Fellowship in Spinal Neurosurgery (Toronto Western Hospital)

Division of Neurosurgery, University of Toronto
Toronto Western Hospital


Michael FehlingsEric Massicotte (Div. of Neurosurgery)
Stephen LewisRaja Rampersaud (Div. of Orthopaedic Surgery)

Term of Appointment

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

Positions Available

Funded posts for 5 fellows per year.


The Toronto Western Hospital Spine Program is a combined orthopaedic and neurosurgical program.  There are two orthopaedic and two neurosurgical trained attending spine surgeons, each with a 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 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 four fellows per year are accepted and are supervised by four 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.
  • For fellows with orthopaedic training, outpatient clinics may also include fracture clinics, which encompasses both spinal and non-spinal trauma.
  • 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 both spinal call and general neurosurgical call. Call coverage will not be more than 1:4 for spine call and one to two days per month of neurosurgical call.

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.


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


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. The particular project 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 Information

Anoushka Singh, PhD
Spine Fellowship Coordinator
Toronto Western Hospital 
Division of Neurosurgery
399 Bathurst Street, MP 11-315
Toronto, Ontario M5T 2S8

For inquiries:  SpineFellowship.Application@uhn.ca
For more information:  UHN Spine Program website

Application Procedure

Please submit the following by email to the Fellowship Contact:

Letters of reference (3)
Proposed start date
Proposed duration of fellowship
Details of any self-funding for the fellowship
Specific title and hospital of the fellowship for which you are applying