our mission - mcmaster university's faculty of health...
TRANSCRIPT
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To facilitate the provision of the highest possible quality of care
of the medical diseases of adults giving
appropriate consideration to costs and
utilities.
Our MissionWe are a Department of Medicine, characterized by a collegial, interprofessional, and
interinstitutional cooperation, working to achieve our goals of excellence in health
education, research and clinical care which embraces the continuum from the basic science
laboratory to the individual patient to the health care system.
Our Goals To develop and critically evaluate new knowledge across a wide range of
disciplines from basic science to the clinical
disciplines of General Internal Medicine and
its subspecialities, to the health care system
itself. The Department of Medicine will
set priorities for its research endeavours,
based upon excellence, societal relevance,
the availability of collaborative links, the
opportunity for national and international
significance, and additional criteria as
judged appropriate.
To take responsibility for the quality of the education programs offered
by McMaster University, for physicians in
training and practice in the disciplines of
General Internal Medicine and the medical
subspecialities and to provide many of
the planners and teachers for this broad
undertaking. To be involved as appropriate in
the education programs offered by McMaster
University for non-physician scientists
working in health-related fields and non-
physician health professionals.research, care & learning
McMaster University | Faculty of Health Sciences
Department of Medicine | Academic Year 2010-2011
Dr. Paul O’Byrne, Professor and Chair of the Department of Medicine, in his clinic at the Firestone Institute for Respiratory Health at St. Joseph’s Healthcare Hamilton.
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Contents
Faculty of Health Sciences
Academic Year �010-�011
Department of Medicine
Reports: Research Institutes
Publications
Faculty
22nd Annual Residents' Research Day
Reports: Division Directors
Reports: Canada Research Chairs
Reports: Endowed Chairs
Global Connections
Reports: Co-ordinators
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Leadership in Learning
Excellence in Care
Groundbreaking Research
Publication Highlights
Faculty Awards and Highlights
Message from the Chair
Message from the Dean and Vice-President
Message from the President and Vice-Chancellor 4
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McMaster is no exception. Despite the fiscal chal-lenges, the Department of Medicine continues to find new opportunities and attracts millions of dollars in research grants and support from provincial and federal governments, not-for-profit organizations, industry and private donors.
Developing close ties to the Hamilton community is critical to the delivery of health care; it’s also part of the overall vision of McMaster University. Thousands of people in Hamilton and the sur-rounding communities benefit from receiving care
from members of the Department of Medicine. Through the creation of strong, sustainable rela-tionships with community partners, we are help-ing to build a better future for the residents of our city.
Congratulations again to the Department of Medicine on making a difference in the lives of people in our community through research, teach-ing and clinical work in our hospitals, health-care centres and research facilities.
McMaster University recognizes the invaluable contribution the Department of Medicine makes to our success. Thank you for your dedication to advancing our mission.
Patrick Deane, BA (Hons), MA, PhD President and Vice-Chancellor McMaster University
More than 470 full- and
part-time members contribute
to teaching the next generation
of doctors, scientists and
health-care professionals
Message from the President and Vice-Chancellor
I wish to congratulate the Department of Medicine on another outstanding year which has seen remark-able achievement in research, teaching and clinical care.
It’s now been over a year since I began my tenure as president and vice-chancellor of McMaster University. In that time, I have been continually impressed by the accomplishments of the Department of Medicine and the magni-tude of its reach.
As the largest academic department at the University, researchers in the Department con-tinually publish in the top journals in the medi-cal field and they are involved in cutting-edge basic and clinical research, including some of the largest and most significant clinical trials in the world. This success remains a key factor in the University’s consistent ranking as one of the top research institutions in the country; it is also critical to ensuring the McMaster name remains synonymous with excellence. Year after year, the Department of Medicine succeeds in helping McMaster to accomplish its mission through a commitment to innovating research and education across multiple disciplines in the health sciences.
Complementing the cutting-edge research and innovation in medical education, the Department of Medicine is well served by its faculty mem-bers who drive these breakthroughs through their passion and dedication to advancing academic and clinical medicine in Canada and beyond. More than �70 full- and part-time mem-bers contribute to teaching the next generation of doctors, scientists and health-care profession-als who receive their training at the Michael G. DeGroote School of Medicine and through affili-ated schools and departments within the Faculty of Health Sciences.
By attracting top scholars from around the world, the Department of Medicine has helped to raise the intellectual bar of the University and provide the necessary talent to train promising health sciences minds to continue to advance health care and seek answers to the world’s most com-plex medical questions. These individuals, along with the students, residents and fellows they train, are helping us to meet our vision of achiev-ing international distinction for creativity, innova-tion and excellence.
In recent years, academic institutions have been faced with increasing budgetary restraints, and
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Three separate studies from the Department of Medicine were named among the top 10 cardiovascular research advancements of �010 by the American Heart Association. Another study was cited among the top 10 research advancements for stroke treatment in �010 by the American Stroke Association.
A landmark study found accessing blocked arteries through the forearm versus the groin led to fewer complications and similar success rates for angioplasty.
The development of a vaccine that will suc-cessfully treat people with cat allergies. Until now, frequent allergy shots have been consid-ered the most effective way to bring relief cat-allergy sufferers.
Researchers from the Department of Medicine found link between gut bacteria and behaviour. For the first time, conclusive evidence was dis-covered showing bacteria residing in the gut influence brain chemistry and behaviour.
In �010-11, the Department welcomed several new endowed research chairs and Canada Research Chairs. Mark Crowther, a professor of medicine and pathology and molecular medicine, was named the inaugural holder of the LEO Pharma Chair in Thromboembolism Research. Mark Loeb, a professor of medicine, pathology and molecular medicine and clinical epidemiology and biostatistics, was named the inaugural holder of the Michael G. DeGroote Chair in Infectious Diseases. Alfred Cividino, clinical professor,
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was named the Abbott Chair in Education in Rheumatology. Michael Surette, a professor of medicine, biochemistry and biomedical sciences, was named the Tier 1 Canada Research Chair in Interdisciplinary Microbiome Research.
Also notable was the official opening of the Farncombe Family Digestive Health Research Institute in October �010. The institute, established with a $15-million gift from the Farncombe Family of Oakville, is already recognized as an interna-tional leader in digestive disease research.
Another gift from Vasu and Jaya Chanchlani established the Chanchlani Research Centre. The centre focuses on understanding disease among diverse ethnic populations, and is headed by Sonia Anand, a professor of medicine, clinical epi-demiology and biostatistics.
I give my sincere congratulations to all the mem-bers of the Department of Medicine on these outstanding accomplishments. On behalf of the entire Faculty, I want to thank you for your com-mitment and wish you well in the year ahead.
Dr. John G. Kelton Dean and Vice-President Faculty of Health Sciences Dean of the Michael G. DeGroote School of Medicine
Message from the Dean and Vice-President
The Faculty of Health Sciences continues to build its reputation as a leader in research, education and clinical care, and much of our success in this area can be attributed to the accomplishments and strengths of the Department of Medicine.
Through its commitment to excellence in schol-arship and research, the Department has seized opportunities to train the next generation of phy-sicians, physician assistants and other health-care professionals, as well as develop and critically evaluate new knowledge across its wide range of disciplines while facilitating the highest quality of patient care and translational research.
The Department continues to expand by suc-cessfully attracting some of the world’s best faculty. Together, they are working to enhance McMaster’s reputation of excellence through widely acclaimed research studies, prestigious career and teaching awards and by attracting increased financial support from government and industry.
Members of the Department received many acco-lades and awards, among them:
Paul O’Byrne was elected a fellow of the Royal Society of Canada
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Deborah Cook was elected a fellow of Canadian Academy of Health Sciences
Brian Haynes was named to the Order of Canada
John Bienenstock was named a �011 laureate to the Canadian Medical Hall of Fame
In recent years, the Department has grown to meet the needs of the Michael G. DeGroote School of Medicine as it has expanded to two regional campuses and increased the number of medical students to more than �00 in each year. The Department has also been a leader in embracing a collaborative approach to research, finding synergies across disciplines and across other departments, school and universities.
Research emerging from the Department of Medicine consistently garners headlines in Canada and around the world. A few examples that sparked media coverage in the past year:
A study showing the community benefit of child vaccination was selected as the �010 research paper of the year by the prestigious journal The Lancet.
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accreditation (five of these without any weakness identified). This is an indication of the high qual-ity of the postgraduate training available in the Department of Medicine.
Undergraduate and postgraduate medical educa-tion continues as the most important academic endeavour of the Department. The Department provides almost one-third of all educational activi-ties within the Faculty and it has the opportunities to undertake stimulating and valuable educational roles. This remains a major reason that we were able to attract so many high-quality, young clini-cian educators to the Faculty of Health Sciences. During this academic year, the Department’s Educational Coordinator, Dr. Ameen Patel, has made a major effort to ensure the careful docu-mentation of the magnitude of the contributions made by faculty members. This is crucial not only at the time of promotion and tenure, but also because the allocation of resources such as the Alternative Funding Plan (AFP) are made based, in part, on these educational contributions.
Postgraduate training in the Department of Medicine also continues to move from strength to strength. The Internal Medicine Residency Training Program is now regarded as one of the most sought after in Canada for newly qualified physicians to begin their training in Medicine.
The program has attracted almost �00 applica-tions in the past year, which included some of the very best applicants in the country, and was able to attract seven out of the top ten applicants ranked by the selection process, and all appli-cants were within the top �0 ranked. All of this success can be accounted for by the energy and commitment of Dr. Parveen Wasi, the previous Program Director and Dr. Shariq Haider, the newly appointed Program Director, and Jan Taylor, the Program Administrator, along with the residents currently in the program and the clinical educa-tors in the Department, who have gone to remark-able lengths to ensure the program is seen to be vibrant, energetic, and forward-looking. Initiatives that continue to be very successful have been the International Health Program, which allows resi-dents to travel to Uganda each year to spend time working in Makerere University in Kampala.
