Core Respirology Medicine Training Program | Department of Medicine | School of Medicine

The respirology training program is central to the mission of the Division of Respirolgy & Sleep Medicine at Queen’s University. The program is designed to produce highly competent respiratory specialists, and is geared to meet the needs of individuals wishing to pursue a career in academic respirology as well as those who choose a career in community respirology. The program is of two years duration. The first year consists of twelve blocks of clinical respirology training and one block of intensive care. The second year is flexible and is moulded to the unique needs of each trainee. The second year includes training in clinical respirology, research and other scholarly activity, and elective experiences related to respirology. The Queen's University Respirology and Sleep Medicine training program has been functioning under the CBME format since 2017, and is compliant with the current Royal College of Physicians and Sugeons of Canada CBD requirements.

Program Highlights

Above all, our Program provides a high-quality, flexible educational experience that fully and successfully prepares our trainees for a career in either academic or community respirology and sleep medicine.

By virtue of a highly flexible Core of Discipline Phase that is tailored to the needs of the individual trainee, trainees are able to choose from a variety of elective/selective experiences that serve to achieve individual career goals. Our faculty are dedicated to ensuring that our trainees are exposed to all aspects of general and subspecialty respirology. Subspecialty experience, supervised by experts in the field, is gained from regular attendance at clinics in cystic fibrosis, COPD, asthma, pulmonary rehabilitation, pulmonary hypertension, lung cancer, tuberculosis, and cough.

Trainees interested in academia have opportunities to take part in research projects in collaboration with our faculty, many of whom are internationally renown. Trainees are supported to attend scientific meetings and symposia to present original research.

Queen’s University, located on the shores of Lake Ontario in picturesque Kingston, Ontario, is one of Canada’s leading academic institutions. As a city, Kingston offers larger-city amenities with a smaller-city feel. In addition to world-class watersports, Kingston and the surrounding area allows easy access to camping, biking and nature trails. Located in the heart of the Thousand Islands, Kingston is also within easy driving distance to the major urban centres of Toronto, Ottawa, and Montreal.

Admission

Admission to the Respirology and Sleep Medicine program at Queen's University is through the Medicine Subspecialty Match, coordinated by the Canadian Resident Matching Service (CaRMS). For specific details and requirements on applying to the Division of Respirology and Sleep Medicine training program at Queen's University, please visit our progam description found on the CaRMS website. Interviews will be held in Kingston, Ontario. On the day of interviews, candidates will have an opportunity to interview with members of the selection committee. Candidates taking part in the interview process will also be invited to take part in a lunchtime orientation sessions hosted by current trainees in the Program. Please refer to our program description.

More information for Canadian Medical Graduates and International Medicial Graduates can be found on the Queen's Postgraduate Medical Education website.

Curriculum and Educational Activities

This residency program is for 2 years. Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.

Longitudinal Experiences:

Throughout the training program, our trainees receive longitudinal experiences in bronchoscopy and other thoracic procedures such as tube thoracostomy. The program maintains an urgent referral clinic/fellow's clinic that sees the majority of the urgent referrals for the Division and provides a venue for Fellows to follow these patients longitudinally. This clinic is supervised at arm’s length by faculty, provides graded responsibility and allows the development of the managerial skills required for transition into clinical practice. PFT interpretation also occurs on a recurring fashion throughout training.

The formal academic program consists of a weekly academic half day that covers all aspects of core respirology. In addition, there are weekly Grand Rounds (attended by all members of the Division of Respirology), Journal Clubs, and ILD Rounds held in conjunction with Respirology, Radiology, Pathology, and Thoracic Surgery. Principles in pulmonary physiology are taught using a core group of lectures offered at the beginning of each academic year, with concepts further reinforced and applied to the clinical setting using monthly workshops.

Trainees with an interest in medical education will have the opportunity to contribute to formal teaching provided to students in both undergraduate and postgraduate medical education. Formal instruction in teaching methodology can be explored by trainees through participation in the Essentials of Successful Teaching Program, and interested trainees have the additional opportunity to take part in a more formal curriculum in Educational Scholarship or Leadership intermitttently offered through the University.

Transition to Discipline / Foundations of Discipline:

The Transition to Discipline / Foundations of Discipline training phase is designed to provide a broad exposure to general respirology, through both inpatient and ambulatory patient encounters. Depending on career path, 1-2 months of ICU and an elective month round out the first year. The Transition to Discipline / Foundations of Discipline trainees are responsible for interpreting PFTs throughout the year, and are assigned to at least one half-day of bronchoscopies per week. Procedural training, including the use of ultrasound-guided thoracentesis and tube thoracostomy, is provided throughout the year.

