Prehospital and Transport Medicine (PTM)

Overview

The objective of the Royal College Physician and Surgeon of Canada’s Accredited Prehospital and Transport Medicine (PTM) Area of Focused Competency (AFC) Diploma Program at the University of Ottawa is to create PTM Physician Specialists by providing a robust educational curriculum and create future leaders in PTM as PTM Physician Specialists. Diploma trainees build expertise in all aspects of prehospital medicine; tactical medicine, event medicine, disaster medicine, fixed and helicopter medicine, medical response/amputation team, quality improvement and patient safety, regulatory oversight, education, licencing, research and publication. 

The PTM program at University of Ottawa is the first accredited PTM Royal College AFC Diploma Program in Canada. 

More details about this can be found at: https://www.royalcollege.ca/rcsite/specialty-discipline-recognition/categories/discipline-recognition-areas-focused-competence-afc-programs-e 

Base Hospital - Regional Paramedic Program for Eastern Ontario (RPPEO)

The Regional Paramedic Program for Eastern Ontario (RPPEO) was created in February 2009 when the Ottawa and Kingston Base Hospitals were amalgamated. The RPPEO certifies paramedics to perform controlled medical acts and is responsible for ongoing continuing medical education and continuous quality improvement for all paramedics in the region. In addition, RPPEO provides medical direction and guidance to paramedics and paramedic services in nine upper-tier municipalities across Eastern Ontario.

The communities served by the RPPEO are: Prescott-Russell, Cornwall SDG Counties, Ottawa, The County of Renfrew, Lanark County, Leeds and Grenville, Lennox and Addington, Hastings County, Prince Edward County and Frontenac County. Combined, this includes nine paramedic services and more than 1400 Primary Care Paramedics (PCP) and Advanced Care Paramedics (ACP). 

The RPPEO champions excellence in Paramedicine, with the ultimate goal of ensuring that our community is provided with the safest and highest-quality clinical care possible.

Links: https://www.rppeo.ca/

Program

Educational experiences of the PTM AFC program will fulfill the required training set by the Competence Training Requirements (CTR) document of the Royal College. This will be achieved through longitudinal activities through the entire year of training with the exception of EMS Block. It is expected that as the trainee progresses, they will be provided with graduated independence with respect to addressing and managing all the issues that arise in the PTM program. The PTM Curriculum is comprised of various complementary components including:

• clinical experiences (Emergency Department, online consultations, HEMS),
• academic sessions,
• journal club,
• scholarly project, and
• Opportunities for selective educational experiences (Wilderness, Flight retrieval medicine, Emergency Management, Event medicine, Global Health and more)

This is not a linear nor a time-based curriculum, the curricular experiences are integrated throughout the training time. Regular review of the trainee’s progress with the Program Director and concomitant review of the competence portfolio by the Fellowship Competence Committee will serve to ensure trainee is meeting the millstones and is successful in completing the PTM AFC Diploma required by the Royal College. The timeframe for coverage of all academic content will be dependent on the trainee’s specific learning and career goals (clinical +/research or education, academic vs community).

Sample Schedule:

Program Highlights

• Exposure to day-to-day workings of medical direction
• Admin experience
• Weekly sessions with PTM Faculty:
  • Example sessions:
    • EMS Governance
    • Quality improvement methodology
    • Educational theory
    • Root-cause analysis
    • EMS legal principles
    • Coroner and death investigation
    • Aeromedical transport considerations

• Provincial and Federal Emergency Management/regulatory experience
• Tactical medicine training

• Ride out experience both land and air
• EMS Boot Camp

• Access to world-class researchers and methodologists
• Access to quality improvement expertise
• Opportunities for selective educational experiences (Wilderness, Flight retrieval medicine, Emergency Management, Event medicine and more)

Requirements

• Expression and demonstration of interest in Prehospital and Transport Medicine
• Clinical competence
• Eligible for appropriate licensure in Ontario by CPSO
• Eligible for appropriate medical liability insurance by CMPA

Relevant Documents

Applications should contain:

• Letter of expression and interest
• CV
• 3 letters of reference (one of which must be from the program director, if applicable)

Suitable candidates who are Canadian medical graduates are required to apply through the Fellowship Application Form.

Suitable candidates who are international medical graduates are required to apply through the Fellowship application system.

