91

Training Pathways

The program consists of training in three broad phases – clinical medicine, academic training, and rotations in public health practice – with some flexibility in the amount of time devoted to each, and the possibility of receiving credit for prior work in these domains. Depending on the time devoted to each of the training phases, there are three potential training pathways (see below). Residents can choose any of these pathways based on their past experience and long-term career goals. Residents who choose Option 3 will have the opportunity to develop competencies in a specific key area (e.g. health protection, health promotion, environmental health, etc.) or may choose to consolidate core public health competencies with a placement in a variety of urban and non-urban settings.

Training pathways

PGY 1

PGY 2

PGY 3

PGY 4

PGY 5

Option 1: Standard PHPM Training

Basic Clinical Training

MSc Epidemiology

MSc Epidemiology

Core PH&PM rotations

Core PH&PM rotations

Option 2: CCFP Certification

Family Medicine

Family Medicine

MSc Intensive Program

Core PH&PM rotations

Core PH&PM rotations

Option 3: Integrated Practicum

Basic Clinical Training

MSc Intensive Program

Core PH&PM rotations

Core PH&PM rotations

Concentration year

Phase 1

Patient Care/Clinical Training phase (1 or 2 years). There are two options:

This phase of training is organized in collaboration with the Department of Family Medicine of 91 in one of their approved training sites. All residents do at least one full year of clinical training.

Our residents can choose from two trajectories during Phase 1:

  1. 1 year of Basic Clinical Training. This involves 6 months of Family Medicine rotations and 6 months of electives, including several periods of introduction to public health practice. Electives are chosen by the resident in consultation with a PHPM program advisor. Many electives are available in the 91 system, including Addictions, Adolescent Medicine, HIV/ STI & Infectious Diseases, Maternal & Child Health, Occupational Health, Toxicology and Tropical Medicine. Residents who choose this option will be based at training sites in Montreal.
  1. 2 years to complete training in Family Medicine. There are two elective blocks available in this option and they must be in domains pertinent to public health practice and chosen in consultation with the PHPM program advisor. Residents who choose this option are expected to successfully completeCCFP certification. One position is available at a Montreal-area teaching unit (GMFU) and one position is available at GMFU Gatineau. Resident preferences with regards to the training site will be taken into consideration, however assignment of the specific Family Medicine teaching site will be dependent on availability. If impossible to meet all preferences, residents will be randomly assigned to available sites.

N.B. PH&PM specialists practicing in Quebec can maintain a clinical practice without having certification in family medicine.

Phase 2

MSc (Epidemiology) (1 or 2 years).

The program's academic training is done in the Department of Epidemiology, Biostatistics, and Occupational Health at 91. The Master's degree is to be done in a thesis (Epidemiology) program. 91's Master's of Epidemiology has a strong emphasis on quantitative methods. Residents will find themselves well-served by this solid foundation in epidemiological methods in their future practice as public health specialists. Completion of the M.Sc. degree is considered an asset for trainees and is recognized as one of the strengths of the 91 Residency Training Program in PH&PM.

During the academic phase, our residents again have two choices:

  1. MSc Epidemiology, regular program (2 years). This program involves 1 year of courses and 1 year of research leading to a thesis. The thesis project and supervisor must be identified near the end of the first year of the MSc.
  2. MSc Epidemiology, intensive program(1 year). This program involves completing coursework and the thesis project simultaneously. This requires that a thesis project and supervisor be identified before applying for the program. See admission and application information here. This training experience is usually completed during PGY3 and provides the resident approximately 15 raining periods to complete the MSc.

It is possible to complete some of the coursework at the Université de Montreal (up to 10 credits: ) which offers numerous courses in Health Administration and Public Health programming and evaluation (courses are taught in French but assignments can be submitted in English).

A list of the various courses and topics available to residents can be found on the department website.

Tuition fees are waived for residents for the first three semesters of full time study. Residents completing the Master's in the intensive program are not subject to tuition fees and those who opt for the two year master's program pay only the additional session fees for their final semester of study.

*Residents with prior graduate-level training in epidemiology or public health may be able to have this portion of their residency training partially or fully credited.

