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 majority of the training will occur from the home-base location, you will be expected to experience different training sites throughout Northern Ontario, in discussion with the program director and site directors.

COVID-19 vaccination policy

Please be aware the Ministry of Health has mandated all hospital and health care employers establish, implement and ensure compliance with a mandatory COVID-19 vaccination policy.  The Ministry directive can be reviewed here. Residents matched to any Ontario residency program must ensure they are able to comply with the Ministry directive in order to start training July 1, 2023.   

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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 December 2, 2023

Supporting documents (excluding letters of reference) that arrive after file review has opened  on  December 2, 2023

Letters of reference that arrive after the unmasking date on December 2, 2023

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Interviews

Dates:

• January 24, 2024
• January 25, 2024
• January 27, 2024

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 delivers 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 Internal Medicine practice.

Our program aims to equip our residents with the necessary skills and 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 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 for candidates who will 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 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.

 

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
• Simulation events/training

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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 Internal Medicine practice.  

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

Each resident will have a solid foundation in Internal Medicine training (Core IM) by the end of year 3 to allow competitive application to subspecialty programs or continued training as an excellent Internist.

The program is organized according to the CBD guidelines from the Royal College.

 

Transition to Discipline (Y1 - Blocks 1-3) & Foundations (Y1 – Blocks 4-13)

This year will be scheduled to include the following rotations:

• 4 MCTU (Medical Clinical Teaching Unit) rotations
  
  
• 2 Cardiology*
  
  
• 1 Nephrology* (within first 4 blocks)
  
  
• 3 Subspecialty** (see below)
  
  
• 1 Foundational ICU
  
  
• 1 Emergency Medicine
  
  
• 1 Geriatrics

Core 1 (Y2 – Blocks 1-13)
 This year will include the following plus a combination of 6 blocks of Electives/Selectives chosen by the resident (see "Other rotations" below:

• 4 MCTU-one block may be completed at the opposite site
  
  
• 2 CCU or 2 ICU 

• 1 Community GIM

Core 2 (Y3 – Blocks 1-13)
 This year will include the following plus a combination of 6 blocks of Electives/Selectives chosen by the resident (see "Other rotations" below:

• 4 MCTU-one block may be completed at the opposite site

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

• 1 Ambulatory GIM (MUST be scheduled in first half of year)
   

Other rotations which must be scheduled any time during Core 1 or Core 2 Training:
                                                                                                                                        

Selectives:

• 1 Community GIM (2nd rotation)

• 1 Nephrology (2nd rotation)

• 1 Medical Oncology

• 1 Respirology

• 3 Subspecialty **(see below)

And:

• 5 Electives

 

**Subspecialty Core Rotations:

Residents must complete a rotation in each of the following subspecialties, in addition to the required rotations listed above.

• Endocrinology 
• Gastroenterology
• Hematology
• Infectious Disease
• Neurology
• Rheumatology 

 

Electives:

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

One and in some cases two 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, either a research project or another acceptable scholarly project. 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 during the annual Research Day.

 

Community IM Experience:

A community GIM 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.  Community GIM rotations are offered in Huntsville, North Bay, Parry Sound, Sault Ste. Marie, Kenora and (Temiskaming Shores and Timmins (PGY3/4 Residents Only)).

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, Sudbury
• Respirology – Thunder Bay, Sudbury, and Ottawa*
• 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.
• Community GIM - Huntsville, North Bay, Parry Sound, Sault Ste. Marie, Kenora, Sudbury, Thunder Bay and (Temiskaming Shores and Timmins (PGY3/4 Residents Only))

Transition to Practice (Y4 - Blocks 1-13)

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 or applying to subspecialty fellowships at other institutions.

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

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

Clinical Responsibilities & On-Call:

The TTP resident is generally expected to function at the level of a junior consultant not at the level of a senior medical resident.  Clinical responsibilities are defined by the preceptor in each block and described in the rotation description.

