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Permanent practice, north of 60: Two specialists share their stories

Permanent practice, north of 60: Two specialists share their stories
Photo: Courtesy of the Department of Health and Social Services, N.W.T.

Sitting at the piano, gliding her hands across the keys, Amy Hendricks, MD, FRCPC, was in Yellowknife, N.W.T., playing at a celebration of life for a beloved local lawyer who had died — someone she’d never met. She thought back to the community newspaper ad she’d answered a few days earlier after returning from a clinic in Fort Simpson. The Choral Society is seeking an accompanist. She hadn’t expected to be brought into the fold so quickly. Just two weeks in her northern home and here she was. Looking around, she couldn’t help but remark at how much her life had changed since finishing her training as an internist. She’d left a city of over a million for a city of about 20,000. The next closest city was now an 18 hour drive away. She remembered mourning the loss of her season tickets to the opera, when leaving Montreal. Now, here she was, helping to create the music.

“What I found up north in the other parts of my life is probably just as important as what I found professionally,” said Dr. Hendricks, who estimates that she produced 40-50 different musical performances during her 14 years as an internist based in Yellowknife.

“I don’t know if I was naturally a builder when I went to the north, but it brings it out in everybody. When you’re that remote, you make your own systems, you make your own fun, you make your own relationships. I think it probably drew that constructive and creative side out of me much more than if I’d stayed south.”

Photo: Dr. Amy Hendricks
Photo: Dr. Amy Hendricks

How Dr. Hendricks and Dr. Guthrie found themselves in Yellowknife

Being a specialist physician in Canada’s North is not without its challenges.

“It’s a very diverse practice. Since there aren’t that many of us, we’re involved in providing care for the whole territory, even the geographically-remote population,” said Bing Guthrie, MBChB, FRCSC, an obstetrician-gynecologist and medical director at Stanton Territorial Hospital in Yellowknife. “It’s a challenging place to recruit to, but it’s a very rewarding place to work.”

So what draws a physician up North?

For Dr. Hendricks, who recently moved to Antigonish, N.S., to start a new phase in her life and career, “It was kind of a fluke. I was at a job fair and just as I was leaving, I saw a poster with the Northern lights and dogsleds and elders. I stopped for just long enough to think ‘Oh that reminds me of Kuujjuaq,’ where I’d done a rotation as a resident. It was the recruiters who drew me in.”

One resume and a phone call later, she was on her way to Yellowknife for a visit.

“The plane landed and I knew. It was this deep sense that this was home and this was what I was meant to do. It was actually a very visceral thing.”

Dr. Guthrie’s recruitment to “Canada’s Last Frontier” took a bit longer and came by way of New Zealand.

“It was supposed to be the beginning of an around-the-world adventure, but my wife and I loved [Canada] so much that we decided to stay,” he said.

His first job was as a GP in Bella Bella, B.C. Like New Zealand, it has mild winters.

“When I first looked at coming up to the North my wife said, ‘if we’re going to do a site visit, we have to do it in the middle of winter because you’ll always love it in the summer.’ So, we did our site visit in January. It was a shock that it didn’t deter us from staying,” he said.

Dr. Guthrie took a position as a family doctor in Hay River, N.W.T. He later did residency training in Obstetrics and Gynecology in Edmonton, sponsored by the government in exchange for a return-of-service. He’s now been in Yellowknife for 12 years and can see himself retiring there.

“It’s a great place to raise a family. My two children enjoyed good schooling here. The community is also very friendly and enjoyable to be part of.”

Photo: Dr. Bing Guthrie
Photo: Dr. Bing Guthrie

How specialist care is managed in the Northwest Territories

The Stanton Territorial Health Authority provides acute care and specialty medical services for all of the Northwest Territories. The Stanton Territorial Hospital and related clinics service patients from the territories’ 33 communities and the Kitikmeot Region of Nunavut.

Patients are either brought down to Yellowknife, or serviced through telehealth or travelling services. For example, internists will visit Inuvik, Fort Smith, Fort Simpson and Hay River. People in the smaller surrounding communities will fly into these “regional hubs” to be seen.

Dr. Guthrie says he spends most of his time doing outpatient clinics with his two obstetrician-gynecologist colleagues, including visits to the high artic, Inuvik and other communities. Two days a week, they share time in the operating room.

“We practice a lot of obstetrics. Our gynecology also involves doing colposcopy, dealing with perinatal issues, doing amniocentesis…. We have a very wide scope of practice because we have to be generalists for everyone,” he explained.

Dr. Guthrie benefited from the knowledge that he would be going north, so he was able to tailor some of his residency training to his anticipated practice needs. He still does locums further south to maintain his tertiary skills, and engages in other learning activities as supported by a generous education benefit package.

In contrast, Dr. Hendricks developed a lot of additional skills while in practice. She lists her training in tuberculosis, insulin management and echocardiography as the three dominant areas she developed while up North to better serve her patients. Specialists in Internal Medicine are persistently hard to recruit for a permanent stay. For two-and-a-half years, she was the only internist living in the territories. This is a unique challenge as you don’t have a department to back you up and offer support.  

“Those were very busy years, but they were also very happy years partly because of good administrative support and the different relationships with the locums.”

The important roles filled by visiting specialists and subspecialists

To fill service gaps, many specialists and subspecialists visit Canada’s north for clinics and locums. These temporary visitors provide vital expertise and valuable perspectives. Many have long-term commitments to the North and visit on a recurrent basis.

