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Breast Cancer Fellowship Program​

The Radiation Oncology Breast Cancer Fellowship Program is designed for physicians who have completed residency training in radiation oncology and who want additional clinical training and research experience focusing on breast cancer management. Excellence in breast cancer management requires a multidisciplinary approach and a sound understanding of the role of research in patient care. This fellowship program is designed to train experts in the management of breast cancer with specific focus on clinical management, technical and research skills in an interdisciplinary academic setting at the Princess Margaret Cancer Centre. We offer a one- to two-year program with a unique opportunity to expand clinical experience and refine research focus. The training is tailored to the individual fellow's career goals and is designed to cultivate areas of interest.

Objectives:
  • To provide focused, specialized clinical and research training in interdisciplinary management of breast cancer
  • To provide additional generalized clinical training to well-trained and qualified candidates who are dedicated to returning to an international setting
  • To explore the use and indication of technical advances in the management of localized and metastatic breast cancer including SBRT and MR Linac
  • To develop research skills and critical abilities in the application of research to clinical care

Description:
Fellows will be expected to participate in the breast group and will be involved as an active member of the group, helping with coverage and emergencies. Expected activities include multidisciplinary rounds, quality assurance rounds and formal learning activities of the centre and of fellowship. Fellows with a clinical and research focus will be predominantly involved in clinical, teaching, academic and research activities of their primary interest. The clinical supervisor(s)/ research mentor(s) will be preferentially selected based on the fellow’s interest.

Central Nervous System Fellowship

At the current time, we are able to support Fellowship opportunities within the CNS site group for individuals who have a keen interest in pursuing further expertise in this area. Fellows would have an excellent opportunity to be involved in the management of primary brain and spinal tumours (malignant and benign) and also brain and spinal metastatic disease within a dynamic multidisciplinary setting, involving neurosurgery and neuro-oncology.

The Pencer Centre within the Princess Margaret Cancer Centre is the location for multidisciplinary clinics for adult neuro-oncology and provides a range of additional health professional resources for the patients in our care, such as social work, physio/occupational therapy and neuropsychology. The Princess Margaret Cancer Center has unique opportunity for training with two Gamma Knife facilities, which are involved in management of brain metastases, benign malignancies, vascular malformations and functional disorders such as tremor and tics. There is an opportunity for increased involvement within the paediatric CNS team for individuals looking to pursue a career in this area.

During Fellowship, individuals will be involved within several weekly multidisciplinary rounds for case discussion and treatment planning. There is a wealth of different CNS cases, which come to the CNS team from across Ontario and Canada. This enables trainees to gain considerable expertise in management of unusual and challenging cases as well as involvement in clinical trials which are offered within the Pencer Centre and Princess Margaret Cancer Centre.

During the fellowship period, individuals will work with their supervisors to identify an area of research interest and develop a research project, which will be undertaken during the fellowship year, with the aim of research presentation at a national or international meeting and a peer-reviewed publication from the work undertaken.

Gastrointestinal Fellowship

Overview
The gastrointestinal (GI) radiation oncology team at Princess Margaret Cancer Centre represents decades of cancer expertise involving an internationally renowned radiation oncology team of pioneering radiation oncology physicians, medical physicists, dosimetrists, radiation therapists, and nurses, working together with the broader multi-disciplinary GI group to provide integrated, streamlined care for every patient.

GI clinical services
The GI group in the Radiation Medicine Program treats all stages and categories of GI cancers, including rare, difficult-to-treat, and advanced-stage malignancy of the upper GI (esophagus and stomach), hepatobilliary cancer (liver, bile duct and pancreas), lower GI (colorectal and anal cancer), as well as stereotactic body radiation therapy (SBRT) for liver and abdominal oligometastasis and oligoprogression.

State-of-art technology
We offer the latest in advanced radiation therapy technology, including intensity-modulated radiation therapy (IMRT), volumetric modulated arch therapy (VMAT), image-guided radiation therapy (IGRT), SBRT, and MR-linac guided radiation therapy.

Multidisciplinary comprehensive care
Our program works within the Comprehensive Cancer Center’s multidisciplinary services to meet individual patients’ needs. Multidisciplinary cancer conferences are attended by GI-subspecialized radiation oncologists, medical oncologists, surgical oncologists, radiologists, pathologist, and support staff for clinical care. We discuss and review challenging and new GI clinical cases and derive consensus regarding optimal management decision for each case. This cross-specialty approach enables us to provide comprehensive care tailored to each patient’s needs.

