Overview
The Centre for Clinical Ethics (CCE) at Unity Health Toronto and the Department of Family and Community Medicine at the University of Toronto—in collaboration with the Centre for Addiction and Mental Health (CAMH), Ontario Shores Centre for Mental Health Sciences (OSCMHS), Sinai Health (SH), and University Health Network (UHN)—invite applications for a two-year, full-time fellowship in clinical, organizational and research ethics, starting in August 2022 in Toronto, Canada.

The CCE (http://www.ccethics.com) is part of Unity Health Toronto, a health network composed of Providence Healthcare, St. Joseph’s Health Centre, and St. Michael’s Hospital. Committed to the mission and values of Unity Health Toronto, the CCE’s goal is to enable members of the healthcare community to identify and resolve ethical issues that arise in the clinical setting. The CCE’s core activities include case consultation, education, policy development, research ethics, and academic research.

In addition to its work within Unity Health Toronto, the CCE also provides ethics services to a range of hospitals and health systems across Ontario: Lakeridge Health, Scarborough Health Network, St. Joseph’s Health System-Hamilton, Toronto Grace Health Centre, Runnymede Healthcare Centre, and Waypoint Centre for Mental Health Care.

The purpose of the fellowship program is to train individuals to be competent practicing healthcare ethicists across diverse healthcare environments. Fellows who complete the program will be equipped to work in both faith-based and non-faith-based healthcare settings and will possess the knowledge, skills, and competencies required to work in a Catholic healthcare setting.

The Fellow will spend two years learning from and contributing to the ethics programs at Unity Health Toronto and across the CCE’s partner organizations, engaging in the programs’ intellectual and scholarly activities, and participating in regular educational and professional development sessions. The Fellow will thereby enhance their knowledge, skills, and competencies in the core areas of clinical, organizational and research ethics (ethics consultation, policy development, education, research review, and academic research). There will be an emphasis on developing leadership capacity in these areas.

Partnerships
Through an ongoing collaboration with CAMH, OSCMHS, SH, and UHN, the Fellow will have the opportunity to spend a significant portion of the fellowship (between 6-12 months) rotating through CAMH, OSCMHS, SH, and/or UHN sites and working closely with their respective bioethics departments. The rest of the Fellow’s time during the program will be spent within Unity Health Toronto and its contract sites.

The Centre for Addiction and Mental Health is Canada's largest mental health teaching hospital and one of the world's leading research centres in its field. CAMH is fully affiliated with the University of Toronto and is a Pan American Health Organization/World Health Organization Collaborating Centre.

Ontario Shores Centre for Mental Health Sciences is a leader in mental health care, providing a range of specialized assessment and treatment services for people living with complex mental illness. Patients benefit from a recovery-oriented environment of care, built on compassion, inspiration and hope. Ontario Shores engages in research, education and advocacy initiatives to advance the mental health care system.

Sinai Health is a leading academic health science centre across the health continuum. A fusion of science, innovation, care and learning has earned Sinai Health international, national and provincial leadership for unique programs and compassionate care. Sinai Health is comprised of Mount Sinai Hospital, Hennick Bridgepoint Hospital, the Lunenfeld-Tanenbaum Research Institute and our system partner Circle of Care.

University Health Network is the largest health research organization in North America and ranks first in Canada for total research funding. It was created through the merger of four major hospitals: Toronto General Hospital, Toronto Western Hospital, the Princess Margaret Cancer Centre and the Toronto Rehabilitation Institute. It also includes the Michener Institute of Education.

The fellowship’s academic home is the Department of Family and Community Medicine at the University of Toronto. The Fellow will receive a Certificate of Completion from the University of Toronto upon fulfilment of the program’s completion requirements and the full term of employment with Unity Health Toronto.

Assessment and Completion Requirements
The fellowship is driven by a competency-based education and assessment framework that the CCE has presented at the International Conference on Residency Education, the annual Canadian Bioethics Society conference, and the American Society for Bioethics and Humanities’ annual conference.

