There must be an appropriate administrative structure for each residency program.

Transcription

1 Specific Standards of Accreditation for Residency Programs in Physical Medicine and Rehabilitation INTRODUCTION 2008 VERSION 1.1 The purpose of this document is to provide program directors and surveyors with an interpretation of the general standards of accreditation as they relate to the accreditation of programs in Physical Medicine and Rehabilitation. This document should be read in conjunction with the General Standards of Accreditation and the Objectives of Training and the Specialty Training Requirements in Physical Medicine and Rehabilitation. STANDARD B1: ADMINISTRATIVE STRUCTURE There must be an appropriate administrative structure for each residency program. Please refer to Standard B1 in the General Standards of Accreditation for the interpretation of this standard. The program director in Physical Medicine and Rehabilitation must have Royal College certification in Physical Medicine and Rehabilitation, or equivalent acceptable to the Royal College. STANDARD B2: GOALS AND OBJECTIVES There must be a clearly worded statement outlining the goals of the residency program and the educational objectives of the residents. The general goals and objectives for Physical Medicine and Rehabilitation are outlined in the Objectives of Training and the Specialty Training Requirements in Physical Medicine and Rehabilitation. Based upon these general objectives each program must develop rotation specific objectives suitable for that particular program, as noted in Standard B2 of the General Standards of Accreditation. STANDARD B3: STRUCTURE AND ORGANIZATION OF THE PROGRAM There must be an organized program of rotations and other educational experiences, both mandatory and elective, designed to provide each resident with the opportunity to fulfil the educational requirements and achieve competence in the specialty. The structure and organization of each accredited program in Physical Medicine and Rehabilitation must be consistent with the specialty training requirements as outlined in the Objectives of Training and the Specialty Training Requirements in Physical Medicine and Rehabilitation. This document may be reproduced for educational purposes only provided that the following phrase is included in all related materials: Copyright 2012 The Royal College of Physicians and Surgeons of Canada. Referenced and produced with permission. Please forward a copy of the final product to the Office of Education, attn: Associate Director. Written permission from the Royal College is required for all other uses. For further information regarding intellectual property, please contact: documents@royalcollege.ca. For questions regarding the use of this document, please contact: accred@royalcollege.ca. Page 1 of 5

2 Residents must be provided with increasing individual professional responsibility, under appropriate supervision, according to their level of training, ability and experience. In addition to offering the components noted in the specialty training requirements, all accredited programs in Physical Medicine and Rehabilitation must offer community-based learning experience outside the academic learning centre. STANDARD B4: RESOURCES There must be sufficient resources including teaching faculty, the number and variety of patients, physical and technical resources, as well as the supporting facilities and services necessary to provide the opportunity for all residents in the program to achieve the educational objectives and receive full training as defined by the Royal College specialty training requirements. In those cases where a university has sufficient resources to provide most of the training in Physical Medicine and Rehabilitation but lacks one or more essential elements, the program may still be accredited provided that formal arrangements have been made to send residents to another accredited residency program for periods of appropriate prescribed training. Learning environments must include experiences that facilitate the acquisition of knowledge, skills, and attitudes relating to aspects of age, gender, culture, and ethnicity appropriate to Physical Medicine and Rehabilitation. 1. Teaching Faculty The faculty must include sufficient numbers of physiatrists and other qualified physicians or clinicians with an interest in postgraduate clinical training to appropriately teach and supervise residents on all clinical rotations, including all ambulatory care experiences. 2. Number and Variety of Patients There must be a sufficient number and variety of both inpatients and outpatients available to the program to allow residents to gain experience in the broad spectrum of clinical practice in the specialty. 3. Clinical Services Specific to Physical Medicine and Rehabilitation The program must provide experience in the following areas of the specialty: i. rehabilitation of patients with acquired brain disorders (including traumatic brain injury and cerebrovascular disease); ii. diagnosis, management and rehabilitation of patients with neurodegenerative disease, peripheral nerve disorders, and muscle diseases; iii. rehabilitation of patients with common and complex musculoskeletal disorders, including but not limited to polytrauma and inflammatory joint disease; iv. rehabilitation of patients with spinal cord disorders, including but not limited to spinal cord injury; v. rehabilitation of patients with amputation and the principles of prosthetic management; vi. principles of orthotic management; Page 2 of 5

