Dalhousie University - Internal Medicine - Saint John


Program Director

Dr. Ian Epstein


Program Site Director

Dr. Alexa Smith

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For more information on the Saint John Based Training Site, please click on this link.

Resident Evaluations

Residents are assessed using a standardized, on-line evaluation system. Residents receive formative feedback from the attendings supervising the rotations and meet regularly with the program director to discuss their performance. In addition, residents have the opportunity to further gauge their academic progress by having the opportunity to write the American Board of Internal Medicine exam and a faculty developed OSCE exam.

Additional Learning Opportunities

The Department of Medicine has sponsored every resident in the current academic year to have individual subscribed access to Up-To-Date. Further, residents can choose to participate in an out-of-province or out-of-country elective rotation provided at an accredited teaching hospital.

Scholarly Activity

All Internal Medicine PGY1s participate in a two-month Research Methods course in October – November in their first year of training. This course provides the foundation necessary to take a project idea to a proposal and then introduces the resources to drive the project to completion at a level required for presentation at a research events and/or publication.

In support of scholarly activity, the Residency Research Director, Committee and Coordinator, all work closely with residents to assist them in reaching their research goals.

During the Ambulatory Care rotation in first year, residents are given the opportunity to set aside a half-day per week dedicated to scholarly activity. In addition, residents are provided support and encouraged to submit project abstracts for presentation at the Department of Medicine Research Day and to other peer-reviewed conferences.

During the year, the Residency Research Committee analyzing residents' research proposals for project approval. Once approval has been received, residents then have the opportunity to set aside additional time for scholarly activity.

Conference & Continuing Education Support

As part of supporting residents' continuing education, the Department of Medicine provides funding for residents to attend at least one academic conference per year. Residents may receive additional financial support to attend a second conference in a year, if they present research.

Academic Activities Include:

  • Medicine Grand Rounds — Medicine Grand Rounds are held at noon on Wednesdays.

  • Noon Seminars — Noon Seminars are held on Mondays, Tuesdays and Fridays throughout the academic year. The July and August seminars concentrate on emergency problems, including key specialty emergencies. The September to June seminars cover a curriculum of key topics. Dalhousie University guest faculty participate and additional teleconferencing rounds are available. Critical appraisal through evaluation of key papers is scheduled within Friday seminar time, and physical examination sessions are scheduled on alternate Fridays at noon.

  • Academic Half Days — Academic Half Days for PGY1s are held on Tuesday afternoons year round and focus on general medicine, sub-specialties, ethics and other medicine related topics. The presentation of cases are provided in a didactic format, which encourages learner interactions, and focus on the application of clinical approaches necessary for internal medicine.

  • Journal Club — The Internal Medicine Residency Program runs a resident-driven Journal Club from September to June. A theme is selected, relevant attending staff are invited and the entire group discusses the papers presented. Attendance and participation in the Journal Club is a compulsory part of the Program and assists the development of critical appraisal skills.

  • Other — Various other scheduled teaching activities occur in association with the specific rotations and are included in rotation specific objectives.

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The Dalhousie University Core Internal Medicine Program was fully accredited by the Royal College of Physicians and Surgeons of Canada during its last evaluation in November 2018, and received the maximum possible approval. Dalhousie University has subspecialty programs in all the specialties of Internal Medicine, except in Clinical Pharmacology and in Clinical Allergy & Immunology.

The Dalhousie University Core Internal Medicine Program has a formal affiliation with the Department of Medicine in Saint John, New Brunswick, a Saint John Based Program in its seventh year. Saint John based residents complete rotations at the Saint John Regional Hospital (SJRH) and at the QEII Health Scoiences Centre in Halifax as outlined in the curriculum above. Accommodations are provided during a resident's stay in Halifax at no cost to the resident, and travel reimbursement is provided.


What are the strongest aspects of your program?

