General Emergency Medicine

Fellowship Information

Overview

The postgraduate fellowship in General Emergency Medicine Physicians is a one year supervised training program open to qualified post-graduate trainees who have completed at least 3 years of post-graduate autonomous work experience in emergency medicine who wish to pursue an extra year of focused GEM training.

McGill's GEM Fellowship is a one-year fellowship program that allows the applicant to:

• develop expertise in managing acutely ill patients with exposure in all spectrum of illness and pathophysiology including resuscitation
• develop expertise in ED patient flow management
• develop skills in interpreting basic plain radiography, CT imaging and acquiring and interpreting basic and advanced sonographic images.

Fellows will acquire an understanding of general emergency medicine with emphasis on:

• trauma/orthopedics
• pediatric emergency medicine
• toxicology
• point of care ultrasound
• oncological emergencies and complications

The one-year Fellowship is based on 13 x four-week periods:

• 6 rotations in an adult tertiary/quaternary ED (RVH) - 14-16 x 8 hour shifts
• 1 rotation in a community ED (SMH/LGH) - 14-16 x 8 hour shifts
• 2 rotations in pediatric emergency medicine (EM) – including regular pediatric trauma simulation initiatives (MCH) - 14-16 x 8 hour shifts
• 2 rotations in trauma (as trauma team leader)/orthopedics (MGH) - 8 x 24 hour Trauma Team Leader (TTL) staff-linked shifts
• 2 rotations POCUS (JGH) - 14-16 x 8 hour shifts

At the end of their training, the Fellow will have acquired the knowledge and skill set to function as an emergency medicine physician.

At the completion of the Fellowship, the fellow will be able to:

• lead and provide competent care for the critically ill/injured patient
• prioritize and the management of the severely injured in mass casualty incidents
• develop ED patient flow skills collaborate effectively and expediently with other consultants for appropriate patient care and expedient disposition

Emphasis will be placed on the initial resuscitation and stabilization of the severely injured or ill patient and the subsequent collaborative emergency management with the consulting teams.

The Fellow will also be required to have knowledge of post-ED care. The Fellow must be cognizant of what happens post-surgical or radiological intervention, in the ICU, step-down unit and in the follow-up clinics.

Most of the training will occur as a member of the Emergency Department of the Montreal General Hospital. The fellow will be under the direct supervision of the core TTL group and selected Emergency Physicians. The fellow will be exposed to trauma as part of the Trauma Service, the TTL team, and as well during Emergency Medicine shifts. The Fellow will be expected to follow his patient longitudinally through admission, ICU, step-down unit, ward to discharge. To complement and enhance the training and exposure, the fellow will be encouraged - with the help of staff involved in global health - to explore other emergency medicine systems (either nationally or internationally).

The Fellow will be expected to carry out scholarly activities by participating in emergency medicine/trauma/pediatric EM rounds, journal club, and grand rounds presentation at emergency medicine academic rounds and if the Fellow wishes/requests, in the form of a minor research project under the supervision of the Fellowship Director. The Fellow will be expected to be up to date on current literature, be able to critically appraise the literature and have an understanding of evidence-based medicine as it applies to the EM literature.

Finally, the fellow will be expected to learn the functioning and components of both the hospital and provincial Trauma Registries.

Regular feedback will be provided for by Fellowship Program Director. Formal feedback will be provided every three periods as per PGME rules and regulations.

Additional academic/scholarly activities

• Core interactive text review (3 times/year)
• Weekly trauma rounds
• Journal club
• Presentations at:
  • Emergency academic rounds x1
  • Emergency journal club x1
  • Trauma Service Academic Rounds (during trauma rotations)