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We’re committed to evidence-informed approaches and practices

The Royal College has a long tradition of pursuing and supporting research and scholarship. In fact, through our educational grant and fellowship programs we are one of only a handful of organizations that fund medical education research in Canada.

Last year, alone, we awarded in excess of $442,000 in funding!

We have just published our first Research Report. Comprehensive and informative, it also serves as an expression of our enduring commitment to research and scholarship.

Check it out. You might be surprised.

Research report highlights

  • Details on the research efforts of some of the brightest researchers in Canada.
  • Updates on major Royal College research and scholarship-related initiatives and activities.
    • Includes our corporate initiatives like the Visiting Scholar program, Physician Employment Study and Medical Care for the Elderly.
  • An introduction to our Research Task Force and its mandate.
  • A list of publications by Royal College staff and affiliated educators.

Request a hard copy of the report
We have a limited number of printed and bound copies available. Email researchunit@royalcollege.ca if you’d like a copy.

Your feedback is welcome
Did anything surprise you in this report? Is there anything missing that you’d like us to include next time? We’d love your feedback: researchunit@royalcollege.ca.


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MOC Tip of the Month
Dr. Mohit Bhandari, FRCSC

How to turn information overload into a practice advantage through scanning

MOC Tip of the Month

Viren Naik Dr. Mohit Bhandari

Are you inundated with publications each month? Are you looking for ways to balance your responsibilities and still stay on top of all of your practice-related literature?

Scanning can help.

Quickly scanning short evidence-based summaries is a technique I use to triage my more in-depth reading. This strategy has helped me hone in on the most important articles to read, while still giving me a broad overview of other relevant literature.

Since integrating daily scanning into my practice, I’ve noticed improvements in my patient outcomes. It has also supported my continuing professional development, in particular in relation to my practice in orthopedic surgery and musculoskeletal medicine.

Start scanning! Five tips to get underway.

In this tip, I’ll share how you can integrate scanning into your daily routine and claim Section 2 MOC credits. OrthoEvidence*, UpToDate and the Cochrane database are just a few of the services available to facilitate scanning. Many major journals also have evidence-based portals.

  1. Integrate daily scans into your clinical routine: Evidence-based summaries have allowed me to create a daily scanning routine during my clinical time. When I get breaks, they’re not usually long enough to retrieve and read a primary paper. Instead, I update my knowledge regularly on one or more of the summary sites. I visit them 10-15 times a day in very short intervals (one to five minutes). It’s very easy for me to consume 20-30 summaries a day and claim Section 2 MOC credits for scanning.
  2. Complement your scans with in-depth journal reading: Reading individual journals takes a considerable amount of time so I often choose the articles I read based on summaries I scanned first. The 20-30 evidence reports I consume in a day may lead me to three or four journal articles that I read for more in-depth knowledge or for a nuanced interpretation of data that I want to evaluate further. The great thing is that I always feel updated, in a broad sense, of what’s coming out of my field.
  3. Bridge the inter-professional divide: Musculoskeletal medicine, for example, covers a broad and interdisciplinary group that includes surgeons like me, but also physiotherapists, nurses and different trainees. There’s a lot of crosspollination of evidence happening. A site like OrthoEvidence has rehabilitation articles that I wouldn’t normally read in my orthopedic core reading, but I value because they are relevant to the care of my patients and collaboration with allied health care professionals.
  4. Make decisions based on high-quality evidence: Several of the scanning sites summarize randomized clinical trials, which in my opinion provide some of the highest quality evidence available for evaluating whether or not a treatment works. For example, in my field there’s considerable debate right now about the best way to manage patients with hip fractures. We’ve been consulting the pre-appraised evidence summaries on the various approaches to treating hip fractures in order to inform us in making good decisions for our patients.
  5. Set your graduate students up for success: I always direct my graduate students who are looking to pursue an avenue of research to evidence-based summaries first. They do a quick search before embarking on any new project and I know they are basing their decisions and ideas on a strong foundation.

