About Sinai ED

“Mount Sinai ED builds leaders.  Several iconic EM leaders started their career here, and several continue to lead important programs provincially, nationally, and internationally from here.” - Howard Ovens, Ontario Expert Lead for EM

From award-winning clinicians, researchers, innovators, educators, and authors, we support personal and professional growth in our staff!

What is it like to work at Sinai ED?

Mount Sinai Hospital has developed a world-wide reputation for excellence in geriatric care, women’s and obstetrical health, surgical oncology, gastrointestinal diseases, diabetes, general psychiatry, critical care and cardiology.  It is a 442 bed hospital. Patient populations range from those who are part of Sinai Health complex specialty care programs to marginalized inner city groups and all in between. Sinai ED has achieved the best combined wait time scores of any adult academic hospital in the province, despite increasing volumes and complexity of patients. Having said that, our priority is to provide excellent patient care and physicians are encouraged to practice at the pace they feel most comfortable.

"Sinai is an academic teaching hospital that *feels* like a much smaller community hospital. People who work at Sinai often stay for the duration of their careers. Therefore, you get to know many people outside of the ED, and it it creates a culture whereby you know each other by first name, you can email or call another physician directly if a patient concern arises, and you feel a shared sense of purpose to provide excellent patient care." - Catherine Varner

What resources do I have available on shift?

Mount Sinai Hospital is a well-resourced emergency department. 

We have a full cohort of Nurse Practitioners and Physician Assistants working in the department alongside our physicians in a shared care model.  We have Geriatric Emergency Medicine nurses (16 hours a day), Social Work (19 hours a day),  Physiotherapy and Occupational Therapy (8 hours a day) and Respiratory Therapy (24 hours a day). We have a Pathway-to-Peers program which supports youth and young adult patients, as well as Maximizing Aging Using Volunteer Engagement program.

We also have a newly launched Psychiatric Emergency Services team comprised of mental health clinicians and a psychiatrist located in the ED. 

Regarding specialty services, the majority of specialties are available for consultation and outpatient follow-up. Access to imaging modalities including CT, U/S, and MRI are available 24/7.

What EMR system do you use?

Mount Sinai Hospital uses a Cerner FirstNet & Powerchart Electronic Medical Record system. The ED currently uses a blended model of paper charts for documentation, with EMR to access patient records and labs. In the future, integrated electronic charting with the option for dictation will be available on the Cerner system. 

How are your shifts set-up or scheduled?

Scheduling is completed 3 months in advance via Metricaid, a scheduling software system where physicians are able to enter their availability, preferences, and requested time off. There is an equitable distribution of shifts amongst the group including weekends, nights and holidays, even amongst new staff. Given the collegiality and responsiveness amongst the group, trading shifts is often easy to do!

The vast majority of shifts are structured so that the first few hours will start in "Major/Resusc", rotate to "RAZ - Rapid Assessment Zone", then finish in "AC - Ambulatory Care". This allows for a natural progression in decreased acuity in order to allow for reassessments and patient dispositions. At the end of the shift, handovers are acceptable and encouraged in order to help physicians finish on time.

There are up to 8 shifts a day with additional on-call support. Most of the shifts having multiple overlapping coverage in the ED.  For new staff, we avoid scheduling them with learners or on overnight shifts until they are acquainted with our department.

Do I need a Masters or FRCPC to work at Mount Sinai ED?

We welcome and celebrate diversity in our group! We have a range of CCFP-EM, FRCPC and ABEM trained physicians. As one of the core training sites for the U of T CCFP-EM program, our site is predominantly CCFP-EM trained. While we support academic interests, having additional training such as an advanced masters degree or specialty focus is NOT a requirement.

The Mount Sinai Emergency Department is a longstanding leader in emergency medicine education. It has a strong learning culture that's committed to excellence and has helped create the foundations of multiple landmark programs, such as the CCFP-EM program, the Geriatric Emergency Medicine fellowship, the Supplemental Emergency Medicine Experience (SEME) and the Israeli Emergency Medicine Fellowship.

We have a wide range of undergraduate and postgraduate learners that rotate through our emergency department. Physicians are actively involved in bedside teaching and clinical supervision, and can choose to participate in interdisciplinary sessions, lecture series, and skills labs. There are also many opportunities for faculty development and continuing medical education through initiatives such as in-situ simulation, ultrasound fellowships and procedural skills days.

Many physicians at Sinai have gone on to hold major educational leadership roles at the University of Toronto and the DFCM Emergency Medicine Division.

Are there opportunities for research?

Mount Sinai Hospital is home to the Schwartz/Reisman Emergency Medicine Institute (SREMI), a not-for-profit research, education and health policy institute, established in November 2013 by a founding gift from the Schwartz/Reisman Foundation. SREMI is a partnership of the Sinai Health and North York General Hospital (NYGH) and includes a team of scientists, educators and staff, with expertise in research methodology, biostatistics, knowledge translation and dissemination. This infrastructure creates a vehicle to support sustained and stable funding for researchers and educators to conduct meaningful work on a long-term basis.

"Our network brings together some of Canada’s leading emergency medicine educators and researchers with expertise in patient care efficiency, care of the elderly, education, simulation and research. We will work hard to improve the effectiveness and efficiency of emergency departments, train the next generation of emergency department healthcare providers and attract the world’s best and brightest minds in the field, all with the goal of improving patient care." - Dr. Bjug Borgundvaag, Director of the Schwartz/Reisman Emergency Medicine Institute

Click here to learn more about SREMI

What is remuneration like?

Mount Sinai ED offers a competitive compensation structure for clinical shifts and academic work via Alternative Funding Agreement (AFA) and Alternative Funding Plan (AFP). 

For clinical work, physicians receive a base pay per shift (with a higher rate for weekends, nights and holidays), then receive an additional rate per patient.

For academic work, emergency physicians receive an hourly rate for teaching, administrative and leadership obligations such as teaching procedural skills seminars, lectures, mentorship, and journal clubs.

Many physicians in the department have a blended source of income due to compensation from other leadership roles, research, and more.

Any downsides to working at MSH ED?

Because Mount Sinai Hospital is located along University Ave, where five hospitals are located within a few city blocks, there can be limited exposure to certain patient populations.

For example, given that the world-renowned Hospital for Sick Children is located across the street, pediatric populations rarely present to Sinai ED. Moreover, major trauma presentations often get diverted to trauma centre St. Michael's Hospital.

Many emergency physicians from the group continue to have exposure to these populations via teaching, simulation, rural locums or additional work at other ED sites.