Crest

University of Toronto - Anesthesiology - Clinician Investigator Program - Toronto

2022 R-1 Main Residency Match - first iteration
CMG Stream for CMG

Last approved on January 17, 2022

Summary of changes

Approximate Quota:

 2 

Accreditation status : Notice of intent to withdraw accreditation

Provincial Criteria


Dr. Eric You-Ten
Dr. Joseph Fiorellino
Anesthesia 
123 Edward Street 
12th Floor
Toronto , Ontario, M5G 1E2
416 946-6362
416 978-6710
University of Toronto - Dept. of Anesthesia
PGME at U of T

Program Contacts

Dr. Eric You-Ten
Program Director
Eric.You-Ten@sinaihealth.ca

Dr. Joseph Fiorellino
Associate Program Director
joseph.fiorellino@uhn.ca

Mr. Dwayne Rodrigues
Residency Program Officer
residency.anesthesia@utoronto.ca
416-978-6362


Important Information

Please be aware that most, if not all, hospitals and Universities in Ontario have mandatory COVID-19 vaccination policies in place that require, in the absence of a valid medical or human rights exemption, proof of vaccination. Acceptable vaccination must be in accordance with Health Canada. You will be required to provide documentation of COVID-19 vaccination to the appropriate institution if matched. Failure to comply and provide the appropriate documentation may result in the termination of the contract. These guidelines could change at any time in accordance with future direction from the Ministry of Health or the Universities based on information from Public Health.  

 

Applicants to the Clinician Scientist Program (CIP) are applying to the anesthesia residency program with the addition of the CIP training.  The same clinical training process applies, but it is a 6 year program with 2 of the 6 years of training being devoted to the Clinician Scientist Program.  

For more details, please visit our department website.

Applicants who wish to be considered for the Anesthesia Residency Program should they not be successful to the CIP match MUST ALSO apply to the CMG stream.

 

 

Eligibility Requirements

CIP trainees are enrolled as Anesthesia residents in the Postgraduate Medical Education Program at the University of Toronto. In addition, they must apply and be enrolled full-time in a Graduate Unit for a minimum of two years. Graduate Units that have participated in the program include: Institute of Medical Science, Institute of Health Policy, Management and Evaluation, Public Health, Education, Laboratory Medicine and Pathobiology, Medical Biophysics, Institute of Biomaterials and Biomedical Engineering and Physiology. Other Graduate Units not listed here are also considered, these are examples only. If pursuing a non-thesis degree (i.e. M.Ed) during their CIP training, the candidates must submit a letter from their potential School of Graduate Studies-qualified supervisor attesting that they will be taking full responsibility for the trainee to receive a well-structured research experience. Applicants must contact the CIP office before applying.

CIP trainees who do not hold a graduate degree will enrol in a graduate program leading to a M.Sc. or Ph.D. degree at the University of Toronto and must fulfill admission requirements of the participating graduate unit. Applicants are reviewed by both the Graduate Admissions Committee of the respective graduate unit and the CIP Committee.

Trainees who have already completed a Ph.D. degree are encouraged to apply and, if accepted, will enter the CIP as a postdoctoral fellow. For such individuals, the CIP will provide an opportunity to integrate research and clinical care to add to their previous research experience in an appropriate mentoring environment. These individuals must still fulfil the requirements of the CIP program.

 

 

Please note the following information:

The Royal College of Physicians and Surgeons of Canada: Applying competency-based practices to residency education

To contribute to the success of Canadian physicians and the delivery of high-quality patient care, the Royal College of Physicians and Surgeons of Canada has embarked upon an initiative to introduce competency-based medical education (CBME) in Canadian postgraduate specialty training and in professional practice in Canada. This initiative, called Competence by Design (CBD), aims to enhance patient care by aligning medical education and lifelong learning with evolving patient needs and empowering learners to more fully engage in their education process.

CBD will use time as a framework rather than the main basis for progression. It is not anticipated that the duration of training will change for the majority of trainees. Residency programs will be broken down into stages, and each stage will have a series of milestones based on required competencies. These milestones will create more targeted learning outcomes and involve more frequent, formative assessments within the clinical workplace to ensure residents are developing and receiving feedback on the skills they need.

Anesthesiology programs in Canada have adopted CBD in July 2017. Thus, residents entering Anesthesiology will experience CBD-based learning and assessment.

All programs implementing CBD will continue to undergo the same rigorous accreditation processes as traditional programs. All CBD programs (and traditional programs) will continue to lead to Royal College approved certification. Certification for trainees in both CBD and traditional programs will include the completion of a Royal College examination; however, residents in CBD programs will also be assessed against program milestones throughout their training. Within a CBD program, all milestones (documented within an electronic portfolio) and the Royal College examination must be successfully completed to achieve certification.

For more information, please contact cbd@royalcollege.ca.

 

 

"CBD at UofT"

The University of Toronto, Department of Anesthesia Residency Program, implemented a complete CBD curriculum July 2017.  The program is in full alignment with the Royal College of Physicians and Surgeons of Canada.  The program has highly functioning CBD development and Competence Committees.  Resident representation is present at all planning and implementation committees.

The program has implemented a full set of competence-based assessment tools and criteria for current trainees.  This includes stage appropriate Entrustable Professional Activities and other workplace-based assessments.  All residents receive detailed orientation and ongoing information sessions regarding CBD process and expectations.  Each resident is reviewed at least twice per year by our very committed Anesthesia Resident Competence Committee.  These reviews are completed and forwarded to each resident for feedback regarding their individual performance and progress.  Individual detailed reports and academic support is provided to each resident regularly.  Each resident is also paired with an Academic Coach and residents can meet with them as often as they wish to discuss their learning trajectory and receive advice and support regarding academic progress. Additionally, the program has developed assessment maps and training requirement documents to guide each resident in managing the CBD requirements. 

