Message from the Co-Directors
Colleagues,
As we approach the end of our academic year, we would like to celebrate our successes for 2023/2024. The U of T Spine Program continues to foster city-wide collaborations within the University and the affiliated hospitals while taking the lead in several key initiatives and garnering a respected academic footprint locally, nationally, and globally. Collaboration and inter-professional multi-disciplinary knowledge exchange remain key elements to our success. The Program has continued to provide a full and rich calendar of academic activities in both online and in-person formats. This has enabled continued participation from alumni and the spinal community throughout Canada and across the globe.
On June 10th this year, our Program marks the 16th Annual Spine Academic Day “SpineFEST.” At this time of the year, we congregate to highlight our spinal community’s accomplishments and disseminate recent clinical, scientific and educational advances. We are pleased to host our SpineFEST keynote speaker for the Tator-Hall Lecture, Professor Serena Hu, MD, Chief of Spine Surgery Services, Department of Orthopaedic Surgery and (by courtesy) Neurosurgery at Stanford Medical School. In leadership, Dr. Hu has been the first woman president of several prestigious surgical organizations, namely, president of the American Orthopedic Association and the Scoliosis Research Society. She has been a leader in the field of Orthopaedic and Spine Surgery with a clinical interest in spinal deformity surgery. She has numerous clinically relevant research interests which has included, for example, work to reduce complications after spine surgery. We are excited about Dr. Hu’s keynote address titled “Standing on the Shoulders of Giants: Spine Deformity Treatment over the Ages”. Please join us in welcoming Dr. Serena Hu to SpineFEST 2024!
Following her keynote lecture, there will be a symposium focusing on Enhancing Perioperative Outcomes in Spine Deformity Surgery chaired by Dr. Stephen Lewis. A number of faculty will update us on their research work related to spinal disorders. The meeting will continue with invited trainee presentations to highlight outstanding clinical and basic science research.
Many thanks to our program judges (Drs. Jeff Wilson, Joel Finkelstein, Jeremie Larouche, Chris Nielsen, Meaghan O’Reilly, Karl Zabjek, Carlo Ammendolia, Michael Hardisty, David Lebel, Margarete Akens, Chris Witiw, Cari Whyne, and Arjun Sahgal) for reviewing numerous abstract submissions. We appreciate their time and expertise. Although many excellent submissions were received, we could only designate a few Best Abstracts for oral presentations. The remaining abstract submitters will present their work at the Elevator Pitch sessions in the morning and the afternoon.
The U of T Spine Program continues to leverage our foundational education platform to help create and support a national spine surgery fellowship training curriculum for cognitive and procedural competencies. Apart from tracking fellowship training experience, our efforts have enhanced cross-institutional and collaborative Neurosurgery and Orthopaedic Surgery spinal training across Toronto Academic Health Sciences Network (TAHSN) teaching hospitals, including Toronto Western Hospital (TWH-UHN), Sunnybrook Health Sciences Centre (SHSC), Unity Health Toronto (UHT), and the Hospital for Sick Children (HSC). We support an academic hub that competitively attracts around 18 national and international clinical fellows including many additional traveling surgeons each year. For several year now, our program continues to offer both a one-year core fellowship training experience as well as two-year fellowship opportunities with a more advanced second year focus on subspecialty exposure. While the fellowships remain primarily based at one of the TAHSN hospitals, opportunities exist and have been supported for city-wide experience. Many thanks to Drs. Albert Yee, Michael Fehlings, Stephen Lewis, Eric Massicotte, Jeremie Larouche, Chris Nielsen, Joel Finkelstein, Howard Ginsberg, Henry Ahn, and Reinhard Zeller for their valued help in shaping our citywide fellowship training opportunities. Building upon our Canadian Spine Society (CSS) national fellowship curriculum, our Program also continues with supporting and growing a surgical case log initiative for our citywide spine fellows. There are over 14,500 cases and procedures recorded since 2015/2016. We thank Drs. Jeremie Larouche, Tony Bateman, and Ms. Nadia Jaber for creating a successful foundational case log tracking program for our citywide fellows.
In recognizing Spine Surgery as a distinct formally designated discipline at the Royal College of Physicians and Surgeons of Canada (RCPSC) level, we have worked with national colleagues to develop an Area of Focused Competence (AFC) in spine surgery. The application for AFC diploma recognition was approved for national development in November 2021. A national Royal College working group with U of T representation and leadership has drafted 3 key documents (a trainee Portfolio highlighting minimal requirements in training, a Clinical Training Requirement CTR document which is an updated national trainee curriculum, and a Standards of Accreditation document for university training centres). Documents are currently being finalized and will soon be available to Canadian university Post Graduate Medical Education (PGME) Offices (PGME). University programs can then apply to become an accredited diploma training centre. There will be both adult and pediatric streams and an eventual stream also for staff surgeons already in established practice. We are well positioned organizationally within our program to apply and become an accredited training centre. Thanks to Drs. Albert Yee, Jeremie Larouche, Michael Fehlings, Scott Paquette, Hamilton Hall, and Ms. Nadia Jaber for taking the lead in engaging our national society, several university spine programs, and fellowship directors across Canada in this initiative. The diploma will provide a valued competency-based model for our surgical educators. This also opens the door for new international collaborations. Several international specialty organizations have already inquired about our approach and plans.
