Annual Review 2012
The future of medical education
Town halls for transformation
Making time for your well-being
Lobby Day 2012
Interview with Dr. Samantha Nutt: War Child Founder and author of Damned Nations
Brink of a revolution
The social history
How to become a “great” physician
Literacy: Why we should care
Stepping outside the box
Contents
CFMS Letters Initiatives X Letter from the editors XX Brink of a revolution — From chocolates and roses to X A letter from your CFMS president social responsibility and humanitarianism XX Memorial’s Rural Medicine Interest Group CFMS Activities XX X Vancouver Native Health Society Clinic — a student Communications: Keeping you in the loop! directed initiative X Career planning and student wellness — re-emerging XX Bone marrow stem cell donation project at UBC themes in medical education Experiences X The future of medical education X Changing how we’re taught will lead to a better health XX Teach me how to doctor care system XX You’re WHAT! X CFMS member services: Discounts are just the XX McGill’s new satellite campus: The Gatineau beginning! experience X Changing minds on Parliament Hill — one meeting at XX The social history a time Opinions X Town halls for transformation XX How to become a ‘great’ physician X Taking care of student health and wellness XX Pfizer and Continuing Medical Education: The ethics X Making time for your well-being of collaboration X Ontario regional update XX Literacy: Why we should care Global Health Featured Interview X The CFMS global health program: A year in review XX X Featured interview — Dr. Samantha Nutt: War Child Global health certificates: Expanding access to global Founder and author of Damned Nations health education in Canada X University of Calgary’s global health concentration Alumni Affairs pilot XX 2011–12: Another year, more alumni X What will you be wearing on April 11? XX Alumni Q & A School Updates XX The LMCC Part 1 — just how hard is it? XX XX University of British Columbia Studying abroad XX XX University of Alberta Photo album XX University of Calgary Creative Works XX University of Saskatchewan XX Endocrine detective story XX University of Manitoba XX Shadow of You XX University of Western Ontario XX Photos XX McMaster University Your CFMS Executive and Representatives XX University of Toronto XX CFMS Executive 2011–12 XX Queen’s University XX MEDSOC Presidents 2011–12 XX University of Ottawa XX CFMS School Representatives XX Northern Ontario School of Medicine XX Dalhousie University XX Cover: Joanna Xuejiao Li, McGill University, class of Memorial University of Newfoundland 2014 and CFMS IT Officer Junior This art work, titled “Growth of a Medical Student”, depicts the transfer of wisdom from the experienced to the young. The old doctor presents a branch from his tree of knowledge to the medical student, in hopes that the student will grow it into a tree of his/her own and use the branches to help treat others. You’veYoou’ve been working towartowardsds this moment your entirentiree life.
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6 6 6 666 666 6 CFMS Letters
Letter from the editors
elcome to the 2012 edition of the Annual Review! This past year has been an exciting Wone for Canadian medical students, and the CFMS is proud to share the many accomplishments and creative aspirations of students from across the country. This edition of the Annual Review will start off with updates from each of our CFMS Executive members and officers. Together, we’ve made great progress in each of our portfolios — including global health, political advocacy, student wellness and communications. You’ll find the results of a 3-year CFMS study on distributed medical education, useful tips on dis- counts and services, a report from our annual Lobby Day and much more. Regardless of your interests, we’re confident that this Annual Review will have something for you! Wilson Kwong Editor, CFMS Annual The Brief Updates section is new to this edition of the Annual Review, and its inclusion Review is meant to provide a brief overview of initiatives and updates from each medical school in Queen’s University, the CFMS. There have also been some changes to our Alumni section this year, with an addi- Class of 2015 tion of a Studying Abroad section to highlight alumni who are currently pursuing post-grad- [email protected] uate studies internationally. Our Feature Interview this year is with Dr. Samantha Nutt, Founder and Executive Director of War Child Canada. Being one of the most prominent advocates for human rights in Canada, we are lucky that Dr. Nutt was able to take the time to talk with us. To end off this edition of the Annual Review, we’re also pleased to present the initiatives, experiences, opinions and creative works of medical students like you! The Annual Review also features a gallery of beautiful wedding and baby photos submitted by CFMS members. Creative art and photo pieces are also included, showing just how talented Canadian medical students are. As always, we thank the Canadian Medical Association publishing staff and our advertis- ers for their invaluable support in creating this year’s Annual Review. A special acknowledge- Matthew Tenenbaum ment goes out to our General Manager, Rosemary Conliffe, who works tirelessly to make CFMS VP everything we do possible. Communications We hope you enjoy reading this edition of the Annual Review! McMaster University, Class of 2013 vpcommunications@ cfms.org
All editorial matter in CFMS Annual Review 2011 represents the opinions of the authors and not necessarily those of the Can adian Federation of Medical Students (CFMS). The CFMS assumes no responsibility or liability for damages arising from any error or omission or from the use of any information or advice herein.
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A letter from your CFMS president
Greetings from your CFMS President he Canadian Federation of Medical Students (CFMS) is a student-run, student-driven T organization uniting over 7500 medical students from beautiful BC to the Rock. The CFMS is your organization. This year, I have the great pleasure and privilege of kicking off the 2012 CFMS Annual Review. I trust that you will enjoy reading about the exciting projects and initiatives featured herein. You will quickly come to realize why I am so passionate about this organization; this Review is a tribute to our executive and general membership’s hard work and dedication.
Noura Hassan The foundation of our organization consists of 3 pillars: representation, communication CFMS President, and services. 2011–2012 McGill University, Representation Class of 2012 The CFMS continues to play an active role in medical education systems reform. We are par- ticularly proud of the advances that have been made in the Association of Faculties of Medicine of Canada (AFMC)’s Visiting Electives Portal Project. Having been on the Governance Committee from the get-go, your CFMS representatives have been contributing to the development of a nation-wide electronic application system for visiting electives. On February 6, 2012 Parliament Hill welcomed medical students from across Canada for yet another successful Lobby Day. Our Global Health chapter brings valuable contributions to a number of international conferences. Finally, we continue to work on member-mandated projects to help improve your learning experiences. Communication We are always looking for new ways to promote dialogue and fluid exchange of information with you. Our biweekly rep communiqués and global health listservs continue to help us keep in touch with our members. You can follow the CFMS on Facebook, Twitter and look for updates on our beautiful new website (www.cfms.org). Our dedicated team also produces press releases in a timely fashion, responding to issues of importance to Canadian medical students. Services One of our top priorities is to help improve your experience in medical school. We continue to provide you with great discounts on services including textbooks, medical apps, hotel rooms, disability insurance and laser eye surgery. The CFMS Residency Interview Database is another highly valuable student-driven resource we encourage you to use and to contribute to. The Global Health Program’s international exchange program remains extremely popular amongst our membership. Make sure to check our website to find out more about the numer- ous services we offer! I can’t help but get excited when I think about the great things the CFMS does and all the exceptional people who help make it happen. It is a great privilege to have been given the opportunity to lead this organization and to represent you within the Canadian medical com- munity and to the world at large. Please feel free to contact us either via email or through your local CFMS representatives for any questions or suggestions. Kindest regards,
APRIL 2012 CFMS Annual Review 7
CFMS Activities
Communications: Keeping you in the loop!
Matthew Tenenbaum VP Communications McMaster University, Class of 2013
eyond providing services and media. If you haven’t already, check us ment. This was identified as an area of Bpolitical representation, the out on Facebook (“Canadian Federa- great concern by MUN students, and CFMS strives to articulate your tion of Medical Students (CFMS)”) we released a statement explaining our voice as Canadian medical students. and Twitter (@CFMSFEMC)! opposition to this proposed course of Communications — both internal and action. The story was picked up by a external — continue to be an impor- Medical student spotlight number of media outlets, including tant part of what we offer, and I’m While the CFMS works to communi- CBC Online and the National Post. pleased to say that this has been a very cate to students, we also strive to be a Atlantic Regional Rep Will Stymiest busy and productive year so far! means for students to share their expe- and MUN PAC Rep Lindsay Ward riences and accomplishments. Medical each gave live interviews, and explained CFMS website Student Spotlight is a new, online ini- why return-of-service agreements are Over the year, the CFMS website has tiative that features the neat ideas and ultimately ineffective. undergone some major renovations, projects that students are working on thanks to lots of hard work from our across the country. Our database has Lobby Day IT Officers Nima Kashani and Joanna amassed a number of academic, chari- Our Lobby Day this year focused on Li. The layout is much more intuitive, table and leadership projects — and it how the federal government can and important goodies — such as mem- continues to grow! If you’ve been work- enhance access to health care in rural ber discounts — are easier than ever to ing on an inspirational initiative that and remote regions of Canada, and we find and use. We’ve also overhauled a you’d like to share, be sure to submit it! were fortunate to have lots of interest lot of the content, and we’ve replaced from the media! Notably, we had text with images wherever possible. Media relations many requests for radio interviews, Improved versions of our CaRMS and Correspondence with the media is a including several from CBC Radio Electives databases are back by popular huge component of the VP Com- and many from local stations across demand. We’re continuing to update muni ca tions portfolio. In addition to the country. While President Noura and improve the website and, looking monitoring current health care and Hassan and VP Advocacy Chloe Ward forward, we’re investigating ways to medical education news, we provide were our primary media contacts, present more useful, individualized the “medical student voice” whenever many of our local PAC members information that will enhance your an important issue comes up. In the stepped up and explained our propos- experience. fall, CFMS President Noura Hassan als to the media. During our visit to was interviewed by the Medical Post Parliament Hill, we were also very Social media regarding rising tuition costs — an pleased to have the support of MP After being introduced last year, area of concern for students. The Bruce Hyer, who supported us through Facebook and Twitter continue to be Canadian Medical Association has his own press release and through a an important way to connect with stu- continued to be a valuable partner in motion in the House of Commons. dents. In addition to sharing CFMS our media relations strategy. This has been a very busy year so news items, social media has allowed far, and there’s still a lot of exciting us to engage students in discussions PEI return-of-service news to look forward to. Don’t forget about timely medical issues. Going This January, the PEI government to keep up-to-date through the forward, the Social Media Committee announced that it would require biweekly Communiques, distributed will continue to discuss how medical Island medical students studying at to each school, the CFMS website, and students can best present themselves as Memorial University to sign a manda- our social media accounts. I look for- young professionals when using social tory, three-year return-of-service agree- ward to staying in touch!
APRIL 2012 CFMS Annual Review 9 CFMS Activities
Career planning and student wellness — re-emerging themes in medical education
Renée Pang VP Education Queen’s University, Class of 2013
he last few years have produced a all 14 CFMS schools. Over the next Career planning during medical T marked change in the landscape two years, senior clerks and first year school training has become an emerg- of health care and medical edu- residents were surveyed to assess the ing field of interest among a variety of cation. Emphasis of current discus- number of hours they were required to stakeholders such as medical student sions has shifted from the reported work per rotation, and whether or not societies, faculty, government and reg- physician shortages to the limited they were aware of the work hour policy ulatory organizations – and rightfully availability of employment for resi- at their schools for each rotation. The so. In response to these concerns, the dents trained in specific areas of sub- preliminary results of this large scale CFMS is conducting a literature specialization. As all stakeholders work analysis were reported at the 2012 review and survey regarding the career together to better coordinate training SGM in Banff. research tools available to medical stu- of residents and students with societal To address the impact on wellness dents. Sameer Shaikh (McMaster, needs, the CFMS works hard to pro- and performance among medical stu- 2012) is chairing the working group vide students with the necessary tools dents in relation to work hours, on career planning this year. By the and information to plan their future. Darrell Ginsberg (Queen’s University, SGM in 2013, we hope to present Career planning and student well- 2014) chairs a working group that will results of our analysis and offer stu- ness are two themes that have resur- analyse the results for the CFMS- dent-centred recommendations to ease faced between various stakeholders in sponsored survey released in 2010 and the transition of medical students from medical education. In the past six 2011. Neil de Laplante (University of career planning into residency. months, the CFMS has undertaken Western Ontario, 2015), a former medical education projects that are engineer, has been helping with data- Future directions for the looking for answers to your concerns. mining in the project. distributed medical education It is my pleasure to provide you with a project brief update on this dynamic portfolio. Career planning in Canadian In May 2011, the CFMS published medical schools their recommendations from a student Clerk work hours Health human resource planning has centred review, which was then present- Recent concern for physician wellness become the new hot topic in the ed and enthusiastically received by the and patient safety has brought attention dynamic political landscape of health Association of Faculties of Medicine of to duty hour policies for residents and care policy. The CFMS has called on Canada at last year’s Canadian attending physicians. Many studies appropriate stakeholders to make job Conference on Medical Education. have shown the negative correlation trend data across different medical spe- In response to the recommenda- between sleep deprivation and informa- cialties available to the public, and tions, the Distributed Medical tion processing. Like physicians, med- more importantly, to medical students Education working group, chaired by ical students report a higher rate of as they choose their future careers. The David Mikhail (University of Western depression than the general population. CFMS is also advocating for better Ontario, 2013) and Alkarim Velji In response to the concern over com- communication between the training (University of Alberta, 2015), was mon practices of duty hours among and the hiring arms of health human tasked with conducting a second study medical professionals, the CFMS began resources to ensure that Canadian to assess the quality of medical educa- a large scale study in 2009 to assess the medical graduates will be entering the tion at such sites and correlation with status of clerk work hour policies at workforce with sufficient information match rates. Neil de Laplante is over- Canadian medical schools. In 2009, we about job market demands across dif- seeing the results and data gleaned compiled clerk duty hour policies from ferent disciplines. from both studies.
10 CFMS Annual Review APRIL 2012 CFMS Activities
Canadian electives portal struction with full support from the Right to research coalition management system Association of Faculties of Medicine of In January 2012, the CFMS Executive Since 2007, the CFMS has been advo- Canada and CFMS. officially endorsed Open Access to cating for a streamlined elective appli- promote equal access to quality cation process for Canadian medical CaRMS update and residency research. Open Access is an alternative students. We are excited to report that positions distribution and publishing model for the final round of consultations was Canadian Medical Graduates (CMGs) scholarly literature that allows any completed in November 2011, and continue to do well in the CaRMS individual, including medical stu- work is now underway to start building match. In 2011, 94.5% matched in dents, to access research for free. the new application interface, currently the first iteration, with 63.1% match- Thank you for reading this brief known as the Canadian Electives Portal ing to their first choice rank list. selection of some of the projects run- Management System (CEPMS). Moreover, 99.8% matched to one of ning this year at the CFMS under the Many senior medical students will their top 3 disciplines. This is compa- Education portfolio. There are a myri- attest that organizing electives can be a rable with last year’s results, and the ad of other exciting projects and very time-consuming, expensive and CFMS will continue to advocate for opportunities that you can find out frustrating process. Each school has residency spaces for all CMGs. The about through your local representa- unique requirements regarding immu- 2012 Matchbook will continue to pro- tive. If you have any questions about nizations and rotations. Although vide important information to all any projects related to medical educa- these factors continue to present some medical students about the matching tion, please do not hesitate to contact challenges in creating a unified appli- process and the competitiveness of me at [email protected]. cation system, CEPMS is under con- particular specialties.
reat workp er, we create g laces Togeth
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APRIL 2012 CFMS Annual Review 11 CFMS Activities
The future of medical education
Renee Pang VP Education Queen’s University, Class of 2013
aced with an increasing need for Distributed medical producing the intended primary out- F rural physicians, distributed come: to increase the likelihood of medical education (DME) was practising in a rural area. The follow- introduced in Canada as a strategy to education is no ing report will elaborate on some of increase enrolment in medical schools. the recommendations that the CFMS Since its inception, DME has explored longer a dream, but was able to make based on this study. a variety of creative innovations in Some of the strengths identified in medical education that have trans- a reality that affects DME included clinical opportunities formed clinical training opportunities and preceptor contact, which were in both undergraduate and post-grad- most, if not all, both ranked 1 and 2, respectively, in uate education in Canada. These importance after aggregating the data include pre-clerkship electives in rural Canadian medical collected from 484 participants. areas, rural core rotations, entire satel- Educational variety was identified as lite campuses that are affiliated with faculties. the next most important strength in medical faculties and horizontal clerk- medical education. The smaller classes ships in rural communities. In 2008, and the opportunities to explore com- the CFMS initiated a three-year study they considered to be strengths and munities were identified as another across all member schools to look at weaknesses in their education, and advantage. Overall, DME seems to the effects of DME on students, what whether or not it has been effective in offer rich educational experiences and
Ranking of strengths Ranking of weaknesses
8 8
7 7
6 6
5 5
4 4
3 3
2 2
1 1
s t ss s s s ie es rs t iety la os o r c c ice niti ccess v pt ll u d cation rvice r r family a a e a Lifestyle u s ce ortuni d e y at home m VC issue r or contact S e y d ne ease u y tional va l disconnect ept urces c St d a u Incr so t lore comm ocia Pre S duc S quality Re E Universit Community sepecialist p Clinical opp Exp S Low
12 CFMS Annual Review APRIL 2012 CFMS Activities
direct contact with attending physi- In terms of relative weaknesses of Other challenges included poor video- cians, which is perceived as both a ben- DME, social disconnect and increased conferencing quality and resource efit and advantage by students enrolled cost were identified as top choices access, as well as limited contact with in these programs. among the list of possible choices. specialist preceptors. Interestingly, fewer students felt that DME offered In brief: Recommendations to enhance distributed medical education them a lower quality education, although the range of responses varied 1. Satellite campuses: greatly for this question. The results a. Lecture content at various sites should be standardized if not identical show that in general, weaknesses were b. Access to resources equivalent to those at main campus resource and network related. Both c. Involve students in UGME selection and application process aspects can easily be improved by d. Monitor match data to ensure that clinical education is on par with main campus enhancing resources and ensuring that students have access to meaningful net- e. Administration should help foster links between students to provide a social envi- ronment and encourage student leadership initiatives works and support during their educa- tional experience. f. Make stipends available for out-of-pocket costs if applicable In terms of the efficacy of DME in g. Allocate funds for campus integration initiatives exposing and inspiring students to pur- sue a career in rural medicine, of the 2. Mandatory rural placements: students who did not want rural medi- a. Expand offerings in various sites cine before entering medical school, 20% now wanted to do rural medicine b. Ensure webcast relay for students in areas without videoconference technology and 25% remained undecided at the c. Ensure preceptors are aware of the educational level and capabilities of medical end of the experience. Conversely, of students and provide them with learning objectives for the rotation the students who wanted to do rural d. Internet access if possible at accommodations medicine, 6% decided they did not e. Allow students to select preferred sites for mandatory placements want to pursue rural medicine and 12% f. Accommodate familial obligations if possible became unsure at the end of the experi- g. Encourage hosting site to organize social events ence. Exposure generally seems to be h. Make placement cost-neutral conducive in encouraging students to practice in smaller communities. Distributed medical education is 3. Electives outside of academic centres: no longer a dream, but a reality that a. Offer a formal introduction and orientation at all new sites affects most, if not all, Canadian med- b. Discuss goals and objectives for the placement with preceptor at beginning ical faculties. Our study indicates that c. Recognize value of clinical electives it offers great clinical training as well as good contact with preceptors. We d. Orientation material prior to departure hope that our recommendations based e. Provide students with a support system on the student-centred review will f. Help improve access to accommodations and offer subsidies if possible allow us to continue enhancing this g. Allocate for bursaries to alleviate anxiety over financial burden educational model and bring benefits for future students and faculties alike.
