LENGTH OF FELLOWSHIP: One year
START DATE: May 15th
ACADEMIC AFFILIATION: 涩里番, Hematology residency program
NAME OF HOSPITALS: 涩里番 Health Centre (MUHC) and Jewish General Hospital (JGH)
FELLOWSHIP PROGRAM DIRECTOR: Dr. Kelly Davison (kelly.davison [at] mcgill.ca)
TEACHING FACULTY: All attending staff with expertise and clinical interest in lymphoma may participate in the training of fellows.
ACADEMIC FACILITIES: Fellows will have access to a safe working environment workspace, equipped with a computer and printer, at each site. They will also have access to laboratory facilities that includes a microscope for the evaluation of bone marrow aspirates and blood smears and access to flow cytometry, molecular and cytogenetics data
FUNDING: Candidates must secure funding (as per PGME guidelines) to apply for this fellowship.
NUMBER OF FELLOWSHIP POSITIONS: One to two fellows per year
PROGRAM ENTRY REQUIREMENTS: Lymphoma fellows must have completed Hematology core training at an institution with Royal College certification or equivalent for foreign fellows. Proficiency in English or French, preferably both, is required. The fellowship will be awarded based on the applicant鈥檚 letter of intent, CV, past performance and an online or in person interview, depending on circumstances. The deadline for application is March 1st of each year.
BRIEF DESCRIPTION: This is a clinical fellowship focused on the diagnosis and treatment of patients with lymphoproliferative disorders (LPD). Fellows will be expected to participate in a clinical and/or translational research project with the aim to present their work at conferences and prepare a manuscript for publication. They will be exposed to patients referred for evaluation and management of LPD in the frontline or relapse settings and will gain proficiency in delivering conventional therapy, experimental therapy in the context of clinical trials and cell therapy (transplant and chimeric antigen receptor T-cell therapy (CAR-T)). Clinical duties will consist of 3-4 outpatient half-day clinics/week and one weekend 鈥渙n-call鈥� per month. Fellows will be expected to participate in lymphoma-related teaching sessions with the hematology trainees, attend tumor boards and academic Hematology rounds, with remaining time dedicated to research.
CONTACT EMAIL: residency.hematology [at] mcgill.ca
Program Information
CLINICAL: Fellows will be assigned to participate in clinics with hematologists who have expertise in treating patients with LPDs. They will have increasing responsibilities over the academic year such that they can have an independent lymphoma practice once they graduate. Approximately 3 to 4 halfday clinics per week will take place at the MUHC and JGH. In addition, fellows will gain expertise in performing consultations for patients referred for cell therapy (transplant and CART). Finally, fellows will be expected to provide one weekend of call per month, where duties will consist of evaluating patients on the consult service and wards.
TEACHING: Fellows are encouraged to attend academic half days with hematology residency trainees when the topics are lymphoma, CLL or CART-related. In addition, they are welcome to attend sessions dedicated to laboratory evaluation of lymphomas (molecular and flow cytometry). They will get more informal teaching by their assigned hematologist around the cases they see in the clinics. They will also be expected to present challenging cases at tumor boards or case rounds. Additionally, fellows will be expected to present at academic rounds and journal clubs once per year at each academic site, on a lymphoma-related topic of their choice.
RESEARCH: Fellows will be expected to participate in a research project with under the supervision of an attending hematologist. Research interests from each faculty member can be found on the 涩里番 website. Opportunities exist in clinical and translational research, as well as outcomes research. Participation in basic science research at the Lady Davis Institute or MUHC is also possible. Interested trainees will be encouraged to reach out to potential research supervisors directly or discuss options with the fellowship director.
FELLOW DUTIES AND RESPONSIBILITIES: Duties and responsibilities evolve over the course of the fellowship to prepare fellows for independent practice with expertise in LPD and CAR-T. Clinical duties include evaluating hematology patients in the outpatient clinics and in the inpatient setting while on call. Fellows are also expected to participate in teaching the hematology residency program and a research project with a dedicated supervisor.
