2075 Bayview Avenue,
Canada M4N 3M5
Holland Orthopaedic & Arthritic Centre
43 Wellesley Street East,
Canada M4Y 1H1
Susan DeSousa or Agnes Ryzynski
p: 416-480-6100 ext. 3377
Sunnybrook Health Sciences Centre Department of Anesthesia and Pain Management
Sunnybrook Health Sciences Centre is fully affiliated with the University of Toronto, and is one of four major teaching hospitals in the city. There are two hospital sites: Sunnybrook and The Holland Orthopedic and Arthritic Institute. Fellows will be expected to work at both sites depending on their subspecialty interest. Sunnybrook is a major tertiary referral centre for cardiac (800 cases/year), trauma (750/yr.), oncology, and burns. A full complement of surgical specialties with the exception of pediatrics and obstetrics are on site. A Chronic Pain Clinic for inpatients and outpatients is independent of the operating room activity, but under the control of the Department of Anesthesia. A full spectrum of procedures are done with fluoroscopy, excluding spinal cord stimulation and infusion pumps. The department runs a Clinical Simulation Centre, providing training for multiple medical specialties.
Education, research and advanced clinical training in anesthesia subspecialties as described below.
Fellows will beassigned to an operating room lists appropriate to their subspecialty training program and clinical experience. Supervision is by consultant staff members of the department at all times. Responsibilities include supervision and teaching of junior and senior residents in the program, and medical students. After hours duty is at the second and third call level, with the first call consultant available at all times. The frequency of on call duties is similar to the consultants. All fellows participate in the Acute Pain Service if the Fellowship schedule can accommodate this.
One research day per week is available to every fellow but is granted only if the fellow is involved in a specific project related to the fellowship area of interest. Fellows participating in research are required to present at Shield’s Day, the yearly University research day, and are expected to produce at least one peer-reviewed publication.
Specialization can be in any one of the following, dependent on availability:
- General Clinical Anesthesia
- Chronic Pain
- Cardiac / TEE
- Regional Anesthesia
- Anesthesia Simulation
Specialty fellowships involve 2-3 days per week in the specialty and 2-3 days per week providing anesthesia for a variety of case types (see General Clinical Fellowship below).
Formal evaluation of fellows is carried out at the 6 and 12-month marks of the fellowship year. The Fellowship Coordinator carries this out after consultation with the Chief of the Department and Departmental staff. At the 12-month point the fellow receives a certificate documenting successful completion of the fellowship if this has occurred.
Evaluation of the Fellowship is done on an ongoing basis through contact between the fellows and the Fellowship coordinator, Chief of the Department, and the Fellowship Supervisor. Fellows are specifically asked about satisfaction with the fellowship program, interpersonal issues with other staff, and whether they perceive significant problems with the fellowship program. Fellows are asked for input into ways of rectifying any problems that arise.
Once in receipt of the required documents, an temporary license is issued by the College of Physicians and Surgeons of Ontario (CPSO). This enables one to practice under direct supervision in a teaching hospital. After successful completion of a 1 to 3 month assessment period, the CPSO issues an educational license and the fellow may continue the fellowship. This assessment period is mandated by the CPSO and failure of this assessment will preclude licensure and the fellowship will be immediately terminated.
Medical Malpractice insurance is provided. Salary is very competitive compared to similar fellowships in Toronto. Some health benefits are provided by the Department of Anesthesia, if the fellow desires.
The fellowship committee will review and rank all candiates and only those highest ranked will be contacted. Fluency in English is mandatory. Applicants whose first language is not English must pass the TOEFL/TSE.
Please send applications to:
Dr. Paul McHardy
Fellowship Coordinator, Department of Anesthesia
Sunnybrook Health Sciences Centre
2075 Bayview Avenue, Room M3-200
Canada M4N 3M5
For Regional Anesthesia Fellowship, please follow application information below.
The General Clinical Fellowship
The General Clinical Fellowship involves gaining experience in the anesthetic management of all types of surgery carried out at Sunnybrook except cardiac anesthesia. Surgical services represented in the OR include general, trauma surgery, otolaryngology, urology, orthopedics, plastic and facial reconstructive surgery, cancer reconstructive surgery involving muscle flaps, gynecologic oncology, ophthalmology, vascular surgery, neurosurgery, and major spine surgery. Ancillary anesthetic locations include the cardiac catheterization laboratory for implantable defibrillator insertion, radiology suite for various embolization procedures, psychiatry ward for electroconvulsive therapy, and the cancer centre for insertion of radiotherapy devices. Fellows may work in the pre-assessment clinic in rotation with staff and also participate in running the acute pain service on a rotational basis. As SHSC is a tertiary care trauma centre, particular experience in managing blunt and penetrating trauma will be gained during this fellowship.
