| "The Royal College program is a 5 year Royal College residency, intended for those who wish an academic career as a consultant in Emergency Medicine...." |
Contacts/ Resources/ Strengths/ Curriculum/ Academic/ Conferences/ Research/ Evaluation/ Program Commitee/ Vacation/ Registration
Program Contact
| Director | Dr. Wes Palatnick wpalatnick@wrha.mb.ca |
| Assistant Director | Dr. Travis Minish |
| Program Assistant |
Chris Cowan |
| Chief Resident Email | er.chief.uofm@gmail.com |
Department of Emergency Medicine
T258 - 770 Bannatyne Ave.
Winnipeg, Manitoba, R3E 0W3
Resources
The Health Sciences Centre- General is an adult tertiary Emergency Department which serves the core area of Winnipeg. It has a high volume of high acuity patients with significant numbers of multiple trauma, toxicology, and disturbed psychiatric patients.
The Children's Hospital, Health Sciences Centre, is situated in the core area of Winnipeg where it provides primary, secondary, and tertiary pediatric care for Winnipeg, Manitoba, NW Ontario and Nunavut. All levels of injury and illness acuity are seen in this Emergency Department with significant multiple trauma, toxicology, and child abuse.
St. Boniface General Hospital Emergency Department treats patients of all ages. It serves as a community hospital for the francophone community of Winnipeg and surrounding rural francophone towns, as well as a tertiary care referral centre. Patient acuity is high with a higher proportion of internal medicine, cardiology, nephrology and geriatrics.
Strengths of the Program
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High patient acuity with large volumes and high rates of pathology
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Full academic day
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Ultrasound and Evidence Based Medicine embedded in the academic day
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Strong simulation program under the direction of Dr C ffrench
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Annual Resident Retreat
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Cohesive and supportive resident group
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Monthly resident-faculty Journal Club
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ACLS, ATLS, PALS, AIME - all paid for under the contract
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One week education leave
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$2,000 Cdn/yr provided to each resident for scholarly activity/conferences
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The program has strong ties with the pre-hospital care system, including the Winnipeg Fire Paramedic Service, the Provincial Air Ambulance (Lifeflight) and the new rotary program STARs
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Two clinical Toxicologists provide a strong Toxicology rotation.
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Research director Dr E Weldon has strengthened both the teaching of evidence based medicine as well as research methods
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Attending physicians with subspecialty training in Critical Care, EMS, ethics, palliative care and Toxicology
Curriculum*
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PGY-1 |
PGY-2 |
PGY-3 |
PGY-4 |
PGY-5 |
|
PERIOD 1 |
Emergency |
Emergency |
Emergency |
Emergency |
Emergency |
|
PERIOD 2 |
Psychiatry |
Emergency |
Emergency |
Emergency |
Emergency |
|
PERIOD 3 |
Surgery |
Anaesthesia (Adult) |
Intensive |
Disaster/Admin/ |
Emergency |
|
PERIOD 4 |
Surgery |
Anaesthesia |
Intensive |
Elective |
Emergency |
|
PERIOD 5 |
Internal Medicine |
IM Consults |
Emergency |
Emergency |
Emergency |
|
PERIOD 6 |
Internal Medicine |
IM Ward Senior |
Emergency |
Emergency |
Emergency |
|
PERIOD 7 |
Peds ER |
Peds ER |
Peds ER |
Peds ER |
Peds ER |
|
PERIOD 8 |
Pediatrics |
Orthopedics |
Toxicology |
Pediatric Intensive Care |
Elective |
|
PERIOD 9 |
Obstetrics & Gynecology |
CCU |
Elective |
Elective |
Elective |
|
PERIOD 10 |
Obstetrics & Gynecology |
Plastic Surgery |
Emergency Medical Services |
Trauma Team Leader |
Elective |
|
PERIOD 11 |
Emergency |
Emergency |
Emergency |
Emergency |
Elective |
|
PERIOD 12 |
Emergency |
Emergency |
Emergency |
Emergency |
Elective |
|
PERIOD 13 |
Vacation |
Vacation |
Vacation |
Vacation |
Vacation |
*Currently in use, and being considered for revision by Curriculum Committee. Revised: July 2013, K. Thompson
PGY-1
The first year of specialty training is a basic clinical training year. Included are two-month rotations in Emergency Medicine, Internal Medicine, Surgery, Pediatrics, and Obstetrics and Gynecology, with one month each of community emergency medicine and elective time.