APRIL 2012 CFMS Annual Review 13 CFMS Activities
Changing how we’re taught will lead to a better health care system
Will Stymiest Atlantic Regional Representative Dalhousie University, Class of 2014
he Canadian model of health which governments can improve their a result this approach has contributed T care has become an essential ele- approaches!1,2 to increased specialization of practice. ment of Canadian life and a cul- This type of training has produced tural symbol by which we identify our- Some examples of current more specialized physicians and has selves to the world. More than a source strategies… given rise to a centralized rather than a of pride to some, our policy of not 1) As part of their effort to increase distributed health care system. only equal, but equitable health care undergraduate training capacity, In order to address issues of has become a dominate part of the Dalhousie University has partnered patient access and quality of care in Canadian ethos. However, it is appar- with the Government of New rural areas, it is important that we real- ent that our current structural frame- Brunswick to create a distributed ize the role education and clinical work for health care delivery is not medical education (DME) site in experience can and should play. This meeting some of its basic goals. Saint John, NB. In addition to pro- type of educational shift is happening Namely, the ability of individuals to viding high-quality clinical experi- as evidenced above, but the paradigm access an acceptable level of quality ences, DME sites and/or DME shift has yet to take place. Traditional care, especially those living in rural and experiences have the ability to thinking about physician training, other underserved regions of the coun- expose undergraduate students to recruitment and retention will not try, is currently inadequate. rural/community practice. The serve us well if we want to create a sys- Canadians in the Atlantic Pro vin - CFMS, through student consulta- tem that meets the needs of all ces, like others across the country, have tion, has highlighted this as an Canadians. The CFMS has been a been affected by these shortfalls and important factor for students who voice in the push for change, and we as over the past two decades governments may otherwise not consider these students must continue to be part of have been searching for ways to address areas of practice. this discussion. these issues. One method and perhaps 2) In recent years a greater emphasis the most basic approach, has been to has been placed on rural experience Bibliography increase the class sizes of medical at the undergraduate level with at 1. Canadian Residency Matching Service schools in order to bolster the numbers least 10 medical schools across the (CaRMS). R-1 Reports & Statistics 2001. 2001 [January 31, 2012]; Available of native physicians trained each year. country (including both Dalhousie from: http://www.carms .ca/eng This strategy comes with one key and Memorial) requiring students /operations_R1stat_2001_e.shtml. caveat: it will only work if the increased complete a rural medicine place- 2. Canadian Residency Matching Service number of medical graduates actually go ment (either as pre-clerks or clerks).3 (CaRMS). R-1 Reports & Statistics 2011. on to practice in these areas of concern. 3) The establishment of a PEI Family 2011 [January 31, 2012]; Available In 2001, there were 1134 Cana- Medicine Residency program allows from: http://www.carms.ca /pdfs/2011R1_MatchResults/1_ dian Medical Graduates (CMGs) who for the expansion of residency train- Summary%20of%20 Match% 20Results participated in the Canadian Resi dency ing and clinical experience to more %20R1%201st_2nd % 20 Combined_en Matching Service (CaRMS) match, rural areas of Atlantic Canada. .pdf. and by 2011 there were 2496 CMGs 3. Canadian Federation of Medical applying to the match. While this Where do we need to go... Students. Distributed Medical Education: A student-centred review is helping to address physician short- Clinical training has classically taken and best practice recommendations. ages, there are important ways in place in large, university centres and as Position Paper, May 2011.
14 CFMS Annual Review APRIL 2012 CFMS Activities
CFMS member services: Discounts are just the beginning!
Robin Clouston VP Services Memorial University, Class of 2013
hrough pre-clerkship and clerk- CFMS discounts save you money. Interview Database went online — T ship, through studying hard and But did you know there are more just in time for CaRMS! Log on to get applying for electives, through CFMS services to make medical stu- the scoop for your CaRMS tour. After your CaRMS tour and beyond, you dent life easier? CaRMS, log on again to post your have needs that are unique to medical own reviews! Clerkship students can student life. In my role at CFMS, it’s CFMS disability insurance now also take advantage of the my job to ensure that we support those What would you do if you had an Electives Database, where student post needs with targeted member services injury as a physician? Disability insur- reviews of the electives they’ve been — designed with you in mind! ance is one of the most important on. Don’t forget to review the electives things a physician will ever purchase. that you’ve completed! Discounts, discounts, As a CFMS member, you have access discounts! to the only plan designed specifically Medical resource reviews Medical students love CFMS dis- for medical students: comprehensive, This longstanding CFMS service, for- counts — in our most recent member no medical exam, and will continue merly known as the Textbook Review survey in 2011, discounts were ranked through your entire career with mini- Committee, provides reviews of medical as the most valuable CFMS service. mal changes. Plus, you get 25% off! textbooks. This year has seen changes Popular discounts include: This CFMS service, offered through with the service expanding to include • Choice Hotels: 20% off Kirkham & Jack, helps you to plan for reviews of medical e-Resources. In addi- • CFMS Disability Insurance: 25% your future. See cfms.org for details on tion, a review can now also be initiated off, no medical exam ever how to enroll. by CFMS members themselves — you • Lasik MD Vision: up to 50% off can recommend a textbook, website or • McGraw Hill Bookstore: 25% off CFMS databases medical app! This year’s reviews, com- over 500 titles In January 2012, through the dedica- pleted by the diverse CFMS Medical • Skyscape med apps: 25% off tion of the CFMS IT team, the new Resource Review Committee, will be • … and more! and improved CFMS Residency available this Summer at cfms.org.
Want to get in touch To access these CFMS services, go to www.cfms.org and and stay informed? click on “Member Benefits”.
Here’s how: If you are a medical student but do not yet have an account, sign up at ww.cfms.org/signup.asp. • Visit www.cfms.org • Facebook: search CFMS The sign up code is available to you through your school’s • Twitter @CFMSFEMC CFMS representative. • Email vpcommunications Sign up today to benefit from these great discounts and @cfms.org more!
APRIL 2012 CFMS Annual Review 15 CFMS Activities
Changes to travel deals were for regular fares only and no Royal Bank Line of Credit at prime This year there were unforeseen online bookings. Students expressed interest rate along with sound financial changes to CFMS travel discounts. In frustration and we tried to restore the advice. You can also check out the the past, members got 10% off at one deal, however the airline opted to dis- Canadian Medical Residency Guide, of Canada’s major airlines from Jan– continue their 10% discount altogeth- developed by medical students and April for CaRMS. Last year, discounts er. This change was unexpected and brought to you by Royal Bank. understandably disappointing to many in 2011, students ranked travel dis- Working together counts as the #1 most valuable service At CFMS we recognize that member In a 2011 member survey, by CFMS. We are actively exploring services go beyond discounts. The students told CFMS which options to find new airline discounts Global Health Program offers interna- services are most valuable to suit the unique needs of medical tional exchanges, the Wellness students. In the meantime, the latest Program provides resources for student to them: information on regular seat sales is health, the Residency Matchbook available at cfms.org. helps you to succeed in CaRMS, and 1. Travel discounts more. In addition, there are fantastic 2. Residency Matchbook Financial wellness products and services offered by the Through a partnership with Royal CMA which student members can 3. Discounts on insurance Bank, the CFMS is delighted to offer access. This year, through working col- 4. CFMS Electives Database 14 CFMS-Royal Bank scholarship, laboratively, we’ve presented more each worth $2500. That’s one scholar- services than ever before, highlighted 5. Textbook discounts ship at each member school! In addi- in CFMS Services Updates, available tion, CFMS members have access to a from your CFMS Rep. Changing minds on Parliament Hill — one meeting at a time
Chloé Ward VP Advocacy University of Ottawa, Class of 2013
n Monday, February 6, mem- school students in rural areas. Students Students arrived in Ottawa for a Obers of the CFMS gathered in held more than 75 meetings to convey weekend of advocacy training before Ottawa for their annual Lobby their point of view to key decision- their meetings with MPs. Prepara - Day on Parliament Hill. Over 60 stu- makers. tions included presentations by dents from across the country, divided “This year’s Lobby Day was a in teams of two or three, sat down with great success,” said Noura Hassan, The arguments Members of Parliament (MP) to dis- CFMS President. “Our team did a cuss issues of importance to Canada’s fantastic job educating politicians made by students medical students. about students’ concerns and we had a This year, the agenda focused on lot of fun here in Ottawa.” improving service delivery in rural The arguments made by students were well received areas. Specifically, students presented were well received by parliamentarians their case on two matters: deferral of and their staff. One MP is even intro- by parliamentarians the repayment of the federal portion of ducing a motion in the House of students loans and the expansion of Commons to demonstrate Parlia ment’s and their staff recruitment programs targeted at high support for the proposal of the CFMS.
16 CFMS Annual Review APRIL 2012 CFMS Activities
Dimitri Soudas, former director of Association. More over, students con- Another Lobby Day should take communications for Prime Minister ducted mock meetings to practice place in 2013. Between now and then, Stephen Harper; Joy Smith, Chair of their lobbying skills. “The CFMS’ the CFMS team will continue to work the House of Commons Standing Political Advocacy Committee did a closely with MPs to try to improve the Committee on Health and MP for spectacular job organizing the train- delivery of health services in rural Kildonan-St. Paul; and a senior policy ing session and lining up our meet- areas. analysts from the Canadian Medical ings,” added Hassan.
Students participating in Lobby Day.
CFMS Political Advocacy Committee Members
Chair ...... Chloé Ward (CFMS Vice President Advocacy) Memorial University ...... Lindsey Ward Dalhousie University ...... Haley Augustine & Nada Ismaiel McGill University ...... Douglas Slobad University of Ottawa ...... Hana Alazem Queen’s University ...... Wilson Kwong, Michelle Khan & Negine Nahiddi University of Toronto ...... Thomas McLaughlin McMaster University ...... Azim Kasmani & Lily Zhao University of Western Ontario ...... Adam Papini Northern Ontario School of Medicine ...... Jill Caines University of Manitoba ...... Sarah van Gaalen University of Saskatchewan ...... Jessica Lydiate & Sarah Miller University of Alberta ...... Roshan Abraham University of Calgary ...... Yan Yu University of British Columbia ...... Trevor Skutezky
APRIL 2012 CFMS Annual Review 17 CFMS Activities
Town halls for transformation
Chloé Ward VP Advocacy University of Ottawa, Class of 2013 s the 2004 Health Care Accord Advocacy Com mittee at the universi- These sessions A is set to expire in 2014, transfor- ty. “A lot of good ideas came out of mation in health care delivery is these sessions. As future physicians, at the forefront of many policy discus- medical students are entirely engaged were designed to sions in meeting rooms across the in these discussions about the future country. The CFMS is also participat- of health care because it will impact generate debates ing in the debates, after having their work later on.” launched a series of town hall meetings Discussions focused around such about health care to consult members on the future of topics as health system funding mod- health care in Canada. As future health els, health human resources, national transformation. care leaders, the onus is on us to main- pharmacare programs, dental care tain and improve our current system to strategies and other initiatives. “This is ensure the delivery of quality care for an exciting opportunity for medical years to come. students to voice their thoughts and Most medical schools across the opinions in a discussion that will have The CFMS will compile a sum- country hosted a town hall during the profound impacts for years to come,” mary of the various town hall efforts winter of 2012. These sessions, to said Jemy Joseph, a medical student at and a corresponding report will be which CFMS members and some fac- the University of Ottawa. available in the spring. ulty were invited, were designed to generate debates about health care transformation. The events were divided into two parts: a keynote address by a subject matter expert, followed by an open policy discussion. Among the many notable and well-spoken presenters were Dr. Haggie, President of the Canadian Medical Association; Dr. Roger Palmer, Alberta’s former Deputy Minister of Health and Wellness; and the Honourable Dr. Carolyn Bennett, former Minister of State (Public Health). “We had two very productive town halls at the University of Western Ontario,” said Adam Papini, Town hall event at the University of Ottawa with Dr. Carolyn Bennett as the keynote the chair of the CFMS Political speaker.
18 CFMS Annual Review APRIL 2012 CFMS Activities
Taking care of student health and wellness
Natalia Ng CFMS National Wellness Officer University of Ottawa, Class of 2013
ow is an exciting time to be the exciting opportunity to lead inter- tive, led a workshop that focused on Ninvolved in medical student active workshops discussing pertinent how well undergraduate curricula are health and well-being! Why, you wellness issues medical students cur- currently meeting their wellness objec- may ask? Because the wellness buzz is rently face. tives. She pointed out that the wellness resonating throughout the medical curricula across schools is still widely community and capturing the atten- variable, and advocated for a standard- tion of medical organizations nation- … students are in ized baseline to ensure that all medical wide. The Canadian Medical Associa- students are receiving adequate well- tion (CMA), the CFMS, and provin- need of more ness support from their schools. cial Physician Health programs are all Helen Yang, a second year medical jumping on the wellness bandwagon. support to balance student and strong supporter of stu- In October 2011, the CMA host- dent wellness, provided an overview of ed the 2nd Canadian Conference on their academic and causes leading to poor performance in Physician Health. This conference was the academic setting and ways of cop- uniquely different from past wellness ing. Causes include a difficult work- conferences due to its focus on well- personal lives. load, lack of sleep, mental health ness issues within the medical student issues, preparing for CaRMS, and the population. With a workshop stream stress of picking a specialty. She highlighting medical student health in Melanie Rodrigues, currently the explained that student behaviours are the academic setting, the CFMS had CFMS Ontario Regional Representa- often a reflection of the values mod- eled by senior clinicians, and that pro- fessional attitudes are best learned from reliable physician mentors. Yang also noted that it is important for stu- dents showing disruptive behaviours to receive unbiased, ongoing support from faculty to redirect them down a more constructive path. As the current CFMS National Wellness Officer, I had to opportunity to focus my talk on medical students crossing boundaries in the non-clinical setting. A discussion by workshop par- ticipants on the topic of residents dat- ing medical students showed that this is often an accepted and popular behav- ior in the medical school community. However, it becomes a boundary issue 2nd Canadian Conference on Physician Health. Toronto, Ontario. if there is a power imbalance between From left to right: Susan Ryan, Melanie Rodrigues, Helen Yang, Natalia Ng, Fran the two individuals. For example, if the Carr, Amandeep Takhar, Lauren LaCaprara. resident is required to evaluate the
APRIL 2012 CFMS Annual Review 19 CFMS Activities
medical student’s clinical performance. by their respective schools. With a students are in need of more support In this case, it is important that these chance to win an iPod Nano courtesy to balance their academic and personal two individuals be aware of and follow of MD Physician Services, students lives. It is anticipated that the results of the appropriate policies and procedures provided us with feedback regarding this survey will be released at the put in place by their institution. the wellness resources that currently Spring General Meeting. In addition, the CFMS has initiat- exist at their schools, versus what they As medicine enters a new genera- ed its own project to carry forward the NEED and WANT in order to achieve tion, medical students nationwide are wellness buzz. Just recently, the CFMS a healthy student life. With over 900 striving to maintain a balanced Wellness Program launched a ques- responses, the Wellness Program hopes lifestyle. The CFMS is committed to tionnaire to survey students’ wellness to show schools that wellness is a hot helping YOU get there! needs and whether they are being met topic among medical students and that Making time for your well-being Melanie Rodrigues Queen’s University, Class of 2012
ver the last year, I have been priv- able wellness resources at their Committee at the CFMS Spring O ileged to be involved in creating schools. General Meeting. If you are unable to a future plan for the CFMS’ • 65.2% of respondents report attend the meeting, but are still inter- Wellness Program. As many of you being “extremely satisfied” or “sat- ested in participating in this commit- know, the first step of this plan involved isfied” with the wellness resources tee, please email myself or the National sending out a Wellness Resource- offered at their schools. Wellness Officer, and we will add you Based Questionnaire to our entire Now that survey analysis is under- to the mailing list! CFMS membership. Remark ably, over way, this coming year will be full of Thank you again to those who 900 students from all academic years change where the CFMS Wellness participated in the 2011 CFMS and each CFMS member school Programming is concerned as we move Medical Student Wellness Resource- responded to our call for information! forward to the second stage of our based Questionnaire and remember to The data is currently being analyzed, Wellness Initiatives — the CFMS make time in your busy schedule for a with plans for a detailed report and the Wellness Website! This year, we hope bit of rest and relaxation! full results to be made available at the to enhance the website by featuring Spring General Meeting in April 2012. quick and healthy recipes from our The raw survey data thus far has members, mindfulness and meditation revealed that while there is significant audio and video clips, and an enhanced variability in the wellness resources section on financial wellness. If you are offered at each school, the majority of interested in adding content to the Canadian medical students indicated CFMS Wellness Website (www. that they were satisfied with their medstudentwellness .ca/), or have any school’s wellness programming. That ideas on how we can improve our well- being said, here is a sneak peak at some ness programming, please don’t hesi- of the survey data, with much more to tate to contact me directly. come in the following months: Additionally, for all those who • 25.1% of students surveyed indi- have demonstrated interest in the past, cated that they did not receive we will be creating a Wellness Sub- core curriculum teaching pertain- ing to wellness at their schools. Every year, classmates, friends and loved ones are afflicted with mental illness. • 78.8% of respondents have never Often, students don’t know where to turn or who to speak to. If you or someone you used a counselor or therapist as a care about is having a difficult time, contact PAIRO’s confidential help line: 1 866 wellness resource. HELP-DOC (1 866 435-7362), www. ePhysicianHealth .com, the CMA’s confidential • 46.8% of students surveyed believe help line: 1 800 851-6606, or your school’s Office of Student Affairs. that they are not aware of all avail-
20 CFMS Annual Review APRIL 2012 CFMS Activities
Ontario regional update
Ian Brasg Ontario Regional Representative University of Toronto, Class of 2014
his year I have had the pleasure sionals in such areas. Exposing future leaders from across the country. Please T of representing the 6 Ontario physicians to the joys of rural practice let me know if you are interested in medical schools — and their stu- as early as possible helps to maximize getting involved! dents — on the CFMS executive. My the likelihood that they will ultimately work to date has consisted of address- practice in these areas. The CFMS has Medical student leadership ing some regional issues while setting advocated for the distribution of scarce survey the groundwork for nation-wide ini- rural elective resources in a way that Lastly, we are in the early stages of pro- tiatives. We are fortunate to have a acknowledges the important role of ducing a national, REB-approved sur- close collaborative relationship with such medical student experiences. vey on medical student leadership. The the Ontario Medical Student Associ a- study of leadership in medicine is tion, which keeps close tabs on provin- Online professionalism becoming an important topic in acade- cial happenings, that allows their initiative mia, in part due to the current climate CFMS counterparts to focus on wider- As many of you know, the CFMS of fiscal restraint. Some studies, for scope efforts. recently produced an excellent guide instance, have shown that hospitals led to professionalism from the student by physician-CEOs are less wasteful Rural elective-funding perspective. This guide has been well and have better aggregated clinical out- austerity measures received by faculty from medical comes than those managed by CEOs For many years now Ontario has been schools across the country, who espe- without clinical training. Despite these privileged to enjoy generous funding cially loved the CanMEDS framework benefits, numerous investigations have for rural medical electives and experi- adopted. While most of the feedback found disincentives to physician ences in concordance with provincial was positive, one criticism of the doc- involvement in leadership at many campaign promises and concerns for ument was that it did not go far stages of professional development and equity and the just distribution of enough in addressing online profes- advancement. We are interested in resources. However, recent slowed sionalism and social media concerns. scoping the current range of medical GDP growth and worsening debt have The faculty leads readily acknowledge student experiences and perspectives forced the government to adopt auster- that this may be an area in which stu- on leadership, as well as the effect of ity measures — and tighten its belt — dents are best positioned to contribute medical education on such involve- in most public service areas. There are to the discourse and help shape expec- ment. We hope that the results of this concerns that such measures will harm tations. Students themselves have also study will help improve medical educa- the funding received for rural electives been expressing widespread concerns tion for our members down the road. arranged by the various regional pro- regarding appropriate medical student I’d like to thank you for your grams, including ERMEP, NOSM, behaviour on the internet. As such, the interest in Ontario and my portfolio, ROMP and SWOMEN. The CFMS CFMS is pleased to begin undertaking and hope that the preceding summary believes that the opportunities afforded the production of a practical guide to of my involvement has been informa- by the various rural medicine programs online professionalism and social tive. Please contact me at ian.brasg @ to medical students are crucial compo- media. We anticipate that this guide utoronto .ca if you have any questions nents of a durable solution to the will build on the great work already or concerns, or would like to get underrepresentation of health profes- being done in this area by student involved!
