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Department of Medicine – Self‐Study 2012

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INTRODUCTION

The Department of Medicine was asked to prepare a self‐study document outlining the

current status of the department, its accomplishments since the last review in 2009 and

ongoing and future challenges in the context of the search for a new Chair of the

Department of Medicine, McGill University and Physician‐in‐Chief of the McGill

University Health Centre (MUHC). The reference period for this report is thus April 2009

to December 31, 2011.

The goal of this document is to provide a snapshot of the Department at a critical point

in its evolution as it deals with major challenges related to the move of services to the

new Glen site and the redevelopment plan associated with this move. Extensive

reorganization of clinical services resulting from the closure of the Royal Victoria

Hospital (RVH) site, the re‐location of teaching and the transfer of research laboratories

will require informed leadership. Strategic decisions driven by the new physical plant

will challenge the Department leadership in the coming years but will provide

opportunities for a re‐thinking of the possibilities, clinical and academic, associated with

the new plan. Redevelopment at the Jewish General Hospital (JGH) site and St. Mary's

Hospital (SMH) will provide enhanced capacity in certain research and clinical areas that

will create opportunities for complementary programs and networking across sites to

maximize academic performance.

The McGill University Department of Medicine aims to be the leading department of

medicine in Canada. It strives to deliver high quality medical care, to educate its medical

students and residents and to perform medically pertinent research at the highest level.

Its many accomplished faculty members fly the flag of the McGill University Medical

Faculty in high level forums nationally and internationally.


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Y

The Department of Medicine is a large, multifaceted academic and clinical organization

built around the medical services of McGill’s principal teaching hospitals: the MUHC, the

JGH and SMH. In addition to clinical and teaching services directly related to patient

care, the Department includes a broad array of research programs and serves as the

host for one of the largest graduate programs within the university, administered

through the Division of Experimental Medicine. Whereas historically the research

activities of the Department were largely confined to the University Medical Clinics of

the MGH and the RVH, the Department’s research effort now extends to all McGill

hospitals and to the McGill campus through cross‐appointments and by the

contributions of its researchers based within the Research Institute of the MUHC

(MUHCRI) and the Lady Davis Research Institute (LDI), the Genome Centre, the Bellini

Life Sciences Complex and the Goodman Cancer Centre. The educational contributions

of the Department are central to the workings of the entire Faculty of Medicine. In

addition to leading roles in many aspects of the pre‐clinical MD curriculum and

contributions to the teaching of clinical internal medicine and its sub‐specialties,

members of the Department are highly present in the Deanery and the Centre for

Medical Education, where they help shape the course and direction for the

development of the Faculty as a whole. Similarly, members of the Department play

central roles in hospital administration. As the major research‐oriented clinical

department within the University, the members of the Department also have key

leadership roles in the MUHCRI and the LDI of the JGH.

I. FACULT

The Department currently counts roughly 840 members on its books, 490 full and 350

part‐time. Of the 490 full time‐time members with primary academic appointments in

the Department of Medicine (see Appendix I A), 285 hold Contract Academic Staff

(clinical) appointments, 160 are tenured (five post‐retirement tenured faculty are not

counted in this number) and 20 are in tenure‐track positions. Of the 160 tenured

members of the Department, they are 88 PhD scientists and 72 clinician‐scientists. At


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the rank of full professor (tenured), there are an equal number of PhD scientists (53)

and clinician‐scientists (53), for a total of 106. At the rank of associate professor

(tenured), there are more PhD scientists (35) than clinician‐scientists (19), for a total of

54. Of the 350 part time faculty members who hold secondary academic appointments

in the Department (see APPENDIX I B), over 130 of these are in part‐time clinical

appointments and there are over 120 adjunct or affiliate members and 70 associate

members. There are more than 25 who hold either (part‐time) professor emeritus or

post‐retirement appointments.

Since the last review, there was modest growth in the Department’s ranks (Appendix 1

FACULTY C), with a total of 67 hires from 2009‐2011. In 2009, there was a total of 22

new hires – 10 of whom were hired into full time positions (four tenure‐track, one

tenured and five contract academic staff) the other 12 into part‐time appointments –

against a total decrease of six staff (voluntary departures or deaths). In 2010 and 2011,

there were 24 hires/7 losses and 21 hires/12 losses, respectively. It must be appreciated

that hiring into clinical positions is dependent on availability of PEMs (Plan d’effectifs

médicaux). This results in significant constraints in the ability to hire sometimes

excellent candidates for whom positions are not readily available.

Method of Orientation of New Faculty Members to Faculty and Hospital Policies and

Procedures

All new clinical faculty members are asked to meet with the Chair and the Physician in

Chief, as one of the first steps in beginning the appointment process. The objectives of

this meeting are to confirm the “fit” of the candidate with overall departmental

priorities, explore and explain how teaching and research will fit with the clinical

activities of the candidate, and to advise the candidate regarding promotions. See

appendix A, Pathways for Appointment of CAS. The letter of offer (see appendix B, CAS

Letter of Offer Template) draws attention to a number of university and faculty

regulations, as well as hospital specific regulations. New faculty members are invited to


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the New Faculty Orientation Workshop, organized and run by the Faculty of Medicine

Faculty Development Office as well as the University orientations. These invitations are

managed through the Faculty and University, rather than by the department.

Attendance is voluntary. Tenure‐track candidates (currently on hold) are also

interviewed and detailed explanations of the responsibilities of the candidate towards

the University and the expectations of the Department are provided. Targets are set for

teaching and for research productivity. Strategies for successful acquisition of operating

funds and a salary award are discussed. The importance of mentoring is stressed and

candidates for this role are proposed. Timelines for evaluation for re‐appointment and

for consideration for promotion and tenure are explained. Further opportunities for

formal review occur at the time of consideration of re‐appointment for tenure‐track

faculty when candidates meet with a re‐appointment committee to review progress.

Annual Performance Reviews

At the Faculty of Medicine’s initiative, in 2010 all departments began regular, individual

annual performance reviews for all full time members. Previously, these had occurred

only for tenure track members, who were the minority of our Department members.

Although time consuming for leaders, this has been an excellent and worthwhile

exercise, leading to opportunities for leaders to better appreciate the accomplishments

of their members, and to provide guidance and mentoring for career development and

promotion. It is an exercise which also helps communicate the standards consistent

with practice within an academic centre.

A detailed list of members of the faculty on Committees of the Hospital and Faculty and

a record of promotions of faculty since the last review can be found in Appendices I‐H.

and I‐L., respectively.


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E II. DEPARTMENTAL ADMINISTRATION AND GOVERNANC

All organizational charts related to this section can be found in Appendix II A.

The McGill Department of Medicine is directed by the Executive Committee. Led by the

Department Chair, this committee includes the Physicians‐in‐Chief of the MUHC

(currently the Interim Chief), JGH and St. Mary’s along with the Vice‐Chairs for Faculty

Affairs (held currently by the Interim Chair), Education (held by the Interim Chief,

MUHC) and Research (held by the Physician in Chief, JGH). This committee meets

formally four or more times per year but its members are in active communication by

email and by phone to oversee key issues across the Department. In particular, the

Executive reviews the rationale for all hiring across sites, assists in developing policy for

the Department as a whole and acts as a mechanism for communication and

harmonization across the hospital sites. It oversees the production of a newsletter that

keeps members of the Department abreast of news related to other members and their

achievements and contributions, as well as events that touch the Department in

different ways.

Currently the Executive Committee (EC) of the Department of Medicine is chaired by Dr.

James G. Martin, Interim Chair of the Department of Medicine and Vice‐Chair, Academic

Affairs. The other current members are Dr. Joyce Pickering, Interim Physician‐in‐Chief of

the MUHC and Vice‐Chair, Education, Dr. Ernesto Schiffrin, Physician‐in‐Chief of the JGH

and Vice‐Chair, Research, and Dr. Michael Bonnycastle, Physician‐in‐Chief of St. Mary’s

Hospital.

The office of the Chair, Department of Medicine / Physician‐in‐Chief, MUHC is staffed by

three McGill employees ‐ Teresa Alper, Manager, Debbie Carr, Budget Officer, Josée P.

Cloutier, Senior Administrative Officer and by two MUHC employees – Mrs. Domenica


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Cami, who is Executive Assistant to the Chair and the Chief, and Mrs. Emily Di Lauro,

Administrative Officer.

The Department of Medicine offices at both the JGH and St. Mary’s Hospital are staffed

by hospital clerical employees. There is no direct university financial contribution to

staffing the departmental offices at these sites, although major activity related to the

university is handled, particularly at the JGH, where there are more than 200 members

of the McGill Department of Medicine including tenured professors, CAS and PhDs, the

latter mostly based at the LDI. There are approximately 50 members at St. Mary's

Hospital.

Hospitals and Divisions

Traditionally Departments of Medicine in North America are organized around divisions

that are established based on the area of specialization, usually related to specific organ

systems. Teaching is also traditionally delivered around these same organ systems.

Research is less neatly organized in this manner. However medical scientists are also

assigned to divisions but there may be considerable overlap in the principal research

interests among scientists appointed within the different divisions. Research faculty

members are located in one of the principal teaching hospitals: MUHC, JGH and St.

Mary’s Hospital and are often cross‐appointed through the hospitals at more than one

site if their clinical activities require it. Most of the divisions are led by a director with

responsibilities for the university‐wide functions of the division and who is also a chief at

one of the major sites. In these instances the division director is assisted in his or her

administrative tasks by chiefs at the other sites. Other divisions still have exclusively

hospital‐based leadership and do not have a McGill Division Director. In some cases, the

McGill Director may serve as chief in multiple hospitals, allowing for a more integrated

organization of clinical care. There has been much inter‐institutional competition in the

past but this is diminishing with the need for integration and rationalization of services.

A particular effort of the Executive of the Department has been directed over the past


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few years toward achieving collegiality and unity of purpose as well as creating closer

relationships and cooperation between divisions in the different hospitals of the McGill

system.

The McGill Division Director is responsible for oversight of education within their

subspecialty, particularly the specialty training of residents and clinical fellows. In many

divisions, there is specific responsibility for medical undergraduate teaching either in

the Basis of Medicine or during the hospital phases of medical school. In contrast, the

Clinical Division Director, in addition to responsibilities for overseeing the provision of

clinical care, is also usually responsible for leading the site‐specific research programs.

The strength of research within divisions is therefore sensitive to the interests and

competence of the hospital divisional director in the area of research. The dependence

of clinical research on hospital resources including the FRQ‐S Research Centre system

and hospital based philanthropy often encourages research at a specific site rather than

supporting the concept of programs of research that span multiple sites.

The MUHC has been given a mandate by the Ministry of Health as a university medical

centre, responsible for tertiary and quaternary care. Thus, within the MUHC there is a

well‐established university culture. The JGH, which for many years had the culture of a

university affiliated teaching hospital with relatively modest academic ambitions, has

over the last 20 years emerged as a strong player with a manifest desire to be a leading

university health centre. This growth and development has been the product of the

efforts of excellent academic leadership, in particular that of Dr. E. Schiffrin, in the

hospital Department of Medicine at the JGH who is supported in his efforts y Dr. R.

McInnis, Scientific Director of the LDI. This evolution of stronger academic programs at

the JGH has been very beneficial to the Department, helping to support new

recruitment and to promote growth in key areas. Nevertheless, academic activities at

both the MUHC and the JGH are highly dependent on support from hospital structures

and funds from hospital donors. These considerations, as well as physical separation of


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the sites has often prevented the development of more collaborative programs of

research. In the educational mission, which involves faculty members from all sites

working closely together, collaboration and coordination are the norm.

In the case of St. Mary’s, the situation is somewhat less complex. A community hospital

with a strong presence of the Department of Family Medicine, St. Mary’s was recently

recognized as a Centre hospitalier affilié universitaire. This status is expected to serve as

an impetus for St. Mary’s to play an increasing role in the Department’s clinical

educational efforts, particularly in the core internal medicine training program. Its

members engage in teaching and research.

Strategic Plan

The Department has not undertaken a formal strategic planning exercise. Instead, it is

participating in strategic planning exercises being conducted by the Faculty of Medicine,

the MUHC and the Research Institute of the MUHC, all more or less in parallel. There is

substantial participation of key departmental leaders in all planning exercises. There are

plans to establish a departmental research committee at the MUHC, with a mandate to

review annual progress on all new recruits funded for research by the Department and

to develop proposals for a more sustained and robust career path for faculty members

engaged in research. The JGH has a similar committee that reviews performance and

provides financial support for clinician researchers, in particular CAS. Clinician scientists

often receive stipends for a few years from the Department practice plan when they are

hired. This is intended to allow the clinician scientist to submit a strong application for

external support by the end of this support, usually three years. It should be noted that

a significant fraction of the financial support provided for many clinician scientists

comes from "taxation" of clinical earnings and reflects the commitment of clinicians to

support the academic mission of the respective institutions.


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Departmental Challenges, Opportunities and Activities

We identify three major challenges, as outlined below (A through C), followed by an

examination of the activities of the Department which can be considered under the

three major themes of teaching, research and clinical programs, in sections III, IV and V,

respectively.

A. The Core Residency Program is the Core

The Department counts on the core training program for the majority of its recruiting.

This program is our best chance to attract talented young clinicians and potential

clinician‐scientists from elsewhere in Canada. It is therefore essential that this program

be given priority with the expectation that it will emerge as the clear leader among

Canadian internal medicine core programs. This process has already begun with the

Clinical Teaching Unit (CTU) external review and will continue with a focused approach

on continual improvement of the quality of the educational experience. Further details

on the specific strengths and challenges for the core program are found in the section

on Education, below.

B. Develop a strategy for sustainable academic careers

Unlike a number of other Canadian academic medical centres, we do not have an

alternate funding plan (AFP). Instead, we have had a “two tier” system for clinicians,

where clinician scientists (spending at least 50% of their time on research activities) are

intended to be hired (or eventually move) into tenure‐track positions, allowing some

financial security and stability to their careers. In contrast, clinicians who are not

scientists are given little or no financial support from the university and department.

Clinician scientists not on tenure‐track may initially obtain outside awards, and be

eligible for “remuneration recherche” which gives them financial support for a number

of years, but in the current competitive environment, this support is uncertain. The

current near‐freeze on hiring into tenure‐track positions therefore leads to lack of

renewal both for PhD scientists and clinician scientists. Creative solutions, such as


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replacing tenure‐track positions with rolling contracts, or fund‐raising to provide the

means to support financially clinician‐scientists and educators and their programs are

needed.

C. Effectively Manage the Department during the MUHC redevelopment process

The closure of the RVH site and the opening of the Glen site are slated for 2015. Fewer

beds and smaller facilities mean that new models of clinical care will have to be actively

developed. A number of clinical activities may move out of a hospital environment.

Although most directly affecting the MUHC clinical services, this may well be felt at the

JGH and SMH and is expected to have a significant impact on our teaching programs.

The Research Institute will also move, and although overall this will be very positive,

during the transition period, research productivity, in particular for wet labs, may suffer.

Proactive measures to address this are currently being explored. The Health Outcomes

Axis of the MUHCRI is without research office space in the current plan. The RI has

articulated a clear plan for this problem, and the Department must continue to advocate

with the hospital redevelopment office to ensure that this comes to fruition.

III. Education

Charts outlining the organization of the education program are found in APPENDIX III‐A.

Undergraduate (MD,CM) Program

The Department has responsibility for medical undergraduate education including a

large portion of the Basis of Medicine, the Clinical Skills course and the Introduction to

Internal Medicine course. In addition, the Department provides clerkships in Medicine

at the three large hospitals (MUHC, SMH and JGH).


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The strengths of the undergraduate program are:

1. Strong educational leaders (Dr. Les Meissner (SMH) and until recently Dr. Jeff

Wiseman (RVH)), and excellent new leaders at the MGH (Dr. Bannerjee), the RVH

(Dr. Ghali), and the JGH (Dr. Cummings).

2. Funding for clinical supervision of students (and residents) since 2008, via RAMQ.

3. Funding for teaching of Introduction to Clinical Sciences (ICS) and Introduction to

Internal Medicine (IIM) students with a combination of funding from the Faculty

and from the Departmental practice plan.

4. Standardized learning experiences, including core learning sessions, evaluation

criteria, and rotation scheduling.

5. Availability on line of the teaching objectives and material.

6. A comprehensive on line, confidential system for evaluation of clerkship

students, faculties and rotations, (thanks to the one45 program from the Faculty

of Medicine), enabling quick correction of problems and detailed feedback to

faculty.

7. Use of a high quality standardized exam (the NBME clinical clerkship shelf exam)

for evaluating clinical clerks at the end of their clinical clerkship.

8. Resident teachers who are committed and enthusiastic about teaching.

9. Attending physicians who are generally rated very highly for their teaching and

supervision and have frequent contact with students.

10. A distributed site, in the Outaouais region of Gatineau, since 2010 allowing more

exposure to community internal medicine.

11. Exposure to a broad variety of clinical conditions that prepare them in a

comprehensive way for their future careers.

Weaknesses of the undergraduate program are:

1. Insufficient exposure to less complicated internal medicine problems,

particularly for those rotating at the MUHC and JGH, as these are tertiary and

quaternary care centers.


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2. Lack of standardization of teaching/evaluation of procedural and communication

skills.

3. Insufficient direct observation of students at the bedside.

Opportunities in the Undergraduate Program are:

1. The new curriculum, which will begin in 2013 will provide opportunities for early

clinical exposure and increased formalized critical appraisal. Although not

specific to the Department of Medicine, there is no doubt that our Department

members will be heavily involved.

2. The presence of video conferencing facilities at all sites means that increased

video conferencing especially including Gatineau clerkship students, is possible.

3. Increased use of sites such as Lakeshore Hospital and Lachine hospital may allow

more exposure to “community” internal medicine within Montreal.

4. The well established Community Hospital Internal Medicine Experience (CHIME)

resident rotations could be used to allow student exposure to community

internal medicine outside of Gatineau and Montreal.