PGY-2 and 3
In the next two years of residency training, 12 months of training is provided in the three affiliated Emergency Departments. Other rotations include two months in each of Anaesthesia, Internal Medicine and Medical Intensive Care. There are one-month rotations in each of Psychiatry, Toxicology, Orthopedics, Emergency Medical Services, Plastic Surgery and one month of elective time.
PGY 4 & 5
During the senior years, a further twelve months of training is provided in the three affiliated Emergency Departments. Other rotations include two months in Acute and Trauma Surgery, or a Trauma Team Leader rotation based at the Health Science Centre Emergency Department, one month in Pediatric ICU, one month in Surgical ICU, Toxicology, and Emergency Medical Services (EMS).
All 4thyear residents serve a term as Chief Resident.
At this time, the program offers six months of elective time. This can be taken as one block, or it can be subdivided and taken at different times to pursue varying areas of special interest. The amount of elective time is subject to annual review. In selected circumstances, the whole fifth year can be taken towards a Fellowship.
Summary
The program was established in 1991 and has undergone curriculum revisions since its initiation. Refinements in the curriculum will no doubt continue. Changes are at the discretion of the Residency Program Committee which consists of faculty and residents.
As can be seen from the curriculum summary above, each resident will receive 24 months of training in Emergency Medicine, including two two-month rotations in a tertiary Pediatric Emergency Department (Children's Hospital). The remaining 20 months will be split between the Health Sciences Centre-General, which is an Adult Emergency Department and St. Boniface General Hospital, which is undifferentiated (sees patients of all ages). In each case, half of the Emergency training will be provided during the first two years and the remainder during the senior portion of the residency.
Off-service rotations are provided in either the Health Sciences Centre or St. Boniface General Hospital, based on the availability of the most appropriate clinical experience.
Residents are junior residents in the first 24 months of training. Junior Residents care for all types of patients in the Emergency Department and participate in resuscitation and perform major procedures under the supervision of the Attending Emergency Physician or a senior resident.
Senior Residents, as well as providing care for all patients who present to the Emergency department, will function as resuscitation team leaders and will review patients seen by medical students and other residents, typically in Family Practice and more junior Emergency Medicine residents, both in the Royal College Program and in the CCFP-EM Program. The Senior Resident will, in conjunction with the Attending Emergency Physician, assume responsibility for the orderly flow and disposition of all patients within the department. The Senior Resident should be able to manage the volume of patients typically seen in a busy Emergency Department while simultaneously caring for several acutely ill or injured patients. Attending staff Emergency Physicians should have confidence in the assessments, treatment decisions, and disposition plans of the Senior Residents.
Academic Program
There is a weekly academic full day on Tuesdays which is protected time for the residents. Both FRCP and CCFP(EM) residents participate in academic day.
The afternoon part of the academic curriculum is based on the Rosen textbook and is organized so that the topics based on the textbook chapters are covered in a 2-year period. Additional CanMeds topics are also included in the curriculum.
The format may be didactic, case-based seminar, major article review or literature review. Presentations are by the Emergency Medicine faculty, non-Emergency Medicine faculty, or by Royal College and/or CCFP-EM residents.
Since 2010, we have expanded our academic teaching to include a weekly morning teaching sessions which incorporates the U of M’s state of the art simulation facility, together with resident and attending led topics including M & M rounds, EBM sessions, radiology, EKG and sub-specialty teaching sessions. We are closely associated with the Pediatric Emergency Fellowship and attend their academic teaching sessions once per month.
Grand Rounds are held approximately every 2 weeks, except over the summer and are city-wide events - with participation from emergency physicians at both teaching and community hospitals. Residents are expected to present at Grand Rounds yearly.
A further mandatory resident educational activity is the Core Curriculum. These are additional education activities provided by the Postgraduate Medical Education Office at the University of Manitoba for all residents in the Faculty of Medicine. .
Finally, the Department of Emergency Medicine hosts a citywide Journal Club once for all faculty and residents under the auspices of the Department of Emergency Medicine CME section.