Clinical trials
We are constantly working to improve patient outcomes in all GI cancers. Offering many clinical trials, aiming to improve the effectiveness of radiation therapy with fewer side effects. These trials range from early phase trails of innovative applications of radiation therapy with or without systemic therapy to practice changing randomized controlled trials.

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Genitourinary Fellowship

The Radiation Medicine GU Group at the Princess Margaret Cancer Center offers one year clinical and research fellowships in GU Radiation Oncology. There are up to three successful candidates annually. These positions may be full time GU or occasionally shared with another disease site. Technical radiotherapy such as brachytherapy, SBRT and MR-based radiotherapy may be interwoven into fellowships as required. Fellowships may also be extended beyond the usual one-year offering, dependent on the needs of the candidate and the group. The group sees more than 1000 new patients annually. Patients seen are within the full spectrum of disease including localized, oligo- and polymetastatic. This provides fellows significant clinical exposure and training in the management of a comprehensive range of GU malignancies. There is a comprehensive technical radiotherapy offering that includes LDR/HDR brachytherapy, EBRT, SBRT (linac and MRL-based) and radionuclide therapy. Patients are assessed in a multidisciplinary environment and treatment approaches span the full range of multiple modalities. There are dedicated multidisciplinary bladder and testis clinics. Fellows will attend ambulatory clinics for the assessment of new and follow-up patients and participate in tumour board and quality assurance rounds. Fellows will be assigned to 2-3 staff allowing for rotations providing an opportunity to work with multiple staff during the fellowship year. Inpatient care is provided by a dedicated Hospitalist whereby fellows will provide a supervisory role and outpatient care during treatment is supplemented by physician assistants in some clinics.

The GU program is very active in both clinical trials and translational research with faculty leading and collaborating in multiple local, national and international studies. Fellows will have opportunities to participate in research during the fellowship year on projects with designated supervisors. Opportunity to develop protocol and grant-writing skills are available. A major aim is publication and presentation at international meetings. The GU program has prospectively collected outcomes databases in bladder and testis cancers. In addition, there is a large repository of planning and imaging data for technical research. Opportunities span the full spectrum of clinical, translational, medical physics, survivorship and quality of life domains, customized based on the fellow’s interests and experience.

Any specific questions regarding the GU Fellowship can be directed to Dr. Peter Chung (peter.chung@rmp.uhn.ca).

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Gynecologic Fellowship

The Radiation Medicine Gynecologic Site Group at the Princess Margaret Cancer Center offers both one-year and two-year clinical and research fellowships.

The Gynecologic radiation group sees more than 500 new patients a year for consideration of radiation therapy, providing fellows significant clinical exposure and training in the management of all gynecological malignancies (endometrial, cervical, vulvar, vaginal and ovarian). Fellows will attend ambulatory clinics for the assessment of new, on-treatment and follow-up patients; vaginal brachytherapy, MRI-guided combined intracavitary/interstitial brachytherapy; as well as weekly multidisciplinary gynecological tumour board and weekly gynecologic radiation quality assurance rounds.

The Gynecology program is very active in all domains of research, including basic science/biology, translational, clinical, imaging/medical physics, and patient-reported outcomes/survivorship. Fellows will have opportunities to tailor their research project(s) to their interest. Several former fellows successfully obtained a Master's degree (with protected time) during their 2-year fellowship while acquiring gynecologic clinical expertise simultaneously. The Gynecology program also has an anthology database since 2006, providing a significant research resource.

Head and Neck Fellowship

The Radiation Medicine Head and Neck Site Group at the Princess Margaret Cancer Center offers one year clinical and research fellowships in head and neck Radiation Oncology to two or three successful candidates annually.

