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Hematology is a subspecialty of internal medicine that focuses on the role, nature and diseases of the blood. Hematological diseases involve the different components of blood including: cells, hemoglobin, blood proteins the coagulation pathway, and can ultimately involve any organ system in the body. These diseases can affect patients of all age groups and can often be serious or fatal. Hematologists will work closely with their patients and other specialists, particularly oncologists, in the management of these diseases.

Training to become a hematologist requires that doctors complete a 3-year residency in internal medicine followed by an additional 2 years specializing in hematology. During the hematology residency, candidates are required to complete training in clinical hematology, pediatric hematology, stem cell transplantation, laboratory hematology and medical oncology. Hematologists are required to stay current with scientific knowledge and procedures as advances in this field occur rapidly.

Hematologists concern themselves with all aspects of blood, as such they act as consultants when caring for patients with diseases of blood. They have a robust understanding of the physiology of blood including blood cells, hemoglobin, blood proteins, coagulation mechanisms and cancer pathogenesis. Hematologists are also required to have an understanding of basic medical sciences. They will often analyze blood films, coagulation tests and bone marrow aspirates to aid in diagnosis. Hematologists work closely with oncologists, and play a role in the education of specialists in oncology.

Common Disease and Disorders

Anemia is a disorder in which a patient’s red blood cells are not functioning properly, or are at insufficient levels to adequately supply the body with oxygen. It is the most common blood disorder that a hematologist will be involved with and as such has a large number of causes including: genetic disorders, chronic disease states, blood loss iron and vitamin deficiencies or poisoning. The role of the hematologist in treating anemia is to discern the underlying cause of the anemia and provide the proper treatment. With chronic anemia a hematologist will be involved in monitoring the state of the disease and patient.

Hemophilia is a rare, inherited bleeding disorder that prevents the formation of proper blood clots resulting in excessive bleeding with even minor cuts or injuries. This disease can range from mild to severe, and the degree of treatment is reflected by disease severity. As hemophilia is a lifelong condition, hematologists will follow these patients throughout their life administering blood and clotting factor transfusions as treatment.

Leukemia is a blood cancer that results from the rapid production of abnormal white blood cells. These cells lose the ability to properly fight infection and impair red blood cell production in the bone marrow. Leukemia can either be acute or chronic. Acute leukemia is typically more severe and occurs predominantly in children, while chronic leukemia is more commonly found in adults and is indolent. The role of the hematologist in leukemia is to recognize the symptoms, make a diagnosis and then administer treatment based on the severity of the disease.

Sickle Cell Disease and Thalassemia
These are genetic disorders resulting in abnormal hemoglobin formation. As a result patients with these diseases have impaired oxygen delivery, anemia and secondary complications. The role of the hematologist in these conditions is to diagnose and follow these patients throughout their life. They are responsible for treating these diseases using blood transfusions, and medications as well as monitor for complications that may arise.

Further Advanced Training Opportunities

Once a candidate has completed their 3-year residency in internal medicine and 2-year residency in hematology, physicians may choose to practice hematology in a community, or continue their training via research or fellowships. These include the Thrombosis Canada Can-VECTOR Research Fellowship, The Canadian Adult Comprehensive Hemoglobinopathy Fellowship, as well as fellowships specializing in leukemia, lymphoma/myeloma, myeloproliferative neoplasms and Consultative Hematology. Options also exist to continue hematology training abroad.

Gender Breakdown
36 responses (2014 National Survey Results)

Age Breakdown
36 responses (2014 National Survey Results)
Hours Breakdown (Excluding on-call activities)
34 responses (2014 National Survey Results)

Activity Hours Worked (mean)
Direct patient care without a teaching component 13.52
Direct patient care with a teaching component 5.78
Teaching/ educating without direct patient care 3.25
Indirect patient care 6.47
Health facility committees 1.27
Administration 3.67
Research 7.88
Managing your practice 1.20
CME/ CPD (Continuing Professional Development) 4.03
Other actvities 1.51
Total Hours 48.58

Hematology Residency Programs in Canada

Contact information for Program Directors can be accessed on the Royal College’s website here: Open in new tab

University of British Columbia
Vancouver, British Columbia

Queen’s University
Kingston, Ontario

University of Calgary
Calgary, Alberta

University of Ottawa
Ottawa, Ontario

University of Alberta
Edmonton, Alberta

McGill University
Montréal, Quebec

Université de Montréal
Montréal, Quebec

University of Manitoba
Manitoba, Winnipeg

Université de Sherbrooke
Sherbrooke, Quebec

Université Laval
Laval, Québec

Western University
London, Ontario

Dalhousie University
Halifax, Nova Scotia

McMaster University
Hamilton, Ontario

University of Toronto
Toronto, Ontario

Page Author(s): Christopher Wynick (2018)
© 2021 Internal Medicine Interest Group (IMIG) - Schulich School of Medicine and Dentistry