Western University - General Surgery - London

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

Last approved on October 22, 2021

Summary of changes

Approximate Quota:


Accreditation status : Accredited

Provincial Criteria

Dr. Julie Ann Van Koughnett
General Surgery 
LHSC - Victoria Hospital  
800 Commissioners Road East, Room E2-214
London ON N6A 5W9, Ontario, N6A 5W9
Western General Surgery CaRMS
General Surgery

Program Contacts

Dr. Michael Ott
Program Director
(519) 663-3269
(519) 685-8260

Rachel Liston
Residency Program Administrator
519-685-8500 x55983

Christine Bruckschwaiger
Division Administrator
(519) 663-3269

Important Information

Received full accreditation in 2019. Next regular survey 2026.

 NOTE: General Surgery started the new Competency by Design training model July 1, 2020.


Strengths of Surgical Foundations

1. Full academic day that is protected and allows for comprehensive learning.

2. State-of-the-art practical learning laboratories and excellent integration of CanMEDS into course and in laboratories.

3. Simulation/hands-on opportunities for learning and achieving EPA's.


Strengths of the program

1. High clinical volume and wide catchment area (service a catchment area of 1.5 million people as a referral base).

2. Very few fellowship programs maximizing resident exposure to operative procedures and complex care.

3. Well organized educational system including academic half-days, rounds, simulation and many more learning events outside of clinical work.

4. Dedicated faculty, Program Director and Program Assistant who are committed to resident wellness and success.

5. Robust research program with dedicated research time, a Research Director and funding to present work at meetings.

6. Close and collegial relationship of faculty and residents.

7. Cost of living is low in London, Ontario allowing more disposable income for trainees.


Postgraduate Medical Education in conjunction with London Health Sciences Centre will hold an Orientation Day to be determined at a later date. 


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 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.

The Royal College anticipates that all specialty and subspecialty programs in Canada will adopt CBD in gradual phases. All disciplines have been divided into seven cohort groups, each of which will adopt CBD at different times. It is anticipated that national implementation of CBD within certain, individual programs could begin as early as July 2017 - with more disciplines to following in subsequent years.

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

General Instructions

Program application language: English

a. Must demonstrate a strong academic performance to be considered for an interview.  We do not require applicants to have done on-site electives.

b. Ratio of residents to faculty is approximately 25:30 (includes 4 pediatric general surgeons)

c. Our residents carry an average load of 10-15 patients.

d. There is a 3-month mandatory community rotation.

e. Evaluations occur online and residents are required to log cases online.

f. Annual Resident Research Retreat

g. Annual Resident Research Day

h. Surgical Foundations Introduction to Surgery Course (1st year)

i. Two week surgical bootcamp at start of residency

j. Annual Resident Focus Group (retreat)

k. Surgical Foundations Refresher Course (2nd year)

l. Non-Medical Expert CanMEDS Competency OSCE Exam (4th year)

m. Master's of Surgery Program


Supporting Documentation

Applicants are advised to only provide the documents requested by the program. No other documents submitted will be reviewed.
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
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)

Proof of current citizenship or permanent resident status must be provided by submitting one of the following verifications to CaRMS by File Review Opening Date (January 31, 2022). (Photocopies acceptable). No other forms of verification are acceptable:

  1. Notarized photocopy of Birth Certificate issued by an authority in Canada with any photo ID, or
  2. Notarized photocopy of Canadian Passport, or
  3. Notarized photocopy of Canadian citizenship certificate, Record of Landing; or
  4. Notarized photocopy of Permanent Resident Card/Canadian Citizen Card – copies of both sides of card must be provided and legible.
Reference documents
Number requested: 3

Only three letters of reference are required. References should be from consultant level physicians. References must be dated no later than one year from time of receipt. Undated reference letters will not be accepted.

Additional documents
Custom Résumé / CV 

A current curriculum vitae. To include a list of elective rotations, presentations, abstracts and publications.

Personal Letter 
Word count
Minimum : None
Maximum : None

A personal letter is required in which candidates outline their reasons for wishing to pursue a surgical career and training at Western. Outline any community or volunteer work you have done, along with any of your hobbies, interests or talents.

Medical School Transcript 

[Note: Photograph is used as memory aid only]

Optional - will be reviewed

A detailed list of abstracts and publications should be included in your curriculum vitae. Please do not send attachments.

