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REPORTS: DIVISION DIRECTORS

Reports: Division Directors

Cardiology.............................................................................. Dr..Stuart.Connolly

Clinical.Immunology.and.Allergy......................................... Dr..Judah.Denburg

Clinical.Pharmacology.and.Therapeutics............................ Dr..Anne.Holbrook

Critical.Care............................................................................ Dr..Andy.Freitag

Dermatology.......................................................................... Dr..Judy.Wismer

Emergency.Medicine............................................................. Dr..Margaret.Ackerman.

Endocrinology.and.Metabolism........................................... Dr..Hertzel.Gerstein

Gastroenterology................................................................... Dr..Paul.Moayyedi

General.Internal.Medicine.................................................... Dr..Akbar.Panju.

Geriatrics................................................................................ Dr..Sharon.Marr

Hematology.and.Thromboembolism................................... Dr..Mark.Crowther

Infectious.Diseases................................................................ Dr..Mark.Loeb

Nephrology............................................................................ Dr..Alistair.Ingram

Neurology............................................................................... Dr..John.Turnbull.

Physical.Medicine.and.Rehabilitation.................................. Dr..David.Harvey

Respirology............................................................................ Dr..Gerard.Cox

Rheumatology........................................................................ Dr..Rick.Adachi

Educational.Activities.Program.Director:.Dr..Alison.Montgomery

The.Cardiology.Residency.Program.has.expanded.to.a.total.of.12.trainees,.4.of.whom.are.Gulf.State.Trainees...Presently,.all.educa-tional.activities.occur.at.the.Hamilton.General.Hospital,.with.the.exception.of.the.two.months.of.Pediatric.Cardiology.and.Adult.Congenital.at.McMaster...Plans.are.underway.to.expand.learning.opportunities.at.HGH.and.Henderson.to.accommodate.the.‘Access.to.Best.Care’.cen-tralization.of.cardiac.services.and.shift.in.the.General.Internal.Medicine.Clinical.Teaching.Unit...Dr..Girish.Nair.was.awarded.the.Ernest.Fallen.Teaching.Award.in.Cardiology...Dr..Sherryn.Rambihar,.PGY5,.received.the.Gold.Medal.2010.for.oral.presentation.at.the.annual.Department.of.Medicine.Research.Day.

Daily.teaching.rounds.are.provided.with.exten-sive.curriculum.development.over.the.past.three.years,.as.well.as.multiple.evaluative.tools.(OSCE’s,.written.and.oral.examinations),.which.have.resulted.in.continued.success.for.our.train-ees.in.their.subsequent.Fellowships.and.RCPSC.exams...

Research.ProgramThe.major.research.programs.in.the.Division.

are.in.clinical.trials,.epidemiology.and.labora-tory-based.studies.on.the.major.factors.affecting.our.cardiovascular.health..These.are.on.the.fol-lowing.themes.in.which.divisional.members.play.leading.roles.as.Principal/Lead.Investigators,.working.through.national.and.international.net-works:.acute.coronary.syndromes.and.myocardi-al.infarction,.cardiac.arrhythmias.(sudden.death,.implantable.defibrillators,.rhythm.and.anti-thrombotic.management.in.atrial.fibrillation),.heart.failure.(in-hospital.and.community.man-agement),.prevention.of.cardiovascular.disease.(primary.and.secondary.prevention,.risk.factors),.and.quality.of.care.initiatives...While.most.of.these.studies.are.carried.out.under.the.umbrella.of.the.Population.Health.Research.Institute.(e.g..INTERHEART,.OASIS.5.&.6,.ONTARGET,.POISE,.HOPE-TOO,.DREAM.and.EpiDREAM,.ACTIVE,.ORIGIN,.PURE,.GIFT,.WAVE,.FAMILY,.BENEFIT),.individual.members.also.collaborate.and.lead.other.studies.with.national.and.international.col-leagues.in.addressing.major.questions.in.cardi-ology.and.cardiovascular.diseases.(e.g..CHARM,.DINAMIT,.ASSERT,.I-PACE,.RAFT,.COURAGE,.FATE,.ASTRONOMER,.AIM.HIGH)..

All.of.these.studies.will.have.a.large.impact.on.the.understanding.and.treatment.of.almost.all.aspects.of.cardiac.and.cardiovascular.risk.factors.and.diseases..Funding.for.these.stud-

Dr. Stuart J. Connolly MD,.FRCPC Division Director

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ies.comes.from.numerous.sources,.including.national.granting.agencies.and.industry.part-ners..Members.have.been.successful.in.obtain-ing.major.grants.from.the.CIHR,.Heart.and.Stroke.Foundation.and.other.granting.authori-ties..A.major.strength.of.the.Division.continues.to.be.the.mentorship,.help.and.support.provided.to.junior.colleagues.with.research.programs.to.help.them.become.established...Reflecting.broad.involvement.by.members.and.the.large.areas.of.research,.the.Division.continues.to.maintain.a.prolific.publication.productivity.with.over.100.publications.per.year..Findings.from.the.research.have.influenced.the.prevention.and.treatment.of.cardiovascular.diseases.globally.

Major.Achievements.The.Cardiology.Division.continues.a.very.

active.role.in.cardiovascular.research...It.is.associated.closely.with.the.Population.Health.Research.Institute.(PHRI).and.many.members.of.the.Division.of.Cardiology.are.active.scientists.within.this.institute...

Future.DirectionsMajor.new.directions.for.the.Division.of.

Cardiology.will.be.to.align.our.services.through.‘Access.to.Best.Care’,.with.changes.occurring.in.all.four.hospitals.in.the.City...Cardiology.consoli-dation.has.been.in.the.planning.stages.for.many.years.and.will.be.realized.as.ABC.is.implement-

ed...A.major.initiative.is.the.development.of.a.peri-operative.high-risk.management.unit.at.the.Henderson.Hospital.to.provide.clinical.care.and.research.opportunities.related.to.the.manage-ment.of.patients.at.high.risk.for.cardiovascular.adverse.events.while.undergoing.non-cardiac.surgery...Another.major.initiative.will.be.con-solidation.of.the.non-invasive.cardiac.diagnostic.units.at.Hamilton.Health.Sciences.under.single.leadership.and.hospital.management...The.plan.is.to.upgrade.these.services,.especially.echocar-diography,.to.continue.to.provide.a.high.level.of.clinical.care.

Dr. Judah A. Denburg MD,.FRCPC.Division Director

Educational.Activities.The.Clinical.Immunology.and.Allergy.training.

program.is.the.only.integrated.Adult/Pediatric.program.in.the.country.and.received.full.approval.in.the.most.recent.Royal.College.onsite.review..Dr..Michael.Cyr.continues.as.Training.Program.Director..There.is.also.an.RCPSC-approved.combined.subspecialty.training.pro-gram.in.Rheumatology/Clinical.Immunology.amd.Allergy..

There.are.five.fellows,.from.both.Pediatrics.and.Internal.Medicine,.currently.in.full-time.training,.in.addition.to.residents.doing.ambulatory.care.in.Clinical.Immunology.and.Allergy..Graduating.trainees.have.proceeded.to.academic.and.clini-cal.careers.in.Clinical.Immunology.and.Allergy.in.Canada.and.internationally..In.addition,.a.substantial.number.of.postdoctoral.PhD.and.MD.research.fellows,.as.well.as.visiting.scientists,.regularly.join.our.Division.

Undergraduate.teaching.is.well.supported.by.our.divisional.faculty..Our.weekly.Allergy.and.Immunology.Rounds,.with.internationally.renowned.invited.speakers.on.occasion,.are.a.major.success,.and.receive.support.through.unrestricted.educational.grants..Other.seminars,.journal.clubs.and.teaching.sessions.are.a.regular.feature..

Research.Programs.Principal.research.themes.are.Inflammation.

and.Immunity.as.they.relate.to.the.respiratory.tract.(allergic.rhinitis,.nasal.polyposis,.asthma),.but.with.interests.also.in.other.organ.systems..Specific.themes.for.which.the.group.has.inter-national.renown.include.autoimmune.diseases,.mechanisms.of.allergic.inflammation.and.immune.regulation,.respiratory.inflammation,.asthma,.and.reproductive.immunology..Peer-reviewed.and.private.sector.funding.for.investi-gation.into.allergic.airways.inflammation,.food.allergy,.immunoregulation,.stress.and.immunity,.and.new.biologics.in.pre-clinical.and.clinical.models.continues.to.grow..Thus.there.exist.many.research.opportunities.for.students,.postdoctoral.fellows.and.others.pursuing.continuing.medical.education.for.an.investigative.career..The.pres-ence.of.AllerGen.NCE.at.McMaster.has.allowed.for.major.expansion.of.ongoing.research.col-laborations,.especially.in.food.allergy,.asthma.and.the.development.of.atopy.

Major.Achievements.The.Division.congratulates.Dr..Derek.Haaland.

on.receiving.the.Geoff.Carr.Fellowship.which.provided.funding.for.one.year.to.study.SLE..Dr..Haaland.and.colleagues.in.Immunology,.Rheumatology,.Nephrology.and.Pathology.

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have.an.ongoing.research.program.exploring.candidate.T-cell.immunogens.in.SLE.and.asso-ciated.nephritis..In.July.2010,.Dr..Haaland.will.be.joining.our.Division.as.an.Assistant.Clinical.Professor.

The.Division.would.also.like.to.congratulate.Dr..Maggie.Larché.who.was.awarded.a.Department.of.Medicine.AFP.Internal.Career.Research.Award.this.year.

Dr..Ilan.Asher.was.the.recipient.of.a.Lung.Association/Canadian.Thoracic.Society/AllerGen.Clinician-Scientist.Asthma.Award,.and.was.actively.involved.in.our.Division.clinically.and.in.laboratory.research.until.May.2010...

Dr..Khalil.Karimi.has.joined.our.Division,.and.along.with.Dr..Petra.Arck,.a.CRC.Tier.2.in.Neuroimmunology.based.at.the.Brain-Body.Institute.at.St..Joseph’s.Healthcare,.will.bolster.research.and.education.in.the.area.of.early-life.determinants.of.allergy.and.asthma,.and.in.neuro-immune.pathways..

Dr..Mark.Larché’s.research.group.published.findings.of.a.major.study.into.the.immunological.mechanisms.of.peptide.immunotherapy.in.the.prestigious.Journal.of.Experimental.Medicine..

Dr..Larché.also.registered.three.patents.in.2009.related.to.the.development.of.peptide.immu-notherapy.vaccines..A.Phase.IIa.clinical.trial.of.a.vaccine.for.cat.allergy.developed.in.Dr..Mark.Larché’s.laboratory.was.completed.by.McMaster-based.Adiga.Life.Sciences.(a.joint.venture.between.McMaster.University.and.Circassia.Ltd.,.a..UK.biotech.company).this.year,.with.encour-aging.results..Further.trials.of.vaccines.for.house.dust.mite,.ragweed.and.grass.allergy.are.cur-rently.underway.in.Canada.

