St. Joseph’s Health Centre is committed to delivering exceptional patient experiences and shaping care through teaching and education. In keeping with these priorities, the St. Joseph’s Health Centre Medical Education Teaching Clinic opened in March 2016.
The SJHC Medical Education Teaching Clinic (METC) is a novel academic space which consolidates clinical care, teaching and research in a community ambulatory setting. With this new resource, we will strive to meet the healthcare needs of our community by providing valuable educational experiences to medical trainees, staff, physicians, patients and families. The Department of Medical Education, Research & Scholarship (DMERS) and the Medicine & Seniors Health Program have partnered to implement this initiative.
The METC consists of the following teaching clinics: Acute Care Surgery (ACS), Vascular Surgery, Palliative and Therapeutic Harmonization (PATH) and Early Arthritis/Connective Tissue Disease. It is located on 3 East in the main building (north end). The METC includes a reception area, a patient waiting area, four clinic rooms, and a physician office where physicians and medical trainees collaborate, debrief and participate in informal teaching opportunities during clinical time.
The METC also houses simulation equipment which allows trainees the opportunity to practice their clinical skills under the supervision of a faculty member, as well as two dedicated teaching rooms for the University of Toronto Faculty of Medicine Integrated Clinical Experience (ICE) Course for first and second-year medical students. As we strive to shape care through teaching and education, the METC Patient Education Resource Centre may be accessed to facilitate the educational needs of patients and families.
Acute Care Surgery (ACS) Teaching Clinic
Acute Care Surgery (ACS) is an evolving specialty with three essential components – trauma, critical care and emergency surgery. In 2014, the ACS service was launched as a branch of the General Surgery division at SJHC. This has allowed medical trainees to hone their skills in collaboration, communication and health advocacy.
The General Surgeons and General Surgery Residents refer patients from consultations in the Emergency Department. Emergency Department physicians and SJHC Academic Family Medicine physicians also refer patients with biliary colic and hernia diagnoses. General Surgery Residents continue to see consults in the Emergency Department and determine if a patient is stable enough to go home and return to be seen in the METC at a later time. Patients are then seen in the METC to determine whether they are surgical candidates and to meet with the surgical team. In addition, patients with complex discharges from the ACS service may receive their follow-up care in the Teaching Clinic.
Common surgical pathologies seen in the clinic include: laparoscopic cholecystectomy, hernia repair, small bowel resection, exploratory laparotomy, wound debridement, acute appendix (post-op only).
The clinic operates one morning per week to allow the team to prepare for operating room time in the afternoon. A portion of clinic appointment time is dedicated to teaching and review with the staff. If you are a medical trainee and want to learn more about the ACS rotation, contact us at email@example.com.
Early Arthritis/Connective Tissue Disease (EA/CTD) Teaching Clinic
The Early Arthritis/Connective Tissue Disease Teaching Clinic is a healthcare service for patients who exhibit symptoms that may indicate early rheumatoid arthritis as well as patients with connective tissue diseases. There are significant benefits to early diagnosis and management of these autoimmune diseases.
This clinic is a critical educational experience for family medicine residents as they are the primary referral base. By participating in this clinic, trainees develop the skills necessary for detecting patients that have new onset autoimmune rheumatogical disease. This addresses a gap which currently exists in their education and trainees are part of the process of investigation and development of the treatment plan alongside the rheumatologist. Learners have the opportunity to hone their skills in referral criteria, history taking, examination, ordering investigations, diagnoses and customizing/monitoring treatment plans. Internal medicine residents and fellows, medical students and physician assistant students benefit in the same way.
Patients meeting a strict clinical/laboratory profile are referred and screened. Referrals received by the Ambulatory Care Centre (ACC) which fall within the EA/CTD Teaching Clinic inclusion criteria, may be forwarded to the clinic for booking.
The clinic operates one afternoon every other week. New patients will be booked for a 1-hour initial consult with a trainee and a rheumatologist. A portion of clinic appointment time is dedicated to teaching and review with the staff. If you are a medical trainee and want to learn more about the Early Arthritis/Connective Tissue Disease Teaching Clinic, contact us at firstname.lastname@example.org.
Exceptional Patient and Learner Experience
We believe that the patients who receive care within the METC should be offered an exceptional care experience. The METC is a patient/family centered care environment, where continuity of care and seamless transitions are a priority. Complementing the patient care experience is access to the Patient Education Resource Centre, which will support the patient’s learning, engagement and education goals.
Mohs Micrographic Surgery Clinic
Mohs micrographic surgery is a subspecialized surgical procedure to remove skin cancers (basal cell carcinoma and squamous cell carcinoma). Named after Dr. Frederick Mohs, the Mohs procedure involves the removal of the tumour in its entirety while preserving the maximum amount of healthy surrounding tissue. Mohs surgery is generally reserved for high-risk tumours on the head and neck, where sparing normal tissue is of significant importance. The physician removes the skin cancer, examines the removed tissue under the microscope to ensure that the cancer is fully removed, and then does reconstructive surgery to fix the defect. Mohs surgery is a one-day, outpatient procedure that does not require an overnight stay in the hospital.
For patients: The Mohs team will work to make you as comfortable as possible during your day at the clinic. Click here for more detailed information on Mohs surgery and what you can expect on the day of your procedure.