The Resident’s Research Day has grown in size and developed in stature over the past five years. This is currently directed by Dr. Donnie Arnold, and is one of the highlights of the academic year. The quality of the presentations and posters at the Research Day were extraordinarily high, and some of our residents went on to win awards at the Canadian Association of Internal Medicine competitions. A research or quality assurance program is mandated during the period of train-
Message from the Chair
The Department of Medicine has continued to expand its size and increase its academic productivity during the academic year 2010-11. During this academic year, a further 19 new geographic full-time faculty members were appointed. The Department now consists of 50� faculty members, of which �0� are geographic full-time faculty, ��� part-time faculty, 35 professor emeriti, � clinical scholars, and �7 joint and associate members. The Department remains the largest in the Faculty of Health Sciences and the largest single department at McMaster University.
The cornerstone of the Department’s activity is patient care, which remains the foundation upon which all scholarly activity occurs. The Department works within the framework of two hospital systems, Hamilton Health Sciences (HHS) and St. Joseph’s Healthcare (SJH). Because of the efforts of the Chiefs of Medicine in these two hospital systems, Dr. Barry Lumb at HHS and Dr. David Russell at SJH, the facilities, the infrastructure, and the quality of the teaching has improved dramatically, particularly over the past � to 5 years. This has been the result, in part, of recruitment of outstanding young clinician edu-cators. These new faculty, together with a core of some of the highest regarded teachers in the Faculty of Health Sciences, have ensured that the clinical teaching units at three of our hospital
sites are remarkable learning environments. This excellence has been reflected in the quality of evaluations from both residents and undergradu-ate trainees. Drs. Lumb and Russell, together with Dr. Shariq Haider, the postgraduate Program Director, are committed to creating learning envi-ronments that ensure our training programs will be amongst the most sought after in Canada. This was reaffirmed by the last Royal College of Physicians and Surgeons (RCPSC) accreditation process. Our General Internal Medicine program received the highest accolades from the RCPSC
accreditors and was approved without a single weakness being identified. In addition, all of the sub-speciality programs have received full
Undergraduate and
postgraduate medical education
continues as the most
important academic endeavour
of the Department
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has seen the distance educational initiatives for McMaster medical students in Waterloo and in St. Catharines both expanding. This is yet anoth-er exciting initiative for the Faculty of Health Sciences and for the Department of Medicine. It also brings challenges in terms of recruiting new faculty and educators to undertake the roles needed to ensure that these educational sites remain strong.
I remain excited and energized by successes that the Department has enjoyed over the past year. Problems remain, but none of these are insur-mountable, and indeed, the challenges in solving
these bring their own rewards. I also regard it as a great privilege to have the opportunity of working closely with so many outstanding col-leagues who are committed to scholarship at the highest level. This is what makes the Department of Medicine at the Michael G. DeGroote School of Medicine at McMaster University a success.
The number of high profile peer-reviewed papers has also increased
during this academic year to more than 600 separate publications
INTERNATIONAL INFLUENCEDepartment of Medicine Invited Presentations, 2010-2011
Paul M. O’Byrne, MB, FRCP(C), FRSC E.J. Moran Campbell Professor Chair, Department of Medicine
Locations Department of Medicine faculty have been invited to present at during 2010-11 showing the Department’s international influence.
ing in Internal Medicine and this provides some opportunity to work with many of the world class researchers within the Department. Indeed, this is a major attraction to obtaining the best candi-dates to our training program.
The parameters which would indicate success in research have also increased over the past year. Faculty in the Department hold 3� endowed chairs or professorships, and Canada Research Chairs. I also want to recognize and congratulate all faculty members in the Department who received awards during �010-11 (Faculty Awards and Highlights). The number of high profile peer-reviewed papers has also increased during this academic year to more than �00 separate publications. Many of them are in the highest quality peer-reviewed journals. The number and quality of these papers attest to the continuing impact that the Faculty of Health Sciences and the Department of Medicine have on basic clinical research, both in Canada and internationally. The research contributions highlight the fact that many of the research groups working within the Department of Medicine are considered to be among the very best in the world in their area of research endeavour.
Research funding is also a mark of research success and this is reflected in the number of peer-reviewed grants and industrial awards to members of the Department. The amount in �010-11 was $��.�M. In addition, faculty in the Department obtained more than $3.5M in per-sonnel awards. The total amount of funding rep-resents more than 30 percent of the entire fund-ing obtained by the Faculty of Health Sciences and does not include many of our industry-spon-sored studies, whose budgets are held in our partner hospitals.
The Department has made major efforts to improve its communication strategies with faculty and with the rest of the world. The Department of Medicine website is fully functional, easy to use and dynamic. It was also selected for a Pinnacle Award, in the category of Electronic and Interactive Communications, by the Canadian Public Relations Society in �011. It contains a completely novel Events Tracking Assistant (ETA) with an ability to document attendance at Rounds which is required for MOCOMP credits. The web-
site also includes divisional sites which highlight the expertise of members, profiles of current faculty, residency sites, monthly publication high-lights, communications from the Department, faculty and staff resources, and a number of new initiatives that are currently being developed.
While the successes enjoyed by the Department of Medicine during the �010-11 academic year are impressive and rewarding, a number of chal-lenges remain. A major challenge continues to be ensuring the best quality in patient care in light of continuing resource constraints imposed on our hospital systems. In addition, maintaining the level and quality of scholarship in both education and research, which is an absolute requirement for a vibrant, energetic department, continues to be difficult in the face of increasing clinical loads.
The ongoing success of members of the Department and by the Faculty of Health Sciences in obtaining peer-reviewed grants and resources for new infrastructure and personal support have made the past few years an exciting time for both expansion and recruitment. The past year
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Dr. Jennie Johnstone CIHR Fellowship Award
Dr. Mark Kamath Editor-in-Chief, the journal Critical Reviews in Biomedical Engineering
Dr. Walter Kean Certificate of Merit for Teaching Excellence, Internal Medicine Residency Program, McMaster University �00�-�010
Dr. Mark Loeb �010 Lancet Research Paper of the Year
Dr. John Marshall Residency Teaching Award, Gastroenterology Training Program
Dr. Carlos Morillo Professor Pierre Rijlant Award from the Académie Royale de Médecine de Belgique
Dr. Cathy Morris College of Physicians of Ontario Council Award �010
Dr. Paul O’Byrne Fellow, Royal Society of Canada
Dr. Menaka Pai Research Fellowship, Canadian Hemophilia Society
Dr. Akbar Panju President’s Award for Distinguished Service, Medical Staff Association, Hamilton Health Sciences
Dr. Ally Prebtani General Appreciation Award, Internal Medicine Residency Program, McMaster University
Outstanding Health Care Professional Award, Canadian Diabetes Association
Teaching Excellence Award for Merit, Internal Medicine Residency Program, McMaster University
Dr. Patangi Rangachari Claude Bernard Distinguished Lecturer
Dr. Shirya Rashid Ontario Ministry of Research and Innovation Early Researcher award
Dr. Holger Schünemann WHO’s Global Advisory Committee on Health Research
Dr. Jonathan Sherbino Elected Fellow, Academy of Medical Educators (UK)
Meredith Marks New Educator Award, Canadian Association of Medical Educators
Dr. Kevin Smith Chair of the Board of Directors, Ontario Hospital Association
Dr. Michael Surette Canada Research Chair in Interdisciplinary Microbiome Research (Tier 1)
Dr. John Turnbull Andrew Bruce Douglas Chair in Neurology
Dr. Elena Verdú Master’s Award in Gastroenterology �010, American Gastroenterology Association
Dr. Susan Waserman Jerry Dolovich Award, Canadian Society of Allergy and Clinical Immunology �010
Dr. Jeffrey Weitz Heart and Stroke Foundation of Ontario/J. Fraser Mustard Chair in Cardiovascular Research
Canada Research Chair (Tier 1) in Thrombosis
Election to Fellowship in the European Society of Cardiology
Innovator of Distinction Award, McMaster University
Dr. John You Canadian Society of Internal Medicine New Investigator Award �010
Dr. Salim Yusuf Director, Population Health Research Institute
Dr. Andrew Arnold European Hematology Association Travel Award
Dr. Mazen Bader Best Teacher Award �011, Infectious Diseases Residency Program
Dr. Karen Beattie Canadian Arthritis Network (CAN) / The Arthritis Society (TAS) Network Scholar Award
Dr. Joseph Beyene John D. Cameron Chair in the Genetic Determinants of Chronic Disease
Dr. Birubi Biman PAIRO Excellence in Clinical Teaching Award, Northern Ontario School of Medicine
Dr. Pauline Boulos Certificate of Merit for Teaching Excellence, Internal Medicine Residency Program, McMaster University �00�-�010
Dr. Alfred Cividino Abbott Chair in Education in Rheumatology
Undergraduate Teaching Award, Department of Medicine
Dr. Stuart Connolly Salim Yusuf Chair in Cardiology
Dr. Deborah Cook Canadian Academy of Health Sciences Fellowship �010
Faculty of Health Sciences Graduate Student Federation Graduate Teaching Award, McMaster University �010
Sisters of St. Joseph’s Mission Legacy Award �010
Dr. Mark Crowther LEO Pharma Chair in Thromboembolism Research
Consultant of the Year, Medical Staff Association at St. Joseph’s Healthcare
Dr. PJ Devereaux Career Investigator Award, Heart and Stroke Foundation of Ontario
Canadian Institutes of Health Research (CIHR) and the Canadian Medical Association Journal (CMAJ) Top Achievements in Health Research National Award for the PeriOperative ISchemic Evaluation (POISE) Trial
Dr. John Eikelboom Tier � Canada Research Chair in Cardiovascular Medicine Renewal
Dr. Micheline Gagnon �011 Internal Medicine Teaching Award
�011 Internal Medicine residents favorite Rotation Award
�011 SAGE Executive/Leadership Award in Geriatrics
Dr. Hertzel Gerstein Prize of Excellence from the Romanian Federation of Diabetes, Nutrition and Metabolic Diseases for “his Exceptional Contribution to the Development of Modern Diabetology”
Diabetologia Journal, Editor’s Choice Paper for December �010
American Heart Association/American Stroke Association Recognition for one of the Top Ten Advances in Cardiovascular Research in �010: The ACCORD Trial
Mt. Sinai School of Medicine (New York) 5th Annual Mirsky Honoree and Lecture
�011 McGill Novo Nordisk Lifescan Lecturer in Diabetes
Dr. Jeffrey Ginsberg David Braley and Nancy Gordon Chair in Thromboembolic Disease
Dr. Sharon Grad McMaster Postgraduate Internal Medicine Teaching Award
Dr. Gordon Guyatt Runner-up in the British Medical Journal Lifetime Achievement Award
Dr. Brian Haynes Officer, Order of Canada
Roger A. Côté Medal of Excellence in Health Informatics for �010, National Institutes of Health Informatics
Fellow, Canadian Academy of Health Sciences
Dr. Luke Janssen Teaching Award, Faculty of Health Sciences Medical Sciences Graduate Program
Faculty Awards and Highlights
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200,000Number of patients provided with care annually by members of the Division of Emergency Medicine
32 Endowed and Canada Research Chairholders in the Department
72,000Number of citations the �,500 papers written by members of the Division of Gastroenterology have received
150Number of undergraduate and postgraduate learners rotating through the geriatric medicine program
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Number of collaborative, multicentre, peer-reviewed research projects funded through CaNNeCTIN, a CIHR-funded program run by the Population Health Research Institute (PHRI)
Number of projects selected for poster and oral presentations at the Annual Resident’s Research Day54
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Publication HighlightsJuly �010 Dr. JL Wallace et alProceedings of the National Academy of Sciences of the USA A pro-resolution mediator, prostaglandin D�, is specifically up-regulated in individuals in long-term remission from ulcerative colitis. Proc Natl Acad Sci USA. �010 Jun 1�. [Epub ahead of print]
August �010Drs. MJ O’Donnell, S. Yusuf et al The Lancet Risk factors for ischaemic and intracerebral haem-orrhagic stroke in �� countries (the INTERSTROKE study): a case-control study. Lancet. �010 Jul 10;37�(9735):11�-�3. Epub �010 Jun 17.
