Trillium Health Partners: Credit Valley Hospital

• Unique program based at community hospital with tremendous academic medicine growth opportunities. Program is entering its fifteenth year in 2020-2021.
• Residents enjoy collegial relationships with family physicians and local specialists as they share in a culture of community care and academic inquiry.
• Hallmark of our program is direct staff-to-resident teaching (often one-on-one ratio).
• Curriculum is aligned with the College of Family Physicians Canada’s (CFPC) mandate to provide training that is centered in family medicine.
• Graduates are prepared for practice in comprehensive family medicine.
• Dynamic mixture of experienced and young enthusiastic family medicine teachers.
• Strong family medicine role models in longitudinal clinic, hospitalist medicine, palliative care, emergency medicine and obstetrics.
• Academic half-day content is thoroughly planned, professionally delivered, and always well received by residents.
• Interdisciplinary health professional integration curriculum offers unique interprofessional collaboration experiences.
• The procedural skills curriculum is consistently a highlight for residents.

Hospital, Community, Teaching Unit and Program

Trillium Health Partners is one of the largest community-based acute care facilities in Canada. Comprised of Credit Valley Hospital, the Mississauga Hospital and the Queensway Health Centre, Trillium Health Partners serves the growing and diverse populations of Mississauga, West Toronto and surrounding communities.

Trillium Health Partners is a teaching hospital affiliated with the University of Toronto and is an associate member of the Toronto Academic Health Science Network.

Trillium Health Partners received over 1.6 million patient visits in 2013-14, including over 266,000 Emergency Department visits. Last year, over 66,000 surgical procedures were performed at the hospital and over 9,000 babies were delivered. Trillium Health Partners has 1,268 beds staffed and in operation across all three sites and has over 10,000 staff, physicians and volunteers.

Trillium Health Partners - Credit Valley Hospital is a 30-year-old, 442 bed community hospital offering a full range of primary and secondary care services as well as regional programs in renal, maternal-child, oncology and clinical genetics. It serves the population of Mississauga, the sixth largest city in Canada, and is located 25 minutes by car from the downtown core of Toronto. Mississauga is also easily accessed by GO train and public transit. Your experience here will encompass the full continuum of patient care from prenatal to geriatric care in collaboration with a team of health care professionals.

The Family Medicine Post Graduate Program (FMPGP) at Trillium Health Partners - Credit Valley Hospital offers a unique horizontal/longitudinal experience. The FMTU is based within the hospital complex. This is where you will see your patients approximately three half days per week throughout your two-year residency. This will allow you to build a practice of your own patients and follow the course of an illness through its management while emphasizing health promotion and illness prevention. Working within this FMTU means functioning within a Family Health Team and allowing exposure to the team-based care provided through interprofessional collaboration. You will be supported by a skilled cadre of active family physicians, consultants as well as other regulated health professionals and will share access to in-patient beds and a new 30,000 square foot ambulatory care centre. Your clinical experience, based on the FMPGP curriculum, will include obstetrics/gynecology, pediatrics, palliative care, geriatrics, mental health, emergency and hospitalist medicine. With over 5,000 deliveries per year and a series of outpatient prenatal and postpartum clinics as part of a regional maternal-child service, an emergency department with over 106,000 visits per year, a Family Medicine hospitalist service where you are the most responsible physician for your patients, the clinical exposure is second to none. This is complemented by options for enrichment in the areas of genetics, cardiology, nephrology, infectious diseases, endocrinology, oncology, respirology, mental health, surgery and its subspecialties and substance abuse. To further enhance your experience, you will interact with a broad range of community support services, both on-site and off-site, to organize and oversee home support for your patients.

Family Medicine teaching at this site is provided by a combination of experienced and young enthusiastic family physician teachers. Your lead teachers in internal medicine (hospitalist) rotations will be family physicians. Your lead teachers in the obstetrical portion of your training will be family physicians, so too in palliative care. Most importantly the clinical teaching in the family medicine teaching unit is the key opportunity for mentoring through appropriate care delivery and management of your ‘own patient practice’. As such, the core competencies as outlined by the Department of Family and Community Medicine are delivered by your family physician teachers. Specialty areas and rotations confirm, expand and enrich your learning experience. Centering your learning within family medicine using our excellent resources ensures your mastering of the core competencies during our two year residency and preparation for a career in comprehensive family medicine. We enhance that learning of family medicine competencies within the teaching unit through a monthly procedural clinic and specialist monthly clinics in dermatology and psychiatry. The Credit Valley Hospital FMPGP allows you to further develop your interviewing and communication skills, teaching abilities and interpersonal skills. Our facility is equipped with video taping and viewing for supervised patient encounters. The residents’ presentations, which are integrated into Family Medicine Rounds for the Department of Family Medicine, provide opportunities for exploring academic interest in greater depth.

