Postgraduate Residency Program Details: North York General Hospital
NYGH Family Medicine Community-Based Teaching Site
Number of residents: 32
Curriculum type: block rotations
Elective months: 2 months of in 1st year, 3 months in 2nd year
- Great academic and real world community.
- One-on-one matching with preceptors in family medicine (FM) and other specialities.
- FM residents are highly valued by the hospital and are the only permanent resident group, i.e., they do not have to compete with speciality trainees for access to specialists and speciality experiences.
- Flexibility in the program with diverse patient population.
- Dedicated exceptional teachers with a variety of extended FM practices including OBS, ER, palliative care, hospitalist and home care.
- Dedicated speciality teachers with good understanding of FM learning needs.
- Musculo-skeletal rotation which includes orthopedics, sports medicine and rheumatology, to reflect the needs of an FM resident for MSK teaching.
- A first-year site for rural-bound residents.
- The hub of the University of Toronto’s Practice Based Research Network (UTOPIAN) under the leadership of Dr. Frank Sullivan.
- Multiple elective experiences available, including a month in Dominica.
Hospital, Community, Teaching Unit and Program
Our program is a "real world" community-based preceptor program where residents work in the offices of one or two preceptors in community practices. You serve as "apprentices "in these practices developing under the supervision of your mentors.
The program is done in block format. You return to your community family practice for one-half day/week when on non-Family Medicine rotations. This is to provide continuity of care and allows you to follow and provide care to a group of patients over the two years.
All of our family medicine preceptors are practicing community family physicians with academic appointments. Most have extended practices including either: obstetrics, emergency, sports medicine, operating room assisting or palliative care, as well as general office care. This diversity provides for high-quality learning and mentoring experiences for our trainees. You receive extra enrichment experiences in dermatology, counselling skills, pharmacy, nutrition, genetics and substance abuse as well as in the care of underserved populations.
The program is a training site for the rural stream of University of Toronto Family Medicine. You do your first-year program at NYGH to benefit from the well-established teaching and mentoring at this hospital. You will then enrich your ability to serve a rural population by receiving your second year of training at a rural site. Through a telecommunications hookup, you will continue to participate in the formal teaching program at NYGH.
Once matched to NYGH you will be asked to describe your educational style and future plans for the purposes of matching you with the appropriate family medicine preceptor. The match is one resident to two or three preceptors. Many of our preceptors work in partnerships, so other family physicians may participate in your training. Some of our teaching physicians work in interdisciplinary work environments, such as the North York Family Health Team where you have access to working with other allied health professionals. This strengthens the mentoring aspect of the program. Many of these relationships last for life.
As a resident in FM, you will:
- Spend the majority of your time with your FM preceptors. If your main preceptors do not include OB deliveries, you are paired with an FM OB preceptor with whom you spend a half day per week.
- Have the option of adding selectives to the FM block, including a half day per week in dermatology, pharmacy, dietetics, diabetes education program, as well as other selective experiences.
- Visit nursing homes, do house calls, ideally shadowing your FM preceptor.
- Be on call for the Seniors Health Centre, managing acute after hours issues for this group of patients either by phone or in their residence.
- Follow six women throughout their two years from ante natal to intrapartum to postpartum.
- Take call 24/7 during FM block time for your select group of OB patients (usually one to three at a time) with the ability to sign out at any time.
- Be linked with an obstetrics preceptor who you work with a minimum of one half-day/week during block time.
There are 12 weeks of training. First year consists of the following:
- Four weeks dedicated to the Family Medicine Hospitalist ward. You will follow six to ten patients under the supervision of one of the FM hospitalists.
- One month in general internal medicine where you will work with one of our dedicated internal medicine hospitalists:
- Two weeks of internal medicine ward
- One week of emergency room consultations
- One week of outpatient med/surg rapid follow-up clinic
- On-call duties with one shift per week of medicine consults, which involves seeing patients in the evening in the emergency department referred to internal medicine.
- Rounding on the hospitalist patients one weekend during the month.
In the second year, geriatrics is four weeks. Palliative is two weeks, and two weeks is an elective of your choice. There is also an opportunity to do geriatrics as an elective in medicine.
Surgeons are keenly aware of what an FM resident needs to know. You will:
- Do ER assessments
- Follow the emergency surgeons
- Attend a variety of surgical clinics (e.g., Breast Diagnostic Center and the Lumps & Bumps Clinic)
Obstetrics & Gynecology
This is a one-month rotation in first year with an emphasis on hospital-based obstetrics and emergency consults. In second year, the emphasis is on outpatient gynecology and obstetrical care as you spend more time in gynecologists’ offices and sub-specialty clinics including FM run STI clinics and the Bay Centre for Birth Control.
Emergency is a very popular and well-run rotation scheduled for one month each year. You work eight-hour shifts and are assigned one emergency doctor to be your main preceptor who will supervise you about 5/16 shifts in a one-month block.
There are opportunities to work in the urgent care centre at the Branson site during FM and medicine rotations, but not during the core emergency medicine block.
The paediatrics rotation consists of some exposure to the inpatient ward and in the ambulatory clinic to see consultations. In addition, you are assigned to one primary preceptor and will be working in his/her community office. You spend time with community paediatricians in their office or attend paediatric sub-specialty clinics. These clinics include the following:
- General paediatrics
- Adolescent health/Eating disorders
- General surgery
There are between 4–7 calls per block, where you do neonatal resuscitation, ER consultations and managing inpatient concerns.
Psychiatry is offered for one month in first year and is a combination of emergency consults, shared care FM patients, and groups. You work with a social worker to acquire counselling skills and an FM addictions specialist during this rotation.
MSK is a four-week block in second year which includes time spent in rheumatology, sports medicine, orthopedics, and physiatry. This is a new innovative rotation at our site to improve skills in managing musculoskeletal complaints.
Dr. Allyson Merbaum
|Ms. Sally Principio
Dr. Michelle Yee
NYGH Sample 2 Year Rotation Schedule
Outline of the Proposed Two Year Postgraduate Rotation Schedule
1st Year: (4-week blocks)
|Rotation||# of Blocks||Rural Stream||# of Blocks|
|Family Medicine||4||Family medicine||3|
|Medicine Hospitalist||1||Medicine Hospitalist||1|
|General Internal Medicine||1||General Internal Medicine||1|
|Internal Medicine Selective||1wk|
2nd Year (4-week blocks)
|Rotation||# of Blocks|
|MSK (Sports Med, Rheum, Ortho)||1|
|Internal Medicine Selectives||1|