Paediatric Emergency Medicine

The Division of Paediatric Emergency Medicine (PEM) continues to be a world leader in the emergent care of acutely ill and injured children.  Recognized as one of the pioneering institutions of pediatric emergency medicine, we continue that tradition of innovation through our state-of-the-art education, quality, safety, and research initiatives.  Our robust training program is responsible for developing both domestic and international specialists in paediatric emergency medicine, in addition to offering unique advanced specializations in point-of-care ultrasound, medical-simulation, trauma, disaster medicine, and research.  Our groundbreaking work in the areas of point-of-care ultrasound, team-training, and competency-based learning has changed global practice.  Now with 74,000 patient visits annually to our Department and increasing complexity in our patient population, we are refocused on ensuring the highest standard of acute care is reliably delivered. 

In 2015-2016, our PEM faculty were again recognized for outstanding academic accomplishments in leadership, education, quality practice and research. Dr. Suzanne Schneeweiss was appointed the Associate Dean of Continuing Professional Development at the University of Toronto, Faculty of Medicine. Dr. Yaron Finkelstein was inducted as a Fellow by the American College of Medical Toxicology in recognition of his expertise and leadership in medical toxicology. Drs. Charisse Kwan and Mark Tessaro made multiple media appearances across the country to share their pioneering work in point-of-care ultrasound. Drs. Tania Principi, Suzanne Schuh and Kathy Boutis received international acclaim for research challenging the established management of bronchiolitis and dehydration.

Our clinical and academic efforts continue in 2016-17 with exciting work already started on patient safety, led by our quality practice team of Drs. Tania Principi, Olivia Ostrow and Deborah Schonfeld. Competency based training, led by our medical simulation team of Drs. Jonathan Pirie and Laura Simone, and physician wellness, led by Dr. Anna Kempinska.

Visit to read more about the Division of Paediatric Emergency Medicine.

Our Emergency Department (ED), is by far one of the busiest paediatric emergency departments in Canada with approximately 200-300 visits per day.  Approximately 82,000 children and their families will visit the ED each year with various needs. Regardless of the reason for these visits, we strive to provide courteous and efficient care at all times.  We are the primary care paediatric hospital for the downtown core of Toronto and the tertiary paediatric referral centre for the Greater Toronto Area. We are also the paediatric trauma centre for Toronto and the Greater Toronto Area with approximately 200 major trauma cases managed per year in our ED. Our team of highly trained and experienced staff deal with a wide spectrum of illnesses, injuries and traumas. Our ability to promptly respond to these children comes from our strong commitment to clinical excellence, education and research.

To ensure that the sickest patients are seen first, we use a two-tiered triage system.  T1 quickly identifies children who are ill and require more urgent assessment. T2 encompasses the completion of a focused history and physical exam by an experienced nurse who assigns of one of five P-CTAS scores (Paediatric Canadian Triage Acuity System). 


The Paediatric Emergency Medicine Residency and Fellowship Training Programs at The Hospital For Sick Children (SickKids), University of Toronto is a fully accredited program with the Royal College of Physicians and Surgeons of Canada. Our program is designed to produce experts in the field of Paediatric Emergency Medicine. Residents benefit from the rich teaching that is provided and the wealth of pathology seen in our division. As one of the largest training programs in Canada, our residents benefit from the large number of trained faculty who are enthusiastic mentors. Our program has been designed to meet all objectives of the Royal College and to produce confident well-rounded physicians who will become leaders in this field.

Training Sites

Hospital for Sick Children, St. Michael's Hospital, as well as national and local hospitals for electives.

Research Experience

The PEM program has a Research Director who facilitates a research curriculum for residents, coordinates residents with staff depending on research interests, and monitors the progress of projects. She runs resident research rounds, mentors residents in project presentation, and helps facilitate the PEM national research conference.                                                                                

The Research Director matches residents with PEM staff, based on research methodology and subject area. Residents meet with staff throughout the year to discuss their project plans and progress. There is a significant amount of faculty-driven research that residents can become involved in; and faculty that is available for mentorship.

In the last two years, a “research boot camp” course has been made available to residents in the first quarter of their first year. This course covers all research topics and provides a statistician to help residents move their project forward. This course was implemented after feedback from the resident group, asking for a more robust research curriculum earlier in their training to allow residents exposure to multiple research modalities, and to help them develop their research projects earlier, therefore, ensuring they have ample time to finish their work upon completion of their training.


Residents and fellows are evaluated at the end of each shift based on the CanMEDS roles. A cumulative report is provided to the Program Director (PD) at the end of each rotation and the information is entered into POWER. There are also examinations that are organized to provide formative assessment and suggest areas for further improvement. These include the OSCE examination and the American Board of Pediatrics In-Training Examination, which are both held on an annual basis. With the launch of Competency by Design (CBD), the PD and the newly formed Competence Committee will review each trainee on a regular basis. A faculty advisor will provide feedback to the trainee following these meetings to ensure they progress appropriately through the program.

Ways To Get Involved

Residents and Fellows are encouraged to participate in a variety of leadership activities throughout their training. Both residents and fellows have standing representation on the Residency Program Committee.

Additional Educational Opportunities

The academic program includes a protected academic half-day program with a rotating curriculum over 2 years. Our academic rounds collaborate with multiple specialities for our Interdisciplinary Rounds including plastic surgery, dermatology, ophthalmology, cardiology, dentistry, urology, and others. Our department also has joint ER/Radiology rounds which discuss and interpret ED specific radiology cases, Interdisciplinary Trauma Teaching rounds together with General Surgery, and monthly Morbidity and Mortality rounds where residents work with multiple specialities to review clinical cases. In the simulation curriculum, residents also work with both Adult Emergency Medicine (EM) and Paediatric resident colleagues in both resuscitation and procedure-based courses (Pediatric EM Simulation Course, Acute Care Resuscitation Course/ARCP, and Paediatric Emergency Procedures Course/PEPC; during these courses, our residents have the opportunity to teach and facilitate EM and Paediatric residents during multiple simulation scenarios. We also host an annual PEM Conference in the fall that involves key not speakers, breakout sessions, and hands-on case-based workshops.

Applying To The Program

Our division has two training programs.  To be eligible for these opportunities, all candidates must be enrolled in, or have completed a residency program in either Paediatrics or Emergency Medicine. The Royal College Accredited Program is open to trainees who are enrolled in programs recognized by the RCPSC and are fulfilling the requirements for primary discipline certification or for certification of special competence.

The Clinical Fellowship Program (non-RCSPC accredited) provides an opportunity for specific training in Paediatric Emergency Medicine to candidates whose medical training was completed outside of North America. In order to apply, they must have a speciality certification in Paediatrics from their country of training. Although the training is non-RCSPSC accredited, it will be comparable to trainees at a similar level in our institution.  A certificate of completion will be provided at the end of the training period.

For more details and how to apply, visit our website.

Elective Opportunities

We provide rotations in paediatric emergency medicine for medical students, residents and fellows in active clinical training programs.

For Postgraduate and Undergraduate electives, visit here.

For any additional information please contact us directly at:


Training Co-Program Directors

Dr. Iwona Baran

Phone: 416-813-7257

Dr. Laura Simone

Phone: 416-813-7257