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University of Toronto - Medical Genetics and Genomics - Toronto

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

Last approved on January 17, 2022

Summary of changes

Approximate Quota:

 1 

Accreditation status : Accredited

Provincial Criteria


Dr. Hanna  Faghfoury
Division of Clinical and Metabolic Genetics 
Hospital for Sick Children  
555 University Avenue
Toronto ON , Ontario, M5G 1X8
(416) 813-6374
(416) 813-5340
Clinical and Metabolic Genetics
PGME at U of T

Program Contacts

Dr. Hanna Faghfoury
Program Director
hanna.faghfoury@utoronto.ca

Brittany Marshman
Education Coordinator
brittany.marshman@sickkids.ca
(416) 813-5340


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.  

Please review the program description carefully with respect to requirements and the application process.


General Instructions

Program application language: English

 Please note that we will be holding an optional virtual meet and greet between candidates and our current trainees, further details will be shared with interview invites.

For further information about our program feel free to reach out to our PA - Brittany Marshman, brittany.marshman@sickkids.ca 


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

If possible one or more letters from a faculty member in Medical Genetics and Genomics is helpful but not required.

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

Medical School Transcript 

Medical Student Performance Record 

Custom Résumé / CV 

Personal Letter 
Word count
Minimum : None
Maximum : None

A personal letter is required. It should not be longer than 1000 words. This letter should outline what aspects of a career in clinical genetics are appealing to the candidate, what specific characteristics make the candidate particularly suitable to a career in medical genetics and what skills they have gained from their previous personal, educational, research, or work experience that strengthen their application to a genetics program.

 


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



Interviews

Dates:

  • March 3, 2022
  • March 10, 2022
  • March 17, 2022
Interviews for the Canadian Medical Graduate Stream will be held virtually on March 3rd, 10th or March 17th in Toronto. When possible, we will accomodate trainees interview schedules in other centres. 

Program will notify all applicants through CaRMS Online and will send email invitations directly to applicants selected for an interview.
Formal interviews will be granted to candidates short listed after review of completed application forms by members of the Residency Training Committee with a standardized rubric. Candidates will be contacted by email. The candidate will be interviewed in one or more groups which will include the program director, division chief, multiple MD faculty members, genetic counsellor(s), the senior resident as well as the junior representative on the Residency Training Committee. There will be questions regarding interests and career goals, general clinical scenarios that require problem solving and ample opportunity to ask the program questions. The interview will occupy a half day and will also provide an opportunity to attend genetics grand rounds as well as our weekly virtual case conference where genetic cases are discussed.  The candidate will also have the opportunity to meet informally with the current residents.


Selection Criteria

Our program seeks curious and compassionate trainees who will provide ethical and patient-focused genetic care and have the potential to demonstrate leadership in the field of genetics and genomics.

This is a 5 year residency program housed out of the Hospital for Sick Children. Trainees will complete rotations at all TAHSN sites allowing a for unique training experience in some of the most highly regarded specialty genetic clinics in North America. We are the largest genetics training program in Canada which allows our program to provide additional training opportunities and supports like career days, balint groups, QI and research training. 

 

Program goals

The practice of Medical Genetics is based on a broad knowledge and application of basic genetic principles, and diagnosis and management of genetic disease through the lifespan. The practice also requires a clear understanding of the principles of genetic counselling and utilization of cutting edge genomic technologies for the diagnosis of genetic disease. 

At the completion of training, the resident will have acquired the following competencies and will function effectively to:

  • Perform a consultation, including the presentation of well-documented assessments and recommendations in written and/or verbal form in response to a request from another health care professional
  • Demonstrate use of all CanMEDS competencies relevant to Medical Genetics
  • Identify and appropriately respond to relevant ethical issues arising in the care of patients and their families
  • Demonstrate the ability to prioritize professional duties when faced with multiple patients and problems
  • Demonstrate compassionate patient and family-centered care
  • Recognize and respond to the ethical dimensions in medical decision-making

It is understood that residents successfully completing a Medical Genetics residency program are regarded as fully competent, undifferentiated consultants in the specialty. The resident will be prepared to pursue further fellowship training in a variety of sub disciplines of the specialty, including but not inclusive to clinical biochemical genetics, prenatal genetics, or laboratory molecular and cytogenetics fellowships.

