CaRMS

FRCPC
CCFP-EM

Program Overview

The goal of the Royal College Emergency Medicine Residency Program at the University of Calgary is to educate physicians who wish to pursue an academic career in Emergency Medicine, including involvement in research and education. Graduates of the program will be thoroughly trained in all aspects of Emergency Medicine, including toxicology, trauma, prehospital care, care for vulnerable populations, paediatric emergency medicine and advanced communications skills. They will be able to demonstrate consultant level abilities in the recognition, understanding, and management of patients with any illness or injury presenting to the Emergency Department, and will be well-prepared for clinical, academic, and leadership roles within the specialty.

Curriculum

The Emergency Medicine Residency Program is five years in duration, including the PGY-1 year, and is an integrated university-based program that involves the Foothills Hospital as a primary site, with 4 other city hospital sites including the Alberta Children’s Hospital. Residents are evaluated on an ongoing basis by means of direct observation, EPAs, as well as quarterly written and oral exams. The program directors review resident progress on a quarterly basis. As a small program, residents work with a core group of experienced and enthusiastic attendings, and each year are paired with a longitudinal preceptor who develops their skills.

PGY-1 (Transition to Discipline and Foundations)

During the first year of training, Calgary residents complete their CBD Transition to Discipline and Foundations phases in an Emergency Medicine focused year. The year begins with an Adult EM rotation in July to meet the staff, feel at home, and complete an ultrasound training course. The objectives of the first year of the program are to build a solid foundation of knowledge and skills in Emergency Medicine. There are 6 adult EM blocks, 2 Pediatric EM blocks and 5 blocks off service (Obstetrics and Gynaecology, Anesthesia, Trauma Surgery, Internal Medicine, Pre-hospital [2 weeks], Addictions [2 weeks]). The PGY-1 year also has an additional introductory SIM curriculum that runs in the summer prior to the Junior SIM curriculum which runs September-June. This EM focused year allows our junior residents to feel comfortable managing patients in the ED and have solid relationships with staff and allied health. Our residents gain an appreciation of the breadth of EM in order to tailor their focus while off service.

PGY 2-4 (Core)

The ~2 years that make up “core” are the work-horse years of the program that involve broad-based training in a variety of disciplines, consistent with the broad-based knowledge base required in the specialty of Emergency Medicine. Core training includes Critical Care (Cardiac, Intensive, Neuro and Pediatric), Orthopedic Surgery, Plastic Surgery, Neurology/Stroke, Rural EM, Pre-hospital medicine[2 weeks], Otolaryngology [2 weeks], Ophthalmology [2 weeks], Internal medicine emergency liaison, Pediatric anesthesia and Toxicology. One month of elective time is available in both the PGY-2 and PGY-3 years. The Royal College exam is now written in the PGY-4 year, leaving dedicated time to pursue an Area of Interest afterwards.

PGY- 5 (Transition to Practice)

The final year of training is to develop consultant level skills and graded responsibility toward independent practice as well as pursuing our areas of interest. All PGY-5’s rotate through Air Transport Medicine with the Alberta Shock Trauma Air Rescue Society (STARS) and complete the equivalent of ~5 months of Emergency Medicine with a focus on developing flow, efficiency and comfort with relevant aspects of independent practice (teacher learners, giving handover, billing etc.) The remainder of the year includes at least 6 months of time to develop a dedicated area special interest within the discipline, which may include a concentrated period of training in a selected domain of Emergency Medicine for example prehospital medicine, stroke, resuscitation, airway, medical education, ultrasound, stroke medicine, simulation, EMS, ultrasound, disaster medicine and sports medicine. In addition to assuming increasing responsibility for the management of patients in the ED, the lead residents have organizational, academic, and administrative responsibilities, which include the scheduling and teaching of more junior house staff and medical students. Our seniors enjoy true multidisciplinary senior SIM, performed in a trauma bay at the Foothills Hospital.

Sample Rotation Schedule

Sample Rotation Schedule

Research

Formal training in critical appraisal, biostatistics, and evidence-based medicine is provided for all residents.  A research project will be developed with the assistance of a faculty preceptor in an area of mutual interest. The interdepartmental research block, early in R2 year, features expert lectures on research methodology and small group interaction for project development lead by emergency faculty. Time and resources can be supplied throughout the remainder of the residency as needed.

