On weekends and holidays, morning report starts at 9:00 AM where the attending physician and seniors meet with the bed coordinator. All house staff are welcome to join. The house staff on‐call for each CTU for that day, and the house staff on call from the previous day, will meet with the attending physician at 9:30 AM, to review all admissions to the service, and discuss any unstable patients. All active patients on the service will be assessed by one of the house staff, and an appropriate progress note documented in the record. Post‐call students and residents will leave the hospital once their patient care responsibilities have been completed, or at 11:00 AM at the latest.

Specific Activities

1. Orientation Week

• Orientation for GIM – Time: 8:45 – 9:30 AM Location: 5D1.06 WMC or virtual (CURRENTLY VIRTUAL) – The first day of each block, please show up at the time and place mentioned above and there will be an orientation held for junior and senior residents. Please ensure that you read this orientation document beforehand and pertinent highlights will be reiterated during the orientation.

• Antibiotic Teaching Orientation – Time: 9:00 – 9:30 AM Location: 5D1.06 WMC (CURRENTLY VIRTUAL) – On each first Wednesday of each block there will be instruction by one of the Infectious Diseases physicians to go over pertinent antibiotic information.  There will also be sessions scheduled Wednesday's at noon (dependent on Dr. Chen's availability).  

2. Pre-Rounding:

All student interns and junior residents are expected to review each patient assigned to their care prior to starting rounds (depending on the timing of teaching, this will either be before or after your teaching). As part of this review, the trainee will review the previous day’s progress notes, identify any changes in the patient’s status overnight as documented in the nurses’ notes, vital signs, relevant flow sheets, and laboratory results. Each student and resident will carry out a focused patient interview and physical examination, to confirm the patient’s clinical status, and in turn be prepared to discuss their patients’ active medical problems, as well as providing specific recommendations for investigation and treatment, when the CTU service meets as a team.

*To facilitate compliance with the PARA contract (26-hour rule), medical students and residents will not be expected to start work until 8:00 AM on the days they are scheduled to be on call.* 

During this same time period, the senior medical resident will become familiar with all new admissions to the service, and become acquainted with any urgent new problems or complications involving other patients on the service. 

3. Rapid Rounds (Time: 8:10 or 9:00 am depending on the unit)

Rapid rounds are 20 minutes rounds held daily on each respective ward. These rounds are interdisciplinary with the attendance of a charge nurse, care coordinator and representatives of allied health team including the physiotherapist, occupational therapist, pharmacist, dietician, etc. The senior resident and attending physician will run these rounds where each patient on the ward is discussed regarding plans for patients and execution of these plans. Student interns and junior residents are welcome to attend providing their initial rounds are completed.

4. Morning Report – Time: 8:45 ‐ 9:00 AM Location: 5D1.06 WMC

(Attendings, Junior Attendings and Senior Residents ONLY)

Morning report provides a forum where the senior resident on call the previous night can present focused, concise summaries and handovers of patients admitted to the CTU services. The senior medical resident will also present one or two admissions in greater detail, to generate further discussion among all participants about the investigation and treatment of both common and unusual medical problems.

In addition, there will be dedicated senior resident teaching for at least 10 minutes during this time (~8:45-9:00am). This will be a Royal College oral scenario (hot seat). Active participation by all house staff and faculty is expected.

On Fridays, rapid rounds and morning report will commence at 9:10AM because of Grand Rounds. The senior resident and attending physicians will split up where one will attend rapid rounds or morning report to have both sides covered.

5. Morning Junior Resident Teaching – 9:00 ‐ 9:30 AM Location: 5D1.06 WMC 

(Junior Residents join in)

These are 30 minute dedicated teaching sessions for junior residents and elective junior residents done by senior residents or junior attendings. There will be attending physician supervision for support. These sessions are usually case‐based and can be didactic or more interactive.

Senior residents will be responsible for teaching every day, please take note of your days:

• Mondays: CTU‐A Senior

• Tuesdays: ER/Ward Consult Senior – please decide amongst the team who will be responsible 

• Wednesdays: CTU‐B Senior

• Thursdays: CTU‐C Senior

• Fridays: No teaching on Fridays because of Grand Rounds.

See Tips for Teaching by Dr. Daniels and Dr. Goldstein if you haven’t already (log in with CCID and click on Educational Resources)

6. Student Bedside Teaching – 8:00 ‐ 8:30 AM 

Students ONLY 

This is a 30 minute dedicated teaching session for students and elective students done by attending physicians or junior attendings. These sessions are usually case‐based with approaches to different medical topics or physical exam sessions. These will run Monday to Thursday. Please note that there is no teaching on Fridays as there are Grand Rounds.

7. Attending Rounds – 9:30 ‐ 12:00 PM

Each week day, the house staff team will meet with the Attending Physician from approximately 9:30 to 12:00 PM to discuss patient care problems on the service. Attending rounds provide an opportunity to review new admissions, carry out bedside teaching focusing on physical examination and physical findings, and discuss the investigation and treatment of a wide range of medical problems. Attending rounds also provide an opportunity to discuss related issues in medical ethics, the health care system, medical economics, quality assurance methods, evidence based medicine, and critical appraisal of the literature.

8. Grand Rounds – Time: Fridays 8:00 – 9:00 AM Location: Classroom D 2F1.04 WMC 

There are Departmental Internal Medicine grand rounds every Friday from the months of September to June of each year, with presentations usually led by staff physicians or visiting speakers. These are encouraged for residents and student interns. Because of grand rounds on Fridays, there is no dedicated student or resident teaching on Friday mornings. Rapid rounds and  morning report will commence on Fridays at 9:10 AM.