This is a 15-bed closed unit in the tertiary care hospital which accepts major trauma and houses the bone marrow transplant, and lung transplant programs. The unit has moved into a newly constructed ICU in 2007. The unit is busy as beds often are in short supply in the region.
All requests outside of Winnipeg for Critical Care beds are primarily directed through the attending physicians in the tertiary Intensive Care Units. Most of this activity is co-coordinated by the Medical Intensive Care unit attending physician at the Health Sciences Centre. The Central Bed Registry identifies the status of all ICU beds in the Winnipeg region and facilitates the identification of available beds at any time of the day or night.
An independent Critical Care transport service has been established to provide safe and timely interfacility transport of critically ill patients to the most appropriate available ICU bed in the region during periods of intensive pressure on Critical Care beds.
Attending physicians actively triage and negotiate interfacility transfers of the most stable patients in tertiary Intensive Care units to community hospital ICUs in order to accommodate patients in urgent need of tertiary or quaternary care.
The rotation in the Medical Intensive Care Unit at HSC is designed to allow the resident to encounter patients with tertiary care medical problems requiring ICU admission.
Common problems encountered will include cardiorespiratory failure, immunocompromised patients, patients with hepatic failure, poisoning, post cardiac arrest patients, and patients with multiorgan system failure/dysfunction. Experience with these patients will enable the resident to develop the knowledge, skills, and attitude necessary to be a Critical Care physician as outlined in the “Goals and Objectives” document of the University of Manitoba program.
Residents will also encounter surgical patients as (in times of bed shortage in SICU) surgical patients will be admitted to the MICU and cared for by the MICU team.
The unit has full invasive monitoring capabilities, access to CRRT machines, invasive (including High Frequency Oscillation) and non invasive ventilation capability, IABP support, and ICP monitoring. There is a satellite pharmacy to support this unit.
Residents see consults from the hospital wards and the Emergency Department. Staff in this unit is responsible for responding to cardiac arrests within the HSC complex. On average one-four consults are received each day.
This is an 12-bed semi-open unit in the tertiary care hospital which accepts major trauma and houses the bone marrow transplantation, and lung transplant programs. It too has recently moved into a newly constructed ICU in 2007.
The rotation in the Surgical Intensive Care Unit at Health Sciences is designed to allow the resident to encounter pre and post operative surgical patients and enable the resident to develop the knowledge, skills, and attitude necessary to be a Critical Care physician as outlined in the “Goals and Objectives” document of the University of Manitoba program.
Specifically, those goals and objectives that deal with Surgical Intensive Care, neurosurgery, trauma, lung transplantation, and burns are to be considered during this rotation.
A large portion of the population in this unit is neurosurgical and neuro trauma patients. Multisystem trauma patients are also accommodated in SICU. Cardiac Surgery has been consolidated at St. Boniface Hospital effective January 15, 2007, but cardiac patients (primarily trauma patients who require cardiac surgery) can still be accommodated in this unit.
The unit has full invasive monitoring capabilities, access to CRRT machines, invasive and non invasive ventilation capability, IABP support, and ICP monitoring. The satellite pharmacy also supports this unit. The residents see consults from the hospital wards, recovery and operating rooms, and the Emergency Department.
At times the unit staff will care for more than 12 patients as ICU patients may be accommodated in the Recovery room when beds are in short supply. On average two-three consults are received each day.
St. Boniface Medical/Surgical ICU
This is a 10-bed unit in the non trauma tertiary care hospital in Winnipeg. There is potential for this unit to expand to 14 beds in the future. The unit moved into newly renovated space in 1998. The hospital is developing as the main clinical site for the WRHA Cardiac Sciences Program. Routine cardiac surgery has been consolidated at this site effective January 2007. Most of the invasive cardiology in the city is occurring at this site.
The rotation in the Med/Surg Intensive Care Unit at St. Boniface is designed to allow the resident to encounter a broad range of patients with tertiary care medical and surgical issues who require ICU admission, and enable the resident to develop the knowledge, skills, and attitude necessary to be a Critical Care physician as outlined in the “Goals and Objectives” document of the University of Manitoba program.
Common problems encountered include cardiorespiratory failure; post cardiac arrest patients; poisoning; septic, cardiogenic and hypovolemic shock; high-risk general and vascular surgery patients; high-risk patients from other surgical services (Obstetrics and Gynecology, Urology, Otolaryngology, and Plastic Surgery); and patients with multiorgan system failure/dysfunction.
Residents and attendings working in the Med/Surg ICU are also responsible for responding to Code Blue calls in the St. Boniface Hospital complex.
The unit has full invasive monitoring capabilities, access to CRRT machines, invasive (including HFO) and non invasive ventilation capability, and IABP support. The residents see consults from the hospital wards and the Emergency Department. At times the unit staff will care for more than 10 patients as MICU patients maybe accommodated in the Recovery room when beds are in short supply. On average two-four consults are received each day.
The St. Boniface site has implemented an electronic medical record including physician order entry.
St. Boniface Intensive Care Cardiac Sciences
This unit was created January 15, 2007. In March 2011, a new 10 bed unit was constructed in the St. Boniface Hospital complex. The unit is the major support for Cardiac Surgery in the WRHA. Current targets for Cardiac Surgery case volume are 1200 cases per year.
