GeneralInternalMedicine

Division of General Internal Medicine

Noteworthy Publications

Horsley T, Lockyer J, Cogo E, Zeiter J, Bursey F, Campbell C.—National programmes for validating physician competence and fitness for practice: a scoping review. BMJ Open 2016;6(4):e010368.

Buchner DL, Bagshaw SM, Dodek P, Forster AJ, Fowler RA, Lamontagne F, Turgeon AF, Potestio M, Stelfox HT.Prospective cohort study protocol to describe the transfer of patients from intensive care units to hospital wards. BMJ Open 2015;5(7):e007913.

Humphrey-Murto S, Mihok M, Pugh D, Touchie C, Halman S, Wood TJ. Feedback in the OSCE; what do residents remember? Teach Learn Med 2016;28(1):52–60.

Kobewka DM, van Walraven C, Turnbull J, Worthington J, Calder L, Forster A. Quality Gaps Identified Through Mortality Review. BMJ Qual Saf 2016;pii: bmjqs-2015-004735.

Pugh D, Touchie C, Humphrey-Murto S, Wood TJ. The OSCE Progress Test—Measuring Clinical Skill Development over Residency Training. Med Teach 2016;38(2):168–73.

Touchie C, ten Cate O. The Promise, perils, problems and progress of competency-based medical education. Med Educ 2016;50(1):93–100.

van Walraven C, McAlister FA. Competing risk bias is common in Kaplan-Meier risk estimates published in prominent medical journals. J Clin Epidemiol 2016;69:170–3.e8.

Wilson K, Hawken S, Potter BK, Chakraborty P, Walker M, Ducharme R, Little J. Accurate prediction of gestational age using newborn screening analyte data. Am J Obstet Gynecol 2016;214(4):513.

 

Key Grants

The members of our division have been very successful in obtaining grants for a variety of research endeavors.

Dr. Alan Forster—Canadian Institutes of Health Research (CIHR). Improving care for emergency department and Pre-hospital patients with acute and life-threatening conditions

Dr. Samantha Halman—Royal College of Physicians and Surgeons of Canada. Bridging the surgical/medical divide: implementation of the Ottawa Clinic Assessment Tool (OCAT) in Internal Medicine.

Dr. Claire Touchie, Dr. Debra Pugh, Dr. James Chan—Royal College of Physicians and Surgeons of Canada. The influence of first impressions on OSCEs: Does scoring format and type of assessment matter.

Dr. Carl van Walraven—National Centre for Excellence, Tech Value Net. Pilot study of an automated one-year mortality prediction tool to trigger Advanced Care Planning

Dr. K. Wilson—Bill & Melinda Gates Foundation. Development of a global algorithm for metabolic gestational age dating.

Dr. K. Wilson—PHAC—Innovation Strategy Program. Development of a mobile enhanced immunization information system.

 

The Academic Division of Internal Medicine at the Ottawa Hospital consists of 26 full and part time academic Internal medicine specialists. These internists have a very active role in both the Faculty of Medicine at the University of Ottawa and The Ottawa Hospital, providing patient care for up to 200 patients daily. One of the strengths of GIM in this Department of Medicine is the fact that it’s core membership is comprised of General Internists. This provides a high and consistent level of patient care and housestaff learning on our clinical units.

In-patient and Consult Service

Twenty-five percent of the hospital Emergency admissions are admitted to Internal Medicine. The in-patient responsibilities include designated monitored bed units and clinical supervision of a non-teaching unit staffed by physician assistants.

In addition to the in-patient care, the division provides a very active ward and ER consultative service at both in-patient sites (Civic and General campuses).

Out-patient and Special Interest Clinics

General Medicine clinics are held at the General and Riverside sites of The Ottawa Hospital. These clinics see newly referred patients for diagnostic workup, difficult pre-operative assessment cases and follow ups from the in-patient wards. The division has an expanding interest in pre-operative medicine and as a result we currently have a dedicated pre-operative ambulatory care program. In addition, we provide a longitudinal educational clinic for our GIM fellows.

Many in the group have varied special clinical interests and training such as thrombosis, HIV, obstetrics, diabetes, rheumatology and critical care.

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Research

The division’s research activities follow two main themes – Epidemiology and Education. The epidemiology group, currently lead by Drs Forster, Van Walraven and Wilson, are currently developing initiatives in the areas of Data Warehouse (Ottawa ICES satellite), Patient Safety and Public Policy.

