The general surgery residency program is primarily based at three sites in Hamilton: St Joseph’s Hospital (SJH), Hamilton General Hospital (HGH) and Juravinski Hospital and Cancer Centre (JHCC). All residents will train at all sites during the five-year residency. The pediatric surgery experience takes place at McMaster University Medical Centre (MUMC).

St. Joseph’s Hospital

• St Joseph’s Hospital is a located in downtown Hamilton – 50 Charlton Street East
• 11 general surgeons
• Acute care service, general surgery, surgical oncology, colorectal surgery, foregut surgery, minimal invasive surgery, bariatric surgery, endoscopy
• Clinical Teaching Unit (CTU) director: Nalin Amin

Hamilton General Hospital

• Located in the east part of Hamilton – 237 Barton Street East
• Eight general surgeons
• Trauma, acute care surgery, general surgery, endoscopy
• CTU director: Edward Passos

Juravinski Hospital and Cancer Centre

• The JHCC is located on the east mountain – 711 Concession Street
• 13 general surgeons
• Acute care service, hepatobiliary surgery, colorectal surgery, breast oncology, general surgery, surgical oncology, endoscopy
• CTU director: Jessica Bogach

Community hospitals commonly involved in the program:

• Oakville
• Joseph Brant in Burlington
• Brantford
• Markham-Stouffville
• MacKenzie Health
• Kitchener-Waterloo
• Collingwood
• St. Catharines and Niagara
• Credit Valley

Clinical Training Curriculum

The clinical training portion of the curriculum is organized by postgraduate years (PGY-).

PGY-1

• 1 block of “rookie camp” (education sessions)
• 1 block of trauma
• 1 block of acute care surgery (ACS) at HGH
• 6 blocks of non-ACS general surgery at SJH and JHCC
• 2 blocks of pediatric general surgery
• 1 or 2 blocks of internal medicine or perioperative medicine
• 1 block of emergency medicine (optional)

PGY-2

• 3 blocks of acute care surgery at SJH or JHCC
• 2 blocks of non-ACS general surgery at HGH
• 2 blocks of non-ACS general surgery anywhere in Hamilton
• 3 blocks of intensive care unit (ICU)
• 3 blocks of endoscopy

PGY-3 and the first 10 blocks of PGY-4

• Up to 6 blocks of community or elective general surgery outside Hamilton
• Up to 4 blocks non-general surgery surgical specialty (e.g., vascular, thoracic, head and neck, urology, plastics)
• 2 blocks of breast oncology
• 3 blocks of acute care surgery at SJH or JHCC
• 1 block of acute care surgery at HGH
• 1 block of trauma
• 4 to 6 blocks of general surgery anywhere in Hamilton
• Up to 3 blocks of non-general surgery elective blocks (e.g., research, global health, non-surgical rotations)

Last 3 blocks of PGY-4 and PGY-5 : The Chief Year

• 14 blocks of general surgery
• 2 blocks of transition to practice clinical experiences

Assessment

As part of the Competence by Design (CBD) model, residents receive feedback through work-based assessments using the Entrustable Professional Activities (EPAs). At the end of each general surgery rotation, every resident receives narrative feedback from each faculty on that rotation through our program’s custom end-of-rotation assessment forms. In PGY3-5, residents also receive feedback on their operative performance using The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) form.

Oral Exams

Practice oral exams occur twice a year for all residents. These exams allow assessment of residents’ knowledge and oral exam skills, as well as feedback for residents.

Canadian Association of General Surgeons (CAGS) EXAM

The CAGS exam occurs each October and allows assessment of resident knowledge.

Surgical Foundations Exam

This occurs in the second year during the spring. Residents must apply for the Preliminary Assessment of Training (PDF) one year prior to taking the Surgical Foundations exam. More information can be found on the Royal College site.

Academic Curriculum

General Surgery Grand Rounds, JHCC (fourth floor lecture room) – Wednesday’s from 7:30 a.m. – 8:30 a.m. Rounds take place from September to June.

PGY1-2 Surgical Foundations Program – Wednesday’s from 9 a.m. – 12 p.m. Organized by Dr. Darren De Sa and Dr. Laura Nguyen. These sessions will help in preparation for the Surgical Foundations exam. PGY-2 residents participate in these sessions until the Surgical Foundations Royal College Exam, after which they participate in the General Surgery teaching listed below.

PGY2-3 Teaching sessions – Wednesday’s from 9 a.m. – 11 a.m.

PGY4-5 Teaching sessions – Thursday’s from 3 p.m. – 5 p.m.

Courses and Other Training

• PGY-1 Advanced Trauma Life Support (ATLS) course
• PGY-2 Endoscopy Training Course
• PGY-1 Basic Laparoscopic Course – Centre for Minimal Access Surgery (CMAS)
• PGY-3 Advanced Laparoscopic (CMAS) Course
• PGY4-5 Abdominal Wall Reconstruction and Parastomal Hernia Course
• PGY-4 Advanced Trauma Operative Management (ATOM) Course
• PGY2-3 Crisis Management Resource Training

Journal Clubs

Several journal clubs are held throughout the year, which are guided and facilitated by residents and faculty. 

Research Day

General Surgery Resident Research Day is held annually.

Research Projects

Each resident is required to complete a minimum of two research projects by the end of the five years. Guidance will be provided by the program’s research director, Dr. Elena Parvez, and other faculty. The research projects are expected to be presented at the annual Program Research Day.

Master’s or PhD During Residency Training

Residents may have the opportunity to pursue an advanced degree (e.g., master’s or PhD) during their residency training. This is typically done through a leave of absence that commences after completion of PGY-2 or PGY-3. Residents may compete for one of McMaster University’s six funded RCPSC Clinician Investigator Program (CIP) positions. Other non-CIP options for pursuing an advanced degree will also be considered.

It may also be possible for some residents to complete part-time degree programs during their residency training without a formal leave of absence.

The Division of General Surgery has an endowment, the Margaret and Charles Juravinski Surgical Fellowship, that is awarded through a competitive peer review and adjudicated process and can provide funding for salary support for a research leave of absence.

Career Review

Each resident meets one-on-one with the program director two times a year. These meetings allow review of resident’s progress, rotations- and career planning, and discussion of any issues that arise during training. An open door policy is in effect at all times with the program director.

Selection Criteria

Candidates are assessed on their:

• Personal letter
• Reference letters
• CV
• Academic record
• Interviews