I like evidence-based summaries because their high-quality curated content helps keep me informed so I can make better decisions for my patients. They also provide opportunities for everyday learning and, of course, I can claim Section 2 MOC credits for my efforts.

Evidence-based summaries are a game-changer — a considerable return on your investment of time. I hope this tip helps you think about scanning in a new and expansive way.

*Conflict of Interest Disclosure: I founded OrthoEvidence, a point-of-care evidence-based summary, to fill a gap for pre-appraised evidence in surgery. It’s free for every orthopedic surgeon, sports medicine practitioner and physiotherapist in good standing through their national specialty society and there are tiers for additional services.


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Canadian wellness program named “Best in class,” topping competitors from Stanford, Harvard…

Dr. Sen presenting at the 2017 International Conference on Residency Education

Two times a charm.

Mithu Sen, MD, FRCPC, is assistant dean of Faculty Equity & Wellness at the Schulich school of Medicine and Dentistry, Western University.

For two years in a row, the Faculty Wellness Program she created and is implementing at Schulich received the American Association of Medical Colleges’ (AAMC) Best in Class Award for Innovation, Resilience and Wellness in Faculty.

“This is a very special honour because there are amazing schools represented,” said Dr. Sen. “It was a real privilege for our work to resonate with so many people. One can only walk away from the experience having learned so much from others and feeling quite confident about what we are trailblazing in Canada.”

Fast facts: “Best in Class”

  • After a very competitive process, 19 programs were selected as finalists and presented to the AAMC Group on Faculty Affairs over four days.
  • Dr. Sen’s program was the only Canadian finalist.
  • Dr. Sen has now won this award two years in a row: in 2016, she won for her presentation on the development of a faculty wellness program; in 2017, she was awarded for her presentation on the program’s implementation.
  • Her work was recently accepted by the AAMC for a third time; Dr. Sen will have the opportunity to present on her program’s assessment (once again, the only Canadian program in the mix).

The roots of Western’s award-winning program

“As an associate professor of Medicine and intensivist-respirologist-sleep medicine physician, we know that there’s a lot of data on physician burnout. I wanted to know how we could influence change. When I started my decanal role in 2014, there was no Canadian framework or institutional understanding of this gap, especially in faculty.”

With Dr. Sen’s leadership, the school created a Faculty Wellness Committee and adopted a simple Body-Mind-Spirit wellness framework. Using departmental focus groups, she sought to define what these elements mean more specifically under academia and education.

For example:

BodyImproving access to a primary care physician, self-awareness, nutrition
MindMotivational speakers on key topics; targeted professional development (early, mid and late-career); a collaborative Talent Management Conference (between the hospital and Schulich); sponsorship
SpiritMentorship (faculty mentorship committee and newly established faculty mentorship award, departmental faculty wellness committees and workshops), resiliency teaching, code of conduct

“This program might not feel like a formal curriculum per se; it is not ‘one size fits all’. It is, however, a lifelong curriculum for faculty as each individual progresses through various career stages. Not everyone will require every aspect of the Body-Mind-Spirit framework, but we discovered aspects of wellness that many faculty were missing and set out to bridge those gaps through our framework.”

Dr. Sen and her team have worked hard to embed these elements into the language of the school. This includes their physician/faculty onboarding practices and in key policies. They have also created faculty wellness workshops, focused their annual Talent Management Conference in 2017 on wellness, and supported about 2,800 faculty members and departments in medicine, dentistry and basic medical sciences. This included increasing capacity by creating “frontline” wellness committees, and more.

She explained, “I was never interested in doing a hundred things and not being able to do them well. It is really about creating impact where it matters. We really wanted to make sure that key aspects of this were done in a meaningful way and that there was communication about what we were doing, how individual faculty can get involved, and embedding this work into our strategic plan so it is woven into our culture.”

