Infectious Diseases

The division is fully accredited by the Royal College of Physicians and Surgeons of Canada as a training program in Paediatric Infectious Diseases and is one of the oldest and largest training programs in Canada. The members of the division are actively involved in teaching at undergraduate, graduate and post-graduate levels at U of T.

One area of research focuses on HIV, including mother-to-child transmission, antiretroviral toxicities in pregnancy, antiretroviral therapies and the application of viral load and genotype testing to clinical management. Other areas include EBV and CMV infections in transplant patients, etiology of encephalitis, infections in Day Care, care of immigrant pregnant women and rotavirus infections.

The Division of Infectious Diseases provides a Consultation Service to all divisions and departments in the hospital providing evaluation and management advice on infections, infectious diseases, and infection prevention and control. A major area of involvement the immunocompromised host, particularly those with malignancies, transplants and HIV. Outpatient care is mainly focused on tuberculosis, HIV, congenital infections, and follow-up of osteomyelitis.

Visit sickkids.ca to read more about the Division of Infectious Diseases.

The Paediatric Infectious Diseases (ID) training program at the Hospital for Sick Children, University of Toronto offers exceptional depth and breadth of clinical experience for trainees at a variety of learning levels.

The hospital provides services that are considered among the top in North America. With as many as 30,000 children entering our region yearly from abroad we see a wide variety of consults. The ID service runs busy tuberculosis, HIV, congenital infection, travel, and general ID outpatient clinics. The ID consult service sees on average 110 consults each month. The many diverse clinical areas to which the ID team provides consultation services include one of the largest paediatric critical care units in the world, among the largest paediatric solid organ transplant centres in North America, the largest paediatric ophthalmology service in North America, as well as a busy and active general paediatrics and complex care program, oncology and stem cell transplant program, cystic fibrosis clinic, sickle cell program, neonatal intensive care unit, and virtually all other paediatric subspecialties. In addition, the training program has a strong relationship with microbiology and its in-house bacteriology, virology,  and molecular labs.

Objectives

The overall goals of our residency program are to provide exemplary pediatric ID training, which is firmly grounded in excellent patient care, and which leads to a variety of career paths (academic, community, public health), by tapping into the many valuable resources available at the Hospital for Sick Children and the University of Toronto.

The ‘exemplary paediatric ID training’ will ensure that our graduates are proficient in all CanMEDS roles, namely:

  • Medical Expert
    • Our graduates will demonstrate and will maintain expertise in the prevention, investigation, diagnosis, and management of human illness caused by any infectious agent. This expertise will be built upon a strong grounding in the practice of Pediatrics. It will include the theoretical basis of the subspecialty and the skill of the clinical exam and clinical reasoning.
  • Communicator
    • Our graduates will practice clear and sensitive communication as well as empathic and effective listening when interacting with patients, families, colleagues, learners, and the public.
  • Collaborator
    • Our graduates will work effectively and respectfully in a health care team in order to achieve optimal patient care.
  • Leader
    • Our graduates will exemplify strong and emotionally intelligent leadership and management skills in all domains of their practice including clinical work, quality improvement, resource management, education and research.
  • Scholar
    • Our graduates will demonstrate a lifelong commitment to reflective learning, teaching and the creation, dissemination, application and translation of medical knowledge.
  • Advocate
    • Our graduates will identify and act upon opportunities for advocacy, health promotion, and disease prevention to the individuals and communities to whom they provide care.
  • Professional
    • Our graduates will demonstrate a commitment to ethical practice, high personal standards of behavior, and physician health and wellness.

Training Sites

  • Hospital for Sick Children
  • Toronto Public Health
  • Public Health Ontario Laboratory
  • University Health Network of Hospitals
  • St. Michael's Hospital
  • Sunnybrook Health Sciences Centre
  • Mt. Sinai Hospital

Program Content

Subspecialty Residency Program

Our program is designed to meet all Royal College of Physicians and Surgeons of Canada (RCPSC) requirements for subspecialty training in Paediatric Infectious Diseases. This includes:

  • 11 blocks of Paediatric ID consult service (divided between the general ID and the immunocompromised ID consult services)
  • 2 blocks of adult ID consult service
  • 1.5 blocks of infection control
  • 1.5 blocks of antibiotic stewardship
  • 3 blocks of microbiology
  • 1 block of public health
  • 4 elective blocks.

The trainees also attend a half-day clinic per week. In the first year this longitudinal clinic experience includes experiences in the congenital infection clinic, autoinflammatory clinic, HIV clinic, tuberculosis clinic, and general ID clinic. In their 2nd year, trainees attend their own individual continuity clinic.

There is a structured formal paediatric ID academic curriculum that includes on average three hours of protected teaching per week. In addition to strong teaching while on the microbiology rotations, a structured year-long plate rounds series also occurs.

Other formal teaching includes the week-long annual National ID fellows’ retreat for which all of our fellows are given protected time to attend.

