Postgraduate Residency Training

The Critical Care Medicine Residency Program at the University of Alberta is one of the leading subspecialty training programs in the country. Our program offers trainees a unique and comprehensive experience, preparing them not only to be excellent clinicians, but leaders in the field of Critical Care Medicine.

We have put together a series of brief videos from members of our department that highlights many of the professional and personal reasons why we love Edmonton.  You can view them here.

Between two main academic teaching hospitals, trainees will gain experience managing the full spectrum of critical illness in general systems ICUs. Three additional months of subspecialty training are dedicated to Cardiovascular ICU, Neurosciences ICU, and community ICU. Edmonton is also the largest transplant centre in western Canada, offering a unique opportunity to be involved in the care of the critically ill transplant patient. We have also developed a strong critical care ultrasound program helping trainees gain the skills necessary to successfully incorporate ultrasound into their practice. In addition, the University of Alberta is a recognized international leader in critical care nephrology, affording trainees unmatched exposure in this field including intensivist prescription of renal replacement therapy (both continuous renal replacement therapy and intermittent hemodialysis) in the critically ill.

In addition to clinical medicine, our program offers a strong academic experience with ample opportunity to pursue clinical and basic science research, quality improvement and informatics. Areas of faculty interest include: critical care nephrology, acute liver failure, traumatic brain injury, nosocomial infections, sepsis, antimicrobial stewardship, peri-operative cardiac management and risk reduction, critical care cardiology, vulnerable populations (such as the immune suppressed, frail, elderly), medical simulation, critical care ultrasound, quality improvement and patient safety, ICU capacity strain and other health services research, health informatics, as well as translational and basic science research.

Our program is flexible and strives to provide personalized training for each trainee. As a valued member of our team we aim to provide you with the experience and tools needed to achieve your goals, whether to become a researcher at an academic institution or a leader in a community ICU. Educational activities are financially well-supported with up to $7,500 per resident per year during the training period. Covered costs include, but are not limited to: specific/selected conferences (including the Critical Care Canada Forum [CCCF] in Toronto, Alberta Society of Intensive Care Physicians [ASICP] Meeting in Lake Louise, Acute Critical Event Simulation [ACES] Conference, and national or international conferences where primary research is presented), courses (e.g. exam review, difficult airway), Up-to-Date subscription, critical care medicine textbooks, and research costs if not covered by the primary research supervisor.

For more information, eligibility requirements and application timelines, please visit the Canadian Residency Matching Service (CARMS) website.


Program Overview

This residency program is for 2 years.

Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.

The Critical Care Medicine program fulfills the Royal College of Physicians and Surgeons of Canada requirements for training over a 2-year period. The mandatory thirteen blocks of core critical care medicine are divided into eight-week blocks at the University of Alberta and Royal Alexandra Hospital sites. One core rotation is also dedicated to both community and vascular surgery exposure at the Grey Nuns Community Hospital. Critical care medicine residents are assigned to a clinical teaching team including an attending intensivist, rotating residents, respiratory therapists, as well as allied health care workers (pharmacists, dieticians, physio- and occupational therapists, social workers and chaplains). Responsibility is graded – residents are expected to progress to the junior attending role over the two-year training program. Residents are scheduled for 8 home-call shifts each 28-day block while on core ICU rotations.

In addition, trainees will spend one block each in the Cardiovascular and Neurosciences ICUs, both of which are located at the University of Alberta Hospital site.

Between core rotations there is ample elective time to round out the resident’s knowledge and pursue special interests or academic projects. Up to three blocks can be allocated to completing the mandatory scholarly (research, quality improvement, other) project. Additional scholarly time is available for residents wishing to pursue academic careers. Other elective options include anesthesia, bronchoscopy, pulmonary, nephrology, echocardiography (level 1 certification), critical care ultrasound, transport medicine, general and/or transplant infectious diseases, acute care surgery, trauma, coronary care unit (CCU), toxicology, palliative care, community/regional ICU (e.g. Grande Prairie, Red Deer) and out-of-province electives.

The Department of Critical Care Medicine is highly productive in clinical and basic science research in relation to faculty size. Research opportunities include investigator-initiated studies funded by CIHR, Canadian Critical Care Trials Group, Alberta Innovates Health Solutions (PRIHS - Partnerships for Research and Innovation in the Health System) and the University Hospital Foundation Competition. The Department holds a large number of peer-reviewed grants. In addition, departmental members are involved a variety of research methodologies (e.g. single-center and multicenter clinical trials, observational studies, meta-analyses, outcomes and health services research). Additional academic activities include weekly Critical Care Medicine Grand Rounds, medical simulation sessions (four times per year), academic half-day sessions (Wednesday afternoons), morbidity and mortality rounds, and department-wide journal clubs.


Training Sites

GENERAL UNITS:
1. UNIVERSITY OF ALBERTA HOSPITAL INTENSIVE CARE UNIT
The E. Garner King General Systems Intensive Care/Trauma and Burns unit (GSICU) within the University of Alberta Hospitals, is a 32-bed unit staffed by 17 Royal College certified Intensivists with base training in Internal Medicine and its subspecialties (Nephrology, Infectious Diseases, Pulmonary Medicine, Gastroenterology, Hepatology), Emergency Medicine, Anesthesiology and General/Trauma Surgery.

