Critical Care Medicine Training Program

Queen's University is proud to offer one of Canada's leading subspecialty training programs in Critical Care Medicine. As a fully accredited program by the Royal College of Physicians and Surgeons of Canada, Queen's offers trainees a rigorous and intensive curriculum, while providing individuals the flexibility to tailor their experience to meet their academic and career goals. Fellowship at Queen's offers all the benefits of a tertiary academic center with world class research and education infrastructure. Moreover, the smaller program size fosters a close, supportive relationship between our faculty and trainees.

The subspecialty program at Queens attracts stellar trainees from a wide variety of base specialities including Internal Medicine, Anesthesiology, Emergency Medicine and General Surgery. This diversity of expertise is reflected both in our trainees and faculty. It is the blending of talent and sharing of knowledge that provides both breadth and depth to the program. Trainees are quickly integrated into our team of multi-disciplinary providers who share a commitment to teaching and providing outstanding clinical care. Opportunities within our research program to lead and actively participate in clinical studies provide our trainees with a well rounded experience. Graduates of the program have gone on to become national and international leaders in Critical Care Medicine as clinicians, educators, researchers and administrators.

As Queen's University embraces the paradigm shift in medical education toward a competency-based curriculum, the innovative spirit of our faculty has driven our institution to play a leading role in the journey. Our commitment to our trainees is to continue to provide a highly rewarding, intense and comprehensive experience as they transition into a career in Critical Care Medicine. I encourage you to learn more about our program and invite you to contact me to discuss opportunities.

Paul Heffernan, MD, MSc, FRCPC, FCCP
Program Director, Critical Care Medicine

Program Structure

The Critical Care Program is generally a two-year program divided into 26 four-week blocks. This includes fourteen blocks of general adult Critical Care, one block of Cardiac Echo training, one block of POCUS, and one block of Cardiac Surgery ICU. Nine blocks are available for electives and other recommended rotations, allowing residents to customize their training to suit their personal career goals. For some residents, Critical Care training may overlap with the final one or two years of base specialty training; for these trainees the program with generally span three years.

In 2017, Queen’s University embarked on an innovative program to transition all training programs to a competency based curriculum ahead of the Royal College Competence by Design initiative. The competency-based curriculum has formalized an approach of graded responsibility and focus on practical acquisition of skills and knowledge that has long been a tenant of our training program. We feel this philosophy will continue to be one of the true strengths of the program as residents continue to achieve a high level of comfort in independent patient care, while enjoying close, collegial relationships with the attending staff.

The curriculum is divided into four phases of training. The “Transition to Discipline” is a short, early introduction to the speciality focused on ensuring comfort with basic concepts, procedures and roles within the ICU. The “Foundations of Discipline” stage occurs in the first large block of rotations and is focused on the development of knowledge of physiology and key critical care concepts. During this stage, trainees supervise patient care by junior trainees with close supervision from attending staff. They assess all consults, admissions and discharges in close collaboration with attending staff.

During the “Core of Discipline” stage, trainees develop competence in advanced technical skills such as bronchoscopy and percutaneous tracheostomy insertion. They take a leadership role in daily team rounds, and participate in the teaching program for junior learners. Supervision by attending physicians gradually evolves into a coaching relationship during this phase.

The final stage is “Transition to Practice” during which residents take on all the roles of an attending physician, including resource allocation and management decision-making. They will supervise and lead patient care in the ICU with the supervising attending physician always available to provide coaching, consultation and discussion.

Research

Research and scholarly activity have been long- identified strengths of the Critical Care Program at Queen’s. There is a strong research infrastructure and expertise in the Program, with approximately $1.5 million of annual operating grants and research support provided to Critical Care research projects.

All residents are provided with one week per block of ICU to dedicate towards independent scholarly activity, which may take the form of a clinical research, education, or a quality assurance project. Faculty play an important role in this process, helping residents to establish and complete their scholarly project. Residents receive funding to attend a national or international meeting at which their research is presented.

Critical Care Trainees who wish to pursue a long- term career as a Clinician Scientist may also be eligible to enrol in an advanced academic degree in conjunction with their clinical CCM training, through the Queen’s Clinician Investigator Program.

Educational Activities

Residents are excused from clinical responsibilities for one afternoon per week. During these academic half-days, facilitated by faculty members, trainees examine a range of Critical Care topics in-depth, and gain a familiarity with the evidence base behind Critical Care practice. Some half-days are spent in the patient simulation laboratory, where trainees have the opportunity to enhance their Crisis Resource Management skills. Practice written exams also help residents to consolidate their knowledge base. During the academic year, trainees also attend and present at weekly Critical Care Grand Rounds, Morbidity and Mortality reviews, and at monthly Journal Club.