Selection process goals

We are looking for students to join our cohort of residents who demonstrate a passion for the field of medical genetics and genomics, curiosity, critical thinking skills, compassion, and advanced communication skills.  

Applicants providing evidence of professionalism, leadership, social accountability, problem solving abilities, skills in collaboration, and empathy within the CaRMS application file components (CV, Medical student Review (MSR), Personal statement, Elective experiences, Reference letters, Research experience, and work and volunteeer experience) will be prioritized for further consideration. 

Successful applicants should be given the opportunity to demonstrate these attributes at the time of interviews. Interviews consist of a series of questions and are ranked with a standardized rubric that priortizes ranking of attributes noted above.

Candidates who fail to meet criteria of demonstrated interest in genetics, professionalism or skills in communication will not be considered further. Other candidates will be ranked based on the scores of their application and interview. Final ranks will be determined by the aggregate score as outlined above and the selection committee reserves the right to adjust final rankings by consensus to address issues of program priority and diversity. 

File review process

Review team composition : All documents are reviewed by the residency selection committee which is a subcommittee of our Residency Program Committee (RPC). The selection committee is comprised of the Program Director, Division chief, multiple MD clinical faculty members, a genetic counsellor(s), chief Resident(s), and other residents. All members of the selection committee complete a conflict of interest attestation as well as an e-learning seminar and test aimed to mitigate unconscious bias that may exist in the selection process. There is an effort to ensure that the selection committee is comprised of a diverse membership.

Average number of applications received by our program in the last five years : 0 - 50

Average percentage of applicants offered interviews : 76 - 100 %

Evaluation criteria :
File component Criteria
CV leadership skills, awards, community activities, advocacy efforts, unique contributions to medicine or education
Electives We recognize that the COVID-19 pandemic has continued to 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 Leadership skills, collaboration skills, professionalism, community activities, advocacy efforts
Leadership skills Evaluated from other components of file
MSPRs Communication skills, collaboration skills, leadership skills
Personal letters Communication skills, Interest in Genetics, Collaboration skills, Patient advocacy
Reference documents Communication, Leadership and professional skills, Compassion/Empathy, Curiosity, Medical Expert related Competencies
Research/Publications Interest in Genetics and Genomics or related field, scientific curiosity, leadership skills, collaboration skills
Transcripts We do not evaluate this component unless there is a failure on record

Elective criteria

We recognize that the COVID-19 pandemic has continued to 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.

Interview process

Interview format :



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

Interview evaluation criteria :
Interview components Criteria
Collaboration skills Ability to collaborate with peers/colleagues and multi-disciplinary team members
Collegiality Ability to interact with current trainees
Communication skills Ability to succinctly and accurately answer questions, ability to communicate complex concepts in simple terms
Health advocacy Respect for patients and families, empathy, appreciation for the scope of genetic practice
Interest in the discipline Basic understanding of the scope of a career in clinical genetics & genomics, clinical and scientific curiosity
Interest in the program Demonstrate insight on the unique limitations and strengths of our program
Leadership skills Ability to work within a multi-disciplinary team in a leadership capacity
Professionalism Appropriate professionalism during interview process and self-reflective capacity
Scholarly activities We do not evaluate this during the interview component

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

University of Toronto Genetics and Genomics Residency Program Overview

The University of Toronto Genetics and Genomics Program is the largest program for Medical Genetics and Genomics training in Canada. The main training site for the program is the world-renowned Hospital for Sick Children (HSC/Sickkids) where there are numerous innovative collaborations in between clinical and research team members.  Participating faculty members hold University of Toronto appointments in the Departments of Molecular Genetics, Paediatrics, Medicine, Biochemistry and Clinical Biochemistry. The Division of Clinical and Metabolic Genetics at HSC also serves as a primary education program for the Master's Program in Genetic Counselling and as such, teaching faculty include a large group of dedicated genetic counsellors who are committed to supporting MD trainees. In addition to our residency program we also offer fellowship training in both Clinical Genetics and Metabolic Genetics, both accredited by the Canadian College of Medical Geneticists (CCMG). As such, the trainees join a diverse and engaged peer group and a well-supported education program. 

