j

[hmmmmh]

 

j

[abcd1288]

They were placed on probation last year for several issues: https://deptmedicine.utoronto.ca/news/departments-response-internal-medicine-residency-accreditation-review-taking-action-address

[Bluberblubo]

1 hour ago, skinnysanders said:

but I have a feeling that maybe people are just being dramatic LOL

You could have probably made the same post without the above comment. Not to sound mean, but tbh when I read this my first thought this clerk is clueless... that being said, it's okay because you probably haven't heard about what has been going on there, so here is some information that can help:

A quick google revealed that the internal medicine program is currently under probation from the royal college with "intent to withdraw" this is basically the last warning before a program loses accreditation... Here is a link to an article: https://deptmedicine.utoronto.ca/news/departments-response-internal-medicine-residency-accreditation-review-taking-action-address

This might not mean much to you but it's actually a big deal for this to happen. Not enough information? Here is a **DELETED** post made just 2 months ago: https://www.**DELETED**.com/r/Residency/comments/vca0cn/name_and_shame_why_im_happy_to_leave_toronto/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

Now I didn't actually go through internal med residency at toronto, but I was a uoft clerk and many of my friends ended up in residency there and multiple people have confirmed to me that what is written in the **DELETED** post is VERY VERY accurate. Maybe someone else who did their residency there might chime in or maybe they won't because they're so overworked they won't find the time to do so...

I will tell you something that I experienced when I was a clerk rotating interviewing for IM in toronto. Basically Dr. Jeannette Goguen who was also the PD at the time gave us a talk and then said something along the lines of "even though we are a big program we still all know each other, so I will leave you with this resident Max who you can ask questions without me being in the room" and then she walks out. What does the resident say "my name is actually John". 

At that point I decided not to rank them for internal medicine but I did apply there to interview for fellowship and then again decided, screw this place I won't come here and am doing my fellowship elsewhere. Buuuut then I did an elective there during my fellowship thinking "maybe things will be better as a fellow" and during and after the elective I remembered just how much I hated everything about academic medicine at UofT and now my plans are to work at a community hospital (maybe in and around the GTA). 

If after reading all this you're not sure how I feel about UofT then I'll summarize it here: FUCK THEM!

Hopefully you found this helpful with regards to making a decision about applying/ranking a program. I'm sure others have felt differently but every experience I've had with UofT internal medicine since a med student has been shit. The only reason (I think) anyone goes there is because of the city, which is great btw!

 

[jb24]

On 8/10/2022 at 3:33 PM, skinnysanders said:

Hello all! 

Just curious how people feel about about the internal medicine program at Toronto? I'm currently about to start M4 at another university and have heard a few times that its busier, attendings are meaner, and that it's more difficult to get facetime with staff, but I have a feeling that maybe people are just being dramatic LOL. Would love to hear peoples honest thoughts!

Thanks!

 

Residency generally sucks, but it sucks more at IM in Toronto from what I've heard. That program seems brutal, and this is despite most IM programs being grueling.

[ACHQ]

On 8/10/2022 at 8:26 PM, skyuppercutt said:

You could have probably made the same post without the above comment. Not to sound mean, but tbh when I read this my first thought this clerk is clueless... that being said, it's okay because you probably haven't heard about what has been going on there, so here is some information that can help:

A quick google revealed that the internal medicine program is currently under probation from the royal college with "intent to withdraw" this is basically the last warning before a program loses accreditation... Here is a link to an article: https://deptmedicine.utoronto.ca/news/departments-response-internal-medicine-residency-accreditation-review-taking-action-address

This might not mean much to you but it's actually a big deal for this to happen. Not enough information? Here is a **DELETED** post made just 2 months ago: https://www.**DELETED**.com/r/Residency/comments/vca0cn/name_and_shame_why_im_happy_to_leave_toronto/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

Now I didn't actually go through internal med residency at toronto, but I was a uoft clerk and many of my friends ended up in residency there and multiple people have confirmed to me that what is written in the **DELETED** post is VERY VERY accurate. Maybe someone else who did their residency there might chime in or maybe they won't because they're so overworked they won't find the time to do so...

I will tell you something that I experienced when I was a clerk rotating interviewing for IM in toronto. Basically Dr. Jeannette Goguen who was also the PD at the time gave us a talk and then said something along the lines of "even though we are a big program we still all know each other, so I will leave you with this resident Max who you can ask questions without me being in the room" and then she walks out. What does the resident say "my name is actually John". 

At that point I decided not to rank them for internal medicine but I did apply there to interview for fellowship and then again decided, screw this place I won't come here and am doing my fellowship elsewhere. Buuuut then I did an elective there during my fellowship thinking "maybe things will be better as a fellow" and during and after the elective I remembered just how much I hated everything about academic medicine at UofT and now my plans are to work at a community hospital (maybe in and around the GTA). 

If after reading all this you're not sure how I feel about UofT then I'll summarize it here: FUCK THEM!

Hopefully you found this helpful with regards to making a decision about applying/ranking a program. I'm sure others have felt differently but every experience I've had with UofT internal medicine since a med student has been shit. The only reason (I think) anyone goes there is because of the city, which is great btw!

 

I went to the UofT for medical school/clerkship, and then for residency. Now I am a GIM staff at a large/teritary non-academic site in the GTA.

