Episode 002: UofT new faculty round table mini series (Part 2/4)
Guests: Dr. Parul Tandon, Dr. Fernanda Onofrio, Dr. Alexa Sasson, and Dr. Ali Kohansal
SHOW NOTES
Huaqi Li
Thanks so much for tuning in again to Scope Notes, your gastroenterology focused medical education podcast created by learners for learners!
For any new listeners, I’m your co-host Huaqi Li, current first year Internal Medicine resident at the University of Toronto in Canada working together with my co-host Mo Bucheeri, 5th year Gastroenterology fellow and Chief Resident also at the University of Toronto. Our amazing faculty advisor is Dr. Parul Tandon, a Staff Gastroenterologist and Clinician Scientist in Inflammatory Bowel Diseases at the University Health Network/Sinai Health in Toronto.
With Scope Notes, you can look forward to monthly episodes covering all things GI including practice guidelines, research reviews, and special career topics! We’ll be specifically featuring prominent Gastroenterology staff from the University of Toronto and across Canada for their expert opinions. So come join us from your favorite podcast streaming app!
We would like also to extend a big thank you to the Division of Gastroenterology and Hepatology at the University of Toronto for their generous support of this podcast.
With all that being said, let’s move on to our episode!
Today, we’re joined by the wonderful Dr. Fernanda Onofrio, a staff Hepatologist at the Toronto Centre for Liver Disease and Francis Family Liver Clinic. Today will be part 2 of our current 4-part mini-series featuring new faculty in the Division of Gastroenterology and Hepatology at the University of Toronto!
Hi Dr. Onofrio, welcome to Scope Notes, and thanks so much for joining. To get us started, could you share with our listeners a bit about yourself and your training background?
Dr. Fernanda Onofrio
Sure. So I'm originally born and raised in Brazil, where I completed my medical training, my GI residency, and followed by my Master's and PhD in Hepatology. And after that, I completed fellowships in clinical Hepatology, two years of clinical Hepatology here at U of T, and then transplant Hepatology at U of T as well. And then I was recruited by the University of Ottawa as an assistant professor and clinician teacher at The Ottawa Hospital, where I spent the last three years until joining UNH again, but at this time as a staff Hepatologist.
Huaqi Li
That's amazing. So you trained in Brazil, you trained in Ottawa, and obviously you trained in Toronto. How have your experiences thus far shaped your career and practice?
Dr. Fernanda Onofrio
I would say my interest in Hepatology started in Brazil because most of my GI mentors were Hepatologists, and the center was a reference for liver transplant. So there was a strong influence in studying liver disease, and also when I started practicing as a GI, most of my patients had liver diseases, and that's why I ended up doing my Masters and Doctorate in the Hepatology post-graduate program of that university. So there was a strong influence in Hepatology.
Huaqi Li
And were you always interested in transplant Hepatology? I feel like that’s a bit more niche compared to all the other training that you've done.
Dr. Fernanda Onofrio
No, no. That's why I ended up at pre-transplant Hepatology management if you can say that, because even though I did a transplant Hepatology fellowship, I don't see post-transplant patients. Now, I see mostly pre-transplant patients.
Huaqi Li
Gotcha. Would you say the patient population or the practice is quite different from Brazil versus Canada, or the medicine is pretty similar?
Dr. Fernanda Onofrio
Not really. We have more rare diseases here because of the way that Toronto is, but overall, many similar diseases for sure.
Huaqi Li
Gotcha. To add on to that, what drew you to working at the University of Toronto, and what have you enjoyed the most so far?
Dr. Fernanda Onofrio
I would say many factors that attracted me to U of T, the expertise and quality of patient care provided by the Hepatologists here, the resources that are available to support and implement a multidisciplinary clinic, which is one of my goals, my dream, the access that we have here to high level work interactions with other related specialties. And last, but not least, important is the fact that I was trained here and that I had such a special relationship with the physicians here, the nurses, the clerks. And so far, what I enjoyed most was the super easy access to high level colleagues to discuss cases, and the nurse support while implementing my, our, multidisciplinary alcohol related liver disease clinic.
Huaqi Li
That's amazing. I think the people you work with are so important to your day-to-day for sure. You mentioned it a little bit, but can you tell us a bit more about the specific program you're working on in Toronto?
Dr. Fernanda Onofrio
Yeah. So we are trying to bring a more comprehensive approach to the care of patients with alcohol related liver disease, to offer a multidisciplinary management which comprises the involvement of mental health, addiction, social medicine and nutrition teams. And my idea is that having experts in each area joining the clinic would ensure that patients have access to integrated care in a timely manner. In addition to that, a systematic assessment would gather important data that could be used to develop stratification and monitoring tools to follow these patients long term.
Huaqi Li
If I wanted to, for example, refer a patient to the program. How would you go about doing that?
Dr. Fernanda Onofrio
So ideally, we would like to have a referral tool that we could refer patients internally, but also for community physicians, like for family physicians who want to refer to the program, so it would be like, easy access, and we plan to implement even on OCEAN, because now it would be easier for those places that are far from Toronto, but they don't have access to a specialist.
Huaqi Li
That's a great point. I think the access is definitely a big issue. And to add on to that, where do you see your program in the next five years?
Dr. Fernanda Onofrio
So hopefully we can implement the program and maintain a well-structured, multi-disciplinary clinic that could become a reference center in the management of alcohol related liver disease patients with national and international connections with other similar centers that have similar programs, right? So that would be the goal, the dream, if we can say that.
Huaqi Li
That’s sounds really interesting and sounds like you have quite a bit of important work ahead of you. To end off, do you have any advice for listeners who are GI trainees or Internal Medicine trainees who are hoping to pursue Gastroenterology and/or Hepatology.
Dr. Fernanda Onofrio
So those who are pursuing GI or Hepatology, my advice would be to take all the opportunities for learning that come up during your training. Show interest, ask questions, stay a bit longer if you want to see your staff removing a large polyp or shadow your staff to see them in action. Write a paper with a worldwide recognized GI scientist. Learn how to be empathetic with patients when you are shadowing a clinic. Learn how to be efficient in charting. GI and Hepatology are broad fields with so many potential areas of interest, such as research, education, endoscopy, clinical practice, leadership. So trainees should be exposed to all the possibilities before deciding what they want to do long term and that exposure would also help them to shape a better trained GI specialist or Hepatologist.
Huaqi Li
Yes, definitely it's a very broad field for sure. That's really helpful. So thank you so much Dr. Onofrio, it was great learning more about your career path so far. That’s it for our episode today! Thanks so much to our listeners for tuning in, join us again next week for part 3 of our new faculty mini-series!
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