Critical Care trainees at Queen’s are provided with a number of resources during their training, including a copy of a recent textbook or an alternative academic resource. Funding is provided for each trainee to attend ACES, ATLS, and ACLS courses, in addition to an allowance of $1,500 to attend national or international Critical Care conferences once during training.

Training Sites

Kingston Health Sciences Centrel (KHSC)

is southeastern Ontario’s leading centre for complex-acute and specialty care, and is home to the Cancer Centre of Southeastern Ontario. An accredited Level 1 Trauma Centre, KHSC is also the major referral centre for injured patients in the region, and is home to the regional Stroke and Primary Cardiac Revascularization programs. KHSC serves almost 500,000 people through its Kingston facility and 24 regional affiliate and satellite sites. It was ranked in 2019 as one of Canada’s Top 40 Research Hospitals by Research Infosource. The intensivist-directed 34 bed ICU at KHSC is located in a new, modern space. In addition, the hospital has a 14-bed Cardiac Sciences Unit and an 18-bed open-medical-model “stepdown” ICU.

Lakeridge Health is a large community hospital corporation serving approximately 600,000 people in the Durham Region at its 5 hospitals in Bowmanville, Oshawa, Ajax Pickering, Port Perry and Whitby. A regional education hub affiliated with Queen’s University, Lakeridge Health, Oshawa, has a 25-bed Critical Care Unit and active clinical teaching unit. It is the regional high-volume thoracic surgery center and stroke centre. Lakeridge provides our trainees with unique opportunities and clinical exposures including exposure to transport medicine.

Critical Care Ultrasound at Queen's

Proficiency in Critical Care Ultrasound is an invaluable skill for the intensivist and is a core competency of adult critical care medicine training. Queen’s University offers a comprehensive critical care ultrasound training program with didactic sessions (half-days), monthly image review rounds, a mandatory one-month critical care ultrasound rotation, and longitudinal quality assurance and feedback.

Archiving software (QpathE) is used to save and report point-of-care ultrasound studies throughout training. This software allows for anyone in the circle of care to see your studies and reports, and also offers a way to track portfolio development during your critical care training.

Kidd-2 ICU has 3 Sonosite EDGE 2 Ultrasounds. In addition, there are a multitude of other ultrasounds connected to the QPathE archiving system throughout the hospital. Resuscitative TEE exposure is available in one-on-one simulation sessions and exposure to the cardiac surgery OR.

How to Apply

Application to the two-year subspecialty program in Critical Care at Queen’s is coordinated through the Medicine Subspecialty Match (MSM) offered by the Canadian Residency Matching Service (CaRMS). Applicants to the match must generally be in their be in their final year of Canadian residency training in Anesthesiology, Emergency Medicine, Cardiac Surgery, or General Surgery, or must be in their third year of a Core Internal Medicine residency. For complete details on eligibility and on applying to the Queen’s CCM Program through the MSM, visit www.carms.ca.

Candidates wishing to apply for CCM training overlapping with their base specialty training in Anesthesiology, Emergency Medicine or General Surgery must have completed at least three years of residency prior to entry into Critical Care. Overlap training is usually restricted to trainees from Queen’s University residency programs, but applicants from other centres may be considered in some circumstances. Overlap training requires the consent and recommendation of the base specialty training program director, and interested applicants should contact the Critical Care program director directly to discuss application requirements and procedures.

Entrance to Critical Care training from other specialty programs is possible, but must follow completion of primary specialty training and candidates must meet the eligibility requirements set by the Royal College of Physicians and Surgeons of Canada Specialty Committee in Critical Care. Such applications are considered on a case-by-case basis, and generally require significant advance planning on the part of the trainee to ensure that entrance requirements are met during base specialty training.

International physicians wishing to pursue Critical Care training at Queen’s University must be fully sponsored and funded for such training by their home government. Interested applicants should contact the Queen’s University Postgraduate Medical Education office for information on eligibility and application procedures

Information for Prospective Residents

We will be interviewing candidates on September 3 and 4, 2025 via Zoom.

A virtual Town Hall will be held on August 26, 2025 where you will have an opportunity to hear a presentation about our program as well as ask questions of our faculty and current residents.

Please contact criticalcaremedicine@queensu.ca with any questions.

Hear from our Trainees

Jessica Wiseman (Lead resident, PGY5 CCM/IM + CIP) & Heather Derocher (PGY5 CCM/IM)

Why Queen’s?

