“We’re so used to pretending that we’re good at multitasking and we’re not.” - Dr. Pippa Moss

What if I told you a few simple exercises could help you

• cut down on stress,
• focus better,
• improve your sleep and
• make you calmer in the face of uncertainty?

These are just some of the benefits reported by staff of Mental Health and Addictions Services in Amherst, Nova Scotia, after participating in a six-week mindfulness program. So, what’s the secret? Can practising mindfulness really improve your wellbeing? More and more research is pointing that way.

But first, what exactly is mindfulness?

If you ask five people what ‘mindfulness’ is, you’d likely get five different answers; still, some common themes would emerge: the ability to consciously focus on the moment, an awareness of your body and breathing, and the ability to control your emotions.

One believer in the practice is Ashwin Varghese, MBBS, MSc, FRCPC, a psychiatrist and assistant professor in the Department of Psychiatry (Faculty of Medicine) at Dalhousie University. Dr. Varghese has engaged in mindfulness exercises for the past 13 years. His particular interests are in seated meditation and yoga. He credits this discipline with helping him maintain wellness while completing his specialty training and, now, his busy practice.

“I see mindfulness as a technology for understanding ourselves and for understanding the lived human experience. It’s really about giving us tools to better manage and handle life.”

Mindful of the hype (i.e. there is research to back this up)

Mindfulness is not a cure-all, but an increasing number of research studies are supporting the long-held belief that mindfulness practices offer tangible health and relational benefits. This research is leading to more acceptance and integration of these practices in government, education and health care settings, and law enforcement and legal professions.

“In the mental health field, mindfulness-based clinical interventions are now very common,” said Dr. Varghese, outlining variations like mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and Mindful Awareness Practices (MAPS).

Links have been made between mindfulness practices and reduced anxiety scores and depressive symptoms. Some studies have also associated mindfulness with physiological benefits like improved blood pressure, altered immune reactivity, changes in inflammatory gene expression, reduced cirrhosis symptoms, and changes in brain structure and function.

“There’s been an explosion of research. Particularly with the advancement of neuroimaging technology, we’ve been able to get a better understanding of what may be happening at a neuro-physiological level. I think that helps demystify the practice,” said Dr. Varghese.

Introducing mindfulness to mental health workers

Dr. Varghese decided to pilot a six-week mindfulness program to benefit his colleagues at the mental health clinic in Amherst where he works. The timing seemed right.

High burnout remains an ongoing risk among health care workers. Added to that, restructuring of the Nova Scotia Health Authority was causing particular stress and uncertainty. Beth Wallace, Dr. Varghese’s colleague from the Atlantic Contemplative Centre, had also just finished her certificate program in Mindful Facilitation through the Mindful Awareness Research Center at the UCLA Semel Neuroscience Institute — making her the first Canadian accredited to deliver the esteemed center’s six-week MAPS program.

“Enhancing compassion, empathy and resiliency, and reducing burnout. In my opinion, mindfulness programs have the potential to augment the innate humanity of the physician,” said Dr. Varghese.

Did the mindfulness program aid health care workers in Amherst?

The program in Amherst that Ms. Wallace and Dr. Varghese collaborated on consisted of one third instruction, one third workshop exercises and a third practice (e.g. posture, breathing, working with difficult emotions, cultivating positive emotions, and how to integrate meditation into home life, etc.)

“It came at a pretty interesting time,” said John Rossong, manager for Mental Health and Addictions in the county northern zone. “I haven’t historically been high-anxiety, but the last year or two I’ve been anxious at times because of my new role. The mindfulness training really helped me settle, focus and recognize things I have control of, and also to be okay with some uncertainty. To learn to sometimes let it go — that was huge for me.”

Pippa Moss, MBBS, FRCPC, is a child and adolescent psychiatrist who works in five different clinics in Nova Scotia as well as in Toronto. She admits her life can be hectic and she often finds herself trying to multitask.

