Interstitial Lung Diseases

Fellowship Title:

Division:

Respirology

Fellowship Type:

Clinical

Supervisor:

Shane Shapera

Application Close Date:

1yr

Application Open and Close Date:

October 15th

Anticipated Start Date(s):

July 1

Number of position(s) per year:

Description:

1. Fellowship Description

The Interstitial Lung Disease fellowship at the University of Toronto is a 1-year clinical research fellowship offered by the Interstitial Lung Diseases (ILD) clinic at the Toronto General Hospital. The fellowship will be offered to one individual per year who has finished 2 years of Respirology training in a program accredited by the Royal College of Physicians and Surgeons of Canada.

2. Goals and Objectives of the Training

The goal of the fellowship is to provide a trainee with supplementary training, education and research opportunities to advance knowledge in assessment and management of patients with ILD. Trainees will also increase their research experience with the goal of producing one or more peer-reviewed publications during their year. Clinical and/or translational research is a vital component of the Fellowship.

In order to facilitate development of the fundamentals of clinical trial design, trainees will be encouraged to audit courses in clinical epidemiology or Quality Improvement (QI) through the Health Policy Management and Evaluation (HPME) department and/or the Institute of Medical Sciences (IMS) at the University of Toronto. Trainees who choose to enroll in a Master’s Program through the HPME, IMS or Master’s programs at another institution will be given priority in the selection process. However, a concurrent Master’s degree is not mandatory.

Please note that the HPME application is due in mid-November, so if trainees are interested in applying, their application to HPME will need to be concurrent with their application for the ILD fellowship.

MEDICAL EXPERT

To develop a comprehensive differential diagnosis to an adult patient with ILD including both known causes and idiopathic causes of interstitial pneumonia
To develop an approach to clinical and laboratory investigations required for a patient with ILD
To master the interpretation of pulmonary function testing (PFT) and high-resolution computerized tomography (HRCT) in patients with ILD with an emphasis on using this test to assist in narrowing the differential diagnosis
To gain expertise in determining which patients with ILD will benefit from pathologic evaluation with either transbronchial biopsy or surgical lung biopsy
To develop an understanding of which patients with ILD are most likely to benefit from treatment with immunosuppressive agents and in-depth knowledge about evidence-based treatment in patients with ILD
To gain knowledge and experience around toxicities, side effects and necessary monitoring for patients who are started on immunosuppressive therapy
To develop an understanding of the appropriate patient selection and timing of lung transplant in patients with ILD

COLLABORATOR

To work with the multidisciplinary health care professionals including Rheumatologists, Radiologists, Respiratory Therapists, and Research Coordinators to provide comprehensive medical care for patients seen in the ILD clinic
To work with researchers from other sub-specialties and other disciplines with the goal of participating in state of the art clinical research in ILD

COMMUNICATOR

To learn how to dictate letters and recommendations to referring physicians when working in the role of quaternary care provider for complex patients with multiple active medical issues
To learn how to counsel patients about the natural history of various interstitial lung diseases and discuss the risks and benefits of specific immunosuppressive therapies

HEALTH CARE ADVOCATE

To understand the importance of environmental exposures in the development of some interstitial lung diseases and advocate on behalf of patients with their employers, landlords and families to minimize exposures while maintaining their ability to function in their work and home environments
To help advocate for your patients to facilitate access to expensive life-saving therapies

LEADER

To develop time management skills to allow adequate time for a comprehensive assessment of complex patients within the time frame of a busy outpatient clinic

SCHOLAR

To incorporate evidence-based medicine into investigations and therapeutic plans
To develop prospective research protocols and projects with incorporation of an understanding of research methodology and clinical trial design
To learn how to approach and consent patients for involvement in clinical trials and databases
To develop methods of database entry that ensure high fidelity data with appropriate cross-reference techniques
To learn techniques to allow high quality retrospective database analysis
To develop techniques for educating other trainees on ILD topics in large and small group sessions