Questions can be submitted to Lisa Lance.

Deadlines

Deadline for application for January start:

March 15th

Deadline for application for July start:

August 15^th

Interviews either in person or virtually will be offered to those successful candidates from review of their applications.

The start date for PTM diploma program is either Jan 2^nd or July 1^st.
Please note this is a 12-month diploma program, irrespective of starting date.

PTM DIPLOMA - PROGRAM DIRECTOR

Dr. Michael Austin, MD, FRCPC

Dr Austin (Emergency Medicine), worked as a Wilderness Helicopter Paramedic for 14 years and is the current Prehospital and Transport Medicine (PTM) Diploma Program Director. He is an Assistant Professor with uOttawa and is Clinician Investigator OHRI.  He has several research grants and is widely published and is regarded as an international expert in this field specifically in the area of pre-hospital medicine. He holds a Subspecialty in EMS and Disaster Medicine from uOttawa and is an Associate Medical Director with the Regional Paramedic Program for Eastern Ontario, also Medical Directors for University of Ottawa Volunteer Crisis Response Team (VCRT) and Ontario Police College.

PTM DIPLOMA – ASSISTANT DIRECTOR

Dr. Simeon Mitchell, MD CM, MScHQ, FRCPC

Dr. Mitchell attended medical school at McGill University and completed residency training in Emergency Medicine at the University of Ottawa. During residency, he pursued an EMS concentration year with the RPPEO and completed a Prehospital and Transport Medicine Fellowship in Ottawa after graduation as well as a Master of Science in Healthcare Quality at Queen’s University. He is currently an Emergency Physician with The Ottawa Hospital. Dr. Mitchell’s academic interests are in prehospital quality improvement, the intersection between the ED and prehospital care, regionalized care, human factors, and using data to inform change. His interest in prehospital medicine began while volunteering as a first responder for an emergency medical service in Montreal for almost a decade. Outside of work he enjoys exploring Ottawa and its surroundings, travelling, and scuba diving.

PTM MONTH – PROGRAM DIRECTOR

Dr. Richard Dionne, MD, CCFP (EM)

Dr Richard Dionne has been an Academic Emergency Physician since 1997, worked in the Eastern Townships of Sherbrooke, Quebec, where he was initiated to the Prehospital World.  In the year 2000, worked in the United-States as an Emergency Physician at the University of Iowa Hospitals and Clinics, and has been in Ontario, as full time Emergency Physician at the Ottawa Hospital, since 2001. He holds the academic position of Associate Professor in Emergency Medicine at the University of Ottawa. Dr Dionne has been the Medical Director of the Regional Paramedic Program for Eastern Ontario since 2016, following him being in the prior position of Associate Medical Director since 2003. 

PTM ADMINISTRATION

Ms. Lisa Lance

Primary administrative contact for the CCFP-EM residency program as well as our Fellowship Programs.

PTM FACULTY LIST

Case Conference (Bi-weekly - 2-3 hour)
Faculty, RPPEO Quality and education staff, AFC trainees and medical directors, will present cases captured by quality review process at RPPEO. The AFC trainees will be responsible to review and prepare cases, present cases, and provide their analysis and opinion. Fellows will become familiar and use relevant concepts such as just culture, root cause analysis, and components of patient safety and versed in the applicable basic life support and advanced life support ministry of health standards for paramedicine in Ontario.

Online Medical Consultation Rounds (Weekly - 1 hour)
Faculty, AFC trainees, Base Hospital Physicians and Medical Directors will present online consultations identified by peer review process discussing potential changes to systems (Medical directives, educational needs etc).

Senior Medical Team Meeting (SMT) RPPEO (Monthly)
Faculty, RPPEO leadership, and AFC trainees review of provincial and other regulatory management material. Trainees are responsible to present and discuss issues providing understanding of good communication and meeting etiquette.

Research meeting RPPEO (Monthly)
Faculty, RPPEO staff, paramedics, Medical Directors and AFC trainees, review of current research projects.

Provincial Medical Advisory Meeting (4 times a year)
Provincial MDs, Directors BHs, paramedic reps, Ontario Associate Paramedic Chiefs (OAPC) reps, Education subcommittee and Data Quality Management (DQM) subcommittee reps, PTM trainees. Review of Medical directives and provide advice to the Ontario Ministry of Health.

