Resident Support

Our program has an active Wellness Committee that hosts social events, wellness initiatives and a bi-monthly newsletter. Support services through Resident Affairs are readily available and easy to access. All residents are encouraged to take advantage of Peer and Faculty Mentorship opportunities, especially during the first year of training. Dr. Joye St. Onge is the Ombudsperson who acts as a confidential advocate for either an individual resident or for the collective resident cohort.

Resident Testimonials

Thank you so much for everything you have done for me and for the program in the past 3 years. You have handled every barrier our program has faced with grace, persistence and passion. Your fierce personality and advocacy remain the reason why each of my classmates chose McMaster internal medicine, and I’m so glad I did. I am so grateful for the experience to train here, and I think the past 3 years have definitely shaped me into who I am today.  

Zahra Merali, PGY3, June 2020

I chose McMaster because of the leadership team, and it has been in full display during these difficult times with the COVID-19 pandemic.  I continue to be amazed at the strength of the program’s advocacy for residents.  I am proud to be part of this program and cannot thank you enough for all that has been done for us. 

Hernan Franco Lopez, PGY3, May 2020

Thank you for supporting me and my family in the critical moments.

Waleed Aljohani, PGY3, May 2020

Entry requirements

Canadian Medical Graduates should submit separate applications to the program for the Hamilton campus and/or Waterloo campus through CaRMS in their last year of medical school.

International Medical Graduates who are Canadian citizens or Permanent Residents of Canada apply through CaRMS for IMG-specific places in the program. 

The program also accepts a limited number of candidates who are sponsored by institutions that have a sponsorship agreement with McMaster. Applications are submitted through the sponsorship office. More details here.

McMaster Postgraduate Medical Education does not have a pathway for self-funded residency.

Equity, Diversity & Inclusion

In the past decade, both medicine and society have seen a shift towards improving Equity, Diversity and Inclusion (EDI) for its populations. It is important for healthcare teams to understand and address the needs of marginalized patients and diverse communities. As residents and future licensed physicians, EDI plays a crucial role in our mandate of patient-centred care and life-long learning and as such, medical education has shifted to prioritize these values in its learners.
The program has recently developed a Resident Education Subcommittee for Equity, Diversity and Inclusion co-chaired by a resident and a faculty supervisor. The purpose of this committee is to improve and incorporate the EDI curriculum into our Internal Medicine training. The committee’s initiatives and events include:

1. Developing EDI learning activities for trainees within the Internal Medicine department and determine ways in which colleagues can improve EDI skills
2. Reviewing ways in which the Internal Medicine program contributes to the McMaster and local EDI communities
3. Reviewing or recommending ways in which diversity can be enhanced within the Internal Medicine program, including, and not limited to the CaRMS admission process

We invite you to watch the videos to learn more about Residency Programs at McMaster and feel the warmth of Hamilton.

Program Highlights

Internal Medicine residency at McMaster is a fast-paced program organized to build a strong skillset within the first year of training to serve as a solid platform for learning.  Residents will care for a diverse population with a broad range of diseases.  A by-product of our busy services is the tremendous clinical experience to be gained. To accommodate the impact of CBME and the PGY3 Royal College examinations, significant changes have been made to reduce the service load to protect teaching time and promote resident wellness. 

Our program is structured with the goal of preparing residents for a gratifying career of their choosing. McMaster is a rich environment for learning and innovation in clinical practice, education, and research.  Foundations for learning are solid and there are many opportunities for enrichment that are readily available to all residents. Some features of our program include: 

Our expert faculty is strong, collegial, and committed to teach.  

Our program is responsive to change. A time-sensitive approach is taken to respond to feedback from residents and faculty.  A positive approach to new and innovative models of teaching will keep the program fresh and strong. 

We are prepared. Rapid adaptation to a virtual curriculum and methods for residents to continue to learn and to retain credit for training during COVID-19 imposed quarantines and redeployment are in place. McMaster Postgraduate Medical Education responded to the COVID-19 pandemic by putting policies and procedures in place to protect the safety, wellness and educational mandate for all residents. The Internal Medicine Residency Program has a customized plan to accomplish the same goals within our own training program.

