Orientation - CCFP EM
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The Department of CCFP - Emergency Medicine
Orientation Handbook

2008 - 2009

 
  1. Orientation
  2. Rotations
  3. Education
  4. Self-directed Learning
  5. Research
  6. Evaluations
  7. Administration
  8. Presentation Expectations
  9. Moonlighting
  10. How to Maximize Your Educational Experience
  11. Problem Solving
  12. Holidays and Stat Days
  13. Passing the Program

    Go to Download Forms to download the Orientation Handbook, and Rotation Specific Objectives and ITERs in Microsoft Word format.
ORIENTATION

Welcome to the University of Manitoba’s CCFP-Emergency Medicine program. Most of your rotations will take place at the Health Sciences Centre complex or at St. Boniface Hospital. There are 13 periods, each of four weeks’ duration, during this academic year. These are divided as follows:

Adult Emergency, St. Boniface Hospital (2)

Adult Emergency, Health Sciences Centre (2)

Pediatric Emergency, Children’s Hospital, HSC Complex (2)

Anesthesia, Adult and Pediatric, HSC and/or St. Boniface Hospital (1)

Trauma Surgery, HSC (1)

MICU, HSC or St. Boniface Hospital (1)

SICU, HSC or St. Boniface Hospital (1)

Two (2) Selectives - not limited to, but may include:

  • Various rural/community Emergency Departments
  • CCU, St. Boniface General Hospital
  • Rankin Inlet, Northern Medical Unit
  • Plastic Surgery, HSC
  • Individualized requests may be acceptable, on approval of the Program Director.

Vacation (1) + 5 days Christmas/New Year’s holidays

At HSC, Emergency Medicine Residents have individual mailboxes in the HSC Adult Emergency Physician office (JJ123D); please check these mailboxes on a regular basis. As well, every resident will be provided with a key to the Emergency residents’ office (GB207) where access is available to a telephone (787-5133), computer and reference textbooks provided by the department. The access code to the Physician office, keys to the Resident office and computer access are all arranged via Anita Bourgeois, Administrative Assistant for HSC Dept of Emergency (located in room GF201; phone 787 2934).

You will have access to the Emergency Physicians’ Office and Computer/Library Room (Room A1050) at SBGH Emergency Department. Joan Hutchinson, Administrative Assistant at SBGH Emergency Medicine Office (Room A1119) will provide you with a key to the computer-library room as well as a numeric access code for the main door. She will also process the necessary System Access Request for the computer. Please contact Joan at 235-3006 for assistance with these issues.

Other important telephone numbers include:

An Internet and e-mail account is available through the University of Manitoba computer services at the Health Sciences Centre campus. If you are interested in this, contact Monica Wilgosh.

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ROTATIONS

Please ensure that you do not miss any orientation sessions that may occur on the first day of each rotation.

You will be responsible for your ITERs (In-training evaluation reports). Please ensure that you give an ITER to each rotation coordinator at the beginning of the rotation. Also, please review the completed ITER with your rotation preceptor at the end of the rotation. You will need to have completed ITERs for each rotation in order to be considered for graduation from this program.

Rotation Coordinators:

St. Boniface Emergency: Dr. Ashvin Shah
HSC Emergency: Dr. Wes Palatnick (Anita Bourgeois for scheduling)
Children’s Emergency: Dr. Scott Sawyer
Trauma Surgery: Dr. Roger Saadia
MICU/SICU: Dr. Dean Bell
Anesthesia: Dr.Rob Brown (Laura-Lee Bouchard, Admin Assistant)
Seven Oaks ER: Dr. Ricardo de Faria
Winnipeg EMS: Dr. Rob Grierson
CCU at SBGH: Dr. Davinder Jassal
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EDUCATION

The academic half-day in Emergency Medicine occurs each Wednesday afternoon from 12:30 to 17:00 hours. These sessions are mandatory. You will be contacted by the FRCP-EM Chief resident with a schedule of the sessions you are responsible for presenting (usually about 5 over the year). You will be assigned specific topics to present. These topics are usually 50 minutes long with 10 minutes for questions. Residents and Attendings generally use PowerPoint for presentation, discuss an overview of the topic and provide one or more interesting cases based on the topic. Any recent articles on the subject may also be presented.

You will be expected to present a 1 hour Grand Rounds (45 min talk, 15 min questions) during the academic year. Various attending physicians are available for presentation suggestions and mentorship. The Program Director is a good initial source.

