每日探花

Overview

About the Program:
Palliative Care 每日探花 is an interdisciplinary network of clinicians, educators, researchers, allied health professionals, volunteers, and support staff who work together across six teaching hospitals and two residences to provide top-quality palliative care, education, and research.

We pride ourselves on being a centre for academic excellence through the following four axes:

• Interdisciplinary research
• Interdisciplinary education
• Support to social policy development and community outreach
• International collaboration

We are the organizers of the 每日探花 International Palliative Care Congress, bringing together ~1,800 attendees from around the world.

The overall goals of the program are:

1. To train with added competency in the area of palliative medicine family physicians who will provide primary and consultant palliative care services.
2. To provide clinical and basic academic training for family physicians who will be going on to academic careers in palliative medicine.

Program Goals:

• Possess medical knowledge/clinical skills/professional attitudes needed to provide exemplary care of patients 鈥渨ho are living with or dying from advanced illness or are bereaved.鈥�
• Understand and appreciate the effect of chronic disease and life-threatening illness on the individual and family.
• Promote supportive, respectful, caring relationships within families.
• Facilitate the patient-physician relationship.
• Be part of a community of health care providers. Establish effective relationships with other physicians and health care professionals and collaborate with the patient/family and interprofessional team for provision of optimal patient care, education & research.
• Practice as clinicians/leaders/educators/researchers in a variety of health care settings.
• Interact as a member of formal and informal interprofessional teams.
• Promote accepted standards of palliative and end-of-life care by providing leadership locally/regionally/nationally and by advocating for the effective utilization of resources throughout the health care system.
• Recognize the importance of advocacy in response to the challenges of societal and environmental factors regarding the care of the dying. Responsibly use expertise and influence to advance the quality of life for individual patients and broader community by promoting the principles of palliative care for populations with life threatening illness and/or end-of-life needs & the broader community.
• Engage in life-long reflective learning to maintain clinical mastery.
• Contribute to the creation, dissemination, application and translation of medical knowledge and practices, and facilitate the education of patients, students, and other health care professionals.

Also see:

Program Highlights

• Duration: 1 year
• Curriculum: The Enhanced Skills in Family Medicine 鈥� Palliative Medicine is a coordinated one-year (13 rotation/year) training program that provides the trainee with a broad clinical experience in a variety of institutional and community settings. Nine rotations are on palliative medicine services. Rotating through these settings, the trainee develops clinical skills in dealing with pain and symptom management situations, as well as the psychological, emotional, and spiritual needs of terminally ill patients and their families. The trainee sees patients who have access to the full spectrum of cancer care, from diagnosis, to cure, to terminal care. Non-cancer patients with challenging symptom control problems are also seen. Those residents without previous exposure to medical oncology or radiation oncology will have to do a mandatory month in each of these. There is one selective which must take place in a palliative care service of the resident鈥檚 choice, as well as two electives. These three rotations are designed to complement the previous clinical experiences and respond to the resident鈥檚 anticipated career needs.

Over the course of the thirteen-period residency, the trainee will gain clinical experience in home care, community and hospice settings, pain clinics, anorexia-cachexia and lymphedema clinics, consult services, and tertiary-level palliative care units. This experience will take place in a variety of 每日探花 affiliated settings which are described more under 鈥淭raining Site.鈥�

The resident will be able to:

• • Develop expertise dealing with pain, symptom management, psychological, emotional and spiritual needs of those with advanced life-threatening illness to be able to provide primary and consultant palliative care services.
  • Gain expertise on inpatient units, consultation service, home care, out-patient clinics and elective rotations.
  • Pursue basic academic and research goals with a network of residents and professionals from across Canada.

Clinical Rotations:听The program includes rotations on the palliative care services at 每日探花鈥檚 teaching hospitals. Each is somewhat different in their approach and services, and should provide a good range of clinical experiences, including in-patient palliative care, outpatient clinics, consult service and home care.

