This residency program is for 2 years.

Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.

Outline of Program:

CBD curriculum will be divided into four phases: Transition to discipline (~ 2 to 3 months), Foundations (~2 to 3 months), Core (~ 16 months) and Transition to practice (~ 2 months). Each phase requires successful completion of Entrustable Professional Activities (EPA) before a resident can progress to the next phase. In order to obtain these EPAs, Residents are given a month or two month rotation, at the beginning of their training, on the Hematology consult service at one of the teaching hospitals to get accustomed to the discipline and to learn the day to day activities of the service and the program. They also get approximately 6 months of laboratory rotations (Coagulation, Transfusion, and Hematopathology).  Residents then complete their additional clinical training including 5 months (in total) of clinical hematology, 2 months of leukemia/BMT, 1 month of pediatric hematology, 2 months of lymphoproliferative disease/Myeloma and 1 month of medical oncology or palliative care or Radiation Oncology. One month is dedicated to a novel ‘administrative project block’ that addresses some of the Health Advocate and Leader roles. We also mandate two months of mentor block, in the last three months of second year, where the residents have an opportunity to assume the role of staff haematologist in preparation for transition to practice. Residents are expected to undertake and complete a scholarly project (3 to 6 months). This leaves ample flexibility for elective rotations at this centre or elsewhere.

NOTE: If the COVID-19 pandemic continues, residents will be required to be flexible in adjustments related to meeting the objectives of training. Residents will be involved in virtual patient-care clinics and virtual academic sessions when applicable.

Clinical Rotations: 

Clinical training in Adult Hematology is obtained on the inpatient and outpatient services of our institutions. CancerCare Manitoba is unique among provincial cancer agencies in that its mandate encompasses all blood disorders, and accordingly all Hematology outpatient clinics, for both benign and malignant disorders, that take place in the CCMB facilities. This offers numerous practical advantages.

Pediatrics (1 month): Experience in Pediatric Hematology/Oncology is provided under the supervision of Dr. Jayson Stoffman. Inpatient services are provided in the provincial Children’s Hospital, part of the HSC complex, while outpatient activities take place in a unique children’s clinic facility at CCMB. The University of Manitoba has a Royal College program in Pediatric Hematology/Oncology.

Leukemia/BMT (2 months): Experience in acute leukemia and blood and marrow transplant is provided by the inpatient and outpatient Leukemia/Bone Marrow Transplantation service, under the direction of Dr. Craig Speziali.   This service is an academic investigative unit which represents the major referral service for all adult patients with acute leukemia in the Province of Manitoba, with inpatient services provided on a specialized closed unit at HSC. The BMT program offers experience in adult marrow and peripheral blood stem cell transplantation, reduced intensity allografting, marrow autografting, and cord blood allografting.

Palliative Care or Radiation Oncology or Medical Oncology (1 month):  Palliative care experience is available at dedicated hospice units at St. Boniface Hospital and Riverview Hospital.  Radiation Oncology experience is available at CCMB outpatient clinics. Experience in Medical Oncology is available on the hospital consult services at both HSC and SBGH and in the disease site specific outpatient clinics of CCMB. Experiences in all aspects of medical oncology practice are available.

General Hematology (5 months): Rotations will be undertaken on the clinical Hematology services at SBH and HSC. During these periods, you will attend outpatient clinics and see in-hospital consults at the respective hospitals. Both are full service tertiary care hospitals, and between them provide all tertiary care services for a population of over one million. HSC has 797 beds and SBH has 555 beds. Both hospitals have a full array of medical wards, surgical specialties, and intensive care units; in addition, HSC has a busy high-risk obstetrics unit and SBH has cardiac sciences and a family practice unit. These wards generate a diversity of types of consultations encompassing the entire spectrum of consultative hematology. Outpatient experience in benign and malignant hematology is also diverse and varied.  Elective rotations in various aspects of clinical hematology can be arranged.

Residents have a half day longitudinal outpatient clinic throughout the two years of their training, under supervision of one of the staff hematologists. The resident functions as the primary consultant in this clinic, allowing him or her to gain experience in the natural history of hematological disorders and to gain skills in the independent management of patients.

Lymphoproliferative Disease/Myeloma (2 months): Rotation will be undertaken through CancerCare Manitoba at the HSC, St. Boniface and Victoria General Hospital sites. Residents will have the opportunity to rotate through lymphoma, myeloma and chronic lymphocytic leukemia clinics and be exposed to clinical and translational research.

Laboratory Training:

A minimum of 6 months laboratory training is required in the program.

The laboratory training includes four months in Hematopathology, under the direction of Dr. Daniel Marko. Residents will have the opportunity to obtain a wide range of experience in blood and bone marrow pathology including molecular, immunology, and cytogenetic techniques. Residents will also be exposed to lymph node pathology.

There is also a one-month Transfusion Medicine rotation at Canadian Blood Services, under the direction of Dr. Debra Lane, and a one-month Hemostasis rotation under the direction of Dr. Sara Israels.

Additional time in laboratory hematology can be arranged, as suits the interests of our trainees.

Academic Activities:

Academic activities that you will be expected to participate in include weekly Medical Grand Rounds, weekly Section of Hematology/Medical Oncology Grand Rounds, weekly Hematology rounds, and weekly Lymphoma Rounds. As well, you may be asked to participate in additional activities of hematology-related disease site groups. Fellows are encouraged to present cases frequently at the Hematology and Lymphoma Rounds, and give formal presentations at least twice per year to the Section Grand Rounds. A journal club is held monthly in conjunction with the Medical Oncology program.

A weekly academic half-day will cover the breadth of the curriculum in Hematology set out by the Royal College objectives of training. The format of these sessions allow both resident-led and staff-led sessions.

The Royal College CanMEDs competencies are addressed throughout the program in clinical training, research and academic half day. However, in order to further address the CanMEDS competencies of Health Advocate, Leader, Collaborator, and Communicator, we have developed an Administrative Project Block of one month, during which you are expected to work on a quality improvement project such as to prepare a submission to the Pharmacy and Therapeutics Committee at CCMB or one of the host hospitals, develop or adapt for local use a clinical practice guideline for a relevant Disease Site Group at CancerCare Manitoba etc.

During the course of the two years of training we expect trainees to become involved with research projects either at the clinical or basic science levels. An asset of our program is the close interaction between clinicians and basic scientists in the CancerCare Manitoba Research Institution (CCMR) which is located within CCMB. Many of the attending physicians in the Section have laboratory research programs of their own in the CCMR, or collaborative projects with the CCMR scientists. Areas of major interest in our institution include: identification of molecular markers of prognostic significance; mechanisms of gene amplification and genomic instability in tumors; regulation of apoptosis; platelet granule proteins, and molecular mechanisms of thrombosis. Another asset is the Cancer Epidemiology program, and the ability to perform population-based research. Participation of fellows in the CancerCare Manitoba Research Day and U of M Internal Medicine Resident Research Day are encouraged, with the hope that the strong prize-winning record of our trainees will continue.