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Your best advice for new specialists – revealed!

Last month, we asked you to share your top advice, tip or words of counsel for newly-certified specialists. Candid, poignant and practical, here are your best submissions.

No matter how long you’ve been in practice, maybe you’ll also find some renewed inspiration?

  • “Follow your passion and give your best. Remember the Hippocratic Oath and why you chose medicine as a career. The rest will follow.” - Zulfikar Juma, MD, FRCPC, FACC

  • “Be gentle and caring but precise.” - Pallav Shah, FRCSC (c), cardiac surgeon, St. Boniface, Winnipeg

  • “It takes only a moment or two to burn a bridge, and years to build it back up again. Suck it up, give the benefit of the doubt, when all else fails be respectful and treat others with respect and dignity. The return on investment is priceless.” - Joy Liao, MD, FRCPC, geriatrician at Langley Memorial Hospital in Langley, B.C.

  • “1) Live like a resident for the first year. 2) Don’t be afraid to ask for help. 3) Have a five-year career plan.” - David Barbic, MD, FRCPC, emergency physician at St. Paul’s Hospital, Vancouver

  • "Start to plan your CPD ... to enable and maintain your abilities and competencies as expert, leader and advocate in the healthcare system." – Maitham Husain, MD, FRCPC

  • “Listen to your patient, learn from your patient and take care of yourself so the years and all the efforts do not burn you out.” – Marcia Shapir, MD, FRCPC, psychiatrist in private practice

  • “Listen to your mentors, provide timely consult reports, CARE about your patients.” – Ian Arnold, MD, CSPQ, FRCPC, occupational health consultant and former general surgeon

  • “Remember, it's about the patient; not the bureaucracy, not the teaching, not even the diagnosis. It's the patient!” – David Roseman, pediatrician, Edmonton

  • “You've studied so hard for so long at the expense of many things. Get back to your hobbies, your loves, your family & friends. You have a whole career ahead of you, time to relax & enjoy yourself a bit. Soon enough, with home, children & practice, things are going to get even busier!” – Benjamin Barankin, MD, FRCPC, Medical Director & Founder of Toronto Dermatology Centre


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Read it now: Health system environmental scan (2017 edition)

Our 2017 edition of Cutting through the fog is now available.

In keeping with previous editions, this reference document provides a national overview of key indicators and trends in five domains in Canada:

  1. Political environment
  2. Economic environment
  3. Socio-demographic environment
  4. Health care systems environment (i.e. performance and human resources for health)
  5. Technological environment

Visit our summary webpage for document highlights.

Or download the full scan as a PDF.


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MOC Tip of the Month
Kim Blake, MBBS, FRCPC

[Section 3 credit opportunity] For easy and effective patient feedback, try a communication guide

MOC Tip of the Month

Kim Blake

Years ago, I developed an interviewing tool that I now use to claim most of my Section 3 MOC Program credits. It’s called the Structured Communication Adolescent Guide (SCAG). I want to share this simple but rigorous tool so that you too can leverage it for your Section 3 learning, whatever your patient demographic.

This tool can be adapted for other patient demographics

I’m a pediatrician at Dalhousie University, but any physician and surgeon who interacts with adolescent patients can benefit from SCAG. Or, if you don’t work with many adolescents or young adults, you can adapt the SCAG to suit your own discipline or scope of practice. For example, I helped some Geriatric Medicine colleagues adapt it into the Comprehensive Geriatric Assessment Guide (CGAG). If you need any support, please feel free to contact me. I would be more than happy to work with you.

SCAG: What’s in it for you?

  • A wonderful source of candid, articulate and honest feedback about your performance from your adolescent and young adult patients (that you can claim for Section 3 MOC credit).
  • A reduced rate of misdiagnoses (your patients will trust you more and be more likely to disclose significant psychosocial information that could influence your treatment plan).
  • An improved adolescent-interviewing skill set (explaining confidentiality, respecting anonymity, separating from parents, and discussing risk-taking behaviours with sensitivity and tact).
  • A deeper appreciation of the Royal College’s CanMEDS Communicator Role competencies (something we all struggle with!)

