Residency in the Division of Cardiac Surgery

Residency in cardiac surgery may be entered via two routes; a three year program after completion of general surgery or a six year program beginning after medical school clerkship. Both streams qualify successful candidates to sit the Royal College of Physicians and Surgeons of Canada fellowship examinations for cardiac surgery. 

Foreign applicants are invited to apply to the six year training program, by post only, and with written documentation of sponsorship from their University or government. Unfortunately, foreign applicants who do not have secured funding from their University or government cannot be considered at this time. 

Foreign medical graduates who have not completed North American Internships, regardless of legal status in Canada, must have successfully completed their MCCE and must apply to the Pre-Entry Assessment Program if they wish to enter an accredited residency training program in Ontario. 
 

Programs


Cardiac Surgery Residency Program

Contact: Dr. Robert James Cusimano
Residency Program Coordinator:  Thanu Sabesan

Toronto General Hospital
University Health Network
4N-468
200 Elizabeth St
Toronto, Ontario
M5G 2C4  Canada

Tel: 416-340-4928
Fax: 416-340-3803
Email: thanu.sabesan@utoronto.ca

Application Form 
Curriculum 
Research 
Seminars 
Selection Criteria 
Resources 

Residency in cardiac surgery for Canadian / U.S. citizens may be entered via two routes: a 3-year program after completion of general surgery or a 6-year program beginning after medical school. Both streams qualify successful candidates to sit the Royal College of Physicians and Surgeons of Canada fellowship examinations. For interested candidates who have completed the general surgery program, please click here for the application form for subspecialty training. For interested candidates interested in the 6-year program, you must follow the Canadian Resident Matching Service (CaRMS) application process. 

Foreign applicants are invited to apply to the six year training program, by post only, and with written documentation of sponsorship from their University or government. Unfortunately, foreign applicants who do not have secured funding from their University or government cannot be considered for an interview at this time. 

Curriculum

The residency program is designed to fulfill the requirements of the Royal College of Physicians and Surgeons of Canada for cardiac surgery. The program extends over a six year period as follows: 

PGY 1&2: The first two years are exposure to the basics of surgery and involve exposure to various disciplines. The two years are designed to prepare the resident for Part II of the MCCQE exams which occur 17 months after commencing the program. 

Following completion of the two years of core surgery, the candidate is prepared to successfully complete the Principles of Surgery exam early in year three of the program. 

The rotations in core surgery are designed to prepare the cardiac resident for training in subsequent years. Basic grounding in general surgery is offered and rotations through intensive care, emergency, related medical specialties, and other surgical subspecialties are offered. 

The resident will be interviewed by both the Director of Core Surgical Education and the Chair of the Division of Cardiac Surgery to construct a course for the individual resident to review progress during the course, and to obtain feedback from the resident. 

PGY 3 to 6: The period following core surgery is customized to strengthen the individual resident's aptitudes and interests. In keeping with the Royal College requirements the following rotations are required: 6 months of residency in related surgical specialty (general surgery or vascular surgery), 6 months as assistant resident in cardiac surgery, 6 months as a senior resident in thoracic surgery, general surgery or vascular surgery, 6 months as senior resident in paediatric cardiac surgery, 1 year as senior resident in adult cardiac surgery. 

In addition, one year is set aside for "academic enrichment". This year allows the candidate to develop a special interest and expertise in an area of interest. A specific area of interest in cardiac surgery or related specialties including echocardiography, nuclear cardiology, and the catheterization laboratory may be arranged. An extensive program in cardiac pacing, electrophysiology, and surgery for arrhythmias is available. Rotations will be arranged at any of the four cardiac units during the four year program. 


Research

Research training is available for residents interested in an academic career. We strongly encourage residents to pursue an M.Sc. or enter the Surgeon Scientist Program, leading towards a Ph.D. 



Seminars

During the two core years, residents are expected to be involved in the series of core lectures leading to successful completion of both the MCCQE Part II and POS exams. There is a mandatory weekly cardiac seminar series for all of the university trainees and a quarterly city-wide seminar series for all cardiac trainees and faculty. There are also Visiting Professorships during the academic year which include a lecture at the hospital rounds and an educational afternoon with the cardiac trainees. Education rounds, seminars, research rounds and combined rounds with cardiology at each of the four cardiac units are available. Active participation by the resident is required. 

Residents in their senior years are expected to attend both national and international meetings including preparation and presentation of presentations and publications. 


