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Residency

The residency training program in Physical Medicine and Rehabilitation (PM&R) at Western University offers training in all subspecialty areas of PM&R.  The majority of the core training occurs at Parkwood Hospital, a free standing rehabilitation center. All off service rotations and a few core rotations are conducted at St. Joseph’s Hospital and London Health Sciences Center (UH and Vic Campuses). The program is 5 years long and divided into 13 four-week blocks.

The residents rotate through each core subspecialty discipline. These comprise: Amputee, Stroke, Spinal Cord Injury, Brain Injury, Musculoskeletal, Pediatric, Neuromuscular Rehabilitation. The residents will complete 3-6 blocks for most subspecialty disciplines.  Large clinical volumes ensure that there is optimum hands-on experience for the residents during their training. Pediatric Rehabilitation is conducted through Victoria Hospital and Thames Valley Children’s Center. Opportunities exist in Pediatrics to augment training by doing 1 of 3 blocks at another University with a fellowship trained Pediatric PMR Specialist.

Resident progress is monitored with twice yearly interviews by the Program Director.  In addition, discussion of the In-Training Evaluation Reports with the supervising physician is carried out in the middle and at the end of each rotation.

The first year is a general year of training that is mostly off service. One early rotation is typically done in Musculoskeletal Rehabilitation with a consultant and senior resident to facilitate integration of the resident and development of familiarity within Parkwood and our PMR group. The second year includes three months each of Orthopedic Surgery, Rheumatology and Neurology. Part of second year and all of third and fourth year involves core PM&R training. The early part of the final year involves working with a consultant to run the different services while supervising a junior resident and functioning as a consultant. The end portion of the final year is typically elective time, as long as the resident has demonstrated adequate skills and has passed all requirements of the training program to be deemed fit for the Royal College Specialty Certification Exam. A typical residency schedule is described below.

PGY-1

The first postgraduate year consists of the following rotations:

  • 6 Blocks – Internal Medicine (3 blocks team, 1 block each Endo, Consults, Cardiology)
  • 2 Blocks – Surgery (typically Neurosurgery, Urology)
  • 1 Block - PMR, ER, Geriatrics, Neuroradiology Trauma and/or Psychiatry

PGY-2

The second postgraduate year consists of the following rotations:

  • 3 Blocks - Orthopaedic Surgery (1 block each of HULC, Arthroplasty, Spine)
  • 3 Blocks - Rheumatology
  • 3 Blocks – Neurology (2 blocks Team, 1 block urgent Neuro Clinic)
  • 4 Blocks –  Physical Medicine & Rehabilitation

PGY-3 and 4

These are core Physical Medicine & Rehabilitation training years. The resident will rotate between the various  Physical Medicine & Rehabilitation services, typically spending 3-4 blocks on each. Early on, the resident functions as a junior resident and by the end of each rotation is expected to run the team, teach medical students and the junior and off service residents. During PGY3, residents are typically also responsible for organizing teaching on Friday mornings for visiting students and residents.  During PGY4, if a resident has progressed appropriately, there will be opportunity for them to function as a Chief Resident.

During the final year of training, consoldation of information, autonomy to function as a consultant, supervise and teach junior residents and students, run a team and work on each CANMEDS role is emphasized.

Teaching

The Physical Medicine & Rehabilitation program at the Schulich School of Medicine & Dentistry, Western University has evolved as a structured program in which every member of the department is expected to participate in teaching. All trainees should view this as a major responsibility and share this commitment to teaching.

This teaching obligation is especially true with regard to the medical students. Many students spend time in either elective or selective rotations in Physical Medicine & Rehabilitation. Some of these students are seriously considering Physical Medicine & Rehabilitation as their future. Therefore, encouragement and participation is required.

Compulsory attendance is demanded for all trainees (residents and students) at all formal didactic teaching sessions. This includes  Physical Medicine & Rehabilitation Grand Rounds monthly on Mondays and the PM&R Academic Half Day from 08:00 or 09:00 to 12:00 every Monday morning.  During weeks of a Holiday Monday, half day will typically occur Friday afternoons 1-4pm. The notices for these sessions are updated weekly and in the Western University PMR Calendar.  All trainees are to be released from service commitments by their staff for these teaching times and attendance is mandatory.

Training Sites

Parkwood Institute

This is the site of most of the core training in Physical Medicine & Rehabilitation. It is here where training in rehabilitation occurs for Amputee, Spinal Cord, Brain Injury, Stroke, Musculoskeletal.

St. Joseph's Health Care London

This is the site of Electrodiagnostic teaching and the Pain clinic.

Fowler Kennedy Sport Medicine Clinic - 3M Centre Western University

This is the site of the Sport Medicine teaching.

London Health Science Centre

Children's Hospital of Western Ontario (CHWO)

Research

Research is divided in 3 one month blocks beginning in PGY2 or PGY3.  This may be basic or clinical and is at the discretion of the trainee with the advice and guidance of their mentor and the research director.  A review of available research opportunities is given at the beginning of each academic year.  Residents may select from these options or pursue study of their own design.  Each resident (PGY2-5) is expected to carry out one clinical or basic science project during their residency and to present this research (and progression) at the Annual Residents' Research Day conference held in the fall of each year.  Residents should discuss in each academic year, their proposed subject of research with Dr. Robert Teasell, Director of Research, or Dr. Tim Doherty (Chair/Chief), who will help to guide the choice, design and consultant supervisor for the project.  The expectations of this project are that a resident will have developed a project, applied for approval through the IRB and ethics and then completed a project, which ideally will be manuscript ready before the completion of residency. Many residents to date have availed of opportunities and had numerous publications during residency. The Postgraduate Medical Education Office has a "Resident Travel Reimbursement Fund" to support trainee travel to present their research at meetings.  The deadline for submissions is on the Western University website and is typically April 30 and October 31. For more information please see the Visiting Student Electives page on the Postgraduate Medical Education website.

