Education & Training
Post Graduate Training Programs
A medical oncologist is an internist with specific training in a broad area of cancer management and who has an extensive knowledge of the pharmacology of cancer chemotherapy.
Cancer is an increasingly multidisciplinary field, which requires input from a variety of specialties. It is the responsibility of the medical oncologist to integrate the numerous physicians involved and to oversee the complete treatment program.
In contrast with physicians in other subspecialties, medical oncologists encounter, and must treat, a variety of internal medicine problems which arise regularly in the management of patients with cancer.
The role of the medical oncologist includes the following:
- To diagnose and treat cancer, caring for the patient in a continuum that extends from the moment of diagnosis throughout the course of the disease, prescribing chemotherapy and other anti-cancer drugs;
- To explain the cancer diagnosis and the meaning of the disease stage to the patient;
- To discuss various treatment options;
- To recommend the best course of treatment;
- To deliver optimal care;
- To improve the quality of life through curative therapy and palliative care, with pain and symptom management.
The major teaching hospitals involved in the Program are the MUHC-Montréal General Hospital, the MUHC-Royal Victoria Hospital, and the MUHC-Montréal Children's Hospital. The affiliated hospitals are the Sir Mortimer B. Davis-Jewish General Hospital and St. Mary's Hospital Centre. Elective periods may be chosen in affiliated hospitals.
The Medical Oncology Residency Training Program meets the requirements of the Royal College of Physicians and Surgeons of Canada, the Collège des médecins du Québec, and the American Board of Internal Medicine for Specialty Training in Medical Oncology.
General Program Objectives
The general objectives of the two-year Medical Oncology Residency Training Program are to communicate an understanding of the basic scientific principles related to cancer and its treatment, and to ensure that the trainee acquires clinical competence in the investigation and management of neoplastic diseases.
Specific Learning Objectives
- The epidemiology and natural history of cancer, including causation risk factors, the biology of growth and spread, and prognostic variables.
- Basic scientific knowledge, including molecular biology, biochemistry, pathophysiology, pharmacology, growth kinetics, genetics, endocrinology and immunology, as they relate to the understanding of cancer and its diagnosis and treatment.
- Assessment and investigations of patients with cancer, including history, physical examination, laboratory and imaging techniques.
- Principles of cancer therapy and the indications for, and complications of, the various treatment modalities alone or in combination.
- Management of medical emergencies and complications which arise as a result of cancer or its treatment.
- The principles and practice of palliative symptomatic treatment of cancer patients.
- Nutritional needs in cancer patients and the methods of management.
- Psychological and ethical aspects of treating patients with cancer and communicating with patients, their families and other members of the health care team.
- Epidemiology and biostatistics, including the conduct and evaluation of clinical trials.
- Specific technical skills, including aspiration of effusions, lumbar puncture, bone marrow aspiration and biopsy, maintenance of vascular access, and examination techniques for specific systems (e.g. pharyngo-laryngeal area, etc.) and their interpretation.
- Comprehensive knowledge of site-specific tumours, encompassing all of the aspects enumerated above.
Trainees will acquire a knowledge base of the following items:
- The basic science of biology, biochemistry, cell kinetics, endocrinology, immunology and pharmacology, as it relates to neoplastic diseases and their treatment;
- Epidemiology and biostatistics in relation to the neoplastic diseases;
- The conduct and analysis of clinical trials;
- The natural history, course and prognostic factors of neoplastic diseases;
- The utility of history, physical examination, and pathological, laboratory and imaging procedures, in the assessment of neoplastic diseases;
- The indications, use, complications and prognostic influence of surgery, radiotherapy and chemotherapy in the treatment of neoplastic diseases;
- The management of oncological emergencies and complications associated with neoplastic diseases and their treatment;
- The nutritional needs, and means for alimentation, of patients with malignant diseases.
Trainees will be able to demonstrate the following skills:
- The ability to utilize clinical examination and appropriate investigations to determine the identity, extent and complications of malignant diseases;
- The ability to formulate an appropriate treatment plan for all patients with neoplastic diseases;
- The ability to interact with other specialties in the determination of the optimal treatment plan;
- The ability to utilize the literature and consultation in order to plan the best approach for the management of rare malignancies;
- The ability to deal with the psychosocial aspects of patient care as well as to communicate the nature, treatment and prognosis to patients and their families.
