Welcome

The fellowship in Metabolic Bone Disease is a 1 year clinical research program. Successful completion of the program will enable the fellow to evaluate , diagnose and provide evidence based management of complex metabolic bone diseases. These include osteoporosis in pre and postmenopausal women as well as in men, fibrous dysplasia, sclerotic bone diseases, osteomalacia, osteogenesis imperfecta, hypophosphatasia, X-linked hypophosphatemia , renal osteodystrophy and paget's disease. The fellow will also gain competence in evaluating complex calcium and parathyroid disorders as well as an understanding of how and when to complete genetic testing for calcium disorders as well as metabolic bone diseases. The fellow will attend the American Society of Bone and Mineral Research annual scientific meeting and submit research for presentation at this meeting . The fellowship curriculum is outlined in the American Society of Bone and Mineral Research Primer. It is expected that the fellow will be gain this knowledge and the clinical skills to implement this knowledge in clinical practice. The fellow will attend the International Society of Clinical Densitometry certification course and obtain ISCD certification in the interpretation of BMD studies. It is expected that the fellow will be involved in clinical research and present at the ASBMR annual scientific meeting as well as at the ISCD annual scientific meeting. 

Certification Outcome

Successful completion of the fellowship will provide the fellow with a McMaster University certificate confirming competence in Metabolic Bone Disease 

Entry Requirements

Requirements - certification in Endocrinology and Metabolism 

Application Deadline

9 months prior to start date 

Goals of Training

Medical Expert

1. gain an in-depth understanding of bone biology and the mechanisms for the development of metabolic bone disease and calcium and parathyroid disorders
2. be able to evaluate and diagnose and provide evidence-based management of complex metabolic bone diseases including fibrous dysplasia, sclerotic bone diseases, osteomalacia, osteogenesis imperfecta, hypophosphatasia, X-linked hypophosphatemia, renal osteodystrophy, premenopausal osteoporosis, Paget's disease as well as calcium and parathyroid disorders
3. become familiar with performing bone biopsies 
4. become certified by the ISCD in interpreting DXA (dual-energy x-ray absorptiometry) studies 
5. gain experience in interpreting DXA studies 

Collaborator

6. complete a clinical research project and publish in a high profile peer-reviewed journal 
7. complete inpatient and outpatient clinical assessments evaluating metabolic bone disease in all ages 
8. attend clinics and rounds and appreciate the value of the multidisciplinary team in addressing care issues 
9. attend journal clubs, endocrine rounds at McMaster University and University of Toronto 
10. work effectively as a member of an interdisciplinary health care team

Scholar and Communicator

11. present at citywide Endocrine Rounds as well as at Endocrine Journal club and at the Academic Half day 
12. educate patients and establish a therapeutic relationship with patients and family members 
13. educate health care professionals, medical students, and residents
14. evaluate medical information and its sources critically and translate new knowledge into clinical practice and assist others in incorporating an evidence-based approach to clinical care 

Manager

15. wisely utilize the limited health care resources inpatient care both inpatient as well as outpatient care 
16. effectively partner with hospital and clinic resources in efficiently managing available services 
17. appreciate the value and role of audits and budget reviews 

Health care advocate

18.  recognize health care requires support and be able to advocate for patients health care needs
19. educate community members regarding measures which can prevent skeletal disease and improve skeletal health 
20. promote the health care needs of the public at risk of parathyroid and skeletal disease as well as patients needs

Professional

21. understand and demonstrate principles of medical ethics as it relates to patient care 
22. be willing to accept peer and supervisor reviews of professional competence 

Length of Training

1 year

Curriculum Highlights

Clinics and Inpatient Responsibilities

Attend the following clinics

• Monday am - Calcium Disorders Clinic at the Boris Clinic MUMC
• Monday pm – Metabolic Bone Clinic
• Tuesday am- dedicated research time
• Tuesday pm – Metabolic Bone Clinic and inpatient consults OTMH
• Weds all day - Metabolic Bone Clinic and inpatient consults OTMH
• Thursday all day – Metabolic Bone Clinic and inpatient consults OTMH
• Friday – dedicated research time

International Meetings

Attend and present at the American Society of Bone and Mineral Research annually as well as the International Society of Clinical Densitometry and The Endocrine Society.

Educational Rounds

Monthly attend and participate in the Endocrine Grand Rounds, Journal Club, Academic half-day in the department of Endocrinology and Metabolism.

Supervision & Feedback

 Evaluations will be formally completed during the fellowship and will include ITER, Webeval as well as Pre-Entry Assessments 

Associated Programs