Program Structure

Rotations

*** The clinical rotations below will change with the anticipated launch of Competence By Design (CBD) in July 2018. Use the rotation map below as a reference. This site will be updated in the fall of 2017 when more information is available.

PGY-1 (Basic Clinical Training)

In this comprehensive year of basic clinical training, medical school graduates broaden their overall knowledge and consolidate chief clinical skills. The year bridges the gap between undergraduate and postgraduate training. Trainees rotate through Pediatric Emergency Medicine, Internal Medicine, General Surgery, Orthopedics, Obstetrics and Gynecology, CCU, Anesthesia and Emergency Medicine. In addition, trainees spend one month exploring areas of interest, or addressing perceived areas of weakness. To maximize learning of emergency medicine concepts, first- and second-year residents attend Junior Rounds several times per month.

Rotations

Duration

Location / Notes

Emergency Medicine 12 weeks RAH, MIS, UAH
Internal Medicine 8 weeks RAH
CCU 4 weeks RAH
General Surgery 4 weeks MIS or RAH
Obstetrics 4 weeks RAH
Orthopedic Surgery 4 weeks RAH or YAH
Psychiatry 4 weeks RAH
Anesthesia 4 weeks RAH
Pediatric Emergency 4 weeks Stollery
Vacation 4 weeks Residents' request

PGY-2

During this year, trainees spend considerable time on surgical rotations (including Plastic Surgery and Neurosurgery) and Pediatric Anesthesia to learn the frontline management of acutely ill or injured patients. The year emphasizes resuscitative skills, including emergency airway management and trauma management. The four months of Emergency Medicine introduce the specialty at a junior level, under the supervision of the Emergency Medicine teaching faculty. As well, residents focus on Emergency Psychiatry for one month. A one-month Ultrasound Rotation has also been developed, to help residents achieve competency in Emergency Department ultrasound early in their training.

Rotations

Duration

Location / Notes

Emergency Medicine 16 weeks GNH, Sturgeon, RAH, UAH
Neurosurgery 4 weeks RAH or UAH
Pediatric Anesthesia 2 weeks Stollery
Emergency Ultrasound 4 weeks RAH
Plastic Surgery 4 weeks UAH
Research/Administration 4 weeks N/A
Pediatric Emergency Medicine 4 weeks Stollery
Electives 10 weeks Residents' request
Vacation 4 weeks Residents' request

PGY-3

In this year, residents spend three months in Adult Critical Care and are on first-call for the ICU. The critical care faculty has an outstanding seminar series that runs over three months and provides an extensive academic foundation in critical care. Residents also undertake two months of Pediatric Critical Care during the PGY-3 year. At this level, residents are given additional responsibility during the emergency medicine rotation, including clinical teaching of junior residents and medical students in the Emergency Department. Residents also complete rotations with STARS Air Ambulance and EMS to further develop knowledge in the subspecialty areas of EM.

Rotations

Duration

Location / Notes

Emergency Medicine 16 weeks RAH and UAH
Emergency Medical Services 4 weeks N/A
ICU 12 weeks RAH or UAH
Pediatric ICU 8 weeks Stollery
Pediatric Emergency Medicine 4 weeks Stollery
Electives 4 weeks Residents' request
Vacation 4 weeks Residents' request

PGY-4

During this year residents act as the Chief Resident, taking full responsibility for EM academic activities. This year is entirely elective, allowing residents to pursue special interests or sub-specialty training. As well, many residents choose to complete an elective in Toxicology. In discussion with the program director, this elective year can occur in PGY-2 to PGY-5. Residents can use this year to enhance their clinical training or to develop special areas of expertise. Optional focus areas include, but are not limited to:

  • Research
  • Administration
  • Pre-hospital Care
  • Disaster Medicine
  • Medical Ethics
  • Trauma
  • Ultrasound
  • Environmental Medicine
  • Toxicology
  • Critical Care Medicine Subspecialization
  • Pediatric Emergency Medicine Subspecialization
  • Masters in Clinical Epidemiology
  • Masters in Medical Education / Distance Education
  • Masters in Health Promotion / Public Health
  • Medical Informatics
  • Sports Medicine

