Medical Oncology Program

PGY4

Dr. F. Hussain	Dr. R. Sambhi	Dr. M. Smith-Uffen

PGY5

Dr. C. Browne

  

Fellows

• Dr. S. Fasih (Breast) 
• Dr. S. Khan (Lung)
• Dr. A. Rajeh (Sarcoma) 
• Dr. S. Verma (Lung)

To learn more about our residents, please visit our Residents & Fellows page.

Applications are made to the Program Director through CaRMS for positions beginning July 1 of the following year.  The London Regional Cancer Program will host their interviews in September 2024.

Applicants should have completed an internship recognized by the College of Physicians and Surgeons of Ontario. In addition, applicants must have completed three years of training in Internal Medicine under Section 2(a) of the Training Requirements in Internal Medicine of the Royal College of Physicians and Surgeons of Canada. It should be noted that trainees are required to be certificated by the Royal College of Physicians and Surgeons of Canada in Internal Medicine in order to be eligible for the Certificate of Special Competence in Medical Oncology.

LOCAL Curriculum

Our program is pioneering a new curriculum format, with longitudinal rotations for the major disease sites, referred to as the LOCAL curriculum. As part of this longitudinal curriculum, multiple educational sessions per disease site are arranged with each resident's disease site coach, allowing for review of important trials and discussion regarding clinical areas that are more expert opinion-based. For more details, please see the Clinical Curriculum section.

The LOCAL curriculum is an overarching curriculum which encompasses clinical rotations and is organized around disease sites. The goal of the LOCAL curriculum is to promote coaching as the primary style of teaching within medical oncology’s competency-based curriculum. This is done by structuring disease site rotations, faculty supervision, and other learning activities over longitudinal periods. Longitudinal disease site rotations allow residents to focus their learning, patient care, and training experiences in those disease sites and establish coaching relationships with faculty to encourage both coaching in the moment and coaching over time.

Within each disease site, residents will be assigned a faculty coach, who will supervise the resident in clinic, and meet with the resident regularly outside of clinic for coaching sessions on disease site topics. EPAs still form the primary activity for assessment in clinic, and the primary means for assessment of progression through the competency committee. Staff are encouraged to structure their teaching and provide feedback using a coaching model.

Disease site rotations are grouped to allow longitudinal exposure with their faculty coaches. For example, the GI disease site has 3 blocks and these are scheduled consecutively with the resident’s GI coach supervising over that entire period. Residents spend most of their time in clinic with that lead coach but do rotate with other faculty to gain an appreciation of variations in practice and for breadth of exposure across the disease site. The major disease sites (GU/GI/Thoracic/Breast) are prioritized to be done mostly within PGY4 during the TTP, Foundation and Core stages of training. Residents rotate through the minor disease sites during PGY5. The major disease sites are revisited during the resident’s longitudinal clinic throughout PGY5.

Academic Half Day

Residents are required to attend the Medical Oncology Academic Half Day at the Verspeeten Family Cancer Centre at LHSC once a week. Teaching sessions are designed to prepare residents not only for the Royal College exam, but life outside the program, and foster a fulfilling and successful career. Topics include:

• Disease Sites
• Clinical Trials
• Ethics
• Communication
• Wellness
• Professionalism
• Finances
• Career Planning

Residents can also expect to be challenged during other learning opportunities such as practice exams, while soaking up new ideas and knowledge through rounds, and journal clubs. Opportunities include:

• Disease Site Group Meetings
• Resident Rounds (weekly)
• Multi-disciplinary Tumour Boards (present a case every rotation)
• ASCO ITE (annually)
• Grand Rounds - weekly lecture series featuring speakers from all disciplines, across the globe
• Resident Grand Rounds - annual presentation to help residents prepare for conference season
• Basic Science Self-Study Reports
• Resident Journal Club (present 2-3 times per year)
• Faculty Journal Club
• Resident Research Rounds (annual)
• Serious Illness Conversation Workshop (annually)

	Disease Site	# of Blocks
Medical Oncology	Breast	3
	Thoracic	3
	Gastrointestinal	3
	Genitourinary	3
	Head & Neck/Cutaneous	2
	Gynecological/CNS	2
	Sarcoma	0.5
	Chemo Call/Research	1
	Radiation Oncology	0.5
	Palliative Care	1
	Hematology	2
	Electives	5

The Residency Program consists of 18 blocks of outpatient medical oncology clinics that are disease site specific. Residents do two blocks of Hematology, which can be done in London, or at a peripheral site in Windsor based on the resident's preference and schedule availability. Residents will also complete one block each in Radiation Oncology (combined with Sarcoma), Palliative Care, and Chemotherapy unit call. Three blocks are available for external experiences and two for internal electives including research time. There is significant flexibility in time and use, based on the needs of the resident and agreed upon by the Program Director.

1. Cancer Research Laboratories: The cancer research laboratories of the London Regional Cancer Program (LRCP) and Western University are located within the LRCP. Translational research fellowships are also available through the Department of Oncology to those completing the required two years of Medical Oncology training.

2. Western University: Western is one of Canada’s premiere universities with world-class faculty offering research and advanced training opportunities in many areas related to medical oncology e.g. Immunology, Pharmacology, Genetics, Epidemiology and Biostatics.