In order to ensure that CBD implementation improves trainee learning and feedback, the program has initiated robust faculty development with an emphasis on data analytics and the creation of a Competence Committee rooted in best practices. The program has also taken the lead in developing Assessment Dashboards detailing the data collected from daily assessments.  These dashboards are highly customizable and allow the residents to view their progress throughout training, including many contextual variables and assessment metrics. 

We are very committed to working with the Royal College of Physicians and Surgeons as the national initiative of CBD implementation continues across all disciplines. We will continue to improve our own program and make any necessary changes to align with or exceed national standards and expectation. 


General Instructions

Program application language: English

Thank you for your interest in our program!

The University of Toronto, Department of Anesthesia is a clinical and academic center of excellence which provides an exceptional opportunity for residency training.  As a department which promotes and values respect and diversity, we are committed to training for excellence in a robust and supportive environment.  Our program seeks to foster an academic and clinical environment which supports excellence across the educational spectrum including clinical excellence, social accountability, and intellectual inquiry.  Accordingly, we are looking for highly motivated and committed candidates who are eager to take advantage of all opportunities the program has to offer.  Strong CanMEDS competences, leadership skills, and high professional standards are key attributes we seek in our applicants.  

We look forward to you getting to know us.

 

CaRMS Meets & Greets 2021-2022 

The Program Director, Associate Program Director and Co-Chief Residents will lead the information sessions followed by breakout room sessions with current residents. CMG applicants are encouraged to attend both the November 30th and January 25th session, and IMG applicants are encouraged to attend all 3 sessions

Please register using the following link to receive further details on these virtual sessions: CaRMS Info Sessions – Registration

Looking forward in meeting you at one of our Meet & Greets!

Visit our website @UofT - Anesthesiology and Pain Medicine

Follow us on Twitter @UofTAnesthesia  #relentlessinnovation #torontoanesthesia

Follow us on Instagram @TorontoAnesthesia

Join our CaRMS Facebook group @Anesthesia CaRMS Facebook Group

 


Supporting Documentation

Canadian citizenship
CaRMS partners with third-party organizations to verify your citizenship or permanent resident status. If your status is verified by one of these organizations, you will not need to provide citizenship documents in your application. If your citizenship status is not verified, you must provide one of the documents listed below.
Document must be notarized/certified
Required
Submit one of the following documents to verify your Canadian citizenship:
• Canadian Birth Certificate or Act of Birth
• Certificate of Canadian Citizenship
• Confirmation of Permanent Residence in Canada
• Passport page showing Canadian Citizenship
• Canadian Permanent Resident Card (both sides of card)
• Canadian Citizenship Card (both sides of card)

Legal Status

Proof of valid current citizenship or permanent resident status must be provided by submitting one of the following verifications to CaRMS by the File Review Opening deadline. Failure to provide valid proof will result in your application being removed. No other forms of verification are acceptable:

  1. Notarized/certified photocopy of Birth Certificate/Act of Birth issued by an authority in Canada accompanied by photo ID (must be Canadian government-issued photo ID).
  2. Documents must be notarized/certified photocopies. Notarized/certified copies must not be older than two years from the application submission deadline; otherwise, a new notarized/certified copy is required.
  3. Confirmation of permanent residence must be accompanied by a photo ID (must be a Canadian government-issued photo ID).

CaRMS is partnering with third-party organizations to automate the verification of citizenship/legal status required by postgraduate offices for entry into residency. Third-party verification simplifies the process for applicants and programs. All applicants who do not receive third-party citizenship verification will be required to upload and assign an acceptable proof of citizenship document. Please see additional information here.

Reference documents
Required
Number requested: 3

All candidates require referees to submit 3 Letters of Reference directly to CaRMS. If possible one or more reference letters from an Anesthesiologist is helpful but not required. 

Additional documents
Required
Photo 
[Note: Photograph is used as memory aid only]

Medical School Transcript 

Order from your Registrar

Medical Student Performance Record 

Order from your Registrar

Personal Letter 
Word count
Minimum : None
Maximum : None

CIP applicants will require 2 letters; please see the Description of Research Interests section for the second requirement

Our Program requires the candidate to write a personal letter which directly answers the following three questions:

  1. What is your perception of Anesthesiology as a specialty and Anesthesiologists as professionals?  How would you define professionalism within residency training? (500 words)
  2. Anesthesiology can be a challenging residency and a stressful specialty. Tell us about your biggest professional failure or challenge, what you learned from it, and how this will help you overcome setbacks as an anesthesiologist. (500 words)
  3. Medicine requires a strong sense of responsibility and dedication (personally, professionally and socially). Tell us how you excel in these areas. (500 words)

       Total Maximum Word Count for Letter 1: 1500 (no minimum requirement)

 

 

Custom Résumé / CV 

A Custom Resume or Curriculum Vitae is required.  This will be used as part of the file review process to assess academic potential.  As such, please highlight personal, professional or academic achievements, leadership positions, volunteerism, examples of global citizenship and teaching experience should be highlighted.  A very brief description of the activity, your commitment and personal involvement, and the impact (impact to you personally/professionally and/or the impact you made) would be very helpful to the reviewers.  We would also be interested in seeing your extracurricular interests and achievements.

NOTE: If you have had academic difficulty, repeat years or gaps in training/education or work history, please indicate so on your CV and/or add an addendum to your CV to explain 

 

Description of research interests 

CIP applicants will be required to write a statement addressing their interest in CIP.  Specifically, their research interest to date and why they are interested in CIP and a career as a Clinician Scientist. Please upload this letter under the “Description of Research Interests” document type.