“Our rheumatologist, Dale Sholter, has gone up [north] for a week every three months for over 15 years. Those [kinds of] subspecialists who come up and know our patients, and who we know we can always call with a question, offer tremendous benefit to the North and they taught me a lot,” said Dr. Hendricks.

Dr. Guthrie echoed his appreciation for working with visiting subspecialists and learning new skills from them. He also highlighted his close relationships with family doctors and other health care providers, including midwives.

“It’s a very collegial environment,” he said.

Dr. Hendricks added, “When you’re in a department of only a few people, it can sometimes get a little bit claustrophobic for everybody. To have other people coming through — other personalities, other skillsets, other perspectives — I think is actually healthy.”

The special rewards of permanent practice in Canada’s north

Physicians who reside permanently in the north are rewarded with continuity-of-care that rivals their counterparts’ practices further south.

“You know the patients and you see them often and I think that does make a big difference,” said Dr. Guthrie.

Some of these patients even become friends.

“I think in every small town that’s going to happen,” said Dr. Hendricks. “You can’t discriminate against your friends by not providing them with the services they need.”

That’s not to say these relationships don’t take time to establish.

“My First Nations and Inuit patients, especially, had a lot of respect for experience. It took them longer to trust a young physician,” explained Dr. Hendricks. “So when I started getting grey hair I thought ‘I’m going to welcome this.’ The more grey hair, the more the elders respect you. That is a cultural thing and I think it’s completely reasonable.”

Many people don’t realize that the Northwest Territories has 11 official languages, including English and French. Both Dr. Guthrie and Dr. Hendricks have had to communicate with patients through medical interpreters or patient escorts. Older patients, in particular, tend to favor native dialects.

“Everyone’s going to have a learning curve, no matter where they practice, it’s just more obvious in the North,” said Dr. Hendricks.

When asked to reflect on her 10+ years of service in Yellowknife, she had this to add:

“My job satisfaction came from a strong community network, supportive hospital administration and good resources. When you have those things, there is so much opportunity to find solutions for local issues, and to develop and improve services.”


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MOC Tip of the Month
Suzan Schneeweiss

Dive into your patient records to improve your practice

MOC Tip of the Month: Suzan Schneeweiss - Region 3

Completing a chart audit with feedback is an excellent way to improve an aspect of care in your practice, and engage in self-assessment for Section 3 MOC Program credits at the same time.

A chart audit is an analysis of your patient medical records — electronic and/or paper — to see what has been done and to determine if it can be done better. You are essentially measuring the quality of the care your practice provides, in order to improve it.

Here is my seven-step process to quality improvement by chart audit. I have also included examples from my perspective as a pediatrician to help you visualize how to implement the process:

  1. Select a topic:

    Ideally, the topic should interest both you and your practice. Ask yourself what is being done (or not done) there that could potentially be done better. Are there any problems that need addressing? What issues are high-risk and high-frequency?

    For example, as a pediatrician, I might like to measure how well my practice is meeting established national benchmarks for vaccine recommendations.

  2. Determine what you will measure and your benchmarks:

    In this step, define your assessment question and select at least three benchmark performance measures or standards of care that you will compare against your performance-in-practice.

    For example, the Government of Canada and my national specialty society — the Canadian Paediatric Society (CPS) — have flagged children under five as being at higher risk of flu complications. I might decide to measure how often the influenza vaccine was offered and given to or declined by my patients in this age group over the past two years. If that was my focus, I would do a literature review to identify available national benchmarks for vaccines. I’d start by reviewing the CPS’s recommendations and the Public Health Agency of Canada’s immunization schedules.

  3. Collect your data:

    Next, identify your patient population and your sample size; then, pull your patient charts. Review the charts that meet all of your selection criteria and record your findings.

    In my example, I might collect data from a random sample of at least 10 charts belonging to my patients aged six months to five-years-old. I would then record how many of them were offered and received or declined the flu vaccine in my selected timeframe.

  4. Compare your data against your measures:

    After you collect your data, compare it to established benchmarks. Your benchmarks will depend on your topic and the performance measures you selected.

    Sometimes benchmarks for comparison do not exist or are not readily available. If that is the case, you can either revise your audit so that it is comparable to existing measures or use your results as a baseline against which you can compare future audit results.

    For example, if my audit determines that the flu vaccine was not offered or given to my sample population as recommended by established benchmarks, I will know that there is room for improvement in my practice and a need for further investigation. 

  5. *Obtain feedback:

    Once you have summarized and compared your practice’s performance against the measures you selected, share your findings with a colleague, peer or mentor in your practice or specialty.

    For example, I might ask one of my colleagues at the University of Toronto to review my data and help me draw conclusions.

  6. Identify outcomes and apply results:

    After going over the results with your reviewer, consider if there’s an area of your practice that you can improve upon. Also consider what actions you could implement to close performance gaps in your practice.

  7. Document your chart audit in your MAINPORT ePortfolio:

    Last but not least, log in to your MAINPORT ePortfolio and record your learning outcomes using the “Chart audit and feedback” option. I recommend you do this as soon as possible, while your learning is still top-of-mind.

A chart audit can illuminate positive ways to improve your practice. By breaking it down into steps, it becomes more manageable to carry out and much easier to implement results!

*Note: Step #5 is especially important. Obtaining feedback is what makes a “chart audit with feedback” a Section 3 assessment opportunity (three credits per hour) instead of a Section 2 self-learning opportunity (two credits per hour). However, if you skip this step, you can still claim learning from this exercise as a personal learning project under Section 2.

