Emergency Medicine

• Dr. Krishna Anchala
• Dr. Lianne McLean
• Dr. Iwona Baran
• Dr. Olivia Ostrow
• Dr. Suzanne Beno
• Dr. Jonthan Pirie
• Dr. Kathy Boutis
• Dr. Adrienne Davis
• Dr. Savithri Ratnapalan
• Dr. Yousef Etoom
• Dr. Daniel Rosenfield
• Dr. Jabeen Fayyaz
• Dr. Suzan Schneeweiss
• Dr. Yaron Finkelstein
• Dr. Deborah Schonfeld
• Dr. Mieille Gharib
• Dr. Suzanne Schuh
• Dr. Greg Harvey
• Dr. Laura Simone
• Dr. Mark Tessaro
• Dr. Michelle Lee
• Dr. Sasha Litwin
• Dr. Alia Sunderji
• Dr. Gabrielle Freire
• Dr. Maya Harel-Sterling

• Appendicitis 
• Asthma 
• Bicycling Injuries 
• Bone fractures 
• Bronchiolitis 
• Car seat usage and safety 
• Pneumonia 
• Quality Improvement 
• Shunt obstruction 
• Septic shock 
• Suicidal ideation or behaviour 
• Traumatic brain injury 

We pride ourselves on innovations and new projects and remain committed to sustainable and equitable solutions in health care. Patients requiring crutches for an injury are eligible to receive crutches at no cost from our emergency department if they are available and return them when finished using them to the orthopaedic clinic. This project aims to reduce cost to families as well as environmental waste. Participation in this project is completely voluntary and will not affect yours or your child’s care. 

If you are part of the ROAR project and have feedback about it, please fill out our patient feedback survey.

Our division has two training programs. To be eligible for these opportunities, all candidates must be enrolled in, or have completed a residency program in, either Paediatrics or Emergency Medicine. 

The Royal College Accredited Program is open to trainees who are enrolled in programs recognized by the Royal College of Physicians and Surgeons Canada (RCPSC) and are fulfilling the requirements for primary discipline certification or for certification of special competence. 

The Clinical Fellowship Program (non-RCSPC accredited) provides an opportunity for specific training in Paediatric Emergency Medicine to candidates whose medical training was completed outside of North America. In order to apply, they must have a specialty certification in Paediatrics from their country of training. Although the training is non-RCSPSC accredited, it will be comparable to trainees at a similar level in our institution. A certificate of completion will be provided at the end of the training period. 

We also have an active Clinical Research Program in the division and are currently expanding the number of clinical investigators who are attached to the division. 

Our PEM training program is approved by the Royal College of Physicians and Surgeons of Canada (RCPSC). 

The RCPSC accredited program is a two-year program with a certifying exam. Only trainees who have completed their residency training in North America are eligible to take the Royal College PEM examination. An additional year of advanced training is available to candidates who wish to develop a focus in a particular area, as well as for eligibility for the American Board of Pediatrics (ABP) PEM examination, which requires three years of training. 

Our program is designed to produce experts in the field of Paediatric Emergency Medicine. Residents benefit from the rich teaching that is provided and the wealth of pathology seen in our division. As one of the largest training programs in Canada, our residents collaborate with the large number of trained faculty who are enthusiastic mentors. Our program has been designed to meet all objectives of the Royal College and to produce confident well-rounded physicians who will become leaders in this field. 

On average we are able to match four positions per year. Successful candidates will receive two years of guaranteed funding in order to meet the requirements of the RCPSC. 

PEM training rotations

The curriculum is designed to ensure that residents receive teaching in clinical medicine, research methodology, evidence-based medicine and administrative issues. 