APRIL 2012 CFMS Annual Review 21 short commute rural and urban communities diverse practice great work lots of room to play environments great schools financial security for my kids
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Physician RecruitmentRecruitment Agency of Saskatchewan Global Health
The CFMS global health program: A year in review
Paxton Bach VP Global Health Queen’s University, Class of 2013
011 was an important year for topic to Canadian medical students, dents. On a national level the GHAs 2 the CFMS and the GHP was no but also provides us with a golden have begun a coordinated campaign to exception. The development and opportunity to showcase the work done bring attention to Bill C-4, an amend- implementation of our new strategic by the GHP. Front and centre will be ment to the Immigration and Refugee plan led to a period of introspection our collaboration with the AFMC Protection Act that threatens to have a and provided the impetus for us to Global Health Resource Group and the significant negative impact on the closely examine all of our existing pro- Global Health Education Consortium manner in which we treat refugees grams and partnerships. It has also to establish core competencies in Glo - arriving in Canada. Lastly, work has meant a chance to put forward a con- bal Health for inclusion into under- now begun on “The Book of Refugee crete vision for the future of the GHP, graduate medical curricula. Covering a & Immi grant Stories”, a publication to ensure the effectiveness and longe- breadth of topics from the global bur- that will contain a collection of stories vity of the program. The new CFMS den of disease, to the social and eco- describing real-life interactions of these website is providing us with a valuable nomic determinants of health, this is at risk populations with the Canadian opportunity to improve our commu- an amazing opportunity to present our medical system. This promises to be a nication, transparency and institution- vision of the basic pillars of Global useful educational and advocacy tool, al memory — we are also working Health necessary for a comprehensive and will be widely distributed upon its hard to unveil several new online serv- medical education. Also being presented completion later this spring. ices, so continue to check back often! at the CCME for the first time will be Overall the strategic plan has been the work of the GHP on helping estab- Aboriginal Health more than just a helpful exercise and lish elective global health programs at The position of Aboriginal Health we feel confident in the continued Canadian medical schools. This meet- Liaison was created by the CFMS in growth and evolution of our projects. ing is a culmination of years of effort Saskatoon at the 2010 CFMS Annual Alongside our strategic planning, from several generations of National General Meeting. From the outset the this remained a busy and productive Officers of Global Health Edu cation goals of the position were to promote year for our programs. We received an and a fantastic opportunity to applaud the incorporation of Aboriginal Health incredible 400 applications from their diligence and hard work. content in Canadian medical schools, Canadian students for clinical and to work in collaboration with Aborigi- research exchanges this fall, and in Global Health Advocacy nal Health interest groups at medical turn will be attempting to place nearly The Global Health Advocacy Program schools across Canada, and to serve as 50 international students this summer theme for 2012 is once again “Immi- a conduit for communication with the who are coming to experience the grant and Refugee Health”. Since this Indigenous Physicians Associ a tion of practice of medicine in Canada. Below theme was chosen one year ago, educa- Canada (IPAC). To this end the AHL are a few more of the highlights we tional and advocacy programs have has built strong ties with IPAC and is have seen over the past year from other been established all across the country. coordinating with them on a number global health portfolios. Existing projects include the creation of initiatives directed at improving of or placement of students into immi- Aboriginal health in Canada. A key Global Health Education grant and refugee health clinics, the goal for the following months will be The theme of the 2012 Canadian development of immi grant and refu- to examine the extent which Abori gi- Conference on Medical Education gee cases for use in clinical skills pro- nal health is included in Cana dian (CCME) is Global Health. This not grams, and the arrange ment of cultural medical school curricula and to advo- only highlights the importance of this competency lectures for medical stu- cate for the adoption of the core com-
APRIL 2012 CFMS Annual Review 23 Global Health
petencies in Aboriginal Health (as out- reproductive and sexual health this schools and this project has now mer- lined in the document “First Nations, year was once again organizing cam- ited publication by the Ontario HIV/ Inuit, Métis Health Core Competen- paigns and providing resources to help AIDS Treatment Network, the OMA’s cies: A Curriculum Frame work for schools mark World AIDS Day. On an Scrub-In, and will be presented at the Undergraduate Medi cal Edu ca tion”) international level, the CFMS partici- IFMSA General Assembly in Accra, as mandatory components of under- pated in the International Federation Ghana this March. graduate medical education in Canada. of Medical Students “Get to Zero” I would finally like to take this The AHL has also begun a partnership campaign against HIV, collaborating opportunity to recognize each of the with STOP TB Canada, calling for on a video with 23 other member 2011 Global Health Program National improved funding for tuberculosis countries. Sights are now set on build- Officers for the countless hours of hard research and treatment worldwide, ing up resources to help observe other work spent on overseeing their indi- and increasing awareness of the high important WHO dates including vidual programs, and for all of their burden of tuberculosis in the indige- International Women’s Day and the contributions to the GHP strategic nous Canadian population. International Day against Homo - plan. The amount of effort each of phobia. These will be accessible by all them has put in is commendable, yet Reproductive and Sexual on the new GHP section of the CFMS often underappreciated. Congratula- Health website. Additionally, HIV electives tions, and thanks to each of you for a The focus of the GHP in the realm of are taking off at many Canadian successful year!
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24 CFMS Annual Review APRIL 2012 Global Health
Global health certificates: Expanding access to global health education in Canada
David Matthews, National Officer of Global Health Education (outgoing), University of Toronto, Class of 2014 Mary Halpine, National Officer of Global Health Education (incoming), Dalhousie University, Class of 2014
n recent years, there has been grow- partner site in Mozambique. In addi- d. Pre-departure training and post- Iing demand for global health educa- tion, students complete a longitudinal return debriefing before and after tion at Canadian medical schools. place ment in the context of an urban the low-resource setting elective. Despite sustained student advocacy for under served community at the e. Student evaluation with fellow increased global health teaching, med- SWITCH clinic in Saskatoon. By par- students and faculty. This may ical schools often struggle to address ticipating in this type of program, stu- include methods like portfolios or this need. A survey of graduating dents are able to experience the local, written reports. Canadian medical students in 2011 national and international aspects of These guidelines are intended to showed that 44.8% of students felt global health, while gaining a solid be flexible and adaptable to the global that instruction in global health was academic foundation in the field. health opportunities available at dif- inadequate.1 As a result, many students Inspired by the success of ferent medical schools. An initial participate in informal or extracurricu- “Making the Links,” the CFMS draft was presented at the CFMS lar global health learning opportuni- Global Health Program is working Annual General Meeting in ties, including international clinical with our faculty partners to create a set September 2011 and generated lots placements, global health lecture series of National Guidelines for Elective of discussion. We are hoping to pres- and volunteer opportunities with mar- Global Health Certificates. It is hoped ent a finalized draft of the guidelines ginalized communities in their local that these certificate guidelines will at the CFMS Spring General area. However, these programs often provide greater recognition for stu- Meeting in Banff. The next article lack the structure and supports neces- dents participating in extracurricular describes the efforts by students at sary to provide students with adequate global health learning activities, and the University of Calgary to establish training in global health. will serve as a template for schools that a Global Health Certifi cate. If you Recognizing the need for more are looking to develop similar pro- are interested in establishing a similar comprehensive global health educa- grams. Key elements of the guidelines program at your school, please con- tion, several Canadian medical schools include: tact [email protected] or your school’s have begun to offer elective global a. Local community engagement Global Health Liaison. health certificate programs. These pro- through clinical and/or research grams combine a number of different experience with community-based References global health learning opportunities organizations. 1. Association of American Medical into a cohesive program. The best b. Global health coursework either Colleges. Medical School Graduation Questionnaire — All Schools Summary developed of these certificates is the within the school’s curriculum, Report, www. aamc.org /data /gq/ “Making the Links” program at the through extracurricular events or allschoolsreports/ (2011) University of Saskatchewan.2 This pro- self-directed learning. 2. University of Saskatchewan, College of gram combines in-depth coursework c. Low-resource setting elective in a Medicine. Making the links: a certifi cate in global health, 2011 in global health with community community within or outside of www. medicine.usask.ca/leadership placements in a remote community in Canada, for a minimum duration /social-accountability/initiatives /mtl1 Northern Saskatchewan and at a of 4–6 weeks. /index.html
APRIL 2012 CFMS Annual Review 25 Global Health
University of Calgary’s global health concentration pilot
Rita Watterson, Global Health Liaison Sr., University of Calgary, Class of 2013 Kimberly Williams, Global Health Liaison Jr., University of Calgary, Class of 2014
n our current globalized society, skill sets to work with these patient a number of students who are inter- Ithere is an urgent need to prepare populations. ested in global health. The ‘global future physicians to face pressing Students participate in three inner health’ that I believe in includes the global health issues. It is well recog- city clinics within a service-learning idea that globalization has created nized that the “immediate need for model in order to understand the legal, political and cultural interac- global health medical education has unique challenges of underserved pop- tions that impact the health of every not been adequately addressed by ulations in Calgary. During pre-clerk- country in innumerable ways. Glo - medical schools.” Currently, medical ship electives, they go to Tanzania to baliza tion has made the nationally education regarding global health work alongside fellow students defined world more intricate, by allows students only a glimpse into this through our partnership with the defining the world as a complex of burgeoning field, and is elementary Bugando University. Throughout their nations and regions as well as a single and sparse in nature. In an effort to undergraduate training they are social space. shift this tide, undergraduate medical involved in monthly journal clubs and The creation of the GHC has education train future doctors to meet seminars under physician mentorship given us students the opportunity to the diverse range of health conditions and evaluation. explore ‘global health’ as we learn to we face as a global community. As a student-led program working become clinicians. It is allowing us to with current undergraduate medical explore the supraterritorial nature of Program development curriculum, we have realized the our globe in hopes that no matter The Global Health Concentration importance of faculty involvement and where we practice, we will be pre- (GHC) pilot program was developed support. Recently, the Global Health pared to be the most effective physi- in an effort to provide hands-on learn- Department appointed a faculty con- cian that we can be. It is through this ing experiences for future medical stu- sultant, a big step forward in ensuring program that we hope to act as physi- dents. Inspired by the ‘Making the the permanency of this program. With cian advocates both inside and out- Links’ program developed at the a combined effort across the country side of the health system. University of Saskatchewan, the GHC we hope more medical students will Submitted on behalf of the was envisioned and implemented over engage in working with underserved University of Calgary GHC Student a 10-month period as a student-run populations during their training and Led Group: Giselle De Vetten, Cherie program with support from faculty in their future practice. Nicholson, Adam Thomas and Adam and staff. Working with the Under - Wiebe graduate Medical Education office To be or not to be a ‘globie’, and the Global Health Department now that is the question! References we developed the concentration to fit Not every medical student is as 1. Brozorgmehr, K. Rethinking the ‘global’ as closely as possible within the exist- interested in doing a Médecins Sans in global health: a dialectic approach. Globalization and Health, 2010; 6:19. ing curriculum. Currently, practical Frontières mission, but based on the opportunities to apply curriculum diversity of the country that we will 2. Kalaichandran, A. & ke, C. Examining the demand for pre-clerkship global knowledge and theory in the commu- practice in, we will not be sheltered health education in Canadian medical nity are limited. Thus, current med- from a rich array of patients. At the schools: the case of the University of ical graduates may lack the necessary University of Calgary, there are quite Toronto. UTMJ, 2010; 88 (1), 36-40.
26 CFMS Annual Review APRIL 2012 Global Health
What will you be wearing on April 11? The Day of Pink and the International Day Against Homophobia and Transphobia 2012
Joshua Dias National Officer of Reproductive and Sexual Health Northern Ontario School of Medicine, Class of 2014
011 brought many highs when it sexual orientation more than doubled year when 15 year old Jamie Hubley 2 comes to lesbian, gay, bisexual, in 2008, and increased another 18% from Ottawa, who after years of bat- transgender and queer (LGBTQ) in 2009; three-quarters of these crimes tling depression and bullying because rights. US Secretary of State Hilary were violent and most resulted in of his sexual orientation, took his own Clinton gave a speech to the UN stat- physical injury to the victim.3 life. ing it should never be a crime to be Health and human rights are While the picture may appear gay. Zimbabwe’s Prime Minister said closely linked and the impact of bleak, many organizations are stepping he hoped for a new constitution with homophobia and transphobia on in to fight discrimination, and pro- freedom of sexual orientation. Argen- health has been well studied. Some mote inclusivity and diversity. The tina passed a comprehensive law on LGBTQ individuals avoid seeking CFMS’s Global Health Program is transsexual equality. However, for health care or withhold personal infor- proud to count themselves as one of LGBTQ people living in one of 76 mation for fear of discrimination. the organizations who believe it’s countries where homosexuality is Many develop emotional, psychologi- essential to promote human rights for criminalized, the situation is not get- cal and substance abuse problems due all people, including sexual orientation ting better — there was a new wave of to prejudice and violence. Increased and gender identity, in order to solidify arrests and convictions for being gay in rates of some STIs, cardiovascular dis- our commitment to global health. Cameroon, political leaders in Ghana ease and some cancers have also been Thus, this year we will be teaming up threatened to get rid of gays from soci- reported. Sexual minorities are also with a leader in anti-bullying and anti- ety, people were executed in Iran for two and a half times more likely than discrimination, charity Jer’s Vision, to their sexual orientation and there were heterosexuals to attempt suicide4,5,6. host events for the International Day reports of arrests and detention of This statistic took a human face last of Pink. LGBTQ individuals in countries like Iraq, Bahrain, Saudi Arabia and Tanzania.1 Here in Canada, we are proud to be leaders when it comes to gay rights. However, while we have made a lot of progress when it comes to laws (trans- sexual rights being the last major front), we still haven’t ended discrimi- nation against sexual minorities. The results from the first national climate survey on LGBTQ discrimination in Canadian schools were shocking: 55% of sexual minority students reported verbal harassment and 21% physical harassment because of their sexual ori- entation; and almost two thirds felt 2 unsafe at school. According to Northern Ontario School of Medicine celebrates their first Day of Pink in 2011 and is Statistics Canada, hate crimes based on looking forward to participating again in 2012!
APRIL 2012 CFMS Annual Review 27 Global Health
The Day of Pink was created after References a Nova Scotia high school student was … wear pink on 1. Kaleidoscope Trust. Global LGBT Rights bullied for his sexual orientation and in 2011: the highs and lows. December 2011. for wearing pink. Two of his straight April 11 to show peers intervened to support the stu- 2. Egale. Every Class in Every School: Final report on the first national climate survey dent. They purchased pink t-shirts and your support for on homophobia, biphobia and transpho- encouraged everyone at their school to bia in Canadian schools. May 2011. arrive wearing pink — showing soli- fighting bullying and 3. Statistics Canada. Police-reported hate darity in stopping homophobic and crime in Canada. June 2011. 7 transphobic bullying. discrimination and 4. Gender and Health: Collaborative This year, the CFMS’s team of Curriculum Project. Modules: Gender Local Officers of Reproductive and promoting diversity. and Sexual Diversity. Accessed February Sexual Health (LORSH) are going to 2012 at www.genderandhealth.ca bring that message to medical schools 5. Rainbow Health Ontario. LGBT Mental across Canada and we’re inviting you ebrate the upcoming 2012 Interna- Health Fact Sheet. June 2011. to participate! Simply wear pink on tional Day Against Homo phobia and 6. Roberts, S.A., Dibble, S.L., Nussey, B. and Casey, K. Cardiovascular disease April 11th to show your support for Transphobia. We at the CFMS look risk in lesbian women. Women’s Health fighting bullying and discrimination forward to playing our role in promot- Issues. 2003. 13(4):167-74. and promoting diversity. In addition, ing equality with the hope of improv- 7. DayOfPink.org. Information Zone. the LORSH team will be putting on ing the health of LGBTQ people in Accessed February 2012 at www. various presentations and events to cel- Canada and around the world. dayofpink.org
28 CFMS Annual Review APRIL 2012 School Updates
University of British Columbia led Professionalism Committee, the School. Each year in early February, This year, UBC has seen a great num- Health Advocacy Leadership Program the U of C joins forces with the ber of students from all four years get and our intra-faculty collaboration ini- University of Alberta medical school involved in ongoing initiatives and tiative with the dentistry, dental for a fun-filled weekend conference in starting up new ones! Arts in medicine hygiene and medical laboratory sci- Banff. AMSCAR (Alberta Medical groups have solidified their place in ence student associations. Students Conference and Retreat) our program. Students, residents, fac- One of our goals is increasing stu- offers a wide array of learning oppor- ulty and friends enjoy attending the dent engagement both with the MSA tunities, including sessions on suturing Medplay, coffeehouses, art shows and and the CFMS. Last September we and basic airway skills, as well as yoga, Medicina: the Arts and Healing were able send more delegates to the photography and hiking. This annual Confer ence each year. CFMS Annual General Meeting. event is organized by both U of C and Wellness is important as we work Increased interest and attendance U of A students and is consistently one hard through medical school and our resulted in the development of a new of the best “conferences” of the year! Wellness Initiative is a student-run student wellness initiative sparked by In February 2011, the CMSA group that offers yoga and medfit work- two first-year students who attended organized the annual U of C Head outs weekly, nutrition seminars and a the meeting in Calgary. Shave fundraiser, raising over $18,000 Wellness Newsletter to help maintain September 2011 also included the to support Brain Cancer research via work-life balance. opening of the Edmonton Clinic the Canadian Cancer Society. In Students interested in politics and Health Academy, a student-focused response to the Japan Earthquake dis- advocacy are involved with UBC’s health sciences centre designed to pro- aster, the U of C organized a Japan Political Advocacy Committee, which is mote interdisciplinary collaboration. Earthquake Relief Fundraiser and col- building toward a provincial lobby day. The new building is home to 12 health lected over $9,000 to support the Red Community outreach and educa- science research and education groups Cross. tion remain popular volunteer oppor- including medicine, dentistry, nursing, Members of the Class of 2013 tunities for students who want to get public health, pharmacy, rehabilitation CMSA council participated in the involved with the many different pop- medicine and nutrition. We hope that CFMS Spring General Meeting. The ulations in BC. A Special Olympics sharing the facility will encourage CMSA was heavily involved in organ- health fair runs each year, as well as more partnerships between the MSA izing the CFMS AGM, which was multiple aboriginal health outreach and our health care colleagues. hosted in Calgary in September. The programs, including in the Downtown In other projects, we are currently Class of 2013 CMSA council also Eastside. Run for Rural Medicine is conducting a review of the MSA con- organized Orientation Week for the hosted at each of UBC’s distributed stitution, our Political Advocacy Com - Class of 2014, a week-long introduc- sites annually to raise awareness about mit tee and Alberta Medical Associa tion tion to both the academic and extra- rural medicine, as well as to keep our Reps are collaborating on a Health care curricular lifestyle of the U of C med- students in shape! Symposium, and arranged a student ical school. O-week entails an Amazing UBC’s Global Health Initiative forum with the CMA Presi den tial Race event, Med Olympics, fun prac- sends students to communities across Nominees. tice OSCEs and peripatetics, and the globe each summer to implement Some of our future projects include many social events. education and building projects. the major task of preparing for accred- The Global Health Interest Group We can’t forget our many interest itation in 2014. Finally, we look for- and CMSA VPs of Global Health groups, clubs, sports and social events ward to continuing to improve the organized the Rich Man Poor Man that keep us busy throughout the year! experience of medical students at the dinner, an annual event designed to With too many initiatives to highlight, U of A. The class of 2011 were #1 on raise funds for both local and interna- every student at UBC has the opportu- the LMCC exams, and we hope that tional charities. This year the Rich nity to get involved in something that we can continue to expand the good Man Poor Man dinner raised over motivates them. work being done by students at the U $20,000. of A. Along with the Professional University of Alberta Association of Resident Physicians of At the University of Alberta, we have a University of Calgary Alberta (PARA), the CMSA partici- number of exciting projects and initia- It has been yet another exciting year at pated in the third annual PARAdime tives on the go including our student- the University of Calgary Medical Backpack Drive. This event entails
APRIL 2012 CFMS Annual Review 29 School Updates
recycling our medical school back- Our Global Health Committee month that culminates in a coffee- packs by collecting non-perishable — Health Everywhere — consistently house fundraiser for prostate cancer, food items, clothing and other daily provides educational and experiential featuring a number of moustached necessities in these backpacks and opportunities for medical students to performers and audience members. donating them to local drop-in centres address health issues throughout the Because of our limitless supply of and homeless shelters. world. Making the Links is a longitu- musical talent, we hold a second cof- Other activities planned include dinal rural and global program feehouse fundraiser in the spring. the 2012 Cancer Head Shave, Atrophy designed to introduce students to the Money raised will help support the Cup (a hockey tournament for both social determinants of health. Along United Way. current students and alumni) and par- with this program, participants receive There is a growing presence of ticipating in the upcoming Interview a university accredited certificate in CFMS on campus. Following a suc- Weekend MMI & Orientation. As global health, which is the first school cessful Health Care Symposium that Calgary is hosting the next IceBowl in in Canada to offer this distinction. In featured Dr. Michael Rachlis, PAC is September 2012, a hockey tourna- the fall of 2012, the global health com- now organizing our second annual ment for all western Canadian medical mittee will be hosting its first global Provincial Lobby Day. Though we schools, the CMSA is heavily involved health conference titled “Local Steps– have held a number of blood drives in in fundraising and organizing this Global Strides: building momen tum the past, our first CFMS-affiliated highly anticipated event. for global health at the University of Blood Services Council is leading the Saskatchewan”. way for this year’s events. Finally, our University of Saskatchewan The University of Saskatchewan Global Health program will be hold- For yet another year, the U of S has continues to grow and change. We are ing its inaugural Rich Man Poor Man maintained an active student body. currently in the pursuit of a new Dean, fundraising dinner in April in support Our student council, the SMSS, con- expanding our class size and moving to of the Winnipeg Harvest, a local food tinues to spearhead initiatives that a 2x2 curriculum as per the rest of donation program. We look forward address the needs of our students. Canada. to continuing this trend when we host Specifically, the inclusion of IMGs in the CFMS AGM in September 2012! the first round of Saskatchewan’s University of Manitoba CaRMs has lead to countless discus- With our recent successful accredita- University of Western Ontario sions and a Town Hall meeting. tion process and current curriculum It has been a very exciting time at Creating a positive impact on our renewal project, students and staff at Western these past couple months. community is another goal of the the University of Manitoba Faculty of This is the first year we welcome the SMSS, with male students participat- Medicine have been busy! We still 4th-years back to our Windsor ing in Movember, the annual Blood managed to find time for a wide vari- Campus, they are the first class to Drive, Adopt-a-Family at Christmas to ety of outreach initiatives on and complete 100% of their medical edu- support under-privileged families at around campus. Some are cemented cation in Windsor. Christmas, and Miles for Smiles a 5 traditions like the Jacob Penner Park The month of December was busy km and half marathon runs to raise and the Children's Hospital programs. with social events, including our winter funds for the construction of a chil- Both regularly bring students and formal “Trapped in a Snow globe” dren’s hospital in Saskatchewan. youth from our nearby community or and FENdWIC, the Festive Non- The Political Advoacy Committee paediatric wards together to interact Denomenational Winter Celebra tion. has lobbied the government regarding and take part in wellness activities. We also held two day long clinical issues of medical education in our Other programs, like the Winnipeg skills days, one in Family Medicine province. Interprofessional Student-Run Health and one in Surgery. We have over 90 The Physician Wellness Initiative (WISH) Clinic, continue to grow each clubs at Schulich so there is something continues to influence the student year. WISH allows students from a of interest for every student, with body to maintain a balanced lifestyle. number of disciplines the opportunity events taking place daily. Activities in this area include an inter- to develop their professional skills This term we plan to continue par- professional Wellness Week, dance under mentor guidance, while provid- tying — at the Schulich Classic, classes, stress reduction seminars and ing an entirely free health care service Schulichpalooza, Spring Formal in providing healthy snacks to stressed to a population in need. Another Wind sor and culminating in our annual exam writers. growing tradition is our Movember musical production Tachycardia!
