University of Toronto Cardiac Surgery Residency Program

With training at four large teaching hospitals, the Cardiac Surgery Residency Program at the University of Toronto led by Dr. David A. Latter, offers trainees a high-volume, broad clinical experience.  As part of the Canadian training system, this residency is principally a direct-entry from medical school, cardiac-specific residency leading to cardiac surgery certification by the Royal College of Physicians and Surgeons of Canada.  Committed to producing leaders in academic cardiac surgery, the program particularly excels in pediatrics, transplantation, complex valve and aortic surgery, coronary disease, and myocardial protection.

While the majority of the trainees are part of an integrated curriculum, having entered the program directly out of medical school, the program also offers a 3-year training option for those who have already completed general surgery training.  The program accepts 1 Canadian trainee per year, as well as 1 international trainee every two years.  The 6-year integrated cardiac training program consists of two years of core surgical training (or “junior” years), in which individual programs have flexibility in the choice of clinical rotations, 1 year of “academic enrichment,” and 3 years of intermediate and senior level training in adult and congenital cardiac surgery.  At the University of Toronto, the first two years include extensive training in ICU care (including CVICU, medical surgical ICU, and CCU), trans-esophageal echocardiography, percutaneous coronary interventions, pacemaker/defibrillator placement and electrophysiology, general cardiology, as well as rotations in general surgery, vascular surgery, cardiac and thoracic surgery.  The “academic enrichment” portion of the training is versatile and can include any training that is career-enhancing.  Typically this portion of the training consists of basic science or clinical epidemiology research.  Residents are encouraged to pursue an advanced degree, such as a masters or PhD, and this portion of the training commonly is extended to 2-3 years.  While the curriculum set-forth by the Royal College for the remaining three years is not as flexible, in special cases the University of Toronto allows trainees to complete some rotations at other institutions.  For trainees who have already completed their general surgery training, their training at University of Toronto predominantly consists of the final three years of intermediate and senior level rotations.

The University of Toronto cardiac surgery program has a number of strengths including the expertise of Dr. Tirone David in complex valve repair and aortic surgery, the Hospital for Sick Children’s renowned pediatric program, and an active transplant program.  The basic science and clinical epidemiological research that occurs at Toronto is also a clear strength of the program, historically and currently.  As cardiac surgery moves forward, residents learn innovations in the field by training under faculty who are using them.  In the eyes of Dr. Steve Singh, a current University of Toronto trainee, the two biggest strengths of the program are (i) its research/academic focus and (ii) training at 4 different, distinguished, high-volume hospitals.  The opportunity to perform high quality research allows trainees to distinguish themselves in the academic community early in their careers.  Training at the four large teaching hospitals  (Toronto General Hospital, Sunnybrook Health Sciences Center, St. Michael’s Hospital, and Hospital for Sick Children), is relatively unique among cardiac training programs and allows residents to receive a breadth of exposure in terms of different clinical approaches and surgical techniques.

The program at the University of Toronto seeks to train academic cardiac surgeons.  Although previous research experience is not required, applicants should be interested in an academic career and show academic potential.  International students are encouraged to apply to the integrated program, but they do need approval and funding from their own University or government.  American students interested in applying should be aware that the Royal College Credentials are recognized by many state licensing boards, allowing graduates from University of Toronto to subsequently practice in the US after completion of their training.

The large number of distinguished faculty at the different teaching hospitals provide a diverse set of potential mentors that can be instrumental in career development for trainees.  While the program itself is large, according to Dr. Singh, the program feels small and mentoring relationships are easily developed.  In addition to informal mentoring relationships, Dr. Wiesel acts as the residents’ official academic mentor in guiding early career development.  In terms of the career paths of graduates from the University of Toronto, approximately 80-90% go into academic surgery and nearly all pursue additional fellowship subspecialty training.

In summary, the cardiac surgery program at University of Toronto provides excellent training for the academic cardiac surgeon.  The breadth and volume of clinical exposure, as well as research opportunities, give the resident a strong foundation for future success in the field.

Acknowledgements

Special thanks to Dr. David A. Latter and Dr. Steve Singh for their contributions to this article, as well as the assistance of Willa Hart.

Additional Resources

Program link: http://www.surg.med.utoronto.ca/card/programs.html

Program contact information