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Paediatric Emergency Medicine
Paediatric Emergency Medicine

Residency

The Hospital for Sick Children's Emergency Department (ED) provides care to almost 50,000 children a year with the most complex, tertiary-care medical problems as well as children with common, ambulatory paediatric illnesses and concerns. We are a primary health-care contact for many children from the downtown Toronto area, and other parts of the Greater Toronto Area for care of acute illness.

You will encounter children with a wide variety of medical, surgical, psychiatric and social problems, each of which is unique in the context of the individual child. You will meet patients and families from a wide range of cultural and socio-economic backgrounds and with a broad variety of expectations relating to their care in the ED. Along with the opportunities to consolidate and broaden your specific knowledge of paediatric problems, there will be no less important opportunities to develop critical decision making and communication skills and efficient work habits in a busy, multi-disciplinary clinical setting. You will have opportunities to refine your approach to the sick, injured and often anxious child so as to learn how to perform a proper assessment and provide care in a sensitive and caring manner.

Please remember that for the child and family with concerns relating to their presenting problem, the unfamiliar setting of the ED, its high level of activity, possible long waiting and differing expectations, may cause a high level of stress. It is part of our job to strive to provide appropriate Emergency care and help children and their families to deal with the stress appropriately.

In this setting, it is our role to identify and manage common problems efficiently and effectively, recognize possible uncommon or rare conditions, provide appropriate Emergency care and help families when care might be better given in a different setting, such as by their primary-care provider or an outpatient clinic.

In this whole process you will be guided and supervised by the experienced Attending Emergency Physicians, Fellows and Senior Residents along with other members of the ED Team. The nurses, respiratory therapists, discharge planners and child-life workers can all provide you with valuable insights and guidance and enhance your learning experience.

Because of the unique nature of some of our patients' management protocols, and some of the special differences of paediatric from adult patients, it is necessary for the ED staff to supervise you closely. This closer supervision will provide you better opportunities for teaching and learning through direct interactions with Staff. Junior trainees in our ED review all patients with a Staff Physician, Fellow or Senior Resident in order to discuss history taking, medical examination, differential diagnosis and proposed treatment or referral plan.

The scheduling coordinator, (phone: 416-813-6014), can help you plan better your rotation with us in the SickKids ED. Various members of our medical staff are responsible for the rotations of house-staff from various programs and the scheduling coordinator can help to direct you to the appropriate staff member. A compulsory formal orientation will take place at the start of your rotation with us.

For those of you who are joining us soon, please introduce yourself to the Attending Physician that you will be working with at the start of each shift. They are responsible for supervising you and will be able to provide you with more individualized guidance that goes beyond the basic orientation.

The Division has set aside protected time on Thursday mornings from 1000 - 1300h for more formal educational activities. Attendance is mandatory. A wide variety of subjects are covered over the course of your rotation. If you would like to participate in a case presentation or subject review, please contact Dr. Jonathan Pirie, who is the Director of Medical Education.

At the end of your rotation, an evaluation will be completed. If you would like to review this evaluation prior to it being returned to your own Program Director, the scheduling coordinator can help you to co-ordinate such an appointment with the appropriate staff physician. Evaluations are based on collected assessment cards, which should be completed for each shift worked by you. You should write your name on one of the cards (found in the charting room) and pass it on to the Attending, Fellow or Senior Resident that you worked with most directly. You may give cards to more than one individual. It is helpful for you to note on the side of the card any particular cases, discussions or procedures to which you were exposed during the shift. This will ensure an accurate and complete evaluation, with appropriate feedback provided to you.

We would also encourage you to complete the yellow "Staff Evaluation" cards. By being responsive to the needs and concerns of the trainees, we have been able to modify aspects of the rotation so as to make it the best possible experience. Appropriate and constructive criticism and commentary (positive or otherwise) from you can provide us with valuable information necessary to the ongoing development of the ED and our educational mission. It is not necessary for you to sign your name to the cards. If you prefer more direct discussion about aspects of your rotation, the scheduling coordinator can guide you to the most appropriate staff physician.

We hope that you will find your time with us to be valuable, enjoyable and a good learning experience and that you will help us to deliver the best of care to our patients and to continue to develop a valuable experience for future trainees.