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Fellowships

OVERVIEW

The Spine Program, Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre offers Clinical Fellowships to graduates of accredited Residency Programs to pursue further subspecialty training in spinal surgery.  The Program is recognized by the University of Toronto and the Royal College of Physicians and Surgeons.

Although the Clinical Fellowship Program has a predominantly surgical focus, Fellows are involved in all aspects of patient care.  Spinal fellows will be exposed to a broad scope of adult spine surgery encompassing traumatic and non-traumatic (degenerative, deformity, neoplastic, and infectious) conditions.  As a designated Level-I Trauma Centre, spine surgery at the Sunnybrook Campus reflects a complex traumatic spinal focus.  Surgery plays a major role in this Fellowship, which includes a total of approximately 600 traumatic and non-traumatic cases per year. Up to two fellows per year are accepted.

SUPERVISORS

  • Dr. Joel Finkelstein
  • Dr. Michael Ford
  • Dr. Albert Yee

FELLOWSHIP OBJECTIVES

At the completion of this Fellowship, the trainee will be able to:

Clinical Skills

  • Demonstrate the ability to take a relevant history;
  • Perform a complete musculoskeletal and neurological examination of the spine;
  • Arrive at an appropriate differential diagnosis
  • Order and interpret appropriate laboratory, radiological and other diagnostic procedures;
  • Produce an acceptable management plan;
  • Display knowledge of and competence in treating surgical and medical complications;
  • Provide a plan for patient follow-up.

Technical Skills

  • Exhibit proficiency in non-operative management of spinal pain and disability;
  • Demonstrate technical competence in surgical decompression and spinal arthrodesis for degenerative, traumatic and neoplastic conditions of the cervical, thoracic and lumbar spine;
  • Show capacity for the correct use of instrumentation for spinal disorders. 

Cognitive Knowledge

  • Demonstrate a fundamental knowledge and understanding of the incidence, etiology, pathophysiology, natural history, diagnosis, investigation, management, prognosis, and complications of the disease processes affecting the spine;
  • Participate in clinical orthopaedic research;
  • Exhibit skills in the critical appraisal of scientific literature specifically in the design, methodology and evaluation of clinical studies.

REQUIREMENTS FOR APPOINTMENT

Candidates must have successfully completed an Orthopaedic Residency Program in an accepted, accredited Training Program in North America.  Foreign fellows are accepted if they have completed comparable Orthopaedic or Neurosurgical training, as determined by the College of Physicians and Surgeons of Ontario.

Candidates must be approved by the Attending Surgeon(s) of the spine service and by the Head of the Division of Orthopaedic Surgery. All Fellows must be approved by the University of Toronto and must qualify for licensure with the College of Physicians and Surgeons of Ontario.  Foreign Fellows will require a work visa.  This will be processed by the University of Toronto and requires at least six months lead-time.

Foreign Fellows must provide evidence that their medical training was completed in English or must successfully pass the Test of English as a Foreign Language (TOEFL) and Test of Spoken English (TSE).

LENGTH OF FELLOWSHIP

The Fellowship Program is usually of twelve months duration commencing in July of one year and ending in June of the following year. Occasionally, six month Fellowships are permitted. The opportunity for a two-year fellowship encompassing both a clinical and fundamental research year is available upon request.

DUTIES

Patient Care
Fellows are expected to be in attendance at surgery to assist the Surgeon.  Spinal surgery performed at Sunnybrook Health Sciences Centre occurs on both Sunnybrook and Holland Orthopaedic Institute campuses. 

Fellows are to attend the Surgeon's Outpatient Clinics and the Spine Clinics.  For fellows with Orthopaedic training, outpatient clinics may also include fracture clinics, which encompasses both spinal and non-spinal trauma. 

The Fellows are expected to provide backup and be a resource to the surgical residents-in-training in the management of in-patient spinal consultations and peri-operative patient care.

On-Call Responsibilities
Call at the Sunnybrook Campus is out of house coverage.  Fellows with Orthopaedic training are anticipated to contribute towards both spinal call and general Orthopaedic trauma call.  Fellows with Neurosurgical training are anticipated to contribute towards spinal call and general Neurosurgical call.  Call coverage will not be more than 1:3. 

Spine and Orthopaedic Rounds
Spine rounds are held on a weekly basis in conjunction with the Division of Neurosurgery.  Attendance is expected and a topic for presentation may be assigned.  While at a specific campus, general Orthopaedic Rounds are held weekly and again attendance is encouraged..  The Fellow is to assist in the preparation of the quarterly meetings of the University of Toronto/Greater Toronto Area spine interest group.  At the Sunnybrook Campus, Fellows may also be requested to assist the in preparation of spinal topics for hospital based medical and trauma rounds.

University Rounds
Fellows are encouraged to make themselves available for many Orthopaedic educational opportunities offered through the University of Toronto Orthopaedic Program.

Teaching
Fellows participate in the educational endeavours at both the HOAI and Sunnybrook Campuses. They are expected to participate in the teaching activities for medical students, residents and allied health professionals.  Fellows will participate in a structure two-day Spinal Instrumentation Learning Centre held quarterly.

Research
As part of their program, Fellows will participate actively in research and academic activities.  Two half days per week are set aside specifically for clinical or fundamental research.  Research projects will be supervised by one of the surgeons on the spine service.  The particular project should be formalized during the early part of the Fellowship.  All research proposals must be prepared and approved according to defined guidelines.  Research opportunities exist in biomechanics, basic science, Epidemiology, and clinical studies.

REMUNERATION

Two funded Fellowships of $50,000 CDN per annum are available.  Unfunded Fellowships are also available.  Fellows are responsible for obtaining licensure with the College of Physicians and Surgeons, and liability insurance with the Canadian Medical Protective Association.  Please note applicants will be reimbursed the registration fees for these applications upon presentation of receipts.  Applicants will also be reimbursed for fees associated with registration with the University of Toronto. Foreign Fellows will be reimbursed for costs of family health insurance.
Individual billing to OHIP is not permitted.  Income derived from surgical assistant's fees and clinic services will be pooled and used to support the Fellowship Program.  Partial remuneration will be paid for attendance at a spine meeting where the Fellow is presenting research conducted as part of the Fellowship.

VACATION AND MEETING TIME

Fellows are entitled to four weeks of vacation per year and two weeks to attend academic meetings.  All requests for leave must be submitted in writing at least four weeks in advance.

PROGRAM EVALUATION

An in-training evaluation will be undertaken by the Supervisor for each Fellow on completion of their program.  Fellows also need to complete an evaluation of their Supervisor.

FOR FURTHER INFORMATION

For further information on any of the Fellowships offered at Sunnybrook Health Sciences Centre please contact:

Attn: Mrs. Carolyn Gimera, Administrative Coordinator
The Spine Program, Division of Orthopaedic Surgery
Sunnybrook Health Sciences Centre
2075 Bayview Ave., Rm MG 314
Toronto, Ontario  M4N 3M5

T: (416) 480-4884
F: (416) 480-5886
E-mail: carolyn.gimera@sunnybrook.ca