Perioperative Point-of-Care Ultrasound Fellowship

Clinical Curriculum

The Perioperative PoCUS fellowship program will take place at both the Toronto Western and Women’s College Hospitals, two academic centres in downtown Toronto. The program aims to develop strong skills in the broad application of bedside diagnostic ultrasound for the non-cardiac anesthesiologist. Our program will focus primarily on the foundations of sonographic diagnosis within an I-AIM framework (Indication, Acquisition, Interpretation and Medical decision-making). With a hands-on approach based on sound clinical practice, fellows will develop skills to identify specific INDICATIONS for the exams, ACQUIRE adequate images, INTERPRET those images towards a timely diagnosis or assessment, and ultimately guide MEDICAL decision-making and patient management at the bedside.

Fellows will acquire skills in the following areas and build a portfolio of studies:

• Ultrasound physics and “knobology”
• Transthoracic Echocardiography (TTE): the 5 Basic Views—50 Studies

(Assess ventricular systolic function, narrow the differential diagnosis of shock, and fluid response.)

• Lung and gastric ultrasound (30 studies each)
• Focused Assessment with Sonography for Trauma (FAST and e-FAST): 30 studies
• Assessment of Optic Nerve Sheath diameter (for ICP assessment), diaphragmatic excursion, and airway ultrasound (5 studies each)

Formal teaching sessions will be scheduled throughout the year and will include:

• Monthly PoCUS live virtual rounds with lectures and case discussions covering the breadth of the curriculum.
• Biweekly full-day hands-on scanning sessions on patients with and without pathology in the perioperative setting and intensive care unit supervised by a PoCUS program faculty
• Quarterly evening TTE hands-on scanning sessions on normal, healthy subjects

• Fellows are encouraged to seek opportunities to perform PoCUS examinations within the course of normal clinical practice, as appropriate to the circumstances. Faculty will be available on an as-needed basis to review these additional images after the fact.
   

PoCUS Certification

Fellows are expected to enroll in and meet the requirements of the American Society of Anesthesiologists’ Certificate of Completion in PoCUS within their year of training. Several of our faculty are registered ASA local mentors and will help with this endeavour.
 

Calls & Other Clinical Duties

Fellows will also provide clinical anesthesia care for a range of inpatient and ambulatory adult surgical cases, including but not limited to orthopedics, general surgery, bariatric surgery, spine surgery, neurosurgery, and urology. Fellows need to be comfortable and safe delivering care to critically ill and medically complex patients (ASA 3/4, emergency, elderly, and morbidly obese). They are expected to function independently with minimal staff supervision during on-call duties in the operating room. There will be opportunities to supervise junior trainees and contribute to the educational activities of the department.

Fellows will participate in general emergency on-call duties at a frequency of approximately 4-5 calls per month.

Research

Involvement in research is not mandatory but encouraged. There may be opportunities to participate in research projects under the supervision of the program faculty.
 

Education

Regular teaching Rounds are held at the departmental level throughout the year and will include journal discussions, case discussions, and didactic presentations. Fellows are expected to participate in these rounds to gain experience in presentation and teaching. Fellows are also expected to take an active role in resident and medical student education when appropriate. There are opportunities for faculty to assist at workshops and meetings that faculty at Toronto Western Hospital are involved with.
 

Applications and Enquiries

Up to two 1-year fellowship positions are currently offered, beginning every July.

Applications open in January and close on July 31^st of the calendar year prior to the start of the fellowship. Short-listed candidates will be informed in August, interviews will take place in September, and decisions will be made in October of the calendar year prior to the start of the program.

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

• An updated Curriculum Vitae (CV)
• Letter of intent stating the applicant's goals and objectives in undertaking the fellowship.
• Names and contact details of 3 referees

Please apply through the online platform:

• For the July 2025 session, complete the online application here (closing date is August 1, 2024).
• For the July 2026 session, complete the online application here (the closing date is August 1, 2025).

DIRECT INQUIRIES TO:

Dr. Anahi Perlas
anahi.perlas@uhn.ca
Director, PoCUS Fellowship Program