Jessica: The community of people at Kingston Health Sciences Center fosters a warm, collaborative environment that enhances patient care through strong interprofessional teamwork. The collaboration among nursing, social work, physical therapy, occupational therapy, and dietitians ensures that patient care is truly a team-based process. Additionally, the diversity of attending physicians, whose specialties range from emergency medicine and general surgery to anesthesia, internal medicine, and pulmonary medicine, brings a wealth of knowledge and unique perspectives that enrich both patient outcomes and the learning environment.

In this program, you are not just a number – you are a valued individual. The physician attendings take the time to get to know each Fellow personally, recognizing your strengths, goals and contributions. This personalized approach creates a supportive and respectful learning environment where you feel seen, heard and truly part of a team.

Furthermore, this small but mighty fellowship program fosters a unique environment in which Fellows develop a close bond with one another. Through collaborative learning, shared challenges and immersive experiences, the Fellows have an opportunity to build lasting relationships and a strong sense of community. This close-knit support system not only enhances personal growth but also enriches the professional journey of each Fellow.

Heather: Before starting my Critical Care Fellowship, I trained here at Queen’s in Internal Medicine. I attribute my love of Critical Care to the mentors that I met going through my residency here. The culture of this training program is what motivated me to stay at Queen’s for fellowship. What makes this department stand out are the incredible people. Staff physicians go above and beyond—whether by seeking out teaching moments, offering guidance, or supporting trainee growth – making this a learner focussed environment. In addition, our unit thrives on its multidisciplinary teamwork, and we’re fortunate to collaborate with a welcoming group of allied health professionals and nurses. This fosters an environment I’m genuinely proud to be part of.

In addition to the medicine, Kingston has been a wonderful place to live for the past four years. There is something for everyone here, and a big community of residents and fellows who are ready to embrace newcomers into the community. For me, the combination of work environment and lifestyle set Queen’s apart for me as the best fit for fellowship.

Life in Kingston

Jessica: As the first capital of Canada, Kingston is an enchanting city that offers an abundance of historical charm. The Market Square offers weekly farmer’s market delights, summertime concerts, salsa dance lessons, and movie screenings that further enhance its charm and sense of community. There are plenty of opportunities for adventure, whether it's taking a ferry to Wolfe Island, wine tasting in Prince Edward County, hiking in the numerous surrounding parks, or visiting the world-renowned Caribbean-like beach at Sandbanks – there is something for everyone.

Best thing about fellowship?

Heather: Our program offers several unique features that truly set it apart. While I’ve already touched on the people—who I genuinely believe are the best part of being a fellow here—there are also structural aspects of the fellowship that make it an exceptional training experience.

One of the standout strengths is how well the program supports us in achieving our individual goals. Compared to residency, there is significantly more flexibility, which empowers us to take real ownership of our training. A key example of this is the structure of our ICU blocks, particularly the night float system.

The night float model creates protected academic time in the following week, which we can use to explore interests both within and beyond medicine. This time can be dedicated to research or scholarly projects, further training in your base specialty, or simply to rest and recharge after busy weeks on service. This balance not only supports professional growth but also helps model what life as an attending Intensivist is truly like—something that I feel prepares us exceptionally well for the realities of practice after fellowship.

Research project?

Jessica: Kingston Health Sciences Center offers a wide range of research opportunities, supported by a robust and dedicated faculty committed to fostering academic growth. Trainees can participate in various projects, including systematic reviews, clinical trials, quality improvement initiatives, and chart reviews. The program actively supports research endeavours, including the Clinician Investigator Program, which is designed for research-intensive Fellows seeking advanced education, such as a master’s degree. However, no matter your level of research interest, there’s something here for everyone

Heather: Within our department, there are numerous opportunities to get involved in research, whether your interests lie in quality improvement, clinical trials, or patient- and family-centred initiatives. Personally, I’m currently working on a project examining levels of inflammatory cytokines in patients who develop new-onset atrial fibrillation during critical illness. The aim is to better understand the underlying drivers of atrial fibrillation in the ICU and, ultimately, to explore potential novel therapeutic targets.

Life after fellowship?

Heather: This program has given me the space to explore my interests, which has, in turn, helped shape my understanding of the kind of career I hope to pursue. At this stage, I envision myself working in a community ICU practice somewhere in British Columbia. The breadth of clinical exposure at Queen’s has provided me with a well-rounded and comprehensive training experience that will serve me well in that setting.

In addition to Critical Care, I have a strong interest in Palliative Care and hope to incorporate it into my future practice. The flexibility of the fellowship has allowed me to pursue dedicated rotations in Palliative Care medicine, preparing me for this potential dual role.

Wherever I ultimately end up practicing, I know I’ll look back on my fellowship at Queen’s with deep appreciation—for both the training I received and, most importantly, for the people who made it such a meaningful experience.

Residency Program