Regional Anesthesia and Pain Management (MSH)

Mount Sinai Hospital (MSH)

Sinai Health System

The Department of Anesthesia, Sinai Health System (SHS), University of Toronto, will offer a one-year fellowship in Regional Anesthesia and Pain Management. The goal of the fellowship is to provide anesthesiologists with the necessary knowledge and skill to manage acute pain for complex patients, including regional anesthesia techniques, multimodal analgesia, and utilizing a transitional pain service. The fellowship will start in July or January.

Sinai Health System is a tertiary academic centre of excellence affiliated with the University of Toronto. The fellowship is salaried and includes research and clinical work within the department.

Clinical Responsibilities

Surgical cases in the operating room consist of general surgery, orthopedics, plastics, gynecology, ophthalmology, otolaryngology, oral and maxillofacial surgery, dentistry, urology, and major oncological surgery. Responsibilities include supervision and teaching of junior and senior residents in the program and medical students. Fellows will be taking 16-hour in-house calls or 24-hour home calls, with in-house consultants available at all times, covering both the operating room emergency surgeries and Labour and Delivery. Fellows will get one protected day every other week to focus on their acute pain research projects and academic work.

Regional Anesthesia

Regional anesthesia at SHS is provided through a block room model under the supervision of experienced regional anesthesiologists. At SHS, our block room performs approximately 1000 single injection nerve blocks per year and 100 continuous nerve block catheters. Fellows will be exposed to and gain proficiency in a variety of regional anesthesia techniques, including common lower limb blocks, brachial plexus blocks, truncal blocks, and continuous nerve block catheter insertions. SHS has a unique orthopedic surgical oncology service that requires complex continuous blocks, as well as a high volume of arthroplasty cases with a complex patient population that requires neuraxial techniques and lower extremity blocks. The successful applicant will learn to perform all peripheral nerve block techniques as well as neuraxial procedures and truncal blocks with ultrasound guidance. Moreover, fellows will develop skills in managing operative room and block room flow.

Acute Pain Service

Fellows will participate in the Acute Pain Service rotation at SHS. The Acute Pain Service manages approximately 1,500 patients per year, including complex patients with chronic pain and cancer pain.

Transitional Pain Service

Fellows will participate in the Transitional Pain Service (TPS) rotation at SHS. The TPS follows patients who are at increased risk for developing Chronic Post-Surgical Pain (CPSP) and provides those patients with follow-up and a multidisciplinary approach to pain management.

Research

Regional Anesthesia and Pain Management fellows are required to participate in academic, research, and educational activities. Over the course of the year, up to 10% of working days may be allocated for academic activities, including the design of new research projects and acute pain quality improvement projects, as well as data analysis and the writing of scientific papers.

Workload Distribution

Service 

Distribution 

Regional Anesthesia Block Room 

50% (Monday - Friday every other week) 

Acute Pain Service 

10% (3-4 weeks/year)

Transitional Pain Service

10% (3-4 weeks/year)

OR (orthopedics/sarcoma focus) 

20% (1-2 days per week) 

Call 

10% 

Eligibility and Requirements

Candidates should have a minimum of 30 months of training completed in clinical anesthesia and have passed all certification exam(s) required for the specialty of anesthesia in their own country. Applicants must be eligible for registration with Post Graduate Medical Education at the University of Toronto. (Check Eligibility Here) and for a postgraduate medical education license with the College of Physicians and Surgeons of Canada.

American applicants should preferably have passed their ABA exams, although consideration will be given to those that are board-eligible. Preference will be given to applicants who are within 7 years of completing their training.

Applicants who have just graduated from a 3-year anesthesia training program are encouraged to complete at least a year of independent practice or a fellowship elsewhere. Preference will be given to applicants who fulfill this requirement. English language requirement (if medical training was not done in English.)

Up to two 1-year fellowship positions are currently offered, beginning every July or January (specific details are available following the application).

Applications should be sent in between 12-24 months before the anticipated start date of the fellowship.

The required documents and information to complete the initial application include:

  1. An updated curriculum vitae
  2. Letter of intent stating the applicant's goals and objectives in undertaking the fellowship.
  3. Names and contact details of 3 referees

Please also refer to the University of Toronto Department of Anesthesia webpage HERE for further details on general eligibility requirements for undertaking fellowship training.

Direct Inquiries to:

Sharon Peacock
Staff Anesthesiologist
Sinai Health System
600 University Avenue
Toronto, ON M5G 1X5
P: (416) 586-4800 x5270
E: sharon.peacock@sinaihealthsystem.ca