scholarly journals Why I Wrote the New Royal College General Internal Medicine Exam: Redefining Our Identity and Revalidation

2015 ◽  
Vol 10 (2) ◽  
Author(s):  
Nadine Abdullah, MD, Med, FRCPC
Keyword(s):  
Internal Medicine ◽  
Professional Identity ◽  
General Internal Medicine ◽  
Royal College ◽  
General Internist ◽  
Successful Completion ◽  
Internal Medicine Training ◽  
Certification Exams ◽  
General Internal

In 2010, the Royal College of Physicians and Surgeons of Canada (RCPSC) recognized General Internal Medicine (GIM) as a distinct subspecialty. Soon after this recognition came a new written certificationexam, the successful completion of which awards the applicant the title of General Internist. For those of us who trained prior to the new status and examination, GIM was the default designation after four years of internal medicine training if a subspecialty was not pursued.What does this new subspecialty status mean for our professional identity, qualifications, and public credibility? Twelve years aftermy successful completion of the Internal Medicine (IM) certification exams, I voluntarily applied for consideration to write the first RCPSC exam in GIM, without a clear reason why. My reflection on the days leading up to the exam and writing the exam itself led me to understand why I did it. The process addressed my skepticism around designating GIM as a unique subspecialty, and through this I have come to appreciate the need for our profession to embrace revalidation.

scholarly journals General Internal Medicine Subspecialty Training Update

2016 ◽  
Vol 7 (4) ◽  
Author(s):  
Sharon E. Card MD MSc
Keyword(s):  
Internal Medicine ◽  
Training Program ◽  
General Internal Medicine ◽  
Royal College ◽  
Working Group ◽  
Subspecialty Training ◽  
Internal Medicine Training ◽  
General Internal

The vast majority of general internal medicine (GIM) programs in Canada have become distinct entities that provide training in additional competencies and leadership above and beyond those required for the specialty of internal medicine. In December 2010, after many years of effort, GIM finally achieved recognition as a distinct subspecialty by the Royal College of Physicians and Surgeons of Canada. A GIM Working Group has finalized the objectives and requirements for a 2-year subspecialty training program in GIM that will follow after the existing 3-year core internal medicine training program. These documents have now been approved by the Royal College.

Unified general internal medicine training programs

1990 ◽  
Vol 5 (2) ◽  
pp. 166-169
Author(s):  
Arthur M. Fournier ◽  
Mark Gelbard ◽  
Laurence B. Gardner
Keyword(s):  
Internal Medicine ◽  
General Internal Medicine ◽  
Training Programs ◽  
Internal Medicine Training ◽  
General Internal

scholarly journals An Ambulatory Clinical Teaching Unit: Filling the Outpatient Gap in Internal Medicine Residency Training

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Mohamed Panju MSc MD ◽  
Ali Kara MD ◽  
Akbar Panju MB ◽  
Martha Fulford MD ◽  
Paul O'Bryne MB ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Royal College ◽  
Clinical Teaching ◽  
Formal Structure ◽  
General Internist ◽  
Clinical Environment ◽  
Educational Curriculum ◽  
General Internal ◽  
Ambulatory Medicine ◽  
Teaching Unit

The majority of time in a core General Internal Medicine (GIM) residency is spent focusing on inpatient medicine, with relatively little time devoted to ambulatory medicine. The Royal College of Physicians and Surgeons of Canada has mandated an improvement in ambulatory exposure. Unfortunately, most ambulatory experiences tend to lack formal structure, a dedicated educational curriculum, and graduated learner-specific responsibilities. The recent Royal College recognition of GIM as a subspecialty places renewed emphasis on core IM training providing a more comprehensive exposure to outpatient medicine as management of patients with multiple complex conditions may be best managed by a general internist. In July 2015, McMaster University opened an outpatient medicine clinic which is designed to be an Ambulatory Clinical Teaching Unit (A-CTU). The A-CTU provides a structured clinical environment which is focused on the management of medically-complex patients. It uses a multidisciplinary model, graded learner levels of responsibility and a dedicated educational curriculum. The unique structure of the A-CTU allows for the assessment of milestones and EPAs (entrustable professional activities) pertaining to consultation skills and chronic disease management, in keeping with competence by design.

scholarly journals The outpatient assessment of patients with anemia by a general internal medicine service

2017 ◽  
Vol 6 (3) ◽  
pp. 41
Author(s):  
H. McFadgen ◽  
S. Couban ◽  
S. Doucette ◽  
A. Kreuger-Naug ◽  
S. Shivakumar
Keyword(s):  
Internal Medicine ◽  
Chronic Disease ◽  
Iron Deficiency ◽  
General Internal Medicine ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
General Internist ◽  
Anemia Of Chronic Disease ◽  
General Internal ◽  
Number Of Patients

At the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, 2,400-2,800 new outpatient referrals for hematology consultation are received annually and approximately 10% of these referrals are specifically for isolated anemia. In recent years, such referrals have been sent from hematology to general internal medicine (GIM) for assessment and management. A retrospective chart review was conducted of a cohort of 99 patients from 2013 to describe the demographics, assessment, management and outcome of these patients, as well as to inform whether this practice should continue. The median age of patients was 60.3 years (min 19.4, max 97.6) and 62% were female. The median hemoglobin level was 109.0 g/L (min 66, max 137) at the time of referral and the median wait time was 53 days (min 8 days, max 171 days). Pearson’s correlation analysis revealed that those with lower hemoglobin levels were seen more quickly. The patients had an additional 2.8 comorbidities on average, and were significantly more likely to receive non-anemia related adjustment to care with increasing number of comorbidities. A small proportion of patients (n = 5, 5.1%) were referred from GIM back to hematology, whereas 21% were referred to gastroenterology. A small number of patients (n = 5, 5.1%) underwent a bone marrow aspirate and biopsy. The most common diagnoses identified in the initial clinic letters were iron deficiency anemia (n = 59, 59.6%) and anemia of chronic disease (n = 8, 8.1%). 26.3% did not have a diagnosis identified. These findings support our practice to have patients with an isolated anemia evaluated by a general internist rather than a hematologist. Most of these patients had iron deficiency anemia or the anemia of chronic disease and received additional care for their comorbid conditions in the GIM clinic. Further work will help to define how such patients can be most effectively assessed and treated.

scholarly journals The General Internal Medicine Certification Examination: Does it Measure What it Should?

1970 ◽  
Vol 11 (1) ◽  
Author(s):  
Debra Pugh MD, MHPE, FRCPC
Keyword(s):  
Internal Medicine ◽  
General Internal Medicine ◽  
Royal College ◽  
Certification Examination ◽  
Present Evidence ◽  
General Internal ◽  
General Internists ◽  
Certification Exam ◽  
Examination Board

A certification exam for the new sub-specialty of General Internal Medicine (GIM) was recently developed by an examination board at the Royal College of Physicians and Surgeons (RCPSC). The board sought to create an exam that would reflect the challenges faced by practising general internists, while minimizing repetition of material already assessed by the Internal Medicine certification exam. In this paper, the authors present evidence for the validity of the content of the exam.

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