Fellowships in the Division of Cardiac Surgery

Fellowship

The four hospital sites (St. Michael's Hospital, Toronto General Hospital, Sunnybrook Health Sciences Centre, and The Hospital for Sick Children) all employ clinical fellows. Clinical fellows are surgeons from Canada, or international countries who have already attained cardiac surgery specialist status from their country of origin. Cardiac fellowship training provides advanced level training in the various aspects of tertiary level and quaternary level cardiac surgery as outlined below.

Applicants must be a certified cardiac surgeon in Canada or their country of origin, or have successfully passed MCQEE www.mcc.ca. All International Medical Graduate fellows must undergo a period of observation of clinical performance lasting 4-12 weeks at University of Toronto hospitals. This period of observation, called PEAP (Pre Entry Assessment Period), is done in the initial 4-12 weeks of the clinical fellowship. Successful completion of the PEAP is mandatory in order to continue in the clinical fellowship.

International Medical Graduates who graduated from a medical school where the language of instruction was NOT in English must pass The Test of English as a Foreign Language (TOEFL) and The Test of Spoken English (TSE) OR the new TOEFL-Ibt http://web1.toefl.org/tstgprog01.cfm.

TSE: Minimum score 50
TOEFL: Minimum score 237, or minimum score 580 for paper based test
TOEFL-Ibt: Minimum score of 93 including a minimum score of 24 on the speaking section.

Work related issues will be outlined in a "Letter of Clinical Fellowship Job Offer" that the applicant and his or her supervisor both sign. Educational issues and responsibilities are clarified in the "Letter of Job Offer" and the "Goals and Objectives" documents before starting the fellowship. All clinical fellows receive evaluations every 6 months.

Salaries for clinical fellows are varied. Some fellows are self funded such as Canadian fellows with an Ontario license to practice medicine, some are sponsored by their country of origin or other external agency, and some are funded by the hospital division itself. Once again this is clarified in the "Letter of Job Offer".

Further information on Clinical Fellowships at The University of Toronto can be found in the Task Force on Clinical Fellows report accessible at: http://www.surg.med.utoronto.ca/fellowships.html

Below are the specific clinical fellowships available at the University of Toronto, Division of Cardiac Surgery.

St Michael's Hospital

2-3 clinical fellows per year

St. Michael's Hospital division of cardiac surgery performs approximately 1100 open heart surgery cases per year. Coronary bypass surgery represents the largest component of our case load and includes high risk coronary bypass surgery cases. Approximately 1/3 of these cases are valve procedures of all varieties, ranging from straightforward aortic and mitral valve replacements to complex mitral valve repairs. Aortic surgery is strongly represented and the hospital has an active endovascular aortic program that includes endovascular surgery on the aortic arch.

There are 5 cardiac surgeons on staff, Daniel Bonneau, Lee Errett, David Latter, Mark Peterson and Subodh Verma, The division has a 30 bed ward, 13 intensive care beds, and runs 3 operating rooms per day. We typically have one senior level cardiac surgery resident from the University of Toronto Cardiac Surgery training program. To complement the one resident the division hires two to three fellows per year from Canada and other countries from around the world. The division prides itself on our operative training of residents and fellows. With the dedicated teaching of our surgeons and the sheer volume of cases performed by the service the fellow is sure to receive an outstanding learning opportunity and develop their surgical technical skills in this fellowship.

Applicants interested in applying for Cardiac Surgery Clinical Fellowship at St Michael's Hospital should contact:

Dr. David Latter
Division Head, Cardiovascular Surgery
St. Michael's Hospital
30 Bond Street,
Toronto, ON, Canada, M5B 1W8
Tel: 416-864-5366
Email: latterd@smh.ca

Toronto General Hospital

5-6 fellows hired per year

The Toronto General Hospital division of cardiac surgery performs 1800 open-heart cases per year. In addition to coronary artery surgery it is the leading cardiac valve and thoracic aorta/arch centre in Canada. The cardiac surgeons perform the majority of the pacemaker/arrhythmia surgery. TGH is the leading ventricular assist/mechanical heart and cardiac (and lung) transplant centre in Canada. In partnership with cardiology and radiology it is taking the lead in percutaneous and transventricular heart valve deployment. In association with the Hospital for Sick Children, TGH is central Canada's centre for adult congenital cardiac surgery.

There are 9 cardiac surgeons on staff. Dr. Tirone David holds the Melanie Munk Chair and as the UHN Division Chief, and is Past President of the AATS. Dr. Richard Weisel is University of Toronto Head and Director of (Surgical) Research, UHN-TGH. Dr. Hugh Scully is Past-President of the Canadian Medical Association, and the Canadian Cardiovascular Society, as well as Co-ordinator of Clinical Fellows in cardiac surgery for the University of Toronto. Dr. Chris Feindel is President of the Canadian Society of Cardiac Surgeons, and is the Ward Chief of UHN-TGH. Dr. Stephanie Brister is UHN-TGH Co-ordinator of the Cardiac Surgery Residency program and Medical Director of the UHN - TGH operating rooms. Dr. Terry Yau holds the Angelo and Lorenza De Gasparis Chair in CV Research and is Director of Research, UHN-TGH Division of CV Surgery. Dr. Vivek Rao , PhD. holds the Alfredo and Teresa De Gaspiris Chair in Heart Failure Surgery and is Director of VAD/Mechanical Heart and Cardiac Transplantation. Both Dr. R.J. Cusimano and Dr. Tony Ralph-Edwards do coronary, valve and pacemaker surgery. Dr. Cusimano also focuses on off-pump coronary surgery, and Dr. Ralph-Edwards has a particular interest in IHSS (HOCM) Surgery.

