Neonatology

Overview

The University of Toronto Division of Neonatology includes neonatologists from The Hospital for Sick Children, Mount Sinai Hospital and Sunnybrook Health Sciences Centre. The Neonatal Intensive Care Unit (NICU) at SickKids is an outborn unit which admits a broad spectrum of premature and mature neonatal patients with medical and surgical diagnoses requiring tertiary or quaternary care. The emphasis in the NICUs at Mount Sinai and Sunnybrook Health Sciences Centre is on antenatal diagnosis and counselling as well as the care of inborn patients resulting from high-risk pregnancies. The University of Toronto Neonatal/Perinatal Fellowship Training Program is a Royal College of Physicians and Surgeons of Canada accredited program.

Objectives

University of Toronto Integrated Neonatal-Perinatal Fellowship Training Program  (2 years)

Neonatal-Perinatal medicine is the branch of medicine concerned with the maintenance of health and long-term development of the newborn and young infant.  The overall goal for members of the training program at the University of Toronto is the development of the necessary knowledge, skills and attitudes related to prevention, diagnosis and treatment of disorders of the fetus, newborn and young infant as outlined in the Specific Standards of Accreditation for Residency Programs in Neonatal-Perinatal Medicine.  This includes:

  • knowledge of the basic sciences applicable to the full range of practice of neonatal-perinatal medicine including clinical disorders affecting all their body systems
  • critical appraisal skills
  • understanding of the complex ethical issues related to perinatology
  • understanding of the principles of quality assurance and administration relevant to perinatal care 
  • special competence in clinical skills and direction of management of the critically ill newborn, including all appropriate technical skills and techniques of resuscitation
  • ability to function as an effective consultant
  • ability to communicate effectively and offer psychological support to parents and members of the health care team
  • ability to teach, supervise and evaluate junior trainees
  • a compassionate interest and understanding of the family unit
  • recognition of the need to function as a member of the health care team
  • acceptance of the obligation for continuing self-education and teaching of others
  • understanding of the principles of cost-effectiveness and continuous quality assurance

SickKids Paediatric Departmental Fellowship in Neonatology (1 year)

The overall goal is the development of the necessary knowledge, skills and attitudes related to prevention, diagnosis and treatment of disorders of critically ill newborn infants. 
These include:

  • Knowledge of the basic sciences applicable to the full range of practice of neonatal-perinatal medicine including clinical disorders affecting all body systems
  • Special competence in clinical skills and direction of management of the critically ill newborn, including all neonatal resuscitation and appropriate procedural skills
  • Recognition of the need to function as a member of the interdisciplinary health care team
  • Ability to communicate effectively and offer psychological support to parents and members of the health care team
  • Understanding of the complex ethical issues related to neonatal-perinatal medicine 
  • Ability to teach, supervise and evaluate junior trainees
  • A compassionate interest and understanding of the family unit 
  • Acceptance of the obligation for continuing self-education and teaching of others
  • Critical appraisal skills
  • Understanding of the principles of quality assurance and administration relevant to perinatal care

SickKids Neonatal/Paediatric Transport Fellowship Program (1 year)

The Transport physician (TP) is an integral part of the Acute Care Transport Services team which resuscitates, stabilizes and safely transports patients from 0 - 13 years of age, in Ontario and beyond. The TP provides medical backup both on-line and hands-on, for the nurses and respiratory therapists on the ACTS team in order to provide optimal care of the patients referred to them, including attendance at high-risk deliveries. The transport physician will gain an intimate knowledge of the principles and practice of transport medicine through their work with the ACTS team; clinical, educational, research and administrative processes will be considered with the emphasis depending on the needs of the individual physician.

Training Sites

  • The Hospital for Sick Children
  • Mount Sinai Hospital
  • Sunnybrook Health Science Centre

Program Content

University of Toronto Integrated Neonatal-Perinatal Fellowship Training Program (2 years)

 This program has received full approval from the Royal College of Physicians and Surgeons of Canada and satisfies the requirements for two years of neonatal-perinatal training as set by the American Academy of Pediatrics. The first year of training includes NICU rotations, neonatal transport, neonatal follow-up and 2-3 months of research/elective time. The second year of training includes NICU rotations, an antenatal rotation, paediatric critical care, one month of follow-up and 4-5 months of research/elective time.  Progression from the first year to second is dependent on satisfactory performance and success at our Structured Oral Examination and OSCE.