For referring physicians: Please note that the Mohs procedure is reserved for biopsy proven basal cell carcinoma and squamous cell carcinoma on the head and neck.
Palliative & Therapeutic Harmonization (PATH) Teaching Clinic
The PATH Teaching Clinic is a healthcare service for older adults with serious health conditions. People with chronic illnesses and their families often face daunting questions about how to get the most out of life, how to make healthcare decisions that reflect individual values, how to manage symptoms, and what lies ahead. When existing health problems get worse, or new ones come along, frail adults and their families may be confronted with care decisions, and the impact of proceeding, or not proceeding, with recommended treatments or interventions offered. The PATH service is available to help patients and families consider options, implications and support around decision making.
The PATH team is led by a group of geriatricians, nurses and other health professionals who have specialized training and many years of experience working with frail, older adults and their families. They help guide patients and families through the process of making healthcare decisions that will protect the patient’s best interests and quality of life.
The clinic operates one afternoon per week. As part of phase II, we are accepting referrals from the Heart Function Clinic. Patients appropriate for a PATH consultation may also be referred by the Outpatient Geriatric Clinic. New patients are booked for a 2-hour initial consult with a team that includes a resident, a geriatrician and a registered nurse or occupational therapist. A portion of clinic appointment time is dedicated to teaching and review with the staff. If you are a medical trainee and want to learn more about the PATH Teaching Clinic, contact us at email@example.com.
The METC is designed to advance the teaching of the intrinsic CanMEDS roles and foster integration of these roles into practice.
As a site for innovation and development, the METC aims to facilitate and advance community-based ambulatory care research and education at the University of Toronto. These initiatives are pursued in collaboration with both the Wilson Centre and Centre for Ambulatory Care Education (CACE) at the University of Toronto.
Vascular Surgery Teaching Clinic
The Vascular Surgery Teaching Clinic is designed to facilitate timely management of vascular diseases at the primary care or acute care level of medicine. With the introduction of the Vascular Teaching Clinic, the aim is to support earlier identification of basic vascular diseases and offer patients access to a vascular service. Focused vascular intervention at an early stage may result in a reduction or slowing of certain vascular disease progression, and may in turn result in the avoidance of complex and life-altering interventions.
The Vascular Teaching Clinic at SJHC is considered an extension of the existing Regional Vascular Program and has been developed in collaboration with Toronto General Hospital (TGH) – the regional vascular site for the TC-LHIN. The Vascular Teaching Clinic offers Family Medicine and Internal Medicine Residents, as well as Physician Assistant and Medical Students who don’t currently have a vascular surgery rotation, the opportunity to learn how to manage patients with vascular disease.
The SJHC Vascular Teaching Clinic is non-procedural. Patients appropriate for the clinic will be non-emergent, and considered routine elective consults. Common surgical pathologies seen in the clinic include: aortic aneurysms, carotid disease, peripheral arterial disease, venous ulcers, non-healing ulcers for vascular assessment, other vascular pathology of concern. Patients appropriate for follow-up in a vascular clinic setting who prefer a west-end Toronto location may be referred. This may include patients who require consultation with a Vascular Surgeon or follow-up after surgery.
As per the current practice, SJHC patients who require consultation by a Vascular Surgeon will continue to be referred to the Regional Vascular Program at TGH (fax: 416 340 5029). Referrals that meet the SJHC Vascular Teaching Clinic criteria will be triaged by TGH and forwarded to the SJHC Vascular Teaching Clinic for scheduling.
The clinic operates one afternoon per week. A portion of clinic appointment time is dedicated to teaching and review with the staff, to ensure teaching around each case is provided.
If you are a medical trainee and want to learn more about the Vascular Teaching Clinic, contact us at firstname.lastname@example.org.
- Medical Learner– learners include medical students, residents, fellows, physician assistant students and nursing practitioner students. They provide the initial medical assessment of the patient, and may order testing and additional consultations as necessary in consult with the staff surgeon, and documents focus notes after each consult.
- Staff Physician – reviews each case with the resident and completes paperwork for testing, consultations, OR bookings, etc.
- Coordinator – develops systems and processes to achieve exceptional and efficient client and family centred care, including scheduling and supplies management
- Secretary – the patient’s first point of contact with the clinic. Organizes appointments and tests and communicates information regarding these to patients. Registers patients for appointments and manages health records.
- Registered Nurse/Registered Practical Nurse – provides an initial assessment of the patient’s health, including vital signs and medication review. Educates patients and families in self-management and disease management.
- Patients must register for every appointment. Please register 15 minutes prior to your appointment time. The registration desk is located in the St. Joseph’s Health Centre Medical Education Teaching Clinic, 3rd Floor, East Wing. If you are taking the East Wing elevators to the 3rd floor, you will exit in front of the Teaching Clinic reception area.
- Please bring your health card, all medications, supplements, and vitamins
- Please bring any additional medical documentation
- Patients who do not speak English are strongly encouraged to have a friend or family member accompany them to their appointment.
- Please use our health resources wisely. If you need to cancel or change your appointment, we require 48 hours advance notice. Please contact the clinic at 416-530-6607.
- If your condition worsens, please return to the Emergency Department.