Program Contacts

---

Important Information

Please refer to the CARMS website for provincial eligibility information - https://www.carms.ca/match/r-1-main-residency-match/eligibility-criteria/

It is important to review the requirements carefully. 

You can also find information on the McMaster Postgraduate Website

Our McMaster FRCPC EM Website

Competency Based Medical Education:

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 within our program uses both competencies as well as a global evaluation strategies as a framework for the basis for progression. Duration of training will not change for our program. The residency program is 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.

McMaster’s Emergency Medicine program (along with others across the country) transitioned to Competence by Design (CBD) in July of 2018. 

The Specialty Committee at the Royal College (including all of the program directors) have developed:

• Entrustable Professional Activities (EPAs).  EPAs are cardinal tasks that are required to become a competent emergency physician.  EPAs along with global and end of block assessments, will form the basis of evaluation and promotion in the Competency Based Education Model.
• Required Training Experiences which will help determine which rotations/experiences residents must undertake.

The new stages for residency programs under CBD are:

• Transition to Discipline (~3 Months)
• Foundations of Discipline (~9 Months)
• Core of Discipline (~3 years)
• Transition to Practice (~1 year) 

Transition between stages will take place once the requisite competencies in a particular stage have been completed and global knowledge base and ED functioning are appropriate for the next stage.

CBME has resulted in:

• Fewer off service rotations
• Modifications to off service rotations to maximize the relevancy to EM
• A program that will be more tailored to individual residents

In the lead up to CBD we implemented a highly-rated, new academic half day curriculum, simulation curriculum, bootcamp series, administration and CQI curriculum. Our curriculum is under constant review and we have made numerous modifications based on resident feedback. 

The Exam will take place after the Core stage and time for training in an Area of Focused Competence (subspecialty training) will take place in the Transition to Practice Stage.

More information will be forthcoming at the CaRMS interviews and for candidates who match to the program.

Further information regarding Competency Based Medical Education (CBME) can be viewed at: https://cbmepg.mcmaster.ca/

---

General Instructions

Program application language: English

Thank you for your interest in the McMaster University Royal College Training Program in Emergency Medicine.

The McMaster University Emergency Medicine Program offers a rich experience for residency training. Our Hospitals provide care for a catchment area of approximately 2 million people in the greater Hamilton area as well as being the primary referral site for surrounding communities including Niagara and Kitchener-Waterloo. We have over 80 faculty at multiple sites in and around Hamilton involved in residency education in this high acuity, high volume environment.

Our teaching sites include – The Hamilton General Hospital, St. Josephs Healthcare Hamilton, The Juravinski Hospital and Cancer Center, McMaster Children’s Hospital along with a number of community sites. Each of these hospitals provide exposure to different aspects of Emergency Medicine to ensure residents receive a broad exposure to Emergency Medicine.

We also have a number of opportunities for subspecialty training and research both within the Division of Emergency Medicine as well as within the University as a whole. Residents within the Program have an abundance of opportunities to become involved in medical education, teaching and leadership based on where their interests lie.

The McMaster University Emergency Medicine Program is accredited by the Royal College of Physicians and Surgeons of Canada.

---

Supporting Documentation / Information

---

Review Process

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

Given the large number of applicants expected, we will be unable to offer an interview to all candidates. Personal interviews will be offered to a limited number of applicants with the highest overall average scores who also do not score below a minimum threshold in any one attribute.

---

Interviews

Dates:

• February 23, 2023

Selection Criteria

Final rank ordering of applicants will take into consideration BOTH the strength of the application and interview performance. 

Program goals

• To prepare our residents to become expert consultant-level clinicians and leaders in Emergency Medicine.
• To provide support for the development of academic, research and professional competencies within the framework of the CanMEDS roles.
• To encourage and support our residents as they develop subspecialty interests in Emergency Medicine and provide resources and guidance to develop these interests.
• To use mentorship, along with our formal curriculum, to provide our residents with the tools to foster successful careers in Emergency Medicine.