30 CFMS Annual Review APRIL 2012 School Updates
McMaster University figuration around needed changes, the pleted 8 months of planning, our team McMaster’s Michael G. DeGroote process has been a positive one and the is still hard at work. With committees School of Medicine has been working Medical Society anticipates the out- and subcommittees totalling more on a number of exciting projects this come to be similar. than twenty individuals, we hope to past year. The medical students’ make this the largest OMSW to date, lounge and the study space are being Queen’s University inviting up to 800 delegates. Our renovated to ensure our medical stu- There has been a lot happening at theme this year will be “Shaping dents can work, relax and socialize. We Queen’s since we last updated everyone! Health Care on the Hill”. Being in the are also working to make sure students In November, students ranging from nation’s capital and just a few steps have access to internet at all the 1st to 4th year organized and per- from Parliament Hill, this conference Hamilton Health Sciences hospitals, formed at the 42nd Medical Variety will allow medical students to practice optimizing the Distributed Medical Night, a spectacular production featur- clinical skills as well as become politi - Education (DEM) technology for our ing singing, short plays, dancing and cally engaged and develop advocacy two regional campuses in Kitchener/ musical talent. All proceeds from this skills needed to become health care Waterloo and Niagara, and mobilizing highly success event are donated to leaders. more funds for electives and confer- local Kingston charities. TedxuOttawa: Who hasn’t heard ence travel. As our online portal — Currently, the Aesculapian Society of the award winning Technology, MedPortal — plays a very important is busy re-vamping our highly valued Enter tainment and Design (TED) role in student education, our IT Team Mentorship program in which stu- confer ences? Through their world is working on optimizing and improv- dents from all years are organized into renowned conferences they have suc- ing the system for maximum user- groups with a pair of faculty members. cessfully enriched the creativity of mil- friendliness and accessibility with the This program allows students and fac- lions and have spread ideas that inspire help of a newly appointed committee. ulty to interact socially and enjoy vari- throughout the world. This fall at the ous planned events such as formal din- University of Ottawa Medical School University of Toronto ners, trivia nights and competitions, in we hope to draw from this success with Overall, the past year has been one of addition to other informal plans made of our own TedxuOttawa (where x= important change for the University of by groups throughout the year. Queen’s independently organized) rendition. Toronto. The Faculty of Medicine offi- students are also in the process of plan- Emphasizing the importance of Inter - cially welcomed its first incoming class ning the annual Global Health Gala, na tional Health and exploring specific of Distributed Medical Education which features drinks, dancing and a yet broad arenas including refugee/ undergraduate medical students in silent auction. The gala seeks to raise immigration health and maternal August 2011 with 54 new students funds for a selected charity that sup- health we are beginning to plan a fan- beginning their studies at the new ports global health initiatives. tastic line up of diverse speakers. Email Mississauga Academy of Medicine. By The start of the 2011–2012 school tedxuottawagh @gmail .com if you have 2015, the campus will be home to 216 year also saw the opening of Queen’s questions. students, adding to the already wide New Medical Building — a new interaction of learners with the health building dedicated specifically to Northern Ontario School of networks of Credit Valley Hospital Queen’s School of Medicine. The Medicine and the Trillium Health Centre. building is a state-of-the-art teaching Lights, Camera, Action! In December, Warmly welcomed by all students, this and learning facility, with fully it was announced that a new medical expansion also has allowed students to equipped surgical and technical skills drama — loosely inspired by NOSM expand extracurricular programming labs, leading edge classrooms, clinical — will soon begin production in and engagement with additional pop- teaching space and everything else a Northern Ontario. Hard Rock Medical ulations and communities in the medical student needs! is an offbeat half-hour drama that fol- greater Toronto area. lows a diverse group of medical stu- In May 2012, the Faculty of University of Ottawa dents navigating their way through a Medicine will be undergoing accredi- OMSW: The University of Ottawa has fictional school’s four-year program. tation by CACMS and LCME, and the privilege and honor of hosting the Appearing on both TVOntario and much work by both students and staff Ontario Medical Students Weekend the Aboriginal Peoples Television over the past year has been spent (OMSW) in October 2012 — the Network, Hard Rock Medical promises preparing for these visits. Through largest annual medical student confer- to provide engaging insight into some self-evaluations and appropriate con- ence in Canada. Having already com- of the unique features and challenges
APRIL 2012 CFMS Annual Review 31 School Updates
of delivering health care in Northern New Brunswick (DMNB) campus The Gateway program (est. 2006) Ontario. created has made more relevant the through the ANC facilitates first med- Here we go again! In March, discussion about residency opportuni- ical contact with refugees and immi- NOSM will host its second MD pro- ties in Atlantic Canada and how stu- grants arriving in NL. Our Gateway gram accreditation site visit since gain- dents need to become involved in the coordinators, Paul Crocker and ing full accreditation in 2009. NOSM discussion. Catherine Winsor (2014), have inte- is very different from all other medical The Dalhousie Medical Students grated a physical examination compo- schools, with a unique organization Society (DMSS) is continuing a nent for a higher quality of care for and curriculum. Administration, facul- remodeling process begun last year patients. ty, staff and students at both campuses with the reworking of its constitution. Zack Warren (2014) started the are busy preparing to receive the In an effort to infuse our governing Emergency Medicine Interest Group accreditors and ensure that they under- document with greater institutional including clinical case presentations by stand our great school and are persuad- memory and internal consistency, the ER physicians and Paramedic ride- ed that, in our own way, we are in com- DMSS has developed a framework for alongs. This allows MUN Med stu- pliance with all 130+ standards. a constitution that better suites its pur- dents an opportunity to appreciate Rendez-Vous 2012! Next October, pose. Now we have a document that what happens before the patient NOSM will be hosting five world con- works better to support students, arrives in the ER. ferences in one — Rendez-Vous 2012. instead of existing as a perpetual MUN MSS and the CFMS are This conference will bring together the annoyance to them. lobbying against a proposed PEI Wonca World Rural Health Confer - Looking forward, students at Return of Service contract, to be ence, the Network: Towards Unity for Dalhousie are excited to explore ways implemented in 2013. Lindsey Ward Health Conference, the NOSM/ through which our newfound presence (PAC Rep, 2014) is leading this initia- Flinders Conference on Community in a second province can help expand tive, completing interviews and draft- Engaged Medical Education, the the reach of medical students' influ- ing media releases to make the public Consor tium for Longitudinal Curri - ence in Atlantic Canada, as well as aware of this topic. We are working cula, and the Training for Health solidifying our current endeavors at towards a solution that addresses the Equity Network. The whole world of the level of the DMSS, both internally recruitment issues for physicians innovation in health professional edu- and externally. returning to PEI. cation will be coming to Northern Memorial’s Global Health Interest Ontario. Check out the conference Memorial University of Group has continued involvement website (www.rendez-vous2012.ca) for Newfoundland with 12 loans through the KIVA lend- more information and the call for The 2010–2011 school year has been ing program, raised money for numer- abstracts. busy for MUN Medicine and several ous charities on World AIDS Day and new student-led program initiatives plans to have a documentary screen- Dalhousie University were launched! ings for students. Dalhousie University Medical School Memorial was awarded the CMA Other interest groups have contin- is going through a period a change and Leadership Innovation Fund to start a ued to grow in the 2010–2011 school transformation. With the creation of a Rural Medicine Interest Group year, including: the Family Medicine new Distributed Medical Education (RMIG). Heidi Wells (RMIG Presi - Interest Group, Pediatrics Interest site in Saint John, New Brunswick, dent, 2014) has organized outreach to Group and Surgery Club. students at Dalhousie have been work- students in rural NL through presenta- As always, MUN Med has put an ing to overcome new challenges as well tions in high schools and housing for emphasis on Student Wellness and the as old. The increase in undergraduate rural applicants interviewing at MUN MSS has arranged many social events seats that the Dalhousie Medicine Med. for students.
32 CFMS Annual Review APRIL 2012 Initiatives
Brink of a revolution — From chocolates and roses to social responsibility and humanitarianism Students from the University of Toronto challenge community to change?
Gautam Goel University of Toronto, Class of 2014
s thoughts of chocolates, roses and for positive actions and change. This one another to sustain humanitarian- A other greeting card-esque clichés change can only happen if we all par- ism. Global Heart Hour included an wistfully meander through peo- ticipate, so we encourage all members audience-driven discussion to encourage ple’s minds around Feb. 14, the current of the community to join us.” collaboration and inspire each other to state of world affairs was hardly so rosy. A A grass-roots student-run initiative, continue to do more for the world. tumultuous 2011 — littered with the Global Heart Hour emerged from a 25- The celebrations included an devastating earthquake in Japan and year Valentine’s Day heart health pro- interprofessional Red Party in support ensuing nuclear crisis, the horrendous motion project. The 2009 launch of Global Heart Hour and fundraised drought in East Africa and continued focused on heart health, occurring in the for a charity of choice. This year’s char- strife despite the fall of Libyan leader midst of the global food, financial and ity, Borderless World Volunteers, an Col. Muammar Gaddafi — was far from climate crises. The link between cardio- organization active in health, education a distant memory. Despite all of this hap- vascular health and poverty and devel- and economic development projects. pening around the world, students from opment was noted, and the community Last year, the Red Party raised over the Faculty of Medicine at the University was invited to promote heart health to $1500 for Right To Play. of Toronto saw an opportunity in its make a better world. The event seeks to Be part of Global Heart Hour and midst. Working over the past four years inspire and sustain humanitarianism in use the sentiment of heart on Valen tine’s as active proponents of social responsibil- the face of decline and inspire commu- Day as inspiration and focus to change ity and humanitarianism, students were nities to collaborate to continue to make your world. Whether by yourself, with looking towards Valentine’s Day as a a difference. Global Heart Hour believes friends, families or colleagues, we chance for change as they work feverishly that humanitarianism remains the most encourage you to join us and be part of to host their annual Global Heart Hour crucial motivation and means for inter- a global collaboration. We encourage event. vention globally. you to take an hour to do something “Our goal is to refocus Valentine’s This year marked the fourth similar, or create your own Global Day from its materialistic nature to Annual Valentine’s Global Heart Hour, Heart Hour to make a difference. Share one that concentrates on humanitari- which was started by an enterprising your thoughts, blog, Facebook, tweet, anism and encouraging social respon- and creative team of medical students at use YouTube, etc. to share with the sibility,” said Hussein Jaffer, a second- the University of Toronto and involves a world and see what others are doing. year medical student at U of T and the large part of the university community. Be part of taking this global — just as current director of Global Heart Hour. Featuring a panel of distinguished lead- we turn lights off for Earth Hour, let’s “That’s why my good friend and col- ers and speakers, the event used a stu- turn our hearts on for Global Heart league, Vanessa Rambihar, first started dent-run open concept approach and is Hour. For more information please this initiative in 2009; we see the a Valentine’s celebration to share ideas, contact [email protected] potential to redefine Valentine’s Day celebrate student involvement in chari- or h.jaffer@ utoronto .ca or see www. into something that could be the force table and volunteer work, and inspire facebook.com/ global hearthour.
APRIL 2012 CFMS Annual Review 33 Initiatives
Memorial’s Rural Medicine Interest Group
Fady Kamel and Heidi Wells Memorial University, Class of 2014
he shortage of rural family the process and challenges of applying early, we hope to increase the number T physicians is a critical issue to medical school. So far, we have had of rural students applying to and across Canada. The latest avail- great success with the seminars. entering medical school in the long able StatsCanada survey suggests that To motivate high schools students, term. up to 10% of people in New found- we have set up an advertisement cam- To track the progress of RMIG’s land and Labrador (NL) do not have a paign that targets high schools across efforts, we are conducting a prospec- regular doctor.1 Furthermore, studies tive study to determine how effective show that medical students from rural this approach will be and hope to pub- origins are more likely to pursue family lish the results in the coming years. We medicine and practice in rural Memorial University also hope that in the future, this effort areas.2,3,4 will be replicated in other medical To tackle this problem, Memorial started RMIG … to schools across the country. University started the Rural Medicine Interest Group (RMIG) as part of a combat NL’s rural Acknowledgments grassroots effort to combat NL’s rural This project has been made possible by physician shortages by increasing the physician shortages funding from the Canadian Medical number of rural students applying to Association, Memorial University’s medical school. This program has a Faculty of Medicine and Memorial two-pronged approach: 1) mentoring the province to educate guidance University’s Office of the President. rural students already attending uni- counselors and students on the feasi- versity and 2) motivating high school bility of medical school as a career References students to attend university and ulti- option. We will also be doing a series 1. Statistics Canada. Canadian Community Health Survey (CCHS), 2003 to the latest mately medical school. of schools visits to encourage students data available; Health Services Access To mentor students already to attend university. One of the great- Survey (HSAS), 2001 attending university, we are currently est barriers for rural area students is the 2. Easterbrook M, Godwin M, Wilson R, hosting a series of Lunch & Learn cost associated with going to universi- Hodgetts G, Brown G, Pong R, et al. Rural background and clinical rural seminars where students have the ty. On our visits we will educate them rotations during medical training: effect opportunity to gain knowledge about on the numerous sources of funding on practice location. CMAJ 1999 Apr the positive and negative aspects of and support available to those who 20;160(8):1159-1163. rural medicine. Each seminar has a attend university. One advantage of 3. Hutten-Czapski P, Pitblado R, Rourke J. general presentation where a physician RMIG is that many of the medical stu- Who gets into medical school? Comparison of students from rural and or resident presents their knowledge, dents participating in the program urban backgrounds. Can Fam Physician experiences and thoughts on practic- have rural backgrounds and can use 2005 Sep;51:1240-1241. ing medicine in rural NL. Following this to show the rural students that it is 4. Mathews M, Rourke JT, Park A. this, there are small group sessions actually possible to get a post-secondary National and provincial retention of medical graduates of Memorial where the attendees have an opportu- education. Also, by exposing the stu- University of Newfoundland. CMAJ nity to discuss with medical students dents to medicine as a career option so 2006 Aug 15;175(4):357-360.