The Medicine Teaching Unit (MTU) experience is considered to be the site’s strongest experience in Internal Medicine. This inpatient unit is managed by two 12-bed teams which is staffed by both general internists and subspecialty staff. Thanks to the Family Medicine Hospitalist unit on site, the types of patients on the MTU are restricted to those requiring Internal Medicine expertise – a factor that provides residents with appropriate and challenging cases that further their development of knowledge and skills.

In addition, since there are fewer residents on each service, there is more opportunity for direct interaction with the attendings, there is a consistently higher level of responsibility, and there is the opportunity for residents to take on leadership roles in guiding junior learners.

What is the general level of satisfaction amongst your residents?

The current residents are very satisfied with our Program. We are a close and supportive group, and we have excellent relationships with our attending staff. There is a strong commitment on the part of the Site Director, the Program Director and the administrative staff to provide the support to the residents, which ensures resdient success in our Program.

What kind of subspeciality experiences are available?

The Saint John Regional Hospital is the largest hospital in New Brunswick, offering experiences in numerous medical subspecialties, including cardiology, respirology, GI, hematology, medical oncology, nephrology, infectious diseases, rheumatology, and endocrinology. In addition, residents have various selective/elective rotations that can be completed in Halifax or elsewhere that supplement any areas of particular interest that a resident might have in Internal Medicine.

What computer-based resources are available?

The Medical Education Department, hospital library, and nursing stations have extensive computer availability. The Medical Education Office has subscribed to the Up-To-Date program accessible at any computer station throughout the hospital. The Medical Information System provides rapid access to laboratory results and Web1000 permits immediate access to diagnostic imaging studies from most computer stations. The MTU also has "workstations on wheels" to provide access to records at the bedside.

What is the relationship between the Saint John-based and Halifax-based residents in the Program?

The Saint John and Halifax based residents in the program complete rotations at each site. This interchange of residents between sites allows residents to build a strong sense of camaraderie between the sites. The combined social activities, an annual Resident Retreat (a weekend of education and socializing), as well as the combined curriculum events throughout the year (particularly the weekly Academic Half Day) allow for further interaction between the sites, which strengthens the relationships between residents.

What is the general training atmosphere like at the Saint John Regional Hospital?

In general, the Saint John Regional Hospital supports an active learning environment. At any given time, over 50 undergraduate and postgraduate learners are on clinical rotations in the various medical and surgical services at the site. In addition, the new medical school based in Saint John further supports the learning and teaching environment for the residents.

The collegiality between residents and staff, including attendings, nursing staff, and interdisciplinary teams , is a unique feature of training in Saint John. This is in part due to the smaller staff size which provides residents with a real sense of engagement. Likewise, the attendings and other hospital staff value and strongly supporting the residency training in Saint John.

Lifestyle is important to me; what does Saint John have to offer?

Saint John is located on the southern coast of New Brunswick and provides an excellent blend of urban advantages and outdoor lifestyle – this combines to allow for an excellent quality of life. A 2007 study by UBC, found Saint John to be the happiest city in Canada, thanks in part to the lifestyle the city offers and the sense of engagement in the community.

The uptown area is a hub for arts, culture and heritage in Saint John. In fact, Heritage Canada recognized Saint John as a 2010 Cultural Capital of Canada. The area is noted for its architecture, theatre, and galleries. Restaurants, festivals, concerts, and sporting events are also attractions in the uptown area.

Outdoor activities are one of the best features of the area. The ease of commuting around the city and the close proximity to parks and waterways means that residents often find themselves in a kayak, on a bike trail or on a golf course within minutes of finishing their shift at the hospital. A few key locations are Rockwood Park (one of the largest urban parks in North America) which is less than 5 minutes from the Saint John Regional Hospital and the Irving Nature Park in the city’s west side. Water activities abound with the Saint John river systems, the Bay of Fundy, lakes, as well as indoor aquatic facilities.

Another feature that residents in the Saint John residency programs enjoy is the city’s strategic location which allows easy access to other locations in Atlantic Canada, Quebec, Ontario, and the northeastern United States. The possibility of weekend road trips to Halifax, Boston, Montreal, etc. are an added bonus to living in Saint John.