Residents are encouraged to present their research each year at the Emergency Medicine Research Day (a high-profile event in our program), as well as at national and international meetings. Conference leave is allowed in each year, and a book/conference travel fund is available annually to residents. Some funding for projects is made available through the Emergency Medicine Research Endowment Fund.

Seminars

The formal academic program is intensive and well organized. Each Thursday, residents attend an Academic Full Day, with Grand Rounds in the morning, followed by SIM / ECG / EBM teaching. In the afternoon, interactive and case-based teaching covers the entire curriculum of EM. Journal Club is held monthly, and includes a review with the staff of the latest literature, held at a staff member’s residence. There is an annual resident educational retreat in the Rocky Mountains, where wellness activities and program-level discussions are held. Practice oral / written exams occur quarterly starting in R1. Use of the Sim lab occurs 2-4x monthly, and seniors attend multidisciplinary senior sim cases, held in the resus bay with nurses and RT’s.

Extra-curricular activities

The residency program, although rigorous, is humane, and numerous group excursions and bonding activities take place. We have two yearly retreats which we hold in the Rocky Mountains. Our Program Directors are very invested in resident wellness, and hold ‘fireside’ chats multiple times a year. Journal Club is held monthly, usually at the home of one of the Emergency Department staff physicians. There are also the annual welcoming and end-of-year parties, golf and ski days, the Department Christmas party, a Research Day dinner, and who can forget the mountains which play host to all types of wellness activities!

Selection Criteria

The most up to date information about our selection criteria can be found on the CaRMS website here: https://www.carms.ca/match/r-1-main-residency-match/program-descriptions/

 

Our review process involves a holistic review of the applicants submitted materials. The overarching questions that our reviewers are asked to answer include:

  1. To what degree does this applicant demonstrate evidence of the academic skill necessary to master the material within the emergency medicine residency program?
  2. To what degree does this applicant demonstrate evidence of communication skills?
  3. To what degree does this applicant demonstrate evidence of excellent interpersonal skills and collaboration?
  4. To what degree does this applicant demonstrate evidence of maturity, insight, and resilience?
  5. To what degree does this applicant demonstrate evidence of commitment to communities and advocacy on behalf of others?
  6. To what degree does this applicant demonstrate evidence of organizational, management and leadership skills?
  7. To what degree does this applicant demonstrate evidence of scholarly curiosity and commitment to scholarly endeavours?

Interviews

Our program relies on a single structured interview day, with both staff and residents acting as interviewers. Interviews are held in late January or early February of each year. Applications are reviewed by members of the Selection Committee, and we will contact applicants selected for interviews.

Approximately 30-40 applicants will be invited to interview on the basis of their academic record, curriculum vitae, personal letter and letters of reference. Each applicant will have three to four interviews of 10-15 minutes each, and each applicant will have an opportunity to meet the Program Director and Assistant Program Director. Candidates are given the opportunity to meet our current residents.

Personal Letter

A personal letter is required. Personal letters will be reviewed as part of our holistic file review process. We aim to understand who our candidates are and how they came to apply to our program. Applicants are encouraged to discuss, to the extent they feel comfortable doing so, life experiences, important personal endeavours or adversity or barriers they have encountered

Reference Letters

Reference letters will be reviewed as part of our holistic file review process for evidence of the 7 pillars in our selection process.

Program Strengths

The Royal College Emergency Medicine Residency Program at the University of Calgary has a collegial philosophy and noncompetitive atmosphere. A close, mutually supportive relationship exists amongst the residents, and a close working relationship exists between the faculty and residents. As one of the smallest programs in Canada, we are very much a family here, and a support network.

There is a large faculty of Royal College certified, residency-trained Emergency Physicians who are dedicated and committed to teaching, and many have made substantial contributions in academic Emergency Medicine. The Departments of Emergency Medicine are well respected in each of the teaching hospitals. FRCPC residents work with a group of highly motivated and strong clinicians, all of whom are deeply invested in residency education. Each resident is paired with a ‘longitudinal preceptor’ with whom they work a majority of their clinical shifts in order to develop their skills.

The educational resources, including an extensive and varied patient population, are excellent. The resident’s office is well-equipped with a computer, and current issues of journals such as Pediatric Emergency Medicine Reports, Emergency Medical Abstracts, and Journal Watch for Emergency Medicine. Current issues of the standard texts in Emergency Medicine (Rosen, Tintinalli, and Roberts & Hedges) are also available.