Email Suzan

Contact your local CPD Educator

Fellow readers, do you have a MOC tip that you would like to share with others?

Fellows, do you have a MOC tip that you would like to share with others? Contact with your tip. If we use it, we will send you a free piece of merchandise from our Insignia collection.


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Medical assistance in dying: where do we go from here?

Medical assistance in dying: where do we go from here?

Medical assistance in dying is top of mind for many Canadians, especially those who work in health care. As Bill C-14 is debated and more details emerge about the proposed federal legislation, we commit to supporting our Fellows. We will do this by connecting you with the information you will need, every step of the way.

We’d like to thank the Fellows who have taken the time to write to us about medical assistance in dying. Your voices are being heard and we are responding to the diversity of perspectives that have been shared with us.

We will connect you with educational materials on assisted death

Some of our Fellows will choose to provide medical assistance in dying as part of their practice, while others will not. We will provide and/or connect all Fellows who are interested in learning more about this area of care with educational resources such as

  • information on medical assistance in dying procedures, including legal obligations and protections (as available);
  • the Canadian Medical Association’s forthcoming online module on medical assistance in dying and end-of-life care (expected mid-June through;
  • new cases within our bioethics curriculum to provide direction and illustrate ethical principles relevant to  medical assistance in dying and other end-of-life care options (expected in July 2016); and
  • specific workshops and other educational modules on this theme (expected in fall 2016).

Looking ahead, we will also ensure that any necessary training elements on medical assistance in dying are included within Royal College-accredited residency programs in Canada.

What about palliative care?

We stand behind calls for more resources for palliative care so that patients have equitable access to a range of end-of-life care options. The federal government has committed to work with the provinces and territories to improve palliative care during their discussions on a new health accord. Dr. Padmos is preparing a post on end-of-life care for his next CEO Message on June 1. Watch your inbox.

Our commitment to work with partners on supporting physicians

We are hopeful the federal legislation, expected on or before June 6, 2016, will provide a consistent approach to medical assistance in dying across Canada. Regardless, we are committed to working with our partners to determine how best to prepare doctors for this change in law. These partners include

  • the Canadian Medical Association,
  • our specialty committees,
  • program directors,
  • deans,
  • national specialty societies,
  • the Canadian Medical Protective Association,
  • medical regulatory authorities and
  • the College of Family Physicians of Canada.

We will also remain closely tuned to the voices of our Fellows as legislation and regulation about medical assistance in dying evolve, and remain committed to providing educational support.

Resources on medical assistance in dying:


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President’s Corner: In matters of your health, start early & stay at it

President’s Corner: In matters of your health, start early & stay at it

How do you integrate your practice and personal life? It’s not easy, but we need to do it.  

As physicians, we know our health and wellness are very important but we often don’t act like it. There are many noble reasons why we may lose ourselves in our work. Medicine is a calling and one that is getting ever more complex, with increasing acuity and busier workloads. There’s a tendency for us to place our own wellbeing last, but we do so at our peril, that of our families and of our patients.

I’ll be the first to admit that, early in my career, I wasn’t exactly a good role model. Like a lot of us, I threw myself into my work without special consideration to my health. I worked increasingly long hours, gained a bit of weight (or more than a bit) every year and became inactive. About three years ago, I decided to make my health and wellbeing a priority. I dedicated myself to eating healthier and becoming more active, and took up running. It was initially hard to find the time, but when you make something a priority you can make it work.

Running has become my outlet. It has not only improved my health and wellness, but I believe has made me more effective in my work and has also connected me with a community of colleagues – both in Canada and at international meetings – who run. Running with a group of postgrad deans and educators from around the world is always a highlight for me of our annual International Conference on Residency Education, for example.

The refreshed CanMEDS Framework identifies physician health and sustainable practice as key concepts. This means that we’re actually professionally-obligated to give this some thought and reflection. It identifies specific competencies that we should teach, that we should expect our trainees to demonstrate and which those of us in practice need to role model.

  • The Leader role sets the expectation that physicians be able to, “Set priorities and manage time to integrate practice and personal life.”
  • The Professional role sets the expectation that we “Manage personal and professional demands for a sustainable practice throughout the physician life cycle.” 

In order to do this, we need to build physician wellness into our training programs, using the CanMEDS competencies above as our guide. As a profession, we must also value these competencies in ourselves and in others. We need to create a comfortable space to talk about health and wellness. We also need to move beyond talking and take action.

This can’t simply be accomplished by building a session into a program academic half day. We need to explicitly encourage our trainees to value their health and personal lives, and our educators need to model this behavior. A friendly soccer match between colleagues or other wellness activities can be great team building activities as well as great fun.

I’m not advocating that all physicians take up running, or any sport for that matter, but I do challenge you to find our own healthy outlets and to role model good behaviour for younger generations. We need to encourage good habits early; ideally, while still a resident but certainly early into practice.

I’m a big fan of the work Resident Doctors of Canada and others have been doing on physician resiliency in training and feel there is a lot we docs in practice can learn from them. I encourage you to take a look at

As a profession, we talk a lot about preventative medicine and early health interventions. We need to model our own advice. The summer is coming, there’s no better time to get outside and give your own health some specialized care.

–    Kevin
@kimrie |


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Our new partnership with Nepal to help boost specialty medical education

Our new partnership with Nepal to help boost specialty medical education
Photo: Annapurna mountain range, Nepal

A small group of Royal College staff and volunteers were recently in Kathmandu to continue our work with Nepali colleagues to build capacity in specialty medical education. The Royal College formalized an educational partnership with the Nepali Ministry of Education by signing a Memorandum of Understanding (MOU) with the recently-created Health Professions Education Commission.

