Rheumatology

Under Construction

Overview

Rheumatology is the branch of medicine concerned with the specialized assessment and care of patients with rheumatologic, autoimmune, and related musculoskeletal health disorders. Traditionally, paediatric patients (usually under age 18) are attended to by paediatricians with subspecialty training in Paediatric Rheumatology. 

The SickKids clinical program is one of the largest in North America and provides fellows and residents with an extremely rich clinical experience and the opportunity to assess and manage the full spectrum of pediatric rheumatic diseases. The trainee has the opportunity to see patients from admission to discharge and follow-up in the ambulatory clinics, ensuring that he or she is able to develop an understanding of the natural history and long-term treatment of rheumatic diseases.

Objectives

On completion of the paediatric rheumatology training program,  the resident will be effective in the assessment, investigation, management, and rehabilitation of patients with inflammatory arthritides, systemic autoimmune rheumatic diseases, vasculitis, autoinflammatory diseases, soft tissue rheumatic disorders, collagen-vascular diseases, spinal, and regional pain problems and the musculoskeletal manifestations of systemic disease. 

Residents in Rheumatology may plan a residency program directed to independent private practice in the community or an academic teaching and research career in the University setting. Private practice Rheumatologists, and in particular those with University clinical appointments may also engage in teaching and research activities. Residents wishing to pursue a career in academic rheumatology are encouraged to take additional research training following completion of the core clinical Rheumatology program. 

Training Sites

The Hospital for Sick Children (SickKids) is the main training site for the Paediatric Rheumatology program. There is also an opportunity to complete rotations at community paediatric rheumatology sites in the Greater Toronto Area (GTA) in addition to an outreach clinic in Sudbury, Ontario.

The adult rheumatology rotation is completed in the ambulatory clinics at the major Adult Rheumatology hospital sites (University Health Network, Mount Sinai Hospital, St Michael’s Hospital, Sunnybrook and Women’s College Health Sciences Centre).

Research Experience

The program has a strong focus on research which residents or fellows are expected to initiate during the first year of their training. Trainees are encouraged and supported to pursue a scholarly project either in basic science, clinical, translational, educational, or quality research and to present their research both locally at the Department of Paediatrics' Research Day and the Rheumatic Disease Unit research day (Rheumatology Ogryzlo Research Day) and to submit an abstract for presentation at the American College of Rheumatology Annual Meeting or Canadian Rheumatology Association Annual Meeting.

Trainees who wish to pursue independent, investigative research careers are encouraged to pursue an additional year or years of training.

Evaluation

As of July 2019, the Paediatric Rheumatology Subspecialty Training Program has adopted the Royal College's Competence By Design (CBD) curriculum. Under this new curriculum, trainees will have their educational experiences structured within a two year time period by stages:

  1. Transition to Discipline - 2 months
  2. Foundations of Discipline - 4 months
  3. Core of Discipline - 16 months
  4. Transition to Practice - 2 months

Promotion from one stage of training to another will be based on successful completion of a designated number of observations as related to specific Entrustable Professional Activities (EPAs), e.g., recognizing rheumatic emergencies and following up appropriately. The promotion will be a decision made by a Competency Committee as a collective. This committee will consist of members including a Chair, program director and clinicians from the specialty of training within and outside of the training program, at a minimum.

Trainees are additionally expected to acquire and demonstrate competencies in all the CanMEDS (Canadian Medical Education for Specialists) roles developed and endorsed by the Royal College of Physicians and Surgeons of Canada, recently revised in 2015. The CanMEDS framework includes the following physician roles:

  • Medical expert
  • Communicator
  • Collaborator
  • Leader
  • Health advocate
  • Scholar
  • Professional

Trainees must demonstrate the knowledge, skills, and attitudes related to gender, culture, and ethnicity pertinent to rheumatology. In addition, trainees must demonstrate an ability to incorporate gender, cultural and ethnic perspectives into research methodology, data presentation, and analysis.

Ways To Get Involved

Trainees are valued members in the Division of Rheumatology and can actively participate in trainee leadership/representative roles in various committees including but not limited to Residency Training Program committee, Clinical council. Education council, Research council, PR-COIN Quality Improvement committee and Family Advisory Committee.

Additional Educational Opportunities

There is a comprehensive academic program which has recently been consolidated into an academic half-day. This half-day includes pediatric rheumatology teaching sessions (core curriculum and subspecialty rounds), research rounds (where division members and fellow present research projects or projects in evolution), journal club/clinical epidemiology rounds, pathology rounds, and morbidity and mortality rounds and ethics seminars and clinical research tools course. Clinical dilemmas or clinical cases of interest are presented by the fellow or resident on service each week. In addition, there are weekly radiology rounds and a weekly basic immunology seminar series.

Residents and Fellows are encouraged to attend many of the national and international rheumatology conferences such as the:

Observership Opportunities

We provide observership opportunities (maximum 1-2 months) for all trainees currently enrolled in an academic program in medicine (undergraduate, postgraduate, fellowship). 

If you are an international applicant, please contact:

Haya Al Husseini

Program Coordinator for the International Office at the Learning Institute

E-mail: haya.al-husseini@sickkids.ca

For more information please contact us directly at: rheumatology.trainingprogram@sickkids.ca

Contact

Training Program Director

Dr. Shirley Tse

Phone: 416-813-5828

E-mail: shirley.tse@sickkids.ca

Education Administrative Coordinator

Kamela Ramlackhan

Phone: 416-813-5828

E-mail: rheumatology.trainingprogram@sickkids.ca