I will say that when I started residency at UofT I was very protective of the program from criticism (as most people are of their home program), but after doing the whole gambit, UofT is a tough program and not for everyone. I would say the only real reason to choose UofT over another program is the fact you get to live in Toronto, if that does not matter to you then just avoid UofT. If you want to eventually work in the GTA, then sure UofT might get you a bit more access to that, but tbh having gone through the hiring process (at least in the community), no one really cares, and as long as you do electives at the site you want to eventually work and everything clicks (like residency), then you will get the job. For academic jobs I can't comment, not sure if UofT prefers their own vs anyone else, but I would say the thing that seems to matter more in that setting is academic productivity.

That being said you will be a good internist, but you will be a good internist anywhere/everywhere. This is not unique to UofT, but you will get good training period and that's all that really matters in the end.

But there are a lot of systemic issues (mostly related to schedueling/wellness, oversight/lack thereof, resident workload etc) that have been ongoing at UofT IM for a while. I think they are going to try and work on it (not sure if it will be fully corrected), so that they don't lose accreditation (which would be unprecedented) and get off of "probation" (which I suspect they will). I have an inkling most of it will be for "show" though.

I read that reedit post and I have to say I thought that's how IM residency was for everyone

That's my take on UofT IM. Although I had a rough time in residency as did most of my colleagues, I don't think I would ultimately change much, as I have all my connections in the GTA and going far away for 4-6 years would lack these important connections. Although I can't compare between programs, the benefits of the lack of systemic issues other programs have (that I'm not 100% sure of anyways) would probably have been balanced by my/my families mental health of us being apart.

[bearded frog]

The problem with U of T (and to a lesser extent, UBC, McGill, etc.) is that regardless of the quality of the program, enough people will want to live/work in the city so that they will always fill the programs with good candidates, so there is no incentive to actually improve the program. Back in the days when we actually physically went to all our interviews, there definitely was a sense the smaller programs in "flyover country" (I'm teasing here ) had a larger focus on program quality and resident support etc vs the larger programs in big cities.

[1D7]

I think to some extent the problems described in the R*ddit post exist in all IM programs. The issues that arise between a medicine resident and ER staff physicians/ICU fellows/surgical residents exist everywhere. The main purpose of an overnight IM service is to work so the staff doesn't have to, and sometimes it means admitting a non-op surgical patient or managing sick patient who doesn't meet ICU criteria—this is essentially how it works at all IM programs.

But these issues are probably a good amount worse at UofT IM given the fact they reached the status of "intent to withdraw"... and also because resident wellness is rarely a focus at UofT.

Ultimately you'll have to ask someone going through it right now to get a good sense, since they may have made some changes after the probation status. Don't ask a junior resident because they're still idealistic and haven't been ground down by the system yet.

[Snowmen]

On 8/15/2022 at 2:33 PM, 1D7 said:

I think to some extent the problems described in the R*ddit post exist in all IM programs. The issues that arise between a medicine resident and ER staff physicians/ICU fellows/surgical residents exist everywhere. The main purpose of an overnight IM service is to work so the staff doesn't have to, and sometimes it means admitting a non-op surgical patient or managing sick patient who doesn't meet ICU criteria—this is essentially how it works at all IM programs.

But these issues are probably a good amount worse at UofT IM given the fact they reached the status of "intent to withdraw"... and also because resident wellness is rarely a focus at UofT.

Ultimately you'll have to ask someone going through it right now to get a good sense, since they may have made some changes after the probation status. Don't ask a junior resident because they're still idealistic and haven't been ground down by the system yet.

I'm not an IM resident but as a PGY-1, I took call exclusively in IM like a regular IM resident (at Laval University, not UofT, to be clear). Not once did I have to argue with an ER doctor that was being a ****. Never had an unstable patient that I felt needed to go to the ICU and didn't go so I had to manage him. Never had to fight with a surgical resident who wanted me to admit one of his patients.

Wanna know why? Because they knew if I said a patient had to go to the ICU/wasn't a medicine patient/etc. and they argued, my attending would have my back.

[indefatigable]

At my center, all PGY1s on CTU call (whether IM or not) had consults screened by staff to avoid any sticky situations.  Staff would outright refuse to take consults they deemed inappropriate.  There would still sometimes be bed/disposition issues since for sicker patients the step-down unit could be full so the patient would go to the ward; or ICU possible patient being put into step-down unit; ER not able/wanting to hold onto patient,; occasional back and forth between hospitalist service and CTU for admission, etc..  ICU patients would be more often admitted through critical care consult rather than CTU consult.  

[Bluberblubo]

7 minutes ago, indefatigable said:

At my center, all PGY1s on CTU call (whether IM or not) had consults screened by staff to avoid any sticky situations.  

This is the first I've heard of a system like that. May I ask what school this is at? Do the pgy2s and 3s get any experience with receiving consults from the er?

[indefatigable]

1 hour ago, skyuppercutt said:

This is the first I've heard of a system like that. May I ask what school this is at? Do the pgy2s and 3s get any experience with receiving consults from the er?

Yes - PGY2+ do get consults directly.  Technically there is a specialized day consult service (PGY 3+) so CTU only accepts consults at night.  Officially PGY1s can be listed as first call, but staff override that - so ER contacts staff first..  It's a smaller program - happy to provide any details via DM.