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Brain medicine in action: Training clinicians of the future

March 10, 2023

A novel approach to training in brain health is underway at Sunnybrook Health Sciences Centre, a fully affiliated teaching hospital with the Temerty Faculty of Medicine at the University of Toronto (U of T).

The Brain Medicine Fellowship is the first of its kind to provide resident doctors unique programming and collaboration with multidisciplinary specialists in the treatment of patients with complex brain disorders.

In a recent publication in Academic Medicine, program leaders note the Brain Medicine Fellowship “fosters the development of a novel type of clinician (a brain medicine specialist)” and is “one of the first nonsurgical fellowships to implement competency-based medical education” – programming which aims to improve patient and local health care needs by enhancing trainees’ skills during residency.

“A unique feature of the Brain Medicine Fellowship is that trainees may enter the program from multiple specialties, including geriatric medicine, neurology, neurosurgery, physical medicine and rehabilitation, and psychiatry,” says Dr. Sara Mitchell, the report's senior author, director of the Brain Medicine Fellowship program, and a neurologist at Sunnybrook.

Residents train outside of their specialties, for example a fellow in psychiatry will work with neurologists, pathologists, radiologists, and other teams.

“The program enables residents to develop skills beyond their specialties, which is an innovative approach to brain health education that creates a more well-rounded experience,” adds Dr. Mitchell, who is also an assistant professor in the Department of Medicine, Division of Neurology at U of T, with a cross-appointment to the department of psychiatry.

Collaboration in Brain Medicine

Complex brain disorders impact a patient’s behaviour, thinking, and memory. Treatment is often fragmented as specialists work separately with patients however, the fellowship involves experts from across the Hurvitz Brain Sciences Program at Sunnybrook.

“Interdisciplinary partnerships in both clinical and educational settings advances a culture of collaboration among brain medicine specialists which can help benefit patients, practitioners, trainees, and the health care system,” explains Dr. Ken Shulman, a report author, professor in the department of psychiatry at U of T, and psychiatrist at Sunnybrook.

In 2011, Dr. Shulman brought together specialist physicians and medical educators across Canada which helped spark the program’s development.

The Brain Medicine Fellowship

Since 2019, the program has been part of a virtual pilot project at Sunnybrook in the Brain Medicine Clinic. Trainees are paired with a coach from outside their specialty who has a shared academic focus in medical education, clinical research, or quality improvement. From there, a personalized program is created for fellows.

“This is brain medicine in action,” explains Dr. Sarah Levitt, the report’s first author, associate director of the Brain Medicine Fellowship, and inaugural fellow.

“Residents receive practical experience that expands their knowledge base by working with other experts. This integration trains future generations of practitioners to take innovative approaches to care for patients with complex brain disorders,” says Dr. Levitt, who is also an assistant professor in the department of psychiatry at U of T.

Three fellows have completed the program to date. Three more are expected to begin their fellowships in July 2024. Over the next year, program leads will continue to refine competencies with insight from physicians to inform formalized assessment tools and measures in the future.

The virtual pilot in brain medicine education will continue to 2024.

Learn more about the Brain Medicine Fellowship.

Read about the virtual pilot.