access to advanced technology and informatics in residency training
• 24/7 access to electric search engines, electronic indexes as well as an extensive collection of electronic medical/health journals and textbooks
• Exceptional lifestyle balance with a wide variety of outstanding Northern Ontario recreational opportunities
• Ultrasound Training
• Annual Simulation event

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Program Curriculum

This residency program is for 4 years.

Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.

The program includes core rotations in Internal Medicine and subspecialty rotations selected to incorporate a diversity of experience and proficiency in subspecialty areas integral to community based practice but less commonly emphasized in traditional Internal Medicine residency programs.

Based on the resident's personal learning plan, the content, sequence of training and schedule of movement between teaching sites may vary. 

TTD (Y1 - BL 1-3) & Foundations (Y1 – BL 4-13)

                                                   

• 4 MCTU*
  
  
• 2 Cardiology*
  
  
• 1 Nephrology* (within first 4 blocks)
  
  
• 3 Subspecialty**
  
  
• 1 Foundational ICU
  
  
• 1 Emergency Medicine
  
  
• 1 Geriatrics

Core 1 (Y2 – BL 1-13)
                                      

• 4 MCTU
  
  
• 2 CCU Ottawa or 2 ICU SUD and TB
  
  
• 1 Community GIM

Core 2 (Y3 – BL 1-13)
                                      

• 4 MCTU

• 2 CCU or 2 ICU (whichever not done in Core 1)

• 1 Ambulatory GIM (MUST be scheduled in first half of year) =>50% outpatient To be define
   

Scheduled any time during Core 1 or Core 2 Training:
                                                                                              

• 1 Community GIM

• 1 Nephrology

• 1 Medical Oncology

• 1 Respirology

• 3 Subspecialty 

• 5 Electives

 

Additional Scheduling Notes:

• Residents cannot be scheduled outside of their home base (Sudbury or Thunder Bay) for more than 2 consecutive blocks without program approval.
• TTD Block 1 must always be scheduled as MCTU.
• ICU in Core 1 or 2 must be scheduled as a two block rotation.
• ICU is also offered in Sault Ste. Marie.
• Community GIM is offered in Huntsville, North Bay, Parry Sound, Sudbury, Thunder Bay and Sault Ste. Marie, Temiskaming Shores and Timmins (PGY3/4 Residents Only).

 

Subspecialty Core:

Residents are strongly encouraged to do one rotation in each of the following subspecialties, in addition to the required rotations listed above.

• Endocrinology (Core or at the end of Foundations, but only one not both Endo and Rheum)
• Gastroenterology
• Hematology
• Infectious Disease
• Neurology
• Rheumatology (Core or at the end of Foundations, but only one not both Endo and Rheum)

 

Electives:

Electives can be done in any subspecialty at any academic institution. The resident is responsible for arranging these rotations.

1 and in some cases 2 elective blocks can be used for research. In order to choose this option residents, residents are required to complete an internal request form (Request for Protected Research Time Form), and there must be a deliverable at the end of each research block.

 

Scholarly Activity:

All residents MUST complete a scholarly activity. It may be done longitudinally or during elective research blocks as outlined above.  Scholarly activities are presented by each resident to the faculty and their peers in their PGY3 year.

 

Community IM Experience:

A community experience outside of Sudbury and Thunder Bay is a key component of the NOSM IM residency program. A minimum of 2 blocks must be done in NOSM communities outside of Sudbury or Thunder Bay, and 1 block can be completed in Sudbury or Thunder Bay.

Approved Sites for Rotations:

• MCTU – Thunder Bay and Sudbury
• Cardiology – Thunder Bay and Sudbury
• Foundational ICU – Thunder Bay and North Bay
• Nephrology – Thunder Bay and Sudbury
• Emergency Medicine – Thunder Bay and Sudbury
• Endocrinology – Thunder Bay and Sudbury
• Gastroenterology – Thunder Bay and Sudbury
• Geriatrics – Thunder Bay and Sudbury
• Hematology – Sault Ste. Marie and Thunder Bay
• Infectious Disease – Sault Ste. Marie, Thunder Bay and Sudbury
• Medical Oncology – Sault Ste. Marie, Thunder Bay and Sudbury
• Neurology – Thunder Bay
• Respirology – Thunder Bay, Ottawa* and Sudbury
• Rheumatology – Barrie and Thunder Bay
• CCU – Sudbury, Ottawa*
• ICU – Sudbury, Thunder Bay and Sault Ste. Marie
  *Ottawa will only be scheduled if NOSM is unable to provide the rotation within a NOSM Community

PGY-4

After completing the three core years of Internal Medicine, residents may choose to continue in a 4th year of NOSM General Internal Medicine. Previous residents have been successful in either route - completing 4th year NOSM General Internal Medicine, as well as applying to subspecialty fellowships at other institutions.

The fourth year NOSM General Internal Medicine program will be designed to meet the particular interests of applicants.

The fourth year of training in Internal Medicine consists of 13 blocks of four weeks duration. 

Clinical Responsibilities & On-Call:

The PGY-4 is generally expected to function at the level of a junior consultant not at the level of a senior medical resident.

Call for core rotations should be 1 in 4 to 1 in 5 (5-7 calls per 28 day block).

Rotation Objectives:

Specific rotation objectives are defined for all core and strongly recommended rotations.

