Upper Extremity & Trauma

Sunnybrook Health Sciences Centre
St. Joseph’s Health Centre

Number of Positions

3 per year

Duration

1 year

Sites

Sunnybrook Health Sciences Centre (Bayview Campus and Holland Orthopaedic and Arthritic Centre), as well as St. Joseph’s Health Centre

Supervisors
  • Dr. Terry Axelrod
  • Dr. Amr ElMaraghy
  • Dr. Patrick Henry
  • Dr. Diane Nam
  • Dr. Robin Richards

This is a comprehensive Upper Extremity Fellowship with both Level 1 and Community Trauma experience. During year, the Fellow will be involved with the care of both elective and trauma patients. We will provide a fellowship experience in shoulder, elbow, wrist and hand surgery, in a preceptor based learning experience. Emphasis will be placed on reconstructive surgery, with wide clinical exposure and operative experience in areas of arthroscopy, soft tissue and joint reconstruction, and wrist and hand surgery. Patient assessment and management in outpatient clinics and fracture clinics in pre- and post-operative care allows the Fellow to participate in treatment plan, surgical procedures and continuing care after surgery.

Academic responsibilities include participation in weekly rounds, resident seminar series, and teaching for both resident and undergraduate students. Each fellow will be involved in a research project with the ultimate goal of publication and presentation at major scientific meetings.

This fellowship focuses on the management of hand, wrist elbow and shoulder conditions. The curriculum is designed to provide the Fellows with a foundation for practice in the area of upper extremity surgery and rehabilitation.

On-call duties will not exceed one in four.

The main site for the clinical fellowship will be Sunnybrook Health Science Centre and St. Joseph’s Health Centre. Workplace Safety and Insurance Board (WSIB) subspecialty assessment clinics and surgery will be attended up to 4 times per month at Sunnybrook Health Sciences Centre, Holland Orthopaedic and Arthritic Hospital for the Shoulder and Elbow clinic.

Proposed training content and time commitment includes:

  1. Clinical activity:
    1. OR ~ 16 hours per week
    2. Fracture Clinic ~ 8 hours per week
    3. Subspecialty Clinic and OR ~ 4 hours per week
  2. On-Call activity: 1 in 5 (home call, exclusively with supervisor)
  3. Scheduled teaching sessions: Weekly Upper Extremity Rounds, Quarterly Upper Extremity Journal Club/Rounds
  4. Courses related to subspecialty: Annual University of Toronto Upper Extremity Update (one day symposium)
  5. Related conferences: OOA, COA, AANA, AAOS, ASES

The clinical fellow is expected to initiate and complete an original clinical or basic science research project and/or to participate in an established research project.

The clinical fellow may be asked to commit a minimum of 1 hour per week to teach on-service surgical residents general orthopaedic and specific upper extremity topics of interest.

The clinical fellow is expected to work closely with the supervisor, participating in daily aspects of his upper extremity orthopaedic surgery practice. The clinical fellow will assess emergency and fracture clinic patients (including all new referrals), observe subspecialty clinic evaluations and assist in the operating room. Spare time will be used to read about cases observed, prepare presentations for rounds and complete a research project.

The CanMeds competencies, as outlined by the Royal College of Physicians and Surgeons of Canada, are relevant to all surgeons, regardless of their country of origin. All University of Toronto Department of Surgery clinical fellows are expected to have these basic skill sets and will be evaluated on them.

Clinical fellows must demonstrate appropriate knowledge relating to gender, culture and ethnicity pertinent to their specialty.

Consistent with the obligation of a physician, clinical fellows must endeavor to deliver the highest quality of care with integrity, honesty and compassion while exhibiting appropriate personal and interpersonal professional behavior. Clinical fellows must adhere to the principles outlined in the University of Toronto Code of Student Conduct.

As continuing education and evaluations are necessary throughout a surgeon’s life, clinical fellows are expected to have an understanding of the role of research and the need for critical analysis of current scientific and practice developments related to their specialty.

Goals and Objectives

This clinical fellowship position is designed to give the applicant enhanced clinical expertise in the following areas:

1. Ability to demonstrate knowledge and understanding of common disease processes specific to the shoulder, elbow, wrist and hand, including, but not limited to:

  • Osteoarthritis (OA)
  • Rheumatoid Arthritis (RA)
  • Instability
  • Trauma
  • Tendinopathy
  • Compressive neuropathy

2. Develop competency in arthroscopic and open upper extremity reconstruction surgery including the clinical management of:

  • Shoulder arthritis
  • Shoulder instability
  • Rotator cuff tendinopathy
  • Elbow arthritis
  • Wrist and hand arthritis
  • Upper extremity RA
  • Upper extremity trauma
  • Compressive neuropathy
  • Sports medicine

3. Develop competency in the correct application, choice and performance of the following surgical procedures:

  • Shoulder, Elbow and Wrist Arthroscopy
  • Total Shoulder and Total Elbow Arthroplasty
  • Arthroscopic and Open Rotator Cuff Reconstruction
  • Arthroscopic and Open Shoulder Stabilization
  • Arthroscopic and Open Elbow Debridement and Release
  • Open Elbow Ligament Reconstruction
  • Hand and Wrist Ligament Reconstruction
  • Hand and Wrist Arthrodesis
  • Scaphoid Reconstruction
  • Tendon Repair and Reconstruction
  • Peripheral Nerve Decompression and/or Transposition

Contact

Attn: Ms. Carolyn Gimera, Administrative Director
Division of Orthopaedic Surgery
Sunnybrook Health Sciences Centre
2075 Bayview Ave., Rm MG 317
Toronto, Ontario M4N 3M5
Tel: 416 480-4884
Fax: 416 480-5886
Email: carolyn.gimera@sunnybrook.ca