Nuclear Medicine

The University of Ottawa Nuclear Medicine Residency Program was approved by the Royal College in 2010. At inception, it was a five-year program, which included one-year rotating internship including internal medicine, three years of nuclear medicine and one year of research and elective rotations. The three years of nuclear medicine included rotations in general nuclear medicine, nuclear cardiology, cross-sectional imaging in diagnostic radiology, PET/CT, pediatric nuclear medicine.

The Program transitioned to Competence by Design (CBD) in July 2020, and had its first CBD graduate, through the dual-certification training stream, in August 2022.

The Ottawa Hospital has a unique collaboration with the lsologic Innovative Radiopharmaceuticals Ltd., which is located within the Ottawa Hospital. This will allow trainees to have direct exposure to a commercial radiopharmacy. Affiliation to McGill University is arranged for the PET/CT rotation to allow the trainees to gain greater exposure to PET/CT. Affiliation in pediatric PET is arranged with the University of Toronto and the University of Montreal for the Pediatric rotation. The trainees will have opportunity to rotate at the University of Ottawa Heart Institute for the Nuclear Cardiology rotation, including PET Cardiac training. The University of Ottawa Heart Institute is one of the most active nuclear cardiology centers in Canada. Its research teams are world renowned and cardiology fellows and post-graduate students from around the world are rotating in the department. Research opportunities are vast with the nuclear cardiology team which is well established with large grants and numerous publications yearly. Research in general nuclear medicine is strongly encouraged with the assistance, if needed, of the staff physicians and the Division’s physicist. If desired. the trainee could rotate in community hospital and to a private nuclear medicine clinic as some of the nuclear medicine physicians hold privileges in these centers in and around Ottawa.

While the Residency is offered in English only, the Ottawa Hospital does operate as a fully bilingual institution.

The overall goal of the training Program is to provide a learning environment in nuclear medicine such that a resident will gain sufficient knowledge of his subject to be able to practice nuclear medicine safely. It is hoped to produce nuclear medicine specialists who will be able to function as valued consultants to their colleagues.

Specific educational objectives concerning individual portions of the program are set up to help ensure that adequate teaching is obtained and maintained by regular feedback mechanisms. The program will contain a broad and detailed experience in nuclear medicine and graduated responsibility throughout, such that the resident will act as a junior consultant at the end of their program of training.

This residency program is for 5 years.

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

This residency program is nominally 5 years depending on trainee’s progress through the CBD stream.

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

During the Transition to Discipline stage, the trainees will rotate in Nuclear Medicine, and there will be several off-service rotations, for e.g., internal medicine, cardiology, emergency, surgery, respirology, etc., to fulfil the Royal College requirements.

In the subsequent training stages (Foundations, Core and Transition to Practice), they will spend time training in core nuclear medicine with rotations in general nuclear medicine, radionuclide therapy, nuclear cardiology, PET/CT, diagnostic radiology.

As the theranostic part of nuclear medicine is growing, there is a very well-established weekly consultation clinic, where trainees get involved in the patient treatment aspect of nuclear medicine with radioactive material.

For further information about the training stages in for Nuclear Medicine, please refer to the Royal College website.

Affiliation with McGill University is arranged for additional rotation in PET/CT. Affiliation with the University of Toronto and the University of Montreal is arranged for the rotation in pediatric nuclear medicine.

Research

Trainees are encouraged to participate in at least one research project during their training. Suggestion for suitable research topics or ongoing advice and assistance is provided by the research coordinator, staff physician or the scientist. The trainees are required to present their research projects during the research rounds. They are also encouraged to present their research topic at the annual Trainees’ Research Day.

The presentation of research projects by trainees at local, national and international meetings is encouraged. In addition, trainees are strongly encouraged to submit their results to postgraduate medical education awards competitions available each year.

Teaching sessions and rounds

Academic half day (AHD) sessions occur weekly for which trainees are excused from their clinical duties to attend teaching. Didactic teaching generally consists of a basic science lecture and a clinical lecture. Every alternate year, a procedure-based skills teaching event is held during the AHD at the University of Ottawa Skills and Simulation Centre, which provides opportunity to learn from the experts in managing real-life scenarios.

Basic sciences teaching covers biennial courses on Physics, Radiobiology and Radiopharmacy; these courses are run by the internal/external subject matter experts. At the end of these courses an exam is held and debrief sessions are organized to provide feedback.