Core of Discipline / Transition to Practice:

The Core of Discipline / Transition to Practice training phase builds on the foundations of general respirology that were developed in the Transition to Discipline / Foundations of Discipline training year. In the Core of Discipline / Transition to Practice phase trainees receive more focused exposure to subspecialty respirology by taking part in weekly subspecialty clinics. Additional rotations in chest radiology, lung cancer, thoracic surgery, and lung transplantation are also included, as is a block spent as a senior resident in the Intensive Care Unit. A minimum of 2 blocks will be spent in sleep medicine. Skills in bronchoscopy are further developed with the use of more advanced techniques such as transbronchial fine-needle aspiration. Core of Discipline / Transition to Practice trainees also spend a block as Junior Attending Staff on the busy inpatient respiratory consultation service, which allows further refinement of consultancy skills. During this year, the trainees are responsible for the interpretation of all cardiopulmonary exercise tests and spend time in the PFT lab to learn aspects of quality control and assurance related to pulmonary function testing. Up to 5 elective blocks are available during the Core of Discipline / Transition to Practice phase, allowing the trainee the flexibility to pursue a career path that is tailored to individual career goals.

Optional Additional Training (PGY 6+)

For trainees who have completed the core training program, and contingent on the receipt of ongoing funding, we are able to offer ongoing Fellowship opportunities in Research, Critical Care Medicine, and Sleep Medicine. Please note that the Royal College of Canada no longer allows for concurrent training in Respirology and Critical Care Medicine; thus, ongoing training in Critical Care requires a separate application to the Critical Care Medicine Program at Queen’s University.

Research

The Core Residency in Respiratory Medicine requires participation in a scholarly endeavor. The Division is well positioned to enable residents and fellows to pursue any level of scholarship including the pursuit of advanced level degrees in selected cases. The Division maintains a robust research program with multiple active researchers in QI, Epidemiology, Physiology, etc. Moreover, opportunities for partnership with other physician groups, Faculty of health sciences, and the wider University are available.

A selected list of recent resident publications are below:

Digby GC, Keenan SP, Parker CM, Sinuff T, Burns KE, Mehta S, Ronco JJ, Kutsogiannis DJ, Rose L, Ayas NT, Berthiaume LR, D'Arsigny CL, Stollery DE, and Muscedere J. Non-Invasive Ventilation Practice Patterns in Canadian Tertiary Care Centers: A Descriptive Analysis. Can Respir J. 2015; 22(6): 331-340.

Digby G, Jalini S, Taylor SW. Medication-Induced Acute Dystonic Reaction: The Challenge of Diagnosing Movement Disorders in the Intensive Care Unit. BMJ Case Reports Published Online: 21 September 2015. doi:10.1136/bcr-2014-207215

Digby GC, Kukla P, Zhan Q, Pastore CA, Piotrowicz R, Schapachnik E, Zareba W, Bayés de Luna A, Pruszczyk P, Baranchuk AM. The Value of Electrocardiographic Abnormalities in the Prognosis of Pulmonary Embolism: A Consensus Paper. Ann Noninvas Electro. 2015; 20(3): 207-223.

Digby GC, Robinson A. Optimizing the Management of COPD in Lung Cancer Patients: A Descriptive Analysis. Queen’s University Department of Medicine Research Day. May 2015 (Oral Presentation).

Kwok, C., DeWit, Y., Olajos-Clow, J., Madeley, C., Styling, G., To, T., & Lougheed, M. D. (2017). Determinants Of Asthma-Related Emergency Department Return Visits In Adults: A Population-Based Study. In B23. NOVEL EPIDEMIOLOGY, MANAGEMENT, AND OUTCOMES IN ASTHMA(pp. A2985-A2985). American Thoracic Society.

Duty Hours: Where have all the Residents Gone? '2012 International Conference on Residency Education (5066) 10/18/12 04:00 PM - 10/20/12 04:45 PM'.

Resident Calendar: A Reliable and Efficient Tool for Creating Call Schedules and Documenting Duty Hours for Residents.

"Spontaneous All Limb Compartment Syndrome. A Case Report." Canadian Journal of Emergency Medicine.

Association between Severe Asthma and CFTR mutation

Drs. G. Riolo and D. Lougheed, Department of Respirology

Training Sites

The majority of clinical training is completed at Kingston General Hospital, a 450-bed acute care facility that serves a catchment area of close to a million people. Ambulatory clinics in respirology are held primarly at Hotel Dieu Hospital and Providence Care both located in Kingston. Mandatory rotations in lung transplantation are completed in Toronto, Ontario.

Policies

All policies relating to Respirology and Sleep Medicine training program can be found on the Queen's Postgraduate Medical Education website.

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