The Fellow’s progress through and completion of the fellowship will be assessed using a combination of event-driven real-time assessment, periodic formative assessments, and summative assessment, within a competency-based framework.

Completion requirements of the program include: ongoing educational modules on core topics in healthcare ethics and Canadian healthcare law; independent scholarly work in healthcare ethics theory or practice (including completion of a manuscript suitable for peer-reviewed publication and submission of an abstract to the Canadian Bioethics Society annual conference or an equivalent conference); at least three Ethics Grand Rounds presentations at Unity Health Toronto or partner hospitals; a specialized education series focused on complex ethical issues relevant to Catholic healthcare institutions; at least three simulation clinical ethics consultations (with simulation-patient actors); a summative one-year review; a record of supervisor-reviewed/evaluated independent clinical ethics consultations during the second year; and an assessment of readiness for practice at the end of the second year.

After a preliminary period focused primarily on immersive education and observation (typically 2-4 months), the Fellow will begin developing greater independence. It is a goal of the program for the Fellow to be providing independent clinical ethics consultation by the end of the first year.

Upon successful completion of a one-year review (at approximately the 12-month mark), a Fellow will transition to the Senior Fellow role for a second year, which is accompanied by an increase in compensation and responsibility.

Compensation
Fellows receive CAN$45,500 (plus 4% in lieu of vacation) over the course of the first year. The current salary of a Senior Fellow (in the second year of the fellowship) is CAN$59,900 (plus 4% in lieu of vacation). These are the expected yearly salaries a Fellow and Senior Fellow would receive when taking their entitled two weeks of unpaid vacation time each year. Fellows are entitled to paid statutory holidays. 

In addition, the CCE will reimburse Fellows for their University of Toronto registration fees, as well as their registration fees and travel expenses for the Canadian Bioethics Society annual conference and (with approval) other relevant conferences. In the second year, Fellows will the receive financial support to complete the Healthcare Ethics Consultant-Certified (HEC-C) certification exam.

Eligibility and Entry Requirements

The ideal candidate will hold a graduate degree (preferably a doctoral degree) in a field relevant to bioethics (e.g., bioethics, law, medical science, theology, religion, or philosophy). The ideal candidate will also have undertaken significant course work in ethics, including (but not limited to) bioethics, and have some previous experience in applied clinical or organizational ethics.

Strong consideration will be given to candidates with academic training in bioethics who also have training and experience in a regulated health profession (e.g., medicine, nursing, occupational therapy, pharmacy, social work).

Each applicant is expected to propose a research project involving healthcare ethics theory or practice that could be completed within 12-24 months, resulting in a manuscript appropriate for publication. The applicant is asked to submit a brief description of the proposed research project, including an explanation of why the applicant believes it will be meaningful to the field.

Applicants will be assessed and ranked based on (1) their relevant academic training, including their academic training in ethics; (2) their experience in applied clinical and/or organizational ethics; (3) their experience in healthcare environments; (4) their commitment to continuing to work in the field of clinical or organizational ethics; (5) evidence of their ability to excel in the fellowship program, based on its structure and requirements; (6) their potential to contribute to the field of bioethics; (7) their interpersonal skills; and (8) the suitability and feasibility of their proposed research project.

Applications will be reviewed by a committee that will include staff from the CCE and Unity Health Toronto and may include staff from CAMH, OSCMHS, SH, UHN, and other CCE partners.

Unity Health Toronto encourages applications from qualified candidates, and we especially welcome applicants who are Indigenous, Black or Racialized, persons with disabilities, people who identify as 2SLGBTQIA+, and all others who may contribute to the further diversification of ideas.

As a condition of employment, all external hires will be required to submit proof of COVID-19 vaccination or documentation unless a valid accommodation under the Ontario Human Rights Code exists. All internal candidates must be in compliance with Unity Health Toronto’s COVID-19 Vaccination Policy. 

Applicants must be eligible to work in Canada for the duration of the fellowship program.