Our program consists of both block and longitudinal rotations to ensure that learners have sufficient exposure to clinical presentation across a wide variety of clinical settings as well as robust opportunities for continuity of care. The program requires completion of 12 months (equivalent to 13 blocks) of training.
The curriculum is structured to ensure that learners develop core competencies in Care of the Elderly (Priority Topics and Key Features for the Assessment of Competence in Care of the Elderly) and Family Medicine (CanMEDS Family Medicine 2017), and still afford learners flexibility to pursue areas of interest and career development. The order of the core and elective rotations varies slightly from year to year but facilitates graduated levels of clinical responsibility and leadership opportunities while providing exposure to diverse clinical presentations across many different clinical contexts.
Core Block Rotations (7 blocks)
- In-Patient Seniors Rehabilitation Unit (PCH): Blocks 1 & 11
- Outpatient Senior’s Day Rehabilitation (outpatient interdisciplinary geriatric rehabilitation) (PCH): Blocks 12 & 13
- Inpatient Geriatric Medicine Consultation Service (KGH, HDH, PCH, PTCC): 1 block or equivalent longitudinal experiences
- Geriatric Psychiatry (community-based interdisciplinary outreach team and clinics): Blocks 7 & 8
Core Longitudinal Rotations (3-4 blocks)
- Outpatient Geriatric Medicine and Care of the Elderly Clinics, including longitudinal clinic with a family physician with a Certificate of Added Competence in COE (PCH)
- Home visits (community)
- Subspecialty clinics with relevance to Care of the Elderly (may include but not limited to: Movement Disorders Clinic, Heart Failure Clinic, Multidisciplinary Kidney Clinic, Osteoporosis Clinic, Palliative Medicine clinics, Physical and Rehabilitation Medicine clinics)
- Community Family Medicine to build on core Family Medicine competencies and develop community- adaptive competence
- Long-term Care (LTC) - recommended but not mandatory
Elective Rotations (2-3 blocks)
- Residents have 8-12 weeks of elective time, depending on how their longitudinal experiences are structured
- Electives and relevant learning objectives will be reviewed and approved by the resident's Academic Advisor and Program Director.
- We encourage residents to select at least one elective that has significant focus on comprehensive family practice.
- There is the option for a short (1 to 2-week) research elective if completion of a specific scholarly project that requires additional protected time above and beyond what is built into the core program is within a resident's individual learning objectives.
Call Requirements
- Residents provide home-call coverage for our Inpatient Seniors Rehabilitation Unit throughout the year, except while they are on electives.
- While no off-service call coverage is built into the program, residents may be required to provide off-service call coverage during elective rotations; this is at the discretion of the program offering the elective.
- All call requirements will adhere to the terms of the current PARO contract.
Academic Requirements (integrated throughout the year)
Scholarly Project
Residents are required to complete a scholarly project for which academic time will be protected throughout the year. Residents have the freedom to define the focus, scope and design of their COE Scholarly Project, which should address a research, critical appraisal, quality improvement, or educational inquiry. Residents are expected to present their project to the Division of Geriatric Medicine towards the end of their program year. It is common but not expected that residents publish their scholarly project. See below for examples of publications that grew directly out of the scholarly projects of recent program graduates:
Goldhar, S., & Frank, C. (2022). Optimizing delirium assessment, management, and prevention. Canadian Family Physician, 68(12), 897-898.
Kindrat, A., & Frank, C. (2023). Pharmalogical management of inappropriate sexual behaviours in patients with dementia residing in long-term care: Review of the evidence. CGS Journal of CME, 12(2).
Teaching
COE Residents participate in the teaching sessions that the Division of Geriatric Medicine offers to all residents during their geriatrics rotations at PCH. COE residents will lead approximately one of these teaching sessions per month during their core rotations. Although they will begin by teaching core topics in Care of the Elderly under direct faculty supervision, once deemed competent in the core topics they are free to design teaching sessions on relevant topics of their own choosing and will lead their sessions independently. COE residents are invited to co-teach two academic half-days on care of the elderly topics for the core family medicine residency-training program with one or more COE faculty. There are also opportunities to be involved in teaching at the undergraduate medical level as well.
Leadership
Residents will be responsible for mentoring and teaching junior house staff while on clinical service and for supporting other residents during their own teaching sessions. Throughout the program year, we work with residents to develop their leadership skills. This is accomplished through formal leadership teaching, “junior attending” roles, and an administrative project, where residents identify an administrative issue and develop a plan to resolve it. In the past, residents have enhanced orientation materials, updated a website, or brought a suggestion through hospital committee processes. The resident’s administrative project can be combined with their scholarly project if there is overlap between them.
Protected Time
- Vacation, Statutory Holidays, and Professional Leave as defined under the PARO contract
- One half-day per week (or equivalent) will be protected for residents to engage in educational activities, including but not limited to:
- Self-directed work on COE Scholarly Project (see above)
- Family Medicine Academic Days (optional but encouraged)
- Palliative Care Academic Half-Days (Monday afternoons, 1-4 pm; optional but encouraged)
- PGME Cross-Departmental Quality Improvement and Patient Safety Curriculum (3 academic half-days, required if not completed during core FM residency program at Queen’s)
- Division of Geriatric Medicine lunchtime teaching sessions (required)
- Department of Medicine Grand Rounds and Morbidity and Mortality Rounds (required)
- Geriatric Psychiatry Case Rounds (optional but encouraged)
- Providence Care Hospital Interdisciplinary Grand Rounds (optional)
Sample year schedule:
Block 1
|
Inpatient Seniors Rehabilitation Unit
|
Block 2
|
Longitudinal block
|
Block 3
|
Longitudinal block
|
Block 4
|
Longitudinal block
|
Block 5
|
Inpatient Geriatric Medicine Consultation Service
|
Block 6
|
Longitudinal block
|
Block 7
|
Outpatient Geriatric Psychiatry
|
Block 8
|
Outpatient Geriatric Psychiatry
|
Block 9
|
Electives
|
Block 10
|
Electives
|
Block 11
|
Inpatient Seniors Rehabilitation Unit
|
Block 12
|
Outpatient Seniors Day Rehabilitation
|
Block 13
|
Outpatient Seniors Day Rehabilitation
|
**Please note that there is significant flexibility in the program schedule.
Sample Longitudinal Schedule:
|
Monday
|
Tuesday
|
Wednesday
|
Thursday
|
Friday
|
AM
|
COE/Geriatric Medicine Clinic (PCH)
|
COE/Geriatric Medicine Clinic (PCH)
|
Subspecialty Clinic (location TBD)
|
COE/Geriatric Medicine Clinic (PCH)
|
COE/Geriatric Medicine Clinic (PCH)
|
Lunch
|
|
Teaching on Delirium
|
|
Wound Care Teaching by APN
|
|
PM
|
COE Longitudinal Clinic (PCH)
|
Family Medicine Clinic (community)
|
Academic Half Day
|
Subspecialty Clinic (location TBD)
|
COE/Geriatric Home Visits (community)
|