Internal Medicine Residency

Dr. Lori Whitehead

Dr. Lori Whitehead

Program Director

Welcome to McMaster University Internal Medicine Program

Welcome to the McMaster University Internal Medicine Residency Program

I am very proud to hold the position of Program Director for the McMaster Internal Medicine residency training program.  On July 1, 2016, I became part of a large group of residents, faculty and administrators responsible for the stellar reputation that our program has earned year after year.  Over the last decade, the program has flourished under the direct leadership of Dr. Parveen Wasi (2000-2011) and Dr. Shariq Haider (2011-2016).   I look forward to honoring the tradition of providing superior residency education for each of our McMaster trainees in Internal Medicine.

I studied Medicine at the University of Toronto and am a graduate of the McMaster programs in Internal Medicine and Respirology.  I have held various administrative roles during my career including Program Director for Respirology and Chair of the Specialty Committee in Respirology for the Royal College of Physicians and Surgeons of Canada.  I have learned to achieve success by building bridges with all project participants.  The resident body is at the center of the team, and will therefore have a strong voice in matters such as program planning and curriculum development. 

Residency education in Internal Medicine at McMaster is based in Hamilton, Ontario.  Our program has a distributive center in Waterloo.  The Waterloo Regional Campus accepts three to four residents in the PGY1 match and provides a blend of community and academic based experiences.  A separate CaRMS application for Internal Medicine training at the Waterloo Regional Campus is required to be considered for admission.    

The next few years will be ones of change as all Canadian Internal Medicine programs face a transition to a Competency Based Medical Education (CBME) model, branded as “Competence by Design” (CBD) by the Royal College of Physicians and Surgeons of Canada.  Residents in all years will be affected, although the impact will be greatest for the PGY1s who will enter training when CBD goes live on July 1, 2019.  Our program has already made significant changes in resident teaching, evaluation, CTU team structure and curriculum in preparation for the adaptation of CBD. The style of teaching has shifted to an increased emphasis on coaching, direct observation and timely feedback at the bedside.  The new CBD Competence Continuum allows for the classification of four developmental stages of training. Entrustable Professional Activities (EPA) are stage-specific tasks of a discipline that an individual can be trusted to perform in a given health care context once sufficient competence has been demonstrated. Milestones are observable markers of each resident’s ability for a given task to be used for planning and teaching. Each EPA integrates multiple milestones when performing a professional activity.  Residents will be eligible for advancement to the next stage after they have demonstrated competence in the EPAs assigned to that stage.  Resident progress will be recorded using an electronic platform. A Competence Committee will review a compendium of assessment data to determine each resident’s progress, including the need for the development of an Enhanced Education Plan (EEP) and eligibility for advancement to the next stage.

Internal Medicine residency at McMaster is a fast-paced program organized to build a strong skill set 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 byproduct of our busy services is the tremendous clinical experience to be gained.  To accommodate the impact of CMBE 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. 

Our program is prepared for the two biggest changes that will affect the new 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-centered. 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.

The Academic curriculum is very robust with protected time for a weekly academic half day, Grand Medical Rounds as well as regularly scheduled CTU Rounds, Journal Clubs, subspecialty rounds and retreats.  The formal teaching activities are tailored to 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. 

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.  

Resident research and scholarly activity is highly supported. There are world-renowned faculty researchers in many fields who are experienced research mentors and supervisors. At the McMaster Annual Resident’s Research Day, many residents are honored and are awarded prizes within various categories of research.   Competitive funding is available for research.  Funding for conferences is available through the program.  

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 sessions on “Teach the Teacher” to provide guidance to residents in their role as educators to medical students and junior residents.  

A 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 have recently submitted a paper that will represent the first published document describing an organized three-tiered Internal Medicine training PoCUS curriculum.

External Elective time includes three months outside of Hamilton during the core Program. PGY2 residents can apply for a fully funded block elective in Uganda.  There is also 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 and meals.

Subspecialty Programs in Allergy/Immunology, Cardiology, Endocrinology, Gastroenterology, Geriatrics, General Internal Medicine, Hematology, Infectious Diseases, Medical Biochemistry, Medical Oncology, Nephrology, Respirology, and Rheumatology are available. Our 3-year core program provides a solid foundation for sub-specialization.  It is a requirement of the program for each resident to apply to the PGY4 CaRMS subspecialty match.

I look forward to another exciting year of partnership with the residents and faculty as we combine the best elements of our existing program with the contemporary changes on the horizon.  

June 4, 2018