Adult Gastroenterology Training Program

Teaching Rounds

A major part of the Adult Gastroenterology Training Program at McMaster University involves active participation of the trainees in a series of regularly scheduled educational activities.

Academic Half-Day in Gastroenterology (Wednesday 0800 h to 1300 h)
Academic Half-Day sessions occur on Wednesday mornings throughout the year. Sessions repeat on a 2-year cycle, allowing residents the opportunities to attend each session during the 2-year program. The Academic Half-Day is protected time when trainees meet as a group to address a wide variety of topics in GI and Hepatology. In addition to core GI topics included under the Medical Expert CanMEDS competency, several sessions designed to satisfy the requirement for teaching of the Collaborator, Communicator, Health Advocate, Manager, Scholar, and Professional domains are also included. This learning experience is partly self-directed and partly didactic. Its structure and content are monitored by the Residency Program Committee, the Academic Half-Day Coordinator and the Program Director. A syllabus is outlined each year by the Chief Resident(s), the Academic Half-Day Coordinator and the Program Director based on feedback from the residents.

The Half-Day begins with Radiology Rounds at 0800 h (see below). This is followed by a semi-didactic teaching session (0900 h to 1000 h) on a predefined subject, led by an invited speaker from the clinical division, the Farncombe Institute or another division. This session is used twice each year for a practice OSCE and written examination. This is followed by the weekly Journal Club (1000 h to 1100 h). The rest of the morning (1100h-1200h) is allocated to group discussion of a complicated, interesting and difficult case. Once every three months, the case discussion takes the form of morbidity and mortality (M & M) rounds, wherein adverse outcomes or complications of therapy are reviewed with the aim of improving patient safety and quality of care. The M & M rounds are preceded by lecture sessions on various topics related to medical ethics. All staff, including those on service at each training site, are encouraged to attend this session to facilitate discussion. Once every three months, the case discussion takes the form of combined Gastroenterology and Surgery Inflammatory Bowel Disease (IBD) case rounds, wherein challenging IBD cases are reviewed with guided discussion by Gastroenterology and Surgery Staff. These rounds aim to promote communication and collaboration between the two services. All trainees attend regardless of particular site of current rotation. The Academic Half- Day ends with the Farncombe Institute GI Rounds at 1300 h (see below).  An evaluation form for the Half-Day lecture is distributed by the Chief Resident (or designate) at each session. 

Attendance at Academic Half-Day is MANDATORY for all residents, except for those residents who are on vacation, post-call or on electives (distance > 50 km from McMaster University).  The minimum required attendance at Academic Half-Day is 80%. This policy will be reinforced by the Program Director and the Chief Residents who regularly take attendance at Academic Half-Day and expect an explanation for any residents missing any Half-Day sessions. A summary of resident attendance at the Academic Half-Day is provided to the Program Director every 6 months. Should any given resident’s attendance fall below the acceptable standards (< 80%), a letter will be sent to the resident by the Program Director. Should there be no adequate justification for these absences and the overall attendance during the two years of residency training falls below 80%, the FITER will reflect this in the “Scholar” and the “Professional” sections of the CanMEDS competences. 

Journal Club (Wednesday 1000 h to 1100 h)
Trainees meet each week to critically appraise newly published research paper using an evidence-based approach. A faculty member is assigned to each session to guide discussion, review topic in detail and teach research methodology as relevant. All trainees attend regardless of particular site of current rotation.

Radiology Rounds (Wednesday 0800 h to 0900 h)
Trainees on inpatient and outpatient services present the clinical history of patients with radiographic findings of interest. Basic approaches to the interpretation of GI radiology are reviewed. These rounds are chaired by GI radiologists (Drs. Parag Vora and Nina Singh). Through participation in these rounds, trainees will appreciate the importance of close collaboration between radiologists and gastroenterologists to optimize patient care. All trainees attend regardless of particular site of current rotation.

Pathology Rounds (Wednesday 1100 h to 1200 h Monthly)
These are combined clinical pathology rounds at which interesting cases are discussed in the context of histopathology and clinical findings. These rounds are chaired by GI pathologists (Dr. Jennifer Ramsay) at McMaster Site once per month. Trainees identify interesting cases from the inpatient and outpatient services, and GI pathologists present interesting specimens from other sources. These rounds are attended by residents and faculty. Through participation in these rounds, trainees can learn about the close collaboration between pathologists and gastroenterologists to optimize patient care. All trainees attend regardless of particular site of current rotation.