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

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 for the TTP resident:

Training in the following procedures can be arranged. The TTP 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 TTP 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 the 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, M&M rounds. Academic half days are held virtually.

Residents from both sites meet face to face a minimum of 1 time each year for OSCE (Objective Structured Clinical Examination) and Simulation events.

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 in a non-intimidating setting.  

Research - 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

NOSM’s Internal Medicine residency is one program, with two main training sites in Sudbury and Thunder Bay. Four 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.
 

Sudbury: 

Health Sciences North is a modern tertiary health care facility located adjacent to Ramsey Lake in the heart of Sudbury that serves as the major referral centre for a large number of communities in Northeastern Ontario. Similar to Thunder Bay, the resident experience in Sudbury involves a mix of inpatient care (including medical and cardiac critical care), and outpatient clinics (general medicine and subspecialty). Due to the relatively small number of post-graduate trainees compared with most training centres, all rotations in Sudbury involve regular daily 1 on 1 interaction with preceptors and the opportunity to participate directly in the care of complex, undifferentiated medical cases. Residents working in Sudbury will discover that they quickly develop close relationships with staff and other residents from all departments. 

The Medical Clinical Teaching Unit (MCTU) is an inpatient general medicine service at Health Sciences North comprised of one rotating staff physician (General Internist or Subspecialist trained in Internal Medicine), 1-2 Senior Medicine Residents (PGY2 or PGY3, Internal Medicine), 2-4 Junior Residents (PGY1 Internal Medicine or other programs), and 2-4 Clinical Clerks (4^th year medical students from NOSM). Compared to other teaching hospitals where there may be 3 or 4 MCTU teams, there is only one MCTU team at HSN.  The MCTU will typically be responsible for the care of 20-25 patients with a variety of acute medical illnesses. During your time on MCTU, you will encounter patients with a wide range of clinical problems including complex multisystem diseases. The primary objective of this rotation is to train our residents to become comfortable recognizing and dealing with complex medical problems and the many underlying issues that exist in these patients and contribute to their admission to hospital. Residents learn how to approach the most commonly encountered problems in Internal Medicine, a skill that is practical and will serve them well for the rest of their careers. 

We do not have many subspecialties who admit, so the majority of interesting medical cases admitted through the emergency department will come to the MCTU service.  You will care for patients admitted to the other subspecialty groups who do admit (Cardiology, Oncology, Nephrology) when you are on those rotations.  There is something to be learned from each and every patient.

Most residents consistently say that they learn more in one week on the MCTU in Sudbury than in an entire block on other services!

Internal Medicine patients who are more unstable or require ICU step-down of care (patients with DKA requiring pressors, acute BiPAP) are also admitted to MCTU.  The MCTU has access to step-down level beds for these patients and you will provide care to this very acute, unstable group, acquiring invaluable experience with the back-up support of the senior residents and staff.

We make every effort to make resident learning the priority. The senior staff physicians and senior medicine residents are passionate about internal medicine and will do everything they can to make the experience on MCTU a good one. Our goal is to create a collegial and supportive environment where as residents we can teach and learn from one another.

Sudbury is similar to Thunder Bay in that its residents have immediate access to hiking, camping, downhill skiing, cross country skiing, boating, rock climbing, fishing and much more all within the city limits. Health Sciences North is situated adjacent to beautiful Ramsey Lake which offers swimming, sailing, rowing, kayaking, and a 3 km ice skating path in the winter. Sudbury is home to the Ontario Hockey League (OHL) Sudbury Wolves and is a concert stop for many top performers. Sudbury is located less than 4 hours driving distance from Toronto and 5.5 hours from Ottawa. It also has an international airport served by Air Canada, Porter, and Bearskin Airlines. Sudbury offers a range of popular restaurants and is home to a large student population with Laurentian University, Cambrian College and College Boreal located within the city. 

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Additional Information