Competencies

The Seven Roles

Enabling Competencies by CanMEDS Role

Medical Expert

The fellow integrates knowledge, clinical skill and judgment to deliver safe, patient-centred neurological consultation to critically ill neonates and PICU patients.

Patient-centred assessment & management

Define the precise clinical question and prioritize the issues in a consultation.
Perform a gestational-age-appropriate neurological examination and apply neurobehavioural tools — general movement assessment and Sarnat staging.
Select the right neurodiagnostic study — neuroimaging, EEG/aEEG, evoked potentials, NIRS, CSF, metabolic and genetic testing — and integrate reported results into a differential.
Establish goals of care and a management plan, applying neuroprotection, therapeutic-hypothermia eligibility, anti-seizure management, analgesia, anticoagulation and tone management.
Understand ventricular reservoir tap and therapeutic LP, indications for neurosurgery, and neurological determination of death in the neonate.

Breadth of applied clinical knowledge

Foundations: neuroanatomy, physiology & embryology; normal and abnormal brain development and malformations.
Preterm injury: GMH-IVH, PVHI, PHVD, white-matter injury/PVL, cerebellar hemorrhage, HIE.
Term injury: HIE, encephalopathy of other causes, hemorrhagic and perinatal arterial ischemic stroke, sinovenous thrombosis.
Seizures: neonatal seizures, epilepsy & genetic epilepsies, and mimickers.
Systemic, metabolic, vascular & maternal: CHD & CDH, hypoglycemia, bilirubin-induced dysfunction, IEM, CNS infection, AVM & vein of Galen, traumatic injuries, and the floppy neonate.

Primary interpretation of MRI, cranial ultrasound and EEG is taught and assessed in the dedicated Neuroimaging and EEG rotations; on the consult service the fellow orders the right test and integrates the result.

Communicator

Build therapeutic relationships with empathy, respect and compassion, including palliative and end-of-life care.
Elicit and synthesize antenatal, perinatal and family history with the family's perspective.
Explain diagnosis, results, prognosis and plan clearly, checking understanding — including abnormal neuroimaging.
Communicate a range of prognoses and engage families in shared decision-making about ongoing, redirected or end-of-life care.

Collaborator

Work within the consultant role, conveying recommendations that enhance patient management.
Engage the referring service and other consultants to coordinate care, including transport.
Manage differences, resolve conflict respectfully and hand over care safely.
Maintain professional relationships across neonatology, neurology, neuroradiology, neurophysiology, neurosurgery, pathology and the PICU.

Leader

Triage referrals — establish the question, judge urgency, communicate with the referrer.
Manage the consultation load through prioritization, delegation, follow-up and time management.
Apply quality-improvement methods — audit, peer review and incident reporting.
Practise resource stewardship and recognize how service organization and neuromonitoring affect outcomes.

Health Advocate

Identify social determinants affecting neurodevelopment and facilitate access to rehabilitative and early-intervention services.
Educate families about neuroplasticity and the interventions that support it — early therapy and family-integrated care.
Incorporate prevention, health promotion and surveillance, and advocate for system-level change.

Scholar

Present clinical cases in structured academic settings at least once per block.
Teach NNCC topics to residents and other professionals, with literature review and critical appraisal.
Integrate best available evidence into consultation recommendations.
Complete the assigned Thinkific education modules and a scholarly project across the year.

Professional

Apply best practice and high ethical standards, attending to gender, sexual orientation, age, culture, belief and ethnicity.
Recognize the ethical considerations specific to the newborn with neurological disease, including prognostic uncertainty and life-sustaining treatment.
Adhere to professional codes and the laws governing practice.
Demonstrate accountability and attend to personal health and well-being to sustain safe care.

Curriculum Plan

How Each Major Task Is Taught & Assessed

Every portfolio task is developed through multiple learning experiences and verified through multiple assessment methods — programmatic by design.

Major Task	Primarily learned / taught through	Assessed through
1 · Consultation for critical neurological conditions	NNCC consult service · NICU rotations · NICU on-call · neurological examination · cranial ultrasound · brain imaging · neurophysiology	Direct observation Case review Consult notes ITER
2 · Antenatal consultation	Antenatal consult service · brain imaging · case reviews	Direct observation Oral case presentation
3 · Neurodevelopmental follow-up	Neonatal follow-up clinic · neurological examination	Direct observation Clinic notes
4 · Interdisciplinary collaboration	NNCC consult service · NICU rotations · neuroradiology rounds	Observation forms Multisource feedback
5 · Family counselling	Consult service · clinics · simulation	Direct observation Note review
6 · Service management	NNCC consult service · NICU on-call	Oral case presentation Supervisor observation
7 · Scholarship & education	Research rotation · formal NNCC teaching · journal club · grand rounds · academic half-day	Teaching evaluation Scholarly progress report

Assessment is programmatic: no single tool determines progression. Evidence from direct observation, portfolio EPAs and global ratings is reviewed together by the Competence Committee. See the full assessment system →

Knowledge

Skills

Attitudes

Enabling Competencies by CanMEDS Role

Patient-centred assessment & management

Breadth of applied clinical knowledge

How Each Major Task Is Taught & Assessed

From competencies to evidence