91ÉçÇø Orthopedic Trauma fellowship

Supervisors:

Gregory K Berry, MD, FRCSC- Trauma, foot and ankle
Edward J Harvey, MD, FRCSC- Trauma, upper extremity
Mitchell Bernstein, MD, FRCSC- Trauma, bone transport, limb deformity
Max Talbot, MD, FRCSC- Trauma, Military trauma
Alexandra Bunting, MD, FRCSC- Trauma, Arthroplasty
Jason Corban, MD, FRCSC- Trauma, Upper extremity, Sports
Rudolf Reindl, MD, FRCSC- Trauma, Spine, (fellowship director)
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Duration of fellowship:

12 months
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Number of fellows:

1
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Site of fellowship:

Montreal General Hospital
Ville Marie Surgical Centre (CMS)

Description:

The Montreal General Hospital is one of two level 1 trauma centers in Montreal, servicing not only the population of Montreal but much of the
western half of Quebec. We serve as the tertiary referral center for complex trauma and high energy polytrauma cases. This is a high-volume orthopedic trauma fellowship with extensive operative exposure to simple and complex orthopedic injuries spanning the full range of orthopedic traumatology. All of the supervisors are orthopedic trauma fellowship trained members of the Orthopedic Trauma Association with sub-specialty interests spanning the entire spectrum of Orthopedic trauma including upper extremity, hip arthroplasty, foot and ankle trauma, upper extremity trauma, knee ligament reconstruction, as well as deformity corrections, bone transport and spine trauma. One to two operating rooms are designated exclusively for trauma cases every day of the week.

Case load:

The fellow can expect to perform and/or assist in 900-1000 cases over the course of the year. These cases will include 70-80 pelvis / acetabular cases, complex articular and long bone fractures in the context of mono- and polytrauma.

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Research:

They will also be expected to complete a publishable research project during the fellowship. A full-time research assistant is available to help with any clinical projects. A close association with the 91ÉçÇø Research Institute also facilitates possible basic science research. If required, the fellow may take time from their clinical duties to work on the research project.

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Teaching:

The fellow will be integrated into the educational activities of the orthopedic program including resident and medical student teaching.

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Evaluation:

The fellow will be evaluated every 3 months during formal feedback sessions with the fellowship director. The feedback sessions are also an opportunity for the fellow to give feedback on the fellowship experience.

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Expected competencies:

Clinical: The candidate will develop a systematic approach to evaluating and managing a wide range of simple and complex orthopedic trauma with a focus on complex articular fractures including acetabular and pelvic reconstruction.
Teaching: The Orthopedic trauma fellow will develop teaching strategies and close cooperation with junior house staff.
Research: The vast research opportunities and support will allow the fellow to gain knowledge of how research is done both in the clinical and basic science aspect or Orthopedic trauma.

Canmeds competencies:

Medical Expert:

Competency Specific Objective:

• Patient assessment: Elicit a comprehensive pain history, and perform a focused physical examination, for pain assessment for children of all ages, including neonates and children with developmental disabilities.
• Select a developmentally and clinically appropriate pain assessment tool.
• Clinical knowledge: Select appropriate investigations for pain diagnosis and management
• Describe the pharmacologic management of pain.
• Describe the pharmacologic management of non-pain symptoms (e.g., dyspnea, nausea and vomiting, constipation, fatigue and delirium)
• Describe non-pharmacological approaches to both pain and non-pain symptom management.
• Identify how serious illness and dying may affect psychosocial and spiritual development in childhood and adolescence.
• Describe how to facilitate a discussion with patients and their families, with the intent of addressing concerns across physical, psychological, social, cultural and spiritual domains.
• Build an end-of-life care plan with or without withdrawal of life-sustaining measures
• Clinical skills: Develop an approach to the management of the following symptoms in a patient with a serious illness: pain, dyspnea, nausea and vomiting, constipation, fatigue and delirium.
• Describe the management of medical emergencies in palliative care such as: acute distress (e.g., pain, dyspnea, hemorrhage), opioid toxicity, bowel obstruction, spinal cord compression, seizures, and delirium.
• Develop an approach to support children or families who are grieving.
• Demonstrate taking a history related to spiritual concerns, and assessing the role that spirituality can play in the experience of children with life threatening illnesses, and their families.
• Discuss interventions that promote quality of life for a child or adolescent with serious illness or who is dying.