Clinical Fellowship Program (International Fellowship Applicants)

In addition to the RCPSC stream of our training program, we offer a two-year clinical fellowship for international trainees who plan to further develop the field of paediatric infectious diseases upon return to their home countries. The rotations and curriculum for this two-year fellowship program are similar to what is described above for the RCPSC subspecialty residency program.

Funding support generally involves sponsorship from the applicant’s home institution or government; however, there are also limited locally funded positions.

Research Experience

  • The program has a designated ‘Resident Research Coordinator’ (RRC) who meets with each Resident individually at the start of their training program in order to introduce them to potential scholarship projects and supervisors. The RRC then meets again with each Resident every 6 months to monitor their progress on their scholarship project.
  • There is a significant amount of faculty driven research and scholarship in the Division in which the Residents may become involved.
  • As part of their mandatory Antimicrobial Stewardship rotation, each Resident participates in a quality improvement project.
  • There is a session on ‘Introduction to Research in Fellowship’ in the Resident’s academic curriculum that is repeated annually.
  • There is a monthly divisional ‘Research Forum’ that all Residents attend
  • All Residents are given protected time to attend the Department of Pediatrics Research Day annually. They are encouraged to submit an abstract to this day in their second year of the program.
  • All Residents are given 7 days conference leave per year during which they may attend national or international ID conferences.

Evaluation

Trainees are assessed in a number of ways:

ITERs

ITER’s (in-training evaluation reports) are completed by various rotation supervisors during the year (e.g. approximately after each rotation). 

FITER

For those planning to take the Royal College exam, there is also a final ITER (aka FITER). This FITER is completed by consensus at the Progress and Promotions committee meeting near the end of the two-year training period.

PRACTICE EXAM

There is a minimum of one practice written test each year.

OTHER EVALUATIONS

e.g. Case rounds presentation evaluation, clinic letter assessment, research ethics training self-evaluation, RRC (resident research coordinator) semi-annual report, CanMEDS self-assessment, managing energy self-assessment and assignment, leader and collaborator reflective pieces, public health rotation portfolio etc.

PROGRESS AND PROMOTIONS REPORT

Twice a year, the Progress and Promotions committee meets to review each trainee's assessments and progress in the program to date. The Progress and Promotions committee is made up of all the ID staff in the Division. Feedback from this meeting is brought back to each individual trainee by the program director at the semi-annual program director meeting.

Ways To Get Involved

Trainees in the program have the opportunity to join a variety of committees including:

  • Residency Training Program Committee
  • Division's Ambulatory and Clinical Care Council
  • The Hospital's Antimicrobial Advisory Group
  • The Hospital's Drugs and Therapeutics Committee.

Additional Educational Opportunities

In addition to the protected academic curriculum, the trainees have the opportunity to attend weekly Citywide Infectious Diseases/Medical Microbiology rounds, Department of Pediatrics Grand rounds, Weekly Divisional Clinical Care rounds, and Monthly Morbidity and Mortality rounds.

Applying to the Program

Subspecialty Residents apply through CaRMs.

Clinical Fellows apply directly to the program through the online application available on the SickKids Website.

Elective Opportunities

Medical student electives are accepted to the program if the elective is between three to six weeks in length. The trainee must be in their clerkship year (year three or four of training) and have completed their core paediatrics or core internal medicine rotation.

University of Toronto MD Students

Please visit the electives website for information on how to apply.

Visiting Medical Students

The University of Toronto Visiting International Electives Program offers elective placements between January to June ONLY for a maximum of four weeks. Electives are not offered to students from international medical schools between the months of July and December.

For more information on how to apply for an international medical school elective, please visit our website.

Resident Electives

Resident electives are available throughout the year if the elective is a minimum of three weeks in length. Please email id.trainingprogram@sickkids.ca to confirm that the elective time you are requesting is available prior to completing the application process.

Please visit the University of Toronto website for information on how to apply.

International Electives

Documents must be submitted at least 8 months in advance. Please email a PDF file with the required documents to the Education Coordinator at id.trainingprogram@sickkids.ca. See the SickKids website for a list of required documents.
 

Observership Opportunities

The Division of Infectious Diseases accepts observers on occasion. We accept international medical observers for a minimum of 2 weeks to a maximum of 12 weeks when space is available. To submit your request please see the International Medical Observer Application page on the SickKids International website.

An observer is a temporary, unfunded appointment which does not allow direct patient contact.  For a ‘hands-on’ patient care education experience, please refer to information for ‘electives’ above. Observers will not receive educational credit or certification from SickKids for time spent observing. An observer is not considered an employee of SickKids for any purpose and therefore is not entitled to salary, benefits, reimbursement of expenses or other forms of compensation. Observers at SickKids are not covered under the Workplace Safety and Insurance Board (WSIB) and are not covered under the hospital's liability insurance. Observers release the hospital and its affiliates from any responsibility or liability for personal injury, and/or damage to, or loss of property.

Contact

Training Program Director

Valerie Waters
416-813-6273
valerie.waters@sickkids.ca

Education Administrative Coordinator

Dana Hiraldo Santos
416-813-6273
dana.hiraldo-santos@sickkids.ca