The educational research group, lead by Drs Touchie, Pugh and Chan are active in AIME (Academy of Innovation & Medical Education) and have outside links to the Medical Council of Canada for research and evaluation.

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Teaching

All members of the Division are clinical teachers at the clerkship and residency level and many are also involved in pre-clerkship teaching, especially CBL (Case based learning) and PSD (physical skills development). Several of our members hold Masters degrees in Education.

Our physicians teach up to 18 med students at any one time and the average team mentors between 11 to 14 residents on the wards and 13 on consults.

The division of GIM holds a large number of education leadership roles within the Department and at the University. These include the core internal medicine program director (Cathy Code) the assistant core internal medicine program director (Jim Nishikawa), the department of medicine director of undergraduate medical education (Heather Clark) and the two site clerkship coordinators (Dr. Vlad Contreras-Dominguez and in 2012, Isabelle Desjardins). In addition we also hold the positions of the director of the exam centre for the University (Debra Pugh), the link block chair (Krista Wooller) and finally the resident research coordinator (Alan Forster).

The division is very active with the Royal College of Physicians and Surgeons of Canada. At least 6 of our division members have been active as internal medicine examiners for the oral exams. Dr. Claire Touchie was involved as the Vice Chair of the Central Examination Committee at the Medical Council of Canada (MCC) but will be stepping down from this position at the end of 2011. Dr. Debra Pugh will be taking over this job in 2012. Claire Touchie will become the Chief Medical Education Advisor with the MCC. Isabelle Desjardins has been nominated to become a committee member for the Medicine Test Committee at the MCC as well.

The Department of Medicine will be rolling out an education bursary for medical education clinical scholars. This will mirror the one available for researchers and will be for $40,000 a year for a possible period of 2 years. This will be offered in on a competitive basis with the deadline being in February 2012. Clinical scholars will be encouraged to apply.

Administration

Many members of our staff play key roles in administrative areas within the medical community, university, Department of Medicine and The Ottawa Hospital. These include Chief of Staff of The Ottawa Hospital, Director of ICES Ottawa, Director of Exam Centre – Medical Counsel of Canada, Vice Chair of Finance, Department of Medicine, Canada Research Chair in Public Health Policy Scientist and Scientific Director, Performance Measurement, The Ottawa Hospital.

Notable Honours and Achievements

  • Dr. Cathy Code—TOH Clinical Recognition Award
  • Dr. Vladimir Contreras-Dominquez—CAME Certificate of Merit Award
  • Dr. Vladimir Contreras-Dominquez—DoM Professionalism and Collegiality Award
  • Dr. Claire Touchie—Dr. Meridith Marks Educator Award for Innovation and Scholarship in Medical Education
  • Dr. Jim Nishikawa—CSIM-Royal College Olser Lecturer 2015
  • Dr. Samantha Halman—CAME Foundation Wooster Family Grant in Medical Education

Quality and Collaboration

General Internal Medicine has been actively involved in many Ottawa Hospital quality projects.

Our Patient Safety and Quality committee is lead by Dr. Delvina Hasimja.

  • General Internal Medicine has been actively involved in many Ottawa Hospital quality projects. Our Patient Safety and Quality committee is led by Dr. Delvina Hasimja.
  • Dr. Delvina Hasimja and Dr. Krista Wooller have created a Foundation of Quality Improvement curriculum for the core IM and GIM programs.
  • We have expanded our M and M rounds with dissemination of information.
  • We are establishing resident led M and M rounds are part of their core education.
  • We have hired two clinical scholars who are doing focussed training and education in Patient Safety/Quality and Medical Informatics.
  • Under the leadership of Dr. James Chan we have expanded our peri-operative clinic. Particularly we are part of the Peri-op Glucose Initiative. This is an active dysglycemia case finding initiative with the goal of decreasing LOS for surgical patients.
  • We participate in a variety of discharge projects at TOH including the COPD Outreach Program and the CHF Gap Tool initiative.
  • We have a variety of ongoing PSQ projects. These include a Code Blue Simulation project, End of Life Communication project and expansion of our Catheter Associated UTI prevention project.
  • We have established ADT (Admit, Discharge, Transfer) criteria for our Advanced Monitoring Areas (AMA). The AMA ADT criteria we established as part of a wider IHO project examining patient flow at TOH.