Our pediatric postgraduate training program at Western is a medium sized program that recognizes each individual learner is a unique and essential team member. We aim to guide learners in developing their best professional selves, acknowledging that every individual brings a unique and diverse complement of experience, interests and skills to the program. Our faculty across all subspecialties are engaged with the general pediatric training program, and take our responsibility to provide a stimulating, safe, and equitable learning environment extremely seriously.

Some of the important details are listed below:

ROTATIONS 

Rotation schedules are created by program leadership and administration by March/April of each year.  Matched PGY1 residents will be sent scheduling options and asked to rank preferences for the PGY1 year when available. We have 13 four-week rotation blocks per academic year, with some rotations being divided into shorter 2-week blocks to accommodate junior call blocks. This provides more rotations than needed to schedule all of the Royal College rotation requirements for training in Pediatrics and the flexibility for accommodating individual resident interests through rotation planning.

There is an extensive elective opportunity in the program. Residents may undertake provincial, national and international electives. International experiences require early planning and appropriate training prior to departure.  All electives must be supported by Royal College Objectives with appropriate supervision and assessment.

We have Junior Call blocks for PGY-1 and PGY2-residents, and Senior Call blocks for PGY-3 and PGY-4 residents, which provide better continuity of care and on-call learning experience compared to traditional intermittent night call. As a result, our residents have minimal post call days during rotations. In preparation for transition to practice, our PGY-4 residents run a biweekly General Pediatrics Continuity Clinic; they are assigned to the same supervisor/practice during the year and are the first point of care for their own patients. PGY-4 residents are able to function as Junior Consultants on the general pediatrics ward, in either an academic or community pediatric inpatient unit.

CURRICULUM

We have a comprehensive 2.75-year teaching rounds curriculum for PGY-1 to PGY-3 residents that is based on the Royal College Pediatrics Competencies. Residents have protected time to attend noon hour teaching rounds twice weekly, and a weekly 3-hour academic halfday. In July and August of each year, our curriculum includes a daily noon hour orientation seminar series for PGY-1 residents and a separate review curriculum for PGY-2 and PGY-3 residents. This PGY-1 “Summer Series” is considered essential by the program for new residents.  It allows for consolidation of entry level pediatric knowledge, and allows designated time for our new groups of trainees to get to know each other as a cohesive group.  Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation Program (NRP) training are organized by the program in the summer for all incoming residents and recertification for PGY-3 residents. The curriculum is reviewed and modified during biannual quality improvement cycles based on learner needs, and learner and faculty feedback.

Late PGY3 and PGY4 residents have a separate Transition to Practice Curriculum that is developed with input from our PGY-4 residents, and in collaboration with our PGY-4 Faculty Lead(s). This Transition to Practice Curriculum focuses both on practice readiness, clinical skill refinement, and elements of Royal College certification exam preparedness. This curriculum is protected time for PGY-4 trainees and is independent of the PGY1-3 curriculum.

Teaching sites in the program outside of London are linked by videoconferencing and online web-conferencing to enable residents to participate in the Academic Teaching Rounds and Academic Half Days.  Curriculum is delivered by a mix of in-person and virtual platform.

CLINICAL RESPONSIBILITIES

Patient care responsibilities are structured for each PG year to ensure a graduated increase in responsibilities. For example, PGY-1 residents are buddied with a PGY-2/3 for call. Starting in the PGY-2 year, residents are then responsible for supervising junior residents and clerks when on- call for CTU.  In July 2021, we have transitioned to Competence By Design (CBD) model, and promotion between stages is being used for CBD trainees to further guide graduated responsibility.

Scheduling of on-call, post-call, vacation etc.  is done in accordance with PARO guidelines (http://www.myparo.ca/).

LEARNING ENVIRONMENT

The ratio of residents to faculty is 1 resident to 2.5 faculty, with active recruitment for a number of new faculty positions over the coming few years. We have few Pediatric subspecialty residents and fellows which gives our residents the opportunity to have primary responsibility for patient assessments and management and to work directly with faculty.

We have a number of strategies to provide support for residents to achieve their personal best. All incoming residents are assigned a senior resident and faculty mentor to assist with the transition from medical school to residency. In addition, each resident is assigned an academic coach who is dedicated to supporting the resident in reaching their academic goals.  Our research subcommittee aids the resident group in finding faculty mentors for resident research projects, as well as tracking and supporting trainees with both short and long-term research goals. In addition, our longitudinal social pediatrics curriculum includes connection with mentors to support a successful resident advocacy project.

The Program Director and Assoc. Program Director have an open-door policy to provide support to each resident. Program Leadership is formally scheduled to meet with each resident twice a year to review progress and set goals, in addition to twice-annual meetings with each PGY group, respectively, and the entire resident group.

We have extensive resident participation in our Residency Program Committee (RPC) and subcommittees (Curriculum, Research, EDI-D, and Wellness). A resident representative from each PGY group is a member of our RPC and residents are represented on RPC subcommittees. We also have 2 elected Resident Leads, who are members of the RPC. We encourage residents and faculty to provide ongoing feedback and ideas to further enhance our program. One of the important mandates of the RPC is Continued Quality Improvement of the training program itself, and recent graduates are now surveyed anonymously on an annual basis.

Resident wellness is taken seriously by the training program. Our active Resident Wellness Subcommittee has both faculty and resident leaders. It is involved in planning social events for residents and at time faculty and residents together, including “TGIFs” and residents’ Fall and Spring retreats. However, it also shifts its focus to wellness on a more regular basis in the working environment, including a growing wellness library, call room “hotel kits”, regularly scheduled debriefing rounds, and community involvement/advocacy. The Program is also well supported by Schulich’s Learner Experience offfice for both individualized resident and group learning activities.

RESOURCES

We have three general pediatrics Clinical Teaching Units (CTU) staffed by academic general pediatricians who come from a broad range of clinical backgrounds. Each of the main CTU teams is comprised of one senior and one junior resident and three clerks.

The program also includes Community Pediatric rotations in smaller communities in the Southwest region of Ontario (i.e. London, St. Thomas and Stratford), some within commuting distance from London. Residents receive full funding for travel and accommodation are being provided by the Schulich’s Distributed Education (DE) for Community Pediatric rotations in St. Thomas, Stratford and other DE network/sites.  For Community Pediatric rotations that are less than 4wks, which are not qualified for funding, the Department of Pediatrics’ Rural and Remote Pediatrics Committee has extended funding support to medical students and pediatrics residents, which residents can apply for.

We have a teaching faculty of just over 100 clinicians, including general Pediatricians, Pediatric subspecialists and Pediatric general and specialist surgeons. All Pediatric subspecialties are available in our program for resident rotations.

We have an onsite simulation center, the Michael Gunning Simulation Centre, that is dedicated to pediatrics and maternal and child health. Our residents participate in many courses and learning activities that use this space, which includes but is not limited to our mandatory simulation curriculum. The program incorporates simulation in multiple areas of the training program, and is increasingly becoming a vital tool for both curriculum delivery and assessment.  We are fortunate to have a number of faculty with formal expertise and commitment to Simulation in Education. 

CTU-Windsor is a mandatory experience for PGY1 and PGY2 trainees, providing opportunities to attend an in-hospital consulting Pediatric clinic and provide consults to the emergency department in a community hospital setting.  Care of the well-newborn is also an integral part of this rotation.  The team consists of  one senior and one junior Pediatric resident, one Family Medicine resident and clerks.  The independence offered to residents in the Windsor setting is something frequently cited as a strength.  

PGY3 residents are also provided the opportunity to complete their PGY3 neonatal rotation in Windsor or London.