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Faculty of Health Sciences

Department of Medicine

Hematology & Thromboembolism – Bleeding Disorders Fellowship

Fellowship Program at McMaster

Welcome to the Bleeding Disorders Fellowship at McMaster University. With the recent acceleration in the therapeutic options available to treat bleeding disorders and the new focus on value-based care, there is a clear need to rigorously train physicians to provide expert care to patients with bleeding disorders. Due to the chronic and often congenital nature of the disease, this condition requires a multidisciplinary approach by an expert team. Through training, our fellows will learn to diagnose and treat bleeding disorders and related comorbid conditions including pharmacological, behavioural, and surgical means.

Welcome

Clinical care

We provide evidence-based medical and surgical treatment to patients with bleeding disorders through a multidisciplinary approach. We are one of the 24 centers federated in the Association of Hemophilia Center Directors of Canada (AHCDC) and we are listed in the World Federation of Hemophilia Center Directory. Our team is composed of internists, hematologists, pediatricians, transfusion medicine experts, social workers, physiotherapists, a nurses coordinator and a data manager. Our program performs preventative surveillance of a population of over 400 patients with congenital bleeding disorders and receives weekly requests for consultation on acquired cases. The clinic is unique in the sense that provides collaborative care within a multidisciplinary team and fellows are encouraged to participate in our multidisciplinary meetings. We have one day a week of planned visits (annual reviews, follow-up) and one clinical team meeting a week. Urgent cases are seen as needed, directly from Monday to Friday 8 am to 5 pm, or by supporting ER overnight or during weekends.

Education

Most education is problem-based learning through participation in clinical activities and research. We offer four structured units (Clinical and laboratory framing of bleeding disorders, Hemophilia A and B, von Willebrand Disease, and Rare bleeding disorders) and we add ad-hoc educational units tailored to specific needs. We are usually able to offer the residents/fellows opportunities to participate in international intensive courses like the Hemophilia Academy as part of the training.

Research

The Bleeding Disorders Program at McMaster is a research-intensive endeavour. We host the Canadian Bleeding Disorders Registry, and two successful international programs, WAPPS-Hemo (population pharmacokinetics) and PROBE (patient-reported outcome). The program has been awarded an endowed Research Chair in the Epidemiology of Congenital Bleeding Disorders and the editorial base of the Congenital Bleeding Disorders Review Group of the Cochrane Collaboration. Clinical research spans retrospective data-linkage exercises, systematic reviews (including Cochrane), guidelines, Phase II, III and IV studies, including gene therapy programs. Residents and Fellows are expected to participate in one or more research projects and attend our weekly research team meeting. We have numerous ongoing research projects and fellows will have the opportunity to work with renowned researchers from McMaster University.

Certification Outcome

The successful completion of the fellowship will grant a Fellowship McMaster Certification.

Entry Requirements

The fellowship program is designed for current residents or recent graduates of internal medicine, hematology, transfusion medicine, physical medicine & rehabilitation, and family medicine programs. Recent graduates are required to submit an application form and comply with McMaster University Postgraduate Medical Education requirements for residents and fellows.

Application Deadline

Inquiries on available positions are welcome all year round. Usually, 9-12 months of lead time is to be accounted for between the inquiry and the start date of the fellowship.

Goals of Training

After completing the training the resident/fellow will have acquired the following competencies:

  1. Diagnose, counsel, and generate a treatment plan for patients with bleeding disorders.
  2. Perform an expert consult on bleeding disorders conditions.
  3. Apply for independent roles in clinical units dedicated to the care of bleeding patients.
  4. Design, execute and appraise research in the field.

Length of Training

The fellowship duration is usually 12 months when the fellows dedicate 50% of their time to the program. “Part-time” opportunities with the dedication of 25% of the time can be arranged and would last between 18 and 24 months.

Funding

A funded position may be available, for a gross amount of $80,000 to $110,000 CAD. The external or self-funded position will be discussed ad hoc.

Curriculum Highlights

  • Participation in the weekly clinic (4-10 annual reviews and follow up) and weekly clinical team.
  • Participation in the weekly research meeting (usually 4-8 researchers and staff in attendance).
  • Supervised self-directed learning.
  • Independent Research Study.

Supervision & Feedback

The trainee will work under the close supervision of the clinical faculty of the Program (Dr. Iorio, Dr. Matino, Dr. Chan). One or two weekly meetings will be offered for the entire duration of the training.