Residency

Queen's Palliative Medicine runs up to 3 concurrent residency programs:

A 1-year "enhanced skills" program through family medicine, leading to a Certificate of Added Competency (CAC) from the College of Family Physicians of Canada.
A 2-year subspecialty program, entered through internal medicine, neurology, or anaesthesia, leading to a subspecialty designation from the Royal College of Physicians and Surgeons of Canada.
A Sponsored Visa Trainee program when educational and clinical capacity allows.

Queen's Palliative Medicine residency programs have a joint administrative structure including program assistant Ruili Fang and program director Dr. Craig Goldie. Please see below for further details of the residency programs.

Program Highlights

Our palliative medicine program provides clinical care in the following settings:

Inpatient Care (KGH)

Inpatient care at KGH is predominantly a consult-based service providing care for patients within the 440-bed tertiary care unit with complex palliative care needs. We have the ability to admit or accept in transfer up to 3 patients as most-responsible-physician (MRP) for complex palliative symptom issues.

Palliative Care Unit (PCU)

Our PCU is a 10-bed unit at Providence Care Hospital. We provide MRP service for those 13 beds for patients at end-of-life (prognosis < 3 months) with goals of care focused on maximal symptom management without escalation of aggressive medical interventions. Our PCU physicians also provide consultation services to the rest of the Providence Care Hospital: complex care, rehabilitation inpatients, and psychiatric patients.

Community Palliative Care

Our community palliative care team provides home visits to residential homes, retirement homes and long-term care facilities to support palliative care needs at home. The model is predominantly a consultant model but if a patient has complex palliative care needs we will assume MRP care from their family physician.

Outpatient Cancer Clinics

We provide 5 full-day clinics in the Cancer Center of Southeastern Ontario (CCSEO) for patients with cancer and significant palliative care needs. The model is predominantly a consultant model but with ongoing care if a patient has complex palliative care needs now or expected in the near future.

Non-Malignant Clinics

We have Neuromuscular Disease Clinic (3rd Tuesday each month) and ILD Clinic (every Friday morning) for patients with non-malignant diseases.

Enhanced Skills Program

Enhanced Skills 1-year program includes 13 blocks:

5 blocks of inpatient care at KGH
3 blocks of PCU combined with community palliative care
3 elective blocks
1 block of medical oncology
1 block of radiation oncology

The enhanced skills fellow have longitudinal exposure to our outpatient clinics at CCSEO, one half-day a week, to allow for ongoing follow-up and continuity of care for cancer clinic patients throughout the year.

Subspecialty Medicine Program

The subspecialty medicine program includes 2 years (26 blocks):

12 blocks of palliative care
- 6 inpatient
- 4 PCU/community
- 2 outpatient cancer clinics
1 medical oncology
1 radiation oncology
6 blocks of medicine within: Cardiology, Critical Care, Gastroenterology, Geriatrics, ID, Nephrology, Neurology, Respirology
1 pediatric palliative care
2 blocks of scholarly activity
3 blocks of selectives

Admission

Queen's Palliative Medicine Residency programs have the capacity to accept 2 Enhanced Skills PGY3 residents per year and 1 Subspecialty resident per year. These numbers are based on educational capacity as well as funding, so are subject to change.

Enhanced Skills PGY3 (1-year certificate of added competency)

Admission to the Enhanced Skills program is currently done outside of the Canadian Resident Matching Service (CaRMS). Details on application information and dates can be found on the PGY3 Enhanced Skills Program website through the Department of Family Medicine.

Subspecialty Medicine (2-year Royal College program)

Admission to the Adult Palliative Medicine program at Queen's University is through the Medicine Subspecialty Match, coordinated by the Canadian Resident Matching Service (CaRMS).

Selection Criteria

The goal of the palliative medicine programs are to develop specialist or consultant physicians in palliative medicine that can provide exceptional palliative care for all patients in all clinical settings, as well as build capacity in palliative care within a defined population or region.

Important attributes include compassion, excellent communication skills, strong foundational medical knowledge, and clear passion regarding palliative medicine as a specialty, as well as an important skill for all physicians and healthcare providers, and an interest in promoting primary and secondary-level palliative care and being a resource to those physicians.