This year, we launched our academic calendar of events on October 2nd with a welcome dinner for our incoming fellows and provided attendees with an updated on our citywide research opportunities. Many thanks to Drs. Carlo Ammendolia and Karl Zabjek who continue to lead this update and for keeping us informed on the progress of spine research in Toronto. We heard from numerous graduate students, residents, fellows, and faculty scientists.
On December 15th, Dr. Stephen Lewis continued an annual tradition of chairing a citywide fellow surgical skills course, introducing advanced anatomy of the spine with fellows performing both anterior and posterior surgical approaches, as well as spinal instrumentation. Over the past several years, Dr. Lewis has expanded this course to include advanced complex procedures including deformity osteotomy, minimally invasive surgery, and trauma techniques. The course encompasses a combination of wet lab with image guidance technology and faculty lectures with case-based discussions throughout the day. Many thanks to our industry partners: Medtronic, Stryker, DePuy Synthes, and Bioventus for their continued support of this integral training experience.
The Traumatic Spinal Cord Injury Course on Management and Classification also continued this year on January 22nd with a hybrid learning model. The program included pre-recorded lectures, online in-steps training, and in-person practicum followed by in-person case-based interactive discussions. Special thanks to Dr. Sukhvinder Kalsi-Ryan and Ms. Jaber for planning and organizing a successful hybrid training model, and many thanks to the course faculty Drs. Michael Fehlings, Jeremie Larouche, Jeff Wilson, and Julio Furlan, for their valued contributions.
On April 8th, we continued to complement the residents’ surgical training with our Royal College Mock Oral course to prep senior residents in both neurosurgery and orthopedic surgery for their residency national exit examinations. We have had 3 neurosurgery and 9 orthopaedic surgery residents sit their Royal College examination this year. Drs. Jeremie Larouche and Jetan Badhiwala assumed co-chairing this established annual course. We appreciate their valued leadership in supporting and enhancing this course to meet the evolving and current format of the Royal College specialty examinations. Many thanks to Drs. Joel Finkelstein, Simon Harris and Colby Oitment for their continued support and teaching at this course. Sincere thanks to our fellow educators, Drs. Luke Reda and Colton Kennedy, for co-leading the teaching case scenarios and prepping the residents for their oral examination.
Over the past several years, our Program has been keen on bringing together citywide surgeons and trainees in multiple virtual events. The citywide Fellow Journal Club continues to be held several times a year. On April 15th, we discussed the newly published Guidelines for the Management of Acute Spinal Cord Injury including additional related papers. Thanks to our citywide fellows Drs. Luke Reda, Colton Kennedy, and Rajesh Kumar, and our research fellow Dr. Mohammed Alvi for leading the article summaries and discussions.
We are pleased to have continued the annual Pediatric Spine Deformity Surgery course for the 2nd year on May 13th. Thanks to Dr. David Lebel for chairing and organizing this well received educational course. Many thanks also to SickKids faculty Dr. Samuel Strantzas, Ms. Jennifer Dermott, and Dr. Mark Camp for their outstanding teaching including case-based lectures.
Our academic calendar of events has continued to grow over the years with new educational initiatives being added regularly. A new course on non-operative spine treatment is under planning for introduction in our upcoming academic year. Thanks to Dr. Ammendolia for his leadership in establishing this course. We also would like to thank Dr. Chris Nielsen for taking the lead in planning and initiating a series of Clinical Case Reviews from across our city-wide hospitals with discussions framed around relevant and focused current literature. We look forward to launching these additional educational opportunities in the upcoming academic year.
Our Program continues to deliver a rich academic program leveraging several local, national, and international opportunities. We were delighted to collaborate with the U of T Dept of Neurosurgery to host and organize a resident cadaver course on Spine Peripheral Nerve Special Topics that was held May 22nd as part of the Canadian Neurological Sciences Federation (CNSF) Annual Meeting and the celebration of U of T Neurosurgery’s 100th year Anniversary Event. Many thanks to Dr. Massicotte and Dr. Jetan Badhiwala for their exceptional efforts in planning and chairing this course. We have also collaborated with AO Spine North America to host an Advanced Concepts on Cervical Spine cadaver course on June 7th -8th in Toronto for attending spine surgeons and fellows from around the world. A heartfelt thank you to Dr. Fehlings and Dr. Richard Bransford for co-chairing and organizing a superb course.