Future.Directions.With.all.the.above.activity,.maintenance.of.a.

critical.mass.of.academically.committed.mem-bers.of.our.division.is.a.high.priority..The.grow-ing.outpatient.load.and.the.hospital.restructur-ing.make.it.necessary.to.provide.greater.service.to.a.larger.volume.of.patients.over.a.larger.area..Moreover,.the.international.stature.of.research.emanating.from.our.Division.and.in.general.from.the.Immunology.and.Infection.Program.at.McMaster,.with.new.opportunities.of.linkage.to.respiratory.health.and.inflammation.through.the.CFI.endeavour.at.St..Joseph’s.Healthcare,.pro-vide.new.opportunities.for.academic.growth.of.our.Division..

Educational.ActivitiesAlthough.the.Division.is.the.smallest.in.the.

Department,.members.play.a.major.role.in.edu-cation..This.includes.year-round.supervision.of.medical.students.and.residents.on.internal.medi-cine.clinical.services.at.St..Joseph’s.Healthcare.and.Hamilton.Health.Sciences,.as.well.as.elec-tive.rotations.through.our.specialty.service..Faculty.members.are.active.supervisors.in.postgraduate.education.at.the.Masters.and.PhD.level.in.Medical.Sciences,.Pharmacology,.Health.Research.Methodology.and.Pharmaceutical.Sciences.at.both.McMaster.University.and.the.University.of.Toronto..The.Division.draws.Doctor.of.Pharmacy.students.from.across.the.country.for.clinical.and.research.rotations,.as.well.as.undergraduate.pharmacology,.health.sciences.and.statistics.students.from.McMaster..In.addi-tion,.the.Division.is.in.constant.demand.to.supervise.workshops,.electives,.tutorials,.aca-demic.half.days.and.continuing.medical.educa-tion.sessions..

Clinical.Pharmacology.and.Therapeutics.(CPT).participates.in.a.University.of.Toronto-coordi-nated.clinical.pharmacology.residency.training.program.accredited.by.the.Royal.College.of.Physicians.and.Surgeons.of.Canada...We.are.actively.recruiting.trainees.and.graduates...We.continue.to.lobby.for.joint.specialty-clinical.

pharmacology.training...Our.CIHR-funded.train-ing.program.provides.clinical.trainees.with.high.quality.evidence.on.interdisciplinary.research.methods.and.practice.

Research.ProgramsDespite.its.small.numbers,.the.Division.contin-

ues.to.be.highly.successful.in.attracting.research.funding,.largely.because.of.a.very.wide.col-laborative.network.within.medicine,.pharmacy,.nursing,.epidemiology,.economics.and.the.social.sciences..Grants.come.from.a.variety.of.sources,.including.the.Canadian.Institutes.for.Health.Research.(CIHR),.Ontario.Ministry.of.Health.and.Long.Term.Care,.Health.Canada,.Canadian.Agency.for.Drugs.and.Technologies.in.Health,.national.foundations,.professional.associations,.colleges.and,.rarely,.pharmaceutical.compa-nies...Our.research.topics.focus.on.the.benefits,.harms,.economics.and.evidence.for.therapies.and.include.projects.examining.methods.of.improving.prescribing,.the.impact.of.electronic.medical.records.and.computer-based.decision.support,.the.impact.of.changes.in.drug.policies.on.health.and.health.care.utilization,.patient.preferences.regarding.therapies,.the.develop-ment,.dissemination.and.implementation.of.evidence-based.guidelines.for.therapies,.medica-tion.assessment.and.pharmacist.intervention.in.

Dr. Anne Holbrook MD,.PharmD,.MSc,.FRCPC.Division Director

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primary.care.clinics,.medication.adherence.sup-port,.patients’.needs.for.therapeutic.information,.electronic.registries.and.automated.data.collec-tion.for.outcomes.research.in.priority.diseases,.and.mechanisms.of.drug.interactions..As.well.as.scholarly.papers.and.presentations,.members.of.the.Division.hold.multiple.copyrights.and.pat-ents.on.research.products,.software,.reports.and.guidances.

Major.AchievementsThe.recent.Department.initiative.to.quantify.

and.rank.academic.activities.of.all.faculty.has.shown.that.clinical.pharmacologists.are.amongst.the.very.top.percentile.group..

One.of.the.unique.features.of.our.division.is.its.ability.to.directly.impact.professional.prac-tice.and.patient.care.through.drug.policy.deci-sion-making...Our.leadership.in.evidence-based.therapeutics.and.inter-professional.practice.leads.

to.multiple.major.advisory.roles.with.the.federal.and.provincial.governments,.as.well.as.leader-ship.positions.in.provincial.and.national.profes-sional.societies...

Future.DirectionsSince.therapies.are.a.prevalent.and.increasing-

ly.costly.sector.of.health.care,.clinical.pharma-cologists.with.training.in.medicine,.pharmacol-ogy.and.epidemiology.are.in.high.demand.but.critically.short.supply..Thus,.a.major.immediate.goal.of.the.Division.is.the.recruitment.of.new.members.to.allow.us.to.address.the.significant.needs.for.therapeutics.and.toxicology.consul-tation,.for.education.to.improve.prescribing.practices.and.medication.safety,.and.to.expand.our.involvement.in.health.policy.and.research..Overall,.the.Division.will.proceed.with.its.goal.of.excellence.in.the.research,.teaching.and.clinical.application.of.pharmacologic.principles.and.evi-dence-based.therapeutics.

Educational.ActivitiesThe.Critical.Care.Program.continues.to.offer.

a.Royal.College.accredited.two-year.Fellowship.Program.(Program.Director:..Dr..T..Karachi)...We.currently.have.14.national.or.international.fel-lows.in.the.program...The.Critical.Care.Program.offers.formal.rotations.for.residents.from.a.variety.of.other.specialties..There.is.a.formal.selective.rotation.in.Critical.Care.being.offered.to.medical.students.in.their.clerkship,.as.well.as.formal.electives.to.medical.students.and.residents...We.continue.to.provide.a.multidisci-plinary.Regional.Critical.Care.Journal.Club,.as.well.as.Regional.Critical.Care.Rounds.hosted.by.our.faculty.(Organizer:.Dr..A..Fox-Robichaud)..We.offer.a.national.advanced.Critical.Care.Simulator.Course.(Organizer:.Dr..A..Fox-Robichaud).using.a.state-of-the-art.laboratory...Formal.educational.sessions.are.conducted.on.a.daily.basis,.as.well.as.a.once.weekly.regional.round.(Organizer:..Dr..M..Soth).for.residents.during.their.Critical.Care.rotation...Regional.weekly.rounds.are.based.at.MUMC.and.are.given.by.the.fellows.with.faculty.supervision..

Research.The.Adult.Critical.Care.Fellowship.Program.

mandates.all.fellows.to.complete.a.research.project.under.the.supervision.of.faculty.in.the.

Division...There.is.an.Annual.Fellows.Research.Day.in.conjunction.with.the.Fellowship.Program.at.the.University.of.Western.Ontario..Many.of.the.abstracts/projects.are.also.presented.at.a.variety.of.international.conferences.with.subse-quent.peer-reviewed.publication...

Drs..D..Cook.and.M..Meade.co-chair.a.research.mentorship.group.dedicated.to.formal.training.in.research.methodology.and.stewardship....

Members.of.the.Division.are.active.participants.in.the.Canadian.Critical.Care.Trials.Group.dedi-cated.to.designing.and.implementing.multi-cen-tre,.multi-national.trials.in.Critical.Care.Medicine..Several.members.of.the.Division.are.either.principal.or.co-investigators.in.a.variety.of.trials.including.studies.involving.DVT.prophylaxis.in.critically.ill.patients;.modes.of.mechanical.ven-tilation.best.suited.for.patients.with.ARDS;.fluid.resuscitation.in.septic.shock.and.sedation.proto-cols.in.ICU.patients...

Major.AchievementsDr..D..Cook.remains.the.Co-chair.of.the.evi-

dence-based.practice.centre.at.McMaster.University.as.well.as.the.Director.of.ICU.Clinical.Effectiveness.and.Outcomes.Research.at.St..Joseph’s.Healthcare,.Hamilton...She.remains.the.Academic.Chair.of.Critical.Care.Medicine.at.

Dr. Andreas Freitag.MD,.FRCPC.Division Director

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McMaster.University.and.holds.the.McMaster.University/St..Joseph’s.Healthcare.Regional.Academic.Chair.in.Critical.Care.Medicine,.as.well.as.the.Canadian.Research.Chair.of.Research.Transfer.in.Intensive.Care...

Dr..C..Hamielec.is.the.President.of.the.Canadian.Intensive.Care.Foundation...Through.the.Ministry.of.Health.there.has.been.the.establishment.of.Critical.Care.Response.Teams.(RACE),.three.of.which.are.in.Hamilton...Dr..P..Kraus.sits.on.a.provincial-wide.Critical.Care.Committee,.which.advises.government.and/or.creates.policy.with.regards.to.future.directions.in.Critical.Care.utilization,.funding.and.standards.of.care...There.is.ongoing.financial.support.for.the.Clinical.Critical.Care.Assistants.Program.sponsored.by.the.Ministry.of.Health,.Hamilton.Health.Sciences.and.St..Joseph’s.Healthcare...Dr..A..Freitag.is.the.Medical.Director.for.the.Regional.Advanced.Adult.Critical.Care.Transport.Team....Dr..D..Jichici,.co-founder.of.the.Canadian.Neurocritical.Care.Society,.remains.the.co-chair......

Future.DirectionsWe.will.continue.to.provide.support.and.lead-

ership.in.the.delivery.of.Critical.Care.Services.in.Hamilton,.as.well.as.the.LHIN,.as.we.recon-figure.through.the.“Access.to.Best.Care”.plan.at.Hamilton.Health.Sciences.and.the.future.expansion.of.St..Joseph’s.Healthcare...We.are.working.with.the.LHIN.to.establish.and.integrate.a.regional.chronic.ventilator.assessment.unit/program..We.will.continue.to.recruit.dedicated.Intensivists.with.an.academic.career.in.Critical.Care.Medicine...Beyond.our.current.practice.we.will.continue.to.develop.and.implement.best.practice.guidelines.in.Critical.Care,.as.well.as.to.establish.two.new.Critical.Care.Response.Teams.–.one.at.the.JCC.and.one.for.high.risk.Obstetrics.at.MUMC..

Dr. Judy Wismer MD,.FRCPC Division Director

Educational.ActivitiesThe.Dermatology.Division.has.continued.its.

commitment.to.undergraduate.teaching...This.year,.a.Malignant.Melanoma.patient.problem.was.introduced.into.the.MF4.tutorial-based.learning...This.will.significantly.expand.the.learn-ers’.introduction.to.skin.oncology,.surgical.and.medical.management,.disease.prevention.and.early.detection...It.will.connect.the.learner.to.an.expanded.E-learning.library.including.basic.morphology.and.skin.immunology...It.is.comple-mented.by.an.extensive.Melanoma.E-learning.module.

The.annual.Day.in.Dermatology,.combining.lecture.format.and.clinical.viewing,.is.offered.in.MF4...Our.understanding.of.its.efficacy.as.a.teaching.format.will.be.aided.by.pre-.and.post-testing.introduced.this.past.year.

