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Announcing our Prix d’excellence - Specialist of the Year and Mentor of the Year recipients


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Me and my MOC: Practising in the North and finding great CPD opportunities

Dr. Danielle Stachiw, FRCSC, has been practising generalist orthopedic surgery and maintaining her Royal College certification in Yellowknife, N.W.T., for three-and-a-half years. In this interview, she explains why she really wouldn’t trade living and learning in the North for anything.

Danielle Stachiw Dr. Danielle Stachiw

What’s your scope of practice like in Yellowknife?

I’m one of two orthopedic surgeons in generalist practice at Stanton Territorial Hospital. We serve all of the Northwest Territories and a portion of Nunavut. In generalist practice, you treat anything and everything. I obtain a lot of my Maintenance of Certification (MOC) from conferences, online webinars and self-assessment exams, and learning different techniques and styles of practice from visiting locum surgeons.

What motivated you to work up North?

The job opportunity arose when one of the long-standing local surgeons retired. I came up for a site visit during my fellowship and fell in love with the community. I enjoy the diverse patient population. About half of my patients are First Nations, Inuvialuit (Inuit) or Métis. Many still live a traditional life in very remote communities. Yellowknife itself is also surprisingly diverse and there are many highly active outdoor enthusiasts. You drive 10 minutes and you can be alone on a lake, kayaking or cross-country skiing.

Danielle Stachiw Part of the allure of northern practice is the lifestyle. Danielle (front) and her colleague Claire, an orthopedic nurse practitioner, enjoy canoeing and fishing.

How did your MOC change when you came up North?

After completing my fellowship training, where MOC opportunities were comparatively plentiful, I came straight to Yellowknife. When I first got here, I thought, ‘How on earth am I going to get all my MOC credits?’ But we’re a bit spoiled here in Yellowknife in that we are afforded 10 days a year to attend conferences.

Online learning opportunities seem to increase yearly and I like to take advantage of these resources as much as possible. The Canadian Orthopaedic Association offers online webinars. I recently listened to the foot and ankle webinar, a portion of which focused on syndesmotic ankle injuries. It was very interesting to hear tips and tricks from experts on how to treat this common yet challenging injury. In addition, the online exams from the American Academy of Orthopaedic Surgeons (AAOS) are great. I previously used them to study for my Royal College exam; now I use them for my MOC. To stay current, I rely a lot on scanning activities. OrthoEvidence is an excellent resource that summarizes new research in my discipline and the strengths and weaknesses of various studies. I also read MOC Tip of the Month and use the Royal College’s website to find accredited activities in my discipline.

What have you learned in northern practice that has made you a better doctor?

I receive a lot of great feedback from the locum surgeons who come to work in Yellowknife, which I record as MOC Section 3 Practice Assessment credits. Working with other orthopedic surgeons creates an excellent learning opportunity.

A locum surgeon and I were once repairing a distal bicep tendon rupture using suture anchors. My technique to tie down the tendon was always finicky. He showed me a different way of running the sutures through the tendon, using a pulley system to bring it down into the wound. It was awesome. I was so appreciative. It’s such a specific example, but for me it was practice-changing. Often we train in one place where everyone tends to do the same thing, but working up North with locums who maybe trained in Ontario or out East gives me the opportunity to see how things can be done differently.

Danielle Stachiw Danielle finds the North a beautiful and exceptional place to practise, and still finds many continuing professional development (CPD) opportunities in the form of conferences, online learning and visiting locum surgeons.

What’s your advice for others considering a transition to CPD in northern practice?

Transitioning to the North is intimidating at first. You’re not in an academic centre anymore. You don’t have access to rounds or subspecialized colleagues. The biggest challenge is keeping up-to-date with the literature and getting over the fear of generalist practice.

But now that I’m here, I really wouldn’t trade it for anything. I can’t see myself giving up certain surgeries or certain patient populations and their health challenges. Every day is different and I like that.

For example, one of my patients broke their leg and bent the rod they already had in their leg from a previous break. I had never seen this before and was intimidated by the task at hand. To prepare, I went online and found a review article and case reports which provided great information regarding the management options of this unusual injury.

