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Critical Care Program

The Critical Care Medicine Residency Program is a fully accredited program accepting trainees from various base specialties: Internal Medicine, General Surgery, Anesthesia, Emergency Medicine, and Cardiac Surgery. Trainees from other specialties are also eligible to apply if all requisite rotations are completed. Canadian medical graduates apply through CaRMS with 3-4 applicants accepted per year. The program also accepts approximately 2 international medical graduates per year. These individuals that seek additional training in specific areas of expertise in critical care, such as neurocritical care, cardiovascular critical care, or clinical research in critical care. Currently, we are able to accept 1-2 individuals per year in each of these areas of sub-specialization.

Residency Program Committee

Oversight of the program is provided by the RPC. This committee meets at least 4 times per year to discuss and review all issues that may impact residency training and education. This committee is comprised of several faculty members that represent each of the roles within the program. Resident representation is provided by is provided by the Chief Resident (appointed position) as well as elected representatives from each year of training, as well as from the IMG pool. As many graduates of the program enter clinical practice in community centres, a community intensivist is a member of the RPC. Consequently, our program has been successful in working with our community partners in order to better provide trainees with a community experience. Dr. Paul Hosek, from Grand River Hospital, is currently the community representative helping to achieve this goal.

Education

We continue to provide a robust academic curriculum to our trainees. Each Tuesday afternoon is a dedicated academic half-day provided by both our faculty as well as lecturers from all departments about divisions of the Faculty of Health Sciences. This educational series serves to over most topics included in the RCPSC Objectives of Training n the Subspecialty of Adult Critical Care Medicine. In addition, all trainees enrolled int he program must complete the Acute Critical Events Simulation (ACES) course, as well as attend the national conference (CCCF) and Canadian Critical Care Review Course (CCCR). Throughout each academic year, the program provides the trainees with high fidelity simulation sessions to enhance and assess their skill set. The program has enjoyed great success with invited speakers providing Regional Critical Care Rounds and Journal Club on a monthly basis. These events have excellent attendance with lively debates.

Clinical Experience

All trainees complete their clinical rotations in the ICU at the teaching hospitals at McMaster University, Hamilton General Hospital (HGH), Juravinski Hospital (JH), and St. Joseph's Healthcare Hamilton (SJHH). The HGH site has 3 intensive care units and 45 level 3 critical care beds providing service for cardiovascular care, neurosurgical and trauma care, and burn management. The JH site has 1 intensive care unit with 19 level 3 critical care beds providing service for surgical, medical, and radiation oncology, regional orthopedic surgery, and the regional GI program. The SJHH site has 1 intensive care unit with 24 level 3 beds. This site is the location of regional dialysis and renal transplant programs, thoracic surgery, and respiratory medicine. All sides have rapid response teams as well as busy acute care surgery and medicine services. CCM trainees rotate through each site as well as various other elective rotations within these hopsitals as well as our community partners.

Program Structure

Our program is uniquely structured to achieve all the requirements of training. During ICU rotations, the trainees follow a 3-week cycle. This cycle includes 1 week of clinical duty in critical care, followed by a week of on-call responsibility, This week as been structured to mimic he typical work week of intensivists in practice throughout much of Canada. Upon completion of this on call week, the trainees complete a week of non-clinical duties whereby most trainees accomplish their studying, teaching of other  individuals, as well as maintain their competency in their base specialty. Trainees have applauded this structure as a major strength of our program since it prepares individuals very well for entrance into independent practice in the specialty.

The Critical Care Medicine (Adult) Residency Program at McMaster University is a two-year program. Applicants must have base specialty training from Internal Medicine, General Surgery , Emergency Medicine, Anesthesia, or Cardiac Surgery. Applications will be considered if the candidate is wither already certified in one of these specialty programs or will be eligible for certification prior to the end of the two-year program. The number of residents accepted to the program varies each year.

The Program, while utilizing the regional resources of both the University and its affiliated teaching hospitals, is centrally coordinated in a multidisciplinary fashion, thus reflecting the cross-specialty, horizontal nature of Critical Care Medicine in Canada. Recognizing the varied backgrounds of the Critical Care trainees, the program is set up to enable a great deal of flexibility with regards to the details of training. This will ensure that - regardless of background - each individual, whether emanating from Medicine, Surgery, or Anesthesia, will be able to function as an ICU consultant on any type of patient. Thus rotations ill vary according to an assessment of the individual's strengths and weaknesses.

The trainee functions at a progressive level of responsibility, assuming the role of ICU coordinator as soon as it is appropriate to do so, although always with direct faculty support. On-call for the ICU is typically out of hospital as support to the in-house physicians. The ICUs are staffed by residents from medicine, surgery, anesthesia, and emergency medicine, as well as by independently-licensed physicians. Therefore, our trainees function in a role that oversees, acting as a supervisor and teacher for junior residents.

During the two-year program, our trainees are required to complete 16 block rotations in ICU at Hamilton Health Sciences and St. Joseph's Healthcare Hamilton. These rotations are designed to provide a broad clinical experience in several busy, multidisciplinary intensive care units. These core rotations are distributed throughout the program and ensure that the trainee is exposed to a large variety of medical and surgical patients. Given the vast referral population, trainees will have a great opportunity ti care for patients of specialty care programs such as Trauma, Burns, Oncology, and all surgical subspecialties, including Neurosurgery and Cardiovascular Surgery.

The remaining 10 blocks are available for elective rotations. These rotations are provided to strengthen and diversify one's skills and abilities. Electives are available in virtually any discipline. They must have clearly-described learning objectives for critical care. The educational curriculum includes academic half-day seminars, journal clubs, regional rounds, as well as other sessions which all round out a full academic experience.

In addition to the clinical ICU experience, the academic side of the program affords varied and full opportunities to develop and perfect teaching skills, as well as to expand and deepen one's appreciation and understanding of the field of critical care. The educational curriculum includes academic half-day seminars, journal clubs, regional rounds, as well as other sessions which all round out a full academic experience.

The Critical Care Medicine (Adult) Residency Program at McMaster University offers a wide-ranging and full clinical experience complemented by an enthusiastic faculty that support the academic objectives of adult learners dedicated toward a fulfilling career in critical care medicine.

Research Opportunities

The program structure is well-suited for trainees that are self-directed in their learning as well as those that are motivated to complete scholarly projects during the course of his or her training. This may be original research or a quality assurance project. Research mentors, Dr. Waleed Alhazzani and Dr. Bram Rochwerg, currently oversee the Research-in-Progress meetings on a quarterly basis to monitor their progress and provide guidance on the research process. Our trainees present their projects at a joint McMaster-Western Research Day held each spring.

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