34 CFMS Annual Review APRIL 2012 Initiatives
Vancouver Native Health Society Clinic — a student directed initiative Nathan Wong, University of British Columbia, Class of 2013 Roveena Sequeira, University of British Columbia, Class of 2014
t has been previously reported by status, social determinants of health serve as guest speakers to talk about Ivarious groups that the Aboriginal would need to be addressed.1,2 their related experiences and engage population are overrepresented in Aboriginal people face many social the group in discussion. the lower health demographics.1,2 issues including, but not limited to a The VNH Clinic provides stu- Com pared to the general population, loss of traditional lifestyles/ culture, dents with the opportunity to develop Aboriginal people have higher rates of homelessness, unemployment, discrim- an understanding of inner city health diabetes, HIV/AIDS, alcohol related ination, violence, sexual exploitation and Aboriginal populations, as well as deaths, hospitalizations and preventa- and substance use.2 At the VNH Clinic, gaining some hands on interdiscipli- ble admissions.2 In Canada, there are under the guidance of a physician and nary experience. Students learn about approximately 1.4 million Aboriginal nurse practitioner, volunteer UBC the challenges and rewards of practic- people, of which 150,000 are in medical and nursing students facilitate ing Aboriginal and inner city health British Columbia.2 In addition, over a comforting and respectful environ- care. In providing such experiences 50% of Aboriginal communities live ment, and provide after hours health early in training, it is hoped that more in urban settings such as Vancouver.2 care to this vulnerable population. future health care providers will be Community Health Initiative by The guiding principles of the attracted to practice in these areas. University Students (CHIUS) is a stu- VNH Clinic are service, learning, inter - dent directed group that recognized professionalism, reflection and student Acknowledgements the importance of addressing these dis- leadership. Students apply their studies We thank Dr. Aida Sadr, VNH physi- parities and offering this vulnerable to a clinical environment and are cian and Sarah-Jane Crossen, VNH community specialized health care responsible for taking a complete his- nurse practitioner, for their continued services. In 2007, CHIUS initiated a tory and systems-focused physical support of this program. cooperative student directed clinic exam, as well as formulating a differen- with the Vancouver Native Health tial diagnosis and management plan. References Society (VNH) Clinic. The VNH Students then present the patient case 1. Saewyc E, Smith A, Bingham B, Brunanski D, Hunt S, Simon S, Clinic is one of three major health care to the staff physician and nurse practi- Northcott M, Matheson M. Moving clinics situated in Vancouver’s Down- tioner, discuss the case and then see the Upstream: Aboriginal Marginalized and town Eastside that provides its services patient together. At the end of each Street-Involved Youth in B.C. McCreary Centre Society. 2008. 1-60. to over 9000 Aboriginal people with 3-hour shift, interesting cases are 2. Vancouver Coastal Health: Aboriginal the goals to promote and improve the reviewed, successes and difficulties are Health Facts [Online]. [updated 2011; physical, mental, emotional and spiri- addressed and further learning ensues. cited 2011 Nov 27]. Available from: tual health of its patients.3 Educational seminars are also arranged aboriginalhealth .vch.ca/facts.htm It is generally agreed upon that to further educate students about 3. Vancouver Native Health Society Aboriginal health has been negatively issues such Aboriginal health, addic- [Online]. [updated 2011; cited 2011 Nov 27]. Available from: www.vnhs.net affected by many external and social tion and street drugs. Experts in the /index.php?option =com _content factors. In order to truly improve health community and volunteer patients &view=article &id=85 & Itemid =93
APRIL 2012 CFMS Annual Review 35 Initiatives
Bone marrow stem cell donation project at UBC
Ying Yao, Merry Gong, Rui Chen, Donald Yung, Celeste Loewe University of British Columbia, Class of 2013
arious life-threatening disorders Contrary to common recruitment of potential donors. V(e.g., leukemia and lymphoma) We also successfully held two on- can be treated with allergenic belief, the majority campus stem cell drives at UBC with hematopoietic stem cell transplants, the help of volunteers. Our final tally of which involve transplanting the donor’s of patients are newly recruited donors was 460 — healthy stem cells to the patient’s bone many more than we had expected! marrow to replace diseased cells. unable to find a Through our efforts, we also encouraged Allogeneic donors and recipients must some of our first-year colleagues to con- share compatible tissue markers (HLA) match within their tinue these drives in the coming year. to minimize complications such as graft- Over the course of the project, we versus-host disease. Contrary to common families were able to fulfill many of the belief, the majority of patients (>70%) are CanMEDS competencies. Forming an unable to find a match within their fam- ed of three phases. During the first understanding of the barriers to stem ilies and must rely on the OneMatch phase, UBC students aged 19–30 and of cell donor registration is much like Stem Cell and Marrow Network to Chinese descent were surveyed to inves- assessing our future patients’ pre-formed search for an unrelated donor. tigate common barriers or misconcep- notions and core values required for any Since a patient’s best chance of tions that help to explain why effective medical consultation. We also finding a non-related donor match is Chinese–Canadian young adults are learned to assess people’s attitudes in an within the same ethnic group, it is underrepresented in the OneMatch effective, culturally-sensitive, and client- important to have adequate representa- Network. Phase two involved holding a centred approach, which is an impor- tion for all ethnicities in the stem cell workshop to raise awareness and edu- tant component of the “Medical registry. Unfortunately, for reasons cate UBC students regarding hemato- Expert” competency. The project unknown, Chinese individuals are quite poietic stem cell donation process. enabled us to collaborate extensively underrepresented in the global stem cell Finally, we held two on-campus stem amongst ourselves, external organiza- registry. Out of the 13 million registered cell drives to increase donor registration tions (OneMatch and the OtherHalf donors in the Bone Marrow Donors in this age group. Chinese Stem Cell Initiative), other Worldwide database, less than 4% are of Preliminary survey results show a medical experts, as well as the media. Chinese origin. Chinese–Canadians lack of understanding of the process Excellent communication, resource make up only 2% of the Canadian reg- involved in hematopoietic stem cell management, organization, and timely istry. Furthermore, young adults, whose transplants. For example, even among decision-making are all essential for an stem cells are healthiest and most suit- the 10% of respondents who are already effective collaboration — in turn devel- able for donation, have relatively low registered as potential donors, 70% of oping our skills which are integral to the registration rates in the OneMatch Stem them were not aware that hemato - “Collabora tor”, “Communicator”, Cell and Marrow Network. poietic stem cells can be collected from “Manager”, and “Professional” compe- To address these issues, we created peripheral blood. It is hoped that the tencies. As our project has been com- the Bone Marrow Stem Cell Donation results of this project will be a valuable mitted to raising public awareness, we Project at the University of British resource to contribute to the success of have also developed our competency as Columbia (UBC). Our project consist- future stem cell campaigns and the “Health Advocates.”
36 CFMS Annual Review APRIL 2012 Experiences
Teach me how to doctor
Srimal Ranasinghe Husband of Carolyn Wong-Ranasinghe University of Calgary, Class of 2013
feel like being married to a medical Medicalese … ing Funglish with a group of friends I student is making me linguistically involving two teams — med students smarter. This is probably partly I dub thee the versus non-med students. The objec- because I have no friends of my own, tive of Funglish is to lay out various and thus attempt to leach off my wife’s language of love. pre-set adjectives that describe words social circle. So I end up spending an to be guessed by your team. inordinate amount of time around they are groundbreaking methods of Here’s a brief excerpt from the medical-types. I am frequently part of learning, testing and evaluating all game: vocabulary-expanding conversations rolled into one. Team NMS 1 (Non-med students): such as the following: MSK turns out to be short for “What’s ‘Large’, ‘Grey’, ‘Non-human’, Med student A: “Have you taken a “musculo skeletal” as opposed to a ‘Living’, ‘Heavy’ look at the CaRMS website yet… covert government agency overseeing NMS 2: “umm…a rock?” sounds like things are getting pretty super-secret testing. “Rheum” and NMS 3: “Iron Man…or Woman?” brutal for the 3rd years.” “Derm” aren’t new passwords being NMS 4: “an elephant?” Wife: “I’m only a first year…I hear used by the CIA, but are short for NMS 1: “Yes!” arranging pre-CaRMS electives is pretty Rheuma tology and Dermatology Team MS 1 (Med students): “What’s intense for the second years, though.” respec tively. Look them up on Google/ ‘Big’, ‘Yellow’, and ‘Danger ous’? Doctor Person: “Which section are Encyclopedia Britannica / micro fiche at MS 2: “Ah…Cholesterol?” you guys in? MSK?” your local library sometime. MS 3: “No no…adipose tissue?” Med student B: “Yeah, MSK/Rheum “Blobfish” and “Aye-Ayes”… I’m MS 4: “Actually *giggle* I think it’s an /Derm. But I’m finding this new TBL yet to figure out the reasoning behind adenocarcinoma.” approach to be a bit painful. All those naming one’s med-class after ugly crea- MS 3: “Ha! That’s genius … but I G-RATS and I-RATS…” tures. Google informs me that the lat- think it’s most probably a mesenchy- 3rd-year student: Oh TBL! By the ter is a spectacularly ugly creature that mal tumor.” way, which class are you guys in? belongs to the lemur family. Try to MS 1: “No no … guys, come on. Blobfish or Aye-Ayes? imagine the offspring of a meerkat mat- Seriously!” 2nd-year student: I’m a Blobfish. ing with a rabid hyena that indulged a What really stumped me was that Hey, nice nametag. Which class was cocaine habit for most of her life, and I never would have thought of the Shree-Malls? you may just see an Aye-Aye in your “Cholesterol” as “Big, yellow, and dan- Me: Umm…that’s actually the mind’s eye. The Blobfish is an even gerous”! Silly me, I was thinking of phonetic pronunciation of my name. more hideous creature. Given that it things like “a large bonfire”, “the sun”, Over the course of the year I dis- resembles Mick Jagger’s shrunken or “Yao Ming”! covered that TBL stands for Team head after being run over by a steam- Needless to say, the non-medical Based Learning and doesn’t involve roller and dipped in a vat of boiling students won the game by a large mar- anal probes. G-RATS and I-RATS are oil, I understand its recalcitrance to gin. not a new species of furry rodents appear in the public spotlight. But what’s really important is that specially created to run around mazes, I have also discovered that medical I finally feel I can communicate with press levers or generate electricity by students think in radically different my wife as an equal. Aaah Medicalese running on large wheels. Apparently ways than the rest of us. We were play- … I dub thee the language of love.
APRIL 2012 CFMS Annual Review 37 Experiences
You’re WHAT?!
Joshua Lai University of British Columbia, Class of 2014 he next one’s interesting,” longer, I blurted out the first thing that “I’m telling you, “T the nurse called out to me came to mind, “Ok, so when’s the last as she passed by. “70-year- time you had, er, intercourse?” “Three I don’t know how, old woman, thinks she’s pregnant. days ago,” she said. Probably dementia, if you ask me.” My eyebrows shot up again before but I’m pregnant!” My eyebrows shot up incredulously I could stop them. She continued, as I turned to thank her. Recomposing “About six months ago, I met my cur- my face into the neutrally friendly, calm rent boyfriend and we’ve been madly preceptor glanced down at the chart, demeanor I was learning to associate in love ever since.” turned to me and asked me to present with professionalism, I knocked and “That’s great!” I offered weakly. my patient. entered. Across the room sat Meredith, “When do you think you got pregnant?” Tentatively, I began, “Meredith is a wearing copious amounts of make-up, “Well, all my symptoms started about a 70-year-old woman who has 1 month large flashy rings on her wrinkled hands month ago,” she replied. “My boyfriend history of nausea and vomiting, uterine and a wig of dark red hair that nearly and I also had sex around then, so maybe cramps, bloating and urinary frequency. hid her age. that’s when it happened.” She believes she’s pregnant.” I paused, I introduced myself and began the “Maybe,” I replied. After confirm- searching my preceptor’s face for any clue. interview. “What brings you to the ing that she was indeed post- Glancing up from the chart, my office today, Meredith?” menopausal, I glanced up at the clock, preceptor asked, “Did you ask her She replied, “I think I must be surprised to see that more than five whether she’s on any medications?” pregnant because I’ve been having all minutes had passed. Anxious to gather Meredith answered for me, “Yes, the symptoms of pregnancy. And just more information before my preceptor I’m on two high blood pressure med- so you know, I have five children, so I came back, I asked in rapid succession, ications, one diabetes medication and know what it feels like.” She paused, “Did anything else change a month the cancer medication you gave me last daring this young first-year medical ago? Your diet? Your bowel habits? The month.” “Oh, what’s the cancer med- student to challenge her. I asked her to color of your urine?” ication for?” I interjected. “My breast describe her symptoms. “No,” she replied curtly each time. cancer,” she replied. “I feel bloated, and I’m always “I took a pregnancy test, which was My preceptor explained to both of nauseous, and I threw up a few times,” negative, but I want the doctor to give us that Tamoxifen, the medication pre- she rattled off. “I’m also getting lots of me another one.” scribed for Meredith’s recent recur- cramps in my uterus and I have to pee “Ok, I’m sure we can arrange rence of breast cancer, was the likeliest a lot too. I’m telling you, I don’t know that,” I replied quickly. “Do you have cause of her symptoms. how, but I’m pregnant!” any previous medical conditions and Afterwards, my preceptor turned I paused, caught in the moment are you on any medications?” to reassure me, “Meredith probably between trying to remain engaged in “I have diabetes and hypertension. doesn’t share her breast cancer diagno- the conversation, thinking about what I’m taking pills for both but I don’t sis with everyone, so don’t feel bad.” I could possibly be going on and pres- remember what they are. Isn’t the doc- nodded, wondering if she might have suring myself to ask an intelligent next tor coming in soon?” chosen to confide in me, if I had question. Was this dementia? Did she Right on cue, my preceptor strode focused less on solving the clinical puz- just want to become pregnant? Or was in. Meredith immediately turned her zle and more on the confused, near- I about to witness a new world record? attention away from me and greeted her panicked woman who thought she was As the confused pause got longer and doctor, a note of relief in her voice. My going to have to give birth again.
38 CFMS Annual Review APRIL 2012 Experiences
McGill’s new satellite campus: The Gatineau experience
Nicholas Chadi McGill University, Class of 2012 ugust 2, 2010. It was a hot and were undeniable advantages A sticky summer day in Gatineau, that had lured me toward Quebec. I was about to begin Gatineau. the most frightening, yet exhilarating Six months after the end part of my medical studies: clerkship. of my year in Gatineau, I can However, unlike most of my class- now reflect on what was def- mates, I was also about to take part in initely an incredibly positive a second new beginning — I was one experience. However, while I of the 9 students who had chosen to was not disappointed by any spend their 3rd year of medical school of the initial promises of the Students from the Gatineau satellite campus. as part of McGill’s new integrated program, my fellow Gati - clerkship program. neau clerks will certainly For many months, the faculty of agree that there were still a fair number Distributed Medical Education medicine had been promoting its new of ups and downs during the year. As Taskforce last year, I was able to appre- Gatineau teaching site which was might be expected with a new teaching ciate the quality and solidity of similar meant to offer a semi-rural and fran- program, many adjustments had to be programs in other universities across cophone learning environment to a made all through the year to correct the country. While research comparing group of students interested in com- some situations where students felt that distributed medical education with pleting all of their mandatory rotations they weren’t necessarily getting equiva- traditional clerkship programs is still in a new 11 month semi-longitudinal lent patient exposure and teaching time scarce, the literature seems to agree clerkship. The promises were numer- as students at McGill’s main campus. that both options offer different ous: a high level of clinical exposure On many occasions, energy and mood advantages and that medical graduates and access to teaching staff, a friendly was often low among the group. coming from satellite campuses are and welcoming environment with very Nevertheless, the teaching and admin- certainly not at a disadvantage when it few residents, enviable schedules and a istrative staff in Montreal and Gatineau comes to applying for residency. As I generous financial compensation for were extremely understanding and prepare for my CaRMS interviews and living and travelling expenses, and a proactive and succeeded in promptly enjoy six consecutive months of elec- fourth year of medical school almost addressing most of our issues. At this tive rotations, my last few words go to entirely devoted to elective rotations point, I personally believe that the pro- students considering getting a taste of (in Gatineau or not). All that and only gram has evolved and improved a great distributed medical education: while a few minutes away from the charming deal, offering an outstanding opportu- you might never actually know for sure city of Ottawa. The decision for me nity for medical students looking for a if your education was truly better or had been an easy one. From the first more tranquil and personalized type of worse, you will most definitely gain time I had heard about the program, I clerkship, away from the hierarchical from an experience away from your knew I wanted to be part of it. The structure of big teaching hospitals. university’s main campus. Don’t hesi- more independent, flexible and inte- Distributed medical edu cation in tate to ask questions, investigate your grated structure of the program, offer- Canada certainly isn’t limited to options and remember, regardless of ing more autonomy and an opportuni- McGill’s new integrated clerk ship pro- your decision, clerkship is by far the ty to become “medically bilingual” gram. Having been part of the CFMS best part of medical school!
APRIL 2012 CFMS Annual Review 39 Experiences
The social history
Tanu Sharma University of Toronto, Class of 2012 hat is the patient’s diag- In the coming weeks, I tried to Still, I considered her harsh teach- “W nosis?” demanded Dr. X justify my poor performance on the ing points in all of my clinical encoun- during my practical examination. My history was limited ters thereafter. By that point in clerk- examination. “Hepatic encephalopathy because my patient was encephalo- ship, history-taking was second nature secondary to liver cirrhosis,” I replied pathic from his liver disease and could as was the anatomical placement of confidently. “Liver cirrhosis?” she not recall the details resulting in his my stethoscope. Yet I found myself mocked. “How many types of cirrhosis admission. Furthermore, he had C. questioning if my algorithmic infor- are there?” “One?” I answered with difficile diarrhea and spent much of the mation gathering was allowing me to embarrassment. What came next manage each patient appropriately caught me off guard. given their specific clinical problem. I “You don’t seem to care about questioned if my physical examina- your patient,” said Dr. X quite bluntly. “Did you or tion was relevant and if I really under- “Medical students nowadays get into stood the sounds of the organs under- medical school by virtue of their did you not ask the lying my instruments. With all this grades but they lack the bedside uncertainty, I went back to the basics manner that is required to be a good patient about his of clinical medicine and re-learned my physician,” she stated. When I protested history taking and physical examina- that she had misinterpreted my nerv- occupation?” tion, considering the value of each and ousness as indifference, she glared at how I could personalize these to meet me and asked sternly, “Did you or did “No,” I mumbled. patient needs. you not ask the patient about his occu- Today my social histories might pation?” “No,” I mumbled. even be considered too extensive. I “Then you didn’t take a proper pull my stethoscope out of my gown social history did you? And by not ask- designated exam time in the bath- before entering a room with contact ing him, you don’t know if he is work- room. My physical exam was limited precautions and I know how to distin- ing, you don’t understand his financial by contact precautions and I fumbled guish dullness from tympany through circumstances, whether he can afford to find my stethoscope under my the ruffle of my gloves. I no longer his medication, support his family or yellow gown. The over-sized latex resent Dr. X because I finally recog- pay for transportation to his appoint- gloves hindered my ability to accurate- nize the invaluable message that res- ments. If you don’t take a proper social ly percuss the liver span and appreciate onates through her harsh manner. history, you don’t understand the the dullness in Traube’s space. When I What Dr. X was teaching me so early disease in the context of the patient.” protested my case Dr. X was unim- in my training was that the same dis- I was confused. I had meticu- pressed. I believed at that time that her ease will affect two patients in very lously gathered all the medical details expectations were exceedingly high for distinct ways. Understanding the psy- relevant to the patient’s diagnosis yet a third-year medical student. Until chosocial impact of disease on a Dr. X remained fixated on my limited that point my clinical evaluations had patient can help optimize their care social history. Her harsh feedback been nothing short of exceptional and and this crucial information can easily was unrelenting and when I finally Dr. X’s feedback was a slap across the be elicited through one commonly stumbled out of her office, I was face that stung for the rest of my clini- neglected aspect of history-taking — angry and tearful. cal training. the social history.
40 CFMS Annual Review APRIL 2012 Opinions
How to become a “great” physician
Yan Yu CFMS Political Advocacy Representative University of Calgary, Class of 2014
s medical students, most of us Don’t get me wrong. Medicine’s For medical students, medical A are keen to become great doc- current sickness-care mandate is defi- school should be, and often is, the tors in the future. But what nitely necessary. I just happen to believe ideal place to learn about effective exactly does it mean for a physician to that physicians must also address the health and social advocacy. Initiatives be “great”? underlying causes of diseases if we are like the annual CFMS National Lobby I’ve thought about this question off truly serious about improving people’s Day demonstrate that students can and on throughout my first year of health. By “underlying”, I mean more make a positive difference on improv- medicine at the University of Calgary. than individual preventable factors like ing the social determinants of health. The last time I asked this question was obesity, tobacco use or lack of physical With our current national prognosis of when I was trying to fall asleep in my activity. I’m talking about the constella- graying baby boomers and limited Ottawa hotel room at the 2012 CFMS tion of environmental, social and eco- health care resources, Canada needs its National Lobby Day. The light was still nomic factors that determine the health current doctors and those in training on, but I had pulled the pillowcase off of whole populations. This involves as well, to take up the role as stewards one of the pillows and was using that as looking at whether or not folks have a of the health care system. a make-shift eye-shade. Clever, eh? stable source of income to buy healthy Being a sharp-minded, trustwor- I was dozing off in this fake, but foods or whether they are empowered to thy and compassionate clinician is not comfortable, darkness when I suddenly improve their own social circumstances. enough. To be a “great” physician, you realized something. By going to sleep Encouragingly, the importance of must simultaneously work for the like this, I was doing exactly what these “social determinants of health” is health of society as a whole: in research, much of medicine is doing today, gaining more than just a foothold in in politics, in health care policy or in something that may prevent me from 21st-century medicine. Today, more other fields that contribute to solving becoming a “great” doctor! and more primary care physicians are the underlying causes of diseases. In I can cover my eyes, ostrich-like, incorporating some degree of social other words, a “great” doctor puts the with as many pillowcases as I want. But activism into their daily practice, rang- “health” back into “health care”. the light will still be on. Similarly, med- ing from advising patients on lifestyle Perhaps this quote from Chinese icine can cover itself with pillowcases of change to working for the government medicine puts it best: symptom-management and temporiz- itself. Organizations like the Canadian ing fixes. But for many diseases, the Medical Association (CMA) are "((#'&', underlying causes will still be there. already helping to facilitate such polit- %(($'&', Nitroglycerin and fibrinolytics in acute ical activism. Physicians have the ((!'&'. coronary syndromes don’t eliminate advantage of being non-partisan, with the underlying, preventable atheroscle- a mandate to enhance the health of all When translated, it is less poetic, rosis. Inhaling buckets of anti-choliner- citizens. As a result, we hold a privi- but its meaning nonetheless resonates: gics can’t stop the preventable, but irre- leged position: we are trusted. What Average doctors treat diseases. versible progression of COPD. Giving we believe carries a lot of weight in Good doctors treat diseases and diuretics to congested patients with society. Thus, physicians have a moral prevent their complications. PND doesn’t reduce the salt content in obligation to live up to this reputation Great doctors prevent diseases prepared foods — a major, preventable and do what they can to improve from happening in the first place. trigger of heart failure. societal health.
