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University of Toronto - General Surgery - Toronto

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

Last approved on January 17, 2022

Summary of changes

Approximate Quota:

 10 

Accreditation status : Accredited

Provincial Criteria


Dr. Savtaj Brar
General Surgery 
University of Toronto 
Sunnybrook Health Sciences Centre
2075 Bayview Avenue, Room H3-17, Toronto, Ontario, M4N 3M5
416-480-6100 ext 83736
General Surgery Residency Program, University of Toronto
Division of General Surgery, University of Toronto
Department of Surgery, University of Toronto
Clinician Investigator Program
Surgeon Scientist Program Website
Surgical Skills Center
University of Toronto Visiting Student Electives
PGME at U of T
@UofTGSx Twitter
@uoftgsx Instagram
Toronto: The World at Your Doorstep

Program Contacts

Madeline Ng
Program Coordinator
gensurg.residency@utoronto.ca
416-480-6100 ext 83736

Dr. Savtaj Brar
Program Director


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.  

Note, the application requirements for Canadian Medical Graduates (CMGs) and International Medical Graduates (IMGs) differ. Carefully read the section relevant to your situation prior to submitting your application.

Review all instructions carefully. Applications with INCOMPLETE and/or EXTRANEOUS documents WILL NOT BE REVIEWED.

Applying competency-based practices to General Surgery Residency Education

The General Surgery Residency Program began Competence by Design (CBD) in July 2020 in alignment with the Royal College of Physicians and Surgeons of Canada’s initiative to introduce competency based medical education (CBME) in Canadian postgraduate specialty training.

Residents entering the General Surgery program in July 2022 will be in the CBD program, including Surgical Foundations.

Residents entering residency in July 2022 should understand that CBD will use time as a framework and competency as the basis for progression. It is not anticipated that the duration of training will change for trainees. 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.

 


General Instructions

Program application language: English

Please note that the language of instruction for this residency program is English. To ensure file reviewers can properly evaluate your application, please ensure all documents submitted are either in English or include an English translation.


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

Three letters of reference must be submitted. These must be from staff physicians. If possible one or more letters from a faculty member in General Surgery is helpful but not required. The letter may be formatted as the referees sees fit.

Our Selection Committee is interested in learning the following from your referee:

  1. How long have you known the applicant? (i.e. years, months, weeks)
  2. Please describe the general structure of your service’s clinical rotations for clerks (e.g. subspecialty exposure, teaching, clinics, call, ORs, endoscopy, etc.)
  3. Is the student able to complete a consult/clinic encounter to an acceptable level in an appropriate amount of time?
  4. Comment on the student’s fund of knowledge and ability to apply their knowledge.
  5. Has the student participated in the OR? If so, how many times?
  6. What surgical skills did you directly observe? To what level did they perform? (e.g. ‘below expectations for a medical student’, ‘at the level of a PGY1’)
  7. Comment on the following attributes (please include specific examples):
    1. Professionalism
    2. Work ethic
    3. Collaboration skills
    4. Perceived enthusiasm/interest in general surgery
  8. Has this student shown the ability to be a self-directed learner? (please give specific examples)
  9. How strongly would you endorse this medical student for a General Surgery residency training program? (e.g. ‘Must-have’, ‘strong candidate’)
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 Dean's office.

Personal Letter 

Please answer the following 5 questions in a single document. All answers should be preceded by the associated question, including the question number. Answer all questions in order. Limit your document to no more than 1000 words (excluding questions). A word count must be included at the end of the document. Personal letters that do not adhere to these standards will not be accepted.

  1. What has been your most significant accomplishment and why was it meaningful?
  2. Describe constructive feedback that you have received in the past and how you responded to it.
  3. Describe two qualities that you possess which will help you to succeed as a general surgery resident.
  4. Why do you wish to pursue a career in General Surgery?
  5. What do you perceive as the greatest challenge you will face in General Surgery training at the University of Toronto and how do you plan to overcome it?

Relevant rotations or health care experience 

Please upload as a separate document a table of all completed and upcoming General Surgery or general surgical subspecialty (e.g. Pediatric Surgery, Thoracic Surgery, Trauma Surgery, Transplant, Surgical Critical Care, etc.) rotations in chronological order. Please use this template, which includes the following column headers:

  • Dates of rotation
  • Location
  • Specialty
  • Rotation type (elective, observership, etc.)
  • Residents and staff who worked with you (for completed rotations)

At the end of the document, please also provide a brief description (<75 words) of the elective requirements/restrictions at your medical school (e.g. our institution requires medical students to complete electives in at least 3 different CaRMS match specialties; please advise if your institution has different requirements).

