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Kingston and 1000 Islands

The Kingston-Thousand Islands (KTI) site of Queen’s Family Medicine offers an exceptional residency training experience. We are the largest single-site program in the country, with incredibly engaged residents and a small-program feel. 

Kingston is ideally located in beautiful southeastern Ontario, and is consistently ranked as one of the best places to live in Canada. My family and I have lived here for more than 10 years now, and we continue to be amazed by this city and love exploring the surrounding region.

KTI offers an excellent combination of urban and rural learning environments with award-winning preceptors. Our supportive education team aims to provide you with the best training opportunities possible and an individualized approach to your residency. Our military and public health streams have been specifically designed around your unique training needs, and our enhanced skills program offers a diverse range of options for residents interested in additional training after completion of their core two-year residency program. 

The KTI site is rotation-based with many built-in horizontal aspects. To help ease your transition into residency, we begin with one block of boot camp — an experience designed to introduce you to your home clinic at the Queen’s Family Health Team (QFHT) in historic downtown Kingston with participation in innovative simulation courses to help build your skills and confidence at the outset. 

Residents spend six blocks of their first year at QFHT in three two-block rotations, returning to the same clinic, patients, and preceptors. This maximizes continuity of care and allows residents to gradually increase their patient care and practice-management responsibilities over time — a definite strength of our program. Residents return to QFHT in PGY2 for two blocks as a senior FM resident, providing many opportunities for leadership, mentorship and teaching of junior learners. In PGY2 residents also spend five blocks in community and/or rural family medicine. Other blocks throughout our program include core off-service rotations and three electives. 

At KTI, you will be surrounded by a supportive team and have all the training opportunities you need to become a competent family physician — just ask our amazing residents.

Dr. Kelly Howse

Kingston-Thousand Islands Site Director

KTI Site Video

Top 10 Reasons Residents Love our KTI Site!

Queen's FM Brochure 

  • Large program, small-program feel
  • Block-based with horizontals
  • Urban/rural mix
  • Bootcamp with SIM
  • POCUS, procedures
  • Resident wellness
  • Focus on practice management
  • Graduate with confidence

Our Kingston-1000 Islands (KTI) program is based in the city of Kingston, Ontario. Home to Queen's University, this is the largest of our four-site programs. 

The KTI site offers a traditional rotation-based residency training program with many horizontal training components. The KTI site program is based around core family medicine rotations, complemented by rotations in internal medicine, obstetrics and gynecology, pediatrics, psychiatry, emergency medicine, and palliative care. In your first year, your core family medicine will take place at the Queen’s Family Health Team (QFHT), located in historic downtown Kingston. The QFHT serves an extremely diverse patient population and serves as a leading example of team-based primary care. In your second year, you will complete most of your family medicine rotations at community teaching practices throughout the region as you develop your independence as a physician. 

The remainder of your residency will comprise rotations in other specialties and experiences related to family medicine. These rotations may be based at any of Kingston's three hospitals or in other communities in the region. These hospital departments offer a modified program for our residents, and the preceptors are enthusiastic about family medicine learners. You will also have the opportunity to work with students from Queen’s School of Medicine and other schools within Queen’s Health Sciences during your placements. 

Your first year will kick off with four weeks of boot camp – an experience designed to introduce you to your home clinic and to give you the opportunity to participate in innovative simulation courses (e.g., NRP, ALARM, Nightmares FM, procedures) to build your skills and confidence for your subsequent rotations. You will then complete your core family medicine blocks in your home team clinic within the Queen's Family Health Team in downtown Kingston. Residents spend six blocks of their first year at QFHT in three two-block rotations, returning to the same clinic, patients, and preceptors. This maximizes continuity of care and allows residents to gradually increase their patient care and practice-management responsibilities over time – a definite strength of our program. Residents return to their home team at QFHT in PGY2 for two blocks as a senior FM resident, providing many opportunities for leadership, mentorship, and teaching of junior learners.  

During your core family medicine rotations at QFHT, you will work for one morning a week at a local long-term-care facility, Providence Manor, caring for a group of patients during the first year. You will also complete half-day or weekly "horizontal" placements in behavioural medicine, mental health, and other special-focus clinics (e.g., minor procedures, street health, chronic pain, sleep disorders, etc.). You will have one professional half-day (PHD) per week that is resident-directed. You may use your PHDs to see patients as needed; catch up on charting/inbox; work on your resident portfolio, educational modules, practice improvement project, research project, or leadership or teaching skills; attend to personal appointments; or participate in wellness activities. Your family medicine experience will also include a core teaching seminar series, journal club, weekly grand rounds and resident rounds, and bi-weekly resident-led peer-support rounds. You will also complete various blocks of specialty rotations (e.g., internal medicine, pediatrics, emergency medicine, etc.) and a four-week elective when you are off-service from your core family medicine blocks during first year. 