This agreement formalizes

  • our support for the development of a national model for postgraduate medical education in the country; and   
  • our assistance in providing expertise to implement elements of the Mathema Committee Report on Health Profession Education Policy — a formal process of educational reform, backed by the Nepali Government.

The Nepali Education Minister, Giriraj Mani Pokharel, witnessed the MOU signing between Susan Brien, MD, FRCSC, vice president, Asia-Pacific, Royal College International (on behalf of the Royal College) and Dr. Bhagwan Koirala, vice-chairman and lead of the commission.

(L to R) Dr. Susan Brien, Dr. Dharam Baskota, Dr. Arjun Karki, Education Minister Giriraj Pokhrel, Unknown, Dr. Bhagwan Koirala
(L to R) Dr. Susan Brien, Dr. Dharam Baskota, Dr. Arjun Karki, Education Minister Giriraj Pokhrel, Unknown, Dr. Bhagwan Koirala

“This educational partnership with the Health Professions Education Commission of Nepal will support them in their mandate to improve their system and standards of postgraduate medical education. We’re happy to share lessons from our Canadian system and assist them in their efforts to provide the best possible care for their people,” said Andrew Padmos, MD, FRCPC, Royal College CEO.

The Royal College has been working in Nepal for several years, underscored by MOUs with the Tribhuvan University Teaching Hospital and Bir Hospital. On this past trip, volunteers continued this work. They delivered a need assessment at Bir Hospital and several faculty development workshops. Our newest agreement will only deepen these ties. We will work with the Health Professions Education Commission and support their mandate to enhance institutional capacity and improve standards of specialty medical education throughout Nepal.

What is the Mathema Report?

The Mathema Report was created by a commission tasked with drafting new health education policy for Nepal. The commission was led by Kedar Bhakta Mathema, former vice chancellor of Tribhuvan University. The report was submitted to the Prime Minister in late June 2015. It details a number of recommendations. Among them,

  • decentralize medical colleges;
  • prioritize student enrollment to medical colleges based on merit;
  • implement a set fee structure and ceiling for medical studies;
  • form a Health Education Council to look at issues in the medical education sector;
  • form a series of directorates to look after areas like accreditation, regulation, medical examinations, and so forth etc.

(Sources: The Himalayan Times. Mathema-led task force submits report to PM and The Rising Nepal. Implement Mathema Report. Last retrieved May 2, 2016).

Fellow focus: Meet volunteers, Dr. George Browman & Dr. Michelle Chiu

George Browman, MDCM, FRCPC, and Michelle Chiu, MD, FRCPC, both joined the Royal College’s team as volunteers in Nepal.

(L to R) Dr. Susan Brien, Dr. Roshana Amatya (Nepal’s pioneer in Anesthesiology who trained at the University of Ottawa) and Royal College volunteers Dr. George Browman and Dr. Michelle Chiu
(L to R) Dr. Susan Brien, Dr. Roshana Amatya (Nepal’s pioneer in Anesthesiology who trained at the University of Ottawa) and Royal College volunteers Dr. George Browman and Dr. Michelle Chiu

  • Dr. Browman is a clinical professor at the School of Population and Public Health, University of British Columbia. He is also a retired medical oncologist with 38 years of practice experience. As founding director of Cancer Care Ontario, he shared his experience with Nepal’s medical leaders. He presented at a workshop at Tribhuvan University held in collaboration with the National Centre for Health Professions Education. He also assisted with the needs assessment of the oncology program at Bir Hospital and supported the team in a number of other activities.
  • Dr. Chiu is an assistant professor and simulation director for the University of Ottawa’s Department of Anesthesiology. She is also co-director of the Anesthesia Fellowship in Simulation and Medical Education. In Nepal, she delivered a series of faculty development workshops around simulation and resident assessment. She also attended the 17th National Conference of Society of Anesthesiologists of Nepal where she presented on “Integrating simulation into competency-based anesthesiology residents training.”


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Why are Clinician Scientists important and how can we support them?

Why are Clinician Scientists important and how can we support them?

Read our new white paper on Clinician Scientists in Canada: Supporting Innovations in Patient Care Through Research.

  • Learn why clinician scientists are vital to patient care across the country.
  • Discover the paths to become a clinician scientist.
  • Review the barriers to the recruitment and retention of clinician scientists.
  • Assess eight recommendations to overcome these challenges.

This paper is a late addition to our white paper series that was created in support of the Future of Medical Education in Canada – Postgraduate Project. It highlights the importance of clinician scientists’ roles. It was written following months of consultation with Fellows, faculties of medicine, clinicians and partner organizations.

Contact us with feedback:


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2016 Honorary Fellows champion Indigenous rights, medical education reform, health research and the health of the Armed Forces

2016 Honorary Fellows champion Indigenous rights, medical education reform, health  research and the health of the Armed Forces

An Indigenous rights champion, a trailblazing leader in Chinese medical education reform, a distinguished surgeon general in the Canadian Armed Forces and a renowned and knighted English pathologist will receive Honorary Fellowship in the Royal College this year.

“Each of our 2016 Honorary Fellows has made exceptional contributions to clinical care, mentorship, teaching, and inspirational leadership — all attributes that are strongly aligned with the Royal College’s mission and mandate,” said Royal College CEO Andrew Padmos, MD, FRCPC.

