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Specialty Training Requirements in
Internal Medicine

2015

VERSION 2.0

These training requirements apply to those who begin training on or after July 1^st, 2015.

MINIMUM TRAINING REQUIREMENTS

Four (4) years of approved residency training. This period must consist of the following:

1. Three (3) years of foundational Internal Medicine training
   1. A minimum of thirteen (13) blocks of general Internal Medicine training, including:
      1. A minimum of six (6) blocks of general Internal Medicine in-patient care in Clinical Teaching Units or preceptorships (a defined period of training organized around focused immersion in a single preceptor’s practice)
      2. A minimum of three (3) blocks or the equivalent longitudinal experience in consultations to other services including all of the following:
         1. Other in-patient services, such as surgery, gynecology, obstetrics and internal medicine
         2. Emergency department
         3. Ambulatory care
      3. A minimum of one (1) block of community-based general Internal Medicine
   2. A minimum of four (4) blocks of training in the care of critically ill patients including:
      1. A minimum of two (2) blocks of adult Critical Care Medicine
      2. A minimum of one (1) block of Cardiology, including acute coronary care in a coronary care unit
   3. Fifteen (15) blocks or equivalent training in selectives, which must include training in at least eight (8) of the following:
      1. Cardiology
      2. Clinical Immunology and Allergy
      3. Clinical Pharmacology and Toxicology
      4. Critical Care Medicine
      5. Dermatology
      6. Endocrinology and Metabolism
      7. Gastroenterology
      8. General Internal Medicine
      9. Geriatric Medicine
      10. Hematology
      11. Infectious Diseases
      12. Medical Biochemistry
      13. Medical Oncology
      14. Nephrology
      15. Neurology
      16. Occupational Medicine
      17. Palliative Medicine
      18. Physical Medicine and Rehabilitation
      19. Respirology
      20. Rheumatology
   4. Up to six (6) blocks or equivalent of electives which can include:
      1. Any of the above
      2. A maximum of three (3) blocks of research
      3. A maximum of three (3) blocks of other approved training
2. One (1) year of advanced Internal Medicine training. This may occur in the following areas, relevant to the objectives of Internal Medicine and approved by the program director
   1. Up to one (1) year further residency in Internal Medicine to reflect the resident’s career goals and needs which will include:
      1. Minimum one (1) block of adult Critical Care Medicine
      2. Minimum one (1) block of community-based general Internal Medicine
      3. Minimum one (1) block (or longitudinal equivalent) of ambulatory care
      4. Minimum two (2) blocks in a junior consultant role, (with as much independence as permitted by ability, licensure restrictions and hospital policy in an academic or community setting), in preparation for transition to independent practice
      5. Up to seven (7) blocks of electives
   2. Up to one (1) year of clinical residency in any of the subspecialty areas listed in 2 or 3
   3. Up to six (6) blocks of approved training in other areas such as health services research, clinical epidemiology, medical education, basic sciences, clinical or basic research (done within the Residency Program), or other related areas

NOTES:

In order to ensure an adequate breadth of training, the maximum experience in any one subspecialty must be limited as follows:

1. Six (6) blocks during the Internal Medicine rotations in Section A (first three years); and
2. Nineteen (19) blocks total over the four years of Internal Medicine specialty training.

Training must incorporate the principle of graded increasing responsibility. The term “approved” throughout means “approved by the candidate’s program director and the Royal College Credentials Committee.”

It must be recognized that the usual duration of residency training may not permit the resident to achieve mastery in all areas of technical skills. Therefore, to achieve additional expertise in highly specialized areas of Internal Medicine, the resident may require additional training.

REQUIREMENTS FOR CERTIFICATION

Royal College certification in Internal Medicine requires all of the following:

1. Successful completion of a four-year accredited program in Internal Medicine;
2. Successful completion of the certification examination in Internal Medicine; and
3. Participation in a scholarly project/activity in Internal Medicine.

The four-year program outlined above is to be regarded as the minimum training requirement. Additional training may be required by the program director to ensure that clinical competence has been achieved.

• REVISED – Specialty Standards Review Committee – April 2011
• REVISED – Specialty Standards Review Committee – March 2015

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