Quality of Care Advisory Committee Meeting (Bi-monthly)
Faculty, RPPEO staff, Paramedic Service representatives, Paramedics, colleges and external stakeholders meet every two months to discuss quality of care issues, education and certification issues, act as an advisory panel to the base hospital, and provides an open forum for dialogue across the region.

National Medical Directors and Operational Directors meeting (Bi-weekly- Thursday)
All provinces and territories MDs meeting to review national issues with guest speakers around important National topics (example offload delay).

PTM Journal Club (Monthly - 2 hour)
Faculty, RPPEO staff, paramedics, Medical Directors and AFC trainees present and discuss 2-3 relevant PTM peered-reviewed manuscripts or articles, posting of summaries on the EM Ottawa Blog site.

Academic Sessions (Bi-weekly - 1.5-2 hours)
Teaching Faculty reviews of a specific topic with PTM AFC trainees (e.g. QI, research, Medical Directives, Legal, Just culture, HEMS, educational methodology etc.) Please find attached the academic sessions (Appendix 4) over a 12-month period with local faculty and guest speakers.

EMS Block – (1-month program)
EMS block for PGY3 residence (local and elective) plus paediatric fellows participate in a month of EMS education coordinated and run by the Fellows. Didactic sessions, table tops exercises and practical skills are reviewed. Including clinical experiences at Boot -camp an opportunity for residents to become paramedics for a day in simulation (see EMS Month Template documents)

Clinical ED shift experiences (maximum of 8 clinical shifts per month in the ED)
The AFC trainee will be assigned clinical shifts in the ED. These assignments will be in every area of the department and includes resuscitation care, emergent care, observation care, and urgent care. Each shift will be supervised by a dedicated staff physician if trainee is not in independent practice. This will ensure that the trainee will be exposed to a broad spectrum of disease state and complications while maintaining a safe clinical environment for both the trainee and patients. Trainees will have to opportunity to interact with Paramedics real time during shifts.

Online Medical Consultation (3-5 shifts/month each 12 hours)
PTM AFC trainees will onboarded using OMCAT and supported with peer review by faculty to provide online medical consultation to paramedics in the Eastern Region of Ontario (9 services 1500 paramedics). They will be on-call 12 hours shifts (days and nights) 3-5 shifts/month answering on average 5-8 calls/shift. Faculty will support trainees real-time to ensure safe and prompt feedback while on call. Trainees will be required to keep a logbook of all consultations which is reviewed by PD.

NAEMSP Medical Directors Course
AFC trainees are required to attend and participate in the National Association of Emergency Medicinal Services Physicians (NAEMSP) Medical Director course occurs annually prior to the NAEMSP Conference. This provides an international perspective of PTM.

Professionalism Day/Wellness Retreat
Annual half day incorporating professionalism session in the morning followed by an afternoon of curling with other fellowship programs.

Just Culture/Reliability Management Course
Trainees will attend a longitudinal Just culture/high reliability course. Reliability Management System provides the structure for seeing, understanding, and managing organizational risk. By integrating and harmonizing programs and practices, each element of the RMS is measured and monitored, providing an auditable standard of evaluation for sustainable performance. This learning will be applied case conference and reviews. High Reliability Organization and Collaborative Just Culture.

Other courses/Electives
To improve upon their knowledge and skills as an educator the trainee will participate in and organize courses and educational opportunities to teach others. Self-directed learning allows AFC trainees to pursue areas of interest and those which require more attention. Data is available to support system change and evidenced based practices. Electives are also available that can be tailored to trainees learning goals and interest, and at the discretion of the AFC program director.

Administration project
The trainee will have, on average, one protected administration day per week. The trainee will identify at least one administration project early on in the AFC (example developing Terms of reference, SWOT assessments etc). A Faculty will be assigned as a main mentor. The trainee will present their work for review and also provide feedback on other AFC trainee’s work.

Educational Projects
The trainee will support and create CME curriculum both for mandatory paramedic content as well as elective paramedic CME using the RPPEO Learning Management platform. These topics will be established at the beginning of the year and trainees will create short online videos to populate content for paramedics.

