Department of Emergency Medicine

The ultrasound objectives and training modules are consistent with the Royal College in-training objectives, the national Canadian Point-of-Care Ultrasound Society (CPoCUS) guidelines, as well as the Canadian Association of Emergency Physician’s (CAEP) position statement. 

From the implementation of a formal postgraduate ultrasound curriculum in 2011, training in point-of-care-ultrasound (POCUS) continues to be a mandatory skill required for Royal College certification as well as a critical skill for Emergency Physicians to possess in order to improve patient care. The ultrasound curriculum has been designed to include two tracks, core and advanced. 

The postgraduate residency ultrasound curriculum has been designed to include two tracks, core and advanced.

The core ultrasound modules are delivered to incoming junior residents (R1/2/CCFP-EMs/PEM fellows) to prepare residents to obtain their IP-core status in eFAST/Cardiac/Aorta/1st Trimester OBs. At the end of the academic year, the junior residents participate in a directly supervised 50 scans & IP exams course for certification with standardized patients while ensuring that at least 1/3 of the scans contain pathology patients. 

The advanced modules delivered to the senior residents (R3/4/5s), include new focused POCUS applications for:

• Diagnosis (renal/bladder, gallbladder, DVT, ocular) 
• Resuscitation (advanced cardiac, pulmonary, IVC, EGLS/RUSH protocols)
• MSK (soft tissue, bones/joints)
• Needle guidance (ortho procedures, nerve blocks, foreign body, lumbar puncture, thoracentesis, paracentesis, peripheral & central lines)

The advanced curriculum runs on a two-year cycle. R3/4 residents also obtain their CPoCUS IP-Resus certification biennially.

The ultrasound modules based on the flip-classroom model, run on a horizontal curriculum embedded within the residents’ academic day sessions.

Each module contains a didactic portion with both online and live lectures followed by hands-on practice scanning on both pathology and standardized models. For quality assurance and for the advanced applications of POCUS, the ultrasound training modules continue to be proctored by ERPs who have obtained their IP/TI/MI status, fellowship-trained, or are specialists with a focused niche. Bi-Monthly clinical POCUS vignettes are incorporated into the ultrasound curriculum with real patient cases to deliver teaching pearls with EBM and stimulate group discussion.

After obtaining their IP status, residents are expected to participate in the Apprentice-Instructorship (AI) program. AIs team-teach and are directly observed by Faculty instructors as they take on leadership roles to proctor junior learners to consolidate their knowledge and skills. This ensures the department creates a strong cohort of POCUS instructors who deliver high quality teaching. Interested residents are also encouraged to take part in an advanced ultrasound elective to enhance their skillset as well as ultrasound research and present their findings at Resident Research Day and national conferences. 

In addition to creating a strong postgraduate ultrasound training program, the ultrasound section consisting of high caliber POCUS faculty instructors continues to offer quality continuing professional development workshops and courses for staff physicians. The POCUS CPD courses at UM has been superbly ranked by staff physicians for its organization, high instructor to learner ratio, and the incorporation of pathology patients to simulate the real clinical world. The emergency medicine department at the UM is a key leader on the national stage for POCUS education. CPD courses that have been offered by the section of ultrasound include the following:

• IP-core certification course
• IP-resuscitation certification course
• IP-diagnostic certification course
• IP-MSK certification course
• EGLS course
• Palliative/oncology course
• Soft tissue and foreign body workshop
• Peripheral and central line workshop

The ultrasound program continues to expand on the multitude of POCUS applications offered through CEPD.

The ultrasound section continues to expand in the areas of knowledge and skill training, research and scholarly work, as well as continuing professional development. Residents and staff physicians report that the ultrasound training has increased their confidence levels with image generation and with their ability to safely apply POCUS to improve standard of care for their patients.

The primary objectives of the HPP course are to provide medical trainees and staff with mental skills and strategies that have been demonstrated to minimize the impact of human factors in performance, optimize psychological preparedness to perform, and lead to enhanced well-being. HPP, which was initiated in 2012 within the emergency medicine department, has been offered to the departments of family medicine, surgery, internal medicine, pediatrics, anesthesia, obstetrics/gynecology, radiology and the cardiac sciences. HPP is tailored to help learners meet the demands of their residency programs and addresses the need for applicable strategies to help physicians perform and cope moreeffectively in their professional and personal lives.

HPP lead instructors, Drs. Jason Brooks and Aman Hussain, are experts in their field. In addition, the rewards of a rich mentoring relationship from the mentorship program benefits mentors and mentees, and also their department, institution, the organization, and the specialty. 
 

The goal of the Professional Sustainability and Wellness Committee is to support the department’s vision of long-term professional sustainability and wellness for emergency medicine faculty and residents. The ultimate reward is improved team function, better management of conflict, better care for patients, and quality enhancement. Gratitude and wellness initiatives to improve workplace civility is invaluable. It creates solidarity, psychological resilience and sustainability of a healthy work moral for the team. A team that functions in solidarity provides better patient care from a shared vision and mission.