We understand that your electives may have been impacted due to COVID-19. If so, please describe it here. Please keep this section to <150 words. 


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


Information regarding the review process:

The General Surgery Program uses a structured and standardized process to review applications in a manner that ensures an equitable evaluation for all applicants. It is therefore essential that your application fully complies with the requirements as described.

Only those applications that adhere to the above requirements will undergo review. APPLICATIONS THAT DO NOT MEET THESE REQUIREMENTS WILL NOT BE REVIEWED. This includes:

  • Submission of a custom CV
  • Submission of a list of abstracts or manuscripts
  • Inappropriately formatted personal letters or Relevant General Surgery Experience document
  • Personal letters >1000 words
  • Applications with >3 reference letters 
  • Incomplete applications

Please follow the application guidelines very closely.

Decisions made by the CaRMS Selection Committee are final and are not open to appeal. The General Surgery Program at the University of Toronto does not have a mechanism in place to provide feedback to unsuccessful applicants.


Interviews

Dates:

  • March 5, 2022
The interview date for 2022 is Saturday, March 5.

Interviews will be done over video conference only.

We have limited capacity to change assigned interview times. We will notify candidates through CaRMS whether or not they have been granted an interview. Those invited for interview will receive further information from the program by email.

Program will notify all applicants through CaRMS Online and will send email invitations directly to applicants selected for an interview.
Each candidate invited for an interview will participate in a multiple mini-interview, tentatively planned to last 50-60 minutes. Each mini-interview team will consist of a faculty surgeon and a resident. A standardized scoring scheme will be applied to the interviews.

In addition to the interviews, formal presentations by the Chair, Program Director and residents will be made at our virtual reception.


Selection Criteria

Program goals

Residents who graduate from the General Surgery Training Program at the University of Toronto, will be confident and capable clinicians able to excel in the practice of General Surgery in a variety of practice settings. Clinical excellence is emphasized in training around the delivery of care to patients and this is achieved through a continuous focus on providing high quality of care in a safe and learner-focused framework. This learning environment supports the development of highly capable surgeons, able to engage in ethical and team-based practice.

For the Program's goals and objectives, click here.

Selection process goals

Successful applicants are typically those that demonstrate strong leadership potential, a commitment to general surgery, a capacity to learn and succeed in a surgical training environment, as well as an ability to work well in a team.

Candidates are assigned a composite score comprised of the file and interview scores. The CaRMS Selection Committee will generate a preliminary rank list on the basis of these scores. 

The University of Toronto General Surgery Residency Program believes that diversity within our program is a strength, one that benefits both our trainees and patients. We are as well cognizant of the negative effects that individuals’ implicit biases can have during review of applicants. In order to limit the effect of these biases and foster diversity, we aim to conduct an equitable and fair applicant review process. We therefore require that all file reviewers participate in implicit bias training before file review. Moreover, we anonymize all applicant files prior to file review.

File review process

Review team composition : Review team composition: Applicants with complete applications (i.e. in compliance with the outlined requirements) will be reviewed by teams comprised of both faculty and residents.

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

Average percentage of applicants offered interviews : 26 - 50 %
(CMGs)

Evaluation criteria :
File component Criteria
CV Although we do not review custom CVs, we do review typed entries in the web-based CaRMS application.
Electives 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 Examination scores entered on CaRMS (if any) will be reviewed to confirm a passing grade was achieved.
Extra-curricular All aspects of the applicant’s extra-curricular activities will be considered, including advocacy and activism work.
Leadership skills All aspects, including leadership in academic, clinical, and extra-curricular settings.
MSPRs All aspects of the MSPR will be considered, including all clinical evaluations.
Personal letters All aspects, including adherence to the application instructions.
Reference documents All aspects, including adherence to the reference letter requirements.
Research/Publications All aspects of the applicant’s research/publication history will be considered.
Transcripts All aspects of the applicant’s transcript will be considered.
Other file component(s) Adherence to the application instructions will be strongly considered.

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.

Other information regarding elective requirement:

The Selections Committee is aware of restrictions on visiting electives this cycle. As such, we will work to organize online information sessions to ensure all students have an opportunity to learn more about our program as well as ask questions to residents and faculty.

Interview process

Interview format :



We routinely accommodate requests to re-schedule interviews for applicants.