Our program has successfully made a transition for the two recent changes affecting our residents – Competency-Based Medical Education (CBME) and the shift of the Internal Medicine Royal College Examination to the PGY3 year. 

Our residents are valued as agents of change. Our program is highly resident-centred. Every committee is populated by resident members from all three years who stimulate important changes based on collective feedback from their cohorts.

Patient selection is diverse and varied. The Hamilton community serves over 1.5 million persons and draws from many surrounding communities to provide exemplary tertiary/quaternary care.  A CTU is placed within each of the three teaching sites, and each of these facilities has been designated as a center of excellence for at least one of the medical subspecialties.

Graded responsibility is commensurate with a resident’s ability to demonstrate competence within a given task.  The academic curriculum, workplace training opportunities, style of teaching and level of supervision are geared to match a resident’s stage of training. The curriculum and scheduled rotations are designed for PGY1 residents to acquire fundamental skills in acute care medicine early in training. Residents are prepared to assume the Senior Medical Resident (SMR) role on Day 1 of their PGY2 year.

A Competitive Block Elective Opportunity in Uganda is offered to 3 PGY2 residents per year.  The elective is supervised by McMaster Internal Medicine faculty with interest in Global Health and who have developed close ties with the healthcare team at the Mulago Hospital in Kampala, Uganda. Please see the Departmental Global Health website for more details.

Leadership & Teaching

The resident learns to be a leader by participating in committees and project work in areas involving program planning, educational scholarship, research, advocacy, etc. Our program encourages professional growth by providing faculty mentorship to residents who step forward into a committee role as a Co-Chair or as a leader of resident innovations. Recent examples of resident-initiated proposals that have enhanced our program include the development of:

• Social Medicine selective (2018)
• Career Fair (2019)
• Journal Club Reboot (2019)
• Virtual Medicine Launch in the Ambulatory CTU including subspecialty ambulatory services (2019)
• “Virtual Ward” for remote resident-led case-based clinical problem-solving sessions for undergraduate medical students targeted to level of training (2019)

The resident learns to be an educator with the opportunity to participate in the teaching of clinical skills to undergraduate medical students.  The program offers regular active workshops for “Teach the Teacher” to provide observed and evaluated experiential learning opportunities for residents to educate junior learners in areas such as procedural skills, OSCE examinations, conducting difficult conversations, acute in-hospital resuscitation, etc

Core Clinical Training

The program attracts applicants who are dedicated to delivering high-quality care and who are enthusiastic about the discipline of internal medicine; who demonstrate intelligence, dedication, efficiency and commitment to patient care; who wish to learn the skills of evidence-based medicine so that they can ultimately practise medicine in accord with its tenets. There are four active hospital sites that offer inpatient and ambulatory clinical training experiences. 

There are 13 blocks per year filled by a combination of clinical experiences as listed under each PG designation. 

PGY-1

• 3 blocks Medical CTU
• 1 block CTU hybrid team, combining daytime ER consults with follow-through ward care
• 2 blocks Ambulatory Care Clinics, including 1 block in the Boris Ambulatory CTU
• 2 blocks Intensive Care Unit
• 4 – 5 blocks Medicine Subspecialties*
• 1 block maximum of Selectives outside of Medicine, i.e. - Emergency Medicine, Psychiatry, Radiology.

