Division of Physiatry
Residency Program Committee
November 18, 2005
Present:
Program Director: John Flannery
Chief Resident: Melanie DeHaan
Director, Division/MSH, UHN representative: Gaetan Tardif
TRI-UC representative: Mark Bayley
TRI-RC: Paul Oh
TRI-LC representative: Colleen McGillivray
Quality Assurance Co-coordinator: Cathy Craven
Elected Resident: Sukhi Bhangu
Regrets:
WPHC representative: Farooq Ismail
SWCHSC/BMCC representative: David Berbrayer
MINUTES
1.
Review of Minutes
Minutes of May 20, 2005 approved.
2.
Business Arising
a) “Stats Boot Camp”
Discussion around the potential offer by the Department of Statistics from
University of Toronto under the leadership of Dr. Duquette to organize a
statistical curriculum of three or four of modules. These modules would occur
next fall and the purpose would be to educate residents around statistical
approach and methodology for research and quality projects. The PD had sent
an email to Dr. Duquette indicating our strong level of interest for anywhere
from four to eight residents.
ACTION:
1. The PD will follow this up on with Dr. Duquette’s offer of educational
modules to the DOM. This offer will likely in the next couple of months.
2. Residents would be freed from appropriate amount of clinical duty to
participate in the sessions.
b) Internal Review
We discussed the response letter to the Internal Review (IR) report from Dr C.
Newman and the letter from the PGME IR review committee that will be sent
to Dr. Verma, as circulated. Feedback was given about this letter and will be
incorporated into the final draft.
RESPONSE AND ACTION PLAN:
1. The letter to Dr. Verma will be acted upon. The PD and Dr. Colleen
McGillivray will discuss the framework for revising the objectives into the
new CANMEDS format update of the CANMEDS framework from the
Royal College of Physicians and Surgeons.
2. The PD will attempt to engage the national group of physiatrists, through
the Interspecialty Committee to look at validation of the new updated
CanMEDS objectives that the University of Toronto group will create.
3. The final letter and the IR itself are to be appended to these minutes.
d) Orientation Manual
The first Draft of the manual has been reviewed by the chief resident and
circulated to the RPC in the New Year as part of the CaRMS meeting process
ACTION: PD to circulate in early New Year 2006
e) Terms of Reference
Draft letter – It was suggested by Dr. Craven the specific roles, actions and
responsibilities of the members of the committee be itemized.
ACTION: The PD will circulate to each member of the RPC a request to
describe his or her role and responsibilities and then review.
f) CaRMS Committee and Format
The format for the CaRMS interview process will be revamped. The CaRMS
applicants will meet for lunch and group presentation. The Residents will be
available for interviews.
The CaRMS Committee will look to have a handout for the candidates with
the + 4 report from TRI research and the annual report.
ACTION: PD to set up a CaRMS subcommittee meeting in Dec ‘05.
3.
Standing Items Updates
3.1
Education Report
The academic half-day attendance is being monitored for staff and resident
attendance to ensure accuracy of comments that have arisen in the past and
more recently the first FFT meeting in Oct ’05.
There have been a few adjustments to the schedule due to scheduling
conflicts for external and internal speaker availability.
ACTION:
1. PD to f/u in the preliminary results on attendance.
2. The Admin Assistant to continue to update the Master Schedule to
reflect the changes
3. PD to continue to collect the Learning Objectives from the Residents
and Internal and External speakers to also update the Master schedule.
3.2
Journal Club Report
Dr. Oh updated the committee as to the present format and its appeal to
the Division. As a result of the success top date, we will carry on with this
format throughout the remainder of this year.
3.3
Research Report
The Resident Research Day is occurring on November 25 and Dr. Bayley
has organized for Dr. Jill Cameron to be the external speaker and
adjudicate on the residents’ presentations.
3.4
Quality Project Report
Dr. Craven had circulated an update as to the status of all the residents’
quality projects. It was noted that the update did not get circulated with
the agenda package and will therefore be circulated with these minutes.
The process for the quality projects has been updated on the webpage and
needs to be followed by the residents. Their requirement of completion of
the quality project to be signed off for:
 Dr. Dan Somogyi,
 Dr. Brad Burke
 Dr. Heather MacNeill
Which are still outstanding.
3.5
Exam Report
The PD has sent two emails to Dr. Kevin Letcher (PD at McMaster) and
will follow up as to the status of the “Mock Royal College” exam in
Hamilton this year. It is should be noted that the exam associated with the
Canadian Comprehensive Review Course will be occurring in March
2006. Many of the Toronto residents will be attending this exam
(potentially seven of the nine residents).
ACTION: PD to follow up with Dr. Kevin Letcher from Hamilton as to
the timing of the exam.
3.6
Resident Selection Committee Report
This is discussed above in the CaRMS section.
3.7
Social Report
This Christmas social is planned for December 16 and will involve the
traditional presentation of some of the skits. The previous years we had
organized Grand Rounds to have a lighter note with some levity at the
Rounds which was reasonably well received. However, there were still
some individuals who felt that they would prefer to have this kind of fun
rounds organized for the Christmas social rather than in the academic
Grand Rounds section.