APRIL 2012 CFMS Annual Review 41 Opinions
Pfizer and continuing medical education: The ethics of collaboration
Adam Dmytriw, MSc (Oxon) Dalhousie University Faculty of Medicine Class of 2014
ontributions from Pfizer and It has long been Senior Editor of the New England other pharmaceutical corpora- Journal of Medicine, Arnold Relman, Ctions to the development of clear that donation relates that any major benefactor continu ing medical education resources expects something in return for an continue to provoke strong criticism in from the investment. During his tenure with the Canada. In 2009, Pfizer and the NEJM, he felt that the pharmaceutical Canadian Medical Association (CMA) pharmaceutical industry had ‘no business educating reached an agreement to develop an physicians at all’.3 This idea of CME online CME resource for physicians industry to with industrial support has been across the country.1 It was somewhat increasing in the United States since unsurprising when the first module to organizations 1984. At the time, contributions from be released from the online resource on industry were approximately US$302 Parkinson’s disease focused on pharma- performing research million, but now exceed US$1.036 bil- ceutical treatment options primarily lion. An ongoing Cochrane Review produced by Pfizer. The Continuing or providing tracing these contributions to CME Medical Education program adminis- and medical practice suggests that trative board currently seats two staff continuing medical resources resulting from these collabo- members from Pfizer; a board that seats rations contribute to ‘moderately large only six members in total.2 education can have changes in clinical practice’.5 Given that the CMA is the self- Despite claims that 2009 repre- described voice for Canadian physi- a significant impact sents an unprecedented downturn into cians, its partnership with Pfizer sends practices typically only seen in the a tacit message of permissibility for on physician United States, one need only look a fraternization with large pharmaceuti- decade earlier. In 1999, Rx&D and the cal companies. In 2009, the CMA behaviour and Medical Research Council (predecessor accepted $780,000 from Pfizer for the to the CIHR) engaged in a lasting part- creation of the CME resource, not particularly nership which has since been updated including future contributions, which in name to the Rx&D/CIHR Research according to the founding press release prescription habits. Collaboration.6 Stipulated in the agree- will be a continual source of funding ment was that certain CME programs for research and development3. in the country. would not necessarily be met with Another equally resounding message Importantly, Pfizer cannot be sole- equal funding from the CIHR, but communicated to Canadian physi- ly implicated in an inherently mutual simply receive a ‘seal of approval’ as the cians is that it is ethically sound to collaboration with the CMA. resource went on to be funded by allow industry to fund continuing Ultimately, the result may be the loss of industrial partners such as AstraZeneca education, which has no precedent in confidence in one of Canada’s most and Pfizer.7 It is further stipulated that nearly any other collegiate profession venerated medical associations. Former industry partners will ‘support where
42 CFMS Annual Review APRIL 2012 Opinions
Pharmalot December 3, 2009. possible the principles and practices of try is feigning an attempt to appear at 3. Weeks, C. Medical association takes CME programs’, with no indication of an arm’s length away from academic heat for Pfizer funding. Globe and Mail what constitutes such a possibility. It is and government institutions, it December 2, 2009. 4. Steinbrook, R. Commercial support and further introduced that both educa- remains to be seen whether its effect continuing medical education. New tional content and instructors may will remain as strong. What is clear is Engl J Med 352, 534-535 (2005). 5. Forsetlund, L. et al. Continuing educa- come from industry if a consensus for that indirect contributions to CME at tion meetings and workshops: effects on approval can be met.7 Moreover, the the level of policy development can professional practice and health care criteria for conflict of interest violations have a marked impact on the commer- outcomes. Cochrane Database Syst Rev, CD003030, doi:10.1002 /14651858 are defined by Rx&D itself to be cial uptake of pharmaceutical goods .CD003030 .pub2 (2009). enforced only upon three previous vio- and physician bias. Our generation 6. Kondro, W. Canada’s MRC and drug lations in the same year. may have to be even more wary than industry try to make amends. Lancet 347, 1478-1478 (1996). It has long been clear that dona- those who have come before us. 7. CIHR. Summary Report of the Interim tion from the pharmaceutical industry Evaluative Study of the CIHR/ RX&D References Program. http://www. cihr -irsc .gc .ca to organizations performing research (2005). 1. Canadian Medical Association. The or providing continuing medical edu- 8. Wazana, A. & Primeau, F. Ethical con- Canadian Medical Association and siderations in the relationship between cation can have a significant impact on Pfizer Canada collaborate. Press Release physicians and the pharmaceutical Ottawa, December 1, 2009. physician behaviour and particularly industry. Psychiat Clin N Am 25, 647-+, 2. Silverman, E. Canada’s medical associa- prescription habits.8 Now that indus- doi:Pii S0193-953x(01)00016-8 (2002). tion chided for Pfizer CME funds.
Society of Rural Physicians of Canada
Ask not what the country can do for you; Ask what you can do in the country! WWW.SRPC.CA
APRIL 2012 CFMS Annual Review 43 Opinions
Literacy: Why we should care
Danny Guo University of Calgary, Class of 2014
eun aut yew zinn chille durin resources very difficult. Whatever the school is to attain medical education D un dert wellve. You probably reason, a study by Statistics Canada so that we may serve the community as don’t understand what that (International Adult Literacy and a physician who promotes the overall last sentence means. But let me re- Skills Survey) demonstrated that health and wellness of society. On that assure you that it is plain English, sim- “those with low levels of literacy work note, it only makes sense to lend our ply written in a way that is difficult to fewer weeks, experience more and attention to those with low literacy. understand by reading it. Now I want longer periods of unemployment, and The Government of Alberta sets you to remember that feeling of confu- an excellent example by contributing sion — or perhaps even irritation — significant funding for non-profit that you experienced while attempting ... ‘education and organizations that provide free tutor- to read that line of apparent gibberish. ing for those with low literacy. This frustration is what many Albertans literacy’ is defined However, the funding is still consider- feel almost every day because 4 out of ably short, forcing many of these insti- 10 Albertans struggle with literacy, by Health Canada tutions to rely on the cheapest form of which the Oxford Dictionary defines student recruitment: print. That’s as “the ability to read and write”. This as the third right, as ironic as it sounds, non-profit means that roughly half of the people literacy organizations use newspapers you run into on the street, train, bus or determinant and posters as their primary means of any other public place will struggle advocacy. The posters might as well say with a doctor’s instruction on treat- of health ... “If you can read this … then never ment plans and reading directions on mind”. This is exactly why medical the back of medications. Imagine the students, who are future doctors and frustration and anxiety that a mother earn lower wages when they are work- health educators, are the perfect vessels would feel if she was unable to give the ing”. Statistics Canada stated that for advocating the importance of liter- proper amount of acetaminophen to roughly 43% of Canadians between acy and education to future genera- her feverish 6 year old, not because she ages 16–65 have minimal or low levels tions. If enough of us take a step in this could not afford it, but because she of literacy skills and that this percent- direction, we can make a dent in the simply could not read English. age hasn’t changed since 1994. persistent trend of low literacy in There are many reasons why one Considering that ‘education and liter- Canada and progress toward a more might struggle with literacy, including acy’ is defined by Health Canada as educated and healthier society. immigration to inadequate education. the third determinant of health, I Now, back to the quote at the Most of the time, it isn’t the individ- would say this is problematic. beginning of this article. The gibberish ual’s fault that their literacy is not up As medical students, we are sur- is actually the instructions on the back to par. Instead, it is usually because the rounded by literate colleagues and of an acetaminophen bottle, as per- environment they grew up in either classmates, and as a result, can often ceived by a mother struggling with lit- downplayed the importance of literacy forget about the literacy issue. The pri- eracy. Ironically, it says: “Do not use in and education, or made access to these mary reason why we are in medical children under 12.”
44 CFMS Annual Review APRIL 2012 Featured Interview
Interview with Dr. Samantha Nutt — War Child founder and author of Damned Nations
Matthew Tenenbaum VP Communications McMaster University, Class of 2013
Dr. Samantha Nutt is an award-winning humanitarian, ac claim ed public speaker and a leading authority on the impact of war on civilians. She is the founder and execu tive director of War Child Canada, an international organization that empowers young people to overcome the challenges of living with conflict. Her new book, Damned Nations, chronicles her 15 years of experience in some of the most devastated regions of the world. Dr. Nutt sat down with the Annual Review to speak about her experiences and her advice for current medical students. AR: Looking back, why did you which had a tremendously negative decide to pursue a career in medicine? impact upon peoples’ health. For me, it was more an extension of what I SN: While I was an undergraduate at was learning from a public health McMaster University, I became increas- perspective. ingly interested in the relationship Confronting that kind of injustice between health and human rights. I head on, the one thing that I wasn’t became very involved in a number of prepared for was the extent to which global health and aboriginal health foreign policy can actually influence groups on campus, and this led me to health outcomes in different corners of apply to medical school. It also shaped the world. One of the things that my choice of Public Health as a spe- astonished me in Somalia was the cialty. rabid proliferation of arms. It wasn’t the only cause of instability, but it cer- AR: After graduating, you travelled tainly had a tremendous negative to Somalia as a volunteer with impact on well-being on the well- UNICEF. How did you find that being of Somalians. experience? Did it connect at all with what you had learned in med- AR: Was this a big transition, com- ical school? ing out of medical school to do humanitarian work? SN: In many ways it did, but it was much more about the broader deter- SN: I think it was a big transition, to minants of health. The social, political find yourself in the middle of a desert and economic situation there pro- community coming under fire because Photo Photo by Dustin Rabin duced violence and uncertainty, you are participating in an assessment. Dr. Samantha Nutt
APRIL 2012 CFMS Annual Review 45 Featured Interview
Nothing really prepares you to con- AR: Is our understanding of how SN: War is in literally everything we front the level of violence and injustice best to help inaccurate? do every day, from conflict minerals in that you see. After experiencing it, you our computers to pension funds that don’t really become desensitized to it. SN: I wouldn’t say it’s inaccurate, but invest in landmines. There are deeply It is still just as shocking to see a 10-year- we don’t always have access to all the rooted political and economic reasons old wielding an AK-47 and to lead that information. Relief plays an important for these conflicts, but in many kind of unstable existence. I think that role in saving lives during very difficult instances our exploitation augments this shock is a good thing and it’s a times, and there is certainly a role for an already unstable environment. part of the reason why I continue to it. But there needs to be a balance so For me, it is about making sound work in this area. that we are not constantly applying ethical choices, and demanding band-aids without addressing the accountability from Canadian indus- AR: Would you say that this was structural deficits. I believe that there try. Seventy-five percent of the world’s what motivated you to start War is room for Canadians to raise their mining companies are headquartered Child? level of development literacy and to in Canada and we are implicated in better understand how our actions four times as many human rights SN: There were a number of factors have positive and negative impacts transgressions as the next two biggest that motivated me. For me, it was pri- elsewhere in the world. offenders. Yet, we have no active legis- marily after spending five years in the lation that governs the behaviour of field and seeing where the gaps are. AR: Have we gotten any better in these corporations in other parts of the The overwhelming focus is often on our understanding of these conflicts world. We can make different choices short-term humanitarian relief, yet over the past 15–20 years? and, though this may not change the many of these communities have been outcome of conflicts, it at least increas- experiencing conflict for generations. SN: It’s hard to call it better or worse. es the likelihood that we are not exac- It became apparent that, unless you’re It has transformed, both in terms of erbating them. invested in breaking that cycle — by our personal decision-making as well empowering training and providing as our foreign policy. Trade has dis- AR: A significant proportion of opportunities for local community- placed aid when it comes to our for- Cana dian medical students are based organizations — the process of eign funding decisions. We aren’t bas- interested in the health of people rebuilding and creating a safer, more ing these decisions on need and there around the globe. What is the best stable environment for children will is much greater focus on what is good way for them to help? How can they never happen. for Canadian companies. The question have the greatest impact? War Child’s programming tries to that is rarely asked is whether this is an fill the gap between short-term humani- appropriate purpose for our aid. I SN: Medical students frequently ask if tarian endeavours and longer-term believe that aid should be for helping they can travel overseas to work in one development, which does not usually the most vulnerable, and that it should of War Child’s programs. While there take place without a greater level of not be primarily about our interests. is certainly value to firsthand experi- security. We’re talking about countries We’re accessing much more informa- ence, we also need to understand the like Sudan, which has experienced tion and engaging in the issues in new limitations of our training and knowl- more than 30 years of war or eastern ways, but we’re not necessarily making edge. We need to understand when it is Congo, which has experienced 15 years better decisions. the right time to engage on that level. of war. If you’re constantly just focus- Donating is extremely important. ing on food, water and shelter, but AR: In your new book Damned Students often think that they don’t children don’t have the opportunity to Nations, one of the things you talk have the resources to have an impact, go to school, then violence simply con- about is how our actions here can but even small amounts of money add tinues. We try to tackle these structural fuel or enable conflicts abroad. up and make a tremendous difference deficits with local partners. What should we know about this? to our programming. For students
46 CFMS Annual Review APRIL 2012 Featured Interview
who are interested in these issues, I also role, you are much better prepared to these. I had a better sense of what I recommend getting as broadly-based go overseas and to make sustainable wanted to be doing, and less of a sense an education as possible. Under - contributions. of how to get there. graduate or post-graduate work related If you are prepared to speak to to international development, interna- AR: As a modern leader in both your mentors and program heads, and tional relations or foreign policy is health care and humanitarian work, to chart a path that is somewhat non- extremely useful. do you have any final words of wis- traditional, it is amazing how flexible If you do want to volunteer, do so dom for medical students looking to people often are. Thanks to people with international organizations here become the leaders of tomorrow? who were willing to make exceptions in Canada. Many organizations, for me based upon my interests, I was including War Child, will take stu- SN: There’s a tremendous amount of able to do what I did and still be work- dents in our offices for about a month. pressure to conform and go in the ing in this field. Students face tremen- Students expect to learn something, same direction as everyone else before dous pressure, and it poses false choices. but if you’re here for only a week it is you. The choices laid out before you You can do this sort of work and still difficult to involve you in something are all very clinically based. You’re have a meaningful career. The trick is meaningful. If you’re prepared to com- asked if you want to be a surgeon, an to seek out the people who can help mit for a longer period of time, we can internist, an OB/GYN, a family doc- you with these alternative choices, and involve you in more significant proj- tor … and end up with labels. I didn’t help get you the education you need to ects. Once you’ve been in that sort of feel like I fit properly in any one of set you on this path.
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APRIL 2012 CFMS Annual Review 47 www.sogc.org Joignez-vous à la Société des obstétriciens et gynécologues du Join the Society Canada : Contribuez à of Obstetricians l’amélioration and Gynaecologists de la santé des femmes! of Canada: Help make a La SOGC représente des milliers de difference professionnels de la santé d’un bout à l’autre in women’s health! du Canada depuis 1944 et se fait ainsi le porte- parole en obstétrique-gynécologie. En tant que membre de la SOGC, vous pouvez nous The SOGC has been representing thousands aider à accomplir notre mandat et vous serez à of health care professionals across Canada la fois en mesure de tirer pro$ t d’une gamme since 1944 and thus is the voice of obstetrics complète d’avantages et de services, tels que : and gynaecology. As a member of the SOGC, • Abonnement au JOGC you can help us achieve our Mission and at • Ressources cliniques les plus récentes the same time, you will be able to access a full • Occasions de perfectionnement range of bene$ ts and services such as: professionnel • JOGC subscription; • Services et apprentissage en ligne • Latest clinical resources; • Promotion des droits et représentation • Professional development opportunities; • Publications complètes • Online services and learning;learning; • Advocacy and representation;esentation; Vous (ainsi(ain que la • Comprehensive publicationsblications SOGCSOGC et l’ensemble desdes Canadiennes)C Becoming a member avezavez tout à gagner en of the SOGC is devenantdev membre a win-win-win de lad SOGC. proposition for you, the SOGC, and all Canadian women. Join the Joignez-vous SOGC à nous dès today! aujourd’hui! Register online Inscrivez-vous en ligne at www.sogc.org. à www.sogc.org. Alumni Affairs
2011–12: Another year, more alumni
Cait Champion Alumni Officer University of Toronto, Class of 2012
ow in its second year, the but on personal milestones as well. into 2012–13 with more alumni par- CFMS Alumni Affairs pro- Our alumni elaborated on the role the ticipating in the selection committee Ngram continues to grow and CFMS has played in their lives in for the CFMS/RBC Student Leader- connect our alumni in the support of terms of finding life partners and ship Awards. We’re also hoping to medical students and medical student developing a passion for medical edu- build opportunities for mentorship initiatives. cation that continues to drive their and leadership skills development for We’ve begun a tradition of hold- careers today. To learn more about the students from the expertise of our ing alumni lunches at our General CFMS's accomplishments over our alumni. Meetings, starting with the 2011 more than 30-year history, visit our In keeping with tradition, we plan Spring General Meeting in Toronto Orga ni za tional Timeline under About to continue our alumni lunches at our and again at our 2011 Annual General Us on the CFMS website. General Meetings. Please let us know if Meeting in Calgary. At the Spring In addition to participating in you will be close by to either of our General Meeting, several past execu- General Meetings, this is the second next stops; Winnipeg, MB in the Fall, tive members and recent graduates year that alumni have contributed to and Quebec City, QC in the Spring of were able to join us in celebrating the Alumni Q&A section of the Annual 2013! medical student achievements through Review. This is just one of the ways that our CFMS/RBC Medical Student alumni can share their experiences with Are you a former Canadian Medi cal Leadership Awards. It was made even current medical students to help us nav- Graduate? Interested in supporting more special by the attendance of igate the transition from medical school current CFMS/FEMC projects and con- several alumni who played a role in to residency, and eventually clinical necting with other alumni? If so, we selecting the award winners. At our practice. We are also featuring a new want to hear from you! Annual General Meeting, our alumni Studying Abroad section this year to Contact our Alumni Officer, Cait shared their CFMS experiences and highlight alumni who are currently pur- Champion (cait.champion@ utoronto .ca) touched not only on the organization’s suing training internationally. or our General Manager, Rosemary important milestones (the creation of The CFMS Alumni Affairs pro- Conliffe ([email protected]) CaRMS and the start of Lobby Day), gram will continue to grow as we head
APRIL 2012 CFMS Annual Review 49 Alumni Affairs
Alumni Q&A What do you love the most about your career and what do you like the least? Cait Champion Alumni Officer University of Toronto, Class of 2012
Dr. Tara Mastracci (University of ing time to be a Vascular surgeon. It a great deal of control and flexibility Ottawa), Vascular Surgeon has always surprised me why everyone over our work schedules is a bonus! Vascular Surgery is a wonderful spe- doesn’t want to become a Vascular With increasing volumes of cialty because it combines the best of Surgeon!! patients using the emergency depart- both Surgery and Internal Medicine. ment as a substitute for a family physi- In the OR and in outpatient clinic, cian, we are seeing more patients with vascular surgeons deal with disease in Dr. Jason Kur (University of Alberta), chronic complaints. It can be difficult all areas of the body, in patients of all Rheumatologist to deal with these patients, because the ages and with different severity of ill- Favourite aspects of Rheumatology: ED is not designed to treat and follow nesses. Thus, vascular training pre- Diagnostic challenges and the spec- chronic illnesses and we are limited in pares you to be comfortable operating trum of diseases. Rheumatology has what we can offer them, which is frus- on extremities, in the neck, and in the some of the most interesting systemic trating to both the patients and the thoracoabdominal cavity — and as diseases to diagnose and manage from emergency physician. As emergency such, no two operations are exactly sarcoid, to ankylosing spondylitis to physicians, we like to diagnose and fix alike. Commonly, the patients also the vasculitides. It’s a constant intellec- problems quickly (or at least get have a very heavy burden of other tual exercise. patients admitted to hospital quickly comorbidities — cardiac, renal, neu- Least favourite aspects of Rheuma- so they can be “fixed” by someone else) rological — so their perioperative care to logy: Dealing with the large volume — and we can’t do that with patients can be very complex — and a vascular of referrals to my practice. Rheumato - with chronic, but stable illness. surgeon gets to practice critical care logy is an underserviced specialty. More medicine, as well as long term preven- and more patients are waiting for assess- tative internal medicine, cardiology, ments because of physician shortages. Dr. Danielle Martin (University of neurology, etc. This also means work- Western Ontario), Family Medicine ing in a multidisciplinary team with My favourite part of my chosen profes- many different specialties in the hos- Dr. Matthew Erskine (McGill sion is the ongoing relationship I have pital. Vascular disease is a relatively University), Emergency Medicine with my patients. As a family doctor, I chronic illness, so over time vascular I love Emergency Medicine, because really get to know them over time, and surgeons do get to develop a long- we work at the “front line” of health that relationship makes my work term relationship with the patients care delivery. We get to actually diag- incredibly rewarding. It also allows me undergoing treatment, which is not nose, stabilize and definitively treat to be a better clinician because my always the case in surgical subspecial- many of the patients before they are growing understanding of the family, ties. Also, the technological advances seen by anyone else, which is exciting work and community factors that con- in endovascular surgery in the last 15 and intellectually challenging. The tribute to their health help me to sup- years have completely revolutionized variety of patients that we see and the port them in finding solutions to their the field, which makes it a very excit- fact that we are never on-call and have challenges that will actually work. My
50 CFMS Annual Review APRIL 2012 Alumni Affairs
least favourite part of my day is trying patients, with new trials coming out all tem can malfunction and how that can to hunt down the results of investiga- the time helping to refine and modify present clinically. I also treasure the tions that have occurred in other hos- my practice approach. There’s never a relationship that I have developed with pitals and trying to bridge the gap dull moment! many of my long-term patients. As is between specialists and primary care I find that most physicians who the case with many branches of medi- when notes are not available. I hope have any degree of unhappiness in cine, we don’t ‘cure’ many patients, that as we move toward a comprehen- their careers feel that it’s primarily due however, we often treat people actively sive electronic health record our to excessive workload and I am no and ameliorate discomfort. At the very patients’ information will be more eas- exception. My community is underser- least, we can listen to people and offer ily accessible to them as well as their viced with too few cardiologists and advice, which is sometimes underval- entire health care team. there simply aren’t enough hours in ued as a therapeutic intervention. the day to see the patients that need to The rest of my time is spent in be seen, making for very long days medical education. I really enjoy my Dr. Mary McHenry (Dalhousie away from home and not enough time interactions with the medical students University), Pediatrics for family or sleep. It can be difficult to and find that it keeps me fresh. My favourite part about pediatrics is balance and maintain control of my Sharing my interest in neurology with working with such a diverse popula- time on occasion. interested students revitalizes my own tion, from newborns to adolescents, interest in my clinical work. I also and all the ages in between! What I spend time working with faculty and find most difficult about working with Dr. Allie Meiwald (Memorial University), residents in the Office of Faculty children is keeping your emotions sep- Emergency Medicine Development, assisting people who are arate from your work when a child has I love the variety. Knowing that every interested in becoming better teachers. a life-threatening illness. Fortunately, patient I see on shift is going to be dif- This allows me to interact with other children are amazing and resilient so ferent keeps me intrigued. Never people, who, like myself, are fascinated this is very rare. knowing when a trauma, MI or severe- by medical education. ly ill patient is going to arrive always The one thing I dislike about my keeps me on my toes. job is the administrative work. I am site Dr. Brad Dibble (University of What I don’t like. Shift work has leader for neurology at my hospital and Western Ontario), Cardiology its ups and downs. Working nights also the program leader for general neu- There’s no way I can pick just one and weekends can sometimes take a rology in Calgary. I have to say, I find it favourite thing because there were toll; however, having days off in the a lot easier to work with patients and many factors about cardiology that middle of the week for regular life students than administrators! I suspect drew me to it as a subspecialty. First of activities — dentist appointments, car that I find it challenging largely because all, it’s simple conceptually because the appointments, banking, etc. does help I’m not passionate about it the way that bulk of the diseases I deal with are due to make up for it. I am about clinical work and education. to either pump, electrical, or plumbing I think that’s the underlying mes- problems, but within each of those sage: if you want to design a great categories there are enough complexi- Dr. Kevin Busche (University of career, you need to find the things you ties I face to keep it interesting and Western Ontario), Neurology are passionate about and pursue them. challenging. Secondly, although it’s I spend about 75% of my time doing I think it’s especially valuable to find unfortunate that cardiovascular disease clinical neurology, and I very much one thing outside of your day-to-day affects so many people worldwide, it enjoy it. At least once every couple of clinical work that gives you a change in has resulted in many clinical trials that days, I see a patient who ‘blows my perspective, whether its education, have answered a lot of important ques- mind’; it’s almost unbelievable how research or administrative work. A tions as to how best to treat these many different ways the nervous sys- change is as good as a rest, as they say.
