Gastroenterology, Hepatology and Nutrition

        

Application process

Information For Applicants To The Fellowship Program,
Division Of Gastroenterology, Hepatology and Nutrition,
The Hospital for Sick Children, University of Toronto

We hope that these notes will provide you with some background information regarding our division. Please feel free to contact us if you have any further questions.

Fellowship Program In Paediatric Gastroenterology, Nutrition and Hepatology

We attempt to provide a training experience that is suited to the background and long range goals of the trainee. We are particularly interested in preparing individuals for academic careers. Generally, fellows stay with us for a minimum of three years; one devoted to intensive clinical exposure and two to research experience. We are approved for sub-specialty residency (fellowship) training by the Royal College of Physicians and Surgeons of Canada; in addition, graduates of American medical schools who have passed the Board examination in General Pediatrics are eligible to sit the Sub-Specialty Boards in Paediatric Gastroenterology after a three-year period of training. However, some trainees come to us only for research experience, others for clinical training alone.

We are a division in the Department of Paediatrics, at The Hospital for Sick Children (SickKids) and the Postgraduate Program, Faculty of Medicine, University of Toronto. The full-time members include Mary Corey, Peter Durie, Anne Griffiths, Nicola Jones, Simon Ling (Director the Training Program), Peggy Marcon, Vicky Ng, Paul Pencharz, Philip Sherman, Mary Zachos and Stan Zlotkin (Division Head).

Research training takes place within the hospital’s Research Institute which provides a large, well organized and stimulating multi-disciplinary environment. In addition, opportunities exist for qualified candidates to pursue a post-graduate degree through the School of Graduate Studies at the University of Toronto.

The clinical activities of our divisions are closely linked with those of other departments (Pathology, Radiology) where there are individuals with specialized GI and Clinical Nutrition interests. We also have a close working relationship with Jacob Langer, Ted Gerstle, Sigmund Ein, Annie Fecteau, Peter Kim, David Grant and their associates in General Surgery and with the Nutrition team consisting of dietitians, ‘parenteral’ pharmacists and nurses specialized in home enteral and parenteral nutrition.

Clinical Training

The large patient population at SickKids (approximately 300 inpatient beds and large number of ambulatory clinics in all sub-specialties), together with a wide referral base allows us to provide clinical training which is both comprehensive and in depth. During the course of a single year, our clinical fellows are exposed to a wide variety of interesting and challenging patients with gastroenterological, nutritional and hepatic disorders.

Patients under our direct care are concentrated on a ward that is shared with other subspecialty services. Clinical GI fellows assume a major responsibility for these patients in conjunction with the second-year general paediatric resident rotating through our service. Patients admitted elsewhere in the hospital, under the care of another staff physician or surgeon, are frequently seen by us in consultation. Both the ward and consult inpatient services are supervised by faculty members.

Outpatient experience is offered through regular half-day clinics in general gastroenterology and clinical nutrition, and specialized clinics for patients with inflammatory bowel diseases, liver disease, cystic fibrosis, liver transplants, and dysphagia

Considerable experience will be gained in carrying out investigative procedures including, upper and lower fibre-optic endoscopy, esophageal pH testing, motility studies, pancreatic stimulation testing, liver biopsies, anthropometry and indirect calorimetry. A well-equipped procedure room is available and experienced, full-time procedure nurses assist in most investigative techniques.

Research Training

Following acceptance to our program, research trainees apply for an appointment to the Research Institute at SickKids. Research directions are determined largely by the interest of the trainee and the interests and expertise within our division and the Research Institute. An individual trainee’s research experience and training is directed by one of the staff members, or by another designated individual within the Research Institute. In our own division, specific areas of research include mucosal defense mechanisms, infectious diarrhea, inflammatory bowel disease, exocrine pancreatic disorders, cellular pharmacology in the liver, multi-drug resistance and transporters in the liver, trace element metabolism, neonatal nutrition, protein, amino acid and energy metabolism, nutritional biochemistry, nutritional aspects of cystic fibrosis, and gastrointestinal motility. Fellows may arrange to enter a postgraduate degree program (MSc, PhD) through the Department of Community Health, Medical Sciences, Pathobiology or Nutritional Sciences, School of Graduate Studies, University of Toronto.