Interview evaluation criteria :
Interview components Criteria
Collaboration skills Collaboration will be evaluated as part of the interview process.
Collegiality Collegiality will be evaluated as part of the interview process.
Communication skills Communication skills will be evaluated as part of the interview process.
Health advocacy Health advocacy skills will be evaluated as part of the interview process.
Interest in the discipline Interest in General Surgery will be evaluated as part of the interview process.
Interest in the program Interest in the Toronto General Surgery program will be evaluated as part of the interview process.
Leadership skills Leadership skills will be evaluated as part of the interview process.
Professionalism Professionalism skills will be evaluated as part of the interview process.
Scholarly activities Scholarship will be evaluated as part of the interview process.
Other interview component(s) We do not offer other interview formats for applicants unable to participate in the MMI on the scheduled interview day. All interviews this year will be done on a virtual platform rather than in-person.

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

  • Department of Surgery ranked #4 in the World
  • Diverse Resident Body
  • Dedicated and Talented Faculty
  • Leadership in Surgical Education Research and Innovation
  • Highly Engaged Program Leadership
  • Surgeon-Scientist Training Program
  • Surgical Skills Center at Mount Sinai Hospital, Toronto Western Hospital/Michener Institute and St. Michael's Hospital
  • Breadth and Depth of Clinical Learning Opportunities
    • 2 Level I Trauma Centers
    • 2 Regional Cancer Centres
    • 4 HPB Centres
    • 4 Bariatric Centres
    • 3 Thoracic Centres
    • North America’s largest transplant program

For more details, click here

Testimonials

“I truly could not have asked for a better training experience than at the University of Toronto. I have recently started independent practice as a Colorectal Surgeon, and have had the opportunity to reflect on my residency. Learning from national and international leaders has taught me to think outside of the box, seek and understand the evidence to improve patient care, and recognize the importance and power of multidisciplinary collaboration for our patients. I learned this in a program where the culture is progressive, supportive, diverse, challenging and extremely rewarding. It has given me the skills and knowledge to manage complex surgical patients, as well as a large group of friends and co-residents that I see as a second family, and an expansive professional network to lean on and learn from. I feel fortunate and honored to be a U of T General Surgery graduate, a program that afforded me the opportunities and mentorship that set me up for success.”

- Marisa Louridas (2018 Graduate) Staff Colorectal Surgeon, St. Michael’s Hospital

“There are two important components to choosing a surgical residency program. First, you need to be confident that the program has the resources and dedication to transform you into a capable surgeon. The second, is that the program has a breadth of surgeons so that you can find the right mentors for you. You will find both of these things at the University of Toronto. Because of this, I was hired for a staff job in the Greater Toronto Area before I even wrote my Royal College and was very grateful for my training when I was performing my first solo trauma splenectomy several weeks after graduating!”

- Sha Ullah (2018 Graduate) Staff General Surgeon at Mackenzie Richmond Hill and Vaughn Hospital 


Program Curriculum

This residency program is for 5 years.

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

Progress in training occurs through demonstration of competence and advancement through the stages of the Competence Continuum. General Surgery is planned as a five-year residency training program. Each year is divided in the 4-week blocks, with 13 blocks per year.

Residents entering the program will advance through the CBD curriculum and will also be enrolled in the Surgical Foundations program in PGY1. For more information on Surgical Foundations, click here.

Transition to Discipline and Foundations of Discipline

PGY1 and PGY2

Rotations in the PGY 1 and 2 years are designed to meet the objectives of Transition to Discipline (TTD) and Foundations of Discipline (FOD) stages of CBD articulated by the Royal College of Physicians and Surgeons of Canada. Progress from the TTD stage is through the Surgical Foundations Program. Progress from the FOD stage is through the Surgical Foundations Program and the General Surgery Residency Program.

The broad experience prepares trainees for the MCCQE II and Surgical Foundations Examinations as well as develops trainees' cognitive and technical skills in General Surgery.

Rotations Completed in the PGY-1 year include:

  • General Surgery
  • Acute Care Surgery
  • Trauma Surgery
  • Pediatric General Surgery (2 blocks)
  • Trauma Surgery (1 block)
  • Thoracic Surgery (1 block)
  • Transplant Surgery (1 block)
  • Emergency Medicine (1 block)

 Rotations Completed in the PGY-2 year include:

  • General Surgery
  • Vascular Surgery (1 blocks)
  • Critical Care Medicine (2 blocks)
  • Endoscopy (2 blocks)
  • Surgical Selective (2 blocks)

Core of Discipline

Rotations in the PGY 3-5 years are designed to meet the objectives of Core of Discipline (COD) stage of CBD articulated by the Royal College of Physicians and Surgeons of Canada. Progress through the COD stage is solely through the General Surgery Program.  The last half of the PGY5 year is reserved for Transition to Practice (TTP) Stage.

PGY 3

The PGY3 year is designed as a transition year to senior residency and Core of Discipline. Residents function as the senior resident on these services with appropriate autonomy and responsibility.