Service

Residents and students will be assigned to a specific PM&R team and rotation that has well-designed educational objectives. Ultimate authority for the activities of each resident rests with the responsible consultant on each rotation. It is expected that the senior resident in each hospital or on each team, will assume considerable responsibility acting, in fact, as a junior attending staff member. Junior residents will be delegated responsibilities commensurate with their level of training. In order for the team approach to be successful, however, no member should assume responsibility for any activity which they are not familiar. We feel that the strength of our program owes much to this philosophy.

On-call rosters are prepared monthly by the Chief Resident. On-call responsibilities will meet PAIRO guidelines. While we acknowledge that being "on-call" is service-oriented, nevertheless, it provides some teaching and learning opportunities. A consultant will always be available for on call coverage with a resident.

Journal Club

Journal Club is held on a monthly basis.  Each journal club will have a resident and staff consultant assigned to organize the session. 1-2 papers from the current literature are selected and each discussed by the resident and consultant.

In-Training Evaluations

Our program has been constructed so that adequate exposure will be provided in all major areas of PM&R, sufficient to prepare the final year resident for the Royal College Fellowship Examination. Assessment of each individual resident's performance is done during and at the end of each three-month rotation. As well, each resident is interviewed by the Program Director twice yearly to discuss their progress. It is expected that each resident PGY2-5 will perform an OSCE 2-3 times per year. One of these is for Western University residents only. The others are done in conjunction with University of Toronto and MacMaster. Written and oral exams are conducted at the end of some core rotations.

In addition to resident evaluations, consultant evaluations are performed after each rotation by the resident and a composite evaluation is done for each consultant at the end of a 2 year cycle by all residents (on and off service).

  • Core Rotations (Directors in parenthesis)
  • Spinal Cord (Dr. Potter/Dr. Loh/Dr. Sequeira)
  • Stroke (Dr. Teasell/Dr. Macaluso/Dr. Bhardwaj)
  • Inpatient MSK (Dr. Miller)
  • Outpatient MSK (Dr. Loh/Dr. Miller/Dr. Macaluso)
  • Amputee (Dr. Payne)
  • Pediatrics (Dr. Campbell)
  • Orthotics (Dr. Payne)
  • Brain Injury (Dr. Loh/Dr. Sequeira)
  • Neuromuscular (Dr. Miller/Dr. Doherty)

Holidays

Residents are allowed one week of holiday time during each three-month rotation (additional holidays can be arranged based on application and circumstances). Statutory holidays will be distributed equitably. A five-day holiday period will be arranged over the Christmas period. All holidays must be arranged through the Chief Resident, Program Director and Administrative Officer and the individual consultant on a given service.

Appeal Mechanism

Postgraduate medical trainees whose performance has been judged unsatisfactory by their teachers have the right to appeal. The grounds of an appeal may include medical, compassionate or extenuating circumstances, bias, inaccuracy or unfairness.

The full Appeal Mechanism Policy is available through the Western University Postgraduate Medical Education Office.

Resident Handbook

The Schulich Resident/Fellow Handbook please see the Postgraduate Medical Education website.

RCPSC Subspecialty Examinations

All PGY-5 residents will be expected to submit an Application for Evaluation of their training to qualify for the RCPSC certification examination by the deadline date provided, by mail or by fax.  Penalty fees will apply to requests received after the deadline.

For more information on submitting the application form, please visit the Royal College web page on Evaluation of an Additional Specialty or contact the Credentials Unit by email at credentials@royalcollege.ca or by phone at 613.730.8191.

In-Training Evaluations

At the completion of each three-month rotation, an In-Training Evaluation Report will be completed on each resident by the attending staff member. The resident will be asked to review this report with the attending staff member and it will then be forwarded to the Program Director to be utilized for an annual evaluation and subsequently to prepare the Final In-Training Evaluation Report for the Royal College.
Conventions & Meetings

Discretionary Funds (PGY 1 - 5) up to $5,000.00

Attendance at any meeting that will entail absence from clinical assignments must be arranged well in advance with the supervising consultant.

Any residents who have submitted an abstract to the CAPM&R or other  Physical Medicine & Rehabilitation conference may be eligible to attend the meeting with appropriate approval, provided it falls within allocated away time. Additional funding may be available depending on the level and quality of the conference.

The maximum total time away from work to attend conferences must not exceed seven working days per year, including travel to and from meetings. Any additional time will be taken from vacation time. All away time will be coordinated by the Chief Resident, Program Director and supervising consultant.

Faculty

  • Dr. Tim Doherty - Chair/Chief  Physical Medicine & Rehabilitation
  • Dr. Steven Macaluso - Residency Program Director
  • Dr. Michael Payne - Undergraduate Musculoskeletal Course Director
  • Dr. Robert Teasell - Research Director
  • Dr. Tom Miller - Electrodiagnostic Director
  • Dr. Eldon Loh - Consultant
  • Dr. Keith Sequeira - Consultant
  • Dr. Patrick Potter - Consultant
  • Dr. Asha Bhardwaj - Consultant
  • Dr. Barry Death - Consultant