Postgraduate Clinical Training Program

The centerpiece of specialty training in the Department remains the core internal

medicine program, led by Dr. Thomas Maniatis with the assistance of Drs. Josée Verdon

(RVH), Ruxandra Bunea (JGH) and Patrizia Zanelli (MGH). The program is responsible for

the training of medical residents in their first three postgraduate years. The program

also provides year 1 training for programs such as Neurology and Dermatology. We are

proud to offer a highly competitive and successful program that attracts residents from

McGill and across Canada. Over the years, this program has been the engine of faculty

recruitment, as given the constraints of the Québec system, it is not easy to recruit and

retain either clinicians or clinician‐scientists who have not already spent part of their

training here.


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Strengths of the Core Medicine Residency Training Program are:

1. A committed and innovative program director who has implemented many new

learning opportunities over the course of his tenure.

2. Committed and caring site directors and administrative staff who are very

supportive of the residents.

3. The Community Hospital Internal Medicine Experience (CHIME) rotations, where

residents experience the practice of internal medicine in community hospitals

remote from an academic centre.

4. A wide variety of clinical exposures, given the size and demographic composition

of the city.

5. The standardization of much teaching in the form of

a. Various simulation centre sessions focusing on technical, communication

and managerial skills.

b. A standardized curriculum for the academic half day sessions.

6. University wide academic evening sessions on clinical vignettes and resident

research yearly.

7. Funding for clinical supervision of residents from RAMQ.

8. Significant financial support from the Departmental practice plan for residency

activities, both social and academic.

9. Abolition of 24 hour in hospital call. It is now a maximum of 16 hours.

10. Purchase of ultrasound machines for the medical wards, with formal training for

all residents.

11. Committed and highly rated clinical teachers.

12. An opportunity for learning about longitudinal follow up of internal medicine

problems in the General Internal Medicine Clinic.

13. Regular opportunities for structured, formative assessment through yearly OSCE

exams and use of the standardized American Board of Internal Medicine in

training exam.

14. A wide choice of opportunities for participation in research.


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15. An opportunity to take a full time, one month course in clinical epidemiology

during the 2nd or third year.

Weaknesses of the Core Medicine Residency Training Program are:

1. Poor physical facilities, most marked at the RVH and MGH sites for

a. Patient care – many patients in 4 bed rooms with one sink and one toilet

b. Resident life ‐ Inconvenient location of much locker and relaxation space.

2. Inadequate access to prompt procedures (largely radiology procedures) leading

to inefficient use of time by residents and unnecessary extra days in hospitals for

patients.

3. Inadequate facilities and support for supportive care for patients – rehabilitation

facilities, long term care facilities etc, leading to insufficient ward “turnover” and

thus decreasing opportunities for clinical exposure on inpatient units.

4. Insufficient weekend and holiday support from pharmacy, social services,

physiotherapy etc. leading to inefficient time use by residents.

Opportunities in the Core Medicine Training Program are:

1. Increased numbers of GIM fellows, who rotate as "junior attending physicians"

on the ward, providing excellent teaching and role modeling for our residents.

2. Recent creation of a RVH site director, separate from the overall program

director, allowing the overall program director to focus more on educational

rather than administrative and logistical aspects of the program.

3. Designation of an additional faculty member to oversee quality initiatives,

allowing residents to observe and participate in more quality improvement

activities.

4. Designation of a Director of Evaluation for the core program (Dr. Ahsan Alam)

allowing for a more standardized evaluation reviews, as well as relieving

program directors of some responsibilities.


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Plans for recruitment specifically in the area of education:

1. Dr. Ning‐Zi Sun, as a clinician scientist in the area of education, in General

Internal Medicine to begin in 2014.

2. Dr. Stephane Beaudoin, as a clinical teacher in respirology, to being in 2013.

3. Dr. Blair Schwartz, currently at Johns Hopkins Hospitals, learning to perform

research on Quality of Care, will join the Division of Internal Medicine at the JGH

in 2013, and will also be carrying out activities as attending in ICU.

In addition to the core training program, each of the divisions supports specialty training

recognized by the Royal College of Physicians and Surgeons of Canada (RCPSC) and the

Collège des Médecins du Québec. At this writing, all of the Department’s specialty

programs are fully accredited.

The Graduate Program [Division of Experimental Medicine]

The Department hosts the Division of Experimental Medicine, which runs one of the

largest graduate programs in the Faculty. This program provides training at both the

PhD and MSc levels in clinical and translational experimental research for the

Departments of Medicine, Pediatrics and Oncology along with a few students from

other departments. Since its inception, the program has also hosted students from the

Institut de Recherche Clinique de Montréal. In addition to its core programs, the Division

hosts a PhD program in Medical Ethics, and recently established the first graduate

program in Family Medicine in Canada. The experimental medicine program continues

to be highly successful with more than 200 students at any time.

Strengths of the Graduate (Experimental Medicine) Program are:

1. The division is served by a Student Affairs Officer (Ms. Dominique Besso) and a

Student Affairs Coordinator (Ms. Marylin Linhares). The Division is known for

personal service and concern shown for student success and well‐being of over

three hundred students enrolled the program.


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2. The Division has over 100 faculty with active research programs located primarily

at the five teaching hospitals affiliated with McGill University. The diversity and

excellence of the research is reflected in the quality of the courses offered in the

graduate program.

3. The Division offers thirty 500 or 600 upper level courses. To meet increasing

demand, four new courses have been created over the past three years.

4. On a trial basis a part‐time position was created to facilitate the tracking of

student performance by taking charge of the scheduling of the hundreds of the

thesis committee meetings that must take place each year. Performance

tracking, now considered mandatory by McGill University, has always been a

priority since the Division was created over thirty‐five years ago.

Weaknesses of the Graduate (Experimental Medicine) Program are:

1. Ensuring that performance of all students is tracked effectively has become an

administrative problem in view of the large numbers in the program.

2. Experimental Medicine 500 level courses are open to undergraduates from all

the Faculties of Science and Medicine. Increased enrolment is putting pressure

on the Experimental Medicine Program and class size is increasing. A class

enrolment of 500 and 600 level courses should be no more than 25 to avoid

compromising the quality of the teaching.

3. Despite the creation of new courses, more are needed to satisfy demand and

increase the breadth of material that is covered. Poorly attended courses need

to be retired.

4. Recruitment of quality graduate students candidates is currently too passive. To

enroll the best students a more pro‐active approach to recruitment is needed.

Timely review of applications with early acceptance letters will also help in this

process.


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Opportunities in the Graduate (Experimental Medicine) Program are:

1. There are excellent teaching opportunities in the Division of Experimental

Medicine. As the nature of the research within the Department of Medicine

diversifies, the creation of new courses is facilitated.

2. Like all graduate programs at McGill University, the Division of Experimental

Medicine is competing with the many other graduate training opportunities

across North America

3. The Faculty of Medicine has consolidated all its recruitment award money and

gives this directly to each graduate program allowing them to disburse this as

they see fit. Currently the awards are used to “top up” stipends provided by

supervisors and are intended to recruit and retain the best students. These

awards are made on a merit basis based upon cPGA as the most accessible

parameter of academic achievement. The effectiveness of this process should be

reviewed and other models for disbursement considered including creation of

recruitment scholarships.

IV. Research

As in most medical schools the McGill Department of Medicine serves a key role as a

driver of fundamental biomedical, clinical and translational research. Its research

programs span a wide gamut of activities ranging from the establishing of risk for

disease through genetics and genomics to studies of optimal health care delivery and

policy. The research therefore spans all four pillars as defined by the Canadian Institutes

of Health Research. Among the faculty there are researchers that are internationally

known for their work in infectious diseases such as tuberculosis, malaria and

leishmaniasis, in diabetes and metabolism, in asthma, chronic obstructive pulmonary

disease, HIV, immune diseases, hypertension, vascular disease, lipidology, nutrition,

aging, pulmonary hypertension and adult congenital heart disease as well as other

forms of cardiovascular disease. They are at the cutting edge of the development of

modern tools for clinical data management and analysis. The scope of the research


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efforts is international, with contributions by faculty members to research and

education in Africa, India and South and Central America in addition to extensive

collaborations throughout the developed world.

Researchers within the Department are located in all of the hospital sites and with the

exception of St. Mary's there are wet and dry laboratories in all of these sites. St. Mary's

Research Centre focuses principally on health services research. Precise figures for the

space allocated to departmental researchers are not available at this time. While space

is rarely a limiting factor to productivity, the nature of the space is not optimal in many

instances. Buildings are old and renovation is costly. Dispersion of the researchers is also

a factor that favours isolation rather than integration, collaboration and cross‐

fertilization.

Research Recruitment

Despite a very challenging environment, we have been successful in recruiting a small

number of outstanding individuals to the Department. In 2009, two outstanding basic

scientists joined the ranks of the Department of Medicine in non‐tenure track positions ‐

Dr. Maziar Divangahi, an expert in immunity whose research focuses on the host

response to influenza and tuberculosis and Dr. Nitika Pai, an expert on point of care

testing for HIV. In 2010, we recruited a clinician‐scientist into a tenure‐track

appointment ‐ Dr. Nathalie Johnson. Dr. Johnson has an excellent track record of very

high quality publications in the area of lymphoma treatment. One of our foreign recruits

– Dr. Ines Colmegna – joined the Division of Rheumatology as a clinician‐researcher and

has very successfully initiated her research area involving stem cells. In 2012 we hired

Dr. Jonathan Afilalo in Cardiology on tenure‐track. Dr. Afilalo is the winner of the Royal

College of Physicians of Canada Medal of Surgery for 2012, has received CIHR, FRSQ and

Heart and Stroke Foundation of Canada grants, and has been a prolific published author

even when he was one of our residents in the McGill Residency system. Further details

on all hires since 2009 appear in Appendix I‐C.


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Manpower challenges to the research enterprise

Clinician scientists: There are major problems of sustainability and renewal posed by the

current funding climate. There is a declining population of clinical scientists in North

America. The problem was identified in the late 70s. Research experience is not

mandated by many residency training programs across Canada and usually trainees are

exposed in only the most cursory of fashions to research. Although all new hires at a

teaching hospital in Quebec must have “formation complementaire”, this post residency

training is not necessarily in research.

As noted earlier, the near‐freeze on tenure‐track positions means that our new hires are

almost exclusively CAS. The resulting balance of CAS to tenure‐track faculty is such that

it is difficult to maintain a culture of research without the critical mass of committed

clinical scientists. Indeed there is no viable long term career structure in place without

the tenure system. Clinician scientists that secure a salary award may benefit from

"remuneration recherche", a billing option which allows specialists to be paid by the

Regie d’assurance maladie du Quebec (RAMQ) for their research time. However, on

cessation of the salary award, this financial support evaporates. It is difficult to envisage

ongoing research productivity when all salary support disappears.

The medical scientist: The lack of tenure‐track positions has brought the hiring of PhD

scientists to a halt. The current cohort will face increasing difficulties with the

acquisition of research operating funds. Already we are witnessing a higher failure rate

at the time of consideration for promotion and tenure. The quality of our medical

scientists has not changed radically but the funding landscape has. The Canadian

Institutes of Health Research are re‐orienting their research programs away from

fundamental biomedical research and clinical research (pillars I and II) to research that is

more related to health services and health policy. The bulk of our medical scientists are

engaged in research that falls into the category of basic biomedical research and their

careers are threatened by these new orientations at CIHR.


of 23

Whereas the previous 5‐year period (2004‐2009) witnessed the recruitment of 12 new

tenure track clinicians (against 3 departures), 8 of whom were at the Assistant Professor

level, since 2009, there have been only two tenure track clinicians hired against 10

losses, a worrisome trend.

The Redevelopment Project – impact on research

By 2015 a major part of our Department will move to the Glen Yards. The new

configuration of the research institute will result in a move towards integration of many

groups currently dispersed throughout our various sites. The increased cohesion will

create opportunities for collaboration not before recognized. The development of core

facilities may promote research that was previously not possible for lack of resources

and expertise. An opportunity to change the hospital culture towards one more

conducive to that of an academic centre will be provided.

The move to the Glen Yards site will no doubt be a challenging task. A likely decline in

research productivity during the time of the move is being addressed proactively by the

RI leadership. There is currently a lack of information about the precise configuration of

some of the research groups attributable to the uncertainty about the number of

recognized funded investigators that will qualify for space, the number of possible

retirements between now and then and other considerations. Certain researchers,

such as those that are engaged in clinical epidemiology and in clinical research, find

themselves without any dedicated office space. Discussions have been initiated by these

researchers to solve this problem. The Centre for Innovative Medicine has been

developed so as to provide infrastructure for clinical research with a major emphasis on

pharmaceutical contract research and access will be on a fee‐for‐service basis. The

Department hopes that this facility will provide an ideal location for the investigators

involved in investigator‐initiated clinical research to pursue their studies in an affordable

manner.


of 23

Research Performance

Although weaknesses in our data gathering ability prevent completely accurate figures

from being provided, the Department is highly research intensive with more than $287

million in research funding during the period spanning 2008‐2011, with an average of

close to $96 million per year (Appendix IV RESEARCH PROGRAM B &C). The members of

the Department are highly productive, publishing a yearly average of 1250 papers per

year (Appendix I FACULTY F). A limitation of our current situation is difficulty in

benchmarking ourselves against other institutions. In addition, the size and breadth of

our Department, the growth of research that crosses departmental boundaries, and the

role played by the Research Institute of the MUHC and the LDI make it difficult to

abstract out activities that are specific to the department.

Grant Funding

The data for the current report include funding received by both full members and

Associate members; this latter group was not included when calculating research

funding data for the report previously submitted in 2009. As this latter group represents

approximately 14% of the total membership in the Department, it is reasonable to

expect that – everything else being equal ‐ the research data reported in the current

2012 report will be higher by approximately 14%. This assumption is borne out, if one

compares the data reported in the previous report for 2007‐2008, where total research

funding (across all sites, and including both peer‐reviewed and non peer‐reviewed

funding) came in at approximately $72 million, compared to the data for 2008‐09 which

comes in at approximately $92 million. For the three‐year period 2008‐2011, peer‐

reviewed funding (excluding career awards) has remained relatively stable from, at close

to $60 million per year (MUHC and JGH combined). As the Department has increased in

size by approximately 3%, this reflects a decrease per member of 3%.

The fact that the Department has been able to maintain close to stable funding in the

context of the challenges noted earlier in this report, is a testament to the strengths of


of 23

of academic performance are reasonably encouraging, and our educational programs

are strong and innovative.

The new Chair and Chief will have many challenges to face. Relocation of a major

portion of the clinical, teaching and research activities to a new site and the

coordination of the move will be a time‐consuming task. With the move, opportunities

will arise for enhanced academic performance through the bringing together of a large

number of investigators and clinicians on a single site. The re‐grouping of faculty

members engaged in health services research as is being proposed by the MUHC

Research Institute will no doubt serve as a catalyst for new teams with novel questions.

The reduction in beds and outpatient space will create pressures that will also serve to

enhance rational planning across sites with a greater degree of collaboration than was

previously necessary. The requirements of the new medical curriculum will need to be

met. Intensive support and mentoring will be required for new faculty members to help

them negotiate the hurdles imposed by funding constraints.

Strong leadership will enable growth in the accomplishments of the Department in all of

these areas.

