Fellowship

Division of Maternal-Fetal Medicine
Division of Gynecologic Oncology
Division of Reproductive Medicine
Division of Urogynecology and Reconstructive Pelvic Surgery (URPS)
Minimally Invasive Gynaecology

Fellowship - Division of Maternal-Fetal Medicine

Introduction: A Career in Maternal-Fetal Medicine

Sub-specialization within Obstetrics and Gynecology has developed over the last two decades. With increasing sophistication in fetal imaging and the ability to observe the intrauterine environment, the concept of the fetus as a patient was born. Concomitant with the explosion in technologies for prenatal diagnosis and medical and surgical fetal therapy came the need for an obstetric perinatologist or fetal physician. Such an individual, by definition, would require a firm grounding in physiology and pathophysiology of the fetus and would be prepared to address, through scientific enquiry, some of the unresolved dilemmas in perinatal medicine. The role of the Maternal-Fetal Medicine (MFM) specialist, or perinatologist, has developed as complementary to that of the obstetrician and in current practice the job description also encompasses the tasks of administration, education and fetal advocate. In this country, where regionalization perinatal care has been shown advantageous, with improved outcome and lowered health acre costs, the obstetric perinatologist will be found in academic tertiary level centers. These individuals have clinical practices limited to care of the high-risk mother and her fetus.

In 1986, the Royal College of Physicians and Surgeons of Canada approved the first sub-specialty training program in Maternal-Fetal Medicine. Currently there are 10 Royal College accredited programs in Canada (accreditation without certification). Graduates of two-year Canadian program may receive a diploma stating that they have successfully completed a program accredited by the Royal College of Physicians and Surgeons of Canada - RCPSC (accreditation without certification). They can expect to gain experience in a wide variety of medical complications of pregnancy, detailed sonographic fetal diagnosis, prenatal genetic diagnosis and screening, and fetal, maternal and neonatal intensive care. The MFM fellow is expected to make an original contribution to the perinatal literature during his/her training, developing an appropriate research question and methodological approach and gather the relevant data to answer it. Within the University based practice the MFM sub-specialists, in addition to fulfilling clinical commitments, plays a role of educator to the community and other members of the health care team, health policy advisor, auditor of ongoing health practices and researcher. The distribution of time spent in these activities may vary widely.

Patterns of clinical practice within Canada also range from an exclusively consultative service to primary care physician for regional perinatal transfer. The ultimate lifestyle of the perinatologist will be predicated by the pattern of practice and the fiscal arrangements (fee-for-service or salaried positions), the size of the regional center and number of practice partners.

Job Opportunities

In 1990 the Maternal-Fetal Medicine Committee of the Society of Obstetricians and Gynecologists of Canada published a prospectus on manpower needs in MFM suggesting an excess demand for MFM sub-specialists for 1990's in excess of the anticipated supply with the current number of trainees. The demand in Canada for trained MFM specialists, though less well defined, favor continued growth in order to meet the target ratio of 6 Maternal-Fetal Medicine specialists per 10,000 birth in each region.

The vocation of an academic career in Maternal-Fetal Medicine awaits the candidate seeking personal fulfillment, financial security and intellectual challenge with the desire to explore the concept of the fetus as a patient.

Mailing Address

The Ottawa Hospital, General Campus
501 Smyth Road
Room 8421
Ottawa, ON
K1H 8L6

Dr. Karen Fung Kee Fung, Fellowship Program Director
E-mail: KFung@ottawahospital.on.ca

For information on MFM Clinical Fellowship, please contact:

Erica Moore
Program Coordinator, Postgraduate Clinical Fellowship Programs
Department of Obstetrics and Gynecology
Phone: 613-737-8899 x 73254
Fax: 613-737-8070
Email: emoore@toh.on.ca

MFM Clinical Fellowship Program application process

All applicants to the Maternal Fetal Medicine Fellowship Program must contact the Postgraduate Medical Education Office at the University of Ottawa when applyinig to the Maternal Fetal Medicine Program our University.

