While physically located in Saskatoon, The College of Medicine is a provincial resource in attitude and in practice. Postgraduate medical education at the University of Saskatchewan takes seriously its role in supporting quality health care to all people of Saskatchewan. This means training physicians to meet the needs of not only urban populations, but also rural and remote populations.

 

The College of Medicine has developed, and continues to develop, rotations in Saskatoon, Regina, and other communities. These rotations are designed to provide educational experiences to enhance your knowledge and skills, and take maximum advantage of unique educational opportunities in diverse communities. All postgraduate programs are expected to develop and incorporate into their curriculum rotations in communities other than their primary training site of Saskatoon or Regina. The way each program does this is not strictly prescribed by the College of Medicine, but is instead determined by the Residency Program Committee, taking into consideration the needs of their residents, and the excellent opportunities available in other locations. These rotations continue to evolve as we seek to build stronger and better programs.

 

Extensive support is available for all rotations completed away from one’s primary site. The exact nature of this support varies with location and program. The communities involved, individual programs, the College of Medicine, and the Ministry of Health work collaboratively to ensure residents are not financially disadvantaged by the need to temporarily relocate.
For residents assigned to short-term rotations in Regina or elsewhere, fully furnished private apartments are provided (including laundry facilities, wi-fi, cable TV) and are in close proximity to their training site. Family-friendly and pet-friendly housing is available. Residents in the Saskatoon Royal College EM Residency Program should plan to complete three blocks of Emergency Medicine in Regina (PGY-1, 2 & 5), one block of Toxicology in Calgary or New York (PGY-3), and one block of regional/rural Emergency Medicine at their site of choice (PGY-4). Residents are welcome to spend more time in Regina for both EM and off-service rotations if they wish.

Over the past year, we overhauled our academic curriculum with the goal of using more active learning techniques, removing redundancies within the curriculum, and delving more into the depths—not just the breadths—of Emergency Medicine. This curriculum, outlined below, is now in its first year of implementation and has received promising initial feedback from residents.

 

Academic Half Day (AHD) takes place on Wednesday afternoons. It is shared with the CFPC-EM Program, which runs a distributed program in Saskatoon, Regina, and Swift Current. AHD is video-conferenced between all three sites. Academic Full Days (AFD) occur approximately twice per month, often including practice exams and simulation sessions in the morning. To see the five-year program curriculum table, click here.

While the following curriculum may seem like a lot, it has been purposely mapped and regularly reviewed to ensure you are given the best opportunity to become a competent Emergency Medicine specialist!

 

Resident-led topic presentations: These 25-minute talks are a focused and in-depth review of two to three major issues within a given topic.

 

Staff-led case presentations: These 25-minute interactive cases illustrate clinical reasoning and application of knowledge through real-time management of cases, delivered by faculty emergency physicians. Cases are delivered by physicians at all three training sites.

 

Resident-led pediatric guidelines rounds: New this year, a two-year curriculum covering the top 22 pediatric EM guidelines has been developed, whereby residents pre-read the provided guidelines and then participate in this resident-led session that aims to focus on the application of the guidelines to common EM cases.

 

Staff-led adult guidelines rounds: New this year, a two-year curriculum covering the top 18 adult EM guidelines has been developed, whereby residents pre-read the provided guidelines and then participate in this staff-led session that aims to focus on the application of the guidelines to common EM cases.

 

Consultant rounds: New this year, we have implemented consultant rounds, which are sessions led by non-EM physicians, focusing on skills that have room for improvement based on the perspective of our non-EM consultant colleagues.

 

Group learning: New this year, we have implemented group learning sessions, which are sessions led by residents that focus on interactive and group-based learning on the topics of the monthly Rosen’s textbook readings. These sessions provide opportunity for group discussion and to delve into the depths of Emergency Medicine.

 

Self-directed learning: In order to remove curriculum redundancies and support residents wellness, we offer self-directed learning time for residents to complete their assigned curriculum tasks during protected AHD time.