File Review

Application files for the residency programs will be reviewed independently by members of the Residency Program Committee (RPC) which is a multidisciplinary committee. Interviews will be offered based on the scoring of the files.

Interview

Each selected candidate will undergo an interview process with a panel of 4 or more interviewers from the Residency Program Committee, including the Program Director and a current resident (either Enhanced Skills or Subspecialty). These can be done in person or via teleconference.

Candidates will have an opportunity to ask questions about the residency program at the end of the interview or to meet informally with current residents or other division members. Guided tours of the facilities may be possible but depend on availability of our residents.

Ranking

Ranks and matches of both programs are through the CaRMS process with more details on their website.

Educational Activities

Academic Half Days

Our residency programs share an academic half-day schedule for the Enhanced Skills residents and the first year of the Subspecialty Medicine residency. The second year of the Subspecialty residency includes more self-directed learning, teaching of the academic half-days, research time and several modules to complete independently, as well as the opportunity to attend any half-days that were missed in first year or the half-days of other subspecialty residency programs if relevant.

Academic Half-days are Monday afternoons from 1-4pm. All residents are expected to attend in person or by teleconference. 4 national Academic Half-Days are arranged through the Canadian Society of Palliative Care Physicians, including 1 potential in-person meeting at the annual Advanced Learning in Palliative Medicine (ALPM) conference.

Journal Club

We host quarterly palliative medicine journal clubs on Friday mornings, where each palliative medicine resident presents 1 article per year.

Advanced Practice Palliative Medicine Rounds

Residents are expected to present 2 palliative medicine grand rounds with a thorough review on particular palliative care topics such as incident pain, lidocaine/ketamine evidence, palliative sedation etc on Friday mornings.

Resident Reflection Rounds

Our spiritual care advisor, Janeta Kobes, facilitates monthly resident reflection rounds for our rotating and palliative medicine residents, to discuss difficult cases, family dynamics, ethical concerns and any other challenges in dealing with palliative patients, death and dying on Friday mornings.

4-Day Course - Educating Family Physicians in Palliative Care

Our residents have an opportunity to take this 4-day educational course for family physicians, run by our program in the first half of their training, with the expectation that they will be able to teach in the course in the second half of their training.

Conference Funding

Our program provides some funding to subsidize resident's attendance at a palliative care conferences.

Resident Schedules

Palliative Care Evenings & Weekends Call Schedule

Block 1 (Jul 1-29, 2024) updated Jun 24, 2024

Block 2 (Jul 30 - Aug 26, 2024)

Block 3 (Aug 27-Sep 23, 2024)

Block 4 (Sep 24-Oct 21, 2024)

Block 5 (Oct 22 - Nov 18, 2024)

Block 6 (Nov 19-Dec 16, 2024) Updated

Block 7 (Dec 17, 2024 - Jan 13, 2025)

Block 8 (Jan 14-Feb 10, 2025)

Block 9 (Feb 11 - Mar 10, 2025)

Block 10 (Mar 11 - Apr 7, 2025)

Block 11 (Apr 8-May 5, 2025)

Block 12 (May 6-Jun 2, 2024)

Block 13 (Jun 3-30, 2025)

Palliative Care Resident Schedule

Block 1 (Jul 1-29, 2024) updated Jun 24, 2024

Block 2 (Jul 30 - Aug 26, 2024)

Block 3 (Aug 27-Sep 23, 2024)

Block 4 (Sep 24-Oct 21, 2024)

Block 5 (Oct 22 - Nov 18, 2024)

Block 6 (Nov 19-Dec 16, 2024) Updated Nov 4, 2024

Block 7 (Dec 17, 2024 - Jan 13, 2025)

Block 8 (Jan 14-Feb 10, 2025)

Block 9 (Feb 11 - Mar 10, 2025)

Block 10 (Mar 11 - Apr 7, 2025)

Block 11 (Apr 8-May 5, 2025)

Block 12 (May 6-Jun 2, 2024)

Block 13 (Jun 3-30, 2025)

Resident Presentation Schedule

Block 1 (Jul 1-29, 2024)

