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Core Paediatric Residency Program
Overview
The University of Toronto’s Core Paediatric Resident Program is dedicated to providing excellence in patient care, education, and scientific investigation. Similarly, it is hoped that all trainees will emerge from the program with first-class clinical skills, the ability and desire to continue to learn throughout their career, and the ability to ask appropriate questions and contribute to understanding and knowledge in their field of interest.
Objectives
- To provide broad-based clinical and academic training in paediatrics with the goal of creating the foundation required for the academically rigorous practice of general and subspecialty paediatrics
- To focus on clinical experiences of a secondary and tertiary nature in general and subspecialty paediatrics as seen in both a large academic health science centre for children and in community practice.
- To ensure training in critical appraisal, research methodology, and the application of evidence-based medicine to practice.
- To emphasize the development of teaching and research skills.
- To provide graded responsibility in the acquisition of leadership skills.
- To fulfil all the objectives of specialty training required in Paediatrics by the Royal College of Physicians and Surgeons of Canada including the seven CanMeds roles.
- To provide an environment which is rich in diversity and inclusion in addition to mentorship and experience which will allow each resident to achieve the goals outlined above.
Training Sites
- Centre for Addiction and Mental Health - CAMH (Mental Health)
- Holland Bloorview Kids Rehabilitation (Developmental and Rehabilitation Paediatrics)
- Michael Garron Hospital (Community Paediatrics)
- Mount Sinai Hospital (Level III Nursery)
- North York General Hospital (Community Paediatrics)
- Orillia Soldier's Memorial Hospital (Rural Community Paediatrics)
- Owen Sound Regional Hospital (Rural Community Paediatrics)
- Royal Victoria Regional Health (Rural Community Paediatrics)
- SickKids Centre for Mental Health
- St. Joseph's Health Centre (Community Paediatrics)
- St. Michael's Hospital (Community Paediatrics, Level I/II Nursery)
- Sunnybrook Health Sciences Centre (Level III Nursery)
- The Hospital for Sick Children
In addition, there are over 100 community paediatricians on staff who participate in teaching, and in a growing network of regional community pediatric centres closely affiliated with The Hospital for Sick Children.
Program Content
This residency program is for 4 years.
Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.
The core curriculum meets the Royal College of Physicians and Surgeons of Canada standards for accreditation in paediatrics. The Competence By Design (CBD) curriculum officially launched for all residents beginning their training after July 2021. The 4 stages of CBD are mapped over 4 years, after which residents can choose to apply to a subspecialty.
The program's specific objectives are as follows:
- To provide broad-based clinical and academic training in paediatrics with the goal of creating the foundation required for the academically rigorous practice of general consulting and subspecialty paediatrics.
- To focus on clinical experiences of a secondary and tertiary nature in general consulting and subspecialty paediatrics as seen in both a large academic health science centre for children and in community practice.
- To ensure training in critical appraisal, research methodology, and the application of evidence-based medicine into practice.
- To ensure training in and exposure to the issues of Child Advocacy, Patient Safety/Quality and Child Health Policy.
- To emphasize the development of teaching and research skills.
- To provide graded responsibility and the acquisition of leadership skills.
- To ensure acquisition of all the Paediatric Competencies clearly laid out in the CBD curriculum (RCPSC 2021), in the context of the seven CanMEDS roles.
- To provide a diverse and inclusive environment with mentorship and experience that will allow each resident to achieve the goals outlined above, and where everyone belongs.
Since July 1, 2008 all University of Toronto Residents entering PGY1 are required to complete the web based PGCorED* core competency modules as part of their residency program certification. These modules provide the foundation for non-clinical roles for the RCPSC and CFPC Programs. These modules are focused for PGY1 and PGY2 trainees. Failure to complete the modules will delay processing of Final In-Training Evaluation Reports (FITERs) and may constitute professional misconduct.
PGY-1
Transition to Discipline Stage (TTD) and Foundation of Discipline (FOD) Stage
This year is designed to provide the foundation for paediatric residency and will include rotations of Adolescent Medicine, Care of the Newborn, Community Paediatrics, Paediatric Emergency, Paediatric Infectious Disease, Immunology/Allergy and Dermatology, General Paediatrics, Paediatric General Surgery, Paediatric Urology and Research.
There is a mixed model of night float and 24-hour call for the PGY1 year.