 

Provincial grand rounds: New this year, the provincial Department of Emergency Medicine is facilitating provincial grand rounds. Residents are encouraged to attend and will have protected time to do so if they wish.

 

Trauma rounds: Residents are encouraged to attend monthly trauma rounds.

 

Saskatchewan Emergency Medicine Annual Conference (SEMAC): SEMAC is a conference targeting family physicians and emergency physicians who work in regional and rural Saskatchewan. It’s a great conference for residents and medical students to attend.

 

CAEP Conference 2024: Saskatoon will be hosting CAEP Conference in 2024! We hope to see you there.

 

Wellness rounds: Once a month, we have a presentation on a wellness topic, followed by a group activity session (fitness and non-fitness options), with the goals of promoting regular healthy habits in the busy life of a resident, providing an opportunity for residents to bond outside of work-related duties, and building resiliency. All physical activities are scalable and adaptable to be inclusive to all, and efforts have been made to have a mix of fitness and non-fitness activities. Wellness rounds are optional for residents, recognizing that wellness looks different to different people.

 

Procedure rounds: Procedure rounds follow a curriculum that is based on the core procedures of Emergency Medicine, and are designed to provide residents with simulated experiences for procedures that they will be expected to perform and collect EPAs on during their clinical rotations. The first half of the session will focus on more advanced procedures (typically led by a staff physician), and the second half of the session will typically be led by residents. Occasionally, allied health professionals or staff/resident physicians from other disciplines will facilitate these sessions.

 

EMS rounds: The Royal College EM Residency Program serves as an adjunct Medical Advisor for Ground Ambulance Services in Saskatchewan, under the supervision of Dr. Owen Scheirer (Central Zone Lead) and Dr. Kamini Erker (Provincial Lead). The Chief Residents chair these meetings and keep minutes to ensure all tasks related to this position are delegated and completed. All tasks are reviewed by Dr. Scheirer. Mini-topic presentations occur and cover key components of the EMS curriculum. This position serves as part of our longitudinal EMS rotation in the PGY3 year. Money earned from this position is used by residents to pay for educational expenses.

 

Ultrasound rounds: Our ultrasound curriculum is stratified by years of training. PGY1 residents focus on FAST scan (free fluid abdomen, lung, heart) and procedural guidance (central line placement) through the RAPID course. PGY2 residents focus on Obstetrical, Renal, and Aorta scanning. PGY3 residents focus on resuscitative ultrasound (advanced cardiac, lung, IVC). Once per month residents meet and review an ultrasound topic, then proceed to practice scanning with supervising faculty. Residents are expected to log a target number of scans each year, with a percentage of them being observed as EPAs. There is an ultrasound exam at the end of each year.

 

SuperSlM: Residents participate in six interdisciplinary, high-fidelity simulation sessions per year based on our resuscitation curriculum themes of Cardiac, Shock, Toxicology, Trauma, Geriatrics, and Airway. Residents also participate in two simulation sessions during each of their Pediatric EM rotations.
The Geriatrics SuperSlM and Toxicology SuperSlM are hosted within our annual special AFDs: Geri-EM Day and Tox-Day. Additionally, we host a yearly Disaster Day, which is an AFD focusing on mass casualty training, with a high-fidelity large-scale simulation event and other learning modalities as well.

 

Simulation for assessment: PGY1 residents participate in Transition to Discipline simulation sessions in July, targeting EPA 1.1 (recognizing the sick patient), and Foundations simulations sessions during the RAPID course, targeting EPA 2.1 (assisting in the care of an ill patient). PGY-2&3 residents participate in Difficult Airway simulation sessions, targeting EPA 3.3 (Airway Management).

 

Journal club: Our combined resident and faculty provincial journal club runs quarterly over the year in the evenings.

