Welcome to the Pediatric Residency Program of McGill University!
Below you will find information about what to expect in your day-to-day life at the hospital. If you have any other questions – contact us!
On Call Duties of Residents
In compliance with the collective agreement between the Quebec Medical Residents' Federation and the Ministry of Health and Social Services for the Province of Quebec, our program has moved to a universal night float call coverage system as of July 2012.
Every service to which residents provide call has a corresponding attending physician on call, usually from home except in the medical emergency room, which always has an ER physician in house. Junior residents are always supervised by a more senior resident on the medical wards and by a fellow or staff physician in the intensive care units (perinatology, neonatology, and PICU). In general, the more senior fellows and/or attendings are always available or present if there are any significant clinical issues. Explicit feedback is provided to the night float resident by the chief resident during the night float rotation.
Everyday there is an "early senior" who ends at 5:00pm and a "late senior" who ends at 8:00pm. At 8:00pm a "night float" replaces the late senior until 8:00am the next day.
As the "junior" resident on call, you should make yourself available to the nurses and medical students. You will be responsible for trouble-shooting on the ward(s) and ideally you will increasingly handle this by yourself as the year progresses. Of course, there is always a senior resident in-house to help you if you have any question or concerns. As the junior resident, you should ordinarily not call the PICU or staff physician without first discussing it with the senior resident.
Medical Students are typically also on call every evening, one to each ward. They take admissions and may do some trouble-shooting also. They do not get post-call days off and hence stop receiving admissions at midnight, after which they may sleep in-house or go home. The junior pediatric and/or family medicine residents are also responsible for admission, assigned by the senior resident.
Once your admission is done, page the senior resident to review. After the first 6 months, you may no longer need to review straightforward admissions (e.g. asthma, UTI), and in fact you might even be asked to review admissions done by the students.
The emergency room may call the senior resident with admissions until 4:00pm (after that time, patients are held in the ER overnight). Hematology/oncology patients, however, are admitted at any time, without being held in the ER.
When you are able to go to your call rooms, it's a good idea to walk by the ward and make sure nothing is outstanding. Make sure your pager is on.
In the morning after a night on call, you should check the status of the patients on the wards. Review the clinical status and vital signs of new patients, and discuss with the nurses any issues that have arisen overnight. During sign-out rounds, all new admissions are reviewed, as well as any overnight problems on the wards.
You should arrive at 5:00pm to get your sign-out. The neonatology staff is your first "back-up" to call for questions or concerns. Do not hesitate to contact them.
You are expected to be aware of the status of each patient, and examine/write notes on all patients with active issues.
Since no babies are born at the MCH, you may receive phone calls on the "transport phone" from referring hospitals wishing to transfer a baby to our hospital. You should write on a transport intake sheet any information the physician can give you regarding the baby's history, physical examination, present status, investigations, etc. Frequently, these physicians wish for you opinion/suggestions. It is best to advise the outside MD that you will call your staff on-call and get further suggestions and contact them. If the baby is to be transferred to the MCH, you should inform the nurse in charge and the "transport team", who will go pick up the child (without you). The secretary on 9C will provide you with a handout with additional details when you do your NICU rotation.
Sign-out rounds in the NICU occur at 7:30am during the week, and at 8:00am on weekends.
The PICU call involves taking care of the patients on the unit as well as doing consults on the wards or in the ER. In addition, you should respond to any "code pink" that is called. There is always a PICU fellow on home call. They come in to see all new consults and admissions. The secretary in PICU will provide you with a handout with additional details when you do your PICU rotation.
Sign-out rounds in the PICU occur at 8:00am during the week, and at 9:00am on weekends.
Don't hesitate to ask the opinion of the nurses, RT's and other team members – they have seen a lot, and frequently have good insight. If at any time you feel overwhelmed there are several places to get help: there is always an in-house senior resident on the wards, and there are in-house residents on 9D and 9C who can offer advice and/or assistance. There are also residents and staff in the emergency room at all times. If a patient is acutely deteriorating, you can call a "code pink", and an overhead announcement will trigger the "STAT" assistance of a variety of people, including all available residents, respiratory therapists, and staff.
Teaching and Rounds
All core clinical rotations begin the day with patient care rounds. Sign-in rounds are moderated by the Chief Medical Resident and revolve around the transfer of care from on-call residents to daytime residents. A brief clinical topic is presented each morning by the Chief Medical Resident(s).
