Program Contacts

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Important Information

Orientation for all incoming residents

Please be advised that the 2022 PGME New Resident Orientation Day is scheduled for Wednesday, June 29, 2022.

This Orientation is mandatory for all incoming residents.

 

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Return of Service

Please provide your Return of Service Contract at the time of application.

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General Instructions

Program application language: English

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Supporting Documentation

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Interviews

Selection Criteria

The Section of Respirology at the University of Manitoba is committed to a fair, equitable, and transparent application process. We maintain the right to choose the applicants we feel are the best candidates for our residency training program.

Our selection processes are outlined below.

Program goals

Mission: We educate the next generation of Respirologists who will sustain and promote the health of those we serve through the provision of the highest quality of clinical care, research, innovation and communication.  

 

Goals (not necessarily in order of priority):

1. To train physicians who will practice in academic and non-academic settings.
2. To train physicians who practice holistic care and who embody excellence in all the CANMEDS roles.
3. To meet the needs of the people we serve, and the academic needs of those we choose to admit to our programs. 
4. To maintain and nurture excellence within our training program.

Objectives (not necessarily in order of priority):

• To develop Respirologists who excel as scholars, communicators, leaders, health advocates, collaborators and professionals.
• To support and mentor our trainees.
• To foster lifelong learning.

Selection process goals

Our program values the following candidate attributes:

1. Excellence in the performance of all the CANMEDS roles in all the areas of practice in Internal Medicine, including General  Internal Medicine.
2. Evidence of activities, whether in one’s personal and/or professional life, that contribute to the well-being of others, and that reflect drive/motivation; skills in leadership, administration, education and communication; innovation; problem-solving and resiliency.

File review process

Evaluation 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

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   
Other : A decision may be made to not rank an applicant at any point in the process between receiving of a CaRMS application and the time we submit our ranking to CaRMS. The performance of an applicant in comparison to his/her cohort is taken into account when deciding whether or not to rank an individual. We also try to evaluate the potential for compatibility or non-compatibility between the candidate and our program.

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Program Highlights

Winnipeg has enjoyed a rich and varied history in pulmonary medicine.

Both of our teaching institutions (see training sites below) have dedicated bronchoscopy suites, as well as a video bronchoscopy system at the Health Sciences Centre. As of July 1, 2011, we have had EBUS; as well as the University of Manitoba Rady Faculty of Health Sciences has a world class clinical simulation centre, allowing the teaching and practice of bronchoscopic skills in a virtual environment prior to patient exposure.

We have a lung transplant program, through partnership with Alberta Health.

There is ample exposure to tuberculosis, cystic fibrosis and pulmonary hypertension.

Research opportunities exist in basic pulmonary sciences, pulmonary physiology, molecular medicine as well as epidemiology.

We have two dedicated full-time pulmonary function labs, as well as complete cardio-pulmonary exercise facilities in both sites.

There is a very-well structured and formalized academic half day scheduled Wednesday afternoons. This includes didactic sessions and pulmonary function testing, comprehensive pulmonary physiology, mechanical ventilation, and evidence-based medicine.

There is also a Monday morning breakfast fellows' lectures which includes didactic sessions on a very wide range of pulmonary topics.

Multi-disciplinary Sleep Rounds are conducted approx every six weeks. There is a dedicated sleep laboratory located at the Misericordia Health Centre which is staffed and run by Respirology clinicians. This provides exemplary exposure to sleep medicine within our training curriculum.

There are monthly combined radiology and pathology rounds which provide invaluable exposure to understanding pulmonary radiology in the context of clinical presentation and pulmonary pathology. These are multi-media presentations with radiology and pathology review.

There are weekly case presentations. This is in addition to a bi-weekly journal club presentation that alternates with Research in Progress seminars.

Both sites offer resident libraries which including internet access. Each teaching hospital also has a full, comprehensive medical library to serve the educational needs of all clinicians and researchers.

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Program Curriculum

This residency program is for 2 years.

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

Overview of our Sub-Specialty Training Program
This two-year program in respirology is designed to provide clinical training over a period of 14 months of “core” general Respirology. These 14 months consist of 5 months of consults at HSC, 4 to 5 months consult service at St. Boniface, 1 month Pulmonary Function Testing and one month of Thoracic Radiology. Within these 14 "core” months there will also an equivalent of 5 months out patient exposure. Residents are allowed 6 months of elective time. The training program is organized as outlined below.

