Core Paediatric Residency Program

Overview 

The University of Toronto’s Core Paediatric Resident Program is dedicated to providing excellence in patient care, education, and scientific investigation. Similarly, it is hoped that all trainees will emerge from the program with first-class clinical skills, the ability and desire to continue to learn throughout their career, and the ability to ask appropriate questions and contribute to understanding and knowledge in their field of interest.

SickKids Paediatric Residency

Objectives

  • To provide broad-based clinical and academic training in paediatrics with the goal of creating the foundation required for the academically rigorous practice of general and subspecialty paediatrics
  • To focus on clinical experiences of a secondary and tertiary nature in general and subspecialty paediatrics as seen in both a large academic health science centre for children and in community practice.
  • To ensure training in critical appraisal, research methodology, and the application of evidence-based medicine to practice.
  • To emphasize the development of teaching and research skills.
  • To provide graded responsibility in the acquisition of leadership skills.
  • To fulfil all the objectives of specialty training required in Paediatrics by the Royal College of Physicians and Surgeons of Canada including the seven CanMeds roles.
  • To provide an environment which is rich in diversity and inclusion in addition to mentorship and experience which will allow each resident to achieve the goals outlined above.

Training Sites

  • Holland Bloorview Kids Rehabilitation (Developmental and Rehabilitation Paediatrics)
  • Michael Garron Hospital (Community Paediatrics)
  • Mount Sinai Hospital (Level III Nursery)
  • North York General Hospital (Community Paediatrics)
  • Orillia Soldier's Memorial Hospital (Rural Community Paediatrics)
  • St. Joseph's Hospital (Community Paediatrics)
  • St. Michael's Hospital (Community Paediatrics, Level I/II Nursery)
  • Sunnybrook Health Sciences Centre (Level III Nursery)
  • The Hospital for Sick Children

In addition, there are over 100 community paediatricians on staff who participate in teaching, and in a growing network of regional community pediatric centres closely affiliated with The Hospital for Sick Children.

Program Content

This residency program is for 4 year(s).

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

The core curriculum meets the Royal College of Physicians and Surgeons of Canada standards for accreditation in paediatrics. After three years of core training, residents may choose to pursue a fourth year in general paediatrics or may choose to apply for training in a paediatric subspecialty. The program's specific objectives are as follows:

  • To provide broad-based clinical and academic training in paediatrics with the goal of creating the foundation required for the academically rigorous practice of general consulting and subspecialty paediatrics.
  • To focus on clinical experiences of a secondary and tertiary nature in general consulting and subspecialty paediatrics as seen in both a large academic health science centre for children and in community practice.
  • To ensure training in critical appraisal, research methodology, and the application of evidence-based medicine into practice.
  • To ensure training in and exposure to the issues of Child Advocacy, Patient Safety/Quality and Child Health Policy.
  • To emphasize the development of teaching and research skills.
  • To provide graded responsibility and the acquisition of leadership skills.
  • To fulfil all the goals and objectives required for paediatrics by the Royal College of Physicians and Surgeons of Canada (see RCPSC document 2008) including the seven CanMeds roles.
  • To provide a diverse and inclusive environment with mentorship and experience that will allow each resident to achieve the goals outlined above.

Since July 1, 2008, all University of Toronto Residents entering PGY1 are required to complete the web-based PGCorED* core competency modules as part of their residency program certification. These modules provide the foundation for non-clinical roles for the RCPSC and CFPC Programs. These modules are focused for PGY1 and PGY2 trainees. Failure to complete the modules will delay the processing of Final In-Training Evaluation Reports (FITERs) and may constitute professional misconduct.

