2022 - 2023 PGME Program Updates

PGME continues to provide central offerings in medical leadership to enhance learnings in individual programs. The 4th annual Postgraduate Leadership Certificate Program welcomed learners from PGY1 through fellowship, across many departments. Ever responsive to feedback from previous years, microlearning sessions were introduced to extend the scope of topics offered, and action learning projects were an opportunity for learners to enact leadership-in-action. Once again participants were grateful for opportunities to learn from experts, engage with their peers and enhance their leadership capabilities. Recordings of most sessions have provided us with a repository of superior teachings for repurposing across the PGME enterprise.

All leaders benefit from multi-source feedback (MSF). This truism is recognized in one of the Royal College's Institutional Standards requiring an effective MSF process to be in place for regular review of each program director’s (PD) performance. Anchored in a published set of competencies for PDs, a protocol has been established to meet these requirements, facilitated by a digital platform, standardized debriefing by trained faculty and support for PDs with identified areas for improvement.

The Office of Learner Affairs (OLA) provides individual, and systems support for residents and clinical fellows, promoting wellness and personal growth. It does this by offering personal counselling, access to career advising, a pathway to discuss/disclose/report learner mistreatment, and support for those with academic/professional/personal challenges.

OLA continues to build on their extensive experience, local outreach initiatives, and support of Postgraduate Learners with accommodation requests due to disability, religion, or family status – with access to a dedicated PG Accessibility Advisor. Furthermore, OLA has presented at national and international conferences to improve education on accommodations and support learners, faculty, and leaders on a larger scale.

Elentra continues to be the primary platform to support the implementation of Competency Based Medical Education (CBME) with 55 Royal College residency programs onboarded to Competency by Design as of the 2022-23 academic year as well as supporting fieldnotes for Family Medicine. In addition, planning is underway to onboard a further 5 Royal College programs, as well as Family Medicine enhanced skills programs in 2023-24. In 2022-23, EPA expiry was modified from 7 to 14 days, and a new Elentra Helpdesk Website was launched to support learners, faculty and administrators.

New interactive visual dashboards were created for all departments in 2022-23 based on faculty assessments completed on the Learner Assessment of Clinical Teacher (LACT) tool. The dashboards were created using quantitative and narrative data collected from both clinical clerks, as well as residents and fellows to increase the total number of assessments used to generate feedback for teachers. The dashboards also included performance indicators and filters to quickly identify teachers who may need support as well as those whose performance was identified as superior. In addition, on-demand LACT forms were also made available in Elentra for all learners to provide formative assessments for both faculty and other PG learners.

The Internal Review Committee (IRC) has worked diligently over the past year to collaborate with programs and assist in their preparations for accreditation follow-up. This process included conducting 10 internal reviews with the help of volunteer internal review team members, supporting learner focus groups for 4 programs, and reviewing the action plan outcome reports for 14 programs. Additionally, we welcomed two new AFC programs that applied for and received an accreditation status of “accredited new program.”  

In May 2023, PGME implemented a Mentorship Program for New Program Directors of Royal College of Physicians and Surgeons of Canada accredited programs that is led by Dr. Jennifer Croke. To date, we have created Mentorship Program resources, including a handbook, held a virtual information session for potential mentors (February 2023), created 10 mentee-mentor dyads (April 2023), and conducted a virtual orientation session for these mentorship dyads (May 2023). An evaluation of the pilot program is ongoing.

Global Health at PGME continues to provide innovative education across the continuum of medical education, developing new leaders, advancing new knowledge, and contributing to better health and equity, globally and locally, meeting our Temerty Medicine social accountability mandate. Our Global Health Education Initiative (GHEI) for postgraduate specialty trainees and our Global Health Education Program (GHEP) for MD Program students advance global health knowledge and collaboration to prepare new leadership for new challenges. Faculty for both GHEI and GHEP continue to include GHEI graduates and innovate new modules in a post-COVID space. The 2023 10th Annual PGME Global Health Day: Reflections on the Future of Global Health saw over 250 registrants, and was led by a resident and fellow planning committee. This event provided an opportunity for current and incoming residents and fellows to consider their critical contribution to ensuring equitable and quality local and global health care as practitioners and as humanitarians, as shared by the Keynote speaker, MSF Canada Executive Director. Importantly, the PGME Global Health Research Showcase, also led by current learners, highlighted burgeoning research across specialties and programs at PGME. PGME Global Health electives restarted in February 2022 with residents positioned in, for example, Northern Canada, Asia, Africa, and South America following guidelines and in collaboration with their program and specialty leads and PGME Global Health.

It is not uncommon for learners to sometimes struggle academically or personally during their training. When this occurs, finding timely support for both the Clinical Fellow and the Supervisor is beneficial. In 2022, PGME developed the Clinical Fellow in Difficulty Pathway which is a step-by-step process that provides tips for Supervisors and Clinical Fellows in difficulty. The Clinical Fellow in Difficulty Pathway outlines educational supports that may help learners accomplish goals and objectives. Clinical Fellows and Supervisors are encouraged to access resources as early as possible if a Clinical Fellow may benefit from discussing wellness, accommodations, leaves of absence, or issues with the learning environment. In 2022, PGME also updated the  Guidelines for Educational Responsibilities in Clinical Fellowships that outline new principles, procedures and processes related to letters of offer, assessment, clinical fellows in difficulty, appeals, termination and review, and concerning fellowship experiences.

Improving the onboarding experience for our learners has been a key priority for 2022-2023. PGME now has nine modules that have been accepted by the TAHSN network, eliminating repetition as learners move between the sites; this includes the introduction of two new e-modules: Donning and Doffing Personal Protective Equipment (PPE) and The Emergency Colour Code System. This change will save substantial time for our learners and help reinforce the cohesion of our hospital partners.  

The 2022 CaRMS PGY1 cycle had a total of 424 PGY1 positions; including a new stream in Obstetrics & Gynaecology offered in partnership with the Northern Ontario School of Medicine. In addition, we received 15 PGY1 expansion positions; 6 positions were allocated to Family Medicine and 9 positions to Royal College of Physicians and Surgeon programs. These positions will support the Dean’s and government’s commitment towards expansion at Trillium Health Partners and the Scarborough Health Network.