 

Rosen’s textbook rounds: Residents will be assigned monthly reading of Rosen’s Emergency Medicine textbook. The bulk of this textbook is covered every two years. A faculty member develops exam-style questions on the assigned reading, and residents write a low-stakes practice exam during protected AHD time. The answers to the questions are reviewed the following week during an evening social event over supper, generally hosted at the faculty member’s house.

 

New this year is a reading schedule that is more purposefully designed to ensure a variety of topics/chapters are covered each month (as opposed to the previous schedule where multiple chapters from the same topic were read in the month). This will provide greater variety and intermingling of concepts for learners.

 

Canadian In-Training Exam (CITE): This short-answer style exam is designed to reflect the style and content of the Royal College Exam. It is written in the fall and winter, and scores are compared nationally to give residents a sense of their progress in training. Our monthly textbook rounds are designed to prepare residents for this type of exam.

 

Practice oral exams: Residents will be exposed to at least one practice oral exam session per year, and several in their final year. We also run an annual mock oral exam, where residents participate in 12 oral exam cases over 2.5 hours. This exam is modelled after the Royal College oral exam format.

You’ll spend the majority of the year being exposed to Emergency Medicine (EM) in order to develop the framework for acquisition of expertise during off-service rotations later in residency. Each EM block will consist of 14 shifts, and you’ll attend other academic and curricular requirements.

 

Longitudinal rotations and extra-curriculum courses

For every EM block in the first two years of residency, residents will complete 3 x 12 hour Toxicology call shifts with PADIS (Poison and Drug Information System).

 

Residents can take up to four weeks during their EM blocks over their first two years of residency to dedicate time to their research project, as it is mandatory for all residents to complete a scholarly project during residency. Funding is available for residents to take a research course if they choose.
In addition to the research course in PGY1, we have monthly resident research rounds. The first session of the year sees all faculty share current research projects, so new residents can get an idea of projects they might be able to join. From there we break into three streams based on the CAEP Research Abstract Competition: Clinical, Education Scholarship & Quality Improvement Patient Safety (QUIPS). Residents identify which stream their project is in and attend these sessions (three sessions over the year per stream) where they can share any challenges they are facing with their projects. We then have a session on tips for presenting research just before our research day, and tips for disseminating research to finish the year.

 

PGY1 residents participate in four focused critical appraisal workshops. The topics are:

 

• Diagnosis I (Sensitivity, Specificity, LRs, PPV, NPV, Accuracy)

 

• Diagnosis II (Clinical Decision Tools, Receiver Operator Curves)

 

• Therapy I (Randomized Controlled Trials, NNT, ARR, RRR)

 

• Therapy II (Systematic Reviews).

 

Sentinel EM articles are used for discussion, and residents are given an assignment to be handed in for marking at the end of each session. PGY5 residents assist in teaching these sessions.

 

All first-year residents will take The Role of Practitioners in Indigenous Wellness Course. This award-winning online course runs over a three-month period during the PGY1 year. https://cmeleaming.usask.calonline-leamingfindigenous-wellness.php

 

Residents are also enrolled in ImageSim, an online, self-directed Pediatric Imaging Learning system, and are expected to complete the modules during their Pediatric EM rotations as part of the Foundations phase of training.

 

The Resuscitation and Procedural Inter-Disciplinary (RAPID) curriculum covers basic resuscitation skills, introductory ultrasound, and central venous access. Sessions are scheduled throughout the first year of training.

 

TIPS is a two-day College of Medicine Residents as Teachers course, preceded by an online Residents as Teachers course. It covers topics on:

 

• How people learn

 

• Motivation

 

• Attention

 

• Structure of a teaching session

 

• PowerPoint for teaching

 

• Clinical teaching techniques

 

• Feedback

 

Family medicine shifts are completed longitudinally through PGY-1.

 

During each EM rotation in PGY-1, you will participate in a Collaborator shift, where you find an allied health professional or service that we interact with in the ED, spend a few hours, and write up a reflection on your experience.