      Total Maximum Word Count for Letter: 1000 (no minimum requirement)


Review Process

Applications submitted after file review has opened on January 31, 2022


Supporting documents (excluding letters of reference) that arrive after file review has opened  on  January 31, 2022


Letters of reference that arrive after the unmasking date on January 31, 2022


Our review process is highly standardized and follows the University of Toronto's PGME published Best Practices In Application and Selection (BPAS).  Our program strives for a fair and unbiased process with specific attention to equity and diversity.  All files are reviewed by a minimum of 4 independent reviewers in accordance with pre-set standardized criteria and scoring rubrics and all available information is considered. All acceptable CIP candidates are interviewed. 

The interview process and scoring are likewise standardized.  The interviews for the CIP program are two stages. The first is identical to and follows the same process as the CMG stream to determine suitability to the anesthesia residency training program itself.  The second is an additional CIP interview. The selection process involves current residents in all aspects of the process including file review, interviews, and Selection Committee. 


Interviews

Dates:

  • March 9, 2022
Our interview date will be Wednesday, March 9th, 2022

Program will notify all applicants through CaRMS Online and will send email invitations directly to applicants selected for an interview.
All applicants will be contacted regarding their status for interview once all files have been reviewed. Unfortunately, arrangements cannot be made for alternative interview dates outside the published dates.  All interviews will take place via videoconference utilizing Zoom.  Applicants who do not have an interview will not be considered for ranking.

Each CIP applicant will have a minimum of two standardized sets of interviews:

First Set: Interviewers may have access to candidate application material for the purpose of asking questions specific to the individual candidate.  Interviewers will not have access to the file assessment or ranking scores.  All application materials are reviewed and scored in a separate process from the interviews described above.  

Second Set: Will focus specifically on suitability to CIP.  Interviewers will have access to candidate application material for the purpose of asking specific questions related to the individual candidate's previous research experience, research focus, and interest.  They will not have access to the file assessment or ranking scores.  They will not have access to the performance or scores from the first set of interviews.  All application materials will be reviewed and scored in a separate process from the interviews.  

On the interview day, applicants will have the opportunity to virtually meet current residents in the program and are encouraged to ask the residents candid questions.  The Program Director will meet with all applicants and will provide a presentation where applicants can learn more about the program and ask any questions. 

 


Selection Criteria

The Anesthesia Program follows the University of Toronto Best Practices in Application and Selection (BPAS).  Our program seeks to foster an academic and clinical environment that supports excellence across the educational spectrum including clinical excellence, social accountability, and intellectual inquiry.  Accordingly, we are looking for academically driven candidates who are eager to take advantage of all opportunities the program has to offer.  Strong CanMEDS competencies and high professional standards are also key attributes we seek in our applicants.  

Applicants providing evidence of strong clinical and academic potential in the CaRMs application file will be prioritized for further consideration.  This would include academic or personal achievement (e.g. awards, innovative scholarship, advanced personal or professional training, research, publications), evidence of leadership capacity and experience (e.g. leadership roles, active and impactful committee memberships), volunteerism and social commitment, and/or teaching excellence.

Personal letters answering the specific program questions (see "additional information" section) and reference letters will also be assessed and will contribute directly to the file application assessment.  Successful candidates will be able to demonstrate strong CanMEDs competencies and suitability to anesthesia with cognitive and technical skills relevant to the specialty.  Demonstration of strong motivation, integrity, and professionalism is important. Excellent communication skills are required.

Candidates will be ranked based on the scores of their application (50%) and interview (50%).  The Selection Committee reserves the right to adjust final rankings by consensus to address issues of program priority and diversity.

The program strives to assess each component of the application (application file documents and interview performance) separately and independently, on its own merits.  One set of interviewers will have access to candidate application material for the purpose of asking specific questions related to the individual candidate.  They will not, however, have access to the file assessment or ranking scores.  All application materials will be reviewed and scored in the separate process to the interview.  

In summary, candidates will be selected based on separate and independent assessments of:

1. A complete file review:

  • evidence of strong academic performance
  • evidence of academic or personal achievement as evident in the curriculum vitae
  • a personal letter which directly answers the program's posed questions (see "additional information")
  • clinical capacity across the CanMEDS roles and suitability to anesthesia as reflected in reference letters submitted directly to CaRMS

2. Impression at interview

  • all invited applicants must attend the interview to be considered further 
  • see "interview" section for more information

Note, the program does NOT include extraneous information in its selection process such as unsubstantiated anonymous information.  Any other relevant information pertaining to an applicant outside the application and interview process would be considered by the Program Director and Department Chair before being presented to the full Selection Committee.

 

Program goals

Our program strives to train our residents to achieve clinical excellence and the ability to deliver preeminent perioperative patient care through continued vigilance, innovation, and scholarship.

The following values guide our training program and reflect the values of our university faculty and training institutions:

  • Integrity and professionalism;
  • Commitment to innovation and excellence;
  • Life-long learning and critical inquiry;
  • Diversity and social justice;
  • Partnership with our health science centres;
  • Collaboration among disciplines, professions, and in our community;
  • Support and collegiality;
  • Accountability; and,
  • Responsiveness to those whom we serve. 

Selection process goals

The skills and attributes we look for in an applicant include:

  • Potential for clinical excellence
  • Leadership skills
  • A strong sense of professionalism, engagement and commitment to training
  • Reliability, diligence, motivation and integrity 
  • Respect and empathy for others 
  • Potential for scholarship and scholarly impact to the profession

Our program seeks to foster an academic and clinical environment which supports excellence across the educational spectrum including clinical excellence, social accountability, and intellectual inquiry.  Accordingly, we are looking for academically driven candidates who are eager to take advantage of all opportunities the program has to offer.  Strong CanMEDS competences and high professional standards are key attributes we seek in our applicants.  