Right now, Dr. Sen is carving out a unique path. The AAMC’s award only serves to confirm that others working in Faculty Affairs are watching closely, no doubt anticipating her program’s assessment and the opportunity to adopt elements for their own work and wellness frameworks.

“There’s a lot of literature and discussion about faculty burnout and wellness,” said Dr. Sen, “but ours has been one of the first papers on developing the framework from the grassroots, and implementing it among our institutions’ frontline faculty. This comprehensive work on an individual, organizational and systems level has not been developed and implemented previously. In the past, various aspects concerning wellness may have been introduced among faculty. My vision and goal in leading this work has been to create a holistic, multilayered approach (much like a multisource environmental scan and assessment) impacting what truly matters for our faculty: their growth, development, lifelong learning and inspiration.”

Learn more about Dr. Sen’s work on Schulich’s Faculty Equity and Wellness website. You can also get in touch with her directly at mithu.sen@schulich.uwo.ca

Dr. Sen receiving her award from the AAMC Dr. Sen receiving her award from the AAMC in 2017

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Mercy Ships: the anesthesiologists’ perspective

MOC Tip of the Month

Soon after publishing a feature on Dr. Sherif Emil and his work with Mercy Ships in March 2018, we heard from Dr. Reuben Eng, FRCPC. Dr. Eng was on the ship with one of his residents at the same time as Dr. Emil. Here is what they had to say about their experience.


Would you roll up your sleeve and give your own blood to transfuse your patient? Reuben Eng, MD, FRCPC, found himself in that predicament while working on the Africa Mercy.

Reuben is director of the Anesthesiology Residency Training Program at the University of Calgary’s Cumming School of Medicine. He boarded the ship on March 11 for two weeks. He was accompanied by Michael Gysel, MD, a PGY-3.

“That was pretty special,” Reuben said about sharing this experience with Michael. “I really encouraged him to delve into the patient stories while we were there.”

Michael shared, “I think the one thing that really surprised me about the experience was seeing how outstanding the whole clinical team was. Everyone worked so well together. It was an awesome experience being in those ORs and working on the cases we were doing.”

Memorable moments on the Africa Mercy

Both Reuben and Michael complimented the ship, admitting they were well set up with the resources and equipment they needed. Nevertheless, an awareness of using resources appropriately permeated their efforts and their “margin of error” was smaller than if they were back in Calgary. They were not in a milieu of abundance. This reality was brought into sharp focus by way of a patient who went into septic shock from an abdominal abscess.

“As we were operating on her, we realized that she needed a transfusion but there was nobody else around with her blood type but me,” said Reuben.

He explained that the ship operates a kind of “living blood bank” using donations from long-term crew members. Only four individuals on the ship had this woman’s blood type, but since it was a Sunday no one was around. Calling it “meant to be,” he stepped in.

“After we stabilized her, I went down to the lab and had blood drawn from me. After it was processed, we gave it back to the patient. That doesn’t happen here at home but we do everything we can to take care of the patients. It worked out well that I was able to be in that OR.”

The two were also fortunate to help a patient who hadn’t been able to open his mouth for over 19 years.

“He went through two thirds of his life without ever being able to open his mouth,” said Michael. “It was something that was completely preventable. He went through all of that just because he didn’t have access to any kind of care.”

“The joy that he had when he opened his mouth for the first time in 20 years — he wouldn’t stop hugging us, thanking us; that was very touching,” said Reuben.

Also impactful was the work they did assisting on vaginal fistula repairs. Socially detrimental, women in need of this procedure face limited fertility, possible abandonment by their spouses, reduced social standing of their families and ostracism.

After the procedures, staff members performed a dress ceremony for these women. Reuben described it as a “kind of reintroduction back into society as these beautiful, strong women.”

Dr. Eng and Dr. Gysel check on a patient (March 2018).

All told, Michael’s final review is a glowing one.