All of the teaching sessions will start in September, with the exception of Protected Teaching Time on Tuesdays, which occurs year-round. Protected Teaching Time means that it is mandatory. You must sign in to all protected teaching sessions and please fill out an evaluation form afterwards. All other rounds are not protected but you are strongly encouraged to attend.
|Chief of Service||Tuesdays
|During these rounds, one resident presents an interesting case each week. The format is to interactively review an approach to a clinical problem, focusing on the differential diagnosis and information gathering. The presenter usually uses the chalkboard as the description of the case evolves, and usually prepares a few PowerPoint slides in advance to present at the conclusion of the case describing the ultimate diagnosis. All the residents take turns presenting; the schedule will be distributed at the end of the summer. Note that R1s do not present until after the winter holidays. We make every effort not to schedule you to present when you are not here (e.g., on vacation, post-call, etc.), but mistakes are sometimes made, so make sure you let us know beforehand if there is a problem. Please come and see us to discuss your presentation before your talk. Staff and residents attend these talks. Please try to invite a staff member and/or fellow who might be able to contribute to the discussion. People usually bring their lunches to these presentations.|
|Summer Protected Teaching Time (R1s only)||Tuesdays
|Summer Protected Teaching during blocks 1 and 2 is mandatory for R1s Pediatric Residents. Starting Block 3, the R1s will join regular Protected Teaching with R2 & R3 Pediatrics Residents. The Summer Protected Teaching for R1s covers introductory topics to the Hospital.|
|Protected Teaching Time (R1, R2, & R3)||Tuesdays
|Protected Teaching on Tuesdays is mandatory for R1, R2, & R3 Pediatric Residents. These interesting talks are given by subspecialists and generalists, and are intended to cover a wide variety of topics important to pediatricians.|
|Protected Teaching Time (R4s only)||Fridays
|Protected Teaching is on Fridays is mandatory for R4 Pediatric Residents only. These interesting talks are given by subspecialists and generalists, and are intended to cover a wide variety of topics important to pediatricians.|
|Pediatric Medical Grand Rounds||Wednesdays
|Pediatric Medical Grand Rounds speakers are often a visiting professor or a member of the McGill faculty who presents recent findings of clinical and research importance. Flyers describing the topic are be circulated by email, and also available on the Pediatric Medical Grand Rounds page. If you do not receive an email please contact the peds.admin [at] muhc.mcgill.ca (Administrative Coordinator) to be added to our list.|
|Ambulatory Pediatric Rounds||Fridays
Room to be confirmed
|Ambulatory rounds are talks presented by either subspecialists or generalists, and are geared toward topics of interest to General Pediatricians.|
Other academic activities (weekly, unless specified)
Research Institute Rounds
Ambulatory Pediatric Rounds
Emergency Department Rounds
Service-specific rounds: topics and journal clubs
For PGY-1s only:
Introductory Pediatric Seminar (summer lecture series)
Pediatric Advanced Life Support training
Neonatal Advanced Life Support Course
Monthly Assessments: Resident performance is evaluated by rotation supervisors every month. Written and verbal feedback is provided at the end of every rotation.
American Board of Pediatrics (ABP) In-Training Exams: All residents write the ABP in-training exam each summer. Exam scores are available in the fall. The ABP distributes mean scores for each year of training and internal mean scores are calculated each year.
Objective Structured Clinical Exam (OSCE): Residents participate in one OSCE per year. These exams may use simulated patients or parents to test specific residency objectives. Feedback on performance is provided individually to residents on the day of the exam.
Observed History and Physical Examinations: Each resident is assigned to a staff person to complete an observed history and physical examination. Cases are appropriate to the level of training. Feedback is given immediately after. Each year, the resident is assigned to a different staff person.
Residents who have satisfactorily completed 3 years of pediatrics residency are eligible for the American Board of Pediatric Examinations.
Residents who will have completed 4 years of pediatrics residency within 54 months of commencing the program are eligible to write the Royal College Pediatric Exams. Of note, candidates for the Collège des Médecins du Québec certificates currently need to complete a fifth year of training in order to receive their certification.
Ways to Get Involved
Residency Program Committee (RTC)
The RTC meets once per month to discuss resident issues, periodic reviews of sub-specialty and core rotations and general program content. There is a resident representative elected by peers each year. If at any point during the year you have resident concerns, let your representative know and these issues can be brought up at the meeting.
In the Fall of each year, the pediatric residents take a day and a half to have fun, socialize and discuss different topics, based on the theme each year. Themes in past years included: Mindful practice and team dynamics; Self-care, Knowing Ones' Self and Networking; Knowing how we learn, Active learning in residency, and Obstacles and challenges to the learning environment.
The Chief Residents are responsible for coordinating the Resident Retreat, and will provide more information to all residents.
Composed of one resident from each year, this is a committee that is responsible for organizing social events for the residents. Outdoor activities, evenings on the town, and helping to organize the retreat and "Skit Night" are all activities of this committee. Most importantly, don't forget to enjoy yourself. You will work hard while you are here, but you will get through it, and you will get to see and do things that few other people have the privilege of.
If you have questions about anything at any time, you should feel free to contact the Chief Residents at 514-412-4400 ext. 22376 – we are here to help!
More Information for Residents
Journals: Complimentary subscriptions to PREP and to Pediatrics and Child Health (the journal of the Canadian Pediatric Society)
Malpractice insurance: The Hospital Association provides malpractice insurance for all residents. No additional coverage is required
Vacations: 1 month of paid vacation is permitted per year as per the collective agreement of the FMRQ.
Conference leave: Up to 10 days of paid leave is permitted for attendance at approved medical conferences.