“What I got out of the program is really learning to be in the moment rather than being distracted by extraneous things. For example, at night now when my mind runs with thoughts such as ‘I’ve got to do this and that the next day’, I can settle it by focusing in on my breathing. I sleep so much better and I think I’m probably more efficient in terms of the day-to-day stuff.”

Participants were given forms to fill out before and after the training. The first was a five-facet questionnaire with a comprehensive mindfulness rating scale. The second was a perceived stress scale (an attempt to quantify stress). After the training was complete, the same tests were administered along with a qualitative feedback form.

“With the quantitative data, we were able to statistically demonstrate significant changes in a well-studied, self-report mindfulness scale when comparing pre- and post-program responses,” said Dr. Varghese. “To me, this suggests that the participants were engaged with mindfulness practice sufficiently to experience some of its well-documented benefits.”

In addition to reduced emotional reactivity and more openness when listening to clients, improved teamwork was also a noted benefit.

“I found it to be a really nice way to destress at work and to share some of the burden we carry as health care workers. It was nice to feel like you’re not alone,” said Ewelina Zaremba, MD, a family doctor at the clinic.

Dr. Varghese plans to do further analysis of data collected at the three and six-month post-program mark. He eventually hopes to do a larger study with a control group and added markers and measures. He and Ms. Wallace are also discussing the possibility of doing a retreat to refresh skills, given the interest expressed by his colleagues to keep this training going.

Will mindfulness transform your life?

“There’s a term that’s used quite often in this work and that’s ‘brain fitness.’ Just like back in the ‘70s we introduced participACTION in Canada to get youth moving more — at the time that was kind of a radical idea. If you weren’t an athlete, why would you be out jogging?” Ms. Wallace said with a laugh.

“We’re realizing now that we can apply the same kind of practice and care to our minds and brains that we do to our bodies. Many people predict that within 10 or 15 years, brain fitness will be just another routine part of the general health we offer ourselves.”

Mr. Rossong, for one, intends to continue the exercises he learned during the program. His biggest take away?

“It’s okay when you feel a strong emotion, like frustration or anger. The question is to not have it overcome your life. What are you going to do with it? How do you look at it? When you ask yourself those questions it creates a bit of pause and that is something that has added to my quality of life,” he said.

Dr. Zaremba is also continuing her efforts.

“Even today, I had quite a stressful morning,” she said. “I’ve been sitting here doing the deep breathing and reminding myself to take five minutes to come back to my breath and be in the moment and not allow my mind to race ahead. If you stop and centre yourself, it just keeps you from spiraling.”

Dr. Moss believes mindfulness is not something new; rather, a skill that we’ve lost.

“My grandmother and my mother had to learn how to cope with quiet. They were not constantly active and having information pass before their eyes. There were times where they were waiting for things, for example on a train or at the doctor’s office or for a meal to cook. Waiting was just something that you needed to learn to do. The difference now is that we’re so busy that we’ve lost the ability to focus and to actually fully experience the moment. Mindfulness takes you back to that.”

Interested in learning more? You can get in touch with Dr. Varghese by email at avarghes@dal.ca and Ms. Wallace at info@bethwallace.com.

Note: For West Coast Fellows, BCALM (BC Association For Living Mindfully) based in Victoria comes recommended by Dr. Rachel Carson, FRCPC (Nephrology and Internal Medicine, Nanaimo Regional General Hospital). She writes, “The Executive Director, Dr. Mark Sherman (CCFP) runs ‘Mindfulness in Medicine’ and ‘Mindfulness for Physicians’ courses that also live up to the hype.” Check it out at www.bcalm.ca

What does it take to be recognized by the Canadian Medical Hall of Fame? Look no further! Settle in and be inspired by the stories (and enduring impact) of this year’s laureates.

