CaRMS

2019 R-1 Match - First iteration
R-1 Match - First iteration
CMG Stream

Last approved on August 20, 2018

Program Name

Otolaryngology - Head & Neck Surgery
University of Toronto

Program Director

Dr. Paolo Campisi

Approximate Quota:

5

Address

Otolaryngology-Head & Neck Surgery
190 Elizabeth Street, TGH RFE Building 
3rd Floor, Room 3S-438
Toronto, Ontario, M5G 2C4
Office: 416-946-8743
Fax: 416-946-8744

Program Contacts

Name: Andrea Donovan
Title: Education Coordinator
Email: ohns.educationcoordinator@utoronto.ca
Phone: 416-946-8743

Program Director: Dr. Paolo Campisi
Email: paolo.campisi@sickkids.ca
Phone: 416-946-8743

Important Information

Applying competency-based practices to Otolaryngology – Head & Neck Surgery 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.  Residents entering the otolaryngology – head & neck surgery program in July 2016 and beyond will experience competency-based training.

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. 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.

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

Supporting Documentation

1. Certificate of Canadian Citizenship:
Proof of current citizenship or permanent resident status must be provided by submitting one of the following verifications to CaRMS by the Rank Order List deadline. (Photocopies acceptable). No other forms of verification are acceptable:

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

2. Letters of Reference:  Maximum number accepted: 5
3. Photo  [Note: Photograph is used as memory aid only]
4. Medical School Transcript
5. Medical Student Performance Record
6. Custom Résumé / CV
7. Personal Letter
8. Ophthalmological Report:
It is strongly recommended the applicant provide a written report from an Ophthalmologist or Optometrist stating the applicant's visual status, including stereopsis and colour vision.  Vision testing, however, is not mandatory.

Interviews

Dates:
January 25, 2019

Notification/Invitation:
Program will notify all applicants

Details regarding the interview process:

In an effort to reduce unnecessary travel and expense, we will be screening applicants based on the submitted package (personal letter, curriculum vitae, transcript, Dean's letter and letters of reference). Applicants that are considered competitive for admission to the program based on the analysis of last year's applicants will be offered an interview. We will contact applicants who are selected for an interview by email. Candidates will attend three, eight minute interviews (each with 2 faculty or current residents) and approximately five Multiple Mini Interviews (MMI) and a technical skills station. No video conferencing or telephone interviews are permitted.

Residents from our program will be available on the interview day to meet with you and discuss any questions you may have pertaining to the program or city.

Selection Criteria

The candidates we are looking for are bright, have excellent interpersonal skills, good clinical judgment, high ethical and professional standards and have a real interest in otolaryngology-head & neck surgery in either academic or community practice. Demonstration or presumed sufficient bimanual dexterity and hand eye coordination to perform delicate surgery is highly desirable.

We are looking for the best candidates for our specialty so preference is not given to any particular medical school. We make our selections based on the dossier you submit as well as personal interviews. Interviews are mandatory and will take place on Friday, January 25, 2019 in Toronto.  The interviews will combine meeting with faculty and residents and Multiple Mini-Interviews (MMIs).  The major factors that influence our ranking are: the strength of the academic record, the letters of reference (minimum of 5) and the interviews.

Elective Requirements:

We are looking for and rewarding applicants who have completed a broad range of electives including our specialty.

Program Curriculum

Length of Program: 5 years

This Otolaryngology - Head & Neck Surgery program at the University of Toronto consists of 1 year of Surgical Foundations training followed by 4 years of specialty training at University of Toronto teaching hospitals.

In core surgery, 13 blocks are in rotations undertaken in general surgery, neurosurgery, plastic surgery, emergency medicine, internal medicine, medical imaging, anesthesia, and critical care medicine. These rotations provide an important knowledge base to complement the core otolaryngology training. 7 months of clinical otolaryngology and 4 months of otolaryngology research comprise the remainder of the 2 year core training. Otolaryngology rotations for PGY1 residents are usually provided at the University Health Network (UHN), the Hospital for Sick Children (HSC), Sunnybrook Health Sciences Centre (SHSC), and St. Michael's Hospital (SMH). PGY2 residents also have a 1 month otolaryngology rotation at North York General Hospital (NYGH). The PGY2 4-month research block is undertaken with the supervision of a clinical or basic science researcher after formal proposal and discussion/approval of the project by Dr. R.V. Harrison, the Director of Research for our department, and Dr. P. Campisi, the Program Director.

