Postgraduate Residency Program: St. Michael's Hospital

Teaching Sites

  • Family Practice Unit
  • St. Lawrence Health Centre
  • Health Centre at 410
  • St. James Town Health Centre
  • Health Centre at 80 Bond Street
  • Sumac Creek Health Centre

Quick Facts

  • Number of residents: 38
  • Curriculum type: block rotations with optional horizontal/longitudinal curriculum in second year
  • PGY1 elective/selective months: 1.5 months
  • PGY2 elective/selective months: 5 elective/selective months

Program Highlights

  • Diverse clinical practices conducted at six clinic sites (all within walking distance) in downtown Toronto with over 48,000 rostered patients within the Family Health Team (FHT).
  • Dedicated and award winning clinical teachers with diverse clinical, academic, administrative, and research interests including: women’s health, obstetrical care, HIV care, addictions medicine, global health, immigrant health, LGBT health, academic medicine, sports medicine, quality improvement, and inner city health research.
  • Exposure to a broad patient population including marginalized individuals and inner city population. Specialized exposures include: integrated HIV-Primary Care clinic, Addictions Medicine Program/Substance Use in Pregnancy clinics, hands-on training with Income Health Security Promoters & Community Engagement Specialist.
  • Focus on academic and professional excellence including: EBM (evidence-based medicine) course, comprehensive and diverse academic half day (AHD) schedule, multiple opportunities for certification exam preparation including Simulated Office Orals (SOOs) and FM-MAP (Family Medicine Mandatory Assessment of Progress).
  • Extremely supportive residency program team with ongoing opportunities for resident feedback and input; resident well-being and positive residency experience a priority.
  • Graduated residents have moved forward in a variety of ways: fellowship positions, academic physicians, private clinics, community health centres, global health, public health, and consulting to name a few.
  • Interprofessional approach to patient care with resources such as: nurse practitioners, nurses, social workers, pharmacists, dieticians, chiropractic care, dentistry, and psychology.

Hospital, Community, Teaching Unit and Program 

Our staff are dedicated to ensuring that our residents graduate from the program with a broad range of skills and are able to work in a variety of settings. You have access to a wide array of agencies which are staffed by members of our department. They include:

  • Covenant House
  • Youthdale (psychiatric adolescent care)
  • Seaton House
  • Casey House
  • Yonge Street Mission
  • Hassle Free Clinic (sexual health)

Though our program is situated in downtown Toronto our graduates acquire the skills to work in settings ranging from academic to rural, remote and international. Each year a few of our residents elect to continue their training in academic medicine or third-year programs. Our residents have access to highly rated hospital rotations with excellent clinical teachers.

The profile of our patient population varies somewhat from one clinical site to another. These sites are as follows:

The Family Practice Unit at 61 Queen Street East, 3rd Floor

  • Diverse patient population of all ages and cultural backgrounds
  • Individuals working in the downtown area including St. Michael’s Hospital employees
  • Patients with complex medical problems
  • Homeless / under-housed individuals
  • Individuals with variety of physical and mental health problems

The St. Lawrence Health Centre at 140 The Esplanade

  • Serves the local community population
  • Diverse patient population of all ages and cultural background
  • Individuals with variety of physical and mental health problems, including common community family practice
  • Problems

Located within the thriving St. Lawrence Market area

The Health Centre at 410 at 410 Sherbourne Street, 4th Floor

  • HIV Primary care
  • Addiction Medicine, including Methadone Maintenance Therapy
  • Gay, Lesbian, Transgendered health
  • New immigrants
  • Homeless/under-housed individuals
  • Individuals with variety of physical and mental health problems

St. James Town Health Centre at 410 Sherbourne Street, Ground Floor.

  • Diverse patient population of all ages
  • People with diverse cultural backgrounds, new immigrants
  • Some HIV primary care
  • Individuals with addiction
  • People living in high-density housing
  • Individuals with variety of physical and mental health problems

Health Centre at 80 Bond Street at 80 Bond Street

  • Diverse patient population of all ages and cultural backgrounds
  • New immigrants
  • Urban professionals
  • Homeless/under-housed individuals
  • Individuals with variety of physical and mental health problems

Houses inter-professional alliances with Chiropractic care, Dentistry, and Ryerson Psychology

Sumac Creek Health Centre

  • DFCM’s newest clinic opened in July 2015
  • Diverse and growing patient population, including the  priority neighbourhoods of Regent Park, Moss Park and St. Jamestown
  • Interprofessional team-based approach to care, including many FHT-wide services
  • Strong orientation to  Social Determinants of Health in day-to-day care
  • Co-located with SMH lab, diagnostic imaging and FOCUS mental health services

Curriculum

The family medicine curriculum includes both a longitudinal and a block (rotation-based) component.