PGY-1

Adolescent Medicine - 4 weeks

Care of the Newborn - 4 weeks

Community Paediatrics - 8 weeks

Paediatric Emergency - 6 weeks

Paediatric Infectious Disease - 4 weeks

Immunology and Allergy/Dermatology- 4 weeks

Paediatric In-Patient - 12 weeks

Paediatric General Surgery - 2 weeks

Paediatric Urology - 2 weeks

Research - 2 weeks

PGY-2

This year is designed to provide paediatric subspecialty experience in paediatric cardiology, developmental paediatrics, endocrinology, gastroenterology/clinical nutrition, oncology, nephrology, neurology, respirology, rheumatology, and neonatal intensive care. There is a four-week elective opportunity which may be taken outside Toronto, nationally or internationally. There are 2 two-week selective or research blocks.

A night float system designed by residents was started in the 2016/17 academic year with great success and will continue.

PGY-3

This year provides graded responsibility and supervisory experiences in a CTU setting on the general paediatric unit, emergency room medicine, neonatal-perinatal medicine (Level III), neonatal medicine (Level II - community), genetics-metabolics and ambulatory experience. In addition, there are experiences in the paediatric intensive care unit as well as experiences in the emergency management and resuscitation of acutely unwell patients through the leadership of the "Code Blue Team".

There is a four-week elective opportunity which may be taken outside Toronto, nationally or internationally, and two 2-week selective/research blocks as well.

PGY-4

General Paediatrics

For those residents who pursue general paediatric training, this is a very flexible year planned to meet the individual resident's academic goals and to develop leadership skills.  There is an emphasis on the skills important to the development of competent general consultant paediatrician.  Emphasis is placed on Community Paediatric rotations as well as rotations that have been specifically developed for the fourth year to meet the needs of a practising consultant paediatrician.  The curriculum is designed around mastery of skills required as a general consultant paediatrician.

Paediatric Subspecialty

This route may be pursued as training in the fourth year and these opportunities are offered in the accredited subspecialties of adolescent medicine, paediatric cardiology, critical care medicine, clinical pharmacology, developmental paediatrics, endocrinology, gastroenterology, genetics/metabolics, haematology/oncology, immunology/allergy, infectious diseases, neonatal-perinatal medicine, nephrology, neurology, paediatric emergency medicine, respiratory medicine and rheumatology. Training is also offered in the non-accredited subspecialty Academic General Paediatrics (after 4 years of training).

Program Highlights

The Paediatric Residency Program at the University of Toronto thrives on a diverse patient population, excellent resources, and an outstanding teaching faculty. The Core Paediatric Residency Training Program is a priority for the Department of Paediatrics, and as such, an outstanding learning environment exists. The program is diverse and inclusive, fostering a welcoming environment where everyone belongs.

A career counselling program is in place, resident retreats are organized on a yearly basis, and social functions including a baseball game, holiday party, annual fundraising gala, and many other activities arranged by the resident engagement committee ensure an excellent spirit of camaraderie.  In addition, a wellness committee run by residents with faculty support ensures a proactive approach to the health and well-being of our residents, building skills and resilience.

The Hospital for Sick Children provides primary, secondary and tertiary care to the local community and tertiary and quaternary level care to the rest of Ontario and beyond when required. There is a very busy emergency room and general paediatric unit where common paediatric problems are seen in large numbers. In addition, all paediatric subspecialties exist at The Hospital for Sick Children which ensure exceptional patient volume and variety. The Atrium tower provides spacious modern facilities for a family-centred-care approach to our paediatric patients. Residents have access to electronic medical resources. While much of the residency training is spent at The Hospital for Sick Children, residents also have the opportunity to gain invaluable experience at a growing number of our community affiliates.

Advocacy and social responsibility are core values of the Department of Paediatrics and are emphasized in the Residency Training Program.  The program has a well-integrated advocacy program, run by residents with faculty oversight.  Social Paediatrics is emphasized and taught throughout the program, appropriately layered throughout the academic curriculum, a part of everything we do.    Child Health Policy and Patient Safety are also woven into the curriculum through teaching and clinical experiences.