Upon completion of the program, graduates should be competent and comfortable to work in any pediatric, general or geriatric emergency department including rural, community, urban and academic. It is also our expectation that graduates should be able to function in the role of trauma team leader. 

Selection process goals

Through the CaRMS process our goal is recruit residents who meet the following criteria:

• Demonstrate interest and insight into Emergency Medicine
• Demonstrate interest in Specialist/Academic Emergency Medicine. This could include, but not limited to, subspecialty training, interest in being an educator, administrator, leader, teacher, or researcher
• Ability to work well with others and where necessary lead a team
• Teaching and Problem-Solving Skills
• Self-Assessment and Reflection Skills
• Teachable with a growth mindset
• Ability to cope with demands of a busy residency
• Will integrate well with our current group of residents and faculty
• Professional behavior

As much as possible we aim to provide a process that is fair and equitable and will endeavor to level the playing field for candidates from non-traditional or disadvantaged backgrounds.

File review process

Evaluation criteria :

Elective criteria

Interview process

Interview evaluation criteria :

Information gathered outside of CaRMS application

Specifically, we may consider:
Social interaction during program related events
Communication with program administration
Social media
Unsolicited reference letters
Unsolicited email references
Unsolicited verbal information on a candidate's prior performance
Unsolicited feedback from colleagues and co-workers

Ranking process

The behavior(s) exhibited below during the interview process may prevent an applicant from being ranked by our program :
Unprofessional or inappropriate behavior   
Did not attend interview   
Interview performance was not competitive   
Other : Not a proper fit for program/discipline

---

Program Highlights

Ultrasound Course/Rotation – All of our PGY 1 residents take part in a hands-on Ultrasound Course to ensure that they have the skills needed for their future rotations. This course includes scanning days, where residents have the opportunity to conduct a number of scans on volunteer patients. Finally, residents have a 2-week scanning block in PGY 2 where they can practice their ultrasound skills in the ED while supervised by one of our POCUS Fellows or Staff and can see and utilize the practical applications of POCUS while in the ED.

Simulation – Residents are given the opportunity to participate in simulation throughout residency training, with more intensive training in the first two months of PGY 1 as well as throughout the year in PGY 2 and PGY 4/5. Sessions take place weekly in the first two blocks of PGY1 in our transition to residency boot camp. In PGY2, sessions occur once a month and are led by faculty with simulation expertise and using high fidelity mannequins. The Senior Simulation Curriculum runs across PGY4 and 5 to ensure that it does not conflict with our PGY4 residents studying for their Royal College Exams. 

Critical Care Day - The program organizes a biennial critical care day to review common and uncommon critical care procedures in the anatomy lab to ensure that our residents are familiar with how to perform them.

Disaster Day - The program organizes a biennial Disaster Day to give our residents the opportunity to participate in a Mock Disaster. Our residents are managing a busy Emergency Department, when disaster strikes! Over the course of the morning they manage the organized chaos of simulated disaster. It has received great reviews from our residents and has been a great learning opportunity.

Administration Curriculum – McMaster has developed a multi-part administration curriculum for residents in PGY 5. Faculty from within the Program as well as guest presenters hold sessions with the residents to discuss administrative topics relevant to the practice of Emergency Medicine. A number of our faculty have an interest in administration and are involved in hospital/university administration. These faculty have been mentors for residents with similar interests. The program is geared to help develop leadership and administrative skills in Emergency Medicine. Over the next year, the Admin Curriculum will transition into a longitudinal transition to Practice Curriculum that will include both the admin topics along with topics relevant to starting practice. 

Retreat – Once a year the program holds a resident retreat off-site. This time is protected for residents to get together outside of the hospital and discuss issues both within and outside of clinical emergency medicine. Topics discussed during the retreat have included –End of Life Care, Career Opportunities, Ethics, International Medicine etc.

