Halifax, Nova Scotia

The health facilities in Halifax serve as the tertiary referral center for the entire province of Nova Scotia and Prince Edward Island. In some cases, the QEII Health Sciences center serves as the quaternary referral center for the entire Atlantic region. There are over 250 Department of Medicine beds and 90+ residents in internal medicine and its subspecialty programs. To the approx. 90 residents in the Department of Medicine there are approx. 200 faculty (full/PT, joint, adjunct).

The 2010 relative pass rate for the RCPSC General Internal Medicine exam for Dalhousie IM graduates was 100%.

The libraries in the hospitals and the resident resource rooms all have computer access. The Department of Medicine has sponsored every resident in the current academic year to have individual subscribed access to Up-To-Date.

Residents will participate in the following rotations:

HEMA / VG: Victoria General Site (QEII HSC)

Residents will be expected to develop a knowledge base in the pathophysiology, diagnosis and treatment of hematological diseases. The depth of knowledge expected will increase from the PGY1 to senior resident level.

At the end of the rotation, the trainee will have developed evidence-based approaches to the investigation and management of patients presenting with:

  • Normal hematopoiesis and regulatory cytokines
  • Normal coagulation and hemostatic pathways
  • Normal immune system
  • Investigated and managed the following conditions and have an understanding of the underlying pathophysiology or representative disorders:
    • anemia, erythrocytosis
    • thrombocytopenia, thrombocytosis
    • leukopenia, leukocytosis
    • hematological malignancies including plasma cell dyscrasias, myeloproliferative disorders, myelodysplastic disorders, chronic and acute leukemia, lymphomas and lymphoproliferative disorders
    • venous thromboembolic disease and hypercoaguable states
    • coagulopathies and hemostatic disorders both congenital and acquired
    • bone marrow transplantation including general indications and complications (eg. graft versus host disease)
    • emergency situations and hematological disease including hypercalcemia, cord compression, hyperviscosity and febrile neutropenia
  • Principles of use and side effects of chemotherapeutic agents used for hematological malignancies
  • The components available for blood product transfusion including indications and dosage and an understanding of transfusion-related complications

IMCU / HI: Halifax Infirmary

The purpose of this rotation is to provide trainees experience looking after patients in need of intermediate care under the direct supervision of the group of IMCU Attending staff. The skills and knowledge learned will better enable trainees to care for critically ill individuals in other rotations such as in the Intensive Care Units and the Coronary Care Unit. One of the benefits of this rotation will be the wide variety of clinical problems and medical emergencies/urgencies that is encountered in this setting. This will give PGY1’s rotating through this rotation a large volume of clinical problems and therapeutics to read around and to become familiar with. The trainee will also benefit from one on one teaching with the Attending staff. If clinical support is required when the Attending staff is not available during the day, one of the PGY3s on MTU can be contacted for assistance.

GI / VG: Victoria General Site (QEII HSC)

During your rotation with our division you will gain exposure to a wide variety of digestive diseases. The division of Gastroenterology is composed of a dynamic team of physicians, senior subspecialty residents and exceptional allied health providers. We provide care to patients presenting with both luminal and hepatobiliary disease. During this rotation you will be exposed to a large number of clinical presentations varying from acute emergency management of unstable patients to inpatient care of complex medical conditions.

This rotation will be four weeks in duration and will serve to introduce you to the spectrum of gastrointestinal disease. You will have the opportunity to return to the GI division in your second and third years of residency for elective experience.

During your one-month rotation, you will spend two weeks as a member of the inpatient consultation service at the New Halifax Infirmary and two weeks as part of the Victoria General based inpatient hepatology service. During both halves of the rotation you will be directly supervised by both an attending gastroenterologist and a senior gastroenterology subspecialty resident. At many points during the year there will also be a clinical clerk on service with you. At the New Halifax Infirmary, you will be responsible for assessing and reviewing inpatient and emergency room consultations with your team members. You will also be responsible for providing ongoing consultative follow up for these same patients. During your two weeks of hepatology you will care for patients admitted to hospital with advanced liver disease including those that are being evaluated for possible liver transplant.

During your rotations in gastroenterology there are many opportunities to identify research projects and apply your management / supervisory skills. It is also an excellent opportunity to practice medicine in a multidisciplinary model.

MTU / HI: Halifax Infirmary

This rotation has been set up to provide trainees experience looking after potentially unstable patients under the direct supervision of the group of IMCU Attending staff. The skills and knowledge learned will better enable trainees to care for critically ill individuals in other rotations such as in the Intensive Care Units and the Coronary Care Unit.

One of the benefits of this rotation will be the wide variety of acute clinical problems and medical emergencies/urgencies that is encountered in this setting. This will give PGY-1’s rotating through this rotation a large volume of clinical problems and therapeutics to read around and to become familiar with. The trainee will also benefit from one on one teaching with the Attending staff and from the presence of the Senior Medicine PGY-3 who will also be available for advice and support.

ICU / VG: Victoria General Site (QEII HSC) or HI: Halifax Infirmary

Critical Care rotation: Critical care is a unique specialty which crosses various other clinical domains including Emergency Medicine, Internal Medicine, General Surgery (and its surgical sub-specialties) and Anesthesia. We care for patients who are acutely ill and require resuscitation and the institution of life support measures. In addition, we manage post op patients and those who require prolonged life support for various reasons. We interact closely with other specialties to provide optimal, multi system care.

Learners of various levels of training and specialties rotate through the ICU. In addition to medical trainees, which range from clinical clerks to senior residents, the ICU also enjoys the presence of Respiratory Therapy, paramedics and nursing students. As the ICU resident you will be taking a lead role in the management and direction of patients and the ICU team.

ACC / VG: Victoria General Site (QEII HSC) or HI: Halifax Infirmary – 4 weeks

As PGY2 & PGY3 residents you will be scheduled for three (3) Ambulatory Care Clinic (ACC) rotations each year. PGY2’s will complete 1 ACC rotations at the SJRH and two ACC rotations at the QEII.

You will have an opportunity to choose in advance with the education office in Dalhousie your preferences for Ambulatory Care Clinic (ACC) rotations. You will be provided a list so that you can rank ALL available ACC rotations at SJRH and QEII in order of preference and the best efforts will be made to get you your top choices.