Applying Competency-based Practices to NOSM's Anesthesiology Program
To contribute to the success of Canadian physicians and the delivery of high-quality patient care, the Royal College of Physicians and Surgeons of Canada has embarked upon an initiative to introduce competency-based medical education (CBME) in Canadian postgraduate specialty training and in professional practice in Canada. This initiative, called Competence by Design (CBD), aims to enhance patient care by aligning medical education and lifelong learning with evolving patient needs and empowering learners to more fully engage in their education process.
As of 2017, residents entering a Canadian anesthesiology program will experience Competence by Design (CBD)-based learning and assessment. As such, all incoming cohorts of successfully matched applicants to NOSM's Anesthesiology program will be entering into a fully integrated CBD-based residency program.
CBD will use time as a framework rather than the basis for progression, and it is not anticipated that the duration of training will change for the majority of trainees. Residency programs will be broken down into stages, and each stage will have a series of milestones based on required competencies. These milestones will create more targeted learning outcomes and involve more frequent, formative assessments within the clinical workplace to ensure residents are developing and receiving feedback on the skills they need.
In 2013 NOSM became the first anesthesiology program in Canada to implement components of a competency-based curriculum, and this curriculum has already been woven into the fabric of NOSM's FRCP Anesthesiology program. Key components of this transition that have been effectively implemented include; competency based assessment, high volume work-place based assessment with frequent, authentic feedback, competency based promotion, and individualized learning plans - which will all continue to evolve with the full transition.
For more information on applying competency-based practices to residency education, please visit www.carms.ca/en/rcpsc.
Program application language: English
Applications will be accepted through the CaRMS R-1 Match application process.
IMPORTANT NOTICE: As per the Ontario Provincial Eligibility Criteria, if you are submitting a Canadian Birth Certificate or Act of Birth, or Confirmation of Permanent Residence in Canada document, you MUST submit a government issued photo I.D. to accompany your citizenship documentation.
Three letters of reference are required. Reference letters must be written by physicians who are well acquainted with the candidate’s medical knowledge, communication skills, clinical performance, and professionalism.
Order from your registrar.Medical Student Performance Record
Order from your Dean's office.Custom Résumé / CV Photo
Appreciated for memory aid.Personal Letter
A personal letter (maximum 1000 words) should focus on the following:
What are some of the unique opportunities and challenges you anticipate at NOSM?
Any additional information about you that should be considered by the Selection Panel.
If your transcript/CV indicates academic difficulty, failure(s), repeat of a year or any gaps in your education or work history please attach a supplementary statement to the beginning of your Personal Letter entitled "Transcript/CV Addendum" explaining the above.
Applications submitted after file review has opened on February 8, 2021
Supporting documents (excluding letters of reference) that arrive after file review has opened on February 8, 2021
Letters of reference that arrive after the unmasking date on February 8, 2021
Two different members of the resident selection committee will review and score each applicant file, including reference letters. The scoring system takes into consideration the selection criteria outlined below. These scores will be aggregated and reviewed by the entire selection committee. Unfortunately we are not able to interview all of the applicants and we will offer interviews to the most competitive candidates based on these reviews.
Candidates for the NOSM Anesthesiology Program are selected based on the following factors:
The NOSM Anesthesiology Program strives to be outstanding and provide an unparalled clinical training experience to our residents. Our program aims to educate our residents to ensure that they achieve full competence in our specialty and that they acquire the necessary skills to prepare them for practise in any setting, and in particular, northern and rural communities.
Our program aims to ensure that upon completion of their training, our residents will have:
Through our selection process, our program aims to identify candidates who have a strong academic history with demonstrated competence and interest in anesthesia (e.g. scholarly activities, conference involvement, and other related work or life experiences). We are seeking candidates who possess superior clinical communication skills and have the ability to relate to patients, their families, and caregivers with compassion, empathy, sensitivity, and humility.
We are looking for candidates who possess the ability and willingness to work collaboratively (within and across professional domains) in a team dynamic to secure optimal patient outcomes while exemplifying the highest standards of professional behavior -- inclusive of responsibility, respect, and self-awareness.
We are also looking to identify candidates who would be a good fit for our program. Candidates who are well suited to our program are those who can adapt and thrive in a hands-on, distributed residency program that requires flexibility and some travel away from their primary location of residence.
