Undergraduate training opportunities
The Division of Emergency Medicine hosts all medical students at the University of Ottawa, Faculty of Medicine during their third year Pediatrics rotation. Each student completes six clinical shifts, where they work alongside a staff physician or senior fellow to assess and manage appropriate patients.
Students also complete three teaching shifts in which three to four students work with a staff member who is dedicated to teaching them during a four-hour block. They discuss interesting cases, review imaging, assess patients and practice procedural skills.
The division also hosts visiting medical students for elective clinical rotations in their third or fourth years. We do not accept observerships or clinical electives from students in earlier years or prior to medical school.
Postgraduate training program
The uOttawa Pediatric Emergency Fellowship Program began in 1988 as one of Canada’s first programs and continues to be a very important part of the mission of this division. This subspecialty has certification by the Royal College of Physicians and Surgeons (RCPSC) since 2001 and our program at the University of Ottawa received Royal College accreditation in November 2001. Subspecialty residents and fellows are eligible for certification by the Royal College after two years of training and successful completion of the new RCPSC PEM examination.
Training in the subspecialty consists of fulfilling the Royal College Subspecialty Committee requirements. This includes a core 13 rotation blocks in the Pediatric Emergency Medicine Department and two blocks of research. Other rotations include pediatric orthopedics, plastic surgery, anesthesia, PICU, radiology/ultrasound EMS, adult emergency, EMS and toxicology.
During their time in the pediatric emergency department, graduated responsibility is encouraged as the resident progresses through training. The resident will initially review all cases with the staff in the department.
As the resident’s experience and ability increases, he/she will be able to function fairly independently and will start supervising more junior trainees. By the end of the two years, he/she will be able to supervise trainees at all levels. This transition is done gradually at a pace acceptable to the resident and the program.
In this high volume centre, residents are given the opportunity to assess and manage patients presenting with a myriad of problems and will learn the importance of department flow and other administrative skills. They are given priority to manage patients presenting in extremis or following a trauma in the resuscitation room. Our residents are encouraged to become the primary physician caring for the patient under the supervision of the staff. Residents are also strongly encouraged to do a wide variety of procedures, initially under appropriate supervision, and gradually with increasing independence with a goal of becoming capable and competent consultants in pediatric emergency medicine. Although many of the procedural skills are taught by our core group of PEM trained staff physicians, training for orthopedics care and wound management also occurs in the off service rotations of pediatric orthopedics and plastic surgery. Airways skills are a core part of the pediatric anesthesia rotation. By the end of the two-year program, each trainee will be ED ultrasound certified by either the Canadian ED Ultrasound Society or hold University of Ottawa certification.
The academic program for the subspecialty training includes all formal education opportunities such as pediatric grand rounds and emergency rounds. At the beginning of the program, there is a summer seminar series that offers each resident/fellow a basic research course, debriefing techniques for simulation and a PEM-specific clinical review course. In addition, subspecialty residents and fellows benefit from a weekly seminar series, monthly journal scan rounds and monthly high fidelity in situ multi-disciplinary simulation sessions.
In order to successfully complete the requirements of the Pediatric Emergency Medicine Fellowship, all candidates must complete either a research or a scholarly project. All candidates will have an identified research advisor/mentor for their chosen topic to provide guidance for completion of the project through to publication if possible. All projects are discussed with the Director of Pediatric Emergency Research and the Program Director in order to encourage the best output for each resident/fellow.
Each trainee will be expected to present at ED rounds each year as well as at the Pediatric Emergency Research Canada meeting as part of their academic program. Teaching opportunities for our trainees include off-service resident simulation teaching sessions to learn to run the high definition simulation mannequins and master team debriefing techniques. Other teaching responsibilities include the medical student skill lab and the pediatric advanced life-support course.
Additional postgraduate training
The Division of Emergency Medicine provides medical education to postgraduate trainees at all levels of training, from various University of Ottawa residency programs, as well as from other provincial and national universities. Trainees come to CHEO for one to two blocks at a time or complete longitudinal rotations, working shifts over the course of the academic year.
Residents rotating through Pediatric Emergency Medicine are assigned to work approximately 14-16 shifts in a 4-week rotation block. Eight hour shifts are assigned to span day, evening and night time as typical of an ED schedule. Trainees have the opportunity to see and manage patients presenting with all types of medical, surgical and mental health complaints under the supervision of an attending staff physician or senior fellow. Many patients require procedures, such as suturing, casting and lumbar punctures. Residents are encouraged to learn these skills during the rotation.
In addition to extensive bedside teaching provided during each shift, residents benefit from a formal education series including weekly pediatric grand rounds, pediatric emergency medicine rounds, and resident simulation sessions. High and low fidelity scenarios geared towards core learning objectives are debriefed by expert staff in the simulation sessions. Residents have the opportunity to be both participants as well as the team leader in a variety of scenarios. The residents also complete a digital teaching file with cases structured to ensure exposure to key clinical presentations. At the end of the rotation, a staff member facilitates a session during which these cases are further discussed.
