Physical Medicine & Rehabilitation Residency Training Program
Resident training in Physical Medicine and Rehabilitation is offered by the Department of Physical Medicine and Rehabilitation at The University of Western Ontario (Western). This training program is fully approved by the Royal College of Physicians and Surgeons of Canada for training in this specialty. The program operates out of Parkwood Hospital. Affiliated hospitals include St. Joseph's Health Care London (SJHC), London Health Sciences Center (LHSC – University Campus) and Victoria Hospital (LHSC – Victoria Campus).
The Physiatrist, is a specialist in Physical Medicine and Rehabilitation (PM&R), needs to be competent in a broad range of diagnostic and therapeutic skills. In addition to competence in relevant clinical areas, the physiatrist must learn management skills including the ability to direct and work with interdisciplinary teams. The physiatrist must have the expertise necessary to critically review the literature, conduct research and quality assurance projects and teach patients, families and colleagues about rehabilitation.
Typical patients seen for rehabilitation include both, adults and children with physical and cognitive impairments resulting in barriers to participation. Common conditions encountered include hemiplegia, paraplegia, quadriplegia, amputation, arthritis, pulmonary and vascular disease, neuromuscular disorders, musculoskeletal problems, acquired brain injury and pain disorders.
Complicated management problems frequently require integration of medical and surgical care with a program of physical and occupational therapy, speech therapy, psychosocial services, family and vocational counseling, education services and therapeutic recreation. Care of the disabled patient demands more than knowledge as a physician; it demands a sensitive and discerning appreciation of the patient and his/her family, friends, work and recreation.
Applicants must hold a recognized medical degree. Applications are administered through the Canadian Resident Matching Service (CaRMS), and applicants should apply directly to CaRMS. It is helpful to the Selection Committee to send a personal letter directly to the Residency Program Director stating why you are interested in Physical Medicine and Rehabilitation as a career, and The University of Western Ontario program in particular, and any biographical information that might help explain and support your interest in physical medicine and rehabilitation.
Dr. Keith Sequeira
Residency Program Director
Department of Physical Medicine & Rehabilitation
801 Commissioners Rd. E
London, ON N6C 5J1
Tel. (519) 685-4292 Ext. 42950
Fax. (519) 685-4098
Typically have between 5-8 residents in the program at a time, and 1-2 PGY1 positions each year.
The department of Physical Medicine and Rehabilitation was consolidated February 2002 under St. Joseph’s Health Care London with rehabilitation programs all located at the Parkwood Hospital site. Parkwood Hospital is a subsidiary of St. Joseph’s Health Care London and has grown to become one of the largest specialized sub-acute care hospitals in Ontario, serving London, Southwestern Ontario and the veterans of Canada through inpatient, outpatient and outreach.
There are libraries available at St. Joseph’s Health Care London and London Health Sciences Centre with computers with various electronic accessories, together with internet access. The purpose of the libraries is to provide current information in support of patient care, education, and research to medical and allied health staff and to students affiliated with the teams. Reference, Database Literature Searches (Accessing online health/medical databases), Interlibrary Loans, Current Contents (Tables of contents pages from selected journals), Library Orientation (Tours by appointment), Database/Internet Instruction (By appointment), large collection of E-journals available on floors or via home. Resident offices and a lounge area are available for individual study.
The Department of Physical Medicine and Rehabilitation provides for many of the off-service rotations (eg. Neurology and Orthopedics during the PGY-2 year and geriatric residents during the PGY-4/5 years). These rotations are primarily inpatient with some outpatient exposure. We attempt to place the residents into the most suitable rotation for their specialty. For instance, we attempt to expose orthopedic residents to the inpatient MSK unit, amputee rehab, orthotics, prosthetics and electrodiagnostics. We attempt to expose neurology residents to rehab in stroke, spinal cord and brain injury and electrodiagnostics. We try and expose geriatric residents to primarily outpatient physiatry.
The training program is five years in length. The PGY-1 is devoted to basic clinical training as required by the Royal College and includes a one-month rotation on Rehabilitation. The PGY-2 year consists of rotations in Rheumatology, Orthopedic surgery, Neurology and Rehabilitation. The PGY-3, 4, and 5 years are spent on Rehabilitation with ample time available for electives, especially in the PGY-5 year.
The core program consists of three-month rotations in Stroke, Spinal Cord Injury, Head Injury, Neuromuscular diseases including Electrodiagnostic Medicine, Prosthetics and Orthotics and Pediatric Rehabilitation. A one-month rotation in Cardiac and Pulmonary Rehabilitation. Six months of Musculoskeletal Inpatients/Outpatients including chronic pain management. Research can be done in monthly blocks or longitudinally usually beginning in the third year and continuing through until the completion of the project. Electives are available in many areas. For an applicant specifically interested in Pediatric Rehabilitation or research, adjustments to the program can be entertained.
All residents are provided with a resident manual that is updated every year. This is a very resourceful manual that includes all objectives and evaluation forms.
The Division is committed to enhancing the knowledge base in Physical Medicine and Rehabilitation and practicing Evidence Based Care.
