Competence by Design (CBD)
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.
CBD will use time as a framework rather than the basis for progression. 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.
All programs implementing CBD will continue to undergo the same rigorous accreditation processes as traditional programs. All CBD programs (and traditional programs) will continue to lead to Royal College approved certification. Certification for trainees in both CBD and traditional programs will include the completion of a Royal College examination; however, residents in CBD programs will also be assessed against program milestones throughout their training. Within a CBD program, all milestones (documented within an electronic portfolio) and the Royal College examination must be successfully completed to achieve certification.
Residents entering the PM&R program at the University of Toronto from July 2020 are part of the CBD curriculum.
For more information, please contact cbd@royalcollege.ca
Program application language: English
Legal Status
Proof of valid current citizenship or permanent resident status must be provided by submitting one of the following verifications to CaRMS by the File Review Opening deadline. Failure to provide valid proof will result in your application being removed. No other forms of verification are acceptable:
CaRMS is partnering with third-party organizations to automate the verification of citizenship/legal status required by postgraduate offices for entry into residency. Third-party verification simplifies the process for applicants and programs. All applicants who do not receive third-party citizenship verification will be required to upload and assign an acceptable proof of citizenship document. Please see additional information here.
Three (3) reference letters should be obtained from clinicians who have worked directly with the applicant and who can attest to the applicant's knowledge, skills and attitude. Additional reference letters will not be reviewed.
If possible one or more letters from a faculty member in PM&R is helpful but not required.
A personal letter must be submitted. Your autobiographical letter should answer the following questions:
Why have you chosen PM&R as your professional career?
What experiences in your past have led you to choose this specialty?
What personal attributes do you possess that would be an asset to this career?
What are your specific reasons for applying to the program at the University of Toronto?
What aspects of our program are important to you?
Where and in what type of community would you prefer to practice upon completion of your training?
Custom Résumé / CV PhotoFor current year Canadian medical graduates (CMGs), there is no action required from you. Your medical school will automatically submit your MSPR to CaRMS on your behalf for you to assign.
If your MSPR is in a language other than the program language of English or French, you are required to have the document translated.
Your medical school transcript can be submitted through one of the methods below:
Order from your Dean's Office. Documents not in English must be accompanied by a notarized translation. Students applying in the last year of medical school will need to submit their most recent marks/transcripts, and will need to provide proof of their MD to CPSO prior to the start of residency training.
Applications submitted after file review has opened on January 10, 2023
Supporting documents (excluding letters of reference) that arrive after file review has opened on January 10, 2023
Letters of reference that arrive after the unmasking date on January 10, 2023
Please Note: In the interest of fairness the Program Director will not meet with individual candidates once CaRMS file review is open. Our Chief residents are available to answer any questions candidates may have pertaining to our residency program.
Dates:
After thorough review of all applications; applicants providing evidence outlined below will be prioritized for further consideration:
- an interest in PM&R, either by completion of observerships, electives or previous experience in a related field
- a solid academic standing
- an interest in medical education and clinical medicine
- excellent communication skills
- demonstrates leadership skills
- research activities
- personal and reference letters
Candidates who fail to meet these criterias will not be considered further.
Selected candidates will be ranked based on a score of their application and interview, demonstrated ability to maintain positive relationships with students, residents and faculty. Input from program admin and residents is solicited. Final rank will be determined by aggregate score as outlined above.
Upon completion of the Physical Medicine & Rehabilitation Residency Program at the University of Toronto, the resident is expected to be a competent specialist in Physical Medicine & Rehabilitation (Physiatrist) capable of assuming a consultant's role in the specialty. Residents must demonstrate the requisite knowledge, skills and attitudes for effective patient-centred care to a diverse population and be able to address issues of gender, sexual orientation, age, culture, ethnicity and ethics in a professional manner.
The successful applicant to our program would demonstrate excellent communication and leadership skills. This individual would have a solid academic standing and a proven interest in research. We seek candidates who demonstrate a collegial attitude and an interest in working with diverse populations. An interest in medical education is also a desirable attribute for a successful applicant to our program.
Review team composition : Review team consists of the program director, faculty (both community and academic staff) and residents of the PM&R program.
Average number of applications received by our program in the last five years : 0 - 50
Average percentage of applicants offered interviews : 51 - 75 %
File component | Criteria |
---|---|
CV | Extracurricular activities, scholarship, research, publications, honors and awards |
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 | Degree of involvement in extracurricular activities before and during medical school. |
Leadership skills | Leadership demonstrated |
MSPRs | Consistent performance throughout medical school |
Personal letters | Communication skills, career goals, insight into the field. |
Reference documents | Three reference letters from clinicians who have worked directly with applicant |
Research/Publications | Involvement in research activities |
Transcripts | Consistent pass |
Interview format :
We may accommodate requests to re-schedule interviews for applicants due to weather, technology failure, or unforeseen circumstances.
Interview components | Criteria |
---|---|
Collaboration skills | Demonstrates collaboration, insight/problem solving |
Collegiality | Demonstrates collegiality and teamwork |
Communication skills | Demonstrates good communication skills |
Health advocacy | We do not evaluate this interview component |
Interest in the discipline | Demonstrates passion & excitement for PM&R |
Interest in the program | Demonstrates an interest in the UofT PM&R program |
Leadership skills | Demonstrates leadership |
Professionalism | Demonstrates professionalism |
Scholarly activities | Discussion of scholarly achievements |
Other interview component(s) | Power Point presentation on a topic of candidates choice. |
The Physical Medicine & Rehabilitation Program at the University of Toronto is one of the largest programs in Canada. Our faculty has a strong commitment to resident education. Our program provides diverse opportunities for training, research and broad clinical exposure within the University of Toronto community. Residents receive financial support for conferences, research, books, technology and social programming. Our program alternates with Edmonton in hosting the Canadian Comprehensive Review Course in Physical Medicine and Rehabilitation. We have a collegial group of residents with a broad informal support network.
