Program Overview

Clinical Training

During Medical Biochemistry training, residents are encouraged to participate in specialty outpatient clinics (Lipids, Preventative Cardiology, Inborn errors of metabolism, Obesity, Diabetes, with others possible depending on the specific interest of the resident) up to one half-day per week, enabling them to maintain clinical skills and enhancing their opportunity to interact with clinical faculty and with resident colleagues in various clinical services. These clinics are conducted in 6-month longitudinal blocks allowing for the development of independence in the outpatient setting.

Laboratory Training

The training is divided into 8-week blocks and groups so that the resident spends at least three 8-week blocks at 3 hospital sites.  In PGY4, the two specialized groups of laboratory training will take place at the McMaster University Medical Centre (Paediatric clinical chemistry, biochemical genetics and pregnancy) and the Hamilton General Hospital (immunology and specialized methods). The PGY5 year will include a range of elective opportunities to allow the resident to balance the needs of the curriculum and their specialized interests.

Research Training

Residents are encouraged to participate in research.  There are projects in the clinical laboratory that are required as part of the training program, and in addition, there is an opportunity to develop or participate in other structured research with our excellent faculty. There is access to resident research grant funding from the Department of Pathology and Molecular Medicine.  Each year, they are expected to present their work during the annual residents’ research day.

Educational Activities

The resident will participate in the Medical Biochemistry and Clinical Chemistry half-day program.   This is largely a problem-based learning course that covers the full spectrum of knowledge required for the RCPSC examination in Medical Biochemistry that will be taken in PGY5.  There are some sessions that cover material in a more didactic fashion and the residents will get the opportunity to deliver these sessions under supervision. There are also sessions on laboratory management that are run for all Laboratory Medicine residents.

There is funding available to support residents’ education needs in attending conferences, etc.

Training Sites

Clinical Training

Will be undertaken with McMaster University postgraduate programs in cooperation with the affiliated teaching hospital St. Joseph’s and Hamilton Health Sciences.  The resident will have rotations at McMaster University Medical Centre, Hamilton General Hospital, Juravinski Hospital and Cancer Centre, and St. Joseph’s Hospital Hamilton.

Elective opportunities in the affiliated regional hospitals are available.

Laboratory Training

The Hamilton Regional Laboratory Medicine Program is organized to provide a full range of analytical services and also functions as a reference laboratory for numerous hospital and community laboratories.  Essential services are maintained in core laboratories located in each hospital site (McMaster University Medical Centre, Hamilton General Hospital, Juravinski Hospital and Cancer Centre and St. Joseph’s Hospital Hamilton).  Special services are distributed over all sites, with the Hamilton General Hospital hosting the majority of these.

Elective opportunities are available in Hamilton or the University of Toronto affiliated hospitals.

Additional Information

The applicant to Medical Biochemistry must have a general appreciation of the role of the clinical laboratory medical practice.  This is best obtained by spending time in a clinical laboratory.  It is highly recommended that the applicant has at least one 2-week elective in a clinical laboratory environment.  The applicant must have completed a residency in either Internal Medicine or Paediatrics.  Prospective applicants are advised to carefully review the CaRMS page to ensure that the application meets the standards required.

Additional Training Possibilities (these all require additional approval and extended training time)

Trainees wishing to combine the training program with basic research experiences may do so by special arrangements.  There are opportunities to undertake joint training as a clinician investigator with the possibility of obtaining an MSc or Ph.D.  Qualified candidates may also pursue an MBA concomitantly in collaboration with the school of business.

Objectives

Medical biochemistry is a two years program with training in medical biochemistry laboratories in Hamilton. The rotations are divided between the 4 teaching hospitals and the planned schedule allows the resident to spend 6 consecutive months at each hospital. The content of these years is very dense as there is a wide variety of methodologies that the resident is required to know before the examination. In addition, the pathophysiology of the disease needs to be well entrenched in the resident’s knowledge so that the utility of testing can be understood. During the medical biochemistry laboratory training, the resident will be expected to continue to develop their area of clinical practice through out-patient clinic rotations.

The need for Medical Biochemists, with expertise in clinical medicine, laboratory medicine and research training has been recognized by the Royal College of Physician of Canada. Rapidly changing laboratory creates a need for experts that can bridge both laboratory medicine to the needs of patients and health care systems. Laboratory medicine is poised to take an increasingly important role in the care of patients, and there is a need to translate these advances into improved care through laboratory medicine leadership and collaboration with clinical colleagues. Medical biochemists are employed by academic centres, private laboratories, as well as community hospitals.

Minimum Training Requirements

Twenty four (24) months of approved residency training in Medical Biochemistry, a maximum of one (1) year of which may be undertaken at the fourth year residency level during training in Internal Medicine or Pediatrics. This period must include:

1. A minimum of twelve (12) months or the longitudinal equivalent of general laboratory training that must include:

1.1. Organization and supervision of clinical laboratories: pre-analytical, analytical and post-analytical phases; safety and regulations; human resources; laboratory information systems; costing and utilization management; and automation and instrument selection

1.2. Theory and practice of laboratory methodologies: basic chemistry; spectrophotometry; enzymology; immunocytochemistry; electrochemistry; electrophoretic methods; urine and body fluids microscopy; isotopes; cell counters; and point of care testing

1.3. Pathophysiology, analysis and interpretation of testing related to carbohydrates; lipids; proteins; intermediate metabolism; vitamins; trace elements; electrolytes; blood gases; hormones; pharmacology; oncology; and pregnancy

1.4. Total quality management: Principles of laboratory statistical analysis; method evaluation; and epidemiology

2. A minimum of six (6) months or the longitudinal equivalent of specialty laboratory training that must include:

2.1. A minimum of two (2) months of perinatal, neonatal and pediatric chemistry in a pediatric or general hospital setting

2.2. A minimum of one (1) month of biochemical or molecular genetic testing

2.3. A minimum of one (1) month of chromatography, mass spectrometry and/or proteomic techniques

2.4. A minimum of one (1) month of therapeutic drug monitoring and toxicology

2.5. A minimum of one (1) month in any other relevant specialized area (including stone analysis, flow cytometry) related to Medical  Biochemistry with the approval of the program director

3. A minimum of two (2) months or longitudinal equivalent in specialized clinics as approved by the program director and verified by the residency training program committee. The specialized clinic must be linked to the practice of medical biochemistry and may include but is not limited to any one of a combination of:

3.1. Metabolic bone and/or stone diseases

3.2. Genetics and/or inborn errors of metabolism

3.3. Nutrition

3.4. Toxicology

3.5. Cardio-metabolic disease prevention

4. A minimum of one (1) month or longitudinal equivalent dedicated to a scholarly project. This may be research protocol development, curriculum development, quality assurance, clinical and/or laboratory audit, ethical issues in laboratory medicine/research, or laboratory quality management. This project should lead to an educational presentation outside the resident’s own centre or a peer-reviewed publication

5. Three (3) months of elective in any of the areas outlined in sections 1, 2, 3, or 4, with no more than two (2) months in any one of these areas

Additional opportunities

Occasionally, we can accommodate post-residency fellowships. These are typically focused on a research project and are dependent on funding. Post-residency fellowships for sponsored candidates are also possible if the candidate is able to meet the requirements of the McMaster Postgraduate office. These can be tailored to meet the requirements of the trainee. Please contact us at bidoche@mcmaster.ca