 

CanMEDS rounds cover topics that are difficult to assess in the confines of clinical work, including:

 

• Time Management & Strategies for Learning

 

• Charting in the ED, Communication with Special Populations

 

• Safe Opioid prescribing, Crucial Conversations

 

• Requesting & Receiving Consultations

 

• Breaking Bad News

 

• Disclosing Adverse Events

Residents will ideally present their research project at our annual research day near the end of the academic year in PGY2 or 3.

We have an inter-university affiliation (IUA) with the University of Calgary for our Toxicology PADIS rotation. Residents spend one block in Calgary in PGY3. New York City is also a training option.

Two longitudinal rotations will occur (EMS and Education) in this year. Residents are given a slight reduction in their shift-load during EM rotations to carry out the learning activities of these longitudinal rotations.

Transfusion Camp is run by the Department of Anesthesia and offers additional training in the areas of transfusion-based resuscitation.

The junior education curriculum provides residents with feedback on their large group teaching, provides resources to read on improving one’s education skillset, provides opportunity for teaching medical students history and physical exam skills, and graded management of learners on shift.

All mandatory (and most optional) courses are paid for by the program. Rosen’s Emergency Medicine and Roberts & Hedges’ Clinical procedures in Emergency Medicine textbooks are paid for by the program.

There are elective opportunities in PGY3&4 to pursue areas of interest. Elective blocks are flexible, and residents will generally use them for additional sub-specialty experience or applying for jobs/fellowships.

PGY4
In PGY-4, residents will consolidate their knowledge and skills in this final year of core. They will also spend one month in a regional ED (usually in North Battleford or Prince Albert, though other opportunities exist and are open to consideration) to gain the perspective of working outside of a tertiary care environment. Residents will complete their Royal College exam near the end of PGY4, after participating in a rigorous written and oral exam preparation curriculum throughout the year.

Residents will be expected to function as a junior staff in the ED, and will serve as Chief Residents for the program. They will participate in a longitudinal Administrative rotation, as well as a Quality Improvement and Patient Safety Curriculum, and a Transition to Practice curriculum focusing on career planning, financial literacy, medicolegal aptitude and professional expectations, leadership, and improving independence.

In PGY-5, residents will work to develop an Area of Comprehensive Expertise (ACE), which can be in any clinical or academic area that will enhance the practice of Emergency Medicine. If residents are performing well, they can integrate this time longitudinally to work towards a focused training program or a Masters Degree. Ideally, the resident will model their future work schedule with a mix of ED work and their proposed niche of expertise.

The senior education curriculum provides opportunity for PGY-5s to improve their skill set as educators as they work shifts where they focus on departmental management learner management concurrently, take a simulation debriefing course, facilitate simulation sessions, co-lead Rosen’s Rounds, and assist with oral exam preparation for the PGY-4 residents, all under the supervision of faculty who provide feedback on their teaching.

Some local options for ACE are Pre-hospital Care and Ultrasound.

The University of Saskatchewan has options for Masters Degrees in Business Administration (https://www.edwards.usask.ca/programs/mba/), Public Health (https://grad.usask.ca/programs/public-health.php), and Health Professions Education (https://grad.usask.ca/programs/health-professions-education.php).

The College of Medicine has a Medical Education Fellowship Program
(https://medicine.usask.ca/facultydev/teaching%20and%20learning/clinician-educator.php).

The Saskatchewan Health Authority offers the CQIP – Clinical Quality Improvement Program
(https://www.saskhealthquality.ca/training-webinars/cqip/).

We do not offer formal fellowships in ICU, Pediatric Emergency Medicine, or Toxicology, but have successfully matched residents to these fellowships (and other fellowships), and will work closely with residents who are interested to ensure they have as many opportunities as possible to explore these career opportunities in Saskatchewan or elsewhere. We will do our best to support resident interests in other areas of expertise; however, our priority will always be to ensure clinical competence in Emergency Medicine in the final year of training.