This two year program offers comprehensive training in adult clinical and laboratory hematology. The program fulfills the requirements of the Royal College of Physicians and Surgeons of Canada, as well as the College des Medecins du Quebec. Residents will gain increasing responsibility and independence in all aspects of their work over the two years of training.
Rotations:
Ward Hematology: The residents join more junior trainees on the inpatient hematology-oncology ward. Excellent exposure to patients who are hospitalized for rapid diagnosis and treatment of a hematologic malignancy; patients admitted for complications or in-patient treatment of their disease. Opportunity is provided to learn about the diagnostic criteria of hematologic malignancies, chemotherapy and associated treatments, hematologic emergencies and medical complications of hematologic diseases. The resident works in conjunction with the attending hematologist, the housestaff and allied health personnel, and acquires expertise in basic and clinical sciences, teaching, communication and management skills.
Consult service: Participation at all adult teaching hospitals, where the resident becomes a consultant for in or outpatients with a wide variety of underlying conditions. There will be a lot of opportunity to learn about coagulopathies, thrombosis management, transfusion medicine, cytopenias, hematologic complications of pregnancy, and hematologic issues in surgical and medical patients. The resident will work in conjunction with an attending hematologist, and usually also more junior trainees. Case based teaching, and review of diagnostic laboratory material will allow the resident to develop in depth expertise in these domains. The resident will acquire all the necessary skills to be an independent consultant by the end of their training.
Outpatient clinics: Rotation in a wide variety of half day outpatient clinics, including for example, oncology day center, high risk pregnancy, hemoglobinopathies, thrombosis clinic and others, that give an excellent overview of outpatient hematology. Given the great shift towards outpatient management of a large number of hematologic conditions, this rotation complements well the preceding clinical rotations that focus more on the hospitalized patient.
Medical oncology: Working with the oncology service, in order to gain appreciation of the diagnosis, staging, and management of solid tumor malignancies, both in the clinic and inpatient setting. The resident is supervised by a medical oncologist, and may often interact with oncology or medicine trainees, as well as allied health professionals as pertains to the care of the medical oncology patient.
Pediatric hematology: The resident spends a rotation at the Montreal Childrens hospital gaining an overview of pediatric hematology.
Stem cell rotation: Combined clinical and laboratory activities, centered on stem cells and transplant activities. The resident will attend transplant clinics, round on inpatients on the bone marrow transplant service, and learn aspects of stem cell biology including mobilization, collection, laboratory evaluation , storage and quality assurance activities. Residents will gain an understanding of donor and patient selection, preparatory regimens, outcomes and complications of stem cell transplant.
Morphology and general laboratory: Opportunity to learn about general laboratory management and operations, with the main focus on acquisition of knowledge on peripheral blood and bone marrow morphology and cell surface marker properties. Residents will participate in the daily review of peripheral blood and bone marrow aspirate interpretations, and will have opportunity to review teaching collections. Whenever possible correlation will be made between findings on routine morphology, special stains and flow cytometry.
Coagulation/thrombosis: Acquisition of the necessary laboratory skills for the interpretation of routine and specialized coagulation testing, including tests for hemostatic and thrombotic disorders. It will be possible to participate in the thrombosis service, anticoagulation clinics and hemophilia clinics during these rotations, as an excellent way to establish clinical and laboratory correlations of coagulation problems.
Blood banking: Time devoted to blood banking and transfusion medicine. Hands on experience will be possible in order to learn simple blood banking techniques. Interpretation of blood bank panels, learning blood bank management and clinical transfusion medicine are also integral parts of the rotation.
Special laboratory: This rotation allows residents to learn about special laboratory procedures, not covered in the above laboratory rotations. Molecular diagnostics, isotope studies and other specialized assays as well as their appropriate utilization will be the focus of the rotation.
Cytogenetics: Intense exposure devoted to the methodological, technical and interpretive aspects of cytogenetics as it pertains to hematologic diseases.
Hematopathology: Time spent with a hematopathologist to gain an understanding of lymph node and bone marrow biopsies as pertains to the practice of hematology.
Electives: Six elective periods are available to use for further in depth training in selected areas, exposure to other aspects of hematology such as for example community electives, courses in clinical epidemiology are available. Part of the elective time should be devoted to a research project.
Longitudinal clinic:
All residents participate in a weekly half day clinic which provides an outstanding longitudinal perspective in the management of hematologic outpatients with both malignant and benign conditions. Working under the supervision of a staff hematologist, by the end of their training the residents are however expected to function autonomously in all aspects of their clinic management.
Teaching/conferences/evaluations:
Residents attend and participate in a large variety of weekly conferences and rounds at all hospital sites. These include medical grand rounds, benign hematology lecture series, lymphoma rounds, hematopathology rounds, journal club, oncology rounds and others.
Academic half day: weekly teaching sessions, morphology review or journal club devoted to cover all major aspects of the hematology curriculum over the two years. The curriculum also includes formal teaching of non-medical expert roles. Contents of the curriculum are reviewed based on feedback at regular intervals. A yearly practice exam is conducted during the winter.
Critical review sessions: structured teaching at the Jewish General Hospital, where residents and attending staff actively participate in a lively debate of current hematology topics.
ASH: The annual meeting of the American Society of Hematology should be attended by all trainees. Funding is provided. ASH Practice exam: available for second year residents.
AHMOQ The annual meeting of the hematologists and medical oncologists of Quebec should be attended. It is an excellent forum for presentation of resident research projects.
Annual residents day and practice exam: Organized by the University of Toronto, for yearly educational and social gathering of trainees from across Canada, usually held in July.
Research:
All trainees are expected to participate in research activities. Information will be provided early in the first year, and elective time is available for research related activities. Combined training in hematology and the clinician scientist program is possible.
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