Block 2 (Jul 30 - Aug 26, 2024)

Block 3 (Aug 27-Sep 23, 2024)

Block 4 (Sep 24-Oct 21, 2024)

Block 5 (Oct 22 - Nov 18, 2024)

Block 6 (Nov 19-Dec 16, 2024)

Block 7 (Dec 17, 2024 - Jan 13, 2025) no presentation scheduled in Block 7

Block 8 (Jan 14-Feb 10, 2025)

Block 9 (Feb 11 - Mar 10, 2025)

Block 10 (Mar 11 - Apr 7, 2025)

Block 11 (Apr 8-May 5, 2025)

Block 12 (May 6-Jun 2, 2024)

Block 13 (Jun 3-30, 2025)

Palliative Care Resident Weekly Schedule

Dec 21, 2024 - Jan 3, 2025

Jan 6-10, 2025

Research

Scholarly Project

Residents are expected to complete an original Scholarly Project during the year, supervised by a faculty member and with access to significant resources through Queen's including excellent librarians, a supportive and effective Research Ethics Board etc. The goal is to disseminate the findings of the project in a conference presentation and/or publication in a palliative medicine journal.

Other research activities will be supported and encouraged by the program, in discussion with the Academic Advisor and Program Director, and with awareness of clinical and educational expectations.

The following are Scholarly Projects by previous residents:

Dr. Arun Agha (2022 - 2023): Development of end-of-life medication deprescribing and conversion guide for trainee use

Dr. Kirsten Litke (2021-2023): TBA

Dr. Emma Polle (2021-2022): Development of a communication tool and checklist to improve transitions from hospital to home for patients with palliative care needs

Dr. Jonathan Tam (2021-2022): Creating a standardized letter to better improve communication between the Queen’s palliative medicine team and local primary care providers

Dr. Day Dai (2020-2021): TBA

Dr. Leora Reiter (2020-2021): TBA

Dr. Karen Ngo (2020-2021): TBA

Dr. Toni Mihaylova (2019-2020): TBA

Dr. Kaitlyn Boese (2019-2020): TBA

Dr. Julianne Bagg (2019-2020): Identification of Palliative Care Needs in Heart Failure Patients

Dr. Majid Iqbal (2018-2019): TBA

Dr. Catherine Monnin (2018-2019): TBA

Dr. Maggie Yu (2018 - 2020): TBA

Dr. Alex Trussler (2017-2019): TBA

Dr. Daniel Robinson (2017-2018): Burnout in Palliative Health Care Workers: How Does Canada Compare?

Dr. Ave Ellaurie (2016-2017): Subjective Response to Treatment in a Palliative Care Clinic Specializing in Management of Advanced Dyspnea in Non-Malignant Population

Dr. Roddy Davey (2015-2016): Muscle Mass with Progressive Dyspnea in Advanced Cancer.

Dr. Jaimi Heidman (2014-2016): Palliative Care Pocket Book

Dr. Saneea Abboud (2014-2015): Exploring the impact of art therapy on ambulatory palliative care patients with an incurable cancer diagnosis

Dr. Kelly Parks (2013-2014): Assisted Death: Murder or End-of-Life Care.

Dr. Stephen Singh (2011-2012): Takotsubo Cardiomyopathy Secondary to Cancer Related Pain Crisis - case study.

Dr. Christina Quinlan (2011-2012): Financial Impact of Palliative Care Services - literature review; Palliative Care Referral Information Sheet.

Dr. Arnell Baguio (2010 - 2011): Developing a rational, step-wise, pharmacologic approach to bowel management for palliative care patients - literature review.

Dr. Desmond Leung (2010-2011): Cancer Cachexia: systematic review of medications used in its management.

Dr. Abdullah Al Suhail (2008 – 2010): Effect of Inhaled Nebulized Fentanyl Citrate on Exercise Tolerance & Exertional Dyspnea in Patients with COPD. Dr. Suhail designed and implemented a randomized, double-blind placebo-controlled, cross-over study to examine the effects of inhaled nebulized fentanyl citrate on the ventilatory and perceptual response to high intensity, constant-load cycle exercise in chronic obstructive pulmonary disease.