last first division1 rankmcg classif hired

ALAM AHSAN NEPHROLOGY ASST GFT-H 2009

BRODEUR CATHERINE GERIATRICS ASST PT 2009

CHEN BRIAN NEUROLOGY ASST FT 2009

DIVANGAHI MAZIAR RESPIRATORY ASST PT 2009

LOVETT AUDREY DERMATOLOGY ASST GFT-H 2009

MAJDAN AGNIESZKA ENDOCRINOLOGY ASST GFT-H 2009

NESSIM SHARON NEPHROLOGY ASST GFT-H 2009

NGUYEN DAO RESPIRATORY ASST GFT-U 2009

PAI NITIKA CLINICAL EPIDEMIOLOGY ASST FT 2009

WYSE JONATHAN GASTROENTEROLOGY ASST GFT-H 2009

YOUNG MEREDITH INTERNAL MEDICINE ASST FT 2009

AUDET RICHARD INTERNAL MEDICINE FAC LEC PT 2009

CASSIS CHANTAL HEMATOLOGY FAC LEC PT 2009

GILBERT ELISE INTERNAL MEDICINE FAC LEC PT 2009

GOETTKE MARKUS INTERNAL MEDICINE FAC LEC PT 2009

KENNEDY RICHARD INTERNAL MEDICINE FAC LEC PT 2009

PLOURDE PIERRE INTERNAL MEDICINE FAC LEC PT 2009

ROY PIERRE-OLIVIER INTERNAL MEDICINE FAC LEC PT 2009

SCHIFF RENEE CARDIOLOGY FAC LEC PT 2009

STARRA RON INTERNAL MEDICINE FAC LEC PT 2009

TAHAN MAJD INTERNAL MEDICINE FAC LEC PT 2009

THIBEAULT DENIS MEDICAL BIOCHEMISTRY FAC LEC PT 2009

NILSSON TOMMY ENDOCRINOLOGY PROF FT 2009

MUCSI ISTVAN NEPHROLOGY ASSC GFT-H 2010

BAASS ALEXIS MEDICAL BIOCHEMISTRY ASST GFT-H 2010

BAGLOLE CAROLYN RESPIRATORY ASST FT 2010

BESSISSOW TALAT GASTROENTEROLOGY ASST GFT-H 2010

BIRNBAUM LEORA GENERAL INTERNAL MEDICIN ASST GFT-H 2010

COLMEGNA INES RHEUMATOLOGY ASST GFT-H 2010

DANDONA SONNY CARDIOLOGY ASST GFT-H 2010

FALLAVOLLITA SABRINA RHEUMATOLOGY ASST GFT-H 2010

HU XIAO WEN ENDOCRINOLOGY ASST GFT-H 2010

JOHNSON NATHALIE HEMATOLOGY ASST FT 2010

LUBARSKY STUART NEUROLOGY ASST GFT-H 2010

MARDIGYAN VARTAN CARDIOLOGY ASST GFT-H 2010

MONDOU MELANIE GERIATRICS ASST GFT-H 2010

NGUYEN JENNIFER CARDIOLOGY ASST PT 2010

PALIOURAS MILTIADIS ASST PT 2010

ROSHDY OSAMA DERMATOLOGY ASST GFT-H 2010

THANASSOULIS GEORGE CARDIOLOGY ASST GFT-H 2010

VINET EVELYNE RHEUMATOLOGY ASST GFT-H 2010

VINH DONALD CUONG INFECTIOUS DISEASES ASST GFT-H 2010

WINSLADE NANCY GERIATRICS ASST PT 2010

YANSOUNI CEDRIC INFECTIOUS DISEASES ASST GFT-H 2010

LEBOVICH IRITH NEPHROLOGY FAC LEC PT 2010

GOLDSTEIN ROSE RHEUMATOLOGY PROF FT 2010

BERNIER MARTIN CARDIOLOGY ASST GFT-H 2011

BRUKNER IVAN MEDICINE ASST PT 2011

FILION KRISTIAN CLIN EPI ASST FT 2011

KHAN AHMAD FAIZ RESPIRATORY ASST PT 2011

LEE TODD INTERNAL MEDICINE ASST GFT-H 2011

PARENTE FABIENNE MEDICAL BIOCHEMISTRY ASST GFT-H 2011

PIAZZA NICOLO CARDIOLOGY ASST GFT-H 2011

SAKR LAMA RESPIRATORY ASST GFT-H 2011

SHAHIN JASON RESPIRATORY ASST GFT-H 2011

SJOSTROM JESPER NEUROSCIENCES ASST FT 2011

SMITH BENJAMIN M. RESPIRATORY MEDICINE ASST GFT-H 2011

TELTSCHER MARTY INFECTIOUS DISEASES ASST GFT-H 2011

VERMA ATUL CARDIOLOGY ASST PT 2011

BOISVERT DENIS GATINEAU FAC LEC PT 2011

DJIANA ROSE MEDICAL BIOCHEMISTRY FAC LEC PT 2011

DUMONT CHARLES INTERNAL MEDICINE FAC LEC PT 2011

FARAH ANTOINE GATINEAU FAC LEC PT 2011

GHAVAMI ALI GATINEAU FAC LEC PT 2011

GIARD FRANCOISE GATINEAU FAC LEC PT 2011

GIROUARD MICHELE GATINEAU FAC LEC PT 2011

LEVESQUE CLAUDE GATINEAU FAC LEC PT 2011

NGUYEN TANG THONG GATINEAU FAC LEC PT 2011

Appendix I: Honours, Awards and Prizes 2009-2010

Cardiology John Burgess’ book, Doctor to the North, made it to the Montreal Gazette bestseller list in June 2009 and it is still being talked about in 2010. Leon Glass has been awarded the distinction of American Association for the Advancement of Science (AAAS) Fellow. Robert Kiss is the winner of the Jonathan Ballon Award, presented to a researcher who achieves the highest rating for a first scientific project submitted to the Heart and Stroke Foundation of Québec. Allan Sniderman has been elected as a Fellow to the Royal Society of Canada.

Clinical Epidemiology

Nancy Mayo has been inducted as Fellow of the Canadian Academy of Health Science (CAHS) this fall 2010.

Clinical Immunology and Allergy Phil Gold has been inducted into The Canadian Medical Hall of Fame in Calgary on April 13, 2010. He was also elected Honorary Member of the Canadian Medical Association. Joseph Shuster was recognized with the MGH 2009 Award of Merit. Mark Wainberg was presented with the 2009 Medal of Honour by the Canadian Medical Association. He has also been awarded with the Prix Wilder-Penfield in biomedical sciences. Emil Skamene received the Masaryk Prize for Lifetime Achievements in Service to Czech community in Canada. Chris Tsoukas received the 2009 Anna-Marie Laroche Distinguished Immunologist Award.

Critical Care Maya Saleh has been awarded the 2010 Canadian Society for Immunology New Investigator Award.

Dermatology

Denis Sasseville received the Canadian Dermatology Association Residents’ Award for Best Teacher of the Year. Brenda Moroz is the recipient of a Lifetime Achievement Award by the Council of Physicians, Dentists and Pharmacists of the MCH.

Endocrinology

The Canadian National Proteomics Network (CNPN) has chosen John Bergeron as this year’s recipient of the CNPN’s Award for Outstanding Contribution and Leadership to the Canadian Proteomics Community. He is also the 2010 recipient of the Human Proteome Organization (HUPO) Discovery Award in Proteomics Sciences. Additionally, he is the recipient of the 2010 MGH Foundation Award from the MUHC-RI. Vassilios Papadopoulos has been awarded the distinction of American Association for the Advancement of Science (AAAS) Fellow. He has also been selected by the Government of Québec to be a member of an Advisory Group for its Québec Strategy for Research and Innovation. He is also the first recipient of the Dr. Phil Gold Chair in Medicine. Robert Sladek has been awarded the 2009 Young Investigator Award by the Canadian Society of Endocrinology and Metabolism. David Goltzman received the Ronald V. Christie Award of the Canadian Association of Professors of Medicine. The Richard and Sylvia Cruess Chair in Medical Education has been created.

Experimental Medicine

TMS Chang is the first President of the newly formed International Academy of Nanomedicine.

Gastroenterology Josée Parent has been elected Vice-President of the FMSQ for a two-year term. Ernest Seidman received the MGH Foundation Award.

General Internal Medicine Stella Daskalopoulou has been selected the 2009 Canadian Society of Internal Medicine New Investigator Award. She also received the 2009 Molson Foundation Award.

The Department of Medicine Physicianship Award was presented to David Dawson. Laurence Green received the Douglas Kinnear Award for outstanding clinician-teacher from the MUHC Department of Medicine. He is also the 2010 recipient of the Faculty of Medicine Osler Award. Thomas Maniatis has been selected for the Canadian Association of Medical Education (CAME) Certificate of Merit. He has also been presented with the Faculty Honour for Educational Excellence Award in June 2010. Furthermore, he is the recipient of the MUHC Department of Medicine Physician-in-Chief Award for highly distinguished servicethe Departmen

to t.

ty of

he

Suzanne Morin received the W.H. Philip Hill Award for outstanding clinician-teacher from the MUHC Department of Medicine. She is also the recipient of the 2009 Lindy Fraser Memorial Award from Osteoporosis Canada. Ernesto Schiffrin has been appointed Member of the Order of Canada. He has also been selected for the 2010 Bjorn Folkow Award and Lecture of the European SocieHypertension. Linda Snell has been chosen the 2010 recipient of The Association of Faculties of Medicine of Canada (AFMC) Award for Exemplary Contribution to Faculty Development in Canada. She also received the Certificate of Appreciation from the Dean, Faculty of Medicine. Vicky Tagalakis is the 2009 recipient of the JGH Auxiliary – Department of Medicine Academic Enrichment Award. Patrizia Zanelli received the MUHC Department of Medicine Physician-in-Chief Award for highly distinguished service to the Department. Laurence Green is this year’s recipient of the Osler Award presented by the Faculty. He also received the Douglas G. Kinnear Award for outstanding clinician-teacher from tMUHC Department of Medicine. Lucie Opatrny was nominated to the ASMIQ as representative of the Montreal region. Patrick Willemot was nominated to the Royal College of Physicians and Surgeons of Canada Examination Board in Internal Medicine. He also received the 2009 Jonathan Campbell Meakins and Meakins Family Memorial Fellowship. Louise Pilote received the RVH Foundation Award from the MUHC-RI Internal Scholarship and Awards Committee. David Dawson is the recipient of the Department of Medicine Physicianship Award for Exemplary Physician.

Geriatric Medicine

Allen Huang has been elected Fellow of the American Geriatrics Society.

Hematology

Jacques Galipeau earned top marks in Québec Science’s Top Ten Discoveries of 2009. The residents at the Jewish General Hospital voted Dr. April Shamy as Teacher of the Year. Chantal Seguin is the recipient of the Catherine & Stuart Townsend Fellowship Hematology Award. Michael Sebag received the Maurice Fast Award.

Infectious Diseases

Marcel Behr has been elected a member of the prestigious American Society for physician-scientists, to which Canadians are rarely admitted.

Meakins-Christie Laboratories

Simon Rousseau has been awarded the 2010-2011 Robbie Promising New Research Award.

Nephrology Marcelo Cantarovich has been elected on the Council of The Transplantation Society for the period of 2008-2012. He is also the President of the Canadian Society of Transplantation.

Neurology

Albert Aguayo is one of the first recipients of the inaugural McGill University Medal for Exceptional Academic Achievement. Michael Rasminsky is a recipient of the 2010 Canadian Association for Medical Education Certificate of Merit.

Anne-Louise Lafontaine was named Teacher of the Year by the McGill University Neurology Residents in 2010.

Nutrition and Food Science Center

Errol Marliss was appointed Fellow to the American Society for Nutrition.

Oncology Vincent Giguère has been elected as a Fellow to the Royal Society of Canada. Balfour Mount has been inducted into the Academy of Great Montrealers.

Respiratory Anne Gonzalez received the Department of Medicine Award for Innovation in Clinical Care. James Martin is this year's Distinguished Lecturer in Respiratory Sciences by the CIHR's Institute of Circulatory and Respiratory Medicine and the Canadian Thoracic

ociety. S

Madhukar Pai received the Core Teaching Award from the McGill Epidemiology, iostatistics and Occupational Health Student Society (EBOSS). B

Simon Rousseau has been awarded the 2010-2011 Robbie Promising New Research ward. A

Rheumatology

Sasha Bernatsky has been selected to receive the 2010 Canadian Rheumatology Association Young Investigator Award. She has also been selected as the recipient of the Mary Betty Stevens Young Investigator Prize of the Lupus Foundation of America. Henri Ménard received the MUHC Department of Medicine Staff Research Award. The Canadian Scleroderma Research Group (CSRG) directed by Murray Baron and the Scleroderma Society of Canada (SSC) received the 2009 CIHR Partnership Award. An electronic Adobe PDF version of this Appendix is available at the following website link: http://www.medicine.mcgill.ca/deptmedicine/home_annualreports_en.htm

http://www.medicine.mcgill.ca/deptmedicine/home_annualreports_en.htm

Appendix I: Honours, Awards and Prizes January to December 2011

Cardiology

James Brophy was elected to the Board of Directors of the newly created Institut national d’excellence en santé et en services sociaux (INESS). He was also elected as a Member of the McGill Senate. Jacques Genest has been inducted as Fellow of the Canadian Academy of Health Sciences. He has also been awarded the 2010 inaugural Margolese National Heart Disorders Prize by the UBC Faculty of Medicine. He was also reappointed to the McGill-Novartis Chair in Medicine for another 5 year term.

Richard I. Levin has been inducted as Fellow of the Canadian Academy of Health Sciences. Ariane Marelli is the 2011 recipient of the Heart Heroes Award by the Adult Congenital Heart Association. Maurice McGregor has been named Officer of the Order of Canada. Mathieu Walker is the recipient of the Osler Award.

Clinical Epidemiology

Theresa Gyorkos received the Canadian Public Health Association’s 2011 International Award.

Nitika Pant Pai & Madhukar Pai were presented with the 2011 Canadian Rising Stars in Global Health Award by Grand Challenges Canada in June 2011. Robyn Tamblyn has been appointed Scientific Director of CIHR’s Institute of Health Services and Policy Research.

Clinical Immunology and Allergy Phil Gold earned the McGill 2011 Medicine Alumni Global (MAG) Lifetime Achievement Award. Mark Wainberg has been elected Fellow of the American Association for the Advancement of Science. He also received an Honorary Doctorate from University of Montreal.

Critical Care Maya Saleh is the laureate of the 2011 inaugural Maude Abbott Prize established by the Faculty of Medicine. She is also the recipient of the Prix André Dupont from the Club de Recherches Cliniques du Québec.

Dermatology

Linda Moreau received the Canadian Dermatology Association Residents’ Award for Best Teacher of the Year.

Endocrinology

Sylvia Cruess has been named Officer of the Order of Canada. Laurent Lecanu is among Québec Science Magazine’s top ten discoveries of 2011. David Morris is the recipient of the 2010-2011 Department of Medicine Outreach Award. Vassilios Papadopoulos has been inducted as Fellow of the Canadian Academy of Health Sciences. He is also among Québec Science Magazine’s top ten discoveries of 2011. Robert Sladek is the 2011 recipient of the Joe Doupe Young Investigator Award by the Canadian Society for Clinical Investigation.

Gastroenterology George Ghattas and the RVH Endoscopy Unit received the CAG Quality Endoscopy Award. Josée Parent became the President of the Association of gastroenterologists of Québec.

General Internal Medicine David Dawson received the 2010-2011 Douglas G. Kinnear Award for outstanding clinician-teacher from the MUHC Department of Medicine. Michelle Elizov has been presented with the Faculty Honour for Educational Excellence Award.

Bert Govig has been named Fellow of the American College of Physicians in April 2011. David Hornstein is the recipient of the 2010-2011 Department of Medicine Physician Award for Exemplary Physician. Susan Kahn is the recipient of the 2011 Clinical Outcomes Research Award by the Venous Disease Coalition. Thomas Maniatis has been named Fellow of the American College of Physicians in April 2011. He is also the recipient of the 2011 Program Director of the Year Award given by the Royal College of Physicians and Surgeons of Canada. Lucy Opatrny has been elected to the Board of Directors of the FMSQ. Louise Pilote received the 2011 George Fraser Award for excellence in clinical research in cardiology. Ernesto Schiffrin is the recipient of the 2011 Excellence Award for Hypertension Research by the High Blood Council of the American Heart Association. He is also the President Elect of the International Society of Hypertension in 2011 and will assume its presidency in 2012. In addition, Dr. Schiffrin is the honoree for the 48th André Aisenstadt Memorial Clinic Da y. Linda Snell received the 2010-2011 W.H. Philip Hill Award for outstanding clinician-teacher from the MUHC Department of Medicine. Patrick Willemot received the 2010-2011 Department of Medicine Award for Innovation in Clinical Care. Jeffrey Wiseman has been named Fellow of the American College of Physicians in April 2011.

Geriatric Medicine

Howard Bergman is co-honorary President of the Société francophone d’oncogériatrie.

Hematology

Patricia Pelletier received the Prix d’excellence from the Association d’anémie falciforme du Québec for her commitment to patients. John Storring is the recipient of the Stewart Memorial Award.

Nephrology

The residents at the Jewish General Hospital voted Dr. Sharon Nessim as 2011 Teacher of the Year.

Andrey Cybulsky was reappointed to the Catherine McLaughlin Hakim Chair in Medicine for a second 5 year term.

Neurology

Alberto Aguayo has been inducted into the Canadian Medical Hall of Fame in April 2011. Brian Chen received a Sloan Research Fellowship. Michael Rasminsky has been selected for the CAME 2011 Certificate of Merit.

Nutrition and Food Science Center Errol Marliss has been named Fellow of the American Society for Nutrition.

Oncology Gerald Batist has been inducted as Fellow of the Canadian Academy of Health Sciences.

Respiratory

Margaret Becklake has been named Grande officière de l'Ordre national du Québec. Qutayba Hamid is this year's Distinguished Lecturer in Respiratory Sciences by the CIHR's Institute of Circulatory and Respiratory Medicine and the Canadian Thoracic Society. Richard Menzies received the 2010-2011 Department of Medicine Staff Research Award. J.A. Peter Paré received the distinguished Achievement Award from the American Thoracic Society.

Rheumatology Marie Hudson received the 2011 Young Investigator Award of the Canadian Rheumatology Association. Henri Ménard was elected “Foreign Corresponding Member of the Nacional Academia de Medicina de Argentina”. An electronic Adobe PDF version of this Appendix is available at the following website link: http://www.medicine.mcgill.ca/deptmedicine/home_annualreports_en.htm

http://www.medicine.mcgill.ca/deptmedicine/home_annualreports_en.htm

262

242

314

331

56

41

66

52

0

50

100

150

200

250

300

350

2008 2009 2010 2011

JGH Publications (2008-2011)

total # of publications as first JGH Author

total # of publications (not available)

# of researchers who published

JGH Publications - Department of Medicine

2008 2009 2010 2011

total # of publications as first JGH Author 262 242 314 331

total # of publications (not available)

# of researchers who published 56 41 66 52

The most published members as first JGH author Pollack 30 Kahn S 21 Pollack 27 Foulkes 30

Schiffrin 19 Hudson 18 Foulkes 23 Pollack 28

Kahn S 13 Foulkes 16 Schiffrin 20 Eisenberg 20

# of publications by first PI ratio 4.68 5.90 4.76 6.37

Count includes ALL members who have an

affiliation with McGill or the JGH

The complete list of publications is available at the following website link:

http://www.medicine.mcgill.ca/deptmedicine/research_pubs_en.htm


1105

1028

1364

1509

278 269 288 279

0

200

400

600

800

1000

1200

1400

1600

2008 2009 2010 2011

MUHC & JGH Combined Publications 2008-2011

total # of publications as first author


844

786

836

904

1086 1052 1050

1178

222 228 222 227

0

200

400

600

800

1000

1200

1400

2008 2009 2010 2011

MUHC Publications (2008-2011)

total # of publications as first RI MUHC Author

total # of publications


MUHC Publications - Department of Medicine

2008 2009 2010 2011

total # of publications as first RI MUHC Author 844 786 836 904

total # of publications 1086 1052 1050 1178

# of researchers who published 222 228 222 227

# of publications by PI ratio (first author) 3.80 3.45 3.77 3.98

# of publications by PI ratio (all) 4.89 4.61 4.73 5.19

The most published members as first RI MUHC author Foulkes 22 Genest 17 Foulkes 21 Foulkes 22

Suissa 17 Foulkes 14 Genest 15 Mucsi 16

Yang 14 Mayo 13 Routy 15 Bernatsky 14

Pilote 13 Sasseville 13 Goltzman 15 Pai 27

Pai 15 Wolfson 13 Buckeridge 17

Kramer 19 Tan 17

Count excludes references electronically

published in the current year but actually

printed the following year. The publication

is counted its year of print only.

