Program Director(s):
Peter Metrakos
Prosanto Chaudhury
Description:
The Fellowship is a two year integrated Hepato-biliary and Pancreatic (HPB) with a Liver Transplant Component. The trainee will have opportunity to participate in ongoing clinical and translational research, and an optional third year is offered to complete a post-graduate degree in clinical or basic science research.
The goal of the Fellowship is to develop academic surgeons in the field of HPB surgery. The trainee will be exposed to the full spectrum of HPB pathologies and treatment. The trainee will acquire the clinical knowledge and experience required to master the pathogenesis, diagnosis, management (medical and surgical) of diseases of the liver, biliary tract and pancreas.
The 2 year HPB Fellowship accepts 1 individual each year and operates in parallel with the 2 year ASTS accredited Kidney and Pancreas Transplant Fellowship.
The structure of the Fellowship is as follows:
First year
This year focuses on the acquisition of an understanding of the diagnosis and management of HPB pathology with a focus on outpatient management. The trainee will participate in outpatient activities in the HPB clinic, the multi-disciplinary HPB oncology clinic, Hepatocellular Carcinoma clinic, and in all weekly service meetings including HPB Tumour Board, Service rounds, Liver listing rounds, Neuroendocrine Tumour Board (monthly) and Biliary rounds (monthly). In addition didactic teaching sessions are held weekly, and journal clubs take place on a monthly basis during the academic year. The trainee will participate in organ procurement call (shared with the other fellows), in elective HPB cases and transplants, and will cover the service along with the senior fellow.
In addition, the trainee is expected to become involved in ongoing clinical and translational research activities and generate his/her own research projects.
The trainee will also be involved in the teaching of residents and students.
Second year
The second year focuses on the consolidation of operative skills and in-patient management. The trainee will continue their responsibility for the in-patient service, and participate in elective HPB cases as well as all liver transplants. Participation in all weekly service meetings and didactic teaching sessions continues in the second year, and the trainee is expected to be actively involved in the clinical teaching of housestaff and students. Although there will be a reduction in outpatient activities there will still be clinics assigned on a biweekly bases.
During this year, the trainee will continue to participate in organ procurement call and wil complete the research projects begun in the first year.
Over the two year fellowship there is latitude to tailor rotations to the Fellow’s academic/research goals.
Basic Program Information:
- Location: Montreal, Quebec, Canada
- Primary Program Site: McGill University Health Center
- Primary Hospital: Total bed size, # OR's, # Surgical ICU beds: 600 beds, 20 OR's, 50 ICU beds
- Secondary Program Site:
- Secondary Hospital: Total bed size, # OR's, # Surgical ICU beds:
- Clinic locations and schedule:
HPB and General surgery clinics are held 3 times per week at the Royal Victoria Hospital and Cedars Cancer Center of the MUHC
The Fellow will also lead a Fellow clinic where he will see new consults, provide assessment and provide follow up after surgery.
- University Affiliation: McGill University
- School of Medicine Affiliation: McGill University Medical School
- Year Program and/or Designation Established: 2001
- Number of Faculty: 6
- % of Program Clinical: 60
- % of Program Research: 40
Additional Program Information:
- Interaction with Residents: Share cases with residents
- Is there a General Surgery Residency at the Primary Institution? Yes
- Is there a General Surgery Residency at the Secondary Institution? No
- Is there a curriculum in place for fellowship? Yes
- Is there a skills lab at the institution with fellow access? Yes
- Are there teaching conferences available for the fellow? Yes
- Is there an evaluation tool for fellow by faculty in place? Yes
- Is there an evaluation tool for faculty by fellow in place? Yes
- Papers Accepted For Publication where PD was an author: 30
- Publications that Involved Input from the Fellow: 4
- Are funds available for the Fellow to attend conferences? No
Malpractice Insurance Information:
- The fellow(s) only works as a fellow, i.e. does not/will not have attending privileges and the program provides the following:This is a Canadian program. Exceptions are made for Canadian-based programs because of their governmental regulations and Sovereign immunity.
