EM Resident Resources

The residents have put together a little map of some of their favorite spots around the city. While you’re here make sure you visit some of the sights and see what Toronto is like outside of the hospitals.

Direct link to Map

1. Attendance Policy
2. Transition to Discipline
3. Foundations
4. Core Academic Days
5. Afternoon Sessions

Our program has one full academic day per week (Wednesday). Attendance at the academic day (both morning and afternoons) is mandatory.

Attendance Policy

Please refer to this document for the full attendance policy

Transition to Discipline

New as of July 2018, PGY1 residents will have a dedicated 3 block academic day with tailored sessions – lectures, workshops and simulation. Dr. Rob Simard is the TTD academic lead. Here is a link to the schedule.

Foundation of Discipline

Upon completion of the TTD academic day sessions, the PGY 1 residents will join the rest of the residents at our academic day, with the exception of Foundation Rounds that are only for PGY1s and run every Wednesday from 8:30-10 am. The Foundation Rounds are led by Dr. Melissa Chacko.

For the remainder of the schedule please link to our Google calendar. We recommend you sync this calendar with your own ical or Google calendar, so changes will be reflected in your own calendars.

Core Academic Days

PGY 2-5’s attend Core Academic Days that consist of morning and afternoon sessions. The morning sessions cover Rosen chapters and a series of other didactic sessions including Grand Rounds. The afternoon sessions consist of small group sessions that cover our longitudinal curricula (see below). Core Academic Days run on a 2 year cycle.

In addition to academic day, residents are required to attend the following mandatory events:

• Critical Skills Day
• Disaster Simulation Day
• Visiting Professor Day

Afternoon Sessions - Longitudinal Curriculum

There are a number of longitudinal academic day sessions that are provided to our residents at different stages of residency:

Full description is found here.

• Journal Club – all years
• Wellness Rounds – all years
• Simulation – all years (note: a separate schedule is sent for simulation so you will know which sessions you need to attend)
• Leadership Rounds – all years
• Advocacy Curriculum - all years
• Clinical Epidemiology and sessions on Foundations of developing a Resident Academic Project – end of PGY 1
• Ethics – PGY 2
• Quality Improvement – PGY 2, 3, 5
• Geriatrics – PGY 3
• Administration – PGY 5

Please review the calendar of events details to ensure you attend the sessions which apply to your year.

• PGME Orientation Manual
• Office of Resident Wellness
• Payroll
• PGCorED
• PGME Global Health
• Awards and Scholarships

PGME Orientation Manual

Postgraduate medical education office (PGME) at the University of Toronto, also, provides a PGME Orientation Manual

Office of Resident Wellness

The PGME office at the University of Toronto provides services for residents:

• Counseling: Residents are frequently seen for stress management, mental health concerns, challenges with work-life balance, academic problems, career uncertainty, and other issues. We offer the following options for support: PGME Wellness Advisor and referrals to external counselors are coordinated by the Director of Resident Wellness.
• Family doctor registry
• Links to Faculty of Medicine, University of Toronto, and community-based resources
• Half-day and longitudinal workshops that teach you resiliency skills aimed at optimizing your coping skills and resources to combat life’s stressors. You can always check out up-to-date information on current workshops being offered at the Wellness Offices.

Payroll

The Toronto Hospitals’ Postgraduate Payroll Association (THPPA) is the University of Toronto Faculty of Medicine paymaster for most postgraduate medical residents. Information related to salary, call stipends, benefits, insurance, and taxes for new and returning residents can be found on the PGME website.

PGCorED

The University of Toronto Postgraduate Medical Education PGCorED is a series of self-directed multimedia web-based learning modules which covers the foundational competencies for University of Toronto postgraduate trainees. PGCorEd covers topics in the CanMEDS 2015 Physician Competency Framework and is accessible from any mobile device.

New modules in this series will be made available to PGY1 and 2 residents as they are developed. Residents are responsible to complete their PGCorEd modules before the end of their PGY2 year. Check with your Program Director to confirm if there is a program specific sequence or deadlines for module completion.

PGME Global Health

PGME Global Health is committed to being an international leader in the development of and offering coordinated, inter-specialty global health programming and initiatives. PGME’s Global Health initiatives reflect local and global social responsibility and accountability, supporting PGME trainees towards contribution and leadership in global health education, research and practice. Residents in our Emergency Program have the opportunity to take an elective as part of our Toronto Addis Ababa Academic Collaboration – Emergency Medicine (TAAAC- EM) program.

On behalf of the Resident Academic Project (RAP) committee, it is our hope that this will serve as a comprehensive resource for guiding the generation, development, implementation, and dissemination of high-quality scholarly projects. Here you will find a detailed guide on developing a scholarly project, information on project supervisors, resources for research ethics, and project guides and timelines. We will also provide updates on scholarly events such as the annual visiting professor, and academic day.