File review process

Review team composition : The file reviews are conducted by a team of faculty and staff. Each file will have at least 4 reviewers, at least one of which is a resident. Each component of the file review is assessed separately and by multiple reviewers.

Average number of applications received by our program in the last five years : 51 - 200

Average percentage of applicants offered interviews : 51 - 75 %

Evaluation criteria :
File component Criteria
CV The CV should briefly describe the entries, including the applicant's role and impact.
Electives Electives are not evaluated. We recognize that the COVID-19 pandemic has impacted candidates’ opportunities to arrange and complete electives and would like to reassure you that a lack of elective activity this year will not negatively impact your application to our program.
Examinations We do not evaluate this file component.
Extra-curricular Activities demonstrating depth of character, commitment or personal accomplishment are duly noted.
Leadership skills Highly valued.
MSPRs Will be reviewed as evidence for academic achievement.
Personal letters Required and reviewed. These should answer the outlined questions (see additional documents).
Reference documents Required and reviewed.
Research/Publications Required and reviewed.
Transcripts Required and reviewed.

Elective criteria

We recognize that the COVID-19 pandemic has impacted candidates’ opportunities to arrange and complete electives and would like to reassure you that a lack of elective activity this year will not negatively impact your application to our program.
We do not require applicants to have done onsite electives.

Due to COVID-19, we do not expect that all applicants will have been able to complete an elective rotation in Toronto. There will be no bias against these applicants.  We also appreciate that many truly interested applicants will not have encountered anesthesia until late in their medical education.

Interview process

Interview format :



We may accommodate requests to re-schedule interviews for applicants due to weather, technology failure, or unforeseen circumstances.

Interview evaluation criteria :
Interview components Criteria
Collaboration skills Evaluated.
Collegiality Evaluated.
Communication skills Evaluated.
Health advocacy Evaluated.
Interest in the discipline Evaluated.
Interest in the program Evaluated.
Leadership skills Evaluated.
Professionalism Evaluated.
Scholarly activities Evaluated.

Information gathered outside of CaRMS application

Specifically, we may consider:







Ranking process

The behavior(s) exhibited below during the interview process may prevent an applicant from being ranked by our program :
   
   
   


Program Highlights

The Clinician Investigator Program in Anesthesia at the University of Toronto

 

The Department of Anesthesia at the University of Toronto is the largest Anesthesia program in Canada and likely the most prolific for research and education. The opportunities for discovery and innovation within our Department abound. The Clinician Investigator Program (CIP) provides a unique opportunity to applicants who are interested in pursuing a career as a clinician scientist, combining medical practice and research.

For additional information, please see the website of the Clinician Investigator Program at the University of Toronto at CIPToronto and from the Special Program Training Requirements for the Clinician Investigator Program published by the Royal College of Physicians and Surgeons of Canada here.

 

Background

The University of Toronto Clinician Investigator Program (CIP) is an accredited Postgraduate Training Program of the Royal College of Physicians and Surgeons of Canada. It was the first fully accredited program in Canada and it is now the largest, with approximately 100 trainees enrolled. The Department of Anesthesia CIP graduates have contributed immensely to the advancement of our specialty and they now have faculty appointment at the University of Toronto or other large research-oriented universities in Canada.

The goals of the Anesthesia Clinician Investigator Program are:

1) to support research training for anesthesia residents enrolled in a graduate degree program;

2) to provide a postdoctoral research experience for anesthesia residents who already hold a doctoral degree

 

Duration of the CIP Training

To achieve these goals and receive the Attestation of Completion of the Clinician Investigator Program, a minimum of 2 years of continuous, intensive research training must be undertaken. During the 2 years of research, the majority of time (at least 80%) must be devoted to research, but some time may be spent in clinical activities (i.e the equivalent of 1 day per week).

Up to one of the research years may also be credited to fulfil the Royal College accredited clinical program requirements with joint approval of the faculty CIP director and the program director. Therefore, the CIP will extend anesthesia residency training by only one year, to a total of minimum 6 years. Additional research training in all CIP pathways can be extended to allow completion of a PhD or other research experiences and will further extend training.

 

CIP Training Streams

The Anesthesia Clinician Investigator Program is offered in two training streams:

  • The Graduate Stream, where applicants enroll in graduate (M.Sc. or Ph.D.) programs at the University of Toronto. CIP trainees can undertake research not only in laboratory and clinical biomedical research but also in other health care-related fields including education, health care economics, social, behavioural and information sciences, etc. Graduate Units at the University of Toronto that have participated in the program include Institute of Medical Science, Institute of Health Policy, Management and Evaluation, Public Health, Education, Laboratory Medicine and Pathobiology, Medical Biophysics, Institute of Biomaterials and Biomedical Engineering and Physiology. For successful completion of this program, CIP trainees in the Graduate Stream must fulfill all the requirements for clinical Anesthesia specialty training, and also all the course and thesis requirements of the graduate degree program they are enrolled in.
  • The Postdoctoral Stream is intended for anesthesia residents who already have a doctoral degree (Ph.D.) and are interested in undertaking a structured research program in a specialized area. Although the research training may be individualized, it but must be similar in content and rigor to a graduate school degree program. For Postdoctoral Stream trainees, completion of the research component means successfully attaining the specified research goals and objectives to the satisfaction of the CIP Committee.

 

Funding for CIP Training

Successful candidates will have the salary and tuition covered for 2 years of research. There are various sources of funding and once enrolled in the program, residents will be mentored and guided to find the best funding strategy for training.

The CIP trainees are encouraged to apply for external salary awards and grants to support their research training and enrich their portfolio.

