Facial Plastic & Reconstructive Surgery Fellowship

Dr. Andres M. Gantous

General Description

The practice is focused on facial plastic and reconstructive surgery. Aesthetic and functional/reconstructive rhinoplasty, blepharoplasty, otoplasty and facelift surgery being the most common procedures performed. Other common procedures that are performed include, but are not limited to: neck and facial liposuction, chin and cheek implants, brow and forehead lifts, scar revision and excision of facial lesions, flaps and grafts about the face. Common office based procedures include: dermal fillers, neuromodulator injections, management of anti-aging skin with medical grade skin care products and PRP treatments. The fellow is provided a well-rounded exposure to facial plastic surgery as well as significant exposure to thyroid, parathyroid and salivary gland surgery.

Fellowship Type (Clinical %, Research %)

Fellowship Director(s)

Objectives

To provide Royal College Fellows and University of Toronto eligible surgeons trained in otolaryngology-head & neck surgery advanced training in facial plastic and reconstructive surgery.
To enhance the fellow's exposure to research through the provision of clinical material for retrospective and prospective studies. To supervise the preparation of research papers for presentation at national and international meetings. To encourage and aid presentations at hospital and departmental rounds.
To stimulate the fellow's interest and provide experience in teaching medical students, residents and peers, such that fellows returning to academic appointments will have improved teaching skills.
To provide the fellow insight and experience in the management of a contemporary medical office to enhance his or her professional management skills.
To provide the fellow and his or her family exposure to a different professional, social and cultural milieu to enhance his or her professional and personal growth

Year Fellowship Established

Principal Locations

Duration of Fellowship

Number of Fellows Accepted Per Year

Required Prior Residency Training

Accept Foreign Medical Graduates (Yes/No)

Foreign Graduate Eligibility Requirements

Annual Stipend/Salary

At the University of Toronto, compensation for clinical fellows is equal to or greater than the salary of a PGY3 resident, or alternatively self-funded. Additional funds are available for presentation and publication of papers. The fellow on the basis of an educational license arranges malpractice insurance through the Canadian Medical Protective Association in Ottawa. This should be arranged prior to the start of the fellowship. The Fellowship Director covers this cost. Health insurance for the fellow is obtainable through the university and is paid by the Fellowship Director. Comprehensive, relatively low cost health insurance is available for dependents.

Additional Benefits (e.g. meetings, housing)

The fellow is given 2 weeks leave during the year, this is to be arranged as closely as possible with absences of the Fellowship Director from the practice. One week is given to attend a meeting at which no presentation is being made. Further time is allowed for presentation of papers at meetings as deemed appropriate. All time away from the practice must be cleared in advance with the Fellowship Director.

On Call Responsibilities

The fellow is on-call for after-hours and weekend call, with some visits required to the office on weekends for suture removal, etc. During the Fellowship Director’s absence from the practice for meetings etc., (this currently is about 8 weeks per year) the fellow is able to visit other cosmetic and reconstructive facial surgeons in Toronto, prepare for examinations, and make headway on research projects.

Case Mix

Primary site for patient consultations and follow-ups, as well as minor procedures is at Toronto Facial Plastic Surgery and at St. Joseph’s Health Centre.

Primary surgical site is at St. Joseph’s Health Centre and the secondary location is at The Cumberland Clinic. Approximately 350 cases per annum.

Cases include general endocrine procedures of the head and neck, salivary gland surgery, facial cosmetic and reconstructive surgery procedures including face and neck lift, septorhinoplasty, otoplasty, blepharoplasty, brow and forehead lift, facial implants and local flap and graft reconstruction of the face and neck

Typical Weekly Timetable

The practice is essentially a private practice with a strong university affiliation. Usually 2 to 3 full days per week are spent in either of the office locations. Operating time currently consists of 2 to 3 full days between the private OR and the hospital. Minor procedures are performed in the office or in the surgical center. Elective students, residents and fellows as well as visiting surgeons intermittently spend time in the office. The fellow is responsible to assist in the office with patient care. He or she is responsible to assist in the operating room, obtaining increasing "hands-on" responsibilities as deemed appropriate for the level of skill exhibited and the specifics of the case.

