The Jewish General Hospital is a McGill University teaching hospital, and as such, many of its health care professionals have academic appointments and teach students and trainees at the undergraduate, graduate and postgraduate level.
The JGH is host to medical students, residents and fellows who have come from Montreal and across Quebec, Canada and around the world to train at McGill. Every year medical students in their second and third years have completed rotations at the JGH in medical oncology, surgical oncology or hematologic oncology, under the expert guidance of the physicians at the Segal Cancer Centre. Medical residents who are enrolled in the McGill Department of Oncology’s Residency Training Programs in medical, surgical or radiation oncology also work with Segal Cancer Centre staff as they rotate through the JGH. Oncology training related to specific tumour sites is done under the auspices of other McGill medical training programs and some examples are described below:
Within the context of the General Surgery program, students and residents of all levels are exposed to the importance of early diagnosis, investigation, and treatment of colorectal malignancies. They receive classroom and bedside teaching, operating room experience and participate in morbidity and mortality rounds, which exposes them to the potential problems patients encounter with operative and non-operative treatment. Management of complicated and advanced disease is discussed and the importance of screening for colorectal cancer is emphasized.
Within the context of the Dermatology program, all residents are exposed to the diagnosis and treatments of skin malignancies. They participate in consultations, excisional surgery and Mohs surgery. Bi-weekly teaching sessions on the surgical aspects of skin cancer are covered.
Undergraduate and postgraduate students obtain basic training in diagnosis and treatment of gynecologic cancers including educational principles of screening, surgery, advanced pelvic surgery, robotic surgery, perioperative complications, medical, and radiation oncology. The program requires students and residents to be exposed to gynecologic oncology and ensures comprehensive clinical training. A clinical fellow (ob-gyn specialist) is associated full-time with the team.
Head & Neck Oncology
Teaching occurs both in the clinic and at the bed-side for McGill University residents in Otolaryngology. A full team of four residents are on the Head and Neck Service. In addition we train dietitians, physiotherapists and nurses on a rotation basis from McGill University. Medical students from McGill University also participate in clinical teaching on a rotational basis. We also train oral surgery fellows, radiation oncology fellows as well as general surgery and plastic surgery fellows. A fellowship program at McGill University is offered for a period of one year. Occasionally, we have a rotating medical students or residents from our sister university programs within Quebec.
The teaching program in hematology-oncology is focused on the investigation, management and follow up of ambulatory patients with a wide variety of hematological cancers. Medical students are exposed, through patient interactions, with the basic principles of investigation of patients with a wide variety of hematologic cancers. Medical residents, through electives on the hematology consultation service, participate in out-patient clinics and are taught the principles of both diagnosis and management in the in-patient and out-patient areas. Hematology fellows are assigned to a 12 month horizontal clinic rotation in which ongoing follow up and management is acquired throughout a prolonged exposure to individual patients. Radiation-oncology fellows from McGill exclusively do their out-patient hematology-oncology clinics at the Segal Cancer Centre with concentrated exposure over a 1-2 month period. All participants in the out-patient clinic program are taught the basic principles of diagnostic investigation and basic management of the common hematologic cancers.
Pulmonary Oncology Program
The Pulmonary Oncology Program of the Segal Cancer Centre is very involved in teaching at all levels. Weekly teaching includes tumour board, pulmonary rounds and radiology reviews. Both Pulmonary and Oncology medical residents and fellows rotate through the Pulmonary Oncology clinic. They are also actively involved in clinical research, and numerous fellows have presented abstracts at major international conferences.
First year medical students are introduced to palliative care by visiting a Palliative Care Unit where they meet with a palliative care physician as well as a patient. They also attend a lecture about being a palliative care physician. In their second year, medical students attend small group sessions focusing on various palliative care issues. Third year medical students have a day-long session of lectures and small group discussions covering a wide range of palliative care topics such as pain management, pediatric palliative care, palliative care emergencies, music and art therapy, bereavement etc. Some students in their third and fourth years may also elect to do a rotation in palliative care. Medical residents in Family Medicine or Radiation Oncology are required to do a month-long rotation in palliative care. Medical residents in other disciplines may also choose to do a palliative care rotation. Finally, the “Year of Added Competency” program allows certain eligible residents to spend a full year doing palliative care rotations in the five different McGill teaching hospitals.