 

CIP Entry Pathways

There are 2 entry pathways into the CIP:

  • Direct application to the CIP stream through CaRMS. This pathway is preferred because it secures a position in the CIP, it allows better planning of the research training and ongoing mentorship from the beginning of the postgraduate training. Please note that applying to the CIP stream will not negatively impact your application to the regular residency stream of our program, should you also apply. Candidates who apply to the CIP stream will ALSO need to apply to the regular residency stream to be considered if unsuccessful at CIP.
  • Residents who enter through the regular stream in the Anesthesia Training Program at the University of Toronto can still apply to CIP provided that there are available positions unfilled (only 2 CIP residents/year of training are generally available in the Department of Anesthesia). Generally, the application deadlines for residents already in the anesthesia program are May 1 for July 1 enrollment and November 1 for January 1 enrollment. CIP applications and instruction can be found on the UofT CIP website http://cip.utoronto.ca/prospective-trainee/httpcip-utoronto-cawp-contentuploads201710cip-application-2017-pdf)

All residents who are accepted in the CIP stream have a position secured in the regular training program.

Clinical Training:

Clinical training in the CIP is the same as the CMG program, except there are 4 years for clinical training.  

The University of Toronto offers a comprehensive program in Anesthesia, which is fully accredited by the Royal College of Physicians and Surgeons of Canada. Over 350 staff anesthesiologists at multiple sites are involved in resident education. These sites include: The Hospital for Sick Children; Mount Sinai Hospital; St. Michael's Hospital; Sunnybrook Health Sciences Centre, at both the Sunnybrook and Holland Centre campuses; Michael Garron Hospital; St. Joseph's Health Science Centre; The University Health Network at both the Toronto General and Toronto Western Hospitals; North York General Hospital and Women’s College Hospital. Each of these hospitals has a particular clinical focus and specific training opportunities which allows the program to offer residents training  in all areas of Anesthetic practice.

The variety of clinical opportunities and experiences that our residents encounter while in our training program is unparalleled. All subspecialties of anesthesia are offered in Toronto; our residents have the opportunity to obtain training in ALL areas of anesthesia practice during their residency.  For example, residents experience Obstetrical Anesthesia longitudinally throughout their training and also have a full protected block in high-risk quaternary-care Obstetrical Anesthesia.  

Other unique opportunities and strengths of our program include:

Simulation: There are multiple high fidelity Anesthesia Simulation Centers in the Department, and a Surgical Skills Center . These centres are used for the clinical training and education of anesthesia residents and multidisciplinary teams particularly in the areas of technical skills, critical event training and crisis resource management. Residents participate in simulator sessions throughout residency. In addition, senior residents are involved in the supervision and teaching of medical students in the simulator at our Sunnybrook site. We have also expanded the use of simulation in other areas including advanced airway management, vascular access and regional anesthesia.  In addition, each hospital has simulation opportunities for residents during rotations resulting in a robust longitudinal simulation curriculum.  For example, Toronto General Hospital has weekly simulation sessions during morning teaching. Virtual reality simulation is currently being pioneered at Sunnybrook Health Sciences, where residents wear a VR headset and run through simulation scenarios in the OR during morning teaching.

Regional anesthesia:  This has become a major focus at a number of sites in the Department of Anesthesia at the University of Toronto. All residents have the opportunity to train in regional anesthesia longitudinally and also complete block rotations specific to regional anesthesia education and experience.  This includes e-learning, simulation training and academic sessions all devoted to the acquisition of regional anesthesia skills. Many opportunities also exist for research in this field - particularly in the area of ultrasound-guided blocks – many commonly performed blocks have been pioneered by Anesthesiologists at UofT.

POCUS: All residents participate in a longitudinal Point of Care Ultrasound (POCUS) training curriculum. This includes full-day bootcamps, and a dedicated POCUS block rotation focused on the acquisition of competencied in cardiac, lung, FAST, airway, and gastric imaging.  There are also academic sessions throughout the year devoted to POCUS.  Residents have access to a spectrum of POCUS resources including trained faculty, US machines, TEE simulators and on-line materials e.g. http://pie.med.utoronto.ca/ 

Academic Curriculum: Our program boasts a very robust Academic Curriculum including morning teaching at all sites and protected academic half-days.  Protected academic time includes teaching sessions as well as protected time for wellness, mentorship, and individual or group study dedicated to developing CanMEDS competencies. In addition, we have a Resident Education Day in November organized by the Departmental Chief Residents focusing on a specific theme. This year, the focus of our Education Day was Dismantling Dominant Ideologies in Medicine: Equity, Diversity, and Inclusion for Patient Advocacy. An important aspect of our academic curriculum is that it is heavily resident driven and there is strong resident input in refining the curriculum each year.

The final year academic curriculum is devoted to the "Senior Revision Tutorial". The focus of these tutorials is a detailed academic review and the development of consultancy level judgement and critical thinking skills.  Through this rigorous program, our residents are very well prepared for the Royal College Examinations and independent practice.  Overall, our residents receive one half-day to one full day per week of protected academic time, including independent study time starting 6-months prior to the Royal College Written Examination. 

Research and Scholarship: The Department of Anesthesia at the University of Toronto is the largest and most productive academic anesthesia department in Canada. There is a very large, productive research community involved in both laboratory and clinical research. A number of internationally recognized researchers work with our department. All residents are have the opportunity to participate in research during their residency.  Residents are actively involved in our annual Shield's Day which showcases trainee research.

As well, we support a Clinician Investigator Program which provides a unique opportunity to applicants who are interested in pursuing a career as a clinician scientist. This is a two-year program which incorporates a centralized curriculum geared toward preparing candidates to become independent clinician scientists and the opportunity to become involved in research as part of a Masters or PhD program. Salary and tuition support is available for successful candidates.  See "Anesthesia Clinician Investigator Program" CaRMS site for more information.