PGY-2

• 3 blocks Senior Medical Resident (SMR) on CTU
• 2 weeks SMR paired with a preceptor
• 2 blocks Nephrology
• 1 block ICU
• 1 block CCU (or complete in PGY3)
• 1 block Cardiology ward (if not done in PGY1)
• 1 - 2 blocks Elective (3 blocks total in the PGY2 or 3 year)**
• 4 weeks Ambulatory Clinics and 4 weeks Research, (either PGY2 or PGY3) two-week modules, paired with Night Float
• 1 or more blocks Medicine Subspecialties*
  

PGY-3

• 2 blocks Chief Medical Resident
• 1 block Academic Reflective Selective or Preceptor-based Junior Attending
• 1 block CTU hybrid team, combining daytime ER consults with follow-through ward care
• 1 block ICU
• 1 block GIM Community (if not taken in PGY2)***
• 1 two-week module on Boris Ambulatory CTU paired with Night Float
• 1 block CCU (if not taken previously)
• 2-8 blocks Medicine Subspecialties *
• 1-2 blocks Elective (if not taken previously)**
• 1 block Ambulatory Clinics & 1 block Research OR maximum 2 blocks Ambulatory Clinics (if not taken previously)

* Medicine Subspecialty elective/selective opportunities at McMaster include: Cardiology, Endocrinology, Gastroenterology, Geriatrics, Hematology, Immunology/Allergy, Infectious Diseases, Medical Biochemistry, Medical Oncology, Nephrology, Neurology, Palliative Care, Respirology, Rheumatology

** The core program electives (option of external) are placed pre-CaRMS, except under exceptional circumstances.  PGY2 residents can apply for a fully-funded competitive block elective in Uganda. 

***There is a mandatory community selective in General Internal Medicine to be done at a center outside of the university footpad.  Community electives in remote, underserviced areas may be funded by the Ontario government for lodging, travel, etc. 

PGY-4

• first year of a two to three-year subspecialty training program, or
• fourth year of training in internal medicine where residents combine required Royal College elements and electives to meet special objectives for their careers

Call duties

Several recent independent audits indicate the call requirements at McMaster are well within the PARO-CAHO Collective Agreement and are at par with other Canadian Internal Medicine programs.

• JMR Call for PGY1s is rotational – 1:4 during CTU and ICU.  4 calls per month for other block rotations
• SMR Call for PGY2 and PGY3s is largely on a Night Float model

Organized Non-Clinical Training

Aside from the necessary clinical experience, the program offers a well-developed academic and research curriculum that allows residents to obtain the skills necessary for a successful career. A variety of methods for non-clinical teaching are organized to address individual styles of learning with a focus on activities that are targeted to maximize resident participation.

There is protected time for a weekly academic half-day, Grand Medical Rounds as well as regularly scheduled CTU Rounds, Journal Clubs, subspecialty rounds, workshops, and retreats.  The formal teaching activities are tailored to the various stages of resident training.  There are separate curricula for Evidence-Based Medicine, Clinical Skills, Problem–Based Learning, Research, SMR preparation, CMR preparation, Simulation, Leadership/Management, and other professional competencies.  

Academic Half-Day in lecture format occurs during PGY1 and the first two blocks of PGY2. Thereafter, the content is led by faculty facilitators through small group Case-Based Learning (CBL).  

A State-of-the-Art Center for Simulation-Based Learning at McMaster Medical Centre provides access to high fidelity simulation and Standardized Patients to support resident training opportunities.  Each teaching hospital houses a simulation room for on-site training during clinical duty hours.  

The Point of Care Ultrasound (PoCUS) Curriculum runs at McMaster’s Centre for Simulation-Based Learning. The curriculum is customized in terms of content and skill level to target residents during each of the three years of training. A McMaster group of faculty and residents published the first paper in the medical literature describing an organized three-tiered Internal Medicine training PoCUS curriculum.

Preparation for the PGY3 Royal College Examinations includes:

• Focused clinical exam prep teaching provided to the PGY3 residents by the GIM subspecialty residents
• A 14-week Exam Review series of lectures for the PGY3 residents hosted by a group of subspecialty residents
• Written and OSCE practice examination organized for all residents each year.

Research

Resident research and scholarly activity are highly supported under the leadership of Dr. Christine Ribic. There are world-renowned faculty researchers in many fields who are experienced research mentors and supervisors. There are dedicated weekly teaching sessions focussed on Evidence-Based Medicine and Research Methodology which are held as a supplement to the Academic Half Day curriculum. At the McMaster Department of Medicine Annual Residents' Research Day, many residents are honoured and are awarded prizes within various categories of research. Competitive research funding for clinical, basic, educational and quality improvement research is also available through an annual grant competition. Funding for conferences is available through the program.

