CaRMS

Program Overview

The goal of the Royal College Emergency Medicine Residency Program at the University of Calgary is to educate physicians who wish to pursue an academic career in Emergency Medicine, including involvement in research and education. Graduates of the program will be thoroughly trained in all aspects of Emergency Medicine, including toxicology, trauma, prehospital care, care for vulnerable populations, paediatric emergency medicine and advanced communications skills. They will be able to demonstrate consultant level abilities in the recognition, understanding, and management of patients with any illness or injury presenting to the Emergency Department, and will be well-prepared for clinical, academic, and leadership roles within the specialty.

Curriculum

The Emergency Medicine Residency Program is five years in duration, including the PGY-1 year, and is an integrated university-based program that involves the Foothills Hospital as a primary site, with 4 other city hospital sites including the Children’s Hospital. Residents are evaluated on an ongoing basis by means of direct observation, as well as quarterly written and oral exams. The program director reviews resident progress on a quarterly basis. As a small program, residents work with a core group of experienced and enthusiastic attendings, and each year are paired with a longitudinal preceptor who develops their skills.

PGY-1 (Transition to Discipline and Foundations)

During the first year of training, Calgary residents complete their CBD Transition to Discipline and Foundations phases in an Emergency Medicine focused year. The year begins with an Adult EM rotation in July to meet the staff, feel at home, and complete an ultrasound training course. The objectives of the first year of the program are to build a solid foundation of knowledge and skills in Emergency Medicine. There are 7 adult EM blocks, 2 Pediatric EM blocks and 4 off service rotations (General Surgery, Anesthesia, Trauma Surgery and Internal Medicine). The PGY-1 year also has an additional introductory SIM curriculum that runs in addition to the bi-monthy Junior SIM. This EM focused year allows our junior residents to feel comfortable managing patients in the ED and have solid relationships with staff and allied health. Our residents gain an appreciation of the breadth of EM in order to tailor their focus while off service.

PGY 2-4 (Core)

The 2 years of “core” are the work-horse years of the program that involve broad-based training in a variety of disciplines, consistent with the broad-based knowledge base required in the specialty of Emergency Medicine. Core training includes Critical Care (Cardiac, Intensive, and Pediatric Intensive Care), Orthopedic Surgery, Plastic Surgery, Neurology/Stroke, Rural EM and EMS. One month of elective time is available in both the PGY-2 and PGY-3 years. The Royal College exam is now written in the PGY-4 year, leaving dedicated time to pursue an Area of Interest afterwards.

PGY- 5 (Transition to Practice)

The final year of training is to develop consultant level skills and graded responsibility toward independent practice as well as pursuing our areas of interest. All PGY-5’s rotate through toxicology and Air Transport Medicine with the Alberta Shock Trauma Air Rescue Society (STARS). However, the remainder of the year allows considerable flexibility and extensive elective time to allow residents the opportunity to pursue areas of special interest within the discipline, which may include a concentrated period of training in a selected domain of Emergency Medicine. Calgary residents have pursued diverse areas of interest locally and abroad such as toxicology, medical education, stroke medicine, simulation, EMS, ultrasound, disaster medicine and sports medicine. In addition to assuming increasing responsibility for the management of patients in the ED, the chief residents have organizational, academic, and administrative responsibilities, which include the scheduling and teaching of more junior house staff and medical students. Our seniors enjoy true multidisciplinary senior SIM, performed in a trauma bay at the Foothills Hospital.

Sample Rotation Schedule

Sample Rotation Schedule

Research

Formal training in critical appraisal, biostatistics, and evidence-based medicine is provided for all residents.  A research project will be developed with the assistance of a faculty preceptor in an area of mutual interest. The interdepartmental research block, early in R2 year, features expert lectures on research methodology and small group interaction for project development lead by emergency faculty.  Residents are given one to one statistical support as well. Time and resources are supplied throughout the remainder of the residency.

Residents are encouraged to present their research each year at the Emergency Medicine Research Day (a high-profile event in our program), as well as at national and international meetings. Conference leave is allowed in each year, and a book/conference travel fund is available annually to residents. Some funding for projects is made available through the Emergency Medicine Research Endowment Fund.