Year 1

• PEM x 7
• *Adult ED/ Trauma
• Anesthesia
• Critical Care
• Orthopaedics
• DI/POCUS
• Research

Year 2

• PEM x 5
• *Adult ED/Trauma
• Selective x 2
• Plastic Surgery
• **Toxicology
• EMS/ACTS/ORNGE
• Research
• PEM Leadership

* Adult ED/Trauma rotations are completed at St. Michael's Hospital 
**Toxicology can be completed either at SickKids or NYC Poison Control

PEM goals for Residents

Clinical 

• To acquire subspecialty expertise in the care of an acutely ill or injured child or adolescent 
• To be able to triage and prioritize multiple patients efficiently 
• To be able to function as ED "mock" attending (under supervision) in the second year of training 
• To manage patient flow 
• To supervise trainees 

Residents are actively involved in simulation training throughout their training, with monthly workshops at the Simulation Centre at the SickKids Learning Institute. These sessions allow practicing critical skills used in resuscitation, trauma and leadership skills. 

Education:

• To demonstrate teaching competence in the various aspects of Paediatric Emergency Medicine 
• One on one bedside teaching 
• Academic day - instructive/puzzling cases, interesting topics 
• Critical appraisal skills 
• Knowledge of PEM literature 
• Teaching skills 

PEM residents and fellows will participate as instructors in divisional resuscitation courses: Advanced Paediatric Life Support, Emergency Procedures Workshop, PEM Conference, Paediatric Update, etc. 

Research:

• To acquire expertise to become a productive investigator 
• To become familiar with various research methods and to be able to apply appropriate methodological principles to address various research questions 
• To be able to critique published literature correctly 

All residents are required to participate in research.  A research methodology course is held each year, over a 3 day period, to introduce basic research concepts and help with projects start-up.  Additionally, a divisional research day is held in the spring and all residents and fellows are expected to present their research proposal and progress report once a year. 

The Department of Paediatrics’ annual research day is attended by all residents and fellows: PEM residents are expected to present a poster or oral presentation. Residents and Fellows are encouraged to present their research at the Paediatric Emergency Research of Canada (PERC) fellows’ research day held in January/February each year. 

Administration/Leadership

An administration course is held longitudinally throughout the year as part of the academic day. Topics include leadership skills, quality assurance, charting, ethics, telephone advice, legal issues and public relations. 

Those interested in applying must do so via the Canadian Resident Matching Service (CaRMS).   

 

For Visa trainees (with sponsorship from your home institution), you will need to apply separately from the Canadian match. Deadline to apply is March 31. Please send your application package to the PGME office at the University of Toronto with confirmation of funding. 

 

Visa Processing, IMGs 

PGME Office 

University of Toronto 

500 University Avenue, 6th floor 

Toronto, ON M5G 1V7 

pgme.international@utoronto.ca

 

Upon completion of your application package, including confirmed funding, suitable candidates may be contacted for an interview. Your application should clearly indicate which training path you are interested in. If you are interested in both an RCPSC (2 year) program and a Clinical Fellowship (1 year), please indicate this on your application. 

 

For any additional inquiries, please email pem.fellowship@sickkids.ca 

The Clinical Fellowship Program is suitable for candidates whose medical training was completed outside North America, or those with paediatric or emergency medicine specialty training who desire additional training in PEM.   

This fellowship training is not accreditable toward Royal College of Physicians and Surgeons of Canada (RCPSC) certification, however the training is comparable to that of all RCPSC trainees at a similar level in our institution. There are usually four funded positions available per year. As this program does not lead to RCPSC certification, it is not intended for physicians who plan to practice PEM in Canada. Most clinical fellows are paediatricians or emergency physicians planning to practice PEM outside of Canada who are interested in formal fellowship training. This program may also be suitable for Canadian emergency physicians or paediatricians who wish to improve their skills in managing paediatric emergencies and desire only one year of training. Clinical fellows will receive a certificate from SickKids upon completion of training as well as a certificate from the University of Toronto. 

This is a one-year fellowship which consists of 12 PEM rotations, and four weeks of a selective rotation. Both the residents and clinical fellows will participate equally in divisional educational activities such as academic rounds and workshops. Clinical fellows are required to complete a research, educational or quality improvement project during the year. 