PGY-2
Early Core of Discipline (COD)
This year is designed to provide paediatric subspecialty experience in Paediatric Cardiology, DevelopmentalPaediatrics, Endocrinology, Gastroenterology/Clinical Nutrition, Oncology, Nephrology, Neurology, Respirology, Rheumatology, and Neonatal Intensive Care.
There is a four-week elective opportunity which may be taken outside Toronto, nationally or internationally and there are 2 blocks while residents have the opportunity to complete either elective or research.
A night float system for call is in place for the PGY2 year.
PGY-3
Late Core of Discipline (COD)
This year provides graded responsibility and supervisory experiences in a Clinical Teaching Unit (CTU) setting on the General Paediatric Unit, Paediatrics Emergency, Neonatal-perinatal Medicine (Level III), Neonatal Medicine (Level II - community), Genetics-Metabolics, Suspected Child Abuse and Neglect, Mental Health, an Ambulatory experience and Pediatric Intensive Care. In addition, there are experiences in the emergency management and resuscitation of acutely unwell patients through leadership of the "Code Blue Team".
There is a four-week elective opportunity which may be taken outside Toronto, nationally or internationally, and there are 2 blocks while residents have the opportunity to complete either elective or research.
A night float system was implemented in 2023 for general paediatric call in PGY3.
PGY-4
Core of Discipline (COD) and Transition to Practice (TTP)
At the beginning of PGY4 residents will complete their late COD stage and then enter into their TTP stage. The TTP curriculum (approximately 9 blocks) allows residents to meet their advanced academic goals, provide clinical care independently, act in the role of a junior attending and to develop leadership skills. Emphasis is placed on Community Paediatric rotations as well as rotations that have been specifically developed for the TTP stage in order to meet the needs of a practicing Consultant Paediatrician.
Program Highlights
The Paediatric Residency Program at the University of Toronto thrives on a diverse patient population, excellent resources, and an outstanding teaching faculty. The Core Paediatric Residency Training Program is a priority for the Department of Paediatrics, and as such, an outstanding learning environment exists. The program is diverse and inclusive, fostering a welcoming environment where everyone belongs.
A career counselling program is in place, resident retreats are organized on a yearly basis, and social functions including a baseball game, holiday party, and many other activities arranged by the resident engagement committee ensure an excellent spirit of camaraderie. In addition, a wellness committee run by residents with faculty support ensures a proactive approach to the health and well-being of our residents, building skills and resilience.
The Hospital for Sick Children provides primary, secondary and tertiary care to the local community and tertiary and quaternary level care to the rest of Ontario and beyond when required. There is a very busy emergency room and general paediatric unit where common paediatric problems are seen in large numbers. In addition, all paediatric subspecialties exist at The Hospital for Sick Children which ensure exceptional patient volume and variety. The Atrium tower provides spacious modern facilities for a family-centred-care approach to our paediatric patients. Residents have access to electronic medical resources. While much of the residency training is spent at The Hospital for Sick Children, residents also have the opportunity to gain invaluable experience at a growing number of our community affiliates. Additionally, the new Patient Support Center provides residents state-of-the-art simulation opportunities and a centralized workspace for all staff and learners.
Advocacy and social responsibility are core values of the Department of Paediatrics and are emphasized in the Residency Training Program. The program has a well-integrated advocacy program, run by residents with faculty oversight. Social Paediatrics is emphasized and taught throughout the program, appropriately layered throughout the academic curriculum, as part of everything we do. Child Health Policy and Patient Safety are also woven into the curriculum through teaching and clinical experiences.
Experiences in Global Child Health have become an integral part of the training program. Many residents take part in international electives, research and local courses pertaining to issues affecting global health. Oversight of international electives exists (both within the program and through the University of Toronto) to ensure our trainees are fully supported with their international endeavours.
Residents in the program have an opportunity to participate in teaching activities, both formal and informal, scholarly projects, advocacy, committee work, leadership roles, curriculum development and resident selection.
Research Experience
Unique elements of C-SIP
The University of Toronto Department of Paediatrics is a world leader in basic and clinical research and is dedicated to the training of the next generation of clinician-scientists. To meet the unique needs and challenges of the clinician-scientist trainee, the Department has created the C-SIP (Clinician-Scientist Investigator Program) stream as part of its core residency program. This highly competitive program is designed for one trainee per year, and includes an individually tailored residency program, individualized research mentorship, and dedicated support for a longitudinal research project.