Count includes ALL members who have an

affiliation with McGill or the MUHC

The complete list of publications is available at the following website link:



1

Procedures for Appointments N.B. These general procedures apply when recruiting, to the McGill Department of Medicine,

individuals who are offered McGill Contract Academic Staff (Clinical) positions and clinical appointments to the McGill University Health Centre (MUHC).

All clinicians and medical scientists who are recruited to one of the McGill University‐affiliated hospitals must also hold an academic appointment in a university department.

Additional procedures apply for tenure‐track recruits and/or recruitment of non‐Canadians. The procedures here are specific to the MUHC. Procedures for the Jewish General Hospital and St. Mary’s Hospital are similar, but not identical.

Phase 1 DEPARTMENT LEVEL APPROVAL 1.1 The division director approaches the Department Chief/Chair with a potential candidate, and

submits a formal written request, along with the candidate’s CV. This formal request must indicate 1.1.1 how they fit within the medical manpower plan for that specialty, i.e. one of: 1.1.1.1 PREM available or 1.1.1.2 Replacing someone giving up a PREM (letter of resignation required) or 1.1.1.3 Derogation will be sought

1.1.2 A description of the candidate’s “formation complémentaire” 1.1.3 the candidate’s qualifications for the position 1.1.4 a completed MUHC Impact Analysis form

(Please note that in the case of a recruit who plans RAMQ funded formation complémentaire prior to their full appointment, the Department must be approached and the appointment process initiated in order for the candidate to receive MSSS approval for this formation complémentaire.)

1.2 The Department Chief/Chair meets and approves the potential candidate 1.3 The Department (Teresa Alper) obtains

1.3.1 the signature of the Chief/Chair of the Department on the McGill Teaching Hospital Physician Appointment Form

1.3.2 the signature of the MUHC Director of Professional Services (DPS) on the McGill Teaching Hospital Physician Appointment Form

1.3.3 the signatures of the Mission Administrative Director (Gary Stoopler) and Chief/Chair of the Department on the MUHC Impact Analysis Form

2

Phase 2 FACULTY LEVEL APPROVAL

2.1 The Department (Teresa Alper) sends the following package to the Dean’s Medical Manpower Committee (chaired by the Associate Dean, Hospital and Government Affairs (Dr. Benaroya) and managed by Ms. Angela Karkatsoulis)

‐ a cover letter to Dr. Benaroya, requesting that the name be placed on the Medical Manpower List. (In order to do this, the name must be approved by the Dean’s Medical Manpower Committee, which meets quarterly, with representation from all hospital Director of Professional Services (DPS) offices. The approval process includes verification by this committee that the formation complémentaire is appropriate and that the candidate fits within the medical manpower plan for that specialty.)

‐ the CV of the candidate ‐ the completed and signed McGill Teaching Hospital Physician Appointment Form

2.2 Following the meeting of the Dean’s Medical Manpower Committee, the Department is advised, via a receipt of the list of approved candidates, that the recruitment may proceed.

2.3 At this point, a letter of offer is normally issued to the candidate by the Department, which states that the appointment is contingent on successful completion of the steps below. The letter is issued at this time in order to assure the candidate of our good faith in proceeding with the process, and also to speed up completion of the process once the other phases have been completed.

Phase 3 HOSPITAL LEVEL APPROVAL 3.1 The Department coordinates the preparation of a complete dossier for presentation to the Qualifications Committee of the Council of Physicians Dentists and Pharmacists (CPDP) of the MUHC The dossier to be presented to the MUHC Qualifications Committee includes:

3.1.1 the signed MUHC Impact Analysis Form (see 1.3.3) 3.1.2 the signed McGill Teaching Hospital Physician Appointment form (see 1.3.1 and 1.3.2) 3.1.3 the following elements that are listed on the Checklist of the Application for Appointment to the MUHC:

i. Up to date Curriculum vitae ii. Proof of liability insurance (if available) iii. Medical licensure (copies of Québec licence from the CMQ, etc.) iv. Specialty diplomas (copies of certificates or attestations) v. Form describing complementary training completed by the candidate AND vi. Confirmation letter for completion of complementary training (formation

complémentaire) completed by supervisor vii. Three (3) letters of reference, addressed to the Chair, Department of Medicine

3.2 Qualifications Committee approves the nomination, and forwards it to the Central Executive Committee (CEC) of the CPDP.

3

3.3 CEC sends its approval to the Board of the hospital, and also to the DPS Office (Stephanie Tiberio) 3.4 The DPS Office sends the approval of the CEC and the university approval to the Montreal Agence regionale de santé et services sociaux (Agence), and enters a “avis de conformite” in the data base of the Agence/MSSS.

Phase 4 AGENCE LEVEL APPROVAL 4.1. The Agence sends an Authorization of Nomination pending Board Confirmation both to the Faculty (Angela) and to the DPS office. (The Faculty (Angela) usually forwards a copy of this to the department by email to expedite the university appointment (Phase 5, below)) 4.2. The DPS office sends the Authorization of Nomination pending Board Confirmation to the Board of the hospital. 4.3. The Board approves it, and sends this approval back to the DPS office. 4.4. The DPS office sends this to the Agence. 4.5. The Agence adds this name to their list, and it is now seen on their monthly reports. 4.6. The DPS office receives the monthly reports, and advises the Department.

Phase 5 UNIVERSITY APPOINTMENT 5.1 Once the Department has received notification that the candidate is added to the Agence list, the Department sends a letter of offer for the McGill academic position to the candidate, should the letter not already have been sent (see 2.3 above). 5.2 The signed letter of offer is returned to the Department by the candidate, and the Department submits a McGill MINERVA appointment form for the academic position (“HIRE” function). 5.3 A final memo, signed by the Chair, is sent to the Associate Dean, Academic Affairs (Dr. Ludwig), requesting formal approval of this hire (supporting documents include the candidate’s CV, and letter of offer signed by the recruit) 5.4 The Faculty Academic Affairs Office approves the appointment and forwards to Central Academic Affairs at McGill. Central academic affairs approves, and a letter of appointment is then issued to the candidate from the McGill Board of Governors 5.5 An automatic email is sent to the recruit, asking them to activate their McGill email account; once this has been done, they have access to One45 and all other McGill applications Prepared by Joyce Pickering, MD, Interim Physician‐in‐Chief, MUHC Most recent update: May 18, 2012

Contract Academic Staff (Clinical) – (formerly GFT-H or PT Clinical)

Last Update: 2012/08/31

Date

Dr. xxx Xxx Xxx Xxx

Dear Dr. xxx,

We are pleased to offer you an appointment as a member of the Contract Academic Staff as a (part-time / full-time) (Faculty Lecturer / Assistant / Associate / Full Professor), Clinical, in the McGill University Department of ___________________. Your appointment as a (Faculty Lecturer / Assistant / Associate / Full Professor) will be for (one / two / three) years and (is / is not ) renewable. Your University appointment is a (nil salary appointment / or indicate salary to be paid by McGill).

The starting date for your appointment will be_______________________.

In the case of recruiting a non-Canadian: or as soon thereafter that you are able to obtain the requisite immigration clearances. Please note that in accordance with Canadian and Québec law, the above offer is conditional upon your obtaining the appropriate authorization to work from Citizenship & Immigration Canada, Immigration Québec and, if applicable, Human Resources & Skills Development Canada (HRSDC). While McGill University undertakes to assist you with the formalities, it cannot guarantee a favourable decision from the Immigration Authorities. The Faculty of Medicine Immigration Coordinator (514-398-5718) can advise you on this procedure.

The general terms of employment for contract academic staff at McGill University are described in the “Regulations Relating to the Employment of Contract Academic Staff” found on the Secretariat’s website at http://www.mcgill.ca/secretariat/policies/academic/. The following website (http://www.mcgill.ca/apo/academic-staff/) found on the Academic Personnel site provides further clarification to these regulations.

Optional: We will also arrange for you to be appointed to the Attending Staff (with admitting (or any other special) privileges) in the Department of __________________, Division of ____________________ of the (Name of Hospital). Your hospital appointment is conditional upon us receiving the requisite approvals from the Board of Directors of the Hospital and the Regional Health Board (the ‘Agence’).

Optional: Please note that the above offer is conditional upon obtaining a license to practise medicine from the Collège des médecins du Québec (C.M.Q.).

Optional for full-time recruits to the MUHC: As a full-time member of the Department of _________, you will also become a member of The Research Institute of the MUHC. As a

member of The Research Institute of the MUHC, you agree to comply with all of the Research Institute policies and procedures.

Your clinical responsibilities will include those outlined to you by Dr. _____________________. These duties will include providing clinical service in ___________________ at the (name of Hospital / site / service) and to teach undergraduate medical student and residents. You are also expected to participate in other divisional and departmental activities such as Grand Rounds. I attach extracts from our department regulations outlining the granting of privileges and the guidelines for the Attending Physician in our Department.

As a member of the Department of Medicine you will join the Department’s practice plan, the Association of Physicians of the M.U.H.C. Department of Medicine. Thus your M.U.H.C. clinical income should be processed through this Association. The Association, or a billing agency approved by the Association, does all billing for all medical acts performed within the Hospital and collects all fees. Ninety percent of the amount collected is returned to the individual who did the act. Of the remaining 10%, approximately 2% is used to pay the expenses of the Association’s Business Offices and 8% is used for stipends for Division Heads and Chiefs of Service and to support the Departmental Research Education and Development Fund. Any funds not used for these purposes are returned to members. In recent years, about 94% of each individual’s income has been paid out. To join the Association of Physicians, please contact the Business Office at 514-844-2682.

You will be required to maintain a teaching dossier, including evaluations by students and course supervisors, in accordance with the Faculty’s requirements (http://www.mcgill.ca/medicine-academic/teaching/ ).

It is the responsibility of all faculty members to adhere to the Faculty of Medicine “Code of Conduct” which may be found at: http://www.mcgill.ca/files/medsra/Code_of_Conduct.pdf.

Only for F/T appointment: As part of our academic performance review process, your performance will be reviewed and feedback given on an annual basis the Chair or Chair’s designate.

The Faculty of Medicine communicates with its faculty members by e-mail addressed to their McGill e-mail address ([email protected]). This is the official means of communication with faculty members. Once your appointment has been processed you will receive e-mail notifications to your personal e-mail account with instructions on how to access the McGill e-mail account.

We have enclosed several forms that we would ask you to return, duly completed and signed, along with your signed acceptance. Please return these documents in a timely fashion to ensure that we may proceed with the processing of your academic appointment. We recommend that you keep a copy of the signed letter of offer for your files.

Only for F/T appointment: We wish to bring to your attention that you are eligible to participate in the McGill Health and Dental plans. You will be contacted directly by Human Resources.

We hope that you will accept this offer. It will remain in effect until ...date...... Please do not hesitate to contact one of us should you need any additional information or clarification.

http://www.mcgill.ca/medicine-academic/teaching/

Lastly, please note that upon receiving your acceptance, we will recommend your University appointment to the Provost. Appointments do not become official until approved by the Provost.

We welcome you to our staff.

Yours sincerely,

_________________________ _________________________

Dr. xxxxxxxxxxxxxxxx Dr. Mara Ludwig, MD Chair, Department of ______________ Associate Dean, Faculty Affairs

cc: Optional: Division Director

Enclosures

PLEASE SIGN AND RETURN TO THE OFFICE OF THE CHAIR OF MEDICINE, KEEPING A COPY FOR YOUR FILES: I accept the offer as outlined above: _______________________________________ (signature) (date)

Self Study, Department of Medicine 2012

APPENDIX I. FACULTY H) COMMITTEES The individuals who are listed in this document are members in the Department of Medicine, McGill University, unless otherwise indicated. An asterisk *denotes Associate Member status. An individual’s role on a Committee is indicated in parentheses.

1) Department Members on University Committees University Tenure Committee Dr. David Eidelman (Chair) Dr. Mara Ludwig University Honours and Awards Committee Dr. James G. Martin

Senate Professor Christina Wolfson

McGill University Academic Unit Review Committee – Dentistry Dr. Joyce Pickering

2) Department Members on Faculty Committees Faculty Promotions Committee Dr. Mara Ludwig, Chair Dr. William Foulkes

Faculty Honour List Committee Dr. Joyce Pickering

Advisory Committee, McGill Medical Simulation Centre Dr. Joyce Pickering Dr. Linda Snell Dr. Donald Boudreau

Curriculum Committee (undergraduate) Dr. Donald Boudreau Dr. Beth Cummings Dr. David Dawson

Dr. Joyce Pickering Dr. Meredith Young

New Curriculum Implementation Executive Committee Dr. Donald Boudreau Dr. Beth Cummings Dr. Colin Chalk

Dr. Melanie Mondou Dr. Joyce Pickering Dr. Meredith Young

New Curriculum Implementation Advisory Committee Dr. Dalius Briedus Dr. Beth Cummings Dr. Colin Chalk

Dr. Melanie Mondou Dr. Joyce Pickering Dr. Meredith Young

Self Study, Department of Medicine 2012 Committee on Student Promotions and Curricular Outcomes Dr. Colin Chalk Dr. Donald Boudreau

Dr. Peter McLeod (Chair) Dr. Joyce Pickering

Faculty Postgraduate Education Committee Dr. Ruxandra Bunea Dr. Shek Fung Dr. Natasha Garfield Dr. Regina Husa Dr. Sameena Iqbal Dr. Elizabeth MacNamara

Dr. Thomas Maniatis Dr. Linda Moreau Dr. Christian Pineau Dr. Kevin Schwartzman Dr. Donald Sheppard Dr. Fanny Silviu‐Dan

Dr. Susan Solymoss Dr. Vicky Tagalakis Dr. Mathieu Walker Dr. Phil Wong Dr. Patricia Zanelli

3) Composition of Select Departmental Committees Department Executive Committee Dr. Michael Bonnycastle (member); Physician‐in‐Chief, St. Mary’s Hospital Dr. James G. Martin (Executive Vice‐Chair, Faculty Affairs), Interim Chair of Medicine Dr. Joyce Pickering (Vice‐Chair, Education), Interim Physician‐in‐Chief, MUHC Dr. Ernesto Schiffrin (Vice‐Chair, Research); Physician‐in‐Chief, Jewish General Hospital Department Promotions and Tenure Committee Dr. James G. Martin (Chair) Dr. Steven Grover Dr. Sabah Hussain Dr. Susan Kahn Dr. Alicia Schiffrin Dr. Ernesto Schiffrin

Dr. Erwin Schurr Dr. Mary Stevenson Dr. Simon Wing Dr. John Hoffer (alternate, Tenure) Dr. Basil Petrof (alternate, Tenure)

Executive Committee of the Division of Experimental Medicine Dr. Hugh P. J. Bennett, Executive Committee Chair and Director of Division Dr. James Martin, Interim Chair, Department of Medicine by Interim Dr. Mario Chevrette, MGH Dr. Joyce Rauch, MGH Dr. Danuta Radzioch, MGH Dr. Sabah Hussain, RVH Dr. Bertrand Jean‐Claude, RVH Dr. Simon Wing, Polypeptide Laboratory, RVH Dr. Ernesto Schiffrin, Physician‐in‐chief, JGH

Dr. Kostas Pantopoulos, LDI Dr. Lorraine Chalifour, LDI Dr. Mark Trifiro, LDI Dr. Andrew Mouland, LDI, member at large Dr. Maxime Bouchard, McGill Rosalind and Morris Goodman Cancer Centre Dr. Paul Goodyer, MCH Dr. Janusz Rak, MCH Dr. Claude Lazure, IRCM Graduate student representative

Department of Medicine Undergraduate Medical Education Committee Dr. Dev Bannerjee Dr. Beth Cummings Dr. Peter Ghali Dr. Elizabeth MacNamara

Dr. Leslie Meisner Dr. Joyce Pickering Dr. David Shannon

Self Study, Department of Medicine 2012 Department of Medicine Residency Training Program (RTP) Committee Dr. Ahsan Alam, Chair of Promotions Committee Dr. Ruxandra Bunea Dr. Thomas Maniatis, Chair of RTP Committee Ms. Maureen Dowd, Secretary Dr. Joyce Pickering

Dr. Josee Verdon Dr. Patrizia Zanelli

4) Department Members on Committees of the Research InstituteMUHC RI‐MUHC Research Council Dr. Bruce Mazer (Chair) Dr. Paul Goodyer* (Co‐Chair and Co‐Leader Human Reproduction and Development Axis) Dr. Hugh Clarke* (Co‐Leader, Human Reproduction and Development Axis) Dr. Nada Jabado* (Co‐Leader Medical Genetics and Genomics Axis) Stéphane Laporte, PhD (Co‐leader, Endocrinology, Diabetes, Nutrition and Kidney Diseases Axis) Dr. Simon Wing (Co‐leader, Endocrinology, Diabetes, Nutrition and Kidney Diseases Axis) Dr. Nancy Mayo (Co‐leader, Health Outcomes Axis) Dr. Michal Abrahamowicz*(Co‐Leader, Health Outcomes Axis) Dr. Pnina Brodt*, Ph.D. (Co‐Leader, Cancer Axis) Patricia Tonin*, PhD (Co‐Leader, Cancer Axis) Dr. James G. Martin (Co‐Leader, Respiratory Axis) Dr. Jean Bourbeau (Co‐Leader, Respiratory Axis) Dr. Styliani Daskalopoulou, PhD (Co‐Leader Cardiovascular Diseases and Critical Care Axis) Dr. Jacques Genest (Co‐Leader Cardiovascular Diseases and Critical Care Axis) Dr. Richard Kremer, PhD (Co‐Leader, Musculoskeletal Disorders Axis) Dr. Henri A. Ménard (Co‐Leader, Musculoskeletal Disorders Axis) Dr. Sal Carbonetto (Co‐Leader, Neurosciences Axis) Dr. Marcel Behr (Co‐Leader, Infection and Immunity Axis) Dr. Ciriaco A. Piccirillo*(Co‐Leader, Infection and Immunity Axis) Dr. James Brophy Dr. Brian Ward (Associate Director, Fundamental Research & Chair of Space Committee) Dr. Vassilios Papadopoulos (Executive Director and Chief Scientific Officer, RI‐MUHC)

