Residency Program Overview

Curriculum Overview:

• 24-month comprehensive educational program with a competency-based curriculum building on the CanMEDS-FM framework and roles
• A minimum of four months of Family Medicine training in both first and second year divided into a Block or Horizontal curriculum
  • Block Curriculum includes 4 months of Family Medicine experience in 1-month blocks (combined as determined by each site), with one half-day of FM per week over the two-year period to provide continuity of patient care.
  • Horizontal Curriculum offers equivalent exposure longitudinally as three half-days per week over the two-year period    
  • Clinical Specialty Rotations may vary by site based on excellence of educational experience and  resources
• Teaching Practices introduce residents to two months of community teaching practice in their second year of residency as part of their core FM training
• Protected Academic Half Days (AHD) with weekly teaching seminars/workshops; the majority delivered locally at the site. There is a central mandatory topic list which is supplemented  by site-specific needs as determined by site leadership involving site program directors/ delegates and chief residents
• Quarterly Core Days with all FM residents present topics of particular importance in Family Medicine
• Quality Improvement Curriculum and Project Development
• Research/Academic Project required    

Flexibility

• Three streams with diverse sites within each stream
• Horizontal or Block rotation schedule
• Hospital-based family medicine teaching unit (FMTU) or preceptor-based teaching models
• Tertiary centres or community hospitals
• Multiple opportunities for electives (independently arranged based on interest) or selectives (resident selects from focused list of options

Resident responsiveness

• Family Medicine Residents Association of Toronto (FRAT)
  • The resident-led council comprised of chief residents and PGY1 reps from each site and stream as well as committee reps & social reps
• Committee memberships (both local, provincial and national)
• Local delivery of curriculum (responsive to site directors/program assistants and site chief residents)
• Professional Association of Residents of Ontario General Council representation relative to program size

Well-resourced

• Diverse patient population (broad range of clinical, socioeconomic, cultural issues)
• Unparalleled learning opportunities
• Excellent teacher to learner rations (does not exceed 1:4 in Family Medicine)

Strong Academic Profile

• Fully accredited by the CFPC 2020
• High pass rates for both Canadian Medical Graduates (CMG) and International Medical Graduates (IMG) residents on the national certification examination
• Scores consistently above the mean on all components of national exam
• Competency-based Curriculum
• Bi-annual Family Medicine Mandatory Assessment of Progress (FM-MAP) for residents to self-monitor progress on essential FM competencies
• Opportunity and support for Research/Academic Projects
• Quality Improvement Curriculum and project support
• Protected weekly academic time at sites (Academic Half Days)
• Protected Quarterly Core Days with central core teaching with residents together from all sites

Additional Program Highlights:

• Practice Management Curriculum
• Teaching Residents to Teach (TRT)
• Neonatal Resuscitation Program (NRP)
• Advances in Labour and Risk Management (ALARM)
• Integrated 3-Year Program (I3P): Family Medicine Leadership
• Integrated 3-Year Program (I3P): Family Medicine Enhanced Skills (FAM-ES)

Breadth and quality of PGY 3 Enhanced Skills Opportunities

Category 1

• Addiction Medicine
• Anesthesia
• Care of the Elderly
• Clinician Scholar - Research Stream
• Academic Palliative Care (12 Month Program)
• Emergency Medicine
• Sport and Exercise Medicine

Category 2

• Breast Diseases
• Clinical Palliative Care (6 Month program )
• Clinical Environmental Health
• Clinician Scholar - Education Stream
• Hospital Medicine
• Global Health and Vulnerable Populations
• Low-Risk Obstetrics
• Women's Health
• HIV Care
• LGBTQ Health
• Intellectual and Development Disabilities
• Adolescent Medicine

1)   How does the internal match work?

After matching to the Family Medicine Program at the University of Toronto, a virtual Open House is held  to provide more information about each hospital teaching site and as an opportunity to have additional questions about individual sites answered. Each newly matched resident will then complete a rank list of all hospital teaching sites in the stream to which they have matched. Most residents in the Canadian Medical Graduate – Greater Toronto Area match receive one of their top four choices. Electives can always be booked at different hospitals and clinics to ensure desired breadth and depth of experience is achieved.

2)   What are the main differences between the hospital teaching sites?

There are 13 Family Medicine hospital teaching sites in the Greater Toronto Area stream.  The Barrie or Newmarket stream is a separate choice with residents selecting either site and residents in the Integrated Communities Stream matching to one of four mid-Ontario communities: Midland, Port Perry, Orillia or Orangeville. Each hospital has a slightly different curriculum with potential for different areas of focus that can be explored by residents. However, the requirements of the College of Family Physicians of Canada are adequately met at every site. You will learn more about the individual sites at a Virtual Meet & Greet session to take place before your interview and by reading the information available on the Department of Family and Community website. For more information about the sites, you can contact the chief residents at the respective site who would be happy to help!

3)   Do residents have a say in the running of the residency program?

The U of T administrative staff welcomes any suggestions for program improvement.  Resident participation runs primarily through FRAT (Family Residents Association of Toronto) which is an organizational council that acts as a link between administrative staff, program directors, and residents. It is comprised of chief residents, PGY1 reps, and committee members from all sites and streams.  Residents also have the option of sitting on various committees, including the governing committee (FRAT Presidents sit on the Residency Program Committee) and PARO.  The administrative bodies, from a resident perspective, are consistently responsive to resident needs and advocacy.

4)   How much elective time does the program offer?

Each hospital teaching site varies with respect to the amount of time allotted to electives.  The minimum would be two or three months over the two years.  As well, many of the hospital teaching sites include selectives in the curriculum.  There is a diverse range of electives given the tremendous opportunities for clinical work in various specialties at UofT.

5)   Is there formal teaching as part of the curriculum?

Hospital teaching sites offer a half day per week for formal teaching.  This Academic Half-Day is considered protected teaching time, meaning that your attendance is expected regardless of your rotation.  Program directors from other specialties are aware of this protected and prioritized time and should allow you to attend. The lectures vary from week to week but always have a focus on topics important in primary care.  In addition to these academic half days Family Medicine residents from all teaching sites will come together every few months for a focused day of seminars and lectures at the Central Core Days. Additionally, all residents come together a few times each year for a curriculum in Practice Management.

6) What types of opportunities are available for a 3rd year of training?

The University of Toronto offers many high-quality 3rd year enhanced skills programs; including Women's Health, Emergency Medicine, Sport and Exercise Medicine, Low-risk Obstetrics, Care of the Elderly, Clinician Scholar Program: Research and Education Streams, Addiction Medicine, Palliative Care and others. We continue to innovate and develop new programs such as our Global Health and Vulnerable Populations Enhanced Skills program. Please contact the Enhanced Skills coordinator at fammed.enhanced@utoronto.ca

7) How are U of T family residents treated on off-service rotations?

The program directors at each site work hard to ensure that the Family Medicine residents are receiving the respect they deserve.  Overall, Family Medicine residents are treated very well on off-service rotations at U of T. Residents also have the opportunity to complete evaluations at the end of rotations as an opportunity to provide feedback.

8)   What is call like? How often and how grueling?

The call schedule adheres to PARO guidelines and depends both on the hospital teaching site and the specific rotation. Residents will do no more than 1 in 4 in-hospital call or 1 in 3 home call.  Traditionally, rotations like internal medicine and general surgery have more rigorous call schedules, while other rotations allow for less frequent call.