Contact Information For Questions:
Veronica Atehortua
Phone: 514-934-1934 ext 65657
Fax: 514-843-1434
Email: veronica.atehortua@muhc.mcgill.ca
Web:
Facilities
Dry Lab
Wet lab
Library
Administrative Support
Basic Science Research
Clinical Research
Simulation Lab
Citizenship and Visa Requirements:
US Citizens US Permanent Residents (Green Card) Canadian Citizens Canadian Permanent Residents Non Canadian Citizens eligible for/with planned Canadian Work Permit during their fellowship (For Canadian Fellowship Programs)Medical School Requirements:
We accept graduates of U.S. or Canadian Medical Schools and Foreign Medical SchoolsExaminations and Certifications:
Applicants must have passed the USMLE/COMLEX Step 1, 2, & 3 exams Applicants must have passed the USMLE/COMLEX Step 1 & 2 exams or the Medical Council of Canada Evaluation Exam (MCCEE) Applicants who are ABS or Canadian Board Eligible or Certified Applicants who hold a General Surgery specialty certificate from a Board or College outside of U.S. or Canada at the beginning of the fellowship Applicants must be AOBS (American Osteopathic Board of Surgery) eligible or certifiedLicensure Requirements and Information:
By University and Quebec Medical College requirements we are able to accept fellows as follows: (further details available from the Faculty of Medicine at http://www.medicine.mcgill.ca/postgrad/admission_fellowships.htm)
Fellowships are for:
Trainees who have completed a full Specialty Program: Residency Programs and
Trainees who hold a Specialty Certificate from a Board or a College and 
Trainees who have completed the MCEE or MCCQEI-II or USMLEs (Deans letter of support may also be acceptable)
Admissions Requirements:

Fellows must meet all of the following conditions:
-Be Medical Doctors who are graduates of Medical Schools listed in the Faimer Directory

-Be Physicians who are recognized as Specialists in Canada or abroad

-Obtain a letter of eligibility and satisfy the requirements of the Collège des médecins du Québec.

-Hold a valid Work Permit such as required by Citizenship and Immigration Canada, if applicable
Licensure Requirements
(Further details available from the College at http://www.cmq.org/en/EtudiantsResidents/PerfectionnementFellow.aspx)
* Have a medical degree from a medical school or university listed in the directory of the Foundation for Advancement of International Medical Education and Research (FAIMER-IMED); * furnish proof of one’s acceptance in a university program in family medicine or in a specialty (letter from the dean or from the assistant dean of the faculty of medicine indicating the discipline, the dates and places where the periods will be served); * also furnish proof of one’s acceptance into a host or exchange program approved by the faculty of medicine or government authority (letter from the government of a country or faculty of medicine or from the Government of Québec or Canada or from an international or scientific organization); * have successfully completed - the Evaluation Examination of the Medical Council of Canada or - the United States Medical Licensing Examination/Step 2 or - hold a standard certificate from the ECFMG.
N.B.: A candidate who holds a specialist’s certificate may be exempted from this condition by forwarding to the CMQ two (2) letters of recommendation: one from the dean of the faculty of medicine of origin, recommending the candidate to the dean of the faculty of medicine in Québec, and one from the dean of the faculty of medicine in Québec accepting the said recommendation.
| Accreditation Status | Accreditation Period | Length of Accreditation | Accredited for HPB | 2025-2027 | 2 |
|---|
Fellowship Opportunity # 1
- Number of Positions Available: 1
- Type of Fellowship: HPB
- Duration: 2 year
- Start Day: July 1
- End Day: June 30,
- Is this a salaried position? Yes
- It is a requirement that the salary must be commensurate to a PGY 6 or greater in the same city. Does your program meet this requirement? Yes
- Is the salary guaranteed for the year? Yes
- Is there funding available beyond salary for meeting attendance, research, etc? Yes
- Is the salary dependent on call? No
- Is the Fellow on call?
Yes
What are the on call requirements? - What are the estimated fellow weekly work hours?
- It is a requirement that Health Insurance be provided. Do you provide health insurance to your fellows? Yes
- Teaching Responsibilities: Yes
- Courses/Academic Presentations: Yes
- Does reimbursement for the above make up part of the salary? No
- Does the fellowship contract include a non-compete clause? No
Clinical Outpatient Experience
This first year focuses on the acquisition of an understanding of the diagnosis and management of HPB pathology with a focus on outpatient management.