Michel G. Bergeron, MD, FRCPC (Québec City, Que.)
Visionary, leading figure in the struggle against infectious disease and superbugs resistant to antimicrobials. An inspiration to thousands of students and researchers, Dr. Bergeron’s innovative achievements have enhanced health, saved lives, and he established in Québec, one of the largest infectious disease centres in North America.

Michel Chrétien, MD, FRCPC (Montréal, Que.)
Internationally recognized physician-endocrinologist and fierce defender of scientific freedom, Dr. Chrétien has built a unified career around his own pro-hormone theory, bridging basic and clinical sciences to secure immediate medical benefits.

F. Estelle R. Simons, MD, FRCPC (Winnipeg, Man.)
Internationally renowned physician-scientist focused on pharmacologic management of allergic diseases, including anaphylaxis and asthma. A widely respected mentor, Dr. Simons played an important role in building the specialty of Allergy & Clinical Immunology nationally and worldwide through leadership in her field.

Richard G. Goldbloom, MDCM, FRCPC (Halifax, N.S.)*
One of Canada’s foremost pediatricians, recognized globally as a pioneer of family participation in the care of hospitalized children. Known for his compassion for humanity, Dr. Goldbloom is highly acclaimed for his contributions to clinical excellence, pediatric research, education, administration and community service.

Michael R. Hayden, MD, FRCPC (Vancouver, B.C.)
Pre-eminent biomedical scientist, innovator and entrepreneur, Dr. Hayden has made substantial contributions to the diagnosis, prevention and treatment of major neurodegenerative disorders, most notably the genetic basis of Huntington disease.

The late Justice Emmett Hall (Saskatoon, Sask.)
Tasked with leading the Royal Commission on Health Services in 1961, Justice Hall had a profound and enduring impact on the organization and funding of health care in Canada. Considered a founding father of Canadian Medicare, he worked tirelessly throughout his law career for Indigenous rights, equal access to health care, and the rights of the disabled.

*Correction: Please note, an earlier version of this article referred to Dr. Goldbloom in error as “The late Dr. Goldbloom.” While Dr. Goldbloom was not able to attend the induction ceremony, he is very much alive and well. We apologize for this error. – Royal College Communications

Hospitals collect and report all kinds of metrics for accreditation and quality improvement. Did you know that you can take advantage of this treasure trove of data for your own continuing professional development?

Here’s how my colleagues and I are improving our individual and group performance in patient flow by analyzing metrics at The Ottawa Hospital, where we work as emergency physicians. I’ll leave you with several ideas for how you can implement a similar model — no matter your specialty or subspecialty. I’ll also highlight opportunities for claiming MOC Program credits (including in Section 3: Assessment).

First things first: uncover existing data collection systems

Whether you work in a hospital or a group practice, you’ll be surprised by the amount of data that’s available to you — it usually takes just one conversation to find out!

We met with our hospital administrators and told them we were interested in analyzing our performance as a group. We discussed what kinds of data they collected that might be relevant to our scope of practice. We were able to capture various emergency room metrics related to patient flow:

• the number of patients seen per day,
• the time spent seeing a patient,
• CT scan and imaging ordering rates,
• the length of stay for patients, and
• wait time for patients before receiving pain control.

Note: While these metrics are specific to Emergency Medicine, your hospital is probably also collecting metrics that are relevant to your discipline. Talk to your hospital administrators and find out what kinds of data they could pull for you and your team!

Make the data work for you: turn assessment into improvement

We noticed that in our department, there was wide variation in patient flow efficiency among individual physicians. Individually reflecting on this data was helpful to know where we stand compared to each other — there were some really high performers and also some lower performers on that distribution curve. Now that we have a better idea of where to focus our efforts, we’re trying to tighten that variation with a combination of interventions. These include individual coaching and tailored educational workshops. The workshops are particularly interesting because they are hosted by our high performers who showcase their best practices as examples to help others improve.

Note: Individual and practice improvement is sometimes uncomfortable. We were lucky that everyone on our team was equally committed to the process. This helped ease some of the inevitable discomfort that comes from comparing individual data for the betterment of the team. It’s important to set parameters and level expectations before getting started.