Experiences in Global Child Health have become an integral part of the training program.  Many residents take part in international electives, research and local courses pertaining to issues affecting these populations.  Oversight of international electives exists (both within the program and through the University of Toronto) to ensure our trainees are fully supported with their international endeavours.

Residents in the program have an opportunity to participate in teaching activities, both formal and informal, scholarly projects, advocacy, committee work, leadership roles, curriculum development and resident selection.

Research Experience

The Department of Paediatrics is renowned for research and this residency program provides the opportunity for residents to become involved in research projects. It is expected that all paediatric trainees will complete at least one scholarly project during their three core years of training as per the Royal College of Physicians and Surgeons of Canada requirements. These efforts are supported by research mentorship programs and two-weeks of protected time in the first year allows trainees the opportunity to begin projects. Further time may be set aside for these projects during the second, third and fourth year.

A Resident Scholarship Oversight Committee has been developed to provide mentorship and support to residents around their scholarly activities.

Evaluation

The Paediatric Training Program has a robust system of assessment.

As per the Competence by Design Curriculum, the program has a Competence Committee made up of departmental faculty, who review each resident’s progress twice a year.  This committee does in-depth reviews to make these progress decisions, reviewing all assessment data available.  Some examples of this assessment data include:

  • The PGY1, PGY2 and PGY3 paediatric residents are required to write the In-Training Examination of the American Board of Pediatrics at the beginning of each academic year. The feedback from this examination provides candidates with an assessment of their knowledge compared with individuals at the same level of training, and with information on areas of strength and weakness. Changes in the absolute score from one year to the next are informative. The exam is also helpful in pointing out problems that may exist in the teaching program.
  • Twice a year MCQ and SAQ examinations are administered during the academic half-day.  Residents receive feedback as to where they performed as compared to peer norms.
  • Once a year residents participate in a 10 station OSCE.  Residents receive feedback as to where they performed as compared to peer norms.
  • Electronic In-Training Evaluation Reports (ITERs) are automatically sent to the supervisor near the end of each rotation. After the supervisor completes the electronic evaluation form, it is forwarded to the trainees who will review and sign it on-line. Staff are expected to discuss the evaluations with the trainees face to face before completing them.
  • Clinical skills assessments are done at least twice a year for all residents and are a mandatory part of the program. During these sessions, residents do a complete history and physical examination while being observed by a faculty member, and subsequently, discuss their approach to the problem. The faculty member completes a written evaluation of this process, and feedback is provided to the trainee.
  • Work-Based Assessments – the backbone of the CBD assessment strategy are work-based assessments.  These assessments are authentic, real-time assessments done in the clinical environment when working directly with patients and a supervisor.  These assessments are required in order to progress towards achieving the Entrustable Professional Activities (EPAs), required throughout each stage of the program.

Evaluation works both ways, and residents are asked to evaluate each rotation and each clinical teacher. In addition, members of the Postgraduate Residency Program Committee support reviews of each rotation through Resident Retreat Reports annually. This information has an important role in the implementation of changes/improvements in the program.

Ways To Get Involved

Residency Program Committee (RPC)

The dynamic and effective RPC of the core Paediatric Residency Training Program, collaborates with the PD in planning, organizing, evaluating and continuously improving the residency program. The RPC ensures that the program is designed on the backbone of the CanMEDs competencies related to the knowledge, skills and attitudes required to be a General Consulting Paediatrician.  The RPC ensures that the residency program is designed to train paediatricians who can meet the needs of the paediatric population in society at large and at the community level.   The RPC ensures that the program is meeting the general and discipline-specific accreditation standards and develops policies and processes that are consistent with the University of Toronto, Faculty of Medicine vision/ mission, policies and processes.   In order to carry out its mission effectively, the RPC has 11 subcommittees who work on different aspects of the program and report directly to the PD and the RPC.