September �010Dr. H. Gerstein et al The New England Journal of Medicine Effects of medical therapies on retinopathy progression in type � diabetes. N Engl J Med. �010 Jul 15;3�3(3):�33-��. Epub �010 Jun �9.
October �010Drs. SR Mehta, JW Eikelboom, SS Jolly, S Yusuf et al The Lancet Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial. Lancet. �010 Sep 1. [Epub ahead of print]
November �010Drs. J Douketis, A Iorio et al Annals of Internal Medicine Patient-level meta-analysis: effect of measurement timing, threshold, and patient age on ability of D-dimer testing to assess recurrence risk after unpro-voked venous thromboembolism. Ann Intern Med. �010 Oct 19;153(�):5�3-31.
December �010Drs. G Paré, S Mehta, S Yusuf, S Anand, S Connolly, J Hirsh and J Eikelboom et al The New England Journal of Medicine
Effects of CYP�C19 genotype on outcomes of clopidogrel treatment. N Engl J Med. �010 Oct ��;3�3(1�):170�-1�.
January �011Dr. M Dolovich et al The Lancet Aerosol drug delivery: developments in device design and clinical use. Lancet. �010 Oct �9. [Epub ahead of print]
February �011Drs. A Iorio and C Kearon et al Archives of Internal Medicine Risk of recurrence after a first episode of symp-tomatic venous thromboembolism provoked by a transient risk factor: a systematic review. Arch Intern Med. �010 Oct �5;170(19):1710-�.
March �011Dr. Mark Loeb et al Journal of American Medical Association Effect of influenza vaccination of children on infec-tion rates in Hutterite communities: a randomized trial. JAMA. �010 Mar 10;303(10):9�3-50.
April �011Drs. SJ Connolly, J Eikelboom, M O’Donnell and S Yusuf et al The New England Journal of Medicine Apixaban in patients with atrial fibrillation. N Engl J Med. �011 Mar 3;3��(9):�0�-17. Epub �011 Feb 10.
May �011Dr. HC Gerstein et al The New England Journal of Medicine Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med. �011 Mar 3;3��(9):�1�-��.
June �011Drs. D. Cook, M. Meade, G. Guyatt, M. Crowther et al The New England Journal of Medicine Dalteparin versus unfractionated heparin in critically ill patients. N Engl J Med. �011 Apr 7;3��(1�):1305-1�. Epub �011 Mar ��.
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Loeb’s received funding by the US National Institutes of Health to conduct a global study on dengue fever (for which there are no drugs avail-able). Loeb is hoping to pinpoint genetic variants, such as vitamin D receptors, that predispose individuals to dengue, from 9,000 samples col-lected from seven countries including Honduras, Nicaragua, Mexico and Vietnam.
These are but a few of the major breakthroughs
made in just the past year by McMaster Department of Medicine researchers, which con-tinue to live up to the institution’s reputation for being the pioneer in evidence-based care. Researchers produce a diverse array of random-ized controlled trials, networking and co-operating wherever possible in order to produce the kind of results that ultimately make a healing difference in people’s lives.
Groundbreaking Research
It’s safe to say that much research done in the labora-tory never goes anywhere. Not so at McMaster’s Department of Medicine and its associate teach-ing hospitals. Its faculty (and residents) are dedi-cated to translating lab discoveries in the areas of heart disease, digestive health, infectious diseas-es and allergies, to name but a few, into clinical research that could lead to new treatments and even disease prevention.
This is because a bench-to-bedside philosophy drives McMaster’s outstanding track record of clinical research, says Dr. Jeffrey Weitz, Deputy Chair, Research Programs and Director of TaARI (Thrombosis and Atherosclerosis Research Institute). Take the existing guidelines for diag-nosing and treating blood clots in veins: they are based on 30 years of clinically driven research at the institute.
More recently, Weitz’s group applied the reverse philosophy, bedside-to-bench, when it noted in past studies that patients were experiencing catheter thrombosis post coronary intervention. “We worked out the mechanics for why, went back to the lab, and showed that the antithrombin fondaparinux is not as good as preventing clot-ting as previously thought. Our recommendations are to combine it with heparin in a unique coat-ing technique that make the catheters resistant to clotting.” This is but one example of McMaster research — that solves health problems with real solutions — and the implication is huge. It could mean patients won’t need any anticoagulants when they are undergoing catheter interventions, says Dr. Weitz.
McMaster’s Department of Medicine research-ers don’t just tackle existing health problems, they study the potential for problems, and in one recent instance, uncovered a lethal drug combi-nation used by millions of people. Leveraging McMaster’s germ-free gnotobiotic facility — the only of its kind in Canada — researchers at the Farncombe Family Digestive Health Research Institute showed that a class of drugs prescribed
to patients taking arthritis medication to prevent stomach damage, called proton-pump inhibitors, actually cause potentially lethal small intestinal damage in mice. “We were further able to deter-mine the mechanism by which this occurs by demonstrating that the proton-pump inhibitors actually change the types of bacteria in the intes-tine significantly,” says Dr. John Wallace, Director of Farncombe.
Successful identification of lifetime patterns and determinant of disease — and solutions — demands an investment in longitudinal, population-based research, and McMaster’s is meeting the need. Take the CHILD study run by McMaster’s Firestone Institute for Respiratory Health: the study is following 5,000 Canadian children from pregnancy through early childhood and will investigate the roles of indoor and out-door environmental exposure, infections, nutrition and genetics in the development of asthma and allergies. Findings from this research will lead to new therapies, medications, and prevention and management strategies for the millions of Canadians suffering from asthma and allergies. “This is the biggest population-based study ever undertaken to examine the beginnings of these diseases,” says Dr. Martin Kolb, Research Director at Firestone. “What really exemplifies McMaster’s incredible research infrastructure, including the skills and data management expertise, is the fact that not one child was recruited from our centre, but other centres across Canada.”
Infectious disease researchers at McMaster used an innovative population-based research approach — focusing on Hutterite colonies in Alberta, Saskatchewan and Manitoba —to prove the herd immunity effect in a large randomized control trial of 3,500 individuals. “The results demonstrate that immunizing children against influenza provides a large indirect benefit to people who do not receive the vaccine,” says Dr. Mark Loeb, Director of the Division of Infectious Diseases. This work received the Lancet Paper of the Year �010 award, and has led to secondary studies assessing vitamin D levels, genetic vari-ance and other variances influence on the ability of the vaccination to induce protection.
McMaster’s outstanding longitudinal research initiatives are also global in scope. For instance,
MCMASTER’S COMMITMEnT TO COLLABORATIVE, CLInICAL RESEARCH PAVES THE WAY FOR ExCITInG ADVAnCES In MEDICAL CARE
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training and education at the Department are clearly making crucial differences in the quality of
care received by Canadians — the ultimate bench-mark of all medicine at McMaster.
Excellence in Care
Educators in McMaster’s Department of Medicine know what the future of care looks like: evidence-based medicine at the point-of-care. In other words, greatly enhanced ambulatory care. So as Hamilton Health Science’s Access to the Best Care plan unfolded in recent years, the faculty took advantage of a physical space opening up to put in place its long-held visions of a “Mini Mayo Clinic of the North” as Dr. Akbar Panju, Deputy Chair, Clinical Programs put it. This Mini Mayo of the North is currently referred to as the McMaster Academic Ambulatory Care Facility (but it will soon have an official name thanks to a generous donor), and it is a first in Canadian medical care.
