Introduction

Metabolic Medicine and Bariatric Medicine involves the care of patients with a wide range of long-term conditions, which require considerable expertise. Some of the conditions are very common; examples are metabolic syndrome, obesity, lipid disorders, osteoporosis and diabetes. Others are rare and include inherited disorders of the metabolism. Metabolic Medicine encompasses the assessment of patients with such disorders, the use of laboratory methods for diagnosing and monitoring such conditions and their treatment.

Bariatric medicine is the branch of medicine that specifically deals with the causes, prevention and treatment of obesity and its complications. With the growing epidemic of diabetes and obesity in Canada and the development of new therapeutics available to treat these conditions, there is a need to rigorously train physicians in this discipline to enhance their ability to provide expert care and understanding emerging therapeutics.

The Bariatric Medical and Surgical Clinic at Saint Joseph’s Hospital is a center of excellence (BCoE) that provides comprehensive patient-centred care for obese patients. Referrals are received from the Ontario Bariatric Registry Portal. Patients go through a thorough assessment program that includes an orientation session and appointments with a bariatric nurse, psychologist and/or social worker and registered dietitian. Patients are asses for medical treatment of obesity and/or consideration for bariatric surgery. There are two internists in the clinic that see patients prior to surgery to assess surgical risk, fitness for surgery and optimize medical conditions. The clinic is unique in the sense that it provides collaborative care within a multidisciplinary team.

Certification outcome

The successful completion of the fellowship will grant a Fellowship McMaster Certification.

Entry Requirements

The fellowship program is designed for current residents or recent graduates of internal medicine, surgery and family medicine programs. Recent graduates are required to submit an application form and comply with McMaster University Postgraduate Medical Education requirements for residents and fellows.

Residents enrolled in the programs of general internal medicine, medicine subspecialties and/or family medicine may participate in this training program with the approval of their Program Director.

Goals of training

Upon the completion of training the trainee is expected to be competent in the following:

Length of Training

This training program is not time-based but competency-based. Training is flexible to accommodate the fellow’s career goals according to his/her baseline knowledge and skills.

This training program is self-directed, trainees are encouraged to set up their own schedules and clinics according to their interests and educational needs.

Curriculum highlights

Training will be delivered in the ambulatory setting with inpatient consultations as required. The main objective of the training is to provide clinical training in several overlapping areas of medicine with focus on obesity, diabetes, lipid disorders, bone health and nutrition. A formal academic curriculum will be developed that will consist of clinical sessions, lectures, journal clubs, group discussions, clinical research and multidisciplinary clinical team meetings.

Supervision & Feedback

The trainee will have a supervisor who will review his/her work regularly. Details of clinical exposure, attendance to meetings and lectures will be recorded in a resident logbook. Supervisors’ evaluations will be used as evidence of satisfactory progress. 

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