Trillium Health Partners - Credit Valley Hospital has an expanding breadth of teaching opportunities. Our residents currently assist in teaching Clinical Skills to medical students as well as seminars for family medicine clerks on their core rotation block. With the Mississauga Academy of Medicine, there are increased opportunities to mentor and teach undergraduate medical students.

This postgraduate program is best suited to those who are self-directed with the goal of establishing a community-based practice offering a full continuum of primary care within the context of a Family Health Team.

Family Medicine Centered Rotations

Family Medicine

The horizontal/longitudinal curriculum model will see you active three half days every week in the FMTU along with dedicated family physicians who competently and confidently practice in the environment of their office practice, as well as playing pivotal roles in hospital-based care. Enrichment experiences will take place on a horizontal basis taught by consultants who visit the family practice unit. Enrichment areas include:

• Dermatology
• Office gynecology
• Office based procedures
• Mental health, genetics
• Ethics and practice management

Inpatient Family Medicine

• For one month in the first year, you will have an integrated experience of inpatient service working with family physician hospitalists and consultants, along with continued involvement in the FMTU.
• You will gain valuable experience with continuity of hospitalized patient care and transition of care back into the community. Seasoned family physicians will provide teaching and clinical support.
• In second year, your inpatient medicine experience will polish ward skills and prepare you for hospital participation as your transition into practice.
• You consistently benefit from 1:1 case based teaching with your family medicine preceptor.
• You develop strong advocacy and practice management skills through collegial relationships with preceptors and consultants.

Internal Medicine – CTU

Two months of CTU are spread out across PGY1 and PGY2. You enjoy an array of enthusiastic internal medicine physicians. During the CTU rotation, you participate in a team including staff physicians, internal medicine residents, family medicine residents, clerks and allied health professionals. Hallmarks of the rotation are regular bedside teaching and structured learning opportunities throughout each week.

Palliative Care

The CVH Palliative Care Service is an integral element of the Peel Regional Cancer Program and its services support palliative care in all specialities. Along with a multi-professional team including a clinical nurse specialist, pharmacist and psychologist, the six FMED palliative care physicians lead the regional program for both the fifteen-bed inpatient unit and the outpatient clinic as well as providing in-home care.

Emergency Medicine

CVH has an excellent cadre of family physicians with CCFP (EM) who teach in the department’s PGY3 Emergency Medicine Program. For two months in first year and one month in second year, you will work approximately three shifts per week with this highly experienced group of teachers.

Specialist Focused Rotations

Geriatrics

CVH currently has four geriatricians on staff providing a wide range of patient care through a series of outpatient clinics and inpatient consultation. You have learning within the Rehab and Continuing Care Program, Seniors Day Hospital, Falls Clinic and Dementia Clinic which are the foundation for regional Geriatric Services that is under development. Geriatrics is closely linked to the inpatient rehab and continuing care units and geriatric psychiatry. There is an extensive multi-professional team approach that includes physiotherapy, occupational therapy, social work and a specialized geriatric emergency management nurse. From an acute care perspective, the geriatricians provide services for the Geriatric Assessment Unit, consultative support to the Family Medicine Hospitalist Service and consultations to all other subspecialties.

Obstetrics and Gynecology

You follow a minimum of six obstetrical patients from prenatal care through to delivery and postnatal care under the supervision of a family physician that practices obstetrics. This is done in a longitudinal manner through the Family Medicine Teaching Unit. Additionally, you spend two months in your first year working closely with obstetricians on labour and delivery developing competencies in labour assessments, labour management and delivery. During these months you will participate in a weekly outpatient urgent gynecology clinic.

Paediatrics

You will be exposed to a wide variety of paediatric clinical experiences during your two months in first year and one month in second year. You will rotate in on-ward service, ER consultant service, neonatal resuscitation, and well baby evaluation. This will be enhanced through a variety of outpatient clinics ranging from general paediatric private offices to hospital based paediatric sub-specialty clinics such as rheumatology, nephrology and endocrinology.

Mental Health

Your mental health learning is longitudinal and includes regular counselling within the FMTU, a specialist led psychiatry clinic and is enhanced by a focused month in the hospital psychiatry clinics. You will rotate in anxiety, depression clinics, substance abuse clinics, geriatric mental health and work in the ER with the Crisis Team.

Electives/Selectives

Our program is proud to provide three months of electives in first year and four months of electives in second year. This engages you to continually evaluate your learning needs, achieve most of your competency goals and tailor your curriculum to meet those objectives. Our residents have completed electives in ER, surgery, anesthesia, cardiology, endocrinology, neurology, nephrology, gynecology, dermatology, sports medicine and more.

Resources That Support Patient Care

You will learn how to understand and use all available resources to support and improve patient care. These resources include CCACs, public health, hospice care, nurse practitioner care, supportive housing, the criminal justice system and the March of Dimes, among many others.

In CVH’s longitudinal program, in most rotations, you will see your patients in the Family Medicine Teaching Unit three half days per week.

1st Year:

2nd Year: