The UHN Hospital Medicine Program was established in 2007, in response to increasing volumes of new admissions to GIM across the three sites (TGH, TWH & MSH). The program includes a Hospital Medicine Service at the TGH (Team 9), TWH (Team A), and MSH (Team E). The teams were designed to manage general medical admissions during the hours of 0800–1400 on weekdays from the corresponding EDs, allowing the CTU (Clinical Teaching Unit) teams protected time for patient care and related educational activities. As part of this process, both Team 9 and Team A also manage referrals from the 3 critical care environments (MSICU, CCU, CVICU).
The MSH Hospitalist service comprises of 4 clinical areas:
- Team “E” (acute general medical inpatient team);
- ED GIM consults during the day;
- Hip fracture co-management; and
- Chronic disease consultations for psychiatry inpatients.
The service regularly welcomes trainees from a variety of other health care professions including NPs and PAs, as well as residents, medical students, and observers. All services utilize an interprofessional approach to patient care where the team members collaborate with bedside nursing staff (RNs, RPNs, and students), RDs, OTs, PTs, SWs, Pharmacists, SLPSs, and discharge coordinators. Patient care and related academic activities are supervised by a faculty member from the Division of General Internal Medicine, who serves as the Attending Physician.
When patient care responsibilities permit, all residents and fellows are encouraged to attend Morning Report, Interprofessional Care (“Bullet”) Rounds, Noon Rounds, and Medical Grand Rounds. While didactic educational sessions provide value, the education emphasis of this clinical fellowship will be found in the daily assessment and management of patients. This is a competency-based learning fellowship, which means that the learning is “by doing”, including bedside teaching and patient care reviews. As such, there is less of an emphasis on classroom-based learning. However, supervising (Attending) physician will provide focused teaching around the new cases and existing patients during daily intake rounds.
All fellows will meet quarterly with the Program Director and Site Directors to outline their specific learning objectives as it pertains to their career development as Hospitalists. The Site Directors, in collaboration with the Attending Physicians, will work to ensure that the fellows are meeting these milestones during their time with us.