Don’t stop there! Repeat the process to put the “continuing” in CPD

We started our quality improvement process last year and expect our next round of data this summer. Our physicians will get scorecards every year on the metrics we’re monitoring. This means we’ll have the opportunity to compare our scorecards year after year and look for continuous improvement. Over time, we’re hoping to see that improvement in the form of less variation in the flow numbers between individual physicians.

Your turn! Start small on a metric that matters …

Our group has the advantage of having a quality improvement unit within our department and a coordinator to help us run our projects. That set-up enabled us to look at a broad spectrum of metrics, from patient flow to ordering rates to patient satisfaction. However, for smaller groups or private practitioners with limited time and resources, I recommend you start by focusing on just one or two metrics that matter to your practice. Once you decide, pull some data and get started!

Are you the kind of person who always has a book tucked under your arm?

Do you read “best of” book lists and feel proud at the number of selections you’ve read?

Listen up – we have an opportunity for you!

Influence your colleagues’ summer reading lists

We’re working on a special newsletter feature on top book recommendations for the summer. Who better to ask for book recommendations for doctors than other doctors?

It’s so quick and easy; you may even want to fill it out more than once!

Note: The deadline to submit a selection is Friday, June 30, 2017.

What happens afterwards?
We’ll feature a collection of your best recommendations in our July newsletter (which goes out to our more than 40,000 members). That’s right — it’s the perfect opportunity for you to influence your colleagues’ summer reading lists and solidify your reputation as a go-to source for solid book recommendations.

What bookworm wouldn’t love that?

It’s awards-and-grants season at the Royal College and we are welcoming submissions.

- Deadline: September 8, 2017, 11:59 p.m. (EST)
- Website: www.royalcollege.ca/awards
- Email: awards@royalcollege.ca

• Detweiler Travelling Fellowship: Study the highest standards at home and abroad. Final-year residents and Fellows in their first five years post-certification can gain valuable experience at medical centres in Canada or abroad. Senior Detweilers are also available for those more than five years post-certification.
  
  Junior applicants could receive up to $25,000; senior applicants up to $12,500
• Harry S. Morton Travelling Fellowship in Surgery: Advance your surgical skills. Surgeons and surgical residents can train in the United Kingdom with this fellowship. This is a wonderful opportunity to benefit your practice and contribute to excellence in Canada’s academic programs.
  
  Valued at up to $50,000/year for two years
• Royal College Teasdale-Corti Humanitarian Award: Nominate an inspiring humanitarian for one of Canada’s most prestigious medical awards. This award recognizes Canadian physicians who go beyond routine practice.
  
  The recipient will receive an engraved memento, plus travel and expenses to a Royal College event at which the award is conferred (usually Convocation)
• Royal College Dr. Thomas Dignan Indigenous Health Award: Nominate a colleague who’s an Indigenous health advocate and devoted to the rights of Indigenous Peoples.
  
  The recipient will receive $1,000, accompanied by an engraved memento; plus, travel and expenses to a Royal College event at which the award is conferred
• Royal College/Associated Medical Services Donald R. Wilson Award: Nominate a colleague who has demonstrated excellence integrating the CanMEDS Roles into a Royal College training program.
  
  The recipient will receive $2,000, accompanied by an engraved memento; plus, travel and expenses to a Royal College event at which the award is conferred

The Collège des médecins du Québec (CMQ) is planning to launch a new règlement in 2018 that will require mandatory reporting of continuing professional development activities from physicians in Quebec. The Royal College is actively collaborating with the CMQ to ensure that our Maintenance of Certification (MOC) Program will enable a seamless reporting experience for Quebec Fellows who wish to fulfill their obligations to CMQ through the MAINPORT ePortfolio reporting platform. Stay tuned for more information.