Large.group.sessions.continued.to.be.provid-ed,.in.addition.to.the.pre-LMCC.lecture...Clinical.rotations.are.organized.for.undergraduate.medi-cal.students,.Family.Medicine.residents.and.PGY1.Internal.Medicine.residents...Block.and.horizontal.electives.are.offered.by.Drs..Muhn,.Edstrom,.O’Malley,.Rosen,.Saveriano,.Vender,.Vignjevic,.Murphy.and.Wismer..

Members.continue.to.lecture.nationally.and.

internationally...Journal.club.and.clinical.teach-ing.rounds.are.held.monthly..

Clinical.RecruitmentThe.division.welcomes.a.new.GFT.faculty.

member,.Dr..Hermenio.Lima...Dr..Lima.obtained.his.MD.from.Universidade.Federal.Do.Ceara.in.Brazil.in.1989...He.completed.his.PhD.in.1995.from.Harvard.School.of.Public.Health...His.major.was.Immunology.and.minor.was.Molecular.Biology.and.Tropical.Medicine...In.2000,.Dr..Lima.was.promoted.to.Full.Professor.of.Dermatology.at.Universidade.Federal.De.Santa.Catarina....Furthermore,.from.2003-2007.Dr..Lima.was.an.Assistant.Professor.and.Head.of.Clinical.Immunology.and.Allergy.at.Universidade.Federal.Do.Parana.in.Brazil...He.also.held.the.position.of.Professor.of.Dermatology,.which.was.a.cross.appointment,.from.2003-2008...From.2008.to.2010,.Dr..Lima.was.a.Research.Fellow.in.the.Department.of.Dermatology.at.Harvard.Medical.School...His.main.research.interests.are.autoimmune.skin.disease.as.well.as.skin.mani-festations.of.tropical.diseases...To.date,.Dr..Lima.has.published.47.peer-reviewed.articles,.one.book.and.three.book.chapters..Dr..Lima’s.clinical.responsibilities.will.be.both.at.the.Kitchener-Waterloo.and.McMaster.campuses...He.is.also.committed.to.ongoing.research.and.teaching.

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responsibilities...We.welcome.Dr..Lima.to.our.division..

Dermatology.Residency.ProgramAt.the.time.of.this.writing,.final.approval.is.

pending.for.a.combined.McMaster/University.of.Toronto.dermatology.residency.program...It.is.expected.that.the.first.resident.will.be.accepted.for.July.2011...The.goal.of.the.joint.Dermatology.Residency.Program.is.to.provide.an.outstanding,.broad-based.education.in.dermatology.and.to.encourage.training.physicians.to.consider.future.practice.within.the.Greater.Hamilton.area.....

The.first.two.years.of.rotating.internship.and.subspecialty.medicine.will.occur.at.McMaster.teaching.sites,.with.the.exceptions.of.tropical.medicine.and.dermatopathology,.which.will.occur.at.Toronto.teaching.sites...Residents.in.the.PGY1.and.PGY2.years.will.participate.in.the.academic.half-day.in.Toronto.for.the.introduc-tory.dermatology.course,.the.once-monthly.longitudinal.course,.all.major.continuing.medi-cal.education.events.and.the.Resident.Retreat..

PGY3-5.years.will.occur.at.University.of.Toronto.teaching.sites,.with.up.to.3.months.each.year.at.McMaster.teaching.sites..

Future.DirectionsAttracting.and.retaining.well-trained,.academic.

dermatologists.continues.to.have.the.highest.priority...This.is.in.addition.to.the.planning.and.implementation.of.the.joint.dermatology.training.program...A.Melanoma.screening.clinic.contin-ues.to.be.a.much.needed.addition.to.the.present.service.model..

Clinical.ActivitiesDermatologists.continue.to.blend.clinical.prac-

tice.in.private.offices.with.hospital-based.service.including.teaching.clinics.at.3V2.McMaster.(Drs..Wismer,.Edstrom.and.Lima),.non-melanoma.skin.cancer.clinic.at.the.Juravinski.Cancer.Centre.(Drs..Muhn.and.Rosen),.and.Vascular.Anomalies.Clinic,.McMaster.site.(Dr..O’Malley)...Hospital.consultative.service.and.on-call.weekend.cover-age.continues.to.be.provided..

Educational.ActivitiesThis.past.year.has.been.one.of.transitions.for.

the.undergraduate.and.postgraduate.programs...After.introducing.Emergency.Medicine.as.a.mandatory.four-week.component.of.the.medi-cal.school.curriculum,.developing.an.innovative.clerkship.teaching.week.and.leading.its.imple-mentation,.Dr..Suneel.Upadhye.stepped.down.from.his.position.as.Undergraduate.Coordinator.with.the.intent.of.enhancing.his.contributions.in.research...He.once.again.won.the.School.of.Medicine.Outstanding.Preceptor.Award...Dr..Sarah.McClennan.is.the.new.Undergraduate.Coordinator.and.is.developing.teaching.resourc-es.on.the.web.site...A.major.challenge.for.the.program.is.providing.similar.teaching.to.the.campuses.in.Kitchener-Waterloo.and.Niagara.

At.the.Annual.Emergency.Medicine.Awards.Dinner,.the.residents.recognized.Dr..John.Crossley.for.his.contributions.as.Program.Director...There.was.a.slide.presentation.of.pic-tures.from.resident.activities.for.the.past.eight.years...He.was.presented.with.a.book.containing.comments.and.pictures.from.past.and.pres-ent.residents...Thanks.go.to.Dr..Teresa.Chan.for.leading.this.initiative...In.July,.Dr..Ian.Preyra,.a.graduate.of.the.program,.assumed.the.role.of.Program.Director...He.will.lead.a.program.that.now.averages.25.residents.with.robust.clinical.

and.academic.components...Dr..Josh.Williams.will.continue.assisting.the.Program.Director,.with.the.Academic.Half.Day.and.Journal.Club.as.his.major.responsibilities.

Dr..Jonathan.Sherbino.continues.to.lead.Professional.Development.for.the.Division...The.EBEM.(Evidence.Based.Emergency.Medicine).Conference.is.an.annual.event.co-chaired.by.Jonathan.and.Dr..Rob.Kerr.and.remains.a.very.popular.event.for.regional.emergency.staff...A.new.monthly.educational.event,.“Coffee.and.Critique”,.for.Emergency.Medicine.faculty.has.been.introduced.that.is.co-ordinated.with.the.assistance.of.Dr..Raj.Vadera...Along.with.discuss-ing.a.topic.of.interest,.the.Emergency.Physicians.get.to.show.the.features.of.their.new.iPads.

BEEM.(Best.Evidence.in.Emergency.Medicine).

Dr. Margaret Ackerman MD,.FRCPC Division Director

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continues.under.the.leadership.of.Drs..Andrew.Worster.and.Suneel.Upadhye,.providing.courses.in.Canada.and.USA...This.unique.program.presents.critical.appraisals.of.relevant.and.interesting.articles.chosen.by.a.large.group.of.Emergency.Physicians...Selected.articles.are.distilled.and.published.in.PEPID...A.new.initia-tive.is.a.journal.club.component.where.a.critical.appraisal.is.posted.monthly.on.the.BEEM.web-site.for.use.in.EM.resident.programs.

Research.ProgramDr..Andrew.Worster.leads.the.Division.research.

program.and.has.a.strong.presence.in.the.resi-dency.curriculum...The.annual.Resident.Research.Day.continues.to.grow.in.quality.under.his.lead-ership...Drs..Worster,.Sherbino,.Upadhye.and.Welsford.continue.to.be.consistent.contributors.to.journals..

Future.DirectionsWith.our.move.to.the.McMaster.Clinic.at.the.

Hamilton.General.Hospital,.there.is.room.to.expand.after.being.2-3.people.per.office...We.continue.to.enhance.our.GFT.base.and.welcome.Dr..Rahim.Valani.to.the.Division...Rahim.will.be.unique.to.McMaster.University.with.Royal.College.Fellowships.in.Emergency.Medicine.and.Pediatric.Emergency.Medicine...This.will.strengthen.undergraduate.and.resident.teaching.in.Pediatric.EM.and.build.relationships.between.the.Departments.of.Medicine.and.Pediatrics...

As.simulator.training.takes.a.more.defined.role.in.training.and.maintaining.competence,.a.pro-gram.under.the.direction.of.Drs..Raj.Grewal.and.Lorna.Junker-Andersen.is.nearing.implementa-tion...In.the.near.future,.faculty.training.on.the.use.of.simulator.and.debriefing.techniques.will.begin,.to.be.followed.by.the.inclusion.of.simula-tor.training.in.the.residency.curriculum.

To.strengthen.the.research.program,.the.Division.plans.to.hire.a.Research.Coordinator.to.be.responsible.for.design.and.implementation.of.studies.for.faculty.members.and.residents.

Dr. Hertzel C. Gerstein MD,.MSc,.FRCPC Division Director

Educational.Activities.and.Roles1. Undergraduate Medicine

Coordination.of.Medical.Foundations.2.(MF2).and.its.endocrine.subunit

Planning.and.leading.large.group.sessions.

Tutoring.in.MF2,.MF3.and.clerkship,.and.clinical.skills.preceptorships

Advising.for.the.McMaster.University.Medical.Journal

OSCE.examinations

2. Postgraduate Medicine

Teaching.on.the.CTU

Co-chairing.the.McMaster.University.Internal.Medicine.Review.Course

Clinical.electives.in.Endocrinology.and.Metabolism

Monthly.city-wide.Endocrine/Metabolic.Grand.Rounds.and.Journal.Club.

Directing.the.International.Health.Program.for.Internal.Medicine.

Program.Director.of.Medical.Biochemistry.Residency.

a)

b)

c)

d)

e)

a)

b)

c)

d)

e)

f)

3. Postgraduate Health Research Methodology and Other Programs

4.current.postdoctoral.students.and.4.MSc.students..

Several.thesis.committees.and.chairs

PhD.comprehensive.exams.and.PhD.exams.

4. Other Education including CME, and General Public Education

Organization.of.one.diabetes.and.one.endocrinology.CME.Program.

Faculty.for.CME.events.for.family.physi-cians,.specialists,.and.allied.health.profes-sionals.in.more.than.100.local,.national.and.international.forums.

Organization.of.annual.diabetes.public.forum.with.>.600.attendees.

Quarterly.publication.of.the.Diabetes.Hamilton.publication.“Knowing.Diabetes”,..and.distribution.to.all.family.MDs.and.4200.people.with.diabetes..

Editorial.consultant.for.American.College.of.Physicians.–.PIER.(.Physicians.Information.and.Education.Resource).module.on.hypercalcemia

a)

b)

c)

a)

b)

c)

d)

e)


Endocrinology and Metabolism

86


Editorial.board.memberships.for.several.journals

Chair.or.co-chair.of:..i).Doctors.for.Humanity.Public.Forum.(an.international.organization.dedicated.to.improving.well-being.by.providing..access.to.advances.in.Medicine);.ii).International.Taskforce.on.the.diagnosis.and.management.of.hypoparathyroidism;.iii).Premenopausal.Osteoporosis.Guidelines.project;.iv).Evaluation.committee.for.the.Physician.Assistant.Program;.v).Scientific.program.of.an.international.diabetes.symposium.

