Postgraduate Residency Program Details: Toronto Western Hospital

UHN Toronto Western – Family Health Team

Quick Facts

Number of residents: 28
Curriculum type: horizontal (residents maintain a family practice three half days per week throughout the two-year program, except when on certain, higher patient acuity, rotations)
PGY1 elective/selective blocks: 4*
PGY2 elective/selective blocks: 8*
* 5 in total are selective blocks - ER is a mandatory selective

Program Highlights

  • Horizontal program allows greater continuity of care and the opportunity to build their own practice.
  • Flexible with twelve selective/elective blocks.
  • Gain skills for full scope family medicine — inpatient service, obstetrics, home visits, emergency.
  • Modern (designed for teaching) Family Health Team.
  • Downtown, lower density, residential community with community businesses, arts and entertainment.

Our program is about leadership and responsibility. It is resident-centered and the co-chief residents play a significant role in ensuring the program meets residents’ needs.

Curriculum

Horizontal Family Medicine Component

One of the most popular aspects of the Toronto Western Family Health Team’s program is its horizontal curriculum.

Family medicine clinics take place on three half days per week over most of the two years. This allows residents to cultivate their own practice (as opposed to seeing their supervisor’s patients during block rotations) and to develop continuing relationships with patients and their families. Teaching ‘care reviews’ occur at the end of each clinical session. Half-days back are flexible, and reduced on the few rotations where service requirements are more demanding.

Flexible Training Experience

Complementary learning experiences are designed around this horizontal time back. While blocks of defined specialty experiences occur mainly in the first year, this program offers elective/selective experiences totaling 12 blocks in the two years. There is considerable support available to help with elective/selective planning. However, residents who are mature, self-directed learners and who (with their preceptors) are able to clearly define their educational needs are preferred, as they take full advantage of the flexible nature of the program. Of the elective/selective blocks, five blocks of selective experiences are drawn from subspecialties within family medicine — these encourage residents to plan a career of broad scope family medicine, while facilitating the development of special interest areas. Commonly, residents also take opportunities to gain international experience and/or experience in the remote north. The academic half-day sessions are planned by the chief residents based on residents’ requests and a large menu of offerings that are modified from year to year based on previous feedback.

Special programs in which residents are involved: In-Patient Experience

The Family Inpatient Service (FIS) at TWH is a team that provides care to up to twenty patients requiring medical care in the TWH, completely run by family doctors in our department. The patients have been admitted to the General Internal Medicine Service and thus have problems that are representative of the full range of inpatient medicine. The FIS affords the opportunity to directly and independently manage inpatient care (as opposed to being an off-service resident on a large internal medicine team), while simultaneously managing an outpatient clinical practice (i.e., you will maintain your half-day back time). There is no overnight in-hospital call on the rotation.

Family Medicine Enrichment Block

This block in first year offers a group of brief selective experiences that introduce you to opportunities outside the office. This includes student health clinics, supervised home visits with the FHT Homebound Program and palliative care experience.

Obstetrical Care Program

You gain prenatal training through experience within a dedicated prenatal clinic operated by our family physicians who do intrapartum obstetrics. This enables you to gain a comprehensive understanding of all issues in prenatal care, through a focused, high volume, team-based care model. In second year, this experience is combined with a full shift per week doing intrapartum obstetrics, as well as time for home visits on newborns in our maternal-newborn month.

Home Visits

Part of a family physician's set of competencies is to provide care to patients in settings other than the ambulatory one, and this includes the home environment. As such, you will participate in the Family Health Team's Home-Based Primary Care Program, which provides both routine and palliative care to patients who are functionally homebound. You will receive more detailed orientation to this program, but the expectation will be that you either "inherit" or identify from your own roster, one or two patients for whom you can provide home-based care.

Partners in Care Program (PIC) – PGY1

The Partners in Care Program introduces the PGY1 to the conceptual components of the patient-centered clinical method. The goal of this program is to develop the clinical skills that will improve the quality of care and enhance the patient and physician’s satisfaction with the encounter. Residents enjoy a variety of learning modalities including small group discussions, observing clinical interviews, interviewing their own patients and evaluating videotapes of their patient interviews.

Partners in Care Program (PIC) – PGY2

Partners in Care builds on the PGY2’s educational experiences in the PGY1 program. Your clinical interviewing skills are further refined in the second-year program. The focus is on assisting you in addressing difficult physician-patient interactions and patients with complex bio-psychosocial problems, within time limitations. The program also prepares you for the oral examination certification process at the end of their residency program, the CCFP exam.

The residents have various learning experiences in this program including videotaping their patient encounters, videotaping a simulated office oral of themselves and faculty as a standardized patient and participating in simulated office orals with trained standardized patients. The simulated office orals are evaluated with the residents using the patient-centred clinical method of interviewing.

If you have additional questions, please contact:

Dr. Diana Toubassi
Program Director
diana.toubassi@uhn.ca 416-603-5397
Ms. Karen Eveleigh
Program Assistant
karen.eveleigh@uhn.ca 416-603-5397
Dr. Corey Bricks
Chief Residents
corey.bricks@uhn.ca  
Dr. Kevin Dong
Chief Residents
kevin.dong@uhn.ca  

TWH Sample 2 Year Rotation Schedule

Outline of the Two Year Rotation Schedule

1st Year

rotation # of months
Elective/Selective 4
Family Medicine Longitudinal

Emergency

1

Internal Medicine

1

Paediatrics-ER

1

Obstetrics

2

FM Inpatient Unit

1

FM Enrichment

1

Psychiatry

1

Palliative Care

1

2nd Year

rotation # of Months
Family Medicine Longitudinal
Teaching Practice 2

FM Inpatient Unit

1

FM Obstetrics (Prenatal and newborn focus)

1

Community Paediatrics

1

Electives/Selective

8

Selectives – 5 blocks - Residents are expected to select five blocks of rotations that support the comprehensive roles of family physicians (e.g. international health, rural medicine, community health, obstetrics, hospital medicine, palliative care, occupational medicine, rehabilitation, sports medicine, long-term care, home care, GP psychotherapy, emergency). ER is a mandatory selective.
 

Hospital Based FPU

X

Non-hospital Based FPU

 

Community Physicians' Offices

 

Number of Family Medicine half-day back (continuity time) per week:

PGY-1: 3 half-days/week clinical time
1 half-day/week academic teaching (Wednesday a.m.)

PGY-2: 2 half-days/week clinical
1 evening/week clinical
1 half-day/week academic teaching (Wednesday a.m.)

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