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Metabolic Bone Disease Fellowship Program at McMaster University

Introduction

McMaster University provides both 1 and 2 year fellowship programs in Metabolic Bone Disease. 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 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 , Rheumatology, Geriatrics or Nephrology.

Application Deadline

9 months prior to starting date.

Director

Professor Aliya A. Khan is the Founding Director of the Fellowship in Metabolic Bone Disease at McMaster University. This is the first program to offer both 1 and 2 year clinical research fellowships in Metabolic Bone Disease in Canada.

Fellows Past and Present

  • Dr. Waleed Hashem – July 2014-July 2015
  • Dr. Yasser Hakami – July 2015- June 2016
  • Dr. Mohamed Almutairi – July 2016- June 2017
  • Dr. Yusuf Alalawi – July 2018 – July 2019
  • Dr. Karel Dandurand – September 2020 – September 2021
  • Dr. Dalal S. Ali – September 2020 – August 2023.
  • Dr. Farah Al-Sarraf – September 2021- December 2022
  • Dr. Khulod Almonaei – September 2021 – August 2022.
  • Dr. Hatim Al-Alwani February 2022 – March 2023.
  • Dr. Abdulrahman Alamri July 2022 – June 2023.
  • Dr Salwa Hussein March 2023 – February 2024

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

  1. Complete a clinical research project and publish it in a high-profile peer-reviewed journal.
  2. Complete inpatient and outpatient clinical assessments evaluating metabolic bone disease in all ages.
  3. Attend clinics and rounds and appreciate the value of the multidisciplinary team in addressing care issues.
  4. Attend journal clubs and endocrine rounds at McMaster University and the University of Toronto.
  5. Work effectively as a member of an interdisciplinary health care team.

Scholar and Communicator

  1. Present at citywide Endocrine Rounds as well as at Endocrine Journal club and at the Academic Half day.
  2.  Educate patients and establish a therapeutic relationship with patients and family members.
  3. Educate health care professionals, medical students, and residents.
  4. 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

  1. Wisely utilize the limited health care resources in inpatient care as well as outpatient care.
  2. Effectively partner with hospital and clinic resources in efficiently managing available services.
  3. Appreciate the value and role of audits and budget reviews.

Health care advocate

  1. Recognize health care requires support and being able to advocate for patients’ health care needs.
  2. Educate community members regarding measures which can prevent skeletal disease and improve skeletal health.
  3. Promote the health care needs

Professional

  1. Understand and demonstrate principles of medical ethics as it relates to patient care.
  2. Be willing to accept peer and supervisor reviews of professional competence.

Length of Training

1 year and 2 year programs are available

Curriculum Highlights

Clinics and Inpatient Responsibilities

Attend tertiary care metabolic bone disease clinics as well as inpatient consultation

  • Monday a.m. – Calcium Disorders Clinic at the Boris Clinic MUMC

  • Monday p.m. – Metabolic Bone Clinic

  • Tuesday a.m.- dedicated research time

  • Tuesday p.m. – Metabolic Bone Clinic and inpatient consults OTMH

  • Wednesday all day – Metabolic Bone Clinic and inpatient consults OTMH

  • Thursday all day – Metabolic Bone Clinic and inpatient consults OTMH

  • Friday – dedicated research time

Foundations of Health Research Methods

Health research involves the systematic collection and analysis of data to improve our understanding of health and illness. There are several types of health research methods, including observational studies, experimental studies, and systematic reviews. It is important for researchers to be familiar with the wide range of research methodologies, their biases and strengths, and have ability to choose the most appropriate methodology to address the research question in a rigorous and unbiased way.
 
This specialized program has been designed for McMaster University Metabolic Bone disease fellows and will cover the following topics:

  1. Developing a research question: An overview on how to develop a good research question in evidence-based clinical practice including how to conduct a literature review and formulating questions according to the PICO format  population, intervention, comparison, outcome)
  2. Study design: An overview of the different types of study designs, including cross-sectional, case-control, cohort and randomized controlled trials.
  3. Research ethics: An overview of ethical considerations involved in health research, such as obtaining informed consent, protecting confidentiality, and minimizing harm
  4. Research dissemination: An overview of how to effectively disseminate research findings, including academic  publications, conference presentations, and dissemination to the public or stakeholders.
  5. Systematic reviews and meta-analyses: A review of how to conduct systematic reviews and meta-analyses, including searching for relevant studies, critically appraising the quality of studies, and synthesizing the results.
  6. Cost-effectiveness and economic evaluation: An overview of how to conduct cost-effectiveness and economic evaluations, including how to identify costs and outcomes, how to conduct sensitivity analysis and how to interpret results.