International.and.Local.Research.Programs

Collaborative.research.across.disciplines.is.the.key.distinguishing.characteristic.of.the.division..All.members.of.the.division.are.directly.or.indi-rectly.involved.in.research..Several.members.are.pursuing.an.extensive.program.of.basic.and/or.clinical.research.related.to.obesity,.diabetes,.dysglycemia,.cancer.and.cardiovascular.disease,.bone.diseases,.and.osteoporosis...These.are.done.in.close.collaboration.with.the.Population.Health.Research.Institute,.members.of.other.divisions,.the.department.of.CE&B,.the.Centre.for.Evaluative.Medicines,.and.other.universities.around.the.world...They.include:.

receipt.of.more.than.6.new.operating.grants.from.peer-review.agencies.or.indus-try;..

publication.of.more.than.35.peer-reviewed.articles.or.chapters.in.the.2009-2010.aca-demic.year;

basic.and.clinical.research.related.to.the.causes.and.consequences.of.dysglycemia;.

international.leadership.of,.and.participa-

f)

g)

1.

2.

3.

4.

tion.in,.several.international.clinical.trials.of.various.approaches.to.prevent.serious.health.outcomes.in.dysglycemic.individu-als;

international.leadership.in.osteonecrosis,.bisphosphonate.therapy,.and.metabolic.bone.diseases;

analysis.of.pan-Canadian.diabetes.care.registry.data.to.assess.diabetes.care.in.Canada;.

assessment.of.knowledge.translation.approaches.to.facilitate.diabetes.self-man-agement;

service.on.4.DSMBs.

Major.Awards.and.New.Achievements.in.2009-2010

The.Endocrinology.and.Metabolism.post-graduate.training.program.successfully.recruited.its.first.subspecialty.fellow.who.began.in.July.2010.

Dr..Manoela.Braga.joined.the.Division.and.will.be.based.at.SJH.

Dr..Gianluca.Iacobellis.accepted.an.appoint-ment.at.the.University.of.Miami.

Future.DirectionsDivisional.recruitment

Developing.and.assessing.innovative.edu-cational.approaches.for.patients.and.physi-cians.

Ongoing.research.assessing:.molecular.mechanisms.by.which.obesity.causes.insulin.resistance/type.2.diabe-tes;

role.of.fats.and.inflammation.as.major.contributing.factors.causing.the.meta-bolic.disturbances.observed.with.obe-sity;...

how.and.why.exercise.prevents/reverses.type.2.diabetes;

causes.and.consequences.of.dysglyce-mia.and.obesity;.

role.of.perioperative.dysglycemia;

bone.health.and.calcium.disorders.

5.

6.

7.

8.

1.

2.

3.

1.

2.

3.a)

b)

c)

d)

e)

f)

Cross sectional view of an artery wall. Vascular smooth muscle cells are stained green. Stress markers that we have associated with conditionals of hyperglycemia and atherosclerosis are stained orange.

Dr. G. Werstuck lab

Diabetes Control

Educational.ActivitiesThe.popularity.of.the.Division.of.

Gastroenterology’s.national.endoscopy.train-ing.programs.continues.to.grow...This.includes.a.“Train.the.Trainers”.course.and.the.sixth.annual.McMaster.Residents’.Endoscopy.Training.Course...Dr..David.Armstrong,.Dr..Frances.Tse.and.Dr..John.Marshall.organize.this.course,.with.invaluable.support.from.the.English.NHS.National.Endoscopy.Training.Lead,.Dr..John.Anderson...Attendance.has.grown.annually.for.this.extremely.popular.course.with.47.adult.and.pediatric.residents.attending.this.year,.represent-ing.GI.programs.from.Vancouver.to.Halifax...The.Gastroenterology.Resident.Training.Program.is.one.of.the.most.highly.regarded.in.Canada,.under.the.leadership.of.Dr..Frances.Tse.as.pro-gram.director.and.supported.by.deputy.program.director,.Dr..Eric.Greenwald...

Research.ProgramsThe.Division.has.been.at.the.forefront.of.GI.

research.for.over.25.years,.culminating.in.the.creation.of.the.Farncombe.Family.Digestive.Health.Research.Institute.(FFDHRI).thanks.to.a.generous.gift.of.$15.million.from.the.Farncombe.family..Dr..John.Wallace.is.the.inaugural.Director.

of.the.FFDHRI.and.many.of.the.GI.Division.fac-ulty.are.also.members.of.the.Institute..The.close.proximity.between.clinicians.and.scientists.with.diverse.disciplines.such.as.immunology,.physi-ology.and.microbiology.has.provided.an.envi-ronment.for.truly.innovative.bench-to-bedside.research..The.FFDHRI.houses.the.Farncombe.Family.Gnotobiotic.Facility,.the.only.germ-free.facility.in.Canada...Together.with.the.metage-nomic.lab.and.the.454.sequencer,.this.will.allow.us.to.understand.how.gut.flora.interact.with.the.host.to.cause.disease.in.the.GI.tract.and.beyond..

The.Upper.Gastrointestinal.and.Pancreatic.Diseases.(UGPD).Cochrane.Review.Group.also.has.its.base.within.the.FFHDRI.under.the.lead-ership.of.Dr..Paul.Moayyedi.with.Dr..Grigoris.Leontiadis.as.Deputy.Editor..This.produces.high.quality.systematic.review.published.in.the.Cochrane.Library.that.informs.clinicians.and.patients.worldwide.on.evidence.based.medicine...We.are.one.of.the.top.two.GI.research.groups.in.Canada.and.one.of.the.top.ten.worldwide..GI.division.members.have.published.over.2,500.papers.that.have.been.cited.over.50,000.times...Three.members.(Drs..Wallace,.Collins.and.Hunt).have.an.h-index.over.50.(a.value.over.40.indi-cates.an.“outstanding.scientist”)...In.2009.work.from.the.GI.division.was.cited.over.4,700.times...

Dr. Paul Moayyedi BSc,.MB,.ChB,.PhD,.FRCP,.FRCPC,.AGAF,.FACG.Division Director

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Major.AchievementsDr..John.Wallace.has.been.awarded.the.pres-

tigious.Premier’s.Summit.Award.by.the.Ontario.Ministry.of.Research.and.Innovation.in.2009..Dr..Stephen.Collins.received.the.Research.Leadership.Award.from.the.Crohn’s.and.Colitis.Foundation.of.Canada..Dr..David.Morgan.is.the.current.President.of.the.Canadian.Association.of.Gastroenterology.and.Dr..Paul.Moayyedi.is.the.joint.Editor-in-Chief.of.the.American.Journal.of.Gastroenterology..The.Canadian.Institutes.of.Health.Research.announced.$9.6.million.in.funding.to.Cochrane.Canada.and.part.of.this.grant.will.fund.the.UGPD.Cochrane.Review.Group.over.the.next.5.years..Dr..David.Armstrong.received.the.Canadian.Association.of.Gastroenterology.Education.Excellence.Award.for.2009.and.Dr..Elena.Verdú.received.the.Canadian.Celiac.Association’s.JA.Campbell.

Research.Award..Dr..Richard.Hunt.gave.the.pres-tigious.Bockus.Lecture.at.the.World.Congress.of.Gastroenterology,.London.UK.in.2009..This.is.regarded.as.one.of.the.highest.honours.in.gas-troenterology.

Future.DirectionsThe.Farncombe.Family.Digestive.Health.

Research.Institute.will.provide.an.innovative.environment.with.the.collaboration.of.clinical.and.basic.science.researchers..Our.challenge.is.to.maintain.this.integrated.approach.of.bench-to-bedside.research.with.the.reorganization.of.health.care.in.Hamilton...Our.goal.is.to.unravel.how.nutrition.and.gut.flora.interact.with.the.intestinal.mucosa.to.produce.health.and.disease...This.applies.not.only.to.disorders.of.the.diges-tive.tract,.but.has.implications.for.diseases.in.all.organ.systems...

In.spite.of.some.clinical.challenges.encoun-tered.in.the.last.12.months,.the.Division.of.General.Internal.Medicine.at.McMaster.University.continues.to.be.vibrant.and.is.able.to.accomplish.its.academic.mandate.in.education.and.research.

The.major.challenge.was.in.maintaining.the.critical.number.of.inpatients.at.the.Clinical.Teaching.Unit.at.McMaster.Medical.Centre.in.view.of.the.decreased.number.of.emergency.room.admissions.at.that.site...The.faculty.at.McMaster.has.worked.very.hard.to.maintain.excellent.educational.activities.at.that.site...Presently.our.three.CTU’s.(McMaster.Medical.Centre,.Hamilton.General,.and.St..Joseph’s.Healthcare).continue.to.be.active.and.are.receiv-ing.excellent.feedback.from.our.learners...We.are.in.the.planning.stage.of.moving.the.McMaster.CTU.to.the.Juravinski.Hospital.as.of.April,.2011.

The.GIM.faculty.members.continue.to.mentor.our.learners.and.many.of.our.faculty.members.were.supervisors.to.learners.in.the.Internal.Medicine.Resident.Research.Day,.including.some.award-winning.presentations.

The.Division.has.appointed.Dr..John.You.as.the.Division.Research.Director...His.mandate.will.be.to.coordinate.and.collaborate.research.activities.

as.well.as.mentoring.junior.faculty.and.learners.in.the.Division...Dr..Khalid.Azzam.continues.to.play.a.major.role.in.simulation.projects...

We.would.like.to.congratulate.Dr..Ameen.Patel.and.Dr..Will.Harper,.co-recipients.of.the.CTU.Teaching.Award...Congratulations.also.to.Dr..Khalid.Azzam.for.completing.the.Academic.Pathways.BEST.certification.level,.and.to.Dr..Clive.Davis.for.receiving.the.OMA.Glenn.Sawyer.Award.

The.Division.of.GIM.was.involved.in.two.very.successful.continuing.educational.activities.over.the.last.12.months...The.Internal.Medicine.Review.Course.held.in.March.2010.and.the.Peri-operative.Course.held.in.April.2010.attracted.participants.from.across.the.province.and.the.country...

Under.the.leadership.of.Dr..Raj.Hanmiah,.the.GIM.Fellowship.Program.has.attracted.many.applicants.and.we.were.able.to.have.two.GIM.Fellows.for.the.last.year...In.addition,.we.have.two.Clinical.Scholars.for.this.year...We.feel.that.there.has.been.a.renaissance.in.GIM.and.we.are.now.able.to.attract.high.calibre.individuals.who.want.to.make.GIM.their.primary.specialty.