Their contact information is as follows: Email: pgme@uottawa.ca or phone: 613-562-5413 & fax: 613-562-5420

Their web site address is as follows: http://www.med.uottawa.ca/postgraduate/

The University of Ottawa will require the following information to complete your application:

Curriculum Vitae
Proof of Medical Degree
Proof of Specialty Degree
3 Current Original Reference Letters (dated and signed)
Confirmation of Sponsorship

Applications will be reviewed by the Fellowship Committee in Maternal Fetal Medicine and candidates will be contacted for interviews in October /November for positions beginning July 1st, 2010, start date.

For information on Post-Doctoral Research Fellowship, please contact:

Leslie Webb
Research Administrative Assistant
OMNI Research Group
Phone: (613) 739-6655
Fax: (613) 739-6266
E-mail: lwebb@ottawahospital.on.ca or lwebb@ohri.ca

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Fellowship - Division of Gynecologic Oncology

This is a two year clinical training program with an optional third year for research.

Program Year

Content & Sequence of Rotations
Number of Months (or 4-week blocks)

First

ICU

G/O

Second

G/O

Med
Onc

Rad
Onc

Elective

First Year:

The first year of training focussed mainly on the care of the critically ill medical and surgical patients and to achieve core competencies in gynaecologic oncology. Formal instructions will also be given in research methodology and critical appraisal skills by didactic lecture series and real world application through regular journal club and mortality and morbidity round presentations. The residents will be expected to fully integrate themselves into the multidisciplinary model of care environment and to function as leader within the team under the supervision of attending staffs.

Graduated goals include – competency in the management of inpatient unit/assistance with inpatients’ consultation/ competencies with radical surgical procedures as applicable to gynaecologic oncology/Tumor Board discussion participation. Active involvement in the evaluation and stabilization of patients presenting to emergency department is expected.

With regard to surgical exposures, the resident in the first year will go through a graduated experience in radical and complex gynaecologic oncology procedures as per program objectives. At present, the division operates five days a week allowing for significant case load variety and volumes .During this year the first year resident is expected to keep a detailed learning portfolio of cases which are linked to program’s objectives which are reviewed on a monthly basis by supervising faculties and at the 6 months review with the program director.

Second Year:

The second year consisted of 5 months in non gynaecologic oncology rotations. This includes 2 months of medical oncology, 2 months of radiation oncology and one month of elective time. The remaining time (7 months) will be done in gynaecologic oncology where the resident will assume the role of a junior consultant gynecologic oncologist.

Leadership of the inpatient and outpatient services with primary management of the multidisciplinary team (MDS) and Chemotherapy Day Care unit will be the expectation of the resident for this year. Furthermore, the resident is expected to take on teaching responsibilities in the O.R. to junior residents in general obstetrics and gynecology as appropriate. Within the medical oncology/radiation oncology rotations they will function as residents with staff supervision as per rotation specific objectives.

Weekly Schedule and Duties:

The resident weekly activities are described below:

Daily: Surgical, medical, and chemotherapy related issues are addressed by the multidisciplinary team with the resident under the supervision of attending staff gynaecologic oncologist

Weekly: Chemotherapeutic rounds are done once a week in preparation of patients for the following week. For each patient, the clinical history and current status will be reviewed by the fellow in conjunction with the team staffs/pharmacist/nurses prior to making plan for subsequent chemotherapy. At these rounds, the opportunity to review disease natural history and strategies for future management are made in a collaborative setting. Further research ideas are also explored and suggested during these sessions.

Weekly: Patient discharge planning rounds are held every Wednesday with active resident participations. Here all inpatients are reviewed and discharge planning are done with the expanded team including inputs from social workers/ psychologist/ nurses/ APN/ and palliative care physician. This will allow for further integration of the resident into the multidisciplinary environment and foster collaborative care philosophy.