Nursing students at the university level (McGill and occasionally from other universities) and CEGEP level do rotations in oncology at the JGH, specifically on the oncology inpatient wards as well as at the oncology clinic.
Psychosocial Oncology Clinical Training
The Psychology Division offers clinical training for pre-doctoral clinical psychology graduate students as part of their requirements for the completion of their doctoral degree. Students with previous experience in psychological assessment and psychotherapy are accepted. Selected students attend full-time (approximately 1600 hours) over the course of one year and receive weekly supervision by several of the senior psychology staff. Students are clinically exposed to cancer patients and their families at all stages of the cancer experience and acquire specialized skills in thought assessment, treatment, supervision and consultation.
Karl Looper, MD, is a psychiatrist specializing in the care of cancer patients. As part of the Consultation-Liaison service of the Department of Psychiatry, Dr. Looper provides psychiatric consultation and treatment at the Segal Cancer Centre and the palliative care service of the Jewish General Hospital. Clinical training is offered to residents enrolled in the post-graduate psychiatry training program of McGill University as well as to elective students, residents, and fellows.
The Social Services Department of the Jewish General Hospital, directed by Allan Ptack, MSW, ts, tcf, is committed to a bio-psychosocial approach to health care in the context of promoting the highest standards of patient-care delivery whether through functions of direct intervention or the associated administrative, consultative, teaching, advocacy and research functions.
Couple and Family Therapy Training Program
Sharon Bond, ts, tcf, PhD, is the Director of Family Therapy, Department of Psychiatry, Jewish General Hospital. The Couple and Family Therapy Section provides couple and family therapy for families presenting with a wide range of couple and family problems including family members with acute and chronic psychiatric and physical illness, such as a cancer diagnosis. It offers a rich, in-depth clinical placement for students interested in developing expertise in the area of couple and family therapy and over the years the service has become a highly desirable clinical internship for students across disciplines. The Program accepts graduate Master’s level students in social work, doctoral interns in psychology, counselling psychology and psychiatric residents in family therapy. The family section offers two postgraduate training programs in Couple and Family Therapy, (one in the English language and one in the French language) accredited by the American Association of Marriage and Family Therapy (AAMFT). In keeping with the tradition of a multidisciplinary approach in Couple and Family Therapy this program draws across multiple disciplines in its curriculum and training including such fields as Social Work, Social and Transcultural Psychiatry, Psychology and Counselling Psychology and Nursing.
The fourth and fifth floors of the Segal Cancer Centre are home to the research laboratories where the clinician scientists and basic scientists conduct fundamental and translational cancer research programs. As members of the Lady Davis Institute for Medical Research and faculty members at McGill, these project leaders supervise and train graduate students (Master’s and PhD), postdoctoral fellows and clinical fellows.
Psychosocial oncology and palliative care are two areas which are also important features of the research landscape of the Segal Cancer Centre. The project leaders are members of the Lady Davis Institute for Medical Research and faculty members of McGill, and supervise and train graduate students (Master’s and PhD) and postdoctoral fellows.
Continuing Professional Education
Health care professionals at the Segal Cancer Centre are encouraged to continue to hone their skills and keep abreast of the latest advancements in all aspects of cancer care, from treatment to medical and psychosocial support. Many attend national and international conferences and not only learn from their colleagues but also present their own work. In addition, they attend seminars given by fellow staff as well as local, national and international colleagues.
The JGH often hosts lectures organized by the McGill University/Université de Montréal Visiting Speakers Program in Oncology, while the JGH’s Cancer Care Nursing Research Rounds is open to health care professionals in other hospitals, CLSCs and palliative care facilities across Quebec. The JGH Palliative Care course Grief, Loss, Death and Dying is offered to Segal Cancer Centre staff as well as to other health care professionals across the province. Other continuing professional education initiatives are currently being explored.
Volunteer Support Training
Hope & Cope relies on well-trained volunteers who provide psychosocial support, assistance and guidance to cancer patients and their families. New volunteers are required to attend a comprehensive general orientation and are then given additional training specific for the team they will be involved in. Hope & Cope also provides ongoing training and support to all of its volunteers and provides opportunities for them to learn and further develop their skills. These opportunities include a Hope & Cope Volunteer Conference Day, held every two years, and, where appropriate, funding to attend national conferences.