PGY-5

During PGY-5, residents complete six months of Emergency Medicine training, divided between the University of Alberta and Royal Alexandra Hospitals. Two months of this year are devoted to Pediatric Emergency Medicine—and many residents choose to extend this time. The Senior CCU rotation is a 1-2 month rotation during which the resident assumes responsibility for the supervision of junior trainees. Many residents choose to complete this rotation during their 4th year. Residents also spend a lot of time in PGY5 preparing for that "little quiz" (the FRCP EM exam). Clinical and administrative responsibilities are scaled back in the later part of the year.

Rotations (PGY4 & PGY5)

Duration

Location / Notes

Emergency Medicine 28 weeks 4 weeks Senior Community Emergency Medicine; 24 weeks RAH or UAH
CCU Senior 4 weeks RAH
Pediatric Emergency Medicine 2 weeks Stollery
Toxicology 4 weeks Residents' request
Electives 52 weeks Residents' request
Vacation 8 weeks Residents' request

Academic Events

  • Core Content Rounds

    Core Content Rounds are organized and run by Drs. Boyd Edgecumbe and Ian Williamson for the CFPC-EM and PGY-2 FRCP residents. This is a program of self-directed study based on the textbook in Emergency Medicine edited by Tintinalli. The residents meet once per month to review the assigned reading for that month and to answer related multiple-choice and short-answer questions. The intent is to cover the content of this textbook over the period of one year.

  • Evidence Based Medicine/Critical Appraisal Seminar Series

    This seminar series, organized by the Research Director, Dr. Brian Rowe, covers the key elements of evidence-based medicine and critical appraisal. The series consists of the following seven sessions, repeated each academic year:

    - Questions and Searching

    - Diagnosiis

    - Therapy I

    - Therapy II

    - Systematic Reviews

    - Health Economics

    - Clinical Practice Guidelines

  • Fleischer Rounds

    These are weekly review sessions on pediatric emergency medicine based on Fleischer's Texbook of Pediatric Emergency Medicine. They are conducted by pediatric emergency medicine faculty for the pediatric emergency medicine fellows. Our residents are invited to these sessions.

  • Mentorship Program/CanMEDs Observership

    Residents are assigned two preceptors. One preceptor will be the five year mentor and will follow the resident through their residency, providing more longitudinal feedback. The second preceptor is a one year preceptor and will change from year to year. During each year of training, residents are expected to undergo at least one two-hour observation session with each mentor.

    These sessions should be coupled with the completion of an evaluation form followed by a 20-30 minute debriefing on the same day. This encounter will be arranged at a time of mutual convenience for resident and mentor and with the permission of the preceptor responsible for the resident's supervision during the ED shift in question. Mentors will attempt to evaluate both clinical acumen and as many of the CanMeds roles as appropriate; however, the focus should be resident/mentor-directed based on real or perceived areas of weakness.

    Evaluation forms, available online, should be used as a foundation for assessment. Residents are responsible for handing in completed evaluation forms to Maria. Over the five-year training period, residents are expected to include day, evening, and possibly night or weekend observations. At the PGY3 or PGY4 level, the session may involve observation of clinical teaching of a junior learner to assess a resident's teaching skills. This would require the prior agreement of the junior learner. During the PGY5 observation, residents are expected to be "in charge" of the department or pod(s) for that shift, handling calls and day-to-day administrative functions.

    During all of these observations, residents interact with, and report back to, the preceptors they've been assigned to. Mentors observe any interactions between residents and staff, as well as resident-patient, resident-family, resident-nurse, resident-learner, resident-consultant, and any other resident interactions.