- Twelve (12) months medical oncology.
The first year program consists of six rotations in the Departments of Oncology at the MUHC hospitals and the Jewish General Hospital.
Each trainee will do one clinic a week at a specified hospital, under the supervision of the same staff member for one to two years. Therefore, when the trainee rotates to the other hospitals, the clinic will continue at the assigned hospital.
During the rotations, trainees will also assist in various outpatient specialty clinics and be responsible for hospitalized patients and new consultations.
During the first year, trainees are expected to accomplish the following:
- Develop competence in the investigation, diagnosis and management of the major types of neoplastic diseases and their complications;
- Become familiar with the use of chemotherapy and the indications of other modalities of therapy in various tumours;
- Acquire skills in the psychosocial management of cancer patients and in communicating with patients and their families;
- Acquire experience in working with other members of the interdisciplinary team in the management of cancer patients.
- Acquire experience in functioning effectively as consultants in medical oncology;
- Participate in, and begin to design, clinical trials;
- Review case studies of a particular cancer topic.
There will be an end-of-year examination to assess knowledge.
- Three (3) months radiation oncology.
- Three (3) months hematology (unless previously completed).
- Six (6) months of electives. This may include further experience in clinical oncology or radiation therapy, pediatric oncology and an appropriate research project.
- Trainees will complete case studies, or a particular review, for presentation and/or publication.
For trainees eligible for qualifications in hematology, a one year training program is available which includes nine months of medical oncology and a three month rotation in radiation therapy.
A substantial proportion of the training takes place in outpatient areas.
By the end of the second year, the resident will have accomplished the following:
- Acquired additional knowledge;
- Matured further in expertise and skills;
- Developed a scholarly attitude towards self-education and critical judgment;
- Participated in the teaching of students, residents and related health care personnel.
There will be an examination to assess knowledge at the end of the second year as well.
During their training years, residents will actively participate in clinical rounds, grand rounds, conferences, seminars and journal clubs, and will attend a program on core multidisciplinary oncology knowledge.
Trainees are usually asked to work one weekend in four and take home call on some rotations. Oncology residents are not primary care-givers—there are IM residents in the hospital to cover the patients. All in-patient work is as a consultant. Call responsibilities involve answering outpatients’ questions about medicines or about going to the ER.
Trainees contemplating a career in academic medicine are strongly advised to spend one or more additional years on a clinical or basic science research project. Appropriate supervision will be arranged.
There are active research programs in both the clinical and basic oncology services at McGill.
Clinical research activities include therapeutic trials in breast, lung, hematological and genitourinary malignancies, as well as sarcoma. Projects are also ongoing in preventative oncology.
Basic research activities include projects in tumour cell kinetics (markers of tumour differentiation), drug resistance and molecular biology of metastasis cancer.
The McGill Centre for Translational Research in Cancer is involved in numerous phase I & II trials, which offer cancer patients a unique opportunity to participate in the latest forms of cancer treatments. In particular, the Centre has several protocols in which in-depth pharmacokinetic analyses and/or tissue correlates of molecular based therapies are examined.
Why Choose to Study at McGill?
McGill University’s internationally-renowned reputation for scholarly achievement and scientific discovery opens doors to career opportunities all over the world. McGill's Department of Oncology is dedicated to excellence in patient care, teaching and research. Our multidisciplinary team works together to train residents in all aspects of medical oncology, providing outstanding experience at the McGill University teaching hospitals, as well as several community-based hospitals. Our departmental members are committed to life-long learning, for themselves and for the benefit of their patients.
McGill University is committed to providing residents and fellows with the clinical and educational experience required to provide quality cancer care.
Applicants should first have completed an internship and three years of training in internal medicine. For complete eligibility guidelines and application information, please see Postgraduate Medical Education. Enquiries may also be directed to the program coordinator.
Dr. Lawrence Panasci