Hepato-Pancreato-Biliary (HPB) Surgical Oncology Fellowship at the University of Toronto and Toronto General Hospital
The Toronto HPB & Transplant Fellows 2024-25
Left to Right: Drs. Ahmer Irfan, Pablo Achurra, Daniel Kilburn, Taylor Koe, Su Kah Goh, Farah Ladak.
Welcome to our Fellowship Programs. The University of Toronto has a legacy for being at the forefront of research, innovation, and education in the fields of transplantation and hepatopancreatobiliary (HPB) surgery. Our respective programs are among the largest in North America based on clinical volumes, and we have a proud history of training many of the leaders in surgery over the last 38 years. We offer two accredited programs: a fellowship council-accredited HPB surgical track program and a combined ASTS-accredited abdominal transplantation surgery track program.
As junior fellows, all trainees are immersed in both disciplines gaining a unique hybrid, high volume experience. As second year fellows, trainees become more focused gaining in-depth exposure within their respective clinical track. They are afforded opportunities to participate in complex HPB and minimally-invasive surgery, and to be a part of one of the largest pediatric transplantation and living donor liver transplant programs in North America. In addition to an outstanding operative experience, the fellow’s knowledge is further enhanced through participation in a robust academic curriculum of teaching seminars and by in-depth training in the pre- and postoperative management of these complex patients in both the inpatient and outpatient settings.
We also offer a multitude of opportunities to participate in both clinical and basic science research with many of our investigators being world leaders in their respective fields. We are proud to continue our legacy of training the future generation of academic transplant/HPB surgeons. We invite you to further explore our website and see how our program may enhance your training and in turn help shape the future of transplantation, HPB surgery, and cancer care.
Chaya Shwaartz, MD
Program Director
Trevor Reichman, MD
Program Co-Director
Distinguishing Features of the Fellowship
Clinical Experience
Hepato-Pancreato-Biliary Surgery
During the first year, the HPB and Transplant Fellowships are integrated. The AHPBA required case volumes are exceeded through:
- Vascular resections & reconstruction, includiing in-situ cooling
- Laparoscopic HPB Surgery
- Intraoperative Ultrasound
- Pre-operative planning & volumetric measurements using Myrian software
- 3-month assignments with HPB & Transplant surgeons for elective surgery & Surgical Oncology Clinics
- Medical & Radiation Oncology Clinics & Multidisciplinary Tumor Boards
During the second year, the HPB Fellow focuses on: Complex HPB Surgery (Klatskins, in-situ cooling procedures, vascular resections and reconstructions, re-resections), Multidisciplinary HPB Oncology, and Clinical Research Projects.
Transplant
During the first year, the HPB Fellow is integrated into the Transplant Program (deceased donor organ procurement and liver transplantation):
- Institutional volume of 200+ liver, 40-50 pancreas, 150+ kidney per year:The HPB Fellow can anticipate approximately 25 liver transplants and 50 muti-organ donors
- Largest living donor liver transplantation program in North America (40+ per year)
- Pediatric liver transplantation: Approximately 25 per year
- Shared on-call responsibilities for MOT ward, donors, and liver & kidney transplantation (1:6 for each)
Education
The Fellowship program offers multiple opportunities for additional learning through:
- SSO Seminar Series
- HPB Conference, Hepatoma Review Board, and GI Surgical Oncology Board
- AHPBA curriculum-based seminars
- Surgical oncology seminars
- Journal Club and Multidisciplinary Liver Conference (Faculty Club)
- HPB Grand Rounds
- Attendance at 1 meeting per year plus any meetings with presentations
- Fellow Exchange program (second year) – Fellow’s choice of institution
Research Opportunities
For Clinical and Outcomes Research, Fellows can expect one project in the first year, and multiple projects in their second year of study. There are Basic Science opportunities for laboratory-based research on the topics of:
- Ischemia/reperfusion
- Genomics/proteomics
- Dendritic cells
- Tolerance
- Stem cell biology
Research in education is also offered.
Lifestyle
Fellows will experience the advantages of a “large” Fellowship program with 7 to 8 Transplant and HPB Fellows:
- Focus on the RUQ!
- On-call scheduling and cross-coverage
- Facilitates time off without compromising clinical experience
- Camaraderie