The University of Toronto Training Program in Neonatal-Perinatal Medicine is formally integrated within three University of Toronto teaching hospitals - Mount Sinai Hospital (MSH), Sunnybrook Health Sciences Centre (SHSC) and The Hospital for Sick Children (SickKids). MSH and SHSC are inborn perinatal units and SickKids is an outborn neonatal unit. Combined, these three facilities provide a total of 38 Level II and over 100 Level III beds, which service the Central East region of the province of Ontario, a region with approximately 85,000 deliveries per year. Faculty includes thirty-six full-time hospital-based neonatologists as well as basic scientists and specialists from paediatric, surgical and obstetrical disciplines.

The Training Program is designed to meet the needs of a variety of individuals seeking subspecialty training in Neonatal-Perinatal Medicine. For more information, visit our website.  

SickKids Paediatric Departmental Fellowship in Neonatology (1 year)

This program is not an accredited program of the Royal College of Physicians and Surgeons of Canada. Positions are generally for one year but extensions are occasionally possible. Departmental Fellows may spend two months on the transport service and two months in research/electives.

The NICU at the Hospital for Sick Children is a busy outborn referral centre which services a large population base and cares for the most complex neonatal medical and surgical patients. Departmental Fellow positions enable individuals to gain valuable clinical experience. For someone with predominantly previous inborn perinatal experience, this unit provides a unique opportunity to see a different spectrum of conditions. It also allows exposure and experience to a highly functional regionalized transport service.

Positions are for individuals who have completed their pediatric training, have at least six months of neonatal experience and are interested in pursuing a career in academic neonatology or paediatrics with a significant neonatal component to their practice.

SickKids Neonatal / Paediatric Transport Fellowship Program (1 year)

This program is not an accredited program of the Royal College of Physicians and Surgeons of Canada. Positions are generally for one year but extensions are occasionally possible. Transport Fellows may spend two months in the NICU and two months in research/electives.

The NICU at the Hospital for Sick Children is a busy outborn referral centre which services a large population base and cares for the most complex neonatal medical and surgical patients. Transport Fellow positions enable individuals to gain valuable clinical experience in transport medicine. Fellows participate in providing online medical control to RN/RT transport team, accompany the team on critical complex interfacility transports, attend high-risk deliveries and provide consultations to the referral community-based physicians. This is an ideal training ground for a neonatologist experienced in developing expertise in transport medicine.

Opportunities to combine Departmental and Transport fellowship over a 1 or 2-year time frame exists based on medical preferences and program needs. Please apply to either Departmental or Transport fellowship and state your preference to be considered for this Hybrid Program.

For more information, visit our website

SickKids Advanced Clinical Support and Research Fellowship (1 year)

This program is not an accredited program of the Royal College of Physicians and Surgeons of Canada. The Advanced Clinical Support and Research Fellow position consist of 60% protected time for research and 40% clinical service in the NICU and follow-up clinical at SickKids. Positions are generally for one year, but extensions are occasionally possible. The clinical responsibilities would include direct front-line patient care with day-time, night-time and weekend call coverage.

For more information, visit our website

Toronto Centre for Neonatal Health Clinical Fellowship Program (1 year)

The Toronto Center for Neonatal Health (TCNH) is offering a Clinical Fellowship. This is not an accredited program of the Royal College of Physicians and Surgeons of Canada. Positions will be available annually across some of the NICUs who are part of the TCNH. Each fellow appointed may rotate between the tertiary NICUs, which include The Sinai Health System, The Hospital for Sick Children and Sunnybrook Health Science Centres, with elective rotations in community hospital NICUs.

This 1-year program offers some flexibility and the opportunity to enhance clinical competencies in neonatology, with cognitive and technical skills focused on both perinatal resuscitation and newborn intensive care. Electives may also be taken in the Acute Care Transport Service (ACTS), Neonatal Follow-Up Program or other clinically relevant areas. This competency-based neonatal training program will help develop the necessary competencies to practice in level 2c or modified level 3 NICUs. Night-time and weekend call will follow the PARO guidelines.

