Orthopaedic Trauma

University of Toronto Orthopaedic Trauma Fellowship

  • St. Michael’s Hospital
  • Sunnybrook Health Sciences Centre

Fellowship Supervisors

Fellowship Description

The University of Toronto Orthopaedic Trauma Fellowship is a one year clinical fellowship in Orthopaedic Trauma designed to produce academic and clinical leaders in the field of orthopaedic trauma. The clinical exposure consists of four 3 month rotations with one of four fellowship-trained orthopaedic trauma surgeons at the University of Toronto. Clinical rotations will be divided evenly between the two Level 1 trauma centres in Toronto: St. Michael’s Hospital and Sunnybrook Health Sciences Centre. Both of these centres are high-volume, Level 1 trauma hospitals with daily orthopaedic trauma and over 800 trauma team activations on an annual basis. Clinical exposure will consist of pelvic/acetabular trauma, poly-traumatized patient care, complex peri-articular trauma, and post-traumatic reconstruction (nonunion/malunion surgery). In addition, each of the fellowship supervisors have active elective surgery practices, and fellows will be exposed to primary and revision hip/knee arthroplasty, upper extremity surgery, and sports medicine/arthroscopy. Academic exposure will include participation in divisional and hospital rounds, teaching of residents/medical students, quarterly city-wide orthopaedic trauma rounds, and participation in orthopaedic trauma research. The University of Toronto is an international leader in orthopaedic trauma research and opportunities for participation in both clinical and basic science research exist, and will be a requirement for fellows.

Application Requirements

  • The applications are due November 1, 2024 for the fellowship year 2026. The fellowship will run from August 1, 2026 to July 31, 2027.
  • Applications should include:
    • a letter of intent addressed to the “University of Toronto Orthopaedic Trauma Fellowship c/o Dr. Aaron Nauth”,
    • an updated curriculum vitae, and
    • 2 letters of reference from orthopaedic surgeons you have trained under.
  • Your appointment is contingent upon being appropriately licensed to engage in clinical activities in the Province of Ontario, upon being granted membership to the College of Physicians and Surgeons of Ontario (CPSO), the Canadian Medical Protective Association (CMPA) and obtaining an OHIP billing number.
  • Please confirm with Ilke Kusatman that your application has been received in full by the deadline.

Fellowship Objectives

The primary objective of the University of Toronto Orthopaedic Trauma Fellowship is to provide trainees with an advanced level of skill and knowledge in the management of orthopaedic trauma conditions. In addition, advanced knowledge in orthopaedic trauma research and education will be acquired. It is anticipated that fellows graduating from this program will have developed many of the skills and knowledge needed to become academic and clinical leaders in the field of orthopaedic trauma.

Specific educational objectives include:

  1. Proficiency in the clinical and radiographic assessment of musculoskeletal injuries.
  2. Proficiency in the surgical and non-surgical management of pelvic/acetabular trauma, long bone fractures, and complex peri-articular injuries.
  3. Advanced understanding of the pathophysiology of the multiply injured patient including the indications for damage control surgery and the appropriate timing of definitive orthopaedic management.
  4. Advanced understanding of the interdisciplinary relationship between various members of the trauma team including general surgery, critical care, anesthesia, neurosurgery, urology, and physical medicine and rehabilitation.
  5. Proficiency in the techniques of advanced trauma life support (ATLS).
  6. Advanced understanding of the principles and surgical techniques in the management of soft tissue injuries, including multi-ligament knee injuries.
  7. Proficiency in techniques for treating deep wound and bone infections, as well as segmental bone loss, and nonunion/malunion.
  8. Proficiency in the techniques for post-traumatic reconstructive surgery, including joint and ligament replacement, augmentation, osteotomy and fusion techniques.
  9. Advanced knowledge of the principles of biomechanics, biomaterials and bioengineering and how they relate to orthopaedic traumatology and reconstruction.
  10. Advanced knowledge regarding the performance of clinical research in orthopaedic trauma.

Furthermore, it is expected that individuals completing this fellowship training will be able to:

  1. Organize and administer an orthopaedic trauma service, and coordinate the activities of the service with other administrative units.
  2. Establish policies and procedures for the management of orthopaedic trauma patients.
  3. Appoint, train, and supervise specialized personnel in orthopaedic trauma.
  4. Teach the specialized body of knowledge required for the comprehensive management of the orthopaedic trauma patients.

Fellowship Structure

Fellowship time will be divided equally between St. Michael’s Hospital and Sunnybrook Hospital, with fellows spending 6 months at each hospital. Fellows will spend 3 months with each of the orthopaedic trauma staff and will attend the operating rooms and clinics of the staff to which they are assigned. On-call responsibilities will be performed at the hospital which the fellow is assigned to. Fellows will maintain cross-appointment at both hospitals for the duration of the fellowship year.

The fellowship supervisors of the University of Toronto Orthopaedic Trauma Fellowship are dedicated to resident teaching and must abide by the rules and regulations of the Division of Orthopaedics. Fellows can expect to share surgical experience and exposure with orthopaedic residents at all times. It will be expected that the fellows actively engage in resident and medical student teaching. It is expected that fellows will be given graduated responsibilities in the clinic and OR with progression to independent operating in the appropriate context.