Chronic Pain Management
The fellow will gain experience in clinical pain management mainly through work in three settings - the Diagnostic Nerve Block and Pain Control Clinic, the Acute Pain Service. The fellow will gain experience in assessment of outpatients and performance of pain management and therapeutic procedures under the guidance of the staff algologist. Assessment and ward rounds of in-patients and cancer patients for chronic pain management will be done throughout the hospital and in the Cancer Centre Clinic. The fellow will participate in the acute pain service on a rotational basis.
All prospective candidates must have had some prior experience in a recognized chronic pain clinic setting. This should include some experience in image guided interventional procedures, e.g. cervical and lumbar facet blocks, epidural injections, and celiac plexus blocks. The pain management fellow is expected to be involved in a clinical research project and will be encouraged to attend the yearly Research Design Seminar Series run by the Anesthesia Research Committee.
Sunnybrook HSC does approximately 800 cardiac cases annually. After an initial period of fully supervised training, fellows will provide progressively independant anesthesia care to mid to high-risk patients for a wide spectrum of cardiac surgical and medical problems. Experience will be gained in a various procedures such as "off-pump" surgery, invasive monitoring, hypothermia and circulatory arrest. Consultant supervision is immediately available at all times.
Fellows will gain knowledge and expertise in trans-esophageal echocardiography both during OR time and during dedicated TEE training time. The fellow is expected to be involved in a clinical research project and will be encouraged to attend the yearly Research Design Seminar Series run by the Anesthesia Research Committee. Fellows will attend cardiac anesthesia rounds and TEE rounds both of which occur monthly.
Sunnybrook Health Sciences Centre performs approximately 3,000 regional anesthesia procedures each year. Under the supervision of a staff regional anesthesiologist, fellows will learn to perform a variety of different peripheral nerve blocks of the upper and lower extremity. Fellows will gain expertise in continuous catheter techniques for postoperative analgesia for both the upper and lower extremities. Central neuraxial techniques, including thoracic epidurals, combined spinal-epidurals, and saddle blocks, are also commonly performed for surgery at our hospital. The successful applicant will learn to perform all peripheral nerve block techniques with ultrasound guidance using state-of-the-art ultrasound machinery with expert instruction.
Fellows will also participate in the Acute Pain Service rotation and non-regional anesthesia cases during the training year. The Acute Pain Service manages approximately 2,500 patients per year including referrals with challenging chronic and cancer pain.
Positions per year: 4
Duration of training: 12 months (6 month fellowships occasionally available)
Research Experience: Regional anesthesia fellows will spend 20% of time in research and educational activities. Under direct staff supervision, regional anesthesia fellows are expected to initiate at least one research project during the training year. Current areas of research include factors facilitating recovery and rehabilitation from major joint surgery and ultrasound-guided peripheral nerve blockade. Fellows will often assume a teaching role especially towards their end of their fellowship year.
Application process: Currently two positions are appointed each January for the following year i.e. appointment in January 2007 for January or July 2008. Applicants are advised to apply at least 18 months in advance of their preferred date of commencement. Interested candidates should send a letter of intent and curriculum vitae. Twelve months prior to each fellowship short listed candidates will be invited to attend for interview and three letters of reference should be received prior to this time. Successful candidates will be advised within two weeks of interview.
Applications should be sent to: Michelle Nazar
The Canadian Simulation Centre for Human Performance and Crisis Management Training was the first high fidelity simulation centre in Canada, and remains one of the most academically productive centres in North America. Approximately 1000 learners attend the centre each year.
The objectives of the Simulation fellowship is as follows
To develop a knowledge of how to establish educational and research programs in part-task and high fidelity simulation.
To develop expertise in using simulation for evaluation purposes
To develop expertise in debriefing of simulation scenarios
To participate in active research programs
To enhance knowledge of the literature with respect to the uses of simulation in medical education
The applicant would have the opportunity to participate in ongoing research studies as well as to pursue an independent study in conjunction with one of the simulation researchers.
Please contact Dr. Stephen Halpern for more information about this fellowship, tel. 416-480-6100 x 87757.