This clinic is a place where many different sub-specialties work under one roof, where patients come to one-stop shop from the best evidence-based care. Currently, patients shuttle around to multiple specialists after they are discharged from hospital, often with long wait times and plenty of overlap. McMaster’s ambulatory care facility is expected to not only speed up care and save on resources, but vastly improve the quality of care provided, since practitioners will be in a position to consult in a collaborative care environment on individual patient cases, says Dr. Barry Lumb, Chief of Medicine at Hamilton Health Sciences.
Adds Panju, “At the same time, this is going to be an ambulatory clinical teaching unit. We will be training the doctors of the future in an environ-ment where they will be applying evidence-based medicine at the point of care.” Canadian schools have done a great job educating residents in car-ing for patients in hospitals, adds Panju. “But not in our offices. Our doctors need to be trained to look after patients as much in offices as in our hospital. This clinic will accomplish that.” He says that the focus is not just on training doctors, but entire heath care teams, including advanced nurse practitioners and physician assistants.
All of this was made possible thanks to changes in care rolled out by Hamilton Health Science’s Access to the Best Care plan, the aim of which
was to consolidate inpatients and manpow-er. When adult patients were moved out of McMaster, except for pregnant patients, the Department developed a children-only Emergency Department, and created an obstetrical medi-cine program. As a result, McMaster moved the Department’s Clinical Teaching to Juravinski Hospital, where it is flourishing, says Lumb.
At the same time, the Department knew that 35,000 square feet of space would be opening up, and present an ideal location for the ambula-tory care facility plan that had been in the works for years. The space is currently under construc-tion and is expected to be open and ready for patients by early �013. “The goal is not just to enhance the education of residents,” adds Lumb, “but enhance the collegiality between disci-plines, allowing improved interaction between medical subspecialties, and opportunities for clinical research.”
These goals were what drove the opening the Internal Medicine Rapid Assessment Clinic a year earlier, in �010, which treats patients not quite sick enough to need to be hospitalized, quickly divert-ing into ambulatory care where subspecialties can rapidly assess them. “It is well-established now, with a consistent referral base,” says Lumb. The Department is hoping to expand it the next year to allow patients to be referred from family physi-cians and the emergency room, too. The goal: to avoid cases being sent from family physicians to the ER at all, says Lumb.
At St. Joseph’s Healthcare Hamilton two major clinical programs, steeped heavily in research, are showing how a tightly wound integration and organization between the university and hospitals at HHS can result in excellence in care, says Dr. David Russell, Chief of Medicine at St. Joseph’s. The Firestone Institute for Respiratory Health treats more than �0,000 patients a year, including applying some leading treatments for life-threatening cases of asthma. And St. Joseph’s Division of Nephrology worked tirelessly and in a highly coordinated manner across various multi-disciplinary teams to dramatically reduce the wait time for kidney transplants to 3.� years in �009 from �.1 years in �00�. “This improvement was planned, engineered down to every detail,” says Russell. Advances in the integration of research,
CuTTInG EDGE EDuCATIOn AnD RESEARCH AT MCMASTER EnSuRES PHYSICIAnS ARE POISED TO PROVIDE THE BEST KInD OF CARE POSSIBLE
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ed) accreditation kudos from the Royal College of Physicians and Surgeons last year, offers an even richer teaching experience for residents, says Haider. “Residents are now exposed to more patients and diseases through Juravinksi, and they
also enjoy better teaching facilities, including a dedicated teaching room.” With such a strong com-mitment to resident education and empowerment, McMaster continues to successfully sow the seed of tomorrow’s leaders in care and in education.
Leadership in Learning
Educators at McMaster’s Core Internal Medicine program know that great medicine hinges learning — lifelong learning. Inspiring a desire for knowledge is imperative for the ongoing pursuit of evidence-based care, which McMaster helped pioneer. And no other Department faculty have quite as many members who take on leadership roles in education, says Dr. Ameen Patel, Department Education Coordinator.
The same can be said for residents, who are actively encouraged and do take on leadership in education roles in the Department. In fact, resi-dents play integral roles in developing curriculum, as much as faculty, and that’s unique to Internal Medicine, as well.
“It’s not just through words, but through actions that this residency program has been made an academic mission of the Department. We want our graduates to be leaders in medical care and in education,” says Dr. Shariq Haider, Director, Internal Medicine Residency Program. He cites the annual Resident Research Day held by McMaster, which offers residents a platform to present their research endeavours, all the while taking advan-tage of faculty mentorship. “I have never seen anything quite like this before,” he adds.
The post-graduate program is continually seeking out new, innovative ways to empower residents so that they gain the skills they need to think and act like evidence-based practitioners, asking the right questions and finding new solutions. In just one example, the Department adopted a case-based (or problem-based) learning program com-ponent. “The approach, which no other Internal Medicine program has, allows for independent learning at a higher level,” explains Patel.
Andrew Burke, a third year resident, can vouch for the quality of McMaster’s learning environ-ment. He co-founded a curriculum with other resi-dents called “Teaching Residents to Evaluate and Teach” (TREaT), which incorporates classroom
and clinical-based learnings in the latest and best knowledge in teaching skills. Residents developed the program after identifying a problem — a good knowledge base doesn’t automatically translate into good teaching skills.
“At McMaster, we are invited to help identify gaps in our learning, because who best to know what we need? And if we have an idea that we are really passionate about pursuing and it is approved, we are given the support we need to make it happen, and further, the support we need to advance our own research and scholarship,” says Burke. “Nine different publications came out of TReAT alone,” he adds. Burke also developed the CanMEDS Manager curriculum to better sup-port residents in becoming team members and transition into clinical practice.
Certainly residents contributed to the two lat-est, exciting curriculum developments in the Department: the formal Simulation curriculum is set to begin in �01�, and the beginning of a first-of-its kind Global Medicine curriculum, which is still in planning stages. The Simulation program integrates state-of-the-art simulation training across all Internal Medicine curriculum. “It allows residents to feel more comfortable in clinical settings, and to develop standardized skills. We are better able to teach, measure and evaluate mechanical tasks, but also a host of non-mechani-cal skill that make for effective physicians, such as how one takes control of situation, uses resourc-es, handles a difficulty, and manages inter-profes-sionally,” says Patel.
Faculty and residents are also in the early stages of planning a Global Health curriculum that will provide residents with the opportunity to attain a formal education in all aspects of global health, explains Haider. This unique program will offer select knowledge and experienced mentorship to those residents interested in pursuing a career in global health.
McMaster internal medicine's biggest accomplish-ment this year was also its biggest challenge: moving its Clinical Teaching Unit to Juravinksi Hospital (because of the transfer of inpatients to other Hamilton hospitals as part of Hamilton Health Science’s Access to the Best Care plan). Now the CTU, which received high (rarely award-
AT MCMASTER, InnOVATIVE TEACHInG APPROACHES COMBInE WITH A PASSIOnATE FACuLTY WHO EMPHASIzES RESIDEnT EMPOWERMEnT. THE RESuLT? OuTSTAnDInG PHYSICIAn EDuCATIOn
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Unfortunately, it’s impossible for any single group or industry to undertake large-scale public health investigations. Only a continued commitment to education and collaboration in global health,
research science and medical advancement, like that of the Department of Medicine and PHRI, will ensure that the world’s population has an equal chance of living healthy lives.
Global Connections
Medicine has no borders — not, at least, in the minds of educators at McMaster University. The Department of Medicine is a leader in the pursuit of international health knowledge exchange and research collaboration. Through its unique Internal Medicine Residency International Health program, and in joint efforts with McMaster’s Population Health Research Institute (PHRI), faculty and resi-dents are showing just how global vision, ingenu-ity, and teamwork paves the way for groundbreak-ing clinical work and research discoveries that affect millions of lives around the world.
The Department’s Internal Medicine Residency International Health program continues to attract participation from residents, and is being expand-ed to include faculty, says Dr. Ally Prebtani, Director, International Health. For the past seven years, the program has sent two or three resi-dents to Uganda for one month of clinical and teaching work. “It’s the only program of its kind in Internal Medicine, and it builds bridges between the two countries,” he says.
The program is just one example of how McMaster aims to inspire career-long contribu-tion of international medical humanitarianism in residents, while expanding clinical skills, enabling sharing of knowledge across borders, and ulti-mately, enhancing the quality of care worldwide. Dr. Tim O’Shea, Assistant Professor, Division of Infectious Diseases, was among the first resident cohort to visit Uganda in �005. Since then he has gone back every year, relishing the chance to learn something new, and to collaborate with the Ugandan physicians who have spent time in Hamilton at McMaster’s postgraduate advanced training program (which has received residents from Mulago Hospital in Makerere for the past 1� years). “They are an idealistic and keen group, and refreshing to work with. It’s terrific to see them work in leadership roles in Uganda, and on a personal note I have made important friendships.”
O’Shea shares how the program has enabled him to be a better teacher and a better physician. “Teaching in different setting really boosts my
versatility. I learn to design programs that take into account different perspectives and that’s taught me to be adaptive.” He adds that the expo-sure to diseases outside of Canada is invaluable.
Now in its second year, the McMaster’s Masters in Global Health program is designed to prepare stu-dents for the global workforce by providing a solid foundation in global health issue, web-based learn-ing through global learning pods and experience in low- and middle-income countries (LMICs). The program is offered in partnership with Maastricht University, The Netherlands, says O’Shea, and stu-dents get to take advantage of a student exchange and learning symposium/field orientation with LMICs. Within the next three years, the Department plans to launch a intensive, thorough postgraduate Global Health curriculum for residents who wish to pursue a career in the field.
Learning possibilities at McMaster are even more profound thanks to the enormous networking efforts of PHRI, which collaborates with like minds in �3 countries around the world to study health problems across disciplines using a wide range of study approaches. “What distinguishes us from the few other population research institutes in the world is our global vision,” says Dr. Salim Yusuf, PHRI Director. “Our goal is not just to publish research. It is to discover new treatments and preventive strategies that have an impact on the health of people everywhere in the world.”
