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We implemented a novel transition-to-practice curriculum incorporating four new processes to prepare CCFP(EM) residents for independent practice. These elements were: 1) explicit sequencing of competency progression; 2) establishment of coaching teams; 3) establishment of independent shifts; and 4) implementation of a transition-to-practice seminar series. Exit surveys of residents rated the new curriculum highly with 15/17 (88.2%) residents reporting they felt prepared for independent practice. All residents rated competency progression, coaching teams, independent shifts and transition-to-practice series favourably. This framework can be used by other 1-year enhanced skills or other fellowship programs to prepare their residents for independent practice.

Periorbital swelling is a common presentation to the emergency department (ED), and its etiology can range from benign to acutely vision-threatening. Orbital subperiosteal hematoma is a rare ED diagnosis that is typically associated with trauma, though can infrequently occur spontaneously in the setting of sudden elevations in cranial venous pressure, bleeding diathesis, and sinusitis. We present a case of a 55-year-old female with a history of chronic sinusitis who presented to the ED with a three-day history of left-sided periorbital swelling along with painful extraocular movements and markedly decreased visual acuity following a cross-country road trip through elevation. Contrast computed tomography scan of the orbits revealed a large extraconal collection in the subperiosteal space causing significant mass effect on the left globe, along with findings of diffuse sinonasal disease bilaterally. Intravenous antibiotics were started immediately and the patient underwent surgical incision and drainage of the subperiosteal space, where she was diagnosed with a spontaneous subperiosteal orbital hematoma secondary to chronic sinusitis. Within the literature, there are fewer than 20 case reports of orbital subperiosteal hematoma secondary to sinusitis. The purpose of this case report is to assist emergency physicians in considering the rare but potentially vision-threatening condition of spontaneous subperiosteal orbital hematoma within their differential diagnosis of patients with periorbital swelling and proptosis, as well as to provide an approach to management within the ED.

The COVID-19 pandemic has created numerous unique challenges for the recruitment of prospective trainees. Cancellation of visiting electives and in-person interviews created challenges for programs to showcase elements that have been shown to influence applicants' program selection, including geographical considerations and program collegiality. Novel strategies have been recommended and employed to facilitate candidate recruitment, but it is unclear how influential such strategies are on candidates' program ranking. It is also unclear what factors influence program selection among CCFP(EM) candidates. We sought to evaluate the impact of novel recruitment strategies on applicants' ranking of the University of Ottawa CCFP(EM) program and determine factors which were most influential in applicants' first-choice program selection.An online survey was distributed to all candidates (n = 127) who applied to the University of Ottawa CCFP(EM) program. The survey instrument included 33 items. Respondents were asked to rate on a 3-point scale how influential specific recruitment strategies were on their ranking of our program and the influence of different training factors on their selection of first-choice program.The survey response rate was 27% (34/127). Recruitment strategies rated as most positively influential included virtual one-on-one meetings with program directors (100%), virtual QA sessions (77.8%), virtual communication with chief residents (73.3%), and a mailed personalized recruitment package (72.2%). The top factors influencing applicants' first-choice program selection included: collegiality between faculty and residents (96.4%); level of responsibility given to residents (96.4%); support within the program (96.4%); and procedural opportunities within the program (96.3%).Facilitating virtual personal interaction with program leadership is highly influential in how CCFP(EM) candidates rank programs. CCFP(EM) candidates value characteristics of a training program over the geographical location and available amenities. Program leaders should consider these findings when recruiting prospective candidates.RéSUMé: OBJECTIF: La pandémie de COVID-19 a créé de nombreux défis uniques pour le recrutement de stagiaires potentiels. L'annulation des stages optionnels et des entrevues en personne a créé des difficultés pour les programmes de présenter des éléments qui se sont avérés influer sur la sélection des programmes des candidats, y compris les considérations géographiques et la collégialité du programme. De nouvelles stratégies ont été recommandées et utilisées pour faciliter le recrutement des candidats, mais on ne sait pas dans quelle mesure ces stratégies influent sur le classement des programmes des candidats. On ne sait pas non plus quels facteurs influencent la sélection des programmes parmi les candidats au CCFP(EM). Nous avons cherché à évaluer l'impact de nouvelles stratégies de recrutement sur le classement des candidats du programme CCFP(EM) de l'Université d'Ottawa et à déterminer les facteurs qui ont eu le plus d'influence sur la sélection du programme de premier choix des candidats. MéTHODES: Un sondage en ligne a été distribué à tous les candidats (n = 127) qui ont postulé au programme CCFP(EM) de l'Université d'Ottawa. L'instrument d'enquête comprenait 43 points. Les répondants devaient évaluer sur une échelle de 3 points l'influence de stratégies de recrutement spécifiques sur leur classement de notre programme et l'influence de différents facteurs de formation sur leur choix du programme de premier choix. RéSULTATS: Le taux de réponse au sondage était de 27% (34/127). Les stratégies de recrutement jugées les plus influentes sont les réunions virtuelles en tête-à-tête avec les directeurs de programme (100%), les séances virtuelles de questions-réponses (77,8%), la communication virtuelle avec les chefs résidents (73,3%) et l'envoi par courrier d'un dossier de recrutement personnalisé (72,2%). Les principaux facteurs influençant le choix du programme de premier choix des candidats comprenaient: la collégialité entre le corps professoral et les résidents (96,4%); le niveau de responsabilité donné aux résidents (96,4%); le soutien au sein du programme (96,4%); et les possibilités de procédures au sein du programme (96,3%). CONCLUSION: Faciliter l’interaction virtuelle personnelle avec le leadership du programme a une grande influence sur la façon dont les candidats du CCFP(EM) classent les programmes. Les candidats CCFP(EM) valorisent les caractéristiques d'un programme de formation plutôt que à l'emplacement géographique et les commodités disponibles. Les chefs de programme devraient tenir compte de ces constatations lorsqu’ils recrutent des candidats éventuels.

Acute exercise increases myocardial tolerance to ischemia-reperfusion (I-R) injury in male but not in female rat hearts, possibly due to a decreased heat shock protein 70 (Hsp70) response in the female hearts. This study examined whether repetitive exercise training would increase Hsp70 and myocardial tolerance to I-R injury in female rat hearts. Adaptations in myocardial manganese superoxide dismutase (MnSOD) and endothelial nitric oxide synthase (eNOS) were also assessed. Ten-week old male (M) and female (F) Sprague-Dawley rats ( n = 40 total) exercise-trained for 14 wk; the last 8 wk consisted of running 1 h at 30 m/min (2% incline), 5 days/wk. Following training, left ventricle mechanical function (LVMF) was monitored for 30 min of reperfusion following 30 min of global ischemia (Langendorff procedure). Myocardial Hsp70 content was not different in M and F control groups, while increases were observed in both trained groups (M greater than F; P < 0.05). Although MnSOD content did not differ between groups, endothelial nitric oxide synthase (eNOS) levels were decreased in F, with no change in M, following training ( P < 0.05). Hearts from control F demonstrated a greater recuperation of all indices of LVMF following I-R compared with control M hearts ( P < 0.05). Hearts of trained M exhibited improved recovery of LVMF (left ventricular diastolic pressure, left ventrcular end-diastolic pressure, +dP/d t, −dP/d t) during reperfusion compared with control M hearts ( P < 0.05). In contrast, hearts of trained F did not show any change in recovery from I-R. Hence, exercise training is more beneficial to M than F in improving myocardial function following I-R injury.