Welcome
The 1-year Clinical Pharmacology fellowship is ideal for trainees from all of the Internal Medicine specialties who wish to advance their training in clinical pharmacology, toxicology, poisoning, evidence-based therapeutics, prescribing skills, medication safety, drug policy, applied research methods, or educational research. This fellowship specializes in correcting suboptimal prescribing habits learned in clerkship and residency, and focuses on safe, evidence-based prescribing allowing for ample time for evidence review and development of leadership potential.
Certification Outcome
The successful completion of the fellowship will grant a McMaster Fellowship Certification
Entry Requirements
The Clinical Pharmacology Fellowship Program is open to trainees who have certification in any of the Internal Medicine core programs, or sub-specialty programs.
Application Deadline
8-12 months prior to start date
Goals of Training
Overall objective of the Clinical Pharmacology Fellowship is to assist trainees in developing knowledge, skills and attitudes that will lead to leadership in rational, evidence-based drug therapy, medication safety and drug policy for clinical practice, education and research.
Additional objectives include:
a) develop clinical expertise to serve as a clinical pharmacology consultant on the inpatient consult service and a future adverse drug reaction clinic.
b) develop knowledge and skills to lead education of medical students and fellows, pharmacy students and fellows, fellow clinicians, with a solid background in the evidence and evidence-based interventions behind improving prescribing practices. Leads at least one formal teaching session for fellow trainees per block.
c) develop basic health research methodology knowledge and skills, rapid literature retrieval and critical appraisal skills, to be conversant in evidence-based therapeutics and evidence-based drug policy.
d) Lead at least one ongoing research or quality assurance project.
Length of Training
1 year.
Curriculum Highlights
A curriculum of topics includes:
- polypharmacy especially psychoactive medications
- managing analgesics especially high dose opioids
- dealing with common symptoms such as nausea and insomnia when there are no safe, effective drug therapies.
- common toxidromes, particularly those where treatment evidence is uncertain.
- approach to high-risk medications (opioids, anticoagulants, hypoglycemics, sedative-hypnotics, antiplatelets, diuretics, chemotherapies, selected antibiotics, etc.)
- advising on the use of expensive non-formulary drugs including biologics
- improving communication skills with patients regarding medication benefits and harms
- deprescribing priorities and methods
- avoiding serious drug interactions
- finding high quality summarized evidence on therapeutics quickly
- learning the physician role in medication safety and mandatory reporting
- basics of personal formulary development and cost-effectiveness
- leading evidence-based quality improvement, including medication-related computerized decision support.
- leading effective collaborative teams when misinformation is rampant.
Learning Activities
1. Rounds
i. Clinical Pharmacology National Rounds (Monthly)
ii. Toxicology Rounds (Biweekly)
iii. Medical Grand Rounds – 2/week
2. Journal Club
i. Quarterly
3. Committee Meetings
i. Hospital – Pharmacy & Therapeutics, Medication Safety, Medication Reconciliation, Quality Improvement, CPT Informatics.
ii. Provincial and National – drug policy, national formulary, et
4. Quality Improvement
i. Focused on evidence-based therapeutics and toxicology policies via P&T and Epic decision support, etc.
5. Procedures
i. Medication reconciliation; teaching complex medication administration eg, insulin pens, inhalers, infusion devices, depot injections, etc.
6. Simulation Sessions
i. Virtual OSCEs, Toxidromes, communications
7. Academic Half Days
i. Topics include: Polypharmacy especially psychoactive medications; managing analgesics especially high dose opioids; dealing with common symptoms such as nausea and insomnia when there are no safe, effective drug therapies; common toxidromes, particularly those where treatment evidence is uncertain; approach to high risk medications (opioids, anticoagulants, hypoglycemics, sedative-hypnotics, antiplatelets, diuretics, chemotherapies, selected antibiotics, etc) improving communication skills with patients regarding medication benefits and harms; deprescribing priorities and methods; avoiding serious drug interactions;
ii. Teaching will be provided by McMaster faculty, with some joint AHD sessions led by U Toronto or Western CPT RCPSC fellowship faculty.