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1 MONTREAL CHILDREN’S HOSPITAL RESIDENT SURVIVAL GUIDE 2010-2011 Brought to you

1 MONTREAL CHILDREN’S HOSPITAL RESIDENT SURVIVAL GUIDE 2010-2011 Brought to you by: THE RESIDENTS’ WELLNESS COMMITTEE 2 TABLE OF CONTENTS: General information ………………………………….. The Curriculum ……………………………………….. Being on Call ………………………………………….. Vacation and Conference Leave ……………………. Electives ……………………………………………….. What to Study …………………………………………. Exams to Write ………………………………………... Fellowship Applications ………………………………. Getting Involved ………………………………………. Wellness Resources ………………………………….. Helpful Tips from the Seniors ……………………….. Keeping track of your patients on OACIS…………... How to use Crescendo dictation system……………. Important Contacts …………………………………… 3 8 11 16 17 18 19 23 27 28 29 34 35 36 3 GENERAL INFORMATION Description of the program The McGill University Pediatric Residency Training program is fully accredited by the Royal College of Physicians and Surgeons of Canada, Le Collège des médecins du Québec, and complies to the requirements for admission of candidates to the certification process of the American Board of Pediatrics. Our program provides full training in pediatrics, as outlined in the Objectives of Training and Specialty Training Requirements (see information by specialty http://rcpsc.medical.org/residency/accreditation/ssas/peds_e.html/ in English and http://crmcc.medical.org/residency/accreditation/ssas/peds_f.html/ in French). Note also that all rotations have rotation specific educational objectives of training. There are no mandatory inter-university affiliations in the McGill University Residency Training Program in Pediatrics. However, given the fact that this is the only city in Canada with two great pediatric programs, residents are encouraged to take advantage of the training opportunities available at Hôpital Ste Justine (and vice-versa), should this be feasible and if they are functional in French. Training overview Residents normally enter training in pediatrics directly from medical school. International Graduates (from the Gulf States) normally have at least one year of training in pediatrics in their home country prior to entry into the program (this time is not counted towards their training in Canada). Training is divided into 3 core years of pediatrics, undertaken by all trainees, including those that will go on to specialize in one of the pediatric subspecialties, and those that will continue to train in the 2 advanced years of general pediatrics. Trainees in the fourth year either continue on in pediatrics in one of three advanced training streams: Academic Pediatrics, Consultant Pediatrics or Social Pediatrics or a join one of the different pediatrics specialty program. There is significant crossover between the skill sets and training in the advanced years of pediatrics but training is significantly individualized and adapted to the trainee’s own career goals. The three core years of training aim to give trainees a solid foundation in the breadth of pediatrics, including adequate exposure to general pediatrics, acute care pediatrics (NICU, PICU, and ER), subspecialties, and longitudinal care. The first year of training is mostly devoted to provide exposure to general pediatrics. Residents acquire major experience to inpatient pediatrics, and rapidly become comfortable with acute care neonatology. They also get exposure to the care of the critically ill child through the pediatric intensive care and Emergency medicine rotations. Outpatient exposures include adolescent medicine, home care, developmental pediatrics, and community pediatrics. A pediatric surgery rotation rounds out the breadth of experiences for the first year. The general philosophy of the programming of this year is to have residents gain rapid comfort in the assessment and preliminary treatment of the ill child in preparation for the significant autonomous functioning that occurs starting in the 4 second year with the nightfloat rotation. The second year of training continues with increased graded responsibility in the areas described above, but with significant elective time. For the elective time, priority is given to candidates’ career choices, as this is the time when most will need to make decisions about fellowship programs for their fourth and fifth years. The nightfloat rotation (night duty on the general pediatrics wards) represents the first major rotation where residents’ capacity for autonomous function is challenged. The general philosophy of the programming of this year is to provide subspecialty electives to aid the resident in career planning and to develop and exercise skills in autonomous function. The third year of training includes three months as the senior on the general inpatient Clinical Teaching Units (CTUs). This experience could be characterized as the apex of the three core years of training. Residents function as the team leader for a diverse group of residents and students, under the tutelage of a staff physician, and consolidate their judgment, leadership, and teaching skills. In all of the environments where they rotate, the