Residency training in Canada is adapting to help improve health outcomes for patients and populations. Central to this goal is the need to develop updated patient safety and quality improvement competencies.

When you attend an ASPIRE (Advancing Patient Safety for Residency Education) program this fall, you will be equipped with the knowledge you need to meet this demand; you will be primed to start building capacity for patient safety, resource stewardship and quality improvement curriculum at your own institution.

"The ASPIRE course has been one of the most valuable faculty development events in my career. The curriculum and speakers were top rate and I’ve utilized the content and the medical education techniques extensively."

- Adam Moir, MD, CCFP (EM), Northern Ontario School of Medicine

Three benefits of attending ASPIRE
After participating in ASPIRE, you will be able to

1. Develop educational activities that address key patient safety and quality improvement competencies in the CanMEDS Framework.
2. Create and implement a patient safety and quality improvement curriculum plan.
3. Lead change in your residency program to integrate training on patient safety and quality improvement.

For more info: ASPIRE website / aspire@royalcollege.ca / 1-800-668-3740 ext. 590

About ASPIRE
ASPIRE is a certificate program for physicians, residents and medical educators. It is designed to advance the teaching of patient safety, quality improvement and resource stewardship in residency training. Over four days of immersive learning, ASPIRE faculty demonstrate teaching and evaluation methods for the core elements of a patient safety and quality improvement curriculum — methods participants can immediately apply at their own institutions.

The Université Quisqueya in Port-au-Prince recently established the first-ever simulation centre in Haiti. Why should Fellows be proud? The centre was made possible through a partnership between the Royal College and the university. In fact, it was furnished with extra equipment donated by the Royal College (including task trainers, mannequins and some laptops to run the more high-tech equipment).

Read more about our work in Haiti on Dr. Padmos’ blog.

Stay tuned for future updates about this and our other international work.

Richard Reznick, MD, FRCSC, is the opening plenary speaker for our 2017 International Conference on Residency Education (ICRE) this October 19-21, in Quebec City. He recently spoke with us about his views on changes in medical education, the importance of learner empowerment, and where he sees medical education heading.

From professor, educator, to dean; how have you seen medical education evolve over the years?

Richard Reznick (RR): Probably the most important change has been learner empowerment. For the most part, medical educators are working with adult learners and need to take a particular approach to interacting with this audience. The most fundamental principle in this is to empower the student to take responsibility of their own learning, and the teacher role changes from transmitter of information to guide, facilitator and coach.

A second major change has been the adoption and celebration of medical education as both an art and a science, and a speciality on its own. When I embarked on my journey in medical education, it was an oddity and an experiment; while in the last 35 years, it’s become mainstream, accepted and celebrated.

The way we assess our learners has also greatly changed over the years. If we were to dial back the clock 40 or 50 years, our tests were very knowledge-focused and often very arbitrary. If we fast-forward to 2017, our tests are now more comprehensive and much more performance-based.

I’ll leave you with one more thought, while there are of course, many more: both interprofessional education and simulation training are now staples to our medical education programs. Years ago, these did not exist, while today, they are a fundamental part of how we train and evaluate our students.

Where do you see the future of medical education going?

RR: I see the future of medical education shifting from a self-perpetuating agenda coming from the profession, to a derivation based on societal needs. In terms of shaping the future, I see the driving force of the agenda being social accountability. This will be a massive shift that will impact how we do things, how we educate and how we prepare our future doctors.

The future of medical education will also see our health professionals much more involved in shaping the system that they work in, as opposed to being passive participants.

The last big picture shift I see is a focus on the culture of wellness in medical education. Instead of strategies for wellness being reactive to the stresses and strains of our workplace, I see us trying to proactively create a more balanced approach to wellness.

What is your proudest accomplishment in a leadership role?

RR: If I had to just pick one thing, it would be through providing an example of how one can establish a successful career using medical education as the backbone. I’ve been involved in the training of around 30 fellows in medical education, many of them who have gone onto very successful careers. I’ve tried to passionately promote the notion that scholarship in medical education is a bona fide academic focus and is one that can and should be promoted.