Educational component 

It is expected that all clinical fellows will participate in our weekly academic rounds which include case rounds, grand rounds, trauma/toxicology/transport rounds, M&M rounds, radiology rounds, procedure workshops, etc. 

It is also expected that each clinical fellow will complete a mandatory in-house sedation course that will be scheduled for you in July.  Also, you will have an opportunity to attend our annual PEM Conference. 

Prior to commencing your fellowship, it is recommended that you have completed the Advanced Trauma Life Support (ATLS) and Advanced Paediatric Life Support (APLS) training. 

Selective 

You will be given an opportunity to spend four weeks of selective time in other specialties such as POCUS, Simulation, Orthopedics, Critical Care, Neonatology, etc.  All selectives will be considered and approved by the program director prior to scheduling. 

Research

All fellows in PEM are expected to complete a research project during their fellowship year. It is recognized that time for research in the clinical fellowship is limited. Therefore, each fellow will select a research mentor early in their fellowship and will be assisted in selecting an appropriate project.  Research projects should be submitted for presentation at the annual Department of Paediatrics Research Day which occurs each year in May. Topics for research can be very wide-ranging and include quality improvement or systems-based projects investigating operational challenges in the ED. 

PEAP (Pre-Entry Assessment Period) 

The PEAP is an assessment process that evaluates international medical graduates to determine whether they can function at their reported level of training. It is 12 weeks in duration, and can be extended by the Program Director if necessary. 

To obtain an unrestricted Postgraduate Medical Education certificate of registration (educational license) from the College of Physicians and Surgeons of Ontario (CPSO), all international medical graduates (IMG) are now required to undergo a Pre-entry Assessment Program (PEAP) and obtain a license from the CPSO prior to full acceptance into an Ontario residency or fellowship program. Completion of the PEAP has always been a CPSO requirement for IMGs applying to residency training programs.   

Qualifications 

The candidate must have a paediatric or emergency medicine specialty or equivalent training and must meet the qualifications for an educational licence through the Ontario College of Physicians and Surgeons. As required by the College of Physicians and Surgeons of Ontario, most foreign-trained fellows must successfully complete all Pre-Entry Assessment Program (PEAP) requirements no later than the 12th week of the Clinical Fellowship in order for their educational license to be extended for the full year. This is facilitated by the Division. Failure to meet these requirements will result in termination of the Fellowship. 

Program Director: Dr. Jabeen Fayyaz 

How to apply

To apply, please fill out the Clinical Fellowship Application 

Clinical Fellowship Application

You will need to upload the following documents for your application.  Please do not email your attachments: 

1. Letter of Intent – explaining your interest in the fellowship program and your future career goals (max. one page) 
2. Current CV 
3. Copy of your Medical Degree (and translation if applicable) 
4. Copy of your Specialty Certificate (and translation if applicable) 
5. Copy of your Passport 
6. A test of English proficiency (either the TOEFL or IELTS) will be a requirement. (TOEFL requirements 24 in speaking and a total of 93; IELTS requirements listening 7.5; Reading 6.5; Writing 7.0; Speaking 7.0)) 
7. Three (3) Reference letters, to be sent to the pem.fellowship@sickkids.ca via email 

Application Deadline: August 31,  2023

Academic Year: July 1, 2024 - June 30, 2025

For any inquiries, please email pem.fellowship@sickkids.ca 

Program highlights

The mission statement of the Focussed Competency Program is to train experts in pediatric emergency medicine who can serve as leaders in their local emergency departments and community at large. 

Our program is designed to be an immersive experience in pediatric emergency medicine. By training at The Hospital for Sick Children, fellows will have the opportunity to work in one of the largest and busiest pediatric emergency departments along-side world-class faculty. They will quickly be given a leadership role within the department and learn both the clinical nuances of pediatric emergency medicine as well as the skills needed for running a busy department and managing multiple learners. With the volume of patients increasing every year, our emergency department currently has over 80,000 visits per year. It also serves as a major referral site for paediatrics within the province and the emergency physician is responsible for taking consultations from community practitioners, providing advice over the phone and accepting transfers.   

