Fellowship Overview

Description

We are a high volume liver transplant center, performing approximately 200 adult liver transplants per year. We are the largest living donor liver transplant program in North America with 50-70 living liver donations per year. Our program follows >2000 recipients in clinic, and maintains a waiting list of 200-250 patients, meaning that approximately 10-15 new patients are assessed for transplant weekly. Our transplant program includes innovative therapies including living liver donation for fulminant liver failure and extensive liver cancer, donation after cardiac death, and liver transplantation with normothermic perfused grafts.

We have four funded transplant hepatology fellowship positions. The trainees come for one or two years, depending on the future career goals for the fellow. We recommend a one-year fellowship if the fellow will return to a center that provides care for transplant patient, but is not performing liver transplantations. If the fellow aims for a future position in an active transplant center a two-year fellowship is advisable. Our fellowship positions are fully funded and a salary is provided. The fellow is required to participate 3-4 times per months in the in-house call of the Multi-Organ transplant service. Our fellowship curriculum involves weekly rotations between the in house liver transplant service, the liver transplant outpatient clinics, and protected time for research. The fellowship also includes participation in elective and emergency endoscopy for liver transplant patients. We will arrange for rotations in transplant related fields such as radiology, pathology, and imaging according to the fellows wishes and needs.

Research

Clinical research is an important component of the fellowship. We provide an extensive database including more than 2000 liver transplantations with liver 20 years of follow-up. A database manager as well as a statistician is available to assist with research projects. Our patient population includes many unique features, such as a large living donor population, patients with extensive hepatocellular carcinomas, large data sets for uncommon indications for liver transplantation. Our expectations are that the fellow completes one project in his/her first year and three projects in the second year.

AFC Solid Organ Transplant Fellowship

Area of Focused Competence in Solid Organ Transplantation.

Our transplant fellowship also offers an Area of Focused Competence (AFC) diploma in Solid Organ Transplantation. Area of Focused Competence (AFC) are diploma programs which are fully accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC). Solid Organ Transplantation is that area of enhanced competence concerned with the care of adult and pediatric patients with end-stage organ failure treated by transplantation, encompassing patients with heart, lung, liver, kidney, pancreas, and intestinal organ transplants.

An AFC diploma in Solid Organ transplantation is a rewarding experience in highly specialized areas of medicine. Our AFC program provides a comprehensive learning experience that aids fellows in achieving skills in all CanMEDS domains. Successful completion of an AFC diploma will result in trainees being recognized as a medical expert, communicator, collaborator, leader, health advocate, scholar and professional by the Royal College.  Upon completion fellows are eligible for credentialing by the Royal College and will be invited to become a Diplomate of the Royal College of Physicians and Surgeons of Canada, receiving the added qualification of the “Diploma of the Royal College of Physicians and Surgeons of Canada (DRCPSC). Members with a DRCPSC will be known nationally and internationally as individuals who have sought to advance their knowledge and expertise with additional complementary skills and competencies. 

Any initial offers made to candidates by the program are subject to final approval by the Postgraduate Medical Education (PGME) office and may be rescinded should a candidate not meet CPSA licensing requirements, including proof of successful completion of one of the CPSA-accepted English Language Proficiency tests (if required).

For more information on the Royal College Area of Focused Competence AFC Diploma discipline information, rationale see the link below.

Solid Organ Transplant AFCs

FAQ’s

1. What is the duration of the fellowship?

The duration of the fellowship is 1 year.

2. What are the entry prerequisites for the fellowship?

Fellows must have Royal College certification or equivalent in one of the following: Gastroenterology and Hepatology.

3. What are the application requirements?

Applicants need to submit a cover letter, current CV, three letters of reference, proof of English language proficiency, a valid passport, and funding documentation if sponsored.

4. What kind of training experiences are included in the fellowships?

Fellowships include supervised care for transplant recipients, rotations in transplant Hepatology, output clinics and ALD clinics.

5. What are the key competencies fellows are expected to achieve?

Fellows are expected to achieve competencies related to the care of patients with end-stage organ failure treated by transplantation, including pre- and post-transplant care, management of immunosuppressive agents, and evaluation of transplant dysfunction.

6. Does the AFC allow me to practice independently?

No, the AFC does not grant independent practice rights on its own, but it is nationally recognized and enhances your skills and knowledge in solid organ transplantation.  

7. What is the process for obtaining medical licensure?

Fellows must obtain medical licensure or postgraduate trainee registration with the College of Physicians and Surgeons of Ontario (CPSO).

8. Are there research opportunities during the fellowship?

Yes, fellows have the opportunity to participate in clinical research during the fellowship program.

9. What is the significance of AFC accreditation?

AFC accreditation ensures that the fellowship program meets or exceeds national standards for quality training, as established by the Royal College of Physicians and Surgeons of Canada (RCPSC).

10. What type of certification will I be receiving after completing my fellowship?

There are two streams of fellowship provided; one in Liver Transplant Hepatology and one in Solid Organ Transplantation.

Upon completing an SOT AFC fellowship in Hepatology, you will receive a certificate that says, “Solid Organ Transplantation Area of Focused Competence (Hepatology).” Once you have completed all the required milestones and have an approved portfolio, you will also get a certificate from the Royal College in AFC in Solid Organ Transplant.

11. Can I change the naming convention on the certificate?

No, your certificate is reflective of your PGME registration. The Royal College has a standardized naming convention that cannot be changed.