Consultation Services
There are consultation services at both the Health Sciences Centre and the St. Boniface Hospital. The residents will spend approximately 5 months at each of these. Both these rotations offer unique and different experiences and are complementary to one another.

The St. Boniface rotation is a busy one, providing day-to-day experience in general respirology and exposure to complex and interesting tertiary care referrals from medical and surgical services as well as family practice and geriatrics. Further, St. Boniface Hospital is the designated Cardiac Centre of Excellence, with an extremely busy Surgical Cardiac Intensive Care. Up to 6 cardiac surgical cases are performed daily, often generating pulmonary consultation. Both teaching centers have very busy tertiary care medical and general surgical intensive care units. The HSC rotation is a combined inpatient / consultation service. The inpatient ward functions as a dedicated respiratory Clinical Training Unit as well as the only provincial tuberculosis centre. The HSC service combines dedicated CTU experience as well respiratory consultations through out the hospital.

Laboratory Rotations
There are three laboratory rotations. The first is a one month Pulmonary Function Lab rotation at the Health Sciences Centre, a tertiary care referral laboratory for the province. Here, extensive experience with pulmonary function equipment, techniques, and interpretation is provided.

The second is at the Sleep Laboratory. The Sleep Lab is located at the Misericordia Health Centre. This is a dedicated sleep lab with ten beds. As of 2011, there are 6 sleep physicians who staff this lab. During this rotation, the residents learn basic concepts of sleep physiology and sleep disorders. The RCPSC mandates at least 2 months of dedicated sleep medicine training.

The third four-week block is at the Radiology Service at St. Boniface Hospital. This rotation provides residents with expertise in the interpretation of chest radiographs, CT scans of the thorax, and the performance of related procedures, such as percutaneous transthoracic needle biopsy and chest tube insertion.

Ambulatory Care (Outpatient Clinics)
During the training program, ambulatory care experience makes up 5 months of training. This takes the form of three dedicated months in general respirology clinics. Additionally the residents are assigned to a longitudinal clinic of a ½ day / week for the duration of the training program.

Procedures
During their training, the residents perform enough procedures to become proficient in bronchoscopy, transbronchial biopsy, thoracentesis, pleurodesis, and chest tube insertion.

Second Year of Training Program
The second year of the training program has well-defined objectives. There is continuing clinical exposure to meet the requirement of the Royal College for 14 months of clinical training. Rotations at the Sleep Laboratory and on consultation service are scheduled. Additionally, the curriculum of the second year focuses on academic and scholarly activities including research, educational, and teaching activities. Several members of the section of respirology have major research interest in fields including basic physiology, biochemistry, immunology, epidemiology, and molecular biology. Residents are required to initiate and complete a research project under the supervision of one of these faculty members. Furthermore, programs of respiratory research in the departments of pathology, pediatrics, and physiology provide extra opportunities for research training.

The second year of training is flexible, allowing requests for out-of-town rotations, an elective, or a community rotation to be accommodated.

The two-year respiratory fellowship program at the University of Manitoba is designed to provide all the skills required of a respirologist by the Royal College, including the clinical and technical skills needed to function in an ICU. Although the respiratory training program is highly structured, there is also a good deal of flexibility. The program is designed with a view to helping residents evolve into the role of specialist consultants in respirology.

Critical Care Medicine
The residents rotate through the tertiary level Intensive Care units of both hospitals for two months of their second year of training. During this rotation, each resident is given a graded responsibility as assessed by the critical care attending staff. Additional months in intensive care can be arranged if desired.

Research Expectations
Our Residents will have the opportunity to partake in a research or a scholarly project. Research projects can be presented at a major International meeting such as the annual American Thoracic Society Meeting and/or the annual Dept of Internal Medicine Resident Research Day.

Academic and Scholarly Activities
Outlined below are the details of the Respiratory Section Educational Half Day as well as other teaching activities.

Academic Half Day
Each Wednesday afternoon is protected time for formal teaching activities. Residents are expected to be present and are exempt from all other activities during this half day, which begins formally in September and runs through to June 30 of the following year. During the summer months (July and August) introductory teaching sessions are organized.

Advanced Pulmonary Physiology
This course is offered to both the first- and second-year residents. Because the subject matter is advanced, trainees often choose to reinforce what they have learned in their first year by attending this course in their second year. A list of the lectures for 2007–2008 is appended. Advanced pulmonary physiology is an accredited course at the University of Manitoba. The residents receive certification upon its conclusion and successful completion of the final examination.