In addition to the clinical exposure, fellows will have protected time for both structured learning at academic day as well as formal teaching opportunities for junior trainees. The curriculum will include formal training in: neonatal resuscitation (NRP), advanced pediatric life support (APLS), advanced trauma life support (ATLS), pediatric procedural sedation, airway workshops and the CASTED course for those who have not completed it. Fellows will also be given formal teaching opportunities in the classroom, simulation sessions and within the clinical environment. Although not a formal expectation of the Focussed Competency Program, a great deal of support exists for fellows who are interested in pursuing academic work in the domains of QI, research, point of care ultrasound, education or knowledge translation. 

Goals of the Focussed Competency Program

Clinical goals: 

• To acquire subspecialty expertise in the care of an acutely ill or injured child or adolescent
• To be able to triage and prioritize multiple patients efficiently
• To be able to assume a “staff role” in managing the Emergency Department as a whole and handling transport and telephone advice
• To manage patient flow and supervise trainees

Education goals:

• To demonstrate teaching competence in the various aspects of Pediatric Emergency Medicine
• To develop skills inone on onebedside teaching 
• To participate in academic rounds - instructive cases,interesting topics, simulation, mock codes
• To develop critical appraisal skills and teaching skills
• To become well-versed in current PEM literature

Administration goals:

• To develop skills in leadership, quality assurance, charting, ethics, telephone advice, legal issues, and public relations

Program curriculum

This Focussed Competency program is for 1 academic year. 

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

The program includes 12 blocks of Pediatric Emergency Medicine and 1 selective block of the candidate’s choosing pending availability. Selective options may include Simulation, POCUS, Adult EM/Trauma, Orthopedics, EMS/ACTs, etc that will be arranged through the Program Coordinator.  Vacation time is 4 weeks per year. 

Course-based curriculum

The program can support additional training in the following course-based training offerings: 

• NeonatalResuscitation Program 
• Advanced Pediatric Life Support
• Advanced Trauma Life Support  
• PediatricProcedural Sedation 
• CASTED course (if not previously taken)

Eligibility

The Ped EM Focused Competency Program is suitable for candidates who have graduated from the CCFP-EM (or are in their graduating year), as well as to residents in their PGY4+ year and in a training program affiliated with the RCPSC. This includes trainees enrolled in EM and Peds. 

Certificates of completion of training will only be offered by the Hospital for SickKids, and not from the University of Toronto.    

Applicants are expected to have had selective/elective experience in PEM or Pediatric Critical Care, previously completed or currently working on scholarly projects in acute care medicine (whether QI, Advocacy, or Research), as well as strong letters of reference. 

Application process

To apply online, select PEM Focussed Competency Fellowship Program via the link below.

Apply for PEM Focussed Competency Fellowship Program

You will need to upload the following documents for your application: 

1. Letter of interest. Your letter should be a personal statement outlining your interest in pursuing this program with specific focus on howthis fitswithin your career goals. 
2. Current CV
3. Copy of your Medical Degree
4. Photo
5. Copy of Passport / Proof of Citizenship
6. Three (3) Reference letters - One must be from your current program director. These can be emailed directly to ritsa.iriotakis@sickkids.ca

Application deadline: August 31, 2023
Academic year: July 1, 2023 - June 30, 2024

Contact information

555 University Avenue 

Toronto, ON Canada M5G 1X8 

email: pem.fellowship@sickkids.ca 

The Paediatric Emergency Medicine Simulation Fellowship at The Hospital for Sick Children (SickKids), is an innovative one-year program designed to train future leaders in the emerging field of medical simulation. 