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 selection process for interviews is non-biased, objective and fair. All applications are reviewed by multiple assessors and interviews are granted based on application scores. We receive many applications each year and interview those that meet the cut off that has been established by the Resident Program Committee and the Resident Selection Committee.



  • March 2, 2022

Interviews will be held on Wednesday, March 2, 2022. A virtual orientation session will be held in the morning for candidates who are selected for an interview.

Once we have determined who will be interviewed, the schedule and information pertaining to the interview dates will be sent electronically to those selected. 


Program will notify all applicants through CaRMS Online and will send email invitations directly to applicants selected for an interview.
All applications are reviewed and scored independently by assessors. Application scores which are above the established criteria set by the Residency Program Committee and the Resident Selection Committe will be invited for interviews.

Candidates will be emailed by the program administrator when interview dates have been set.

Candidates will participate in two 10 minute interviews with two seperate interviewing teams. The majority of interviewing teams will include one current resident and one faculty member. Interviews are scored independently by all interviewers. The interview questions and scoring system is standardized. The application score and interview score are weighed and combined and then used to rank candidates.

Selection Criteria

Selection and ranking is based on a compilation of standardized scoring of both the application and interview. The Resident Selection Committee suggests a rank order list which is ratified by the entire department. No preference is given to internal candidates or candidates who have completed electives at Western University.

Program goals

The aim of the General Surgery Training Program at Western is to train surgeons whose exellent clinical skills are based on a strong foundation of basic sciences knowledge. The wealth of experience gained during residency matures this knowledge base and develops good technical sills. The surgeon will have the knowledge and skills to supervise all elements of care of the surgical patient from initial consultation until correction of the problem. A lifelong attitude of learning and adaptation to the changes of surgical practice will be obtained. 



Selection process goals

Sucessful applicants will demonstrate:

1. Commitment to general surgery as a career

2. Strong interpersonal skills and leadership potential

3. Apptitude to engage in research

4. Honesty and integrity

5. Ability to communicate clearly with colleagues

6. Ability to work as a team player

7. The ability to be  flexible and calm under pressure

8. Posses a good work ethic 

9. Ability to progess technically

File review process

Review team composition : Resident Selection Committee consists of faculty & trainees

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 Personal success and contribution to teams
Electives Elective choice is not used as a screening measure for an interview.
Examinations We do not evaluate this file component.
Extra-curricular Well roundedness
Leadership skills Leadership potential
MSPRs We do not evaluate this file component
Personal letters Commitment to general surgery
Reference documents Reference letters are assessed
Research/Publications Ability to participate in research and produce scholarly output
Transcripts We do not evaluate this file component

Elective criteria

Elective choice is not used as a screening measure for an interview.
Elective choice is not used as a screening measure for an interview.

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 Collaboration abilities
Collegiality Teamwork abilities
Communication skills Professional communicator
Health advocacy We do not evaluate this interview component
Interest in the discipline Dedication to general surgery as a career
Interest in the program Understanding of Western's program and how they might be a good match
Leadership skills Leadership potential
Professionalism Professional behaviour in difficult situations
Scholarly activities Ability to engage and produce meaningful scholarly work

Information gathered outside of CaRMS application

We do not consider any information gathered outside of the CaRMS application and local interview processes.

Ranking process

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

Program Highlights

  • Computerized evaluation system both for residents and faculty.

  • Computerized procedure logging.

  • Self-scheduling for senior residents.

  • Protected 5th year study time.

  • Resident travel fund. Funding for travel when presenting research at a conference.

  • Kelman Center for simulation training.

  • Canadian Surgical Technologies and Advanced Robotics (CSTAR)

  • Introduction to Surgery Course (Surgical Foundations)

  • Surgical Foundations Review Course (2nd year)

  • Two week boot-camp for incoming residents


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.


The General Surgery training program at Western is a five year program and transitioned to Competence by Design in 2020. The program as designed will provide residents with exceptional training in general surgery with flexibility to obtain career goals based on independent needs.

Transition to Practice (Approximately 3-6 Months) - During the Transition to Practice, residents will participate in the Surgical Foundations Course and Boot Camp. In order to facilitate this, residents will be preferentially placed on general surgery services (elective and acute care).

