The University of Alberta has a Royal College of Physicians and Surgeons of Canada (RCPSC) accredited residency training program in Medical Oncology. This program provides two years of subspecialty training at the R4 and R5 level for residents completing their core three years of training in Internal Medicine in a RCPSC accredited training program. All applications for training are accepted through the CaRMS application process. The program at the University of Alberta is based on the training requirements set out by the RCPSC and is compliant with their standards of training.
The R4 year is a foundation year in Medical Oncology and residents spend most of their time completing their core rotations. Rotations are tumour specific, not preceptor based. Initially, residents spend time in an introductory rotation to familiarize themselves with the workings of the cancer treatment system and how various allied health professions interact to manage cancer patients. Following this, residents spend time in core rotations, such as Radiation Oncology, breast, GI, GU, lung, and hematology. Other smaller tumour sites (e.g. sarcoma, head/neck) are combined with the larger sites such that some blocks of time are spent learning about two or more tumour groups. These mandatory rotations take up the first year and potentially part of the R5 year as well.
The R5 year is a time for the resident to consolidate their learning and have opportunities to explore interests in various tumour sites by taking electives and to spend more time on research activities. All residents have six months of elective time that they generally will use in the R5 year to either revisit tumour sites that are of interest to them, explore electives at outside institutions, or work on research projects that they have previously initiated. All residents are expected to participate in scholarly activity and are required to undertake a research project that should be completed by the end of their R5 year.
During the course of training, residents are expected to take on more graded responsibility and be more independent. This is fostered through a number of activities, such as junior staff on-call as well as a longitudinal clinic. The longitudinal clinic is especially valuable for residents as they are able to manage patients from initial consultation, treatment, and follow up and are the primary point of contact for their patients, with support and back up from staff physicians. This allows the resident to gain a sense of the continuity of care, management of the patient through the trajectory of care, and valuable skills in terms of time and practice management. Participating in a junior staff on-call rotation allows residents to see how they will interact with outside physicians once in practice and allows them to gain insight into multidisciplinary management of cancer patients in the community.
The emphasis of our program is on education over service. Residents are given ample opportunity for education, including protected academic half days, dedicated teaching in basic science of oncology, pharmacology and drug development, and biostatistics. Clinical service delivery is not dependent on residents being present, so residents are not slotted into rotations solely to deliver patient care but are there to be learners. Likewise, residents are not placed on mandatory inpatient rotations to take care of patients as a service delivery component of their training and when assigned to inpatient care, they act as consultants.
Following successful completion of Medical Oncology residency training, the Cross Cancer Institute/University of Alberta does offer clinical fellowship training to interested candidates. This training is coordinated separately from the Residency Training Committee and is open to anyone who has completed training in Medical Oncology and is interested in basic, clinical, or translational experience in the fellowship setting. Applications for fellowships do not get submitted through the CaRMS process but rather interested parties would apply directly to the fellowship training director. In addition, we will try to facilitate external fellowship placements for local trainees who wish to go elsewhere for extra training upon successful completion of their Medical Oncology training.