The Division of Clinical and Metabolic Genetics provides comprehensive training in all aspects of medical genetics in the setting of a large quarternary care institution. Our program is committed to excellence in training individuals for careers in community genetics or in academic clinical/research careers. The Centre for Genetic Medicine and SickKids newly established Genome Clinic provides unparalleled opportunities to participate in cutting-edge whole exome and whole genome sequencing projects with a variety of expert collaborators. There are numerous faculty members involved in clinical trials and genetic-based therapies and they provide a unique opportunity to mentor trainees in a novel areas of genetic therapeutics; this is likely to become an important future areas in a geneticists scope of practice. Training sites not only include HSC but leading Canadian institutions such as Mount Sinai Hospital, University Health Network, Princess Margaret Hospital, amongst several other community partners within the GTA. 

The Division serves primarily the Ontario central east region, a large and diverse population of approximately 6 million residents. As such, our program sees a wide variety of genetic problems, including those with birth defects, inborn errors of metabolism, genetic cancer syndromes, and prenatal cases with active inpatient and outpatient services that run year-round. We are backed by in-house biochemical, molecular and cytogenetic laboratories that all concurrently serve as educational fellowship sites. The program sees over 5000 patients per year. As such, there are virtually no groups of rare diseases a trainee would not encounter during their time in the program. 

 

The educational environment 

There are ample opportunities for trainees to further develop expertise in education, ethics, and Quality Improvement (QI). In-house courses are provided for Cytogenetics, Research methodology, and a QI-curriculum as part of a trainees protected training. Resident research is supported by a research committee available to trainees comprised of senior scientists with vast experience in mentorship and residents are allowed up to 1 year for research. The protected half-day curriculum is managed by a dedicated curriculum faculty lead and includes content that is continuously improved with innovative and engaging teaching approaches. A well-attended weekly case-conference encourages active participation from trainees and other divisional members and promotes discussions in a collaborative setting. 

Trainee wellness is prioritized in our program. A Balint group is coordinated for trainees, formal and informal wellness activities are organized several times per year, and a resident retreat is well supported financially by our program. We have a standing wellness agenda item during our residency program committee meetings. Further, multiple ongoing initiatives are underway to promote equity, diversity and inclusion in our program. This includes divisional sessions on allyship, implicit bias, the hidden curriculum, and ensuring the academic-half day offerings cover issues related to discrimination such as sexism, ableism, and racism. 

 

The city 

One would be remiss to describe the program in such detail without a note about the city. Toronto is a vibrant, diverse city with its multiple smaller and unique neighbourhoods that make its whole. There is no shortage of restaurants or arts and culture within the city that contribute to an unforgettable training experience. City cyclists have access to hundreds of km of dedicated bike routes within the city and while it is not always well-advertised, the unique ravine system and trails within Toronto allows for a magical downtown escape that is easily accessible by city transit. Expect travel post-pandemic to be easy with a convenient downtown airport and travel to other worldwide locations with direct access to a large international airport within 20 minutes of downtown. 


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.

***Please note these are only a guideline as we will be moving to Competency Based Medical Education in July 2022. Many of the core rotations and priciples will remain the same but there will be some changes to the training goals listed below. ***

ROYAL COLLEGE TRAINING GOALS

The practice of Medical Genetics is based on an in-depth knowledge of basic genetic principles, knowledge of genetic disease as it affects all body systems and individuals of all ages, and a clear understanding of the principles of genetic counselling.

 

In keeping with the requirements of the Royal College of Physicians and Surgeons, this is a 5-year program with rotations in the following:

PGY-1 & 2

24 months (minimum) of basic clinical training includes:

-8 months (minimum) in each of internal medicine and paediatrics

-2 months (minimum) in high-risk obstetrics/fetal assessment

-1 month (minimum) full-time or full-time equivalent in a counselling and communication theory/practice area outside the actual genetics unit

-up to 5 months selective experiences relevant to Medical Genetics (with no more than 3 months in a clinical genetics unit)

The rotations in paediatrics include general paediatrics, neonatology, perinatology, neurology, cardiology, endocrinology, social work and haematology/oncology. Internal medicine includes rotations in general internal medicine, adult nephrology, adult neurology, adult rheumatology, and adult endocrinology. Two months is also spent in the High Risk Obstetrics Unit and two months (1 in year 1 and 1 in year 2) in the genetics clinic, where the resident will be active in the in-patient consultation service. In addition, residents will gain teratogen counselling experience through the Motherisk Program as well as family counselling at SickKids. Ongoing communication with the medical genetics program occurs all year in years 1 and 2 through a resident half-day, which includes genetic rounds and case conference.