3.8
Mentorship
A brief discussion occurred around mentorship. The prospect of staff
mentorship is discussed with the residents at their trimester meetings with
the PD. The majority of residents seek mentors through their quality
projects, research projects, as well as some of the clinical rotations that
they have.
ACTION: PD to carry on with the topic on a one-to-one basis with the
residents during their trimester meetings.
4.
New Business
No new business was brought up.
5.
Resident Issues
No other new resident issues were brought up.
6.
Other Business
No other business was brought up.
Next Meeting:
December 16, 2005, 8:15 am
Appendix 1
November 21, 2005
Dr. Sarita Verma
Associate Dean, Postgraduate Medical Education
Faculty of Medicine
University of Toronto
Ste. 207, 500 University Ave.
Toronto, ON M5G 1V7
Dear. Dr. Verma:
RE:
PD Response to U of T, Division of Physiatry Internal Review,
May 26th, 2005
Thank you for your written feedback, as well as the feedback from the Internal Review
team consisting of Dr. Christine Newman, Chair, Dr. Lee Ford-Jones Faculty Member
and Dr. Sara Kuruvilla, PAIRO Representative. I have had a chance to review the
document in its entirety. I will focus my comments on that document sent to me on
September 9, 2005, as well as your comments in the document sent to me later that same
month.
In Section 9 of the summary there were five (5) strengths that were noted under section
9.1 as well as two (2) weaknesses noted in section 9.2.2. The weaknesses found in the last
External Review in section 9.2 were corrected.
Under Section 9.2.2 weaknesses that have developed since the last review include the
following:
 Absent ongoing rotation review (Standard B1)
 Evaluation not always timely and signed with copy on the file (StandardB6)
With regards to the first weakness of lack of ongoing rotation review, the issue has been
discussed at Residency Program Committee (RPC) meetings and will be addressed in the
subsequent 12 months to have completed by Jan 2007. Although listed broadly under
Standard B1 this rotation review includes issues from Standards B2, B3, and B5. The
recent update of the CanMEDS Physician Competency Framework 2005 will be
incorporated into the rotation review to itemize the rotation specific objectives in updated
CanMEDS format and description. In addition the graded responsibility of these
objectives along with clear resident expectation and evaluation will be addressed. A
strategy has been formulated and discussed at our Divisional Advisory Group as well as
at our
Divisional retreat and RPC. This review process will be taken on by each specific
rotation and looked at for both the graded responsibility of the residents, either in their
junior (PGY2 to PGY4) or their senior core rotations (PGY5).
With the help of the Division, which appears quite supportive for this endevour, I will
explore the possibility of national validation through the other Academic Centers.
With respect to the second weakness identified of lack of timeliness of evaluations and
lack of signed evaluations on the file under standard B6, this is being revised. The
administrative assistant and myself will undertake review of this process during the fall
and winter months to develop a process to address this shortcoming. The conversion
from the standard paper evaluation to the POWER system has many advantages but is a
new process. Both of these deficiencies will certainly be remedied.
Lastly, with respect to the comments that you had for me with regards to the Pre-Survey
Questionnaire (PSQ) check list, the general format will be addressed administratively
(Standard B1). Lastly, two additional comments were the noted under the standards B4
and B5 clearly identified deficiencies in the preparation for the document submission.
Certainly the attachments will be clearly numbered and maintained in the PSQ structure.
It is our goal to have all attachments arrive with the PSQ and this will be achieved for the
College External review in 2007.
I would like to thank all of our division as well as our administrator Mrs. Nancy Turner
for all the support in preparation for the Internal Review. In addition, I would like to
thank Dr. Christine Newman and her team for their strong efforts and helpful report. We
look forward to progressing on these recommendations and improving our overall quality
of our residency program.
Yours sincerely,
John Flannery, MD, FRCPC
Residency Program Director
c. Dr. Christine Newman
Dr. Lee Ford-Jones
Dr. Sara Kuruvilla
Appendix 2
Appendix 3
Residency Program Committee
Quality Assurance Update
14 November 2005
Overview of Recent Activities:
1. Inaugural Resident Quality Improvement Workshop July 2005
2. Revised Resident Quality Improvement Objectives, Expectations and Evaluation
Forms on Division website.
3. Update of Resident Progress to date ( see below, Table 1).
4. Formulate Action Plans and Timelines
Resident Name
Discussed
Project
PG
Y
Faculty
Supervisor
Brad. Burke
Heather McNeil
Sonja. McVeigh
Dan. Somogyi
Paul Winston
Melanie DeHaan
Sukhi. Banju
Steve. Dilkus
D Rabinovich





4.5
5
4
4.5
3
3
1
1
John Flannery
Denyse Richardson
Paul Oh
John Flannery
Cathy Craven
Jaime Guzman

Proposal
Submitted
& Accepted
Oral
Written
X
X
1/2
X
X
X
X
X
1/2
X
Final
Eval
Complete
X
X