Clinical Fellows will be exposed to the full range of adult cardiac surgical services: both straightforward and complex coronary and valve surgery, aortic root and thoracic arch reconstructive surgery, pacemaker and arrhythmia surgery, VAD/mechanical heart and transplantation, adult congenital surgery and team-based pre-operative, ICU and ward-based care of cardiac surgical patients. There are active academic seminars in all aspects of the care of cardiac patients, and the Fellows are expected to be both participants and leaders in these sessions.

Applicants interested in applying for Cardiac Surgery Clinical Fellowship at the Toronto General Hospital should contact:

Dr Vivek Rao
Division Head, Cardiac Surgery
Toronto General Hospital
Division of Cardiovascular Surgery
200 Elizabeth Street, 4N-457
Toronto, ON, Canada, M5G 2C4
Tel: 416 340-4789
Email: vivek.rao@uhn.ca

Sunnybrook Health Sciences Centre

2-3 fellows per year

Sunnybrook Health Sciences Centre is one of the teaching hospitals of the University of Toronto, situated in the north-central part of Toronto. The cardiac unit performs approximately 800 adult cardiac operations annually. Our case volume includes on and off-pump coronary bypass surgery, aortic, mitral, and tricuspid valve surgery, surgery of the thoracic aorta (including stent-grafting), surgery for left ventricular aneurysm or septal rupture, atrial ablation procedures for atrial fibrillation, pericardiectomy, and simple adult congenital heart surgery. Pediatric heart surgery is done at the Hospital for Sick Children in Toronto and complex congenital heart surgery in the adult and cardiac transplantation at the Toronto General Hospital. We have active clinical and basic research programs.

We are currently reviewing possible candidates for 2008. We are interested in quality applicants, which is based on our assessment of the curriculum vitae, the letters of recommendation, the case-list of the applicant, and whether the applicant has a promised staff position in cardiac surgeon following completion of all of his/her training. The funding status is also important when assessing the application, but not of primary importance. Candidates must have received board certification in Cardiac surgery.

To better assess your application, can you send us the following:

Current CV
Case List, broken down to procedure and whether you functioned as the assistant or surgeon
3 letters of recommendation
A statement regarding whether you have a staff position in cardiac surgery following fellowship
A statement indicating whether you be self-funded or will require funding.

The fellowship would be for 12 months. In some cases, the fellowship may be extended longer than 12 months, but that is determined during the fellowship, not before the fellowship. The fellows receive a total of 4 weeks holidays per year, usually 1 week at a time. Fellows participate in the call schedule and in the educational rounds along with the other fellows and residents. Clinical fellows may participate in a clinical research project during their fellowship, but it is not required. The Division will cover the travel costs of the fellow for one scientific meeting in North America each year, as well as the travel costs to any scientific meeting if the fellow is presenting an abstract of a study completed at Sunnybrook. We also cover the cost of the fellow's medical malpractice insurance in Canada.

We decide who we will accept for fellowship approximately 12 months before the fellowship is planned to begin. The application process for the candidate's approval from the Office of Postgraduate Education of the Department of Surgery at the University of Toronto, employment visa from the Canadian government and educational license from the College of Physicians and Surgeons of Ontario takes 10 to 12 months.

Applicants interested in applying for Cardiac Surgery Clinical Fellowship at Sunnybrook Health Sciences Centre should contact:

Dr. Stephen Fremes
Division Head, Cardiac Surgery
Sunnybrook Health Sciences Centre
2075 Bayview Ave., Room H-405,
Toronto, ON, Canada, MA4 3M5
Tel: 416 480-6073
Email: stephen.fremes@swchsc.on.ca

Hospital for Sick Children

There are four cardiac fellows/residents being trained at any given time. Every six months a cardiac resident from the University of Toronto rotates. The Division also serves as the training site for the McMaster University cardiac surgical trainees. McMaster Residents are present every few years. We typically train one North American fellow each year. The remaining fellows are international with a number now being trained from Asia.

Past fellows are now employed as staff surgeons in countries such as South Africa, Australia, Beijing, Seoul, Canada, Berlin and the US amongst others, including one now employed at the Mayo Clinic. The Division has historically been a major training site for congenital heart surgeons. The current Head of Boston Children’s Hospital trained here as did the major surgeon at the University of California in San Francisco. A number of others at major programs around the US also trained at SickKids.

Dr. Williams established the Kirklin Fellowship in the Congenital Heart Surgeons Society, which allows for a two-year duration fellowship.

While we have trained many successful congenital cardiac surgeons, updating our training strategy to a more structured teaching experience for all levels of trainees will be a focus in the future, as the Division intends to develop learning objective based teaching strategies for medical students, rotating residents and yearly fellows. Cross training of surgical and interventional fellows is currently being explored and will likely come to fruition.

APPLYING FOR FELLOWSHIP

We accept positions on a year-to year-basis:

Next available fellowship position: July 1, 2017
Application submission deadline: March 31, 2016
Selection process will takes place: May 2016

Requirements

Qualified Cardiac Surgeon or one in training

Applicant to provide the following documents by email to cvsfellowship.observership@sickkids.ca :

Copy of most recent CV
Photo
Three reference letters from current or former colleagues/employers
Download the Fellowship Application

**Incomplete Applications will not be considered.

Send an email to: cvsfellowship.observership@sickkids.ca