The group sees more than 800 new patients a year for consideration of radiation therapy providing fellows significant clinical exposure and training in the management of a comprehensive range of head and neck malignancies. Patients are assessed in a multidisciplinary environment and treatment approaches span the full range of multiple modalities. Fellows will attend ambulatory clinics for the assessment of new and follow-up patients and participate in tumour board and quality assurance rounds. Every staff has a weekly on treatment review clinic whereby fellows are engaged in the management of acute toxicity providing supportive care. Fellows will be assigned to two staff for 3-month rotations providing an opportunity to work with multiple staff during the fellowship year. Inpatient care is provided by a dedicated Hospitalist whereby fellows will provide a supervisory role and outpatient care during treatment is supplemented by a dedicated Head and Neck Nurse Practitioner through a Radiation Nursing drop-in clinic.

The Head and Neck Program is very active in both clinical trials and translational research with faculty leading multiple national and international studies. Fellows will have opportunities to participate in research during the fellowship year on research projects with designated supervisors including Oncologists and Medical Physicists with an aim to publication and presentation at international meetings. The Head and Neck Program has the world’s largest prospectively collected outcomes database containing over 14,000 patients providing a significant research resource in addition to large repositories of planning and imaging data. Opportunities for research span the full spectrum of clinical, translational, medical physics, survivorship and quality of life domains and can be customized based on the fellow’s interests and experience.

Any specific questions regarding the Head and Neck Fellowship can be directed to Dr. John Waldron (john.waldron@rmp.uhn.ca).

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Lung Fellowship

The Radiation Medicine Lung Site Group at the Princess Margaret Cancer Center offers one year clinical and research fellowships in Lung Radiation Oncology to two or three successful candidates annually.

The management of lung cancer requires a multidisciplinary approach, including all of the major disciplines of surgery, medical oncology, radiation oncology, pathology and imaging. Within radiation oncology, further multidisciplinary collaboration is essential amongst radiation physics, radiation therapy, imaging and basic/translational scientists. The group sees more than 1000 new patients a year for consideration of radiation therapy providing fellows significant clinical exposure and training in the management of a comprehensive range of lung malignancies. Patients are assessed in a multidisciplinary environment and treatment approaches span the full range of multiple modalities. Fellows will attend ambulatory clinics for the assessment of new and follow-up patients and participate in tumour board and quality assurance rounds. Every staff has a weekly on treatment review clinic whereby fellows are engaged in the management of acute toxicity providing supportive care. Fellows will be assigned to two staff for 3 month rotations providing an opportunity to work with multiple staff during the fellowship year. Inpatient care is provided by a dedicated Hospitalist whereby fellows will provide a supervisory role and outpatient care during treatment is supplemented by a Nurse Practitioner through a Radiation Nursing drop in clinic.

Members of our group lead numerous local, regional, provincial, national and international lung cancer clinical trials. Fellows will have opportunities to participate in research during the fellowship year on research projects with designated supervisors including Oncologists and Medical Physicists with an aim to publication and presentation at international meetings. We have established prospective databases for our SBRT treated patients, which include Stage 1 primary lung cancer, lung metastases and oligometastases as well as our Stage III NSCLC patients, among others. These databases provide a wealth of data for outcomes analysis and research. Opportunities for research span the full spectrum of clinical, translational, medical physics, survivorship and quality of life domains and can be customized based on the fellows interests and experience.

Any specific questions regarding the Lung Fellowship can be directed to Dr. Alex Sun (alex.sun@rmp.uhn.ca).

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Lymphoma Fellowship

The Radiation Medicine Lymphoma Site Group at the Princess Margaret Cancer Center offers a one year clinical/research fellowship in Hematological Radiation Oncology to one successful candidate annually.

The group with 4 staff ROs sees approximately 500 new patients a year providing the fellow significant clinical exposure and training in the management of a comprehensive range of hematological malignancies. There is active programs in lymphoma, myeloma, leukemia, stem cell transplants (allogeneic and autologous), as well as CART cell therapy. Fellows will attend outpatient clinics for the assessment of new and follow-up patients and participate in tumor board and quality assurance rounds. The fellow will be working in lymphoma with two staff and rotate after 6 months, providing an opportunity to work with multiple staff during the fellowship year. Inpatient care is provided by a dedicated Hospitalist usually on the Lymphoma-Myeloma-Transplant service, hereby the fellow will provide Radiation Oncology consultation or input where necessary. The fellow will be assigned to a second disease site in addition to Lymphoma.

