The Evolution of General Internal Medicine (GIM)in Canada: International Implications

Card, Sharon E.; Clark, Heather D.; Elizov, Michelle; Kassam, Narmin

doi:10.1007/s11606-016-3891-z

Cited by 11 publications

(16 citation statements)

References 25 publications

(20 reference statements)

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“…This is especially true since GIM has been recently recognized as an official subspecialty by the RCPSC since 2010, which provides a targeted focus on both ambulatory and acute care management. 5 Additionally, the demand and nature of practice for the ambulatory internist is changing as patient volumes and complexity increase. 5 Despite this societal need, the Royal College only mandates one ambulatory block within the first three years of core internal medicine residency training, which approximates to 2.6% of a resident’s entire duration of training, 4 creating discordance between training needs in preparation for independent practice and accreditation standards.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Additionally, the demand and nature of practice for the ambulatory internist is changing as patient volumes and complexity increase. 5 Despite this societal need, the Royal College only mandates one ambulatory block within the first three years of core internal medicine residency training, which approximates to 2.6% of a resident’s entire duration of training, 4 creating discordance between training needs in preparation for independent practice and accreditation standards. While a commitment to ACE is evident and necessary, further exploration of discordances in accreditation standards and training requirements is warranted.…”

Section: Discussionmentioning

confidence: 99%

“…1 This gives credence to the notion that ACE has become a key educational priority for internal medicine, especially in Canada with the advent of GIM subspecialty training, warranting further study. 5 We deliberately chose the 2005-2015 time frame to understand the literature in the five years preceding and following the recognition of GIM as a distinct subspecialty of internal medicine by the RCPSC in 2010. 5 This decade spans a period where Canadian internal medicine residency programs were undergoing substantial organizational changes to launch 2-year subspecialty GIM programs.…”

Section: Methodsmentioning

confidence: 99%

“… 5 We deliberately chose the 2005-2015 time frame to understand the literature in the five years preceding and following the recognition of GIM as a distinct subspecialty of internal medicine by the RCPSC in 2010. 5 This decade spans a period where Canadian internal medicine residency programs were undergoing substantial organizational changes to launch 2-year subspecialty GIM programs. At the same time, the internal medicine patient population was changing in terms of higher volumes and complex multimorbidity that partly created the demand for ambulatory care within GIM.…”

Section: Methodsmentioning

confidence: 99%

“…The Royal College of Physicians and Surgeons of Canada (RCPSC) defined GIM as “a subspecialty of internal medicine which embraces the values of generalism, is aligned with population needs, and promotes the practitioner’s ability to adapt their practice profile when population needs change.” 4 (p1) Given its nascent state, internists across Canada are attempting to define the role of ambulatory care within GIM, and how that can be reflected in its training. 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

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A narrative review of ambulatory care education in Canadian internal medicine

et al. 2020

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Background: The Canadian healthcare system faces increasing patient volumes and complexity amidst funding constraints. Ambulatory care offers a potential solution to some of these challenges. Despite growing emphasis on the provision of ambulatory care, there has been a relative paucity of ambulatory care training curricula within Canadian internal medicine residency programs. We conducted a narrative review to understand the current state of knowledge on postgraduate ambulatory care education (ACE), in order to frame a research agenda for Canadian Internal Medicine ACE. Methods: We searched OVID Medline, Embase, and PsycINFO for articles that included the concepts of ambulatory care and medical or health professions education from 2005-2015. After sorting for inclusion/exclusion, we analyzed 30 articles, looking for dominant claims about ACE in Internal Medicine literature. Results: We found three claims. First, ACE is considered to be a necessary component of medical training because of its distinction from inpatient learning environments. Second, current models of ambulatory care clinics do not meet residency education needs. Third, ACE presents opportunities to develop non-medical expert roles. Conclusions: The findings of our narrative review highlight a need for additional research regarding ACE in Canada to inform optimal ambulatory internal medicine training structures and alignment of educational and societal needs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A narrative review of ambulatory care education in Canadian internal medicine

et al. 2020

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Generalist vs specialist acute medical admissions - What is the impact of moving towards acute medical subspecialty admissions on efficacy of care provision?

Smyth

Gorey

O'Keeffe

et al. 2022

European Journal of Internal Medicine

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The current state of general paediatric fellowships in Canada

Maawali

Puran

Schwartz

et al. 2021

Paediatrics &Amp; Child Health

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Introduction The field of Paediatric Medicine has grown tremendously over the last two decades. Several niche areas of practice have emerged, and opportunities for focused training in these areas have grown in parallel. The landscape of ‘General Paediatric Fellowship’ (GPF) Programs in Canada is not well described; this knowledge is needed to promote standardization and high-quality training across Canada. This study explores the structure and components of existing GPFs in Canada and identifies the interest and barriers to providing such programs. Methods A questionnaire was created to explore the landscape of GPF Programs in Canada. Invitations to participate were sent to leaders of General Paediatric Divisions across Canada, with a request to forward the survey to the most appropriate individual to respond within their local context. Results A total of 19 responses (95%) representing 17 different Canadian universities were obtained. Eight universities offered a total of 13 GPF Programs in 2019, with one additional university planning to start a program in the coming year. Existing programs were variable in size, structure and curriculum. Most programs identified as Academic Paediatric Programs, with an overlap in content and structure between Academic Paediatrics and Paediatric Hospital Medicine programs. The majority of respondents felt there was a need for GPF Programs in Canada but cited funding as the most common perceived barrier. Conclusion A growing number of GPF Programs exist in Canada. Current fellowship programs are variable in structure and content. Collaboration between programs is required to advance GPF training in Canada.

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The Evolution of General Internal Medicine (GIM)in Canada: International Implications

Cited by 11 publications

References 25 publications

A narrative review of ambulatory care education in Canadian internal medicine

A narrative review of ambulatory care education in Canadian internal medicine

Generalist vs specialist acute medical admissions - What is the impact of moving towards acute medical subspecialty admissions on efficacy of care provision?

The current state of general paediatric fellowships in Canada

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