During your second year as a KTI resident, you will complete three blocks of community family medicine in one of our many southeastern Ontario communities or with one of our Kingston community practices. You will also complete a two-block "rural" family medicine rotation in a smaller or isolated community such as Picton, Brockville, Bowmanville, Napanee, Moose Factory (an isolated community in Northern Ontario), other small communities in Eastern Ontario, or the Falkland Islands (by special arrangement). These placements may be combined. You will also complete the remainder of your specialty rotations (subspecialty internal medicine or surgery and others) and eight weeks of electives during your second year. 

Your rotation locations will be based on personal preference and availability. However, please note that your obstetrics and gynecology rotation and rural/remote family medicine rotation will be outside of Kingston. There are also opportunities to spend extended periods of time in the same smaller community if you desire. Accommodation and travel stipends are provided for rotations outside of Kingston. 

Trainees must be able to provide their own transportation to and from their training sites as well as to and from work. Possession of a vehicle, while not required, allows you to make full use of community-based learning opportunities. Our program will provide funding for exceptional travel expenses as required. 

Our DND Military stream is similar to our regular family medicine residency stream, with extra relevant exposure to rotations in trauma and military psychiatry. 

Our PHPM stream is similar to our regular family medicine residency stream, with extra exposure to public health and infectious diseases, as well as weekly public health academic half-days. 

Your PGY1 Core Family Medicine Rotations will consist of the following:

  • Clinical duties at Queen’s Family Health Team (QFHT) in downtown Kingston (3 days/week)

  • Long Term Care duties (1/2 day/week)

  • Horizontal Clinic Placements (1/2-1 day/week)

  • Teaching sessions (1/2 day/week)

  • Resident-Directed Half Days (1/2 day/week)

  • Call Duties (approx. 1/10 days, 2-3 weekends/year)

Clinical Duties:

The QFHT is a leading model in interdisciplinary and collaborative primary care, with a strong emphasis on quality improvement and patient safety. You will be part of an award-winning team of family physicians, nurse practitioners, nurses, pharmacists, social workers and administrators who all work together to deliver outstanding health care to patients. The QFHT serves a population of more than 14,000 patients who have a wide variety of social and economic backgrounds. QFHT physicians also follow low-risk obstetrical patients, participate in the obstetrics call group, work with local community services (e.g. Ongwanada) and perform minor procedures. The QFHT also offers smoking cessation programs, anticoagulation management, asthma care, diabetes care, chronic disease self-management, foot care and other comprehensive services to patients.

Click here for more information about Family Health Teams in Ontario.

Quality Improvement Project

The Queen's Department of Family Medicine (DFM) has a long-standing interest in quality improvement (QI) and patient safety. For example, the Queen's Family Health Team (QFHT) was one of the first FHTs in the province to develop a QI plan, and the team has won several awards recognizing its leadership in improving quality and safety in primary care. Quality improvement and patient safety are rapidly growing fields in Ontario and across the country, and family physicians have a key role to play in improving the quality and safety of patient care and the health-care system as a whole. To help residents feel more prepared to take on these challenges, they are introduced to key QI principles from the beginning of their PGY1 year in the form of didactic lectures and a year-long experiential group project, and through small-group mentoring. Residents are also encouraged to participate in existing QI and safety initiatives within their site, including QI and safety committees and special projects. For more information about the QI curriculum at the Queen's DFM, please contact our Physician Lead and QI Lead, Dr. Karen Hall Barber, at karen.hallbarber@dfm.queensu.ca.

Intellectual and Developmental Disabilities (IDD) Program:

Queen’s Department of Family Medicine has a long history in providing its family medicine residents with a strong foundation in caring for adults with intellectual and developmental disabilities. Family physicians have a special responsibility for improving the health care of people with inequities in access, and we want our graduates to feel confident and competent in taking on the medical care of patients with IDD.

The IDD Program for PGY1 residents include didactic teaching, as well as opportunities for family medicine residents to participate in the clinical Health Check Program. This program focuses not only on educating residents about providing primary care to IDD patients, but also on fostering an understanding among residents about the ethical and the medical considerations specific to IDD patients. We also have a PGY3 Enhanced Skills Program in Intellectual and Developmental Medicine.