I guess of all the things that I’ve done, if I’ve played a small role in more people thinking that this is a bona fide career focus, I feel that’s time well spent.

What is your advice for ensuring we shape the best doctors for our future?

RR: Let me frame this answer through the vision of Queen’s medical school and our faculty. Our vision is that we “ask questions, seek answers, advance care and inspire change.” If I were to be giving advice to either students or faculty, it would be that they need to promote and foster the desire to seek answers through scholarship and research, and practising medicine in an evidence-based way.

In all that we do, whether it is research or education, we have to have a singular focus in mind; that focus is what we need to make the health of our population and each individual as optimized as possible, and we remember every single day that that’s why we are here.

Finally, we must take the most creative minds, the best and brightest getting into our medical school programs, and instill in them this intense desire to embrace, celebrate and discover change.

Dr. Reznick will deliver his plenary address at ICRE on Thursday, October 19 2017.

Register for ICRE today and save with the early bird rate: www.royalcollege.ca/icre

Exciting news: full ICRE 2017 program is NOW AVAILABLE
This year’s program features five plenaries, 19 learning tracks, more than 60 workshops and over 200 poster and paper presentations.

Access the full conference program »

Join the conversation:
@ICREConf | @CIFRConf | @drjfrank (Conference Chair) #ICRE2017

Join hundreds of simulation educators, researchers, health care professionals and others engaged in the field at our unique and practical medical simulation conference.

Register for the 2017 Simulation Summit »

With a dynamic lineup of workshops, presentations and plenaries, the 2017 conference will offer participants the opportunity to

• collaborate with international colleagues on knowledge translation as it relates to simulation in health care,
• examine new technologies in medical simulation,
• investigate advances in medical simulation, and more.

The early bird deadline for online registration is September 15, 2017.

Visit www.royalcollege.ca/simulationsummit for more conference details.

Connect with us:
@RC_SimSummit | @doc4brains (Conference chair) | simsummit@royalcollege.ca

“We will lose an entire generation, I feel, to this opiate crisis,” – Del Dorscheid, MD, FRCPC (“‘We will lose an entire generation’: St. Paul’s doctor speaks out on fentanyl crisis,” Global News).

“In Canada, the second most common prescription for pain is opioids and that’s a problem,” – Shelley Duggan, MD, FRCPC (“Ask the Doctor: chronic pain and the opioid crisis,” Global News Morning Edmonton).

“I can’t emphasize enough the importance of physicians not abruptly reducing doses,” – David Jurrlink, MD, FRCPC (“Chronic pain patients fear being collateral damage of new opioid guidelines,” Global News Morning Edmonton).

"In heart failure, the patient definitely suffers a lot and so if there are ways in which we can improve not only the survival but also improve the quality of life I think that's really a win," – Peter Liu, MD, FRCPC (“Heart failure symptoms traced to unusual source,” CBC News Health).

“When you hear something that sounds better than it should, a simple way to solve a really complex problem, stand back, pause, take a deep breath and say, what’s the science behind this?” - Noni MacDonald, MD, FRCPC (“Autism ‘myths’ fuelled by the Internet, Halifax health experts say,” Global News).

“We have very consistent emergent evidence that changing lifestyle, particularly exercises that combine aerobic training … plus a healthy diet and controlling blood flow risk factors, may be very good to also push back the progression of dementia,” - Manuel Montero-Odasso, MD, FRCPC (“Walking and talking could help forecast early stages of dementia: study,” The Londoner).

“We’ve been increasing the number of physicians at about three per cent per year for the last 10 years and the population is only going up at one per cent per year,” Michael Rachlis, MD, FRCPC (“The problem is doctor distribution, not shortage,” CFJC Today).