Phase 3

Field Placements in Public Health & Preventive Medicine(2 years, plus a few short rotations in the early years). This is the “core” of the program. The time spent in this phase will vary (from 2 to 3 years) depending on residents’ previous experience, time spent in previous phases, as well as their main career goals. During the first year of the practicum, residents acquire basic competencies in public health surveillance and health protection. The second year is used for developing cross-cutting competencies in health promotion / disease prevention and planning / management, as well as for integration of multiple functions and roles. Residents who choose a three-year practicum phase will have the opportunity to deepen selected competencies and skills during their R5 year.

Junior rotations (R1-R3):

Residents are expected to complete an Introduction to Public Health & Preventive Medicine (1 period) rotation early in their first year of training. They then undertake an additional 2-3 periods of PH&PM field placements (Introduction to Aboriginal Health; Introduction to Reporting, Investigation & Intervention (RII)) during PGY1-3 training years. The aboriginal health block is preferably done after a rural Family Medicine rotation in an aboriginal community.

In addition, all residents will be expected to participate in on-call responsibilities for infectious diseases and environmental health as of the PGY2 year, or upon completing Introduction to RII. The intensity of this commitment will depend on concurrent on-call responsibilities in other clinical services. These public health rotations in the early years of training help the resident become familiar with Public Health practice well before field placements begin and help to foster an esprit de corps among all of our residents despite the fact that training takes place at several different institutions.

Senior rotations (R4-R5):

  • Surveillance (2 blocks)
  • Infectious diseases (3blocks)
  • Environmental health (2blocks)
  • Occupational health (2blocks)
  • Promotion/prevention (2blocks)
  • Management and planning (2blocks)
  • Integration (5 blocks)
  • Electives (3-5blocks)

These training experiences allow each resident to gain a working knowledge of the programs and projects in each of the department's units, and to develop skills relevant to core public health functions, including community diagnosis, program planning, implementation, and evaluation. In each unit, the resident becomes an integral member of the team. Each resident also has the opportunity to deepen his/her involvement with a particular field of practice, by returning to that placement in their final year for more experience.

These training placements, the core of practical training in the public health sciences, are primarily based at Montreal Public Health (principal teaching site: . With an urban population of 1.8 million, the Montreal health region presents all the challenges of modern public health practice: preventing chronic diseases such as diabetes; promoting smoking cessation; reducing harms associated with drug use; sexually transmitted infections and HIV; delivering public health programs such as vaccination, mother and child care, and school health; promoting healthy public policies; creating supportive environments for health; empowering communities and neighbourhoods; addressing a range of social determinants of health in a highly diverse population (poverty, education, etc.); communicating with different ethnic communities effectively; and measuring the impact of change in the health care sector.

Field placements are also available in Quebec's Regional Public Health Units, including in the Laval, Montérégie and Outaouais health regions, as well as the Cree Territory in James Bay and the Nunavik region. The Aboriginal Health rotation includes one period of patient care in a rural location followed by one period of applied PH&PM practice in an institutional setting.

International and out-of-province electives which are approved by the 91 Postgraduate Office and by the Collège des médecins du Québec can be arranged. For example, residents may participate as Affiliates in thewhich is usually done as part of core training in infectious diseases. These elective experiences are limited to a total of three months during the course of training in order to be remunerated.

During the field placements at Montreal's Public Health Department, residents are provided with the necessary resources (desks, computers, telephones, internet, photocopying, and printing facilities), as well as access to the Centre de Documentation (library). The program also has a "teaching suite"for residents and faculty to facilitate cross-teaching site interactions (e.g. videoconferencing).

Concentration Year

Some learning outcomes are best achieved or consolidated through periods of more focused, repeated and directed practice. Trainees who spent only one year in each of the first two phases may use their R5 year to further consolidate specific competencies or promote their generalist skills within specific settings, thus enhancing their particular career aims. This concentration year may be undertaken in a variety of local and regional settings, including public health departments in rural settings, INSPQ, INESS, PHAC, etc. For trainees intending to pursue a career in international public health, training may be possible with WHO or other international agencies abroad.

Academic Curriculum

All residents (PGY1-5) are required to attend academic half-day sessions occurring on average twice per month. During the PGY4-5 years, residents are also encouraged to participate in weekly seminars offered by the Department of Epidemiology, Biostatistics and Occupational Health and clinical rounds at Montreal Public Health. Also during this phase, residents are encouraged to participate in weekly lunchtime sessions coordinated by the University of Sherbrooke and held at a nearby university campus. During the PGY5 year, residents are supported in their preparation for the RCPSC exams by participating in oral exam simulation sessions between January and April.

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