The Division of Gastroenterology at Queen's University offers a nationally respected two-year residency program that prepares graduates for stimulating careers as independent consultants and academic physicians.
Our residents benefit from an outstanding educational experience. The Gastroenterology program provides exposure to a wide diversity of cases and procedures while strongly supporting research at the same time.
In the first year of the program, half of the time is spent in Integrated Consultation, Ambulatory Care, and Endoscopy (I-C/A Endo). The remaining time is split between Gastroenterology Clinical Teaching Units (GI CTU) and Inpatient Consults, in addition to one block of Radiology.
During the second year of the program, residents again concentrate in I-C/A Endo and GI CTU, but also have one research block and one elective.
The program provides instruction in all aspects of endoscopic intervention. Residents acquire competence in the cognitive and technical aspects of upper endoscopy, colonoscopy, and sigmiodoscopy. Senior residents are offered additional training in endoscopic retrograde cholangiopancreatography (ERCP) and usually perform 70-90 cases under supervision. PGY4 residents focus on core skills while PGY5 residents undertake more complex procedures, such as dilations, enteral stenting, complex polypectomy, and achalasia pnuemtaic dilations.
The GI CTU enables residents to act as junior consultants under attending supervision. They are involved in decision-making and patient care in complex and seriously ill cases. Residents perform all of the inpatient procedures, including on those patients seen by the consult service, and are expected to execute formal nutrition assessments for cases requiring nutritional support.
Residents gain ambulatory care experience by attending up to five half-day clinics each week. These include two general GI clinics and two specialty clinics (Liver, Hepatitis, IBD, Motility, and Pediatric GI). An Urgent Clinic is added in the PGY5 year.
The Hotel Dieu Hospital motility lab is a busy unit performing upper and lower motility and fully supported by faculty.
In order to acquire the professional skills and knowledge to enable effective consultation, up to eight months is provided on the Inpatient Consultation Service. Resident supervise a team that includes internal medicine senior residents and triage all inpatient consultations, routine and emergent, and review the cases with the responsible attending. Consults are formally recorded with a management plan and residents are expected to follow up all consults through to resolution of the identified problems.
Admission to the Gastroenterology program at Queen's University is through the Medicine Subspecialty Match, coordinated by the Canadian Resident Matching Service (CaRMS).
The program will notify those applicants who have been selected for an interview, and who should plan on spending a half-day in Kingston. Their visit will include a group lunch, an interview with the program director, an interview with other GI faculty members, a tour of the ambulatory care centre, a meeting with the chief resident, and the potential tour of the Gastrointestinal Diseases Research Unit.
Programs will adhere to the guidelines of the Medicine Subspecialty Match, agreed to by Canadian Association of Professors of Medicine, the Canadian Association of Internal Medicine Program Directors, the Canadian Associate Deans (Postgraduate Education) and the Canadian Association of Interns and Residents.
Dedicated education half days occur weekly throughout the year to ensure that residents have ample opportunity to cover the entire curriculum in a comprehensive manner. These half-days include evidence-based clinical rounds delivered by residents. GI Pathology rounds cover liver disorders and GI diseases, while GI Oncology rounds provide broad coverage of case-based GI oncological topics. Weekly Medicine Grand Rounds cover general topics while monthly Health Sciences Education Rounds cover broader topics in medical education than span across programs and health professions. A case based learning series occurs throughout the academic year, with a focus on topics not necessarily covered in the other rounds.
Journal Clubs further expand clinical knowledge and consolidate critical appraisal skills. In addition, a national program of monthly videoconferences sponsored by the Canadian Association of Gastroenterology (CAG) addresses additional topics in basic science related to the GI tract and the liver.
The GI program strongly supports resident research activity. Residents are supported throughout the entire process, from the development of an idea, through to grant application, execution, analysis, and ultimately publication and presentation. Our residents are encouraged to conduct research simultaneously with their other clinical responsibilities, and a research block has been introduced into the PGY5 year if additional protected time is required.
The Gastrointestinal Diseases Research Unit (GIDRU) at Queen’s University is internationally renowned as a leading centre for GI research. Residents directly benefit from the broad base of expertise and its researchers are proactive in recruiting residents for lab work. The GIDRU is a multidisciplinary group of investigators (8 MDs and 8 PhDs) all of whom are pursuing research related to gastrointestinal/hepatobiliary physiology and pathophysiology. Many projects are collaborative. Most investigators have postgraduate students from the basic sciences – a reality that enriches the research experience for trainees. The main themes include basic and clinical motility, neurophysiology, inflammation and repair and hepatic transport. Investigators routinely use animal models, cell cultures, isolated cell preparations, sophisticated imaging and molecular biology. GIDRU actively integrates with the GI Clinical Trials group (8 Staff). Trials include both in-house and pharmaceutically sponsored projects in IBD, liver disease, acid peptic diseases and motility. Research by trainees is facilitated by the Director of GIDRU who can assist in choosing a supervisor/mentor and project.
Trainees may choose to spend their elective time blocks entirely in pursuit of their research goals. In special circumstances trainees with a long-term interest in academic practice may be assigned additional protected time for research purposes. Trainees focused on clinical community-based careers are not expected to devote time to wet lab projects.
All research undertaken is at a level that should allow peer-reviewed publication. Selected trainees may elect to supplement their research training with courses offered by the university. Additional research support is available in the form of a Clinical Trials Group and the National Cancer Institute of Canada Clinical Trials Group based at Queen’s. A biostatistician is also available to any trainee in the program for advice on trial/experimental design and interpretation.
Research is a key strength of the GI program; many of our graduates have had sophisticated research careers and now hold important academic appointments across North America.
Kingston General Hospital
Kingston General Hospital (KGH) is a regional gastroenterology resource for a population of about 750,000. Facilities include a busy emergency department, a large multi-functional ICU, coronary care and neurological intensive care specialty units and renal dialysis. Gastroenterology maintains a dedicated inpatient CTU. The case mix includes patients awaiting special procedures, inflammatory bowel disease patients, patients with unstable GI bleeding, and liver failure cases. A well equipped endoscopy suite with dedicated endoscopy nursing staff provides all endoscopic services 24 hours a day.
The KGH experience is designed to provide trainees with supervised opportunities to evaluate and manage sick GI cases requiring hospital based care and to develop additional skills critical to the efficient use of hospital resources. Residents assigned to the ward act as Junior Consultants and are expected to be involved with the care of critically ill GI cases. Residents also perform all of the endoscopy procedures on the inpatient cases. These include all consultation endoscopies as well as the GI CTU cases. Approximately one third of a resident’s time will be spent at KGH.
Hotel Dieu Hospital
Hotel Dieu Hospital (HDH) is an ambulatory (or outpatient) care facility, providing medical care or treatment that does not require an overnight stay and that includes services such as specialized clinic visits, day surgeries, and diagnostic procedures using advanced technology, equipment, or procedures. Approximately 2/3 of the training time is spent at HDH in ambulatory care including up to 8 half-day clinics (general, liver, hepatitis, motility and IBD) and 2 procedure half days weekly.
The objectives of ambulatory training are to provide supervised exposure to both common and unusual ambulatory GI problems and to instruct residents in the organization and operation of an ambulatory endoscopy facility. HDH has excellent well-staffed clinic space and a fully functioning ambulatory endoscopy unit staffed by dedicated endoscopy nurses. A multifunctional GI lab offers a range of breath tests, traditional esophageal manometry, anorectal manometry ambulatory pH-motility testing, and video capsule endoscopy.
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