Perhaps most importantly, contact information for our stellar RAP committee members. As a group we are all committed to your success as young investigators – so please be in touch!

• Resident Academic Project (RAP) Committee Contacts and Bio
• Research Ethics Board (REB) FAQs
• Cycle and Timeline
• Developing Scholarly Project
• Important Forms to Submit
  1. PGY1 Academic Background Form
  2. Research Project Proposal
  3. Example of Completed Project Proposal
  4. Resident Academic Project Update
  5. Additional Professional Day Request Form for Conference Attendance
• Site Specific Research Associates
• Resident Research Funding and Statistical Support Opportunities
• Predatory Journal Checklist
• Clinical Epidemiology
• Research Academic Day Program 2018

Resident Academic Funds

There will be $750/year for use towards academically related purchases. For example, these funds may be used to build your emergency medicine library or to attend conferences (travel, conference fees, etc.). This also includes medical software purchases for your PDA/Smartphone but not for the purchase of hardware. You must keep receipts of your purchases and fill out a reimbursement sheet.

Terms of Academic Reimbursements

• Up to 750 per academic year. Academic funds do not carry over at the end of the academic year. Must be submitted by June 30th. If you need to check if you have funds left check with division.em@utoronto.ca
• Academic Reimbursements apply for educational books; software or apps; conferences in which you are not presenting; travel/accommodation for rotations outside of Toronto; certificate courses/educational courses;
• DOES NOT INCLUDE: laptops; iPads; any hardware purchases; items unrelated to residency education
• If not listed please contact division.em@utoronto.ca to see if it will be approved.

Steps to applying for Academic Reimbursement

• Fill out the Academic Reimbursement Form
• Submit the appropriate supporting documents & original receipts
  • The DOM wants original receipts not scans. You can drop them off to me at the DOM. The DOM’s address is located at TGH. It’s 6 Queen's Park Crescet West, C. David Naylor Building, Third Floor. You can either leave it with the Admin at the front or bring it back to me in the office. The office has staff at the front from 9am-5pm
    • Supporting Documents/ Receipts (DOM Requirments)
      • Digital Receipts- The DOM wants original receipts. If the digital receipt you have is the original that was sent to you. Make a note that is the original copy or send me an email stating it is the original copy. That way we do not have to follow-up with you or the conference/course to find out what type of receipts they provide
      • Cash payments- If you paid for something in cash, please note it so we don’t ask for a credit card statement
      • Items purchased by Credit Card- if you purchased something by credit card, please include a copy of the statement. Especially if the receipt or statement doesn’t show payment was made and received or how it was paid for.
      • Conferences/Courses- You are not able to submit before attending. The DOM wants certificates of attendance or something that confirms you attended. If the Conference/Course does not provide certificates, send the division admin an email stating you attended the conference/course and they do not provide certificates. This will be the additional documentation the DOM will use.
      • Someone else bought it for you and you paid them back- Send an email clearly explaining the circumstances when submitting documents. If possible, always pay for whatever you are asking for reimbursement yourselves.
      • Split reimbursement- If you and another resident are splitting a reimbursement (eg shared accommodation while on Tox rotation in New York) again send a clear email explaining the split purchases.
      • Travel and Accommodation for Rotations outside of Toronto- please include the name of the rotation, dates of rotation, and supervisor while on rotation.

Resident Conference Award

To encourage residents to prepare and present scientific abstracts at national and international conferences, the Division of Emergency Medicine is providing limited financial support to residents whose work has been accepted for presentation.

Terms of Conference Award

• Max one conference submission per year up to $1000 per resident. Funds do not carry over at the end of the academic year. Must be submitted by June 30th, with conference completed in that academic year. If you need to check if you have funds left check with division.em@utoronto.ca
• Resident must be physically present at the conference to receive funding and have proof of attendance.
• The program director reserves the right to decline to provide funding to a resident who will present at a conference determined to be of low academic value or relevance (the resident may appeal this decision to the EMRTC)
• Poster Presentation: $750
  • No difference for moderated or not moderated
  • “e-poster” (poster without paper): same value as a traditional poster
• Oral presentation: $1000
  • Pre-recorded presentation (e.g. at SMACC): same value as an oral presentation

Steps to applying for Conference Award

• Fill out the Conference Award Form
  • When filling out the form, make sure to add your Date of Birth and SIN number for payroll purposes. This is an award and must be noted on your taxes. This will be on your T4A in box 28 as an award.
• Submit the appropriate supporting documents
  • Residents must provide copies of the letter of acceptance of the abstract(s) following conference peer-review, a copy of the abstract(s), and a conference program confirming the presentation to be eligible for support. Must submit originals, not scans. Receipts are not needed to be submitted. This is a scholarship and must be noted on your taxes. You can drop them off to the Division Administrator at the DOM. The DOM’s address is located at TGH. It’s 6 Queen's Park Crescet West, C. David Naylor Building, Third Floor. You can either leave it with the Admin at the front or bring it back to me in the office. The office has staff at the front from 9am-5pm.
  • DO NOT SUBMIT RECEIPTS FOR THIS AS IT WILL BE CONFUSED FOR ACADEMIC REIMBURSEMENTS

Restricted Registration

Are you considering applying for a Restricted Registration License?