One such example is PHRI’s Prospective Urban and Rural Epidemiological Study (PURE), which is one of the largest most collaborative studies of its kind, involving �00,000 individuals in over �0 countries. Its goal is nothing short of under-standing how societal changes increase the risk of chronic diseases, in order to develop strategies that mitigate the processes.
PURE is just one example of a wide array of mas-sive global research undertakings by PHRI inves-tigating determinants of various diseases from cardiovascular risk factors to the prevention of dia-betes, says Dr. Hertzel Gerstein, Deputy Director of PHRI. “The problems that affect people’s health are global. And the solutions are also global,” he says. “We can get the best understanding and identify determinants of disease by collaborating interna-tionally to conduct research around the world.”
MCMASTER RECOGnIzES THAT BuILDInG BRIDGES IS KEY TO GLOBAL HEALTH ADVAnCES
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Research Funding 2010-2011
Federal Centres of Excellence – 20%
Disease Specific – 6%
Regional – 7%
Provincial – 4%National Institutes of Health/International – 2%
Heart and Stroke Foundation of Canada/Ontario – 7%
Tricouncil/Canada Research Chairs – 45%
REsEARCH FUNDING $28,836,194
PERsONAL AwARDs by sOURCE $3,522,661Other – 13%
Canada Research Chairs – 38%
Canadian Institutes of Health Research – 20%
PERsONAL AwARDs by TyPE $3,522,661
Fellowships – 13%
Studentships – 5%
REsEARCH FUNDING IN MILLIONs
2010-112009-102008-092007-082006-07
60
50
40
30
20
10
0
Industry – 6%
Other National – 3%
Regional – 17%
Heart and Stroke Foundation of Canada/Ontario – 12%
Other Faculty Support – 15%Career Awards – 67%
The mandate of the Deputy Chair (Research) is to promote and facilitate research within the Department. To meet this mandate, the Deputy Chair has focused on the following activities: (1) ensuring the success of junior faculty involved in research activities, (�) updating the scoring system that was implemented to quantify research output of faculty for purposes of remuneration and promotion and tenure, (3) ensuring that adequate departmental resources are earmarked for research, and (�) facilitating the inter-nal peer review of tri-council grant submissions.
The Deputy Chair (Research) meets all new recruits to provide feedback to the Chair regarding their research potential. Those selected for faculty appointments meet with the Deputy Chair on a regular basis in the research stream for mentorship and advice regarding grant applications, funding and career planning. The Deputy Chair also pro-vides advice to department members regarding new funding opportunities and research strategies.
The Deputy Chair (Research) serves as a member of the Departmental Executive, Research Executive, Promotion and Tenure, and Alternate Funding Plan Committees. The role of the Deputy Chair (Research) on these committees is to advise and advocate for research. A standardized scoring system has been developed to quantify research output.
The Department of Medicine Internal Career Awards for new faculty members have a tenure of up to
three years and are granted on a competitive basis. Awards are available for both research and educa-tion and are aimed at fostering the next genera-tion of researchers and educators. Funding from this source can be used to offset clinical expenses, thereby increasing protected time for research. The Deputy Chair (Research) is a member of the com-mittee that reviews and prioritizes the applications for Internal Career Awards.
The Department of Medicine continues to be a major contributor to the research productivity of McMaster University. The number of grants held by the Department has increased; however, the total amount of research funding held by the Faculty has decreased. This decline in research funding, from a peak in the �007-0� academic year, has occurred in all categories of awards. In �010-11, research funding to the Department of Medicine administered by the Faculty of Health Sciences was $��.� million. The majority of this funding is from peer-reviewed sources, particularly tri-coun-cil. Members of the Department of Medicine also received a considerable amount of funding from industry, which is mainly administered through the hospitals. These accomplishments are all the more noteworthy given the increasing emphasis on clini-cal productivity and the competitive nature of the grant review process.
Jeffrey I. Weitz, MD, FRCP(C), FACP, FCCP
Deputy Chair, Research These accomplishments are all the more noteworthy given the increasing emphasis on clinical productivity and the competitive nature of the grant review process.
Dr. Jeffrey I. Weitz
MD, FRCP(C), FACP, FCCPProfessor of Medicine and Biochemistry and Medical Sciences, McMaster University
Director, Thrombosis and Atherosclerosis Research Institute
HSFO/J. Fraser Mustard Chair in Cardiovascular Research
Canada Research Chair in Thrombosis (Tier 1)
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REPORTs: CO-ORDINATORs
TeachingDepartment members continue to hold signifi-cant education administrative roles. In the past academic year, the Department contributed over �3,000 hours of teaching to the MD Program. This includes contributions as tutors, profession-al skills preceptors, clinical skills preceptors and large group lecturers. Many members of the Department also contribute in the admissions process and in providing clinical supervision for medical students. Many key education admin-istrative roles within the MD Program are held by Department of Medicine members including several Medical Foundation Directors and Sub-Unit Planners.
The postgraduate programs continue to excel and are highly competitive with programs across the country. Members of the Department are significant contributors to medicine and its sub-specialty programs but also to other postgradu-ate programs including family medicine, surgery, anesthesia and psychiatry.
Dr. John Cunnington, a member of the Division of General Internal Medicine, successfully launched Ontario’s first Physician Assistant Program.
Graduates of the first class have been hired at the Hamilton General Hospital and St. Joseph’s Healthcare as physician extenders on the internal medicine service.
Education ResearchIt has been a successful year with the identifica-tion and initiation of a Simulation Committee that includes faculty and residents. This follows the development of a Simulation Curriculum that will be delivered over three years and includes simulation retreats. There has also been introduc-tion of simulation into the core Internal Medicine PGY3 Case-Based Learning Academic Half-Day. The Department has had excellent representa-tion of education research at the International Conference on Residency Education.
Dr. O’Byrne, division heads, program directors, and faculty members had another extremely suc-cessful year in educating students, resident and colleagues. The Department continues to build on its international reputation and to extend the reputation of the University through our leader-ship in education.
Ameen Patel, MB, FRCP(C), FACP
(left to right) Dr. Ayman Al-Saleh, PGY4 Cardiology; Dr. Mark Loeb, Director, Division of Infectious Diseases; Dr. Shannon Bates, Associate Professor Medicine; Dr. Hertzel Gerstein, Director, Division of Endocrinology and Metabolism; and Dr. Shariq Haider, Director, Internal Medicine Residency Program at the 22nd Annual Resident’s Research Day.
Tenure and PromotionThe Department continues to have great success with promotion of both full-time and part-time faculty, although the tenure and promotion process becomes more rigorous with each pass-ing year. The Faculty and University Tenure and Promotion Committees are scrutinizing STAR CVs and teaching tables more carefully; necessitating members pay even more atten-tion to these critical documents. All faculty are aware of the importance of having all education activities evaluated and maintaining a dossier of evaluations, which can be used to populate teaching tables. Faculty are encouraged to update their STAR CV every three to six months. We have created a contact list for STAR CV administrators that can be obtained from Mrs. Cathy Stampfli, the Department’s Tenure and Promotion Coordinator, or my office. I have represented the DEC Committee on a STAR Database and Education Committee that is reassessing all education roles and values. It is hoped education values for similar roles can be standardized across all departments and an easier mechanism for capturing postgraduate clinical activities can be agreed upon.
Awards and Faculty DevelopmentThe Department of Medicine and AFP Internal Career Awards are available to all clinician-edu-cators within the first five years of a faculty appointment. These awards are intended to sup-port academic excellence and advance education, research and innovation. Dr. Khalid Azzam, Dr. Rajendra Carmona, Dr. Dr. Tim O’Shea, Dr. Smita Halder, Dr. J.D. Schwalm, Dr. Jan Brozek and Dr. Kjetil Ask were the recipients of these awards.
Many members continue to upgrade their edu-cation skills with faculty development courses and workshops. A significant number of new clinician-educator recruits are completing for-mal training in education through the Program for Faculty Development (University Teacher Program), the Master Teacher Program at the University of Toronto or Masters of Education at other institutions.
Many divisions have continued to offer educa-tion conferences, which have been highly touted. These include the Annual Update in Internal Medicine (GIM), Annual McMaster Update in Thromboembolism and Hemostasis (hematology/thrombosis), Update in Cardiology (cardiology) and Perioperative and Anesthesia Conference (GIM).
In the past academic year, the Department contributed over 23,000 hours of teaching to the MD Program.
Dr. Ameen Patel
MB, FRCP(C), FACPProfessor, Medicine Department Education Coordinator
Department Education Co-ordinator
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REPORTs: CO-ORDINATORs
visionary leadership. Dr. Wasi was recognized by her peers in the Department of Medicine by being awarded the prestigious �010/11 Jack Hirsh Award for Outstanding Academic Achievement.
New faces in the Residency OfficeI have the pleasure of taking on the position of Director of the Internal Medicine Residency Program effective July �011 from Dr. Wasi. I have been most fortunate to have had direct mentor-ship under Dr. Wasi for the past year in my role as the Deputy Program Director. Her guidance and support have been invaluable in my transition into this position. The residency office has a number of new faces in the administrative structure. Mrs. Jan Taylor is the new Program Administrator of the core Internal Medicine Residency Program follow-ing the retirement of Mrs. Gail Trevisani. Mrs. Taylor is supported by two new administrative assistants: Ms. Sharlene Honaizer and Ms. Linda Agro, who join Ms. Mary-beth Ribble in their new roles. We are thrilled with their appointments and I have no doubt that they will do an outstanding job in sup-porting the Internal Medicine Residency Program.