Practising in the North, I encounter many unique patient cases like that. You go through residency thinking, ‘Oh, that’s super rare, I’ll never see it.’ But up here, you do! All this variety can be intimidating but I’ve grown to love it. The North is beautiful and an exceptional place to practise. Some of its allure is the remote location. However, despite this, I can still engage in professional development and remain up-to-date on current practices and trends.


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How a prevention program targeting new parents is saving lives in B.C. — and beyond

“Shaken baby syndrome, we always say, is not the most frequent form of abuse but it is the most serious form of abuse.”

Ronald Barr Dr. Ronald Barr

Dr. Ronald Barr, FRCPC, is a developmental pediatrician who has spent the past 20 odd years working to prevent shaken baby syndrome (more properly referenced as abusive head trauma or AHT). AHT is the most serious form of abuse for infants under the age of two. Roughly 80 per cent of cases result in lifelong disabilities.

Dr. Barr’s mission to prevent its occurrence has resulted in an expansive educational program named the Period of PURPLE Crying.

According to a study published in Child Abuse and Neglect and co-authored by Dr. Barr, the Period of PURPLE Crying has been associated with a 35 per cent reduction in admissions for AHT for children under the age of two in B.C. hospitals where this program has been implemented since 2009.

“We’re thrilled that this has been as successful as it has, although we’d love it to be even more successful, if possible.”

What is the Period of PURPLE Crying?

According to the National Center on Shaken Baby Syndrome in the United States, frustration with a baby’s crying is the most common stimulus for shaken baby syndrome/AHT. The Period of PURPLE Crying was born out of a desire to teach parents and caregivers that this crying cycle is a normal part of all children’s development.

The program uses an acronym (PURPLE) to remind parents that all babies have a crying curve that usually peaks in the second month of life. At this time, babies will cry more per day, on average. The crying may start unexpectedly and be resistant to soothing.

“There’s a huge baby-to-baby variability so some mothers will say, ‘Oh, I’ve got a good baby. It doesn’t cry.’ It actually does, but it doesn’t cry to a point that makes them irritated. The peak pattern of that baby might only be half an hour or 45 minutes a day whereas the peak pattern of another baby — all totally normal — could be five or six hours a day,” says Dr. Barr, who has dedicated years to the study of early infant crying.

Purple infographic Courtesy of purplecrying.info

Dr. Barr worked with the National Center on Shaken Baby Syndrome to develop the educational materials for this initiative. Nurses share key messages when they introduce the program and distribute the materials to parents and caregivers in maternity wards.

“We documented that by two-to-four months of age, 74 per cent of parents had gone back and read the materials again,” says Dr. Barr. “So the idea of having educational materials to take home was critical, we think, to the success of the program.”

Program has been implemented in more than 2,000 hospitals

The Ministry of Children & Family Development of British Columbia has backed province-wide adoption of the Period of Purple Crying and provided funding. Over 3,000 nurses in the province have been trained in the program. Each year, health authorities distribute an estimated 40,000 booklets and other educational materials.

“It’s been a learning experience. This stuff is not easy, even though all of us know that prevention is the much better option. There has to be a lot of monitoring and cooperation amongst a lot of people who have a lot of other things to do,” says Dr. Barr.

So far, over 2,000 hospitals have implemented the PURPLE protocol. These include numerous sites in Ontario, Nova Scotia, Prince Edward Island and the Yukon, as well as 13 U.S. states and cities in five other countries.

For more information on this initiative, visit www.purplecrying.info or www.dontshake.org


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Dr. Kollias on how writing a children’s book is a creative form of patient education… and advocacy

Carrie Kollias Dr. Carrie Kollias

This goes way back to about 2008 when Carrie Kollias, MD, FRCSC, an orthopedic surgeon in Lethbridge, Alta., was still an orthopedic resident in Calgary.

“Every time a kid came in with a broken bone the whole ordeal was quite anxiety-provoking. What is a cast? What is a fracture? It’s all very foreign to most kids. I thought ‘man, there should really be a book — a kid’s book — that explains it all,” she says.