The Lymphoma program is very active in both clinical trials and translational research with faculty (RO or hematology colleagues) leading multiple national and international studies. The fellow will have opportunities to participate in research during the fellowship year on research projects with designated supervisors including Oncologists and Medical Physicists with an aim to publication and presentation at international meetings. The Lymphoma program has a outcomes database providing a significant research platform. Opportunities for research span the full spectrum of clinical, translational, late effects, survivorship and population based health outcomes research, and can be customized based on the fellow’s interests and experience.

Any specific questions regarding the Lymphoma Fellowship can be directed to Dr. Richard Tsang (richard.tsang@rmp.uhn.ca).

Palliative Radiotherapy & Oligometastasis Program (PROP) Fellowship

The Radiation Medicine Palliative Radiotherapy & Oligometastasis Program (PROP) Site Group at the Princess Margaret Cancer Centre offers one year clinical and research fellowships to one to two full-time successful candidates annually, or two to three candidates evenly splitting their time with another disease site. The fellowship is one year, with an option to apply for a second year concentrating on metastatic disease research for individuals who have secured outside funding from their home institution or a granting agency.

There are several overarching goals of PROP:

  1. Provide compassionate and patient-centered care for each patient with metastatic cancer.
  2. Redefine the role of radiation therapy in patients with metastatic cancer through innovative technology, personalized and biology-based treatment, and multi-disciplinary collaboration.
  3. Improving symptom management and efficacy in clinical workflow.
  4. Use of radiation for prevention of future cancer-related symptoms.

The PROP team sees around 750 new patients a year for consideration of palliative radiotherapy, providing fellows significant clinical exposure and training in the management of a comprehensive range of metastatic malignancies. Fellows are trained to manage and prevent symptoms arising from advanced cancer. Our patient population ranges from outpatients to inpatients (Princess Margaret Cancer Centre, Toronto General Hospital, and Mount Sinai Hospital). Fellows benefit from active interaction with all medical disciplines involved in the care and treatment of patients with advanced cancer as well as their families.

In addition to offering rapid access to quality palliative radiotherapy, the team will also evaluate the patients comprehensively for indications of locally ablative metastasis-directed radiotherapy, stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), intended to eradicate individual metastatic lesions. PROP members and fellows will collaborate with members from other radiation oncology site groups to facilitate SBRT for treating patients referred to PROP.

The PROP team is also very active in both clinical trials and patient-centered research with faculty leading multiple national and international studies. Fellows will have opportunities to participate in research during the fellowship year with designated mentors across the whole spectrum of palliative disciplines for presentation at national and international meetings as well as subsequent publication. Fellows with prior experience in clinical trial are also encouraged to formulate a clinical protocol and apply for additional funding to support innovative trials. Opportunities for research span the full spectrum of clinical, translational, medical physics, survivorship and quality of life domains and can be customized based on the fellows’ interests and experience.

Fellowship Program Goals

  • To train individuals to provide state-of-the-art radiotherapy for patients with metastatic cancer.
  • To develop leaders in the field of metastatic disease radiotherapy.
  • To provide a rigorous academic experience in which fellows can participate in clinical research under the guidance of experienced mentors.
  • Fellows will be familiar with the clinical course in major symptomatic complications of metastatic cancer and develop expertise in providing appropriate radiotherapy.
  • Fellows will gain expertise in clinical decision-making in palliative care across different disciplines.
  • Fellows will have excellent skills in communication and counselling of patients and their families.
  • Fellows will be familiar with the latest literature and evidence-based decision making for implementing radiotherapy in metastatic cancer.
  • Fellows will be able to utilize the skills and knowledge learned from the PROP experience to develop a similar metastatic disease radiotherapy program in their home program.

Research Goals

This program will also prepare fellows for a career in academic and clinical research collaboration. Fellows will receive adequate mentoring for developing research proposals and projects suitable for publication.

Please contact Dr. C. Jillian Tsai (Jillian.Tsai@rmp.uhn.ca) for further inquiries.

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Pediatric & CNS Radiation Oncology Fellowship

The University of Toronto fellowship in Pediatric & CNS Radiation Oncology is a clinical fellowship undertaken at Princess Margaret Cancer Centre (PM) and the Hospital for Sick Children (SickKids).

This pediatric fellowship is combined with an adult CNS experience (Dr. Laperriere) and an adult Lymphoma experience (Dr. Hodgson). Upon completion the fellow will receive certification of competence in Pediatric Radiation Oncology and CNS and Lymphoma sites.