We also believe that candidates who are resilient, can prioritize their personal well-being and work-life balance, and are also committed to self-reflective learning, continuing professional development, and quality improvement, are well-suited to our program. Through our selection process we aim to identify and successfully match candidates who possess these attributes as well.
Review team composition : Each application is reviewed and scored independently by two members of the file review team. Our file review team consists of program faculty; including the program director, site directors, and other key faculty members.
Average number of applications received by our program in the last five years : 51 - 200
We receive on average around 70 applications to the program.
Average percentage of applicants offered interviews : 51 - 75 %
Approximately the top 40 candidates are selected for interviews
|CV||Academic & work background/experiences, personal/professional achievements/awards, volunteerism|
|Electives||We recognize that the COVID-19 pandemic has impacted candidates’ opportunities to arrange and complete electives and would like to reassure you that a lack of elective activity this year will not negatively impact your application to our program.|
|Examinations||We do not evaluate this file component.|
|Extra-curricular||An asset to demonstrate work-life balance and wellness, personal interests. Include in CV|
|Leadership skills||Any leadership roles held throughout training should be outlined in the CV|
|MSPRs||Patient interactions, Anes.rotation competencies, any academic, personal or professionalism concerns|
|Personal letters||Practise goals, interest/knowledge in Anes. and our program, personal and northern/rural suitability|
|Reference documents||Commitment to Anes., performance, knowledge/clinical skills, character/attitude towards learning|
|Research/Publications||Past achievements/successes and interest in participating in future scholarly activity|
|Transcripts||Strength of academic record, any red flags/concerns|
|Other file component(s)||
If any part of your application indicates academic difficulty, failure(s), repeat of a year or any gaps in your education or work history, a supplementary statement at the END of your Personal Letter is required. Please entitle your statement as "Transcript/CV Addendum", explaining the above.
Interview format :
We routinely accommodate requests to re-schedule interviews for applicants.
|Collaboration skills||Demonstrated ability to work well in a team setting/multidisciplinary environment|
|Collegiality||Personable, respectful towards others, values the importance of a supportive/collegial atmosphere|
|Communication skills||Able to reflect and communicate responses clearly and concisely, can communicate well with others|
|Health advocacy||We do not formally evaluate this component during the interview|
|Interest in the discipline||Genuine passion for Anes., future practise goals, clear understanding of the specialty, experiences|
|Interest in the program||Knowledgeable about our program, training sites, northern Ontario patient populations and challenges|
|Leadership skills||Qualities such as: proactive/takes initiative, accountable, innovative, motivated and goal-oriented|
|Professionalism||Conducts themselves in a professional manner, self-aware, unbiased, morally/ethically responsible|
|Scholarly activities||We do not formally evaluate this component during the interview|
|Other interview component(s)||
Problem-Solving Skills: Overcoming challenges, conflict resolution, ability to assess, plan, and take appropriate action.
Personal Attributes: Personal characteristics and interests, learning style/attitude towards learning.
The Anesthesiology program at NOSM strives to be outstanding. We are entering our eighth year of this program that has grown out of a decade of training Royal College residents. We have a proven track record at the Royal College Examinations, an unparalleled clinical experience, and incredibly skilled and enthusiastic staff. The academic program is heavily based in “active learning” through simulation and problem-based cases. Through an innovative, comprehensive curriculum and assessment process, residents in this program will receive frequent feedback to help acquire lifelong, reflective learning skills, ensuring clinical excellence. In addition to the CBD framework, novel education interventions, simulation, and e-Learning are integral parts of the program. This program is constantly evaluated and modified to ensure an “outstanding” academic and clinical program We are using a unique, modular framework to implement CBD to help organize and guide the residents progress while adding flexibility to allow individualized progress.
Residents in this program will have a number of opportunities unique to Northern Ontario. While the majority of the training takes place in Sudbury, the opportunity to have clinical experiences in various centers across the North, from small rural hospitals to other major centers such as Thunder Bay, provides a unique chance to understand how anesthesia is provided outside of the major teaching center, and exposure to potential career opportunities. As a new and growing program, resident feedback is an integral part of shaping this program for the future. This is a program that is extremely responsive to resident input. In addition to clinical research opportunities, residents have a unique ability to engage in medical education scholarship in this cutting edge program.
Northern Ontario is not dependent on resident service to function. Residents are an integral part of the perioperative team but are not necessary for the day to day functioning of the hospital. This means we are all about education! The service to education balance is very much in favour of the resident!