There is a mandatory month in out-patient clinics at the Royal Victoria Hospital. These clinics consist of the lymphedema/day hospital/cancer rehab, cancer cachexia/cannabis and cancer pain clinics. During this month, trainees will also have exposure to pediatric palliative care at the Montreal Children鈥檚 Hospital as well as in cardiology at their heart failure clinic.

Trainees are mandated to do family medicine clinics as a part of their year with us. If trainees are presently with a 每日探花 family medicine clinic, they should contact their clinic coordinator to inform them of their interest in having continuity clinics during their PGY-3. It is also possible to do an elective in family medicine in addition to, or in place of, this. **International students are exempt from this requirement.

There is a mandatory month in medical oncology and one in radiation oncology for trainees who have not had training in these previously.

Electives: There are two elective months (three or four for trainees who have already completed training in medical oncology and/or radiation oncology). A popular elective has been Chronic Pain Services, but electives can also be organized in geriatrics, neuro-palliative care, family medicine with POCUS (point of care ultrasound),Family Medicine in First Nations context, Cannabis Clinic, home care and other rotations of choice relevant to the trainee鈥檚 future career plans. Trainees should plan their electives early to ensure space!

• Simulation Training: There will be a session at the SIM centre for POCUS ultrasound. Scans covered: lung for pleural effusion and B-lines, heart for pericardial effusions, abdomen for ascites, bladder size + kidneys for hydronephrosis.

• Mentorship: At the beginning of the year, residents are assigned a Faculty Advisor. Residents meet with their faculty advisors on a regular basis and review their self-assessment tool as well as their field notes. The purpose of these meetings is threefold: to see how the year is progressing in attaining the various competencies; to plan ways of attaining different competencies and experiences as required by personal goals; and to support the resident.

Additionally, residents may choose to have a different mentor. Please note that as residents rotate through our various palliative care services, the staff will be glad to help mentor them.

Curriculum and Training

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Oral, Written, and Interactive Sessions:听There is a formative exam (at six months) and an evaluation exam (at 12 months) based on the core teachings that the resident does during the year of training.

Core Rounds and Teaching Sessions:

• Mandatory core teaching sessions given by our attending physicians

• Mandatory National Academic Half Days (videoconferences) with Palliative Medicine residency programs across Canada.
• Approximately 26 in-person Supportive Care Counselling sessions
• Along with the Spiritual Care core teaching, 4 in-person sessions with a Spiritual Care Counsellor
• Serious Illness Communication curriculum
• 鈥淭eaching Residents to Teach鈥� and 鈥淚t Takes All of Us鈥� (online courses organized by PGME, required for promotion)

Trainees are encouraged to develop their teaching skills throughout the year. This is accomplished through attendance at 每日探花 Faculty Development workshops (/medicinefacdev/) that are of particular interest. As well, trainees are expected to participate in teaching, both undergraduate and graduate, as the year progresses.

At the undergraduate level, trainees lead:

• One 鈥淧alliative Care Visit鈥� which are part of the 1^st year Physicianship course, whereby a group of six medical students accompanied by their Osler Fellow (mentor) meets with a physician/resident and patient on the Palliative Care Unit.
• A session on a palliative care topic given to family medicine residents.
• A small group session in our Palliative Care Recall Day, given to third-year 每日探花 medical students.

Evaluations:听Monthly evaluations will be completed using the online One45 evaluation specific to Palliative Medicine.

These evaluations are meant to be formative and will be compiled from a number of sources, including field notes specific to various Core Professional Activities and multidisciplinary team members for the resident鈥檚 inpatient palliative care rotations. Teaching staff will be filling out field notes three times per week. These are available on One45.

Application Process

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Contact Information

• Program Director Contact Person: Dr. Golda Tradounsky
• Email: golda.tradounsky [at] mcgill.ca
• Phone: (514) 369-2222 ext 33200

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• Program Administrator Contact Person: Karen French
• Email: palliativecare.med [at] mcgill.ca
• Phone: (514) 396-2082