The trainee will participate in outpatient activities in the HPB clinics, the multi-disciplinary HPB oncology clinic, Hepatocellular Carcinoma clinic, and in all weekly service meetings including HPB Tumour Board, Service rounds, Liver listing rounds, Neuroendocrine Tumour Board (monthly) and Biliary rounds (monthly).
This allows the Fellow to gain an understanding of pre-operative patient management from diagnosis to the operating room, and then participate in outpatient post-operative care and long term patient follow-up.
Research/Scholarship Resources
Program Director(s) Detailed Information
Dr. Peter Metrakos MD
- At Institution Since: 1996
- Program Director Since : 2001
- Board Certification: Board Certified
Society Memberships
ACS
SSAT
AHPBA
Other
ASTS, CST, AACR
Areas of Expertise
Hepato-pancreato-biliary and Transplant SurgeryTeaching Qualifications
Summary of Qualifications
Dr. Peter Metrakos, MD CM, FACS, FRCSC is a Professor of Surgery, Pathology and Anatomy and Cell Biology McGill University. He is the Director of Liver Transplant Program and Director of Hepatopancreatobiliary Surgery at the McGill University Health Center. As well as program leader of the Cancer Reserach program of the Reserach Institute of the Mcgill University Health Center.
Dr. Metrakos graduated in General Surgery from McGill University Faculty of Medicine, where he also completed a three-year Basic Science Fellowship in the Department of Experimental Surgery focusing on the physiology of the pancreas and cellular transplantation. Additional Fellowships were carried out in London, Ontario, for liver, kidney and small bowel transplantation, and in Minnesota for whole organ pancreas and islet cell transplantation.
Dr. Metrakos runs a high-volume hepatopancreatobiliary and transplant surgery service, and has a high volume complex liver surgery practice as well as directing one of 18 accredited HPB fellowship Programs in North America.
Dr. Metrakos Research interests include basic/translational and clinical research. Research includes the role and interaction of chemotherapy and liver resection in the management of liver malignancies, these include Hepatocellular cancer, Cholangio Cancer and Liver metastasis. He is one of the funding members of the Liver Metastasis Research network (LMRN), with worldwide membership that focuses on the study of colon cancer liver metastasis. Dr. Metrakos’s overriding theme of work is Systems Medicine and Personalized Care of our patients. This has led to numerous collaborations across disciplines at McGill and other Universities, and with other national and international groups. I am also one of the founders of the Liver Metastasis Research Network (LMRN), focused on international collaborations
His clinical Interest are in Colon Cancer, Liver Mets, Primary Liver Cancers, fatty Liver Disease, Precision Oncology
His Research focus is on Benign and Malignant Liver Disease
https://pubmed.ncbi.nlm.nih.gov/?term=peter+metrakos
Recent articles:
Rada M, Lazaris A, Kapelanski-Lamoureux A, Mayer TZ, Metrakos P. Semin Cancer Biol. 2021 Jun;71:52-64. doi: 10.1016/j.semcancer.2020.09.001. Epub 2020 Sep 10.
Schadde E, Grunhagen DJ, Verhoef C, Krzywon L, Metrakos P. Semin Cancer Biol. 2021 Jun;71:10-20. doi: 10.1016/j.semcancer.2020.09.008. Epub 2020 Sep 24.PMID: 32980499
Ibrahim NS, Lazaris A, Rada M, Petrillo SK, Huck L, Hussain S, Ouladan S, Gao ZH, Gregorieff A, Essalmani R, Seidah NG, Metrakos P. Cancers (Basel). 2019 Dec 20;12(1):35. doi: 10.3390/cancers12010035.PMID: 31877668
Vessel co-option mediates resistance to anti-angiogenic therapy in liver metastases.
Frentzas S, Simoneau E, Bridgeman VL, Vermeulen PB, Foo S, Kostaras E, Nathan M, Wotherspoon A, Gao ZH, Shi Y, Van den Eynden G, Daley F, Peckitt C, Tan X, Salman A, Lazaris A, Gazinska P, Berg TJ, Eltahir Z, Ritsma L, Van Rheenen J, Khashper A, Brown G, Nystrom H, Sund M, Van Laere S, Loyer E, Dirix L, Cunningham D, Metrakos P, Reynolds AR. Nat Med. 2016 Nov;22(11):1294-1302. doi: 10.1038/nm.4197. Epub 2016 Oct 17.PMID: 27748747 Free PMC article.