All University of Toronto residents entering PGY1 are required to complete the web based PGCorEd core competency modules as part of their residency program certification. These modules provide the foundation for the non-Medical Expert roles for the Royal College of Physicians and Surgeons of Canada Specialty Programs. Completion of these modules will be required before the end of PGY2 year.

PGY-3 to 5

36 months (minimum) of approved residency in Medical Genetics, which includes:

-2 months (minimum) in a cytogenetics laboratory

-2 months (minimum) in a molecular genetics laboratory

-2 months (minimum) in a biochemical genetics laboratory

-18 months (minimum) in a clinical/medical genetics unit, which will include a year of senior residency

 

The clinical/medical genetics rotations includes in-patient and out-patient clinics, prenatal diagnosis, adult genetics, cancer genetics and the genetic metabolic clinic. Residents will see a wide variety of clinical conditions including dysmorphic syndromes, various mendelian disorders, complex genetic conditions and genetic metabolic disorders.



Research

The University of Toronto offers a rich environment for scientific enquiry. There are many active investigators in basic and clinical sciences and we encourage the involvement of residents in research projects in which they can experience the design, conduct and evaluation of investigations into relevant problems.

An annual presentation to the residents is scheduled as part of orientation by the programs faculty research coordinators. Before the start of the PGY3 year, residents will meet with one of the coordinators to explore opportunities for research projects and set up specific goals and objectives.

We also offer excellent opportunities for residents to pursue graduate degrees, not only in the basic and clinical sciences (MSc and PhD) but also in clinical epidemiology and medical education. A program in health administration is also available. Residents committing to at least a two-year experience in a Master's or PhD program can satisfy the requirement of the Royal College Clinician Investigator Program. Funding is available through the department if extra time is required to complete a degree program.



Educational Activities

Five hours of protected time per week make up the academic half day. This curriculum provides a wide variety of learning opportunities addressing all of the CanMeds roles. The Half Day activities include: case conference, walk rounds, journal club and lectures on Current Topics in Medical Genetics. This 3 year theme-based course covers the fundamentals of genetics and the CanMeds competencies as they apply to genetics. The objective of this course is to bridge the gap between well accepted knowledge (available in textbooks), important updates and new developments derived from the current medical literature. It emphasizes the areas that are important for maintaining a high standard of clinical practice in medical genetics.

Residents can also audit the Master's in Genetic Counselling courses.

 

Seminars and Courses

In keeping with the requirements of the Royal College of Physicians and Surgeons, the resident will complete course work in genetics, cell biology, and cytogenetics. These courses are taken throughout the last 3 years.

 The residents are also encouraged to attend and present at least one national or international conferences. Residents are eligible for up to $1500.00 of funding per academic year for conference. Other educational opportunities include clinical case conferences, journal club, and research seminars and rounds which amounts to approximately five hours per week.

In addition, Objective Standardized Clinical Encounters (OSCE) and practice written examinations are held twice a year. OSCE's are multi-station exams designed to be similar to the Royal College examination format.

Residents also participate in Telehealth for Genetic Residents and Fellows (TeleGRAF) sessions; across Canada monthly teaching seminar series delivered via videoconference.




Training Sites

The vast majority of the five year Medical Genetics residency is spent at the Hospital for Sick Children, except for rotations in Internal Medicine and other Adult clinics (including Endocrinology, Neurology, Genetics, Cancer and Prenatal Diagnosis) which are done at the University Health Network (Toronto General Hospital, Toronto Western Hospital, Princess Margaret Hospital), Mount Sinai Hospital, and St. Michaels Hospital. Rotations in Perinatology and High Risk Obstetrics are completed at Mount Sinai Hospital.

Most of the hospitals are located within 4 blocks of the SickKids. There is also opportunity for electives which can be done at other University of Toronto institutions as well as hospitals abroad, which may include attending genetics clinic part of the Northern Regional Genetics Program, which is funded yearly for a senior trainee. Our Medical Genetics residents are also encouraged to attend genetics conferences and workshops.


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.

As of September 2021, there are 11 residents in the Royal College Program and 3 fellows in the Canadian College of Medical Geneticist Clinical Fellowship programs.

The library facilities at the University of Toronto and SickKids as well as the Division has an excellent library which includes over a hundred books and journals, access to OSSUM/POSSUM and OMIM, the London Dysmorphology Database. Medical Genetics residents also have designated office space with computer access and telemedicine capabilities.


Summary of changes

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