The.last.12.months.have.seen.some.faculty.members.retiring.and.resigning.from.practic-

Dr. Akbar Panju MB,.ChB,.FRCPC,.FRCP(Edin),.FRCP(Glasg).Division Director

General Internal Medicine


90


ing.GIM.in.Hamilton;.Dr..Frances.Lester,.Dr..Edemariam.Tsega.and.Dr..Tony.Kerigan.have.retired.from.GIM.activities;..Dr..Gavino.Perez.has.retired.from.inpatient.GIM.activities.and.Dr..Martin.O’Donnell.moved.back.to.Ireland.for.per-sonal.reasons...We.were.able.to.recruit.Dr..Jenny.Legassie.(GIM.with.interest.in.Palliative.Care),.Dr..Geena.Joseph.(GIM.with.interest.in.maternal.health),.Dr..Rebecca.Amer.(GIM.with.interest.in.Respirology),.Dr..Amitabha.Chakroborty.(GIM.with.interest.in.tropical.medicine),.Dr..Timothy.O’Shea.(GIM.with.interest.in.International.Health.and.Infectious.Diseases)...We.are.presently.on.track.with.our.recruitment.plan.and.have.identi-fied.three.excellent.recruits.over.the.next.two.years...

Our.faculty.members.have.continued.to.be.involved.in.administrative.and.leadership.activities...Dr..Ameen.Patel,.as.the.Department.

Educational.Coordinator,.continues.to.do.a.phe-nomenal.job...Dr..Akbar.Panju,.Division.Director,.became.President.of.the.Hamilton.Academy.of.Medicine.

Our.focus.for.the.next.few.months.will.be.to.establish.a.new.CTU.at.Juravinski.Hospital.and.also.to.develop.an.Academic.Ambulatory.Care.facility.at.McMaster.Medical.Centre...We.believe.that.providing.academic.ambulatory.facilities.would.be.a.great.addition.to.our.educational.mandate...

I.believe.we.have.had.a.very.successful.year.in.the.Division.and.I.look.forward.to.more.exciting.times.in.the.future.as.we.develop.a.new.CTU,.new.outpatient.educational.activities,.continue.to.recruit.high.calibre.individuals.and.make.the.Fellowship.Program.an.attractive.one.for.our.Fellows.

Educational.ActivitiesServing.over.200.undergraduate.and.post-

graduate.learners.rotating.through.the.Division.of.Geriatric.Medicine.Program,.the.educational.leaders.are.Dr..Michelle.Gagnon,.Dr..Joye.St..Onge,.Dr..Sharon.Marr,.Dr..Brian.Misiaszek,.Dr..Cheryl.Allaby,.Dr..Tricia.Woo,.and.Dr..David.Cowan...The.Division.hosted.Dr..Dorothy.‘Sam’.Williams,.a.visiting.professor.from.the.Vancouver.Island.Health.Authority;.Dr..Pam.Jarrett,.a.visiting.professor.from.Dalhousie.and.Memorial.Universities,.and.Dr..John.Young,.a.visiting.geriatrician.from.the.University.of.Leeds,.U.K..Geriatrics.welcomed.its.new.residents.Dr..Abdullah.AlSuhail.and.Dr..Maram.AlFousan...The.Division.remains.very.active.in.continuing.medical.education.in.aging.and.had.a.strong.presence.at.the.Second.Annual.McMaster.Internal.Medicine.Course,.McMaster.Annual.Gerontologic.Courses,.and.Canadian.Geriatric.Society.Annual.Meeting...Monthly.geriatric.grand.rounds.are.held.locally.and.are.videocon-ferenced.to.more.than.15.community.locations.

Dr..Misiaszek.has.been.instrumental.in.devel-oping.the.2nd.edition.of.the.Geriatric.Medicine.Survival.Guide.with.our.faculty,.which.will.be.available.at.McMaster.University.in.2011..This.resource.is.given.to.all.learners.who.complete.a.geriatric.medicine.rotation...The.2nd.Annual.

Inter-professional.Geriatric.Skills.Day.success-fully.took.place.with.Dr..Tricia.Woo.as.the.faculty.advisor..

Thank.you.to.Dr..Molloy,.who.has.stepped.down.as.the.Regional.Geriatric.Program.(RGP).Director.and.Chair.at.St..Peter’s.Hospital,.for.his.passion.and.vision.for.geriatrics.which.led.to.innovative.program.development.with.the.divi-sion,.including.telehealth.and.outreach.clinics..Dr..Nicole.Didyk.remains.active.as.the.Regional.Educational.Leader.for.the.Medicine.Selective.Clerkship.program.(Waterloo.campus).and.together.with.Dr..Sadhana.Prasad.they.supervise.Family.Medicine.residents.and.clinical.clerks.during.their.geriatric.rotations...

Research.ProgramsThank.you.to.Dr..Heckman,.who.has.stepped.

down.as.the.Geriatric.Division.Research.Director.but.will.continue.as.the.Geriatric.Residency.Research.Director...Dr..Heckman.has.accepted.the.Schlegel.Research.Chair.in.Geriatrics.at.the.University.of.Waterloo..We.wish.him.every.suc-cess.in.his.new.position..The.Division.continues.to.have.a.number.of.outstanding.and.success-ful.research.endeavours.and.projects.such.as.the.Gentle Persuasive Approaches (GPA) Acute Care; Stay Well Program; Hospital Elder Life Program (HELP); Osteoporosis Falls and Fracture.

Dr. Sharon Marr MD,.FRCPC,.MEd Acting Division Director

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Prevention for LTC; Enhancing Dementia Care in Primary Care;.as.well.as.studies.such.as.the.Ontario.MOHLTC.Osteoporosis.Strategy.for.Long-Term.Care.(PI,.Dr..Papaioannou);.Multi-centred.RCT.of.Doxycycline.and.Rifampin.for.Alzheimer’s.disease.(DARAD).(PI,.Dr..Molloy);.Osteonecrosis.of.the.jaw.–.bisphosphonates.and.other.risk.factors.(PI,.Dr..Khan);.and.Adapting.the.Canadian.Cardiovascular.Society.Recommendations.on.Heart.Failure.for.Long-Term.Care.Homes.(PI,.Dr..Heckman).

Major.AchievementsCongratulations.to.Dr..Gagnon.who.was.suc-

cessful.in.her.promotion.to.Professor...Dr..Christopher.Patterson.was.awarded.the.Corner.Stone.Award.for.his.exemplary.leadership.and.commitment.in.caring.for.older.persons.within.HHSC.and.its.community...Dr..Papaioannou.was.exceptional.in.her.former.role.as.the.Division.Head.for.Geriatrics...She.has.stepped.down.and.will.now.focus.her.time.on.her.research.interests.enabled.by.the.Eli.Lilly.Endowed.Chair.in.Osteoporosis.and.the.CIHR/Eli.Lilly.Canada.Research.Chair.in.Osteoporosis,.Falls.and.Fracture.Prevention..Travel.awards.have.been.

established.to.support.two.internal.medicine.res-idents.to.present.their.research.at.the.Canadian.Geriatric.Society.Annual.Meeting..Dr..Karen.D’Silva.and.Dr..Kartika.Malik.were.this.year’s.recipients...The.Division.of.Geriatric.Medicine,.in.recognition.of.Dr..Irene.Turpie’s.leadership.in.education.at.McMaster.University,.has.estab-lished.annual.undergraduate.awards.which.will.be.awarded.to.two.medical.students.from.the.Class.of.2011..

Future.DirectionsThe.Division.will.continue.to.develop.strong.

relationships.with.each.of.its.academic.health.science.centre.(AHSC).partners.including.St..Joseph’s.Hospital,.HHSC,.RGP,.and.provincial.AHSC’s.to.ensure.that.the.needs.of.the.frail.elderly.are.addressed.and.to.help.manage.their.chronic.health.conditions.and.prevent.further.deterioration.whenever.possible,.to.educate.and.train.future.generations.of.interdisciplinary.health.professionals.in.the.care.of.the.elderly,.and.to.focus.research.programs.on.knowledge.dissemination.and.translation.activities.related.to.aging.

The.Division.of.Hematology.and.Thromboembolism.at.McMaster.University.is.an.internationally.recognized.leader.for.its.research,.education.and.clinical.excellence..The.Division.is.one.of.the.largest.such.divisions.in.North.America,.and.delivers.a.complete.range.of.clinical,.academic,.administrative.and.research.services..Our.faculty.continues.to.occupy.impor-tant.positions.on.local,.national.and.international.stages.in.each.of.these.four.domains.

Educational.ActivitiesFaculty.members.span.four.departments:.

Medicine,.Pathology.and.Molecular.Medicine,.Pediatrics.and.Oncology..Members.contribute.importantly.to.educational.activities.in.all.depart-ments,.both.at.the.undergraduate.and.post-graduate.levels..Additionally,.our.faculty.mem-bers.hold.cross-appointments.in.Biochemistry.and.elsewhere.in.the.broader.university,.where.they.also.contribute.importantly.to.educational.activities..In.2009-2010.achievements.in.educa-tion.included.continuing.excellence.by.our.resi-dency.training.program,.ably.led.by.Dr..Shannon.Bates,.and.the.appointment.of.Dr..Catherine.Hayward.as.Associate.Dean.of.Graduate.Studies,.Health.Sciences..A.number.of.our.PhD.faculty.also.lead.undergraduate.and.graduate.courses.at.McMaster.within.various.domains..With.the.

amalgamation.of.the.inpatient.clinical.units,.the.2010-2011.academic.year.will.see.significant.changes.in.our.residency.program.rotations..These.changes.will.be.among.the.first.major.structural.changes.to.the.rotations.in.the.last..25.years.

Research.ProgramWithin.the.research.realm.our.faculty.mem-

bers.are.world.leaders.with.publications.during.the.year.in.journals.such.as.Blood,.the.Annals.of.Internal.Medicine,.The.New.England.Journal.of.Medicine.and.Lancet..This.past.year.saw.the.movement.of.the.Henderson.Research.Centre.to.the.Thrombosis.and.Atherosclerosis.Research.Institute.at.the.David.Braley.Cardiac.Vascular.and.Stroke.Research.Institute..This.state-of-the-art.facility.will.allow.this.research.group,.led.by.Dr..Jeff.Weitz,.to.continue.cutting.edge.inves-tigations.in.the.basic.science.of.coagulation.disorders..McMaster’s.investment.in.stem.cell.research.will.also.benefit.hematology,.given.the.potential.for.stem.cell.therapies.to.impact.a.wide.variety.of.disorders;.the.only.current.widely.used.form.of.stem.cell.treatment.is.for.the.use.of.bone.marrow.disorders..Individual.faculty.profiles.on.the.Department.of.Medicine.web.site.highlight.specific.faculty.research.information.

Dr. Mark Crowther MD,.MSc,.FRCPC.Division Director

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Major.AchievementsThe.2009-10.academic.year.saw.final.plan-

ning.for.the.amalgamation.of.the.two.regional.inpatient.units.to.one.site;.this.move.occurred.in.early.August.2010.and.was.uncomplicated,.thanks.to.the.extensive.planning.and.organi-zational.development.activities.at.the.HHS..The.2010-11.year.will.see.the.completion.of.the.majority.of.the.HHS.ABC.clinical.service.delivery.changes..The.impact.on.Hematology.should.be.limited..We.anticipate.continued.research.excel-lence.with.the.announcement.of.several.large.research.grants,.at.least.one.endowed.chair.and.further.expansion.of.our.basic.and.translational.research.program.