There are approximately 1800 admissions per year including general medical/surgical, multisystem trauma, burns, multi-organ failure and solid organ transplantation. The site's solid organ Transplant Program is recognized as a national leader in both transplant volumes and success rates, and a large proportion of these patients require critical care support, either pre- or post-transplantation. Consultative coverage is also provided for 4 contiguous high dependency Burns beds.

The GSICU also has special isolation capability for up to 3 patients with a suspected or confirmed infection with highly contagious infectious organisms (e.g. Ebola). An active Medical Emergency Team (MET), Code team, and ICU Outreach Service is also staffed by the Intensivist team with more than 1000 activations per year and greater than 30% of these patients requiring ICU admission. Clinical service is equally proportioned among the three clinical teams and the MET team with four Intensivists on service at a time providing a collegial and mutually supportive environment.

2. ROYAL ALEXANDRA HOSPITAL INTENSIVE CARE UNIT
The Royal Alexandra Hospital is a large, inner city, teaching hospital with a 25-bed ICU staffed by 10 Royal College certified intensivists with subspecialty training in Anesthesiology, Pulmonary, Nephrology, General Internal Medicine, General Surgery/Trauma, Otolaryngology and Emergency Medicine.

The unit admits approximately 1350 patients per year and is structured with two clinical daytime teams and a night physician from Monday-Friday. The unit is also responsible for a Rapid Response team at this site. The case mix is varied – including medical and surgical patients (both elective and emergent) and includes all thoracic surgery patients in the region.

The Royal Alexandra Hospital also provides obstetrical and surgical gynecology critical care support for the adjoining Lois Hole Hospital for Women. The unit provides high volume and intensity with graded clinical responsibility.

3. GREY NUNS COMMUNITY HOSPITAL INTENSIVE CARE UNIT
The GNH ICU is an active urban community ICU, with approximately eight beds and 500 medical/surgical admissions per year. The unit is staffed by six Royal College certified intensivists with a variety of base specialties, including Anesthesiology, Nephrology and Pulmonary Medicine – structured with one intensivist on service per week. Aside from trauma, neurosurgical, and cardiac surgical care, intensivists provide all tertiary support (including renal replacement therapy and plasmapheresis).

In addition, the Grey Nuns Hospital is the Northern Alberta referral site for all vascular surgery. The GNH ICU therefore provides perioperative support for emergency and high-risk abdominal and thoracoabdominal aortic surgery. The Grey Nuns Hospital also has an extremely busy labor and delivery service, with the requisite that intensivists also provide obstetrical critical care support.

SUBSPECIALTY UNITS:
1. CARDIOVASCULAR INTENSIVE CARE UNIT
The Cardiovascular ICU at the University of Alberta Hospital/Mazankowski Alberta Heart Institute is a very active specialized unit with 24 funded beds managed by seven cardiovascular intensivists with two clinical teams at all times. The unit admits an average of 1500 patients per year, the vast majority of which represent the full spectrum of post-operative cardiac surgery patients, including heart and lung transplantation. The unit is also the regional referral centre for patients requiring ECMO or Ventricular Assist Devices.


2. NEUROSCIENCES INTENSIVE CARE UNIT
The Peter B.R. Allen Neurosciences Intensive Care Unit at the University of Alberta Hospital is an 10-bed unit with an additional bed allocated for the support of potential organ donors. An additional four beds are managed by neurointensivists as High Intensity Unit (HIU) beds that support invasive hemodynamic monitoring, low dose vasoactive drug support, non-invasive mechanical ventilation, and external ventricular drains. Both units are staffed by seven Royal College certified intensivists, two of whom hold subspecialty designation in Neurocritical Care by the United Council of Neurological Subspecialties. Base specialties include General Internal Medicine, Anesthesiology, and General Surgery/Trauma.

The Neurosciences ICU/HIU admit approximately 900 admissions per year. The case mix is predominantly neurosurgical including traumatic brain injury, spinal cord injury, subarachnoid hemorrhage, cerebrovascular disease and cerebral oncology, but also includes neurological patients such as those suffering from stroke and neuromuscular diseases.

In addition, 90% of regional organ donors (30-40 per year) are managed in the Neurosciences ICU. The neurointensivists have expertise and training in multi-modality monitoring including routine and extended duration EEG monitoring, transcranial doppler, and invasive cerebral oximetry (LICOX). In addition, under the umbrella of the University of Alberta Neurosciences Program the neurointensivists share a collaborative model of care with members of the Stroke Neurology program.

Neurointensivists provide support and active consultative services for a 4-bed Stroke Unit which cares for acute stroke patients receiving thrombolytic therapy or catheter-directed thrombectomy. Our stroke program is integrated with the Alberta Health Services Edmonton Region stroke ambulance. Our neurocritical care faculty are actively involved as executive members of the Canadian Neurocritical Care Society and the Organs & Tissues Section of Canada Blood Services.