The uniquely designed program fosters critical training in a combined clinician-scientist career and is thus targeted to individuals planning a significant component of research within their future career in pediatrics. The program includes a personalized approach to clinical training that creates opportunities for substantial longitudinal research experience(s) while also fulfilling the Royal College of Physicians and Surgeons requirements for certification in Paediatrics - While contingent on meeting the programs established competencies - The successful candidate will work with the program director to create a bespoke schedule that will allow for approximately 12 months worth of research time within the mandatory 4-year residency. The program also includes dedicated mentorship (under the guidance of the program director), access to training opportunities through the Research Training Centre at the Research Institute at the Hospital for Sick Children, and access to support for resident research projects.
Evaluation
The Paediatric Training Program has a robust system of assessment.
As per the Competence by Design Curriculum, the program has a Competence Committee made up of departmental faculty, who review each resident’s progress twice a year. This committee does in-depth reviews to make these progress decisions, reviewing all assessment data available. Some examples of this assessment data include:
- The PGY1, PGY2 and PGY3 paediatric residents are required to write the In-Training Examination of the American Board of Pediatrics at the beginning of each academic year. The feedback from this examination provides candidates with an assessment of their knowledge compared with individuals at the same level of training, and with information on areas of strength and weakness. Changes in the absolute score from one year to the next are informative. The exam is also helpful in pointing out problems that may exist in the teaching program.
- Twice a year MCQ and SAQ examinations are administered during the academic half-day. Residents receive feedback as to where they performed as compared to peer norms.
- Once a year residents participate in a 10 station OSCE. Residents receive feedback as to where they performed as compared to peer norms.
- Electronic In-Training Assessment Report (ITAR) are automatically sent to the supervisor near the end of each rotation. After the supervisor completes the electronic evaluation form, it is forwarded to the trainees who will review and sign it on-line. Staff are expected to discuss the evaluations with the trainees face to face before completing them.
- Clinical skills assessments are done at least twice a year for all residents and are a mandatory part of the program. During these sessions, residents do a complete history and physical examination while being observed by a faculty member, and subsequently, discuss their approach to the problem. The faculty member completes a written evaluation of this process, and feedback is provided to the trainee.
- Work-Based Assessments – the backbone of the CBD assessment strategy are work-based assessments. These assessments are authentic, real-time assessments done in the clinical environment when working directly with patients and a supervisor. These assessments are required in order to progress towards achieving the Entrustable Professional Activities (EPAs), required throughout each stage of the program.
Evaluation works both ways, and residents are asked to evaluate each rotation and each clinical teacher. In addition, members of the Postgraduate Residency Program Committee support reviews of each rotation through Resident Retreat Reports annually. This information has an important role in the implementation of changes/improvements in the program.
Ways To Get Involved
Learners can get involved in the following resident committees and/or initiatives in our program:
Residency Program Committee (RPC)
The dynamic and effective RPC of the core Paediatric Residency Training Program, collaborates with the PD (Program Director) in planning, organizing, evaluating and continuously improving the residency program. The RPC ensures that the program is designed on the backbone of the CanMEDs competencies related to the knowledge, skills and attitudes required to be a General Consulting Paediatrician. The RPC ensures that the residency program is designed to train paediatricians who can meet the needs of the paediatric population in society at large and at the community level. The RPC ensures that the program is meeting the general and discipline-specific accreditation standards and develops policies and processes that are consistent with the University of Toronto, Faculty of Medicine vision/ mission, policies and processes. In order to carry out its mission effectively, the RPC has 11 subcommittees who work on different aspects of the program and report directly to the PD and the RPC.
The PeRLS Subcommittee (Academic Half-Day committee)
Chaired by the PD and a faculty member and is made up of residents from PGY-1 to 3 and the chief residents. This committee is charged with the oversight of the AHD (Academic Half-Day) curriculum, responding to resident feedback, ensuring compliance with the RCPSC goals and objectives of training and planning the blueprint for the upcoming academic year.
Resident Research and Scholarship Subcommittee
The aim of the Resident Research and Scholarship Committee is to support and strengthen resident research and scholarship within the Core Paediatrics Training Program. This committee meets regularly with all residents in the program to provide support, advice and monitor progress of their scholarly activity. The committee meets regularly, and the Chair meets regularly with the PD.
CaRMS Subcommittee
Charged with monitoring, reviewing and designing the CaRMS process for prospective candidates applying to the University of Toronto Program. This committee is chaired by residents, and includes residents from all years in the program.
