Elective Name: Transplant Hepatology with focus on living donation liver transplant
Division: Gastroenterology
Director of the Fellowship and Elective Programs: Dr. Cynthia Tsien
Overview of Liver Transplant Program in Toronto General Hospital at UHN
We are a high-volume liver transplant centre performing approximately 200 adult liver transplants per year. We are one of the largest living donor liver transplant programs in North America with 50-70 cases per year. Our program follows over 2000 recipients in clinic, and maintains a waiting list of more than 250 patients, with approximately 10-15 new patients assessed for transplant weekly. We also partner with SickKids on the largest paediatric living donor liver transplant program in Canada. We consider living liver donation for all indications, including fulminant liver failure, extensive liver cancers, cholangiocarcinoma and metastatic colorectal cancer. The program is run by 7 full time staff surgeons and 4 full time staff hepatologists. The team also includes transplant hepatology fellows, surgical fellows, nurse practitioners, physician assistants, coordinators, nursing and ancillary staff. We work closely with transplant programs and gastroenterologists and hepatologists in the Greater Toronto Area, Winnipeg, Ottawa and other locations across Canada. Toronto General Hospital is one the world’s top 10 hospitals and the University Health Network (UHN), which encompasses Toronto General, is Canada’s leading research hospital.
Living Donation Elective for GI residents
Background
It is likely that every GI-trained physician will be expected to see/follow/refer patients with liver disease during their career, and that some of those patients will require transplantation. It is also likely that, as more and more people become aware of living liver donation, patients will ask for specific information on living donor liver transplantation. UHN patients come from across Canada and it would be beneficial for more of these patients to receive follow-up care from a specialist closer to home. Expertise in liver transplantation and living liver donation requires training beyond what is typically offered in GI/Hepatology residency.
Overview of the Elective
This is a one month elective for PGY4/5 GI residents who would like to learn more about liver transplant with an emphasis on living donor liver donation and transplantation. It is suitable for all GI residents, not necessarily, only those interested in pursuing a career in hepatology.
Residents will be provided with an appropriate reading list prior to starting the elective. The residents will rotate through both inpatient service (ward, intermediate and intensive care units) and outpatient clinics (assessment, pre- and post-transplant clinics, living donor clinics and day unit). There will be a special focus on ensuring that the residents are involved in clinics, meetings and discussions around living donor liver transplants. Residents will attend the operating room to participate in living donor liver surgery as well as a liver transplant recipient surgery. In addition to participation in clinical services, the resident will attend weekly patient management conferences, including the living donor team meeting, living donor radiology review and the liver patient listing meeting. The program offers a number of formal teaching events including weekly seminar series, morbidity and mortality rounds, multi-organ transplant rounds, journal club, pathology rounds and research rounds. The resident, through interaction with other experts, will have the opportunity to gain experience in living liver donation as well as other specialty transplant areas such as hepatobiliary oncology, transplant infectious diseases and hepatopathology.
There will be NO overnight call commitment associated with this elective.
Expected scholarly activities to be undertaken within the elective
Residents are expected to read the relevant articles that are provided and to attend all the educational sessions. During their first week of elective, they will, with the help of the elective supervisor, select an interesting topic/journal article to review and will present this topic to the team during the last week of the elective.
Assessment of the elective
The resident will meet with the Elective Program Director at the beginning of the elective to document the objectives for the elective. The resident will work with many of the faculty members during the elective, all of whom will be asked for feedback on the resident’s performance. The Elective program director will compile these evaluations and discuss them in person with the resident at the end of the rotation and complete an In-training Evaluation Report (ITER) or equivalent.
Funding available
5 Fellowships will be supported by the Centre for Living Organ Donation at UHN. The successful applicants will be offered a stipend of $3,000.
Selection process
Applications will be reviewed by the Elective Program Director and Attending staff. All suitable candidates intending to practice in Canada will be offered an elective position, pending availability. Priority will be given to applicants intending to practice in underserved areas or with underserved populations.
We will begin accepting applications for our Transplant Hepatology Elective. Please forward your application letter, CV and two letters of reference to TxHepatologyFellowship@uhn.ca.
UHN is strongly committed to diversity within its community and especially welcomes applications from racialized persons / persons of colour, women, Indigenous / Aboriginal People of North America, persons with disabilities, LGBTQ persons and others who may contribute to the further diversification of ideas. All qualified candidates are encouraged to apply; however, Canadians and permanent residents will be given priority.
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