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Northern Ontario School of Medicine - Internal Medicine - Thunder Bay

2021 R-1 Main Residency Match - first iteration
CMG Stream for CMG

Last approved on November 23, 2020

Summary of changes

Approximate Quota:

 3 

Accreditation status : Accredited

Provincial Criteria


Dr. Sandra Cameron
c/o Program Coordinator 
Postgraduate Education - Internal Medicine 
935 Ramsey Lake Road
Sudbury, Ontario, P3E 2C6
705-662-7103
Northern Ontario School of Medicine

Program Contacts

Shane Esarik
Program Coordinator (Thunder Bay)
sesarik@nosm.ca

Melanie Desloges
Program Coordinator (Sudbury)
mdesloges@nosm.ca
705-662-7103


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.


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.


Supporting Documentation

Canadian citizenship
Document must be notarized/certified
Required
Submit one of the following documents to verify your Canadian citizenship:
• Canadian Birth Certificate or Act of Birth
• Confirmation of Permanent Residence in Canada
• Passport page showing Canadian Citizenship
• Canadian Permanent Resident Card (both sides of card)

IMPORTANT NOTICE: As per the Ontario Provincial Eligibility Criteria, if you are submitting a Canadian Birth Certificate or Act of Birth, or Confirmation of Permanent Residence in Canada document, you MUST submit a government issued photo I.D. to accompany your citizenship documentation.

Reference documents
Required
Number requested: 3
Reference letters must be written by clinical teachers and/or faculty who have reasonable knowledge of you, either through close association in clinical training situations or as your faculty advisor. References should provide an assessment of your: medical knowledge; clinical skills; interpersonal skills, ability to communicate effectively; and your attitudes toward learning.
Additional documents
Required
Photo 
[Note: Photograph is used as memory aid only]

Appreciated for memory aid.

Medical School Transcript 

Order from your registrar.

Medical Student Performance Record 

Order from your Dean's office.

Custom Résumé / CV 

Personal Letter 

The personal letter (maximum 1000 words) focusing on the following:

  • experiences that led to your interest in Internal Medicine;
  • aspects of the NOSM Internal Medicine program that interest you;
  • personal qualities that make you an ideal candidate for practice in Northern and remote settings;
  • how you anticipate this program will assist you in becoming an excellent Internal Medicine specialist;
  • your greatest challenge if you are accepted into this program;
  • additional information about yourself that should be considered by the Selection Panel.

If your transcript/CV indicates academic difficulty, failure(s), repeat of a year or any gaps in your education or work history please attach a supplementary statement to the END of your Personal Letter entitled "Transcript/CV Addendum" explaining the above.

Optional - will be reviewed
Abstract/Publications 


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.


Interviews

Dates:

  • March 9, 2021
  • March 10, 2021
  • March 13, 2021
March 9, 10 & 13 Virtually

Our program socials will be hosting a fireside chart virtualy in order to answer any candidate questions, date to be determined

Please note that only successful applicants will be notified. 

Our program uses a different interview notification and scheduling system. Please see below for additional details.
Notification/Invitation (continued):
As our programs uses a different system to notify and schedule interviews during the first iteration, applicants will be notified by email via this system if they have been successful in obtaining an interview, and will have the ability to schedule their interview directly through this system as well.

Interview Process:
Applicants will participate in a two-part panel-style interview process, with two separate interview teams. Each part of the interview will be approximately 20 minutes, for a total duration of 40 minutes. Interview teams will be a combination of program and site directors, clinical faculty, and current residents of the program. 

Further details will be provided upon selection and acceptance of interview.

Program staff, faculty and residents will also be present during the interviews.  The program will be hosting a fireside chat, virutally, to answer any questions and provide candidates with any and all information that they may need about the program and training sites.

 


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

Review team composition : Each application is reviewed and scored independently by either the program director or another file reviewer. Members of our file review are the program director and other Internal Medicine faculty involved in our program.

Average number of applications received by our program in the last five years : 51 - 200
We average approximately a combined total of 75 applications between both streams.

Average percentage of applicants offered interviews : 76 - 100 %
We typically offer interviews to approximately the top 50-60 candidates, and interview approximately 25-30 candidates per interview site.

Evaluation criteria :
File component Criteria
CV Academic & work background/experiences, personal/professional accomplishments/achievements
Electives Internal Medicine elective(s), diverse range relevant to discipline, rural &/or northern an asset
Examinations We do not evaluate this file component
Extra-curricular Personal interests, volunteerism, an asset to demonstrate work-life balance & wellness
Leadership skills Any leadership roles held throughout training should be outlined in the CV
MSPRs Patient interactions, I.M. rotation competencies, any academic/personal/professionalism concerns
Personal letters Practice goals, interest/knowledge in I.M. and our program, personal & northern/rural suitability
Reference documents Performance, knowledge/clinical skills, character, attitude towards learning, suitability
Research/Publications Any scholarly activities, including academic or research awards, published or presented work
Transcripts Strength of academic record, any red flags/concerns
Other file component(s) Transcript/CV Addendum:

If any part of your application indicates academic difficulty, failure(s), repeat of a year or any gaps in your education or work history, a supplementary statement at the END of your Personal Letter is required. Please entitle your statement as "Transcript/CV Addendum", explaining the above.

Elective criteria

We recognize that the COVID-19 pandemic has impacted candidates’ opportunities to arrange and complete electives and would like to reassure you that a lack of elective activity this year will not negatively impact your application to our program.

Interview process

Interview format :



We accommodate additional interview formats as an option for applicants unable to attend an in-person interview due to weather or unforeseen circumstances.

Interview evaluation criteria :
Interview components Criteria
Collaboration skills Demonstrated ability to work well in a team setting/multidisciplinary environment
Collegiality Personable, respectful towards others, values the importance of a supportive/collegial atmosphere
Communication skills Able to reflect and communicate responses clearly and concisely, can communicate well with others
Health advocacy We do not formally evaluate this component during the interview
Interest in the discipline Genuine passion for internal medicine and future practice goals
Interest in the program Knowledgeable about our program, training sites, northern Ontario patient populations and challenges
Leadership skills Qualities such as: proactive/takes initiative, accountable, innovative, motivated and goal-oriented
Professionalism Conducts themselves in a professional manner, self-aware, unbiased, morally/ethically responsible
Scholarly activities We do not formally evaluate this component during the interview
Other interview component(s) Problem-Solving Skills: Overcoming challenges, conflict resolution, ability to rationalize and take appropriate action.

Personal Attributes: Personal characteristics and interests, experiences, learning style/attitude towards learning.

Information gathered outside of CaRMS application

Specifically, we may consider:







Ranking process

The behavior(s) exhibited below during the interview process may prevent an applicant from being ranked by our program :
   
   
   


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


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.


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.  

 


Additional Information

To learn more about northern Ontario, please visit the "Wider Campus of the Northern Ontario School of Medicine" webpage. 


Summary of changes

SUMMARY ID Section Summary of changes Updated on NOTIFY APPLICANTS SECTION NAME