Selection Criteria

1. A superior academic record demonstrating special proficiency in subjects related to our specialty. 

2. Candidates should have a proven interest in our specialty, demonstrated by electives or other rotations in cardiothoracic surgery or related fields. 

3. Three references are required. Where possible, you are encouraged to obtain references from academic specialists in cardiothoracic surgery, attesting to your interest and proficiency in the specialty, as well as comments on exemplary interpersonal skills. 

4. Candidates with an interest and/or proven experience in research, either at the level of basic science or clinical research, are encouraged to apply. 
 

Resources 

There are four cardiac units within the University of Toronto. In addition, there are extensive research facilities at all four of these hospitals: 
(This also includes the Medical Sciences Building located on campus at the University of Toronto.)

Hospital for Sick Children

Hospital for Sick Children 


Pediatric Cardiac Surgery began at the Hospital for Sick Children in the late 1940's under the direction of Dr. W.T. Mustard. A broad referral pattern from a population of about 10 million people has allowed a focused development of care for the newborn, infant and child with congenital heart disease. A complete range of cardiologic investigation and intervention, echocardiography, anesthesia and 40 bed Intensive Care Unit allows for surgical management of approximately 700 children per year. Care for the adult with congenital heart disease is provided at the adjacent Toronto Hospital in the Toronto Congenital Cardiac Centre for Adults. The adult clinic cares for over 3,500 patients and over 100 adults per year undergo surgery for congenital heart disease. 
There are three full time pediatric cardiac surgeons at the Hospital for Sick Children. Two of the surgeons have a major commitment to laboratory research and two are involved in the adult cardiac surgical clinic. 

The Hospital for Sick Children provides senior resident experience for trainees in the University of Toronto Cardiac Surgery Program. Six months experience is required by the Royal College as part of the Fellowship training. The resident is involved in a complete range of pediatric patients with congenital and acquired heart lesions. 

Toronto General Hospital

Toronto General Hospital
Mission Statement:

To provide exemplary and compassionate patient care.
To develop the clinical, teaching and research skills of physicians, surgeons, nurses, allied health care professionals, students, life scientists and other colleagues in the field of cardiovascular medicine.
To create, apply and disseminate new knowledge for the well-being of patients.
To maintain excellence in patient care, education, and research, in accordance with the highest ethical standards.
To manage the resources entrusted to us for these purposes responsibly and honourably.

Clinical Activities (1994)
Open heart procedures:

coronary artery bypass 1,373 patients, valve surgery 398 patients, miscellaneous (thoracic aortic aneurysms, transplants, congenital heart defects, etc.) 283 patients 

Other:

pacemakers 481 patients, defibrillators 25 patients 
 

Educational Activities:

Staff surgeons participate actively in medical undergraduate education (yrs 2, 3 and 4). The Division has 2 residents (1 assistant and 1 senior) and 5 fellows (2 in research and 3 in clinical activities). 
 

Permanent Manpower:

Staff surgeons: 8; Clinical assistants: 5; Nurse clinicians: 4 

Sunnybrook and Women's College HSC

Sunnybrook Health Sciences Centre

Sunnybrook Health Science Centre currently performs 735 open heart cases, 20% valvular. There are active clinical trials and research protocols in myocardial protection and valve reconstruction. Opportunities exist for clinical fellows and/or assistants with an Education Licence or OHIP billing number. 

St Michael's Hospital

St. Michael's Hospital
Terrence Donnelly Heart Centre
Mission Statement:

To prevent, detect and treat diseases of the cardiovascular system, with particular attention to atherosclerosis, heart failure and valvular heart disease. Through these efforts, we attempt to provide exemplary patient care in a contemporary and caring medical environment, foster challenging and stimulating educational programs for undergraduate and post graduate students, and pursue new knowledge through research in selected aspects of our discipline. 
 

Clinical Activities:

At the Terrence Donnelly Heart Centre at St. Michael’s Hospital, 1500 cardiac procedures are performed. Close to 400 of these are valve complex aortic procedures. In addition, the vascular service performs 300 graft procedures per year. Electrophysiology: 150 defibrillators, and 300 pacemakers. Within the hospital, there is the Terrence Donnelly Cardiac surgical and vascular biology research laboratories. Its focus of interest include angiogenesis gene therapy and investigating the mechanism of restenosis. 

The clinical trial division is extremely active and has national and international collaborative approaches. 

There is usually one resident and several fellows on the service. The residents get a wealth of experience caring for the cardiac surgical patients. Also, there is time allotted for research projects suited to the individual resident. 

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