In addition to research opportunities, our residents have a plethora of opportunities for scholarship. This includes QI/QA projects, development of patient safety initiatives, involvement in medical education (including simulation, creation of educational curriculum and e-modules), and teaching development.  Some residents have even completed graduate degrees and certificates during residency.

Please visit our website for further information. 

In addition to the robust and exciting clinical and academic opportunities, our residents are supported in many additional ways:

 

Resident Leadership:  As a resident-driven program, residents are encouraged to be involved in the development and governance of the program.  Residents from each year are active members of the program committees (Residency Program Committee, Applicant Selection Committee, etc.). Selected residents are also involved in Postgraduate Medical Education and Professional Association of Residents of Ontario.  There are Chief Residents at each training site as well as Departmental Chief Resident(s) who serve as resident program leaders. They facilitate two-way flow of information and ideas, especially in the context of program reorganization and change. Our residents are represented as true stakeholders in the program. The opinions and feedback of our residents is essential and ensures trainee involvement in the design and implementation of any changes.

Mentorship:  Our residency program endeavours to provide mentorship in residency training by structuring a mentorship program that is aimed to enhance personal and professional development, and to provide guidance to all residents .  Our program has always had an open door policy for the residents to informally seek advice and support from faculty including Site Coordinators and the Program Director.  In addition, residents entering into the program are assigned to a formal Mentorship Group and are paired with a Near-Peer mentor for additional support.

Academic Support: In addition to the academic support of the individual Site-Coordinators and the Program Director, every resident entering our program will be paired with an Academic Coach.  This faculty member helps residents in defining their learning objectives, following their learning plans to completion, all while providing encouragement, motivation, and one-to-one dialogue.

Resident Wellness:  Our program has a Wellness Committee with a Faculty Lead and Resident Leads.  The Resident Wellness Committee is responsible for providing vision and leadership in relation to resident wellness initiatives.  The program also works closely with the University's PGME Resident Wellness Office to support our residents’ individual needs.

Social Committee: Part of resident life includes socialization and social events.  Our resident Social Committee helps to organize events to maintain collegiality and help foster socialization amongst residents and faculty.  An excellent example is our annual Sports Day and BBQ where residents and staff team up for a fun-filled day of games - all competing for the coveted "Laryngoscope Award" along with bragging rights and fund-raising for charity.


Program Curriculum

This residency program is for 6 years.

Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.

Goals and Objectives of the CIP

The fundamental aim of the Royal College Clinician Investigator Program is to provide trainees with the knowledge, skills and attitudes necessary to embark on a successful career in health research. In most cases, further research training specific to the candidate’s field of interest will be required so that they can succeed as an independent investigator. CIP educational objectives comply with the Royal College of Physician and Surgeons of Canada CanMEDS competency guidelines.

Communicator

  • Communicates clearly with research participants, peers and other professionals to establish rapport, trust and ethical relationships.
  • Effectively write research proposals, reports, grant proposals and manuscripts
  • Effectively present work at lab meetings, research seminars, thesis advisory committee meetings, scientific meetings, and able to defend and discuss the presentation in an articulate and polished manner

Collaborator

  • Participate effectively and appropriately in interprofessional research teams
  • Form collaborative relationships within the scientific community
  • Effectively work with others in research teams to prevent, negotiate and resolve interprofessional conflicts

Health Advocate

  • Demonstrate an appreciation of social economic and biologic factors that impact health research
  • Demonstrate advocacy for subjects, patients, populations, communities, as appropriate, including ensuring that research subjects have access to appropriate supports, information, and services
  • Promote research knowledge translation to patients, populations, communities, other stakeholders, as appropriate

Leader

  • Effectively and efficiently manage research project and resources (financial and materials)
  • Manage experimental data recording and result interpretation appropriately in research endeavors
  • Serve in administration and leadership roles, as appropriate to their research career
  • Meet appropriate deadlines (funding, submission, REB, draft manuscripts to reviewers)

Scholar

  • Establish and maintain knowledge and understanding of general principles and fundamentals of research, including research ethics
  • Establish and maintain knowledge and understanding of the specialized topics in the specific area of research
  • Elicit, synthesize, and critically evaluate information and apply it appropriately to research
  • Demonstrate overall competence in techniques required for the research project (i.e. experimental design, data collection and management, and analysis)
  • Demonstrate overall competence in analyzing and interpreting the results of an experiment
  • Consult appropriately for feedback on knowledge and performance

Professional

  • Demonstrate commitment to the profession, society, research participants, patients and collaborators through absolute objectivity, honesty, and adherence to ethical standards in the conduct and reporting of research
  • Demonstrate commitment to ethical research practice, including demonstrating ethical conduct in the treatment of human and animal research subjects.
  • Demonstrate a commitment to the application of exemplary bioethical standards to clinical practice and research in such areas as consent, confidentiality, conflict of interest, resource allocation, and research ethics.

Medical Research Expert

  • Function effectively as a clinician investigator, integrating all of the CanMEDS Roles to function as a clinician and to conduct ethical research
  • Seek appropriate consultation from others as required, recognizing the limits of their own clinical research expertise
  • Effectively manages activities for career development, including the integration of clinical and research activities

To achieve these goals and receive the Attestation of Completion of the Clinician Investigator Program, a minimum of 2 years of continuous, intensive research training must be undertaken. During the 2 years of research, the majority of time (at least 80%) must be devoted to research, but some time may be spent in clinical activities (i.e the equivalent of 1 day per week).

Up to one of the research years may also be credited to fulfill the Royal College accredited clinical program requirements with joint approval of the faculty CIP director and the program director. Therefore, the CIP will extend anesthesia residency training by only one year, to a total of 6 years. Additional research training in all CIP pathways can be extended to allow completion of a PhD or other research experiences and will further extend training.