RI‐MUHC Management Committee (role is in parentheses) Vassilios Papadopoulos, PhD (Chair) Marianna Newkirk, PhD (Dean’s Representative) Dr. Bruce Mazer (Chair, Research Program Council) Dr. Brian Ward (General Director Fundamental Research) Dr. Qutayba Hamid, MD PhD (Director of Recruitment and Career Development) Janet E. Henderson, PhD (Site Director MGH) Andrew Bateman, PhD (Site Director RVH) Dr. Jacques Genest (Director, Centre for Innovative Medicine – CIM) Dr. James G. Martin, Interim Chair of Medicine Dr. David Eidelman, Dean of Medicine

Self Study, Department of Medicine 2012 5) Current membership on EXTERNAL Committees – the following is a

representative sample of some members of the department; it is not an exhaustive list of external committee membership for the entire department

Dr. Dana Baran • Member, HLA National Advisory Committee, Canadian Blood Services Dr. Alan Barkun • Clinical lead, Programme Quebecois du Depistage du Cancer ColoRectal, (PQDCCR) Quebec Ministry

of Health Chair, Comité des Normes Cliniques (PQDCCR) Quebec Ministry of Health

• Chair, Comité de la Qualité (PQDCCR) Quebec Ministry of Health Quebec representative for coloretal cancer screening networks, Canadian Partnership Against Cancer Member, writing committee for the Multisociety CRC Task Force Paper on colorectal cancer ‐ colonoscoscopy preparations : American Gastroenterological Association, American College of Gastroenterology, and American Society of Gastrointestinal Endoscopy

Dr. Marcel Behr, Member, CIHR Banting Post‐Doctoral Fellowship Committee Dr. John Bergeron, Chair, Scientific Advisory Board, PROSPECTS for the European Commission David Blank, Chief Examiner in Medical Biochemistry, Royal College of Physicians and Surgeons Dr. James Brophy • Member of the Board, L'Institut national d'excellence en santé et services sociaux • Member, Expert Panel on the Medical and Physiological Impacts of Conducted Energy Weapons, Canadian Council of Academies • Member, Board of Directors, l’Institut national d’excellence en santé et en services sociaux • Member, Health Policy Statement on Use of Cardiovascular Diagnostic Imaging, American College of Cardiology Quality Control • Scientific Advisor, all Clinical Programs of the FRQ‐S Dr. Charles Bourque, Chair, CIHR Neurosciences A Grant Review Panel Dr. Lorraine Chalifour, Member, CIHR Cardiovascular B Peer Review Committee Dr. Ann Clarke • Member, Systemic Lupus International Collaborating Clinics Committee (Group of 30 internationally

recognized lupus clinician/researchers) • Member, Canadian Network for Improved Outcomes in Systemic Lupus

• Program Leader, Network for Centres of Excellence for Allergic Diseases, Allergen

• Co‐Chair, Membership Committee, Systemic Lupus International Collaborating Clinics

Self Study, Department of Medicine 2012 Dr. Robert Côté, Member of the Provincial Advisory Committee, Quebec Stroke Strategy Dr. Denis Cournoyer, Member, FRQ‐S Advisory Committee on Ethics Dr. Beth‐Ann Cummings, Co‐Chair, AFMC Interest Group for Clerkship Directors Dr. Kaberi Dasgupta, Member, Central Review Committee of the Canadian Hypertension Education Program Dr. Samuel David • President, Canadian Association of Neuroscience • Scientific Advisory Board of Wings for Life, Spinal Cord Research Foundation • Member of the Medical Advisory Committee, Multiple Sclerosis Society of Canada • Member of the Scientific Advisory Committee, Brain Canada Dr. Mark Eisenberg Eisenberg – International Committees • Member, ACCF Writing Committee of the Expert Consensus Document on Patient Radiation Safety • Member, Editorial Board, Journal of the American College of Cardiology

• Ad hoc reviewer for: American Heart Journal; American Journal of Cardiology; American Journal of Medicine; Annals of Internal Medicine; Archives of Internal Medicine; Circulation; Heart; Journal of the American College of Cardiology Cardiovascular Interventions; Journal of the American Medical Association; Journal of Cardiac Failure; Journal of Cardiovascular Pharmacology; Lancet; Medical Care; New England Journal of Medicine

Eisenberg – National Committees • Member, CIHR Institute of Circulatory and Respiratory Health Career Development Strategy

Working Group • Member, CIHR Institute of Circulatory and Respiratory Health Distinguished Lecturer in

Cardiovascular Sciences Award Committee • Member, Organizing Committee and Chair, Program Advisory Committee, CIHR Institute of

Circulatory and Respiratory Health 2012 Young Investigators Forum • Member, CIHR Institute of Circulatory and Respiratory Health Advisory Board • Member, Editorial Board, Canadian Journal of Cardiology • Ad hoc reviewer for: Canadian Journal of Cardiology; Canadian Medical Association Journal

Dr. Carlo Fallone • Vice President ‐ Administrative Affairs, Canadian Association of Gastroenterology • Vice President, Canadian Helicobacter Study Group • Advisory Member, Survey of Access to GastroEnterology • Member, Committee on determination of guidelines for colonoscopy surveillance after polypectomy, Canadian Association of Gastroenterology Dr. Jacques Genest • Member, Canadian Cardiovascular Society

Self Study, Department of Medicine 2012 • Member, American Society for Biochemistry and Molecular Biology • Elected Fellow, Canadian Academy of Health Sciences • Co‐Chair, 2012 Annual Cardiovascular Conference (Banff, AB) • Grant Reviewer: Medical Research Council of Canada; Fonds de la recherche en santé du Québec;

Heart and Stroke Foundation of Canada; NIH Project Program Grant (ad hoc) • Member, CIHR Clinical Trials « D » Committee Dr. Norbert Gilmore, Chair, Scientific Review Committee, Ontario HIV Treatment Network Dr. Mark Goldberg, Co‐editor in Chief, Environmental Research Dr. Christina Greenaway • Chair, Grants and Awards Committee, Association of Medical Microbiology and Infectious Diseases

Canada • Member, Steering Committee to develop Canadian Preventive Health Care Guidelines for Newly

Arrived Immigrants and Refugees, Canadian Collaboration on Immigrant and Refugee Health • Liaison Member to the Committee to Advise on Tropical Medicine and Travel for the Association of

Medical Microbiology and Infectious Disease (AMMI) Canada ‐ An advisory committee to the Population and Public Health Branch, Health Canada

• Associate Chair, Scientific Committee for the (2013)13th Annual Conference of the International Society of Travel Medicine (Netherlands)

Dr. Marina Klein • Member, Governing Council, International AIDS Society • Member, Review Committee for the evaluation of “bourses de chercheurs clinicians, volet clinique

et épidemiologique”, Fonds de la Recherche en Santé du Quebec (FRSQ) • Co‐Chair, Working group of co‐morbidities and aging in HIV, Advisory Committee CIHR HIV/AIDS • Member, Expert Advisory Committee on Blood Regulation ‐ Biologics and Genetic Therapies

Directorate, Health Canada • Member, Scientific Steering Committee, North American AIDS Cohort Collaboration on Research

and Design and Chair of Liver Disease Working Group • Member, INSIGHT/SMART Hepatitis Panel to develop research in hepatitis co‐infections, NIH • Member, Liver Disease Workgroup Member, Veterans Aging Cohort Study and Member; Co‐Chair,

Working group of co‐morbidities and aging in HIV • Member, Steering Committee, Canadian Observational Cohort Collaboration, CIHR Team in

Treatment Outcomes • Member, Scientific Committee, Reseau SIDA et Maladies Infectieuses du FRSQ • Co‐leader, Co‐infections and Conncurrent Diseases Core Group, Canadian HIV Trials Network • Member, Scientific Committee, Symposium on Hepatitis C, Programme National de Mentorat sur le

VIH/SIDA Dr. Donald Laporta • Member and McGill RUIS representative, Groupe d'Experts en Soins Intensifs du Québec (GESIQ),

Advisory committee to Quebec Health Ministry for Critical Care • Board Member on the offficial representing body for Québec Critical Care physicians, Quebec

Society of Intensivists

Self Study, Department of Medicine 2012 Dr. Stéphane Laporte, Chair, "Chercheur Boursier Junior 1" Committee, FRSQ Dr. Louise Larose • Member, FRSQ CFI‐Leaders Committee • Member, CDA (Canadian Diabetes Association) Personal Awards Committee Dr. Anne‐Marie Lauzon, Member, Respiratory Section, CIHR Committee Dr. Stephanie Lehoux • Deputy Chair and Scientific Officer, Canada Heart and Stroke Foundation (Committee IVa) • Editorial board member, Arteriosclerosis, Thrombosis and Vascular Biology • Executive committee: Canadian Society for Atherosclerosis, Thrombosis and Vascular Biology;

Societe québecoise d'hypertension arterielle Dr. Michael Libman • Councillor, Executive Council, Association of Medical Microbiology and Infectious Disease, Canada • Executive Committee Member, and Head, Infectious Disease Section, Association of Medical

Microbiology and Infectious Disease – Canada • Montreal Site Director, Geo Sentinel Network (US Centres for Disease Control and Prevention, and

International Society for Travel Medicine Sentinel Surveillance Network) • Councillor, Executive Committee, American Committee on Clinical Tropical Medicine and Travelers'

Health • Co‐Director, Annual Short Course in Clinical and Laboratory Tropical Medicine, Christian Medical

College, Vellore, India • Member, Scientific Committee for the 13th Conference of the International Society of Travel

Medicine, Maastricht, 2013 • Member, Diagnosis and Management of Leishmaniasis Guidelines Committee, Infectious Disease

Society of America • Chair, Regional Infection Control Committee (Nunavik), Department of Public Health • Member, Scientific Committee on HIV Diagnostics, Institut National de Santé Publique du Québec • Member, Quebec Provincial Committee on Perinatal Infections • Member, Prix Louis Pasteur Selection Committee, Association des médecins microbiologistes

infectiologues du Québec Dr. Vivian Loo • Member, Quebec Provincial Committee for Clostridium difficile Surveillance Program • Member, Infectious Disease Society of America Clostridium difficile Guideline Committee • Member, Society of Hospital Epidemiologists of America Clostridium difficile Compendium

Guidelines Dr. Sara J. Meltzer • Member, WHO committee to re‐assess the diagnostic criteria of gestational diabetes • Associate Editor, Canadian Journal of Diabetes Dr. Dick Menzies, Chair, Tuberculosis Committee, Canadian Lung Association

Self Study, Department of Medicine 2012 Dr. Mark Miller • Chairman, Infection Control Working Group of the McGill University Teaching Hospital Council • Co‐Chair, C. difficile surveillance committee of the Canadian Nosocomial Infection Surveillance

Program (CNISP) of the Public Health Agency of Canada • Member, Comité des infections nosocomiales de Québec (CINQ) • Member, AMMIQ‐INSPQ advisory committee • Member, Table régionale provinciale des infections nosocomiales (TRPIN) Dr. Wilson H. Miller, Jr. • Member, Institutional Review Board, Faculty of Medicine, McGill University • Member, Executive Committee of Lady Davis Institute of Research, Jewish General Hospital • Member, Editorial Board, Section Editor for acute promyelocytic leukemia, Leukemia • Chartered Peer Review Panel Member, Basic Mechanisms of Cancer Therapeutics Study Section,

National Institute of Health (US) Center for Scientific Review, 2010‐2016 • Journal reviewer: Blood 1993‐, Leukemia 1995‐, Cancer Research 1995‐, JNCI 1995‐, Annals of

Oncology 1995‐, Clinical Cancer Research 1996‐, Biochimica et Biophysica Acta 1996‐, J Clinical Oncology 1999‐, Oncogene 2001‐, Leukemia Research 2002‐, Cancer Cell 2002‐, Nature Reviews Cancer 2002‐, Brit. J Pharm 2003‐, The Hematology Journal 2003‐, Mol Cell Biol. 2003‐, Mol Ca Res 2003‐, Cancer Letters 2004‐, J Biol Chem 2004‐, Free Radical Biology and Medicine 2004‐, Science 2005‐, J Cellular Bioch 2006‐, Nature Medicine 2007‐

Dr. José Morais, Associate Director, FRSQ Quebec Research Network in Aging Dr. Suzanne Morin • Vice Chair, Scientific Advisory Council, Osteoporosis Canada • Co‐chair, Osteoporosis Surveillance Working Group, Public Health Agency of Canada Dr. Sharon Nessim, Member, International Society for Peritoneal Dialysis Education Committee Dr. Marianna Newkirk • Member, Committee of Associate Deans Research for all the Universities in Canada with medical

schools (provincial and national levels) • Member, Committee of University Delegates, CIHR Dr. Gaston Ostiguy

• Member, Committee Preparing a Statement on Chronic Beryllium Disease, American Thoracic Society

• Member, National Advisory Board on Smoking Cessation • Member, INSPQ (provincial) Advisory Board on the use of Asbestos • Consultant to Health Canada for the Notices and Pictures on the packages of cigarettes

Dr. Vassilios Papadopoulos Papadopoulos ‐ Provincial Committees • Member, Board of Directors and Member, Executive Committee, Montreal In Vivo • Member, Board of Directors, Centre Québécois sur la Découverte du Médicament (CQDM) • Member, Board of Directors, Centre Québécois de Valorisation des Biotechnologies (CQVB)

Self Study, Department of Medicine 2012 • Member, Board of Directors, Fonds de la Recherche du Québec ‐ Santé (FRQS) • Member, Board of Directors, Montreal Board of Trade • Member, Scientific Advisory Board for the FRSQ Groupe de recherche axé sur la structure des

protèines (GRASP) • Member, Knowledge transfer committee, Réseau Québécois en Reproduction • Member, Selection committee, Armand‐Frappier Prize for scientific achievements • Member, Comité stratégique en science et innovation, Ministére du Développement Economique,

de l'Innovation et de l'Exportation, Quebec Government Papadopoulos ‐ Federal Committees • Ad hoc committee member of Endocrinology peer review committee, Canadian Institutes of Health

Research (CIHR) • Member, Vice‐President for Research Committee, Association of Canadian Academic Health

Organizations Papadopoulos ‐ International Committees • External advisor of the Neuroimmunomodulation Research Group (Director: Dr. J. Palermo‐Neto) at

the University of Sao Paulo, Brazil • Member, Executive Leadership Group of Vice‐Presidents for Research, Association of Academic

Health Centers, Washington, DC • Member, Executive Committee of the Organization of Testis Workshops, USA • Member, Assessment panel in Biological and Medical Sciences for the Ministry of Education Life

Long Learning and Religion Affairs‐ responsible for Higher Education, Research and Technology, Athens, Greece (2010‐2012)

• Chair, Scientific Program Committee, American Society of Andrology 2013 annual meeting at San Antonio, Texas

• Member, Society for the Study of Reproduction Development Committee, USA • Member, Therapeutic Discovery Review Team, National Center for Advancing Translational Sciences

(NCATS), National Institutes of Health, USA Dr. Fabienne Parente, Member, INESS (Institut national d'excellence en santé et services sociaux) : comité d'expert en dépistage néonatal Dr. Basil Petrof • Member, FRSQ award evaluation committee for Chercheur Boursier Senior (Fondamentale) • Member, Canadian Thoracic Society Guidelines Committee for Home Ventilation Dr. Joyce Pickering • Member of the Executive Board, Research and Development Committee and Nomination

Committee, McGill University Representative, Medical Council of Canada • Chair, Scientific Program Committee, 2013 Canadian Conference on Medical Education Dr. Raghu Rajan • Member, CEPO (Comite de l'evolution des pratiques en oncologie), a provincial committee

evaluating oncology practices, producing guidelines and recommendations • Member, one of the standing committee Comite scientifique permanent en sante et en services

sociaux, for Institut national d'excellence en sante et en services sociaux

Self Study, Department of Medicine 2012 • Member, Scientific Committee of the Programme de gestion therapeutique des médicaments, an

initiative of all of the Quebec CHUs Dr. Joyce Rauch, Member, International Advisory Board for the 14th International Congress (Sept 2013) On Antiphospholipid Antibodies, Rio de Janeiro, Brazil Dr. Jean‐Pierre Routy • Chair of the 2012 Canadian Association for HIV/AIDS Research Conference • Member, Towards Eradication Working Group of the International AIDS Society • Co‐Chair, Clinical Trials involved in decreasing HIV reservoir to try to eradicate HIV • Co‐Chair, HIV Vaccine and Immunotherapy Core for the CIHR/CTN Dr. Mary‐Ann K. Sanfaçon • Chair of the Certification Committee, Canadian Academy of Clinical Biochemistry • Editor‐in‐Chief of the bimonthly newsletter CSCC, Canadian Society of Clinical Chemists Dr. Ernesto Schiffrin • President Elect, International Society of Hypertension • Member, Council of the International Society of Hypertension • Member, Nomination and Awards Committee, International Society of Hypertension • Member, Board of Trustees, Inter‐American Society of Hypertension • Co‐Chair, Working Group on Target Organ Damage in Hypertension, NHLBI, USA • Member, Board of Trustees, Hypertension Canada • Member, Board of Trustees, Québec Hypertension Society • Member, Writing group for Arterial Stiffness ‐ Recommendations for Assessment and Use,

American Heart Association • Associate Editor, Hypertension • Member of the Editorial boards of the following seven (7) journals: Hypertension, Hypertension

Research, Journal of Hypertension, Journal of Vascular Research, High Blood Pressure and Cardiovascular Prevention, Italian Society of Hypertension and Journal of the American Society of Hypertension

• External grant reviewer for the following eight (8) agencies: Medical Research Council of Canada, CIHR, CFI, Heart and Stroke Foundation of Canada, Kidney Foundation, FRSQ FCAR and the Foundation of the Montreal Heart Institute

Dr. Kevin Schwartzman • Scientific Advisor, FRQ‐S • Panel member, CIHR peer review committee, New Investigator salary awards • Vice President and Program Committee Chair (and Executive Committee), International Union

