Division of General Internal Medicine
Guidelines for Applying to Fellowships in General Internal Medicine
A limited number of posts are available in the General Internal Medicine (GIM) Fellowship Program at McMaster University. Applicants choose between a single PGY-4 year focusing on clinical practice leading to the FRCPC, or a two year academic program which combines clinical and academic work leading to the FRCPC and a Masters Degree in Clinical Epidemiology and Biostatstics. In the two year program, opportunities exist to pursue studies in clinical epidemiology and clinical research methods; the design and evaluation of educational innovations; or health administration. The prerequisite is completion of the Medicine PGY-3. Eligible candidates are Canadian graduates registered in a Canadian residency training program or U.S. graduates of an LCME accredited school who is registered in a U.S. residency training program. U.S. graduates must provide a letter of intent to return home. Resident stipends (at the PGY-4 level) are available for the first year, and a range of alternative stipends for the second.
Interested candidates are invited to review the application process through the Canadian Residency Matching Service.
Deadline for applications is September 1. Invitations for interviews will be given to selected applicants. Posts will be offered via the PGY4 Match and be completed by the end of November.
Description of the Two-Year Fellowship in General Internal Medicine
To prepare residents for academic careers in General Internal Medicine, Residents who enter this Fellowship Program will receive advanced training in clinical General Internal Medicine, in addition to instruction and practical experience in an area of their choice:
- clinical research methods (via the Masters Degree Program in Health Research Methodology [HRM])
- educational development and evaluation
- health administration
Upon completion, residents will be ready to take on leadership roles in hospital and community-based practice and will be excellent candidates for university faculty positions. Residents will have had ample, guided opportunities to develop their skills as clinical teachers.
Reasons for the Program
The need for more General Internists, with advanced general internal medicine, academic and research training, has been recognized by all sectors of Canadian health education and health care. Specifically,
- General Internists play a vital role in the care of increasingly complex patients with problems that cross sub-specialties.
- General Internists make a major contribution to student, resident and primary care practitioner education. Leadership roles in education (ie. Directors of Medical Clinical Teaching Unit) are increasingly being filled by General Internists.
- Medical schools across Canada are in need of clinical epidemiologists who are able to teach clinical medicine, look after problems of patients on general medical units and in medical clinics, and conduct research concerning diagnostic procedures and treatments used in internal medicine. They address dilemmas that internists face every day in prognosis, diagnosis and therapy. The methodology taught by the Department of Clinical Epidemiology and Biostatistics is an ideal training for this pursuit.
- Hospitals across Canada are in urgent need of General Internists.
- There is a national trend toward generalism as outlined in the Barer-Stoddart Report, and a parallel movement in the U.S.6. Within a few years, it is extremely likely that the FRCP designation will be changed from "Internal Medicine" to "Medicine", and a Certificate of Special Competency in General Internal Medicine will be created for those with advanced training (similar to those already in place for the other medical sub-specialties).
The GIM Fellowhip Program
The program officially starts at the beginning of the fourth year of training in internal medicine. However, interested residents often take one or two of the clinical epidemiology courses during their first three years of training to gain exposure to the approach. The fourth year of the residency will be the main GIM Fellowship year. In addition to clinical activities, teaching, and course work, Fellows will have the opportunity to conduct research projects, write chapters and papers, and present their work at local, national and international meetings. In the second Fellowship year, the Fellow has the option of being a Clinical Scholar in McMaster University's Postgraduate Program; alternatively, funding through personal awards from provincial or national granting agencies may be sought.
The Masters of Science Degree
During the two years of GIM Fellowship, the resident may obtain a Masters Degree in Health Research Methodology (HRM). The degree includes six half-courses and with the option to do a thesis. In general, each course meets for one half-day per week, with the need for about three to five hours of outside preparation per hour of class time. The three basic courses are an introduction to clinical epidemiology, an introduction to biostatistics, and a course on research methodology, in which students learn how to prepare a research protocol. In addition, HRM students participate in research internships designed to provide practical experience in clinical research. One project involving the planning and execution of data analysis is required at some point during the HRM program.The thesis may be a "design" thesis, in which the candidate designs a study in his/her area of interest, including the implementation and analytic strategies, while considering and addressing the relevant methodologic issues. Although conducting the study is not a requirement of the thesis, Fellows are strongly encouraged to choose projects which they would actually like to carry out. Often the thesis forms the basis of a grant proposal that can launch the next phase of career development as a clinical investigator. It takes most candidates the equivalent of four months of full-time work to complete this thesis. Admission to the HRM program is not automatic and the process is competitive; however, we will help you with your application.
Obtaining the MSc. degree in Health Research Methodology is not a necessary requirement for successful completion of the GIM Fellowship, but it is a desirable goal. Whether this degree is completed or not, training will be provided which allows the participant to become a competent investigator and collaborator by the end of the GIM Fellowship.
Advanced Training in Education and Administration
GIM Fellows interested in educational development and evaluation or health administration will have opportunities for similar graduate student training, depending upon their special needs and career plans.
The End Product
A resident who completes the GIM Fellowship program can expect to end up practising general internal medicine in combination with teaching, clinical investigation, and administration. GIM Fellows may also have gained expertise in a special area of interest during Fellowship which could comprise a substantial portion of their clinical work. Potential opportunities that can lead to a stimulating career include a Clinical Teaching Unit Directorship and active collaboration with colleagues or principal investigator status in the evaluation of clinical skills, the interpretation of diagnostic tests, and the evaluation of treatments. Graduates of GIM Fellowship Program can anticipate considerable interest from Department Chairs of Medicine across North America and exciting careers in General Internal Medicine.
Interested candidates should go to the CaRMS website and follow the instructions there for application. Deadline for application is September 1.