graded responsibility is appropriately increased to reflect their more senior level. The general philosophy of the programming of this year is to develop skills in executive function (leadership, decision making), teaching (and important part of the specialist’s job), and excellence in clinical care. The fourth and fifth year Academic Pediatrics program is aimed at creating the pediatric hospitalist with the skill set necessary for practice in the academic environment. As such it includes exposures to innovative clinical environments (Ambulatory Care, Outreach, and Clinical Teaching Units), and in addition, residents are expected to undertake major scholarly work, possibly including advanced degrees. The three academic areas identified where scholarly work can be undertaken are clinical or basic research, medical education, and health administration. The program is set up such that residents must choose one “major” and two “minors” in each of these three areas. The fourth and fifth year Consultant Pediatrics program is aimed at creating the consultant paediatrician in a non-university centre. As such it includes significant exposures to round out residents’ exposure to the breadth of pediatric problems, including acute care pediatrics and neonatology. It is also possible for a resident to spend time in a “minispecialization” block, where, for instance, they may develop some advanced knowledge in one subspecialty area if they will practice with a particular interest in that area. Last, the fourth and fifth year Social Pediatrics program is offered for candidates wishing to develop a clinical and scholarly career focused on practicing within socially disadvantaged patients and their communities. The fourth and fifth year programs for each stream are designed to be sufficiently flexible to tailor the program to the candidate’s individual needs. The continuity clinics run throughout the residency in pediatrics and continue into the advanced years of training for residents who continue in one of the 5 Advanced Pediatrics Training streams. As per Quebec governmental requirements, there are three mandatory months of rotations in non-university centers in the three core years of training. One of those months is the social pediatrics rotation, which is not rural, but includes exposures to pediatrics in various disadvantaged populations (homeless, multigenerational poverty, youth protection etc.) around Montreal. The other two months are completed in two of 4 rural sites (Gatineau, Ste-Hyacinthe, Val d’Or, or Iqaluit). Residents in the Advanced Pediatrics streams may undertake further training in rural non-university sites. The program views these exposures as an important part of training in that they help to provide perspective and exposure to another very important type of pediatric practice. Increasing Professional Responsibility Graded responsibility is provided in all of the key CTU areas of the program, which are discussed separately below: General In-patient Pediatrics: Junior residents have a clearly defined role as team members on the wards. They follow their own patients, and as they gain experience, begin assuming a teaching and reviewing role with the medical students. They are never on call alone on the general inpatient wards. PGYII residents have their first taste of significant autonomous function during their nightfloat rotation. The senior residents (PGYIII) consolidate their leadership and team management skills during their CTU months. Finally, for residents in the Advanced Academic Pediatrics streams there is a junior attending rotation where residents function in a quasi-attending role with a clinical supervisor available for back up. Each of these roles has a set of specific educational objectives. Medical Emergency: Similar to the general inpatient wards, there is a progression in roles with specific teaching as well for junior and senior residents in the emergency room. As their training increases, residents are expected to assume a greater responsibility for patient flow in the emergency room, as well as an aggressive involvement in the critical cases. There are specific objectives for the different levels of core pediatrics trainees. The advanced trainees function as junior attendings in the ER, with staff back up. Neonatology: As residents progress through neonatology rotations they are expected to take on a greater supervisory role over the medical students and short cycle residents. Residents rotate through neonatology in each of the 3 core years have a substantial change in role at these different times. PICU: Due to the nature of the work in PICU the rotations in the PGYI and PGYII year involve increasing consolidation of knowledge, and thus graded responsibility based upon this, but residents do not function as team leaders in general in the PICU given the complexity of the patients there. 6 Environment for Teaching and Learning The McGill University Pediatric Residency Program applies the standards set forth in the American Association of Medical Colleges Residents’ Compact in assuring the highest possible standards for uploads/Voyage/ survival-guide.pdf