3 simple steps to use the SCAG

The SCAG is a 33-item checklist derived from the Calgary Cambridge Observation Guide. It was most recently updated in 2016 to include modern behaviours, such as cyberbullying, vaping, screen time and social media.

Download the SCAG here and print out several copies to keep in your interview rooms

  1. During your clinical interview, explain to your adolescent patient that you’re looking for personal feedback and ask them if they would be open to filling out this questionnaire at the end of the appointment. Give them the SCAG and ask them in particular to fill out the comments section — one or two items you did well or could improve on. Repeat with a couple of adolescent patients a week for one or two months.
  2. At the end of the month, review your SCAGs. Are you getting a lot of zeros or ones? See if there’s something in the comments section that you can act on to improve. Are you getting a lot of twos? Congratulations are in order, but don’t rest on your laurels. Look for trends and other more subtle ways to improve.
  3. Most importantly, keep using the SCAG several times a year. Keep working on the areas where you can improve or that are uncomfortable for you as a communicator, and keep doing the interview properly. For example, don’t skip confidentiality discussions because it’s important for the patients — as well as their parents — to hear this part. (The value of confidentiality being explained and discussed is also supported in the literature.) And don’t skip interviewing the adolescent alone — this is where you’ll get the most honesty.

My story: Conversations around sexual identity

Even after many years of using the SCAG, I am continually learning things about myself that I can improve upon thanks to this checklist.

For example, I was once talking to a young lady about boyfriends and girlfriends, and I noticed that she was hedging. When I asked “how do you see yourself?” she told me she wasn’t sure if she was male or female, and where she fits. She commented in the SCAG that she could see I was uncomfortable but was glad that I asked. She comes from a strict family background and was grateful that we had discussed confidentiality.

In another example, when a different female patient told me about her boyfriend, I asked her about past boyfriends. It was an insight to me when her mother later told me that her daughter said she was a lesbian. I realized that because the young lady told me about a boyfriend, I had assumed she had also had previous boyfriends.

After I reflected on these experiences, I came to the conclusion that while I was strong in assessing depression, eating habits, social media and bullying, I was weaker in the area of discussing sexual preferences and sexual identity. So much of our medicine today is about lifestyle and not what I saw during my training; perceptions of gender and sexual identity have changed significantly over the years.

I created a CPD goal in my MAINPORT ePortfolio to “raise my awareness of the transgender community by reading more articles and paying more attention to where talk about sexual identity is going. I’m going to improve how I broach sexual identity during the interviewing process. Training myself to ask exploratory questions instead of absolute ones may help me to avoid making assumptions.”

This is why I like the SCAG—for me, it not only generates good observations that have enhanced my self-awareness, it also opens up dialogue to helps me become a better physician. And I hope it does the same for you!

Did you know? The SCAG is currently taught to medical students at Dalhousie University, Queen’s University, the University of Calgary and the University of British Columbia. We have demonstrated its utility as a source of structured feedback and validity as an alternative to direct observation by a peer. We have also proven that it improves performance in residency following a study with PGY1 residents from eight specialties (four medical and four surgical).

Share "what works" for you!

Big or small, we'd love to hear your MOC tip. Submit a tip through our online form. If we use it, we'll send it to our 40,000+ members in an upcoming issue of Dialogue (attributed to you). We'll also post it on our website where it can be searched and read by all our MOC Program participants.