EMS Rotation – Residents in PGY2 take part in a formal EMS Curriculum. During this time residents have didactic sessions, attend EMS related meetings, take part in ride outs with Paramedics in one of the local EMS Services and may conduct an EMS related project.

Practice Exams - Residents have the opportunity to write practice written examinations several times per year:

• The Canadian In-Training Exam is written twice per year
• Block exams approximately 3 times per year covering material reviewed in academic half days in the preceding months.

All of these exams are in a format similar to the written component of the Royal College exam. All of these exams are excellent practice for the Royal College Exams.

Residents also have the opportunity to participate in practice oral exams:

• PGY 2-3 - Semi Annually
• PGY 4 (year of exam) - Monthly

Research Curriculum and Support - Residents can participate in research to a level commensurate with their career goals and objectives. At a minimum, residents are responsible for completing:

• At least one academic project suitable for submission to a peer-reviewed process over the course of their residency
• Presenting a completed academic project at our Internal Research Day at least once

Residents are also encouraged to present at national and international meetings.

Formal training in Critical Appraisal and Epidemiology is provided over a 2 month block for all residents during their PGY 1 year.

Bootcamp Curriculum – the bootcamp curriculum is designed to help Residents transition through the various stages of residency. There are bootcamps at each stage of training tailored to help our residents develop new skills they will need to be successful Emergency Medicine Residents and Physicians.

Wellness Curriculum - The resident run wellness committee has created a curriculum to address the many aspects of collective wellness and challenges that trainees face during residency. Mediums of wellness promotion include workshops conducted during Academic Half Day on social aspects of medicine, team building and social events throughout the year, and initiatives within the emergency department to promote healthy work habits. This curriculum includes resident-chosen speakers to address topics of their choice felt to be important by the group; for example, mindfulness and stress reduction, and the integration of theatre and play in medicine.

 IDEA Curriculum - The Inclusion, Diversity, Equity and Anti-Racism Committee is a resident led committee with a dual focus on academic programming and on increasing representation in emergency medicine. They have worked with the program to expand our current curriculum to include more content in these areas during Academic Half Day. 

---

Program Curriculum

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.

This residency program is for 5 year(s)

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

Clinical Curriculum

PGY 1 – Transition to Discipline & Foundations of Discipline:

The PGY 1 year provides comprehensive basic clinical training in: Emergency Medicine, Pediatric Emergency Medicine, Internal Medicine, General Surgery, Anesthesia, Pediatrics, and Obstetrics and Gynecology. Residents will rotate through the Hamilton General Hospital, St. Josephs Healthcare Hamilton, The Juravinski Hospital and the McMaster Children's Hospital. Residents in PGY 1 also participate in a 2-month research seminar series to prepare them for developing their own research projects as well as an introductory ultrasound course.

PGY 2 – Core of Discipline:

The PGY 2 year provides comprehensive training in Emergency Medicine. Residents spend the entire year in the emergency department. In addition to this, there is an EMS Curriculum as well as the POCUS Scanning Block. This intensive exposure helps consolidate Emergency Medicine knowledge and prepares residents for their off-service consultation year.

PGY 3 – Core of Discipline:

The PGY 3 year provides comprehensive training in subspecialties relevant to the practice of Emergency Medicine. Rotations include: Community Emergency Medicine, Critical Care (adult and pediatric), Cardiac Care, Trauma and 4 selective blocks which can include Plastic Surgery, Orthopedic Surgery, Trauma, Research, Radiology, Neurosciences, Consult Medicine, Family Medicine, OBGYN, Public Health, Community Anesthesia and Thoracic Surgery. These selective blocks allow residents the opportunity to tailor their learning to meet unmet needs in their training to date and/or explore areas of interest to them that may become part of their subspecialty year.

