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Highlights of the Fellowship:
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As a quaternary care academic practice in the public health system of Canada, we enjoy a centralization of referrals which create a very clinically busy Endocrine section in our Division. Further, our section is located in a highly prolific academic milieu involving 6 teaching hospital networks and the University of Toronto campus, which harbors a vast amount of scientific and academic opportunities with respect to clinical, educational, basic science, translational and ethics research.
Our staff surgeons include 4 academic fellowship trained endocrine surgeons (Rotstein, Devon, Pasternak, Madani) and affiliated HPB faculty who are very active clinically, and are highly engaged in the academic community. Our surgeons work at 4 affiliated hospitals located in the downtown core in the City of Toronto including Toronto General Hospital, Princess Margaret Cancer Centre, Toronto Western Hospital and Women’s College Hospital.
We expect fellows to complete between 300 and 350 cases per year including thyroidectomy (with central and lateral neck dissections), parathyroidectomy, adrenalectomy (including laparoscopic transabdominal, retroperitoneoscopic, and open approaches), as well as resection of GI/pancreatic neuroendocrine tumors. Within the OR, we use routine nerve monitoring and are currently initiating a transoral thyroidectomy (TOETVA) program. Fellows will have large volume exposure to outpatient clinic patients and will routinely perform neck ultrasounds, fine-needle aspirations and flexible laryngoscopy. According to their learning objectives, the fellow may attend several multidisciplinary tumor boards including 1) Thyroid/Parathyroid Tumor Board (2 per month), 2) Adrenal Tumor Board (1 per month), 3) GI/Neuroendocrine Tumor Board (1 per month), 4) Province-Wide Neuroendocrine Tumor board (1 per month), as well as 5) weekly Quality-Improvement Rounds and Endocrine Teaching Conference.
They will gain skills to ultimately become leaders in the field of Endocrine Surgery both technically in the operating room and with regards to the perioperative management of complex surgical endocrinology. The fellow as well as the entire team will interact regularly with various non-surgical team members who are leaders in their field, including endocrine oncology, endocrinology, radiology, genetics, nuclear medicine, medical oncology, radiation oncology and pathology. There is especially a high volume of exposure to rare endocrine disorders given the quaternary care nature of this endocrine surgery section, and management of these patients as a multidisciplinary team will be stressed. Since the start of the COVID-19 Pandemic, all non-clinical interactions have been moved to the virtual setting, helping with time management for the entire team.
Depending on the career plans of the clinical fellow, there will be opportunity for funding in an additional year for a research fellowship with potential for obtaining an advanced degree (MSc or other) from the University of Toronto.
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