Our program has participated in the Restricted Registration program (RR) for a number of years. RR brings many benefits for the residents, and we are happy to support our resident’s involvement in it. Please be advised that obtaining an RR license is a privilege and not guaranteed to all residents. Assessment of resident eligibility to apply for an RR license and approval of the application is at the discretion of the Program Director in consultation with the Competence Committee and EMRTC, and is decided on an individual basis. Our residents are allowed to obtain an RR license in PGY 3-4 in the non-CBD cohort and in PGY 3 (and potentially PGY 5 – subject to change) in the CBD cohort, and are expected to follow the steps outlined below:

1. Before starting your application process, please review the requirements on the CPSO and RR website in detail. You are responsible for all steps in the process and complying with the conditions of the RR license.
2. Approval will have to be obtained at regularly scheduled Competence Committee meetings.
3. Ensure that the RR work does not interfere with the clinical and non-clinical work requirements of the residency program. For example it is not acceptable: to miss academic day, show up late or miss program related shifts, miss mandatory program events etc. to work under a RR license.
4. Ensure that any additional hours worked not be done in a fashion which would contravene the PARO-CAHO collective agreement. You are responsible for your wellness and maintaining patient safety standards.
5. The Competence Committee reviews your file on a regular basis. Should you fail to maintain academic standing or fail to comply with the above, you will be asked to cease working under the RR license. In the situation were there is non-compliance, the Program Director will notify the RR Program office and the Postgraduate Dean of these concerns and recommend cessation of the RR license. This will be effective immediately and there can be no appeal of this decision. Please be advised that a RR license is a CPSO license, and termination of the RR license will significantly impact your future CPSO licensing applications.

Stage Specific CBD Resident Expectations

As part of CBD residents will be required to complete regular assessments. Here is a link to an overall map of the assessment requirements for all stages.

Entrustable Professional Activities and Special Assessments

EPAs are one component of the assessments and a CBD requirement. Each stage has specific EPAs that are assigned to it (determined by the Royal College Emergency Medicine Specialty Committee), and successful completion at each stage (as determined by Competence Committee) will be required to move from one stage to another. Here is a link to a list of EPAs.Here is a link to the Royal College document for a detailed breakdown. To avoid getting overwhelmed, start by reviewing the first stage (TTD) EPAs (there are only 4!)

• Elentra user guide
• Entrustment Scale

  • The staff physicians who supervise residents during clinical rotations assess EPAs using the Entrustment Scale. We expect that most of the resident EPAs will be given an “Intervention”, “Direction” and “Supervision” category, and only a few will be given “Autonomous” and “Excellence” especially in the early phase of a stage, and in early years of residency.

    Special Assessments are non-EPA assessments that are requirements of the Royal College. Each tool is different, and residents will be provided detailed information on their completion under each stage.

    Other assessments are called “Notes to File” and “Professional Behavioural Monitoring Form”.

    All these assessments will be completed on the Elentra e-platform, and can be initiated by the resident or their supervisor. In general, we expect that each resident complete at least 1 EPA (or SA tool if applicable) per shift on EM rotations and that as the resident is able, they complete EPAs on off-service rotations.

• Emergency Medicine EPAs – All Stages
  • For more details on stage-specific EPA and SA tool completion please refer to the specific sections below – TTP documents will be provided and uploaded to the website at a later date

In-Training Exams

You are required to attend mock orals and written exams as outlined in the Stage Specific CBD Resident Expectations.

Royal College

• Royal College Examination

The Royal College requires residents to complete the assessment requirements for 4 EPAs (FOD 1-4) and one special assessment (FOD SA 1) in Foundations (FOD). However, in our program residents are required to complete FOD SA 1 in the Core stage. You will also be required to complete Core EPA 14 requirements in FOD. For detailed guidelines on completing these assessments, please refer to the link below:

EPAs

• How to Complete FOD EPAs + Core EPAs 3, 13, 14

ITARS - See Below

• CBD Sample Rotation Schedule
• Transition to Discipline/Foundations
• Core/Transition to Practice
• Area of Advanced Learning

We have made a number of changes to our rotation schedule to align with CBD and also to address some identified gaps. For example, residents will be doing more EM rotations in your PGY 1 year under CBD then our previous rotation schedules.