Residents in this program will work in a collegial group, dedicated to outstanding clinical care and education, living in a growing city with lots of opportunities for "outdoor living".
In addition to the above, other aspects of the NOSM program that set it apart include:
This residency program is for 5 years.
Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.
Since 2017, residents entering an anesthesiology program experience Competence by Design (CBD) based learning and assessment. Incoming cohorts of successfully matched applicants to NOSM’s Anesthesiology program will be entering into a CBD-based residency program.
CBD will use time as a framework rather than the basis for progression, and it is not anticipated that the duration of training will change for the majority of trainees. Residency programs will be broken down into stages (Transition to Discipline, Foundations, Core, Transition to Practice) and each stage will have a series of milestones based on required competencies. These milestones will create more targeted learning outcomes and involve more frequent, formative assessments within the clinical workplace to ensure residents are developing and receiving feedback on the skills they need.
In 2013 NOSM became the first anesthesiology program in Canada to implement components of a competency-based curriculum, and this curriculum has already been woven into the fabric of NOSM’s FRCP Anesthesiology program. Key components of this transition that have been effectively implemented include; competency-based assessment, high volume work-place based assessment with frequent, authentic feedback, competency based promotion, and individualized learning plans – which will all continue to evolve with the full transition.
Below is an overview of what the program has mapped out for our CBD Residents. Working with assigned stage leads and other program leadership, you will have the opportunity to tailor it to meet your training needs as you progress through residency.
Please refer to NOSM's Anesthesiology Program Competency by Design Module Map for a comprehensive snapshot of our clinical curriculum.
Residents in this program will have a number of opportunities unique to Northern Ontario. While the majority of the training takes place in Sudbury, the opportunity to have clinical experiences in various centers across the North, from small rural hospitals to other major centers such as Thunder Bay, provides a unique chance to understand how anesthesia is provided outside of the major teaching center, and exposure to potential career opportunities.
The small size of the program allows for close mentorship between the faculty and the residents. This has been frequently identified as one of the great strengths of our program and enables a rapid progression to independent activities for individual residents. Our formal mentorship program pairs residents with staff that they have identified as mentors to support their progress and overall well-being throughout residency.
As a new and growing program, resident feedback is an integral part of shaping this program for the future. This is a program that is extremely responsive to resident input throughout their training. Program Review dinners take place twice per year, giving residents a formal arena to offer feedback.
The core academic program is heavily based in active learning techniques such as problem based learning and simulation with didactic sessions used to ensure completeness. Residents participate in 3 year cycle of weekly afternoon teaching sessions as well as written, oral and simulation-based assessments to help guide them to success in their Royal College examinations. Additionally, first year residents are part of the “Summer Series” program which is an intensive, interactive introduction to a selection of key topics in anesthesia. In addition to the core program, our rich academic program includes Trouble Rounds, ICU rounds, Anesthesia Department Rounds and Journal club.
Built into the core program is a comprehensive physician scholar program. This includes an introductory course in Evidence Based Medicine with core seminars on critical appraisal and research methods. Residents are expected to undertake a scholarly project, with guidance from faculty, structured around a series of Research Milestones. This scholarly project can be a clinical or basic sciences research project, a quality improvement project or any other scholarly project in areas relevant to academic anesthesiology.
Simulation plays a major role in the active learning curriculum of the NOSM anesthesiology residency program. Our simulation program incorporates high-fidelity simulation with mannequins, hybrid patients, and standardized patients. Residents participate in approximately 5 half days and 2 full days of simulation per academic year. Each simulation scenario is followed by a rich student-led debriefing session. The debriefing sessions focus on anesthesia non-technical skills such as teamwork, crisis resource management, situational awareness, and decision-making.
All residents acquire certification in advanced cardiac life support (ACLS), advanced trauma life support (ATLS), and neonatal resuscitation program (NRP) as part of their residency program. Residents receive support from the Anesthesiology program for completion of these courses. It is expected that you receive ACLS training before entry to the program or within the first three months. Opportunities to undertake neonatal and pediatric anesthesia occur throughout the foundation and core years of training in the North, and this experience supplements the mandatory three month rotation at the Hospital for Sick Children in Toronto.
There are 22 other hospitals in Northern Ontario that NOSM is directly associated with including but not limited to:
To learn more about northern Ontario, please visit the "Wider Campus of the Northern Ontario School of Medicine" webpage.
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