Against Tuberculosis and Lung Disease (North America Region) • Secretary, Tuberculosis Scientific Section, International Union Against Tuberculosis and Lung

Disease (North America Region) Dr. Maida Sewitch • Member of the Research Committee, Canadian Association of Gastroenterology • Member of the Program Committee, American Psychosomatic Society

Self Study, Department of Medicine 2012 Dr. Nitika Pant Tai, Member, TAG Technical Advisory Group of the Path and Gates Foundation on self testing initiatives for HIV for Africa Dr. Robyn Tamblyn, Scientific Director, CIHR Institute of Health Services and Policy Research Dr. Christos Tsoukas • Member, CQCS “Comite aviseur sur la prise en charge cliniques des personnes avec le VIH” • Member, FRSQ Steering Committee on Primary HIV Infection • Member, Canadian HIV Legal AIDS Network • Member, McGill University Tenure Committee for the Schulich School of Music • Member, CIS Continuing Medical Education Committee • Member, McGill University Bedside to Bench and Back Again Committee • Chair, McGill University Health Centre Committee for Off Site Out‐Patient Facility Development for

the Department of Medicine • Panel Member, U.S. National Institutes of Health, Division of AIDS – CFAR Review Panel • Panel Member, NIH/NIAID IPCP‐HTM (Integrated Preclinical/Clinical Program for HIV Topical

Microbicides) • Reviewer, Cardiovascular Workshop‐Canadian Partnership for Tomorrow CIHR‐Invited Rapporteur‐

Consensus Conference on Inflammation in Chronic Disease Dr. Donald Cuong Vinh • Vice‐chair, Association of Medical Microbiologists and Infectious disease specialists (AMMI) Canada

National Guidelines Committee • Member/Co‐author, AMMI Canada Guidelines on Candidiasis • Member/Co‐author, AMMI Canada Guidelines on Aspergillosis Dr. Brian Ward • Member, CIHR Institutional Advisory Board (IAB) for Infection, Inflammation and Immunity Institute • Expert Witness, MSSS and USA Dept Health & Human Services ‐ Vaccine Injury Compensation

Programs Dr. Margaret Warner, President, Association of Hemophilia Clinic Directors Dr. John White • Member, CCSRI Gene Expression Panel for Innovation Grants • Member, FRQ‐Sante Chercheur‐Boursier Senior panel Dr. Simon Wing • Member, Council of the Canadian Society for Endocrinology and Metabolism • Member, CIHR Endocrinology Grant Review Committee – Fall 2012 • External reviewer, Division of Endocrinology and Metabolism, University of Ottawa, January 2012 • Member of External Review Committee for the Research Program at the Weill‐Cornell Medical

College in Qatar, October 2012. Dr. Jean‐François Yale, Co‐organizer and Co‐chair, Annual Meeting of the Canadian Diabetes Association/ Canadian Society for Endocrinology and Metabolism

1

APPENDIX I FACULTY L Department of Medicine Promotions & Tenure

2009-2011

2009 Associate Professor with Tenure Christina Haston Andrew Mouland Keith Murai Salman Qureshi Awarded Tenure Jean-Pierre Routy Full Professor Chantal Autexier Marcelo Cantarovich Robert Côté Giovanni Di Battista William Foulkes Susan Kahn Janet Henderson Konstantinos Pantopoulos Brian Ward Xiang-Jiao Yang

2010 Associate Professor with Tenure Arnold Kristof Donald Sheppard Peter Siegel

2

Associate Professor Lorraine Chalifour Serge Lemay

2011 Associate Professor with Tenure Sasha Bernatsky Kaberi Dasgupta Stéphanie Lehoux Chen Liang Madhukar Pai Christian Rocheleau Maya Saleh Maida Sewitch Marc Tischkowitz Full Professor Silvia Vidal Associate Professor Nandini Dendukuri Andrew Hirsh Iqal Sebag Michael Tamilia

ADMINISTRATIVE OFFICEDepartment of Medicine

Faculty of Medicine / MUHC

Teresa Alper[McGill] Manager

Dr. James G. MartinInterim Chair, Department of Medicine

Dr. Joyce PickeringInterim Physician-in-Chief, MUHC

Debbie Carr[McGill] Budget Officer

Josée Cloutier[McGill] Senior Admin. Coord.

Revised August 2012

Domenica Cami[MUHC] Executive Assistant to the Interim

Chair and Interim Physician-in-Chief

Emily Di Lauro[MUHC] Administrative Officer

Approximately 40 [McGill] non-academic staff

EXECUTIVE COMMITTEEDepartment of Medicine

McGill University

Revised August 2012

Dr. James G. MartinInterim Chair and

Vice-Chair, Academic Affairs

Dr. Joyce PickeringInterim Physician-in-Chief, MUHC

and Vice-Chair, Education

Dr. Ernesto SchiffrinPhysician-in-Chief,

Jewish General Hospitaland Vice-Chair, Research

Dr. Michael BonnycastlePhysician-in-Chief St. Mary’s Hospital

TEACHING OFFICESDepartment of Medicine

McGill University

Dr. T. ManiatisDirector, Post Graduate

Internal Medicine Residency Training Program

Dr. P. GhaliDirector

Undergraduate Training Program

Dr. Joyce PickeringVice-Chair, Education

Revised August 2012

Dr. J. VerdonProgram Director, RVH site

Dr. P. GhaliUndergrad Director, RVH site



Dr. D. Banerjee AND Dr. J. ShannonUndergrad Directors, MGH site

Dr. B. CummingsUndergrad Director, JGH site

Dr. L. MeissnerUndergrad Director, St. Mary’s site

Dr. P. ZanelliProgram Director, MGH site

Dr. R. BuneaProgram Director, JGH site

McGILL UNIVERSITYDepartment of MedicineInternal Divisional structure

VacantEndocrinology

Dr. L. PiloteInternal Medicine

VacantClinical Epidemiology

Dr. J. Burgess [Interim]Cardiology

Dr. H. BennettExperimental Medicine

Dr. S. CaplanHematology

Dr. A. CybulskyNephrology

Please note that the Divisions all have Directors at each major teaching hospital site. This organizational chart only describes appointments of Directors that are McGill-wide and not site-specific.

VacantDermatology

Dr. J. MoraisGeriatrics

Dr. R. MenziesRespiratory

Dr. M. LibmanInfectious Diseases

Dr. C. TsoukasClinical Allergy & Immunology

Dr. A. BittonGastroenterology

Dr. H. MenardRheumatology

Dr. James G. MartinInterim Chair, Department of Medicine

Faculty of Medicine

Revised August 2012

MUHCDepartment of MedicineInternal Divisional structure

Dr. T. LeeCo-Director, Quality & Safety

Dr. L. MoreauDermatology

Dr. J. MoraisGeriatrics

Dr. H. MenardRheumatology

Dr. D. JayaramanCo-Director, Quality & Safety

Dr. C. TsoukasClinical Allergy & Immunology

Dr. M. WarnerHematology

Dr. M. LibmanInfectious Diseases

Dr. G. CrelinstenAssociate Physician-in-Chief

RVH

Dr. M. RadnakrishnaPhysical Medicine /

Rehabilitaion Service

Dr. L. PiloteInternal Medicine

Dr. J. BrophyClinical Epidemiology

Dr. L. GreenAssociate Physician-in-Chief

MGH

Dr. M. Sherman [Interim] Endocrinology

Dr. J. SturgeonMedical Oncology

Dr. C. ChalkNeurology

Dr. Joyce PickeringInterim Physician-in-Chief

MUHC

Revised August 2012

Dr. D. BlankMedical Biochemistry

Dr. N. GiannettiCardiology

Dr. A. BittonGastroenterology

Dr. Q. HamidMeakins-Christie Labs

Dr. R. MenziesRespiratory

Dr. A. CybulskyNephrology

JEWISH GENERAL HOSPITALDepartment of MedicineInternal Divisional structure

Dr. M. LipmanAssociate Physician-in-Chief

Dr. A. CohenGastroenterology

Dr. D. RosenblattGenetics

Dr. R. FriedmanGeriatric Medicine

Dr. S. Caplan Hematology

Dr. L. RudskiCardiology

Dr. R. BillickDermatology

Dr. P. SmallAllergy & Immunology

Dr. M. Trifiro Endocrinology

Dr. A. Dascal [Interim]Infectious Diseases

Dr. R. BeckerInternal Medicine

Dr. E. MacNamaraMedical Biochemistry

Dr. M. LipmanNephrology

Dr. Ernesto SchiffrinPhysician-in-Chief

Jewish General Hospital

Revised August 2012

Dr. D. SmallPulmonary

Dr. M. BaronRheumatology

Dr. S. SuissaClinical Epidemiology

APPENDIX III EDUCATION PROGRAM (A) Undergraduate Medical Education Basis of Medicine (BOM) occupies the first 18 months of medical school. It provides a system-based, integrated approach to normal and abnormal function. Eight units, in blocks of three to fourteen weeks, include basic sciences applicable to clinical practice. Introduction to Clinical Medicine (ICM), Year 2. It provides a clinical experience, using both in-patient and ambulatory settings. The initial segment of this component, Physicianship 2B (Intro to Clinical Sciences - ICS) teaches the physical examination, medical ethics and evidence-based medicine. Subsequent to this are rotations in various clinical disciplines: internal medicine, pediatrics, neurology, family medicine, surgery, oncology, anaesthesia, radiology, psychiatry, dermatology, and ophthalmology. ICS Course Director: Dr. David Shannon (for the 2011-12 academic year)

4 w e e k s Montreal General Hospital Royal Victoria Hospital Jewish General Hospital St. Mary’s Hospital

Site Coordinator Dr. J. David Shannon Dr . P . Gha l i Dr. B. Cummings Dr. L. Meissner

Students per site 60 58 32 25

Tutor – Faculty 3 13 8 8

Tutors - Residents 1 0 7 8 0

IIM Course Director: Dr. Jeffrey Wiseman (replaced by Dr. Peter Ghali, July 1, 2012) (for the 2011-2012 academic year)

Each of 3 -7 week cohorts Montreal General Hospital Royal Victoria Hospital Jewish General Hospital St. Mary’s Hospital

Site Coordinator Dr. J. David Shannon Dr . P . Gha l i Dr. B. Cummings Dr. L. Meissner

Students per site 16 to 17 per Cohort

16 to 17 per Cohort

16 student per cohort

25 (5-10 per Cohort)

Tutor – Faculty 12 10 12 11

1

Core Clerkship, Year 3. This consists of a one week Intro to Clerkship course, 6 eight-week rotations, 1 four-week rotation and 1 four-week elective. Core Clerkship Director: Dr. Jeffrey Wiseman (replaced by Dr. Peter Ghali, July 1, 2012) (for the 2011-12 Academic year)

8 week blocks August to June

Mon t rea l Gene ra l Hosp i ta l Royal Victoria Hospital Jewish General Hospital S t . M a r y ’ s H o s p i t a l

S i t e C o o r d i n a t o r D r . D . B a n n e r j e e D r . P . G h a l i D r . B . C u m m i n g s D r . L . M e i s s n e r

S t u d e n t s p e r s i t e 7 to 8 students per site

7-8 students 8 to 9 students per group

5 per period

C l i n i c – Facu l t y Per month 4 attendings on 17E4 attendings on 15E4 attendings on 15W 4 in ER 10 in Clinic

Per month 4 attendings on 10 M 2 attendings on 6 M 1-2 attending on 7 M 4 in ER 13 in Clinic

P e r m o n t h : 2 attendings on 7W2 attendings on 74 in ER 4 on 2NE/CCU

4 p e r p e r i o d

Senior Clerkship, Year 4. This will consist of 3 four week compulsory rotations, 4 four week electives (either clinical or basic science seminars), Physician Apprenticeship 4 and Physicianship 4, a four-week course including Medicine and Society, Public Health, and Communication Plus. Department of Medicine Members are involved in clinical electives, offering basis science seminars and participate in Physician Apprenticeship 4 and Physicianship 4. Physicianship: Physician Apprenticeship consists of small groups that meet throughout the 4 years. Physicianship 1 and 2 run during the Basis of Medicine. Physicianship 3 and 4 are in parallel with the Clerkships. Physicianship and Physician Apprenticeship courses must be successfully completed during the relevant promotion periods. New MDCM Curriculum: Of note, the undergraduate medical education office has been working on developing a new curriculum for the MDCM program, which will be implemented in August of 2013. Members of the Department of Medicine are heavily involved in planning for this, included leading major themes and components within the new curriculum. The new curriculum will introduce earlier clinical exposure and will emphasize interprofessionalism and lifelong learning skills. Many department members will also be involved in the implementation and on-going teaching of this new curriculum.

2

3

(B) Postgraduate Clinical Training Programs Program Total Number

of Postgrad Trainees

July 2010

Total Number of Postgrad Trainees

July 2011

Total Number of Postgrad Trainees

July 2012

Program Director as of July 1, 2012

Core Internal Med

(R1-R3)

JGH (40)

MGH (34)

RVH (39)

Total 113

JGH (37)

MGH (35)

RVH (40)

Total 112

JGH (37)

MGH (35)

RVH (38)

Total 110

Dr. Thomas Maniatis

Allergy and Immunology

0 1 2 Dr. Fanny Silviu-Dan

Cardiology 19 20 21 Dr. Regina Husa/

Dr. Mathieu Walker

Critical Care 14 15 12 Dr. Patrick R.P.

Melanson Dermatology 23 19 27 Dr. Linda Moreau Emergency Medicine 25 31 34 Dr. Joel Turner Endocrinology 8 11 12 (one resident

out of phase – starting April 2013)

Dr. Natasha Garfield

Geriatrics 3 1 1 Dr. Shek Fung Gastroenterology 9 13 15 Dr. Philip Wong General Internal Medicine

15 16 14 Dr. Vicky Tagalakis

Hematology 9 8 8 Dr. Susan Solymoss

Infectious Diseases/Microbiology

6 5 5 Adult ID/MM

2 Peds ID

Dr. Donald Sheppard

Medical Biochemistry 6 7 7 Dr. Elizabeth MacNamara

Medical Oncology 6 11 9 Dr. Lawrence Panasci

Nephrology 2 4 5 Dr. Sameena Iqbal Respirology 11 12 10 Dr. Kevin

Schwartzman Rheumatology 2 2 5 Dr. Christian Pineau

2008 2009 2010Peer Reviewed incl Career Awards $66,520,690 $65,117,071 $64,857,225Career Awards $5,598,254 $5,933,246 $5,316,612Non-Peer Reviewed $26,925,495 $33,631,023 $29,992,876

$0

$10

$20

$30

$40

$50

$60

$70

Milli

ons

IV. Research Funding

Appendix V. A‐C CLINICAL PROGRAMS CARDIOLOGY (MUHC)

Current Clinical Programs and New Clinics* in Cardiology (MUHC)

MAUDE Unit [2005]: integrated care of adults with congenital heart disease within a program that combines medical, pediatric, surgical, interventional approaches. (RVH) Heart Failure Clinic [2000]: diagnosis and treatment of patients with advanced heart failure, offering a multi‐disciplinary approach with highly innovative approaches, including heart and multi‐organ transplants, mechanical cardiac support systems and artificial hearts. (RVH) Preventive Cardiology / Lipid Clinic [2000]: Residents are exposed to a wide variety of often rare and severe lipoprotein and metabolic disorders associated with premature cardiovascular disease. (RVH) The Women’s Heart Health Initiative [2009], lead by Nurse Wendy Wray fills a important aspect of the Women’s Heath mission of the MUHC and reflects the importance of cardiovascular disease in women. (RVH) Medical‐Surgical Valve Clinic [2012]*: for highly specialized valvular heart disease care was established. Patients are evaluated by medical and surgical teams simultaneously such that decisions can be made as a team. (RVH) Interventional Cardiology [2006]: the creation of a non‐coronary intervention unit within cardiology now allows the implantation of percutaneous aortic valves, closure devices for cardiac septal defects, and innovative approaches to structural heart disease. This unit works in close collaboration with the cardiac surgery team. (RVH)

AFIB Clinic, Programme FA‐CILITER [2012]* which stands for Atrial fibrillation in an integrated clinic to limit thromboembolic events (Fibrillation Auriculaire dans une Clinique Intégrée pour LImiTer les évènEments thRombo‐emboliques) is a new programme launched at the MUHC in 2012. Programme FA‐CILITER is a two‐year pilot project aiming to better care for patients suffering from AF, the most common heart rhythm disorder, as well as promote best medical practices based on the Canadian Cardiovascular Society's AF guidelines. Dr. Thao Huynh, cardiologist at the McGill University Health Centre is the founder and Head Coordinator of Programme FA‐CILITER. Electrophysiology [2011]*: McGill’s first Cardiac Electrophysiology Laboratory was inaugurated on April 28, 2011 in the presence of Dr. Mark E. Josephson, pioneer in the field of electrophysiology. This achievement represents years of intensive teamwork under the leadership of Dr. Vidal Essebag, Director of Cardiac Electrophysiology. The state of the art facility located at the Montreal General Hospital is equipped with biplane fluoroscopy and the latest 3‐dimensional mapping technologies that have allowed our

team to perform the most complex electrophysiology procedures including ablation of atrial fibrillation and ventricular tachycardia. The creation of the new EP lab at the MUHC in 2011, now allows us to evaluate and treat cardiac rhythm disorders with by ablation therapies, defibrillators and cardiac re‐synchronization therapies. (RVH) The Cardiology Rapid Access Clinic [2011]* was created in 2011 to offer rapid access to care to patients presenting to the ER with non‐acute cardiac issues. This new clinic is meant to unload the ER and decrease length of stay in the CCU. This also facilitates other urgent consults. Patients who present with non‐acute cardiac issues should be sent to this clinic where they will be seen in a few days. (RVH)

Future Plans for Clinical Development in Cardiology (MUHC)

The Division of Cardiology at the MUHC is currently in the process of evaluating the creation of a new cardiology outpatient clinic to be inaugurated prior to the Glen’s inauguration.