Goals for Learning Institute Simulation Fellows

• Knowledge of development of a simulation centre, including needs assessment, development of vision and mission, development of policies and procedures 
• Learning theory and application to simulation, including knowledge, technical and behavioural skills 
• Knowledge of types of simulation including but not limited to: 
  • High fidelity simulation 
  • Procedural task training 
  • Standardized patients 
  • Computer based training and  
  • Virtual reality simulation 
• Knowledge and skill to select, use and maintain simulation equipment 
• Development of simulation scenarios and courses, including setting learning objectives and simulation curriculum development 
• Able to obtain consent and maintain confidentiality 
• Ability to run simulation scenarios 
• Ability to debrief simulation scenarios 
• Assessment of learners, evaluation of sessions and overall program 
• Scholarship in simulation – participation in research projects, attendance at simulation meetings/conferences 

Fellows responsibilities

• Fellows will be expected to facilitate and debrief simulation cases (resuscitation, task training) for divisional and extra-divisional simulation programs. 
• Monthly journal club – fellows participate or lead an interactive discussion of pivotal and cutting-edge simulation literature. 
• Scholarly work – fellows will prepare scholarly work suitable for submission and peer review to a scholarly publication. Options include: journal reviews, textbook chapters and online references.
• Fellows contribute to the Simulation Program administration. Options include: curriculum development, rounds development or administration (e.g., Journal Club) or education programs (e.g., Junior Mock Code Program). 
• Courses – fellows are expected to attend a facilitation & debriefing course either internally or internationally (optional). 
• Clinical – faculty shifts in the ED at SickKids (approximately 8 shifts/month). 

Distinctly SickKids 

• Premier, free-standing, level-one trauma and tertiary-care paediatric hospital 
• Busy, inner-city referral Emergency Department 
• Formally trained faculty in EM, PEM and POCUS 
• Dedicated divisional research faculty and research assistants 

Eligibility

• Successful completion of a PEM fellowship and PEM Board Eligible in Canada or the United States 
• Hold or be eligible for a certificate of registration to practice medicine in Ontario as issued by the College of Physicians and Surgeons of Ontario 

Application process

• Fill out the Advanced Fellowship Training Online Application
• Application opens: April 1, 2023
• Application deadline: September 15, 2023
• Academic year: July 1, 2024 – June 30, 2025
• Up to two positions will be awarded on a competitive basis annually. 
• Further details and compensation available upon request. 

Contacts

Jonathan Pirie, MD, MEd, FRCPC,  FAAP (PEM) 

Fellowship Director & Lead PEM Simulation Program 

Emergency Physician, Division of Paediatric Emergency Medicine 

Email: jonathan.pirie@sickkids.ca 

PEM Fellowship, Division of Emergency Medicine
Email: pem.fellowship@sickkids.ca 

Mailing address: 

The Hospital for Sick Children 

555 University Avenue 

Toronto, Ontario 

M5G 1X8 

Canada 

The Emergency Department accepts medical students and elective students from Canadian and international medical schools allowing for a distinctive and diverse practice for rotations of two, three or four weeks. The department cannot accommodate observers.

Our ED provides care to almost 82,000 patients annually with the most complex, tertiary-care medical problems, as well as children with common, ambulatory paediatric illnesses and concerns. 

As a student, you will be guided and supervised by the experienced Attending 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. Due to the unique nature of some of our patients' management protocols, and the differences between paediatric care from adult patients, you will be supervised closely. This supervision will provide you with better opportunities for teaching and learning through direct interactions with staff. Junior trainees in our ED review all patients with an Attending Physician, Fellow or Senior Resident in order to discuss history taking, medical examination, differential diagnosis and proposed treatment or referral plan. 

Arranging for your rotation

Postgraduate trainees

Our program coordinator can help plan your placement with us and confirm availability for your preferred slot. Please connect via email at pem.scheduling@sickkids.ca to ensure availability.   

For more information on how to apply and if you qualify, visit The University of Toronto's Elective Training portal.

Undergraduate trainees

Electives for visiting students are available only for those students who would be registered in their final year of medical school at the time when the elective would take place. The student should have completed their core/basic paediatric training.   

Please contact Pamela Hardy at pamela.hardy@sickkids.ca prior to applying through the University of Toronto, to confirm availability for your preferred slot. 

