Complex Obstetric Surgery Fellowship

Updated: August 14, 2023

Program Director: 
Dr. Sebastian Hobson
Head of Labour & Delivery, Maternal Fetal Medicine Specialist, Mount Sinai Hospital 

Contact:
Mrs. Nancy Moniz
Tel: (416) 586-8764
Email: Nancy.Moniz@sinaihealth.ca

Site: Mount Sinai Hospital & Credit Valley Hospital

Application Deadline: Submit completed Application Form and all required documents by September 1st of each year 

To All Applicants:

If you have also applied to the U.S match through the National Residency Matching Program (NRMP), please be advised that the University of Toronto is a participating institution and adheres to the match policy. The policy states that "Applicants who have matched to a program or have accepted a position during the Supplemental Offer and Acceptance Program (SOAP), shall not apply for, discuss, interview for, or accept a concurrent year position in another program prior to the NRMP granting the requested waiver." More information is accessible at http://www.nrmp.org/wp-content/uploads/2017/06/2018-MPA-Specialities-Matching-Service.pdf.

Program Information

Complex Obstetric Surgery is within the field of Obstetrics & Gynecology concerned with the diagnosis, management and treatment of complex obstetric surgery in pregnancy. The Fellowship is based primarily at Mount Sinai Hospital, a high-volume leading tertiary-level obstetric care facility in Toronto. Secondments are to Credit Valley Hospital (Trillium Health Partners) through longitudinal modules in Advanced Gynaecological Surgery.

Upon completion of training, the Fellow is expected to be a competent specialist in Complex Obstetric Surgery, capable of assuming the role of consultant. The Fellow must acquire a working knowledge of the theoretical basis of the specialty, including its foundations in the basic medical sciences and research. The Complex Obstetric Surgery consultant possesses the appropriate medical, surgical and obstetrical knowledge and skills with educational and research interests, administrative ability and special training in the identification and management of complex obstetric surgical problems. Specialists in Complex Obstetric Surgery are consultants to their general Obstetrician colleagues and related health care providers. Their practice is focused on referred high risk obstetric surgery patients, and to provide ambulatory emergency assistance to colleagues when required in their respective centres.

Fellows must demonstrate the requisite knowledge, skills, and attitudes for effective patient-centred care and service to a diverse population. In all aspects of specialist practice, the graduate must be able to address ethical issues and issues of gender, sexual orientation, age, culture, and ethnicity in a professional manner. 

The duration of the fellowship is 1-2 years. Fellows are encouraged to concurrently consider undertaking a relevant postgraduate degree (i.e., MSc) which compliments the Fellowship. This is an academic Fellowship in which trainees are expected to conduct 1-2 research projects to publication within the field of Complex Obstetric Surgery. 

Canadian medical graduates who possess excellent surgical skills and interest with an independent CPSO license and specialist qualifications in Obstetrics and Gynaecology are encouraged to apply. Alternatively, subspecialists in Maternal Fetal Medicine may find this Fellowship an invaluable additional training opportunity to refine their skills. International medical graduates with funding support may also be considered if a local applicant is not identified, however they must be able to demonstrate outstanding surgical skills and interest through provision of case logs, activities and specific letters of reference.

Please direct all queries and completed applications to Mrs. Nancy Moniz (Program Coordinator).

Objectives

The objectives of this Fellowship Program are as follows:

• To develop skills and professional experience in Complex Obstetric Surgery aligned with each of the CanMEDS Framework roles.
• To gain the technical skills necessarily to safely and expertly perform advanced surgical procedures in the field of obstetrics, including but not limited to:
  • Complex cervical cerclage insertion and removal
  • Ultrasound-guided dilatation and evacuation of the gravid uterus up to 24 weeks’ gestation
  • Use of ultrasound and MRI to assess placenta accreta spectrum disorders and fibroids in pregnancy
  • Complex assisted vaginal birth (including rotational forceps)
  • Cesarean section in patients with previous abdominal surgery (including >3 prior CS)
  • Cesarean section in patients with Class III obesity
  • Pelvic sidewall dissection to identify the ureter and iliac vasculature (surgical ligation of the internal iliac artery, uterine artery and ovarian/tubal branches of the uterine artery)
  • Cystoscopy and ureteric stenting
  • Cystotomy and bladder dome repair
• To plan and conduct delivery of patients with known or suspected placenta accreta spectrum disorders in the 2nd and 3rd trimesters, including modified radical and subtotal hysterectomy.
• To develop intermediate skills in the use of obstetrical ultrasound examination.
• To become a medical expert in all aspects of Complex Obstetric Surgery.
• To collaborate and communicate as an independent, respectful and effective member of multidisciplinary teams.
• To advocate for patient health and lead effectively within the clinical context and medical climate.
• To function as a professional with dedication to teaching and education within the field of Complex Obstetric Surgery.
• To pursue scholarly activities and research furthering our knowledge and improving outcomes in Complex Obstetric Surgery.
• To attend and participate in educational rounds, seminars and conferences provided within the Department of Obstetrics & Gynaecology related to advanced obstetric care.
• To function as an ally and advocate in the areas of equity, diversity and inclusivity.