Spine Program
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The Division of Spine 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.


  • Dr. Leo da Costa
  • Dr. Joel Finkelstein
  • Dr. Jeremie Larouche
  • Dr. Farhad Pirouzmand
  • Dr. Albert Yee


At the end of this Fellowship, the trainee will have attained competence in the assessment and surgical management (including pre and post-operative care) of disorders of the Spine.

  1. As all applicants to clinical fellowship positions are specialists having completed specialty residency training it is expected that all applicants are already competent to function at the consultant level in:
    1. Spine Surgery/Trauma
  2. This clinical fellowship position is designed to give the applicant enhanced clinical expertise in the following areas:
    1. Develop competency in clinical management of:
      1. Spine and Trauma surgeries.
    2. Develop competency in the correct application, choice, and performance of the following surgical procedures:
      1. Surgical decompression and spinal arthrodesis for degenerative, traumatic and neoplastic conditions of the cervical, thoracic and lumbar spine.
  3. The CanMEDS competencies, as outlined by the Royal College of Physicians and Surgeons of Canada, are relevant to all surgeons, regardless of their country of origin. All University of Toronto Department of Surgery clinical fellows are expected to have these basic skill sets and will be evaluated on them. See CanMEDs competencies on page 15-17 of the Clinical Fellowship Task Force report.
  4. Fellows must demonstrate appropriate knowledge relating to gender, culture, and ethnicity pertinent to their specialty.
  5. Consistent with the obligation of a physician, fellows must endeavor to deliver the highest quality care with integrity, honesty, and compassion while exhibiting appropriate personal and interpersonal professional behavior. Fellows must adhere to the principles outlined in the University of Toronto Code of Student Conduct.
  6. As continuing education and evaluations are necessary throughout a surgeon’s life, fellows are expected to have an understanding of the role of research and the need for critical analysis of current scientific and practice developments related to their specialty.

Academic Responsibilities

  • The academic time dedicated to a research project will be granted based on the following criteria:
    1. The fellow is actively involved in research protocol development, ethics submission, project implementation and manuscript writing
    2. Project submissions will include a one-page summary outline the plan, milestones and deliverables, and reviewed on a quarterly basis
  • You will be responsible for the following:
    1. Participating in all educational activities, such as journal clubs, and rounds.
    2. Participating in research projects: planning, coordinating, implementing one or more projects; trial data analysis, presenting results at local, national, and/or international meetings; preparing final, peer-reviewed manuscripts for publication.
  • Protected academic time is assigned to all fellows for the purpose of carrying out research projects. Research must be conducted on-site, meaning that you must be in the Department on your research days.
  • At the completion of the fellowship, the Department requires fellows to prepare one manuscript, suitable for publication, for each year of fellowship training. The Department also expects fellows to prepare at least one hour-long lecture for each year of fellowship training.
  • As described in your fellowship application, as a Fellow you will be expected to undertake or collaborate or support research studies under the mentorship of your research supervisor. The division of time between clinical and research activities will be negotiated between you and your supervisor.
  • Sunnybrook is extremely active at the levels of undergraduate, postgraduate, continuing and public education, and as a clinical fellow it is expected that you will take an active part in these activities. You may also be expected to teach/supervise medical students and residents who are assigned to the Division of Spine Surgery and you may be called upon to teach in some courses and other educational events.
  • To participate in all academic activities, including but not limited to:
    1. Presentations of patients at weekly Divisional Rounds
    2. Presentation of cases and discussion of their peri-operative course at Morbidity and Mortality Rounds
    3. Reviews of topics assigned for discussion at didactic rounds
    4. Participation in the supervision of interns and residents
    5. When appropriate, responsibility for some teaching of undergraduate medical students
    6. Undertaking of one or more clinical research projects leading to presentation and publication

Clinical Duties

  • Clinical fellows are responsible for providing on-call coverage as part of their program.
  • To participate in all clinical duties in the Division of Spine surgery including:
  • Admit patients, record their medical history and physical examination in clinic and ward environment
  • Assist in outpatient and fracture clinics under supervision of the attending
  • Consult on patients on medical wards, ICUs, outpatient clinics and emergency department
  • Make rounds in the various hospital units assigned, order appropriate medications, tests and other forms of therapy required for continued care, plan discharge with nurse clinicians and charge nurse, and write a daily progress note in the chart where appropriate
  • Finish the term, which means staying until the end of their arranged fellowship
  • Demonstrate a collaborative ability with residents, other health care providers and other clinical fellows

You will be responsible for the following:

  • To perform all requested consults (e.g. history, physical, assessment, plan and dictation of consult notes for inpatient service within three (3) working days of request
  • To perform new clinic consults and follow up visit assessments and dictation in a timely fashion as a consultant with appropriate supervision i.e. be able to run a parallel clinic to the attending staff.
  • To perform relevant patient administrative and or clinical forms
  • To review paper admission forms in determining the suitability for inpatient rehabilitation
  • To participate in multidisciplinary team rounds and chair family conferences when appropriate
  • To be exposed to current research carried out in the rehabilitation programs
  • To attend and be involved in continuous educational learning with postgraduate academic half days weekly and the monthly grand rounds
  • To present education or best practice rounds at least two times during fellowship
  • To perform education of more junior trainees, e.g. junior residents, medical students and interprofessional students
  • On call duties are a mandatory educational component of the clinical fellowship.