There are Core Curriculum sessions occurring over the course of the academic year. You may have already attended a number of these sessions during your previous 2 years in Family Medicine. Of these sessions, the TIPS teaching course is mandatory. You will be notified of these sessions by September.

By the end of the academic year, you must be certified in ACLS, ATLS and PALS. If you have not yet taken these courses, you are obligated to do so over the course of the upcoming year. Start arranging these early; dates can be limited. As these courses are mandatory, you will be reimbursed the cost of the course.

The Department of Emergency Medicine Journal Club occurs on a weekday evening once a month from September to May (except December) with all Winnipeg ER faculty invited. A few recent articles are presented for discussion with a view of improving current clinical practice. Journal Club is an important forum for learning and discussion of recent controversies in Emergency Medicine. The food is pretty good, too! Your attendance, while not mandatory, is expected!

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SELF-DIRECTED LEARNING

The recommended textbook is the current edition of Tintinalli’s Emergency Medicine. The academic half-days are based on Rosen’s Emergency Medicine. Journals that may be useful are Annals of Emergency Medicine and Canadian Journal of Emergency Medicine. The Residents’ office has a library with recent textbooks and current journals. As well, there is a University of Manitoba Medical Library in the John Buhler Research Centre next to the HSC complex and in the St. Boniface Research Centre.

Five days are allowed for conference leave. You may use this time for Emergency-related conferences or courses, but should book the time off of the affected rotation ahead of time. Please notify Carolin Backmann-Smith with your conference leave requests. Conferences such as CAEP, ACEP, and Manitoba CME Emergency Medicine Update occur yearly. There are usually courses offered in ATLS, ACLS, PALS, ALSO, and NRP throughout the year.

The St. Boniface and HSC Emergency Attending Physicians provide funding for Conferences. You can apply for up to $1000 conference funding ($500 from HSC and $500 from St. Boniface). Please save your receipts and submit to:

  • HSC: Susan Woodward (988-4863), outgoing box is in HSC ER Physician’s office.
  • St. Boniface: Joan Hutchinson (235-3006), Emergency Medicine Office.

You may want to join CAEP, the Canadian Association of Emergency Physicians. As a member in this association, you will receive the CJEM journal and notification of any CAEP-sponsored conferences. Please see the CAEP website located at www.caep.ca for more details.

In the past, residents have found that resident-directed study sessions outside of half-day and Director meetings have been beneficial. This is something you may wish to try in studying for the upcoming exam in September of the next year.

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RESEARCH

You are expected to complete a Resident Research Project. The written manuscript is due June 1st of each year. There is an expectation that your project be presented at Resident Research Day, which generally occurs in mid-June of each year. Usually, the project starts in the form of a question of current practice or an interesting case report. Other options include a QA study or review of a health policy. Discuss your ideas with the Program Director early in the year. There are many resources for ideas and mentorship.

For the upcoming year, the suggested deadlines are as follows:

  • Aug. 1: Research topic selection to be completed.
  • Sept. 1: Relevant literature review complete.
  • Oct. 1: Submission to Research Ethics Board
  • Autumn: Data variables established, hypothesis and methods established.
  • Winter: Data collected and reviewed.
  • Jun. 1: Deadline for written manuscript. To be submitted to relevant journal.
  • May: Potential poster presentation of topic at Faculty of Medicine Resident Research Day.
  • Mid Jun: 10 minute slide presentation of topic at Resident Research Day.

You may also choose to join in an existing study. Copies of previous Research projects are available in the Department of Family Medicine office. The Research Project will be discussed with you in further detail in the Resident/Director meetings.

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EVALUATIONS

Practice written examinations and practice oral examinations will be included in the academic half-day schedule three times per year. As well, you will receive a list of the preceptors in the city who are currently involved in helping residents prepare for the oral portion of the national exam. You should start scheduling sessions with these preceptors early in the New Year.

Each rotation completed will require an In-Training Evaluation Report (ITER) to be handed in to the CFPC-EM Program office. As well, please fill out a faculty evaluation for each rotation as this feedback will be used to improve resident experience on each rotation.

While no formal procedure book exists, it is suggested that you keep a log of various procedures you have completed as this may be a requirement for proof of mastering different types of procedures when applying for jobs.

