Residency Training Program


Clinical Pharmacology & Toxicology Residency Training Program

The Division of Clinical Pharmacology provides a Royal College of Physicians and Surgeons of Canada accredited subspecialty residency training program. This is for applicants who are eligible for the FRCPC specialist certification. 

The Clinical Pharmacology & Toxicology residency is a 2 year program. Applicants usually have completed 3 years of Internal Medicine in an accredited Canadian training program. We will also consider applicants who have completed core accredited training in Pediatrics as well. All applicants must be eligible for educational licensure in the province of Ontario. We will accept 1-2 new residents each year. 

We will also consider trainees for a dual subspecialty within Internal Medicine (e.g. Clinical Pharmacology & Toxicology + critical care medicine, endocrinology, respirology, rheumatology, etc). This will be a 3 year program. At the end of the 3 years, the trainee will be eligible for dual subspecialty certification from the Royal College of Physicians and Surgeons. If an applicant is interested in this route, both program directors will need to be notified in advance of the application, and agree to the request for the combined subspecialty training. Feel free to contact Dr. Gryn if you need more information. 

Our program is intended to provide the trainee with a solid background in principles of drug action, adverse drug reactions, drug-drug interactions, and the emerging field of Personalized Medicine. Specifically, the fellow will receive training and clinical experience in the following areas:

Personalized Medicine

Incorporating the latest technologies in the area of pharmacogenomics and drug level analysis using LC-MS/MS technologies to deliver individualized care to our patients. The Personalized Medicine Program is led by Dr. Richard Kim, his team is involved in applying personalized medicine to the care of outpatients and hospitalized patients, focusing on therapeutic areas including anticoagulation, cardiovascular medicine, and oncology. Learn more.

Adverse Drug Reactions

Residents will assess patients with adverse drug reactions in a variety of settings, including inpatients in the intensive care unit and hospital wards, and also outpatients with a focused experience in Dr. Rieder’s clinics (adult and pediatric), as well as outpatient clinics with some of our other faculty members. Learn more.

Hypertension and Vascular Health

The patient with uncontrolled hypertension is a prototypical case for complex therapeutics.  They may be intolerant of medications, or require complex regimens for optimal control.  Drs. Alfonsi, Dresser, Gryn, Hackam, and Spence provide outpatient care relating to hypertension and stroke prevention.  Our trainees can expect to build competence and expertise in these important therapeutic area. 

Anticoagulation therapy is also commonly used for stroke prevention, and given the safety risks of these medications, our opinions are often sought, especially regarding drug interactions, medication choice/dosing in renal/hepatic dysfunction, etc.  Our group’s Anticoagulation Clinic is the leading referral site for local emergency department patients with newly diagnosed atrial fibrillation. Learn more.

Pediatric Clinical Pharmacology & Toxicology

Our trainees will have opportunities to assess pediatric adverse drug reactions in clinic and the inpatient setting, as well as assess for fetal risks after maternal exposures.


Our trainees will receive both didactic training and spend at least 1 block at the Ontario Poison Centre.  In addition, they will provide bedside toxicology consults in London. Learn more.

Research and Teaching

A number of our faculty conduct world class bench-to-bedside research. Our residents will be involved in various research projects, attend conferences, and present research findings. In addition, tailored teaching by our faculty will be provided to our fellows on the topics of pharmacokinetics and drug development. Learn more.

An application for our residency program can be found on the CARMS website in the Medicine Subspecialty Match. If you have questions about our subspecialty residency training or research program, feel free to contact Dr. Steven Gryn.