It was a good thought, but one that got pushed to the backburner as she finished her residency, subsequent fellowships and began a family of her own.

“Fast forward a few more years, I’d had a second child and I still felt like I really needed to do this from an educational standpoint. This whole move towards getting a more diverse health care worker population was added fuel to the fire for me. I thought there was an opportunity to incorporate that into this book.”

The result is Maria’s Marvelous Bones (2018) — a self-published, illustrated book that follows Maria as she breaks her arm and goes to the hospital to have it fixed. You meet various health care workers along the way, including Nurse Peter; Dr. Anna, the bone doctor; and Marsha, the cast tech.

Celebrated U.K. artist, Gill Guile, brings the book to life with her illustrations — a bit of a coup, as she took this work on as a rare freelance project.

“Her daughter happens to be an orthopedic registrar in Bristol and so she said ‘I think we can make a beautiful book. Let’s do it,’” recalls Dr. Kollias, chuckling at her good luck.

Dr. Kollias, originally from New Brunswick, is the only person in her family in any medical profession. She recognizes the importance of mentors and peer examples in bridging entry into the field, though her own pathway into Orthopedic Surgery was rooted more in her dual interest and talent in science, and her desire to be in “a caring profession,” than the influence of any specific individual.

Her primary aim for this book, aside from the educational piece, was to showcase diversity in the health professions — a known challenge — and to “plant the seed” early for children to someday consider pursuing one of these career paths.

“The first character you meet in the book, aside from the family unit, is a male nurse. We know in Canada that about 8 per cent of nurses are male. The orthopedic specialist in the book is a visible minority female. That inclusivity was all really intentional,” explains Dr. Kollias.

“The last data I saw showed about 11 per cent of orthopedic surgeons in Canada are female and that doesn’t even account for the minority ethnic groups. In the U.S., it’s significantly worse. Only about 6.1 per cent are female and 4.8 per cent are of an ethnic minority. We need more balance because we know when we work in teams where there’s more diversity then the team is stronger. That’s my hope. It’s coming, but this is a long-term end game.”

Dr. Kollias’ book is being sold in the Chinook Regional Hospital gift store (with proceeds from sales going to the Friends of Chinook Regional Hospital). It is also available at several stores around Calgary and online through Amazon, Indigo and Barnes & Noble.

“The feedback I love is, for instance, ‘I bought this for my niece. She read it. She wants to be an astronaut surgeon now,’” she says with a good-natured laugh. “A friend of mine bought the book two months ago. Incidentally, her son recently broke his leg playing baseball and she says it was super helpful since he knew from the story what to expect. I love hearing those stories because it makes it worthwhile.”

Maria book cover “A wonderful resource to help prepare children for medical intervention after an injury.” — Kirkus Review

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Have you “socked it to us” yet?

By now you should have received an email with your personalized and secure link to our Member Value Survey.

Please take 15 minutes to fill it out. We need your help to know what current and future services you value, and your thoughts on our communications efforts.

The deadline to complete the survey has been extended to September 28, 2018.

Didn’t receive the email? Check your spam folder. Still can’t find it? Please email membersurvey@royalcollege.ca

Limited edition socks on the line!
In appreciation for your willingness to “sock it to us” with your feedback, you can choose to be entered into a draw for one of 100 pairs of Royal College branded unisex socks.

Royal College socks

A note about The Portage Group
The email directs you to a survey platform hosted by The Portage Group, a third-party service provider with expertise in research for member-based organizations. We have contracted them to conduct the survey on our behalf. All results they collect will remain confidential and will only be shared with the Royal College in an aggregate form.


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“What I wish I’d known….” Lessons that have made you a better doc

Every year, over a thousand medical specialists are newly-certified and start the next stage in their professional careers. We’d like to share some words of wisdom with them.

Tell us, what is one valuable lesson that you’ve learned from your time in practice?

We will publish a selection of responses in an upcoming newsletter.



Note: Depending on the volume of response we receive, we cannot guarantee that all responses will be published. Submissions may be edited for clarity, brevity, etc. Please contact communications@royalcollege.ca with further questions.