The pediatric radiation oncology service at PM consists of three radiation oncologists (Dr. David Hodgson, Dr. Norm Laperriere, Dr. Derek Tsang), a dedicated nurse for new and on-treatment patients (Susan Awrey), and a nurse practitioner for Survivorship care (Mary Stuart).

The fellowship involves 5-6 half day clinical sessions per week, as follows:
  • There is a once weekly clinic at SickKids, followed by a Neoplastic Cancer Conference and a Neuro-Oncology Cancer Conference that same afternoon after clinic where new and recurrent pediatric cancer cases are presented and discussed in a multidisciplinary manner (imaging, pathology, medical/neuro-oncology, surgery, radiation oncology). There also a once weekly Survivorship clinic in which adult survivors of childhood cancer are seen to prevent or manage late effects.
  • The service at PM/SickKids covers the full spectrum of cases seen in pediatric oncology and sees and treats approximately 150 new and recurrent pediatric cases with radiotherapy annually and is an excellent preparation for anyone considering becoming a radiation oncologist with an ability to see and manage pediatric oncology cases.
  • The adult CNS service consists of a once weekly clinic with Dr. Laperriere where the full spectrum of primary CNS cases are seen and managed, and a once weekly multidisciplinary cancer conference.
  • The adult Lymphoma service consists of once weekly new patient clinic (combined with on treatment reviews) and a twice-monthly well patient follow-up clinic. Multi-disciplinary case conference occurs week.

Workload is shared with the resident(s) also on one or more of these services. The fellow will participate in most cases, and be involved in new patient consultations, follow up visits, radiotherapy treatment planning and weekly review of patients receiving radiotherapy.

The fellowship provides opportunities for research and resident teaching if desired.​

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Sarcoma Fellowship

The Radiation Medicine Sarcoma Site Group at the Princess Margaret Cancer Center offers one year clinical and research fellowships in soft tissue and bone to one or two successful candidates annually. The group sees more than 400 new patients a year for consideration of radiation therapy providing fellows significant clinical exposure and training in the management of soft tissue and bone sarcomas in the extremity, truncal thoracic and intra-abdominal sites. Patients are assessed in a multidisciplinary environment and treatment approaches span the full range of multiple modalities. Fellows will attend ambulatory clinics for the assessment of new and follow-up patients and participate in tumour board and quality assurance rounds. Fellows participate in treatment review clinic whereby fellows are engaged in the management of acute toxicity providing supportive care. It is a shared practice model, and Fellows will have the opportunity to work with four staff during the fellowship year.

The sarcoma program is very active in both clinical trials and translational research with faculty leading national and international studies. We have access to very high precision radiotherapy tools such as MR-Linac for clinical use and clinical research. Fellows will have opportunities to participate in research during the fellowship year on research projects with an aim to publication and presentation at international meetings.

The University of Toronto Multidisciplinary Sarcoma Program is one of the largest in North America. We have a prospectively collected outcomes database containing over 7,000 patients providing a significant research resource in addition to large repositories of planning and imaging data. Opportunities for research include clinical, translational, translational imaging, medical physics, survivorship and quality of life domains and can be customized based on the fellows interests and experience.

Any specific questions regarding the Sarcoma Fellowship can be directed to Dr. Charles Catton (charles.catton@rmp.uhn.ca)

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Spine SBRT Fellowship

As a fellow with our spine SBRT group, you will develop expertise in the multidisciplinary care of patients with primary and metastatic tumors in the spine. Our spine SBRT service is highly active and leads a multidisciplinary conference that includes spine surgery and neuro-radiologists who also specialize in interventional techniques, including augmentation. Our fellows are busy but clinic time is limited to 2 days per week, providing ample time for learning and research. Our expectation is that you will not only assist with the development of and accrual to our ongoing clinical trials, but also use the opportunity to leverage our prospective databases to achieve a minimum of one first authored publication during fellowship.

Any specific questions regarding the Spine SBRT Fellowship can be directed to Dr. David Shultz (David.shultz@rmp.uhn.ca).

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https://www.uhn.ca/PrincessMargaret/Education/Continuing_Education_Programs/Pages/continuing_education_programs.aspx
Last reviewed: 12/13/2022
Last modified: 11/1/2023 9:47 AM
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