Postgraduate Medical Education

 

The primary responsibility that I have for teaching at the postgraduate level involves paediatric residents in Paediatric Residency Program at the University of Calgary, with whom I work with on the inpatient/consult gastroenterology and nutrition service where I spend the majority of my clinical time. It is thus in this environment where I provide most of my teaching and guidance.

 

Previously, as a paediatric resident, I worked with and provided teaching to fellow paediatric residents in the Paediatric Residency Program at the University of Alberta. Clinical teaching occurred primarily on the inpatient Clinical Teaching Unit (CTU), but also on overnight call and night float rotations affiliated with inpatient service. Through similar clinical experiences, I helped facilitate the training of residents from family medicine training programs, as well as those from other training programs rotating through CTU as part of their pediatrics rotation during their basic clinical year of training.

 

Outside of the clinical domain, I have assisted in the education of residents in several training programs, through a variety of lectures, seminars, and case rounds, often as part of their formal academic sessions that also constitute as continuing education for attending faculty members.

Involvement in postgraduate medical education initially seemed daunting as a junior learner myself within the postgraduate paediatric residency training program. However, I eventually found several niches for active involvement, as I transitioned to the roles and responsibilities of a senior paediatric resident, and subsequently, a paediatric gastroenterology fellow.

 

During my time as a paediatric resident, I tried to positively impact the educational experience of others rotating through hospital medicine, or inpatient paediatrics on the Clinical Teaching Unit (CTU). This service has remained an integral component of a resident's training in paediatrics, particularly for junior residents who spend three months during their first year of training on CTU, where they are given the opportunity to take primary responsibility for patients assigned to them. Such patients provide relevant contextual learning experiences for residents, whether they have common clinical diseases or presenting complaints, or more complex, often multisystem diseases requiring more comprehensive and coordinated care plans. As a senior resident, my expanded managerial and supervisory role on the inpatient service, and its associated overnight call and night float care shifts, afforded me the opportunity to work repeatedly with several junior residents in this stage of their development. Further, during several paediatric subspecialty service rotations, as the most senior learner, I was asked to take a similar role in working with junior residents and medical students.

 

These experiences have prepared me for my current role as a senior paediatric gastroenterology and nutrition fellow. Our service is a busy one providing inpatient care and both inpatient and emergency consultations throughout the Alberta Children’s Hospital. All paediatric residents at the University of Calgary spend one month during their first year of training on gastroenterology service, in addition to Canadian paediatric residents joining the service as an elective rotation. My work with these residents has allowed me to provide clinical teaching through various means.

 

In all of these settings working with paediatric residents, I always try to learn their interests, strengths, experiences, learning needs and objectives from the onset of their rotations. This allows me to better assist them in finding clinical experiences that are more relevant and conducive to their goals. For many, this leads nicely to teaching through bedside rounds, review of consults and clinical impressions and plans, as well as informal discussions around associated knowledge that either myself or another member of the team takes responsibility for acquiring and sharing with the group. All of this clinical education is patient-centered and problem-oriented, and encourages active participation in the learning process. Providing residents with increasing independence and responsibility in patient care is always a goal that is on my agenda, as long as they feel comfortable and supported by me in these endeavours. When advice is needed, I also find it important for ask residents to explain their analysis, synthesis, and evaluation of the question at hand before offering them resources or suggestions on how to solve the dilemma. I make a concerted effort to have one-on-one discussions with the residents frequently to re-address their progress, and to suggest specific strategies for further improvement. It is truly enjoyable for me to work with these residents closely over a significant period of time, where I am able to get to know these learners as individuals quite well, and play a role in their learning and development in unique and varied ways.

 

I have a particular interest in clinical problem solving, and in particular case/admission rounds, which I have been actively involved in leading while on clinical service throughout residency and clinical fellowship training. I feel that questions can always be asked or framed in ways that lead to collaboration and engagement in clinical decision-making, and am always striving on using a current clinical case to illustrate important steps in the process of solving a variety of dilemmas that require several or all of the roles demanded from the CanMEDS physician competency framework (Frank et al., 2014). Examples of templates and associated visuals for these sessions can accessed by selecting the buttons.

 

 

 

 

 

 

 

References

 

Frank, J.R., Snell, L.S., Sherbino, J., editors. (2014). Draft CanMEDS 2015 Physician Competency Framework – Series III. Ottawa: The Royal College of Physicians and Surgeons of Canada.

I have had ample opportunity to teach myself as well as others during my training in paediatrics and its subspecialties. While invaluable in my own training, these individual sessions challenged me to educate through lectures, seminars, and case rounds. Such sessions were scheduled into the formal academic meetings of specialty and subspecialty resident training programs, were attended by a variety of learners, as well as Faculty members who were simultaneously fulfilling commitments to continuing medical education. Click the in-text links for examples of some of these presentations.