EVALUATION AND FEEDBACK: Fellows will meet with the fellowship program director quarterly to evaluate their progress and goals. Fellows will be evaluated on their performance at both the clinical and research levels. Research evaluations and feedback will be provided by the Research Supervisor in the form of one鈥恛n鈥恛ne sessions at which time the Fellow will present their research progress and results as well as discuss problems and future directions. Clinical evaluations and feedback will be provided by the attending physicians, both informally during and after each clinic, and formally at 3鈥� month intervals.
ENRICHMENT OF THE HOST RESIDENCY TRAINING PROGRAM: The hematology residency training program will be enriched by lymphoma fellows through their contribution to resident teaching at academic half days, where fellows will be asked to deliver one teaching session on a lymphoma topic of their choice. They will also contribute to fruitful discussions at tumour board meetings, journal clubs and the hematology academic half days that they attend. Fellows will also provide residents with the opportunity for research collaboration.
ELECTIVES: Electives will not be permitted during the year-long fellowship.
VACATIONS: Fellows will be entitled to four weeks of vacation per year.
ADDITIONAL RESOURCES:
- Specialized clinics (eg cutaneous lymphoma clinics, CAR-T clinics)
- Specialized clinical laboratory access (next generation sequencing, cytogenetics, flow cytometry)
- Biobanks, registries and laboratory bench space, depending on the fellow鈥檚 research interests
- Microscopy facilities for evaluation of bone marrow aspirates and blood smears
READING MATERIAL: Relevant reading material will be provided by the program director at the start of the fellowship year.
At the end of the fellowship, the trainee will have acquired the following competencies:
MEDICAL EXPERT:
- Function effectively as consultants, integrating all the CanMEDS Roles to provide optimal, ethical and patient-centered medical care
- Demonstrate problem solving and clinical decision-making, including the ability to correlate, evaluate, and prioritize information acquired by clinical, pathology (biopsy, molecular, cytogenetic and flow) and imaging assessments; formulate an appropriate problem list; develop and implement a diagnostic and therapeutic plan using appropriate knowledge derived from clinical appraisal of relevant literature
- Demonstrate use of all CanMEDS competencies relevant to Adult Hematology
- Identify and appropriately respond to relevant ethical issues arising in patients undergoing treatment for LPD (in frontline and relapse)
- Demonstrate the ability to prioritize professional duties when faced with multiple patients and problems.
- Demonstrate compassionate and patient-centered care
COMMUNICATOR:
- Describe the diagnostic procedures, investigations and treatment plan to a patient and family member
- Obtain informed consent to perform a procedure, such as a bone marrow biopsy, administration of blood products and participation into a research study.
- Communicate effectively to the other members of the team participating in the patient鈥檚 care plan (e.g. pheresis, CART coordinator, clinical research study coordinators and other physicians鈥�)
- Complete a comprehensive consultative report to referring physicians.
- Provide appropriate post-therapeutic plan to patients and caregivers (e.g. post CART or transplant surveillance).
- Participate actively in teaching sessions
- Prepare and present at academic rounds / journal clubs
COLLABORATOR:
- Work with the house-staff team in the care of patients
- Understand and support the roles of allied health professionals (nurse, clinical research coordinators, pharmacists鈥�)
- Work with the other treating hematologists, pathologists and radiation oncologists to assess, plan, provide and integrate care for individual patients or groups of patients
SCHOLAR:
- Conduct or contribute to a research project related to LPD
- Access and interpret evidence relevant to LPD diagnosis and therapies
- Critically review relevant publications relapsed to LPD at journal clubs
- Educate residents in hematology about lymphoma related topics (2 presentations per year) at their academic half day
- Recognize gaps in knowledge regarding patient problems and develop strategies to fill the gap through reading and consulting other members of the health care team
PROFESSIONAL:
- Apply the principles of good clinical practice (GCP) and obtain division 5 certification to conduct clinical research
- Deliver care with integrity, honesty and compassion
- Understand the professional, legal and ethical codes to which physicians are bound.
Dr. Kelly Davison