“Without a doubt I’d recommend it [Mercy Ships]. It’s a wonderful learning experience. It’s amazing in so many ways because of the people you get to work with, the environment you’re working in, the things you’re doing for patients and, most importantly, it’s just so refreshing to go and do something overseas and be reminded of why all of us went into medicine in the first place; which is to do some good and help people.”

“When I come back from overseas work, I never complain about resources or equipment. I’m just so grateful for everything we have here; the abundance we have,” said Reuben.

Canadians on board: Drs. Étienne St-Louis, Sherif Emil, Reuben Eng and Michael Gysel on the Africa Mercy (March 2018)
Do you have an interesting story to share?
From lifetime achievements to cool ventures to hidden talents to career-defining moments, we want to tell your stories! Email us: communications@royalcollege.ca.

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Canadian Medical Hall of Fame: Meet the newest laureates (#inspiration)

On April 12, 2018, six medical heroes were inducted into the Canadian Medical Hall of Fame, among them three Fellows and one Honorary Fellow. Please join us in congratulating them!

Watch the videos; hear stories of each laureate’s impact and contributions to medicine.


Dr. Philip B. Berger, MD, CCFP, FCFP, FRCPSC
At the forefront of many battles for humane health care, Dr. Berger is a 40-year veteran of medicine and a tireless advocate for all people. Notably, in 2012 Dr. Berger co-founded Canadian Doctors for Refugee Care, coordinating nationwide protests on cuts to refugee health, eventually leading to the restoration of health coverage to 100,000 refugees.



Dr. B. Brett Finlay, OC, PhD, FRSC
A Peter Wall Distinguished Professor at the University of British Columbia, Dr. Finlay's research in cellular microbiology has led to vaccines and treatments for drug-resistant infections. He is also known as the co-author of the provocative bestseller, Let Them Eat Dirt: Saving Your Child from An Oversanitized World, which presents scientific evidence about the dangers of excessive cleanliness.



Dr. Vladimir Hachinski, CM, MD, FRCPC
He has transformed our understanding, diagnosis, treatment and prevention of the two greatest threats to the brain: stroke and dementia. Prior to the 1970s, stroke was untreatable. His eponymic Hachinski Ischemic Score (HIS) is now a standard for identifying the treatable components of dementia.



Dr. Balfour M. Mount, OC, MC, FRCSC
Credited with coining the term "palliative care," Dr. Mount recognized the need for special care to alleviate suffering and enhance dignity for dying patients. Dr. Mount is known for achieving the integration of palliative care as integral to humane health care. Future patients and their families will experience dignity and compassion facing some of their greatest challenges because of his vision.



Dr. Cheryl Rockman-Greenberg, MDCM, FRCPC
Dr. Rockman-Greenberg has devoted her career to bringing advanced medical knowledge and care to isolated and often vulnerable Indigenous populations. Working closely with the communities themselves, she developed diagnostic tests, screening programs, and treatments for disorders once poorly understood, improving the lives of generations of children and their families.



The late Dr. Emily Stowe, MD
As the first female physician to practice medicine in Canada, Dr. Stowe was eventually granted her license by the College of Physicians and Surgeons of Ontario in the 1880s, after being denied entry into medical school in Canada. In 1883, she spearheaded the creation of the Woman's Medical College and later helped found the Toronto Women's Literary Guild, Canada's first suffragette group.

Special thanks to the Canadian Medical Hall of Fame for the use of their photo, summary text and videos about this year’s laureates. Discover more at http://cdnmedhall.org.


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Things we did last year — and a preview of what’s ahead!

If you’re not quite sure what your Royal College is all about, check out our 2017 Annual Review. It’s like a crash course on all our major achievements from the past year, plus some things to look forward to in 2018. Visit www.royalcollege.ca/annualreview.