The PGY3 year involves 12 months of clinical otolaryngology at University of Toronto teaching hospitals (usually SHS, HSC, SHSC, and/or UHN). PGY3 residents spend a total of 2 weeks in the Division of Anatomy at the University of Toronto learning from anatomy professors, dissecting cadaver specimens, and teaching head & neck anatomy to first year medical students.

The PGY4 year involves 10 months of clinical otolaryngology at University of Toronto teaching hospitals (usually SHS, HSC, THP, SMH, SHSC, and/or UHN). The PGY4 resident is the senior resident at SHS, THP and UHN. PGY4 residents have a 3-month block for electives, dedicated facial plastic surgery rotation, sleep medicine rotation, and head & neck pathology rotation.

The PGY5 year involves 12 months of clinical otolaryngology at University of Toronto teaching hospitals (usually UHN, HSC, SMH, SHSC, and MGH or SJHC). The PGY5 residents are the senior or chief resident during each rotation. They have an unparalleled exposure to all aspects of otolaryngology-head & neck surgery and by the end of their year are expected to function at the consultant level.

The graded responsibilities of residents are clearly outlined to them by the postgraduate director and the site co-ordinators/hospital chiefs during their orientation sessions at each new rotation.

Since July 1, 2008 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 non-clinical roles for the RCPSC and CFPC Programs.  These modules are focused for PGY1 & PGY2 trainees.  Failure to complete the modules will delay processing of Final In-Training Evaluation Reports (FITERs) and may constitute professional misconduct and/or prevent promotion to the next PGY level.

A.T.L.S. Training: Certification in Advanced Trauma Life Support (A.T.L.S.) is mandatory traininng provided and funded by our department for all PGY1 residents. 

Fellows

The University of Toronto teaching program is not only a leader in the education of residents, but also in the education of postgraduate fellows. There are a large number of clinical and research fellowships offered for advanced training. However, it is made absolutely clear that residents have first priority for any learning experience, including the operating room. The fellows are considered unique to our program in bringing outside experience and knowledge. Our residents have found them to be excellent teachers and have formed lasting friendships. We consider the fellows a uniquely positive addition to our training program. Prospective candidates are encouraged to speak with our current residents about the positive impact our fellows have had on their education.

Electives

There is a great deal of flexibility in choosing electives anywhere residents wish. However, residents must submit to the program director, a written request detailing the nature of the elective, the proposed dates, a set of objectives and the name, affiliation and address/telephone/e-mail of the supervisor.

Subspecialties

Our program provides a full range of adult and pediatric care over seven institutions. General otolaryngology exposure is integral and available in all teaching hospitals, particularly at St. Michael's Hospital, the Michael Garron Hospital and St. Joseph's Health Centre. The bulk of otolaryngology care in these three institutions can be defined as "general otolaryngology".

In addition to general otolaryngology, the following institutions also provide sub-specialty training as follows:

UHN: Head & Neck surgery/Reconstruction, Otology/Neurotology and Skull base surgery

SHS: Head & Neck surgery emphasizing Endocrine surgery, Rhinology and Sinus surgery

SMH: Laryngology, Rhinology, Endocrine Head & Neck surgery, Skull base surgery

HSC: Paediatric otolaryngology

SHSC: Otology/Neurotology, Skull base surgery, Head & Neck surgery/Reconstruction