Future DevelopmentsSimulation Curriculum:
Through the work of the Simulation Committee, chaired by Dr. Khalid Azzam, we have developed a blueprint for a longitudinal Simulation Curriculum over the three years of training. Selective high-lights of the curriculum are: PGY-1- InterSIMS (using simulation to introduce residents to team dynamics and collaboration in acute medical set-tings), and the AIHR course (Acute In Hospital Resuscitation) offered at the end of the first year to prepare them for their SMR role. In the PGY-� year, the residents are taught ultrasound (U/S) guided line insertion, U/S guided thoracentesis, and U/S guided paracentesis, as well as lumbar puncture (LP) with use of simulation, led by Dr. Azim Gangji. Finally, in their PGY-3 year the resi-dents are given an opportunity to teach junior residents how to use simulation for the purposes of teaching. A graded curriculum in simulation will facilitate the transition of our residents from being learners to teachers. We are committed to establishing the Internal Medicine Residency Program as a future leader in the use of simula-tion in education.
Global Health Curriculum:
Following the success of the one-month interna-tional health elective in Uganda (established by Dr. Ally Prebtani) offered in the PGY-3 year, we are moving to the next stage of development of a formal Global Health Curriculum to be intro-duced in a longitudinal fashion over the three years of training. This is an ambitious project but we are fortunate to now have faculty with formal training in global health. Dr. Tim O’shea has completed his Masters in Global Health in Boston, and Dr. Christian Kraeker has completed his Masters in Tropical Medicine in London, UK. We have established a working group that will develop a blueprint for a tiered curriculum with the following themes:
1) Global burden of disease – including knowl-edge of the major causes of global mortality and morbidity, and the concepts of health care rationing and priority setting.
�) Health implications of travel, migration and displacement.
3) The Social and Economic Determinants of Health.
�) Population, resources and environment – including the effect of rapidly expand-ing global population and management of scarce resources on health outcomes.
5) Healthcare in low resource settings.
�) Human rights in global health.
We recognize the challenges of implement-ing such a curriculum but see this as a further opportunity for our Internal Medicine Residency Program to demonstrate innovation and leader-ship in education.
Postgraduate Education in WaterlooJuly �011 will mark the acceptance of the first two residents who will be completing their postgradu-ate core Internal Medicine Residency Program at the Waterloo Campus. The Undergraduate MD Program has had a distributive campus estab-lished in Waterloo, as well placement of Family Medicine Residents with great success. Katie Gregory and Mark Kuprowski will be complet-ing all their subspecialties in Waterloo, with the exception of their CTU rotations which will be completed in Hamilton.
Residency
The TREAT curriculum has inspired other training programs across Canada to adopt similar modules for their trainees.
Dr. Shariq Haider
MD, FACP, FRCPC, CCST(UK), DTMHDirector, Internal Medicine Residency Program Associate Professor, Department of Medicine
Training Program
This past academic year highlighted the ongoing produc-tivity and recognition of residents in our training program. Educational modules of the TREaT curriculum (Teaching Residents to Evaluate and Teach), devel-oped by residents, were formally implemented as a longitudinal curriculum over the three years of training. Dr Andrew Burke (PGY-3), Dr. Zain Kassam(1st year GI Fellow), Dr. Simon Oczkowski (PGY-3) and Dr. Ian Mazzetti (PGY-3) were the founders of this curriculum a year ago and they have taken leadership in implementing this cur-riculum into our core program.
The value of the TREAT curriculum was once again recognized at the �011 International Conference in Residency Education (ICRE), as a poster presentation by Dr. Zain Kassam. The TREAT curriculum has inspired other training pro-grams across Canada to adopt similar modules for their trainees. Further testament to the success of our residents was the incredible accomplish-ment of being selected for four of the top five abstracts in the “What Works” category at the ICRE �011 meeting:
Patient education and reflective learning (PeaRL) module: Piloting a resident-driven patient education program: F. Amin, Z. Kassam, A. Burke, P. Wasi, C. Kraeker, M. Matsos
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CanMEDS retreat: Early exposure to the CanMEDS competencies through annual faculty and resident led retreat: F. Amin, L. Pitre, P. Wasi
Observation of feedback by senior resi-dents: Real-time vs. remote observation of feedback encounters: I. Mazzetti, A. Burke, R. Hundal, Z. Kassam, S. Oczkowski, and P. Wasi (named top paper)
Case-Based Learning curriculum in post-graduate medical education: A. Gangji, T. Xenodemetropoulos, P. Wasi
Dr. Zain Kassam was selected for the prestigious Resident Leadership Award at the ICRE �011 meet-ing in Quebec City. This award is given annually to a resident who has demonstrated leadership in Canadian specialty education and encourages the development of future leaders in medicine.
Ten years of Outstanding LeadershipDr. Parveen Wasi has been the Program Director of the Core IM Residency Program for the past 10 years. Her incredible dedication and commitment to Residency Education has been instrumental in the success of our residents. Dr. Wasi was the recipient of the Program Director of the Year Award by the RCPSC in �010; a recognition of her
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This academic year has been one of transition and col-laboration. The Department of Medicine faculty within the Hamilton, Niagara, and Waterloo cam-puses have worked in collaboration to ensure that our Medicine Clerkship Program provides excellence in clinical training and education to our medical students. The dedication, leadership and pursuit of teaching excellence by our faculty and their staff has remained a key component of our program’s ongoing success and has been greatly appreciated and valued by our Medicine Clerkship Committee and medical students.
Campus UpdatesWith the growth of the Waterloo and Niagara regional campuses, the number of medical stu-dents completing their Internal Medicine and Medicine Selective Clerkship at all three campus sites will be 19� and �0� for the class of �01� and �013. The class of �013 will have a total of 15� students based in Hamilton, and �7 students based within each regional campus. Our pro-gram has been able to maintain an equitable and accessible training program at all sites. However, with the growth of our medical school and faculty of health sciences programs, future consideration for greater community placements will need to be explored.
The inaugural class of medical students at the Niagara Regional Campus of the DeGroote School of Medicine successfully graduated in May �011. Dr. Eli Rabin, Regional Education Leader (REL) for Internal Medicine; Dr. George Zimakas, REL for Medical Selective Subspecialty (MSS); clinical teachers such as Dr. Ryuta Nagai; and the regional campus MD program have been prominent lead-ers in the success of our Medicine Clerkship Program in the Niagara Regional Campus.
Within the Hamilton campus, the students have been assigned to the Clinical Teaching Units (CTUs) at the Hamilton General Hospital (HGH), McMaster University Medical Centre (MUMC) and St. Joseph’s Hospital (SJH). With the Hamilton Health Sciences Access to the Best Care plan, the MUMC CTU was transferred to the Juravinski Hospital in April �011. The CTU move to the Juravinski Hospital has been a smooth transi-tion overall due to the enormous effort and sup-port from its CTU director and administrative assistant, Dr. Patel and Ms. Hendershott; Chief of Medicine and assistant, Dr. Lumb and Ms. Kane; Department of Medicine Chair, Dr. O’Byrne, and his staff; Internal Medicine Residency Program and its Director, Dr. Wasi; Medicine Clerkship Program; Dr. Panju; Dr. Hunt; and the Medicine and HHS administrative staff.
The inaugural class of medical students at the Niagara Regional Campus of the DeGroote School of Medicine graduated in May 2011.
Dr. Sharon Marr
BSc, MD, FRCPC, MEdFaculty Clerkship Director Internal Medicine and Medicine Selective Subspecialty Clerkship Program
Clerkship Co-ordinatorClinical
I have the pleasure of announcing Dr. Nicole Didyk as the local Regional Educational Leader for the Waterloo Internal Medicine Residency Program. Dr. Didyk is a geriatrician who has been actively involved in the Undergraduate MD Program based in Waterloo. Dr. Didyk brings her clinical experience and educational leadership to her new role in post-graduate education. I look forward to working with her in creating a positive post-graduate experience for our two residents capitalizing on the significant strengths of subspe-cialty experiences in Waterloo. Both our residents have the opportunity to help shape and evaluate the Waterloo program, and share their experienc-es with other programs looking at post-graduate expansion outside of Hamilton.
Clinical Teaching Units Post ABCIn April �011, the new Juravinski Hospital officially opened the Clinical Teaching Unit (CTU) follow-ing its relocation from the McMaster University Medical Centre site. The new CTU site has been a great success providing state of the art edu-cational resources and physical space to deliver quality education to our residents. I am indebted to our residents and our faculty who are based at
the juravinski site for their professionalism and commitment to our new CTU site. The juravinski CTU site joins our two outstanding CTU sites based at the Hamilton General Hospital (HGH) and (St. Joseph’s Hospital (SJH). The leadership of the three CTU directors (Drs. Ameen Patel, Raj Hanmiah and Will Harper) has been instrumen-tal to the success of our CTUs, which receive exceptional reviews from visiting trainees. As a testament of faculty commitment to the residency training program, we have introduced a cap on our CTU-based teams to �5 patients per team (three teaching teams per CTU site) to ensure a balanced educational experience. To accommo-date this cap all three CTU sites have created MD-based teams of varying structures supported by physician extenders.
I wish to thank all of our residents and faculty for their support in my early days as the Program Director. I am committed to ensuring that this pro-gram retains its recognition as a resident-driven and resident-centered program, and its growing reputa-tion as a leader in innovative medical education.
Shariq Haider, MD, FACP, FRCPC, CCST(UK), DTMH
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REPORTs: CO-ORDINATORs
sites and clerkship programs. In addition, medical students will continue to have additional learning resources available to them such as mandatory e-learning cases (Simulated Internal Medicine Patient Learning Experience, SIMPLE) to com-plete. Overall the feedback on SIMPLE has been very positive.
The Medicine Clerkship Committee, with rep-resentation from faculty within the regional and Hamilton campuses, second and third year classes, and administrative staff, will continue to be an integral part of our program. Dr. Christian Kraeker will be the Internal Medicine Clerkship site coordinator for the Juravinski Hospital and will join our committee in October �011. The com-mittee hosted its annual retreat meeting. In �010 an inaugural workshop, which focused on faculty development of teaching skills and knowledge, was organized. The workshop, “Ambulatory Teaching in Clinics (ACT)” was open to committee and faculty members who taught or supervised medical students during the medicine clerkship rotation. Due to the success of this workshop faculty development sessions will be an annual event and will be organized in conjunction with the Medicine Clerkship retreat. For �011 the focus of the faculty development session will be pro-fessionalism and interprofessional education. The annual administrative retreat for the inter-nal medicine and MSS administrative staff also
occurred and focused on curriculum updates such as STAR and new initiatives within the clerkship program and medical school.