Dr. Rawabi Shaikh (2007-2008): Establishing home based palliative care in King Fahad Specialist Hospital Saudi Arabia. Dr. Shaikh developed a proposal for the development of a home palliative care service based on the CHPCA Square of Care and the Pan-Canadian Gold Standards for Palliative Home Care. Using this as her proposal, she has subsequently received funding and established this service in Saudi Arabia.

Dr. Natalie Kondor (2006-2008): Palliative Care in Prince Edward County: Addressing a Priority. Dr. Kondor evaluated the experiences and needs of Prince Edward County Family Physicians and Nurse Practitioners in providing palliative care to their patients. Participants completed a survey that examined their palliative care experiences, palliative referral practices, and use of palliative care resources. This was presented to the newly developing Prince Edward County Family Health Team to assist them in the development of the palliative care component of their program.

Dr. Julia Wildish (2005-2006): Efficacy of Topical Opioids for the Treatment of Pain from Skin Ulcers: A Review of the Evidence. Dr. Wildish undertook a literature review to assess the current evidence for the use of topical opioids to treat pain from cutaneous ulcers.

Dr. Lana Tan (2004-2005): Opioid Rotation to Methadone for Cancer Pain: A retrospective chart review. Dr. Tan described the method of opioid rotation to methadone used by the Palliative Care Medicine Service at Kingston General Hospital through a retrospective chart review of inpatients during the years 1999-2004.

Dr. Areej Matar (2004-2005): A randomized, double-blind, placebo-controlled study of menthol for management of dyspnea. Dr. Matar developed the protocol for a study to determine the efficacy and safety of menthol for management of dyspnea in palliative care patients with plans to implement the study on her return to Saudi Arabia.

Dr. Desiree Dunn (2003-2004): Physician Burnout: A Palliative Care Fellow’s Recommendations for Prevention. Dr. Dunn undertook a review of the literature related to burnout and concluded with recommendations for palliative care residency programs to prevent it in their fellows.

Dr. Rafa Al-Shehri (2002-2003): A Comparative Descriptive Study of Palliative Care in Saudi Arabia and Palliative Care in Canada. In this paper, Dr. Al-Shehri outlined the history of the development of palliative care and the current state of palliative care in Saudi Arabia. He contrasted the service that is currently available in Saudi Arabia with the services provided by two palliative care programs in Canada.

Training Sites

The majority of training will occur at Kingston Health Sciences Centre (KHSC) at the Kingston General Hospital (KGH) site and the Cancer Center of Southeastern Ontario (part of KGH) with another significant part of the training at Providence Care Hospital (PCH).

All of these sites are located within close proximity of one another and Queen's University in Kingston.

The Enhanced Skills program does not have mandatory out-of-town rotations. The Subspecialty Program has currently 2 mandatory rotations in Ottawa, Ontario: Pediatric Palliative Care and Geriatric Medicine, as these academic rotations are not available in Kingston at this time.

Elective rotations can be done in any setting that the program and PGME office feel is suitable. Subspecialty program selective rotations can be taken at centres accredited by the RCPSC, or at international centres that offer a strong educational contribution. The latter will require discussion and review by the program and PGME office at Queen's University to ensure suitability.

Residents are required to arrange their own licensing and liability ensurance when doing out-of-providence rotations; we will provide timely support for required documentation.

Residency

Program Highlights

Inpatient Care (KGH)

Palliative Care Unit (PCU)

Community Palliative Care

Outpatient Cancer Clinics

Non-Malignant Clinics

Enhanced Skills Program

Subspecialty Medicine Program

Admission

Enhanced Skills PGY3 (1-year certificate of added competency)

Subspecialty Medicine (2-year Royal College program)

Selection Criteria

File Review

Interview

Ranking

Educational Activities

Academic Half Days

Journal Club

Advanced Practice Palliative Medicine Rounds

Resident Reflection Rounds

4-Day Course - Educating Family Physicians in Palliative Care

Conference Funding

Resident Schedules

Research

Scholarly Project

Training Sites

Policies

Life in Kingston

Rotating Resident Orientation