Meet our 2016 Royal College Honorary Fellows

Thomas A. Dignan,  O.Ont., MD, BScN

Thomas A. Dignan, O.Ont., MD, BScN
Medical Officer, Health Canada – First Nations and Inuit Health Branch; Former primary care physician, Wabano Health Access Centre, Ottawa, Ont.; Former primary care physician, Anishnawbe-Mushkiki, Thunder Bay, Ont.

A Seneca from Six Nations Territory of the Grand River, Dr. Dignan is a tireless advocate for improving the health status of Canada’s Indigenous Peoples. Read full bio »

“Dr. Dignan’s quiet leadership and wise counsel in Indigenous health is consistently sought by physicians, governments and organizations, not only for his vast expertise and experience, but also for his ability to create bridges and coalesce disparate views into positive action. The demands on his time are persistent, yet he allocates it generously and unselfishly.” — nominator quote

Yucun Liu, MD

Yucun Liu, MD
President, Peking University First Hospital, Beijing, China; Professor, Peking University First Hospital, Beijing, China

Since 2006, Dr. Liu has served as president of the Peking University First Hospital (PUFH), a 1500-bed hospital in Beijing, China, where he is an advocate for medical education reform based on the CanMEDS Framework. Read full bio »

“In recent years, he presided over the cooperation of post-medical education between PUFH and the Royal College, making the first large-scale practice of competency-based residency training in mainland China. He has achieved remarkable results, which captured the attention of the government and medical education experts.” — nominator quote

Brigadier-General H.C. MacKay, OMM, CD, QHP, MD

Brigadier-General H.C. MacKay, OMM, CD, QHP, MD
Surgeon General, Commander Canadian Forces Health Services Group; Head of the Royal Canadian Medical Service

Brigadier-General MacKay joined the Canadian Armed Forces in 1983. His career in the Canadian Armed Forces’ medical service has included work in Canada, Turkey and Afghanistan where he led the NATO Multinational Medical Hospital in Kandahar in 2007. Read full bio »

“Based on both the lengthy and important relationship between the Royal College and the Canadian Armed Forces, as well as the personal characteristics and accomplishments exhibited by Brigadier-General MacKay in his roles as physician and member of the Armed Forces, I am honoured to recommend him as an excellent candidate for Honorary Fellowship in the Royal College.” — nominator quote

Professor Sir Nicholas Wright, MBBS, MD, PhD, DSc

Professor Sir Nicholas Wright, MBBS, MD, PhD, DSc
Centre Lead, Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, United Kingdom.

Professor Sir Nicholas Wright is one of the United Kingdom’s most distinguished physicians and was knighted in 2005 for his “services to medicine.” In parallel with his career as a pathologist, he has also succeeded as an academic researcher, mentor and administrator. Read full bio »

“Sir Nicholas is known for his energy, blistering pace, perseverance, organizational skills, fairness, honesty, and ability to successfully complete tasks however difficult they may be. He embodies determination, application, and a desire to succeed in all undertakings.” — nominator quote

Please visit for more information about these recipients and Honorary Fellowship in the Royal College. The next call for nominations will open in October 2016.


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Change the system, change the outcome: ICRE adds compelling speaker

Change the system, change the outcome: ICRE adds compelling speaker

According to one of the most well-known – and talked about – quotes from Paul B. Batalden, MD, “every system is perfectly designed to get the results it gets.”

This seemingly simple idea has resonated with quality improvement (QI) movements around the world. It is becoming more evident that the only way to truly enhance health care quality and, ultimately, health outcomes is to redesign the system itself.

Internationally-renowned QI expert, Dr. Batalden, will share his personal experiences with the quality improvement movement and with health-system redesign at this year’s International Conference on Residency Education (ICRE).

Dr. Batalden’s closing plenary takes place Saturday, October 1, 2016 (16:00 – 17:30) in Niagara Falls, Ont. Register now for ICRE 2016.

Dr. Batalden: The key to sustainable services lies in coordination

Paul B. Batalden
Dr. Paul B. Batalden

Improving the value of the contribution that health care services might make to overall health is at the crux of what the quality improvement movement is all about, says Dr. Batalden.

“A systems-understanding of work helps us see that the work we do involves other people, behaviours and information technology, in relationship, and for a shared purpose,” said Dr. Batalden. “When we ‘get’ that, we realize that if we seek change, it is that system which must be understood and modified.”

Increased flexibility and individualization need to be built into the way that health care systems are structured to deliver services to patients. 

“We labour under models of value-creation that work for manufacturing and products, rather than creating more flexible models that fit the need for particularization and flexibility,” said Dr. Batalden.

As medical education and training in North America is improved and enhanced, Dr. Batalden said that a more intersectional and transformative approach to QI is crucial.

“I believe that until we link better outcomes, better system performance and better professional development, we will not have sustainable, generative improvement of health care services,” he said.

Read an extended Q&A with Dr. Batalden on the ICRE Blog.

Special two-day quality improvement conference

Attend Building the Bridge to Quality: An Urgent Call to All Educators, from September 28–29, 2016, in Niagara Falls, Canada. Join thought leaders, frontline clinicians and policy-makers from around the world. Together, create an actionable list of recommendations to transform how health professions education is structured and delivered. Register or find out more.


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Top 10 reasons to attend the 2016 Simulation Summit

Top 10 reasons to attend the 2016 Simulation Summit

You may not realize all the ways you can benefit from attending our Simulation Summit.

In anticipation of registration opening later this month, we’ve listed our top 10 reasons you should block off October 14-15 in your calendar to attend this year’s meeting.