PROFESSIONAL

To demonstrate professionalism during interactions with patients and multiple members of the health care team
To exhibit professional behaviour by ensuring punctuality and attendance at all scheduled clinics and to provide adequate notice if you are unable to attend a clinic for personal reasons or illness to ensure that your absence does not negatively influence patient care

3. The Training Structure

The ILD fellowship is primarily a research fellowship. Trainee time will be divided as 80% research activities and 20% clinical activities. Trainees will attend multi-disciplinary case conference rounds once per week, radiology rounds once per week, Research in Progress rounds twice per month and will attend our weekly ILD clinic. Trainees will be expected to present cases at our formal pathology MDD once every 4 weeks. During clinical activities, trainees will provide direct patient care under the supervision of the attending physicians in the clinic. Other, subspecialty clinics are optional and may be attended once or twice per month. There is no inpatient component to the Fellowship and there are no “on-call” responsibilities. Non-clinical time (4 days per week) will be spent pursuing research activities.

4. The Application Process

The fellowship is administered through the Interstitial Lung Diseases Program at the Toronto General Hospital. Applications should include a brief letter outlining the applicant’s goals during their fellowship, a Curriculum Vitae and 3 letters of reference. Applications should be mailed to:

Dr. Shane Shapera
Interstitial Lung Diseases Program Director
Toronto General Hospital
585 University Avenue, 9N-971
Toronto, Ontario, Canada
M5G 2N2
Email: shane.shapera@uhn.ca

Decisions regarding acceptance into the Fellowship will be made jointly by the members of the ILD program. Members include:

Dr. Shane Shapera – ILD Program Director	Dr. Lee Fidler
Dr. Jolene Fisher – ILD Program Research Director	Dr. Jakov Moric
Dr. Matthew Binnie	Dr. Ambrose Lau

Applications must be received before October 15th to be considered for the following academic year. Interviews will be held in November and the recipient of the fellowship position will be announced in December for a position starting on July 1st of the following year.

Once a person has been accepted into the ILD Fellowship Program, a formal appointment will be initiated by the Supervisor with the Department of Medicine, Division of Respirology, Administration office, and the Post Graduate Medical Education Office (PGME)

5. Eligibility

This one-year fellowship accepts a maximum of one individual each year. It is offered to individuals who are eligible to take the written and oral examinations in Respirology at the Royal College of Physicians and Surgeons of Canada. Preference for acceptance to the fellowship will be given to individuals who have demonstrated academic potential with research experience and who have a commitment to an academic research career.

6. Funding Opportunities

Trainees will receive a minimum of $60,000 per year given as a bimonthly direct deposit. In some years, additional funding may be available (up to a salary of $75,000 per year) depending on availability of funds from the funding source.

2 weeks of paid vacation (plus 10 days off over the Christmas and New Year’s break) will be granted to all trainees during their year.

7. List of publications in the area by U of T faculty.

http://www.ncbi.nlm.nih.gov/pubmed?term=Shapera%2C%20Shane%5BAuthor%5D
http://www.ncbi.nlm.nih.gov/pubmed?term=Fisher%2C%20Jolene%5BAuthor%5D
http://www.ncbi.nlm.nih.gov/pubmed?term=Binnie%2C%20Matthew%5BAuthor%5D
http://www.ncbi.nlm.nih.gov/pubmed?term=Fidlerr%2C%20Lee%5BAuthor%5D
http://www.ncbi.nlm.nih.gov/pubmed?term=Lau%2C%20Ambrose%5BAuthor%5D
http://www.ncbi.nlm.nih.gov/pubmed?term=Moric%2C%20Jakov%5BAuthor%5D

Contact Name:

Rhiannon Davies

Role:

Division Administrator, Respirology

E-mail:

Rhiannon.davies@utoronto.ca

Mailing Address:

University of Toronto, Division of Respirology, 1 King's College Circle, Rm 6263 MSB, Toronto, ON, M5A 1A8