AcknowledgementsOn behalf of the Medicine Clerkship Program and the medical students, I would like to express my deepest thanks to the Department of Medicine division heads and faculty, CTU directors and their assistants, Ms. Lynn Pacheco (Medicine Clerkship program administrative coordina-tor), the Medicine Clerkship Committee mem-bers, Internal Medicine Residency Program and its residents and administrative staff for their overwhelming support and commitment to the Medicine Clerkship Program. It is due to their generous support and commitment to teaching excellence that our Medicine Clerkship Program has strengthened and maintained its high aca-demic standard.
Special thanks to Dr. Paul O’Byrne, Dr. Alan Neville, Dr. Ameen Patel, Dr. Parveen Wasi, the Internal Medicine Residency Program, Ms. Annette Rosati, Dr. Barry Lumb, Dr. David Russell, Dr. Rob Whyte, and Ms. Cathy Oudshoorn for their continuous support and guidance over the past four years.
Sharon Marr, BSc, MD, FRCPC, MEd
The Medicine Clerkship Program awarded “Teaching Excellence Awards” for the class of �011 as follows:
Rotation
Internal Medicine
MSS
Niagara Regional Campus
Dr. Eli Rabin
Dr. George Zimakas
Waterloo Regional Campus
Dr. Mary Jackson
Dr. John Landridge
Hamilton Campus
Hamilton General: Dr. Christine Bradley MUMC: Dr. John You St. Joseph’s Healthcare: Dr. Joseph McMullin
Dr. Tricia Woo
Another new development, which will certainly benefit our Medicine Clerkship Program, will be the expansion of the Internal Medicine Residency Program into the Waterloo Regional Campus in July �011 with its first two residents. Dr. Nicole Didyk, our Waterloo Regional Campus MSS Clerkship Coordinator has been appointed the Internal Medicine Residency Program Regional Education Leader. We are looking forward to this initiative and its positive impact on our Medicine Clerkship Program.
The two-week MSS Clerkship Program in Hamilton has remained strong and has provided clinical experiences in several medicine special-ties such as cardiology, critical care, gastroenter-ology, geriatrics, hematology, nephrology, and rheumatology. Medical oncology has joined this MSS Clerkship Program this academic year and offers rotations at the Juravinski Cancer Centre. Over the next year, the MSS Clerkship Program with Dr. Azim Gangji, the new MSS Faculty Coordinator, will work with the MSS coordina-tors to expand our ambulatory component of this rotation that is offered across all three campuses. Each campus will continue to provide its unique assortment of medicine subspecialty rotations and a mix of inpatient and outpatient experiences.
This past academic year we were pleased to offer new student awards. Starting with the class of �011, the Internal Medicine Clerkship Program will present one medical student from each of the five hospital sites with a “Dr. Paul O’Byrne Award for
Outstanding Clinical and Academic Achievement”. The Medicine Selective Subspecialty Program will award three students (one from each campus) the “Dr. Alan Neville Award for Outstanding Clinical Performance”. Dr. O’Byrne’s and Dr. Neville’s dedication, enthusiasm and passion for medi-cal education and its learners has inspired and supported many students to specialize in this field and has helped to strengthen our Medicine Clerkship Program. Nominees for these awards will be recognized for their outstanding perfor-mance by having their names posted on our Medportal clerkship website. At the end of the class academic year an awards dinner will be held annually. Student recipients for each award will be presented at the dinner. Also, faculty from the Department of Medicine will be recognized for their excellence in teaching during our medicine clerkship rotations.
Program UpdatesThe internal medicine and MSS Clerkship Program has been collecting data on the clinical clerks’ clinical experiences, clinical conditions, and professional competencies since �00�. The data collected has been invaluable, as all medi-cal school campuses must ensure that the patient clinical experiences are comparable amongst all teaching sites and meeting the program’s learning objectives. Data collected so far has revealed that the students have comparable clinical experienc-es. In November �011 students will be submitting their clinical experiences online across all campus
For the class of �011, the “Dr. Paul O’Byrne Award for Academic Achievement” during the internal medicine clerkship rotation was awarded to the following medical students:
Hamilton Campus - Sites SJH - Joshua Wald HGH - Caroline Correia MUMC - Rebecca Jarvis
Waterloo Regional Campus Richard Oosthuizen
Niagara Regional Campus Robyn Visser
For the class of �011, the “Dr. Alan Neville Academic Achievement Award” during the MSS clerkship rotation, was awarded to the following recipients:
Geriatric Medicine, Dr. Irene Turpie Award - Amy Montour Rheumatology, Dr. Fred Bianchi Award - Sen Han Phang
Hamilton Campus - Michelle Marlborough Waterloo Regional Campus - Lauren Davies Niagara Regional Campus - Jonah Mizzau
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opportunity to showcase our performance from �00�-�011 in terms of education and research under the leadership of Dr. Paul O’Byrne and our Division Directors. During this time, many fac-ulty members received prestigious honours and awards, including 10 Canada Research Chairs and �7 Endowed Chairs or Professorships.
There has been some re-aligning of Departmental administrative services during the past year. Changes were necessary not only for cost effec-tiveness in this financially challenging climate, but also to streamline organizational structure to bet-ter serve our faculty, students and staff. Change can be good but also difficult for some. The result, however, has been the establishment of a superb administrative team in the Department of Medicine. Our dedicated team of site co-ordina-tors respond effectively to issues as they emerge at the hospital sites. The team consists of Gail Laforme (Juravinski Hospital), Roberta Petitti (Hamilton General Hospital) and Zrinka DiVincenzo (MUMC). During this past year, Courtney Humes assumed the role as Site Co-ordinator for the St. Joseph’s Healthcare site. This “hands on” approach is important to form and maintain rela-tionships at each of the hospital sites.
During the past year, an Executive Administrative Team was created to assist with the implementa-tion of the strategic direction of the Department. The Team consists of Terry DeCola (Office Manager), Lorrie Reurink (Human Resources Co-ordinator), Zrinka DiVincenzo (Human Resources Assistant) as well as Lisa Greer (Finance Manager). The Department was also fortunate enough to hire a dedicated AFP Analyst, Graeme Matheson. Graeme is now responsible for all aspects of the AFP including membership, financial transactions and support to the AFP Executive and Finance Management Committees. Graeme also works closely with Dr. Ameen Patel, Department Education Coordinator, and Dr. Jeff Weitz, Deputy Chair, Research, with regard to the AFP academic merit process.
I look forward to another exciting year and to con-tinue to work amongst the most talented patient care providers, educators, researchers, adminis-trators and staff in the Department of Medicine.
Annette Rosati, BA
The Department of Medicine continued to be extremely productive and successful in 2010-11. Having com-pleted my first full year in the role as Director of Administration, I have had the opportunity to meet and work closely with many faculty and staff during the past year. With �0� geographic full-time faculty and ��� part-time faculty, there are still many more to meet. I continue to be astonished at the high caliber of our faculty mem-bers. The Department of Medicine has extremely committed and dedicated Division Directors and Deputy Chairs who help to ensure that the goals and mission of the Department are met; that is, an excellent academic and clinical environment. The Department also has an excellent support system in terms of research and administrative staff. These dedicated and hard-working individuals are essential to the success of our faculty members and to the Department as a whole.
The Department continues to work closely with our hospital partners and in particular, Dr. Barry Lumb at Hamilton Health Sciences (HHS) and Dr. David Russell at St. Joseph’s Healthcare Hamilton (SJHH). Hamilton Health Sciences (HHS) underwent their Access to Best Care (ABC) move in April �011. The tireless efforts and dedi-cation of the HHS administration and the Capital Development Team helped to ensure a seamless
transition for patients, faculty and staff. Gail LaForme and Barb Kane worked tirelessly to orga-nize and direct the re-location of faculty and staff at the Juravinski site, not only for the ABC move, but an additional internal move as well.
Planning is ongoing for the development of a new McMaster Academic Ambulatory Care (MAAC) clinic at the MUMC site. The objective for this new and innovative adult outpatient facility is to ensure a coordinated approach to patient care with linkages to other clinical programs. MAAC will also provide an opportunity to enhance the academic environment for learners. The plans have progressed to architectural drawings and endorsement from the HHS and Faculty of Health Sciences administration that this innovative out-patient facility is vital to the MUMC site and to the community.
SJHH is also undergoing enormous re-develop-ment to its site. Construction has begun at its West 5th campus which will house a state-of-the-art health care facility with 305 beds and �00,000 square feet of integrated health services. Slated for completion in �01�, this redevelopment will free up much needed space at its Charlton site.
The Department of Medicine undertook a 5 year review during the past year. This was a perfect
The Department of Medicine has extremely committed and dedicated Division Directors and Deputy Chairs who help to ensure that the goals and mission of the department are met; that is, an excellent academic and clinical environment.
Annette Rosati
BADirector of Administration Department of Medicine
Director of Administration
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Construction and redevelopment continues at all of our sites and includes:
HGHA new electrophysiology (EPS) lab, rede-velopment of the Coronary Care Unit and a fourth floor Cardiology Unit
Major renovations to the Emergency Room
Major renovations of non-clinical care areas in support of the inpatient units
JHCCCompletion of Phase 1B of the massive site reconstruction will conclude in March of �01� and will specifically include fur-ther new office areas for the Department of Medicine, a new dedicated medicine ambulatory care, inpatient registration, medical diagnostic unit and outpatient laboratory
MUMCReconstruction of the new pediatric ER continues
New endoscopy unit in the former �X ward area will open in September of �011
One ICU bed and � step down beds have been constructed and are operational in the labour and delivery area in support of critically ill women
The Ministry of Health and Long-Term Care (MOHLTC) has provided funding to the acute care institutions in Ontario to improve the quality of care patients admitted through our emergency rooms receive. The MOHLTC Innovation Fund members have agreed to establish a Quality Director for the Department of Medicine. This individual will be funded for two years and will focus on improving the quality of care of this large and difficult patient group. This will be done in close consultation with the overall quality ini-tiatives of Hamilton Health Sciences.
