Education & training

Education opportunities

Senior Residency | Fellowships | Research in Education

The obstetrical anaesthesia division provides excellent first-hand training and experience in obstetrical anesthesia to senior residents in postgraduate years four and five. In addition, we also offer an in-depth obstetrical anaesthesia fellowship program.

Senior Residency

Rotations in obstetrical anaesthesia are offered to senior anesthesia residents in postgraduate years 4 and 5. Residency positions are assigned by the University of Toronto's Postgraduate Committee in the Department of Anesthesia.

The obstetrical curriculum focuses on providing pain management for women in labour, as well as for delivery by caesarean section. The obstetrical anesthesia program is an essential part of the DAN Women & Babies Program at the Sunnybrook Health Sciences Centre.

Fellowships

Obstetrical Anesthesia Fellowship Program

A one-year fellowship in obstetrical anesthesia is offered at the post-residency level. In addition to clinical and teaching responsibilities, the fellowship includes protected time for research.

There are approximately 4,000 deliveries per year, and of those, 20% are high risk. The caesarean section rate is about 38%. About 80% of our women patients receive neuraxial analgesia.

Clinical

This includes coverage of the labour floor, as well as inpatient/outpatient consultations.

Research

Fellows participate in our active clinical research unit: the Obstetrical Anesthesia Research Unit (OARU). Current and recent projects include:

1. The comparison of large (17g) to small (19g) epidural needles for labour analgesia. This is a multi-centred randomized control trial (RCT) that will include 3,100 patients. The primary outcome is the incidence of post-dural puncture headache. Secondary outcomes will include headache severity, duration, treatability and quality of life measures.
2. Physician beliefs, practices and attitudes toward use of regional (spinal/epidural) anesthesia in pregnant women with lumbar spine tattoos: an Ontario provincial survey. This health services study also explores the impact of lumbar spine tattoos on women's access to maternity anesthesia services across the province.
3. Development of a Quality of Neuraxial Labour Analgesia Index. This program of research explores a variety of aspects related to women's pain during labour and delivery, as well as development of a tool to measure the quality of neuraxial (epidural/spinal) pain relief received by women during clinical research trials.
4. An anatomic study using lumbar ultrasound in patients (non-pregnant) who are having a lumbar CT scan, to compile a teaching library of normal/abnormal lumbar spines on ultrasound that can be used as a diagnostic tool for placement of neuraxial blocks.
5. Obstetrical team training using high fidelity simulation.

Fellows have 1-2 days per week for research and are invited to do their own projects as well.

Teaching

All faculty and fellows are involved in teaching junior and senior residents in the obstetrical anesthesia curriculum. Teaching sessions are also provided to nurses, medical students, midwives and community members.

In order to qualify for the fellowship, you must have completed anesthesia training in your country.

Interested candidates can start their application process on the Department of  Anesthesia Fellowships page

For general inquiries about the Obstetrical Fellowship please contact:

Dr. Pamela Angle
Sunnybrook Health Sciences Centre
2075 Bayview Ave.
Toronto, ON
Canada M4N 3M5

Tel: 416-480-6100 ext. 685054
Fax: 416-480-5614
Email: pamela.angle@sunnybrook.ca

Research in Education

Simulator-Based Obstetrical Team Training of Non-technical Skills

This study is conducted under the auspices of the Obstetrical Anesthesia Research Unit (OARU) and takes place in the Simulation Centre at the Sunnybrook Health Sciences Centre. A series of four different simulation scenarios are being used to develop a reliable tool to assess the non-technical skills involved in obstetrical team training. These scenarios were developed using information about the causes of maternal morbidity and mortality collected from various databases.

Funded by:
Canadian Patient Safety Institute (CPSI)

For more information:

• Obstetrical Anesthesia Research Unit (OARU)
• Canadian Simulation Centre for Human Performance and Crisis Management Training, Sunnybrook Health Sciences Centre.
• Department of Anesthesia, University of Toronto.