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If you’re not going to ICRE 2018, here’s what you’re missing

The International Conference on Residency Education (ICRE) is the world’s largest conference devoted exclusively to advancing residency education.

There’s still time to join us at this year’s conference in Halifax (October 18–20, 2018).

Register to attend: Online pre-registration is available until September 27, 2018.

Six plenaries, 21 learning tracks, more than 60 workshops and approximately 200 poster and paper presentations… Join us as we explore the theme, “The Learning Environment and Residency Education: The Evolution of Training.”

Plus, don’t miss these other, lesser-known event highlights:

  • New preconference: Understanding the Complex Construct of the Learning Environment will enhance your understanding of the clinical learning environment, and identify and suggest systematic interventions to improve it.
  • Interactive plenary: A mainstay of our Simulation Summit, ICRE 2018 will host a Sim Trek Plenary – Part 1 & Part 2. Get ready for a dynamic learning experience with sim-styled theatre and on-the-spot debriefing.
  • New debate style: Think BBC not pro/con for this year’s plenary debate. In fact, former BBC News Anchor Maxine Mawhinney will host.
  • Social takeover: ICRE chief resident, Simon Fleming, will live tweet from @ICREConf sharing photos and insights of his experience.
  • Special presentation: The first recipient of the Royal College Dr. Karen Mann Catalyst Grant in Medical Education Research will be announced. This grant honours the late Dr. Karen Mann, a passionate Dalhousie educator, scholar and mentor.
  • Sophisticated socials: Try “Educators Explore Malts: Whisky 101" for your chance to sample premier Nova Scotia whiskies.
  • Global cues: We’ve always attracted a global audience, now you’ll be able to track where everyone has come from through our world map near registration. International posters in the exhibit hall will also be identified for easy reference.
  • New ribbons: Past attendees of ICRE will know that we take our ribbons seriously! This year, we’ve added a variety of new ones including a ‘make your own’ option (a winner for most creative will be selected).
  • #ICREWithMe Twitter photo contest: Repeat attendees who bring a colleague/friend to ICRE for the first time are encouraged to take a selfie together. One repeat attendee will win a complimentary registration for 2019!

Check out even more event details on our new conference website: www.royalcollege.ca/icre


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Deadline extended — Strategic request for proposals: Advancing evaluation of competency-based medical education

Are you working on scholarship related to competency-based medical education? Your research project may qualify for up to $30,000 in funding for a two-year period.

Learn more about our strategic request for proposals: advancing evaluation of competency-based medical education across the continuum.

The deadline to apply has been extended to October 1, 2018.

Note re: eligibility for Royal College staff and contractors


Current employees and paid-contractors of the Royal College are not eligible to apply for this strategic request for proposals. If your project includes a Royal College employee or contractor (as principal investigator or co-investigator) you are instead invited to apply for a Royal College Intramural Grant.

Please direct questions to strategicgrants@royalcollege.ca.


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Members in the news

Doctor walking down a hospital hallway

“Some patients want to elect physician-assisted death and they also want to donate organs in the best possible condition. This raises the question of how protocols might change to allow both of these things to happen simultaneously,” – Ian Ball, MD, FRCPC (“Western University doctors: We need rules for assisted-death organ donors,” The London Free Press).

"It will work. There is no Plan B," - Daniel Borsuk, MD, FRCSC (“The face of a stranger,” CBC News- Feature).

“We saw a huge improvement in people who suffered badly and for a long time,” – Alexandre Dumais, MD, FRCPC (“People with schizophrenia learn to fight their demons with virtual reality,” Vancouver Sun).

“It’s like cancer. But we ignored it for decades, and now we’re surprised?”- Catharine Munn, MD, FRCPC (“More than 5,800 Canadian kids have died by suicide in the past 13 years. It's 'like a cancer',” Toronto Star). Marshall Korenblum, MD, FRCPC, is also quoted.

“When you look at the history of assisted dying, you get an initial blip up, it settles down and takes some time for them to begin to grow,” – Jim Silvius, MD, FRCPC (“Alberta doctor-assisted deaths up nearly 50 per cent this year,” Calgary Herald).


