What you’ll learn
By the time you complete your residency program, you’ll be a highly competent pediatric physician with the knowledge, clinical skills, clinical judgment and procedural expertise you’ll need to pursue a consultancy career or enter into subspecialty pediatric training.
We fully launched Competence by Design (CBD) in July 2021. Residents must finish all 4 stages of pediatrics before moving to subspecialty training unless the individual subspecialty program can guarantee that they can provide the experience and evaluation to complete the remaining EPAs and required training experiences. For most residents this will take 4 years and by the time you’re done, you’ll be eligible to take the Royal College of Physicians and Surgeons of Canada Certification Examinations. This is a national change, not specific to Dalhousie.
PGY1 (Transition to Practice/Foundations Stage)
The first couple of months of PGY1 is now called Transition to Discipline. Residents will generally complete:
- 4 weeks of General Inpatient Pediatrics
- 4 weeks of Pediatric Emergency Medicine
- 4 weeks of Outpatient Clinics (either cardiology, Respirology, GI or the junior clinic rotation which is a mix of general pediatrics and other clinics such as ENT, and dermatology)
- Longitudinal orientation with learning sessions every Tuesday for the first 2 months
During this time residents do buddy call with a more senior resident. During the first 2 months, first year residents also have a longitudinal orientation with learning sessions every Tuesday.
Once the EPAs and other requirements have been completed for Transition to Discipline residents will move to Foundations of Discipline. Residents will complete:
- 8 additional weeks of General Inpatient Pediatrics
- 2 weeks of Normal Newborn Pediatrics
- 2 weeks of Introduction to NICU
- 4 weeks of Neonatal Intensive Care (Level II)
- 4 weeks of Pediatric Surgery
- 4 weeks of Community Pediatrics (outside of the Halifax Regional Municipality)
- 4 weeks of Academic Skills Course
- 12 weeks of subspecialty rotations (3 of Cardiology, Nephrology, Respirology, GI or Junior Clinics)
Residents get 4 weeks of vacation, timing to be negotiated with program. You’ll also need to fulfill on-call requirements. During the first two years of the program, you’ll be on call one night in four. Residents work shifts when working in the Emergency Department. Resident after a night call, go off duty after morning sign-over.
Throughout the entire program, beginning in first year, you’ll attend academic half-days. This means you’ll spend four hours a week attending seminars or rounds specifically aimed at your level. These seminars will cover basic clinical sciences relevant to pediatrics, as well as major subspecialties and:
You’ll also attend journal clubs and Grand Rounds.
PGY2 (Foundation/Core Stage)
Your second year will focus mainly on pediatric subspecialties areas, including:
- 4 weeks in the Pediatric Intensive Care Unit (Level III) as the junior resident
- 8 weeks in the Neonatal Intensive Care Unit (Levell III) (once as the junior and once as the senior resident)
- 4 weeks in the Pediatric Medical Unit
- 2 weeks of Pediatric Anesthesia
- 4 weeks with a community pediatrician (or an additional elective depending on career goals)
- 4 weeks in adolescent medicine/social pediatrics
- 2 weeks in the Emergency Department
- 12 weeks of subspecialty rotations
Pediatric subspecialty rotations may include:
- Hematology and Oncology
- Infectious Disease
Rotation in Saint John
There’s also a mandatory six-week rotation in general pediatrics based out of the Saint John Regional Hospital in Saint John, New Brunswick. This hospital is linked closely to the IWK, and offers a wide range of inpatient general and subspecialty pediatric services, plus many outreach consultant pediatric clinics. Here you’ll supervise family medicine trainees and clinical clerks on a general inpatient pediatric ward and in the ambulatory clinics. Some time is also spent in the NICU. Trainees also have the opportunity to participate in the clinic setting in smaller communities outside the Saint John region or in offices of Saint John pediatricians.