APRIL 2012 CFMS Annual Review 51 Alumni Affairs
The LMCC part 1. Just how hard is it?
Matthew Sheppard PGY1 Anesthesia, University of Ottawa CFMS Past President
o now that I’ve graduated med- Population Health/ Legal/ Ethical/ Orga - LMCC and I didn’t think Internal ical school and moved on to ni za tional Aspects of Medicine. A quick Medicine or Peds would be high yield Sgreener pastures, I can tell you glimpse at Toronto Notes or any other so I didn’t review any of those sections. the tale of the MCCQE Part 1. A lot review book will tell you that reading The last thing I did was spend about 4 of my friends from the year behind me through the entire section on Psychi- hours doing multiple choice questions are asking questions about this dread- atry only takes an afternoon whereas for all specialties because that’s how it ed hoop in the quest to become a reading through all the subspecialties is presented on the exam. I think all physician, so I thought I’d share my of Medicine to the same depth will my studying could have been con- thoughts in the Annual Review. easily take a week. So, I prioritized. densed into 20 hours. My advice for studying for the This strategy might not work well LMCC is simple: do not spend too for you, but it did for me. Sure, some much time studying and definitely do of the multiple choice questions were not spend extra money on more med- Take the exam out of this world, and a lot of the clin- ical review books and practice exams ical decision making questions were specifically for the LMCC. seriously, but like those ‘read my mind’ questions You have been writing tests in you got pimped on in clerkship, but medical school for four years now and don’t study too everyone found the exam weird so I if you’ve done well up until this point didn’t fret. (i.e., you’ve passed), then there is no much for it. Bottom line: take the exam seri- reason why this kick at the can should ously, but don’t study too much for it. be any different. Unless you’ve com- If you were consistently near the bot- pletely slept through the last four years I read over every page of the tom of your cIass in medical school, (including the examinations) and Psychiatry (twice, because I like Psych spend some more time than usual on played hookey during clerkship, you and it was the shortest section) and this test — while failing the MCCQE should have nothing to worry about. Ob/Gyn sections of Toronto Notes. Part 1 is not the end of the world, it is At graduation, the school has con- Next on my list was Legal/ Ethical/ a pain to have to rewrite. But if you’re ferred upon you its confidence that Organizational Aspects of Medicine. in the top 95%, most residents say you are safe to enter residency — that’s Do yourself a favour and read Chapter they regret studying too hard for this kind of a big deal. 15 of Shaw’s Public Health and Pre ven - exam versus not studying enough. Having said that, if you’re like tive Medicine in Canada (no need to Study a few hours a week the most self-respecting medical students, buy, just check it out from your friend- month before the exam and don’t ‘winging’ an exam is probably not ly medical school library). I wish I had stress yourself out. You’ll miss out on your idea of a stress-free day. So, I’ve read it twice. It might seem a little the last few opportunities to hang out outlined my simple strategy below. bland for some people (although I and enjoy the company of your class- The LMCC multiple choice sec- thought it was really interesting), but it mates. It’s been a long four years and tion is made up of 6 equal parts: provided an excellent background for your class has come far together, take Psychiatry, Internal Medicine, Pedia- numerous questions on the LMCC. I some time to celebrate, because you trics, General Surgery, Ob/ Gyn and did a month of Gen Surg before the won’t have such luxury in residency.
52 CFMS Annual Review APRIL 2012 Alumni Affairs
Studying abroad
Stepping outside the box … Tyler Johnston idea. This is probably the most impor- PGY2 Emergency Medicine, tant consideration, so take some time Dalhousie University to think this through. CFMS President 2009–10 s health care gets increasingly 2) Talk to as many people as com plex and as trainees try to you can … A tailor their careers to their inter- The experience of others can help you ests, medical students and residents are figure out exactly what you want to do increasingly choosing to go beyond and which program best fits your traditional medical pathways and pur- needs. Make sure you do your home- sue training in a complimentary field. work and speak with people who’ve In the US, many medical students actually done the program because Tyler Johnston are now taking a year out of their core what transpires in practice can be dif- studies to pursue training in research, ferent than what appears on websites time. Be sure that the additional train- public health and management. A and in advertisements. ing will help meet your goals, that you number of combined degrees (e.g. can reasonably afford the program and MD/ MPH, MD/ MBA, MD/ Msc.) that you maximize your search for fund- are also springing up in addition to … additional ing (e.g. scholarships, home depart- existing MD/PhD programs. Resi- ment, research councils, fellowships). dents also have a variety of options training are not including master’s programs and clini- 5) It’s a long career so do cal investigator programs that can be a exclusively for what’s right for you … great way to start a career in medical This is similar to the first point, but research. people interested it’s also more than that and worth These forms of additional training repeating. Pick the right time in your are not exclusively for people interest- in research career to do this type of training; it ed in research anymore and they can anymore … could be in medical school, residency prove enriching and enlightening. or after many years in practice. Still, in order to make sure you get Similarly, some people complete this the most out of additional training 3) A word about research … type of training online so they can stay there are some things to consider: If research is a major goal, make sure home with loved ones and new chil- the program you choose provides good dren, while others want to live in inter- 1) Why? research training and seriously consid- esting places (i.e., the UK, etc.). All of Why are you considering additional er choosing a program that is at least these reasons are valid — it’s your life, training? Are you pursuing a passion? two years in duration to allow for so make this training work for you. What specifically are your interests? acclimatization and the time to con- What do you hope to gain and how duct meaningful research. Examples of Common will it help you in your future career? Programs Make sure you’re doing the train- 4) Assessing the investment … Master’s of Community Health and ing because you want to and not This type of training often involves a Epi de miology because someone else thinks it’s a good considerable investment of money and Master’s of Medical Education
APRIL 2012 CFMS Annual Review 53 Alumni Affairs
Master’s of Public Health one that I found I wasn’t getting ian relief. The breadth is exciting and Clinician Investigator Programs enough of in my medical training. I suits me well, but I’m having to work MBA/Master’s of Health Administra- knew I wanted to make global health a a little harder in it to reach my research tion significant part of my future career, goals. All in all, I hope that my MPH but I also wanted to maintain my will help me better understand health PhD medical science commitment to clinical medicine so I systems, medical research and how to When I made my choice to do addi- enrolled in a one-year MPH in Global look after my patients both at home tional training at Harvard Univer sity Health. It’s a multidisciplinary degree and abroad. I am also having a great in Boston, it was because I wanted to including training in epidemiology, time checking out my new city and get back to global health, a field I had biostatistics, management, global sleeping in my own bed … every night worked in before medical school and health, refugee studies and humanitar- of the week (i.e., there is no call).
Choices and opportunities
Mark Preston with a concentration in Clinical Urologist Effectiveness. This program is geared University of Ottawa, Class of 2006 toward providing physicians with the completed medical school and my methodology and skills required to be urology residency at the University an effective clinical researcher while Iof Ottawa, graduating in 2011. providing opportunities for other During this time, I was actively interests. I have been involved in global involved with the CFMS before surgical development for years now spending four years on the Board of and am currently working on a collab- Directors at PAIRO. These experi- oration between MGH and a university ences taught me a tremendous amount hospital in Uganda for improving about medical education, health policy Mark Preston research (burden of surgical disease, and leadership, which has, and will surgical outcomes) and educational continue to serve me well throughout capacity. Boston is an epicenter for my career. In addition, I had the You are limited only education or research endeavors and opportunity to meet and work with the wealth of opportunities is stagger- incredibly interesting and fun people by your ideas and ing. You are limited only by your ideas from all over Canada. and your energy level. I am now in Boston completing a your energy level My long term plan is to return to Fellowship in Urologic Oncology at an academic center in Canada where I Massachusetts General Hospital can continue my clinical, educational, (MGH). I chose this position due to mentors. Concurrently, I am studying research and surgical development its very large clinical volume, excep- toward a Masters in Public Health at pursuits. I hope this training will allow tional research possibilities and the Harvard School of Public Health me to make a unique contribution.
54 CFMS Annual Review APRIL 2012 Alumni Affairs
Beyond the CFMS: Exploring health policy, planning and financing at the LSE and LSHTM
André Bernard to learn the fundamentals of health Anesthesiologist, Dalhousie policy engagement and research, with University a specific focus on how health systems CFMS President 2006–07 are built, financed and sustained from ello CFMSers from coast-to- innumerable perspectives. I was a coast! My name is André member of a class of nearly 55 people HBernard. I’m currently on staff just like me: clinicians and policy peo- as an anesthesiologist at Dalhousie ple, NGO workers and government University in Halifax, Nova Scotia. officials, feeding a passion for facilitat- Having just completed residency train- ing health transformation in each per- ing, I’ve remained grateful to my son’s context. CFMS experience from 2002–2007 My time in London was transfor- André Bernard when I served as VP International Pro- mative. I had the distinct opportunity grams and Partnerships, VP Finance, to live at Goodenough College, a post- Wimbledon, to living and learning President (and Past President). The graduate residence (and much more) with people from 100 different coun- CFMS remains the most dynamic and tries — it is a place I would recom- engaging organization with which I’ve Identify your mend to anyone wishing to study and ever worked. I think of it (and you) live in London for a year. often and I’m pleased to see your con- interests and pursue I think in medicine we can often tinued growth and strengthening. feel trapped into following a single and The CFMS set me on a path in your goals both direct course to our ultimate clinical which health policy has become cen- destination. I would encourage you to tral to how I see my role in medicine. within and outside identify your interests and pursue your It has enhanced and complemented goals both within and outside of clini- my work as a clinical anesthesiologist. of clinical cal training over the coming years. My It has enabled me to serve as an instru- residency program provided me with a ment working for change for our training over leave of absence and, ultimately, six health system. Beyond the CFMS, in months of credit toward my residency. 2009–10 I had the opportunity to these coming years. There are countless former undertake my Master of Science in CFMSers who have followed a similar Health Policy, Planning and Financing in Bloomsbury, Central London. In path. If you’re interested in hearing jointly between the London School of addition to my year of rigorous aca- more, don’t hesitate to get in touch Economics and Political Science (LSE) demic study, Goodenough provided a with me or any other previous alumni! and the London School of Hygiene world of opportunities that I could In the meantime I remain a proud and Tropical Medicine (LSHTM) in never of had living anywhere else — alumnus wishing you success now and London, UK. This 1-year degree pro- from having access to a private box at in the future. vided an incredibly rich opportunity Royal Albert Hall, to tickets to Good luck and all the best.
APRIL 2012 CFMS Annual Review 55 Alumni Affairs
Biking around Oxford’s dreaming spires
Sayeh Zielke learned to dismount my bike Fellowship, Adult Congenital without shame, knowing I had Heart Disease, Royal Brompton done my best for that day. Some Hospital, London days where better than others, CFMS President 2003–04 and I had to accept that. oday I made it up the hill. Medical training is the same I did! I did! It took six as learning to climb the hill. It T months, but guess what, I takes a long time to develop the made it up that hill. required skill sets and expertise. Oxford is not particularly a One must not get discouraged, hilly town. But the University of but learn to maintain a critical Oxford’s John Radcliffe Hospital Sayeh Zielke learning momentum to grow and sits on top of one of the steepest develop as a clinician. It is also hills in the city, the infamous important to know when to “dis- “Hedding ton Hill”. The latter is mount” and ask for help. There not really a big deal for true It took … six months were lovely periods through my Oxonians bike masters of this training and there were weeks land. But for me, with my subop- … to finally make it up and months that I would rather timal athletic skills, lack of dex- forget, but what stands out are terity, and heels that I wear to the hill … and it the incredible teachers and men- work, this represented a true chal- tors that invested heavily in my lenge. I had to work hard to con- paralleled my medical formation and the patients that vince my loving husband to let made it all worthwhile. Six years me loose on a bike. The rules training in many ways of one-in-four call in internal were clear: I shall wear a snow- medicine and cardiology training boarding helmet; wear a florescent was tough. Old grumpy profes- construction vest and only bike during ends to the hospital to finally make it sors to work around were tougher. The day light hours. This limited the fre- up the hill without dismounting. And internal medicine and cardiology quency of the 30-minute bike trips to today, there it was — I got to the hos- Royal College exam each took a good the hospital, given my work day typi- pital in my heels and snowboarding year of my life to study for and success- cally begins and ends before sunrise helmet without getting off my bike. fully pass. and sunset during the fall and winter. I learned a lot through the process I am now thrilled to be wrapping The first time I biked to work, I and it paralleled my medical training up my training at University of Oxford dismounted at the sight of the hill. I in many ways. First, I believed that I John Radcliffe’s Hospital. Four years at just did not know how to even begin to could and must make it up the hill. University of Ottawa Medical School, challenge this little mountain. We had And then I surrendered to the fact that six years at University of Calgary in the driven up that hill everyday to get to it will take weeks and months to get Internal Medicine and Cardiology res- the hospital. I knew how steep it was. I there. I committed to going one meter idency program, it is time for this long watched every day half a dozens bikers longer each time. Red faced and short training period to come to an end. But huff and puff their way up, most walk- of breath, I watched Oxonians whip not before I could realize a childhood ing up with their bikes, with selected by me day after day. I learned that I dream. few pushing through to the top. needed to keep a minimum critical I remember naively emailing the It took the last entire six months, speed while biking up the hill or I University of Oxford Medical School mostly leisurely bike trips on the week- would lose balance and fall. So I to ask to spend some time on an elec-
56 CFMS Annual Review APRIL 2012 Alumni Affairs
tive, the week I received my accept- ance letter from University of Ottawa Medical School. I didn’t really know what an elective was, but as long as I can remember I wanted to go to Oxford. The elective plan at Oxford did not pan out. Neither could I find time during my internal medicine and cardiology training to get to Oxford. However, I decided to apply for a fellowship in echocardiography and adult congenital heart disease in the United Kingdom. It was not easy to come for training to the United Kingdom. The visa process and med- ical licensing issues were quite bur- densome. It took months and a great amount of perseverance and energy to navigate the bureaucratic layers for a cross-continental training. But here I am, biking through Oxford’s glori- ous architecture, up the Heddington Hill and to the hospital. And my col- leagues are exactly as I imagined them to be: academic, intelligent, reserved and lovely. If I could sum up my echo fel- lowship in one sentence it would be this: Training in a postcard. I love the quaint house with squeaky floors that we rent, the beautiful meadows that inspired Alice in www.gnb.ca/physicians Wonderland are just a block away, www.gnb.ca/médecins the little coffee shops, the lively and historic pubs the likes of which were frequented by C.S. Lewis and J.R. Tolkien and, more history and aca- demic legacy than one could absorb in a lifetime. The Heddington Hill won’t be my last climb in life. I am sure there will be steeper ones yet to come. But I am sure glad today I finally made it up the hill.