Seminars

The formal academic program is intensive and well organized. Each Thursday, residents attend an Academic Full Day, with Grand Rounds in the morning, followed by SIM / ECG / EBM teaching. In the afternoon, interactive and case-based teaching covers the entire curriculum of EM. Journal Club is held monthly, and includes a review with the staff of the latest literature, held at a staff member’s residence. There is an annual resident educational retreat in the Rocky Mountains, where wellness activities and program-level discussions are held. Practice oral / written exams occur quarterly starting in R1. Use of the Sim lab occurs 2-4x monthly, and seniors attend multidisciplinary senior sim cases, held in the resus bay with nurses and RT’s.

Extra-curricular activities

The residency program, although rigorous, is humane, and numerous group excursions and bonding activities take place. We have two yearly retreats which we hold in the Rocky Mountains. Our Program Directors are very invested in resident wellness, and hold ‘fireside’ chats multiple times a year. Journal Club is held monthly, usually at the home of one of the Emergency Department staff physicians. There are also the annual welcoming and end-of-year parties, golf and ski days, the Department Christmas party, a Research Day dinner, and who can forget the mountains which play host to all types of wellness activities!

Selection Criteria

All selection to the residency program is through the Canadian Resident Matching Service (CaRMS). The following criteria will be considered in the selection process:

  • Academic performance
  • Interest in emergency medicine (e.g. elective rotations or research project).
  • Excellent communication and interpersonal skills.
  • Letters of Reference. Note: At least one letter of reference from a specialist emergency physician working in an academic centre is strongly encouraged. More than one reference from such a physician strengthens the application.
  • The candidate must have demonstrated proficiency in those areas important for the specialty of Emergency Medicine (e.g. clinical judgment and decision-making ability).

The candidate must be considered likely to make a significant contribution to the specialty of Emergency Medicine (commitment, leadership). 

Interviews

Our program relies on a single structured interview day, with both staff and residents acting as interviewers. Interviews are held in late January or early February of each year. Applications are reviewed by members of the Selection Committee, and we will contact applicants selected for interviews.

Approximately 30-40 applicants will be invited to interview on the basis of their academic record, curriculum vitae, personal letter and letters of reference. Each applicant will have three to four interviews of 10-15 minutes each, and each applicant will have an opportunity to meet the Program Director and Assistant Program Director. Candidates are given the opportunity to meet our current residents, to tour the various Emergency Departments used as teaching sites in the residency program, and are given a tour of the city of Calgary. An informal lunch is offered at which our current residents and teaching faculty make themselves available to answer any questions.

Personal Letter

A personal letter is required by mid-November. Candidates should explain their motivation for pursuing Royal College specialty training in Emergency Medicine, their career goals, and their reasons for choosing Calgary as a training site. They should outline their interests and accomplishments, discuss their own strengths and weaknesses, consider the pros and cons of a career in Emergency Medicine, and describe what personal qualities make them suitable for a career in Emergency Medicine.

Reference Letters

A minimum of three letters of reference from staff physicians is required. Letters from senior residents will not be accepted. Letters of reference from practicing Royal College-trained Emergency Physicians are strongly encouraged. The program requires that all references be sent to them directly.

Program Strengths

The Royal College Emergency Medicine Residency Program at the University of Calgary has a collegial philosophy and noncompetitive atmosphere. A close, mutually supportive relationship exists amongst the residents, and a close working relationship exists between the faculty and residents. As one of the smallest programs in Canada, we are very much a family here, and a support network.

There is a large faculty of Royal College certified, residency-trained Emergency Physicians who are dedicated and committed to teaching, and many have made substantial contributions in academic Emergency Medicine. The Departments of Emergency Medicine are well respected in each of the teaching hospitals. FRCPC residents work with a group of highly motivated and strong clinicians, all of whom are deeply invested in residency education. Each resident is paired with a ‘longitudinal preceptor’ with whom they work a majority of their clinical shifts in order to develop their skills.