  • Monthly Journal Club

    The U of A Emergency Medicine program's Journal Club has changed to a Journal Watch format. Presenting Residents will review 5-6 recent articles, generally published in the last six months. A crtical appraisal/summary handout on each article will be created and distributed at Journal Club. It is held monthly at a faculty member's house or a restaurant. Journal Club is always a fun and non-intimidating learning experience. The approach to Journal Club is to focus on the entire process of evidence based medicine (clinical scenario / posing a question / search strategy / critical appraisal of an article).

  • Off Service Rounds

    While on their off-service rotations, residents attend rounds held by these services, and at times present.

  • Pediatric Resuscitation Rounds

    These are weekly sessions for the housestaff that our residents attend while they are their Peds ER rotations. They are held at 9:30 am in A pod of the University of Alberta Hospital ED.

  • Research Day/Clinical Photography Competition

    The Research Director organizes an Annual Research Day in June for the Department of Emergency Medicine, at which faculty and residents present completed and ongoing research efforts. In addition, a photography competition is held with categories in medical human interest and clinical photography.

  • Senior Interactives

    Senior Resident Interactive Sessions are designed for FRCP residents within their third to fifth years of training. These monthly sessions are a mandatory part of FRCP EM residency training at the U of A (exceptions are made for those on vacation or out-of-town rotations). The schedule for the sessions can be found on the U of A EM website. The sessions are designed to promote excellence in academic emergency medicine, exam preparation, reading habits, and oral presentation.

  • Trauma Rounds

    Trauma Rounds are held on a monthly basis at both the University of Alberta and Royal Alexandra Hospitals (the two major trauma centres in the region). Attendees include trauma team leaders, emergency department staff, surgical and critical care residents and staff, and anyone else with an interest in trauma, including EMS personnel.

  • Weekly Rounds and Academic Full Day

    EM Grand Rounds are held every Tuesday morning from 9:00 to 12:00. The format combines core content topics, clinical cases, and presentations by invited expert speakers. In addition, several Tuesdays in each month are academic full days, with time designated to practice oral and written exams, human patient simulation sessions, hands-on skills sessions, as well as evidence-based medicine sessions.

    Academic responsibilities for residents are split into major and minor presentations. Journal Club and Case Presentations are considered minor presentations, while Core Content topics are considered major presentations. Responsibilities are as follows:

    - PGY-1: 3 minor presentations (1 Journal Club and 2 Cases)

    - PGY-2 and 3: 2 major and 2 minor presentations (2 Topics, 1 Case, and 1 Journal Club)

    - PGY-4: 1 major and 2 minor presentations (1 Topic, 1 Case, and 1 Journal Club)

    - PGY-5: 1 minor presentation (1 Case)

PALS/ATLS

Residents are expected to achieve certification in PALS (Pediatric Advanced Life Support) and ATLS (Advanced Trauma Life Support) by their PGY-2 year. Many residents become instructors for these programs-some earning extra money on the side during lighter rotations.


ACLS

Resident are expected to have ACLS certification before commencing residency and become ACLS Instructors. The Emergency Medicine Faculty and Residents are actively involved in teaching ACLS courses for the graduating University of Alberta medical class.


Human Patient Simulation

A new HPS curriculum has been introduced in 2007/08 for FR residents in their R2 and R3 years. Along with the EM residents, this group participates in three sessions per year, plus an introductory session in July. The cases correlate with the relevant Tintinalli Rounds topics for the month, with the goal of adding a practical aspect to these teaching sessions.


EMS Medical Director Experience

PGY-4 residents pusuing EMS as the Area of Expertise take on the role of EMS Director for the City of Spruce Grive to develop real-world skills in EMS. The EMS resident will attend the National EMS Directors' course.


Disaster Planning

Dr Jeffrey Franc has developed a popular series of disaster medicine seminars and runs a disaster simulation each year for all residents. A large number of residents and faculty hold certification in Advanced HAZMAT Life Support (AHLS), which was most recently offered in Edmonton in September 2007.