“A guaranteed income is a simpler, more transparent approach to social assistance, and extends protection to those who are currently not covered,”- Rosana Salvaterra, MD, FRCPC (“Opinion: It’s time to talk about a ‘BIG’ idea: How a basic income guarantee could improve health,” The Province).

“We think this will be a game changer, because the way these cells act is like something we have never seen before,” - Bernard Thébaud, MD, FRCPC (“A potential game-changer to battle lung disease in premature babies,” CTV News Ottawa).

“Bottom line, almost everyone is eating unhealthy levels of sugar,” - Tom Warshawski, MD, FRCPC (“Canadian children are consuming five times more sugar than they should,” Globe and Mail).

Ronald James Baird, MD, FRCSC, died on March 26, 2017, in Fort Lauderdale, FL, USA, at age 87. He was certified by the Royal College in General Surgery in 1959 and Cardiovascular and Thoracic Surgery in 1965. He helped contribute to the discoveries of anti-coagulation therapies, heart valve replacements, bypass procedures and more. Read more about Dr. Baird.

Jason Brandon Ashley, MD, FRCPC, died on May 2, 2017, in Sudbury, Ont., at age 43. Dr. Ashley was certified by the Royal College in Diagnostic Radiology in 2008. He previously worked as a radiologist at the Sudbury Regional Hospital. Read more about Dr. Ashley.

Michael Bliss, OC, FRCPSC, died on May 18, 2017, in Toronto, Ont., at age 77. An acclaimed and award-winning historian, he was made an Honorary Fellow of the Royal College in 2003. Read more about Mr. Bliss.

Harvey Chochinov, MD, FRCSC, died on April 10, 2017, in Winnipeg, Man., at age 89. Dr. Chochinov was certified by the Royal College in General Surgery in 1961. For over 40 years, he worked in general and pediatric surgery in Winnipeg. He was also a well-respected teacher at Winnipeg General Hospital. Read more about Dr. Chochinov.

George Davis Douglas, MD, FRCPC, died on May 7, 2017, in Ammon, N.S., at age 77. Dr. Douglas was certified by the Royal College in Internal Medicine in 1969.

Donald Ralph Fuller, MD, FRCPC, died on April 6, 2017, in London, Ont., at age 89. Dr. Fuller was certified by the Royal College in Internal Medicine in 1981. A family physician for close to 20 years, he later worked as an internal medicine specialist in Stratford, Ont., until his retirement in 1998. Read more about Dr. Fuller.

Robert Walter Hogarth, MD, FRCSC, died on April 10, 2017, in Thunder Bay, Ont., at age 87. Dr. Hogarth was certified by the Royal College in Urology in 1972. He practised Urology until his retirement in 1996. Read more about Dr. Hogarth.

Karl Maxwell "Max" Irwin, MD, FRCSC, died on April 4, 2017, in Long Sault, Ont., at age 86. Dr. Irwin was certified by the Royal College in Obstetrics and Gynecology in 1962. He practised in Cornwall, Ont., for many years. Read more about Dr. Irwin.

Arthur Kaminker, MD, FRCPC, died on April 7, 2017, in North York, Ont., at age 87. Dr. Kaminker was certified by the Royal College in Internal Medicine in 1960. In his 57 years of medical practice, he worked as an allergist, clinical immunologist and physician. He was a past president of the Allergy Asthma & Immunology Society of Ontario. Read more about Dr. Kaminker.

A.C. “Craig” MacDonald, MD, FRCPC, died on April 20, 2017, in London, Ont., at age 86. Dr. MacDonald was certified by the Royal College in Diagnostic Radiology in 1965. Prior to his retirement, he was a clinical professor and professor emeritus at Western University. Read more about Dr. MacDonald.

Baldev Krishan Mohindra, MD, FRCPC, died on April 11, 2017, in Peterborough, Ont., at age 76. Dr. Mohindra was certified by the Royal College in Internal Medicine in 1974. For over 35 years, he worked in Peterborough where he oversaw the Chemotherapy Clinic at St. Joseph’s Hospital. Read more about Dr. Mohindra.