Family Medicine residents also have the opportunity to do an elective in Care of Adults with Intellectual and Development Disabilities through Queen's. This four-week rotation includes complex continuing primary care of adults with IDD, adult IDD consulting clinic, dual diagnosis psychiatry, developmental genetics clinic, epileptology and sleep disorders clinic, and physical and rehabilitation medicine clinics. There are also special clinics such as seating clinic and enteral feeding clinic, as well as opportunities to observe allied health professional assessments (i.e. OT, PT, SLP, and psychology).

The elective is open to interested family medicine residents. For more information about this elective program, please contact Dr. Liz Grier at iddprogram@dfm.queensu.ca. Care of Adults with Intellectual and Developmental Disabilities is an exciting and emerging field in which family physicians are playing a key role at the national level and within the College of Family Physicians of Canada. For more information about this IDD work within the CFPC, please visit the CFPC's Developmental Disabilities Program Committee website. 

For Information about all our IDD Programs, please visit the department’s Intranet or contact Dr. Meg Gemmill, Director of Developmental Disabilities, at the following email: iddprogram@dfm.queensu.ca.

Long Term Care:

Under your preceptor, you will be responsible for a small cohort of patients at the Providence Manor Long Term Care Facility. You will round on these patients weekly and manage their care throughout your core FM placements.

Horizontal Clinic Placements:

These are unique primary care settings that will augment your regular clinic duties. These placements help you access patients with unique or complex care needs, often in unique settings. These clinics are held either at the QFHT, in the local hospitals or other settings in the city.

You will also complete placements in the QFHT procedure clinic, performing minor surgical procedures such as removal of skin lesions, punch biopsies, ingrown toenails, etc.

Examples of Horizontal Clinics:

  • Asthma

  • Congestive Heart Failure

  • Child & Adolescent Psychiatry

  • Children’s Outpatient Clinic 

  • Chronic Pain

  • COPD

  • Ear, Nose and Throat

  • Eye Clinics

  • Foot/Wound Care

  • Familial Oncology Genetic Counselling

  • INR/Anticoagulation Management

  • Internal Medicine (Endocrinology)

  • Palliative Care

  • Parkinson’s Disease

  • Physiotherapy

  • Prison Medicine

  • Procedure Clinics

  • Sexual Health Clinic

  • Sleep Clinic

  • Street Health

Teaching Sessions:

Each week, faculty members will lead teaching sessions on topics to help you improve your practice as a physician and also to help prepare for the CFPC exams. Occasionally, guest speakers from other departments or the community may present. There will also be weekly resident rounds and bi-weekly research and pharmacy rounds.

Over your two years, there will be several special Academic Days featuring additional teaching sessions and skill training.

Resident Directed Half-Days:

Most weeks, you will receive a half-day with no formal learning activities scheduled. This time is for you to complete self-directed activities that will benefit your learning and well-being. Many residents use these days to make home visits to patients who cannot come to the regular clinic, work on their resident project, clinical audits or Global Health modules, or complete important personal tasks such as medical or bank appointments.

Call Duties:

QFHT offers a physician on-call for patients 24/7. You can expect to be on-call approximately one day in ten during your core FM rotations. You can also expect 2-3 call weekends. On-Call duties include working in the After Hours Clinic on evenings and weekends, and then taking pages from patients, the Long Term Care facility and Telehealth Ontario. Two residents are on call at any given time, with one taking responsibility for QFHT patients, the other for Long Term Care and then supporting the first call resident. You will always be on call with a staff physician. All our call policies conform to PARO guidelines and call stipends are paid accordingly.

Your second year Family Medicine Rotation will be comprised of 24 weeks of Family Medicine. The CFPC requires that of those 24 weeks, at least eight must be in a rural community, at least eight with a Family Physician who does their own intrapartum care and deliveries and at least eight with a Family Physician who cares for their own patients in hospital. At Queen’s, we have built relationships with many different community physicians (both within Kingston and in nearby communities) in order to offer many different options to help you fulfill these requirements. You might choose to complete all 24 weeks at one comprehensive practice or spend equal amounts of time in two or three different locations.  