Objective

This program will focus on quantitative research methods commonly used in health research, such as observational studies, experimental studies, and systematic reviews. Students will learn about the different types of quantitative research designs, their
advantages and limitations, and how to select the most  appropriate methodology for their study.


The course will also cover how to develop a good research question, how to critically evaluate existing research studies, data collection and analysis, ethical considerations in health research, and knowledge dissemination. Upon completing the course, students will have a solid understanding of the basics of quantitative research methods and will be equipped with the knowledge and skills to design and conduct their own quantitative research studies. Additionally, students will be able to evaluate the research work of thers critically and make evidence-based decisions.

Format

The program will include interactive large group sessions and discussions once a week on Fridays for one hour. Sessions will take place remotely via Zoom.

Schedule

Date

Unit

Session

February 3, 2023

1

Introduction and developing a research question

February 10, 2023

2

How to conduct a literature search

February 17, 2023

3

Systematic Reviews and meta-analysis

February 24, 2023

4

Observational Studies

March 3, 2023

5

Randomized Control Trials

March 10, 2023

6

Measures of disease frequency

March 17, 2023

7

How to Sample

March 24, 2023

8

Ethics

March 31, 2023

9

Knowledge translation

International Meetings

It is expected that fellows will 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 attendance and participation in the McMaster University City Wide Endocrine Grand Rounds, Journal Club, and 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.

International Research Award Winners :

McMaster University Metabolic Bone Disease Fellows – winners of International Research Awards under the supervision of the Fellowship Director Professor Aliya A. Khan

  1. Dr Waleed Hashem – International Society for Clinical Densitometry – Young Investigator Award
    for outstanding research abstract “ Atypical Femoral Fractures – histomorphometric features”
    ISCD Annual Scientific Meeting Illinois USA February 2015
  2. Dr Karel Dandurand – American Society of Bone and Mineral Research – Young Investigator Award for “ Barakat Syndrome – A mini -series” ASBMR Annual Scientific Meeting 2021
  3. Dr Dalal Ali – Endocrine Society – Outstanding Abstract –“Transition from low dose denosumab 30mg to iv zoledronic acid: effect on bone mineral density in postmenopausal women with osteoporosis – a prospective observational study” ENDOCRINE society Annual Scientific meeting 2022 
  4. Dr Dalal Ali – Endocrine Society – C. Wayne Bardin International Travel Award for outstanding abstract “ Genotype and Phenotype correlations in calcium sensing receptor mutations”   ENDOCRINE society Annual Scientific meeting 2023 Chicago
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Dr. AbdurRahman Alamri completed his fellowship with outstanding performance June 2023

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Dr. AbdurRahman Alamri completed his fellowship with outstanding performance June 2023

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Dalal Ali Fellow Recipient of Outstanding abstract Award by Endocrine Society 2022

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Dr Farah Alsarraf Fellow presenting at CSEM Annual Scientific Meeting 2022

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Congratulations to Dr Hatim Alalwani on completing his fellowship in Metabolic Bone Disease Feb 2022

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Dr. Khulod Almonaei completed her fellowship in metabolic bone disease in June 2022

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Dr. Karel Dandurand , Fellow 2020 - 2021

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Congratulations to Dr. Khulod Almonaei who completed her fellowship in metabolic bone disease in June 2022

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Dr. Dalal Ali, Fellow 2020 - 2021

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Dr. Waleed Hashem completed his fellowship in Metabolic Bone Disease in 2015 was also awarded the Young Investigator Award by the International Society of Clinical Densitometry (ISCD) for, “Atypical Femoral Fractures histomorphometric features” which was presented at the  ISCD Annual Meeting in Illinois in February 2015.

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Dr. Yusuf Alalawi alongside Dr Khan after the completion of his fellowship in Metabolic Bone Disease in July 2019

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Fellowship teaching session Sept 2021

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Dr. Karel Dandurand alongside Dr. Khan after the completion of her fellowship in Metabolic Bone Disease

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Dr. Karel Dandurand received the ASBMR "Young Investigator Award" in October 2021

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Dr Dalal Ali celebrating the completion of the first year of her two year fellowship in Metabolic Bone Disease

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Dr Yasser Hakami completed his fellowship in Metabolic Bone Disease in June 2018

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