In horizontal/longitudinal:

  • You are assigned to one of our four clinical sites and return to the clinic, one-half day per week, throughout your residency.
  • You develop a practice and provide continuous care to a defined group of your own patients.

Block family medicine rotations (four in first year and two in second year) include:

  • Clinical activities in family medicine as well as enrichment experiences.
  • One to two half days per week, in a discipline chosen by each resident.
  • The opportunity to provide care to the clients of Seaton House, one of the largest men’s hostels in Canada (during two consecutive family medicine block months).

Throughout the year, residents will return to the department every Wednesday morning for presentations by residents, family physicians and consultants, on topics in family medicine. During block time, additional sessions in evidence-based medicine and behavioural health are incorporated into the rotation. The family medicine experience is based on a team approach to care. Team members, including nurses, nutritionists, social workers, pharmacists, occupational therapists and addictions counsellors, play a central and essential role in both patient care and teaching. In addition, our residents complete the NRP (neonatal resuscitation) and ATLS (trauma) courses.

In first year, one of the four months of family medicine has been modified to emphasize inner city health. During that month residents may spend up to four clinical half days per week in community agencies and clinical settings which serve the inner city community. The schedule is kept flexible to allow residents to select both clinical and enrichment activities that correspond to their learning needs and interests.

Similarly, the flexibility of our second-year curriculum recognizes the need for residents to identify their learning objectives and select rotations accordingly. Mandatory experiences are outlined (one month in each of internal medicine selective, women’s health, palliative care, mental health) but residents choose and arrange the type of rotation which meets their learning needs. Residents in good academic standing have the opportunity to complete their second-year requirements on a longitudinal/horizontal basis.

Residents are provided with support for completion of their resident academic project (RAP). A dedicated resident academic project coordinator physician and the departmental research assistant provide guidance while other departmental research activities provide opportunities for exploring family medicine research.

In short, our residents, the expertise of more than 80 staff representing all members of the health care team, our commitment to a diverse, challenging and rewarding patient population and our central role in one of the leading tertiary care centres in this country make our department a rewarding learning environment where the basics of family medicine are extended to the integrated care of those marginalized by our society.

If you have additional questions, please contact:

Dr. MaryBeth DeRocher
Program Director
derocherm@smh.ca 416-867-3725
Dr. Nasreen Ramji
Associate Program Director
ramjina@smh.ca 416-864-6060 x6803
Mr. Ed Ang
Education Coordinator
ange@smh.ca 416-867-7461
Ms. Gilda Barillas
Administrative Assistant
barillasg@smh.ca 416-867-7460 x8122
Dr. Shelby Jaeranny
Dr. Alex Francella

Chief Residents
chiefresfm@smh.ca 647-221-5025

SMH Sample 2 Year Rotation Schedule

1st Year

Rotation # of Block Rotation
Family Medicine 4
Obstetrics 1

Internal Medicine

2

Emergency Medicine

1

General Surgery

1

Paediatrics SMH

1

FM/OB/Elective

1
Elective 1

2nd Year

rotation # of Block rotation

Mandatory:

 

Family Medicine

2

Teaching Practice

2

Women's Health Selective

1

Internal Medicine Selective

1

Palliative Care Selective

1

Mental Health

1

Recommended: Selective

 

Paediatrics

1

Musculo-skeletal

1

Emergency Medicine

1

Elective

2

Unique rotations or opportunities residents should be aware of:

Immigrant Health

Evidence-based medicine and critical appraisal skills

Nutrition in Family Medicine

Perspectives in the socioeconomic basis of health in the inner city setting

Covenant House (Street Youth)

Psychiatry Crisis Team

Hassle Free (Sexual Health Clinic)

Substance Abuse/Methadone Program

Low Risk Obstetrics

Welfare Agencies

Seaton House (Men's Hostel)

LGBT Health

HIV Clinic/Team

Geriatric Assessment Clinic

Ambulatory Medical Clinics - diabetic, TB, allergy, GI,
neurology, respiratory, plastics, etc

Mental Health/Psychosocial

Family Medicine Block Time
(X indicates location of family medicine block time rotations)

Hospital Based FPU

X

Non-hospital Based FPU

X

Community Physicians' Offices

 

Number of family medicine half-day backs (continuity time) per week: 1 half day

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