Research and Scholarship

This is strongly mentored and supported in the 2 years of study and research within the CIP program. 



 Clinical training:

Throughout residency clinical training, residents can be expected to gain increasing skill and independence in the anesthetic management of patients for all types of surgical procedures and in the management of pain.  Large numbers of patients are seen for transplantation, cardiovascular, thoracic, neurosurgery and multi-trauma injuries. All residents participate in the High Fidelity Anesthesia Simulators situated at St. Michael's Hospital and Sunnybrook Health Sciences Centre. Residents attend the simulator centres annually as part of the core teaching program and residents supervise and teach medical students throughout their residency.

A wide variety of electives are available and residents may propose their own. There are options for community and rural electives. All residents complete a community hospital experience which is usually a one block elective. Out-of-province and international electives are also permitted.

The usual clinical experience includes:

Broad and diverse clinical experiences to obtain competencies in clinical anesthesia, including obstetrical anesthesia, trauma (including experience at both of Toronto's Trauma Centers), transplantation, thoracic, cardiovascular and neuroanesthesia.  Special rotations in high-risk obstetrical anesthesia, regional anesthesia and chronic pain management will be completed.  Pediatric anesthesia training includes clinical rotations at the Hospital for Sick Children.

Internal medicine and critical care medicine rotations occur at several quaternary care facilities across the city. Internal medicine training includes rotations in Respirology and CCU as well as opportunities to experience a wide variety of medical subspecialty training. The critical care rotations occur at several potential sites with exceptional learning opportunities. This including potential experience in medical/surgical, neurosurgical, neurotrauma, trauma, and cardiovascular ICUs across the city. During the program, there is also opportunities for experience in pediatric and neonatal intensive care.

Toronto offers a wealth of clinical experiences and abundant patient resources.  Our residents routinely train in quaternary care hospitals as well as academic community hospitals.  The clinical case exposure is unparalleled.  Our residents enjoy a wealth of resources which span the clinical, academic, research and teaching faculty arenas.

 

In July 2017, our Program implemented Competency Based Education and follows the Royal College Competency By Design framework.

 

Transition to Discipline Stage:

This is a robust 3 block training period which includes core skills and competencies needed for early residency success.  These include real and simulated training experiences designed to support technical skills, patient assessment and perioperative patient management.  There are several weeks of highly structured academic curriculum incorporating didactic, case-based, e-module, simulation, and interactive learning.  This is paired with clinical experience including buddy-call exposure.

 

Foundations Stage:

This training period spans roughly 20 months of residency.  Residents experience clinical rotations designed to support educational opportunities which allow achievement of broad-based competencies that every trainee must acquire before moving on to more advanced competencies in their anesthesia training. This stage corresponds with Junior Resident status and supports graduated independence and clinical responsibility, including independent call. Residents rotate through several hospitals and experience a level appropriate, broad exposure of anesthesia sub-specialty training including pediatric anesthesia.  Residents also complete training in medicine and critical care.

 

Core Training Stage:

This training period is expected to span roughly 24 months of training. This stage covers the core competencies that make up the majority of perioperative medical training and subspecialty anesthesia training. This stage corresponds to the Senior Resident status.  The clinical rotations support advanced patient management experiences and clinical responsibility.   Residents experience high case complexity exposure to all anesthesia sub-specialty training.  Residents also complete medicine and critical care training.  Residents undertake selective rotations in High-risk Obstetrical Anesthesia, Thoracics, Regional Anesthesia and Chronic Pain. 

 

Transition to Practice stage:

During this time, the senior trainee will obtain clinical experiences designed to support readiness for independent practice.

Academic Program

There is a rich academic curriculum that spans all 5 years of residency training.  This includes morning rounds, protected academic time, resident educational retreats, simulation training (part-task, high-fidelity, and crisis resource management), Journal Club, POCUS educational curriculum (bootcamps, block rotations and longitudinal educational sessions), transfusion medicine educational series, portfolio sessions, research training curriculum and "Senior Revision Tutorial".

There is a robust morning academic teaching curriculum across the city at every training site.  The morning teaching is mapped to align with the clinical and educational focus of the hospital and the National Curriculum.  There are sessions 4-5 mornings each week, lead by faculty.  The city-wide curriculum includes didactic teaching, trouble round discussions, case-based questions, simulation sessions, hands-on tutorials, and Grand Rounds.

Additional resident academic and education sessions are held weekly during the protected Academic Time (half and full days) and include an introduction to a wide range of anesthesia topics and related subjects including resident wellness and stress management.  The curriculum is based on extensive knowledge objectives and the National Curriculum. Topics include communication skills, biostatistics, critical appraisal, airway management, monitoring and equipment, obstetrical anesthesia, regional anesthesia, pain management, critical care, perioperative medicine and the individual areas of operative subspecialty anesthesia. There is also a focus on education of the CanMEDs competencies.  This curriculum includes sessions with expanded education in ethics, critical appraisal, teaching and communication skills, leadership, and the skills of practice management. Simulation sessions and sessions on advanced airway management, vascular access, and regional/neuraxial skills in an anesthesia skills lab and with full and part-task simulation are also part of the curriculum as is Crisis Resource Management Simulation.

In the final year of training, weekly small group sessions called "Senior Revision Tutorial" allow residents to consolidate their knowledge, build judgement and critical thinking for independent clinical practice and assist in preparation for The Royal College Examinations.

 

Portfolio Groups

Our residents participate in a group learning process, facilitated by Faculty Leads.  The process involves sharing narratives and reflections with one another which underpin the CanMEDs competencies in clinical practice. One of the goals is to develop new knowledge, perspectives, skills and attitudes in the intrinsic roles and to promote introspection and to challenge ourselves, our ideas and our behaviors.