3 vii. rehabilitation of the disabled child and adolescent; viii. diagnosis and comprehensive management of musculoskeletal disorders and pain syndromes; ix. rehabilitation of patients with cardiopulmonary disorders; x. rehabilitation of patients with complex medical conditions, including but not limited to HIV, cancer, burns, and solid organ transplant. a. Ambulatory The program must provide ambulatory care experiences, which must include appropriate clinical space and support resources. This may be in a traditional hospital outpatient clinic area, or in other settings that include a private office. Supervision by an appropriate clinical preceptor must be readily available to the resident for consultation at all times, consistent with the resident's level of training and experience. Timely review of all consultations with the preceptor must occur. b. Inpatient The program must provide inpatient rehabilitation experiences that include participation in interprofessional teams and the comprehensive care of patients admitted to the service. Supervision by an appropriate clinical supervisor must be readily available to the resident during the rotation, consistent with the resident s level of training and experience. Timely review of all admissions and or consultations with the preceptor must occur. c. Consultation Resident responsibilities must include consultations to services of all related medical and surgical disciplines, including but not limited to Internal Medicine, Neurology, Neurosurgery, Orthopedic Surgery, Plastic Surgery, and Rheumatology, in sufficient numbers to allow experience in physiatric consultation practice. d. Community Learning Experience All programs must offer community-based experiences. These experiences may contain any mix of inpatient, ambulatory care, and consultation responsibilities occurring outside a tertiary rehabilitation centre or unit. 4. Clinical Services Related to Physical Medicine and Rehabilitation The program must provide opportunities for experience in Internal Medicine, Rheumatology, Neurology and Orthopedic Surgery. 5. Supporting Services Specific to Physical Medicine and Rehabilitation - Clinical, Diagnostic, Technical a. Institutions participating in the program must have access to supporting facilities, including but not limited to the following diagnostic and consulting services: pathology; radiology, specifically musculoskeletal and neuroradiology; nuclear medicine; ultrasonography; Page 3 of 5

4 urodynamics; and electrodiagnosis. b. Adequate and prompt access to emergency support services must be available to all facilities in which training occurs. This must be sufficient to ensure quality of care and prevent inappropriate assumption of acute or intensive care roles on the part of rehabilitation staff and residents while on rehabilitation services. c. The participating teaching services must have adequate facilities and rehabilitation professional and support staff, appropriate for the size of that institution and its physical medicine and rehabilitation service. There must be good liaison between the physical medicine and rehabilitation services and community providers such as home care, geriatric or long term care programs, and support groups for the disabled. STANDARD B5: CLINICAL, ACADEMIC AND SCHOLARLY CONTENT OF THE PROGRAM The clinical, academic and scholarly content of the program must be appropriate for university postgraduate education and adequately prepare residents to fulfil all of the CanMEDS Roles of the specialist. The quality of scholarship in the program will, in part, be demonstrated by a spirit of enquiry during clinical discussions, at the bedside, in clinics or in the community, and in seminars, rounds, and conferences. Scholarship implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice. Please refer to Standard B5 in the General Standards of Accreditation, the Objectives of Training, the Specialty Training Requirements in Physical Medicine and Rehabilitation, and the CanMEDS Framework for the interpretation of this standard. Each program must develop a curriculum for each of the CanMEDS Roles, which reflects the uniqueness of the program and its particular environment. Specific additional requirements are listed below. 1. Medical Expert 2. Communicator In addition to the General Standards of Accreditation, the following requirement applies: - Programs must ensure that residents acquire the requisite skills to communicate effectively with patients, families, other physicians, other health and rehabilitation professionals, and community groups in settings that include team and family meetings. 3. Collaborator Page 4 of 5

5 4. Manager 5. Health Advocate 6. Scholar 7. Professional In addition to the General Standards of Accreditation, the following requirements apply: - Programs must ensure that residents receive training on ethical issues related to clinical practice, to research, and particularly to people with disabilities. Teaching may occur in formal seminars, courses or workshops, and as part of the clinical training in rehabilitation. STANDARD B6: ASSESSMENT OF RESIDENT PERFORMANCE There must be mechanisms in place to ensure the systematic collection and interpretation of assessment data on each resident enrolled in the program. Please refer to Standard B6 in the General Standards of Accreditation for the interpretation of this standard. Adopted by Council - September 1997 Revised Revised March 2004 Revised SSRC July 2008 Revised Specialty Committee 2011 Editorial Revision Office of Education September 2012 Page 5 of 5