Clinical Fellowship Program

The Department of Critical Care Medicine at Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada offers clinical and clinical/research fellowships in adult Critical Care Medicine. Candidates must be fluent in spoken and written English, and eligible for provincial licensure in Ontario and specialty certification in their country of origin. The fellowship involves provision of primary patient care in a closed unit model (with Critical Care Medicine as most responsible service for a total of approximately 60 beds, and consulting care to a further 10 beds.

This fellowship is busy and patient acuity is high. Full time clinical fellows typically assess and manage about 1200 unique critically ill patients per annum during this fellowship, in addition to ongoing care of patients previously assessed, on the following rotations/units:

Medical-Surgical-Trauma

The department provides primary care for this 24-bed unit, which admits approximately 1200 patients annually from our trauma, medical and surgical populations. This group includes all ventilated patients from the largest trauma program in Canada.  There is a separate Trauma Resuscitation Fellowship opportunity available: University of Toronto, Department of Surgery.

Cardiovascular

The department provides primary care for this 14-bed unit, which admits approximately 1000 cardiac surgery, major vascular surgery and cardiogenic shock patients annually. The cardiac population includes 70% coronary revascularization, 25% valvular (including percutaneous and minimally invasive approaches), and 5% congenital. Extracorporeal support is provided occasionally. The vascular population includes open and endovascular thoracoabdominal aneurysm repairs. This unit also admits a substantial volume of cardiogenic shock patients after percutaneous coronary interventions.

Neurosurgical-Trauma stepdown

The department provides primary care for this 13-bed unit, which admits approximately 750 neurosurgical, trauma and other surgical patients annually.

Medical-Surgical stepdown

The department provides primary care for this 8-bed unit, which cares for approximately 50% acute medical or surgical admissions for deterioration, and 50% elective admissions after major surgery.

Float

In addition to the units below, our Critical Care Medicine team cares as most responsible service for 2500 patient-days per annum of patients off unit, in addition to off unit consultations and resuscitations that do not result in assumption of care. The Float fellow rotation / team may be involved with any of these, and has primary responsibility for assessment and management of Emergency Room patients who require service from our department.

Burn

This 10-bed unit handles approximately 200 acute burn admissions annually, which is the largest adult volume in Canada. Critical Care staff physicians covering this unit provide daily consultant service on all critically ill patients; fellows often choose this unit as an elective experience.

Critical Care staff physicians (who all also hold appointments to the Departments of Anaesthesia, Medicine, Emergency Medicine and/or Surgery) attend for a week at a time on these rotations. The fellow is an integral part of the team, and has the opportunity to assume a position of considerable responsibility. Fellows are involved in all levels of patient care, including primary assessment and management, procedural work, coordination of admissions and discharges, liaison with referring services, and external consultations. Through graded assignment of responsibility during the year, the fellow will optimally assume the role of a junior staff physician.

Educational activities are a prominent feature of the fellowship. These include University of Toronto seminars, grand rounds, journal rounds, case discussions, staff physician seminars, and bedside teaching. Protected time for structured academic work or elective clinical rotations is often feasible.

The in house on call schedule for clinical critical care is typically 1 night in 4. Five weeks of leave are provided.

For further information or to apply, email Dr. Cameron Guest.

Expressions of interest should include a CV, proposed duration of training and range of feasible start dates.