Clinical Responsibilities

Office:

Assist Dr. Gantous in all aspects of patient management.
Assist with consultations and follow-up visit appointments with patients, including full disclosure of procedures, discussion of risks, benefits and options, signing of consent forms, preparation of prescriptions and answering patient questions.
See patients in follow-up and manage care as deemed appropriate. Refer such patients to Dr. Gantous under the following circumstances: a) the patient has specific concerns; b) there is a problem unfamiliar to the fellow; c) the patient so requests; or, d) the patient has not been evaluated by Dr. Gantous during previous two follow-up appointments.
Acquire the knowledge and skills to photograph patients (pre-operative and post-operative digital slides) and maintain the patient photographic database.
Morph patient images.
Maintain personal consultation room and examining rooms in pristine fashion in conjunction with the Nurse Practitioner.
All patient interactions, both in person and by telephone, are to be noted in the patient’s chart appropriately.
Call in prescriptions to pharmacies, or write prescriptions for medications as needed. All medication orders are to be noted in the chart in red ink (or highlighted in the EMR).

Operating room:

Act as the first assistant for operative procedures. And in all ways, facilitate and expedite the management of operative cases.
Review patient charts pre-operatively and confirm the pre-operative investigations, physical examinations, and other appropriate investigations have been completed satisfactorily. In association with the Nurse Practitioner, notify Dr. Gantous of potential problems with pre-operative clearance or atypical laboratory results, as indicated.
Complete operative notes in a timely fashion, including copies forwarded to referring physicians. Templates for all operative procedures are located on the Fellow computer and can be modified to accurately reflect the operative procedure performed. Three copies should be created, one each for: a) the patient chart; b) the Fellow’s Files; c) the file of cases required by the AAFPRS for program certification (if applicable). All operative procedures, including office “touch ups” should be dictated and noted in the chart.
Update operative log on a weekly basis, this is to include both chronological listing of all procedures with patient names, as well as a cross-referenced listing of specific procedures.

Application Deadline

Decision Deadline

Additional Features of the Fellowship

Toronto is a cosmopolitan city of 3 million people, the greater Toronto area 5.7 million people, situated on the north shore of Lake Ontario. It is about 500 miles from New York and Boston, 365 miles from Montreal, 100 miles from Buffalo and 250 miles from Detroit. The fellow has every opportunity to enjoy the cultural amenities of a large international city. The United Nations has recognized Toronto as the most multicultural city in the world, and it consistently ranks in the top 10 of the best cities in the world in which to live. Toronto has several professional sports teams, hundreds of art galleries and museums, and the third largest theatre scene in the world after London and New York. There are extensive park and trail networks for strolling, running and cycling. There are also many parks and waterfront activities in Toronto for summertime activities. Beautiful lakes and wooded country are within one to two hours driving from the city, and alpine skiing in the wintertime is within two hours driving. A wide variety of accommodation is available downtown or on the subway system. The public school system is generally considered one of the best in North America. The University of Toronto has many academic, cultural and social activities. The city is noted for its safety, cleanliness, public transportation and cosmopolitan nature. If you have any questions or require any further details, please do not hesitate to contact me, or my office staff. We have also enclosed a list of former fellows who would be pleased to speak with you about our program.

As a condition of their medical educational licensure, clinical fellows must register with the University’s Post MD Education Office. An Orientation Handbook can be downloaded here: https://pg.postmd.utoronto.ca/current-trainees/before-starting-a-new-training-session/resources-for-new-trainees/ The Handbook contains useful information for new fellows, including a timeline for the registration process.

How to Apply

Send a letter of interest, updated curriculum vitae and the names of three references to Dr. Gantous at the email address below. Personal interviews are recommended, as this is a highly competitive fellowship.

To All Applicants:
If you have also applied to the U.S match through the National Residency Matching Program (NRMP), please be advised that the University of Toronto is a participating institution and adheres to the match policy. The policy states that "Applicants who have matched to a program or have accepted a position during the Supplemental Offer and Acceptance Program (SOAP), shall not apply for, discuss, interview for, or accept a concurrent year position in another program prior to the NRMP granting the requested waiver." More information is accessible at https://www.nrmp.org/wp-content/uploads/2022/03/2022-MPA-Institutions-1.pdf.