3. Clinical Trials Centre:The clinical trials centre of the LRCP is one of the largest oncology clinical trial centres in Canada.  There are Phase II and Phase III clinical trials in progress for many disease sites.  Phase I facilities are being developed in conjunction with the Department of Pharmacology and the Cancer Research Laboratories.

In order to more fully develop the Collaborator, Professional, and Manager roles as a medical oncologist, residents will have the opportunity to run their own clinic as the primary treating oncologist. This clinic will enhance skills as an Advocate and Medical Expert and increase confidence in independent decision-making.

Starting in May-June of their R4 year, residents will run clinic on Wednesdays with a rotating roster of supervising Medical Oncology staff. This clinic continues for one year to allow residents the opportunity to follow patients through their complete treatment course. In conjunction with a primary nurse, the residents will see one new consult per week as well as a limited number of scheduled follow-up patients. The residents will see the consult first, develop a management plan, and then discuss the case with the designated Medical Oncologist who ultimately remains the most responsible physician (MRP). The MRP will meet the patient, directly observe the resident going through the management plan with the patient and be available to answer any questions the resident is unable to.

This management plan will also be presented that morning at Resident Case Rounds, attended by the MRP and other staff as able. The case will be discussed, as well as any relevant learning points for the case, so the resident can be prepared for their clinic and so formal teaching around the case can occurr.

Once the consultation occurs with the patient’s consent, from that point onward, the patient’s follow-up care will continue in the residents’ clinic. The MRP will remain available to the resident for any issues that arise, but will not come to directly see the patient unless so requested by the patient or the resident. Any major changes in treatment or management will be discussed with the MRP before implementation. Copies of notes from all clinic visits are to be sent to the MRP as well as the family doctor and referring physicians to keep them up to date on the patients’ status. If residents are away on the clinic day for any reason, they are expected to arrange coverage for their patients with another resident or the MRP.

The cases for consultation will be selected by the residents to allow for expertise with triage, in consultation with the supervising MRP and the Medical Oncology Program Director, and will span the major disease sites. Cases will be “bread and butter” to gain solid expertise in the most common oncologic scenarios. However, residents may also occasionally see rare or interesting cases for the purposes of enhancing their education.

At the end of the year of clinic, the patients will be absorbed into the practices of the MRPs in order to ensure seamless continuity of care.

During the two years of training, residents are expected to complete a research project. Under the supervision of Dr. Danilo Giffoni, Research MO Lead, and Dr. Paul Stewart, Residency Program Director, incoming residents will meet with the Research MO Lead to identify a project of educational benefit and link them to other potential mentors. The Research Scholar Program will focus on the following "Key and Enabling Compentencies:"

• Integrate best available evidence into practice
• Contribute to the creation and dissemination of knowledge and practices applicable to health

The curriculum includes a monthly session on various elements of Research Methodology, Critical Appraisals, and Epidemiology of cancer. To apply the principles from the Research Scholar Curriculum, this program also encompasses Resident Journal Club (every second month) and Resident Research Rounds (formal appraisals 1 sessions/year).

Residents will be required to present their research outcomes to the following:

• 1 abstract submission for each resident to an international conference
• 1 publications
• Resident to present at MO Faculty Journal Club once every 2 years

Most of the ambulatory training is done in the outpatient clinics of the Verspeeten Familty Cancer Centre. The Verspeeten Family Cancer Centre is a contiguous part of Victoria Hospital, London Health Sciences Centre (LHSC-VH) where there is a 40-bed oncology inpatient unit, and inpatient consultations are done. The London Health Sciences Centre provides pathology and imaging services. Consultations may also be done at University Hospital, London Health Sciences Centre. The Children’s Hospital at London Health Sciences Centre is also located at the Victoria Hospital site.

The Medical Oncology Ward Service (MOWS) is run by out inpatient hospitalist team Monday to Friday. Residents will participate in overnight and weekend call on this ward, accompanied and supported by the on-call oncologist. There is no longer a dedicated MOWS block, as it was felt this time was better used for chemotherapy call to ensure the resident is capable of responding to acute chemotherapy related issues.

In collaboration with the Department of Family Medicine, the Medical Oncology program provides family physicians with knowledge and skills to care for patients with cancer. The program is open to family medicine residents who have successfully completed their training in an accredited Canadian residency program. The General Practitioner-Oncology (GP-O) model is a step above what the typical family physician would provide in oncological care to patients and has been around for over twenty years in Canada. Residents will gain experience in a wide variety of tumour sites. The bulk of activities will be outpatient oriented and will occur in a Multi-disciplinary setting. Much of the training will occur at the London Regional Cancer Program at London Health Sciences Centre (Victoria Campus) but may also occur at the Windsor Regional Hospital. A strong focus will be managing oncology emergencies and managing problems in the chemotherapy suite.

Current Resident

Not applicable at this time

Program Alumni

Dr. Daphne Southcott, 2019 - 2020
Dr. Priya Patel, 2020 - 2021
Dr. Nicholas Chandna, 2022 - 2023
Dr. Anish Tejura, 2023 - 2024

For more information, please visit our Enhanced Skills - Family Medicine - Western University page.