Radiation Safety course is also offered every other year during the AHD in collaboration with the Radiation and Laser Safety Department at the Ottawa Hospital.

Interesting case rounds are held weekly where interesting cases are presented and discussed by the trainees and moderated by the faculty members. City wide Nuclear Medicine Grand Rounds are held every month from September to June; trainees, staff physicians, as well as visiting professors present at these rounds. Morbidity and Mortality Rounds are typically held four times a year for the purpose of quality assurance and teaching. Journal Club is held every four times/year (except for summer months) where presentations are made on the journal articles selected by the trainees and the faculty.

In addition, trainees also attend the Multidisciplinary Cancer Conferences (MCC) when they are on Consults, Treatment and MCC (CTM) rotations, as well as when on their home rotations in general nuclear medicine and PET/CT. Participation at these rounds provides them exposure to interact with physicians from other disciplines and partake in discussions on diagnosis and treatment plans from the nuclear medicine perspective. Some of MCC they will attend are, Gastrointestinal rounds, Genitourinary rounds, Breast rounds, Melanoma rounds, Lymphoma rounds, Endocrine rounds, Thoracic rounds, etc.
Trainees are also invited to the Nuclear Medicine Patient Safety and Quality Improvement (PSQC) meetings; this allows them to get involved in the patient safety matters and the quality improvement initiatives.

University of Ottawa Heart Institute

The nuclear cardiology department at the University of Ottawa Heart Institute performs a large number of nuclear scans including myocardial perfusion scan, radionuclide ventriculogram, cardiac PET with fluorodeoxyglucose, ammonia, rubidium. More than five thousand scans are performed annually. Three dual-head SPECT cameras, one SPECT/CT, one solid-state detector camera, one PET and one PET/CT are operating. A microSPECT and a microPET are also used for research. The research is very active with a very successful world-renowned research team. Cardiology fellows from around the world are rotating in the nuclear cardiology department.
 
The Ottawa Hospital

The Nuclear Medicine department is a busy, moderate to large sized Nuclear Medicine department that sees approximately 18000 patients per year. More than eight thousand general nuclear medicine cases are performed yearly across the General and Civic Campuses. Approximately 5000 BMDs are performed at the Riverside Campus. PET/CT yearly caseload is over 3000 studies.

The Ottawa Hospital, General Campus

The General Campus is a large department with two SPECT/CT cameras, three SPECT cameras, one single head camera, one PET/CT. A substantial portion of cases includes oncology cases, but other cases such as cardiology, nephrology, endocrinology, rheumatology, infectious, post-surgical, neurology cases are also performed. Bone densitometry is also performed remotely but supervised and interpreted at the General campus. The general nuclear medicine rotations are offered at that site. PET/CT scans are performed for main oncologic indications in close relative to the Ottawa Cancer Center. Additional PET/CT exposure is offered in a specific rotation at the McGill University hospitals.

The Ottawa Hospital, Civic Campus

The department is a busy nuclear medicine department with one dual -head SPECT cameras and two SPECT/CT cameras. The lsologic Radiopharmaceuticals Inc., commercial radiopharmacy, is located within the nuclear medicine department. Cases are performed include infection, rheumatology, endocrinology, oncology, surgery, neurology.

The general nuclear medicine rotation is offered at The Ottawa Hospital General and the Civic sites.

Toronto Hospital for Sick Children

The three-month pediatric rotation is done at the Toronto Hospital for Sick Children. 2500 scans are performed annually,1200 pediatric bone mineral densities, and two hundred pediatric PET/CT scans.

Montreal General Hospital and Jewish General Hospital

To provide additional exposure to PET outside of the current Ontario Ministry of Health indications, a three-month PET/CT rotation is offered at the:

• McGill University Hospitals. The Montreal General Hospital and the Jewish General Hospital have one PET/CT unit each and perform two thousand cases annually! each. Most of the scans are fluorodeoxyglucose PET/CT for oncology.
• CSSSG Hospital de Gatineau, affiliated with McGill University (for French speaking training)

CHU Sainte-Justine Centre Hospitalier Universitaire Mere Enfant (CHU Sainte-Justine Mother and Child University Hospital Center)

CHU St.-Justine Hospital Centre is affiliated with the University of Montreal. Pediatric Nuclear Medicine rotations are also offered for French speaking trainees.

Program Director
Dr. Alireza Khatami

Program Administrator
Bilquis Hyder Ali
bhyderali@toh.ca