Particular expertise exists in Ultrasound, Air Transport, Toxicology, Prehospital Care, Sports Medicine, Medical Education, Simulation, Research, Global Health and Stroke. We are very welcoming of anyone with niche areas of interest, but with our diverse faculty (~200) chances are there is someone else will also have some interest in your area.

The Medical Directors fo the STARS Air Ambulance, the Poison Centre, and EMS are all Royal College-trained Emergency Medicine faculty.

Calgary’s proximity to the resort towns of Canmore, Banff, and Lake Louise make it an attractive place to live and work. Please see our “Why Calgary” page for more! The city offers a wide range of cultural and recreational facilities that are unique in Canada. There is a lively theatre and art scene with multiple local theatrical and dance companies, numerous art galleries, the Calgary Philharmonic Orchestra and Opera Company, frequent performances by internationally acclaimed artists, and the world famous annual Calgary Stampede (aka: the Greatest Show on Earth). Calgary is a vibrant city that blends nature and exploration with the liveliness of a large metropolitan centre.

Finally, the program has benefited enormously from the tremendous contributions and hard work of so many outstanding former and current residents.

Program Overview

The CCFP-EM program at Calgary has a long history of offering a comprehensive curriculum in emergency medicine by an enthusiastic group of core faculty. The total number of residents in emergency medicine in Calgary is usually around 28; 8 CCFP-EM and 4 FRCP per year. Military / Canadian Forces candidates are considered on a year-by-year basis according to resources. The CCFP-EM residents benefit from a close association with the FRCP residents and the learning atmosphere is cooperative, challenging, and dynamic. Most academic rounds are jointly held; however, the two groups will separate for program-specific rounds periodically. The curriculum is designed to maximize cooperation between the programs while ensuring the CCFP-EM residents still get exposed to all the core topics in their year. The CCFP-EM academic curriculum includes a curated reading schedule around the Tintinalli's Emergency Medicine textbook, monthly SIM sessions, basic and advanced POCUS training leading to "Independent Practitioner" certification, monthly journal clubs, and written/oral practice exam practice delivered by experienced CCFP-EM staff. The Calgary Department of EM's large reservoir of nation-leading researchers and healthcare administrators also provide ample mentorship opportunities for residents to engage in the extra-clinical pursuit of their choice. The goal of the program is to offer excellent residents in family medicine a chance to be immersed in a comprehensive environment of emergency medicine training. The year is designed to allow the motivated physician to develop the skills necessary for a career in emergency medicine in any setting within Canada, from rural EDs to tertiary-care, academic urban sites. Most of our graduates will pursue a fulltime career in emergency medicine. Particular emphasis is given to development of habits suitable for lifelong learning, personal wellness, and extra-clinical contributions to the field of emergency medicine. The CCFP-EM residents complete rotations at all four academic teaching hospitals in Calgary, with a focus at the Foothills Medical Center (trauma, cardiac). The other three sites are: Peter Loughheed Centre (vascular), Rockyview General Hospital (urology, ophthalmology), and South Health Campus. Pediatric rotations take place at the Alberta Children's Hospital.

Highlights and Strengths of the Calgary CCFP-EM Program

 

  1. The Calgary Zone Emergency Department is an integrated group of over 250 full-time emergency physicians, roughly half of whom hold the CCFP(EM) designation. The Calgary Zone ED is the largest regionalized department of emergency medicine in Canada, with over 300,000 visits a year to the region’s four adult hospitals and one pediatric facility. This allows the program to draw from a large pool of preceptors with many areas of sub-specialty expertise such as additions, critical care, sports medicine, palliative care, POCUS, leadership and administration, and others.
  2. All Calgary EM residents are scheduled at all four adult EDs, with approximately half of the shifts taking place at the Foothills Medical Centre (FMC), which is the regional trauma and cardiac referral centre. All ED MDs in Calgary are considered "Trauma Team Leaders" and therefore lead all of the Level 1 trauma cases at FMC. As such, Calgary does not have a "trauma rotation", because all ED rotations trauma rotations.
  3. Calgary's CCFP-EM program enjoys a collaborative and integrated relationship with the FRCP-EM program. Most academic half days are shared, with resources and teaching programs being combined including Grand Rounds, Journal Clubs, didactic teaching, retreats, and many more activities. This provides many opportunities for professional and extracurricular collaboration, social networking, as well as setting up a positive working relationship as residents transition into attending staff.
  4. Calgary's EM programs are uniquely resourced to provide nation-leading education: the University of Calgary Postgraduate Medical Education department provides considerable funding for teaching developement, educational leadership, resource acquisition, and professional development. This allows us to surround our learners with dedicated and highly supported professional educators to enhance the residency experience.
  5. Canadian Forces / Department of National Defence candidates are welcome to apply at any point during the year. We have been proud to support our colleagues in the DND, and will make unique accomodations and a tailored learning experience for interested parties. Please contact the Program Director if you are a service-member interested in this pathway.