Over the academic year, the Program invites several world-renowned Professors as part of our well-established Hospital-Based Visiting Professorship series. On December 18th, we were thrilled to have Dr. Daniel Sciubba (the Senior Vice President of Neurosurgery at Northwell Health) visit with the event hosted by St. Michael’s Hospital, Unity Health Toronto (UHT). We enjoyed Dr. Sciubba’s morning Grand Rounds talk on Managing the Challenges of Spine Tumors. His evening talk during our Greater Toronto Area (GTA) Spine Rounds on Integrating Clinical Advancements, Technology and Humanity into Neurosurgery was also very well received. Thanks to Dr. Jeff Wilson and the UHT team for organizing and hosting a successful visiting professorship event with Dr. Sciubba. On May 23rd, the Tator-Turnbull Spinal Cord Injury Symposium took part in the 100 years of Neurosurgery at the University of Toronto celebration and the CNSF annual meeting featuring our visiting professor Dr. James Guest, a Professor of Neurological Surgery from the University of Miami. The symposium also highlighted a number of excellent SCI research presented by faculty and trainees. This year, the symposium marks its 23rd anniversary. We appreciate the continued support of Dr. Fehlings and his relentless efforts in upholding this annual legacy recognizing the substantive contributions of Dr. Charles Tator and Barbara Turnbull to the field.
We are very thrilled to have Dr. Jetan Badhiwala join our Program as a new staff spine neurosurgeon at the Sunnybrook Health Sciences Centre and an Assistant Professor of Neurosurgery at the U of T. His academic program is focused on health outcomes research in traumatic and non-traumatic spinal cord injury. Dr. Badhiwala is a well-accomplished early career surgeon with over 125 peer-reviewed papers, 50 conference abstracts, and 15 book chapters. Please join us in welcoming Jetan to our Program.
At the provincial level, our program, led by Drs. Raj Rampersaud and Jeremie Larouche in collaboration with other city-wide surgeons is advocating for further enhancements in spinal care triage to address population needs and wait times to see a specialist. Central intake opportunities and further leverage of Advanced Practice Provider (APP) expertise is aimed to bridge current clinical care gaps complementing the important work conducted already to expand the provincial degenerative spine QBP program. The Provincial Neurosurgery Ontario Expert Panel has also secured additional funding to support enhanced urgent assessment for both cranial and spine conditions. The province continues to focus on regional, central intake, and long waiter efforts alongside initiatives directed at human resource recruitment/retention, capacity, and efficiency.
We want to take this moment and celebrate the graduation of our 2023/2024 citywide spine fellows, who will be completing their fellowship training in July or later in December this year. Congratulations to Drs. Maria Pia Monjardino, Motti Zucker, Rajesh Kumar, Luke Reda; Colton Kennedy Ariel Zohar, Prarthan Amin, Peyton Lawrence, Yousef Al-Jamaan, Francois Dantas, Karlo Pedro, Hiroyuki Kato, Fahad Alotaibi, Gianfranco Ligarotti, Ran Ankory, Zsolt Zador, and Shun Hayasaka. We wish them a successful and rewarding professional career. We look forward to their continued future engagement in our Program’s activities as valued alumni members.
On a final note, we are pleased to announce that an external review will be conducted by the University Department of our Program at the end of this year or early next year. Opportunities for leadership and other collaborative roles will exist at the Program directorship level. In anticipation of the Royal College AFC diploma in spine surgery, a programmatic AFC committee will need to be established within the university’s existing Post Graduate Medical Education AFC structure. By way of this note, we want to extend our appreciation to the University of Toronto Department of Surgery Spine Program Council, Program educators, and trainees for their continued dedication and remarkable contribution over many years to the numerous successes of our Program. We are privileged to benefit from the specialized and diverse knowledge of our Program members. Notably, we wish to recognize the support from the U of T Department of Surgery and Divisions of Neurosurgery and Orthopedic Surgery. Special thanks to Dr. Carol Swallow (Chair of the Department of Surgery), Dr. Peter Ferguson (Chair of Orthopedic Surgery), and Dr. Gelerah Zadeh (Chair of Neurosurgery) for their longstanding and strong Departmental and Divisional support of our University-Wide Program. We also would like to thank all our industry partners (Medtronic, DePuy Synthes, and Stryker) who have stood steadfast along our side in support of our important academic endeavours even through recent challenging pandemic years. We extend thanks this year also to Bioventus for their educational support. Special thanks to Ms. Nadia Jaber, our Program Manager, for her outstanding expertise and valued information technology and communication skills. She remains invaluable towards moving forward our collaborative agenda and is integral to the continued development and growth of our Program. She has been instrumental in adapting innovative models for us to deliver our academic content and events which continues to evolve even during this post-pandemic time. A big thank you to our Program Volunteer Ms. Delphine Li for her great help in maintaining the fellow case log and her excellent assistance in organizing our Program activities. We wish her tremendous enjoyment and success as she embarks on the next phase of her professional life in the field of medicine.
In closing, we wish to celebrate another outstanding academic year in our U of T Spine Program. We wish everyone a safe, healthy, and enjoyable summer break followed by an exciting 2024-2025 academic calendar.
Sincerely,
Michael Fehlings & Albert Yee
Co-Directors, U of T Spine Program
June 10, 2024