Foundations to Discipline (Approximately 18-24 months) - During the Foundations to Discipline, trainees will rotate through 8-blocks of general surgery, 2-blocks trauma, 1-block transplantation and 2-blocks vascular, 2-blocks of thoracic surgery, 2-blocks of critical care, 4-blocks of endoscopy, 3-blocks of community surgery, 2-blocks of pediatric surgery and 2-blocks of breast surgery.

Core of Discipline (Approximately 24 months) - The majority of senior general surgery blocks will be completed preparing individuals for the written Royal College exam which will happen in the fall of the R5 year. Electives may be granted as part of the Core of Discipline.

Transition to Practice (Approximately 6-12 months) - During the Transition to Practice rotations will be tailored to the individual resident career goals. 


There is an opportunity for full time research within the general surgery program. Early in the academic year a Research Retreat will be held to help residents understand their research objectives. An annual Residents' Research Day is held during which work is presented by all postgraduate trainees. An opportunity is available to spend a year or more to obtain a Masters. 

Funding is provided for residents to attend conferences where their research has been accepted for presentation. 


A series of seminars are held on Wednesday mornings (8:30 am - 11:30 am ). This time is protected from clinical duties and attendance is mandatory. These seminars cover a broad range of clinical and basic science topics. There are additional seminars for core year residents preparing to write the Surgical Foundations exam (all core year residents).

Surgical Foundations Course: This innovative course is mandatory for Foundations residents and is held every Wednesday beginning in mid- September and concluding in early March.  The course consists of lectures, the ATLS course  and numerous "wet" labs where residents learn surgical techniques in an animal laboratory.

Surgical Boot-Camp: A 10-day bootcamp has been designed to provide incoming residents with the basic knowledge and skills needed to assist with transition into residency.

Transition to Residency: An 8-week transition to residency program is held once a week and hosted by the PGME office.

Trauma Simulation Sessions: A series of trauma simulation sessions are held throughout the academic year. 

Training Sites

Main Training Sites

Three main training sites are used all within the City of London. The two main full service hospitals include London Health Sciences Centre, University Campus (339 Windermere Rd, London, ON N6A 5A5, Canada) and London Health Sciences Centre, Victoria Campus (800 Commissioners Rd E, London, ON N6A 5W9, Canada). St. Joseph's Hospital includes mainly ambulatory care and endoscopy.

Rural Regional Program

Western has established a rural regional component to its training program and has developed linkages with Windsor, St. Thomas, Stratford, Owen Sound, Woodstock, Strathroy and Chatham. All residents will have the opportunity to participate in community rotations. In the past, these rotations have been highly evaluated and are encouraged by our division. Residents wishing to pursue careers in community surgery will have an opportunity to expand the amount of time spent in the community over the course of residency training.

Additional Information

Additional Comments:

Resident evaluations are conducted monthly based on a CBD Block ITER as well as regular EPA completion.  The Canadian Association of General Surgery In-Training Examination is written annually to provide feedback and measure progress. An extensive series of practice oral exams is conducted during the final year to help residents prepare for their Royal College Fellowship Exams. Rotations can usually be designed to meet the student's needs and goals as there is a wide variety of clinical material and a high yearly case load. Flexibility is a popular feature and strength of the Western program.

The unique combination of the small size of the program with a very large clinical volume allows frequent clinical interaction between staff and residents, and there are many benefits from the consultants and residents coming to know each other well.

The strength of Western's General Surgical Program is the educational experience provided during our teaching rounds and protected academic half-days. Broad clinical experience in all subspecialty areas of general surgery provide the necessary exposure to train excellent surgeons.

Western graduates have an extremely high rate of pass on Royal College examinations, and approximately 75% of our graduates in the last 10 years have obtained national or international fellowships in every area of subspecialty.

Call Requirements:

Senior Call: on call ratio is 1 in 4 for senior residents "at home".

Junior Call: Junior residents will do a "night shift" while rotating on service. The shifts run Monday to Thursday and each resident would do 4 shifts in a 28 day block.

Ratio of Consultants to Residents:

The ratio of consultants to residents is on average 3 consultants per team. Each team has a senior and at least one junior resident. Currently we have 25 residents and 24 consultants (includes 4 pediatric general surgeons) at our London teaching hospitals. 

Each site also has an acute care emergency surgical service. Faculty rotate on this service at  1-week intervals. This team responds to all emergency cases during the hours of 0700-1700. Handover occurs daily at 1700 with the ACCESS team and the incoming senior resident on call and then again at 0700. 

Summary of changes

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