PGY 4 – Core of Discipline:

The PGY-4 year provides comprehensive training in Emergency Medicine and Pediatric Emergency Medicine. Over the course of PGY 4 residents must complete a minimum of 10 Blocks of Emergency Medicine and 2 Blocks of Pediatric Emergency Medicine. Within CBD Residents write their Royal College Examinations at the End of Core, typically near the end of PGY4

PGY 5 - Transition to Practice and Area of Focused Competence

The PGY 5 year encompasses both the Transition to Practice Stage as well as an Area of Focused Competence:

 The Transition to Practice period includes EM Time as well as elective experiences to prepare residents for independent practice.

This AFC period allows residents to design their own curriculum to formally pursue subspecialty training or to develop expertise in an area relevant to Emergency Medicine and the resident's career goals. The AFC may be done off-site or in non-clinical areas with relevance to Emergency Medicine. Some examples of previous AFCs include:

• Masters Programs:
• Master of Business Administration
• Master of Medical Education
• Master of Economics in Health Policy 
• Trauma
• Toxicology
• Critical Care
• Pediatric Emergency Medicine
• Sports Medicine
• Simulation
• Point of Care Ultrasound (POCUS)
• International Health
• Pre-Hospital Care
• Administration
• Research
• Disaster Medicine
• Wilderness Medicine
• Medical Education (Royal College Clinician Educator Program)
• Tropical Medicine
• Quality Improvement and Patient Safety
• Hyperbaric Medicine
• Geriatric Emergency Medicine

AFC proposals must be approved by the Residency Education Committee midway through the PGY 4 year and are developed in conjunction with the Program Director. Although formally listed as 6 months of Transition to Practice and 6 months of AFC, they can be done concurrently and he AFC period may be stretched to a full year as long as Transition to Practice Goals are also completed.

Academic Curriculum

Formal Academic Curriculum

The McMaster Emergency Medicine Program has a robust academic curriculum. Our residents have a minimum of a weekly protected academic half day. Depending on the year there is often an academic full day or other academic sessions throughout the week. The core curriculum covers all of the medical expert topics one needs to become a consultant emergency physician. In parallel to the medical expert curriculum there are sessions that cover the intrinsic CanMEDS competencies. In addition to the core academic half day, most years have specific academic programs tailored to meet their academic needs.

PGY 1:

Introduction to Residency - PGY 1 Residents have a number of sessions with the Program Directors and senior Residents to prepare them for residency along with an introduction to the city and the various hospitals that they will be working at over the duration of the program.

Bootcamps - Over the first few months of residency PGY 1 Residents have a Transition to Residency Bootcamp which covers Cardinal EM Presentations along with simulation sessions that will prepare them for managing a variety of emergency presentations they will experience both in the ED as well as their off-service rotations. This is in addition to the core Academic Half Day.

Research Course - PGY 1s also participate in a research course that will review critical appraisal and research methods to prepare them for completing their research project later in training.

Introductory POCUS Course - Run annually for PGY1 - introduces residents to Point of Care Ultrasound 

PGY 2: 

Bootcamp – Early in PGY 2 bootcamp sessions focus on communication, collaboration and documentation in the ED. Later in PGY 2, the focus is on the management of critically-ill patients to prepare residents for their critical care rotations.

Simulation - Junior Residents have monthly simulation rounds to review the management of core ED presentations and to practice resuscitation skills as well as team and resuscitation management

CQI Curriculum – PGY 2 residents participate in a multi-disciplinary CQI curriculum to learn principles of CQI and are given the option to complete a related scholarly project in this area of research.

EMS – Residents take part in Didactic Sessions, Ambulance Ride Outs, an EMS Specific Project and Paramedic Education Sessions.

POCUS - Residents have a POCUS Block where they perform Point of Care Ultrasound in the ED under the supervision of Faculty or POCUS Fellows to gain further experience in using POCUS in the clinical setting. 

PGY 4:

Bootcamp – Late PGY3/Early PGY4 – Transition to Senior Resident – includes topics such as teaching in the ED, flow management and large and small group teaching.

