The program is based on a 13 block lunar calendar, the majority of the rotations being 2 blocks (eight weeks in duration).

During the first year, 5 blocks are spent on the General Internal Medicine (GIM) medical teaching units (MTU). One block is spent on the GIM consult service. The cardiology selective is mandated in the first year. This selective consists of 1 block of CCU (FHH) and 1 block of hospital consultation and clinics. The remainder of the blocks are on subspecialty services or electives. The subspecialties available include infectious diseases, hematology, oncology, rheumatology, respirology, gastroenterology, endocrinology, geriatrics, nephrology, and neurology.

In the second year 2 blocks are dedicated to Critical Care at the FMC, 2 to 3 blocks to GIM (consult service or rural GIM and emergency liaison senior for the MTU).  The remainder of the blocks are on subspecialty services or elective.

The third year consists of 5 blocks at MTU leader, 2 blocks of critical care (PLC) and 6 blocks of subspecialties or electives.  During the 3 core years the residents are expected to do at least 2 blocks of neurology.  There is mandatory ambulatory care rotation in the second or third year. The type of clinics that the resident attends is individualized.  During this elective the resident is expected to do 1 in 4 night call on the MTU.

Each of the two MTU's (one at FMC and one at PLC) is comprised of four or five PGY 1 residents (from Internal Medicine, Family Medicine and other disciplines), an Emergency Liaison resident (PGY 2 or 3 in Internal Medicine), a teaching senior, an MTU leader (PGY 3 in Internal Medicine), three to four Clinical Clerks and one General Internist preceptor.  Each team has a home-base ward and a director.  The MTU senior residents are expected to assess all referrals from Emergency but may accept or decline any given patient for admission to the MTU based on the relative educational value and severity of illness of the case.  Night and weekend call on the MTU's in usually one in four.  The MTU normally has anywhere from 20 to 30 patients.

Critical Care experience at FMC is offered in the Trauma/Intensive Care Unit (two blocks in the second year) and in the Coronary Care Unit (as part of the Cardiology selective).  At PLC, the Coronary and ICU experiences are integrated into one unit and one rotation (two blocks in the third year).  Residents from a variety of programs serve in the Critical Care Units.  Night and weekend call in the Critical Care Units is usually one in four.

Electives include the subspecialties of Internal Medicine (which are predominantly consultation services), Neurology, and Emergency Medicine.  Electives include research, rotations in disciplines other than Medicine, and out of town experiences.  A maximum of three blocks during three years of "core" training may be dedicated to such electives.

The program offers a community GIM selective in Lethbridge and in other rural areas such as Yellowknife, etc. with prior program approval.  This selective allows the resident to work with general internists and subspecialists in a smaller community.  Additional funding is available for residents doing this rotation to help defray any additional costs occurred.

Call is one in four in-house call for residents rotating on the MTU.  The resident post call is excused from all clinical duties at noon on the day post call ("26 hour rule").  ICU and CCU care is one in three call.  Residents post call in the ICU at the FHH are excused from clinical responsibilities after sign in (24 hour call).  For the PGY 2 and 3 years subspecialties in Internal Medicine the call is 1 in 9 out of house call.  During the R2 and R3 years, residents are expected to cross over as the MTU senior (in house call) approximately 2 weekday nights and 1 weekend day per block.

Ambulatory care experience is routinely available on all subspecialty rotations and is the major component of Endocrinology and Metabolism, Rheumatology, and Geriatrics.  MTU senior residents attend a weekly clinic which includes follow-up of patients discharged from the MTU's and GIM referrals from the hospital Emergency Departments.  There is a mandatory 1 block ambulatory care selective in the second or third year.

The program is designed to provide continuous evolution from a predominantly primary care role to that of a junior consultant.  Responsibility for independent patient care and for teaching of other members of the team increases progressively in a manner suited to the ability and mastery of clinical skills demonstrated by the individual resident.

A philosophy of independent self directed learning underlines the program.  Since it is impossible for any individual to master all of the knowledge in Internal Medicine, it is essential that skills be developed which allow the physician to access pertinent current literature easily, to analyze information critically and to adopt a pattern of self directed learning which will continue beyond the completion of the program.