Conferences
There is one week of conference leave per year. If the resident is on a core Emergency Rotation, the resident will be given the time to attend the conference. If the resident is on an off service rotation, it is their responsibility to arrange the necessary time off. There is financial support of $2000 provided by the Department of Emergency Medicine for conferences or other academic endeavours. There may be additional financial support from the Department of Emergency Medicine for additional conferences if the resident is presenting original research.
OTHER COURSES:
Under the PARIM contract, the following mandatory courses are paid for: ACLS, ACLS Instructor, ATLS, PALS, and Ultrasound for vascular access..(during their Critical care rotations)
Research
Dr. Erin Weldon is the Program Research Director.
As per Royal College guidelines, all residents are required to produce a scholarly project that is either published in a peer reviewed publication or presented at a national or international meeting, or is considered of similar quality by the Residency Program Committee
Residents are instructed in all aspects of a research project including study design, grant submission, implementation, data analysis, paper submission and presentation. Residents should schedule a meeting with Dr. Erin Weldon early in their program. The development of a research project from concept to publication can be a slow and tedious process, and so approaching this component of the program aggressively early on is recommended.
View the Research Department's Page.
Evaluation
Upon completion of each rotation, the resident is formally evaluated on an official In Training Evaluation Report (ITER). This is to be completed by the Rotation Coordinator or delegate and should be reviewed with the resident by the person completing it. It should be signed by the resident. ITERs should be sent to the Program Assistant, room T258 - 770 Bannatyne Avenue, Winnipeg, Manitoba, R3E 0W3 .
The resident should expect feedback on his/her performance halfway through a rotation and Rotation Coordinators are informed of this expectation. However, if the resident has not received this feedback, they should actively pursue this to avoid surprises at the end of a rotation. A mid-term evaluation allows the resident to modify his/her behavior to enhance their performance.
Where appropriate, the resident is expected to complete a Procedures Form for each rotation.
It is the resident's responsibility to ensure that ITERs, Procedures Forms, and Rotation Evaluation Forms are completed for each rotation. The resident's academic file is used at the completion of training as part of the evaluation of training. Residents will also be asked to fill out faculty evaluation forms after each ER rotation.
There are a number of practice examinations written by the residents during training. These are used to provide feedback on their training and practice in the examination process. These include the Canadian In-Training Examination, the American Board of Emergency Medicine in Training examination and formal practice oral examinations conducted by faculty.
Finally, the Program Director will meet with each resident semi-annually to provide feedback on their performance and review the resident's file. It is expected that each resident in turn will offer feedback on the adequacy of the training they are receiving.
Program Committee
The Residency Program Committee generally meets quarterly. The Committee is comprised of faculty, including the site directors of the major teaching sites, the directors of Ultrasound, Simulation and Research and two residents. The resident membership includes the Chief Resident (or delegate) and a resident representative elected by the resident group.
A subcommittee of the Residency Program Committee is the CaRMs committee which is tasked with selecting candidates for interview as well as conducting the annual CaRMs interviews each year
Vacation
Residents are entitled to four weeks of vacation during the year. This may be scheduled as a single four week block or divided into two week blocks. If the resident chooses to divide the vacation time, these are to be taken during either rotations at St. Boniface Emergency or the HSC Adult Emergency only.
If residents have requirements for specific days off at other times during the academic year, the schedule can usually be designed to accommodate these requests.
The four weeks of vacation time is to be used in each academic year and cannot be banked or carried from year to year.
The maximum time allowed for vacation during July and August is two weeks
Registration
It is expected that each resident will ensure that he/she is registered with the University of Manitoba and with the College of Physicians and Surgeons of Manitoba on the Educational Register. As well, each resident is expected to have up-to-date CMPA coverage. .
After two years of training, residents are eligible for a full licence under the College of Physicians and Surgeons of Manitoba.
Faculty of Medicine Counselling
Free confidential consultation and treatment for students experiencing emotional stress. Service is available to students of the Faculty of Medicine, their spouses and immediate family.
Located in A120 Chown - Bannatyne campus. Phone: (204) 789-3328 for initial appointments
Other resources can be found through the following link:
http://umanitoba.ca/faculties/medicine/student_affairs/wellness_hub.html