Adult Gastroenterology Training Program

Electives

OVERVIEW

The objectives of the elective experience are to provide flexibility and opportunities to explore career possibilities, to gain experience in aspects of medicine beyond the core curriculum, and to study certain areas in greater depth. Knowledge, skills and attitudes are further developed in a self-directed choice of area across the curriculum.

Trainees are provided between one and four months for elective experience. Trainees are free to identify and choose specific electives in keeping with their individual training objectives, subject to approval by the Program Director and Residency Program Committee. It is expected that electives will be undertaken in Hamilton, barring exceptional circumstance where the trainee demonstrates that the regional facilities are insufficient to meet his/her training objectives. For each elective, trainees must identify a supervisor responsible for monitoring his/her experience and evaluating his/her performance. Both the resident and the supervisor are responsible for ensuring a clear, mutual understanding of the learning activities designed to meet the objectives of the elective.

A completed and signed Elective Request Form must be submitted to the Program Director at least four weeks prior to beginning an elective. Using this form, the trainee is expected to provide: (1) a summary of the elective experience; (2) a statement of goals and objectives for the elective experience; and (3) a schedule of activities and responsibilities to be undertaken during the elective. This document must be signed by the Program Director, the elective supervisor and the trainee. The goals and objectives of elective rotations must address the CanMEDS physician roles identified by the Royal College. Elective evaluations will address both the CanMEDS roles and the elective-specific objectives identified by the trainee. The trainee may choose to undertake two electives in parallel, if neither provides full-time activity.

The following list suggests some appropriate electives and potential supervisors:

            Hepatology (Drs. Puglia, Witt-Sullivan, Tsoi)
            Gastrointestinal motility (Drs. Bercik, Collins)
            Clinical nutrition (Dr. Armstrong)
            Inflammatory bowel disease (Drs. Marshall, Halder)
            Colorectal Surgery (Drs. Kelly, Stephens, Forbes)
            Gastrointestinal oncology (Drs. Zbuk, Wong)
            Gastrointestinal radiology (Drs. Vora, Midia)
            Gastrointestinal anatomical pathology (Dr. Ramsay)
            Psychiatry (Dr. Anglin)
            Pain management (Drs. Buckley)
            Pediatric Gastroenterology (Drs. Issenman, Brill, Ratcliffe, Zachos)
            Laser endoscopy (Dr. Morgan)
            Biliary endoscopy (Drs. Lumb, Seaton, Tse)
            Endoscopic ultrasound (Dr. Tse)
            Swallowing disorders (Dr. Mazzadi)

Responsibilities of the Resident

Rotation schedule is prepared by the resident and the clinical supervisor for the elective. The schedule will need to be approved by the Program Director prior to the start of the rotation. Residents are expected to attend each assigned activity, to be punctual, and to complete written documentations on all patients seen in a timely fashion. Clinical supervisors must be informed of vacation / professional leave 4 weeks prior to the start date of the rotation. In addition, clinical supervisors must be informed when residents are unable to attend assigned activities due to post-call reasons. Residents are expected to develop, implement and monitor a personal continuing education strategy. To facilitate this objective, at least one half day is set aside per week for self-directed learning of topics and diseases encountered during the elective. Residents on elective experience are not exempted from on-call duties.

Evaluation of the Resident

Residents are encouraged to seek informal verbal feedback throughout the elective concerning their performance. A formal evaluation session with the resident will take place at the end of the rotation. Input is sought from other members of the health care team who have worked with the resident (e.g. nurses, other allied health professionals). Based on all feedback received, at the end of the rotation, a formal web-based CanMEDS compliant ITER is compiled by the supervisor. Final evaluations are discussed with the resident.

Evaluation of the Rotation

Residents are encouraged to provide feedback on how the rotation and teaching are structured. As with all rotations, an anonymous rotation evaluation is handled by the One 45 WebEval System. Each teaching faculty is evaluated separately in a similar manner. The Residency Program Committee meets semi-annually to compile a collective rotation and faculty evaluation, respecting anonymity. This has been important to maintaining feedback.

GOALS AND OBJECTIVES

The broad goals of the elective rotation are noted below. The following CanMEDS competencies apply to all clinical elective experiences and are listed on the evaluation form for the elective:

Medical Expert

Key Competencies: Physicians are able to

  1. Function effectively as consultants, integrating all of the CanMEDS Roles to provide optimal, ethical and patient-centered medical care
  2. Establish and maintain clinical knowledge, skills and attitudes appropriate to Gastroenterology
  3. Perform a complete and appropriate assessment of a patient
  4. Use preventive and therapeutic interventions effectively
  5. Demonstrate proficient and appropriate use of procedural skills, both diagnostic and therapeutic
  6. Seek appropriate consultation from other health professionals, recognizing the limits of their expertise

Communicator

Key Competencies: Physicians are able to

  1. Develop rapport, trust, and ethical therapeutic relationships with patients and families
  2. Accurately elicit and synthesize relevant information and perspectives of patients and families, colleagues, and other professionals
  3. Convey relevant information and explanations accurately to patients and families, colleagues and other professionals
  4. Develop a common understanding on issues, problems and plans with patients, families, and other professionals to develop a shared plan of care
  5. Convey effective oral and written information about a medical encounter

Collaborator

Key Competencies: Physicians are able to

  1. Participate effectively and appropriately in an interprofessional health care team
  2. Work with other health professionals effectively to prevent, negotiate, and resolve interprofessional conflict

Manager

Key Competencies: Physicians are able to

  1. Participate in activities that contribute to the effectiveness of their health care organizations and systems
  2. Manage their practice and career effectively
  3. Allocate finite health care resources appropriately
  4. Serve in administration and leadership roles, as appropriate

Health Advocate

Key Competencies: Physicians are able to

  1. Respond to individual patient health needs and issues as part of patient care
  2. Respond to the health needs of the communities that they serve
  3. Identify the determinants of health for the populations that they serve
  4. Promote the health of individual patients, communities, and populations

Scholar

Key Competencies: Physicians are able to

  1. Maintain and enhance professional activities through ongoing learning
  2. Critically evaluate medical information and its sources, and apply this appropriately to practice decisions
  3. Facilitate the learning of patients, families, students, residents, other health professionals, the public and others
  4. Contribute to the development, dissemination, and translation of new knowledge and practices

Professional

Key Competencies: Physicians are able to

  1. Demonstrate a commitment to their patients, profession, and society through ethical practice
  2. Demonstrate a commitment to their patients, profession and society through participation in profession-led regulation
  3. Demonstrate a commitment to physician health and sustainable practice

Criteria Specific to Elective

In addition, specific objectives are to be agreed BEFORE the beginning of the elective by the resident and the supervisor: at least two major specific objectives are to be listed in the space provided on the Evaluation Form.