Fellowship Supervisors

Dr. Aaron Nauth, MD, MSc: Dr. Nauth is an Assistant Professor at the University of Toronto and an Orthopaedic Trauma and Sports Medicine Surgeon at St. Michael’s Hospital. He is also a trauma team leader at St. Michael’s Hospital. Dr. Nauth’s orthopaedic trauma practice is diverse and includes pelvic/acetabular trauma, polytrauma, flail chest surgery, complex peri-articular injuries, periprosthetic fractures, nonunion/malunion treatment and multi-ligament knee reconstruction. His elective practice comprises about 30 percent of his clinical time and involves arthroscopy and sports medicine. Dr. Nauth is a surgeon-scientist and has an active clinical and basic science research program in orthopaedic trauma. Dr. Nauth is the fellowship coordinator for the University of Toronto Orthopaedic Trauma Fellowship.

Dr. Jeremy Hall, MD, MEd: Dr. Hall is an Assistant Professor at the University of Toronto and an Orthopaedic Trauma and Upper Extremity Surgeon at St. Michael’s Hospital. He is also a trauma team leader at St. Michael’s Hospital. Dr. Hall’s orthopaedic trauma interests include pelvic/acetabular trauma, polytrauma, complex peri-articular injuries, upper extremity periprosthetic fracture surgery, reverse shoulder for proximal humeral fracture, and nonunion/malunion treatment. A large proportion of the fracture care at St. Michael’s Hospital is performed by either Dr. Hallor Dr. Nauth. His elective practice comprises about 40 percent of his clinical time and involves upper extremity soft tissue reconstruction and arthroplasty. Dr. Hall is an associate program director of the orthopaedic residency program at the University of Toronto and is actively involved in orthopaedic education at all levels.

Dr. Markku Nousiainen, MD, MSc, MEd: Dr. Nousiainen is an Assistant Professor at the University of Toronto and an Orthopaedic Trauma and Arthroplasty Surgeon at Sunnybrook Hospital. Dr. Nousiainen’s orthopaedic trauma interests include pelvic/acetabular trauma, polytrauma, complex peri-articular injuries, fracture fixation and revision surgery for periprosthetic fractures, and nonunion/malunion treatment. His elective practice comprises about 60 percent of his clinical time and involves primary and revision arthroplasty. Dr. Nousiainen is the program director of the orthopaedic residency program at the University of Toronto and is actively involved in orthopaedic education at all levels.

Dr. Richard Jenkinson, MD, MSc: Dr. Jenkinson is an Assistant Professor at the University of Toronto and an Orthopaedic Trauma and Arthroplasty Surgeon at Sunnybrook Hospital. Dr. Jenkinson is the orthopaedic trauma section leader at Sunnybrook. Dr. Jenkinson’s orthopaedic trauma interests include pelvic/acetabular trauma, polytrauma, complex peri-articular injuries, fracture fixation and revision surgery for periprosthetic fractures, foot and ankle trauma, and nonunion/malunion treatment. His elective practice comprises about 40 percent of his clinical time and involves primary and revision hip/knee arthroplasty. His Master’s degree is in clinical epidemiology which supports research interests in outcomes and processes of care of trauma and arthroplasty patients.

Fellowship Sites

Sunnybrook Health Sciences is a Level 1 trauma centre located in Toronto. Sunnybrook has approximately 1400 trauma team activations per year and has a dedicated orthopaedic trauma OR five days a week. Sunnybrook is also a primary referral centre for isolated pelvic and acetabular fractures.

St. Michael’s Hospital is a Level 1 trauma centre located in downtown Toronto. St. Michael’s has approximately 800 trauma team activations per year and has dedicated trauma OR’s five days a week. St. Michael’s is also a primary referral centre for complex upper extremity fractures, knee dislocations and isolated pelvic/acetabular trauma.

Fellow Duties and Expectations

Patient Care

Fellows must be in attendance at the operating rooms and outpatient clinics of their designated supervisor. It is expected that fellows will review all surgical cases pre-operatively and develop a surgical plan. Although inpatient care of post-operative patients and emergency room coverage is generally performed by the orthopaedic residents, fellows may be responsible for primary in-hospital care. The opportunity for trauma team leader coverage will be made available to fellows during their rotations at St. Michael’s Hospital.

On-Call Responsibilities

Fellows are responsible for providing on-call coverage as part of their fellowship activities. At Sunnybrook Hospital, fellows will be part of a rotating fellowship call schedule (approximately 1 in 8). At St. Michael’s Hospital, fellows will be expected to take call when their supervisor is on call (approximately 1 in 6).

Rounds

Fellows will be required to attend weekly Hospital trauma rounds at their designated sites and quarterly city-wide orthopaedic trauma rounds. Fellows will be strongly encouraged to make themselves available for the many orthopaedic educational opportunities offered through the University of Toronto Orthopaedic Program including City Wide Rounds, University Rounds, and Grand Surgical Rounds.

Research

As part of the University of Toronto Orthopaedic Trauma Fellowship Program, fellows will be expected to complete one clinical or basic science research project. One protected half day per week will be allotted to participate in research. Fellows will be required to present the results of their research project at the annual Division of Orthopaedics Fellowship Research Day. Research projects will be supervised by one of the fellowship supervisors and should be formalized during the early part of the Fellowship.

Teaching

Fellows will be expected to actively participate in the education of orthopaedic residents, medical students and allied health.

Fellow Evaluation

Formal evaluations for each fellow will be completed by the fellowship supervisors at the conclusion of each 3 month rotation. Fellows will be required to complete an evaluation of their supervisor at the end of each rotation. A final evaluation will be completed for each fellow by the fellowship coordinator.

Contact

Ilke Kusatman
Email: ilke.kusatman@unityhealth.to

Educational grants to help us support our trauma fellows were provided by:
DePuySynthes  Zimmer Biomet