MGH: Sinus surgery, Pediatric Otolaryngology, Facial cosmetic surgery

MAM: Otology, Sinus surgery, Pediatric otolaryngology

NYGH: Otology, Sinus surgery, Laryngology, Pediatric laryngology

St. Joseph's Health Centre: General Otolaryngology

Didactic and Practical Skills Courses

There is a substantial program of didactic and practical skills courses arranged for residents during their 5 year residency. During the PGY1 year, residents attend the Principles of Surgery lecture series given weekly by the Department of Surgery. PGY2 residents usually take the Royal College Principles of Surgery examination in the first half of their year, which is a pre-requisite to taking the final Royal College exam in Otolaryngology-HNS. In addition, PGY1 residents attend a prep camp in July and refresher course in September at the Surgical Skills Centre, Sinai Health Systems. The curriculum covers the full range of basic surgical skills (airway management, suturing, bone plating, lasers, etc.). At the end of the program in the spring of each year, PGY1 residents undergo a practical skills assessment exam and are graded against residents in all of the other surgical specialties.

PGY2 to PGY4 residents have protected academic time each Friday morning from 9am to 12pm during the academic year for core lectures. This is a 3 year cycle of lectures given by faculty within and outside our department as required. The lectures cover all aspects of otolaryngology management as well as specific lectures on the 7 CanMEDS roles, ethics, and epidemiology/critical appraisal. At the end of each block of lectures, residents write a 3 hour exam in the same format as the final Royal College exam (short answer). In addition to core lectures, residents have 2 temporal bone drilling sessions in the surgical skills centre during core lecture time.

PGY3 residents spend the equivalent of 2 weeks in the Division of Anatomy. They receive didactic head & neck anatomy lectures and interactive seminars from Division of Anatomy professors. Residents dissect cadaver specimens and are demonstrators (teachers) for first year University of Toronto medical students. Where possible, otolaryngology faculty participate to show residents surgical anatomy. Residents write an anatomy exam at the end of their experience.

PGY5 residents participate in a fellowship study course organized by our department from September to March each academic year. The lectures are held on Mondays for 2-3 hours and again cover the major topics in otolaryngology-head & neck surgery. The course is revised each year with input from the most recent graduates and the current PGY5 residents.

Residents are invited and encouraged to attend the 8-10 continuing education courses held each year organized by our department. Residents in their PGY4 year are sponsored to attend the annual American Academy of Otolaryngology-Head & Neck Surgery meeting. Wherever possible, residents are encouraged to attend scientific meetings related to otolaryngology-head & neck surgery.

Practice Exams

Practice exams are an integral part of our training program. In addition to a practice Principles of Surgery exam,  PGY1 practical surgery skills exam, and core lecture exams, our residents write the National In-Training exam (NITE) each year. The National In-Training exam questions are submitted by otolaryngology faculty across the 13 Canadian training programs and all PGY2-PGY5 residents across the country take the exam. Results are tabulated by resident year and sent to each resident and program.

Practice oral exams are an integral part of the training program. The PGY1, PGY2, PGY3, and PGY4 year will usually undergo 2 sessions with 4-5 examiners each year (i.e., 8-10 practice oral exams) and the PGY5 residents will undergo 4-5 sessions with 4-6 examiners each year (i.e., 20-30 practice oral exams). After each exam, residents are sent their marks for each station compared with their peer's marks. More importantly, residents are given specific written comments from the examiners regarding their performance. The PGY5 residents in particular have found these practice oral exams an invaluable experience and tremendous preparation for the final Royal College exam.

PGY1

Otolaryngology - 7 months
Anesthesia - 1 month
Neurosurgery - 1 month
Adult Emergency Medicine - 1 month
Internal Medicine - 1 month
Medical Imaging - 1 month

PGY2

Otolaryngology - 4 months (research)
General Surgery - 2 months
Otolaryngology at North York General (NYGH) - 1 month
Plastic Surgery - 3 months
Intensive Care Medicine - 2 months

All PGY-1 residents participate in the Principles of Surgery (POS) course within the Department of Surgery. PGY1 residents participate in a unique hands-on surgical skills training program on a weekly basis during the academic year.

PGY3

This is a year of clinical otolaryngology. Trainees have ten months of rotations at University of Toronto Teaching Hospitals, as well as 1 month of elective. In addition, PGY3 residents have a unique opportunity by spending 2 weeks of dedicated time in the anatomy laboratory and teaching head & neck anatomy to first year medical students.