Three cardiac OR’s run most days with 25-30 cases targeted per week. The unit is unique in the Winnipeg system as there is an attending intensivist assigned to the unit and present in the hospital at all times. For continuity of patient care one intensivist is assigned for 58 hours per week (five ten hour day shifts Monday to Friday, and two four hour day shifts Saturday and Sunday). The remaining 110 hours in the week are covered by other intensivists working 14 hour night and 20 hour weekend shifts. As a result the unit is not dependent on house staff to provide clinical service. House staff rotating in this unit have an opportunity to work with cardiac anesthetists and get experience with TEE, and intraoperative management.
The unit has full invasive monitoring capabilities, access to CRRT machines, invasive (including HFO) and non invasive ventilation capability, and IABP support. Over the past two years an active mechanical cardiovascular support program has been established in the WRHA and ECMO and VAD patients are commonly resident in this unit. Medical staff in the unit are responsible for responding to Code Blue calls from the cardiac surgery inpatient ward and the Asper Centre.
How much do I get paid?
|July 1, 2010
There is also an on call stipend for EACH in house call as follows:
|July 1, 2010
In addition, residents in the program are paid a yearly stipend above and beyond the base salary. This is not deducted at source allowing residents to claim this income as “professional income” and deduct some expenses. This should be done with advice from a competent tax professional.
What is ‘Lifeflight?’
Life Flight is the Manitoba Provincial Air Ambulance Program. The plane is a Cessna Citation jet run by the Provincial government with high safety standards. Medical coverage is provided by Critical Care residents and Emergency physicians. Expansion to include rotor wing transport is currently underway.
Lifeflight is run and administered by the Manitoba Health & Healthy Living Emergency Services Branch. Life Flights shifts run from 8 a.m. - 8 a.m. the following day. Physicians covering the service become the ‘in-charge’ physician when they arrive to pick up the patient. This is an opportunity for autonomy and graded responsibility. Backup is provided by the intensivists in the unit the patient is destined for and from the medical director of the Air Ambulance (who is a practicing intensivist). Specific academic sessions on aeromedical transport are provided.
Residents are paid regardless of whether they fly or not. The catchment area is Manitoba, Northern Ontario and Northern Saskatchewan.
Shift reimbursement for Lifeflight is as follows:
- Adult, Pediatric and Obstetrics/Gynecology: $1,305.20
- Adult and Pediatrics only: $1,138.27
Internal medicine background residents receive funding for a PALS course to help make them more comfortable with pediatric transports. Advice/backup for pediatric calls can be obtained from the PICU attending on call. Pediatric issues will also be covered during academic day sessions.
There is a requirement to do in-house call during both years of the program. The requirement is 45 call equivalents during year one and 35 call equivalents during year two. A 17-hour (1600-0900h) shift is one call equivalent. A 24-hour shift (0900-0900h) is 1.5 call equivalents.
ICU program residents will generally do four-five calls per four week ICU rotation. They may do call in ICU during elective or research rotations. On occasion, the call shift for a Critical Care Program resident may be to provide direct in hospital back up for an inexperienced junior resident. These shifts count as a full call equivalent for the Critical Care Residents.
In return for providing this in hospital coverage the program has arranged an extra stipend in addition to their Resident salary. This is paid via the Winnipeg Regional Health Authority (WRHA). If a resident does more than 45 call equivalents in year one or 35 call equivalents in year two, they are additionally remunerated at the current Resident replacement rates established by the WRHA.
When assigned to an ICU the resident is excused from clinical duties after morning rounds if they were on call the night before. Resident duties must terminate within two hours of a 24-hour on call shift, including time for sign over and residents can do in-hospital call no more than seven times in a 28 day rotation.
How cold is it?
Supports the contention that it is a “dry cold”!
Don’t say we didn’t warn you! On the plus side you will be spending lots of time in the units…….
Winnipeg is a friendly, multi-cultural city of approximately 700,000, situated in the centre of Canada. It is fairly laid back as a city with a friendly atmosphere, but has more culture than most of the large cities across Canada.
Winnipeg is home to the Royal Winnipeg Ballet, the Winnipeg Symphony Orchestra, Manitoba Opera, and many theatre companies, including Rainbow Stage and Manitoba Theatre Centre. We are also known for our variety of excellent restaurants, serving food from all parts of the world. The Winnipeg Blue Bombers, and the Winnipeg Goldeyes are ever popular for the sports fan. A new NHL team will begin their season in the MTS Centre downtown this year.
Summers in Winnipeg are filled with festivals, including the Folk Festival (which is outstanding!), the Jazz Festival, the Fringe Festive, and unique to Winnipeg, Folklorama.
As Winnipeg is in close proximity to numerous lakes, parks and beaches, there is no shortage of places to camp, fish and hike. The summers are sunny and very hot for the most part. This also makes ideal weather for many summer sports including ultimate Frisbee, football and running (through our numerous parks).
Winnipeg is also known for its cold winter months. The readily-available snow allows for a variety of winter sports and gives an ideal setting for the Festival du Voyageur. We are also home to many professional and amateur sports teams, including the Winnipeg Blue Bombers (football) and the, Winnipeg Goldeyes (baseball).
Finally, Winnipeg has an affordable cost of living in Canada. It is easy to find a very nice apartment within ten minutes of either hospital for a reasonable cost. Food, gas and car insurance are also quite a bit less expensive than other provinces, so your money goes further.