The program in Paediatric Emergency Medicine is designed to provide training in the comprehensive care of acutely ill and injured children. To fulfill this objective the program provides training and guidance in the following areas: clinical skills, research, academic, teaching, ethics and administration.

The usual course of training a resident would follow in this program would involve both core rotations in pediatric emergency medicine, reciprocal rotation training, subspecialty rotations, and elective rotations over a two-year period to provide residents with the opportunity to fulfill the educational requirements and achieve competence in the specialty.

Clinical Training

Paediatric emergency medicine rotations would comprise at least 12 months of the training period with a minimum of 5 months in each of the years. The initial months are spent primarily in the role of a resident with direct responsibility for patient care and are used to further develop the skills of history taking, physical examination and development of differential diagnoses and care plans for acutely ill and injured children. Progressive independence from direct supervision to independent learning and academic discussions of clinical problems will be expected during the first year. In the second year of the program the resident would spend progressively more time teaching and supervising housestaff in the performance of the above duties. Progressive independent decision-making with appropriate staff supervision would exist to allow the resident to develop their autonomy.


A minimum of 2 months would be spent in adult trauma and emergency medicine and a one month rotation in plastic/orthopedic surgery by residents with a background in paediatrics.

Residents with a background in emergency medicine would spend a minimum of 1 month in each of neonatology, paediatric ICU, and paediatric ambulatory care.
Six months of subspecialty rotations would include: toxicology with a balanced emphasis on adult and paediatric aspects, EMS system/disaster planning, and administration.
All residents are required to spend one month doing Paediatric Anaesthesia in order to master vascular and airway skills such as bag and mask ventilation, intubations, intravenous and central lines. In addition this provides a chance for the resident to familiarize themselves with the various conscious sedation and pain management practices used in PER and the physiology of the anaesthetized patient.

Finally, residents are expected to obtain APLS and ATLS courses in their first year if not previously completed. This is paid for by the Program.

Research

Research is an expectation of all trainees. Trainees will obtain skills through a horizontal course lecture series at UWO in clinical epidemiology and/or statistics and by their initiation of an independent research project. At the end of their two years all trainees are expected to have completed at least one project and presented it at a national meeting and/or submitted it for publication. The research project may be either clinically or laboratory based and may be carried out at the Children's Hospital or the laboratories of the London Health Sciences Centre depending on the interests of the resident.

Academic

During the two years the resident is expected to attend the weekly academic seminar series which takes place on Mondays and, over the two years, covers a virtually complete curriculum of the basic and clinical science as they pertain to Paediatric Emergency Medicine. We have monthly journal clubs in which the resident is responsible for presenting a review of the current literature on a given topic. In addition there are PEM rounds for the residents which are centered around a case and are organized (and often presented) by the resident. The PEM attending staff is present at these rounds to provide discussion and feedback to the residents.

PER Administration

Residents are expected to acquire an understanding of PER administration and management in preparation for their ultimate roles as attending paediatric emergency physicians. They attend the monthly PER Operations Committee and the quarterly Care Review Committee Meetings. In both of these forums, quality assurance, budget, and administrative issues are routinely discussed. In addition, the Academic Seminar Series addresses many administrative issues in a more theoretical forum. Residents are members of the Paediatric Emergency Postgraduate Committee. To further develop their administrative and organizational skills the residents are put in charge of the monthly resident rotation scheduling, PER rounds and journal clubs.

Teaching

The residents are responsible for the supervision and teaching of the junior house staff when they are on rotation in the PER. They are responsible for organizing, directing and sometimes presenting the monthly PER rounds. They also are component teachers in the weekly junior resident teaching series while on rotation in the PER.

Ethics

The residents are exposed to ethics on both a formal and informal basis. The informal teaching occurs regularly in case discussion at the bedside and in discussion with various consulting services. The formal teaching occurs in quarterly Ethics Rounds presented by a trained Ethicist as well as inclusion in the Paediatric Critical Care Medicine Academic Seminar Series and in focused sessions in the PER Academic Seminar Series on ethical issues as they pertain to PER.

University of Western Ontario, Department of Paediatrics
800 Commissioners Road East, Rm E6-103
London, Ontario, Canada N6A 5W9
Tel: (519) 685-8129  Fax: (519) 685-8156