How to navigate the online annual review

Skim or scan achievements across various sections:

Or, skip straight to

Interested in a print promo of this year’s review? This highly-visual, sparse and specially-designed marketing document teases some of our top news of the year. Plus, find out the identity of the Fellow on our cover.


Email communications@royalcollege.ca if you’d like a copy mailed to you.


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Notice of request to change discipline name: Emergency Medical Services


We are seeking feedback from members on a proposed change of name for the Area of Focused Competence (AFC-Diploma) in Emergency Medical Services.

Current nameProposed name changeDeadline for feedback
Emergency Medical ServicesPrehospital and Transport MedicineJuly 8, 2018

Rationale and process for change

The change to “Prehospital and Transport Medicine” was requested by the AFC Working Group in Emergency Medical Services. This request was initiated to better reflect the discipline’s extended scope of practice, which includes a wide range of medical services for both emergency and non-emergency patients during transportation and pre-hospitalisation.

The request was reviewed by the Royal College’s Committee on Specialties on April 6, 2018. The committee agreed to proceed with the intent toward the change. They are now inviting feedback from stakeholders before a final decision is made.

Send your feedback by July 8, 2018


Stakeholders are invited to provide feedback concerning this request by July 8, 2018 (i.e. within 60 days of publication of this notice, dated May 9, 2018). Please forward your feedback to the Office of Specialty Education at cos@royalcollege.ca, Attn: Jason R. Frank, MD, MA (Ed), FRCPC, Director, Specialty Education, Strategy and Standards.


All feedback received within this timeframe will be used by the Royal College’s Office of Specialty Education in reaching a final decision regarding the above request.


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Award winner announcement


Did you catch last month’s award winner announcement?

Dr. Padmos revealed the names of seven award recipients for 2018 in his CEO Message from April 25.

Click to reveal the recipient of the following awards, plus some high-level bio details:

Learn more about the Royal College’s awards program at www.royalcollege.ca/awards


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Members in the news

Doctor walking down a hospital hallway

“When we see patients in the clinic, it’s very difficult to be 100 per cent sure that patient, who has developed dementia, has Alzheimer’s disease, because there are other dementing illnesses where there is an overlap,” – Sultan Darvesh, MD, FRCPC (“Dalhousie researchers on the hunt to fund new Alzheimer’s tool,” Global News)

"The chance of significant recovery, with current technology in 2018, is poor. It is unlikely he will regain any meaningful function below the level of the injury," - Daryl Fourney, MD, FRCSC (“Why spinal injuries like Broncos bus crash survivor Straschnitzki's are so challenging,” CBC News). Ken Thomas, MD, FRCSC, was also quoted.

“In terms of benefits, we believe it will reduce the rates of heart disease and death as well," – Alex Leung, MD, FRCPC (“1.3M Canadians could benefit if doctors lowered blood pressure targets: study,” CBC News)

"We talk about promoting health and a lot of doctors would like to engage in that, but here they're actually talking about shifting toward a different goal," – Robert Maunder, MD, FRCPC (“Doctors should help patients fight disease and treat their well-being, too, according to medical journal essay,” CBC News).

“Naloxone is equipping thousands of people in our community to recognize an emergency and respond in an appropriate way when that emergency happens. That’s not just a band aid, that’s a community wide change,” - Aaron Orkin, MD, FRCPC (“Experts agree naloxone is central to fighting Canada’s opioid crisis — but they also say it’s not a ‘wonder drug’,” Toronto Star).

“The most important thing is if they think their children have respiratory symptoms that are not gradually getting better, or are getting worse, or their children are having difficulty breathing, they should always see their physician,” – Jeffrey Pernica, MD, FRCPC (“Whooping cough more prevalent in Ontario, study says,” Toronto Star)

"Shingles in a younger person could be a sign of another underlying health condition," - Lynora Saxinger, MD, FRCPC (“Why are more and more Canadian adults getting shingles?”) Fred Aoki, MD, FRCPC, and Allison McGeer, MD, FRCPC, were also quoted.