What people are saying about MOC tips

“Thank you for your MOC Tip of the Month. I very much enjoyed it and used it to create a template for developing a PLP. As the CPD Chair for the Canadian Society of Otolaryngology-Head and Neck Surgery, I am trying to assist our members in their CPD activities. We will use the template at our annual meeting this year for both the accredited and non-accredited educational activities.” — Gigi Osler, MD, FRCSC, 2017 President-Elect of the Canadian Medical Association

“I received several positive comments about my PLP tip. People felt the steps were helpful with the use of the personal example. In fact, one person is planning to attend a course on Indigenous health!” — Shahid Ahmed, MD, FRCPC, MOC tip author


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Livestream ICRE 2017’s five dynamic plenary sessions on leadership and change in residency training

Can’t make it to Quebec City this month for the 2017 International Conference on Residency Education? Good news: we’re bringing the world’s largest conference on residency education to you.

That’s right. Livestream dynamic lectures, panels and debates on this year’s conference theme, Leadership and Change in Residency Training: A Call to Action.

To watch: Visit the ICRE website a few minutes prior to the session(s) of your choice, and follow the prompts.

Plenaries being streamed

  • The Buffalo Experiment: Alive and well in medical education
    Thursday, October 19, 2017 (16:00 – 17:30 EDT)

    Speaker: Dr. Richard Reznick (Queen’s University, Canada)
  • Leading change in medical education
    Friday, October 20, 2017 (08:00 – 09:15 EDT)

    Speaker: Dr. Abeer A. Arab (King Abdulaziz University, Saudi Arabia); Dr. Simon Fleming (British Orthopaedic Trainees’ Association, United Kingdom); Dr. Leslie Flynn (Queen’s University, Canada); Dr. Robert Rogers (The University of Kentucky College of Medicine, United States)
  • Be it resolved that “Leadership training is required for every resident”
    Saturday, October 21, 2017 (08:00 – 09:00 EDT)

    Speaker: Dr. Ian Incoll (Australian Orthopaedic Association, Australia); Dr. Jonas Nordquist (Karolinska University Hospital, Sweden)
  • Royal College/JGME top research in residency education
    Saturday, October 21, 2017 (09:00 – 10:15 EDT)

    Speaker: Dr. Kori LaDonna (Schulich School of Medicine and Dentistry, Canada); M. Gaby Tremblay (Université Laval, Canada) Dr. Kenji Yamazaki (Accreditation Council for Graduate Medical Education, United States)
  • Leadership: A force for change
    Saturday, October 21, 2017 (16:00 – 17:30 EDT)

    Speaker: Dr. John S. Andrews (University of Minnesota, United States); Dr. Pierre Dussault (Hôpital Anna-Laberge and Air Canada, Canada)

Can’t watch live? All webcasts will be made available on the ICRE YouTube channel, following the conference.


Nominations are open for Royal College Honorary Fellowship

Honorary Fellowship is one of the most prestigious awards that the Royal College can bestow upon individuals who are ineligible for Royal College Fellowship. A nomination is a significant way to pay tribute to someone deserving whom you admire and respect.

Nominate someone for Honorary Fellowship »

Celebrate someone whose work is exceptional

Celebrate a health care leader or innovator (in Canada or abroad) by nominating him or her for Honorary Fellowship. The deadline to submit a nomination is November 10, 2017.

Recent Honorary Fellows include Brigadier-General H. C. MacKay, Surgeon General of Canada, and Dr. Thomas Dignan, Indigenous health advocate and leader.

Find out more about Honorary Fellowship: www.royalcollege.ca/honorary


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[Webinar] Sharing Proven Strategies to Reduce Unnecessary Antibiotic Use


Choosing Wisely Talks is back. This webinar series runs on the first Thursday of every month from 12:00-13:00 EDT.

