Fellowships

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.

Cardiac Anesthesia

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.

Regional Anesthesia

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

Competitive salary

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

Anesthesia Simulation

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.

Obstetrical Anesthesia

Please contact Dr. Stephen Halpern for more information about this fellowship, tel. 416-480-6100 x 87757.