“A major problem can be self-esteem or problems with depression and using food to cope. Using medication to grapple with that for a reasonable period of time is a reasonable answer,” – Sean Wharton, MD, FRCPC (“Stigma and bias' hinder health care for obese: Advocate,” Ottawa Sun).


 

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In memoriam

Stethoscope

Christopher Karl Adey, MD, FRCPC, died on March 11, 2018, in Windsor, Ont., at age 65. Dr. Adey was certified by the Royal College in Diagnostic Radiology in 1985. Read more about Dr. Adey.

Josephine Nancy Bird, MDCM, FRCPC, died on March 25, 2018, in North York, Ont., at age 89. Dr. Bird was certified by the Royal College in Internal Medicine in 1958. Read more about Dr. Bird.

Bireswar Bose, MBBS, FRCSC, died on March 3, 2018, in Edmonton, Alta., at age 87. Dr. Bose was certified by the Royal College in General Surgery in 1974. Read more about Dr. Bose.

Frederic Norman Brown, MDCM, FRCSC, died on March 18, 2018, in Kanata, Ont., at age 94. Dr. Brown was certified by the Royal College in General Surgery in 1955. Read more about Dr. Brown.

Philip Charles Etches, MBChB, FRCPC, died on March 20, 2018, in Vancouver, B.C., at age 72. Dr. Etches was certified by the Royal College in Pediatrics in 1980.

Philip Harry Gordon, MD, FRCSC, died on April 11, 2018, in Montreal, Que., at age 75. Dr. Gordon was certified by the Royal College in General Surgery in 1972. Read more about Dr. Gordon.

Alexander Edward Hipwell, MBChB, FRCPC, died on February 15, 2018, in Dartmouth, N.S., at age 67. Dr. Hipwell was certified by the Royal College in Psychiatry in 1984.

Ivan Hronsky, MD, FRCPC, died on April 2, 2018, in Toronto, Ont., at age 81. Dr. Hronsky was certified by the Royal College in Internal Medicine in 1970. Read more about Dr. Hronsky.

Fiona Mackenzie Key, MBChB, FRCPC, died on March 4, 2018, in Montreal, Que., at age 71. Dr. Key was certified by the Royal College in Psychiatry (1979) and Pediatrics (1977). Read more about Dr. Key.

Magdy Samir Isaac Makar, MSc, FRCSC, died on April 1, 2018, in Orillia, Ont., at age 60. Dr. Makar was certified by the Royal College in General Surgery in 1997. Read more about Dr. Makar.

Noel Henri Montgrain, MD, FRCPC, died on March 31, 2018, in Quebec, Que., at age 84. Dr. Montgrain was certified by the Royal College in Psychiatry in 1966. Read more about Dr. Montgrain.

Bill Yuk Ong, MD, FRCPC, died on March 3, 2018, in Winnipeg, Man., at age 68. Dr. Ong was certified by the Royal College in Anesthesiology in 1978. Read more about Dr. Ong.

Roger Jean J. Pelletier, MD, FRCPC, died on April 5, 2018, in Ottawa, Ont., at age 87. Dr. Pelletier was certified by the Royal College in Psychiatry in 1965. Read more about Dr. Pelletier.

Chander Prakash, MBBS, FRCPC, died on March 26, 2018, in Halifax, N.S., at age 84. Dr. Prakash was certified by the Royal College in Internal Medicine in 1973.

Frank Joseph Skain, MD, FRCSC, died on March 18, 2018, in Toronto, Ont., at age 89. Dr. Skain was certified by the Royal College in Obstetrics and Gynecology in 1960. Read more about Dr. Skain.

Jean-Paul Thibault, MD, FRCSC, died on March 20, 3018, in Saint-Jérôme, Que., at age 95. Dr. Thibault was certified by the Royal College in General Surgery in 1952. Read more about Dr. Thibault.


 

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