 

Cumming School of Medicine (University of Calgary), Postgraduate Medical Education

 

Paediatric Gastroenterology, Hepatology & Nutrition Program Invited Presentations:

 

July 2015         Paediatric Upper Gastrointestinal Bleeding. University of Calgary, Paediatric Gastroenterology Academic Half-Day

 

June 2015        Pancreatic Neoplasms/Lesions. University of Calgary, Paediatric Gastroenterology Academic Half-Day.

 

May 2015         Journal Club: Central Line-Associated Bloodstream Infections in Paediatric Intestinal Failure with Review of Ethanol        

                          & Taurolidine Line-Locking Strategies. University of Calgary, Paediatric Gastroenterology Academic Half-Day.

 

Feb 2015          Paediatric Hepatitis C: Pathogenesis and Management. University of Calgary, Paediatric Gastroenterology Academic Half-Day.

 

Jan 2015          Paediatric Hepatitis C: Epidemiology, Diagnosis, and Anticipatory Guidance. University of Calgary,

                          Paediatric Gastroenterology Academic Half-Day.

 

Oct 2014           Journal Club: Immune Dysregulation and the Putative Role of IL-17 in Autoimmune Hepatitis. University of Calgary,

                          Paediatric Gastroenterology Academic Half-Day.

 

Sept 2014         Wilson Disease. University of Calgary, Paediatric Gastroenterology Academic Half-Day.

 

June 2014         Gastric Motility and Associated Disorders. University of Calgary, Paediatric Gastroenterology Academic Half-Day.

 

March 2014      Journal Club: Paediatric Outcomes after Percutaneous Endoscopic Gastrostomy Tube Insertion and Laparoscopic

                            Fundoplication. University of Calgary, Paediatric Gastroenterology Academic Half-Day.

 

Nov 2013           Journal Club: Prophylaxis of Variceal Bleeding in Portal Hypertension. University of Calgary,

                           Paediatric Gastroenterology Academic Half-Day.

 

Oct 2013            Pancreatic Physiology. University of Calgary, Paediatric Gastroenterology Academic Half-Day.

 

Aug 2013           Helicobacter pylori. University of Calgary, Paediatric Gastroenterology Academic Half-Day.

 

July 2013           Approach to Lower Gastrointestinal Bleeding. University of Calgary, Paediatric Gastroenterology Academic Day.

 

Jan 2009            Protein-Losing Enteropathy (PLE) and PLE following Fontan Operation. University of Calgary,

                            Paediatric Gastroenterology Academic Half-Day.

 

University of Alberta, Postgraduate Medical Education

 

Paediatric Residency and Subspecialty Program Invited Presentations:

 

Aug 2012            Retropharyngeal Abscess and Lemierre Syndrome. University of Alberta,

                             Divisions of Adult and Paediatric Infectious Diseases, Joint Grand Rounds.

 

July 2012            Infant Formula Alternatives. University of Alberta,

                             Paediatric Residency Academic Half-Day.

 

May 2012            Toilet training: Just what do we Really Know? University of Alberta,

                              Division of Developmental Paediatrics Grand Rounds

 

Sept 2011            Pulmonary Hypertension. University of Alberta, Division of Paediatric Respirology Academic Half-Day.

 

Feb 2011              Approach to Ambiguous Genitalia. University of Alberta, Divisions of Adult and Paediatric Endocrinology, Case Conference.

 

July 2010             Neonatal persistent diarrhea. University of Alberta, Division of Paediatric Gastroenterology and Nutrition, Academic Half-Day.

 

May 2010             Approach to Diarrhea. University of Alberta, Paediatric Residency Academic Half-Day.

 

March 2010         Renal Tubular Acidosis. University of Alberta, Division of Paediatric Nephrology, Academic Half-Day.

 

July 2009             Congenital/Perinatal CMV Infections and Hepatic Involvement. University of Alberta,

                              Division of Paediatric Gastroenterology and Nutrition Academic Half-Day.

 

Dec 2007             Paediatric Hypertension and Association with Obstructive Sleep Apnea. University of Alberta,

                              Division of Paediatric Nephrology, Academic Half-Day.

 

Paediatric Grand Rounds:

 

Feb 2011             Inhalant Abuse. University of Alberta Paediatrics Grand Rounds (Co-presenter: Dr. Eileen Estrabillo).

 

March 2010         Cardiovascular Risk Assessment before the use of Stimulant Medications.

                              University of Alberta Pediatrics Grand Rounds (Co-presenter: Dr. Simona Hasal).