Research rounds act as a forum for teaching research methodology, statistics and evidence-based rehabilitation, and for the peer review of research proposals. Journal Clubs are incorporated regularly into academic half days. The department has research links with the Lawson Research Institute, Robarts Research Institute, the Faculty of Health Sciences, Departments of Surgery, Neurotrauma and the Divisions of Plastic Surgery and Orthopedics.
The Rehabilitation research group at Western is composed of internationally renowned clinical and basic scientists. There is opportunity for vigorous enhancement of research skills through collaborative research or pursuing graduate studies.
The Aging, Rehabilitation and Geriatric Care program of the Lawson Health Research Institute was formed in 1998 following the transfer of governance of Parkwood Hospital to St.Joseph's Health Care London, as part of the Province-wide health services restructuring. The program was formed to incorporate the research activities conducted at Parkwood Hospital, the pain research group at the Grosvenor Site, as well as, some of the research at the Canadian Centre for Activity and Aging, into the Lawson Health Research Institute structure.
It is mandatory that residents complete a research project during their training. Residents are strongly encouraged to participate in the National Resident Research and Resident Essay contest offered by the Canadian Association of Physical Medicine and Rehabilitation.
On-call is taken from home. Residents are each provided with a long-range beeper for the duration of their residency.
Evaluations are based on the objectives of each rotation and residents are encouraged to put forth personal objectives reflecting their interests or needs. Residents are evaluated informally on a daily basis and formally at the end of each block via online evaluation (ITER). OSCE-type practice exams are held once a year in London and once/year at either Toronto or Hamilton. Residents are encouraged to attend practice examinations at other centres. The program director formally meets with each of the residents at least twice a year to discuss six monthly evaluation reports. The program director is accessible and makes himself available to address resident concerns. Residents also participate in the yearly American in-training exams in Physical Medicine & Rehabilitation.
Conferences and Teaching
Residents receive financial assistance to attend a rehabilitation review course during their PGY-4 year. Residents are funded for conferences where they present their research findings. Residents are also funded to attend local conferences and seminars, as appropriate.
Formal teaching specific to the rotation occurs in each of the rotations and is preceptor based. Weekly academic half days are organized from September to June. Residents are freed from clinical responsibilities to attend. The academic half-day consists of Clinical Management rounds, Research rounds, Ethics rounds, Evidence-Based Medicine rounds, Journal clubs, Prescription rounds and X-ray rounds. Fall and winter term core modules incorporating basic science and its clinical applications are organized during academic half days. During the summer months Anatomy and clinical skills are taught in the Anatomy laboratory.
Nine Physiatrists are actively involved in the teaching program. One new recruitments is expected within the next year. Some staff members have large outpatient practices, others are involved mainly in hospital-based rehabilitation. One staff member coordinates the research program for the residents. We have one full-time internationally reclaimed PhD Researcher, Dr. Hayes who coordinates the research needs of the residents.
This staff complement is able to provide a wide variety of learning opportunities for residents.
We have an active social committee that organizes formal and informal get-togethers throughout the year. Staff-resident interaction is excellent. Counseling is available for stress management through the University.
Nestled at the forks of the Thames River in the heart of southwestern Ontario, London is a special place to live, work and play, and offers friendly communities, good job opportunities, world-class schools, excellent public health care, and services to help you get settled quickly. Home to nearly half a million, London is has diverse population with people from all countries, cultures and faiths.
London’s unsurpassed beauty of tree-lined streets, pristine parks, extensive walking and biking trails and an abundance of recreation facilities are just a few of the qualities that entice families to London. It is home to many private and public golf courses, summer festivals that occupy almost every weekend from June to September, a bustling nightlife and a myriad of theatre, music and museum options. The John Labatt Centre, where major concerts and events take place outside of Toronto and Detroit, is a fabulous 10,000-seat sports arena and recreation facility home to the London Knights. It is renowned for big-name acts including Cher, Sting, Billy Idol, Michael Buble, Broadway musicals; and public speakers including former US president Bill Clinton, and so much more.
This program provides solid training in all the core areas of rehabilitation and strives for maximum flexibility to accommodate elective experiences. This is crucial in a specialty as broad as Physical Medicine and Rehabilitation, where many different types of practice options are available.
Vithya Gnanakumar - PGY5
Dr. Vithya Gnanakumar is a PGY3 in PM&R. She is from Alberta, and has a BSc.in Biology and an MD from the University of Calgary. She is interested in international medicine and hopes to complete a fellowship abroad. She enjoys sports, travelling and reading.
Steven Macaluso - PGY4
Medical Degree (M.D.) - UWO 2007
Bachelor of Science
(Kinesiology with Biology - UWO 2003)
PMR Interests: MSK, Sports Medicine, SCI
Status: Happily Married
Hobbies: Sports, Videogames, and Kimbo Slice
Ricardo Viana - PGY3
B.Sc Honours Biochemistry - McMaster University
(Minor in Business Administration
B.Sc Occupational Therapy - McGill University
MD - University of Western Ontario
Interests: Neurological Rehabilitation, EMG / NCS, Golf
Dr. Keith Sequeira
Residency Program Director