Fourth year University of Toronto medical students can apply for SickKids electives via ROUTE on MedSIS. 

For visiting medical students, (those from other Canadian or International medical schools) your elective applications must be processed and approved by the Electives Office, Faculty of Medicine, at the University of Toronto. Information regarding the elective procedures and the online application is available at the AFMC Student Portal.

Starting your placement in the ED

Having completed all compulsory learning and a formal orientation, you are ready to begin your first shift. 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. 

At the end of your rotation, an evaluation will be completed for you. Evaluations are based on collected and summarized online assessments. You should ask the Attending, Fellow or Senior Resident that you worked with most directly to complete an evaluation for you at the end of each shift. You may also ask more than one individual. 

We would also encourage you to complete the "Staff Evaluation" online assessment as well. 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. 

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. 

Academic Rounds

PEM Teaching is held every Thursday from 9:00 to 13:00 at 525 University Ave (6th and 12th floors).  You may be excused if you have worked the night before or if you have been assigned a shift. Junior trainees and clinical clerks will not be assigned a shift until after 15:00. This academic day is teaching time and should not be considered free time. Attendance will be taken and will be reflected in your evaluation. 

Dedicated time has been allocated to junior trainees between 9:00 and 11:00 for teaching with a rotating schedule of interactive sessions and mock codes. Junior trainees should join the regular rounds after this time. 

You should receive a teaching schedule when you begin your rotation. 

Any questions regarding your evaluation or rounds, or to report your absence from rounds, should be directed to Ritsa Iriotakis at (pem.rounds@sickkids.ca). 

Acute illness and trauma are the leading causes of unnecessary death in the paediatric population. In response to this, the Emergency Nurses Association has developed a comprehensive course to teach nurses the various aspects of paediatric emergency nursing care. The course is intended to expand the knowledge base and technical skills of the nurse to care for children in the emergency setting.

View dates and register

Course Director: Jane Stuart-Minaret

Contact info:

Tel: 905-621-9151
email: info.pem@sickkids.ca or
For course content information: jane.stuart-minaret@sickkids.ca.

Advanced Paediatric Emergency Procedural Sedation Course 

Course dates: Coming soon

525 University Ave, Simulation Centre, 6^th Floor 

Open to everyone - Register now for the course!

This course is designed for practitioners currently using procedural sedation for children in the emergency setting who are interested in learning about evidence-based strategies to provide effective sedation while minimizing the risk of adverse events. Participants will have an opportunity to refine and practice skills in a simulated environment.

Learning Objectives: At the end of this course participants will be able to:

• Discuss recent advances in procedural sedation for children.
• Choose the most appropriate agents for sedation based on clinical indication, safety profile and desired level of sedation. 
• Recognize and manage potential adverse events from procedural sedation in children.
• Provide a safe and consistent approach to evaluating and managing children requiring procedural sedation in the emergency setting.

Target Audience: Physicians Nurses Respiratory Therapists
Course director: Suzan Schneeweiss

Prerequisites

• PALS Certification
• Airway Management Competency

Participants will receive pre-course study materials, a sedation handbook and pocket card. Upon successful completion of this course participants will receive a certificate of completion.

Questions regarding this course: info.pem@sickkids.ca

Participants will: 

• Participate in breakout sessions and hands-on, case-based workshops 
• Identify new developments in the field of paediatric emergency medicine 
• Enhance their skills in managing the challenging patient 
• Learn how to use emerging technology efficiently 
• Practice their skills in various hands-on workshops 
• Review common pitfalls and decide if a change in practice is appropriate 
• Specific objectives for each session will be highlighted by the presenter 

Over 150 attendees and 50 speakers from across the continuum of emergency paediatric care will be in attendance, including: 

• Paediatric emergency physicians and nurses 
• Adult emergency physicians and nurses 
• Paediatricians 
• Family physicians and general practitioners 
• Physician trainees 
• Paramedics and EMTs 

Organizers: Division of Paediatric Emergency Medicine 

Email: info.pem@sickkids.ca