Tune into the next session:

Antibiotics Wisely: Sharing Proven Strategies to Reduce Unnecessary Antibiotic Use

  • Date and time: Thursday, November 2, 2017 at 12:00-13:00 EDT
  • Speaker: Dr. Jerome Leis, FRCPC, physician lead of Antimicrobial Stewardship and medical director of Infection Prevention & Control at Sunnybrook Health Sciences Centre, Toronto
  • Description: Approximately 25 million antibiotic prescriptions are dispensed by Canadian pharmacies annually. That’s almost the equivalent of every person in Ontario, Quebec and Nova Scotia (65% of the country’s population) receiving an antibiotic prescription within one year. During this webinar, Dr. Leis will present different interventions proven to be effective in reducing unnecessary antibiotic use across different health care settings and the need for coordinated changes in Canadian health care to improve appropriateness of antibiotics to combat the threat of antimicrobial resistance.

For more details on this session or other talks in this series, visit choosingwiselycanada.org/events

About Choosing Wisely Canada

Choosing Wisely Canada is a national campaign to help clinicians and patients engage in conversations about unnecessary tests and treatments, and make smart and effective care choices. It launched on April 2, 2014, and is organized by a small team from the University of Toronto, Canadian Medical Association and St. Michael’s Hospital. It is part of a global movement that began in the United States in 2012 and now spans 20 countries across 5 continents…. Learn more at choosingwiselycanada.org


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40 - 60% off Royal College merchandise and CanMEDS publications

Our fall sale continues with up to 60% off our CanMEDS publications and items in our Insignia Collection (e.g. branded ties, scarves, mugs, pens, etc.)

The sale runs while supplies last.

Link to our online store »

(Please note: Discounts have already been applied; prices as marked)


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Have you met Doug yet?

Dr. Doug Hedden is the Royal College’s new Executive Director of Professional Practice and Membership. His efforts in this new role will directly impact your future interactions with the Royal College. Get to know him by reading a short Q&A on Dr. Padmos’ blog.

Read the short Q&A ».

Among the questions Dr. Hedden answers,

  • What attracted you to this new position?
  • What are your initial plans?
  • If you could change one thing about how the Royal College interacts with its members, what would it be?

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Will we see you there? Our booths at upcoming events

Meet staff face-to-face, ask questions and learn more about your Royal College.

International Conference on Residency Education (ICRE)
October 19-21, 2017
Quebec City, Quebec
www.royalcollege.ca/icre

Canadian Association of Physician Assistants (CAPA) Annual Conference
October 26-29, 2017
Ottawa, Ontario
https://capa-acam.ca/capa-events/capa-2017-conference/capa-2017-program/

Canadian Cardiovascular Congress
October 21-24, 2017
Vancouver, British Columbia
www.cardiocongress.org

Canadian Society of Internal Medicine Annual Meeting
November 1-4, 2017
Toronto, Ontario
http://csim.ca/annual-meetings/csim-annual-meeting-2017/

2017 CSEM/Diabetes Canada Professional Conference & Annual Meetings
November 1-4, 2017
Edmonton, Alberta
http://www.endo-metab.ca/53-front-page/222-2017-csem-cda-professional-conference-annual-meetings


 

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Download the 2017 Simulation Summit mobile app

Doctor walking down a hospital hallway

Want the latest information and updates at your fingertips during this year’s Simulation Summit? Then download the 2017 conference app.

This handy mobile app will give you quick access to valuable information about the Simulation Summit, including

  • floor plans,
  • speaker bios,
  • program schedules,
  • conference abstracts,
  • session evaluations, and much more.

You can still attend the 2017 Simulation Summit: Sign up onsite

If you missed the online pre-registration deadline for the 2017 Simulation Summit, you can still sign up onsite for this year’s conference!

Onsite registration will officially open on Tuesday, October 31 at 16:30 (EDT) in the Ballroom Foyer at Le Centre Sheraton Montréal Hotel.

Registration desk hours for the 2017 Simulation Summit are as follows:

  • Tuesday, October 31, 16:30 – 19:00 (EDT)
  • Wednesday, November 1, 07:00 – 16:30 (EDT)
  • Thursday, November 2, 07:00 – 14:00 (EDT)

Email us in advance at simsummit@royalcollege.ca with any registration-related questions.