You will have 2 formal reviews with the Program Director, which will occur at the halfway point and near the end of your program year, respectively. During these reviews, it is expected that you will have your ITERs up to date.

Daily Evaluation Sheets should be completed at the end of each shift. Completed sheets should be forwarded to the following people:

  • HSC ER: Anita Bourgeois
  • SBGH ER: Joan Hutchinson
  • SOGH ER: Dr. Ricardo de Faria
  • Peds ER: Dr. Lynn Warda
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ADMINISTRATION

There are committees (as always) that require Resident participation. The 2 committees are:

  • The Department of Emergency Medicine Academic Council
  • The CFPC-EM Advisory Committee

These committees meet every quarter to discuss issues pertinent either directly to the program or to the emergency academia in general.

One resident will also be requested to sit on the CFPC-EM Resident Selection Committee for each upcoming year (mid-October).

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PRESENTATION EXPECTATIONS

Here is a basic list of the presentations you will be asked to do during the academic year. This list is not inclusive but should give you advance notice of some expectations to help you organize your time.

a. Grand Rounds, 45 minute slide presentation

b. Research project, written and slide presentation, potential poster presentation, 10 minutes, 10-15 slides

c. Academic Half-day seminars (about 5)

d. TIPS course: 15 minute talks (2)

e. Undergraduate Emergency Medicine Academic ½ Day Lecture (1).

i. Topics and presentations developed – need to present topic to undergraduate students.

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MOONLIGHTING

Moonlighting is a controversial subject in all residency-training programs. In the CFPC-Emergency program, it is preferred that you do not moonlight, but it is your decision. If you choose to moonlight, there are restrictions. If you choose not to abide by these restrictions, you risk failing the CFPC-Emergency program.

The restrictions are:

f. No resident may moonlight in a rotation that has not yet been completed. For example, if you wish to moonlight in an Emergency department but have not yet completed the rotation requirements within that Emergency department, then you are unable to moonlight in that department until doing so.

g. No resident may change the call schedule to allow time off for a previously booked moonlighting shift. As well, no resident may book time off a shift/rotation/half-day/grand rounds/etc to accommodate a moonlighting shift. It is not allowed to rearrange your education to suit the timing of your moonlighting. If you choose to moonlight, it should be arranged after you know your schedule and should not be in conflict with your schedule or your self-directed learning time. If you do not complete each rotation requirement or if you obtain poor evaluations on rotation or in practice exams, you risk failing the rotation and the program.

h. The Program Director will not provide any references during the program for the purpose of the resident obtaining moonlighting privileges. The Program Director will be more than pleased to provide references for jobs/careers that are to begin after the program is completed.

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HOW TO MAXIMIZE YOUR EDUCATIONAL EXPERIENCE

Each rotation has a list of objectives that mesh with the final objectives in your Orientation Handbook. Each rotation plays a different part in your overall training to becoming a CCFP(EM) MD. Some rotations are more focused on “hands-on” experience, with the education embedded in the chance to perform (with guidance) complex procedures/codes on patients (Trauma Surgery is an example of this). The person that will have the most influence on your learning experience is you. The way you interact with other healthcare professionals and obtain information from them can greatly add to any textbook/journal reading you do in your time away from the hospital. Here are some suggestions on how to recognize and enhance your educational experience:

Pre-Rotation:
  • i. Introduce yourself to the attendings ahead of time, stating your name, your year of training, your program and program director. Tell them of your previous experience and what you would like to improve or focus on during the rotation.
  • j. Review your rotation objectives.
  • k. Get your call schedule ahead of time.
  • l. Orient yourself to the daily “5 W’s”. Who are the housestaff? Where is the OR? Where are the greens/lockers? Where do rounds take place? What time do morning rounds start?
  • m. Find out presentation expectations ahead of time and keep your eye out for a likely topic from the beginning
On Rotation:
  • Get to know the team of fellow residents, medical students, attendings, RNs, ward clerks, unit assistants, etc. They will be valuable help during the rotation.
  • If someone knows something that you don’t, ask where they read it. If possible, ask for the reference article or a copy of it.
  • Read around your cases. Even 5 – 10 minutes on the subject will go a long way.
  • Ask your attending for “5 minute talks”. eg. “Can we talk about pancreatitis for a few minutes?”
  • Ask questions about treatment/prognosis.
  • Ask “Can I do that?”, “Can you show me how to…”
  • Get your hands dirty. Show your strong work ethic.
  • Ask for feedback/halfway review. Review what you’ve already seen/accomplished, and make a game plan for the rest of the rotation.
  • Talk about “that interesting case” with your fellow emergency residents/attendings.
  • Fill out your procedure book.
End of Rotation:
  • Ensure that your ITER is filled out and sent to your Program Office.
  • Ask for any articles that the attendings think will round out your experience.
  • Think about your experience. Is there anything that could be improved? Is there any attending/fellow/resident that was particularly helpful? (Thank them)
  • Fill out the rotation and attending evaluation forms and hand in to your Program office.
  • Review your rotation objectives to see if anything was not encountered on rotation. This ensures that you’ll read about it to round out your experience.