  1. Network and exchange ideas with an interprofessional group of medical educators and simulation enthusiasts from around the world.
  2. Earn up to 20 MOC Section 1 credits by participating in educational sessions.
  3. Examine new technologies and investigate advances in medical simulation with engaging workshops.
  4. Explore state-of-the-art simulation innovations in the exhibit hall.
  5. Socialize with old (and new) friends and colleagues during relaxed receptions.
  6. Stay up-to-date on advances in simulation by listening to plenary lectures.
  7. Observe an “extreme” simulation scenario and debriefing-in-action during SimTrek.
  8. Welcome newly-accredited simulation programs to the simulation community.
  9. Soak up new research and unique takes on simulation in a variety of contexts and settings (for example, hospitals and rural/remote locations like oil rigs).
  10. Turn your trip into an impromptu holiday. Take advantage of the breathtaking sights and sounds of St. John’s, N.L.

Visit our event site to learn more.

Reminders: Send us your rants, get social

  • We want your sim-themed rants: Do people often say you have a strong point-of-view? Do you have something to say about a topic linked to simulation-based education? Get your video camera out! We want to hear your best “rant.” We may even present it at this year’s summit. Download our guidelines and submission instructions.
  • Get social with #ExtremeSim: Follow @RC_SimSummit for the latest news and updates. Use the hashtag, #ExtremeSim, to link up with conference-related discussions. You can also use the hashtag to tell us what you’d like to see during the conference.


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Members in the news

Members in the news

Advice, expertise and opinion

Perry Kendall, MD, FRCPC (Community Medicine) sent a letter urging Victoria’s council to reconsider their plan to allow the sale of marijuana edibles, as reported by The Globe and Mail. Dr. Kendall is provincial health officer for the province of British Columbia. [Source]

Allison McGeer, MD, FRCPC (Internal Medicine, Infectious Diseases) cautioned that the current shortage in medication to treat syphilis could lead to more cases. She also called on the federal government to do more to halt the common recurrence of medication shortages. Dr. McGeer is director of Infectious Disease Control at Mount Sinai Hospital in Toronto. [Source]

Hakique Virani, MD, FRCPC (Community Medicine) was quoted in the Calgary Herald questioning why the Alberta government is delayed in developing a fentanyl treatment strategy in the midst of a province-wide crisis. Dr. Virani is an assistant clinical professor in the University of Alberta’s Faculty of Medicine. He is an addiction specialist who also works at the Metro City Clinic in Edmonton. [Source]

Richard Swartz, MD, FRCPC (Neurology) explained to CTV News that Canadian speed skater Denny Morrison’s stroke was not a rare medical occurrence; strokes are more common in young adults than many realize. Dr. Swartz is a stroke neurologist at the Sunnybrook Health Sciences Centre in Toronto. [Source]

Ellen Warner, MD, FRCPC (Internal Medicine, Medical Oncology) and Karen Glass, MD, FRCSC (Obstetrics and Gynecology) explained to CTV News the importance of women with cancer considering their fertility options. Dr. Warner is a medical oncologist at the Sunnybrook Health Sciences Centre in Toronto and founder of PYNK: Breast Cancer Program for Young Women. Dr. Glass is director of the fertility preservation program at the Create Fertility Centre in Toronto. [Source]

Research, technology and innovation

Robert Balyk, MD, FRCSC, and David Sheps, MD, FRCSC (Orthopedic Surgery) are lead co-authors of new research that suggests patients who “cheat” after rotator cuff repair surgery (i.e. don’t wear their slings as told) show earlier signs of improved range of motion. Dr. Balyk is chief of Orthopedics at the Grey Nuns Community Hospital. Dr. Sheps is facility medical director at Sturgeon Community Hospital. Martin Bouliane, MD, FRCSC (Orthopedic Surgery) was also a co-author of the study. He is an assistant clinical professor in the Faculty of Medicine & Dentistry at the University of Alberta. [Source]

Chris Hanson, MD, FRCSC (Ophthalmology) and Vikram Lekhi, MD (Royal College Resident Affiliate) told Metro News/Calgary the benefits of using a new simulator to practice eye surgery. Dr. Hanson is the program director for the University of Calgary’s Cumming School of Medicine residency program for Ophthalmology. Dr. Lekhi is in his final year of residency training. [Source]

Profiles and achievement

Sharon Peters, MD, FRCPC (Internal Medicine) and Laura Swaney, MD (Royal College Resident Affiliate) are winners of Resident Doctors of Canada Awards for 2015-2016. Dr. Peters, a professor of Medicine at Memorial University, was awarded the RDoC Mikhael Award for Medical Education. Dr. Sweeney, a resident pediatrician at Dalhousie University, was awarded the RDoC Puddester Award for Resident Wellness. [Source]

David McKeown, MD, FRCPC (Community Medicine) has announced his retirement as Toronto’s medical officer of health after 12 years. His announcement was covered by the Toronto Star. [Source]

Carmen Wiebe, MD, FRCPC (Psychiatry) was the individual winner of a 2016 Wayne Skinner Award from the Centre for Addiction and Mental Health (CAMH) in Toronto. Dr. Wiebe is a staff psychiatrist in the Borderline Personality Disorder Clinic at CAMH. [Source]

Congratulations to the winners of 2016 Awards of Excellence from the Schulich School of Medicine & Dentistry [Source]. The winners include several Fellows:

