Clinical Curriculum
Rotation Schedule
5 Blocks – Tertiary Care Emergency Medicine
Available Sites:
Health Sciences North
Thunder Bay Regional Health Sciences Centre
1 Block – Community Emergency Medicine
Available Sites:
Muskoka Algonquin Health Centre
North Bay Regional Health Centre
Sault Area Hospital
Timmins and District Hospital
1 Block – Anesthesia
Available Sites:
Health Sciences North
Thunder Bay Regional Health Sciences Centre
2 Blocks – Intensive Care Unit / Critical Care Unit
Available Sites:
Health Sciences North
Thunder Bay Regional Health Sciences Centre
1/2 Block – Orthopedic Surgery
Available Sites:
Health Sciences North
Thunder Bay Regional Health Sciences Centre
1/2 Block – Plastic Surgery
Available Sites:
Health Sciences North
Thunder Bay Regional Health Sciences Centre
1 Block – Pediatric Emergency Medicine
Available Sites:
Children’s Hospital of Eastern Ontario (Ottawa)
Sick Kids Hospital (Toronto)
1 Block – Trauma
Available Site:
Sunnybrook Hospital (Toronto)
1 Block – Elective
Orientation and Unified Rounds
The NOSM University PGY3 FM-EM program begins with an intensive warm-up with two days of simulation and procedural skills workshops, and a full day ultrasound course. Throughout the year there are two more of these multi-day full group sessions involving simulation and procedural skills (such as U/S guided central line placement).
Trauma Horizontal Exposure
In addition to the Trauma rotation (1 block at Sunnybrook), our residents participate in Trauma Team call, during Emergency rotations, to further enhance their exposure to traumatized patients.
Emergency Ultrasound
Emergency Ultrasound has always been a strength of the NOSM University PGY3 FM-EM program. EDE course training, tailored to previous experience, is provided at the beginning of the year to all the EM residents during the initial NOSM University EM Orientation days. We have further U/S teaching and allotted U/S training time provided to residents with the goal of obtaining full independent practitioner certification in EDUS with the Canadian Emergency Ultrasound Society (CEUS) by the end of the training year. EDE certification is encouraged prior to program start date, if EDE independent practitioner status is achieved prior to program start then there may be an opportunity to achieve IP certification in EDE-2.
Simulation
Residents participate in a formative Simulation Series throughout the year (10 cases), in addition to three separate two-day simulation events during the year (Orientation and Unified Rounds x 2). During these sessions, residents have the opportunity to hone their skills in leadership, communication, resuscitation, teaching and teamwork. Simulation Based Assessment cases have also recently been piloted to provide residents with direct, individualized feedback. There are also opportunities to learn how to run and be involved with simulations for undergraduate and postgraduate learners.
Advanced Life Support Training
Acknowledging the increased independence and resuscitative skills required of Northern and rural Emergency physicians, the Northern Ontario School of Medicine provides funding towards an advanced resuscitation course, such as ATLS or PALS, to all NOSM University PGY3 FM-EM residents. These courses are often available at our teaching sites, particularly in Sudbury and Thunder Bay. Residents must have ACLS certification prior to starting their EM residency and if they have not completed ACLS prior to starting their residency should complete it in their first few months of training.
Pre-Hospital Care/EMS
Residents will take part in EMS land ambulance ride-outs during their PGY3 year (this may be subject to change based on COVID-19 restrictions).
Teaching
The residents have opportunities to interact with and teach off-service residents and medical students in “Residents as Teachers” procedural teaching and case based teaching sessions, as well as assist in running simulations for med students and off-service residents. Residents also are invited to and present at M&M Rounds.
Feedback & Evaluations
Residents are provided with written, formative feedback on a daily basis on most rotations, based on discussions with their preceptors. Direct Observation is also used. These assessments (of both clinical and academic performance) are compiled into oral and written summative evaluations at mid- and end-rotation. This allows residents maximal opportunities to improve their skills.
PULSE 360
The PULSE (P.hysicians U.niversal L.eadership S.kills E.ducation) Survey is a “360°” educational tool that provides each participant with constructive feedback (on a variety of behaviors related to professionalism, interpersonal and communication skills, leadership, and teamwork). It highlights their strengths, weaknesses, and any improvement opportunities that would benefit the participant. Residents participate in this survey partway through their PGY3 FM/EM year. The PULSE Survey and feedback process is meant to help individuals and departments gain awareness of how they are perceived by others in the workplace in order to foster more effective professionalism, interpersonal communication, leadership development, and teamwork. Specifically, the PULSE Survey can assist participants in developing workplace-appropriate interpersonal behavior, teamwork, and leadership skills by identifying behaviors that others perceive as strengths, as well as patterns that may need improvement.
Academics
Academic Rounds
Academic teaching is provided in weekly half-day rounds. The year is divided into thirteen, four-week blocks, each with a specified theme (e.g. Acute Coronary Syndromes, Toxicology, Urology, Trauma, etc.). Each topic is explored using a problem-based, small-group learning format. The emphasis is on advanced management skills and evidence-based practice. Residents participate in the PGY3 FM/EM Academic Half Day (AHD) on all rotations using online communications technology. There is also a Journal Club held once each block, to review developments in the EM literature and help develop critical appraisal skills and practice statistics calculations.
Research Project
Residents are expected to complete a small research project during the year, for presentation at Research Day in Block 12. Options include chart audits, surveys, practice guideline development or implementation, etc.. Educational and statistical support is provided for this endeavor.
Educational Resources
The hospitals have a variety of clinical and educational software, and the major information sources relevant to Emergency Medicine. Residents also have access to the Northern Ontario Health Information Network library system.