Calgary Zone Emergency Departments

 
 
Foothills Hospital is a comprehensive tertiary care hospital and Level I trauma and cardiac centre. It is adjacent to the University of Calgary Medical School and the Tom Baker Cancer Centre, and serves as a referral centre for Southern Alberta and Southeastern British Columbia. The emergency department sees approximately 80,000 patients per year with very high acuity of sub-specialty, medical, surgical and trauma patients.
 
Peter Lougheed Centre is a busy teaching hospital in Northeast Calgary. The emergency department census is in excess of 80,000 patients per year with a wide variety of pediatric and adult emergencies. The vascular and podiatric surgery departments are located here.
 
Rockyview Hospital is a large community hospital located in Southwest Calgary. The emergency department census is in excess of 80,000 patients per year with a wide variety of adult emergencies. It is the regional referral center for urologic and ophthalmologic emergencies.
 
South Health Campus is the newest hospital in Calgary, located in the growing southern suburbs of Calgary. The site sees a large volume comparable to the other 3 adult sites.
 
Alberta Children’s Hospital is a tertiary children’s hospital referral centre for Southern Alberta and Southeastern British Columbia. The emergency department sees many complicated pediatric problems as well as a large volume of common pediatric emergencies. 
 
Poison and Drug Information Service (PADIS) is the regional Poison Centre for all of Alberta and the Northwest Territories, and is located in the Foothills Medical Centre.
 
Shock Trauma Air Rescue Society (STARS) provides both rotary and fixed-wing dedicated air transport capability, and interfacility transfer of critically ill or injured patients. The flight crew includes paramedics, emergency/critical care nurses and Emergency Physicians and serves a prominent role in our trauma services. 
 
Urgent Care Centres (UCCs): The Calgary Zone is uniquely supported by 5 regionally situated UCCs. The UCCs service approximately 180,000 patient visits per year, typically of a lower acuity. The impact of this on the Calgary EDs cannot be overstated: a significant majority of low acuity presentations do not present to hospital EDs, making the hospital ED learning experience highly focused on complex and high-acuity patients. Note: unless specifically requested, emergency medicine residents do not rotate through the urgent cares.

Academic Curriculum

The University of Calgary CCFP-EM program adheres to the standards and meets the objectives of the CFPC. The program is based at the Foothills Medical Centre; however, residents receive their training at four hospitals in Calgary, and also at regional hospitals in Banff.

The year is comprised of 13 four-week blocks:
(subject to change, annually)

  • Emergency Medicine – 8 blocks (5 adult, 1 pediatric, 1 Banff and 1 additional rural selective)
  • ICU – 1 block
  • CCU – 1 block
  • Anesthesia – 1 block (2 weeks adult, 2 weeks pediatric)
  • Toxicology – 0.5 block
  • Ophthalomolgy – 1 week
  • Elective – 1 block

The EM blocks include Pediatric Emergency Medicine at the Alberta Children’s Hospital, and four weeks at the Banff Mineral Springs Hospital, where orthopedics in the E.D. is stressed. The Lethbridge Regional Hospital offers excellent teaching in a regional centre, and is an optional rotation for those residents who see themselves practicing in such a setting. The preponderance of the adult ED shifts are scheduled at the trauma/cardiac centre, Foothills Medical Centre.

Changes to the block schedule occur regularly to accomodate learner life circumstances, special career interests, particular learning needs, or where rotations have been completed in the past.

