Area of Focused Competency (AFC) Hyperbaric Medicine Program

Background

The Area of Focused Competency (AFC) in Hyperbaric Medicine Program was launched by the Department of Anesthesiology and Pain Medicine at the University of Toronto in 2022 and fully accredited by the Royal College of Physicians and Surgeons of Canada in 2023. The program is delivered under the leadership of Dr. Rita Katznelson, Associate Professor of Anesthesia and Staff anesthesiologist and hyperbaric physician at the UNH-Toronto General Hospital.

The overall goal of the AFC Training Program in Hyperbaric Medicine at U of T is to produce competent specialists in Hyperbaric Medicine (Clinical Hyperbaric Medicine Stream).

Who can Apply?

Trainees who have a background in Anesthesia/Emergency Medicine/Intensive Care are expected to complete the program full-time for three months or part-time for a period equivalent to three months.  It is anticipated that a trainee accepted without a background in Anesthesia/Emergency Medicine/Intensive Care will require additional time outside of hyperbaric medicine to meet all competencies.

The trainee will acquire the ability to disseminate medical knowledge about the established and evolving biomedical, clinical, epidemiological and social-behavioural science of hyperbaric oxygen therapy, as well as apply this knowledge to patient care.

Program Capacity

The Program can accommodate between 1-4 trainees per year, depending on the number of applications and the duration of the trainee’s commitment to the program.

The program focuses on:

  • Assessing appropriateness for hyperbaric oxygen treatment (HBOT) according to accepted scientific guidelines
  • Identifying severity of the referred condition and urgency of treatment
  • Appropriate prescription of HBOT and/or other treatments as indicated
  • Prescription of standardized treatment schedules and tables (depth, duration, descent and ascent rates), and potential modifications
  • Recognition of circumstances when HBOT should be postponed or cancelled
  • Recognizing contra-indications for hyperbaric treatment
  • Diagnosis and management of side effects and complications related to hyperbaric oxygen

Program Details

Program length:The AFC Hyperbaric Medicine Program is a competency-based, program. The program length is a minimum 3-12 months (maximum 24 months), depending upon whether the components are undertaken on a full or part time basis. A minimum of 60 clinical days, as well as on-call requirements, must be completed.

Session dates: Variable

Program structure: Hospital-based rotations with graduated responsibility

Evaluation methods: In-training assessments, training portfolio

Program Director: Dr. Rita Katznelson

Certification: Diploma of the Royal College of Physicians and Surgeons of Canada

Accreditation: Royal College of Physicians and Surgeons of Canada

Structure of the Program

The hyperbaric unit is located at the Toronto General Hospital.  Elective clinical coverage is provided in the unit from 7 am to 5 pm daily, with 24 hr on-call coverage for emergencies. Trainees can expect to be on call a minimum of 4 days per month, including weekends.

The mandatory clinical educational experience includes:

  • 2-12 month horizontal experience in the Hyperbaric Medicine Unit
  • 5-days in the Wound Care Clinic
  • Optional selective rotations (ENT and Vascular Lab experience)
  • Additional training time and experience outside of hyperbaric medicine for acute care management (including anesthesia and ICU experience) in trainees without an acute care clinical background

Assessments of Trainees

  1. Intake Assessment in the Simulation Lab using Entrustable Professional Activities Tools (EPAs)
  2. Rotation based ITARs
  3. Multisource Feedback assessments (MSF)
  4. Regular review of consultations, follow-up plans and discharge letters
  5. Completion of a scholarly project

At the end of the program, the AFC Competency Committee and the Program Director will assess the trainee’s portfolio and, if successful, they will obtain the RCPSC Diploma in Hyperbaric Medicine.

Eligibility and Application Process

  1. AFC candidates must be licensed MDs certified by either the Royal College of Physicians or Surgeon of Canada (RCPSC or FRCPC) or by the College of Family Physicians of Canada (CFPC or CCFP).
  2. Successful completion of an approved 40-hour course in Hyperbaric Medicine from the Undersea and Hyperbaric Medical Society (UHMS) or Canadian Undersea and Hyperbaric Medical Association (CUHMA) AND successful completion of an approved BCLS and ACLS course in the 12 months prior to submitting the application.
  3. For internationally educated applicants, documentation of equivalency will be required.

Applications must include:

  • Updated CV
  • Personal statement for the intent of training
  • 3 reference letters and copies of recent BCLS and ACLS certificates.

Application Process:

  • Application deadlines on December 1st and May 1st of each year. 
  • It is expected to take up to 6 months for Canadian physicians to complete the registration process with U of T after acceptance and prior to starting the Program. This process can take 12 months for international physicians.  Please keep this in mind when planning your application and thinking about potential start dates.  

To apply, please submit your complete application via email to: Dr. Rita Katznelson (rita.katznelson@uhn.ca)

Funding

  • Funding is supported by the Department of Anesthesia and Pain Management, UHN.