For more information, visit our website

SickKids Neonatology-Neurology Fellowship Program (1 year)

This program is not an accredited program of the Royal College of Physicians and Surgeons of Canada. Positions are generally for one year but extensions are occasionally possible. Neonatal Neurology Fellows will participate in the clinical care of newborns at SickKids with neurological diseases, develop enhanced skills in neonatal and paediatric neurology subspecialties, and conduct clinical/translational and basic research related to Neonatal Neurology.

Fellows who complete this Neonatal-Neurology training program will have advanced competencies in the neurological assessment and clinical management of newborn infants with complex neurological disorders. Moreover, the fellow will have the training to determine the utility of bedside monitoring tools (e.g. aEEG and continuous EEG) and advanced MRI techniques to enhance assessment and management.

Clinical and research experience during this advanced fellowship is tailored to the career needs of the applicant, but each trainee is expected to complete a potentially high impact clinical/translational or basic research project by the end of the training.

For more information, visit our website

Research Experience

There are many opportunities for trainees to participate in research activities, they receive time throughout their training to develop their research. Each trainee in the Core program is encouraged and supported to pursue a scholarly project. They are given the opportunity to present their research during the Neonatal Research Day and the Department of Paediatrics Research Day.

Evaluation

University of Toronto Integrated Neonatal-Perinatal Fellowship Training Program

Evaluation of fellows and residents is done through the end of rotation In-Training Evaluation Reports (ITERs). Electronic In-Training Evaluation Reports (ITERs) are automatically sent to the supervisor near the end of each rotation. After the supervisor completes the electronic evaluation form, it is forwarded to the trainees who will review and sign it on-line. Staff are expected to discuss the evaluations with the trainees face to face before completing them. Feedback and evaluation of trainees are performed both formally as well as informally via a variety of methods:

  • end-of rotation in training evaluations
  • annual practice OSCE
  • annual Structured Oral Exam (SOE).

With the launch of Competency by Design (CBD), we will be introducing new evaluations based on Entrustable Professional Activities (EPAs) and In-Training Assessment Reports (ITARs). The Program Director and Competence Committee will review each trainee on a regular basis. A faculty advisor will provide feedback to the trainee following these meetings to ensure they progress appropriately through the program.

SickKids Paediatric Departmental Fellowship in Neonatology

Evaluation of fellows and residents is done through the end of rotation In-Training Evaluation Reports (ITERs). The feedback from this provides candidates with an assessment of their knowledge and with information on areas of strength and weakness. Electronic In-Training Evaluation Reports (ITERs) are automatically sent to the supervisor near the end of each rotation. After the supervisor completes the electronic evaluation form, it is forwarded to the trainees who will review and sign it on-line. Staff are expected to discuss the evaluations with the trainees face to face before completing them. Evaluation works both ways, and trainees are asked to evaluate each rotation and each clinical teacher.

With the launch of Competency by Design (CBD), we will be introducing new evaluations based on Entrustable Professional Activities (EPAs) and In-Training Assessment Reports (ITARs). The Program Director and Competence Committee will review each trainee on a regular basis. A faculty advisor will provide feedback to the trainee following these meetings to ensure they progress appropriately through the program.

Neonatal/Paediatric Transport Fellowship Program

Evaluation of fellows and residents is done through the end of rotation In-Training Evaluation Reports (ITERs). The feedback from this provides candidates with an assessment of their knowledge and with information on areas of strength and weakness. Electronic In-Training Evaluation Reports (ITERs) are automatically sent to the supervisor near the end of each rotation. After the supervisor completes the electronic evaluation form, it is forwarded to the trainees who will review and sign it on-line. Staff are expected to discuss the evaluations with the trainees face to face before completing them. Evaluation works both ways, and trainees are asked to evaluate each rotation and each clinical teacher.

With the launch of Competency by Design (CBD), we will be introducing new evaluations based on Entrustable Professional Activities (EPAs) and In-Training Assessment Reports (ITARs). The Program Director and  Competence Committee will review each trainee on a regular basis.  A faculty advisor will provide feedback to the trainee following these meetings to ensure they progress appropriately through the program.

Ways To Get Involved

There are existing committees where trainees may participate in throughout the course of their training, including the Competence & Training Committees. In addition, trainees can be nominated as Year 1 and Year 2 representatives as well as being nominated to the position of Chief Fellow, where they are actively involved in decision-making for the program, and are responsible for scheduling calls, approving vacation, and facilitating communication between the trainee and Program Director.