 

Academic Days:

All Thursdays in the program are protected throughout the year, including during off-service rotations, to provide value-added emergency medicine teaching. Academic days include weekly Grand Rounds (attended typically by over 100 resident and staff physicians) presentations which are provided by both residents and staff. The academic full days are shared and done in conjunction with the FRCP residency, which is considered a major advantage of the program. Residents are mentored and supported by senior residents in the Royal College residency.

Special Teaching Sessions:

1. Tintinalli Rounds and formal exam preparation curriculum: formal reading schedule, monthly formative exams, and quarterly in-person simulated mock oral exams, curated by our in-house exam experts to maximize success for the CCFP-EM examination

2. CCFP-EM ECG rounds: taught by an ECG expert, bi-monthly approximately

3. Longitudinal SIM Program: developed specifically for CCFP-EM residents, led by SIM-educational experts, occuring on a monthly basis

4. Casting Workshop: provided by Registered Orthopedic Technicians to cover common casts and splints in the ED

5. Monthly Journal Club: done in conjunction with FRCP program, hosted at the home of an attending physician.

6. Multiple hands-on airway courses during the year, equivalent or similar to AIME 

7. POCUS curriculum: includes standard "EDE1" equivalency course, scanning days (where needed), as well as advanced POCUS teaching to cover common topics such as gallbladder, lung, DVT, etc. All residents are offered the opportunity to complete their CPOCUS Independent Practitioner designation at no cost if desired.

8. Vascular access course and Advanced Procedures Labs: done in conjunction with FRCP residents

9. Longitudinal Preceptor: Each resident is paired with a longtidudinal preceptor who will work with them at least 2 to 3 shifts per ED block, providing them with mentorship, feedback, and advocacy as the resident traverses through a challenging and demanding fellowship year.

10. Transition to practice curriculum: insurance, licensing, personal finances, and all the things "we wish we had" when we were transitioning to practice.

 

Scholarly Project and Grand Rounds

All residents are supported in developing their own Grand Rounds to the entire Calgary Zone Department of Emergency Medicine. They are paired with an attending preceptor (including a specialist, where necessary). This is considered a highlight of the academic program and provides high visibility of the resident to the clinial department.

An academic/research project is also an integral part of the program. This project may be a small clinical trial, contribution to ongoing research, a quality improvement study, a case report with literature review, or a survey. All projects are presented in the Spring at Research Day, which is shared with the Calgary FRCPC program.

 

Sample schedules below:

Special Events

The formal academic program is intensive and well organized. Each Thursday, residents attend an Academic Full Day, with Grand Rounds in the morning, followed by SIM / ECG / EBM teaching. In the afternoon, interactive and case-based teaching covers the entire curriculum of EM.

Journal Club is held monthly, and includes a review with the staff of the latest literature, held at an attending physician's residence.

Residents usually organize a start-of-year retreat in BC for icebreaking activities. Time is usually protected for this. There is also an annual resident educational retreat in the Rocky Mountains during the winter, where wellness activities and program-level discussions are held. 

Residents are invited to an annual welcoming/end-of-the-year barbecue, Department Christmas party, and the annual Research Day. Numerous other social and academic events occur throughout the year.

Residents receive $500 for books or other education related tools. The University of Calgary provides additional funding for specific educational opportunities on a year to year basis which typically ranges from $500-1500 per year.

Application Information

Required Documents

All selection to the residency program is through the Canadian Resident Matching Service (CaRMS). Information and application forms may be found at the CaRMS website http://www.carms.ca

Interview Information

Interview format changes yearly. We have performed online / remote interviews recently. Information will be provided after candidates are selected for interview.

 

Selection Criteria

The goal of this program is to raise up the future leaders of emergency medicine throughout Canada, irrespective of their chosen practice location (urban, regional, or rural).

Candidates must hold a CFPC designation at the time of enrollment in the program.

Preference is given to candidates with a history of aptitude and interest in emergency medicine, who have excelled in their CFPC training and/or clinical practice.

Candidates must have excellent communication and interpersonal skills.

Consideration will be given to the potential contribution that candidates could make to the specialty of emergency medicine.

Return-from-practice applications are accepted.

Military or Canadian Forces applicants are also considered on a case-by-case basis.

International or other types of applicants apart from the stated above can be considered on a case-by-case basis in conjunction with the PGME at the University of Calgary.