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.
The Physical Medicine and Rehabilitation (PM&R) Residency Program at the University of Toronto is a 5 year postgraduate training program. This program is fully accredited and meets the Objectives of Training and Specialty Training Requirements set out by the Royal College of Physicians & Surgeons of Canada.
The PM&R residency program transitioned to Competence by Design (CBD) in July 2020. Resident performance is reviewed at regular intervals by our Competence Committee. This committee reviews the Entrustable Professional Activities (EPAs) and In-Training Assessment Records (ITARs) to make decisions regarding the resident's successful completion of each CBD stage and progression to the next.
Transition to Discipline (TTD) - This stage spans the first two blocks of residency. Residents complete 1 block of MSK and 1 block of Neuro (choose from acquired brain injury, spinal cord injury or stroke rehab).
Foundations of Discipline (FOD) - This stage spans the remainder of PGY1 and the first six blocks of PGY2.
Rotations completed in PGY1 during FOD are:
General Internal Medicine - 3 blocks
Rheumatology (outpatient clinics) - 1 block
Plastic Surgery - 1 block
Urology or Vascular surgery - 1 block
Geri-Rehab - 2 blocks
Medicine/ Subspecialty Selectives: Three 1 block rotations (choose from eg. ICU, Cardiology Endocrinology, Radiology, Psychiatry, Emergency Medicine, Palliative Care, Occupational Medicine and Sports Medicine).
Rotations completed in PGY2 during FOD are:
Neurology - 3 blocks
Orthopedics - 3 blocks
COD spans about 30-35 blocks during which residents will develop the necessary clinical skills and knowledge in a variety of physiatric related conditions for the competent practice of the specialty of PM&R. Rotations included in core are:
Spinal Cord Rehabilitation - 3 blocks
Acquired Brain Injury Rehabilitation - 3 blocks
Pediatric Rehabilitation - 2 blocks
Prosthetics & Orthotics - 3 blocks
Stroke Rehabilitation - 3 blocks
Cancer Rehabilitation - 1 block
Cardiac Rehabilitation - 1 block
Chronic Pain - 1 block
Consult Service - 1 block
Musculoskeletal Rehabilitation - 4 blocks (2 outpatient, 2 inpatient senior rotation)
Spasticity - 1 block
Diseases of Nerve and Muscle (incl. EMG) - 4 blocks
Senior Resident Longitudinal Clinics (PGY5)
Research- 1 block
Other subspecialty rotations are available such as sports medicine, ambulatory care and community based rotations - at the discretion of the Program to ensure balanced training is achieved.
Electives which are organized by the resident in order to meet their self identified educational goals.
This final stage of residency spans 13 blocks. The resident would function as a junior attending in both inpatient and ambulatory settings to acquire the competencies for independent practice. This stage would also allow the resident to develop leadership, time-management and advocacy skills in a variety of contexts.
Research is a required program component and residents must complete at least one research project during their residency. Each year residents participate and benefit from feedback on their projects at the Annual Division Research Day. Residents can consult with research staff at UofT affiliated and partially affiliated teaching hospitals. In addition, UofT offers fantastic libraries at each hospital site and residents have access to UofT online journals and Robarts Library.
Academic Half Days, planned and taught by both residents and faculty, are held on Friday morning. This is strictly protected educational time for all residents allowing comprehensive coverage of rehab topics and includes sessions on basic science, case rounds, physical examination and anatomy sessions structured over a two year cycle (MSK & Neuro).
Division wide Grand Rounds and Journal Club are organized on the 3rd Friday of each month (September-June) to allow residents and staff to interact academically and socially.
Residents participate in various teaching activities with the MD program (e.g. clinical skills, case-based learning, MSK skills sessions) allowing them to develop and refine their teaching skills.
Residents participate in regular practice exams (written and OSCE component). Junior residents act as standardized patients during PGY1 and PGY2. There is also opportunities to participate in practice exam held by Hamilton and London PM&R programs.
The University of Toronto has fully affiliated teaching hospitals including adult rehabilitation hospital UHN-Toronto Rehab and pediatric rehabilitation hospital (Holland Bloorview Kids Rehab) and several partially affiliated teaching hospitals, including four regional rehabilitation hospitals (West Park Healthcare Centre, Bridgepoint Health, St. John's Rehabilitation Hospital and Providence Healthcare). In addition to the excellent staff, the University of Toronto offers exposure to many world experts in subspecialty areas.
How many residents are in the program?
Currently, there are 16 residents in our program.
What are the main training sites?
UHN-Toronto Rehab, University Centre is the home base for PGY1-5 residents and the training site for most core PM&R rotations. PGY1-2 residents complete General Internal Medicine, Neurology, Orthopedics and surgical rotations at acute care sites and community hospitals. Residents also complete core rotations at Bridgepoint Hospital, West Park Healthcare, St. John's Rehab and Holland Bloorview Kids Rehab.
Are there opportunities for community-based electives?
Yes, residents have opportunities to work with community staff in affiliated hospitals and in private offices.
Are out-of-town electives possible?
Yes, some residents have completed electives in Ottawa, Calgary, Vancouver.
What are the on-call responsibilities?
On-call responsibilities vary by service. Call guidelines are outlined at http://www.myparo.ca/top-contract-questions/#on-call. PGY2-5 residents complete home call and cover two rehab sites.
What resources are available to residents?
Residents receive an annual educational allowance and additional funding is provided to support attendance at the PM&R Comprehensive Review Course.
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