  • Douglas Ross, MD, FRCSC (Plastic Surgery) – Schulich Excellence in Education Awards for Graduate/Postgraduate Education: Distinguished Leader
  • Chris Watling, MD, FRCPC (Neurology) – Schulich Excellence in Education Awards for Graduate/Postgraduate Education: Schulich Leader Award
  • Anthony Nichols, MD, FRCSC (Otolaryngology – Head and Neck Surgery) – Dean’s Awards of Excellence for Faculty: Junior Faculty
  • Anthony Jevnikar, MD, FRCPC (Internal Medicine) -  Dean’s Awards of Excellence for Faculty: Lifetime Achievement Award
  • Team member, Shannon Venance, MD, FRCPC (Neurology) -  Dean’s Awards of Excellence for Faculty: Team Award
  • Thomas Haffner, MD, FRCPC (Internal Medicine) – Schulich Award for Excellence for Faculty in Distributed Sites


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In memoriam

In memoriam

Léo L. Baribeau, MD, FRCSC, died on March 30, 2016, in Saint-Jean-sur-Richelieu, Que., at age 83. Dr. Baribeau was certified by the Royal College in Obstetrics and Gynecology in 1965. He earned his medical degree from Laval University in 1959. Read more about Dr. Baribeau.

Melody Cheung-Lee, MD, FRCPC, died on March 15, 2016, in Edmonton, Alta., at age 36. Dr. Cheung-Lee was certified by the Royal College in Dermatology in 2009. Born in China, she came to Canada at the age of eight and went on to become an accomplished doctor. She was deeply loved by her family and patients. Read more about Dr. Cheung-Lee.

George Harvey Cook, MDCM, FRCSC, died on April 2, 2016, in Truro, N.S., at age 93. Dr. Cook was certified by the Royal College in General Surgery in 1959. He completed his medical studies after serving as a pilot during WWII. One of his first jobs was providing medical services as the only physician in Fort Smith, N.W.T. Read more about Dr. Cook.

Joseph Alexander Devenyi, MD, FRCSC, died on March 19, 2016, in Toronto, Ont., at age 89. Dr. Devenyi was certified by the Royal College in Otolaryngology – Head and Neck Surgery in 1969. Deeply loved by his family and colleagues, he formerly worked at Etobicoke General Hospital. Read more about Dr. Devenyi.

Roger Michael Flinn, MD, FRCPC, died on March 31, 2016, in Orlando, Florida, at age 70. Dr. Flinn was certified by the Royal College in Diagnostic Radiology in 1983. For 27 years, he served in the Canadian Forces including as chief radiologist from 1991-1994. He finished his career at Soldier’s Memorial Hospital in Middleton, N.S. Read more about Dr. Flinn.

Scott Hebert Garner, MD, FRCPC, died on January 14, 2016, in Dundas, Ont., at age 60. Dr. Garner was certified by the Royal College in Physical Medicine and Rehabilitation in 1984. He served as a rehabilitative physician in the Hamilton-Burlington (Ont.) area for over 30 years. He was also a member of the Royal College examination committee for his specialty from 1991-1994. He is deeply missed by his family. Read more about Dr. Garner.

Hans Martin Heick, MD, FRCPC, died on March 19, 2016, in Ottawa, Ont., at age 82. Dr. Heick was certified by the Royal College in Medical Biochemistry in 1974. Most of his career was spent as a laboratory physician at the Children’s Hospital of Eastern Ontario. He was a founding member and first director of the CHEO Research Institute. He also served on the Royal College’s Medical Biochemistry Examination Committee from 1980-1991. Read more about Dr. Heick.

Otto Hierz, MD, FRCSC, died on February 19, 2016, in Austria, at age 92. Dr. Hierz was certified by the Royal College in Obstetrics and Gynecology in 1964. He practiced his specialty at the Royal Victoria and Lakeshore General hospitals until his retirement. He is remembered by former patients as a warm and kind physician. Read more about Dr. Heirz.

Emeric L. Hofstader, MDCM, FRCPC, died on March 13, 2106, in Scarborough, Ont., at age 94. Dr. Hofstader was certified by the Royal College in Internal Medicine in 1958. A Holocaust survivor, he arrived in Canada in 1949. He holds the distinction of being the first gastroenterologist at the Scarborough General Hospital. Read more about Dr. Hofstader.

Barry Dale Lloyd Hubbard, MD, FRCPC, died on March 19, 2016, in North Battlefords, Sask., at age 72. Dr. Hubbard was certified by the Royal College in General Pathology in 1985. He worked as director of Pathology at the Battlefords Union Hospital from 1985 until his retirement in 2009. Read more about Dr. Hubbard.

Jacques Alfred Loeb, MBBS, FRCSC, died on March 10, 2016, in Oakville, Ont., at age 90. Dr. Loeb was certified by the Royal College in General Surgery in 1959. He worked at the Oakville-Trafalgar Memorial Hospital from 1962 to 1985. He later worked as a tutor and surgical consultant to the Department of Anatomy, University of Toronto. Read more about Dr. Loeb

Oliver Harris Millard, MDCM, FRCSC, died on March 19, 2016, in Halifax, N.S., at age 86. Dr. Millard was certified by the Royal College in Urology in 1964. He was a former president of the Canadian Urological Association. He is remembered as a compassionate surgeon and trusted colleague. Read more about Dr. Millard.

John Swallow Nielsen, MD, FRCPC, died on March 15, 2016, in Collingwood, Ont., at age 92. Dr. Nielsen was certified by the Royal College in Anesthesiology in 1958. He earned his medical degree from Royal College of London in 1951. For 45 years, he practised his specialty in London, Ont. Read more about Dr. Nielsen.