Additional Educational Opportunities

Trainees are invited to attend subspecialty rounds, such as Fetal Medicine, Surgical, Radiology, Morbidity and Perinatal rounds. They also have the opportunity to present in the weekly Journal Club education sessions. Trainees are allotted one week of professional leave and an allowance to attend conferences.

Applying To The Program

To access the applications, visit http://www.sickkids.ca/Neonatology/Education-and-Learning/index.html

Note: Incomplete applications will not be considered. 

Elective Opportunities

Canadian Resident Electives

If you are eligible and interested in pursuing an elective with Division of Neonatology, please send your requested start and end dates to determine availability to the Neonatology Medical Education email: neonatal.fellowship@sickkids.ca.

Once available dates have been confirmed, Canadian Resident Electives submit their applications through the University of Toronto PGME.  A profile must be created through The University of Toronto’s PGME Electives Program.
 

International Resident Electives

If you are eligible and interested in pursuing an elective with Division of Neonatology, please send your requested start and end dates to determine availability to the Neonatology Medical Education email: neonatal.fellowship@sickkids.ca.

Once available dates have been confirmed, International Resident Electives must apply through the Post Graduate Medical Education (PGME) Office at the University of Toronto. In order for international trainees to be eligible, they need to be registered and be in good standing in a medical program at a university medical school at a PGY 3 level. It is also required that they continue to be paid by their medical school/training program during their elective time.

The application process takes approximately eight to nine months to complete.  Final approval is granted once all requirements have been met as required by the Postgraduate Medical Education Office (PGME) at the University of Toronto and the College of Physicians and Surgeons of Ontario (CPSO) for licensure.

International Elective Eligibility for Licensure

In order to take up an elective at the University of Toronto, candidates must be eligible for licensure by the College of Physicians and Surgeons of Ontario (CPSO), the body which regulates the practice of medicine in the province of Ontario. Please visit the CPSO website for Registration Applications and Forms required for the issuance of a certificate of registration.

International Elective Funding

International trainees who wish to take an elective under the supervision of a University of Toronto postgraduate program director/training program must be fully funded for the duration of the proposed elective by an acceptable sponsoring agency.  Foreign governments and foreign government-funded agencies, for example, are considered acceptable sources of funding for non-Canadian residency trainees. Charitable foundations, private corporations or self-funding are not considered acceptable sources of funding. Elective residency trainees must have funding for their elective training in accordance with the scale of remuneration of the PARO-CAHO Agreement.

All elective applications are processed and must be approved by the Elective Office, Faculty of Medicine at the University of Toronto.

Contact

Education Administrative Coordinator: Tara Dwomoh 
Email: tara.dwomoh@sickkids.ca 

 

Observership Opportunities

Program Overview

The Observership Program in the Division of Neonatology at The Hospital for Sick Children is open to Canadian and International Medical School Graduates who are board-eligible or certified in Paediatrics, and are interested in gaining experience at The Hospital for Sick Children. Observers shall not have any patient care responsibilities and shall not begin a term without prior approval by the Medical Affairs Office. Observers will not participate in any direct patient contact and therefore, do not require an Independent or Educational license from the CPSO.

Eligibility

Canadian and International Trainees who are board eligible or certified in Paediatrics or Neonatology.

Cost

A non-refundable observer application fee of $175 is applicable to observers (> 4 days).

Deadlines

Observership applications will be accepted up to two months prior to agreed-upon start date.

Application Process

Interested applicants are requested to send their most recent CV and Letter of Intent with their requested dates for approval to Tara Dwomoh, the Education Administrative Coordinator via email: neonatal.fellowship@sickkids.ca.

For International Observership Requests

Once availability has been confirmed by Tara Dwomoh, please visit the International Learner Program and complete the online application, or send an email to ilp.requests@sickkids.ca.

Contact

Training Program Director

Dr. Jennifer Young

Phone: (416) 586-4800 ext 7605
E-Mail: Jennifer.young@sinaihealth.ca

Training Program Director

Dr. Linh Ly

Phone: 416-813-7203 X207203
E-Mail: linh.ly@sickkids.ca

Training Program Director

Dr. Hilary Whyte

Phone: 416-813-8829 X208829
E-Mail: hilary.whyte@sickkids.ca

Education Administrative Coordinator

Tara Dwomoh

Phone: 416-813-8829 X228902
E-Mail: tara.dwomoh@sickkids.ca