The educational resources, including an extensive and varied patient population, are excellent. The resident’s office is well-equipped with a computer, and current issues of journals such as Pediatric Emergency Medicine Reports, Emergency Medical Abstracts, and Journal Watch for Emergency Medicine. Current issues of the standard texts in Emergency Medicine (Rosen, Tintinalli, and Roberts & Hedges) are also available.

Particular expertise exists in Ultrasound, Air Transport, Toxicology, and Prehospital Care, as the Medical Directors of STARS Air Ambulance, the Poison Centre, and EMS are all Royal College-trained Emergency Medicine faculty.

Calgary’s proximity to the resort towns of Canmore, Banff, and Lake Louise make it an attractive place to live and work. Please see our “Why Calgary” page for more! The city offers a wide range of cultural and recreational facilities that are unique in Canada. There is a lively theatre and art scene with multiple local theatrical and dance companies, numerous art galleries, the Calgary Philharmonic Orchestra and Opera Company, frequent performances by internationally acclaimed artists, and the world famous annual Calgary Stampede (aka: the Greatest Show on Earth). Calgary is a vibrant city that blends nature and exploration with the liveliness of a large metropolitan centre.

Finally, the program has benefited enormously from the tremendous contributions and hard work of so many outstanding former and current residents.

Program Overview

The CCFP-EM program at Calgary has a long history of offering a comprehensive curriculum in emergency medicine by an enthusiastic group of core faculty. The total number of residents in emergency medicine in Calgary is usually around 28; 8 CCFP-EM and 4 FRCP per year. Military / Canadian Forces candidates are considered on a year-by-year basis according to resources. The CCFP-EM residents benefit from a close association with the FRCP residents and the learning atmosphere is cooperative, challenging, and dynamic. Most academic rounds are jointly held; however, the two groups will separate for program-specific rounds periodically. The curriculum is designed to maximize cooperation between the programs while ensuring the CCFP-EM residents still get exposed to all the core topics in their year. The CCFP-EM academic curriculum includes a curated reading schedule around the Tintinalli's Emergency Medicine textbook, monthly SIM sessions, basic and advanced POCUS training leading to "Independent Practitioner" certification, monthly journal clubs, and written/oral practice exam practice delivered by experienced CCFP-EM staff. The Calgary Department of EM's large reservoir of nation-leading researchers and healthcare administrators also provide ample mentorship opportunities for residents to engage in the extra-clinical pursuit of their choice. The goal of the program is to offer excellent residents in family medicine a chance to be immersed in a comprehensive environment of emergency medicine training. The year is designed to allow the motivated physician to develop the skills necessary for a career in emergency medicine in any setting within Canada, from rural EDs to tertiary-care, academic urban sites. Most of our graduates will pursue a fulltime career in emergency medicine. Particular emphasis is given to development of habits suitable for lifelong learning, personal wellness, and extra-clinical contributions to the field of emergency medicine. The CCFP-EM residents complete rotations at all four academic teaching hospitals in Calgary, with a focus at the Foothills Medical Center (trauma, cardiac). The other three sites are: Peter Loughheed Centre (vascular), Rockyview General Hospital (urology, ophthalmology), and South Health Campus. Pediatric rotations take place at the Alberta Children's Hospital.

Other Advantages

  1. The Calgary Zone Emergency Department has over 200 full-time emergency physicians and roughly half hold the CCFP(EM) designation. The Calgary Zone ED is the largest regionalized department of emergency medicine in Canada, with nearly 300,000 visits a year to the region’s four adult hospitals and one pediatric facility.
  2. The toxicology referral service (PADIS) for all of Alberta, Saskatchewan and parts of Northern Canada, is located at Foothills Medical Centre. We have three board certified toxicologists who are formally involved in clinical and didactic teaching of toxicology.
  3. Calgary EMS and the Shock Trauma Air Rescue Society (STARS) are both led by staff emergency physicians in the Calgary Health Region who are actively involved in teaching residents. Opportunities exist for experience in administration of prehospital care services.
  4. The intensive care rotation takes place in a high acuity, high volume ICU with strong emphasis on learning through dedicated academic rounds as well as clinical experience. Residents can typically get as much procedural experience as they want during this rotation.
  5. The pediatric emergency rotations are supervised by a dedicated residency director in a brand new start-of-the-art tertiary care pediatric hospital.
  6. Several faculty have a strong interest in simulation based education, and residents are provided with multiple opportunities to improve their procedural and clinical skills in a simulation environment. Resources include both adult and pediatric human patient simulators and formal sessions on airway and central venous access simulation.
  7. Emergency Department Targeted Ultrasound is widely practiced within the Calgary Zone with many CCFP(EM) faculty certified in its use. With the development of a formal ultrasound elective, ample opportunity exists for residents to become certified during the course of their training.