Recruitment continues despite these fiscally challenging times and we have been fortu-nate to welcome the following new faculty this year: Dr. Wee Shian Chan, Associate Professor,
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Obstetrical Medicine; Dr. Robert Hart, Professor, Neurology; Dr. Alfonso Iorio, Associate Professor, Hematology and General Internal Medicine; Dr. Christian Kraeker, Assistant Professor, General Internal Medicine; Dr. Daniela Leto, Assistant Professor, Infectious Diseases; Dr. Dominik Mertz, Assistant Professor, Infectious Diseases; Dr. Menaka Pai, Assistant Professor, Hematology; Dr. Ted Xenodemetropoulos, Assistant Professor, Gastroenterology; and Dr. Natalia Yakubovich, Assistant Professor, Endocrinology.
A provincial election will take place in October of �011 and it is highly likely that we will be challenged even further following the election to respond to the severe fiscal challenges that the province is experiencing. Hamilton Health Sciences will embark on a strategic planning exer-cise in the post ABC era and I anticipate that this will also be a challenging exercise. Despite the magnitude and the pace of change, I continue to be overwhelmed by the support I receive from so many members of our department. It is a privi-lege to work with a department of such commit-ted clinicians, educators and researchers.
Dr. Barry Lumb, MD, FRCP(C)
This has been a year of unprecedented change of the face of health care in Hamilton. During these chal-lenging times, we have continued to benefit from remarkable leadership. Many members of the Department have contributed significantly over this last year but I would like to specifically acknowledge Drs. Christine Bradley, Shariq Haider, Will Harper, Dereck Hunt, Akbar Panju, Ameen Patel, Parveen Wasi, and Ms. Annette Rosati for their outstanding commitment and contribution.
Our Chair, Dr. Paul O’Byrne, continues to pro-vide outstanding leadership and is a valued friend, mentor and advisor. Dr. David Russell has taken over the reigns as Chief of Medicine at St. Joseph’s Healthcare Hamilton and is already a tremendous colleague. His years of leadership within Nephrology are now applied to the entire Department of Medicine and I very much appreci-ate the opportunity to work with him.
Change is seldom a single event but rather a long process. However, on April �, �011 a fundamental change in adult care occurred in Hamilton. On that day, after three years of planning, the adult inpatient and ER at MUMC were closed and the medical and surgical beds redistributed across the other three acute care sites. Adult women’s care continues at the McMaster University Medical Centre (MUMC) site, specifically focused on
high risk obstetrics and gynecology. The Clinical Teaching Unit (CTU) at MUMC was moved to the Juravinski site (formerly Henderson General Hospital) after major reconstruction of the ward, teaching and office areas. The CTU is now well established at the Juravinski Hospital and Cancer Centre (JHCC) and running very well. Feedback has been quite positive from our faculty and learners and the return of the residents and interns to this site has been invigorating for all of the staff.
The next step in the overall Access to the Best Care (ABC) initiative is to complete the planning and begin construction of the McMaster Academic Ambulatory Centre (MAAC). This is an extremely ambitious plan to renovate the former �th floor yellow quadrant for an enhanced outpatient ambulatory care for adults. This will be the first outpatient medical CTU in Canada and will be an outstanding addition to the educational opportu-nities for our learners and research opportunities of our staff.
We have also established an Obstetrical Medicine Service at the MUMC site to provide expert medi-cal support for complex, high risk women. This service is supported by ��-hour intensive care and anesthesia.
Dr. Barry Lumb
MD, FRCP(C)Chief, Department of Medicine Hamilton Health Sciences Professor, Department of Medicine
Hamilton Health Sciences The next step in the overall Access to the Best Care (ABC) initiative is to begin construction of the McMaster Academic Ambulatory Centre (MAAC). This will be the first outpatient medical CTU in Canada.
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The General Internal Medicine Rapid Assessment Clinic has been successful in preventing or short-ening hospital admissions and has now received annual funding from LHIN �. The Hospital has also received supplementary funding for a Short Stay Unit which will allow early transfer of patients from the Emergency Department to a ward bed. The Ministry of Health and Long-Term Care (MOHLTC) has funded a quality improve-ment project to improve the rates of early dis-charge using a dedicated nurse managed care path. The Department has also applied for additional MOHLTC funding to develop quality initiatives to reduce the length of stay and re-admission rates for patients with obstructive lung disease and congestive heart failure.
Patient safety continues to be a major clinical and academic objective for the Department of Medicine. The Hospital’s experience with a c. dif-ficile outbreak last year had led to a number of safety initiatives focussed on preventing this seri-ous infection. A dedicated antibiotic stewardship program had been developed and Dr. Christine Lee now directs the overall approach to c. difficile infection in the Hospital. Fecal transplantation is an important advance in the treatment of relaps-ing c. difficile infection and Dr. Lee has reported these results in the Archives of Internal Medicine.
The Department recruited six new members in the past academic year. They are:
Cardiology, Dr. Fred Spencer
Endocrinology, Dr. Manoela Braga
General Internal Medicine, Dr. Rebecca Amer, Dr. John Neary
Gastroenterology, Dr. Khurram Khan
Geriatrics, Dr. Heather McLeod
Rheumatology, Dr. Viktoria Pavlova
We welcome these new members to the Department and the Hospital.
It is with much sadness that I note the passing of Dr. Freddy Hargreave. Dr. Hargreave was Professor Emeritus in the Division of Respirology and had worked at St. Joseph’s Hospital at the Firestone Institute for Respiratory Health for over forty years. He was an internationally recognized
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investigator in asthma and revolutionized the way physicians think about airflow obstruction.
Lastly, I want to acknowledge the following St. Joseph’s physicians who received honours and distinctions over the past year:
Dr. Alf Cividino received the Canadian Rheumatology Association Clinician Educator Award for �010 and is the inaugural endowed Abbott Chair in Rheumatology
Dr. Deborah Cook received the Sister’s of St. Joseph’s Mission Legacy Award
Dr. Mark Crowther was named Consultant of the Year by the St. Joseph’s Medical Staff Association and is also the inaugural Leo Pharma Chair in Thromboembolism Research
Dr. Zara Khalid was awarded the Department of Medicine Training Program’s General Internal Medicine Teaching Award
Dr. Paul O’Byrne was elected a Fellow of the Royal Society of Canada
Dr. Christine Ribic received the Dr. Jeff Ginsberg Subspecialty Award given for excellence in professionalism, leadership, research and education.
Dr. Doug Wright was awarded the David Feldman Award for the best Internal Medicine Resident
Dr. Micheline Gagnon, Internal Medicine Teaching Award
Over the past year teaching hospitals in Hamilton have faced significant change which has occurred against a background of tight budgets, strin-gent wait time requirements and a demand for clinical services that often outstrips bed capac-ity and resources. Members of the Department of Medicine have met these circumstances with professionalism and plain hard work and have continued to strive to make academic medicine thrive at St. Joseph’s. I am extremely proud of their effort and their achievements.
Dr. David Russell, MD, FRCPC
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It is a pleasure to present my first report as Chief of Medicine at St. Joseph’s Healthcare. I am fortunate indeed to have taken over a unified and ener-getic department from my predecessor, Dr. Hugh Fuller, who is now Vice-President of Medical and Academic Affairs at St. Joseph’s. I would like to thank the department members and in particular the heads of service for their advice and collegial-ity over the past year. I am also indebted to Drs. Paul O’Byrne, Barry Lumb and Akbar Panju for fostering a spirit of co-operation and goodwill in planning for the clinical and academic needs of three busy hospitals during a year of unprec-edented change.
Over the past year, the implementation of the Access to the Best Care (ABC) plan, the reorga-nization of the Clinical Teaching Unit's (CTU’s) and the increased clinical demands placed on the General Internal Medicine (GIM) Service have dominated the agenda in the Department of Medicine. Despite the complexity in plan-ning the ABC initiative, its implementation has been a seamless clinical transition aided tremen-dously by the personal efforts and commitment of Drs. Joe McMullin and Raj Hanmiah at St. Joseph’s and Drs. Barry Lumb, Ameen Patel and Akbar Panju at HHS. At St. Joseph’s, the General Internal Medicine Service has seen roughly a 15
percent increase in admissions in the year prior to the completion of the ABC plan, and this level of clinical activity has grown further. The average daily in-patient census in GIM alone now runs in the range of 1�5 patients with peaks as high as 1�5 in-patients. The CTU reorganization has also required the Service of General Medicine to now care for approximately �0 to 50 patients on a daily basis without the support of residents. St. Joseph’s was fortunate in recruiting two nurse practitioners and two physician assistants to help with this additional clinical work. This approach, along with the creation of two additional physi-cian led teams, has worked effectively in manag-ing a large and demanding hospital practice. The clinical burden on General Medicine has also been eased significantly by the increased role of Nephrology, Critical Care, Gastroenterology and Respirology in providing most responsible physi-cian (MRP) services. As a result, on an average day, approximately ��0 patients are under the care of physicians in the Department of Medicine. While extraordinarily busy, this clinical environ-ment is ideal for teaching and research and many divisions at St. Joseph’s excel in both domains.
Managing patient flow within the Hospital is essential to meet the clinical needs of patients and several initiatives are planned or underway.
Dr. David Russell
MD, FRCPCChief, Department of Medicine St. Joseph’s Healthcare Associate Professor, McMaster University
St. Joseph's Healthcare While extraordinarily busy, this clinical environment is ideal for teaching and research and many divisions at St. Joseph’s excel in both domains.
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