Charles Leo O’Connell, MD, FRCSC, died on March 28, 2016, in Kitchener, Ont., at age 92. Dr. O’Connell was certified by the Royal College in General Surgery in 1965. He practised as a general surgeon in Kitchener. He was awarded a Queen’s Jubilee Medal for his work in Honduras and Indonesia with Care Medico. Read more about Dr. O’Connell.

Magalie Painchaud, MD, FRCPC, died on March 18, 2016, in Lévis, Que., at age 43. Dr. Painchaud was certified by the Royal College in Psychiatry in 2002. She is fondly remembered for helping treat patients with depression, including through art-therapy and mindfulness. Read more about Dr. Painchaud.

William David Parsons, MDCM, FRCPC, died on April 12, 2016, in St. John’s, N.L., at age 91. Dr. Parsons was certified by the Royal College in Internal Medicine in 1961. He was a former president of the Newfoundland Medical Association and is remembered, in particular, for his work with veterans and his passion for history. Read more about Dr. Parsons.

Joseph Andrew Peller, MD, FRCPC, died on March 18, 2016, in Guelph, Ont., at age 90. Dr. Peller was certified by the Royal College in Internal Medicine in 1955. He worked as chief of medicine for Hamilton Civic hospitals from 1960-1965. The next year, he followed his father into the wine business, serving as president of Andrés Wines Ltd. Read more about Dr. Peller.

Morris R. Perchanok, MDCM, FRCPC, died on April 1, 2016, in Sarnia, Ont., at age 92. Dr. Perchanok was certified by the Royal College in Internal Medicine in 1954. He served in Sarnia for 32 years, including as chief of medicine at Sarnia General and St. Joseph’s hospitals. Read more about Dr. Perchanok.

Anand Prakash, MBBS, FRCPC, died on April 9, 2016, in Riverside, CA, USA, at age 81. Dr. Prakash was certified by the Royal College in Neurology in 1971. He earned his medical degree from Agra University in 1957.

Garth Barrie Purves, MD, FRCSC, died on March 11, 2016, in Vancouver, B.C., at age 73. Dr. Purves was certified by the Royal College in Neurosurgery in 1974. He started his career as Lions Gate Hospital in North Vancouver. He later practised In Sioux City, Iowa, where he helped build up a large group practice and the Siouxland Surgical Center. Read more about Dr. Purves.

Quentin A.F. Rae-Grant, MBChB, FRCPC, died on March 16, 2016, in Toronto, Ont., at age 86. Dr. Rae-Grant was certified by the Royal College in Psychiatry in 1984. He was a member of the Royal College examination committee for his specialty from 1976-1989. He worked to advance the field of child psychiatry in Canada, and is a former chairman of the board of the Canadian Psychiatric Association. Read more about Dr. Rae-Grant.

Jack Theodore Ratner, MD, FRCPC, died on March 1, 2016, in Montreal, Que., at age 85. Dr. Ratner was certified by the Royal College in Internal Medicine in 1959. He served as director of Professional Services and physician-in-chief at Maimonides Hospital from 1978-1996. He also taught at McGill University. Read more about Dr. Ratner.

Catherine C. Ryan, MBChB, FRCPC, died on March 25, 2016, in Toronto, Ont., at age 87. Dr. Ryan was certified by the Royal College in Dermatology in 1968. She earned her medical degree in Dublin. She first practiced medicine in St. John’s, N.L., and later did postgraduate work in in Houston, Texas, eventually moving there in 1972. Read more about Dr. Ryan.

Robert Duncan Shortreed, MD, FRCSC, died on March 23, 2016, in Sarnia, Ont., at age 82. Dr. Shortreed was certified by the Royal College in Otolaryngology- Head and Neck Surgery in 1963. He served the Sarnia community for 40 years as an ENT doctor, where he was well-liked by his patients and colleagues. Read more about Dr. Shortreed.

Terry-Nan Tannenbaum, MD, FRCPC, died on March 17, 2016, in Montreal, Que., at age 63. Dr. Tannenbaum was certified by the Royal College in Public Health and Preventative Medicine in 1986. She documented her journey as a patient with lung cancer. For her efforts in lung health, she was awarded a Queen Elizabeth II Golden Jubilee medal. Read more about Dr. Tannenbaum (Globe and Mail tribute).

Hugh D’Orsey Tildesley, MDCM, FRCPC, died on March 13, 2016, in Vancouver, B.C., at age 65. Dr. Tildesley was certified by the Royal College in Internal Medicine in 1983. An innovator, he created the Western Canadian Insulin Pump Centre and Endocrine Research Society. He also built the Internet Blood Glucose Monitoring System. Read more about Dr. Tildesley.

Desmond Walker, MBChB, FRCPC, died on March 8, 2016, in Uxbridge, Ont., at age 82. Dr. Walker was certified by the Royal College in Diagnostic Radiology (1967) and Nuclear Medicine (1976). He earned his medical degree at the University of Manchester in 1956. Read more about Dr. Walker.

John Gerald Wright, MBChB, FRCPC, died on March 13, 2016, in Niagara on the Lake, Ont., at age 80. Dr. Wright was certified by the Royal College in Psychiatry in 1975. He immigrated to Canada in 1969. He practised at St. Catharines General Hospital. He also served for 23 years as director of Psychiatric Services at Brantford General Hospital. Read more about Dr. Wright.


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