The Resident Selection Subcommittee

This subcommittee is charged each year with the selection of candidates for the paediatric training program. The Resident Selection Committee meets from November to February, at least once a month, and often more frequently, to deal with the large numbers of applications to the program. The work of this committee involves application reviews to select candidates for interview and in-depth file review after the interview and the ultimate ranking of candidates. This committee is also responsible for reviewing and updating the selection process on an ongoing basis in order to ensure that our processes are evidence-informed and designed to select for values, attributes and skills that align with our program. This committee has broad and intentionally diverse faculty representation and resident representation.

The Resident Selection Subcommittee (International)

This subcommittee is charged each year with the selection of candidates for the paediatric training program through the IMG stream. The Resident Selection Committee – International meets from November to February, at least once a month, and often more frequently, to deal with the large numbers of applications to the program. The work of this committee involves application reviews to select candidates for interview and in-depth file review after the interview and the ultimate ranking of candidates. This committee is also responsible for reviewing and updating the selection process on an ongoing basis in order to ensure that our processes are evidence-informed and designed to select for values, attributes and skills that align with our program. This committee has broad and intentionally diverse faculty representation and resident representation, including faculty who are IMGs. 

The PeRLS Subcommittee (Academic Half-Day committee)

Chaired by the PD and a faculty member and is made up of residents from PGY-1 to 3 and the chief residents. This committee is charged with the oversight of the AHD curriculum, responding to resident feedback, ensuring compliance with the RCPSC goals and objectives of training and planning the blueprint for the upcoming academic year. 

Resident Research and Scholarship Subcommittee

The aim of the Resident Research and Scholarship Committee is to support and strengthen resident research and scholarship within the Core Paediatrics Training Program. This committee meets regularly with all residents in the program to provide support, advice and monitor progress of their scholarly activity. The committee meets regularly, and the Chair meets regularly with the PD. 

CaRMS Subcommittee

Charged with monitoring, reviewing and designing the CaRMS process for prospective candidates applying to the University of Toronto Program. This committee is chaired by residents, and includes residents from all years in the program.

Resident Wellness Subcommittee

This subcommittee is chaired by to senior residents with faculty oversight. This committee is made up of residents from multiple years in the program. The committee evaluates factors influencing the physical and mental wellbeing of paediatric residents during training with the goal of implementing strategies to enhance resident wellbeing. Projects will include, but are not limited to, formal education, curricular activities, mentorship, Balint groups, and advocating for systems-level change.

Advocacy Subcommittee

This committee is chaired by residents with faculty oversight. It oversees and supports a number of resident-led initiatives including the Paediatric Outreach Program (POP clinic for uninsured patients), Make Room to Read, Firgrove school initiatives, Legislative Advocacy, as well as the Elementary and High-school outreach initiatives as some examples. The mandate of this committee is to aid in teaching the Health Advocate role, participate in advocacy initiatives, as well as engage in scholarly activity in the realm of advocacy. It is comprised of several subcommittees, each with a focus on a longitudinal advocacy project. The purpose of the Paediatric Resident Advocacy Committee is to: 

  • Provide leadership and organization: Provide templates for subcommittees to set tangible goals, meet with subcommittees semi-annually to track progress and provide resources as guidance to troubleshoot issues and concerns. 
  • Be accountable and credible to the University of Toronto Paediatric Resident Program as part of the advocacy curriculum: Provide detailed yearly reports to summarize the efforts of Paediatric residents in their individual advocacy projects. 
  • Oversee finances including budgets and funding applications 
  • Continue to engage residents to act as advocates for children and their families in the Greater Toronto Area 

Resident Engagement Subcommittee

Comprised of 3-5 executive members. The mandate of the committee is to plan and execute events throughout the year that function to bring residents and staff together in an environment outside the workplace. Events in previous years have included the R1/R2 mingler, the staff-resident softball game, the holiday event, the Annual Resident Spring Charity Formal and the resident end-of-year BBQ. In any residency, success is dependent upon the ability to form meaningful working relationships with your colleagues and staff. The Resident Engagement Committee creates a forum to help foster these connections, particularly in such a large residency program.