Future.DirectionsThe.Division.of.Hematology.and.

Thromboembolism.will.continue.to.strive.to.remain.the.pre-eminent.such.division.in.North.America..Focused.recruitments.will.continue.in.areas.of.need..We.anticipate.Drs..Menaka.Pai.and.Madeleine.Verhovsek.being.recruited.to.fac-ulty.in.the.next.academic.year..Integration.and.cooperation.between.sites.in.Hematology.and.in.Thromboembolism.will.lead.to.efficiencies.in.clinical.care...Expansion.of.our.basic.science.and.translational.research.enterprise.will.further.expand.our.reach,.both.within.McMaster.and.outside.McMaster.

Frozen sections: Cross-section of the Aorta (nuclei stained with DAPI) Frozen sections: Cross-section of the Aorta (staining for EPCR)

Liaw Laboratory, 2010

Dr. Mark Loeb MD,.MSc,.FRCPC.Division Director

Educational.ActivitiesUnder.the.leadership.of.Residency.Program.

Director.Dr..Phil.El-Helou,.the.Division.partici-pates.actively.in.undergraduate.MD.teaching.and.in.the.training.of.residents.from.Infectious.Diseases,.Internal.Medicine,.Anesthesia,.Family.Medicine,.Neurology.and.Critical/Intensive.Care...The.Division.shares.trainees.with.Medical.Microbiology.in.the.program.headed.by.Dr..Cheryl.Main..Our.residents.presented.their.research.at.various.national.and.international.meetings.including.the.Association.of.Medical.Microbiology.and.Infectious.Disease.Canada,.the.Canadian.Association.for.HIV.Research,.and.the.Immunocompromised.Host.Society.Meeting...Educational.highlights.in.2009-10.included.Dr..Shariq.Haider’s.supervision.of.Dr..Amir.Abidi.who.received.the.Canadian.Journal.of.Medical.Microbiology.and.Infectious.Diseases.award.for.the.top.review.article.awarded.at.the.Association.of.Medical.Microbiology.and.Infectious.Disease.Canada.2009.meeting..Dr..Cheryl.Main.was.awarded.the.McMaster.Infectious.Disease.and.Medical.Microbiology.Faculty.Teaching.Award..Dr..Marek.Smieja.was.invited.to.be.a.visiting.lecturer.to.teach.a.short.graduate.course.in.Diagnostics.Research.at.Stellenbosch.University,.Cape.Town,.South.Africa..Dr..Haider.organized.the.first.University.of.Toronto.and.McMaster.University.combined.ID.Transplant.rounds.

Research.ProgramsDr..Smaill,.along.with.Zhou.Xing,.continues.

to.conduct.a.vaccine.trial.for.tuberculosis...Dr..Marek.Smieja.is.conducting.a.CIHR-sponsored.multicentre.study.to.improve.influenza.diag-nostic.testing..Dr..Smieja.is.also.studying.the.epidemiology.of.respiratory.infections.among.university.students..Dr..Atreyi.Mukherji.is.evalu-ating.management.strategies.for.patients.with.intravenous.drug.dependency..Dr..Christine.Lee.is.assessing.novel.therapeutic.strategies.for.Clostridium.difficile...Drs..Johnstone.and.Loeb.are.conducting.a.nursing.home.study.to.assess.immune.phenotypes.correlated.with.influenza.infection...Dr..Mark.Loeb.is.conducting.a.CIHR.and.NIH-funded.cluster.randomized.trial.to.assess.whether.immunization.of.children.in.Hutterite.colonies.can.reduce.transmission.of.influenza.in.the.entire.community...This.study.will.allow.for.the.assessment.of.genetic.determi-nants.of.immunogenicity...Dr..Loeb.is.leading.a.Public.Health.Agency.of.Canada.study.to.assess.genetic.determinants.of.immunity...Flavivirus.research.being.conducted.by.Dr..Loeb.includes.an.NIAID.population.genomics.study.on.West.Nile.and.pilot.studies.being.conducted.in.Central.America.on.dengue....Drs..Loeb.and.Johnstone.were.awarded.a.CIHR.grant.to.assess.immune.phenotypes,.immunogenicity,.and.genetic.deter-minants.of.zoster.in.a.nursing.home.cohort..

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Major.Accomplishments.Dr..Kevin.Woodward.was.recruited.as.a.clini-

cal.educator.at.St..Joseph’s...Dr..Shariq.Haider.was.appointed.Deputy.Director.of.the.Internal.Medicine.Residency.Program..Dr..Haider.spear-headed.the.development.of.a.new.transplant/malignant.infectious.diseases.service.at.the.Henderson.hospital...Dr..Main.was.promoted.to.Associate.Professor...Dr..Jennie.Johnstone.transitioned.from.Clinical.Scholar.to.Assistant.Professor...Dr..Johnstone’s.awards.have.included.a.Faculty.of.Health.Sciences.Graduate.Program.Outstanding.Achievement.Award,.a.Canadian.Thoracic.Society.Fellowship.Salary.Award,.Public.Health.Agency.of.Canada/.Canadian.Institutes.of.Health.Research.Influenza.Research.Network.Scholarship.Award,.and.a.CIHR.Fellowship.

Salary.Award...Dr..Johnstone,.along.with.Dr..Loeb.and.Dr..Jonathan.Bramson,.was.awarded.a.CIHR.operating.grant...Dr..Loeb.was.awarded.an.NIH.population.genomics.grant.for.an.inter-national.research.program.to.assess.genetic.sus-ceptibility.to.dengue...Dr..Loeb.was.awarded.the.CSIA.level.2.designation...

.Future.DirectionsWe.plan.to.recruit.another.clinician.scientist.

to.the.ID.Division...The.focus.will.be.to.develop.more.strength.in.epidemiological.studies.to.assess.biomarkers,.such.as.immunologic.and.genetic.studies,.and.in.so.doing.bridge.gaps.with.colleagues.who.do.fundamental.research,.as.well.as.continue.basic.epidemiologic.studies.of.infectious.diseases.

Dr. Alistair Ingram MD,.FRCPC Division Director

Educational.ActivitiesThe.Division.of.Nephrology.continues.to.be.

very.active.in.both.undergraduate.and.post-graduate.medical.education..All.13.members.of.the.Division.contribute.substantially..In.terms.of.undergraduate.medical.education,.all.mem-bers.of.the.Division.continue.to.serve.as.tutors.in.MF1,.MF2.and.MF3.as.well.as.clerkship..The.Division.now.offers.a.clerkship.rotation.on.the.inpatient.services.which.has.been.very.popular..Dr..Dianne.Arlen.is.the.Renal.Unit.Planner.for.the.undergraduate.program,.a.role.that.will.be.taken.by.Dr..Robert.Yang.for.2010-2011..Dr..Azim.Gangji.continues.to.chair.the.Academic.Half-day.Program.for.PGY3’s.in.the.Department.of.Medicine.and.is.also.clerkship.coordinator.for.the.Nephrology.inpatient.rotation.

There.are.currently.three.fellows.pursuing.spe-cialty.training.in.Nephrology.through.the.train-ing.program..After.the.successful.Royal.College.review.in.2009.and.under.the.very.capable.direc-torship.of.Dr..Darin.Treleaven,.we.continue.to.see.considerable.interest.in.coming.to.McMaster.to.train..The.Division.continues.to.offer.post-subspecialty.training.for.those.pursuing.careers.in.Academic.Nephrology..In.the.past.five.years,.seven.trainees.have.completed.such.Clinical.Scholar.training.with.the.Division,.four.of.whom.have.completed.Master’s.or.PhD.degrees.

The.Division.plays.a.major.role.in.the.Internal.Medicine.training.program,.with.upwards.of.20.trainees.rotating.through.for.two-month.blocks.throughout.the.year..Training.is.provided.in.inpa-tient.nephrology.and.transplantation,.as.well.as.outpatient.clinics..Dr..Darin.Treleaven.coordi-nates.this.program,.which.was.recognized.as.the.top.clinical.experience.in.the.training.program.last.year..

Research.ProgramsThe.research.mission.of.the.Division.contin-

ues.to.grow..The.Hamilton.Centre.for.Kidney.Research.(HCKR),.led.by.the.Amgen.Chair.of.Nephrology.research,.Dr..Richard.Austin,.is.highly.successful.and.very.well.funded,.with.around.$2.million.in.yearly.operating.and.sal-ary.support.funding..A.focus.in.developing.links.with.the.Division.of.Urology.and.fostering.growth.of.research.in.prostate.and.renal.cancers.has.also.developed,.with.original.observations.on.prostate.cancer.tumorigenesis.published.in.early.2010.in.Journal.of.Clinical.Investigation.by.Dr..Damu.Tang,.a.Division.of.Nephrology.PhD.and.investigator.in.the.HCKR..Dr..Austin.has.also.published.novel.data.concerning.thrombotic.complications.of.prostate.cancer.in.Journal.of.Biological.Chemistry.and.Laboratory.Investigation.in.the.past.year..Two.clinician.sci-

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entists.are.also.vital.HCKR.members.–.Dr..Joan.Krepinsky.continues.to.publish.highly.regarded.work.in.both.diabetic.and.hypertensive.renal.dis-ease.in.the.highest.impact.nephrology.journals,.while.Dr..Peter.Margetts.has.published.further.work.on.peritoneal.membrane.injury.in.high.impact.nephrology.journals.and.continues.to.be.the.international.reviewer.of.choice.in.this.area..

Clinical.research.has.enjoyed.two.major.suc-cesses.in.the.past.year..The.first.was.the.suc-cessful.recruitment.of.Dr..Michael.Walsh.to.the.Division.as.a.clinician-scientist,.with.a.cross-appointment.to.CE&B..Although.a.young.investi-gator,.Dr..Walsh.already.leads.one.of.the.largest.trials.in.vasculitis.ever.conducted,.and.holds.several.million.dollars.in.peer-reviewed.funding.from.agencies.in.Canada,.the.UK.and.the.US.for.this.and.for.his.work.in.perioperative.renal.injury..In.addition,.Drs..Scott.Brimble.and.Azim.Gangji.secured.a.large.multi-year.operating.grant.from.Baxter.to.conduct.a.trial.of.bioimped-ance.in.peritoneal.dialysis.patients.

Major.AchievementsRecruitment.of.Dr..Michael.Walsh,.who.will.lead.large.clinical.trials.in.Nephrology.from.McMaster

Continued.success.in.both.funding.and.publication.in.HCKR,.and.fostering.of.research.in.prostate.cancer

Ongoing.remarkable.growth.in.the.clini-cal.renal.transplant.program.under.the.Directorship.of.Dr..David.Russell,.with.100.transplants.again.performed.in.2009.and.nearly.1000.successfully.transplanted.patients.now.followed.in.the.program.

