Subspecialty Program Information - Haematology

This residency program is for 2 year(s)

Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.

OUTLINE OF PROGRAM:

Residents are given a one or two month rotation on the Hematology consult service at one of the teaching hospitals to get accustomed to the discipline and to learn the day to day activities of the service and the program. They then spend 6 months in their laboratory rotations (Coagulation, Transfusion, and Hematopathology).  Residents then return to clinical service to complete their clinical training including 5 months (in total) of clinical hematology, 2 months of leukemia/BMT, 1 month of pediatric hematology, 1 month of lymphoproliferative disease, and 1 month of medical oncology or palliative care. One month is dedicated to a novel ‘administrative project block’ that addresses some of the Health Advocate and Leader roles. Residents are expected to undertake a research project (3 to 6 months). This leaves ample flexibility for elective rotations at this centre or elsewhere.


CLINICAL ROTATIONS:

Clinical training in Adult Hematology is obtained on the inpatient and outpatient services of our institutions. CancerCare Manitoba is unique among provincial cancer agencies in that its mandate encompasses all blood disorders, and accordingly all Hematology outpatient clinics, for both benign and malignant disorders, take place in the CCMB facilities. This offers numerous practical advantages.

Pediatrics (1 month): Experience in Pediatric Hematology/Oncology is provided under the supervision of Dr. Jayson Stoffman. Inpatient services are provided in the provincial Children’s Hospital, part of the HSC complex, while outpatient activities take place in a unique children’s clinic facility at CCMB. The University of Manitoba has a Royal College program in Pediatric Hematology/Oncology.

Leukemia/BMT (2 months): Experience in acute leukemia and blood and marrow transplant is provided by the inpatient and outpatient Leukemia/Bone Marrow Transplantation service, under the direction of Dr. David Szwajcer.   This service is an academic investigative unit which represents the major referral service for all adult patients with acute leukemia in the province of Manitoba, with inpatient services provided on a specialized closed unit at HSC. The BMT program offers experience in adult marrow and peripheral blood stem cell transplantation, reduced intensity allografting, marrow autografting, and cord blood allografting.

Medical Oncology or Palliative Care (1 month): Experience in Medical Oncology is available on the hospital consult services at both HSC and SBGH and in the disease site specific outpatient clinics of CCMB. Experiences in all aspects of medical oncology practice are available. Palliative care experience is available at dedicated hospice units at St. Boniface Hospital and Riverview Hospital.

General Hematology (5 months): Rotations will be undertaken on the clinical Hematology services at SBH and HSC. During these periods, you will attend outpatient clinics and see in-hospital consults at the respective hospitals. Both are full service tertiary care hospitals, and between them provide all tertiary care services for a population of over one million. HSC has 797 beds and SBH 555 beds. Both hospitals have a full array of medical wards, surgical specialties, and intensive care units; in addition, HSC has a busy high-risk obstetrics unit and SBH has cardiac sciences and a family practice unit. These wards generate a diversity of types of consultations encompassing the entire spectrum of consultative hematology. Outpatient experience in benign hematology is also diverse and varied.  Elective rotations in various aspects of clinical hematology can be arranged.

Residents have a half day longitudinal outpatient clinic throughout the two years of their training, under supervision of one of the staff hematologists. The resident functions as the primary consultant in this clinic, allowing him or her to gain experience in the natural history of hematological disorders and to gain skills in the independent management of patients.

Lymphoproliferative Disease (1 month): Rotation will be undertaken through CancerCare Manitoba at the HSC, St. Boniface and Victoria General Hospital sites. Residents will have the opportunity to rotate through lymphoma, myeloma and chronic lymphocytic leukemia clinics and be exposed to clinical and translational research.


LABORATORY TRAINING:

A minimum of 6 months laboratory training is required in the program.

The laboratory training includes four months in Hematopathology, under the direction of Dr. Arshad Ahsanuddin. Residents will have the opportunity to obtain a wide range of experience in bone marrow and lymph node pathology including molecular, immunology, and cytogenetic techniques.

There is also a one-month Transfusion Medicine rotation at Canadian Blood Services, under the direction of Dr. Debra Lane, and a one-month Hemostasis rotation under the direction of Dr. Sara Israels.

Additional time in laboratory hematology can be arranged, as suits the interests of our trainees.


ACADEMIC ACTIVITIES:

Academic activities that you will be expected to participate in include weekly Medical Grand Rounds, weekly Section of Hematology/Medical Oncology Grand Rounds, weekly Hematology rounds, weekly Lymphoma Rounds, and a monthly joint Hematology Disease Site Group/Hemostasis Disorders Care Team meeting. As well, you may be asked to participate in additional activities of hematology-related disease site groups. Fellows are encouraged to present cases frequently at Lymphoma Rounds, and give formal presentations at least twice per year to the Section Grand Rounds. A journal club is held monthly in conjunction with the Medical Oncology program.

A weekly academic half-day will cover the breadth of the curriculum in Hematology set out by the Royal College objectives of training. The format of these sessions is dependent on the number of fellows in the program; when numbers allow, they are primarily resident-led, but faculty-supervised formal small group learning activities; if only a single Fellow is involved, they will for the most part take the form of one-on-one tutorials with assigned faculty members.

The Royal College CanMEDs competencies are addressed throughout the program in clinical training, research and academic half day. However, in order to further address the CanMEDS competencies of Health Advocate, Leader, Collaborator, and Communicator, we have developed an Administrative Project Block of one month, during which you are expected to prepare (i) a submission to the Pharmacy and Therapeutics Committee at CCMB or one of the host hospitals, and (ii) develop or adapt for local use a clinical practice guideline for a relevant Disease Site Group at CancerCare Manitoba.

During the course of the two years of training we expect trainees to become involved with research projects either at the clinical or basic science levels. An asset of our program is the close interaction between clinicians and basic scientists in the Research Institute in Oncology and Hematology’ (RIOH) which is located within CCMB. Many of the attending physicians in the Section have laboratory research programs of their own in the (RIOH), or collaborative projects with the RIOH scientists. Areas of major interest in our institution include: identification of molecular markers of prognostic significance; mechanisms of gene amplification and genomic instability in tumors; regulation of apoptosis; platelet granule proteins, and molecular mechanisms of thrombosis. Another asset is the Cancer Epidemiology program, and the ability to perform population-based research. Participation of fellows in the CancerCare Manitoba Research Day and U of M Internal Medicine Resident Research Day are mandatory, with the hope that the strong prize-winning record of our trainees will continue.

Many of our trainees become involved in their own projects under the supervision of one or more of the attending faculty. Initially trainees become involved with some of the ongoing projects under the supervision of one of the faculty but later develop projects according to their own interests with the support of their supervisor.

 

To apply for the Medicine Subspecialty match please click here for details.

 

Contact:
Dr. Arjuna Ponnampalam
Director, Haematology Subspecialty Training Program
Room GF338, Health Sciences Centre
820 Sherbrook Street
Winnipeg, MB     R3A 1R9
Phone: (204) 787-1103
Fax: (204) 787-8632
Program Administrator: Melissa Blonjeaux