PGY4 and PGY5

Two years of clinical otolaryngology - head & neck surgery at University of Toronto teaching hospitals including a minimum of 3 months of community otolaryngology (Michael Garron Hospital or St. Joseph's Health Centre).  A 3-month block comprising a 1-month pathology rotation, a 1-month facial plastic & reconstructive surgery rotation, a sleep medicine rotation and a 1-month elective are included in PGY4. Residents in their PGY4-PGY5 years generally spend 3-4 month rotations at the University Health Network, Sinai Health System, the Hospital for Sick Children, Sunnybrook Health Science Centre, Michael Garron Hospital, and Trillum Health Partners.

Research

One of the mandates of the University of Toronto Department of Otolaryngology - Head & Neck Surgery is to train the community and academic leaders of tomorrow. An important aspect of our training program is to foster clinical and basic science research. In his capacity as the director of research for our department, Dr. Robert V. Harrison oversees the research agenda in collaboration with 4 PhD researchers and 8 research laboratories.

A dedicated 4 month research block takes place in the PGY2 year through a mentorship program; research projects are presented at our annual Percy Ireland Academic Day during the spring of each year. Trainees who are interested in pursuing a career in academic otolaryngology are encouraged to take advantage of the clinician scientist program through the University of Toronto. Some residents pursue advanced degrees (e.g. clinical epidemiology, surgeon scientist, education, health economics) during their residency training but this is not a requirement of our program.

Rounds

There are numerous weekly academic teaching sessions, hospital rounds, quality assurance rounds (M & M rounds), and grand rounds during the academic year. Residents are responsible for preparing hospital based rounds and PGY2-PGY4 residents give departmental grand rounds once per year in conjunction with a faculty mentor. Residents also prepare and present at journal club with articles focused around a particular subject or theme and include the teaching of clinical epidemiology and critical appraisal.

Training Sites

The University of Toronto Otolaryngology-Head & Neck Surgery Program is fully integrated. Affiliated hospitals are:

Sinai Health System (SHS)
St. Michael's Hospital (SMH)
Sunnybrook Health Sciences Centre (SHSC)
University Health Network (UHN) - Toronto General Hospital, Toronto Western Hospital, Princess Margaret Hospital
Hospital for Sick Children (HSC)
Michael Garron Hospital (MGH)
North York General Hospital (NYGH)
St. Joseph's Health Centre (SJHC)
Trillium Health Partners (THP)

Resources

http://pg.postmd.utoronto.ca/about-pgme/affiliated-hospitals/

We have the largest and most comprehensive training program in Canada.

We have significant depth and cover all subspecialties within Otolaryngology - Head & Neck Surgery.

Most of our core teaching faculty are recognized national leaders in Otolaryngology - Head & Neck Surgery and many are considered international leaders.

We have extremely well-organized and comprehensive didactic and hands-on skills training to cover the depth and breadth of Otolaryngology - Head & Neck Surgery.

Our residents are very happy. 

Once our residents have completed their training, they possess unique skills and unparalleled experience to enter a community setting or initiate a career in an academic setting.

Many of our residents and fellows go on to assume leadership roles in both academia and the community.

Our research programs and support are innovative, comprehensive, and award winning.

Additional Information

Otolaryngology-Head & Neck Surgery is a broadly based discipline involved in the diagnosis and management of disease occurring above the clavicles and largely outside the orbit and cranial cavity. As such, it encompasses many systems and involves a very broad area of medical practice, including communication disorders, hearing loss, neurotology, skull base surgery, head and neck surgery, endoscopy, facial and reconstructive surgery and allergy in all age groups. The faculty has a broad range of skills with leaders represented in virtually all sub-disciplines. Very close relationships exist, including cross-appointments, with a number of other disciplines such as radiation oncology, pathology, and certain of the basic sciences. The discipline is vital, changing and growing. It is very exciting to be a part of this specialty.

 

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