 

Mentorship Groups  

All residents are assigned a Mentorship Group of peers and faculty to provide guidance and support throughout the residency journey.

A successful mentoring relationship has a number of benefits:

  1. The resident gains from advice and expertise from those who have “already been there.”
  2. A mentor can help provide a supportive work environment, offer advice on career development, function as an advocate for the resident, and be a role model.
  3. From the mentor’s perspective, they have a unique opportunity to encourage the professional and personal development of an individual in training and help contribute to the strengths of our medical community. This includes faculty and the residents themselves - who act as near-peer mentors to their colleagues.
 


Training Sites

The University of Toronto has the largest anesthesia residency program in Canada in number of teaching staff, research productivity, hospital facilities and patient volume. These resources offer an unequaled opportunity for anesthesia residency. 

All our residents rotate through our many specialized hospitals, each with a unique focus of patient care, clinical expertise, and training opportunities:

  • The Hospital for Sick Children, a world-renowned center sub-specialized in advanced pediatric care 
  • Mount Sinai Hospital, which includes high risk Obstetrical Anesthesic care
  • St. Michael's Hospital, including the cities local trauma centre, cardiac and neuroanesthesia
  • Sunnybrook Health Sciences Centre, including Ontario's Regional Trauma Centre, the busiest trauma centre in Canada
  • Women's College Hospital, specializing in Ambulatory Anesthesia and home to the Toronto Academic Pain Medicine Institute 
  • The Holland Centre, with a focus on Regional Anesthesia
  • Michael Garron Hospital and St. Joseph Health Centre, academic community hospitals with significant thoracic anesthesia exposure
  • Toronto General Hospital, voted the top 7th Hospital in the world, supports the largest transplant program in North America, a robust ECLS program and also focuses on thoracic and cardiac anesthesia
  • Toronto Western Hospital, specializing in neuroanesthesia and major orthopedic surgery including spines

In addition, our residents have the opportunity to complete elective rotations in the large number of community hospitals in and around the Greater Toronto area - some travel may be required to attend these sites. Over 350 staff anesthesiologists participate in our teaching program. The University of Toronto is the tertiary and quaternary care referral centre for a metropolitan population of more than 2,700,000 and a surrounding population of about 6,000,000.

 


Additional Information

  1. Permanent Residents: Successful applicants who hold Permanent Resident status in Canada will be required to disclose their Country of Citizenship to the postgraduate medical education office in order to comply with current reporting requirements of the Ontario Ministry of Colleges and Universities
  2. Matched applicants: CaRMS will provide their electronic data file to the matched university’s postgraduate education office. The postgraduate office will share the information as needed, but not limited to, the Ontario Physician Human Resource Data Centre, Canadian Post-MD Education Registry, the College of Physicians and Surgeons of Ontario, the Royal College of Physicians and Surgeons, the College of Family Physicians of Canada, the Association of Faculties of Medicine of Canada, the Professional Association of Residents of Ontario, teaching hospitals and other training sites, Touchstone Institute and the Ontario Ministry of Health.
  3. Changes: The Ontario Faculties of Medicine and Ontario Ministry of Health reserve the right to make changes to the information published on the CaRMS website pertaining to Ontario postgraduate training without prior notice.
  4. Failure to meet or provide proof of any of the stated requirements may result in the applicant file not being reviewed and removed.


FAQ

Why should I enroll in the CIP?

There are many advantages to being part of the CIP during your anesthesia residency training. Here is a list of just a few advantages of this program:

  • Anesthesia Residents will have an opportunity to train as clinician investigators in an accredited and audited Royal College research training program and concomitantly pursue a Master of Science or Applied Science, Master of Education, Doctor of Philosophy degree, or Postdoctoral training
  • The Clinician Investigator Program is designed to provide dedicated and funded research time, as well as opportunity to apply for external funding.
  • CIP trainees have the opportunity to attend practical and informative research and career-focused seminars
  • CIP trainees receive bioethics training
  • CIP graduates obtain a certificate of completion from the RCPSC, attesting to the completion of the research and clinical components of the program
  • CIP graduates are better able to compete for grant funding opportunities because they have proven dedication to a clinician-investigator career by enrolling in CIP.

 

How long am I expected to engage in full-time research to complete the research component of the CIP?

All CIP trainees are required by the RCPSC standards to complete two years (24 months) of full-time (min. 80%) research. However, we acknowledge that various degree have different requirements and we are committed to work with the trainee and the CIP Committee to allow maximum flexibility in organizing the research training component.

 

Does the CIP find a supervisor for me?

No, the CIP does not find a supervisor for its trainees. However, the Anesthesia Department and the CIP Committee will provide mentorship and guidance to find a supervisor. The graduate units usually have a list of faculty members in their department who could be potential supervisors.

 

I started my graduate studies already, may I still apply to CIP?

Yes, the CIP committee will permit up to six months of retroactive registration in the CIP. However, you must remain in the program for a total of two years in full-time research and fulfill all program requirements in order to receive your CIP certificate.

 

Will I be allowed to take a leave of absence during the CIP training?

Yes, you are allowed to take a leave of absence or paternity leave, the program is very flexible. However, this will extend your training by the number of weeks/months you take off and must be reviewed and approved by the Program Director, your research supervisor and the CIP Committee.

 

When do I receive my CIP certificate from the RCPSC?

You will only receive your certification as a clinician investigator from the Royal College after you have finished both the clinical and research components of your training. You must pass the Royal College Anesthesia Exam, received your degree from the School of Graduate Studies, and approval of your CIP requirements by the CIP Committee.

 


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