Global objectives for 2012

There currently are over 10 different clinics where cardiologists from the MUHC practice. There is a lack of unity amongst members of the Division. In the “private office” setting, there is no teaching and no research. These MUHC cardiology patients are therefore not part of the academic mission of our institution. There is a committee in place to develop a centralized outpatient cardiology clinic where all patients will be included in a data‐base and where clinical research and education will take place. The main goal of this clinic is for outpatient general cardiology to become more academic. A multidisciplinary prevention clinic is also being planned. Other objectives include offering accessible cardiology service to our Institution and the community.

DERMATOLOGY (MUHC)

Clinical tasks, 95% of which take place in outpatient settings, constitute the core of our Division’s activities. Teaching to residents, rotators, and medical students is carried out in the outpatient clinics, as well as during consultations on inpatients, in the pathology laboratory, during weekly Thursday academic Rounds, and in outside approved affiliated centers (laser training, dermatological surgery).

The ulcer clinic which is one of our specialty clinics offering patient care related to chronic wounds of the leg

Our unique patch test clinic for contact dermatitis Transplant patient clinic for care of transplant patients as they are a unique population at risk for skin cancers

Future Plans for Clinical Development in Dermatology (MUHC)

We would like to establish two other tertiary care and multidisciplinary clinics. We would like to develop a testing center for drug reaction where we would combine both our dermatology expertise with our patch test technique and combine it with allergy/immunology service with their expertise in the prick and IDR testing procedures. This clinic would also require the help of pharmacy for proper mixing of the appropriate dose of the medication for proper testing. We would like to establish a hand dermatitis clinic with a focus on occupational dermatitis. This would involve our expertise and possible involve physio/ergotherapy to rehabilitate patients who have occupational dermatitis.

ENDOCRINOLOGY (MUHC)

Current Clinical Programs in Endocrinology (MUHC) Insulin pump program Endocrine tumours clinic Reproductive endocrinology clinics Home TPN Clinic for hereditary bone disorders

Future Plans for Clinical Development in Endocrinology (MUHC) Introduction of clinical research database Transition clinic for diabetes with MCH

GASTROENTEROLOGY (MUHC)

The GI division has a very large clinical load, with a wide outpatient and in‐patient referral base. In addition, the tertiary‐quaternary expertise of the division attracts referrals of patients with chronic and often complex illness (IBD, cirrhosis, liver transplant, pancreatico‐biliary disease, complex endoscopic procedures)

Current Clinical Programs in Gastroenterology (MUHC)

Specialized Clinical Programs The McGill IBD Program (MGH, RVH) Hepatology and Liver transplant (RVH) Esophageal program including radiofrequency ablation (MGH) Gastrointestinal Motility Program (MGH) Therapeutic Endoscopy and Biliary Program (MGH, RVH)

Unique clinical facilities Endoscopy Unit (RVH, MGH) Multi‐Media room (MGH) Motility Laboratory (MGH)

Breath Test Room (RVH)

Future Plans for Clinical Development in Gastroenterology (MUHC)

Endoscopy a) Certain advanced endoscopic activities in digestive oncology which are in keeping

with our tertiary care mandate b) Leading the Assessment of Endoscopic Quality for the Provincial Colorectal Cancer

Screening Program Inflammatory Bowel Disease a) Prioritize the IBD program in view of providing exceptional care to patients with

complex disease in keeping with our tertiary care mandate. b) Create a unique, state‐of‐the‐art IBD outpatient centre at the MGH Mountain

Site, to serve as a platform for providing excellent multidisciplinary care within a research and academic‐intensive environment

Hepatology and Liver Transplant a) Prioritize in collaboration with our infectious disease colleagues the care of our

patients with chronic viral hepatitis b) Prioritize care of patients with advanced liver disease and its complications. There is

opportunity to create a Quebec‐wide network in transplant and a nationwide network throughout the Canada

c) Liver Treatment Group (CLTG). We are evaluating the use of non‐invasive markers /tests ( eg fibroscan) of liver fibrosis

Transition Care a) Prioritize pediatric to adult transition for various GI conditions; establish an IBD

transition clinic in the fall of 2012 Digestive Disease Program: Vision for the MUHC – MGH campus and future Glen Yards campus To provide surgical and gastroenterology services at both MUHC sites in view of optimizing the high‐quality multidisciplinary care to patients

GENERAL INTERNAL MEDICINE (McGill‐wide; all sites) The overarching mission of the McGill University Division of General Internal Medicine is to continue to grow as an academic leader in clinical care, medical education and research. Specific areas of growth currently include quality improvement, peri‐operative medicine, vascular health and medical obstetrics. Excellence and leadership in clinical care, research and education are integral building blocks for accomplishing this mission.

Specialized Clinical Programs GIM Clinics : MUHC / JGH Peri‐Op Clinics : MGH and RVH Vascular Medicine / HTN clinic / CVD : MUHC and JGH

Medical Obstetrics: RVH and St. Mary’s Hospital Thrombosis: JGH Acute Outpatient Thrombosis Program: RVH Point‐of‐care ultrasound: MUHC/JGH General Internal Medicine Clinics MUHC and JGH These clinics provide the bulk of training in ambulatory internal medicine. Over the past five years, the major initiatives in terms of clinical programs have been the revamping of the GIM clinics at the MUHC and the design of the Complex Care Centre, which will become a model for multidisciplinary internal medicine clinics with ongoing outpatient QI projects. We are working on incorporating electronic medical records. Peri‐op Medicine MUHC and JGH GIM is involved with peri‐operative clinics at the two sites: in collaboration with surgery we are planning to expand the peri‐operative services. Vascular Health Unit (hypertension clinic and vascular clinic) MGH This is a hypertension clinic which is paired with a state‐of‐the‐art vascular biology lab. The vascular health unit at the Montreal General Hospital expanded to additional space. The Cardiovascular Prevention Centre JGH Dr Ernesto Schiffrin is the Director and Dr Luc Trudeau the Associate Director of the Cardiovascular Prevention Centre at the JGH. The Cardiovascular Prevention Centre is dedicated to diagnosing and treating all risk factors of cardiovascular disease through our hypertension, diabetes, dyslipidemia, nutrition and smoking cessation clinics. With a unique multi‐disciplinary approach, a team of trained nurses, nutritionists, psychologists (for smoking cessation) and specialized physicians (Internal Medicine, Endocrinology, Neurology, Cardiology), attend patients in primary and secondary prevention. As well, the Clinic serves as a platform for physician training and research projects in basic and clinical cardiovascular medicine. The clinic generally has two fellows from the Internal Medicine Fellowship program either from McGill or from other universities, currently Laval University, as well as foreign fellows. This has allowed the development of the program of research in blood pressure measurements, large artery and small artery changes in all these conditions. Medical Obstetrics: RVH and St. Mary’s Hospital Consultation with internal medicine for medical obstetrics (medical complications of pregnancy) is available at the RVH in two clinics weekly and at St. Mary’s once weekly. When needed, telephone and inpatient consultations are provided as well. At both the RVH and St. Mary’s, the clinic is physically hosted in the obstetrics area in order to work with nurses with obstetrical experience as well as (at the RVH) provide face to face contact with the obstetrical colleagues. The major initiatives to date that have been successfully implemented include:

• Pre‐evaluation of all patients by a nurse with the taking of vital signs • use of home BP sheets Current priorities as discussed with the obstetricians and nurses include: • improved communication between internist and treating physician

• improved communication between internist and obstetrical triage regarding BP target

• ability to provide regular inpatient consultative services Strengths • Unique specialty of internal medicine with increasing visibility and recognition • high appreciation by users of the consultative service (anonymous questionnaire

feedback) • filling a gap of clinical need • high connectivity with other medical obstetrics colleagues in Quebec and Canada

Thrombosis JGH The Thrombosis Clinic is part of the Thrombosis Program, providing state‐of‐the‐art patient care, teaching thrombosis medicine to medical students, residents and nurses, and conducting research and research training in causes, risk factors, prevention and treatment of thrombosis. Acute Outpatient Thrombosis Program RVH This program involves the assessment and management of deep venous thrombosis as well as pulmonary emboli in the outpatient setting, with care coordinated by a dedicated Nurse Clinician in liaison with outpatient community resources. Point‐of‐care ultrasound: MUHC/JGH This program involves the training and implementation of point‐of‐care ultrasound on the Clinical Teaching Units across McGill's core teaching network. In the first phase, select physicians and residents are being trained in point‐of‐care ultrasound techniques and will pilot the use of these techniques on the Clinical Teaching Units, before widespread adoption of these techniques can be assured.

Clinical Centres of Excellence The Vascular Health Program at the MGH and the Cardiovascular Prevention Centre and Thrombosis Clinic at the JGH are becoming centres of excellence

Future Plans for Clinical Development in General Internal Medicine

• Formalize the Clinical/Research/Education Innovation groups to share and promote McGill wide innovation within the division

• Actualize McGill‐wide programs in peri‐operative medicine, medical obstetrics, vascular medicine and quality improvement

• Develop the Complex Care Centre GERIATRIC MEDICINE (McGill‐wide; all sites) The McGill University Division of Geriatric Medicine of the Department of Medicine is comprised of faculty from the Divisions of Geriatric Medicine of the Jewish General Hospital (JGH), the McGill University Health Centre (MUHC), and St. Mary's Hospital. Faculty from the Department of Family Medicine play a key role in the Division. There are links with the Division of Geriatric Psychiatry of the Department of Psychiatry and with the Department of Clinical Epidemiology. Faculty from

epidemiology, molecular and cell biology and neurology with an active and significant interest in aging research and who have been involved in research with division members are integrated in the division. Investigators from other departments continue to show interest and have requested joining the Division. There is ongoing and close collaboration for clinical work, teaching and research with nursing, physiotherapy, occupational therapy and social work. There is significant collaboration with our colleagues from the Université de Montréal as well as other Quebec and Canadian Universities in areas of research and program development. International collaboration has also considerably developed.

Approche adaptée Initiatives As the number of elderly patients continues to grow in all hospital wards, our Division is actively working with the hospital administrations to make the hospital a friendlier environment to our frail patients. At the JGH and MUHC, we are championing the Approche adapté. This is a directive from the MSSS for every acute care hospital to have programs that meet the needs of vulnerable elderly patients to decrease the rate of functional deterioration during hospitalization. An Office dedicated to Approche adapté was created at the MUHC with support from the Ministry of Seniors. Functioning of the Geriatric Medicine Units and Consultation Services At the present time, there are 88 beds under Geriatric Medicine in the McGill hospitals (MUHC, JGH, St. Mary’s). The number of acute geriatric beds has been reduced at MUHC with a 16‐bed unit at each MGH and RVH sites. This reduction has its positive and negative aspects. On the positive side, it liberates manpower to be available for consultations throughout the hospital, thus increasing our presence to improve the care of frail elderly person. On the negative side, it decreases the capacity to admit to the acute geriatric unit with increase stay in ED or in buffer zones, such as Short Stay Units. All the Divisions run active consultation services in the Emergency Room as well as on the medical, surgical and psychiatric wards. In the last year there were approximately 3500 consultations (not counting follow‐up visits) done in the emergency rooms and on the wards. There are outpatient general geriatric clinics in each of the sites, as well as a Geriatric Day Hospital at the MUHC‐RVH site. Ultra‐specialized clinics include: the JGH/McGill Memory Clinic and the Geriatric Cognitive Disorders clinic at the MUHC‐RVH‐MGH, an Incontinence Clinic, a Competency Clinic and a Geriatric Pain Clinic, all at the MUHC/MGH. The latter is an interdisciplinary program with specialized expertise in pain for older patients, which includes a nurse clinician, a physical therapist and a psychologist. This service works in close collaboration with the McGill Pain Center. At the JGH, the Senior Oncology Consultation Service with its clinic is an innovative and growing clinical, teaching and research program. Each of the sites is actively involved in other community outreach programs with the CLSC home care services and community intermediate care resources. We have been successful in implementing a community based memory clinic in the territory of the CSSS Cavendish. Geriatricians and other members of the multidisciplinary team participate actively in program planning and management for services of the elderly in each of the hospitals as well as with the CSSSs, the Agence and the Ministry.

Future Plans for Clinical Development in Geriatric Medicine

There is a need to realign and reconfigure our clinical activities within the hospital and within the community in order to best achieve our clinical goals and support the objectives of our respective hospitals and communities. In the face of limited PREMS, we may need to seriously rethink our “primary care” in‐hospital bed commitment if we are to respond to the growing consultative hospital and community needs without compromising our teaching and research program. We have an important challenge in meeting our growing community and RUIS Commitments. The development of the RUIS represents an extremely important challenge for us. Up until now, our hospital divisions have worked independently but with the RUIS we will now have to rethink the configuration of our services and our relationship with our clinical partners. These partners include closer CSSS (Cavendish and Métro/Côte des Neiges/Park Extension). We have a responsibility as a secondary and tertiary care centre for those two CSSS. As well, we have responsibilities to other CSSS on the island, particularly the West Island CSSS, which includes the Lakeshore General Hospital. We have already been solicited to work with the Lakeshore General in order to consult and advise on the development of their program for older persons. We have already been solicited to assist with the implementation of the Geriatric Service at the Lachine Hospital. Finally, we have the responsibilities toward the outlined regions, including l’Outaouais and Abitibi; for example, the l’Outaouais some students are now doing their Geriatric rotation in that region.

HEMATOLOGY

(JGH) Segal Cancer Centre – divisions’ activities in cancer are now concentrated in the Segal Cancer Centre (7th floor) and all benign disease including thrombosis continues to be evaluated in the existing location on the first floor of pavilion E. The out‐patient oncology program has been expanded and allows for rapid evaluation of new consults in hematology‐oncology

(MUHC) Hematology

The Division of Hematology continues to offer care to both malignant and benign hematology patients with many subspecialty clinics for patients with defined or rare blood disorders. Specialty clinics are available for high risk obstetrics/hematology, anticoagulation, hemoglobinopathies (sickle cell disease and thalassemia major/intermedia), hemophilia and other rare congenital bleeding disorders, HIV/immunodeficiency and stem cell transplant and multiple myeloma. These clinics function using a multi‐disciplinary team approach and participate in related clinical trials. The combined photophoresis program (MUHC‐Maisonneuve Rosemont Hospital (MRH)) continues to function well, providing care for patients with graft versus host disease and T‐Cell Lymphoma. The number of patients treated in the program is limited by the provincially provided budget. A formal request has been made to the Agence to provide additional funding for this program both for the MUHC and MRH

Specialized clinical programs (MUHC)

• Stem Cell Transplant (Provincially designated) • Photopheresis (Provincially designated) • Hemophilia and rare congenital bleeding disorders (Provincially designated) • Sickle Cell Disease Clinic • Thalassemia major/intermedia Clinic • High risk obstetrics/hematology Clinic • Multiple Myeloma Clinic • Anticoagulation Clinic

Major service lines in hospital(s), major initiatives and priorities

• The MUHC is a major referral center for malignant hematology, particularly acute leukemia (which can only be treated in a limited number of facilities), high grade lymphomas, stem cell transplant candidates, multiple myeloma (given our dedicated myeloma clinic, with associated research activities), relapsed malignant hematology cases and malignant hematology in immune‐compromised hosts. These services, and particular the Stem Cell Transplant Program which is provincially designated, remain a high priority.

• Stem Cell Transplant: The MUHC/McGill transplant program has been provincially designated, FACT and Health Canada certified. It is a major referral program for patients who are transplant candidates within our RUIS.

• Photopheresis: provincially designated program, co‐directed with Hôpital Maisonneuve Rosemont. Treats patients with graft versus host disease and T cell lymphomas.

• Congenital Bleeding Disorders: as one of four provincially designated, this combined adult/pediatric program provides specialized comprehensive care to patients with rare blood disorders. We follow patients and product use from throughout the McGill RUIS. This remains a high priority for our Division.

• Hemoglobinopathies (Sickle cell and Thalassemia): Although not formally designated by the province yet, this activity provides care to a growing population of patients who require expertise in the field and comprehensive care teams. Only two centers in Montreal have established adult sickle cell clinics. Given the rarity of these diseases and the expertise required, we believe this continues to be a high priority for the Division and the MUHC. Further funding/support will be needed in the very near future to support this growing program to allow us to provide truly comprehensive care.

• Multiple Myeloma: In 2010, the MUHC established a dedicated multiple myeloma clinic at the Royal Victoria Hospital site. This clinic is associated with a robust basic science research laboratory program allows patients access to numerous clinical trials. The clinic has become well known in the province with multiple referrals from almost every center in the province.

• High risk obstetrics/hematology: this is an essential supportive care program which functions in conjunction with high risk obstetrics.

Unique, departmental clinical facilities

• In‐Patient Units 7 Medical (RVH) and 17 East (MGH): These dedicated units provide specialized care to patients undergoing stem cell transplant, receiving myeloabaltive chemotherapy, or recovering from these procedures.

• Cell Separator Unit (Plasmapheresis Unit): this unit is located on the 7 Medical in‐patient unit. It provides treatment for both hematological and non‐hematological patients (neurological, solid organ transplant).

• Oncology Day Center and Medical Day Hospital: Many hematology activities can and are performed in Medical Day Hospital settings. This keeps a large number of patients out of emergency rooms and in‐patient units.

Clinical centers of excellence

• Stem Cell Transplant: FACT/Health Canada accreditation ensures quality of services provided.

• Hemophilia/Congenital Bleeding Disorders Clinic: This clinic represents a true example of comprehensive care delivery. This clinic also benefits from being a combined adult/pediatric center with concentration of staff with the required expertise.

• Multiple Myeloma Program: the fusion of clinical care, basic science research and clinical trials has allowed this clinic to flourish into a unique clinical care structure.

• AVN clinic: this clinic also provides a unique blend of basic science research (Dr. Séguin, endothelial disease) and patient care.

Future Plans for Clinical Development in Hematology (MUHC)

• Stem Cell Transplant: this program now benefits from a solid treatment team, laboratory service and database. It has been provincially designated, FACT and Health Canada certified. If it is destined to grow to truly accommodate the requirements of patients within the McGill RUIS, it will continue to require MUHC support, including additional in‐patient space and resources.