Research Excellence & Discovery Day 2020 - 31th Annual Residents’ Research Day in Medicine

EBM and Research Curriculum sample agendas

Student electives

Resident electives

Contact list for Resident electives only

Overview

McMaster’s Waterloo Regional Campus is a robust community-based Internal Medicine residency training program.  We combine excellent internal medicine clinical training in a community environment with the academic and research support of our Hamilton campus to effectively prepare residents for practice as a generalist or a subspecialist.  We seek to prepare our residents to effectively deal with the full range of medical patients with chronic multi-system disease to the critically ill. 

The program is organized into 13 block rotations per year, each of 4 weeks’ duration. Clinical rotations occur at the 3 main hospitals in Hamilton (St. Joseph’s Healthcare, Hamilton General Hospital, and Juravinski Hospital), as well as the two main teaching hospitals in the Waterloo Wellington Region, Grand River Hospital and St. Mary’s General Hospital. Within the KW area, additional placements may occur at Guelph General Hospital in Guelph and Cambridge Memorial Hospital in Cambridge (both within a thirty-minute drive), but these placements are less frequent.

Clinical exposure is broad. Grand River Hospital hosts several regional programs including the Grand River Regional Cancer Centre, Hepatobiliary Surgical Program, Regional Stroke and Renal disease programs, and a large Mental Health Programs. It is home to a busy General Internal Medicine Rapid Access Clinic, a 30-bed Clinical Teaching Unit and a 22-bed Level III Critical Care Unit. 

St. Mary's General Hospital is a Regional Cardiac Care Centre and a Centre of Excellence for Respiratory and Centre of Thoracic Care. Both sites are equipped with videoconferencing capabilities and both sites are busy with 65,000-75,000 ER visits per year. The two hospitals receive constant referrals from outside hospitals, and trainees are exposed to a huge variety of pathologies from peripheral communities. Finally, these two hospitals are conveniently located fewer than four kilometers apart.

Program highlights

Small, close-knit program: With just 3 residents per year, our faculty to learner ratio and hands-on opportunities for patient care and procedural skills are highly conducive to the development of strong mentorships and clinical confidence.

Resident-centered: We are committed to involving residents in all major decisions affecting the nature of the program. We seek and act upon resident feedback and involve them in planning and enacting the educational growth and development of our campus. Each resident’s trajectory through the program is specifically designed to help them meet their specific professional and career goals.

Strong relationship with McMaster University’s Hamilton Campus: Waterloo Regional Campus residents have access to and participate in each and every highlight of the Hamilton campus, including our highly acclaimed annual international health elective in Uganda; numerous academic retreats and social events, and access to mentorship from world class research and academic faculty.  WRC residents also participate in McMaster’s well-developed academic curriculum through a combination of video conferencing and locally hosted sessions.

Clinical placements at a variety of hospital and clinic sites: Our residents have access to clinical training at a host of hospital sites, including four teaching hospitals in Hamilton, and multiple community hospital sites across the Waterloo-Wellington Region.  Because of the regional nature of many of our clinical programs, residents are exposed to a wide variety of pathology from peripheral communities and a multitude of procedural opportunities. Consistently integrated ambulatory care experiences are also a key feature the Community Based Program. 

Electives: Our residents have the opportunity to take three external electives anywhere in Canada during their core training years, approved by the program director. At least two occur before the start of PGY3; all occur before the PGY4 CaRMS match.

Research contacts

Click here for more information on research in the Waterloo region.

Elective opportunities

Click here for more information on electives in the Waterloo region.

Partner hospitals and highlights of the community

• Waterloo Regional Campus
• Grand River Hospital
• St. Mary's General Hospital
• Guelph General Hospital
• Cambridge Memorial Hospital
• Region of Waterloo
• City of Guelph
• City of Cambridge

Residents in action

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