Transportation to these clinics is made available and trainees find this experience exceedingly relevant and rewarding as they have the opportunity to see first-hand the life of a community pediatrician. This experience also provides junior trainees with the ability to act at a more senior level, supervising the more junior house staff. The health problems of the patient population seen, are wide and comprehensive providing an excellent general pediatric experience.
Resident housing in Saint John is provided in the form of apartments close to the hospital. Family accommodation may be available if requested 4 months in advance.
Finally, you’ll do a four-week elective block, within the IWK Health Centre, Dalhousie University or another centre offering pediatric experience. Often, trainees leave the metropolitan area for electives, sometimes even working in areas outside of North America.
Four weeks of research time is provided in the PGY2 year with more time permitted and encouraged in the third and fourth years of training to facilitate the completion of their scholarly project.
At some point during PGY2 year most residents will move to Core of Discipline. Residents get 4 weeks of vacation, timing to be negotiated with program. You’ll also need to fulfill on-call requirements. During the first two years of the program, you’ll be on call one night in four. Resident after a night call, go off duty after morning sign-over. Residents also start participating in a Continuity Clinic once/month.
PGY3 (Core Stage)
Mandatory rotations include:
- 4 weeks of General Inpatient Pediatrics as the senior resident
- 4 weeks of Emergency Pediatrics
- 4 weeks of Pediatric Intensive Care as the senior resident
- 4 weeks of Neonatology (consolidated rotation)
- 4 weeks of Suspected Trauma and Abuse Response Team
- 4 weeks of Developmental Pediatrics
- 4 weeks of Child Psychiatry
This year’s electives may also include:
- other pediatric subspecialty rotations (those listed under PGY2 and palliative care)
- community pediatrics
- medical education
- non-pediatric rotations, like radiology
This year also includes a four-week elective block. You can choose to do this elective within the IWK Health Centre, Dalhousie University or another centre offering pediatric experience. Often, trainees leave the metropolitan area for electives, sometimes even working in areas outside of North America.
Community Pediatrics block
This year also include a four-week community pediatrics block which may be taken within Canada but may also be taken outside of Canada or North America as well. Of the 4 elective/community pediatric blocks in PGY2/PGY3 years, 1 block of 4 weeks must be community and 1 block of 4 weeks must be done outside of Halifax Regional Municipality but within the Maritimes.
Of the 4 elective/community pediatric blocks in PGY2/3 years, 1 block of 4 weeks must be community and 1 block of 4 weeks must be done outside of Halifax Regional Municipality but within the Martimes.
Lastly, if you’re involved in a research project, you’ll be allowed a four-week research rotation.
Residents get 4 weeks of vacation, timing to be negotiated with program. You’ll also need to fulfill on-call requirements. During PGY3, you’ll be on call one night in five. Residents work shifts when working in the Emergency Department. Resident after a night call, go off duty after morning sign-over. Residents continue with their monthly Continuity Clinics.
PGY4 (Core/Transition to Practice Stage)
Core of Discipline will generally continue into the PGY4 year. Once completed, residents will move to Transition to Practice. During Transition to Practice, residents complete:
- 4 weeks in a junior attending role (as a senior supervising residents on the inpatient unit or in a community setting) outside of HRM but within the Maritimes
- 4 weeks in a NICU + Community rotation, outside of HRM but within the Maritimes
- 4 weeks in Complex Care (2 weeks PACT, 2 weeks Rehab)
- 4 weeks in Community Psychiatry (planned to start in 2024/25 year)
- 4 weeks as admitting senior on PMU
- 6 weeks senior clinics
- 4 weeks in an elective rotation
The remainder of the general fourth year will be spent in 4 or 6-week selective rotations based on the resident’s career plans and identified areas for further study as well as working on the remaining Transition to Practice EPAs and required experiences (including focus on quality improvement and patient safety and teaching skills.
Residents get 4 weeks of vacation, timing to be negotiated with program. You’ll also need to fulfill on-call requirements. During PGY4, you’ll be on call one night in six. Resident after a night call, go off duty after morning sign-over. Residents continue with their monthly Continuity Clinics.