van Dam PJ, van der Stok EP, Teuwen LA, Van den Eynden GG, Illemann M, Frentzas S, Majeed AW, Eefsen RL, Coebergh van den Braak RRJ, Lazaris A, Fernandez MC, Galjart B, Laerum OD, Rayes R, Grünhagen DJ, Van de Paer M, Sucaet Y, Mudhar HS, Schvimer M, Nyström H, Kockx M, Bird NC, Vidal-Vanaclocha F, Metrakos P, Simoneau E, Verhoef C, Dirix LY, Van Laere S, Gao ZH, Brodt P, Reynolds AR, Vermeulen PB. Br J Cancer. 2017 Nov 7;117(10):1427-1441. doi: 10.1038/bjc.2017.334. Epub 2017 Oct 5.PMID: 28982110 Free PMC article.
Faivre S, Niccoli P, Castellano D, Valle JW, Hammel P, Raoul JL, Vinik A, Van Cutsem E, Bang YJ, Lee SH, Borbath I, Lombard-Bohas C, Metrakos P, Smith D, Chen JS, Ruszniewski P, Seitz JF, Patyna S, Lu DR, Ishak KJ, Raymond E. Ann Oncol. 2017 Feb 1;28(2):339-343. doi: .1093/annonc/mdw561.PMID: 27836885 Free article. Clinical Trial.
Wu JB, Sarmiento AL, Fiset PO, Lazaris A, Metrakos P, Petrillo S, Gao ZH. World J Gastroenterol. 2019 Jul 14;25(26):3408-3425. doi: 10.3748/wjg.v25.i26.3408.PMID: 31341365
Dr. Prosanto Chaudhury MD
- At Institution Since: 2007
- Program Director Since : 2009
- Board Certification:
Society Memberships
AHPBA
Other
Royal College of Physicians and Surgeons of Canada
Areas of Expertise
Colon cancer liver metastasis, Liver kidney and pancreas transplantation, clinical pathway development, organ donation, evidence based medicineTeaching Qualifications
Associate Professor of Surgery and Oncology, McGill Univeristy
MSc, Evidence based Medicine
Society Memberships: International Hepato-pancreato-biliary Association (IHPBA), Canadian Hepato-pancreato-biliary Association (CHPBA), Canadian Society of Transplantation, The Transplantation Society, International Surgical Society (ISS), American Society of Transplantation (ASTS), Canadian Liver Transplant Network (CLTN)
Summary of Qualifications
- General Surgery Residency McGill University 1998-2004
- HPB and Transplant Fellowship McGill University 2004-2006
- Multi-organ Transplant Fellowship, Northwestern University, 2006-2007
- Current president CHPBA
- Past-president CLTN
- Board Member and treasurer CST
- Interim Director multi-organ transplant program, McGill University Health Center
- Director Clinical Teaching Unit , HPB surgery
- Medical Director Transplant Quebec
List relevant publications or technical developments
- Buell JF, Cherqui D, Geller DA, O'Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D'Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS; World Consensus Conference on Laparoscopic Surgery .The international position on laparoscopic liver surgery: The Louisville Statement, 2008; Ann Surg. 2009 Nov;250(5):825-30.Ball, I, Hornby, L., Rochwerg, B., Weiss, M., Gillrie, G., Chassé, M. D’Aragon, F., Meade, M., Soliman, K., Ali, A., Arora,A., Basmaji, J., Boyd, G., Cantin., B. Chaudhury, P., Cypel, M., Freed, D., Frenette, A-J., Hruska, P., Karvellas, C., Keenan, S., Kramer, A., Kutsogiannis,D., Lien, D., Mahoney,M., Singh, J., Wilson, L., Wright,A., Zaltzman, J., Shemie, S. Management of the neurologically deceased organ donor: A Canadian clinical practice guideline. CMAJ 2020 Month April;192:E361-E369. doi: 10.1503/cmaj.190631
- Manara A, Shemie SD, Large S, Healey A, Baker A, Badiwala M, Berman M, Butler AJ, Chaudhury P, Dark J, Forsythe J, Freed DH, Gardiner D, Harvey D, Hornby L, MacLean J, Messer S, Oniscu GC, Simpson C, Teitelbaum J, Torrance S, Wilson LC, Watson CJE. Maintaining the permanence principle for death during in situ normothermic regional perfusion for donation after circulatory death organ recovery: A United Kingdom and Canadian proposal. Am J Transplant. 2020 Aug;20(8):2017-2025. doi: 10.1111/ajt.15775. Epub 2020 Jan 27.