Weekly: Residents are expected to lead gynaecologic oncology/ pathology tumor board presentations on interesting/ challenging patients on Wednesday morning in conjunction with gynaecologic pathologists and radiation oncologists. Discussions are recorded and lessons learnt together with management decisions are posted on the knowledge management system (GOSOCS) for further comments and feedbacks by other team members to sharpen the residents’ communicator role in the team.

Friday morning: residents participate and eventually lead the surgical oncology/gynaecology teaching rounds for general Obstetrics and Gynecology residents. Here surgical issues and critical care issues as well as specific gynaecologic oncology related topics are reviewed critically with emphasis on evidence based medical practice.

Didactic Teachings

The Gynaecologic Oncology Program is part of the larger Surgical Oncology Program of the Integrated Cancer Program at The Ottawa Hospital and is also a division within the Department of Obstetrics and Gynaecology and Newborn care affiliated with the University of Ottawa. This relationship allows for easy access to an expanded structured education offerings and resources from both programs to fulfill the stated goals and objectives.

The course material is based on the objectives of the program (please see attached curriculum)
General medical and radiation oncology topics are covered in weekly oncology lecture series of the Integrated Cancer Program regularly held on Wednesdays afternoon with medical and radiation oncology residents
Specific surgical topics as related to surgical oncology are covered in specific days within the Department of Surgery academic schedule that the resident will attend
Issues of embryogenesis/ sexuality/ gynaecologic oncology will be covered by the Department of Obstetrics and Gynaecology postgraduate curriculum
Medical ethics and communications skills will be covered by regularly held university hosted lectures series
Issues of palliative care/ symptoms management/ breaking bad news will be covered by the division palliative care physician through a series of lectures and case discussions during the academic year (please see attached curriculum)
Topics on epidemiology/ biostatistics/ research design/ critical appraisals will be covered by faculties in the division with special training in clinical epidemiology through a series of lectures, supervision of journal club presentations, and discussion at teaching rounds occurring on a weekly basis during the academic year (please see attached curriculum)

In addition, the residents’ knowledge management/transfer strategies will be developed over the course of the training using the objectives and individual resident learning portfolio as a guide. This will be a central part of the residents’ educational management encouraging life long continuous learning. Here the resident documents active learning using a case-based inquiry-based model that is recorded on a Web-based format and is available to the faculties for review and assessment prior to didactic/tutorial series.

Research

The division’s research strengths are in: ovarian cancer translational and clinical research, health service research, minimal invasive surgery, and knowledge transfer/management. The program has an established strong basic science department and an endowed chair in ovarian cancer research. Three of the four teaching faculties have Master’s degree (two in clinical epidemiology, biostatistics and population health and one in lab/science and translational research). In addition, the program has two senior accomplished basic scientists who are very active in basic research and two gynaecologic pathologists. Residents are expected to carry out at least one publishable research project at the end of their training to fulfill the research requirement of the Royal College. The following supports will be available to the residents to assist them in fulfilling these requirements.

There is yearly course in epidemiology, biostatistics, and research methodology organized by Dr. Le and Dr. Hopkins
Monthly Journal Clubs meeting where critical appraisal skills are taught and developed
Research Committee meetings are held monthly which involves the larger multidisciplinary team where research planning and update of ongoing research projects is done. Membership in the committee includes medical/nursing/psychologist/allied health professionals and residents in gynaecologic oncology
Resident chooses a research project and mentor (Drs. Le/Hopkins/Weberpals) in the first year to help them develop and complete their research project in a timely manner
The residents are expected to present their research protocols and final results at the department of Obstetrics and Gynecology research day in May of each year

Application Process:

Interested applicants should send a personal letter, a complete CV, and 3 reference letters to:

Erica Moore
Program Coordinator, Postgraduate Clinical Fellowship Programs
Department of Obstetrics and Gynecology
Phone: 613-737-8899 x 73254
Fax: 613-737-8070
Email: emoore@toh.on.ca

The deadline for application is the end of September prior to the commencement of the fellowship program on July 1 of the following academic year.