• MUHC Transfusion: with the designation of Dr. Patricia Pelletier as the “Expert en Médecine Transfusionelle” for the McGill RUIS, the quality, academic profile and accomplishments of this program will develop.

• “Best Care for Life”: with the movement of the MUHC to the Glen, small programs for rare disorders (blood and other) could be designed with true transition/comprehensive care vision.

MEDICAL BIOCHEMISTRY (MUHC)

Direct Patient Care by attending RVH outpatient clinics: • Lipid Clinics • Adult Genetics Clinic • Osteoporosis Clinics

NEPHROLOGY (MUHC) We continue to provide clinical services in nephrology consultations, hemodialysis, peritoneal and kidney and kidney/pancreas transplantation. We have a strong emphasis on quality assurance in our clinical programs.

Current Clinical Programs Nephrology In addition to general nephrology clinics, we operate predialysis clinics, which offer specialized multidisciplinary services to patients with advanced chronic renal failure. The Division operates a number of tertiary care multidisciplinary clinics, including kidney stones (with Urology and Nutrition) ‐ monthly, complex hypertension (with Internal Medicine) ‐ monthly, systemic lupus erythematosus and kidney disease (with Rheumatology) ‐ monthly, kidney disease in pregnancy (with Obstetrics, Internal Medicine and Endocrinology) ‐ twice monthly, and pediatric to adult kidney disease transition care (with Pediatric Nephrology) and the HIV Nephropathy clinic (with Infectious Disease). We operate a nocturnal home hemodialysis program. The Division oversees two satellite hemodialysis units in Northern Quebec; coverage is, in part, provided via telenephrology. A process for renewing hemodialysis equipment is in progress; equipment has been reviewed and new equipment appears to have been selected. Some new equipment has arrived and the rest is being phased in over the next several months.

Future Plans for Clinical Development in Nephrology

Reorganization of chronic hemodialysis program Another area of clinical and clinical research expertise which could be strengthened is dialysis, including peritoneal dialysis, conventional hemodialysis and continuous hemodialytic therapies. Our nocturnal hemodialysis program has not been able to expanding due to lack of financial support from the administration. Implementation of a hospital information system in hemodialysis at the RVH has progressed somewhat in the past year, although slowly.

NEUROLOGY (MUHC, MGH)

Out‐patients: The MGH site continues to be the venue for 3 subspecialty referral clinics: the McGill Cerebrovascular, Movement Disorders, and Neuropathy Clinics. In addition to being the sites for consultation and ongoing care of patients with these types of neurological disease, these clinics are important

teaching venues for residents. The Movement Disorders Clinic has been recognized since 2008 by the National Parkinson’s Foundation (USA) as a Centre of Excellence for provision of clinical services for patients with Parkinson’s disease and related disorders. In the Cerebrovascular clinic, capacity to see patients with TIA promptly remains an important preoccupation, and for the most part waiting times are in line with evidence‐based clinical guidelines. The Neuropathy Clinic has expanded its clinical staff, allowing the clinic to function weekly throughout the year. In‐patients: The MGH Stroke Unit continues to provide quality care for patients with stroke, in accordance with current Canadian and North American standards of care. Stroke patients are now transferred regularly from the RVH emergency room, and the procedures involved for the most part now occur efficiently and safely. RUIS: The Division continues to provide on‐call telephone consultation to hospitals in Abitibi, covering approximately half of nights and weekends. A tele‐neurology service for patients in Nunavik is being gradually established. The initial goal is to use the service to assist with the management of epilepsy patients, and thus avoid unnecessary and costly air transfers of patients to Montreal.

Future Plans for Clinical Development in Neurology (MGH)

Establish coherent functioning of the McGill Stroke Service Parkinson’s Disease Navigator Project: expand services in rapid‐access clinic for patients with newly diagnosed Parkinson’s disease

RESPIRATORY/PULMONARY A major strength of the Respiratory Division (MUHC) is the development of new highly specialized clinical programs which are integrated with research programs often led by members of the Respiratory Epidemiology and Clinical Research Unit.

Specialized Clinical Programs in Respiratory Medicine and current centres of excellence *(MUHC)

Asthma Clinic*, MCI, MGH Bronchoscopy Clinic – MCI COPD Clinic* – MCI CSST Clinic – MCI Cystic Fibrosis Clinic – MCI Occupational and Environmental Health Clinic – MCI Rapid Investigation Clinic (RIC) ‐ for lung cancer ‐ MCI Sleep Disorders Clinic* – MCI, RVH Smoking Cessation Clinic – MCI

Tuberculosis Clinic* ‐ MCI Lung Cancer Clinic – MGH – developing centre of excellence

Other Developing center of excellence is in home ventilation

New Clinical Programs in Respiratory Medicine (MUHC)

The most important new clinical activity is the Rapid Investigation Clinic for lung cancer, housed at the day hospital at the Montreal Chest Institute. This clinic seeks to substantially to reduce the delays in diagnosis and staging of patients with lung cancer and works closely with members of the multi disciplinary lung cancer clinic at the Montreal General Hospital.

Referrals for pleural procedures including thoracoscopy and PleurX catheter insertion for diagnosis and management of malignant pleural effusion has expanded, while endobronchial ultrasound (EBUS) continues to be a very active service.

Current Clinical Programs in Pulmonary Medicine (JGH)

Airways Centre (4+ years) ‐ multidimensional and multidisciplinary care for patients with asthma and COPD. The COPD program continues to strengthen the established links with Mount Sinai Hospital, the Smoking Cessation and pre‐admission clinics, the CSSS and with exercise facilities in the community Pulmonary Oncology (20+ years) ‐ The Brojde Lung Cancer Centre combines traditional Chinese Medicine and other complementary modalities with mainstream treatment for our lung cancer patients and is based on the philosophies of integrative oncology and holistic nursing Center for Pulmonary Vascular Disease (10+ years) ‐ is one of two major referral centers in the province that diagnose and manage patients with pulmonary hypertension of all causes The Tuberculosis Clinic (10+ years) ‐ serves the hospital by managing the care of almost all patients diagnosed with active tuberculosis in the hospital. Cases of latent tuberculosis are also managed through the TB clinic. Almost all active TB cases both pulmonary and non‐pulmonary are managed through the TB clinic. There are close liaisons with the Departments of Public Health both on and off the island of Montreal.

RHEUMATOLOGY (McGill‐wide; all sites)

The McGill Rheumatology Division provides clinical care in the outpatient, inpatient and emergency areas of all major teaching hospitals of the McGill network. It provides daily, extremely busy consultation services in general rheumatology clinics as well as in specialized collaborative multidisciplinary programs/clinics. To increase expertise and quality of care, specialized clinics are favored. At MUHC, corridors of service are in place with the Constance Lethbridge Rehabilitation

Center for out‐patient care. A corridor of service exists with the Jewish Rehabilitation Center for in‐patient care. All scleroderma patient care is concentrated at JGH.

Current Clinical Programs and New Clinics in Rheumatology

Osteoporosis and bone disease clinics are run in all hospitals (MUHC‐RVH‐The Bone Center, MUHC‐MGH and JGH) in collaboration with endocrinology, nephrology and internal medicine. Scleroderma clinics are held regularly at JGH with cardiology. A joint cardio‐rheumatology clinic is held monthly for scleroderma patients with lung disease and/or pulmonary hypertension. Regional McGill Network referrals and the National Scleroderma Registry are successfully fueling clinical and basic research in scleroderma conducted by the Canadian Scleroderma Research Group. Nailfold videocapillaroscopy is being implanted at the JGH.

Systemic Autoimmune Rheumatic Diseases (SARD) like SLE, SS and vasculitides clinics are held at MUHC‐MGH with neuro., nephro., derm., IM, resp. and hematology. The McGill Lupus and Vasculitis Clinic is a multi‐specialty model of care offering a unique patient‐centered approach. It involves rheumatologists, immunologists, a nephrologist, a respirologist, an internist interested in metabolic bone disease, a haematologist, a neurologist and a dermatologist.

Rheumatoid arthritis clinics are held once a week at MUHC‐RVH with psychologist and nurse practitioner and a corridor of service to CLRC.

Pain clinics are held weekly in conjunction with the Pain Center at MUHC‐MGH with anesthetist, physiatrist, psychologist, OT/PT and social worker.

Transition Clinic The Young Adults Rheumatic Disease (YARD) clinic is growing steadily. YARD transition clinics are held once‐a‐week at MUHC‐MGH with a corridor of service to CLRC. A relationship with the Constance Lethbridge Rehabilitation Center has been established to offer a complementary multidisciplinary program including OT/PT/Social worker, specifically for YARD patients.

Description of unique, departmental clinical facilities

• MSK US imaging to assess disease activity (MUHC sites at RVH, MGH and MCE and JGH

• Polarized light microscopy for crystal identification (regional service) • Videocapillaroscopy to document and establish prognosis in Raynaud’s

phenomenon (regional service) Clinical centers of excellence

• YARD Program at MGH • SARD/CTD Program at MGH • PSS and PHT Program at JGH

• RA Program at RVH • Bone Clinics at all site • Muscle Clinic at MNH • Pain Clinic at all sites and Pain Center at MGH • General Rheumatology Clinics at all sites

Future Plans for Clinical Development in Rheumatology

Musculoskeletal Ultrasound (MSK US) Imaging is now used and performed by rheumatologists all over the world, will soon become officially a required part of adult and pediatric rheumatology training. We are moving forward to be leaders in that area and MSK US imaging equipment was acquired at the three adult sites.

V Clinical Program D‐H

MUHC Clinical Volume Data

MUHC Medical Mission Patient‐days, 5 year summary Acute and Transition Care

2011‐2012 2010‐2011 2009‐2010 2008‐2009

2007‐2008

Royal Victoria Hospital Acute Care

M5C 6,092 6,328 5,897 6,133 5,566 6 Med 8,698 8,554 8,686 9,053 8,186 7 Med 5,607 5,736 5,601 5,701 5,676 8 Med 8,965 8,894 6,759 5,721 6,412 10 Med 8,769 8,707 9,668 10,582 10,209 SSU 4,306 2,843 2,364 3,009 2,623

Total acute 42,437 41,062 38,975 40,199 38,672 Transition Care S7W 8,622 8,247 8,987 9,905 11,297 Total RVH 51,059 49,309 47,962 50,104 49,969

Montreal General Hospital Acute Care

CCU 3,592 3,592 1,879 1,634 1,828 10E 4,959 5,055 5,012 4,608 4,794 13E 8,001 7,984 7,945 7,981 7,891 15TH 16,268 16,590 16,767 17,160 16,494 17E 4,535 4,363 4,009 3,683 4,365 SSU 3,210 2,883 2,717 1,975 1,968

Total acute 40,565 40,467 38,329 37,041 37,340 Transition Care 16TH 10,467 10,656 10,452 10,895 10,927

Total MGH 51,032 51,123 48,781 47,936 48,267

Montreal Chest Institute Acute care 8,731 9,284 9,260 9,170 9,502 Long Term Care 13,538 13,958 13,719 15,670 15,660 Total MCI 22,269 23,242 22,979 24,840 25,162

Total Medical Mission Grand total 124,360 123,674 119,722 122,880 123,398

Excludes patients admitted and discharged the same dayThere is stability or perhaps a slight increase over the past years at the MUHC. These figures do not include any level of complexity.

Source: S:\ADMITTING\ADMITTING SERVICES\Admission & Discharge Statistics Reports Prepared by Dept of Quality, Patient Safety & Performance, APS

MUHC Medical Mission Ambulatory Visits, 5 year summary

Includes doctors’ and nursing visits; excludes ED and day treatment

2011‐2012

2010‐2011

2009‐2010

2008‐2009

2007‐08

252,409 253,715 247,158 237,098

The goal over the next 3 years, as the RVH site closes down and the Glen site opens is to go to a reduction of about 30% in volume, but an increase in complexity. More significant than the crude numbers may be the specialized clinics and services offered by the Department of medicine as listed in A‐C above.

Our weaknesses in the clinical program at the MUHC are mainly in two areas:

1. Insufficient communication between clinical care givers, due at least partly to the lack of a real electronic medical record. 2. Insufficient access to primary care or continuity care, particularly for patients with multisystem disease.

Future Opportunities:

1. The move to the Glen yards is an opportunity to refine how we manage and care for patients requiring specialty care, and how we interact with other community resources and primary care givers. For outpatient services, Drs. Willemot, Sherman, Inglis and Moreau have been mandated to be part of a committee that will determine how to transition medical ambulatory services to an effective model by 2015.

2. The Clinical Investigation Module (CIM) at the MUHC has the opportunity to increase both the quantity and quality of clinical research conducted at the MUHC.

Planned Recruitments:

The Programme Regionale des effectifs medicaux (PREM) system limits the number of MD recruits that may be hired by each division. Thus our main focus is to ensure that those recruited are of excellent calibre and that they are recruited in a manner consistent with the MUHC Clinical Activities Priority Setting (CAPS) exercise. This exercise was completed in 2010, and is a useful document for guiding decisions about hiring and other resource utilization.

Saint Mary’s Hospital Centre Clinical Volume Data

PATIENT DAYS

2011-2012

2010-2011

2009-2010

2008-2009

2007-2008

Totals Totals Totals Totals Totals

8 Main - CD 16,149 16,184 14,732 11,072 9,6958 Main - LC 0 0 0 661 1,2438 Main - SP 819 898 1,185 5,478 6,577

16,968 17,082 15,917 17,211 17,515

7 main - CD 93 2037 main - LC 404 7217 main - SP 14,838 15,532

0 0 0 15,335 16,456

5 South - CD 11,624 11,387 11,450 11,425 11,3135 South - LC 0 0 0 47 5 South - SP 0 2 0 12

11,624 11,389 11,450 11,484 11,313

5 North - CD 7,864 7,633 7,413 6,733 7,8725 North - LC 0 0 0 638 5 North - SP 48 323 492 530

7,912 7,956 7,905 7,901 7,872

Critical Care ICU 2,097 2,051 1,998 2,122 2,011CCU 1,145 1,152 1,178 1,219 1,112

VISITS 2011-2012

2010-2011

2009-2010

2008-2009

2007-2008

Totals Totals Totals Totals Totals

MEDICINE OPD CLINIC

Allergy

406

439

475 410 449

Arthritis

1,386

1,739

1,584 1695 1977

Chest

5,135

4,802

4,496 3981 3624

G.I.

865

836

1,372 1251 1496

Infectious Disease

705

605

599 650 631

Internal Medicine

1,343

1,824

1,773 886 593

OTHER CLINICS

Hematology

6,512

6,439

6,002 5990 5767

Cardiology

3,094

3,352

3,422 3213 2513

Endocrinology

996

1,004

919 795 461

Neurology

721

524

486 428 481 Geriatrics 55 81 64 48 60

Nephrology

1,690

1,681

1,413 1537 1352

MDC CLINICS

Diabetic

1,185

1,153

1,252 1169 1272 Endocrinology - - 2 28 86

JGH Clinical Volume Data

STATS - DEPARTMENT OF MEDICINE -JGH

DIVISION CLINICS 2006-

O7 TOTAL 2007-

O8 TOTAL 2008-

O9 TOTAL 2009-

1O TOTAL 201O-

11 TOTAL 2011-2012 TOTAL

Cardiology General 537 702 1840 2111 2156 5999

Ambulatory Service 8377 7592 5922 5089 5241 1964

Total 8914 8294 7762 7200 7397 7963 Clinical Immun. General 5125 5125 5390 5390 5284 5284 5741 5741 5195 5195 5397 5397 Dermatology General 14328 16579 14723 16423 17112 22204


Total 23261 26989 24477 26212 26854 31275 Endocrinology General 19511 20272 20782 22415 23580 25467

Ambulatory Service 75 77 94 42 ? ?

Pagets 1296 1306 1243 1045 1051 1045 Nutrition Diabetic 1062 1006 1062 1182 993 754 Total 21944 22661 23181 24684 25624 27266 Gastroenterology General 15502 19487 20673 21693 23429 23226


Gastroscopies 7140 3268 Dietician 97 120 130 93 90 Total 23117 24514 22364 23518 25016 24854 Genetics General 0 0 0 0 0 0 Geriatrics General

Geriatric Assessment 601 638 706 715 806 1138

Memory 795 727 834 715 1006 1100 Total 1396 1365 1540 1430 1812 2238 Hematology General 12390 13046 14046 14596 14351 14529 Anticoagulant 21759 20652 20644 20230 21117 21327 CML/CTL Clinic 403 436 433 468 402 365 MPD Clinic 155 202 DVT Clinic 1149 1040 1194 1520 1395 1327 Total 35701 35174 36317 36814 37420 37750

Infectious Dis. Soc/Infectious 16610 14802 14823 18526 18672 19226 TB Total 16610 14802 14823 18526 18672 19226 Internal Medicine General 2600 2281 2139 2355 2839 2187 OPD Clinic 1416 1400 1800 2160 CVPC Clinic 912* 1570* 1455* 1222* 1222* 1222* CVPC Program 50 197 234 162 Smoking 51 203 465 489 Dietician 401 639 926 924 953 Residents' Clinic 1382 1839 1731 1581 1520 Total 4016 5464 6518 7572 6043 5311 Nephrology General 3815 3694 7420 4575 5352 5211 KTC Clinic 508 1155 637 728 829 Dialysis Clinic 358 1113 675 891 782 Renal 248 191 158 178 167 213 Total 4063 4751 9846 6065 7138 7035 Neurology General 8788 8788 8818 8818 7696 7696 7645 7645 7842 7842 6761 6761 Pulmonary General 9323 9323 9803 9803 9949 9949 11842 11842 12585 12961 Clinic 2964 2853 Total 15549 15814 Rheumatology General 5240 5692 5646 6244 7275 10296 Arthritis 517 511 3656 3769 605 1015 Osteoporosis 1296 1351 1487 1604 2479 2412 Total 7053 7554 10789 11617 10359 13723 GRAND TOTAL 169311 169311 175579 175579 180546 180546 188866 188866 194921 194921 204613 204613

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