For example, your schedule might look like one of these options:

  • 24 weeks in one rural Family Medicine practice with Obstetrics and Hospitalist care

  • 16 weeks in one Family Medicine practice (rural and with Hospital care) and 8 weeks in a second Family Medicine practice (with Obstetrics)

  • 8 weeks in one rural Family Medicine practice with Obstetrics and Hospitalist care and 16 weeks in an urban Family Medicine setting

There are also options to combine your Community Family Medicine rotation with emergency medicine, psychiatry, or palliative care. We will work with you to arrange a schedule that satisfies your educational requirements and is also compatible with your personal needs.

During your two years of residency, your core Family Medicine rotations will be supplemented by rotations in other specialties that will help you develop into a comprehensive Family Physician. These rotations can take place in Kingston or in other communities. We will work with you to develop a schedule that meets your educational needs and compliments your personal life.

Internal Medicine

General Internal Medicine (PGY1)
During your first year of residency, you will complete a general Internal Medicine rotation. This rotation gives you an excellent exposure to hospital-based medicine and patient care. The preceptors in Internal Medicine are used to having Family Medicine residents working in their teams and are enthusiastic about helping you learn.

Locations: Kingston, Brockville, or Belleville

Subspecialty Internal Medicine (PGY2)
During your second year, you will complete another Internal Medicine rotation, this time focusing on a specific subspecialty. We try our best to match you with your specialty and location of interest.

Locations and Subspecialties:

Kingston: CardiologyEndocrinologyGIHematologyInfectious DiseaseNephrologyNeurology, Respirology

Oshawa: Cardiology only
Belleville: Cardiology only

Surgery

Your Surgery rotation will be completed during your first year of residency. This rotation helps you to develop your surgical skills and care for patients with acute and complex conditions. You can choose between general surgery, plastic surgery or orthopedic surgery for this rotation, offered in three different locations.

Locations:

Kingston: General, Plastics, or Orthopedic

Belleville: General or Orthopedic

Oshawa: General or Orthopedic

Paediatrics

Your Paediatrics rotation can take place at any time during your two-year residency.

Locations:

Kingston (combination of outpatient, wards and NICU)

Oshawa (community)

Toronto (Sick Kids Emergency Dept.)

Obstetrics & Gynecology

Your Obstetrics & Gynecology rotation can take place at any time during your two-year residency. Unfortunately, due to space and learner number limitations, this rotation must be completed outside of Kingston.

Locations: Belleville, Cobourg, Oshawa

Psychiatry

Your Psychiatry rotation can take place at any time during your two-year residency. There are many different options and settings available for this rotation.

Locations:

Kingston: Adult inpatient, Consultation liaison, Mood Disorders Unit, Geriatric, combined outpatient and inpatient
Smiths Falls/Carleton Place: Outpatient clinics, 8 week long rotation (will require use of one electives block), can also be offered paired with an FM rotation in Smiths Falls

Belleville: combined outpatient and inpatient

Oshawa: Crisis Unit at Lakeridge Health

Emergency Medicine

Your Emergency Medicine rotation can take place at any time during your two-year residency.

Locations: Kingston, Napanee, or Cobourg

Palliative Care or Care of the Elderly

You will complete either a Palliative Care or Care of the Elderly rotation. This rotation can take place at any time during your two-year residency. Both are offered in Kingston; Palliative Care through the Palliative Care Unit.

During your two years at Kingston & 1000 Islands, you will have 12 weeks of elective placements.
 
You will work with your academic advisor to choose electives that fill in gaps in your learning, are relevant to your future career goals (e.g. PGY3 options) and meet your interests. There are many opportunities to pair an elective with one of your core requirements in your PGY2 year.
 
The vast majority of electives are completed within Ontario (as your salary is paid by the Ontario government), however some residents complete electives across Canada or internationally in conjunction with the Global Health module.

As a KTI resident, you will work clinically with junior residents, medical students, and other interdisciplinary learners. There are additional opportunities to teach pre-clerkship students at their formal clinical skills sessions and at family medicine resident teaching nights, and to join a mentorship program for first-year medical students. You may also present rounds, lead journal clubs, and assist in training new residents and international medical graduates as they transition into the residency program.

Flexible Program 

We strive to help you make the most of your residency. We will work with you to build a schedule that meets your interests and needs. If it’s important for you to stay in Kingston as much as possible, or if you want to have a wide range of experiences across the region, we will do our best to make it happen. 

Resident Well-being 

Resident well-being is a priority at Queen’s. We have a resident wellness subcommittee with a faculty lead, resident wellness representatives for each cohort, bi-weekly peer-support rounds while at QFHT, a dedicated wellness counsellor for all residents, and many other resources.