Combined Gastroenterology and Surgery Inflammatory Bowel Disease Case Rounds (Wednesday 1000 h to 1130 h Quarterly)
Every three months, a topic-oriented IBD Case Rounds takes place and the GI residents (alternating with General Surgery residents) are responsible for presenting challenging IBD cases and conducting a literature review on the topic with guided discussion by GI and Surgery Staff. Cases are chosen to highlight important issues in the medical and surgical management of IBD. Through participation in these rounds, trainees can learn about the close collaboration between surgeons and gastroenterologists to optimize patient care. All trainees attend regardless of particular site of current rotation.

Farncombe Institute GI Rounds (Wednesday 1200 h to 1300 h)
These rounds are the main weekly avenue at which clinicians and basic scientists meet. There is a formal seminar (45 minutes) given followed by discussion (15 minutes). Speakers include visiting faculty, in-house faculty, clinical trainees and research trainees in the Farncombe Institute. The topics vary considerably but, overall, they cover the spectrum of GI physiology, pathophysiology, mucosal immunity, inflammation, drug therapy and the clinical management of all gastroenterological or hepatological diseases. GI trainees are expected to organize and present at least 1 formal presentation every year on their research protocol / results. All trainees attend regardless of particular site of current rotation.

Farncombe Research-in-Progress Seminars (Wednesday 0900 h to 1000 h)
These rounds are a forum for the informal presentation of research in progress. Since GI residents are expected to undertake a research project, this event affords trainees the opportunity to present their own work. The rounds are organized by the Farncombe Institute. Attendance by trainees is encouraged.

Morbidity and Mortality (M & M) Rounds (Wednesday 1100 h to 1200 h Quarterly)
The goals of M & M Rounds are to: identify medical errors, improve patient care by implementing preventative strategies for further errors, review medical literature related to medical errors and medico-legal issues, and encourage residents to consider research in Quality Improvement. These rounds are not intended to be punitive, and are moderated by an attending physician supervisor and the Chief Residents to ensure this is followed. All faculty members and health care providers involved in the case are invited to participate to facilitate the discussion. Residents prepare and present M & M Rounds at least once during their residency.

Mock OSCE and Written Examinations
In preparation for the Royal College of Physicians and Surgeons Examination in Gastroenterology, two mock OSCE and written examinations are held annually. The results of these tests are reviewed with the resident and should be used as a tool to guide the setting of future learning objectives. They are NOT used by the Residency Program for evaluative purposes. These mock examinations are MANDATORY for all residents.

Canadian Association of Gastroenterology (CAG) Basic Science Video Conferencing Rounds (Wednesday 1200 h to 1300 h Monthly)
This national initiative of CAG is an interactive satellite broadcast to all GI training programs in Canada. Prominent speakers present on a variety of topics with trainees from each site able to ask questions “live”. These interactive lecture series are intended to integrate clinical Gastroenterology with basic science and pathophysiology. All trainees attend regardless of particular site of current rotation.

Multidisciplinary Academic Half-Day (MAD) (Wednesday 1300 h to 1700 h Quarterly)
The Postgraduate Medical Education Office organizes multi-disciplinary sessions for all residents on Wednesday afternoons at McMaster University. The MAD days provide a forum for residents to meet, discuss, and learn about issues that cross all disciplines of medicine. They are intended to focus on the Non-Medical Expert CanMEDS roles. The topics are derived from the interests and leadership of the resident planners who are the steering committee of the Postgraduate Medical Education Office. Topics may include financial planning, career planning, professionalism and the social contract, international health and physician involvement in the inner city, the power of overcoming barriers, resident stress and harassment. Attendance at MAD days is MANDATORY for all residents, except for those residents who are on vacation, post-call or on electives (distance > 50 km from McMaster University). 

CanMEDS Sub-Specialty Medicine Combined Rounds (Thursday 1500 h to 1700 h Quarterly)
These are interactive lecture series organized by the Internal Medicine Sub-Specialty Programs Committee. They are intended to focus on the Non-Medical Expert CanMEDS roles. Topics may include hospital administration, patient complaints, the power of habit, billing and office management. Attendance at the CanMEDS rounds is highly encouraged.

Medical Ground Rounds (Thursday 0800 h to 0900 h)
These are rounds attended by faculty and housestaffs from all divisions of the Department of Medicine. Topics focus on clinical issues, with an emphasis on critical appraisal and evidence-based learning. The rounds are organized by the Department of Medicine and are broadcast to all three Hamilton Health Sciences Sites. Attendance by trainees is strongly encouraged.

First Year GI Residents’ Endoscopy Training Course
This is an intensive 2-day training course hosted by McMaster University, but attended by First Year GI residents from across Canada. This course incorporates didactic lectures, small group discussions, hands-on training on simulation and dinner event with debate by course faculty.  Topics covered include endoscopic techniques, endoscopy reporting, preparing for endoscopy, bioethics, endoscopy unit management, endoscope construction and care, and endoscopic equipment and accessories. Attendance is MANDATORY for all first year trainees.