Resources

Foothills Hospital is a comprehensive tertiary care hospital and Level I trauma and cardiac centre. It is adjacent to the University of Calgary Medical School and the Tom Baker Cancer Centre, and serves as a referral centre for Southern Alberta and Southeastern British Columbia. The emergency department sees approximately 80,000 patients per year with very high acuity of sub-specialty, medical, surgical and trauma patients.
 
Peter Lougheed Centre is a busy teaching hospital in Northeast Calgary. The emergency department census is in excess of 80,000 patients per year with a wide variety of pediatric and adult emergencies. The vascular and podiatric surgery departments are located here.
 
Rockyview Hospital is a large community hospital located in Southwest Calgary. The emergency department census is in excess of 80,000 patients per year with a wide variety of adult emergencies. It is the regional referral center for urologic and ophthalmologic emergencies.
 
South Health Campus is the newest hospital in Calgary, located in the growing southern suburbs of Calgary. The site sees a large volume comparable to the other 3 adult sites.
 
Alberta Children’s Hospital is a tertiary children’s hospital referral centre for Southern Alberta and Southeastern British Columbia. The emergency department sees many complicated pediatric problems as well as a large volume of common pediatric emergencies. 
 
Poison and Drug Information Service (PADIS) is the regional Poison Centre for all of Alberta and the Northwest Territories, and is located in the Foothills Medical Centre.
 
Shock Trauma Air Rescue Society (STARS) provides both rotary and fixed-wing dedicated air transport capability, and interfacility transfer of critically ill or injured patients. The flight crew includes paramedics, emergency/critical care nurses and Emergency Physicians and serves a prominent role in our trauma services.
 
Urgent Care Centres (UCCs): The Calgary Zone is uniquely supported by 5 regionally situated UCCs. The UCCs service approximately 180,000 patient visits per year, typically of a lower acuity. The impact of this on the Calgary EDs cannot be overstated: a significant majority of low acuity presentations do not present to hospital EDs, making the hospital ED learning experience highly focused on complex and high-acuity patients. Note: unless specifically requested, emergency medicine residents do not rotate through the urgent cares.

Curriculum

The University of Calgary CCFP-EM program adheres to the standards and meets the objectives of the CFPC. The program is based at the Foothills Medical Centre; however, residents receive their training at four hospitals in Calgary, and also at regional hospitals in Banff.

The year is comprised of 13 four-week blocks:
(subject to change, annually)

  • Emergency Medicine – 8 blocks (5 adult, 1 pediatric, 1 Banff and 1 additional rural selective)
  • ICU – 1 block
  • CCU – 1 block
  • Anesthesia – 1 block (2 weeks adult, 2 weeks pediatric)
  • Toxicology – 0.5 block
  • Ophthalomolgy – 1 week
  • Elective – 1 block

The EM blocks include Pediatric Emergency Medicine at the Alberta Children’s Hospital, and four weeks at the Banff Mineral Springs Hospital, where orthopedics in the E.D. is stressed. The Lethbridge Regional Hospital offers excellent teaching in a regional centre, and is an optional rotation for those residents who see themselves practicing in such a setting. The preponderance of the adult ED shifts are scheduled at the trauma/cardiac centre, Foothills Medical Centre.

An academic/research project is an integral part of the program. This project may be a small clinical trial, contribution to ongoing research, a quality improvement study, a case report with literature review, or a survey. All projects are presented in the Spring at Research Day, which is shared with the Calgary FRCPC program.

Residents are required to have ACLS and ATLS certification.

Sample schedules below: