Sinai Health - Mount Sinai Hospital

Postgraduate Residency Program Details

Quick Facts

Number of residents: 24
Curriculum type: horizontal
PGY1 elective/selective months: 1
PGY2 elective/selective months: 6
VIDEO: 2023 Open House—Site Overview

Program + Site Highlights

  • Inherit your own practice — horizontal program enables continuity of care throughout residency
  • Plenty of elective time in second year
  • Exposure to a variety of dedicated faculty
  • Excellent primary care obstetrics experience
  • Well-equipped facility with electronic medical records in a central downtown teaching hospital on the subway line

The Mount Sinai Hospital (MSH) Family Medicine Residency Program is based on a horizontal/longitudinal curriculum where residents maintain a family practice three half days per week throughout the two-year program.

The MSH program will expose you to a mix of full time academic and community-based family physicians for supervising and teaching. Our unit is a Family Health Team which includes social workers, dieticians, nurses, nurse practitioners, midwives, psychiatry, a pharmacist and a diabetes team.

Many of the faculty are involved in research, and we are pursuing the goal of fully integrating scholarly inquiry into the clinical activities of the office.

You will have regular opportunities to learn by participating in a variety of academic endeavours:

  • Dedicated faculty supervisors with video recording and ongoing feedback during clinical encounters
  • Review of cases with faculty supervisors at the completion of each half-day clinic
  • Academic half day seminars every Wednesday afternoon
  • Weekly grand rounds presentations, featuring critical appraisal
  • Quality Improvement experience
  • Resident Academic Project
  • Faculty mentor

You will benefit most from the MSH program if you are committed to caring for your own patients and enthusiastic in identifying your learning goals and choosing opportunities to fulfill them.

The Family Medicine Centre is located in the Mount Sinai Hospital Murray Street building which houses many of Mount Sinai’s ambulatory care clinics. Mount Sinai’s patient population includes a mosaic of cultures, socio-economic groups and all age groups, reflecting central Toronto.

Curriculum

The Family Medicine (FM) Experience

  • You will take over a practice from a departing resident.
  • On most rotations, you will see your own FM patients on three half days each week throughout the two years (exceptions are no half-days back when away at teaching practice and two half-days back when on internal medicine).
  • You get the opportunity to build and maintain your own practice, to develop continuing relationships with your patients and their families and to grow into your role as a family physician.
  • Most core rotations are at MSH, making it convenient to get from other rotations to the FM clinic.

Family Medicine Obstetrical and Newborn Care

  • You will be on call for approximately six or seven 24-hour shifts per block for two blocks in first year and one block in second year. These three blocks in our horizontal/longitudinal program is equivalent to two blocks in a traditional block-program.
  • You will attend your three half day FM clinics and have additional time to work with the respiratory therapists, lactation clinics and Prenatal Diagnosis Clinic
  • You are on call for patients of family doctors only. Therefore, you will follow patients together with the FM staff, rather than being a junior member of the obstetrical team and this allows you more autonomy.
  • You will be the primary resident responsible for all patients admitted to the FM team. This includes managing labour and delivery (cervical assessments, application of fetal scalp electrodes, vaginal deliveries, episiotomies and perineal repairs) as well as managing postpartum and newborn care (managing jaundice and breastfeeding issues). The family doctor is there for support throughout labour and is always present for the delivery.
  • Our program provides excellent preparation for residents whose goals include the ability to practice primary care obstetrics upon graduation. For those not interested in obstetrics, it is still a great way to learn because there is minimal ‘scut-work’ and you will get a lot of hands on experience with reliable, excellent backup from the staff physician.

Pediatrics

The pediatrics experience includes a one-block emergency rotation at the Hospital for Sick Children or St Joseph’s Hospital and one block of outpatient pediatrics in the community.

Musculoskeletal Rotation

The MSK experience includes one block with a combination of rheumatology clinics, sports medicine and chiropractic clinics. 

Palliative Care

The Palliative Care includes one-block of exposure to palliative care in the inpatient setting and doing home visits.

Women’s Health/Gynecology

Residents work in a variety of clinics including gynecology offices, fertility clinics, osteoporosis clinics, breast clinics and the Bay Centre for Birth Control. Residents will also participate in a Women's Health Procedures Clinic in our Family Health Team.

Emergency Medicine

The Emergency medicine rotation includes approximately three shifts per week in the MSH emergency department for three blocks (two blocks in first year, one block in second year). The emergency department staff at Mount Sinai is made up of CCFP-EM family physicians who are great role models for those wanting to do emergency medicine. Residents have the option of arranging one of their three block of adult emergency medicine at an alternative hospital site.

Internal Medicine

This experience runs over two-blocks in first year:

  • You will be part of a team consisting of one staff, a senior medical resident, two to three PGY1s and medical students.
  • You will follow patients you admit while on call and will have an opportunity to perform any procedures your patients require. There are many opportunities to manage emergency situations (e.g., respiratory distress, chest pain, cardiac arrests).
  • You will do standard one-in-four call with your team.

