New Pediatric Residents
Welcome to Pediatrics
Welcome to The Pediatric Residency Program of McGill University. Here is some information about what to expect in your day-to-day life here. If you have any other questions – just ask! Please consult our ResidentSurvivalGuide2012.pdf
Montreal Children's Hospital
This is where you will be spending the vast majority of your time. Floors and stuff to know:
1st – ER, amphitheatre for Grand Rounds, Café Vienne
2nd – Resident Continuity Clinic, Pediatric Test Centre (PTC)
3rd – Lounge, lockers, call rooms, cafeteria, radiology
4th – Administrative office, protected teaching, library, labs
5th – Offices
6th – Medical wards – blue = 6C1 and yellow = 6C2
7th – Surgical wards
8th – Hema-Onc wards
9th – 9C = NICU, 9D = PICU
10th – OR
11th - Anesthesia teaching offices
12, 13th – ID, microlab
Jewish General Hospital
This is where you will spend 1- 2 blocks to do NICU / maternity during your residency. The NICU is located on the fifth floor of the B wing.
Royal Victoria Hospital
This is where you will spend 1 - 2 blocks to do NICU / maternity during your residency. The NICU is located on the seventh floor of the Centennial pavillion.
As of July 2012, call coverage is done by a nightfloat system in pediatrics. Please refer the FMRQ webpage for details on the resident collective agreement outlining matters such as rules and regulations pertaining to working hours.
Everyday there is an "early" senior who ends at 17h00 and a "late senior" who ends at 20h00. At 20h00 a "night float" replaces the late senior until 8h00 the next day.
Call on the wards:
As the "junior" resident on call, you should make yourself available to the nurses and medical students (i.e., introduce yourself to the nurses, write your beeper number down on the chalkboard). You will be responsible for trouble-shooting on the ward(s) and ideally you'll increasingly handle this by yourself as the year progresses. Of course, there's always a senior resident in-house to help you out if you have any questions 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 admissions, assigned by the senior resident.
Once your admission is done, page the senior resident to review. After the first 6 months, you might 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 04h00 (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 room, it's a good idea to walk by the ward and make sure nothing is outstanding. Make sure your pager is on! The call-rooms are located on the 2nd floor of the F-wing.
The combination codes to the call rooms are included as an attachment to this handout. If you have any trouble getting a call room, notify the Security office at 2-4409 (B-128).
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. Sign-out rounds are held in the ward conference room. During these rounds, all new admissions are reviewed, as well as any overnight problems on the wards.
Call on 9C (NICU)
Again, you should arrive at 17h00 to get your sign-out. The neonatology staff is your first "back-up" to call for questions or concerns. Do NOT hesitate to call!
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 (except the exceptional case in the ER), 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 your opinion/suggestions. It is best to advise the outside MD that you will call your staff on-call and get further suggestions and re-contact them (get their phone number!). 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 07h30 during the week, and at 08h00 on weekends.
Call on 9D (PICU)
The 9D 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 on 9D will provide you with a handout with additional details when you do your PICU rotation.
Sign-out rounds in the PICU occur at 08h00 during the week, and at 09h00 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 of the teaching sessions will start in September, with the exception of "Protected Teaching Time" on Tuesdays, which occurs year-round. Protected Teaching means that it is mandatory and occurs every Tuesday from 12h00 to 16h00 and every Wednesday from 8h00 to 9h00 (Grand Rounds). 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.
Tuesday: Chief of Service
Chief of Service rounds are on Tuesdays in the fourth floor lecture hall (C-417) from 12h00 to 13h00. 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.
Tuesday: Protected Teaching Time
"Protected Teaching" is on Tuesdays in the fourth floor lecture hall (C-417) from 13h00 to 16h00 and is mandatory for all pediatric residents. These interesting talks are given by subspecialists and generalists, and are intended to cover a wide variety of topics important to pediatricians.
Wednesday: Pediatric Grand Rounds
Pediatric Grand Rounds take place on Wednesday at 08h00 in the amphitheatre on the 1st floor (D-182). The speaker is 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 posted around the hospital, including on the 4th floor in front of Dr. Guyda's office (C-414).
Friday: Ambulatory Pediatric Rounds
Ambulatory rounds are in Room E-333 (near the cafeteria) on Fridays from 12h00 to 13h00. These talks are presented by either subspecialists or generalists, and are geared toward topics of interest to general pediatricians.
WAYS TO GET INVOLVED
Residency Training Committee
This is a committee that 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.
There is a resident retreat in the fall. Fellows and staff cover the hospital services while we spend a day and a half having fun, socializing and discussing a different topic each year. You will soon be receiving some more information about this yearly event.
"Skit Night" takes place once per year (in December). It is held in the amphitheatre (D-182). Residents & fellows prepare skits, videos, songs, etc., to parody the subspecialty services, attending staff – anything goes. It is a fun evening, well attended by many hospital employees.
Composed of one resident from each year, this is a new 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 ask us – we are here to help!
Our office phone number is 22376.