Haakon O.L. Murray, MDCM, FRCSC, died on May 2, 2017, in Kamloops, B.C., at age 94. Dr. Murray was certified by the Royal College in General Surgery in 1953. He spent the bulk of his career at the Irving Clinic in Kamloops, where he worked from 1960 until his retirement. Read more about Dr.Murray.

Richard (Dick) Pachal, MD, FRCPC, died on April 10, 2017, in Cobble Hill, B.C., at age 65. Dr. Pachal was certified by the Royal College in Psychiatry in 1999. After a brief career in law, he switched gears and worked as a psychiatrist for the last 18 years. Read more about Dr. Pachal.

Rudolph (Rudy) Lewis Ozere, MD, FRCPC, died on April 18, 2017, in Halifax, N.S., at age 91. Dr. Ozere was certified by the Royal College in Pediatrics in 1972. Just prior to his retirement in 1990, he was chairman of the Department of Paediatrics at Memorial University of Newfoundland and physician in chief, Department of Paediatrics, Janeway Child Health Centre in St. John's. Read more about Dr. Ozere.

Michel Poisson, MD, FRCPC, died on April 8, 2017, in Montreal, Que., at age 66. Dr. Poisson was certified by the Royal College in Medical Microbiology in 1980. He practised at CHUM-Hôtel-Dieu de Montréal and was also an associate clinical professor in the Department of Microbiology at the Université de Montréal. Read more about Dr. Poisson.

Peter A. Rechnitzer, MD, FRCPC, died on April 15, 2017, in London, Ont., at age 91. Dr. Rechnitzer was certified by the Royal College in Internal Medicine in 1956. Among other achievements, he co-founded the Canadian Centre for Activity and Aging and was its first director. Read more about Dr. Rechnitzger.

Brian J. Sproule, MD, CM, FRCPC, died on April 15, 2017, in Edmonton, Alta., at age 91. Dr. Sproule was certified by the Royal College in Internal Medicine in 1957. He is credited with establishing Pulmonary Medicine as a specialty in Canada. For this and other contributions, he was invested in the Order of Canada. Read more about Dr. Sproule.

Joan Christie Stevenson, MD, FRCPC, died on April 27, 2017, in Saskatoon, Sask., at age 62. Dr. Stevenson was certified by the Royal College in Anesthesiology in 2007. She spent her career at the Saskatoon Health Region's Department of Anesthesiology at Saskatoon City Hospital and the Labour and Delivery Unit at the Royal University Hospital. Read more about Dr. Stevenson.

William (Bill) Tiller, MD, FRCPC, died on April 18, 2017, in Miami, FL, USA, at age 77. Dr. Tiller was certified by the Royal College in Diagnostic Radiology in 1971. He was a diagnostic radiologist at the Grace General Hospital in St. John’s, N.L. Read more about Dr. Tiller.

Karin Lynn Verstraten, MD, FRCSC, died on April 3, 2017, in Calgary, Alta., at age 68. Dr. Verstraten was certified by the Royal College in Ophthalmology in 1993. She worked in private practice for over 25 years, in addition to being a clinical assistant professor of Ophthalmology at the University of Calgary. Read more about Dr. Verstraten.

Mark A. Wainberg, FRCPSC, died on April 11, 2017, Bal Harbour, FL, USA, at age 71. A renowned AIDS researcher and director of the McGill University AIDS Centre at the Jewish General Hospital, he was made an Honorary Fellow of the Royal College in 2003. Read more about Mr. Wainberg.

Robert Tudor Williams, MD, FRCPC, died on April 22, 2017, in Calgary, Alta., at age 88. Dr. Williams was certified by the Royal College in Anesthesiology in 1972. He co-founded the Department of Anesthesia at the Calgary Foothills Hospital. He also invented the Williams Airway Intubator. Read more about Dr. Williams.