The Department of Anesthesia and Pain Management of the University Health Network and the University of Toronto offers a 12-month fellowship training program in Regional Anesthesia and Acute Pain Management at the Toronto Western Hospital. Our training program aims to confer both the clinical proficiency and academic knowledge that a consultant regional anesthesiologist in modern anesthetic practice requires.

A total of 4 fellowship places are offered each year, beginning in July. Applications should be made at least 18 months in advance, and shortlisted candidates should be prepared to travel to Toronto for a site visit and interview. Final selection decisions are generally made 1 year in advance of the start date.

Clinical Experience

The Toronto Western Hospital performs approximately 3,000 regional anesthesia procedures each year. These are organized around a block room model.

Fellows will gain both organizational skills related to regional anesthesia as well as technical expertise in a variety of peripheral nerve block techniques performed for orthopedics, plastics, and general surgery. Under the direct supervision of an attending regional anesthesiologist, fellows will learn to perform interscalene, supraclavicular, infraclavicular, and axillary brachial plexus blocks, as well as distal forearm blocks of individual nerves. Lower extremity blocks routinely performed at our institution include femoral, sciatic, popliteal, and ankle blocks. Fellows will also gain expertise in continuous catheter perineural infusion techniques for both the upper and lower extremities, as well as neuraxial blocks. Fellows will master the fundamental skills of ultrasound –guided intervention, which will allow them to apply it to virtually any procedure. 

Fellows will also participate in the Acute Pain Service rotation and non-regional anesthesia cases during the training year. The Acute Pain Service manages approximately 2,000 patients per year including some referrals with challenging chronic and cancer pain.

On non-regional days and on call, fellows will have clinical exposure to the other surgical specialties at Toronto Western Hospital, which include neurosurgery, major spine surgery, general surgery, bariatric surgery, urology, and interventional radiology.

Research Experience

Regional anesthesia fellows will be allocated to spend 20% of their time in research and educational activities. There is a strong academic focus at Toronto Western Hospital, and fellows are expected to demonstrate commitment to academic work. Under direct staff supervision, regional anesthesia fellows are expected to initiate at least one research project and prepare at least one research protocol during the training year. There is ample opportunity to participate in research projects already underway in various stages from data collection to manuscript preparation, as well as to assist in the authorship of monographs and book chapters. Fellows are expected to present their research at national and international meetings as well as publish their work in high-impact journals. Our current areas of research include ultrasound-guided peripheral nerve blockade and neuraxial blockade, education and training in ultrasound-guided regional anesthesia, complications of regional anesthesia, outpatient pain management techniques, and anesthetic applications of diagnostic ultrasound.

Education

Regular Regional rounds are held at the departmental level throughout the year which will include journal discussions, case discussions, and didactic presentations. Fellows are expected to participate in these rounds to gain experience in presentation and teaching. The group conducts several regional anesthesia workshops throughout the year in which fellows are expected to participate, first as attendees, and then as faculty.

Teaching Experience

Fellows are expected to assume a teaching role and instruct both junior and senior residents in regional anesthesia techniques. Fellows will also have opportunities to further develop teaching skills as faculty at many of the educational initiatives offered by our Department of Anesthesia, including our quarterly Hands-On Ultrasound for Regional Anesthesia Workshops, the annual Regional Anesthesia and Pain Medicine Conference, and bi-annual International Symposium on Ultrasound in Regional Anesthesia in Pain Medicine.

Candidates must have completed specialty training by the time of commencement of fellowship, to a level equivalent to Royal College of Physicians and Surgeons of Canada certification. 

ACGME approved fellowship: There is presently no sub-specialty certification 

Fellowships commence on July 1st of each year. Applications are due at least 18 months in advance of the start date. The application must include a letter of intent (stating the desired start date, and describing personal goals in undertaking the fellowship as well as future career objectives), curriculum vitae, and three letters of recommendation. 

Applications are reviewed in January-March of the preceding year, and shortlisted candidates will be invited for interview. Candidates are strongly encouraged to visit the department prior to the interview if possible. Successful candidates will be notified at least 12 months in advance of the commencement date. Applications received less than 15 months before the desired start date can only be considered in the event that unexpected openings occur in the program. 

[email protected]