FM clinics are reduced to two half days per week on this rotation.

Care of the Elderly

Experiences include:

  • Falls clinic
  • Memory clinic
  • Home visits
  • Geriatrics assessments and FM with a geriatrics focus

Mental Health Care

This core rotation occurs during PGY-2. Residents spend time in a Bridging Clinic (patients with mental health concerns recently discharged from ER), addictions medicine (at one of the city’s multidisciplinary RAAM clinics), and in clinics for geriatric and pediatrics/adolescent psychiatry. The aim is to reinforce the DFCM mental health competencies encompassing more acute presentations and early outpatient management.

Flexible Second Year

Residents complete core rotations required for certification in FM such as ambulatory internal medicine (cardiology and endocrinology), a final block of FM obstetrics, one block of Mental Health and one block of emergency medicine. The remainder of the second year of the program may be customized to meet your specific educational goals, while you maintain your ongoing practice in the FM clinic.

Two blocks in second year will be spent in a FM practice in a smaller community of your choice (Teaching Practice). The remaining blocks will consist of self-selected learning experiences. In total, there are six months of elective time in second year.

Sample Two-Year Rotation Schedule

In Mount Sinai’s horizontal program you will see your patients in the Family Medicine Centre three half days per week in all rotations except internal medicine and teaching practice. All rotations are four weeks in length so there are 13 blocks per year.

1st Year

Rotation

Location

Number of Blocks

Description

Emergency Medicine

MSH ER

2 blocks
(~3 shifts/wk)

You will work in a busy ER with excellent staff teachers.  You have the option of arranging to do the second month at another hospital.

Internal Medicine

MSH Team Medicine

2 blocks

You will be assigned to a Team and will be on call 1 in 4.  You will do 1 full day back to the Family Medicine Centre instead of 3 half days during these months. 

Family Medicine Maternity and Newborn Care

MSH

2 blocks
(2-3x24 hour shifts/wk)

You will be responsible for all family medicine patients being assessed in triage, patients admitted in labour, postpartum patients and newborns.  When you are not on call, you will have your 3 half days in the FMC and gain exposure to neonatal resuscitation and breast feeding issues.

Women’s Health

Bay Centre for Birth Control and other clinics

1 block

During this month you will attend clinics at the Bay Centre, plus a variety of other clinics (breast, gynecology, osteoporosis, etc.) You may also do 1-2 shifts of obstetrics call if needed.

Paediatric Emergency

Sick Kids/ St. Joseph’s Health Centre

1 block

You will do shifts in both the fast track and ER areas at the Sick Kids or the pediatric section of SJHC.

Community Pediatrics

Community Office

1 block

You will work in a busy community pediatrics office and see a variety of common pediatric problems.

Geriatrics

Mount Sinai /UHN

1 block

You will do a combination of specialty geriatrics clinics (Falls Clinic, Memory Clinic) and home visits.

Elective

 

1 block

Any elective can be organized according to your specific learning objectives. Electives must be approved by the Program Director in advance.

Palliative Care

Pediatric MSH in patient (2 weeks) Home Visits (2 weeks)

1 block

This month will expose you to palliative care both in the home and hospital.

MSK

MSH

1 block

You will do a combination of rheumatology clinics, work with a chiropractor and sports medicine clinics at MSH.

Total: 

     

2nd Year 

Rotation

Location

Number of Blocks

Description

Elective

 

6 blocks

Any elective can be organized according to your specific learning objectives. Electives must be approved by the Program Director in advance.

Emergency Medicine

MSH ER

1 blocks
(~3 shifts/wk)

You will work in a busy ER with excellent staff teachers

Cardiology Clinics

WCH

1 block

1 month will be spent in a cardiology office.

Endocrinology Clinics

UHN/TWH/WCH

1 block

1 month will be spent in a combination of outpatient clinics & inpatient consultations.

Family Medicine Maternity and Newborn Care

MSH

1 block
(2-3 x 24 hours shifts per week)

You will be responsible for all family medicine patients being assessed in triage, patients admitted in labour, postpartum patients and newborns.  When you are not on call, you will have your 3 half days in the FMC and gain exposure to neonatal resuscitation and breast feeding issues.

Teaching Practice

 

2 blocks

You will be at a rural site for 2 months and will likely be involved in inpatient care, ER shifts, and obstetrical care. 

Mental Health

CAMH

1 block

1 month will be spent in a combination of outpatient clinics

Total:

     

Contacts

Name & Title

E-mail Address

Phone Number

Dr. Natalie Morson
Site Director

Natalie.Morson@sinaihealth.ca

 

Ms. Paula DaRocha
Medical Education Coordinator

Paula.Darocha@sinaihealth.ca

416-586-4800 ext. 3114

Dr. Yasna Mehdian
Dr. Nicole Czegledy

Chief Residents

Yasna.Mehdian@sinaihealth.ca
NicoleMargaret.Czegledy@sinaihealth.ca

416-586-4800x3114