There is one month of elective time in the PGY1 year and a total of nine months of elective time in the PGY2 through PGY5 years. These nine months of electives generally are taken toward the end of the residency, however the program allows the flexibility to insert elective time at any point in the PGY2 to PGY5 years. These electives have been used for a variety of purposes, both to round out education and enhance areas of interest or weakness. Some examples of popular electives are as follows:

1.    TOXICOLOGY/EMS - This elective allows the resident to get concurrent experience in EMS and Clinical Toxicology. One half of this elective involves being on-call for Clinical Toxicology through the Poison Control Centre at Sick Children's Hospital in Toronto. The resident on-call will take calls from Poison Control nurses, and direct the management of toxicologic cases that come through this large Poison Control Centre. The resident is backed up by a board-certified medical toxicologist to discuss cases as they come in. In addition, the resident attends weekly rounds at the Hospital for Sick Children in Toronto, and is occasionally responsible for a case presentation and discussion. As the call for this elective is every other week, in the "off weeks" the resident can focus on the EMS portion of the elective.

This elective provides the resident with opportunity to gain clinical and administrative experience in emergency medical services. The resident is responsible for frequent ride-outs with the paramedics, both on land and through the ORNGE air base at the London, ON airport.  In addition to these clinical observation periods, the resident is responsible for one project done in concert with the Medical Director of Prehospital Care. This project may involve audits, literature reviews in prehospital care, or small research projects.

2.    TOXICOLOGY – NYC – In addition or substitution of the above tox elective, residents may choose to do a 1month elective at Bellevue Hospital in New York City, the birthplace of toxicology in medicine.  Responsibilities include daily attendance at emergency morning rounds at Bellevue Hospital, followed by call-backs and teaching at the New York City Poison Control Centre. 

3.    CLINICAL TEACHING SKILLS - An elective in clinical teaching skills provides the senior level resident with experience and feedback at clinical teaching in the emergency department. The resident is on-duty for case review with more junior level housestaff in the emergency department. The resident is not responsible for seeing patients primarily and is there only to provide an educational experience for more junior housestaff. The residents are observed and given feedback on their teaching skills by the consultants on-duty. Additionally, the resident is expected to supervise, in an observed way, a small group teaching session. Finally, at least one lecture-based presentation is given by the resident and feedback on the lecture provided by consultants. In addition to these practical teaching skills with feedback, the resident is expected to work on one scholarly project on medical education during this two month elective. This may involve the development or revision of an innovative curriculum in education for emergency medicine, the initiation of a research project in medical education, or a literature review on an educational topic of interest.

4.    TRAUMA - An elective experience has been negotiated through the Maryland Institute of Emergency Medical Services at the University of Maryland. During this one month elective, the resident acts as a member of the Trauma Team at the Shock/Trauma Institute in Baltimore, Maryland. Here, the resident sees a wide variety of inner city penetrating trauma at one of the world's busiest trauma centres. This popular elective allows residents exposure to a high volume of trauma not normally seen in Canadian centres. Residents are eligible to receive support for travel and accommodation from the program for this elective.

Another trauma elective has been organized at Tygerberg Hospital in Cape Town, South Africa.  It is encouraged that elective time be at least 2 months due to the costs associated and time spent travelling to and organizing the elective.  The Princess of Wales Trauma Unit at the Tygerberg Academic Hospital is the teaching hospital Level 1 (equivalent) Trauma Centre for the Northern Suburbs of the Western Cape, South Africa. It is situated in the Tygerberg Hospital, a 1400 bed multidisciplinary teaching hospital. It is a “trauma only” emergency unit separate form the other hospital emergency units.

5.    MISCELLANEOUS ELECTIVES - Residents are encouraged to use elective time towards areas of interest. Residents looking to pursue further training in subspecialty areas of emergency medicine are encouraged to try and incorporate some of their subspecialty training into their elective time. Residents in the past have used this time toward certification in critical care, anaesthesiology, medical education, sports medicine, masters in business administration, advanced degrees in clinical epidemiology and Masters of Business Administration. Other opportunities exist and are generally supported by the program committee