Communicator: Competency Specific Objective

• Establish a therapeutic relationship
• Establish therapeutic and supportive relationships with patients and their families based on understanding and trust.
• Exhibit a compassionate approach to patient, family, and staff distress.
• Elicit an understanding of the patient/family’s perception of health, illness and death, concerns and expectations regarding medical management, and of the impact of illness.
• Discuss end-of-life issues and imminent death with patients/families.
• Demonstrate an ability to support and counsel a patient/family about serious illness and/or impending death.
• Engage patients, families, and relevant health professionals in shared decision-making to develop consensus about a plan of care.
• Care plan shared with patients, family, and care team Communicate effectively; obtain and synthesize relevant history from patients, families and referring teams. Present clinical problems clearly, concisely, and accurately in verbal reports and written notes and letters.
• Organize and facilitate a family meeting effectively and manage intrafamilial dynamics during difficult discussions.
• Communicate clearly about the benefits and burdens of different management decisions and options within the framework of the patient/family’s goals of care.

Collaborator: Competency Specific Objective

• Participate in an interdisciplinary health care team
• Consult effectively with other physicians, while promoting the central role of the primary health team that is best known to the family to preserve these relationships.
• Contribute effectively to interdisciplinary team activities, with a clear understanding of the role of each member of the team.
• Encourage involvement of other disciplines such as nursing, social work, child life, psychology, and spiritual care in meeting the diverse needs of children with serious illnesses and their families.

Leader: Competency Specific Objective

• Career management
• Develop an awareness of the stresses when caring for children with serious illnesses and their families, and identify systems factors important in facilitating staff strength and resilience.
• Consultancy skills
• Demonstrate the ability to weigh burdens and benefits of further testing and treatments to each child, in consultation with the primary team.
• Management of resources
• Allocate health care resources wisely when caring for children with serious illness and their families (including at end-of-life) in several settings.

Health Advocate: Competency Specific Objective

• Advocating for patient needs within and beyond the clinical environment
• Identify important determinants of health affecting a child with a serious illness and their families.
• Identify the available resources available to children with serious illnesses, and advocate for the needs of individual patients and their families.
• Engage the multidisciplinary and interprofessional team appropriate to meet the child and family’s needs.
• Understand the need for bereavement follow-up of all families in their care.
• The candidate will learn to incorporate their personal letter or call of condolence as a standard of care they offer to all bereaved families.

Scholar: Competency Specific Objective

• Integrate best evidence into practice
• Participate in the education of patients and caregivers, medical students, residents, and other health professionals regarding pediatric palliative care, resolution of ethical dilemmas, and optimal end-of-life symptom management in children.
• Have a familiarity with how to critically appraise medical information as it pertains to pediatric palliative care. Ongoing learning and teaching
• Implement a continuing education strategy by demonstrating an understanding of, and ability to, apply the principles of self-learning.

Professional: Competency Specific Objective

• Commitment to patients and society
• Demonstrate an understanding of the principles of medical ethics as they relate to decision making, futility and foregoing life-sustaining treatment.
• Understand and reflect on how one’s own beliefs and values can impact on the interactions with patients and families.
• Develop personal strategies when experiencing the emotional challenges of dealing with suffering, dying and grief.
• Demonstrate recognition of personal limitations of competence with willingness to accept feedback.

Funding

Salary: $ 60000.00 CAD
Meetings: $6000.00 CAD (registration and travel/hotel expenses)
Tuition: paid by fellowship
Alternate funding:
Applicants funded by third parties are acceptable, subject to the rules and regulations set out by the University. Self-funding is not possible.

Eligibility:

The applicant must be a fully trained and certified orthopedic surgeon or a trauma surgeon specializing in Orthopedic trauma. He/she has to fit the requirements set out by our post graduate medical education office (See Application section below). Domestic and International applicants may apply subject to the rules and regulations of the University.
Language
Montreal is a multi-cultural bilingual city in a predominantly francophone Canadian province. While many of our patients are francophone, the daily activities at the 91ÉçÇø Hospitals are conducted in English. Charting and medical records are predominantly English but both French and English are accepted. The applicant should be fluent in English and/or French.

Contact:

For specific questions regarding the fellowship, please contact:
Rudolf Reindl, MD, FRCSC
1650 Cedar Avenue. B5159.2
rudy.reindl [at] gmail.com

Application:

To submit your application, or for questions regarding the application process, please visit:

Deadlines:

The deadline for submissions to this fellowship is September 1st. One (possibly two) candidate (s) will be chosen from the submitted applications in mid- December to start the following July 1st.