Hey… you’re also a representative of the CFPC-EM Program and other E.M. Residents - - always do your best!

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PROBLEM SOLVING

In this program, we have ZERO TOLERANCE FOR ANY KIND OF HARASSMENT of any resident or staff member. We expect the staff, residents and medical students to treat patients, families and each other with PROFESSIONAL, COURTEOUS BEHAVIOUR AT ALL TIMES. If you observe or are subject to any sort of harassment at all, please bring the episode up to the attention of the Program Director and Attending Physician of the rotation you are in IMMEDIATELY.

As a resident of the CFPC-EM Program, you are a PARIM member. Your representation currently is through the FRCP Emergency Program Chief Resident. The PARIM office is located in the Health Sciences Centre complex and can be reached at 787-3673.

If you have a concern with academics or otherwise, several routes of action are available. The concern may be brought up either with the Chief Resident of either CFPC-EM or FRCP(EM) programs, the Director of the Program, the CFPC-EM Advisory Committee, or PARIM.

The Postgraduate Medical Education office is in the Brodie Centre at HSC and is reachable through 789-3453. The Physician at Risk program at 602-400 Tache Ave. in the St. Boniface area is available 24 hours a day for other personal concerns. The telephone number for accessing this service at any time is 237-8320.

Included in this package is the “Resident Wellness Handout”. Make sure you review this package. This handout has suggestions for how to cope with the stresses of a residency-training program and beyond. Dr. Gren Mowat at the St. Boniface Emergency (235-3006) is available for comments on this package.

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HOLIDAYS AND STAT DAYS:

You will have 4 weeks official holiday time that may be split into two 2-week periods. You will also have 5 days off during the Christmas/New Year holiday period. There is no guarantee you will get the 5 days you request, but each rotation will do its best. If a resident opts to take vacation during period 7, their 3 stat days are transferable to other rotations throughout the year - not 5 days.

If you work at least 8 hours on an official hospital holiday, you will be allowed 1 STAT day in return. If you do not use the STAT day within the rotation it occurred in, you will require formal documentation from the Rotation coordinator that you are still owed a STAT day (a simple note with their signature should suffice). In order to use a STAT day outside a rotation it occurred in, you will need Program Director approval, the documentation and signature. You will also need to clear it with the coordinator of the rotation you wish to use the STAT day in. Please keep in mind that not all rotations honour outside STAT days, and not all rotations are able to honour the specific day requested and may want you to take the STAT on a different day.

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PASSING THE PROGRAM:

In order to pass the program, you must achieve the following:

1. Successfully complete all rotations and ensure that all ITERs are submitted in timely fashion to either Carolin Backmann-Smith or the Program Director. These are to be used in the final program evaluation of the resident. You need all ITERs submitted in order to graduate. These ITERs must demonstrate a clear passing grade in order for the resident to be considered for graduation from the program. Your ITERs will be reviewed with you throughout the year. The ITERs will be used along with verbal evaluations from preceptors. These will determine the need for any additional time to be spent on a failed/poor/minimal pass rotation.

2. You must submit a completed Procedure book to either Carolin Backmann-Smith or the Program Director by the end of the academic year. Please bring this book to your Resident/Director sessions for review during the year.

3. You must achieve at least 75% attendance at half-day sessions while on rotation.

4. You must write the three CFPC-EM practice written exams. You must also be available for review of these exams.

5. In addition to submitting all ITERS, you must submit at least one faculty (attending physician) evaluation form per rotation.

6. Completion of a resident research project.

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Bon Chance and have fun!

Sincerely,

Paul Doucet, MD, CCFP-EM

Director, CFPC-Emergency Program

Revised June 2008