Opening.of.a.hemodialysis.unit.on.the.Six.Nations.reserve.in.Oshweken..The.Division.now.manages.hemodialysis.units.at.St..Joseph’s.(Charlton.and.Stoney.Creek),.Bayshore,.Brantford.and.Oshweken.and.co-manages.a.new.unit.in.Burlington.

Securing.of.funding.(more.than.$1.million).from.industry.and.pharmaceutical.partners.such.as.Gambro.AG,.Astellas.and.Roche,.to.permit.clinic.redevelopment.and.seed.fund-ing.for.new.research.projects.

Future.DirectionsThe.Division.intends.to.leverage.its.research.

productivity,.biobanks.and.collaborations.with.Urology.in.the.development.of.a.major.centre.for.Kidney.and.Urinary.research.at.McMaster.to.be.located.at.the.St..Joseph’s.site..Collaboration.between.HCKR.lab.researchers.and.the.new.clinical.trials.program.should.further.develop.work.in.biobanking.and.markers.of.renal.disease.progression.or.relapse..Clinically,.we.intend.to.roll.out.a.comprehensive.dialysis.information.system.this.year,.and.we.will.continue.to.expand.and.enhance.the.transplant.program.to.best.serve.high.medical.and.immunologic.risk.recipients.

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T24/83 bladder carcinoma cells preloaded with the fluorescent indica-tor Fura 2-AM. Fluorescence microscopy reveals the intensity of the colour generated from the calcium released from endoplasmic reticulum (ER) stores by the cells after binding of anti-GRP78 autoantibodies (derived from the blood of patients with prostate cancer) to cell surface GRP78.

Austin Laboratory, 2010

Dr. John Turnbull MD,.PhD.Division Director

Educational.ActivitiesDr..Oczkowski.continues.as.co-chair.of.the.neu-

roscience.subunit.for.undergraduate.medicine,.and.most.members.participate.in.clinical.skills.activities.for.medical.students..Dr..Rathbone.continues.to.offer.his.popular.neurology.‘boot.camp’.for.medical.students..At.the.postgradu-ate.level,.Dr..Yegappan.continues.as.program.director.of.the.neurology.residency.program..Drs..Paulseth,..Rathbone,.and.Goodwin.continue.as.site.coordinators..The.committee.has.repre-sentation.from.adult.neurosurgery.(Dr..Reddy),.pediatric.neurology.(Dr..Cowan).and.community.practice.(Dr..Tara.Lad-.on.maternal.leave)..In.spite.of.significant.strengths,.several.deficien-cies.were.noted.in.a.recent.RCPSC.review,.which.we.believe.have.now.been.rectified..Our.first.graduating.resident,.Dr..Picard,.has.worked.as.a.Clinical.Scholar.for.the.past.year.with.Drs..Baker.and.Tarnopolsky.in.neuromuscular.disease,.and.for.the.upcoming.year.in.neuro-oncology.with.Dr..Rathbone..Our.second.resident,.Dr..Brian.Van.Adel,.is.undertaking.a.two-year.fellowship.in.interventional.neurology.in.London,.and.we.hope.that.he.will.return.to.Hamilton.afterwards.to.join.the.neurovascular.group..Dr..Silva.coor-dinates.the.neuroscience.rounds.at.the.HGH,.and.Dr..Goodwin.again.coordinated.the.annual.regional.CME.program.in.neuromuscular.dis-eases..Dr..Michael.Kronby.has.been.instrumental.

in.raising.funds.for.the.residency.program..Drs..Rathbone,.Mazurek,.Turnbull.and.Tarnopolsky.are.all.involved.in.graduate.education..The.division.has.accepted.several.clinical.fellows.for.training..

Research.ActivitiesDr..Rathbone.leads.the.CIHR-funded.neuro-

restorative.group,.with.particular.interest.in.the.trophic.role.of.purinergic.compounds..Dr..Jim.Sahlas.has.several.funded.studies.in.stroke..Dr..Tarnopolsky.remains.prolific.in.neuromus-cular.research,.as.does.Dr..Baker..Dr..Mazurek.continues.his.research.in.neuropsychiatry,.and.Dr..Turnbull.continues.with.clinical.and.basic.research.in.motor.neuron.disease..Dr..Upton.remains.near.to.realizing.his.dream.of.commer-cializing.the.smart.pacemaker.and.the.respon-sive.brain.stimulator,.as.well.as.a.portable.mag-netic.stimulation.device.for.the.self-treatment.of.migraine,.and.continues.his.collaboration.with.Dr..Robert.Fischell.of.Baltimore,.and.his.son.Dr..David.Fischell..Dr..McComas.continues.his.research.in.neuromuscular.mechanisms.and.the.use.of.transcranial.stimulation.in.migraine...Dr..Brown.continues.with.international.research.in.rate-dependent.block.in.ALS.patients...Dr..Gilani.continues.his.research.interest.in.chronic.pain,.particularly.as.related.to.peripheral.neuropa-thies..Dr..Morillo.and.Dr..Jichici.are.collaborating.with.other.Canadian.groups,.particularly.with.Dr..

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Bryan.Young.in.London,.developing.a.research.program.to.assess.the.effectiveness.of.continu-ous.EEG.monitoring.in.ICU.patients.

Clinical.Activities.Drs..Oczkowski,.Silva,.Sahlas,.Yegappan,.and.

Jichici.are.involved.in.the.acute.stroke.program.at.the.Hamilton.General,.which.is.now.the.most.active.in.the.province.in.terms.of.numbers..Dr..Yegappan.also.works.in.stroke.at.St..Joseph’s.Healthcare...Dr..Giammarco.continues.her.com-plex.headache.clinic...Neuromuscular.activi-ties.and.ALS.have.been.greatly.expanded,.and.Drs..Tarnopolsky,.Baker,.Brown,.Goodwin.and.Turnbull.are.involved..Dr..Jichici.continues.to.

provide.neurocritical.care.expertise,.and.gradu-ates.from.our.neurology.residency.will.now.have.the.option.of.applying.to.a.two-year.fellowship.in.neurocritical.care..Dr..Michelle.Shapiro.has.joined.us.after.completing.a.two-year.fellowship.in.epilepsy.at.Harvard,.and.is.working.with.Dr..Morillo.to.further.develop.regional.epilepsy..

Continuing.EducationLast.year.Dr..McComas.organized.an.interna-

tional.symposium.in.Poland.on.electrical.stimu-lation.of.the.brain,.and.Dr..Adrian.Upton.chaired.one.of.the.sessions.and.gave.four.lectures..Plans.are.underway.for.a.follow-up.symposium.

Dr. David T. Harvey MD,.FRCPC.Division Director

The.Regional.Rehabilitation.Centre.opened.in.September.2009.and.will.eventually.have.approximately.95.rehabilitation.beds.at.this.centre..We.have.consolidated.inpatient.and.outpatient.facilities.from.three.sites.to.the.new.Rehabilitation.Centre..

EducationDr..Peter.Varey.is.our.Residency.Program.

Director.and.led.a.very.positive.Royal.College.Review,.with.full.approval..Once.again.we.matched.two.of.our.top.candidates.in.the.CaRMS.match...We.have.one.of.the.largest.PM&R.Residency.Programs.in.Canada.

Dr..Shothour.Alghunaim.and.Dr..Tonya.Ballard.successfully.completed.the.Royal.College.exams..Our.residents.scored.very.well.on.the.American.Self.Assessment.Examination...All.of.our.residents.taught.Unit.4.clinical.skills.in.the.undergraduate.MD.program.with.very.positive.feedback.from.learners..Several.of.our.faculty.members.participate.in.undergraduate.medicine.Unit.4.as.tutors.and.clinical.skills.supervisors,.and.Dr..Leo.Farrauto.provides.a.liaison.between.our.Division.and.the.medical.school.

ResearchDr..Mark.Tarnopolsky.and.Dr..Steve.Baker.con-

tinue.to.be.the.leading.researchers.in.neuromus-cular.rehabilitation.in.the.country,.with.tremen-dous.innovation.and.groundbreaking.research.in.peripheral.nerve.and.neuromuscular.disorders...Dr..Dinesh.Kumbhare.continues.to.be.active.in.MSK.research.at.St..Joseph’s.Healthcare..The.main.theme.of.research.is.the.development.of.measurement.methods.for.musculoskeletal.inju-ries..Drs..David.Harvey,.Kevin.Letcher.and.Leo.Farrauto.continue.to.develop.research.related.to.inpatient.rehabilitation.outcomes.in.patients.with.cancer.and.following.orthopedic.surgery..At.the.Regional.Rehabilitation.Centre,.Dr..Jane.Gillett.continues.to.develop.research.related.to.ABI..The.ABI.team.received.a.large.grant.from.the.ONF.to.create.an.online.“community.of.practice”.to.facilitate.knowledge.mobilization.to.frontline.staff..Dr..Gillett.helped.to.establish.the.new.International.Pediatric.Brain.Injury.Society.

Dr..Gillett.and.Dr..John.Connolly.are.collaborat-ing.on.projects.related.to.language.assessment.and.recovery.in.ABI..Research.related.to.virtual.reality.and.rehabilitation.in.people.with.ABI.is.starting...

Future.DirectionsDr..Harvey.will.be.stepping.down.as.Chief.

of.the.Department.at.HHS.and.Director.of.the.

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Division.of.PM&R..The.division.enthusiastically.welcomes.Dr..Shanker.Nesathurai.as.the.fifth.Division.Director.for.PM&R.and.Chief.of.the.Department.for.Hamilton.Health.Sciences.and.St..Joseph’s.Healthcare...The.consolidation.at.the.new.Rehabilitation.Centre.has.given.us.new.opportunities.to.look.at.integrated.care.across.the.spectrum.from.acute.care.to.rehabilitation.and.we.are.very.excited.about.the.development.of.the.new.integrated.stroke.program..

At.the.Henderson.we.are.developing.an.inte-grated.model.for.management.of.fractured.hip.and.total.joint.replacement.with.the.addition.of.a.rehabilitation.hospitalist.

We.are.in.the.midst.of.recruiting.a.new.special-ist.in.ABI..We.continue.to.develop.a.specialized.program.for.the.rehabilitation.of.patients.with.cancer.at.the.Henderson.site...

Clinical.Programs.We.will.have.three.main.foci.of.activity.in.the.

city.with.the.neurological.and.trauma.related.rehabilitation.centered.at.the.Rehabilitation.Center.at.the.Hamilton.General,.the.orthope-dic.and.cancer.rehabilitation.program.at.the.Henderson.and.the.respiratory,.renal.and.gen-eral.rehabilitation.programs.at.St..Joseph’s.

Dr. Gerard Cox MB,.FRCP(I),.FRCP(C)Division Director

Educational.ActivitiesMembers.of.the.Respiratory.Division.are.

involved.in.planning,.tutoring,.clinical.skills.pre-ceptorship.and.lecturing.in.the.Undergraduate.Medical.Program..The.Respirology.Residency.Training.Program.has.gone.from.strength.to.strength.under.the.leadership.of.Dr..Lori.N..Whitehead..Her.contributions.have.been.recog-nized.by.her.peers.in.other.training.programs.and.Dr..Whitehead.has.been.elected.to.leader-ship.roles.in.resident.education.at.the.provin-cial.and.national.levels..The.program.is.fully.subscribed.and.each.year.attracts.much.inter-est.from.across.Canada..In.recognition.of.her.accomplishments,.Dr..Whitehead.was.nominated.for.the.RCPSC.Program.Director.of.the.Year.Award.