For all elective rotations, the resident is expected to develop objectives based on their own learning goals. These require preceptor and program approval. Objectives must be received by the program 4 weeks prior to the start of the rotation. In addition to the resident developed objectives, there are also general objectives that will apply to elective rotations.

Procedural Training:

Training in the following procedures can be arranged. The resident must identify this goal prior to the beginning of their academic year. 

• Exercise stress testing
• Ambulatory ECG monitoring (e.g. Holter monitors)
• Pulmonary Function Testing
• Bone marrow biopsy and aspiration 

If the resident requires training in other procedures due to a need in their expected community of practice, the program may be able to accommodate.

Procedures requiring more extensive training (e.g. echocardiography, endoscopy) are now included in the scope of a subspecialty GIM fellowship and cannot be accommodated in our PGY-4 IM year.

Academics

Academic half day sessions occur weekly, on Wednesdays, throughout the year during protected time from clinical duties. Academic half days are on a 2 year topic rotation. At the commencement of your residency, academic half days focus on Internal Medicine emergencies to provide an overview for new residents. Residents will also have the opportunity to participate in educational rounds, presentations, journal clubs and rounds through the Ontario Telemedicine Network. 

Residents from both sites meet a minimum of 1 time each year for OSCE and other teaching sessions.

Simulation – Each year, NOSM residents gather for a weekend course designed to teach an approach to various clinical scenarios, including code leadership and core procedure skills with the help of new simulation lab and other modern technologies. 

OSCE – Residents are given the opportunity each year to participate in a formative OSCE delivered in the same format as standard national certification and licensing examinations for the purpose of exam preparation and structured feedback on clinical skills by practicing physicians (including several certified Royal College examiners) in a non-intimidating setting.  

Residents will participate in an evolving research curriculum. They will also have access to a Physician research advisor dedicated to Internal Medicine Residents, a research assistant, and a Research Librarian. All residents will do two four-week rotations in research or scholarly activity. Residents are expected to complete a research project and present their research at the Resident Research Day.  Expert guidance and funding is available to provide high quality research experiences.  In consultation with the Program Director, elective time can also be arranged for research.

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Training Sites

Applicants who successfully match to the program will be required to home-base in the community (stream/site) they've matched to.

NOSM’s Internal Medicine residency is one program, with two main training sites in Sudbury and Thunder Bay. Three spots are available at each site. While, residents will match to either the Sudbury and Thunder Bay sites, opportunities exist to complete rotations throughout NOSM's vast distributed list of training sites based on the resident's learning objectives and consultation with the Program Director.

Thunder Bay:

Thunder Bay Regional Hospital is the referral centre for all of North Western Ontario. It has a full complement of Internal Medicine services. Your subspecialty rotations will be one on one with your preceptor. Your days will be a mixture of inpatient consults, procedures, and clinic. Teaching will be based on you reading around cases and discussions around patients with your preceptor. In such a small medical community you will have to opportunity form close relationships with staff and residents from other specialties. This assures you will be called when interesting cases come into the hospital.

Our Medical Clinical Teaching Unit (MCTU) is staffed by both Subspecialists and General Internists. Your team will have the unique opportunity to care for a roster of 10-15 Most Responsible Physician (MRP) patients and 5-10 consult patients admitted to other services. Your team consists of a Junior Attending, Senior Medical Resident, and Junior Medical Resident as well as 1-3 PGY1s and 2s from other specialties and 2-3 medical students. Senior residents and Staff will lead daily bed side physical examination, noon rounds and regular teaching sessions. On Thursdays we have ICU rounds, and Fridays are Chest Rounds. In the evening you will be on call by yourself overnight with support of your preceptor over the phone. You will typically see 4-6 consults in a call shift. In addition, we provide a procedure service to the hospital including paracentitis, thoracentisis, joint aspiration, and lumbar puncture. 

Our hospital divides consults with a hospitalist service. This assures we see the most interesting and more acute patients.  Our Gastroenterology, Respirology, Rheumatology, Endocrinology, and Infectious Disease services do not admit patients, so we get the chance to care for the most complicated, interesting and unusual cases from these specialties. We also accept regional referrals community hospitals. These patients tend to be quite complicated and present in later stages of disease

In addition, there will be many opportunities for you to teach as a PGY1 on MCTU as well as at the medical school.

NOSM has a thriving resident social committee shared by family medicine, obstetrics, general surgery, orthopedic surgery, psychiatry, emergency medicine, and anesthesia. We plan trips on a quarterly basis, holiday parties, and social events.

Thunder Bay is an outdoor paradise located on the shore of Lake Superior the world's largest fresh water lake. It is adjacent to beautiful landscapes such as the iconic Sleeping Giant Provincial Park. You have hiking, camping, downhill skiing, cross country skiing, boating, sailing, rock climbing, ice climbing, fishing and much more at your door step. Thunder Bay is located 60 km from Minnesota USA, and 700 km from Winnipeg MN. It has an international airport served by Air Canada, Porter, West Jet, US Airways and Bearskin Airlines with 6-8 flights per day to Toronto. Thunder Bay has many great restaurants in any price range. It has a large student population with both Lakehead University and Confederation College. A physician recruiter is available to answer any further questions you may have.  

 

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Additional Information