Rotations Completed in the PGY-3 year include:

  • Acute Care Surgery
  • Trauma Surgery
  • Community Surgery
  • Breast Surgery
  • MIS
  • Electives (2 blocks)

PGY 4 and 5

During PGY 4 and 5, residents focus on completing their Core of Discipline with rotations assigned in consultation with the Program Director in order to ensure that training experiences are aligned with the residents educational objectives and career goals. The PGY4-5 residents will spend time at either one of the two trauma centres to ensure optimal exposure to surgical management of trauma patients.

Rotations completed in the PGY4-5 years include:

  • Colorectal Surgery
  • Hepato-Pancreato-Biliary Surgery
  • Complex Surgical Oncology
  • Endocrine Surgery
  • Community Surgery
  • Electives (3 blocks)

Transition to Practice

The last four blocks of PGY-5 are dedicated to TTP stage of the CBD program. Specific components include involvement in clinics, ambulatory surgery and endoscopy. During the TTP stage, the program will arrange seminars and lectures preparing residents for practice.

Surgeon Scientist Training Program

Residents accepted into the program have the opportunity to apply for the Surgeon Scientist Training Program (SSTP) following their PGY-2 or PGY-3 year. Acceptance to the SSTP is competitive and enrollment varies year to year. Acceptance to the program will be based on clinical performance and the proposed research project. Residents who enter the SSTP must enroll in at least a two-year thesis based graduate program. Taking call shifts during SSTP is NOT mandatory. However, the program recommends that residents complete 1-3 call shifts/month in order to maintain their clinical skills. Residents have a wide choice of graduate programs to consider including Basic Science, Clinical Epidemiology, Health Services Research, and Research in Surgical Education. Further details regarding these programs can be found on the School of Graduate Studies website.

Residents return to senior clinical training after completing their Master's or PhD degree. All SSTP residents will complete 5 years of clinical training (i.e. they DO NOT skip a PGY year). The Surgeon Scientist Training Program satisfies the requirements of the Royal College Clinician Investigator Program. Further details regarding the Surgeon Scientist Training Program can be found on the SSTP website.

Research Expectations

Resident research experience is mandatory. All trainees are expected to complete and present at least one research project. Elective blocks may be used for research experience.

Program Wide Teaching

In addition to a rich offering of site-specific teaching, there are a large number of centrally organized lectures and seminars.

  • PGY1 and 2
    • Surgical Foundations Lecture Series
    • Surgical Skills Training
    • Core General Surgery lectures
    • Fundamentals of Laparoscopic Surgery (FLS) course
    • Endoscopic simulation training course
    • ATLS
    • PGCorEd curriculum: web-based core competency modules focused on non-clinical roles for PGY 1 and 2s.
  • PGY3-5
    • Weekly teaching
    • Advanced laparoscopy and operative trauma training (ATOM) courses for PGY 3-4
    • Exam preparation for PGY 5
  • Annual oral exams for PGY-2 through PGY-5
  • Annual Canadian Association of General Surgeons written exam for residents at all levels


Training Sites

Core Training Sites

  • 5 Academic adult training sites:
    • Mount Sinai Hospital:
      • General surgery, surgical oncology, colorectal surgery
    • University Health Network - Toronto General Hospital, Women’s College and Princess Margaret Cancer Centre:
      • General surgery, hepatobiliary surgery (HPB), transplant surgery, head and neck surgery, breast surgical oncology
    • University Health Network - Toronto Western Hospital:
      • General surgery, colorectal surgery, minimally invasive surgery (MIS), bariatric surgery
    • St Michael's Hospital:
      • General surgery, trauma, colorectal surgery, MIS, breast surgical oncology, bariatric surgery
    • Sunnybrook Health Sciences Centre
      • General surgery, trauma, HPB, colorectal, breast and melanoma surgical oncology
    • Academic pediatric training site:
      • The Hospital for Sick Children
    • Community training sites:
      • St Joseph's Health Care Centre:
        • General surgery, head and neck surgery, thoracic surgery, MIS, HPB
      • Michael Garron Hospital
        • General surgery, MIS, colorectal, thoracic surgery, bariatric surgery
      • North York General Hospital
      • Humber River Hospital
      • Trillium Health Partners (Mississauga)

Exposure to both community and academic surgery is built into program structure and tailored to meet residents' aspirations and career objectives.

Non-core Training Sites

  • Training sites available via the Rural Ontario Medical Program
    • Barrie, Owen Sound, Collingwood
  • Mackenzie Health (Richmond Hill)
  • The Scarborough Hospital
  • William Osler Health Centre (Brampton)
  • Peterborough Regional Health Centre

 


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.


Summary of changes

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