Pediatric Critical Care

Subspecialty Residency Program

The Pediatric Critical Care Subspecialty Residency Program was developed in 1987 and became an accredited training program of the Royal College of Physicians and Surgeons of Canada in 1990. Our goal is to prepare our graduates to assume leadership roles in pediatric critical care in academic institutions worldwide. Trainees include highly qualified Canadian and foreign candidates who have already completed at least three years of accredited base specialty training (e.g. Pediatrics, Anesthesia). Upon completion of this two-year program, candidates will be eligible for certification in Pediatric Critical Care by the Royal College and with an additional one year of training for the American Board of Pediatrics.

Our multidisciplinary PICU allows for the acquisition of advanced skills such as (but not limited to) neurocritical monitoring and care, all modes of invasive and non-invasive respiratory support, cardiovascular support (including ECLS and assist-devices) and renal support (CRRT). Trainees are trained to care for patients requiring critical care services through our many specialized programs: congenital cardiac surgery, trauma (level 1 centre), craniofacial reconstruction, airway reconstruction, complex scoliosis repair, seizure surgery, and solid organ transplant (kidney and heart). Trainees gain first hand experience to organ support through ECLS (ECMO and VAD) and CRRT.

Additional clinical training includes electives in anesthesiology, cardiology, neurointensive care, echocardiography, and in other subspecialties relevant to critical care. Residents receive training in bedside ultrasound applied to critical care. Furthermore, our training program includes a formal pediatric critical care teaching program (protected half day a week) with teaching provided by pediatric critical care staff and experts in other specialties. The curriculum includes training in ethics, arrythmia interpretation, epidemiology, physiology, journal clubs and clinical question reviews. There is a significant role of medical simulation training in our program including weekly interdisciplinary, in situ simulations, airway and ventilator simulation, trauma and code orange (mass casualty). Residents are mentored to prepare and deliver educational sessions and design curriculum as well.

Residents are mentored by the multidisciplinary faculty of the Division of Pediatric Critical Care. Our faculty have appointments in Pediatrics, Pediatric General Surgery, Pediatric Anesthesia, Epidemiology, Nursing, and Bioethics. Our trainees are implicated in all aspects of PICU functioning to train them in leadership, consultant and teacher roles. All trainees will be expected to share on-call duties in the PICU during clinical blocks. Trainees will also be expected to pursue a scholarly project under the mentorship of one of the research faculty members; this project may be in the areas of clinical research, health professions education, quality improvement, knowledge translation, etc. Finally, all trainees participate in clinical conferences, multidisciplinary rounds, quality improvement activities and weekly meetings of other subspecialty services, e.g., cardiology, cardiovascular surgery, and radiology.

Program length: 2 years
Average number of trainees per year: 3

Training Requirements

Clinical: 

Entrustable Professional Activity Guide - Pediatric Critical Care

Research:

  • Principles of epidemiology and biostatistics
  • Principles of medical education and quality improvement research
  • Formulating a research question
  • Conducting a literature review
  • Developing a study protocol
  • Developing and submitting an application for ethical approval
  • Taking part in grant applications
  • Developing a database and the statistical analysis approach (under guidance)
  • Performing (under guidance) statistical analysis
  • Presenting study results at a scientific conference (local, provincial, national, and or international
  • Writing and submitting a manuscript for a peer-reviewed journal

Types of electives:

  • Anesthesia
  • Cardiology for the Intensivist
  • Radiology
  • Neuro Intensive Care
  • Pediatric Critical Care Unit at other sites

Training Sites:

  • Montreal Children's Hospital
  • Montreal Neurological Institute
  • Hospital Ste. Justine

Committees:

All trainees in the program participate in administrative activities to gain an exposure to this important role of the intensive care physician. This might include committees much as the CPR committee, quality/safety committee, infection control, ICU Liberation committee and improvement project teams.

Awards:

Trainees receive an academic stipend each year to support participation in conferences, courses or for the purchase of educational materials.

Innovations

Educational

  • We launched the Royal College’s Competency Based Medical Education program in July 2019.
  • Simulation based medical education with weekly in-situ, interdisciplinary simulation training, airway and ventilation simulations, hospital level simulation of airway emergencies, trauma and mass casuality and donation and ECMO simulations in development.
  • Each trainee is assigned an academic advisor for the length of their training.
  • Clinical training in critical care point of care ultrasound.
  • Rotational electives in neurocritical care (Montreal Neurologic Hospital).

Research

  • PICU Research program director is a PhD clinician scientist and a full-time member of the Division (Dr. Fontela).
  • PICU Research Program staffed with a research coordinator and research assistants.
  • Faculty with varied research focuses including clinical research, quality of care and health care processes, medical education, medical simulation, resuscitation, healthcare policy, organ donation.
  • Interdisciplinary research model with weekly PICU Research Meetings and Pediatric Critical Care Journal Club.
  • Trainee Research Program overseen by the PICU Research program director including participation in the Canadian Child Health Clinician Scientist Program, journal club curriculum, monthly presentation of trainee projects’ progress.

Clinical

  • Complex surgical programs including airway, epilepsy, neurosurgery, craniofacial reconstruction and spine.
  • Complex congenital cardiac surgery program including single ventricle repairs.
  • Extracorporeal membrane oxygenation (ECMO) and Ventricular Assist Device (VAD) program.
  • Quality and Safety Program with annual strategic plan and monitoring through a visual management system (Salle de Pilotage).

Educational Opportunities

Electives and Observerships

The Pediatric Critical Care Program offers electives for a period of 3-8 weeks for medical students and residents, and observerships for a minimum of 4 weeks. Please contact tanya.digenova [at] mcgill.ca (Dr. Tanya Di Genova) for more information.

Contact Us

Division Director

Dr. Saleem Razack

Postgraduate Medical Education

Residency Program Director
Dr. Tanya Di Genova

Clinical Advanced Pediatric Intensive Care Fellowship Program Director
Dr. Ronald Gottesman

Research Advanced Pediatric Intensive Care Fellowship Program Director
Dr. Patricia Fontela

Administrative Staff

Residency Program Coordinator
programadmin.picu [at] mcgill.ca (Andria Caputo)
514-412-4400 ext. 22489

MUHC Administrative Assistant
chantal.podilchuk [at] muhc.mcgill.ca (Chantal Podilchuk)
514-412-4400 ext. 22696

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