Introduction
There is an increasing demand for physicians with hospitalist medicine training. Given the aging population, there are additional demands placed on hospitals in the management of older and more complicated patients. In addition, discharge planning and disposition are complex and require a multidisciplinary approach. The aim of the Hospitalists Fellowship Medicine Program at McMaster University is to train physicians in hospital medicine who can oversee these complex patients.
The one-year curriculum is designed to provide the trainees with broad exposure to different fields of medicine to develop competencies in the oversight of these patients. The curriculum includes rotations in GIM, Medical Stepdown, Stroke, Cardiology, Geriatrics, Hematology-Oncology, Addictions, Wound Care, and Palliative Medicine as well as providing the trainees with an opportunity to select four medical specialties rotations all of which are two weeks each. This flexibility in the curriculum provides the trainees with an opportunity to identify and fill in knowledge gaps.
Given the depth of knowledge and skill that is required to become a hospitalist, the fellowship committee has not made research a mandatory component of the curriculum. If fellows are interested in pursuing research, they will be supported in this area.
Certification outcome
The successful completion of the fellowship will grant a Fellowship McMaster Certification.
Entry Requirements
Resident in Family Medicine, Internal Medicine or Emergency Medicine Training Program or completion of a four-year General Internal Medicine program or medical subspecialties program outside of Canada.
Application Deadline: 12 months prior to start date
Goals of training
The overall training objectives for the Hospitalist Fellowship Program are:
- Gain the ability to manage an inpatient ward independently with proficiency.
- To be able to collaborate with health care providers to optimize patient care.
- Manage acute complications and demonstrate proficiency in medically urgent situations.
- Gain proficiency in patient flow and safe and effective discharge planning.
- To gain a contextual understanding of hospital administration and structure.
- To gain broad exposure in managing patients in various medical specialties.
Medical Expert:
- Master complex discharge planning to various discharge locations, including home, long-term care, convalescent care or palliative care.
- Ensure safe and appropriate follow-up plans were in place for patients.
- Demonstrate an understanding of common factors leading to readmission and implement strategies to reduce the risk of readmission.
- Demonstrate improved knowledge and management plans for common medical issues encountered in a general medicine ward.
- Demonstrate an understanding of common procedure techniques, risks and benefits in the general medicine ward such as thoracentesis, paracentesis, knee aspiration, lumbar puncture, arterial blood gas and skin biopsies.
- Show an understanding of bedside POCUS skills
Length of Training
Duration: 1 year.
Curriculum highlights
- Grand Rounds
- Journal Clubs
- Rounds
- Committee Meetings: Examples below
- Oncology Committee
- Pharmacy Reconciliation Program
- Quality Control
- Readmission/Reduction
- Bed Flow & Allocation
- Possible Quality Improvement projects (not mandatory)
- Academic Half Day: Topics Below
- CAD
- CHF Management
- Stroke
- Respiratory Failure
- AKI
- Chemotoxicity
Supervision & Feedback
The McMaster Hospitalist Fellowship Training program utilizes a variety of assessment tools to enhance our learners’ education in building competency. Some of the tools utilized for evaluation include:
- ITARs
- Written exam