Connect with us:

@RC_SimSummit | @doc4brains (Conference Chair) | simsummit@royalcollege.ca


 

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Members in the news

Doctor walking down a hospital hallway

“People just don't think of plague in 2017 as a cause of illness. We think of this in medieval times killing a huge proportion of the world but lo and behold, it's alive and well," - Isaac Bogoch, MD, FRCPC (“The plague is spreading rapidly in Madagascar, which already had highest number of cases worldwide,” CBC News World)

“The key thing with influenza is that it’s predictably unpredictable but a few arrows are pointing in the direction that this may be a bit more on the rough side for influenza seasons,” - Isaac Bogoch, MD, FRCPC (“Here’s why Canada may be in for a miserable 2017-18 flu season,” Global News).

“They’re going to enter the workforce with, not only the tools to be able to have the ability to have that cultural safety and humility, but they’re also going to leave with the responsibility that they don’t have an option this time around,” – Nadine Caron, MD, FRCPC (“Meet Canada's 1st female Indigenous surgeon,” CTV News)

“It's taken years to accumulate this evidence. Ten years ago people would have been very skeptical that it's even possible." - Hertzel Gerstein, MD, FRCPC (“Reversing Type 2 diabetes? Yes, it can be done,” CBC News)

“So far, we’ve tested 9,000 people [since starting the study in 2013], and our analysis has shown a 27 per cent reduction in the severity of depression symptoms in patients whose doctors have followed the guidance,” - James Kennedy, MD, FRCPC (“There’s a DNA test that can determine which antidepressants are right for you,” Global News).

Our results indicate that viewing a hockey game can be the source of an intense emotional stress, as manifested by marked increases in heart rate,” - Paul Khairy, MD, FRCPC (“Watching hockey could affect fans with heart disease, Canadian study says,” Toronto Star).

“It was an exciting study for the clinical trials staff here at Kingston to be involved with, and for me personally, and for a lot of our patients who are still benefiting,” - Andrew Robinson, MD, FRCPC (“Clinical trial could change lung cancer treatment strategy”, Kingston Whig-Standard)

"We're almost working with one arm tied behind our back in the era of modern medicine," – Michael Warner, MD, FRCPC (“'Working with one arm tied behind our back': Hospitals are ill-equipped to treat obese patients, experts say,” CBC News)


 

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In memoriam

Stethoscope

Parvez Ansari, MBBS, FRCSC, died on August 10, 2017, in Fonthill, Ont., at age 74. Dr. Ansari was certified by the Royal College in Orthopedic Surgery in 1974. He worked for many years at the Douglas Memorial Hospital in Fort Erie, Ont., as well as at the Welland County General Hospital, where he was well-loved by all. Read more about Dr. Ansari.

Craig William Beattie, MD, FRCSC, died on August 2, 2017, in Vancouver, B.C., at age 70. Dr. Beattie was certified by the Royal College in Ophthalmology in 1976. A well-loved teacher, he was named "Teacher of the Year" from the UBC Department of Ophthalmology more than once. Read more about Dr. Beattie.

John Edgar Curtis, MD, FRCPC, died on August 19, 2017, in London, Ont., at age 80. Dr. Curtis was certified by the Royal College in Internal Medicine in 1967. After moving to Windsor, he helped establish the Windsor Regional Cancer Centre. Read more about Dr. Curtis.

Brian Philip Egier, MD, FRCPC, died on September 2, 2017, in Ancaster, Ont., at age 63. Dr. Egier was certified by the Royal College in Internal Medicine (1985) and Anesthesiology (1988). He is remembered as a “brilliant and dedicated Physician” and loving family man.” Read more about Dr. Egier.

Peter James Fitzpatrick, MBChB, FRCPC, died on August 17, 2017, in Alliston, Ont., at age 87. Dr. Fitzpatrick was certified by the Royal College in Therapeutic Radiology in 1964. Born in England, he survived the Blitz during the Second World War and those events helped shape his “appreciation and outlook in life.” Read more about Dr. Fitzpatrick.