Trainees.from.Internal.Medicine,.Anesthesia,.Radiation.Oncology,.Head.and.Neck.Surgery,.and.other.postgraduate.programs.apply.for.rota-tions.in.Respirology..The.Respirology.groups.at.Henderson.Hospital.and.St..Joseph’s.Healthcare.have.provided.these.training.opportunities.in.the.past,.and.this.year.the.group.at.the.Hamilton.General.site.has.taken.on.trainees.also..This.over-subscription.indicates.the.popularity.of.the.Respirology.training.experience.among.students.and.residents.and.reflects.the.commitment.to.education.among.our.faculty..A.number.of.

faculty.won.internal.awards.for.their.teaching.including.Drs..Christine.Bradley,.Lori.Whitehead.and.Parameswaran.Nair.

Our.Division.is.also.actively.involved.in.graduate.and.non-MD.postgraduate.education...Several.members.of.the.Division.supervise.both.MSc.and.PhD.graduate.students..Two.very.successful.graduate.courses.are.organized:.Pulmonary.Physiology.by.Dr..Mark.Inman.and.Pathophysiology.of.Lung.Diseases.by.Drs..Gail.Gauvreau.and.Roma.Sehmi..One.feature.that.graduate.students.find.very.attractive.is.the.contribution.to.these.courses.by.clinical.faculty,.which.provides.context.to.the.basic.science.and.mechanisms.of.disease.that.they.learn..Members.of.the.Division.frequently.contribute.to.Continuing.Medical.Education.programs,.both.within.and.outside.Canada..Dr..Mark.Soth.is.chair.of.the.Ontario.Thoracic.Society.commit-tee.responsible.for.organizing.the.annual.Better.Breathing.Conference.

Research.ProgramsMajor.research.themes.include.the.epidemiol-

ogy,.pathophysiology.and.treatment.of.asthma;.the.physiology.and.pathophysiology.of.airway.and.vascular.smooth.muscle;.the.cellular.and.molecular.biology.of.pulmonary.inflamma-

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tion;.controlled.trials.of.therapy.in.respiratory.disorders,.and.the.impact.of.the.environment.on.respiratory.health..The.Firestone.Aerosol.Research.Laboratory,.under.the.leadership.of.Dr..Myrna.Dolovich,.hosted.the.2nd.annual.Aerosol.School.with.sponsorship.from.the.International.Society.of.Aerosol.Medicine..Professor.Malcolm.Sears.and.colleagues.direct.the.CHILD.Study.with.major.funding.from.CIHR.and.AllerGen...A.recent.research.tool.is.the.use.of.personal.hand-held.devices.to.obtain.daily.information.from.patients..Neil.Johnson.and.Dr..Andrew.McIvor.used.this.technology.in.a.study.of.patients.with.COPD..Many.research.activities.are.car-ried.on.in.collaboration.with.investigators.in.other.Divisions.-.Allergy.and.Immunology,.Microbiology,.Gastroenterology,.Rheumatology;.and.Departments.–.Thoracic.Surgery,.Pathology,.Pediatrics;.within.the.Faculty...

Achievements.and.AwardsWe.welcome.new.faculty.member.Dr..Marcel.

Tunks...Dr..Tunks.completed.a.Clinical.Scholar.year,.furthering.his.training.in.non-invasive.ventilation.and.management.of.complex.air-way.conditions..He.has.joined.colleagues.at.the.Firestone.Institute.for.Respiratory.Health.at.St..Joseph’s.Healthcare.and.will.continue.his.contri-butions.as.a.Clinician-Educator...

In.recognition.of.his.contributions.to.the.sci-ence.and.practice.of.respiratory.medicine,.Dr..Frederick.Hargreave.received.an.honorary.doc-toral.degree.from.the.University.of.Modena,.Italy,.one.of.the.oldest.educational.institutions.in.Europe..Dr..Stewart.Pugsley.was.awarded.

Fellowship.of.the.Royal.College.of.Physicians,.London,.England,.and.closer.to.home.received.honorary.life.membership.of.the.Ontario.Medical.Association.

Our.membership.continued.to.contribute.out-side.Hamilton..Dr..McIvor.has.completed.his.5-year.term.as.Chair.of.the.Asthma.Committee.of.the.Canadian.Thoracic.Society,.one.the.most.active.and.influential.committees.of.the.CTS,.especially.in.the.area.of.guideline.development.and.implementation..Dr..Helen.Ramsdale.con-tinues.as.Chair.of.the.Respiratory.Section.of.the.OMA.and.as.an.examiner.in.respirology.for.the.Royal.College...Dr..Gerard.Cox.is.a.member.of.the.Steering.Committee.and.of.the.Executive.Committee.of.the.Lung.Health.Framework,.which.recently.received.an.award.of.$10.million.from.the.federal.government.with.a.broad.mandate.to.advance.respiratory.health.in.Canada..

Future.DirectionsThe.Division.has.very.strong.clinical.activi-

ties.and.its.members.provide.a.broad.range.of.high.quality.clinical.services..We.will.continue.to.enhance.these.activities.through.recruitment.of.new.faculty.and.development.of.new.initiatives.such.as.interventional.bronchoscopy,.outpatient.management.of.pleural.effusions.and.co-opera-tive.programs.with.other.specialties.including.Thoracic.Surgery,.and.Rheumatology..We.would.like.to.build.on.our.activities.in.translational.research.and.better.harness.the.new.knowledge.being.created.by.our.colleagues.in.basic.science.to.improve.patient.care.

Dr. Jonathan (Rick) Adachi BSc,.MD,.FRCPC.Division Director

Educational.ActivitiesThe.Division.of.Rheumatology.is.active.in.the.

undergraduate.educational.program..Our.focus.on.patients.has.contributed.to.our.success..Clinical.skills.sessions.led.by.the.Division.of.Rheumatology,.interactive.large.group.sessions.introduced.by.Dr..Cividino,.the.patient.partners.program.headed.by.Dr..Scocchia.and.our.elec-tive,.“Rheumatology.Boot.Camp”..under..Dr..Bobba.with.support.from.Dr..Matsos.play.impor-tant.roles.in.our.educational.endeavours..

Under.Dr..Khalidi,.the.Rheumatology.training.program.has.received.full.approval.from.the.Royal.College.

Research.ProgramsWe.have.received.major.peer-reviewed.and.

corporate.funding.in.our.areas.of.research:.

Dr..Bensen.continues.to.develop.Bone.Destiny,.a.program.that.helps.physicians.determine.osteoporosis.treatment..He.is.also.moving.forward.with.his.novel.clini-cian-friendly.clinical.evaluation.of.patients.with.RA.

Non-invasive.imaging.remains.a.corner-stone.of..our.research.and.utilizes..pQCT.

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ultrasound.and.pMRI.for.the.measurement.of.bone.mass,.joint.and.cartilage.structure...Dr..Webber,.Dr..Inglis.and.Dr..Gordon.have.advanced.our.imaging.capabilities.

Dr..Khalidi.is.working.with.two.major.research.groups,.the.Canadian.Scleroderma.Research.Group.and.the.Vasculitis.Clinical.Research.Consortium.

Dr..Larché.continues.to.develop.her.interest.in.early.RA.and.is.investigating.the.role.of.cyclic.citrullinated.peptides.and.non-inva-sive.imaging.in.rheumatoid.arthritis..She.is.part.of.a.national.cohort.study.in.newly.diagnosed.RA.and.JIA..She.is.also.studying.the.anaerobic.exercise.capacity.in.patients.with.JIA..In.a.separate.field.of.research,.Dr..Larché.is.studying.self-peptides.as.stimulators.of.immune.response.in.systemic.sclerosis.

Dr..Cividino.and.Dr..Beattie.have.continued.their.work.with.GALS.and..have.moved.forward.with.their.CIORA.grant.evaluating.GALS.

Dr..Adachi,.with.members.of.the.Division.of.Rheumatology,.has.been.measuring.the.

impact.of.MRI.in.RA.with.his.CIORA.grant..

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Major.AchievementsDr..Cividino.received.the.prestigious.CRA.Teacher.Educator.Award.this.spring..He.Chairs.the.Scientific.Committee.for.the.CRA.and.is.a.member.of.the.Executive.for.the.Ontario.Rheumatology.Association..

Dr..Bensen’s.program,.Bone.Destiny,.has.met.with.great.success.and.remains.the.cornerstone.of.the.management.of.patients.with.osteoporosis.in.Hamilton.

Dr..Karen.Beattie.has.received.a.Department.of.Medicine.Career.Award.for.her.work.in.osteoporosis.and.osteoarthritis.

Dr..Khalidi.continues.with.his..Clinician-Teacher.Award.from.the.Arthritis.Society.based.on.his.excellence.in.transforming.the.Rheumatology.Residency.training.program.into.the.premier.rheumatology.training.pro-gram.in.Canada.

Dr..Kean.is.a.Delphi.panel.member.for.the.World.Health.Organisation,.estab-lishing.International.Core.Set.Values.for.rheumatoid.arthritis..He.is.an.Assistant.Editor.for.the.pharmacology.journal,.Inflammopharmacology.and.he.was.reap-pointed.to.the.Editorial.Advisory.Board.of.

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Current.Medical.Research.and.Opinion..He.was.reappointed.by.Professor.Albert.Zink.to.continue.musculoskeletal.research.on.the.Similaun.Iceman.in.Bolzano,.Italy.

Dr..Larché.received.a.Department.of.Medicine.career.award..She.helped.to.set.up.the.multi-divisional.systemic.sclero-sis.research.group.which.she.chairs...Dr..Larché.has.been.instrumental.in.setting.up.a.“Centre.of.Imaging.Excellence”.funded.by.Abbott.

Drs..Mark.Matsos.and..Raj.Carmona.have.joined.the.Division.of.Rheumatology..Dr..Carmona.has.been.awarded.an.AFP.Internal.Career.Clinician.Education.Award.

Future.DirectionsOsteoarthritis,.osteoporosis.and.rheumatoid.

arthritis.research.will.be.our.focus.in.the.coming.years.with.further.clinical.and.research.exper-tise.being.developed.in.systemic.sclerosis.and.vasculitis..We.will.continue.with.our.expertise.in.non-invasive.imaging,.examining.cartilage.thick-ness,.bone.microarchitecture,.edema.and.ero-sions.in.rheumatoid.arthritis.using.basic.x-rays,.ultrasound,.pQCT.and.pMRI.

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Panel A: single axial slice from an MRI thigh scan of patient with knee osteoarthritis.

Panel B: same scan analyzed to quantify bone and soft tissue cross-sectional area. Successive slice analysis provides tissue volume measurements.

Dr. K. Beattie lab

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Reports: Division Directors - McMaster University