Resident Wellness Subcommittee
This subcommittee is chaired by senior residents with faculty oversight. This committee is made up of residents from multiple years in the program. The committee evaluates factors influencing the physical and mental wellbeing of paediatric residents during training with the goal of implementing strategies to enhance resident wellbeing. Projects will include, but are not limited to, formal education, curricular activities, mentorship, Balint groups, and advocating for systems-level change.
Advocacy Subcommittee
This committee is chaired by residents with faculty oversight. It oversees and supports a number of resident-led initiatives including the Paediatric Outreach Program (POP clinic for uninsured patients), Make Room to Read, Legislative Advocacy, as well as the Elementary and High-school outreach initiatives as some examples. The mandate of this committee is to aid in teaching the Health Advocate role, participate in advocacy initiatives, as well as engage in scholarly activity in the realm of advocacy. It is comprised of several subcommittees, each with a focus on a longitudinal advocacy project. The purpose of the Paediatric Resident Advocacy Committee is to:
- Provide leadership and organization: Provide templates for subcommittees to set tangible goals, meet with subcommittees semi-annually to track progress and provide resources as guidance to troubleshoot issues and concerns.
- Be accountable and credible to the University of Toronto Paediatric Resident Program as part of the advocacy curriculum: Provide detailed yearly reports to summarize the efforts of Paediatric residents in their individual advocacy projects.
- Oversee finances including budgets and funding applications
- Continue to engage residents to act as advocates for children and their families in the Greater Toronto Area
Resident Engagement Subcommittee
Comprised of 3-5 executive members. The mandate of the committee is to plan and execute events throughout the year that function to bring residents and staff together in an environment outside the workplace. Events in previous years have included the Year 1/2 mingler, the staff-resident softball game, the holiday event, the Annual Resident Spring Charity Formal and the resident end-of-year BBQ. In any residency, success is dependent upon the ability to form meaningful working relationships with your colleagues and staff. The Resident Engagement Committee creates a forum to help foster these connections, particularly in such a large residency program.
Equity, Diversity and Inclusion Committee (EDI)
This newly formed committee has a mandate to ensure that all aspects of the program are incorporating best practices in EDI into their work. The goal is to have EDI become entrenched as part of the “fabric” of who we are as a program and constantly challenge ourselves to do better. We are committed to a culture of EDI throughout all that we do in the program, and this committee will provide leadership in this area.
There are many more opportunities to get involved including PARO representatives, CPS, AAP, the Informatics Group, etc.
Additional Educational Opportunities
Each resident has 4 hours of protected time per week throughout their residency as part of Academic Half-Day. Additionally, first-year residents have an additional 4 hours of protected time per week for the first 3 blocks, focusing on curriculum specifically designed to equip them with the knowledge and skills for starting residency. This rich curriculum provides a wide variety of learning opportunities addressing all the CanMEDs roles. There are three to five additional hours per week of protected teaching time depending on the rotation. Paediatric and neonatal life support courses are taught during orientation and throughout the program. Financial support is available to support conference leave in each academic year.
Applying To The Program
Residency positions are available to Canadian citizens or landed immigrants of Canada who are in their final year of medical school in North America. Residency positions are also available to Canadian Citizens or landed immigrants of Canada who trained outside North American through the International Medical Graduate Stream (IMG). All applications are handled centrally by the Canadian Resident Matching Service (CaRMS), 51 Slater Street, Suite 1004, Ottawa, Ontario, K1P 5N1. For additional information on the eligibility requirements or to apply to the program visit the CaRMS website.
Postgraduate training agreements are currently in place between the University of Toronto Faculty of Medicine and sponsoring agencies from the following countries:
- Bahrain
- Kuwait
- Oman
- Qatar
- Saudi Arabia
- United Arab Emirates
Applications for residency training from citizens of these countries must reach the PGME Office directly from the sponsoring agency.
Fall Program Information Sessions: https://canprepp.ca/
Contact
Training Program Director
Dr. Kevin Weingarten
Phone: 416-813-5310 ext. 405310
Email: kevin.weingarten@sickkids.ca
Education Administrative Coordinator
Courtney Smart
Phone: 416-813-5310 ext. 405310
Email: paeds.residencyprogram@sickkids.ca
Education Administrative Coordinator
Mingming Zou
Phone: 416-813-7654 ext. 414845
Email: paeds.residencyprogram@sickkids.ca
Education Administrative Coordinator
Michelle Lee-Parker
Phone: 416-813-5295 ext. 405295
Email: paeds.residencyprogram@sickkids.ca