CBD Sample Rotation Schedule

Here is a link to the Master Rotation Schedule for all 5 years. There are 13 rotation blocks in each academic year. A number of rotations are “on service” (i.e. emergency medicine or related rotations such as EMS and Ultrasound), and some are “off service”. Residents will rotate through our core teaching sites, as well as affiliated sites.

• Core sites:
  • Sunnybrook Health Sciences Centre (SHSC)
  • St. Michael’s Hospital (SMH)
  • University Health Network (UHN): includes Toronto General Hospital (TGH) and Toronto Western Hospital (TWH)
• Affiliated Sites:
  • North York General Hospital (NYGH)
  • Hospital for Sick Children (HSC)

Transition to Discipline/ Foundations

TTD entails the first 3 blocks of the CBD PGY 1 year, and FOD the remaining 9 blocks. Here is a link to a Sample Learner Schedule for TTD and FOD. Residents will each be provided their own specific TTD and FOD learner schedule by email.

In TTD residents do 3 blocks of Emergency Medicine (EM) at one of our core sites (SHSC, SMH, or UHN). In FOD you do 4 months of adult EM (3 at our core sites and 1 at NYGH), 1 Pediatric EM at the Hospital for Sick Children, Ultrasound (includes EM shifts), Sports Medicine, GIM-Clinical Teaching Unit (CTU), Pediatric-CTU and Anesthesia.

Each Rotation has a specific Rotation Plan. Residents should review the Rotation Plans prior to the start of each rotation.

• TTD EM Rotation Plan
• FOD Ultrasound Rotation Plan
• FOD Sports Medicine/MSK Rotation Plan
• FOD Peds CTU Rotation Plan
• FOD PEM Rotation Plan
• FOD Anesthesia
• FOD CTU GIM

For all EM rotations, we have asked that our site coordinators schedule 30% of a resident's shifts with a preceptor. We ask that the resident contact their preceptor and meet them at the start of their rotation, mid-way and at the end of their rotation to discuss objectives and progress. Please be advised that this is a mandatory program requirement. (Clinical Duty Scheduling and Absenteeism Policy)

Core and Transition to Practice

COD entails the full 39 blocks during the PGY2 to PGY4 years. Here is a link to a Sample Learner Schedule for COD. Residents will each be provided their own specific COD learner schedule by email.

In COD, residents do 3 - 5 blocks of Emergency Medicine (EM) at our core sites, 1 in ICU, 2 in Trauma/General Surgery, 1 in Anesthesia, 1 in Psychiatry, 1 in OB/GYN, 1 in Orthopedics, and 1 in Pediatric Emergency Medicine at SickKids. The number of EM blocks completed is dependent on their Goal Directed Experiences (GDE). The GDE replaces the traditional “electives”. You can see that it is included in the Master Rotation Schedule More details will be provided about the GDE at a later date.

• GDE request form (Updated May 2020)

Each Rotation has a specific Rotation Plan. Residents should review the Rotation Plans prior to the start of each rotation.

• COD Anesthesia
• COD EM - Junior
• COD-EM- Senior
• COD ICU
• COD OB/GYN
• COD Orthopedics
• COD PEM
• COD Psychiatry
• COD Trauma/General Surgery
• COD Advanced Ultrasound
• COD Toxicology
• COD EMS
• COD Peds and Community Anesthesia

The details of the TTP rotations will be finalized in the next couple of years. We will provide residents with Rotation Plans TTP closer to the date.

Area of Advanced Learning

In the past, residents in our program were provided with 1-year (PGY 4) to pursue an Area of Advanced Learning (AAL). Due to CBD requirements, this has changed to 6-7 months, and the nature of the AAL will depend on progression through the CBD stages. We will provide residents with more details as we monitor progress.

Graded Responsibilities and Supervision

• Subspecialty Policy- (Feb 2019)
• Subspecialty Form

The University of Toronto provides an opportunity for a non-CBD PGY 4 advanced area of learning (AAL) year, in which each resident personally designs an AAL curriculum. This curriculum must abide with the Royal College Emergency Medicine committee requirements and be submitted to and approved by the EMRTC during the PGY 3 year. Residents should review the Subspecialty Policy gain clarity and guidance regarding the requirements for the AAL year.

Residents will be asked to fill out the Subspecialty Form in the early fall of their PGY3 year.

In the past, areas of focus have included: pediatric emergency medicine; Masters of Clinical Epidemiology; Masters of Medical Education; Masters in Health Administration; inner city health; international health; toxicology; trauma; critical care medicine; sports medicine; prehospital care; medical informatics; research; aeromedical transport; clinician-scientist program; bioethics; international emergency medicine; ultrasound; simulation, and geriatric emergency medicine.

1. Sample Subspecialty Topics
2. Resident stories of Subspecialty year