This residency program is for 2 years.

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

The overall mission of the Paediatric Rheumatology Program at the University of Toronto is to produce graduates who have all the skills and competencies required to function as consultants in Paediatric Rheumatology and to have the ability to readily embark on further postgraduate fellowship training if they wish to pursue this.

As of July 2019, the Pediatric 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 2-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 relates to specific Entrustable Professional Activities (EPAs), e.g., Recognizing rheumatologic emergencies and following up appropriately. 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 minimum. For more information on CBD, please visit:

http://www.royalcollege.ca/rcsite/cbd/rationale-why-cbd-e

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, manager, health advocate, scholar and 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.

The overall goals will be accomplished by establishing the relevant inpatient and ambulatory clinical experiences in addition to a complementary academic program that will facilitate the successful achievement of the competencies required. There will be a graded escalation of responsibility commensurate with the clinical resident/fellow’s level of training and competence.

The training program comprises 13 blocks each year with specific rotations at The Hospital for Sick Children as well as a rotation in the ambulatory clinics at the major Adult Rheumatology hospital sites (University Health Network, St Michael’s Hospital, and Women’s College Health Sciences Centre).

It is anticipated that training experiences within the CBD curriculum will be as follows:

First year: 7 clinical outpatient blocks, 3 clinical inpatient/consult blocks, 2 infusion and joint injection blocks, 1 elective block. 4 weeks vacation.

Second year: 6 clinical outpatient blocks, 2 clinical inpatient/consult blocks, 2 infusion and joint injection blocks, 1 elective, 1 research block, 1 Adult Rheumatology block. 4 weeks vacation.

The ambulatory program has approximately 5,000 patient visits per year. Trainees have the opportunity to spend six-month rotations in General Rheumatology clinics and at least 2-4 months in each of the subspecialty clinics: systemic lupus erythematosus, neonatal lupus, systemic juvenile idiopathic arthritis, spondyloarthritis, juvenile dermatomyositis, systemic vasculitis, Kawasaki Disease, autoinflammatory diseases and scleroderma/ morphea. Residents will also have their own rheumatology longitudinal clinic throughout their 2 year training period.

There is a comprehensive academic program which has recently been consolidated into an Academic Half Day held every Tuesday morning. This Half Day includes Pediatric Rheumatology Teaching Sessions (Core Curriculum and Subspecialty Rounds), Research Rounds, Journal Club, Pathology Rounds, Radiology Rounds, Quality Improvement Rounds, Morbidity and Mortality Rounds, Ethics Seminars, Immunology Rounds and CanMeds Rounds. Clinical dilemmas or clinical cases of interest are presented by the Resident or Fellow on service each week. In addition, there are weekly Radiology Rounds.

The program has a strong focus on research/scholarship and Residents or Fellows will participate in a scholarly project over their 2 year training period. Trainees are supported to pursue either basic science, clinical, translational, quality improvement or educational projects and to present their findings both locally at the Department of Pediatrics’ Research Day and the Rheumatology Research Day (Ogryzlo Day) and to submit an abstract for presentation at the American College of Rheumatology or Canadian Rheumatology Association conference. Additionally trainees in their second year will have the opportunity to engage in a quality improvement curriculum and to complete a rheumatology quality improvement project.  Trainees who wish to pursue independent, investigative research careers are encouraged to pursue an additional year or years of training.