Internal Med Question

[HamiltonMeds]

For internal medicine residencies in ontario, do schools need a CTU elective done or can all internal electives in a clinic setting suffice?

 

Thanks

[MedNSports]

You will likely get interviews even if you don't have CTU electives, but serious IM applicants usually do at least one CTU elective and 1-2 subspecialty electives. One thing to add, a strong reference letter from any internist is better than average reference letter from a CTU attending so if you have good subspecialty or clinic references, use these but I think having a two week CTU elective is helpful but not necessary.

[frozenarbitor]

CTU electives are held in high regard by IM programs for many reasons which include:

 

1. You are willing to do the crappiest most horrendously mind numbing and frustrating part of the job.

 

2. You have experienced CTU in more depth than just clerkship so you will be more independent on the wards.

 

I've heard CTU (Clinical teaching unit?) multiple times but don't really understand what it is. I'm M1 at Calgary by the way. Internal med is something I'm really considering going into. Could someone explain to me why it's often perceived as the most difficult part of internal?

[A-Stark]

Inpatient work of any kind can be busy and stressful - and shining on CTU shows that you can handle management of sick patients in a reasonably efficient way. Clinic is way more relaxed (at least usually on medicine, especially in academic centres... surgery clinic can be crazier depending on the subspecialty).

 

Probably the ideal elective would combine CTU and emerg consults, on call or otherwise.

[Jochi1543]

I've heard CTU (Clinical teaching unit?) multiple times but don't really understand what it is.

 

A place that will crush your mind, body, and soul.

[A-Stark]

It's a terrible misnomer.

 

CTU stands for Clinical Teaching Unit.

 

However, there is no clinic. It's inpatient. There is also very little opportunity for teaching due to busy yet inefficient work days.

 

I propose we call it SWASU. Social Work and Scut Unit.

 

It's not difficult to do. It's difficult to tolerate.

 

My core MTU was (is) very much about social work and ALC patients - but there is lots of teaching, twice a day, everyday in fact. But not so much on rounds.

 

My first elective CTU rotation was all about acute care and sick patients and, yes, teaching too, formally and informally. But that hospital is run mainly by hospitalists, so that patients are only admitted to medicine if they're more complex and sicker. And since it's small enough that most subspecialties don't have their own inpatient wards, we got all the interesting GI and nephro patients. Otherwise, the IT system provides for fully electronic orders, vitals, and results, so that the most you use the paper chart for is progress notes (and these can be done electronically as well). It is just so... efficient, which might have something to do with the fact that while a tertiary care centre, this hospital operates on a fee-for-service basis.

[thebouque]

I've heard CTU (Clinical teaching unit?) multiple times but don't really understand what it is. I'm M1 at Calgary by the way. Internal med is something I'm really considering going into. Could someone explain to me why it's often perceived as the most difficult part of internal?

 

It's not the most difficult part, just the most boring.

[Alastriss]

My core MTU was (is) very much about social work and ALC patients - but there is lots of teaching, twice a day, everyday in fact. But not so much on rounds.

 

My first elective CTU rotation was all about acute care and sick patients and, yes, teaching too, formally and informally. But that hospital is run mainly by hospitalists, so that patients are only admitted to medicine if they're more complex and sicker. And since it's small enough that most subspecialties don't have their own inpatient wards, we got all the interesting GI and nephro patients. Otherwise, the IT system provides for fully electronic orders, vitals, and results, so that the most you use the paper chart for is progress notes (and these can be done electronically as well). It is just so... efficient, which might have something to do with the fact that while a tertiary care centre, this hospital operates on a fee-for-service basis.

 

My institution is the same way. We had a family medicine-hospitalist service that mopped up all the social "failure to cope" stuff.

[A-Stark]

I think one of the most satisfying things about call at that hospital came when I told the ERP that our staff agreed that a patient was not an appropriate medicine admission, but that he should consult the hospitalist-on-call. On the CTU itself, patients will even get transferred to hospitalists if they become more chronic or in need to longer-term rehab.

[aquablue]

What would be considered the best IM program in Canada?