Pulmonary Function Testing
This didactic course on techniques of pulmonary function testing and interpretation is scheduled from September to February of each academic year. Objectives of this course are to prepare residents for the role of consultants who can provide expert interpretation of pulmonary function tests.

Clinical Epidemiology
A short course on epidemiology and biostatistics is organized each year. Usually four lectures of 1 to 1½ hours each cover most of the following topics:

1. Epidemiologic approach to disease and intervention
   • Measuring the occurrence of disease
   • Assessing the validity and reliability of diagnostic and screening tests
   • Assessing the efficacy of preventive and therapeutic measures: randomized trials
2. Using epidemiology to identify the cause of disease
   • Cohort studies
   • Case-control and cross sectional studies
   • Estimating risk
   • Bias, confounding, and interaction
3. Applying epidemiology to evaluation and policy
   Using epidemiology to evaluate health policy, etc.
4. Biostatistics
   • Types of data analysis
   • Univariate analysis
   • Bivariate analysis
   • Multivariate
   • Probability
   • Hypothesis testing
   • Confidence intervals
   • Statistical power

Clinical Chest Conference, Wednesday
The rounds consist of the presentation of two patients, including their radiographs, relevant pulmonary function tests, and relevant pathology.

The specific objectives of the clinical conference are as follows:

• Target audience: respiratory residents and faculty, rotating residents, and students and allied health professionals.
• Develop an approach to the differential diagnosis and cost-effective evaluation of patients with respiratory disease.
• Learn a multidisciplinary approach (clinical-pathological-radiological) and teamwork.
• Develop an approach to the management of complex clinical problems.
• Provide a learning experience for the residents in identifying a clinical question, searching the medical literature, and making an informative presentation.
• Prepare the residents for clinical consultations and Royal College examinations.
• Provide scientific, evidence-based literature of the clinical topics as continuing medical education for the target audience.
• Provide an interactive presentation to include both the presenter and the audience.

Research in Progress (RIP), Wednesday
Ongoing research activity is presented at these rounds. Residents are encouraged to attend, especially if the topic is relevant to an area of research in which they intend to be active.  These rounds begin in September.

Journal Club Wednesday (alternated with Research in Progress)
Critical appraisal of literature is formally taught through the biweekly journal clubs. Articles for review are circulated to all section members a week in advance. Currently these meetings are held every other Wednesday.

The McMaster University format is recommended to critically evaluate each article. Please read the enclosed articles in the section ‘Critical Appraisal of Medical Literature.’ The objectives of the journal clubs are to provide an understanding of medical literature by:

• Reviewing articles reporting major new clinical observations.
• Learning how to review the literature critically.
• Learning the application of principles developed by the Evidence-Based Medicine Working Group about how to use an article dealing with diagnosis, therapy, and prevention. Developing an evidence-based approach to the evaluation and management of a wide variety of respiratory disorders.

Other Formal Teaching Activities

Pulmonary Review Course, Monday 0800 to 0900 hours.
A pulmonary review course organized by the residents for coverage of topics not well covered in existing teaching venues. In last few years we have invited various experts from and outside the section to either give a didactic lecture or have an interactive teaching session with the residents

• Joint Clinical-Radiology-Pathology
  These joint rounds will be held from 11:30 to 12:30 hours on the first Wednesday of the month in the Oncology Conference Room at St. Boniface General Hospital. They have been organized by radiologists, pathologists, and chest medicine. Through these rounds we hope to interact with the local thoracic surgical group on a regular basis.
  
  The purpose of these rounds is to enhance the radiologic-pathologic correlations of lung diseases, with emphasis on the radiology and pathology of both common and rare conditions. These rounds will have a different focus and different objectives from the weekly chest conference. The thoracic surgical group has agreed to present the radiologic and pathologic aspects; the clinical context will also be discussed. A large number of cases will be reviewed to increase residents’ and residents’ familiarity with a wide variety of lung diseases. These rounds will be scheduled monthlPresentations will alternate between thoracic surgery and chest medicine.
• CanMEDs Rounds
  CanMEDs rounds will be held four times per year. This is an informal round.  Discussion will centre on the CanMEDS objectives.  Target audience is the Respiratory Residents.  These rounds have a circulated agenda with minutes taken at each session.
• Multidisciplinary Sleep Rounds
  These multidisciplinary rounds are attended by the faculty interested in sleep disorders (Respirology, neurology, psychology, general internal medicine and otolaryngology), sleep technologists, home ventilatory assist devices program personnel, respiratory therapists and others interested or involved in providing care to the patients with sleep disorders. The rounds are designed to meet the educational goals of all attendees and often utilize case presentation format with didactic lecture to cover wide variety of topics. They are scheduled last Monday of each month and continue through the summer. Additionally, these rounds also serve as a forum to bring the various sleep professional together at University of Manitoba.
• Mechanical Ventilation
  This is an interactive course on invasive and noninvasive modes of mechanical ventilation. This course is delivered in the form of five one-hour discussions.

