Toronto Western Hospital Combined Neurosurgery and Orthopaedic Spine Surgery Fellowship

Divisions of Neurosurgery and Orthopaedic Surgery, University of Toronto, Toronto Western Hospital

Click here for fillable fellowship application form.

This fellowship is SNS-CAST accredited.

TWH

Number of Positions: 5 per year

Duration: 1 year clinical; 2 year clinical/research available upon request

Site: Toronto Western Hospital, University Health Network

Supervisors

The Toronto Western Hospital Spine Program is a combined Orthopaedic and Neurosurgical program. There are three Orthopaedic and two Neurosurgical trained attending spine surgeons, each with different clinical and research focus. The main areas of research include spinal cord injuries, deformity, education, minimally invasive spine surgery as well as clinical outcomes in all aspects of surgical spine care. We offer Clinical Fellowships to graduates of accredited Orthopaedic or Neurosurgical Residency Programs to pursue further subspecialty training in spinal surgery. 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. The Toronto Western Hospital is home to the largest Neurosurgical program in Canada and attracts complex spinal cases of all types of diagnoses. The Toronto Western Hospital is affiliated with the University Health Network which includes Princess Margaret Hospital and the Toronto General Hospital. This attracts complex tumour cases to the Spine program as well as collaboration with other surgical services in complex resections and reconstructions. Up to five fellows per year are accepted and are supervised by five fellowship trained academic spinal surgeons.

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 spine research;
Exhibit skills in the design and implementation of a research project
Exhibit skills in the critical appraisal of scientific literature specifically in the design, methodology and evaluation of clinical studies.

Length of the Fellowship

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

Patient Care Duties

Fellows are expected to be in attendance at surgery to assist the Surgeon.
Fellows are to attend the Surgeon’s Outpatient Clinics and the Spine Clinics.
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 Toronto Western Hospital is out of house coverage. Fellows are anticipated to contribute towards spine call. Call coverage will not be more than 1:4.

Spine Rounds

Spine rounds are held on a weekly basis in conjunction with the Division of Neurosurgery. Fellow participation and attendance in case/topic presentations are expected. Fellows are invited to attend weekly Spine rounds for the Orthopaedic residents. In addition, the Fellow is encouraged to assist in the preparation of the quarterly meetings of the University of Toronto/Greater Toronto Area spine interest group, and in quarterly Mortality and Morbidity rounds.

University Rounds

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

Teaching

Fellows participate in educational endeavours — they are expected to participate in the teaching activities for medical students, residents and allied health professionals.

Research

As part of their program, Fellows will participate actively in research and academic activities and be expected to complete two research projects during their fellowship year. Research projects will be supervised by one of the surgeons on the spine service. Projects 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 basic science, Epidemiology, and clinical studies. Opportunities exist for fellows that may be interested in a two year combined clinical and research fellowship with a goal towards obtaining a Masters level graduate degree with the University School of Graduate Studies.

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.

Contact

Spine Fellowship Director

Christopher J Nielsen MD, FRCSC

Fellowship Coordinator

Anoushka Singh

Send inquiries and application(s) to: SpineFellowship.Application@uhn.ca