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 in 1st year, 4 months in 2nd year
- Great academic and real world community.
- Responsive and flexible program.
- All residents are matched on a one-to-one two basis with community-based family doctors for weekly half day back and core family medicine block time. Match is done with consideration of residents' preferences and career plans.
- Varied patient population exposure from Prenatal, Pediatrics to Geriatrics.
- 20+ family physicians that do intra-partum obstetrics and teach family medicine residents in their offices and the delivery room.
- There are opportunities for interprofessional practice and teaching including working with a Dietitian, Social Worker, Pharmacist, Nurses and Nurse Practitioners.
- Selectives available during Family Medicine blocks, including Breast Clinic, Prostate Clinic, After-Hours Clinic, Sports Medicine, Pain Clinic, Chiropody, Genetics, and Cancer Survivorship Clinic.
- Family Medicine oriented specialty rotations.
- One to one teaching on many specialty rotations including General Internal Medicine, Surgery and Emergency Medicine.
- Family Medicine residents make up the majority of residents in the hospital, so that there are many opportunities for hands-on experience.
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. These residents do their first-year program at NYGH to benefit from the well-established teaching and mentoring at this hospital. Theh will then enrich their ability to serve a rural population by receiving their second year of training at a rural site. Through a telecommunications hookup, they 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 Family Medicine, 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 4 months of training. First year consists of one block each of Hospitalist Medicine and General Internal Medicine. Second year consists of one block of Geriatric Medicine and one block of Palliative Care.
- You will follow six to ten inpatients under the supervision of one of the FM Hospitalists.
- During this rotation, you will provide direct patient care and develop more independence in assessment, management and discharge planning under the guidance of an experienced hospitalist.
General Internal Medicine
- Your GIM rotation is a composite of inpatient ward, ER consultation and ambulatory medicine clinic. There is no overnight call on this rotation.
- The geriatric service at North York General Hospital is patient-centred, holistic, interdisciplinary, and evidence-based.
- As part of the team, you will have the opportunity to work at the Internal Consultation Team, Geriatric Outreach Team, Geriatric Medicine Clinic, Memory Disorders Clinic and the Parkinson's Clinic.
- Residents will work as part of The Freeman Centre for the Advancement of Palliative Care interdisciplinary team to provide comprehensive care for the patients and their families at all stages of their disease, including end-of-life.
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 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.
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.
Dr. Allyson Merbaum
|Ms. Sally Principio
Dr. Stephanie Klein
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|
|Hospitalist Medicine||1||Hospitalist Medicine||1|
|General Internal Medicine||1||General Internal Medicine||1|
2nd Year (4-week blocks)
|Rotation||# of Blocks|