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Fellowship - Division of Reproductive Medicine

University/Location	Ottawa
Program Title	Gynecologic Reproductive Medicine Fellowship
Program Director	Dr. Doron Shmorgun
Mailing Address	955 Greenvalley Crescent, Ottawa, ON K2C 3V4
Telephone	613-686-3378
E-mail Contact	dshmorgun@conceive.ca
Positions (yearly)	1 position every 2 years
Application Due	April 30^th each year for start, on July 1^st of the following year
Salary Year I	$61,546.00, same in year 2
Length of Program	2 years

Dr. Doron Shmorgun
Program Director Gynaecologic Reproductive Medicine Program
Department of Obstetrics and Gynaecology
University of Ottawa
955 Greenvalley Crescent
Ottawa, ON
K2C 3V4
dshmorgun@conceive.ca

Fellows are registered with the Faculty of Medicine, University of Ottawa as post-graduate trainees and are as such eligible for all extra training programs offered through the Faculty of Medicine. Applicants must have completed five years of training in ObThe University of Ottawa Department of Obstetrics and Gynaecology, Division of Gynaecologic Reproductive Medicine invites applicants for fellowship training in Gynaecologic Reproductive Endocrinology and Infertility. This is a fully funded Royal College Accredited two-year program.

This fellowship incorporates all Royal College Requirements for training in a fully individualized training program. Fellows will gain extensive training in clinical or basic science research, and the medical and surgical care of infertility patients.

Training is broken down as follows:

Clinical Rotation in: Clinical Reproductive Endocrinology and Infertility. Paediatric Gynecology, Paediatric Endocrinology, IVF- ET and Infertility Surgery.
Ultrasound: This rotation is spent specifically learning ultrasound with respect to follicle tracking and problems of the infertility patient. The fellow is expected to take the ARDMS examination by the end of the two years.
Menopause: This rotation is spent in a clinic dedicated to the care of menopausal women.
Research: The research rotation will include a course at the University of Ottawa on Clinical Trials and Statistical Methods. The fellow has the option to include laboratory experience in the basic science laboratories in the Loeb Research Institute and the gamete laboratory of the human IVF lab.

The trainee will be expected to have submitted at least one research paper to a peer-reviewed journal by the end of the training period. Funding is provided to attend meetings to present research. The trainee will also participate in teaching our OB/GYN resident staff and undergraduate students.

The University of Ottawa Fertility Centre sees approximately 8000 clinic visits per year. The IVF unit treats 550 cycles of IVF per year and also treats 600 cycles per year of AI, Ovulation induction and Superovulation with Intrauterine Insemination.

Fellows are registered with the Faculty of Medicine, University of Ottawa as post-graduate trainees and are as such eligible for all extra training programs offered through the faculty of medicine.

Applicants must have completed five years of training in Obstetrics and Gynaecology with certification from the Royal College of Physicians and Surgeons of Canada (by the time they begin fellowship). Applicants must be Canadian Citizens.

Applications should include a cover letter, CV, and 3 letters of reference.

Applications will be accepted until April 30^th each year for start, on July 1^st of the following calendar year and should be sent to the address below. Interviews take place in May each year.

Dr. Delani Kotarba
Program Director Gynaecologic Reproductive Medicine Program
Department of Obstetrics and Gynaecology
University of Ottawa
955 Greenvalley Crescent
Ottawa, ON
K2C 3V4
dkotarba@conceive.ca

Fellowship

Fellowship - Division of Maternal-Fetal Medicine

Fellowship - Division of Gynecologic Oncology

Fellowship - Division of Reproductive Medicine

Fellowship - Division of Urogynecology and Reconstructive Pelvic Surgery (URPS)

Fellowship - Minimally Invasive Gynaecology