CBD Steering Subcommittee

This committee was formed to help guide the core program around the transition to implementing Competence By Design (CBD). This committee is made up of members of the RPC, with additional membership ensuring that all rotations and sites within the core program are represented. There are residents on the committee from each year in the program. The CBD Steering Subcommittee is a committee charged with advising and overseeing the implementation of Competence by Design into the core program. Responsibilities of this committee include: 

  • Identify faculty and resident development needs around CBME/CBD, andCBD and advise on the planning and dissemination of faculty and trainee development around these topics. 
  • Discuss best practices regarding CBD curriculum design and alignment, innovative CBD instructional approaches and assessment of learners, and updates from the RCPSC. 
  • Determine the educational strategies that can best fit the needs of our Pediatric training program with regards to the CBME/CBD transition and implementation, and formulate recommendations (based on consensus with the committee members) to report to the Residency Program Committee (RPC).

Equity, Diversity and Inclusion Committee (EDI)

This newly formed committee has a mandate to ensure that all aspects of the program are incorporating best practices in EDI into their work.  The goal is to have EDI become entrenched as part of the “fabric” of who we are as a program and constantly challenge ourselves to do better. We are committed to a culture of EDI throughout all that we do in the program, and this committee will provide leadership in this area. 

Additional Educational Opportunities

Four hours of protected time per week make up the academic half-day. This rich curriculum provides a wide variety of learning opportunities addressing all the CanMEDs roles. There are three to five additional hours per week of protected teaching time depending on the rotation. Paediatric and neonatal life support courses are taught during orientation and throughout the program. Financial support is available to support conference leave in each academic year.

Applying To The Program

Residency positions are available to Canadian citizens or landed immigrants of Canada who are in their final year of medical school in North America. Residency positions are also available to Canadian Citizens or landed immigrants of Canada who trained outside North American through the International Medical Graduate Stream (IMG). All applications are handled centrally by the Canadian Resident Matching Service (CaRMS),  51 Slater Street, Suite 1004, Ottawa, Ontario, K1P 5N1. For additional information on the eligibility requirements or to apply to the program visit the CaRMS website.

Postgraduate training agreements are currently in place between the University of Toronto Faculty of Medicine and sponsoring agencies from the following countries:

  • Bahrain
  • Kuwait
  • Oman
  • Qatar
  • Saudi Arabia
  • United Arab Emirates

Applications for residency training from citizens of these countries must reach the PGME Office directly from the sponsoring agency. 

We are hosting virtual information sessions for interested candidates. The sessions will include an address from the Program Director, Dr. Adelle Atkinson, the Chief Residents, along with other residents in the program. These sessions will highlight what makes our training program so special and will provide an opportunity for a Q&A period. If you are interested in attending or would like to be informed about the dates and times of future information sessions, please fill out this survey. Also, consider following us on Twitter and Instagram (@UofTpaedsres) to learn more about our program and to stay up-to-date on all upcoming virtual events this CaRMS cycle.

Testimonials

AdelleAtkinson V2

AshnaAsim V3 Jan2021

CelineConforti V2

Danielle Arje

Eliza Pope

Justin Lam

Lauren Friedman

Warner Finstad

Yolanda Scoleri

Ziyad Alrajhi

Contact

Training Program Director (Interim)

Dr. Adelle Atkinson

Phone: 416-813-5310 ext. 205310

Email: adelle.atkinson@sickkids.ca

Education Administrative Coordinator

Courtney Smart

Phone: 416 813 7654 ext. 205310

Email: paeds.residencyprogram@sickkids.ca

Education Administrative Coordinator

Brigette O'Leary (maternity leave July 2021-August 2022)

Vanissa Kamptapersaud

Phone: 416-813-7654 ext. 245540

Email: paeds.residencyprogram@sickkids.ca