APRIL 2012 CFMS Annual Review 57 Alumni Affairs
Photo album
Geeta Yadav, Northern Ontario School of Medicine, class of 2010, CFMS Ontario Regional rep 2007–08 and Andrew Graham. Married on July 2, 2011 inside Hart House at the University of Toronto Gil Eamer, University of British Columbia, class of 2012 and Erin Eamer were married on August 9, 2009 in Edmonton
Janis Friesen, University of Manitoba, class of 2012 married Mohamed Abaza on July 11, 2010. Meira Louis, University of Calgary, class of 2009 and CFMS Western Mohamed is from Cairo, Egypt. Regional rep 2007–08 married Tyrell Doig on May 21, 2011
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… and Michelle with girl friends from med school: Ashley Macdonald, Melanie Waite and Erin Gallagher
Michelle van Walraven, University of Ottawa class of 2012, CFMS rep to CFPC and Neil Leicester. Married at the cottage in Muskoka, Ont. on July 24, 2010
Natasha and Rodney Gaudet were married on July 2, 2011 in Stanley Bridge, PEI. Natasha is a Piotr (Peter) Wtorek, University of Manitoba, class of 2015 and Amy Memorial medical student, class of 2014 Wood. Married October 8, 2011
APRIL 2012 CFMS Annual Review 59 Alumni Affairs
Rachell and Mark So were married July 30, 2011. Rachell is a UBC Danny Guo, University of Calgary class of 2014, medical student, class of 2014 CFMS Political Advocacy Committee, married Belle Zou on December 24, 2011 in Shen Zhen (city), China.
Bryson Alexander Wettig born May 27, 2011 to Kara Wettig, University of Manitoba medical student, class of 2012 Lalina Dorais Ram, daughter of Rithesh Ram, University of Calgary, class of 2013 and Veronique Ram. Born August 29, 2010
Emma Galya Preston, born Georgia Avalyn Mondoux was January 20, 2012. Daughter of born on August 10, 2011. She Diane Belder-Preston, University is the daughter of Shawn of Ottawa, class of 2007 and Mondoux, PGY-1 University of Mark Preston, University of Ottawa and CFMS VP Ottawa, class of 2006 and Education 2009–10 and CFMS rep to CAIR 2004–06 Bronwyn Hammel
60 CFMS Annual Review APRIL 2012 Creative Works
Endocrine detective story
Jessica van der Sloot University of Alberta, Class of 2014
he dusty, squeaky ceiling fan “Gonna be a long day, Carter. I hit up the regulars first. You take the T spun lazily in the sweltering can just tell.” bone marrow, check in with RBC, I’ll afternoon heat. The 3 o’clock “How’s that?” Carter asked from talk to Bobby up in the hypothalamus. sun filtered through even dustier behind his shoes. Maybe it’s just a sleep issue.” blinds, painting the scene a golden “Remember Ricky? Guy from Friedman shook his head. “Sleep. sepia tone. The man in the black fedora Central? Says he’s got an unsolvable We should be so lucky it’s just sleep.” tipped his hat up to wipe the sweat case for us.” The next afternoon found Carter from under it. That’s typical Chicago Carter lowered his paper. and Friedman wilting once again body heat for you. “Unsolvable? Central’s got good fellas under the crummy ceiling fan. This Black Fedora’s name was Private to deal with.” time, the desk had been cleared of Detective Jonathan Carter, according “Not like this. They’ve only got everything except a handful of reports to the tarnished nameplate on the oak one lead and most of Central’s busy and pocketbook of handwritten notes. desk. Said desk was covered in mounds just with maintenance. The brain boys Friedman’s bristly hair stood out of newspapers, notes, and records piled ain’t got time for this.” at a hundred different angles from haphazardly to form his own paper Carter pulled his feet off the desk. running his hands through it in frus- mountain range. Carter sat behind his Unsolvable? If Central’s busy picking tration. He repeated the gesture and desk, feet upon it, browsing that day’s up the pieces … then this must be an threw down the report he was reading. paper (later to join its fellows on Mount inside job. There’s no other reason to “Nothing. God almighty, abso- News). The headline read, “IMMUNE call in joe’s like Carter and Friedman lutely nothing.” SQUAD FAILS IN TB STING.” — an infection or toxin they’d hand Carter looked up from the hema- “Damn lazy neutrophils,” Carter off to another system. The problem tology report. “So the bone boys had muttered. must be in the belly of the beast some- nothing for you?” Heavy footsteps down the hall where. Literally. “Nah. Bit of structural weakness, alerted Carter to the approach of his “What’s the lead?” bit of achiness, but 65 years’ll do that long-time, thick-necked partner. Friedman leaned over the desk. to ya. My guy tells me WBC and RBC Moments later the brick-like figure “Fatigue.” are both out of the DX — they’re start- that was Jeremy Friedman wandered Carter’s eyebrows disappeared ing a bakery, you know that? Walking through the door (labelled in gold into the brim of his fedora. “That’s it? the straight and narrow, sounds like.” block letters “Carter and Friedman, Fatigue?” Carter made a peculiar “harumph” P.I.”), buried in his own copy of the Friedman shrugged and leaned sound under his breath. “We’ll see how newspaper. back. “That’s it. Fatigue.” long that lasts. One URTI and WBC “Carter,” Friedman said, without Carter’s mind ground into action will be high as a kite.” looking up and sat down across the — fatigue … fatigue … Holy Hippo- “I’m optimistic. So sue me. desk from him. crates that could be anything. Hema- What’d Central have to say?” “Friedman.” Carter did likewise. tology, the neuro boys, the endocrine “Everything seems to be all right There then followed their custom- gang … Where would they even start? … I talked to Bobby, he said every- ary ten minutes of silence, interrupted “So what’s the plan, boss?” thing was on the up and up. TSH, only by the scratching of paper-on- Carter stood up and stretched. GH, FSH, LH, even sleep pattern … paper and the rhythmic squeaking of “You’re right, definitely gonna be a everything’s okay. Straight up fatigue, the ceiling fan. Friedman finally put long day.” He grabbed his coat from though — I’ve got a hunch it’s those down his paper and sighed. the wobbly rack next to him. “We’ll endocrine hooligans.”
APRIL 2012 CFMS Annual Review 61 Creative Works
“Great.” Friedman threw his voice dropping to a low whisper: “I’m were even the beginnings of what hands up dramatically. “Now we’ve telling you, it ain’t me. But …” He looked like tiny crystallized snowballs gotta do house calls.” leaned in closer. “ … I’ve got contacts floating through the tubules, bumping “We’ve gotta hit the target organs in the kidney. Pretty close quarters, into others, clumping together … if we want to figure out what’s going you know? There’s a rumour going Friedman ran his hands through on,” Carter said with an edge of around that there’s been electrolyte his thoroughly dishevelled hair. “This annoyance. “Got a better plan?” deals.” isn’t good. Definitely not good.” “Yeah. I think I’ll retire.” Carter sighed. He’d been afraid of It was a long trip back to the neck, Some time later, Carter and this. Tracking down the electrolytes and traffic was congested at the heart. Friedman arrived at their first stop, the getting passed around was going to be But not even Friedman complained pancreas. The trip along the main tough. “Anything else?” that it took them three beats to get arteries had been rougher than usual, through the pulmonary artery. They to which Friedman complained bitter- knew what was at stake. ly. Carter, however, took notes in his After calling in backup from the pocketbook…and promptly whacked Carter’s mind thymus and cervical lymph nodes, Friedman across the head with it to Carter and Friedman took their exit at shut him up. ground into action the thyroid. But that wasn’t their des- At the head of the pancreas, they tination. A little beyond and posterior began the tedious job of seeking out — fatigue … to it, they arrived at one of the the Islets of Langerhans. It took them parathyroid lobes. a full half hour to find the beta cell fatigue … Holy It was impossible to miss. There they were looking for. Hippocrates that was a big commotion on the medial “Manny, good to see you.” Carter aspect of the lobe — overgrown vas- greeted his old informant and intro- could be anything. culature, parathyroid hormone spew- duced his partner. “We need some ing in every direction … And right in information.” the middle of it all was Richard Manny grinned good-naturedly. Trevor. Or rather, several hundred “Figures. You come down here once Manny shrugged. “Lots of Trevors. every thousand cardiac cycles, not to rumours, but none of them really seem “Trevor!” Carter, Friedman, and see how I’m doin’, but what I can do solid.” the Immune Squad advanced on the for you. Nice.” If there had been a light bulb growing number of Trevors. “Hands Carter wouldn’t be deterred. above Carter’s head at that moment, it and hormones where I can see them!” “We’re lookin’ for the idiot with the would have just switched on. The Trevors turned in unison. nerve to mess with energy levels. Don’t Solid. One stepped ahead of the others — tell me you haven’t noticed — hell, Solid. Or rather, less solid. the original Trevor. “What do you you and alphie here are the go-to guys Carter hurriedly shook Manny’s want? I’m expanding my business, for glucose metabolism.” hand and shouted a farewell over his nothing malignant.” Manny’s grin disappeared in an shoulder as he sprinted to the superior Friedman shouted, “Save it! We instant. “What?! Carter … you — mesenteric vein. As usual, Friedman know you’ve been dealing in calcium!” you and I been pals for a long time, objected loudly to Carter’s pace. And “You’ve got no proof.” right? You know I’d never mess with as usual, Carter forcibly (and cheerful- “Actually, we do.” Carter held up a big stuff like that. Never.” ly) shut Friedman up. report from Central. “Hyper calce mia, Friedman scrutinized him closely. A quick check with the nephrons fatigue, bone weakness and pain … “You’re not tellin’ us everything. Ain’t confirmed what Carter already knew. Everything’s pointed at you, your ya?” Some of the cells were completely out PTH, and your little adenoma opera- Manny’s anxiety rose visibly, his of it and covered in fine crystals. There tion you’ve got here.”
62 CFMS Annual Review APRIL 2012 Creative Works
The original Trevor laughed nas- ING,” and featured an action shot of Carter raised an eyebrow. “You tily. “Ooh, ya got me! Chain me up the ongoing fight. know our … generous host is a neuro- and take me to county!” The Trevor “You think they’ll win?” Friedman surgeon, right?” clones shuffled restlessly. Original asked. Friedman went to argue, then Trevor turned to them and gave a sin- “The Immune Squad?” Carter thought better of it. “Ah well. At least gle command: folded up his paper. “Nah. This adeno- he’s not an anaesthetist, am I right? “Sic ’em.” ma’s too big for them to handle. Now those folks are creepy! With the Back in the office, Carter and Probably have to wait for the … what’s- needles and the stabbing and the pok- Friedman both perused their papers his-name, the knife-guy. The surgeon.” ing …” contentedly. The headline Friedman shuddered. “Man, I Carter rolled his eyes and went announced “PARATHYROID ADE- hate those guys. Cutting stuff out, dic- back to his paper. NOMA FOUND — HELP COM- ing stuff up …”
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APRIL 2012 CFMS Annual Review 63 Creative Works
Shadow of you
Ahmad Abdullah University of British Columbia, Class of 2015
ust as the alarm went off, Eva “psycho” she didn’t take him seriously and quickly started to scribble some- Jswiftly leapt out of her bed and — but still firmly said “no.” She even thing down, taking a peek at Eva’s splashed her face with ice-cold tried explaining herself as best she shadow every now and then. The water before running downstairs. The could. Often times though, she would group of medical students discussed fear of being late yet again was loom- wonder what was really going on inside Michael’s condition, unaware of what ing over her head, so she bolted his head. No one could ever know. he was doing, while Eva could not take through the doors and into her car to her eyes off of him. She was extremely head for Riverview Hospital. Today curious as to what he was writing. His was her last day of volunteering in the face was red, as if he was on the verge psychiatry unit. She instantly of exploding with anger. His hand Her mind was overflowing with moved quickly across the pad as he mixed feelings. There was the excite- realized wrote. One could almost hear it from ment of returning home to Ottawa. yards away. When he reached half way There was a peculiar sadness about these spots on the page, Eva noticed his expres- saying goodbye. But one thought that sions had softened up quite a bit and continuously overwhelmed her was were Michael’s something was dripping onto his pad. whether or not she had treated She stood still for a while wondering Michael, the 20-year-old male psy- dried tears. what to do. Confused and unsure, she chosis patient in bed #18, properly. went on with her normal routine for She was not sure what to think of the day until it came time for her to him. Michael was definitely the most leave. unusual, most interesting and most Late in the evening, Eva and a Eva had one step out the door frightening patient she had met over team of medical students came to when she noticed Michael coming the last 3 years of volunteering. He Michael’s bed. This was the last time toward her. She was terrified, but kept would frequently be found talking to she would see him, and she wondered composed and forced out a smile. himself about his gold mountain if Michael was aware of this. Michael ripped the front page off the somewhere in the Arabian desert, his Everything seemed normal, until she writing pad, handed it to Eva and alien friends and his collection of 50 noticed that he was no longer staring silently left. Not a single word. Eva thousand replicas of King Tut’s mask. into her eyes. Instead, he had his gaze stood still for a while. She did not feel He would rarely notice anyone else fixed on her slender, dark shadow on the courage to read the page there and around him. And then his piercing- the ground. The shadow had formed then, so she put it into her bag. yet-soft stare, mixed with a peculiar as the glistening rays of the setting sun A few hours later, Eva was enjoy- hint of affection, would make Eva feel came through the window and shone ing her snack on her return flight even more uncomfortable. Once, he on Eva’s delicate body. home when she remembered the paper even passionately said “I love you” to But then something very strange that Michael had given her. She took it her during a spontaneous attempt at occurred. Michael pulled a pad of out and opened it. It looked like a conversation. Thinking he was just a paper out from underneath his pillow poem. It read:
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“The rebellious rays of light Nothing can separate us I boastfully bet Escaping the sun’s fierce might Until sadly it’s time for the sun to set Piercing through the clear sky Alas it’s how the world works With a zeal quite high It doesn’t ever have regrets Come falling down upon you The sun slowly drifts away into the sky’s wilderness And brighten everything around you And I painfully begin to fade away into nothingness
And so I am born As the darkness dissolves me into itself I have nothing to adorn I curse the setting sun over the continental shelf Dark, black, faceless And then begins the endless wait But existing with some strange blissfulness For the next dawn to break I have no control whatsoever So I can be born anew But I would rather stay this way forever And spend the next bright day with you
As long as the sun shines in its full glory This is what I think every lonely night And the clouds stay away from this story This is what a day in my life would be like I follow you everywhere you go Yes every night would be a dark storm Mark your every step and so And since you turned me down in my human form You sing and run and boisterously frolic O my love wish I was a shadow of you And I enjoy your presence like an alcoholic My very existence would be because of you”
She noticed smudging of the ink spots were Michael’s dried tears. Not of the same spots that Michael had at some spots on the paper. It knowing what to do or how to feel, shed his own tears earlier. appeared as if something had dripped she burst into tears. Her teardrops fell on it. She instantly realized these onto the paper … perhaps onto some
APRIL 2012 CFMS Annual Review 65 Creative Works
UBC Camp Alia Dharamsi, University of British Columbia, class of 2014 (counterclockwise from bottom) Alia Dharamsi, Devon Rasmussen, Harpreet Ghuman, Candace Pearson, Gavin Wilson, Matthew Miles, Andrew Hurlburt, Lawrance Chow, Thomas De Los Scarred Reyes Mark Lipson Camp Makefriends was a weekend away for new UBC MD and DMDs to get to University of Manitoba, class of 2012 know each other, relax after their first week of classes, and make some lifelong memories.
Greece Sarah Blowers, Memorial University, class of 2013 Summer vacation in Greece with 5 of my best friends, fellow MUN class of 2013 classmates. We have all seen each other through the thick and thin over the past three years of medical school … and I figure that’s worth celebrating! (l to r: Meighan Kelly, Jessica Downing, Kayla Churchill, Kelly Au, Sarah Blowers, Sarah Hann)
66 CFMS Annual Review APRIL 2012 Creative Works
Satelite on mud hut Tanu Sharma, University of Torornto, class of 2012
View Tanu Sharma, University of Torornto, class of 2012 This photograph was taken in Mbeya, Tanzania from the back of a pick-up truck where I sat with a dying Maasai woman whom we were transporting to hospital.
Septra Tanzania Tanu Sharma, University of Torornto, class of 2012 Health card This is a photograph of the packaging Tanu Sharma, University of Torornto, class of process of TMP/SMX for distribution to 2012 patients with HIV/AIDS in rural Tanzania.We This is a photograph of the old version of spent hours counting and hand packaging the health card. Although a dying breed, this hundreds of sachets for distribution. card is still in use and this photograph suggests that our current health care system may “crack” under the current model.
Stormy Unveil Yingwei Liu, University of Ottawa, class of 2013
APRIL 2012 CFMS Annual Review 67 You’ve committed to helping others. So we’re committed to helping you. Our commitment to your success is to provide convenient, personalized banking solutions to help you save money, while freeing up more time for your studies. Our RBC Plan for Medical & Dental Students includes: Free† student banking RBC Rewards® Visa‡ Gold Card with no annual fee A student line of credit1 up to $200,000 Discounted car loan rates All through a dedicated RBC® medical and dental student specialist, your single point of contact for your fi nancial needs and advice.
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CFMS Executive 2011–12
Noura Hassan Matthew Sheppard Renee Pang Paxton Bach President Past President VP Education VP Global Health [email protected] [email protected] [email protected] [email protected]
Matthew Tenenbaum Jesse Kancir Chloé Ward Robin Clouston VP Communications VP Finance VP Advocacy VP Services [email protected] [email protected] [email protected] [email protected]
Alyssa Cruz Chris Skappak Melanie Rodrigues Ian Brasg Western Regional Representative Western Regional Representative Ontario Regional Representative Ontario Regional Representative [email protected] [email protected] [email protected] [email protected]
Phil Vourtzoumis Will Stymiest Quebec Regional Representative Atlantic Regional Representative [email protected] [email protected] Officers 2011–12 Natalia Ng ...... Wellness ...... [email protected] Wilson Kwong ...... Annual Review Editor (Publications) ...... [email protected] Maegan Springman ...... Blood Drive ...... [email protected] Nima Kashani ...... Information Technology Sr...... [email protected] Joanna Li ...... Information Technology Jr...... [email protected] Daniel Rosenfield ...... IPE Officer ...... [email protected] Cait Champion ...... Alumni Affairs ...... [email protected]
APRIL 2012 CFMS Annual Review 69 Your CFMS Executive and Representatives
MEDSOC Presidents 2011–12 Michael Yang University of British Columbia [email protected] Anthony Lott University of Alberta [email protected] Andrea Deurome University of Calgary [email protected] Melissa Anderson University of Saskatchewan [email protected] Mark Lipson University of Manitoba [email protected] OR [email protected] Vanessa Ellies Northern Ontario School of Medicine [email protected] Rob Moreland University of Western Ontario [email protected] Caryn Green McMaster University [email protected] Ahmed Taher University of Toronto [email protected] Vinay Garg Queen’s University [email protected] OR [email protected] Josh Koczerginski University of Ottawa [email protected] Elsi Osmanlliu McGill University [email protected] Mike MacDonald Dalhousie University [email protected] Fady Kamel Memorial University [email protected]
MEDSOC Senior and Junior CFMS Representatives 2011–12 Kate Milne — Sr. University of British Columbia [email protected] Mimi Lermer — Jr. [email protected] Rannie Tao — Sr. University of Alberta [email protected] Sarah Stonehocker — Jr. [email protected] Urooj Chaudry — Sr. University of Calgary [email protected] Chris Skappak — Jr. [email protected] Allison Finningley — Sr. University of Saskatchewan [email protected] Lindsay Anderson — Jr. [email protected] Terry Colbourne — Sr. University of Manitoba [email protected]
Dana Zoratto — Sr. Northern Ontario School of Medicine [email protected] Sean Bryan — Jr. [email protected] David Mikhai — Sr. University of Western Ontario [email protected] Adam Papini — Jr. [email protected] Yixin Xie — Sr. McMaster University [email protected] Parmian Arjmand — Jr. [email protected] Jesse Kancir — Sr. University of Toronto [email protected] Sabrina Nurmohamed — Jr. [email protected] Fahima Dossa — Sr. Queen’s University [email protected] OR [email protected] Soniya Sharma — Jr. [email protected] OR [email protected] Stephanie Kenny — Sr. University of Ottawa [email protected] Nahid Punjani — Jr. [email protected] Marina Ibrahim — Sr. McGill University [email protected]
Jennifer Gillis — Sr. Dalhousie University [email protected] Will Stymiest — Jr. [email protected] David Harnett — Sr. Memorial University [email protected] Laura Butler — Jr. [email protected]
70 CFMS Annual Review APRIL 2012 We know that being healthy is all about being informed.
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