Training in Paediatric Emergency Medicine at the Children’s Hospital, LHSC at Western University is designed to develop outstanding clinicians who will be successful in an academic career. The annual census of the Paediatric Emergency Department is approximately 37 000 patients, and they present with a wide range of medical and surgical emergencies.

Fellows are constantly reminded of the fellowship’s mission statement while in training:

“To train Paediatricians and emergency physicians to provide exceptional care for all children in Southwestern Ontario and to develop leaders in academic Paediatric Emergency Medicine.”

The majority of the first year of training is spent in the Paediatric Emergency Department.  Clinical exposure in the PED will include developing hands-on skills in fracture reduction, procedural sedation, complex laceration repairs and trauma assessments.   Rotations such as Orthopedic Surgery, Plastic Surgery, PCCU, and Anesthesia are also completed in the first year to complement the emergency department experience. Initiation of a scholarly project is essential, and first-year fellows are encouraged to present their research idea at the annual Pediatric Emergency Research Canada Fellows’ Conference. Monthly research meetings and mentorship allow for fellows to develop and successfully complete a project of interest during their fellowship.   In the first month of fellowship, fellows will complete an Emergency Department Targeted Ultrasound Course.  Fellows will become Point of Care Ultrasound Certified by completing a combined radiology and POCUS block, where they complete hands-on POCUS scanning shifts.  Equally as important, our fellows writing their core Paediatrics or Emergency Medicine Exam are fully supported in their exam preparation by offering them practice OSCE’s and flexible scheduling around the time of their exams.

Fellows in their second year will be provided increasing independence in the PED.  Fellows will be encouraged to develop skills in patient and departmental flow during their second year and will have the opportunity to function as a consultant during “shadow staff” shifts towards the end of their second year.  The majority of our Trauma Team Leaders are PEM physicians, so there is significant opportunity to act as TTL for our fellows.  During the second year, fellows will also complete rotations in EMS, General Emergency, trauma at LHSC or Sunnybrook Health Sciences Centre and in toxicology at the Ontario Poison Control Centre or New York Poison Centre. Elective opportunities exist in both years and past fellows have completed rotations in point of care ultrasound, medical education/simulation, radiology, child protection, and sports medicine to name a few. Depending on the needs of the fellow, opportunities to complete courses in clinical epidemiology and biostatistics exist either formally or online.

A rigorous weekly academic half-day curriculum exists. Monthly sessions include didactic teaching on medical and surgical emergencies, multidisciplinary simulation sessions, journal club and a critical appraisal teaching curriculum. Morbidity and mortality case reviews are held quarterly. Opportunities are present to attend teaching sessions and Academic Half Days in related programs including General Emergency Medicine and Pediatric Critical Care.

Opportunities to participate in undergraduate, postgraduate, and community teaching sessions exist.  Fellows are involved in weekly didactic and simulation teaching of residents rotating through the PED.  Fellows with an interest in simulation are offered the opportunity to further develop debriefing skills and are able to participate as instructors for simulation sessions for medical students, paediatric residents and community outreach.  We are also one of the few institutions that conduct both PALS and APLS courses in which fellows may serve as instructors.

Fellows are actively involved in the administrative components of the Paediatric Emergency Department. Fellows complete 16 shifts in the PED for core blocks and are allowed to self-schedule.  Senior fellows will share the responsibility of scheduling residents rotating through the PED and teaching schedules.  All of our fellows have been members of the Postgraduate Education Committee and are involved in the interview process for potential new fellows.

The Paediatric Emergency Department at Children’s Hospital offers fellows close mentoring in all facets of the program and faculty are highly supportive of the fellowship program.  We are a smaller division and as such fellows truly become members of our PED family.  Our program has a long history of training excellent PEM fellows who have gone on to become leaders in PEM nationally and internationally.