Senior Simulation Curriculum – PGY 4 Residents have monthly simulation sessions to review the management of Advanced/Complex ED presentations and to hone resuscitation skills as well as team and resuscitation management 

Exam Review Sessions – As part of their studying, the PGY 4 Residents can identify any areas that they feel they require a review session, which can be set up with the program or with individual faculty members.

Practice Oral Exams - Practice Oral Exams are done semi-annually for Residents in PGY 2-3, however in preparation for the Royal College Exam these sessions are done monthly.

PGY 5:

Bootcamps:

• Teaching & Flow Bootcamp – Early in PGY5 - Will focus on developing clinical teaching skills as well as learning practical/advanced aspects of ED management and flow.
• Transitioning to Practice Bootcamp – Late in PGY5 - Includes topics such as administrative topics, Billing, Finances and Educational Promotion

All 

Residents also participate in a number of longitudinal education sessions, including Regional Rounds with invited local, national and international guest speakers. In addition, we hold Morbidity and Mortality/Amazing and Awesome rounds a few times a year. This gives residents an opportunity to discuss both challenging cases as well as cases that highlight excellence in clinical care in a safe environment. These rounds help inform the clinical services on how we can make system level improvements.

Journal Club

The Program runs eight Journal Club sessions per year to assist in the development of the residents’ critical appraisal skills and to keep abreast of new and practice-changing research. Sessions focused on updates of current literature take place in staff homes with a dinner served while other sessions will take place in small group settings concurrent with half-day to specifically focus on critical appraisal skills.

---

Training Sites

Patient Load

Average patient load depends on the site and level of the resident. Junior residents are closely supervised by either staff or senior residents. As residents become more senior they are given more autonomy and supervisory roles while still being supervised themselves. They also practice taking on additional responsibilities such as teaching, managing patient volume/flow, and how to approach concurrent administrative duties in the emergency department. Our Emergency Departments are not dependent on trainees to function. 

Training Sites:

Hamilton General Hospital

The Hamilton General Hospital is the regional referral center for Trauma, Cardiac, Stroke, Vascular and Neurosciences programs. It is a busy, high acuity department in downtown Hamilton and caters to a large inner city population. Rotations at the HGH exposes residents to issues of substance abuse, blunt and penetrating trauma, infectious diseases and other health problems that can affect marginalized populations.

Juravinski Hospital

The Juravinski Hospital is adjoining the regional cancer center. As such, many of the patients who present to the ED have complex conditions requiring significant work up and management at the ED level. This, coupled with a large number of patients from the surrounding area, makes the Juravinski an excellent teaching site with a wide breadth of patient types.

McMaster Children's Hospital

MCH is a tertiary care pediatric hospital. It is the regional pediatric referral center for all of the EDs in the region and is also the regional pediatric trauma center. The emergency department provides a unique opportunity to see a great diversity of clinical conditions and disease states in pediatric patients. It provides excellent exposure to almost all pediatric subspecialties. MCH is a high-volume Pediatric Emergency Department staffed by a mix of PEM trained as well as FRCPC EM trained physicians.

St. Joseph’s Healthcare Hamilton

St. Joseph’s Hospital in Hamilton is a very high-volume site also in the core of the city. SJH houses the regional psychiatry, nephrology and thoracic surgery programs. The emergency department manages a large number of patients with a variety of toxicologic presentations as well as patients from the above programs and the surrounding community. While rotating at SJH, residents also work a few shifts at the SJH Urgent Care which is a high-volume site with lots of procedural opportunities and a varied patient mix including pediatrics.

Community Sites

Our Community Sites are very busy community emergency departments. Our Residents have the option to work at a number of community sites, both on Emergency Medicine Electives as well as for other elective or selective rotations. These include:

• Brampton Civic Hospital
• Trillium Health Partners
• St. Catherine’s General Hospital
• Grand River Hospital
• St. Mary’s Hospital

These are a high volume, high acuity community EDs with a large number of faculty who are committed to teaching EM Residents.