Michael Richard Freeman, MD, FRCPC, died on September 3, 2017, in Toronto, Ont., at age 68. Dr. Freeman was certified by the Royal College in Internal Medicine and Cardiology in 1978. At the time of his death, he was a cardiologist at St. Michael’s Hospital in Toronto, and medical director of the Heart and Vascular Program, director of Medical Informatics, and director of Nuclear Cardiology. Read more about Dr. Freeman.

Alfredo Zialcita Guanzon, MD, FRCPC, died on August 22, 2017, in Vancouver, B.C., at age 86. Dr. Guanzon was certified by the Royal College in Anesthesiology in 1965. For 37 years, he practised as an anesthesiologist before retiring from the Royal Columbian Hospital in New Westminster, B.C. Read more about Dr. Guanzon.

Earl Glen Isbister, MDCM, FRCSC, died on September 12, 2017, in Burlington, Ont., at age 86. Dr. Isbister was certified by the Royal College in Urology in 1969. A general urologist who specialized in prostatic surgery, he also taught at McMaster Health Sciences and was chief of Surgery at the Henderson General Hospital. Read more about Dr. Isbister.

Francis Paul Kelly, MDCM, FRCSC, died on August 30, 2017, in Leamington, Ont., at age 94. Dr. Kelly was certified by the Royal College in General Surgery in 1957.

Mark Stanley Landis, MD, FRCSC, died on August 11, 2017, in London, Ont., at age 39. Dr. Landis was certified by the Royal College in Orthopedic Surgery in 2011. At the time of his death, he was an assistant professor of Medicine/Radiology, Western University, and interventional chest radiologist at Victoria Hospital, London Health Sciences Centre. Read more about Dr. Landis.

Peter Digby L. Roper, MBChB, FRCPC, died on August 11, 2017, in Montreal, Que., at age 95. Dr. Roper was certified by the Royal College in Psychiatry in 1960. At 18, he enlisted in the Royal Air Force. He survived the torpedoing of the SS Orcades off the coast of South Africa in 1942. Read more about Dr. Roper.

Iain Ogilvie Stewart, MBChB, FRCPC, died on September 1, 2017, in Ancaster, Ont., at age 92. Dr. Stewart was certified by the Royal College in Medical Microbiology in 1968. He was an Emeritus Professor at McMaster University, as well as head of Laboratories and chief of Staff at the Hamilton General Hospital. Read more about Dr. Stewart.

Vincent Paul Sweeney, MBChB, FRCPC, died on September 10, 2017, in Ottawa, Ont., at age 87. Dr. Sweeney was certified by the Royal College in Neurology in 1967. He is a former professor of Medicine and director of Biomedical Ethics, University of British Columbia. Read more about Dr. Sweeney.

Kimberly Lynn Trites, MD, FRCSC, died on August 20, 2017, in Lake Echo, N.S., at age 44. Dr. Trites was certified by the Royal College in Obstetrics and Gynecology in 2008. Two years ago, she closed her medical practice and covered on-call OBGYN in small hospitals in Eastern Canada. Read more about Dr. Trites.

William Reid Waters, MDCM, FRCSC, died on August 4, 2017, in Winnipeg, Man., at age 86. Dr. Waters was certified by the Royal College in Plastic Surgery in 1961. He helped establish a plastic surgery residency program in Winnipeg and was a former associate professor at the University of Manitoba in the Faculty of Medicine. Read more about Dr. Waters.

Masaru Ryan Yukawa, MD, FRCPC, died on August 4, 2017, in Edmonton, Alta., at age 40. Dr. Yukawa was certified by the Royal College in Anesthesiology in 2008. He is remembered as a caring and a “phenomenal echocardiographer.” Read more about Dr. Yukawa.


 

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