Our former trainees have benefited greatly from the interactions and collaborations readily available within the Research Institute. The Research Institute is the largest hospital-based research program in Canada, and is among the largest paediatric research programs in the world. The multidisciplinary structure of the Research Institute encourages collaborative research. For example, Dr. Durie collaborates with the large C.F. Research group at this hospital. Dr. Phil Sherman has a productive collaboration with Dr. Cliff Lingwood in Microbiology. Dr. Anne Griffiths actively collaborates with the University of Toronto IBD Genetics research team, headed by Dr. Mark Silverberg. Dr. Stan Zlotkin has ongoing collaboration with Dr. George Beaton in the University Department of Nutrition. Dr. Pencharz has an ongoing collaboration with Dr. Stephen Cunnane from the University of Toronto, Department of Nutritional Sciences. Drs. Pencharz and Zlotkin are also members of the University Department of Nutritional Sciences. Dr. Pencharz has an active collaboration with Dr. R. Ball in the Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta where they have a piglet model for TPN and gastrostomy feeding studies. Dr. Peggy Marcon collaborates with Dr. Nicholas Diamant in the University Department of Medicine and Physiology in studying gastrointestinal motility.

Broader interaction and integration with other disciplines within the Research Institute is highly dependent upon the nature of individual research projects. The depth and breath of expertise within the Research Institute cannot be understated, given the immense resources that are available to us. For example, research fellows with specialized interests are regular attendees at weekly basic science seminars which may include membrane physiology, biochemistry, genetics, microbiology and pharmacology research. The physical facilities within the hospital are conductive to interaction among trainees and staff. Clinical and research fellows share office space and a small conference room in our office area.

Application Procedures

For those wishing to commence training on July 1, 2011 please apply before March 1, 2010. To comply with deadlines in the U.S., if suitable applicants are available, final decisions are made in mid-May, but on rare occasions it is possible to consider outstanding applicants at a later date. To assist us in the assessment process, please submit an application form, your curriculum vitae, “official” academic transcripts (undergraduate and postgraduate) together with any additional information that might be helpful to us. In addition, please ask three individuals who know you well to send confidential letters in support of your application. Your referees should comment upon your interpersonal skills, clinical skills and provide us with some insights regarding your background or potential for research.

If at all possible, you are encouraged to visit Toronto to see our program firsthand, to meet our faculty and Fellows and to discuss potential areas of research. Obviously, if you live a long distance from here, it may not be feasible to arrange a visit.

Previous Training

For applicants interested in applying for the three-year training program, a minimum of three years of general paediatric training is required. Prior research experience is not necessary. Applicants with post-graduate experience in the basic sciences (for example, biochemistry, molecular biology, physiology, immunology, etc.) or in veterinary medicine are also encouraged to apply for research training.

Funding

Salary support is available on a competitive basis from the hospital residency program for the year of clinical training. The majority of our research trainees successfully obtain salary support from extra-mural sources for the two years of research training. Some funds for research training are available from agencies within Canada, but overseas applicants are strongly encouraged to secure support from their own institution or country of origin. Limited intramural support is available on a competitive basis to excellent applicants.

Application Form

To download the application form in PDF format, please click here

Please return the application form, supportive documents, and letters of reference to:

Simon Ling
Fellowship Training Program Director
Paediatric Gastroenterology/Nutrition
The Hospital for Sick Children
555 University Avenue
Toronto, Ontario M5G 1X8
Canada
Phone: 416-813-6555
Fax: 416-813-6531

Remember the application deadline is March 1, 2010 (for Fellows who will start in July 2011)