Area of Focused Competency (AFC) Hyperbaric Medicine Program

The Department of Anesthesiology and Pain Medicine at the University of Toronto is delighted to announce a new postgraduate education program - Area of Focused Competency (AFC) Hyperbaric Medicine Program. The program will be delivered under the leadership of Dr. Rita Katzelneson, Associate Professor of Anesthesia and a staff anesthesiologist at the UHN-Toronto General Hospital.

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

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.

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.

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 mandatory clinical educational experience includes:

  • 2-12 month horizontal experience in the Hyperbaric Medicine Unit
  • 1 week in Anesthesia
  • 2-days in ICU
  • 5-days in Wound Care Clinic
  • Additional training time and experience outside of hyperbaric medicine with critically ill patients will be structured

Assessments of Trainees

  1. Intake Assessment in the Simulation Lab using Entrustable Professional Activities Tools (EPAs)
  2. Monthly ITER
  3. Multisource Feedback assessments (MSF)
  4. Weekly review of consultations, follow-up plans and discharge letters
  5. Information is collected based on the Chart Documentation Assessment Form
  6. 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 with certification from either the Royal College of Physicians or Surgeon of Canada (RCPSC or FRCPC) or certified by the College of Family Physicians of Canada (CFPC or CCFP).
  2. Have successfully completed 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 successfully completed 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 deadline for January 1st start: December 1st of the previous year
  • Application deadline for July 1st start: May 1th the same year

To apply, submit your application via email to: Dr. Rita Katznelson (


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