Minimally Invasive Gynaecology and Pelvic Floor Reconstruction

Updated: February 27, 2026

Program Director:

Dr. André LaRoche, MD, FRCSC
Humber River Health
Email: alaroche@hrh.ca

Duration: 1 year

Application Deadline: We follow the CanSAGE application and matching process and deadlines. See the CanSAGE website for details.

Note: At the current time, we are only accepting applications from Canadian-trained graduates.

To All Applicants:

If you have also applied to the U.S match through the National Residency Matching Program (NRMP), please be advised that the University of Toronto is a participating institution and adheres to the match policy. The policy states that "Applicants who have matched to a program or have accepted a position during the Supplemental Offer and Acceptance Program (SOAP), shall not apply for, discuss, interview for, or accept a concurrent year position in another program prior to the NRMP granting the requested waiver." More information is accessible at https://www.nrmp.org/residency-applicants/soap/.

Program Description

Humber River Health (HRH) is a prominent 1.8 million square foot, fully digital acute-care facility in Canada, equipped with state-of-the-art technology and catering to a wide range of medical needs. It serves a population of over 850,000 individuals residing in the northwest Greater Toronto Area. HRH operates 722 acute inpatient beds at the Wilson site, with over 4,000 staff, approximately 800 physicians and over 1,000 volunteers. HRH also includes the Reactivation Care Centres (RCCs) at the Finch and Church Campuses, which represent a unique partnership among multiple hospitals in the GTA with a focus on delivery of specialised care with the focus on reactivation to patients who have been designated as Alternative Level of Care.

Our program consists of four fellowship-trained minimally invasive gynaecologic surgeons, one urogynaecologist and one generalist ob-gyn. During our 1-year program, trainees will gain the skillset and experience in managing challenging surgical and clinical scenarios.

Trainees will spend 0.5-1 day per week in an ambulatory setting. This includes chronic pelvic pain clinic, MIS surgery clinic, urogynaecology clinic, as well as outpatient hysteroscopy clinic.

They will spend 3-4 days per week in the operating room. They will spend 2-3 days per week with the MIS team and 1 day per week with the urogynaecology team. The remainder of the time will be dedicated to research.

Trainees will focus on surgical management of fibroids, adenomyosis, advanced endometriosis with combined surgery with general surgery or urology, and pelvic floor reconstruction. They will graduate with proficiency in laparoscopic procedures such as hysterectomy, myomectomy, excision of deeply infiltrating endometriosis; hysteroscopic procedures, such as myomectomy, septoplasty and lysis of adhesions; as well as laparoscopic radiofrequency fibroid ablation (Acessa) and robotic surgery. Trainees will also participate in planned cesarean hysterectomy for placenta accreta spectrum disorder and develop skills at internal iliac ligation.

Trainees will become surgeon teachers by educating residents and medical students in a variety of settings, as well as staff colleagues, including non-structured teaching at the bedside and operating room and structured teaching during academic half days, as well as simulation at the James B Neill Centre for Applied Simulation and Innovation.

Goals and Objectives

1. Medical Expert (Core Competency)

Goal: To become a highly proficient surgeon capable of performing complex MIGS procedures.

Objectives:

Master advanced laparoscopic, hysteroscopic, and robotic techniques for treating endometriosis, fibroids, and pelvic floor disorders.
Acquire skills to manage intraoperative complications and complex pelvic anatomy.
Integrate evidence-based medicine into clinical decision-making for patient-centred care.
Utilize advanced imaging techniques, such as endometriosis ultrasound, for preoperative planning.

2. Communicator

Goal: To establish effective therapeutic relationships with patients and team members.

Objectives:

Provide informed consent for complex procedures, discussing risks and benefits of various surgical approaches (e.g., vaginal vs. robotic vs. laparoscopic).
Communicate clearly with patients regarding chronic pain management and surgical expectations.
Effectively document patient encounters and operative notes, particularly for complex, high-volume cases.

3. Collaborator

Goal: To work effectively within interprofessional teams to improve patient outcomes.

Objectives:

Collaborate with subspecialists (e.g., urology, colorectal surgery) in multidisciplinary management for severe endometriosis.
Foster a cooperative, safe environment in the OR, facilitating the education of residents and fellows.
Utilize simulation and team-based learning (TBL) to improve team communication and efficiency.

4. Leader

Goal: To lead in the operating room and take responsibility for patient care.

Objectives:

Implement quality improvement initiatives to enhance perioperative care.
Participate in the management of high-volume, complex surgical cases within the institution.

5. Health Advocate

Goal: To advocate for the best care for patients with gynaecologic conditions.

Objectives:

Promote access to minimally invasive techniques as a standard of care over traditional open procedures.
Advocate for comprehensive, multidisciplinary care for patients with chronic pelvic pain or endometriosis.
Use patient-centred tools, including AI-generated patient education materials, to improve patient understanding.

6. Scholar

Goal: To contribute to the advancement of MIGS through research and education.

Objectives:

Complete a research project for submission to a national/international meeting and a peer-reviewed journal.
Participate in and lead educational sessions, including wet/dry labs, simulation, and grand rounds.
Critically appraise current literature to refine surgical techniques.

7. Professional

Goal: To demonstrate commitment to health and safety, ethics, and accountability.

Objectives:

Adhere to high ethical standards in patient care and research.
Commit to life-long learning and maintaining competency in a rapidly evolving field.
Demonstrate ethical use of technology and AI in clinical settings.