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In memoriam

Stethoscope

Shehbaz Ali Butt, MD, FRCPC, died on July 12, 2018, in Markham, Ont., at age 46. Dr. Butt was certified by the Royal College in Anesthesiology in 2002. An outdoorsman and adventurer who previously attempted to climb Everest, Dr. Butt worked as an anesthetist at the Markham-Stouffville Hospital prior to his death. Read more about Dr. Butt.

Patrick (Paddy) Graham Coffey, MBChB, FRCSC, died on July 17, 2018, in Newcastle, Ont., at age 92. Dr. Coffey was certified by the Royal College in General Surgery in 1965. Remembered for his humour, sincerity and kindness, he previously worked for the Licence Appeal Tribunal. Read more about Dr. Coffey.

Paul Donald Desjardins, MD, FRCSC, died on June 22, 2018, in Laval, Que., at age 82. Dr. Desjardins was certified by the Royal College in Obstetrics and Gynecology in 1966. A former president of the Fédération des médecins spécialites du Québec, he was later an advisor for the ministère de la Santé et des services sociaux du Québec. Read more about Dr. Desjardins.

You Ding (Y.D.) Leong, MD, FRCPC, died on July 3, 2018, in Nepean, Ont., at age 83. Dr. Leong was certified by the Royal College in Internal Medicine in 1969. Humble and optimistic, he established a successful practice that served the Ottawa-Carleton community and Canadian Forces for close to four decades. Read more about Dr. Leong.

Mary Elizabeth Horsey, MD, FRCPC, died on July 2, 2018, in Toronto at age 85. Dr. Horsey was certified by the Royal College in Psychiatry in 1971. She set up a private practice in Barrie, Ont., and was on staff of the Royal Victoria Hospital for many years. She retired at the age of 80. Read more about Dr. Horsey.

M. Gabriel Khan, MD, FRCPC, died on July 9, 2018, in Ottawa, Ont., at age 84. Dr. Khan was certified by the Royal College in Internal Medicine in 1969. He was a consulting cardiologist in practice since 1969, associate professor in the Division of Medicine, University of Ottawa, and author of 10 books on heart disease. Read more about Dr. Khan.

Ta Luan Peng, MD, FRCPC, died on July 9, 2018, in Peterborough, Ont., at age 90. Dr. Peng was certified by the Royal College in Anatomical Pathology in 1976.

Stella Psarakis, MD, FRCSC, died on June 20, 2018, in Burlington, Ont., at age 60. Dr. Psarakis was certified by the Royal College in Obstetrics and Gynecology in 1992. Passionate about women’s health, she was the first woman surgeon at the Joseph Brant Memorial Hospital in Burlington and the first woman gynecologist in the department. Read more about Dr. Psarakis.

Joseph Michael Sendbuehler, MDCM, FRCPC, died on July 24, 2018, in Ste. Agathe des Monts, Que., at age 85. Dr. Sendbuehler was certified by the Royal College in Psychiatry in 1962. His research contributed to our understanding of suicide. Read more about Dr. Sendbuehler.

Carl Theohar, MD, FRCPC, died on June 28, 2018, in Toronto, Ont., at age 80. Dr. Theohar was certified by the Royal College in Psychiatry in 1968. Dedicated to his patients, he ended his practice earlier this year. Read more about Dr. Theohar.

Dennis Jordan Vince, MD, FRCPC, died on July 19, 2018, in West Vancouver, B.C., at age 88. Dr. Vince was certified by the Royal College in Pediatrics in 1959. He was a pediatric cardiologist at the B.C. Children's Hospital and emeritus professor at the University of British Columbia. Read more about Dr. Vince.

Paul Gerald Walfish, MD, FRCPC, died on July 28, 2018, in Toronto at age 83. Dr. Walfish was certified by the Royal College in Internal Medicine in 1963. He had a productive career at Mount Sinai Hospital in Toronto where he led groundbreaking research in thyroid cancer, among other accomplishments. Read more about Dr. Walfish.


 

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