Scholarly Project
The trainee will have, on average, one protected research day per week. The trainee will identify at least one scholarly project early on in the AFC. Projects are typically research, quality improvement, or program development. A Faculty will be assigned as a main mentor. The trainee will present their work for review and also provide feedback on other AFC trainee’s work. The trainee will participate at the monthly PTM journal club assigned within the AFC curriculum.

Current 2021-2022

Dr. Nick Costain

My name is Nick Costain and I'm an Emergency Physician predominantly based out of the Ottawa Hospital but I do some community shifts in the Ottawa Valley. I also work with the MAiD program at the Ottawa Hospital. I'm originally from PEI but have called Ottawa home for the past 9 years. I have a great spouse and 2 girls, ages 5+7, who keep me focused on what's important. I enjoy downhill skiing (real skiing) and have been an avid backcountry skier for most of my adult life.

Dr. Justin Godbout

Justin is an emergency physician at The Ottawa Hospital, and fellow with the Regional Paramedic Program of Eastern Ontario. Having an interest in prehospital and retrieval medicine, he previously completed fellowships with STARS Air Ambulance, and Auckland Rescue Helicopter Trust.  

Dr. François Scarborough

I am  Dr. François Scarborough.I am completing a Prehospital and Transport Medicine Fellowship in Ottawa. I willl also be working clinically at the Emergency Departement of the Civic and General hospital in Ottawa for the next year.

I was born and raised in Montreal. I attended Medical School at Laval University and completed my CCFP-EM residency at Laval University. I'm working at Sacré-Coeur Hospital in Montréal since 1999, in the past I have worked at The Montreal Cardiology Institute and l’Hôpital de la Cité-de-la-Santé de Laval. I am an Assistant Professor at The University of Montreal.  

My academic interests are Emergency Medicine, EMS and quality improvement.  I also completed two Humanitarian Mission in Haiti with Médecins du Monde (Doctors of the World).  I have two kids. In my spare time, I love to travel and watch movies. 

Dr. Alex Trajkovski

Hi everyone, my name is Alex Trajkovski and I’m one of the base hospital physicians here in Ottawa. I’m one of the prehospital and transport medicine fellows and did my CCFP-EM training in Regina. I’ve been interested in working with EMS since volunteering and working closely with medics as a ringside doctor for local boxing/MMA events, and with medical event services at a variety of music festivals (Pemberton, Boots and Hearts, and VELD to name a few). I also spent 2 years rurally in Cape Breton, where I saw the importance of a robust EMS system firsthand. Outside of the hospital my pandemic hobbies included picking up golf and running, pre-pandemic I used to wrestle, swim, and sail.

Alumni 2021

• Dr Daniel Beamish  (Year 2)
• Dr Renee Bradley (Year 1)
• Dr Harrison Carmichael  (Year 2)
• Dr Jill Coleby

Alumni 2020

• Dr Justin Godbout (uOttawa) (Year 1)

Alumni 2019

• Dr Mohammad Fakhraldeen (McGill University) 

Alumni 2018

• Dr Daniel Beamish (uOttawa) (Year 1)
• Dr Harrison Carmichael (uOttawa ) (Year 1)
• Dr Simeon Mitchell (uOttawa) (Year 2)

Alumni 2017

• Dr Valérie Charbonneau (uOttawa) (Year 2)
• Dr Ayesha Zia (uOttawa)

Alumni 2016

• Dr Simeon Mitchell (uOttawa) (Year 1)

Alumni 2015

• Dr Valérie Charbonneau (uOttawa) (Year 1)
• Dr Nicholas Costain (uOttawa) 

Alumni 2014

• Dr Chris Fabian (uOttawa) 

Alumni 2013

• Dr Aseem Bishnoi (uOttawa) 

Alumni 2012

• Dr Michael Austin (uOttawa) 
• Dr Francois Bégin (Laval University, Quebec) 
• Dr Mark Froats (Queens University, Kingston) 
• Dr Andrew Willmore (uOttawa) 

Alumni 2011

• Dr Hani Ibrahim (Saudi Arabia) 

Alumni 2009

• Dr Cory Brulotte  (Calgary)

Alumni 2007

• Dr Abdulaziz Alrajhi (Saudi Arabia)

For a list of our Publications, please view our RPPEO site:

https://www.rppeo.ca/paramedic-practice/quality-patient-safety/research/research-news.html