Critical Care Medicine Residency

Introduction

The (Adult) Critical Care Medicine Program at the University of Toronto is a two-year residency program that leads the successful physician to Royal College of Physicians and Surgeons of Canada (RCPSC) sub-specialty certification. Each year the Ministry of Health and Long-Term Care (MOHLTC) funds approximately 7 places in our program for eligible physicians. In addition to these places the Division has the capacity to support exceptional trainees to complete an equivalent academic curriculum and clinical training to the Residency Program.

The rapidly expanding body of knowledge regarding the treatment of the critically ill, the continuing introduction of new technology for life support, and more complex societal issues (legal, moral, ethical) have created a need for specialists trained in the recognition and management of this patient subset. To develop such specialists, our residency program focuses on the knowledge, skills, and attitudes pertinent to the expected roles and competencies of the adult critical care medicine specialist. Residents training within the unique interactive environment in which the critically ill are managed learn to respect the rights of the patient and family and acknowledge the importance of age, gender, culture, and ethnicity.

The Residency Program is divided into 26 four-week training blocks. In accordance with the Objectives of Training set out by the RCPSC and by the Education Program Committee of the IDCCM, University of Toronto; the training program has mandatory and elective content.
 

Core Training

Each trainee following the Residency Program will complete 16 blocks of Core Critical Care training with 15 blocks spent in Academic hospitals and 1 block spent in an affiliated community hospital. Generally speaking trainees will spend 9 blocks in Academic hospitals in year 1, and undertake 6 blocks of academic hospital training and their community hospital block in year 2.

Academic Hospitals: Toronto General Hospital, Sunnybrook Health Science Centre, St. Michael’s Hospital, Toronto Western Hospital, Mount Sinai Hospital

Community Hospitals: Trillium Health Partners, St. Joseph’s Hospital, Toronto East General Hospital, North York General Hospital

Scholarly Activity: Each trainee will be afforded 6 blocks of protected academic time to complete a scholarly project.

 

Elective Training

Elective or “selective” blocks of clinical training relevant to Critical Care Medicine, are chosen by the trainee and approved by the program director. The elective training blocks in complementary disciplines broaden the overall educational experience of the Program.

Electives also enable trainees to develop sub-specialty expertise in Critical Care - which is vital both for career advancement and for academic development. They must be taken in periods of not less than four weeks and can be nominated from any of the recognized Royal College medical or surgical subspecialties, including but not limited to the following list:

  • Anaesthesiology
  • Burns Management
  • Cardiovascular Surgery
  • Cardiovascular ICU
  • Neurocritical Care
  • Trauma ICU
  • Paediatric Critical Care
  • Community ICU
  • Critical Care Ultrasound
  • Palliative Care Medicine
  • Echocardiography
  • Neurosurgery
  • Radiology
  • Transplantation (Lung, Liver, Heart, Bone Marrow)
  • Transport Medicine
  • Nephrology and Dialysis
  • Trauma Surgery
  • Emergency Medicine

For information regarding experiences outside of Canada, please read the information from the University of Toronto contained with the Appendix: Global Health Initiatives.

Resources

The following resources are available to trainees in the Critical Care Residency Program and are commensurate with those available to Clinical Fellows from their base hospital:

Conference Attendance

The program offers all Residents an Education Allowance of $3000 during their 2-years of training to attend critical care conferences and courses of their choice. This can be used to reimburse trainees for registration, travel and accommodation (subject to University regulations). Examples of meetings to attend include: ATS meeting, SCCM, ESICM, National ACES Course, Critical Care Review Program. The program pays for all CCM trainees to attend the annual Critical Care Canada Forum in addition to the Education Allowance.

When presenting work e.g. an abstract, on behalf of the University of Toronto it is expected that the trainees’ supervisor and or the research group will offset costs and therefore the impact on the trainee’s allowance by providing additional support for e.g. poster printing, travel expenses.

The Education Allowance cannot be used for the purchase of items such as textbooks, computers and software, or for laboratory equipment and such consumables for research.

ACLS and ATLS

The program pays for residents to complete both ACLS and ATLS, if they have not already completed these courses.

Site Resource Rooms

Each site has dedicated resources such as a residents’ and fellows’ room with computers and printing, scanning, faxing, and shredding equipment.

Practice Examinations

The program funds all trainees to sit the SCCM MCCKAP multiple choice exam and the University of Toronto Critical Care OSCE annually.

 

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