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Training Sites

The Adult Respiratory Program at the University of Manitoba consists of two teaching hospitals, an off-site dedicated sleep laboratory at the Misericordia Hospital, A description of the major centres is provided below.

In terms of a cachement area for pulmonary referrals, this includes all of Manitoba and parts of north-western Ontario, Nunavut and the Northwest Territories. This area encompasses approximately 1.5 million people. This contributes to a very large plethora of pulmonary pathology and exposure to cystic fibrosis, pulmonary hypertension and tuberculosis, not normally available to centres of our size.

We have an active bone marrow transplant program as well, contributing to an ample opportunity for diagnostic bronchoscopy.

Resources for Residents
We have resident libraries located at both Health Sciences Centre and St. Boniface Hospital. Both libraries also host a computer, as well as internet access. There are multi-media components available for self-directed teaching for thoracic radiology in addition to the standard radiology rotation of one-month.

Health Sciences Centre
There are approximately 800 beds available at this location.
Number of Emergency Room patients per year: approximately 41,000.

Health Sciences Centre is a large tertiary care referral centre. In terms of relevance to Adult Pulmonary medicine, it includes a very large medical teaching unit system in addition to two tertiary care Critical Care units -- one medical and the other dedicated to surgical trauma. This centre alone provides exposure to essentially all aspects of pulmonary medicine.

St. Boniface General Hospital
There are approximately 600 beds available at this location.
Number of Emergency Room patients per year: approximately 37,000.

St. Boniface General Hospital is the second largest hospital in Winnipeg. It is also a tertiary care centre, with a ten-bed tertiary combined medical-surgical critical care unit, a ten-bed dedicated cardiac sciences intensive care unit, and a coronary care unit. It also has robust internal medicine teaching units as well as family medicine practice, geriatric medicine programs, dialysis, tertiary care interventional radiology, complete cardiac catherization laboratories, MRI scanner, and oncology services.

At St. Boniface General Hospital, our residents are exposed to all aspects of pulmonary care.

Misericordia Health Centre
A state-of-the-art sleep laboratory is now located at this site. This is staffed by six Respirology faculty members. This site is extremely active in the diagnosis, management, and all aspects of sleep pathology. This centre provides trainees with exemplary training in sleep medicine and the potential for further training upon completion of their two-year subspecialty residency.

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Additional Information

Research/Publications

The applicants must indicate which publications are in peer reviewed versus non-peer reviewed journals/publications. If the applicant has submitted an article for publication at the time of CaRMS application, the applicant must provide evidence of journal notification of submission. The applicants must indicate all presentations at local resident research day as well as national and international conferences, and any prizes awarded.  If a presentation (oral or abstract) has been submitted to a conference, the applicant should include any letter of acceptance by conference organizers.

 

Curriculum Vitae (CV)

A current curriculum vitae (CV) including all relevant information required for assessment of education, leadership, administrative and research experience is mandatory.  Where applicable, please document whether activities are voluntary or reimbursed.    Your CV should be downloaded to the document section.  For research papers that have been submitted but not yet published, please include acknowledgement of submission from the journal.  See comments above under Research/Publications for information regarding how to document your work.

 

Other Document - Evaluation of Training - for International or US Medical Graduates Only

International or US Medical Graduates Only - you must provide a RCPSC assessment of training form from the Royal College of Physicians and Surgeons of Canada: website:  www.rcpsc.medical.org

 

Interviews

For the CaRMS Match which will take place in the Fall of 2021, all interviews will be conducted electronically. The applicant may meet electronically with a panel of interviewers, or with interviewers individually, or a combination of both.

 

Orientation for all incoming residents

Please be advised that the 2022 PGME New Resident Orientation Day is scheduled for Wednesday, June 29 2022.  This Orientation is mandatory for all incoming residents.