- Ball IM, Healey A, Keenan S, Priestap F, Basmaji J, Honarmand K, Parsons Leigh J, Shemie S, Chaudhury P, Singh JM, Zaltzman J, Beed S, Weiss M.Organ Donation after Medical Assistance in Dying - Canada's First Cases. N Engl J Med. 2020 Feb 6;382(6):576-577. doi: 10.1056/NEJMc1915485.
- Park KM, Rashidian N, Mohamedaly S, Brasel KJ, Conroy P, Glencer AC, He J, Passeri MJ, Katariya NN, Alseidi A; TrainHPB research group. Unifying the Hepatopancreatobiliary Surgery Fellowship Curriculum via Delphi J Am Coll Surg. 2021 Sep;233(3):395-414. doi: 10.1016/j.jamcollsurg.2021.06.004. Epub 2021 Jun 21.
- Marino A, Bessissow A, Miller CS, Valenti D, Boucher LM, Chaudhury P, Barkun J, Forbes N, Khashab MA, Parent J, Waschke K, Martel M, Chen YI. Modified EUS-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS): a pilot study. Endoscopy. 2021 Feb 16. doi: 10.1055/a-1392-4546. Online ahead of print.
- Chen YI, Chatterjee A, Berger R, Kanber Y, Wyse J, Lam E, Gan I, Auger M, Kenshil S, Telford J, Donnellan F, Quinlan J, Lutzak G, Alshamsi F, Parent J, Waschke K, Alghamdi A, Barkun J, Metrakos P, Chaudhury P, Martel M, Dorreen A, Candido K, Miller C, Adam V, Barkun A, Zogopoulos G, Wong C. Endoscopic ultrasound (EUS)-guided fine needle biopsy alone vs. EUS-guided fine needle aspiration with rapid onsite evaluation in pancreatic lesions: a multicenter randomized trial. Endoscopy. 2021 Jan 27. doi: 10.1055/a-1375-9775. Online ahead of print.
Division of Time
Percentage of Time Spent in Clinical Activity:
60%
Percentage of Time Spent in Research
Activity:40%
Case Load (as estimated by Program)
| Case Type | # of Open Cases | # of MIS Cases (Lap & Robotic) |
# of Endoscopy Cases | # of Anastomotic Cases (Bariatric programs only) |
|
| HPB | Liver- lobe | 85 | 15 | ||
| HPB | Liver- ablation | 15 | 0 | ||
| HPB | Pancreas- whipple | 35 | 0 | ||
| HPB | Pancreas- distal | 15 | 3 | ||
| HPB | Pancreas- other | 30 | 0 | ||
| HPB | Bile duct- resection | 10 | 0 | ||
| HPB | Bile duct- exploration | 30 | 0 | ||
| HPB | Liver- <2 segments | 10 | 0 | ||
| HPB | Liver- other | 50 | 0 | ||
| HPB | Liver- wedge | 15 | 0 | ||
| MIS | Diagnostic Laparoscopy | 0 | 30 | ||
List of Contributing Faculty
| Prosanto Chaudhury MD, MSc | 25% |
| Area of Expertise HPB, Transplant, MIS |
|
| Role in Training Associate Program Director |
|
| Peter Metrakos MD | 25% |
| Area of Expertise HPB, Transplant |
|
| Role in Training Program Director |
|
| Jeffrey Barkun MD, MSc | 15% |
| Area of Expertise HPB, Transplant, MIS |
|
| Role in Training |
|
| Jean Tchervenkov MD, | 10% |
| Area of Expertise Transplant, HPB |
|
| Role in Training |
|
| George Zogopoulos MD, PhD | 10% |
| Area of Expertise HPB, Transplant |
|
| Role in Training |
|
| Steven Paraskevas MD, PhD | 5% |
| Area of Expertise Transplant sugery |
|
| Role in Training |
|
Accreditation History
| Director | Program | Length | Start | End | |
|---|---|---|---|---|---|
| Peter Metrakos | HPB | 2 | 2025 | 2027 |