Electrocautery workshop
This is an annual workshop organized by ConMed Canada. The workshop is intended to provide trainees with the principles, practice, and safety of electrosurgery and the various electrosurgical technologies available. Trainees also have the opportunities to gain hands-on exposure to endoscopic electrocautery and accessories. 

Speakers’ Training Workshop
This is an annual workshop designed to help residents develop their presentation skills. This workshop is filled with practical information on improving delivery skills, and also includes interactive coaching sessions for participants to immediately apply the learning. This seminar emphasizes personal delivery styles and the mechanics of presenting. Trainees will learn the power of body language, eye contact, and gestures for enhancing their personal effectiveness and style. Also included are techniques for maintaining control of the audience through planned movements, key body angles, balanced actions and proper phrasing. Other discussion points will include optimizing visual design elements, especially when presenting research data and other information that may appear challenging. For optimal skills coaching session, trainees are required to deliver about 5 to 7 slides, containing materials that they are familiar presenting.

Hamilton Association of Gastroenterology (Last Wednesday of each month)
These are professional / social evening events at which gastroenterologists and GI trainees discuss clinical issues of common interest (e.g. practice guidelines or regional deployment of service). Attendance by trainees is encouraged.

Hamilton District Gut Club (2nd Thursday of each month)
These are professional / social evening events at which difficult cases from the region are presented and discussed. The rounds are held at a restaurant in the Hamilton area and are organized by Dr. Bruno Salena. The rounds are attended by many community gastroenterologists, surgeons, and radiologists. Attendance by trainees is encouraged.

Annual Department of Medicine Research Day
The Department of Medicine Resident Research Day is a high profile educational and social event where residents can share their work with core internal medicine residents, subspecialty residents, and faculty. GI residents are encouraged to submit at least one abstract to the Department of Medicine Research Day for presentation each year.

Annual Farncombe Trainee Research Day
The Farncombe Trainee Research Day is an educational and social event where clinical and basic trainees can share their work with each other. GI residents are encouraged to submit at least one abstract to the Farncombe Research Day for presentation each year.

PAIRO Resident Well Being Day (Annual)
Resident well-being is becoming increasingly recognized as an area that medicine has not devoted enough time to. The PAIRO Resident Well-Being Days are held at McMaster University every year featuring topics related to residents’ lives and other fun filled participating events.

Scientific Conferences
Residents are encouraged to attend at least one national or international meeting every year (e.g. Canadian Digestive Disease Week, Digestive Disease Week). In case of limited attendance allowance, selection will be made by the Program Director based on career goals, equity and fairness. Random draw will be used in case of stalemate.

Conferences allowed per Academic Year:

  • CAG GRIT Course (contingent on acceptance of abstract to GRIT)
  • CDDW / CASL Meeting (contingent on acceptance of abstract to main meeting)
  • International conferences (e.g. DDW, ACG annual meeting, AASLD), subject to Program Director’s approval.
  • National / Regional conferences of sound academic value, subject to Program Director’s approval (Canadian IBD Conference, North American IBD Conference, ACG Second Year Fellows’ Course).

Funding

  1. Funding per resident per academic year is currently set at $1,500 per year. The amount is subject to annual review by the Program Director based on available funding resources.
  1. The annual allowance must be used by the end of the academic year, and unused amount cannot be carried forward.

  2. Approval for all meetings and funding request must be submitted prior to booking of airline tickets or hotel accommodation. Official request must be submitted via medportal at least 2 months before conference date. Funding will not be approved retroactively.
  1. Residents are encouraged to approach the research supervisor first for partial or complete funding support.
  1. Additional funding may be available for any resident who is presenting a poster or talk at a conference.
  1. Meetings funded by industry (with no prior approval by Residency Program Committee or the Program Director) are not permitted.

Guidelines for travel reimbursement

  1. Residents are to refer to the McMaster University Travel Guidelines for policy on reimbursement.
  1. To claim a travel allowance, an expense form can be obtained from the GI Residency Program Assistant. The resident is responsible for completing the sections pertaining to contact information and meeting details (dates, location, purpose), as well as for signing and dating the form. The Program Assistant will complete the remainder of the form detailing the expenses, based upon the ORIGINAL receipts and credit card statements submitted by the resident. The resident should also keep a photocopy of these receipts for their files.
  1. For airfare to be reimbursed, three items are required: itinerary / invoice / bill / receipt which the travel company provides at the time of booking the flight + credit card statement + boarding passes are required.
  1. For meals to be reimbursed, original, itemized receipts and credit card statements are required.
  1. The resident is encouraged to submit their expenses within 15 days. The time to reimbursement is dependent upon the Finance Department.