---

Additional Information

Emergency Medicine Residency Education Committee

The REC is responsible for the overall operations of the Royal College Training Program in Emergency Medicine. This includes ensuring that residents in the program have the environment, mentorship and uniform experience to successfully complete the program objectives. Members of the REC are also responsible for assisting and contributing to the program functions for the Emergency Medicine Residency Program at McMaster University, including the following important domains:

• Program Design
• Training Program Academic Curriculum
• Recruitment
• Resident Evaluations
• Appeals
• Resident Well Being

Membership of the committee includes representation from departments significantly involved in resident education, related program representation, and resident representation. Resident representation includes the Chief Residents and an elected Junior Resident and Senior Resident.

Chief Residents

The Chief Residents are appointed by the Program Directors following an application process. All PGY 5 residents have the option to apply for the position. The term of the chief residents runs from July to June. The Chief Residents act as a liaison between the residents and the faculty/administration and have very close communication with the Program Directors. 

Elected Resident Representatives

The residents elect a Junior and Senior Representative to the REC each year for a term of 12 months. All Resident Representatives are voting members of the REC and are responsible to their peers to bring forward concerns and share information discussed at REC.

Wellness Committee

The resident run wellness committee has created a curriculum to address the many aspects of collective wellness and challenges that trainees face during residency. Mediums of wellness promotion include workshops conducted during Academic Half Day on social aspects of medicine, team building and social events throughout the year, and initiatives within the emergency department to promote healthy work habits. This curriculum includes resident-chosen speakers to address topics of their choice felt to be important by the group; for example, mindfulness and stress reduction, and the integration of theatre and play in medicine. Group activities also focus on fostering a welcoming resident environment and making creative outlets for our learners through painting classes, climbing courses and social activities all trainees can participate in. First year residents also receive a peer-lead wellness orientation in their first week to get acquainted with available mental-health resources, and receive advise on common challenges such as studying, financial wellness and the transition from medical school to residency.  The program also holds Ice Cream Rounds; a safe forum where residents can discuss personal and program related issues, and also celebrate their successes and ideas with the rest of their colleagues to solicit advice and support. All these initiatives are based off current evidence on strategies used to build effective wellness curricula to combat resident burn out. 

These sessions are in addition to the Resident Retreat, Fall Event, Holiday Brunch as well as Night Rounds, informal social events for Residents and Staff.  

Equity, Diversity and Inclusion

McMaster University is located on the traditional territories of the Haudenosaunee and Mississauga Nations and, within the lands protected by the “Dish with One Spoon” wampum agreement.

In keeping with its Statement on Building an Inclusive Community with a Shared Purpose, McMaster University strives to embody the values of respect, collaboration and diversity, and has a strong commitment to employment equity. The diversity of our workforce is at the core of our innovation and creativity and strengthens our research and teaching excellence. The University seeks qualified candidates who share our commitment to equity, diversity and inclusion. All qualified candidates are invited to apply and we particularly welcome applications from women, persons with disabilities, First Nations, Métis and Inuit peoples, members of visible minorities, and LGBTQ+ persons.

The McMaster FRCPC Emergency Medicine Program in particular aims to build a community that is safe, inclusive, and respectful for all. We unequivocally condemn racism in all forms, and recognize that Black, Indigenous, and people of colour suffer disproportionate acts of hatred and discrimination. We stand in solidarity with our patients and colleagues who experience injustice and commit to creating a more tolerant reality. 

As current and future Emergency Medicine practitioners we recognize the power and privilege we hold when caring for patients, often at their most vulnerable. We see the result of social inequality on a daily basis manifested as poor health outcomes. Advocacy should be a foundational component of our academic, research, and clinical work.

Our program pledges to embed this in the work that we do. We commit to continually reflecting, listening, learning, and, where needed, changing our systems. The Inclusion, Diversity, Equity, and Anti-racism (IDEA) committee is a group of McMaster EM residents with a dual focus on academic programming and on increasing representation in emergency medicine.